• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.156-160
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• 2002

Purpose : To evaluate the results and usefulness of meniscal repair using meniscal arrows with ACL reconstruction. Material and Methods : Among cases of the simultaneous meniscal arrow fixation and ACL recontruction performed between May, 1997 and September, 2000, 17 cases could be evaluated. The average follow-up were 18.5 months. Twelve cases were medial meniscus, 5 cases, lateral meniscus. All cases were longitudinal tear. Meniscal tear were seen at red-red zone in 13 cases, red-white zone in 5 cases. The results were analyzed by pain, joint line tenderness, locking, McMurray test, the Marshall knee scoring scale and complications. Results : Postoperatively two patients had mild joint line tenderness without pain on joint motion or weight bearing. No patient had locking or positive McMurray test. At last follow-up, 15 cases $(88\%)$ were 'excellent' or 'good' according to the Marshall knee score scale. There were two complications which are soft tissue irritation sign on active knee motion and a femoral chondral injury due to protruded T-shaped head of meniscus arrow. Conclusion : Meniscus arrow can be one of the options in repairing the associated meniscus tear, especially the posterior horn of medial meniscus, during ACL reconstruction. However, surgeons using meniscus arrow should be aware of its potential complications such as pain due to soft tissue irritation and chondral damage of the femoral condyle.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.63-68
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• 2001

Purpose : To propose the diagnosis, 'hypertrophy of the anterior cruciate ligament(ACL)', and its clinical, radiological and pathological characteristics. Materials & Method : Since Dec. 1995, we have experienced 10 patients(12 knees) with hypertrophy of the ACL. There were 2 males and 8 females, and the age of the patients ranged from 35 to 67 years. Characteristics of clinical, radiological and pathological findings were analysed. Results : The chief complaint was insidious onset of dull pain on the knee which became worse with activity. The constant physical finding was painful limitation of full extension of the knee. Sagittal MR images showed diffuse swelling of the ACL, similar finding that could be seen in acute ACL tear. Arthroscopically, noted was a marked enlargement of the ACL causing notch impingement. Biopsies of the hypertrophied ACL showed increased collagenous tissue with variable degree of myxoid degeneration. With partial excision of the hypertrophied ACL with or without notchplasty, the symptoms improved in all. Conclusion : Hypertrophy of the ACL, a newly proposed diagnosis, should be considered be determining the cause of the painful knee, and further study should be done about its pathogenesis.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.177-182
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• 2002

Purpose : To validate the arthroscopic synovectomy for the treatment of hemophilic knee. Materials and Methods: From January 1996 to January 2001, 28 arthroscopic synovectolny were performed in 26 patients with hemophilic arthropathy of the knee. The mean age was 17.8 years. The mean follow-up period was 3 years 11 months. We used six portals (two anterior, two suprapatellar and two posterior) and posterior trans-septal portal in all cases. Result : The mean frequency of hemarthrosis was 4 times per month preoperatively and 2 postoperatively. The mean amount of factor replacement was 4,633 units preoperatively and 1,505 postoperatively. The mean range of motion was $112^{\circ}$ preoperatively and $107^{\circ}$ postoperatively. On radiographic evaluation, three cases were progressed at the latest follow-up. On the subjective evaluation, significant or moderate improvement were in 19 cases $(68\%)$, and no improvement or deterioration in 9 cases $(32\%)$. Conclusion : With complete synovectomy through the appropriate arthroscopic portals, arthroscopic synovectomy of the knee in hemophilic patients is the successful method in decreasing bleeding episodes, amount of factor replacement, knee pain and preventing or delaying onset of end-stage hemophilic arthropathy.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.264-267
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• 2009

Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the synovium of joints. It occurs most commonly in the knee joint. The disease is composed of 2 different forms: diffuse and localized. The localized form is less frequent than the diffuse one. Most cases of localized PVNS involve the anterior compartment of the knee and can be usually easily diagnosed and treated with arthroscopy. We experienced a patient of localized PVNS developed on the posterior cruciate ligament, whose main symptom was persistent pain after trauma. This case occurs rarely and complete removal of the lesion was performed arthroscopically, using posterior trans-septal portal. We report this case with review of literatures.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.75-83
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• 2008

과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

• Physical Therapy Rehabilitation Science
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• v.7 no.2
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• pp.61-66
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• 2018

Objective: Patellofemoral pain syndrome (PFPS) is a condition that is characterized by patellar discomfort or pain that is aggravated during certain activities such as ascending/descending stairs. The Patellofemoral Disability Index (PDI) was developed to assess the effect of pain on functional activities in individuals with PFPS. The objectives of the current study were to determine the internal consistency, test-retest reliability, and validity of this index. Design: Cross-sectional study. Methods: Forty-one subjects who had PFPS with a mean age of $28.8{\pm}5.0years$ and a mean body mass index of $25.6{\pm}4.7kg/m^2$ participated in the study. All subjects were concurrently enrolled in a clinical trial for which they were instructed to complete hamstring-resistance exercises for 4 weeks. Over the course of the intervention, they completed both the PDI and the Oswestry Disability Index (ODI) at baseline after two weeks, and after four weeks. Pearson correlation coefficient was used to assess the criterion validity. Cronbach's ${\alpha}$ was used to examine the internal consistency. Intraclass correlation coefficients with 95% confidence interval were computed to examine test-retest reliability. Results: Subjects' responses within both the PDI and the ODI yielded Pearson correlation coefficient values that were positive and highly significant (range, 0.73-0.97; p<0.001). There was a high level of internal consistency (Cronbach's ${\alpha}{\geq}0.8$), with the exception of stair climbing (Cronbach's ${\alpha}=0.65$). Intraclass correlation ranged from 0.87 to 0.92, indicating high levels of test-retest reliability. Conclusions: The PDI is a valid, reliable, and feasible method of assessing pain and functional ability in patients with PFPS.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.121-126
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• 1999

Diagnosis of localized pigmented villonodular synovitis (PVNS) is difficult because of its rarity and indistinctive symptoms. This study presented 11 cases of localized PVNS of the knees, which were diagnosed and treated by arthroscopic technique. There were 6 males and 5 females between the age of 15 and 59 years (mean 34.6 years). The interval from the onset of symptoms to treatment ranged from 2 months to 3 years (average 29.9 months). All patients complained knee pain and 7 patients complained palpable mass. Four of the 11 patients had trauma history. The most common involved site was anteromedial synovium near the anterior horn of medial meniscus (5 patients). The remaining cases were identified on anterior fat pad (2 cases), suprapatellar pouch, posteromedial compartment, medial gutter and the anterior horn of the lateral meniscus, respectively. Nine cases had 1 mass and the remaining cases each had 2 or 3 masses. There was no evidence of recurrence during the follow-up period (average 29.9 months). Arthroseopy is effective in the diagnosis of localized PVNS with minimal morbidity and in the definitive treatment for PVNS.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.92-99
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• 2003

The prevalence of anterior cruciate ligament (ACL) injury is continuously increased due to sports activities and traffic accident. Simultaneously ACL reconstruction operations are on the increase. Several kinds of autografts and allografts are used in ACL reconstruction. Although ACL reconstruction using an autogenous bone-patellar tendon-bone graft is the good standard, it might have potential morbidity, anterior knee pain and minimal extension loss. To minimize the complications and disadvantages on each graft and to select appropriate graft for each patient, it is necessary to understand the unique characteristics of each graft for biomechanical aspect, morbidity and disadvantage. Selecting the appropriate graft depends on numerous factors including surgeon's preference and experience, patient's activity level and age, extent of ligament injury, tissue availability, and patient's selection for graft .

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.134-137
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• 2016

Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.125-128
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• 1988

A case of the left stellate ganglion block (SGB) with a warm serration of the left lower extremity in a 25-year-old male soldier is presented. During the Korean War, this patient received a penetrating gun shot wound from the right knee through the left abdominal wall, left upper arm and left thumb. He was evacuated to the a marine corps surgical hospital where amputation of the left thumb and an end-to-end anatomosis of the left brachial artery were performed. After surgery, left ulnar and median nerve paralysis and causalgia developed and about 9 months later an upper thoracic ganglionectomy was proposed at the Chin-Hae Navel Hospital. Before the ganglionectomy a stellate ganglion block for diagnostic and prognostic purposes was requested by the surgeon. This block was performed by the supraclavicular anterior approach using 10 ml of 2% procaine. The effect of the block including Horner's syndrome was confirmed 5 minute later in this patient. This patient returned to the ward by walking unassisted 10 minutes after the block, and complained of a warm sensation in the left lower extremity 20 minutes later as well as the left upper arm. This warm sensation in the lower extremity following ipsilateral stellate ganglion block indicates that the local anesthetics solution injected tinto the neck spread down to lumbar sympathetic ganalgion along the fascial membrane of the sympathetic chain as a consequence of the 10 minutes walk.