• 제목/요약/키워드: Synovectomy

검색결과 65건 처리시간 0.03초

방사성 동위원소 활액막절제술의 임상응용 (Radiation Synovectomy: when, which disease, and which joint)

  • 최창운
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 1999년도 제38차 춘계학술대회
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    • pp.196-199
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    • 1999
  • Radiation synovetomy with various radiopharmaceuticals has been used to alleviate pain and swelling of rheumatoid arthritis and related joint diseases for more than 40 years. It is an attractive alternative to the surgical synovectomy for the management of the various joint diseases. Recently, the development of new radiopharmaceuticals labeled with $^{90}Y,\;^{32}P,\;^{186}Re,\;^{188}Re,\;^{153}Sm,\;^{165}Dy$ and $^{166}Ho$, for the effective management of synovial inflammation and related arthritic problems are gaining attention. In this article the general concepts and the clinical application of radiation synovectomy are reviewed.

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류마토이드 관절염에서 슬관절의 관절경적 활액막 절제술 (Arthroscopic Synovectomy of the Knee in Rheumatoid Arthritis)

  • 정재훈;박일성;양동현
    • 대한관절경학회지
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    • 제1권1호
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    • pp.91-97
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    • 1997
  • There has been a controversy about the effectiveness of the synovectomy of the knee in the rheumatoid arthritis. So we studied to determine if the arthroscopic synovectomy of the knee was of benefit in the rheumatoid arthritis. We ana lysed 25 knees of 15 patients who underwent the arthroscopic synovectomy of the knee joint for their rheumatoid arthritis from Jun. 1995 to Oct. 1996. The average follow-up period was 20.1 months($12\~28$ months). The results were as follows; 1. Satisfactory results were obtained in 20 knees $(80\%)$ for the pain and the effusion each, 23 $(92\%)$ for the range of motion and 19 $(76\%)$ for the functional capacity. 2. In the overall results for the pain. effusion. range of motion and the functional capacity. we obtained excellent results in 14 knees $(56\%)$ and satisfactory results in 9 knees $(32\%)$. 3. In the patient's self assessment, 11 patients $(44\%)$ were delighted and 10 patients $(40\%)$ were satisfactory. 4. In the overall results according to the articular cartilage damage, satisfactory results were obtained in 15 $(93\%)$ out of 16 knees in Grade I and II, and 6 $(75\%)$ out of 8 knees in Grade III and IV. In conclusion, arthroscopic synovectomy could be one of very useful treatments for the rheumatoid knee. But further study is needed to get the long-term results of the synovectomy because there's many reports saying gradual decrease of good results with increasing time. And continuous and proper medical treatment including DMARDs, is needed to effectively control the rheumatoid arthritis even after the synovectomy.

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Ho-166 활액막절제술의 임상시험 (Preclinicnl Trial of Radiation Synovectomy with Ho-166)

  • 이종두
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 1999년도 제38차 춘계학술대회
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    • pp.200-204
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    • 1999
  • Rheumatoid arthritis (RA) is o chronic inflammatory disease of joints with proliferation of synovial epithelial tissue. Therapeutic approach of the RA consists of pharmacological and surgical interventions. Synovectomy is indicated in patients with progressive inflammatory signs and symptoms intractable to medical treatment including local intracavitary steroid injection. Recently, local injection of radionuclides which emit high energy beta rays are labeled with chemical compounds such as $^{90}Y,\;^{165}Dy-ferric$ hydroxide macroaggregate and have been introduced as an alternative therapeutic modality to surgical synovectomy. Holmium-166 is one of beta emitter and Ho-166-chitosan complex was developed for radiation synovectomy. Preclinical trial is on-going at our hospital using Ho-166-chitosan. The procedure and methods of preclinical trial are discussed.

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발목관절의 미만형 색소 융모 결절성 활액막염에서 관절경적 및 개방적 활액막 절제술을 이용한 수술적 치료: 증례 보고 (Surgical Treatment for Diffuse Pigmented Villonodular Synovitis of the Ankle by A Combined Open and Arthroscopic Synovectomy: A Case Report)

  • 최준철;송우석;변찬웅;김진;한은미
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.139-142
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    • 2019
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.

DA-7911, rhenium-188 ($Re^{188}$) tin colloid. as a strong candidate agent for radiation synovectomy

  • Shin, Chang-Yell;Jung, Mi-Young;Lee, In-Ki;Son, Mi-Won;Kim, Soon-Hoe;Kim, Won-Bae
    • 대한약학회:학술대회논문집
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    • 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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    • pp.252-252
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    • 2002
  • Radiation synovectomy is an useful alternative treatment to rheumatoid arthritis and Re$\^$188/ is suggested as an ideal radiopharmaceutical agents because beta ray (2.1 MeV) emitted from Re$\^$188/ is appropriate for synovial cell ablation and gamma ray (155 KeV) is ideal for dosimetry. Its' ideal particle size (2-5 mm) was achieved by conjugation with tin-colloid, In this study, we investigated the toxicity, stability and biodistribution to evaluate the suitability of DA-7911 as a synovectomy agent. (omitted)

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족관절에 생긴 활액막성 연골종증 (Synovial Chondromatosis of the Ankle Joint)

  • 서진수;김지훈;김종인;김한성
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.14-18
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    • 2009
  • Purpose: We evaluated the results of treatment and clinical symptoms of 11 cases of synovial chondromatosis in the ankle joint. Material and Method: From February 2001 to May 2008, 11 cases with synovial chondromatosis involving ankle joint underwent surgical treatment. There were 5 males and 6 females. The average age at surgery was 51 years. The average follow-up period was 42 months. Duration from onset of symptom to treatment was 117 months. Chief complaints of patients, 9 cases were pain and 1 case was mass like lesion, 1 case was found on x-ray. Preoperatively, all cases were evaluated on simple x-ray, 4 cases on CT, 4 cases on MRI and 1 case on ultrasonogram. 10 cases underwent synovectomy and loose body removal. 5 cases of 10 cases underwent open synovectomy and loose body removal and arthrosocpic surgery. 4 cases of 10 cases underwent only open synovectomy and loose body removal and 1 case of 10 cases underwent only arthroscopic surgery. 1 case underwent tibiotalar arthrodesis. Results: The location of loose bodies was 7 cases on posterior and 4 cases on anterior and 4 case on lateral and 3 cases on multiple site. Postoperatively, all patients showed marked clinical improvement and had subjective satisfaction except reoperation 2 cases and arthrodesis 1 case. AOFAS score of all patients was average 82.2. Conclusion: Clinical results of the synovial chondromatosis of ankle joint were satisfactory. More accurate preoperative evaluation is required to achieve prevention of postoperative recurrence and better outcome.

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Initial experience with intra-articular 188Re-tin colloid as a "radiation synovectomy" agent in various joints

  • Shinto, Ajit S;Indira, VU;Kamaleshwaran, KK;Banka, Vinay Kumar;Aswathy, KK;Thirumalaisamy, SG;Rajamani, V;Mallia, Madhav;Banerjee, Sharmila
    • 대한방사성의약품학회지
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    • 제1권2호
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    • pp.109-117
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    • 2015
  • Radiation synovectomy has been proposed as a promising palliative therapy for recurrent joint effusions for the last two or three decades. Ionizing radiations emitted by intrarticularly administered radiolabelled colloids. The aim of this study was to assess the effectiveness of radiation synovectomy (RSV) using $^{188}Re$-tin colloid in the treatment of recurrent joint effusions and chronic synovitis of knee joints. Three phase bone scan was acquired for the concerned joint prior to radiosynovectomy. $^{188}Re$-tin colloid was prepared as per the reported protocol. 9 patients, diagnosed with rheumatoid arthritis and suffering from chronic resistant synovitis of the knee, ankle or elbow joints were administered the radiopharmaceuticals, checked for radiochemical purity >95% by intraarticular route. A whole body scan was acquired 2 h post-radiosynovectomy. In all the 9 treatments, no leakage to non-target organs was visible in the whole body scan. Static scans of the joint revealed complete retention of $^{188}Re$-tin colloid in the joints post administration of the agent. Clinically all patients exhibited a complete or partial response. RSV with $^{188}Re$-tin colloid was safe and effective in patients with chronic synovitis of rheumatoid origin.

혈우병성 슬관절염의 관절경적 활액막 제거술 (Arthroscopic Synovectomy of the Knee in Hemophilic Patients)

  • 배대경;윤경호;김희선;김승환;정선택
    • 대한관절경학회지
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    • 제6권2호
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    • pp.177-182
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    • 2002
  • 목적 : 혈우병성 슬관절염 환자에 대해서 관절경적 활액막제거술을 시행한 후 임상적 결과를 분석하고자 한다. 대상 및 방법 : 1996년 1월부터 2001년 1월까지 혈우병성 슬관절염으로 관절경적 활액막 제거술을 시행 받은 환자 중 1년 6개월 이상 추시가 가능하였던 26명 28례를 대상으로 하였다. 평균 연령은 17.8세 ($8\~37$세), 추시 기간은 평균 3년 11개월 (1년 7개월$\~$6년 7개월)이었다. 수술은 전 례에서 6부위의 portal (two anterior, two suprapatellar and two posterior)과 posterior trans-septal porta 을 사용하였다. 결과 : 출혈의 빈도는 수술 전 평균 1개월에 4회에서 최종 추시 시 2회로 감소하였고, 항혈우병 인자의 투여량은 수술 전 평균 1개월에 4,633 units에서 최종 추시 시 1,505 units로 감소하였다. 운동범위는 수술 전 평균 112도, 최종 추시 시 평균 107도였다. 방사선학적으로는 최종 추시 3례에서 수술 전에 비해 혈우병성 관절염이 진행하였다. 환자의 주관적 평가는 significant 혹은 moderate improvement 19례 $(68\%)$, no improvement 혹은 deterioration 9례 $(32\%)$였다. 결론 : 혈우병성 슬관절염 환자에서 관절경적 활액막 제거술은 합병증이 적고, 출혈의 빈도와 동통을 감소시키고 관절 운동 범위를 유지 할 수 있는 효과적인 치료 방법이라고 사료된다.

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활액막 연골종증의 관절경적 치료 (Arthroscopic Treatment of Synovial Chondromatosis)

  • 배대경;권오수;이정희;임찬택
    • 대한관절경학회지
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    • 제6권1호
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    • pp.43-48
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    • 2002
  • 목적 : 슬관절에 발생한 8명(9례)의 환자에서 관절경을 이용한 수술적 치료에 대한 결과를 분석 보고하고자 한다. 대상 및 방법 : 1989년 6월부터 1999년 9월까지 활액막 연골종증으로 진단되어 관절경적 활액막 전절제술 및 유리체 제거술을 시행받은 8명 9례를 대상으로 하였다. 남자 6명, 여자 2명이었고, 평균 연령은 44.1세였다. 평균 추시기간은 5.9년이었다. 진찰소견에서 동통 및 종창이 주증상 이었으며, 2례에서 장김 현상, 3례에서 평균 28도의 굴곡 구축을 보였다. 결과 : 병리소견 및 관절경 소견상 Milgram 1기 1례, 2기 6례 및 3기 2례였고 부위별로 전반적인 활액막 비후를 보인 경우가 6례, 국소적인 활액막 비후를 보인 경우가 1례 였으며, 국소적 1례의 경우 후내방 및 후외방 구획의 병변을 보였다. 술후 전례에서 임상적 증상의 소실과 함께 정상적 운동범위를 보였다. 술후 재발은 1례로 1차 수술 소견상 Milgram 2기였으며 술후 11개월에 이차적 관절경 수술을 시행받았다. 결론 : 비교적 희귀한 질환인 활액막 연골종증 9례에서 관절경을 이용한 유리체 제거술 및 활액막 전절제술로 합병증 없이 임상적으로 만족스러운 결과를 얻을 수 있었다. 재발 방지를 위해 활액막 전절제술이 필요할것으로 사료된다.

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