• 대한정형외과스포츠의학회지
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• 제9권1호
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• pp.48-57
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• 2010

목적: 자가 골-슬개건-골과 자가 슬괵건을 이용한 전방 십자 인대 재건술 후, 골관절염의 발생률과 위험인자를 비교하고자 하였다. 대상 및 방법: 8년 이상 추시가 가능하였던, 자가 슬개건 53예 및 자가 슬괵건 40예를 이용한 전방 십대 인대 재건술을 시행한 총 93예를 대상으로 하였다. Kellgren and Lawrence의 분류에 따라 방사선상의 골관절염의 변화를 관찰하였고, 슬관절의 임상적 기능 (Lysholm 슬관절 점수, Tegner 운동 지수), 신체검사상의 전방 이완 정도 (Lachman 검사, Pivot-Shift 검사) 및 $Telos^{(R)}$ 기구를 이용한 전방 이완 정도를 비교 평가하였다. 결과: 자가 골-슬개건-골을 이용한 대상 중 24예 (45.3%)에서, 자가 슬괵건을 이용한 대상 중 14예 (35.0%)에서 방사선 검사상 골관절염 변화가 확인되었다. 동반된 연골판 손상 (골-슬개건-골 군 p<0.001, 슬괵건군 p=0.091), 수상에서 재건술까지 12개월 이상 경과 (골-슬개건-골 군 p=0.037, 슬괵건 군 p=0.021), 재건술 당시 연령 25세 이상 (골-슬개건-골 군p=0.003, 슬괵건 군 p=0.048) 등이 골관절염의 유의한 위험 인자로 나타났다. 하지만, 골관절염의 발생과 임상적 결과, 방사선적 안정성과의 연관성은 없었다. 결론: 자가 골-슬개건-골 및 자가 슬괵건을 이용한 전방 십자 인대 재건술 후 평균 10년 추시상 두 군 모두에서 임상적으로 양호한 결과를 얻었으나, 상당한 비율에서 방사선적 골관절염 변화가 관찰되었다. 또한 동반된 연골판 손상, 수상 후 재건술까지의 지연된 시간, 25세 이상의 연령 등의 다양한 인자가 이에 관련됨을 알 수 있었다.

• 한방재활의학과학회지
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• 제25권2호
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• pp.15-35
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• 2015

Objectives This study was performed to investigate the effects of Bujasasim-tang ethanol extract (BST) on oxidative stress, inflammation and osteoarthritic rat model. Methods To ensure safety of BST, heavy metal levels were measured and cytotoxicity test was done. In vitro, To evaluate antioxidative effects of BST, total phenolic contents, 1,1-diphenyl-2-picryl-hydrazyl (DPPH), 2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) scavenging activity, reactive oxygen species (ROS) levels were measured. Also, to evaluate anti-inflammatory effects of BST treated group, total nitric oxide (NO) and pro-inflammatory cytokines (IL-$1{\beta}$, IL-6, TNF-${\alpha}$) levels were measured in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. In vivo, We injected MIA $50{\mu}l$ (60 mg/ml) into knee joints of rats to induce osteoarthritis. Rats were divided into total 3 groups (normal, control, BST treated group, each n=7). Normal group was not treated at all without inducing osteoarthritis and taken normal diet. Control group was induced osteoarthritis by MIA and taken with 2 ml of distilled water once a day for 4 weeks. BST treated group was induced osteoarthritis by MIA and taken BST 2 ml (200 mg/kg/mouse) once a day for 4 weeks. We evaluated dynamic weight bearing with the Incapacitance Test Meter. At the end of experiment, the rats were sacrificed to observe the functions of liver and kidney, changes of WBC, neutrophil, lymphocyte, monocyte levels in blood, to evaluate the levels of pro-inflammatory cytokines, tissue inhibitor of metallopreteinases-1 (TIMP-1), matrix metalloproteinase-9 (MMP-9), prostaglandin $E_2$ ($PGE_2$), leukotriene $B_4$ ($LTB_4$) within serum. We observed change of articular structures by Hematoxylin & Eosin (H&E), safranin-O staining method and measured amount of cartilage by micro CT-arthrography. Statistical analysis was done by unpaired student's t-test with significance level at p<0.05 in SPSS 11.0 for windows. Results 1. Safety of the BST was identified. 2. AST, ALT, BUN, creatinine levels of BST treated group were within normal limit. In vitro, 1. DPPH and ABTS free radical scavenging activities of BST showed dose-dependent increase. 2. ROS production were significantly decreased. 3. Total nitric oxide (NO) and IL-$1{\beta}$ production were decreased. 4. IL-6 and TNF-${\alpha}$ production were significantly decreased. In vivo, 1. Weight bearing ability was significantly increased. 2. WBC, neutrophil, lymphocyte, monocyte levels in blood were decreased. 3. IL-$1{\beta}$ and TNF-${\alpha}$ levels in serum were significantly decreased. and the IL-6 level was decreased. 4. TIMP-1, MMP-9, $LTB_4$, $PGE_2$ levels in serum were significantly decreased. 5. Cartilage volume of BST treated group was significantly increased. Also changes of cartilage, synovial membrane, fibrous tissue were suppressed. Conclusions The results obtained in this study Bujasasim-tang have effects of antioxidative, anti-inflammatory, relieve pain and protection of cartilage. Therefore we expect that Bujasasim-tang is effective treatment for osteoarthritis.

• 대한관절경학회지
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• 제9권2호
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• pp.174-179
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• 2005

목적: 관절경을 이용한 반월상 연골 절제술 후의 슬관절의 임상적 및 방사선학적 변화를 알아보고자 한다. 대상 및 방법: 1990년 10월부터 1992년 9월까지 반월상 연골의 손상으로 본원에서 슬관절의 관절경적 시술을 시행 받은 144명의 환자 중 $10\sim15$년 뒤 장기 추적이 가능했던 79명의 환자를 대상으로 임상적 평가와 체중 부하 슬관절 방사선 촬영을 시행하여 그 변화를 관찰하였다. 79명 중 52명은 남자였으며, 평균 연령은 34.6세$(17\sim48)$였다. 결과: 추시 결과, Fairbank 변화와 관절강 협소를 포함한 방사선학적 변화는 부분 절제술 후 54예 중 23예(42.6%), 전 절제술 후 25예 중 22예(88.0%)에서 발생하여 전 절제술 후 많은 변화를 보였다(p=0.03). 임상적 결과는 부분 절제술군에서 만족이 54명 중 39명(72.4%), 전 절제군에서 25명 중 14명(56.0%)으로 부분절제술 후 만족도가 높았으나 통계적 의의는 없었다(p=0.24). 결론: 반월상 연골 절제술 후의 평균 12년 후 추시 결과, 방사선적 변화는 전 절제술시 크게 나타났으며, 이러한 변화는 슬관절 기능과 활동성에 영향을 미치지 않는 것으로 생각된다.

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.67-71
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• 2022

Subchondral cysts are frequently encountered in patients with temporomandibular joint osteoarthritis (TMJ OA), particularly in advanced stage. Subchondral cysts within osteoarthritis are typically lying adjacent to the joint surface where initial load bearing occurs during activity and have been associated with greater pain and disease progression. Although the etiology of these cysts remains uncertain, recently studies report that the induction of the subchondral bone mechanical stress caused subchondral cysts. Repeated overloading leads to further deterioration of subchondral bone which render subchondral bone structure more fragile, increase the risk of osteoarthritis progress. The purpose of this study was to assess the effect of conservative treatment and longitudinal osseous changes of a large subchondral cyst in a mandibular condyle in a symptomatic TMJ OA patient.

• Imaging Science in Dentistry
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• 제54권2호
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• pp.201-206
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• 2024

This report showed a case of temporomandibular joint (TMJ) ankylosis suspected to be associated with ankylosing spondylitis based on the observation of bony ankylosis of the cervical spine on computed tomography (CT) images. A 53-year-old man presented with a chief complaint of difficulty in opening his mouth. His medical history indicated that in his 20 s, he became aware of the difficulty in moving his neck. CT revealed marked osteoarthritic changes in the right mandibular condyle, suggesting fibrotic TMJ ankylosis. In addition, bony ankylosis of the cervical vertebral body and facet joints from the axis (C2) to C5 in continuity was observed. CT of the entire spine also showed bony deformity of the sacroiliac joints and bony ankylosis. Based on these findings, ankylosing spondylitis was suspected. The possibility of an ankylosing spondylitis complication should be considered in cases of TMJ ankylosis if bony ankylosis of the cervical spine is observed.

• Journal of Veterinary Science
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• 제21권3호
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• pp.21.1-21.14
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• 2020

Background: Physical exercise is known to cause significant joint changes. Thus, monitoring joint behavior of athletic horses is essential in early disorders recognition, allowing the proper management. Objectives: The aims of this study were to determine the morphological patterns, physical examination characteristics and ultrasound findings of show jumping horses in training and to establish a score-based examination model for physical and ultrasound follow-ups of metacarpophalangeal joint changes in these animals. Methods: A total of 52 metacarpophalangeal joints from 26 horses who were initially in the taming stage were evaluated, and the horses' athletic progression was monitored. The horses were evaluated by a physical examination and by B-mode and Doppler-mode ultrasound examinations, starting at time zero (T0), which occurred concomitantly with the beginning of training, and every 3 months thereafter for a follow-up period of 18 months. Results: The standardized examination model revealed an increase in the maximum joint flexion angles and higher scores on the physical and ultrasound examinations after scoring was performed by predefined assessment tools, especially between 3 and 6 months of evaluation, which was immediately after the horses started more intense training. The lameness score and the ultrasound examination score were slightly higher at the end of the study. Conclusions: The observed results were probably caused by the implementation of a training regimen and joint adaptation to physical conditioning. The joints most likely undergo a pre-osteoarthritic period due to work overload, which can manifest in a consistent or adaptive manner, as observed during this study. Thus, continuous monitoring of young athlete horses by physical and ultrasound examinations that can be scored is essential.

• 대한관절경학회지
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• 제12권2호
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• pp.107-111
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• 2008

목적: 50세 이상 환자에서 반월상 연골 절제술 후 최소 3년 이상 추시시 임상적 및 방사선적 결과를 알아보고자 하였다. 대상 및 방법: 1997년 12월부터 2003년 12월까지 반월상 연골 절제술을 시행 받았던 50세 이상 환자 36명, 36예의 슬관절을 대상으로 하였다. 평균 나이는 56.4세, 평균 추시 기간은 5년 3개월이었다. 술전 Kellgren and Lawrence 분류 상 Grade I 16예, II 12예, III 6예, IV 2예, Outerbridge 분류상 Grade I 16예, II 10예, III 7예, IV 3예이었다. 술후 Lysholm 점수, 환자의 주관적인 만족도, 방사선학적 변화 등을 후향적으로 비교, 분석하였다. 결과: Lysholm 점수는 24예(66.7%)에서 양호 이상의 결과를 보였으며, 26예(72.2%)의 환자들이 술후 결과에 만족하는 것으로 조사되었다. 대퇴 경골간 각이 술전 평균 외반 3.9도에서 술후 평균 외반 2.6도로 변화하였으며, 술후에 관절염이 진행한 경우가 22예(61.1%)로 나타났다. 결론: 50세 이상 환자에서 반월상 연골 절제술 후 최소 3년 이상 추시시 72.2%의 환자에서 만족할만한 임상적인 호전을 보였으나 방사선적으로 술전 관절염 변화나 관절경적 관절 연골 손상이 심한 경우 임상적 결과가 좋지 못한 것으로 나타났다.

• Journal of Acupuncture Research
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• 제33권2호
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• pp.35-49
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• 2016

Objectives : This study was designed to investigate the anti-osteoarthritic effects of clematidis radix pharmacopuncture on the MIA-induced osteoarthritis rats. Methods : The subjects were divided into 4 groups ; Normal rat group(N, n=5), MIA-induced osteoarthritis control rat group(C, n=5), MIA-induced osteoarthritis rat group injected with normal saline at ST36(NS, n=5), and MIA-induced osteoarthritis rat group injected with clematidis radix pharmacopuncture at ST36(CR, n=5). The experiment was conducted over a period of 21 days after injecting MIA. We analyzed body weight, hind paw weight distribution, liver and renal function, immunocytes, cykokines, inflammatory mediators, inflammatory proteins and mRNA expressions, as well as histopathological changes. Results : The CR group showed a significant increase in the hind paw weight distribution, and significant decreases in IL-$1{\beta}$, IL-6, $PGE_2$, $LTB_4$, osteocalcin, deoxypyridinoline level, the protein expression of COX2, arachidonate 5 lipoxygenase, and the mRNA expression of COX2, TNF-${\alpha}$, IL-$1{\beta}$, and NOS-II. In terms of the joint damages induced by osteoarthritis, the CR group showed a greater protective effect than group C in histopathologic observation (H&E, Safranin-O staining). Conclusion : These results demonstrated that clematidis radix pharmacopuncture had anti-inflammatory and analgesic effects. In addition, these results showed that it inhibited the progression of osteoarthritis.

• 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.

• 한방재활의학과학회지
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• 제24권2호
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• pp.51-64
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• 2014

Objectives This study was carried out to know the effects of Keonbodan (hereinafter referred to KBD) in osteoarthritis induced by Monosodium iodoacetate(hereinafter referred to MIA) on Wistar rat. Methods Osteoarthritis was induced by injection of MIA into left knee joint cavities of rat. Osteoarthritis rats were divided into 4 groups (normal (n=6), control (n=6), indomethacin (n=6), KBD (n=6) group). The control group was administered normal saline and indomethacin group was administered indomethacin (2 mg/kg). And the KBD group was administered KBD (142 mg/kg). Each groups were administered by orally for 4 weeks. This experiment were carried out in vivo. In vivo, at the end of the experiment (5 weeks after MIA injection), effects on hepatotoxicity and nephrotoxicity, cytokines in serum, arachidonic acid, osteocalcin, MMP-9, TIMP-1 and cartilage volume were evaluated. And histopathological examinations on the articular structures of knee joints were performed. Results 1. In weight-bearing measurement, level of weight was increased. 2. In order to hepatotoxicity and nephrotoxicity, ALT, AST, BUN and creatinine were tested. And there were no significant changes. 3. In serum, levels of TNF-$\alpha$, IL-$1{\beta}$ were significantly decreased. IL-6 was insignificantly decreased. 4. In serum, level of MMP-9 and TIMP-1 was decreased. 5. In serum, level of $LTB_4$, $PGE_2$ and osteocalcin was decreased. 6. In ${\mu}$CT-arthrography, the cartilage volume was greater than that of the control group. 7. The joint damage induced by osteoarthritis was lesser than the control group in histopathologic observation (H&E, Safranin-O staining). Conclusions These results demonstrated that KBD suppressed the osteoarthritis- inducing effects of MIA in rat. And further studies are required to find out more effective substance and anti-osteoarthritic mechanism in the future.