• Title/Summary/Keyword: 퇴행성 슬관절염

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Clinical Results after Arthroscopic Treatment in Acute Pyogenic Arthritis of the Knee (급성 화농성 슬관절염에서 관절경적 치료 후 결과)

  • Lee, Jung-Hwan;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.53-57
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    • 2008
  • Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

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Clinical and Histopathological Study in Repaired Cartilage after Microfracture Surgery in Degenerative Arthritis of the Knee (퇴행성 슬관절염에서 미세 천공술후 재생된 연골의 임상 및 병리조직학적 연구)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;So, Jae-Keun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.18-28
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    • 2005
  • Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

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Second look arthroscopic findings after microfracture surgery in osteoarthritic knee (퇴행성 슬관절염에서 미세천공술 후 이차 관절경 소견)

  • Bae, Dae Kyung;Kim, Jin Moon;Lee, Jeong Heui;Park, Yong Koo
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.85-90
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    • 1999
  • Purpose : The purpose of this study is to evaluate the clinical and histological results of the osteoarthritic patients who had second look arthroscopy after microfracture surgery. Materials and Methods : From Oct. 1997 to Dec. 1998, 46 patients, 48 knees were treated by microfracture technique. In the 22 patients, 24 knees, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. Three patients were men and 19 patients were women. Average age of the patients were 58 years (range, 40-75 years). The average follow up period was 12 months(7-20 months). We analysed clinical results according to the nine-point scale. Also we observed type II collagen formation with immunohistochemical staining. Results : Clinical results were excellent in 83% and good in 17%. Among the 24 knees, more than 80% areas of chondral defect were covered with regenerated cartilage in 21 knees. Histologically, the regenerated tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Regenerated cartilage contains variable amount of type II collagen with immunohistochemical staining. Conclusion : Most of the patients had significant improvement clinically. 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Microfracture in the full thickness chondral defect provides and enriched environment for cartilaginous tissue regeneration.

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Comparison of Warm-Needling and Acupuncture for Knee Osteoarthritis: A Randomized Controlled Trial (퇴행성 슬관절염에서의 온침과 침의 효능 비교 연구)

  • Min, Woong-Ki;Yeo, Sujung;Kim, Ee-Hwa;Song, Ho Sueb;Koo, Sungtae;Lee, Jae-Dong;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.30 no.1
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    • pp.64-72
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    • 2013
  • Objectives : The aim of this study was to investigate whether warm-needling is more effective than acupuncture in relieving the pain and improving the symptoms of knee osteoarthritis(OA). Methods : 76 volunteers with knee OA participated in the study. The subjects were randomly assigned to one of two groups. One group received warm-needling(n=38), while the other group received acupuncture(n=38). Sixteen sessions of warm-needling or acupuncture were conducted on the pain region of each problematic knee over a period of 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) scores, physical health score based on the 36-Item Short-Form Health Survey(SF-36) and the Global Assessment(PGA) was measured. Results : Compared to the acupuncture group, the warm-needling group showed a significant decrease in pain, function, and total WOMAC scores according to the Mann-Whitney U-test. The PGA scores of the warm-needling group also showed a significant improvement compared to the acupuncture group. Conclusions : Warm-needling showed a greater pain relief effect on knee OA compared to the acupuncture group. These findings suggest that warm-needling may be a promising alternative therapy for treating knee OA.

Results of Anterior Cruciate Ligament Reconstruction with Unicondylar Arthroplasty for Medial Compartment Knee Osteoarthritis combined with Anterior Instability (전방 불안정성과 동반된 슬관절 내측 구획 진행성 관절염환자에서 전방십자인대 재건술 및 인공 관절 부분 치환술의 결과 - 3예 보고 -)

  • Lee, Chul Hyung;Song, In Soo;Ji, Jong Hun;Kim, Tae In
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.88-94
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    • 2013
  • Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

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The Effect of Arthroscopic Medial Meniscectomy in Degenerative Arthritis of the Knee (슬관절 퇴행성 관절염에서 관절경적 내측 반월상 연골 절제술의 효과)

  • Kim, Do-Yeon;Choi, Yun-Jin;Lee, Seung-Joo;Ko, Min-Seok;Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.79-84
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    • 2010
  • Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.

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스포츠와 관련된 과사용 증후군 - 슬관절 -

  • Kyung, H.S.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.75-83
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    • 2008
  • 과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

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The Effects of Kinesio Taping on the Pain and Functional Improvement in Patients With Degenerative Arthritis (키네시오 테이핑이 퇴행성관절염 환자의 통증 및 기능회복에 미치는 효과)

  • Son, Gil-Soo;Lee, Moon-Hwan;Lee, Chang-Ryeol;Nam, Hyoung-Chun
    • Korean Journal of Applied Biomechanics
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    • v.18 no.1
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    • pp.45-52
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    • 2008
  • This study was conducted to investigate the effects of kinesio taping on the pain and functional improvement of patients with degenerative arthritis. 40 female patients were participated in this study. To evaluate the effects of taping therapy we calculated pain, range of motion, and get up and go(GUG) test. The results were as follow: Pain of experimental and control group were significantly decreased after than before treatment, but there was significant difference between experimental and control group. ROM of experimental and control group were significantly increased after than before treatment, but there was significant difference between experimental and control group. Time of GUG of experimental and control group were significantly decreased after than before treatment, but there was significant difference between experimental and control group. And Steps of GUG was significantly decreased only experimental group. So we think that kinesio taping have effectiveness on the pain and functional improvement in patients with degenerative arthritis.

Effects of Auricular Acupressure on Joint Pain, Range of Motion, and Sleep in the Elderly with Knee Osteoarthritis (이압요법이 퇴행성 슬관절염 노인의 관절 통증, 관절 가동범위 및 수면에 미치는 효과)

  • Jang, Minjin;Lim, Yun-Mi;Park, Hyojung
    • Research in Community and Public Health Nursing
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    • v.30 no.1
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    • pp.79-89
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    • 2019
  • Purpose: The purpose of this paper is to determine effects of auricular acupressure on knee pain, range of motion, and sleep in the elderly with knee osteoarthritis. Methods: This is an experimental study designed with randomization and single-blind in a placebo-control approach. The subjects included the elderly with knee osteoarthritis who were using an elderly welfare facility. In each of the groups, 28 subjects were assigned. For the experimental group, auricular acupressure was applied to five pressure points related to the pain caused by osteoarthritis and sleep. In the case of the placebo-control group, auricular acupressure was applied to other five points than the former. The intervention lasted eight weeks. In order to examine intervention effects of auricular acupressure, joint pain, Pressure Pain Thresholds (PPTs), and extension and flexion range of motion (ROM) were measured weekly. As for the preand post-examinations, pain, sleep quality, and the time-by-sleep stage of the patients with knee osteoarthritis were measured. Results: The VAS scores in the experimental group with auricular acupressure significantly decreased through time (p<.001) and WOMAC also significantly decreased (p<.01) compared with the placebo-control group. However, there were no significant differences in PPTs. The flexion (p<.01) and extension (p<.001) ROMs measured for eight weeks improved over time. Meanwhile, sleep quality improved significantly after the intervention termination (p<.01), but there was no significant difference found in the time-by-sleep stage. Conclusion: Auricular acupressure applied for eight weeks was found to be effective in reducing joint pain, improving knee ROM, and improving sleep quality in patients with degenerative knee arthritis.