• Journal of Digital Convergence
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• v.13 no.2
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• pp.215-225
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• 2015

This study was conducted to develop a severity-adjusted LOS(Length of Stay) model for knee replacement patients and identify factors that can influence the LOS by using the Korean National Hospital Discharge in-depth Injury Survey data. The comorbidity scoring systems and data-mining methods were used to design a severity-adjusted LOS model which covered 4,102 knee replacement patients. In this study, a decision tree model using CCS comorbidity scoring index was chosen for the final model that produced superior results. Factors such as presence of arthritis, patient sex and admission route etc. influenced patient length of stay. And there was a statistically significant difference between real LOS and adjusted LOS resulted from health-insurance type, bed size, and hospital location. Therefore the policy alternative on excessive medical utilization is needed to reduce variation in length of hospital stay in patients who undergo knee replacement.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.37-44
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• 2019

Purpose: Tumor infiltration around the knee joint or skip metastasis, repeated infection sequelae after tumor prosthesis implantation, regional recurrence, and mechanical failure of the megaprosthesis might require combined distal femur and proximal tibia replacement (CFTR). Among the aforementioned situations, there are few reports on the indication, complications, and implant survival of CFTR in temporarily arthrodesed patients who had a massive bony defect on either side of the knee joint to control infection. Materials and Methods: Thirty-four CFTR patients were reviewed retrospectively and 13 temporary arthrodesed cases switched to CFTR were extracted. All 13 cases had undergone a massive bony resection on either side of the knee joint and temporary arthrodesis state to control the repeated infection. This paper describes the diagnosis, tumor location, number of operations until CFTR, duration from the index operation to CFTR, survival of CFTR, complications, and Musculoskeletal Tumor Society (MSTS) score. Results: According to Kaplan-Meier plot, the 5- and 10-year survival of CFTR was 69.0%±12.8%, 46.0%±20.7%, respectively. Six (46.2%) of the 13 cases had major complications. Three cases underwent removal of the prosthesis and were converted to arthrodesis due to infection. Two cases underwent partial change of the implant due to loosening and periprosthetic fracture. The remaining case with a deep infection was resolved after extensive debridement. At the final follow-up, the average MSTS score of 10 cases with CFTR was 24.6 (21-27). In contrast, the MSTS score of 3 arthrodesis cases with failed CFTR was 12.3 (12-13). The average range of motion of the 10 CFTR cases was 67° (0°-100°). The mean extension lag of 10 cases was 48° (20°-80°). Conclusion: Although the complication rates is substantial, conversion of an arthrodesed knee to a mobile joint using CFTR in a patient who had a massive bony defect on either side of the knee joint to control infection should be considered. The patient's functional outcome was different from the arthrodesed one. For successful conversion to a mobile joint, thorough the eradication of scar tissue and creating sufficient space for the tumor prosthesis to flex the knee joint up to 60° to 70° without soft tissue tension.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.254-260
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• 2019

Purpose: To evaluate the relationship between the knee function at 1 year postoperation and the gap difference (90° flexion gap-extension gap) in total knee replacement. Materials and Methods: Eighty-two consecutive osteoarthritis knees that underwent primary total knee replacement using navigation from March 2017 June 2017 were evaluated prospectively. The gap was measured using navigation after reducing the patella with towel clips. After checking the average values of the medial and lateral gaps at extension and 90° flexion knee, the gap difference (90° flexion gap-extension gap) was calculated. The knees were divided into three groups according to the gap difference (gap difference<0 mm, 0 mm≤gap difference<2 mm, 2 mm≤gap difference). The Knee Society score (KSS) and maximal knee flexion were compared at 1 year postoperation among three groups. Results: The numbers of knees according to groups were 37, 29, and 16 knees in regular order. The average of the KSS knee, KSS function, and maximal knee flexion at the 1-year follow-up were 81.21±8.31, 71.34±9.84, and 126.48°±7.28°, respectively. No statistically significant difference in KSS was observed among the 3 groups. The third group (2 mm≤gap difference) showed a larger maximal knee flexion than the other groups in the Mann-Whitney test. Conclusion: The group of total knee replacement (2 mm≤90° flexion gap-extension gap) showed larger maximal knee flexion than the other groups at the 1-year follow-up in statistics.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2007.06a
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• pp.203-204
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• 2007

• Transactions of the Korean Society of Mechanical Engineers A
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• v.28 no.11
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• pp.1664-1671
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• 2004

It is necessary to have a model that describes the feature of the knee Joint with a sufficient accuracy. Koreans, however, do not have their own knee joint model to be used in the total knee replacement arthroplasty. They have to use European or American models which do not match Koreans. Three-dimensional visualization techniques are found to be useful in a wide range of medical applications. Three-dimensional imaging studies such as CT(computed tomography) and MRI(magnetic resonance image) provide the primary source of patient-specific data. Three-dimensional knee joint models were constructed by image processing of the CT data of 10 subjects. Using the constructed model, the dimensions of Korean knee joint were measured. And this study proposed a three-dimensional model and data, which can be helpful to develop Korean knee implants and to analyze knee joint movements.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.87-92
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• 2021

The radiographic findings of an osteolytic lesion in the knee may indicate numerous possible impressions. Furthermore, osteolysis is a possible cause if there is a surgical history of total knee arthroplasty (TKA). The authors diagnosed osteolysis of the fibular head after aseptic loosening of the tibial component of a cemented TKA in an 83-year-old female patient who visited with right knee pain and report their treatment with revision TKA along with a literature review.