• Journal of Yeungnam Medical Science
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• v.37 no.3
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• pp.149-158
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• 2020

Mesenchymal stem cells (MSCs) are emerging as an attractive option for osteoarthritis (OA) of the knee joint, due to their marked disease-modifying ability and chondrogenic potential. MSCs can be isolated from various organ tissues, such as bone marrow, adipose tissue, synovium, umbilical cord blood, and articular cartilage with similar phenotypic characteristics but different proliferation and differentiation potentials. They can be differentiated into a variety of connective tissues such as bone, adipose tissue, cartilage, intervertebral discs, ligaments, and muscles. Although several studies have reported on the clinical efficacy of MSCs in knee OA, the results lack consistency. Furthermore, there is no consensus regarding the proper cell dosage and application method to achieve the optimal effect of stem cells. Therefore, the purpose of this study is to review the characteristics of various type of stem cells in knee OA, especially MSCs. Moreover, we summarize the clinical issues faced during the application of MSCs.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.1-6
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• 2008

Medial gastrocnemius flap has been known as a useful option for soft tissue reconstruction of the knee and upper 1/3 of lower extremity, but it has a limitation to cover the lateral defect of the knee joint. We performed the combined gastrocnemius-medial sural artery perforator flap for coverage of the anterolateral defects of the knee joint, which is compound flap using a medial gastrocnemius flap and a medial sural artery perforator flap. This flap is a useful method for reconstruction of anterolateral knee defects, providing a easy dissection without the microsurgery and intramuscular dissection of the perforators.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.159-163
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• 1998

We reviewed the cases of 35 knees of 34 patients who had arthroscopic debridement for degenerative osteoarthritis of the knee. The patients were followed up for an average of 29 months (range: 13 months to 45 months). The mean age of the patients at operation was 54 years (range: 44 years to 75 years). At the time of follow up, the patients were evaluated using the nine-point scale by Baumgaertner et al. We divided the knee into 4 stages according to the classification system by Jackson et al. Satisfactory results were achieved in 80%(stage I), 75%(stage II), 55.6%(stage III) and 25%(stage IV) of the patients. Arthroscopic debridement is of significant value in the earlier stages of degenerative osteoarthritis (stage I and II) for the symptom relief as a simple procedure with rare complication as well as in the later stages(stage III and IV) as a time buying procedure before the total knee arthroplasty.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.3
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• pp.190-193
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• 1999

Benign fibrous histiocytoma is characteristically composed of fibroblastic and histiocytic cells. Most commonly, this tumor occurs in the dermis and superficial subcutis, but it is uncommon in the knee. We experienced a case of deep benign fibrohistiocytoma in a 38-year-old woman who complained of palpable tender mass on the medial aspect of the right knee. MR imaging findings included a well-delineated oval mass with low signal intensity on T1-weighted and high-signal intensity of T2-weighted images, as well as a marked peripheral contrast enhancement. Histopathologically, the lesion contained a mixture of fibroblastic and histiocytic cells that were often arranged in a cartwheel or storiform pattern and accompanied by varying numbers of inflammatory cells, foam cells, and siderophages. After surgical removal of the lesion, no recurrence was observed.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.1
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• pp.97-107
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• 2018

Objectives This is one of the manuals of East-West integrative medicine which was created by the committee on integrative medicine of Chung-Yeon Korean Medicine Hospital. The purpose of this manual is to support clinical decision-making and communication between Korean and western medical staff in a Korean medicine hospital during the rehabilitation of patients after knee surgery. Methods The draft was made by two rehabilitation specialists in Korean medicine. After a rehabilitation specialist in western medicine reviewed the draft and exchanged their ideas, a revised version that reflects the goal of consultation was made. Then the committee agreed to adopt the manuals through the process of review and feedback in addition to face-to-face discussions. Results This manual describes clinical decision-making for rehabilitation after arthroscopic partial meniscus resection, meniscus refixation, reconstruction of anterior and posterior cruciate ligaments. Therefore, it contains the schedule of rehabilitation treatment by the surgical technique, general goal of the rehabilitation by phase, guide for patients and postoperative infection management. Conclusions Despite some limitations, this manual has significance as the first example of a decision-making protocol suggestion for East-West integrative rehabilitation treatment after a knee surgery in one medical institution.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.7-13
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• 2008

Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.

• Knee surgery & related research
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• v.30 no.4
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• pp.303-310
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• 2018

Purpose: The purpose of this study was to investigate whether surgical experience could improve surgical competency in medial open wedge high tibial osteotomy (MOWHTO). Materials and Methods: One hundred consecutive cases of MOWHTO were performed with preoperative planning using the Miniaci method. Surgical errors were defined as under- or overcorrection, excessive posterior slope change, or the presence of a lateral hinge fracture. Each of these treatment failures was separately evaluated using the cumulative summation test for learning curve (LC-CUSUM). Results: The LC-CUSUM showed competency in prevention of undercorrection, excessive posterior slope change, and lateral hinge fracture after 27, 47, and 42 procedures, respectively. However, the LC-CUSUM did not signal achievement of competency in prevention of overcorrection after 100 procedures. Furthermore, the failure rate for overcorrection showed an increasing tendency as surgical experience increased. Conclusions: Surgical experience may improve the surgeon's competency in prevention of undercorrection, excessive posterior slope change, and lateral hinge fracture. However, it may not help reduce the incidence of overcorrection even after performance of 100 cases of MOWHTO over a period of 6 years.

• Journal of muscle and joint health
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• v.3 no.2
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• pp.135-150
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• 1996

This study was performed to analyze the patient's experience during the progress of disease in the patients with osteoarthritis, who are taken the replacement surgery of knee Joint. The examine was consisted of five patients with osteoarthritis, who are taken the replacement surgery of knee joint from Dec. 4. 1995 to May, 20, 1996 at C university hospital. After hospitalization, the physical and psycho-logical status of the patients during preoperation, postoperation and discharge was examined. The data were examined according to the ethnographic method. The results are as follows. The patients experienced the periods of embarrasment, conflict, before surgery suffering, acceptance period after surgery. In the embarrasment period, the patients take a multiple medication therapy including hospital treatment, oriental medication and folk medication to ameliorate joint pain after first diagnosis on arthritis. The embarrasment period includes compulsive drug medication, oriental medication, folk medication, trouble some, sadness and survey of hospitals. In the conflict period, the patients consider the operation of knee because of working difficulty and severe Joint Pain, while they feel anxiety about the surgery. They condemn their physical situations. They have the conflict and anxiety on surgical operation. they consider the quality of life. They hope the surgery makes patients to improve walking ability. This period includes self-condemned, sorry, tiresomeness, expectation, worrisomeness, anxiety and hesitance. In the suffering period, the patients experience post operation physical discomfort after the total knee replacement. They do physical exercise, including extension and straight leg raising to maintain walking ability, while they endure to wait approximately 6 months for normal walking movements and they are also unstable to environmental people's sight. This period includes postoperative pain, continuous discomfort, inability and communication difficulty to other's people. In the acceptance period, the patients consider longerity of artificial Joint and also endure mild remaining joint pain. Some of them have religions for their wellbeing of life. This period include a self-protesting policy, abandonment, self-consolation, dependence on religions. According to the result from this study I suggested these shown below. 1) After replacement surgery of knee joint, continuous investigation on outcome patient is necessary. 2) It is also necessary to analyze on patient's experiences, who are taken the replacement surgery of hip Joint. 3) Study on disease experiences of patients with rhematoid arthritis, who take drug medication and physical therapy alone without surgery, is necessary. 4) Investigation on patient's favorable folk medication may be helpful to analyze disease experience of patients with osteoarthritis.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.51-56
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• 2011

During below knee amputation, the amputation stump must be covered with well-vascularized and sensate soft tissue. Many flaps can be used for this purpose, but available reconstructive options are limited. We performed reverse flow ALT flap elevation on two patients with below knee amputations to reconstruct defects in the stumps. The sizes of the defects in the stumps were $4{\times}16$ cm and $5{\times}5$ cm, respectively. The most distal portion of the defects were located 20 cm and 16 cm lateral to the knee joint in a curve, respectively. The size of the elevated flap was $5{\times}18$ cm for case 1 and $18{\times}10$ cm for case 2. The respective pivot points of the pedicles were 7 cm and 6 cm above the patella and the respective lengths of the pedicles were 17 cm and 16 cm. In both cases, venous congestion occurred on the second postoperative day and the flap distal to 10 cm or more from below the knee joint was necrotized at the second postoperative week. Surgeons should be cautious when using a reverse ALT flap to reconstruct a soft tissue defect located 10 cm or more distal from below the knee joint. Since a pedicle longer than 15 cm may develop partial necrosis of the flap, simultaneous application of antegrade venous drainage is recommended.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.1-8
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• 1997

The anterior cruciate ligament(ACL) is, perhaps, the most intriguing component of the knee joint. Initially referred to crucial ligament because of the cruciate or crossed arrangement or the anterior and posterior ligaments within the knee. the irony or the ACL being crucial to the well-being or the joint has only recently appreciated. The anterior cruciate ligament of human knee joint is a complex structure and its orientation, construct and biology arc directly related to the knee function as a constraint of knee joint motion. In addition to its functional role as a static stabilizer or the knee. the ACL has a unique neurovascular system. The vascular anatomy of the ACL plays a crucial role in the repair and reconstruction of the ligament, and the neuroreceptors found in its substance suggest a possible proprioceptive role for the ligament. The structural complexity of the ACL allows the ligament to function through the normal range of motion as a static stabilizer or the knee. hut it also makes the exact duplication of this structure very difficult. A comprehensive knowledge or the anatomy of the ACL can provide the orthopedic surgeon with a blueprint for the idealized repair and reconstruction of this most complex structure.