• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.300-308
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• 1999

Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.26-32
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• 2009

Purpose: This study was performed to compare the strength of ligamentous attached sites of cadaveric distal femur and to obtain reliable biomechanical data to use in ligamentous reconstruction or augmentation. Materials and Methods: Fifteen cadaveric distal femurs were used for this study. After measuring the bone density, 5.0 mm cannulated screw (Experiment 1) or reconstructed porcine ligament (Experiment 2) was inserted into the each ligamentous attached sites of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). In experiment 2, reconstructed porcine graft was fixed with bioabsorbable screw in ligamentous insertion sites. And we measured the maximal pullout force of each ligamentous attached sites of cadaveric distal femur. Results: Average bone mineral density was $1.205{\pm}0.137\;g/cm^2$ in experiment 1, $1.236{\pm}0.089\;g/cm^2$ in experiment 2, which showed no statistically significant differences. In experiment 1, average pull-out strength of ACL, PCL, MCL and LCL group were $519.1{\pm}111.7$ N, $638.9{\pm}144.4$ N, $169.7{\pm}56.0$ N, $225.6{\pm}61.5$ N respectively. In experiment 2, the average pull-out strength were $310.6{\pm}31.0$ N, $379.9{\pm}47.4$ N, $104.0{\pm}14.4$ N, $131.5{\pm}21.9$ N respectively. In experiment 1, there was no significant difference between ACL and PCL group and between MCL and LCL group. However, the maximal pullout strength of MCL and LCL group were significantly lower than that of ACL and PCL group (p<0.01). Experiment 2 showed the same results of experiment 1. Conclusion: Because stiffness of MCL and LCL attached sites are much lower than that of ACL and PCL attached sites, we may consider augmented fixation in ligamentous reconstructions of MCL and LCL.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.90-97
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• 1977

This is a report of a. case in which a long narrow segment coarctation of the aorta was successfully corrected with Teflon graft. The patient was 30 year old man with hypertensive symptoms that occurred 7 years prior to operation. Blood pressure measured 230/110 mmHg in the arms and 110/80 mmHg in the legs. Pulses were strongly tensive in radial artery, but very weak in femoral artery and even absent in dorsal pedis artery. Final preoperative diagnosis was made by aortography which showed a long narrow segment between aortic arch and descending thoracic aorta and highly developed collateral circulations. A long hypoplastic narrow segment was located proximal to the ligament arteriosus, and diaphragmatic stenosis of the aorta was located just distal to the ligamentum arteriosus. After prosthetic correction of the coarctation of the aorta, blood pressure were measured 130/ 80 mmHg in the arms and 150/100 mmHg in the legs. Peripheral pulses were palpated normally, and the postoperative course was uneventful.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.201-207
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• 2003

Purpose: We reviewed the value of treatment for chronic lateral instability of theankle with arthroscopic procedure combined with Brostrom one. Material and Method: From May 2000 to June 2002, 18 patient with chronic lateral instability of the ankle with Modified Brostrom procedure and arthroscopic one. Mean follow-up period was 18 months. Result: Chronic lateral instability of the ankle almost had intraarticular pathology, such as osteophye, osteochondral lesion, So we could resolve intraarticular pathology by arthroscopic procedure during Brostrom one for lateral collateral ligament reconstruction. Conclusion: Modified Brostrom procedure and arthroscopic one are an excellent treating method for chronic lateral instability of the ankle which has intraarticular pathology.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.98-102
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• 2004

Purpose: The purpose of this study was to make a report on the clinical prognosis of post traumatic lateral and posterolateral instability of the knee after LCL augmentation and popliteal tenodesis. Materials and Methods: The assessment was made among 21 cases who underwent augmentation of lateral collateral ligament(LCL) and popliteal tenodesis with allograft or artificial ligament (synthetic polyester, ABC ligament, Surgicraft, U.K.) at this Medical Center during the period from July 1996 to July 2003 and whose follow-up period was longer than one year. The authors recorded and analysed the physical findings (external rotation recurvatum test & posterolateral drawer test), stress roentgenograms(preoperative and postoperative) and Lysholm score. Results: The lateral and posterolateral instability of the knee were improved in 20 cases postoperatively, acccording to the clinical test and stress roentgenograms . Average Lysholm score was 52.5 preoperatively and 86.7 postoperatively .Conclusion: Our study found the surgery of lateral and posterolateral instability of the knee with augmentation of LCL and popliteal tenodesis using allograft or artiflcial ligament is simple technique. Taking these results into consideration, it seems to be one of effective methods of treatment.

• 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.12 no.1
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• pp.24-31
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• 2008

Purpose: We purposed to analyze the incidence and the patterns of the injuries associated with anterior cruciate ligament(ACL) tears. Materials and Methods: We retrospectively reviewed 547 knees that had undergone ACL reconstructions and compared the associated injuries according to the time of injury(acute vs. chronic), the cause of injury(sports vs. non-sports) and the type of sports. Results: Medial collateral ligament(MCL) injury and bone contusion were more in acute injury group less than 3 months after trauma(p=0.001, 0.019) and the injuries of medial or lateral meniscus were more in chronic injury group more than 3 months after trauma(p=0.014, 0.029). The trochlea in acute injury group(p=0.027) and the medial femoral condyle in chronic injury group(p=0.011) had higher incidence of chondral injury. Grade I, II chondral injury was frequent in acute injury group(p=0.016) and grade III, IV chondral injury was frequent in chronic injury group(p=0.017). Lateral meniscus injury was frequent in sports injury group(P=0.035). Medial collateral ligament injury was frequent in ski(P=0.005), and chondral injury was in gymnastics(P=0.017). Conclusions: The incidences of medial and lateral meniscus tears and grade III, IV chondral defects were high in chronic injury group. According to the causes of the tears and the types of sports, some differences in the incidence and pattern of associated injuries were found.

• Investigative Magnetic Resonance Imaging
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• v.18 no.3
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• pp.225-231
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• 2014

Purpose : The biceps femoris tendon (BFT) and lateral collateral ligament (LCL) in the knee were formerly known to form a conjoined tendon at the fibular attachment site. However, the BFT and LCL are attached into the fibular head in various patterns. We classified insertion patterns of the BFT and LCL using MR imaging, and analyzed whether the LCL attaches to the fibular head or not. Materials and Methods: A total of 494 consecutive knee MRIs of 470 patients taken between July 2012 and December 2012 were retrospectively reviewed. There were 224 males and 246 females, and patient age varied from 10 to 88 (mean, 48.6). The exclusion criteria were previous surgery and poor image quality. Using 3T fat-suppressed proton density-weighted axial images, the fibular insertion patterns of the BFT and LCL were classified into following types: type I (the LCL passes between the anterior arm and direct arm of the BFT's long head), type II (the LCL joins with anterior arm of the long head of the BFT), type III (the BFT and LCL join to form a conjoined tendon), type IV (the LCL passes laterally around the anterior margin of the BFT), and type V (the LCL passes posteriorly to the direct arm of the BFT's long head). Results: Among the 494 cases of the knee MRI, there were 433 (87.65%) type I cases, 21 (4.25%) type II cases, 2 (0.4%) type III cases, 16 (3.23%) type IV cases, and 22 (4.45%) type V cases. There were 26 cases (5.26%) in which the LCL and BFT were not attached into the fibular head. Conclusion: The fibular attachment pattern of the BFT and LCL shows diverse types in MR imaging. The LCL does not adhere to the head in some patients.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.200-205
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• 2003

Purpose: To report our experiences of clinical features, treatment method and results of giant cell tumor of 5 patients in proximal fibula. Materials and Methods: Five patients managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon followed up between January 1997 and July 2001. Preoperative plain radiograph and MRI and bone scan were checked. The recurrence of the tumor was judged by plain radiograph and clinical signs. Lateral instability of knee joint was checked during the outpatient follow-up. Results: The mean age of the patients at the time of operation was twenty- three (21-29). There were one male and four female patients. Dull pain was main symptom and palpable mass was seen in two patients. Peroneal nerve palsy and local recurrence were not observed except one case of temporary peroneal nerve palsy. During the outpatient follow up, one among 5 patients showed slight lateral instability and the other 4 patients showed no instabililty. Conclusion: Giant cell tumor in proximal fibula managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon showed favorable results.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.5-12
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• 2001

Purpose: To find out the priority of which procedure has had a better outcome both clinically and radiographically between the two groups, one is treated by primary repair and the other by modified Brostr$\ddot{o}$m's procedure, by comparing the postoperative ankle joint stability and the patient's degree of satisfaction. Material and methods: 16 cases were taken into consideration whose number of severed ligaments were at least two or more of the lateral collateral ligaments of the ankle, and also were confirmed intraoperatively. Among them, 8 cases were treated with primary repair and the other 8 cases were treated with primary repair and the other 8 cases by modified Brostr$\ddot{o}$m's procedure. Results: There was no distinguishable difference for the patient's degree of satisfaction between the two procedures above mentioned. In 3 cases treated with primary repair, functional instability was observed. In case of postoperative ankle joint stability, 7 of 8 cases treated by modified Brostr$\ddot{o}$m's procedure has revealed increased joint stability. And 3 of 8 cases which were treated by primary repair have showed postoperative residual instability. Conclusion: Actually, the severed ligament can not maintain its normal strength though several months has elapsed, and possible residual instability could be remained. Therefore, it can be expected that modified Brostr$\ddot{o}$m's procedure also would be a .good method in obtaining suitable ankle joint stability as well as subtalar joint stability because of its reinforcement using extensor retinaculum.