Purpose : To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw Materials and Methods : 103 patients (104 cases) who were followed up at least more than 2 years after ACL reconstruction were included in this study. The average period of follow-up was 36 months. The clinical results such as physical examination and Lysholm knee score and instrumented anterior laxity test with Telos were evaluated. Results : The Lysholm knee score was 57.9 in average preoeratively and improved to 95.2 in average at follow up. On the Lachman test, there were mild (+) instability in 46 cases $(45\%)$, moderate (++) in 33 $(31\%)$, severe (+++) in 25 $(24\%)$ preoperatively. 90 cases $(87\%)$ were converted to negative and 14 $(13\%)$ to mild at follow up. On Pivot-shift test, there were negative (-) instability in 22 cases $(22\%)$, mild (+) in 62 $(59\%)$, moderate (++) in 12 $(11\%)$ and severe in 8 $(8\%)$ preoperatively. 87 cases $(84\%)$ were converted to negative and 17 $(16\%)$ to mild at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference on 20 lb was $13.4{\pm}5.6$ (7-25) mm in average preoperatively, and was decreased to $3.6{\pm}1.5$ (1-6) mm in average at follow-up. Complications were quadriceps muscle atrophy in 27 $(30.0\%)$, saphenous nerve paresthesia in 19 $(18.3\%)$, anterior knee crepitus in 13 $(12.5\%)$ and over-penetration of screw through lateral femoral cortex in 5 cases $(4.8\%)$. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of graft and fixatives in restoring knee stability and in improving clinical results with little complications such as anterior knee pain.
A 12-year-old male poodle weighing 2.0 kg presented for evaluation of right thoracic limb lameness. The owner reported that the dog showed recurrent bilateral shoulder joint luxation after a car accident for a year. Recently, the left shoulder joint appeared well maintained, but right shoulder joint luxation was exacerbated. On physical examination, the dog showed non-weight bearing lameness on the right thoracic limb. Craniocaudal radiographic views revealed medial displacement of the right humerus. Mediolateral radiographic views revealed overlap of the glenoid cavity and humeral head. Muscle atrophy of the right thoracic limb, reduced biceps brachii muscle tendon tone, a tear of the medial glenohumeral ligament, and a rupture of the subscapularis tendon were identified intraoperatively. Transposition of the biceps muscle tendon was performed. However, at 7 days, there was evidence of right shoulder reluxation on radiographs. The second surgery was performed with two $2mm{\times}6mm$ cortical bone anchors and a $4mm{\times}6mm$ cancellous bone anchor placed in the cortical bone of the distal scapula and the cancellous bone of the proximal humerus respectively. Two scapular bone anchors were then connected with a humeral bone anchor using heavy nylon suture to minimize shoulder abduction range of motion. On radiographs right after surgery and 6 weeks after surgery, the affected limb revealed no evidence of medial shoulder luxation. At 6 months, no evidence of lameness was noted on the right thoracic limb.
We came to the conclusion after considering all the information from many kinds of books on the circulation courses, cross-link points, functions and the symptoms of disease of Chongmai. The results were as follows : 1. The Chongmai that starts from a Uterus flows to Dazhu through the inside of vertebra after joining Renmai and Duimai at Huiyin. The Chongmais up-line that comes out from Qichong into a surface of body arrives and is scattered at a chest through an abdomen. One strand of them goes upward again and is connected to a throat and lips area. After coming out from Qichong, separated down-line is divided into two parts when it arrives a inner part of a heel through the inner part of a leg. One is for an instep, the other is for the sole of a foot. 2. We call it "Sea of Twelve Meridians" or "Meridian's Sea". Because Chongmai controls all of Meridian by acquired "Basic energy" as getting Stomach's energy, Kidney's energy and air-energy, and there are responsible of physiological phenomenon control. And also we name it "Sea of Blood", because it starts from and provides a nutrition to Uterus. 3. All of these four Meridian such as Renmai, Kidney Meridian, Stomach Meridian and Spleen Meridian are ones that flow around the part of a chest and an abdomen. Chongmai makes energy and blood circulation of a chest and an abdomen be stronger and be controlled. Therefore it makes viscera, bowels and body surface be warm and given a nutrition. So Chongmai becomes "Sea of Viscera and Bowels". 4. Chongmai provides a nutrition for ligament and muscle and makes legs get warm as making energy and blood circulate from head to foot. If Chongmai is energetic, hair is completely easy to grow. 5. To see in pathological phase, Chongmais failure or weakness causes like a chest pain, stomachache, heart attack, a menstrual irregularity and sterility and so on. And also if Chongmai is damaged, it happens that giving a nutrition for lips area is stopped, and then mustache doesn't grow any more.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.13
no.1
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pp.67-72
/
2007
Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.
Jain, Preyal D.;Nayak, Akshatha;Karnad, Shreekanth D.;Doctor, Kaiorisa N.
Clinical and Experimental Pediatrics
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v.65
no.3
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pp.142-149
/
2022
Background: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. Purpose: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. Methods: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. Results: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. Conclusion: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.
Objective : The purpose of this study is to present the standard for practical application of ginger herbal pharmacopuncture Material and Methods : We refer to ancient literatures and the recent papers for ginger. Conclusions : The following results have been obtained 1. The effect of ginger(Zingiber officinale Roscoe) is to "release exterior", "balance nutrient & defensive qi", "resolve phlegm", "arrest coughing", "warm the lungs". So ginger herbal pharmacopuncture can be applied to treating fever, chilling sign, headchae, snuffle and gasping cough due to cold affection and treating the symptoms like sputum and asthma that be revealed by pulmonary disease. 2. The effect of ginger is to "warm spleen and stomach", "arrest vomiting" "promote normal flow of water". So ginger herbal pharmacopuncture can be applied to treating nausea, vomiting, abdominal distension and diarrhea due to phlegm & dampness and treating edema. 3. The effect of ginger is to eliminate blood stasis. So ginger herbal pharmacopuncture can be applied to treating contusion, blood stasis, sprain and gynecologic disease. 4. Ginger can treat myalgia and pain due to wind-damp and have anti-inflammatory effect in pharmacology. So ginger herbal pharmacopuncture can be applied to treating disease of joint, ligament and muscle. 5. Ginger can resolve phlegm and resuscitate. So ginger herbal pharmacopuncture can be applied to treating unconsciousness. But, treating incipient cardiovascular accident, it needs to call your special attention to the danger of blood pressure increase. 6. In pharmacology, ginger is effective for antitumor, antioxidant effects and activating immunocyte. So ginger herbal pharmacopuncture can be applied to treating broadly varieties of tumor and allergic disease.
The purpose of this study is to compare the results between conventional and accelerated rehabilitation program following ACL reconstruction using bone-patellar tendon-bone. Conventional rehabilitation focused on protecting the new ligament by blocking terminal extension and avoiding active quadriceps function in the terminal degrees of extension. But there is current trend toward early postoperative mobilization and intensive. so called 'accelerated', rehabilitation stressing hyperextension of the knee. The results of intraarticular ACL reconstruction with conventional and accelerated rehabilitation were prospectively compared for one year postoperatively in a series of 27 patients. Range of motion and thigh circumference were checked preoperatively, and weekly up to 8 weeks, 3 months. 6 months, and 1 year postoperatively. Stress radiologic test, KT-1000 arthrometer. Cybex II dynamometer were checked in preoperatively, and 3 months, 6 months, and 1 year postoperatively. There were no differences of objective stability and restoration of muscle power. But the accelerated group had a low incidence of extension loss. excellent range of motion, and less difference of thigh circumference. We concluded that accelerated rehabilitation program is recommendable due to superiority in terms of range of motion, especially less extension loss without increasing laxity of knee joint.
Kang, Minsuk;Nam, Yong Seok;Kim, In Jong;Park, Hae-Yeon;Ham, Jung Ryul;Kim, Jae Min
Journal of Korean Neurosurgical Society
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v.65
no.2
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pp.307-314
/
2022
Objective : The percutaneous thread transection technique is a surgical dissecting method using a dissecting thread inserted through a needle under ultrasound guidance without skin incision. As the new dissecting threads were developed domestically, this cadaver study was conducted to compare the effectiveness and safety between the new threads (ultra V sswire and smartwire-01) and a pre-existing commercial dissecting thread (loop & shear) by demonstrating a modified looped thread cubital tunnel release. Methods : The percutaneous cubital tunnel release procedure was performed on 29 fresh cadaveric upper extremities. The pre-existing commercial thread was used in 5 upper extremities. The two newly developed threads were used in 24 upper extremities. Two practitioners performed the procedures separately. After the modified looped thread cubital release, anatomical and histological analyses were performed by a blinded anatomist. The presence of the dissected cubital tunnel and damaged adjacent soft tissue was assessed. Results : Out of the 29 cadaveric upper extremities, 27 specimens showed complete dissection of the Osborne ligament and the proximal fascia of the flexor carpi ulnaris muscle. One specimen was incompletely dissected in each of the ultra V sswire and smartwire-01 groups. There were no injuries of adjacent structures including the ulnar nerve, ulnar artery, medial antebrachial cutaneous nerve, or flexor tendon with either the commercial thread or the newly developed threads. The anatomical analysis revealed clear and sharp incisional margins of the cubital tunnel in the Smartwire-01 and loop & shear groups. All three kinds of threads maintained proper linear elasticity for easy handling during the procedure. The smartwire-01 provided higher visibility in ultrasound than the other threads. Conclusion : The newly developed threads were effective and safe for use in the thread cubital tunnel release procedure.
Purpose: This study identified the co-activation of quadriceps and hamstring muscles during hamstring strengthening exercises in healthy adults. Methods: Twenty-one participants were required for the present study design to achieve 80% power, 0.8 effect size (η2), and an alpha level of 0.05. Thus, this study recruited 21 healthy adults. All participants performed Nordic exercises, bridge exercises, and one-leg deadlifts randomly. The activity of the rectus femoris, vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (SM) were measured. In addition, the ratios of VM/VL and hamstring/quadriceps (HQ) were measured during the three hamstring strengthening exercises using electromyography. One-way ANOVA was used to compare the co-activation of quadriceps and hamstring muscles in the three exercises. Results: The activity of VM and VL during the performance of one-leg deadlifts was significantly higher than the other two exercises. The BF had significantly higher activity during the Nordic exercises compared to the other two exercises. In addition, the SM activation was significantly greater during Nordic exercises than one-leg deadlifts. Additionally, there was significant difference in HQ ratio among hamstring strengthening exercises. In specific, the one-leg deadlifts yielded a significantly lower HQ ratio. Conclusion: This study revealed that one-leg deadlifts are effective in rehabilitation for anterior cruciate ligament injury. In addition, Nordic exercises can be recommended to facilitate hamstring muscle activation.
This study was conducted to investigate the relation between visual analogue scale and recovery time with type of injury that occur in elite wrestling athletes. The incidence rate of injury was analyzed the Poisson ratio, and the VAS and recovery time according to the type of injury were compared using the one-way ANOVA. In addition, the VAS and recovery time were examine the relationship using the Simple Linear Regression, and statistical significance level was α =.05. Injuries occurred most commonly in the ligament, followed by the muscle, cartilage and tendon.The VAS and recovery time according to the type of injury was statistically significant (p=.001, p=.001, respectively). The VAS and recovery time according to the type of injury was statistically significant (p=.001, p=.001). Also, increase in VAS of 1 point was associated with about 1.89 recovery time. These studies are expected to be useful as basic data for return to sports and safe training.
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