거골의 골연골 병변의 원주형 생검에서 관절 연골과 연골하 골의 조직병리학적 변화

이호승,장재석,이종석,조경자,이상훈,정홍근,김용민,Lee, Ho-Seong,Jang, Jae-Suk,Lee, Jong-Suk,Cho, Kyung-Ja,Lee, Sang-Hoon,Jung, Hong-Keun,Kim, Yong-Min 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.2

Purpose: This study was aimed at elucidating the pathogenesis of talar osteochondral lesion by analyzing the histopathological findings. Materials and Methods: Twenty specimens from 20 patients who underwent surgical treatment for talus osteochondral lesions were studied. Preoperative MRI images including T1, T2, and stir images were taken and cases were classified according to modification of the Anderson's classification. There were 5 cases of MRI group 1, 6 cases of group 2, 7 cases of group 3 and 2 cases of group 4. A full thickness osteochondral plug including the osteochondral lesion of the talus was harvested from each patient and reviewed histopathologic changes of osteochondral fragment using H-E staining. Mean diameter of specimens was 8.5 mm and mean depth was 10.3 mm. Pathologic changes of articular cartilage and subchondral bone were observed. Subchondral bone was divided into superficial, middle and deep zones according to depth. Cartilage formation, trabecular thickening and marrow fibrosis were observed in each zone. Results: There were detachment of the joint cartilage at the tidemark in 16 cases of 20 cases and the separated cartilages were almost necrotic on the histopathologic findings. Cartilage formation within subchondral bone was discovered beneath the tidemark in 12 cases. Trabeculae were increased and thickened in 17 cases. These pathologic changes were similar to fracture healing process and these findings were more conspicuous near the tidemark and showed transition to normal bone marrow tissue with depth. No correlation between the pathological progression and MRI stages was found. A large cyst shown on MRI's was microscopically turned out to be multiple micro-cysts accompanied by fibrovascular structure and newly formed cartilage tissue. Conclusion: The histopathologic findings of osteochondral lesions are detachment of overlying cartilage at the tidemark and subsequent changes of subchondral bone. Subchondral bone changes are summarized as cartilage formation, marrow fibrosis and trabecular thickening that mean healing process following repeated micro fractures of trabecular. These osteochondral lesions should have differed from osteochondral fractures.

족저근막 파열의 임상양상

이호승,이종윤,정재중,Lee, Ho Seong,Lee, Jong Yoon,Jeong, Jae Jung 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.1

Purpose: The purpose of this study is to analyze the clinical features of plantar fascia rupture. Materials and Methods: We retrospectively reviewed 312 patients with plantar fasciitis between March 2008 and February 2013. We investigated age, sex, site, visual analogue scale (VAS), body mass index (BMI), characteristics of pain, awareness of rupture, and duration of symptoms. Acute rupture was defined as a rupture that occurred during exercise; chronic rupture was defined as a degenerative rupture after plantar fasciitis. We investigated the frequency of acute and chronic rupture. Results: Among 312 patients, 38 patients (12.2%) were diagnosed with plantar fascia rupture. Thirty-eight patients consisted of 14 men (36.8%) and 24 women (63.2%). The mean age of plantar fascia rupture was $58.29{\pm}12.54years$. The mean VAS score was 5.92 points (3~9 points). The mean BMI was $25.92{\pm}1.59kg/m^2$. Among the 38 patients, 2 patients had acute plantar fascia rupture and 36 had chronic plantar fascia rupture. In 34 patients-out of 36 chronic plantar fascia rupture, there were no subjective symptoms. Conclusion: Chronic rupture of the plantar fascia that occurred after plantar fasciitis was more common than acute rupture. Chronic rupture occurred at approximately 12% of patients treated with plantar fasciitis. In chronic rupture of the plantar fascia, there were no subjective symptoms of rupture. Therefore, we should doubt chronic rupture of plantar fascia when plantar fasciitis is prolonged.

무지 외반증에서 외측 연부 조직 유리술을 함께 시행한 원위 갈매기형 절골술의 치료 결과

이호승,지형철,이성우,김종민,Lee, Ho-Seong,Ji, Hyung-Chul,Lee, Sung-Woo,Kim, Jong-Min 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.2

Purpose: To evaluate the results and effectiveness of distal chevron osteotomy combined with lateral soft tissue release for the correction of hallux valgus deformity. Materials and Methods: 31 patients who underwent distal chevron osteotomy with lateral soft tissue release between July 2002 and June 2003, were analyzed in terms of hallux valgus angle, intermetatarsal angle, subluxation of sesamoid, AOFAS score and the occurrence of avascular necrosis of the first metatarsal head. Results: The mean amount of the correction of hallux valgus angle was $26.3^{\circ}$. The mean amount of the correction of intermetatarsal angle was $6.6^{\circ}$. The mean amount of the correction of sesamoid subluxation was 1.2 points. The mean improvement of AOFAS score was 25.8 points. Avascular necrosis of the first metatarsal head was not found in any cases. Conclusion: For correction of hallux valgus deformity, distal chevron osteotomy with lateral soft tissue release showed improvement of hallux valgus angle, sesamoid subluxation and AOFAS score with no evidence of avascular necrosis of the first metatarsal head.

테마파크의 라이드 어트랙션 디자인

이호승(Lee Ho-Seong) 한국디자인학회 2002 디자인학연구 Vol.- No.48

급성 아킬레스 건 파열의 개방적 봉합 후 조기 재활 치료의 결과

이호승 ( Ho Seong Lee ),김상우 ( Sang Woo Kim ),조우신 ( Woo Shin Cho ),정재중 ( Jae Jung Jeong ),이원재 ( Won Jae Lee ),진영수 ( Young Soo Jin ) 대한스포츠의학회 2009 대한스포츠의학회지 Vol.27 No.2

The purpose of this study was to evaluate the outcomes of surgical repair for acute Achilles tendon rupture with early motion exercise and early weight bearing. It is a retrospective study of 54 patients who underwent open repair and early rehabilitation for acute Achilles tendon rupture from January 2003 to June 2007. The average age was 40.5 years old and mean follow-up period was 20 months (12-63 months). A short leg splint was applied for an average of 14.7 days after open repair and then started motion exercise. The average duration of bracing with a ankle-foot orthosis was 7.1 weeks (5-9 weeks). We permitted partial weight bearing from 2 weeks postoperatively and full weight bearing from 4 weeks later after surgery. We assessed the outcomes using the following parameters; range of motion, single heel rasing test, calf circumference, Arner-Lindholm criteria. According to Arner-Lindholm criteria, 47 cases were grouped as excellent (87%), good in 7 cases (13%). Returning to pre injury work is possible from 42 days (27-70 days) after operation. Returning to sports activity is possible from 5.7 months (2-7 months) after operation. At the six months follow up, single heel raising was possible in every cases. Comparing to contralateral side, a little limitation of dorsiflexion was observed in 7 cases without functional limitations. Post operative complications were not found in any cases. Early joint motion exercise and early weight bearing after Achilles tendon repair showed good clinical outcomes and this treatment is recommendable.

혈청 음성 척추 관절증에서의 후족부 동통과 단순 후족부 동통 증후군과의 감별 진단

이호승(Ho-Seung Lee),원중희(Choong-Hee Won),김용민(Yong-Min Kim),최의성(Eui-Seong Choi),서중배(Joong-Bae Seo),이경배(Kyoung-Bae Lee),궁성수(Sung-Soo Koong) 대한정형외과학회 2001 대한정형외과학회지 Vol.36 No.4

화분 조각에 의한 열상 후 발생한 Scedosporium prolificans 감염증

이호승(Ho-Seung Lee),빈성일(Seong-Il Bin) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.4

Scedosporium prolificans는 주로 흙에서 기생하는 진균류로 흙과 관련된 감염시 반드시 의심해보아야 한다. Scedospo­rium prolificans에 의한 근 골격계 감염은 매우 드물며, 면역 능력이 저하되지 않은 경우에 진균에 의한 감염을 간과하기 쉬워 진단과 지화 지연되는 경우가 많다. 저자들은 화분 조각에 의한 슬관절의 열상 후 발생한 Scedosporium prolificans감염에 대하여 적절한 치료가 이루어지지 않고 간과 된 1예를 보고하고자 한다. Scedosporium prolificans is a fungus that can be found in soil or polluted water. It is mandatory to evaluate Scedosporium prolificans infection in case of injury by soil-contaminated materials. Musculoskeletal infections by Scedosporium prolificans are extremely rare and the clinical manifestations are similar to other bacterial infections. So it is difficult to detect Scedosporium prolificans infection. We report a neglected case with bone and joint infection by Scedosporium prolificans after joint laceration with a broken piece of flowerpot in a 10-year-old boy.

거골의 골 연골 병변

정재중,이호승,Jeong, J.J.,Lee, Ho-Seong 대한관절경학회 2009 대한관절경학회지 Vol.13 No.3

당뇨병성 족부 궤양의 치료

서동교,이호승,Seo, Dong-Kyo,Lee, Ho Seong 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.1

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

후족부 정렬의 새로운 방사선학적 평가 방법

한우연,이호승,김원경,안지용,Han, Woo-Yeon,Lee, Ho-Seong,Kim, Won-Kyeong,Ahn, Ji-Yong 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.3

Purpose: There are various methods proposed for the evaluation of the hindfoot alignment. However, due to structural calcaneus variances between patients, it is hard to assess this alignment definitively. Thus, this study proposes a new method for evaluating of the hindfoot alignment and its comparisons to the existing current methods. Materials and Methods: This study includes simple weight bearing hindfoot coronal view radiographs of 120 patients, taken between the time period of March 2008 to November 2009. Among the 120 patients, there was a 1:1 ratio of male to female with an average age of 40. The newly proposed method for evaluating this alignment is to draw a moment arm from the point where the sustentaculum tali meets the medial calcaneus border to the most prominent aspect of the lateral process of the calcaneal tuberosity. The angle produced via the intersection of this moment arm to the mid-longitudinal axis of the tibia is found and used to evaluate the hindfoot alignment. The inter and intra-observer reliability was evaluated using the coefficient of intraclass correlation. This study also investigates the comparisons between the newly proposed method to the traditionally used Saltzman et al hindfoot alignment evaluating technique. Results: The newly proposed method has higher inter and intra-observer reliability than the existing traditional Saltzman et al technique. Conclusion: This new method is recommended over the traditionally used Saltzman et al technique as it has a stronger confidence level and is appropriate for assessing hindfoot alignment in simple radiographs.