• The Journal of Korean Physical Therapy
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• v.35 no.3
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• pp.83-88
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• 2023

Purpose: This study was to investigate the effect of forward head posture (FHP) and round shoulder posture (RSP) on changes in muscle activities according to shoulder flexion and abduction tasks. Methods: Twenty-two male subjects with no history of neurological, musculoskeletal surgery or injuries, or pain in the spine region within the previous 3-month periods were recruited for this study. Craniovertebral angle (CVA) and Scapula Index were measured before performing 90° abduction and flexion tasks holding a 3kg dumbbell. Muscle activities were measured during the tasks. All measurements except height of the acromion were carried out in a sitting position at the height of the subject's knee angle of 90 degrees, and two tasks were randomly performed with the arm that the subject mainly use to throw the ball. The abduction and flexion angles were checked by the examiner using a goniometer beside the subject. Results: Correlation coefficient analysis between Scapular Index and upper trapezius muscle activity during shoulder abduction task showed significant positive correlation. No significant correlation was observed between CVA, Scapular Index, and other muscle activities. Conclusion: FHP showed increased muscle activation, making it difficult to change muscle activity under lower loads, and RSP was correlated with UT activation in shoulder abduction. Therefore, in the RSP, the loaded shoulder abduction is considered a potential risk factor for increasing shoulder muscle tension. This paper proposes an approach to treating RSP before FHP.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.674-687
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• 2022

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.1
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• pp.33-36
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• 2008

Purpose: The purpose of this study was to evaluate the mechanism of injury in the anterior cruciate ligament tears sustained in participation in soccer. Materials and methods: 50 patients whose knees were injured during playing soccer were enrolled in this study. The mean age was 27 years old, 47 were male and 3 female. 15 of them were either professional or amateur soccer players, the rest were non-professional. The injury mechanism was investigated by evaluation of the medical records or by telephone interview. Results: The injury mechanism involved contact injuries in 17 patients and non-contact in 33. 41 patients were bearing weight on the involved side at the time of injury, and 9 patients were not. In cases of contact injury, 9 of the 17 patients had sustained a valgus force to the knee, and 5 patients had varus force, 11 patients had their foot planted, and 6 did not. Among those patients with a planted foot, 3 patients were injured by the rotation of the thigh, 1 patient was injured by hyperextension, and there were no deceleration mechanism injuries. In non-contact injuries, 30 out of 33 patients had their foot planted at time of injury and only 3 patients did not. Of these 30 patients, 16 were injured by the rotation of thigh, 6 sustained a varus force on the knee joint and 5 had a valgus force, 5 were injured by hyperextension, and 2 by deceleration. 3 patients, who did not have their foot planted, were injured while kicking with the involved leg. Conclusions: For soccer players in this series, the most common mechanisms resulting in anterior cruciate ligament tears were non-contact, most often by rotation of the torso over a planted foot. In contact injuries, the most common mechanism was the application of valgus force by tackle.

• 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.

• Investigative Magnetic Resonance Imaging
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• v.11 no.1
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• pp.27-32
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• 2007

Purpose : To evaluate the mucoid degeneration (MD) of the anterior cruciate ligament (ACL) of the knee by correlation of MRI findings with pathology, in the patients with osteoarthritis (OA). Materials and Methods : This study included 17 patients (mean 68.8 years old) who underwent preoperative MRI. In proton density-weighted sagittal and coronal images ACLs were evaluated for the thickness and signal intensity (SI). Total knee replacement arthroplasty was performed and the pathologic findings of ACL were evaluated. MD was classified as 3 grades according to the degenerated amount in microscopy. Thickness and SI was evaluated as normal or increased on MRI. Results : All of the 4 patients who showed thickened ACL showed increased SI on MRI. All of the 8 patients with increased SI of the ACL on MRI had MD in the ACL. However, remained 9 patients also had MD, in spite of their normal thickness and SI on MRI. Calcification was seen in 5 patients. Conclusion : Eight cases who showed ACL thickening or increased SI on MRI were well correlated with MD, however, because the other nine cases who showed normal thickness and normal SI of ACL on MRI also showed MD in pathology, normal MRI finding should not exclude the possibility of MD of ACL.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.154-161
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• 2005

Purpose: to describe the histologic appearance of the type III bone bruise in knees which had sustained an acute anterior cruciate ligament (ACL) rupture. Materials and Method: Twenty-five patients who sustained acute ACL rupture were prospectively enrolled in this study. On MRI, 14 patients demonstrated type III bone bruise on lateral femoral condyle, and 11 patients didn't demonstrated bone bruise. Arthroscopic evaluation and biopsy of the articular cartilage and subchondral bone wert performed before ACL reconstruction. Histologic and immunohistochemical evaluations were done. Results: There was no difference between the bone bruise and control group in the hematoxylin-eosin staining for cell distribution, Masson's trichrome staining for collagen and immunohistochemical staining for type I and type II collagen (p>0.05). But in the safranin-O staining for glycosaminoglycan distribution, the bone bruise group had an evidence of decreased staining at the superficial and middle layers, compared with the control group (p<0.05). We also found fatty change of bone marrow in calcified zone of the bone bruise group with safranin-O staining. Conclusion: We suggest that the type III bone bruise found on MRI indicates a substantial damage to normal articular cartilage homeostasis, and may induce further damage of the articular cartilage.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.137-142
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• 2005

Purpose: The purpose of this study is to evaluate the results of arthroscopic anterior cruciate ligament(ACL) repair with minimal incision and to review prognostic factors according to ACL tear patterns and the presence of associated injury Materials and Methods: Thirty eight patients (thirty nine knees) with acute ACL tear were given arthroscopic ACL repair between January 2001 and December 2002 and were followed up at least over six months. Intraoperative findings such as ACL tear pattern and the presence of synovial or concomitant medial collateral ligament injuries were recorded. Each knee was then postoperatively re-evaluated with aid of KT-1000 arthrometer and Lachman test and Lysholm score. Results: Postoperative limitation of motion was significant when combined typed ACL tear was present with concurrent medial collateral ligament(MCL) injury. In contrast, in the case where there were sole proximal ACL tear or no evidence of synovial injury, the limitation of motion was not significant. Anterior laxity was significantly associated with the presence of combined typed ACL tear or concurrent synovial injury, but was not significant when there were sole proximal ACL tear. Conclusion: In the case where there is sole proximal ACL tear without concurrent synovial injury, arthroscopic ACL repair can be considered as a treatment modality for the treatment of acute ACL injury.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.9-13
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• 2004

Purpose: We studied the incidence rate and patterns of bony contusions of the knees with isolated traumatic meniscal tears. Materials and Methods: We analyzed retrospectively MRI scans and medical records of forty-two patients(42 knees) which had undergone operations for isolated traumatic meniscal tears. Mean age, 33.7 years, the number of patients with lateral, medial or both meniscal tears were 19, 18 and 5, respectively. Bony contusions were examined according to incidence, Location, and in relation to the types of meniscal tears. Results: Bony contusion was identified in 5 cases (11.9%) which had medial meniscal tear (4 cases0 or both meniscal tear (1 case). It was always located on the medial compartment of the joint. Bony contusion was found in the knee with various type of traumatic meniscal tears. Conclusion: Bony contusions in thd knees with isolated traumatic meniscal tear have very low incidence and they seem to disappear at or less than 12 months after the trauma. The bony contusions are mainly related to medial meniscal tear and located in the medial compartment of the joint.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.100-104
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• 2005

Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.

• Journal of Yeungnam Medical Science
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• v.19 no.1
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• pp.39-48
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• 2002

Background: The treatment of rheumatoid arthritis still depend on conserve therapy in major. Recent studies report that n-3 polyunsaturated fatty acids(PUFA) could modulate the incidence and progress of arthritis. The purpose of this study was to investigate the effects of n-3 PUFA on the development of collagen-induced arthritis in rats. Materials and Methods: Female Louvain rats were used for this experiment. Rats were randomly assigned into either normal (n=8) or collagen-immunized groups, and collagen immunized groups were divided into control(n=8, normal diet) and n-3 PUFA(n=8, 5% n-3 PUFA in diet) groups. One week after feeding n-3 PUFA to rats, they were immunized with type II collagen emulsified in incomplete Freund's adjuvant into tail and back. Development of arthritis was confirmed by x-ray and microscopic examination. Results: Incidence of arthritis at the 5th week after immunization was 38% in control and 0% in n-3 PUFA. Rats with arthritis showed edema in hind paws and inflammation in synovial membrane of the knee joint. Plasma glucose and insulin were not changed by both of immunization and diet. Plasma triglycerides and cholesterol concentrations were decreased by n-3 PUFA. Conclusion: n-3 PUFA may prevent or treat collagen-induced arthritis m rats. Further studies are needed for action mechanism of it.