• Title/Summary/Keyword: Anterior drawer test

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The Modified $Brostr{\ddot{o}}m$ Procedure for Chronic Lateral Ankle Instability (만성 족관절 외측 불안정성에 대한 $Brostr{\ddot{o}}m$ 변형 술식)

  • Song, Ha-Heon;Shim, Dae-Moo;Lee, Byoung-Chang;Kim, Dong-Churl;Cho, Yong-Woo;Yang, Jung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.81-85
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    • 2004
  • Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

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Comparative Study of Arthroscopic ACL Reconstruction Using Bone-Patellar Tendon-Bone Versus Four-Stranded Semitendinosus-Gracilis Tendon (관절경적 전방십자인대 재건술시에 골-슬개건-골과 네가닥 반건양건-박건을 이용한 방법의 비교연구)

  • Kim, Jin Goo;Lim, Young;Kim, Byung Jik;Ko, Han Suk;Moon, Hyung Tae
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.107-113
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    • 1998
  • This study is retrospective analysis of 31 patients treated by arthroscopically assisted ACL reconstruction, from September 1995 to September 1996. ACL reconstructions using autogenous bone patellar tendon bone (B-PT-B) were done in 18 patients, and using hamstring tendon were done in 13 patients. We used four-stranded hamstring tendon grafts and fixed the grafts using Endobutton and screw. The mean postoperative Lysholm knee score was 87.2 points in B-PT-B. group, and 89.0 points in hamstring tendon group. There were no clinically significant results between two groups in Telos test, quadriceps atrophy, Lachman test, anterior drawer test and pivot shift test, but the incidences of anterior knee pain were lower in hamstring group. Four-stranded hamstring tendon graft showed enough stability and good functional outcome similar to that of patellar tendon graft, and had an advantage of quicker return of quadriceps function and less donor site morbidity.

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The Effect of Meniscectomy on Clinical Result After ACL Reconstruction (전방십자인대 재건술에서 반월상 연골 절제술의 영향)

  • Cho, Hyung-Jun;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Yoon, Kyoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.7-12
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    • 2010
  • Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

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Diagnostic Accuracy of Clinical Test for Anterior Cruciate Ligament Injury: Systematic Review

  • Deniz Yasemin;Sang-Woo Pyun;HyungSu Lee;Seong-Eun Kim;SunGyu Han;Dongyeop Lee;Ji-Heon Hong;Jae-Ho Yu;Jin-Seop Kim;Seong-gil Kim
    • The Journal of Korean Physical Therapy
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    • v.35 no.3
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    • pp.57-63
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    • 2023
  • Purpose: The aim of this study was to conduct a systematic review of randomized controlled studies from 2012 to present that explore the diagnostic accuracy of clinical tests used for diagnosing anterior cruciate ligament (ACL) injury. Methods: Study design: Systematic review. Literature search of the PubMed and Scholar databases was conducted using keywords related to diagnostic accuracy of clinical tests for ACL injury. The PRISMA Guidelines were followed to conduct this study. The Cochrane Risk of Bias Tool was utilized to assess the quality of each included study. Results: As a result, 8 studies were included, and 6 clinical tests used in ACL tears were evaluated for diagnostic accuracy. The pivot shift test was reported as having the highest +LR (29.5) value with a sensitivity of 59% and a specificity of 98%. However, the test with the lowest -LR value was the lever test, and the values were as follows: -LR (0.08), +LR (4.7), specificity (80%), sensitivity (94%). Conclusion: In this study, it was concluded that a single clinical test is not sufficient to determine the presence of ACL injury. Test combinations have a higher diagnostic accuracy than a single test. In this study, the accuracy of the clinical tests was examined without considering the amount of ACL rupture and acute-chronic condition. Further research is required to examine the impact of these two factors on diagnostic accuracy of clinical test.

Comparative Medium Term Results of Arthroscopic ACL Reconstruction with Quadrupled Semitendinosus Tendon versus BPB tendon (4겹의 반건양건과 골-슬개건-골을 이용한 관절경적 전방 십자 인대 재건술의 중기적 치료 결과 비교)

  • Kim, Hyoung-Soo;Park, Seung-Rim;Kang, Joon-Soon;Lee, Woo-Hyeong;Kim, Ki-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.1-6
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    • 2001
  • Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using central one third bone-patellar-tendon bone(BPB) autograft versus quadrupled semitendinos-us(ST) autograft as the medium term review. Materials and Methods : Eighty patients(40 BPBs,40 STs) with isolated ACL injury were available for a mean follow up of 49.4 months(BPB) and 48.8 months(ST). There was no significant difference between the two groups with respect to age and sex. We compare the final results between two groups with respect to subjective Lysholm score, objective laxity including anterior drawer test, Lachman test, pivot shift test, KT-2000 measurements and International Knee Documentation Committee(IKDC) evaluation system. Results : Postoperatively, positive anterior drawer test was found in $22.5\%\;and\;27.5\%$, positive Lachman test was found in $30.0\%$ and $25.0\%$ and positive pivot shift test was found in $15\%\;and\;20\%$ of the ST and BPB group, respectively(p>0.05). Mean side to side difference of KT-2000 at 20 lbs was 2.2 mm for the ST group and 2.1 mm for the BPB group. There was no significant difference between the two groups about Lysholm score(>0.05). Anterior knee pain was knee common in the BPB group. Eighty-three percent of the patients were nearly normal according to the IKDC grade in both groups. Conclusion : We consider that autogenous semitendinosus tendon is a good alternative subsititute in ACL reconstruction together with the bone-patellar tendon-bone autograft.

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Initial Fixation Power of Human Bone Interference Screw (인간 골 간섭 나사못의 초기 고정력)

  • Kim Jung-Man;Chung Yang-Kook;Kim Yang-Soo;Oh In-Soo;Koh Ihn-Joon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.26-30
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    • 2002
  • Purpose: To estimate the initial and early phase fixation power of the human bone interference screw in reconstruction of the anterior cruciate ligament with bone-patellar tendon-bone allograft. Materials and Methods: The results of twenty eight knees of reconstruction with bone-patellar tendon-bone allograft were analysed in 6 weeks, 12 weeks, 6 months and one year following operation. Physical examination including Lachman test, flexion rotation drawer test and jerk test were performed. The KT-1000 measurement was performed at the same time. In Lachman test 0 $\~$2mm anterior displacement of the tibia was considered normal. The KT-1000 measurement of normal side was compared with operation side and the difference of the two was recorded. The MRI was checked at final follow-up. Results: All but one knee showed normal in physical examination. The failed case showed proximal migration of the graft due to insufficient number of interference screw fixation in widened tibial tunnel. Conclusions: The human cortical bone interference screw showed sufficient initial and early phase fixation power in reconstruction of the anterior cruciate ligament.

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Notchyplasty with Flexible Reamer (대퇴과간절흔 성형술에서 유연성 연마기를 이용한 방법)

  • Chae, In-Jung;Lee, Kwang-Suk;Back, Jong-Ryoon
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.123-127
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    • 1997
  • Arthroscopic anterior cruciate ligament reconstructions using bone-patella tendon-bone have been considered the best method by which others are compared. The notchyplasty is one of the important steps of this procedure and it is emphasized recently to prevent retear of the reconstructed ACL caused by impingement. However, until now, there is controversy about adequate amount of notchyplasty. Also, it is hard to examine the adequacy of notchyplasty even in the arthroscopic field, The purpose of this paper is to describe the surgical technique of notchyplasty, using the flexible reamer and preliminary result of its operation. In this study the results of ACL reconstruction with notchyplasty which is made by us were analized from January. 1994 to December, 1995. The results were as follows: 1. The notchyplasty with flexible reamer is the method that can be obtained adequate amount of removal, perfectly smooth notchyplasty. 2. The range of motion of the affected knee joint was normal ROM after post operation 6 month. 3. In the last follow up, 2 cases were positive in anterior drawer test 4 cases were positive in Lachmann's test and 1 knee was positive in Pivot shift test 4. Average Lysholm knee scoring scale was 70 points at preoperative and 92 points at the last follow up.

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Comparison of Anterior Cruciate Ligament Reconstructions Using Hamstring Tendon Autograft and Tibialis Tendon Allograft (자가 슬괵건 및 동종 경골건을 이용한 전방 십자 인대 재건술의 결과 비교)

  • Song, Eun-Kyoo;Seon, Jong-Keun;Bae, Bong-Hyun;Park, Sang-Jin;Kim, Jong-Seon;Lee, Dam-Seon
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.141-147
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    • 2006
  • Purpose: To compare the clinical and radiological results of anterior cruciate ligament(ACL) reconstruction using hamstring autograft and tibialis tendon allograft. Materials and Methods: Twenty four ACL reconstructions using hamstring autograft and 30 using tibialis anterior tendon altograft were followed up at least 1 year. We performed femoral tunnel fixation with Ligament Anchor(LA) screw and tibial tunnel fixation with biodegradable interference screw. Evaluations included Lysholm knee(LK) score, Tegner activity scale, Lachman test, Pivot-Shift test, Quardriceps atrophy, incision site numbness, anterior knee pain and instrumented anterior laxity with $Telos^{(R)}$ device. Results: Preoperativ mean LK score was $60.3(18{\sim}82)$ in autograft group and 61.2(25-80) in allograft group. Mean LK score improved to $91.6(68{\sim}100)\;and\;92.6(77{\sim}100)$ respectively. Activity level, using Tegner activity scale, slightly decreased compared with that of Preinjury state in both groups. Lachman test, pivot-shift test, Quadriceps atrophy, anterior knee pain, incision site numbness, and anterior drawer test using $Telos^{(R)}$ device showed no significant difference between two groups (p>0.05). Conclusion: In performing the ACL reconstruction, there was no statistically significant difference between hamstring autograft group and tibilis anterior allograft group in clinical or in radiological results.

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Reconstruction of Anterior Cruciate Ligament with Human Allograft (동종 이식건을 이용한 전방 십자 인대 재건술)

  • Suh Jeung-Tak;Cheon Sang-Jin;Lee Jung-Sub
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.7-12
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    • 2000
  • Purpose : The purpose of this study is to evaluate the clinical outcomes and radiological changes after reconstruction of anterior cruciate ligament with human allograft. Material and Method : Authors analyzed 22 cases of anterior cruciate ligament allograft reconstruction which were done from January, 1995 to December, 1998 and could be followed up for a year or more. All cases were followed and reviewed in terms of anterior drawer test, Lachman test, Pivot shift test, radiographic examination, knee range of motion, and side-to-side difference of anteroior tibial translation using CA-4000 knee motion analyzer, and Lysholm knee scoring system. Result : The mean Lysholm knee score was 54 preoperatively and improved to 81 postoperatively by average of 27. The side-to-side difference of anterior tibial translation using CA-4000 knee motion analyser was less than 3 mm in 16 cases$(73\%)$, between 3 and 5 mm in 4 cases$(18\%)$, and greater than 6 min in 2 cases$(9\%)$. Average tibial tunnel enlargement was 1.5 mm, but there were not any osteoiysis or cystic formation along the tunnel and no relationship between tunnel enlargement and clinical outcome. Conclusion : Although this study had limited cases, clinical results of anterior cruciate allograft reconstruction were similar to those of reconstruction with autograft reported in the literatures. We think that allograft is an acceptable substitute fer autograft in anterior cruciate ligament reconstruction.

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Clinical Approach of Chukyu Pharmacopuncture and Brainspotting Through a Traffic Accident Patient Case (교통사고 환자 증례를 통한 척유약침과 Brainspotting의 임상적 접근)

  • Lee, Do-Eun;Ha, Ji-Su;Park, Hyun-Mee;Youn, In-Ae;Seo, Joo-Hee
    • 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.