• Title/Summary/Keyword: knee injury

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Cross-Leg Free Flap: Crossing the Border Zone of Ischemic Limb-A Case Report of Limb Salvage Procedure following a Delayed Diagnosis of Popliteal Artery Injury

  • Hui Yuan Lam;Wan Azman Wan Sulaiman;Wan Faisham Wan Ismail;Ahmad Sukari Halim
    • Archives of Plastic Surgery
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    • v.50 no.2
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    • pp.188-193
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    • 2023
  • Vascular injury following traumatic knee injury quoted in the literature ranges from 3.3 to 65%, depending on the magnitude and pattern of the injury. Timely recognition is crucial to ensure the revascularization is done within 6 to 8 hours from the time of injury to avoid significant morbidity, amputation, and medicolegal ramifications. We present a case of an ischemic limb following delayed diagnosis of popliteal artery injury after knee dislocation. Even though we have successfully repaired the popliteal artery, the evolving ischemia over the distal limb poses a reconstruction challenge. Multiple surgical debridement procedures were performed to control the local tissue infection. Free tissue transfer with chimeric latissimus dorsi flap was done to resurface the defect. However, the forefoot became gangrenous despite a free muscle flap transfer. His limb appeared destined for amputation in the vicinity of tissue and recipient vessels, but we chose to use a cross-leg free flap as an option for limb salvage.

Assessment of the Global Rating of Knee Function in Patients Following Anterior Cruciate Ligament Reconstruction

  • Ross, Michael D;Prall, Joshua
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.1-7
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    • 2022
  • Objective: The purpose of this study was to assess the validity of the global rating of knee function as a measure of participation restrictions experienced during activities of daily living and sports by patients with a history of anterior cruciate ligament reconstruction (ACLR). Design: Cross-sectional study. Methods: Forty-three subjects (33 males, 10 females, age=20.3 ± 1.3 years), at a mean of 31.2 ± 14.4 months following ACLR, participated in this study. During testing, subjects were first asked to provide a global rating of function by assessing their level of knee function on a 0 to 100 scale, with 0 points representing complete loss of function due to their knee injury and 100 points representing their level of function prior to their knee injury. After providing a global rating of function, subjects completed the Knee Outcome Survey (KOS) Activities of Daily Living Scale (ADLS) and Sports Activity Scale (SAS), which served as the measure of participation restrictions in this study. Results: Pearson product correlations revealed moderate relationships between the global rating of function and the ADLS (r=0.66, p<0.0001) and SAS (r=0.69, p<0.0001). Conclusions: The global rating of knee function provides a valid measure of participation restrictions experienced during activities of daily living and sports by patients with a history of ACLR.

Gait Study on the Normal and ACL Deficient Patients after Ligament Reconstruction Surgery Using Chaos Analysis Method (카오스 해석법을 이용한 전방십자인대 재건수술 환자와 정상인의 보행연구)

  • Ko Jae Hun;Son Kwon;Park Jung Hong;Suh Jeung Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.23 no.2 s.179
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    • pp.164-171
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    • 2006
  • Anterior cruciate ligament(ACL) injury of the knee is common and a serious ACL injury leads to ligament reconstruction surgery. Gait analysis is used to identify the result of surgery. The purpose of this study is to numerically evaluate and classify knee condition of patients through the chaos analysis. Experiments were carried out for 13 subjects (8 healthy subjects, 5 ACL deficient patients) walking on a treadmill. Sagittal kinematic data of the right lower extremity were collected by using a 3D motion analysis system. The recorded gait patterns were digitized and then coordinated by KWON3D. The largest Lyapunov exponent from the measured knee angular displacement time series was calculated to quantify local stability. It was found that the Lyapunov exponent becomes larger as the knee condition becomes worse. This study suggested a method of the severity of injury and the level of recovery. The proposed method discerns difference between healthy subjects and patients.

The study of anterior cruciate ligament injury after a ski accident (스키에 의한 전방십자인대 손상에 대한 고찰)

  • Park, Ju-Hwan;Jun, Sung-Hwa;Yang, Nan-Hea;Kim, Yong-Kwon;Kim, Chi-Hyuk
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.222-231
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    • 2003
  • The ACL(Anterior cruciate ligament) is the smallest of the four main ligaments of the knee, but it is the primary stabilizer. Injuries have a tendency to occur when the foot is firmly planted and the knee is twisted. Any sports that requires acceleration, change of direction and deceleration can increase the chances of suffering an ACL tear. The incidence of severe knee sprains that involve the ACL are at an all-time high. Since 1980, the number of these injuries have increased at least three-fold. Although the rate of increase has been much less dramatic since the middle 1980s, even the ultra-modem releasable ski binding has not been able to start reducing the incidence of ACL injuries. An ACL injury prevention program developed for downhill skiers by the Vermont Safety Research group emphasized increasing awareness of situations that can potentially result in an ACL injury and pre-planning strategies if events, leading to these situations, begin to fall in place. As part of the above study by Ettlinger et al., an educational prevent program was developed to teach these principles and thus reduce the rate of serious knee injuries. Four thousand instructors and patrol at 20 ski resorts who received the training had a 62% decline in serious knee injuries compared to a similar group that did not receive this training. Whenever you fall, try not to fully straighten your legs. Don't try to get up until you've stopped sliding(unless you are try to avoid an obstacle or other skier). When you're down, stay down. And don't land on your hand. So, if you feel yourself falling: arms forward, ski plates together, hands over knee. Then you will be able to save your ACL.

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Case Report : 3 Cases of CPM Combined with Korean Medical Treatment for Knee Joint Rehabilitation (한방 치료를 병행한 슬관절 재활 CPM 증례보고 3례)

  • Ha, Hyunju;Kim, Myeongkyu;Lee, Chiho;Oh, Minseok
    • Journal of Haehwa Medicine
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    • v.25 no.1
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    • pp.15-26
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    • 2016
  • Objectives : The aim of this study was to report the cases of knee injury that are treated with both CPM and Korean medicine. Methods : We treated 3 patients who had knee joint pain and gait disturbance by knee injuries with Korean medicine and CPM treatment. We evaluated the outcomes by checking NRS, ROM, Lysholm knee score, walking state and other symptoms. Results : The NRS, ROM, Lysholm knee score, and other symptoms of 3 patients were improved before they. These results show possibilities of simultaneous treatment of Korean medicine and CPM. But there is a limit that the number of cases is not sufficient, and there was no long-term follow-up after discharge. Conclusions : Simultaneous treatment of Korean medicine and CPM has an effect on knee joint rehabilitation. Further studies are needed to prove the effectiveness of Korean medicine combined with CPM.

Effects of Knee Brace on the Anterior Cruciate Ligament Injury Risk Factors during Spike Take Off in Female Volleyball Players (여자 배구 선수들의 스파이크 도약 시 무릎보호대가 전방십자인대 부상위험 요인에 미치는 영향)

  • Yang, Chang-Soo;Lim, Bee-Oh
    • Korean Journal of Applied Biomechanics
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    • v.24 no.1
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    • pp.27-33
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    • 2014
  • In volleyball, the most common injuries are anterior cruciate ligament (ACL) tears. For this reason, volleyball players frequently use knee brace as prophylactic and rehabilitation measures. The purpose of the study was to investigate the effects of knee brace on anterior cruciate ligament injuries risk factors during spike take off in female volleyball players. Fifteen female volleyball players were recruited and performed randomly spike take off with and without knee brace. Kinematics and ground reaction data were collected to estimate the anterior cruciate ligament injuries risk factors. The ACL risk factors are knee maximum flexion angle, thigh maximum adduction angle, thigh maximum internal rotation angle, shank maximum abduction angle, shank maximum external rotation angle, knee maximum extension moment and knee maximum abduction moment. Data were analyzed with paired samples t-test with Bonfferoni collection. Female volleyball players with knee brace had no significant results in knee maximum flexion angle, thigh maximum adduction angle, thigh maximum internal rotation angle, shank maximum abduction angle and shank maximum external rotation angle compare to without knee brace. Female volleyball players, however, with knee brace showed more reduced knee maximum extension moment and knee maximal abduction moment than without knee brace. In conclusion, Female volleyball players with knee brace reduced anterior cruciate ligament stress.

Prevention and Rehabilitation of Runner's Knee Injury (달리기 운동을 하는 사람에서 무릎 손상의 예방과 재활)

  • Seo, Seung-Suk;Kim, Jung-Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.22-27
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    • 2010
  • Many people in these days participate in running as leisure due to urbanization and socio-economic development. Running is a simple exercise but it can induce its own specific injury pattern because of its repetitive motion. Most runners' injury is caused by chronic overuse syndrome rather than acute trauma. And common accompanying injury in running are anterior knee pain syndrome, Iliotibial band syndrome, stress fracture, plantar fasciitis, Achilles tendinitis, posterior tibial tendon syndrome. Most common area of runners' injury is knee joint. Therefore the authors reviewed the recent literatures and described the classification, etiology, prevention, rehabilitation in this article.

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The Effect of Gender Difference in Injury Experience on Biomechanical Variables of Lower Extremity during Two Leg Drop Landing (양발 착지 시 성별에 따른 상해 경험이 하지관절의 운동역학적 변인에 미치는 영향)

  • Lee, Seong-Yeol;Kwon, Moon-Seok
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.2
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    • pp.424-433
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    • 2019
  • The purpose of this study was to investigate the effects of gender difference in injury experience on biomechanical variables of lower extremity during two leg drop landing. 20 male(injury experience=8, non-injury experience=12) and 20 female(injury experience=11, non-Injury Experience=9) in their 20's were selected as subjects. Two-way mixed ANOVA was performed on the biomechanical variables obtained from the two leg drop landing in a 45cm height box and post-test was performed with bonferroni adjustment(p <.05). The results of this study suggest that the group of female who injury experience could induce the reduction of the peak vertical ground reaction force by increasing the valgus and internal rotation of the knee joint and flexion and internal rotation of the hip joint. In the INE(injury non-experienced) female group, the peak knee flexion angle was the smallest, as well as the flexion of the hip joint and the external rotation angle, and the peak vertical ground reaction force was the highest. On the other hand, the INE female group showed high vertical ground reaction force because they did not utilize the knee and hip joints relatively than the IE(injury experienced) female group, this means that it is relatively exposed to the risk of injury. Therefore, it was found that gender difference in injury experience is a factor affecting factors of knee and hip joint movement and peak vertical GRF(ground reaction force).

One Case Report of Internal Derangement of Knee with Patella Tendon and Posterior Cruciate Ligament Injury - with a Focus on Burning Acupuncture Therapy and Exercise Therapy - (슬개건 및 후방십자인대 손상을 동반한 슬내장증 환자에 대한 치험 1례 - 가열식 화침 치료 및 운동 치료를 중심으로 -)

  • Kim, Min-Chul;Ju, Won-Sang;Park, Ga-Young;Park, Eun-Young;Park, Jin-Soo;Kim, Esther;Kim, Sung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.257-267
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    • 2011
  • Objectives: The purpose of this study is to evaluate the effect of the burning acupuncture therapy and exercise therapy on the internal derangement of knee with patella tendon and posterior cruciate ligament injury. Methods: Burning acupuncture therapy was administered three times and exercise therapy was administered during 4 weeks. The improvement of clinical symptom was evaluated by VAS(visual analogue scale) and KOOS(knee injury and osteoarthritis outcome score). Results: After treatment, the patient's VAS score was reduced to 0 pant. The KOOS score of pain, symptom, ADL, sport/rec, QOL(quality of life) improved from 28 to 75, from 36 to 71, from 22 to 65, from 0 to 15, from 25 to 38 respectively. Conclusions: Burning acupuncture therapy and exercise therapy fer internal derangement of knee with patella tendon and posterior cruciate ligament injury was effective. Although this case presented valuable result, further research is encouraged to confirm the effectiveness of this treatment with large number of patient.

The Effect on the Hip Muscle Activation of the Fall Direction and Knee Position During a Fall

  • Lee, Kwang Jun;Lim, Kitaek;Choi, Woochol Joseph
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.84-91
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    • 2021
  • Background: A hip fracture may occur spontaneously prior to the hip impact, due to the muscle pulling force exceeding the strength of the femur. Objects: We conducted falling experiments with humans to measure the activity of the hip muscles, and to examine how this was affected by the fall type. Methods: Eighteen individuals fell and landed sideways on a mat, by mimicking video-captured real-life older adults' falls. Falling trials were acquired with three fall directions: forward, backward, or sideways, and with three knee positions at the time of hip impact, where the landing side knee was free of constraint, or contacted the mat or the contralateral knee. During falls, the activities of the iliopsoas (Ilio), gluteus medius (Gmed), gluteus maximus (Gmax) and adductor longus (ADDL) muscles were recorded. Outcome variables included the time to onset, activity at the time of hip impact, and timing of the peak activity with respect to the time of hip impact. Results: For Ilio, Gmed, Gmax, and ADDL, respectively, EMG onset averaged 292, 304, 350, and 248 ms after fall initiation. Timing of the peak activity averaged 106, 96, 84, and 180 ms prior to the hip impact, and activity at the time of hip impact averaged 72.3, 45.2, 64.3, and 63.4% of the peak activity. Furthermore, the outcome variables were associated with fall direction and/or knee position in all but the iliopsoas muscle. Conclusion: Our results provide insights on the hip muscle activation during a fall, which may help to understand the potential injury mechanism of the spontaneous hip fracture.