• 대한족부족관절학회지
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• 제25권3호
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• pp.117-125
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• 2021

Purpose: The aim of this study was to evaluate biological ligament healing quantitatively after suture-tape augmentation for chronic lateral ankle instability. Materials and Methods: Thirty-two patients underwent magnetic resonance imaging (MRI) at a minimum of 2 years after lateral ligament augmentation using suture-tape. Signal/noise ratios (SNRs) and widths of anterior talofibular ligaments (ATFLs) were measured on preoperative and postoperative MRI by three researchers. ATFL biological healing degrees were analyzed using changes in SNRs and widths of ATFLs and by comparing these metrics with those of normal contralateral ankles. Clinical evaluations were performed using foot and ankle outcome scores (FAOSs), Foot and Ankle Ability Measure (FAAM) scores, and ankle stress radiographs. Results: Mean FAOS and FAAM scores improved significantly from 62.4 to 93.6 and 58.3 to 92.3, respectively, at final follow-up (p<0.001). Mean SNRs and ATFL widths improved insignificantly from 8.49 to 8.21 and 2.07 to 2.15 mm, respectively, at final follow-up (p=0.424, p=0.718). Significant differences in mean SNRs and ATFL widths were found between ipsilateral and contralateral sides (p<0.001, p=0.002). Spearman's correlation analysis revealed no significant association between clinical outcomes and degrees of biological healing of ATFLs based on MRI findings. Conclusion: Despite improvements in clinical outcome measures, the effects of suture-tape augmentation for chronic lateral ankle instability on biological ligament healing were insignificant. In addition, no significant correlation was found between clinical outcomes and degrees of biological healing of ATFLs.

• 대한간호학회지
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• 제18권1호
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• pp.34-43
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• 1988

The present study has been undertaken to assess the electrical activity of right tibialis anterior, right gastrocnemius, right rectus femoris, right biceps femoris and right paralumbarvertebral muscles quantitatively by EMC while standing erect on the height of 0cm, 3cm, 5cm and 7cm heels. The inclinations of the heels were 0, 6, 11, 17 degrees, respectively. Foully young women ranging from 18 to 24 of age were examined. Electrical activity of various muscles while standing erect on the height of various heels were compared with that of 0cm heel. The results obtained were as follows : 1. Electrical activity of the tibialis anterior increased significantly as the height of heels became higher ; which was thought to be due to the effort to counteract the instability standing with high heels. 2. There was a significant increase in electrical activity of the gastrocnemius as the height of heels increased. It might be due to compensatory activity against shifting of the center of gravity forward. 3. There was a significant increase .in electrical activity of the rectus femoris and biceps femoris at the height of 3cm, 5cm and 7cm heels ; which seemed to be due to the effort to stabilize the knee joint. 4. Electrical activity of the paralumbarvertebral muscles increased significantly at the height of 5cm and 7cm heels ; which was considered to be due to the effort to prevent forward imbalance. From These results, it may be concluded that electrical activities of various postural muscles increase significantly while standing erect on the height of 3cm, 5cm and 7cm heels to counteract an instability of their posture and compensate the forward shifting tendency of the center of gravity.

• 대한족부족관절학회지
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• 제27권4호
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• pp.137-143
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• 2023

Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

• 대한족부족관절학회지
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• 제6권1호
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• pp.66-72
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• 2002

Purpose: To evaluate the overall results and its major affecting factors(athlete/associated injury) of modified Brostrom procedure for chronic ankle lateral instability. Materials and Methods: Fifty-one patients (51 ankles) with chronic ankle lateral instability were sub-grouped athletes and non-athletes and again sub-grouped with associated injury and without associated injury. Associated injuries were osteochondral defect(6), peroneal tendon abnormality(10), os subfibularae(4), os subtibialae(4), anterior impingement(5) and loose body(2). The overall surgical results were evaluated and also see whether or not athletes and associated injury affect the result. Result: Of the 51 operations performed, there were 39 excellent, 8 good and 4 fair as a whole. Of the 24 athletes operated, there were 19 excellent, 3 good, and 2 fair. Among the 27 non-athletes, there were 20 excellent, 5 good and 2 fair results. The average time to ordinary life in the non-athlete group was 2.5 months and average time to sports activity in the athlete was 4.5 months postoperatively. Those who didn't have any associated injury had all excellent result, on the contrary, those who had associated injuries, 14 excellent, 8 good and 4 fair results. All the fair results were associated with osteochondral lesion of talus. Whether or not the patient is athlete does not affect the surgical results, but whether or not there were associated injuries does affect the surgical results. Conclusion: Modified Brostrom procedure for chronic ankle lateral instability itself is an excellent to good operation. This procedure can be used in athletic populations who need high demand of sports activity. But chronic ankle lateral instability with associated injury group showed variable, less satisfactory results than those without associated injury. Careful preoperative and intraoperative examination should be done to find out the associated injury with chronic ankle lateral instability.

• 대한족부족관절학회지
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• 제12권1호
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• pp.36-40
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• 2008

Purpose: The purpose of this study is to find out the normal results in ankle on varus stress, valgus stress, and anterior draw stress in young men in korea. This would be helpful as the basic data of measuring of ankle instability for operational indication. Materials and Methods: Varus and Valgus stress anteroposterior radiographs and Anterior drawing stress lateral radiographs of 600 normal ankles were reviewed. First, A line parallel was drawn parallel to the articular surface of the distal tibia, and another line was drawn parallel to the articular surface of the talus on anteroposterior radiographs. The interior angle that subtended by these two lines was measured. Second, the reference point is located at the posterior border of the tibia, and the shortest distance from this point to the proximal posterior articular surface of the talus is measured. Results: There were 300 males and 600 ankles. The mean age overall was 21 years (19-22 years) old. The mean length of ankle on anterior draw stress was $5.54{\pm}3.33\;mm$. The mean a interior angle of ankle on varus stress was $0^{\circ}-8.93^{\circ}$, and on valgus stress $0^{\circ}-7.78^{\circ}$. Conclusion: We can consider for operational indication at over the 8.87 mm on anterior draw stress, over the $8.93^{\circ}$ on varus stress, and over the $7.78^{\circ}$ on valgus.

• Journal of Korean Neurosurgical Society
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• 제55권1호
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• pp.12-17
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• 2014

Objective : Anterior cervical discectomy and fusion (ACDF) is often complicated by subsidence, pseudoarthrosis, kyphosis, and graft donor site morbidities. To decrease the occurrence of these complications, various types of cages have been developed. We designed this retrospective study to analyze and compare the efficacy and outcomes of ACDF using double cylindrical cages (DCC) (BK Medical, Seoul, Korea) versus an anterior cervical plating system with autogenous iliac crest grafts. Methods : Forty-eight patients were treated with autograft and plating (plate group), and 48 with DCC group from October 2007 to October 2011. We analyzed construct length, cervical lordotic curvarture, the thickness of the prevertebral soft tissue, segmental instability, and clinical outcomes. Results : There were no significant differences between the two groups with regard to the decrease in construct length or cervical lodortic curvature at the 3-, 6-, and 12-month follow-ups. The prevertebral soft tissue was thinner in the DCC group than the plate group immediately after surgery and at the 3-, 6-, and 12-month follow-ups. The difference in interspinous distance on flexion-extension was shorter in the plate group than the DCC group at the 3- and 6-month follow-ups. However, there was no significant difference in this distance between the two groups at the 12-month follow-up. Conclusion : A double cylindrical cage is a good alternative for fusion in patients with cervical degenerative diseases; the surgical method is relatively simple, allows good synostosis, has less associated prevertebral soft tissue swelling, and complications associated with autografting can be avoided.

• 대한관절경학회지
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• 제3권1호
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• pp.30-34
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• 1999

30세의 남자환자로 자가 슬개골 건을 이용한 전방 십자 인대 재건술 후 이식건에 발생한 일과성 석회화 1례를 보고 하고자 한다. 환자는 양측 절개술의 관절경하 전방 십자 인대 재건술을 시행 받았으며 술 후 6개월 방사선 필름 상, 이식 건 주위로 석회화 음영이 나타났으며 술 후 13개월 석회화 음영이 사라졌다. 술 후 2개월 Lachman 검사와 pivot shift 검사에서 음성을 보였으며. KT-1000 Arthrometer 검사 상 20 Ibs에서 건측과 1mm의 차이를 보였으나, 술 후 6개월에 이식 건 주위로 석회화 음영이 나타났을 때는 경도의 전방 불안정성이 관찰되었으며, 이후 석회화 음영이 없어지면서 슬관절의 전방 불안정도 회복되었다.

• Clinics in Shoulder and Elbow
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• 제8권1호
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• pp.23-30
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• 2005

Purpose: This paper analyzes the results of arthroscopic bankart repair for anterior recurrent dislocation following a trauma on shoulder. Material and Methods: The subjects were twenty-three (23) cases that were available to follow up for more than eighteen months during the period from November 2001 to June 2003 and were chosen from patients to whom arthroscopic bankart repair was applied using a knotless suture anchor for their traumatic anterior recurrent dislocation on the shoulder. Their average age was 28 (ranging from 15 to 60) with 20 males and 3 females. The injury from sports activities accounted for the most cases with 14 subjects. The average follow-up period was 27 months (ranging from 18 months to 35 months). There were 19 cases of bankart lesions, 4 cases of ALPSA lesions and associated with 5 cases of partial tear in the rotator cuff. The anchors employed were knotless anchor (Mitek) for all the cases. Rowe scoring scale was adopted to judge the results after operations. Patients' subjective satisfaction and range of motion of external rotation were addressed together. Results: Rowe scores showed that 20 cases (87%) reaches the level of 'good' and hinger. The average patients' satisfaction accounted for 90 points out of 100. It was also found that external rotations averagely decreased by 6.5 degree when the range of motion was in at the side. Conclusion: There were satisfactory results of arthroscopic bankart repair using knotless suture anchors as an operative treatment for traumatic anterior recurrent dislocation on shoulder.

• 척추신경추나의학회지
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• 제5권2호
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• pp.151-158
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• 2010

Objective : SLAP is rupture of biceps brachii muscle tendon and it's origin, posterior side of superior labral to anterior glenoid fossa. Snapping and Pain, instability are its typical symptoms. SLAP is physical damage so surgeons use arthroscopy. In point of surgeons view, a conservative medicine is not effective for lesion of labrum. So In this article, we report a result of conservative treatment for the amatuer baseball player diagnosis with type 2 superior labral anterior posterior lesion. Methods : In this case, patient played amatuer baseball for 2 years, had diagnosis with type 2 Superior labral anterior posterior lesion by MRI after right shoulder Injury. OS recommened arthroscopy surgery. But he receive conservative Korean medicin treatment in Korean medicine hospital, including Atx, BV, herbal acupunture and rehabilitation excersise. Results : After 6 months, in the end of continuous conservative treatment and rehabilitation excersise, patient can play baseball normally, and felt a little pain. But In physical examination, he still has a some abnormal signs. Conclusion : A Conservative treatment for an amatuer baseball player diagnosis with SLAP type 2 was effective in restore of fuctional activities, but usefulness of this treatment needs more study.

• 대한물리치료과학회지
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• 제29권3호
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• pp.48-55
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• 2022

Background: The purpose of this study is to examine the effect of push-up plus exercise on the changes in the thickness of the trapezius trapezius, serratus anterior and pectoralis major muscles involved in shoulder stability in various support surfaces. Design: Randomized controlled trial. Methods: The thickness change of the shoulder stabilizing muscle was measured using an ultrasound device. Corresponding t-test was performed to confirm the change within the group before the experiment and after 5 weeks. And one-way ANOVA was used to confirm the change between groups after 5 weeks. As a post hoc test, the least significant difference test was performed, and the significance level was set to a=0.05. Results: Changes in the thickness of the trapezius muscle within the group were significantly different between UPEG and SPEG after 5 weeks (p<0.05), and there was a significant difference between groups after 5 weeks (p<0.05). Changes in the thickness of the serratus anterior and pectoralis major muscle within the group were significantly different after 5 weeks in PEG, UPEG and SPEG (p<0.05), and the changes between the groups were significantly different in the serratus anterior muscle after 5 weeks (p<0.05). Conclusion: From the results of this study, it was found that the push-up exercise on an unstable support surface was effective for strengthening the trapezius upper and serratus anterior. This study intends to suggest the possibility of application as basic data for a push-up plus exercise program in clinical practice.