Oh Soo Kwon

Influence of Bundle Diameter and Attachment Point on Kinematic Behavior in Double Bundle Anterior Cruciate Ligament Reconstruction Using Computational Model

A protocol to choose the graft diameter attachment point of each bundle has not yet been determined since they are usually dependent on a surgeons preference. Therefore, the influence of bundle diameters and attachment points on the kinematics of the knee joint needs to be quantitatively analyzed. A three-dimensional knee model was reconstructed with computed tomography images of a 26-year-old man. Based on the model, models of double bundle anterior cruciate ligament (ACL) reconstruction were developed. The anterior tibial translations for the anterior drawer test and the internal tibial rotation for the pivot shift test were investigated according to variation of bundle diameters and attachment points. For the model in this study, the knee kinematics after the double bundle ACL reconstruction were dependent on the attachment point and not much influenced by the bundle diameter although larger sized anterior-medial bundles provided increased stability in the knee joint. Therefore, in the clinical setting, the bundle attachment point needs to be considered prior to the bundle diameter, and the current selection method of graft diameters for both bundles appears justified.

Anterior Cruciate Ligament Reconstruction Using a Contralateral Hamstring Tendon Graft in Combined Anterior Cruciate and Medial Collateral Ligament Injury

Purpose : We reviewed the results of a series of patients with combined anterior cruciate ligament and medial collateral ligament injury who received nonoperative management of medial collateral ligament with anterior cruciate ligament reconstruction using a contralateral hamstring tendon graft. Materials and Methods : From May 2000 to June 2001, 12 cases (20-46 years; mean, 35 years) were available for follow-up (12-23 months; mean, 16.7 months) with combined anterior cruciate ligament and medial collateral ligament injury that underwent anterior cruciate ligament reconstruction alone using a contralateral hamstring tendon graft. Follow-up evaluation involved; KT-2000 arthrometer testing, valgus stress testing and the International Knee Documentation Committee (IKDC) evaluation form. Results : Mean side to side difference of manual maximum anterior displacement using the KT-2000 arthrometer was 1.75 mm. All cases showed a firm end point by the valgus stress test. At the final IKDC evaluation, 2 cases were graded as normal, 8 nearly normal, 1 abnormal and 1 severely abnormal. The donor site result of the IKDC evaluation form showed normal in 8, nearly normal in 3 and abnormal in 1. Conclusion : These results demonstrate the effectiveness of ACL reconstruction alone using the contralateral hamstring tendon graft as an autograft in combined ACL and MCL injury, which was found to restore satisfactory stability with minimal complications at both injured and donor sites.