• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.206-214
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• 2003

Purpose : To analysis each clinical results after arthroscopic ACL reconstruction with using variable fixatives which are metallic and bioabsorbable interference screw, and RIGIDfix. Therefore, We reported the clinical reliability and safty of ACL reconstruction using RIGIDfix. Materials and Methods : We evaluated the results of arthroscopic ACL resconstruction with patellar tendon autograft among three groups, of which group 1 is used metal interference screw for 44 patients, group 2 used bioabsorbable interference screw for 47 patients, group 3 used RIGIDfix for 42 patients. We compared the clinical results by physical examination (anterior drawer test, Lachman test and pivot shift test), Lysholm score and KT-2000 arthrometer and compared the radiological results by measurement of tunnel and fixatives position and widening and by MRI findings. We analyzed the results by SAS 8.2 Ducan. Tukey and paired t-test Results : Physical instability was in 5 cases, which group 2 had 4 cases and group 3 had 1 case. Lysholm score improved from 59.8. 64.4, 61 to 90.1, 92.3. 92. KT-2000 arthrometer instability improved from 9.20, 10.2, 9.5 to 1.43. 1.62. 2.00 (p=0.478). Radiologically, all cases had excellent tunnel position and cyst change was observed the 8 cases in the group 2, but, all 20 cases 2nd MRI had signal change of peri-fixatives. But, no correlation of clinical results. Conclusion : No statistical difference of clinical instability was found among three groups. And femoral tunnel changes were much observed in group I, II than III. We considered the RIGIDfix has much advantages because the short operation time, better fixation position and much bone contact surface. But, further long term follow up study was needed.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.27-34
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• 2011

Purpose: To evaluate the short term clinical result of ACL reconstruction with autologous hamstring tendon using Cross pin and Graft Tensioner and to seek way to resolve the experienced technical problems. Materials and Methods: From January 2008 to March 2009, 35 patients who had been treated arthroscopic ACL reconstruction were enrolled. The femoral side of ACL graft was fixed with Cross pin. The tibial side of graft was fixed with Intrafix and post-tie. The graft was tensioned with Graft Tensioner at 80N. We analyzed the clinical, radiographic results and complications. Results: IKDC subjective score and Lysholm score improved to 89.1 and 91.4 points. Also, Pivot shift test and One-leg hop test showed good results postoperatively. Side to side difference using KT-1000 arthrometer and Telos stress radiography improved compared with normal limb to $2.8{\pm}1.6$ mm and $2.6{\pm}1.3$ mm, respectively. The femoral tunnel enlarged to $2.3{\pm}1.1$ mm. Soft tissue irritation and femoral tunnel-graft harness length mismatch, femoral tunnel-cross pin tunnel mismatch were happened as peri-operative complications. Conclusion: Using of Cross pin and Graft Tensioner for ACL reconstruction with hamstring tendon is one of the good method for obtaining stability in short-term clinical result. But to reduce femoral tunnel-cross pin mismatch, it needs to shorten femoral bone tunnel and to create cross pin tunnel as vertical as possible. And to reduce femoral tunnel-graft harness mismatch, it needs to advance position rod further 3 mm when to create femoral tunnel.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.150-155
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• 2002

Purpose : The purpose of this study was to evaluate the clinical results of meniscal repair using the bioabsorbable devices. Materials and Methods : From 1998, 21 meniscal repairs were underwent using the bioabsorbable devices and followed more than 1 year. The Meniscus $Arrow^{\circledR}$(Bionx) and the Meniscal $Fastener^{\circledR}$(Mitek) had been applied. The indication for meniscus refixation was an unstable longitudinal tear in the posterior horn of the medial or lateral meniscus. Concurrent ACL reconstruction with meniscal repair was performed on 9 knees. The clinical result was evaluated using Lysholm knee score. Result : The average Lysholm knee scores for all patients improved from 56 preoperatively, to 89 postoperatively. The type of the device were not significantly related to clinical outcome or Lysholm knee score. But the concurrent ACL reconstruction group and the patients treated within 8 weeks had better clinical result than the others. Conclusion : The all-inside meniscal repair technique using bioabsorbable devices can be considered to be an useful method in the well selected patients and concurrent ACL reconstruction surgery.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.132-136
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• 2005

Purpose: The purpose of this study was to compare the clinical results of the arthroscopic anterior cruciate ligament reconstruction used by Bone-Patella tendon-Bone autograft and Achilles tendon allograft. Materials and Methods: We reviewed the results of patients who had been managed with arthroscopic anterior cruciate ligament reconstruction using different graft such as Bone-Patella tendon-Bone autograft and Achilles les tendon allograft. 60patients (average age, 33.5 years)were retrospectively evaluated. The one group(average age, 33.4 years) was 32 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Bone-Patella tendon-Bone autograft. The other group(average age, 32.1 years) was 28 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Achilles tendon allograft. 2 groups were evaluated subjectively by Lysholm knee scoring scale and objectively by KT-2000 arthrometer. The follow-up period was more than a year(average, 18 month). An early rehabilitation protocol was instituted. Results: On Lysholm knee scoring scale, the final evaluation was nearly normal in all patients. We could not find statistical difference among the two groups by KT-2000TM arthrometer. Conclusion: The use of allografts may be an acceptable choice for ACL reconstruction.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.31-36
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• 2002

Purpose : ACL (anterior cruciate ligament) reconstruction using achilles allograft was done for whom ACL injured person in recreational sports activity. The purpose of this study was to evaluate the clinical results and return to their sports activity in these patients. Materials and Methods : ACL injured 56 amateur athletes who had experienced sports 3 times a week more than 5 years, reconstructed with Achilles allograft, and it was analyzed subjective and objective parameter, Tegner scoring, Telos stress arthrometer, Lysholm Knee Scoring System and modified Feagin scoring system. The average age was 25 years old (range: 18$\~$49), the average follow up period was 15 months (range: 12$\~$19). Morbid sports were football (29 cases), basket ball (14 cases), badminton (5 cases), tennis (3 cases), squash (2 cases) and otherwise (3 cases). Result : The mean Lysholm Knee Scoring System was improved to 88.2 from 60. Telos arthrometer in anterior stress test revealed 2.3 mm improved from 7.1 mm. The modified Feagin scoring system showed 50 cases (89$\%$) with excellent and good results. We had obtained 12 cases (21$\%$) of Tegner score VI, 32 cases (57$\%$) of score V, 20 cases (35%$\%$ of score IV, 3 (5.3$\%$) cases of score III. Conclusions : Reconstruction of anterior cruciate ligaments can restore stability sufficient to allow sports activity in ACL injured patients, but it’s difficult to achieve 'normal' sports activity. So we will have to solve the reasons of this dissatisfaction at furthermore.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.66-68
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• 2008

Recently, devices using radiofrequency energy have been developed for arthroscopic soft tissue ablation, cauterization and shrinkage. After ACL reconstruction operation, articular metallic foreign body was found in the post-operative radiographs. It was proven to be the tip of bipolar radiofrequency system after foreign body removal. After that we experienced 2 more cases during the acromioplasty procedure. We requires attention to prevent the separation of the tip from the body in the arthroscopic surgery using bipolar radiofrequency system.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.143-147
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• 2005

Purpose: In case of anterior cruciate ligament (ACL) reconstruction, graft tendon is generally fixed in tibial tunnel with knee extended. When reconstructing ACL using hamstring tendon, the authors aim to find out the effect of knee joint position during graft fixation on postoperative knee joint stability and range of motion. Materials and Methods: Prospective study was done on patients who have undergone ACL reconstruction using hamstring tendon from May 2002 to January 2003 We used Rigifix system (Mitek Product, Johnson and Johnson, USA) and Intrafix system for fixation. Thirty nine patients received ACL reconstruction during this period. Excluding 2 patients lost in the follow-up, 37 patients were analyzed. The mean follow-up period was 14 months $(13{\sim}25months)$. Knee position was decided alternatively without any bias. Clinical evaluation was based on Lachman test, pivot shift test, Lysholm score, IKDC(international knee documentation committee) assessment and side to side KT-1000 maximal manual arthrometer difference. Results: After the last follow-up, average postoperative Lysholm score was 93.1 poins(65-98points). According to IKDC score, 26 cases were normal, 10 cases were nearly normal, 1 case was abnormal and we had no case of severe abnormality. The mean difference from the normal side was 2.5 mm under maximal manual loading KT-1000 arthrometer. According to postoperative Lachman test, 32 cases were normal,2 cases were grade I and 1 case was grade II. There were 34 cases of normal, 2 cases of grade I and 1 case of grade II. When using maximal manual KT-1000 arthrometer side to side difference, the difference from the normal side while fixing the tibia at 20'knee flexion was 2.3 mm and at full extention the difference was 2.7 mm. The range of motion at postoperative 1 year showed 5 degree flexion contracture in 1 case at 20 degrees knee flexion and 10 degrees of flexion limitation was observed in 2 cases at full extension. Conclusion: When ACL reconstruction using autogenous hamstring tendon, anterior laxity showed no difference in its stability between two groups. Tibial side fixation at full extension may be helpful in preventing flexion contracture due to overconstrained graft tendon.

• 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 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.