• 제목/요약/키워드: Cartilage injury

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관절 연골 손상의 병태 생리 (Pathophysiology of Articular Cartilage Injury)

  • 박정호
    • 대한정형외과스포츠의학회지
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    • 제4권1호
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    • pp.6-11
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    • 2005
  • 관절 연골 손상은 급성 손상과 만성 손상인 퇴행성 관절염으로 구분되며, 급성 손상은 연골 손상의 깊이에 따라서 미세 손상, 연골 골절, 골연골 골절의 세 종류로 구분할 수 있고 각 손상의 종류별로 서로 다른 양상의 치유 반응과 예후를 보인다. 만성 관절 연골 손상은 다양한 원인으로 인해서 발생하며 관절 연골의 전반적인 퇴행성 관절염의 형태를 보인다. 관절 연골 손상 시 초기 손상의 정도가 예후를 결정짓는데 가장 중요하고 이외에도 손상의 크기, 부위, 나이, 활동성, 비만 정도, 하지 정렬 상태등도 예후를 결정하는 중요한 요소들이다. 본 논문에서는 관절 연골 손상 시 발생하는 관절 연골 내의 병태 생리적 변화에 대하여 기술하고 비수술적인 치료 방법을 생역학적인 측면과 생물학적인 측면으로 구분하여 그 효과를 알아보고자 한다.

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Hypopharyngeal Wall Exposure within the Surgical Field : The Role of Axial Rotation of the Thyroid Cartilage during Anterior Cervical Surgery

  • Choi, Byung-Kwan;Cho, Won-Ho;Choi, Chang-Hwa;Song, Geun-Sung;Kim, Choon-Grak;Kim, Hak-Jin
    • Journal of Korean Neurosurgical Society
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    • 제48권5호
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    • pp.406-411
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    • 2010
  • Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

방기음의 Monosodium Iodoacetate에 의한 관절연골손상 억제효과 (Protective Effects of Banggi-eum (FangchiYin) on the Articular Cartilage Injuries Induced by Monosodium Iodoacetate in Rats)

  • 정해창;정수현;서일복
    • 한방재활의학과학회지
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    • 제24권3호
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    • pp.39-50
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    • 2014
  • Objectives The objective of this study is to investigate the protective effects of Banggi-eum (FangchiYin) on the articular cartilage injuries in rat model of osteoarthritis. Methods Articular cartilage injury was induced by injection of monosodium iodoacetate (MIA) (0.25 mg) into both knee joint cavities of rats. Rats were divided into control group (n=8) and Banggi-eum (FangchiYin) group (n=8), which was taken extracts of Banggi-eum (FangchiYin) by orally for 20 days. At the end of the experiment (20 days after MIA injection), gross and histopathological examinations on the articular structures of knee joints were performed. Proteoglycan (PG) content in articular cartilages was analyzed by safranin O staining method. And also, tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interleukin-$1{\beta}$ (IL-$1{\beta}$) contents in synovial fluid were measured by ELISA method. Results 1. Grossly, the degree of articular cartilage injury in the Banggi-eum (FangchiYin) group was alleviated compared with the control group. 2. PG content in articular cartilage of the Banggi-eum (FangchiYin) group was increased significantly compared with the control group. 3. Histopathologically, osteoarthritic score of the Banggi-eum (FangchiYin) group was decreased significantly compared with the control group. 4. TNF-${\alpha}$ and IL-$1{\beta}$ content in synovial fluid of the Banggi-eum (FangchiYin) group was increased compared with the control group. But there was no significance. Conclusions On the basis of these results, we suggest that Banggi-eum (FangchiYin) have inhibiting effects on the progression of articular cartilage injury in MIA-induced osteoarthritis model.

골관절염에서 줄기세포를 이용한 연골 재생의 최신 지견 (Current Update of Cartilage Regeneration Using Stem Cells in Osteoarthritis)

  • 선종근;최익선;고지욱
    • 대한정형외과학회지
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    • 제54권6호
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    • pp.478-489
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    • 2019
  • 골관절염은 관절연골 침식의 진행을 특징적으로 보이는 질환으로 관절운동 중에 통증을 증가시키고 기계적 스트레스를 견디는 능력을 감소시켜 결과적으로 관절의 가동성과 기능을 저하시킨다. 외상 또는 퇴행성으로 인한 관절연골의 손상이 일반적 관절염의 주요 원인으로 생각되며 이러한 관절연골 손상의 재생에 관한 수많은 연구와 시도들이 현재까지 진행되어 오고 있다. 현재까지 연골 손상의 경우 미세골절술과 자가연골세포 이식술이 일반적인 수술적 치료방법으로 제시되어 왔으나 비교적 양호한 임상 결과에도 불구하고 정상 유리연골의 생성이 미흡하여 시간이 경과하면서 결과가 악화되는 등 단점이 있다. 이를 보완하기 위하여 줄기세포 기반 치료법이 개발되었다. 이 종설에서는 현재 사용되는 다양한 연골 재생 방법들의 장단점 및 결과에 대해 요약하고 특히 중간엽 줄기세포(mesenchymal stem cells) 기반 연골 재생 치료법을 논하고 나아가 이상적인 미래 연골 재생 치료법에 대해서도 고민해보고자 한다.

양측 족관절에 발생한 외측 거골원개 골연골의 골절에 대한 골편제거 후 다발성 천공술 및 생흡수성 핀을 이용한 골편고정: 증례 보고 (Bony Fragment Excision Followed by Multiple Drilling and Fragment Fixation Using Bio-absorbable Pins for Bilateral Osteochondral Fracture of the Lateral Talar Dome: A Case Report)

  • 이용재;서진수;최준영
    • 대한족부족관절학회지
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    • 제23권4호
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    • pp.201-207
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    • 2019
  • An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favorable clinical outcome was obtained at 18 months follow-up.

전위를 동반한 갑상연골 골절의 자연 치유 치험 1례 (Spontaneously Healed Thyroid Cartilage Fracture with Displacement: Report of a Case)

  • 류현호;이병국;정경운
    • Journal of Trauma and Injury
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    • 제23권1호
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    • pp.53-55
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    • 2010
  • A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

흰쥐 퇴행성 관절염모델을 이용한 봉독약침의 치료효과 (Effect of Bee Venom Herb-acupuncture on the Repair of Articular Full-thickness Defect in Rat)

  • 조미애;함대현;이승기;최선미;김건호;심인섭;강성길;이혜정
    • 동의생리병리학회지
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    • 제19권3호
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    • pp.618-622
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    • 2005
  • Articular cartilage is an important target for studying the arthritic diseases. To verify the therapeutic effects of bee venom herb-acupuncture in vivo, 3${\mu}$l of diluted solution of bee venom for herb-acupuncture were injected into articular cavity once a day during 3 months after making full-thickness defects in rat articular cartilage. Histological examination and immunohistochemistry indicated that the chondrocyte-like tissue was formed during the repair process of cartilage injury, and the expression of a cartilage-specific protein, collagen type II, were significantly activated. It means that the expression of the gene encoding type I collagen was down-regulated, whereas those of collagen type II were up-regulated. Histological examination by hematoxylin-eosin staining indicated that the cells regained their original round morphology. In addition, a homogeneous distribution of articular cartilage extracellular matrices was detected around the cells. These results suggested that bee venom herb-acupuncture was very effective on the recovery of articular chondrocyte phenotype.

귀 연골조직에서 발생한 부분적 골화 (A Case Report of Focal Ossification of the Auricular Cartilage)

  • 서현우;김효성;하기영;한은미;김부영
    • 대한두개안면성형외과학회지
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    • 제12권1호
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    • pp.58-62
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    • 2011
  • Purpose: The focal ossification of auricular cartilage is an unusual clinical entity in which the ear becomes partially or totally rigid and immalleable. This condition may result from cold injury, local trauma, inflammation, or various systemic diseases. Patients may feel mild discomfort, but there are usually no other serious symptoms. We present a case of focal ossification of auricular cartilage in which the cause is unknown. Methods: A healthy 58-year-old man presented with a 2-year history of hard mass of right posterior auricular area. He denied any precipitating historical events like cold injury and inflammation. Routine testing did not demonstrate systemic abnormalities. Ultrasonographic examination revealed a $22{\times}10{\times}11mm$ sized heterogenous isoechoic mass showing an acoustic shadow. Results: Excisional biopsy was performed under local anesthesia. Histological examination revealed the ossification with deposition of trabecular bone in normal elastic cartilage. The patient was healed without any problems and satisfied with the result. Conclusion: We report clinical experience of focal ossification of auricular cartilage, which is quite a rare clinical entity. It should be considered that there is the possibility of ossification of cartilage when it meets the benign mass of the ear.