• Title/Summary/Keyword: Knee Replacement Arthroplasty

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Simulation of Three Dimensional Motion of the Knee Joint in Total Knee Arthroplasty (인공 무릎 관절의 3차원 운동 시뮬레이션)

  • Moon, Byung-Young;Son, Kwon;Kim, Ki-Bum;Seo, Jung-Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.9
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    • pp.188-195
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    • 2004
  • 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 1.ue in the clinical cases. In this study the motion 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 and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement 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 motion as well as different contact forces.

Influence of Interferential Current Therapy and Laser Therapy on Functional Recovery after Total Knee Replacement

  • Oh, Seung-Keun;Kim, Yong-Nam
    • The Journal of Korean Physical Therapy
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    • v.26 no.3
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    • pp.175-181
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    • 2014
  • Purpose: The purpose of this study is to investigate the effects of interference current therapy and laser therapy on functional recovery after total knee arthroplasty by measuring the Berg balance scale and range of motion. Methods: Subjects were 30 patients who were admitted to G Hospital after total knee arthroplasty. They were randomly assigned to experimental group I in which interference current therapy was applied (n=10), experimental group II in which laser therapy was applied (n=10), or the control group (n=10). The Berg balance scale and range of motion of the subjects were measured before, after 2 weeks, and after 4 weeks of therapy. Results: There was a statistically significant change (p<0.05) in the Berg balance scale and range of motion before and after therapy intervention among the laser therapy group and the interference current therapy group. There was also a significant change between the groups in the Berg balance scale and range of motion. Tukey's post hoc comparison showed a statistically significant difference between the control group and experimental group I and between the control group and experimental group II (p<0.05). Conclusion: The application of interference current therapy and laser therapy resulted in a significant change in both the Berg balance scale and range of motion among patients with total knee arthroplasty. The findings of this study can be used as preliminary clinical data in evaluating functional recovery in patients with total knee arthroplasty in a post-clinic setting.

Factors Influencing Health-related Quality of Life among Knee or Hip Arthroplasty Patients (하지 인공관절 치환술 환자의 건강 관련 삶의 질 영향요인)

  • Kang, Mi Kyung;Kim, Geun Jin;Kim, Hye Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.3
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    • pp.209-218
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    • 2017
  • Purpose: The purpose of this research was to identify factors that influence health-related quality of life of patients who have had knee or hip arthroplasty. Factors included sleep disorders, pain, activities of daily living, and depression. Methods: The participants in this research were 97 patients within one year after receiving knee or hip arthroplasty surgery and who regularly visited a hospital outpatient department. Data were analyzed using descriptive statistics, t-test, ANOVA, and stepwise regression analysis with the SPSS program. Results: Sleep disorders, pain, activities of daily living, and depression had significant correlations with health related quality of life. Factors influencing health-related quality of life among arthroplasty patients were the length of time since surgery, sleep disorders, activities of daily living, and depression. These factors explained 58% of the participants' health-related quality of life. Conclusion: The results show that various factors can affect patients' health-related quality of life following joint replacement surgery. The findings indicate that sleep disorders and depression should receive continued attention after the arthroplasty. It is also necessary to develop appropriate nursing intervention programs to lower depression and increase patient participation in daily living activities.

Clinical and radiologic study of total knee replacement arthroplasty using Doujet GF bone cement (liquid-powder bone cement containing gentamicin) (Doujet GF 골 시멘트를 사용한 인공 슬관절치환술의 임상적, 방사선적 고찰)

  • Sungwook Choi;Seong-meen Yoon;Joseph Y. Rho;In-seok Son
    • Journal of Medicine and Life Science
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    • v.20 no.2
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    • pp.60-66
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    • 2023
  • Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.

The Analysis of Hospital Characteristics affecting Blood Transfusion to the patients under Knee or Hip Total Replacement Arthroplasty (슬관절과 고관절 전치환술 환자의 수혈에 영향을 미치는 병원특성 요인 분석)

  • Oh, Ji-Young;Kim, Sang-Mi;Lee, Seong-A
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.4031-4039
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    • 2015
  • The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.

The Effect of Pre-Operative Patient Controlled Analgesia Education on Elderly Patients with Total Knee Arthroplasty (슬관절 전치술 노인 환자의 수술 전 자가통증조절기 사용 교육이 수술 후 환자에게 미치는 효과)

  • Shim, Joohee;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.318-325
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    • 2014
  • Purpose: The purpose of this study was to investigate the effects of preoperative patient controlled analgesia (PCA) education on total knee replacement arthroplasty (TKRA) patients' PCA usage, level of pain, the frequency of pro re nata (prn) administrations, number of ambulations/day and continuous passive motion (CPM) angle after TKRA. Methods: This research used the non-equivalent control group pre-test and post-test design. Forty-five TKRA patients at a hospital in Seoul, Korea were included for in the study. For the experimental group, a 20-minute education session was provided a day before surgery. Data were analyzed using Windows SPSS Statistics 21.0 program. Results: Knowledge was higher in the experimental group than in the control group (p<.001). Incidence of nausea was lower in the experimental group (p=.01). No significant differences were found in post-operative pain scores, the frequency of prn analgesics administrations, dizziness, number of ambulations/day and CPM angle. Conclusion: This study showed that pre-operative PCA education could be an effective nursing intervention for increasing patient knowledge on PCA and nausea reduction after TKRA.

Effects of Herbal Medicine after Total Knee Arthroplasty: A Systematic Review and Meta-Analysis (슬관절 전치환술 후 한약 치료의 효과: 체계적 문헌고찰과 메타분석)

  • Lee, Sang-Jin;Ko, You-Me;Park, Jung-Sik;Park, Tae-Yong;Lee, Jung-Han;Cho, Jae-Heung;Hwang, Eui-Hyoung;Kim, Kyoung-Ja;Choi, Mi-Young;Song, Yun-Kyung
    • 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.

Preoperative Serum Albumin Levels Predict Treatment Cost in Total Hip and Knee Arthroplasty

  • Rudasill, Sarah E.;Ng, Andrew;Kamath, Atul F.
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.398-406
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    • 2018
  • Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.

Osteolytic Lesion of the Fibular Head after Cemented Total Knee Arthroplasty (슬관절 전치환술 후 비골 두에 발생한 골용해성 병변)

  • Lee, Chae-Chil;Park, Ki-Bong;Hwang, Il-Yeong;Yang, Doo-Guen
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.87-92
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    • 2021
  • The radiographic findings of an osteolytic lesion in the knee may indicate numerous possible impressions. Furthermore, osteolysis is a possible cause if there is a surgical history of total knee arthroplasty (TKA). The authors diagnosed osteolysis of the fibular head after aseptic loosening of the tibial component of a cemented TKA in an 83-year-old female patient who visited with right knee pain and report their treatment with revision TKA along with a literature review.

May-Thurner Syndrome with Deep Vein Trombosis after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 메이-터너 증후군 및 심부정맥 혈전증)

  • Lee, Hwa-Sung;Kim, Yong-Woo;Jung, Se-Hoon;Lee, Se-Won
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.343-347
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    • 2020
  • May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.