Comparative Study of Clinical and Radiographic Outcomes of High Tibial Osteotomy in Patients with Kissing Lesions and Non-Kissing Lesions

( Oog-jin Shon ),( Sang-jin Park ),( Bum-jin Shim ),( Dong-yeol Lee ) 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.4

Purpose: High Outerbridge grade lesions of the articular cartilage have been associated with poor outcomes of high tibial osteotomy (HTO). However, there has been no report on the efficacy of HTO in the presence of kissing lesions. The purpose of this study was to compare clinical and radiographic outcomes of HTO between kissing lesion and non-kissing lesion groups. Materials and Methods: Of the patients with medial compartment osteoarthritis and varus deformity treated with HTO between 2007 and 2012, 21 cases with kissing lesions and 22 cases without kissing lesions were selected. Clinical outcomes were assessed using the Lysholm knee scoring scale score, visual analogue scale score, Hospital for Special Surgery score, Western Ontario and McMaster Universities score, and Tegner activity score. Radiographic outcomes were assessed using the femoral-tibial angle, mechanical axis deviation, medial proximal tibial angle, posterior tibial slope angle, and joint space width. Results: Clinical outcomes were improved in both groups from the postoperative assessment to the final follow-up, which showed no statistically significant difference between groups at the final follow-up. No statistically significant differences were observed with regard to radiographic assessment. Conclusions: Since both groups showed favorable short-term clinical and radiographic outcomes, HTO might be an alternative treatment option for degenerative osteoarthritis with kissing lesions in relatively young patients.

Comparison of Difference in Hematologic and Hemodynamic Outcomes between Primary Total Knee Arthroplasty and Revision of Infected Total Knee Arthroplasty

( Oog Jin Shon ),( Dong Chul Lee ),( Seung Min Ryu ),( Hyo Sae Ahn ) 대한슬관절학회 2016 대한슬관절학회지 Vol.28 No.2

Purpose: This study is to identify preoperative cautions for revision of infected total knee arthroplasty (TKA) by understanding the differences in hematologic and hemodynamic changes between primary TKA and revision of infected TKA. Materials and Methods: The study included 40 patients in each of the two groups: one group with patients who underwent TKA and the other group with patients who underwent revision of infected TKA. All patients matched for age and body mass index. The following data were compared between the groups: changes in blood pressure, variations in hemoglobin level, amount of postoperative blood loss and transfused blood, incidence of blood transfusion, white blood cell (WBC) count, albumin level, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and liver enzyme level. Results: The hemoglobin levels, transfusion rate, and the amount of blood loss were significantly higher in the revision group (p=0.012). In both groups, CRP reached the highest level on the 3rd postoperative day but it was normalized 2 weeks postoperatively; however, the revision TKA group showed a greater tendency to normalization (p=0.029). There were significant differences between the groups in ESR, WBC, blood pressure, and changes in liver enzyme levels. Conclusions: Revision of infected TKA results in greater hemodynamic variations than primary TKA. Therefore, more efforts should be made to identify pre- and postoperative hemodynamic changes and hematologic status.

Does the degree of intraoperatively identified cartilage loss affect the outcomes of primary total knee arthroplasty without patella resurfacing? A prospective comparative cohort study

( Oog-jin Shon ),( Gi Beom Kim ) 대한슬관절학회 2022 대한슬관절학회지 Vol.34 No.-

Purpose: The aim of this study was to investigate whether the degree of patellar cartilage loss confirmed during index surgery affects the clinical and radiologic outcomes of total knee arthroplasty (TKA) performed without patellar resurfacing. Methods: We prospectively divided 2012 patients with a minimum follow-up of 12months into two groups according to intraoperatively graded cartilage lesions graded usingthe International Cartilage Repair Society (ICRS) system: group 1, grades 0-2 (n = 110); group 2, grades3-4 (n = 102). Relevant locations, such as medial, lateral, or both facets of the patella, were also assessed. Clinical outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index, Feller’s patella score, and Kujala anterior knee pain score. Radiographic outcomes included patellar tilt angle and lateral patellar shift on Merchant’s view. Results: Clinical and radiographic outcomes were not significantly different between the two groups. No patient underwent secondary patellar resurfacing. Although the lateral facet was significantly more involved, there were no significant differences in outcomes. Conclusions: The degree of intraoperatively identified patellar cartilage loss did not affect the short-term outcomes following primary TKA without patellar resurfacing. Level of evidence II: Prospective comparative study.

Current Concepts of Posterolateral Corner Injuries of the Knee

( Oog-jin Shon ),( Jae-woo Park ),( Beum-jung Kim ) 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.4

The number of posterolateral corner (PLC) injury patients has risen owing to the increased motor vehicle accidents and sports activities. Careful examination is required because this injury is easy to overlook and may lead to chronic instability. The purpose of this article is to review the anatomy, biomechanics, diagnosis, classification and, treatment of PLC injuries and summarize the recent literatures regarding the treatment outcomes.

Factors Associated with Mechanical Complications in Intertrochanteric Fracture Treated with Proximal Femoral Nail Antirotation

( Oog-jin Shon ),( Chang Hyun Choi ),( Chan Ho Park ) 대한고관절학회 2021 Hip and Pelvis Vol.33 No.3

Purpose: Although proximal femoral nail antirotation (PFNA; Synthes, Switzerland) has demonstrated satisfactory results when used for the treatment of intertrochanteric fractures, mechanical complications may occur. To better quantify the risk of mechanical complications when proximal femoral nail antirotation is used to treat intertrochanteric fractures, this study aimed to: (1) characterize the frequency of mechanical complications and extent of blade sliding and their correlation with reduction quality and (2) identify factors associated with mechanical complications. Materials and Methods: A review of medical records from 93 patients treated for intertrochanteric fractures with a minimum of 6-months of follow-up between February 2014 and February 2019 was conducted. Blade position was evaluated using Tip-apex distance (TAD) and Cleveland index. The extent of blade sliding was evaluated using the adjusted Doppelt’s method for intramedullary nailing. Individuals were classified as having or not having mechanical complications, and reduction quality and radiologic outcomes were compared between the two groups. Results: Mechanical complications occurred in 12 of 94 hips (12.8%), with 11 out of 12 being from the intramedullary reduction group. There was no significant difference in TAD between groups; however, there were significant differences were noted in Cleveland index, AO/OTA classification, reduction quality and extent of blade sliding. The mean blade sliding distance was 1.17 mm (anatomical group), 3.28 mm (extramedullary group), and 6.11 mm (intramedullary group), respectively (P<0.001). Data revealed that blade sliding was an associated factor for mechanical complications (odds ratio 1.25, 95% confidence interval 1.03-1.51). Conclusion: The extent of blade sliding determined using the adjusted Doppelt’s method was significantly associated with mechanical complications suggesting that prevention of excessive sliding through proper intraoperative reduction is important to help achieve satisfactory treatment outcomes.

타박상에 의해 발생된 급성 대퇴부 구획 증후군 -4예 보고-

손욱진 ( Oog Jin Shon ),김기범 ( Gi Beom Kim ),박철현 ( Chul Hyun Park ) 대한골절학회 2012 대한골절학회지 Vol.25 No.3

Acute compartment syndrome of the thigh, which usually occurs in the anterior compartment, is a rare condition. It can have various causes including femur fractures, vessel injury, pseudoaneurysm of the femoral or popliteal artery, and use of anticoagulant. However, there have been few reports of acute compartment syndrome of the thigh without fracture caused by blunt trauma. We report 4 cases of acute compartment syndrome of the thigh without fracture caused by blunt trauma, in which three patients were treated with fasciotomy and a Vacuum-Assisted wound Closure system and the other one had a delayed diagnosis, and eventually underwent above-knee amputation.

대퇴골 원위부 골절에서 잠김 금속판의 종류에 따른 최소 침습 금속판 골유합술의 결과 비교

손욱진 ( Oog Jin Shon ),권문수 ( Moon Soo Kwon ),박철현 ( Chul Hyun Park ) 대한골절학회 2012 대한골절학회지 Vol.25 No.4

목 적: 대퇴골 원위부 골절에서 최소 침습 금속판 골유합술 시 잠김 압박 금속판과 관절 주위 잠김 금속판의 결과를 분석하고자 하였다. 대상 및 방법: 2006년 4월부터 2009년 3월까지 대퇴골 원위부 골절로 최소 침습 금속판 골유합술을 시행한 총 31예를 후향적으로 분석하였다. 16예에서 잠김 압박 금속판(A군)을 사용하였고, 15예에서는 관절 주위 잠김 금속판(B군)을 사용하였다. 결 과: A군과 B군의 평균 수술시간은 78분과 76분(p=0.273), 방사선 피폭 시간은 1.9분과 2.3분(p=0.001)이었다. A군 중 4예에서 수술 중 금속판을 휘어 사용하였다. 슬관절 운동범위는 A군과 B군에서 각각 117.5도, 118.2도였으며(p=0.825), Lysholm knee score 는 81.3점, 81.8점(p=0.723)이었다. Schatzker의 평가 방법상 A군의 93.8%, B군의 93.3% (p=1.0)에서 양호 이상의 결과를 보였다 (p=1.0). 결 론: 대퇴골 원위부 골절의 치료에서 두 내고정물 간의 임상적 결과에서 유의한 차이가 없었으나, 잠김 압박 금속판이 상대적으로 해부학적 정합도가 낮았고, 관절 주위 잠금 금속판에서 수술시 방사선 노출량이 더 많았다. Purpose: To compare results of minimally invasive plate osteosynthesis using a locking compression plate and a periarticular locking plate in distal femur fractures. Materials and Methods: We retrospectively reviewed 31 consecutive femoral fractures who treated by minimally invasive plate osteosynthesis from April 2006 to May 2009. Sixteen patients were treated using a locking compression plate (group A) and 15 patients were treated using a periarticular locking plate (group B). Results: The mean operation time was 78 minutes and 76 minutes (p=0.273), and the mean radiation exposure time was 1.9 minutes and 2.3 minutes (p=0.001) in the group A and B, respectively. The plate bending during operation was performed in 4 cases of group A. The knee range of motion was 117.5° and 118.2° (p=0.825), and the Lysholm score was 81.3 and 81.8 (p=0.723) in the group A and B, respectively. Schazker criteria showed more than good grade in 93.8% of group A and in 93.3% of group B (p=1.0). Conclusion: No significant differences in clinical results were observed between the two groups. However, a lower anatomical compliance was showed in the locking compression plate, and a higher risk of radiation exposure was showed in the periarticular locking plate.

불유합의 비수술적 치료

손욱진 ( Oog Jin Shon ),이만호 ( Man Ho Lee ),안효세 ( Hyo Sae Ahn ) 대한골절학회 2014 대한골절학회지 Vol.27 No.4

외상 후 골수염

손욱진 ( Oog Jin Shon ),곽은석 ( Eun Seok Kwak ),이만호 ( Man Ho Lee ) 대한골절학회 2010 대한골절학회지 Vol.23 No.1

원위 경골 골절에서 외측 금속판을 이용한 최소 침습적 경피적 금속판 골유합술

손욱진 ( Oog Jin Shon ),김대성 ( Dae Sung Kim ) 대한골절학회 2010 대한골절학회지 Vol.23 No.1

목적: 원위 관절면에서 3 cm 내에 위치하고 내측 연부 조직의 손상이 동반된 원위 경골 골절에서 외측 금속판 (Zimmer, Periarticular Lateral Distal Tibial Plates, USA)을 이용하여 최소 침습적 경피적 금속판 골유합술 후 그 유용성에 대해 평가해보고자 한다. 대상 및 방법: 원위 경골 골절로 2005년 1월부터 2007년 12월까지 본원에서 외측 금속판을 이용하여 최소 침습적 경피적 금속판 골유합 술 후 최소 1년 이상의 추시가 가능하였던 15예를 대상으로 하였다. 방사선 사진을 통해 골유합 시기를, IOWA ankle rating system을 이용해 임상적 결과를 평가하였으며, 합병증을 알아보았다. 결과: 전 예에서 방사선학적인 골유합을 얻었으며 평균 골유합 기간은 16.7(12∼20)주였다. 족관절 기능적 평가에서는 평균 90.3점으로 만족할 만한 결과를 얻었다. 최종 추시 시 전 예에서 불유합, 5도 이상의 각변형 및 감염은 없었다. 결론: 원위 관절면에서 3 cm 내에 위치하고 내측 연부 조직의 손상이 동반된 원위 경골 골절에서 외측 금속판을 이용한 최소 침습적 경피적 금속판 골유합술은 만족할 만한 골유합률과 낮은 합병증으로 기능적 회복을 얻을 수 있는 유용한 방법으로 생각된다. Purpose: To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a lateral plate (Zimmer, Periarticular Lateral Distal Tibial Plates, USA) in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage. Materials and Methods: From January 2005 to December 2007, 15 patients with distal tibial fracture treated by MIPPO technique using a lateral plate were analyzed. The duration of follow-up was more than 1 year. We evaluated union time by simple X-ray, clinical results by IOWA ankle rating system, and complication. Results: The bone union was achieved in all cases at average 16.7 weeks. Evaluation of the ankle function test showed an average of 90.3 points, resulting in satisfactory. At the last follow-up, there was no non-union, angular deformity more than 5 degrees or infection. Conclusion: We concluded that MIPPO technique using a lateral plate is a efficient method for high functional recovery with good bone healing and low complication in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage.