• Title/Summary/Keyword: 인공관절

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생체재료 표면개질과 골접합성

  • ;;;Takao Hanawa
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2003.10a
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    • pp.51-51
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    • 2003
  • 생체친화재료란 생체내에 사용하거나 혹은 생체외에서 보조재료로 사용되는 것을 총칭하고, 인체와 직접 또는 간접적으로 접촉하여 사용되는 것이 특징이며 그 때문에 사용상 안전을 확보하기 위하여 생체에 대한 무해성 내지 생체적합성이 요구된다. 생체적합성이란 각각 고유의 기능을 가진 생체와 인공재료가 그 계면에서 서로 기능을 해치는 상호 반응을 일으키지 않고 공존하며 사용목적을 달성하는 것을 말한다. 생체친화재료로서는 재료의 종류에 따라서 인공관절의 고밀도 폴리에틸렌제, 인공힘줄이나 혈액 펌프등의 폴리우레탄 등 고분자재료, 생체기능을 대행하는 구조재료로서 스테인레스강, CO-Cr 합금, 타이타늄 및 그 합금, 탄탈륨 등 금속재료, 정형외과나 치과 등 굵은 조직대체용 재료로서의 세라믹재료로 구분되고 있다.

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Prognostic Factors after Arthroscopic Treatment of Infectious Knee Arthritis (감염성 슬관절염의 관절경적 치료 이후 예후 인자에 대한 분석)

  • Kang, Sang-Woo;Choi, Eui-Sung;Kim, Dong-Soo;Jung, Ho-Seung;Hong, Seok-Hyun;Go, Ban-Suk
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.30-36
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    • 2019
  • Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

Class Classification and Validation of a Musculoskeletal Risk Factor Dataset for Manufacturing Workers (제조업 노동자 근골격계 부담요인 데이터셋 클래스 분류와 유효성 검증)

  • Young-Jin Kang;;;Jeong, Seok Chan
    • The Journal of Bigdata
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    • v.8 no.1
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    • pp.49-59
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    • 2023
  • There are various items in the safety and health standards of the manufacturing industry, but they can be divided into work-related diseases and musculoskeletal diseases according to the standards for sickness and accident victims. Musculoskeletal diseases occur frequently in manufacturing and can lead to a decrease in labor productivity and a weakening of competitiveness in manufacturing. In this paper, to detect the musculoskeletal harmful factors of manufacturing workers, we defined the musculoskeletal load work factor analysis, harmful load working postures, and key points matching, and constructed data for Artificial Intelligence(AI) learning. To check the effectiveness of the suggested dataset, AI algorithms such as YOLO, Lite-HRNet, and EfficientNet were used to train and verify. Our experimental results the human detection accuracy is 99%, the key points matching accuracy of the detected person is @AP0.5 88%, and the accuracy of working postures evaluation by integrating the inferred matching positions is LEGS 72.2%, NECT 85.7%, TRUNK 81.9%, UPPERARM 79.8%, and LOWERARM 92.7%, and considered the necessity for research that can prevent deep learning-based musculoskeletal diseases.

Arthroscopic Management for Pyogenic Arthritis with Positive Culture in the Knee Joint (배양 검사로 증명된 화농성 슬관절염의 관절경적 치료)

  • Baek, Seung-Hoon;Kim, Se Sik
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.167-174
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    • 2012
  • Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.

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A Study on the Usefulness of an Ankle Joint Examination Assistive Device using a 3D Printing (3D 프린터를 이용한 발목관절 검사 보조기구의 유용성연구)

  • Dong-Hee Hong;Eun-hye Kim;Young-Cheol Joo
    • Journal of the Korean Society of Radiology
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    • v.17 no.7
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    • pp.1099-1108
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    • 2023
  • The mortise view radiography procedure is an ankle joint examination and observes the presence of trauma, sprain, or dislocation suspected in the ankle joint. The auxiliary equipment used during the mortise view radiography procedure can generate artifacts in the radiograph images and is not diverse enough to be custom-made for each patient; not cost-efficient. The purpose of this study is to create a custom assistive device to support mortise view radiography procedure. This study utilized 3D printing technology to create the mortise view radiography procedure assistive device (ShinHan Device; SHD). The lengths of the tibiotalar joint (TTJ), talar calcaneal joint (TCJ), and medial joint (MJ) were measured and evaluated by five researchers using both SHD and the prototype Hologic tool. The mean ranges were found to be 39.42-39.47 mm for TTJ, 31.41-31.57 mm for TCJ, and 21.21-21.23 mm for MJ while using SHD device. On the other hand, the measurements showed mean ranges of 39.73-39.79 mm for TTJ, 31.46-31.50 mm for TCJ, and 21.31-21.35 mm for MJ while using the Hologic tool. Based on this study results, the error ranges at all positions decreased by 24% for TTJ, 17% for TCJ, and 36% for MJ when using SHD device compared to the Hologic tool. Moreover, when SHD was used, it allowed for a highly reproducible examination posture (ICC = 0.99), and it enabled the acquisition of radiograph images without artifacts, which were present in the Hologic tool.

Evaluation of the Effect of Metal Artifacts Varying the Parameters of the Attenuation Map for the artificial Hip Joint in SPECT/CT (SPECT/CT에서 인공고관절에 대한 감쇠보정지도(Attenuation Map)의 매개변수 변화에 따른 금속 인공물(Metal Artifact)의 영향 평가)

  • Kim, Sang Gyu;Kim, Jung Yul;Park, Min Soo;Jo, Seung Hyun;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.3-7
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    • 2014
  • Purpose SPECT/CT scan to be performed attenuation correction on the basis of CT induce an overestimation of the site due to the beam hardening artifact by metal cover and reduce the images quality. Therefore, this study using a phantom that has been inserted artificial hip joint investigated that effect on the SPECT/CT image causing by metal artifact for varying the parameters of the Attenuation Map. Materials and Methods Siemens Symbia T16 SPECT/CT equipment was used. Artificial hip joint was inserted to SPECT/PET phantom, 17 mm sphere of Bright Streak area in CT image was filled with Tc-99m so that the radiation activity was 8 times compared to background. And then Hot and Background was measured in varying Wide Beam Coefficient on Attenuation Map and RBR (Region to Background Ratio) of Metal and Non-Metal was calculated and analyzed depending on the presence or absence of the hip joint. Results It tended to hot count of Non-Metal and Metal to increase as the value of the manual mode is increased, hot count ratio with the group of both manual mode 0.5 and 0.4 is the best match. Also, in automatic mode, the ratio of RBRNon-Metal and RBRMetal was 1.135, statistically significant difference was not observed in the manual mode 0.5 and 0.4. Conclusion In the automatic mode of Wide Beam Coefficient in attenuation correction map, it was found that it is over-correction by 13.52%, it was possible to minimize the over-correction by the artifact in 0.5 and 0.4 of manual mode. Further studies should be performed in order to apply to a patient with the help of this and it is considered possible to reduce the over-correction by the metal artifact of an artificial hip joint for Hip-Resurfacing Arthroplasty patients, and to improve the diagnostic performance.

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Cementless Total Hip Arthroplasty Using Ceramic Femoral Head on Cross-Linked Ultra-High-Molecular Weight Polyethylene Liner in Patients Older than 65 Years: Minimum Five-Year Follow-Up Results (세라믹 대퇴 골두 및 교차결합 초고분자량 폴리에틸렌 라이너를 이용한 65세 이상 무시멘트형 인공 고관절 전치환술: 최소 5년 중기 추시 결과)

  • Yun, Ho Hyun;Cheong, Ji Young;Sim, Hyun Bo;Park, Jae Hong
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.490-497
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    • 2018
  • Purpose: To evaluate the utility of ceramic-on-polyethylene articular bearing surface when cementless total hip arthroplasty is performed in patients older than 65 years through an analysis of the minimum five-year follow-up results using the ceramic femoral head and cross-linked polyethylene liner. Materials and Methods: From March 2010 to September 2012, 51 patients (56 hips) who were older than 65 years were enrolled in this retrospective study. The mean age at surgery was $70.9{\pm}5.1years$ old. A clinical assessment was analyzed using the Harris hip score. For the radiographic assessment, the cup inclination and anteversion, stem alignment, and wear amount were measured. The postoperative complications were also determined. Results: The mean Harris hip score was improved from preoperative 48 points to postoperative 87 points (p<0.05). The mean cup inclination was $40.9^{\circ}{\pm}6.4^{\circ}$ and the mean cup anteversion was $20.3^{\circ}{\pm}8.1^{\circ}$. The mean cup anteversion of the elevated liner-used group (16 cases) was $14.3^{\circ}{\pm}7.9^{\circ}$ and the mean cup anteversion of the neutral liner used group (40 cases) was $22.4^{\circ}{\pm}9.1^{\circ}$ (p<0.05). The mean stem alignment angle was $0^{\circ}$ (range, varus $4^{\circ}$-valgus $4^{\circ}$). The mean linear wear amount was $0.458{\pm}0.041mm$ and the average annual linear wear rate was $0.079{\pm}0.032mm/yr$. Six cases (10.7%) of intraoperative periprosthetic femoral fractures were encountered. Conclusion: Based on these results, the use of a ceramic-on-polyethylene articular bearing surface in elderly patients with cementless total hip arthroplasty is beneficial. On the other hand, careful effort is needed to prevent intraoperative periprosthetic femoral fractures.