• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.79-84
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• 2010

Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.18-23
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• 2008

Purpose: The purpose of this study is to evaluate the clinical results of the function and stability of ACL reconstruction using the flexible reamer. Materials and Methods: We reviewed 98 patients who taken ACL reconstruction using the flexible reamer from March, 1999 to May, 2004. And the follow-up period was more than 12 months in all cases. We used the subjective tests including Lysholm knee score and 2000 International Knee Documentation Committee(IKDC) subjective knee score, and the objective tests such as anterior drawer test, Lachman test, pivot shift test, and KT-2000 arthrometer to evaluate the clinical results. Results: In the range of motion of the affected knee, the extension deficit more than 5 degree was 8 cases preoperatively and 1 case postoperatively. The flexion deficit more than 5 degree was 12 cases preoperatively and 2 cases postoperatively. The mean Lysholm knee score was 61.3 point(${\pm}3.5$ SD) preoperatively and 87.7 point(${\pm}2.0$ SD) postoperatively. The mean 2000 International Knee Documentation Committee(IKDC) subjective knee score was 49 point(${\pm}3.3$ SD) preoperatively and 84 point (${\pm}2.2$ SD) postoperatively. 93 cases were more than grade II in Lachman test preoperatively and 5 cases postoperatively. 71 cases were more than grade II in pivot shift test preoperatively but 89 cases were negative postoperatively. The mean maximal manual difference by KT-2000 arthrometer was 6.8 mm(${\pm}1.9$ SD) preoperatively and 1.8 mm(${\pm}0.8$ SD) postoperatively. Conclusion: ACL reconstruction using the flexible reamer achieved the ideal isometric point of femur and anatomic graft placement, so we could obtain good results, especially in rotational stability.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.205-210
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• 2008

Purpose: To evaluate the clinical results after microfracture surgery for full-thickness chondral lesion of the knee. Materials and Methods: Thrity-seven patients, who had underwent microfracture surgery for full-thickness chondral lesion of the knee between January 1999 and December 2005, were reviewed. Their mean age at the time of operation was 31 years (range, 21~38 years) and mean follow up period was 2.7 years. All patients were reviewd every 6 months after operation. Clinical outcomes were evaluated by activity of daily living (ADL), Tegner activity scale, International Knee Documentation Committee (IKDC) knee examination form, Lysholm score and satisfaction of treatment. Results: ADL and Tegner activity score improved in 83% of patients during first 18 months, but decreased during next 6months. IKDC score improved from 58 points at operation time to 86 points after 12 months, but decreased to 79 points and 68 points at 18 and 24 months after operation, respectively. Also, Lysholm score improved from 61 points at operation time to 89 points after 12 months, to 92 points after 18 months, but 73 points after 24 months. At the last follow-up, 22 patients were excellent or good in satisfaction of treatment, whereas 12 patients were fair, 3 patients were poor. Conclusion: Microfracture surgery for full-thickness chondral lesion of the knee has a good functional improvement for first 12 months after operation, but its effectiveness has decreased over time.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.28-33
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• 2009

Purpose: To compare the clinical outcomes after meniscus allograft transplantation between lateral and medial or isolated and combined procedure groups. Materials and Methods: Of the patients who had undergone arthroscopic meniscal allograft transplantation between Dec. 1997 and Jun. 2007, 52 patients were available for retrospective evaluation. Patients were grouped into lateral(33 cases) and medial(19 cases) transplant groups as well as those with isolated(18 cases) and combined(34 cases) procedure. The average age was 34.2 years and the mean follow-up period was 42.2 months. Postoperative range of motion (ROM), visual analog scale (VAS), International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, patient's subjective satisfaction, $2^{nd}$ look arthroscopy and MRI were evaluated retrospectively. Results: Mean postoperative ROM was $130.3^{\circ}$. The VAS showed an improvement from 5.96 to 3.05 at the last follow up. IKDC subjective score and Lysholm score also showed an improvement from 46.5 to 64.5 and from 61.9s to 79.58 respectively. Tegner score was improved from 2.9 to 3.6. Overall, 61.5% of patients reported they were completely or mostly satisfied with procedure. There were no significant differences noted between lateral and medial groups as well as isolated and combined groups. In 2nd look arthroscopy, 10 of 18 cases showed good pheripheal healing and there were 6 cases of partial and 2 of complex tear. We observed graft subluxation or extrusion in 12 of 16 cases who were evaluated with follow-up MRI. Conclusion: Meniscus allograft transplantation alone or in combination with other procedure showed an improvement in knee pain and clinical score. But there were no significant difference between lateral and medial groups or isolated and combined procedure groups.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.155-160
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• 2006

Purpose: To evaluate the results of meniscal repair and partial meniscectomy of lateral meniscus injury associated with tibial plateau fracture. Materials and Methods: Between February 1993 and August 2004, 24 cases (23 patients) of lateral meniscus tear with tibial plateau fracture were evaluated retrospectively. The most frequent type of tear was the longitudinal tear of the meniscocapsular junction (14 cases, 66.7%). All fractures were reduced under the control of arthroscopic and image intensifier. Arthroscopic repair of the longitudinal tear of the lateral meniscus or arthroscopic partial meniscectomy was performed. The final results were evaluated with the Ikeuchi criteria and Lysholm score. Results: At the final follow-up, the outcome was excellent in 12 cases (85.7%), good in 1 case (7.1%) and fair in 1 case (7.1%) among 14 cases of meniscal repair, and the excellent in 4 cases (66.7%) and good in 2 cases (33.3%) among 6 cases of partial meniscectomy according to the Ikeuchi criteria, There was a significant improvement of Lysholm score after surgery, 92.3 postoperatively compared with 56.6 preoperatively (p<0.0001, paired t-test). Conclusion: The fracture of the lateral tibial plateau did not seem to affect on the healing of the meniscus repair and partial meniscectomy.

• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.24-28
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• 2013

Purpose: All-inside meniscal repair using FasT-Fix (Smith & Nephew Endoscopy, Andover, Massachusetts, USA) is a popular method for the meniscal tear. However, there was no report after all-inside repair using FasT-Fix for the meniscal tear in Korea. Therefore, the purpose of this retrospective study was to report clinical outcomes after all-inside meniscal repair using FasT-Fix. Materials and Methods: 25 consecutive patients underwent meniscal repairs using FasT-Fix for tears of the posterior horn of the medial or lateral menisci combined with hamstring anterior cruciate ligament (ACL) reconstructions. Postoperative evaluations included Lysholm knee score and Tegner activity scale. Using clinical criteria, a repaired meniscus was considered healed if there was no effusion or joint line tenderness, negative McMurray test, and no sense of giving way. Results: The average follow-up was 47.9 months (range, 40 to 61 months). At follow-up, the mean Lysholm score was 91.8 and the mean Tegner activity scale was 5.6. According to clinical criteria, 20 (80%) menisci was healed, and 5 (20%) failed. Conclusion: All-inside meniscal repair using FasT-Fix showed satisfactory results in patients with hamstring ACL reconstructions.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.138-142
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• 2009

Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.53-60
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• 2006

Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

• 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).