• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.13-18
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• 2000

Purpose : The purpose of this study was to compare the efficacy of bone-patellar tendon-bone(B-PTB) allograft with autograft B-PTB reconstruction of anterior cruciate ligament(ACL) according to the subjective and objective criteria. Materials and Methods : 42 patients were treated for acute rupture or chronic insufficiency of the ACL between March 1993 and June 1996. There were 18 autografts and 24 allografts for ACL reconstruction. At 2 years of follow-up after operation, autograft and allograft groups were compared based on subjective, objective criteria and Telos stress arthrometer. Results : The modified Feagin Scoring System revealed 16 patients$(88.9\%)$ with a satisfactory result by autografts, but 21 patients$(87.5\%)$ with a satisfactory result by allografts after 2-years follow-lip. There was no statistically significant difference between the two groups. ACL reconstruction with B-PTB allograft did not produce a significant functional deficit. But patellofemoral pain and crepitus were more frequent in the autografts$(33.3\%)$ than allografts$(8.3\%)$ (p<0.05). Conclusion : The ACL deficient knees treated with allografts for ACL reconstruction tended to be better than those reconstructed with autografts fur the reduction of patellofemoral crepitus and pain. B-PTB allograft provides an acceptable alternative to autograft tissue for reconstruction of the ACL.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.12-17
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• 2008

Purpose: This study presents clinical results of anterior cruciate ligament(ACL) augmentation using autogenous two-strand semitendinosus tendon in the treatment of partial ACL tears with preservation of residual portion. Materials and Methods: From January 2004 to June 2006, twenty two patients who had an ACL injury underwent ACL augmentation using autogenous two-strand semitendinosus tendon were enrolled in this study. We evaluated the clinical results with regard to clinical findings(range of motion, Lachman test, pivot shift test), standard knee scales(Lysholm, Modified Feagin Scoring System), and KT-1000 arthrometer testing. Results: At minimum one year postoperatively, there was no limitation of range of motion. Lachman and pivot shift tests were negative in all knees. On instrumented anterior laxity test by KT-1000 arthrometer, mean side to side difference was improved from 4.6mm preoperatively to 1.7mm postoperatively. Average Lysholm score was improved from 70 to 92. Ninety one percent of cases were rated as good or excellent in Modified Feagin Scoring System. Conclusion: Augmentation using autogenous two-strand semitendinosus tendon with preservation of residual portion of the ACL seems to be an acceptable method for restoring knee stability and proprioceptive function.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.7-11
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• 2008

Purpose: The purpose of this study was to compare the clinical outcomes of ACL reconstruction using autogenous hamstring tendon and allo-tibialis tendon. Materials and Methods: Between March 2002 and March 2005, We performed 30 ACL reconstuructions using hamstring autograft and 20 ACL reconstuructions using tibialis tendon allograft. The average follow up period was 22 months in auto-hamstring tendon and 18 months in allo-tibialis tendon. For the clinical evaluation, we measured the Lysholm score, International Knee Documentation Committee(IKDC) score and anterior laxity by KT-2000 arthrometer at final follow up and compare the results between two groups. Results: The Lysholm score improved from 69.5 preoperatively, to 95.3 at final follow-up in the hamstring autograft groups and from 69.0 to 90.4 in the tibialis allograft groups. According to the IKDC evaluation form, 80% of autogenous hamstring tendon group and 73% of allograft group were good results, higher than B(almost normal)(p>0.05). The average KT-2000 arthrometer side-to-side difference, decreased from 7.1mm preoperatively, to 1.8mm at final follow-up in the hamstring autograft groups and from 7.4 mm to 2.4mm in the tibialis allograft groups. Conclusion: The clinical results of ACL reconstruction using auto-hamstring tendon and allo-tibialis tendon showed no significant differences. The allo-tibialis tendon is an acceptable substitute for auto-hamstring tendon in ACL reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.25-30
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• 2002

Purpose : To evaluate the clinical results of displaced tibial intercondylar eminence fractures which were treated with transpatellar cannulated screw fixation. Materials and Methods : Ten patients with displaced tibial intercondylar eminence fractures were treated between December 1998 and May 2001 and then followed up for more than one year. They were treated arthroscopic reduction and fixation of fracture site by cannulated screw through the hole of nonarticular surface of inferior patella. They were prospectively evaluated with regard to their clinical and radiologic results. Results : Radiologic unions occurred at an average of 9.2 weeks. Average anterior displacements were 1.8 mm in stress x-rays and 1.1 mm in KT-2000 arthrometer. Average loss of extension was $4.1^{\circ}$. Functional results were excellent in 7 cases and good in 3 cases. Conclusion : Arthroscopic transpatellar cannulated screw fixation is one of the useful methods for the treatment of displaced tibial intercondylar eminence fractures.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.176-182
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• 2003

Purpose : The purpose of this study is to describe the surgical technique of ACL reconstruction with the flexible reamer and evaluate the clinical results of this method. Materials and Methods : Twenty four patients who followed for 12 months were included. The results were evaluated by Lachman test, KT-2000 arthrometer, Lysholm score, and postoperative roentgenogram of the knee. Results : The range of motion of the affected knee was acceptable except one case(10 to 90 degree) and at the last follow up, two cases were positive in Lachman test. Mean Lysholm knee scoring scale was 63.7 point preoperatively and 91.4 point at the last follow up. The results of KT-2000 arthrometer was 6.6mm preoperatively and 1.5mm at the last follow up. In operative time, there were decrease of mean 13.5 minute than ACL reconstruction without the flexible reamer, Conclusion : ACL reconstruction with the flexible reamer achieves the ideal isometric point of tibia and femur with no difficulty, proper notchplasty preventing from the impingement, and lessens the operative time.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.183-188
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• 2003

Purpose : The purpose of this study is to evaluate the results of revision surgery for failed anterior cruciate ligament (ACL) reconstruction using quadruple hamstring tendon autograft. Materials and Methods : From May 2000 to July 2002, six patients received ACL revision surgery using quadruple hamstring autograft for failed ACL reconstruction. Femoral tunnels were made 40 mm in depth and fixed with a cross pin and a bioabsorbable interference screw to fill the bone defect. In tibial tunnels, the grafts were fixed with Intrafix(Mitek, Norwood, MA). In case of tibial tunnel widening, additional screw-washer fixation was done. Follow up was at least 12 months postoperatively. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee(IKDC) evaluation form and manual maximal side to side difference using KT-2000 arthrometer. Results : The average Lysholm knee score improved from 77.2 preoperatively to 87.7 postoperatively. At the final IKDC evaluation, 1 case was graded as normal, 4 nearly normal, 1 abnormal. Mean side to side difference of manual maximum anterior displacement using the KT-2000 arthrometer was 1.8mm. The success rate was $83\%$. Conclusion : ACL revision surgery using quadruple hamstring autograft with double fixation is considered good procedure with successful results.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.143-148
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• 2009

Purpose: To investigate the causes of failure on ACL reconstructions and evaluate the effectiveness of one stage revision ACL reconstructions. Materials and Methods: From November 2004 to July 2008, thirty three patients who had got revision ACL recontstructions after reruptures of ACL were evaluated. The causes of failure of ACL reruptures were 22 vertical femoral tunnels, 7 neglected PLRI, 3 severe traumas and 1 deep infection after ACL reconstruction. The femoral tunnels were aimed at the 10 or 2 o'clock position and the tibial tunnels were used with previous tunnels. Previous femoral screws from the improper femoral tunnels were removed and filled with the new allograft bones. Results: The average periods of follow up were 22.2 months (12~52 months). There was improvement on an average Lysholm knee score from $61.5{\pm}16.8$ to $86.3{\pm}11.5$, IKDC score from $63.9{\pm}15.1$ to $81.3{\pm}14.3$. Mean side to side difference was decreased from $6.0{\pm}2.2\;mm$ to $1.6{\pm}1.4\;mm$ using KT-2000 arthrometer. Conclusion: One stage revision ACL reconstruction can be a useful method with good clinical results.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.138-142
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• 2009

Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.160-168
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• 2003

Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.30-34
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• 1999

We report the case of a 30-year-old man who was presented with transient calcification on the graft shortly after anterior cruciate ligament(ACL) reconstruction using a autogenous bone patellar tendon. The patient underwent ACL reconstruction with two incisional technique and six month later, calcific density was seen radiologically around the graft. On postoperative 13 months follow-up radiographic films, the calcific density disappeared. After two months of operation, Lachman and pivot shift test were negative and one millimeter side to side difference was detected in KT-1000 with 20 Ibs strength. But 6 months after the reconstruction, mild anterior instability was detected with the calcific density around the grafted tendon. However the anterior stability was recovered according to the disappearance of calcific density.