• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.155-162
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• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.235-240
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• 2019

Ulnar collateral ligament injuries of the elbow are frequent among overhead athletes. The incidence of ulnar collateral ligament reconstructions (UCLRs) in high-level players has increased dramatically over the past decade, but the optimal technique of UCLR is controversial. Surgeons need to manage the patients' expectations appropriately when considering the mode of treatment. This article reviews current studies on the management of ulnar collateral ligament injuries, particularly in overhead athletes.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.197-200
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• 2005

We performed lateral ankle ligament reconstructions using Achilles allograft on patients who had failed previous Brostrom repair. The bone plug is fixed with an interference screw into the calcaneus, the tendon graft is passed through a fibular tunnel, and then anchored into the talus with the biotenodesis screw. The graft is strong enough to maintain joint stability until graft incorporation and remodeling occurs. In patients with chronic failed lateral ankle instability requiring graft for ligament reconstruction, this technique allows anatomic reconstruction without the need to sacrifice autogenous peroneal tendons.

• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.62-66
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• 2016

A modified $Brostr{\ddot{o}}m$ procedure has been widely accepted as a treatment of choice for patients with chronic lateral ankle instability. The procedure is highly reliable and provides successful outcomes in approximately 90% of cases. Severe degree of instability, absence or poor quality of the ligamentous remnant, obesity, and generalized joint hypermobility have been regarded as poor prognostic factors related to the modified $Brostr{\ddot{o}}m$ procedure. However, these perceptions are based on a low level of evidence studies or expert opinions. Therefore, the aim of this article was to search for evidences regarding the poor prognostic factors of the modified $Brostr{\ddot{o}}m$ procedure.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.13-20
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• 2023

Purpose : The purpose of this study is to compare the balance ability between subjects with chronic ankle instability and normal people and the center of pressure displacement during the sit to stand and stand to sit. Methods : The subjects of this study were 63 who met the inclusion criteria and were classified into normal group (n=33) and chronic ankle instability group (n=30). The displacement of the center of pressure during sit to stand and stand to sit was measured. And the limit of stability and Y-balance tests were performed to measure the balance ability. Independent t-test was conducted to compare center of pressure displacement and balance ability between groups, and pearson correlation was conducted to analyze the correlation between the center of pressure displacement and balance ability. Results : In the case of the center of pressure displacement, there was a significant difference between the two groups during sit to stand and stand to sit. In the case of balance, both limit of stability and Y-balance test showed significant differences between the two groups. At the time of sit to stand, the center of pressure displacement showed a significant correlation with balance abilities, and at the time of stand to sit, the center of pressure displacement showed a significant correlation with Y-balance test. Conclusion : Chronic ankle instability shows that there is a lot of sway in the body due to compensation to replace the decrease in ankle joint range of motion when performing sit to stand and stand to sit due to sensory input damage such as decrease in ankle range of motion and decrease in ankle proprioception. Chronic ankle instability is expected to have a negative effect on our daily lives in life. The results of this study will serve as the basis for the dynamic approach to objective evaluation, treatment, and prevention of chronic ankle instability.

• Journal of the Korean Institute of Intelligent Systems
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• v.17 no.5
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• pp.640-647
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• 2007

This paper presents a joint controller for a humanoid robot based on genetic algorithm. h humanoid robot has basically instability during walking because it isn't fixed on the ground. Moreover nonlinearities of the joints increase its instability. If one of them isn't satisfied, the robot may fall down at the ground during walking. To attack one of those problems, joint controller is proposed. It can perform tracking control preciously and reduce the effect of nonlinearities by gear, limitation of the input voltage, coulomb friction and so on. This controller is based on fuzzy-sliding mode controller (FSMC) and compensator and control gains are searched by a proposed genetic algorithm. It can reduce the effect by nonlinearities. Also, to improve the tracking performance, the proposed controller has motion controller. From the given controller, a humanoid robot can moved more preciously. Here, all the processes are investigated through simulations and it is verified experimentally in a real joint system for a humanoid robot.

• The Journal of Korean Physical Therapy
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• v.28 no.5
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• pp.303-307
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• 2016

Purpose: This study was conducted to determine the effects of Mulligan's mobilization with movement (MWM) on changes in the talofibular interval in the sagittal plane in subjects with chronic ankle instability (CAI). Methods: Sixteen subjects with chronic ankle instability participated in this study. The talofibular intervals were measured from US images, and the weight-bearing lunge test was used to assess dorsiflexion of the ankle joint. Each dependent variable were measured on the both affected side and sound side in three trials in pre- and post-MWM. Dependent variables were examined with a two-way mixed-design analysis of variance (ANOVA). The two factors were side (sound side versus affected side) and intervention (pre- versus post-intervention). For post hoc analysis, paired t-tests were performed to compare the dependent variables. A p<0.05 was considered to indicate significance. Results: Dorsiflexion and talofibular interval differed significantly pre- and post-intervention (p<0.05). Post-hoc analysis revealed that the talofibular interval post-MWM was significantly less than that pre-MWM on the both the affected and sound side (p<0.05). The ankle dorsiflexion in the post-MWM group was significantly greater than that in the pre-MWM group on the affected side and the sound side (p<0.05). Conclusion: The Mulligan's MWM decreased the talofibular interval in subjects with CAI. These findings suggest that the MWM technique can change the position of the talus relative to the fibular in the weight bearing position.

• Steel and Composite Structures
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• v.28 no.4
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• pp.427-438
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• 2018

Static stability is a decisive factor in the design of domes. Stability-related external factors, such as load and supports, are incorporated into structural vulnerability theory by the definition of a relative rate of joint well-formedness ($r_r$). Hence, the instability mechanism of domes can be revealed. To improve stability, an optimization model against instability, which takes the maximization of the lowest $r_r$ ($r_{r,min}$) as the objective and the discrete member sections as the variables, is established with constraints on the design requirements and steel consumption. Optimizations are performed on two real-life Kiewitt-6 model domes with a span of 23.4 m and rise of 11.7 m, which are initially constructed for shaking table collapse test. Well-formedness analyses and stability calculation (via arc-length method) of the models throughout the optimization history demonstrate that this proposed method can effectively enhance $r_{r,min}$ and optimize the static stability of shell-like structures. Additionally, seismic performance of the optimum models subjected to the same earthquake as in the shaking table test is checked. The supplemental simulations prove that the optimum models are superior to the original models under earthquake load as well.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.1-5
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• 2008

Shoulder instability is generally diagnosed from a detailed history, physical examination and various radiological studies. Although, a physical examination is essential for making a diagnosis, it is quite difficult. For a precise physical examination, a thorough anatomical knowledge and a great deal of experience is needed. In addition, normal translation and pathologic laxity should be differentiated. An anatomical and biomechanical understanding of a stable and unstable shoulder joint and a precise physical examination are needed to determine the direction and extent of the instability as well as to diagnose the associated lesions and improve the surgical results.