• 대한간호
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• 제27권2호통권145호
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• pp.53-57
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• 1988

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.398-406
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• 2018

Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.

• Clinics in Shoulder and Elbow
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• 제27권2호
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• pp.196-202
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• 2024

Background: As the population is aging and indications are expanding, shoulder arthroplasty is becoming more frequent, especially bilateral staged replacement. However, surgeons are hesitant to use bilateral reverse prostheses due to potential limitations on activities of daily living. Methods: This meta-analysis was conducted to compare bilateral anatomic to bilateral reverse shoulder implants. PubMed, Cochrane, and Google Scholar (pages 1-20) were searched until April 2023. The clinical outcomes consisted of postoperative functional scores (American Shoulder and Elbow Surgeons [ASES], Single Assessment Numeric Evaluation [SANE], Physical Component Score [PCS], Mental Component Score, and Simple Shoulder Test), pain, and range of motion (external rotation and forward elevation). Three studies were included in this meta-analysis. Results: Bilateral anatomic implants had better postoperative functional outcomes and range of motion, but no significant difference was seen in postoperative pain when compared to the reverse prosthesis. Better ASES score, SANE score, and PCS as well as better external rotation and forward elevation were seen in the bilateral anatomic shoulder replacement group, but no significant difference in pain levels was seen between the two groups Conclusions: The results may be explained by the lower baseline seen in the reverse prosthesis group, which may be due to an older population and different indications. Nevertheless, more randomized controlled studies are needed to confirm these findings. Level of evidence: III.

• 대한족부족관절학회지
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• 제26권4호
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• pp.151-156
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• 2022

The proportion of patients with end-stage ankle arthritis is increasing. The leading surgical methods for treating patients with end-stage ankle arthritis are ankle arthrodesis and total ankle arthroplasty. Ankle arthrodesis is considered the standard treatment for end-stage ankle arthritis. Many studies have been conducted on the two procedures, but it is unclear which is superior, and total ankle arthroplasty cannot be said to be a clear indication. Therefore, this review compares the advantages and disadvantages of two representative surgical methods for treating end-stage ankle arthritis.

• 기본간호학회지
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• 제24권3호
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• pp.209-218
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• 2017

Purpose: The purpose of this research was to identify factors that influence health-related quality of life of patients who have had knee or hip arthroplasty. Factors included sleep disorders, pain, activities of daily living, and depression. Methods: The participants in this research were 97 patients within one year after receiving knee or hip arthroplasty surgery and who regularly visited a hospital outpatient department. Data were analyzed using descriptive statistics, t-test, ANOVA, and stepwise regression analysis with the SPSS program. Results: Sleep disorders, pain, activities of daily living, and depression had significant correlations with health related quality of life. Factors influencing health-related quality of life among arthroplasty patients were the length of time since surgery, sleep disorders, activities of daily living, and depression. These factors explained 58% of the participants' health-related quality of life. Conclusion: The results show that various factors can affect patients' health-related quality of life following joint replacement surgery. The findings indicate that sleep disorders and depression should receive continued attention after the arthroplasty. It is also necessary to develop appropriate nursing intervention programs to lower depression and increase patient participation in daily living activities.

• 한방재활의학과학회지
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• 제30권4호
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• pp.105-117
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• 2020

Objectives The objective of this study is to assess the effectiveness of electroacupuncture for patients with hip arthroplasty. Methods According to participants, intervention, comparison, outcome, study design, we searched for clinical studies that conducted electroacupuncture for patients with hip arthroplasty. Results Finally 11 randomized controlled trials were chosen for systemic review and meta-analysis. The frequently used evaluation tools were Incidence of postoperative cognitive dysfunction (POCD), heart rate, blood pressure. Almost studies showed electroacupuncture has effects for patients with hip arthroplasty. Through meta analysis, Electoacupuncture showed statistically significant effect of reducing the anesthetic dosage and incidence of postoperative psychonosema and adverse reactions in intra-operation period, reducing the incidence of POCD in peri-operation period, incidence of deep venous thrombosis in post-operation period. Conclusion 11 studies reported that electroacupuncture has significant effects on hip arthroplasty. But, many studies were assessed in a probable high risk of bias. And all studies published in one overseas country. So, it requires attention to comprehend this study. To make up for this limitaion, more well designed clinical research are needed.

• 임상간호연구
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• 제19권3호
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• pp.419-431
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• 2013

Purpose: This study was to evaluate the effect of supportive nursing care program for patients with total hip arthroplasty. Methods: Forty-two patients with total hip arthroplasty were enrolled in this study from September, 20, 2011 to January, 3, 2012. The participants were assigned to one of two groups: Twenty-six subjects in the experimental group were provided with supportive nursing care program which comprised of 6 nurse visits pre and post operation and 4 follow-up phone calls after discharge. Another 26 subjects received conventional nursing care program as a control group. Hip function, anxiety, and uncertainty were evaluated before the intervention, and 5 weeks after completion of the intervention. The analysis included descriptive statistics, Chi-square test, and t-test by SPSS 18.0. Results: Hip function was significantly increased in the experimental group (t=-3.31, p<.002). Anxiety and uncertainty group was significantly lower in the experimental group (t=7.12, p<.001 and t=4.66, p<.001). Conclusion: The results of this study indicate that the supportive care intervention for patients receiving total hip arthroplasty could be utilized as a nursing intervention to improve hip function and to reduce anxiety and uncertainty of patients receiving total hip arthroplasty.

• Clinics in Shoulder and Elbow
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• 제24권1호
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• pp.42-52
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• 2021

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

• Journal of Korean Biological Nursing Science
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• 제16권4호
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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.

• Journal of Yeungnam Medical Science
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• 제37권1호
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• pp.40-46
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• 2020

Background: Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint. Methods: The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain. Results: Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain. Conclusion: Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.