• 대한정형외과학회지
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• 제56권4호
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• pp.357-360
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• 2021

수술 후 장폐색(postoperative ileus, POI)은 복부나 대장 수술 후에 발생빈도가 높지만 하지 수술 후에는 드문 것으로 알려져 있다. 저자들은 슬관절 인공관절 전치환술 이후 4일째부터 증상이 시작된 POI로 사망한 81세 환자를 경험하였고, 이에 대한 위험 요인과 진단, 예방법 및 치료에 대해 문헌 고찰하여 보고하고자 한다.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2012년도 춘계학술대회 논문집
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• pp.1213-1214
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• 2012

• 대한정형외과학회지
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• 제56권1호
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• pp.87-92
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• 2021

방사선 검사상 골용해성 병변이 슬관절에서 발견되는 경우 다양한 원인을 감별해야 한다. 특히 슬관절 전치환술을 받은 수술력이 있다면 골용해도 가능한 원인이 될 수 있다. 저자들은 우측 무릎 통증으로 내원한 83세 여성 환자에서 시멘트를 사용한 슬관절 전치환술의 경골 삽입물의 비감염성 해리가 선행된 비골 두의 골용해성 병변을 진단하였고 슬관절 재치환술을 통해 치료한 경험을 문헌 고찰과 함께 보고하는 바이다.

• Journal of Medicine and Life Science
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• 제18권1호
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• pp.11-15
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• 2021

In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

• Journal of Medicine and Life Science
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• 제20권2호
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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.

• 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.

• 한국병원경영학회지
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• 제23권3호
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• pp.52-62
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• 2018

This study aims to analyze the factors affecting in-hospital complication and length of stay in elderly patients with total knee arthroplasty. A total of 8,224 inpatients over 65 years old were selected from the national old inpatient sample data which was produced by Health Insurance Review and Assessment Service in 2016. STATA 12.0 was performed using frequency, chi-square test, t-test, ANOVA and multiple linear and logistic regression analysis. Analysis results show that ages(over 85), Charlson Comorbidity Index, district(metropolitan) for general hospitals and gender, district, beds(100-199) for hospitals are significantly influenced in-hospital complication. Statistically significant factors affecting the length of stay are gender, insurance type, depression, district, bed(300 over) for general hospitals and gender, type of insurance, Charlson Comorbidity Index, depression, district, beds(200-299) for hospitals. Based on these findings, the factors affecting in-hospital complication and length of stay were different depending on the type of medical institution. Accordingly, policymakers should analyze the differences in care behavior depending on the type of medical institution and expand policy and financial support to resolve them.

• 대한관절경학회지
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• 제16권2호
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• pp.190-194
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• 2012

인공 슬관절 전치환술 후 발생한 폴리에틸렌 마모를 관절경을 통한 진단은 이전에 보고된 바 있다. 이번 논문에서 저자들은 인공 슬관절 단일구획 치환술 후 발생된 폴리에틸렌 마모와 재발성 아탈구를 관절경을 통해 진단하여 폴리에틸렌의 교환만으로 치료된 증례에 대해 보고하는 바이다. 인공 슬관절 단일구획 치환술 후 발생된 폴리에틸렌 마모와 탈구의 진단에 관절내시경이 도움이 되며 문제의 원인, 진단 및 치료 방침을 정하는데 유용한 것으로 사료된다.

• 대한관절경학회지
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• 제13권1호
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• pp.39-45
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• 2009

목적: 슬관절 치환술 후에 발생한 합병증의 치료를 위해 시행한 관절경술의 결과를 알아보고 그 효용성을 확인하고자 하였다. 대상 및 방법: 1992년 5월부터 2008년 6월까지 본원에서 슬관절 치환술을 시행받은 후 합병증으로 인하여 관절경적 치료를 받았던 25예를 연구 대상으로 하였다. 25예 중 슬관절 전치환술을 시행받았던 경우가 19예, 부분치환술을 시행받았던 예가 6예였다. 모든 환자에서 관절경을 시행하기 전에 합병증의 원인을 밝히기 위해서 이학적 검사와 방사선 검사를 시행하였으며, 감염이 의심되는 경우 관절액 천자 및 혈액학적 검사를 추가로 시행하였다. 결과: 관절경술 시행 시 진단으로는 전치환술을 시행한 예에서는 감염 11예, 관절의 유착 및 섬유화로 인한 운동 제한 6예, 연부 조직의 충돌 2예 등이 있었으며, 부분 치환술을 시행한 예에서는 반월상 연골 파열, 유동성 치환물의 아탈구, 혈관절증, 관절 내 시멘트 유리체, 연부 조직 충돌 및 슬관절 강직으로 인한 운동 제한이 각각 1예 씩 총 6예가 있었다. 감염이 있던 11예 중 9예에서 관절경술만으로 치료가 되었고, 관절 강직이 있던 7예는 평균 슬관절 운동 범위가 술 전 $65^{\circ}$에서 최종 추시 시 $105^{\circ}$로 향상 되었으며, 나머지 예에서도 관절경술로 성공적인 치료 결과를 보였다. 결론: 슬관절 치환술 후 발생한 합병증의 치료로 시행한 관절경술은 적절한 환자의 선택 시 안전하고 효과적인 방법임을 확인할 수 있었다.

• 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.