• Title, Summary, Keyword: Lysholm score

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The Effect of a Tibial Remnant Preservation Technique on the Synovialization of the Graft Tendon in Anterior Cruciate Ligament Reconstruction - Based on the Second Look Arthroscopic Findings - (전방십자인대 재건술시 잔류 조직 보존술이 이식 인대의 활막화(synovialization)에 미치는 영향 - 2차 관절경 소견을 중심으로 -)

  • Ahn, Gil Yeong;Nam, Il Hyun;Moon, Gi Hyuk;Lee, Yeong Hyun;Choi, Seong Pil;Yoo, Jong Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.11-17
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    • 2013
  • Purpose: The purpose of this study is to evaluate the effect of preservation of the tibial remnant on the synovialization of graft tendon after the reconstruction of anterior cruciate ligament (ACL) based on the second look arthroscopic findings. Materials and Methods: From May 2005 to May 2012, among sixty three patients having ACL reconstruction with the four-strand hamstring using a bioabsorbable cross pin (RigidFix$^{(R)}$) for the femoral tunnel, nineteen patients who had second look arthroscopy were analyzed. We classified them into three groups according to the tibial remnant of the torn ACL for arthroscopic findings. Group 1 had less than 5 mm of a remnant tissue, Group 2 had from 6 mm to 10 mm of it, and Group 3 had more than 11 mm. We estimated the percentage of synovial coverage on the graft tendon during second look arthroscopy. We evaluated Lysholm score and Tegner activity score preoperatively and in the last follow-up. Results: At the time of ACL reconstruction, the mean length of preserved tibial remnant of torn ACL was 2.3 mm in Group 1, 7.4 mm in Group 2, and 13.7 mm in Group 3. In the second look arthroscopy, the average percentage of synovial coverage was 55.4% in Group 1, and 77.9% in Group 2, and 89.7% in Group 3. Lysholm score and Tegner activity score improved from 74.2 and 7.3 preoperatively to 94.1 and 8.5 in the last follow-up. Conclusion: The preservation of tibial remnant of torn ACL influenced the synovial coverage of the graft tendon and the volume of preserved remnant in accordance with the surface of synovial coverage. It would have a good effect on graft healing and preservation of proprioceptive function.

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The Clinical Study on the Effect of the Sulguanjul-bang No.1 According to Formulation (퇴행성 슬관절염 환자에 대한 슬관절방(膝關節方) 1호(號)의 제형변화 유효성 임상연구)

  • Park, Min-Jung;Seo, Jin-Woo;Sung, In-Hyung;Kim, Nam-Ok;Sung, Su-Min;Chung, Ae-Kyung;Shin, Dae-Hee;Park, Koae-Hwan
    • Herbal Formula Science
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    • v.13 no.2
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    • pp.193-206
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    • 2005
  • Objective: This study is designed to compare the effects of Sulguanjul-Bang No.1 on osteoarthritis in knee joint according to formulation. Methods: 47 patients with symptomatic osteoarthritis of the knee joint were enrolled in a open clinical trial. The 47 patients were devided into two groups at random and taken Sulguanjul-bang No.1 with decoction type, suspension type respectively for8 weeks. After 8-week treatment period, the following parameters were analyzed ; Visual analogue Scale(VAS), Lysholm index score, patients' global assessment. Results: Sulguanjul-bang No.1 treatment led to significant improvement in the pain and symptoms of osteoarthritis as determined by all efficacy measures. After 8 weeks of therapy, there was significant improvement in VAS, Lysholm index and patients' global assessment. But there is no significant difference between two groups. Conclusions: Sulguanjul-bang No.1 was very beneficial pain relief effect and functional improvement irrespect of formulation, decoction type or suspension type.

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Short-Term Results of Hybrid Closed-Wedge High Tibial Osteotomy: A Case Series with a Minimum 3-Year Follow-up

  • Saito, Hidetomo;Saito, Kimio;Shimada, Yoichi;Yamamura, Toshiaki;Yamada, Shin;Sato, Takahiro;Nozaka, Koji;Kijima, Hiroaki;Miyakoshi, Naohisa
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.293-302
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    • 2018
  • Purpose: High tibial valgus osteotomy (HTO) is a well-established surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closed-wedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the short-term results in a consecutive series of patients treated with hybrid CWHTO. Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average follow-up of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The Kellgren-Lawrence grading system and pre- and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed. Results: The FTA and MA significantly changed from $180.7^{\circ}$ to $170.4^{\circ}$ and from $22.0^{\circ}$ to $60.2^{\circ}$, respectively. No significant differences were observed between the mean pre- and postoperative posterior tibial slope, Insall-Salvati ratio, or Caton-Deschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.

Widening of Bony Tunnel after ACL Reconstruction Using Hamstring Tendon with Ligament Anchor(LA) Screw (슬괵건 및 LA나사를 이용한 관절경적 전방 십자 인대 재건술 후 골터널의 확장)

  • Song Eun Kyoo;Yoon Taek Rim;Jung Jong Wook;Jeong Kwang Cheul
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.69-73
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    • 2001
  • Purpose : To evaluate the clinical results and widening of bony tunnel after anterior cruciate ligament(ACL) reconstruction using hamstring tendon with Ligament Anchor(LA) screw, which is newly designed fur fixation of graft into femur. Materials and Methods : Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon were included in this study. The graft was fixed with LA screw at femoral tunnel and with bioabsorbable interference screw at tibial tunnel. The average period of follow-up was 28 months. The clinical results such as physical examination and Lysholm knee score and radiological results. widening of bony tunnel and instrumented anterior laxity test with $Telos^{\circledR}$(Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results . The Lysholm knee score was 60.0 in average preoperatively and improved to 94.0 in average at follow up. On the Lachman test, there were mild(+) instability in 16 cases, moderate(++) in 24, severe(+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 20 lb was 12.9mm in average preoperatively, and was decreased to 3.1mm in average follow-up. The femoral tunnel was widened from 10.6mm postoperatively to 12.7mm$(21.1\%)$ at follow up on antero-posterior plane and from 10.7mm to 12.4mm$(16.5\%)$ on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm$(20.7\%)$ on antero-posterior plane and from 9.9mm to 11.7mm$(18.9\%)$ in lateral plane. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixatives in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel.

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Reconstruction of Anterior Cruciate Ligament in Adolescent (청소년기에 시행한 전방십자인대 재건술)

  • Song Eun Kyoo;Shim Sang Don;Kim Hyung Jong;Kim Hyung Won
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.101-108
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    • 2002
  • Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.

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Short Term Results of Arthroscopic ACL Reconstruction using Fresh Frozen Achilles Allograft (신선동결 동종 아킬레스건을 이용한 전방십자인대 재건수술의 단기추시 결과)

  • Choi, Ho-Rim;Park, Jong-Seok;Lee, Sang-Seon;Woo, Seung-Han;Hong, Chang-Hwa;Kim, Byung-Heum;Lee, Byung-Ill
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.41-44
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    • 2006
  • Purpose: To evaluate the short-term results of arthroscopic ACL reconstruction using fresh frozen Achilles allograft Materials & Methods: From March 2002 to March 2004, arthroscopic ACL reconstructions using fresh frozen Achilles allograft were performed in 25 knees of 25 patients. The average age at operation was 30.1 years (range, 18-50 years) and the average follow-up was 17 months (range, 12 to 27months). Preoperative and follow-up clinical results were evaluated using the Lysholm knee score, IKDC knee rating system, physical examination and KT-2000 arthrometer. Results: The Lachman test was positive in 25 patients preoperatively and 18 patients(72%) had negative results at latest follow-up. The average side-to-side differences of anterior tibial translation using KT-2000 arthrometer under loading of 301b were improved from $7.9{\pm}2.4mm\;to\;2.6{\pm}1.6mm$. The average Lysholm score was improved from $61.1{\pm}13.9\;to\;93.5{\pm}5.3$ points. The IKDC grade was abnormal(C) or severely abnormal(D) in 25 cases preoperatively They improved 22(88%) of normal(A) or nearly normal(B) and 3(12%) of abnormal. Conclusion: Short term results of ACL reconstruction using Achilles allograft was acceptable. Achilles allograft can be a reasonable graft alternative to autograft for ACL reconstruction.

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The Clinical Results of Anterior Cruciate Ligament Reconstruction in over 50 year (50세 이상의 연령에서 전방십자인대 재건술의 임상적 결과)

  • Lee, Kwang-Won;Kim, Yong-In;Seo, Dong-Wook;Cha, Yong-Han;Kim, Kap-Jung;Choy, Won-Sik
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.73-78
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    • 2010
  • Purpose: To compare the clinical results after reconstruction of the anterior cruciate ligament (ACL) between above the 50 years old patients and below the 50 years old patients retrospectively. Materials and Methods: The results obtained 18 patients above 50 years old (mean age 55.1) and 198 patients below 50 years old (mean age 31.2) who underwent reconstruction of the ACL between July 2004 and April 2008. Clinical evaluation was performed with the International Knee Documentation Committee (IKDC) and Lysholm knee score scale. Anterior displacement of knee was measured by KT-2000 arthrometer. Results: Lysholm scores improved from 69.5 to 93.6 in patients above 50 years old, from 69.0 to 92.6 in patients below 50 years old (p<0.05). According to IKDC score, results more than nearly normal was 83% (15 cases) in patients above 50 years old, 86% (170 cases) in patients below 50 years (p<0.05). The mean difference of anterior displacement measured by KT-2000 was decreased from 7.4 mm to 2.2 mm in patients above 50 years old, from 7.1 mm to 2.0 mm in patients below 50 years old (p<0.05). Conclusion: There was no significant difference between the patients above 50 years old and below 50 years old. In patients above 50 years old, the reconstruction of ACL obtained satisfactory results.

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The Results of Partial Meniscectomy according to the Grade of the Articular Cartilage Injury (관절 연골 손상 정도에 따른 반월상 연골 부분절제술의 결과)

  • Choi, Nam-Yong;Yang, Young-Jun;Nah, Ki-Ho;Yang, Hyuk-Jae;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.22-27
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    • 2009
  • Purpose: To identify the damage of the articular cartilage and analyze the clinical results of the partial medial meniscectomy. Materials and Methods: From January 2001 to December 2004, forty-eight patients in the degenerative arthritis and medial meniscal tear of knee who undertook arthroscopic partial meniscectomy and were able to keep pace with the times follow-up for more than 3 years were enrolled in this study. Six cases were men and 42 were women, and the mean age was 55.7 years (40~78 years). The patients were classified into two groups according to the Outerbridge grade. Grade I and II were classified into group 1 and grade III and IV into group 2. Group 1 included 30 cases and group 2 included 18 cases. The result were analyzed according to the Tapper & Hoover classification and Lysholm knee scoring scale. And we measured the distance of medial joint space in standing anteroposterior (AP) view of both sides at the pre-operative and the last follow-up. Results: According to the Tapper & Hoover classification, 28 cases were excellent, 7 cases good, 8 cases fair, and 5 cases poor. Among group 1, 25 cases were excellent, 2 cases good, 2 cases fair, 1 case poor. However, among group 2, 3 cases were excellent, 5 cases good, 6 cases fair, 4 cases poor. Average Lysholm knee score was improved from 62.4 preoperatively to 94 postoperatively in group 1, and from 58 preoperatively to 77.9 postoperatively in group 2. The joint space narrowing showed no statistically significant difference in both knees standing AP view. Conclusion: The arthroscopic partial meniscectomy for a patient with the degenerative articular cartilage was an effective treatment. However, we could not satisfy the results, in cases of Outerbridge grade III and IV. In grade III and IV, the partial meniscectomy was not aggravated the cartilage damage.

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The Clinical Results of ACL Reconstruction with Tibialis Allograft Using Hybrid Femoral Fixation and $Retroscrew^{(R)}$ (Hybrid 대퇴 고정과 $Retroscrew^{(R)}$를 사용한 동종 경골건 이용 전방 십자 인대 재건술의 임상적 결과)

  • Kim, Doo-Sub;Rah, Jung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.8-13
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    • 2009
  • Purpose: We used tibialis allograft for the reconstruction of ACL and used Hybrid femoral fixation utilizing $Endobutton^{(R)}$ and $Rigidfix^{(R)}$ for femoral fixation, and used $Retroscrew^{(R)}$ and additional fixation for tibial fixation to evaluate the clinical results. Materials and Methods: The ACL reconstruction were performed from February 2004 to February 2007 utilizing Hybrid femoral fixation and $Retroscrew^{(R)}$ and 32 patients, 32 cases which were available for year-long observation (12 to 25 months). The clinical results (Lysholm knee score, IKDC grade) and the radiologic results(bone tunnel expansion, Telos anterior displacement test) were evaluated. Results: The Lysholm knee score was improved from the average of $67.9{\pm}5.4$ points (range: 51~77) before operation and to $94.1{\pm}6.8$ points (range: 68~98) at the last follow up (p<0.05). 22 cases (69%) were evaluated normal (A), 9 cases (28%) were evaluated nearly normal (B) and only 1 case (3%) was evaluated not normal (C) at IKDC final evaluation and no case was evaluated abnormal. From $Telos^{(R)}$ stress x-ray evaluation, difference from the opposite knee was improved average 13.2 mm{\pm}5.8 (range: 6~21 mm) to average $3.4\;mm{\pm}2.8$ (range: 0~11 mm) after operation (p<0.05). The femoral and tibial tunnel were widened by 18.7% and 9.6% in the AP view and 12.4% and 8.5% in the lateral view, respectively (p<0.05). However, any statistic significance was not observed between bone tunnel expansion and knee joint functions (p>0.05). Conclusion: An ACL reconstruction with tibialis allograft using Hybrid femoral fixation and $Retroscrew^{(R)}$ enabled anatomical fixation of the graft tendon with satisfactory clinical results.

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Comparison of Clinical Results in Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft and Tibialis Anterior Tendon Allograft (자가 슬괵건과 동종 전경골건을 이용한 전방 십자 인대 재건술의 임상적 결과 비교)

  • Lee, Hee-Young;Choi, Chul-Jun;Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.109-114
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    • 2009
  • Purpose: The purpose of this study is to compare the clinical results of ACL reconstruction between two groups using hamstring tendon autograft and tibialis anterior tendon allograft. Materials and Methods: Between January 2006 and June 2007, we analyzed 68 cases of ACL reconstruction, 32 cases using hamstring tendon autograft and 36 cases using tibialis anterior tendon allograft, with a minimum follow-up of 24 months. For the clinical evaluation, we evaluated the Lysholm score, anterior laxity by Telos device and KT-2000 arthrometer. Results: The mean diameter of graft were 8.0 mm (7.0~9.0 mm) in autograft group and 9.1 mm (8.0~10.0 mm) in allograft group. In all cases, the range of motion was above 135 degrees. The average side to side difference in Telos stress test decreased from $7.3{\pm}1.0$ mm to $2.4{\pm}1.1$ mm in autograft group and from $7.4{\pm}1.2$ mm to $2.3{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from $72.6{\pm}3.4$ to $92.3{\pm}3.5$ in autograft group and from $72.3{\pm}3.5$ to $91.6{\pm}3.3$ in allograft group. There was no significant difference between two groups in clinical results. Conclusion: Both hamstring tendon autograft and tibialis anterior tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. We suggest that both hamstring tendon autograft and tibialis anterior tendon allograft will be considered as acceptable graft for anterior cruciate ligament reconstruction.

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