• 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.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.06a
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• pp.1933-1936
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• 2005

The isometric area of the anterior cruciate ligament was calculated during knee flexion-extension. Flexion-extension motion data of the joint were obtained using Fastrak and a three-dimensional motion measurement system. A total of five subjects were seated on a flat table and the tibia sensor position was measured with the femur fixed on the table. A three-dimensional knee model was constructed using a graphic tool to simulate the knee motion. Twenty seven positions of the tibia region and forty two positions of the femur region were selected and the distances between the determined tibial and femoral points were calculated. Highly isometric areas were found and displayed as three dimensional aspects.

• 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 the Korean Arthroscopy Society
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• v.17 no.1
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• pp.88-94
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• 2013

Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

• Proceedings of the KSME Conference
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• 2003.04a
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• pp.929-934
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• 2003

Three dimensional joint motion data were obtained using precise magnetic sensors and X-ray. Six metal markers were inserted on the femur and the tibia to set the coordinate system. Two magnetic position sensors were used to record motion data and these positions were transformed into the knee motion. The quadriceps muscle was extended in an automatic manner by an extraction machine. Results of the knee motion were the same as the clinical data. The proposed method is found to be reasonable in describing the knee motion so that these motion data can be used to simulate the normal knee joint.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.66-72
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• 2004

Purpose: To evaluate the compensatory mechanism in vivo and develop the treatment guide by performing the comprehensive functional tests of the posterior cruciate ligament (PCL) deficient subjects. Material and Methods: 10 PCL deficient subjects and 10 healthy control group were evaluated. Performed functional tests were range of motion, posterior drawer test, Telos, 30$^{\circ}$ flexion wt-bearing view, KT-1000 arthrometer, gait analysis, EMG test and isokinetic tests. Results: Physical, KT-1000, Telos posterior tests showed significant differences, but 300 full weight bearing lateral view, muscle strength test revealed no difference between two groups. Less knee flexion at initial contact and reduced maximum valgus moment were observed in PCL deficient group. In vertical drop landing, PCL group had increased plantar flexion angle at initial contact. Conclusion: Compensatory mechanisms such as reduced unstable components and absorbing the maximal load of the joint were occurred after PCL insufficiency, which result in good clinical and functional outcomes. Further investigations would be needed to understand the functional adaptations of PCL deficient subjects.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.31-36
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• 2004

Purpose: We reviewed the effectiveness and the result of arthroscopic resection for ganglion cyst of posterior cruciate ligament(PCL) through the posterior trans-septal approach. Material and Method: Seven patients with symptomatic ganglion cyst of the PCL were treated with arthroscopic resection using posterior trans-septal approach. We analyzed advantages of the posterior trans-septal approach and presence of intra articular problem. Knee function was assessed using the lysholm knee scale. Results: The overall result for the 7 knees were very satisfied in all. We found that four of seven patients had intra articular problems, and past history of trauma could be found in 3 cases. The Lysholm knee scale was increased from average 93.3 points preoperatively to average 97.8 points postoperatively. Conclusion: Arthroscopic posterior trans-septal approach shows an effective technique for complete resection of cyst and evaluation of the combined posterior compartment injury.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.99-103
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• 2007

Purpose: To report the results of graft retention treatment for infection cases after anterior cruciate ligament(ACL) reconstruction. Materials and Methods: From a group of 511 consecutive ACL reconstruction patients, we report 5 who sustained septic arthritis. All patients underwent arthroscopic lavage, debridement, synovectomy with graft retention, and treatment with intravenous antibiotics. Results: All patients were evaluated at an average of 34 months after operation. The infection was successfully eradicated. No patient showed instability with KT-2000 arthrometer testing. The clinical outcome was inferior to normal ACL reconstruction patients. Two patients were graded as nearly normal and 3 patients were graded as abnormal with International Knee Documentation Committee evaluation form. Conclusion: There were no recurrences of septic arthritis or bone infection with graft retention treatment for infection patients after ACL reconstruction.

• 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 Veterinary Clinics
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• v.20 no.4
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• pp.443-448
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• 2003

To determine whether localization of tartrate-resistant acid phosphatase (TRAP) and cathepsin K was associated with rupture of the cranial cruciate ligament (CCL) in dogs. Tissue specimens were obtained from 30 dogs with CCL rupture during surgical treatment, 8 aged normal dogs, and 9 young normal dogs that were necropsied for reasons unrelated to this study and unrelated to musculoskeletal disease. The cranial cruciate ligament was examined histologically. $TRAP^+$ cells and cathepsin $K^+$ cells were identified by histochemical staining and immunohistochemical staining respectively. TRAP and cathepsin $K^+$ were co-localized within the same cells principally located within the epiligamentous region and to a lesser extent in the core region of ruptured CCL. Localization of $TRAP^+$ cells (P < 0.05) and cathepsin $K^+$ cells (P =0.05) within CCL tissue was significantly increased in dogs with CCL rupture, compared with aged-normal dogs, and young normal dogs (P < 0.05 - TRAP, P < 0.001 - cathepsin K). Localization of $TRAP^+$ cells and cathepsin $K^+$ cells within the CCL tissue of aged-normal dogs was also increased compared with young normal dogs (P < 0.05). Small numbers of $TRAP^+$ cells and cathepsin $K^+$ cells were seen in the intact ligaments of aged-normal dogs, which were associated with ligament fasicles in which there was chondroid transformation of ligament fibroblasts and disruption of the organized hierarchical structure of the extracellular matrix. $TRAP^+$ cells and cathepsin $K^+$ cells were not seen in CCL tissue from young-normal dogs. Localization of the proteinases $TRAP^+$ and cathepsin $K^+$ in CCL tissue was significantly associated with CCL rupture. Small numbers of proteinase positive cells were also localized in the CCL of agednormal dogs without CCL rupture, but were not detected in CCL from young-normal dogs. Taken together, these findings suggest that the cell signaling pathways that regulate expression of these proteinases in CCL tissue may form part of the mechanism that leads to upregulation of collagenolytic ligament remodeling and progressive structural failure of the CCL over time.