• PNF and Movement
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• 제6권1호
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• pp.53-60
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• 2008

Purpose : To describes the important aspects of knee joint movement and function used when applying PNF technique to the lower limb. Method : The knee was a very important roles in the lower limb movement and ambulation. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The tibiofemoral joint is usually described as a modified hinge joint with flexion-extension and axial rotation by two degrees of freedom movement. These arthrokinematics are a result of the geometry of the joints and the tension produced in the ligamentous structures. The patellofemoral joint is a sellar joint between the patella and the femur. Stability of the patellofemoral joint is dependent on the passive and dynamic restraints around the knee. In a normal knee the ligaments are inelastic and maintain a constant length as the knee flexes and extends, helping to control rolling, gliding and translation of the joint motions. Conclusions : It is important to remember that small alterations in joint alignment can result in significant alterations in patellofemoral joint stresses and that changes in the mechanics of the patellofemoral joint can also result in changes in the tibiofemoral compartments. Successful treatment requires the physical therapist to understand and apply these arthrokinematic concepts. When applied to PNF low extremity patterns, understanding of these mechanical concepts can maximize patient function while minimizing the risk for further symptoms or injury.

• 대한관절경학회지
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• 제13권2호
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• pp.161-164
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• 2009

외상성 슬관절 탈구 중 도수 정복되지 않는 경우는 매우 드물며 대개는 관혈적 정복술을 요한다. 본 증례는 도수 정복되지않는 슬관절 탈구에 대한 관절경적 치료 경험으로 자기공명 영상에서 정복을 방해하는 내측 인대 및 관절낭 구조물을 관찰하고 관절경 검사로 확인한 후 대퇴골 내측와가 완전히 관찰되고 관절이 정복 될 때까지 끼어있는 조직을 제거하였으며 인대 봉합이나 재건술은 시행하지 않았다. 술 후 약 4주간의 신전상태에서 고정 후 점진적인 관절운동 및 체중부하 보행을 허용하였다. 3년 추시 관찰에서 경도의 슬관절 불안정성은 있었으나 일상생활에 지장 없었으며 정상범위의 관절운동범위를 회복하였다.

• Journal of Acupuncture Research
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• 제39권1호
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• pp.59-63
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• 2022

Spontaneous osteonecrosis of the knee (SONK) is a common form of osteonecrosis of the knee and mainly affects the medial condyle due to localized vascular insufficiency. We report a case of SONK in a 65-year-old woman who had severe knee pain in her left knee whichimpeded her capacityto walk beyond 10 minutes. Bilateral knee X-rays revealed degenerative osteoarthritis of both knees and magnetic resonance imaging revealed R/O SONK in the lateral aspect of the medial femoral condyle, as well as a medial meniscal posterior horn root tear, and a Grade 1 medial collateral ligament injury. She was hospitalized at Jaseng Hospital of Korean Medicine for 21 days and receivedcombination therapy includingacupuncture, pharmacopuncture, and herbal medicine. Patient-reported scales indicated that her pain and physical functional limitations were alleviated. Combination therapy consisting of Korean traditional medicine may bean alternative nonoperative treatment approach for patients with SONK.

• Safety and Health at Work
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• 제11권4호
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• pp.485-490
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• 2020

Background: Meniscal tears are among the major risk factors for knee osteoarthritis progression. This study aimed to investigate the relationship between meniscal tears and work-related factors in the farming occupation. Methods: The participants included 486 farmers (238 men and 248 women), aged 40-69 years, who were among the 550 farmers registered in the Korea Farmer's Knee Cohort (KFKC). Data such as those on gender, age, body mass index (BMI), mechanical axis, cumulative heavy-lifting working time (CLWT), cumulative squatting working time (CSWT), and previous knee injury history were collected from the questionnaire, along with whole leg radiographic findings. Two radiologists assessed the magnetic resonance images of both knees to confirm the presence of meniscal tears. The factors related to meniscal tears were analyzed by multiple logistic regression. Results: A total of 54.5% of the farmers (48.7% of men and 60.1% of women) had meniscal tears. These tears were associated with gender, age, and BMI. We also identified an association between meniscal tears and CSWT, an especially important factor in farming [10,000-19,999 working hours, odds ratio = 2.16, 95% confidence interval (CI): 1.14-4.07, ≥20,000 working hours, odds ratio = 2.35, 1.45-3.80]. However, mechanical axis, knee injury history, and CLWT were not significantly related to meniscal tears. Conclusion: This study's findings show that squatting for long periods, as an occupational factor, is related to meniscal tears.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.369-375
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• 2023

Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm², and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm², and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.

• 한국소음진동공학회:학술대회논문집
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• 한국소음진동공학회 2002년도 추계학술대회논문집
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• pp.446-452
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• 2002

This paper Presents a 3-D design and a Vibration control of a new walking R.G.O.(Robotic Gait Orthosis) and would like to develop a simulation by this walking system. The vibration control and evaluation of the new knee joint mechanism on the biped walking R.G.O.(Robotic Gait Orthosis) was a very unique system and was to obtain by the 3-axis accelerometer with a low frequency vibration for the paraplegia It will be expect that the spinal cord injury patients are able to recover effectively by a biped walking R.G.O.. The new knee joint system of both legs were adopted with a good kinematic characteristics. It was designed attached a DC-srevo motor and controller, with a human wear type. It was able to accomodate itself to a environments of S.C.I. Patients. It will be expect that the spinal cord injury patients are able to recover effectively by a new walking R.G.O. system.

• 대한약침학회지
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• 제17권4호
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• pp.50-54
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• 2014

Objectives: Digital infrared thermographic imaging (DITI) has been used widely for various inflammatory diseases, circulatory diseases, skin diseases, musculoskeletal diseases and cancers. In cases of ligament injury, obviously the temperature of the damaged area increases due to local inflammation; however, whether the temperature also increases due to DITI has not been determined. The purpose of the present study was to identify whether or not the changes of temperature in patient's with medial collateral ligament injury were really due to infrared thermography and to determine the applicability of DITI for assessing ligament injuries. Methods: Twenty patient's who underwent DITI for a medial collateral ligament injury from September 2012 to June 2014 were included in the current study. The thermographic images from the patient's knees were divided to cover seven sub-areas: the middle of the patella, and the inferomedial, the inferolateral, the superomedial, the superolateral, the medial, and the lateral regions of patella. The temperatures of the seven regions were measured, and the temperature differences between affected and unaffected regions were analyzed by using the Wilcoxon signed rank test. Results: The 20 patient's were composed of 14 women (70%) and 6 men (30%), with a mean age of $62.15{\pm}15.71$ (mean${\pm}$standard deviation (SD)) years. The temperature of the affected side, which included the middle of the patella, and the inferomedial, the superomedial, the superolateral, and the medial regions, showed a significant increase compared to that of the unaffected side (P < 0.05). The inferolateral and the lateral regions showed no significant changes. Conclusion: Our study results suggest that DITI can show temperature changes if a patient has a ligament injury and that it can be applied in the evaluation of a medial collateral ligament injury.

• 한국운동역학회지
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• 제26권4호
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• pp.433-441
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• 2016

Objective: The purpose of this study was to understand the injury mechanism and to provide quantitative data to use in prevention or posture correction training by conducting kinematic and kinetic analyses of risk factors of lower extremity joint injury depending on the change of direction at different angles after a landing motion. Method: This study included 11 men in their twenties (age: $24.6{\pm}1.7years$, height: $176.6{\pm}4.4cm$, weight: $71.3{\pm}8.0kg$) who were right-leg dominant. By using seven infrared cameras (Oqus 300, Qualisys, Sweden), one force platform (AMTI, USA), and an accelerometer (Noraxon, USA), single-leg drop landing was performed at a height of 30 cm. The joint range of motion (ROM) of the lower extremity, peak joint moment, peak joint power, peak vertical ground reaction force (GRF), and peak vertical acceleration were measured. For statistical analysis, one-way repeated-measures analysis of variance was conducted at a significance level of ${\alpha}$ <.05. Results: Ankle and knee joint ROM in the sagittal plane significantly differed, respectively (F = 3.145, p = .024; F = 14.183, p = .000), depending on the change of direction. However, no significant differences were observed in the ROM of ankle and knee joint in the transverse plane. Significant differences in peak joint moment were also observed but no statistically significant differences were found in negative joint power between the conditions. Peak vertical GRF was high in landing (LAD) and after landing, left $45^{\circ}$ cutting (LLC), with a significant difference (F = 9.363, p = .000). The peak vertical acceleration was relatively high in LAD and LLC compared with other conditions, but the difference was not significant. Conclusion: We conclude that moving in the left direction may expose athletes to greater injury risk in terms of joint kinetics than moving in the right direction. However, further investigation of joint injury mechanisms in sports would be required to confirm these findings.

• 대한관절경학회지
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• 제1권1호
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• pp.26-30
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• 1997

Recently, the incidence of anterior cruciate ligament injury is rapidly increasing because many young Korean are actively participating in sports activities including basketball, skiing and soccer. Sometimes acute ACL injuries arc misdiagnosed as sprain because of pain and muscle spasm. An accurate physical examination and careful history taking are very important to diagnose the ACL injuries. Therefore author described the skill of history taking and the technique of physical examination to diagnose ACL injuries. The most sensitive test is the Lachman's test, which is performed with the knee in 200 of flexion, the femur stabilized with full flexed examiner's knee placed behind patient's distal thigh and one hand of examiner, and the proximal tibia grasped with the other. The pivot shift test is a passive motion test that attempts to subluxate the tibia anteriorly, then have it reduce rapidly. The pivot shift test is very sensitive test to diagnose the chronic ACL injuries.

• 대한관절경학회지
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• 제1권1호
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• pp.20-25
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• 1997

In the present paper the current clinical knowledge about proprioception is given for the shoulder, knee, ankle, elbow and the radiocarpal joint. Proprioceptive capabilities are decreased after knee joint injury such as anterior cruciate ligament. Joint position sense is significantly improved by cruciate reconstruction. Thus, we review of the articles for the proprioception of the anterior cruciate ligament of the knee joint. The present information on proprioception will influence our clinical practice in the future. We should choose surgical procedures that not only reconstruct the anatomy, but also the neurophysiologic feed-back mechanism.