• Title/Summary/Keyword: 관절내 주입법

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Accuracy of the Glenohumeral Joint Injection According to the Approach (도달 방법에 따른 관절와상완 관절내 주사의 정확도)

  • Choi, Nam Yong;Lee, Kang Wook;Kim, Hyung Seok;Song, Hyun Seok
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.45-52
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    • 2013
  • Purpose: We wanted to compare the accuracy between the blind anterior approach and ultrasound guided posterior approach, which are preferred in the present clinical practice for the glenohumeral joint injection. Materials and Methods: The consecutive 95 cases were included in that the glenohumeral joint injection was done in the university hospital and the medical record and ultrasonography were available. There were 52 cases which were injected by blind anterior approach (group I) and 43 cases who were injected by ultrasound guided posterior approach (group II). The injection was decided as accurate if the fluid was visualized in the posterior joint under the ultrasound. We evaluated the range of motion before and after 2 weeks of injection. A subjective satisfaction of the patients was interviewed at the 2 weeks after injection. Results: The accuracy of the glenohumeral joint injections of the group I and group II was 80.8% and 90.7%, respectively. The range of motion was improved for the all cases regardless of the approaches. At the 2 weeks after injection, the subjective satisfaction (better than good) was achieved in 73.7%. Conclusion: The accuracy of the blind anterior approach for the glenohumeral joint injection was 80.8%. The accuracy of the ultrasound guided posterior approach was 90.7%. In this comparative study by the one physician, the ultrasound guided posterior approach showed the better accuracy.

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Accuracy and Clinical Outcomes of Ultrasound-guided Glenohumeral joint Injection: Acromioclavicular Approach in Patients with Adhesive Capsulitis (초음파를 이용한 견관절 관절강내 주사의 정확성과 임상적 결과: 유착성 관절낭염 환자의 견봉 쇄골 접근법)

  • Lhee, Sang-Hoon;Hwang, Seok-Min
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.9-14
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    • 2012
  • Purpose: The purpose of the study was to evaluate the accuracy and clinical outcome of ultrasound-guided glenohumeral joint steroid injection on adhesive capsulitis. Materials and Methods: Patients who were diagnosed as adhesive capsulitis by MRI and physical examination and did not improve their symptom with physical therapy and NSAIDS treatment more than 6 months were included in the study. Patients who showed any other shoulder pathology or history if trauma were excluded from the study. 33 patients including 15 males and 18 females were enrolled in the study, the average age being 55.1 (age 42~72). Cocktail of steroid, lidocaine, saline and contrast medium injected inside shoulder glenohumeral joint using novel approach (which we called acromioclavicular approach) under ultrasound guidance. Clinical outcome was measured through passive range of motion and VAS scoring system. Results: Based on radiographic findings, cases were classified according to the leakage of contrast medium; perfect confinement of contrast-medium inside the capsule, partial leakage of the medium and contrast-medium found at outside the joint. Total 25 cases (76%) out of 33 cases showed perfect confinement of contrast-medium inside the glenohumeral joint. Partial leakage was observed in 6 cases (18%), and contrast medium was observed outside of the glenohumeral joint in 2 cases (6%). Perfect-confinement group showed $111^{\circ}$($80{\sim}140^{\circ}$) of forward flexion and $48^{\circ}$($0{\sim}90^{\circ}$) of external rotation before injection, and improved to $134^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($30{\sim}90^{\circ}$) of external rotation after injection (p<0.01). Partial leakage showed $120^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($10{\sim}90^{\circ}$) of external rotation before injection, and improved to $139^{\circ}$($135{\sim}140^{\circ}$) of forward flexion and $78^{\circ}$($50{\sim}90^{\circ}$) of external rotation after injection (p<0.01). VAS score improved from 7.1 (score 3~9) to 2.6 (score 0~5) (p<0.01) in perfect confinement group, from 7.5 (score 7~9) to 3.3 (score 2~4) (p<0.01) in partial leakage group. Two group showed no significant difference. Conclusion: Accuracy of Acromioclavicular approach was 94% which is better than any other methods published so far. Partial leakage of the injection material did not show inferior result compared to perfect injection.

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PERFORATION OF THE TEMPOROMANDIBULAR JOINT MENISCUS: DIAGNOSED BY MAGNETIC RESONANCE IMAGING (MAGNETIC RESONANCE IMAGING을 이용한 악관절 원판 천공 진단)

  • Kim, Houng-Gon;Dolan, Eward;Vogler, James B.;Nokes, Steven R.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.11-18
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    • 1989
  • Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders, however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using intrarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging(MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective review of fifteen patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging pre-operatively demonstrated a sixty-five percent correlation between the radiographic diagnosis and the surgical findings.

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Effect of Knee Joint Stimulation on the Activity of Phrenic Nerve and Inspiratory Nuron in the Cat (슬관절 자극이 횡격신경 및 흡식중추신경에 미치는 영향)

  • Cho, Dong-Ill;Han, Hee-Chul;Nahm, Sook-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.683-693
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    • 1993
  • Background: During movement the major inputs to nervous system come from firstly the muscle and joint to maintain posture and motion and secondly the chemoreceptors and baroreceptors to adjust the cardiovascular and respiratory function. Their complex relationships are generally studied for many years but the direct relation between the joint and respiratory system is not studied thoroughly until now. So this experiment was performed to determine whether the natural movement of knee joint can cause the enhancement of respiratory function by observation of the changes of respiratory rate, phrenic nerve activity and inspiratory neuron activity during the stimulation of knee joint in cat anesthetized with $\alpha$-chloralose. Method: Twenty six male adult cats were used and the extracelluar recording using bipolar platinum electrode and carbon filament electrode was done to record the changes in the activities of phrenic nerve and inspiratory neuron movement of knee joint, injection of chemicals into the joint cavity and electrical stimulation of articular nerve were done. Results: The 60 Hz. could not but 120 Hz. flexion-extension movement of knee joint increased respiratory rate(R.R.), tidal neural activity(TNA) and minute neural activity(MNA). Intra-articular injection of lactate could not increase R.R. but significantly increase TNA and MNA which represented the enhanced respiratory function. Injection of potassium chloride showed similar effects with the case of lactate but the duration of effect was shorter. The electrical stimulation of medial articular nerve with IV strength which could activate only group I and II afferents showed increased TNA and MNA during stimulation but 20 V stimulation which could activate all the afferents increased all the respiratory parameters. The changes of inspiratory neuron activity by knee joint stimulation was similar to that of phrenic nerve. Conclusion: The respiratory center could be directly stimulated by the activation of group I and II articular afferents and it seemed that the magnitude of the respiratory center enhancement is proportional to the amount of sensory information from the knee joint. These facts might suggest that the respiratory function could be enhanced even by the normal movement of knee joint.

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A Comparison Study on Animal Models for Osteoarthritis in Temporomandibular Joint (측두하악관절에서의 골관절염 유도 동물모델 비교연구)

  • Yu, Sun-Nyoung;Yi, Young-Chul;Park, Hae-Ryoun;Ryu, Mi-Heon;Jeon, Hye-Mi;Kim, Kwang-Youn;Kim, Sang-Hun;Ok, Soo-Min;Ko, Myung-Yun;Ahn, Yong-Woo;Ahn, Soon-Cheol;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.261-271
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    • 2011
  • Osteoarthritis in patients with temporomandibular disorders(TMDs) induces pain, limitation of mouth opening, occlusal problems, and most commonly affects their life quality. Control method and progressive process of osteoarthritis are being extensively researched. The researchers focus on histologic changes, synovial changes, muscular and ligamental changes and observed reaction to pain. Therefore most of them developed the animal model for osteoarthritis in TMD patients. In this study, we applied several methods which induces osteoarthritis of temporomandibular joint(TMJ) in rats or mice. For locally induce osteoarthritis in TMJ, Monosodium iodoacetate(MIA) or interleukin-$1{\alpha}$(IL-$1{\alpha}$) were injected into TMJ joint space for 5 or 3 weeks. Other groups are chosen for osteoarthritis under systemic control including hormonal changes and aging. To observe cellular change, increased collagen, degenerative bony destruction and distribution of proteoglycans (PGs), safranin-O staining and Masson's trichrome staining were used.

The effect of steroid for fibrous dysplasia of the humerus combined with multiple cystic lesion (낭종성 병변을 동반한 상완골의 섬유성 골이형성증에서 steroid의 효과 - 증례 보고 -)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bo-Hyun;Won, Jung-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.20-26
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    • 2002
  • Fibrous dysplasia is a benign pathologic condition in which the normal cancellous bone is replaced by the fibro-osseous tissue. It is found mostly in the femur, tibia, skull, rib, and humerus. Clinically it may develops pain, progressive deformity, and pathologic fracture. Curettage with bone graft has been the most popular treatment method thesedays. A 17-year-old female who had fibrous dysplasia of the humerus combined with multiple cystic lesion was treated by intralesional steroid injection into the lesion total 2 times. The follow-up plain X-ray which was taken 11 months after steroid injection reveals decrease in size and increase in bone density and cortex thickness. The follow-up MRI reveals significant decrease in size and signal intensity. The signal intensity was decreased to that of normal bone marrow in T2 weighted image. She complains no pain and lives symptom free in last follow-up at 2 years and 8 months after steroid injection.

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Limitation of Nitrogen ion Implantation and Ionplating Techniques Applied for Improvement of Wear Resistance of Metallic Implant Materials (금속 임플란트 소재의 내마모성 향상을 위하여 적용되는 질소 이온주입 및 이온도금법의 한계)

  • 김철생
    • Journal of Biomedical Engineering Research
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    • v.25 no.2
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    • pp.157-163
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    • 2004
  • Nitrogen ion implantation and ion plating techniques were applied for improvement of the wear resistance of metallic implant materials. In this work, the wear dissolution behaviour of a nitrogen ion implanted super stainless steel (S.S.S, 22Cr-20Ni-6Mo-0.25N) was compared with those of S.S.S, 316L SS and TiN coated 316L SS. The amounts of Cr and Ni ions worn-out from the specimens were Investigated using an electrothermal atomic absorption spectrometry. Furthermore, the Ti(Grade 2) disks were coated with TiN, ZrN and TiCN by use of low temperature arc vapor deposition and the wear resistance of the coating layers was compared with that of titanium. The chemical compositions of the nitrogen ion implanted and nitride coated layers were examined with a scanting auger electron spectroscopy. It wat observed that the metal ions released from the nitrogen ion implanted S.S.S surface were significantly reduced. From the results obtained, it was shown that the nitrogen ion implanted zone obtained with 100 KeV ion energy was easily removed within 200,000 revolutions from a wear dissolution testing under a similar load condition when applied to artificial hip joint. The remarkable improvement in wear resistance weir confirmed by the nitrides coated Ti materials and the wear properties differ greatly according to the chemical composition of the coating layers. for specimens with the same coating thickness of about 3$\mu\textrm{m}$, TiCN coated Ti showed the highest wear resistance. However, after removing the coating layers, the wear rates of all nitrides coated Ti reverted to their normal rates of below 10,000 revolutions from Ti-disk-on-disk wear testing under the same load condition. From the results obtained, it is suggested that the insufficient depth of the 100 Kel N$\^$+/ ion implanted zone and of the nitrides coated layers of 3$\mu\textrm{m}$ are subject to restriction when used as frictional parts of load bearing implants.

Cell study on the Magnesium ion implanted surface with PSII (PSII를 이용한 마그네슘 이온 주입 임플란트에 대한 MC3T3-E1 골모양 세포 반응 연구)

  • Shin, Hyeong-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra;Lee, Hee-Su;Cha, Min-Sang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.361-374
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    • 2009
  • For successful osteogenesis around the implants, interaction between implant surface and surrounding tissue is important. Biomechanical bonding and biochemical bonding are considered to influence the response of adherent cells. But the focus has shifted surface chemistry. The purpose of this study is to evaluate the MC3T3-E1 osteoblast like cell responses of magnesium (Mg) ion implanted titanium surface produced using a plasma source ion implantation method. Commercially pure titanium disc was used as substrates. The discs were prepared to produce four different surface, A: Machine turned surface, B: Mg implanted surface, C: sandblasted surface, D: sandblasted and Mg implanted surface. MC3T3 El osteoblastic like cells were cultured on the disc specimens. Cell adhesion, proliferation, differentiation, and synthesis of extracellular matrix were evaluated. The cell adhesion morphology was evaluated by SEM. RT PCR assay was used for assessment of cell adhesion, proliferation and differentiation. ALP activity was measured for cell differentiation. The results of this study were as follows: 1. SEM showed that cell on Mg ion groups was more proliferative than that of non Mg ion groups. On the machine turned surface, cell showed some degree of contact guidance in aligning with the machining grooves. 2. In RT PCR analysis, osteonectin and c-fos mRNA were more expressed on sandblasted and Mg ion implanted group. 3. ALP activity was not significantly different among all groups. Within the limitations of this study, the following conclusions were drawn: It might indicate Mg ion implanted titanium surface induce better bone response than non Mg ion groups.

Effects of Red or Black Ginseng Extract in a Rat Model of Inflammatory Temporomandibular Joint Pain (흰 쥐의 턱관절 염증성 통증모델에서 홍삼 및 흑삼추출물의 효과)

  • Lee, Hyeon-Jeong;Kim, Yun-Kyung;Choi, Ja-Hyeong;Lee, Jung-Hwa;Kim, Hye-Jin;Seong, Mi-Gyung;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • v.17 no.1
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    • pp.65-72
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    • 2017
  • Temporomandibular joint (TMJ) pain is characterized by persistent jaw pain associated with dysfunction and tenderness of the temporomandibular muscles and joints. The aim of this study was to investigate whether treatment with red or black ginseng extract helps in the modulation of inflammatory TMJ pain. Male Sprague-Dawley rats weighing 220~260 g were used. The experimental group was subdivided into 4 groups based on the treatment method (n=6, each group): formalin (5%, $30{\mu}l$), formalin after distilled water (vehicle), formalin after red or black ginseng extract (per oral, single or repeated, respectively). To induce TMJ pain, $30{\mu}l$ of formalin was injected into the articular cavity under ether inhalation anesthesia. The number of noxious behavioral responses of scratching the facial region proximal to the injection site was recorded for 9 successive 5-min intervals following formalin injection. Repeated treatment with red or black ginseng extract reduced the nociceptive responses in the second phase (11~45 min). Nuclear factor erythroid 2-related factor 2 (Nrf2) is an oxidative stress-mediated transcription factor. Both ginsengs significantly down-regulated the increased Nrf2 level compared to the vehicle group. In the test for liver and kidney functions, repeated treatment with red or black ginseng was not different compared to the vehicle group. These results indicate that red and black ginseng extract might be promising analgesic agents in the treatment of inflammatory TMJ pain.