• The Journal of the Korean bone and joint tumor society
• /
• v.13 no.2
• /
• pp.96-104
• /
• 2007

Purpose: The authors investigated whether 35 flexible nail-rotating hinge composite reconstructions around knee joint minimize junctional osteolysis of host bone. Material and Method: The reconstructive technique was as follows: 1) en bloc tumor resection, 2) filling of the host bone marrow cavity with multiple Ender nails, 3) assembling the Ender nails and an Endo-Link type total knee component with wire and bone cement. Result: Mean follow-up was 53 months (ranged 30~79). At final follow-up, 29 patients retained a mobile joint. Resection of more than 40% of bone showed a positive relationship with junctional hypertrophy (p=0.028). Eight patients showed nail breakage and eight prostheses were removed due to early or late infection. The cumulative prosthetic survival rate was 33% at 6 year. Average functional score according to the MSTS criteria was 26.8. Conclusion: Mid-term evaluations showed that results were fair. The revision process was straightforward. Junctional hypertrophy observed appears to give some clues as to how to minimize osteolysis at the prosthesis-host junction after modular prosthesis fixation.

• Journal of the Korean Society of Radiology
• /
• v.7 no.5
• /
• pp.313-320
• /
• 2013

For some patients with joint illnesses such as rheumarthritis or varus deformity, the total knee arthroplasty (TKA) procedures are performed. However, when inserting metal cutting guide for the procedures, due to the femoral shaft bowing, complications such as the cortex of the femoral shaft damages or secondary fractures can be caused. If the central coordinate value of the femoral shaft is known, the metal cutting guide could be inserted into the anatomical center, so such complications can be prevented. In this study, CT images of femoral shafts of 10 individuals in the experiment group who are in need of receiving the total knee arthroplasty procedures and those of 10 individuals in the control group without illness in the femoral shaft have been utilized to locate the 3-dimensional coordinate values. Then, Matlab was utilized to identify the central coordinate value in order to obtain a graph reflecting the anatomical shapes as well as to acquire the 3-dimensional radial curvature values by section. As a result, the average curvature range and standard deviation of femoral shafts of the experiment group was determined to be $758.15{\pm}206.3mm$ whereas the that of the control group was determined to be $1672.97{\pm}395.6mm$. The statistical significance of the measured results was verified through f-distribution analysis. Based on these results, it was verified that the level of curvature of the femoral shaft of the experiment group was higher. If the anatomical central points are located and analyzed using this methodology, it would be helpful in performing orthopedic operations such as the total knee arthroplasty.

• Journal of the Korean Arthroscopy Society
• /
• v.9 no.1
• /
• pp.65-69
• /
• 2005

It is well known that the two main variants of the anterior cruciate ligament (ACL) ruptures in an adolescent include tibial eminence fractures and midsubstance tears. Authors report a case of 17-year-old girl with simultaneous bilateral anterior cruciate ligament ruptures at the ligamento-osseus junction of tibial attachment which was treated with arthroscopic primary repair.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.8 no.4
• /
• pp.259-265
• /
• 2014

The aims of this study are to investigate the walking intention detection of a rollator based on Infraed (IR) sensor measuring knee joint anterior displacement and leg muscle activities. We used Active Walker attached IR sensor to measure the knee joint anterior displacement and EMG signal of leg muscles(rectus femoris, biceps femoris, tibialis anterior, gastrocnemius) were taken by Delsys bagnli-8ch. Subjects were eight healthy males(age $23.7{\pm}0.5years$, height $175.4{\pm}2.3cm$, weight $70.6{\pm}5.6kg$) and they were involved in experiments which had been proceeded 30 minutes a week, during 3 weeks. This system indicates that the knee joint anterior displacement had the distinction increases according to the gait slope and velocity. We showed the increase of the femoral muscle activities along the anterior tilt and the increase of the crural muscle activities along the posterior tilt.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.3 no.2
• /
• pp.128-133
• /
• 2004

Purpose: This study was planned to evaluate complications? of posterior cruciate ligament (PCL) reconstruction with tibial inlay technique using autogenous bone-patellar tendon-bone graft. Materials and Methods: From September 1994 to January 2004, we analyzed surgical complications in fifty-seven patients with fifty-eight cases who underwent PCL reconstruction. Fifty of them were male and seven female. The mean age of the patients was 35(15$\~$73). Twenty eight cases of injury were isolated PCL, while thirty cases had associated injury of knee. The causes of injury were thirty-nine cases of traffic accident, seven sport injuries, seven fall down injuries, and five of others. The follow-up study was done at 4 weeks, 3 months,6 months and 1 year after surgery. KT-2000 arthrometer and posterior stress X-ray were used to examine the stability of the knee joint and the Lysholm Knee Score and a variety of clinical complications were evaluated. Results: Although the mean score of the preoperative Lysholm Knee Score was 43.2, the postoperative score was increased to 87.9. The preoperative mean value of knee stability using KT-2000 arthrometer was 8.75 mm(6.2$\~$14.3 mm) but the postoperative mean was 3.41 mm(2.1$\~$10.6 mm). The intraoperative complications were: one case of popliteal artery injury with compartment syndrome, one case of patellar fracture, two cases of 20$^{\circ}$ flexion loss, and two cases of anterior cortical penetration of the screw through proximal tibia during screw fixation. The postoperative complications were: eleven cases of knee instability, one case of patellar fracture, five cases of extension loss, thirteen cases of flexion loss, twenty-one cases of around knee pain and eight cases of kneeling pain. Conclusion: After PCL reconstruction with tibial inlay technique using autogenous bone-patella tendon-bone graft, complications were observed in this study. Careful attention during and after the operation, as well as rehabilitation must be required.

• Journal of the Korean Arthroscopy Society
• /
• v.13 no.1
• /
• pp.46-52
• /
• 2009

Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.1 no.2
• /
• pp.73-77
• /
• 2008

Purpose: The purpose of this study was to describe the method of dynamic sonographic measurements in the evaluation of the MCL injury of the knee joint while applying valgus and varus stress. Materials and Methods: Seven cases of MCL injury from January to April of 2008 was used for the study. For the evaluation of the medial instability, sonography was used immediately after injury, 6 weeks and 12 weeks after conservative treatment with limited motion brace. The length between the foot of the medial femoral epicondyle and the most proximal point of the tibial cortex was measured in 30 degrees flexion with valgus and varus stress of the knee joint. Results: The foot of the medial epicondyle and the starting point of the proximal tibial cortex underneath the round portion of the articular cartilage were always able to be seen on ultrasonography, even in varus and valgus stress with gravity in 30 degrees flexion of the knee joint. The results of measurements were always constant. Conclusion: Sonography can be used in evaluation of medial instability under the dynamic valgus and varus stress of the knee joint without further injury.

• Journal of the Korean Society for Precision Engineering
• /
• v.23 no.11 s.188
• /
• pp.126-134
• /
• 2006

In this study, the effect of stem-end design on contact pressure and stress distribution in revision TKR was investigated using finite element method. The finite element model of tibia, including the cortical bone, the cancellous bone and canal, was developed based on CT images. The implant models with various stem lengths, diameters, friction coefficients, and press-fit effects were considered. The results showed that the longer stem length, the stronger press-fit, the bigger stem diameter, and the higher friction coefficient increased both peak contact pressure and Von-Mises stress distributions. The results supported the clinical hypothesis that peak contact pressure and stress are related to the stem end pain. The results of this study will be useful to design the stem and reduce the end-of-stem pain in revision TKR.

• 한국HCI학회:학술대회논문집
• /
• 2007.02a
• /
• pp.109-114
• /
• 2007

본 논문에서는 하지 편마비 환자의 편마비 정도를 측정하여 사용하지 않으려고 하는 근육을 강제적으로 사용하도록 하여 하지를 재활할 수 있도록 훈련하는 시스템을 제안한다. 제안하는 시스템은 체중 부하 및 하지 슬관절의 움직임을 측정하여, 이를 통해 환자가 자신의 편마비 정도를 인식할 수 있도록 화면에 출력함으로써 환자가 피드백을 통해 강제적으로 편마비 하지를 사용 하도록 훈련 시킬 수 있다. 하지 슬관절(Knee Joint)의 움직임은 기존의 방법과는 달리 적외선 필터를 장착한 단일 카메라를 통한 모션 캡쳐 기술을 사용하여 획득한다. 또한, 재활 시스템에 가상현실 기술을 도입하여 무릎을 동시에 굽혔다가 펴는 기립훈련과 양측 하지를 이용한 보행훈련을 입력으로 가상공간을 탐험할 수 있게 함으로써 환자가 흥미롭게 재활훈련을 받을 수 있도록 하였다.

• Journal of Biomedical Engineering Research
• /
• v.22 no.1
• /
• pp.29-34
• /
• 2001

본 연구의 목적은 대퇴부가 절단된 다리의 생체 역학적 기능을 복구할 수 있게 하는 의지의 개발을 위하여 5축 링크, 슬관절 완충장치를 사용하여 보행시 입각기를 제어할 수 있는 대퇴 의지 시스템 개발에 있다. 이를 위하여 입각기시 대퇴의지와 지면간 접촉 중 충격 에너지 흡수를 하는 슬관절 완충장치의 기계적 특성 및 거동을 분석하였다. 임상시험을 통하여 개발된 대퇴의지의 성능을 검증한 결과 대퇴 절단 피검자들의 보행특성은 정상인의 보행에 근접한 경향을 보였다. 결론적으로 본 연구에서 개발된 입각기 대퇴의지는 입각기시 현저한 보행 안전성을 보였다.