• Title/Summary/Keyword: 환자의 추시

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Treatment of Giant Cell Tumor Around Knee - by Intralesional Excision Using High Speed Burr and Methylmethacrylate - (슬관절 주변에 발생한 거대세포종의 치료 - 고속 바(High-Speed Burr)와 골 시멘트를 이용한 병소 내 절제술 -)

  • Park, Jong-Hoon;Lee, Soo-Yong;Jeon, Dae-Geun;Cho, Wan-Hyung;Song, Won-Seok;Kim, Jin-Wook;Koh, Han-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.160-167
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    • 2005
  • Purpose : Distal femur and proximal tibia are the common sites affected by giant cell tumor of bone. There are a variety of treatment modality including wide excision and intralesional curettage. We evaluated the local recurrence rates and the post-operative functional scores of giant cell tumors around knee joint and investigated the identification of possible prognostic factors for recurrence. Materials and Methods: We reviewed 41 patients pathologically confirmed as giant cell tumors around knee joint that have undergone intralesional curettage using high-speed burr and methylmethacrylate. We evaluated the recurrence rate and post-surgical functional score and possible prognostic factors for recurrence, such as, gender, age, tumor location, size, subchondral invasion, intra-articular invasion and the Campanacci Grades. Mean follow up period was 50 (12-122) months. Results: The recurrence rate was 17% and mean recurrence onset was 10 months postoperatively. According to Musculoskeletal Tumor Society (MSTS) functional evaluation system, the average score was 27.8(93%) and 78% had excellent function. According to our study, suspected prognostic factors revealed not significant for recurrence. Conclusion: We found no significant recurrence related factors. Intralesional excision with high-sped burring and PMMA provides a low recurrence rate, similar to others in the literature, and good functional scores.

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Analysis of Treatment Results of Malignant Melanoma (악성 흑색종의 치료결과 분석)

  • Shin, Duk-Seop;Kim, Ui-Sik
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.1
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    • pp.30-35
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    • 2011
  • Purpose: This study was designed to evaluate the treatment results of malignant melanoma and to analyze the factors influencing prognosis. Materials and Methods: Thirty one cases of malignant melanoma were included in this study. They were treated in our hospital surgically, medically and immunologically from January 1996 to December 2005, and were followed more than 5 years. We compared 5 year survival rate (5YSR) according to the age, gender, anatomical site, depth of tumor, TNM stage, involvement of lymph node and immuno-chemotherapy. Results: Overall 5YSR was 80.6%. 5YSR of the age group below 65 years was 89.7% and 66.7% for the age group over 65 (p=0.033). 5YSR for men was 75% and 90.9% for women. 5YSR according to the site of occurrence showed 66.7% in upper extremities, 89.5% in lower extremities, and 66.7% in other site. 5YSR was 100% for the Clark level below III and 62.5% for the level above IV (p=0.032). 5YSR was 53.8% for lymph node metastasis group and 100% for non-lymph node metastasis group (p=0.021). Conclusion: We concluded that early diagnosis and wide excision was the most important in treatment of malignant melanoma. The prognostic fractors of malignant melanoma were age, depth of tumor (Clark's stage) and metastasis of lymph node.

Clinical Outcome and Arthroscopic Evaluation of Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술의 임상적 결과 및 이차적 관절경 소견)

  • Song, Eun-Kyoo;Seon, Jong-Keun;Lee, Kyoung-Jai;Kim, Hyung-Soon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.28-34
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    • 2010
  • Purpose: The aim of this study was to evaluate short-term clinical results and second-look arthroscopic findings after double-bundle anterior cruciate ligament (DB ACL) reconstruction. Materials and Methods: Forty-nine patients, who were followed up for at least 24 months after DB ACL reconstruction, were included. Clinical results, such as, Lysholm knee and Tegner activity scores, and manual laxity and instrumented anterior laxity test results were evaluated. In fifteen patients (15 knees), second-look arthroscopy with staple removal was performed. At second-look arthroscopy, the authors assessed about reconstructed ACL rupture, subjective graft tension and extent of synovial coverage. Results: Lysholm knee scores significantly improved from 67.4 preoperatively to 96.1 at last follow-up (p<0.01). Tegner activity scale improved from 2.0 to 6.1. The Lachman test, at last follow-up, showed normal laxity in 39 (of 49) patients, and the pivot-shift test showed normal laxity in 36 (of 49) patients. Mean side-to-side differences improved significantly from 10.8 mm to 3.3 mm (p<0.01). Second-look arthroscopic findings showed that all patients had a normal or a near normal anteromedial bundle. However, 8 patients (53.3%) were found to have partial or complete posterolateral bundle rupture. Conclusion: Even though double-bundle ACL reconstruction was clinically effective means of restoring knee rotational and anteroposterior stabilities, there were some ruptured posterolateral bundles observed in cases under arthroscopy after double-bundle ACL reconstruction.

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Treatment of Acromioclavicular Joint Injuries Using Clavicle Hook Plates (Clavicle Hook Plate를 이용한 견봉 쇄골 관절 손상의 치료)

  • Kim, Myung-Ho;Seo, Joong-Bae;Moon, Sang-Young
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.92-98
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    • 2010
  • Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.

Reconstruction of Anterior Cruciate Ligament with Fresh-frozen Achilles Allograft (신선 동결 동종 아킬레스건을 이용한 전방 십자인대 재건술)

  • Choi, Nam-Yong;Han, Suk-Ku;Nah, Ki-Ho;Seo, Sang-ll;Lee, Do-Sung;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.26-30
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    • 2004
  • Purpose: We analyzed the clinical results of ACL(anterior cruciate ligament) reconstruction of chronic anterior cruciate ligament injuries with a fresh frozen Achilles allograft, retrospectively. Methods: Thirty-eight patients(average age 32.4 years) who had an chronic injury of ACL reconstructed with an Achilles allograft between January 1999 and February 2001 were included. The mean follow-up was 19.2(12-36) months. The clinical evaluation was done by range of motion, Lachman and pivot-shift test, KT-1000 arthrometer, Lysholm knee score, and the modified Feagin score. Results: All patients recovered full range of motion of affected knees. With use of Lachman and pivot-shift test data, thirty seven(97.4%) were functional. When comparing KT-1000, we found mean maximum side-to-side differences less than 2.1 mm. According to Lysholm knee score, mean postoperative score was 90.4. Thirty four(89.5%) had good to excellent results in modified Feagin score. Conclusion: Results of ACL reconstruction using fresh frozen Achilles allografts were comparable to autografts. ACL reconstruction with Achilles allograft could be a reasonable altemative to autografts.

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The Effect of Indwelling Silk Suture Material Following Aspiration in the Treatment of Chronic Prepatellar Bursitis (흡인 후 견 봉합사 거치를 통한 만성 슬개골전 점액낭염의 치료)

  • Lee, Bong-Jin;Lee, Sung-Rak;Kim, Chung-Hyun;Kim, Seong-Tae
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.55-59
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    • 2005
  • Purpose: To evaluate the drainage effect of silk suture material following aspiration of the bursa as an early treatment of chronic prepatellar bursitis. Materials and Methods: Twelve cases, which have over two weeks of history and over one year of follow-up, were investigated. The average duration of follow-up was 18.3 months. The average symptom duration before introduction into this study was 2.2 months. With an aseptic technique, the aspiration of the bursa was done with spinal needle or injection needle and syringe and then the insertion of silk suture material through the aspiration needle was performed. Over one year follow-up, recurrence, infection, pain, and limitation of range of motion were investigated by telephone interview. Results: Redness around the insertion site of silk suture material was found in all cases, but there was no development of active infection in eleven cases. At five days after procedure, a supprative infection was developed in one case. The results were considered satisfactory in 92% of cases and the average duration of treatment is 14.5 days. Conclusion: The drainage with silk suture material following aspiration of the bursa is effective and less invasive method in the early treatment of chronic prepatellar bursitis.

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Arthroscopic Management for the Treatment of Ankle Gutter Syndrome (족 관절 구 증후군에 시행한 관절경적 치료)

  • Choi Chong Hyuk;Park Jin-Oh;Ogilvie-Harris D. J.
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.54-60
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    • 2000
  • Purpose : The purpose of this study was to evaluate the gutter pathologies and the clinical results of arthroscopic treatment for ankle gutter syndrome. Materials and Methods : Seventy six patients(77 ankles) who had lesions in the ankle gutter were treated by arthroscopy. The gutter pathology could be divided into 3 categories; hypertrophic scar tissue, loose bodies and bone spurs. Fifty two patients were evaluated subjectively and functionally with authors' criteria. The follow-up period averaged 44 months(range, 2.9 year-8.5 year). Results : The incidence of the gutter lesion was $21\%$(77 ankles) among 366 ankles undergoing arthroscopy. The most common pathology was hypertrophic scar tissue. In 31 ankles$(40\%)$, the lesions were found only in gutter, and 46 ankles$(60\%)$ were associated with pathologies in other areas. All of parameters for subjective and functional evaluation were improved with statistical significance(p<0.001). Seventeen patients$(33\%)$ could returned to competitive or contact sports activity with same level of premorbid period. Conclusion : Ankle gutter is an important site of pathologies which cause chronic ankle pain, and should be explored in ankle arthroscopy. The ankle arthroscopy is a very effective treatment method fur the removal of pathologies in ankle gutter syndrome.

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Anterior Cruciate Ligament Augmentation Using Autogenous Semitendinosus Tendon (자가 반건양건을 이용한 전방 십자 인대 보강술)

  • Choi, Nam-Yong;Han, Chang-Hwan;In, Yong;Moon, Chan-Woong;Choi, Seung-Woog;Jin, Sung-Ki
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.12-17
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    • 2008
  • Purpose: This study presents clinical results of anterior cruciate ligament(ACL) augmentation using autogenous two-strand semitendinosus tendon in the treatment of partial ACL tears with preservation of residual portion. Materials and Methods: From January 2004 to June 2006, twenty two patients who had an ACL injury underwent ACL augmentation using autogenous two-strand semitendinosus tendon were enrolled in this study. We evaluated the clinical results with regard to clinical findings(range of motion, Lachman test, pivot shift test), standard knee scales(Lysholm, Modified Feagin Scoring System), and KT-1000 arthrometer testing. Results: At minimum one year postoperatively, there was no limitation of range of motion. Lachman and pivot shift tests were negative in all knees. On instrumented anterior laxity test by KT-1000 arthrometer, mean side to side difference was improved from 4.6mm preoperatively to 1.7mm postoperatively. Average Lysholm score was improved from 70 to 92. Ninety one percent of cases were rated as good or excellent in Modified Feagin Scoring System. Conclusion: Augmentation using autogenous two-strand semitendinosus tendon with preservation of residual portion of the ACL seems to be an acceptable method for restoring knee stability and proprioceptive function.

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Magnetic resonance imaging Usefulness after Medial Meniscus Posterior Root Tear Repair (내측 반월상 연골판 후각 기시부 파열 봉합 후 추시 자기공명영상 검사의 유용성)

  • Chon, Jegyun;Kim, Jun-Beom;Lee, Bong-Ju
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.6-10
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    • 2013
  • Purpose: This study intends to verify the usefulness of magnetic resonance imaging (MRI) for estimate recovery after arthroscopic pull-out repair at root tears of medial meniscus. Materials and Methods: We performed 17 patients who examined MRI and arthroscopy among patients who had received repair of medial meniscus from November, 2007 to June, 2011. To determine restoration meniscus, we performed arthroscopy and MRI. Results: Lysholm knee scores before and after operation were average 56.4 and 79.0 and visual analogue scale (VAS) score was improved from 8 points to 3 points. From secondary look arthroscopy performed after operation, 17 cases showed stabilization after regeneration. However, In MRI, cleft sign implying root tears of medial meniscus was observed in all cases before and after operation, ghost sign was observed in 10 cases and 9 cases respectively, radial linear defect was showed 17 cases and 15 cases respectively. Conclusion: It was not useful that MRI after medial meniscus repair in non-anatomical site, to consider restoration of medial meniscus. To evaluate for recovery medial meniscus after repair more exactly, secondary arthroscopy would be required.

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Study for the Usefulness of Arthroscopic Repair with UU MA SB Stitch for the Full Thickness Rotator Cuff Tear (preliminary report) (회전근개 파열에서 관절경 감시하의 봉합술 - UU MA Suture Bridge를 이용한 봉합의 유효성(예비보고) -)

  • Ko, Sang-Hun;Lee, Seon-Ho;Rhee, Young-Girl;Lee, Chae-Chil
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.1-5
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    • 2013
  • Purpose: To evaluate the clinical results of arthroscopic repair with Ulsan University - Mason Allen - Suture Bridge (UU MA SB) stitch for the full thickness rotator cuff tear. Materials and Methods: Fifteen patients with full thickness rotator cuff tear underwent arthroscopic repair with UU MA SB stitch between September 2010 and December 2010. Clinical and functional evaluations were made according to Korean shoulder score (KSS), American shoulder and elbow surgeon (ASES), University of California, Los Angeles (UCLA), visual anabgue scale (VAS) and the range of motion. Results: The mean KSS improved from 51.4 preoperatively to 92.0 at final follow-up (p<0.05). The mean UCLA score improved from 15.07 preoperatively to 31.93 postoperatively, the mean VAS of pain during the motion was 7.2 before treatment and 0.93 at final follow-up (p<0.001). At last follow-up, the mean range of motion was improved but they had not shown statistical significance (p>0.05). Conclusion: The arthroscopic repair with UU MA SB stitch may be an effective procedure in the full thickness rotator cuff tear for pain relief and improvement of the range of motion.

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