• Title, Summary, Keyword: Lysholm score

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7 to 22Y Follow-up of Anterior Cruciate Ligament Reconstruction : from the standpoint of OA (전방 십자 인대 재건술 7년에서 22년 장기 추시: 관절염 관점에서)

  • Yang, Sang-Hoon;Sim, Jae-Ang;Kwak, Ji-Hoon;Kim, Byung-Kag;Ahn, Byung-Moon;Lee, Beom-Koo
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.20-24
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    • 2010
  • Purpose: To evaluate the long term outcomes of the ACL reconstruction from the standpoint of osteoarthritis. Materials and Methods: We evaluated 31 patients who underwent ACL reconstruction from April 1986 to April 1999 and could be followed-up more than 7 years. Mean follow-up period was 10.1 years (7~22 years). In terms of the graft, 11 cases were treated with the ACL reconstruction using a autologous hamstring tendon graft, 20 cases were treated with using a autologous bone patellar tendon bone graft. For femoral tunnel, 11 cases were placed through transtibial tunnel, 20 cases were placed through anteromedial portal using mini-open arthrotomy. Functional and radiographic evaluation was performed. Results: Mean Lysholm score was $89.2{\pm}11.7$ points. Patients had KT-2000 side-to-side differences were $2.1{\pm}1.9\;mm$. IKDC ligament evaluation showed 38.7% type A, 48.3% type B, 6.5% type C and 6.5% type D. Femoral tunnel were placed at 11 or 1 o'clock position in transtibial technique and placed 10 to 10:30 or 2 to 2:30 o'clock position in technique using anteromedial portal. Radiographic analysis for degenerative arthritis revealed that in group using anteromedial tunnel, 50.0% were excellent, 25.0% were good. In group using transtibial tunnel 18.2% were excellent, 18.2% were good. Conclusion: More than 87.1% of cases, long term result of the ACL reconstruction showed good and excellent result in IKDC score. Especially, the group using tunnel through anteromedial portal showed good results for degenerative arthritis.

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ACL reconstruction with autologous hamstring tendon - Short term clinical result using new femoral suspensory fixation device 'Cross Pin' and graft tensioner for maintaining a constant tension- (자가 슬괵건을 이용한 전방 십자 인대 재건술 - 새로운 대퇴부 현수고정법인 Cross Pin과 일정한 긴장력 유지를 위한 Graft Tensioner 사용의 단기 추시 결과 -)

  • Seo, Seung-Suk;Kim, Chang-Wan;Kim, Jin-Seok;Choi, Sang-Yeong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.27-34
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    • 2011
  • Purpose: To evaluate the short term clinical result of ACL reconstruction with autologous hamstring tendon using Cross pin and Graft Tensioner and to seek way to resolve the experienced technical problems. Materials and Methods: From January 2008 to March 2009, 35 patients who had been treated arthroscopic ACL reconstruction were enrolled. The femoral side of ACL graft was fixed with Cross pin. The tibial side of graft was fixed with Intrafix and post-tie. The graft was tensioned with Graft Tensioner at 80N. We analyzed the clinical, radiographic results and complications. Results: IKDC subjective score and Lysholm score improved to 89.1 and 91.4 points. Also, Pivot shift test and One-leg hop test showed good results postoperatively. Side to side difference using KT-1000 arthrometer and Telos stress radiography improved compared with normal limb to $2.8{\pm}1.6$ mm and $2.6{\pm}1.3$ mm, respectively. The femoral tunnel enlarged to $2.3{\pm}1.1$ mm. Soft tissue irritation and femoral tunnel-graft harness length mismatch, femoral tunnel-cross pin tunnel mismatch were happened as peri-operative complications. Conclusion: Using of Cross pin and Graft Tensioner for ACL reconstruction with hamstring tendon is one of the good method for obtaining stability in short-term clinical result. But to reduce femoral tunnel-cross pin mismatch, it needs to shorten femoral bone tunnel and to create cross pin tunnel as vertical as possible. And to reduce femoral tunnel-graft harness mismatch, it needs to advance position rod further 3 mm when to create femoral tunnel.

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Operative Treatment of the Displaced Bucket Handle Tear of the Medial Meniscus (내측 반월상 연골의 전위된 양동이 손잡이형 파열의 수술적 치료)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Lee Dong-Ho;Kim Min-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.142-149
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    • 2002
  • Purpose : The purpose of this study is to compare with result of repair and resection in displaced bucket handle medial meniscal tear. Materials and Methods : From Sep. 1998 to Dec. 2001, we experienced 46 cases, 45 patients. We classified them into repair group (group I, 23 cases) and resection group (group II, 23 cases). We analyzed the time interval between injury and operation, zone of tear, the status of reduction and quality of displaced fragment of all cases. Average follow-up period is 29, 28 months, respectively. We evaluated the final results of both groups as Lysholm knee score, radiologic changes and 2nd look arthroscopy. Results : Mean age was 25 years old in both group, respectively. Mean interval between injury and surgical treatment was 12 and 17 weeks. respectively. In group I, 6 of 7 cases were evaluated as clinical success in red-red zone, 12 of 15 cases were assessed as clinical success in red-white zonal tear, stable reduction. Another case which is evaluated as clinical failure showed red-white zonal tear, unstable reduction and poor quality meniscal fragment. 5 cases showed variant degrees of tibio-femoral compartment symptom. In group II, red-white zone (9 cases) and white-white zone (14 cases) were treated as resection and got good results. Conclusion : Considering zone of tear, reducibility and quality of meniscal fragment before treatment will improve the success rate of meniscal repair.

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Arthroscopic Posterior Cruciate Ligament Reconstruction with Preservation of the Remnant Posterior Cruciate Ligament (남아 있는 후방 십자 인대 다발을 보존한 관절경하 후방 십자 인대 재건술)

  • Ahn Jin Hwan;Ha Kwon Ik;Chung Yoon Sung;Yang Il Soon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.97-104
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    • 2000
  • Purpose : The majority of PCL deficient knees have some intact remnant PCL bundles. In these cases, the remnant PCL bundles were removed fur easy passage of graft(especially in bone-patellar tendon-bone graft). The purpose of study is to report the results of PCL reconstruction by posterior transseptal portal technique and by preserving the remnant posterior cruciate ligament bundles. Materials & Methods : From November 1993 to June 1999, 44 arthroscopic posterior cruciate ligament reconstructions have been performed by one surgeon. We studied 37 knees those were followed up over 1 year among them. The mean age($14\~56$ years) was 31.8 years. The average follow-up period was 17.8 months($12\~61$ months). The graft materials were 29 double-loop hamstring autografts, 4 double-loop hamstring allografts and 4 Achilles tendon-bone allograft. Results : There are significant improvement of the preoperative subjective symptoms. The last follow-up shows that the average Lysholm knee score was markedly improved from 59.8 pre-operation to 89.2 post-operation and the average KT 2000 side difference was decreased from 11.1mm pre-operation to 2.3 mm post-operation. Follow-up MRI showed that the graft was healed with remnant posterior cruciate ligament bundles as one ligament. Conclusion : The posterior trans-septal portal makes it possible to locate the exact tibial tunnel. The arthroscopic PCL reconstruction preserving the remnant of original PCL bundles seems to provide the good result.

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Arthroscopic Anterior Cruciate Ligament Reconstruction - A Prospective Comparison of the Bone-Patellar Tendon-Bone and the Quadrupled Hamstring Tendon Autografts - (관절경적 전방 십자 인대 재건술 - 골-슬개건-골과 4중 슬괵건 자가이식의 전향적 비교 연구 -)

  • Kim, Hyoung-Soo;Park, Seung-Rim;Kang, Joon-Soon;Lee, Woo-Hyoeng;Kim, Young-Hoon;Park, Ju-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.51-58
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    • 1998
  • Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using the central one third bone patellar tendon bone(BPB) autograft versus a quadrupled semitendinosus/gracilis(ST) autograft in patients with "isolated" ACL tears. Materials & Methods : A strict criteria to identify isolated ACL tears was used which included : no previous surgery, no other ligamentous injury, no history of patellofemoral symptoms, no patellofemoral malalignment, no meniscal pathology, no chondromalacia or chondral injury and no limitation of motion of the injured knee. 30 patients (15 BPB, 15 ST) with a mean age of 27.4 years were available for a mean follow up of 18 months (between 12 months and 26 months). Preoperatively, there was no significant difference between the two groups with respect to age, sex and degree of laxity. Results : Postoperatively, we couldn't find significant differences between the two groups with respect to subjective Lysholm score, objective laxity including Lachman test, pivot shift test and KT-2000 measurements. Mean side to side difference of KT-2000 scores at 20lbs were 1.5mm for the BPB group and 1.4mm for the ST group. Positive Lachman test was found in 26.7% and 33.3% and positive pivot shift was found in 20% and 33.3% of the patients in the BPB and ST groups, respectively. Anterior knee pain (33.3%) was more common in the BPB group. There were 80% of the patients in both groups above nearly normal grade according to the IKDC grade. Conclusions : In patients with "isolated" ACL tears, the overall results, ligamentous stability for the patellar tendon and the quadrupled semitendinosus/gracilis were comparable. We consider that the quadrupled autogenous hamstring tendon is a good alternative substitute in ACL reconstruction together with the bone patellar tendon bone.

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The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease (슬관절의 통증과 기능장애의 평가도구에 관한 연구)

  • Jung, Chan-Yung;Kim, Eun-Jung;Hwang, Min-Seop;Cho, Hyun-Seok;Kim, Kyung-Ho;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft - The comparison of mid term & long term follow-up results - (골-슬개 건-골을 이용한 전방 십자 인대 재건술 - 중기 및 장기 추시 결과의 비교 -)

  • Song Eun Kyoo;Yoon Taek Rim;Lee Young Keun;Kim Jong Seok
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.117-122
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    • 2000
  • Purpose : To compare the mid term with long term follow up results of the anterior cruciate ligament(ACL)> reconstruction using patellar tendon. Materials and Methods : Seventy-six cases, which could be followed up more than 2 years were included in this study. They were classified into two groups, mid-term group(41 cases) with mean follow-up periods of 2 years and 10 months and long-term group(35 cases) off years and 6 months. Clinical and radiological results and peripatellar complications were evaluated & compared. Results . There was no statistically significant difference in radiological finding and anterior instability between two groups. However, the incidence of anterior knee pain, paresthesia at incision site, kneeling pain, crepitus and quadriceps weakness was lower in long-term group than in mid-term group. Conclusion : ACL reconstruction using patellar tendon graft could successfully restone the stability of knee joint, but there are some complications in donor site and patellofemoral joint. However this complications were gradually decreased with long term follow-up.

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The Effects of Trunk Stability Exercise on Knee function, Balance, Gait in patients after Total Knee Arthroplasty (체간 안정화 운동이 무릎관절 전치환술 환자의 무릎기능, 균형, 보행에 미치는 영향)

  • Lee, Jae-Hong;Min, Dong-Ki;Lee, Sang-Jae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.422-428
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    • 2018
  • This study was conducted to investigate the effects of trunk stability exercise on knee function, balance and gait in patients who underwent total knee arthroplasty. The subjects of this study were recruited from individuals diagnosed with degenerative arthritis who had undergone total knee arthroplasty. Overall, 24 patients were randomly divided into a control groups and an experimental groups (12 each). The trunk stability exercise was conducted for 4 weeks with three exercises developed in a previous study. The measurement tools used were knee function measurements based on the Lysholm knee score, balance ability measured using a test of TUG and OLS, and a walking ability test measured using a 10MWT. Pre and post test results were within groups were compared using the paired t-test, whole differences between groups were compared using the independent t-test. The experimental group showed significantly enhanced results relative to the control group (p<0.05). Based on these results, trunk stability exercise in parallel with knee joint therapy effectively improves the recovery of patients with total knee arthroplasty.

Arthroscopic treatment of septic arthritis of the knee in adults (성인의 화농성 슬관절염의 관절경적 치료)

  • Kyung Hee-Soo;Ihn Joo-Chul;Oh Chang-Wug;Kim Sung-Jung;Kim Joon-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.21-24
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    • 2002
  • Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease repeatedly.

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