• Title/Summary/Keyword: 골 소파술

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Treatment of Simple Bone Cyst in Calcaneus with Endoscopic Curettage and Autologous Bone Graft - Case Report - (종골에 발생한 단순 골낭종의 내시경적 소파술 및 골 이식술 - 증례 보고 -)

  • Jung, Gu-Hee;Kim, Jae-Do;Kim, Ji-Youn
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.182-186
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    • 2008
  • Simple bone cysts are common, benign bone tumor and for the treatment, curettage with bone grafting, resection and intralesional steroid or autogenic bone marrow injections were usually performed. Simple bone cysts of the calcaneus are relatively uncommon and curettage with autologous bone grafting were proposed for management rather than intralesional steroid injections. We would like to report 9 year-old male with calcaneal simple bone cyst treated satisfactorily by minimally invasive endoscopic curettage and autologous bone grafting with review of the relevant literature.

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The Treatment of the Benign Bone Tumor by Curettage and Fresh Frozen Allograft (양성 골 종양의 절제 및 소파술 후 사용한 신선 동결 동종골 이식의 결과)

  • Jung, Sung-Taek;Bae, Bong-Hyun;Lim, Keun-Young;Kong, Il-Kyu
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.62-70
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    • 2005
  • Purpose: We compared the time how much time spent until the bone unions, when we grafted fresh frozen allograft during therapy of benign bone tumor depends on the degrees of bony unions. Materials and Methods: This study selected 29 cases, in which a curettage on the benign bone tumors was conducted and a fresh frozen allograft was transplanted. The area of the focus, the new bone formation, the recurrence of the focus and complications in the plain radiographs were observed. Results: The average time when we could find out bony unions in the radiographs is eleven weeks. The time when we could observe the unions in the radiographs are 11.4 weeks in allograft group, 10.7 weeks in allograft and autograft groups and 13.6 weeks in allograft and bone substitute. On radiologic findings, the average lesion size is 40 cm3. The time when we could find bony unions are 9.3 weeks in less than 40 $cm^3$ and 12.9 weeks in more than 40 $cm^3$. We could observe recurrences in two cases. Conclusion: The authors could get the similar results between fresh frozen allograft, allograft and autograft after curettage of benign bone tumor. We can think the ideal method which is the transplantation of autograft, but if we can’t get autograft enough, the best way which heal the defects is the transplantation of fresh frozen allograft.

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Recurrence Analysis of Giant Cell Tumor after Curettage and Cementation (거대 세포종에서 골 소파술 및 시멘트 충전술 후의 재발 분석)

  • Hahn, Soo-Bong;Lee, Won-Jun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.71-78
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    • 2004
  • Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

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Treatment of Intraosseous Ganglion of the Talus with Hindfoot Endoscopy - A Case Report - (후족부 내시경술을 이용한 거골내 결절종의 치료 - 증례 보고 -)

  • Kim, Sung Yoon;Lee, Woo Chun
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.52-55
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    • 2012
  • An intraosseous ganglion typically exists in periarticular epiphysis or subchondral area, and is usually treated with open curettage of cyst or curettage and bone graft. We report a case of intraosseous ganglion of talus treated by endoscopic curettage and bone grafting with a review of the literature.

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The Analysis and Treatment of Benign Bone Tumor by Curettage and Debridement with Bone Graft Substitutes (양성 골종양의 절제 및 소파술 후 사용한 골이식 대체물의 결과 및 분석)

  • Jung, Sung-Taek;Seo, Hyoung-Yeon;Seon, Jong-Keun;Lee, Jae-Joon;Kim, Seung-Sik
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.139-147
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    • 2003
  • Purpose: The purpose of this study was to determine if bony union can be obtained when a bone graft substitute is transplanted in order to treat a benign bone tumor and if there is a difference between calcium sulfate and hydroxyapatite in the healing procedure when the degree of the bony union after the bone graft are compared. Materials and Methods: This study selected 20 cases, in which a curettage on the benign bone tumors was conducted and a bone graft substitute was transplanted. The area of the focus, the new bone formation, the recurrence of the focus in the plain radiographs and histological findings were observed. Results: Twenty cases (13 males, 7 females) were evaluated. Their mean age at surgery was 15.8 years (2~45), and the mean follow-up period was 3 years. The mean area of focus was 30.7 $cm^3$ in the radiographs, and 19 cases showed successful results in the ultimate visit, while 1 case has a recurrence of the focus. Conclusion: Calcium sulfate has osteoconduction and superior bioavailability, and is absorbed in vivo in proportion to the new bone formation. On the other hand, hydroxyapatite has good osteoconduction. It can result in better bone formation when it is combined with an autologous bone graft, autologous bone marrow, and an allogenic bone graft, but is absorbed in vivo more slowly than the former.

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The Effect of Platelet-Rich Plasma on Allograft Transplantation after Curettage in Benign Bone Tumor (양성 골 종양의 소파술 후 실시한 동종골 이식에서 혈소판 풍부 혈장 투여의 효과)

  • Kim, Jae-Do;Kim, Ji-Youn;Jang, Su-Jin;Chung, So-Hak;Jung, Gu-Hee
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.8-13
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    • 2010
  • Purpose: This study was performed to evaluate the effi ciency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. Materials and Methods: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. Results: The mean size of lesion was 33.5 $cm^3$ (range, 2.3-181.9 $cm^3$) (29.4 $cm^3$ in PRP group and 40.2 $cm^3$ in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. Conclusion: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.

Allogeneic Inlay Cortical Strut Grafts for Large Cysts or Post-curettage Cavitary Bony Defects (거대 낭종성 골병소 또는 소파 후 잔유 골 결손부에 시행한 내재형 동종 피질 지주골 이식술)

  • Chung, Yang-Guk;Kang, Yong-Koo;Kim, Chol-Jin;Lee, An-Hi;Park, Jeong-Mi;Bahk, Won-Jong;Yoo, Hyun-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.73-78
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    • 2011
  • Purpose: This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones. Materials and Methods: Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months. Results: Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up. Conclusion: Inlay cortical strut graft provided additional mechanical stability and bone stock for screw purchase in large cyst or cavitary defects of long bones, which allow early mobilization and excellent functional outcome.

Treatment of Giant Cell Tumor Around Knee - by Intralesional Excision Using High Speed Burr and Methylmethacrylate - (슬관절 주변에 발생한 거대세포종의 치료 - 고속 바(High-Speed Burr)와 골 시멘트를 이용한 병소 내 절제술 -)

  • Park, Jong-Hoon;Lee, Soo-Yong;Jeon, Dae-Geun;Cho, Wan-Hyung;Song, Won-Seok;Kim, Jin-Wook;Koh, Han-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.160-167
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    • 2005
  • Purpose : Distal femur and proximal tibia are the common sites affected by giant cell tumor of bone. There are a variety of treatment modality including wide excision and intralesional curettage. We evaluated the local recurrence rates and the post-operative functional scores of giant cell tumors around knee joint and investigated the identification of possible prognostic factors for recurrence. Materials and Methods: We reviewed 41 patients pathologically confirmed as giant cell tumors around knee joint that have undergone intralesional curettage using high-speed burr and methylmethacrylate. We evaluated the recurrence rate and post-surgical functional score and possible prognostic factors for recurrence, such as, gender, age, tumor location, size, subchondral invasion, intra-articular invasion and the Campanacci Grades. Mean follow up period was 50 (12-122) months. Results: The recurrence rate was 17% and mean recurrence onset was 10 months postoperatively. According to Musculoskeletal Tumor Society (MSTS) functional evaluation system, the average score was 27.8(93%) and 78% had excellent function. According to our study, suspected prognostic factors revealed not significant for recurrence. Conclusion: We found no significant recurrence related factors. Intralesional excision with high-sped burring and PMMA provides a low recurrence rate, similar to others in the literature, and good functional scores.

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Grade I and II Chondrosarcoma of the Humerus (상완골에서 발생한 Grade I 및 Grade II 연골육종 - 증례 보고 -)

  • Cho, Wan-Hyeong;Jeon, Dae-Geun;Park, Jong-Hoon;Song, Won-Seok;An, Joon-Hwan;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.131-135
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    • 2006
  • Chondrosarcoma can be divided into grade I, II and III by histological finding and a relationship between the prognosis and the histological grading has been identified. Although the surgical treatment of grade II and III chondrosarcoma necessitates wide resection margin, there has been controversy about curettage versus wide resection in case of grade I chondrosarcoma. The authors report a case of grade I chondrosarcoma of proximal humerus and grade II chondrosarcoma of distal humerus with good oncological and functional result through curettage and wide resection respectively.

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Metastasising Recurrent Giant Cell Tumor - A Case Report - (폐 전이를 일으킨 재발성 거대세포종 - 증례 보고 -)

  • Kim, Tae-Seung;Park, Jun-Sic
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.73-79
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    • 2001
  • Giant cell tumor is usually found around the knee joint, especially in the distal femur or proximal tibia. Despite being classified as benign, it has unusual biological behavior of local aggressiveness and tend to have severely destructive lesion and develop rare pulmonary metastasis. Therefore, when the patient is presented to the physician with an expansile lytic lesion of challenging clinicopathologic entity extending to subchondral bone, the physician faces up to difficulties in treatment. We report a case of 25 years old patient having recurrent giant cell tumor in the right distal femur which developed metastasis to lung. The primary bone lesion was treated with local curettage and fillings with methylmethacrylate, but when he returned to the hospital two years later, the recurrence had developed with lung metastasis.

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