• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.06a
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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.

• The Journal of Korean Academic Society of Nursing Education
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• v.22 no.3
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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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• v.4 no.2
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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.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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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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• 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 East-West Nursing Research
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• v.16 no.2
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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.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.88-94
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• 2013

Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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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.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.39-45
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• 2009

Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

• Knee surgery & related research
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• v.30 no.4
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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.