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KMID : 0359619950070020136
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Journal of Korean Knee Society
1995 Volume.7 No. 2 p.136 ~ p.141
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The Factors of Graft Failure of the ACL Reconstruction (About Impingement)
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Schech, Joseph M.
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Abstract
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The am of this study was to investigated the influnce of impingement of the geaft by intercondylar roof to stability of the joint and clinical result after reconstruction of anterior cruciate ligament9ACL) with bonepatellar tendon-bone graft.
Among 74 cases of ACL reconstruction were done by one tunnel arthroscopic technique from Nay 1991 to February 1994, 30 cases with excellent result and 4 cases with poor result were analysed by radiological measurements & stability assessed by
Lachman
test and KT-1000 arthrometer, OAK(Orthop?ische Arbeitsgruppe Knee) knee score.
Impingement was assessed by relationship between the locations of intersection points on tibial tunnel plateau made by the lines drawn along the tibial tunnel and the slope of femoral intercondylar roof in full extension lateral roentgenogram.
Impingement was defined as severe(group I) when the line of tibial tunnel was in front of the lne of intecondylar slope ; moderate or non when the former was at the same point or behined the latter(group II).
In addition to that, the digree of impingement was evaluated by dividing the distance between the interwesction point of intercondylar slope line and anterior margin of tibial tunnel by the width of tibial tunnel, and expressed in terms of
percentage.
@ES The were as follows;
@EN 1. There 2 cases of group I(severe impingement) and 32 cases of group II (moderage or no impingement)
2. Regarding the range of motion, one case of group I showed limitation of extension under 10 degrees, and one case of group II showed limitation of flexion under 15 degrees.
3. Lachman test was positive in one case of group I and 3 cases of group II, and negative in one case of group I and 29 cases of group II.
4. Maximal manual displacement measured by KT-100TM arthrometer was 4.8±1.0 in group I and 1.0±1.7 in group II(statistically significant diffcrence at p=0.001).
5. The degree of impingement obtained by radiological measurement was 123% in group I and 34% in group II(statistically signficant difference at p=0.001).
6. According to OAK criteria, one cases of group I and 29 cases group II showed excellent result, one case of group I and 3 cases of group II showed poor result.
From above results, the presence and degree of impingement assessed by full extension lateral roentgenogram seems to have influence on the stability and clinical result after reconstruction of ACL by one tunnel arthroscopic technique.
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KEYWORD
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