• Title/Summary/Keyword: Ligament Reconstruction

Search Result 356, Processing Time 0.021 seconds

Factors Affecting the Extent of Graft Tendon Synovialization after Double-Bundle Anterior Cruciate Ligament Reconstruction: Based on Second-Look Arthroscopic Findings

  • Ahn, Gil Yeong;Nam, Il Hyun;Lee, Yeong Hyeon;Lee, Yong Sik;Choi, Young Duk;Lee, Hee Hyung;Hwang, Sung Hyun
    • Clinics in Orthopedic Surgery
    • /
    • v.10 no.4
    • /
    • pp.413-419
    • /
    • 2018
  • Background: We aimed to examine the factors that influence synovialization of the grafted tendon after double-bundle anterior cruciate ligament (ACL) reconstruction based on second-look arthroscopic findings. Methods: Out of 205 knees that were treated between August 2008 and May 2016 with double-bundle ACL reconstruction using bio-absorbable cross-pins and Endobuttons for femoral tunnel fixation, we enrolled 65 knees (64 patients) that underwent second-look arthroscopy with hardware removal at 1 year postoperatively. Measured clinical outcomes included the Lysholm score and Tegner activity score that were evaluated preoperatively and during the final follow-up. We analyzed the relationship between synovial coverage and patient age, length of the preserved remnant tissue on the tibial side, type of bundle (anteromedial or posterolateral), type of graft (autograft or allograft), and time from injury to surgery. Results: The area of synovial coverage showed a significant statistical correlation with patient age and the length of the preserved remnant tissue on the tibial side. The average synovial coverage was significantly better for the anteromedial bundle than for the posterolateral bundle, better for the autograft than for the allograft reconstruction, and better when treated in the acute stage than in the chronic stage. However, synovialization of grafted tendon did not correlate to clinical outcomes. Conclusions: While we were able to identify several factors influencing synovialization of the grafted tendon after double-bundle ACL reconstruction, including patient age, length of preserved remnant tissue of the torn ACL, type of bundle, type of graft, and time from injury to surgery, we found no evidence that increased synovialization improves clinical outcomes at 1 year postoperatively.

Exercise Treatment of Knee Joint After Anterior Cruciate Ligament Reconstruction Operation (전방십자인대 재건술 후 슬관절 운동치료 접근에 관한 고찰)

  • Kim, Yeun-Jung;Jung, Jae-Min;Han, Jin-Tae
    • Journal of the Korean Society of Physical Medicine
    • /
    • v.3 no.1
    • /
    • pp.27-37
    • /
    • 2008
  • Purpose : Today, it enjoys a sports and a leisure where the anterior cruciate ligament(ACL) injury patient increase. The knee joint is important means of human body movement and to do an important duty when it encounters ACL injuries of the knee joint and the many restriction follows in the life which is ordinary. When it is damaged ACL, it comes to determinate that ACL reconstruction and preservation treatment that the according to condition of ligament and knee joint. After ACL reconstruction, that is the fact which already becomes known the exercise treatment advances a recovery and to reduce a sequela. Methods : we researched the method of exercise treatment after anterior cruciate ligament reconstruction operation by journal of science direct and KISS in daecu university. Results : The representative exercise treatment is isometric exercise, isokinetic exercise isotonic exercise and complex exercise but what kind of exercise treatment most is effective, it revealed and support it was not. The method of exercise treatment is very various, so It causes a confusion made to the therapist and patients. So it executes once again it sought the kinetic therapeutic method which is efficient from this research and it tried to observe preceding research after ACL reconstruction. To operation a various the exercise treatments, operation only the treatment which is general compared to it was effective in muscular power and muscle functional improvement. But this like improve despite with the exercise treatment consequence which is continuous from research of most the pain leg compares to the health leg, it appeared the discrepancy which is a muscular power, a muscular endurance and a hypertrophy muscle etc, to the health leg or before operating 100% of muscular power to having gets the many therapy time was the recovery rate. Conclusion : Therefore after ACL reconstruction, it will become the many research continuously which is improve the muscle functional and ROM of the exercise treatment method and From therapeutic site of the patients it does to memorizes knowledge in advance about ACL injuries and the application the isokinetic treatment or exercise program are the set of necessary, frequency and amusement that considers complex what kind of therapeutic exercise becomes accomplished with the patient take care of attention.

  • PDF

TREATMENT OF NASO-ORBITO ETHMOIDAL FRACTURE;A CASE REPORT (비안와 사골골절의 치료;증례보고)

  • Kim, Young-Kyun;Yeo, Hwan-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.16 no.1
    • /
    • pp.72-78
    • /
    • 1994
  • A naso-orbito-ethmoid(NOE) fracture is very complex diagnostically and therapeutically. The diagnosis of this fractures is usually made by physical findings aided by a CT scan. The primary treatment of NOE fracture must be directed toward the reconstruction of medial canthal ligament and bony skeleton. We prefer to correct lacrimal system abnormalities secondarily A 32-year old male patient visited emergency room of our hospital with NOE fracture. After emergency treatment and consultation with neurosurgery and ophthalmology, we treated this patient by performing reconstruction of medial canthal ligament, bone graft of media orbital rim blowout fracture, and dorsal nasal cantilever bone graft with calvarial bone. The authors present a case report with literature review.

  • PDF

Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술)

  • Kim, Jae-Hwa;Kim, Jung Ryul
    • Journal of the Korean Arthroscopy Society
    • /
    • v.15 no.2
    • /
    • pp.132-139
    • /
    • 2011
  • The concept of double-bundle ACL reconstruction was introduced recently to restore the anatomical and biomechanical functions of the native ACL. According to anatomical and biomechanical studies, the separate reconstruction of anteromedial and posterolateral bundle expect to increase the overall postoperative stability and clinical results compared to single-bundle ACL reconstruction. But there is still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the real advantages of double-bundle ACL reconstruction. The purpose of this article is to review the evidence to support double-bundle technique and to address controversies existing over the usefulness of this technique.

  • PDF

Symptomatic Mid-Substance Posterior Cruciate Ligament Calcification of the Knee Joint (증상을 동반한 슬관절의 후방십자인대 실질부에 발생한 석회화)

  • Ahn, Gil Yeong;Lee, Tae Hun;Hwang, Sung Hyun;Lee, Kyung Jin
    • Journal of the Korean Orthopaedic Association
    • /
    • v.56 no.1
    • /
    • pp.93-97
    • /
    • 2021
  • Calcification in the tendon is a common disease especially in the rotator cuff. The condition can be treated conservatively in the chronic stage, but surgically in the acute stage. On the other hand there are few reports of calcification in the cruciate ligament of the knee joint, especially calcification of the posterior cruciate ligament. A 51-year-old patient with symptomatic calcification in the mid-substance of the posterior cruciate ligament was treated conservatively. The symptoms did not improve after eight months of conservative treatment, so arthroscopic surgery was performed. During arthroscopic removal of the calcification, the ligament was damaged beyond preservation. Eventually a posterior cruciate ligament reconstruction was performed. At two years after surgery, radiography confirmed no recurrence of the calcification, and the patient was free. We report this case study with a review of the relevant literature.

Dual reconstruction of both the radial collateral ligament and lateral ulnar collateral ligament at the annular ligament in posterolateral rotatory instability of the elbow: a new technique - A report of 3 cases- (요측측부인대 및 외측척골측부인대의 동시재건술을 이용한 주관절 후외측회전 불안정성의 수술적치료: 새로운 수술 기법 - 증례 3예 보고 -)

  • Ryu, In-Hyeok;Kim, Hyeong-Jin;Jeong, Jae-Ik;Seo, Bo-Geon;Kim, Gyeong-Cheol
    • The Academic Congress of Korean Shoulder and Elbow Society
    • /
    • 2009.03a
    • /
    • pp.189-190
    • /
    • 2009
  • PDF

Endoscopic ACL Reconstruction Using A Quadrupled Semitendinosus Graft (4겹의 반건양근 건을 이용한 전방십자인대 재건술)

  • Lee, Kwang-Won
    • Journal of the Korean Arthroscopy Society
    • /
    • v.1 no.1
    • /
    • pp.72-80
    • /
    • 1997
  • Numerous techniques of anterior cruciate ligament (ACL) reconstruction have been described in literature. All have inherent advantages and disadvantages. The central one-third patellar tendon and hamstring tendons are the most commonly used autogenous tissues for replacement of a torn anterior cruciate ligament. Although the central one-third patellar tendon is considered to be 'the gold standard' for replacement of torn ACL. equivalent results have been reported using hamstring tendon grafts. Autogenous hamstring grafts provide adequate strength while avoiding donor site morbidity associated with bone-tendon-bone harvest. $EndoButton^{\circledR}$ femoral fixation allows precise femoral tunnel placement without a second incison. The purpose of this article is to describe surgical techniques using a quadrupled semitendinosus tendon and $EndoButton^{\circledR}$ fixation, and review the results of replacement of ACL.

  • PDF

Minimal Ablation of the Tibial Stump Using Bony Landmarks Improved Stability and Synovial Coverage Following Double-Bundle Anterior Cruciate Ligament Reconstruction

  • Kodama, Yuya;Furumatsu, Takayuki;Hino, Tomohito;Kamatsuki, Yusuke;Ozaki, Toshifumi
    • Knee surgery & related research
    • /
    • v.30 no.4
    • /
    • pp.348-355
    • /
    • 2018
  • Purpose: To evaluate the clinical effects of using anatomical bony landmarks (Parsons' knob and the medial intercondylar ridge) and minimal ablation of the tibial footprint to improve knee anterior instability and synovial graft coverage after double-bundle anterior cruciate ligament reconstruction. Materials and Methods: We performed a retrospective comparison of outcomes between patients who underwent reconstruction with minimal ablation of the tibial footprint, using an anatomical tibial bony landmark technique, and those who underwent reconstruction with wide ablation of the tibial footprint. Differences between the two groups were evaluated using second-look arthroscopy, radiological assessment of the tunnel position, postoperative anterior knee joint laxity, and clinical outcomes. Results: Use of the anatomical reference and minimal ablation of the tibial footprint resulted in a more anterior positioning of the tibial tunnel, with greater synovial coverage of the graft postoperatively (p=0.01), and improved anterior stability of the knee on second-look arthroscopy. Both groups had comparable clinical outcomes. Conclusions: Use of anatomical tibial bony landmarks that resulted in a more anteromedial tibial tunnel position improved anterior knee laxity, and minimal ablation improved synovial coverage of the graft; however, it did not significantly improve subjective and functional short-term outcomes.

Surgical Reconstruction Using a Flanged Mesh Cage without Plating for Cervical Spondylotic Myelopathy and a Symptomatic Ossified Posterior Longitudinal Ligament

  • Kang, Jung Hoon;Im, Soo-Bin;Yang, Sang-Mi;Chung, Moonyoung;Jeong, Je Hoon;Kim, Bum-Tae;Hwang, Sun-Chul;Shin, Dong-Seong;Park, Jong-Hyun
    • Journal of Korean Neurosurgical Society
    • /
    • v.62 no.6
    • /
    • pp.671-680
    • /
    • 2019
  • Objective : We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL). Methods : Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom's criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months. Results : In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom's criteria or between the single-level and two-level corpectomy groups. Conclusion : The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.