• Title/Summary/Keyword: 슬관절 탈구

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Arthroscopic Treatment of Osteochondral Fractures Associated with Patella Dislocation (슬개골 탈구에 동반된 골연골 골절의 관절경적 치료)

  • Lee Byung-Ill;Min Kyung-Dae;Choi Hyung-Suk
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.104-110
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    • 2001
  • Purpose : To analyze the patterns of osteochondral fracture associated with patellar dislocation and to assess the results of arthroscopic treatment. Materials and Methods : Fourteen patients were treated from March, 1989 to April, 1998 for patellar dislocations with osteochondral fracture. The average follow-up was 32 months. All were treated by arthroscopic procedures. The location and size of the fracture fragments were recorded. To assess the functional results, we used Larsen & Lauridson's score system. Results : Osteochondral fractures were found 8 cases in medial side of patella, 1 case in lateral side of patella, 5 cases in lateral margin of lateral femoral condyle. The range of maximal diameter of osteochondral fragment was from 1cm to 4.2cm. Treatments include fragment excision only in 6 cases, excision and medial retinacular repair in 2 cases, excision and medial retinacular repair and lateral retinacular release in 3 cases, and internal fixation only in 3 cases. The functional results were excellent in 5 cases$(36\%)$. good in 6 cases$(43\%)$, fair in 1 case$(7\%)$ and poor in 2 cases$(14\%)$. Conclusion : In osteochondral fractures associated with patellar dislocation, arthroscopic treatment is useful to diagnose precisely, to determine proper treatment modality, and to minimize the complications.

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KNEE: Basic Science and Injury of Bone (슬관절 주위 글격의 기초과학 및 스포츠 손상)

  • Kim Hee-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.77-81
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    • 2003
  • Purpose: The biomechanics and kinematics of knee joint were reviewed in this article. And then the common sports injuries were presented. Anatomy and Kinetics: None of the pairs of bearing surfaces in the knee joint is exactly congruent This allows the knee six degrees of freedom of motion. Tibiofemoral Kinematics: In flexion and extension, the axis of motion is not perpendicular to the medial-lateral plane of the joint, nor is it perpendicular to the axis of longitudinal rotation. This results in coupled varus angulation and internal rotation with flexion and in valgus angulation and external rotation with extension. Patellofemoral Articulation: Loads across the patellofemoral joint are indirectly related to the angle of knee flexion and directly related to the force generated within the quadriceps mechanism. Fractures of the Patella: Nonoperative treatment is indicated if the extensor mechanism is intact and if displacement of fragment is minimal. The specific type of internal fixation depends on the fracture pattern. It is important to repair retinaculum. Acute and Recurrent Patellar Instability: The degree of dysplasia and the extent of the instability play a large part in determining the success of nonoperative treatment. Patients who experience recurrent dislocations and patients with major anatomic variations require surgery to minimize their instability. Sports Injuries in School-age Atheletes: Patellar pain in young athletes groups a number of conditions, including Idiopathic Adolescent Anterior Knee Pain, Osgood- Schlatter Disease, and Sinding-Larsen-Johansson Disease.

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Management of Multiple Ligament Injured Knee (슬관절 다발성 인대 손상의 치료)

  • Sim, Jae-Ang;Lee, Beom-Koo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.16-23
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    • 2013
  • Multiple ligament knee injury is defined as rupture to at least two of the four major knee ligament structures. Three or four knee ligament injury results in knee dislocation as complete disruption of the integrity of the tibiofemoral articulation. In multiple ligament knee injury, vascular and neurologic assessment should be performed meticulously and systematically. Emergency surgery should be needed if arterial injury is suspected. Surgical treatment rather than conservative management should be done and early surgery might be better than delayed surgery. Reconstruction of ACL and PCL, repair or reconstruction of MCL, and reconstruction of posterolateral corner are recommended, although many debates have occurred. Multiple ligament knee injury requires more aggressive management than single ligament knee injury.

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Knee Joint Replacement Virtual Surgery Based on CAD System (CAD기반의 슬관절 전치환술에 대한 가상 수술 구현)

  • Yoon, Young-Soo;Park, Se-Hyung;Lee, Soo-Hong;Kim, Lae-Hyun;Choi, Kui-Won
    • 한국HCI학회:학술대회논문집
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    • 2006.02a
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    • pp.75-81
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    • 2006
  • 슬관절 전치환술은 관절염이나 사고로 인해 일상적인 활동의 제약을 받는 환자의 슬관절을 인공 관절로 대체함으로써 본래의 기능을 복원하고자 하는 수술이다. 이 수술은 인공 관절의 위치 및 정렬에 매우 민감하게 영향을 받기 때문에 수술이 잘못되는 경우 정렬 이상으로 인한 해리, 삽입물의 파손, 인공 슬관절 주위 골절, 슬개골 탈구, 굴곡 각도의 제한 등의 증상이 발생할 수 있다. 현재의 인공 관절은 임상에 적용되는 다양한 인공 관절 중에서 적당한 형상의 관절을 선택하여 시술되고 있지만 환자의 골 형상에 정확히 일치하는 인공 관절 선택의 어려움 때문에 종종 시술 후 부작용이 발생한다든지 심지어는 재수술을 해야 될 경우도 발생하게 된다. 본 논문은 Mechanical CAD 소프트웨어인 CATIA에서 제공하는 절단, Assembly, Analysis, Kinematic Simulation 기능 등을 이용하여 가상 수술을 수행하는 과정을 보여준다. 슬관절 전치환술 과정을 그대로 재현하여 절단량과 절단각을 결정하고 환자의 골격 형상에 적합한 최적의 인공 관절을 실제 수술 전에 미리 선정할 수 있다. CAD 시스템을 이용함으로써 외과의들이 실제 수술 시에 시행착오법을 통해 인공 관절을 선택하는 과정을 줄이고 수술의 정확도를 높일 수 있다. 향후 ADAMS나 ANSYS와 연계하여 수술 후 동작이나 하중을 분석할 수 있으며, 수술 과정에 대한 교육용으로 활용될 수 있다.

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Rehabilitative Effect of Intramuscular Electrostimulation after Reconstruction of Medial Patellar Luxation in Small Sized Dog (소형견의 내측 슬개골 탈구 정복술 후 근육 내 전기자극의 재활효과)

  • Lee, Shinho;Lee, Joo-Myoung;Park, Hyunjung;Won, Sangcheol;Cheong, Jongtae
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.16-21
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    • 2015
  • Medial patellar luxation (MPL) of dog is one of the most common joint diseases. This study performed to know rehabilitative effect after reconstruction as application with intramuscular electrostimulation (IMES) on the cranial part of sartorius muscle. In this study, the 12 dogs with operated medial luxation divided into electrostimulation group (n = 8) and no electrostimulation group (n = 4) measured affected sided range of motion, muscle mass, lameness score and weight bearing for hospitalization 2 weeks. IMES group showed significant results after operation on 5th day (p < 0.01). Except lameness score, IMES group showed significant results on 10th day (p < 0.05). As results, in small sized dog after reconstruction of MPL, IMES on the cranial part of sartorius muscle considered a great help in the initial rehabilitation.

Percutaneous Lateral Release and Medial Reefing for Recurrent Patellar Dislocation (재발성 슬개골 탈구의 경피적 외측부 유리술 및 내측부 중첩술)

  • Choi, Chong-Hyuk;Oh, Kyung-Soo;Kim, Hyoung-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.33-38
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    • 2006
  • Purpose: This study seeks to address the results of percutaneous lateral release and medial reefing for patients with recurrent patellar dislocation. Materials and Methods: This paper focuses on 27 cases from 25 patients who had a surgical operation at our hospital in a span of eight years and six months from the time of December 1996 to May 2005. The subjects consist of 11 males and 14 females, and their average age was 22.2 years old. All the patients had their trauma history, and the average frequency of dislocation before surgery was 11.5 times. Results: The congruence angle before operation was 23.3 degree on the average, while the lateral patellofemoral angle was -5.7 degree on average. However, the congruence angle after surgery came to -2.4 degree, while the lateral patellofemoral angle recovered to the normal range of within 11.5 degrees. Four cases showed the recurrent dislocation, and two out of those four cases had -35, -12 degrees of their lateral patellofemoral angle respectively and 59, 14 degrees of their congruence angle respectively. Conclusion: Using percutaneous lateral release with medial reefing can be considered as an effective treatment for recurrent patellar dislocation

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