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- 저자 : 이효열 ( Hyo Yeol Lee ) (검색결과 4 건)
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All-suture 봉합 나사와 고전적 봉합 나사 간의 방카르트 봉합술 결과 비교: 체계적 문헌고찰 및 메타분석
이효열 ( Hyo Yeol Lee ),김태훈 ( Tae Hoon Kim ),김민극 ( Min Geuk Kim ) 국군의무사령부 2021 대한군진의학학술지 Vol.52 No.1
Objective; The aim of this meta-analysis was to compare the result between All-suture anchors and conventional screwin anchors for Bankart repair, in terms of biomechanical properties and outcomes. Method; MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and SCOPUS electronic databases for articles published up until July 2020 were searched to find relevant articles comparing biomechanical properties of all-suture anchor versus conventional screw-in anchor for Bankart repair. Data searching, extraction, analysis, and quality assessment were performed according to Cochrane Collaboration guidelines. The biomechanical outcomes were evaluated using various outcome values such as stiffness, ultimate load to failure, elongation and displacement. Results are presented as mean difference (MD) or weighted mean difference (WMD) for continuous outcomes with 95% confidence intervals (CI). Result; Five biomechanical studies were included. No significant biomechanical differences between All-suture anchors and conventional screw-in anchors were found regarding ultimate load to failure (MD=33.21; 95% Confidence Interval[CI], -10.68 to 77.09; I2=88%), Displacement (WMD = -0.70; 95% CI, -1.71 to 0.30; I2 = 85%), and stiffness (WMD=0.24; 95% CI, -0.54 to 1.01; I2=76%). The most common mode of failure for both types of anchor was anchor pullout. Conclusion; Compared to conventional screw-in anchors, All-suture anchors showed no significant differences regarding biomechanical outcomes. All-suture anchors could replace conventional screw-in anchors when used in Bankart repair.
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천상진(Sang Jin Cheon),이효열(Hyo Yeol Lee),안성진(Sung Jin Ahn) 대한정형외과학회 2017 대한정형외과학회지 Vol.52 No.5
목적: 저자들은 건의 상태가 불량한 회전근 개 파열 환자에서 재파열을 줄이기 위해 변형된 Mac 교량형 봉합술을 고안하였고 임상적 및 영상학적 치료 결과를 분석하여 새로운 봉합법의 유용성에 대해 알아보고자 하였다. 대상 및 방법: 2010년 1월부터 2014년 12월까지 부산대학교병원에서 관절경적 회전근 개 봉합술을 시행한 환자들 중 수술 전 시행한 자기공명영상 검사와 수술 중 관절경 소견을 종합 평가한 결과 건의 상태가 불량하다고 판단되는 경우 변형된 Mac 교량형 봉합술을 시행하였다. 이 중 최소 1년 이상 추시가 가능하였던 환자 52명을 연구대상으로 하였다. 남자 25명, 여자 27명, 평균 연령은 60세였다. 평균 추시 기간은 20개월이었다. 임상적 결과는 술 전 그리고 최종 추시 시 American Shoulder and Elbow Surgeon (ASES) score, University of California, Los Angeles (UCLA) score, Constant shoulder score (CSS), visual analogue scale (VAS), 관절운동 범위를 비교하여 평가하였다. 수술 후 평균 7개월째 자기공명영상 추적관찰을 시행한 42예에서는 Sugaya 분류를 이용하여 구조적 상태를 분석하였다. 결과: 수술 후 시행한 추적 자기공명영상상 치유 정도는 I형은 15명(35.7%), II형은 22명(52.4%), III형은 3명(7.1%), IV형은 2명(4.8%), V형은 없었다. I, II, III형으로 병변의 회복상태로 판단되는 환자는 40명으로 전체의 95.2%에 해당하였다. 재파열(IV, V형)은 2명(4.8%)에서 관찰되었다. 재파열 환자 2명 중 1명은 대파열, 1명은 광범위 파열 환자였다. 최종 추시 시 ASES score는 평균 56.75점에서 83.44점으로, UCLA score는 20.52점에서 29.23점으로, CSS는 64.04점에서 80.90점으로, VAS는 술 전 6.17점에서 술 후 1.62점으로 유의하게 호전되었다(p<0.001). 관절운동 범위는 전방거상 108°에서 158°, 외전 109°에서 160°, 외회전(외전) 27°에서 50°, 내회전(외전) 31°에서 57°로 유의한 회복을 보였다(p<0.001). 결론: 건의 상태가 불량한 회전근 개 파열에서 변형된 Mac 교량형 봉합술은 임상적 및 영상학적 회복 측면에서 기존에 알려진 봉합법들에 대한 유용한 대안이 될 수 있다. Purpose: Base on the concept of the Mac stitch, we designed the modified Mac-suture bridge technique to improve the outcome of arthroscopic repair of rotator cuff tear with poor tissue quality. Moreover, we evaluated both the radiological and clinical outcomes of the surgery to assess the effectiveness of the newly designed technique. Materials and Methods: From January 2010 to December 2014, a total of 52 patients (25 males, 27 females) with rotator cuff tear, with poor tissue quality according to both radiological and intraoperative findings, who underwent arthroscopic rotator cuff repair using the modified Mac-suture bridge technique and followed-up for at least 1 year were included in this study. The mean patient age at the time of surgery was 60 years. The average follow-up period was 20 months. We evaluated the clinical outcomes by checking the range of motion and compared the following, both preoperatively and postoperatively: American Shoulder and Elbow Surgeon (ASES) score, University of California, Los Angeles (UCLA) score, Constant shoulder score (CSS), visual analogue scale (VAS). In addition, we analyzed 42 series of postoperative magnetic resonance imaging by using the Sugaya’s classification for the evaluation of the repair integrity. Results: All clinical scores showed significant improvement (ASES score improved from 56.75 to 83.44, UCLA score from 20.52 to 29.23, CSS from 64.04 to 80.90, and VAS from 6.17 to 1.62; p<0.001). The range of motion was also improved; forward flexion improved from 108° to 158°, abduction from 109° to 160°, external rotation from 27° to 50°, and internal rotation from 31° to 57° (p<0.001). Satisfactory radiologic results were noted on postoperative magnetic resonance imaging, consisting of 15 cases (35.7%) type I, 22 cases (52.4%) type II, 3 cases (7.1%) type III, 2 cases (4.8%) type IV, and no type V, according to the Sugaya’s method. Conclusion: The modified Mac-suture bridge technique provided satisfactory results both radiologically and clinically for the treatment of rotator cuff tear with poor tendon tissue quality. It could possibly be a good alternative to previous techniques of arthroscopic repair.
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만성 외측 발목 불안정에서 변형 Brostrm 술식 후 스포츠로의 복귀에 관한 문헌 고찰
이동영 ( Dong Yeong Lee ),남준호 ( Jun Ho Nam ),이효열 ( Hyo Yeol Lee ) 국군의무사령부 2019 대한군진의학학술지 Vol.50 No.1
Objectives; The time of return to play after modified Brostrm operation remains uncertain. The purpose of the present study was to review published studies regarding the return to play after modified Brostrm operation in patients with chronic lateral ankle instability. Methods; Several electronic databases were queried for articles published until June 2019 that evaluated outcomes of return to play after modified Brostrm operation in patient with chronic lateral ankle instability. Only clinical studies written in English were included. Data searches, extraction, analysis, and quality assessment were performed according to the Cochrane Collaboration guidelines, and the clinical outcomes were evaluated using various outcome values such as clinical scoring, complication, and return to play timeline data. Results; Five studies were included. Due to insufficient data description, a quantitative analysis has not performed. The preset study revealed the modified Brostrm operation has demonstrated favorable clinical outcomes and low complication rate. Related to return to play, the mean length of time was expected return to comparative sports play at approximately 14 weeks. Conclusion; The modified Brostrm operation is a safe and effective treatment for chronic lateral ankle instability providing a stable ankle and expected return to comparative sports play or training at approximately 14 weeks. This finding should be interpreted with caution because the data involved were extracted from only a few studies and high heterogeneity of included studies.
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