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Precoat 대퇴스템을 이용한 혼합형 인공 고관절 전치환술(8-18년 추시결과)
송상헌(Sang Heon Song),허영재(Young Jae Hur),윤호현(Ho Hyun Yun),오종건(Jong Keon Oh),허창룡(Chang Yang Hu),손원용(Wan Yong Shon) 대한정형외과학회 2011 대한정형외과학회지 Vol.46 No.2
목적 : 혼합형 인공 고관절 전치환술에서 개선된 시멘트 기법을 사용한 Precoat 대퇴 스템의 평균 15.5년(8.4~18.3년) 추시 결과를 통한 생존율을 알아보고자 하였다. 대상 및 방법 : 1990년 10월부터 1995년 8월까지 본원에서 Precoat 대퇴 스템을 사용한 혼합형 인공 고관절 전치환술을 시행한 98명의 환자(105예)를 대상으로 하였다. 그 중 34명 (34예)은 사망하였으며 17명(17예)은 추시 관찰 기간 중 소실되었다. 나머지 47명(54예)에서 외래 방문 및 전화 인터뷰를 통한 임상적, 방사선학적 추시 관찰이 가능하였다. 환자들의 평균 추시 관찰 기간은 평균 15.5년(8.4-18.3년)이었고 성별로는 남자 32명(37예), 여자 15명(17예)이었다. 수술 당시 환자의 평균 나이는 46세(최소 22세, 최고 67세)이었다. 결과 : 비구컵은 무균성 이완 15예(27.8%), 리이너의 심한 마모나 해리 및 골용해로 12예에서(22.2%) 라이너와 골두만을 재치환하였고, 대퇴스템은 무균성 이완 12예에 대해(22.2%) 재치환술을 시행히였으며 이 때 라이너와 골두를 함께 재치환하였다. 이 중 재치환술을 시행하였거나 대퇴스템의 Harris 등의 기준에 따른 이완 중 확정적 이완(definite loosening)을 보였던 예는 B등급 18 예 중 3예, C등급 9예 중 9예 이었다. 임상적 결과로는 54예 중 52예(96.3%)에서 우수하거나 양호한 결과를 보였으며 평균 Harris Hip Score는 88점(72-96점)이었다. 결론 : Precoat 대퇴스템의 무균성 이완으로 인한 재치환술을 기준으로 평균 15.5년 생존율은 78%이었으며 Precoat 대퇴 스템의 실패의 원인은 다양하며 기존의 보고된 바와 같이 대퇴스템의 디지인, 수술기법 및 시멘트 기법과 함께 환자의 연령, 활동성 및 체중 등이 영향을 미칠 수 있다고 사료된다. Purpose : The purpose of this study was to evaluate the 15.5 year long term survival rate of the Precoat femoral stem. Materials and Methods : We reviewed the results of 105 primary hybrid total hip replacements (98 patients) that were performed by one surgeon between October 1990 and August 1995 using a cemented polymethyl-methacrylate coated femoral prosthesis (Precoat) and contemporary cementing techniques. Thirty four patients (34 hips) died and seventeen patients (17 hips) were lost to follow-up. Forty seven patients (54 hips) were available for clinical follow-up, with an average follow-up period of 15.5 years (range: 8.4 to 18.3 years). The average age of the patients at the time of the index operation was 46 years (range: 22 to 67 years). There were 32 male patients (37 hips) and 15 female patients (17 hips). Results : For the acetabular component, 15 hips (27.8%) were revised for cup loosening and isolated liner exchange was performed in 12 hips (22.2%) for liner wear and osteolysis. For the femoral component, 12 hips (22.2%) were revised due to aseptic loosening. Of these twelve hips, 3 hips had Grade B cement mantles and 9 had Grade C cement mantles. The clinical results of the 54 retained hips were good or excellent in 52 hips (96.3%) with the average Harris hip score being 88 points (range: 72 to 96 points). Conclusion : The mean 15.5 years' survival rate of the Precoat cemented femoral stem was 78%. We think that there were several factors for the failure of femoral stem fixation, including age, physical activity and the body weight, as well as the stem design and the surgical technique had an influence on the stem's survival.
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허영재 세종대학교 1983 세종대학 논문집 Vol.10 No.-
The Korean gorvernment, recognizing the need for trading Companies to raise their Marketing capabilities, introduced the Japanese style GTC system in 1975 in order to appropriately and quickly adapt to the rapidly changing internal and international environment. There is a need to review the Korean GTC's present situation because six years have passed since the introduction of KGTC. Therefore, the thesis is designed to compare and analyze the management performances of Korean and Japanese GTCS, and to raise the KGTC's facing problems and to present their future vision. For the above mentoned objectives, the composition of the thesis is as follows, An overview of the definition, characteristics and the background of establishment of KGTC is made in the 2 chapter, and it is also reviewed how they are performing their activities from 1975 till 1982. In the 3 chapter, comparision and analysis of the organizations, functions and performances of two countries' GTCs are made, In the 4 chapter, some problems facing Korean GTCs are raised, some proposals for further improvement in three sides (diversification of area, product item, and function) are presented. The pending problems and improvement measure are as follows. Firstly, in the field of functional diversification , KGTCs have performed just export activity from 1975 till now, while Japanese GTCs have performed diversified function such as export, import, domestic transation, triple party trade, overseas resource development and F.D.I. with a view to challenging rapid changes of internal and international environment. Therefore, I propose that KGTCs should expand and stengthen the trading company's many sided activities as Japanese GTCs. Because export, import, domestic sales and multi-party trade are not independence but organic combination, GTC can exist and develop when their organic relation creat value. Secondly, export trade structure in Korea was converted from light industry goods to heavy-chemistry industry ones with the introduction of KGTC system. We should consider both satisfactory performances and profitability in pursuit of diversification of product item. There are some problems that go with excessive pursuit of exporting heavy industry goods. KGTC's heavy industry goods have weak export competition and are dumped in world market because of their poor product quality and production technique. We should raise their technical level of product quality competition from the far-sighted standpoint, because we can't attempt to diversify heavy industry goods within the short period. We should also make every effort to expand and develope the items of textiles and footwears, because, in light industry goods, we have strong export competition on the basis of wide experiences and technical accumulations. Thirdly, in the side of market diversification, KGTCs attach much importance to US-Japan market on account of a small-scale trading companies, while Japan GTCs build many branches and subsidiaries and many-sided information network in world-wide area. Therefore, KGTCs should put emphasis on developing new market such as ME, Africa, Central America and Oceania, from Us-Japan preponderance. For the purpose of this object, KGTCs, in the short period, should seek the balanced market diversifcation in consideration of Market priority between advanced countries and under developed counties when they select the object of major penetration area, in the long period, they should lay emphasis on grading high quality and strengthing competition power.
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