• Title/Summary/Keyword: Anterior cruciate ligament (ACL)

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Anatomy of the Anterior Cruciate Ligament (A Blueprint for Repair and Reconstruction) (전방십자인대의 해부학)

  • Jung, Young-Bok;Yum, Jae-Kwang
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.1-8
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    • 1997
  • The anterior cruciate ligament(ACL) is, perhaps, the most intriguing component of the knee joint. Initially referred to crucial ligament because of the cruciate or crossed arrangement or the anterior and posterior ligaments within the knee. the irony or the ACL being crucial to the well-being or the joint has only recently appreciated. The anterior cruciate ligament of human knee joint is a complex structure and its orientation, construct and biology arc directly related to the knee function as a constraint of knee joint motion. In addition to its functional role as a static stabilizer or the knee. the ACL has a unique neurovascular system. The vascular anatomy of the ACL plays a crucial role in the repair and reconstruction of the ligament, and the neuroreceptors found in its substance suggest a possible proprioceptive role for the ligament. The structural complexity of the ACL allows the ligament to function through the normal range of motion as a static stabilizer or the knee. hut it also makes the exact duplication of this structure very difficult. A comprehensive knowledge or the anatomy of the ACL can provide the orthopedic surgeon with a blueprint for the idealized repair and reconstruction of this most complex structure.

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All-Inside Technique of Anterior Cruciate Ligament Reconstruction using Central Quadriceps Tendon and Patella Bone Block (관절강 내에서 모든 수술 과정을 시행하는 관절경적 전방십자인대 재건술)

  • Jeong, Hwa-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.66-71
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    • 1997
  • The all inside anterior cruciate ligament reconstruction technique places an anterior ligament substitutes within two bony sockets rather than hone tunnel. This approach is accomplished through arthroscopic three portal which avoids the surgical exposure and morbidity associated with creating traditional bone tunnel. This technique has several distinct advantages when compared with the traditional ACL reconstruction through the bone tunnels. It offers the surgeon a less morbid method for ACL reconstruction that positions an ACL substitute at the anatomic attachment sites of the original ACL with two bone sockets, obviating the need for traditional bone tunnels. Graft fixation at or near the anatomic attachment points of the original ACL minimizes creep with early range of motion and reduces the abrasive 'wind-shield wipe' motion of the graft which occur with bone plugs positioned inside bone tunnels. The sagittal posterior angle to the tibial socket increases fixation strength to pullout with anterior translation force for the tibia on the femur. This technique is not graft specific and can accomodate any graft in which graft length can be customized to the intraarticular native ACL length.

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Treatment Principles of Anterior Cruciate Ligament Injury (전방십자인대 손상의 치료 원칙)

  • Ha, Kwon-Ick
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.36-40
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    • 1997
  • Anterior Cruciate Ligament (ACL) plays an important biomechanical role for the stability of knee joint. ACL injury often leads to injuries of articular cartilage, menisci, or other supporting structures, and subsequent development of degenerative arthritis. Controversies still exist in the best treatment modalities of ACL injuries. hut the author considers it most important to make the appropriate patient selection for operative reconstruction or nonoperative treatment. and describes the treatment principles of ACL injury, including diagnosis, patient selection and the treatment modalities for successful treatment of ACL injury.

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Comparing Changes in Knee Muscle Strength after Reconstruction of the Anterior and Posterior Cruciate Ligaments

  • Hyun, SangWook;Kim, SoHee;Kim, TaeHo
    • The Journal of Korean Physical Therapy
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    • v.31 no.6
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    • pp.339-345
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    • 2019
  • Purpose: The purpose of this study was to identify changes in knee muscle strength after reconstruction of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Methods: Thirteen subjects (males) with anterior ligament injury and ten subjects (males) with posterior ligament injury voluntarily participated in this study. Both groups were evaluated at the pre-and post-reconstruction stages using an isokinetic dynamometer. Peak torque, total work, and the hamstrings to quadriceps (H/Q) peak torque ratio were calculated at angular velocities of 60°/sec and 180°/sec. Statistical analysis was conducted on SPSS 18.0 for Windows using t-tests to compare mean differences. Results: At an angular velocity of 60°/sec, both the ACL and PCL groups showed a significant increase in muscle strength in the flexors and extensors. Muscle strength in the extensors was significantly increased in the PCL group compared to the ACL group. At an angular velocity of 180°/sec, the ACL group showed a significant increase in muscle endurance in the flexors and extensors, and the PCL group showed a significant increase in muscle endurance in the flexors. At angular velocities of 60°/sec and 180°/sec, the H/Q peak torque ratio increased in the ACL group but decreased in the PCL group. Consequently, the H/Q peak torque ratio was significantly different for the two groups. Conclusion: The results suggest that the patients with ACL injury should focus on strengthening the knee extensors and that the patients with PCL injury need to strengthen the knee flexors.

The Natural History of Anterior Cruciate Ligament Deficient Knee (전방십자인대 손상 슬관절의 자연적 병의 경과)

  • Kim, Hyoung-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.41-46
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    • 1997
  • The natural history of the anterior cruciate ligament(ACL)-deficient knee remains controversial. although numerous investigation have tried to ascertain the course that the knee would follow once the ACL has lost functional integrity. An extensive review of the literature performed according to symptoms. physical examinations, associated surrounding tissue injuries. returns to activity level and radiological changes in the knee joint. An active individual with a non-functioning ACL was susceptible to injury to the menisci and deteriorate the articular cartilage, followed radiographic changes. An activity levels in general also changed after injury. The most common symptom was pain. But instability varied in these individuals. Conclusively we believe that all these factors will eventually, if not initially, result in a symptomatic knee. which will result in significant limitations to the individual's desired level. So we recommend an aggressive approach in person who desired to return to a relatively active life style in young person as well as in middle aged individuals who have significant symptomatic ACL deficient knee.

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Tunnel Position for Anatomical Reconstruction of the Anterior Cruciate Ligament (해부학적 전방십자인대 재건술을 위한 터널의 위치)

  • Lee, Jin Kyu;Yang, Jae-Hyuk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.305-310
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    • 2020
  • The review provides updated concepts regard to the anatomy of the anterior cruciate ligament (ACL) footprints. The concept of anatomical ACL reconstruction, in which the graft is placed in the native ACL insertion area, has been introduced. However, there is still no consensus on the anatomical positioning of the femoral and tibial tunnel. In this study, authors review and update the literature regarding the tunnel position for anatomical ACL reconstruction.

Conservative Treatment for Injured Anterior Cruciate Ligament - Two Cases Report - (손상된 전방십자인대의 보존적 치료 - 증례 보고 -)

  • Jung Young Bok;Tae Suk Ki;Yum Jae Kwang;Kim Jin Soo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.112-115
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    • 1997
  • While the cruciate ligament has a profuse vascular response following injury, spontaneous repair does not occur. This may result from the fact that synovial fluid dilution of the hematoma following injury prevents the formation of a fibrin clot and thus the initiation of the healing mechanism. Another theory suggests that the dynamic nature of the fascicles of the anterior cruciate ligament(ACL) through even small ranges of motion prohibits spontaneous union to these fibers. But we experienced two cases of spontaneous healing of partially injured ACL. Initially they showed more than grade II anterior instability. 6 mm difference by stress roentgenographs(pull view) and difference of 8 mm by KT 1000TM arthrometer between the ACL injured knee and normal side knee. Lax, nearly complete tear of ACL and synovial bleeding were noted during arthroscopic examination but the continuity of synovial membrane was seemed to be intact. These cases were treated by conservative management rather than reconstructive procedure. Postoperatively they showed excellent clinical results, no anterior instability and unlimited athletic activity. Based on our clinical experience. we think that cruciate ligament has the spontaneous healing potential in acute stage and middle aged patient. We consider the microfracture technique and initial immobilization for accelleration of healing response of the ACL.

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Anterior Cruciate Ligament Reconstruction using the Autogenous Bone-Patellar Tendon-Bone Graft (관절경적 전방십자인대 재건술)

  • Jung, Young-Bok;Yum, Jae-Kwang
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.47-51
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    • 1997
  • A torn anterior cruciate ligament(ACL) is the most common serious ligamentous injury to the knee joint. The incidence of ACL tears seems to be increasing, at least partly as a result of the increasing participation of individuals of all ages in high-risk sports. The most commonly used graft source for ACL reconstruction is the autogenous bone-patellar tendon-bone graft unit. Despite a good success record. postoperative complications, such as infection, patellar contracture/patellar baja, patellar fracture, rupture of the patellar tendon, graft failure without reinjury, can occur following ACL surgery. The purpose of this paper is to provide guidelines regarding the key points of the reconstructive procedure in a sequence and how to prevent or minimize the complications that can follow ACL reconstructive surgery. We want this knowledge can help orthopaedic surgeons to understand the reasons for previous and current successes and failures of reconstruction of the ACL, and it can help them to plan the care of patients who have an injury of the ligament.

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Bilateral Congenital Deficiency of The Anterior Cruciate Ligament (선천성 양측 전방십자인대 결핍)

  • Park Seung Rim;Kim Hyoung Soo;Kang Joon Soon;Lee Woo Hyeong;Lee Joo Hyung;Lee Tong Joo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.108-111
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    • 1997
  • Congenital deficiency of the anterior cruciate ligament (ACL) is a rare disorder that has been reported in association with other knee dysplasia like as congenital knee dislocation. congenital short femur, congenital absence of menisci, congenital ring meniscus, and thrombocytopenia-absent radius syndrome. There has been no published explanation about the etiology of bilaeral ACL deficiencies without other abnomality. The patient of congenital ACL deficiency must be carefully inspected about combined anomaly. Those efforts may be helful in treatment or ACL deficient patients and evaluation of pathophysiology or ACL deficiency. However there has not been a ruptured congenital deficiency of the ACL without other dysplasia or the knee and other congenital skeletal abnomalities. We reported a case of symptomatic bilateral congenital deficiencies of the ACL which have not been associated with other skeletal abnormalities.

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A Numerical Study on Mechanical Behavior with Cyclic Deformation of Anterior Cruciate Ligament (슬관절 전방 십자 인대의 반복 변형하에서의 역학적 거동에 관한 수치적 연구)

  • Ban, Yong;Choi, Deok-Kee
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.33 no.12
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    • pp.1366-1374
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    • 2009
  • Anterior cruciate ligament(ACL) of human body experiences a large deformation. May during everyday when large deformation is repeated by various activities such as outdoor activity, ACL easily get damaged. In order to acknowledge the effect of the cyclic large deformation to ACL, the constitutive equations for ACL are derived from experiment data. The concept of the objective stress rate plays a important role wherever large deformation occurs. In order to obtain the objective stress rates the eigenprojection technique is used. A comparison is made for four different cases: Jaumann rate, Green-Naghdi rate, logarithmic rate and twirl tensor of Eulerian triad rate for an isotropic material subject to cyclic deformation, such as simple shear motion. Four different materials are studied to compare the behavior of the materials for ACL using different objective rates. Finally, more complicated model with fibers for soft tissues is used to calculate the behavior subjected to cyclic large deformation.