• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2003년도 춘계학술대회 논문집
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• pp.1310-1315
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• 2003

Severe osteoarthrosis of the knee joint often requires total knee arthroplasty (TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily true in the clinical cases. In this study the motions of the intact joint and the joint after TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension while it showed only rotation for other flexion angles. Physiologic external rotation of the tibia near full extension was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motions as well as different contact forces.

• 한국간호교육학회지
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• 제22권3호
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• pp.316-325
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• 2016

Purpose: This study was conducted to identify the effects of early exercise education using videos on exercise knowledge and compliance of elderly patients who undergo total knee replacement surgery. Methods: This is a quasi-experimental study with a nonequivalent control group non-synchronized design. The participants were 70 elderly patients who had total knee arthroplasty in the C university hospital located in G city, Korea. Thirty-five patients were assigned to an experimental group and the other patients were assigned to a control group. After the total knee arthroplasty, the early exercise education accompanied by watching video instruction was conducted on the experimental group at post-operation second and third day for 15 minutes. General exercise education was administered to the control group. The exercise knowledge and compliance of the elderly patients were measured through structured questionnaires. Conclusion: The results of this study indicate that early exercise education using videos has positive effects to improve the exercise knowledge and compliance of elderly patients after total knee arthroplasty. This early exercise education can be used going forward as nursing intervention for elderly patients who undergo total knee replacement surgery.

• Physical Therapy Rehabilitation Science
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• 제4권2호
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• pp.79-86
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• 2015

Objective: This study was carried out to compare changes in pain, swelling and range of motion (ROM) between the two groups according to physical therapy intervention. Design: Randomized controlled trial. Methods: There were a total of 20 elderly subjects ages 65-75 years old who have been admitted to the hospital for a total knee arthroplasty. After surgery, the experimental group (n=10) carried out quadriceps femoris muscle strengthening exercise, hamstring stretching exercises and gastrocnemius stretching exercise with a physical therapist for 30 minutes and additionally, received ice pack therapy for 20 minutes once a day. The control group (n=10) carried out continuous passive motion for 30 minutes and received ice pack therapy for 20 minutes once a day. The experimental group and control group carried out each intervention program for 2 weeks 3 times a week. The Visual Analogue Scale was used to assess pain, tape measurements were taken to assess swelling, and a steel goniometer was used to assess knee joint ROM. Results: As a result, the experimental group showed a statistically significant decrease in the pain and swelling, and a significant increase in knee flexion ROM after the intervention, compared to the control group (p<0.05). There was a significant improvement in pain, edema, and knee flexion and extension ROM in all subjects after intervention (p<0.05). Conclusions: According the results of this study, exercise in the experimental group is effect on the pain, swelling and ROM for total knee arthroplasty.

• 대한족부족관절학회지
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• 제11권2호
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• pp.135-140
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• 2007

Purpose: To evaluate the incidence and describe radiologic pattern of ankle arthritis following change of mechanical loading axis by total knee arthroplasty. Materials and Methods: We reviewed radiographs of 419 cases, 243 patients underwent total knee arthroplasy from January 2002 to October 2006 retrospectively. We described radiologic parameters around the ankle joint and measured the amount of change of knee varus or valgus angle by comparing preoperative and postoperative anteroposterior standing lower extremities AP X-rays. We divided cases into two groups, one with radiologically arthritic change of the ankle joint and the other one without any radiologic change after surgery. We compared two groups in each parameters and analyzed statistically (SPSS v13.0). Results: Three hundred eighty one cases were divided into varus group and 38 cases in valgus group. 125 cases were divided into ankle arthritic change-positive subgroup among the varus group and 251 cases were in negative subgroup. The amount of varus angle correction by total knee arthroplasty showed significant difference between two subgroups. There was no significant difference in each parameters between subgroups within 38 valgus cases. Conclusion: Ankle arthritis can be aggravated after total knee arthroplasty because of the change of mechanical loading axis onto the ankle joint. Therefore it may be needed to evaluate symptoms and function of ankle joints before performing total knee arthroplasties especially in patients with huge varus deformities of knee joints.

• Archives of Plastic Surgery
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• 제32권1호
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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.

• 동서간호학연구지
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• 제16권2호
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• pp.164-171
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• 2010

Purpose: The aim of study was to investigate relationship between compliance and recovery of patients with osteoarthritis of the knee patients after knee arthroplasty. Methods: 193 patients living in Seoul were participated in this study. Data were collected using the Knee Society Clinical Rating System and Medical Outcomes Study Short Form 36(SF-36) and analyzed by ANCOVA, t-test, and repeated measure ANOVA. Results: There was a significant difference of physiological recovery based on the number of co-morbidity patients have. Physical recovery level was different according to age, religion, and the number of co-morbidity. Age and education level of patients were different in emotional recovery. The level of physiological and physical recovery were significantly different consistent with compliance. Compared to preoperative scores, physiological and physical scores showed significant improvement at six weeks, three months, and six months after surgery while emotional scores did not showed significant improvement. Conclusion: The results of this study suggest that nursing interventions to increase compliance are needed for better recovery of patients after knee arthroplasty.

• 대한관절경학회지
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• 제17권1호
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• pp.88-94
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• 2013

비교적 젊은 연령의 환자에서 슬관절 내측 구획의 퇴행성 관절염(Kellegrene-Laurence 제 3단계 및 Outerbridge 제 4단계)과 전방십자인대의 파열이 동반되어 전방 불안정성이 있는 3예에서 2예는 전방십자인대 재건술의 6개월 이후 단계적으로 인공 관절 부분 치환술을 시행하고 나머지 1예는 동시에 전방십자인대 재건술 및 부분 치환술을 시행하였으며 수술 전, 후의 International Knee Documentation Committee (IKDC), Lysholm 점수와 최종 추시 상 Hospital for special surgery (HSS)와 knee society score (KSS) 점수를 측정하였다. 저자들의 슬관절의 전방 불안정성과 동반된 내측 구획의 진행성 관절염에서 전방십자인대 재건술과 함께 동시에 또는 단계적으로 시행한 내측 구획 인공 관절 부분 치환술은 슬관절 불안정성과 진행성 관절염에 의한 통증을 동시에 또한 만족스럽게 해결할 수 있는 좋은 선택이라고 사료된다.

• 한방재활의학과학회지
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• 제31권4호
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• pp.35-47
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• 2021

Objectives This study was conducted to evaluate the therapeutic effect of herbal medicine after total knee arthroplasty. Methods Key words such as total knee arthroplasty and herbal medicine were searched in 10 databases (Ovid-Medline, Ovid-EMBASE, Ovid-AMED, Cochrane Library, China National Knowledge Infrastructure [CNKI], National Digital Science Library [NDSL], Koreanstudies Information Service System [KISS], Oriental medicine Advanced Searching Integrated System [OASIS], KoreaMed, KMBASE), and only suitable randomized controlled trials (RCTs) were selected. Results 8 RCTs were finally selected, and herbal medicine showed positive results for pain relief and functional recovery after total knee arthroplasty. However, the analyzed 8 RCTs showed a high overall risk of bias. Conclusions In the future, RCTs with a higher level of evidence on the effect of herbal medicine after total knee arthroplasty need to be continuously conducted.

• 대한관절경학회지
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• 제13권1호
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• pp.39-45
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• 2009

목적: 슬관절 치환술 후에 발생한 합병증의 치료를 위해 시행한 관절경술의 결과를 알아보고 그 효용성을 확인하고자 하였다. 대상 및 방법: 1992년 5월부터 2008년 6월까지 본원에서 슬관절 치환술을 시행받은 후 합병증으로 인하여 관절경적 치료를 받았던 25예를 연구 대상으로 하였다. 25예 중 슬관절 전치환술을 시행받았던 경우가 19예, 부분치환술을 시행받았던 예가 6예였다. 모든 환자에서 관절경을 시행하기 전에 합병증의 원인을 밝히기 위해서 이학적 검사와 방사선 검사를 시행하였으며, 감염이 의심되는 경우 관절액 천자 및 혈액학적 검사를 추가로 시행하였다. 결과: 관절경술 시행 시 진단으로는 전치환술을 시행한 예에서는 감염 11예, 관절의 유착 및 섬유화로 인한 운동 제한 6예, 연부 조직의 충돌 2예 등이 있었으며, 부분 치환술을 시행한 예에서는 반월상 연골 파열, 유동성 치환물의 아탈구, 혈관절증, 관절 내 시멘트 유리체, 연부 조직 충돌 및 슬관절 강직으로 인한 운동 제한이 각각 1예 씩 총 6예가 있었다. 감염이 있던 11예 중 9예에서 관절경술만으로 치료가 되었고, 관절 강직이 있던 7예는 평균 슬관절 운동 범위가 술 전 $65^{\circ}$에서 최종 추시 시 $105^{\circ}$로 향상 되었으며, 나머지 예에서도 관절경술로 성공적인 치료 결과를 보였다. 결론: 슬관절 치환술 후 발생한 합병증의 치료로 시행한 관절경술은 적절한 환자의 선택 시 안전하고 효과적인 방법임을 확인할 수 있었다.

• Knee surgery & related research
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• 제30권4호
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• pp.319-325
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• 2018

Purpose: Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA. Materials and Methods: We prospectively enrolled 67 patients undergoing primary TKA. Correlation coefficients were used to evaluate the associations of tourniquet time, a surrogate of surgical difficulty, with BMI, pre- and intraoperative anthropometric measurements, and radiographic knee alignment. Similarly, Knee Injury and Osteoarthritis Outcome Score (KOOS) was compared to BMI. Results: Tourniquet time was significantly associated with preoperative inferior knee circumference (p=0.025) and ankle circumference (p=0.003) as well as the intraoperative depth of incision at the quadriceps (p=0.014). BMI was not significantly associated with tourniquet time or any of the radiographic parameters or KOOS scores. Conclusions: Inferior knee circumference, ankle circumference, and depth of incision at the quadriceps (measures of peripheral obesity) are likely better predictors of surgical difficulty than BMI. Further study of alternative surgical indicators should investigate patients that may be deterred from TKA for high BMI, despite relatively low peripheral obesity.