대한관절경학회지 (Journal of the Korean Arthroscopy Society)
- 제6권2호
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- Pages.161-170
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- 2002
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- 1226-9352(pISSN)
거골 박리성 골 연골염의 관절경적 치료
Arthroscopic Treatment of Osteochondritis Dissecans of the Talus
- Choi, Chong-Hyuk (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
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Cheon, Yong-Min
(Department of Orthopaedic Surgery, Yonsei University College of Medicine)
- 발행 : 2002.12.01
초록
목적 : 관절경을 이용한 거골 박리성 골연골염의 단순 절제술 후 그 결과를 알아보고 이차 관절경을 통하여 결손 부위의 육안 및 조직학적 변화를 알아보고자 하였다. 대상 및 방법 : 관절경으로 유리체 및 괴사 골 조직을 제거한후 출혈되는 기저부를 남겨두고 치료한 22예를 대상으로 하였으며, 임상적 및 기능적 평가를 하여 수술의 유용성을 알아보았다. 7예에서 이차 관절경을 술 후 3개월에서 8년 사이에 시행하여 병변 부위의 관찰 및 타 부위의 이차적인 병변을 관찰하였으며, 생검을 시행하여 결손부 재생 조직에 대한 조직학적 검사를 시행하였다. 추시 관찰은 평균 42개월(14개월
Purpose : To investigate arthroscopic simple excision for the treatment of osteochondritis dissecans of the talus and to examine gross change and histological evaluation of the defect through second look arthroscopy. Materials and Methods : This study included twenty-two patients who had osteochondritis dissecans of the talus that was treated with excision of arthroscopic loose body and necrotic bone tissue, leaving bleeding bed. In 7 cases, we performed second look arthroscopic examination for the evaluation of gross change of defects and histologic findings. Final results were evaluated with two clinical and functional protocols. Average follow up period was 42 months from 14 months to 8 years. Results : Ankle-hindfoot score (100 point) was improved significantly (p<0.003). Subjective and functional scores (100 points) averaged 82 points. The defect of lesion had a tendency of filling with fibrous tissue and fibrocartilage. Although the defect was filled with fibrocartilage, specific secondary lesion was not detected through second look arthroscopic examination. Conclusion : Arthroscopic debridement was an effective method for the treatment of osteochondritis dissecans of the talus without progression of secondary lesion even though the defect was filled with fibrocartilage.