• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.244-252
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• 2020

Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.13-17
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• 2009

Purpose: The purpose of this study was to know the cause of the tenderness at pes anserinus. Materials and Methods: Out of 24 patients with tenderness at pes anserinus, 23 patients were female and 1 patient was male, and their average age was 65.9 years old. We checked the tenderness at pes anserinus by history taking & physical examniation and then, checked the pes anserinus for the presence of bursitis by US in outpatient clinic. With no evidence of bursitis by US, we injected steroid-lidocaine mixture intraarticularly and checked whether the tenderness disappeared after 2~3 minutes. Results: There was no case with bursitis at pes anserinus by US. The tenderness at pes anserinus diminished in 2-3 minutes after the intraarticular injection of the steroid-lidocaine mixture. After 6 weeks follow up, 16 patients(66.7%) had little or no tenderness at pes anserinus. 8 cases had the recurrence of tenderness recurred, 4 cases underwent arthroscopic operation on the meniscal tear, and 1 case underwent total knee arthroplasty. All cases underwent any operations had the tenderness at pes anserinus disappeared. The others 3 cases did not undergo total knee arthroplasty despite of radiologic obliteration of knee joint adequate for Kellgren-Lawrence grade IV. Conclusion: Without the bursitis at Pes Anserinus, patients the osteoarthritis may have the tenderness due to the referred pain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4031-4039
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• 2015

The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.

• Journal of East-West Nursing Research
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• v.21 no.1
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• pp.43-51
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• 2015

Purpose: This study was to identify factors to regular exercise among patients with osteoarthritis prior to total knee replacement. Methods: For this cross-sectional descriptive study, the data were collected using questionnaires from 136 patients scheduled for total knee replacement from July 2014 to December. This study aimed to analyse regular exercise status, intensity of physical activity, and factors affecting regular exercise. Results: Twenty two percent of patients expecting for total knee replacement are performing regular exercise and the intensity of it was very low. The use of walking aids, 6-minute walk test, self efficacy for exercise and pain, and quality of life (mental) were significantly associated with regular exercise before surgery. Factors affecting regular exercise were self efficacy for exercise (OR=1.059, CI=1.037-1.091) and 6 minutes walking distance (OR=1.007, CI=1.001-1.014). Conclusion: The results suggest that pre-surgery programs for physical activity and self efficacy were necessary for patients expecting total knee replacement. Regular exercise program could be beneficial for better outcomes after total knee replacement.

• Journal of Korean Physical Therapy Science
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• v.16 no.4
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• pp.11-17
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• 2009

Background: The purpose of this study was to find out the real truth of the effect of PROM (Passive range of motion) and AAROM (Active assistive range of motion) exercise on increasing the knee flexion. This randomized, controlled trial examined whether or not the incorporation of PROME(passive range of motion exercise) to a postoperative rehabilitation protocol would offer a better clinical outcome after TKA (Total knee arthroplasty) Method: The subject (n=36) measured range of motion (ROM).18 consecutive patients who underwent TKAs at SNUH dept. OS received PROME for knee by a physical therapist during the physiotherapy sessions and not for the other 18 patients who underwent TKAs received No-PROME (AAROME) for knee by herself. Result: There were significant differences in the PROME group, No-PROME group ROM progress width And there were significant differences in the PROME group between No-PROME group ROM improvement width. Conclusion: This study demonstrates that the incorporation of PROME does offer additional clinical benefits to the patients after TKA. Our findings may suggest that encouraging patients to perform PROM exercises would be a better option and that physiotherapy session by a physical therapist holds good even now.

• The Journal of Korea CHUNA Manual Medicine
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• v.5 no.1
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• pp.141-150
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• 2004

Objectives : The objective of this study is to evaluate the treatment effect of Oriental therapy including exercise therapy in chronic ankylosing spondylitis with total hip replacement. Methods : Oriental therapy and exercise therapy were performed for 64days admission in a patient who had chronic ankylosing spondylitis with total hip replacement and physical tests were examined. Result : Pain and ROM of cervical. lumbar spine, and left hip joint has improved with this treatment. And Anorexia, dyspepsia, and fatigue were also decreased. Conclusions: In this case, oriental therapy was proved to be effective in improving chronic symptoms and general prostration of Ankylosing Spondylitis. And It is necessary to carry out exercise therapy regulary.

• Journal of the Korean Society for Precision Engineering
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• v.21 no.9
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• pp.188-195
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• 2004

Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.111-116
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• 2006

An infection after total knee arthroplasty has many complications such as severe bone defect, skin and soft tissue problems, devastated general condition, so arthrodesis is preferred as treatment option. However, poor bony contact due to severe bone defect and inadequate conditions of the soft tissue often cause nonunion or severe limb shortening after arthrodesis. More over these conditions, it is not easy to choose appropriate fixative devices. In these situations, the arthrodesis using vascularized fibular graft can be the solution. Vascularized fibular graft (VFG) can playa role as a suitable material for the treatment of bone defects. And VFG can overcome poor blood circulation caused by scar tissues, and can be relatively more durable and adequate length. In the long term, VFG can be hypertrophied by weight bearing, and will give mechanical stablility. The purpose of the paper is to report the successful results of arthrodesis using VFG in a patient who got extensive bone defect after failed revision total knee arthroplasty with infection.

• Journal of muscle and joint health
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• v.25 no.2
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• pp.61-74
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• 2018

Purpose: The purpose of this study was to examine the factors affecting changes in Korean Knee Score (KKS) and ranges of motion (ROM) of the knee after the structured exercise programs for the patients with total knee arthroplasty. Methods: This was a retrospective study using electronic medical records from January 2015 to February 2017, and the subject of this study was a total of 124 out of 434 patients underwent total knee replacement operation. They took part in a structured step-by-step exercise program conducted by orthopedic nurses, and then were evaluated for KKS and Knee ROM for 12 weeks after operation. Results: Post-intervention scores increased significantly in the KKS subdomains including pain and symptoms (t=-22.31, p<.001), function (t=-20.68, p<.001), evaluation of floor life (t=-14.18, p<.001), socioemotional function (t=-28.94, p<.001) over time. As for the change in the ROM, knee extension (t=9.23, p<.001) and knee flexion (t=4.04, p<.001) showed a statistically significant changes over time. Conclusion: This study illuminated the factors affecting the changes in pain and symptom, physical function, evaluation of floor life, socioemotional function and range of motion after structured exercise training programs for knee arthritis patients.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.266-275
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• 2015

Purpose: The objective of this study was to verify the effects of elastic-band exercise on pain, range of motion, and fear of falling in patients with total knee replacement. Methods: The study design was a nonequivalent control group non-synchronized quasi-experimental design. Data were collected from December 10, 2014 to January 10, 2015 in an orthopedic specialty hospital located in the C city. Forty-eight patients participated in the study, and each twenty-four were assigned to the experimental group and the control group. The elastic-band exercise was used with the experimental group for 10 days. The numeric rating scale was used to measure pain, goniometer to measure range of motion, and a questionnaire to measure fear of falling. The data were analyzed using $x^2-test$, Fisher's exact, t-test and paired t-test. Results: Compared to the control group, pain in the experimental group decreased (t=-2.89, p=.006), range of motion increased (t=2.98, p=.005), and fear of falling decreased (t=-4.63 p<.001). Conclusion: The elastic-band exercise for total knee replacement patients is considered to be an effective nursing intervention to decrease pain and fear of falling, and to increase range of motion.