• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.158-161
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• 2004

The isometric position of the anterior cruciate ligament was calculated during flexion-extension. Flexion-extension motion data of the knee joint were obtained by Fastrak, a three-dimensional motion measurement system. A subject was seated on a flat table and the tibia sensor position was measured with the femur fixed at the table. A three-dimensional knee model was constructed using a graphic tool to simulate the knee motion. Three surgical positions of the femoral tunnel were selected and the distances between the determined tibial tunnel and each femoral tunnel were calculated. The maximum elongation position was found to be in the ten thirty direction of clock.

• Archives of Reconstructive Microsurgery
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• v.15 no.1
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• pp.26-32
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• 2006

Purpose: The purpose of this study was to evaluate the effectiveness of limb reconstruction and functional recovery using vascularized fibular graft in the treatment of extensive bone defect of long bone caused by various diseases. Materials and Methods: From september 1995 to March 2005, 21 patients with segmental bone defects were managed with vascularized fibular graft: 13 males and 8 females, aged 39 years on average (range, $8{\sim}65\;years$). The reconstructed site was the humerus in 9 patients, the femur in 5, the tibia in 4 and the forearm bone in 3. The length of bone defect ranged from $8{\sim}17\;cm$. Results: Twenty grafts were successful. The mean period to obtain radiographic bone union was 5.7 months on average. Conclusion: Fibular grafts allow the use of a segment of diaphyseal bone and of sufficient length to reconstruct most skeletal defects of the long bone. The vascularized fibular graft is indicated in patients with intractable nonunions where conventional bone grafting has failed or large bone defects.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.2
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• pp.81-87
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• 1998

Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.118-124
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• 2008

Purpose: Recent development and advances in the arthroscopic surgical techniques for anterior cruciate ligament(ACL) reconstruction have led to the ideal location for more oblique anatomic point of the femur from 10 to 10:30 o'clock(in the right knee) and from 2 to 1:30 o'clock(in the left knee) in the frontal plane. This study was performed to compare the operative methods and the radiologic results of the femoral tunnels made through the tibial tunnel(trans-tibial approach) and the anteromedial portal. Materials and Methods: From January 2003 to May 2004, on hundred reconstructions of ACL were performed. Group I(the femoral tunnel made through the tibial tunnel) consisted of 50 cases and group I(the femoral tunnel made through the anteromedial portal) consisted of 50 cases. The operative methods and the radiographic results of the femoral tunnels were compared. Results: Femoral tunnel was made more easily at more oblique anatomic point in group II than in group I. In group II, better visual field was achieved at the angle of 100? flexion of the knee joint, the risks of the posterior cortical breakage and the tunnel-graft mismatching were reduced more, and the divergence of femoral interference screw from the radiograph decreased more than in group I(p<0.05). The angle between the femoral tunnel and the longitudinal axis of ACL increased in group II. Conclusion: Anteromedial portal technique was useful for femoral tunneling toward 10 to 10:30 o'clock(in the right knee) and 2 to 1:30 o'clock(in the left knee) in ACL reconstruction. Level of Evidence:Level III, case-control study.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.71-81
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• 2005

Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.491-499
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• 2018

Background: Advances in surgical techniques, implant technology, radiotherapy, and chemotherapy have increased the recovery chances of patients with bone sarcomas. Accordingly, patients' expectations on life quality have also increased, highlighting the importance of objective evaluation of the functional results of reconstruction. Methods: Thirteen patients with distal femoral endoprosthesis, who had been followed for an average of 2.9 years were evaluated. Postural stability, daily energy expenditure, muscle power, and range of motion were the four parameters analyzed in this study. The Musculoskeletal Tumor Society (MSTS) score and Toronto Extremity Salvage Score (TESS) were used to assess postoperative function and examine correlations with other parameters. Results: Patients had sedentary activities in 84% of their daily lives. They exhibited a slower speed in the walk across test and a higher sway velocity in the sit-to-stand test (p = 0.005). MSTS scores were significantly correlated with the daily energy expenditure and walking speed. Conclusions: Objective functional results acquired from various clinics will provide significant data to compare reconstruction techniques, rehabilitation protocols, and surgical techniques. In this way, it will be possible to satisfy the expectations of patients that increase in relation to enhanced recovery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.4
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• pp.438-441
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• 1995

Chondrosarcoma is a rare malignant neoplasm which constitutes approximately 10% of all primary malignant bone tumors. It occurs most often in the pelvis, femur, rib and humerus and the involvement of the jaw is rare, and what is more, chondrosarcoma arising in the condyle is extremely rare and only a few cases were previously reported and there is no domestic report. We report a chondrosarcoma of a condyle presenting as a painful swelling on the left preauricular area.

• Journal of the Korean Society for Precision Engineering
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• v.20 no.4
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• pp.174-182
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• 2003

Recently, medical imaging has taken interest on CAD based solution for anatomical part fabrication or finite element analysis of human body. In principle, contours representing object boundary are obtained through image processing techniques. Surface models are then approximated by a skinning method. For this, various methods should be applied to medical images and contours. The major bottleneck of the reconstruction is to remove shape inconsistency between contours and to generate the branching surface. In order to solve these problems, bi-directional smoothing and the composite contour generation method are proposed. Bi-directional smoothing has advantage of removing the shape inconsistency between contours and minimizing shrinkage effect with a large number of iterations. The composite contour by the proposed method ensures smooth transition in branching region.

• Proceedings of the KSME Conference
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• 2003.04a
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• pp.929-934
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• 2003

Three dimensional joint motion data were obtained using precise magnetic sensors and X-ray. Six metal markers were inserted on the femur and the tibia to set the coordinate system. Two magnetic position sensors were used to record motion data and these positions were transformed into the knee motion. The quadriceps muscle was extended in an automatic manner by an extraction machine. Results of the knee motion were the same as the clinical data. The proposed method is found to be reasonable in describing the knee motion so that these motion data can be used to simulate the normal knee joint.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.54-61
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• 1998

Free vascularized fibular is the most usuful bony donor of the long bone reconstruction in reconstructive microsurgical field. It has many benifits such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter with long pedicle, minimal donor site morbity too. In that situations of the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transfered. The bony circulation of the fibula has two ways, one from nutrient artery via peroneal artery through nutrient foramen which makes endosteal arterial network inside of the fibula, another way is periosteal network through outside encircling vascular network of the bone which distributed in muscle sleeves of the fibular diaphysis. Authors modified free vascularized fibular bone graft with transverse osteotomy is made from the anterolateral aspect of the fibular shaft just distal to entry of the nutrient artery. This produces two vascularized bone struts that may be folded pararell to each other but that remain connected by the periosteum and muscle cuff surrounding the peroneal artery and veins. The proximal strut is vascularized by both a periosteal and endosteal blood supply, whereas the distal strut is vascularized by a periosteal blood supply alone. This procedure can call "doule barrel" free vascularized fibular graft. We performed 7 cases of doule barrel fashined fibular transplantation on distal femur and proximal tibial large defects. Average bone union time takes 7 months from that procedure. There were no significant bone union time differences between both proximal and distal struts. After solid union of the transfered double barrel fibular graft, there were no stress fracture in our series. We can propose double barrel free vascualized fibular graft is usuful method in that cases with very large bone defect on large long bones especially metaphyseal defects.