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슬관절 전방 십자 인대 재건술 후 발생한 이식 건의 일과성 석회화 - 증례 보고 -
정현기,최충혁,김종헌,김재영,Chung, Hyun Kee,Choi, Choong Hyeok,Kim, Jong Heon,Kim, Jae Young 대한관절경학회 1999 대한관절경학회지 Vol.3 No.1
30세의 남자환자로 자가 슬개골 건을 이용한 전방 십자 인대 재건술 후 이식건에 발생한 일과성 석회화 1례를 보고 하고자 한다. 환자는 양측 절개술의 관절경하 전방 십자 인대 재건술을 시행 받았으며 술 후 6개월 방사선 필름 상, 이식 건 주위로 석회화 음영이 나타났으며 술 후 13개월 석회화 음영이 사라졌다. 술 후 2개월 Lachman 검사와 pivot shift 검사에서 음성을 보였으며. KT-1000 Arthrometer 검사 상 20 Ibs에서 건측과 1mm의 차이를 보였으나, 술 후 6개월에 이식 건 주위로 석회화 음영이 나타났을 때는 경도의 전방 불안정성이 관찰되었으며, 이후 석회화 음영이 없어지면서 슬관절의 전방 불안정도 회복되었다. We report the case of a 30-year-old man who was presented with transient calcification on the graft shortly after anterior cruciate ligament(ACL) reconstruction using a autogenous bone patellar tendon. The patient underwent ACL reconstruction with two incisional technique and six month later, calcific density was seen radiologically around the graft. On postoperative 13 months follow-up radiographic films, the calcific density disappeared. After two months of operation, Lachman and pivot shift test were negative and one millimeter side to side difference was detected in KT-1000 with 20 Ibs strength. But 6 months after the reconstruction, mild anterior instability was detected with the calcific density around the grafted tendon. However the anterior stability was recovered according to the disappearance of calcific density.
정현기,최충혁,김종헌,송상준,Chung, Hyun Kee,Choi, Choong Hyeok,Kim, Jong Heon,Song, Sang Jun 대한관절경학회 1998 대한관절경학회지 Vol.2 No.2
The arthroscopic ACL reconstruction using the bone-patellar tendon-bone has been considered as the gold standard in the treatment of the ACL insufficiency. There are many reports about the good functional outcome and the restored stability of the knee joint. But there are a few reports showing whether this surgery has good results in the patients' satisfaction. The purpose of this study is to evaluate the patients' satisfaction in this surgery. Authors analysed 32 cases who had taken the ACL reconstruction from Jannuary, 1989 to June, 1997. The average follow-up was 40 months. At the last follow-up, 32 patients reported the patients' satisfaction degrees(four degrees; very satisfied, generally satisfied, improved, no change or aggravated), KT-1000 arthrometer test, Vastus atrophy(thigh circumference), and three kinds of the knee scores(Lysholm, HSS, IKDC). Among the 32 cases, 12 cases (37.5%) were very satisfied, 17 cases(53.1%) were generally satisfied and 3 cases(9.4%) were improved. No case showed no change or aggravated. The satisfaction degree in this surgery had little relation with the age, operation time, follow-up period, combination of meniscectomy, but had significant relations with anteroposterior stability evaluated by KT-1000, thigh circumference measurements and the functional scoring of the knee(Lysholm, HSS, IKDC scores).
전방 십자 인대 재건술시 대퇴 터널의 위치에 대한 방사선학적 평가
정현기,최충혁,이중학,Chung, Hyun Kee,Choi, Choong Hyeok,Lee, Joong Hak 대한관절경학회 1998 대한관절경학회지 Vol.2 No.1
The isometric position for the graft is important in the anterior cruciate ligament reconstruction surgery. It is well known that the femoral position is more critical than tibial side. But, there is few deciding method of proper graft position after the anterior cruciate ligament reconstruction surgery. So we planned to evaluate the ideal femoral isometric position with 6 adult cadavaric femurs and exact radiographs. After the insertion of femoral interference screw on ideal isometric position, we obtained roentgenograms of true lateral view and 10, 20, 30, 45 degree internal and external rotation views. Then we measured the shortest distance from the posterior cortical margin of lateral femoral condyle to posterior border of interference screw on the radiographs. We also measured true distance between posterior cortical margin of lateral femoral condyle to the posterior margin of femoral tunnel after cutting of distal femur. Based on this study, we could not determine the permissible rotation degree of radiographs. But we concluded that if the distance between posterior cortical margin of lateral femoral condyle and posterior border of interference screw ranges 4.5-6.5mm on the lateral view, the femoral position is considered as a relatively ideal isometric good position.