• 제목/요약/키워드: Bone replacement

검색결과 234건 처리시간 0.04초

고관절전치환 성형술 후 관절주위 골형성 예방을 위한 수술 후 방사선 요법 (Postoperative Irradiation for Prevention of Heterotopic Bone Formation after Total Hip Replacement Arthroplasty)

  • 박우윤;김일한;하성환;박찬일
    • Radiation Oncology Journal
    • /
    • 제4권1호
    • /
    • pp.75-80
    • /
    • 1986
  • 관절주위 골형성은 고관절치환 성형술을 시행받은 환자의 $0.6\~61.7\%$에서 생친 수 있는 합병증이다. 저자들은 1981년 1월부터 1985년 5월까지 서울대학교병원 치료방사선과에서 고관절전치환 성형술 후 관절주위 골형성 예방을 위하여 방사선요법을 시행받은 4명의 환자(8개의 고관절)를 분석하였다. 방사선요법은 수술후 $6\~10$일이내 시작하였으며 2,000cGy를 10회 분할 조사하였다. Modified Brooker system에 의하여 7계의 고관절에서는 Grade(1개 의고관절에서는 Grade) 2의 결과를 얻었다. 저자들의 이번 연구결과 및 문헌조사에 의하면 고관절 성형술 후 관절주위 골형성 예방을 위하여 호발군에 있어서의 방사선요법은 효과적이라고 하겠다.

  • PDF

Doujet GF 골 시멘트를 사용한 인공 슬관절치환술의 임상적, 방사선적 고찰 (Clinical and radiologic study of total knee replacement arthroplasty using Doujet GF bone cement (liquid-powder bone cement containing gentamicin))

  • 최성욱;윤성민;노조셉;손인석
    • Journal of Medicine and Life Science
    • /
    • 제20권2호
    • /
    • pp.60-66
    • /
    • 2023
  • Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.

Atypical Vancouver B1 periprosthetic fracture of the proximal femur in the United Kingdom: a case report challenged by myeloma, osteoporosis, infection, and recurrent implant failures

  • Sayantan Saha;Azeem Ahmed;Rama Mohan
    • Journal of Trauma and Injury
    • /
    • 제37권1호
    • /
    • pp.89-96
    • /
    • 2024
  • The indications for total hip replacement are increasing and not limited to osteoarthritis. Total hip replacement may also be done for trauma and pathological fractures in patients otherwise physiologically fit and active. This trend has led to an inevitable rise in complications such as periprosthetic femoral fracture. Periprosthetic femoral fracture can be challenging due to poor bone quality, osteoporosis, and stress fractures. We present a case of periprosthetic femoral fracture in a 71-year-old woman with some components of an atypical femoral fracture. The fracture was internally fixed but was subsequently complicated by infection, implant failure needing revision, and later stress fracture. She was on a bisphosphonate after her index total hip replacement surgery for an impending pathological left proximal femur fracture, and this may have caused the later stress fracture. Unfortunately, she then experienced implant breakage (nonunion), which was treated with a biplanar locking plate and bone grafting. The patient finally regained her premorbid mobility 13 months after the last surgery and progressed satisfactorily towards bony union.

Prognosis of closure of large sinus membrane perforations using pedicled buccal fat pads and a resorbable collagen membrane: case series study

  • Kim, Young-Kyun;Yun, Pil-Young;Oh, Ji-Su;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제40권4호
    • /
    • pp.188-194
    • /
    • 2014
  • For large membrane perforations that develop during sinus-bone grafting, we performed repairs using a pedicled buccal fat pad and a resorbable collagen membrane simultaneously with the bone graft. This study included eight patients. Postoperative maxillary sinusitis developed in two patients, which we managed with incision and drainage, and antibiotics. Ultimately, six patients received 12 implants, three of which failed (75% success). Implant replacement was performed after the removal of the failed replacement, at which point the prosthetic treatment was considered complete. In all of the six cases that we were able to follow-up with, the sinus-bone graft was healing favorably. We observed that the sinus bone height decreased gradually with time. Based on these case series, we conclude that our procedure of repairing large sinus-membrane perforations with a pedicled buccal fat pad and a collagen membrane is a reliable technique.

시멘트-대퇴Stem 경계면 해리가 골-시멘트 경계면에 미치는 응력 분석 -3차원 비선형 Finite Element Analysis- (Stress analysis of the effect of debonding of cement-femoral stem interface to the bone-cement interface -A three-dimensional Finite Element Analysis-)

  • 김성곤
    • 대한의용생체공학회:학술대회논문집
    • /
    • 대한의용생체공학회 1996년도 추계학술대회
    • /
    • pp.337-346
    • /
    • 1996
  • Debonding of cement-femoral stem interface has been suggested as a initial focus of loosening mechanism in many previous studies of cemented total hip replacement. The purpose of this study was to investigate the effect of debonding of cement-femoral stem interface to the bone-cement interface by using three-dimensional non-liner finite element analysis. Three cases of partial debonded, full debonded, full bonded cement-bone interface were modelled with partial bonding of distal 70mm from the tip of femoral stem. Each situation was studied under loading stimulating one-leg stanced gait of 68kg patient. The results showed that under partial and full debonded cement-stem interface condition the peak von Mises stress(3.1 MPa) were observed at the cement of bone-cement interface just under the calcar of proximal medial of femur, and sudden high peak stresses(3.5MPa) were developed at the distal tip of femoral stem at the lateral bone-cement interface in all 3 cases of bonding. The stresses were transfered very little to the cement of upper lateral bone-cement interface in partial and full debonded cases. Thus, once partial or full debonded cement-femoral stem interface occured, 3 times higher stress concentration were developed on the cement of proximal medial bone-cement interface than full bonded interface, and these could cause loosening of cemented total hip replacement. Clinically, preservation of more rigid cement-femoral stem interface may be important factor to prevent loosening of femoral stem.

  • PDF

Performance analysis of bone scaffolds with carbon nanotubes, barium titanate particles, hydroxyapatite and polycaprolactone

  • Osfooria, Ali;Selahi, Ehsan
    • Biomaterials and Biomechanics in Bioengineering
    • /
    • 제4권1호
    • /
    • pp.33-44
    • /
    • 2019
  • This paper presents a novel structural composition for artificial bone scaffolds with an appropriate biocompatibility and biodegradability capability. To achieve this aim, carbon nanotubes, due to their prominent mechanical properties, high biocompatibility with the body and its structural similarities with the natural bone structure are selected in component of the artificial bone structure. Also, according to the piezoelectric properties of natural bone tissue, the barium titanate, which is one of the biocompatible material with body and has piezoelectric property, is used to create self-healing ability. Furthermore, due to the fact that, most of the bone tissue is consists of hydroxyapatite, this material is also added to the artificial bone structure. Finally, polycaprolactone is used in synthetic bone composition as a proper substrate for bone growth and repair. To demonstrate, performance of the presented composition, the mechanical behaviour of the bone scaffold is simulated using ANSYS Workbench software and three dimensional finite element modelling. The obtained results are compared with mechanical behaviour of the natural bone and the previous bone scaffold compositions. The results indicated that, the modulus of elasticity, strength and toughness of the proposed composition of bone scaffold is very close to the natural bone behaviour with respect to the previous bone scaffold compositions and this composition can be employed as an appropriate replacement for bone implants.

페경기 여성에서 호르몬 대체요법의 지질대사 및 골밀도에 대한 효과: 지속적 요법과 순차적 요법의 비교 (Efficacy of Hormone Replacement Therapy on Lipid Profile and Bone Mineral Density in Postmenopausal Women: Continuous vs. Sequential Treatment)

  • 이창연;이숙향
    • 한국임상약학회지
    • /
    • 제10권3호
    • /
    • pp.101-106
    • /
    • 2000
  • Menopausal women experience urogenitory and vasomotor symptoms with increased risk of osteoporosis and cardiovascular diseases, which can be reduced by hormone replacement therapy. However unopposed estrogen therapy has been associated with an increased risk of endometrial hypeiplasia or cancer. The objectives of this study were to compare effects of continuous vs. sequential hormone replacement therapy (HRT) on lipid profile, bone mineral density and menopausal symptoms of postmenopausal women and to assess how they perceive the menopause and HRT culturally. In this retrospective study, women in menopause longer than 6 months, normal in the mam-mogram and Papanicolaou smear, cholesterol level lower than 190 mg/dL or triglyceride level lower 4han 500 mg/dL were treated with Srogen (conjugated equine estrogen 0.625 mg tablet) and Provera (medroxyprogesterone acetate 2.5 mg tablet) for continuous treatment(CT) or Cycloprogynova (Estradiol valerate 2 mg and Norgestrel 0.5 mg complex tablet) for sequential treatment(ST). They were evaluated for lipid profile, bone mineral density, menopausal symptoms, side effects and their perception of menopause and HRT. As results, total sixty-seven patients out of ninety-four enrollees were included in final analysis (33 in continuous therapy, 34 in sequential therapy). There were significant decrease in total cholesterol ($15.04\pm3.17$, p=0.0001), LDL ($19.72\pm3.27$, p=0.0001), and increase in HDL ($5.89\pm1.63$, p=0.0001). Bone minora) density increased significantly with HRT ($0.02\pm0.11$, p=0.0001). But, there were no significant differences in change of lipid profile between continuous and sequential therapy: Total cholesterol, $13.12\pm4.7\;vs.\;16.91\pm4.3;\;LDL\;20.53\pm4.1\;vs.\;18.93\pm5.12:HDL\;7.15\pm2.3\;vs.\;4.67\pm2.2,\;p>0.05$. Incidences of flush reduced from $75\%\;(CT)\;to\;3.13\%\;and\;71.88\%\;(ST)\;to\;9.35\%$. The change of endometrium and breast were found 3 (CT) and 5 (ST) women, respectively. Most of women recognized that HRT is necessary $(70\%)$ for postmenopausal period but did not understand well the cardiovascular protective effect. In conclusion, hormone replacement therapy was effective in improving lipid profile, bone mineral density and menopausal symptoms in both continuous and sequential treatments with similar efficacy.

  • PDF

외상 후 파괴된 주관절 또는 진구성 탈구에서의 주관절 전치환술 (Total elbow arthroplasty for posttraumatic destroyed or unreduced elbow joint)

  • 김영규;정이혁
    • Clinics in Shoulder and Elbow
    • /
    • 제6권1호
    • /
    • pp.37-43
    • /
    • 2003
  • Purpose: To evaluate the results in patients who received total elbow replacement for posttraumatic destroyed or unreduced elbow joint. Materials and Methods: Six patients with posttraumatic destroyed, or unreduced elbow joint, who were nearly impossible to move actively and had pain and grossly unstable joint, were followed up average 42 months. 3 cases were soft tissue injuries and bone defects which were caused by severe comminuted fracture, 1 was a nonunion with comminuted fracture, and 2 were unreduced elbow joint. Total elbow replacement was performed average 10 months after the injury. All the cases were used by semiconstrained prosthesis, and the results were estimated by Mayo elbow perfomance score. Results: Pain was decreased in all the cases postoperatively. Average ranges of motion were improved with active extension 20° and flexion 120°. Mayo elbow performance scores were pain 42.5 points, range of motion 17.5 points, stability 8.3 points, function 19.2 points and totally 87.5 points, and final results were 3 excellent and 3 good. Loosening of prosthesis was not found in all the cases by final follow-up radiograph. Conclusicon: Semiconstrained TER can be used as a effective treatment improving pain and active ranges of motion caused by posttraumatic destroyed or unreduced elbow joint, however, long term follow-up is needed because early loosening of TER can be occurred due to severe bone defects.

골 대체재로의 스트론튬(Sr)이 고용된 Hydroxyapatite (Sr-containing Hydroxyapatite for Bone Replacement)

  • 최정신;박홍채;윤석영
    • 한국세라믹학회지
    • /
    • 제45권10호
    • /
    • pp.589-593
    • /
    • 2008
  • The hydroxyapatite with different amounts of strontium was synthesized with wet chemical technique. The structural, morphological and chemical characterizations for the prepared hydroxyapatite with various strontium amounts were carried out with XRD, SEM, EDS, and FT-IR. Strontium is quantitatively incorporated into hydroxyapatite where its substitution for calcium provokes a well distribution in the EDS mapping and a linear shift of the infrared absorption bands of the hydroxyl and phosphate groups, coherent with the greater ionic radius of strontium.