무릎인공관절치환술(TKR) 수술 가이드

문서 내 토픽

1. Total Knee Replacement(TKR)

TKR은 관절 연골이 완전히 손상되어 약물, 물리치료 등으로 회복되지 않을 때 인공 슬관절로 대치하는 수술입니다. 통증 완화, 관절 기능 유지 및 향상, 관절 변형 교정, 운동성 및 안정성 부여를 목적으로 합니다. 장점은 빠른 재활과 낮은 통증이며, 90%의 환자가 일상 활동 복귀가 가능합니다. 단점은 고가 수술, 무릎 굴곡 제한, 재수술 위험성이 있습니다.
2. 골관절염(Osteoarthritis)

골관절염은 관절 연골과 뼈에 퇴행성 변화가 진행되는 비염증성 만성질환입니다. 55세 이상 약 80%, 75세 이상 거의 전 인구가 보유하며, 여성에게 더 심합니다. 원인은 노화, 체중과다, 외상, 근육 약화, 유전적 소인입니다. 증상은 관절통증, 강직, 염발음, 근육 경련 등입니다.
3. 무릎 해부학(Knee Anatomy)

무릎은 대퇴골(femur), 슬개골(patella), 경골(tibia), 반월판(meniscus), 전방십자인대(ACL) 등으로 구성됩니다. 대퇴골은 인체에서 가장 길고 큰 뼈이며, 경골은 체중을 지탱합니다. 반월판은 초승달 모양의 섬유연골 구조이고, 전방십자인대는 관절 운동 감지 및 신호 전달 역할을 합니다.
4. TKR 수술 절차

TKR 수술은 척추 마취 하에 앙와위에서 진행됩니다. 경골 절단, 대퇴골 절단, 갭 확인, 크기 측정, 시험 삽입, 임플란트 삽입 등의 단계를 거칩니다. 골 시멘트를 사용하여 임플란트를 고정하며, 각 단계마다 정렬과 크기를 확인합니다. 마지막으로 insert를 삽입하고 봉합합니다.

Easy AI와 토픽 톺아보기

1. Total Knee Replacement(TKR)

Total Knee Replacement is a significant surgical advancement that has substantially improved quality of life for patients with severe knee arthritis. The procedure has demonstrated excellent long-term outcomes with high patient satisfaction rates, typically exceeding 85-90%. Modern TKR techniques, including minimally invasive approaches and computer-assisted navigation, have enhanced precision and reduced recovery times. However, careful patient selection remains crucial, as success depends on factors like age, bone quality, and realistic expectations. While complications are relatively rare, infection and implant loosening remain concerns requiring ongoing monitoring. The cost-effectiveness of TKR is well-established, particularly when considering pain relief and functional restoration over the patient's lifetime. As implant technology continues to evolve with better materials and designs, TKR remains one of orthopedic surgery's most successful interventions for end-stage knee disease.
2. 골관절염(Osteoarthritis)

Osteoarthritis represents a major public health challenge, particularly as global populations age. This degenerative joint disease causes significant morbidity and disability, affecting millions worldwide. While the pathophysiology involves cartilage degradation and inflammatory processes, current treatment options remain largely symptomatic rather than disease-modifying. Conservative approaches including physical therapy, weight management, and pharmacological interventions provide initial relief but often prove insufficient for advanced cases. The economic burden of osteoarthritis is substantial, encompassing direct medical costs and lost productivity. Recent research into biological therapies and regenerative medicine offers promising possibilities, though clinical translation remains limited. Prevention through lifestyle modifications and early intervention strategies deserve greater emphasis in public health initiatives. Understanding individual risk factors and implementing personalized treatment approaches could optimize outcomes and reduce the progression to severe disability requiring surgical intervention.
3. 무릎 해부학(Knee Anatomy)

Understanding knee anatomy is fundamental to appreciating both normal function and pathological conditions. The knee's complex structure, comprising bones, cartilage, ligaments, and muscles, enables remarkable mobility while maintaining stability. The articulation between the femur, tibia, and patella, along with the menisci's crucial role in load distribution, demonstrates elegant biomechanical design. However, this complexity also explains why the knee is vulnerable to various injuries and degenerative conditions. Detailed anatomical knowledge is essential for healthcare professionals involved in diagnosis, treatment planning, and surgical intervention. Modern imaging techniques have enhanced our ability to visualize intricate knee structures, improving diagnostic accuracy. The interconnected nature of knee anatomy means that pathology in one component often affects others, necessitating comprehensive assessment. Appreciation of anatomical variations among individuals is important for personalizing treatment approaches and predicting outcomes in both conservative and surgical management strategies.
4. TKR 수술 절차

Total Knee Replacement surgery has evolved into a highly refined procedure with standardized techniques and excellent reproducibility. The surgical approach involves precise bone resurfacing, ligament balancing, and implant positioning to restore normal knee mechanics. Modern surgical techniques, including computer-assisted navigation and robotic-assisted systems, have enhanced accuracy and consistency. Proper surgical execution is critical for long-term implant survival and patient satisfaction. Preoperative planning, including imaging and patient optimization, significantly influences outcomes. Intraoperative decisions regarding implant selection, alignment, and soft tissue management require surgeon expertise and judgment. Postoperative rehabilitation protocols are equally important, with early mobilization and progressive strengthening essential for optimal functional recovery. Minimally invasive approaches have reduced tissue trauma and accelerated recovery without compromising outcomes. Continuous refinement of surgical techniques and implant designs continues to improve results. However, success ultimately depends on the surgeon's experience, meticulous attention to technical details, and comprehensive perioperative management.