• Title/Summary/Keyword: Knee

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Vein Injury and Wound Complications Associated with Techniques of Saphenous Vein Harvest (복재정맥 수확방법에 따른 이식편의 손상과 수술창의 합병증의 빈도)

  • 최종범;박권재;양현웅;이삼윤;최순호
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.504-509
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    • 2003
  • Although arterial grafts are widely used due to the advantage of long-term patency in coronary bypass surgery, greater saphenous vein is still an important additional conduit. It was reported that preservation of the adventitia of vein graft and the adjacent tissues may bring the improved long-term graft patency. The aim of this study is to look for a harvest technique that can reduce vein injury and wound complications. Material and Method: In thirty-four patients that vein grafts were used for coronary bypass surgery, 50 harvest sites were included for the study. In 25 harvest sites in calf below knee (group 1), vein was exposed through a long incision and then clearly dissected from the adjacent tissue. Ten endoscopic vein harvests were performed in the thighs (group 2). Fifteen other vein grafts that were bluntly dissected were harvested from the thighs through three separate incisions (group 3). Result: Vein harvest time was longest in endoscopic harvest group (44.7$\pm$9.8 minutes) and shortest in group 3 (24.2$\pm$5.9 minutes) (p=0.000). Most avulsion injuries of vein branches happened in the endoscopic group. Sequential grafting numbers per vein were 1.72$\pm$0.98 with thigh vein graft and 1.16$\pm$0.37 with calf vein (p=0.02). Swelling of foot and/or leg, which was the most common wound complication after vein harvest, was most commonly presented in group 1 (20/25 sites; p=0.000). Tingling, the most common neurologic complication, was also most prevalent in group 1 (7/25 sites; p=0.013). The risk factor of the wound complication was vein harvest from calf, and the vein harvest technique was not a risk for wound complication. Conclusion: Vein harvest technique through three separate incisions from thigh presented shorter harvest time and less vein injury and wound complication compared with the endoscopic harvest technique from thigh or the harvest through a long incision from calf.

Arthroscopic Reduction and Internal Fixation of Intra-articular Fractures of Lateral Tibial Plateau (관절면을 침범한 경골 외과 골절의 관절경적 정복 및 내고정술)

  • Lee, Kwang-Won;Lee, Hang-Ho;Yang, Dong-Hyun;Choy, Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.53-60
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    • 2006
  • Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

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The Clinical Analysis of Lateral Discoid Meniscus in Adults Over 40 years old (40세 이상에서 발견된 외측 원판형 연골의 임상분석)

  • Lim, Hong-Chul;Noh, Kyoung-Sun;Jung, Hyo-Sub
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.77-82
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    • 2006
  • Purpose: The purpose of this study was to analyze the clinical results of symptomatic lateral discoid meniscus found in adults over 40 years old. Materials & Methods: From March 1994 to March 2004, 53 cases treated for lateral discoid meniscus in 48 patients aged over 40 years with the mean age $48.4(40{\sim}62)$ who were followed up more than 1 year, were analyzed by physical findings, simple X-ray, MRI and arthroscopic exam. Results: Most of the cases (42 cases, 79.2%) had symptoms for less than 1 year duration. 26 cases(49.1 %) out of 53 had trauma history. Simple radiologic evaluation showed that lateral condylar abnormality such as the flattening of lateral femoral condyle, marginal osteophytes, and subchondral sclerosis was seen in 37cases(69.8%). Also medial condyle showed degenerative changes in 16 cases (30.2%). Tear of discoid meniscus in 45 cases(84.9%) were examined by arthroscope and tear was not detected in 8 cases(15.1%). Type of tear was complex(18 cases), longitudinal(12 cases), horizontal(11 cases) and transverse(4 cases). Concomitant medial meniscal rupture was found in 7 cases(13.2%). The simple procedure done was reshaping(46 cases), subtotal resection(5 cases), total resection(1 case) and meniscal repair after reshaping in 6 cases, and arthroplasty was performed after arthroscopic examination in 1 case. Conclusion: Onset of symptom in adult lateral discoid meniscus is usually traumatic in origin. Most cases showed radiologic abnormality such as degenerative change in lateral condyles as well as medial condyles and the results of preservative surgical treatment was the most preferred option in most patients.

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Arthroscopic Meniscectomy in Patients Aged Over 50 - More than 3 Years Follow-Up Result - (50세 이상 환자에서의 반월상 연골 절제술 - 최소 3년 이상 추시 결과 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Go, Sang-Hun;Jung, Kwang-Hwan;Cha, Jae-Ryong;Lee, Chae-Chil;Jeong, Ji-Young;Seo, Dong-Kyo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.107-111
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    • 2008
  • Purpose: To evaluate the clinical and radiographical results of arthroscopic meniscectomy in patients aged over 50 with minimum 3-year follow-up. Materials and Methods: Of the patients who had undergone arthroscopic meniscectomies between Dec. 1997 and Dec. 2003, 36 patients(36 knees) were available for retrospective evaluation. The average age at the time of surgery was 56.4 years and the mean follow-up period was 63 months. According to the Kellgren-Lawrence classification, grade I change were noted in 16 patients, II in 12, III in 6 and IV in 2. According to Outerbridge classification, grade I articular lesions were noted in 16 patients, II in 10, III in 7 and IV in 3. Postoperative Lysholm score, patient s subjective satisfaction and radiographic changes were evaluated retrospectively. Results: Twenty-four patients(66.7%) were good or excellent for the Lysholm score and 26 patients(72.2%) were satisfied at final follow-up. Tibiofemoral angle was changes from mean valgus 3.9 degrees to mean valgus 2.6 degrees and 22 patients(61.1%) showed the progression of osteoarthritic changes. Conclusion: The satisfactory results could be obtained in 72.2% of patients aged over 50 with a minimal follow-up of 3 years after arthroscopic meniscectomy. The results tended to be worse in patients with moderate or severe tibiofemoral osteoarthritic changes or with articular cartilage lesions.

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Double-bundle Anterior Cruciate Ligament Reconstruction using Autogenous Hamstring Grafts (이중 다발 자가 슬괵건을 이용한 전방십자인대 재건술)

  • Choi, Nam-Yong;Nam, Won-Sik;Yang, Young-Jun;Han, Chang-Hwan;Moon, Chan-Woong;Kwon, Jae-Young;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.112-117
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    • 2008
  • Purpose: Double-bundle reconstruction of anterior cruciate ligament(ACL) has the advantage of restoring the isometry and original function of ACL. The purpose of this study is to evaluate the clinical results following double-bundle reconstruction of ACL using autogenous hamstring grafts through an accessory anteromedial portal. Materials and Methods: From January 2005 to July 2006, sixty patients(52 males, 8 females) underwent double-bundle ACL reconstruction using autogenous hamstring tendons..The mean age was 31.7 years($20{\sim}51$ years). The mean follow up period was 13.4 months($12{\sim}16$ months). We made a horizontal-oblique skin incision just medial to tibial tuberosity and harvested semitendinosus and gracilis tendon. Tibial tunnel for posterolateral bundle was made near its anatomical position. By modifying an anatomic reconstruction of ACL by Yasuda et al., we made a femoral tunnel for posterolateral bundle through accessory anteromedial portal. Tunnels for anteromedial bundle were made with conventional method. We reconstructed anteromedial bundle with semitendinosus tendon and posterolateral bundle with gracilis tendon. Clinical results at last follow up were evaluated by range of motion, extent of anterior displacement(KT-1000 arthrometer), pivot-shift test. Functional evaluation of clinical outcomes were evaluated by Lysholm score and modified Feagin Scoring System. Results: There was no limitation of motion of knee joint at last follow up. Mean side to side difference of anterior displacement of tibia by KT-1000 arthrometer was improved from 8.4 mm preoperatively to 1.7 mm postoperatively(p<0.05). Average Lysholm score was improved from 64.1 preoperatively to 92.2 postoperatively(p<0.05). In modified Feagin Scoring System, 90% of cases were rated as good or excellent. Conclusion: Double-bundle reconstruction of ACL using autogenous hamstring grafts through accessory anteromedial portal results in good clinical outcomes.

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Seasonal Sedimentary Characteristics and Depositional Environments after the Construction of seawall on the Iwon Macrotidal Flat (방조제 건설 후 이원 대조차 조간대의 계절별 퇴적학적 특성 및 퇴적환경)

  • Kum, Byung-Cheol;Park, Eun-Young;Lee, Hi-Il;Oh, Jae-Kyung;Shin, Dong-Hyeok
    • Journal of the Korean earth science society
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    • v.25 no.7
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    • pp.615-628
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    • 2004
  • In order to elucidate seasonal sedimentary characteristics and depositional environment after construction of seawall on macrotidal flat, a seasonal observations of surface sediments (total 450) and sedimentation rates on 4 transects have been investigated for 2 years. The eastern area of Iwon tidal flat, has been changed from semi-closed coast to open coast by construction of seawall, shows general seasonal changes similar to characteristics of open coast type, which represented both fining and bad sorted distribution due to deposition of fine sediments under low energy condition in the summer, and relatively coarser and better sorted distribution because of erosion of fine sediments in the winter. In considering angles of transects, distribution patterns of surface sediments, the northern and southern parts of eastern tidal flat are dominantly influenced by wave and tidal effects, respectively. As time goes by, the eastern tidal flat shows coarsening-trend of surface sediments caused by direct effect of tidal current, were and typhoon. Meanwhile the western area of seawall, which has been re-formed by construction seawall, is sheltered from northwesterly seasonal wind. The seasonal change pattern of western area of seawall is slightly different from that of eastern tidal flat. Mean grain size and sorting of surface sediments during spring is finer and worse than those during summer. This seasonal change pattern maybe influenced by topographic effects caused from the construction of seawall. In consideration of all result, the transport of fine sediments in the study area, which is supplied to limited sediments, shows clockwise circulation pattern that fine sediments are transported from the eastern tidal flat to the western area of seawall because of blocking of seawall in the winter and are transported reversed direction the summer. As a result, many changes have been observed in the study area after construction of seawall; however, this change is still in progress and is expected to need continuous monitoring.

Effect of Massages on The Skeletal Muscles of Sciatic Nerve Neurectomized ddY Mice (마사지가 좌골신경 절단 마우스의 골격근에 미치는 영향)

  • Kim Chul-Yong;Kim Seong-Hak;Park sang-Ock;Bae Sung-Soo;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.15 no.2
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    • pp.19-51
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    • 2003
  • To demonstrate the effect of massages on the skeletal muscles of immobilization ddY mice models induced by right side sciatic nerve neurectomy, the cross sectional histological profiles of the muscularis (M) gastrocnemius, M. tibialis cranialis and M. tibialis caudalis were observed after 28 days of treatment of massages with the changes of body weight, thickness of hind limb and individual muscle weights. In addition, changes of serum aspartate amino- transferase (AST) and creatine phosphokinase (CK) levels were also demonstrated with diameter of individual muscle fiber and muscle fasciculata, and number of muscle fiber in each of three types of muscles located in the calf. The experimental groups were divided into five groups, 1) Sham-operated group (Sham), 2) Neurectomized but not massage control group (Control), 3) Neurectomized and massage at knee joint regions (T1), 4) Neurectomized and massage at calf regions (T2), and 5) Neurectomized and massages at achilles tendon regions (T3). The experimental animals were used 5 per groups. The results are as follow: 1. No significant changes of body weight were demonstrated in this groups during whole experimental periods compared to that of Sham group. In addition, no significant changes of body weight gains during experimental periods (Day 0 - Day 27: 28 days of treatment) were also observed. 2. The thickness of intact left side hind limb was not changes in all tested groups compared to that of Sham group. However, the thickness of right side hind limb were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of thickness of hind limb between right and left sides were also significantly increased in Control and massage groups (T1, T2 and T3) compared to that of Sham group. However, the thickness of right side of hind limb were significantly increased and the differences of thickness between both sides of hind limb were dramatically decreased in massage groups compared to that of Control group in followed order: T1 > T3 > T2. 3. Absolute and relative weight of M. gastrocnemius in the intact left side of hind limb was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. gastrocnemius were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. gastrocnemius between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. gastrocnemius were significantly increased and the differences of weight between both sides of M. gastrocnemius were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 >. 4. Absolute and relative weight of M. tibialis cranialis in the intact left side was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. tibialis cranialis were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. tibialis cranialis between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. tibialis cranialis were significantly increased and . the differences of weight between both sides of M. tibialis cranialis were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 > T2. 5. Absolute and relative weight of M. tibialis caudalis in the intact left side was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. tibialis caudalis were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. tibialis caudalis between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. tibialis caudalis were significantly increased and the differences of weight between both sides of M. tibialis caudalis were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 > T2. 6. A significant increase of serum AST levels were demonstrated in Control group. However, serum AST levels of massage groups were significantly decreased compared to that of Control group in followed order: T3 > T1 > T2. In case of 73 group, the values decreased into similar levels compared to that of Sham group. 7. A significant increase of serum CK levels were demonstrated in Control group. However, serum CK levels of massage groups were significantly decreased compared to that of Control group in followed order: T3 > T1 > T2.

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Sports Biomechanical Analysis of Physical Movements on the Basis of the Patterns of the Ready Poses (준비동작의 형태 변화에 따른 신체 움직임의 운동역학적 분석)

  • Lee, Joong-Sook
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.179-195
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    • 2002
  • The purpose of this research is to provide a proper model by analyzing the sports biomechanical of physical movements on the basis of the two patterns(open-stance and cross-stance) at the ready-to-start pose. The subjects for this study are composed of five male handball players from P university and five female shooting players from S university. Three-way moving actions at start(right, left, and forward) are recorded with two high-speed video cameras and measured with two Force platforms and a EMG system. Three-dimensional action analyzer, GRF system, and Whole body reaction movement system are used to figure out the moving mechanisms at the start pose. The analytic results of the moving mechanism at the start pose were as follows. 1. Through examining the three-way moving actions at start, I have found the cross-stance pose is better for the moving speed of body weight balance than the open-stance one. 175 degree of knee joint angle at "take-off" and 172 degree of hip joint angle were best for the start pose. 2. The Support time and GRF data shows that the quickest center of gravity shift was occurred when cross-stanced male subjects started to move toward his lefthand side. The quickest male's average supporting time of left and right foot is 0.19${\pm}$0.07 sec., 0.26${\pm}$0.06sec. respectively. The supporting time difference between two feet is 0.07sec. 3. Through analyzing GRF of moving actions at start pose, I have concluded that more than 1550N are overloaded on one foot at the open-stance start, and the overloaded force may cause physical injury. However, at the cross-stance pose, The GRF are properly dispersed on both feet, and maximum 1350N are loaded on one foot.

Kinematical Analysis of Woman Javelin Throwing (창던지기 동작의 kinematic적 특성분석)

  • Lee, Jong-Hoon
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.345-359
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    • 2002
  • The purpose of the study was to provide the fundamental data to instruct athletes through the analysis athletes' movement in javelin. Three athletes in the level of national representative were participated in this study. The study analyzed kinematic variables(lead foot and releasing javelin) through 3-D analysis and obtained the following results. 1. During withdrawal, it is important to maintain of running horizontal velocity. 2. It was showed that throng average height was $84{\pm}3.3%$ and javelin adequative degree, Among the athletes, $S_2$ who had the best record was released the javelin with the fast velocity, but throw the javelin with the less releasing velocity. 3. $S_2$ released after lead foot were completely landed and therefore it is no problem in a kinematic aspect. However, $S_1$ angle was too small. it caused increase of release velocity to be prevented. 4. $S_2$ showing the best result indicated shorter in duration time. Generally, the shorter duration time in release phase showed the longer release distance. Especially $S_1$ and $S_3$ showing the worse result indicated the longer duration time in preparatory phase, causing the breakup of force. Therefore to improve the record, it should be decreased the duration time in preparatory phase. 5. Compared with $S_1$ and $S_3$, $S_2$ showing the best record indicated the higher velocity in center of mass, trunk, upper arm, lower arm and hand That is the higher velocity of upper arm at release leaded the better velocity transfer from upper arm to following lower arm and hand, these action should be considered to be helpful of better record. According to the above conclusion, when the athletic leaders cauch athletes, they should focus on maintaining knee angle, upper body and hip angle in a previous stage of release and throwing angle, throwing height, throwing velocity in a release stage.

Biomechanics analysis by golf drive swing pattern (골프 드라이브 스윙시 구질 변화에 따른 운동학적 분석)

  • Choi, Sung-Jin;Park, Jong-Jin;Yang, Dong-Ho
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.259-278
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    • 2002
  • This study divided straight success, pade success and failure with 7male golfers who have experiences more than 3 years, analyzed kinematic factors of golf swing to suggest scientifically. The conclusions were follows. 1) The wrist angle has significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 2) The body twist angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 3) The shoulder joint rotation angle has no significant difference in success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 4) The left hip joint vertical angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 5) The hip joint rotation angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 6) The trunk angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 7 )The left knee joint angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. This study divided golf swing motion of pattern change in straight success, pade success and failure and analyzed the kinematic factors by 3-dimension cinematography to improve performance. In the future, many researchers have to study kinematic analysis to improve performance in every events.