• Title/Summary/Keyword: 슬관절 골관절염

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An Integrated and Complementary Evaluation System for Judging the Severity of Knee Osteoarthritis Using CNN (CNN 기반 슬관절 골관절염 중증도 판단을 위한 통합 보완된 등급 판정 시스템)

  • YeChan Yoon
    • Journal of Korea Society of Industrial Information Systems
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    • v.29 no.4
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    • pp.77-89
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    • 2024
  • Knee osteoarthritis (OA) is a very common musculoskeletal disorder worldwide. The assessment of knee osteoarthritis, which requires a rapid and accurate initial diagnosis, is determined to be different depending on the currently dispersed classification system, and each classification system has different criteria. Also, because the medical staff directly sees and reads the X-ray pictures, it depends on the subjective opinion of the medical staff, and it takes time to establish an accurate diagnosis and a clear treatment plan. Therefore, in this study, we designed the stenosis length measurement algorithm and Osteophyte detection and length measurement algorithm, which are the criteria for determining the knee osteoarthritis grade, separately using CNN, which is a deep learning technique. In addition, we would like to create a grading system that integrates and complements the existing classification system and show results that match the judgments of actual medical staff. Based on publicly available OAI (Osteoarthritis Initiative) data, a total of 9,786 knee osteoarthritis data were used in this study, eventually achieving an Accuracy of 69.8% and an F1 score of 76.65%.

The Septic Knee Arthritis Caused by Klebsiella pneumoniae in a Patient with Type 2 Diabetes Mellitus and Osteoarthritis of the Knee (제2형 당뇨 및 골관절염을 동반한 환자에서 발생한 Klebsiella pneumoniae균에 의한 화농성 관절염)

  • Ha, Joong-Won;Lee, Sanghyeon;Park, Sang-Hoon;Kim, Tae-Yup
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.67-71
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    • 2019
  • Klebsiella pneumoniae causes that liver abscess mostly, also spread to pneumonia, meningitis, urinary tract infections. Septic arthritis caused by K. pneumoniae is a quite rare and has not been reported in Korea. Therefore, the authors report a case of the septic arthritis in the knee joint caused by K. pneumoniae in a patient with type 2 diabetes mellitus and osteoarthritis of the knee that successfully treated by early detection and arthroscopic synovectomy.

슬(膝) 골관절염(骨關節炎)의 외과술(外科術) 전단계(前段階) 진료형식(診療型式)의 모형화(模型化)

  • Na, Hyeon-Jong
    • The Journal of Korea CHUNA Manual Medicine
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    • v.1 no.1
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    • pp.139-143
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    • 2000
  • 통증감소를 위주로 하는 기존의 슬 골관절염 치료는 슬관절의 퇴행을 가속화시킬 수 있기 때문에 한의학적 각종 침구요법 및 물리요법, 약물요법이나 의학적 주사요법 등을 '슬관절에 대한 부하 힘을 감소시킨 상태'에서 시행하는 진료형식을 제안한다. 그리고 이러한 슬관절질환 치료의 추나요법을 채택하여 임상적용이 가능하도록 이를 기계화 도구화하고, 진단과 치료를 동시에 시행할 수 있는 방식이 되도록 연구할 필요가 있다.

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Anterior Cruciate Ligament Reconstruction Using Autologous Bone-patellar Tendon-bone (자가 골-슬개건-골을 이용한 전방십자인대 재건술)

  • Kyung, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.88-91
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    • 2010
  • 전방십자인대 재건술시 자가건 선택에 대해서는 많은 논쟁의 소지가 존재하며 많은 보고들이 나오고 있으나, 현 시점에서 이식건으로써 자가 골-슬개건-골이 표준(gold standard)라는 주장은 이제 변화하고 있으며, 골-건 고정방법의 개선에 따른 조기 슬관절 안정성의 호전으로 자가 슬괵건의 사용이 점점 증가되고 있는 추세이다. 자가 골-슬개건-골은 이식건으로써 강한 물성, 튼튼한 고정, 장기 추시에서 높은 성공률 등으로 젊고, 강한 활동을 요하는 운동선수에서 종종 선택되고 있으며 조기에 강한 활동으로의 운동 복귀를 할 수 있다. 그러나 슬관절 전방 통증, 무릎을 꿇을 때의 통증, 슬개골골절, 슬개-대퇴 관절의 염발음 및 대퇴사두근력의 감소 등 이식물 채취로 인한 공여부 이환이 문제가 되었다. 그래서 자가 골-슬개건-골의 이식건으로서의 문제점 및 문헌상 고찰을 하여 논하고자 한다.

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Correlation between femoral rotation and clinical results after high tibial osteotomy in primary osteoarthritis patient (퇴행성 골관절염 환자에서 시행한 근위 경골 절골술 후 대퇴골의 회전과 임상결과의 상관관계)

  • Park, Sang Eun;Mun, Sang Won
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.100-104
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    • 2011
  • The purpose of this article is to examine correlation between femoral rotational angle and subjective satisfaction of high tibial osteotomy outcome of the range of motion of knee joint. The subjects were 15 patients (6 males, 9 females) with primary osteoarthritis undergoing high tibial osteotomy from June of 2004 to August of 2008. They were CT tested on the knee joint before and after high tibial osteotomy. TEA (Fig. 1) and Akagi's line (Fig. 2) are analyzed as percentages. The Kendall's and Spearman's nonparametric correlation coefficient were used for the statistical tests with 0.5 level of significance. The result reveals that femoral rotational angle correlates with not the range of motion of knee joint but subjective satisfaction of the patients. Therefore, this will enable patients and physicians to have better clinical outcome.

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Effects of Oyster Shell Extract on Papain-induced Osteoarthritis in C57BL/6J Mice (굴 패각 추출물이 Papain으로 유도된 골관절염 C57BL/6J Mice에 미치는 영향)

  • Lee, Se-Young;Kim, Hak-Ju;Han, Ji-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.8
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    • pp.1183-1189
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    • 2013
  • We investigated the effects of oyster shell extract (OSE) on papain-induced osteoarthritis in C57BL/6J mice. Osteoarthritis was induced in mice by a papain injection into the knee joint. The mice were divided into a total of five groups (n=8). The normal group was untreated, whereas the papain group (negative control) was induced with osteoarthritis and treated with water daily. The papain+DS group (positive control) was treated with diclofenac sodium. Papain+OSE groups were treated with OSE concentrations of 100 and 200 mg/kg/bw for 20 days. Proteoglycan content in articular cartilage was analyzed through safranine-O fast green staining and H&E staining. The histopathological changes in cartilage were measured by the Rudolphi score approach. The contents of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin (IL)-$1{\beta}$, and IL-6 in plasma were analyzed by the ELISA method. After experiments, body weights of the treated groups were not significantly different compared with the normal group. Cartilage loss and joint instability significantly improved in a dose-dependent manner in the OSE-treated group compared with the papain group (P<0.05). Proteoglycan content was significantly higher in the OSE-treated group than the papain group (P<0.05). Osteoarthritis scores of the OSE-treated group were significantly decreased compared with the papain group (P<0.05). TNF-${\alpha}$, IL-$1{\beta}$, and IL-6 content in the plasma of the papain+OSE treated groups significantly decreased in a dose-dependent manner compared with the papain group (P<0.05). These results suggest that OSE treatment might have anti-arthritic effects on papain-induced osteoarthritis in C57BL/6J mice.

Recycling Total Joint Autotransplantation in Osteosarcoma around the Knee Joint (슬관절 주위 골육종에서 체외 방사선 조사를 이용한 재활용 전 자가 관절 이식술)

  • Chung, So-Hak;Cho, Yool;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.31-36
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    • 2007
  • Purpose: Recycling extracorporeal irradiated autograft is used as one of the reconstruction methods after limb salvage with malignant bone tumor. However, there were some problems such as joint instability, progressive arthritis, insufficient joint resection margin were found after intraarticular recycling autograft. Thus, we carried out a research in order to investigate the results of recycling total joint autotransplantation after extracorporeal irradiation that could resolve the problems. Materials and Methods: There were five cases of patients who were diagnosed as osteosarcom around the knee joint and underwent same operation from June 1997 to Feb 2006. All patients had been evaluated from 93 to 105 months (mean 100 months) and their mean age was 21.6. Results: The roentgenographic union of junctional sites began at 15.6 months (9~40 months) postoperatively. As regards to the orthopaedic functional results, we used the criteria of Ennecking et al. Overall mean functional result was 71.6%. Complication such as epiphyseal collapse (three cases) and joint instability (five cases) were noted respectively. In all the cases, tumor prosthesis was used to replace the knee joint. Conclusion: Because recycling total joint autotransplantation after extracorporeal irradiation does not prevent joint instability and progressive arthritis, tumor prosthesis is recommended in young adult.

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Computer-Assisted Navigation in Total Knee Arthroplasty (내비게이션 장치를 이용한 슬관절 전치환술)

  • Jeong, Hwa-Jae;Park, Yong-Beom;Lee, Han-Jun
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.478-489
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    • 2018
  • Total knee arthroplasty has become a standard procedure for advanced knee arthritis to relieve pain and improve function. Computer-assisted navigation systems have been used in total knee arthroplasty to improve the mechanical axis of the limb as well as the alignment and position of the components. A computer-assisted navigation system has the advantage of real-time feedback during surgery, such as mediolateral balance in extension and flexion gap, alignment of the lower limb, and components. On the other hand, the computer-assisted navigation system requires an additional stab wound for tracker fixation, which can increase the likelihood of superficial wound infection and stress fractures and increase the operation time and cost of surgery. The clinical efficacy of computer-assisted navigation in total knee arthroplasty is also controversial. Compared to the conventional technique, computer navigation improves the accuracy of the postoperative mechanical axis within outliers of $3^{\circ}$ varus or $3^{\circ}$ valgus. This paper reviews the surgical technique, pitfalls, clinical and radiological outcomes, useful clinical cases, and future perspectives in computer-assisted navigation total knee arthroplasty.

Clinical Results of the Single-bundle, Transtibial Posterior Cruciate Ligament Reconstruction: A Systematic Review (경경골 단일다발 후방십자인대 재건술의 임상 결과: 체계적 고찰)

  • Kim, Yeong-Mo;Lee, Cassandra A.;Matava, Matthew J.
    • 대한관절경학회:학술대회논문집
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    • 2009.10a
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    • pp.57-57
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    • 2009
  • 관절경적 경경골 단일 다발 후방십자인대 재건술은 전통적으로 가장 흔하게 사용되는 사용되는 술기이다. 그러나, 후방십자 단독 파열시 이 술기의 결과에 대한 임상 평가 및 효용성에 대한 임상적 분석 자료가 거의 없는 실정이다. 이 술기를 시행받은 환자군들에서 객관적 슬관절 이완이 존재함에도 불구하고 주관적 슬관절 기능 장애는 우수한 결과를 나타낸다고 인정되어 왔다. 후방십자인대 단독 파열 후 경경골 단일 다발 재건술을 시행한 문헌 10개를 대상으로 잔존하는 후방 이완과 주관적, 객관적인 기능 평가, 활동성 정도, 환자 만족도, 골관절염의 발생 빈도, 술후 합병증을 체계적으로 고찰하였다. 술전 후방 슬관절 이완은 8.38~12.3 mm에서(4문헌) 술후 1.96~5.9 mm으로(9 문헌) 호전되었다. Lysholom 점수는 평균 81~100점이었다(9 문헌). IKDC는 75%에서 정상 또는 거의 정상의 결과를 보였다(6 문헌). 평균 Tegner 활동도는 4.7~6.3점이었다(8 문헌). 이번 고찰을 통한 결과에서 이 술기 후 퇴행성 변화가 관찰되었으며 보고된 합병증은 거의 없었다. 후방십자인대 단독 파열에서 경경골 단일 다발 재건술은 정상 슬관절의 안정성까지 회복하지는 못하나 한 등급 정도의 후방 슬관절 이완의 호전을 기대할 수 있다. 재활 및 운동으로의 회복에 대한 주관적 슬관절 점수는 80점이며 75%의 정상 또는 정상에 가까운 객관적 결과를 보여주었다. 이 술기가 퇴행성 관절염을 예방할 수는 없더라도 이러한 결과는 후방십자인대 재건 술기의 평가에 도움이 될 것으로 사료된다.

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Mid-Term Results of Fixed Bearing Unicompartmental Knee Arthroplasty: Minimum 5-Year Follow-Up (고정형 슬관절 단일 구획 치환술의 중기 추시 결과: 최소 5년 추시)

  • Oh, Jeong Han;Joo, Il-Han;Kong, Dong-Yi;Choi, Choong-Hyeok
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.498-504
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    • 2018
  • Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.