• Title/Summary/Keyword: Lateral Stability

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Clinical Results of ACL Reconstruction in the Immature Adolescent via Transphyseal Approach in Tibia Based on a New Indication Paradigm (새로운 수술적응증에 의한 골 미성숙 전방십자인대 손상 환자에서의 성장판을 통과하는 전방십자인대 재건술의 결과)

  • Lee, Dong Chul;Shon, Oog Jin;Park, Chul-Hyun;Kwon, Moon Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.1-8
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    • 2012
  • Purpose: To evaluate clinical and radiologic outcomes of transphyseal anterior cruciate ligament (ACL) reconstruction in patients with open physes who were selected with authors' new operative indications. Materials and Methods: We evaluated 15 patients with open physes who underwent a transtibial ACL reconstruction and were followed up for 4~6 years after surgery. Our operative indications involved 1) choronologic age of ${\geq}$ 16 in male and ${\geq}$ 14 in female, 2) open physes of ${\leq}$ 2 mm width, and 3) Risser sign and Tanner stage of ${\geq}$ 3. Tibialis anterior tendon allograft was used in all patients, and endobutton and bioscrew were used for femoral and tibial fixations, respectively. Functional outcomes were evaluated using Lysholm Knee Scoring scale, Tegner activity scale, and International Knee Documentation Committee (IKDC) 2000 subjective score. Physical examinations to evaluate stability involved Lachman and pivot shift tests. For radiographic results, we evaluated side to side differences of anterior displacement in stress views. In addition, with use of scannograms taken at last follow-up, we examined side to side differences of femorotibial angles, anatomical and mechanical lateral distal femoral angles, mechanical medial proximal tibial angles and leg lengths. Results: The mean Lysholm Knee score was 51(40-61) points preoperatively and 97(94-100) points at last follow up. The mean Tegner activity score was 2.6 points preoperatively and 7.1 points at last follow up. The mean IKDC score was 32.6 points preoperatively and 88.3 points at last follow up. The mean anterior displacement of the tibia was improved from 6.7(${\pm}1.0$) mm to 1.9(${\pm}0.9$) mm. There were no leg length discrepancies over 5 mm and no statistically significant differences in all the radiographic variables representing growth disturbance. Conclusion: This study suggests that patients with open physes who selected by authors' new indication would safely undergo transphyseal ACL reconstruction with successful outcomes.

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Complex Terrain and Ecological Heterogeneity (TERRECO): Evaluating Ecosystem Services in Production Versus water Quantity/quality in Mountainous Landscapes (산지복잡지형과 생태적 비균질성: 산지경관의 생산성과 수자원/수질에 관한 생태계 서비스 평가)

  • Kang, Sin-Kyu;Tenhunen, John
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.12 no.4
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    • pp.307-316
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    • 2010
  • Complex terrain refers to irregular surface properties of the earth that influence gradients in climate, lateral transfer of materials, landscape distribution in soils properties, habitat selection of organisms, and via human preferences, the patterning in development of land use. Complex terrain of mountainous areas represents ca. 20% of the Earth's terrestrial surface; and such regions provide fresh water to at least half of humankind. Most major river systems originate in such terrain, and their resources are often associated with socio-economic competition and political disputes. The goals of the TERRECO-IRTG focus on building a bridge between ecosystem understanding in complex terrain and spatial assessments of ecosystem performance with respect to derived ecosystem services. More specifically, a coordinated assessment framework will be developed from landscape to regional scale applications to quantify trade-offs and will be applied to determine how shifts in climate and land use in complex terrain influence naturally derived ecosystem services. Within the scope of TERRECO, the abiotic and biotic studies of water yield and quality, production and biodiversity, soil processing of materials and trace gas emissions in complex terrain are merged. There is a need to quantitatively understand 1) the ecosystem services derived in regions of complex terrain, 2) the process regulation occurred to maintain those services, and 3) the sensitivities defining thresholds critical in stability of these systems. The TERRECO-IRTG is dedicated to joint study of ecosystems in complex terrain from landscape to regional scales. Our objectives are to reveal the spatial patterns in driving variables of essential ecosystem processes involved in ecosystem services of complex terrain region and hence, to evaluate the resulting ecosystem services, and further to provide new tools for understanding and managing such areas.

Posterior Lumbar Interbody Fusion Using Posterolateral Placement of A Single Cylindrical Threaded Cage and Two Regular Cages : A Biomechanical Study (단일 나사형 Cage를 이용한 후방 요추체간 융합술과 두개의 나사형 Cage를 이용한 PLIF의 생체 역학적 비교)

  • Park, Choon Keun;Hwang, Jang Hoe;Ji, Chul;Kwun, Sung Oh;Sung, Jae Hoon;Choi, Seung Jin;Lee, Sang Won;Kim, Moon Kyu;Park, Sung Chan;Cho, Kyeung Suok;Park, Chun Kun;Yuan, Hansen;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.883-890
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    • 2001
  • Objectives : An in vitro biomechanical study of posterior lumbar interbody fusion(PLIF) with threaded cage using two different approaches was performed on eighteen functional spinal units of bovine lumbar spines. The purpose of this study was to compare the segmental stiffnesses among PLIF with one long posterolateral cage, PLIF with one long posterolateral cage and simultaneous facet joint fixation, and PLIF with two posterior cages. Methods : Eighteen bovine lumbar functional spinal units were divided into three groups. All specimens were tested intact and with cage insertion. Group 1(n=12) had a long threaded cage($15{\times}36mm$) inserted posterolaterally and oriented counter anterolaterally on the left side by posterior approach with left unilateral facetectomy. Group 2(n=6) had two regular length cages($15{\times}24mm$) inserted posteriorly with bilateral facetectomy. Six specimens from group 1 were then retested after unilateral facet joint screw fixation in neutral(group 3). Likewise, the other six specimens from group 1 were retested after fixation with a facet joint screw in an extended position(group 4). Nondestructive tests were performed in pure compression, flexion, extension, lateral bending, and torsion. Results : PLIF with a single cage, group 1, had a significantly higher stiffnesses than PLIF with two cages, group 2, in left and right torsion(p<0.05). Group 1 showed higher stiffness values than group 2 in pure compression, flexion, left and right bending but were not significantly different. Group 3 showed a significant increase in stiffness in comparison to group 1 for pure compression, extension, left bending and right torsion(p<0.05). For group 4, the stiffness significantly increased in comparison to group 1 for extension, flexion and right torsion(p<0.05). Although there was no significant difference between groups 3 and 4, group 4 had increased stiffness in extension, flexion, right bending and torsion. Conclusion : Posterior lumbar interbody fusion with a single long threaded cage inserted posterolaterally with unilateral facetectomy enables sufficient decompression while maintaining a majority of the posterior elements. In combination with a facet joint screw fixation, adequate postoperative stability can be achieved. We suggest that posterolateral insertion of a long threaded cage is biomechanically an ideal alternative to PLIF.

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