• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.170-177
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• 2013

Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2003.11a
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• pp.175-180
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• 2003

상완골 근위부 골절의 치료를 위해서 실시하는 상완골 두 치환술은 고난도의 수술이다. 그러나 수술 수기에 만전을 기하고 골절을 위해서 특별하게 고안된 치환물을 사용하면 통증을 해소되는 것은 물론이며 대부분의 견관절 기능도 회복이 가능하다고 생각한다. 또한 보다 좋은 결과를 얻기 위해서는 치환물과 수술 수기 등에 대해서 지속적인 개선이 매우 중요하다고 생각한다.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.93-98
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• 2009

족관절 고정술은 족관절에 발생한 심한 관절염(end-stage arthritis)에서 전통적으로 시행하던 술식으로 현재 사용되고 있는 인공 족관절 치환술이 발달되기 전까지는 gold standard 로 알려져 있었으며 현재에도 심한 족관절의 변형이나 파괴, 족관절 인공 관절의 실패시에 시행되고 있다. 1897년 Albert가 처음으로 족관절 고정술을 소개한 이후로 30여가지가 넘는 방법이 행해지고 있으나 개방적 관절 고정술의 단점인 수술 후 염증, 유합 지연, 연부조직의 손상에 의한 피부 괴사 등을 극복하고 유합물을 높이기 위해 다양한 내고정 및 외고정 장치를 사용하고 있다. 관절경 술식이 발달하면서 Schnider가 1983년 최초로 관절경을 이용한 족관절 고정술을 발표한 이후로 관절경하의 족관절 고정술은 개방적 족관절 고정술 보다 높은 유합율과 적은 수술 합병증으로 인해 관심의 대상이 되었지만 족관절의 변형이 심한 경우에는 시행하기 어려운 단점이 있는 것으로 알려져 왔다.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.110-119
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• 2019

Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.427-434
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• 2019

Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.1-11
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• 1991

족부의 교정을 위해서는 비정상적인 상태 및 원인 그 치료법에 대해서 충분히 이해해야 할 것으로 생각되며, 비 척행족에 대해서는 먼저 정확한 원인 인자의 파악과 수술전 평가, 수술의 선택, 수술의 범위등을 정해야 한다. 이렇게 함으로써 변형에 대한 충분한 교정이 가능하며, 수술후 예후가 좋은 척행족으로 될 것이다. 그리고 위에서 밝힌 치료의 원칙은 변하지 않겠지만, 관절 고정술을 대체하여 다른 남은 관절에 영향을 주지 않으면서 더 많은 유연성을 가질 수 있는 기능있는 족부를 만들 수 있는 새로운 수술방법이(관절 치환술등) 더 개발되어 져야할 것으로 생각된다.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.352-352
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• 2005

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2004.03a
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• pp.51-51
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• 2004

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.18-31
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• 1999