• 제목/요약/키워드: osteoarthritis of knee

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분쇄가 심한 Ruedi-Allgower II, III형의 개방성 경골 천정 골절에서 단계적 수술의 결과 (Result of Staged Operation in Ruedi-Allgower Type II and III Open Tibia Pilon Fractures with Severe Comminution)

  • 최귀연;이준영;장현웅;김영욱
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.110-115
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    • 2019
  • Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

내측 사선 광근에 대한 EMG Biofeedback 훈련과 테이핑 적용이 슬개골 부정렬 환자의 기능향상에 미치는 효과 (Effect of EMG Biofeedback Training and Taping on Vastus Medialis Oblique for Function Improvement of Patient with Patella Malalignment)

  • 김동연;김수현;임영은;이동걸;김태열
    • The Journal of Korean Physical Therapy
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    • 제20권3호
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    • pp.35-43
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    • 2008
  • Purpose: We investigated the effect of isometric resistance exercise on the vastus medialis oblique muscle with inelastic tape and EMG biofeedback training applied to the patello-femoral joints of patients with patella malalignment. Methods: The 39 elderly subjects that had patella malalignment but no neuromuscular disorders were divided into a control group, taping group, and EMG biofeedback training group. Evaluations of function improvement performed before and after the treatment, as well as 4 weeks after treatment. Results: Change in pain in the knee joint were significantly different among groups (p<0.05). Maximum voluntary isometric contractility in the quadriceps muscle was significantly in the EMG biofeedback group (p<0.001). The WOMAC (Western Ontairo & McMaster Questionnaire) index showed a significant change (p<0.05) in pain, function, and total score. Taping and EMG biofeedback training showed a lasting effect until measurement 4 weeks after treatment. SF-36 (Medical outcome short form-36), which assesses the quality of life, did not significantly change. Conclusion: In osteoarthritis patients with a loss of patello-femoral joint function, isometric resistance exercise of the vastus medialis oblique muscle with taping seems effective.

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독일에서 수행된 대규모의 침 치료 임상연구 Acupuncture Randomized Trials와 the Acupuncture in Routine Care에 대한 고찰 (Review of the Acupuncture Randomized Trials(ART) and the Acupuncture in Routine Care(ARC): the Acupuncture Trials in Germany)

  • 한국인;윤주연;정진수;이승호;장인수
    • Journal of Acupuncture Research
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    • 제30권5호
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    • pp.117-123
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    • 2013
  • Objectives : The purpose is to review large-scale clinical researches, the acupuncture randomized trials(ART) and the acupuncture in routine care(ARC), concerning efficacy and effectiveness of acupuncture performed in Germany. Methods and Results : We have reviewed the studies that were searched by keyword 'acupuncture' as the title and'Witt CM' as one of the main authors in PubMed. Sixteen clinical reports focused on the ART and ARC studies were analyzed among all thirty six were searched. Six studies were related with the ART and eight were focused on the ARC, and other two were on both. Finally, across all researches except osteoarthritis of knee trials in the ART, compared the acupuncture group with the control were significantly improved. On the other hand, ARC showed that additional acupuncture plus routine care was more effective than routine care alone and the response to treatment of the non-randomized group did not differ the one of the randomized acupuncture group. Conclusions : The results may suggest that acupuncture treatment has obvious clinical effectiveness. These results are expected to inspire domestic research and clinical applications in Korea, and more rigorous research on the efficacy of acupuncture should be guaranteed.

거머리 요법에 대한 연구동향 (The literature review of Leech therapy)

  • 장효길;허동석
    • 대한약침학회지
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    • 제13권1호
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    • pp.103-120
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    • 2010
  • Objective : To review the trend of the study related to Leech therapy and to establish the hereafter direction for the study on Leech therapy. Methods : I reviewed and analyzed all the theses published in Domestic and Foreign research institution from 1990 to 2009. Results : The following results were obtained in this study. 1. Analyzed number of theses published, there was no significance per year. 2. Classified by theme of journal, journals related to surgery were most(41 journals, 75.92%) among 54 kinds. 3. Classified by theses by research method and thesis types, case report accounted for nearly twothirds (52 pieces, 68.42%) of all theses and consideration of document was next(9 pieces, 11.84%). 4. With the most case of venous congestion after plastic and reconstructive surgery(33 pieces, 63.46%), leech therapy was effective on illnesses such as haematoma, macroglossia, purpura, varicous vein, avulsion injury, neurovascular compression, diabetic neuropathy, penoscrotal oedema, buerger's disease, rheumatoid arthritis. 5. Two most appeared adverse effects were anemia and infection. Immediate blood transfusion was done for recovering anemia and prophylactic 3rd generation antibiotics to infection were emphasized in more than half of case reports. 6. All of consideration of documents was retrospective study of cases related leech therapy and 3 pieces of them emphasized prophyratic antibiotic treatment for preventing infection. 7. The study of clinical trail type started first in 2002 and osteoarthritis of knee and carpometacarpal joint were main target. As see above result, Leech therapy was effective cure and could be used in disease induced by venous congestion. And I think that it is necessary to perform additional study related to solution of problems about leech therapy and protocol for using in clinical practice.

개방형 근위경골절골술의 3차원 수술계획을 위한 절골해석모델 (Analytical Osteotomy Model for Three-dimensional Surgical Planning of Opening Wedge High Tibial Osteotomy)

  • 구본열;박병건;최동권;김재정
    • 한국CDE학회논문집
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    • 제18권6호
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    • pp.385-398
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    • 2013
  • Opening wedge high tibial osteotomy (OWHTO) is widely used to treat unicompartmental osteoarthritis of the knee caused by degenerative deformations of the anatomical axes of the leg. However, since it is difficult to accurately plan the surgical degrees of adjustment such as coronal correction angle and tibial posterior slope angle to align the axes before the actual procedure, a number of studies have proposed analytical models to solve this problem. While previous analytical models for OWHTO were limited to specific cases, this study proposes an analytical osteotomy model (AOM) and a surgical planning system (SPS) that are suitable for a wide range of tibial morphologies and tibia conditions. The validity and generality of the model were verified in a total of 60 OWHTO cases. Results of the test showed that, as predicted, surgical degrees are affected quite significantly by tibia shape and slope of the resected surface. Comparison of the required surgical degrees and the degrees estimated from virtual surgery simulations using AOM showed a very small average difference of $0.118^{\circ}$. SPS, based on AOM, allows the operating surgeon to easily calculate surgical parameters needed to treat a patient.

과수작목 농업인의 건강실태 및 근골격계 통증호소율 (Health Condition and Musculoskeletal Disorders (MSDs) in Fruit-growers)

  • 김경란;이경숙;김효철;고은숙;송은영
    • 한국지역사회생활과학회지
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    • 제20권1호
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    • pp.5-17
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    • 2009
  • The objective of this study was to analyze the factors regarding work-related musculoskeletal disorders (MSDs) in fruit-growers and offer the fundamental data for work improvement. The 587 fruit-growers (409 males and 178 females) working with 5 kinds of fruit: apple, pear, peach, grape, and mandarin participated in a questionnaire survey regarding MSDs and health condition in 2004 and 2005. The results are as follows: 1. Smoking rate was highest in apple growers. 2. Drinking rates were highest in male peach growers and in female grape growers. 3. Regular exercise rates were higher in pear and mandarin growers. 4. Physical and mental fatigue was higher in females than in males in most cases. 5. The prevalence rate of medically diagnosed diseases was highest for osteoarthritis (16.4%), herniated nucleus pulposus (HNP, 13.5%), and chronic gastritis/gastric ulcer (10.5%). As well as, the prevalence of dermatosis was higher in pear and mandarin growers. 6. The prevalence rate of musculoskeletal symptoms among the various pain areas was highest for lower back, shoulders, and knees. The prevalence rate was also high for lower back, shoulder, and knee pain in apple and grape growers. 7. The significant indexes used determining the musculoskeletal symptoms were BMI, working period, and regular exercise. These results can be practically used for work improvement for the fruit-growers to prevent MSDs.

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흡수성 반월상 연골나사를 사용한 얇은 골연골 골절의 치료 - 증례 보고 - (Biodegradable Meniscus Screw Fixation of Thin Flap Osteochondral Fracture - Two Case Report -)

  • 전재균;선두훈;송인수;김영우;정재용;이봉주
    • 대한관절경학회지
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    • 제14권2호
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    • pp.131-134
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    • 2010
  • 관절내 골연골 골절은 적절한 치료가 이루어 지지 않은 경우 골관절염을 초래하여 통증과 기능장애를 초래할 수 있다. 골 연골 골절의 크기가 큰 경우에는 관혈적 정복 및 금속고정 수술등으로 치료를 할 수 있으나, 골편의 두께가 2mm 이하로 얇은 경우 튼튼한 고정력을 얻기 어려워 제거 하는 경우가 많았다. 저자들은 대퇴 내과에 발생한 박리성 골연골염 환자와 슬개골 골절로 골편의 두께가 2mm이하인 환자에서 흡수성 반월상 연골나사를 이용하여 좋은 결과를 얻었기에 보고하고자 한다.

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발의 형태학적 특성에 따른 시공간 보행 변인과 하지의 기능 및 통증 차이 (Differences in Spatiotemporal Gait Parameters and Lower Extremity Function and Pain in Accordance with Foot Morphological Characteristics)

  • Jeon, Hyung Gyu;Lee, Inje;Lee, Sae Yong;Ha, Sunghe
    • 한국운동역학회지
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    • 제31권2호
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    • pp.95-103
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    • 2021
  • Objective: The aim of this study was to investigate the differences in spatiotemporal gait performance, function, and pain of lower-extremity according to foot morphological characteristics. Method: This case-control study recruited 42 adults and they were classified into 3 groups according to foot morphology using navicular-drop test: pronated (≥ 10 mm), normal (5~9 mm), and supinated (≤ 4 mm) feet. Spatiotemporal gait analysis and questionnaires including Foot and Ankle Ability Measure activities of daily living / Sports, Western Ontario and McMasters Universities Osteoarthritis Index, Lower Extremity Functional Scale, International Physical Activity Questionnaire, and Tegner activity score were conducted. One-way analysis of variance was used for statistical analysis. Results: The pronated feet group showed longer loading response and double limb support in both feet and increased pre-swing phase in non-dominant feet. The supinated feet group demonstrated a longer swing phase in non-dominant feet and single limb support in dominant feet. However, there was no significant group difference in function and pain of knee joint and lower-extremity between groups. Conclusion: Our results indicated that abnormal spatiotemporal gait performance according to foot morphology. Although there was no difference in lower extremity dysfunction and pain according to the difference in foot morphology, they have the possibility of symptom occurs as a result of continuous participation in activities of daily living and sports. Therefore, individuals with pronated or supinated foot should be supplemented by utilizing an orthosis or training to restore normal gait performance.

침구치료에 사용되는 고출력 레이저에 대한 고찰 (High Intensity Laser for Laser Acupuncture Application)

  • 양창섭;선승호;장인수
    • Korean Journal of Acupuncture
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    • 제28권3호
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    • pp.1-12
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    • 2011
  • Objectives : The purpose of this study is to review laser acupuncture studies to find possibility for applying high intensity laser to acupuncture and moxibustion treatment. Methods : Searching papers was performed using search engines of five electronic databases, including Pubmed, Thomson ISI, EMBASE, Sciencedirect, and EBSCO, from inception to May 2011 without language limitation. Inclusion criteria were clinical studies with human, randomized controlled trials (RCTs), case-control studies, and case reports. Selecting papers was performed with titles and abstracts in first step, scrutinize full text in second step, and then the extrated data was analyzed by two authors independently. The methodological quality for RCTs was evaluated using Jadad's scale. Results : Total 8 papers, (3 RCTs, 5 controlld studies, and 1 case reports), were finally selected. The study dealt with surgical laser, argon and $CO_2$ laser was one for each, with GaAs laser was two, and with new semiconductor laser, GaN, were four. The output range was from 110 mW to 15 W. The study diseases were alcohol addiction, knee osteoarthritis, bronchopneumonia and asthma for children, and circulation. All studies reported positive effect. The methodological quality in all RCTs was low because of below 3 points and all studies had few subject numbers. Conclusions : We suggest that high intensity laser can be applied to acupuncture and moxibustion. Further rigorous and well-designed study will be needed for various disease. The oriental medical society needs to take active measures to study and clinical application of acupuncture and moxibustion treatment with high intensity laser.

자가연골 세포이식 (Autologous Chondrocyte Implantation)

  • 정화재
    • 대한관절경학회지
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    • 제12권3호
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    • pp.159-166
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    • 2008
  • 연골 세포는 무혈관성, 신경과 림프계가 없는 해부학적 특성으로 인해 연골 손상에 대한 치료가 어렵다. 연골 손상에 대한 수술적 치료는 간단한 변연 절제술로부터 천공술, 미세 골절술, 연골 이식술, 자가 연골 이식술 등 다양한 방법이있으며 이들 중 자가 연골 세포 이식술은 장기적 예후에서 여러 가지 이점이 기대되는 수술로 신체적 활동 요구도가 높은 15 ~ 55 세의 환자에게 좋은 적응이 된다. 자가 연골 세포 이식술은 1984년 Peterson 등의 동물 실험 결과를 토대로 발전하여 1994년에 사람을 대상으로 한 임상 실험에서 좋은 결과를 보였다. 성공적인 수술 결과를 얻기 위해서는 시술자는 자가 연골 세포 이식술의 적응증, 수술 술기 등을 잘 숙지하여야 하며, 수술 후 연골 세포의 재생 과정에 따른 술 후의 관리 및 환자 교육이 필요하다.

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