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- 저자 : 한용호 ( Yong Ho Hahn ) (검색결과 2 건)
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최소한의 골이식과 압박고정개념을 이용한 비구측 인공관절 재치환술의 결과
이중명 ( Joong Myung Lee ),한용호 ( Yong Ho Hahn ),조덕연 ( Duck Yun Cho ) 대한고관절학회 1997 Hip and Pelvis Vol.9 No.2
Acetabular revision is being important because of development of surgical technique and prolonged average age. And also, it is difficult to provide the implant stability and to restore the normal center of rotation and the leg length. We performed acetabular revision by using minimal allograft or autograft but not using structural allograft because of later collapse of allograft. And inserted uncemented big cup which was contact with acetabular rim above 50 %. The total case which was above 2 years follow up period were 50 hips of 47 patients from Oct. 1991 to Nov.1995. The bone defect of acetabulum was classified by AAOS classification which was type I in 3 hips, type II in 14 hips, type III in 29hips and type IV in 4 hips. And also,classified by Paprosky classification which was type I in 8 hips, type IIA in 17 hips, type IIB in 12 hips, type IIC in 4 hips, type IIIA in 4 hips and type IIIB in 5 hips. The fresh frozen femoral head allograft was grafted on 31 hips and allograft combined with structural autograft on 5 hips which were c1assified by Paprosky type IIIB. But not grafted on 10 hips which the bone defect was minimal. The contact between cup & host bone at simple AP view was 39.06% on the average. We used big size of Harris-Gallante Prosthesis II cup which was from 60 to 70 mm diameter on 26 hips. The vertical migration which was above 3mm was noted on 2 hips and horizental migration which was above 3 mm on 1 hip and rotational migration which was above 8 degree was not noted. The radioluscent line between bone & cup and host bone & grafted bone which was above 2 mm was not noted. While we need more long term follow-up, we think for the revision of acetabular side, minimal bone graft with press-fit concept seems to be better option than structural autograft or mas- sive allograft or acetabular reconstruction ring.
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Wagner Revision Femoral Stem을 이용한 인공 고관절 재 치환술
이중명 ( Joong Myung Lee ),한용호 ( Yong Ho Hahn ),조덕연 ( Duck Yun Cho ) 대한고관절학회 1998 Hip and Pelvis Vol.10 No.1
A retrospective follow-up study was performed on 37 revision total hip arthroplasties using Wagner revision stem in 34 patients due to the loosening of arthroplasty at the department of orthopaedic surgery, National Medical Center from March 1991 to March 1996. The average age at the surgery was 53 years old (range, 34 to 47 years). The follow-up period ranged from 2 years to 8 years. The acetabular side was revised with hemispherical cup and allograft, which was not reviewed in this study. According to the AAOS method, the bone defect of the femur was classified as cavitary type in 5 hips, combined type in 29 hips and discontinuity type in 3 hips. According to the Paprosky method, the bone defect was classified as type I in 5 hips, type IIA in 7 hips, type IIB in 8 hips and type III in 17 hips. The fresh-frozen femoral head allograft was used for filling the gap between proximal stem and cortex in recently operated 14 hips. Within this period, the loosening or failure developed in one case, but postoperative infection did not occur. Subsidence developed in three cases by less than 5 mm. The stress shielding was minimal(grade I or II according to Engh s criteria). Until the latest follow-up time, the results of this technique were excellent. We will continuously follow up these patients for the exact evaluation.
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