• Title/Summary/Keyword: ACL Reconstruction

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Development of an ACL Anchor: Effects of the Design Parameters on the Performance of a New Anterior Cruciate Ligament Fixation Device

  • Kim, Jong-Dae;Oh, Chae-Youn;Kim, Cheol-Sang
    • Journal of Biomedical Engineering Research
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    • v.29 no.2
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    • pp.132-138
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    • 2008
  • We investigated the biomechanical properties of a newly designed self-expansion type anterior cruciate ligament (ACL) anchor. The ACL anchor consists of the ring section giving the elastic force, the wedge for maintaining in contact with the femur tunnel wall and the link suspending hamstring graft or artificial ligament. The main design parameters that determine the performance of this device were the expansion angle (${\theta}$) and the thickness ($t_R$). The Ti6Al4V anchors were heated after inserting in a jig for 1 hour at $800^{\circ}C$ in a protective argon gas atmosphere and allowed to cool to room temperature in the furnace. In order to investigate the influence of the expansion angle and the thickness of the ring on the biomechanical properties of the anchor, the maximum pull-out load, stiffness and slippage of the ACL anchor were measured using the pull-out tester, and statistical analyses were also executed. The present results showed that the design parameters gave a significant effect on the performance of the self- expansion type of anchor. The pull-out load of the ACL anchors significantly increased as the thickness of the ring section was increased, having a similar trend for both expansion angles. The ACL anchor showed about 2.5 times higher values of the pull-out load than that of the minimum load (500N)required for the "accelerated rehabilitation". The optimum ${\theta}$ and $t_R$ values of this ACL anchor were suggested to have sufficient resistance against the pull-out force, high stiffness and relatively low slippage after ACL reconstruction.

Measurement of the Grafts for the Anterior Cruciate Ligament Reconstruction with Tension Load Technique and Achilles Tendon Autograft using Postoperative Magnetic Resonance Imaging (자가 아킬레스 건과 장력 부하 기법을 이용한 전방십자인대 재건술 후 자기 공명 영상을 이용한 이식건의 평가)

  • Seo, Jai-Gon;Moon, Young-Wan;Yoo, Jae-Chul;Chang, Moon-Jong;Kim, Seung-Yeon;Kim, Mu-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.191-197
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    • 2008
  • Purpose: To evaluate the postoperative magnetic resonance image (MRI) findings of anterior cruciate ligament (ACL) reconstructed with a tension load technique using auto-Achilles tendon, and to compare the results with knees with a native ACL. Materials and Methods: We evaluated 21 postoperative MRI scan of 21 patients (group A) who had undergone ACL reconstruction between January 1995 and November 1996. The control group (group B) consisted of 50 patients whose meniscus tear had been operated by arthroscopy and whose ACL was intact. We measured the orientation of the graft in the sagittal and coronal planes and compared it with that of the native ACL. Results: The mean sagittal angle of the ACL angle in group A ($55.7{\pm}5.6^{\circ}$, range $47.2{\sim}68.8^{\circ}$) was statistically lesser than group B ($58.7{\pm}3.8^{\circ}$, range $50.4{\sim}67.5^{\circ}$) (p=0.036). But there was no statistically significant difference between the two groups with regard to the mean ACL-Blumensaat line angle (group A: $8.1^{\circ}{\pm}4.9^{\circ}$, range $1.7^{\circ}{\sim}22.0^{\circ}$, group B: $8.6^{\circ}{\pm}3.6^{\circ}$, range $2.6^{\circ}-18.1^{\circ}$) and the mean coronal angle of the ACL (group A: $64.9^{\circ}{\pm}9.1^{\circ}$, range $46.9^{\circ}{\sim}76.4^{\circ}$, group B: $65.9^{\circ}{\pm}4.4^{\circ}$, range $57.7^{\circ}{\sim}75.2^{\circ}$)(p=0.88, p= 0.62). In the sagittal plane, the mean center of tibial insertion of the ACL graft in group A ($31.9{\pm}7.1%$, range 22.4-47.9%) was positioned more anteriorly than group B ($37.0{\pm}4.9%$, range $18.5{\sim}44.7%$)(p=0.005). But in the coronal plane, there was no statistically significant difference between the two groups(group A: $46.3{\pm}2.8%$, range $42.1{\sim}52.5%$, group B: $45.7{\pm}2.8%$, range $41.0{\sim}49.1%$)(p=0.392). Conclusion: We performed an ACL reconstruction with the tension load technique using auto-Achilles tendon and we found that the graft orientation in MRI was as good as that of the native ACL.

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Radiofrequency thermal Shrinkage for Elongated Anterior Cruciate Ligament after Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술 이후 이완된 전방십자인대에 시행한 고주파 에너지 열 수축)

  • Kim, Yeung-Jin;Chun, Churl-Hong;Kim, Tae-Kyun;Yang, Hwan-Deok;Kim, Hyoung-Joon;Kim, Young-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.27-32
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    • 2008
  • Purpose: To evaluate the clinical results of the patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity after ACL reconstruction. Material and Methods: From October 1999 to March 2006, we performed 133 cases of ACL reconstruction. Among them we experienced 16 patients who had the laxity of reconstructed ACL in second look arthroscopy. Mean follow-up was 20.4 months. Mean age was 33.5 years. 12 cases were male and 4 cases were female. The elongated ACL were treated by bipolar radiofrequency energy with an output of grade II. Subjective and objective parameters were utilized in analyses, such as: the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test, IKDC score. Wilcoxon signed-rank test was used to perform the data analysis. P<0.05 was considered to be statistically significant. Results: Postoperative mean Lysholm knee score (preop: $82.2{\pm}5.2(77{\sim}85))$ (P=0.04), postop: $85.2{\pm}4.8$(82-90)) and anterior displacement by the Telos stress test (preop: $5.4{\pm}4.6(3{\sim}10)mm$, postop: $2.1{\pm}1.9(0{\sim}4)mm)$ (P=0.02), Lachman's test, and IKDC scores (P=0.04) demonstrated significant differences statistically compared to the preoperative. There were no statistical differences in mean range of motion, Tegner activity scale. Conclusions: Arthroscopic shrinkage for the ACL laxity after ACL reconstruction with radiofrequency device showed good clinical results and was applicable operative technique.

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The effects of functional movement recovery of physical therapy after ACL reconstruction with MCL injury (물리치료가 슬관절 내측측부인대 손상을 동반한 전방십자인대 재건술 후 운동기능 회복에 미치는 영향)

  • Kim, In-Sup;Lim, Weon-Sik;Vae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.27-37
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    • 2002
  • This is the study of the knee joint injured patients at the orthopaedic surgery clinic where is located in Daejon, who has MCL combine injured ACL reconstruction caused by sport activity and accident during the period from Jan. 2001 to Oct. 2001. By comparing with groups between 7th case of I-group for MCL combined stitch and II-group for ACL reconstruction since 6weeks cast. We have been concluded with that following results. 1. Range of motion for the knee was not limited at 5th case(37%) of I-group, 6th case(42%) of II-group and the cases of Flexion deficit less then 10 -degree were 2nd case(13%) of I-group and II-group 1st case(8%) with no extension deficit more then 5 -degree. 2. The level of activity that tells you whether you are capable of exercise for six month after operation. It han been divided by 3 levels. The case of capable of doing low risk exercise(swimming, cycling, etc.) was 5th case of I-group, the case of capable of doing medium risk exercise(jogging, etc.) was 3rd case of I-group and 4th case of II-group and the case of capable of doing high risk exercise(football, etc.) were 3rd case of I-group and 3rd case of II-group. 3. The timing of the return to their job were average 6.4 weeks for I-group and average 22.9 weeks for II-group(P<.05, statistical difference). 4. There was no statistical difference between I-group and II-group for the timing of the return to their job(P>.05). 5. By using VAS to compare them there was no statistical difference between I-group and II-group of clinical results according to Lysholm scale.

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Failure of Cross-Pin Femoral Fixation after Anterior Cruciate Ligament Reconstruction - A Case Report - (전방십자인대 재건술후 대퇴골 경골핀 고정의 실패 - 증례보고 -)

  • Lee Kee-Byoung;Kwon Duck-Joo;Ji Yong-Nam
    • 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.

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Rigidfix 와 Infrafix 로 고정한 슬괵건을 이용한 전방 십자인대 재건술 후 경골터널의 확장

  • Choi, Nam-Hong;Jung, Yoo-Hoon
    • 대한관절경학회:학술대회논문집
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    • 2009.10a
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    • pp.153-153
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    • 2009
  • The purpose of this study was to evaluate tibial tunnel widening prospectively after anterior cruciate ligament (ACL) reconstruction with hamstring tendon grafts using Rigidfix (DePuy Mitek, Raynham, MA) femoral fixation and Intrafix (DePuy Mitek) tibial fixation. 56 consecutive patients who underwent ACL reconstruction with a minimum of 2 years' postoperative evaluation were reviewed. On the anterior-posterior (AP) and lateral radiographs, the diameter of the tibial tunnel was measured at proximal, middle, and distal positions and the shape of the tibial tunnels were classified. Tunnel widening was defined as widening of greater than 2 mm. Group I was defined as cases with no tunnel widening and group II defined as cases with tunnel widening. Postoperative laxity evaluations were performed using Lachman test, pivot-shift test, and Instrumented laxity testing using the KT-1000 arthrometer. On the AP radiographs, the average diameter of the tibial tunnel increased 8.8% at 6 months and 8.5% at 12 months postoperatively compared to the immediate postoperative day. On the lateral radiographs, the average diameter of the tibial tunnel increased 7.2% at 6 months and 8.1% at 12 months year postoperatively compared to the immediate postoperative day. The tunnel shape evaluation revealed predominantly linear type in 53 patients (95%). Group I was 42 patients (75%) and group II was 14 (25%). The average KT-1000 measurement was 1.0~1.8 mm in group I and 2.1~2.8 mm in group II (p>0.05) The Lachman and pivot-shift showed tests no significant differences between the two groups. In conclusion, hamstring ACL reconstruction using Rigidfix and Intrafix fixation showed less widening of the tibial tunnels than observed in previously published studies.

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ACL-GAN: Image-to-Image translation GAN with enhanced learning and hyper-parameter searching speed using new loss function (ACL-GAN: 새로운 loss 를 사용하여 하이퍼 파라메터 탐색속도와 학습속도를 향상시킨 영상변환 GAN)

  • Cho, JeongIk;Yoon, Kyoungro
    • Proceedings of the Korean Society of Broadcast Engineers Conference
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    • 2019.11a
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    • pp.41-43
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    • 2019
  • Image-to-image 변환에서 인상적인 성능을 보이는 StarGAN 은 모델의 성능에 중요한 영향을 끼치는 adversarial weight, classification weight, reconstruction weight 라는 세가지 하이퍼파라미터의 결정을 전제로 하고 있다. 본 연구에서는 이 중 conditional GAN loss 인 adversarial loss 와 classification loss 를 대치할 수 있는 attribute loss를 제안함으로써, adversarial weight와 classification weight 를 최적화하는 데 걸리는 시간을 attribute weight 의 최적화에 걸리는 시간으로 대체하여 하이퍼파라미터 탐색에 걸리는 시간을 획기적으로 줄일 수 있게 하였다. 제안하는 attribute loss 는 각 특징당 GAN 을 만들 때 각 GAN 의 loss 의 합으로, 이 GAN 들은 hidden layer 를 공유하기 때문에 연산량의 증가를 거의 가져오지 않는다. 또한 reconstruction loss 를 단순화시켜 연산량을 줄인 simplified content loss 를 제안한다. StarGAN 의 reconstruction loss 는 generator 를 2 번 통과하지만 simplified content loss 는 1 번만 통과하기 때문에 연산량이 줄어든다. 또한 이미지 Framing 을 통해 배경의 왜곡을 방지하고, 양방향 성장을 통해 학습 속도를 향상시킨 아키텍쳐를 제안한다.

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