• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.93-98
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• 2009

족관절 고정술은 족관절에 발생한 심한 관절염(end-stage arthritis)에서 전통적으로 시행하던 술식으로 현재 사용되고 있는 인공 족관절 치환술이 발달되기 전까지는 gold standard 로 알려져 있었으며 현재에도 심한 족관절의 변형이나 파괴, 족관절 인공 관절의 실패시에 시행되고 있다. 1897년 Albert가 처음으로 족관절 고정술을 소개한 이후로 30여가지가 넘는 방법이 행해지고 있으나 개방적 관절 고정술의 단점인 수술 후 염증, 유합 지연, 연부조직의 손상에 의한 피부 괴사 등을 극복하고 유합물을 높이기 위해 다양한 내고정 및 외고정 장치를 사용하고 있다. 관절경 술식이 발달하면서 Schnider가 1983년 최초로 관절경을 이용한 족관절 고정술을 발표한 이후로 관절경하의 족관절 고정술은 개방적 족관절 고정술 보다 높은 유합율과 적은 수술 합병증으로 인해 관심의 대상이 되었지만 족관절의 변형이 심한 경우에는 시행하기 어려운 단점이 있는 것으로 알려져 왔다.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.185-185
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• 2009

관절와 및 상완골의 의미 있는 골결손을 동반한 불안정한 견관절에 대해 어떻게 최선의 치료를 할 것인가에 대한 의문은 남아있다. 어떤 저자들은 외회전과 외전을 제한하는 것으로 Hill-Sachs 병변의 진입을 예방하는 일종의 관혈적 관절낭 변위를 통한 제한된 상완와관절 운동을 주장해왔으며, 다른 관혈적 시술들은 극하근건과 관절낭을 Hill-Sachs 병변 내로 관혈적 전이시키는 것으로 기술되어왔다. 최근에는 여러 저자들에 의해 Hill-Sachs 병변의 진입을 치료하는 더 새로운 접근법들이 기술되었으며, Bankart 병변 복원술에 더하여 Hill-Sachs 병변을 채우기 위해 관절경 하 후방 관절낭 고정술과 극하근건 고정술로 이루어진 이른바 'Remplissage'술기가 소개된 바 있어, 이에 저자는 외상성 견관절 불안정성으로 관절경 하 Bankart 병변 복원술 및 관절낭 축화술 시행 후 외상으로 재발된 견관절 불안정성이 발생하여 관절경 하 Bankart 병변 복원술과 함께'Remplissage'술기를 이용한 Hill-Sachs 병변 복원술을 시행한 예를 보고하는 바이다.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.148-153
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• 2000

Purpose : This study was conducted to analyze the results of arthroscopic ankle arthrodesis and to verify the advantages of the technique compared to open ankle arthrodesis. Materials and Methods : Between October 1992 and August 1996, the arthroscopic ankle arthrodesis had been performed in five patients(six ankle joints): two patients with seropositive rheumatoid arthritis(one patient surgically treated bilaterally), two with osteoarthritis and one with tuberculous arthritis. There were one man and 4 women. Average age was 48 years ranging from 38 to 65 years. Follow up period was average 45 months(range, $12\~80$). Results : All patients were successfully treated with ankle joint arthrodesis under arthroscopic control. The mean time to fusion was 10 weeks(range, $6\~15$). There was a $100\%$ fusion rate without any complication. Conclusion : The arthroscopic ankle arthrodesis was successful in all cases with less morbidity and short hospital stay. It was technically feasible with excellent predictability.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.37-44
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• 2019

Purpose: Tumor infiltration around the knee joint or skip metastasis, repeated infection sequelae after tumor prosthesis implantation, regional recurrence, and mechanical failure of the megaprosthesis might require combined distal femur and proximal tibia replacement (CFTR). Among the aforementioned situations, there are few reports on the indication, complications, and implant survival of CFTR in temporarily arthrodesed patients who had a massive bony defect on either side of the knee joint to control infection. Materials and Methods: Thirty-four CFTR patients were reviewed retrospectively and 13 temporary arthrodesed cases switched to CFTR were extracted. All 13 cases had undergone a massive bony resection on either side of the knee joint and temporary arthrodesis state to control the repeated infection. This paper describes the diagnosis, tumor location, number of operations until CFTR, duration from the index operation to CFTR, survival of CFTR, complications, and Musculoskeletal Tumor Society (MSTS) score. Results: According to Kaplan-Meier plot, the 5- and 10-year survival of CFTR was 69.0%±12.8%, 46.0%±20.7%, respectively. Six (46.2%) of the 13 cases had major complications. Three cases underwent removal of the prosthesis and were converted to arthrodesis due to infection. Two cases underwent partial change of the implant due to loosening and periprosthetic fracture. The remaining case with a deep infection was resolved after extensive debridement. At the final follow-up, the average MSTS score of 10 cases with CFTR was 24.6 (21-27). In contrast, the MSTS score of 3 arthrodesis cases with failed CFTR was 12.3 (12-13). The average range of motion of the 10 CFTR cases was 67° (0°-100°). The mean extension lag of 10 cases was 48° (20°-80°). Conclusion: Although the complication rates is substantial, conversion of an arthrodesed knee to a mobile joint using CFTR in a patient who had a massive bony defect on either side of the knee joint to control infection should be considered. The patient's functional outcome was different from the arthrodesed one. For successful conversion to a mobile joint, thorough the eradication of scar tissue and creating sufficient space for the tumor prosthesis to flex the knee joint up to 60° to 70° without soft tissue tension.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.183-189
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• 2021

Arthrodesis is one of the last options available to obtain a stable, painless knee in patients who are unable to undergo reconstructive surgery due to a damaged knee joint. A variety of techniques have been used, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Another option is the use of a short nail such as the Neff nail, the Wichita nail, or the Huckstep nail, but there are no commercial short nails available for use in Korea. This technical report describes a technique for knee arthrodesis using a retrograde femoral intramedullary nail.

• Journal of the Korean Arthroscopy Society
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• v.14 no.3
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• pp.169-174
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• 2010

대다수의 견관절 전방 불안정성에서 관절와에 골 소실이 큰 경우는 Bankart 복원술을 튼튼하게 하였을지라도 상완골두를 지탱할 관절 궁이 감소되어 골에 의한 버팀이 줄어들므로 Bankart 복원이 실패할 가능성이 높다. 따라서 관절와 결손이나 상완골 두 결손이 큰 경우 정확한 측정으로 결손의 범위를 파악하여야 하며, 관절와 결손이 25% 이상이거나 상완 골 두 결손이 30% 이상인 경우 추가적인 수술적 처치가 요하여 최근 보고되고 있는 Latarjet 술식이나 관절경적 Remplissage 술식을 시행하는 것이 바람직하다.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.317-325
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• 2021

Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.1
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• pp.19-26
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• 2007

최근에 스포츠 손상이 증가하고 관절경을 이용한 치료가 발전하면서 조기에 더 적극적인 치료를 하는 추세이다. 또한 방사선 소견에 비하여 관절경하에서는 연골이 불안정하거나 분리되어 있는 경우도 있으므로 기존의 수술 적응증보다는 좀 더 광범위하게 관절경 검사 및 수술적 치료가 요구된다고 생각한다. 치료 방법을 하면 $1.5cm^2$ 이하의 병변을 가진 50세 이하의 환자는 관절경을 이용하여 변연 절제술, 연골하 천공, 연마, 미세 골절술, 소파술 등의 방법으로 치료할 수 있다. 같은 방법으로 50세 이상의 $3cm^2$ 이하의 병변을 가진 환자 중 mosaicplasty와 자가 연골 세포 이식술을 적용할 수 없는 환자에서 시도해볼 수 있다. $1.5\sim3cm^2$의 병변을 가진 50세 이하의 환자, 그전의 관절경적 치료로 실패한 경우에는 자가골 연골 이식 또는 자가 연골 세포 이식술을 이용하여 치료해야 한다. $3cm^2$ 이상의 병변을 가진 50세 이하의 환자는 자가 연골 세포 이식술이나 동종 골 연골 이식을 이용하여 치료하며, 50세 이상의 환자는 관절 고정술이나 족근 관절 인공치환술을 고려하는 것이 바람직하다.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.127-131
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• 2010

Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.47-52
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• 2010

Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.