• Journal of Korean Foot and Ankle Society
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• v.2 no.2
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• pp.64-70
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• 1998

Primary osteoarthritis of the ankle without history of trauma is rare. We are reporting the use of a low tibial osteotomy on 2 ankles in one patient. The osteotomy is designed to correct the varus tilt and anterior opening of the distal tibial joint surface where it has been shown by weight-bearing radiographs. Follow-up at 8 months the result showed to be excellent, by Takakura's scoring system. We experienced that slight overcorrection of deformity by low tibial osteotomy is effective in treating intermediate-stage primary osteoarthritis of the ankle.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.433-442
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• 2012

PURPOSE: This study investigated to correlation between foot and knee posture characteristics in knee osteoarthritis patients. METHODS: The subjects of this study were 103 patients with clinically and radiographically-confirmed knee osteoarthritis was investigated using the quadriceps angle (QA), distance of both knee (DBK), ankle dorsiflexion angle (ADA), navicular drop (ND). One-way ANOVA and Pearson's correlation were used to investigate the correlation between foot and knee posture measurements. All of whom agreed to participate in the study. In order to assure the statistical significance of the results, we used for SPSS ver. 18.0 for windows. RESULTS: The results of this study were as follows : 1) There were statistically significant difference in the correlation between QA and DBK. 2) There were statistically significant difference in the correlation between DBK and ADA. CONCLUSION: According the results of this study, patients with osteoarthritis exhibit more genu varus knee posture. Moreover patients with osteoarthritis were not correlation between foot and knee Posture characteristics.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.62-70
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• 2020

Purpose: External tibia torsion and proximal tibial vara have been reported in severe varus deformed osteoarthritis, which is a tibio-femoral angle of more than 20°. The radiology measurements were compared with those of control group and the preoperative and follow-up radiology and clinical results were examined. Materials and Methods: From January 2007 to March 2016, 43 knees from 37 persons, who underwent total knee arthroplasty for a severe varus deformity of more than 20° on the tibio-femoral angle on the standing radiographs and had a follow-up period more than two years, were examined. The mean follow-up period was 45.7 months. The control group, who underwent conservative treatments, had Kellgren-Lawrence grade three osteoarthritis and a tibio-femoral angle of less than 3° varus. The external tibial torsion of enrolled patients and control group were estimated using the proximal tibio-fibular overlap length and the tibial torsion values on computed tomography. The proximal tibia vara was measured using the proximal tibial tilt angle. The preoperative and postoperative proximal tibio-fibular overlap length, tibial torsion value, proximal tibial tilt angle, and hospital for special surgery (HSS) score were evaluated. Results: The mean proximal tibio-fibular overlap length was 18.6 mm preoperatively and 11.2 mm (p=0.031) at the follow-up. The control group had a mean proximal tibio-fibular overlap length of 8.7 mm (p=0.024). The mean tibial torsion value was 13.8° preoperatively and 14.0° (p=0.489) at the follow-up. The control group had a mean tibial torsion value of 21.9° (p=0.012). The mean proximal tibial tilt angle was 12.2° preoperatively and 0° (p<0.01) at the follow-up. The control group had a mean proximal tilt angle of 1.2° (p<0.01). The preoperative tibiofemoral angle and mechanical axis deviation were corrected from preoperative 28.3° and medial 68.4 mm to postoperative 0.7° and medial 3.5 mm (p<0.01, p<0.01), respectively. The HSS scores increased from 34 points of preoperatively to 87 points at the last follow-up (p=0.028). Conclusion: Patients with advanced osteoarthritis with a severe varus deformity of more than 20° had significant increases in the external tibial torsion and varus of the proximal tibia. The tibial torsion value before and after surgery in the enrolled patients was not changed statistically, but good clinical results without complications were obtained.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.37-47
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• 2006

Purpose : The purpose is to assess the effects of muscle activity of normal person with contact laterally wedged insoles with strapping of varying elevations of 9, 15, 21mm. Methods : The subjects were adult males and women who had not experienced any knee injury. They were asked to performed from isometric contraction exerciese in four postures using lateral wedged. The normalized EMG activity levels(%MVC) of the vastus lateralis, vastus medialis, tibialis anterior, soleus for the four postures of the lower extremities were compared using one way repeted measures ANOVA. Results : Comparison of EMG amplitudes across all postures revealed no significant differences among all muscles(P>0.05). Conclusion : Further studies of the effect of wedged insole angle on knee varus torque in patients with medial-lateral knee osteoarthritis are needed.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.81-94
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• 2007

The purpose of this study was to critically review biomechanical studies on foot orthoses (FO) in normal and diseased foot and provide beneficial information obtained from researches until now and future researching focus. The search was performed by Medline and Embase database including studies published in English from January 1980 to April 2007. The searching terms were foot orthoses, foot orthotics, insoles and shoe insert. 57 studies including 54 journal articles and 3 abstracts were finally selected under the conditions of having clinical trials, FO, control condition, movement, scientific measuring system. The reviewed studies were divided into 10 categories according to subject characteristics; healthy normal, excessive pronation or flexible flat foot, rheumatoid arthritis, diabetes, medial knee osteoarthritis, forefoot varus, plantar fasciitis, patellofemoral syndrome, cavus foot and finite element model. In summary, first, soft and semirigid FOs with some degree of cushioning showed much higher comfort and efficacy than rigid FO. Second, no big differences between prefabricated and custom FO were shown. Third, the full length's FO was preferable to the half length's FO or simple arch supports. Fourth, the wearing of FO combining medial arch supports and metatarsal dome made positive roles to enhance comfort and functionality and redistribute plantar pressure under the foot. Fifth, for patients with knee-related diseases lateral wedges were preferable. Sixth, measuring systems were properly applied according to the types of foot diseases.

• Journal of the Ergonomics Society of Korea
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• v.26 no.1
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• pp.19-27
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• 2007

Despite the widespread use of laterally wedged insoles for patients with knee osteoarthritis and medially wedged insoles for controlling rearfoot pronation, an understanding of the effects of wedged insoles was limited and sometimes controversial. The objective of this study was to evaluate the effect of wedged insoles on the kinematics and kinetics of normal gait. Ten male subjects without history of lower limb disorders were recruited. Each subject performed four gait cycles under each of seven conditions; shod with 5$^{\circ}$, 8$^{\circ}$ and 15$^{\circ}$, 8$^{\circ}$ and 15$^{\circ}$ laterally wedged insoles. In order to determine statistical differences among seven conditions, the measured temporal spatial variables, angular displacements, joint moments, and ground reaction forces were compared with a one-way analysis of variance. Some significant changes induced by wedged insoles were apparent in joint moments and ground reaction forces. The medially wedged insole increased the laterally directed ground reaction force and varus moments at the ankle force and varus moments at the ankle and the knee.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.37-43
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• 2012

Purpose: This study is to evaluate the clinical results of pull-out suture for root tear of posterior horn of medial meniscus. Materials and Methods: Between March 2006 and February 2011, We studied 40 cases with the root tear of posterior horn of medial meniscus which follow up more than 1 years. Mean age was 49.5 years old. We excluded osteoarthritis or varus deformity patients more than 5 degrees. pull-out suture was performed to the patients with grade 0-2 of Kellgren and Lawrence classification. According to Outerbridge classification, evaluation of cartilage damage was performed during arthroscopy. Evaluation of clinical result was used the Lysholm score. Results: The mean pre-operation Lysholm score was 63.9 and post-operation score was 86.3. The complete failure rate was 3 of 40 cases (7.5%). Twenty of 40 cases (50%) showed cartilage lesions in weight bearing portion of medial femoral condyle which were 12 cases in grade 1, 5 cases in grade 2 and 3 cases in grade 3 according to the Outerbridge classification. Conclusion: In the treatment of pull-out suture for root tear of posterior horn of medial meniscus, exclusion of more than moderate arthritis or varus deformity is very importment. Pull-out suture seems to be a useful treatment of the root tear of posterior horn of medial meniscus in mild osteoarthritis or varus deformity of middle ages.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.45-50
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• 2007

Purpose: To evaluate the short-term clinical outcomes of total ankle arthroplasty for the post-traumatic osteoarthritis. Materials and Methods: Fourteen patients who had undergone total ankle arthroplasty from February 2005 to June 2006 were reviewed. Eleven patients were male and three patients were female. The mean age was 52.8 years (range, 33 to 69 years). The mean follow-up duration was 15.9 months (range, 12 to 24 months). Primary injuries were pilon fractures in eight cases, malleolar fractures in three, ankle syndesmotic injury in one, talus fracture and dislocation in one, and distal tibial physeal injury in one. Visual analogue scale (VAS), Range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and complications were evaluated. Results: The mean VAS improved from 8.6 preoperatively to 2.6 at last follow-up. The mean ROM improved from 24.6 degrees preoperatively to 33.1 degrees postoperatively. The mean AOFAS score improved from 44.5 points preoperatively to 75.1 points postoperatively. Radiographically, all components were stable, but there were component malpositions in two cases, including one varus malposition of tibial component and one increased anterior translation of talar component. Complications were deep infection in one case, intraoperative malleolar fracture in three, marginal wound necrosis in two, and heterotopic ossification in one. One prosthesis was revised because of deep infection. Conclusion: Total ankle arthroplasty for the post-traumatic osteoarthritis is believed to be an useful method for preservation of the motion, relief of the pain and high satisfaction of patients in short-term results.

• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.157-162
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• 2022

Total ankle arthroplasty has become a viable motion-preserving alternative to ankle arthrodesis, especially in the last two decades. Recent improvements have been achieved in the strength of implant design and surgical technique. Nevertheless, addressing preoperative deformities is essential for successful outcomes of total ankle arthroplasty. Residual malalignment can produce instability and edge loading, causing acceleration of polyethylene wear, followed by osteolysis and an increased risk of revision surgery. Therefore, the accompanying deformities and their correction techniques need to be comprehensively elucidated and understood. In this article, we provide a review of the application of total ankle arthroplasty in arthritis with coronal plane varus and valgus deformities.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.90-101
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• 2003

Gait analysis can provide a better understanding of how the alignment of the lower limb and foot can contribute to force observed at the knee. Anatomic and mechanical factors that affect loading in the knee pint can contribute to pathologic change seen at the knee in degenerative pint disease and should be considered in treatment plan. The purpose of this study is to present the gait analysis data and to determine whether there is any relationships between alignment of the lower limb, foot progression angle and knee pint moments in elderly healthy women with 3-dimensional motion analyzer. The results were as follows; 1. Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04 m, Step length was 0.56 m. 2. According to the parameters of kinematics, the maximal knee flexion angle through swing phase showed left $46.82^{\circ}$, right $40.19^{\circ}$ and the maximal knee extension angle showed left $-1.32^{\circ}$, right $2.01^{\circ}$. knee varus showed left $26.90^{\circ}$, right $30.93^{\circ}$. 3. Moment, one of kinetic parameters of knee pint the maximal flexion moment showed left 0.363. Nm/kg, right 0.464 Nm/kg and maximal extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximal. adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg and the maximal internal rotatory moment showed left 0.13 Nm/kg, right 0.140 Nm/kg. 4. On sagittal plane, the maximal power of knee joint showed left 0.571 J/kg, right 0.629 J/kg. On coronal plane, the maximal power of knee joint showed left 0.11 J/kg, right 0.12 J/kg. On transverse plane, the maximal power of knee joint showed left 0.058 J/kg, right 0.072 J/kg. 5. The subject who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase. 6. The subject who had large foot progression angle had statistically lower in knee adduction moment in late stance phase. A relationship was observed between the alignment of the lower extremity and the adduction moment of the knee joint during stance phase. Hence, we need some research to figure, out the change of adduction moment according to the sort of knee joint osteoarthritis and the normal geriatrics as well. And we also require more effective, specific therapeutic program by making use of those background of researches.