• 대한의용생체공학회:의공학회지
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• 제29권6호
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• pp.451-456
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• 2008

Total knee arthroplasty(TKA) using computer-assisted navigation has been increased in order to improve the accuracy of femoral and tibial components implantation. Recently, a few clinical studies have reported on the femoral stress fracture after TKA using computer-assisted navigation. The purpose of this study is to investigate the stress concentration around the femoral pin-hole for different pin-hole diameter, the modes of pin penetration by finite element analysis to understand the effects of pin-hole parameters on femoral stress fracture risk. A three-dimensional finite element model of a male femur was reconstructed from 1 mm thick computed tomography(CT) images. The bone was rigidly fixed to a 25 mm above the distal end and 1500 N of axial compressive force and 12 Nm of axial torsion were applied at the femoral head. For all cases, transcortical pin penetration mode showed the highest stress fracture risk and unicortical pin penetration mode showed the lowest stress concentration. Pin-hole diameter increased the stress concentration, but pin number did not increase the stress dramatically. The results of this study provided a biomechanical guideline for pin-hole fracture risk of the computer navigated TKA.

• 대한정형외과학회지
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• 제56권4호
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• pp.305-309
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• 2021

목적: 단일 병원 조직은행에서 건강보험심사평가원의 병력 및 투약 이력 조회 시행 후 기증된 대퇴골두의 폐기가 증가하고 있어 이에 대한 분석을 시행하였다. 대상 및 방법: 2009년부터 2018년까지 본원에 기증된 대퇴골두 총 340개를 대상으로 식약처 조직은행 표준 모델을 토대로 작성된 본원 조직은행 표준운영지침에 따른 항목별 폐기율 및 폐기율 변화를 분석하였다. 결과: 2009년부터 2018년까지 채취된 대퇴골두 323개 중 총 107개(33%)가 폐기되었고, 그 중 2015년부터 2018년까지 채취된 대퇴골두는 142개 중 65개(46%)가 폐기되었다. 가장 많은 원인을 차지하는 이유는 치매 병력 관련, 핵의학 검사 시 사용하는 방사성 동위원소 투여와 관련되었다. 결론: 현재의 기증 조직 적합성 선별방식으로 채취된 조직을 폐기할 시에는 사용 가능한 조직을 폐기하는 오류가 발생할 수 있다. 따라서 개선된 기준 및 선별 방식 마련이 필요하다.

• 한국윤활학회:학술대회논문집
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• 한국윤활학회 2004년도 학술대회지
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• pp.355-361
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• 2004

Ceramic femoral heads in the total hip replacement have been developed to reduce the polyethylene liner wear, Alumina and zirconia (3Y-TZP) having the excellent tribological properties are coupled against acetabular cups of polyethylene and are used in clinical application worldwide. However, alumina has a risk of catastrophic failure, and zirconia has the low temperature degradation in spite of enhanced fracture toughness. Recently, novel zirconia/alumina composite is very attractive due to the low temperature degradation (LTD)-free character and high fracture toughness. In the present study, we focus on the wear of ceramic on ceramic, which are able to be used as femoral heads and acetabular cups. Therefore, LTD-free zirconia/alumina composites with three compositions are made in a form of disk and cylinder, and the wear of the composites is performed on pin-on-disk type wear tester. The wear is conducted with or without lubricant. All the composites fabricated with the different composition show the good wear resistance.

• 대한관절경학회지
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• 제2권1호
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• pp.1-3
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• 1998

The PCL reconstruction in chronic isolate PCL reconstruction was still controversy. 1) In isolate PCL deficient knee, functionally not so bad as like ACL deficient knee. 2) The result of the PCL reconstruction was not as good as ACL reconstruction. Therefore, isolate PCL injuries has been treated as nonoperatively. Hey Grovere, who was the first to attempt an intra-articular reconstruction of the PCL, utilized the semi-tendinous tendon other static procedures have been described in only a few cases with very limited follow-up. Dynamic procedures utilizing the medial head of the gastrocnemius has been reported by Hugston and Degenhardt, Kennedy and Grainger, and Insall and Hood. These procedures did not improve static stability. Dr Clancy, who was introduce the use of BPTB for the PCL reconstruction transtibial and femoral tunnel. From 1995, untill early 1990 PCL reconstruction was done as tend as placement of the isometric point. Physiometic placement of Anatomical placement of the femoral tunnel in PCL reconstruction were introduced in 1995. Tibial Inlay Technique was reported by Dr Berg in 1995. The main advantage of the tibial Inlay Technique was to avoid fraying of the graft at the posterior tibial tunnel orifice. In complete PCL ruptured and severely posterior unstable knee, dual femoral tunnel technique will be to get better result than one bundle technique. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the posterolateral structures. Futher research is necessary to evaluate new surgical approches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

• 한국임상수의학회지
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• 제37권2호
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• pp.67-74
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• 2020

The purpose of this study is to identify clinical features of sound (non-lame) dogs with medial patellar luxation (MPL). Medical records of 72 dogs diagnosed with MPL were retrospectively reviewed. There were no significances in breed, sex, body weight, body condition score (BCS), osteoarthritis (OA) score, inclination of the femoral head angle (IFA), and mechanical medial proximal tibial angle (mMPTA) between sound and lame dogs, respectively. The mean age of sound dogs was significantly higher than that of lame dogs (P < 0.05), especially in MPL grade 3. The frequency of sound dogs with MPL grade 1 and 2 was 2.3 times higher than that of sound dogs with MPL grade 3 and 4 (P < 0.05). The anatomical lateral distal femoral angle (aLDFA) of sound dogs was significantly lower than that of lame dogs (P < 0.05). However, there were no statistical differences in aLDFA between sound and lame dogs in MPL grade 1, 2, and 4, except for MPL grade 3. This study suggests that in case of MPL grade 1 and 2, frequency of sound dogs is significantly high, and also that in MPL grade 3, if mean ± (standard deviation) age of the dogs is 7.4 ± 3.6 years old and the aLDFA is 105.6 ± 4.1 degrees, they are very highly possible to be sound dogs.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.379-384
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• 2008

Purpose: Currently, using perforator artery flaps especially anterolateral thigh flaps are widely used for reconstruction of extremities, head and neck. Obtaining a precise anatomical picture prior to operation will translate to a more accurate, efficient and safe procedure. Authors used 3D-image work up via 64-slice MDCT to make a more precise preoperative plan. Methods: A total of 10 patients underwent soft tissue reconstruction with anterolateral thigh flap from December 2006 to December 2007. The 64-Channel MDCT (LightSpeed VCT, GE, USA) was used and 3D images were reconstructed. Findings from MDCT were applied to the preoperative planning and confirmed with intraoperative findings. Results: The average number of perforator arteries from lateral circumflex femoral artery was 2. The average lengths of vascular pedicle from the origin of lateral circumflex femoral artery to the first and second perforator artery were 11.0 cm and 20.0 cm, respectively. The average diameter of the pedicle artery was 2.2 mm. The locations of the perforator arteries were mapped and localized on the body surface based on the MDCT result. These were confirmed through direct visualization intraoperatively. Conclusion: MDCT has an advantage of obtaining accurate images of the general anatomy and even fine structures like perforator arteries. By using this state-of-the-art diagnostic imaging technique, it is now possible to make an operative plan safely and easily.

• 대한골관절종양학회지
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• 제9권1호
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• pp.84-92
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• 2003

서론: 대퇴골 근위부에 발생하는 종양은 양성일지라도 수술적 병변의 제거시 관절내 도달이 필요하거나 대퇴골 경부에 손상을 줄 수 있는 등 주위 고관절의 구조 및 기능을 위협할 수 있어 그 예후가 좋지 않을 수 있고 치료에 어려움이 있으나 고관절부의 동통을 유발하는 양성 골종양의 치료는 비관혈적 수술이 현재로는 거의 불가능하다. 최근 CT등을 이용한 경피적 절제술, 경피적 고주파 열치료등 비교적 덜 침습적인 치료법에 대한 관심과 연구가 증가하고 있으나, 아직까지는 대퇴골 근위부 종양중 비교적 흔한 유골골종(osteoid osteoma)에 국한된 연구가 대부분이다. 이에 저자는 대퇴골두내 발생한 내연골종 및 피질골내 연골종을 경피적 고주파 열치료를 통해 치료한 후 이를 보고하는 바이다. 증례: -증례1 - 31세 여자환자로 1년 전부터 시작된 우측 둔부 및 서혜부 외측의 통증을 주소로 내원하였다. 사무직 여성으로 과거력 및 가족력 상 특이 소견 없었으며 통증의 양상은 간헐적으로 야간에 심해지는 양상으로 통증 발현 시에는 체중 부하하기 힘든 정도였다. 통증에 대해 수개월간 대증적 치료를 시행하였으나 수일에서 수주 후 재발되는 양상이었으며 비스테로이드성 소염 진통제에 비교적 효과가 있었으나 내원 시에는 증상이 점차 심해지며 지속적인 양상으로 소염진통제가 계속적으로 필요하였다. 이학적 소견상 우측 고관절의 운동제한은 없었으나 Patrick 검사 양성이었으며 내회전시 불쾌감을 호소하였다. 단순 방사선 검사상 우측 대퇴 골두 부위에 주변으로 경화상을 보이는 방사선 투과성 병변이 관찰되었으며, MRI상 T1WI와 T2WI에서 낮은 신호강도를 보이면서 1.5${\times}$1cm 크기로 경계가 비교적 분명하였고 주변에 반응성 부종이 관찰되어. 유골골종의 가능성이 큰 것으로 보아 고주파열치료를 시행하기로 하였으며 전신마취하에서 먼저 CT시행 하에 세침 생검을 실시한 후 Radionics$^{(R)}$ 고주파침을 삽입하여 병변 중앙에 위치시킨 후 $80^{\circ}C$ 평균모드으로 6분간 고주파 열 치료 시행하였으며 시행 중 다른 합병증은 발생하지 않았다. 환자는 마취에서 의식이 돌아온 직후와 술 후 14시간 후에 통증 전혀 호소하지 않았으며 술후 1일째 체중 부하시 통증 없는 것 확인 후 퇴원 조치 하였으며 술 후 3주 뒤 MRI로 병변 부위 관찰하였으며, 이때 병변부위 소실된 것 확인할 수 있었다. 술 후 15개월째 환자는 일상 생활에 지장없었으며 통증 호소하지 않았다. 조직 검사결과는 피질골내 연골종으로 확인되었다. -증례 2- 56세 여자환자로 3개월 전부터 시작된 좌측 둔부 및 대퇴부 외측의 통증을 주소로 내원하였다. 통증은 주로 밤에 악화되었으며 1달 전부터 통증 심해지고 지속되는 양상으로 타 병원에서 아스피린으로 통증 조절되었고 유골 골종 의심 하에 본원으로 전원되었다. 과거력이나 가족력상 특이사항 없었으며 이학적 검사상 고관절 운동 범위 제한은 없었으나 외전과 내회전시 좌측 서혜부에 통증을 호소하였다. 단순 방사선 소견상 좌측 대퇴골두 하방 내측으로 석회화를 동반하고 주변 경화상을 보이는 방사선 투과성 병변이 관찰되었으며 MRI상 T1WI와 T2WI에서 비교적 낮은 신호강도를 보이는 양상으로, 유골골종의 가능성이 높은 것으로 보아 고주파 열치료를 시행하기로 하였으며 전신 마취 후 CT시행 하에 먼저 세침 조직 검사를 실시한 후 Radionics$^{(R)}$ 고주파침 삽입 후에 평균 모드 $80^{\circ}C$로 6분간 열 치료 시행하였고 환자는 마취에서 회복 후 즉시 통증 감소 보였으며 시술 후 1일째 이학적 검사 및 체중 부하 시행하였을 때 통증이 없는 것을 확인한 후 퇴원 조치 할 수 있었으며 술 후 1달째 MRI검사를 통해 병변이 사라지고 성공적으로 시술을 시행하였음을 확인할 수 있었으며 이후 시술 3개월째로 통증호소없었고 이학적소견상 정상이었다. 조직검사결과는 내연골종으로 확인되었다. 결론: 저자들은 수술적으로 치료가 비교적 어려운 대퇴 골두 부위에 발생한 피질골내 연골종과 내연골종에 대해 경피적 고주파열치료를 시행한 후 이를 보고하는 바이며 동통을 유발하는 유골 골종 이외의 다른 양성골 종양에 대해 치료 계획시 그 도달이 어렵거나 술 후 주위 구조물과 관절의 불안정성등의 합병증이 유발될 수 있는 경우 그 적응증의 확대를 신중히 고려해야 할 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.455-461
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• 2000

Malignant tumors of the head and neck frequently require treatment with both radiotherapy and surgery. Reconstruction of the defect in previously irradiated field is a challenge to surgeon, who must produce both a functional and an esthetic result. Hyperbaric oxygen therapy(HBO) has been used in an attempt to reduce the deleterious effects of radiation. But the issue of whether prior irradiation and HBO of the recipient site of a free flap affects the result of reconstruction continues to generate controversy. So, the effects of irradiation and hypergbaric oxygen therapy on microvascular anastomosis was evaluated in an experimental study in femoral vessels of rats. The experimental groups were divided into 3 groups, contorol group, irradiation group, and irradiation and HBO group. Preoperative irradiation was delivered in the left groin field with single dose corresponding 2,000cGy and total 48 hours of HBO was given 100% oxygen at 2.4 atmosphere for 4 weeks. The femoral vessels of 60 rats were anastomosed after irradiation and HBO treatment. Three days, 1 week, 2 weeks and 4 weeks after surgery, the femoral vessels were evaluated for patency and histopathologic changes. There was no notable effect of irradiation on patency of femoral vessels in rats and the radiation effects were obvious on histological examination which showed the sloughing of the endothelial cells, subintimal hyperplasia and fibrosis on the media and adventitia of femoral arteries. The histologic changes of the femoral veins were mild and not typical. But the effects of hyperbaric oxygen therapy after irradiation was seen not marked difference in irradiation group.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 추계학술대회 및 정기총회
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• pp.94-94
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• 2006

• 한국윤활학회:학술대회논문집
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• 한국윤활학회 1996년도 제24회 추계학술대회
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• pp.189-194
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• 1996

The modern orthopaedics frequently uses the total hip replacement in the artificial hip joint. The wear in this joint requires the re-replacement of the hip joint beacuse it is under the severe load and friction conditions. To solve these problems the previous studies have been mainly focused on the development of the new materials. The research of new material, however, needs much time and effort since it should be experimented for its bio-compatibility, friction, and wear characteristics. To reduce the work, in this study, the finite element analysis is applied to find the new combination of the materials in the total hip replacement which has the excellent contact characteristics. The finite element uses MARC and the 5-node aximetric element. The results show that in case of acetabulum UHMWP has good characteristics, in femoral head, the $Al_2O_3$, and in stem, Ti6Al4V.