• 제목/요약/키워드: Autologous osteochondral graft

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슬관절의 연골결손에 대한 자가 골연골 이식술 (Mosaicplasty for the Treatment of the Chondral Defect of the Knee)

  • 최남홍
    • 대한정형외과스포츠의학회지
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    • 제4권1호
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    • pp.12-17
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    • 2005
  • 슬관절의 연골 결손에 대한 치료로 여러가지 방법이 시행되어 왔는데, 기존의 방법들은 치 유된 결손 부위가 섬유연골로 덮히는 것으로 알려져 있다. 최근 시행되는 자가 골연골 이식술과 자가 연골세포 이식술은 결손 부위가 대부분 초자연골로 덮힌다고 알려져 있다. 이 논문에서는 자가 골연골 이식술의 기초적 연구, 적응증, 수술 기법, 수술 후 결과를 기술하고자 한다.

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슬관절의 연골결손에 대한 자가 골연골 이식술 (Mosaicplasty for The Treatment of the Chondral Defect of The Knee)

  • 최남홍
    • 대한관절경학회지
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    • 제12권3호
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    • pp.147-153
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    • 2008
  • 슬관절의 연골 결손에 대한 치료로 여러가지 방법이 시행되어 왔는데, 기존의 방법들은 치유된 결손 부위가 섬유연골로 재생되는 것으로 알려져 있다. 최근 시행되는 자가 골연골 이식술과 자가 연골세포 이식술은 결손 부위가 대부분 초자연골로 재생된다고 알려져 있다. 이 논문에서는 자가 골연골 이식술의 기초적 연구, 적응증, 수술 기법, 수술 후 결과를 기술하고자 한다.

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거골 골연골 병변에 대한 미세 골절술 실패 후 2차 치료로서 자가연골 세포 이식술 (Autologous Chondrocyte Implantation as a Secondary Procedure after Failed Microfracture for Osteochondral Lesion of Talus)

  • 김진수
    • 대한족부족관절학회지
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    • 제19권1호
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    • pp.7-10
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    • 2015
  • Microfracture as a reparative strategy is the treatment of choice for an osteochondral lesion of talus. Although the results of microfracture are generally excellent, at least 30% of patients who received microfracture have acute or chronic ankle pain with several or unknown causes. The most important factor for unsatisfactory outcome after microfracture is the size of the lesion. For failed osteochondral lesion of talus, the second options are autologous osteochondral graft, autologous chondrocyte implantation, or re-microfracture. In this article, we present the autologous chondrocyte implantation as a second procedure for failed microfracture and compare its clinical outcome with other methods based on a literature review.

거골의 골연골 병변에 대한 자가 골연골 이식술의 결과: 내과 절골 도달법과 전방 관절낭 절개 도달법의 비교 (Results of Autologous Osteochondral Transplantation of the Ostochondral Lesion on the Talus: A Comparison Study between Medial Malleolar Osteotomy Approach and Anterior Arthrotomy Approach)

  • 이용식;안길영;남일현;이영현;이태훈;김대근;이동현
    • 대한족부족관절학회지
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    • 제21권4호
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    • pp.139-143
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    • 2017
  • Purpose: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. Materials and Methods: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. Conclusion: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).

내측 거골 체에 발생한 비교적 큰 골연골 병변에 대한 수술적 치료 결과 (Results of Operative Treatment for Large Osteochondral Lesion of Medial Talar Dome)

  • 정운섭;박용욱;이제형
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.150-155
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    • 2006
  • Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting harvested from medial side of talus for relatively large osteochondral lesion of the medial talar dome. Materials and Methods: From October 2004 to September 2005, 12 patients with osteochondral lesion measured more than 10 mm in axial MRI who were followed up more than 1 year after operation were analyzed. We evaluated postoperative symptoms by Mann and Reynolds scale, morbidity of donor site, and compared the range of both ankle motion. We also evaluated the union at the medial malleolar osteotomy site, trabecular connection between the grafted osteochondral mass and talus, irregularity of the articular surface in lesion. Results: Clinical results were rated as excellent in 4, good in 7, fair in 1. The mean angle of the total range of motion in affected ankle was decreased by 3 degrees compared to that in unaffected ankle. We did not observe abnormal findings at donor site. The osteotomized bone was united at mean 9 weeks (range, 8-12 weeks). We observed trabecular connection between grafted osteochondral mass and talus at mean 14 weeks (range, 12-16 weeks). We also observed irregular articular surface in osteochondral lesions in 6, smooth articular surface in 6. Conclusion: The local autologous osteochondral graft for relatively large osteochondral lesion of the medial talar dome is useful operative method with advantages of wide operative field, low morbidity of donor site, and high satisfaction rate.

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거골의 골연골 병변에 대한 자가 골연골 이식술의 결과 (The Result of Autologous Osteochondral Grafting for the Osteochondral Lesion of the Talus)

  • 안영준;한성호;양보규;이승림;유재호;정선욱;빈성우;주민홍;김성완
    • 대한족부족관절학회지
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    • 제10권1호
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    • pp.48-55
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    • 2006
  • Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. Materials and Methods: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. Results: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. Conclusion: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.

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거골 골연골 병변의 자가 골연골 이식술의 임상 결과 (The Clinical Results of Autologous Osteochondral Grafts in Osteochondral Lesion of the Talus)

  • 최홍준;문정석;이우천;고한석
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.209-215
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    • 2007
  • Purpose: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. Materials and Methods: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. Results: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. Conclusion: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.

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연골 결손의 치료

  • 이범구;심재앙
    • 대한관절경학회:학술대회논문집
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    • 대한관절경학회 제21차 추계 학술대회
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    • pp.165-169
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    • 2009
  • 연골 결손은 자체 치유 능력이 적어 그 크기가 1 cm 이상인 경우 골관절염이 발생할 수 있다. 최근에는 3-tesla MRI 등의 발전으로 인해 수술 전에 미리 연골 손상을 정확히 진단할 수 있어 연골 손상의 치료를 더욱 적극적으로 할 수 있다. 이제까지 연골 손상에 대한 수술적 치료는 세척술(lavage) 및 변연 절제술(debridement), 미세 천공술(microfracture), 자가 골연골 이식술(autologous osteochondral graft), 자가 연골 세포 이식술(autologous chondrocyte implantation, ACI), 동종 골연골 이식술(osteochondral allograft)이 있다.

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Autologous Osteochondral Graft Transfer

  • Choi Nam-Hong
    • 대한정형외과스포츠의학회:학술대회논문집
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    • 대한정형외과스포츠의학회 2005년도 춘계학술대회 대한정형외과 스포츠의학회
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    • pp.52-55
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    • 2005
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