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금속판 부착 슬개 삽입물 사용환자에 시행한 슬관절 재치환술
김성수,배대경,배은환 대한슬관절학회 1996 대한슬관절학회지 Vol.8 No.1
Metal hacked patellar component failure is a new complication of TKR and will be seen in increasing numbers. A type of failure was a separation of the polyethylene from the metal backing and this dissociation is followed by wearing of the metal backing against the femoral component. From February 1991. To June 1994, the revision was done in 18 knees in 15 patients(2 males, 13 females) who had metal backed patellar component at Kyung Hee University Hospita1. The authors reviewed clinical and radiological findings. The initial diagnosis was OA in 13 cases, and RA in S cases. The average bocly weight was 66.7kg (54kg to 84kg). The average age was 62 years (41 years to 74 years). The initial prosthesis of TKR included PCA in 8 cases, MG I in 5 cases, PFC in 2 cases, Microloc in 2 cases, and TC IV in l case. 1n l5 cases, cemented TKR was done. All patients had swelling and pain. Six cases had the click sound and the dislocation of patella was found in 3 cases. Lateral tilting of pate11a(more than 160 congruence angle) in skyline view was ohserved in 6 cases. The femorotibia1 angle before the revision was average ualgus 3.80(varus 150-va1gus 150), and range of motion was average 1060(800-1350) The average time from initial TKR to the revision was S years 8 months (range; 3 years to 8 years). In revision surgery, patellar component was revised in one case and tibial insert and patellar components were revised in three cases. All three components were revised in remaining cases. Lateral releases were performed in 2 cascs. The average duration of follow-up was 2 years and 10 months. The average knee score was 57 before the revision and the last follow-up score was 88. We concluded that failure was associated with metal hacking, surgical technique, patient activity.
한정수,이용걸,배은환,김성수,김성태,Han, Chung-Soo,Lee, Yong-Girl,Bae, Eun-Hwan,Kim, Sung-Soo,Kim, Sung-Tae 대한근골격종양학회 1996 대한골관절종양학회지 Vol.2 No.1
Ossifying fibroma is one of a group of fibro-osseous lesions which arises typically within the jaw bones and only rarely affects the long bones. Ossifying fibroma of the long bones almost involve exclusively the tibia but may also involve the fibula. Ossifying fibroma of the long bones is distinct from fibrous dysplasia, adamantinoma and nonossifying fibroma with regard to age of the patient, site, radiographic appearance, histological features, and clinical course. We are reporting the cases of seven patients with a tumor-like lesion that named osteofibrous dysplasia. It is most commonly found in the tibia and fibula of a child ten years of age or younger. Of the seven cases reported in this study, only one patient was younger than ten years. In all cases, the lesions were usually located in the tibial diaphysis. The average duration of clinical manifestation was 5.2 years. The clinical symptoms were anterior bowing of the tibia in 2 cases, buldging of the tibia in 2 cases, and mass overlying the tibia in 3 cases. On the roentgenography, it shows multiple radiolucent lesion with intervening sclerotic rim of the tibial diaphysis. In seven patients, 6 cases were confirmed with biopsy. We had done curettage and bone graft in three cases, VFG was done in one case. The other three cases underwent conservative management.
인공슬관절 부분치환술의 전향적 분석 및 단기 추시 결과
김경태(Kyung Tae Kim),이송(Song Lee),배은환(Eun Hwan Bae),김현수(Hyun Soo Kim),박준성(Joon Seong Park),차상규(Sang Gyu Cha) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.2
목적: 인공슬관절 부분치환술을 시행한 환자들의 전향적인 추시 관찰을 통해 수술 후 시간 경과에 따른 변화를 비교하고 최종 추시 결과를 분석함으로써 인공슬관절 부분치환술의 초기 결과를 알아보고자 하였다. 대상 및 방법: 2002년 1월부터 본원 정형외과에서 시행한 인공슬관절 부분치환술 중 수술 후 2년이 경과하고 수술 후 3개월, 6개월, 12개월 및 24개월에 정기적 추시가 가능했던 67예를 대상으로 전향적 조사 방법을 사용하여 임상적 평가와 함께 방사선학적 변화 등을 확인하여 기간 경과에 따른 변화를 비교하고 최종 추시 결과를 분석하였다. 결과: 수술 후 2년까지 정기적 추시가 가능했던 67예에서 슬관절 점수는 수술 전 평균 54.6점에서 수술 후 3개월 80.1, 6개월 85.4, 12개월 86.8, 24개월 89.2점으로 증가되었고 기능 점수는 수술 전 평균 56.3점에서 수술 후 3개월 70.4, 6개월 76.0, 12개월 80.2, 24개월 83.0점으로 증가되었다. 슬관절 운동 범위는 수술 전 127.6˚에서 수술 후 3개월에 128.6˚로 회복되었고 대퇴경골각은 수술 전 0.7° 외반에서 수술 후 24개월에 5.7° 외반으로 변화했다. 결론: 슬관절의 퇴행성 관절염에 시행한 인공슬관절 부분치환술에서 만족할만한 슬관절 점수와 기능 점수의 향상 및 관절 운동의 회복을 수술 후 조기에 얻을 수 있었고 단기 추시 결과도 비교적 우수한 결과를 보였다. Purpose: To evaluate the early postoperative results of Unicompartmental Knee Arthroplasty (UKA) based on a prospective analysis and follow up study. Materials and Methods: Clinical assessments were carried out using the Knee Society Score (KSS) rating system. The tibiofemoral angle and radiographic changes were measured using weight-bearing X-rays. Prospective assessments were conducted preoperatively, and regularly followed up after the operation. Among the cases of UKA performed since January 2002, 67 were able to be followed up at 3, 6,12 and 24 months after the operation. Results: For these 67 knees, the average preoperative knee score and the knee function score were 54.6 and 56.3 points, respectively. The knee score was improved to 80.1, 85.4, 86.8 and 89.2 points at 3, 6,12 and 24 months follow ups, respectively. The knee function score was also improved to 70.4, 76.0, 80.2 and 83.0 points at 3,6,12 and 24 months. The average range of knee motion was 127.6 degrees preoperatively, and recovered to 128.6 degrees at 3 months postoperatively. The preoperative tibiofemoral angle was 0.7 degrees of valgus, which changed to 5.7 degrees of valgus at 24 months postoperatively. Conclusion: As shown in this prospective study, the early postoperative results of UKA were satisfactory for improvement of knee score, function score and in the recovery of knee motion.