• 제목/요약/키워드: Joint instability

검색결과 327건 처리시간 0.028초

슬관절 주위 골육종에서 체외 방사선 조사를 이용한 재활용 전 자가 관절 이식술 (Recycling Total Joint Autotransplantation in Osteosarcoma around the Knee Joint)

  • 정소학;조율;김재도
    • 대한골관절종양학회지
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    • 제13권1호
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    • pp.31-36
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    • 2007
  • 목적: 악성 골종양 환자에서 사지구제술 후 결손부위의 재건방법 중 체외 방사선 조사를 이용한 재활용 자가골 이식술이 한 방법으로 시행되고 있다. 그러나 관절주위에서 발생한 종양의 수술시 관절 내 절제술 및 재활용 자가 관절이식술 시행 후 발생하는 관절의 불안정성, 진행되는 관절염 등의 단점이 있다. 이러한 단점을 보완하기 위해 생각되어진 관절외 절제술 및 체외 방사선 조사를 이용한 재활용 전 자가 관절 이식술을 시행하여 그 결과를 알아보고자 하였다. 대상 및 방법: 1997년 6월부터 2006년 2월까지 슬관절 주위의 악성 골종양으로 진단받고, 동일한 수술을 시행한 5례를 대상으로 하였다. 추시 중 합병증과 재발의 유무를 확인하기 위해 주기적 진찰 및 검사를 시행하였다. 추시 기간은 최단 93개월에서 최고 105개월로 평균 100개월이었으며, 평균 나이는 21.6세였다. 결과: 단순 방사선상 골 유합기간은 평균 15.6개월(9~40개월)이었으며, Enneking 기준의 기능적 평가결과 평균 71.6%(66.6~80%)였으며 재발은 1례도 없었다. 합병증은 골단부 붕괴 3례, 관절 불안정성 5례가 발생하였고, 전례에서 종양 대치물로 관절 치환술을 시행하였다. 결론: 슬관절 주위에 원발성 골종양이 발생한 경우 체외 방사선 조사를 이용한 재활용 전자가 관절이식술은 관절 불안정성을 일으켜 영구적인 관절 기능을 유지하지 못하므로 종양 대치물의 사용이 적절할 것으로 생각된다.

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Effects of Joint Mobilization on Foot Pressure, Ankle Moment, and Vertical Ground Reaction Force in Subjects with Ankle Instability

  • Yoon, Na Mi;Seo, Yeon Soon;Kang, Yang-Hoon
    • 한국운동역학회지
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    • 제26권2호
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    • pp.153-159
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    • 2016
  • Objective: The purpose of this study was to investigate the effects of joint mobilization on foot pressure, ankle moment, and vertical ground reaction force in subjects with ankle instability. Method: Twenty male subjects (age, $25.38{\pm}3.62yr$; height, $170.92{\pm}5.41cm$; weight, $60.74{\pm}9.63kg$; body mass index (BMI), $19.20{\pm}1.67kg/m^2$) participated and underwent ankle joint mobilization. Weight-bearing distribution, ankle dorsi/plantar flexion moment, and vertical ground reaction force were measured using a GPS 400 and a VICON Motion System (Oxford, UK), and subsequently analyzed. SPSS 20.0 for Windows was used for data processing and paired t-tests were used to compare pre- and post-mobilization measurements. The significance level was set at ${\alpha}$ = .05. Results: The results indicated changes in weight-bearing, ankle dorsi/plantar flexion moment, and vertical ground reaction force. The findings showed changes in weight-bearing distribution on the left (pre $29.51{\pm}6.31kg$, post $29.57{\pm}5.02kg$) and right foot (pre $32.40{\pm}6.30kg$, post $31.18{\pm}5.47kg$). There were significant differences in dorsi/plantar flexion moment (p < .01), and there were significant increases in vertical ground reaction forces at initial stance (Fz1) and terminal stance (Fz2, p < .05). Additionally, there was a significant reduction in vertical ground reaction force at midstance (Fz2, p < .001). Conclusion: Joint mobilization appears to alter weight-bearing distribution in subjects with ankle instability, with resultant improvements in stability.

발목 불안정성에 키네시오 테이핑적용이 관절가동범위 및 균형에 미치는 영향 (Effects of Kinesio Taping Applied on the Ankle Instability to Range of Motion and Balance)

  • 서태화;고현민;박종항;김윤환;김태원;박현식
    • 대한정형도수물리치료학회지
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    • 제23권1호
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    • pp.7-13
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    • 2017
  • Background: To evaluate the effect of Kinesio taping applied on the ankle instability, joint range of motion and balance. Methods: The participants included in this study were male and female, 20~30 ages, who experiencing an ankle sprain or had chronic pain, did not exercise during the intervention, and did not experience severe exercise at least 3 weeks before. A total of twenty-four participants were divided into two groups: Kinesio taping applied group (n=12) and control group (n=12). The experiment was conducted for a three days. Measurements were taken for ankle joint range of motion using goniometer, and measurements were taken for balance using good balance system. Pre-test measurements were conducted on before Kinesio taping apply, and 24 hours after, 48 hours after, 72 hours after measurements were conducted. Statistical analysis was done using a independent samples t-test and repeated measure ANOVA. Results: There were significant differences to the duration of intervention in ankle joint range of motion and balance within the both group. However, there was a significant differences Kinesio taping group when comparing the groups. Conclusions: According to the results of this study, applying Kinesio taping to ankle instability is more effective on ankle joint range of motion and to recover balance.

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Horizontal instability after acromioclavicular joint reduction using the two-hole technique is preferred over the loop technique: a single-blind randomized clinical trial

  • Mardani-Kivi, Mohsen;Asadi, Kamran;Leili, Ehsan Kazemnejad;Hashemi-Motlagh, Keyvan;Izadi, Amin;Pishgahpour, Mona;Darabipour, Zohre
    • Clinics in Shoulder and Elbow
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    • 제25권3호
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    • pp.224-229
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    • 2022
  • Background: Most acromioclavicular joint (ACJ) injuries are caused by direct trauma to the shoulders, and various methods and techniques are used to treat them; however, none of the options can be considered the gold standard. This study examines the horizontal stability of the ACJ after a complete dislocation was repaired using one of two Ethibond suture techniques, the loop technique and the two holes in the clavicle technique. Methods: In this single-blind, randomized clinical trial, 104 patients diagnosed with complete ACJ dislocation type V were treated using Ethibond sutures with either the loop technique or the two holes in the clavicle technique. Horizontal changes in the ACJ were radiographically assessed in the lateral axial view, and shoulder function was evaluated by the Constant (CS) and Taft (TS) scores at intervals of 3, 6, and 12 months after surgery. Results: The horizontal stability of the ACJ was better with the two-hole technique than the loop technique at all measurement times. CS and TS changes showed a significant upward trend over time with both techniques. The mean CS and TS at the final visit were 95.2 and 11.6 with the loop technique and 94.0 and 11.9 with the two-hole technique, respectively. The incidence of superficial infections caused by the subcutaneous pins was the same in the two groups. Conclusions: Due to the improved ACJ stability with the two-hole technique, it appears to be a more suitable option than the loop technique for AC joint reduction.

Posterior and Multidirectional Instability

  • Kim, Seung-Ho
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2005년도 제3차 연수강좌
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    • pp.78-93
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    • 2005
  • The posterior and multidirectional instability of the shoulder is a complex problem in terms of diagnosis and treatment. Increased joint volume by redundant capsular ligament has been regarded as a major pathogenesis of the posterior and multidirectional instability. Distinct from multidirectional hyperlaxity, multidirectional instability has symptoms related with increased translations in more than one direction. Recent report that shoulder symptom originates from labral lesion which was created by excessive rim-loading of the humeral head on the posteroinferior glenoid labrum during repetitive subluxation helps us to understand the pathogenesis of such instability. Painful jerk and Kim tests indicate labral lesion in the multidirectionally loose shoulder, suggesting multidirectional instability. Also, painful jerk test is a prognostic sign of failure of nonoperative treatment. The labral lesion can be an incomplete tear or a concealed lesion which often has been underestimated. Operative treatment is indicated when nonoperative treatment has failed. Arthroscopic capsulolabroplasty is a reliable procedure, which not only provides capsular balance, but also restores the labral height.

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만성 발목 불안정증의 치료에서 관절경 수술 (Arthroscopic Procedure in the Treatment of Chronic Lateral Ankle Instability)

  • 이호진;정비오
    • 대한족부족관절학회지
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    • 제25권1호
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    • pp.25-31
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    • 2021
  • The open Broström procedure is considered the surgery of choice for treating chronic lateral ankle instability. The role of arthroscopy has gained popularity in the surgical treatment of chronic lateral ankle instability, partly for the ability to manage the intra-articular pathology combined with ankle instability. Arthroscopic techniques can be divided broadly into the arthroscopic-assisted Broström technique and arthroscopic all-inside ligament repair. The clinical results of these arthroscopic techniques are similar to open procedures. The arthroscopic technique may be an excellent alternative to the open Broström procedure in treating chronic lateral ankle instability when applying the appropriate indications.

가장자리 하중조건에서의 볼 조인트 마찰소음 연구 (Investigation of Friction Noise in Ball Joint Under Edge Loading Condition)

  • 강재영
    • 대한기계학회논문집A
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    • 제38권7호
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    • pp.779-784
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    • 2014
  • 본 연구에서는 볼 조인트 구조에서 가장자리 하중을 받고 있을 때의 마찰 소음을 이론적으로 연구하였다. 구형 베어링 구조체와 반구 형태의 소켓간 마찰접촉 모델을 수학적으로 유도하여 동역학적 운동방정식을 전개하였다. 그 결과 볼 조인트부 굽힘 모드가 마찰에 의해 불안정할 수 있음을 보였고, 축력 및 접촉강성이 볼 조인트 동적 불안정성에 크게 영향을 주고 있음을 보였다. 반면 소켓의 틸팅 각도는 동적 불안정성에 크게 기여하지 않음을 보였다.

Assessment of Gait Ability of Subjects With Chronic Ankle Instability During an Inter-trial Variability Gait Task According to Changes in Gait Speed

  • Jeonghan Kwon;Jongduk Choi
    • 한국전문물리치료학회지
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    • 제30권4호
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    • pp.268-274
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    • 2023
  • Background: Ankle sprains occur frequently among humans who undertake various body movements. Diverse walking environments and dual tasks, that can affect ankle sprains, have been studied. However, there is a lack of research on inter-trial variability according to the changes in gait speed. Objects: The purpose of this study was to compare the adaptive ability of walking between the subjects with chronic ankle instability and healthy adults while performing a walking task with different walking speeds. Methods: In this study, 24 people in the chronic ankle instability group and 24 people in the healthy ankle group were selected as subjects. The length of the pre-measurement and the actual walking measurement were both set to 4.6 m. Once the subjects entered the measurement section, they changed their gait speed according to the randomly assigned speed change. Gait was measured twice and the average value was used for the analysis. Results: The coefficient of variation (CV) of cycle time in subjects with chronic ankle instability showed a significant difference in all cases except when the subjects changed their speed from preferred to slow and from slow to preferred. The CV of step length demonstrated a significant difference in all cases except for the change from slow to preferred and from preferred to fast. The cycle time and step length differential showed a significant difference only when the subjects changed the speed from slow to fast. Conclusion: The subjects with chronic ankle instability were found to have significantly reduced walking adaptability while performing inter-trial variability tasks with different gait speeds compared to healthy subjects.

Peri-anchor cyst formation after arthroscopic bankart repair: comparison between biocomposite suture anchor and all-suture anchor

  • Jin, Seokhwan;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • 제23권4호
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    • pp.178-182
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    • 2020
  • Background: The purpose of this study is to investigate clinical outcomes and radiological findings of cyst formation in the glenoid around suture anchors after arthroscopic Bankart repair with either biocomposite suture anchor or all-suture anchor in traumatic anterior shoulder instability. We hypothesized that there would be no significant difference in clinical and radiological outcomes between the two suture materials. Methods: This retrospective study reviewed 162 patients (69 in group A, biocomposite anchor; 93 in group B, all-suture anchor) who underwent arthroscopic Bankart repair of traumatic recurrent anterior shoulder instability with less than 20% glenoid defect on preoperative en-face view three-dimensional computed tomography. Patient assignment was not randomized. Results: At final follow-up, the mean subjective shoulder value, Rowe score, and University of California, Los Angeles shoulder score improved significantly in both groups. However, there were no significant differences in functional shoulder scores and recurrence rate (6%, 4/69 in group A; 5%, 5/93 in group B) between the two groups. On follow-up magnetic resonance arthrography/computed tomography arthrography, the incidence of peri-anchor cyst formation was 5.7% (4/69) in group A and 3.2% (3/93) in group B, which was not a significant difference. Conclusions: Considering the low incidence of peri-anchor cyst formation in the glenoid after Bankart repair with one of two anchor systems and the lack of association with recurrence instability, biocomposite and all-suture anchors in Bankart repair yield satisfactory outcomes with no significant difference.