감염된 인공 고관절 반치환술에서 PROSTALAC을 사용한 2단계 고관절 재치환술

국문 초록 (Abstract)

목적: 감염된 인공고관절 시멘트형 반치환술에서 일단계 수술시 삽입된 인공 고관절을 제거한 다음 자체 제작한 PROSTALAC 기구를 삽입 후 이단계로 무시벤트 고관절 재치환술을 시행한 환자들의 임상적 및 방사선적 결과를 알아보고, 본 술식의 유용성을 알아보는데 있다.
대상 및 방법: 1996년 11월부터 2001년 10월까지 타병원에서 인공 고관절 수술을 받고 본원에서 인공 고관절의 감염으로 진단되어 이단계로 재치환술을 시행한 13명의 환자를 대상하였다. 수술 후 6주, 3개월, 6개월, 매 1년마다 혈액 검사를 포함한 임상적 및 방사선적 검사를 시행하여 감염의 재발 유무 및 재치환된 인공 고관절 삽입물의 해리 유무를 관찰하였다. 평균 추시 기간은 41.6개월(28-89개월)이었다.
결과: 재치환술 후 감염의 재발을 보인 예는 한 예도 없었으며, 최종 추시결과 Harris hip score는 수술전 평균 52.4에서, 수술 후 평균 84.0으로 향상되었고, 전례에서 해리를 의심할 만한 방사선 소견을 관찰할 수 없었다.
결론: 감염된 인공 고관절 환자에서 자체 제작한 PROSTALAC 기구를 사용하여 이단계로 무시멘트 고관절 재치환술을 시행한 환자의 결과는 전례에서 감염 재발 및 인공 관절의 해리 소견없이 우수한 결과를 보였으며, 감염된 인공관절 치료에 유용한 술식으로 사료된다.

다국어 초록 (Multilingual Abstract)

Purpose: This study evaluated the clinical and radiological findings as well as the and effectiveness of a two-stage reconstruction using the PROSTALAC for an infected hip bipolar hemiarthroplasty. This reconstruction technique comprises of an initial procedure, the removal of the implant, the insertion of a self-made PROSTALAC and, a reconstruction with cementless implants.
Materials and Methods: From November 1996 to October 2001, at our institution, an infection around a hip arthroplasty which had been performed elsewhere in 13 patients (13 infected hips) was treated with a two-stage reconstruction. Postoperatively, all the patients returned for a clinical and radiographic follow-up at 6 weeks, 3 months, 6 months, and every year after the reconstruction to examine the recurrence of the infection and to determine if there was any loosening of the component. The average follow-up duration was 41.6 months (range, 28 months to 89 months).
Results: At the latest follow-up, there were no recurrence of the infection nor was there any loosening of the implants and Harris hip score changed from 52.4 preoperatively, to 84.0 postoperatively.
Conclusion: A two-stage reconstruction for infected hip arthroplasty with cementless implants showed excellent results, no recurrence of the infection or loosening of the implants, and it is believed that this technique is effective and safe.

목차 (Table of Contents)

• 연구 대상 및 방법
• 결과
• 고찰
• 결론
• 참고문헌

참고문헌 (Reference)

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