• Title/Summary/Keyword: 해부학적 재건술

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Tunnel Position for Anatomical Reconstruction of the Anterior Cruciate Ligament (해부학적 전방십자인대 재건술을 위한 터널의 위치)

  • Lee, Jin Kyu;Yang, Jae-Hyuk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.305-310
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    • 2020
  • The review provides updated concepts regard to the anatomy of the anterior cruciate ligament (ACL) footprints. The concept of anatomical ACL reconstruction, in which the graft is placed in the native ACL insertion area, has been introduced. However, there is still no consensus on the anatomical positioning of the femoral and tibial tunnel. In this study, authors review and update the literature regarding the tunnel position for anatomical ACL reconstruction.

Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술)

  • Kim, Jae-Hwa;Kim, Jung Ryul
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.132-139
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    • 2011
  • The concept of double-bundle ACL reconstruction was introduced recently to restore the anatomical and biomechanical functions of the native ACL. According to anatomical and biomechanical studies, the separate reconstruction of anteromedial and posterolateral bundle expect to increase the overall postoperative stability and clinical results compared to single-bundle ACL reconstruction. But there is still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the real advantages of double-bundle ACL reconstruction. The purpose of this article is to review the evidence to support double-bundle technique and to address controversies existing over the usefulness of this technique.

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Arthroscopic Double-Bundle Posterior Cruciate Ligament Reconstruction (관절경적 이중다발 후방십자인대 재건술)

  • Chun, Churl Hong;Kim, S.H.
    • 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.

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Anatomical Reconstruction of the Lateral Ankle Ligaments using Semitendinosus (반건양근 건을 이용한 족관절 외측 인대의 해부학적 재건)

  • Lee, Woo-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.19-23
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    • 2008
  • Purpose: Several methods of anatomical reconstruction for chronic lateral ankle instability has been reported to avoid the problems of nonanatomical reconstruction. Precise reconstruction of the normal anatomy is essential to the restoration of normal joint mechanics and stability. The problem with anatomical reconstruction is that it is very difficult to reconstruct the normal anatomic course of the ligaments. We thought making one tunnel at the fibular attachment of anterior talofibular ligament and calcaneofibular ligament was more anatomical than making separate tunnels for each ligaments because the two ligaments are contiguous. In this article, the basis of anatomical reconstruction of the lateral ankle ligaments was reviewed and a technique of reconstruction using semitendinosus was introduced.

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Clinical Results of Anatomical Single Bundle Anterior Cruciate Ligament Reconstruction Using Autogenous Quadriceps Tendon (자가 대퇴사두건을 이용한 해부학적 단일 다발 전방십자인대 재건술의 임상적 결과)

  • Park, Jin;Kim, Young Sin;Lee, Ju Hong;Wang, Seong Il;Park, Chan Ill
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.26-33
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    • 2012
  • Purpose: The purpose of this study was to evaluate the clinical outcomes and stability of anatomical single bundle anterior cruciate ligament reconstruction (SBACLR) with quadriceps tendon comparable to double bundle anterior cruciate ligament reconstruction (DBACLR). Materials and Methods: We retrospectively reviewed 28 consecutive patients (16 male, 12 female) who underwent SBACLR using quadriceps tendon from March 2009 (Group 1) and compared its clinical results to whom DBACLR with semitendinosus tendon for 53 patients (51 male, 2 female) from August. 2006 (Group 2). Mean age were 34.9 (range, 16-52) in Group 1 and 21.6 (range, 17-55) in Group 2. Mean follow up periods were 13.9 months (range, 12-20) in Group 1 and 36.2 months (range, 20-52) in Group 2. Lysholm score, International Knee Documentation Committee (IKDC) evaluation form and Tegner score were performed for evaluating the clinical outcome. Lachman test, pivot shift test and KT-1000 arthrometer (MEDmetric Corp., San Diego, CA, USA) were performed for stability. Results: There was no statistical significant difference between the two groups in terms of Lysholm score (Group 1: $85.9{\pm}2.6$, Group 2: $90.9{\pm}1.0$, P=0.226), IKDC score (P=0.345) and Tegner score (Group 1: $6.9{\pm}1.4$, Group 2: $7.1{\pm}1.3$, P=0.523). Nor was there statistical significance between the two groups in terms of KT-1000 arthrometer (Group 1: $1.5{\pm}1.1\;mm$, Group 2: $1.5{\pm}1.6\;mm$, P=0.457), Lachman test (P=0.547) and pivot shift test (P=0.073). Conclusion: Anatomical SBACLR with quadriceps tendon shows similar clinical outcomes and stability comparable to anatomical DBACLR with hamstring tendon.

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Clinical Outcomes after the Anatomic Single Bundle Anterior Cruciate Ligament Reconstruction Using Outside-in Technique (Outside-in 술기를 이용한 해부학적 단일 다발 전방십자인대 재건술의 임상적 결과)

  • Sohn, Myung-Whan;Kim, Jeong-Tae;Seo, Seung-Suk;Seo, Jin-Hyeok;Kim, Chang-Wan
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.18-23
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    • 2013
  • Purpose: The purpose of this study is to evaluate the usefulness of anatomical single bundle anterior cruciate ligament (ACL) reconstruction using outside-in technique by clinical outcome analysis. Materials and Methods: From July 2009 to July 2010, 41 cases of single bundle ACL reconstruction using outside-in technique which were followed minimum 1 year were enrolled. Clinical results were evaluated using International Knee Documentation Committee (IKDC) subjective knee evaluation score, Lysholm score, pivot shift test, one leg hop test, KT-1000 arthrometer test, Telos stress arthrometer test. Results: IKDC subjective knee score and Lysholm score were improved to $86.1{\pm}2.1$ and $91.2{\pm}3.8$ postoperatively (p<0.0001 and p<0.0001, respectively). KT-1000 arthrometer test and Telos stress arthrometer test also were improved to $2.2{\pm}0.9\;mm$ and $2.3{\pm}1.2\;mm$ (p<0.0001 and p<0.0001, respectively). Pivot shift test and one leg hop test revealed good results. Conclusion: Anatomical single bundle anterior cruciate ligament reconstruction using outside-in technique showed good clinical results, so it was considered available method.

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Clinical Review in Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술의 임상적 결과)

  • Lee, Ju-Hong
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.111-114
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    • 2009
  • Double-bundle anterior cruciate ligament reconstruction (DBACLR) has been developed to produce better clinical outcomes in traditional single-bundle reconstruction, which showed considerable rate of dissatisfaction in restoration of stability and function of the anterior cruciate ligament deficient knee. There is plenty of evidence that DBACLR has theoretical advantages in anatomical, biomechanical, biological, kinematical, and possibly clinical standpoint compared with traditional one but still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the substantial advantages of DBACLR. The purpose of this article is to review the clinical outcomes of double-bundle technique and to address controversy exists over the usefulness of this technique.

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Femoral Tunnel Drilling Techniques in Anterior Cruciate Ligament Reconstruction (전방십자인대 대퇴터널 형성을 위한 방법들과 각각의 장단점)

  • Lee, Sang Hak;Lee, Myeong Gu
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.311-317
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    • 2020
  • The most recent concept in anterior cruciate ligament reconstruction is an anatomical single bundle anterior cruciate ligament reconstruction. For an anatomical anterior cruciate ligament reconstruction, the tibial tunnel is made anterior than before, and the femoral tunnel is made in a lower and oblique direction compared to the classical method using the transtibial technique. The anteromedial portal technique, outside-in technique, and modified transtibial technique have been performed to produce femoral tunnels with anatomical positions. Each method has different advantages and disadvantages and is chosen based on the operator's preferences, experience, instruments, and implants.