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슬와 낭종을 형성한 슬관절의 미만성 색소 융모 결절성 활액막염 - 1례 보고 -
김명구,고석면,오인석,김려섭,신진호,Kim, Myung Ku,Ko, Suk Myun,Oh, In Suk,Kim, Ryuh Sup,Shin, Jin Ho 대한관절경학회 1999 대한관절경학회지 Vol.3 No.1
색소 융모 결절성 활액막염은 슬관절에 호발하고 슬와부로 팽창되는 경우는 드물며 이 경우 베이커씨 낭종이나 악성 종양으로 오진될 수도 있다. 저자들은 슬와부로 팽창되어 낭종을 형성한 미만성 색소 융모 결절성 활액막염을 관절경적 활액막 전 절제술과 낭종 제거술로 치료하였고 1년 이상의 추시 기간상 재발이 안된 1례를 보고하는 바이다. Pigmented villonodular synovitis most commonly occurs in the knee joint and rarely extends into the popliteal space, which not only has mimicked Baker's cyst but also has been misdiagnosed as malignant tumor. We report a case of a diffuse pigmented villonodular synovitis of knee joint which is extended into the popliteal space as like a popliteal cyst. We treated this case by arthroscopic total synovectomy and excision of cyst. There was no recurrence during more than one year after operation.
관절경하 유관 나사를 이용한 족관절 관절 고정술 (3례 보고)
김명구,Kim, Myung Ku 대한관절경학회 1998 대한관절경학회지 Vol.2 No.1
There have been numerous methods to obtain a stable arthrodesis of the tibiotalar joint. However, a controvercy has arisen over the most successful and reproducible method to obtain an arthrodesis. The objective of this report is to show that an ankle arthrodesis can be performed successfully and advantageously by using cannulated screws under arthroscopic control and that our csaes will be a part of the multicentric study of arthroscopic ankle arthrodesis in korea. Between May 1996 and May 1997, we perfomed 3 ankle arthrodesis under arthroscopy using cannulated screws. Two patients had post-traumatic osteoarthritis and one had rheumatoid arthritis. Clinical ankylosis in one case and radiological union in two cases were obtained in 12 weeks postoperatively. We propose that arthroscopic ankle arthrodesis is effective procedure in patient who has minimal deformity and bone loss, advantages like small incision, minimal morbidity, low infection rate and rapid return to normal daily activity, but more cases and comparision with open tecnique will be needed.
김명구,배주한,전윤상,Kim, Myung-Ku,Bae, Joo-Han,Jeon, Yoon-Sang 대한관절경학회 2009 대한관절경학회지 Vol.13 No.2
목적: 석회화 건염에 대하여 보존적 치료 및 조기 관절경을 이용한 수술적 치료 후 통증과 임상경과를 비교 관찰하였다. 대상 및 방법: 2002년 2월부터 2008년 5월까지 석회화 건염으로 진단받은 30예 중 6개월 이상 추시관찰이 가능하였던 스테로이드 주사치료 15예 및 수술 치료 15예를 대상으로 하여 석회질의 통증과 운동 범위의 호전을 2주, 12주, 24주째 각각 비교 관찰하여, Constant-Murley score를 이용하여 평가하였다. 결과: 통증 정도는 Constant-Murley score상 보존적 치료군의 경우 수술 전 평균 3.2에서 치료 이후 2주, 12주, 24주째 각각 13.6점, 14.5점, 14.7점이었으며, 수술적 치료군은 수술 전 평균 3.3에서 수술후 2주, 12주, 24주째 각각 10.2점, 13.0점, 14.3점이었다. 운동 범위는 보존적 치료군의 경우 수술 전 평균 14.3에서 치료 이후 2주, 12주, 24주째 각각 21.7점, 31.3점, 35.7점이었으며, 수술적 치료군은 수술 전 평균 14.4에서 수술후 2주, 12주, 24주째 각각 33.1점, 35.8점, 36.4점이었다. 치료 2주째 및 12주째 두 간의 비교에서는 수술적 치료 군이 유의하게 우수하였으나, 최종 추시시는 통계학적인 차이가 없었다. 결론: 석회화 건염의 조기 관절경적 치료는 환자의 만족도를 높이고 조기에 일상 생활로 복귀할 수 있는 효과적인 치료법으로 사료된다. Purpose: We evaluated the level of pain and clinical presentation of calcific tendinitis after treatment with conservative and early arthroscopic operation. Materials and Methods: We reviewed 30 patients with calcific tendinitis with the minimum of 6 months of follow up period, treated from February 2002 to May 2008. We implemented Constant-Murley score to evaluate the pain of calcification and improvement of range of motion at the 2nd week, 12th week and 24th week with the patients who had treatment with steroid injection in 15 cases and operation in the other 15 cases. Results: Evaluating the level of pain using Constant-Murley score, we found that conservative treatment group had the scale of 3.2 before treatment and 13.6, 14.5 and 14.7 at 2nd, 12th, and 24th week, respectively since started treatment. The operation group, on the other hand, had the scale of 3.3 preoperatively and 10.2, 13.0, and 14.3 at 2nd, 12th and 24th week postoperatively. The range of motion in the conservative treatment group showed 14.3 on average before the treatment and 21.7, 31.3 and 35.7 at 2nd, 12th and 24th week after treatment. The operation group had 14.4 on average preoperatively, and 33.1, 35.8 and 36.4 at 2nd, 12th and 24th week postoperatively. The operation group had statistically significant improvement compared to the conservative group at the 2nd and 24th week, but showed no difference between the two groups at the final follow up. Conclusion: Early arthroscopic treatment of calcific tendinitis seems to be an excellent option that can increase the level of satisfaction of the patients and an efficient way of putting the patients back to their normal life promptly.
김명구(Myung-Ku Kim),문경호(Kyoung-Ho Moon),이동주(Tong-Joo Lee),김루시아(Lucia Kim),이중선(Joong-Sun Lee) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.1
슬개골에 골용해성 병변을 보이는 예로는 양성 또는 악성 골종양, 전이성 골종양, 골용해성 감염질환, 퇴행성 또는 대사성 골질환이 있다. 통풍으로 인하여 슬개골에 골용해성 병변을 보이는 몇 예의 보고가 있으나, 이분 슬개골에 발생한 증례는 한 예만이 문헌에 보고되었다. 본 증례의 경우 양측 이분 슬개골에 종양 혹은 대사성 질환을 의심할 만한 골용해성 병변을 보여, 생검 및 조직학적 검사를 실시한 바 통풍 결절로 확인되었다. 단순 방사선 촬영 상 골용해성 병변이 양측 이분 슬개골에 발생한 증례가 아직 국내에 보고된 적이 없어 문헌 고찰과 함께 보고하는 바이다. Osteolysis of the patella occurs in benign or malignant bone tumors, metastatic disease, osteolytic infections, degenerative, or metabolic bone disease. Several cases of patellar destruction secondary to gout have been reported. However, there has only been one case of bipartite patellar bone destruction secondary to gout reported in the literature. We encountered a patient with an osteolytic lesion of the bipartite patella suggesting a bone tumor or metabolic bone disease. A biopsy and histology examination suggested a diagnosis of gout tophi. This case demonstrated bilateral bipartite patella with gout involvement on the plain roentgenograms.
전방십자인대의 경골 고정 시 생흡수성 봉합나사 및 금속나사 고정의 기능적 결과
김명구 ( Myung Ku Kim ),박주용 ( Ju Yong Park ),안치훈 ( Chi Hoon Ahn ) 대한스포츠의학회 2014 대한스포츠의학회지 Vol.32 No.2
The aim of this study was to evaluate the postoperative outcomes of anterior cruciate ligament (ACL) reconstructionuction using 2 additional fixation technique on tibial side. Between October 2008 and February 2012, sixty consecutive patients who underwent ACL reconstruction with allograft for ACL injuries were retrospectively enrolled. All patients were reconstructed with fresh frozen achilles tendon or posterior tibialis tendon allograft. Fixation on tibial side with bioabsorbable suture anchor (BSA) was in 30 patients (group A) and metal screw fixation was in 30 patients (group B). The data was collected at preoperatively and at least 1 years postoperatively, which included KT-2000 arthrometer objectively, and Tegner score, Lysholm score, and International Knee Documentation Committee (IKDC) scores subjectively. At the final follow up, the KT-2000 arthrometer improved significantly with an average of 3.28 mm anterior translation in the group A, 3.56 mm in group B. The preoperative mean Lysholm, Tegner and IKDC score was 46.14, 4.86, 63.17 in the group A, and 45.30, 4.40, 54.07 in the group B. The postoperative mean Lysholm, Tegner and IKDC score was 83.80, 8.14, 75.57 in the group A, and 88.75, 7.62, 65.10 in the group B. All functional outcomes were improved significantly (p=0.004) in both groups, but no differences were noted between the 2 groups (p>0.05). Both additional fixation techniques using BSA or metal screw fixation on tibial side in ACL reconstruction improved functional outcomes significantly. BSA technique seems to provide adequate strength suitable for early rehabilitation after ACL reconstruction.