• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.146-154
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• 2011

Injury of posterolateral corner is unusual, but it can cause disability due to severe instability and cartilage damage. However, the anatomical structures, diagnosis and treatment have not defined clearly yet. Posterolateral corner injury is regarded as the one of main factor to the results of failure in cruciate ligament reconstcution if it was undiagnosed and untreated. Diagnosis of postetolateral corner injury is consists of physical exam, radiographic finding, MRI, and arthroscopic findings. The treatment method of of postetolateral corner injury depends on the time and severity of injury. Anatomical reconstruction of posterolateral corner shows the better clinical outcome than non anatomical reconstructions, but the clinical results of long term follow up is still needed. Therefore, the aim of this article is to review the recent literatures and to organize diagnosis and treatment of posterolateral corner injury.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2004.09a
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• pp.23-23
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• 2004

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.127-136
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• 2003

Posterolateral instability of the knee occurs more commonly in association with an injury to anterior and posterior cruciate ligament and combined injuries are severe injuries that result in significant functional instability and articular cartilage degeneration. Reconstruction of the anterior and posterior cruciate ligament without an appropriate treatment of posterolateral corner injury result in failure of the reconstructed cruciate ligaments. Meticulous physical examinations, imaging studies, lower limb alignment and gait pattern should be evaluated. Acute grade III isolated or combined injury of the posterolateral corner is best treated within three weeks by direct repair, or augumentation, or reconstruction. The appropriate surgical method or combined methods are selected among the several methods of posterior and posterolateal reconstruction, and all injuried posterolateral and cruciate ligament structures are anatomically reconstructed simultaneously or by stages. If a varus alignment and varus thrust is disclosed in chronic posterolateral instability of knee, soft tissue reconstructions laterally are highly unlikely to be able to correct tile problem. It is appropriate that valgus osteotomy should be done before soft tissue reconstruction and reevaluate the posterolateral instability about 6 months later.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2004.09a
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• pp.27-27
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• 2004

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.49-50
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• 2009

• 대한정형외과스포츠의학회:학술대회논문집
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• 2004.09a
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• pp.28-28
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• 2004

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.49-55
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• 2004

Purpose: we would like to suggest the proper surgical methods according to the severity of instability by analyzing the results. Materials and Methods: Between January 1998 and August 2002, eighty five patients have been operated on because of posterolateral rotatory instability (PLRI). The materials were included the patients who had followed-ups for over 2 years in sixty one patients and the patient's assessments were done by clinical score (OAK, IKDC) and posterolateral drawer and dial test. Results: Through our results, the fibular tunnel turned out to be superior compared to the tibia tunnel method in rotational stability. Hughston-Jacobson methods and biceps tenodesis showed poor results. Fibula head tunnel was superior to tibia tunnel in rotational stabiliaty Conclusion: The surgical technique that passes the modified posterolateral corner sling through the fibula head tunnel may provide good clinical results in grade II PLRI. It is necessary to reconstruct both tibia and fibula tunnel in grade III PLRI. When there is combined varus instability, a positive result may be obtained if an additional LCL reconstruction is performed.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.102-108
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• 2009

Purpose: The purpose of this study is to report a result of the technique that reconstruct posterior cruciate ligament (PCL) and posterolateral corner (PLC) simultaneously using a fresh-frozen Achilles tendon allograft. Materials and Methods: Forty two patients (45 legs) underwent PCL and PLC reconstruction were included. There were 38 males and 4 females. Mean age was 39 years. Used graft was a fresh frozen Achilles tendon allograft, which was divided by two size, larger one (${\emptyset}$ 10 mm) for PCL reconstruction and smaller one (${\emptyset}$ 8 mm) for PLC reconstruction. Arthroscopic reconstruction of the PCL was performed using transtibial, single incision, and single bundle technique with 10mm fresh frozen Achilles allograft tendon first. After PCL reconstruction, reconstruction procedure for posterolateral instability was performed using modified figure of "8" technique using smaller gtaft. For clinical evaluation, range of motion, posterior drawer test, varus stress test, prone external rotation (dial) test, Lysholm score, Tegner activity scale and posterior stress radiograph were used. Mean follow up period was 25 months. Results: Preoperatively posterior drawer test was 5 cases in grade II and 40 cases in grade III posterior instability. At final follow-up 22 cases returned within normal condition, 18 cases grade I and 5 cases grade II posterior instability. Though all patients showed positive result over 10 degrees in dial and varus stress test preoperatively, but only 9 cases showed positive both test at final follow-up. The range of motion deficit over $10^{\circ}$ flexion was 3 cases. Lysholm score was improved from mean 50 preoperatively to mean 83(p<0.05) and Tegner activity scale improved from mean 2.1 preoperatively to mean 4.6(p<0.05). In posterior stress radiographs, posterior displacement was improve from mean 16mm preoperatively to 4.1mm after treatment(p<0.05). All patients had improved compared to their pre-operative status as measured by physical examination such as posterior drawer test, varus stress test, dial test. Conclusion: We had successful results by combined reconstruction of the PCL & PLC with a fresh frozen Achilles tendon allograft in patients with PCL and posterolateral rotatory instability at a time.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.113-119
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• 2018

Background: This study was undertaken to evaluate the positional relationship between planes of the glenoid component (the scapular plane and the perpendicular plane to the glenoid) and its surrounding structures. Methods: Computed tomography (CT) images of both shoulders of 100 patients were evaluated using the 3-dimensional CT reconstruction program ($Aquarius^{(R)}$; TeraRecon). We determined the most lateral scapular bony structure of the scapular plane and measured the shortest distance between the anterolateral corner of the acromion and the scapular plane. The distance between the scapular plane and the midpoint of the line connecting the posterolateral corner of acromion and the anterior tip of the coracoid process (fulcrum axis) was also evaluated. The perpendicular plane was then adjusted to the glenoid and the same values were re-assessed. Results: The acromion was the most lateral scapular structure of scapular plane and perpendicular plane to the glenoid. The average distance from the anterolateral corner of the acromion to the scapular plane was $10.44{\pm}5.11mm$, and to the plane perpendicular to the glenoid was $9.55{\pm}5.13mm$. The midpoint of fulcrum axis was positioned towards the acromion and was measured at $3.90{\pm}3.21mm$ from the scapular plane and at $3.84{\pm}3.17mm$ from the perpendicular plane to the glenoid. Conclusions: Our data indicates that the relationship between the perpendicular plane to the glenoid plane and its surrounding structures is reliable and can be used as guidelines during glenoid component insertion (level of evidence: Level IV, case series, treatment study).

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.50-57
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• 2008

The anatomy which is the systemic understanding of a structure and the physical examinations which is the functional assessment of its role comprise the fundamental capability for a clinician providing medial care to the knee. This article provides the basic anatomy of the bones, meniscus, anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, muscles, medial and lateral 3 layer concept, anterior and posterior aspect of the knee, bursae around the knee, and the physical examinations of the meniscus, medial and lateral collateral ligament, anterior and posterior cruciate ligament with posterolateral corner. The conceptual and systemic understanding of the anatomy and the physical examinations of the knee would be a compass or lighthouse for the physician providing medical care to the knee.