• 한국전문물리치료학회지
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• 제20권3호
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• pp.54-61
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• 2013

This study was to determine the reliability and validity of manual measurements of patellar height to standard radiographic measurements in 30 knees of 15 subjects. Patellar height was measured using manual and radiographic methods. The manual measurements were performed by two examiners using digital vernier calipers with the subject sitting and the knees in $30^{\circ}$ of flexion. The radiographic measurements were performed in the same position. The reliability of the manual measurements was assessed by means of intraclass correlation coefficients [ICC(3,1)], and the validity was investigated using the Pearson's product-moment correlation coefficient and an independent t-test. The intra- and inter-rater reliabilities of the manual measurement of patellar height were excellent (ICC=.86 and .88 respectively). The validity of patellar height measured manually compared to the radiographic method was good (Pearson's r=.69). In conclusion, the manual method is an objective, qualitative measurement of patella height.

• 한국전문물리치료학회지
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• 제19권1호
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• pp.37-45
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• 2012

The purpose of this study was to assess the influence of patellar height on quadriceps muscles' electromyography (EMG) activity during a squat exercise in adults with patella baja. For the study, we recruited 15 volunteers who had patella baja on the right side. We measured the EMG activity of the right rectus femoris, vastus medialis oblique, and vastus lateralis muscles during squat exercises under two conditions, specifically with and without an infra-patellar strap. The infra-patellar strap was applied below the tested patella to elevate the patella to a normal height. A paired t-test was used to compare the effects of patella height on EMG activity of the quadriceps muscles. The EMG activity of the rectus femoris (RF), vastus medialis oblique (VMO), and vastus lateralis (VL) muscles were significantly decreased during the squat exercise with the infra-patellar strap compared to the same exercise without the infra-patellar strap (p<.05), while the VMO/VL ratio was not different significantly between two conditions (p>.05). The findings of this study suggest that an infra-patellar strap may benefit people with patellar baja, as changes in patellar height could improve the efficiency of the quadriceps muscles.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.407-412
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• 2018

Background: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels - the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. Results: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). Conclusions: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.

• 대한관절경학회지
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• 제4권2호
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• pp.128-133
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• 2000

목적 : 전방 십자 인대 재건술후 슬개-대퇴 관절의 문제중 슬개건의 길이 변화, 슬개-대퇴 관절의 선열의 변화 및 환자의 주관적 증상으로 비교 하였고 슬개건의 침습이 없는 동종 이식술과 슬개건을 침습한 자가 이식술을 비교하여 슬개건의 침습이 슬개-대퇴 관절에 미치는 영향을 분석하였다. 대상 및 방법 : 전방 십자 인대 재건술을 시행 받은 환자 중 1년 이상 추시 가능했던 환자 87명을 대상으로 하였으며 자가 골-슬개건-골을 이용해 재건술을 시행한 환자 52예를 제 1군, 동종 골-슬개건-골과 동종 아킬레스건을 이용해 재건술을 시행한 환자 35예를 제 2군으로 하였다. 수술 전, 후 단순 방사선 사진상에서 Blackburne-Peel 방법, 일치각(Congruence angle), 외측 슬개-대퇴 각(Lateral patellofemoral angle), 환자의 주관적 증상에 기초를 두어 결과를 판정하였다. 결과 : 시상면에서 슬개골 위치는 제 1군에서 술전 0.86에서 술후 0.80으로 유의할 만하게 감소하였으며, 제2군에서 술전 0.87에서 술후 0.83로 감소하였지만 통계적 유의성은 없었다. 외측 슬개-대퇴 각은 양군에서 유의할 만한 차이는 없었으며, 일치각은 제 1군에서 술전 $-1.43^{\circ}$에서 술후 $-5.43^{\circ}$로 $4^{\circ}$내측으로 전위되었고 제2군에서 술전 $-1.53^{\circ}$에서 술후 -3.65로 약 $2.12^{\circ}$내측으로 전위되었다. 결론 : 전방 십자 인대 재건술후 슬개-대퇴 관절의 선열은 변하며 이러한 변화는 자가 이식건의 채취, 십자 인대 재건술 자체, 대퇴 사두근 약화등 여러 가지 요소에 의한 것으로 사료된다.

• 국제물리치료학회지
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• 제9권1호
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• pp.1435-1441
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• 2018

The main focus of this study was to investigate effects of lumbar central posteroanterior (PA) mobilization on isometric knee extension (IKE) ability and patellar tendon reflex amplitude (PTRA) in healthy university students. University students aged 19-26 (male; 10, female; 10) without any neurological disorders participated voluntarily and excluded the subjects with abnormal reflexes. The participation had an average body mass of $64.25{\pm}13.52kg$, an average height of $1.66{\pm}0.08m$, and an average Body Mass Index (BMI) of $23.07{\pm}3.21$. Every student was randomly assigned to be received squatting exercise and PA mobilization sequentially with 5 days of wash out period. IKE and PTRA were not significantly different between the two groups after the intervention. All the outcome measures were arranged into two data groups; PA mobilization and squatting exercise data group. In the PA mobilization data group, IKE and PTRA significantly increased after the intervention, however, these aspects were decreased in the squatting exercise group. These findings suggest that IKE and PTRA increase immediately after PA mobilization, therefore PA mobilization could be a valuable topic for controlled clinical trials.

• 대한관절경학회:학술대회논문집
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• 대한관절경학회 2007년도 제17차 추계학술대회 심포지움
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• pp.97-98
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• 2007

• 한국임상수의학회지
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• 제39권3호
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• pp.93-99
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• 2022

The present study was performed to compare cranial tibial wedge osteotomy (CTWO) and tibial plateau leveling osteotomy (TPLO) through radiographic evaluation. The experiment was conducted with five cadaver dogs [mean (± SD) weight, 32.9 ± 4.1 kg; mean (± SD) age, 6 ± 2 years; three males and two females] euthanized for reasons unrelated to this study. The cadaver dogs consisted of German Shepherd (n = 3), Belgian Malinois (n = 1), and mixed breed (n = 1). CTWO and TPLO were carried out by the standard surgical method. Radiographic evaluation was performed by comparing several factors, including the flexion and extension angles, the anatomical mechanical axis angle (AMA-angle), tibial length, patellar height measurement using the Labelle-Laurin method, mechanical medial proximal tibial angle (mMPTA), mechanical medial distal tibial angle (mMDTA), and frontal plane alignment (FPA). Both the CTWO and the TPLO groups showed significantly increased flexion angles after surgery. Only the CTWO group had significantly increased extension angle. Although both groups showed significant decreases in the AMA-angle, the mechanical axis moved cranially against the anatomical axis only in the CTWO group. The patellar height was significantly lowered in the CTWO group. No significant differences were found in mMPTA, mMDTA, or FPA. In conclusion, radiographic comparison revealed more changes in CTWO group than in TPLO group.

• 대한물리치료과학회지
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• 제15권1호
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• pp.57-66
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• 2008

This study was conducted to investigate the effects of kinesio taping in patients with degenerative arthritis. 40 female patients with degenerative arthritis were voluntarily recruited and randomly divided into experimental and control group. Experimental group(mean age was 73.4 years, height was 153.5cm, and weight was 59.9kg) was applied patellar inferior and medial gliding, quadriceps, tibial external rotation, gastrocnemius, and soleus using a kinesio tape. And control group(mean age was 72.7 years, height was 154cm, and weight was 58.6kg) was received a interferential current therapy(ENDOMED 582, Enraf－Nonius, Holland). And we received a consent form from all subjects. Measuring was conducted by using a 3－dimensional gait analysis system for measuring of stride length, cadence, and velocity. The results were as follow: Stride length was significantly increased after than before treatment(p<.05). Cadence was significantly increased after than before treatment(p<.05). And Velocity was significantly increased after than before treatment(p<.05). Cadence was a significant difference between experimental and control group(p<.05), but there was no significant difference stride length and velocity between two groups. So we suggest that kinesio taping has a effectiveness in patients with degenerative arthritis.

• 한국전문물리치료학회지
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• 제15권2호
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• pp.54-63
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• 2008

The purpose of this study was to examine the effect of the hip internal rotation on knee extensor and hip abductor electromyographic (EMG) activity during stair up and stair down mobility. Eighteen healthy subjects were recruited. All subjects performed stair up and down movements on a step of 30cm height while maintaining the hip in neutral (condition 1) and hip in internal rotation (condition 2). Surface EMG activity was recorded from five muscles (gluteus maximus, vastus lateralis (VL), vastus medialis oblique (VMO), posterior gluteus medius (Gmed), and tensor fascia latae (TFU)) and hip internal rotation angle was measured using a three dimensional motion analysis system The time period for stair up and down was normalized using the MatLab 6.5 program, and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities according to the hip rotation (neutral or internal rotation) during the entire time period of stair up and down in each phase were compared using a paired t-test. During the entire period of stair up, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). During the entire period of stair down, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). However, the EMG activities of the other muscles were not significantly different between the conditions (p>.05). These results suggest that the stair up and down maintaining hip internal rotation was could be a contributing factor on patellar lateral tracking.

• 대한관절경학회지
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• 제6권2호
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• pp.101-108
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• 2002

목적 : 성장이 남아있는 청소년기 전방 십자 인대 손상에 대한 전방 십자 인대 재건술의 임상적, 방사선학적 결과에 대해 알아보고자 하였다. 대상 및 방법 : 1993년부터 2001년까지 전방십자인대 재건술을 시행받은 445예 중 19세 이하 12예를 대상으로 하였다. 남자가 11예 여자가 1예였고 수술당시 평균 나이는 75.9$(13.1\~16.9)$년 최종추시상 20.1$(18.1\~22.7)$년 이었다. 평균 추시기간은 45.1$(24\~120.6)$개월이었다. 사용된 이식건은 자가 슬괵건이 11예 자가 골-슬개건-골이 1예였다. 임상성적은 Lysholm Knee Scoring Scale, 관절운동범위, 수상 전 스포츠로 복귀정도를, 방사선학적 결과는 $Telos^{\circledR}$ 기기를 이용한 전방전위도를 정상측과 비교하였다. 골성숙도는 술전 월령, 신장 및 슬관절 전후면 방사선 촬영상 성장판의 상태로 평가 하였고 최종 추시상 Teleorontegehogram로 하지부동 정도와 대퇴경골각 (Femorotibial angle), 해부학적 및 역학적 외측 원위 대퇴각(aLDFA, mLDFA), 역학적 내측 근위 경골각 (mMPTA)을 정상측과 비교하여 성장장애를 평가하였다. 결과 : Lysholm Knee Score는 술전 평균 51$(25\~63)$점에서 최종추시상 98$(94\~100)$점으로 호전되었고, $Telos^{\circledR}$ 기기를 이용한 전방전위도는 술 전 평균 13.5$(6\~27)$ mm에서 술후 평균 2.9$(1\~4)$ mm로 호전되었으며 임상적으로 의의있는 슬관절 불안정성은 관찰되지 않았다. 최종추시상 성장판 손상에 의한 1 cm 이상의 하지부동은 관찰되지 않았다. 결론 : 성장이 남아있는 골 미성숙 환자의 전방 십자 인대 재건술은 하지부동이나 슬관절 정열이상이 없는 좋은 치료방법으로 생각된다.