• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.80-84
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• 1998

The isometric position for the graft is important in the anterior cruciate ligament reconstruction surgery. It is well known that the femoral position is more critical than tibial side. But, there is few deciding method of proper graft position after the anterior cruciate ligament reconstruction surgery. So we planned to evaluate the ideal femoral isometric position with 6 adult cadavaric femurs and exact radiographs. After the insertion of femoral interference screw on ideal isometric position, we obtained roentgenograms of true lateral view and 10, 20, 30, 45 degree internal and external rotation views. Then we measured the shortest distance from the posterior cortical margin of lateral femoral condyle to posterior border of interference screw on the radiographs. We also measured true distance between posterior cortical margin of lateral femoral condyle to the posterior margin of femoral tunnel after cutting of distal femur. Based on this study, we could not determine the permissible rotation degree of radiographs. But we concluded that if the distance between posterior cortical margin of lateral femoral condyle and posterior border of interference screw ranges 4.5-6.5mm on the lateral view, the femoral position is considered as a relatively ideal isometric good position.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.190-190
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• 2009

• Journal of the Korean Society for Precision Engineering
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• v.26 no.6
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• pp.131-135
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• 2009

In this study, we performed the compressive strength test of trabecular bone in knee joint for measuring the elastic modulus and ultimate strength. The main knee joint is femorotibial articulation between the lateral and medial femorotibial condyle. In the case of osteoarthritis, some patients have only medial condylar osteoarthritis. We performed the mechanical test for comparison the difference of the each condylar strength. We used diamond core-drill and linear precision saw for making the specimens. Specimens were cored from both condyle in distal femur and proximal tibia in fresh cadaver (male 10, female 12), and tested by universal test machine with temperature control saline circulation system. Results of the test in distal femoral parts, averaged elastic modulus was $360.61{\pm}159.40MPa$ for male, $150.89{\pm}70.65MPa$ for female. Averaged ultimate strength was $6.79{\pm}2.91MPa$ for male, $2.89{\pm}1.31MPa$ for female. Male was 2.4 times stronger than female. In the proximal tibial parts, averaged elastic modulus was $108.80{\pm}52.88MPa$ for male, $73.45{\pm}55.06MPa$ for female. Averaged ultimate strength was $2.59{\pm}1.39MPa$ for male, $1.75{\pm}1.16MPa$ for female. Male was 1.5 times stronger than female. In the distal femoral condyle, medial condyle had more strength than lateral condyle at middle region. But lateral condyle had more strength than medial condyle at anterior & posterior regions (p<0.02). In the proximal tibial condyle, medial condyle had more strength than lateral condyle. (p<0.01).

• Korean Journal of Radiology
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• v.23 no.6
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• pp.674-687
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• 2022

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.102-107
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• 1997

Discoid meniscus has been well known to a frequent anomaly of meniscus and much reported in diagnosis and treatment. But, associated X-ray findings have not been known well. We reported its significance of X-ray findings in discoid meniscus. From May 1995 to May 1997, 31 cases of discoid meniscus were compared with 51 cases of nondiseoid meniscus both confirmed by arthroscopy, with simple X-my findings. Both groups were evaluated by X-ray findings in view of lateral joint space widening, peripheral spur of lateral joint space, sclerotic change of lateral tibial plateau, concave lateral tibial plateau, flattening of lateral femoral condyle, hypoplasia of lateral femoral condyle and high riding fibula. The results of analysis were as follows: 1. Widening of lateral joint space, sclerotic change of lateral tibial plateau and cupping of lateral tibial plateau were statistically significant in discoid meniscus. 2. X-ray findings in discoid meniscus were not associated with patient's injury history and symptom duration. 3. Other X-ray findings were not related in discoid meniscus significantly. X-ray findings with patient's history and physical examination arc helpful in the diagnosis of discoid meniscus.

• The Korean Journal of Pain
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• v.31 no.4
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• pp.289-295
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• 2018

Background: The intraarticular (IA) injection has become popular for the management of the osteoarthritic knee without an effusion. The success rate of IA injection would be better if it was able to be visually confirmed. We hypothesized that an anterolateral approach, which targets the synovial membrane of the lateral condyle using ultrasound, would provide an equivalent alternative to the anterolateral approach, targeting the synovial membrane of the medial condyle for IA injection of the knee. Methods: A total of 96 knees with osteoarthritis were randomized placed into the two groups, which were group I (anterolateral approach to the medial condyle) and group II (anterolateral approach to the lateral condyle). The primary outcome was to compare the success rate of the two methods of IA injection. The required length of the needle for injection was also measured and compared. Pain intensity was assessed using the Numeric Rating Scale in order to evaluate the success of injection. Results: There were no significant differences in the success rate between both groups. The success rate of group I and group II were 87.8% (95%, CI 78.7-97.0) and 91.5% (95%, CI 83.6-99.5), respectively (P = 0.549). The needle depth was $5.0{\pm}0.8$ (3.0 to 6.1 cm) in group I, and $3.0{\pm}0.8$ (1.5 to 5 cm) in group II (P < 0.001). Conclusions: The anterolateral approach to the lateral femoral condyle, using ultrasound, is an alternative method to the approach targeting the medial femoral condyle, using shorter needle.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.185-188
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• 1998

Spontaneous osteonecrosis of the knee was first described by Ahlbck et al in 1968 as the spontaneous and sudden onset of severe pain, usually on the medial side of the knee joint, in old age(>60 years) with no specific etiologic factors. They differentiate the disease from osteochondritis dissecans, osteoarthritis, fracture, infection, neuropathic joint and secondary osteonecrosis of the knee joint. So far many investigators described this disease but had never observed cases developed in young patient with familial occurrence. The report presented here is a case of spontaneous osteonecrosis of both medial and lateral femoral condyles involving the bilateral knee joint that were treated by arthorscopic loose body removal and multiple drilling.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.300-308
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• 1999

Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.49-54
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• 2002

Purpose : To analyze the clinical results of treatment for the osteochondritis dissecans of femoral condyle by age, the type of lesion and method of treatment. Methods : From March 1991 to February 2000, 17 patients (20 cases) with osteochondritis dissecans of the femoral condyle were followed up over 1 year. Three patients had bilateral lesion. There were 12 cases with trauma history (9 cases with sports injury and 3 cases with direct trauma). The initial symptoms were pain, clicking, locking, giving way in the order of frequency, pain was revealed in all cases. Clinical evaluation of IKDC and Hughston method were used for subjective and objective function. Results : The number of male patient was 12, and the mean age was 19.8 year old (11$\~$50). The location of the lesion was 14 cases in medial femoral condyle and 6 cases in lateral femoral condyle. The arthroscopic findings of the lesion in 15 cases were as follows, early separation in 6 cases, partially detachment in 4 cases, and crators and complete detachment in 5 cases. 5 cases were treated with mutiple drilling and 5 cases with Herbert screw fixation, 3 cases with Herbert screw fixation and bone graft. In early stage, 7 cases were treated with conservative method. In the grading of Hughston score, 6 cases were graded as excellent, 9 cases as good, 15 cases were graded as good to excellent. Based on the IKDC scale, 1 case was graded as normal, 6 as nearly normal, and 10 as abnormal. Conclusions : The trauma seemed to be important factor in occurrence of osteochondritis dissecans of the femoral condyle. The clinical results of juvenile period showed better than adolescence and adult period, it is necessary to detect the lesion as soon as possible. The result of subjective evaluation was worse than the Hughston evaluation. It was caused by limiting involvement of sports activity and limited activity in the adolescence.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.168-172
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• 1998

Discoid lateral menisci were common morphological anomaly and several classifications were proposed. Watanabe et al classified all discoid menisci, as seen arthroscopically, into three types 1) complete 2) incomplete and 3) Wrisberg ligament type. The purpose of this study is to report a rare case of both painful snapping knee joints in 6 year-old female. On arthroscopic examination, complete lateral discoid meniscus which consisted of taut Wrisberg ligament and intact tibial insertion of posterior horn was found, and abnormal anterior cruciate ligament(ACL) which has expanded femoral origin over the posterior articular surface of lateral femoral condyle was also found. At the time of arthroscopic surgery, hypertrophied high-riding Wrisberg ligament was resected, and expanded femoral origin of the anterior cruciate ligament was partially resected nearly to normal margin, and discoid lateral meniscus was saucerized. After these procedures, abnormal snapping sound was disappeared in full range of motion. On the follow-up examination after 1 year, pain and snapping sound were disappeared and any instability and limping were not found.