• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.88-91
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• 2007

Persistent instability following an acute lateral ankle sprain eventually require ligamentous reconstruction in some cases. Over 50 surgical procedures have been described to reestablish lateral ankle stability varying from direct in situ repair of the anterior talofibular ligament and the calcaneofibular ligament to augmented reconstructions with either autograft or allograft tissue. The author describes the rationale and the technique of anatomic ankle ligament reconstruction with the 4th extensor digitorum longus tendon.

• Advances in nano research
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• v.13 no.3
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• pp.247-257
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• 2022

Extraordinary properties of nanocomposites make them a primary replacement for many conventional materials. Anterior cruciate ligament (ACL) reconstruction, which is a frequent surgery in sport activities, is one of the fields in which nanocomposites could be utilized. In the present study, the mechanical properties of different porous scaffolds made from graphene nano-composites are presented ad load bearing capacity of these materials is calculated using finite element method. The numerical results are further compared with experimental published data. In addition, several geometrical and material parameters are analyzed to find the best configuration of nanocomposite scaffolds in reconstruction of ACL. Moreover, coating of detoxification chemicals are extremely easier on the nano-structured materials than conventional one. Detoxification potential of nano-composites in the injured body are also discussed in detail. The results indicated that nano-composite could be successfully used in place of auto- and allografts and also instead of conventional metallic screws in reconstruction of ACL.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.117-121
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• 2007

Purpose: The purpose of this study is to evaluate the results of arthroscopic primary repair of a posterior cruciate ligament(PCL) avulsion injury without bony fragment at the femoral attach site. Materials and Methods: From Jan. 1993 to Dec. 2002, we performed 10 cases of PCL repair by arthroscopic suture technique. The mean follow-up period was $38.7{\pm}11$ months and the mean age of the patients was $28.2{\pm}6$ years old. 8 cases were men. 2 cases were women. At last follow-up, all cases were evaluated with the Lysholm and Gillquist knee rating system and International Knee Documentation Committee criteria. Posterior tibial displacement on stress lateral radiograph and posterior instability with posterior drawer test were measured also in all cases. Results: The mean Lysholm and Gillquist score was $94.5{\pm}2.6$. 4 cases were IKDC A(normal) and the other 6 cases were IKDC B(nearly normal). Posterior instabilities by posterior drawer test were grade I in 5 cases and grade II in 5 cases. A mean posterior translation of tibia was $3{\pm}2.3$ mm on stress lateral radiographs. Conclusion: Arthroscopic primary repair of PCL avulsion without bony fragment at the femoral attach site is one of the useful methods that reduce the posterior instability and improve the functional outcomes.

• Journal of the Korean Arthroscopy Society
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• v.7 no.1
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• pp.63-69
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• 2003

Purpose : Clinical outcome of meniscal repair fur meniscal injury was examined and the factors affecting the outcome were determined. Materials and Methods : We examined 55 patients with meniscal injury who underwent arthroscopic meniscal repair and could be followed-up for more than 1 year. Clinical outcome according to Tapper & Hoover classification was examined in relation with age, gender, injury site, the presence of bucket-handle tear, method of repair, the period between injury to repair, and the concomitant reconstruction of anterior cruciate ligament. Results : According to Tapper & Hoover classification, the outcome was excellent in 29 cases, good in 23 cases and fair in 3 cases. Age and method of repair have significant relationships with clinical results according to Tapper & Hoover classification, but gender, injury site, the presence of bucket-handle tear, the period between injury to suture, and the concomitant reconstruction of anterior cruciate ligament have no significant relationships. Conclusion : A satisfactory results was obtained in $95\%$ of the patients with meniscal injury with meniscal repair. Age at injury and method of repair have significant relationships with clinical result statistically.

• 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 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.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.22-29
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• 2022

Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.112-115
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• 1997

While the cruciate ligament has a profuse vascular response following injury, spontaneous repair does not occur. This may result from the fact that synovial fluid dilution of the hematoma following injury prevents the formation of a fibrin clot and thus the initiation of the healing mechanism. Another theory suggests that the dynamic nature of the fascicles of the anterior cruciate ligament(ACL) through even small ranges of motion prohibits spontaneous union to these fibers. But we experienced two cases of spontaneous healing of partially injured ACL. Initially they showed more than grade II anterior instability. 6 mm difference by stress roentgenographs(pull view) and difference of 8 mm by KT 1000TM arthrometer between the ACL injured knee and normal side knee. Lax, nearly complete tear of ACL and synovial bleeding were noted during arthroscopic examination but the continuity of synovial membrane was seemed to be intact. These cases were treated by conservative management rather than reconstructive procedure. Postoperatively they showed excellent clinical results, no anterior instability and unlimited athletic activity. Based on our clinical experience. we think that cruciate ligament has the spontaneous healing potential in acute stage and middle aged patient. We consider the microfracture technique and initial immobilization for accelleration of healing response of the ACL.

• Journal of Veterinary Clinics
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• v.34 no.5
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• pp.366-369
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• 2017

A 30 kg, 6-year-old spayed female Samoyed dog was referred with a history of intermittent weight-bearing lameness in her right hindlimb for 3 weeks. The patient hadsurgery to correct a medial patellar luxation in the same limb 3 years prior. Based on the physical examination and radiographic findings, MPL and CCLR of the right hindlimb were diagnosed. Pre-surgical arthroscopy examination was performed, revealing a complete rupture of the cranial cruciate ligament, medial caudal meniscal tears and fibrotic cartilagechanges on the trochlear groove. An arthroscopy-assisted partial meniscectomy was used to repair themedial caudal meniscus. To correct the tibial plateau angle and medial patellar luxation, a tibial plateau leveling osteotomy (TPLO) was performed. A tibial tuberosity transposition (TTT) was performed to realignthe quadriceps mechanism with the trochlear block recession followed by soft tissue reconstruction. The post-surgical recovery was uneventful, and the patient was weight-bearing with normal ambulation on the repaired limb. There were no complications, and the implants were well positioned at the last follow-up. The clinical outcome of the caseindicates that combining TPLO with TTTis a good surgical option for treatingconcurrent CCLR and MPL.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.259-261
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• 2005

Ganglion is the most common soft tissue tumor of the hand, and most of them usually arise from the scapholunate ligament, scarphotrapezial ligament, radiocarpal joint or flexor tendon sheath. However, intratendinous ganglion is very rare with unknown etiology and pathogenesis that originates within tendon. We have experienced three clinical cases of intratendinous ganglion in extensor tendons of hand. The average of patients at operation was 36 years. All patients were treated by excision of the ganglion in conjunction with tenosynovectomy followed by repair of the tendon. The length of mean follow up time was 6.7 months and all of them showed no evidence of recurrence.