• Title/Summary/Keyword: Replacement arthroplasty

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Biomechanics of Hip and Hip Replacement Arthroplasty (고관절 및 인공 고관절의 생역학)

  • Lee, Young-Kyun;Choi, Ji Hye;Won, Heejae;Koo, Kyung-Hoi
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.377-383
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    • 2019
  • The biomechanics study of the hip is aims to understand and explore the dynamic principles of weight transfer through the hip joint. This basic science knowledge can be applied in a variety of areas, including degenerative joint diseases and hip replacement arthroplasty. In particular, understanding of the biomechanics of the hip has led to the development of materials, design and fixation of implants, and it can be applied in various areas, such as the selection of surgical methods and the location of the implant. Moreover, it is essential to have good knowledge of the biomechanics of the hip to achieve better clinical results for patients. Therefore, this paper introduces the basic knowledge and biomechanical characteristics of a normal hip and hip replacement arthroplasty, which are needed to approach the biomechanics of the hip.

Recovery According to Follow-up Period and Compliance in Osteoarthritic Patients after Knee Replacement Arthroplasty (인공 슬관절 치환술 후 치료순응도와 경과기간에 따른 회복 양상)

  • Park, Su-A;Kang, Hyun-Sook;Choi, Jin-Yi
    • Journal of East-West Nursing Research
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    • v.16 no.2
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    • pp.164-171
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    • 2010
  • Purpose: The aim of study was to investigate relationship between compliance and recovery of patients with osteoarthritis of the knee patients after knee arthroplasty. Methods: 193 patients living in Seoul were participated in this study. Data were collected using the Knee Society Clinical Rating System and Medical Outcomes Study Short Form 36(SF-36) and analyzed by ANCOVA, t-test, and repeated measure ANOVA. Results: There was a significant difference of physiological recovery based on the number of co-morbidity patients have. Physical recovery level was different according to age, religion, and the number of co-morbidity. Age and education level of patients were different in emotional recovery. The level of physiological and physical recovery were significantly different consistent with compliance. Compared to preoperative scores, physiological and physical scores showed significant improvement at six weeks, three months, and six months after surgery while emotional scores did not showed significant improvement. Conclusion: The results of this study suggest that nursing interventions to increase compliance are needed for better recovery of patients after knee arthroplasty.

The Analysis of Hospital Characteristics affecting Blood Transfusion to the patients under Knee or Hip Total Replacement Arthroplasty (슬관절과 고관절 전치환술 환자의 수혈에 영향을 미치는 병원특성 요인 분석)

  • Oh, Ji-Young;Kim, Sang-Mi;Lee, Seong-A
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.4031-4039
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    • 2015
  • The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.

Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty

  • Jo, Young-Hoon;Lee, Seung Gun;Kook, Incheol;Lee, Bong Gun
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.152-155
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    • 2020
  • Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

Total Ankle Replacement Arthroplasty (족관절의 인공관절 치환술)

  • Sung, Il Hoon;Kim, Hyun Uk
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.1
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    • pp.1-6
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    • 2015
  • Total ankle replacement has been performed for treatment of end stage arthritis of the ankle, hopefully being an alternative to ankle arthrodesis. However, due to its high failure rates, earlier versions of ankle replacements were not regarded as successful procedures. The latest design has shown increasingly positive results. Total joint replacement of the ankle itself is still regarded as a demanding procedure and much more challenging than that of the hip and knee in many aspects. Several studies, however, have pointed out that it is becoming the viable, accepted alternative for arthrodesis with advanced implants, appropriate patient selection, and proper training experience of procedures. Compared with arthrodesis, it shows equal or better outcomes in pain relief, range of motion, and patient's satisfaction. We are attempting to review its biomechanical characteristics, implant design, indications, complications, clinical outcomes, and survival rate.

Spinopelvic Motion: A Simplified Approach to a Complex Subject

  • Cale A. Pagan;Theofilos Karasavvidis;Jonathan M. Vigdorchik;Charles A. DeCook
    • Hip & pelvis
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    • v.36 no.2
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    • pp.77-86
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    • 2024
  • Knowledge of the relationship between the hip and spine is essential in the effort to minimize instability and improve outcomes following total hip arthroplasty (THA). A detailed yet straightforward preoperative imaging workup can provide valuable information on pelvic positioning, which may be helpful for optimum placement of the acetabular cup. For a streamlined preoperative assessment of THA candidates, classification systems with a capacity for providing a more personalized approach to performance of THA have been introduced. Familiarity with these systems and their clinical application is important in the effort to optimize component placement and reduce the risk of instability. Looking ahead, the principles of the hip-spine relationship are being integrated using emerging innovative technologies, promising further streamlining of the evaluation process.

Debridement, antibiotics, and implant retention in infected shoulder arthroplasty caused by Serratia marcescens: a case report

  • Lim, Sungjoon;Lee, Jun-Bum;Shin, Myoung Yeol;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.154-157
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    • 2022
  • Periprosthetic joint infection (PJI) is one of the most devastating complications that can occur after shoulder arthroplasty. Although staged revision arthroplasty is the standard treatment in many cases, surgical intervention with debridement, antibiotics, and implant retention (DAIR) can be an effective option for acute PJI. We report a complex case of infected reverse shoulder arthroplasty (RSA) in a 73-year-old male. The patient had been previously treated for infected nonunion of a proximal humerus fracture caused by methicillin-resistant Staphylococcus epidermidis. He presented with a sinus tract 16 days after the implantation of RSA and was diagnosed with PJI caused by Serratia marcescens. The patient was successfully treated with DAIR and was free of infection at the last follow-up visit at 4 years postoperatively.

Incidence of Venous Thromboembolism after Primary Total Hip Arthroplasty with Mechanical Prophylaxis in Hong Kong Chinese

  • Daniel Wai-Yip Wong;Qunn-Jid Lee;Chi-Kin Lo;Kenneth Wing-Kin Law;Dawn Hei Wong
    • Hip & pelvis
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    • v.36 no.2
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    • pp.108-119
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    • 2024
  • Purpose: The incidence of deep vein thrombosis (DVT) following total hip arthroplasty (THA) without chemoprophylaxis could be as high as 50% in Caucasians. However, according to several subsequent studies, the incidence of venous thromboembolic events (VTE) in Asians was much lower. The routine use of chemoprophylaxis, which could potentially cause increased bleeding, infection, and wound complications, has been questioned in low-incidence populations. The objective of this study is to determine the incidence of VTE after primary THA without chemoprophylaxis in an Asian population using a fast-track rehabilitation protocol and to verify the safety profile for use of 'mechanical prophylaxis alone' in patients with standard risk of VTE. Materials and Methods: This is a retrospective cohort study of 542 Hong Kong Chinese patients who underwent primary THA without chemoprophylaxis. All patients received intermittent pneumatic compression and graduated compression stockings as mechanical prophylaxis. Multimodal pain management was applied in order to facilitate early mobilisation. Routine duplex ultrasonography was performed between the fourth and seventh postoperative day for detection of proximal DVT. Results: All patients were Chinese (mean age, 63.0±11.9 years). Six patients developed proximal DVT (incidence rate, 1.1%). None of the patients had symptomatic or fatal pulmonary embolism. Conclusion: The incidence of VTE after primary THA without chemical prophylaxis can be low in Asian populations when following a fast-track rehabilitation protocol. Mechanical prophylaxis alone can be regarded as a reasonably safe practice in terms of a balanced benefit-to-risk ratio for Asian patients with standard risk of VTE.

A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty

  • You, Di;Qin, Lu;Li, Kai;Li, Di;Zhao, Guoqing;Li, Longyun
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.271-287
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    • 2021
  • Background: Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. Methods: We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Conclusions: Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.