• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.16-23
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• 2013

Multiple ligament knee injury is defined as rupture to at least two of the four major knee ligament structures. Three or four knee ligament injury results in knee dislocation as complete disruption of the integrity of the tibiofemoral articulation. In multiple ligament knee injury, vascular and neurologic assessment should be performed meticulously and systematically. Emergency surgery should be needed if arterial injury is suspected. Surgical treatment rather than conservative management should be done and early surgery might be better than delayed surgery. Reconstruction of ACL and PCL, repair or reconstruction of MCL, and reconstruction of posterolateral corner are recommended, although many debates have occurred. Multiple ligament knee injury requires more aggressive management than single ligament knee injury.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.17-25
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• 2012

Purpose: The aim of this retrospective study was to evaluate the relationship between appearance and size of bone bruise and severity of anterior cruciate ligament (ACL) injury with magnetic resonance imaging (MRI), furthermore, to identify the mechanism of ACL injury by analyzing the footprint of bone bruise. Materials and Methods: Sixty-five subjects who was taken an MRI within 6 weeks after acute ACL injury were studied. All MRI showed ACL injury and associated bone bruises. Bone bruises were analyzed using Costa-Paz classification based on appearance and location and also scored using Kornaat bone bruise grading system based on size and location. The severity of the ACL injury was graded using a 4-point system (ie, grade 0-3) with oblique coronal MRI. Results: There was statistically significant correlation between Costa-Paz classification of bone bruises in lateral femoral condyle and grade of ACL injury. There were more type 2 lesions in partial tear group (grade 1, 2), however, type 3 lesions of Costa-Paz classification in complete tear group (P=0.037). Significant positive correlations were observed between Kornaat total bone bruise score and grade of ACL injury (P=0.014). Most common ACL injury mechanism was pivot shift injury. Other mechanisms were clip valgus injury, phantom foot injury, and hyperextension injury. Conclusion: It is highly suggested that appearance and size of bone bruise is related to severity of ACL injury after acute ACL injury. The foot print of bone bruise provides valuable clues to identify ACL injury mechanism.

• Proceedings of the Korean Society of Computer Information Conference
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• 2017.01a
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• pp.9-12
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• 2017

본 논문에서는 어깨 초음파 영상을 분석하여 인대 손상(Tear) 영역을 추출하는 방법을 제안한다. 제안된 방법은 초음파 영상에서 ROI(Region of Interest) 영역을 추출하고 추출된 ROI 영역에서 사다리꼴 형태의 소속 함수를 적용한 퍼지 스트레칭 기법을 이용하여 명암 대비를 높인다. 명암 대비가 조정된 ROI 영역에서 밝기 평균 이진화 기법을 적용하여 ROI 영역을 이진화한다. 이진화가 적용된 ROI 영역에서 워터쉐드 기법을 적용하여 연골과 힘줄의 후보 영역들을 추출한다. 추출된 연골과 힘줄의 후보 영역들 중에서 위에서 아래로 스캔하여 수평 너비가 가장 큰 영역에 해당하는 힘줄 영역의 상단 경계선을 추출한다. 그리고 아래에서 위로 스캔하여 수평 너비가 가장 큰 영역의 상단 경계에 스플라인 곡선을 적용하여 연골 영역의 상단 경계선을 추출한다. 힘줄 영역의 상단 경계선과 연골 영역의 상단 경계선 양 끝에 2차 함수 곡선을 적용하여 곡선 사이의 양자화할 영역을 추출한 후, SOM 기법을 적용하여 인대 손상 후보 영역을 양자화한다. 양자화된 인대 손상 후보 영역을 분석하여 어깨 힘줄의 손상 영역과 비손상 영역을 구분하고 인대 손상(Tear) 영역을 추출한다. 제안된 방법을 어깨 힘줄이 있는 초음파 영상을 대상으로 실험한 결과, 인대 손상(Tear) 영역이 비교적 정확히 추출되었다.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2016.05a
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• pp.477-479
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• 2016

본 논문에서는 초음파 영상에서 어깨 부위를 분석하여 어깨 힘줄(Tendon) 영역에서 인대 손상영역을 추출하는 방법을 제안한다. 제안된 방법은 초음파 영상에서 ROI(Region of Interest)을 추출하고 샤프닝 기법을 적용하여 ROI 영역을 뚜렷한 후에 퍼지 스트레칭 기법을 적용하여 명암 대비를 높인 후, 평균 이진화 기법을 적용하여 ROI 영역을 이진화 한다. 이진화된 ROI 영역에 침식, 팽창기법과 라벨링 기법을 적용하여 전체 ROI의 면적 영역에서 0.4%이하인 객체 영역들을 잡음으로 간주하여 제거한 후, ROI 영역에서 수평 너비가 가장 큰 영역의 상단 경계에 스플라인 곡선을 적용한다. 스플라인 곡선이 적용된 영역에서 곡선이 가장 높은 지점을 구한 후, 구한 지점으로부터 ROI 영역의 세로 길이의 1/5를 갖는 상단부분을 제거한 후에 양자화할 영역을 추출하고 FCM을 적용하여 양자화를 한다. 양자화된 영역에서 어깨 힘줄 영역 안에 있는 인대 손상의 후보 영역을 추출하고 면적의 크기가 0.14%이상이거나 3%이하인 영역을 어깨 힘줄의 인대 손상 영역으로 추출한다. 제안된 방법을 어깨 힘줄이 있는 초음파 영상을 대상으로 실험한 결과, 제안된 방법이 어깨 힘줄의 인대 손상 영역이 비교적 정확히 추출되었다.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.140-145
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• 2011

후방십자인대 손상의 이상적 치료는 아직까지도 확립되지 않았다. 과거 몇 십 년간 후방십자인대에 대한 지식과 슬관절 안정성에 대한 후방십자인대의 생역학에 대한 지식이 증가하였다. 특히 이중 다발에 대한 지식이 증가하고 이러한 모든 노력들은 후방십자인대의 해부학적인 특징을 최대한 복원하기 위해 이루어졌다. 재건술의 수술 방법은 특정 손상 양상에 따라 그에 맞게 이루어지는데 만성 손상의 경우나 remnant가 거의 존재하지 않는 경우에는 이중 다발을 재건하는 것이 만족스러운 결과를 보인다. 아직까지 이중 다발 후방십자인대 재건술의 결과에 대해서는 논란이 많은 것은 사실이나 장기 추시가 가능해지면 이중 다발 후방십자인대 재건술이 해부학적으로나 생역학적으로 더욱 정상에 가깝기 때문에 더 나은 장기적 결과를 보여줄 것으로 예상된다.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.101-111
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• 2001

Background: We analyze the functional evaluation, posterior stability after surgery of acute injuries in the femoral detachment and tibial avulsion fracture of posterior cruciate ligament. Materials and Methods: Twenty two patients who underwent primary repair were followed more than one year after operation (mean follow-up 33.7 months). The patients were evaluated with KT 2000 arthrometer and posterior stress test for posterior stability. Lysholm knee score was used for knee function. Results: Lysholm score revealed 85.3 in femoral detachment group and 91.1 in tibial avulsion fracture group (P<0.05). Posterior displacement of the posterior stress test showed 17.2 mm at initial injury and 8.6 mm at last follow up in femoral detachment group, 16.8 mm at initial injury and 7.1 mm at last follow up in tibial avulsion fracture group. There revealed the tendency of the improved posterior stability of the tibial avulsion group compared with femoral detachment group, but there showed no statistical significance in KT 2000 arthrometer and posterior stress x-ray. Conclusion: Functional results of tibial avulsion fracture group revealed the better outcome compared with femoral detachment group, but the degree of posterior stability in tibial avulsion fracture group showed no statistical significance in posterior stability.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2006.09a
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• pp.11-11
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• 2006

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.147-152
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• 2012

Purpose: The purpose of this study was to compare the preoperative magnetic resonance image (MRI) findings with postoperative arthroscopic findings on meniscus injury with anterior cruciate ligament (ACL) rupture. Materials and Methods: We reviewed MRI images and arthroscopic findings of 225 patients treated by ACL reconstruction due to rupture, from February 2001 to November 2010. There were 154 cases of meniscus tear in arthroscopic findings. We examined the sensitivity for detecting meniscal tears varied with the presence of a rupture of the ACL, with the location of the tear within the meniscus, and among configurations of meniscal tears. Results: In the presence of a rupture of the ACL, the sensitivity of MRI was 0.88 for medial meniscal tears and 0.69 for lateral meniscal tears. And sensitivity of MRI was lowest in posterior horn and peripheral portion tears in lateral meniscus injury accompanying ACL rupture, sensitivity was low in anterior horn and flap shape tears in medial meniscus injury accompanying ACL rupture. Conclusion: In Meniscus injury with ACL rupture, a special attention shoulder given to the posterior horn and peripheral portion injury in lateral meniscus during arthroscopic surgery due to difficulty in detecting on MRI.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.37-43
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• 2003

Purpose: This study is to analyse the injury patterns of knee ligament and the factors influencing ligament injuries of knee, and to evaluate the changes of knee function and activity after ski injury. Materials and Methods: Thirty cases of ligament injuries of knee were studied with a questionaire, stress radiographs, magnetic resolution imaging, and physical examination. Mean age was 28.6 years old and mean follow up was 29.6 months. Clinical evaluation of Lysholm knee scoring scale was used for knee function and Tegner activity score was used for activity change after ski injury. Results: The anterior cruciate ligament (ACL) injury accompanied with medial collateral ligament(MCL) injury was most in 11 cases and isolated MCL injury was the next in 9 cases. The common types of injury mechanism were Phantom foot phenomenon (13 cases, 43$\%$) and valgus external rotation injury (12 cases, 40$\%$), which constitute 83$\%$ of all case. At the last follow up, the mean Lysholm score was 93.4 and mean Tegner activity score was 4.2. The reduced Tegner activity score after injury was 1.9. Among several injury groups, the evaluation of knee function and activity was best in the isolated MCL injury group and worst in the ACL injury accompanied with MCL injury group. The factors to influence ski injury were participation to ski class, release of binding, and skiing long time more than 2 hours. Conclusions: Lysholm score at last follow up revealed good grading, but sports activity after ski injury was reduced when compared with pre-injury state. It seems to need a active, systemic sports rehabilitation program after sports injury.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.46-50
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• 2005

Purpose: The purpose of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of acute anterior cruciate ligament (ACL) injury and its tear pattern in comparison with arthroscopic finding. Materials and Methods: Sixty consecutive patients with acute ACL injury were taken NRI followed by arthroscopic examination between January 2002 and June 2004. MRI findings were reviewed according to the presence of ACL discontinuity, diffuse swelling or thickening, focal edema, collapse on distal end, and any combined tear. The pathologic findings were then confirmed arthroscopically. The diagnostic accuracy of MRI on ACL tear pattern was analyzed by obtaining its positive predictive value. Results: All fifty two cases with presence of discontinuity on MRI showed ACL rupture arthroscopically. The location of ACL tear, diffuse swelling and focal edema on MRI also corresponded with arthroscopic findings respectively. However, the diagnostic accuracy of MRI was relatively lower in the presence of other ACL patterns such as collapses and combined tear. Conclusion: Preoperative MRI findings seem to be in accordance with arthroscopic findings and is significantly accurate in detection of location and diffuse swelling and focal edema of ACL tear.