• Investigative Magnetic Resonance Imaging
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• v.20 no.2
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• pp.95-104
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• 2016

Purpose: To evaluate the knee joint after double-bundle anterior cruciate ligament (ACL) reconstruction with three-dimensional (3D) isotropic magnetic resonance (MR) image, and to directly compare the ACL graft findings on 3D MR with the clinical results. Materials and Methods: From January 2009 to December 2014, we retrospectively reviewed MRIs of 39 patients who had reconstructed ACL with double bundle technique. The subjects were examined using 3D isotropic proton-density sequence and routine two-dimensional (2D) sequence on 3.0T scanner. The MR images were qualitatively evaluated for the intraarticular curvature, graft tear, bony impingement, intraosseous tunnel cyst, and synovitis of anteromedial and posterolateral bundles (AMB, PLB). In addition anterior tibial translation, PCL angle, PCL ratio were quantitatively measured. KT arthrometric values were reviewed for anterior tibial translation as positive or negative. The second look arthroscopy results including tear and laxity were reviewed. Results: Significant correlations were found between an AMB tear on 3D-isotropic proton density MR images and arthroscopic proven AMB tear or laxity (P < 0.05). Also, a significant correlation was observed between increased PCL ratio on 3D isotropic MRI and the arthroscopic findings such as tear, laxities of grafts (P < 0.05). KT arthrometric results were found to be significantly correlated with AMB tears (P < 0.05) and tibial tunnel cysts (P < 0.05). Conclusion: An AMB tear on 3D-isotropic MRI was correlated with arthroscopic results qualitatively and quantitatively. 3D isotropic MRI findings can aid the evaluation of ACL grafts after double bundle reconstruction.

• PNF and Movement
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• v.15 no.1
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to use an ICF tool in an intervention for anterior cruciate ligament reconstruction (ACLR) patients to examine and evaluate the patients' functional problems, measure the results of the intervention, and present the process of preparing proprioceptive neuromuscular facilitation (PNF) intervention strategies, thereby contributing to changes in and development of relevant future clinical practices. Methods: A PNF rehabilitation exercise program using an ICF tool was applied to ACLR patients five times per week for four weeks. To measure the resulting changes, the ICF evaluation display, the visual analog scale (VAS), the manual muscle test (MMT), the range of motion (ROM) test, the Lysholm knee score (LKS), and the muscle endurance test (MET) were used. Results: After the intervention was applied to the ACLR patients, improvements were achieved in all the tests: ICF evaluation display, VAS, MMT, ROM, LKS, and MET. Conclusion: Utilizing the ICF tool, this study identified functional problems of ACLR patients. When the intervention was applied, physical functions improved, and structural damage was reduced, leading to enhanced levels of functional activities such as postural changes, posture maintenance, gait, movements, and movements between different places. The patients were able to complete the teacher training, which was their goal.

• Journal of Microbiology and Biotechnology
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• v.31 no.10
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• pp.1401-1408
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• 2021

This study examined whether the oral administration of low-molecular-weight collagen peptide (LMCP) containing 3% Gly-Pro-Hyp with >15% tripeptide (Gly-X-Y) content could ameliorate osteoarthritis (OA) progression using a rabbit anterior cruciate ligament transection (ACLT) model of induced OA and chondrocytes isolated from a patient with OA. Oral LMCP administration (100 or 200 mg/kg/day) for 12 weeks ameliorated cartilage damage and reduced the loss of proteoglycan compared to the findings in the ACLT control group, resulting in dose-dependent (p < 0.05) improvements of the OARSI score in hematoxylin & eosin (H&E) and Safranin O staining. In micro-computed tomography analysis, LMCP also significantly (p < 0.05) suppressed the deterioration of the microstructure in tibial subchondral bone during OA progression. The elevation of IL-1β and IL-6 concentrations in synovial fluid following OA induction was dose-dependently (p < 0.05) reduced by LMCP treatment. Furthermore, immunohistochemistry illustrated that LMCP significantly (p < 0.05) upregulated type II collagen and downregulated matrix metalloproteinase-13 in cartilage tissue. Consistent with the in vivo results, LMCP significantly (p < 0.05) increased the mRNA expression of COL2A1 and ACAN in chondrocytes isolated from a patient with OA regardless of the conditions for IL-1β induction. These findings suggest that LMCP has potential as a therapeutic treatment for OA that stimulates cartilage regeneration.

• Korean Journal of Applied Biomechanics
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• v.28 no.4
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• pp.199-205
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• 2018

Objective: The purpose of this study was to examine the effect of increase in barbell weight on closely related variable to the anterior cruciate ligament (ACL) injury which are knee joint kinematics, joint load, joint moment, and maximum load attainment point during snatch of the weight lifting. Method: The subjects of the study were 10 male Korean national weight lifting athletes (69 kg 5, 77 kg 5; age: $21.80{\pm}3.91yrs.$, height: $168.00{\pm}4.06cm$, weight: $75.00{\pm}4.02kg$, career: $7.8{\pm}3.99yrs.$, snatch records: $168{\pm}4.06kg$). The weight of the barbell during the snatch operation was set at 70%, 75% and 80% of the highest records for each subject studied. Results: The result obtained from the one-way repeated measure ANOVA are as follows: With increased barbell weight, the extension moment of the left knee joint was higher in the 80% condition than the 70% (p<.001). However, other variables were not statistically significant difference. According to the factor analysis of the variables related to maximum load attainment point of the ACL major injury variables, the first sub-factor was the internal shear force, the posterior shear force, the abduction moment, and the muscle activity of the VL. The second sub-factor was the extension moment of the knee joint, compressive force, adduction moment, and the third sub-factor was the muscle activity of BF. Conclusion: These results indicate that the possibility of ACL injury can be lowered when performing a stable snatch movement.

• Journal of Veterinary Clinics
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• v.39 no.3
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• pp.100-106
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• 2022

The center of rotation of angulation-based leveling osteotomy (CBLO) has been introduced for the stabilization of cranial cruciate ligament rupture (CCLR) in small-breed dogs. This technique can be applied to the tibia without damaging its tuberosity. Although different designs of CBLO plates are available, tibial plateau leveling osteotomy (TPLO) plates have been still used for stabilization during CBLO. To the best of our knowledge, no studies have reported the effects of TPLO plates on the postoperative limb alignment after CBLO. Therefore, the present study (January 2020 to February 2021) aimed to compare the postoperative outcomes (postoperative tibial plateau angle [TPA] and tibial alignment) in patients receiving CBLO and TPLO plates during CBLO. Paired stifle joints (n = 16) were obtained from eight toy-breed cadaver dogs (mean weight, 4.4 kg) that underwent CBLO. The joints were randomly assigned to receive the CBLO (CBLO group) or TPLO plates (TPLO group). Pre-and postoperative radiographs were obtained, and the dissected tibiae were evaluated. The following postoperative parameters were compared to evaluate the surgical outcome: TPA, osteotomy location, mechanical medial proximal tibia angle, inter-segment gap, and tibial plateau translation. No significant differences were found in the postoperative alignment between the two groups. Therefore, TPLO plates may be considered as a viable alternative in toy-breed dogs undergoing CBLO.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.1
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• pp.33-36
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• 2008

Purpose: The purpose of this study was to evaluate the mechanism of injury in the anterior cruciate ligament tears sustained in participation in soccer. Materials and methods: 50 patients whose knees were injured during playing soccer were enrolled in this study. The mean age was 27 years old, 47 were male and 3 female. 15 of them were either professional or amateur soccer players, the rest were non-professional. The injury mechanism was investigated by evaluation of the medical records or by telephone interview. Results: The injury mechanism involved contact injuries in 17 patients and non-contact in 33. 41 patients were bearing weight on the involved side at the time of injury, and 9 patients were not. In cases of contact injury, 9 of the 17 patients had sustained a valgus force to the knee, and 5 patients had varus force, 11 patients had their foot planted, and 6 did not. Among those patients with a planted foot, 3 patients were injured by the rotation of the thigh, 1 patient was injured by hyperextension, and there were no deceleration mechanism injuries. In non-contact injuries, 30 out of 33 patients had their foot planted at time of injury and only 3 patients did not. Of these 30 patients, 16 were injured by the rotation of thigh, 6 sustained a varus force on the knee joint and 5 had a valgus force, 5 were injured by hyperextension, and 2 by deceleration. 3 patients, who did not have their foot planted, were injured while kicking with the involved leg. Conclusions: For soccer players in this series, the most common mechanisms resulting in anterior cruciate ligament tears were non-contact, most often by rotation of the torso over a planted foot. In contact injuries, the most common mechanism was the application of valgus force by tackle.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.1
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• pp.27-32
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• 2008

Purpose: To evaluate the clinical results of the patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity after ACL reconstruction. Material and Methods: From October 1999 to March 2006, we performed 133 cases of ACL reconstruction. Among them we experienced 16 patients who had the laxity of reconstructed ACL in second look arthroscopy. Mean follow-up was 20.4 months. Mean age was 33.5 years. 12 cases were male and 4 cases were female. The elongated ACL were treated by bipolar radiofrequency energy with an output of grade II. Subjective and objective parameters were utilized in analyses, such as: the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test, IKDC score. Wilcoxon signed-rank test was used to perform the data analysis. P<0.05 was considered to be statistically significant. Results: Postoperative mean Lysholm knee score (preop: $82.2{\pm}5.2(77{\sim}85))$ (P=0.04), postop: $85.2{\pm}4.8$(82-90)) and anterior displacement by the Telos stress test (preop: $5.4{\pm}4.6(3{\sim}10)mm$, postop: $2.1{\pm}1.9(0{\sim}4)mm)$ (P=0.02), Lachman's test, and IKDC scores (P=0.04) demonstrated significant differences statistically compared to the preoperative. There were no statistical differences in mean range of motion, Tegner activity scale. Conclusions: Arthroscopic shrinkage for the ACL laxity after ACL reconstruction with radiofrequency device showed good clinical results and was applicable operative technique.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.455-459
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• 2012

Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.11-17
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• 2013

Purpose: The purpose of this study is to evaluate the effect of preservation of the tibial remnant on the synovialization of graft tendon after the reconstruction of anterior cruciate ligament (ACL) based on the second look arthroscopic findings. Materials and Methods: From May 2005 to May 2012, among sixty three patients having ACL reconstruction with the four-strand hamstring using a bioabsorbable cross pin (RigidFix$^{(R)}$) for the femoral tunnel, nineteen patients who had second look arthroscopy were analyzed. We classified them into three groups according to the tibial remnant of the torn ACL for arthroscopic findings. Group 1 had less than 5 mm of a remnant tissue, Group 2 had from 6 mm to 10 mm of it, and Group 3 had more than 11 mm. We estimated the percentage of synovial coverage on the graft tendon during second look arthroscopy. We evaluated Lysholm score and Tegner activity score preoperatively and in the last follow-up. Results: At the time of ACL reconstruction, the mean length of preserved tibial remnant of torn ACL was 2.3 mm in Group 1, 7.4 mm in Group 2, and 13.7 mm in Group 3. In the second look arthroscopy, the average percentage of synovial coverage was 55.4% in Group 1, and 77.9% in Group 2, and 89.7% in Group 3. Lysholm score and Tegner activity score improved from 74.2 and 7.3 preoperatively to 94.1 and 8.5 in the last follow-up. Conclusion: The preservation of tibial remnant of torn ACL influenced the synovial coverage of the graft tendon and the volume of preserved remnant in accordance with the surface of synovial coverage. It would have a good effect on graft healing and preservation of proprioceptive function.

• Journal of Veterinary Clinics
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• v.30 no.5
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• pp.346-352
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• 2013

The study was aimed to investigate the influence of diode laser on osteoarthritis (OA) of stifle joint induced by anterior cruciate ligament transection (ACLT). Sixty 10-week-old male Sprague-Dawley rats were used in this study. Right stifle joint was operated to create ACLT or sham. There were five study groups: control, Sham, ACLT, ACLT + Laser irradiation (ACLT+L) and ACLT + meloxicam administration (ACLT+M). Low-level laser therapy (LLLT) was applied at the operated stifle joint twice a week using an 808-nm indium-gallium-arsenide (InGaAs) diode laser during 8-week experimental period. Radiographical, gross morphological and histopathological findings were examined at 2, 4 and 8 weeks post-surgery. Radiography, CBC and chemistry tests showed no significant difference between groups. ACLT+L group showed remarkable cartilage damages compared with sham group morphologically and histopathologically at 2, 4 and 8 weeks after surgery. ACLT+M group also had more cartilage damages compared with sham group. Low-level laser therapy (LLLT) showed limitation to prevent progression of OA in the rat anterior cruciate ligament transection models; on the contrary it accelerated cartilage damage. It is assumed that the aggravating results of LLLT in this study might be due to excessive unstable movement of stifle joint from the pain-relieving effect of LLLT, rather than direct damaging effect of irradiation since LLLT did not affect cell viability.