• 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.6 no.1
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• pp.45-49
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• 2007

Purpose: We analyzed the location and type of meniscus tear associated with ACL rupture in order to estimate and prepare whether the meniscus tear is in a repairable location. Materials and Methods: We reviewed 78 cases who had ACL reconstructive surgery due to ACL rupture. We set the period of acute injury on the basis of under 12 months after trauma. The location and type of meniscus tear was analyzed in accordance with MRI findings and arthroscopic findings. Results: The 50 cases of meniscus tear were detected out of the 78 ACL rupture;32 cases were lateral meniscus tears, 24 were medial meniscus tears and 6 cases were both menisci tears. From a total of 56 meniscus tears, 30 cases were longitudinal tears, 22 cases were red-red zone tears and 35 cases(62%) were posterior horn tears. Conclusion: The most common type of meniscus tear associated with ACL rupture war longitudinal tear at the red-red zone or meniscosynovial junction. Majority of the tears located at that place can be healed with conservative treatment, arthroscopic meniscus suture.

• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.54-56
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• 2014

A 9-year-old Korean native cattle was referred with chief complaint of left hind limb lameness during 2 months. He could not bear a weight on the left hind limb. On palpation, the stifle joint was swollen and mild fever was felt. In X-ray images, increased joint fluid, subchondral bone erosions, osteophyte formation along the trochlear ridge, and changes in the shape of the infrapatellar fat pad were shown. Cranial displacement of the tibia and intercondylar eminence could be seen. Based on the history, physical examination and radiographic findings, the bull was diagnosed as anterior cruciate ligament rupture. Because he could not participate in further bullfighting competition anymore, we indicated the slaughter as soon as possible.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.91-96
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• 1999

Purpose : The purpose of this study is to compare the clinical and radiologic results of the anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone unit with doubled semitendinosus and gracilis tendons. Materias and Methods : Clinical results of ACL reconstructions which were performed in 47 patients using doubled semitendinosus and gracilis were compared with those performed in 45 patients using bone-patellar tendon-bone autograft. There were no differences in preoperative parameters(age, sex, instability). Average follow-up period were 17 months and 19 months each. Results : There were no significant differences between two groups in functional results (Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parapatellar complication, especially anterior knee pain after long distance walking or exercise and quadriceps weakness less occurred in hamstring tendon group than in bone-patellar tendon-bone group. Conclusion : Although there were no significant differences in clinical results of ACL reconstruction using bone-patellar tendon-bone autograft and doubled semitendinosus and gacilis, parapateller complications occurred more in the bone-patellar tendon-bone autograft group than in the doubled semitendinosus and gracilis group. It is thought that the careful selection of patient, achivement of skillful technique and active rehabilitation are important to prevent the parapatellar complications.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.28-34
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• 2010

Purpose: The aim of this study was to evaluate short-term clinical results and second-look arthroscopic findings after double-bundle anterior cruciate ligament (DB ACL) reconstruction. Materials and Methods: Forty-nine patients, who were followed up for at least 24 months after DB ACL reconstruction, were included. Clinical results, such as, Lysholm knee and Tegner activity scores, and manual laxity and instrumented anterior laxity test results were evaluated. In fifteen patients (15 knees), second-look arthroscopy with staple removal was performed. At second-look arthroscopy, the authors assessed about reconstructed ACL rupture, subjective graft tension and extent of synovial coverage. Results: Lysholm knee scores significantly improved from 67.4 preoperatively to 96.1 at last follow-up (p<0.01). Tegner activity scale improved from 2.0 to 6.1. The Lachman test, at last follow-up, showed normal laxity in 39 (of 49) patients, and the pivot-shift test showed normal laxity in 36 (of 49) patients. Mean side-to-side differences improved significantly from 10.8 mm to 3.3 mm (p<0.01). Second-look arthroscopic findings showed that all patients had a normal or a near normal anteromedial bundle. However, 8 patients (53.3%) were found to have partial or complete posterolateral bundle rupture. Conclusion: Even though double-bundle ACL reconstruction was clinically effective means of restoring knee rotational and anteroposterior stabilities, there were some ruptured posterolateral bundles observed in cases under arthroscopy after double-bundle ACL reconstruction.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.1
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• pp.33-36
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• 2008

Purpose: The purpose of this study was to evaluate the mechanism of injury in the anterior cruciate ligament tears sustained in participation in soccer. Materials and methods: 50 patients whose knees were injured during playing soccer were enrolled in this study. The mean age was 27 years old, 47 were male and 3 female. 15 of them were either professional or amateur soccer players, the rest were non-professional. The injury mechanism was investigated by evaluation of the medical records or by telephone interview. Results: The injury mechanism involved contact injuries in 17 patients and non-contact in 33. 41 patients were bearing weight on the involved side at the time of injury, and 9 patients were not. In cases of contact injury, 9 of the 17 patients had sustained a valgus force to the knee, and 5 patients had varus force, 11 patients had their foot planted, and 6 did not. Among those patients with a planted foot, 3 patients were injured by the rotation of the thigh, 1 patient was injured by hyperextension, and there were no deceleration mechanism injuries. In non-contact injuries, 30 out of 33 patients had their foot planted at time of injury and only 3 patients did not. Of these 30 patients, 16 were injured by the rotation of thigh, 6 sustained a varus force on the knee joint and 5 had a valgus force, 5 were injured by hyperextension, and 2 by deceleration. 3 patients, who did not have their foot planted, were injured while kicking with the involved leg. Conclusions: For soccer players in this series, the most common mechanisms resulting in anterior cruciate ligament tears were non-contact, most often by rotation of the torso over a planted foot. In contact injuries, the most common mechanism was the application of valgus force by tackle.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.150-155
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• 2002

Purpose : The purpose of this study was to evaluate the clinical results of meniscal repair using the bioabsorbable devices. Materials and Methods : From 1998, 21 meniscal repairs were underwent using the bioabsorbable devices and followed more than 1 year. The Meniscus $Arrow^{\circledR}$(Bionx) and the Meniscal $Fastener^{\circledR}$(Mitek) had been applied. The indication for meniscus refixation was an unstable longitudinal tear in the posterior horn of the medial or lateral meniscus. Concurrent ACL reconstruction with meniscal repair was performed on 9 knees. The clinical result was evaluated using Lysholm knee score. Result : The average Lysholm knee scores for all patients improved from 56 preoperatively, to 89 postoperatively. The type of the device were not significantly related to clinical outcome or Lysholm knee score. But the concurrent ACL reconstruction group and the patients treated within 8 weeks had better clinical result than the others. Conclusion : The all-inside meniscal repair technique using bioabsorbable devices can be considered to be an useful method in the well selected patients and concurrent ACL reconstruction surgery.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.92-98
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• 2007

Purpose: We evaluated the clinical results of arthroscopic ACL reconstruction using quadrupled hamstring tendon with tibial remnant-preserving technique. Materials and Methods: Thirty-five cases were evaluated from Feb, 2003 to May, 2006. The average interval from injury to surgery was $2.6{\pm}1.6$ months. The cause of injury was mostly sports-related trauma. The average follow-up period was 17 months. Tibial remnant was preserved as much as possible and caution was taken not to damage the remnant during ACL reconstruction. Postoperative rehabilitation was the same as the usual rehabilitation method after ACL reconstruction, except for delaying motion for 2 weeks with an extension locking brace. Clinical evaluation was performed using ROM; Lachman test; pivot-shift test; anterior displacement measurement using KT-2000 arthrometer; Lysholm score and proprioception measured by single limb standing test. Results: There was no limitation of knee motion without contracture. The Lachman test and pivot-shift test were both negative. The side-to-side difference of anterior displacement measured using KT-2000 arthrometer was improved from 6.7 mm to 2.2 mm. The average Lysholm score improved from 81 to 96. The single limb standing test for proprioceptive evaluation showed no significant difference from a normal leg. Conclusion: ACL reconstruction with tibial remnant-preserving technique can preserve mechanoreceptors with prorioception and expect good functional recovery.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.107-113
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• 2012

Purpose: The purpose of this study was to evaluate the posterior cruciate ligament (PCL) reconstruction with single bundle, single-incision technique using Achilles tendon and tibialis anterior allograft with ligament remnant preservation. Materials and Methods: Twenty six patients underwent PCL reconstruction was included. There were 21 males and 5 females. Mean age was 32 years. Used graft was a fresh frozen Achilles tendon allograft (group I, 14 cases) and tibialis anterior allograft (group II, 12 cases). Arthroscopic PCL reconstruction was performed using transtibial, single-incision and single bundle technique with remnant preserving as possible. For clinical evaluation, range of motion, posterior drawer test, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and posterior stress radiograph were used. The mean follow-up period was 21.6 months (12-40 months). Associated injuries were 5 medial collateral ligament injuries, which were treated by conservative method. Results: Range of motion (ROM) was returned to normal range in 24 cases, but ROM deficit under $10^{\circ}$ flexion was 2 cases at final follow-up period. Preoperative posterior drawer test was 17 cases in grade II and 9 cases in grade III. At final follow-up 13 cases returned within normal grade, 7 cases grade I and 6 cases grade II posterior instability. Lysholm mean score was improved from preoperatively 62 to 90 at final follow-up period. Tegner activity mean scale improved from preoperatively 3.5 to 5.6 at final follow-up period. IDKC grade was grade A was 3 cases, grade B 17 cases, grade C 6 cases. In posterior stress radiograph, posterior displacement was improved from mean 12 mm preoperative to 4.5 mm at final follow-up. There were no statistical differences between two groups in clinical evaluations. There were two cases of re-rupture of graft at the bone-tendon junction in group I. Conclusion: We had successful results of PCL reconstruction with single-incision, single bundle technique using Achilles and tibialis anterior allograft without difference between two groups in patients with PCL injury. There were more re-rupture of graft in Achilles tendon group.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.63-68
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• 2007

Purpose: The authors introduce a new technique of arthroscopic all inside repair using anterolateral and anteromedial portals for lateral meniscus root complete radial tear in patients who underwent concurrent anterior cruciate ligament (ACL) reconstruction. Operative technique: Arthroscope is placed through anteromedial portal and suture hook ($Linvatec^{TM}$, Largo, Florida, USA) is delivered through anterolateral portal. By rotating the suture hook, it penetrates posterior horn of the torn meniscus from femoral to tibial surface for vertical orientation. PDS No. 1 ($Ethicon^{TM}$, Somerville, NJ, USA) is delivered through the suture hook, and then it is withdrawn. Both end of PDS No. 1 are taken out through the anterolateral portal. MAXON 2-0 ($Syneture^{TM}$, Norwalk, Connecticut, USA) is used to penetrates remnant of tibial attachment of the torn meniscus from tibial to femoral surface in a same manner. MAXON 2-0 is changed for PDS No. 1 from tibial to femoral surface by shuttle relay technique. PDS No. 1 is tied using SMC (Samsung Medical Center) knot. Conclusion: All inside repair is a useful technique to achieve anatomical repair and to restore the hoop tension in lateral meniscus root complete radial tear.