Comparison of the Modified Transtibial Technique, Anteromedial Portal Technique and Outside-in Technique in ACL Reconstruction

( Oog Jin Sohn ),( Dong Chul Lee ),( Kang Hyun Park ),( Hyo Sae Ahn ) 대한슬관절학회 2014 대한슬관절학회지 Vol.26 No.4

purpose: To compare clinical and radiographic results of anterior cruciate ligament (ACL) reconstruction using modified transtibial technique (mTT), anteromedial (AM) portal technique and outside-in (OI) technique. materials and methods: From March 2007 to December 2012, ACL reconstruction was performed using the mTT, AM portal technique and OI technique in 20 patients each. Anteroposterior and rotational stability were assessed using the GNRB arthrometer and pivot-shift test. Femoral tunnel obliquity was measured on the anteroposterior and lateral radiographs. results: Tegner score, Lysholm score, International Knee Documentation Committee score, pivot-shift test were improved at final follow-up in all three groups. However, statistical difference was not shown. Side-to-side difference in GNRB arthrometer was average of 1.4 mm, 1.0 mm and 0.9 mm in mTT, AM and OI group, showing the signicant difference between mTT and AM/OI groups (p<0.001). The mean femoral tunnel obliquity was 56.4° in the mTT group, 39.4° in the AM group and 33.6° in the OI group, showing significant intergroup difference (p<0.001). It showed the significant difference among three groups (p<0.001). conclusions: Clinical results were improved in all three groups. Femoral tunnel obliquity in AM and OI were more horizontal on the coronal plane. They are thought to have more benefits in oblique positioning of the grafted ACL in rotational stability; however, there was no significant difference among three techniques in pivot-shift test to assess the rotational stability in this study.

동측 하지에 발생한 대퇴골 분절 골절과 경골 골절

손욱진 ( Oog Jin Sohn ),박철현 ( Chul Hyun Park ),배상근 ( Sang Keun Bae ) 대한골절학회 2009 대한골절학회지 Vol.22 No.3

The ipsilateral femoral segmental and tibial fractures seldom occur such as traffic accidents needed high energy mechanisms. For these fractures, surgical stabilization and early mobilization of joint produce can be the best clinical outcomes. We have experienced a case of ipsilateral femoral segmental and tibial fracture and gained good clinical results with surgical treatment. We have reported here on this case and included a review of the relevant literature.

대퇴 전자간 골절의 치료에서 ITST 골수정과 근위 대퇴 골수정(PFN)의 비교

손욱진 ( Oog Jin Sohn ),김세동 ( Sae Dong Kim ),김인환 ( In Whan Kim ),변성준 ( Seong Joon Byun ) 대한골절학회 2006 대한골절학회지 Vol.19 No.3

목적: 대퇴 전자간 골절환자에게 ITST 골수정과 근위 대퇴 골수정 (PFN)으로 수술을 시행한 환자군의 결과를 비교분석하고자 하였다. 대상 및 방법: 2002년 7월부터 2005년 11월까지 대퇴 전자간 골절을 가진 환자 중 ITST 골수정과 근위 대퇴 골수정을 사용하여 수술을 시행한 각각 30예를 대상으로 하였다. 방사선적 결과는 수술 전 및 수술 후 정기적으로 시행한 방사선 촬영을 분석하였으며, 결과는 Parker와 Palmer의 보행점수와 Salvati와 Wilson의 고관절 기능점수 및 Jensen의 사회기능 점수를 이용하여 분석하였다. 결과: 방사선적 결과 중 지연 나사의 평균 활강은 ITST군이 4.1 mm, PFN군이 6.6 mm로 유의한 차이를 보였다 (p=0.003). 임상적 결과로 Parker와 Palmer의 보행점수와 Salvati와 Wilson의 고관절 기능점수의 하락은 ITST군과 PFN군에서 서로 유사하게 나타났다. 근위 외측 대퇴부 통증을 호소한 환자는 ITST군에서 5예 (17%), PFN군에서 8예 (27%)였다. 결론: 대퇴 전자간 골절에서 ITST 골수정과 PFN을 이용한 치료는 안정 골절 및 불안정 골절에서 양 군 모두 좋은 결과를 얻었다. Purpose: To evaluate the radiographic, clinical results and the complications between who had intertrochanteric fracture, treated with the ITST or the PFN. Materials and Methods: We selected each 30 patients of intertrochanteric fracture which were treated with ITST or PFN from July 2002 to November 2005. We evaluated the radiographic results by follow-up radiography and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index. Results: The mean distance of lag screw sliding was 4.1 mm at the ITST group and 6.6 mm at the PFN group. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score were similar. Patients complaint pain over lateral thigh area in 5 cases (ITST group) and 8 cases (PFN group). Conclusion: The ITST nail and PFN were seen good results in treatment of stable and unstable intertrochanteric fracture.

동일 환자에서 회전형과 고정형인공 슬관절 전 치환술의 비교

손욱진(Oog Jin Sohn),이동철(Dong Chul Lee),조재호(Jae Ho Cho) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.2

목적: 동일 환자에서 양측 슬관절에 회전형과 고정형 인공 슬관절 전 치환술 후 임상적, 방사선적 결과 및 환자의 주관적 만족도 등을 비교하고자 하였다. 대상 및 방법: 양측 퇴행성 관절염으로 한쪽은 회전형, 다른 쪽은 고정형 후방십자인대 보존형 슬관절 전 치환술을 시행한32명을 대상으로 하였다. 임상적 평가는 슬관절 점수를, 주관적 만족도 및 환자의 선호도는 WOMAC 평가를 이용하였으며, 그 외 수술 전후 관절 운동 범위, 대퇴 경골간 각도, 방사선 소견, 합병증 등을 비교 분석하였다. 결과: 슬관절 점수는 회전형 군 39에서 86, 고정형 군 42.5에서 87.3으로, WOMAC 점수는 회전형 군 84.9에서 11.2, 고정형 군 85.5에서 16으로 술 전에 비해 술 후 호전되었고 회전형 군이 고정형 군에 비해 높은 만족도를 보였다. 관절운동 범위는 회전형 술 전 104.5°에서 술 후 114.5°로 고정형 군은 각각 104,7°에서 113.8°로, 회전형 군에서 다소 호전되었으나 양군의 차이는 없었다. 대퇴 경골 각은 회전형 군 내반 4.5°에서 외반 5.3°로, 고정형 군 각각 3.8°, 6°로 양 군에서 모두 정상 정렬을 회복하였다. 결론: 동일 환자에서 회전형과 고정형 슬관절 전 치환술을 시행하여 단기 추시 시 슬관절 기능 평가와 관절 운동범위는 양 군에서 유사하였고 주관적 만족도 및 환자 선호도에서 회전형을 사용한 군이 더 높았다. Purpose: To evaluate the radiological and clinical results including the patient's satisfaction after total knee arthroplasty (TKA) using two differently designed system for both knees in the same patient. Materials and Methods: From January 2002 to January 2003, thirty-two bilateral TKAs were prospectively performed using two differently designed systems. One side TKA was performed using a mobile bearing (PFC RP, Dupey) system, and the other side was performed using a fixed bearing system (PFC, Dupey). All 32 patients were followed up for an average of 51.4 months. The mean age of the study group was 67 years (range 54-75). The clinical results were evaluated from the Knee Score, WOMAC score for the patient's satisfaction and range of motion. Radiological analysis including the tibiofemoral angle was also carried out. An independent T-test was used for statistical analysis. Results: The preoperative average knee score improved to 87.3 from 42.5 in the mobile bearing group and to 86 from 39 in the fixed bearing group respectively. The preoperative average WOMAC score decreased to 11.2 from 84.9 in the mobile bearing group and to 16 from 85.5 in the fixed bearing group. The average preoperative range of knee motion improved to 114.5° from 104.5° in the mobile bearing group and to 113.8° from 104.7° in the fixed bearing group. The average preoperative tibiofemoral angle improved to 5.3° valgus form 4.5° varus in the mobile bearing group and to 6° valgus from 3.8° varus in the fixed bearing group. The only result statistically significant was the WOMAC score (p<0.05). Conclusion: The two differently designed TKA system produce similar outcomes except for the subjective satisfaction in the mid-term clinical and radiological evaluation.

동측 하지에 발생한 대퇴골 분절 골절과 경골 골절

손욱진 ( Oog Jin Sohn ),박철현 ( Chul Hyun Park ),배상근 ( Sang Keun Bae ) 대한골절학회 2009 대한골절학회지 Vol.22 No.2

The ipsilateral femoral segmental and tibial fractures seldom occur such as traffic accidents needed high energy mechanisms. For these fractures, surgical stabilization and early mobilization of joint produce can be the best clinical outcomes. We have experienced a case of ipsilateral femoral segmental and tibial fracture and gained good clinical results with surgical treatment. We have reported here on this case and included a review of the relevant literature.

재발성 화농성 관절염에 대한 치료로서의 2단계 인공관절 치환술

손욱진(Oog Jin Sohn),이동철(Dong Chul Lee),이성준(Sung Jun Lee),문정재(Jeong Jae Moon),손휘승(Whee Sung Son) 대한정형외과학회 2014 대한정형외과학회지 Vol.49 No.2

목적: 퇴행성 관절염이 동반된 재발하는 화농성 슬관절염 환자에서 인공관절 치환술의 유용성을 평가하고자 하였다. 대상 및 방법: 2005년 1월부터 2012년 4월까지 최소 1년 이상의 추시된 관절염을 동반한 재발한 화농성 슬관절염 환자 중 2단계 인공관절 치환술을 시행한 22예를 대상으로 하였다. 임상적 평가는 슬관절 점수, 기능적 점수, International Knee Documentation Committee (IKDC) 평가를 이용하였으며, 방사선 소견, 배양 균주, 당뇨병 유무, 인공관절 치환술까지 소요된 기간 등에 따른 결과를 분석하였다. 결과: 최종 추시 시 슬관절 운동 범위는 평균 115o였으며, 수술 후 슬관절 점수는 평균 81.0점, 슬관절 기능 점수는 평균 73.2점이었 으며, IKDC 주관적 만족도 평가에서는 normal 15예, nearly normal 7예로 조사되었다. 당뇨병을 가진 환자군이나 배양 균주가 검출 된 환자군에서 유의한 차이는 없었다. 최종 추시 시 슬관절의 감염이 재발한 예는 없었다. 결론: 퇴행성 관절염이 동반된 재발성 화농성 슬관절염 환자에서 2단계 인공관절 치환술은 만족할 만한 결과를 보여, 치료방법의 하 나로서 선택적으로 사용할 수 있을 것으로 생각한다. Purpose: The purpose of this study is to evaluate the usefulness of a two-stage approach to primary knee arthroplasty with recurrent septic arthritis. Materials and Methods: We studied 22 patients with recurrent septic arthritis, and we observed them for more than one year of follow-up survey from January 2005 to April 2012 at Yeungnam University Medical Center. The clinical assessment was performed following Knee Society knee score, Knee Society function score, and International Knee Documentation Committee Score (IKDC) subjective assessment. In addition, we analyzed the causative organisms, significant medical comorbidities (diabetes mellitus), period up to primary knee arthroplasty, and radiologic assessment with reference to disease prognosis. Results: The average range of postoperative knee motion showed a good result, with an average of 115o. Knee Society knee score improved from 23.5 to 81.0, and Knee Society function score also increased from 22.5 to 73.2. Subjective assessment by IKDC was divided into 15 normal patients and 7 nearly normal patients. No significant difference was observed between patients with causative organisms and those with diabetes mellitus. In the final follow-up survey, recurrence of infection was not reported. Conclusion: A two-stage approach to primary knee arthroplasty with recurrent septic arthritis is a useful method, because it showed good clinical and radiologic results and favorable subjective assessment.

척추감염을 동반한 양측 슬관절 전치환술 후 감염의 치료

심범진(Bum-Jin Shim),손욱진(Oog-Jin Sohn),조창우(Chang-Woo Cho) 대한정형외과학회 2017 대한정형외과학회지 Vol.52 No.1

슬관절 전치환술 후 감염은 큰 관심을 가지는 문제로 국소 부위 및 전신적 감염의 형태로 나타날 수 있으며, 때로는 패혈증으로 진행되는 사례가 보고되고 있다. 이러한 패혈증은 신체의 다양한 부위로 전파될 수 있으며 사망에까지 이르게 하는 중대한 합병증이다. 하지만 감염 후 척추로 전이된 경우는 임상 증상이 뚜렷하지 않아 진단이 어려우며, 이러한 증례에 대한 보고는 어떠한 문헌에도 없었다. 이에 양측 슬관절 전치환술 후 감염으로 인하여 패혈증으로 진행되어 척추로 전이된 증례를 보고하고자 한다. Postoperative infection from total knee arthroplasty (TKA) is an issue drawing great attention, which can manifest as a local or general infection. Its development into sepsis has also occasionally been reported. Such sepsis is a critical complication that can spread to various parts of the body, which can ultimately lead to mortality. However, the cases where infection has spread to the spine do not have clear clinical signs, making diagnosis difficult. These cases are not found in the literature. Therefore, this is a case study on both postoperative infection from TKA that has developed into sepsis and spread to the spine.

Carthamus tinctorius L. Increases BMP-2 Gene Expression during Bone Fracture Healing in Rats

Kwang-Hee Lee,Oog-Jin Sohn,Jong-Chul Ahn,Yong-Woon Kim,So-Young Park,Jong-Yeon Kim 대한생리학회-대한약리학회 2006 The Korean Journal of Physiology & Pharmacology Vol.10 No.3

Carthamus tinctorius L.is known to improve fracture healing, and bone morphogenetic proteins (BMPs) are associated with the formation and healing process of bone. BMP-2 and BMP-7 are two of the most important BMPs during the bone healing process. Human osteosarcoma MG63 cells and rats were used to determine the effects of Carthamus tinctorius L. extract (CTE) on BMP-2 gene expression. BMP-2 gene expression by CTE treatment in human osteosarcoma MG63 cells was not different from the control group until 8 hours of incubation, but was significantly higher, by 31%, than that of the control group at 16 hr of incubation. Microscopic findings of the 9th rib 3 weeks after fracture showed typical rimming of the osteoblast and immature bone formation in control and CTE groups. BMP-2 gene expression by in situ hybridization was remarkably increased by a CTE-supplemented diet in the fracture group compared to the control group. In conclusion, Carthamus tinctorius L. increased BMP-2 gene expression in human osteosarcoma cells and fractured bone. But further studies would be needed to elucidate the effect of CTE on fracture healing in vivo because our results did not show any evidence of healing improvement histologically 3<SUP>rd</SUP> week after fracture.

Carthamus tinctorius L. Increases BMP-2 Gene Expression during Bone Fracture Healing in Rats

Lee, Kwang-Hee,Sohn, Oog-Jin,Ahn, Jong-Chul,Kim, Yong-Woon,Park, So-Young,Kim, Jong-Yeon The Korean Society of Pharmacology 2006 The Korean Journal of Physiology & Pharmacology Vol.10 No.3

Carthamus tinctorius L.is known to improve fracture healing, and bone morphogenetic proteins (BMPs) are associated with the formation and healing process of bone. BMP-2 and BMP-7 are two of the most important BMPs during the bone healing process. Human osteosarcoma MG63 cells and rats were used to determine the effects of Carthamus tinctorius L. extract (CTE) on BMP-2 gene expression. BMP-2 gene expression by CTE treatment in human osteosarcoma MG63 cells was not different from the control group until 8 hours of incubation, but was significantly higher, by 31%, than that of the control group at 16 hr of incubation. Microscopic findings of the 9th rib 3 weeks after fracture showed typical rimming of the osteoblast and immature bone formation in control and CTE groups. BMP-2 gene expression by in situ hybridization was remarkably increased by a CTE-supplemented diet in the fracture group compared to the control group. In conclusion, Carthamus tinctorius L. increased BMP-2 gene expression in human osteosarcoma cells and fractured bone. But further studies would be needed to elucidate the effect of CTE on fracture healing in vivo because our results did not show any evidence of healing improvement histologically $3^{rd}$ week after fracture.

퇴행성 슬관절염에서 Mobile-bearing과 Fixed-bearing 슬관절 전치환술의 비교

이동철 ( Dong Chul Lee ),손욱진 ( Oog Jin Sohn ) 대한슬관절학회 2007 대한슬관절학회지 Vol.19 No.2