• Journal of Yeungnam Medical Science
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• 제37권1호
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• pp.40-46
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• 2020

Background: Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint. Methods: The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain. Results: Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain. Conclusion: Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.130-134
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• 2018

Heterotopic ossification (HO) around the hip joint is not uncommon following neurological injury. Often, surgical treatment is performed in patients with restricted motion and/or refractory pain due to grade III or IV HO according to Brooker classification. The major complication that occurs as a result of surgical HO removal is perioperative bleeding due to hyper-vascularization of the lesion. Here, we report a case of preoperative embolization in a 51-year-old male patient presenting with restricted bilateral hip range of motion (ROM) due to HO following a spinal cord injury. In the right hip without preoperative arterial embolization, massive bleeding occurred during surgical removal of HO. Thus, the patient received a transfusion postoperatively due to decreased serum hemoglobin levels. For surgery of the left hip, preoperative embolization of the arteries supplying HO was performed. Surgical treatment was completed without bleeding complications, and the patient recovered without a postoperative transfusion. This case highlights that, while completing surgical removal for ROM improvements, orthopedic surgeons should consider preoperative arterial embolization in patients with hip HO.

• 대한정형외과학회지
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• 제55권5호
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• pp.359-365
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• 2020

소아 고관절 이형성증은 비구 또는 근위 대퇴골, 혹은 양쪽 모두를 포함하는 고관절의 부적절한 발달을 지칭하는 광범위한 개념이다. 초음파적 검사로 영아기의 고관절 탈구 진단이 간과되거나 수술적인 치료가 필요한 경우는 감소하고 있으나 모든 고관절 이형성증을 찾아내지는 못하고 있다. 아탈구가 없는 고관절 이형성증은 우연히 진단되며, 40대 이후 여자에서 퇴행성 관절염과 강한 연관성을 가진다. 아탈구를 동반한 고관절 이형성증은 아탈구의 정도에 따라 증상이 다양한 시기에 걸쳐 나타나며, 특히 여성에서 임신 중 발현되는 경우가 많다. 신생아에 대한 정확한 이학적 검사와 조기 치료는 이 질환의 양호한 결과를 위해 매우 중요하다. 진단의 간과를 막고 조기 치료의 기회를 제공하기 위해 저자는 고관절 이형성증이 의심스러운 2세 이하 영아 모두에게 고관절 검사를 추천한다. 본 연구에서는 고관절 이형성증의 진단 및 초기 치료에 대해 고찰해 보고자 한다.

• PNF and Movement
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• 제20권2호
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• pp.295-306
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• 2022

Purpose: This study aimed to investigate the effect of robot-assisted gait training on the active ranges of motion, gait abilities, and biomechanical characteristics of gait in patients who underwent lower extremity surgery, and to verify the effectiveness and clinical usefulness of robot-assisted gait training. Methods: This study was conducted on 14 subjects who underwent lower extremity surgery. The subjects participated in robot-assisted gait training for 2 weeks. The active ranges of motion of the lower extremities were evaluated, and gait abilities were assessed using 10-m and 2-min walk tests. An STT Systems Inertial Measurement Unit was used to collect data on biomechanical characteristics during gait. Spatiotemporal parameters were used to measure cadence, step length, and velocity, and kinematic parameters were used to measure hip and knee joint movement during gait. Results: Significant improvements in the active ranges of motion of the hip and knee joints (flexion, extension, abduction, and adduction) and in the 10-m and 2-min walk test results were observed after robot-assisted gait training (p < 0.05). In addition, biomechanical characteristics of gait, spatiotemporal factors (cadence, step length, and velocity), and kinematic factors (gait hip flexion-extension, internal rotation-external rotation angle, and knee joint flexion-extension) were also significantly improved (p < 0.05). Conclusion: The results of this study are of clinical importance as they demonstrate that robot-assisted gait training can be used as an effective intervention method for patients who have undergone lower extremity surgery. Furthermore, the findings of this study are clinically meaningful as they expand the scope of robot-assisted gait training, which is currently mainly applied to patients with central nervous system conditions.

• 대한정형외과 초음파학회지
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• 제2권1호
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• pp.45-52
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• 2009

고관절과 그 주위의 질환들의 진단적 검사는 그 동안 주로 단순 방사선 검사와 CT, MRI등이 이용되어 왔다. 그러나 고관절 주위의 건과 점액낭 등에 의한 병변에는 초음파 검사가 진단에 유용할 수 있으며 또한 추적 검사에도 활용될 수 있는 장점이 있다. 그 외에도 인공고관절 치환 수술 후에도 추적 검사상 활용도가 있어 그 사용이 넓어질 여지가 있다. 하지만 시술자의 숙련도에 따라 결과가 달라질 수 있다. 본 논문에서는 고관절 주위의 정상적인 구조물들의 초음파 영상과 병적 소견들을 소개하고 그 개략적인 것들을 설명하였다.

• 대한족부족관절학회지
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• 제22권1호
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• pp.8-15
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• 2018

Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

• 대한골관절종양학회지
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• 제11권1호
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• pp.71-81
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• 2005

목적: 근위 대퇴골의 전이성 종양에서 소파술 후 금속 내고정술 또는 고관절 성형술을 시행했던 환자에게서 종양의 국소 재발로 인한 금속 부전을 경험한 저자들은 광범위 절제술 후 재활용 자가골 이식을 이용한 고관절 성형술을 시행하고, 술 후 국소 재발의 유무와 하지의 기능, 합병증의 발생을 통해 전이성 골종양에서 광범위 절제술 후 재활용 자가골을 이용한 재건술의 타당성에 대해 연구하고자 한다. 대상 및 방법: 2000년 5월부터 2003년 5월까지 근위 대퇴골의 전이성 종양 환자 중 광범위 절제술 후 재활용 자가골을 이용한 재건술을 시행한 6례, 5명의 환자를 대상으로 하였다. 환자의 평균 연령은 60.8세, 남녀 비는 3:2였고 술 후 평균 생존 기간은 23.2개월(7~57개월) 이었다. 원발 병소로는 폐암이 2례였고, 위암, 신장암, 다발성 골수종이 각각 1례였다. 수술은 전례에서 광범위 절제술 후 고관절 재건술을 시행하였으며, 재건술로는 체외 방사선 조사 후 자가골 이식술 및 고관절 반치환술을 4례, 저온 처리한 자가골 이식술 및 고관절 전치환술을 2례에서 시행하였다. 술 후 6개월의 Musculoskeletal Tumor Society(MSTS) 기능 평가 지수(1993년) 및 합병증, 생존 기간 동안의 국소 재발의 유무에 대해 조사하였다. 결과: 술 후 6개월에 조사한 MSTS 기능 평가 지수는 63.3%였고, 술 후 합병증으로는 고관절 탈구가 1례에서 발견되었다. 생존 기간 동안 국소 재발의 소견은 관찰되지 않았다. 결론: 술 후 생존 기간이 6개월 이상으로 추정되는 근위 대퇴골의 전이성 종양에서 소파술 후 금속 내고정술이나 고관절 성형술을 시행하는 것보다 광범위 절제술 후 재활용 자가골을 이용한 고관절 재건술을 시행하는 것이 국소 재발을 방지하여, 환자의 생존 기간동안 사지의 기능을 보존하는데 도움이 될 것으로 사료된다.

• 대한정형외과 초음파학회지
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• 제4권2호
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• pp.97-100
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• 2011

장요 점액낭은 장요근건과 고관절 막 사이에 존재하는 구조물로 정상적인 경우 초음파로 확인하기 힘들지만 일부에서 고관절과 연결되어 있어 관절내 병변에 동반되어 장요 점액낭염이 나타나기도 한다. 저자들은 만성 고관절 동통을 호소하는 환자들에서 장요 점액낭염과 동반된 비구순 파열 2예를 초음파를 통해 진단하고 경험하였기에 이를 보고하고자 한다.

• 대한정형도수물리치료학회지
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• 제21권2호
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• pp.63-71
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• 2015

Background: The purpose of the study, using the ICF Tool in the process of rehabilitation of artificial joint replacement surgery of the hip joint, goal setting and understanding of the problem, through the process of creating intervention strategies, useful clinical practical course for rehabilitation I try to present the data. Methods: Fracture was the left total hip replacement (THR) surgery due to women of 76 years old. I proceed in order screening, evaluation, diagnosis, prognosis, treatment planning and intervention, re-screening. Needs of the patient was walking short distances for using the toilet. In order to improve was carried out arbitration, after you have created a list of issues that limit the ability to walk short distances. Results: It was revealed improved results in self-paced walk test (SPWT) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to examine whether the goals. In addition, MMT VAS, DGI, and TUG is a detailed goal was improved. Conclusions: It can be shown objectively the results of interventions performed for the purpose of solving the problem which is grasped through clinical Practical course for short-range walking ability enhance patient THR. I considered practical clinical course using the ICF Tool would be useful.

• 대한족부족관절학회지
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• 제14권2호
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• pp.173-176
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• 2010

Synovial chondromatosis is a benign lesion forming multiple round cartilagenous nodules or osseous loose bodies in joint cavity. Predilection sites are known as knee, hip and elbow joints. However, the involvement of ankle joint was rarely reported in the literature. Moreover, extraarticular chondromatosis in synovial sheath or bursa of extremities is extremely rare. We present a case of synovial chondromatosis of the left ankle joint and flexor hallucis longus tendon sheath.