• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.95-121
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• 2008

Purpose: The goal is to identify the effectiveness of the IKDC subjective score in the clinical outcome study after reconstruction of the anterior cruciate ligament. Materials and Methods: Twenty-four patients after ACL reconstructions using twelve hamstring autografts and twelve Achilles allografts were evaluated. Lysholm knee score, IKDC subjective score, Knee Outcome Survey score and Tegner activity score were evaluated for the subjective outcome value. Static instability tests, Biodex dynamometer and one-legged hop for distance tests were done for the objective outcome value. Three functional performance tests (FPTs) including Carioca test, Shuttle run test and Co-contraction test were performed for deciding the final results. Each scale was compared with FPTs results and Pearson's correlation test was used to test the correlation between the parameters. Results: IKDC subjective score, single hop test, and quadriceps power in low velocity of Biodex dynamometer tests had a positive correlation with the total FPTs results. Conclusion: IKDC subjective score can be an effective test to evaluate the functional status as well as the subjective outcome after ACL reconstruction.

• 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 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.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.7-12
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• 2010

Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.95-101
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• 2009

Purpose: The purpose of this study was to determine how many of our patients who had had anterior cruciate ligament (ACL) reconstruction returned to their previous levels of sports and to identify why not doing so. Material and Methods: We evaluated 43 knees with a minimum of two years follow-up among whom undergoing 109 ACL reconstruction from September 2003. The mean age of patients was 26 years (17 to 45 years) Clinical results was evaluated according to the Lysholm Knee scores, Tegner activity score, subjective IKDC questionnaires, objective IKDC evaluation form and KT-1000 arthrometer. Results: The overall clinical results demonstrated significant improvement at the final follow-up comparing to preoperative data (P<0.05). Among 43 patients, 25 patients (58%) returned to their previous level of sports and 18 patients (42%) did not. Of whom, 11 patients (61%) were not able to return to sports due to fear to re-injury and 7 patients (39%) suffered from instability and pain. The differences in the Lysholm Scores, KT-1000 arthrometer and subjective IKDC in the 3 groups of patients by ANOVA test were found to be statistically significant (P<0.001). Although there is no difference in objective IKDC and KT-1000 arthrometer, the difference was observed in Tegner activities, subjective IKDC obtained by those who returned to sport and those who had fear to reinjury (P<0.001). Conclusion: This study showed that a quater of patients could not return to their previous level of sport after ACL reconstruction because of fear to reinjury. We thought that not only improving the technique of ACL reconstruction and systemic rehabilitation but also considering psychological factor of patients could allow more patients to return to the previous level of sports.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.14-18
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• 2004

Purpose: To compare the mid-term follow-up results of anterior cruciate ligament(ACL) reconstruction with the bone-patellar tendon- bone(BTB) autograft to those with the BTB allograft. Materials and Methods: Retrospective study was performed in 59 cases with BTB autograft and 42 cases with BTB allograft. Evaluations include Lysholm score, 2000 IKDC subjective knee score, Shelbourne patello-femoral pain score , Lachman test, pivot shift test, KT-1000 arthrometer test and 2000 IKDC knee examination. Results: There were no significant statistic differences between two groups in Lysholm score and 2000 IKDC subjective knee score of more than 70 (p<0.05). Five cases(8.5%) showed the patello-femoral pain score less than 80 according to Shelboume with autograft group and two cases(4.8%) with allograft group (p<0.05). Lachman test, pivot shift test and KT-1000 arthrometer test showed no significant statistic differences between two groups(P<0.05). Fifty-four cases(91.5%) were normal or nearly normal according to the 2000 IKDC knee examination with autograft group and thirty-eight cases(90.4%) with allograft group(p<0.05).Conclusion: BTB allograft as well as BTB autograft is considered to be an acceptable choice for ACL reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.28-33
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• 2009

Purpose: To compare the clinical outcomes after meniscus allograft transplantation between lateral and medial or isolated and combined procedure groups. Materials and Methods: Of the patients who had undergone arthroscopic meniscal allograft transplantation between Dec. 1997 and Jun. 2007, 52 patients were available for retrospective evaluation. Patients were grouped into lateral(33 cases) and medial(19 cases) transplant groups as well as those with isolated(18 cases) and combined(34 cases) procedure. The average age was 34.2 years and the mean follow-up period was 42.2 months. Postoperative range of motion (ROM), visual analog scale (VAS), International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, patient's subjective satisfaction, $2^{nd}$ look arthroscopy and MRI were evaluated retrospectively. Results: Mean postoperative ROM was $130.3^{\circ}$. The VAS showed an improvement from 5.96 to 3.05 at the last follow up. IKDC subjective score and Lysholm score also showed an improvement from 46.5 to 64.5 and from 61.9s to 79.58 respectively. Tegner score was improved from 2.9 to 3.6. Overall, 61.5% of patients reported they were completely or mostly satisfied with procedure. There were no significant differences noted between lateral and medial groups as well as isolated and combined groups. In 2nd look arthroscopy, 10 of 18 cases showed good pheripheal healing and there were 6 cases of partial and 2 of complex tear. We observed graft subluxation or extrusion in 12 of 16 cases who were evaluated with follow-up MRI. Conclusion: Meniscus allograft transplantation alone or in combination with other procedure showed an improvement in knee pain and clinical score. But there were no significant difference between lateral and medial groups or isolated and combined procedure groups.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.104-110
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• 2007

Purpose: The purpose of this study is comparison of clinical outcomes in ACL reconstruction between auto-hamstring tendon and allo-tibialis anterior tendon. Materials and Methods: In this prospective study, we included 60 subjects who underwent ACL reconstruction using 30 hamstring autograft(mainly, national health insurance) and 30 tibialis anterior allograft(including MVA and industrial injuries) between May 2003 and June 2005 by a single surgeon, with a minimum follow-up of 12 months. Outcome measurements were the range of motion, the Lachman test, the IKDC score, the Lysholm score, KT-1000 arthrometer and one-leg hop test. Results: For all the cases, the range of motion was above 135 degrees. The Lachman test, KT-1000 arthrometer and one-leg hop test showed no significant difference between two groups. The IKDC score of auto-hamstring group($87.840{\pm}2.106$) was significantly higher than that of allo-tibialis anterior group($85.273{\pm}2.782$). The Lysholm score of auto-hamstring group($88.067{\pm}2.586$) was also significantly higher than that of allo-tibialis anterior group($85.300{\pm}3.030$). Conclusion: The results of ACL reconstruction using the auto-hamstring tendon and allo-tibialis anterior tendon showed no significant difference in objective items but auto-hamstring group showed better results in subjective scoring. This difference may result from individual factors such as economic problem, secondary gain.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.107-113
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• 2010

Purpose: To evaluate the outcome of the two-bundle anterior cruciate ligament reconstruction with single femoral tunnel and tibialis anterior tendon allograft and to determine any functional advantages. Materials and Methods: From June 2006 to March 2008, we performed single femoral tunnel and two-bundle ACL reconstruction with tibialis anterior tendon allograft in 26 cases. Mean age was 35.5 years. 20 cases were male and 6 cases were female. Average follow-up period was 2 years and 5 months, range from 1 year to 3 years and 5 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test and IKDC score. Results: Postoperative mean Lysholm knee score, IKDC Evaluation Form, Tegner activity scale, Pivot shift test, and anterior displacement by the Telos stress test demonstrated statistically significant differences compared to the preoperative. Conclusion: Two-bundle anterior cruciate ligament reconstruction with single femoral tunnel showed good clinical results and was good operative technique.