• Title/Summary/Keyword: Knee replacement

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Influence of Malalignment on Tibial Post in Total Knee Replacement Using Posterior Stabilized Implant (슬관절 전치환술에서 후방 안정 임플란트의 오정렬이 경골 기둥에 미치는 영향)

  • Kim, Sang-Hoon;Ahn, Ok-Kyun;Bae, Dae-Kyung;Kim, Yoon-Hyuk;Kim, Kyung-Soo;Lee, Soon-Gul
    • Journal of Biomedical Engineering Research
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    • v.28 no.1
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    • pp.108-116
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    • 2007
  • Recently, it has been reported that the posterior stabilized implant, which is clinically used for the total knee replacement (TKR), may have failure risk such as wear or fracture by the contact pressure and stress on the tibial post. The purpose of this study is to investigate the influence of the mal alignment of the posterior stabilized implant on the tibial post by estimating the distributions of contact pressure and von-Mises stress on a tibial post and to analyze the failure risk of the tibial post. Finite element models of a knee joint and an implant were developed from 1mm slices of CT images and 3D CAD software, respectively. The contact pressure and the von-Mises stress applying on the implant were analyzed by the finite element analysis in the neutral alignment as well as the 8 malalignment cases (3 and 5 degrees of valgus and varus angulations, and 2 and 4 degrees of anterior and posterior tilts). Loading condition at the 40% of one whole gait cycle such as 2000N of compressive load, 25N of anterior-posterior load, and 6.5Nm of torque was applied to the TKR models. Both the maximum contact pressure and the maximum von-Mises stress were concentrated on the anterior-medial region of the tibial post regardless of the malalignment, and their magnitudes increased as the degree of the malalignment increased. From present result, it is shown that the malalignment of the implant can influence on the failure risk of the tibial post.

Isokinetic Effect of the Extensors and Flexors in Total Knee Replacement Patients (슬관절전치환술 환자의 슬관절 신전근 및 굴곡근에 대한 등속성운동 효과)

  • Bae, Sung-Soo;Nam, Kun-Woo;Lee, Keun-Heui
    • The Journal of Korean Physical Therapy
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    • v.13 no.1
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    • pp.19-31
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    • 2001
  • The twenty one individuals with total knee replacement who were admitted to Kang-Dong Hospital for comprehensive physical therapy were studied in order to demonstrate the effectiveness of an isokinetic test program using the Cybex 6000 machine. The subjects were divided into three groups with the isometric exercise group receiving isometric exercise. the isokinetic eccentric exercise group, and isokinetic eccentric exorcise group receiving isokinetic exercise(eccentric. concentric) to knee flexors and extensors muscles for a six weeks period using the Cybex 6000. The results were follow :1 . The peak torque was increased significantly in the flexors and extensors of the isokinetic conccentric exorcise among three groups(p<.05). 2. The progress of peak torque was increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups(p<.05). 3. The total work was more increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups(p<.05). 4. The progress of total work was more increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups(p<;.05). 5. The ratio of endurance was not increased significantly in all three groups. 6. The extensors in the peak torque was likely to recover rapidly than the flexors. 7.The average R.O.M in the pre-exercise and post-exercise was not different significantly in all three groups. According to the above results, In the muscle strength recovery for total knee replacement patients, isokinetic concentric exercise group was significantly greater than the isokinetic eccentric and isometric exercise groups after a six weeks training.

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Quality of life of persons after total knee replacement surgery

  • Leem, Soo-Hyun;Lee, Byounghee;Chung, EunJung;Lee, Jiyeon;Kim, Jung-Hee
    • Physical Therapy Rehabilitation Science
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    • v.8 no.3
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    • pp.170-174
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    • 2019
  • Objective: The objective of this study was to investigate the differences in the quality of life between two groups of patients who received or did not receive total knee replacement (TKR) surgery after being diagnosed with knee osteoarthritis (OA), and to investigate changes in the quality of life for persons who had TKR surgery. Design: Cross-sectional study. Methods: The subjects were randomized into a surgery group (n=70) and a non-surgery group (n=65). Subjects were selected from individuals diagnosed with knee OA from Himchan Hospital in Seoul, South Korea. Their sex, age, weight, height, body mass index, unilateral or bilateral, and quality of life were evaluated. Changes in the quality of life was measured using the Short Form-36 Health Survey (SF-36). Seventy out of 135 patients had TKR surgery, and their quality of life was evaluated at 6 months and 12 months after the surgery. Results: SF-36 scores were significantly improved at 6 months and 12 months after the surgery compared to the scores before the surgery (p<0.05). Also, the comparison between 6 and 12 months after surgery showed that the Vitality and Social Function scores in the SF-36 were significantly increased (p<0.05). Conclusions: The findings of this study showed that TKR surgery has a positive effect on the quality of life for persons with knee OA as a therapeutic intervention.

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.

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.

A Comparative Study of Use of Cephalosporins in Total Knee Replacement Surgery in Terms of Economic Efficiency (슬관절치환술 환자의 Cephalosporin계 항생제 사용에 대한 경제효율성 비교연구)

  • Cho, Dong-Sun;Song, Hyun-Ju;Park, Sung-Uk;Sohn, Uy-Dong
    • YAKHAK HOEJI
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    • v.52 no.2
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    • pp.101-110
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    • 2008
  • Total Knee Replacement (TKR) surgery is one of the invasive procedures for patients with late-stage knee joint disorders. In the present study, economic efficiency was compared between uses of the 2nd and 3rd generation cephalosporins for the prophylaxis before and after the surgery using frequency analysis in terms of various factors such as medication costs, the number of days of antibiotic use and hospitalization due to TKR surgery. The results showed that the 3rd generation cephalosporins did not reduce the infection rate and total medication costs, but rather raised antibiotic cost in comparison with the 2nd ones. A frequent use of the 3rd ones is closely related to emergence of resistant bacterial strains. Therefore, we suggest that unnecessary prescriptions for the broad spectrum antibiotics should be avoided.

Evaluation of O-MAR XD Technique for Reduction of Magnetic Susceptibility Artifact of Knee Implant (인공 무릎관절에서 자화율 인공물의 감소를 위한 O-MAR XD 기법의 평가)

  • Lee, Jung-Hoon
    • Journal of radiological science and technology
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    • v.41 no.5
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    • pp.413-419
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    • 2018
  • Magnetic Resonance Imaging for patients with metallic implant has poor image quality, and signal loss and artifacts including distortion can occur. The purpose of this study is to carry out a comparative evaluation on high receive bandwidth(hiBW), O-MAR, O-MAR XD to reduce artifacts in knee implant. To take MRI, 3.0T scanner and dual-source radiofrequency transmission were used. O-MAR XD technique's strong option showed a significant difference (p<0.001) with O-MAR XD technique's weak option, O-MAR and hiBW excluding the medium option. O-MAR XD's medium option had a significant difference (p<0.01) with O-MAR XD's weak, O-MAR and hiBW. O-MAR XD technique's weak option had a significant difference (p<0.01) with O-MAR XD's strong and medium options, O-MAR and hiBW. O-MAR technique had a significant difference (p<0.001) with strong, medium, weak options of O-MAR XD technique except for hiBW. HiBW had a significant difference (p<0.001) with strong, medium and weak options of O-MAR XD technique except for O-MAR. The results showed that O-MAR XD technique was more useful for MRI scan for patients with knee replacement surgery than traditional techniques such as hiBW or O-MAR, and susceptibility artifacts decreased more when O-MAR XD technique's strong or medium option was applied. Based on the results above, it is considered that it will be possible to acquire images whose susceptibility artifacts were highly decreased by using O-MAR XD technique's strong or medium option when conducting MRI for artificial knee joint and it will be helpful for checking and monitoring patients with knee joint replacement.

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.

Availability Assessment about Implementing Lower Extremity Venography after Cementless of Total Knee Replacement (인공관절 수술 후의 하지정맥조영술 시행에 관한 유용성 평가)

  • Hong Jung Pyo;Han Sang Sub;Lee Pyeong Jae;Oh Jae seon;Kwon Young Ho
    • Journal of The Korean Radiological Technologist Association
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    • v.30 no.1
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    • pp.124-130
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    • 2004
  • To evaluate about usefulness of lower extremity venography to diagnose and prevent in assessment about human work cementless of total knee replacement after surgical operation patient's deep vein thrombosis something wrong of other vein with swelling, ana

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