• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.160-168
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• 2003

Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.24-28
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• 2013

Purpose: All-inside meniscal repair using FasT-Fix (Smith & Nephew Endoscopy, Andover, Massachusetts, USA) is a popular method for the meniscal tear. However, there was no report after all-inside repair using FasT-Fix for the meniscal tear in Korea. Therefore, the purpose of this retrospective study was to report clinical outcomes after all-inside meniscal repair using FasT-Fix. Materials and Methods: 25 consecutive patients underwent meniscal repairs using FasT-Fix for tears of the posterior horn of the medial or lateral menisci combined with hamstring anterior cruciate ligament (ACL) reconstructions. Postoperative evaluations included Lysholm knee score and Tegner activity scale. Using clinical criteria, a repaired meniscus was considered healed if there was no effusion or joint line tenderness, negative McMurray test, and no sense of giving way. Results: The average follow-up was 47.9 months (range, 40 to 61 months). At follow-up, the mean Lysholm score was 91.8 and the mean Tegner activity scale was 5.6. According to clinical criteria, 20 (80%) menisci was healed, and 5 (20%) failed. Conclusion: All-inside meniscal repair using FasT-Fix showed satisfactory results in patients with hamstring ACL reconstructions.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.8-13
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• 2009

Purpose: We used tibialis allograft for the reconstruction of ACL and used Hybrid femoral fixation utilizing $Endobutton^{(R)}$ and $Rigidfix^{(R)}$ for femoral fixation, and used $Retroscrew^{(R)}$ and additional fixation for tibial fixation to evaluate the clinical results. Materials and Methods: The ACL reconstruction were performed from February 2004 to February 2007 utilizing Hybrid femoral fixation and $Retroscrew^{(R)}$ and 32 patients, 32 cases which were available for year-long observation (12 to 25 months). The clinical results (Lysholm knee score, IKDC grade) and the radiologic results(bone tunnel expansion, Telos anterior displacement test) were evaluated. Results: The Lysholm knee score was improved from the average of $67.9{\pm}5.4$ points (range: 51~77) before operation and to $94.1{\pm}6.8$ points (range: 68~98) at the last follow up (p<0.05). 22 cases (69%) were evaluated normal (A), 9 cases (28%) were evaluated nearly normal (B) and only 1 case (3%) was evaluated not normal (C) at IKDC final evaluation and no case was evaluated abnormal. From $Telos^{(R)}$ stress x-ray evaluation, difference from the opposite knee was improved average 13.2 mm{\pm}5.8 (range: 6~21 mm) to average $3.4\;mm{\pm}2.8$ (range: 0~11 mm) after operation (p<0.05). The femoral and tibial tunnel were widened by 18.7% and 9.6% in the AP view and 12.4% and 8.5% in the lateral view, respectively (p<0.05). However, any statistic significance was not observed between bone tunnel expansion and knee joint functions (p>0.05). Conclusion: An ACL reconstruction with tibialis allograft using Hybrid femoral fixation and $Retroscrew^{(R)}$ enabled anatomical fixation of the graft tendon with satisfactory clinical results.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.1
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• pp.38-44
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• 2007

Purpose: To evaluate status of reconstructed ACL and changes around graft through second-look arthroscopy after arthroscopic reconstruction of the ACL with autograft tendons. Material and Methods: Between Jun. 2003 and Feb. 2007, the second look arthroscopy was performed on 22 cases. Second-look arthroscopy was conducted on average 15.1 $(7\sim31)$ months after reconstruction. 15 cases received hamstring tendon autograft, 7 cases received bone-patellar tendonbone autograft. We measured graft tension using displacement by probing, synovial coverage by visual analysis at second-look arthroscopy The assay in Lysholm score, Lachmann test and KT-2000 arthrometer were evaluated status of reconstructed ACL. Results: The hamstring tendon group showed normal tension in 11 cases and lax tension in 4 cases. The patellar tendon group showed normal tension in 3 cases, lax tension in 2 cases and partial tear in 2 cases. In the hamstring tendon group, synovial coverage was good in 11 cases, half in 3 cases and pale in 1 case, and the bone-patellar tendon-bone group was good in 4 cases and half in 3 cases. The patellar tendon group was superior to the hamstring tendon group in Lysholm score (p<0.05), but insignificance difference in KT-2000 arthrometer results statistically. Conclusion: The hamstring tendon group was superior to the bone-patellar tendon-bone group in second-look arthroscopy after ACL reconstruction with autograft tendons results, but long term follow up will be necessary to further evaluated.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.198-204
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• 2008

Purpose: The purpose of this study is to analyze the merits and demerits of double bundle reconstruction and achieve improvements hereafter, by comparing the results of double bundle and single bundle reconstruction using tibialis anterior allograft. Materials and Methods: Twenty seven patients were divided to undergo either double bundle(n=14) or single bundle(n=13) reconstruction with tibialis anterior allograft tendon. The evaluation methods were AP laxity with KT-2000 arthrometer, isokinetic knee strength measurements, pivot-shift test, IKDC subjective score, Lysholm knee score, Tegner activity score, radiographic evaluations with postoperative MRI, and second look arthroscopy. Results: Lysholm knee score and Tegner activity score were significantly better in double bundle reconstruction. In pivot-shift test, single bundle reconstruction was evaluated as grade 0 in 10 of the knees, grade 1 in 1, and grade 2 in 2. Double bundle reconstruction was evaluated as grade 0 in 13, and grade 2 in 1. In second look arthroscopy, single bundle was evaluated as excellent in 6 of the knees, fair in 7, anteromedial bundle of double bundle reconstruction was excellent in 13 and fair in 1, and posterolateral bundle was excellent in 4, fair in 9, and poor in 1. There were no significant differences in other evaluations. Conclusion: Favorable outcome may be expected with double bundle reconstruction of ACL. However there are still need for improvement in terms of reconstruction technique and rehabilitation protocol to reduce PL bundle injury.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.63-68
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• 2007

Purpose: The authors introduce a new technique of arthroscopic all inside repair using anterolateral and anteromedial portals for lateral meniscus root complete radial tear in patients who underwent concurrent anterior cruciate ligament (ACL) reconstruction. Operative technique: Arthroscope is placed through anteromedial portal and suture hook ($Linvatec^{TM}$, Largo, Florida, USA) is delivered through anterolateral portal. By rotating the suture hook, it penetrates posterior horn of the torn meniscus from femoral to tibial surface for vertical orientation. PDS No. 1 ($Ethicon^{TM}$, Somerville, NJ, USA) is delivered through the suture hook, and then it is withdrawn. Both end of PDS No. 1 are taken out through the anterolateral portal. MAXON 2-0 ($Syneture^{TM}$, Norwalk, Connecticut, USA) is used to penetrates remnant of tibial attachment of the torn meniscus from tibial to femoral surface in a same manner. MAXON 2-0 is changed for PDS No. 1 from tibial to femoral surface by shuttle relay technique. PDS No. 1 is tied using SMC (Samsung Medical Center) knot. Conclusion: All inside repair is a useful technique to achieve anatomical repair and to restore the hoop tension in lateral meniscus root complete radial tear.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.183-187
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• 2009

Purpose: We describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence avulsion fracture using bioabsorbable pins in skeletally immature patients. Operative Technique: Diagnostic knee arthroscopy is performed using anterolateral and anteromedial portals. Fracture debris and blood clot are debrided to expose the injured site well. The fragment is reduced with the probe and fixed temporarily with a 1.1-mm diameter K-wire that is inserted percutaneously from the anterosuperior aspect of the knee joint. The drill guide is introduced into the joint and the fragment is secured by bioabsorbable, poly-p-dioxanone 1.3-mm pins inserted from different angles. The pins are 40 mm in length. The knee is placed in a long leg cast in extension for 4 weeks to assure that full extension is obtained. Conclusion: Arthroscopic fixation of an tibial intercondylar eminence avulsion fracture using bioabsorbable pins is not a technically demanding, suitable method that ensures fracture healing and restores the stability of the joint.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.153-159
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• 2003

Purpose : The purpose of this study was to compare the pattern of displaced bucket-handle tear of lateral and medial menisci and the treatment modality and results from accompanying injury. Materials and Methods : Patients who were diagnosed for displaced bucket-handle tear of medial meniscus (group I: 52patients, 52cases) and lateral meniscus (group II: 31patients, 32cases) from September 1998 to December 2002. The mean ages were 25years $(16\~66)$ for Group I and 29years $(18\~63)$ for Group II, and the average follow-up period were 18months $(12\~44)$ and 13months $(6\~46)$, respectively. The zone of meniscus tear and the existence of accompanying injury were verified through intraoperative arthroscopy and discoid type meniscus was additionally examined for group II. The assessment was made according to the physical examination and clinical pattern at the postoperative last follow-up, and the 2nd look arthroscopy was performed in 19cases $(23\%)$ for the cases accompanying anterior cruciate ligament (ACL) injury in both groups. Results : There were 38cases $(73\%)$ in group I, 5cases $(16\%)$ in group II for associating ACL injury. We observed discoid type meniscus (19cases, $59\%$) in group II. At last follow-up clinical success in repair cases of group I and II are 22cases $(85\%)$, 2cases $(67\%)$, in resection cases are 26cases $(100\%)$, 26cases $(93\%)$ respectively. Reoperation is performed 2cases in repair cases of group I. One case is re-rupture, the other case is newly developed tear in white-white zone. Reoperation is performed 2cases due to remnant meniscal tear in resection cases of group II. All of 2cases are discoid type menisci. Conclusion : Displaced bucket-handle tear of medial & lateral menisci would be substantially different an aspect, considering on difference would help to select proper treatment modality.