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인공 고관절 전치환술의 최소 침습 수술법

Minimally Invasive Surgical Technique for Total Hip Arthroplasty

  • 윤택림 (전남대학교 의과대학 화순전남대학교병원 정형외과학교실) ;
  • 박경순 (전남대학교 의과대학 화순전남대학교병원 정형외과학교실) ;
  • 문재영 (전남대학교 의과대학 화순전남대학교병원 정형외과학교실)
  • Yoon, Taek-Rim (Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Park, Kyung-Soon (Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Moon, Jae-Young (Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School)
  • 발행 : 2011.09.30

초록

최근 정형외과 영역의 여러 분야에서 최소 침습 수술이 대두되고 있으며, 인공 고관절 전치환술에서도 여러 술자들이 최소 침습 술식을 이용한 고관절 전치환술을 시행해 왔다. 그러나 최근에는 최소 침습이라는 용어보다는 최소 절개 술식이라는 용어가 적합하다는 주장들이 주류를 이루며, 최소 침습 수술 시 수술 시야가 좋지 않고 이로 인해 삽입물이 제대로 위치하지 않을 가능성 및 그에 따른 탈구와 신경 손상 등의 합병증이 증가할 수 있다고 보고되고 있다. 최소 절개 술식의 성공 요소로 가장 중요한 것은 적합한 환자의 선택이며, 또한 적절한 적응증에서의 수술 시행 및 정확한 수술 술기의 습득이 필요하다. 또한 충분한 고관절 수술 경험이 있는 시술자가 알맞은 수술 기구의 구비 후 시행하는 것이 중요할 것으로 판단된다.

Minimally invasive surgery is commonly used in a range of orthopedic fields with many surgeons employing minimally invasive techniques for total hip arthroplasty. Some surgeons, however, have recently suggested that the term 'mini-incision' is more correct than 'minimally invasive'. Many studies have reported the increased malposition of implants and complications, such as dislocations and nerve injury, in minimally invasive surgery due to the compromised visualization of the surgical field. Patient selection with the proper indications is of utmost importance for the success of minimally invasive total hip arthroplasty. In addition, selection of the correct surgical technique is essential. Furthermore, the procedure should be performed by an experienced surgeon with the appropriate surgical instruments.

키워드

참고문헌

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