• 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.

• Journal of Biomedical Engineering Research
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• v.28 no.1
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• pp.108-116
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• 2007

Recently, it has been reported that the posterior stabilized implant, which is clinically used for the total knee replacement (TKR), may have failure risk such as wear or fracture by the contact pressure and stress on the tibial post. The purpose of this study is to investigate the influence of the mal alignment of the posterior stabilized implant on the tibial post by estimating the distributions of contact pressure and von-Mises stress on a tibial post and to analyze the failure risk of the tibial post. Finite element models of a knee joint and an implant were developed from 1mm slices of CT images and 3D CAD software, respectively. The contact pressure and the von-Mises stress applying on the implant were analyzed by the finite element analysis in the neutral alignment as well as the 8 malalignment cases (3 and 5 degrees of valgus and varus angulations, and 2 and 4 degrees of anterior and posterior tilts). Loading condition at the 40% of one whole gait cycle such as 2000N of compressive load, 25N of anterior-posterior load, and 6.5Nm of torque was applied to the TKR models. Both the maximum contact pressure and the maximum von-Mises stress were concentrated on the anterior-medial region of the tibial post regardless of the malalignment, and their magnitudes increased as the degree of the malalignment increased. From present result, it is shown that the malalignment of the implant can influence on the failure risk of the tibial post.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.20-26
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• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.454-458
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• 2017

A Maltese (case 1) and a Pomeranian (case 2) presented with acute right and left hind limb weight-bearing lameness. On physical examination, they exhibited severe pain and crepitus on the coxofemoral joint of affected hind limb. In addition, decreased thigh girth measurements were noted compared with the opposite leg. Radiological exam revealed necrotic areas in the femoral head of affected hind limb. These dogs were diagnosed with Legg-$Calv{\acute{e}}$-Perthes disease (LCPD). The dogs underwent micro total hip replacement (THR). After surgery, at 3 years (case 1) and 7 months (case 2), both dogs recovered normal activity. The thigh girth and lameness scores were apparently improved in the affected limbs of both dogs. No complications of prosthesis implants, such as loosening, were noted. The clinical outcomes of these cases indicate that dogs with LCPD can be successfully treated with micro THR and have a good prognosis immediately after surgery.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.77-83
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• 2018

Background: The purpose of this study is to investigate that effect of manual therapy using pelvic compression belt on hip abductor strength and balance ability in total knee replacement (TKR) patients. Methods: The subjects consisted of twenty two post-TKR patients. Participants were randomly assigned to a pelvic belt group (n=11) and a placebo group (n=11). All participants underwent manual therapy including range of motion exercise, soft tissue mobilization around knee joint, strengthening exercise (Quad set, SLR, sidelying hip abduction, standing hamstring curls, sitting knee extension, step-up, wall slide to $45^{\circ}$ knee flexion). Manual therapy was executed five times a week for 2 weeks. Outcome measures included hip abductor strength by using Biodex system 4 pro, anterior to posterior balance, medial to lateral balance, total balance by using Biodex balance system SD. Results: After the completion of the manual therapy, hip abductor strength was showed statistically significant improvements in pelvic belt group (p<.05). Anterior to posterior balance, medial to lateral balance, total balance were showed statistically significant improvements in pelvic belt group and placebo group (p<.05). There was a statistically significant difference between the two groups in hip abductor strength and there was no statistically significant difference in balance. Conclusions: This results suggest that manual therapy using pelvic compression belt has could be used for selective muscle activation of the hip abductor muscle and has useful in hip abductor strength and balance ability in TKR patients.

• Steel and Composite Structures
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• v.27 no.4
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• pp.495-508
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• 2018

In this paper, cyclic loading tests on composite frame inner joints of steel-reinforced recycled concrete (SRRC) column-steel beam were conducted. The main objective of the test was to obtain the shear behavior and analyze the shear strength of the joints. The main design parameters in the test were recycled coarse aggregate (RCA) replacement percentage and axial compression ratio. The failure process, failure modes, hysteresis curves and strain characteristics of the joints were obtained, and the influences of design parameters on the shear strength of the joints have been also analysed in detail. Results show that the failure modes of the joints area are typical shear failure. The shear bearing capacity of the joints maximally decreased by 10.07% with the increase in the RCA replacement percentage, whereas the shear bearing capacity of the joints maximally increased by 16.6% with the increase in the axial compression ratio. A specific strain analysis suggests that the shear bearing capacity of the joints was mainly provided by the three shear elements of the recycled aggregate concrete (RAC) diagonal compression strut, steel webs and stirrups of the joint area. According to the shear mechanism and test results, the calculation formulas of the shear bearing capacity of the three main shear elements were deduced separately. Thus, the calculation model of the shear bearing capacity of the composite joints considering the adverse effects of the RCA replacement percentage was established through a superposition method. The calculated values of shear strength based on the calculation model were in good agreement with the test values. It indicates that the calculation method in this study can reasonably predict the shear bearing capacity of the composite frame inner joints of SRRC column-steel beam.

• Journal of Veterinary Clinics
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• v.33 no.5
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• pp.295-299
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• 2016

A 2-year-old, 1.94 kg spayed female Toy Poodle was referred for revision surgery for patellar reluxation following surgery for bilateral medial patellar luxation (MPL). Intermittent non-weight-bearing lameness of the right hindlimb and weight-bearing lameness of the left hindlimb were evident on general inspection. A physical examination revealed that there was a bilateral grade 4 MPL. On radiographs, the medial and lateral trochlear ridge was bilaterally worn out. Patellar groove replacement (PGR) was performed in two stages to replace the bilateral femoral trochlea that had a severely worn out groove. Corrective femoral osteotomy with increasing anteversion angle, tibial tuberosity transposition, medial releasing, lateral imbrications and PGR were performed on the right hindlimb. Six months after surgery on the right hindlimb, a PGR prosthesis was positioned medially on the frontal plane and tibial tuberosity transposition and lateral imbrications were performed on the left hindlimb. Two weeks after surgery, reluxation of the patella occurred on the left hindlimb. The tibial tuberosity transposition was performed to realign the patella more laterally than the previous surgery, and a patellar sling was applied. Two years after the last surgery, the patient showed no pain on the stifle joint and satisfactory weight-bearing ambulation. Reluxation did not recur. PGR maybe a successful treatment for dogs with iatrogenically damaged and/or worn out patellar grooves.

• Journal of the Korea Society of Computer and Information
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• v.28 no.12
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• pp.183-189
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• 2023

The propose of this study was to investigate the effects of squat exercise using a reformer on muscle strength, range of motion, and gait in hip joint replacement patients. This study was conducted on 20 patients hospitalized at a rehabilitation hospital in G City. As an intervention method, the experimental group performed squat exercises using a reformer, and the control group performed squat exercises, 7 times a week for 2 weeks. In the within-group comparison of the reformer group, there was a significant difference in hip flexion, extension, and abduction strength (p<0.05). There were significant differences within the group in the range of motion of hip extension and abduction and gait in the Reformer group (p<0.05). In comparison between groups, significant differences occurred in hip extension strength, hip extension, abduction range of motion, and gait (p<0.05).

• 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.

• Journal of muscle and joint health
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• v.18 no.2
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• pp.203-214
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• 2011

Purpose: The purpose of the study was to identify the effects for 4-weeks muscle strengthening exercise program on pain, fatigue, and physical function(muscle strength of leg, walking competence, balance, flexibility of patella) in elderly women with total knee arthroplasty(TKA). Method: Utilizing a quasi-experimental design, 30 TKA patients consisted of the experimental group (n=15) and control group (n=15). The experimental group participated in the muscle strengthening exercise program, twice a day for 4 weeks. Data were analyzed with SPSS WIN 18.0 program, using repeated measure ANOVA. Result: As time goes by, There were significant differences in muscle strength of leg (F=6.60, p<.001), walking competence(F=7.15, p<.001), and balance(F=17.55, p<.001) between the experimental and the control groups. Conclusion: The findings of this study revealed the positive effects of muscle strengthening exercise program in elderly women with TKA.