• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.46-50
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• 2005

Purpose: The purpose of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of acute anterior cruciate ligament (ACL) injury and its tear pattern in comparison with arthroscopic finding. Materials and Methods: Sixty consecutive patients with acute ACL injury were taken NRI followed by arthroscopic examination between January 2002 and June 2004. MRI findings were reviewed according to the presence of ACL discontinuity, diffuse swelling or thickening, focal edema, collapse on distal end, and any combined tear. The pathologic findings were then confirmed arthroscopically. The diagnostic accuracy of MRI on ACL tear pattern was analyzed by obtaining its positive predictive value. Results: All fifty two cases with presence of discontinuity on MRI showed ACL rupture arthroscopically. The location of ACL tear, diffuse swelling and focal edema on MRI also corresponded with arthroscopic findings respectively. However, the diagnostic accuracy of MRI was relatively lower in the presence of other ACL patterns such as collapses and combined tear. Conclusion: Preoperative MRI findings seem to be in accordance with arthroscopic findings and is significantly accurate in detection of location and diffuse swelling and focal edema of ACL tear.

• 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.9 no.2
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• pp.137-142
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• 2005

Purpose: The purpose of this study is to evaluate the results of arthroscopic anterior cruciate ligament(ACL) repair with minimal incision and to review prognostic factors according to ACL tear patterns and the presence of associated injury Materials and Methods: Thirty eight patients (thirty nine knees) with acute ACL tear were given arthroscopic ACL repair between January 2001 and December 2002 and were followed up at least over six months. Intraoperative findings such as ACL tear pattern and the presence of synovial or concomitant medial collateral ligament injuries were recorded. Each knee was then postoperatively re-evaluated with aid of KT-1000 arthrometer and Lachman test and Lysholm score. Results: Postoperative limitation of motion was significant when combined typed ACL tear was present with concurrent medial collateral ligament(MCL) injury. In contrast, in the case where there were sole proximal ACL tear or no evidence of synovial injury, the limitation of motion was not significant. Anterior laxity was significantly associated with the presence of combined typed ACL tear or concurrent synovial injury, but was not significant when there were sole proximal ACL tear. Conclusion: In the case where there is sole proximal ACL tear without concurrent synovial injury, arthroscopic ACL repair can be considered as a treatment modality for the treatment of acute ACL injury.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.154-161
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• 2005

Purpose: to describe the histologic appearance of the type III bone bruise in knees which had sustained an acute anterior cruciate ligament (ACL) rupture. Materials and Method: Twenty-five patients who sustained acute ACL rupture were prospectively enrolled in this study. On MRI, 14 patients demonstrated type III bone bruise on lateral femoral condyle, and 11 patients didn't demonstrated bone bruise. Arthroscopic evaluation and biopsy of the articular cartilage and subchondral bone wert performed before ACL reconstruction. Histologic and immunohistochemical evaluations were done. Results: There was no difference between the bone bruise and control group in the hematoxylin-eosin staining for cell distribution, Masson's trichrome staining for collagen and immunohistochemical staining for type I and type II collagen (p>0.05). But in the safranin-O staining for glycosaminoglycan distribution, the bone bruise group had an evidence of decreased staining at the superficial and middle layers, compared with the control group (p<0.05). We also found fatty change of bone marrow in calcified zone of the bone bruise group with safranin-O staining. Conclusion: We suggest that the type III bone bruise found on MRI indicates a substantial damage to normal articular cartilage homeostasis, and may induce further damage of the articular cartilage.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.103-107
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• 2006

Simultaneous acute rupture of the anterior cruciate ligament (ACL) and the patellar tendon is a very unusual injury. That is difficult to diagnose in initial evaluation of knee injury, because the patellar tendon rupture is often missed. We report a 26 year-old male patient who was treated with ACL reconstruction using achilles allograft and direct patellar tendon repair with achilles allograft augmentation. The patient had the stable knee and full range of motion. It's clinical results were excellent(Lysholm score 93, Tegner activity score 6).

• The Journal of Korean Physical Therapy
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• v.35 no.3
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• pp.57-63
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• 2023

Purpose: The aim of this study was to conduct a systematic review of randomized controlled studies from 2012 to present that explore the diagnostic accuracy of clinical tests used for diagnosing anterior cruciate ligament (ACL) injury. Methods: Study design: Systematic review. Literature search of the PubMed and Scholar databases was conducted using keywords related to diagnostic accuracy of clinical tests for ACL injury. The PRISMA Guidelines were followed to conduct this study. The Cochrane Risk of Bias Tool was utilized to assess the quality of each included study. Results: As a result, 8 studies were included, and 6 clinical tests used in ACL tears were evaluated for diagnostic accuracy. The pivot shift test was reported as having the highest +LR (29.5) value with a sensitivity of 59% and a specificity of 98%. However, the test with the lowest -LR value was the lever test, and the values were as follows: -LR (0.08), +LR (4.7), specificity (80%), sensitivity (94%). Conclusion: In this study, it was concluded that a single clinical test is not sufficient to determine the presence of ACL injury. Test combinations have a higher diagnostic accuracy than a single test. In this study, the accuracy of the clinical tests was examined without considering the amount of ACL rupture and acute-chronic condition. Further research is required to examine the impact of these two factors on diagnostic accuracy of clinical test.

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.13-18
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• 2000

Purpose : The purpose of this study was to compare the efficacy of bone-patellar tendon-bone(B-PTB) allograft with autograft B-PTB reconstruction of anterior cruciate ligament(ACL) according to the subjective and objective criteria. Materials and Methods : 42 patients were treated for acute rupture or chronic insufficiency of the ACL between March 1993 and June 1996. There were 18 autografts and 24 allografts for ACL reconstruction. At 2 years of follow-up after operation, autograft and allograft groups were compared based on subjective, objective criteria and Telos stress arthrometer. Results : The modified Feagin Scoring System revealed 16 patients$(88.9\%)$ with a satisfactory result by autografts, but 21 patients$(87.5\%)$ with a satisfactory result by allografts after 2-years follow-lip. There was no statistically significant difference between the two groups. ACL reconstruction with B-PTB allograft did not produce a significant functional deficit. But patellofemoral pain and crepitus were more frequent in the autografts$(33.3\%)$ than allografts$(8.3\%)$ (p<0.05). Conclusion : The ACL deficient knees treated with allografts for ACL reconstruction tended to be better than those reconstructed with autografts fur the reduction of patellofemoral crepitus and pain. B-PTB allograft provides an acceptable alternative to autograft tissue for reconstruction of the ACL.

• 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.