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거골 골연골병변 치료 동향: 대한족부족관절학회 회원 설문조사 분석
조병기,조재호,양기원,이동연,배서영,2021 대한족부족관절학회 학술위원회,Cho, Byung-Ki,Cho, Jaeho,Young, Ki Won,Lee, Dong Yeon,Bae, Su-Young,The Academic Committee of Korean Foot and Ankle Society, 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.4
Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.
무지외반증 치료 동향: 대한족부족관절학회 회원 설문조사 분석
조재호,조병기,박현우,성기선,배서영,2021 대한족부족관절학회 학술위원회,Cho, Jaeho,Cho, Byung-Ki,Park, Hyun-Woo,Sung, Ki-Sun,Bae, Su-Young,The Academic Committee of Korean Foot and Ankle Society, 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.4
Purpose: This study aimed to report the current trends in the management of the hallux valgus (HV) deformity over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experience in correction in patients with an HV deformity. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: One hundred and nine (19.8%) of the 550 members responded to the survey. The most common symptom for determining surgical treatment was bunion pain (68.8%), and different surgical techniques were selected according to the following radiological parameters: HV angle 30 to 40 degrees and intermetatarsal angle 15 to 20 degrees. The two procedures most preferred by the respondents were distal chevron osteotomy (55.0%), and proximal chevron osteotomy (21.1%). In an average of 71.6% of respondents, Arkin osteotomy was performed simultaneously during HV surgery. HV accompanied by an overriding deformity of the second toe was most often addressed with a combination of second metatarsal osteotomy and soft tissue rebalancing procedure (35.8%). After HV surgery, the recurrence rate of HV deformity was found to be 12.2% on average and the surgeons who had performed minimally invasive surgery (MIS) for HV comprised 34.9% of the total respondents. Conclusion: This study provides updated information on the current trends in the management of the HV deformity in Korea. Both consensus and variation in the approach to patients with HV were identified by this survey study. Although MIS for HV has increased, it appears the consensus for selecting this method has not yet been established.
족관절 관절염 치료 동향: 대한족부족관절학회 회원 설문조사 분석
조병기,조재호,곽희철,김학준,배서영,2021 대한족부족관절학회 학술위원회,Cho, Byung-Ki,Cho, Jaeho,Gwak, Heui-Chul,Kim, Hak Jun,Bae, Su-Young,The Academic Committee of Korean Foot and Ankle Society, 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.3
Purpose: Variations in the preferred conservative and operative treatment methods for ankle arthritis may be observed in the practice of orthopedic surgeons. This study is based on the Korean Foot and Ankle Society (KFAS) member survey and aims to report the current trend and changes in the management of ankle arthritis over the last few decades. Materials and Methods: A web-based questionnaire containing 24 questions was sent to all KFAS members in July 2021. The questions were mainly related to the preferred techniques and clinical experience in osteotomy, arthrodesis, and total ankle arthroplasty (TAA) for patients with ankle arthritis. Results: Sixty-three out of 550 surgeons (11.5%) responded to the survey. The responses to 6 out of the total of 24 questions (25.0%) achieved the levels needed to reflect a tendency. Answers that showed a tendency were related to the following: a surgical approach for arthrodesis (anterior approach), use of auto-bone graft for arthrodesis (iliac bone), a nonunion rate of more than 10% following arthrodesis, main reason related to unsatisfactory results after arthrodesis (nonunion or delayed union), the main reason to change total ankle prosthesis (unstable supply of prosthesis), the unusualness of revision TAA and conversion of fusion to TAA. Diversity was found in several aspects of treatment (degree of experience and satisfaction in supramalleolar osteotomy, fixation method for arthrodesis, preferred TAA prosthesis and longevity, degree of experinece, annual number of TAA operation. Conclusion: This study proposes updated information with regard to the current trends in the management of ankle arthritis in Korea. Both consensus and variations in the approach to patients with ankle arthritis were identified through this survey. With an increasing preference for TAA, the need for the development of a prosthesis optimized for Koreans and a stable supply of prostheses were the suggestions made by the study.
족근관절 관절경의 예후 인자와 상방 입구의 유용성에 대한 임상적 분석 (169례 보고)
김성재,김성훈,강응식,이진우,Kim, Sung-Jae,Kim, Sung-Hun,Kang, Eung-Shick,Lee, Jin-Woo 대한족부족관절학회 2001 대한족부족관절학회지 Vol.5 No.2
Purpose: The purpose of this study was to evaluate prognostic factors of ankle arthroscopy and the effectiveness of high anteromedial and anterolateral portals in diagnosis and treatment for various disease entities. Materials and Methods: The results of ankle arthroscopy were evaluated between March 1992 and January 2000 by one surgeon. Total 169 patients who were followed for a minimum of 12 months, were included in this study. Using high anteromedial and high anterolateral portals, all procedures were done with accessory portals if necessary. A functional evaluation was performed using the Karlsson score and questionnaire subjectively. Results: Fifty-six synovial impingement, 48 osteochondral lesion on talus, 10 impingement exostosis, 8 loose body, 27 osteoarthritis and chondromalacia, 10 postfracture fibrosis, 3 lateral plica, and 1 pigmented villonodular synivitis(PVNS) among 169 patients were diagnosed. Patients with the former four groups had satisfactory results and the latter four groups had not. Remaining 6 patients underwent arthroscopic arthrodesis, and 5 had satisfactory results. Conclusion: Using high anteromedial and anterolateral portals, we could get better visualization of talar dome and posterior chamber of ankle. For better clinical results, in ankle arthroscopy, not only operative skill but also proper indications are important. In case of synovial impingement after trauma, arthroscopy should be considered within one year after initial trauma. There were little correlation between the radiographic findings and arthroscopic findings of articular cartilage in osteochondral lesion of talus, and it is better to determine treatment modality based on the arthroscopic or MRI findings. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.
만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증
박재용,최기원,조재호,강찬,최경진,정진화,김학준,배서영,차승도,김기천,한승환,2015 대한족부족관절학회 보험장애판정위원회,Park, Jae Yong,Choi, Gi-Won,Cho, Jae-ho,Kang, Chan,Choi, Kyungjin,Chung, Jin-Wha,Kim, Hak Jun,Bae, Su-Young,Cha, Seung-Do,Kim, Ki Ch 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.1
Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.
이우천,김정래,Lee, Woo-Chun,Kim, Jung-Rae 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.3
본 연구는 내반 족관절 퇴행성관절염에서 선열에 대하여 고찰하고, 과상부 절골술의 적응증과 수술술기에 대하여 고찰하였다. 초기 족관절 퇴행성 관절염에서 경골 천장 및 후족부의 선열은 상당히 다양한 형태를 보이며, 과상부 절골술은 거골 경사가 경미하고, 후족부 선열이 중립이거나 내반인 경우가 적응증이다. This article has reviewed the alignment of the ankle and hindfoot in varus ankle osteoarthritis. The indication and surgical technique of the supramalleolar osteotomy has been reviewed. Alignment of tibial plafond and hindfoot is variable in early stages of ankle osteoarthritis. Supramalleolar osteotomy is indicated for the treatment of ankle osteoarthritis in patients with minimal talar tilt and neutral or varus heel alignment.
제 4, 5 족근중족 관절염의 anchovy 건 개재 관절 성형술을 이용한 치료 - 증례 보고 -
김재영,박신이,이경태,양기원,Kim, J-Young,Park, Shin-Yi,Lee, Kyung-Tai,Young, Ki-Won 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.2
The 4th and 5th metatarsocuboid joint arthritis causes moderate functional deficit during walking. It is difficult to obtain good results with conservative treatment. The arthrodesis of the affected joints can be a possible surgical option, but with a limited success. We report two cases of the 4th and 5th metatarsocuboid joint arthritis managed with anchovy tendon interposition arthroplaty.
외측 족근중족관절에 발생한 류마토이드 관절염의 건 개재 관절성형술을 이용한 치료 (증례 보고)
김현옥,박진성,이동영,남대철,Kim, Hyun-Ok,Park, Jin-Sung,Lee, Dong-Yeong,Nam, Dae-Cheol 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.4
Controversies exist regarding the treatment options for the end-stage arthritic change in the lateral tarsometatarsal joints. Arthrodesis has been frequently performed, but has a disadvantage of sacrificing a mobile joint. Resection arthroplasty also gained its popularity, especially in the patients with Rheumatoid arthritis, but possible hypermobility can lead to deformity. We report a successful clinical outcome of a patient with Rheumatoid arthritis in the 4th, 5th tarsometatarsal joints treated with tendon interpositional arthroplasties.
이성준,이동철,김지훈,박강현,박철현,Lee, Sung Jun,Lee, Dong Chul,Kim, Jee Hoon,Park, Kang Hyun,Park, Chul Hyun 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.3
Osteoarticular tuberculosis is often misdiagnosed as other disease because of a rare incidence and nonspecific clinical and radiographic presentation. Therefore, it is important to know clinical and radiographic presentations of osteoarticular tuberculosis and to diagnose in early phase. Especially, fistula formation is one of the most important clinical features which suspects osteoarticular tuberculosis. We report a case of ankle tuberculosis to be misdiagnosed as subtalar osteoarthritis and performed subtalar arthrodesis.
Broström 술식과 비골 골막 젖힘 보강술로 치료한 구상 발목관절에 동반된 족근관절 외측 불안정증: 증례 보고
신우진,조홍만,박지연,Shin, Woojin,Cho, Hong Man,Park, Jiyeon 대한족부족관절학회 2020 대한족부족관절학회지 Vol.24 No.2
We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followed-up. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.