• 한방재활의학과학회지
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• 제30권4호
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• pp.219-231
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• 2020

The objective of this study is to propose a Korean medical rehabilitation protocol for total knee replacement (TKR) and to report its effectiveness. This study was conducted as a retrospective study which analyzes the medical records of 4 patients undergoing Korean medical rehabilitation with protocol and continuous passive motion exercise for more than two weeks after TKR. We evaluated the outcome checking physical examination findings of the knee joint, numeric rating scale (NRS), Lysholm knee score (LKS) and walking state. After the treatment, we observed that the function of knee joint, NRS, LKS, walking state of patients were improved. This study showed that Korean medical rehabilitation protocol has effect on knee joint recovery after TKR. The limitation of this study was the insufficient number of cases and short-term follow up. Further studies should be done steadily to report the effectiveness of a Korean Medical rehabilitation protocol for TKR.

• 대한물리치료과학회지
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• 제24권2호
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• pp.53-60
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• 2017

Purpose: This study aimed to investigate the effect of physiotherapy on the range of motion (ROM) of patients with hemophilic arthropathy after total knee replacement (TKR) during treadmill gait. Method: Nineteen patients (age range, 30-61 years) who received physiotherapy at the Korea Hemophilia Foundation (KHF) Clinic in Seoul between 2011 and 2013 after TKR were recruited. Protocol rehabilitation was performed (KHF Clinic, Department of Physiotherapy) with an average follow-up of 70 days (range, 6-141 days). Result: Physiotherapy after TKR improved the ROM parameters, including the post-operative average ROM. The post-operative and follow-up ROM also significantly increased. Conclusion: Patients with hemophilia require different physiotherapeutic techniques and need dedicated post-operative care in comparison with the general population.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2007년도 춘계학술대회 논문집
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• pp.207-208
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• 2007

• 보건행정학회지
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• 제30권1호
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• pp.62-71
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• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• 대한의용생체공학회:의공학회지
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• 제37권6호
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• pp.215-221
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• 2016

Conformity between the femoral component and tibial insert within the knee replacement may be measured in frontal or sagittal view, and shows differences in the curvature radius of the femoral component depending on the flexion angle, i.e., curvature radius has a complex effect on contact stress. Therefore, it is essential to confirm how the curvature radius effects contact stress, and provide an important variable to reduce contact stress. This study correlated contact stress with curvature radius measured in frontal and the sagittal views and confirmed the effect of curvature radius for assessment of the Newly Designed Unicompartment Knee Replacement (NDUKR). Finite element models were constructed for NDUKR and $Zimmer^{(R)}$ Unicompartment High Flex Knee Replacement system (ZUKR), incorporating the curvature radius as measured in either frontal or sagittal view. The femoral component had 1200N of compressive load applied approximately 1.65xbody weight. Contact stress was predicted at flexion angles $0^{\circ}C$, $30^{\circ}C$, $60^{\circ}C$, $90^{\circ}C$ and $120^{\circ}C$, for NDUKR: 42, 47.7, 47.7, 51.2, and 54.1 MPa, and ZUKR: 41.2, 49.5, 53.2, 54.3, and 57.4 MPa, respectively. Correlation analysis showed the influence of curvature radius measured from the sagittal view was larger than for frontal view.

• The Journal of Korean Physical Therapy
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• 제24권2호
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• pp.118-126
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• 2012

Purpose: The purpose of this study was to investigate pain relief and functional recovery after total knee replacement. Methods: The treatment was performed by dividing individuals into a control group ($n_1=5$), ultrasound treatment group ($n_2=5$), and micro-current treatment group ($n_3=5$). The control group applied the hot pack for 15 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes, and Continuous Passive Movement (CPM) for 40 minutes. The ultrasound therapy group applied the frequency of 1 MHz, intensity of 1.0 $W/cm^2$ for five minutes following the same treatment as the control group. The micro-current therapy group applied the intensity of 25 ${\mu}A$, and pulsation frequency 5 pps for 15 minutes following the same treatment as the control group. After treatment, Visual Analogue Scale (VAS), Korean Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), Berg Balance Scale (BBS), Range of Movement (ROM) and wound length was measured. Results: VAS showed significant effect in the control group and micro-current therapy group during the treatment period. According to the treatment of K-WOMACK, BBS, ROM, and Healing wounds showed main effects between groups. Conclusion: According to the results of this study, data showed improvement of pain relief, wound healing effects, and range of motion recovery. Thus, these selected treatments were effective after total knee replacement. In other words, electrical treatment continues to influence pain relief and functional recovery after total knee replacement.

• PNF and Movement
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• 제18권2호
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• pp.233-244
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• 2020

Purpose: The study investigated pain and falls as psychological factors in Total Knee Replacement patients and examined the relationship between these factors. Methods: Ninety-six total knee replacement patients aged 69.31±7.01 (male: 21, female: 75) participated in the study. Post-surgery pain was assessed on a visual analog scale, and fall risk scores were evaluated on fall fear and fall efficacy scales. Other psychological factors assessed included national anxiety and trail anxiety, fear prevention, Beck depression score, and psychological health measures. The data were analyzed using SPSS version 22.0. Results: A statistically significant correlation was found between pain before surgery and FES fall fear score before surgery (p < 0.05). A statistically significant correlation was found between pain after surgery and PWBS fall fear score after surgery (p < 0.05). A statistically significant correlation was found between state anxiety and PWBS, Trail anxiety (p < 0.05). A statistically significant correlation was also found between trail anxiety and BDI, PWBS (p < 0.05). State anxiety and fear avoidance before surgery were found to affect trail anxiety, and pain before surgery and fall fear score before surgery were found to affect FES. In addition, PWBS was found to affect BDI. Conclusion: The study confirms that increased pain in Total Knee Replacement patients can be a risk factor for falls. In addition, fall fears increase fear avoidance and cause psychological deterioration. This suggests that efforts should be made to reduce pain and to manage psychological factors.

• 대한간호학회지
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• 제50권4호
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• pp.554-570
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• 2020

Purpose: This study aimed to develop and test a structural equation model of health-related quality of life among older women following bilateral total knee replacement based on a literature review and Wilson and Cleary's model of health-related quality of life. Methods: One hundred ninety three women who were diagnosed with osteoarthritis, were older than 65 years, and were between 13 weeks and 12 months of having a bilateral total knee replacement were recruited from an outpatient clinic. Data were collected from July 2017 to April 2018 using a structured questionnaire and medical records. Data were analyzed using SPSS/WIN 22.0, AMOS 22.0, and Smart PLS 3.2.4. Results: The fitness of the hypothetical model was good, with coefficients of determination (R²) ranging between .28 and .75 and predictive relevance (Q²) between .26 and .73. The standardized root mean square residual of the model fit indices for the hypothetical model was .04; which explained 64.2% of physical and 62.5% of mental health-related quality of life. Self-efficacy, symptom status, functional status, and general health perceptions had a significant direct effect on physical health-related quality of life, while social support, symptom status, and general health perceptions had a significant direct effect on participants' mental-health-related quality of life. Conclusion: To improve the physical and mental quality of life of older women who receive bilateral knee replacement, nursing-based intervention strategies that reduce symptoms, improve functional status, and increase health perceptions, self-efficacy, and social support are needed. The most important factor is the symptom status.

• 한국컴퓨터정보학회논문지
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• 제26권5호
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• pp.119-126
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• 2021

본 연구는 무릎관절 전치환술 환자에게 시행된 운동 프로그램이 통증과 균형에 미치는 효과크기를 확인하고, 추후 이에 관한 운동 프로그램 개발에 대한 기초자료를 제공하고자 한다. 총 3개의 데이터베이스에서 문헌을 검색하여 본 연구에 적합한 연구 10편을 최종 선정하였다. R 프로그램을 이용하여 개별 연구의 효과크기를 확인한 결과, 전체 효과크기는 0.87로 큰 효과크기로 나타났다. 또한 통증에 관한 효과크기는 0.62로 중간 효과크기로 나타났고, 균형에 관한 효과크기는 1.00으로 큰 효과크기로 나타났다. 이처럼 각각의 운동 프로그램이 무릎관절 전치환술 환자의 통증을 감소시키고 균형 능력을 개선하는데 긍정적인 영향을 미친다.

• 대한정형도수물리치료학회지
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• 제27권2호
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• pp.69-76
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• 2021

Background: Degenerative arthritis accounts for a large portion of the elderly, causing a lot of inconvenience in daily life. Total knee replacement (TKR) are performed to relieve pain in the knee joint. The purpose of this study was to determine whether knee joint stabilization exercises are effective in improving balance and walking ability in degenerative arthritis patients who have undergone TKR. Methods: A total of 30 TKR patients participated in this study. They were assigned to two groups. The experimental group, the group that underwent knee stabilization exercises, joint mobilization and general physical therapy. On the other hand, and the controlled group, the group that underwent joint mobilization and general physical therapy. All exercises were conducted thrice a week, for four weeks. The main balance outcomes were evaluated using the posture balance training system, while walking ability was assessed using a wireless 3-axis accelerometer. Results: The experimental group had significantly higher scores in postural stability testing (PST), limits stability testing, and waling ability. The post-intervention evaluation, there were significant differences in all variables between the two groups. However, no significant difference was noted in the foam eyes closed test in PST. Conclusion: This study suggests that knee joint stabilization exercises effectively improve the balance and walking ability of TKR patients. Thus, it could be presented as useful in clinical practice.