• Journal of the Korean Arthroscopy Society
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• v.7 no.1
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• pp.92-95
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• 2003

A 34-year-old man with ACL total rupture due to slip down injury, had received ACL reconstruction using autogenous hamstrings tendon with cross-pin femoral fixation. Postoperative course was as usual. But postoperative 3 months later, he complained posterolateral knee pain, recurrent effusion and mild instability. He was managed repeatitive aspiration and nonsteroid antiinflammatory drugs but was failed to relieve symptoms & signs. In CT scans, perforation of posteromedial femoral cortex of lateral femoral condyle was found. In second look arthroscopy, two pieces of broken femoral cross pin were found in between tibiofemoral Joint which was badly injured cartilage. We considered malposition of pins was the main cause of failure. We propose that femoral tunnel must be made more acute angle and femoral cross-pin guide must be positioned more external rotation 10-20 degree than transepicondylar axis made confirm the cross-pin tunnel position in order to avoid posterior cortex perforation and early failure.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.1
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• pp.175-184
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• 2018

The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.30 no.4 s.247
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• pp.457-464
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• 2006

The anterior cruciate ligament (ACL) is liable to a major injury that often results in a functional impairment requiring surgical reconstruction. The success of reconstruction depends on such factors as attachment positions, initial tension of ligament and surgical methods of fixation. The purpose of this study is to find isometric positions of the substitute during flexion/extension. The distance between selected attachments on the femur and tibia was computed from a set of measurements using a 6 degree-of-freedom magnetic sensor system. A three-dimensional knee model was constructed from CT images and was used to simulate length change during knee flexion/extension. This model was scaled for each subject. Twenty seven points on the tibia model and forty two points on the femur model were selected to calculate length change. This study determined the maximum and minimum distances to the tibial attachment during flexion/extension. The results showed that minimum length changes were $1.9{\sim}5.8mm$ (average $3.6{\pm}1.4mm$). The most isometric region was both the posterosuperior and anterior-diagonal areas from the over-the-top. The proposed method can be utilized and applied to an optimal reconstruction of ACL deficient knees.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.89-96
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• 2002

Purpose : The purpose is to analyze the relationship between bone bruise in MRI and associated injuries after the knee joint trauma. Materials and Methods : Total 50 cases were reviewed, divided into two groups according to initial trauma energy. High-energy group (group I), such as traffic accident was 13 cases, low-energy group (group II), such as sports trauma was 37 cases. The type of the lesion was used the classification by Costa-Paz. The site of lesion was analyzed according to femoral/tibial, medial/lateral and anterior/middle/posterior site respectively. Associated injuries were confirmed by physical examination, radiograph, MRI and arthroscopy. Results : In group I there was a various distribution of the bone bruise in the knee joint according to mechanism of injury. The bone bruise with ACL injury was 38$\%$ only and the most frequent type was Costa-Paz type I (52.6 $\%$). In group II more frequent locations were the middle portion of the lateral femoral condyle and the posterior portion of the lateral tibial condyle. Bone bruise associated with ACL injury, was upto 56.8 $\%$ and the frequent type were Costa-Paz type II (48 $\%$), in order type I (42 $\%$). As a result, in the high-energy injury the bone bruise had a various location in both condyle and less frequently associated injury, but in the low-energy injury there was particularly frequent location of bone bruise, associated injury and type. Conclusions : We could assess the associated injury by analysis of the location and type of bone bruise, especially in the low-energy injury, e.g. sports injury. But further study will be necessary with more case analysis.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.26-30
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• 2004

Purpose: We analyzed the clinical results of ACL(anterior cruciate ligament) reconstruction of chronic anterior cruciate ligament injuries with a fresh frozen Achilles allograft, retrospectively. Methods: Thirty-eight patients(average age 32.4 years) who had an chronic injury of ACL reconstructed with an Achilles allograft between January 1999 and February 2001 were included. The mean follow-up was 19.2(12-36) months. The clinical evaluation was done by range of motion, Lachman and pivot-shift test, KT-1000 arthrometer, Lysholm knee score, and the modified Feagin score. Results: All patients recovered full range of motion of affected knees. With use of Lachman and pivot-shift test data, thirty seven(97.4%) were functional. When comparing KT-1000, we found mean maximum side-to-side differences less than 2.1 mm. According to Lysholm knee score, mean postoperative score was 90.4. Thirty four(89.5%) had good to excellent results in modified Feagin score. Conclusion: Results of ACL reconstruction using fresh frozen Achilles allografts were comparable to autografts. ACL reconstruction with Achilles allograft could be a reasonable altemative to autografts.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.82-85
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• 2009

Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.2
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• pp.109-115
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• 2005

Purpose: The purpose of this study was to evaluate the effectiveness of three functional performance tests and one-legged hop test and to establish the reference data of the three functional performance tests of the active young Korean men. Materials and methods: We performed five tests on 40 normal subjects such as one-legged hop test (single hop, triple hop) and the three functional performance tests (carioca test, co-contraction test, shuttle run test). The mean age was 28.4 years. The mean score of Tegner activity scale was 6.2 and Lysholm score 98.2 Mean value and standard deviation were obtained. The correlation of age, height and weight with the results, the relationship between FPT and one-legged hop test and the mean difference between dominant and non-dominant limbs were statistically calculated. Results: All data obtained were normally distributed and there were no significant relationship between age, height and weight. The paired t-test of one legged hop test showed no statistical significance between dominant and non-dominant limbs. The results of one legged hop test had strong relationship with functional performance test. Conclusion; The three functional performance tests can be a useful functional test in ACL-insufficient athletes. Our results can be used as normal reference data of the normal active Korean men.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1461-1466
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• 2008

In the case of Posterior Cruciate Ligament (PCL), the most frequent mechanism is the dashboard injury, which is directly pressurized to the anterior of the proximal tibia in the state of the knee hyperflexion. The PCL associated ligament damage happens when the posterior injury, the varus, the valgus, the hyperextension and the severe vagus torque are out of the critical value of PCL. After the successful operation cases of Anterior Cruciate Ligament (ACL) reconstruction using the allograft were informed from 1986, a number of results kept over the maximum 10 years were reported. Unfortunately, PCL reconstruction are crowded the surgery techniques such as the graft, the tibia fixing method, the fixation device, the location of the femoral tunnel, the number of the graft bundles and PCL reconstruction to access to the stability of the normal joint is being developed. Therefore, this study is the basic research of these above facts. The current transtibial tunnel surgery using the cadaveric Achilles tendon grafts is chosen for the various PCL reconstruction. The initial extension of the Achilles tendon by the fixing device and its location under the cyclic loading, were observed.

• Korean Journal of Applied Biomechanics
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• v.33 no.2
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• pp.45-51
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• 2023

Objective: The aim of this study was to examine the effect of strength training targeting medial quadriceps/hamstrings and non-targeting strength training on dynamic balance. Method: A total of 51 healthy subjects were randomly assigned to control, targeting strength training, or non-targeting training groups. To measure the dynamic balance, the star excursion balance test (SEBT) was performed before and after training. The SEBT parameters were compared using repeated measures ANOVA, and post-hoc paired t test at a significance level of 0.05. Results: Greater anterior (p= .011), anteromedial (p= .001), medial (p< .001), lateral (p< .001), and anterolateral (p= .001) reach distances were found between pre- and post-training in the strength training targeting medial thigh muscles group. Only greater lateral reach distance was found after non-targeting strength training (p= .029). In addition, no differences were found for any SEBT scores in the control group. Conclusion: Strength training targeting medial quadriceps and hamstrings can improve the dynamic balance, thereby it positively affected in lower extremity injury risk, whereas non-targeting strength training rarely changes the dynamic balance.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.141-146
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• 2006

Purpose: This study was performed to analyze the mechanism and type of knee injury during soccer game and to evaluate the functional recovery after treatment. Materials and Methods: From October 2002 to January 2005, 49 patients were treated surgically. Mean age was 28.8 (8-36) years old, mean follow-up duration was 14.9 (8-36) months. Injury was evaluated by physical examination, radiography, and arthroscopic finding. Clinical results were evaluated with Lysholm score and Tegner activity score. Results: According to classification of the ligament injury, the incidence of single ACL injury was the most frequent and 27 cases. Injuries took place, in 2nd half of the games, and in the winter. Among the mechanism of injury, turn & twisting was 20 cases and the most frequent. The preoperative Lysholm score, Tegner activity score were 45, 2 and those of last follow-up were 87.6, 6, respectively. Conclusion: The recovery of Lysholm and Tegner activity score were good, but the sports activity was clearly decreased alter injury. It was suggested that appropriate physical & psychological rehabilitation and education were inevitable.