• Title/Summary/Keyword: Anterior Cruciate Ligament

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Mechanism of Injury in the Anterior Cruciate Ligament Tears Sustained in Participation in Soccer (축구 손상에 의한 전방 십자인대 파열 환자의 수상 기전)

  • Cho, Kwang-Hyun;Park, Young-Eun;Choi, Nam-Hong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.33-36
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    • 2008
  • Purpose: The purpose of this study was to evaluate the mechanism of injury in the anterior cruciate ligament tears sustained in participation in soccer. Materials and methods: 50 patients whose knees were injured during playing soccer were enrolled in this study. The mean age was 27 years old, 47 were male and 3 female. 15 of them were either professional or amateur soccer players, the rest were non-professional. The injury mechanism was investigated by evaluation of the medical records or by telephone interview. Results: The injury mechanism involved contact injuries in 17 patients and non-contact in 33. 41 patients were bearing weight on the involved side at the time of injury, and 9 patients were not. In cases of contact injury, 9 of the 17 patients had sustained a valgus force to the knee, and 5 patients had varus force, 11 patients had their foot planted, and 6 did not. Among those patients with a planted foot, 3 patients were injured by the rotation of the thigh, 1 patient was injured by hyperextension, and there were no deceleration mechanism injuries. In non-contact injuries, 30 out of 33 patients had their foot planted at time of injury and only 3 patients did not. Of these 30 patients, 16 were injured by the rotation of thigh, 6 sustained a varus force on the knee joint and 5 had a valgus force, 5 were injured by hyperextension, and 2 by deceleration. 3 patients, who did not have their foot planted, were injured while kicking with the involved leg. Conclusions: For soccer players in this series, the most common mechanisms resulting in anterior cruciate ligament tears were non-contact, most often by rotation of the torso over a planted foot. In contact injuries, the most common mechanism was the application of valgus force by tackle.

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The Effect of a Tibial Remnant Preservation Technique on the Synovialization of the Graft Tendon in Anterior Cruciate Ligament Reconstruction - Based on the Second Look Arthroscopic Findings - (전방십자인대 재건술시 잔류 조직 보존술이 이식 인대의 활막화(synovialization)에 미치는 영향 - 2차 관절경 소견을 중심으로 -)

  • Ahn, Gil Yeong;Nam, Il Hyun;Moon, Gi Hyuk;Lee, Yeong Hyun;Choi, Seong Pil;Yoo, Jong Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.11-17
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    • 2013
  • Purpose: The purpose of this study is to evaluate the effect of preservation of the tibial remnant on the synovialization of graft tendon after the reconstruction of anterior cruciate ligament (ACL) based on the second look arthroscopic findings. Materials and Methods: From May 2005 to May 2012, among sixty three patients having ACL reconstruction with the four-strand hamstring using a bioabsorbable cross pin (RigidFix$^{(R)}$) for the femoral tunnel, nineteen patients who had second look arthroscopy were analyzed. We classified them into three groups according to the tibial remnant of the torn ACL for arthroscopic findings. Group 1 had less than 5 mm of a remnant tissue, Group 2 had from 6 mm to 10 mm of it, and Group 3 had more than 11 mm. We estimated the percentage of synovial coverage on the graft tendon during second look arthroscopy. We evaluated Lysholm score and Tegner activity score preoperatively and in the last follow-up. Results: At the time of ACL reconstruction, the mean length of preserved tibial remnant of torn ACL was 2.3 mm in Group 1, 7.4 mm in Group 2, and 13.7 mm in Group 3. In the second look arthroscopy, the average percentage of synovial coverage was 55.4% in Group 1, and 77.9% in Group 2, and 89.7% in Group 3. Lysholm score and Tegner activity score improved from 74.2 and 7.3 preoperatively to 94.1 and 8.5 in the last follow-up. Conclusion: The preservation of tibial remnant of torn ACL influenced the synovial coverage of the graft tendon and the volume of preserved remnant in accordance with the surface of synovial coverage. It would have a good effect on graft healing and preservation of proprioceptive function.

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Influence of Diode Laser (808 nm) on a Rat Anterior Cruciate Ligament Transection Model of Osteoarthritis (전십자인대 단열을 통한 랫드 골관절염모델에서 다이오드레이져 (808 nm)의 영향)

  • Park, Seongkyu;Minar, Maruf;Hwang, Yawon;Kim, Somin;Park, Minhyeok;Choi, Seok-Hwa;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.346-352
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    • 2013
  • The study was aimed to investigate the influence of diode laser on osteoarthritis (OA) of stifle joint induced by anterior cruciate ligament transection (ACLT). Sixty 10-week-old male Sprague-Dawley rats were used in this study. Right stifle joint was operated to create ACLT or sham. There were five study groups: control, Sham, ACLT, ACLT + Laser irradiation (ACLT+L) and ACLT + meloxicam administration (ACLT+M). Low-level laser therapy (LLLT) was applied at the operated stifle joint twice a week using an 808-nm indium-gallium-arsenide (InGaAs) diode laser during 8-week experimental period. Radiographical, gross morphological and histopathological findings were examined at 2, 4 and 8 weeks post-surgery. Radiography, CBC and chemistry tests showed no significant difference between groups. ACLT+L group showed remarkable cartilage damages compared with sham group morphologically and histopathologically at 2, 4 and 8 weeks after surgery. ACLT+M group also had more cartilage damages compared with sham group. Low-level laser therapy (LLLT) showed limitation to prevent progression of OA in the rat anterior cruciate ligament transection models; on the contrary it accelerated cartilage damage. It is assumed that the aggravating results of LLLT in this study might be due to excessive unstable movement of stifle joint from the pain-relieving effect of LLLT, rather than direct damaging effect of irradiation since LLLT did not affect cell viability.

Diameter of Autologous Four Strand Hamstring Tendon for Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술을 위해 채취한 네 가닥 자가 슬괵건의 직경)

  • Choi, Jun-Weon;Han, Sang-Ho;Kim, Eu-Gene;Kim, Jong-Min
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.148-152
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    • 2006
  • Purpose: The purpose of this study was to investigate the distribution of the diameter of four strand autologous hamstring tendon and to identify the factors related to the diameter. Materials and Methods: Between December 2004 and July 2006, 66 patients underwent anterior cruciate ligament reconstruction using autologous hamstring tendon. Sixty one patients were male and the other 5 patients were female. Both semitendinosus and gracilis tendon were harvested in every case. Harvested two tendons were folded once together to create a four strand double loop graft and were passed through cylindrical sizer to measure their diameter. Parameters such as sex, age, height and weight were analyzed for their correlation with the diameter of the graft. Results: The diameter of the graft ranged from 6 mm to 10 mm. The graft with the diameter of 8 mm was most common and the average diameter of all the grafts was $7.85{\pm}0.92mm$. Seven patients (10.6%) had a graft with the diameter of 6 mm, which is considered too thin to be ideal one. No statistically significant correlation was found between age of the patient and the diameter of the graft. However, the diameter of the graft was significantly correlated with sex, height and weight of the patient. Female patients had a significant tendency to have thinner hamstring tendons. Both small height and light weight of the patients were correlated with thinner hamstring tendons significantly. Conclusion: Sex, height and weight of the patients were the factors that had a statistically significant correlation with the diameter of the graft. Being aware of the risk factors related with harvesting exceedingly thin hamstring tendon prior to anterior cruciate ligament reconstruction, one can utilize wide range of options in selecting an optimal graft.

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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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Graft Selection in ACL Reconstruction (전방 십자 인대 재건술에서 이식건 선택)

  • Lee Dong-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.92-99
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    • 2003
  • The prevalence of anterior cruciate ligament (ACL) injury is continuously increased due to sports activities and traffic accident. Simultaneously ACL reconstruction operations are on the increase. Several kinds of autografts and allografts are used in ACL reconstruction. Although ACL reconstruction using an autogenous bone-patellar tendon-bone graft is the good standard, it might have potential morbidity, anterior knee pain and minimal extension loss. To minimize the complications and disadvantages on each graft and to select appropriate graft for each patient, it is necessary to understand the unique characteristics of each graft for biomechanical aspect, morbidity and disadvantage. Selecting the appropriate graft depends on numerous factors including surgeon's preference and experience, patient's activity level and age, extent of ligament injury, tissue availability, and patient's selection for graft .

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Clinical Results after ACL Reconstruction using Tibialis Anterior Tendon Allograft and Hamstring Tendon Autograft (동종 전경골건과 자가 슬괵건을 이용한 관절경적 전방 십자 인대 재건술의 결과 비교)

  • Yoon, Kyoung-Ho;Bae, Dae-Kyung;So, Dong-Hyuk;Lee, Jeong-Hwan;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.85-91
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    • 2007
  • Purpose: To analyze the clinical results and second look arthroscopic findings of anterior cruciate ligament(ACL) reconstruction with a tibialis anterior tendon allograft and a hamstring tendon autograft. Materials and Methods: We reviewed the cases of athroscopic ACL reconstructions using allogenous tibialis anterior(TA) tendon and autogenous hamstring tendon done from March, 2002 to August, 2005 and followed-up more than 1 year. The 250 cases were included in this study and allogenous TA tendon was used in 150 cases and autogenous hamstring tendon in 100 cases. The mean follow-up period was 15 months and 14 months, respectively. The clinical evaluation was done by Lachman test, Pivot shift test, KT-1000 arthrometer and International Knee Documentation Committee(IKDC) knee score. Graft tension, synovial coverage were observed in cases of second look arthroscopy. Results: At final follow-up, there was no significance between the two groups in clinical examination. On second look arthroscopy, synovial coverage was better in autogenous hamstring tendon group than allogenous TA tendon group(p=0.005). But no difference was found in graft tension(p>0.05). Conclusion: There were no significant differences between the two groups in the clinical results. But autogenous hamstring tendon group had better synovial coverage than allogenous TA tendon group in second look arthroscopy.

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Effect of Backward Walking Exercise on ROM, VAS score and Proprioception in Anterior Cruciate Ligament Reconstruction Patients (전방십자인대 재건술 환자의 후방보행 재활운동이 관절의 가동범위 및 통증점수, 고유수용성감각에 미치는 영향)

  • Moon, Dae-Hyung;Oh, Du-Hwan;Zhang, Seok-Am;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.522-529
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    • 2016
  • This study examined the effects of 4-weeks of backward walking exercise on ROM, VAS (Visual Analogue Scale) score and proprioception in anterior cruciate reconstruction patients. Fourteen subjects were randomly assigned to either a backward walking group (BWG, n=7) or a control group (CON, n=7) and then participated in rehabilitation program for 4 weeks. The ROM of the flexion significantly decreased in both groups (BWG, p<0.001 vs CON, p<0.01), while ROM of extension significantly decreased only in the BWG (p<.05) post exercise, but no significant difference was observed between groups. Additionally, VAS score decreased significantly in both groups (P<0.001) and BWG was lower than CON post exercise (p<0.001). Finally, proprioception decreased significantly in both groups (BWG, p<0.001 vs CON, p<0.05), but did not differ significantly between groups. These results suggest that the 4 week backward walking rehabilitation program improves ROM, VAS score, and proprioception and has positive effects on functional recovery of anterior cruciate ligament reconstruction patients.

Histological studies on the development of the stifle joint in Korean cattle (한우의 무릎관절 발생에 관한 조직학적 연구)

  • Paik, Young-ki;Lee, Han-kyoung;Yang, Hong-hyun;Kim, In-shik
    • Korean Journal of Veterinary Research
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    • v.33 no.1
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    • pp.7-21
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    • 1993
  • The morphogenesis of the stifle joint in Korean cattle embryos and fetuses was observed by radiography, alizarin red S stain and light microscopy. Fourty-eight(48) embryos and fetuses, ranging from 11mm to 160mm in crown-rump length (C-R L), were used for this study. The experimental samples were divided into twelve separate groups according to their C-R L. The first to the nineth group ranged from 11-100mm in C-R L, spaced at 10mm intervals. The tenth to the twelfth group ranged in C-R L from 101mm to 160mm, and were spaced at 20mm intervals. The results were as follows; 1. The first appearance of the interzone between the femur and tibia was formed in the second experimental group. The patellar ligament and cruciate ligament appeared in the third group and the patella, menisci and synovial cavity appeared in the fourth group. 2. The lateral and medial menisci were first obseved in the fourth group, and these structures showed crescent shape in the fifth group of the fetuses. 3. The first appearance of the femoro-tibial joint cavity was in the third group. The fifth group contained the first appearance of the patello-femoral cavity. Also, the femoro-tibial cavity was divided into two cavities by the anterior and posterior cruciate ligament.

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Clinical Results of Footprint Restoration Anterior Cruciate Ligament Reconstruction with Remnant Preservation (잔여부 보존술식을 이용한 고유부착부 재현 전방십자인대 재건술의 임상결과)

  • Chung, Hyun-Min;Seo, Young-Jin;Song, Si Young;Cha, Myoungsoo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.537-546
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    • 2019
  • Purpose: Anteromedial (AM), posterolateral (PL), anterior, and posterior remnant preserving anterior cruciate ligament (ACL) reconstructions were conducted on patients with partial ACL tears based on the arthroscopic findings. The clinical results of the four groups were compared. Materials and Methods: This study included 98 patients who underwent a remnant preserving ACL reconstruction from January 2013 to June 2016 and could be followed-up for at least two years. The subjects were categorized into four groups according to the selective bundles reconstructed: group A, anteromedial selective bundle reconstruction; group B, posterolateral selective bundle reconstruction; group C, anterior bundle reconstruction; and group D, posterior bundle reconstruction. The preoperative and postoperative anterior translation from the stress X-ray, International Knee Documentation Committee Subjective Knee Form (IKDC SKF) score, Lysholm score, and hospital for special surgery (HSS) score were compared. Results: All four groups showed significant improvement in anterior translation on the stress X-ray conducted with knees at 15° flexion, IKDC SKF score, Lysholm score, and HSS score postoperatively (in all groups, p<0.001). No intergroup differences were observed in terms of the functional outcomes except that preoperative IKDC SKF score was higher in the C group than in the A group (p=0.021), and the preoperative Lysholm score was higher in the B group than in the A group (p=0.03). Conclusion: After the AM, PL, anterior, and posterior remnant preserving ACL reconstructions, all four groups showed satisfactory results in terms of the anteroposterior stability and functional knee scores with no significant intergroup differences.