Treatment of Schatzker Type V and VI Tibial Plateau Fractures Using a Midline Longitudinal Incision and Dual Plating

조계열,오현섭,유재호,김덕현,김강일,조영주 대한슬관절학회 2013 대한슬관절학회지 Vol.25 No.2

Purpose: The purpose of this study was to evaluate the results of the treatment of Schatzker type V and VI tibial plateau fractures using a midline longitudinal incision and dual-plate fixation. Materials and Methods: Ten patients with Schatzker type V and VI tibial plateau fractures treated with a midline longitudinal incision and dual plating were analyzed. The patients were followed for a minimum of one year. Clinical outcomes were evaluated using range of motion, visual analogue scale (VAS) and Knee Society Score. Radiological outcomes were evaluated using the bony union time, medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA). Results: The mean VAS score was 2.2 points, and the mean Knee Society function score was 85 points at the final follow-up. The mean flexion contracture was 2.5o and the mean further flexion was 125o. It took an average of 4 months until bony union occurred. The mean MPTA and PPTA were 90.5o and 4.4o, respectively. There was one case of delayed wound healing, but no other complications were observed. Conclusions: The treatment of Schatzker type V and VI tibial plateau fractures with a midline longitudinal incision and dual-plate fixation resulted in satisfactory clinical and radiological outcomes. This can be an option when treating Schatzker type V and VI tibial plateau fractures.

Does Cruciate-Retaining Total Knee Arthroplasty Show Better Quadriceps Recovery than Posterior-Stabilized Total Knee Arthroplasty? - Objective Measurement with a Dynamometer in 102 Knees

조계열,김강일,송상준,Dae Kyung Bae 대한정형외과학회 2016 Clinics in Orthopedic Surgery Vol.8 No.4

Background: Cruciate-retaining (CR) prostheses have been considered to produce more physiologic femoral rollback, provide better proprioception, and result in better quadriceps recovery than posterior-stabilized (PS) prostheses after total knee arthroplasty (TKA). However, there are very few studies demonstrating these benefits in an objective manner. We investigated whether CR-TKA could result in (1) better quadriceps recovery; (2) a greater proportion of patients with beyond the preoperative level of recovery; and (3) better clinical outcomes than PS-TKA. Methods: This was a prospective non-randomized comparative study on the results of CR-TKA and PS-TKA. CR prostheses were used in 51 knees and PS prostheses in 51 knees. Quadriceps force was measured with a dynamometer preoperatively and at postoperative 6 weeks, 3 months, and 6 months consecutively. The Knee Society score (KSS) and range of motion (ROM) were also evaluated. Results: There were no differences between two groups in terms of the objective quadriceps force during the follow-up period. The proportion of patients with beyond the preoperative level of recovery was similar between groups. Moreover, the KSS and ROM were not significantly different between two groups. Conclusions: CR-TKA did not result in better quadriceps recovery than PS-TKA during the 6-month follow-up. In other words, PSTKA could lead to comparable quadriceps recovery despite greater preoperative weaknesses such as more restricted ROM and more severe degenerative changes of the knee.

견관절 강직을 동반한 회전근 개 파열의 관절경적 봉합술

조남수,조계열,이용걸 대한견주관절의학회 2006 대한견주관절학회 학술대회논문집 Vol.2006 No.5

인삼 유래 성분들의 항염증 약리 효능

김주영,조계열,Kim, Joo-Young,Cho, Jae-Youl 고려인삼학회 2007 고려인삼연구와 산업 Vol.1 No.2

슬관절 전치환술 후 발생한 삽입물 주위 골절 시 슬관절 재치환술을 이용한 치료법

김강일,조계열,강동근 대한골절학회 2011 대한골절학회지 Vol.24 No.4

Compartment Syndrome Following Total Knee Arthroplasty: Clinical Results of Late Fasciotomy

박철희,이승혁,강동근,조계열,이상학,김강일 대한슬관절학회 2014 대한슬관절학회지 Vol.26 No.3

Compartment syndrome after total knee arthroplasty (TKA) is a rare complication. Because of its rarity, it may be overlooked and misdiagnosed as peroneal nerve palsy or deep vein thrombosis. This misdiagnosis could have a profound impact on the patient’s outcome. We report a case of a 77-year-old female who developed unilateral compartment syndrome in the calf after staged bilateral TKA at an outside clinic. The patient presented with medical complications related to compartment syndrome: rhabdomyolysis and myoglobinuria, which caused acute renal failure. Thus, we performed late fasciotomy one week after symptom onset to debride necrotic tissue and salvage the compartment. In the discussion section, we will discuss risk factors for compartment syndrome after TKA, results of late fasciotomy and other indications for surgical treatment of compartment syndrome.

컴퓨터 시스템을 이용한 고관절 치환술

김강일 ( Kang Il Kim ),유기형 ( Kee Hyung Rhyu ),조계열 ( Kye Youl Cho ),허대석 ( Dae Seok Huh ) 대한고관절학회 2011 Hip and Pelvis Vol.23 No.4

Despite the overall satisfactory results of total hip arthroplasty, post-operative complications continue to occur. To minimize these problems, computer-assisted total hip arthroplasty using navigation or robot-assisted systems is being developed. A navigation system is defined as a system that locates a position in three-dimensional space and traces the target spot, and a robot-assisted system is defined as a system that performs operations automatically with mechanical robot arms based on prior preoperative planning. Computer-assisted surgeries have shown superior results to conventional methods in implant positioning, fixation, and accurate lower extremity alignment in the limited reports available. However, computer-assisted surgeries take longer compared to conventional methods. Due to the extra time needed, the risk of postoperative infection and blood loss is considered to be higher. Nevertheless, robot-assisted system is being developed for the field of hip arthroplasty, and thus its efficacy and accuracy needs to be further investigated. Since these methods have other advantages compared to conventional methods, they are the focus of much interest.

고관절 대수술 후 심부 정맥 혈전증의 발생 빈도와 D-dimer의 진단적 유용성

유명철(Myung Chul Yoo),조윤제(Yoon Je Cho),김강일(Kang Il Kim),임양진(Yang Jin Im),조계열(Kye Youl Cho),류경남(Kyung Nam Ryu) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.1

목적: 고관절 대수술 후 발생하는 심부 정맥 혈전증의 발생빈도와 D-dimer 검사의 유용성을 검토하여 혈전증 조기진단 의 가능성을 알아보고자 한다. 대상 및 방법: 2003년 5월부터 2004년 8월까지 289명의 환자를 대상으로 전향적으로 조사하였다. 모든 환자에서 술전 B-mode 초음파 검사를 시행하였고 술 후 7-10일 사이에 하지 정맥 조영술이나 초음파 검사를 시행하여 혈전증 유무를 판단하였다. D-dimer 검사는 술 전 및 술 후 제3일과 7일에 시행하였다. 결과: 총 29예(10.1%)에서 심부 정맥 혈전증이 발생하였고, 60세에서 69세 사이에서는 28.8%에서 발생하였다. 술 전 측정한 환자들의 D-dimer 수치는 평균 0.60 ㎍/㎖였으며 술 후 제3일에 DVT (-) 환자군에서 평균 2.26 ㎍/㎖, DVT(+) 환자군에서 평권 3.82 ㎍/㎖였고 술 후 제7일에 각각 평균 2.89 ㎍/㎖, 5.19 ㎍/㎖로 모두 유의하게 증가하였다. 술 후 제3일과 7일에 심부 정맥 혈전증을 예측할 수 있는 최적의 D-dimer 수치는 각각 2.585 ㎍/㎖와 3.625 ㎍/㎖였다. 결론: 한국인에서 고관절 대수술 후 심부 정맥 혈전증은 서양에 비해 발생 빈도가 낮은 양상을 보였으나, 연령이 증가할수록 심부 정맥 혈전증의 발생빈도가 의미 있게 증가하였다. 또한 D-dimer 검사는 술 후 제7일에 3.625 ㎍/㎖를 기준으로 하여 심부 정맥 혈전증의 선별검사로 이용할 수 있을 것으로 사료된다. Purpose: To evaluate the incidence of deep vein thrombosis (DVT) after major hip surgery along with the efficacy of the D-dimer as a routine noninvasive - screening test for DVT. Materials and Methods: From May 2003 to August 2004, 289 patients who underwent major hip surgery were evaluated prospectively. All the patients underwent B-mode ultrasonography (US) preoperatively, and venography or US on postoperative 7 to 10 days. The D-dimer level was also estimated preoperatively, and at 3 and 7 days after surgery. Results: The preoperative D-dimer level was an average 0.60 ㎍/㎖. DVT was encountered in 29 patients (10.1%) and in 28.9% of those over 60 years of age (p<0.05). Three days after surgery, the average D-dimer level was 3.82 ㎍/㎖ in the DVT positive patients and 2.26 ㎍/㎖ in the DVT negative patients. Seven days after surgery, the average D-dimer level in the DVT positive and negative patients was 5.19 ㎍/㎖ and 2.89 ㎍/㎖. The most predictable D-dimer level for DVT 3 and 7 days after surgery were 2.585 ㎍/㎖ and 3.625 ㎍/㎖, respectively. Conclusion: The overall incidence of DVT in our patients undergoing major hip surgery seemed lower than in Western populations. However, there was a significantly increasing tendency if the development of DVT in the older age group. We also recommend a D-dimer assay at postoperative 7 days as a valuable screening test for detection of DVT.