• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.128-131
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• 1997

전방십자인대의 일차수복술이나 재건술후에 장기간의 비체중부하가 필요한지를 결정하기 위해서 일차수복술을 시행한 96례와 재건술을 시행한 82례등 총 178례를 대상으로 술후 체중부하시기에따라 두군으로 나누어 비교분석 하였다. 모든 례에서 술후 보조기를 착용하였고 120례에서는 술후 첫6주간 점차적으로 관절운동범위를 증가를 시키고 다음 6주간은 완전운동범위 회복상태에서 유지후 술후 12주에 체중부하를 허용하였으며 나머지 58례에서 술후 완전신전상태에서 즉시 체중부하를 시켜서 정기적으로 Lachman검사, KT 2000을 이용하여 불안정성여부를 관찰하였다. 평균 추시기간은 4.2년(2년$\~$6년)이었고 불안정성에 대한 평가는 AMA 분류에 따랐다. 최종추시상 모든환자에서 1+이상의 불안정성은 발견되지 않았으며 술후 12주에 체중부하를 한군에서 1a+가 104례$(86.7\%)$, 1b+군이 16례$(13.3\%)$로 관찰되고 즉시 체중부하를 한 군에서 1a+가 51례$(87.9\%)$, 1b+가 7례$(12.1\%)$에서 보였으나 통계적으로 의미있는 차이는 없었다(P>0.05). 본연구의 결과로 전방십자인대 일차수복술이나 재건술후 신전보조기를 착용시키고 즉시 보행을 시키는 것이 술후 슬관절의 불안정성에 영향을 주지 않으며 안전한 재활방법으로 생각된다.

• Journal of the Korean Arthroscopy Society
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• v.7 no.1
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• pp.92-95
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• 2003

A 34-year-old man with ACL total rupture due to slip down injury, had received ACL reconstruction using autogenous hamstrings tendon with cross-pin femoral fixation. Postoperative course was as usual. But postoperative 3 months later, he complained posterolateral knee pain, recurrent effusion and mild instability. He was managed repeatitive aspiration and nonsteroid antiinflammatory drugs but was failed to relieve symptoms & signs. In CT scans, perforation of posteromedial femoral cortex of lateral femoral condyle was found. In second look arthroscopy, two pieces of broken femoral cross pin were found in between tibiofemoral Joint which was badly injured cartilage. We considered malposition of pins was the main cause of failure. We propose that femoral tunnel must be made more acute angle and femoral cross-pin guide must be positioned more external rotation 10-20 degree than transepicondylar axis made confirm the cross-pin tunnel position in order to avoid posterior cortex perforation and early failure.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.187-191
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• 2006

Few cases have been reported in which the femoral interference screw has migrated into the posterior compartment after an ACL reconstruction. It usually requires removal, because it leads usually to mechanical symptom. However, the arthroscopic removal of a screw is a technically demanding procedure, especially in the case of an intact integrated ACL graft or one that is encapsulated around the screw. We present a case in which a displaced femoral interference screw migrated within the posterior compartment 11 years postoperatively, after the graft had been successfully incorporated at the femoral site and showed good continuity on MRI and arthroscopic examination. Although it is often technically challenging, through the use of a posterior trans-septal portal, we can successfully remove a displaced femoral interference screw even in the most difficult locations in the posterior compartment without damage to ACL graft.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.153-153
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• 2009

The purpose of this study was to evaluate tibial tunnel widening prospectively after anterior cruciate ligament (ACL) reconstruction with hamstring tendon grafts using Rigidfix (DePuy Mitek, Raynham, MA) femoral fixation and Intrafix (DePuy Mitek) tibial fixation. 56 consecutive patients who underwent ACL reconstruction with a minimum of 2 years' postoperative evaluation were reviewed. On the anterior-posterior (AP) and lateral radiographs, the diameter of the tibial tunnel was measured at proximal, middle, and distal positions and the shape of the tibial tunnels were classified. Tunnel widening was defined as widening of greater than 2 mm. Group I was defined as cases with no tunnel widening and group II defined as cases with tunnel widening. Postoperative laxity evaluations were performed using Lachman test, pivot-shift test, and Instrumented laxity testing using the KT-1000 arthrometer. On the AP radiographs, the average diameter of the tibial tunnel increased 8.8% at 6 months and 8.5% at 12 months postoperatively compared to the immediate postoperative day. On the lateral radiographs, the average diameter of the tibial tunnel increased 7.2% at 6 months and 8.1% at 12 months year postoperatively compared to the immediate postoperative day. The tunnel shape evaluation revealed predominantly linear type in 53 patients (95%). Group I was 42 patients (75%) and group II was 14 (25%). The average KT-1000 measurement was 1.0~1.8 mm in group I and 2.1~2.8 mm in group II (p>0.05) The Lachman and pivot-shift showed tests no significant differences between the two groups. In conclusion, hamstring ACL reconstruction using Rigidfix and Intrafix fixation showed less widening of the tibial tunnels than observed in previously published studies.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.57-57
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• 2009

관절경적 경경골 단일 다발 후방십자인대 재건술은 전통적으로 가장 흔하게 사용되는 사용되는 술기이다. 그러나, 후방십자 단독 파열시 이 술기의 결과에 대한 임상 평가 및 효용성에 대한 임상적 분석 자료가 거의 없는 실정이다. 이 술기를 시행받은 환자군들에서 객관적 슬관절 이완이 존재함에도 불구하고 주관적 슬관절 기능 장애는 우수한 결과를 나타낸다고 인정되어 왔다. 후방십자인대 단독 파열 후 경경골 단일 다발 재건술을 시행한 문헌 10개를 대상으로 잔존하는 후방 이완과 주관적, 객관적인 기능 평가, 활동성 정도, 환자 만족도, 골관절염의 발생 빈도, 술후 합병증을 체계적으로 고찰하였다. 술전 후방 슬관절 이완은 8.38~12.3 mm에서(4문헌) 술후 1.96~5.9 mm으로(9 문헌) 호전되었다. Lysholom 점수는 평균 81~100점이었다(9 문헌). IKDC는 75%에서 정상 또는 거의 정상의 결과를 보였다(6 문헌). 평균 Tegner 활동도는 4.7~6.3점이었다(8 문헌). 이번 고찰을 통한 결과에서 이 술기 후 퇴행성 변화가 관찰되었으며 보고된 합병증은 거의 없었다. 후방십자인대 단독 파열에서 경경골 단일 다발 재건술은 정상 슬관절의 안정성까지 회복하지는 못하나 한 등급 정도의 후방 슬관절 이완의 호전을 기대할 수 있다. 재활 및 운동으로의 회복에 대한 주관적 슬관절 점수는 80점이며 75%의 정상 또는 정상에 가까운 객관적 결과를 보여주었다. 이 술기가 퇴행성 관절염을 예방할 수는 없더라도 이러한 결과는 후방십자인대 재건 술기의 평가에 도움이 될 것으로 사료된다.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.45-49
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• 2007

We report a case of a girl with a symptomatic anomaly of medial meniscus. The complaint of the patient was pain and snapping of the knee. The anterior horn of medial meniscus has anomalous insertion which was extended to the intercondylar notch of the femur on the surface of the anterior cruciate ligament, it attached to lateral wall of medial femoral condyle. This anomalous band was not detected in MRI of knee but found during the operation. After resection of anomalous band, the symptoms completely disappeared.

• Journal of Veterinary Clinics
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• v.37 no.5
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• pp.261-269
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• 2020

The purpose of this study is to investigate the clinical effects of carboxymethyl chitosan (CMC) and adipose-derived mesenchymal stem cells (MSCs) on osteoarthritis (OA). Thirty New Zealand white rabbits were used as cranial cruciate ligament transection and partial meniscectomy models. The rabbits were divided into five groups (n = 6) according to the intra-articular injection materials: the control group with PBS, the HA group with hyaluronic acid, the CMC group with CMC, the MSC group with MSCs emerged in PBS, and the MSC+CMC group with CMC and MSCs. Knee thickness, extension angle, gross morphology, histopathology and immunohistochemistry were performed to evaluate the effects of CMC and MSCs on rabbit OA. On the morphologic and histologic examination, the articular surfaces of the femur and tibia were markedly damaged in control group with higher Mankin score and lower cartilage surface thickness. However, OA related cartilage defects were alleviated by the treatment of MSC and/or CMC. The expressions of apoptotic and inflammatory cytokines were decreased and cartilage extracellular matrix (ECM) related collagens I and II were enhanced by the treatment of MSC and/or CMC. In conclusion, this study showed that CMC and MSC treatments have a beneficial effects on OA via the protection of cartilage damage, the stimulation of ECM, and the inhibition of inflammatory and apoptotic reaction.

• PNF and Movement
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• v.17 no.3
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• pp.441-450
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• 2019

Purpose: This study identified the co-activation of quadriceps and hamstring muscles during hamstring strengthening exercises in healthy adults. Methods: Twenty-one participants were required for the present study design to achieve 80% power, 0.8 effect size (η2), and an alpha level of 0.05. Thus, this study recruited 21 healthy adults. All participants performed Nordic exercises, bridge exercises, and one-leg deadlifts randomly. The activity of the rectus femoris, vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (SM) were measured. In addition, the ratios of VM/VL and hamstring/quadriceps (HQ) were measured during the three hamstring strengthening exercises using electromyography. One-way ANOVA was used to compare the co-activation of quadriceps and hamstring muscles in the three exercises. Results: The activity of VM and VL during the performance of one-leg deadlifts was significantly higher than the other two exercises. The BF had significantly higher activity during the Nordic exercises compared to the other two exercises. In addition, the SM activation was significantly greater during Nordic exercises than one-leg deadlifts. Additionally, there was significant difference in HQ ratio among hamstring strengthening exercises. In specific, the one-leg deadlifts yielded a significantly lower HQ ratio. Conclusion: This study revealed that one-leg deadlifts are effective in rehabilitation for anterior cruciate ligament injury. In addition, Nordic exercises can be recommended to facilitate hamstring muscle activation.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.1-6
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• 2009

The usefulness and accuracy of computer-assisted surgery have been evaluated clinically in many orthopedic fields, such as, joint replacement arthroplasty, cruciate ligament reconstruction, and pedicle screw placemen. Recently several preliminary reports have been issued on the application of navigation to bone tumor surgery. The main advantage of navigation-assisted bone tumor surgery is that it provides highly accurate three-dimensional radiological information for intraoperative guidance. In particular, distances from tumors to resection margins can be precisely determined using intraoperative three-dimensional images. Accordingly, the technique allows preservation of function to be maximized by minimizing unnecessary resection. However, surgeons should recognize that the accuracies of navigation systems in bone tumor surgery have some hidden pitfalls. Here, based on our clinical results, we describe the surgical techniques used and include some cautionary notes.

• Korean Journal of Applied Biomechanics
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• v.24 no.2
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• pp.121-129
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• 2014

The purpose of this study was to investigate the effect of the toe headings on the biomechanics of knee joint in drop landing in an attempt to find the potential risk of non-contact anterior cruciate ligament (ACL) injury. Seventeen male college students ($20.5{\pm}1.1$ yrs; $175.2{\pm}6.4$ cm; $68.8{\pm}5.8$ kg), having no neuromuscular injury within an year, participated in this study. Three different toe headings such as toe-in (TI), neutral (N), and toe-out (TO) positions were tested. Motion capturing system consisting of eight high speed cameras and two force platforms were used to collect three-dimensional motion data and ground reaction force data during landing. Results indicated joint angles and peak joint moments were significantly affected by the toe headings. TI position produced larger valgus angle due to reduce knee distance in addition to higher flexion and valgus moment than other positions, which was somewhat vulnerable to the potential risk of non-contact ACL injury. TO position caused the largest internal rotation angle with smaller joint moments. Therefore, it is recommended that athletes need to land on the ground with neutral toe-heading position as possible in order to minimize the potential risk of non-contact ACL injury.