• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.37-43
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• 2003

Purpose: This study is to analyse the injury patterns of knee ligament and the factors influencing ligament injuries of knee, and to evaluate the changes of knee function and activity after ski injury. Materials and Methods: Thirty cases of ligament injuries of knee were studied with a questionaire, stress radiographs, magnetic resolution imaging, and physical examination. Mean age was 28.6 years old and mean follow up was 29.6 months. Clinical evaluation of Lysholm knee scoring scale was used for knee function and Tegner activity score was used for activity change after ski injury. Results: The anterior cruciate ligament (ACL) injury accompanied with medial collateral ligament(MCL) injury was most in 11 cases and isolated MCL injury was the next in 9 cases. The common types of injury mechanism were Phantom foot phenomenon (13 cases, 43$\%$) and valgus external rotation injury (12 cases, 40$\%$), which constitute 83$\%$ of all case. At the last follow up, the mean Lysholm score was 93.4 and mean Tegner activity score was 4.2. The reduced Tegner activity score after injury was 1.9. Among several injury groups, the evaluation of knee function and activity was best in the isolated MCL injury group and worst in the ACL injury accompanied with MCL injury group. The factors to influence ski injury were participation to ski class, release of binding, and skiing long time more than 2 hours. Conclusions: Lysholm score at last follow up revealed good grading, but sports activity after ski injury was reduced when compared with pre-injury state. It seems to need a active, systemic sports rehabilitation program after sports injury.

• Physical Therapy Korea
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• v.25 no.3
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• pp.19-26
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• 2018

Background: Genu varum is also known as bow leg. It is a deformity wherein there is lateral bowing of the legs at the knee. it does give rise to pain, and persistent bowing can often give rise to discomfort in knees, hips and ankles. Objects: This study investigated the effect of narrow squats on the knee joint during a gait and distance between the knees of person with genu varum. Methods: This study analyzed 23 patient with genu varum that grade III, 12 narrow squat group and 11 genenal squat group in motion analysis laboratory. The subjects of experiment took gait before and after intervention, the range of joint motion, moment of knee joint adduction, power, distance of the knees were measured. And in order to make an analysis between groups, an paiered t-test and independent t-test was carried out. For statistical significance testing, it was decided that significance level ${\alpha}$ be .05. Results: It was shown that the group of narrow squat exercise significantly decreased in distance of knees (p<.05),In moment of adduction of knee joint, it was shown to significantly decrease in two groups (p<.05), was significantly decreased in adduction, abduction, and rotation (p<.05). In relation of peak-knee adduction moment and valgus angle, there was significant decrease in narrow squat group (p<.05). Conclusion: When the above result of study were examined, a narrow squat exercise given to the genu varum patients significantly decreased the distance between the knees, range of knee adduction and abduction, knee adduction moment, knee power. And stability gains through the decrease of excursion of knee medial part be effective for the correction of genu varum deformation.

• Korean Journal of Applied Biomechanics
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• v.20 no.1
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• pp.67-73
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• 2010

The purpose of this study was to compare the differences in kinematic and kinetic parameters of the ankle and knee joint according to three landing direction(central, left, right). Fifteen collegiate male athletes(age: $22.7{\pm}3.5$ years, height: $174.9{\pm}7.1\;cm$, weight: $69.4{\pm}6.7\;kg$) with the right leg as dominant were chosen. The subjects performed series of drop landings in three directions. In terms of the three different landing directions, plantar flexion was the greatest during the central drop landings. For each initial contact of the landing direction, plantar flexion of the ankle was greatest at the central drop landing, inversion of the ankle was greatest at the right landing and valgus of the knee was greatest at the left drop landing. Regarding the peak force, the greatest was at the 1st peak force during the central drop landing. For the time-span of the 2nd peak force and the 2-1 peak force, both right sides resulted as the greatest. Therefore, with the appropriate training in landing techniques and developing neuromuscular training for proprioception by taking the injury mechanisms on ankle and knee during drop landings into account, it will assist in preventing such injuries.

• Journal of Biomedical Engineering Research
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• v.28 no.1
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• pp.108-116
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• 2007

Recently, it has been reported that the posterior stabilized implant, which is clinically used for the total knee replacement (TKR), may have failure risk such as wear or fracture by the contact pressure and stress on the tibial post. The purpose of this study is to investigate the influence of the mal alignment of the posterior stabilized implant on the tibial post by estimating the distributions of contact pressure and von-Mises stress on a tibial post and to analyze the failure risk of the tibial post. Finite element models of a knee joint and an implant were developed from 1mm slices of CT images and 3D CAD software, respectively. The contact pressure and the von-Mises stress applying on the implant were analyzed by the finite element analysis in the neutral alignment as well as the 8 malalignment cases (3 and 5 degrees of valgus and varus angulations, and 2 and 4 degrees of anterior and posterior tilts). Loading condition at the 40% of one whole gait cycle such as 2000N of compressive load, 25N of anterior-posterior load, and 6.5Nm of torque was applied to the TKR models. Both the maximum contact pressure and the maximum von-Mises stress were concentrated on the anterior-medial region of the tibial post regardless of the malalignment, and their magnitudes increased as the degree of the malalignment increased. From present result, it is shown that the malalignment of the implant can influence on the failure risk of the tibial post.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.127-136
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• 2003

Posterolateral instability of the knee occurs more commonly in association with an injury to anterior and posterior cruciate ligament and combined injuries are severe injuries that result in significant functional instability and articular cartilage degeneration. Reconstruction of the anterior and posterior cruciate ligament without an appropriate treatment of posterolateral corner injury result in failure of the reconstructed cruciate ligaments. Meticulous physical examinations, imaging studies, lower limb alignment and gait pattern should be evaluated. Acute grade III isolated or combined injury of the posterolateral corner is best treated within three weeks by direct repair, or augumentation, or reconstruction. The appropriate surgical method or combined methods are selected among the several methods of posterior and posterolateal reconstruction, and all injuried posterolateral and cruciate ligament structures are anatomically reconstructed simultaneously or by stages. If a varus alignment and varus thrust is disclosed in chronic posterolateral instability of knee, soft tissue reconstructions laterally are highly unlikely to be able to correct tile problem. It is appropriate that valgus osteotomy should be done before soft tissue reconstruction and reevaluate the posterolateral instability about 6 months later.

• Physical Therapy Korea
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• v.23 no.1
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• pp.20-30
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• 2016

Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC ($n_1$=19) or the QIIC ($n_2$=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.

• Physical Therapy Korea
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• v.13 no.4
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• pp.1-9
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• 2006

The purpose of this research was to analyze the effects of the increase of the femoral anteversion angle on the unbalanced quadriceps femoris muscle causing the increase of the valgus force on the knee joints and patellofemoral pain syndrome by comparing with the group that shows the smaller femoral anteversion angle. The method for the research was to compare the femoral muscle's activity while the subjects were maintaining the knee joint flexed isometrically for 10 seconds. The evaluation tool for femoral muscle's activity was QEMG-4 (model LXM 3204). The results were as followings. Firstly, in case of the experimental group, the muscle strength of the vastus lateralis muscle was strong while the rectus femoris and vastus medialis were weak. In these facts, we can see the statistically meaningful difference in vastus medialis muscle activity. Secondly, in the muscle activity analysis for vastus lateralis and medialis of the two groups, we could see the vastus lateralis muscle was strong in anteversion wider for experimental group while the vastus medialis muscle contracted far more stronger in anteversion smaller for control group. From these results, we can see the significant differences in muscle recruitment between the two groups. Above results show that if the anteversion becomes wider, vastus medialis muscle will become seriously weaker, on the other hand, vastus lateralis act stronger.

• Journal of Oriental Neuropsychiatry
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• v.32 no.3
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• pp.261-273
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• 2021

The purpose of this study was to introduce effects of Chukyu pharmacopuncture and Brainspotting on knee pain, headaches, and acute stress disorder of a patient with a traffic accident. We treated a patient with Chukyu pharmacopuncture and Brainspotting. Numerical rating scale (NRS), Range of Motion (ROM), Hyperextension Position (HEP), Effusion (Eff), Patella Compression Test (PCT), Frontal Flexion Position (FFP), McMurray (MCM), Lateral Joint Line Tenderness (LJLT), Medial Joint Line Tenderness (MJLT), Anterior Drawer Test (ADT), Lachman Test, Varus/Valgus stress, Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), Core Seven Emotions Inventory Short Form (CSEI-S), Subjective units of disturbance scale (SUDs), and Heart rate variability (HRV) were used to evaluate the patient. After the patient was treated by Chukyu pharmacopuncture and Brainspotting, the patient showed improvement in NRS, physical examination, and psychological symptom assessment. These results indicate that Chukyu pharmacopuncture and Brainspotting are effective on knee pain, headache, and acute stress disorder after a traffic accident.

• Korean Journal of Applied Biomechanics
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• v.33 no.4
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• pp.128-136
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• 2023

Objective: The aim of this study was to investigate the effect of an 8-week closed kinetic chain typed Reformer and Chair Pilates exercise on static and dynamic lower limb alignment for healthy female adults. Method: Ten healthy young female adults without musculoskeletal injury history in last 6 months (Age: 29.3 ± 3.5 yrs., Height: 165 ± 3.4 cm, Body mass: 58.2 ± 5.4 kg) participated in this study. All participants asked to join the 8-week closed kinetic chain typed Reformer and Chair Pilates exercise, and the program was conducted for 60 minutes twice a week. Participants were asked to be measure a static Q-angle and performed free squat one week before and after the program. A 3-D motion analysis with 8 infrared cameras and 5 channels of EMG was executed in this study. The effectiveness of the training was evaluated by paired t-test, and the significance level was set at .05. Results: A significantly decreased in internal rotation angles was found at hip joint during free squat after the training. Also, significantly decreased in lateral rotation angles were found at knee and ankle joint during free squat after training. Finally, significantly decreased in muscle activations were found at adductor longus and peroneus longus during free squat after training. Conclusion: From results of our study, it is concluded that an 8-week closed kinetic chain typed Pilates exercise positively effect on lower limb alignment during dynamic movement.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.77-81
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• 2003

Purpose: The biomechanics and kinematics of knee joint were reviewed in this article. And then the common sports injuries were presented. Anatomy and Kinetics: None of the pairs of bearing surfaces in the knee joint is exactly congruent This allows the knee six degrees of freedom of motion. Tibiofemoral Kinematics: In flexion and extension, the axis of motion is not perpendicular to the medial-lateral plane of the joint, nor is it perpendicular to the axis of longitudinal rotation. This results in coupled varus angulation and internal rotation with flexion and in valgus angulation and external rotation with extension. Patellofemoral Articulation: Loads across the patellofemoral joint are indirectly related to the angle of knee flexion and directly related to the force generated within the quadriceps mechanism. Fractures of the Patella: Nonoperative treatment is indicated if the extensor mechanism is intact and if displacement of fragment is minimal. The specific type of internal fixation depends on the fracture pattern. It is important to repair retinaculum. Acute and Recurrent Patellar Instability: The degree of dysplasia and the extent of the instability play a large part in determining the success of nonoperative treatment. Patients who experience recurrent dislocations and patients with major anatomic variations require surgery to minimize their instability. Sports Injuries in School-age Atheletes: Patellar pain in young athletes groups a number of conditions, including Idiopathic Adolescent Anterior Knee Pain, Osgood- Schlatter Disease, and Sinding-Larsen-Johansson Disease.