• Journal of the Korean Society of Radiology
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• v.8 no.2
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• pp.57-63
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• 2014

This study aims to find out the standardized test criteria regarding patients with the anterior cruciate ligament damage by identifying the degree of the flexion gap of femur and tibia upon bending of the anterior cruciate ligament in order to carry out the accurate test of such impairment. On the standardized test method and judgement criteria upon the anterior cruciate ligament test using Telos, it has been shown that there was no significant difference in the results according to the position of a fixed roller in the anterior cruciate ligament test for normal patients. However, in a test for patients who had undergone the anterior cruciate ligament reconstruction, it has been shown that the measured values of the anterior cruciate ligament tended to be pushed when the position of a fixed roller was less than 1cm in the test according to the position of a fixed roller of Telos (less than 1cm, more than 3cm), and this was statistically significant. The anterior cruciate ligament test (knee stress test) is a limited method used in orthopedics and rehabilitation medicine, and there have been no standardized test guidelines available yet although numerous ligament measurement tests have been performed. In addition, since the measured values are often different depending on testers even on the test that is expected to give the same result, the reproducibility of the test is still low. Accordingly, it is considered that the criteria for the anterior cruciate ligament test need to be established, and this would contribute to the accuracy of the diagnosis through the accurate test and standardized measurements.

• Journal of Oriental Neuropsychiatry
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• v.32 no.3
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• pp.261-273
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• 2021

The purpose of this study was to introduce effects of Chukyu pharmacopuncture and Brainspotting on knee pain, headaches, and acute stress disorder of a patient with a traffic accident. We treated a patient with Chukyu pharmacopuncture and Brainspotting. Numerical rating scale (NRS), Range of Motion (ROM), Hyperextension Position (HEP), Effusion (Eff), Patella Compression Test (PCT), Frontal Flexion Position (FFP), McMurray (MCM), Lateral Joint Line Tenderness (LJLT), Medial Joint Line Tenderness (MJLT), Anterior Drawer Test (ADT), Lachman Test, Varus/Valgus stress, Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), Core Seven Emotions Inventory Short Form (CSEI-S), Subjective units of disturbance scale (SUDs), and Heart rate variability (HRV) were used to evaluate the patient. After the patient was treated by Chukyu pharmacopuncture and Brainspotting, the patient showed improvement in NRS, physical examination, and psychological symptom assessment. These results indicate that Chukyu pharmacopuncture and Brainspotting are effective on knee pain, headache, and acute stress disorder after a traffic accident.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.107-113
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• 2010

Purpose: To evaluate the outcome of the two-bundle anterior cruciate ligament reconstruction with single femoral tunnel and tibialis anterior tendon allograft and to determine any functional advantages. Materials and Methods: From June 2006 to March 2008, we performed single femoral tunnel and two-bundle ACL reconstruction with tibialis anterior tendon allograft in 26 cases. Mean age was 35.5 years. 20 cases were male and 6 cases were female. Average follow-up period was 2 years and 5 months, range from 1 year to 3 years and 5 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test and IKDC score. Results: Postoperative mean Lysholm knee score, IKDC Evaluation Form, Tegner activity scale, Pivot shift test, and anterior displacement by the Telos stress test demonstrated statistically significant differences compared to the preoperative. Conclusion: Two-bundle anterior cruciate ligament reconstruction with single femoral tunnel showed good clinical results and was good operative technique.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.1
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• pp.27-32
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• 2008

Purpose: To evaluate the clinical results of the patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity after ACL reconstruction. Material and Methods: From October 1999 to March 2006, we performed 133 cases of ACL reconstruction. Among them we experienced 16 patients who had the laxity of reconstructed ACL in second look arthroscopy. Mean follow-up was 20.4 months. Mean age was 33.5 years. 12 cases were male and 4 cases were female. The elongated ACL were treated by bipolar radiofrequency energy with an output of grade II. Subjective and objective parameters were utilized in analyses, such as: the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test, IKDC score. Wilcoxon signed-rank test was used to perform the data analysis. P<0.05 was considered to be statistically significant. Results: Postoperative mean Lysholm knee score (preop: $82.2{\pm}5.2(77{\sim}85))$ (P=0.04), postop: $85.2{\pm}4.8$(82-90)) and anterior displacement by the Telos stress test (preop: $5.4{\pm}4.6(3{\sim}10)mm$, postop: $2.1{\pm}1.9(0{\sim}4)mm)$ (P=0.02), Lachman's test, and IKDC scores (P=0.04) demonstrated significant differences statistically compared to the preoperative. There were no statistical differences in mean range of motion, Tegner activity scale. Conclusions: Arthroscopic shrinkage for the ACL laxity after ACL reconstruction with radiofrequency device showed good clinical results and was applicable operative technique.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.128-133
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• 2012

Purpose: This study examined the relationship between graft appearance on follow-up magnetic resonance imaging (MRI) and knee stability after double bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods: For each patient, 1.5 tesla MRI's were obtained. The signal intensity of grafts was divided into 3 grades by Sononda's classification. The course of grafts was divided into two patterns: straight and curved. We assessed Lachman test, KT 2000 arthrometer and anterior drawer stress radiograph using Telos$^{(R)}$ in $30^{\circ}$ knee flexion for anterior stability and evaluated pivot shift test for rotatory stability. The correlation between graft appearance on MRI and the results of knee stability tests was evaluated. Results: The anteromedial (AM) graft was evaluated as being grade 1 in 66.7%, grade 2 in 26.7%, and grade 3 in 6.7% of the cases and the posterolateal (PL) graft was assessed as being grade 1 in 63.3%, grade 2 in 33.3%, and grade 3 in 3.3% of the cases according to the signal intensity. The AM graft was evaluated as being straight in 83.3% and curved in 16.7% of the cases, and the PL graft was assessed as being straight in 86.7% and curved in 13.3% of the cases according to the course. The course of AM graft was correlated with the results of anterior stability tests and the course of PL graft was correlated with the result of rotatory stability test. However, the signal intensity of grafts was not correlated with the results of anterior stability and rotatory stability tests. Conclusion: The course of AM is correlated with anterior stability and the course of PL is correlated with rotatory stability on follow-up MRI after double bundle ACL reconstruction.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.21-25
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• 2002

Purpose: To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw, which is newly designed for fixation of graft into femur. Materials and Methods: Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon and LA screw were included in this study. The graft was fixed with LA screw at femoral tunnel and with only bioabsorbable interference screw at tibial tunnel. The mean follow-up period was 28 months. The clinical results were evaluated by physical examination and Lysholm knee score. Widening of bony tunnel and anterior laxity difference compared with normal side by instrumented anterior laxity test with Telos(R) (Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results: The Lysholm knee score improved from 60.0 points preoperatively to 94.0 points at last follow up. On the Lachman test, there were mild (+) instability in 16 cases, moderate (++) in 24,severe (+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at postoperative follow up. On instrumented anterior laxity test with Telos(R), difference between normal and affected knee on 20 lb was 12.9 mm in average preoperatively, and was decreased to 3.1mm at last follow-up. The femoral tunnel was widened from 10.6 mm postoperatively to 12.7 mm (21.1$\%$) at follow up on antero-posterior plane and from 10.7 mm to 12.4 mm (16.5$\%$) on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm (20.7$\%$) on antero-posterior plane and from 9.9mm to 11.7 mm ($18.9\%$) on lateral plane. Complications were: anterior knee crepitus in 17 case, quadriceps muscle atrophy(>3 cm) in 6, penetration of screw over the lateral femoral cortex in 5, saphenous nerve paresthesia in 2.Conclusions: ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixation devices in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel and anterior knee pain

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.44-49
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• 2013

Purpose: To compare of the results between anterior cruciate ligament (ACL) reconstruction alone and combined with high tibial osteotomy for ACL ruptured knees with varus alignment. Materials and Methods: We retrospectively reviewed 8 cases of ACL reconstruction combined with high tibial osteotomy (Group I) and 13 cases of ACL reconstruction alone (Group II) for varus angulated ACL ruptured knees (from March 2005 to February 2007). Mean age were 34.1 years (range: 20-53) in Group I, 34.9 years (range: 21-50) in Group II. Average follow up period were 22.6 months (range: 12-35) in Group I, 20 months (range: 13-33) in Group II. We analyzed clinical and radiological results. Results: There were no significant differences in clinical and radiologic results between two groups for IKDC scores, Lysholm knee scores, Lachman test, pivot shift test, KT-2000 arthrometer, $30^{\circ}$ and $90^{\circ}$ anterior drawer stress radiographs. Tegner activity scales and Cincinnati knee ligament rating scales were 4.9, 57.9 in Group I, and 5.6, 72.9 in Group II. Group I was statistically lower than Group II for Tegner activity scales and Cincinnati knee ligament rating scales (p<0.05). Conclusion: There were no significant differences in daily living between ACL reconstruction alone and combined with high tibial ostetomy for varus angulated ACL ruptured knees. However, ACL reconstruction combined with high tibial osteotomy could limit sport activity ability.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.69-73
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• 2001

Purpose : To evaluate the clinical results and widening of bony tunnel after anterior cruciate ligament(ACL) reconstruction using hamstring tendon with Ligament Anchor(LA) screw, which is newly designed fur fixation of graft into femur. Materials and Methods : Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon were included in this study. The graft was fixed with LA screw at femoral tunnel and with bioabsorbable interference screw at tibial tunnel. The average period of follow-up was 28 months. The clinical results such as physical examination and Lysholm knee score and radiological results. widening of bony tunnel and instrumented anterior laxity test with $Telos^{\circledR}$(Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results . The Lysholm knee score was 60.0 in average preoperatively and improved to 94.0 in average at follow up. On the Lachman test, there were mild(+) instability in 16 cases, moderate(++) in 24, severe(+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 20 lb was 12.9mm in average preoperatively, and was decreased to 3.1mm in average follow-up. The femoral tunnel was widened from 10.6mm postoperatively to 12.7mm$(21.1\%)$ at follow up on antero-posterior plane and from 10.7mm to 12.4mm$(16.5\%)$ on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm$(20.7\%)$ on antero-posterior plane and from 9.9mm to 11.7mm$(18.9\%)$ in lateral plane. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixatives in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.18-26
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• 2011

Purpose: This study is to compare the clinical results of ACL reconstruction between three groups using hamstring tendon autograft, mixed and tibialis tendon allograft. Materials and Methods: Between August 2003 and August 2008, we analyzed 169 cases of ACL reconstruction, 66 cases used hamstring tendon autograft, 42 cases used mixed graft and 61 cases used tibialis tendon allograft, with a minimum follow-up of 12 months. For the clinical evaluation, we evaluated the Lysholm score, Telos stress test device and IKDC score. Results: The average side to side difference in Telos stress test decreased from $7.5{\pm}1.0$ mm to $1.6{\pm}1.0$ mm in autograft group, from $7.6{\pm}1.1$ mm to $1.4{\pm}1.1$ mm in mixed graft group and from $7.4{\pm}1.3$ mm to $2.5{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from 58.6 to 92.3 in autograft group, from 60.6 to 92.6 in mixed graft group and from 55.3 to 91.5 in allograft group. There was no significant difference between three groups in clinical results. At second look arthroscopy, tension of ligament and synovial coverage were good result in autograft and mixed graft than allograft group. Conclusion: All hamstring tendon autograft, mixed graft and tibialis tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. Both hamstring tendon autograft and mixed graft showed good synovial coverage in second look arthroscopy. So mixed graft will be considered as good alternative in case of shorter or thin harvested hamstring tendon.