• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.168-172
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• 1998

Discoid lateral menisci were common morphological anomaly and several classifications were proposed. Watanabe et al classified all discoid menisci, as seen arthroscopically, into three types 1) complete 2) incomplete and 3) Wrisberg ligament type. The purpose of this study is to report a rare case of both painful snapping knee joints in 6 year-old female. On arthroscopic examination, complete lateral discoid meniscus which consisted of taut Wrisberg ligament and intact tibial insertion of posterior horn was found, and abnormal anterior cruciate ligament(ACL) which has expanded femoral origin over the posterior articular surface of lateral femoral condyle was also found. At the time of arthroscopic surgery, hypertrophied high-riding Wrisberg ligament was resected, and expanded femoral origin of the anterior cruciate ligament was partially resected nearly to normal margin, and discoid lateral meniscus was saucerized. After these procedures, abnormal snapping sound was disappeared in full range of motion. On the follow-up examination after 1 year, pain and snapping sound were disappeared and any instability and limping were not found.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.45-52
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• 2008

Purpose: The purpose of the study is to provide the clinical results of arthroscopic posterior cruciate ligament(PCL) reconstruction with preservation of the original PCL using transtibial tunnel and posterior transseptal portal. Materials and Methods: 36 patients underwent PCL reconstruction with achilles tendon allografts. We tried to preserve of the original PCL.At the final follow-up, patients were evaluated retrospectively by four measurements: Lysholm knee scores, IKDC grades, Telos stress radiography, and second look arthroscopy.Follow-up periods were from 12 months to 30 months. Results: The average Lysholm knee score improved from $66.0{\pm}8.67$ to $87.9{\pm}5.04$. Preoperative IKDC grades were abnormal in 15(41.7%) and severely abnormal in 21(58.3%), postoperative IKDC grades were normal in 6(16%),nearly normal in 24(66%), abnormal in 5(16%) and severely abnormal in 1(2%).The average side to side difference in Telos stress test decreased from $12.5{\pm}2.61(7{\sim}20)$ mm to $3.9{\pm}1.34(7{\sim}1)$ mm (paired sample T test, p=0.001) Conclusion: Arthroscopic posterior cruciate ligament(PCL) reconstruction with preservation of the original PCL using transtibial tunnel and posterior transseptal portal is useful surgical method.

• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.93-100
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• 2021

Purpose: (1) To evaluate the trabecular pattern at the femoral attachment of the posterior cruciate ligament (PCL) in patients with a PCL injury; (2) to analyze bone microarchitecture by applying gray level co-occurrence matrix (GLCM)-based texture analysis; and (3) to determine if there is a significant relationship between bone microarchitecture and posterior instability. Materials and Methods: The study included 96 patients with PCL tears. Trabecular patterns were evaluated on T2-weighted MRI qualitatively, and were evaluated by GLCM texture analysis quantitatively. The grades of posterior drawer test (PDT) and the degrees of posterior displacement on stress radiographs were recorded. The 96 patients were classified into two groups: acute and chronic injury. And 27 patients with no PCL injury were enrolled for control. Pearson's correlation coefficient and one-way ANOVA with Bonferroni test were conducted for statistical analyses. This protocol was approved by the Institutional Review Board. Results: A thick and anisotropic trabecular bone pattern was apparent in normal or acute injury (n = 57/61;93.4%), but was not prominent in chronic injury and posterior instability (n = 31/35;88.6%). Grades of PDT and degrees of posterior displacement on stress radiograph were not correlated with texture parameters. However, the texture analysis parameters of chronic injury were significantly different from those of acute injury and control groups (P < 0.05). Conclusion: The trabecular pattern and texture analysis parameters are useful in predicting posterior instability in patients with PCL injury. Evaluation of the bone microarchitecture resulting from altered biomechanics could advance the understanding of PCL function and improve the detection of PCL injury.

• 대한관절경학회:학술대회논문집
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• 2007.10a
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• pp.36-36
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• 2007

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.54-60
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• 2011

Puropse: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant or elongated ligament. Materials and Methods: From October 2004 to March 2010, we performed PCL reconstruction with Achilles tendon allografts in 22 complete rupture patients. Mean age was 31.5 years. 14 cases were male and 8 cases were female. Average follow-up period was 3 years and 7 months, range from 1 year to 6 years and 4 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, IKDC score, and second look arthroscopic examination. Results: Postoperative Lysholm knee score, IKDC scores, Tegner activity scale, and posterior displacement by the Telos stress test demonstrated statistically significant improvement compared to the preoperative state. Conclusion: Arthroscopic PCL reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant showed good clinical results and posterior stability.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.64-67
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• 1998

A ganglion cyst is a soft tissue mass that is surrounded by a dense connective-tissue capsule. The capsule is filled with a viscous fluid that is rich in hyaluronic acid and other mucopolysaccharides. But, Ganglion cysts in the knee joint are rare. There are very few case reports of ganglion cysts related to the surface of the anterior cruciate ligament, Posterior cruciate ligament and medial meniscus. We are reporting a case of a ganglion cyst in the anterior aspect of the anterior cruciate ligament accompanying with discoid lateral meniscus in the right knee of a 46-year-old woman without any history of trauma. The cyst and discoid lateral meniscus were treated successfully with arthroscopic excision and partial meniscectomy.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.80-84
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• 1998

The isometric position for the graft is important in the anterior cruciate ligament reconstruction surgery. It is well known that the femoral position is more critical than tibial side. But, there is few deciding method of proper graft position after the anterior cruciate ligament reconstruction surgery. So we planned to evaluate the ideal femoral isometric position with 6 adult cadavaric femurs and exact radiographs. After the insertion of femoral interference screw on ideal isometric position, we obtained roentgenograms of true lateral view and 10, 20, 30, 45 degree internal and external rotation views. Then we measured the shortest distance from the posterior cortical margin of lateral femoral condyle to posterior border of interference screw on the radiographs. We also measured true distance between posterior cortical margin of lateral femoral condyle to the posterior margin of femoral tunnel after cutting of distal femur. Based on this study, we could not determine the permissible rotation degree of radiographs. But we concluded that if the distance between posterior cortical margin of lateral femoral condyle and posterior border of interference screw ranges 4.5-6.5mm on the lateral view, the femoral position is considered as a relatively ideal isometric good position.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.125-131
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• 2011

Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.135-140
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• 1998

From 1989 to 1994, authors have reconstructed the posterior cruciate ligament(PCL) in 51 knees with an autogenous central one-third of the patellar tendon by transtibial two tunnel technique, but there were not a few cases of unfavorable results. So from January 1995, we have reconstructed the PCL deficient knees by "modified tibial inlay technique" to avoid the grafted tendon abrasion at the posterior opening of the tibial tunnel(killer turn). Purpose of this study was to compare the results of two surgical techniques and what its advantages and disadvantages are. We could follow up 39 cases of transtibial two tunnel techique group(group A) more than one year, average being 23.7 months and 21 cases of modified tibial inlay technique group(group B) more than 12 months, average being 14.7 months. The clinical results were evaluated by the OAK knee scoring system ($M{\ddot{u}}ller$'s criteria) and the posteror stress roentgenography (push view) with Telos stress device compared with the uninjured knees. The arthroscopic second-look findings were also evaluated. In group A : The $M{\ddot{u}}ller$'s knee score was average 80.1 points, the posteror displacement in push view was average 4.4mm at the last follow up. There were 17 cases(44%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view. Among the 19 cases of arthroscopic second look examinations, nearly normal PCL appearances of the grafted tendons were noted only in 9 cases(47%). In group B : The $M{\ddot{u}}ller$'s knee score was average 86.7 points, the posterior displacemnet in push view was average 3.6mm at the last follow up. There were 5 cases(23.8%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view but 4 out of 5 cases showed 6mm posterior displacement in push views. Among the 7 cases of arthroscopic second-look examinations, 6 cases(86%) showed nearly normal PCL appearances of the grafted tendons. In modified tibial inlay technique of PCL reconstruction, it was easier to pull out the BPTB and in cases of remained laxed meniscofemoral ligament it was easier to preserve the remained structures than transtibial two tunnel technique. We expect the "modified tibial inlay technique" may solve the problem of grafted patellar tendon abrasion at the posterior orifice of tibial tunnel and may contribute to the successful PCL reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.21-24
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• 1998

There are many controversies in managing fresh substance tear of PCL. Conservative treatment of partial tear is generalby accepted idea, and less than 10mm posterior instability is known to be acceptable in terms of funtion. More than 10mm posterior instability and complete fresh tear of the ligament are regarded as candidates of reconstruction of the ligament. However, many authors believe that posterior instability may be a cause of early osteoarthritis in the long run. Author described the rationale and the technique of arthroscopic primary repair of the PCL in case of proximal and mid 1/3 substance tear. Postoperative rehabilitation program and their rationale were also described.