활액막 연골종증의 관절경적 치료

배대경,권오수,이정희,임찬택,Bae Dae Kyung,Kwon Oh Soo,Lee Jeong Heui,Lim Chan Teak 대한관절경학회 2002 대한관절경학회지 Vol.6 No.1

Purpose : We evaluated the results of the arthroscopic treatment of nine cases of synovial chondromatosis in the knee joints. Materials and Methods : From June 1989 to September 1999, eight patients nine cases with synovial chondromatosis involving knee joints underwent arthroscopic total synovectomy and removal of loose bodies. There were 6 females and 2 males. The average age at surgery was 44.1 years(range, 20-57 years). The average follow-up period was 5.9 years (range, 2.5-7.3 years). All cases had pain and swelling and two cases had locking preoperatively. Flexion contracture was found in three cases. Results : Pathologic finding revealed Milgram I in one case, Milgram II in six cases and Milgram III in two cases. There were six cases of generalized synovial hypertrophy and one case of localized type. All patients had symptomatic relief by arthroscopic total synovectomy and loose body removal. Second arthoroscopic surgery was performed in one patient due to recurred lesions 11 months after the primary surgery. Conclusion : Clinical results of the synovial chondromatosis with arthroscopic total synovectomy and loose body removal were satisfactory. Arthroscopic total synovectomy was also effective for the recurred case.

반월상 연골 파열환자에서 봉합술 후 결과 분석

배대경,윤경호,정기웅,권창혁,신능철,Bae, Dae-Kyung,Yoon, Kyoung-Ho,Jeong, Ki-Woong,Kwon, Chang-Hyeok,Shin, Neung-Choel 대한관절경학회 2000 대한관절경학회지 Vol.4 No.1

Purpose : To clinically analyze 62 patients who had meniscal repair and compare the results according to methods of repair. Materials and Methods : Between May 1997 and June 1998, we repaired 68 torn menisci in 68 patients. There were 52 male and 10 female with an average age of 26.9 years(ranging from 6 to 51 years). We used Linvatec suture in 46 knees(group A)and meniscal arrow in 16 knees(B group). In six knees we used Linvatec and meniscal arrow both. These 6 knees were excluded and 62 of 68 repaired meniscus were analyzed in this study. Average follow-up period was 18.5 months(ranging 12 to 26 months). We evaluated clinical results by Tapper and Hoover's grading system and subjective symptoms of the patients. Results : There were excellent in 47 cases$(76\%)$, good in 12$(19\%)$ and fair in 3$(5\%)$. In group A, there were excellent in 35 cases$(76\%)$, good in 9$(20\%)$ and fair in 2$(4\%)$. In group B, there were excellent in 12 cases$(75\%)$, good in 3$(19\%)$ and fair in 1$(6\%)$. There was no significant differences in clinical results between two groups. But mean operative time taken for meniscus repair was 40 minutes in group A and 25 minutes in group B. Conclusion : We can obtain good clinical results with short operation time in meniscal repair by proper selection of methods of repair according to the type, location, and size of meniscal tear and associated lesions.

족관절 전치환술 - 평균 8년 추시 -

배대경,김용찬,조남수,임찬택,하정한,Bae, Dae-Kyung,Kim, Yong-Chan,Cho, Nam-Su,Lim, Chan-Teak,Ha, Jeong-Han 대한족부족관절학회 2001 대한족부족관절학회지 Vol.5 No.1

Purpose: To evaluate the clinical and functional results of ankle arthroplasty and to analyze the complications in total ankle arthroplasty. Materials and Methods: Between October 1988 and October 1991, the total ankle arthroplasty had been performed in eight ankle joints of seven patients.. There were five patients with rheumatoid arthritis, one with osteoarthritis and one with traumatic arthritis. One patient had bilateral replacement. New Jersey type of prosthesis was used in six patients and one patient was performed with Odland type of prosthesis. The average age at surgery was 42.3 years (range, 33-54 years). The average follow-up period was 8.2 years (range, 6-10.5 years). Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The average score was 81.4 (range, 76 - 90) at the most recent follow-up. All patients were satisfied with their clinical results. Relief of pain was excellent in most patients, but postoperatively there was no significant improvement in range of motion. One patient had arthrodesis at three year six months after total ankle arthroplasty due to deep infection. Conclusion: This study shows total ankle arthroplasty is a good alternative treatment in selected cases of osteoarthritis and rheumatoid arthritis.

슬관절 재치환술 시 심한 골 결손에사용한 구조적 동종골 이식

배대경,윤경호,김선구 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.3

=목 적: 슬관절 재치환술 시 심한 골 결손이 있는 환자에서 구조적 동종골 사용 후, 임상적 및 방사선학적 결과를 분석하고자 한다.대상 및 방법: 1992 년 1월부터 2003 년 2월까지 슬관절 재치환술을 시행한 158명의 환자, 184예 중, 골 결손이 심하여 구조적 동종골 이식술 시행 후 추시 가능하였던 48명의 환자, 52예를 후향적으로 분석하였고, 술 후 추시 기간은 평균 5년 6개월이었다. 모든 예에서 신선 동결된 대퇴 골두를 동종골로 사용하였다. 임상적으로 미국 슬관절 학회의 임상적 평가 방법을 이용하였고, 방사선학적으로 이식골의 유합 여부, 수술 전후 대퇴 경골각의 변화 및 미국 슬관절 학회의 방사선학적 평가 방법에 따라 삽입물 주위의 방사선 투과선을 관찰하였다.결 과: 슬관절 점수는 술 전 평균 38.6점에서 술 후 평균 82.6점으로 증가하였고, 기능 점수는 술 전 평균 30.3점에서 술 후 평균 76.4점으로 향상되었다. 방사선 사진상, 모든 예에서 이식골의 골 유합을 보였고, 대퇴 경골각은 술 전 평균 외반 1.8도에서 술 후 평균 외반 6.2도로 교정되었다. 방사선 투과선은 모든 예에서 4점 이하였고, 삽입물 주위에 2 mm 이상의 방사선 투과선을 보인 예는 없었다.

p53 Mutations in Ewing's Sarcoma

배대경,선승덕,Bae, Dae-Kyung,Sun, Seung-Deok The Korean Musculoskeletal Tumor Society 2000 대한골관절종양학회지 Vol.6 No.4

Purpose : The p53 tumor suppressor gene is one of the most frequently altered genes in human malignancies. We try to explore the implication of p53 alteration in Ewing's sarcoma. Materials and Methods : We analyzed 35 paraffin blocks to explore the deletion and sequence alterations of p53. Results : Quantitative PCR analysis showed that 2 tumors showed a homozygous deletion of the gene. Mutational analysis of exons 4 to 9 of p53 by PCR-SSCP revealed that 3 tumors carry sequence alterations in exons 5 or 8, and DNA sequencing analysis identified missense point mutations. Conclusion : Taken together, our data demonstrate that p53 is genetically altered in a small fraction of Ewing's sarcoma.

퇴행성 슬관절염에서 미세 천공술후 재생된 연골의 임상 및 병리조직학적 연구

배대경,윤경호,소재근,Bae, Dae-Kyung,Yoon, Kyoung-Ho,So, Jae-Keun 대한정형외과스포츠의학회 2005 대한정형외과스포츠의학회지 Vol.4 No.1

Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

퇴행성 슬관절염의 관절경적 치료 -Arthroscopic Treatment in Osteoarthritis of the Knee-

배대경 中央醫學社 1999 中央醫學 Vol.64 No.3

슬관절에 발생한 색소 융모 결절성 활액막염의 관절경적 치료

배대경,조남수,Bae, Dae-Kyung,Cho, Nam-Su 대한관절경학회 2001 대한관절경학회지 Vol.5 No.1

Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.

슬관절 반월상 연골 낭종의 관절경적 치료

배대경,윤경호,권오수,신동준,임양진,Bae, Dae-Kyung,Yoon, Kyung-Ho,Kwon, Oh-Soo,Shin, Dong-Jun,Im, Yang-Jin 대한관절경학회 2002 대한관절경학회지 Vol.6 No.1

Purpose : To analyze the clinical result of the arthroscopic decompression of meniscal cyst and meniscus resection or repair of meniscus tear. Materials and Methods : From April 1994 and October 2001, 19 patients with diagnosis of meniscal cyst associated with tears of the meniscus were treated by arthroscopic meniscal resection or repair with decompression of the cyst. The mean age was 39.8 years(range, 22-58years). The follow-up period ranged from 3 months to 36 months with an average of 18 months. Seven of 19 patients had tenderness over the joint line with palpable mass. Treatment consists of arthroscopic resection or repair of meniscal tear with decompression of the cyst through transmeniscal approach. Open excision of cyst was performed in one case. Clinical evaluation was performed using Lysholm knee score and Tegner activity. All cases were executed proper treatment using arthroscopy. Results : Twelve cysts involved the lateral meniscus$(64\%)$ and seven cysts were on medial cyst$(36\%)$. Most of lateral meniscal cysts were located in anterior one-third and medial meniscal cyst were on posterior one-third. Meniscal tear were observed in seventeen cases$(89.5\%)$ and most tears were horizontal$(79\%)$. Preoperative symptom disappeared and no cyst recurrences were observed at last follow-up(mean follow-up: 18 months). Conclusion : Meniscal cysts involved lateral side in $64\%$ and most of them were associated with meniscus tear$(89.5\%)$ which consists of mainly horizontal component$(79\%)$.

전방 십자 인대 파열시 손상된 대퇴골 외과 연골의 병리조직학적 연구

배대경,윤경호,김희선,Bae, Dae-Kyung,Yoon, Kyoung-Ho,Kim, Hee-Seon 대한관절경학회 2005 대한관절경학회지 Vol.9 No.2

목적: 급성 전방십자인대 파열 시 동반된 제 3형의 골멍의 조직학적 소견을 분석하였다. 대상 및 방법: 25례의 급성 전방십자인대 파열 환자에서 MRI상 대퇴골 외과에 제 3형의 골멍이 동반된 14례와 골멍이 동반되지 않은 11례를 대상으로 하였다. 남자가 22례, 여자가 3례였으며 평균 나이는 25세였다. 수상 후부터 MRI 검사까지의 기간은 최소 1일에서 최대 30일이였고 수상 후부터 전방십자인대 재건술까지의 기간은 평균 45일이었다. 전방십자인대 재건술 시 연골과 연골하 골에 trephine biopsy를 시행하여 조직학적 및 면역조직학적 소견을 비교 분석하였다. 결과: hematoxylin-eosin 염색시 세포에 대한 변화는 발견할 수 없었고, Masson's trichrome 염색에서 콜라겐의 분포차이는 보이지 않았다. 또한 면역화학염색으로 관찰된 제 1형 콜라겐과 제 2형 콜라겐의 분포에서 아무런 차이를 발견할 수 없었다(p>0.05). 그러나 Safranin-O를 이용한 글리코스아미노글리칸 염색에서 골멍군의 표층과 중간층의 글리코스아미노글리칸 염색 분포가 정상 대조군보다 떨어졌다(p<0.05). 또한 골멍군에서 석회화층에 지방세포들이 같이 발견되는 빈도가 높았다. 결론: 전방십자인대 파열시 동반되는 제 3형의 골임은 슬관절의 불안정성과 함께 추후 관절 연골의 손상을 유발하는 중요한 요인이 될 것으로 사료된다.