• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.406-413
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• 2021

Objective: The purpose of this study was to investigate effects of taping technique applied to knee instability. Design: Cross sectional study. Methods: Twenty-six participants with knee instabilityparticipated in this study. They were randomly assigned to the Kinesio taping (KT) group (n=13) and the dynamic taping (DT) group (n=13). Both groups applied knee stabilization taping techniques. In order to compare the effects of each taping technique, the change in the landing error scoring system (LESS) and lower extremity joint angle wasrecorded before and after the intervention. Results: Both groups significantly decreased in the change before and after the LESS (p<0.05). At the joint angle of the lower extremities, KT group significantly reduced the valgus angle at the max knee flexion (p<0.05). In DT group knee joint flexion and hip joint flexion angles were significantly increased at foot contact (p<0.05). In max knee flexion, the knee joint flexion angle was significantly increased (p<0.05). In foot contact, max knee flexion, the knee joint valgus angle was significantly increased (p<0.05). DT group showed more significant changes in knee joint flexion angle at foot contact and hip joint flexion angle at max knee flexion. Conclusions: Dynamic taping is a clinically applicable intervention method for lowering the risk of non-contact injury in participants with knee instability and for knee stability during rehabilitation exercises.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.77-85
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• 2021

BACKGROUND: This study aimed to determine the changes in muscle strength and walking ability in patients who complained of knee instability due to excessive pronation of the foot. METHODS: Twenty patients (ten men and ten women) who complained of instability of the knee joint due to excessive pronation of the foot participated in the experiment. In the experimental group, the internal rotation of the tibia caused by excessive adduction of the foot was maintained as external rotation, and the joint state was to recognize the movement of the joint position changed through maintenance of the muscle. This exercise was performed five times for each patient, and the muscle strength maintenance was performed for 20 seconds. In the control group, stretching and range of motion (ROM) exercises were performed. For the stretching exercise, one specific motion was performed for 20 second, and the ROM exercise was performed to confirm the change in muscle strength in the knee joint area and walking ability. RESULTS: The knee flexion and extension strength in the patients with excessive pronation of the foot differed significantly from those in the subjects from the control group (p<.05). Further, the before-after comparison of the step time and length in the evaluation of walking ability, which affects overall postural movement due to knee joint instability, revealed a significant difference between the experimental and control groups (p<.05). CONCLUSION: The patients that were subjected to manual therapy and ROM exercise for the knee joint showed improved knee joint muscle strength and walking ability compared to the subjects from the control group.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.136-141
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• 2003

Posterolateral instability of the knee is known as one of the most challenging injuries . Although several procedures have been designed for the posterolateral instability, there is no gold standard management yet. We present a technique for posterolateral instability of the knee using tibialis posterior tendon allograft, which reconstructed lateral collateral ligament and popliteal tendon.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.88-94
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• 2013

Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

• Korean Journal of Applied Biomechanics
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• v.32 no.1
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• pp.9-16
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• 2022

Objective: The purpose of this study was to investigate how the chronic ankle instability affects postural control during forward jump landing. Method: 20 women with chronic ankle instability (age: 21.7 ± 1.6 yrs, height: 162.1 ± 3.7 cm, weight: 52.2 ± 5.8 kg) and 20 healthy adult women (age: 21.8 ± 1.6 yrs, height: 161.9 ± 4.4 cm, weight: 52.9 ± 7.2 kg) participated in this study. For the forward jump participants were instructed to stand on two legs at a distance of 40% of their body height from the center of force plate. Participants were jump forward over a 15 cm hurdle to the force plate and land on their non-dominant or affected leg. Kinetic and kinematic data were obtained using 8 motion capture cameras and 1 force plates and joint angle, vertical ground reaction force and center of pressure. All statistical analyses were using SPSS 25.0 program. The differences in variables between the two groups were compared through an independent sample t-test, and the significance level was to p < .05. Results: In the hip and knee joint angle, the CAI group showed a smaller flexion angle than the control group, and the knee joint valgus angle was significantly larger. In the case of ankle joint, the CAI group showed a large inversion angle at all events. In the kinetic variables, the vGRF was significantly greater in the CAI group than control group at IC and mGRF. In COP Y, the CAI group showed a lateral shifted center of pressure. Conclusion: Our results indicated that chronic ankle instability decreases the flexion angle of the hip and knee joint, increases the valgus angle of the knee joint, and increases the inversion angle of the ankle joint during landing. In addition, an increase in the maximum vertical ground reaction force and a lateral shifted center of pressure were observed. This suggests that chronic ankle instability increases the risk of non-contact knee injury as well as the risk of lateral ankle sprain during forward jump landing.

• Journal of Korean Physical Therapy Science
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• v.9 no.3
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• pp.161-170
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• 2002

knee injuries are among the most common problems confronting patients, physical therapist and physicians. since the bony structure provides little stability, the soft tissues are required to withstand high forces, often resulting in tissue overload and injury immobilization of the knee in the presence of a hemarthrosis usually leads to proliferation of intraarticular connective tissue adhesions and pint fibrosis. the physical basis of treating scar tissue is early controlled motion. the management of the knee with increased instability is to strengthening the muscles to properly treat an soft tissue injuries, physical therapist should know about the anatomic structures and biomechanical function of the knee joint, in this review article, we discuss the physiologic properties of soft tissue, biomechanical observation in fibrous connective tissue, managing soft tissue contractures, principles in treating scar tissue and treatment of the knee with increased instability.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.127-136
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• 2003

Posterolateral instability of the knee occurs more commonly in association with an injury to anterior and posterior cruciate ligament and combined injuries are severe injuries that result in significant functional instability and articular cartilage degeneration. Reconstruction of the anterior and posterior cruciate ligament without an appropriate treatment of posterolateral corner injury result in failure of the reconstructed cruciate ligaments. Meticulous physical examinations, imaging studies, lower limb alignment and gait pattern should be evaluated. Acute grade III isolated or combined injury of the posterolateral corner is best treated within three weeks by direct repair, or augumentation, or reconstruction. The appropriate surgical method or combined methods are selected among the several methods of posterior and posterolateal reconstruction, and all injuried posterolateral and cruciate ligament structures are anatomically reconstructed simultaneously or by stages. If a varus alignment and varus thrust is disclosed in chronic posterolateral instability of knee, soft tissue reconstructions laterally are highly unlikely to be able to correct tile problem. It is appropriate that valgus osteotomy should be done before soft tissue reconstruction and reevaluate the posterolateral instability about 6 months later.

• Journal of Biomedical Engineering Research
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• v.33 no.2
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• pp.78-88
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• 2012

Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.112-118
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• 2014

Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.98-102
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• 2004

Purpose: The purpose of this study was to make a report on the clinical prognosis of post traumatic lateral and posterolateral instability of the knee after LCL augmentation and popliteal tenodesis. Materials and Methods: The assessment was made among 21 cases who underwent augmentation of lateral collateral ligament(LCL) and popliteal tenodesis with allograft or artificial ligament (synthetic polyester, ABC ligament, Surgicraft, U.K.) at this Medical Center during the period from July 1996 to July 2003 and whose follow-up period was longer than one year. The authors recorded and analysed the physical findings (external rotation recurvatum test & posterolateral drawer test), stress roentgenograms(preoperative and postoperative) and Lysholm score. Results: The lateral and posterolateral instability of the knee were improved in 20 cases postoperatively, acccording to the clinical test and stress roentgenograms . Average Lysholm score was 52.5 preoperatively and 86.7 postoperatively .Conclusion: Our study found the surgery of lateral and posterolateral instability of the knee with augmentation of LCL and popliteal tenodesis using allograft or artiflcial ligament is simple technique. Taking these results into consideration, it seems to be one of effective methods of treatment.