Clinical Results Comparing Transtibial Technique and Outside in Technique in Single Bundle Anterior Cruciate Ligament Reconstruction

서승석,김창완,김전교,진성엽 대한슬관절학회 2013 대한슬관절학회지 Vol.25 No.3

Purpose: To compare the clinical results of single-bundle anterior cruciate ligament (ACL) reconstruction using the conventional transtibial technique and the anatomical outside-in technique for femoral tunneling. Materials and Methods: From 2007 to 2011, 89 patients who received ACL reconstruction were followed for ≥1 year were enrolled in the study. The conventional transtibial technique was used in 41 patients and the outside-in technique, in 48 patients. Femoral tunnel angle measurement and three-dimensional computed tomography (3D CT) were used for radiologic assessment of the location of femoral tunnel and Lysholm score and other tests were used for clinical assessment. Results: Both techniques did not reveal statistical differences in the clinical assessment. However, in International Knee Documentation Committee subjective knee evaluation, the sum of two questionnaire items regarding instability showed a statistically significant difference (p=0.01). In the pivot shift test, the anatomical outside-in technique showed outstanding rotational stability over the transtibial technique (p=0.04). The mean femoral tunnel inclination in coronal plane were 69.2o and 30.3o, respectively, for both techniques, and 21.6o and 50.8o, respectively in sagittal plane, showing statistically significant differences on simple radiography (p=0.04, 0.05). A 3D CT was performed in 17 patients with the conventional transtibial technique and 25 patients with the outside-in technique. Coefficients of variation were 0.33 and 0.13, respectively, from dorsal border of the condyle and 0.67 and 0.24, respectively, from the roof of intercondylar notch. Conclusions: Femoral tunnels created with the outside-in technique have superior knee joint rotational stability compare to the transtibial technique. Therefore, the outside-in technique could be considered as a valuable technique in single-bundle ACL reconstruction.

성장판이 남아 있는 청소년기의 습관성 슬개골 외측방 탈구에서 변형된 Galeazzi 술식을 이용한 치료

서승석,정경칠,김정원 대한슬관절학회 2004 대한슬관절학회지 Vol.16 No.2

여가동기에 관한 연구 -인사동 전통문화거리를 대상으로-

서승석,곽한병 한국스포츠리서치 2005 한국 스포츠 리서치 Vol.16 No.2

Clinical Results Associated with Changes of Posterior Tibial Slope in Total Knee Arthroplasty

서승석,김창완,김정한,민영경 대한슬관절학회 2013 대한슬관절학회지 Vol.25 No.1

Purpose: The purpose of this retrospective study is to investigate the effect of posterior tibial slope (PTS) on clinical results in total knee replacement arthroplasty (TKA). Materials and Methods: We analyzed 801 knees in 768 patients who underwent TKA using a cruciate-retaining prosthesis for osteoarthritis from July 2003 to July 2009. PTS was measured on simple X-ray films and patients were divided into 5 groups, according to the change in PTS that was calculated by subtracting the preoperative from the postoperative PTS: group 1, >3o; group 2, 3o to 1o; group 3, 1o to -1o; group 4, -1o to -3o; and group 5, <-3o. We analyzed the correlations between the change in PTS and clinical results, such as Knee Society knee score, Knee Society functional score, Feller patella score, Kujala score, visual analog scale score, range of motion, and complications. Results: There was no statistically significant intergroup difference; however, Feller patella score and Kujala score were significantly different in groups 2 and 3. There were no complications, such as progressive loosening of implants, fractures of polyethylene inserts and wears. Conclusions: Clinically meaningful improvement was observed in all patients after TKA. Groups 2 and 3 (3o to -1o) showed significant improvement compared to the other groups.

충전제 투입위치 이원화 및 Engineered PCC 혼합에 따른 하이로딩 기술의 응용

서승석,남기영,윤동호,이경호,원종명,조병욱,김형진,이태주 한국펄프·종이공학회 2011 한국펄프·종이공학회 학술발표논문집 Vol.2011 No.10

이산화탄소 · 섬유 저감형 로딩기술 개발을 위한 경탄 제조 및 활용

서승석,남기영,윤동호,이경호,원종명,조병욱,김형진 한국펄프·종이공학회 2011 한국펄프·종이공학회 학술발표논문집 Vol.2011 No.4

전완부 동시 골절의 수술후 골의 길이변화에 따른 완관절의 기능 평가

서승석,김기용,최장석,김영창,박재근 대한골절학회 2003 대한골절학회지 Vol.16 No.1

목 적 : 전완골 동시 골절에 있어서 술 후 전완골의 길이 변화에 따른 완관절의 기능 회복의 연관성과 우수한 기능적 회복을 위해 허용되는 적정한 길이에 대해 알아보고자 한다. 대상 및 방법 : 1995년 1월부터 2000년 12월까지 전완골 동시 간부 골절로 압박금속판과 나사를 이용한 수술적 치료를 받았던 환자중 술 후 1년 이상 추시 관찰 가능하였던 21례를 대상으로 골절 양상 및 완관절의 기능을 평가하였다. 평균 추시기간은 3년 6개월이었으며, 술 후 완관절의 방사선사진으로 건측과 전완골의 길이 차이를 비교하였다. 술 후 길이가 1㎜이내, 1~2㎜, 2~3㎜, 3㎜초과의 4군으로 나누어 각각을 A, B, C, D군으로 분류하여 비교하였으며, 완관절의 기능평가는 Anderson의 방법 및 Mayo modified wrist score를 이용하였다. 결 과 : 각각의 군에서 A군 11례(52.3%), B군 5례(23.8%), C군 4례(19.0%), D군 1례(4.8%)로 나타났으며, Anderson의 분류기준에 의하면 Excellent 11례(52.3%), Good 7례(33.3%), Fair 3례(14.3%)로 나타났었고, 이중 2㎜이하의 길이 차이를 보이는 례에서는 Excellent 11례 및 Good 5례로 우수한 결과를 보였다. Mayo Modified Wrist Score를 측정한 결과 2㎜이하의 길이 차이를 보이는 례에서는 75.15점 및 2㎜이상의 경우는 61.15점으로 차이를 보였다. 결 론 : 전완부 동시 골절의 관혈적 정복시 전완골을 재건하는데 있어 전완골의 정상 길이 회복이 우수한 기능적 결과를 얻는데 필수적인 요소이며, 길이 차이를 2㎜이하로 유지하는 것이 중요할 것으로 생각된다. Purpose : To evaluate the relationship between the length changes of both forearm bones and function of wrist. To know permitted length discrepancy for good wrist function after operation in fracture of both bones of forearm. Materials and methods : From Jan. 1995 to Dec. 2000, 21 cases were followed over 1 year, were treated with compression plate and screws due to fracture of both bones of forearm in our hospital. Mean duration of follow-up was 3 years 6 months. The postoperative length difference was compared to preoperative or unaffected side in roentgenography. Four groups were defined to A, B, C and D by postoperative length difference ; ≤ 1㎜. 1~2㎜, 2~3㎜, and 3㎜ for comparison. The function of wrist joint was evaluated with the Anderson's classification and Mayo modified wrist score. Result : Group A were 11 cases(52.3%), B 5 cases(23.8%), C 4 cases(19.0%) and D 1 case(4.8%). By the Anderson's classification, the number of Excellent were 11 cases(52.3%), Good 7(33.3%), Fair 3(14.3%)/ In the group of the length difference lesser than 2㎜, the number of Excellent were 11, and Good 5. The Mayo modified wrist score was 75.15 in the group of the length difference lesser than 2㎜, that was higher than 61.15 in the group of more than 2㎜. Conclusion : To obtain a good wrist function after operative treatment of fracture of both bones of forearm the length discrepancy of both bones should be lesser than 2㎜.

종골 견인을 이용한 관절경적 족관절 고정술

서승석,김훈,Seo, Seung-Seok,Kim, Hoon 대한족부족관절학회 1997 대한족부족관절학회지 Vol.1 No.2

The arthroscopic ankle arthrodesis is one of the good method of the ankle arthrodesis. Mechanical distraction of tibiotalar joint is an absolute necessity for adequate visualization and operative instrumentation. However, there are several disadvantages. Thus we performed arthroscopic ankle arthrodesis using calcaneal traction in three cases and achieved following results. 1. The procedure is easy and the operation time is shorter than the other arthroscopic ankle arthrodesis. 2. The risk of neurovascular damage and infection is reduced by using calcaneal traction. 3. It does not require the expensive distraction device. 4. The adequate visualization for operative instrumentation is obtained.

Legg-Calve-Perthes 병에서 대퇴골 절골술에 대한 고찰

서승석,김영창,최장석,이영구 인제대학교 1991 仁濟醫學 Vol.12 No.2

부산 백병원 정형외과에서 Legg-Calve-perthes병으로 진단을 받고 대퇴골 절골술을 실시하였던 환자중 최소 원격추시가 18개월이상 가능하였던 27례, 29고관절에 대해 임상소견 및 방사선소견을 분석하였다. The methods of surgical treatment in L-C-P disease are a femoral osteotomy and inominate osteotomy There have been many studies and controversies about its surgical treatment. The material were 29 hips in 27 cases that were treated by a femoral osteotomy at Department of Orthopedic Surgery, Pusan Paik Hospital, Inje University from January, 1984 to November. 1988. These materials were followed more than 18 months to fully regenerated stage. We analyzed these mateials about factors affecting prognosis after surgery and the Influence of the femoral osteotomy. Following results were obtained; 1.At the time of surgery 14 hips(48%) were Catterall Group III and 11 hips(38%) were Callerall Group Iv. 2.Overall result after femoral osteotomy was good in 55%. 3.Results were affected by patient's age, head involvement, stave at surgery, and extrusion ratio. 4.Femoral osteotomy was more efficient surgical treatment in that it shortened the disease course and was not necessary for patient to use the trace for a long time.

Management of Focal Chondral Lesion in the Knee Joint

서승석,김창완,정대원 대한슬관절학회 2011 대한슬관절학회지 Vol.23 No.4

Articular cartilage does not contain vascular, nervous and lymphatic tissue and chondrocytes hardly participate in the healing or repair process of chondral tissue because of being surrounded by plenty of extracellular matrix. Th erefore, the injury to articular cartilage frequently requires an operative treatment. Th e goal of surgical repair of articular cartilage is to regenerate nearly normal chondral tissue and prevent degenerative arthritis caused by the articular cartilage defect. Microfracture is a kind of cartilage repair procedure that makes a fibrin clot containing mesenchymal stem cells in the chondral lesion. Microfracture is a simple procedure but it has a disadvantage that the repaired tissue is fi brocartilage. Autologous chondrocyte implantation has an advantage that it implants fully diff erentiated chondrocytes to the lesion, which theoretically produces hyaline cartilage. Its disadvantages are that it is a two stage and a costly procedure. Osteochondral autograft transplantation is a one stage procedure and repairs the lesion with hyaline cartilage. But its limitation is the lack of donor site availability. Surgeons who understand the theoretical background,indications, surgical methods, rehabilitation, complications, and clinical course of cartilage repair procedures can achieve the goal of preventing degenerative arthritis.