스포츠 손상에서의 비구순 파열

Acetabular Labral Tear in Sports Injury

목적: 스포츠손상에의한비구순파열환자에서진단및치료에대해고찰해보고자하였다. 대상및방법: 1995년3월부터2000년1월까지스포츠손상후발생한고관절통으로본원에내원한환자에서비구순파열로진단된15예를대상으로하였다. 원인별로달리기5예, 격투기3예, 에어로빅3예, 수영2예, 등산1예, 자전거 1예등이었다. 남자가6명, 여자가9명이었고, 나이는 평균41세였다. 모든 환자는6개월간격으로 추시하였고, 보존적 치료를 시행한 경우최소2년 이상 투약 및 증세관찰을 하였고, 관절경적 수술을 시행한6예에서 수술 전, 수술 후 6개월과 12개월에 Harris Hip Score (이하HHS)를측정하였고, JOA pain scoring system에의해결과를평가하였다. 결과: 보존적치료를 시행한9예에서 HHS는 평균 15점 향상되었고, 그중 4예는 1단계의 통증 지수 향상이 있었는데, 이들 모두Czerny 분류상type IA였다. 관절경적수술을 시행한6예에서수술후 HHS는 32점향상되었고, 6예모두에서2단계이상의통증지수향상이관찰되었다.결론: 스포츠손상환자에서급,만성고관절통을호소하는경우비구순파열은반드시감별진단되어야하며, 이학적검사상의심이될경우자기공명관절조영술을이용한진단이유용할것으로사료된다. 확진이된경우관절경을이용한파열된비구순의변연절제술이효과적인치료방법으로생각된다.

Purpose: The purpose of this study is to evaluate diagnosis and treatment of acetabular labral tears in sports injuries. Materials and Methods: From March 1995 to January 2000, We treated 15 patients with acetabular labral tear by sports injuries. There were 6 men and 9 women. Mean age was 41 years old. Running injuries are 5 cases, fighting 3, aerobic exercise 3, swimming 2, climbing 1, bicycle 1. For conservative treatment, we performed medication and observation at least for 1 year. For the patients with arthroscopic surgery, we performed Harris Hip Score (pain and function) preoperatively and postoperatively at 6, 12 months, and evaluated patient’s pain by JOA pain scoring system and postoperative subjective satisfaction. Results: The mean score of HHS improved 15 points with conservative treatments and 32 points with hip arthroscopy. In 4 cases of conservative treatment, there was 1 scale improvement of JOA pain scoring system. In arthroscopic partial labrectomy, all cases were improved to more than 2 scale. Conclusion: We considered that acetabular labral tears occurred associated with sports injuries. So it is important to be interested in enthusiastic diagnosis and appropriate treatment for hip pain caused by sports injuries, especially about acetabular labral tears.