• Clinics in Shoulder and Elbow
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• 제24권1호
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• pp.42-52
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• 2021

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.517-525
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• 2022

Objective: The rehabilitation protocols for functional recovery have been emphasized after total knee arthroplasty, and Pilates is in the spotlight as a safe and easily modified exercise method. The purpose of this study was to investigate the effects of mat Pilates exercise on lower extremity function, postural balance, and walking in the individuals with total knee arthroplasty. Design: One group pretest-posttest design. Methods: Eighteen older women with unilateral total knee arthroplasty was recruited in the study. The subjects were evaluated on lower extremity function, postural balance, and walking before and after mat Pilates exercise. All subject performed one hour mat Pilates exercise, 3 times a week for 8 weeks. Mat Pilates exercises were focused on core stability and lower extremity strengthening and, more dynamic movements were added to increase the difficulty of movements every two weeks. The lower extremity function was measured using the Western Ontario and McMaster Osteoarthritis Index (WOMAC), knee joint position sense, and five times sit-to-stand test. Postural balance was assessed by single leg stance test, functional reach test, and timed up and go test. Walking was measured by OptoGait system to temporospatial parameter. Results: The lower extremity function, postural balance, and walking were significantly improved after mat Pilates exercise, except for five times sit-to-stand test (p<0.05). Conclusions: This study demonstrated that the mat Pilates exercise was a useful method to improve lower extremity function, postural balance, and walking in the older women with unilateral total knee arthroplasty.

• 한국엔터테인먼트산업학회논문지
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• 제13권8호
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• pp.661-670
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• 2019

본 연구는 만성 퇴행성관절염인 슬관절과 고관절 전치환술 환자의 수혈에 영향을 주는 요인을 분석하고, 수혈이 관절 치환술 환자의 의료이용에 미치는 영향을 연구하여 양질의 의료를 위한 기초자료로 활용하고자 한다. 연구대상은 심평원의 환자표본자료(HIRA- NIS-2017) 중 입원개시일자가 2017년 1월 1일부터 12월 30일까지 단측 전치환술을 시행한 환자 중 65세 이상 슬관절 전치환술(N2072)과 고관절 전치환술(N0711)로 청구된 코드만을 대상으로 총 분석 대상은 1,580건이었다. 연구결과는 다음과 같다. 첫째 슬관절 전치환술이 병원특성 및 환자특성별로 수혈여부에 유의한 차이가 있는지 비교하였다. 유의한 변수로는 의료기관종류, 시도, 병상수준, 성별, 빈혈에서 통계학적으로 유의한 연관이 있는 것으로 나타났다. 둘째, 고관절 전치환술의 병원특성 및 환자특성별로 수혈여부에 유의한 차이가 있는 지 비교하였다. 유의한 변수로는 의료기관종류, 병상수준에서 유의한 연관이 있는 것으로 나타났다. 셋째, 슬관절 전치환술의 병원특성 및 환자특성별로 당뇨병 유무에 유의한 차이가 있는 지 비교하였다. 유의한 변수로는 의료기관종류, 병상규모, 빈혈에서 유의한 연관이 있는 것으로 나타났다. 넷째, 수혈여부에 영향을 미치는 요인을 파악하기 위해 로지스택 회귀분석을 실시한 결과, 수혈에 영향을 주는 요인 분석 결과 슬관절 전치환술의 수혈여부에 유의한 영향을 미치는 독립변수는 의료기관 종류, 기관소재지, 성별, 빈혈이었다. 고관절 전치환술의 수혈여부에 유의한 영향을 미치는 독립변수는 의료기관 종류, 성별로 나타났다

• Archives of Plastic Surgery
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• 제42권6호
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• pp.716-720
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• 2015

Background This study has been conducted with the aim of evaluating modified T-plate interpositional arthroplasty. Methods A prospective comparative study in patients admitted with temporomandibular joint ankylosis. Ankylotic temporomandibular joint arthroplasty included condylectomy gap arthroplasty in 7, temporalis muscle flap interpositional arthroplasty in 8, and modified T-plate interpositional arthroplasty in 13 cases. The patients were followed for three years. Collected data were tabulated and subjected to Fisher's exact test, chi-square test and probability estimation. Results A significant increase in interincisal distance of 32 mm was seen in 12 (92.31%) patients in the T-plate interposition group, in 2 (25%) cases of the temporalis muscle flap interposition group, and in 1 case (14.28%) of the condylectomy group at 12, 24, and 36 months. Re-ankylosis was observed in 1 case (9.69%) of the T-plate interposition group, while as it was observed in 4 (50%) cases in the temporalis muscle flap interposition group and 4 (57.14%) cases in the condylectomy group, and these differences were statistically significant. Conclusions Our clinical experience with the use of the T-plate over the past 5 years has been encouraging, and our physiotherapy technique is quite simple. Even illiterate parents can assess it easily. Hence, we recommend this easy technique that does not damage the temporalis muscle for the management of temporomandibular joint ankylosis.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.146-152
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• 2011

목적: 주관절 전지환 성형술의 최근 수술 결과와 합병증에 대하여 문헌을 토대로 기술하고자 한다. 대상 및 방법: 주관절 전치환술의 적응증은 다른 수술 방법으로 관절 기능의 회복이 불가능한 류마토이드 관절염, 외상후 관절염, 관절 강직, 종양 제거 후 상태, 그리고 고령의 원위 상완골 분쇄 골절 등이 있다. 합병증으로는 가장 심각한 합병증인 감염을 비롯하여 삽입물 이완, 삽입물 골절, 삽입물 주위 골절, 척골 신경병증, 이소성 골화, 상완 삼두근 손상, 탈구를 포함한 불안정, bushing의 마모 등이 있다. 결과 및 결론: 재치환술을 기준으로 한 주관절 치환술의 수명은 10년을 기준으로 85% 정도인 것으로 알려져 있다. 염증성 관절염이 가장 예후가 좋으며 외상후 관절염의 이완율이 비교적 높다. 합병증은 다른 관절의 치환술에 비해 많이 발생하는 경향이 있으며 특히 심부 감염은 3~5% 정도로 높은 편이다. 주관절 치환술은 재건술로 관절 기능을 회복할 가능성이 없는 활동력이 높지 않은 환자에 대해 신중하고 적절하게 시행한다면 만족스러운 기능 회복을 기대할 수 있다.

• 대한족부족관절학회지
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• 제5권1호
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• pp.55-61
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• 2001

Purpose: To evaluate the clinical and functional results of ankle arthroplasty and to analyze the complications in total ankle arthroplasty. Materials and Methods: Between October 1988 and October 1991, the total ankle arthroplasty had been performed in eight ankle joints of seven patients.. There were five patients with rheumatoid arthritis, one with osteoarthritis and one with traumatic arthritis. One patient had bilateral replacement. New Jersey type of prosthesis was used in six patients and one patient was performed with Odland type of prosthesis. The average age at surgery was 42.3 years (range, 33-54 years). The average follow-up period was 8.2 years (range, 6-10.5 years). Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The average score was 81.4 (range, 76 - 90) at the most recent follow-up. All patients were satisfied with their clinical results. Relief of pain was excellent in most patients, but postoperatively there was no significant improvement in range of motion. One patient had arthrodesis at three year six months after total ankle arthroplasty due to deep infection. Conclusion: This study shows total ankle arthroplasty is a good alternative treatment in selected cases of osteoarthritis and rheumatoid arthritis.

• 척추신경추나의학회지
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• 제16권1호
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• pp.13-23
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• 2021

Objectives To assess the effectiveness of chuna manual therapy for patients with total knee arthroplasty. Methods We searched 9 electronic databases(KISS, NDSL, RISS, OASIS, KMBASE, Cochrane Library, PubMed, CNKI, Wangfang data) using the keywords 'total knee arthroplasty OR total knee replacement' and 'tuina OR chuna' to identify RCTs that investigated the effectiveness of Chuna manual therapy after total knee arthroplasty. Results 23 RCTs were selected based on inclusion criteria. The systematic review showed positive effect of using chuna manual therapy after total knee arthroplasty. Conclusions 23 studies reported that chuna manual therapy had significant effects on total knee arthroplasty. However, many studies were exposed to probable high risk of bias. Also, all of the studies were published in one overseas country. Therefore, further research is required using well-designed RCTs to support the effectiveness of chuna manual therapy.

• 대한물리치료과학회지
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• 제28권3호
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• pp.88-97
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• 2021

Purpose: Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. This study aimed to investigate the effect of complex balance exercises on unstable ground, on the gait, balance, and daily living ability of patients with total knee arthroplasty. Design: Randomized controlled trial. Methods: The participants consisted of 30 patients placed into two groups of 15 each: a experimental group (complex balance exercise) and a control group (physical therapy exercise). Both group exercise was applied for 3 times a week for 30 minutes for four weeks. Force plate for balance ability and Timed up and go (TUG) test were the primary outcome measures. The secondary outcome measures included 10-m walk test (10MWT) and the daily living ability using the Knee Outcome Survey Activities of Daily Living scale (KOS-ADL). Results: The result of this study showed that the experimental group had a significant difference in TUG and 10MWT than the control group, and balance was significantly different in CEA, CPL, and CAV. There was a significant difference in daily living ability between the experimental and control groups. This study confirms that the physical therapy with complex balance exercise on unstable surfaces has positive effects on balance, gait and daily living ability in patients with total knee arthroplasty. Conclusion: As a result of this study, complex balance exercise on unstable surface was more effective in improvement gait, balance and daily living ability in total knee arthroplasty. From this study, physical therapy with complex balance exercises on unstable ground may be proposed as and effective intervention method for improving gait, balance, and daily living ability in patients with early total knee arthroplasty.

• 대한통합의학회지
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• 제11권2호
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• pp.159-168
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• 2023

Purpose : This study aimed to investigate how neuromuscular electrical stimulation (NMES) affects the balance ability of patients who have undergone total knee arthroplasty owing to osteoarthritis. Methods : Thirty patients who had undergone total knee arthroplasty were randomized to an experimental group (n=15) and a control group (n=15). The experimental group received conventional physical therapy for 50 minutes and NMES treatment for 30 minutes, whereas the control group received conventional physical therapy for 50 minutes and active range of motion (AROM) exercises for 30 minutes. Within-group and between-group changes in static and dynamic balance ability before and after the 4-week intervention were analyzed. Results : In the within-group comparison, sway velocity in the center of gravity and total distance were significantly improved in both the experimental and control groups (p<.05), with no significant differences between the groups (p>.05). In the within-group comparison, both the experimental and control groups showed significant improvement in the functional reach test and movement velosity (p<.05). In the between-group comparison, the experimental group showed a significantly better improvement than the control group in the functional reach test (p<.05), but there was no significant difference in the movement velosity test (p>.05). Conclusion : In this study, NMES improved the static and dynamic balance in patients who had undergone total knee arthroplasty. Compared with AROM exercises, there was a greater effect on dynamic balance partially; however, the overall effect was similar. Therefore, NMES may be one option among various interventions to improve the balance ability in patients who have undergone total knee arthroplasty. In particular, this method may be effective when it is difficult to apply balance training for patients with total knee arthroplasty in a clinical setting.

• Hip & pelvis
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• 제35권3호
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• pp.157-163
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• 2023

Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.