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

손욱진,박상진,심범진,이동열 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 the Modified Transtibial Technique, Anteromedial Portal Technique and Outside-in Technique in ACL Reconstruction

손욱진,이동철,박강현,안효세 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 - 증례 보고 -

손욱진,박철현,배상근 대한골절학회 2009 대한골절학회지 Vol.22 No.3

동측의 대퇴골 분절 골절 및 경골 골절은 흔히 발생하지 않으며, 교통사고 등의 고에너지 손상에 의해 발생한다. 이런 골절의 경우 골절부를 수술적 치료로 안정화하고 조기 관절 운동을 시행해야 좋은 임상적 결과를 얻을 수 있다. 저자들은 대퇴골의 다발성 분절 골절과 동측의 경골 골절이 동시에 발생한 증례를 경험하고 수술적 치료를 시행하여 좋은 결과를 얻은 바 있어 이를 문헌 고찰과 함께 보고 하고자 한다.

Current Concepts of Posterolateral Corner Injuries of the Knee

손욱진,박재우,김범정 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.

Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO

손욱진,강동화 대한정형외과학회 2011 Clinics in Orthopedic Surgery Vol.3 No.1

Background: To evaluate the radiological, clinical results in patients with open distal tibia factures, who were treated with astaged treatment protocol using the lateral minimally invasive plate osteosynthesis (MIPO) technique. Methods: From January 2007 to June 2009, 10 patients with open distal tibia fractures (Gustilo-Anderson classifi cation II, 3; IIIA,1; IIIB, 6) were treated using a staged treatment protocol. The initial debridement and application of an external fi xator were performedwithin 24 hours and the mean interval from injury to defi nitive surgical treatment was 15 days (range, 6 to 52 days). Eightweeks later, an additional bone graft was performed in 3 patients. The follow-up duration was more than 1 year. Results: The mean fracture healing time was 21 weeks (range, 17 to 28 weeks), and the average Iowa ankle rating score was84.5 points. At the last follow-up, there was no non-union, angular deformity > 5°, shortening > 10 mm or infection. In 10 patients,2 patients had a superfi cial wound infection, and another 2 patients showed limitation of ankle joint motion. Conclusions: This staged treatment protocol using a lateral MIPO technique is a useful alternative method for achieving highfunctional recovery with good healing and low complication rates in patients with an open distal tibia fracture.

A Comparison of Arthroscopically Assisted Single and Double Bundle Tibial Inlay Reconstruction for Isolated Posterior Cruciate Ligament Injury

손욱진,이동철,박철현,Won Ho Kim,Kwang Am Jung 대한정형외과학회 2010 Clinics in Orthopedic Surgery Vol.2 No.2

Background: This study evaluated the clinical results of arthroscopically assisted single and double bundle tibial inlay reconstructions of an isolated posterior cruciate ligament (PCL) injury. Methods: This study reviewed the data for 14 patients who underwent a single bundle tibial inlay PCL reconstruction (Group A) and 16 patients who underwent a double bundle tibial inlay PCL reconstruction (Group B) between August 1999 and August 2002. The mean follow-up period in groups A and B was 90.5 months and 64 months, respectively. Results: The Lysholm knee scores in groups A and B increased from an average of 43.3 ± 7.04 and 44.7 ± 5.02 preoperatively to 88.1 ± 7.32 and 88.7 ± 9.11 points at the final follow-up, respectively. In group A, stress radiography using a Telos device showed that the preoperative mean side-to-side differences (SSDs) of 9.5 ± 1.60 mm at 30° of flexion and 9.8 ± 1.70 mm at 90° of flexion were improved to 2.8 ± 1.19 mm and 3.0 ± 1.1 mm, respectively. In group B, the preoperative SSDs of 10.4 ± 1.50 mm at 30° of flexion and 10.7 ± 1.60 mm at 90° of flexion improved to 2.7 ± 1.15 mm and 2.6 ± 0.49 mm, respectively. There was no significant difference in the clinical scores and radiologic findings between the two groups. Conclusions: Single bundle and double bundle PCL reconstructions using the tibial inlay technique give satisfactory clinical results in patients with an isolated PCL injury, and there are no significant differences in the clinical and radiological results between the two techniques. These results suggest that it is unnecessary to perform the more technically challenging double bundle reconstruction using the tibial inlay technique in an isolated PCL injury.

대퇴골 간부 골절에서 비확공성 대퇴 금속정시행 후 유합시기에 대한 예후 인자 분석

손욱진,이원제 대한골절학회 2004 대한골절학회지 Vol.17 No.1

흰쥐에서 고혈당 및 고지질혈증이 운동 중 골격근 당원이용에 미치는 영향

이석강,이동우,안종철,손욱진 영남대학교 의과대학 1999 Yeungnam University Journal of Medicine Vol.16 No.1

고혈당과 고지질혈증이 운동 중 골격근의 당원 절약효과가 있는지 또는 골격근섬유의 특성에 따른 차이가 있는지를 규명하기 위해서 흰쥐(Sprague Dawley)를 대상으로 실험한 연구결과를 요약하면 다음과 같다. 먼저 고혈당에 의한 결과는 하지근 중 족척근의 운동부하 45분군의 당원농도가 고혈당군에서 대조군의 그것보다 약 13% 높아서 고혈당에 의한 족척근의 당원절약효과를 관찰할 수 있었으며 또한 백색 비복근의 운동부하 45분군에서 절약효과를 관찰할 수 있었다. 그러나 서근인 가자미근과 서근의 특성이 강한 적색 비복근에서는 모든 실험군에서 5-13%의 절약경향이 있었다. 이때 고혈단군의 혈당농도는 운동부하 전, 운동부하 30 및 45분후에 각각 145.7±7.4, 164±6.2 및 156±6.8mg/dL로서 대조각군의 혈당농도보다 유의하게 높았다. 고지질혈증은 복강내 heparin투여와 10% 인트라리포즈를 경구 투여하여 유도하였으며 대조군, 대조운동부하군 및 고지질혈증군에서 유리지방산 농도(uEq/L)가 247±41.1, 260±58.6 및 444±23.1로서 고지질혈증군이 다른 양 군보다 유의하게 높았다. 고지질혈증에 의한 근당원절약효과가 있는지 여부를 관찰한 결과 가자미근, 적색 비복근 및 족척근 등에서 통계적으로 유의한 절약효과를 관찰할 수 없었으나 백색 비복근에서 절약의 경향을 보였다. 이상의 결과로 보아 흰쥐에서 비교적 단시간의 운동부하 중 평균 155mg/dL의 고혈당을 유지하였을 때 족척근과 백색 비복근에서 근 당원이 절약되었으며 고지질혈증에 의해서는 근당원의 절약효과가 없었다. 또한 속근섬유의 근육에서 고혈당에 의한 당원 절약효과가 서근보다 뚜렷하였다. The effects of hyperglycemia and hyperlipidemia on utilization of muscle glycogen during 45 minute session of treadmill running(26 m/min, 8 % grade) were evaluated using Sprague Dawley rats, and the characteristics of the 4 different type of muscles, i, e., soleus, white and red gastrocnemius, and plantaris, on glycogen utilization were simultaneously investigated. Hyperglycemia was induced by 145-165 mg/dL of oral glucose administration, and hyperlipidemia was induced by combined treatment of intraperitoneal heparine injection of 444 uEq/L and 10 % intralipose oral adminstration. During the hyperglycemic trial, the glycogen utilization of plantaris muscle was decreased by 13% in 45 minute session of treadmill running compared to the control trial (p<0.05), and the glycogen utilization of white gastrocnemius was also decreased. The sparing tendency of glycogen was observed in soleus and red gastrocnemius by 5-13 % during 30 and 45 minute session of treadmill running in hyperglycemic trial. There was no glycogen sparing effect of hyperlipidemia in soleus, red gastrocnemius and plantaris muscle subjected in this experiment during exercise. However, only a slight sparing tendency of white gastrocnemius muscle was observed. In summary, the glycogen sparing effect of hyperglycemia during exercise was observed in plantaris and white gastrocnemius muscles in rats. However, there was no glycogen sparing effect of hyperlipidemia in the 4 hindlimb muscles. It was observed that the glycogen sparing effect of hyperglycemia is more prominent in fast glycolytic muscle fibers.

쇄골 골절의 지연된 골유합술 후 발생한 급성 쇄골하 가성동맥류 파열 -증례 보고-

손욱진 ( Oog Jin Shon ),김지훈 ( Jee Hoon Kim ),박강현 ( Kang Hyun Park ) 대한골절학회 2014 대한골절학회지 Vol.27 No.1

Subclavian vessels are well protected by muscles, fascia and sheaths, so vascular complications associated with clavicular fractures are rare. Pseudoaneurysms after clavicular fractures have been reported, and the occurrence or rupture of pseudoaneurysm has been reported rarely as a late complication. However, cases of pseudoaneurysm after rupture of the clavicular fracture following delayed osteosynthesis of the clavicular fracture have not been reported. A 58-year-old female that presented with a right clavicular shaft fracture obtained conservative treatment. Surgery was performed after 4 months because of non-union in the local medical center. After operation, rupture of the subclavian pseudoaneurysm occurred following osteosynthesis of the clavicular shaft fracture. We report this case here with a review of the 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.