• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.111-116
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• 2011

Purpose: The purposes of this article are to review the mid-term results and the complications after reverse total shoulder arthroplasty and to analyze the influence of the etiology on the result. Materials and Methods: We conducted a systemic review of the published literature with the mid-term follow-up after reverse total shoulder arthroplasty was performed. The overall rates of problems, complications, reoperations and revisions were determined. Results: The reported complication rates varied from 0% to 68%. The first series of reverse prosthesis with at least 2 yrs of follow-up confirmed the preliminary results, with excellent functional outcomes. However, a systemic review of the published literature with a mid-term follow-up showed problems in 44% of the cases, complications in 24% of the cases, reoperations in 3.5% of the cases and revision in 10% of the cases. Conclusion: Reverse total shoulder arthroplasty has relatively high complication and revision rates. So, a reverse prosthesis should be used in patients with very disabling arthropathy and a massive cuff tear and who are over seventy (at least sixty-five) years old.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.93-99
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• 2005

In spite of proper maneuver of total knee replacement arthroplasty, some patients suffer from skin necrosis just above the implant. From Mar. 2000 to Jan. 2004, the authors performed reconstruction of knee skin defects after total knee replacement athroplasty. Total 6 cases of flap surgery were performed and patients ranged between 43-years-old to 82-years-old. Rectus femoris perforator based reversed adipofascial flaps were used in 2 cases, medial gastrocnemius muscular island flaps were used in 2 cases and sural artery based on adipofascial rotation flap was used in 1 case. One patient with extended necrosis underwent reconstruction with dual flaps of sural artery based adipofascial rotation flap and medial gastrocnemius muscular island flap. There were no distinctive complication needing additional procedure in all cases during the long term follow up. Reconstruction of necrosis following total knee replacement arthroplasty had several characteristics different from simple knee defect. The patients might have the history of long term steroid usages, excessive skin tension due to implants, underlying disease such as diabetes, rheumatoid disease, and etc. In addition, the early ambulation is mandatory in these patients of total knee replacement arthroplasty. With regards to these special considerations, a single stage and reliable operation must be needed. The authors introduce various reconstruction methods and algorithm that may aid easy decision making.

• Journal of Korean Clinical Nursing Research
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• v.20 no.1
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• pp.28-39
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• 2014

Purpose: The purpose of this study was to investigate the effect of preoperative education about patient controlled analgesia (PCA) on postoperative pain control for elderly after total knee arthroplasty. Methods: The study applied a quasi-experimental design. To prevent communication between experimental group and control groups, data from control group were collected before provision of preoperative education for the experimental group. A total of 50 elderly patients who underwent total knee arthroplasty and older than 65 years old participated in this study. The preoperative education about PCA was provided for the experimental group before surgery. The preoperative education program consisted of fifteen minute education about pain control, and PCA use, as well as demonstration of PCA use. Results: The experimental group had higher knowledge score about pain and PCA use, and more positive attitudes toward pain and use of analgesics after surgery than the control group. There was no significant difference in use of additional analgesics after surgery between the two groups. The experimental group had significantly lower pain score at 8, 24 and 36 hours after surgery than the control group. The experimental group had higher level of satisfaction about PCA use than the control group. Conclusion: The preoperative education about PCA, customized for elderly patients could be an effective nursing intervention for postoperative pain control after total knee arthroplasty.

• 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 Korean Foot and Ankle Society
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• v.6 no.2
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• pp.161-166
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• 2002

Purpose: To evaluate the effectiveness of distraction arthroplasty as treatment for moderate or severe ankle osteoarthritis Materials and Methods: Thirteen patients who underwent distraction arthroplasty using the Ilizarov external fixator were available. We removed osteophytes around the ankle before applying the external fixator. We encourage the patients to do active range of motion exercise and to walk with cruch. Follow-up averaged 15 months (range, 10-31 months). Both the patients' postoperative satisfaction and the radiographic joint space were retrospectively evaluated. Results: The duration from applying the external fixator to remove was 12 weeks. Breakage of the wire applied to the forefoot occurred in 2 cases. All patients satisfied with the postoperative clinical results. The ankle joint space averaged $1.6{\pm}0.2mm$ in pre-operative, $4.2{\pm}0.9mm$ in post-Ilizarov external fixator's removal, and $2.3{\pm}0.3mm$ in last follow-up ankle lateral view. Conclusion: We think that distraction arthroplasty with external fixator is useful operative method for the moderate or severe ankle osteoarthritis.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.398-406
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• 2018

Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.2
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• pp.95-103
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• 2022

Objectives This study was conducted to assess the effect of chuna manual therapy after hip arthroplasty. Methods We searched across 9 electronic databases (PubMed, Cochrane Library, Wangfang data, China National Knowledge Infrastructure [CNKI], Oriental Medicine Advanced Searching Integrated System [OASIS], National Digital Science Library [NDSL], Korean Medical Database [KMBASE], Koreanstudies Information Service System [KISS], Research Information Sharing Service [RISS]) to find randomized controlled clinical trials for chuna manual therapy after hip arthroplasty. Results On inclusion criteria, 11 appropriate studies were included and analyzed. The deep vein thrombosis incidence of the chuna manual therapy group was statistically lower than the conventional treatment group (p=0.0002). Chuna manual therapy significantly improved the Harris hip score compared with conventional treatment (p<0.00001). Also, chuna manual therapy combined with herbal fumigation therapy significantly elevated the hip joint function score of Harris hip score compared with the conventional therapy group (p<0.00001). Conclusions The systematic review showed that chuna manual therapy had significant effects on hip arthroplasty. Nonetheless, considering the high risk of bias and geographic bias, further research with well-designed studies is required to support the effectiveness of chuna manual therapy.

• Hip & pelvis
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• v.35 no.4
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• pp.233-237
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• 2023

Purpose: The objective of this study was to analyze the results from a cohort of patients who underwent a revision total hip arthroplasty (THA) using a dual mobility cup (DMC) implant. Materials and Methods: A retrospective review of revised THAs was conducted using the database from a single tertiary referral hospital. A total of 91 revision THAs from 91 patients were included in the study. There were 46 male hips and 45 female hips. The mean age was 56.3±14.6 years, and the mean follow-up period was 6.4±5.9 years. In performance of revision THAs, the DMC implants were used in 18 hips (19.8%), and the conventional implants were used in 73 hips (80.2%). Results: During the follow-up period, three dislocations were identified, and the overall dislocation rate was 3.3%. Early dislocation (at one month postoperatively) occurred in one patient, while late dislocation (at a mean of 7.5 years) occurred in two patients. There was no occurrence of dislocation in the DMC group (0%), and three dislocations were detected in the conventional group (4.1%). However, no significant difference in the rate of dislocation was observed between the two groups (P=0.891). Conclusion: Although the rate of dislocation was higher in the conventional group, there were no statistically significant differences between the two groups due to the small number of patients. Nevertheless, we believe that the dual mobility design is advantageous in terms of reducing dislocation rate and can be recommended as an option for a revision THA.

• Proceedings of the KSME Conference
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• 2001.06c
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• pp.482-484
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• 2001

In orthopedics, hip arthroplasty is the operation that replaces damaged hip joint to artificial joint. In hip arthroplasty, quite better result can be achieved if robot is applied to machine cavity in bone, especially when cementless stem is used. So several kinds of robots were introduced for hip arthroplasty, but they used MRI, CT Scan, vision analysis and real time tracking of bone position for registration of robot. To overcome shortage of conventional robot surgery, gauge based registration method was proposed and small robot was designed. In this method, small robot is mounted on femur, and its position is determined by gauge registration method. Operation procedure was performed on model femur and result was analyzed. This robotic hip surgery system is expected to more adaptable in operation room.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.154-157
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• 2000

Author report a case of double metatarso-phalangeal joint transplantation to the elbow joint in the 31 years old female patient who have large bone defect associated with skin and soft tissue defect. The donor joints were second and third metatarso-phalangeal joint as double joint transfer fashion to enhance stability of graft. The graft based on dorsalis pedis vessel to anastomosed with radial artery of recipient site. The result is unsatisfactory because of long lasting lateral instability of reconstructed elbow joint in spite of 40 degree flexion motion and fair axial stability. We can conclude that joints from foot can not be an effective donor for biologic joint arthroplasty of elbow joint even though double metatarso-phalangeal joint were harvested.