• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.131-137
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• 2002

Purpose: To evaluate and compare the functional results, activity status, and anterior stability between conservative group with partial ACL injury and reconstruction group with bone-patellar ten-don-bone autograft in ACL total rupture. Materials and Methods: Thirty-eight patients with ACL injury were diagnosed and treated with arthroscopy and followed for more than two years. The number of patients with partial injury was 12(mean age; 38.3) and reconstruction group was 26 (mean age; 25.3). Objective stability was estimated under anterior loading of 15 lb and 20 lb by KT-2000 Arthrometer (MED metric, USA). Functional evaluation using Lysholm score and Tegner activity score were performed. Results: Average functional score of Lysholm was 88.5 in partial injury group and 89.3 in reconstruction group. Average score of Tegner was 5.3 in partial injury group and 5.1 in reconstruction group(P<0.05).Average anterior displacement compared with normal side. Under loading of 20lb, 1.7$\pm$4.3 mm in partial injury group, 2.3$\pm$1.9 mm in reconstruction group were anterior displaced (P<0.05). Under loading of 15lb, 1.2$\pm$1.0 mm in partial injury group, 1.4$\pm$1.5 mm in reconstruction group were dis-placed (P<0.05). There were giving way, effusion, instability and anterior knee pain in complication. Giving way was the frequent complication in the partial injury group. Conclusions: Clinical results of both group were similar. Functional evaluation of Lysholm was good and status of Tegner activity was maintained to physical fitness activites (jogging, regular bik-ing) in both groups on average. The results of conservative treatment for the partial ACL injury (less than 50$\%$) was satisfactory and equivalent to that of reconstructive treatment for the total ACL injury.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.1-6
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• 2001

Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using central one third bone-patellar-tendon bone(BPB) autograft versus quadrupled semitendinos-us(ST) autograft as the medium term review. Materials and Methods : Eighty patients(40 BPBs,40 STs) with isolated ACL injury were available for a mean follow up of 49.4 months(BPB) and 48.8 months(ST). There was no significant difference between the two groups with respect to age and sex. We compare the final results between two groups with respect to subjective Lysholm score, objective laxity including anterior drawer test, Lachman test, pivot shift test, KT-2000 measurements and International Knee Documentation Committee(IKDC) evaluation system. Results : Postoperatively, positive anterior drawer test was found in $22.5\%\;and\;27.5\%$, positive Lachman test was found in $30.0\%$ and $25.0\%$ and positive pivot shift test was found in $15\%\;and\;20\%$ of the ST and BPB group, respectively(p>0.05). Mean side to side difference of KT-2000 at 20 lbs was 2.2 mm for the ST group and 2.1 mm for the BPB group. There was no significant difference between the two groups about Lysholm score(>0.05). Anterior knee pain was knee common in the BPB group. Eighty-three percent of the patients were nearly normal according to the IKDC grade in both groups. Conclusion : We consider that autogenous semitendinosus tendon is a good alternative subsititute in ACL reconstruction together with the bone-patellar tendon-bone autograft.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.1-6
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• 2008

Purpose: The purpose of this study is to compare the results of the arthroscopic reconstruction of ACL using autologous hamstring tendon and autologous bone-patellar tendon-bone. Materials and Methods: From January, 2000 to December, 2004, 120 patients underwent arthroscopic ACL reconstruction using autologous hamstring tendon(60 cases) and autologous bone-patellar tendon-bone(BPTB)(60 cases). The mean followed up period of hamstring tendon group was 42 months(range $24{\sim}69$ months) and patellar tendon group was 52 months(range $24{\sim}84$ months). At the time of the final follow up, sixty patients in each group were evaluated the results of physical examination, activity level, patients' satisfaction, functional status, and objective anteriror stability using KT-2000 arthrometer. Results: At the time of the final follow up we compared the two groups who had ACL reconstruction using either autologous hamstring tendon or BPTB, and the final results of the Lachman test showed negative, or mildly positive in 85%(51 cases) of the hamstring tendon group and 90%(54 cases) of the BPTB group. Pivot shift test indicated positive in both groups, 8%(5 cases) and 5%(3 cases) respectively and showed no statistically significant difference. The evaluation of the anterior laxity using the KT-2000 arthrometer revealed no significant difference in the hamstring and BPTB groups: differences less than 3 mm compared to the healthy side were 85%(51 cases) and 90%(54 cases)(p>0.05). The Lysholm score improved from a preoperative score of 51 to a postoperative score of 79.1 in the hamstring groups and from 52 to 82.2 in the BPTB groups. According to the IKDC rating system, 87%(52 cases) were normal or near normal in the hamstring group. In the BPTB group, 83%(50 cases) were normal or near normal. The Tegner score for the hamstring groups was 4.8 preoperatively and 7.1 at the final follow up, and the Tegner score for the BPTB groups was 4.5 preoperatively and 7.3 after the last follow-up. The anterior knee pain was found in 7%(4 cases) in the hamstring tendon group and 10%(6 cases) in the patellar tendon group. Conclusion: Arthroscopic ACL reconstruction using both the autologous hamstring tendon and the patellar tendon during their mid term follow up period demonstrated excellent results. However, the final results during their last follow up showed no statistically significant difference between the two groups.

• Journal of Korean Academy of Nursing
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• v.2 no.1
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• pp.3-33
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• 1971

Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.