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MGⅠ과 MG Ⅱ 슬관절전치환술에서 슬개삽입물의 안정성 비교
김정만,선두훈,송영오 대한슬관절학회 1994 대한슬관절학회지 Vol.6 No.2
Authors compared the patellofemoral complications in Miller-Galate l aod Miller-Galante II to know the cause and method of teatment of it. During the time between 1986 and 1988 we performed 68 knees of MG I. Since 1991 we perfarmad 98 knees of MG II. We performed lateral retinacular release in only 5 out of 68 MG I knees(7.4%) and in 86 out of 98 MG II knees(87.8%). In MG I symptomatic lateral subluxation of the patella occurred in 3 cases(4.4%) and asymptomatic lateral subluxation occurred in 15 knees(12.5%). Mild initial lateral tilting of the patella occurred in 30 knees(44.1%). So altogether 48 knees out of 68 MG I(70.6%) knees showed some abnormality in patellofemoral articulations. There was no patellofemoral joint abnormality in case of lateral retinacular release. In MG II no case showed patellofemoral articulation abnormality in X-ray. The indication of ihe lateral retinacular release in MG I was decided with $quot;no thumbs technique$quot;(static). However, since many cases showed lateral patellar subluxation during initial 20-60 degree flexion although this phenomenon disappeared in more than 90 degree flexion lateral retinacular release was performed even in those cases in MG II(dynamic). The main cause of patellofemoral subluxaxion seemed to be shallow groove, thicker anterior flange of the component than removed bone. From these results it would be suggested that the thickness of the anterior flange should be decreased, the patellofemoral groove should be deepened and the indication of the iateral retinacular release should be made in dynamic condition intraoperatively.
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요추 및 요천추 결핵의 고식적 요법 : 구베변형의 추이
문명상,하기용,장한,선두훈,송영오 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.2
The goal in the treatment of spinal tuberculosis is to eradicate the active infecton. to provide stability for the spine, and to arrest or cerrect the kyphosis. However among these, the residual deformity in the lumbar and lumbosacral spines has been an issue compared with that of the thoracic spine. Therefore this study was performed to assess the residual kyphos angle in the area after the conservative treatment. The subjects consisted of 50 regularly examined patients(13 children and 37 adults) having active tubetculosis who had ambulatory treatment from 1972 to 1993. Triple chemotherapy for 18 months(isoniazid, ethambutol, and rifampicin) were used in adults, and PAS was used in children instead of ethambutal. Kyphosis angle was measured at each observation time. The children had a mean initial involvement of 1.7 vertebral bodies, compared with 1.4 in the adults. Twelve had no body height loss except the disc involvement. Paravertebral abscess was aspi- rated or drained when it became subcutaneous and very large. All had a favorable response to chemotherapy without neurological complication. The elevat- ed ESR became normal within 3 or 6 months. The 23 patients had new involvement of the adja- cent bodies within 18 months of treatment, though the kyphosis did not increase. Abscess disap- peared in from 3 to 12 months, and the sinuses disappeared by 24 months. At 18 months the lesions became inactive in all, and body fusion was evident in 12 patients(24%) at 18 months and in 19 patients(38%) at 36 months. The mean internal kyphosis angle at pre-medication, 18 and 36 months in children and adults were 14.7%, 21.9%, 24.2% and 10.6%, 14.8%, 15.9% respec- tively. It is reconfirmed that the chemotherapy was effective in curing the tuberculosis and also preventing the progress of kyphosis. Radical surgery should be reserved for the exceptional cases.
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