• Title/Summary/Keyword: Knee instability

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Biceps Rerouting Technique(Modification of Clancy) for Posterolateral Rotatory Instability (대퇴이두건 전환술(Clancy 변형 술식)을 이용한 후외측 회전 불안정성의 재건)

  • Kim Sung-Jae;Shin Sang-Jin;Kim Jin-Yong;Rhee Dong-Joo
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.25-31
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    • 2000
  • Introduction : This study compared the clinical results with biceps rerouting fer the isolated posterolateral instability (PLI) and for the PLI combined with PCL injuries. Methods : 21 cases of isolated PLI (group I) and 25 cases of PLI combined with PCL rupture were included in the study. The PLI was reconstructed by modified biceps femoris rerouting technique with PCL reconstructions performed prior to the PLI correction in cases of combined injury The clinical results were reviewed and analyzed. Results : Pre-operatively positive reverse pivot shift test turned negative in 43 cases post-operatively. Increased preoperative external rotation thigh foot angle (ERTFA) showed significant differences between the two groups and all fell within normal limits post-operatively At a mean follow-up of 40.3 months, the average Lysholm knee score and. The Hospital for Special Surgery Knee Ligament Score for group I and group II revealed above 90 points without statistically significant difference between the groups. 3 cases of tenodesis failure developed and re-operation was performed. Discussion and Conclusion : The advantages of modified Clancy technique include reduced surgical damages to the iliotibial band and fixation of the biceps tendon at the isometric position. The modified biceps rerouting technique is recommended for the reconstruction of both isolated and combined PLI except in patients with severe damages at the attachment of biceps tendon.

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A Review of Patellofemoral Angle (슬개대퇴골각에 관한 고찰)

  • Bae, Sung-Soo;Kim, Ho-Bong;Lee, Sang-Yong;Kim, Eun-Young
    • The Journal of Korean Physical Therapy
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    • v.13 no.1
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    • pp.197-204
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    • 2001
  • Knee is a middle joint in lower extremity and has relationship with hip joint and ankle joint alignment. Therefore the knee joint alignment is very important in aspect of biomechanically. Knee joint alignment depend upon patellar stability. Instability of the patellofemoral articulation, in the form of patellar subluxation or dislocation may be associated with a number of factors. Normal range of patellofemoral angle is very different by the reporter and by the gender also.

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Analysis of Gait Parameters According to the Clinical Features of Parkinson's Disease Using 3-D Motion Analysis System with Electrogoniometer (3차원 전기측각 보행분석기를 이용한 파킨슨씨병 환자의 임상 양상에 따른 보행 분석)

  • Baek, Hye-Jin;Yoon, Joon-Shik;Kim, Sei-Joo;Lee, Gyu-Ho;Koh, Seong-Beom
    • Annals of Clinical Neurophysiology
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    • v.11 no.1
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    • pp.9-15
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    • 2009
  • Background: To investigate the differences of locomotor dynamics between Parkinson's disease (PD) patients with tremor dominant symptom and patients with postural instability dominant symptom. Methods: 66 subjects with PD were classified into two subgroups, tremor-dominant group and postural instability and gait disorder group by Unified Parkinson's disease rating scale (UPDRS). The spatial, temporal and electrodynamic gait parameters were recorded automatically using computerized 3-D motion analysis system with electrogoniometer. Results: There was no significant difference in cadence, pelvic tilt range, hip flexion range, knee flexion range and ankle dorsiflexion range. Postural instability and gait disorder group showed decreased gait velocity, short stride length, decreased range of motion in pelvic obliquity, pelvic rotation and ankle plantar flexion. Conclusions: There was meaningful difference in locomotor dynamics between Parkinson's disease(PD) patients with tremor dominant symptom and patients with postural instability dominant symptom.

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Plantar Hypoesthesia Alters Gait Kinematics Pattern in Individuals with and without Chronic Ankle Instability (만성 발목 불안정성 환자군과 정상인 군의 발바닥 감각기능 저하에 따른 운동학적 보행 패턴의 변화)

  • Kang, Tae Kyu;Lee, Sae Yong;Lee, Inje;Kim, Byong Hun;Jeong, Hee Seong;Kim, Chang Young
    • Korean Journal of Applied Biomechanics
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    • v.31 no.2
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    • pp.79-86
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    • 2021
  • Objective: The purpose of this study was to identify the effect of reduced plantar cutaneous sensation on gait kinematics during walking with and without CAI. Method: A total of 20 subjects involved in this study and ten healthy subjects and 10 CAI subjects participated underwent ice-immersion of the plantar aspect of the feet before walking test in this study. The gait kinematics were measured before and after ice-immersion. Results: We observed a before ice-immersion on plantar cutaneous sensation, CAI subject were found to reduced ankle dorsiflexion, knee external rotation, hip adduction, and internal rotation compared to control subject. After ice-immersion, CAI subjects were found to reduce knee external rotation, hip adduction. However, no significant ankle joint kinematics. Conclusion: While walking, gait pattern differences were perceived between groups with and without plantar cutaneous sensation. The results of the study may explain the abductions in the hip angle movements in CAI patients at initial contact compared to healthy subjects in the control group when plantar cutaneous sensation was reduced. A change in proximal joint kinematics may be a conservative strategy to promote normal gait patterns in CAI patients.

Recycling Total Joint Autotransplantation in Osteosarcoma around the Knee Joint (슬관절 주위 골육종에서 체외 방사선 조사를 이용한 재활용 전 자가 관절 이식술)

  • Chung, So-Hak;Cho, Yool;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.31-36
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    • 2007
  • Purpose: Recycling extracorporeal irradiated autograft is used as one of the reconstruction methods after limb salvage with malignant bone tumor. However, there were some problems such as joint instability, progressive arthritis, insufficient joint resection margin were found after intraarticular recycling autograft. Thus, we carried out a research in order to investigate the results of recycling total joint autotransplantation after extracorporeal irradiation that could resolve the problems. Materials and Methods: There were five cases of patients who were diagnosed as osteosarcom around the knee joint and underwent same operation from June 1997 to Feb 2006. All patients had been evaluated from 93 to 105 months (mean 100 months) and their mean age was 21.6. Results: The roentgenographic union of junctional sites began at 15.6 months (9~40 months) postoperatively. As regards to the orthopaedic functional results, we used the criteria of Ennecking et al. Overall mean functional result was 71.6%. Complication such as epiphyseal collapse (three cases) and joint instability (five cases) were noted respectively. In all the cases, tumor prosthesis was used to replace the knee joint. Conclusion: Because recycling total joint autotransplantation after extracorporeal irradiation does not prevent joint instability and progressive arthritis, tumor prosthesis is recommended in young adult.

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Minimal Ablation of the Tibial Stump Using Bony Landmarks Improved Stability and Synovial Coverage Following Double-Bundle Anterior Cruciate Ligament Reconstruction

  • Kodama, Yuya;Furumatsu, Takayuki;Hino, Tomohito;Kamatsuki, Yusuke;Ozaki, Toshifumi
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.348-355
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    • 2018
  • Purpose: To evaluate the clinical effects of using anatomical bony landmarks (Parsons' knob and the medial intercondylar ridge) and minimal ablation of the tibial footprint to improve knee anterior instability and synovial graft coverage after double-bundle anterior cruciate ligament reconstruction. Materials and Methods: We performed a retrospective comparison of outcomes between patients who underwent reconstruction with minimal ablation of the tibial footprint, using an anatomical tibial bony landmark technique, and those who underwent reconstruction with wide ablation of the tibial footprint. Differences between the two groups were evaluated using second-look arthroscopy, radiological assessment of the tunnel position, postoperative anterior knee joint laxity, and clinical outcomes. Results: Use of the anatomical reference and minimal ablation of the tibial footprint resulted in a more anterior positioning of the tibial tunnel, with greater synovial coverage of the graft postoperatively (p=0.01), and improved anterior stability of the knee on second-look arthroscopy. Both groups had comparable clinical outcomes. Conclusions: Use of anatomical tibial bony landmarks that resulted in a more anteromedial tibial tunnel position improved anterior knee laxity, and minimal ablation improved synovial coverage of the graft; however, it did not significantly improve subjective and functional short-term outcomes.

Intervention Strategy Applied ICF Checklists for Sitting Cross-Legged in Patient with Multiple Ligament Knee Injury: Single Subject Study

  • Kim, Chan Yang;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • v.33 no.3
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    • pp.168-177
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    • 2021
  • Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.

A Comparative of Knee Joint Instability and Muscle Activity Due to Medial or Lateral Deviation of Knee while Lunge Exercise

  • Sijin Lee;Byeong-Jo Min;Jin-A Park;Hyeong-Geun Kim;Doochul Shin
    • Physical Therapy Rehabilitation Science
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    • v.13 no.2
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    • pp.163-170
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    • 2024
  • Objective: The purpose of this study was to compare the muscle activity of the vastus lateralis, vastus medialis, rectus femoris, and gluteus medius muscles according to the medial/lateral bias of the knee during lunge exercise. Design: Crossed-control group study Methods: This study recruited 20 healthy men and women in their 20s who were capable of lunge exercise and had no musculoskeletal or neurological abnormalities. All three postures were performed three times each during lunge exercise. In each posture, surface electromyography (EMG) equipment was used to measure muscle activity of the vastus lateralis, vastus medialis, rectus femoris, and gluteus medius during lunge exercise. Results: As a result of comparing lower extremity muscle activity in normal, medial and lateral knee-deviation postures according to lunge exercise, the muscle activity of the vastus medialis was 107.09±13.90% in the normal posture, 79.24±5.26% in the medial- deviation posture and 125.73±14.30% in the lateral- deviation posture, which was a statistically significant difference (p<0.05). However, In the case of the vastus lateralis, rectus femoris and gluteus medius there was no statistically significant difference in muscle activity in the medial and lateral deviation positions(p>0.05). Conclusions: As a result, it was found that the muscle activity of the vastus medialis during lunge exercise significantly increased in the lateral deviation posture compared to the normal and medial deviation postures. In the case of the vastus lateralis, rectus femoris and gluteus medius there was no significant difference in muscle activity for medial and lateral knee deviation.

Proper Surgical Methods of Posterolateral Rotatory Instability of the Knee (슬관절 후외측 회전 불안정성의 적합한 수술적 방법)

  • Jung Young Bok;Lee Yong Seuk;Song Kwang Sup;Jin Ho Sun;Lee Jong Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.49-55
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    • 2004
  • Purpose: we would like to suggest the proper surgical methods according to the severity of instability by analyzing the results. Materials and Methods: Between January 1998 and August 2002, eighty five patients have been operated on because of posterolateral rotatory instability (PLRI). The materials were included the patients who had followed-ups for over 2 years in sixty one patients and the patient's assessments were done by clinical score (OAK, IKDC) and posterolateral drawer and dial test. Results: Through our results, the fibular tunnel turned out to be superior compared to the tibia tunnel method in rotational stability. Hughston-Jacobson methods and biceps tenodesis showed poor results. Fibula head tunnel was superior to tibia tunnel in rotational stabiliaty Conclusion: The surgical technique that passes the modified posterolateral corner sling through the fibula head tunnel may provide good clinical results in grade II PLRI. It is necessary to reconstruct both tibia and fibula tunnel in grade III PLRI. When there is combined varus instability, a positive result may be obtained if an additional LCL reconstruction is performed.

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