• Hip & pelvis
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• 제30권4호
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• pp.276-281
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• 2018

Pseudotumors are not uncommon complications after total hip arthroplasty (THA) and may occur due to differences in bearing surfaces of the head and the liner ranging from soft to hard articulation. The most common causes of pseudotumors are foreign-body reaction, hypersensitivity and wear debris. The spectrum of pseudotumor presentation following THA varies greatly-from completely asymptomatic to clear implant failure. We report a case of pseudo-tumor formation with acetabular cup aseptic loosening after revision ceramic-on-metal hip arthroplasty. The patient described herein underwent pseudotumor excision and re-revision complex arthroplasty using a trabecular metal shell and buttress with ceramic-on-polyethylene THA. Surgeons should be aware of the possibility of a pseudotumor when dealing with revisions to help prevent rapid progression of cup loosening and implant failure, and should intervene early to avoid complex arthroplasty procedures.

• Clinics in Shoulder and Elbow
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• 제19권2호
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• pp.101-104
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• 2016

Reverse total shoulder arthroplasty has been performed with promising results in rotator cuff tear arthropathy. However, the global complication of the reverse total shoulder arthroplasty is relatively higher than that of the conventional total shoulder arthroplasty. Neurologic complications after reverse total shoulder arthroplasty are rare but there are sometimes remaining sequelae. The cause of the neurologic complication is multifactorial, including arm traction, position and the design of the implant. Most cases of neurologic palsy following reverse total shoulder arthroplasty occur in the axillary nerve and the radial nerve. The authors report on a case of a 71-year-old man with isolated musculocutaneous nerve palsy after reveres total shoulder arthroplasty with related literature.

• Journal of Korean Neurosurgical Society
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• 제44권4호
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• pp.217-221
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• 2008

Objective : Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. Methods : We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. Results : Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. Conclusion : Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.

• 한방재활의학과학회지
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• 제29권1호
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• pp.31-39
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• 2019

Objectives To obtain future research basis of Korean Medicine for total knee arthroplasty patient by analyzing medical and Korean Medical service utilization and treatment duration. Methods Data sampling was performed on Health Insurance Review and Assessment Service patient data of 2015 (Confidence level of 97%) to analyze patients' medical and Korean Medical service tendency. Sampling groups were divided into two groups; i) Patients who completed their treatment within 5 months of total knee arthroplasty, ii) Patients who continued their treatment after 5 months of total knee arthroplasty, to investigate patients' medical and Korean Medical service tendency and individual characteristics were carefully monitored. Results It was confirmed that total of 1,655 patients had gone through total knee arthroplasty out of 1,453,486 patients who were gathered for sampling. First sampling group (Patients who completed their treatment within 5 months of total knee arthroplasty) was 287 patients and second sampling group (Patients who continued their treatment after 5 months of total knee arthroplasty) was 385 patients. The proportion of patients who visited Korean Medical service in first sampling group was lower than that of second sampling group. Conclusions It was confirmed that medical and Korean Medical service and cost consumed by second group (Patients who continued their treatment after 5 months of total knee arthroplasty) was higher than that of first group (Patients who continued their treatment after 5 months of total knee arthroplasty). It is highly recommended to continue with further study for efficient medical and Korean Medical service and reduced cost.

• Journal of Yeungnam Medical Science
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• 제21권1호
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• pp.1-11
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• 2004

Total knee arthroplasty has become a common procedure for treatment of severe osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. In the past, failure of total knee arthroplasty was commonly attributable to aseptic loosening, often associated with component malalignment, soft tissue imbalance. With improved surgical instrumentation and soft tissue balancing techiniques, failure secondary to mechanical loosening has been minimal. But surgeons are still dissatisfied with implant malalignment. Correct tibiofemoral alignment seems to be particularly important since it is generally agreed that axial deviation and imprecise implantation may lead to loosening of the implant component. Navigation systems and robotic techniques could potentially solve problems of imprecision in traditional total knee arthroplasty. It is expected that the success rate and longevity of total knee arthroplasty will be improved during the twenty first century.

• Clinics in Shoulder and Elbow
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• 제21권2호
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• pp.105-110
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• 2018

Since the introduction of shoulder arthroplasty by Neer in 1974, the design of not only the glenoid component but also the humeral component used in shoulder arthroplasty has continually evolved. Changes to the design of the humeral component include a gradually disappearing proximal fin; diversified surface finishes (such as smooth, grit-blasted, and porous coating); a more contoured stem from the originally straight and cylindrical shape; and the use of press-fit uncemented fixation as opposed to cemented fixation. Despite the evolution of the humeral component for shoulder arthroplasty, however, stem-related complications are not uncommon. Examples of stem-related complications include intraoperative humeral fractures, stem loosening, periprosthetic fractures, and stress shielding. These become much more common in revision arthroplasty, where patients are associated with further complications such as surgical difficulty in extracting the humeral component, proximal metaphyseal bone loss due to stress shielding, intraoperative humeral shaft fractures, and incomplete cement removal. Physicians have made many attempts to reduce these complications by shortening the stem of the humeral component. In this review, we will discuss some of the limitations of long-stem humeral components, the feasibility of replacing them with short-stem humeral components, and the clinical outcomes associated with short-stemmed humeral components in shoulder arthroplasty.

• 대한족부족관절학회지
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• 제21권1호
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• pp.39-42
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• 2017

Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.

• Clinics in Shoulder and Elbow
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• 제13권1호
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• pp.132-140
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• 2010

목적: 광범위 회전근 개 파열에 대한 수술적 치료는 매우 어려우며, 다양한 수술 방법이 알려져 있다. 여러 수술 방법 중 광범위 회전근 개 파열에서 적용될 수 있는 관절 성형술에 대해 고찰하고자 한다. 대상 및 방법: 광범위 회전근 개 파열에 대한 수술 방법 중 하나인 관절 성형술에 관한 문헌들을 조사하여 요약하고 정리하였다. 결과: 봉합이 불가능한 광범위 회전근 개 파열 환자에서 관절 성형술은 일차적 치료법 또는 구제술로 사용될 수 있으며, 반관절 성형술은 오구 견봉 궁이 건재할 경우 Neer의 제한적 기준을 목표로 삼는다면 만족스런 결과를 얻을 수 있다. 또한, 역형 견관절 전 성형술은 가성 마비를 동반한 고령의 환자에서 동통 완화와 능동적 거상을 회복할 수 있는 구제술이다. 결론: 치료가 어려운 광범위 회전근 개 파열 환자에서 적절한 관절 성형술의 선택은 견관절의 동통 완화와 기능적 관절 운동 범위 회복을 가능케 할 수 있을 것으로 사료된다.

• 대한정형외과학회지
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• 제54권2호
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• pp.100-109
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• 2019

견관절 인공관절 성형술의 빈도가 빠른 속도로 증가함에 따라 일차적 인공관절 성형술과 관련된 다양한 형태의 합병증이 발생하고, 이로 인해 재치환술 역시 증가하고 있는 추세이다. 견관절 인공관절 재치환술은 여러 원인에 의해 발생되는 것으로 알려져 있는데 일차적 인공관절 성형술 후 나타난 회전근 개 파열, 관절와 상완 관절의 불안정성, 관절와 또는 상완골 치완물의 해리, 인공 치환물의 실패, 치환물 주위 골절, 감염 등이 있다. 재치환술은 술기적으로 어려운 과제이다. 실패한 견관절 인공관절 성형술은 해결할 수 있는 외과적 선택이 많지 않다. 특히 관절와 골 결손 또는 봉합 불가능한 회전근 개 파열이 있는 경우에는 더욱 어렵다. 또한 재치환술의 결과는 일차적 성형술의 결과에 비해 항상 좋지 않다. 결국 외과의는 수술을 결정하기 전에 일차적 인공관절 성형술이 실패한 원인을 잘 파악하여야 한다. 따라서 본 논문에서는 실패한 일차적 인공관절 성형술 후 재치환술의 적응증에 대해 살펴보고 실패의 원인에 따른 재치환술의 술기에 대해 논의하고자 한다.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.179-185
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• 2016

Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.