• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.196-200
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• 2003

Purpose : To evaluate clinical outcomes after anterior cruciate ligament (ACL) reconstruction in middle-aged patients and determine the factors affecting the outcome. Subjects and Methods : Clinical results obtained from 60 cases (60 patients) older than 40 years of age at the time of surgery and 58 cases (58 patients) younger than 40 years of age who underwent ACL reconstruction between August 1988 to January 2002, return to sports activity, and stress radiographs using Telos instrument were compared. Results : The Lysholm knee score was improved from the preoperative score of 54.0 points to the postoperative score of 92.9 in patients older than 40 years of age and was improved from 56.2 points to 92.2 points in patients younger than 40 years of age. Clinical outcome was excellent in 51 cases $(85\%)$ and good in 9 cases $(15\%)$ in patients olde. than 40 years of age and was excellent in 47 cases $(81.0\%)$ and good in 11 cases $(19.0\%)$ in patients younger than 40 years of age. There was a significant difference in the rate of returning to preoperative sports activity between patients older than 40 years of age ($60\%$, 36 cases) and younger than 40 years ($82.8\%$, 48 cases). According to Telos stress radiography, the preoperative difference of 11.2 mm was decreased to the postoperative difference of 3.1 mm in patients older than 40 years of age and the preoperative difference of 10.7 mm was decreased to the postoperative difference of 2.9 mm in patients younger than 40 years of age. Clinical outcome did not show significant correlation with age, gender, surgery method, the presence of additional injury, and the rate of return to sports activity before receiving injury (p>0.05). Conclusion : Age didn't have a significant influence on the final outcome of ACL reconstruction and good results could be obtained with ACL reconstruction even in middle-aged patients.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.107-113
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• 2012

Purpose: The purpose of this study was to evaluate the posterior cruciate ligament (PCL) reconstruction with single bundle, single-incision technique using Achilles tendon and tibialis anterior allograft with ligament remnant preservation. Materials and Methods: Twenty six patients underwent PCL reconstruction was included. There were 21 males and 5 females. Mean age was 32 years. Used graft was a fresh frozen Achilles tendon allograft (group I, 14 cases) and tibialis anterior allograft (group II, 12 cases). Arthroscopic PCL reconstruction was performed using transtibial, single-incision and single bundle technique with remnant preserving as possible. For clinical evaluation, range of motion, posterior drawer test, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and posterior stress radiograph were used. The mean follow-up period was 21.6 months (12-40 months). Associated injuries were 5 medial collateral ligament injuries, which were treated by conservative method. Results: Range of motion (ROM) was returned to normal range in 24 cases, but ROM deficit under $10^{\circ}$ flexion was 2 cases at final follow-up period. Preoperative posterior drawer test was 17 cases in grade II and 9 cases in grade III. At final follow-up 13 cases returned within normal grade, 7 cases grade I and 6 cases grade II posterior instability. Lysholm mean score was improved from preoperatively 62 to 90 at final follow-up period. Tegner activity mean scale improved from preoperatively 3.5 to 5.6 at final follow-up period. IDKC grade was grade A was 3 cases, grade B 17 cases, grade C 6 cases. In posterior stress radiograph, posterior displacement was improved from mean 12 mm preoperative to 4.5 mm at final follow-up. There were no statistical differences between two groups in clinical evaluations. There were two cases of re-rupture of graft at the bone-tendon junction in group I. Conclusion: We had successful results of PCL reconstruction with single-incision, single bundle technique using Achilles and tibialis anterior allograft without difference between two groups in patients with PCL injury. There were more re-rupture of graft in Achilles tendon group.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.97-104
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• 2000

Purpose : The majority of PCL deficient knees have some intact remnant PCL bundles. In these cases, the remnant PCL bundles were removed fur easy passage of graft(especially in bone-patellar tendon-bone graft). The purpose of study is to report the results of PCL reconstruction by posterior transseptal portal technique and by preserving the remnant posterior cruciate ligament bundles. Materials & Methods : From November 1993 to June 1999, 44 arthroscopic posterior cruciate ligament reconstructions have been performed by one surgeon. We studied 37 knees those were followed up over 1 year among them. The mean age($14\~56$ years) was 31.8 years. The average follow-up period was 17.8 months($12\~61$ months). The graft materials were 29 double-loop hamstring autografts, 4 double-loop hamstring allografts and 4 Achilles tendon-bone allograft. Results : There are significant improvement of the preoperative subjective symptoms. The last follow-up shows that the average Lysholm knee score was markedly improved from 59.8 pre-operation to 89.2 post-operation and the average KT 2000 side difference was decreased from 11.1mm pre-operation to 2.3 mm post-operation. Follow-up MRI showed that the graft was healed with remnant posterior cruciate ligament bundles as one ligament. Conclusion : The posterior trans-septal portal makes it possible to locate the exact tibial tunnel. The arthroscopic PCL reconstruction preserving the remnant of original PCL bundles seems to provide the good result.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.118-122
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• 2006

Purpose: We introduce a technique of all inside arthroscopic capsular imbrication and lateral release used to treat patellofemoral instability. Methods: With the arthroscope in the anteromedial portal for best viewing, the arthroscopic scissor is placed through superolateral portal for proximal to distal release. The release performed 5mm to 1cm from the edge of the patella. After completion of the procedure, with the arthroscope in anterolateral portal, we inserted 5mm cannula in superolateral portal and made working portal from superomedial portal. Medial reefing was performed with all inside technique by using curved needle of the spectrum suturing system and No. 1 monofilament PDS suture is passed through the superomedial portal percutaneously and retrieved through a superolateral portal. Conclusion: Several methods for arthroscopic patella realignment have been proposed, but they have consisted primarily of arthroscopically assisted techniques using a medial incision. We believe that our procedure is preferable to arthroscopically assisted methods commonly used, in that an incision is avoided and the vastus medialis obliqqus is not violated. Our technique is minimally invasive and is easy to control the tightness of the medial patellofemoral ligament (MPFL) under direct vision.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.26-32
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• 2006

Purpose: We evaluated the result of the degree of reduction and anterior instability after arthroscopic treatment of tibial spine fractures. Materials and Methods: Thirty-two cases of tibial spine fractures treated with arthroscopic procedure could be evaluated and the mean follow-up period was $18\;(12{\sim}48)$ months. Evaluations included Lachman test, rotatory instability examination and side to side difference (SSD) using KT-2000 arthrometer. The degree of radiologic reduction was classified as accurate reduction, anterior elevation and reduction failure, according to which the degree of anterior instability was measured. Results: There were twenty three cases (71%) of accurate duction, eight cases (25%) of anterior elevation and one case (4%) of education failure. Eight (29%) of twenty eight cases with pull-out method showed anterior elevation. The SSDs of the accurate reduction and the anterior elevation group were 2.0 mm and 2.8 mm, respectively showing no significant difference. However, the percent age of grade 0 Lachman test and SSD less than 3 mm of the accurate reduction group were significantly higher. Conclusion: Accurate reduction is important in reducing anterior instability especially in unstable fractures. Therefore, arthroscopic pull-out method should be performed with great caution to avoid anterior elevation of the fracture fragment.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.36 no.3
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• pp.351-361
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• 2012

The leading surgical method for correcting the misalignment of the varus and valgus in the knee joint is the high tibial osteotomy (HTO). In the opening wedge HTO (OWHTO), there is no concern about damaging the peroneal nerve on the lateral tibia of the proximal fibula. OWHTO has been the preferred choice, as the opening of the correction angle can be modulated during the operation. The correction of the varus and valgus on the coronal plane are performed adroitly. Nevertheless, there have been numerous reports of unintended changes in the medial tibial plateau and posterior slope angle (PSA). The authors have developed an HTO method using computer-assisted surgery with the aim of addressing the abovementioned problems from an engineer's perspective. CT images of the high tibia were reconstructed three-dimensionally, and a virtual osteotomy was performed on a computer. In addition, this study recommends a surgical method that does not cause changes in the PSA after OWHTO. The results of the study are expected to suggest a clear relationship between the anteromedial cortex oblique angle of each patient and the PSA, and an optimal PSA selection method for individuals.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.91-97
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• 1995

Synovial sarcoma is a malignant soft tissue tumor which is the most prevalent in adolescents and young adults between 10 and 40 years of age. It occurs primarily in the para-articular regions, usually in close association with tendon sheath, bursae and joint capsules. Favorable clinical factors are young age of the patients, tumor size smaller than 5cm, and distal rather than proximal location in the extremities. We analysed clinical findings of 13 cases of synovial sarcoma that had been experienced from January 1983 to December 1992. There were 8 females and 5 males, whose age was averaged as 28 years and 10 months ranging from 6 years to 54 years. The mean follow-up was 3 years(range : 9 months- 9 years 1 month). Palpable mass was frequent clinical symptom and lower extremity especially around the knee was the most prevalent site. Treatment modalities were the combination of surgery, radiotherapy and chemotherapy. Distant metastasis occured in 5(38%) cases : 4 cases to lung and 1 case to neck, and 2 cases had local recurrences. At final follow-up 6 cases were continous disease free, 2 alive with disease and 5 died of disease. The Kaplan-Meier's estimated 5 year survival rate of total 13 cases was 66% and satisfactory results were obtained with mass size smaller than 5cm.

• The Korean Journal of Physiology and Pharmacology
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• v.22 no.2
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• pp.163-172
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• 2018

PRF001 is a fragmented DNA polymer extracted from the testes of salmon. The purpose of this study was to assess the anti-inflammatory effect of PRF001 in vitro as well as the protective effect of PRF001 intake against arthritis in a rat model. In vitro, cell survival and inflammatory markers after $H_2O_2$ treatment to induce cell damage were investigated in CHON-001 cells treated with different concentrations of PRF001. In vivo, osteoarthritis was induced by intra-articular injection of monosodium iodoacetate (MIA) into the knee joints of rats. After consumption of PRF001 (10, 50, or 100 mg/kg) for 4 weeks, inflammatory mediators and cytokines in articular cartilage were investigated. In vitro, the levels of inflammatory markers, $IL-1{\beta}$, $TNF-{\alpha}$, COX-2, iNOS, and PGE2, were significantly suppressed by PRF001 treatment. In vivo, the inflammatory mediators and cytokines, $IL-1{\beta}$, p-Erk1/2, $NF-{\kappa}B$, $TNF-{\alpha}$, COX-2, and PGE2, as well as MMP3 and MMP7, which have catabolic activity in chondrocytes, were decreased in the MIA-induced osteoarthritic rats following intake of PRF001. Histological analysis revealed that PRF001 had a protective effect on the articular cartilage. Altogether, these results demonstrated that the anti-inflammatory property of PRF001 contributes to its protective effects in osteoarthritis through deregulating $IL-1{\beta}$, $TNF-{\alpha}$, and subsequent signals, such as p-Erk1/2, $NF-{\kappa}B$, COX-2, PGE2, and MMPs.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.32-39
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• 2008

Purpose: To evaluate the effectiveness of MRI after ACL reconstruction with femoral tunnel at 10 o'clock position. Materials and Methods: MRI findings of 29 patients after ACL reconstruction using hamstring tendon autograft were evaluated. The mean period from operation to MRI was 18.9 months($7{\sim}40$ months). Signal intensity, morphology and continuity of graft, femoral insertion, graft angle, roof impingement, cross pin breakage and position were evaluated. Those findings were compared with KT-2000, Lysholm knee score and pivot shift test. Results: There was no significant correlation between signal intensity of graft and the duration to MRI. Most common pattern of the morphology was straight, and the continuity was well-preserved. 13 cases of femoral tunnel insertion were zone 4 and 16 were zone 3. There were no roof impingement. 10 cases showed cross pin breakages, of which 5 were found at the outside of distal femoral posterior cortex. 9 showed cross pin directed posteriorly in axial view. There was no significant correlation between clinical results and cross pin breakage. Conclusion: MRI examinations after ACL reconstructions are useful to evaluate the graft status, position of the graft and cross pins. Since the direction of the cross pin is important especially in 10 o'clock femoral position, care should be taken to avoid cross pin breakage.

• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.32-37
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• 2018

Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was $70.0{\pm}9.6years$. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.