• Title/Summary/Keyword: 퇴행성 관절염

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Second look arthroscopic findings after microfracture surgery in osteoarthritic knee (퇴행성 슬관절염에서 미세천공술 후 이차 관절경 소견)

  • Bae, Dae Kyung;Kim, Jin Moon;Lee, Jeong Heui;Park, Yong Koo
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.85-90
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    • 1999
  • Purpose : The purpose of this study is to evaluate the clinical and histological results of the osteoarthritic patients who had second look arthroscopy after microfracture surgery. Materials and Methods : From Oct. 1997 to Dec. 1998, 46 patients, 48 knees were treated by microfracture technique. In the 22 patients, 24 knees, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. Three patients were men and 19 patients were women. Average age of the patients were 58 years (range, 40-75 years). The average follow up period was 12 months(7-20 months). We analysed clinical results according to the nine-point scale. Also we observed type II collagen formation with immunohistochemical staining. Results : Clinical results were excellent in 83% and good in 17%. Among the 24 knees, more than 80% areas of chondral defect were covered with regenerated cartilage in 21 knees. Histologically, the regenerated tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Regenerated cartilage contains variable amount of type II collagen with immunohistochemical staining. Conclusion : Most of the patients had significant improvement clinically. 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Microfracture in the full thickness chondral defect provides and enriched environment for cartilaginous tissue regeneration.

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Factors Affecting Exercise Adherence of the Elderly with Degenerative Arthritis: focusing on self-efficacy and social support variables (퇴행성관절염 노인의 운동지속 영향요인: 자기효능감과 사회적지지 변수를 중심으로)

  • Park, Hee-Sook;Lee, Byoung-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.3
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    • pp.250-259
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    • 2018
  • This study was conducted to investigate the factors influencing exercise adherence among elderly with degenerative arthritis. The data were analyzed by t-test, ANOVA, Scheffe's test, pearson's correlation, and multiple regression using SPSS 22.0. Data were collected from October 30 to November 10, in 2017. A total of 121 elderly in Daegu and Gyeongsan who had degenerative arthritis were surveyed. Significant differences in exercise adherence were observed among education level, spouse, type of residence, subjective health status, amount of exercise per week, and exercise time per day. The subjects' exercise adherence was positively correlated with self-efficacy (r = 0.621, p <0.001) and social support (r = 685, p <0.001). Elderly with degenerative arthritis had an explanatory power of 68.9%. There results showed that social support, self-efficacy, and amount of exercise per week were influencing exercise adherence by elderly with degenerative arthritis, and that social support was the most influential

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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The Effect of Aralia Cordata Thunb and Cimicifuga Heracleifolia on Cartilage Protection by the Regulation of Metabolism in Human Osteoarthric Chondrocytes (퇴행성 관절염에 대한 독활.승마 복합처방의 대사조절을 통한 연골보호 효과)

  • Shin, Ye-Ji;Beak, Yong-Hyeon;Park, Dong-Suk;Kim, Jae-Kyu;Koh, Hyung-Kyun
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.39-53
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    • 2010
  • 목적 : 퇴행성 관절염은 염증성 사이토카인인 IL-$1\beta$에 의해 연골관절이 파괴되고 이로 인해 염증성 사이토카인이 더욱 증가하는 질환이다. 퇴행성 관절염을 치료하기 위해서는 연골 파괴를 가속화시키는 catabolic cytokines의 활성을 줄이고, 성장인자인 anabolic factor의 활성을 증가시는 연골 보호 작용이 있어야 한다. 본 연구에서는 독활 승마 처방(OAH19T)이 catabolic/anabolic 대사 조절에 어떤 영향을 미치는지와 그 신호 전달 기전에 대해 연구하였다. 또한 OAH19T를 구성하는 단미재 및 임상에서 사용되는 COX-2 inhibitor인 Celebrex(CEL)와 효능을 비교 실험하였다. 방법 : 배양된 세포에 IL-$1\beta$로 자극한 후 (1) glycosaminoglycan(GAG)의 분해 억제 정도, (2) OAH19T와 CEL에 대하여 MMP-1과 MMP-3의 유전자 발현 및 활성 억제, (3) Aggrecan 및 Aggrecanases의 유전자 발현 및 활성 억제, (4) OAH19T의 growth factor의 조절 능력, (5) MAPK pathway 등을 RT-PCR(reverse transcriptase-polymerase chain reaction), ELISA(Enzyme-linked immunosorbent assay), western blot, viability 측정을 통해 검증했다. 결과 : 사람 관절 세포에서 (1) 독활 승마 각각의 단미재, 임상에서 사용중인 셀레콕시브(CEL), 조인스보다 실험 약물(OAH19T)이 저농도에서 GAG 분해 억제 효과가 우수하였고, 부탄올로 분획한 OAH19B와는 동등한 효과를 보였다. (2) OAH19T는 IL-$1\beta$에 의하여 활성화된 MMP-1과 MMP-3의 발현을 모두 억제하였으나, CEL은 MMP-1의 발현은 억제하였으나 MMP-3의 발현은 억제하지 못하였다. (3) OAH19T는 IL-$1\beta$에 의하여 손상된 Aggrecan을 회복시켰으며 이는 활성화된 Aggrecanase-1과 Aggrecanase-2를 억제시킴으로써 나타난 결과이다. 그러나 CEL의 경우, 손상된 Aggrecan을 회복시키지 못하였다. (4) 배양된 세포는 IL-$1\beta$에 의하여 TGF-$\beta$II및 TGF-$\beta$ receptor II의 발현이 억제되었으나, OAH19T는 TGF-$\beta$II및 TGF-$\beta$ receptor II의 발현을 회복시켜 OAH19T가 anabolic한 조절능력이 있음을 시사한다. 그러나 CEL의 경우 growth factor에 대한 조절 능력이 없었다. (5) 대사 조절 작용에 대한 기전으로서 MAPK pathway에 대해서 연구한 결과 IL-$1\beta$에 의하여 유도된 pERK, pp38 kinase의 활성은 억제하였고, pJNK의 활성은 변하지 않았다. 또한 OAH19T는 연골 세포에 독성이 없었으며 IL-$1\beta$에 의해 유도된 세포 증식만을 억제시켰다. 이 결과로, OAH19T가 OA chondrocyte의 탈분화 및 세포 고사를 억제하여 연골보호 및 회복 효과가 있음을 알 수 있었다. 결론 : OAH19T는 이를 구성하는 단미재 및 CEL보다 연골보호 효과가 월등하였고, 이러한 연골보호 효과는 catabolic cytokines/growth factors의 균형으로 대사조절을 통해 연골세포의 탈분화 및 세포 고사를 억제하여 연골보호 및 회복 효과가 있음을 알 수 있었다.

The Effects of Kinesio Taping on the Pain and Functional Improvement in Patients With Degenerative Arthritis (키네시오 테이핑이 퇴행성관절염 환자의 통증 및 기능회복에 미치는 효과)

  • Son, Gil-Soo;Lee, Moon-Hwan;Lee, Chang-Ryeol;Nam, Hyoung-Chun
    • Korean Journal of Applied Biomechanics
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    • v.18 no.1
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    • pp.45-52
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    • 2008
  • This study was conducted to investigate the effects of kinesio taping on the pain and functional improvement of patients with degenerative arthritis. 40 female patients were participated in this study. To evaluate the effects of taping therapy we calculated pain, range of motion, and get up and go(GUG) test. The results were as follow: Pain of experimental and control group were significantly decreased after than before treatment, but there was significant difference between experimental and control group. ROM of experimental and control group were significantly increased after than before treatment, but there was significant difference between experimental and control group. Time of GUG of experimental and control group were significantly decreased after than before treatment, but there was significant difference between experimental and control group. And Steps of GUG was significantly decreased only experimental group. So we think that kinesio taping have effectiveness on the pain and functional improvement in patients with degenerative arthritis.

Operative Treatment for Degenerative Arthritis of Elbow - Arthroscopic surgery with traction in Lateral position - (주관절의 퇴행성 관절염에 대한 수술적 치료 - 측와위에서 견인을 이용한 관절경 수술 -)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Whang, Chan-Ha;Kang, Shin-Taek;Kim, Jung-Man;Kim, Hyoung-Jun;Lee, Dong-Yeob
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.178-183
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    • 2006
  • Purpose: We reported the results and efficiency of arthroscopic treatment in a state of the lateral traction about the degenerative arthris of elbow Materials and Methods: Twenty one elbows with the degenerative arthritis who were followed up for at 12 months were enrolled in this study. Male were 15 cases, female were 6 cases, the mean age was 47 years and right dominant hand was 14 cases. In all cases, during arthroscopic treatment under the traction of 10 pounds, we had done synovectomy, excision of loose body and anteroposterior spur. After operation, immobilization was done in the full extension state, and then continuous passive motion (CPM) was started two day Results: The average preoperative ROM of the elbow joint was $30{\sim}l15$ degree and the average postoperative ROM of the elbow joint was $5{\sim}130$ degree. The increasement of ROM was totally 41 degree in extension 25 degree and flexion 16 degree. The decrement of VAS in pain was from 7.5 into 2.3 and the increasement of the satisfactory function was from 1.8 into 9.0. Complication was in two cases. One was paresthesia of ulnar nerve, but resolved. The other was bullae formation around the elbow joint, but cured. Conclusion: Regarding degenerative arthritis of elbow, arthroscopic treatment showed excellent result in recovery of range of motion and relief of pain. We could obtain good visual field with distraction in lateral position.

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Clinical and Histopathological Study in Repaired Cartilage after Microfracture Surgery in Degenerative Arthritis of the Knee (퇴행성 슬관절염에서 미세 천공술후 재생된 연골의 임상 및 병리조직학적 연구)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;So, Jae-Keun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.18-28
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    • 2005
  • Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

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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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Arthroscopic Ankle Arthrodesis (관절경하 족근관절 고정술)

  • Bae Dae Kyung;Yoon Kyoung Ho;Ko Byoung Won;Cho Nam Su
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.148-153
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    • 2000
  • Purpose : This study was conducted to analyze the results of arthroscopic ankle arthrodesis and to verify the advantages of the technique compared to open ankle arthrodesis. Materials and Methods : Between October 1992 and August 1996, the arthroscopic ankle arthrodesis had been performed in five patients(six ankle joints): two patients with seropositive rheumatoid arthritis(one patient surgically treated bilaterally), two with osteoarthritis and one with tuberculous arthritis. There were one man and 4 women. Average age was 48 years ranging from 38 to 65 years. Follow up period was average 45 months(range, $12\~80$). Results : All patients were successfully treated with ankle joint arthrodesis under arthroscopic control. The mean time to fusion was 10 weeks(range, $6\~15$). There was a $100\%$ fusion rate without any complication. Conclusion : The arthroscopic ankle arthrodesis was successful in all cases with less morbidity and short hospital stay. It was technically feasible with excellent predictability.

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A Case Report for a Obese Patient Accompanied with Hypertension, Dyslipidemia and Osteoarthritis (고혈압, 고지혈증, 퇴행성 관절염을 동반한 비만 환자의 증례보고)

  • Kim, Dong-Yeol;Kim, Gil-Su
    • Journal of Korean Medicine for Obesity Research
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    • v.1 no.1
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    • pp.13-20
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    • 2001
  • Obesity is an excess of body fat frequently resulting from an imbalance between energy intake and expenditure, raises the risk of morbidity from chronic diseases such as hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, fatty liver and osteoarthritis. Recently we experienced a 51 years old obese woman who was accompanied with hypertension, dyslipidemia and osteoarthritis. Through weight reduction program(very low calorie diet, Chegameuiintang, exercise) during 3 months, total weight loss was 17.0kg, her condition was improved.

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