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술전 방사선학적 평가로서 Dorr씨 법에 의한 근위 대퇴골의 분류에 대한 고찰
손원용 ( WY Shon ),이석현 ( SH Lee ),서승우 ( SW Suh ),전승주 ( SJ Jeon ) 대한고관절학회 1995 Hip and Pelvis Vol.7 No.1
The suitability of femoral stem to proximal femur is essential to total hip arthroplasty, especially non-comented femoral stem. 7herefore, it is important to assess the bone quality and morphology of proximal femur preoperatively. We performed the radiographic evaluation of 120 normal Korean proximal femurs which were consist of 60 males and 60 females with age range from 20 years old to 80 years old. We obtained the both hip AP and lateral view from each person, who was supine position and applicated the brace which consistently made the both feet into 15 internal rotation and 15 abduction. Qualitatively, we classified the proximal femurs into type A, B, C and quantitatively calculated the calcar-to-canal isthmus ratio (CC ratio) on AP view and cortical index (CI) on AP and lateral view in the use of method reported by Dorr. The results were as follows: 1. Qualitatively, 47 proximal femurs were type A bones, 41 were type B bones and 32 were type C bones. 2. 7ype A bone had average CC ratio 0.61, CI on AP view 0.62 and CI on lateral view 0.58. Type B bone had average CC ratio 0.62, CI on AP view 0.49 and CI on lateral view 0.47. Type C bone had average CC ratio 0.68, CI on AP view 0.36 and CI on lateral view 0.43. 3. CFI (canal flare index) of each group were as follows: Type A: 4.325, Type B: 3.806, Type C: 3.16 4. Type A bone was more commonly seen in younger persons and had smaller CC ratio and larger CFI and type C bone was vice versa. The CC ratio and CFI showed significant inversional corre lationship statistically (r = -0.552. p<0.05) 5. Our study showed that preoperative radiographic evaluation for total hip arthroplasty needs not only quantitative assessment of proximal femur but also qualitative assessment because morpho logic endosteal geometry of proximal femur is not always correlated with the bone quality. On this point of view, radiological classification as described by Dorr was thought to be one of the useful method for preoperative radiological evaluation of total hip arthroplasty.
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장재석 ( JS Chang ),김용기 ( KY Kim ),이수호 ( SH Lee ),정종기 ( SJ Lee ),이석현 ( JK Jeong ) 대한고관절학회 1994 Hip and Pelvis Vol.6 No.2
We have isolated cells from the interface membrane between bone and implant to identify which cell was playing a role in the bone resorption. The interface membrane was made up of three layers of which foreign bodies and granulomas were identified and the foreign bodies were confirmed mostly to be the polyethylene by the polarized microsope. The morphology of the cultivated cells were variable; mononuclear cells were spindle or polygonal shape and giant cells were also identified. The giant cells were positive to TRAP reaction and negative to immunocytochemistry to CDllb and CD14 which shows same phenotype expression with osteoclasts. And they could make resorption pits on calcified bone slices. We have confirmed the bone resorption activity of the giant cells of interface membrane of which activity would persist as long as they exist, so adequate implant material and operative techniques are needed to eliminate these bone-implant interface membrane.
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