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Autograft Versus Allograft Bone-Patellar Tendon-Bone in Anterior Cruciate Ligament Reconstruction - A Comparison Of Mid-Term Follow-Up Results - (자가 및 동종 골-슬개건-골을 이용한 전방 십자 인대 재건술 -중기 추시 결과의 비교-)

  • Cho, Sung-Do;Cho, Su-Hyun;Woo, Jong-Ken;Yoo, Chang-Hyun;Park, Moon-Su;Lew, Sog-U
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.14-18
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    • 2004
  • Purpose: To compare the mid-term follow-up results of anterior cruciate ligament(ACL) reconstruction with the bone-patellar tendon- bone(BTB) autograft to those with the BTB allograft. Materials and Methods: Retrospective study was performed in 59 cases with BTB autograft and 42 cases with BTB allograft. Evaluations include Lysholm score, 2000 IKDC subjective knee score, Shelbourne patello-femoral pain score , Lachman test, pivot shift test, KT-1000 arthrometer test and 2000 IKDC knee examination. Results: There were no significant statistic differences between two groups in Lysholm score and 2000 IKDC subjective knee score of more than 70 (p<0.05). Five cases(8.5%) showed the patello-femoral pain score less than 80 according to Shelboume with autograft group and two cases(4.8%) with allograft group (p<0.05). Lachman test, pivot shift test and KT-1000 arthrometer test showed no significant statistic differences between two groups(P<0.05). Fifty-four cases(91.5%) were normal or nearly normal according to the 2000 IKDC knee examination with autograft group and thirty-eight cases(90.4%) with allograft group(p<0.05).Conclusion: BTB allograft as well as BTB autograft is considered to be an acceptable choice for ACL reconstruction.

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The Effect of Meniscectomy on Clinical Result After ACL Reconstruction (전방십자인대 재건술에서 반월상 연골 절제술의 영향)

  • Cho, Hyung-Jun;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Yoon, Kyoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.7-12
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    • 2010
  • Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

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Arthroscopically Assisted Lateral Release and Medial Imbrication for Recurrent Patella Dislocation (재발성 슬개골 탈구에서 관절경적 외측 유리술 및 내측부 중첩술)

  • Kang, Sung-Shik;Yoo, Jae-Doo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.98-103
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    • 2010
  • Purpose: We reported the results of arthroscopically assisted lateral release and medial imbrication for the recurrent patella dislocation. Materials and Methods: Twenty patients (20 knees) underwent arthroscopically assisted surgery for the recurrent patella dislocation. There were 4 males and 16 female. The average age was 20.2 years. All patients had definite trauma history and average follow-up period was 19 months. The surgical results were evaluated according to the Lysholm knee score and the Kujala score. The congruence angle and lateral patellofemoral angle were measured on plain radiograph and the tibial tubercle-trochlear groove distance was calculated on computerized tomography. Results: The median value of preoperative congruence angle was $16.5^{\circ}$ (range, $0.0{\sim}+34^{\circ}$) and the average final follow-up was $-6.4^{\circ}$ (range, $-19{\sim}10^{\circ}$) with statistically significant improvement (p=0.025). The median value of preoperative Lysholm knee score was 70 (range, 63~81) and the final follow-up score had changed to 88 (range, 80~95) with statistically significant improvement (p=0.0341). The median value of preoperative Kujala score was 72 (range, 65~80) and the average final follow-up score showed 87 (range, 80~92) with statistically significant improvement (p=0.024). Recurrent dislocations after surgery occurred in 2 cases, one case which showed positive "thumb to forearm test" had been treated with medial patellofemoral ligament reconstruction. Conclusion: Arthroscopically assisted lateral release and medial imbrication for recurrent patella dislocation without bony malaligmenent showed the effective treatment, but would be inappropriate for the patients with the generalized joint laxity.

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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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LCL Augmentation and Popliteal Tenodesis for Lateral and Posterolateral Instability Of The Knee (슬관절 외측 및 후외측 불안정성에 대한 외측 보강술 및 슬와근 건고정술)

  • Park, Jin-Uck;Lee, Ju-Hyup;Sohn, Sung-Won
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.98-102
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    • 2004
  • Purpose: The purpose of this study was to make a report on the clinical prognosis of post traumatic lateral and posterolateral instability of the knee after LCL augmentation and popliteal tenodesis. Materials and Methods: The assessment was made among 21 cases who underwent augmentation of lateral collateral ligament(LCL) and popliteal tenodesis with allograft or artificial ligament (synthetic polyester, ABC ligament, Surgicraft, U.K.) at this Medical Center during the period from July 1996 to July 2003 and whose follow-up period was longer than one year. The authors recorded and analysed the physical findings (external rotation recurvatum test & posterolateral drawer test), stress roentgenograms(preoperative and postoperative) and Lysholm score. Results: The lateral and posterolateral instability of the knee were improved in 20 cases postoperatively, acccording to the clinical test and stress roentgenograms . Average Lysholm score was 52.5 preoperatively and 86.7 postoperatively .Conclusion: Our study found the surgery of lateral and posterolateral instability of the knee with augmentation of LCL and popliteal tenodesis using allograft or artiflcial ligament is simple technique. Taking these results into consideration, it seems to be one of effective methods of treatment.

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Comparative Analysis of Double Bundle and Single Bundle ACL Reconstruction with Tibialis Anterior Allograft (동종건을 이용한 단일다발 및 이중다발 전방십자인대 재건술의 비교 분석)

  • Kim, Deok-Weon;Lee, Kang;Kim, Young-Woo;Yang, Sang-Jin;Seo, Jeong-Gook;Kim, Jin-Goo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.198-204
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    • 2008
  • Purpose: The purpose of this study is to analyze the merits and demerits of double bundle reconstruction and achieve improvements hereafter, by comparing the results of double bundle and single bundle reconstruction using tibialis anterior allograft. Materials and Methods: Twenty seven patients were divided to undergo either double bundle(n=14) or single bundle(n=13) reconstruction with tibialis anterior allograft tendon. The evaluation methods were AP laxity with KT-2000 arthrometer, isokinetic knee strength measurements, pivot-shift test, IKDC subjective score, Lysholm knee score, Tegner activity score, radiographic evaluations with postoperative MRI, and second look arthroscopy. Results: Lysholm knee score and Tegner activity score were significantly better in double bundle reconstruction. In pivot-shift test, single bundle reconstruction was evaluated as grade 0 in 10 of the knees, grade 1 in 1, and grade 2 in 2. Double bundle reconstruction was evaluated as grade 0 in 13, and grade 2 in 1. In second look arthroscopy, single bundle was evaluated as excellent in 6 of the knees, fair in 7, anteromedial bundle of double bundle reconstruction was excellent in 13 and fair in 1, and posterolateral bundle was excellent in 4, fair in 9, and poor in 1. There were no significant differences in other evaluations. Conclusion: Favorable outcome may be expected with double bundle reconstruction of ACL. However there are still need for improvement in terms of reconstruction technique and rehabilitation protocol to reduce PL bundle injury.

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Clinical Results of Anatomical Single Bundle Anterior Cruciate Ligament Reconstruction Using Autogenous Quadriceps Tendon (자가 대퇴사두건을 이용한 해부학적 단일 다발 전방십자인대 재건술의 임상적 결과)

  • Park, Jin;Kim, Young Sin;Lee, Ju Hong;Wang, Seong Il;Park, Chan Ill
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.26-33
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    • 2012
  • Purpose: The purpose of this study was to evaluate the clinical outcomes and stability of anatomical single bundle anterior cruciate ligament reconstruction (SBACLR) with quadriceps tendon comparable to double bundle anterior cruciate ligament reconstruction (DBACLR). Materials and Methods: We retrospectively reviewed 28 consecutive patients (16 male, 12 female) who underwent SBACLR using quadriceps tendon from March 2009 (Group 1) and compared its clinical results to whom DBACLR with semitendinosus tendon for 53 patients (51 male, 2 female) from August. 2006 (Group 2). Mean age were 34.9 (range, 16-52) in Group 1 and 21.6 (range, 17-55) in Group 2. Mean follow up periods were 13.9 months (range, 12-20) in Group 1 and 36.2 months (range, 20-52) in Group 2. Lysholm score, International Knee Documentation Committee (IKDC) evaluation form and Tegner score were performed for evaluating the clinical outcome. Lachman test, pivot shift test and KT-1000 arthrometer (MEDmetric Corp., San Diego, CA, USA) were performed for stability. Results: There was no statistical significant difference between the two groups in terms of Lysholm score (Group 1: $85.9{\pm}2.6$, Group 2: $90.9{\pm}1.0$, P=0.226), IKDC score (P=0.345) and Tegner score (Group 1: $6.9{\pm}1.4$, Group 2: $7.1{\pm}1.3$, P=0.523). Nor was there statistical significance between the two groups in terms of KT-1000 arthrometer (Group 1: $1.5{\pm}1.1\;mm$, Group 2: $1.5{\pm}1.6\;mm$, P=0.457), Lachman test (P=0.547) and pivot shift test (P=0.073). Conclusion: Anatomical SBACLR with quadriceps tendon shows similar clinical outcomes and stability comparable to anatomical DBACLR with hamstring tendon.

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Gait Analysis After Posterior Cruciate Ligament Reconstruction Using Fresh-Frozen Achilles Allograft (신선 동결 아킬레스 동종건을 이용한 후방십자인대 재건술 후 보행분석)

  • Chun, Churl-Hong;Cho, Jae-Deuk;Chun, Keun-Churl
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.76-82
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    • 2009
  • Purpose: The purpose of this study was to analyze the clinical result and the gait patterns for patients who had undergone the arthroscopic posterior cruciate ligament (PCL) reconstruction using Achilles allograft. Materials and Methods: Among the patient who had undergone the arthroscopic PCL reconstruction using fresh-frozen Achilles allograft between March 2004 to March 2005, we selected 12 patients who compliance to our rehabilitation program. Clinical result and gait analysis were carried out at 36 months postoperatively. There were measured by using range of motion (ROM), Lysholm knee score, Tegner activity score, IKDC score, posterior stress test, and posterior translation measured by using Telos stress arthrometer. Kinematic gait analysis was carried out using 3-dimensional gait analysis system. Results: The PCL reconstruction surgery yielded statistacally significant results in all of clinical evaluation. In gait analysis, the average knee flexion angle increased during stance phase and decreased during the swing phase, but was not statistically significant and there were no significant difference between both sides of their knees overall. Conclusion: Since there was no statistically significant difference between the injured and uninjured sides as a result of the gait evaluation of the patients who had arthroscopic reconstruction surgery on their PCL injured knee and conformed to the rehabilitation program, systemic and strict rehabilitation ought to be important in the reconstruction surgery.

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Clinical Outcomes of Minimum 12-Month Follow-Up of Anatomical Double Bundle ACL Reconstruction with a Longitudinally Split Tibialis Anterior Allograft (종분할된 전경골 동종건을 이용한 해부학적 전방 십자 인대 이중다발 재건술의 최소 12개월 임상 결과)

  • Seo, Young-Jin;Song, Si Young;Kim, In Sung;Ahn, Jung Tae;Yoo, Yon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.99-107
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    • 2011
  • Purpose: The purpose of this study was to investigate the clinical results after a anatomical double bundle ACL reconstruction using a longitudinally split tibialis anterior allograft. Materials and Methods: We evaluated 24 patients with a minimum follow-up of 12 months who had undergone anatomical double bundle ACL reconstructions. The grafts utilized in all cases were tibialis anterior allografts which were longitudinally split into two strands. A standard rehabilitation protocol was applied in all patients. The pre- and post-operative data including Lysholm scores, International Knee Documentation Committee (IKDC) scores, Lachman test, pivot shift test and the side-to-side differences of anterior laxity measured by KT-2000 arthrometer were analyzed by use of a statistical method Results: The mean side-to-side instrumented laxity measured by the KT-2000 arthrometer significantly improved to a mean of $1.04{\pm}0.80\;mm$ (P < 0.001). The Lysholm knee scores also improved from $58.34{\pm}15.32$ to $86.25{\pm}6.48$ after surgery (P < 0.001). The patients exhibited improved IKDC scores (A: 15 cases, B; 9 cases) at the final follow-up, compared to preoperative scores (B: 5, C: 10, D: 9). Conclusion: Our data demonstrated that clinical results of anatomical double bundle ACL reconstruction with a split tibialis anterior allograft are encouraging with excellent side-to side laxity, significantly improved Lysholm knee score, IKDC score, Lachman and pivot shift data.

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Clinical Study on Effect of Rainbow Power Therapy on Osteoarthritis in Knee Joint (Rainbow Power 요법 시술이 퇴행성 슬관절염에 미치는 임상 효능연구)

  • Sung, Hyun-Jae;Kim, Ee-Hwa;Hwang, Jae-Wok;Ryu, Chungr-Yeul
    • Korean Journal of Acupuncture
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    • v.20 no.4
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    • pp.85-98
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    • 2003
  • Objective : This study is designed to find out the effects of Rainbow Power therapy on knee joint with osteoarthritis. Methods : Patient with the osteoarthritis of knee joints are divided into Rainbow Power therapy group(20 people) and none-Rainbow Power therapy group(20 people). After treatment, we evaluated the effect per each group. Results : 1. Fifty and Sixty aged patients were the most in the Rainbow Power group(30% each) and sixty aged patients were the most in the None-Rainbow Power group(45%). 2. In the both groups, 1-3 years duration of disease was the most(40%, 45% each). 3. In the none-Rainbow Power group, patients improved (Lysholm score : $49.20{\pm}11.54{\rightarrow}63.90{\pm}9.54$, p<0.05), but, did not improved in the part of squatting and dystrophy. In the Rainbow Power group, patients improved(Lysholm score : $46.55{\pm}9.89{\rightarrow}80.90{\pm}13.78$, p<0.05), but, did not improved only in the part of dystrophy. 4. The effects of treatment by VNRS were follow : After treatment, $4.10{\pm}1.22$ in Rainbow Power Group and $4.55{\pm}1.15$ in none-Rainbow Power group. 5. The effects of treatment by nine points scale were follow : In the Rainbow Power group, the Excellent was 7 cases(35%), the Good was 9 cases(45%), the Fair was 4 cases(20%) and there was no Poor. The Excellent was 6 cases(30%), the Good was 8 cases(40%), the Fair was 6 cases(30%) and there was no Poor.

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