During below knee amputation, the amputation stump must be covered with well-vascularized and sensate soft tissue. Many flaps can be used for this purpose, but available reconstructive options are limited. We performed reverse flow ALT flap elevation on two patients with below knee amputations to reconstruct defects in the stumps. The sizes of the defects in the stumps were $4{\times}16$ cm and $5{\times}5$ cm, respectively. The most distal portion of the defects were located 20 cm and 16 cm lateral to the knee joint in a curve, respectively. The size of the elevated flap was $5{\times}18$ cm for case 1 and $18{\times}10$ cm for case 2. The respective pivot points of the pedicles were 7 cm and 6 cm above the patella and the respective lengths of the pedicles were 17 cm and 16 cm. In both cases, venous congestion occurred on the second postoperative day and the flap distal to 10 cm or more from below the knee joint was necrotized at the second postoperative week. Surgeons should be cautious when using a reverse ALT flap to reconstruct a soft tissue defect located 10 cm or more distal from below the knee joint. Since a pedicle longer than 15 cm may develop partial necrosis of the flap, simultaneous application of antegrade venous drainage is recommended.
Kim, Jin Goo;Lim, Young;Kim, Byung Jik;Ko, Han Suk;Moon, Hyung Tae
Journal of the Korean Arthroscopy Society
/
v.2
no.2
/
pp.107-113
/
1998
This study is retrospective analysis of 31 patients treated by arthroscopically assisted ACL reconstruction, from September 1995 to September 1996. ACL reconstructions using autogenous bone patellar tendon bone (B-PT-B) were done in 18 patients, and using hamstring tendon were done in 13 patients. We used four-stranded hamstring tendon grafts and fixed the grafts using Endobutton and screw. The mean postoperative Lysholm knee score was 87.2 points in B-PT-B. group, and 89.0 points in hamstring tendon group. There were no clinically significant results between two groups in Telos test, quadriceps atrophy, Lachman test, anterior drawer test and pivot shift test, but the incidences of anterior knee pain were lower in hamstring group. Four-stranded hamstring tendon graft showed enough stability and good functional outcome similar to that of patellar tendon graft, and had an advantage of quicker return of quadriceps function and less donor site morbidity.
Journal of the Korean Society of Clothing and Textiles
/
v.27
no.9_10
/
pp.1048-1059
/
2003
This study focusses pattern draft and grading of jeans for women in their 20s, who consume jeans the most. Pattern was drafted based on existing patterns collected from companies. It is different from the existing educational patterns. It suggests new sizing system for twenties referring to sizes used companies and grading rule and method. he results were as follows; 1. Companies manufacture 2-8 sizes and they referred to the Korean Industrial Standards, KS K 0051, for their sizing system. 2. Drawing method for Pattern of the study had following measurements for each part: in the case of waist circumference, front part was W/4+1.5cm, back part was W14+2cm, front hip circumference was H/4-1.5cm, crotch line was the crotch length (practical measurement), hip circumference was (upper crotch line length)/5+0.5cm, front crotch part was 2.7cm, back crotch part was W/5+2.7cm, knee height was (the length of leg)/2+6cm and the circumference of knee and the tip of pants were 40cm. Through the wearing test on the subject of twenties, researched pattern received higher ratings, especially in appearance than the existing pattern. 3. 5 sizes system was made referred to the sizing system of companies and National Anthropometric Survey of Korean in 1997 Grading rule for 12 grading points of front part and 13 grading points of back part was suggested. Results of wearing test on the graded patterns showed high ratings similar to standard size.
Jung, Young Bok;Tae, Suk Kee;Yum, Jae Kwang;Koo, Bon Ho
Journal of the Korean Arthroscopy Society
/
v.2
no.2
/
pp.135-140
/
1998
From 1989 to 1994, authors have reconstructed the posterior cruciate ligament(PCL) in 51 knees with an autogenous central one-third of the patellar tendon by transtibial two tunnel technique, but there were not a few cases of unfavorable results. So from January 1995, we have reconstructed the PCL deficient knees by "modified tibial inlay technique" to avoid the grafted tendon abrasion at the posterior opening of the tibial tunnel(killer turn). Purpose of this study was to compare the results of two surgical techniques and what its advantages and disadvantages are. We could follow up 39 cases of transtibial two tunnel techique group(group A) more than one year, average being 23.7 months and 21 cases of modified tibial inlay technique group(group B) more than 12 months, average being 14.7 months. The clinical results were evaluated by the OAK knee scoring system ($M{\ddot{u}}ller$'s criteria) and the posteror stress roentgenography (push view) with Telos stress device compared with the uninjured knees. The arthroscopic second-look findings were also evaluated. In group A : The $M{\ddot{u}}ller$'s knee score was average 80.1 points, the posteror displacement in push view was average 4.4mm at the last follow up. There were 17 cases(44%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view. Among the 19 cases of arthroscopic second look examinations, nearly normal PCL appearances of the grafted tendons were noted only in 9 cases(47%). In group B : The $M{\ddot{u}}ller$'s knee score was average 86.7 points, the posterior displacemnet in push view was average 3.6mm at the last follow up. There were 5 cases(23.8%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view but 4 out of 5 cases showed 6mm posterior displacement in push views. Among the 7 cases of arthroscopic second-look examinations, 6 cases(86%) showed nearly normal PCL appearances of the grafted tendons. In modified tibial inlay technique of PCL reconstruction, it was easier to pull out the BPTB and in cases of remained laxed meniscofemoral ligament it was easier to preserve the remained structures than transtibial two tunnel technique. We expect the "modified tibial inlay technique" may solve the problem of grafted patellar tendon abrasion at the posterior orifice of tibial tunnel and may contribute to the successful PCL reconstruction.
Shin, So Yeon;Seo, Dong Kyun;Kim, Shin Young;Seo, Jong Cheol;Seo, Yeon Ju;Lee, Yoon Joo;Bin, Chang Hyun;Jung, Taek Gun;Song, Chun Ho;Yoon, Hyun Min;Kim, Cheol Hong;Jang, Kyung Jeon
Journal of Acupuncture Research
/
v.32
no.3
/
pp.163-173
/
2015
Objectives : The aim of this study is to determine whether Chinemys reevesii Gray pharmacopuncture is a clinically effective treatment for women with knee osteoarthritis. Methods : Female patients with knee osteoarthritis were recruited from May $1^{st}$, 2014 to April $15^{th}$, 2015 at the Department of Acupuncture & Moxibustion Medicine of Dong-Eui University Korean Medical Hospital. Patients were randomly assigned to two groups. 4.0 ml of Chinemys reevesii Gray pharmacopuncture was injected at acupuncture points of the experimental group(n = 24) twice a week for three weeks. The control group(n = 24) received 5 % dextrose injections in order to identically stimulate the same acupuncture points of $ST_{35}$, $ST_{34}$, $SP_9$, $SP_{10}$, $GB_{34}$, $LR_8$, $EX-LE_4$, and $EX-LE_2$. The Short-Form McGill Pain Questionnaire(SF-MPQ), the Korean Western Ontario and McMaster Universities Osteoarthritis Index(KWOMAC), and the European Quality of Life-5 Dimensions(EQ-5D) were recorded to evaluate treatment efficacy at first visit, after two weeks and four weeks from the initial visit. Results : 40 patients completed the trial. The experimental group showed more significant improvement than the control group in the scores of SF-MPQ, KWOMAC, and EQ-5D. However, there was no significant difference between groups in a few of the assessment scales. Conclusions : Chinemys reevesii Gray pharmacopuncture can be an effective treatment in control of pain, improvement in function and health-related quality of life for women with knee osteoarthritis.
Background: The multitude of the therapeutic usefulness of intra-articular injection of hyaluronate on oateoarthritis of the knee is still in question. The objective of this systemic review was to elucidate both the therapeutic efficacy and the safety of intra-articular administration of hyaluronic acid for degenerative osteoarthritis of the knee joints. Methods: I searched MEDLINE and Korea Medical Database (KMbase) from January 1990 to April 2007 using a combination search terms for knee osteoarthritis and hyaluronic acid and a filter for randomized controlled trials. I extracted data on pain at rest, and during or just after movement, on joint function, and on adverse events. Results: Ten trials that reported usable quantitative information on any of the predefined end points were identified and included in the systemic review. Intra-articular injection of hyaluronic acid can decrease symptoms of osteoarthritis of the knee. The study revealed significant improvements in pain and functional outcomes with few adverse effects. However, there was significant between-study heterogeneity in the estimates of the efficacy of hyaluronic acid. Sub-group analysis showed that lower methodological quality such as a single-blind or single-center design resulted in higher estimates hyaluronic acid efficacy, and that patients older than sixty years of age and those with the most advanced radiographic stage of osteoarthritis were less likely to benefit from intra-articular injection of hyaluronic acid. Conclusion: According to the currently available evidence, intra-articular hyaluronic acid has been proven clinically effective for the patients bearing the knee osteoarthritis with NSAID-induced GI troubles or inapplicable to any surgery, and may be associated with lower risk of adverse events.
Purpose: The purpose of this study was to compare the effects of Tai-Chi exercise (TCE) and resistance exercise (RE) when used as part of a community-based exercise program on improvement of physical function in elderly women with knee arthritis. Methods: Forty-seven women with knee arthritis participated in this study. They were assigned to one of two groups: the TCE group (n=22) or the RE group (n=25). Tai-Chi exercise and resistance exercise sessions were held for 1 hour per session, twice per week, for 8 consecutive weeks. At pre-treatment and post-treatment, subjects were tested using the following measurements: one-legged stand test (sec), a functional reach test (cm), a test of the strength of the knee extensor and flexor muscles, determination of the pathway of center of foot pressure and vertical ground reaction force for stance phase at pre and post treatment time points. An independent t-test and a ${\chi}^2$ were used to determine the significance of differences between group means using SPSS 12.0. Results: After 8 weeks of participation in the exercise programs, there were significant improvements for both groups in joint pain, difficulty of performing activity, muscle strength of knee extensor and flexor. Also, vertical ground reaction force increased at the loading response phase for both groups. The RE group was significantly different from TC group on the eyes-closed one-legged stand test (sec). Conclusion: Tai-Chi exercise and resistance exercise programs improve physical functioning and reduce pain and locomotion difficulties.
Kim, Kyung Tae;Lee, Song;Kim, Jin Hak;Lee, Ho Young;Kim, Myung Jin
Journal of the Korean Orthopaedic Association
/
v.56
no.1
/
pp.34-41
/
2021
Purpose: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in elderly patients older than 70 years by analyzing cases that have been implanted for >10 years ago. Materials and Methods: The long-term follow-up results were evaluated in 39 patients (46 cases) who underwent medial UKA from March 2002 to February 2004. The mean age of the patients at the time of surgery was 74.0 years, and the preoperative diagnosis was degenerative arthritis of the knee in all cases. Results: Of the 46 cases, reoperation occurred due to the complications in four cases. In 22 cases without 14 cases of death and six cases of follow-up loss, follow-up more than 10 years was possible. The mean Knee Society knee and function scores improved significantly from 53.0 and 52.5 points pre-operatively to 89.4 and 80.9 points at the last follow-up, respectively (p<0.001). The mean range of motion of the knee recovered to 132.5°, and the mean tibiofemoral angle changed to 5.9° of valgus at the last follow-up. Complications following the UKA occurred in four cases; the most prevalent complication was mobile bearing dislocation (n=2). One case of failure occurred due to aseptic loosening and degenerative arthritis of the lateral compartment, respectively. The cumulative survival rate of the implants was 95.0% at 10 years and 85.7% at 15 years. Of the 40 cases, excluding six cases of follow-up loss, 36 cases (90.0%) could be used without reoperation until death or at the last follow-up after surgery. Conclusion: These results showed the outstanding functions of the knee and satisfactory long-term survivorship after UKA. Therefore, UKA could be a useful method for the treatment of osteoarthritis of the knee in elderly patients older than 70 years of age.
Objectives: In order to select proper acupoints, it is important to understand the principle of major acupoints composition among 361 acupoints. Methods: We investigated the composition of major acupoints from Four Command points to Star Twelve points based on the classical medical texts. We reviewed the common principle of major acupoints composition. Results: First, major acupoints are chosen to treat the targeted diseases associated with the corresponding meridian channels and these acupoints are located in distal part of the body below the knee and the elbow. Second, main acupoints are supposed to be the representative points among acupoints with similar indications. Main acupoints can be selectively to treat a specific disease or condition, rather than be used for general effect simultaneously. Conclusions: We demonstrated the major acupoints from classical medical texts and revealed the common principles of major acupoints composition. These findings can help Korean medical doctors to choose more appropriate acupoints by understanding the principle of major acupoints composition.
Objective: The purpose of this study is to provide a better understanding of long turn mechanism by describing long turns after kinematic analysis and provide skiers and winter sports instructors with data through which they are able to analyze right postures for turns in skiing in a systematic, rational and scientific manner. Method: For this, a mean difference of kinematic variables (the center of gravity (CG) displacement of distance, trajectory, velocity, angle) was verified against a total of 12 skiers (skilled and unskilled, 6 persons each), regarding motions from the up-start to down-end points for long turns. Results: First, concerning the horizontal displacement of CG during a turn in skiing, skilled skiers were positioned on the right side at the upstart and edge-change points at a long turn. There was no difference in anteroposterior and vertical displacements. Second, in terms of CG-trajectory differences, skilled skiers revealed a significant difference during a long turn. Third, regarding skiing velocity, skilled skiers were fast at the edge-change and maximum inclination points in long turns. Fourth, there was no difference in a hip joint in terms of a lower limb joint angle. In a knee joint, a large angle was found at the up-start point among skilled skiers when they made a long turn. Conclusion: In overall, when skilled and unskilled skiers were compared, to make a good turn, it is required to turn according to the radius of turn by reducing weight, concerning the CG displacement. Regarding the CG-trajectory differences, the edge angle should be adjusted via proper inclination angulation. In addition, a skier should be more leaned toward the inside of a turn when they make a long turn. In terms of skiing velocity, it is needed to reduce friction on snow through the edging and pivoting of the radius or turn according to curvature and controlling ski pressure. Regarding a lower limb joint angle, it is important to make an up move by increasing ankle and knee angles instead of keeping the upper body straight during an up motion.
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