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황정모,계범진,김태현 대한화학회 2015 Bulletin of the Korean Chemical Society Vol.36 No.1
Terminally crosslinked, highly sulfonated poly(arylene ether sulfone) (csPES) block copolymers with a network structure were prepared by heat-induced crosslinking of the allyl-terminated telechelic sulfone polymers using a bisazide. The block copolymers in different hydrophilic and hydrophobic compositions were fully characterized by 1H NMR. With their highly sulfonated block copolymer structure and terminally crosslinked network, the crosslinked polymer membranes offered excellent proton conductivity under high and low relative humidity, together with hydrolytic, dimensional, and thermal stability.
황정모,황득수,강찬,이우용,이기수,이정길,김윤기 대한정형외과학회 2019 Clinics in Orthopedic Surgery Vol.11 No.3
Background: Patients with extraspinal diffuse idiopathic skeletal hyperostosis (DISH) involving the hip joint have symptoms like femoroacetabular impingement (FAI). To date, no reported study has determined the clinical outcomes of arthroscopic treatment in extraspinal DISH involving the hip joint. Methods: A total of 421 hips with FAI that underwent arthroscopic treatment were reviewed retrospectively. We determined the extraspinal involvement of DISH with three-dimensional computed tomography (3D-CT) and simple radiography of the pelvis and hip joint. Clinical outcomes were evaluated at a minimum of 2 years postoperatively. The visual analog scale score (VAS), modified Harris hip score (MHHS), and hip outcome score–activity of daily living scale (HOS-ADL) were used, and hip range of motion (ROM) was evaluated pre- and postoperatively and at the time of the final follow-up. Results: Among the 421 hips (372 patients) with FAI that underwent arthroscopic treatment, 17 hips (12 patients, 4.04%) had extraspinal DISH on the hip joints. The mean age of the patients was 51.5 years. The 3D-CT scans and simple radiographs showed extraspinal DISH on multiple points around the pelvis and hip joint. Nine of the 17 hips (seven of 12 patients) had spinal DISH. At the final follow-up, VAS, MHHS, and HOS-ADL improved significantly from 6.5, 65.3, and 66.6, respectively, to 1.2, 87.8, and 89.5, respectively, and hip flexion and internal rotation improved significantly from 97.7° and 7.9°, respectively, to 117.1° and 18.2°, respectively. Conclusions: This study has demonstrated that extraspinal DISH involving the hip joint could lead to FAI, and arthroscopic treatment could result in relief of symptoms, including pain and ROM limitation, in extraspinal DISH patients.
대퇴 비구 충돌에서 골성형술 후 대퇴부 Cam형 병변의 형태학적인 변화 관찰
황정모(Jung-Mo Hwang),황득수(Deuk-Soo Hwang),노창균(Chang-Kyun Noh),정룡(Long Zheng),유창현(Chang-Hyun Yoo) 대한정형외과학회 2018 대한정형외과학회지 Vol.53 No.4
목적: 본 연구는 대퇴 비구 충돌(femoroacetabular impingement, FAI) 증후군으로 고관절 관절경 수술 후 최소 2년 추시에서 3-dimensional computed tomography (3D-CT)를 이용하여 cam형 변형의 형태학적인 변화와 임상 양상을 분석하였다. 대상 및 방법: 2007년 2월부터 2014년 3월까지 FAI로 진단받고 고관절 관절경 수술을 받은 환자 중 3D-CT를 이용한 추시가 가능하였던 환자를 대상으로 후향적으로 분석하였다. 수술 전, 후 촬영된 3D-CT를 이용하여 대퇴 융기부 제거술을 시행한 형태학적인 범위에 대한 정량적 측정 및 방사선적 알파각과 대퇴 두경부 오프셋을 측정하였고 이를 임상적 결과와 비교하였다. 결과: 총 32명의 환자, 37예를 대상으로 하였고 평균 연령은 31.2세(16-69세), 평균 추시 기간은 47.3개월 (26-119개월)이었다. 알파각은 수술 전 평균 59.6° (52.0°-69.5°), 수술 후 평균 39.8° (31.1°-52.4°), 최종 추시에서 평균 43.1° (32.5°-54.0°)로 측정되었다. 수술 후와 최종 추시에서 알파각은 통계적으로 유의한 차이를 보이지 않았다(p>0.05). 대퇴 두경부 오프셋은 수술 전 평균 8.2 mm (3.6-10.2 mm), 수술 후 평균 11.7 mm (10.1-13.0 mm), 최종 추시에서 평균 11.0 mm (8.4-12.7 mm)를 보였다. 수술 후와 최종 추시에서 두경부 오프셋도 통계적으로 유의한 차이를 보이지 않았다(p>0.05). 3D-CT를 이용한 수술 후 측정된 cam형 변형의 제거 면적은 평균 48.9 mm² (13.2-106.4 mm²)로 최종 추시에서의 평균 37.9 mm² (7.83-90.37 mm²)와 일부 차이가 있었으나 이는 통계적으로 유의하지는 않았다(p>0.05). 임상 평가는 모든 항목에서 통계적으로 유의한 호전을 보였다(p<0.05). 결론: FAI 시 관절경을 이용한 대퇴 융기부 절제술 후 최종 추시에서 cam형 변형의 저명한 재발은 없었고 이와 연관된 임상 증상의 호전을 확인하였다. 이는 관절경을 이용한 대퇴 융기부 제거술은 낮은 재발률과 훌륭한 임상 결과를 보이는 것으로 각생된다. Purpose: We evaluated the morphologic change of cam lesion of femoroacetabular impingement (FAI) using 3-dimensional computed tomography (3D-CT) at the minimum 2-year follow-up and estimated its relationship with clinical outcomes. Materials and Methods: Between February 2007 and March 2014, all patients who underwent hip arthroscopic femoroplasty under the impression of FAI were retrospectively evaluated. We selected patients who received 3D-CT and were followed-up for more than 2 years. We estimated the quantitative volume of femoroplasty, alpha angle and femoral head-neck offset using 3D-CT. Results: Thirty-two patients (37 cases) were selected in our study. The mean age was 31.2 years (16–69 years) and the mean follow-up duration was 47.3 months (26–119 months). The mean resection volume measured after femoroplasty using 3D-CT was 48.9 mm² (13.2–106.4 mm²), and follow-up mean resection volume was 37.9 mm2 (7.83–90.37 mm²). A little bit of the mean volumatic overgrowth of the resection area between immediate postoperative and last follow-up was shown; however, there was no statistically significant difference in the mean values (p>0.05). The clinical outcomes showed a significant improvement during the perioperative and follow-up periods in all categories (p<0.05). Conclusion: There was no significant regrowth of cam lesion after femoroplasty for FAI at maximum 9 years. Moreover, in most cases, clinical outcomes were improved. This suggests that we were able to achieve good clinical outcomes without harmful anatomical regrowth of cam deformity using arthroscopic femoroplasty.
Arthroscopic Treatment of Symptomatic Internal Snapping Hip with Combined Pathologies
황득수,황정모,김필성,이성민,박승환,강수용,하용찬 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.2
Arthroscopic iliopsoas tendon release was introduced in 2000. The purpose of this study was to evaluate clinical outcomes of arthroscopic iliopsoas tendon release for painful internal snapping hip with concomitant hip pathologies. Methods: Between January 2009 and December 2011, we performed arthroscopic iliopsoas tendon release and related surgeries in 25 patients (20 men and 5 women; mean age, 32 years; range, 17 to 53 years) with combined intraarticular hip pathologies. The patients were followed for a minimum of 2 years postoperatively. Clinical and radiological evaluations were performed. Results: Snapping sounds had disappeared by the 2-year follow-up in 24 of the 25 patients. All patients who had presented with loss of flexion strength postoperatively showed recovery at postoperative week 6 to 10. Harris hip score improved from 65 points (range, 46 to 86 points) preoperatively to 84 points (range, 67 to 98 points) postoperatively (p < 0.001). Seven hips (28%) had an excellent score, 15 hips (60%) a good score, 2 hips (8%) a fair score, and one hip (4%) a poor score (p < 0.001). The Tonnis grade of osteoarthritis did not change in any of the patients at the last follow-up. Conclusions: Patients with painful internal snapping hip have combined hip pathologies. Therefore, the surgeon should keep in mind that painful internal snapping hips are frequently combined with concomitant intraarticular pathologies.
Usefulness of the Medial Portal during Hip Arthroscopy
강찬,황득수,황정모,PARK EUGENE JAE JIN 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.3
The current conventional portals for hip arthroscopic surgery are the anterior, anterolateral, and posterolateral portals. For lesions in the medial anteroinferior or posteroinferior portion of the hip, these portals provide insufficient access to the lesion and consequently lead to incomplete treatment. Thus, in such a situation, a medial portal approach might be helpful. However, operators have avoided this procedure because of the risk of injury to the obturator, femoral neurovascular structures, and the medial femoral circumflex artery. Thus, to overcome the disadvantages of the conventional method for medial lesions of the hip, we performed a cadaveric study to evaluate the technique, usefulness, and risk of the medial portal technique.
강찬,황득수,황정모,송재황,신병건,박종화,Kang, Chan,Hwang, Deuk-Soo,Hwang, Jung-Mo,Song, Jae-Hwang,Shin, Byung-Kon,Park, Jong-Hwa 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.3
Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.
Pathological Fracture of the Femoral Neck due to Tophaceous Gout: An Unusual Case of Gout
Yoo-Sun Jeon,황득수,황정모,Jeong-Kil Lee,박용철 대한고관절학회 2019 Hip and Pelvis Vol.31 No.4
A 48-year-old man visited the emergency room with right hip pain that started abruptly while walking out of the bathroom. Computed tomography showed an intraosseous mass in the femoral neck. The patient had a 15-year history of gout and had numerous bilateral tophi in his hands, feet, knees, and elbows. After operation, we diagnosed a pathological fracture due to intraosseous tophi. Patients with hip pain who have many subcutaneous tophi and long-standing gout should be diagnosed carefully. Peri-hip joint pain caused by gout is uncommon, however, if a patient complains of pain, a simple X-ray may be required. If intraosseous tophi are present, appropriate treatment (e.g., strict hyperuricemia control with or without prophylactic internal fixation), may be required before fracture occurs.