• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.72-76
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• 1998

Between March 1992 and December 1995 at St. Paul's, Holy Family, St. Vincent and Eui Jung Bu St. Mary Hospitals Catholic University, two hundred and eighty patients underwent arthroscopic anterior cruciate ligament(ACL) reconstruction using central one-third bone-patellar tendon-bone autograft. Nine of these patients had limitation of motion(LOM) defined as a knee flexion contracture greater than 10o or less than 125o of passive knee flexion. This study analyzes the causes of LOM after ACL reconstruction as well as the results after passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM. The results are as follows: 1. Out of nine patients, initially three had isolated ACL injuries and six had combined injuries. Seven of nine cases were perfomed by ACL reconstruction within four weeks and two were performed after four weeks following injury. 2. Treatment for LOM after ACL reconstruction was done after 5.5 months on average. 3. Arthroscopic adhesiolysis was done in 5 cases. There were fibrous adhesions at suprapatellar pouch and femoral intercondylar notch in all cases, respectively, infrapatellar fat pad in 3 cases and medial para patellar gutter in 2 cases. Two patients had a fibrous nodule, "cyclops" lesion, which formed anterior to the ACL graft. 4. Range of motion and Lysholm knee score were much improved following passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.30-34
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• 1999

We report the case of a 30-year-old man who was presented with transient calcification on the graft shortly after anterior cruciate ligament(ACL) reconstruction using a autogenous bone patellar tendon. The patient underwent ACL reconstruction with two incisional technique and six month later, calcific density was seen radiologically around the graft. On postoperative 13 months follow-up radiographic films, the calcific density disappeared. After two months of operation, Lachman and pivot shift test were negative and one millimeter side to side difference was detected in KT-1000 with 20 Ibs strength. But 6 months after the reconstruction, mild anterior instability was detected with the calcific density around the grafted tendon. However the anterior stability was recovered according to the disappearance of calcific density.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.135-140
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• 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.

• Journal of Veterinary Clinics
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• v.34 no.1
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• pp.7-12
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• 2017

Twelve dogs weighing less than 10 kg underwent unilateral TTO to stabilize the stifle joint with cranial cruciate ligament rupture. Surgical findings, intra-operative and post-operative complications were recorded. Radiographic examinations were performed for 8 weeks following surgery. Postoperative outcome was evaluated using a visual analogue lameness scoring system. Mean preoperative PTA (the angle created by the intersection of the tibial plateau extrapolation line and the patellar tendon) was 103.8 degrees. Mean tibial wedge angle was 16.6 degrees. Mean postoperative PTA was 92.1 degrees. Intraoperatively, fracture through the caudal tibial cortex occurred in all dogs, through the distal tibial crest cortex in 2 dogs, through the lateral tibial cortex in 2 dogs and through the fibula in 1 dog. Four-week postoperative radiographs demonstrated evidence of progressive bone union at osteotomy site and complete unions were identified at 8 week in 10 dogs. All dogs were healed in 11 weeks. Most of dogs revealed weak lameness in 4 weeks and normal ambulation in 8 weeks postoperatively except for only one dog returned in 11 weeks. Despite frequent minor complication, it appears that the TTO is an alternative procedure for management of cranial cruciate ligament rupture in small breed dogs.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.131-134
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• 2001

The knee joint is most commonly affected. Until now, there were several reports of this condition, but this report seems to be the first one reporting localized Pigmented Villonodular Synovitis (PVNS) after anterior cruciate ligament(ACL) reconstruction. The authors experienced localized PVNS after ACL reconstruction with bone-patellar tendon-bone at follow-up 4 years and confirmed the diagnosis by pathologic examination.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.92-99
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• 2003

The prevalence of anterior cruciate ligament (ACL) injury is continuously increased due to sports activities and traffic accident. Simultaneously ACL reconstruction operations are on the increase. Several kinds of autografts and allografts are used in ACL reconstruction. Although ACL reconstruction using an autogenous bone-patellar tendon-bone graft is the good standard, it might have potential morbidity, anterior knee pain and minimal extension loss. To minimize the complications and disadvantages on each graft and to select appropriate graft for each patient, it is necessary to understand the unique characteristics of each graft for biomechanical aspect, morbidity and disadvantage. Selecting the appropriate graft depends on numerous factors including surgeon's preference and experience, patient's activity level and age, extent of ligament injury, tissue availability, and patient's selection for graft .

• Korean Journal of Veterinary Research
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• v.33 no.1
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• pp.7-21
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• 1993

The morphogenesis of the stifle joint in Korean cattle embryos and fetuses was observed by radiography, alizarin red S stain and light microscopy. Fourty-eight(48) embryos and fetuses, ranging from 11mm to 160mm in crown-rump length (C-R L), were used for this study. The experimental samples were divided into twelve separate groups according to their C-R L. The first to the nineth group ranged from 11-100mm in C-R L, spaced at 10mm intervals. The tenth to the twelfth group ranged in C-R L from 101mm to 160mm, and were spaced at 20mm intervals. The results were as follows; 1. The first appearance of the interzone between the femur and tibia was formed in the second experimental group. The patellar ligament and cruciate ligament appeared in the third group and the patella, menisci and synovial cavity appeared in the fourth group. 2. The lateral and medial menisci were first obseved in the fourth group, and these structures showed crescent shape in the fifth group of the fetuses. 3. The first appearance of the femoro-tibial joint cavity was in the third group. The fifth group contained the first appearance of the patello-femoral cavity. Also, the femoro-tibial cavity was divided into two cavities by the anterior and posterior cruciate ligament.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.92-101
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• 2010

The Hamstring autograft and the bone patellar bone tendon autograft have been widely used for anterior cruciate ligament reconstruction. In recent years, use of hamstring autograft for ACL reconstrution has been increased. The reason seems to be the advantages of the hamstring tendon such as high ultimate tensile load, low donor site morbidity and development of graft fixation method. These theoretical advantages have been increased as studies have shown that hamstring tendons actually regenerate after harvesting for ACL reconstruction. However, the concerns have arisen regarding the disadvantages of hamstring harvest, which were weakness of tibial internal rotation, the loss of flexion strength. The flexion strength loss has been controversial, therefore it needs to study whether restoration of flexion strength after hamstring regeneration is or not. In this study, we reviewed the current research of concerns on the advantage and disadvantage of hamstring tendon autograft and the hamstring regeneration. Furthermore, we compared the earlier studies and experiences regarding Hamstring regeneration with our research.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.88-91
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• 2010

전방십자인대 재건술시 자가건 선택에 대해서는 많은 논쟁의 소지가 존재하며 많은 보고들이 나오고 있으나, 현 시점에서 이식건으로써 자가 골-슬개건-골이 표준(gold standard)라는 주장은 이제 변화하고 있으며, 골-건 고정방법의 개선에 따른 조기 슬관절 안정성의 호전으로 자가 슬괵건의 사용이 점점 증가되고 있는 추세이다. 자가 골-슬개건-골은 이식건으로써 강한 물성, 튼튼한 고정, 장기 추시에서 높은 성공률 등으로 젊고, 강한 활동을 요하는 운동선수에서 종종 선택되고 있으며 조기에 강한 활동으로의 운동 복귀를 할 수 있다. 그러나 슬관절 전방 통증, 무릎을 꿇을 때의 통증, 슬개골골절, 슬개-대퇴 관절의 염발음 및 대퇴사두근력의 감소 등 이식물 채취로 인한 공여부 이환이 문제가 되었다. 그래서 자가 골-슬개건-골의 이식건으로서의 문제점 및 문헌상 고찰을 하여 논하고자 한다.

• 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.