Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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A Study on the Development of Degenerative Osteoarthritis after Arthroscopic Total Menisectomy

관절경적 반월상 연골 전 절제술 후 퇴행성 슬관절염의 발생에 관한 연구

Jeong, Bi-O;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Lee, Dong-Hun
정비오;윤경호;배대경;이동훈

  • Published : 2008.02.01
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Abstract

Purpose: This study compared the clinical and radiological incidence of osteoarthritis after a total meniscectomy. Materials and Methods: Seventy eight patients, who underwent a total meniscectomy, were evaluated after a minimum follow up of five years. The operations were a medial meniscectomy (group I) in 16 cases, a lateral meniscectomy (group II) in 17 cases, a discoid meniscus (group III) in 29 cases and medial meniscectomy with an anterior cruciate ligament reconstruction (group IV) in 16 cases. The development of degenerative osteoarthritis was analyzed using the Kaplan-Meyer survivorship. Results: At postoperative 5 years and 7 years, degenerative osteoarthritis developed in 17% and 36% of patients, respectively. The incidence ofdegenerative osteoarthritis at postoperative 5 years and 7 years in groups I, II, III and IV was 9% and 18%, 14% and 29%, 25% and 46%, and 28% and 55%, respectively. The difference was statistically significant. Conclusion: The meniscus deficient knee joint which varies according to the patterns of a meniscal injury, had a higher incidence of degenerative osteoarthritis. Careful attention should be paid to the treatment of meniscal tears.

목 적: 슬관절 반월상 연골 전 절제술을 시행한 후 임상적 및 방사선학적 방법으로 퇴행성 관절염의 발생률을 조사하고 절제 부위에 따른 퇴행성 관절염의 발생률을 비교하고자 하였다. 대상 및 방법: 반월상 연골 전 절제술 시행 후, 5년 이상 추시가 가능하였던 78예를 대상으로 하였다. 내측절제(I군) 16예, 외측 절제(II군) 17예, 원판형 연골(III군) 29예 및 전방십자인대 재건술과 동반 된 내측절제(IV군)가 16예였다. 관절염 발생은 관절 간격이 50% 이상 감소하는 Ahlback Grade II 이상으로 규정하고 Kaplan-Meyer의 생존분석법을 이용하였다. 결 과: 술 후 5년 및 7년 경과 시 17% 및 36%에서 퇴행성 관절염이 발생하였다. I군의 경우 5년에 9%, 7년에 18% 이었으며, II군 각각 14%, 29%, III군 25%, 46%, IV군 28%, 55%이었다. 각 군 간의 차이는 통계적으로 유의하였다(p＜0.05). 결 론: 반월상 연골이 결여된 슬관절은 그 손상형태에 따라 다르지만 높은 빈도의 퇴행성 관절염의 발생을 보였다. 그러므로 가능한 한 전 절제술을 피하기 위한 노력이 필요할 것으로 생각한다.

Keywords

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