• Title/Summary/Keyword: Joint Replacement

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Analysis of Loosening Phenomenon in Artificial Hip Joint Application Related to Design Parameters (인공고관절의 설계인자들이 해리현상에 미치는 영향에 대한 해석)

  • Kim, Young-Eun;Chung, Chung-Hwa
    • Journal of Biomedical Engineering Research
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    • v.14 no.2
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    • pp.155-162
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    • 1993
  • The human's biomechanical structure keeps an optimal state by adapting the original biomechanical structure according to a change in the physical environment. This phenomenon is believed to be the main cause of loosening of the total hip replacement which is used widely in these days. In this study the bone density change due to artificial hip joint, which is generally believed as bone-remodeling, was investigated by the finite element method. For this, 2-D FEM models with 4 nodal point elements were constructed for intact and implanted cases. The density was calculated by comparing the relative amounts of effective stress for these two cases. In this way, calculated new density values were used in the next step as input values and this procedure repeated until convergence was obtained. Severe density change was detected at the femoral cortex of the proximal-medial side as expected. Moreover, following surprising result was found from this analysis. Titanium alloy prosthesis showed less density change compared to stainless steel prosthesis at earlier stage, however, almost same amount of the density change was detected at final stage. It was also found that other design parameters could not significantly affect its density change.

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Evaluation of Field Applicability of Controlled Low Strength Materials as Cavity Filling Materials Various Industrial by Products (공동충전재로써 산업부산물을 복합적으로 활용한 슬러리계 되메움의 현장적용성 평가)

  • Liao, XiaoKai;Kim, Dong-Hun;Lim, Nam Gi
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2021.11a
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    • pp.72-73
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    • 2021
  • In this study, the engineering characteristics of CLSM mixed with GBFS and GF were identified to review the applicability as a replacement material and further evaluate the recharge and field applicability as a joint filler material. First, Using more than 30% of GBFS to replace FA enabled bleeding control through improved fluidity. Second, When using more than 30% of FNS to replace sand, it was found that adding 0.25~0.35 of the AE agent is effective for bleeding control through improved fluidity. Third, When using more than 30% of both GBFS and FNS in combination, it was found that adding 0.3~0.35 of the AE agent is effective for bleeding control through improved fluidity. Also, it was confirmed that proper mixing of 15~60% of GF secured the effective strength and desired quality as a refiller and joint filler material.

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Pyrocarbon hemiarthroplasty and the shoulder: biomechanical and clinical results of an emerging treatment option

  • Mohamad Y. Fares;Jaspal Singh;Peter Boufadel;Matthew R. Cohn;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.117-125
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    • 2024
  • While shoulder hemiarthroplasty is still used to treat young patients with shoulder pathology, the use of this procedure has substantially declined in recent years due to its significant complication profile. Glenoid wear with arthrosis is one of the major postoperative complications following shoulder hemiarthroplasty, and efforts to prevent this complication led many scientists to explore alternative weight-bearing surfaces on arthroplasty implants to decrease joint wear and improve patient outcomes. Pyrolytic carbon, or pyrocarbon, is a material that has better biocompatibility, survivorship, strength, and wear resistance compared to the materials used in traditional shoulder hemiarthroplasty. Pyrocarbon implants have been used in orthopedics for over 50 years; recently, their utility in shoulder hemiarthroplasty has garnered much interest. The purpose behind the use of pyrocarbon in shoulder hemiarthroplasty is to decrease the risk of progressive glenoid wear, especially in young active patients in whom joint preservation is important. Promising survivorship and outcomes have been demonstrated by recent studies, including limited glenoid wear following pyrocarbon hemiarthroplasty. Nevertheless, these clinical studies have been limited to relatively small case series with limited long-term follow-up. Accordingly, additional research and comparative studies need to be conducted in order to properly assess the therapeutic efficacy and value of pyrocarbon hemiarthroplasty.

Strength Evaluation of Sin91e-Radius Total Knee Replacement (TKR) (인공무릎관절의 단축법위 회전시 근력정가)

  • Wan, Jin-Young;Sub, Kwak-Yi
    • Journal of Life Science
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    • v.14 no.3
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    • pp.484-489
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    • 2004
  • Artificial joint replacement is one of the major surgical advances of the 21th century. The primary purpose of a TKA (Total Knee Arthroplasty) is to restore normal knee Auction. Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from a chair or climbing stairs;(b) allow the same range of motion as an complete knee; and (c) provide adequate knee joint stability. Four individuals (2 peoples after surgery one year and 2 peoples after surgery three years) participated in this study. All they were prescreened for health and functional status by the same surgeon who performed the operations. Two days of accommodation practice occurred prior to the actual strength testing. The isometric strength (KIN-COM III) of the quadriceps and hamstring were measured at 60$^\circ$ and 30$^\circ$ of knee flexion, respectively. During isokinetic concentric testing, the range of motion was between 10$^\circ$ to 80$^\circ$ of knee flexion (stand-to-sit) and extension (sit-to-stand). for a given test, the trial exhibiting maximum torque was analyzed. A 16-channel MYOPACTM EMG system (Run Technologies, Inc.) was used to collect the differential input surface electromyographic (EMG) signals of the vastus medialis (VM), vastus lateralis(VL), rectus femoris (RF) during sit-to-stand and stand-to-sit tests. Disposable electrodes (Blue SensorTM, Medicotest, Inc.) were used to collect the EMG signals. The results were as follows; 1. Less maximum concentric (16% and 21% less for 1 yew man and 3 years mm, respectively) and isometric (12% and 29%, respectively) quadriceps torque for both participants. 2.14% less maximum hamstrings concentric torque for 1 year man but 16% greater torque for 3 years mm. However, 1 year man had similar hamstring isometric peak torque for both knees. 3. Less quadriceps co-contraction by 1 year man except for the VM at 10$^\circ$-20$^\circ$ and 30$^\circ$-50$^\circ$ range of knee flexion.

A CLINICAL CASE OF ALLOPLASTIC CONDYLE REPLACEMENT WITH CONDYLAR PROSTHESIS IN SEVERE DEGENERATIVE JOINT DISEASE (심한 퇴행성 악관절 질환 환자에서 보철성 과두를 이용한 하악과두 재건술의 치험례)

  • Jeon, Yong-Min;Kim, Chang-Hyun;Cha, Jeong-Seop;Min, Kyung-Gi;Kwon, Jong-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.162-167
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    • 2010
  • This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

EFFECTS OF CRYOPRESERVATIVE AGENTS ON THE REPAIR OF THE TEMPOROMANDIBULAR JOINT DISK WITH ALLOGENEIC CARTILAGE GRAFTS IN RABBITS (동종 연골을 이용한 가토 측두하악관절원판 재건시 냉동 보존제의 영향에 관한 실험적 연구)

  • Kim, Won-Gyu;Kim, Soo-Nam;Min, Seung-Ki;Sung, Gil-Hyun;Keon, Heak-Do
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.303-316
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    • 1993
  • The auricular cartilage grafts have been widely used in replacement of the temporomandibular joint disk. Cartilage grafts itself have a low metabolism and high survival rate after grafting. In processing the grafting materials, it was important to preserve the properties of chondrocyte proper. We used 15% glycerol and 10% DMSO (Dimethyl Sulfoxide) solutions for cartilage fixation before deep freezing. We have performed the allogenic auricular cartilage graft in the temporomandibular joint of 20 rabbits which 10 specimen was treated with 15% glycerol and the other 10 specimen was treated with 10% DMSO respectively and examined in 1, 2, 4, 6 and 8 weeks after operation histopathologically. The result were : 1. Inflammatory cell infiltration around the grafted material appeared more glycerol groups than DMSO groups at 1 week, but each group has no differences after 2 weeks. 2. Degenerative changes of grafted auricular chondrocytes were more deveolped in glycerol group than DMSO groups till 4 weeks, but there were no differences between two groups after 6 weeks. 3. Fibrous union between grafted fragment and mandibular condyle was prominent in DMSO group. 4. Vascular proliferation of the grafted auricualr cartilage was more developed in DMSO groups than glycerol group in early stage. 5. Amount of the additional growth of grafted auricular cartilage was more existed in DMSO groups than glycerol group. 6. General survival rate after grafting was more prominent in DMSO group. In summary, allogenic auricular cartilage grafts treated with 15% glycerol and 10% DMSO solution have supported to survivalbility as a cryopreservative agents, especially DMSO groups have little inflammatory cell infiltration in early stages and degenerative changes and additional growth are more prominent than glycerol groups.

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Properties Evaluation of Controlled Low Strength Materials Used Industrial by-Products of A Great Quantity (다량의 산업부산물을 활용한 슬러리계 되메움 재료의 물성 평가)

  • Liao, Xiaokai;Kim, Dong-Hun
    • Journal of the Korea Institute of Building Construction
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    • v.20 no.5
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    • pp.441-448
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    • 2020
  • In this study, the engineering characteristics of CLSM mixed with GBFS and GF were identified to review the applicability as a replacement material and further evaluate the recharge and field applicability as a joint filler material. This study has resulted in the following findings. First, Using more than 30% of GBFS to replace FA enabled bleeding control through improved fluidity. Moreover, it has been confirmed that effective strength and proper quality can be achieved when it was applied as a refiller and joint filler material with higher early strength than the base material. Second, When using more than 30% of FNS to replace sand, it was found that adding 0.3~0.35 of the AE agent is effective for bleeding control through improved fluidity. Third, When using more than 30% of both GBFS and FNS in combination, it was found that adding 0.3~0.35 of the AE agent is effective for bleeding control through improved fluidity. Also, it was confirmed that proper mixing of 15~60% of GF secured the effective strength and desired quality as a refiller and joint filler material. Fourth, The relationship between the superficial level and internal micro pores of CLSM from the curing process needs to be discussed and reviewed in more detail through further research studies.

Joint Problems in Patients with Mucopolysaccharidosis Type II

  • Kim, Min-Sun;Kim, Jiyeon;Noh, Eu Seon;Kim, Chiwoo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.5 no.1
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    • pp.17-21
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    • 2021
  • Hunter syndrome or mucopolysaccharidosis type II (MPS-II) (OMIM 309900) is a rare lysosomal storage disorder caused by deficiency in the activity of the enzyme iduronate-2-sulfatase. This enzyme is responsible for the catabolism of the following two different glycosaminoglycans (GAGs): dermatan sulfate and heparan sulfate. The lysosomal accumulation of these GAG molecules results in cell, tissue, and organ dysfunction. Patients can be broadly classified as having one of the following two forms of MPS II: a severe form and an attenuated form. In the severe form of the disease, signs and symptoms (including neurological impairment) develop in early childhood, whereas in the attenuated form, signs and symptoms develop in adolescence or early adulthood, and patients do not experience significant cognitive impairment. The involvement of the skeletal-muscle system is because of essential accumulated GAGs in joints and connective tissue. MPS II has many clinical features and includes two recognized clinical entities (mild and severe) that represent two ends of a wide spectrum of clinical severities. However, enzyme replacement therapy is likely to have only a limited impact on bone and joint disease based on the results of MPS II studies. The aim of this study was to review the involvement of joints in MPS II.

From diagnosis to treatment of mucopolysaccharidosis type VI: A case report with a novel variant, c.1157C>T (p.Ser386Phe), in ARSB gene

  • Yoo, Sukdong;Lee, Jun;Kim, Minji;Yoon, Ju Young;Cheon, Chong Kun
    • Journal of Genetic Medicine
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    • v.19 no.1
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    • pp.32-37
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    • 2022
  • Mucopolysaccharidosis type VI (MPS VI) is an autosomal recessive lysosomal disorder caused by the deficiency of arylsulfatase B due to mutations in the ARSB gene. Here, we report the case of a Korean female with a novel variant of MPS VI. A Korean female aged 5 years and 8 months, who is the only child of a healthy non-consanguineous Korean couple, presented at our hospital for severe short stature. She had a medical history of umbilical hernia and recurrent otitis media. Her symptoms included snoring and mouth breathing. Subtle dysmorphic features, including mild coarse face, joint contracture, hepatomegaly, and limited range of joint motion, were identified. Radiography revealed deformities, suggesting skeletal dysplasia. Growth hormone (GH) provocation tests revealed complete GH deficiency. Targeted exome sequencing revealed compound heterozygous mutations in the ARSB genes c.512G>A (p.Gly171Asp; a pathogenic variant inherited from her father) and c.1157C>T (p.Ser386Phe; a novel variant inherited from her mother in familial genetic testing). Quantitative tests revealed increased urine glycosaminoglycan (GAG) levels and decreased enzyme activity of arylsulfatase B. While on enzyme replacement therapy and GH therapy, her height increased drastically; her coarse face, joint contracture, snoring, and obstructive sleep apnea improved; urine GAG decreased; and left ventricular mass index was remarkably decreased. We report a novel variant-c.1157C>T (p.Ser386Phe)-of the ARSB gene in a patient with MPS VI; these findings will expand our knowledge of its clinical spectrum and molecular mechanisms.

The Dome Technique for Managing Massive Anterosuperior Medial Acetabular Bone Loss in Revision Total Hip Arthroplasty: Short-Term Outcomes

  • Tyler J. Humphrey;Colin M. Baker;Paul M. Courtney;Wayne G. Paprosky;Hany S. Bedair;Neil P. Sheth;Christopher M. Melnic
    • Hip & pelvis
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    • v.35 no.2
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    • pp.122-132
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    • 2023
  • Purpose: The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique. Materials and Methods: A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B anterosuperior medial acetabular bone loss from 2013-2019 with a minimum clinical follow-up period of two years. Twelve cases in 12 patients were identified. Baseline demographics, intraoperative variables, surgical outcomes, and patient reported outcomes were acquired. Results: The implant survivorship was 91% with component failure requiring re-revision in only one patient at a mean follow-up period of 36.2 months (range, 24-72 months). Three patients (25.0%) experienced complications, including re-revision for component failure, inter-prosthetic dual-mobility dissociation, and periprosthetic joint infection. Of seven patients who completed the HOOS, JR (hip disability and osteoarthritis outcome score, joint replacement) survey, five patients showed improvement. Conclusion: Excellent outcomes can be achieved using the dome technique for management of massive anterosuperior medial acetabular defects in revision THA with survivorship of 91% at a mean follow-up period of three years. Conduct of future studies will be required in order to evaluate mid- to long-term outcomes for this technique.