고관절 관절경의 초기 경험과 합병증
Early Experiences and Complications of Hip Arthroscopy
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목적: 고관절 관절경의 초기 경험에 대하여 기술하고자 한다. 대상 및 방법: 2007년 11월에서 2009년 2월까지 고관절 관절경을 시행 받은 41명(45예)의 환자 를 대상으로 연구하였다. 연구 집단을 3개의 군으로 나누었으며(1군: 증례 1~15, 2군: 증례 16~30, 3군: 증례 31~45) 수술 시간, 투시 검사 시간, 견인 시간, 합병증 유무 및 종류에 대하여 분석하였다. 결과: 3개의 군에서 수술 시간 및 견인 시간은 통계적으로 유의한 차이가 없었다. 투시 검사 시간 은 1군에서 41분, 3군에서 11분으로 감소하였다(p<0.01). 신경 손상은 총 4예가 발생하였으며 회음 신경 마비는 1군에서 2예, 2군에서 1예 발생하였고 비골 신경 마비는 3군에서 1예 발생하였 으며 모두 수일 이내에 완전 회복되었다. 의인성 관절순 손상은 1군에서 4예, 2군에서 3예가 발 생하였으나 3군에서는 발생하지 않았다. 의인성 대퇴 골두 손상은 1군에서 2예, 2군에서 3예, 3 군에서 1예 발생하였으나 모두 수술 결과에 영향은 없었다. 결론: 고관절 관절경을 숙달하는 학습 과정에서 투시 검사 시간의 감소가 가장 명확하게 나타났다. 사망이나 영구적인 신경 손상과 같은 심각한 합병증은 발생하지 않았다.
Abstract
Purpose: To report our early experience of hip arthroscopy. Materials and Methods: Forty one patients (45 hips) who underwent hip arthroscopy from November 2007 to February 2009 were enrolled in the study. The population was divided into 3 groups in sequence. The operation time, fluoroscopic time, traction time, and complications were analyzed. Results: There was no significant difference in operation time and traction time between the three groups. The fluoroscopic time decreased from 41 minutes in group I to 11 minutes in group III (p<0.01). There were four cases of nerve palsy; 2 pudendal nerve palsy in group I, 1 pudendal nerve palsy in group II, and 1 peroneal nerve palsy in Group III. All cases recovered completely within few days after surgery. Iatrogenic labral injury occurred in 4, 3 and 0 hips in group I, II and III, respectively. Iatrogenic cartilage damage to the femoral head occurred in 2, 3 and 1 hip in group I, II and III, respectively, which did not affect the outcomes. Conclusion: Definite improvement in the hip arthroscopy technique was observed in the fluoroscopic time. No serious complications, such as death or permanent nerve palsy, were encountered.
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