• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.123-127
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• 2000

Purpose : To evaluate of the surgical outcome of primary repair in anterior cruciate ligament rupture. Material & Method : Twenty-five patients underwent arthroscopic primary repair of ACL. We performed pull-out suture of ruptured ligament in 18 cases, and suture and augumentation with gracillis & semitendinosus in 7 cases. At follow up, the International Knee Documentation Committee(IKDC) scale & Lysholm score were used to grade outcome, and also the KT-2000 arthrometer was used to evaluate objective ligament laxity. Results : In analysis of IKDC scale, final evaluation group were group A in 3 cases, group B in 13 cases, group C in 9 cases. The mean value of Lysholm score was 83 points. In KT-2000 arthrometer examination, mean anterior translation was 3.9mm at 201b, 7.3mm at 30lb. The mean difference value between injured knee and uninjured knee was 1.1mm at 201b, 2.29mm at 301b. There was statistical significance in mean difference value between injured and uninjured knee. Conclusion : By analysis of clinical & objective data, we could confirm that the mid-term result of ACL suture is not satisfactory. So, we recommend that ACL reconstruction would be done in young active patient rather than suture.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.102-108
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• 1999

Purpose : The purpose of this study was to evaluate the clinical results of bone-patellar tendon-bone(B-PTB) allograft for ACL reconstruction without mechanical tensioning device. Material and Method : Forty-six knees in 43 patients were reviewed and evaluated with subjective evaluation, objective evaluation, Telos stress arthrometer and modified Feagin Scoring System. The average age at the time of operation was 27 years(range, 18-42) and the average follow up period was 41 months(range, 22-79). Authors reconstructed ACL using B-PTB allograft which was prepared by rehydration preoperatively without tensioning by mechanical tensioning device. The tension for allograft was obtained by full flexion and extension intraoperatively. All operation were performed arthroscopically by two-tunnel method to avoid the mismatching of allograft tendon length. Result : The modified Feagin Scoring System revealed 39 cases(84.7%) with excellent or good results and 7 cases(15.3%) with fair or poor results. The mean follow-up Lysholm Knee Score was 84. Telos arthrometer revealed 41 cases had an injured-to-uninjured difference of 5 mm or less(mean 2.3mm). The range of motion of knee was nearly normal and there was no extension lag in any cases at last follow up. Conclusion : Clinical results using B-PTB allograft showed less morbidity than B-PTB autograft. The intraoperative tensioning method by full flexion and extension without mechanical tensioning device was not bad. Therefore, B-PTB allograft is a good substitute material in reconstruction of the ACL.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.18-23
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• 2013

Purpose: The purpose of this study is to evaluate the usefulness of anatomical single bundle anterior cruciate ligament (ACL) reconstruction using outside-in technique by clinical outcome analysis. Materials and Methods: From July 2009 to July 2010, 41 cases of single bundle ACL reconstruction using outside-in technique which were followed minimum 1 year were enrolled. Clinical results were evaluated using International Knee Documentation Committee (IKDC) subjective knee evaluation score, Lysholm score, pivot shift test, one leg hop test, KT-1000 arthrometer test, Telos stress arthrometer test. Results: IKDC subjective knee score and Lysholm score were improved to $86.1{\pm}2.1$ and $91.2{\pm}3.8$ postoperatively (p<0.0001 and p<0.0001, respectively). KT-1000 arthrometer test and Telos stress arthrometer test also were improved to $2.2{\pm}0.9\;mm$ and $2.3{\pm}1.2\;mm$ (p<0.0001 and p<0.0001, respectively). Pivot shift test and one leg hop test revealed good results. Conclusion: Anatomical single bundle anterior cruciate ligament reconstruction using outside-in technique showed good clinical results, so it was considered available method.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.92-98
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• 2007

Purpose: We evaluated the clinical results of arthroscopic ACL reconstruction using quadrupled hamstring tendon with tibial remnant-preserving technique. Materials and Methods: Thirty-five cases were evaluated from Feb, 2003 to May, 2006. The average interval from injury to surgery was $2.6{\pm}1.6$ months. The cause of injury was mostly sports-related trauma. The average follow-up period was 17 months. Tibial remnant was preserved as much as possible and caution was taken not to damage the remnant during ACL reconstruction. Postoperative rehabilitation was the same as the usual rehabilitation method after ACL reconstruction, except for delaying motion for 2 weeks with an extension locking brace. Clinical evaluation was performed using ROM; Lachman test; pivot-shift test; anterior displacement measurement using KT-2000 arthrometer; Lysholm score and proprioception measured by single limb standing test. Results: There was no limitation of knee motion without contracture. The Lachman test and pivot-shift test were both negative. The side-to-side difference of anterior displacement measured using KT-2000 arthrometer was improved from 6.7 mm to 2.2 mm. The average Lysholm score improved from 81 to 96. The single limb standing test for proprioceptive evaluation showed no significant difference from a normal leg. Conclusion: ACL reconstruction with tibial remnant-preserving technique can preserve mechanoreceptors with prorioception and expect good functional recovery.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.105-110
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• 2000

Purpose : The purpose of this study was to evaluate the clinical results of fresh-frozen achilles allograft PCL reconstruction. Materials and Methods : 34 patients(35 cases) who was reconstructed PCL arthroscopically using achilles allograft were analyzed subjective and objective parameters, Telos stress arthrometer and Modified Feagin Scoring System. The average age was 36.2 years old($16\~57$ year) and average follow up period was 18.5 months($12\~27$ months). Result : The mean Lysholm Knee Scoring was improved from 47.5 to 87.4. Posterior translation by Telos arthrometer decreased to 2.3mm from 7.1mm. The modified Feagin scoring system showed 32 cases$(91.5\%)$ with excellent and good result. Conclusion : Clinical results of PCL reconstruction by Achilles allograft revealed good result as to scales. Achilles allograft provided enough initial tension with length and minimized the complication of using autograft. Therefore achilles fresh-frozen allograft in PCL reconstruction is a good substitute material for autograft.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.92-98
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• 2007

Purposes: The purpose of this study was to report surgical technique of double bundle anterior cruciate ligament(ACL) reconstruction and to compare the short-term clinical results between arthroscopic single-bundle and double-bundle ACL reconstruction. Materials and Methods: From May 2005 to May 2006, ninety-eight patients were underwent ACL reconstruction. We designed prospective study with sixty-one patients who were revealed isolated ACL injury. We serially checked clinical and radiologic data preoperatively and postoperatively. We compared single-bundle with double-bundle ACL reconstruction patients with preoperative datas and postoperatively 1-year data. There were 30 single bundle reconstruction and 31 double bundle reconstruction. Stability was assessed objectively by anterior stress radiographs with the $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer. The clinical results were assessed by IKDC(International Knee Documentation Committee) and OAK(Orthopadische Arbeitsgruppe Knie) scores. Also, we evaluated postoperative thigh circumference and range of motion. All of operations were done by only one surgeon. Results: At single-bundle reconstruction group, preoperative AP instability which was checked by $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer was $7.9{\pm}3.3$ and $7.4{\pm}2.0$, respectively. At double-bundle reconstruction group, it was $8.3{\pm}3.5$ and $7.9{\pm}3.2$, respectively. Residual AP laxity checked at 1 year after operation was $1.9{\pm}1.2$ and $2.2{\pm}1.6$ in single-bundle reconstruction group, and $1.1{\pm}0.9$ and $1.0{\pm}1.0$ in double-bundle reconstruction group. So, double-bundle reconstruction had better results in both anterior stress radiographs with the $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer, and there were significant differences in statistics. But, clinical results such as IKDC(International Knee Documentation Committee) scores, OAK(Orthopadische Arbeitsgruppe Knie) scores, thigh circumference and range of motion had no significant difference between two groups. Conclusions: On the basis of stability, the side-to-side anterior laxity of double-bundle ACL reconstruction was significantly better than that of single-bundle reconstruction, although there were no significant differences in the other clinical measures among them.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.159-164
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• 2006

Purpose: To evaluate the clinical stability and function after one-stage revision anterior cruciate ligament (ACL) reconstruction using fresh-frozen Achilles tendon allograft Materials and Methods: Thirteen patients who underwent one-stage revision ACL reconstruction using Achilles tendon allograft could be evaluated. The average time from primary procedure to revision surgery was 61.8 months. The mean follow-up period was 38.4 months. The bone defects of pre-constructed femoral and tibial tunnels were filled with calcaneal bone attached to Achilles tendon and the new femoral and tibial tunnels were created. Evaluations included the causes of failure of primary ACL reconstruction, Lysholm knee score, Lachman test, pivot shift test and KT-1000 arthrometer measurement. Results: The most common causes of failure of ACL reconstruction were poor surgical techniques in 10 cases (76.9%). Ten patients (76.9%) were good or excellent on the Lysholm score. Twelve patients (92.3%) had negative or 1+firm end Lachman test. Eleven patients (84.6%) had negative pivot shift test. Nine patients (69.2%) had less than 3 mm difference of manual maximum by KT-1000 arthrometer. Conclusion: One-stage revision ACL reconstruction with fresh-frozen Achilles tendon allograft, creating new tunnels after filling bone defects, resulted in a reliable and predictable outcome in terms of stability.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.1-7
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• 2009

Purpose: To evaluate the 2 to 4-year follow-up results after arthroscopic anterior cruciate ligament (ACL) reconstruction using transtibial femoral tunnel at 10 or 2 O'clock position. Materials and Methods: Eighty-six ACL reconstructions could be evaluated. Evaluations included 2000 International Knee Documentation Committee (IKDC) subjective knee score, Lachman test, Pivot-shift test, KT-1000 arthrometer measurement, 2000 IKDC knee examination and second-look arthroscopy. Results: Seventy-five patients (87.2%) had over 80 in 2000 IKDC subjective knee score. Eighty-three patients (96.5%) had 1+firm end or negative Lachmann test. Seventy-eight patients (90.7%) had a negative Pivot-shift test. Eighty-three patients (96.5%) had less than 5 mm difference by KT-1000 arthrometer. Eighty patients (93.0%) were normal or nearly normal by 2000 IKDC knee examination. Second-look arthroscopy was done in fifteen cases. Nine cases showed good synovialization, four cases showed partial synovialization, two cases showed poor synovialization and graft failure was noted in one case. Conclusion: ACL reconstruction using transtibial femoral tunnel at 10 or 2 O'clock position resulted in a good outcome in terms of rotatory stability as well as antero-posterior stability.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.13-19
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• 2007

Purpose: We investigated the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. Materials and Methods: Between February 1999 and October 2006, we evaluated retrospectively the results of acute, isolated posterior cruciate ligament injuries treated conservatively. The subjects consisted of 21 patients. At initial and follow up visits physical examination, $KT-2000^{TM}$ arthrometer and MRI were performed to assess improvement on the knee stability and continuity of the posterior cruciate ligament. IKDC (International Knee Documentation Committee) knee scoring and quadriceps muscle strength were also checked in all population. Comparing the results of initial and follow up examinations we assessed the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. The mean follow up period was 22.7 months. Results: The posterior drawer test showed 14 cases of Grade I, 6 cases of Grade II and 1 case of Grade III progressing 18 cases of Grade I and 3 cases of Grade II. The mean difference of 5.7mm by $KT-2000^{TM}$ arthrometer was changed Into 2.7mm and the continuity of posterior cruciate ligament initially checked by 48.1% on MRI increased to 69.7%. The mean quadriceps muscle strength was grade 'Good' and mean IKDC knee score was nearly grade 'A'. Conclusion: Our study suggests that patients with acute, isolated posterior cruciate ligament injuries treated conservatively may get good clinical outcomes on clinical situation and MRI.

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.27-32
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• 2016

Purpose: The purpose of this study is to examine the effects of sensorimotor training on knee joint stability after anterior cruciate ligament reconstruction. Methods: The subjects were sixteen 16 adults who received anterior cruciate reconstruction by arthroscopy, and underwent sensorimotor training for which was to have them maintenanceain of a standing position with a step Balance ball on the affected side over 30 degrees knee flexion with 100% weight bearing for 15-20 seconds. Before the genuine experiment commenced, the Lysholm scale was had been used to assess functional disorders on the affected knee joint. KT-2000 Arthrometer measurement equipment was used to measure anterior displacement of tibia against to femur before and after the sensorimotor training. Results: There was significant relaxation on the affected side in tibia anterior displacement of the affected and sound sides on in supine position before the sensorimotor training. There was little significant difference in tibia anterior displacement of the affected knee joints on in the supine position before and after the sensorimotor training. The results also showed that there was a reduction in the difference of tibia anterior displacement of the affected knee joints on in the standing position. These results suggest that the effects of sensorimotor training on knee joint stability after anterior cruciate ligament reconstruction is to induce the change of tibia anterior displacement against femur and the variation of muscles activation. Conclusion: The sensorimotor training may contribute to the improvement of joint functional stability in people who are in post-operation state and with orthopedic musculoskelectal injuries.