• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.21-29
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• 2013

Purpose : The purpose of this study was to determine the changes in ultrasound imaging of the lower limbs in patients with degenerative osteoarthritis who received a total knee replacement (TKR). Methods : The participants for the study were ten patients who were to receive a total knee replacement. Measurements were taken a total of three times: before receiving a total knee replacement, and one week and two weeks after receiving a total knee replacement. The vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle were measured using ultrasound imaging. Results : Muscle thickness of the vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. White area index (WAI) and density of vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. Conclusion : In conclusion, lower quality muscles were due to a decrease in muscle fiber and an increase in fat fiber. Therefore, initial physical therapy after total knee replacement should consider this point and be designed appropriately as a therapeutic approach for total knee replacement patients.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.485-489
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• 2007

Purpose: The basic vascular anatomy and versatility of the anterolateral thigh flap was reported firstly by Song in 1984 and then by Zhang who introduced the reverse flow pattern of this flap. In this case, the authors reviewed various articles and their experiences with the distally based anterolateral thigh flap and applied it for coverage of bone-exposed wound occurred at the distal of the disarticulated knee stump. We consequently reported the reliability and resourcefulness of this flap in the difficult and limited situation. Methods: A 67-year-old-man who had suffered from arteriosclerotic obliterans inevitably underwent the disarticulation at knee joint due to clinical deterioration. He presented to our clinic with soft tissue necrosis and bone exposure at the stump. We debrided the wound and conducted the distally based anterolateral thigh island flap by transecting proximal portion of descending branch of the lateral circumflex femoral artery and the $14{\times}10cm$ sized flap was transferred to cover the defect. The pedicle measured 14 cm in length with pivot point 7 cm above the patella. Results: The postoperative course was mainly uneventful except early venous congestion for 4 days and subsequent partial skin loss. The wound was healed by secondary intension and no other sequelae had been observed during follow-up period of 12 months. Conclusion: Despite the presence of various reconstructive choices, the distally based anterolateral thigh island flap can be designed to repair soft tissue defects around the knee region, providing its reliable blood supply and long pedicle length, especially in the challenging cases.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.146-150
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• 2009

Osteochondromas typically arise from the metaphyseal ends of long bones. Extraskeletal paraarticular osteochondromas are unusual osteocartilaginous lesions that arise in the soft tissue adjacent to a joint with no bony continuity. We present a case of pathologically proven extraskeletal paraarticular synovial osteochondroma of the knee observed in 42-year-old female with a literature review.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.108-111
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• 1997

Congenital deficiency of the anterior cruciate ligament (ACL) is a rare disorder that has been reported in association with other knee dysplasia like as congenital knee dislocation. congenital short femur, congenital absence of menisci, congenital ring meniscus, and thrombocytopenia-absent radius syndrome. There has been no published explanation about the etiology of bilaeral ACL deficiencies without other abnomality. The patient of congenital ACL deficiency must be carefully inspected about combined anomaly. Those efforts may be helful in treatment or ACL deficient patients and evaluation of pathophysiology or ACL deficiency. However there has not been a ruptured congenital deficiency of the ACL without other dysplasia or the knee and other congenital skeletal abnomalities. We reported a case of symptomatic bilateral congenital deficiencies of the ACL which have not been associated with other skeletal abnormalities.

• Clinical Pain
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• v.20 no.2
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• pp.105-121
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• 2021

Objective: Physiologically, the vastus medialis muscle is the first muscle to undergo muscle atrophy, and it was thought that pain in patients with knee osteoarthritis could be reduced if this muscle could be strengthened and stabilized. The purpose of this study was to prove the effectiveness in knee osteoarthritis using polydioxanone sutures that have been tried in other musculoskeletal areas. Method: Forty knee osteoarthritis patients voluntarily participated in the study, and divided into 30 polydioxanone suture needle (MEST-B2375 produced by Ovmedi Co.) and 10 sham needle (without suture). And the needles were inserted into the vastus medialis muscle. In all patients, safety evaluation including blood tests and ultrasonography as well as efficacy evaluation including isometric maximal contractile strength of quadriceps muscle, weight bearing pain, impression of change, quadriceps angle, rescue drug intake were evaluated up to 30 weeks after the procedure. Results: Isometric maximal contractile strength showed a significant improvement at 4 weeks after the procedure in the polydioxanone suture group, and the weight-bearing pain showed a significant improvement at every visit in the polydioxanone suture group compared with baseline values. Patient global impression of change score showed significant improvement at 20 and 30 weeks, and clinical score showed improvement at every visit. Conclusion: Insertion of polydioxanone sutures showed improvement in muscle strength and knee pain by supporting and fixation of the vastus medialis muscle in patients with degenerative knee osteoarthritis. Insertion of polydioxanone sutures is considered to have a therapeutic effect in knee osteoarthritis patients.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.95-100
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• 2020

In general, most knee dislocations are reduced easily by simple traction. In rare cases, closed reduction of the knee dislocation is attempted, but ruptured ligaments or muscles are stuck in the joints and cannot be reduced. The cases of this irreducible knee dislocation have sometimes been reported. The authors encountered a case of irreducible knee posterolateral rotational dislocation that was not reduced by simple traction and report it along with a review of the literature. This case provides an opportunity for clinicians to examine the clinical considerations when experiencing an irreducible knee dislocation.

• Journal of muscle and joint health
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• v.21 no.3
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• pp.206-214
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• 2014

Purpose: The aim of this study was to explore the elderly women patients' experience of treatment for total knee replacement. Methods: The participants in this study are 10 elderly women age 65 and over who were discharged after total knee replacement. The data were collected from August 5, to September 20, 2012, and it has been done by in-depth interview. Data were analyzed the phenomenological method of Colaizzi. Results: In this study, four categories were extracted: 'Suffering due to intolerable pain', 'A stable mind and body', 'Retrospection about old wounds', 'A desire for a new life'. Conclusion: This study provides the useful basic data to understand the elderly women patients who have experienced total knee replacement. Nursing intervention is required for pain control after surgery in order to improve the quality of life. In addition, nursing care through individual counseling and emotional support during the recovery period is very important. Therefore, various programs should be developed for elderly women patients to help their body recovery as well as psychological support after total knee replacement surgery.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.769-772
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• 2022

Femoral nerve injuries are devastating injuries that lead to paralysis of the quadriceps muscles, weakening knee extension to prohibit ambulation. We report a devastating case of electrical injury-induced femoral neuropathy, where no apparent site of nerve disruption can be identified, thus inhibiting the traditional choices of nerve reconstruction such as nerve repair, grafting, or transfer. Concomitant spinal cord injury resulted in spastic myopathy of the antagonist muscles that further restricted knee extension. Our strategy was to perform (1) supercharge end-to-side technique (SETS) to augment the function of target muscles and (2) fractional tendon lengthening to release the spastic muscles. Dramatic postoperative improvement in passive and active range of motion highlights the effectiveness of this strategy to manage partial femoral nerve injuries.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.40-44
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• 1998

The use of autogenous tissues is preferred for knee ligament reconstruction. However allografts play a role in major ligament reconstructive procedures in which multiple substitutions or revisions are required. In the dislocated knee, allografts may offer an advantage in reconstructing the PCL. But allografts in knee ligament surgery must be considered in terms of biomechanical and regenerative properties, disease transmission and immunogenecity, and methods of preservation and sterilization. Also only a few authors have described the use of allograft for reconstruction of a ruptured PCL, either a single procedure, or in combination with ACL repair following knee dislocation. Furthermore, the problems that the clinician faces with use of allografts is the necessity for supervision to ensure that the grafts are correctly processed, secondarily sterilized, and free of transmissible diseases. For these reasons, the routine use of allograft materials in the treatment of ligament deficiencies should be avoid and provide with meaningful outcome studies, including longterm follow-up.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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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.