• Title, Summary, Keyword: Lysholm score

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Clinical results of arthroscopic meniscal repair according to joint stability (반월상 연골의 관절경적 봉합시 관절안정성에 따른 결과)

  • Kyung Hee-Soo;Ihn Joo-Chul;Baek Seung-Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.37-42
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    • 2002
  • Purpose : The purpose of this study was to evaluate the results of arthroscopic meniscal repair according to joint stability. Materials and Methods : Twenty cases were reviewed, which had underwent arthroscopic meniscal repair. The mean age was 32.3 years old. The mean follow-up period was 59.7 months. Menisci that had underwent complete repair of associated ligament injuries (8cases, Sa) and menisci that had no associated ligament injury (9 cases, Sb) were classified as stable group (S), and the others (3 cases) as unstable group (U). Also stable group was divided into acute and chronic group. The result was evaluated with Lysholm score and IKDC method. The statistical analysis was done using Wilcoxon rank sum test and Fisher's exact test (p<0.05). Results : Group Sa had $87.5\%$ satisfactory and Lysholm score was 90.9. Group U had $66.7\%$ satisfactory, and Lysholm score was 77.7. Group Sb had $89.9\%$, satisfactory and Lysholm store was 91.4. In acute group $91.7\%$ was satisfactory, Lysholm score 92.5, in chronic group $80\%$ was satisfactory, Lysholm score 88.6. Conclusion : Joint stability was important factor for the outcome of meniscal repairs. So, it is desirable to repair meniscus injury early and the repair of associated ligament injuries should be performed together.

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Ligament Injuries of Knee in the Recreational Skiers (스키에 의한 슬관절 인대 손상)

  • Lee Dong Chul;Ko Jin Hyeok;Kim Dong Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.37-43
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    • 2003
  • Purpose: This study is to analyse the injury patterns of knee ligament and the factors influencing ligament injuries of knee, and to evaluate the changes of knee function and activity after ski injury. Materials and Methods: Thirty cases of ligament injuries of knee were studied with a questionaire, stress radiographs, magnetic resolution imaging, and physical examination. Mean age was 28.6 years old and mean follow up was 29.6 months. Clinical evaluation of Lysholm knee scoring scale was used for knee function and Tegner activity score was used for activity change after ski injury. Results: The anterior cruciate ligament (ACL) injury accompanied with medial collateral ligament(MCL) injury was most in 11 cases and isolated MCL injury was the next in 9 cases. The common types of injury mechanism were Phantom foot phenomenon (13 cases, 43$\%$) and valgus external rotation injury (12 cases, 40$\%$), which constitute 83$\%$ of all case. At the last follow up, the mean Lysholm score was 93.4 and mean Tegner activity score was 4.2. The reduced Tegner activity score after injury was 1.9. Among several injury groups, the evaluation of knee function and activity was best in the isolated MCL injury group and worst in the ACL injury accompanied with MCL injury group. The factors to influence ski injury were participation to ski class, release of binding, and skiing long time more than 2 hours. Conclusions: Lysholm score at last follow up revealed good grading, but sports activity after ski injury was reduced when compared with pre-injury state. It seems to need a active, systemic sports rehabilitation program after sports injury.

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Posterior cruciate ligament reconstruction using fresh-frozen Achilles tendon allograft with preservation of ligament remnant (남아 있는 인대를 보존하고 신선 동결 동종 아킬레스건을 이용한 후방십자인대 재건술)

  • Kim, Yeung Jin;Chae, Soo Uk;Kim, Jong Yun;Kim, Byung Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.54-60
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    • 2011
  • Puropse: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant or elongated ligament. Materials and Methods: From October 2004 to March 2010, we performed PCL reconstruction with Achilles tendon allografts in 22 complete rupture patients. Mean age was 31.5 years. 14 cases were male and 8 cases were female. Average follow-up period was 3 years and 7 months, range from 1 year to 6 years and 4 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, IKDC score, and second look arthroscopic examination. Results: Postoperative Lysholm knee score, IKDC scores, Tegner activity scale, and posterior displacement by the Telos stress test demonstrated statistically significant improvement compared to the preoperative state. Conclusion: Arthroscopic PCL reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant showed good clinical results and posterior stability.

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Surgical Outcome of Primary Repair in Anterior Cruciate Ligament Rupture - Minimum 4-years follow-up - (전방 십자 인대 봉합술의 수술적 치료 - 최소 4년 이상 추시 결과 -)

  • Byun, Ki-Yong;Rhee, Kwang-Jin;Lee, Suk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.123-127
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    • 2000
  • Purpose : To evaluate of the surgical outcome of primary repair in anterior cruciate ligament rupture. Material & Method : Twenty-five patients underwent arthroscopic primary repair of ACL. We performed pull-out suture of ruptured ligament in 18 cases, and suture and augumentation with gracillis & semitendinosus in 7 cases. At follow up, the International Knee Documentation Committee(IKDC) scale & Lysholm score were used to grade outcome, and also the KT-2000 arthrometer was used to evaluate objective ligament laxity. Results : In analysis of IKDC scale, final evaluation group were group A in 3 cases, group B in 13 cases, group C in 9 cases. The mean value of Lysholm score was 83 points. In KT-2000 arthrometer examination, mean anterior translation was 3.9mm at 201b, 7.3mm at 30lb. The mean difference value between injured knee and uninjured knee was 1.1mm at 201b, 2.29mm at 301b. There was statistical significance in mean difference value between injured and uninjured knee. Conclusion : By analysis of clinical & objective data, we could confirm that the mid-term result of ACL suture is not satisfactory. So, we recommend that ACL reconstruction would be done in young active patient rather than suture.

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Reconstruction of Posterior Cruciate Ligament and Posterolateral Structure with Allo-Achilles Tendon (동종 아킬레스 건을 이용한 후방 십자 인대 및 후 외방 구조물 재건술)

  • Oh, In-Suk;Lee, Dong-Joo;Cho, Kyu-Jung;Kim, Myung-Ku
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.162-166
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    • 2005
  • Purpose: The purpose of this study were to evaluate the results of arthroscopic PCL reconstruction and posterolateral structure reconstruction. Materials and Methods: We performed 10 cases of arthrocopic PCL and posterolateral structure reconstruction using allo-achilles tendon. The average follow-up period was 25 months. We performed KT-2000 testing and posterior drawer test for posterior instability and tibial external rotation test for posterolateral rotatory instability, and measure Tegner and Lysholm score preoperatively and compared these with the results of a final evaluation in each cases. Results: The Preoperative average KT-2000 tests was 7.1 mm, posterior drawer test was Grade III and tibial external rotation test was positive at both 30 and 90 degrees of knee flexion in all cases. Preoperative average Lysholm score was 65.9 and Tegner score was 3.1. At the final evaluation, an average KT-2000 test was 2.2 mm, posteior drawer test, Grade 0 was 2 cases, Grade 1.4 cases, Grade II, 3 cases, Grade III, 1 cases. The tibial external rotation test at both 30 and 90 degrees of knee flexion was positive in 1 cases and positive at only 90 degrees in 2 cases. Lysholm score was 87.6 and Tegner score was 5.7. The objective and subjective score of final evaluation is increased in compare with preoperative one. Conclusion: Arthrocopic PCL and posterolateral structure reconstruction using allo-achilles tendon is one of the good surgical treatment method in patients having posterior and posterolateral rotatory instability.

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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 Meniscal Repair with Bioabsorbable Devices (생체 흡수성 기구를 이용한 반월상 연골 봉합술)

  • Kim Jong Soon;Shin Kyoo Seog;Lee Dong Hwa;Sok Jin Ho;Park Sang Hwan;Heo Jeong Kuk
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.150-155
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    • 2002
  • Purpose : The purpose of this study was to evaluate the clinical results of meniscal repair using the bioabsorbable devices. Materials and Methods : From 1998, 21 meniscal repairs were underwent using the bioabsorbable devices and followed more than 1 year. The Meniscus $Arrow^{\circledR}$(Bionx) and the Meniscal $Fastener^{\circledR}$(Mitek) had been applied. The indication for meniscus refixation was an unstable longitudinal tear in the posterior horn of the medial or lateral meniscus. Concurrent ACL reconstruction with meniscal repair was performed on 9 knees. The clinical result was evaluated using Lysholm knee score. Result : The average Lysholm knee scores for all patients improved from 56 preoperatively, to 89 postoperatively. The type of the device were not significantly related to clinical outcome or Lysholm knee score. But the concurrent ACL reconstruction group and the patients treated within 8 weeks had better clinical result than the others. Conclusion : The all-inside meniscal repair technique using bioabsorbable devices can be considered to be an useful method in the well selected patients and concurrent ACL reconstruction surgery.

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Clinical Results of the Radial Tear of Posterior Root of Medial Meniscus (내측 반월상 연골 후각부 방사형 파열의 임상적 결과)

  • Nha, Kyung-Wook;Jo, Jin-Ho;Lee, Dong-Bong
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.128-133
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    • 2007
  • Purpose: To examine the clinical results after arthroscopic meniscectomy of radial tear of medial meniscus. Materials and Methods: We studied 45 cases with the radial tear of medial meniscus which follow up more than 2 years(range 2 to 7 years). Arthroscopic surgery was performed to the patients with grade 0-2 according to the Kellgren and Lawrence classification. Evaluation of cartilage damage was performed on surgical photos according to Outerbridge classification. Evaluation of clinical result was used the modified Lysholm score. Results: The mean pre-operation Lysholm score was 79.1, 71.2, 68.5, 67.9, 67.2, 61.5 and post-operation Lysholm score was 86.3, 75.1, 73.0, 73.1, 73.2, 66.2 and 61.5%, 62.5%, 60.0%, 50.0%, 50.0%, 25.0% improved knee pain and 69.2%, 75.5%, 70.0%, 66.6%, 75.0%, 75.0% were satisfied knee surgery and 30.7%, 20.5%, 20.0%, 50.0%, 25.0%, 50.0% required further surgery in patients respectively. According to Kellgren and Lawrence classification, 7 cases(15.5%) progress grade 3 osteoarthritis. Conclusions: The radial tear of medial meniscus showed the poor results with arthroscopic meniscectomy even if the grade 0-2 osteoarthritis. For the improvement of the clinical results, consider the technique to restore the hoop stresses or use the high tibia osteotomy for preventing the osteoarthritis.

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Mid to Long - Term Results of Meniscal Allograft Transplantation (동종 반월상 연골 이식술 후 중장기 추시 결과)

  • Chun, Churl-Hong;Kweon, Seok-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.19-25
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    • 2009
  • Purpose: We report mid to long - term results of meniscal transplantation and evaluate the important factors for successful outcomes. Materials and Methods: Between December 1999 and September 2002, 25 meniscal transplantations were performed using fresh frozen allograft. The lateral meniscus was transplanted in 19 cases and medial meniscus in 6 cases. The mean age was 34 years (range, 17~50 years) and the mean follow up was 54.8 months (range, 6~85 months). Preoperative measurements were made using a ruler graded in millimeters. Lateral meniscus was fixed by keyhole technique and medial meniscus was fixed by double bone plug technique with suturing the periphery of the meniscal transplant. All patients were evaluated with Knee Assessment Scoring System (KASS), Lysholm knee score, and Tegner activity scale for daily activity. Results: Symptoms improved in all cases. The average KASS score increased from 61.7 preoperatively to 83.8 postoperatively. The average Lysholm knee score increased from 77.7 preoperatively to 87.7 postoperatively (excellent in 3 cases, good in 17 cases, fair 4 cases, poor 1 case). But painful swellings were 3 cases, numbness in 1 case, and granuloma due to non-absorbable suture material in 1 case. Peroneal nerve palsy in 1 case was recovered after 6 weeks postoperatively. Conclusion: Meniscal allograft transplantation after subtotal or total menisectomy can significantly relieve pain and improve function of the knee joint. The exact preoperative sizing and secure fixation are essential for successful outcomes.

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

  • Lee, Soo Won;Kim, Sung Hwan;Kim, Yoon Gi
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.34-39
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    • 2012
  • Purpose: This study performed to compare degree of joint stiffness and clinical results between early and delayed reconstruction of acute anterior cruciate ligament (ACL) injuries. Materials and Methods: Thirty-four Patients who underwent ACL reconstruction between March 2008 and October 2010 enrolled this study. We divided the patient into 2 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 including self exercise. We checked range of motion, the Lachman test, the pivot shift test, 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 91.82 in the early group and 94.83 in the delayed group. All the cases were rated above B (near normal) on IKDC score (P=0.217, P=0.845). The Tegner score was 6.7 in the early reconstruction group and 7.1 in the delayed group (P=0.840), there was no difference between the groups for the range of motion (P=0.873, P=0.873), no complication such as deep vein thrombosis or infection, no difference in the Lachman test, pivot shift test (P=0.606, P=0.118). Conclusion: We could obtain satisfactory clinical results in both the early and delayed reconstruction groups of acute ACL injuries. Therefore, the early reconstruction of ACL performed before a week could be one of the treatment options for acute ACL injury.

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