• Title/Summary/Keyword: Knee surgery

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Localized Giant Cell Tumor in Knee Joint - 1 Case Report- (슬관절내에 발생한 국소형 거대 세포종 - 1예 보고 -)

  • Cho, Jin-Ho;Wang, Kook-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.190-194
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    • 2007
  • Giant cell tumor is slow-growing, unilateral and solitary lesion that is most commonly seen in the digit of the hand, but occasionally occurs in the hips, ankles, toes and wrists and rarely in knee. We experienced 1 case of giant cell tumor in knee joint. That was excised arthroscopically and pathologically confirmed. So we report this case with a review of the literatures.

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A Comparison of Knee and Ankle Coronal Plane Alignment According to Quadriceps Exercise Method in Early Phase of Total Knee Arthroplasty: Lower Extremity Isometric Co-Contraction and Quadriceps Isolated Isometric Contraction (슬관절 전치환술 초기의 대퇴사두근 운동 방법에 따른 슬관절과 족관절의 관상면 정렬 비교: 하지 등척성 동시수축과 대퇴사두근 단독 등척성 수축)

  • Kim, Hyung-soo;Jeong, Young-hee
    • Physical Therapy Korea
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    • v.23 no.1
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    • pp.20-30
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    • 2016
  • Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC ($n_1$=19) or the QIIC ($n_2$=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.

The Effect of Preoperative Education about Patient Controlled Analgesia on Postoperative Pain Control of Elderly Receiving Total Knee Arthroplasty (수술 전 통증자가조절기 교육이 슬관절치환술 노인의 수술 후 통증에 미치는 효과)

  • Lee, Ji Heun;Kim, Hwa Soon;Lee, Young Whee;Kim, Soo Hyun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.28-39
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    • 2014
  • Purpose: The purpose of this study was to investigate the effect of preoperative education about patient controlled analgesia (PCA) on postoperative pain control for elderly after total knee arthroplasty. Methods: The study applied a quasi-experimental design. To prevent communication between experimental group and control groups, data from control group were collected before provision of preoperative education for the experimental group. A total of 50 elderly patients who underwent total knee arthroplasty and older than 65 years old participated in this study. The preoperative education about PCA was provided for the experimental group before surgery. The preoperative education program consisted of fifteen minute education about pain control, and PCA use, as well as demonstration of PCA use. Results: The experimental group had higher knowledge score about pain and PCA use, and more positive attitudes toward pain and use of analgesics after surgery than the control group. There was no significant difference in use of additional analgesics after surgery between the two groups. The experimental group had significantly lower pain score at 8, 24 and 36 hours after surgery than the control group. The experimental group had higher level of satisfaction about PCA use than the control group. Conclusion: The preoperative education about PCA, customized for elderly patients could be an effective nursing intervention for postoperative pain control after total knee arthroplasty.

Neuromuscular electrical stimulation improves strength, pain and weight distribution on patients with knee instability post surgery

  • Asakawa, Yasuyoshi;Jung, Ji-Hye;Koh, Si-Eun
    • Physical Therapy Rehabilitation Science
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    • v.3 no.2
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    • pp.112-118
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    • 2014
  • Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

Huge Insertional Bone Cyst at the Femoral Attachment of the Posterior Cruciate Ligament in the Knee (슬관절 후방십자인대 대퇴 부착부 거대 삽입성 골낭종)

  • Min, Kyoung-Dae;Kim, Kyoung-Bum;Cho, Whi-Je
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.445-449
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    • 2021
  • Insertional bone cysts of the knee joint mainly appear in the form of small cysts at the bone attachment of the cruciate ligaments, and are usually not associated with symptoms. The authors report a 31-year-old man diagnosed with a huge insertional bone cyst connected to the femoral attachment of the posterior cruciate ligament in the knee joint, who obtained good results after curettage and bone cement filling.

Anterior Cruciate Ligament Reconsruction Using Tibialis Tendon Allograft - A Short-Term Follow-Up Result - (동종 경골건을 이용한 전방 십자 인대 재건술 -단기 추시 결과-)

  • Woo, Jong-Ken;Ko, Sang-Hun;Lew, Sog-u;Park, Moon-Soo;Jung, Kwang-Hwan;Gwak, Chang-Youl;Lee, Chae-Chil;Cho, Sung-Do
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.89-93
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    • 2004
  • Purpose: To evaluate the clinical stability and function after arthroscopic anterior cruciate ligament(ACL) reconstruction using fresh-frozen tibialis tendon allograft. Materials and Methods: Of the patients who underwent ACL reconstruction using tibialis tendon allograft from July 2002 to June 2003, thirty-one patients could be evaluated and the mean follow-up period was 19 months. Evaluations included were Lysholm knee score, 2000 International knee Documentation Committee (IKDC) subjective knee score, Lachman test, pivot shift test, KT-1000 arthrometer measurement and 2000 IKDC knee examination. Results: The mean Lysholm score was 88. Twenty-eight patients (90.3%) were good or exellent for the measured parameters. Twenty-seven patients(87.1%) was over 70 in IKDC subjective knee score. Thirty patients (96.8%) had 1+ firm end or negative Lachman test. 27 patients (87.1%) had a negative pivot shift. Thirty patients (96.8%) had less than 5mm difference of maximal manual difference by KT-1000 arthrometer. Twenty -nine patients (93.5%) were nearly normal or normal grade by 2000 IKDC knee examination. Complications were 1 case of failure and 1 case of infection. Conclusion: ACL reconstruction with the double-stranded fresh-frozen tibialis tendon allograft resulted in a reliable and predictable outcome after short-term follow-up.

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Usefulness of Ultrasound for the Loose Body in Knee (슬관절내 유리체에 대한 초음파 검사의 유용성)

  • Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Jin, Sung-Ki;Choi, Seung-Kyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.8-14
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    • 2010
  • Purpose: We wished to evaluate the clinical usefulness of ultrasound, when loose body is palpated and is shown radiographically in knee. Material and Methods: Twenty-five knees of twenty-two patients with loose body in knee radiographically from March, 2007 to July, 2009 were involved in this study, there were 8 males and 14 females, there were 11 right knees, 8 left knees and 3 both knees, the average age was 56.3 years (range, 32~76 years). The location of loose bodies were 13 cases at suprapatella pouch, 1 case at infrapatella anterior compartment and 11 cases at posterior compartment. In loose bodies of suprapatella pouch, we examined the mobility of loose bodies longitudinally with ultrasound placed at superior patella pole while flexing and extending the knee. In loose bodies of infrapatella anterior and posterior compartment, we examined the mobility of loose bodies longitudinally and transversely with ultrasound while flexing and extending the knee. Results: All cases of suprapatella pouch and infrapatella anterior compartment were diagnosed to movable loose bodies and were removed surgically, all cases of posterior compartment were diagnosed to immovable loose bodies and were not removed. Conclusion: When we determined the surgical removal according to mobility of loose body in knee, ultrasound may be helpful clinically.

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Computer-Assisted Navigation in Total Knee Arthroplasty (내비게이션 장치를 이용한 슬관절 전치환술)

  • Jeong, Hwa-Jae;Park, Yong-Beom;Lee, Han-Jun
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.478-489
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    • 2018
  • Total knee arthroplasty has become a standard procedure for advanced knee arthritis to relieve pain and improve function. Computer-assisted navigation systems have been used in total knee arthroplasty to improve the mechanical axis of the limb as well as the alignment and position of the components. A computer-assisted navigation system has the advantage of real-time feedback during surgery, such as mediolateral balance in extension and flexion gap, alignment of the lower limb, and components. On the other hand, the computer-assisted navigation system requires an additional stab wound for tracker fixation, which can increase the likelihood of superficial wound infection and stress fractures and increase the operation time and cost of surgery. The clinical efficacy of computer-assisted navigation in total knee arthroplasty is also controversial. Compared to the conventional technique, computer navigation improves the accuracy of the postoperative mechanical axis within outliers of $3^{\circ}$ varus or $3^{\circ}$ valgus. This paper reviews the surgical technique, pitfalls, clinical and radiological outcomes, useful clinical cases, and future perspectives in computer-assisted navigation total knee arthroplasty.

A Literature Study about Clinical Outcome Parameters for Total Knee Replacement to Develop Core Outcome Set for Osteoarthritis by Korean Medicine Treatment (슬관절 전치환술 후 한의 핵심 결과 지표를 개발하기 위한 임상 평가지표에 대한 문헌 연구)

  • Jeon, Chaeheun;Kim, Hyejin;Lee, Jungmin;Kwon, Miri;Jang, Seungwon;Kim, Hyunho;Kong, Byunghee;Leem, Jungtae
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.51-60
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    • 2019
  • Objectives Osteoarthritis is hard to manage with both conventional and Korean medicine treatment. The core outcome set (COS) to demonstrate the effectiveness of Korean medicine treatment has not been established yet. We aimed to present preliminary data of COS by performing a literature review on the evaluation indices used in existing clinical research. Methods We examined the literature from 2000 to 2017 in two Korean electronic databases (Korea citation index and oriental medicine advanced searching integrated system) by searching for the following 3 terms 'total knee replacement (Korean)', 'total knee replacement,' and 'knee surgery.' We found 333 articles; among them, 50 duplicates were removed. Finally, we selected 160 articles after complete screening. We then extracted measured indices and clinical outcomes from the selected articles and categorized the relevant criteria. Results According to this study, the hospital for special surgery and knee society, range of movement angle, cross leg, Berg balance scale and balance ability, muscle strength, 6 minutes walking test, visual analogue scale, self-efficacy, the 12-item and 36-item short form survey and self-rated health status are the most commonly used outcomes of knee. Conclusions This study found that the several categories after total knee replacement (TKR) are being evaluated in the literature, and we were able to verify the most frequently used evaluation indices in these categories. The results of this study will be used to establish evaluation indices for the treatment of TKR in the future using Korean medicine.