Hip & pelvis

  • 제22권1호
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  • Pages.58-65
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  • 2010
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
권호 표지

안정된 Harris-Galante 비구컵 주위의 골용해의 치료 - 비구컵 보존군과 재치환군 간의 비교 -

Management of Osteolysis around a Stable Harris-Galante Acetabular Cup - Retention vs Revision of the Acetabular Component -

  • 한승범 (고려대학교 의과대학 안암병원 정형외과) ;
  • 박종훈 (고려대학교 의과대학 안암병원 정형외과) ;
  • 경봉수 (고려대학교 의과대학 안암병원 정형외과) ;
  • 김태권 (고려대학교 의과대학 안암병원 정형외과) ;
  • 박상원 (고려대학교 의과대학 안암병원 정형외과)
  • Han, Seung-Beom (Department of Orthopedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University) ;
  • Park, Jong-Hoon (Department of Orthopedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University) ;
  • Kyeong, Bong-Soo (Department of Orthopedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University) ;
  • Kim, Tae-Kwon (Department of Orthopedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University) ;
  • Park, Sang-Won (Department of Orthopedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University)
  • 발행 : 2010.03.31
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 본 연구는 견고하게 고정된 무시멘트형 비구컵 주위에 발생한 골용해에 대해서 수술적으로 치료한 결과를 분석하고, 비구컵을 재치환하는 것과 비구컵을 유지한 채 골이식과 함께 폴리에틸렌 라이너만 교체하는 것에 대해 비교하였다. 대상 및 방법: 견고하게 고정된 무시멘트형 비구컵 주위에 발생한 골용해로 수술적 치료를 시행하고 2년 이상 추시가 가능하였던 30예를 대상으로 하였다. 비구컵을 보존하며 라이너만 교체한 경우가 7예, 비구컵을 재치환한 경우가 23예였다. 각군에서 비구컵의 크기, 폴리에틸렌 라이너의 두께, 비구부 골용해의 진행 정도, 치료 결과 등을 분석하였다. 결과: Harris 고관절 점수는 두 군 모두에서 향상되었다. 보존군에서는 평균 59.9개월 추시 시 7예 모두 안정적 고정을 보였고, 3예에서 국소적 골용해의 소견을 보였다. 재치환군에서는 평균 57.2개월 추시 시 무시멘트형 비구컵을 사용한 20예 모두 안정적 고정을 보였다. 결론: 견고하게 고정되어 있는 무시멘트형 비구컵 주위에 발생한 골용해의 치료로써 비구컵 재치 환술과 비구컵을 보존하며 골이식을 시행하는 방법 모두 만족스런 임상적 결과를 보였으나, 골용해가 광범위한 경우에는 잠금 기전의 손상이 없더라도 무시멘트형 비구컵으로 재치환하는 것이 보다 믿을 수 있는 방법으로 판단되었다.

Purpose: We analyzed and compared 30 clinical cases of acetabular osteolysis around a stably fixed acetabular cup, and this was managed by changing the liner along with retaining or revising the cup. Materials and Methods: We analyzed 30 patients who underwent acetabular component revision or retention with a bone graft for osteolysis around a stably fixed Harris-Galante acetabular cup and these patients were followed up for more than 2 years. There were 7 cases with a conserved the acetabular cup and only the liner was changed, and 23 cases with a totally revised acetabular component. We compared the size of the acetabular cup, the thickness of the polyethylene liner, the progression of osteolysis and the clinical outcomes. Results: The Harris hip score was improved in both groups. In the retention group, during an average of 59.9 months of follow up, 7 cases showed stable fixation and 3 cases showed locally advanced osteolysis. In the revision group, during an average of 57.2 months of follow up, all 20 cementless acetabular cups showed stable fixation. Conclusion: We suggest that in patients with osteolysis around the stable cementless acetabular cup, both methods show satisfactory clinical outcomes. But considering recurrence of osteolysis, cup revision is more reliable than changing the liner with a bone graft.

키워드

참고문헌

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