• Title/Summary/Keyword: Ligament augmentation

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Arthroscopic Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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Posterior Cruciate Ligament Augmentation Using an Autogenous Hamstring Tendon Graft and the Posterior-Posterior Triangulation Technique (만성 단독 후방십자인대 파열에서 자가 슬괵건과 후-후 삼각술기를 이용한 만성 후방십자인대 보강술)

  • Kim, Yeung Jin;Chae, Soo Uk;Choi, Byong San;Kim, Jong Yun;Lee, Hwang Yong;Han, Chang Wan;Han, Su Hyoun
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.24-30
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    • 2013
  • Purpose: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique with preservation of ligament remnant or elongated ligament. Materials and Methods: From January 2002 to December 2009, we performed PCL augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique in 32 patients. The mean age was 35.2 years. Twenty two cases were male and 10 cases were female. Average follow-up period was 5 years and 5 months (range: 2-7.9). Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, International Knee Documentation Cominittee (IKDC) grade, and second look arthroscopic examination. Results: At last follow up posterior displacement by the Telos stress test decreased from $10.8{\pm}5.1\;mm$ to $2.8{\pm}3.7\;mm$ (p<0.05). The final Lysholm knee score improved from $60.4{\pm}5.8$ to $84.6{\pm}4.8$. Tegner activity score improved from 3.2 to 4.8. The final IKDC grade was A in 18, B in 11, C in 3. Postoperative Lysholm knee score, IKDC grades, Tegner activity scale, and posterior displacement demonstrated statistically significant improvement compared to the preoperative state (p<0.05). Conclusion: Arthroscopic PCL reconstruction using an autogenous hamstring tendon with preservation of ligament remnant showed a good clinical results and posterior stability.

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Coracoclavicular Ligament Augmentation Using TightRope® for Acute Acromioclavicular Joint Dislocation : Surgical Technique and Preliminary Results (TightRope®를 이용한 급성 견봉 쇄골 관절 탈구의 치료 : 수술 술기 및 예비 보고)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Kang, Chul-Hyung;Oh, Geon-Myeoung
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.165-171
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    • 2008
  • Purpose: The purpose of this study was to introduce a new surgical technique and to evaluate the preliminary results after operative treatment with using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation. Material and Methods: We studies 10 patients who were followed up for more than 6 months after operative treatment with using an TightRope$^{(R)}$. A longitudinal incision approximately 4cm in length was made from 1cm medial to the acromioclavicular joint to the coracoid process, and then coracocalvicular ligament augmentation using TightRope$^{(R)}$ was done after splitting the deltoid. For postoperative stability, two 1.6 mm Kirschner wires were inserted temporarily across the acromioclavicular joint in all cases. The radiologic results on the serial plain radiographs and the clinical results according to the UCLA score were analyzed. Results: Radiologically, 7 cases showed anatomical reduction, 2 cases showed a slightly loss of reduction and 1 case showed partial loss of reduction. Clinically, 6 cases were excellent, 3 cases were good and 1 case was fair. Conclusion: Coracoclavicular ligament augmentation using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation is a minimally invasive, safe procedure that provides satisfactory radiologic and clinical preliminary results. Yet the long-term results have to be analyzed to determine the final results of this procedure.

Current Concepts in Reconstruction of Anterior Cruciate Ligament (전방십자인대 재건술의 경향)

  • Yoon, Kyoung Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.1-7
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    • 2013
  • This article provides an overview of the current concepts regarding anterior cruciate ligament reconstruction, including anatomy, biomechanics, operative techniques and clinical results. Many techniques have been introduced for ACL reconstruction: single bundle reconstruction, remnant preserving augmentation, and double bundle reconstruction. Each technique has its strong and weak points, and it is not sure which technique is superior than others. It is considered to suggest that rather than to select the same method of surgery in all patients, select the method of reconstruction depending on the characteristics of the individual patient, the state of the residual ligaments and extent of the damage.

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Early Unrestricted Weight-Bearing in a Stirrup Brace Following the Broström Procedure with Suture Tape for Chronic Lateral Ankle Instability (족관절 외측의 만성 불안정성에 Broström 술식과 Suture Tape을 이용한 보강술 후 조기에 시행한 등자보호대 착용 및 체중부하 보행)

  • Jaeyoung, Lee;Geon-Ho, Kwon;Jin-Wha, Chung
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.171-176
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    • 2022
  • Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Brostrom procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Brostrom procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Brostrom procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

Forced orthodontic eruption for augmentation of soft tissue prior to implant placement (임플란트 식립 전 연조직 증대를 위한 교정적 정출술)

  • Park, Chul-Wan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.29 no.1
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    • pp.54-61
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    • 2020
  • Forced orthodontic eruption(FOE) is a non-surgical treatment approach that allows augmenting both soft- and hard-tissue profiles of potential implant sites, by forced orthodontic extrusion of "hopeless" teeth and their periodontal apparatus. By stretching the gingival and periodontal ligament fibers during extrusion, tension is imparted to the entire alveolar socket, stimulating osseous apposition at the alveolar crest. FOE increases the width of the attached gingiva, and the mucogingival junction remains stable when the gingival margin migrates coronally. Based on these effects, FOE of non-restorable teeth prior to implant placement is a viable alternative to conventional surgical augmentative procedures in implant site development. The aim of this case report is to describes coronal soft-tissue augmentation around fractured teeth, which was achieved by FOE before implant placement.

Comparison of the Modified Brostrom Repair Technique with and without Augmentation Using Suture Tape for Chronic Ankle Instability (만성 족관절 불안정성을 가진 환자군에서 변형 브로스트롬 술식과 봉합 테이프를 추가한 술식 간의 결과 비교)

  • Gwak, Heui-Chul;Jung, Soo-Hwan;Kim, Jung-Han;Park, Dae-Hyun;Choo, Hye-Jung;Kim, Dae-Yoo
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.40-47
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    • 2022
  • Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m2; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

Simultaneous Acute Rupture of Anterior Cruciate Ligament and Patellar Tendon - A Case Report - (전방십자인대 및 슬개건 급성 동시 파열 - 1예 보고 -)

  • Kim, Yeung-Jin;Kim, Tae-Kyun;Yang, Hwan-Deok;Kim, Hyoung-Jun;Park, Jin-Young;Seo, Kwang-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.103-107
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    • 2006
  • Simultaneous acute rupture of the anterior cruciate ligament (ACL) and the patellar tendon is a very unusual injury. That is difficult to diagnose in initial evaluation of knee injury, because the patellar tendon rupture is often missed. We report a 26 year-old male patient who was treated with ACL reconstruction using achilles allograft and direct patellar tendon repair with achilles allograft augmentation. The patient had the stable knee and full range of motion. It's clinical results were excellent(Lysholm score 93, Tegner activity score 6).

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