• Title/Summary/Keyword: 관절 연골

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Current Update of Cartilage Regeneration Using Stem Cells in Osteoarthritis (골관절염에서 줄기세포를 이용한 연골 재생의 최신 지견)

  • Seon, Jong-Keun;Choi, Ik-Sun;Ko, Jee-Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.478-489
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    • 2019
  • Osteoarthritis is a disease characterized by the progression of articular cartilage erosion, that increases pain during joint motion and reduces the ability to withstand mechanical stress, which in turn limits joint mobility and function. Damage to articular cartilage due to trauma or degenerative injury is considered a major cause of arthritis. Numerous studies and attempts have been made to regenerate articular cartilage. In the case of partial degenerative cartilage changes, microfracture and autologous chondrocyte implantation have been proposed as surgical treatment methods, but they have disadvantages such as insufficient mutual binding to the host cells, inaccurate cell delivery, and deterioration of healthy cartilage. Stem cell-based therapies have been developed to compensate for this. This review summarizes the drawbacks and consequences of various cartilage regeneration methods and describes the various attempts to treat cartilage damage. In addition, this review will discuss cartilage regeneration, particularly mesenchymal stem cell engineering-based therapies, and explore how to treat future cartilage regeneration using mesenchymal stem cells.

Technical Note of Meniscal Allograft Transplantation using Minimal Incision (최소 절개술에 의한 반월상 연골 동종이식 수술기법)

  • Min, Byoung-Hyun;Kim, Ho Sung;Jang, Dong Wok;Kang, Shin Young
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.54-61
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    • 1999
  • The current treatment of extensive meniscal injuries has resulted in numerous investigations and clinical trials to restore normal meniscal functions. A cryopreserved meniscal allograft transplantation is one of the successful methods available to restore the meniscus. All the procedures of 26 cases were performed in an minimal open fashion, though initial four cases were done with the aid of arthroscope. In all of the grafts, we used a bone bridge which was attached to meniscus for better stability and healing. Anterior cruciate ligament reconstructions were also performed simultaneously with the meniscal procedures. We attempted to minimize articular cartilage by employing so called the "Key-hole technique" for the medial meniscus transplantation. First, the meniscal cartilage bone bridge was shaped into a cylinder and a bone tunnel was made just beside the medial border of the anterior criciate ligament insertion of the recipient knee joint, and the bone bridge of the meniscal cartilage was push to press-fit. The inserted meniscal cartilage was sutured by the usually employed technique under arthroscopic control. The lateral meniscus was shaped different to the medial meniscus in that the bone bridge was semicylindrical and the bone trough was made beside the lateral border of the anterior criciate ligament insertion of the recipient knee joint. The meniscus was put into the bone trough and the leading suture was extracted anterior to the tibia and tied the knot. The inserted meniscus was sutured in the same manner as the medial meniscus transplantation. By the above described method, the authors were able to minimize the articular cartilage invasion and transplant the meniscus with relative accuracy.

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Discoid Medial Meniscus - A Case Report - (내측 원판형 연골 - 증례 보고 -)

  • Nha, Kyung-Wook;Kim, Dong-Hwan;Kim, Young-Ju
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.218-221
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    • 2005
  • The most of discoid meniscus is located in lateral side. Medial discoid meniscus is rare. The medial discoid meniscus was reported by Cave and Staples at first in 1941 but rarely reported since then. A 8 year's old boy was diagnosed as having a complete medial discoid meniscus by means of MRI and arthroscopy. Authors performed the arthroscopic partial menisectomy for medial discoid meniscus. For confirmation of the bilaterality, arthroscopic examination on contralateral knee was performed but we did not find a medial discoid meniscus. We report 1 case of a medial discoid meniscus with a brief review of literatures.

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관절 연골세포에서 glucosamine sulfate가 미치는 영향

  • Im, Jeong-Eun;Jo, Yeo-Won;Cheon, Jong-Hui;Lee, Hyeon-Jeong;Jeong, Su-Il;Min, Byeong-Hyeon;Park, So-Ra
    • Proceedings of the Korean Nutrition Society Conference
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    • 2004.05a
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    • pp.122-122
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    • 2004
  • 골관절염은 관절연골의 퇴행성 변화로 연골기질의 분해로 인하여 연골 강도와 cushion으로서의 능력이 감소되는 질환이다. 골관절염의 대부분 약물치료는 통증과 염증을 감소시키는 목적으로 사용되며, 근본적인 치료효과를 주는 약물은 현재까지 개발되어 있지 않다. 영양약학 제품에 대한 질병의 예방적, 치료 보조적 차원에서 인체에 대한 기초적인 생리활성의 중요성을 인식하게 됨으로써 그 역할이 중요하게 인식되고 있다. 특히, 골관절염 치료에 쓰이는 glucosamine은 proteoglycan (PG)와 glucosaminoglycans(GAGs)의 합성의 전구물질로서 연골세포 생성을 자극하며, 통증, 염증의 경감 및 진행과정을 억제시키고, 관절기능 회복을 촉진하는 것으로 알려져 있다. 그러나 glucosamine이 어떤 기전에 의해 관절연골세포에 직접적인 영향을 주는지 밝혀져 있지 않다. 본 연구에서는 glucosamine sulfate가 연골세포에 미치는 영향을 규명하고자 하였다.

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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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Arthroscopic Technique of Partial Meniscectomy for Bucket Handle Tear of Medial Meniscus using Posteromedial Portal (내측 반월상 연골판 양동이형 파열의 후내측 도달법을 이용한 관절경적 부분 절제술 - 수술 수기 -)

  • Ahn, Jin-Hwan;Lee, Jong-Yoon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.71-75
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    • 2000
  • Purpose : To introduce arthroscopic partial meniscectomy fur bucket handle tear of medial meniscus using posteromedial portal, which is superior to arthroscopic partial meniscectomy using standard anterior portals commonly used. Method : After arthroscopic examination of the knee, we reduce the torn meniscus, advance the arthroscope into posteromedial compartment under arthroscopic visualization, we make posteromedial portal with reexamination of the compartment and perform arthroscopic partial meniscectomy. Conclusion : With the technique of arthroscopic partial meniscectomy using standard anterior portals, accurate partial meniscectomy can not be done because of inadequate visual field, associated meniscal injuries of posterior horn and cartilage lesion of posterior aspect of the medial femoral condyle can be missed, commonly posterior cruciate ligament can be injured and artificial damage to weight bearing surface of medial femoral condyle is possible. An arthroscopic partial meniscectomy using posteromedial portal is an excellent method fur bucket handle tear of medial meniscus.

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2 Separate Meniscal Cysts Arising from Tears of the Medial Meniscus - A case report - (내측 반월상 연골 파열에서 발생한 독립된 2개의 반월상 연골 낭종 - 1예 보고 -)

  • Suh, Mn-Sam;Park, Hyung-Taek;Kim, Sang-Hyo
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.214-217
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    • 2005
  • Meniscal cyst is an uncommon disease of knee joints, arising less frequently from medial meniscus than lateral. Most of they are accompanied with horizontal tear of meniscus. This is the case of 24 year old man who had 2 separate medial meniscal cysts with longitudinal tear on posterolateral side of medial meniscus without trauma. Treatment consisted of arthroscopic decompression of cysts and meniscal repair.

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Pathophysiology of Articular Cartilage Injury (관절 연골 손상의 병태 생리)

  • Park, Jung-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.6-11
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    • 2005
  • Injury of articular cartilage can be classified into acute injury and chronic degenerative osteoarthritis Acute mechanical trauma on articular cartilage causes injuries that are divided into three distinct types based on the depth of injury: microdamage, chondral fracture, osteochondral fracture and each type has different potential of healing response and long-term prognosis. Articular cartilage undergoes degradation in response to a number of stimuli and eventually degenerative osteoarthritic changes will progress. The extent of initial injury to the articular cartilage is the most important factor affecting the long-term outcome of the healing response and other variables such as the size of lesion, site, age, activity level, obesity, limb alignment are also important factors. In this review, the pathophysiology that occurs within articular cartilage after different injuries and the effect of nonsurgical treatment mainly in physicochemical aspect and biological aspect will be discussed.

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Meniscus Allograft Transplantation; Surgical method (동종 반월상 연골 이식술의 술기)

  • Lee, B.S.;Chung, J.W.;Bin, Seong-Il
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.175-179
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    • 2010
  • 동종 반월상 연골 이식술은 불가피하게 반월상 연골이 소실된 환자에서 증상을 호전을 위한 매우 효과적인 치료이다. 관절연골의 보호 효과 등 장기적인 결과에 대해서는 아직까지는 많은 연구가 필요한 상태이지만, 이러한 환자에서 반월상 연골의 기능을 회복시키기 대안이 많아 점차 널리 시행되는 추세이다. 이식된 반월상 연골이 제 기능을 하기 위해서는 적절한 수술방법을 통하여 반월상 연골 이식물을 정확한 위치에 이식을 하는 것은 필수적일 것이다. 여러 저자들 마다 서로 다른 다양한 반월상 연골 이식술의 방법들을 사용하고 있지만, 어떤 방법을 선택하던지 간에 이식된 반월상 연골의 전각 및 후각을 해부학적인 위치에 견고하게 고정을 하는 것이 매우 중요하다. 술자의 선호도에 따라 다양한 방법중의 하나를 선택을 할 수 있지만, 어떤 방법이든 수술 술기상의 어려움이 있으므로, 철저한 준비와 노력이 필요할 것이다. 본 종설에서는 반월상 연골 이식술 중 개방적 방법에 대한 간단한 소개와 함께 저자들이 사용하는 관절경을 이용한 수술방법을 정리하였다.

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Change in the Levels of Intracellular Antioxidants during Aging of Articular Chondrocytes and Cartilage (연골세포 및 관절연골의 노화 과정에서 세포내 항산화 인자들의 변화)

  • Kim, Kang Mi;Kim, Yoon Jae;Kim, Jong Min;Sohn, Dong Hyun;Park, Young Chul
    • Journal of Life Science
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    • v.29 no.8
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    • pp.888-894
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    • 2019
  • Cartilage diseases, such as rheumatoid arthritis (RA) and osteoarthritis (OA), are associated with the loss of chondrocytes and degradation of articular cartilage. Recent studies revealed that inflammatory reactive oxygen species (ROS) and age-related oxidative stress can affect chondrocyte activity and cartilage homeostasis. We investigated changes in the levels of intracellular antioxidants during cellular senescence of primary chondrocytes from rat articular cartilages. Cellular senescence was induced by serial subculture (passages 0, 2, 4, and 8) of chondrocytes and measured using specific senescence-associated ${\beta}$-galactosidase ($SA-{\beta}-gal$) staining. ROS production increased significantly in the senescent chondrocytes. In addition, total glutathione (GSSG/GSH) and superoxide dismutase (SOD) levels and heme oxygenase-1 (HO-1) expression increased in senescent chondrocytes induced by serial subculture. Analysis of changes in intracellular antioxidant levels in articular cartilage from rats of different ages (5, 25, 40, and 72 wk) revealed that total glutathione levels were highest after 40 wk and slightly decreased after 72 wk as compared with those after 25 wk. SOD and HO-1 expression levels increased in accordance with age. Based on these results, we conclude that intracellular antioxidants may be associated with cartilage protection against excessive oxidative stress in the process of chondrocyte senescence and age-related cartilage degeneration in an animal model.