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Articles by J. C Yoo
Total Records ( 3 ) for J. C Yoo
  J. C Yoo , J. H Ahn , S. H Lee and Y. C. Yoon
  Background

No consensus has been reached with regard to the ideal timing of anterior cruciate ligament reconstruction in terms of reducing secondary meniscal tears in anterior cruciate ligament–deficient knees.

Hypothesis

Delay in anterior cruciate ligament reconstruction increases the incidence and severity of medial meniscal tears.

Study Design

Case series; Level of evidence, 4.

Methods

Thirty-one patients were evaluated with arthroscopic all-inside suturing of medial meniscal tears with concurrent anterior cruciate ligament reconstruction who had at least 2 preoperative magnetic resonance imaging studies. Patients were evaluated during the acute phase of injury, but anterior cruciate ligament reconstruction surgery was delayed at least 6 months. Mean interval between first and second imaging studies was 36.8 months. Subsequent medial meniscal tears were identified as longitudinal or bucket-handle types. Relationships between medial meniscal lesions and patient age, time interval between the date of initial injury and surgery, repetitive injury, and patient activity level were evaluated.

Results

During the first preoperative magnetic resonance imaging studies, 14 knees had no medial meniscal tear, 15 a longitudinal tear, and 2 a bucket-handle–type tear; during the second preoperative imaging studies, 5 knees had no medial meniscal tear, 19 a longitudinal tear, and 7 a bucket-handle–type tear. The incidence of medial meniscal tears increased from 55% in first studies to 84% in second studies for chronic anterior cruciate ligament–insufficient knees (P = .0054). Eight knees without a tear during first studies had a longitudinal tear during second studies, 1 knee without a tear and 4 with a longitudinal tear in first studies had a bucket-handle–type tear in second studies. Thirteen knees (42%) had a worse meniscal status during the second studies.

Conclusion

Delayed anterior cruciate ligament reconstruction increases the likelihood of a medial meniscal tear, suggesting that early anterior cruciate ligament reconstruction should reduce or prevent additional medial meniscal injury. The findings show that further medial meniscal damage is common if surgery is delayed by 6 months or more.

  J. H Ahn , Y. S Lee , J. C Yoo , M. J Chang , K. H Koh and M. H. Kim
  Background

Tears of the medial meniscus posterior horn (MMPH) are frequently found in knees with deficient anterior cruciate ligaments (ACLs). There are few studies that have evaluated healing of the menisci and the factors associated with healing.

Hypothesis

The repaired menisci would show good healing in the knees with reconstructed ACLs, and the healing capacity of the menisci would differ according to the size, type, and location of the tear as well as the age and gender.

Study Design

Case series; Level of evidence, 4.

Methods

From August 1997 to February 2007, 311 knees underwent MMPH repair using either a modified all-inside or inside-out technique with concomitant ACL reconstruction. Among these patients, a second-look arthroscopy was performed at a mean of 37.7 months postoperatively (range, 12–128 months) in 140 patients. Clinical parameters and outcomes were evaluated. The repaired menisci were divided into complete, incomplete, and failure-to-heal groups. The factors associated with meniscal healing were statistically assessed.

Results

Among 140 patients, 118 (84.3%) showed complete healing, 17 (12.1%) had incomplete healing, and 5 (3.6%) failed to heal. The clinical success rate was 96.4% (135/140) because patients in the incomplete group showed no clinical symptoms associated with meniscal tears. Healing was associated with the tear location (P <.001) and type of tear (P =.0237) on the univariate analysis and the location (P =.0401) only on the multivariate analysis.

Conclusion

Repaired MMPH tears in knees with reconstructed ACLs healed without complications and had satisfactory clinical results. The tear location and type were factors associated with healing on the univariate analysis and location only on the multivariate analysis.

  J. C Yoo , J. H Ahn , J. R Yoon and J. H. Yang
  Background

Over 60 repair/reconstruction techniques have been described for the treatment of coracoclavicular (CC) ligament injuries.

Purpose

To report the functional and radiological outcomes of single-tunnel CC ligament reconstruction using autogenous semitendinosus tendon.

Study Design

Case series; Level of evidence, 4.

Methods

Between August 2005 and January 2008, a total of 21 patients, 16 patients (14 men, 2 women) with a Rockwood type IV, type V, or a chronic type III acromioclavicular (AC) dislocation and 5 patients (4 men, 1 woman) with a painful nonunited distal clavicle fracture with CC separation, underwent CC reconstructive surgery using a semitendinosus autograft. All 21 patients were followed up clinically and radiographically. The mean follow-up was 33 months (range, 18–47), and the mean patient age was 39.8 years (range, 18–70). Chronic type III AC dislocations and nonunited distal clavicle fractures with CC separation were scored using preoperative AC scoring (AC Joint Separation Questionnaire). Constant, University of California–Los Angeles (UCLA), and AC scores were evaluated for all patients at final follow-up.

Results

At the final follow-up, 10 patients achieved an "excellent" result and 11 a "good" result according to the AC scoring scheme. Mean final Constant and UCLA scores were 84.7 (range, 67–94) and 30.0 (range, 23–35), respectively. In the antero-posterior (AP) plane, 17 (81%) of the 21 patients maintained complete reduction, and 1 of the remaining 4, a manual laborer, had complete reduction loss. Of the 17 patients with an axillary view at final follow-up, 1 patient (5.9%) showed partial subluxation, although no subluxation was observed in the AP radiograph. The other 16 patients (94.1%) had a complete reduction state in axillary view.

Conclusion

Single-tunnel CC reconstruction with an autogenous hamstring tendon graft after a mean follow-up of 33 months (range, 18–47) appears to be a satisfactory means of treating acute Rockwood type IV, V, chronic type III, and painful nonunited distal clavicle fractures with CC separation.

 
 
 
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