• Title/Summary/Keyword: the joint angle

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A Comparison of Outcomes after Early and Delayed Reconstruction in the Acute Posterior Cruciate Ligament Injuries (급성 후방십자인대 손상 환자에서 조기 재건군과 지연 재건군의 결과 비교)

  • Lee, Yong Sik;Lee, Soo Won;Seo, Byung Ho;Kim, Yoon Gi
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.31-37
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    • 2013
  • Purpose: This study performed to compare degree of joint stiffness and clinical results between early and delayed reconstruction of acute posterior cruciate ligament (PCL) injuries. Materials and Methods: Thirty-two Patients who underwent PCL reconstruction between March 2008 and October 2011 enrolled this study. We performed transtibial single bundle reconstruction using the allo-achilles tendon in all cases. We divided the patient into two groups, early reconstruction group underwent surgery before a week, delayed reconstruction group underwent surgery after 3 weeks, before 6 weeks. All the patients underwent aggressive joint motion exercise till surgery and enrolled post operative rehabilitation program. We checked posterior drawer stress radiography, range of motion, the Lysholm score, the International Knee Documentation Committee (IKDC) score and the Tegner score to evaluate the results. Results: At the final follow up the Lysholm score was 92.1 in the early group and 93.8 in the delayed group. All the cases were rated above B (near normal) on IKDC score (p=0.808, p=0.722). The Tegner score was 6.6 in the early reconstruction group and 6.2 in the delayed group (p=0.480), The average of maximum flexion and extension angle was $133.9^{\circ}$, $1.4^{\circ}$ in the early group and $133.6^{\circ}$, $1.1^{\circ}$ in the delayed group (p=0.560, p=0.581), no complication such as deep vein thrombosis or infection, no difference in posterior drawer stress radiography (p=0.750). Conclusion: We could obtain satisfactory clinical results in both the early and delayed reconstruction groups of acute PCL injuries. Therefore, the early reconstruction of PCL performed before a week could be one of the treatment options for acute PCL injury.

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Mid-Term Results of Fixed Bearing Unicompartmental Knee Arthroplasty: Minimum 5-Year Follow-Up (고정형 슬관절 단일 구획 치환술의 중기 추시 결과: 최소 5년 추시)

  • Oh, Jeong Han;Joo, Il-Han;Kong, Dong-Yi;Choi, Choong-Hyeok
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.498-504
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    • 2018
  • Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

Optimization for Underwater Welding of Marine Steel Plates (선박용 강판의 수중 용접 최적화에 관한 연구)

  • 오세규
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.20 no.1
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    • pp.49-59
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    • 1984
  • Optimizing investigation of characteristics of underwater welding by a gravity type arc welding process was experimentally carried out by using six types of domestic coated welding electrodes for welding of domestic marine structural steel plates (KR Grade A-1, SWS41A, SWS41B,) in order to develop the underwater welding techniques in practical use. Main results obtained are summarized as follows: 1. The absorption speed of the coating of domestic coated lime titania type welding-electrode became constant at about 60 minutes in water and it was about 0.18%/min during initial 8 minutes of absorption time. 2. Thus, the immediate welding electrode could be used in underwater welding for such a short time in comparison with the joint strength of in-atmosphere-and on-water-welding by dry-, wet-or immediate-welding-electrode. 3. By bead appearance and X-ray inspection, ilmenite, limetitania and high titanium oxide types of electrodes were found better for underwater-welding of 10 mm KR Grade A-1 steel plates, while proper welding angle, current and electrode diameter were 6$0^{\circ}C$, above 160A and 4mm respectively under 28cm/min of welding speed. 4. The weld metal tensile strength or proof stress of underwater-welded-joints has a quadratic relationship with the heat input, and the optimal heat input zone is about 13 to 15KJ/cm for 10mm SWS41A steel plates, resulting from consideration upon both joint efficiency of above-100% and recovery of impact strength and strain. Meanwhile, the optimal heat input zone resulting from tension-tension fatigue limit above the base metal's of SWS41A plates is 16 to 19KJ/cm. Reliability of all the empirical equations reveals 95% confidence level. 6. The microstructure of the underwater welds of SES41A welded in such a zone has no weld defects such as hydrogen brittleness with supreme high hardness, since the HAZ-bond boundary area adjacent to both surface and base metal has only Hv400 max with the microstructure of fine martensite, bainite, pearlite and small amount of ferrite.

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Arthroscopic Pull-out Suture Repair of Posterior Root Tear of the Medial Meniscus - Minimum 5 Years Follow-up Results - (내측 반월상 연골판 후방 부착부 파열의 관절경적 견인 봉합술 - 최소 5년 추시결과 -)

  • SaKong, Hyub;Shin, Hong Kwan;Lee, Young-Kook;Bae, Ki Cheor;Cho, Chul Hyun;Lee, Kyung Jae;Son, Eun-Seok;Kim, Doo Han
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.153-159
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    • 2012
  • Purpose: This study aims at evaluating our results with a 5-year follow up of arthroscopic pull-out suture repair of posterior root tear of the medial meniscus. Materials and Methods: This study enrolled 30 cases who underwent a arthroscopic pull-out suture repair to treat the posterior root tear of the medial meniscus from January 2001 to May 2005 and followed up at least 5 years. The average follow-up period was 76 months (range, 60-90 months). Clinical results by use of the Lysholm knee score and radiographic grade by use of the Kellgren-Lawrence classification were evaluated and second-look arthroscopy was done in all cases. The clinical results were compared with trauma history, obesity, varus deformity and time to operation. Results: At the last follow up, the Lysholm knee score improved from 55 points to 86 points. For the radiological results, 23 cases displayed maintenance or improvement of the medial joint space on the follow up X-ray, but 7 cases displayed decrease of the medial joint space, and 1 case was lately performed total knee replacement due to progressive osteoarthritic change. Conclusion: Arthroscopic pull-out suture repair has a good result at 27 cases (90%) in minimum 5 years follow-up. The clinical improvement was significantly reduced in more severe varus angle.

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Comparison of the Outcomes after Primary Total Hip Arthroplasty Using a Short Stem between the Modified Anterolateral Approach and Direct Anterior Approach with a Standard Operation Table (일반 수술 침대와 짧은 대퇴 주대를 이용한 인공 고관절 전 치환술의 직접 전방 도달법과 변형된 전 측방 도달법에 따른 결과 비교)

  • Park, Myung-Sik;Yoon, Sun-Jung;Choi, Seung-Min;Cho, Hong-Man;Chung, Woochull;Kang, Kyung-Rok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.244-253
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    • 2019
  • Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

Distributional Characteristics of Microcrack in Tertiary Crystalline Tuff from Northeastern Gyeongsang Basin (경상분지 북동부의 제3기 결정질 응회암에서 발달하는 미세균열의 분포특성)

  • Park, Deok-Won;Lee, Chang-Bum
    • The Journal of the Petrological Society of Korea
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    • v.18 no.4
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    • pp.315-336
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    • 2009
  • We have studied the orientational characteristics of microcrack frequency, it's length and density in Tertiary crystalline tuff from the northeastern part of the Gyeongsang Basin. 134 sets of microcracks on horizontal surfaces of 3 rock samples from Heunghae-eup were distinguished by enlarged photomicrographs of the thin sections. The variability in patterns among microcrack length-frequency histograms for three rock samples from different altitudes were derived. The pattern of histograms changes progressively from negative exponential form to log-normal form in proportion to altitude. The distribution pattern for rock sample no.1 from lower altitude shows the broad length distribution characterized by higher mean and median, and higher standard deviation. Meanwhile, this distribution pattern corresponds with characteristics of joint length distribution in sedimentary rocks of the lower part of the Gyeongsang Supergroup. The occurrence frequency of shorter microcracks increases toward both NW and NE directions from the $N0{\sim}10^{\circ}W$, with the dominant direction of $N80{\sim}90^{\circ}W$ and $N80{\sim}90^{\circ}E$, respectively. This distribution pattern represents the relative differences in formation timing among microcrack sets and the result of the new initiation of shorter microcracks. Meanwhile, the longest microcracks within $N60{\sim}70^{\circ}W$($L_{max}$:1.18 mm) and $N0{\sim}10^{\circ}W$($L_{max}$:0.80 mm) directions are seen, but this kind of microcracks are very limited in number. Whole domain of the directional angle($\theta$)-frequency(N), length(L) and density($\rho$) chart can be divided into five sections in terms of phases of the distribution of related curves. From the distribution chart, density curve shows five distinct peaks in the WNW-ESE($N70{\sim}80^{\circ}W$), NS~NNE-SSW($N0{\sim}10^{\circ}W$, $N10{\sim}20^{\circ}E$), ENE-WSW($N50{\sim}60^{\circ}E$), and nearly EW($N80{\sim}90^{\circ}E$) directions, respectively. Especially, main directions of faults correspond with the directional angle showing high density. Consequently, these distribution patterns of density curve reflect the representative maximum principal stress orientations suggested in previous studies.

The Diagnostic Usefulness of Stress Radiography in Chronic Lateral Ankle Instability (만성 발목 관절 외측 불안정성의 진단에서 스트레스 방사선검사의 유용성)

  • Kim, Yong-Min;Cho, Byung-Ki;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Park, Kyoung-Jin;Kim, Dong-Hwan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.35-40
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    • 2011
  • Purpose: This study was performed to evaluate the diagnostic usefulness of ankle stress radiograph for evaluation of chronic lateral ankle instability. Materials and Methods: Among patients undergoing the modified-Brostrom procedure, 42 cases with complete rupture of the anterior talofibular ligament were enrolled in this study. Sixty Korean adults (120 cases) were recruited as the control group. Radiologic measurement of talar tilt and anterior talar translation was performed through stress radiographs using Telos device. We obtained the normal range of Korean adults, and used as a standard value for judgment of mechanical instability. We analyzed the sensitivity, specificity, positive and negative prediction value of ankle stress radiograph. Results: On ankle stress radiograph, normal range of talar tilt angle and anterior talar translation was below $8.3^{\circ}$, below 7.6mm. Talar tilt angle on varus stress radiograph showed 57% of sensitivity, 97% of specificity, 89% of positive and 86% of negative prediction value. Anterior talar translation on anterior drawer stress radiograph showed 69% of sensitivity, 97% of specificity, 91% of positive and 90% of negative prediction value. Conclusion: Ankle stress radiograph had a good specificity, positive and negative prediction value for the evaluation of mechanical instability. However it underestimated the mechanical instability of ankle joint. It must be remembered that normal stress radiograph does not exclude ankle instability.

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Usefulness of Dual-Echo in Steady State (DESS) Image in Chondromalacia of Knee Joint: Comparison of DESS and Turbo Spin-Echo MR Images (슬관절 연골 연화증의 진단에서의 Dual Echo in Steady State (DESS) 영상의 유용성 : 급속 스핀에코 자기공명 영상과 비교)

  • 윤삼현;하두회
    • Investigative Magnetic Resonance Imaging
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    • v.3 no.1
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    • pp.66-72
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    • 1999
  • Purpose : To evaluate the usefulness of Dual Echo in Steady State(DESS) image in the diagnosis of chondromalacia of the knee compared with turbo spin-echo MR images Materials and Methods : We included 26 patients with chondromalacia of the knee. MR imaging was obtained with a 1.5T imager. Sagittal and coronal double echo T2 weighted images(TR/TE 3000-4200/16-96msec, FOV $140-160{\times}140-160mm$, matrix size $180{\times}256$, slice thickness 4.0mm, interslice gap 0.5mm), and sagittal DESS image(TR/TE 25.4/9.0msec, flip angle $35-45^{\circ}$, FOV $150-160{\times}150-160mm,{\;}matrix{\;}size{\;}192{\times}256$, effective slice thickness 1.5mm) were obtained. Cartilage lesions were staged according to a modified scheme proposed by Outerbirdge: grade 0, normal; grade 1, softening or/and swelling; grade 2, mild surface fibrillation or/and less than 50% of cartilage thickness; grade 3, severe surface fibrillation or/and loss of more than 50% of cartilage thickness but without exposure of subchondral bone; and grade 4, complete loss of cartilage with subchondral bone exposure. Gradings were determined by two readers with consensus, and patellofemoral, medial and lateral tibiofemoral compartments were evaluated. Results : Arthroscopic findings revealed grade 1 in seven cases, grade 2 in 21 cases, grade 3 in six cases, and grade 4 in 18 cases. Sensitivity of turbo spin-echo MR image was as follows; 0%, 14%, 0%, 61% in each grade, and sensitivity of DESS image was as follows; 0%, 33%, 50%, 67%, in each grade(p=0.001). In the detection of chondromalacic lesions regardless of gradings, sensitivity, specificity and accuracy of conventional MR image were 59.6% 88.6% 78.8%, and of DESS image, 73.1% 88.4%, 82.2%(p=0.007). Conclusion : For chondromalacia of knee joints, DESS images showed higher sensitivity than turbo spin-echo MR images. Therefore, DESS images will be helpful for diagnosis of chondromalacia of knee joints.

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Analysis of the Lower Extremity's Coupling Angles During Forward and Backward Running (앞으로 달리기와 뒤로 달리기 시 하지 커플링각 분석)

  • Ryu, Ji-Seon
    • Korean Journal of Applied Biomechanics
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    • v.16 no.3
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    • pp.149-163
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    • 2006
  • The purpose of this study was to compare the lower extremity's joint and segment coupling patterns between forward and backward running in subjects who were twelve healthy males. Three-dimensional kinematic data were collected with Qualisys system while subjects ran to forward and backward. The thigh internal/external rotation and tibia internal/external rotation, thigh flexion/extension and tibia flexion/extension, tibia internal/external rotation and foot inversion/eversion, knee internal/external rotation and ankle inversion/eversion, knee flexion/extension and ankle inversion/eversion, knee flexion/extension and ankle flexion/extension, and knee flexion/extension and tibia internal/external rotation coupling patterns were determined using a vector coding technique. The comparison for each coupling between forward and backward running were conducted using a dependent, two-tailed t-test at a significant level of .05 for the mean of each of five stride regions, midstance(1l-30%), toe-off(31-50%), swing acceleration(51-70%), swing deceleration(71-90), and heel-strike(91-10%), respectively. 1. The knee flexion/extension and ankle flexion/extension coupling pattern of both foreward and backward running over the stride was converged on a complete coordination. However, the ankle flexion/extension to knee flexion/extension was relatively greater at heel-strike in backward running compared with forward running. At the swing deceleration, backward running was dominantly led by the ankle flexion/extension, but forward running done by the knee flexion/extension. 2. The knee flexion/extension and ankle inversion/eversion coupling pattern for both running was also converged on a complete coordination. At the mid-stance. the ankle movement in the frontal plane was large during forward running, but the knee movement in the sagital plane was large during backward running and vice versa at the swing deceleration. 3. The knee flexion/extension and tibia internal/external rotation coupling while forward and backward run was also centered on the angle of 45 degrees, which indicate a complete coordination. However, tibia internal/external rotation dominated the knee flexion/extension at heel strike phase in forward running and vice versa in backward running. It was diametrically opposed to the swing deceleration for each running. 4. Both running was governed by the ankle movement in the frontal plane across the stride cycle within the knee internal/external rotation and tibia internal/external rotation. The knee internal/external rotation of backward running was greater than that of forward running at the swing deceleration. 5. The tibia internal/external rotation in coupling between the tibia internal/external rotation and foot inversion/eversion was relatively great compared with the foot inversion/eversion over a stride for both running. At heel strike, the tibia internal/external rotation of backward running was shown greater than that of forward(p<.05). 6. The thigh internal/external rotation took the lead for both running in the thigh internal/external rotation and tibia internal/external rotation coupling. In comparison of phase, the thigh internal/external rotation movement at the swing acceleration phase in backward running worked greater in comparison with forward running(p<.05). However, it was greater at the swing deceleration in forward running(p<.05). 7. With the exception of the swing deceleration phase in forward running, the tibia flexion/extension surpassed the thigh flexion/extension across the stride cycle in both running. Analysis of the specific stride phases revealed the forward running had greater tibia flexion/extension movement at the heel strike than backward running(p<.05). In addition, the thigh flexion/extension and tibia flexion/extension coupling displayed almost coordination at the heel strike phase in backward running. On the other hand the thigh flexion/extension of forward running at the swing deceleration phase was greater than the tibia flexion/extension, but it was opposite from backward running. In summary, coupling which were the knee flexion/extension and ankle flexion/extension, the knee flexion/extension and ankle inversion/eversion, the knee internal/external rotation and ankle inversion/eversion, the tibia internal/external rotation and foot inversion/eversion, the thigh internal/external rotation and tibia internal/external rotation, and the thigh flexion/extension and tibia flexion/extension patterns were most similar across the strike cycle in both running, but it showed that coupling patterns in the specific stride phases were different from average point of view between two running types.

Physical and Mechanical Properties on Ipseok-dae Columnar Joints of Mt. Mudeung National Park (무등산국립공원 입석대 주상절리대에 대한 물리역학적 특성)

  • Ko, Chin-Surk;Kim, Maruchan;Noh, Jeongdu;Kang, Seong-Seung
    • The Journal of Engineering Geology
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    • v.26 no.3
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    • pp.383-392
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    • 2016
  • This study is to evaluate the physical and mechanical properties on the Ipseok-dae columnar joints of Mt. Mudeung National Park. For these purposes, physical and mechanical properties as well as discontinuity property on the Mudeungsan tuff, measurement of vibration and local meteorology around columnar joints, and ground deformation by self-weight of columnar joints were examined. For the physical and mechanical properties, average values were respectively 0.65% for porosity, 2.69 for specific gravity, 2.68 g/cm3 for density, and 2411 m/s for primary velocity, 323 MPa for uniaxial compressive strength, 81 GPa Young's modulus, and 0.25 for Poisson's ratio. For the joint shear test, average values were respectively 3.15 GPa/m for normal stiffness, 0.38 GPa/m for shear stiffness, 0.50 MPa for cohesion, and 35° for internal friction angle. The JRC standard and JRC chart was in the range of 4~6, and 1~1.5, respectively. The rebound value Q of silver schmidt hammer was 57 (≒ 90 MPa). It corresponds 20% of the uniaxial compressive strength of intact rock. The maximum vibration value around the Ipseok=dae columnar joints was in the range of 0.57 PPV (mm/s)~2.35 PPV (mm/s). The local meteorology of surface temperature, air temperature, humidity, and wind on and around columnar joints appeared to have been greatly influenced the weather on the day of measurement. For the numerical analysis of ground deformation due to its self-weight of the Ipseok-dae columnar joints, the maximum displacement of the right ground shows when the ground distance is approximately 2 m, while drastically decreased by 2~4 m, thereafter was insignificant. The maximum displacement of the middle ground shows when the ground distance is approximately 0~2 m, while drastically decreased by 3~10 m, thereafter was insignificant. The maximum displacement of the left ground shows when the ground distance is approximately 5~6 m, while drastically decreased by 6~10 m, thereafter was insignificant.