• Title/Summary/Keyword: 골연골 이식술

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Mosaicplasty for the Treatment of the Chondral Defect of the Knee (슬관절의 연골결손에 대한 자가 골연골 이식술)

  • Choi, Nam-Hong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.12-17
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    • 2005
  • Several methods to resurface the lost cartilage of the knee have been used, multiple drilling, microfracture, abrasion arthroplasty Resurfaced cartilages resulting from above techniques are mostly fibrocartilage. Autologous osteochondral graft transfer and autologous chondrocyte transfer are known to resurface the lost cartilage with mostly hyaline cartilage. This article reviews basic researches, indications, operative technique, and clinical results of autologous osteochondral graft transfer.

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Mosaicplasty for The Treatment of the Chondral Defect of The Knee (슬관절의 연골결손에 대한 자가 골연골 이식술)

  • Choi, Nam-Hong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.147-153
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    • 2008
  • Several methods to resurface the lost cartilage of the knee have been used; multiple drilling, microfracture, abrasion arthroplasty. Resurfaced cartilages resulting from above techniques are mostly fibrocartilage. Autologous osteochondral graft transfer and autologous chondrocyte transfer are known to resurface the lost cartilage with mostly hyaline cartilage. This article reviews basic researches, indications, operative technique, and clinical results of autologous osteochondral graft transfer.

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연골 결손의 치료

  • Lee, Beom-Gu;Sim, Jae-Ang
    • 대한관절경학회:학술대회논문집
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    • 2009.10a
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    • pp.165-169
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    • 2009
  • 연골 결손은 자체 치유 능력이 적어 그 크기가 1 cm 이상인 경우 골관절염이 발생할 수 있다. 최근에는 3-tesla MRI 등의 발전으로 인해 수술 전에 미리 연골 손상을 정확히 진단할 수 있어 연골 손상의 치료를 더욱 적극적으로 할 수 있다. 이제까지 연골 손상에 대한 수술적 치료는 세척술(lavage) 및 변연 절제술(debridement), 미세 천공술(microfracture), 자가 골연골 이식술(autologous osteochondral graft), 자가 연골 세포 이식술(autologous chondrocyte implantation, ACI), 동종 골연골 이식술(osteochondral allograft)이 있다.

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Current Concepts of Osteochondral Lesions of Talus (거골 체 골연골 병변에 대한 최신 지견)

  • Park, Y.W.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.27-32
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    • 2007
  • 골연골 병변에 관한 논문들을 살펴본 결과, 연구 방법, 각기 다른 치료 방법에 의해 얻어진 결과가 상당한 가변성을 보였다. 현 시점에서 골연골편 제거술 및 병변의 변연 절제와 천공술 그리고 자가 골연골 이식술 등이 가장 널리 이용되고 있으며 효과적인 치료 방법으로 사료된다. 그러나 가장 적절한 치료 수단이 무엇인지에 대한 명확한 결론을 유추하기 위해서는 무작위 임상 실험과 동일한 연구 방법에 의한 결과 측정의 비교가 우선되어져야 할 것으로 사료된다.

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Autogenous Osteochondral Grafts for the Osteochondritis dissecans of the Knee (슬관절 박리성 골연골염에 대한 자가 골연골 이식술)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chun Shun-Wook;Seo Ji-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.142-148
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    • 2003
  • Purpose: This study was performed to evaluate the operative results of osteochondritis dissecans treated with autogenous osteochondral grafts. Materials and Methods: From May 1990 to May 2000, this study included 13 patients, 17 cases treated with autogenous osteochondral grafts. The mean age of patients at operation was 23.4 years (range,20 to 32 years), all cases were men, and the mean follow-up was for 24.2 months (range, 12 to 110 months). Treatment was done by open or arthroscopic method using with Osteochondral Autograft Transfer System (OATS, Arthrex, USA). Results: Trauma history existed in all cases, and major trauma history in 7 cases, and minor repetitive in 10 cases. The involved sites of lesion were medial femoral condyle in 11 cases, in which extended classic site was 9 cases, inferocentral site was 2 cases, and lateral femoral condyle in 6 cases, in which all cases were inferocentral site. Magnetic resonance imaging (MRI) staging was stage II in 1 case, stage III in 11 cases, stage IV in 5 cases, and arthroscopic staging was stage III in 12 cases, stage IV in 5 cases. The mean lesion size was 3.19$cm^2$ (range, 1 to 8$cm^2$). Clinical results evaluated with grading system by Aichroth, were excellent in 3 cases (18$\%$), good in 11 cases (65$\%$), moderate in 2 cases (12V), poor in 1 case (5$\%$), which revealed satisfactory results in 83$\%$. Congruent articular surface, satisfactory articular thickness, and no loosening or subsidence was evidenced by follow-up MRI or arthroscopic finding. Conclusion: Autogenous osteochondral grafts can be an alternative treatment in lesions larger than 1$cm^2$ in size, unstable lesion, and involvement of weight-bearing articular surface. Long term follow-up will be needed for the final efficacy of autogenous osteochondral grafts.

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Second look Arthroscopic finding after Osteochondral Autogenous Graft Transfer for the Chondral defect of the Knee (연골결손에 대한 자가 골연골 이식 수술 후 이차 관절경 소견)

  • Choi Nam-Hong;Kwak Ho-Yoon;Song Baek-Yong;Bae Sang-Wook;Lee In-Mook;Kim Woo-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.99-103
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    • 2001
  • Purpose : The purpose of this prospective study was to evaluate second look arthroscopic finding after osteochondral autograft transfer(OAT) for the treatment of the chondral defect of the knee. Materials & Methods : Fourteen out of forty cases underwent second look arthroscopy after the OAT for the treatment of the chondral defect of the knee. The average age of patients was 34 years. Preoperatively, magnetic resonance imaging was performed in eleven cases and chondral defect was confirmed in nine cases. The site of the chondral defect located at medial femoral condyle at seven, trochlea in four, and lateral fomoral condyle in three cases. The average size of the condral defect was $13\times10mm$, maximum $22\times20mm$. The number of graft was one in eight, two in three, three in two, and five in one case. The average follow-up period was twenty-one months. Second look arthroscopy was performed at six months in almost cases. Results : After the OAT, $86\%$ of cases showed that the consistency of grafted cartilage was firm and $93\%$ of cases showed that grafted cartilage was well incorporated with surrounding cartilage. Conclusion : The results of this study suggest that OAT can be one of treatment modality in the chondral defect of the knee.

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Osteochondral Lesion of the Talus (거골의 골연골 병변)

  • Lee, K.B.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.19-26
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    • 2007
  • 최근에 스포츠 손상이 증가하고 관절경을 이용한 치료가 발전하면서 조기에 더 적극적인 치료를 하는 추세이다. 또한 방사선 소견에 비하여 관절경하에서는 연골이 불안정하거나 분리되어 있는 경우도 있으므로 기존의 수술 적응증보다는 좀 더 광범위하게 관절경 검사 및 수술적 치료가 요구된다고 생각한다. 치료 방법을 하면 $1.5cm^2$ 이하의 병변을 가진 50세 이하의 환자는 관절경을 이용하여 변연 절제술, 연골하 천공, 연마, 미세 골절술, 소파술 등의 방법으로 치료할 수 있다. 같은 방법으로 50세 이상의 $3cm^2$ 이하의 병변을 가진 환자 중 mosaicplasty와 자가 연골 세포 이식술을 적용할 수 없는 환자에서 시도해볼 수 있다. $1.5\sim3cm^2$의 병변을 가진 50세 이하의 환자, 그전의 관절경적 치료로 실패한 경우에는 자가골 연골 이식 또는 자가 연골 세포 이식술을 이용하여 치료해야 한다. $3cm^2$ 이상의 병변을 가진 50세 이하의 환자는 자가 연골 세포 이식술이나 동종 골 연골 이식을 이용하여 치료하며, 50세 이상의 환자는 관절 고정술이나 족근 관절 인공치환술을 고려하는 것이 바람직하다.

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