• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.102-108
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• 1999

Purpose : The purpose of this study was to evaluate the clinical results of bone-patellar tendon-bone(B-PTB) allograft for ACL reconstruction without mechanical tensioning device. Material and Method : Forty-six knees in 43 patients were reviewed and evaluated with subjective evaluation, objective evaluation, Telos stress arthrometer and modified Feagin Scoring System. The average age at the time of operation was 27 years(range, 18-42) and the average follow up period was 41 months(range, 22-79). Authors reconstructed ACL using B-PTB allograft which was prepared by rehydration preoperatively without tensioning by mechanical tensioning device. The tension for allograft was obtained by full flexion and extension intraoperatively. All operation were performed arthroscopically by two-tunnel method to avoid the mismatching of allograft tendon length. Result : The modified Feagin Scoring System revealed 39 cases(84.7%) with excellent or good results and 7 cases(15.3%) with fair or poor results. The mean follow-up Lysholm Knee Score was 84. Telos arthrometer revealed 41 cases had an injured-to-uninjured difference of 5 mm or less(mean 2.3mm). The range of motion of knee was nearly normal and there was no extension lag in any cases at last follow up. Conclusion : Clinical results using B-PTB allograft showed less morbidity than B-PTB autograft. The intraoperative tensioning method by full flexion and extension without mechanical tensioning device was not bad. Therefore, B-PTB allograft is a good substitute material in reconstruction of the ACL.

• 대한관절경학회:학술대회논문집
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• 2008.04a
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• pp.37-38
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• 2008

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.13-18
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• 2000

Purpose : The purpose of this study was to compare the efficacy of bone-patellar tendon-bone(B-PTB) allograft with autograft B-PTB reconstruction of anterior cruciate ligament(ACL) according to the subjective and objective criteria. Materials and Methods : 42 patients were treated for acute rupture or chronic insufficiency of the ACL between March 1993 and June 1996. There were 18 autografts and 24 allografts for ACL reconstruction. At 2 years of follow-up after operation, autograft and allograft groups were compared based on subjective, objective criteria and Telos stress arthrometer. Results : The modified Feagin Scoring System revealed 16 patients$(88.9\%)$ with a satisfactory result by autografts, but 21 patients$(87.5\%)$ with a satisfactory result by allografts after 2-years follow-lip. There was no statistically significant difference between the two groups. ACL reconstruction with B-PTB allograft did not produce a significant functional deficit. But patellofemoral pain and crepitus were more frequent in the autografts$(33.3\%)$ than allografts$(8.3\%)$ (p<0.05). Conclusion : The ACL deficient knees treated with allografts for ACL reconstruction tended to be better than those reconstructed with autografts fur the reduction of patellofemoral crepitus and pain. B-PTB allograft provides an acceptable alternative to autograft tissue for reconstruction of the ACL.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.132-136
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• 2005

Purpose: The purpose of this study was to compare the clinical results of the arthroscopic anterior cruciate ligament reconstruction used by Bone-Patella tendon-Bone autograft and Achilles tendon allograft. Materials and Methods: We reviewed the results of patients who had been managed with arthroscopic anterior cruciate ligament reconstruction using different graft such as Bone-Patella tendon-Bone autograft and Achilles les tendon allograft. 60patients (average age, 33.5 years)were retrospectively evaluated. The one group(average age, 33.4 years) was 32 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Bone-Patella tendon-Bone autograft. The other group(average age, 32.1 years) was 28 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Achilles tendon allograft. 2 groups were evaluated subjectively by Lysholm knee scoring scale and objectively by KT-2000 arthrometer. The follow-up period was more than a year(average, 18 month). An early rehabilitation protocol was instituted. Results: On Lysholm knee scoring scale, the final evaluation was nearly normal in all patients. We could not find statistical difference among the two groups by KT-2000TM arthrometer. Conclusion: The use of allografts may be an acceptable choice for ACL reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.94-97
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• 2004

Purpose: To report the results of arthroscope assisted posterior cruciate ligament reconstruction without tourniquet, which has not yet been reported in documents within the country. Materials and Methods: Out of the 75 cases of arthroscope assisted posterior cruciate ligament reconstruction on patients with posterior cruciate ligament damage from January, 1998 to May,2003 in this hospital, study was done on 49 cases of patients with isolated posterior cruciate ligament damage, excluding 16 cases of patients who were applied tourniquet in extraarticular operation due to combined damage such as in lateral collateral ligament and posterolateral collateral ligament, and 10 cases where the postoperative observation period was less than 12 months. There were 13 cases where reconstruction was done using autogenous bone-patella tendon-bone, 19 cases using allogenous bone-patella tendon-bone, and 17 cases using allogenous achilles tendon. For assessment, the 49 cases were compared using Lysholm knee scoring scale. Results: The average duration of operation was 105 minutes. There were no severe complications such as swelling, bleeding, infection etc . Assessment results attained by Lysholm knee scoring scale was 74(fair) for cases where autogenous bone-patella ten-don-bone was used,75(fair) for cases where allogenous achilles tendon was used, and 76(fair) for cases where allogenous bone-patella tendon-bone was used. Conclusion: There are no difficulties to perform the arthroscopic assisted posterior cruciate ligament reconstruction. Reconstruction without tourniquet can be thought to prevent complications that could follow when using it.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.74-79
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• 2001

Purpose : The purpose of this study is to evaluate the clinical results after arthroscopic PCL reconstruction and to compare the clinical results after arthroscopic PCL reconstruction using BPTB(bone patellar tendon bone) autograft(Group I : 11 cases), Achilles tendon allograft(Group II : 7 cases) and BPTB allograft(Group 111.6 cases). Materials and Methods : We reviewed the result of 24 patients who had been managed with arthroscopic reconstruction using different graft materials such as BPTB autograft, Achilles tendon allograft and BPTB allograft. Twenty-four patients(average age, 37 years) with PCL rupture were retrospectively evaluated more than one year(average, 31 months) after having arthroscopic posterior cruciate ligament reconstruction. The clinical results were evaluated by IKDC ligament standard evaluation form, using $KT-2000^{TM}$ knee ligament arthrometer and also evaluated Lysholm knee scoring scale. Results : The final evaluation was nearly normal in 11 patients($45\%$ in Group I, $43\%$ in Group II, $50\%$ in Group III). The corrected posterior sagging was abnormal(side to side difference more than 6mm) in 8 patients($36\%$ in Group I, $29\%$ in Group II, $33\%$ in Group III). We could not find significant difference among three groups by IKDC scale. Conclusion : Comparing with other reports, our overall results were not satisfactory. And also, we could not find any remarkable difference among the three groups. Further research is necessary to evaluate new surgical approaches as well as improved techniques for capsular and collateral ligament injuries.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.128-133
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• 2000

Purpose : To compare the changes of the patellar height, patellofemoral alignment and subjective symptom and to compare the effects of patellar tendon harvest after anterior cruciate ligament(ACL) reconstruction using autograft and allograft. Materials and Method : ACL reconstruction was performed on 87 patients who were followed up for minimum 1 year. The group I was 52 patients who were operated with bone-patellar tendon-bone autograft and the group II was 35 patients who were operated with bone-patellar tendon-bone allograft and achilles tendon allograft. At the time of follow-up, the authors evaluated the patellar height by Blackburne-Peel method, Merchant congruence angle, Lateral patellofemoral angle and subjective symptoms were assessed. Results : The patellar heights were significantly decreased from 0.86 preoperatively to 0.80 postoperatively in the group I and from 0.87 preoperatively to 0.83 postoperatively in the group II. There were no significant differences in the lateral patellofemoral angles between the both groups but in the Merchant congruence angle, significant differences were observed in the both groups, from$-1.43^{\circ}$ preoperatively to-$5.43^{\circ}$ postoperalively in the group I and from$-1.53^{\circ}$ preoperatively to$-3.65^{\circ}$ postoperatively in the group II. Conclusion : After ACL reconstruction, the patellofemoral alignment was changed and this kind of changes may be caused by multiple factorials such as harvest of autografts, ACL reconstruction itself, and quadriceps muscle atrophy.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.26-30
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• 2002

Purpose: To estimate the initial and early phase fixation power of the human bone interference screw in reconstruction of the anterior cruciate ligament with bone-patellar tendon-bone allograft. Materials and Methods: The results of twenty eight knees of reconstruction with bone-patellar tendon-bone allograft were analysed in 6 weeks, 12 weeks, 6 months and one year following operation. Physical examination including Lachman test, flexion rotation drawer test and jerk test were performed. The KT-1000 measurement was performed at the same time. In Lachman test 0 $\~$2mm anterior displacement of the tibia was considered normal. The KT-1000 measurement of normal side was compared with operation side and the difference of the two was recorded. The MRI was checked at final follow-up. Results: All but one knee showed normal in physical examination. The failed case showed proximal migration of the graft due to insufficient number of interference screw fixation in widened tibial tunnel. Conclusions: The human cortical bone interference screw showed sufficient initial and early phase fixation power in reconstruction of the anterior cruciate ligament.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.1-13
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• 2021

Considerable progress on anterior cruciate ligament reconstruction surgery has been made over the past 20 years, and the results have improved significantly. An anatomical understanding of the anterior cruciate ligament has also changed, and the surgical technique has also changed accordingly. The double-bundle concept is still valid, but the ribbon-shaped anterior cruciate ligament concept, including direct fiber and indirect fiber, is gradually replacing it. The isometry point theory no longer exists, and various surgical methods, such as single-bundle anatomical reconstruction, double-bundle reconstruction, remnant preservation, and rectangular tunnel technique, are being performed. Regarding the graft, interest in the bone-patellar tendon-bone, patellar tendon, quadriceps tendon, and allogeneic tendon change over time, and this change is ongoing.