• Title/Summary/Keyword: Osteoarthritis

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Home Healthcare Service Awareness Survey for Korean Medicine Doctors: a survey study

  • Hye In Jeong;Taegwang Nam;Minhui Hong;Kyeong Han Kim
    • Journal of Pharmacopuncture
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    • v.26 no.1
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    • pp.60-66
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    • 2023
  • Objectives: Discussions regarding "medical blind spots" in Korea's "aging society" are continuously rising. In addition, the demand for medical attention and care for the elderly and vulnerable populations continues to increase. Given this, the government is promoting the "home healthcare service" project. This study aims to lay the foundation for promoting this project by investigating the perception of clinical Korean Medicine (KM) doctors in the "community health care" project. Methods: With the cooperation of the Association of Korean Medicine, we sent a questionnaire to all KM doctors through e-mail. The survey included personal information, awareness, appropriate disease and intervention, proper visit location, and pros and cons. Results: A total of 602 responses were collected and analyzed. Approximately 20% of the doctors answered that they were well aware of the service, while 55% responded that they did not know about it. For a visit, a KM doctor selected the appropriate diseases in the order of stroke, dementia and Parkinson's disease, osteoarthritis, and chronic diseases. Among treatments, acupuncture, moxibustion, and herbal medicine exhibited similar results. The most common opinion was that KM doctors should schedule their visits once a week for 6-12 months, which was the most prolonged period among the given options. More than 80% (84.1%) of the doctors replied that care projects were highly essential, and about 63.8% expressed their willingness to participate in these projects. Conclusion: To provide appropriate home health care, we must raise awareness among Korean medicine doctors. In addition, the healthcare budget must be increased to provide the required support.

Mixed reality visualization in shoulder arthroplasty: is it better than traditional preoperative planning software?

  • Sejla Abdic;Nicholas J. Van Osch;Daniel G. Langohr;James A. Johnson;George S. Athwal
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.117-125
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    • 2023
  • Background: Preoperative traditional software planning (TSP) is a method used to assist surgeons with implant selection and glenoid guide-pin insertion in shoulder arthroplasty. Mixed reality (MR) is a new technology that uses digital holograms of the preoperative plan and guide-pin trajectory projected into the operative field. The purpose of this study was to compare TSP to MR in a simulated surgical environment involving insertion of guide-pins into models of severely deformed glenoids. Methods: Eight surgeons inserted guide-pins into eight randomized three-dimensional-printed severely eroded glenoid models in a simulated surgical environment using either TSP or MR. In total, 128 glenoid models were used and statistically compared. The outcomes compared between techniques included procedural time, difference in guide-pin start point, difference in version and inclination, and surgeon confidence via a confidence rating scale. Results: When comparing traditional preoperative software planning to MR visualization as techniques to assist surgeons in glenoid guide pin insertion, there were no statistically significant differences in terms of mean procedure time (P=0.634), glenoid start-point (TSP=2.2±0.2 mm, MR=2.1±0.1 mm; P=0.760), guide-pin orientation (P=0.586), or confidence rating score (P=0.850). Conclusions: The results demonstrate that there were no significant differences between traditional preoperative software planning and MR visualization for guide-pin placement into models of eroded glenoids. A perceived benefit of MR is the real-time intraoperative visibility of the surgical plan and the patient's anatomy; however, this did not translate into decreased procedural time or improved guide-pin position.

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 Effects of Neuromuscular Electrical Stimulation of the Quadriceps Femoris on the Balance in Patients with Total Knee Arthroplasty (넙다리네갈래근의 신경근전기자극치료가 무릎관절 전치환술 환자의 균형에 미치는 영향)

  • Hoon Jo;Sang-Cheol Im;Kyoung Kim
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.159-168
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    • 2023
  • Purpose : This study aimed to investigate how neuromuscular electrical stimulation (NMES) affects the balance ability of patients who have undergone total knee arthroplasty owing to osteoarthritis. Methods : Thirty patients who had undergone total knee arthroplasty were randomized to an experimental group (n=15) and a control group (n=15). The experimental group received conventional physical therapy for 50 minutes and NMES treatment for 30 minutes, whereas the control group received conventional physical therapy for 50 minutes and active range of motion (AROM) exercises for 30 minutes. Within-group and between-group changes in static and dynamic balance ability before and after the 4-week intervention were analyzed. Results : In the within-group comparison, sway velocity in the center of gravity and total distance were significantly improved in both the experimental and control groups (p<.05), with no significant differences between the groups (p>.05). In the within-group comparison, both the experimental and control groups showed significant improvement in the functional reach test and movement velosity (p<.05). In the between-group comparison, the experimental group showed a significantly better improvement than the control group in the functional reach test (p<.05), but there was no significant difference in the movement velosity test (p>.05). Conclusion : In this study, NMES improved the static and dynamic balance in patients who had undergone total knee arthroplasty. Compared with AROM exercises, there was a greater effect on dynamic balance partially; however, the overall effect was similar. Therefore, NMES may be one option among various interventions to improve the balance ability in patients who have undergone total knee arthroplasty. In particular, this method may be effective when it is difficult to apply balance training for patients with total knee arthroplasty in a clinical setting.

Diagnosis and Management of Suspected Case of Early Rheumatoid Arthritis in the Temporomandibular Joint: A Case Report

  • Tae-Seok Kim;Yeon-Hee Lee
    • Journal of Oral Medicine and Pain
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    • v.48 no.1
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    • pp.31-36
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    • 2023
  • This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

Overviews on the Clinical Use of Stem Cells in Orthopaedics (근골격계에서 줄기세포를 이용한 재생치료의 개관)

  • Im, Gun-Il
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.475-477
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    • 2019
  • Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and the relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. On the other hand, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system, few reliable clinical studies have been published. Stem cell therapy can be applied locally for bone, cartilage, and tendon regeneration. The candidate disease modalities in bone regeneration include large bone defects, nonunion of fractures, and osteonecrosis. Focal osteochondral defect and osteoarthritis are the current targets for cartilage regeneration. For tendon regeneration, bone-tendon junction problems, such as rotator cuff tears are hot topics in clinical research. To date, the literature supporting stem cell-based therapies comprises mostly case reports or case series.

RUNX1 Ameliorates Rheumatoid Arthritis Progression through Epigenetic Inhibition of LRRC15

  • Hao Ding;Xiaoliang Mei;Lintao Li;Peng Fang;Ting Guo;Jianning Zhao
    • Molecules and Cells
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    • v.46 no.4
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    • pp.231-244
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    • 2023
  • Leucine-rich repeat containing 15 (LRRC15) has been identified as a contributing factor for cartilage damage in osteoarthritis; however, its involvement in rheumatoid arthritis (RA) and the underlying mechanisms have not been well characterized. The purpose of this study was to explore the function of LRRC15 in RA-associated fibroblast-like synoviocytes (RA-FLS) and in mice with collagen-induced arthritis (CIA) and to dissect the epigenetic mechanisms involved. LRRC15 was overexpressed in the synovial tissues of patients with RA, and LRRC15 overexpression was associated with increased proliferative, migratory, invasive, and angiogenic capacities of RA-FLS and accelerated release of pro-inflammatory cytokines. LRRC15 knockdown significantly inhibited synovial proliferation and reduced bone invasion and destruction in CIA mice. Runt-related transcription factor 1 (RUNX1) transcriptionally represses LRRC15 by binding to core-binding factor subunit beta (CBF-β). Overexpression of RUNX1 significantly inhibited the invasive phenotype of RA-FLS and suppressed the expression of proinflammatory cytokines. Conversely, the effects of RUNX1 were significantly reversed after overexpression of LRRC15 or inhibition of RUNX1-CBF-β interactions. Therefore, we demonstrated that RUNX1-mediated transcriptional repression of LRRC15 inhibited the development of RA, which may have therapeutic effects for RA patients.

Diagnostic Usefulness of Digital Infrared Thermal Image in Carpal Tunnel Syndrome (수근관 증후군에서 적외선 체열 검사의 진단적 유용성)

  • Park, Jihyun;Lee, Jang Woo;Lee, Sang Eok;Kim, Byung Hee;Park, Dougho
    • Clinical Pain
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    • v.18 no.2
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    • pp.70-75
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    • 2019
  • Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.

Effects of Fermented Achyranthes japonica Nakai, Angelica gigas Nakai, and Eucommia ulmoides Oliver Extracts on Regulation of Apoptosis in Articular Chondrocytes (Primary Chondrocytes에서 발효우슬, 당귀, 두충 복합물의 세포사멸 조절 효과)

  • Dakyung Kim;Wonhee Jo;Minhee Lee;Hyun Cheol Jeong;Sung-Jin Lee;Seunghun Lee;Jeongmin Lee
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.7-14
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    • 2023
  • The effects of fermented Achyranthes japonica Nakai, Angelica gigas Nakai, and Eucommia ulmoides Oliver extracts (FAAE) on regulation of inflammation and apoptosis were investigated in primary cultured rat cartilage cells. To identify the protective effects of FAAE against H2O2, cell survival was measured by MTT assay. Smad3, Collagen type I, MMP3, and MMP13 were measured by real-timpe PCR and westernbot and the inflammatory (NF-κB pathway, COX-2, iNOS) factors were determined by western blot. The apoptosis related factors (JNK, c-Fos, c-Jun, caspase 3, Bax, and Bcl-2) were determined by western blot. FAAE significantly increased the follwing: H2O2 treated cell survival, mRNA and protein expression of Smad 3, collagen type I. In addition, FAAE significantly decreased the protein expression of inflammatory and apoptosis related factors. This study suggests that FAAE have a protection effect of chondrocytes through inhibition of inflammation and apoptosis. Thus, FAAE is a therapeutic potential food componet in osteoarthritis.

Exercise Using Isokinetic Strength Training Equipment and Physical Function Improvement

  • Hyon-Min Tae;Su-Yeong Eom;Byoung-Kwon Lee;Dae-Sung Park
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.8-17
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    • 2024
  • Objective: This study aims to explore the relationship between isokinetic strength training and the enhancement of physical function in older adults. It also evaluates the effectiveness of isokinetic strength training equipment. Method: This study randomly divided twenty healthy adults into two groups.The experimental group engaged in isokinetic strength training for 30 minutes, three times a week, over a four-week period. In contrast, the control group did not participate in any exercise regimen. We assessed several outcome measures including physical functions (sit-to-stand test, flexibility, Timed Up and Go test), grip strength, balance, thigh circumference, the Korean version of the Patient Health Questionnaire-9 (PHQ-9), and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Additionally, the experimental group's self-perceived improvement in lower limb condition was evaluated using the Global Rating of Change (GROC) scale. Results: The experimental group showed significant improvements compared to the control group in various aspects: reduced sit-to-stand test duration (7.00±2.05 seconds), increased flexibility (4.69±3.90 cm), improved grip strength (1.54±1.74 kg), increased thigh circumference (left: 1.29±1.19 cm, right: 1.19±1.27 cm), enhanced Timed Up and Go test performance (-1.47±0.86 seconds), better balance (eyes open stance: -8.08±4.03 cm, eyes closed stance: -0.27±0.13 cm/s), and a decrease in depression severity (-0.15±1.51 points). Furthermore, significant increases were observed in the experimental group's maximal isokinetic strength at 90°/s for both flexion (19.62±7.03 Nm) and extension (19.60±14.65 Nm) over the study period. Conclusion: The findings suggest that isokinetic strength training equipment can significantly enhance physical functions in seniors when incorporated into an exercise regimen.