• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.165-172
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• 2006

Purpose: The purpose of this study is to evaluate the effects of intratunnel fixation in the tibial side on the arthroscopic ACL reconstruction with quadruple hamstring tendon at the second look arthroscopy. Materials and Method: From Dec 1999 to May 2005, we arthroscopically reexamined 32 cases who had been done arthroscopic ACL reconstruction with quadruple hamstring tendons. Hamstring tendons of all cases were fixed at femoral side with RigidfixTM. At the tibial side hamstring tendons were fixed only Post-tie (Group I) or Post-tie combined with IntrafixTM (Group II). At the time of second look arthroscopy mean age of cases was 30 years and mean duration for second look arthroscopy was 21.3 months. We analyzed the results with IKDC score, KT-1000 arthrometer under anesthesia, Telos stress radiography, tibial tunnel widening on the radiography and second look arthroscopic findings. Results: Group II had more superior than group I at side to side differences with KT-1000 and Telos stress radiograph, IKDC score, but the differences were insignificant. At arthroscopic evaluation, Group ll also had more superior than group I at graft tension and graft appearance, graft synovialization, but the differences were insignificant. Tibial tunnel widening in the knee AP radiograph was 2.3 mm in Group I and 1.7 mm in Group II and the difference was significant. (P=0.042) Conclusions: Additional procedure of tibial intratunnel fixation in arthroscopic ACL reconstruction with autogenous hamstring tendon significantly prohibited from tibial tunnel widening but clinical results, radiologic joint stability, findings in second look arthroscopy were insignificantly different. We concluded that Post-tie itself induced satisfactory clinical results, joint stability and graft maturation and that tibial tunnel widening did not affect the results.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.128-133
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• 2012

Purpose: This study examined the relationship between graft appearance on follow-up magnetic resonance imaging (MRI) and knee stability after double bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods: For each patient, 1.5 tesla MRI's were obtained. The signal intensity of grafts was divided into 3 grades by Sononda's classification. The course of grafts was divided into two patterns: straight and curved. We assessed Lachman test, KT 2000 arthrometer and anterior drawer stress radiograph using Telos$^{(R)}$ in $30^{\circ}$ knee flexion for anterior stability and evaluated pivot shift test for rotatory stability. The correlation between graft appearance on MRI and the results of knee stability tests was evaluated. Results: The anteromedial (AM) graft was evaluated as being grade 1 in 66.7%, grade 2 in 26.7%, and grade 3 in 6.7% of the cases and the posterolateal (PL) graft was assessed as being grade 1 in 63.3%, grade 2 in 33.3%, and grade 3 in 3.3% of the cases according to the signal intensity. The AM graft was evaluated as being straight in 83.3% and curved in 16.7% of the cases, and the PL graft was assessed as being straight in 86.7% and curved in 13.3% of the cases according to the course. The course of AM graft was correlated with the results of anterior stability tests and the course of PL graft was correlated with the result of rotatory stability test. However, the signal intensity of grafts was not correlated with the results of anterior stability and rotatory stability tests. Conclusion: The course of AM is correlated with anterior stability and the course of PL is correlated with rotatory stability on follow-up MRI after double bundle ACL reconstruction.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.131-137
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• 2002

Purpose: To evaluate and compare the functional results, activity status, and anterior stability between conservative group with partial ACL injury and reconstruction group with bone-patellar ten-don-bone autograft in ACL total rupture. Materials and Methods: Thirty-eight patients with ACL injury were diagnosed and treated with arthroscopy and followed for more than two years. The number of patients with partial injury was 12(mean age; 38.3) and reconstruction group was 26 (mean age; 25.3). Objective stability was estimated under anterior loading of 15 lb and 20 lb by KT-2000 Arthrometer (MED metric, USA). Functional evaluation using Lysholm score and Tegner activity score were performed. Results: Average functional score of Lysholm was 88.5 in partial injury group and 89.3 in reconstruction group. Average score of Tegner was 5.3 in partial injury group and 5.1 in reconstruction group(P<0.05).Average anterior displacement compared with normal side. Under loading of 20lb, 1.7$\pm$4.3 mm in partial injury group, 2.3$\pm$1.9 mm in reconstruction group were anterior displaced (P<0.05). Under loading of 15lb, 1.2$\pm$1.0 mm in partial injury group, 1.4$\pm$1.5 mm in reconstruction group were dis-placed (P<0.05). There were giving way, effusion, instability and anterior knee pain in complication. Giving way was the frequent complication in the partial injury group. Conclusions: Clinical results of both group were similar. Functional evaluation of Lysholm was good and status of Tegner activity was maintained to physical fitness activites (jogging, regular bik-ing) in both groups on average. The results of conservative treatment for the partial ACL injury (less than 50$\%$) was satisfactory and equivalent to that of reconstructive treatment for the total ACL injury.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.27-34
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• 2011

Purpose: To evaluate the short term clinical result of ACL reconstruction with autologous hamstring tendon using Cross pin and Graft Tensioner and to seek way to resolve the experienced technical problems. Materials and Methods: From January 2008 to March 2009, 35 patients who had been treated arthroscopic ACL reconstruction were enrolled. The femoral side of ACL graft was fixed with Cross pin. The tibial side of graft was fixed with Intrafix and post-tie. The graft was tensioned with Graft Tensioner at 80N. We analyzed the clinical, radiographic results and complications. Results: IKDC subjective score and Lysholm score improved to 89.1 and 91.4 points. Also, Pivot shift test and One-leg hop test showed good results postoperatively. Side to side difference using KT-1000 arthrometer and Telos stress radiography improved compared with normal limb to $2.8{\pm}1.6$ mm and $2.6{\pm}1.3$ mm, respectively. The femoral tunnel enlarged to $2.3{\pm}1.1$ mm. Soft tissue irritation and femoral tunnel-graft harness length mismatch, femoral tunnel-cross pin tunnel mismatch were happened as peri-operative complications. Conclusion: Using of Cross pin and Graft Tensioner for ACL reconstruction with hamstring tendon is one of the good method for obtaining stability in short-term clinical result. But to reduce femoral tunnel-cross pin mismatch, it needs to shorten femoral bone tunnel and to create cross pin tunnel as vertical as possible. And to reduce femoral tunnel-graft harness mismatch, it needs to advance position rod further 3 mm when to create femoral tunnel.