• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.31-36
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• 2004

Purpose: We reviewed the effectiveness and the result of arthroscopic resection for ganglion cyst of posterior cruciate ligament(PCL) through the posterior trans-septal approach. Material and Method: Seven patients with symptomatic ganglion cyst of the PCL were treated with arthroscopic resection using posterior trans-septal approach. We analyzed advantages of the posterior trans-septal approach and presence of intra articular problem. Knee function was assessed using the lysholm knee scale. Results: The overall result for the 7 knees were very satisfied in all. We found that four of seven patients had intra articular problems, and past history of trauma could be found in 3 cases. The Lysholm knee scale was increased from average 93.3 points preoperatively to average 97.8 points postoperatively. Conclusion: Arthroscopic posterior trans-septal approach shows an effective technique for complete resection of cyst and evaluation of the combined posterior compartment injury.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.13-19
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• 2010

Purpose: To evaluate and compare the postoperative knee stability and functional scores between single- and double- bundle anterior cruciate ligament (ACL) reconstruction at a minimum 2 years follow-up. Materials and Methods: 56 patients (group T) with ACL injury in one knee were recruited with 27 allocated to the double bundle ACL reconstruction group (group D) and 29 to the single bundle ACL reconstruction group (group S). Clinical outcomes including Lysholm knee scores, Tegner activity scores, Lachman and pivot shift test results, and radiographic stabilities were also compared between two groups. Results: Clinical outcomes including Lysholm knee and Tegner activity scores were similar in the two groups at 2 years follow-up. Furthermore, stability results of Lachman test, pivot shift test, and radiological findings failed to reveal any significant inter-group differences. Conclusion: Double bundle ACL reconstruction does not produce better in clinical outcomes and postoperative stabilities.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.40-43
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• 1999

Arthroscopic anterior cruciate ligament(ACL) reconstruction using four-strand hamstring tendon with looping around transfixing screw in femoral tunnel requires osteointegration between the grafted tendon and bone for stability of the knee. Authors have experienced a histologic finding of osteointegration between the grafted autogenous hamstring tendon and bone in femoral tunnel after arthroscopic ACL reconstruction. A patient received arthroscopic ACL reconstruction with autogenous four strand hamstring tendon for the ACL injury. Traumatic re-rupture of mid-substance of ACL graft was developed at thirteenth week after operation. During the procedures of arthroscopic revision at fifteenth week after initial ACL reconstruction, biopsy was performed at the site of interface between grafted tendon and bone in femoral tunnel. Integration between the grafted tendon and bone was evident by demonstrating the continuity of collagen fiber between bond and tendon. This histologic finding and the low incidence of early graft failure suggest that free tendon autograft attached to bone by looping around a transfixing screw in femoral tunnel undergoes adequate osteointegration between 12 and 15 weeks after surgery and authors thought that insertion of bone chip into the femoral tunnel would accelerate osteointegration procedure.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.12-17
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• 2008

Purpose: This study presents clinical results of anterior cruciate ligament(ACL) augmentation using autogenous two-strand semitendinosus tendon in the treatment of partial ACL tears with preservation of residual portion. Materials and Methods: From January 2004 to June 2006, twenty two patients who had an ACL injury underwent ACL augmentation using autogenous two-strand semitendinosus tendon were enrolled in this study. We evaluated the clinical results with regard to clinical findings(range of motion, Lachman test, pivot shift test), standard knee scales(Lysholm, Modified Feagin Scoring System), and KT-1000 arthrometer testing. Results: At minimum one year postoperatively, there was no limitation of range of motion. Lachman and pivot shift tests were negative in all knees. On instrumented anterior laxity test by KT-1000 arthrometer, mean side to side difference was improved from 4.6mm preoperatively to 1.7mm postoperatively. Average Lysholm score was improved from 70 to 92. Ninety one percent of cases were rated as good or excellent in Modified Feagin Scoring System. Conclusion: Augmentation using autogenous two-strand semitendinosus tendon with preservation of residual portion of the ACL seems to be an acceptable method for restoring knee stability and proprioceptive function.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.31-36
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• 2002

Objective : The purpose of this study was to evaluate the clinical and radiological results after treatment of old ACL(anterior cruciate ligament) avulsion fracture of tibia. Materials and Method : 11 cases who were followed up at least 2 years after treatment in chronic ACL avulsion fracture of tibia were included in this study. The average age of patients was 26(9-66) years and the mean period of follow up was 53(24-131) months. After evaluation of the lesion and treatment of associated lesion under arthroscope, open reduction and internal fixation or fragment removal was performed. Pull-out suture was performed in 8 cases, screw fixation in 2 cases. Results : The Lysholm knee score was 64.3 in average preoperatively and improved to 96.2 average at follow up. On the Lachman test, there were mild(+) instabilities in 7 cases, moderate(++) in 4 cases. On the postoperative Lachman test, there were no instabilities in 9 cases, mild(+) instabilities in only 2 cases. According to Meyers and Mckeever's evaluation protocol, 9 cases $(81.8\%)$ were excellent, 2 case $(18.2\%)$, good. On preoperative instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 201b was 7.8(10-4) min in average and 2.1(6-0) mm in average at follow-up. Conclusion : In chronic ACL avulsion fracture, it is thought that combination of arthroscopic evaluation of associated injury and open reduction and fixation and fragment removal can bring about satisfactory results.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.82-85
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• 2009

Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.209-216
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• 2010

Purpose: The purpose of our study was to compare treatment results of two different surgical techniques for chronic acromioclavicular joint dislocations. Materials and Methods: Fifty consecutive patients diagnosed as chronic acromioclavicular joint dislocations between January 1997 and June 2009 were included in the study. Patients were randomized into two different groups. Patients in the first group (n=20) were treated using a modified Weaver and Dunn method using a simple coracoacromial ligament transfer method. Patients in the other group (n=30) were treated with acromial bone-block transfer containing coracoacromial ligament. Mean follow-up times for the two groups were 13.1 and 14.9 months, respectively. Results: At 1 year postoperatively, mean coracoclavicular distance, the VAS score and the ASES score for the Weaver-Dunn method group; for the bone block transfer method group were 3.8 mm (-3 to 6 mm), 3.5 (1.0 to 7.0) and 91.1 (81.66 to 95); 3 mm (-2 to 6 mm), 4.2 (1.0 to 7.5) and 79.6 (31.66 to 95). There were no significant differences in radiologic (p=0.377) and functional (p=0.093) results between the two groups. Failures in the former and latter group were, respectively, two and one. Conclusion: The bone block transfer method shows a tendency to maintain coracoclavicular distance and appeared to yield similar results as the modified Weaver Dunn method.

• 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 Korean Foot and Ankle Society
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• v.9 no.2
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• pp.167-172
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• 2005

Purpose: We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment. Materials and Methods: Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system. Results: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were $74.0{\pm}5.5$, which improved to $89.3{\pm}6.7$ at the follow-up after the treatment (P<0.001). Conclusion: Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.201-206
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• 2005

Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.