Validation of Functional Performance Tests after Anterior Cruciate Ligament Reconstruction

공두환,김진구,양상진,하정구,장석환,서정국 대한슬관절학회 2012 대한슬관절학회지 Vol.24 No.1

Purpose: To validate the functional performance tests (FPTs) after anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Thirty men in their third decade after ACL reconstruction at 6 month follow-up and thirty healthy subjects were selected. Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, Tegner activity score, KT-2000 arthrometer test, isokinetic strength test, functional performance tests (one leg hop test, co-contraction test, shuttle run test, carioca test) were performed in two groups. We evaluated the test-retest reliability of FPTs in healthy group and the between FPTs and other parameters in ACL reconstruction group. Results: The test-retest result showed high correlation in co-contraction test (r=0.511), shuttle run test (r=0.746), carioca test (r=0.742). In the ACL reconstruction group, the IKDC score, Tegner activity score, extensor power at 60o/s, and one leg hop test also showed high correlation between each test. Conclusions: The three FPTs showed correlations with the established methods for determining return to sports activities after ACL reconstruction and had high test-retest reliability. Therefore we believe the three FPTs can be useful methods to assess knee function in athletes after ACL reconstruction.

전방십자인대 수술 후 재활운동

공두환 대한운동사협회 2021 대한운동사협회 운동사대회자료집 Vol.2021 No.-

어깨의 재활운동

공두환 ( Doo Hwan Kong ) 대한운동사협회 2009 대한운동사협회 운동사대회자료집 Vol.2009 No.-

흉추가동성 운동이 견봉하 충돌증후군 환자의 증상 개선 및 견갑골 위치에 미치는 영향

최문영,공두환,김진성,장석환 대한스포츠의학회 2022 대한스포츠의학회지 Vol.40 No.1

Purpose: The purpose of this study was to identify effects of the thoracic spine mobility exercise in patients with subacromial impingement syndrome (SIS). Methods: Twenty patients diagnosed with SIS were selected and randomized into the combination exercise (CE) group (n=10) and shoulder exercise (SE) group (n=10). Both groups performed the same SE program for 12 weeks, and CE group performed the thoracic spine mobility exercises additionally. Before and after the exercises, visual analogue scale (VAS), shoulder range of motion (ROM), thoracic spine mobility, American Shoulder and Elbow Surgeons Shoulder Score (ASES) and Constant score, isokinetic strength, and scapula position were assessed. Results: After 12 weeks of exercise intervention, there were significant improvements in VAS, thoracic spine mobility, ASES, isokinetic shoulder external rotation, and abduction strength in the CE group (p<0.05). However, there were no significant interaction effects between the groups in shoulder ROM, Constant score, isokinetic shoulder internal rotation, and adduction strength. With scapular position, the internal rotation, anterior tilting, and protraction angles were significantly decreased after thoracic spine mobility exercise in the CE group (p<0.05). Conclusion: The symptoms and scapular positions of patients with SIS showed more improvement when the thoracic spine mobility exercises were performed in combination with shoulder exercises compared to shoulder exercises only.

뒤십자인대 및 뒤가쪽 복합체 동반 수술 후 재활운동에 따른 기능회복 차이

김현목,하성희,공두환,김창국 한국융합학회 2022 한국융합학회논문지 Vol.13 No.3

This study aimed to compare functional recovery after rehabilitation exercise between isolated PCL reconstruction and combined PLC reconstruction. Patients were divided into two groups: those who had isolated PCL reconstruction (n = 16) and those who had combined PLC reconstruction (n = 16). We assessed knee joint ligament laxity, subjective questionnaires, and isokinetic muscle function before, after 12, and 24 weeks of a rehabilitation exercise program. In both groups, there were significant differences in knee joint laxity (p = 0.048), IKDC subject score (p < 0.001), Lysholm score (p < 0.001), Tegner score (p = 0.027), and isokinetic muscle deficit (p = 0.040) by estimated period. However, no significant difference between groups was observed (p > 0.05). These results suggest that rehabilitation exercise after isolated PCL and combined PLC reconstruction influenced structural, subjective, functional recovery positively. 본 연구는 뒤십자인대 단독 재건술과 뒤가쪽 복합체 동반 수술 후 재활운동에 따른 기능회복의 차이를 확인하는데 목적이 있다. 뒤십자인대 단독 재건술을 받은 환자 16명과 뒤가쪽 복합체 동반 수술을 받은 환자 16명을 대상으로 24주간 재활운동에 따른 무릎관절 인대 이완, 주관적 설문지, 등속성 근 기능의 변화를 수술 전, 수술 후 12주, 24주에 걸쳐 자료를 분석하였다. 본 연구 결과 뒤십자인대 단독 재건술군과 뒤가쪽 복합체 동반 수술군의 무릎관절 인대 이완 차이(p = 0.048), IKDC 주관적 점수(p < 0.001), Lysholm 무릎 점수(p < 0.001), Tegner 활동 점수(p = 0.027), 등속성 폄 근력(p = 0.040)은 기간에 따른 통계적 차이가 나타났으나 집단 및 상호작용 효과는 관찰되지 않았다(p > 0.05). 등속성 굽힘 근력 결손률은 기간, 집단, 상호작용 효과 모두 차이가 없었다(p > 0.05). 본 연구 결과, 뒤십자인대 단독 재건술과 뒤가쪽 복합체 동반 수술 후 24주간의 재활운동은 기능회복에 영향을 미칠 수 있다.

회전근개 봉합술 후 고 신체활동의 효과

최문영,김진성,공두환,장석환 대한스포츠의학회 2023 대한스포츠의학회지 Vol.41 No.1

Purpose : This study aims to determine the effectiveness of high physical activity (PA) on shoulder pain, functionalrecovery, and structural outcome in the early healing phase after arthroscopic rotator cuff repair (ARCR). M e thods: Forty-two patients were included in this study according to inclusion criteria. Subjects were classified intohigh PA (HPA) group (n=22) and low PA (LPA) group (n=20) according to the classification criteria. Differencesbetween groups according to the PA level were analyzed by comparing visual analogue scale (VAS), range of motion(ROM), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and isokinetic strength before and 6weeks, 3, and 6 months after surgery. Structural outcome was analyzed by evaluating magnetic resonance imagingperformed 6 months after ARCR. Results: VAS, ROM, and ASES were significantly higher in the HPA group at 6 weeks and 3 months after ARCRwith a significant interaction effect between time and group (p<0.05). The isokinetic muscle strength was significantlyhigher in the HPA group at 3 months after surgery with a significant interaction effect on forward flexion and externalrotation strength (p<0.05). There was no significant difference in extension and internal rotation strength. In thestructural outcome of 6 months after surgery, the retear rate was lower in the HPA group with a significant trend(p<0.05). Conclusion: In this study, higher PA levels in the early healing phase after ARCR were found to result in fasterpain relief and restoration of shoulder function. In addition, higher PA level was associated with lower retear ratesin structural outcomes related to tendon healing.

전방십자인대재건술 후 운동복귀 여부 판단을 위한 기능성 검사: 체계적 문헌고찰

하정구,정규성,공두환,송한의 대한스포츠의학회 2020 대한스포츠의학회지 Vol.38 No.2

Functional tests have been widely used for evaluating the ability to determine return to sports after anterior cruciate ligament (ACL) reconstruction. To object of this study is to review the current literatures which use functional tests to determine return to sports after ACL reconstruction. A literature search was conducted using the PubMed database. The inclusion criteria were articles published from 2015 to 2019, the English language, original clinical trials, all levels of evidence, primary ACL reconstruction, skeletal maturity, and >1 functional test used to allow release to sports activities. The exclusion criteria were revision ACL reconstructions or dislocated knees; major concomitant procedures such as high tibial osteotomy, meniscus allograft, other knee ligament reconstructions, immature patients. Twenty-three studies with 5,282 patients were included for this review. Total 47 kinds of tests for determining return to play were used at an average of 8.4 months. Single leg hop test was the most commonly used functional test, which was used in 16 studies, followed by triple hop and cross-over hop tests. Average limb symmetric index of the single leg hop test was 92.5%. Among the muscle strength tests, 60 deg/sec isokinetic knee extension test is the most common, which was used in eight studies, followed by 180 deg/sec isokinetic knee extension test, isometric knee extension test, 60 deg/sec isometric knee flexion test. Ten kinds of functional tests with motion analysis were performed in three studies. Single leg hop test was the most commonly reported functional test for determining return to play following ACL reconstruction and muscle strength test and motion analysis were also used as functional tests.

National Trends of Meniscectomy and Meniscus Repair in Korea

정규성,하정구,김윤석,김정훈,라호정,공두환,Pei Wei Wang,최충혁,김진구 대한의학회 2019 Journal of Korean medical science Vol.34 No.32

Background: Meniscus surgeries are frequently performed in orthopaedics. However, their current status is not well known in many countries, including Korea. This study aimed to investigate the national trends of meniscus surgery in Korea. Methods: Information from the national database was acquired through the Korean Health Insurance Review and Assessment Service from 2010 to 2017. All cases coded as meniscectomy or meniscus repair were included. The total number and incidence of cases of meniscus surgery per 100,000 persons were determined, and the results were stratified by age and gender. The meniscus repair ratio for the total number of meniscus surgeries was evaluated. Results: The total number and incidence of meniscectomy cases were 65,752 and 137, respectively, in 2010, which increased to 74,088 and 154, respectively, in 2017. The number of meniscectomies increased by 12.67% in 8 years. The total number and incidence of meniscus repair cases were 9,055 and 18, respectively, in 2010, which increased to 14,945 and 31 in 2017. The number of meniscus repairs increased by 65.04%. The meniscus repair ratio was 12.1% in 2010, which increased to 16.8% in 2017. The highest peak was noted for patients who underwent meniscus surgeries in their 50s and 60s. Meniscectomy was performed more frequently in women (57%) than in men (43%), whereas repair was performed more frequently in men (54%) than in women (46%) over the study period. Conclusion: The total number and incidence of meniscus surgeries increased from 2010 to 2017; the number and incidence of meniscus repair procedures increased more rapidly than those of meniscectomy, with the peak treatment age for both surgeries being in the 50s and 60s. The current study will contribute to understanding the epidemiology of meniscus surgery, its prevention, and cost-saving measures in Korea.

Novel Non-Chlorinated EP for Non-ferrous and Low-ferrous Alloys Including Titanium, Aluminum and Stainless Steel

Duong Nguyen,Luke Lester,John Nussbaumer,Lou Bona,Mark Harr,Don Stevenson,공두환 한국트라이볼로지학회 2008 Lubricants SYMPOSIUM Vol.2008 No.10

자가 슬괵건을 이용한 전방십자인대 재건술 후 슬관절 굴곡력의 약화

양상진(Yang, Sang-Jin),정재은(Jung, Jae-Eun),공두환(Kong, Doo-Hwan),김진구(Kim, Jin-Goo) 대한운동학회 2007 아시아 운동학 학술지 Vol.9 No.2

자가 슬괵건을 이용한 전방십자인대 재건술 후 등속성 슬관절 굴근력 검사를 통하여 공여부의 근력 회복여부를 알아보고자 하였다. 자가 슬괵건을 이용하여 전방십자인대 재건술을 시행하고 2년 이상 추시가 가능했던 60명을 대상으로 술 후 등속성 슬관절 굴곡력 근력 검사를 시행하였다. BIODEX System III(USA)를 이용하여 앉은 자세(0°-90°)와 엎드린 자세(60°-120°)에서의 등속성 최대 우력 (Isokinetic Peak Torque)을 측정하여 건측에 대한 환측의 차이를 결과치로 설정하였다. 등속성 슬관절 굴곡력 검사에서 최대우력을 건측과 비교하였을 때 15% 미만의 근력 차이를 보인 환자는 각속도 60°/sec, 240°/sec 및 과 굴곡 시에 각각 48명(81.6%), 54명(90%), 5명(8.3%)이었다. 0°-90°에서의 슬관절의 굴근력은 대부분의 환자에서 정상 범위 내로 회복되었으나, 과 굴곡 시는 대부분의 환자의 손상된 다리에서 굴곡력의 약화를 보였다. The purpose of this study was to evaluate recovery of hamstring force after anterior cruciate ligament (ACL) reconstruction using hamstring tendon grafts. Sixty patients who underwent ACL reconstruction with hamstring autograft were evaluated after a minimum period of 2 years. To analyze the functional deficit after graft harvest, the peak isokinetic torque for knee flexion were measured in sitting position and prone position using the BIODEX System III(USA). Comparing the isokinetic peak torque with unaffected knee, the number (percentage) of patients that showed less than 15% difference in strength at 60°/sec and 240°/sec in sitting position, and hyperflexion in prone position, were 48(81.6%), 54(90%), and 5(8.3%), respectively. Recovery of flexor strength of the knee after reconstruction of ACL with hamstring autograft may be expected for 0°-90°. However, the loss of knee flexor strength were found in injury knee of patients at high knee flexion angles.