• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.1-6
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• 2011

Purpose: To evaluate the usefulness of ultrasonography in diagnosis of the medial meniscus tear as a screening tool before performing magnetic resonance imaging. Materials and Methods: From April 2009 to September 2010, magnetic resonance imaging (MRI) was taken in 147 knees out of 341 knees examined with ultrasonography (US) under the suspicion of medial meniscus tear. The sonographic findings were 16 without abnormality, 12 inhomogeneity, 4 cluster, 60 cleavage and 55 more than 5mm medial extrusion of medial meniscus. In Statistical analysis, sensitivity and specificity, positive predictive value and negative predictive values were calculated. Results: The MRI showed abnormality in 104 knees. Sensitivity and specificity of ultrasonography for MRI was 94.2% and 23.3%, respectively. Positive predictive value was 74.8%, negative predictive value was 62.5%. The positive predictive value of ultrasonography were 58.3% in heterogeneity, 100% in showing cluster, 75% in visible cleft and 80% in medial extrusion. Conclusion: The US is a useful tool in prediction of medial meniscus tear before confirming it in high-cost MRI.

• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.37-41
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• 2013

Purpose: We investigated the short term results of medial deltoid ligament repair after diagnosis of chronic medial ankle instability. Materials and Methods: 262 military patients with ankle instability symptom were evaluated between May 2007 and December 2009. We diagnosed 29 chronic medial ankle instability cases with medial drive through sign under arthroscopy, radiologic findings and physical exam, treated with deltoid talo-navicular band repair using anchor suture. We used the American orthopedic foot and ankle society ankle-hindfoot score (AOFAS), visual analog scale (VAS) and ankle functional satisfactory scores were carried out. Results: 29 patients (11.1%) has chronic medial ankle instability, mean AFOAS score, VAS was improved from 65.4(range; 43-83), 6.0(range; 4-10) to 82.0(range; 60-100), 3.2(range; 1-7). Patients satisfaction were excellent 13(44.8%), good 11(37.9%) and poor 5(17.2%). Two cases was recurred and revised with allo-tendinous reconstruction. Conclusion: We underwent surgery to repair the talo-navicular ligament for chronic medial ankle instability, and about 83% of satisfactory results were obtained.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.81-86
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• 2011

Background: Facet joint disease plays a major role in axial low-back pain. Few diagnostic tests and imaging methods for identifying this condition exist. Single photon emission computed tomography (SPECT) is reported that it has a high sensitivity and specificity in diagnosing facet disease. We prospectively evaluated the use of bone scintigraphy with SPECT for the identification of patients with low back pain who would benefit from medial branch block. Methods: SPECT was performed on 33 patients clinically suspected of facet joint disease. After SPECT, an ultrasound guided medial branch block was performed on all patients. On 28 SPECT-positive patients, medial branch block was performed based on the SPECT findings. On 5 negative patients, medial branch block was performed based on clinical findings. For one month, we evaluated the patients using the visual analogue scale (VAS) and Oswestry disability index. SigmaStat and paired t-tests were used to analyze patient data and compare results. Results: Of the 33 patients, the ones who showed more than 50% reduction in VAS score were assigned 'responders'. SPECT positive patients showed a better response to medial branch blocks than negative patients, but no changes in the Oswestry disability index were seen. Conclusions: SPECT is a sensitive tool for the identification of facet joint disease and predicting the response to medial branch block.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.280-284
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• 2009

Purpose: The authors introduce a new technique of arthroscopic reduction of subluxed medial meniscus using suture anchor for the restoration of hoop stress. Operative Technique: Anterolateral, anteromedial, and medial midpatellar arthroscopic portal are used. Arthroscope was inserted through anterolateral portal. Through the scope, we confirmed subluxation of medial meniscus. Transection of menisci including radial and root tear were excluded. We released the anterior horn of medial meniscus through anteromedial and burred the future insertion site of suture anchor. After inserting suture anchor through medial midpatellar portal, we used 90 degree suture hook and no.2 Nylon to retrieve the suture of inserted anchor. We tied the suture by sliding knot-tying method. Weight bearing was limited for 6 weeks postoperatively. Conclusion: Arthroscopic retightening of medial meniscus is less invasive, conserving and progressed method for subluxed meniscus.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.192-199
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• 2018

Background: The currently available reverse shoulder arthroplasty (RSA) designs can be classified into medial glenoid/medial humerus (MGMH), lateral glenoid/medial humerus (LGMH), and medial glenoid/lateral humerus (MGLH) prosthesis designs. The purpose of this study was to radiologically analyze the effect of different RSA designs on humeral position following RSA. Methods: A total of 50 patients who underwent primary RSA were retrospectively analyzed. Among 50 patients, 33 patients (group A: MGMH) underwent RSA with Aequalis system (Wright, Inc, Bloomington, MN, USA), 6 (group B: LGMH) with Aequalis system using bony increased offset, and 11 (group C: MGLH) with Aequalis Ascend Flex system. The acromiohumeral distance, acromioepiphyseal distance (AED), lateral humeral offset (LHO), LHO from the center of rotation ($LHO^{COR}$), and deltoid length were radiologically measured to quantify the distalization and lateralization of the humerus. Results: The increment in postoperative AED was $19.92{\pm}3.93mm$ in group A, $24.52{\pm}5.25mm$ in group B, and $25.97{\pm}5.29mm$ in group C, respectively (p=0.001). The increment in postoperative LHO was $0.13{\pm}6.30mm$, $8.00{\pm}12.14mm$, and $7.42{\pm}6.88mm$, respectively (p=0.005). The increment in postoperative $LHO^{COR}$ was $20.76{\pm}6.06mm$, $22.04{\pm}5.15mm$, and $28.11{\pm}4.14mm$, respectively (p=0.002). Conclusions: The radiologic analysis of the effect of different RSA designs on humeral position following RSA showed significant differences in the increment in postoperative AED, LHO, and $LHO^{COR}$ between the 3 groups. Therefore, MGLH design seems to be more effective for humeral distalization and lateralization compared to original Grammont design.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2005.03a
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• pp.61-61
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• 2005

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.10a
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• pp.155-156
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• 2006

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.37-43
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• 2012

Purpose: This study is to evaluate the clinical results of pull-out suture for root tear of posterior horn of medial meniscus. Materials and Methods: Between March 2006 and February 2011, We studied 40 cases with the root tear of posterior horn of medial meniscus which follow up more than 1 years. Mean age was 49.5 years old. We excluded osteoarthritis or varus deformity patients more than 5 degrees. pull-out suture was performed to the patients with grade 0-2 of Kellgren and Lawrence classification. According to Outerbridge classification, evaluation of cartilage damage was performed during arthroscopy. Evaluation of clinical result was used the Lysholm score. Results: The mean pre-operation Lysholm score was 63.9 and post-operation score was 86.3. The complete failure rate was 3 of 40 cases (7.5%). Twenty of 40 cases (50%) showed cartilage lesions in weight bearing portion of medial femoral condyle which were 12 cases in grade 1, 5 cases in grade 2 and 3 cases in grade 3 according to the Outerbridge classification. Conclusion: In the treatment of pull-out suture for root tear of posterior horn of medial meniscus, exclusion of more than moderate arthritis or varus deformity is very importment. Pull-out suture seems to be a useful treatment of the root tear of posterior horn of medial meniscus in mild osteoarthritis or varus deformity of middle ages.

• Journal of Preventive Medicine and Public Health
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• v.24 no.1 s.33
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• pp.57-69
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• 1991

This study examined the cross-sectional association of central body fat distribution with hypertension as well as the superiority of medial calf skinfold measured as peripheral fat distribution over the conventional triceps skinfold using 450 Korean Navy divers selected by authors' convenience in 1990. Their mean age was 27.9 and range of it was 19-51. The centrally located body fat was approximated by subscapular skinfold and peripherally located fat by triceps and medial calf skinfolds. Four indices were constructed from these skinfold measures to reflect central versus peripheral fat distribution pattern : 2 ratios and 2 differences. After controlling age and overall obesity (body mass index), prevalance odds ratios of the 2/4, 3/4, 4/4 quartiles of subscapular skinfold comparing with lowest 1/4 quartile were 2.05(95% confidence interval, CI 1.18-3.59), 2.02(95% CI 1.06-3.86), 4.00 (95% CI 1.99-8.06) respectively. The difference of subscapular and medial calf skinfolds was associated with hypertension (odds ratio 2.45, 95% CI 1.28-4.68 comparing highest with lowest quartiles). Triceps and medial calf skinfolds alone did not show any odds ratio not including unity. The adjusted odds ratios were generally reduced in small magnitude compared with crude odds ratios not adjusted for age and overall obesity. The medial calf skinfold appeared to be more representative of peripheral body fat distribution than triceps skinfold. These findings suggest that central fat distribution rather than peripheral distribution is associated with hypertension independent of age and overall level of obesity and medial calf skinfold may replace conventional triceps skinfold in predicting peripheral distribution of body fat.