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

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Endoscopic ACL Reconstruction Using A Quadrupled Semitendinosus Graft (4겹의 반건양근 건을 이용한 전방십자인대 재건술)

  • Lee, Kwang-Won
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.72-80
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    • 1997
  • Numerous techniques of anterior cruciate ligament (ACL) reconstruction have been described in literature. All have inherent advantages and disadvantages. The central one-third patellar tendon and hamstring tendons are the most commonly used autogenous tissues for replacement of a torn anterior cruciate ligament. Although the central one-third patellar tendon is considered to be 'the gold standard' for replacement of torn ACL. equivalent results have been reported using hamstring tendon grafts. Autogenous hamstring grafts provide adequate strength while avoiding donor site morbidity associated with bone-tendon-bone harvest. $EndoButton^{\circledR}$ femoral fixation allows precise femoral tunnel placement without a second incison. The purpose of this article is to describe surgical techniques using a quadrupled semitendinosus tendon and $EndoButton^{\circledR}$ fixation, and review the results of replacement of ACL.

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The Relationship between Bone Bruise in MR-Imaging and the Degrees of Acute Anterior Cruciate Ligament Injury (급성 전방십자인대 손상 시 자기공명영상에서 나타나는 골멍과 전방십자인대 손상 정도의 관계)

  • Jeong, Hwa-Jae;Shin, Hun-Kyu;Ko, Chun-Suk;Kim, Jang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.17-25
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    • 2012
  • Purpose: The aim of this retrospective study was to evaluate the relationship between appearance and size of bone bruise and severity of anterior cruciate ligament (ACL) injury with magnetic resonance imaging (MRI), furthermore, to identify the mechanism of ACL injury by analyzing the footprint of bone bruise. Materials and Methods: Sixty-five subjects who was taken an MRI within 6 weeks after acute ACL injury were studied. All MRI showed ACL injury and associated bone bruises. Bone bruises were analyzed using Costa-Paz classification based on appearance and location and also scored using Kornaat bone bruise grading system based on size and location. The severity of the ACL injury was graded using a 4-point system (ie, grade 0-3) with oblique coronal MRI. Results: There was statistically significant correlation between Costa-Paz classification of bone bruises in lateral femoral condyle and grade of ACL injury. There were more type 2 lesions in partial tear group (grade 1, 2), however, type 3 lesions of Costa-Paz classification in complete tear group (P=0.037). Significant positive correlations were observed between Kornaat total bone bruise score and grade of ACL injury (P=0.014). Most common ACL injury mechanism was pivot shift injury. Other mechanisms were clip valgus injury, phantom foot injury, and hyperextension injury. Conclusion: It is highly suggested that appearance and size of bone bruise is related to severity of ACL injury after acute ACL injury. The foot print of bone bruise provides valuable clues to identify ACL injury mechanism.

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The Effect of Silicone Sleeve and Taping on Balance and Strength in Anterior Cruciate Ligament Reconstruction Patients

  • Kwon, Hyo-Jeoung;Park, Dae-Sung;Jeong, Ju Ri;Jung, Kwang-Ik
    • The Journal of Korean Physical Therapy
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    • v.26 no.3
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    • pp.147-155
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    • 2014
  • Purpose: This study was to determine the effects of before and after application of silicone sleeve on balance and muscle strength in anterior cruciate ligament (ACL) reconstruction patients. Methods: 13 subjects who had one or more months after ACL surgery were involved. Dynamic balance, timed up and go (TUG), stair step, vertical jump, proprioception and isokinetic knee strength were measured while subjects under taped, untapped and silicone sleeve conditions. Results: For 30 seconds one-leg standing, there was a significant improvement under silicone sleeve on operated side with eyes open and both taping and silicone sleeve revealed similar effects with eyes closed (p<0.01). Application of silicone sleeve showed significant effects in proprioceptive function on the operated side compared to both taping and none (p<0.05). For stair step test, TUG and vertical jump was a tendency to improve after application of silicone sleeve, but no significant different. Muscle strength on operated side of quadriceps and hamstring was significantly improved compared with none or taping(p<0.05). Conclusion: Silicone sleeve application for ACL reconstruction patients was effective immediately on improving strength and balance. Therefore, depending on the intended use and the disease is considered appropriate use of silicone sleeve will be able to help prevention and functional movement.

ACL Reconstruction: Bone-Patellar Tendon-Bone Autograft (전방 십자 인대 재건술: 골-슬개건-골 자가이식물)

  • Koh, Hae-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.102-108
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    • 2005
  • The incidence of anterior cruciate ligament tears is increasing as a result of the increasing participation of individuals of all ages in high-risk sports. Endoscopic anterior cruciate ligament reconstruction using autogenous central third bone-patellar tendon-bone graft is the most commonly used method. With regard to BPTB graft as the go]d standard in ACL reconstruction, there are no data that refute this claim to date. Author reviewed the biomechanical properties, donor site morbidity and selection of the bone-patellar tendon-bone graft and described the surgical technique of endoscopic ACL reconstruction using BPTB autograft.

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Effects of Landing Tasks on the Anterior Cruciate Ligament Injury Risk Factors in Female Basketball Players (여자 농구 선수들의 착지 유형이 전방십자인대 손상위험 요인에 미치는 영향)

  • Lee, Gye-San;Lim, Bee-Oh
    • Korean Journal of Applied Biomechanics
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    • v.24 no.4
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    • pp.385-390
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    • 2014
  • The purpose of this study was to investigate the effects of landing tasks on the anterior cruciate ligament (ACL) injury risk factors in female basketball players. Fifteen female basketball players performed a drop landing and a drop landing with a vertical jump on the 40 cm height box. Three-dimensional motion analysis system and ground reaction force system was used for calculate the ACL injury risk factors. Paired samples t-test with Bonfferoni correction were performed. The drop landing with a vertical jump had the higher knee flexion angle, peak knee varus moment, trunk flexion angle than a drop landing. However, the drop landing had the higher trunk rotation angle than a drop landing with a vertical jump. These results indicate that seemingly minor variations between drop landing and drop landing with a vertical jump may influence the ACL injury risk factors. Caution should be used when comparing studies using different landing tasks.

Alteration of Trabecular Bone Microarchitecure at Tibial Epiphysis due to Knee Joint Instability by Anterior Cruciate Ligament Rupture: Difference between Medial and Lateral Part (전방십자인대 손상으로 인한 슬관절 불안정성에 따른 경골 골단 해면골 미세구조 변화 : 내방과 외방에서의 해면골 미세구조 패턴 변화)

  • Lee, Joo-Hyung;Chun, Keyoung-Jin;Kim, Han-Sung;Lim, Do-Hyung
    • Journal of Biomedical Engineering Research
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    • v.33 no.2
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    • pp.78-88
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    • 2012
  • Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

The Clinical Case Report about Postoperative Rehabilitation for the Tear of Anterior Cruciate Ligament Treated with Korean Medical Treatment and Continuous Passive Motion (한방 치료와 연속 수동 운동(CPM)을 병행한 전방 십자인대 파열 환자의 수술 후 재활 치료에 대한 증례 보고)

  • Park, Chang-Hyun;Song, Yun-Kyung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.97-107
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    • 2016
  • Objectives : The objective of this study is to report the effect of Koran medical treatment and CPM exercise on recovery after reconstruction surgery of torn anterior cruciate ligament Methods : A 27-year-old male patient who had anterior cruciate ligament reconstruction surgery was treated by Korean medical treatment and CPM exercise from March 24th 2015 to April 16th 2015. Results : After treatments, VAS were generally decreased, ROM of Lt. knee got better from $95^{\circ}/10^{\circ}$(flexion/extension) to $120^{\circ}/-5^{\circ}$ (flexion/extension), Lysholm Score increased from 26 to 63. Conclusions : This study showed that Korean medical treatments and CPM exercise has meaningful effect on recovery after reconstruction surgery of anterior cruciate ligament. And it is considered that we need to apporoach recovery of these kinds of operation with more active Korean medical treatment, and further researches should be done steadily.

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Diagnosis of Anterior Cruciate Ligament Injury (전방십자인대 손상의 진단)

  • Ahn, Jin-Whan
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.26-30
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    • 1997
  • Recently, the incidence of anterior cruciate ligament injury is rapidly increasing because many young Korean are actively participating in sports activities including basketball, skiing and soccer. Sometimes acute ACL injuries arc misdiagnosed as sprain because of pain and muscle spasm. An accurate physical examination and careful history taking are very important to diagnose the ACL injuries. Therefore author described the skill of history taking and the technique of physical examination to diagnose ACL injuries. The most sensitive test is the Lachman's test, which is performed with the knee in 200 of flexion, the femur stabilized with full flexed examiner's knee placed behind patient's distal thigh and one hand of examiner, and the proximal tibia grasped with the other. The pivot shift test is a passive motion test that attempts to subluxate the tibia anteriorly, then have it reduce rapidly. The pivot shift test is very sensitive test to diagnose the chronic ACL injuries.

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Exercise Treatment of Knee Joint After Anterior Cruciate Ligament Reconstruction Operation (전방십자인대 재건술 후 슬관절 운동치료 접근에 관한 고찰)

  • Kim, Yeun-Jung;Jung, Jae-Min;Han, Jin-Tae
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.1
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    • pp.27-37
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    • 2008
  • Purpose : Today, it enjoys a sports and a leisure where the anterior cruciate ligament(ACL) injury patient increase. The knee joint is important means of human body movement and to do an important duty when it encounters ACL injuries of the knee joint and the many restriction follows in the life which is ordinary. When it is damaged ACL, it comes to determinate that ACL reconstruction and preservation treatment that the according to condition of ligament and knee joint. After ACL reconstruction, that is the fact which already becomes known the exercise treatment advances a recovery and to reduce a sequela. Methods : we researched the method of exercise treatment after anterior cruciate ligament reconstruction operation by journal of science direct and KISS in daecu university. Results : The representative exercise treatment is isometric exercise, isokinetic exercise isotonic exercise and complex exercise but what kind of exercise treatment most is effective, it revealed and support it was not. The method of exercise treatment is very various, so It causes a confusion made to the therapist and patients. So it executes once again it sought the kinetic therapeutic method which is efficient from this research and it tried to observe preceding research after ACL reconstruction. To operation a various the exercise treatments, operation only the treatment which is general compared to it was effective in muscular power and muscle functional improvement. But this like improve despite with the exercise treatment consequence which is continuous from research of most the pain leg compares to the health leg, it appeared the discrepancy which is a muscular power, a muscular endurance and a hypertrophy muscle etc, to the health leg or before operating 100% of muscular power to having gets the many therapy time was the recovery rate. Conclusion : Therefore after ACL reconstruction, it will become the many research continuously which is improve the muscle functional and ROM of the exercise treatment method and From therapeutic site of the patients it does to memorizes knowledge in advance about ACL injuries and the application the isokinetic treatment or exercise program are the set of necessary, frequency and amusement that considers complex what kind of therapeutic exercise becomes accomplished with the patient take care of attention.

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Diagnostic Accuracy of Clinical Test for Anterior Cruciate Ligament Injury: Systematic Review

  • Deniz Yasemin;Sang-Woo Pyun;HyungSu Lee;Seong-Eun Kim;SunGyu Han;Dongyeop Lee;Ji-Heon Hong;Jae-Ho Yu;Jin-Seop Kim;Seong-gil Kim
    • The Journal of Korean Physical Therapy
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    • v.35 no.3
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    • pp.57-63
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    • 2023
  • Purpose: The aim of this study was to conduct a systematic review of randomized controlled studies from 2012 to present that explore the diagnostic accuracy of clinical tests used for diagnosing anterior cruciate ligament (ACL) injury. Methods: Study design: Systematic review. Literature search of the PubMed and Scholar databases was conducted using keywords related to diagnostic accuracy of clinical tests for ACL injury. The PRISMA Guidelines were followed to conduct this study. The Cochrane Risk of Bias Tool was utilized to assess the quality of each included study. Results: As a result, 8 studies were included, and 6 clinical tests used in ACL tears were evaluated for diagnostic accuracy. The pivot shift test was reported as having the highest +LR (29.5) value with a sensitivity of 59% and a specificity of 98%. However, the test with the lowest -LR value was the lever test, and the values were as follows: -LR (0.08), +LR (4.7), specificity (80%), sensitivity (94%). Conclusion: In this study, it was concluded that a single clinical test is not sufficient to determine the presence of ACL injury. Test combinations have a higher diagnostic accuracy than a single test. In this study, the accuracy of the clinical tests was examined without considering the amount of ACL rupture and acute-chronic condition. Further research is required to examine the impact of these two factors on diagnostic accuracy of clinical test.