• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.83-88
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• 2009

Purpose: To evaluate the efficacy of arthroscopic Bankart repair using metal suture anchors for treatment of chronic traumatic anterior instability of shoulder joint. Materials and Methods: 85 patients (80 male and 5 female) were included in this study. The average age was 26 (15~52) years old and the period from the first injury to operation was average 20 (6~38) months. All cases had Bankart lesion and 44 cases had Hill-Sachs lesion. The SLAP lesion was associated in 10 cases and 7 cases had partial rotator cuff tear. The average follow-up period was 89 (68~108) months. Results: Preoperative Rowe score was average 29.3 (25~50) and Rowe score improved to 86.8 (40~100), excellent in 28 cases (32.9%) and good in 46 cases (54.1%) at last follow up period and 70 cases (82.4%) had full range of motion of the shoulder. The arthroscopic revision surgery of the shoulder was performed in 3 cases (3.5%) because of postoperative re-dislocation. Conclusion: We concluded that arthroscopic Bankart repair with metal suture anchors is one of the reliable and effective method for recurrent anterior shoulder dislocation with Bankart lesion.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.91-96
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• 1999

Purpose : The purpose of this study is to compare the clinical and radiologic results of the anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone unit with doubled semitendinosus and gracilis tendons. Materias and Methods : Clinical results of ACL reconstructions which were performed in 47 patients using doubled semitendinosus and gracilis were compared with those performed in 45 patients using bone-patellar tendon-bone autograft. There were no differences in preoperative parameters(age, sex, instability). Average follow-up period were 17 months and 19 months each. Results : There were no significant differences between two groups in functional results (Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parapatellar complication, especially anterior knee pain after long distance walking or exercise and quadriceps weakness less occurred in hamstring tendon group than in bone-patellar tendon-bone group. Conclusion : Although there were no significant differences in clinical results of ACL reconstruction using bone-patellar tendon-bone autograft and doubled semitendinosus and gacilis, parapateller complications occurred more in the bone-patellar tendon-bone autograft group than in the doubled semitendinosus and gracilis group. It is thought that the careful selection of patient, achivement of skillful technique and active rehabilitation are important to prevent the parapatellar complications.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.36-42
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• 2005

Purpose: To investigate the arthroscopic findings, and to evaluate the clinical outcomes of the treatment of posterior internal impingement of the shoulder in baseball players. Materials and Methods: We followed up 5 cases who were diagnosed as posterior internal impingement for the mean 15 months. All of the cases complained of the pain in the posterior shoulder at late cocking, and were positive in the relocation test added by hyper-horizontal abduction at $120^{\circ}$ abduction of the arm. We sutured posterior labral tear and SLAP lesion arthroscopically, and conducted debridement for rotator cuff. Three cases were performed of anterior capsular plication and the other two were performed of thermal capsular shrinkage. Pain, range of motion, and level of return to sports activity were assessed for the results. Results: As to the arthroscopic findings, all the five cases showed the fraying in posterosuperior labrum, and two of them was accompanied with the flap tear in posterosuperior labrum and the other one was accompanied with type 2 SLAP lesion. All the cases showed the fraying in supraspinatus, and one case showed partial tear. Meanwhile, in all the cases, the rotator cuff was impinged to the labrum at $90^{\circ}{\sim}120^{\circ}$ of abduction and external rotation. As to the postoperative results, all the cases did not complain of pain or instability while pitching, and the competition was recovered to be the mean 88%($80{\sim}100%$) of that before the injury. Conclusion: Definite diagnosis for the posterior internal impingement would be possible through arthroscopic examination. Favorable outcomes could be obtained with capsular plication or shrinkage for anterior microinstability and stretching exercise for posterior capsule tightness inducing the internal impingement.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.95-121
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• 2008

Purpose: The goal is to identify the effectiveness of the IKDC subjective score in the clinical outcome study after reconstruction of the anterior cruciate ligament. Materials and Methods: Twenty-four patients after ACL reconstructions using twelve hamstring autografts and twelve Achilles allografts were evaluated. Lysholm knee score, IKDC subjective score, Knee Outcome Survey score and Tegner activity score were evaluated for the subjective outcome value. Static instability tests, Biodex dynamometer and one-legged hop for distance tests were done for the objective outcome value. Three functional performance tests (FPTs) including Carioca test, Shuttle run test and Co-contraction test were performed for deciding the final results. Each scale was compared with FPTs results and Pearson's correlation test was used to test the correlation between the parameters. Results: IKDC subjective score, single hop test, and quadriceps power in low velocity of Biodex dynamometer tests had a positive correlation with the total FPTs results. Conclusion: IKDC subjective score can be an effective test to evaluate the functional status as well as the subjective outcome after ACL reconstruction.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.654-664
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• 2020

Purpose To determine the frequency of ossification of the transverse ligament of the atlas (OTLA) and to investigate the associated findings on cervical spine CT and plain radiography. Materials and Methods We reviewed 5201 CT scans of the cervical spine of 3975 consecutive patients over an 11-year period for the presence of OTLA and compared them with those of age- and sex-matched controls. The frequency and associated findings of OTLA were investigated and statistically correlated. Results The overall frequency of OTLA was 1.1% (45 of 3975 patients) and increased with age (p < 0.005). The frequency of OTLA in patients over 80 years was 12%. The space available for the spinal cord (SAC) was smaller in patients with OTLA (p < 0.005). Mineralization of the complex of the anterior atlantooccipital membrane and Barkow ligament, ossification of the ligamentum flavum, and kyphosis of the cervical spine positively correlated to the presence of OTLA (p < 0.005). Conclusion OTLA was associated with age, SAC narrowing, cervical kyphosis, and ossification of other cervical ligaments and may be associated with degenerative spondylosis, systemic hyperostotic status, or mechanical stress or instability.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.109-114
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• 2002

Propose : The purpose of this retrospective study was to test the posterior cruciate ligament (PCL index) for diagnosis of a tear of the anterior cruciate ligament (ACL) by means of MR imaging. Materials and Methods : From Mar. 1997 to Feb. 2001, concomitant magnetic resonance imaging (MRI) and knee joint arthroscopy were performed in 56 patients of either pain or instability of the knee. The shortest distance between the femoral and tibial attachment of PCL (X) and the distance from that line to the tip of the arc marked by the PCL (Y) on the sagittal plane images were measured. The quotient of these two parameters (Y/X) defined the PCL index. Results : Using MRI diagnosis, there were 35 patients diagnosed with ACL rupture and 21 patients were ruled out of ACL injury. Using arthroscopy, 32 of the 35 patients diagnosed by MRI showed ACL rupture, and 20 of the 21 patients were ruled out of ACL injury. The mean PCL index was 0.40 in the 33 patients diagnosed with ACL rupture through arthroscopy. The mean PCL index was 0.23 in 23 patients with an uninjured ACL through arthroscopy. In 33 patients with ruptured ACL, this value exceeds 0.31. The index value was 0.31 in 3 patients with uninjured ACL. The value of the index was not above 0.31 with an uninjured ACL. PCL index on MRI had a sensitivity of $91\%$ and a specificity of $94\%$ for determining the status of the anterior cruciate ligament. Conclusion : Injury to the ACL changes the PCL index markedly. In diagnostically unreliable MR images, amelioration of the PCL index could help in the diagnosis of ACL injury.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.1-6
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• 2011

Purpose: The purpose of this prospective study is to compare the results of arthroscopic reconstruction of ACL using autologous hamstring tendon (Group 1) and autologous bone patella tendon bone (Group 2). Materials and Methods: From Jan. 2004 to Dec. 2007, fifty patients were analyzed in this study. A single surgeon performed the ACL reconstruction with autologous hamstring tendon (25 patients) and autologous bone patella tendon bone (25 patients) alternatively each other. The mean follow up period of two groups was 38 months (range 25~58 months). We evaluated the result of Lachman test, Pivot shift test as a physical examination and Lysholm score, Tagner activity scale as patients' satisfaction and functional status and Telometer for anterior instability of each groups at the time of final follow up. Results: In final results, negative or mild positive findings on Lachman test were 24 out of 25 cases (equally) in each groups.) Twenty two cases in the Group 1 and 21 cases in the Group 2 were negative on Pivot shift test. Lysholm scores mark 94.6 points in group 1 and 92.3 points in group 2 at the final follow up and Tegner activity scales mark 8.5 points (Group 1) and 8.1 points (Group 2) at the time of last follow up and there were no differences between the two groups statistically. The numbers of patients who have less than 5 mm of anterior translation of tibia under telometer at 20 degrees of knee flexion are 24 cases in group 1 and 23 cases in group 2. Conclusion: The overall improvements of clinical scores (Lysholm scores and Tegner Activity scales) of the group 1 were a little bit superior to those of the group 2, but there were no significant statistical difference between two groups.

• The Journal of Korean Physical Therapy
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• v.27 no.6
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• pp.381-385
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• 2015

Purpose: This study was to identify the relationship between the game score and muscle strength in order to elucidate whether the obtained score for the dorsiflexor and plantar flexor muscles in the ankle joint using an EMG-based interactive game system can reflect muscle strength as measured conventionally. Methods: Forty adults were enrolled in the present study. They had no congenital deformities, and no neurological or orthopedic disorders in the 6 months prior to the start of the study. The Biodex were used to measure the isokinetic concentric maximal strength of the plantar flexor and dorsiflexor muscles in the ankle joint. EMG electrodes were attached to the tibialis anterior and gastrocnemius. Results: (1) There was a positive relationship between the obtained game score by the plantar flexor (sPF) and muscle strength of the plantar flexor (tPF) and dorsiflexor (tDF). In addition, the tPF affected the sPF, but the tDF did not. Thus, the higher the tPF, the higher the sPF. (2) There was no relationship between the obtained game score of dorsiflexor (sDF) and tPF or tDF. In addition, neither the tDF or tPF affected the sDF. Conclusion: The game score had a relationship with muscle strength, which is related to ankle instability and re-impairment. Thus we suggest that this game system can be used to predict the degree of weakness of muscle strength.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.140-145
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• 2010

Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.144-151
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• 2015

Background: The consensus is that a bony Bankart lesion shorter than 25% of the length of glenoid does not affect the clinical result; hence, such lesions were often neglected. However, small bony Bankart lesions are associated with various types of capsulolabral lesions. Methods: A total of 82 patients who had undergone arthroscopic capsulolabral lesion repair surgery for anterior shoulder dislocation were reviewed. The prevalence rates of early and late type of capsulolabral lesions were compared between a group of patients with and a group without small bony Bankart lesions. In addition, the types of accompanying capsulolabral lesion were analyzed according to the type of bony Bankart lesion. Finally, the clinical outcomes were evaluated (active range of motion, American Shoulder and Elbow Surgeons score and Rowe's score). Results: Among the 13 patients who had small bony Bankart lesions, the prevalence rate of early and late type of capsulolabral lesions was 38.5% and 61.5%, respectively. Among the 69 patients without bony Bankart lesion, the prevalence rates of early and late type of capsulolabral lesions were 74% and 26%, respectively. Significantly worse clinical outcome was observed for the group of patients with both small bony Bankart lesions and late type of capsulolabral lesion. Conclusions: More severe type of small bony Bankart lesion appears to be associated with late type of capsulolabral lesion. The significantly worse clinical outcome for patients with both small bony Bankart lesion and late type of capsulolabral lesion indicates that small bony Bankart lesions cannot always be neglected.