• Title/Summary/Keyword: 관절 성형술

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Arthroscopic Osteochondroplasty of the Osteochonral Lesion of the Talus (거골의 골연골 병변에 대한 관절경적 골연골 성형술)

  • Min, Sang-Hyuk;Jung, Hong-Geun;Kim, You-Jin;Kim, Young-Jae;Yoo, Moon-Jib
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.144-149
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    • 2006
  • Purpose: To evaluate the clinical characteristics and the functional results of the osteochondral lesions of the talus (OLT) treated with arthroscopic osteochondroplasty. Materials and Methods: The study was based on 25 cases (25 feet) of osteochondral lesion of talus that were treated with arthroscopic osteochondroplasty from May 1997 to June 2005 with at least 1 year follow-up. Follow-up period was average 21.8 months. The average age was 37.2 years old. Male patients were 22 while female were 3. Postoperative evaluation was performed with American Orthopedic Foot and Ankle Society (AOFAS) Functional score, patient satisfaction and complications. Results: Ninety-two percent of patients had trauma history. Seventy-two percent of the lesions were located at the medial dome. As for the cartilage classification, 56% were fibrillation/fissure lesions while 44% were flap tears. Visual analogue scale (VAS) pain score improved from 6.8 points to 2.2 points, and AOFAS score improved from 71.3 points to 87.3 points. Eighty-eight percent of the patients were satisfied with the surgery and average period of returning to previous job was 6.5 weeks. Conclusion: We concluded that the arthroscopic osteochondroplasty is a viable surgical option for the osteochondral lesion of the talus.

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Resection Arthroplasty on Lessor Toe Deformity (소족지 변형에서 시행한 관절 절제 성형술)

  • Kim, Ji Hoon;Park, Hyung Jun;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.153-158
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    • 2014
  • Purpose: The objective of this study was to examine the clinical results and effectiveness of resection arthroplasty for correction of lesser toe deformity. Materials and Methods: From January 2000 to November 2012, 92 cases of resection arthroplasty for lesser toe deformity were reviewed. Hammer toe was the most common type of deformity, accounting for 44 toes (33 patients). Hallux valgus was the most common comorbid illness. Second toe was the most commonly affected toe and proximal interphalangeal joint was the most common location of resection arthroplasty (69 toes, 75.0%). We also analyzed the alignment of phalanges using the last follow-up weight bearing radiographic image. The analysis included clinical evaluation with American Orthopaedic Foot and Ankle Society (AOFAS) score as well as subjective satisfaction. Results: Flexor tenotomy (19 cases) was the most common combined surgery. Floating toe (4 cases) was the most common complication. The last follow-up alignment of phalanges was better than good in 71 toes (77.2%) in anteroposterior view and in 69 toes (75.0%) in lateral view. Sixty one cases (85.9%) resulted in better satisfaction than 'good' and the final average AOFAS score was 87.4. Conclusion: Resection arthroplasty is a valuable surgical option for treatment of lesser toe deformity, with high patient satisfaction, easy surgical technique and remarkable correction of deformity.

Surgical Treatment of Malignant Tumors in Shoulder Girdle (견갑관절 주위 악성종양의 치료경험)

  • Song, Seok-Whan;Chang, Ju-Hai;Kang, Yong-Koo;Kim, Jung-Man;Kim, Hyoung-Min;Rhee, Seung-Koo;Woo, Young-Kyun;Bahk, Won-Jong;Moon, Myung-Sang;Kim, Yang-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.68-76
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    • 1995
  • To evaluate the clinical result of surgical treatment of malignant tumors in shoulder girdle, nine patients who were treated in Department of Orthopedics, Catholic University Medical College between January 1991 and December 1993, were evaluated. There were 5 men, 4 women. The mean age at operation was 47 years(range from 22 to 64 years). Of 9 patiens, 2 were soft tissue tumors(1 MFH, 1 dermatofibrosarcoma protuberance); one was treated with forequarter amputation, and the other with wide excision, Seven were bone tumor(2 chondrosarcoma, 1 osteosarcoma, 1 MFH, 1 plasmacytoma, 1 thyroid carcinoma metastasis, 1 malignant schwannoma); one patient was treated with segmental excision of proximal humerus, 4 with Malawer type I-A resection and arthroplasty or arthrodesis, 1 with Malawer type V-B resection and arthrodesis. Five patients received adjuvant chemotherapy, with or without local radiation therapy, and one patient received radiation therapy alone. All patients have survived now, but I had local recurrence. Functional results of arthrodesis and arthroplasty were similar.

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May-Thurner Syndrome after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 May-Thurner 증후군)

  • Shim, Chang Heon;Park, Jin Woo;Wang, Lih
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.277-281
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    • 2021
  • Iliac vein compression syndrome, which results in thrombosis of the left iliac veins, was first described by May and Thurner in 1957. May-Thurner syndrome should be considered when deep vein thrombosis-like symptoms appear, especially in the left lower extremities without an invasive procedure. The authors encountered an interesting case of a middle-aged female patient, who presented with sudden pain, swelling and skin color changes to the left lower extremity after right total knee arthroplasty and was diagnosed May-Thurner syndrome by computed tomography venography. This case is of clinical significance in that the early diagnosis of May-Thurner syndrome in the left lower extremity was made, which might have been overlooked after right total knee arthroplasty. This case is reported with a review of the literature review.

Finite Element Analysis for the Contact Stress of Ultra-high Molecular Weight Polyethylene in Total Knee Arthroplasty (전 슬관절 치환 성형술에 사용되는 초고분자량 폴리에틸렌 삽입물의 접촉응력에 관한 유한요소해석)

  • Jo, Cheol-Hyeong;Choe, Jae-Bong;Choe, Gwi-Won;Yun, Gang-Seop;Gang, Seung-Baek
    • Journal of Biomedical Engineering Research
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    • v.20 no.1
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    • pp.37-44
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    • 1999
  • Because of bone resorption, wear of ultra-high molecular weight polyethylene(UHMWPE) in total knee arthroplasty has been recognized as a major factor in long-term failure of knee implant. The surface damage and the following harmful wear debris of UHMWPE is largely related to contact stress. Most of the previous studies focused on the contact condition only at the articulating surface of UHMWPE. Recently, contact stress at the metal-backing interface has been implicated as one of major factors in UHMWPE wear. Therefore, the purpose of the is study is to investigate the effect of the contact stress for different thickness, conformity friction coefficient, and flexion degree of the UHMWPE component in total knee system, considering the contact conditions at both interfaces. In this study, a two-dimensional non-linear plane strain finite element model was developed. The results showed that the maximum value of von-Mises stress occurred below the articulating surface and the contact stress was lower for the more conforming models. All-polyethylene component showed lower stress distribution than the metal-backed component. With increased friction coefficient on the tibiofemoral contact surface, the maximum shear stress increased about twofold.

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Surgical Treatment of Metastatic Tumor in Pelvis (골반부 전이성 종양의 수술적 치료)

  • Kim, Jae-Do;Park, Woong;Jo, Myung-Rae;Son, Jung-Whan;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.61-70
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    • 2004
  • Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

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Limb Salvage Surgery with Intramedullary Nailing and Cementization for the Bone Tumors of the Proximal Humerus (근위 상완골 골종양에서 골수강내 금속정과 골시멘트를 이용한 사지 구제술)

  • Kim, Han-Soo;Oh, Joo-Han;Nam, Woo-Dong;Rhie, Tae-Yon;Jeong, Jin-Young;Lee, Han-Koo;Lee, Sang-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.53-60
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    • 2000
  • Purpose : The purpose of the current study is to evaluate the functional and oncologic results of the limb salvage surgery with intramedullary nailing and cementization in malignant bone tumors of the proximal humerus. Materials and Methods : We reviewed 18 cases of limb salvage surgery of resection and reconstruction with an intramedullary nail and cement-molded humeral head for the malignant bone tumors of the proximal humerus, which performed between August, 1992 through the April, 1998. The diagnoses included the osteosarcoma in 7 patients, chondrosarcoma in 3, the recurrent giant cell tumor in 3, metastatic tumor in 3, multiple myeloma in one patient and the one patient with malignant fibrous histiocytoma. The mean age at the time of surgery was 38 years(range, 15-73 years). The mean follow-up period was 26 months(range, 6-67 months). Results : Average functional score by ISOLS evaluation system was 21.1(70.3%). There were 3 local recurrences and 5 distant metastases. There were one case of shoulder instability and one case of deep infection. The seven patients are continuously disease free state and seven patients are alive with disease. Four patients died from the disease. Conclusion : The limb salvage surgery with intramedullary nailing and cementization in the bone tumors of the proximal humerus may be considered an option for the malignant bone tumors of the proximal humerus in selected patients.

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Surgical Repair of Coxofemoral Joint Luxation in a Wild Black-Crowned Night Heron (Nycticorax nycticorax) (야생 검은댕기해오라기에서 대퇴관절 탈골의 수술적 교정)

  • Kim, Eun-Ju;Lee, Jong-Hyun;Kim, Min-Su;Lee, Ki-Chang;Kim, Nam-Soo;Shin, Gee-Wook;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.49-52
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    • 2013
  • A wild black-crowned night heron (Nycticorax nycticorax) with dehydration and a non-weight bearing lameness of the left leg was rescued. On physical examination, the left knee was displaced laterally at almost a $90^{\circ}$ angle with firm swelling and crepitus in the area of the coxofemoral joint. Radiographs confirmed cranio-dorsal coxofemoral luxation. A closed reduction attempt failed. The coxofemoral joint luxation was reduced surgically by placement of the femoral neck next to the pelvis with a suture. Ten days after surgery, radiographs and computed tomography showed the femoral neck and head were positioned well within the acetabulum. At 20 days, the bird was using the affected limb normally, and could hunt and forage for food in a rehabilitation housing unit with a small pond. The bird was successfully released into the wild. The placement of the femoral neck adjacent to the pelvis with a suture can be successfully performed for cases of avian coxofemoral joint luxation. Furthermore, this procedure can provide sufficient stabilization of the coxofemoral joint and acceptable limb function.

Treatment of Snoring and Sleep Apnea with Botulinum Toxin (보툴리눔 독소를 이용한 코골이 및 수면무호흡 치료)

  • Jang, Jae-Young;Chung, A-Young;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.391-398
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    • 2013
  • Botulinum toxin has been used for treating strabismus, blepharospasm, cerebral palsy, cervical dystonia, hyperhydrosis, facial wrinkle and chronic migraine under US Food and Drug administration approval. Also it has been tried spasticity-induced pain, post-herpetic neuralgia, myofascial pain and aphthous ulcer as off-label use. In this study, we reviewed recent studies that suggested effects of botulinum toxin on snoring and sleep apnea.

Closed Manual Reduction of Mandibular Condylar Fracture Assisted by C-arm Fluoroscopy (C-arm 형광투시를 이용한 하악관절돌기골절의 비관혈적 도수정복)

  • Choi, Eui Chul;Kang, Sang Gue;Jung, Sung Gyun
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.131-134
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    • 2009
  • Purpose: Mandible fractures are common in maxillofacial trauma and the incidence of condylar fracture is high. The management of mandibular condylar fracture continues to be controversial. Conservative treatment of it may lead to complications such as asymmetry, malocclusion, temporomandibular joint dysfunction. Moreover, open reduction can cause facial nerve injury, parotid gland injury, scarring and hematoma formation. We present a case of mandibular condylar fracture that was treated by manual reduction without incision under C-arm fluoroscopy. Methods: A 76-year-old female was admitted due to left side mandibular condylar fracture that required surgical intervention. Because of her age, history of diabetes mellitus, hypertension, she underwent closed manual reduction under general anesthesia. We adopted C-arm fluoroscopy as a method of identifying the fracture site and a evaluation of reduction state. C-arm fluoroscopy was set up like modified Towne's view. Results: The reduction was successful and didn't result in any complications that could occur in open reduction-facial nerve injury, infection, parotid gland injury, hematoma, avascular necrosis. The mandibular-maxillary fixations were removed after 4 weeks and patients were could open 3.5 cm after 6 weeks with physical therapy. Conclusion: We tried closed manual reduction of mandibular condylar fracture due to high risk of complication using C-arm fluoroscopy and did achieve anatomic reduction with avoiding open incision. This is simple, effective, reversible, time saving and fairly attemptable method in condylar fracture cases before open reduction.