• Title/Summary/Keyword: 인공관절치환술

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Limb Salvage Using a Combined Distal Femur and Proximal Tibia Replacement in the Sequelae of an Infected Reconstruction on Either Side of the Knee Joint (슬관절 주위 재건물 감염 후유증 시 슬관절 상하부 종양인공관절을 이용한 사지 구제술)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Park, Hwanseong;Nam, Heeseung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.37-44
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    • 2019
  • Purpose: Tumor infiltration around the knee joint or skip metastasis, repeated infection sequelae after tumor prosthesis implantation, regional recurrence, and mechanical failure of the megaprosthesis might require combined distal femur and proximal tibia replacement (CFTR). Among the aforementioned situations, there are few reports on the indication, complications, and implant survival of CFTR in temporarily arthrodesed patients who had a massive bony defect on either side of the knee joint to control infection. Materials and Methods: Thirty-four CFTR patients were reviewed retrospectively and 13 temporary arthrodesed cases switched to CFTR were extracted. All 13 cases had undergone a massive bony resection on either side of the knee joint and temporary arthrodesis state to control the repeated infection. This paper describes the diagnosis, tumor location, number of operations until CFTR, duration from the index operation to CFTR, survival of CFTR, complications, and Musculoskeletal Tumor Society (MSTS) score. Results: According to Kaplan-Meier plot, the 5- and 10-year survival of CFTR was 69.0%±12.8%, 46.0%±20.7%, respectively. Six (46.2%) of the 13 cases had major complications. Three cases underwent removal of the prosthesis and were converted to arthrodesis due to infection. Two cases underwent partial change of the implant due to loosening and periprosthetic fracture. The remaining case with a deep infection was resolved after extensive debridement. At the final follow-up, the average MSTS score of 10 cases with CFTR was 24.6 (21-27). In contrast, the MSTS score of 3 arthrodesis cases with failed CFTR was 12.3 (12-13). The average range of motion of the 10 CFTR cases was 67° (0°-100°). The mean extension lag of 10 cases was 48° (20°-80°). Conclusion: Although the complication rates is substantial, conversion of an arthrodesed knee to a mobile joint using CFTR in a patient who had a massive bony defect on either side of the knee joint to control infection should be considered. The patient's functional outcome was different from the arthrodesed one. For successful conversion to a mobile joint, thorough the eradication of scar tissue and creating sufficient space for the tumor prosthesis to flex the knee joint up to 60° to 70° without soft tissue tension.

Arthroscopic Diagnosis of Polyethylene Wear of Meniscal Bearing in Unicompartmental Knee Arthroplasty - A Case Report - (인공 슬관절 단일구획 치환술 후 폴리에틸렌 마모의 관절경적 진단 - 증례 보고 -)

  • Kang, Kyu-Bok;Yoon, Jung-Ro;Park, Sung-Chul;Song, Seungyeop;Yang, Jae-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.190-194
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    • 2012
  • The role of arthroscopy for the diagnosis of polyethylene wear after total knee arthroplasty has been reported previously. In this report, we demonstrate a case of wear of meniscal bearing in unicompartmental knee arthroplasty (UKA) and recurrent meniscal bearing subluxation which was diagnosed by arthroscopy. Arthroscopic examination has its role in diagnosing the wear and subluxation of polyethylene bearing after UKA.

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인공슬관절의 소개 및 연구 개발 동향

  • Gang, Gyeong-Tak;Jeon, Heung-Jae
    • Journal of the KSME
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    • v.55 no.3
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    • pp.28-32
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    • 2015
  • 이 글에서는 정형외과 인공관절 치환술 중 가장 많은 부분을 차지하고 있는 인공슬관절 치환술과 임상적 이론과 함께 적용되는 기계공학적 해석 및 설계 방법의 접근에 따른 연구 개발 동향을 소개하고자 한다.

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Results of Anterior Cruciate Ligament Reconstruction with Unicondylar Arthroplasty for Medial Compartment Knee Osteoarthritis combined with Anterior Instability (전방 불안정성과 동반된 슬관절 내측 구획 진행성 관절염환자에서 전방십자인대 재건술 및 인공 관절 부분 치환술의 결과 - 3예 보고 -)

  • Lee, Chul Hyung;Song, In Soo;Ji, Jong Hun;Kim, Tae In
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.88-94
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    • 2013
  • Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

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Etiology and Treatment of Revision Shoulder Arthroplasty (견관절 인공관절 재치환술의 원인과 치료)

  • Kim, Young-Kyu;Jung, Kyu-Hak
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.100-109
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    • 2019
  • The rapidly increasing rate of shoulder arthroplasty is certain to increase the number of revision arthroplasties because of parallel increases in complication numbers. It has been widely reported that the causes of revision shoulder arthroplasty include rotator cuff deficiency, instability, glenoid or humeral component loosening, implant failure, periprosthetic fracture, and infection. Revision arthroplasty can be technically challenging, and surgical options available for failed shoulder arthroplasty are limited, especially in patients with glenoid bone loss or an irreparable rotator cuff tear. Furthermore, the outcomes of revision arthroplasty are consistently inferior to those of primary arthroplasty. Accordingly, surgical decision making requires a good understanding of the etiology of failure. Here, we provide a review of indications of revision arthroplasty and of the surgical techniques used by failure etiology.

Linked Semi-constrained or Unlinked TER: What We Should Know Before We Use? (연결형, 반구속형 또는 비연결형, 비구속형 주관절 인공 관절 성형술: What We Should Know Before We Use?)

  • Jung, Hong-Jun;Jeon, In-Ho;Chun, Jae-Myeung
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.99-104
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    • 2011
  • Purpose: Total elbow arthroplasty (TEA) is still in its infancy as compared with other forms of arthroplasty. TEA designs have evolved with experience, but comparatively little long-term outcome data is available. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Material and Method: The designs of total elbow prostheses can be subdivided into three categories: unlinked, linked, and convertible. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Results and Conclusion: By proper patient selection and by utilizing implant design advances, improvements in cementation techniques, a meticulous surgical technique, and appropriate postoperative rehabilitation, total elbow arthroplasty can provide a high level of patient satisfaction and pain relief.

Biomechanics of the Glenohumeral Joint: Influence on Shoulder Arthroplasty (견관와-상완 관절의 생역학: 견관절 치환술에 대한 영향)

  • 염재광
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2004.11a
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    • pp.129-135
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    • 2004
  • 만약 Glenoid side를 해부학적으로 정확하게 치환하고, 상완골측의 prosthesis를 삽입할 때 실제 골두의 크기와 같은 prosthetic head를 쓰고, humeral stem의 위치 및 높이를 정확하게 맞추어 삽입하여, humeral head component의 center와 glenoid component의 center가 일치되고 lateral glenohumeral offset이 정상에 가깝게 수술을 시행하면 인공 치환물로 대치된 glenohumeral joint가 정상에 가장 가까운 kinematics를 가질 수 있다 (당연한 얘기지만 이렇게 수술하려면 많은 경험이 필요). 따라서 Glenohumeral joint의 인공 관절 치환술은 항상 technique-dependant 수술이며, 아무리 좋은 치환물도 훌륭한 수술 기법보다 더 중요할 수는 없다.

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견관절 골연골 병변의 진단과 치료

  • Kim, Tae-Su;Kim, Jong-Heon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.1-7
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    • 2008
  • 일반적으로 진행된 골관절염 등 골연골 병변에 대해서는 골연골을 치유시키는 술식에서부터 인공 관절 치환술까지 치료방법이 다양하게 보고되고 있다. 특히 견관절 인공 관절 치환술을 비롯한 여러 수술 방법에 대한 적응증 및 금기증을 잘 숙지하고, 각각의 고유 질병에 따른 병리 소견과 견관절의 정상적 해부학 및 생역학을 이해하며, 적절한 기구 선택과 정확한 술기로 수술을 시행할 때 제한된 치료 목표이지만 보다 긍정적인 치료 결과를 예측할 수 있다.

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Arteriography and Embolization of Lateral Inferior Genicular Artery of Recurrent Spontaneous Hemarthrosis after Total Knee Arthroplasty (인공 슬관절 치환술 후 발생한 재발성 혈관절증의 치료를 위해 시행한 혈관조영술 및 하외슬동맥색전술)

  • Chon, Je-Gyun;Kang, Jong-Won;Yoon, Ja-Yeong;Jeong, Uitak
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.173-177
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    • 2021
  • Recurrent spontaneous hemarthrosis is a relatively rare complication of total knee arthroplasty. This paper reports a case of a patient treated with arterial embolization for recurrent spontaneous hemarthrosis even after undergoing arthroscopic surgery. The patient had several relapses after total knee arthroplasty.