• Title/Summary/Keyword: High tibial osteotomy

검색결과 32건 처리시간 0.219초

개방형 근위경골절골술의 3차원 수술계획을 위한 절골해석모델 (Analytical Osteotomy Model for Three-dimensional Surgical Planning of Opening Wedge High Tibial Osteotomy)

  • 구본열;박병건;최동권;김재정
    • 한국CDE학회논문집
    • /
    • 제18권6호
    • /
    • pp.385-398
    • /
    • 2013
  • Opening wedge high tibial osteotomy (OWHTO) is widely used to treat unicompartmental osteoarthritis of the knee caused by degenerative deformations of the anatomical axes of the leg. However, since it is difficult to accurately plan the surgical degrees of adjustment such as coronal correction angle and tibial posterior slope angle to align the axes before the actual procedure, a number of studies have proposed analytical models to solve this problem. While previous analytical models for OWHTO were limited to specific cases, this study proposes an analytical osteotomy model (AOM) and a surgical planning system (SPS) that are suitable for a wide range of tibial morphologies and tibia conditions. The validity and generality of the model were verified in a total of 60 OWHTO cases. Results of the test showed that, as predicted, surgical degrees are affected quite significantly by tibia shape and slope of the resected surface. Comparison of the required surgical degrees and the degrees estimated from virtual surgery simulations using AOM showed a very small average difference of $0.118^{\circ}$. SPS, based on AOM, allows the operating surgeon to easily calculate surgical parameters needed to treat a patient.

근위경골절골술에서 해부학적 축과 역학적 축의 변화가 경골후방경사각에 미치는 영향 (The Effect of Anatomical Axis and Mechanical Axis on Change of Posterior Tibial Slope Angle in PTO(Proximal Tibial Osteotomy))

  • 신은지;김철웅;이호상;배지훈;왕준호;;오동준
    • 대한기계학회:학술대회논문집
    • /
    • 대한기계학회 2008년도 추계학술대회A
    • /
    • pp.1543-1546
    • /
    • 2008
  • The purpose of this study was to investigate factors affecting the change of tibial posterior slope and introduce a mathematical model which calculate, through 3-dimensional analysis of the proximal tibia, how the angle of the opening wedge along the anteromedial tibial cortex influences the tibial posterior slope and valgus correction when performing a medial open wedge osteotomy. This mathematical model with navigation system can be guidelines which provide surgeons on preoperative and intraoperative measurements to maintain or correct the tibial slope and to obtain the desired valgus correction of the lower limb during an opening wedge osteotomy.

  • PDF

퇴행성 골관절염 환자에서 시행한 근위 경골 절골술 후 대퇴골의 회전과 임상결과의 상관관계 (Correlation between femoral rotation and clinical results after high tibial osteotomy in primary osteoarthritis patient)

  • 박상은;문상원
    • 대한정형외과스포츠의학회지
    • /
    • 제10권2호
    • /
    • pp.100-104
    • /
    • 2011
  • 이 연구의 목적은 근위 경골 절골술 후 대퇴골의 회전각도와 슬관절 운동범위 및 주관적 환자 만족도 사이의 상관 관계를 분석하는 것이다. 2004년 6월부터 2008년 8월까지 고위 경골 절골술을 시행한 15명의 원발성 골 관절염 환자들이 연구 대상으로 수술 전 후 슬관절 CT를 시행하였다. 9명은 여자였으며 6명은 남자였다. 수술 전 후 슬관절의 CT를 촬영하여 대퇴골 회전 각도(TEA (Fig. 1) 및 Akagi's line (Fig. 2)으로 측정)를 백분율로 환산하여 분석하였으며 수술 후 슬관절 운동 각도와 주관적 만족도(Lysholm)의 상관관계를 확인하였다. 통계적 기법은 Kendall's 및 Spearman's nonparameter correlation coefficient 로 검정하였다. 결과상 대퇴골회전 정도와 수술 후 슬관절의 운동 각도는 의미 있는 상관 관계가 없으며 대퇴골 회전 정도와 수술후 환자의 주관적 만족도와는 의미 있는 상관 관계가 있었다. 따라서 이런 점을 알고 수술적 계획을 세운다면 보다 좋은 임상결과를 얻을 수 있을 것이다.

  • PDF

Tracking-Pin과 Fluoroscopic G-arm 이미지를 이용한 경골근위부절골술 지원시스템 개발 (Development of Computer-Aided Surgery System for High Tibial Osteotomy Using Tracking-Pin and Fluoroscopic G-arm Images)

  • 구본열;김철웅;이순혁;배지훈;박철우;김재정
    • 한국CDE학회논문집
    • /
    • 제16권5호
    • /
    • pp.331-343
    • /
    • 2011
  • High tibial osteotomy (HTO) is a widely accepted treatment for unicompartmental osteoarthritis of the knee and other lower extremity deformities, particularly for young and active patients. However, it is generally recognized as a technically demanding procedure. Thus the limitations of conventional surgical methods have been reported. Currently, the use of computer-aided surgery (CAS) system for successful surgery was increased. However it has been reported many problems such as expensive equipment, infection or fracture caused by inserting half-pin and delaying surgery. Therefore we propose a novel method which can be tracked by using tracking-pin inserted in arbitrary locations of the femur and tibia, and fluoroscopic images obtained from G-arm of antero-posterior and lateral-medial.

내측개방형 근위경골절골술의 경골절단면 및 경골개방축의 설정에 따른 영향 (Effect of Tibial Cut Planes and Hinge Axes on Medial Opening Wedge High Tibial Osteotomy)

  • 박병건;이호상;김재정;김철웅
    • 대한기계학회논문집A
    • /
    • 제35권8호
    • /
    • pp.835-846
    • /
    • 2011
  • 최근 보편화 되고 있는 내측개방형절골술 시에 의도하지 않은 경골후방경사각의 변화로 인한 문제점들이 보고되었다. 이를 해결하기 위해 많은 연구들이 진행되어 왔지만 환자의 다양한 경골의 형상 및 절단면의 기울기에 적용될 수 있는 일반적 해석 모델은 아직 제안되지 못하고 있다. 따라서 본 논문에서는 일반적인 케이스에 적용할 수 있는 근위경골절골술의 해석 모델을 제안한다. 이를 위해 내반교정각만을 조정할 수 있는 가상경골축을 정의하고, 이를 통해 절단면과 경골개방축이 내반교정각에 주는 영향을 나타내는 수학적 모델을 제안하고, 기존의 수술적인 변수들간의 상관관계를 명확히 나타내었다. 또한 내반교정각과 경골후방경사각에 추가로, 새로운 각도인 경골뒤틀림각의 존재를 도입함으로써 수술 시 발생하는 모든 기하학적 변수들간의 관계를 완성된 형태로 표현하였다.

Computer Assisted Surgery(CAS)를 이용한 개방형 쐐기 근위경골 절골술에서 전내측 경골피질경사각이 후방경골경사각의 변화에 미치는 영향 (The Effect of Anteromedial Tibial Cortex Angle on Change of Posterior Tibial Slope Angle in PTO(Proximal Tibial Osteotomy) using Computer Assisted Surgery(CAS))

  • 이호상;김철웅;배지훈;왕준호;박종웅;오동준
    • 대한기계학회:학술대회논문집
    • /
    • 대한기계학회 2008년도 추계학술대회A
    • /
    • pp.1467-1470
    • /
    • 2008
  • An upper tibial opening wedge osteotomy is an operation to cure a malalignment and a degenerate arthritis. To prevent the postoperative malalignment caused by the upper tibial opening wedge osteotomy, the research to define the relationship between a Hinge Axis Angle and a Posterior Slope Angle is needed. The effect of the relationship between the hinge axis angle and the gap angle on the posterior slope angle is studied. After 3-D Compute Tomography (CT) scanning image is reconstructed, the virtual surgery is performed by the reconstructed 3-D tibia model. It was proved that the relationship between the hinge axis angle and the gap angle were constant and the simple mathematical model could be derived. To verify the suggested mathematical model, it compared with the measured data from the virtual surgery. In conclusion, while the deviation between the data from the virtual surgery and ones of the mathematical model under the gap angle<$10^{\circ}$ was less than 1%.

  • PDF

Pseudoaneurysm Formation due to Popliteal Artery Injury Caused by Drilling during Medial Opening Wedge High Tibial Osteotomy

  • Chun, Keun Churl;So, Byung Jun;Kang, Hyun Tak;Chun, Churl-Hong
    • Knee surgery & related research
    • /
    • 제30권4호
    • /
    • pp.364-368
    • /
    • 2018
  • We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.