• Hip & pelvis
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• 제35권4호
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• pp.277-280
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• 2023

Dislocation after a total hip arthroplasty occurs in approximately 1% of patients; however, the frequency is much higher after revision surgery. To prevent dislocation, use of a larger femoral head is recommended, and a dual mobility femoral head has been introduced. However, reducing the dual mobility femoral head to the acetabular component is difficult in cases involving contracture in the soft tissue around the joint. A 72-year-old male patient who developed a periprosthetic joint infection underwent two-stage revision surgery using MUTARS^®. Two months after the revision, the hip joint became dislocated and manual reduction was attempted; however, dislocation occurred again. During another revision using a dual mobility bearing, the soft tissue around the hip joint was too tight to reduce. The problem was overcome by first repositioning the dual mobility head into the acetabular socket, followed by assembly of the diaphyseal portion of the implant.

• The Journal of Korean Physical Therapy
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• 제23권4호
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• pp.15-22
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• 2011

Purpose: The purpose of this study was to investigate the relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain. Methods: Fifty-two female patients were recruited for this study. The patients' history was recorded and was used to determine the general characteristics of the female complaints. The women were additionally examined to determine whether the level of pain was characteristic of patients with chronic lumbar instability. The following tests were also carried out in the subjects during the examination: 1) the prone instability test. 2) the test for aberrant movement patterns during lumbar flexion test. 3) the straight leg raising test. 4) posterior-to-anterior mobility test, and 5) the test for age and strength of the hip abductor muscle following assessment of the dominant side. In particular, hip abductor muscle strength was evaluated using a dynamometer. Results: The test results showed that the number of positive responses for the five types of lumbar instability tests performed, was significantly related to the strength of the hip abductor muscle. The average hip abductor muscle strength in total subjects was $72.89{\pm}7.66N$, whereas the average hip abductor muscle strength in subjects who showed positive responses to more than four out of the five tests, was $44.70{\pm}5.79N$. Conclusion: The results demonstrated that the hip abductor muscle strength and lumbar instability were negatively correlated. The lower was the strength of the hip abductor muscle, the higher was the possibility of lumbar instability.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.155-162
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• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.

• Clinics in Shoulder and Elbow
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• 제22권4호
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• pp.235-240
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• 2019

Ulnar collateral ligament injuries of the elbow are frequent among overhead athletes. The incidence of ulnar collateral ligament reconstructions (UCLRs) in high-level players has increased dramatically over the past decade, but the optimal technique of UCLR is controversial. Surgeons need to manage the patients' expectations appropriately when considering the mode of treatment. This article reviews current studies on the management of ulnar collateral ligament injuries, particularly in overhead athletes.

• 대한족부족관절학회지
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• 제9권2호
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• pp.197-200
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• 2005

We performed lateral ankle ligament reconstructions using Achilles allograft on patients who had failed previous Brostrom repair. The bone plug is fixed with an interference screw into the calcaneus, the tendon graft is passed through a fibular tunnel, and then anchored into the talus with the biotenodesis screw. The graft is strong enough to maintain joint stability until graft incorporation and remodeling occurs. In patients with chronic failed lateral ankle instability requiring graft for ligament reconstruction, this technique allows anatomic reconstruction without the need to sacrifice autogenous peroneal tendons.

• 대한족부족관절학회지
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• 제20권2호
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• pp.62-66
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• 2016

A modified $Brostr{\ddot{o}}m$ procedure has been widely accepted as a treatment of choice for patients with chronic lateral ankle instability. The procedure is highly reliable and provides successful outcomes in approximately 90% of cases. Severe degree of instability, absence or poor quality of the ligamentous remnant, obesity, and generalized joint hypermobility have been regarded as poor prognostic factors related to the modified $Brostr{\ddot{o}}m$ procedure. However, these perceptions are based on a low level of evidence studies or expert opinions. Therefore, the aim of this article was to search for evidences regarding the poor prognostic factors of the modified $Brostr{\ddot{o}}m$ procedure.

• Korean Journal of Radiology
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• 제22권3호
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• Hip & pelvis
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• 제34권1호
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• pp.62-67
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• 2022

Posterior wall fractures are the most common type of acetabular fractures. Treatment can be conservative or surgical. Operative treatment is indicated for acetabular fractures that result in hip joint instability and/or incongruity, as well injuries with incarceration of fragments of bone or soft tissue within the hip joint. Surgical treatment can range from open reduction and osteosynthesis to hip arthroplasty. Arthroscopy has recently been used as the main surgical technique or as a reduction aid. In this case a 26-year-old male with a fracture of the posterior wall who underwent a posterior miniinvasive approach, followed by hip arthroscopy. This allowed joint wash, removal of the loose body, confirmation of reduction and absence of intra-articular hardware. Excellent clinical and radiological results were obtained. This case demonstrates the advantage of using hip arthroscopy in assessment of fracture reduction, the absence of intra-articular hardware or fragments, as well as a less invasive approach.

• 대한통합의학회지
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• 제11권1호
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• pp.13-20
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• 2023

Purpose : The purpose of this study is to compare the balance ability between subjects with chronic ankle instability and normal people and the center of pressure displacement during the sit to stand and stand to sit. Methods : The subjects of this study were 63 who met the inclusion criteria and were classified into normal group (n=33) and chronic ankle instability group (n=30). The displacement of the center of pressure during sit to stand and stand to sit was measured. And the limit of stability and Y-balance tests were performed to measure the balance ability. Independent t-test was conducted to compare center of pressure displacement and balance ability between groups, and pearson correlation was conducted to analyze the correlation between the center of pressure displacement and balance ability. Results : In the case of the center of pressure displacement, there was a significant difference between the two groups during sit to stand and stand to sit. In the case of balance, both limit of stability and Y-balance test showed significant differences between the two groups. At the time of sit to stand, the center of pressure displacement showed a significant correlation with balance abilities, and at the time of stand to sit, the center of pressure displacement showed a significant correlation with Y-balance test. Conclusion : Chronic ankle instability shows that there is a lot of sway in the body due to compensation to replace the decrease in ankle joint range of motion when performing sit to stand and stand to sit due to sensory input damage such as decrease in ankle range of motion and decrease in ankle proprioception. Chronic ankle instability is expected to have a negative effect on our daily lives in life. The results of this study will serve as the basis for the dynamic approach to objective evaluation, treatment, and prevention of chronic ankle instability.

• 한국지능시스템학회논문지
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• 제17권5호
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• pp.640-647
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• 2007

본 논문은 유전알고리즘을 기초로 한 휴머노이드 로봇의 관절 제어에 관한 논문이다. 휴머노이드 로봇은 지면에 고정된 시스템이 아니기 때문에 기본적으로 불안정성을 내포하고 있다. 게다가 각 관절의 비선형성은 로봇의 안정성에 악영향을 미친다. 이에 만약 둘 중 하나라도 안정하지 못하면 로봇은 보행 중에 넘어지게 될 것이므로, 휴머노이드 로봇의 안정성을 확보하기 위해서는 이 두 가지가 모두 고려되어야 할 것이다. 이에 본 논문에서는 보행 안정성을 확보하기 위해 이 두 가지 문제 중에 로봇의 비선형성을 제거하면서 로봇이 주어진 궤적을 잘 추종하여 제어할 수 있는 제어기를 제안하였다. 이 제어기는 퍼지-슬라이딩 모드 제어기를 기본으로 하고 있으면서 모션 제어기가 첨가되어 있다. 그리고 이때 이러한 제어 이득값을 유전알고리즘을 통해 추종함으로써 보다 정밀한 제어가 가능하도록 하여 휴머노이드 로봇이 보다 안정적으로 보행할 수 있도록 하였다. 이 모든 과정은 시뮬레이션과 실험을 통해 검증하였다.