• Title, Summary, Keyword: 전방 십자인대

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Arthroscopic Anterior Cruciate Ligament Reconstruction with Remnant Bundle Preservation (남아있는 다발을 보존한 전방십자인대 재건술)

  • Ahn, Jin-Hwan;Lee, S.H.
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.87-96
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    • 2009
  • 최근 전방십자인대 손상의 치료에 남아있는 인대 다발이 이식건의 생물학적 치유를 도우며 고유 수용감각(proprioception) 기능을 유지할 뿐만 아니라 슬관절의 전방 전위 억제의 생역학적 기능을 가지는 것으로 연구되고 있다. 이러한 이론을 바탕으로 남아있는 전방십자인대를 보존하는 노력들은 다양하게 시도되고 있다. 전방십자인대 손상의 자연 경과는 아직도 논란이 되고 있으나 선택적인 환자에 있어서 보존적 치료는 비교적 좋은 결과를 얻을 수 있으므로 불필요한 재건술을 줄일 수 있다. 최근 시도되고 있는 선택적 다발 재건술 및 남아있는 다발을 보존하는 전방십자인대 재건 수술 수기들은 다양한 방법으로 시도되고 있으며 남아있는 다발을 보존하는 장점이 있으나 협소한 적응증을 가진다. 저자들의 남아있는 다발을 보존하는 전방십자인대 재건술은 자가 슬괵건을 이용한 단일다발 재건술을 시행하면서 잔존하는 이완된 다발에 봉합사를 통과시킨 후 봉합사를 추가적인 터널 없이 bioabsorbable cross pin (RIGIDfix system, Mitek, Johnson & Johnson, USA) 구멍을 통하여 당기고 고정하는 방법이다. 전방십자인대 재건술시 남아있는 다발을 보존하는 방법은 이식건의 생물학적 치유을 촉진하고 또한 경골 부착부에 남아있는 기계수용체를 보존하므로 기능적 회복에 도움이 될 것으로 기대된다. 저자들의 방법은 비교적 광범위한 적응증을 가지며 적은 합병증으로 남아있는 다발을 효과적으로 보존할 수 있는 술식으로 전방십자인대 수술시 좋은 치료 선택의 하나로 사료된다.

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Comparison of the Patella Baja in Patients With and Without Anterior Cruciate Ligament Injury (전방 십자 인대 손상군과 정상군에서 슬개골 저위증의 비교)

  • Lee, Woo-Suk;Kim, Sung-Hun;Cho, Sung-Jin;Lim, Ji-Hyuk;Chung, Whan-Young;Hwang, Cheol-Mog
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.39-44
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    • 2006
  • Purpose: The object of this study is to compare the Insall-Salvati ratio and Carton index between the patients who have an anterior cruciate ligament (ACL) tear and the patients who have no ACL tear. Materials and Methods: The study group included 114 patients who had an ACL tear and received arthroscopic reconstruction. The group I was acute ACL tear group, within 3 weeks after injury. The group II was chronic ACL tear group who had MRI was done after 3 weeks from injury. The group III was normal control group. We measured the Insall-Salvati ratio and Carton index on Magnetic Resonance Images (MRI) for all patients. Results: The Insall-Salvati ratio of control group was $1.02{\pm}0.12$ and Carton index of control group was $1.14{\pm}0.16$. The ACL-tear study group was $0.91{\pm}0.12\;and\;0.89{\pm}0.20$ respectively. The Insall-Salvati ratio and Caton index in ACL tear group was significantly less than those of control group. There were no significant differences in comparing with acute and chronic ACL tear group. Conclusion: Our study show that patella baja has an association with ACL tears, therefore in patients with an ACL tear who had patella baja, ideal graft for reconstruction was seriously considered.

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The Relationship between Bone Bruise in MR-Imaging and the Degrees of Acute Anterior Cruciate Ligament Injury (급성 전방십자인대 손상 시 자기공명영상에서 나타나는 골멍과 전방십자인대 손상 정도의 관계)

  • Jeong, Hwa-Jae;Shin, Hun-Kyu;Ko, Chun-Suk;Kim, Jang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.17-25
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    • 2012
  • Purpose: The aim of this retrospective study was to evaluate the relationship between appearance and size of bone bruise and severity of anterior cruciate ligament (ACL) injury with magnetic resonance imaging (MRI), furthermore, to identify the mechanism of ACL injury by analyzing the footprint of bone bruise. Materials and Methods: Sixty-five subjects who was taken an MRI within 6 weeks after acute ACL injury were studied. All MRI showed ACL injury and associated bone bruises. Bone bruises were analyzed using Costa-Paz classification based on appearance and location and also scored using Kornaat bone bruise grading system based on size and location. The severity of the ACL injury was graded using a 4-point system (ie, grade 0-3) with oblique coronal MRI. Results: There was statistically significant correlation between Costa-Paz classification of bone bruises in lateral femoral condyle and grade of ACL injury. There were more type 2 lesions in partial tear group (grade 1, 2), however, type 3 lesions of Costa-Paz classification in complete tear group (P=0.037). Significant positive correlations were observed between Kornaat total bone bruise score and grade of ACL injury (P=0.014). Most common ACL injury mechanism was pivot shift injury. Other mechanisms were clip valgus injury, phantom foot injury, and hyperextension injury. Conclusion: It is highly suggested that appearance and size of bone bruise is related to severity of ACL injury after acute ACL injury. The foot print of bone bruise provides valuable clues to identify ACL injury mechanism.

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전방십자인대 부상요인과 부상기전 연구 방법

  • Sin, Chung-Su
    • Journal of the KSME
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    • v.50 no.2
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    • pp.51-54
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    • 2010
  • 이 글에서는 슬관절의 기능에 중요한 역할을 하는 인대인 전방십자인대의 부상에 대해 소개하고, 전방십자인대 부상기전을 연구하는 여러 가지 생체역학 연구 방법의 동향에 대해 알아보기로 한다.

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Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술)

  • Kim, Jae-Hwa;Kim, Jung Ryul
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.132-139
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    • 2011
  • The concept of double-bundle ACL reconstruction was introduced recently to restore the anatomical and biomechanical functions of the native ACL. According to anatomical and biomechanical studies, the separate reconstruction of anteromedial and posterolateral bundle expect to increase the overall postoperative stability and clinical results compared to single-bundle ACL reconstruction. But there is still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the real advantages of double-bundle ACL reconstruction. The purpose of this article is to review the evidence to support double-bundle technique and to address controversies existing over the usefulness of this technique.

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The Relationship between the Anterior Cruciate Ligament Tear and the Posterior Cruciate Ligament Index on MRI Findings (자기공명영상 상 전방십자인대 파열과 후방십자인대 곡선값의 연관성)

  • Kang Jae Do;Kim Kwang Yul;Kim Hyung Cheon;Lee Sung Chun
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.109-114
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    • 2002
  • Propose : The purpose of this retrospective study was to test the posterior cruciate ligament (PCL index) for diagnosis of a tear of the anterior cruciate ligament (ACL) by means of MR imaging. Materials and Methods : From Mar. 1997 to Feb. 2001, concomitant magnetic resonance imaging (MRI) and knee joint arthroscopy were performed in 56 patients of either pain or instability of the knee. The shortest distance between the femoral and tibial attachment of PCL (X) and the distance from that line to the tip of the arc marked by the PCL (Y) on the sagittal plane images were measured. The quotient of these two parameters (Y/X) defined the PCL index. Results : Using MRI diagnosis, there were 35 patients diagnosed with ACL rupture and 21 patients were ruled out of ACL injury. Using arthroscopy, 32 of the 35 patients diagnosed by MRI showed ACL rupture, and 20 of the 21 patients were ruled out of ACL injury. The mean PCL index was 0.40 in the 33 patients diagnosed with ACL rupture through arthroscopy. The mean PCL index was 0.23 in 23 patients with an uninjured ACL through arthroscopy. In 33 patients with ruptured ACL, this value exceeds 0.31. The index value was 0.31 in 3 patients with uninjured ACL. The value of the index was not above 0.31 with an uninjured ACL. PCL index on MRI had a sensitivity of $91\%$ and a specificity of $94\%$ for determining the status of the anterior cruciate ligament. Conclusion : Injury to the ACL changes the PCL index markedly. In diagnostically unreliable MR images, amelioration of the PCL index could help in the diagnosis of ACL injury.

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Unusual Pattern of Simultaneous Bilateral Anterior Cruciate Ligament Ruptures in an Adolescent - A Case Report - (청소년기의 비전형적 양측 전방 십자인대 동시 파열 - 증례 보고 -)

  • Min, Kyung-Dae;Ahn, Young-Joo;Kim, Jun-Bum;Choi, Hyung-Suk;Lee, Byung-Ill
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.65-69
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    • 2005
  • It is well known that the two main variants of the anterior cruciate ligament (ACL) ruptures in an adolescent include tibial eminence fractures and midsubstance tears. Authors report a case of 17-year-old girl with simultaneous bilateral anterior cruciate ligament ruptures at the ligamento-osseus junction of tibial attachment which was treated with arthroscopic primary repair.

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ACL Reconstruction: Bone-Patellar Tendon-Bone Autograft (전방 십자 인대 재건술: 골-슬개건-골 자가이식물)

  • Koh, Hae-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.102-108
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    • 2005
  • The incidence of anterior cruciate ligament tears is increasing as a result of the increasing participation of individuals of all ages in high-risk sports. Endoscopic anterior cruciate ligament reconstruction using autogenous central third bone-patellar tendon-bone graft is the most commonly used method. With regard to BPTB graft as the go]d standard in ACL reconstruction, there are no data that refute this claim to date. Author reviewed the biomechanical properties, donor site morbidity and selection of the bone-patellar tendon-bone graft and described the surgical technique of endoscopic ACL reconstruction using BPTB autograft.

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Reconstruction of Anterior Cruciate Ligament with Fresh-frozen Achilles Allograft (신선 동결 동종 아킬레스건을 이용한 전방 십자인대 재건술)

  • Choi, Nam-Yong;Han, Suk-Ku;Nah, Ki-Ho;Seo, Sang-ll;Lee, Do-Sung;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.26-30
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    • 2004
  • Purpose: We analyzed the clinical results of ACL(anterior cruciate ligament) reconstruction of chronic anterior cruciate ligament injuries with a fresh frozen Achilles allograft, retrospectively. Methods: Thirty-eight patients(average age 32.4 years) who had an chronic injury of ACL reconstructed with an Achilles allograft between January 1999 and February 2001 were included. The mean follow-up was 19.2(12-36) months. The clinical evaluation was done by range of motion, Lachman and pivot-shift test, KT-1000 arthrometer, Lysholm knee score, and the modified Feagin score. Results: All patients recovered full range of motion of affected knees. With use of Lachman and pivot-shift test data, thirty seven(97.4%) were functional. When comparing KT-1000, we found mean maximum side-to-side differences less than 2.1 mm. According to Lysholm knee score, mean postoperative score was 90.4. Thirty four(89.5%) had good to excellent results in modified Feagin score. Conclusion: Results of ACL reconstruction using fresh frozen Achilles allografts were comparable to autografts. ACL reconstruction with Achilles allograft could be a reasonable altemative to autografts.

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Arthroscopic Cannulated Screw Fixation of Avulsion Fracture of the Intercondylar Eminence of the Tibia in a Child -A Case Report- (소아에서 발생한 전방 십자인대 견열 골절에서 유관 나사못을 이용한 관절경적 정복술 -증례보고-)

  • Moon, Kyu Pill;Kim, Kyung Taek;Kang, Min Soo;Park, Won Ro
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.62-65
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    • 2012
  • Avulsion fractures of the intercondylar eminence of the tibia are uncommon. This kind of fracture is most commonly found in adolescents, with an increasing incidence for those involved in competitive athletics. Recently, an arthroscopic procedure is preferred to reduce the operation-related morbidity. Screws, K-wires, Suture anchor have been described as fixation devices. Cannulated screw fixation is a simple method, but this instrument has the risk of causing damage to the growth plate. The authors report good results using cannulated screw in arthroscopic treatment for pediatric anterior cruciate ligament avulsion fracture.

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