• 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 Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.88-91
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• 2007

Persistent instability following an acute lateral ankle sprain eventually require ligamentous reconstruction in some cases. Over 50 surgical procedures have been described to reestablish lateral ankle stability varying from direct in situ repair of the anterior talofibular ligament and the calcaneofibular ligament to augmented reconstructions with either autograft or allograft tissue. The author describes the rationale and the technique of anatomic ankle ligament reconstruction with the 4th extensor digitorum longus tendon.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.169-175
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• 2003

Purpose : The purpose was to evaluate the early result of revision of failed anterior cruciate ligament (ACL) reconstruction. Materials and Methods : From August 1997 to February 2002, this report presents the findings of 18 patients who had revision surgery for failed ACL reconstruction. There was an average of 39 $(7\~120)$months from index procedure to the time of revision. Allografts were used in 14 $(78\%)$cases and autografts were used in 4 $(22\%)$cases and the revision procedures were assisted by arthroscopic technique. The majority of chief complaints were instability in 16 $(89\%)$cases. Sixteen $(89\%)$ cases had 1 previous reconstruction, 2 $(11\%)$ cases had 2. Before and after revision, patients were evaluated by Lachman test, pivot shift test, KT 2000, radiographs, Lysholm score and HSS score and subjective satisfaction. Results : Average length of followup was 27 $(12\~60)$months. Preoperatively, all cases were positive in Lachman test and pivot shift test. After revision the majority of cases were negative. Objectively improving stability was confirmed by KT 2000 and all average KT 2000 was 7.75 $(3.5\~12.5)$mm preoperatively and 2.36 $(1.0\~6.0)$mm at final followup. Lysholm score and HSS score were also improved from 72.6 $(66\~77)$ and 72.5 $(68\~78)$ preoperatively to 89.2 $(80\~92)$ and 88.2 $(81\~92)$ at final followup. Most $(89\%)$ of patients were satisfied with their results. The most common causes of failed ACL reconstruction were malposition of femoral tunnel in 11 $(61\%)$cases. Conclusion : Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.47-53
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• 2011

Purpose: As the number of the anterior cruciate ligament (ACL) reconstruction has increased, the incidence of revision of ACL reconstruction due to reconstruction failure has been also increased. Therefore, authors analyzed the reason of the failure of ACL reconstruction and the clinical result of the ACL revision. Materials and methods: From February 1998 to July 2010, we selected 36 cases which was followed at least 12months after the ACL reconstruction failure. Duration from reconstruction to revision, the average duration was 60 months (5~334) and on first reconstruction, we used allograft on 23 cases (63.9%) and autograft on 13 cases (36.1%). For the main symptom of ACL reconstruction failure, instability was the most common symptom, and 35 cases (97.5%) were undergone only one reconstruction and 1case (2.5%) was undergone two reconstruction. Clinical results were evaluated by Lysholm knee joint score, pivot shift test, and Telos device. Results: Average follow-up duration of the patients was 21 months (12~40), and the reason for the ACL reconstruction failure, trauma was most common by 19 cases (52.8%), malposition of the femoral tunnel was 13 cases (36.1%), malposition of the tibia tunnel was 1case (2.8%), and failure of osteointegration was 3 cases (8.4%). On performing the ACL revision, we used allograft on 34 cases (94%) and autograft on 2 cases (6%), and 21 cases accompanied injury of the meniscus (medial meniscus 14 cases, lateral meniscus 7 cases). Lysholm knee joint score was improved from 66.5 points, preoperatively to 92 points on last follow-up (p<0.01). In most cases, patients were satisfied (92%) with the operation results. Tegner activity score was also improved from 2.0 points preoperatively to 6.2 points on the last follow-up. On Lachman and pivot sift test, 33 cases and 30 cases were improved to grade I respectively, and on stability test using Telos device, the bilateral difference was improved from mean 15.5 mm preoperatively to 4.5 mm on the last follow-up. Conclusion: After 1 year follow-up, Revision of ACL had a little anterior instability but it showed satisfactory result on clinical result and patient's subjective satisfaction.

• 대한관절경학회:학술대회논문집
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• 2007.10a
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• pp.23-24
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• 2007

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.58-62
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• 2008

Posterior cruciate ligament reconstructions are dangerous procedure in terms of neurovascular complication. But deep vein thrombosis and associated compartment syndrome after posterior cruciate ligament reconstruction has not been reported, yet. We have experienced a patient who developed a deep vein thrombosis and compartment syndrome after revision posterior cruciate ligament reconstructive surgery, and report the importance of diagnosis and management with the discussions.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.123-131
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• 2005

The central third of the patellar tendon and hamstring tendons(semitendinosus and gracilis) are the most frequently used tissues for intra-articular replacement of the anterior cruciate ligament(ACL). At present, many surgeons consider the central third patellar ten don graft to be the gold standard for replacement of the ACL. Recent prospective studies by Marder et at and Aglietti et al, however, have failed to show any statistically significant differences in knee stability and functional outcome between central third patellar tendon grafts and hamstring tendon grafts. The review of this article is to (1) review the historical use of hamstring tendon grafts for ACL reconstruction; (2) discuss indications for use of hamstring tendon grafts for ACL reconstruction; (3) describe our present operative technique using a combined double-looped semitendinosus and gracilis graft with $RIGIDFIX^{circledR}$ and $INTRAFIX^{circledR}$ and (4) review the results of hamstring ACL reconstructions.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.44-49
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• 2013

Purpose: To compare of the results between anterior cruciate ligament (ACL) reconstruction alone and combined with high tibial osteotomy for ACL ruptured knees with varus alignment. Materials and Methods: We retrospectively reviewed 8 cases of ACL reconstruction combined with high tibial osteotomy (Group I) and 13 cases of ACL reconstruction alone (Group II) for varus angulated ACL ruptured knees (from March 2005 to February 2007). Mean age were 34.1 years (range: 20-53) in Group I, 34.9 years (range: 21-50) in Group II. Average follow up period were 22.6 months (range: 12-35) in Group I, 20 months (range: 13-33) in Group II. We analyzed clinical and radiological results. Results: There were no significant differences in clinical and radiologic results between two groups for IKDC scores, Lysholm knee scores, Lachman test, pivot shift test, KT-2000 arthrometer, $30^{\circ}$ and $90^{\circ}$ anterior drawer stress radiographs. Tegner activity scales and Cincinnati knee ligament rating scales were 4.9, 57.9 in Group I, and 5.6, 72.9 in Group II. Group I was statistically lower than Group II for Tegner activity scales and Cincinnati knee ligament rating scales (p<0.05). Conclusion: There were no significant differences in daily living between ACL reconstruction alone and combined with high tibial ostetomy for varus angulated ACL ruptured knees. However, ACL reconstruction combined with high tibial osteotomy could limit sport activity ability.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.203-208
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• 2006

Purpose: Previous transtibial double bundle posterior cruciate ligament (PCL) reconstruction methods have several problems in graft length and tibial fixation. We introduce new surgical method that is less restrictive by graft length and is more stable with single tibial fixation. Operative technique: After diagnostic arthroscopy, we prepare the graft, ream the tibial tunnel and perform the procedure for TransFix tibial fixation. Femoral 2 tunnel is made and graft is passed via anteromedial (AM) portal. Tibial fixation is done and femoral 2 graft is fixed sequentially at each knee position. Conclusion: TtransFix tibial single fixation method in double bundle PCL reconstruction provides more stable fixation, more free graft selection and prevents graft damage by passing the graft via AM portal.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.45-49
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• 2006

목적: 자가 골-슬개건-골과 슬괵건을 이용한 전방 십자 인대 재건술의 5년 중기 추시 결과를 비교 분석하고자 한다. 대상 및 방법: 전방 십자 인대 재건술을 시행한 후 5년 이상 추시 관찰이 가능한 65예를 대상으로 하였고, 골-슬개건-골이 38예, 슬괵건이 27예였다. 술 후 평가는 Lysholm 점수, 관절 운동 범위, 대퇴부 중간 부위 둘레 길이, Lachman 검사, 축 이동 검사, KT 2000 관절 계측기를 시행하였고, 술 후 합병증을 평가하였다. 결과: Lysholm 점수는 골-슬개건-골군과 슬괵건국에서 각각 평균 91점, 94.2점으로 슬괵건군이 우수하였고, 대퇴부 중간 부위 둘레 길이는 건측에 비해 각각 평균 1.7cm, 1.3cm의 차이를 보였다. 양 군간에 관절 운동 범위, Lachman 검사, 축 이동 검사 및 KT 2000 관절 계측 결과는 통계적으로 유의한 차이가 없었으나, 술 후 합병증은 과도한 보행이나 운동 후 슬관절 동통이 골-슬개건-골군에서 7예, 슬괵건 군에서 4예 관찰되었고, 전방 슬관절 동통이 골-슬개건-골군에서 4예 관찰되어, 골-슬개건-골군에서 더 많이 발생하였다. 결론: 5년 중기 추시에서 자가 슬괵건군이 우수한 슬관절 기능, 적은 합병증 등 임상적으로 우수하였으나 장기 추시가 요할 것으로 사료된다.