• Title/Summary/Keyword: Knee surgery

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A Study of Pain and Psychological Well-Being in Total Knee Replacement Patients (무릎 전치환술 환자의 통증과 심리적 안녕에 관한 연구)

  • Chae, Jung-Byung;Jung, Ju-Hyeon
    • PNF and Movement
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    • v.18 no.2
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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.

Short-Term Results of Hybrid Closed-Wedge High Tibial Osteotomy: A Case Series with a Minimum 3-Year Follow-up

  • Saito, Hidetomo;Saito, Kimio;Shimada, Yoichi;Yamamura, Toshiaki;Yamada, Shin;Sato, Takahiro;Nozaka, Koji;Kijima, Hiroaki;Miyakoshi, Naohisa
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.293-302
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    • 2018
  • Purpose: High tibial valgus osteotomy (HTO) is a well-established surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closed-wedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the short-term results in a consecutive series of patients treated with hybrid CWHTO. Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average follow-up of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The Kellgren-Lawrence grading system and pre- and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed. Results: The FTA and MA significantly changed from $180.7^{\circ}$ to $170.4^{\circ}$ and from $22.0^{\circ}$ to $60.2^{\circ}$, respectively. No significant differences were observed between the mean pre- and postoperative posterior tibial slope, Insall-Salvati ratio, or Caton-Deschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.

Irrigation Solutions in the Knee Arthroscopy - Comparison with Normal Saline and Lactated Ringer's Solution (슬관절 관절경 수술시 세척액 - 생리 식염수와 Lactated Ringer 용액의 비교)

  • Lee, Woo-Suk;Bae, In-Tak;Hur, Yun-Moo;Park, Won-Ki;Oh, Byung-Hak;Chung, Whan-Yong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.125-128
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    • 2008
  • Purpose: The object of this study is to compare the clinical results of noraml saline and Lactated Ringer's solution in the arthroscopic meniscus surgery on the knee. Materials and Methods: The study group included 64 patients who had an medial meniscus tear and received arthroscopic partial medial meniscectomy. The group I was normal saline group, which was used as an irrigation solution during operation. The group II was Lactated Ringer's solution group. We measured the visual analogue scale, painless active knee flexion angle, and the ratio of the knee swelling at postoperative one day for all patients. Results: The visual analogue scale and the painless active knee flexion angle were no significant differences in comparing with normal saline and Lactated Ringer's solution group. The ratio of the knee swelling in Lactated Ringer's solution group was significantly less than those of noraml saline group. Conclusion: Lactated Ringer's solution has an advantage of decreasing the knee swelling in the arthroscopic meniscus surgery on the knee.

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Gait Study on the Normal and ACL Deficient Patients after Ligament Reconstruction Surgery Using Chaos Analysis Method (카오스 해석법을 이용한 전방십자인대 재건수술 환자와 정상인의 보행연구)

  • Ko Jae Hun;Son Kwon;Park Jung Hong;Suh Jeung Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.23 no.2 s.179
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    • pp.164-171
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    • 2006
  • Anterior cruciate ligament(ACL) injury of the knee is common and a serious ACL injury leads to ligament reconstruction surgery. Gait analysis is used to identify the result of surgery. The purpose of this study is to numerically evaluate and classify knee condition of patients through the chaos analysis. Experiments were carried out for 13 subjects (8 healthy subjects, 5 ACL deficient patients) walking on a treadmill. Sagittal kinematic data of the right lower extremity were collected by using a 3D motion analysis system. The recorded gait patterns were digitized and then coordinated by KWON3D. The largest Lyapunov exponent from the measured knee angular displacement time series was calculated to quantify local stability. It was found that the Lyapunov exponent becomes larger as the knee condition becomes worse. This study suggested a method of the severity of injury and the level of recovery. The proposed method discerns difference between healthy subjects and patients.

Open Posterior Approach versus Arthroscopic Suture Fixation for Displaced Posterior Cruciate Ligament Avulsion Fractures: Systematic Review

  • Song, Jae-Gwang;Nha, Kyung-Wook;Lee, Se-Won
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.275-283
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    • 2018
  • Purpose: To compare the clinical outcomes between the open posterior approach and arthroscopic suture fixation for displaced posterior cruciate ligament (PCL) avulsion fractures. Methods: A literature search was performed on MEDLINE, EMBASE, and the Cochrane Library databases. The inclusion criteria were as follows: papers written in English on displaced PCL avulsion fractures, clinical trial(s) with clear description of surgical technique, adult subjects, a follow-up longer than 12 months and modified Coleman methodology score (CMS) more than 60 points. Results: Twelve studies were included with a mean CMS value of 72.4 (standard deviation, 7.6). Overall, 134 patients underwent the open posterior approach with a minimum 12-month follow-up, and 174 patients underwent arthroscopic suture fixation. At final follow-up, the range of Lysholm score was 85-100 for the open approach and 80-100 for the arthroscopic approach. Patients who were rated as normal or nearly normal in the International Knee Documentation Committee subjective knee assessment were 92%-100% for the open approach and 90%-100% for the arthroscopic approach. The range of side-to-side difference was 0-5 mm for both approaches. Conclusions: Both arthroscopic and open methods for the treatment of PCL tibial-side avulsion injuries resulted in comparably good clinical outcomes, radiological healing, and stable knees.

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.

The Septic Knee Arthritis Caused by Klebsiella pneumoniae in a Patient with Type 2 Diabetes Mellitus and Osteoarthritis of the Knee (제2형 당뇨 및 골관절염을 동반한 환자에서 발생한 Klebsiella pneumoniae균에 의한 화농성 관절염)

  • Ha, Joong-Won;Lee, Sanghyeon;Park, Sang-Hoon;Kim, Tae-Yup
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.67-71
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    • 2019
  • Klebsiella pneumoniae causes that liver abscess mostly, also spread to pneumonia, meningitis, urinary tract infections. Septic arthritis caused by K. pneumoniae is a quite rare and has not been reported in Korea. Therefore, the authors report a case of the septic arthritis in the knee joint caused by K. pneumoniae in a patient with type 2 diabetes mellitus and osteoarthritis of the knee that successfully treated by early detection and arthroscopic synovectomy.

Intracapsular Chondroma of the Knee - A case report - (슬관절에 생긴 연골종 - 증례보고 -)

  • Ji, Jong-Hoon;Kim, Young-Yul;Kim, Jin-Young;Shafi, Mohamed;Kim, Ji-Chang;Lee, Sang-Wook;Kim, Weon-Yoo
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.54-57
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    • 2004
  • Intracapsular chondromas of the knee have been reported rarely, so the authors report one case about its clinical and histologic findings. This is the case about 38-year-old man who feel painful swelling of the knee joint and the tenderness on the anterior aspect of knee. After arthroscopic excision, grossly there was a 2.5${\times}$l.5${\times}$1cm sized white colored firm mass which had central brownish lesion. Microscopically it was confirmed to chondroma which was consisted of hyaline cartilage and outer thinly synovial membrane.

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Reliability and Validity of the Femorotibial Mechanical Axis Angle in Primary Total Knee Arthroplasty: Navigation versus Weight Bearing or Supine Whole Leg Radiographs

  • Kim, Seong Hwan;Park, Yong-Beom;Song, Min-Ku;Lim, Jung-Won;Lee, Han-Jun
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.326-333
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    • 2018
  • Purpose: To evaluate the reliability and validity of the femorotibial mechanical axis angle from radiographs in the weight bearing (WB) and supine positions compared with navigation-measured values. Materials and Methods: Sixty-eight cases of navigation-assisted total knee arthroplasty (TKA) were included. The pre- and postoperative whole leg radiographs (WLRs) in WB and supine positions were compared with the initial and final navigation values. Results: The mean mechanical axis angle from the preoperative WBWLR and navigation were not statistically different (p=0.079) and were correlated strongly with each other (intraclass correlation [ICC], 0.818). However, on postoperative measurements, although the WBWLR and navigation values were not different (p=0.098), they were not correlated with each other (ICC, 0.093). The standard error of measurement was $1.8^{\circ}{\pm}3.6^{\circ}$ for the preoperative WBWLR and $2.5^{\circ}{\pm}4.8^{\circ}$ for the postoperative WBWLR. The validity that was determined by the Bland-Altman plot was not acceptable for both pre- and postoperative measurements. Conclusions: The preoperative WBWLR could provide accurate but not precise measurement value of the femorotibial mechanical axis angle for navigation-assisted TKA, and postoperative measurements in navigation were not comparable with radiographic measurements. The lack of agreement was found between the radiographic and navigation measurements of the coronal alignment regardless of pre- or postoperative evaluation although the accuracy was found acceptable. Level of Evidence : Level 4.

The Effect of Knee Flexion and Posterior Septal Release on the Location of Popliteal Artery (무릎 굴곡 및 후방 관절낭 절제술이 슬와 동맥의 위치에 주는 영향)

  • Seo, Seung-Suk;Seo, Jin-Hyuk;Kim, Chang-Wan;Kwon, Yong-Wook
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.69-74
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    • 2012
  • Purpose: By confirm the change of popliteal arterial position when extension or flexion of the knee and estimate the change of popliteal arterial position after posterior capsular release, we tried to know the position can minimize injury of popliteal artery during arthroscopic surgery and usefulness of posterior capsular release. Materials and Methods: Total of two middle-aged man and woman, fresh frozen cadavers as systemic, all four cases of the knee were included in this study. After the knee was flexed to 0 degrees, 30 degrees, 60 degrees, 90 degrees angle, we estimated distance from posterior tibial cortex to popliteal artery at articular surface, the distal 1 cm and 2 cm from articular surface. We performed posterior capsular release by arthroscopy, and estimated distance between posterior tibial cortex and popliteal artery in the same way. Results: Mean distance between popliteal artery and posterior tibial cortex was 6.3 mm (4.5~7), 4.6 mm (3.6~6), 4.9 mm (3.9~5.8) when knee flexion to 0 degrees at articular surface, distal 1 cm and 2 cm from articular surface each. When knee flexion to 30 degrees, it was 7.4 mm (5.2~9), 4.9 mm (3.6~7.2), 5.3 mm (3.8~6.6). When knee flexion to 60 degrees, it was 8.7 mm (5.4~11), 5.2 mm (4.9~7.3), 6.2 mm (5.4~9.6). When knee flexion to 90 degrees, it was 9.8 mm (5.8~12.1), 5.5 mm (5.1~7.4), 6.5 mm (5.4~10.7). After posterior capsule release, the distance was 6.5 mm (5.5~7.5), 5.8 mm (3.9~7.2), 5.2 mm (3.8~7.0) when knee flexion to 0 degrees, 7.7 mm (5.5~9,1), 7.1 mm (4.6~7.6), 5.5 mm (4.1~6.9) when knee flexion to 30 degrees, 8.9 mm (5.7~11.2), 8.5 mm (5.5~9.2), 6.4 mm (5.3~10.1) when knee flexion to 60 degrees and 10.2 mm (6.3~13.6), 9.5 mm (6.5~11), 6.6 mm (5.9~9.8) when knee flexion to 90 degrees. Conclusion: As knee joint is flexed, the distance from posterial tibial cortex to popliteal artery are increased beween knee joint articular surface and distal 2 cm from knee joint. So popliteal artery injury will be reduced at knee joint surgery. Posterior capsular release could also reduce popliteal artery injury by increasing distance between posterior tibial cortex and popliteal artery.

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