The primary goal of this study was to provide a systematic methodology of utilizing 3D technology for tight-fit performance sportswear using information of skin deformation in various posture. Technical tools used in this study are Cyberware whole body scanner, RapidForm2004, 2C-AN 3D pattern development program, and YukaCAD. Analysis of the 3D skin deformation while knee joint was bent from $0^{\circ}$ to $60^{\circ}$ revealed that the length of dermatomes L4 was remained consistent during knee bending. Therefore, L4 was chosen as a major cutting line. To develop a highly ergonomic pattern, replicas of static and dynamic postures were developed and integrated using two methods, one is morphing method (Sqirlz Morph), and the other is AutoCAD. Experimental tight-fit garments called 'Derm-Mov Pattern' was designed using dematomes L4, L2, and inner line under knee and compared with four other patterns. As results, AutoCAD was appropriate as a integrating method of various postures. In wear test, 'Derm-Mov Pattern' was rated high (p < .001), in terms of pressure comfort especially around front crotch area. However, wear sensation was not signipicantly different in other area due to highly extensible property of materials. Pressure distribution was relatively even in these experimental garments.
Purpose: Evaluation and analysis of the incidence of postoperative complications after arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft. Materials and Methods: We reviewed 172 cases of arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft in anterior cruciate ligament tear without meniscal injury. We performed Lysholm knee score and KT-2000 testing, simple radiograph, physical examination as evaluation factor. Also, around knee pain, swelling, limitation of motion, patellofemoral crepitation, paresthesia and pain on kneeling were evaluated. Results: The average follow up period was 49.8 months. In 172 patients, 148 males and 26 femlaes were evaluated. The average age was 34.4 years. The Lysholm knee score improved from 51.9 points preoperatively to 90.8 points at final follow up. Clinical outcome was excellent in 83%, good in 11%, fair in 4% and poor in 2%. There were many cases of complications, 24 cases (14%) of around knee pain, 12 cases (7%) of swelling, 45 cases (26.2%) of patellofemoral crepitation, 52 cases (30%) of donor site paresthesia, 65 cases (38%) of pain on kneeling, 10 cases (5.8%) of limitation of motion at extension, 13 cases (8%) of limitation of motion at flexion and 2cases (1.2%) of patellar fracture. Conclusion: Although arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone had good clinical results, many complications were noted. Some factors in surgical technique were suspected to be related to the complications and long term follow up will be necessary to further evaluated.
Kim Myung-Ho;Park Hee-Gon;Yoo Moon-Jib;Byun Woo-Sup;Shim Shang-Ho
Journal of Korean Orthopaedic Sports Medicine
/
v.3
no.2
/
pp.128-133
/
2004
Purpose: This study was planned to evaluate complications? of posterior cruciate ligament (PCL) reconstruction with tibial inlay technique using autogenous bone-patellar tendon-bone graft. Materials and Methods: From September 1994 to January 2004, we analyzed surgical complications in fifty-seven patients with fifty-eight cases who underwent PCL reconstruction. Fifty of them were male and seven female. The mean age of the patients was 35(15$\~$73). Twenty eight cases of injury were isolated PCL, while thirty cases had associated injury of knee. The causes of injury were thirty-nine cases of traffic accident, seven sport injuries, seven fall down injuries, and five of others. The follow-up study was done at 4 weeks, 3 months,6 months and 1 year after surgery. KT-2000 arthrometer and posterior stress X-ray were used to examine the stability of the knee joint and the Lysholm Knee Score and a variety of clinical complications were evaluated. Results: Although the mean score of the preoperative Lysholm Knee Score was 43.2, the postoperative score was increased to 87.9. The preoperative mean value of knee stability using KT-2000 arthrometer was 8.75 mm(6.2$\~$14.3 mm) but the postoperative mean was 3.41 mm(2.1$\~$10.6 mm). The intraoperative complications were: one case of popliteal artery injury with compartment syndrome, one case of patellar fracture, two cases of 20$^{\circ}$ flexion loss, and two cases of anterior cortical penetration of the screw through proximal tibia during screw fixation. The postoperative complications were: eleven cases of knee instability, one case of patellar fracture, five cases of extension loss, thirteen cases of flexion loss, twenty-one cases of around knee pain and eight cases of kneeling pain. Conclusion: After PCL reconstruction with tibial inlay technique using autogenous bone-patella tendon-bone graft, complications were observed in this study. Careful attention during and after the operation, as well as rehabilitation must be required.
Jeon, Dae-Geun;Cho, Wan Hyeong;Park, Hwanseong;Nam, Heeseung
Journal of the Korean Orthopaedic Association
/
v.54
no.1
/
pp.37-44
/
2019
Purpose: Tumor infiltration around the knee joint or skip metastasis, repeated infection sequelae after tumor prosthesis implantation, regional recurrence, and mechanical failure of the megaprosthesis might require combined distal femur and proximal tibia replacement (CFTR). Among the aforementioned situations, there are few reports on the indication, complications, and implant survival of CFTR in temporarily arthrodesed patients who had a massive bony defect on either side of the knee joint to control infection. Materials and Methods: Thirty-four CFTR patients were reviewed retrospectively and 13 temporary arthrodesed cases switched to CFTR were extracted. All 13 cases had undergone a massive bony resection on either side of the knee joint and temporary arthrodesis state to control the repeated infection. This paper describes the diagnosis, tumor location, number of operations until CFTR, duration from the index operation to CFTR, survival of CFTR, complications, and Musculoskeletal Tumor Society (MSTS) score. Results: According to Kaplan-Meier plot, the 5- and 10-year survival of CFTR was 69.0%±12.8%, 46.0%±20.7%, respectively. Six (46.2%) of the 13 cases had major complications. Three cases underwent removal of the prosthesis and were converted to arthrodesis due to infection. Two cases underwent partial change of the implant due to loosening and periprosthetic fracture. The remaining case with a deep infection was resolved after extensive debridement. At the final follow-up, the average MSTS score of 10 cases with CFTR was 24.6 (21-27). In contrast, the MSTS score of 3 arthrodesis cases with failed CFTR was 12.3 (12-13). The average range of motion of the 10 CFTR cases was 67° (0°-100°). The mean extension lag of 10 cases was 48° (20°-80°). Conclusion: Although the complication rates is substantial, conversion of an arthrodesed knee to a mobile joint using CFTR in a patient who had a massive bony defect on either side of the knee joint to control infection should be considered. The patient's functional outcome was different from the arthrodesed one. For successful conversion to a mobile joint, thorough the eradication of scar tissue and creating sufficient space for the tumor prosthesis to flex the knee joint up to 60° to 70° without soft tissue tension.
Purpose: Bone contusion is usually treated with conservative therapy for 3 months. Bone contusion around knee and hip joints has been extensively reported on, but there are scant reports on this condition in foot and ankle joints. This study evaluated the nature, characteristics and location of bone contusion around foot and ankle joints to enlighten clinicians on how to better treat this disease entity. Materials and Methods: We classified bone contusion of the 76 patients into three types (102 sites; 47 ankle sprains, 18 traffic accidents, 11 falls) according to the Costa-Paz system with employing magnetic resonance imaging (MRI), and the study then analyzed the common sites and areas of occurrence according to the mechanism of injury and duration of pain after first conducting conservative therapy. Results: Of the 76 patients (102 sites) on the MRI, 43 case (42.2%) for talus, 19 cases for distal tibia, and 12 cases for calcaneus were involved. The classification, according to the Costa-Paz system, was Type I, 51 cases; Type II, 32 cases; and Type III, 19 cases. The duration of pain after conservative treatment was 12.15±2.17 weeks for Type I, 14.5±2.15 weeks for Type II, and 21.0±3.8 weeks for Type III. Conclusion: The most common location of post-traumatic bone contusion around both the foot and ankle is the talus, distal tibia, and calcaneus. The most common type of injury noted on MRI is a diffuse signal with change of the medullary component (Type I), In cases of bone contusion extending to a subjacent articular surface or disruption or depression of the normal contour of the cortical surface (Types II, III), the patients' pain appears to last longer. Thus, it is necessary to consider a longer period of conservative treatment in cases of Types II and III bone contusion because the patients' pain may last longer than 3 months.
Seo, Young-Jin;Song, Si Young;Ahn, Jung Tae;Kim, Yoon-Sang;Ko, Jun Ho;Jang, Seong-Wook;Yoo, Yon-Sik
Journal of the Korean Arthroscopy Society
/
v.16
no.2
/
pp.160-166
/
2012
Purpose: The aim of this study was to determine the patterns of the stress distribution within the reconstructed anterior cruciate ligament (ACL) double bundles in response to an anterior tibial load and rotatory load at $45^{\circ}$ flexed knee model by use of a 3-dimensional finite element analysis (FEM). Materials and Methods: The $0^{\circ}$ and $45^{\circ}$ flexed 3-D knee model were reconstructed based on the high resolution computed tomography (CT) images from the right knee of a healthy male subject. To simulate double bundle ACL reconstruction, in $0^{\circ}$ analytic model, four 7 mm diameter tunnels were created at the center of each anteromedial (AM) and posterolateral (PL) footprints on the femur and tibia. The grafts were inserted into the corresponding bone tunnels and then reconstructed knee model was flexed to $45^{\circ}$. As a next step, the 5 mm anterior tibial load and internal rotational load of $10^{\circ}$ were applied on the final Computer aided design (CAD) model. And then stress patterns of each bundle were assessed using a finite element analysis. Results: In response to the 5 mm of anterior tibial load, the AM bundle showed increased stresses around the tibial and femoral attachment sites; especially in the anterior aspect of the bundle. In the PL bundle, the highest stress concentration was also noticed on the anterior aspect of the bundle. Under $10^{\circ}$ internal rotational load, the stress concentration was predominant around the anterior aspect of the tibial attachment site within the AM bundle. The PL bundle also showed highest stress concentration on the anterior aspect of the bundle. Conclusion: Although the stress patterns were not identical among the AM and PL bundle, there were common trends in the stress distribution. The stress concentration was predominant on the anterior aspect of both bundles in response to the anterior tibial load and rotatory load.
Heungdukwang'(興德王) costume ordinance(834A.D.) is a very important written historical record because it reveals Tongil Shills's(統一新羅) costume. But among the clothing pieces that appeared in Heundukwang'(興德王) costume ordinance, classification of Naeoe(內衣) and Danoe(短衣) is not clear. This study focuses on the categorization of Naeoe(內衣) and Danoe(短衣). Upper garments included among costume ordinance were Pyooe(表衣), Naeoe(內衣) and Danoe(短衣), Pyooe(表衣) and aeoe(內衣) were unisex, while Danoe(短衣) was worn only by women excluding the lower class. Pyooe(表衣) is applicable to Po(袍), Naeoe(內衣) is aplicable to Yu(유). Shilla'(新羅) upper garments appearing in visual records are as follows: -With the exception of Pyooe(表衣), the length of men's upper garments were between hip and knee length. These upper garments featured V-neck and round neck styles with the left side of the garments folded over the right side. -Again excluding Pyooe(表衣), women's upper garments were similar to men's upper garments having V-neck and round necklines. We know this to be true from the relics found during the excavations of Hwangsungdong and Yonggangdong, as well as from the women in the stone reliefs of Sangju. Although we know the shape of necklines. the length of upper garments remained a mystery because women of that tome tucked in their upper garments into the skirts and/or wore an over garment. However a clay doll found around Bulguksa(佛國寺) wearing a knee length garment with V-neck. The upper garment was opened in the front and was worn over another garment with same length and round neckline. At that time, The upper garments found in China and Japan. were not much different than those found in Shilla (新羅). They also included garments that were waist length, had peach-shaped necklines, or were worn over head. Shilla's(新羅) traditional upper garment was between hip and knee length, but with the introduction and influence of Chinese costume. upper garments with a length coming down to the high waist line began to appear. In addition to Chinese influence, because Shilla's(新羅) women wore the upper garment first and then the lower garment, a long upper garment was not necessary. These shorter upper garments came to be known as 'Danoe(短衣)'When we perceive clothing. we look at silhouette first and then the details. Silhouette is much determined by length and neckline or the front of the garment determines the details, So we need to attention to the basis of ancient dress classifications. These classifications were according to first length [Po(袍), Yu(유)] and then neckline [Danryoung(團領), Jingryoung(首領)]. As a result. Naeoe(內衣) and Danoe(短衣) are classified by the length. The length (內衣) was between hip and knee length while Daneoe(短衣) was waist length. Danoe(短衣) was worn by putting the bottom of it inside skirt naeoe(內衣) was worn over a skirt or plant. But both had V-neck and round neck styles, and styles with the left side of the garments folded over the right side.
This study was designed to observe the ultrastructural localization of synoviocytes, which are concerned with the function of phagocytic synovial cells (type A synoviocytes, macrophage-like synoviocytes), in the knee joint of the human for CD14 and CD105 by cryo-immune-electron microscopic technique. The synovium were dissected and fixed for two hours (in 4% paraformaldehyde and 0.1% glutaraldehyde mixture), and were immerged in 2.3 M sucrose and 20% PVP solution. Finally, they were cut with the cryoultramicrotome and labelled with primary antibodies (monoclonal mouse anti-human CD14, monoclonal mouse anti-human CD105 (endoglin) and secondary (donkey anti-mouse IgG) tagged with 6 nm colloidal gold particles. The tissues were observed under transmission electron microscope. This study was resulted as follows. 1. In the synovium of the human knee joint, CD14+ cells were identified. These cells showed phagocytic synovial cell's features. In the phagocytic synoviocyte, the distributions of CD14 were marked in the cytoplasm, around vacuoles, and in cytoplasmic process, but not detected inside of vacuoles. 2. In the synovium of the human knee joint, CD105+ cells were identified. These cells were recognized endothelial cells and phagocytic synovial cells. In the phagocytic synovial cells, the distributions of CD105 (endoglin) were marked in cytoplasic process, around vacuoles, and in cell membrane, but not detected inside of vacuoles. On the basis of above findings, it is obvious that phagocytic synovial cells were marked at CD 14 and CD 105, and might be play the role of activated macrophages or phagocytes in the synovial membrane.
The purpose of this study is to elucidate the mechanical characteristics of lower extremity joint movements at different walking speeds in obese people and suggest the very suitable exercise for obese person's own body weight and basic data for clinical application leading to medical treatment of obesity. This experimental subjects are all males between the ages of 20 and 30, who are classified into two groups according to Body Mass Index(BMI): one group is 15 people with normal body weight and the other 15 obese people. Walking speed is analysed at 3 different speeds ($1.5^m/s$, $1.8^m/s$, $2.1^m/s$) which is increased by $0.3^m/s$ from the standard speed of $1.5^m/s$. We calculated joint moments of lower extremity during stance phase through video recording and platform force measurement.Two-way ANOVA(Analysis of Variance, Mix) is applied to get the difference of moments according to walking speeds between normal and obese groups. Pearson's Correlation Analysis is applied to look into correlation between walking speeds and joint moments in both groups. Significance level of each experiment is set as ${\alpha}=.05$. As walking speed increases maximum ankle plantar flexion moment in the stance phase is smaller in obese group than in normal group, which is suggestive of weak toe push-off during terminal stance in obese group, and the highest maximum ankle plantar flexion moment in obese group during the middle speed walking($1.8^m/s.$). Maximum ankle dorsal flexion moment in obese group is relatively higher than in normal group and this is regarded as a kind of compensatory mechanism to decrease the impact on ankle when heel contacts the floor. Maximum knee flexion and extension moments are both higher in normal group with an increase tendency proportional to walking speed and maximum hip flexion and extension moments higher in obese group. In summary, maximum ankle plantar flexion moment between groups(p<.025), maximum knee moment not in flexion but in extension(p<.001) within each group according to increasing walking speed, and maximum hip flexion and extension moment(p<.001 and p<.004, respectively according to increasing walking speed are statistically significant but knee and hip moments between groups are not. Pearson correlation are different: high correlation coefficients in maximum knee flexion and extension moments, in maximum hip extension moment but not hip flexion, and in maximum ankle dorsal flexion moment but not ankle plantar flexion, in each group. We suspect that equilibrium imbalance develops when the subject increases walking speed and the time is around which he takes his foot off the floor.
Kim, Tai-Seung;Kim, Jong-Heon;Lee, Bong-Gun;Kim, Soon-Myung
The Journal of the Korean bone and joint tumor society
/
v.11
no.2
/
pp.168-174
/
2005
Purpose: We experienced 8 cases of osteoid osteoma arising around hip joint which had some characteristics that differ from those arising on long bone. we reports the characteristics of osteoid osteoma arising around the hip joint. Materials and Methods: 8 cases of osteoid osteoma were diagnosed during 1985 to 2004 at hanyang university hospital. all cases were comfirmed patholgically. 6 cases were male, 2 cases were female patients. The mean age was 17 years old (ranged from 8 to 29). They occurred in intertrochanteric area (4 cases), subtrochanteric area (2 cases), acetabulum (1 case) and femoral neck (1 case). We used radiologic tools including magnetic resonance image, computed tomography, bone scintigraphy. clinicopathologic test including erythrocyte sedimentation rate and Creactive protein. Results: The patients expressed various symptoms including thigh pain, knee pain, low back pain and radiating pain respectively. 2 patients had experienced operation on knee joint. 3 patients showed limping gait. Aspirin relieved the pain in 3 patients. The difference in circumference was 1cm between both thighs in 2 cases. Conclusion: Patients with osteoid osteoma arising around hip joint which have various symptoms such as severe knee pain and claudication, differ from infectious disease by clinicopathologic test including erythrocyte sedimentation rate and C- reactive protein and had better diagnostic result in computed tomography.
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