• Title/Summary/Keyword: Anterior cruciate ligament injuries

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Stiff Knee Following Anterior Cruciate Ligament Reconstruction - Cause Analysis and Treatment - (전방 십자 인대 수술 후 합병된 슬관절 강직 - 원인분석 및 치료 -)

  • Choi, Nam Yong;Lee, In Ju;Choi, Moon Ku;Ko, Hae Sok;Kim, Seung Ki;Park, Sung Jin;Han, Suk Koo;Kang, Young Mok
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.72-76
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    • 1998
  • Between March 1992 and December 1995 at St. Paul's, Holy Family, St. Vincent and Eui Jung Bu St. Mary Hospitals Catholic University, two hundred and eighty patients underwent arthroscopic anterior cruciate ligament(ACL) reconstruction using central one-third bone-patellar tendon-bone autograft. Nine of these patients had limitation of motion(LOM) defined as a knee flexion contracture greater than 10o or less than 125o of passive knee flexion. This study analyzes the causes of LOM after ACL reconstruction as well as the results after passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM. The results are as follows: 1. Out of nine patients, initially three had isolated ACL injuries and six had combined injuries. Seven of nine cases were perfomed by ACL reconstruction within four weeks and two were performed after four weeks following injury. 2. Treatment for LOM after ACL reconstruction was done after 5.5 months on average. 3. Arthroscopic adhesiolysis was done in 5 cases. There were fibrous adhesions at suprapatellar pouch and femoral intercondylar notch in all cases, respectively, infrapatellar fat pad in 3 cases and medial para patellar gutter in 2 cases. Two patients had a fibrous nodule, "cyclops" lesion, which formed anterior to the ACL graft. 4. Range of motion and Lysholm knee score were much improved following passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM.

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Reconstruction of Anterior Cruciate Ligament with Fresh-frozen Achilles Allograft (신선 동결 동종 아킬레스건을 이용한 전방 십자인대 재건술)

  • Choi, Nam-Yong;Han, Suk-Ku;Nah, Ki-Ho;Seo, Sang-ll;Lee, Do-Sung;Song, Hyun-Seok
    • 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.

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Magnetic Resonance Imaging of ACL Injury (전방십자인대 손상의 자기공명영상)

  • Song, Eun-Kyoo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.31-35
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    • 1997
  • MRI(magnetic resonance imaging) is very useful to visualize the anterior cruciate ligament (ACL) injury of the knee. Differential features of ACL injury at MRI according to acute and chronic stage should be evaluated to enable accurate assessment of the integrity or ACL. Distinguishing features of normal anatomy. acute and chronic injuries or ACL at MRI will be reviewed.

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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 Incidence and the Patterns of Associated Injuries of Anterior Cruciate Ligament Tear (전방십자인대 파열 시 동반 손상의 빈도 및 양상)

  • Lee, Jung-Hwan;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Eo, Jae-Hyoung;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.24-31
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    • 2008
  • Purpose: We purposed to analyze the incidence and the patterns of the injuries associated with anterior cruciate ligament(ACL) tears. Materials and Methods: We retrospectively reviewed 547 knees that had undergone ACL reconstructions and compared the associated injuries according to the time of injury(acute vs. chronic), the cause of injury(sports vs. non-sports) and the type of sports. Results: Medial collateral ligament(MCL) injury and bone contusion were more in acute injury group less than 3 months after trauma(p=0.001, 0.019) and the injuries of medial or lateral meniscus were more in chronic injury group more than 3 months after trauma(p=0.014, 0.029). The trochlea in acute injury group(p=0.027) and the medial femoral condyle in chronic injury group(p=0.011) had higher incidence of chondral injury. Grade I, II chondral injury was frequent in acute injury group(p=0.016) and grade III, IV chondral injury was frequent in chronic injury group(p=0.017). Lateral meniscus injury was frequent in sports injury group(P=0.035). Medial collateral ligament injury was frequent in ski(P=0.005), and chondral injury was in gymnastics(P=0.017). Conclusions: The incidences of medial and lateral meniscus tears and grade III, IV chondral defects were high in chronic injury group. According to the causes of the tears and the types of sports, some differences in the incidence and pattern of associated injuries were found.

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Patterns of Meniscus Injury with Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열과 동반된 반월상 연골 손상의 양상)

  • Cho Sung-Do;Ko Sang-Hoon;Hwang Soo-Yeon;Kim Moon-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.58-62
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    • 2003
  • Purpose : The purpose of this study was to investigate the incidence, location, type and treatment of meniscal injury associated with acute anterior cruciate ligament (ACL) tears Material and Methods: From Mar. 1997 to Feb. 2002, we reviewed 73 cases of acute ACL tear. There were 66 males and 7 females. The average age at the time of surgery was 33 year old (range, 16-62 years). The common causes of meniscal injury were sports injuries (45 cases) and traffic accidents (19 cases). In 45 sports injuries, thirty four cases were soccer injuries. All patients had undergone arthroscopic evaluation. We analyzed incidence, type, location, and treatment of meniscal injuries, especially those of soccer injuries. Results : Foully eight (57 sites) out of 73 had meniscal tears : Of these injuries, tears of lateral meniscus (26 cases, $54.2\%$) were more common than medial meniscus. Posterior horn of the meniscus was the most common location (52 cases, $91.2\%$) and radial tears were the most common type (15 cases, $26.3\%$). Thirty eight cases $(66.7\%)$ were treated by partial menisectomy. In soccer injuries, twenty eight (33 sites) out of 34 had meniscal tears. and tears of lateral meniscus (17 cases, $60.7\%$) were more common. Posterior horn of the meniscus was the most common location (30 cases, $90.9\%$) and radial tears were the most common type (9 cases, $27.3\%$). Twenty two cases $(66.7\%)$ were treated by partial menisectomy. Conclusions : Lateral meniscal tears in the setting of an acute ACL insufficiency are more common than medial meniscal tears. The findings in the this study would be helpful in clinical diagnosis and subsequent treatment decisions in patients with an acute ACL tears.

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Decay-Accelerating Factor Differentially Associates With Complement-Mediated Damage in Synovium After Meniscus Tear as Compared to Anterior Cruciate Ligament Injury

  • V. Michael Holers;Rachel M. Frank;Michael Zuscik;Carson Keeter;Robert I. Scheinman;Christopher Striebich;Dmitri Simberg;Michael R. Clay;Larry W. Moreland;Nirmal K. Banda
    • IMMUNE NETWORK
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    • v.24 no.2
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    • pp.17.1-17.16
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    • 2024
  • We have reported that anterior cruciate ligament (ACL) injury leads to the differential dysregulation of the complement system in the synovium as compared to meniscus tear (MT) and proposed this as a mechanism for a greater post-injury prevalence of post traumatic osteoarthritis (PTOA). To explore additional roles of complement proteins and regulators, we determined the presence of decay-accelerating factor (DAF), C5b, and membrane attack complexes (MACs, C5b-9) in discarded surgical synovial tissue (DSST) collected during arthroscopic ACL reconstructive surgery, MT-related meniscectomy, osteoarthritis (OA)-related knee replacement surgery and normal controls. Multiplexed immunohistochemistry was used to detect and quantify complement proteins. To explore the involvement of body mass index (BMI), after these 2 injuries, we examined correlations among DAF, C5b, MAC and BMI. Using these approaches, we found that synovial cells after ACL injury expressed a significantly lower level of DAF as compared to MT (p<0.049). In contrast, C5b staining synovial cells were significantly higher after ACL injury (p<0.0009) and in OA DSST (p<0.039) compared to MT. Interestingly, there were significantly positive correlations between DAF & C5b (r=0.75, p<0.018) and DAF & C5b (r=0.64 p<0.022) after ACL injury and MT, respectively. The data support that DAF, which should normally dampen C5b deposition due to its regulatory activities on C3/C5 convertases, does not appear to exhibit that function in inflamed synovia following either ACL injury or MT. Ineffective DAF regulation may be an additional mechanism by which relatively uncontrolled complement activation damages tissue in these injury states.

Effect of Lateral and Posterior Placement of Single-Bundle and Double-Bundle ACL Reconstructions on Tibial Internal Rotation During Single-Leg Landing (전방십자인대 한다발재건술의 후외측다발 재건 및 두다발재건술이 외발착지 동작 시에 경골내회전에 미치는 영향)

  • Shin, Choong-Soo
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.35 no.5
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    • pp.517-523
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    • 2011
  • Anterior cruciate ligament (ACL) injuries are treatedwith surgical reconstruction. Although ACL consists of two functional bundles, only the anteromedial bundle is surgically reconstructed, and the effect of the reconstruction of the posterolateral bundle is unknown. The purpose of this study is to investigate the role of the posterolateral bundle and the effect of double-bundle reconstruction during single-leg landing. A 3D dynamic knee with various ACL reconstructed models was created using MRI, and single-leg landing motion was simulated using in-vivo human experimental data. The results showed that the lateral shift of the tibial insertion of the anteromedial bundle and the posterolateral bundle of the ACL constrain the tibial internal rotation more efficiently than a single anteromedial bundle can. In addition, double-bundle ACL reconstruction is less sensitive to inaccuracies in the tibial tunnel placement.

Arthroscopic Repair for the Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열의 관절경적 봉합술)

  • Choi, Chong-Hyuk;Yoon, Han-Kook;Kim, Hyung-Sik
    • 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.

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Modeling and Simulation of Human Knee Joint in Three Dimension By Using the Method of Optimal Triangular Patches (최단 거리 삼각형 패치 형성법을 이용한 무릎 관절의 3차원 형상 모델링과 시뮬레이션)

  • Moon, Byung-Young;Son, Kwon;Kim, Kwang-Hoon;Seo, Jung-Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.20 no.12
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    • pp.205-212
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    • 2003
  • Many people are exposed to accidents by vehicles or sports. The most frequent injuries by these accidents is concerned with a knee joint. The three-dimensional surface model of a knee is needed for dynamic analysis of knee motion and knee reconstruction. three-dimensional motion data of a knee joint were obtained using X-ray and precise magnetic sensors. The surface data of a femur and a tibia were obtained using cross-sectional pictures by CT. The three-dimensional surface models of a femur and a tibia were made by the method of optimal triangular patch. Using obtained motion data, we simulated the motion of three-dimensional knee joint model.