• Title/Summary/Keyword: 대퇴각도

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Comparision of Trans-Tibial and Anteromedial Portal Approach in Femoral Tunneling of Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술의 대퇴골 터널 굴착시 경경골 접근법과 전내측통로 접근법의 비교)

  • Sohn, Sung-Keun;Chang, Yun-Suk;Chung, ll-Kwon;Kim, Kyung-Taek
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.75-81
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    • 2004
  • Purpose: Recent development and advances in arthroscopic surgical techniques for Anterior Cruciate Ligament(ACL) reconstruction have led to the ideal location for the etric point from 10 o'clock (in right knee) and 13:30 (in left knee) to 10:30 (in right knee) and 14 o'clock (in left knee) in the frontal plane. This study was performed to compare operative methods and the radiologic results of femoral tunnels made through the tibial tunnel(trans-tibial approach) and the anteromedial portal. Material and Methods: From January 2003 to May 2004, one-hundred reconstructions of anterior cruciate ligament were performed. Group I (femoral tunnel through tibial tunnel) was composed of 50 cases and group ll (femoral tunnel through anteromedial portal) was consisted of 50 cases. The study was performed to compare the radiographic results of femoral tunnels made through the tibial tunnel and the anteromedial portal and operative methods. Results: In operative methods at Group II, femoral tunnel was made more easily at isometric point than Group I, a good visual field was achived because 100$^{\circ}$ flxion of knee, they can be reduced risk of posterior cortical breakage and tunnel-graft mismatching and decreased divergence of femoral interference screw in radiology (P<0.05). The angle between femoral tunnel and longitudinal axis of ACL wae increased at Group ll. Conclusion: Aanteromedial portal technique was more useful in ACL reconstruction for femoral tunnel toward 10 o'clock to10:30(in right) or 1:30 to 2 o'clock(in left).

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ACL Reconstruction using Transtibial Femoral Tunnel at 10 or 2 O'clock Position - Technical Note - (10시 혹은 2시 방향의 경경골 대퇴 터널을 이용한 전방 십자 인대 재건술 - 수술 수기 -)

  • Cho, Sung-Do;Ko, Sang-Hun;Park, Mun-Soo;Jung, Kwang-Hwan;Cha, Jae-Ryong;Gwak, Chang-Youl;Kim, Sang-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.209-213
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    • 2006
  • Purpose: Conventional transtibial approach for the anterior cruciate ligament (ACL) reconstruction tended to place the femoral tunnel in too vertical position (11 or 1 o'clock), which could provide the postoperative anteroposterior (AP) stability but not provided the rotational stability. Therefore we present a surgical technique to make the transtibial femoral tunnel at 10 or 2 o'clock position. Surgical approach: To make a transtibial femoral tunnel at the 10 or 2 o'clock position, the direction and position of the tibial drill guide was important. We set the tibial drill guide at $40{\sim}45$ degrees and the intraarticular guide tip was 1 mm anterior and medial to the conventional site. The starting point for the guide pin on the proximal tibia was proximal to the pes anserinus and anterior to the medial collateral ligament. The tibial tunnel was initially drilled 1mm less than the diameter of the graft. Then femoral offset guide could be easily placed at 10 or 2 o'clock position through the tibial tunnel. The tibial tunnel and the femoral tunnel of 30 mm in length were made with the reamer that was same size with the graft. Conclusion: We report a surgical technique to create a transtibial femoral tunnel at 10 or 2 o'clock position in ACL reconstruction to provide the rotational stability as well as the AP stability.

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KNEE: Basic Science and Injury of Bone (슬관절 주위 글격의 기초과학 및 스포츠 손상)

  • Kim Hee-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.77-81
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    • 2003
  • Purpose: The biomechanics and kinematics of knee joint were reviewed in this article. And then the common sports injuries were presented. Anatomy and Kinetics: None of the pairs of bearing surfaces in the knee joint is exactly congruent This allows the knee six degrees of freedom of motion. Tibiofemoral Kinematics: In flexion and extension, the axis of motion is not perpendicular to the medial-lateral plane of the joint, nor is it perpendicular to the axis of longitudinal rotation. This results in coupled varus angulation and internal rotation with flexion and in valgus angulation and external rotation with extension. Patellofemoral Articulation: Loads across the patellofemoral joint are indirectly related to the angle of knee flexion and directly related to the force generated within the quadriceps mechanism. Fractures of the Patella: Nonoperative treatment is indicated if the extensor mechanism is intact and if displacement of fragment is minimal. The specific type of internal fixation depends on the fracture pattern. It is important to repair retinaculum. Acute and Recurrent Patellar Instability: The degree of dysplasia and the extent of the instability play a large part in determining the success of nonoperative treatment. Patients who experience recurrent dislocations and patients with major anatomic variations require surgery to minimize their instability. Sports Injuries in School-age Atheletes: Patellar pain in young athletes groups a number of conditions, including Idiopathic Adolescent Anterior Knee Pain, Osgood- Schlatter Disease, and Sinding-Larsen-Johansson Disease.

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The Assessment of Tube Incidence Angle for Minimizing the Patellofemoral Joint Overlap Distance in Merchant View (Merchant 검사 시 슬개대퇴관절 겹침 최소화를 위한 중심 X선 입사각에 대한 평가)

  • Ko, Ye-Weon;Joo, Young-Cheol;Kim, Min-suk;Go, Yu-Rim
    • Journal of radiological science and technology
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    • v.43 no.3
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    • pp.161-167
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    • 2020
  • This study aimed to found out the effect of patellofemoral overlap distance by changing femur thickness and center X-ray angles in Merchant method images. Based on the femur thickness, it suggested tube angle minimizes overlap. It was conducted by Merchant method, a knee tangential view, and the image was obtained by changing the thigh thickness from 14 to 20 cm and the center ray angle from 60°, 57°, 55°. The images were measured by five researchers using a method of measuring the overlap, which was designed by them. The results showed at 60°, 57°, 55° angle, the patellofemoral overlap distance resulted in 0.47±0.66 to 20.89±0.65 cm, 2.26±0.28 to 15.73±0.62 cm, 1.39 ± 0.83 to 12.49 ± 0.37 cm. However, for 57° and 55°, no overlap in thickness under 14.5 and 14 to 15.5 didn't appear. it showed high correlation between femur thickness and overlap. The difference in the mean value of overlap in each group showed a statistically significant difference (p<0.01), all were classified as independent groups in the post-hoc test. In all images, the patellofemoral overlap distance increased as the thickness increased, and at the average thickness of Korean men and women, overlap decreased when reducing center ray. When conducting Merchant tests on Koreans, it was suggested it would be useful to use 57° angle because it minimize the effects of overlap and intrusions of tibia.

Design and Optimization of an Knee Joint of Fully-active Transfemoral Prosthesis for Stair Walking (계단 보행을 위한 능동형 대퇴의지 무릎 관절의 설계 및 최적화)

  • Ahn, Hyoung-Jong;Lee, Kwang-Hee;Hong, Yi;Lee, Chul-Hee
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.10 no.1
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    • pp.65-72
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    • 2016
  • In this study, a fully active transfemoral prothesis with a knee joint is designed considering stair walking conditions. Since the torque at the knee joint required for stair walking condition is relative high compared with the one in normal walking condition, the proposed design has high torque generating mechanism. Moreover, the transfemoral prothesis is designed in compact size to reduce its weight, which is related to comfortable fit and fatigue of patients. Flat type BLDC motor is used for simple and compact structure and various components are used to generate required torque with target working angle and speed. The weight reduction of structure is carried out using optimization method after the initial design process is complete. The optimization is conducted under the load conditions of stair walking. The optimized design is validated via finite element analysis and experiments. As a result, the weight is reduced using topology and shape optimization but maintaining the safety of structure. Also the space efficiency is improved due to its compact size.

Lower Extremity Kinematics and Muscle Activity of Cutting Movement in Older Parkinson's Diseases (파킨슨 환자들의 방향전환 보행 향상을 위한 하지의 운동학 및 근육 활동 규명)

  • Kim, Mi-Young;Kim, Jong-Duk
    • Korean Journal of Applied Biomechanics
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    • v.19 no.2
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    • pp.257-264
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    • 2009
  • The purpose of this study was to investigate the lower extremity kinematics and muscle activities of adductor longus(AL), gluteus medius(GME), gluteus maximus(GMA), biceps femoris(BF), rectus femoris(RF), gastrocnemius(GA), and tibialis anterior(TA) using three dimensional and Noraxon 8 channels EMG system during turn 0, 60, 90 and 120 degrees in patients with Parkinson's disease. Seven parkinson's patients and five healthy subjects were participated in the study. Participants with Parkinson's disease demonstrated significant differences in reduction of stride length and stride width. Also, they showed ill difference in muscle activities. The strength and balance of the lower extremity muscles may help to improve cutting movement and to prevent falling in parkinson's patients.

Differences in Angle of the Lower Extremities and Electromyography of Elderly Women Experienced a Fall (낙상경험 여성노인의 하지 분절 각도와 근전도 차이)

  • Jeon, Kyoung-Kyu;Park, Kwang-Dong;Park, Se-Hwan;Kang, Young-Seok;Kim, Dae-Geun
    • Korean Journal of Applied Biomechanics
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    • v.19 no.2
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    • pp.245-255
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    • 2009
  • The purpose of this study is to analyzed the coordination of lower limb of elderly women who experienced a fall to present basic information for sports science and to deal with the factors that make elderly women fall more effectively. Twenty elderly women were divided into two groups of 10. The mechanisms of balancing lower limb during walk and differences were compared and analyzed using motion analysis and electromyography. The findings of this study are as follows. The first, walking patterns of these women were unstable as their hip joints did not provide sufficient support because of aging. Second, the left and right knee joints showed different walking patterns. The third, the motions of ankle joints became abnormal with increased age. As for the activation of major lower limb muscles, rectus fermois muscle and biceps fermois muscle contracted more to prevent the bending of knees and moved forward while anterior tibial muscle and inner gastrocnemius muscle were demanded highly during walk and the rate of plantar flexion was reduced.

Influence of Couch and Collimator on Dose Distribution of RapidArc Treatment Planning for Prostate Cancer in Radiation Therapy (치료테이블과 콜리메이터가 전립선암 래피드아크 치료계획의 선량분포에 미치는 영향)

  • Kim, Hyung-Dong;Kim, Byung-Young;Kim, Sung-Jin;Yun, Sang-Mo;Kim, Sung-Kyu
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.99-105
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    • 2012
  • We investigated the influence of photon energy, couch and collimator angle differences between arcs on dose distribution of RapidArc treatment planning for prostate cancer. RapidArc plans were created for 6 MV and 10 MV photons using 2 arcs coplanar and noncoplanar fields. The collimator angle differences between two arcs were $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $75^{\circ}$ and $90^{\circ}$. The plans were optimized using same dose constrains for target and OAR (organ at risk). To evaluate the dose distribution, plans were analyzed using CI (conformity index), HI (homogeneity index), QOC (quality of coverage), etc. Photon energy, couch and collimator angle differences between arcs had a little influence on the target and OAR. The difference of dosimetric indices was less than 3.6% in the target and OAR. However, there was significant increase in the region exposed to low dose. The increase of V15% in the femur was 6.4% (left) and 5.5% (right) for the 6 MV treatment plan and 23.4% (left), 24.1% (right) for the noncoplanar plan. The increase of V10% in the Far Region distant from target was 54.2 cc for the 6 MV photon energy, 343.4 cc for the noncoplanar and 457.8 cc for the no collimator rotation between arcs.

Generation of Motor Velocity Profile for Walking-Assistance System Using Humanoid Robot Model (휴머노이드 로봇 모델을 이용한 보행재활 훈련장치의 견인모터 속도 파형 생성)

  • Choi, Young-Lim;Choi, Nak-Yoon;Park, Sang-Il;Kim, Jong-Wook
    • Journal of the Korean Institute of Intelligent Systems
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    • v.22 no.5
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    • pp.631-638
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    • 2012
  • This work proposes a new method to generate velocity profile of a traction motor equipped in a rehabilitation system for knee joint patients through humanoid robot simulation. To this end, a three-dimensional full-body humanoid robot model is newly constructed, and natural human gait is simulated by applying to it reference joint angle trajectories already published. Linear velocity is derived from distance data calculated between the positions of a thigh band and its traction motor at every sampling instance, which is a novel idea of this paper. The projection rule is employed to kinematically describe the humanoid robot because of its high efficiency and accuracy, and measured joint trajectories are used in simulating human natural gait referring to Winter's book. The attained motor velocity profile for a certain position in human body will be applied to our walking-assistance system which is implemented with a treadmill system.

ACL Reconstruction with Remnant Preserving Technique - Technical Note - (잔류조직 보존 술기를 이용한 전방 십자 인대 재건술 - 수술 술기 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Jeong, Ji-Young;Jeon, Hyung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.82-85
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    • 2009
  • Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

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