• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.88-91
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• 2010

전방십자인대 재건술시 자가건 선택에 대해서는 많은 논쟁의 소지가 존재하며 많은 보고들이 나오고 있으나, 현 시점에서 이식건으로써 자가 골-슬개건-골이 표준(gold standard)라는 주장은 이제 변화하고 있으며, 골-건 고정방법의 개선에 따른 조기 슬관절 안정성의 호전으로 자가 슬괵건의 사용이 점점 증가되고 있는 추세이다. 자가 골-슬개건-골은 이식건으로써 강한 물성, 튼튼한 고정, 장기 추시에서 높은 성공률 등으로 젊고, 강한 활동을 요하는 운동선수에서 종종 선택되고 있으며 조기에 강한 활동으로의 운동 복귀를 할 수 있다. 그러나 슬관절 전방 통증, 무릎을 꿇을 때의 통증, 슬개골골절, 슬개-대퇴 관절의 염발음 및 대퇴사두근력의 감소 등 이식물 채취로 인한 공여부 이환이 문제가 되었다. 그래서 자가 골-슬개건-골의 이식건으로서의 문제점 및 문헌상 고찰을 하여 논하고자 한다.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.92-101
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• 2010

The Hamstring autograft and the bone patellar bone tendon autograft have been widely used for anterior cruciate ligament reconstruction. In recent years, use of hamstring autograft for ACL reconstrution has been increased. The reason seems to be the advantages of the hamstring tendon such as high ultimate tensile load, low donor site morbidity and development of graft fixation method. These theoretical advantages have been increased as studies have shown that hamstring tendons actually regenerate after harvesting for ACL reconstruction. However, the concerns have arisen regarding the disadvantages of hamstring harvest, which were weakness of tibial internal rotation, the loss of flexion strength. The flexion strength loss has been controversial, therefore it needs to study whether restoration of flexion strength after hamstring regeneration is or not. In this study, we reviewed the current research of concerns on the advantage and disadvantage of hamstring tendon autograft and the hamstring regeneration. Furthermore, we compared the earlier studies and experiences regarding Hamstring regeneration with our research.

• 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.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.14-25
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• 2021

Several factors need to be considered for a successful anterior cruciate ligament (ACL) reconstruction, such as preoperative planning, operation technique, and postoperative rehabilitation. Graft choice, fixation, preparation method, maturation, incorporation to host bone, and graft tension should also be considered to achieve a good outcome after an ACL reconstruction. Factors to consider when selecting a graft are the graft strength, graft fixation, fixation site healing, and donor site morbidity, as well as the effects of initial strength, size, surface area, and origin of the graft on its potential for weakening during healing. There are two types of graft for an ACL reconstruction, autograft or allograft. Several autografts have been introduced, including the bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon-bone. On the other hand, each has its advantages and disadvantages. The recent increased use of allografts for an ACL reconstruction is the lack of donor site morbidity, decreased surgical time, diminished postoperative pain, and good availability of source. Despite this, there are no reports suggesting that an allograft may have a better long-term outcome than an autograft. Allografts have inherent disadvantages, including a longer and less complete course of incorporation, remodeling, biomechanically inferiority to autograft, the potential risk of an immunogenic reaction and disease transmission. Higher long-term failure rates and poorer graft maturation scores were reported for allografts compared to autografts. An autograft in an ACL reconstruction should remain the gold standard, although the allograft is a reasonable alternative. If adequate length and diameter of autograft can be obtained for an ACL reconstruction, an autograft with adequate graft fixation and postoperative rehabilitation should be chosen instead of an allograft to achieve better results.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.111-116
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• 2000

Purpose : We reviewed the results of arthroscopic posterior cruciate ligament reconstruction using Achilles tendon allograft, and the efficacy of the surgical technique using gradual tibial tunneling and posterior transseptal technique. Materials and Methods : From september 1997 to September 1999, 8 patients with complete PCL injury were treated by arthroscopic PCL reconstruction using Achilles tendon allograft. Mean follow-up period was 21.7 months. Mean preoperative posterior laxity was 14mm. The clinical outcome was assessed by Telos stress test, Lysholm knee score and IKDC score. Result : There was no complication such as infection and neurovascular injury. Posterior translation using Telos device was less than 5mm in 6 cases$(75\%)$, and between 6 to 10mm in 2 cases$(25\%)$. The mean Lysholm knee score was 45 preoperatively and improved to 87 postoperatively. In IKDC system, 2 of 8 patients were group A and 6 were group B. Conclusion : Arthroscopic PCL reconstruction using achilles tendon allograft and posterior transseptal technique shows reliable stability, short operative time and minimizing donor site morbidity but needs more long term follow-up.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.138-142
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• 2009

Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.