• Title/Summary/Keyword: Joint Stiffness

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Mid-Term Results of Fixed Bearing Unicompartmental Knee Arthroplasty: Minimum 5-Year Follow-Up (고정형 슬관절 단일 구획 치환술의 중기 추시 결과: 최소 5년 추시)

  • Oh, Jeong Han;Joo, Il-Han;Kong, Dong-Yi;Choi, Choong-Hyeok
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.498-504
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    • 2018
  • Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

Effects of 12 weeks of home-based exercise program in patients with ankylosing spondylitis (강직성 척추염 환자에 대한 12주간의 가정기반 운동 프로그램의 효과)

  • Cho, Kyoung-Hwan;Jeon, Yunah
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.3
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    • pp.771-785
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    • 2021
  • This study was performed to provide detailed and comprehensive information on inflammation-related blood indicators, joint range of motion, pain scale, and psychological indicators by patient characteristics by performing a 12-week home-based exercise program for ankylosing spondylitis patients. For the purpose of this study, 10 patients with ankylosing spondylitis were selected by age (30s vs. 40s vs. 50s), gender (male vs. female), and duration (less than 5 years vs. 5 years or more). The home-based exercise program was a combination of aerobic exercise and Pilates-based resistance exercise, and was performed 4 times a week for 12 weeks at an intensity of 50-70% of maximal heart rate (MHR). As a result, after 12 weeks of home-based exercise intervention, the blood C-reactive protein (CRP) concentration of patients with ankylosing spondylitis decreased (-35.6%, p=.002), and the blood inflammation level was improved, and each joint (hip, lumbar, cervical) improved mobility (p<.05). In addition, the bath ankylosing spondylitis disease activity index (BASDAI) was decreased by -67% (p=.001) and the visual analogue scale (VAS) was decreased by -64.8% (p=.001), stiffness and pain has been alleviated. In particular, as the degree of depression decreased by -65.5% (p=.001) and the degree of anxiety by -55.2% (p=.003), 12 weeks of home-based exercise improved not only physical changes but also psychological factors. On the other hand, there was no difference in exercise effect according to age, gender, and disease duration in ankylosing spondylitis patients (p>.05). These results suggest that the 12-week home-based exercise applied in this study can be an effective exercise program that can be universally used for ankylosing spondylitis patients regardless of patient characteristics.

Compressive Behavior of Precast Concrete Column with Hollow Corresponding to Hollow Ratio (중공비율에 따른 중공 프리캐스트 철근콘크리트 기둥의 압축거동)

  • Lee, Seung-Jun;Seo, Soo-Yeon;Pei, Wenlong;Kim, Kang-Su
    • Journal of the Korea Concrete Institute
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    • v.26 no.4
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    • pp.441-448
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    • 2014
  • From several researches, recently, it was found that using hollowed precast concrete (HPC) column made more compact concrete casting in joint region possible than using normal solid PC (Precast concrete) column. Therefore, the rigidity of joints can be improved like those of monolithic reinforced concrete (RC). After filling the hollow with grout concrete, however, it is expected that the HPC column behaviors like composite structure since PC element and grout concrete have different materials as well as there is a contact surface between two elements. These may affect the structural behavior and strength of the composite column. A compressive strength test was performed for the HPC column with parameter of hollow ratio for the case with and without grout in the hollow and the result is presented in this paper. The hollow ratios in the test are 35, 50 and 59% of whole section of column. Concentrated axial force was applied to top of the specimens supported as pin connection for both ends. In addition, finite element (FE) analysis was performed to simulate the failure behavior of HPC column for axial compression. As a result, it was found that the hollow ratio did not affect the initial stiffness of HPC filled with grout regardless of the strength difference of HPC and grout. However the strength was increased inversely corresponding to the hollow ratio. The structural capacity of HPC without grout closely related to the hollow size. Especially, the local collapse governs the overall failure when the thickness of HPC is too thin. Based on these effect, a suitable equation was suggested for calculation of the compressive strength of HPC column with or without grout. FE analysis considering the contact surface between HPC and grout produced a good result matched to the test result.

The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture (상완골 근위부 분쇄 골절에서의 상완골 두 치환술의 단기 추시 결과)

  • Sung, Chang-Meen;Cho, Se-Hyun;Jung, Soon-Taek;Hwang, Sun-Chul;Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.92-98
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    • 2007
  • Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

Cyclic Behavior of Wall-Slab Joints with Lap Splices of Coldly Straightened Re-bars and with Mechanical Splices (굽힌 후 편 철근의 겹침 이음 및 기계적 이음을 갖는 벽-슬래브 접합부의 반복하중에 대한 거동)

  • Chun, Sung-Chul;Lee, Jin-Gon;Ha, Tae-Hun
    • Journal of the Korea Concrete Institute
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    • v.24 no.3
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    • pp.275-283
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    • 2012
  • Steel Plate for Rebar Connection was recently developed to splice rebars in delayed slab-wall joints in high-rise building, slurry wall-slab joints, temporary openings, etc. It consists of several couplers and a thin steel plate with shear key. Cyclic loading tests on slab-wall joints were conducted to verify structural behavior of the joints having Steel Plate for Rebar Connection. For comparison, joints with Rebend Connection and without splices were also tested. The joints with Steel Plate for Rebar Connection showed typical flexural behavior in the sequence of tension re-bar yielding, sufficient flexural deformation, crushing of compression concrete, and compression rebar buckling. However, the joints with Rebend Connection had more bond cracks in slabs faces and spalling in side cover-concrete, even though elastic behavior of the joints was similar to that of the joints with Steel Plate for Re-bar Connection. Consequently, the joints with Rebend Connection had less strengths and deformation capacities than the joints with Steel Plate for Re-bar Connection. In addition, stiffness of the joints with Rebend Connection degraded more rapidly than the other joints as cyclic loads were applied. This may be caused by low elastic modulus of re-straightened rebars and restraightening of kinked bar. For two types of diameters (13mm and 16mm) and two types of grades (SD300 and SD400) of rebars, the joints with Steel Plate for Rebar Connection had higher strength than nominal strength calculated from actual material properties. On the contrary, strengths of the joints with Rebend Connection decreased as bar diameter increased and as grade becames higher. Therefore, Rebend Connection should be used with caution in design and construction.

A Case Report of Novel Mutation in GNPTAB in Two Siblings with Mucolipidosis Type III Alpha/beta (GNPTAB 유전자에서 새로운 돌연변이가 확인된 뮤코지방증 III형 남매)

  • Kim, Min-Sun;Park, Esther;Song, Ari;Im, Minji;Park, Hyung-Doo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.3
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    • pp.99-106
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    • 2018
  • Mucolipidosis type III (pseudo-Hurler polydystrophy) is a mucolipids degrading disorder caused by a mutation in the GNPTAB gene and is inherited by autosomal recessive. It is diagnosed by examining highly concentrated mucolipids in blood and the diagnosis can be confirmed by genetic testing. Mucolipidosis type III is a rare and progressive metabolic disorder. Its initial signs and symptoms usually occur around 3 years of age. Clinical manifestations of the disease include slow growth, joint stiffness, arthralgia, skeletal abnormalities, heart valve abnormalities, recurrent respiratory infection, distinctive facial features, and mild intellectual disability. Here, we are presenting two siblings of mucolipidosis type III, a 4-year-old female and a 2 years and 7 months old male with features of delayed growth and coarse face. The diagnosis was confirmed by [c.2715+1G>A(p.Glu906Leufs*4), c.2544del(p.Glu849Lysfs*22)] mutation in targeted gene panel sequencing. In this case, c.2544del is a heterozygote newly identified mutation in mucolipidosis type III and was not found in the control group including the genome aggregation database. And it is interpreted as a pathogenic variant considering the association with phenotype. Here, we report a Korean mucolipidosis type III patients with novel mutations in GNPTAB gene who have been treated since early childhood. Owing to recent development of molecular genetic techniques, it was possible to make early diagnosis and treatment with pamidronate was initiated appropriately in case 1. In addition to these supportive therapies, efforts must be made to develop fundamental treatment for patients with early diagnosis of mucolipidosis.

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