Revision Anterior Cruciate Ligament Reconstruction Using Two Anteromedial Portal Technique / 대한스포츠의학회지

There are numerous reasons for the failure of anterior cruciate ligament (ACL) reconstruction. Among them, surgical technical failure and wrong femoral tunnel location are the most common. The authors focused on the results of ACL revision using two anteromedial portals. Sixteen patients were selected with two anteromedial portals that were designed to decrease the femoral tunnel slope in sagittal plane. Clinical analysis was carried out based on Lysholm score, Tegner score and International Knee Documentation Committee (IKDC). For anterior stability test, Lachman test, KT-2000 arthrometer were used. pivot shift test was measured for rotatory stability test. Preoperative Lachman test and pivot shift test showed positive finding in all cases, however, postoperative Lachman with 10 cases (62.5%) and pivot shift test with 10 cases (62.5%) were negative. The difference of anterior displacement with the non-affected side using KT 2000 arthrometer showed 6.57 mm (range: 4.0-12.0 mm) preoperatively and 2.20 mm (range: 1.0-4.0 mm) postoperatively on average. Score of Tegner and Lysholm improved from 4.86 (range: 2.0-7.0), 46.14 (range: 33-52) preoperatively, to postoperative score of 8.14 (range: 7.0-9.0), 83.43 (range: 74-89) at the final follow up. IKDC result also showed improvement. ACL reconstruction method using two anteromedial tunnels that is desgined to decrease femoral tunnel slope at sagittal plane is an effective technigue for revision surgery after initial ACL reconstruction failure. This technigue allows superior femoral tunnel selection, firm fixation of grafts and also shows excellent clinical results with stability.

The Change of Articular Cartilage Thickness of the Knee Joint Related to Age in Korean

PURPOSE: The purpose of this study is to assess the change of the articular cartilage thickness resulting from physiological aging in normal Korean people without any disease in knee joint. MATERIALS AND METHODS: Voluntary participants of 81 cases, physically normal and free from knee joint disease at present or in the past, were chosen for our research program. The subjects were divided into young, middle and old age group respectively for the male and female; and articular cartilage thickness using MRI were measured. RESULT: Each of the three groups reveals the tendency of decrease in the thickness of the knee joint cartilage in all of the age groups along with the increase of the age. The cartilage thickness according to age for both sex, except for the tibial medial condyle, decreased significantly. For the male subjects, the degree of decrease in cartilage thicknes indicates difference in each sections. However, in case of female, the change of articular cartilage thickness in overall sections showed more significantly decreased in young to middle age group than in middle to old age group. CONCLUSION: The results revealed the normal articular cartilage thickness of knee and time that the thickness of articular cartilage was decreased with age. And we could evaluate the severity of degenerative change of articular cartilage by comparison to normal articular cartilage thickness.