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RISS 인기검색어
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- 저자 : 이규혁(Gyou-Hyouk Lee) (검색결과 4 건)
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골시멘트를 사용하지 않는 고관절 전치환술에서 미세 포말형 비구컵의 폴리에틸렌 라이너의 마모에 대한 연구
박상원,우경조,이규혁 고려대학교 의과대학 1997 고려대 의대 잡지 Vol.34 No.2
The debris of polyethylene liner in the acetabular cup is considered to be one of the important reasons for osteolysis and thus loss of fixation and later failure of total hip arthroplasty. The purpose of this study was to measure amount and rate of linear wear of the polyethylene liner of the porous-coated acetabular cup in cementless total hip arthroplsty. The authors devided the 101 cases into two groups according to with or without wear of polyethylene liner; Group Ⅰ (no wear group) and Group Ⅱ (wear group). The follow-up period was ranged from 24 months to 96 months, the average being 34.8 months in Group Ⅰ and 41.2 months in Group Ⅱ. The amount and rate of linear wear of the polyethylene liner in porous-coated acetabular cup were determined by a comparision of the thicknesses of the acetabular cup as measured on the postoperative two weeks and most recent follow-up radiographs. The measurements were corrected for radiographic magnification error by direct measurement of the femoral head diameter of the 28 mm on each radiographs. The patients in two groups to be matched for age, sex, body weight, size of the acetabular cup, duration of the follow-up, Harris hip score and degree of the osteolysis were analysed. The results obtained were as follows; 1. Sixty eight cases(67.3%) were wear of the polyethylene liner and 33 cases(32.7%) were not wear of the polyethylene liner 2. The linear wear were averaged 0.38±0.17mm(range, zero to 1.68) over-all, with a mean rate 0.13±0.09mm (range, zero to 0.84) per year. 3. The linear wear of group Ⅱ(wear group) were averaged 0.57±0.39mm, with 0.2±0.16mm per year. 4. The amount and rate of linear wear of the polyethylene liner of the acetabular cup has positive correlation with incidence of the osteolysis, duration of the follow-up and under 49 years of the age. 5. There was no relationship with the sex, body weight, size of the acetabular cup and Harris hip score. 6. The frequency of the osteolysis were higher in the femoral side than the acetabular side, with higher wear rate of the polyethylene liner. Because the rate of wear of the polyethylene liner is higher in younger age group, these patients should be followed more closely to mimimize the late complications, such as osteolysis and failure of total hip arthroplasty following to excessive wear of polyethylene liner.
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고령의 대퇴경부 골절에 시행한 골시멘트를 이용한 이극성 반치환성형술
박상원,변영수,이규혁,김종원 대한골절학회 1997 대한골절학회지 Vol.10 No.3
Elderly patients with femoral neck fracture often have other medical diseases, poor bone quality and poor compliance which make it more difficult to obtain satisfactory results after internal fixation. Therefore, prosthetic replacement is accepted as an appropriate treatment for elderly patients. The purpose of this study was to analize clinical results of cemented bipolar hemiarthroplasty in the femoral neck fractures of elderly patients. The authors analyzed thrity-seven patients with 38 fractures of the femoral neck older than 65 years of age who were treated with cemented bipolar hemiarthroplasty from Jan. 1991 to Dec. 1995. The average follow-up period was three years, ranged from one to five years. The functional results were evaluated according to the criteria of the Hams hip score. The results obtained were as follows: 1. The average Harris hip score was 84.6 points. ranged from 61 to 97 points. 2. The average pain score was 40.3 points. Twelve cases did not complain of pain, slight pain in 26 cases and mild pain in 2 cases. 3. The average limping gait score was 8.9 points. Twelve cases had no limping gait, slight limping in 25 cases and moderate limping in one case. 4. The average support score was 8.4 points. Seventeen cases could be walked without support, sixteen cases did use cane for long walk, two cases did use cane at full time, and three cases did use crutch. 5. Intraoperative complications were partial fracture of greater trochanter in 2 cases and one nondisplaced calcar fracture. 6. Postoperative complications were heterotopie ossification in 2 cases, dislocation of bipolar cup with proximal migration in 1 case and ipsilateral femur fracture below the tip of femoral stem in 1 case. Above results suggest that the cemented bipolar hemiarthroplasty for femoral neck fracture in elderly patients appears to be a method of treatment better than internal fixation for early ambulation and functional recovery.
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