• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.115-120
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• 2002

Purpose : To compare the functional evaluation with the posterior translation after arthroscopic PCL reconstruction in isolated and combined PCL-deficient knees. Materials and Methods : We retrospectively evaluated 45 patients with PCL-deficient knees who were treated by arthroscopic PCL reconstruction using Achilles tendon allograft from June 1994 to June 2000. The differences of posterior translation were measured with posterior stress lateral radiographs and KT-2000 arthrometer. The functional results were evaluated using the Lysholm knee score and IKDC evaluation form. Results : Preoperative mean side to side differences of the posterior translation were 11.83 mm in isolated PCL-deficient knees and 12.7 mm in combined PCL-deficient knees respectively. At the last follow-up in isolated and combined PCL-deficient knees, the mean radiographic side to side differences of the posterior translation were 6.38 mm and 6.7 mm, the average corrected 20 Ib posterior displacements using KT-2000 arthrometer were 3.5 mm and 4.1 mm, the mean Lysholm score were 87.4 and 81.2, the grade A and B of IKDC evaluation form were 16 cases $(88.9\%)$ and 23 cases $(85.2\%)$, respectively. Conclusion : The functional results had no relationship with the degree of posterior translation after arthroscopic PCL reconstruction. Tendency of posterior translation may be influenced by associated injury of the knee.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.187-191
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• 2006

Few cases have been reported in which the femoral interference screw has migrated into the posterior compartment after an ACL reconstruction. It usually requires removal, because it leads usually to mechanical symptom. However, the arthroscopic removal of a screw is a technically demanding procedure, especially in the case of an intact integrated ACL graft or one that is encapsulated around the screw. We present a case in which a displaced femoral interference screw migrated within the posterior compartment 11 years postoperatively, after the graft had been successfully incorporated at the femoral site and showed good continuity on MRI and arthroscopic examination. Although it is often technically challenging, through the use of a posterior trans-septal portal, we can successfully remove a displaced femoral interference screw even in the most difficult locations in the posterior compartment without damage to ACL graft.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.117-121
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• 2007

Purpose: The purpose of this study is to evaluate the results of arthroscopic primary repair of a posterior cruciate ligament(PCL) avulsion injury without bony fragment at the femoral attach site. Materials and Methods: From Jan. 1993 to Dec. 2002, we performed 10 cases of PCL repair by arthroscopic suture technique. The mean follow-up period was $38.7{\pm}11$ months and the mean age of the patients was $28.2{\pm}6$ years old. 8 cases were men. 2 cases were women. At last follow-up, all cases were evaluated with the Lysholm and Gillquist knee rating system and International Knee Documentation Committee criteria. Posterior tibial displacement on stress lateral radiograph and posterior instability with posterior drawer test were measured also in all cases. Results: The mean Lysholm and Gillquist score was $94.5{\pm}2.6$. 4 cases were IKDC A(normal) and the other 6 cases were IKDC B(nearly normal). Posterior instabilities by posterior drawer test were grade I in 5 cases and grade II in 5 cases. A mean posterior translation of tibia was $3{\pm}2.3$ mm on stress lateral radiographs. Conclusion: Arthroscopic primary repair of PCL avulsion without bony fragment at the femoral attach site is one of the useful methods that reduce the posterior instability and improve the functional outcomes.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.102-108
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• 2009

Purpose: The purpose of this study is to report a result of the technique that reconstruct posterior cruciate ligament (PCL) and posterolateral corner (PLC) simultaneously using a fresh-frozen Achilles tendon allograft. Materials and Methods: Forty two patients (45 legs) underwent PCL and PLC reconstruction were included. There were 38 males and 4 females. Mean age was 39 years. Used graft was a fresh frozen Achilles tendon allograft, which was divided by two size, larger one (${\emptyset}$ 10 mm) for PCL reconstruction and smaller one (${\emptyset}$ 8 mm) for PLC reconstruction. Arthroscopic reconstruction of the PCL was performed using transtibial, single incision, and single bundle technique with 10mm fresh frozen Achilles allograft tendon first. After PCL reconstruction, reconstruction procedure for posterolateral instability was performed using modified figure of "8" technique using smaller gtaft. For clinical evaluation, range of motion, posterior drawer test, varus stress test, prone external rotation (dial) test, Lysholm score, Tegner activity scale and posterior stress radiograph were used. Mean follow up period was 25 months. Results: Preoperatively posterior drawer test was 5 cases in grade II and 40 cases in grade III posterior instability. At final follow-up 22 cases returned within normal condition, 18 cases grade I and 5 cases grade II posterior instability. Though all patients showed positive result over 10 degrees in dial and varus stress test preoperatively, but only 9 cases showed positive both test at final follow-up. The range of motion deficit over $10^{\circ}$ flexion was 3 cases. Lysholm score was improved from mean 50 preoperatively to mean 83(p<0.05) and Tegner activity scale improved from mean 2.1 preoperatively to mean 4.6(p<0.05). In posterior stress radiographs, posterior displacement was improve from mean 16mm preoperatively to 4.1mm after treatment(p<0.05). All patients had improved compared to their pre-operative status as measured by physical examination such as posterior drawer test, varus stress test, dial test. Conclusion: We had successful results by combined reconstruction of the PCL & PLC with a fresh frozen Achilles tendon allograft in patients with PCL and posterolateral rotatory instability at a time.

• 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 radiological science and technology
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• v.33 no.2
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• pp.93-96
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• 2010

This study evaluates usefulness of the developed assistant device by taking projection of patellofemoral joint in emergency patients who were doubt posterior cruciate ligament injury in knee joint. The subjects of experiment were patients who visited Eul-Ji University Hospital due to knee injury from January 2006 to December 2006. Seventeen patients, who took the Knee post stress view, Knee merchant view, Knee Seo's view to use assistant device and Knee MRI. To make assistant device of $170{\times}50{\times}70\;cm$, we evaluated its usefulness by measuring posterior dislocation of tibia. Seo's view is more accurate to make judgment of posterior cruciate ligament injury than original knee post stress view. Interval difference of posterior dislocation of original knee post stress view is $6.17{\pm}3.04$ and Seo's view is $8.74{\pm}4.47$. The results show injury of patellofemoral joint, vertical fracture of patella and posterior cruciate ligament injury by taking a projection using Seo's view. Therefore, it is useful to take projection earlier than talometer and MRI in emergency patients who were doubt posterior cruciate ligament injury in 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.5 no.2
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• pp.80-84
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• 2001

Purpose : To evaluate the clinical and radiological results of posterior cruciate ligament reconstruction(PCL) by tibial inlay technique. Materials and Methods : Twenty four patients(25 cases), who underwent reconstruction of posterior cruciate ligament by tibial inlay technique and were followed up for at least 2 years, were reviewed retrospectively. Mean age at operation was 35 years and mean period of follow up was 34 months. Clinically Lysholm knee socre, posterior drawer test and step off sign were evaluated. Instrumented posterior laxity test with $Telos^{\circledR}$ device(Telos stress device; Austin & Associates, Inc., Polston, US) was performed. Results : Lysholm knee score was improved from 56.9 points preoperatively to 94.6 points at fellow up. Posterior drawer test showed grade II instability in 1 case, grade III in 18 and Grade IV in 6 preoperatively and improved to grade I In 12, grade II in 10 and grade III in 3 at follow up. Step off signs were changed from -10mm in 6 cases, -5mm in 18 and flush in 1 preoperatively to -5mm in 3, flush in 10 and +5mm in 12 at follow up. Side to side difference of instrumented posterior laxity test was improved front 13.6mm preoperatively to 4.3mm at follow up. Conclusions : PCL reconstruction by tibial inlay technique is considered to be a good treatment method to restore posterior stability of the knee, which could result in satisfactory clinical and radiological results at more than 2 years' follow up.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.121-125
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• 2002

Purpose : The purpose of this study was to assess the clinical outcomes and radiological changes of arthroscopic augmentation with synthetic polyester ligament for posterior cruciate ligament injury Materials and Methods : The assessment was made among 60 patients who underwent arthroscopic augmentation with synthetic polyester ligament (ABC ligament, Surgicraft, U.K.) into the substance of ruptured PCL proper under the arthroscopic control from January, 1990 to January, 1996 and whose follow-up period was more than 5 years (average 7.8 years). The results were analyzed by using the posterior stress radiographs by Telos stress device, KT-2000 arthrometer and the clinical assessment by using Lysholm knee score. Results : The average difference of posterior displacement on stress radiographs were 13.2 mm preperatively and 3.6 mm at last follow up. Both knee showed minimal difference on KT-2000 arthrometer (0.7 mm on 20 lb) at the last follow-up. The mean Lysholm knee score was 49.2 preoperatively and improved to 84.3 post-operatively. Conclusion : Authors observed that long-term results of arthroscopic augmentation with synthetic polyester ligament for PCL injury were similar with those using human allograft. Taking these results into consideration, the synthetic polyester ligament is assumed to be a method of treatment of the PCL injury.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.139-146
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• 2008

Purpose: The purpose of this study is to introduce the double bundle posterior cruciate ligament(PCL) reconstruction using Achilles allograft by the tibial inlay method and evaluate the clinical results of 11 cases who had PCL reconstruction using this method and were followed for more than 2 years after surgery. Materials and Methods: Our series consists of 11 cases of PCL reconstruction due to chronic posterior instability of knee and acute PCL rupture. The clinical results were assessed using the IKDC(International Knee Documentation Committee) scoring system, posterior stress radiographs and the maximum posterior displacement using a KT-1000TM arthrometer. Results: The average preoperative posterior displacement in 90 degree flexion stress radiograph was measured 13.4 mm and in 10 degree flexion the average posterior displacement using the KT-1000TM arthrometer was measured 11.4 mm. Postoperatively the 13.4 mm reduced to 4.4 mm and the 11.4 mm reduced to 3.9 mm. According to IKDC scoring system, 9 cases(81.8%) were satisfied. One case showed limitation of flexion with mild stiffness in the knee and another one case was not improved the posterior instability sufficiently and no complication of allograft was noticed. Conclusion: The double bundle PCL reconstruction using Achilles allograft by the tibial inlay method is a useful method for acute PCL rupture and chronic posterior instability of the knee including failed PCL reconstruction, because it will also make the posterior stability in the extension and 90 degree flexion position, and avoid the grafted tendon abrasion by acute turn of tibial tunnel.