본문 바로가기
KERD
논문KCI 등재

대퇴 비구 충돌 환자의 관절경적 치료 : 5-7년 추시 결과

Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: 5-7 Years Result

이기수|강동훈|전유선|황득수|한순철|강찬
대한고관절학회 (The Korean Hip Society)|2012.09|Hip and Pelvis|제24권 제3호|pp. 237-244|DOI http://dx.doi.org/10.5371/hp.2012.24.3.237

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

ArthroscopyFemoroacetabular impingementLabrum관절경대퇴 비구 충돌비구순

초록

목적: 대퇴 비구 충돌로 진단받고 관절경적 치료를 시행한 환자들의 중장기 추시 후 결과를 보고하고자 한다. 대상 및 방법: 대퇴 비구 충돌로 진단받고 관절경적 비구순 부분 제거술, 대퇴 성형술 혹은 비구 성형술을 시행한 79예를 대상으로 하였다. 임상 결과는 변형된 해리스 고관절 점수, 통증 점수 및 Hip outcome score를 이용하였고, 방사선학적으로 알파각과 대퇴 오프셋을 측정하였다. 결과: 임상적 결과로 수술전, 중기(2-5년) 및 장기(5-7년)의 통증 점수는 6.0점, 1.7점, 2.1점, 변형된 해리스 고관절 점수는 58.9점, 81.9점, 79.3점으로 나타났고, Hip outcome score는 일상 생활척도가 각각 술 전 59.2점에서 중기 84.7점, 장기 81.2점, 운동 척도는 57.5점, 84.5점, 79.5점으로 호전된 결과를 보였다. 방사선학적으로 알파각은 술 전 61.2。에서 40.9。로 감소하였으며, 대퇴 오프셋은 술 전 4.8 mm에서 10.0 mm로 증가하였다. 결론: 대퇴 비구 충돌의 관절경적 치료는 중기와 장기 추시상 방사선적 평가 및 임상적 결과에서 만족할 만한 결과를 보였고, 대퇴 비구 충돌의 증상 호전에 효과적인 방법으로 안전하게 시행할 수 있는 치료 방법으로 사료된다.

Abstract

Purpose: To report the mid- and long-term follow up results of patients who underwent arthroscopic treatment after being diagnosed with femoroacetabular impingement. Materials and Methods: 72 consecutive patients diagnosed with femoroacetabular impingement underwent arthroscopic partial labrectomy and femoroplasty(79 cases). In order to evaluate the clinical results, a modified Harris hip score, and VAS and Hip outcome scores were utilized. In addition, the alpha angle and femoral offset were measured radiologically. Results: Based on the clinical results from all consecutive patients, the preoperative mean pain score was 6.0 and 1.7, and 2.1 points on the mid-(2-5 years) and long-term(5-7 years) follow ups, respectively. The mean modified Harris hip score improved from 58.9 points to 81.9 and 79.3 points for the mid-term and long-term follow up groups, respectively. Prior to surgery, the daily activity scale and motor scale results associated with Hip outcome scores were 59.2 and 57.5 points for the mid- and long-term groups, respectively. These scores improved to 84.7 and 84.5, and 81.2 and 79.5 for each group upon the mid- and long-term postoperative follow ups, respectively. Based on the radiological results, the mean alpha angle decreased from 61.2。preoperatively to 40.9。after surgery, and the mean femoral offset increased from 4.8 mm to 10.0 mm. Conclusion: The mid- and long-term clinical and radiological follow ups to evaluate the results of arthroscopic treatment of femoroacetabular impingement revealed satisfactory improvement. This finding further demonstrates that arthroscopy is an effective and safe treatment for cases of femoroacetabular impingement.

참고문헌 (34)

  1. Burman MS, "Arthroscopy or the direct visualization of joints: an experimental cadaver study", J Bone Joint Surg Am, 13, pp.669~695 (1931)
  2. Ganz R, "Femoroacetabular impingement: a cause for osteoarthritis of the hip", Clin Orthop Relat Res, (417), pp.112~120 (2003)
  3. Ganz R, "Cervicoacetabular impingement after femoral neck fracture", Unfallchirurg, 94, pp.172~175 (1991)
  4. Eberhardt K, "Hip involvement in early rheumatoid arthritis", Ann Rheum Dis, 54, pp.45~48 (1995)
  5. Law LA, "Shoulder, knee, and hip pain as initial symptoms of juvenile ankylosing spondylitis: a case report", J Orthop Sports Phys Ther, 27, pp.167~172 (1998)
  6. Philippon MJ, "Arthroscopy for the treatment of femoroacetabular impingement in the athlete", Clin Sports Med, 25, pp.299~308 (2006)
  7. Sampson TG, "Arthroscopic treatment of femoroacetabular impingement: a proposed technique with clinical experience", Instr Course Lect, 55, pp.337~346 (2006)
  8. 황득수, "대퇴비구 충돌을 일으키는 골성 변형의 관절경적 치료- 단기 추시 결과 -", Hip and Pelvis, 19(2), pp.112~120 (2007), 대한고관절학회
  9. 이정범, "대퇴 비구 충돌의 관절경적 치료: 2-5년 추시 결과", 대한정형외과학회지, 45(3), pp.188~197 (2010), 대한정형외과학회
  10. Siebenrock KA, "Effect of pelvic tilt on acetabular rertoversion: a study of pelves from cadavers", Clin Orthop Relat Res, (407), pp.241~248 (2003)
  11. Tonnis D, "Congenital dysplasia and dislocation of the hip in children and adults", pp.167~ (1987), Springer-Verlag
  12. Tannast M, "Femoroacetabular impingement: radiographic diagnosis--what the radiologist should know", Am J Roentgenol, 188, pp.1540~1552 (2007)
  13. Collins DH, "The pathology of articular and spinal diseases" (1949), Edward Arnold
  14. Vulpius O, "orthopaadische operationslehre" (1913), F. Enke
  15. Byrd JW, "Hip arthroscopy: evolving frontiers", Oper Tech Orthop, 14, pp.58~67 (2004)
  16. Ito K, "Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset", J Bone Joint Surg Br, 83, pp.171~176 (2001)
  17. Farjo LA, "Hip arthroscopy for acetabular tears", Arthroscopy, 15, pp.132~137 (1999)
  18. McCarthy JC, "The role of hip arthroscopy in the diagnosis and treatment of hip disease", Can J Surg, 38(Suppl 1), pp.S13~S17 (1995)
  19. Santori N, "Arthroscopic findings in the initial stages of hip osteoarthritis", Orthopedics, 22, pp.405~409 (1999)
  20. Seldes RM, "Anatomy, histologic features, and vascularity of the adult acetabular labrum", Clin Orthop Relat Res, (382), pp.232~240 (2001)
  21. Beck M, "Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment", Clin Orthop Relat Res, (418), pp.67~73 (2004)
  22. Bare AA, "Hip impingement: the role of arthroscopy", Orthopedics, 28, pp.266~273 (2005)
  23. 송용남, "Articular cartilage friction increases in hip joints after the removal of acetabular labrum", JOURNAL OF BIOMECHANICS, 45(3), pp.524~530 (2012), ELSEVIER SCI LTD
  24. Philippon MJ, "Arthroscopic repair of the acetabular labrum: a histologic assessment of healing in an ovine model", Arthroscopy, 23, pp.376~380 (2007)
  25. Kelly BT, "Arthroscopic labral repair in the hip: surgical technique and review of the literature", Arthroscopy, 21, pp.1496~1504 (2005)
  26. Murphy KP, "Repair of the adult acetabular labrum", Arthroscopy, 22, pp.567~ (2006)
  27. Byrd JW, "Prospective analysis of hip arthroscopy with 2-year follow up", Arthroscopy, 16, pp.578~587 (2000)
  28. O’leary JA, "The relationship between diagnosis and outcome in arthroscopy of the hip", Arthroscopy, 17, pp.181~188 (2001)
  29. Santori N, "Acetabular labral tears: result of arthroscopic partial limbectomy", Arthroscopy, 16, pp.11~15 (2000)
  30. Safran MR, "The acetabular labrum: anatomic and functional characteristics and rationale for surgical intervention", J Am Acad Orthop Surg, 18, pp.338~345 (2010)
  31. Philippon MJ, "Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up", J Bone Joint Surg Br, 91, pp.16~23 (2009)
  32. Goker B, "Quantification of progressive joint space narrowing in osteoarthritis of the hip: longitudinal analysis of the contralateral hip after total hip arthroplasty", Arthritis Rheum, 43, pp.988~994 (2000)
  33. Conrozier T, "Measurement of the radiologic hip joint space width. An evaluation of various methods of measurement", Osteoarthrtis Cartilage, 9, pp.281~286 (2001)
  34. Guanche CA, "Arthroscopic treatment of femoroacetabular impingement", Arthroscopy, 22, pp.95~106 (2006)

이 간행물의 다른 논문 (12건)

RAO를 이용한 고관절증(염)의 5가지 치료 모델강창수pp. 165-185수산화 인회석 전 표면 처리 대퇴 스템을 이용한 무시멘트 인공 고관절 전 치환술의 단기 추시 결과김의석, 한계영pp. 186-1934세대 세라믹-세라믹 관절면을 이용한 무시멘트 인공 고관절 전치환술: 최소 2년 이상 추시 결과이송, 김대근, 양종화, 서봉수, 김진학pp. 194-199혈액 투석 환자의 고관절 골절에서 시행한 무시멘트 인공 고관절 반치환술황규태, 김이석, 김영호, 이준환pp. 200-205인공 고관절 전치환술 후 발생한 치환물 주위 종괴강찬, 이기수, 김의창, 송재황, 황득수, 전유선pp. 206-212
원문 보기