Korean Medicine Therapy to Ruptured Anterior Cruciate Ligament with Meniscal Tears: Report of 4 Cases

반월상 연골판 손상을 동반한 전방 십자인대 부분파열 환자의 한의학적 치료 효과: 증례보고

  • Lee, Gi-Eon (Department of Korean Rehabilitation Medicine, Daejeon Jaseng Hospital of Korean Medicine) ;
  • Byun, Da-Young (Department of Korean Rehabilitation Medicine, Daejeon Jaseng Hospital of Korean Medicine) ;
  • Han, Si-Hoon (Department of Korean Rehabilitation Medicine, Daejeon Jaseng Hospital of Korean Medicine) ;
  • Yoo, Hyung-Jin (Department of Korean Rehabilitation Medicine, Daejeon Jaseng Hospital of Korean Medicine) ;
  • Lee, Jin-Hyun (Cheongyang Public Health Center)
  • 이기언 (대전자생한방병원 한방재활의학과) ;
  • 변다영 (대전자생한방병원 한방재활의학과) ;
  • 한시훈 (대전자생한방병원 한방재활의학과) ;
  • 유형진 (대전자생한방병원 한방재활의학과) ;
  • 이진현 (청양군 보건의료원)
  • Received : 2017.12.26
  • Accepted : 2018.01.15
  • Published : 2018.01.31


The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.


  1. Beynnon BD, Johnson RJ, Abate JA, Fleming BC. Treatment of anterior cruciate ligament injuries, part I. The American Journal of Sports Medicine. 2005;33:1579-602.
  2. Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee. A biomechanical study. The Journal of Bone and Joint Surgery. 1980;62:259-70.
  3. Grood ES, Suntay WJ, Noyes FR, Butler DL. Biomechanics of the knee-extension exercise: effect of cutting the anterior cruciate ligament. The Journal of Bone and Joint Surgery. 1984;66:725-34.
  4. Hsieh HH, Walker PS. Stabilizing mechanisms of the loaded and unloaded knee joint. The Journal of Bone and Joint Surgery. 1976 Jan;58(1):87-93.
  5. Tetsuo Hagino, Satoshi, et al. Meniscal tears associated with anterior cruciate ligament injury. Archives of Orthopaedic and Trauma Surgery. 2015;135:1701-6.
  6. Lee JH, Yoon KH, Bae DK, Eo JH, Kim JW, Park SY. The incidence and the patterns of associated injuries of anterior cruciate ligament tear. Journal of Korean Arthroscopy Society. 2008;12:24-31.
  7. Noyes FR, Butler DL, grood ES, Zernicke RF, Hefzy MS. Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions. The Journal of Bone and Joint Surgery. 1984;66:344-52.
  8. De Smet AA, Graf BK. Meniscal tears missed on MR imaging: relationship to meniscal tear patterns and anterior cruciate ligament tears. American Journal of Roentgenology. 1994;162:905-11.
  9. Poehling GG, Ruch DS, Chabon SJ. The landscape of meniscal injuries. Clinical Journal of Sport Medicine. 1990;9:539-49.
  10. Sherman MF, Warren RF, Marshall JL, Savatsky GJ. A clinical and radiographical analysis of 127 anterior cruciate insufficient knees. Clinical Orthopaedics and Related Research. 1988;227:229-37.
  11. Ciccotti MG, Lombardo SJ, Nonweiler B, Pink M. Non-operative treatment of ruptures of the anterior cruciate ligament in middle-aged patients. Results after long-term follow- up. The Journal of Bone and Joint Surgery. 1994;76: 1315-21.
  12. Jomha NM, Pinczewski LA, Clingeleffer A, Otto DD. Arthroscopic reconstruction of the anterior cruciate ligament with patellar-tendon autograft and interference screw fixation. The results at seven years. J Bone Joint Surg Br. 1999;81:775-9.
  13. Strehl A, Eggli S. The value of conservative treatment in ruptures of the Anterior Cruciate Ligament(ACL). The Journal of Trauma and Acute Care Surgery. 2007;62: 1159-62.
  14. Jeong Seok Han, Jeong Eun Choi, Gil Jun Bae. Case Report of Conservative treatment by Oriental Medicine on Anterior Cruciate Ligament Tear. J Sports Koerean Med 2014;13(2):17-25.
  15. Won-Kyo Oh, Young-Dal Kwon, Yung-sun Song. Effectiveness of Oriental Medical Therapy and Bongchuna on Anterior Cruciate Ligament Rupture of Knee, Two Case Reports. Journal of Korean Medicine Rehabilitation. 2010;20(4);241-54.
  16. Wall PD, Mozack Ronald. Textbook of PAIN : Seoul : Jungdam Publication. 2002: 483-4.
  17. Jung CY, Kim EJ, Hwang MS, Cho HS, Kim KH, Lee SD, Kim KS. The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease. The Acupuncture. 2010;27(2):123-42.
  18. Lee YK, Nam HS, Chuang LH et al. South Korean Time Trade-Off Values for EQ-5D Health States: Modeling with Observed Values for 101 Health States. Value Health. 2009;12(8):1187-93.
  19. Lee SI. Validity and reliability evaluation for EQ-5D in Korea [Internet]. Korea Centers for Disease Control and Prevention; 2011 [cited 2012 March 08]. Available from: 28&cid=1742&ctype=1.
  20. Lee JH, Yoon KH, Bae DK, Eo JH, Kim JW, Park SY. The incidence and the patterns of associated injuries of anterior cruciate ligament tear. Journal of Korean Arthroscopy Soc. 2008;12:24-31.
  21. Oiestad BE, Holm I, Aune AK, et al. Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: A prospective study with 10 to 15 years of follow-up. The American Journal of Sports Medicine. 2010;38(11):2201-10.
  22. Yagi M, Wong EK, Kanamori A. Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. The American Journal of Sports Medicine. 2002:30:660-6.
  23. Lin SH, Wang TC, Lai CF, et al. Association of anterior cruciate ligament injury with knee osteoarthritis and total knee replacement: A retrospective cohort study from the Taiwan National Health Insurance Database. PLoS One. 2017 May 30;12(5):e0178292.
  24. Cannon WD Jr. Arthroscopic meniscal repair. Inside-out technique and results. The American Journal of Knee Surgery. 1996;9(3):137-43.
  25. Barber FA, Click SD. Meniscus repair rehabilitation with concurrent anterior cruciate reconstruction. The Journal of Arthroscopic and Related Surgery. 1997;13(4):433-7.
  26. Wei Jiang, Shu-guang Gao, Kang-hua Li, et al. Impact of Partial and complete rupture of anterior cruciate ligament on medial meniscus: A cadavaric study. Indian Journal of Orthopaedics. 2012;46(5)514-9.
  27. CB Weiss, M Lundberg, P Hamberg, KE DeHaven, J Gillquist. Non-operative treatment of meniscal tear. J Bone Joint Surg Am. 1989;71:811-22.
  28. Dawson AG, Hutchison JD, Sutherland AG. Is Anterior Cruciate Reconstruction Superior to Conservative Treatment? J Knee Surg. 2016;29(1):74-9.
  29. Linko E, Harilainen A, Malmivaara A, Seitsalo S. Surgical versus conservative interventions for anterior cruciate ligament ruptures in adults. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001356.
  30. Streich NA, Zimmermann D, Bode G, Schmitt H. Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up. Int Orthop. 2011;35(4): 607-13.
  31. Fujimoto E, Sumen Y, Ochi M, Ikuta Y. Spontaneous healing of acute anterior cruciate ligament (ACL) injuriesconservative treatment using an extension block soft brace without anterior stabilization. Arch Orthop Trauma Surg. 2002;122(4):212-6.
  32. Preiss A, Brodhun T, et al. Rupture of the anterior cruciate ligament in growing children: surgical or conservative treatment? A systematic review. Der Unfallchirurg. 2012 Sep;115(9):848-54.
  33. Feucht MJ, Bigdon S, Bode G, et al. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res. 2015 Mar 18;10:34.
  34. Hong Moon Sohn, Gwang Chul Lee, Dong Hwi Kim, et al. Comparison the Preoperative MRI Findings with Postoperative Arthroscopic Findings on Meniscus Injury with Anterior Cruciate Ligament Rupture. Journal of Korean Arthroscopy Society abbreviation. 2012;16(2):147-52.