• Journal of Medicine and Life Science
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• 제20권1호
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• pp.32-37
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• 2023

The demand for total knee arthroplasty (TKA) is rapidly increasing worldwide. The most common indication for TKA is osteoarthritis (OA); however, some patients with rheumatoid arthritis (RA) also undergo TKA. This study aimed to investigate the effects of RA on TKA. Our findings revealed that patients with RA underwent TKA at a younger age than did patients with OA. However, contrary to the findings of pre-21st century studies, the average age of TKA among patients with RA was not significantly different from that of patients with OA. Additionally, patients with RA had a 1.5-fold higher risk of undergoing TKA. Although not statistically significant, patients with RA had a higher revision TKA rate, a shorter time until revision TKA, and underwent more revision TKAs due to infections than did patients with OA. An analysis of factors that affect revision TKA revealed that the risk of revision increased if the erythrocyte sedimentation rate and C-reactive protein levels were increased at the time of TKA. This study showed that patients with RA have a slightly higher risk of undergoing TKA than did patients with OA. Furthermore, the presence of inflammation at the time of TKA increases the risk of revision; therefore, inflammation should be adequately controlled before performing TKA.

• 생명과학회지
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• 제16권5호
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• pp.773-779
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• 2006

단축범위 무릎인공관절 수술자와 다축범위 무릎인공관절 수술자를 대상으로 앉았다 일어나는 동안 운동학적 및 운동역학적 요인들을 비교분석한 결과는 다음과 같다. 앉았다 일어나는 동작은 다축범위 수술자 집단이 단축범위 수술자 집단보다 0.19초(p= 0.033) 빠르게 나타났다. 최대상체 굴곡각도는 다축범위 수술자 집단이 단축범위 수술자집단 보다 $10^{\circ}(p=0.014)$정도 크게 나타났다. 상체굴곡 각속도는 다축범위 수술자 집단이 단축범위 수술자 집단보다 $7^{\Omega}{\cdot}S^{-1}$(p= 0.058)빠르게 나타났다. 단축범위 수술자 집단과 다축범위 수술자 집단의 ADD와 ABD의 차이는 거의 없었다. 대퇴사두근의 근전도분석은 내측광근은 무릎굴곡각 $60^{\Omega}-15^{\Omega}$(p＜0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다. 외측광근은 무릎굴곡각 $60^{\Omega}-45^{\Omega}$(p＜0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다. 대퇴직근의 값은 무릎굴곡각 $60^{\Omega}-30^{\Omega}$(p<0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다. 대퇴이두근의 값은 무릎굴곡각 $75^{\Omega}-15^{\Omega}$(p＜0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다.

• 근관절건강학회지
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• 제22권1호
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• pp.48-56
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• 2015

Purpose: The purpose of this study was to verify the effects of visual information on nursing management to elderly total knee arthroplasty (TKA) patients. Methods: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used in this study. Participants of this study were 60 elderly patients with TKA admitted to one hospital: the control group (30) between July and September, 2013, and the experimental group (30) between April and July, 2013. Anxiety and uncertainty were determined at baseline and at 3 days after TKA in both groups. Results: Two days after the visual information, the experimental group showed a significant decrease in anxiety and uncertainty compared with the control group. Conclusion: The results of this study show that providing visual information was effective in decreasing postoperative patient anxiety and uncertainty in elderly TKA patients. Therefore, when an elderly patient is hospitalized for TKA, positive and systematic provision of visual information may provide a positive effect by reducing postoperative patient anxiety and uncertainty.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2008년도 추계학술대회A
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• pp.1518-1520
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• 2008

Recent clinical studies have shown that computer navigation for total knee arthroplasty (TKA) provides improved component alignment accuracy. However, femoral stress fracture after computernavigated TKA have been reported due to the pin hole and we hypothesized that osteoporosis would be one of the key factors in pin hole fracture after computer-navigated TKA. We investigated the von-Mises stress around the femoral pin-hole for different elastic modulli and ultimate stresses and four different pin penetration modes to understand the aging effect on femoral stress fracture risk after computer-navigated TKA by finite element analysis. In this study, aging effect was shown to increase the femoral stress fracture risk for all pin penetration modes. Especially, aging effect was shown dramatically in the transcortical pin penetration mode.

• Knee surgery & related research
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• 제30권4호
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• pp.284-292
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• 2018

Purpose: As the number of total knee arthroplasties (TKAs) increases, the incidence of femoral periprosthetic fractures after TKA is also increasing. This review aimed to suggest a new surgically oriented classification system for femoral periprosthetic fractures. Methods: We investigated the classifications, and current treatment trends for femoral periprosthetic fractures after TKA by means of a thorough review of the relevant literature. Results: Numerous studies reported good results of surgical treatment with modern fixatives including locking compression plates and retrograde intramedullary nails. However, few classifications of femoral periprosthetic fractures reflect the recent developments in surgical treatment. Conclusions: We recommend that surgical management be considered the first-line treatment for femoral periprosthetic fractures after TKA. Our new classification will help in deciding the surgical treatment option for femoral periprosthetic fractures after TKA.

• 대한정형도수물리치료학회지
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• 제23권2호
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• pp.45-49
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• 2017

Background: The purpose of this study was to investigate the effect of structured cryotherapy on edema of patients who had a total knee arthroplasty (TKA). Methods: The subjects were 58 patients who were diagnosed with osteoarthritis and had total knee arthroplasty in D hospital. In total, 29 people were in the leg elevation cryotherapy group (LECTG), 29 people were in the control group (CTG). After TKA, the patients' swelling on post operation days (POD) 3 were checked. After the post OP checking, LECTG was treated with cryotherapy with leg elevation for 12 days but CTG was cryo therapy with sit on chair. Results: Swelling show significant difference within the group (p<.05), but did not show signigicant difference between groups (p>.05). Conclusions: Base on the results, it was found the cryo therapy of $-78^{\circ}C$ improved swelling after TKA. Accordingly, it is thought that cryo therapy of $-78^{\circ}C$ has positive effect on swelling in the process of recovery after operation. but It did not approve that the leg elevation was even more effective. For this study, the reserch developed to enhance the effectiveness of the cryotherapy, would make it possible to apply to an effective cryotherapy posture.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2011년도 춘계학술대회 논문집
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• pp.285-286
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• 2011

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2005년도 춘계학술대회 논문집
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• pp.896-902
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• 2005

An orthopedic surgeon normally gets the operational parameters of total knee arthroplasty from medical images(CT, MRI). Anatomical axis, mechanical axis, the width and height of femur, or tibia are the most important parameters related with accomplishment of TKA. This paper presents a methodology of simulation that virtually operates TKA according to 2D medical images. Using this simulator, some important parameters for operation can be achieved before hand. The simulator provides the 3D computational model of a knee joint and then derives the proper size of implant corresponding to the joint. The whole process of TKA can be simulated such as clipping a knee joint, assembling the joint and its implants, visualizing all the operation steps, deriving some crucial parameters such as anatomical axis and cutting thickness, and predicting the result of TKA. Some examples are given and discussed to validate the methodology.

• Knee surgery & related research
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• 제30권4호
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• pp.319-325
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• 2018

Purpose: Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA. Materials and Methods: We prospectively enrolled 67 patients undergoing primary TKA. Correlation coefficients were used to evaluate the associations of tourniquet time, a surrogate of surgical difficulty, with BMI, pre- and intraoperative anthropometric measurements, and radiographic knee alignment. Similarly, Knee Injury and Osteoarthritis Outcome Score (KOOS) was compared to BMI. Results: Tourniquet time was significantly associated with preoperative inferior knee circumference (p=0.025) and ankle circumference (p=0.003) as well as the intraoperative depth of incision at the quadriceps (p=0.014). BMI was not significantly associated with tourniquet time or any of the radiographic parameters or KOOS scores. Conclusions: Inferior knee circumference, ankle circumference, and depth of incision at the quadriceps (measures of peripheral obesity) are likely better predictors of surgical difficulty than BMI. Further study of alternative surgical indicators should investigate patients that may be deterred from TKA for high BMI, despite relatively low peripheral obesity.

• Knee surgery & related research
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• 제30권4호
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• pp.334-340
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• 2018

Purpose: The purposes of this study were to compare clinical results after total knee arthroplasty (TKA) using the Attune and PFC Sigma knee designs and to investigate whether the use of the Attune prosthesis increased the risk of patellar injury in Asian patients. Materials and Methods: Three hundred knees that underwent TKA using Attune (group A) were compared to 300 knees that underwent TKA using PFC Sigma (group B). The Knee Society Knee Score (KS) and Function Score (FS), and range of motion (ROM) were compared. The residual patellar thickness was compared to evaluate the risk of patellar injury. Results: The postoperative KS and ROM of group A were better than those of group B (93.1 vs. 88.8, p<0.001 and $131.4^{\circ}$ vs. $129.0^{\circ}$, p=0.008, respectively). The postoperative FS did not differ significantly between the two groups (80.9 vs. 78.7, p=0.427). The residual patella was thinner in group A (14.8 mm vs. 15.7 mm, p=0.003), which made up a higher proportion of the high-risk group for patellar fractures with a residual thickness of <12 mm (7.5% vs. 2.1%, p=0.003). Conclusions: TKA using the Attune prosthesis provided more favorable clinical results than TKA using PFC Sigma. However, the risk of injury in the residual patella was increased with use of the Attune prosthesis in Asian patients.