• Title/Summary/Keyword: Knee valgus

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Biomechanical Characteristic on Lower Extremity with or without Chronic Ankle Instability during Double Leg Drop Landing (양발 드롭랜딩 시 만성적인 발목 불안정성 유무에 따른 하지주요관절의 역학적 특성)

  • Jeon, Kyoungkyu;Park, Jinhee
    • Korean Journal of Applied Biomechanics
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    • v.31 no.2
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    • pp.113-118
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    • 2021
  • Objective: The purpose of this study was to investigate differences of landing strategy between people with or without chronic ankle instability (CAI) during double-leg drop landing. Method: 34 male adults participated in this study (CAI = 16, Normal = 18). Participants performed double-leg drop landing task on a 30 cm height and 20 cm horizontal distance away from the force plate. Lower Extremities Kinetic and Kinematic data were obtained using 8 motion capture cameras and 2 force plates and loading rate was calculated. Independent samples t-test were used to identify differences between groups. Results: Compared with normal group, CAI group exhibits significantly less hip internal rotation angle (CAI = 1.52±8.12, Normal = 10.63±8.44, p = 0.003), greater knee valgus angle (CAI = -6.78±5.03, Normal = -12.38 ±6.78, p = 0.011), greater ankle eversion moment (CAI = 0.0001±0.02, Normal = -0.03±0.05, p = 0.043), greater loading Rate (CAI = 32.65±15.52, Normal = 18.43±10.87, p = 0.003) on their affected limb during maximum vertical Ground Reaction Force moment. Conclusion: Our results demonstrated that CAI group exhibits compensatory movement to avoid ankle inversion during double-leg drop landing compared with normal group. Further study about how changed kinetic and kinematic affect shock absorption ability and injury risk in participants with CAI is needed.

Effect of 1-RM Direct Measurement Method on Beginners' Back Squat (1-RM 직접측정법이 초보자의 백스쿼트에 미치는 영향 )

  • Jaeho, Kim;Sukhoon, Yoon
    • Korean Journal of Applied Biomechanics
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    • v.32 no.4
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    • pp.134-140
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    • 2022
  • Objective: This study aims to verify effect of 1-RM direct measurement method of back squat on beginners. Method: Total of 8 healthy adults were recruited for this study (age: 29 ± 3.81 yrs., height: 174 ± 3.83 cm., body mass: 74 ± 11.63 kg., 1RM: 96 ± 19.78 kg). All participants performed the back squat with 80%, 90% and 100% of the pre-measured 1RM. A three-dimensional motion analysis was performed with 8 infrared cameras and 3 channels of EMG were used for this study. One-way ANOVA with repeated measure was used for the statistical analysis with the significant level set to α=.05. Results: The ankle joint ROM in the transverse plane was significantly increased as the weight increased during the concentric contraction phase 2 (p < .05). In addition, the erector spinae and the gluteus maximus, which are synergist for the motion, showed a significant difference according to the increased weight (p < .05). Conclusion: Our results revealed that beginners increase potential dynamic knee valgus as weight increased. Therefore, it is thought that field coaches should pay attention to this to minimize and prevent injuries when measuring 1-RM for beginners.

Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty (슬관절 부분 치환술의 장기 생존 분석)

  • Park, Cheol Hee;Lee, Ho Jin;Son, Hyuck Sung;Bae, Dae Kyung;Song, Sang Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.427-434
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    • 2019
  • Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.

Effect of Anteromedial Cortex Oblique Angle on Change of Tibial Posterior Slope Angle in High Tibial Osteotomy Using Computer Assisted Surgery (CAS) (Computer Assisted Surgery(CAS)를 이용한 개방형 근위경골절골술 시 전내측피질골경사각이 경골후방경사각에 미치는 영향)

  • Lee, Ho-Sang;Kim, Jay-Jung;Wang, Joon-Ho;Kim, Cheol-Woong
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.36 no.3
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    • pp.351-361
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    • 2012
  • The leading surgical method for correcting the misalignment of the varus and valgus in the knee joint is the high tibial osteotomy (HTO). In the opening wedge HTO (OWHTO), there is no concern about damaging the peroneal nerve on the lateral tibia of the proximal fibula. OWHTO has been the preferred choice, as the opening of the correction angle can be modulated during the operation. The correction of the varus and valgus on the coronal plane are performed adroitly. Nevertheless, there have been numerous reports of unintended changes in the medial tibial plateau and posterior slope angle (PSA). The authors have developed an HTO method using computer-assisted surgery with the aim of addressing the abovementioned problems from an engineer's perspective. CT images of the high tibia were reconstructed three-dimensionally, and a virtual osteotomy was performed on a computer. In addition, this study recommends a surgical method that does not cause changes in the PSA after OWHTO. The results of the study are expected to suggest a clear relationship between the anteromedial cortex oblique angle of each patient and the PSA, and an optimal PSA selection method for individuals.

Posture Analysis of Healthy Right-handed Male and the Effect of Chuna Treatment (건강한 오른손잡이 남성의 자세분석에 따른 추나치료의 효과)

  • Kim, Min-Soo;Lee, Ji-Young;Shin, Hee-Ra;Yeom, Seung-Ryong;Kwon, Young-Dal
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.3
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    • pp.125-136
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    • 2017
  • Objectives The present study was designed to analyze the posture pattern of healthy right-handed male and to investigate the effect of Chuna treatment. Methods Twenty healthy right-handed male were selected in this study. Body posture was measured by Body $Style^{(R)}$. After that, subjects received Chuna treatment on lumbar and pelvis area. Finally, the 2nd measurement was carried out. Results In shoulder height, left shoulder was higher than right one. In pelvic height, right iliac crest was higher than left, followed by longer right leg than left. In lower limb angle suggesting valgus or varus knee. In height of scapula inferior angle, right seemed higher than left. After the Chuna treatment, shoulder height, pelvic height, and leg length difference showed significant improvement. Other variables showed improvement but it was not significant. Conclusions These results suggest that right-handed male have some characteristic posture pattern because of their daily life habits, and Chuna treatment can be effective in correcting bad posture.

Biomechanical evaluation of a bioactive artificial anterior cruciate ligament

  • Guerard, Sandra;Manassero, Mathieu;Viateau, Veronique;Migonney, Veronique;Skalli, Wafa;Mitton, David
    • Advances in biomechanics and applications
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    • v.1 no.4
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    • pp.239-252
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    • 2014
  • This study aimed to assess the biomechanical performance of a new generation of artificial ligament, which can be considered "bioactive" and "biointegrated," implanted in sheep. Thirty sheep were implanted: 15 sheep received the artificial ligament grafted with a bioactive polymer (grafted) and 15 received the artificial ligament without a bioactive polymer (non-grafted). The animals were sacrificed 3 or 12 months after implantation. The knee kinematics, namely flexion-extension, anterior drawer, and varus-valgus tests, were evaluated using a fully characterized custom-made device. Afterward, the specimens were tested under uniaxial tension until failure. The flexion-extension showed significant differences between (grafted or non-grafted) artificial and native ligaments 3 months after implantation. This difference became non-significant 12 months postoperatively. The anterior tibial drawer was significantly increased 3 months after implantation and remained significantly different only for non-grafted ligament 12 months after implantation. Twelve months after implantation, the differences between grafted and non-grafted ligament biomechanical properties were significant in terms of stiffness. In terms of load to failure, grafted ligaments seem to have had slightly better performance than non-grafted ligaments 12 months postoperatively. Overall these results suggest that grafted artificial ligaments have slightly better biomechanical characteristics than non-grafted artificial ligaments 12 months after implantation in sheep.

Patellar Inferior Pole: New Landmark for the Anteromedial Instrument Portal for Arthroscopic Surgery of the Medial Meniscus Posterior Horn (슬개골 하극: 내측 반월상 연골판 후각부에 대한 관절경 수술을 위한 전내측 기구 삽입구의 새로운 표식)

  • Kim, Young-Mo;Hwang, Deuk-Soo;Lee, June-Kyu;Shin, Hyun-Dae;Kang, Tae-Hwan;Kim, Dong-Kyu;Kim, Pil-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.128-134
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    • 2008
  • Purpose: We prospectively evaluated the clinical usefulness of the patellar inferior pole (PIP) as a landmark of the anteromedial (AM) portal for the arthroscopic surgery of the medial mensiscus posterior horn (MMPH). Materials and Methods: Group 1 (50 normal left knees of adults), Group 2 (10 normal knees under anesthesia), and Group 3 (50 consecutive knees undergoing elective arthroscopic surgery for relatively simple intraarticular pathologies, or diagnostic arthroscopy) were included. In Group 1 and 2, the true lateral (A) and valgus stress lateral radiographs (B) on $30^{\circ}$ flexion were obtained, and the lines (AM portal line) passing through the PIP and distal-most medial femoral condyle (MFC) were drawn under the condition without considering the thickness of articular cartilage of MFC (1, 2-A, B group), and considering it as 2.5mm on B (1, 2-C group). Then, we investigated the meeting point of the AM portal line with medial tibial plateau (C-D percentage), and measured the distance between the PIP and the anterior joint line (E-length), and medial tibial-femoral joint space (F-length). In Group 3, the AM portal was made at the PIP level and clinical usefulness of the approach to the MMPH and body of the lateral meniscus (LM) was analyzed. Results: The average C-D percentage came out as 85.8, 101.3, 69.1% for each Group 1-A, B, C, and 102.4, 144.6, 116.8% for each Group 2-A, B, C. Measured E-length was an average of 15.1 (Group 1-A), 15.5 (Group 1-B, C), 13.1 (Group 2-A), and 12.9 mm (Group 2-B, C) and the change by valgus stress had no statistical significance. The F-length increased about 1.2 (Group 1) and 3.6 mm (Group 2) when valgus stress was applied, which had statistical significance (p<0.001, p<0.001). In Group 3, 49, 48 knees were classified as good for the MMPH, and the body of LM in aspect of the clinical usefulness of AM portal made on the PIP level. Conclusion: We identified the clinical usefulness of the PIP as a skin landmark of AM portal for the arthroscopic surgery of the MMPH.

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Arthroscopic Meniscectomy in Patients Aged Over 50 - More than 3 Years Follow-Up Result - (50세 이상 환자에서의 반월상 연골 절제술 - 최소 3년 이상 추시 결과 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Go, Sang-Hun;Jung, Kwang-Hwan;Cha, Jae-Ryong;Lee, Chae-Chil;Jeong, Ji-Young;Seo, Dong-Kyo
    • 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.

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Prognostic Factors Affecting the Treatment of the Tear of the Posterior Horn of Meniscus (반월상 연골 후각부 파열의 치료에 영향을 미치는 요인)

  • Ha, Dong-Jun;Kim, Chang-Wan;Seo, Seung-Suk;Cho, Il-Je
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.89-94
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    • 2009
  • Purpose: The purpose of this study was to evaluate the factors affecting the treatment results of medial meniscus posterior horn tear. Materials and Methods: Forty seven patients who had been performed the arthroscopic surgery for medial meniscus posterior horn tear were enrolled in this study. We analyzed the clinical outcomes with Lysholm score and Tegner activity score in accordance with the factors such as patients' age, tibiofemoral angle, uptake in bone scintigraphy, surgical methods and patterns of meniscal tears, respectively. Results: The patients' age didn't affect to the results, but the preoperative tibiofemoral angle over valgus $4^{\circ}$ and the preoperative normal uptake in scintigraphic assessment showed a positive influence on the clinical outcomes. The partial meniscectomy and repair in surgical methods had no statistically significance. In addition, the pattern of meniscal tear did not have an effect on the clinical results. Conclusion: We can conclude that many factors should be considered to get satisfactory results. Among them, preoperative bone scintigraphy may be a good assessment factor for the postoperative prognosis, reflecting the condition of meniscal tear and the periarticular bone and soft tissue.

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Effects of Visual Information Blockage on Landing Strategy during Drop Landing (시각 정보의 차단이 드롭랜딩 시 착지 전략에 미치는 영향)

  • Koh, Young-Chul;Cho, Joon-Haeng;Moon, Gon-Sung;Lee, Hae-Dong;Lee, Sung-Cheol
    • Korean Journal of Applied Biomechanics
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    • v.21 no.1
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    • pp.31-38
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    • 2011
  • This study aimed to determine the effects of the blockage of visual feedback on joint dynamics of the lower extremity. Fifteen healthy male subjects(age: $24.1{\pm}2.3\;yr$, height: $178.7{\pm}5.2\;cm$, weight: $73.6{\pm}6.6\;kg$) participated in this study. Each subject performed single-legged landing from a 45 cm-platform with the eyes open or closed. During the landing performance, three-dimensional kinematics of the lower extremity and ground reaction force(GRF) were recorded using a 8 infrared camera motion analysis system (Vicon MX-F20, Oxford Metric Ltd, Oxford, UK) with a force platform(ORG-6, AMTI, Watertown, MA). The results showed that at 50 ms prior to foot contact and at the time of foot contact, ankle plantar-flexion angle was smaller(p<.05) but the knee joint valgus and the hip flexion angles were greater with the eyes closed as compared to with the eyes open(p<.05). An increase in anterior GRF was observed during single-legged landing with the eyes closed as compared to with the eyes open(p<.05). Time to peak GRF in the medial, vertical and posterior directions occurred significantly earlier when the eyes were closed as compared to when the eyes were open(p<.05). Landing with the eyes closed resulted in a higher peak vertical loading rate(p<.05). In addition, the shock-absorbing power decreased at the ankle joint(p<.05) but increased at the hip joints when landing with the eyes closed(p<.05). When the eyes were closed, landing could be characterized by a less plantarflexed ankle joint and more flexed hip joint, with a faster time to peak GRF. These results imply that subjects are able to adapt the control of landing to different feedback conditions. Therefore, we suggest that training programs be introduced to reduce these injury risk factors.