• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.478-489
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• 2018

Total knee arthroplasty has become a standard procedure for advanced knee arthritis to relieve pain and improve function. Computer-assisted navigation systems have been used in total knee arthroplasty to improve the mechanical axis of the limb as well as the alignment and position of the components. A computer-assisted navigation system has the advantage of real-time feedback during surgery, such as mediolateral balance in extension and flexion gap, alignment of the lower limb, and components. On the other hand, the computer-assisted navigation system requires an additional stab wound for tracker fixation, which can increase the likelihood of superficial wound infection and stress fractures and increase the operation time and cost of surgery. The clinical efficacy of computer-assisted navigation in total knee arthroplasty is also controversial. Compared to the conventional technique, computer navigation improves the accuracy of the postoperative mechanical axis within outliers of $3^{\circ}$ varus or $3^{\circ}$ valgus. This paper reviews the surgical technique, pitfalls, clinical and radiological outcomes, useful clinical cases, and future perspectives in computer-assisted navigation total knee arthroplasty.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.1
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• pp.44-50
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• 2006

The purpose of this study is to assess the radiographic effects of normal person with contact laterally wedged insoles with strapping of varying elevations. Eight person who were randomized into group according to their birth dates and wedge elevation, participants wore contact laterally wedged insoles with strapping with elevation of 9, 15, 21mm. Standing radiographs were used to analyze the femorotibial angle for each subject, The result of repeated measures ANOVA's reveled that laterally wedged insoles with strapping of varying elevations produced significantly the femorotibial angle. The degree of change in femorotibial angle with the insole with strapping was effected by the tilt of the lateral wedge(P<0.05). We suggest that these results may be beneficial for manufacturing foot orthotic devices, such as wedged insoles, to control medial and later compartment forces in the knee varus-valgus deformity.

• Korean Journal of Applied Biomechanics
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• v.18 no.1
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• pp.1-10
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• 2008

This study analyzed the rear foot angle of the supporting leg and the anatomical rotation angle of the kicking angle in soccer instep kick and drew conclusions as follows. When the supporting leg was landing on the ground, the valgus angle of the ankle joint reached the maximum peak, and plantar flexion was slightly different in the timing of the maximum peak between the two groups. The flexion angle of the rear foot was statistically significantly different between the two groups, and the movement of the crus on the landing of the supporting foot did not show a statistically significant difference between the groups. The crus leaned backward most before the impact, and the side to side gradient of the crus on impact was $22^{\circ}$. The flexion/extension of the hip joint of the kicking leg reached the maximum peak when the supporting foot was landing on the ground, and at the moment, the maximum extension angle of the hip joint was over $30^{\circ}$. The flexion angle of the knee joint of the kicking leg was largest after landing. While the maximum plantar flexion angle and maximum valgus angle of the ankle joint were not significantly different between the two groups, the maximum external rotation angle was significantly different.

• 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 Orthopaedic Association
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• v.53 no.6
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• pp.498-504
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• 2018

Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.34-41
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• 2021

Purpose: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in elderly patients older than 70 years by analyzing cases that have been implanted for >10 years ago. Materials and Methods: The long-term follow-up results were evaluated in 39 patients (46 cases) who underwent medial UKA from March 2002 to February 2004. The mean age of the patients at the time of surgery was 74.0 years, and the preoperative diagnosis was degenerative arthritis of the knee in all cases. Results: Of the 46 cases, reoperation occurred due to the complications in four cases. In 22 cases without 14 cases of death and six cases of follow-up loss, follow-up more than 10 years was possible. The mean Knee Society knee and function scores improved significantly from 53.0 and 52.5 points pre-operatively to 89.4 and 80.9 points at the last follow-up, respectively (p<0.001). The mean range of motion of the knee recovered to 132.5°, and the mean tibiofemoral angle changed to 5.9° of valgus at the last follow-up. Complications following the UKA occurred in four cases; the most prevalent complication was mobile bearing dislocation (n=2). One case of failure occurred due to aseptic loosening and degenerative arthritis of the lateral compartment, respectively. The cumulative survival rate of the implants was 95.0% at 10 years and 85.7% at 15 years. Of the 40 cases, excluding six cases of follow-up loss, 36 cases (90.0%) could be used without reoperation until death or at the last follow-up after surgery. Conclusion: These results showed the outstanding functions of the knee and satisfactory long-term survivorship after UKA. Therefore, UKA could be a useful method for the treatment of osteoarthritis of the knee in elderly patients older than 70 years of age.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.254-258
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• 2009

Tibial eminence fracture is caused by distortion, excessive flexion and extension, varus and valgus injury of the knee joint in the form of avulsion fracture. A failure over the exact anatomical reduction of fragment can lead to instability and limitation of joint motion. Recently, a variety of arthroscopic assisted reduction and fixation technique have been used. In the tibial eminence fracture, we created an arthroscopic pull-out wire fixation technique using a cannulated screw that is easy and more convenient than in the conventional technique. So we report this technique with a review of current literatures.

• Journal of the Korean Applied Science and Technology
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• v.36 no.2
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• pp.424-433
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• 2019

The purpose of this study was to investigate the effects of gender difference in injury experience on biomechanical variables of lower extremity during two leg drop landing. 20 male(injury experience=8, non-injury experience=12) and 20 female(injury experience=11, non-Injury Experience=9) in their 20's were selected as subjects. Two-way mixed ANOVA was performed on the biomechanical variables obtained from the two leg drop landing in a 45cm height box and post-test was performed with bonferroni adjustment(p <.05). The results of this study suggest that the group of female who injury experience could induce the reduction of the peak vertical ground reaction force by increasing the valgus and internal rotation of the knee joint and flexion and internal rotation of the hip joint. In the INE(injury non-experienced) female group, the peak knee flexion angle was the smallest, as well as the flexion of the hip joint and the external rotation angle, and the peak vertical ground reaction force was the highest. On the other hand, the INE female group showed high vertical ground reaction force because they did not utilize the knee and hip joints relatively than the IE(injury experienced) female group, this means that it is relatively exposed to the risk of injury. Therefore, it was found that gender difference in injury experience is a factor affecting factors of knee and hip joint movement and peak vertical GRF(ground reaction force).

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1461-1466
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• 2008

In the case of Posterior Cruciate Ligament (PCL), the most frequent mechanism is the dashboard injury, which is directly pressurized to the anterior of the proximal tibia in the state of the knee hyperflexion. The PCL associated ligament damage happens when the posterior injury, the varus, the valgus, the hyperextension and the severe vagus torque are out of the critical value of PCL. After the successful operation cases of Anterior Cruciate Ligament (ACL) reconstruction using the allograft were informed from 1986, a number of results kept over the maximum 10 years were reported. Unfortunately, PCL reconstruction are crowded the surgery techniques such as the graft, the tibia fixing method, the fixation device, the location of the femoral tunnel, the number of the graft bundles and PCL reconstruction to access to the stability of the normal joint is being developed. Therefore, this study is the basic research of these above facts. The current transtibial tunnel surgery using the cadaveric Achilles tendon grafts is chosen for the various PCL reconstruction. The initial extension of the Achilles tendon by the fixing device and its location under the cyclic loading, were observed.