• Title/Summary/Keyword: 골성 관절염

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Arthroscopic Anterior Debridement and Mini-Open Posterior Resection for Primary Osteoarthritis of the Elbow (주관절 원발성 골성 관절염의 관절경적 전방 변연 절제술 및 최소 절개 후방 절제술)

  • Kim, Young-Kyu;Moon, Sung-Hoon;Cho, Seung-Hyun;Oh, Won-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.40-46
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    • 2012
  • Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.

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Alternative Fixation Technique for Bony Bankart Lesion with Using Suture Anchor (봉합나사와 골터널을 이용한 골성 반카르트 병변의 고정)

  • Kim, Byung-Kook;Lee, Ho-Jae;Kim, Go-Tak;Dan, Jinmyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.574-578
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    • 2019
  • For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

Arthscopic Treatment of Osteochondritis Dissecans in Femoral Condyle (관절경을 이용한 대퇴골과 박리성 골연골염에 대한 치료)

  • Kim Sung-Jung;Kyung Hee-Soo;Ihn Joo-Chul;Lee Seong-Man
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.138-143
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    • 2000
  • Purpose : We analyzed clinical and radiological results of the treatment of osteochondritis dissecans in the femoral condyle under arthroscopic guidance. Materials and Methods : The study group consists 19 cases in 17 patients. Average follow up period was 34 months and average age was 16 years. The cases were classified by 4 different groups, using the fellowing system: Group 1-stable lesion and no specific treatment after arthroscopic examination; Group 2-early separation and multiple drilling; Croup 3-unstable lesion and Herbert screw fixation; Croup 4-loose body removal and/or crater curettage. The results were analyzed by the criteria of Hughston which including clinical and radiologic outcomes. Results : There were 14 cases$(74\%)$ of good and excellent results in 19 knees in which, $75\%$(3/4) in Group 1, $75\%$(3/4) in Group 2, $86\%$(7/8) in Group 3 and $33\%$(1/3) in Group 4. The result of Herbert screw fixation group was better than that of other groups with statistically significant differences. Conclusion : In the treatment of osteochondritis dissecans of skekletally immature patients, arthroscopic finding was reliable guidance in decision of treatment method and active fixation was recommended in patients with large, unstable lesion.

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Operative Treatment for Degenerative Arthritis of Elbow - Arthroscopic surgery with traction in Lateral position - (주관절의 퇴행성 관절염에 대한 수술적 치료 - 측와위에서 견인을 이용한 관절경 수술 -)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Whang, Chan-Ha;Kang, Shin-Taek;Kim, Jung-Man;Kim, Hyoung-Jun;Lee, Dong-Yeob
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.178-183
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    • 2006
  • Purpose: We reported the results and efficiency of arthroscopic treatment in a state of the lateral traction about the degenerative arthris of elbow Materials and Methods: Twenty one elbows with the degenerative arthritis who were followed up for at 12 months were enrolled in this study. Male were 15 cases, female were 6 cases, the mean age was 47 years and right dominant hand was 14 cases. In all cases, during arthroscopic treatment under the traction of 10 pounds, we had done synovectomy, excision of loose body and anteroposterior spur. After operation, immobilization was done in the full extension state, and then continuous passive motion (CPM) was started two day Results: The average preoperative ROM of the elbow joint was $30{\sim}l15$ degree and the average postoperative ROM of the elbow joint was $5{\sim}130$ degree. The increasement of ROM was totally 41 degree in extension 25 degree and flexion 16 degree. The decrement of VAS in pain was from 7.5 into 2.3 and the increasement of the satisfactory function was from 1.8 into 9.0. Complication was in two cases. One was paresthesia of ulnar nerve, but resolved. The other was bullae formation around the elbow joint, but cured. Conclusion: Regarding degenerative arthritis of elbow, arthroscopic treatment showed excellent result in recovery of range of motion and relief of pain. We could obtain good visual field with distraction in lateral position.

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Intrusion of the extruded maxillary central incisor using skeletal anchorage system and unilateral segmental intrusion arch (골성 고정원과 편측 분절호선을 이용한 정출된 상악 중절치의 압하 치료)

  • Kwon, Eun-Young;Baek, Young-Jae;Park, Soo-Byung;Kim, Seong-sik;Kim, Yong-il;Choi, Youn-kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.180-190
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    • 2019
  • Patients who have a moderate periodontitis with pathologic tooth migration of maxillary incisors, it is necessary not only periodontal treatment for reduce periodontal inflammation, but also orthodontic treatment to teeth repositioning. For orthodontic treatment, it is necessary to apply less force and careful considerations of the center of resistance of the tooth and optimal force of tooth movement. At this time, the segmental arch applied only to the target teeth, is more effective and predictable, because applied force and direction can be controlled. In addition, to design the orthodontic appliance that can prevent the unwanted tooth movement that used as an anchorage is important. In recent years, various types of skeletal anchorage system have been used for preventing loss of the anchorage. We reported the patient who had extruded maxillary central incisor due to pathologic tooth migration, treated by a successful periodontal-orthodontic multidisciplinary treatment using an orthodontic appliance designed to apply less traumatic force and reduce an anchorage loss.

Orthodontic intrusion treatment of mandibular anterior teeth in a periodontal patient with hyperdivergent skeletal pattern: 8-year follow-up (장안모를 보이는 치주 질환자에서 하악 전치의 압하를 통한 과개 교합 치료: 8년 경과 관찰)

  • Kwon, Eun-Young;Jung, Kyung-Hwa;Park, Soo-Byung;Kim, Seong-sik;Kim, Yong-il;Choi, Youn-kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.1
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    • pp.48-60
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    • 2021
  • Patients who have extruded anterior teeth and deep bite with pathologic tooth migration, it is necessary not only periodontal treatment for reduce inflammation, but also orthodontic treatment for intrusion of anterior teeth. However, it is difficult to place the orthodontic brackets due to the deep bite, and there is a problem that the extrusion of the posterior teeth occurs more easily than the intrusion of the anterior teeth biomechanically. In particular, in patients with long face, relative intrusion of the anterior teeth by extrusion of the posterior teeth causes the clockwise rotation of the mandible and makes the facial profile worse. Therefore the biomechanical consideration and appliance design that can block these problems are required from the treatment plan. This is a patient who had a deep overbite with extruded anterior teeth, treated by periodontal treatment and intrusion of mandibular anterior teeth using cute brackes and miniscrews, and resulted in favorable maintenance during 8-year retention.