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대퇴 사두건을 이용한 관절경적 이중 다발 전방 십자 인대 재건술
김성재,정광암,송대흡,Kim, Sung-Jae,Jung, Kwang-Am,Song, Dae-Heup Korean Arthroscopy Society 2005 대한관절경학회지 Vol.9 No.2
Recently, the interest on anatomical ACL reconstruction with double bundle technique is increased to reproduce the original load distribution, and kinematics of the knee. We developed an arthroscopic double bundle ACL reconstruction technique using autogenous quadriceps tendon with 2 splitted graft and patellar bone plug. The anteromedial bundle and posteolateral bundle of the ACL is replicated with each splitted graft of quadriceps tendon and fixed with biodegradable interference screw on the 2 femoral tunnels. The patellar bone plug of quadriceps tendon is fixed with biodegradable interference screw within the 1 tibial tunnel. We suggest that our technique using quadriceps tendon may be an alternative in arthroscopic double bundle ACL reconstruction.
인공 슬관절 및 고관절 전치환술후 ESR , CRP 의 변화
김세동,이동철,정광암,백승희 대한슬관절학회 2001 대한슬관절학회지 Vol.13 No.1
Purpose: To study the changes of ESR and CRP after total hip arthroplasty(THA) and total knee arthroplasty(TKA). Material and Methods: We tested the values of ESR and CRP of total 61 patients, who received THA or TKA. The levels of ESR and CRP were compared before operation, on the 2nd, 4th post-op. Day, 1st, 2nd, 3rd week after operations. Results: The peak level of ESR was reached on the 4th post-op day(70.7mm/hr) in unilateral TKA group, but on the 7th day(53.2mm/hr) in bilateral group. The peak level of ESR was reached on the 4th day in unilateral THA group(71.5mm/hr), as was in bilateral group(50.6mm/hr). The values of ESR were declined to the normal range until the 3rd week except 9 cases(15%). The peak level of the CRP of TKA(14.0mg/dL, 15.0mg/dL) and THA(12.7mg/dL, 17.7mg/dL) in unilateral and bilateral group were reached on the 2nd day after operations. After the peak level, the values of CRP were abruptly declined to the normal and pre-op level until the 3rd week. Conclusion: The highest value of the CRP revealed on the 2nd post op day in bilateral group and declined to the normal range at 2nd week. The peak value of the ESR showed on the 4th post-op day, but the peak value of the bilateral group was low and the range of increase was narrow when compared with the unilateral group. The value of CRP after post-op 2 weeks could be used as the index of normal and infection in TKA or THA.
안면환,신덕섭,정광암,하정옥,Ahn, Myun-Hwan,Shin, Duk-Seop,Jung, Kwang-Am,Hah, Jeong-Ok 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.3
Ewing's sarcoma is an uncommon malignant neoplasm of the long bone and it has a poor prognosis due to its early metastasis and aggressive local spread. It is mostly found before the age of 30 and it is rare in extraskeletal sites. Extraskeletal Ewing's sarcoma has been reported to occur in various sites including the larynx, scalp, nasal fossa, neck, chest wall, lung, pelvis, perineum, arm, finger, leg and toe, but it is extremely rare as a primary epidural tumor of the spine. We experienced a case of extraosseous epidural Ewing's sarcoma arising in the lumbar spinal canal at L3-L5 level in a 9-year-old boy. Following total laminectomy from L3 to L5 with a lumbar vertebrae and mass excision, he received chemotherapy with complete remission.
퇴행성 슬관절 골관절염 환자에서 골다공증 치료의 국내 건강보험 심사평가원과 FRAX® 기준에 대한 비교 연구
이수찬,남창현,윤지열,정광암,황보현,안혜선 대한정형외과학회 2012 대한정형외과학회지 Vol.47 No.5
Purpose: To compare and evaluate any differences in the osteoporosis treatments of elderly patients with degenerative osteoarthritis of the knee joints, in accordance with the Korean Health Insurance Review & Assessment Service (HIRA) criteria versus the World Health Organization (WHO) fracture risk assessment tool (FRAX®, http://www.shef.ac.uk/FRAX/) criteria, which is a fracture risk assessment tool developed by the WHO. Materials and Methods: From June 2010 to March 2011, we investigated and screened the target populations of osteoporosis treatments among 65-year-old or older patients with degenerative osteoarthritis of the knee joints who scheduled to undergo elective total knee arthroplasty. They were classified in the treatment group only if they met either the HIRA criterion, defined as having a T score of ≤−2.5 points, or the FRAX® criteria, defined as the 10-year probability of a major osteoporotic fracture and hip fracture of ≥20% or ≥3%, respectively. Results: Of a total of 929 patients, the number of patients included in the treatment group as screened according to the HIRA or FRAX® criteria was 562 (60.5%) and 372 (40.0%), respectively. The number of patients who met both criteria was 339 (36.5%), and including 334 non-treated patients (36.0%), a total of 673 patients (72.4%) showed low diagnostic concordance (k=0.471). Of 319patients diagnosing osteopenia, 33 (10.3%) patients were included in the treatment group according to the FRAX® criteria. Conclusion: A combination of the HIRA and FRAX® criteria is required to improve the current guidelines for osteoporosis treatment. 목적: 고령의 퇴행성 슬관절 골관절염 환자를 대상으로 국내 건강보험 심사평가원(Health Insurance Review & Assessment Service, HIRA) 기준과 세계보건기구 fracture risk assessment tool (FRAX®, http://www.shef.ac.uk/FRAX/)에서의 골절 확률을 바탕으로 한 골다공증 치료 대상의 차이를 비교, 평가하고자 한다. 대상 및 방법: 2010년 6월부터 2011년 3월까지 퇴행성 슬관절 골관절염으로 인공관절 전치환술 시행예정인 65세 이상의 환자를 조사하였다. 치료 대상은 국내 HIRA 기준, T 점수 -2.5 이하이거나 FRAX® 기준의 10년 주요 골다공증 골절 확률 20% 및 대퇴골절 확률 3% 이상으로 정하였다. 결과: 929명 환자 중 골다공증 치료 대상은 국내 HIRA 기준 562명(60.5%), FRAX® 기준 372명(40.0%)이었다. 두 기준 모두 치료 대상으로 만족하는 경우는 339명(36.5%)으로, 비치료 대상 334명(36.0%)을 포함하여 673명(72.4%)의 낮은 진단 일치도를 보였다(κ값=0.471). 골감소증 319명 환자 중 33명(10.3%)은 FRAX® 기준의 치료 대상으로 분류되었다. 결론: 골다공증을 진단하고 치료함에 있어 국내 HIRA 기준에 FRAX®를 반영한 적정 치료 지침에 대한 보완이 필요하다.
퇴행성 슬관절 골관절염 환자에서 골다공증 치료의 국내 건강보험 심사평가원과 FRAX<SUP>®</SUP> 기준에 대한 비교 연구
이수찬(Su Chan Lee),남창현(Chang Hyun Nam),윤지열(Ji Yeol Yoon),정광암(Kwang Am Jung),황보현(Bo Hyun Hwang),안혜선(Hye Sun Ahn) 대한정형외과학회 2012 대한정형외과학회지 Vol.47 No.5
목적: 고령의 퇴행성 슬관절 골관절염 환자를 대상으로 국내 건강보험 심사평가원(Health Insurance Review & Assessment Service, HIRA) 기준과 세계보건기구 fracture risk assessment tool (FRAX<SUP>®</SUP>, http://www.shef.ac.uk/FRAX/)에서의 골절 확률을 바탕으로 한 골다공증 치료 대상의 차이를 비교, 평가하고자 한다. 대상 및 방법: 2010년 6월부터 2011년 3월까지 퇴행성 슬관절 골관절염으로 인공관절 전치환술 시행예정인 65세 이상의 환자를 조사하였다. 치료 대상은 국내 HIRA 기준, T 점수 -2.5 이하이거나 FRAX<SUP>®</SUP> 기준의 10년 주요 골다공증 골절 확률 20% 및 대퇴골절 확률 3% 이상으로 정하였다. 결과: 929명 환자 중 골다공증 치료 대상은 국내 HIRA 기준 562명(60.5%), FRAX<SUP>®</SUP> 기준 372명(40.0%)이었다. 두 기준 모두 치료 대상으로 만족하는 경우는 339명(36.5%)으로, 비치료 대상 334명(36.0%)을 포함하여 673명(72.4%)의 낮은 진단 일치도를 보였다(κ값=0.471). 골감소증 319명 환자 중 33명(10.3%)은 FRAX<SUP>®</SUP> 기준의 치료 대상으로 분류되었다. 결론: 골다공증을 진단하고 치료함에 있어 국내 HIRA 기준에 FRAX<SUP>®</SUP>를 반영한 적정 치료 지침에 대한 보완이 필요하다. Purpose: To compare and evaluate any differences in the osteoporosis treatments of elderly patients with degenerative osteoarthritis of the knee joints, in accordance with the Korean Health Insurance Review & Assessment Service (HIRA) criteria versus the World Health Organization (WHO) fracture risk assessment tool (FRAX<SUP>®</SUP>, http://www.shef.ac.uk/FRAX/) criteria, which is a fracture risk assessment tool developed by the WHO. Materials and Methods: From June 2010 to March 2011, we investigated and screened the target populations of osteoporosis treatments among 65-year-old or older patients with degenerative osteoarthritis of the knee joints who scheduled to undergo elective total knee arthroplasty. They were classified in the treatment group only if they met either the HIRA criterion, defined as having a T score of ≤?2.5 points, or the FRAX<SUP>®</SUP> criteria, defined as the 10-year probability of a major osteoporotic fracture and hip fracture of ≥20% or ≥3%, respectively. Results: Of a total of 929 patients, the number of patients included in the treatment group as screened according to the HIRA or FRAX<SUP>®</SUP> criteria was 562 (60.5%) and 372 (40.0%), respectively. The number of patients who met both criteria was 339 (36.5%), and including 334 non-treated patients (36.0%), a total of 673 patients (72.4%) showed low diagnostic concordance (k=0.471). Of 319 patients diagnosing osteopenia, 33 (10.3%) patients were included in the treatment group according to the FRAX<SUP>®</SUP> criteria. Conclusion: A combination of the HIRA and FRAX<SUP>®</SUP> criteria is required to improve the current guidelines for osteoporosis treatment.