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인공 슬관절 전치환술 시 압박대의 압력에 따른 대퇴부 동통과 실혈량에 대한 영향
서재성 ( Jae Seong Seo ),민학진 ( Hak Jin Min ),윤의성 ( Ui Seoung Yoon ),김진수 ( Jin Soo Kim ),조기현 ( Ki Hyun Jo ),김용훈 ( Yong Hoon Kim ),박철희 ( Cheol Hee Baak ) 대한슬관절학회 2008 Knee Surgery and Related Research Vol.20 No.2
Purpose: We wanted to analyze the effects of tourniquet pressure on the postoperative thigh pain and blood loss of patients who undergo total knee arthroplasty. Materials and Methods: This prospective randomized study focused on one-hundred sixty-one unilateral total knee arthroplasties that were done with using a tourniquet. The tourniquet pressures were 300 mmHg in group I (seventy-four cases) and 100 mmHg higher than the systolic blood pressure in group II (eighty-seven cases). We analyzed the postoperative thigh pain with using a visual analog scale (VAS), and we assessed the hemoglobin levels and the hematocrits. Results: The incidence of postoperative thigh pain in group II was statistically lower than that of group I. The intensity of the postoperative thigh pain of group II was lower than that of group I at both 6 hours and 72 hours after surgery. There were no statistical differences in blood loss between the two groups. Conclusion: Using a tourniquet pressure of 100 mmHg above the systolic blood pressure during total knee arthroplasty can reduce the postoperative thigh pain. When comparing the above technique with a TKA using 300 mmHg of tourniquet pressure, there was no statistically significant difference of the postoperative blood loss.
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VerSys fiber metal tapered대퇴 주대를 사용한 고관절 전치환술의 중기 추시 결과
강준순 ( Joon Soon Kang ),문경호 ( Kyoung Ho Moon ),김범수 ( Bom Soo Kim ),권대규 ( Dae Kyu Kwon ),최종민 ( Jong Min Choi ) 대한고관절학회 2012 Hip and Pelvis Vol.24 No.2
Purpose: We evaluated the clinical and radiological results of patients who received the cementless VerSys fiber metal tapered stem for total hip arthroplasty. Materials and Methods: Thirty seven hip joint replacements (31 patients) were evaluated over a minimum four year period following the procedure with an average follow-up period of 56 months (48-96 months). The mean patient age was 47.9 years old. Clinical results were analyzed using Harris hip scores, incidence of thigh pain and radiographic analysis was used to assess fixation of the stem, stress shielding, cortical hypertrophy and radiolucent lines around the femoral stem. Results: The average Harris hip score was 90.7 points (82-99 points). Thigh pain was noticed in 6 hips (16%). Proximal femoral bone resorption by stress shielding was observed in 32 hips (86.5%). Cortical hypertrophy was noticed in 16 hips (43.2%) and was statistically correlated with stress shielding of 2nd degree or more according to the Engh classification. Stable bone ingrowth at the last follow-up was seen in 36 hips (97.2%). Conclusion: Cementless total hip arthroplasty using the cementless VerSys fiber metal tapered stem demonstrated excellent midterm clinical results as well as excellent radiologic results for stable fixation and endosteal new bone formtion. However, long term follow-up evaluation will be required because of the high rates of proximal bone resorption by stress shielding.
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