Purpose: The association between the healing of an injured anterolateral ligament (ALL) and residual pivot-shift following anterior cruciate ligament (ACL) reconstructions is rarely reported. This study analyzed the relationship between unhealed ALL and residual pivot-shift after an ACL reconstruction. Materials and Methods: The inclusion criteria were patients who underwent autologous hamstring ACL reconstructions within 6 weeks after injury from January 2008 to March 2021. Preoperative ALL injuries and postoperative ALL healing were graded according to the magnetic resonance imaging classification, with postoperative magnetic resonance imaging performed 7.8 months after surgery on average. The patients were categorized based on postoperative ALL healing, and the clinical scores (Lysholm score and Tegner activity scale) and knee stability (Lachman test and pivot-shift test) were assessed at the 1-year postoperative follow-up. Results: One hundred and forty-five patients were enrolled in this study. One hundred and twenty-eight (88.3%) patients had a concomitant ALL injury. Among 86 patients with preoperative grade B, 16 (18.6%) patients showed grade 1 (good), and 70 (81.4%) showed grade 2 (partial) ALL postoperatively. Among the 42 patients with preoperative grade C (complete tear), 1 (2.4%) patient showed grade 1 (good), 21 (50.0%) showed grade 2 (partial), and 20 (47.6%) showed grade 3 (non-visualized) ALL. Preoperative grade C was significantly associated with a higher incidence of grade 3 (non-visualized) postoperatively than the other groups (p<0.001). Postoperatively, the Lachman test, KT-1000 (MEDmetric Corp.) arthrometer (side-to-side difference), Lysholm score, and Tegner activity scales did not show a significant difference among the intact, grade 1, grade 2, and grade 3 ALL groups. The pivot-shift test showed a significant difference between the ALL grades (p=0.001). Grade 3 ALL group showed a higher incidence of pivot-shift than the intact, grade 1, and grade 2 ALL groups. Conclusion Patients with preoperative grade C had a higher rate of grade 3 postoperatively compared to the other groups. In addition, the grade 3 group had a significantly higher incidence of a pivot-shift. Therefore, in cases of ACL injuries with concomitant complete ALL tears, ALL reconstruction should be considered during ACL reconstruction.

Conversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC).To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy.The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion herapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%).Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy.

Conversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC).To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy.The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion herapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%).Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy.

Purpose: The association between the healing of an injured anterolateral ligament (ALL) and residual pivot-shift following anterior cruciate ligament (ACL) reconstructions is rarely reported. This study analyzed the relationship between unhealed ALL and residual pivot-shift after an ACL reconstruction. Materials and Methods: The inclusion criteria were patients who underwent autologous hamstring ACL reconstructions within 6 weeks after injury from January 2008 to March 2021. Preoperative ALL injuries and postoperative ALL healing were graded according to the magnetic resonance imaging classification, with postoperative magnetic resonance imaging performed 7.8 months after surgery on average. The patients were categorized based on postoperative ALL healing, and the clinical scores (Lysholm score and Tegner activity scale) and knee stability (Lachman test and pivot-shift test) were assessed at the 1-year postoperative follow-up. Results: One hundred and forty-five patients were enrolled in this study. One hundred and twenty-eight (88.3%) patients had a concomitant ALL injury. Among 86 patients with preoperative grade B, 16 (18.6%) patients showed grade 1 (good), and 70 (81.4%) showed grade 2 (partial) ALL postoperatively. Among the 42 patients with preoperative grade C (complete tear), 1 (2.4%) patient showed grade 1 (good), 21 (50.0%) showed grade 2 (partial), and 20 (47.6%) showed grade 3 (non-visualized) ALL. Preoperative grade C was significantly associated with a higher incidence of grade 3 (non-visualized) postoperatively than the other groups (p<0.001). Postoperatively, the Lachman test, KT-1000 (MEDmetric Corp.) arthrometer (side-to-side difference), Lysholm score, and Tegner activity scales did not show a significant difference among the intact, grade 1, grade 2, and grade 3 ALL groups. The pivot-shift test showed a significant difference between the ALL grades (p=0.001). Grade 3 ALL group showed a higher incidence of pivot-shift than the intact, grade 1, and grade 2 ALL groups. Conclusion Patients with preoperative grade C had a higher rate of grade 3 postoperatively compared to the other groups. In addition, the grade 3 group had a significantly higher incidence of a pivot-shift. Therefore, in cases of ACL injuries with concomitant complete ALL tears, ALL reconstruction should be considered during ACL reconstruction.

Conversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC).To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy.The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion herapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%).Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy.

Purpose: The association between the healing of an injured anterolateral ligament (ALL) and residual pivot-shift following anterior cruciate ligament (ACL) reconstructions is rarely reported. This study analyzed the relationship between unhealed ALL and residual pivot-shift after an ACL reconstruction. Materials and Methods: The inclusion criteria were patients who underwent autologous hamstring ACL reconstructions within 6 weeks after injury from January 2008 to March 2021. Preoperative ALL injuries and postoperative ALL healing were graded according to the magnetic resonance imaging classification, with postoperative magnetic resonance imaging performed 7.8 months after surgery on average. The patients were categorized based on postoperative ALL healing, and the clinical scores (Lysholm score and Tegner activity scale) and knee stability (Lachman test and pivot-shift test) were assessed at the 1-year postoperative follow-up. Results: One hundred and forty-five patients were enrolled in this study. One hundred and twenty-eight (88.3%) patients had a concomitant ALL injury. Among 86 patients with preoperative grade B, 16 (18.6%) patients showed grade 1 (good), and 70 (81.4%) showed grade 2 (partial) ALL postoperatively. Among the 42 patients with preoperative grade C (complete tear), 1 (2.4%) patient showed grade 1 (good), 21 (50.0%) showed grade 2 (partial), and 20 (47.6%) showed grade 3 (non-visualized) ALL. Preoperative grade C was significantly associated with a higher incidence of grade 3 (non-visualized) postoperatively than the other groups (p<0.001). Postoperatively, the Lachman test, KT-1000 (MEDmetric Corp.) arthrometer (side-to-side difference), Lysholm score, and Tegner activity scales did not show a significant difference among the intact, grade 1, grade 2, and grade 3 ALL groups. The pivot-shift test showed a significant difference between the ALL grades (p=0.001). Grade 3 ALL group showed a higher incidence of pivot-shift than the intact, grade 1, and grade 2 ALL groups. Conclusion Patients with preoperative grade C had a higher rate of grade 3 postoperatively compared to the other groups. In addition, the grade 3 group had a significantly higher incidence of a pivot-shift. Therefore, in cases of ACL injuries with concomitant complete ALL tears, ALL reconstruction should be considered during ACL reconstruction.

Objective: To evaluate C2 muscle preservation effect and the radiological and clinical outcomes after C2 recapping laminoplasty. Methods: Fourteen consecutive patients who underwent C2 recapping laminoplasty around C1–2 level were enrolled. To evaluate muscle preservation effect, the authors conducted a morphological measurement of extensor muscles between the operated and nonoperated side. Two surgeons measured the cross-sectional area (CSA) of obliquus capitis inferior (OCI) and semispinalis cervicis (SSC) muscle before and after surgery to determine atrophy rates (ARs). Additionally, we examined range of motion (ROM), sagittal vertical axis (SVA), neck visual analogue scale (VAS), Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) score to assess potential changes in alignment and consequent clinical outcomes following posterior cervical surgery. Results: We measured the CSA of OCI and SSC before surgery, and at 6 and 12 months postoperatively. Based on these measurements, the AR of the nonoperated SSC was 0.1% ± 8.5%, the AR of the operated OCI was 2.0% ± 7.2%, and the AR of the nonoperated OCI was -0.7% ± 5.1% at the 12 months after surgery. However, the AR of the operated side’s SSC was 11.2% ± 12.5%, which is a relatively higher value than other measurements. Despite the atrophic change of SSC on the operated side, there were no prominent changes observed in SVA, C0–2 ROM, and C2–7 ROM between preoperative and 12 months postoperative measurements, which were 11.8 ± 10.9 mm, 16.3° ± 5.9°, and 48.7° ± 7.7° preoperatively, and 14.1 ± 11.6 mm, 16.1° ± 7.2°, and 44.0° ± 10.3° at 12 months postoperative, respectively. Improvement was also noted in VAS, NDI, and JOA scores after surgery with JOA recovery rate of 77.3% ± 29.6%. Conclusion C2 recapping laminoplasty could be a useful tool for addressing pathologies around the upper cervical spine, potentially mitigating muscle atrophy and reducing postoperative neck pain, while maintaining sagittal alignment and ROM.