• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.669-689
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• 2002

Purpose : The purpose of the present study is to develop a clinical pathway applied with activity-based management methodology for efficient clinical management to cope with rapid changing medical environments. Method : After making a preliminary pathway based on which a conceptual frame of reference was established to develop a clinical pathway, the final one was confirmed by verifying experts validity and clinical validity. The ultimate activity-based clinical pathway was restructured after clarifying, schematizing and analyzing the whole activities of clinical pathway in accordance with the conducting process of activity-based management. Result : A clinical pathway for total hip replacement was developed, in which the vertical axis consisted of assessment, examination, consultation, medication, treatment, diet, activity, and education, and the horizontal axis was composed of six days of hospitalization. Then, on the basis of the development, the clinical pathway including the improved contents and information was restructured after making the reform measure by analyzing each of activities in the pathway. And the list of contents related to the clinical management activity was made, which was described its main contents and the pre-activities that ought to be completed before conducting each of activities in the pathway. Conclusion : The clinical pathway applied with activity-based management may be used as a standard guidance for providing continuous and consistent patient care. It will provide the information for nursing activities to nurses and the management information about hospital and nursing activities to the hospital administrators. It will also be used as a tool for communication between medical staff. Besides, it will contribute to creating profits for the hospital by shortening the length of stay in patients.

• Journal of the Korean Society for Precision Engineering
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• v.29 no.6
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• pp.680-685
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• 2012

Ceramic femoral heads are now widely used in Total Hip Replacement (THR). Due to their high biocompatibility and low ductility, ceramic femoral heads are considered to be suitable for young and active patients. However, as in testing the mechanical stability of the femoral head, the conventional proof test (standard ISO 7206-10) has its limit of showing axisymmetric stress distribution on the contact surface, while non-uniformed stress distribution is expected after THR. Since non-uniformed stress distribution can result in the increased probability of ceramic femoral head fracture, it is considerable to evaluate the stress distribution in vivo-like conditions. Therefore, this study simulated the ceramic femoral heads under in vivo-like conditions using finite element method. The maximum stress decreased when increasing the size of the femoral head and stress distribution was concentrated on superior contact surface of the taper region.

• Journal of muscle and joint health
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• v.25 no.2
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• pp.122-134
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• 2018

Purpose: The purpose of this study was to develop a 12-week structured exercise program (12-week-SEP) and evaluate its effects on pain, physical function and quality of life in patients with total hip arthroplasty (THA). Methods: A nonequivalent control group non-synchronized design was utilized to examine the effects of the 12-week-SEP on patients' outcomes after THA. A total of 46 adult patients (experimental group=25, control group=21) who had THA were recruited for the study. The 12-week-SEP consisted of education, exercise (muscle strengthening and progressive walking), and feedback. Data were analyzed by SPSS/WIN 21.0 using the $x^2$ test and repeated measures ANOVA. Results: The mean age of the participants was 60.9 years and 25 men (54.5%) and 21 women (45.7%) were included in the study. There were significant intervention effects on pain reduction and increased physical function but no effects on quality of life. Conclusion: The 12-week-SEP provided pain relief and enhanced physical function in patients underwent THA. Clinical application of the 12-week-SEP can improve postoperative nursing practices for patients with THA. Future research with larger sample is of necessity to obtain greater generalizability of the empirical evidences of the 12-week-SEP.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.2
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• pp.239-247
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• 2003

Purpose: The purpose of this study is to examine how well patients who had hip arthroplasty comply with medical regimens given to them after the operation. Method: The subjects of the study were patients who had arthroplasty at P Hospital between April 1, 2001 and August 30, 2002. 20 patients of the subjects experienced complications after the operation and the other 20 did not. Data from a survey using the qustionnaire were statistically analyzed in terms of real number, percentage point, mean and standard deviation by using $X^2$-test, t-test and ANOVA. Result: 1) the surveyed patients were significantly different in the compliance of medical regimen among them according to their education background as one of the subjects general characteristics. 2) It was found that the group of complication was higher in the compliance of medical regimen than that of non-complication. The two groups showed statistically significant difference with each other in the degree of compliance with therapeutic instructions than the experimental group in terms of the maintenance of abduction after the operation, training instructions on step-by-step basis, urination cotrol on bed, accurate use of crutch, compliance with medication, balance among medical treatment, training, leisure, rest and nutrition, instructions by physicians, nurses and physical therapists, use of low armchairs and toilet bowels and no bending of the body forward, and use of a non-operated leg in case of go upstairs or downstairs. Conclusion: It seems necessary to develop systematic and sessional education programs for improving the compliance of medical regimen, ultimately reducing complications following hip arthroplasty.

• Journal of muscle and joint health
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• v.22 no.2
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• pp.67-77
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• 2015

Purpose: This study was a qualitative research using focus group interviews to collect data on the health care providers' perceptions of physical function in older adults with arthroplasty from hip fracture. Methods: A total of 12 subjects participated in this study. In order to conduct focus group interviews, structured manuscript, field notes, visual recording, and debriefing notes were referred and thematic analysis was used in analysis phase. Results: The six themes were raised: 'burdensome client', 'health care providers' perception of functional decline in older adults after surgery', 'health care providers' perception of caregiver', 'medical environment perceived as affecting physical function', 'crucial components perceived as encouraging functional restoration', and 'difficulty of pain management' with 18 subthemes. Conclusion: Healthcare providers perceived functional decline of elderly after arthroplasty and identified points facilitating or disturbing physical function Moreover, various perspectives on pain management related to physical function were represented.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.113-118
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• 2007

Surgical treatment of pelvic bone tumors represent one of the most complicated problem in musculoskeletal oncology. Because of three dimensional anatomy of the pelvis, tumors reach huge sizes and the diagnosed late relatively to a similar tumors in extremity. Especially, there are limited reconstruction methods to keep the function of hip joint after resection of periacetabular tumors, and the results of reconstruction is not so promissing. We present one case of periacetabular metastatic tumor from renal cell carcinoma, which was resected with wide margin and reconstructed with composite of pasteurized autogenous bone graft and constrained total hip arthroplasty.

• Journal of Biomedical Engineering Research
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• v.23 no.2
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• pp.119-130
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• 2002

The nonlinear finite element program has been developed to analyze the design performance of an artificial hip prosthesis and long term behavior of a treated femur with stems made of composite material after cementless total hip arthroplasty(THA). The authors developed the three dimentional FEM models of femoral bone with designed composite stem which was taken with elliptic cross section of 816 brick elements under hip contact load and muscle farce in simulating single leg stand. Using the program, density changes, stress distributions and micromotions of the material femoral bone were evaluated by changing fiber orientation of stems for selected manufacturing method such as plate cut and bend mold. The results showed that the composite materials such as AS4/PEEK and T300/976 gave less bone resorption than the metallic material such as cobalt chrome alloy, titanium alloy and stainless steal. It was found that increasing the long term stability of the prosthesis in the femur could be obtained by selecting the appropriate ply orientation and stacking sequence of composite.

• Proceedings of the KOSOMBE Conference
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• v.1994 no.12
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• pp.75-78
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• 1994

Clinically, proximal bone resorption in the femur is frequently seen postoperatively on the follow up X-rays after total hip replacement(THR). We developed the finite element model of cementless THR. The model is two dimensional side plate model, whereby the three dimensional structural integrity of the bone can be accounted for by a separate two dimensional mesh, a side plate. The subject of this article is the development and application of this two dimensional side plate FEM to study the reverse effect of the various degree of bone resorption of femur after THR. The results of this study indicates that two dimensional side plate model is good and simple alternative to complex three dimensional model and the severity of the proximal bone resorption has the effect of more increasing stress on the cortex at the level of femoral stem tip.

• Journal of radiological science and technology
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• v.21 no.2
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• pp.43-46
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• 1998

When a patient was irradiated with prosthetic hip, the dose distribution was changed according to inhomogeneous materials. The density, effective atomic number, and the composition of material had influence on absorbed dose distribution. In this study, the influence of inhomogeneous material(Ti) was measured using a polyethylene phantom, which consisted of various diameter of titanium, with film dosimetry. As a result, the backward dose showed 29.5% increas by backscattering, the forward dose showed 28% decreas by absorption, and the side dose showed 7% increas by scattering, when 25 mm diameter Ti was used. In addition forward dose was in inverse proportion to the thickness of prosthetic material. When the prosthetic hip of patient is in an irradiated field, we must carefully study the absorbed dose distribution.

• Korean Journal of Computational Design and Engineering
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• v.5 no.2
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• pp.122-126
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• 2000

A major mechanical problem with total hip replacement is the loosening of the femoral component. The loss of proximal support, with firm fixation distally, has been thought to be a major caused of fatigue failure of femoral stems. While many causes have been proposed, the most frequently suggested cause of the calcar resorption is the disuse atrophy of the cortex of the calcar due to the stress shielding of the proximal bone by the metal femoral stem. In this research, the new-designed stem(modified collar stem) was considered which made a hole inside stem and had a 3 mm thickness. Using the 3-dimensional finite element methods, the common collar stem and the modified colla stem was modeled and analysed. Also, the two models was compared. The results showed that the modified collar stem decreased the stress-shielding and it made a effective load transfer at the entire femoral region.