• Title/Summary/Keyword: Arthroplasty

검색결과 508건 처리시간 0.028초

Lateral arthroplasty along with buccal fat pad inter-positioning in the management of Sawhney type III temporomandibular joint ankylosis

  • Malhotra, Vijay Laxmy;Singh, Virendra;Rao, JK Dayashankara;Yadav, Sunil;Gupta, Pranav;Shyam, Radhey;Kirti, Shruti
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권3호
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    • pp.129-134
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    • 2019
  • Objectives: The objective of this study was to highlight the role of lateral arthroplasty along with interposition of the buccal fat pad (BFP) in the management of Sawhney type III temporomandibular joint (TMJ) ankylosis. Materials and Methods: Ten patients with TMJ ankylosis (7 unilateral and 3 bilateral, total of 13 joints) were treated with lateral arthroplasty and BFP interposition. The bony bridge of the ankylotic mass on the lateral aspect was resected, leaving a distance of 1.5 to 2.0 cm from the base of the skull to the neck of the condyle. The condyle was left intact. Coronoidectomy was performed on the ipsilateral side via the same approach in all cases. The inter-incisal opening was measured at that time, and if it was less than 35 mm, contralateral coronoidectomy was performed by using the intra-oral approach. After satisfactory inter-incisal mouth opening (${\geq}35mm$) was achieved, the TMJ surgical site was revisited, and BFP was retrieved and used to cover the lateral aspect of the medially placed condyle. Results: With lateral arthroplasty, the medially displaced condyle can be left in-situ to maintain the mandibular ramal height and function and to act as a growth center in children. Interposition of the BFP prevents reformation of the lateral bony bridge that was removed. Conclusion: Lateral arthroplasty along with interpositioning of the BFP is a novel technique for managing Sawhney type III ankylosis that achieves management goals while avoiding complex and advanced reconstructive surgical procedures.

슬관절 전치환술 후 한약 치료의 효과: 체계적 문헌고찰과 메타분석 (Effects of Herbal Medicine after Total Knee Arthroplasty: A Systematic Review and Meta-Analysis)

  • 이상진;고유미;박정식;박태용;이정한;조재흥;황의형;김경자;최미영;송윤경
    • 한방재활의학과학회지
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    • 제31권4호
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    • pp.35-47
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    • 2021
  • Objectives This study was conducted to evaluate the therapeutic effect of herbal medicine after total knee arthroplasty. Methods Key words such as total knee arthroplasty and herbal medicine were searched in 10 databases (Ovid-Medline, Ovid-EMBASE, Ovid-AMED, Cochrane Library, China National Knowledge Infrastructure [CNKI], National Digital Science Library [NDSL], Koreanstudies Information Service System [KISS], Oriental medicine Advanced Searching Integrated System [OASIS], KoreaMed, KMBASE), and only suitable randomized controlled trials (RCTs) were selected. Results 8 RCTs were finally selected, and herbal medicine showed positive results for pain relief and functional recovery after total knee arthroplasty. However, the analyzed 8 RCTs showed a high overall risk of bias. Conclusions In the future, RCTs with a higher level of evidence on the effect of herbal medicine after total knee arthroplasty need to be continuously conducted.

Primary Arthroplasty for Unstable and Failed Intertrochanteric Fractures: Role of Multi-Planar Trochanteric Wiring Technique

  • Javahir A. Pachore;Vikram Indrajit Shah;Sachin Upadhyay;Shrikunj Babulal Patel
    • Hip & pelvis
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    • 제35권2호
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    • pp.108-121
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    • 2023
  • Purpose: The primary objective of the current study is to demonstrate the trochanteric wiring technique. A secondary objective is to evaluate the clinico-radiological outcomes of use of the wiring technique during primary arthroplasty for treatment of unstable and failed intertrochanteric fractures. Materials and Methods: A prospective study including follow-up of 127 patients with unstable and failed intertrochanteric fractures who underwent primary hip arthroplasty using novel multi-planar trochanteric wiring was conducted. The average follow-up period was 17.8±4.7 months. Clinical assessment was performed using the Harris hip score (HHS). Radiographic evaluation was performed for assessment of union of the trochanter and any mechanical failure. P<0.05 was considered statistically significant. Results: At the latest follow-up, the mean HHS showed significant improvement from 79.9±1.8 (at three months) to 91.6±5.1 (P<0.05). In addition, no significant difference in the HHS was observed between male and female patients (P=0.29) and between fresh and failed intertrochanteric fractures (P=0.08). Union was achieved in all cases of fractured trochanter, except one. Wire breakage was observed in three patients. There were five cases of limb length discrepancy, three cases of lurch, and three cases of wire-related bursitis. There were no cases of dislocation or infection. Radiographs showed stable prosthesis in situ with no evidence of subsidence. Conclusion: Use of the proposed wiring technique was helpful in restoring the abductor level arm and multi-planar stability, which enabled better rehabilitation and resulted in excellent clinical and radiological outcomes with minimal risk of mechanical failure.

합병증이 병발된 슬관절 치환술에 시행한 관절경술의 효용성 (The Effectiveness of Arthroscopy in Complicated Knee Arthroplasty)

  • 김경태;이송;고동오;김관수;김태우;박순열
    • 대한관절경학회지
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    • 제13권1호
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    • pp.39-45
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    • 2009
  • 목적: 슬관절 치환술 후에 발생한 합병증의 치료를 위해 시행한 관절경술의 결과를 알아보고 그 효용성을 확인하고자 하였다. 대상 및 방법: 1992년 5월부터 2008년 6월까지 본원에서 슬관절 치환술을 시행받은 후 합병증으로 인하여 관절경적 치료를 받았던 25예를 연구 대상으로 하였다. 25예 중 슬관절 전치환술을 시행받았던 경우가 19예, 부분치환술을 시행받았던 예가 6예였다. 모든 환자에서 관절경을 시행하기 전에 합병증의 원인을 밝히기 위해서 이학적 검사와 방사선 검사를 시행하였으며, 감염이 의심되는 경우 관절액 천자 및 혈액학적 검사를 추가로 시행하였다. 결과: 관절경술 시행 시 진단으로는 전치환술을 시행한 예에서는 감염 11예, 관절의 유착 및 섬유화로 인한 운동 제한 6예, 연부 조직의 충돌 2예 등이 있었으며, 부분 치환술을 시행한 예에서는 반월상 연골 파열, 유동성 치환물의 아탈구, 혈관절증, 관절 내 시멘트 유리체, 연부 조직 충돌 및 슬관절 강직으로 인한 운동 제한이 각각 1예 씩 총 6예가 있었다. 감염이 있던 11예 중 9예에서 관절경술만으로 치료가 되었고, 관절 강직이 있던 7예는 평균 슬관절 운동 범위가 술 전 $65^{\circ}$에서 최종 추시 시 $105^{\circ}$로 향상 되었으며, 나머지 예에서도 관절경술로 성공적인 치료 결과를 보였다. 결론: 슬관절 치환술 후 발생한 합병증의 치료로 시행한 관절경술은 적절한 환자의 선택 시 안전하고 효과적인 방법임을 확인할 수 있었다.

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비연결형 및 전환형 주관절 전치환술 (Unlinked and Convertible Total Elbow Arthroplasty)

  • 문준규;천성광
    • Clinics in Shoulder and Elbow
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    • 제16권2호
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    • pp.163-169
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    • 2013
  • 주관절 전치환술은 과거 임상적 결과를 토대로 새로운 디자인이 개발 중이며 불안정성이나 해리 등의 단점을 개선하고 수명을 향상시킬 수 있을 것으로 기대된다. 본 종설은 비연결형 주관절 치환술과 전환형 주관절 치환술의 일반적 개념을 기술하고자 한다. 과거의 비연결형 치환물 중 현재는 일부만 사용되고 있다. 기존의 단점을 보완한 최근의 비연결형 디자인은 더 안정적인 관절면 모양, 스템형 치환물 및 요골-소두 치환술을 첨가하는 형태 등으로 개선되고 있다. 전환형 디자인은 전세계적으로 두 개의 모델이 개발되어 사용 중이며 최근 국내에서도 사용 가능하게 되었다. 비연결형 디자인에서 추가적인 연결고리를 이용하면 쉽게 연결형으로 전환이 가능하다. 비연결형 주관절 치환술은 인체 주관절과 유사한 운동 구조를 가지게 되어 폴리에틸렌 마모나 치환물의 해리를 감소시킬 수 있는 장점이 있다. 주변골과 연부 조직이 보존된 경우 또는 활동도가 높은 젊은 환자에서 적응증이 될 수 있다. 전환형 주관절 치환술은 치환물의 선택을 넓히고 재수술을 용이하게 하는 장점을 가지고 있다. 두 개의 치환물의 사용은 연결형 치환술이 가지고 있는 단점을 보완하고 장기적인 결과를 향상시킬 수 있을 것으로 기대된다.

Reconstructive Procedure of Elbow Joint -Semiconstrained Total Elbow Arthroplasty-

  • 이용걸
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 1995년도 학술대회
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    • pp.5-6
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    • 1995
  • ${\cdot}$ total elbow replacement arthroplasty incremental improvement. ${\cdot}$ semiconstrained device broadens the indications for joint replacement. ${\cdot}$ avoidance of complications is achieved by carefully planning and meticulous technique

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무지 수근중수 관절염에 대한 현수 봉합 관절성형술의 결과 (Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis)

  • 김세훈;공현식;이세연;이민호;김지형;백구현
    • Archives of Hand and Microsurgery
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    • 제23권4호
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    • pp.223-229
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    • 2018
  • 목적: 무지 수근중수 관절염(thumb carpometacarpal joint arthritis)에 대한 관절성형술로 대다각골을 제거한 후 중수골을 안정시키는 여러 방법이 소개되어 있다. 현수 봉합 관절성형술은 덜 침습적이면서 술식이 쉬운 장점이 있다. 본 연구는 무지 수근중수 관절염 환자에서 이 술식을 이용하여 수술한 결과를 알아보고자 한다. 방법: 무지 수근중수 관절염으로 진단받고 현수 봉합 관절성형술을 시행한 환자 12명을 대상으로 후향적으로 연구하였다. 시각통증척도, 수술만족도, DASH (disabilities of the arm, shoulder and hand) 점수를 조사하였고, 단순방사선 검사에서 대다각골 공간 비율을 계측하였다. 결과: 평균 추시 기간은 23개월이었다. 수술 전후 통증 점수는 7.0에서 2.9로 유의하게 감소하여 호전을 보였고 (p<0.05), 수술만족도는 평균 6.9였다. 그러나 수술 전후 DASH 점수는 유의한 차이가 없었다(p=0.06). 평균 대다각골 공간 비율은 수술 전 0.45, 수술 직후 0.33, 마지막 추시 시 0.23이었다. 결론: 현수 봉합 관절성형술은 수술 결과가 만족스럽고, 다른 술식과 비교하여 중수골 침강에 의한 대다각골 공간의 감소도 큰 차이가 없어 진행된 무지 수근중수 관절염 환자에서 유용하게 사용될 수 있을 것으로 생각한다.

Influence of Interferential Current Therapy and Laser Therapy on Functional Recovery after Total Knee Replacement

  • Oh, Seung-Keun;Kim, Yong-Nam
    • The Journal of Korean Physical Therapy
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    • 제26권3호
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    • pp.175-181
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    • 2014
  • Purpose: The purpose of this study is to investigate the effects of interference current therapy and laser therapy on functional recovery after total knee arthroplasty by measuring the Berg balance scale and range of motion. Methods: Subjects were 30 patients who were admitted to G Hospital after total knee arthroplasty. They were randomly assigned to experimental group I in which interference current therapy was applied (n=10), experimental group II in which laser therapy was applied (n=10), or the control group (n=10). The Berg balance scale and range of motion of the subjects were measured before, after 2 weeks, and after 4 weeks of therapy. Results: There was a statistically significant change (p<0.05) in the Berg balance scale and range of motion before and after therapy intervention among the laser therapy group and the interference current therapy group. There was also a significant change between the groups in the Berg balance scale and range of motion. Tukey's post hoc comparison showed a statistically significant difference between the control group and experimental group I and between the control group and experimental group II (p<0.05). Conclusion: The application of interference current therapy and laser therapy resulted in a significant change in both the Berg balance scale and range of motion among patients with total knee arthroplasty. The findings of this study can be used as preliminary clinical data in evaluating functional recovery in patients with total knee arthroplasty in a post-clinic setting.

고관절 골절로 인공고관절 수술을 받은 노인의 신체적 기능에 대한 의료인의 인식 분석 (Health Care Providers' Perceptions of Physical Function in Older Adults with Arthroplasty from Hip Fracture)

  • 고영지;이주희
    • 근관절건강학회지
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    • 제22권2호
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    • pp.67-77
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    • 2015
  • Purpose: This study was a qualitative research using focus group interviews to collect data on the health care providers' perceptions of physical function in older adults with arthroplasty from hip fracture. Methods: A total of 12 subjects participated in this study. In order to conduct focus group interviews, structured manuscript, field notes, visual recording, and debriefing notes were referred and thematic analysis was used in analysis phase. Results: The six themes were raised: 'burdensome client', 'health care providers' perception of functional decline in older adults after surgery', 'health care providers' perception of caregiver', 'medical environment perceived as affecting physical function', 'crucial components perceived as encouraging functional restoration', and 'difficulty of pain management' with 18 subthemes. Conclusion: Healthcare providers perceived functional decline of elderly after arthroplasty and identified points facilitating or disturbing physical function Moreover, various perspectives on pain management related to physical function were represented.