• Journal of Biomedical Engineering Research
• /
• v.23 no.3
• /
• pp.171-179
• /
• 2002

It is well known that the geometry of the articular surface plays a major role in the kinematic and kinetic analysis to understand human knee joint function during motion. The functionality of the knee joint cannot be accurately modeled without considering the effects of sliding and lolling motions. We Present a 3-D human knee joint model considering sliding and rotting motion and major ligaments. We employ more realistic articular geometry using two cam profiles obtained from the extrusion of the sagittal Plain view of the representative Computerized Tomography image of the knee joint compared to the previously reported model. Our model shows good agreement with the already reported experimental results on Prediction of the lines of force through the human joint during gait. The contact point between femur and tibia moves toward the Posterior direction as the knee undergoes flexion, reflecting the coupling of anterior and Posterior motion with flexion/extension. The anterior/posterior displacement of the contact Point on the tibia plateau during one gait cycle is about 16 mm. for the lateral condyle and 25 mm. for the medial condyle using the employed model Also. the femur motion on the tibia undergoes lateral/medial movement about 7 mm. and 10 mm. during one gait cycle for the lateral condyle and medial condyle. respectively. The developed computational model maybe Potentially employed to identify the joint degeneration.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.140-145
• /
• 2011

Purpose: Installing a radial head prosthesis has developed into a reliable procedure to replace the native radial head for treating unreconstructible radial head fracture when this is associated with an unstable elbow or forearm. A variety of implants have been developed and these are now commercially available. This article reviews the literature related to the indications, the available implants and the surgical techniques of radial head replacement arthroplasty. Materials and Methods: The main indication for a metallic radial head prosthesis is a comminuted fracture that is not amenable to reconstruction, and particularly if it is associated with complex elbow injuries. Excision of the radial head should be avoided in the presence of combined injured ligaments or interosseous membrane injury. Three different implants are available in Korea, including the bipolar, press fit monopolar and loose fit monopolar radial head prostheses. A primary technical goal of radial head arthroplasty is the insertion of an implant that closely replicates the native radial head. The major pitfall when using a metallic radial head prosthesis is the insertion of a longer implant, which results in overstuffing of the radiocapitellar joint. Results and Conclusion: Satisfactory clinical results can be anticipated when a radial head prosthesis is used for the correct indications and when a systemic approach is undertaken to ensure proper sizing. For the future studies, we need data regarding the long term outcomes and comparison of the various types of prostheses.

• Clinics in Shoulder and Elbow
• /
• v.13 no.2
• /
• pp.286-292
• /
• 2010

Purpose: Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. Materials and Methods: Morrey et al. reported that the functional range of motion of the elbow joint is $30-130^{\circ}$ of flexion-extension and $50^{\circ}C$ of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge. Results and Conclusions: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.

• Clinics in Shoulder and Elbow
• /
• v.9 no.1
• /
• pp.50-59
• /
• 2006

Purpose: The nonoperative outcome of elbow dislocations with associated radial head and coronoid fractures are often unsatisfactory because of chronic instability and stiffness from proloned immobilization, Therefore we managed these injuries with well programed surgical appproaches. Method: Ten patients with this injury were evaluated retrospectively from May 1998 to June 2004 after a minimum of 12 months. These injuries include elbow dislocation and associated fractures of both the radial head and the coronoid process. All ten patients were treated by one clinic operatively with similar scheduled surgical methods which started on the lateral side and terminated on the medial side of the elbow. Radial head and neck fractures were classified Mason types, as two and three types respectively with six and four cases and six cases were fixated. Coronoid process were fixated with screws anteroposterior directly or anchor suture in all cases, each type was classified one, two and three. where were three type one, four type two, and three type three were according to Regan and Morrey classification. Results: The outcome was three resulting in excellent, four good, two normaland and the remaining case was one poor according to the Mayo Elbow Performance score. At a terminal follow up, the range of motion of the elbow averaged flection contracture, $6^{\circ}(0{\sim}20^{\circ})$ and further flection, $129^{\circ}(115{\sim}140^{\circ})$. Two patients had complications requiring additional care. One, displaced coronoid process which was repaired with capsule and the other patient experienced, palsy of ulnar nerve and contracted elbow joint. Conclusions: Usage of early operation as the minimum injury of medial ligaments complex and the rigid fixation of fractures to prompt motion with our scheduled management for elbow dislocations with associated radial head and coracoid fractures provided excellent results.

• The Journal of Korean Physical Therapy
• /
• v.12 no.2
• /
• pp.255-265
• /
• 2000

The term 'myositis ossificans' encompasses four categories of clinicopathological disorders. The first, myositis ossificans progressive(fibrodysplasia ossificans progressive), is a rare genetic disease characterized by progressive heterotopic ossification involving skeletal muscle, tendon, ligaments, and fascia, with congenital malformation of the great toes, and usually microdactyly, monophalangism, and mal formed proximal phalanges. with valgus deformity of metatarsophalangeal joint. The ossification begins shortly after birth and may contribute to the patient's death. The second, heterotopic ossificans, can occur in patients with neuromuscular and chronic diseases such as paraplegia, poliomyelitis, polymyositis, bum, tetanus, and infection. But the lesions in these cases often lack the typical histologic features of myositis ossificans. The third, myositis ossificans traumatica, is the most common; it develops in response to soft tissue trauma such as a single severe injury, minor repetitive injures, fracture, joint dislocation, stab wound, or surgical incision. The forth, nontraumatic myositis ossificans, also designated :pseudomalignant osseous tumors of extraskeletal soft tissues' and 'psedomalignant myositis ossificans', occurs in persons repeated small mechanical injures or nonmechanical soft tissue injuries due to local ischemia, inflammation. or other factors cannot be ruled out in such cases.

• Journal of Acupuncture Research
• /
• v.18 no.6
• /
• pp.114-124
• /
• 2001

Objective : To evaluate the effect of treatment for cervical headache by using Cathami Flos herbal acupuncture that are known for anti-inflammatory and function of relieving the pain. Methods : Evaluated the result of Cathami Flos herbal acupuncture treatment twice in a week for patients who have cervical headache with cervical MRI abnormality at Gun-Po Oriental medical hospital in affiliation with wonkwang university. Results : 1. In the distribution of sex; Female rate was 45.9% and male rate was 54.1%., In the distribution of age, Thirties and forties group was the largest group by each 32.8%. 2. In the distribution of Cervical MRI abnormality; Abnormality of C2/3, C3/4, C4/5 was 94.6%, disk bulging and disk protrusion was 94.5%. 3. The effect of treatment by age was as follows; Thirties and forties group were each 31.1%, total 62.2%. 4. In the distribution of treatment period and curative value; 'Two weeks to four week' was 63.9%. Conclusion : These results shows that it is possible for headache to be occurred by cervical abnormality and that the effect of treatment by Cathami Flos herbal acupuncture is exellent by relaxing contracted muscles, strengthening weakened' ligaments and improving inflammatory parts.

• Journal of Biomedical Engineering Research
• /
• v.21 no.3 s.61
• /
• pp.295-301
• /
• 2000

It is known that among many factors, relative micromotion at bone/implant interfaces can hinder bone ingrowth into surface pores of an implant. Loading conditions, mechanical properties of spinal materials, friction coefficients at the interfaces and geometry of spinal segments would affect the relative micromotion and spinal stability. A finite clement model of the human lumbar spine segments (L4-L5) was constructed to investigate the mechanical sensitivity at the interfaces between bone and cage. Relative micromotion. Posterior axial displacement. bone stress, cage stress and friction force were predicted in changes of friction coefficients, loading conditions. bone density and age-related material/geometric properties of the spinal segments. Relative micromotion (slip distance in a static loading means relative micromotion in routine activity) at the interfaces increased significantly as the mechanical properties of cancellous bone, annulus fibers or/and ligaments decrease or/and as the friction coefficient at the interfaces decreases. The contact normal force at the interfaces decreased as cancellous bone density decreases or/and as the friction coefficient increases A significant increase of slip distance at anterior annulus occurred with an addition of torsion to compressive preload. Relative micromotion decreased with an increase of disc area. In conclusion. relative micromotion, stress response. Posterior axial displacement and contact normal force are sensitive to the friction coefficient of the interfaces, bone density, loading conditions and age-related geometric/material changes.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.1 no.1
• /
• pp.55-60
• /
• 2002

Purpose : To assess the change in the number of mechanoreceptors of posterior cruciate ligament(PCL) after transecting posterior cruciate ligament of the rabbit. Materials and Methods : We selected 10 skeletally-matured New Zealand white rabbits and one of the two posterior cruciate ligaments was transected and the other underwent sham-operation on each rabbit. Afterward, PCLs with synovium were obtained at femoral attach area in both knees in 20 weeks postoperatively, but in one of the cases, the transected PCL did not heal and had to be excluded from this study. Consequently, histologic examination of the ligament for the remaining 9 cases was done after being prepared with modified gold chloride stain. Results : The study showed a little bit more decrease in the number of mechanoreceptors in the transected group compared with that in the sham-operated group, but the number was statistically negligible. Conclusions : It is considered that the knee joint with injured PCL may still maintain proprioception since the decrease in the number of mechanoreceptors is not considerable, but further study on biomechanical role and function of mechanoreceptor of healed PCL is required.

• Archives of Plastic Surgery
• /
• v.37 no.6
• /
• pp.783-787
• /
• 2010

Purpose: There are many articles describing about Guyon canal compression syndrome. Until recently, most of these articles have been presented about the symptoms of ulnar nerve compression, but there have been no reports about ulnar artery compression. In this article, besides the nerve compression symptoms in the Guyon's canal, we represented the symptoms and treatments based on the ulnar artery obstruction. Methods: Guyon canal is composed of the hamate and pisiform, and the ligaments which connect them. The course of the ulnar nerve and artery, which passes through this narrow canal, is affected by the anatomical structure of the base of the canal. Out of 14 patients (21 cases) were retrospectively reviewed in this study from 2006 to 2009. Of 14 patients, there were 5 men and 9 women with ages between 21 to 61 years old. The symptoms had volar sensory loss of ulnar sided digits, with muscular atrophy of hypothenar muscles. Prior to surgery, most of these patients had vascular disorders which was diagnosed definitively by angiography and electromyogram. Results: The release of Guyon canal and interposition graft of the obstructed arteries was carried out to 11 patients (15 cases) who had artery (vascular) occlusive disorder, and. 12 cases had sympathectomy and interposition graft after resection of obstructed ulnar artery. Six cases had release of carpal tunnel performed simultaneously. There were no major complications after surgery. The circulation of the ulnar artery was improved along with the patients' symptoms. Conclusion: The pre-existing articles about Guyon canal compression syndrome were mainly focused on ulnar nerve compression. This study, which was carried out by our department, showed that most of these patients had ulnar artery obstruction or stenosis simultaneously with ulnar nerve compression. The vascular disorder was corrected by interposition graft after the resection of the site of ulnar artery occlusion. And to conclude, When we resolve the ulnar nerve compression, the proper diagnosis & treatment of impaired ulnar artery circulation should be carried out concomitantly.

• Journal of Veterinary Clinics
• /
• v.20 no.4
• /
• pp.443-448
• /
• 2003

To determine whether localization of tartrate-resistant acid phosphatase (TRAP) and cathepsin K was associated with rupture of the cranial cruciate ligament (CCL) in dogs. Tissue specimens were obtained from 30 dogs with CCL rupture during surgical treatment, 8 aged normal dogs, and 9 young normal dogs that were necropsied for reasons unrelated to this study and unrelated to musculoskeletal disease. The cranial cruciate ligament was examined histologically. $TRAP^+$ cells and cathepsin $K^+$ cells were identified by histochemical staining and immunohistochemical staining respectively. TRAP and cathepsin $K^+$ were co-localized within the same cells principally located within the epiligamentous region and to a lesser extent in the core region of ruptured CCL. Localization of $TRAP^+$ cells (P < 0.05) and cathepsin $K^+$ cells (P =0.05) within CCL tissue was significantly increased in dogs with CCL rupture, compared with aged-normal dogs, and young normal dogs (P < 0.05 - TRAP, P < 0.001 - cathepsin K). Localization of $TRAP^+$ cells and cathepsin $K^+$ cells within the CCL tissue of aged-normal dogs was also increased compared with young normal dogs (P < 0.05). Small numbers of $TRAP^+$ cells and cathepsin $K^+$ cells were seen in the intact ligaments of aged-normal dogs, which were associated with ligament fasicles in which there was chondroid transformation of ligament fibroblasts and disruption of the organized hierarchical structure of the extracellular matrix. $TRAP^+$ cells and cathepsin $K^+$ cells were not seen in CCL tissue from young-normal dogs. Localization of the proteinases $TRAP^+$ and cathepsin $K^+$ in CCL tissue was significantly associated with CCL rupture. Small numbers of proteinase positive cells were also localized in the CCL of agednormal dogs without CCL rupture, but were not detected in CCL from young-normal dogs. Taken together, these findings suggest that the cell signaling pathways that regulate expression of these proteinases in CCL tissue may form part of the mechanism that leads to upregulation of collagenolytic ligament remodeling and progressive structural failure of the CCL over time.