• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.2
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• pp.1-10
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• 2006

The purpose are to assess the efficacy of a contact lateral-wedged insole with strapping on the femorotibial angle in patients with varus deformity osteoarthritis of the knee after treatment period. 25 outpatients with knee osteoarthritis (OA) were randomized to be treated with a contact lateral-wedge insole with strapping. Standing radiographs were used to analyze the femorotibial angle for each subject. The result of repeated two-way ANOVA's reveled that a contact lateral-wedged insole with strapping produced significantly differences in the femorotibial angle between groups after treatment period (P<0.05). and repeated one-way ANOVA's reveled that it produced significantly differences in the femorotibial angle between experimental groups after treatment period (P<0.05). We suggest that these results may be beneficial for manufacturing foot orthotic devices, such as wedged insoles, to control medial and later compartment forces in the knee varus-valgus deformity.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.1
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• pp.44-50
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• 2006

The purpose of this study is to assess the radiographic effects of normal person with contact laterally wedged insoles with strapping of varying elevations. Eight person who were randomized into group according to their birth dates and wedge elevation, participants wore contact laterally wedged insoles with strapping with elevation of 9, 15, 21mm. Standing radiographs were used to analyze the femorotibial angle for each subject, The result of repeated measures ANOVA's reveled that laterally wedged insoles with strapping of varying elevations produced significantly the femorotibial angle. The degree of change in femorotibial angle with the insole with strapping was effected by the tilt of the lateral wedge(P<0.05). We suggest that these results may be beneficial for manufacturing foot orthotic devices, such as wedged insoles, to control medial and later compartment forces in the knee varus-valgus deformity.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.355-372
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• 2002

The purpose of this study was to evaluate the effect of multiaxial lower extremity orthosis on correction of genu valgum. 20 volunteers among people visited department of Rehabilitation Medicine, chungnam national university hospital, who had been diagnosed as genu valgum without other musculoskeletal problems were included. 10 individuals(mean age: 9.gyrs) who had been taken multiaxial lower extremity orthosis at least 12month were included in experimental group and the other 10 individuals(mean age: 11.7yrs) refused taking this orthosis in the control group. We measured the Q-angle & femorotibial angle using plain roentgenogram images at visiting day and repeat same test after 1year follow up. Multiaxial lower extremity orthosis consist of proximal horizontal bar with both thigh cuff, central vertical bar and distal horizontal bar with both shoes. we narrowed inter-shoes distance from start to 6th month and inter-thigh cuff distance together with above correction for next 6month in the frontal plane and from 10th month, dorsiflexed both shoes in sagittal plane. Also, we rotate the both shoes externally and retract the proximal vertical bar every month. This orthosis have to be taken at least 4 hours during sleep. The result were as follows 1. There were no statistical significant difference in each parameter between the right and left Q-angle before multiaxial lower extremity orthosis. 2. The left Q angle reduced $-11^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 3. The right Q angle reduced $-13^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 4. There were no statistical significant difference in each parameter between the right and left femorotibial angle before multiaxial lower extremity orthosis. 5. The left femorotibial angle reduced $-10.1^{\circ}$ between 1st day and after lyear follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 6. The right femorotibial angle reduced $-11.2^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001).

• Knee surgery & related research
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• v.30 no.4
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• pp.326-333
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• 2018

Purpose: To evaluate the reliability and validity of the femorotibial mechanical axis angle from radiographs in the weight bearing (WB) and supine positions compared with navigation-measured values. Materials and Methods: Sixty-eight cases of navigation-assisted total knee arthroplasty (TKA) were included. The pre- and postoperative whole leg radiographs (WLRs) in WB and supine positions were compared with the initial and final navigation values. Results: The mean mechanical axis angle from the preoperative WBWLR and navigation were not statistically different (p=0.079) and were correlated strongly with each other (intraclass correlation [ICC], 0.818). However, on postoperative measurements, although the WBWLR and navigation values were not different (p=0.098), they were not correlated with each other (ICC, 0.093). The standard error of measurement was $1.8^{\circ}{\pm}3.6^{\circ}$ for the preoperative WBWLR and $2.5^{\circ}{\pm}4.8^{\circ}$ for the postoperative WBWLR. The validity that was determined by the Bland-Altman plot was not acceptable for both pre- and postoperative measurements. Conclusions: The preoperative WBWLR could provide accurate but not precise measurement value of the femorotibial mechanical axis angle for navigation-assisted TKA, and postoperative measurements in navigation were not comparable with radiographic measurements. The lack of agreement was found between the radiographic and navigation measurements of the coronal alignment regardless of pre- or postoperative evaluation although the accuracy was found acceptable. Level of Evidence : Level 4.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.101-108
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• 2002

Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.

• Knee surgery & related research
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• v.30 no.4
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• pp.293-302
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• 2018

Purpose: High tibial valgus osteotomy (HTO) is a well-established surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closed-wedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the short-term results in a consecutive series of patients treated with hybrid CWHTO. Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average follow-up of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The Kellgren-Lawrence grading system and pre- and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed. Results: The FTA and MA significantly changed from $180.7^{\circ}$ to $170.4^{\circ}$ and from $22.0^{\circ}$ to $60.2^{\circ}$, respectively. No significant differences were observed between the mean pre- and postoperative posterior tibial slope, Insall-Salvati ratio, or Caton-Deschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.498-504
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• 2018

Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.427-434
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• 2019

Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.