• Title/Summary/Keyword: 관절보존

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Clinical Effect of Arthrocentesis for Patients with Disc Displacement without Reduction of Temporomandibular Joint : Report of Cases (측두하악관절의 비정복성 관절원판변위 환자에 대한 관절강 세정술의 임상효과 : 증례보고)

  • Kim, Cheul;Kim, Young-Jun
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.177-183
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    • 2006
  • The management of refractory pain and limitation of mouth opening in the temporomandibular joint (TMJ) is both challenging and controversial. Arthrocentesis is a simple technique and it can be used instead of more invasive surgical procedures for patients who failed to conventional conservative treatments. The patients in this case report had complained persistent severe pain and restricted mandibular movement of TMJ, although they had been treated with conservative therapy, e.g., stabilization splint therapy, behavioral therapy, physical therapy, pharmacological therapy. Therefore we employed arthrocentesis for these patients, and they showed significant reduction of pain and improvement of mandibular movement after repetitive arthrocentesis. We recommend arthrocentesis as an effective, minimally invasive technique for patients with continuing severe pain and restricted mobility in the TMJ that is unresponsive to conservative management.

The Effect of Additional Mobilization with Conservative Physical Therapy in Patients with Frozen Shoulder on ROM and Subjective Pain Scale (동결 견 환자에 대한 보존적 물리치료와 관절 가동술의 병행이 주관적 통증지수와 관절가동범위에 미치는 효과)

  • Hyong, In-Hyouk;Ha, Mi-Sook
    • The Journal of the Korea Contents Association
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    • v.9 no.11
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    • pp.271-279
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    • 2009
  • Frozen shoulder is clinically characterized by pain and reduced ROM. The therapeutic goal of frozen shoulder can be reducing pain and increasing ROM in shoulder joint, resulting in improvement of joint movement. Therefore, this study was conducted to know the effect of mobilization in parallel with conservative physical therapy(H/P, TENS, U/S) in patients with frozen shoulder on subjective pain scale and ROM. 26 patients diagnosed with frozen shoulder were included for study. Among them, 13 patients(experiment group) were managed by mobilization as well as conservative physical therapy, another 13 patients(control group) were only treated by conservative physical therapy alone. All the patients were treated three times a week for 4 weeks, and after each treatment subjective pain scale and ROM were measured. In experimental group, pain has decreased and ROM has increased in abduction, external rotation and internal rotation. In control group, pain has also decreased but ROM has not changed in abduction, external rotation and internal rotation. There were no significant difference in subjective pain scale between two groups but some difference in ROM (external rotation, internal rotation). According to the results, we concluded that both conservative physical therapy and joint mobilization technique are more effective for increasing ROM especially external rotation, internal rotation than conservative physical therapy alone.

Arthroscopic Anterior Cruciate Ligament Reconstruction with Remnant Bundle Preservation (남아있는 다발을 보존한 전방십자인대 재건술)

  • Ahn, Jin-Hwan;Lee, S.H.
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.87-96
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    • 2009
  • 최근 전방십자인대 손상의 치료에 남아있는 인대 다발이 이식건의 생물학적 치유를 도우며 고유 수용감각(proprioception) 기능을 유지할 뿐만 아니라 슬관절의 전방 전위 억제의 생역학적 기능을 가지는 것으로 연구되고 있다. 이러한 이론을 바탕으로 남아있는 전방십자인대를 보존하는 노력들은 다양하게 시도되고 있다. 전방십자인대 손상의 자연 경과는 아직도 논란이 되고 있으나 선택적인 환자에 있어서 보존적 치료는 비교적 좋은 결과를 얻을 수 있으므로 불필요한 재건술을 줄일 수 있다. 최근 시도되고 있는 선택적 다발 재건술 및 남아있는 다발을 보존하는 전방십자인대 재건 수술 수기들은 다양한 방법으로 시도되고 있으며 남아있는 다발을 보존하는 장점이 있으나 협소한 적응증을 가진다. 저자들의 남아있는 다발을 보존하는 전방십자인대 재건술은 자가 슬괵건을 이용한 단일다발 재건술을 시행하면서 잔존하는 이완된 다발에 봉합사를 통과시킨 후 봉합사를 추가적인 터널 없이 bioabsorbable cross pin (RIGIDfix system, Mitek, Johnson & Johnson, USA) 구멍을 통하여 당기고 고정하는 방법이다. 전방십자인대 재건술시 남아있는 다발을 보존하는 방법은 이식건의 생물학적 치유을 촉진하고 또한 경골 부착부에 남아있는 기계수용체를 보존하므로 기능적 회복에 도움이 될 것으로 기대된다. 저자들의 방법은 비교적 광범위한 적응증을 가지며 적은 합병증으로 남아있는 다발을 효과적으로 보존할 수 있는 술식으로 전방십자인대 수술시 좋은 치료 선택의 하나로 사료된다.

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A Study of Conservative Treatment for Patients with Osteoarthritis of the TMJ (측두하악골관절염 환자의 보존적 치료에 관한 연구)

  • Son, Dae-Eun;Ok, Seung-Joon;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.227-239
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    • 2007
  • To evaluate the treatment outcome after conservative treatment in patients with osteoarthritis of the TMJ(OA), the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as osteoarthritis of the TMJ, and treated with conservative methods from 1994 to 2006. 101 patients with diagnosis of osteoarthritis of the TMJ were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorders(MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subject's status at the first and the last visit. The results were as follows : 1. In the OA group, satisfactory treatment outcome was obtained with conservative methods. But, at the last visit, the symptoms of the OA group were not improved enough compared with those of the MMD group. 2. In the OA group, radiographic findings of panorama view and transcranial projection were positive by about 60 percent. But, computed tomography and single photon emission computed tomography were positive by more than 90 percent. 3. At the last visit of the OA group, the joint noise was reduced significantly. 4. In the majority of the OA group, satisfactory treatment outcome was obtained with conservative methods such as medication, physical therapy, and occlusal stabilization appliance. In the majority of the MMD group, satisfactory outcome was obtained with medication and physical therapy. 5. It took the OA group from 6 months to 2 years to be cured well while the MMD group within 6 months.6. The OA group needed more than 10 times' treatment for satisfactory outcome while the MMD group needed less than 10 times' treatment.

Outcome of Conservative Treatment for Patients with Disc Displacement of Temporomandibular Joint (측두하악관절 원판변위 환자의 보존적 치료결과)

  • Kim, Kyung-Hee;Kim, Ik-Hwan;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.305-318
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    • 2007
  • To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.

Conservative Treatment of the Knee Injury and Pain (슬관절 손상과 동통의 보존적 치료)

  • Bin Seoung-I1;Nam Tae-Seok;Ahn Ji-Hyun;Jung Kwang-Whan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.107-110
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    • 2004
  • Treatment of knee injury and pain consists of conservative and surgical treatment. Although conservative treatment is suffice in many cases, surgical treatment is performed which is not necessary. Therefore, thorough knowledge of injury mechanism and selection of treatment modalities are required. Injury mechanism and conservative treatment of knee injury patients will be discussed.

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견봉쇄골 관절염 및 골용해증

  • Choe, Chang-Hyeok
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2006.11a
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    • pp.139-144
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    • 2006
  • 견봉 쇄골 관절의 관절염 변화 및 골 용해로 인한 통증 및 기능제한은 보존적 치료를 원칙으로 하며, 보존적 치료에 실패하거나, 활동량이 많은 경우 운동선수일 경우 수술적 치료를 고려할 수 있다. 어떤 방법의 치료를 선택하던 간에 이전의 운동 범위를 얻고 통증없이 근력 및 기능회복을 할 수 있어야 하며, 이를 위해서는 잘 조절된 재활치료를 시행하는 것이 무엇보다 중요하다.

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