• 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.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1518-1520
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• 2008

Recent clinical studies have shown that computer navigation for total knee arthroplasty (TKA) provides improved component alignment accuracy. However, femoral stress fracture after computernavigated TKA have been reported due to the pin hole and we hypothesized that osteoporosis would be one of the key factors in pin hole fracture after computer-navigated TKA. We investigated the von-Mises stress around the femoral pin-hole for different elastic modulli and ultimate stresses and four different pin penetration modes to understand the aging effect on femoral stress fracture risk after computer-navigated TKA by finite element analysis. In this study, aging effect was shown to increase the femoral stress fracture risk for all pin penetration modes. Especially, aging effect was shown dramatically in the transcortical pin penetration mode.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.06a
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• pp.881-887
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• 2005

A total knee replacement is an extremely 'position-sensitive' operation; a malposition or a malalignment of the components will lead to a breakage of the component, a fracture around the knee prosthesis, and the limitation of range of the motion, etc. In a conventional total knee replacement, surgeons have to select an appropriate prosthesis according to the shape of the surgical region. A wrong selection may give rise to side effects or to need re-operation. Nevertheless, it is so difficult to choose the most proper prosthesis out of various kinds of prosthesis. This paper presents a surgical planning system for the total knee replacement with an operation simulating method in order to determine the parameters for the total knee replacement operation. We select an alignment axis and a resection angle as major operation parameters in the total knee replacement operation, and introduce the method to determine the major operation parameters with the operation simulator we developed. The simulator is used to determine operation parameters for optimized operations, to select the most appropriate prosthesis, and to analyze the prospective problems of the operation.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.343-347
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• 2020

May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.39-45
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• 2009

Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.527-533
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• 2020

Purpose: This study compared the effects of a buprenorphine transdermal patch (BTDP) on the chest and knee for pain control after total knee arthroplasty (TKA). Materials and Methods: A retrospective case-control study was conducted from August 2018 to August 2019 on 231 patients who underwent TKA. Two hundred cases were selected considering age, sex, and body mass index. Before and after applying the BTDP, the Numeric Rating Scale (NRS), adverse effects and compliance were measured. All measurements in the chest application group (group A=100) and knee application group (group B=100) were compared. Results: NRS was similar in rest between the groups treated with BTDP, but at two days and three days afternoon, five, six, and seven days postoperatively in group B, the NRS was significantly lower than that of group A. The adverse effects of the central nervous system and gastrointestinal system after applying BTDP were significantly lower in group B than in group A. No significant differences in adverse effects of the cardiovascular system and skin were observed between the two groups. Regarding the maintenance of BTDP, group B was significantly higher than group A. Conclusion: The direct application of BTDP after TKA to painful knee joints showed excellent results in early postoperative pain control and can be a useful method for increasing patient compliance by reducing the frequency of adverse effects.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.117-126
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• 2020

Total knee arthroplasty is performed widely in degenerative arthritis of the knee joint, and the frequency of use is increasing. Efforts should be made to achieve functional recovery, such as returning to daily life, and the recovery of strength and range of motion after surgery. The procedure should be approached from a range of perspectives, such as patient factors, surgical technique and rehabilitation. The patient's age, degree of obesity, sex, and strength of the quadriceps muscle can affect the functional recovery after surgery. In addition, the patient's mental state, such as expectation value and satisfaction, can also have an effect. For functional recovery, patient education, pain control, and strengthening of the quadriceps muscle can be performed prior to surgery. Postoperative physiotherapy, such as icing and compression, transcutaneous electrical nerve stimulation therapy, neuromuscular electrical stimulation therapy, low frequency low intensity magnetic field therapy, strengthening of quadriceps muscle, and range of motion exercise can also be applied. In recent years, hydrotherapy, which restores the strength and balance of the leg, is being performed increasingly. These treatments are not only performed shortly after surgery, but are also performed continuously. In addition, the surgeon should apply it appropriately considering the patient's condition, compliance, and social and psychological conditions.

• Journal of muscle and joint health
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• v.22 no.1
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• pp.48-56
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• 2015

Purpose: The purpose of this study was to verify the effects of visual information on nursing management to elderly total knee arthroplasty (TKA) patients. Methods: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used in this study. Participants of this study were 60 elderly patients with TKA admitted to one hospital: the control group (30) between July and September, 2013, and the experimental group (30) between April and July, 2013. Anxiety and uncertainty were determined at baseline and at 3 days after TKA in both groups. Results: Two days after the visual information, the experimental group showed a significant decrease in anxiety and uncertainty compared with the control group. Conclusion: The results of this study show that providing visual information was effective in decreasing postoperative patient anxiety and uncertainty in elderly TKA patients. Therefore, when an elderly patient is hospitalized for TKA, positive and systematic provision of visual information may provide a positive effect by reducing postoperative patient anxiety and uncertainty.

• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.253-265
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• 2012

Purpose: The focus of this research was a systematic review of published articles and theses for a degree in Korea and foreign countries on rehabilitation therapy for patients with total knee arthroplasty (TKA). Methods: The literature until December in 2011 were searched and the data basis included Medline, CINAHL, KERIS, National Library of Korea, and National Assembly Library web sites. Words for the search were TKA or TKA and rehabilitation. Studies included randomized controlled and non-equivalent control group pretest-posttest design. 31 studies were analyzed focusing on type, application method, dependant variable and effect using descriptive statistics. Results: Seventeen rehabilitation therapies and forty-nine dependant variables were used. The application methods of rehabilitation therapy were diverse. The most frequently used rehabilitation type was an exercise therapy and a pain/discomfort was the most frequently used dependant variable. The effects of rehabilitation therapy were inconsistent. Conclusion: The individualized rehabilitation therapy must be comprised of type, time, frequency, period and duration. Attention must be made as to the research design, especially the better measurement of the dependent variables. This review may serve as a base for future research.

• Korean Journal of Adult Nursing
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• v.19 no.2
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• pp.207-216
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• 2007

Purpose: The purpose of this study was to ascertain the effects of preoperative information on postoperative state anxiety, plasma cortisol, and pain for patients under total knee arthroplasty, and to provide generic data with nursing intervention for total knee arthroplasty. Methods: Data were collected from 34 patients who had total knee arthroplasty from January 3, 2003 to January 15, 2004. An experiment group of 17 patients was provided with pre-operative information prepared by the researchers; a control group of another 17 patients was provided with general information. Data were analyzed through Chi-squared test, t-test, paired t-test and ANCOVA using SPSS WIN 11.0. Results: There was no significant differences between the experiment group and the control group in post operative state anxiety(p=.612). However, there was statistically a significant difference between the above two groups in post operative plasma cortisol(p=.012). There was a statistically significant difference between the above two groups in post operative pain(p=.041). Conclusion: According to the results of the study, the authors concluded that the preoperative information for patients under total knee arthroplasty had the effect on the decrease of postoperative plasma cortisol and pain.