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퇴행성관절염 ‘인공관절치환술, 줄기세포 연골재생술’ 장단점은?
5월 8일 어버이날을 맞아 어떤 선물을 할지 고민하는 경우가 많다. 부모님들의 건강선물을 먼저 챙겨보는 것은 어떨까?
최고관리자 send emailㅣ 기사입력 2020/06/27 [12:13]
 
[정형외과 시술 바로알기]퇴행성관절염 ‘인공관절치환술, 줄기세포 연골재생술’ 장단점은?
  • 기사등록 2020-05-04 13:48:29              

5월 8일 어버이날을 맞아 어떤 선물을 할지 고민하는 경우가 많다. 올해부터는 부모님들의 건강을 먼저 챙겨보는 것은 어떨까?


부모님들이 가장 많이 불편해하는 대표적인 것이 퇴행성관절염이다.
실제 건강보험심사평가원 분석 자료에 따르면 퇴행성관절염 환자는 계속 증가하고 있으며, 10명 중 7명 이상이 60세 이상 노인이다.


특히 영농작업을 하는 노인들의 경우 비닐하우스는 물론 논, 밭과 관련된 일들을 하다보면 장시간 쪼그려 앉거나 일어서는 동작을 반복하면서 무릎 연골 마모가 되기 쉽다.
실제 농사일을 하다가 무릎이 붓고, 무릎을 굽히거나 펴는 동작은 물론 걷기도 힘들어서 병원을 찾는 경우는 물론 무릎 연골 마모로 다리가 ‘0'자형으로 변형되는 경우도 많다.


◆인공관절치환술 장·단점은?
무릎퇴행성 관절염 환자 수술에 대표적인 것이 인공관절치환술이다.
인공관절 치환술은 ▲고령 환자들도 수술이 가능하다는 점, ▲회복시간이 짧다는 점, ▲중증도에 따라 적절한 치료가 가능하다는 점이 대표적인 장점이다.


반면 ▲영구적으로 사용하기 어렵다는 점, ▲재활치료 시 통증이 많다는 점 등이 대표적인 단점으로 제시되곤 한다.


인공관절 치환술의 건강보험을 적용 받기 위해서는 단순방사선 사진상 KL-grade 4이면서 만 60세 이상 환자에게만 건강보험 급여 적용이 가능한 상황이다,


◆카티스템 이용한 줄기세포 연골재생술 장·단점은?
최근에는 카티스템을 이용한 줄기세포 연골재생술도 주목받고 있다.
제대혈 줄기세포 재생치료는 연골 손상 부위에 일정 간격으로 미세한 구멍을 내어 무릎 관절내시경으로 치료 부위를 확인한 뒤 줄기세포 치료제인 카티스템으로 채우고 주변을 도포해 아직 남아 있는 연골을 정상 연골로 복원하는 치료법이다.


경골절골술(HTO)을 병행하여 휘어진 다리를 곧게 펴 주면서 관절면에 미세한 구멍을 내고 배양한 줄기세포를 주입하여 무릎을 살려주는 치료 방법이다.


대표적인 장점은 ▲간단한 시술(약 1시간 소요), ▲통증 개선, ▲기존의 관절 최대한 보존 등이다.
반면 ▲줄기세포 배양시 주문 생산을 해야 한다는 점, ▲시술 비용이 고가라는 것이 단점이다.

 

bf44d45e79dae57ad19eae6ab1ce4f5a_1593227 


천안 본정형외과 김진일 병원장은 “뻗정다리에 힘없는 ‘0’자형 하지에 카티스템 줄기세포를 이용한 경골근위부절골술(HTO)을 병행하면 거의 원래 상태로 회복되어 일상생활에 전혀 지장 없는 최고 무릎퇴행성 관절염 치료 방법이 될 수 있지만 고가라는 단점이 있어 카티스템 약제의 건강보험 적용이 시급한 상황이다.”며, “이 시술은 단순 치료를 넘어 재생하는 방향으로의 치료는 물론 영구적인 무릎 사용이 가능하고, ▲‘0’자형 다리, ▲뻗정다리, ▲쪼그려 앉기, 양반다리 자세가 어려울 경우, ▲걸을 때 다리를 절룩거리는 경우 등에 도움이 될 수 있다.”고 설명했다.


또 “최근에는 20~30대 젊은층 퇴행성관절염 환자수도 증가하고 있기 때문에 평소에 건강한 식습관과 건강한 관절을 유지하기 위해 무리한 동작의 반복, 좋지 않은 자세 등을 피하고, 관절에 통증 등 이상이 느껴질 경우 병원을 방문해 조기에 정확한 진단 및 치료를 하는 것이 중요하다.”고 강조했다.
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