• The Korean Journal of Pain
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• v.20 no.2
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• pp.130-137
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• 2007

Background: We evaluated the role and effects of prolotherapy in patients presenting with lower back pain and detected sacral asymlocation, by retrospectively analyzing the results of prolotherapy performed at our institute. Methods: Twenty-three patients with referred pain in the lower back rather than distinct radiculopathy, were detected to have sacral asymlocation by simple X-ray from May 2004 through July 2005. The patients were treated with prolotherapy and manipulation by the Ongley's method around the lumbosacral junction, iliolumbar ligament, and sacroiliac joint. They were treated for approximately one to two week intervals, and during this period were rechecked by X-ray and evaluated using the visual analogue scale (VAS). Results: A total of 23 patients were included in the study (10 male and 13 female), and the average age was 41 years. The average VAS at the time of visit was B.5, the average treatment time was 4,7 days, and the average VAS after treatment was 2.1. Conclusions: Back pain, and associated leg and buttock pain, originate from several causes. In these case analyses, instability around the lumbosacral area and sacral asymlocation might have been important causes of patient back pain and associated buttock and leg pain. We therefore applied prolotherapy as well as manipulation techniques devised by Ongley to these patients, and obtained good results.

• Journal of Korean Neurosurgical Society
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• v.62 no.6
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• pp.661-670
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• 2019

Objective : Rheumatoid arthritis (RA) is known to involve the cervical spine up to 86%. It often causes cervical instability like atlantoaxial subluxation (AAS), subaxial subluxation, and vertical subluxation (VS). In order to find the relation between RA and cord compression, we will evaluate the characteristics and risk factors of basilar invagination (BI) and cervicomedullary junction (CMJ) compression. Methods : From January 2007 to May 2015, 12667 patients administrated to Hanyang University Medical Center. Four thousand three hundred eighty-six patients took cervical X-ray and 250 patients took cervical computed tomography or magnetic resonance imaging. Radiologic parameters, medication records were obtained from 242 patients. Multivariate logistic regression analysis was performed with correlation of CMJ compression, basin-dental interval (BDI), basin-posterior axial line interval (BAI), pannus formation, BI, and AAS. Results : In the point of CMJ compression, atlantodental interval (ADI), posterior-atlantodental interval, BAI, AAS, and BI are relatively highly correlated. Patients with BI have 82 times strong possibility of radiologic confirmed CMJ compression, while AAS has 6-fold and pannus formation has the 3-fold possibility. Compared to the low incidence of BI, AAS and pannus formation have more proportion in CMJ compression. Furthermore, wrist joint erosion was correlated with VS and AAS. Conclusion : BI has a very strong possibility of CMJ compression, while AAS and pannus formation have a high proportion in CMJ compression. Hence bilateral wrist joint erosion can be used as an indicator for the timing of screening test for cervical involvement. We suggest the early recommendation of cervical spine examination for the diagnosis of cervical involvement in order to prevent morbidity and mortality.

• Physical Therapy Korea
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• v.28 no.1
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Journal of Veterinary Science
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• v.21 no.5
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• pp.53.1-53.12
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• 2020

Background: The TightRope System is a device developed to provide extracapsular stabilization of the cranial cruciate ligament (CCL) rupture in canine stifles. I was then also employed for the extra-articular treatment of shoulder instability and for the intra-articular treatment of hip luxation in dogs and cats. Objectives: To evaluate the feasibility of the Mini-TightRope (mTR) System for the intraarticular treatment of CCL rupture in small breed dogs. Methods: A cadaveric canine model was used to record the steps of the surgical procedure. Five client owned dogs weighing from 8 to 10 kg and from 2 to 12 years of age were enrolled in the prospective study in which the mTR device was implanted in the stifle joint to replace the ruptured CCL. The dogs were graded using the Bologna Healing Stifle Injury Index (BHSII) and radiographic osteoarthritis (OA) scores. Results: The outcomes obtained at the time of the surgery (T0) and for the following 12 months (T12) showed an improvement in the functional parameters (BHSII from a median of 74.3 [range, 58.1-82.4] at T0 to 95.6 [range, 94.1-99.3] at T12]). The OA did not change in 3 dogs and increased by only 1 point in 2 dogs. Conclusions: In this preliminary study, the mTR was a successful and repeatable intraarticular surgical procedure for all dogs. Additional studies related to the clinical application of the technique in medium-large dogs should be encouraged.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.49-61
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• 2022

PURPOSE: This study compared the effects of proprioceptive sensation, subacromial space, and dynamic function according to proprioceptive neuromuscular facilitation (PNF), static stretching (SS), and complex rotational stretching (CRS). METHODS: Thirty students without any musculoskeletal disease who volunteered to participate were included in this study. The following metrics were measured to evaluate the function and stability under the normal conditions, with the PNF, SS, and CRS: special test and flexion, extension, abduction, adduction, internal rotation, external rotation (shoulder range of motion) and reaching distance on the medial (ME), superolateral (SL), inferolateral (IL), and subacromial space and proprioceptive sensation were evaluated. All measures were analyzed using one-way ANOVA and repeated measures of ANOVA. RESULTS: A clear difference in adduction in the range of motion was observed in all groups (p < .05). Significant differences could not be identified in all values in the error test, except for Ab (p < .05). Significant differences in reach were noted in all directions of the SS and PNF in the Me, SL, and IL (p < .05). After the intervention, significant differences in the average values could be identified in all groups except for the SS group after rest (p < .05). After the intervention, there was a significant difference between the CRS and SS and PNF groups (p < .05). CONCLUSION: The application of CRS is as helpful as the existing SS and PNF for improving the joint range of motion improvement, shoulder balance, and subacromial space.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.16-21
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• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.531-548
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• 2024

Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.103-108
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• 2004

Purpose: This study reported the outcomes following the use of bioabsorbable knotless anchor in patients with anterior instability of shoulder. Methods: We studied fifteen cases with traumatic anterior shoulder instability underwent arthroscopic Bankart repair with bioabsorbable knotless suture anchor between January 2003 and June 2003. Among fifteen patients, fourteen were male and one was female, with a mean patient age of 24 years (range 16-42). The mean follow-up was 14 months (range 12-18 months). We compared with operation time of twenty cases of arthroscopic Bankart repair by the suture anchor technique between January 2002 and October 2002. Results: Neither recurrent dislocation nor subluxation was happened in postoperative follow-up. Mean score for functional evaluation by Rowe et al. was 89.4 and that for patient subjective satisfaction was 87,5. At last follow-up period, average shoulder range of motion for flexion and external rotation was 171$^{\circ}$ and 54$^{\circ}$ respectively. All patients were satisfied except three who had an apprehension at the follow up. During Bankart repair, it took an average of 25.5 minutes for one knot with the use of suture anchor technique whereas an average of 16.5 minutes for one knot with the use of bioabsorbable knotless anchor. Significantly, we saved operation time with the use of bioabsorbable knotless anchor (P<0.05).Conclusion: Repairing the Bankart lesion with the use of knotless anchor technique has the advantage of obtaining good capsular tensioning and saving operation time. And it is considered to be very successful in treating shoulder instability without recurrent dislocation or subluxation.

• Geotechnical Engineering
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• v.12 no.3
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• pp.35-48
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• 1996

Reinforced soil structures may experience large local movements between soil and reinforcement. The failure modes of a reinforced structure depend on several factors which are governed by deformation and slipping of the reinforcement. In some cases, pulling out of the reinforcement may occur instead of rupturing, The growing use of geosynthetic liner system for storage of solid and liquid wastes has led to a number of slope instability problems where the synthetic liner may undergo a large amount of stretching and slipping as a result of the loading. The conventional finite element model for the soil-reinforcement interface uses a zero thickness joint element with normal and shear stiffnesses and can only accommodate a small amount of deformation. When a large slippage occurs, the model provides an i ncorrect mechanism for deformation. This paper presents a new interface finite element model which is able to simulate a large amount of slippage between soil and reinforcement. The formulation of the model is presented and the capability of the model is demonstrated using illustrative examples.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.2
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• pp.47-54
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• 2015

Purpose: This study was to investigate the effects of lumbar stabilization exercise and lower extremity strengthening program on pain, lower extremity muscle in patients with chronic low back pain. Method: The subject were randomly divided two groups. 15 people who were conducted lower extremity exercises and lumbar stabilization exercises called the combined exercise group and other(15 people) who were only conducted lower extremity exercise group. The assessment tools were the pain level and the led muscle power. Exercise was conducted for eight weeks. Result: Pain of the combined exercise group showed significant differences in the change in pain level(p<.05). The leg muscle power showed significant differences within group which hip flexor, extensor muscles and abductor muscles. there were significant differences within combined exercise group (p<.05). But the knee joint in each group showed a significant difference within group (p<.05). Conclusion: This study suggest that the lumbar stabilization exercises and lower extremity exercises showed more efficient results in the pain levels and leg muscles power than only the lower extremity exercise for patients with lumbar instability.