• PNF and Movement
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• v.16 no.1
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• pp.75-83
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• 2018

Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) exercise on the range of motion (ROM), pain, and functional activity of patients who received total knee arthroplasty (TKA). The purpose of this study was to provide fundamental data regarding the use of PNF exercise among patients with musculoskeletal disease. Methods: Fourteen patients who received TKA were randomly divided into an experimental group (n=7) that took part in PNF exercise and a control group (n=7) that performed general rehabilitation exercise. Both groups performed the respective exercises for 30 minutes, five times a week for 2 weeks. For the measurement of ROM, the range of knee flexion was measured using a clinometer smartphone application. A visual analogue scale (VAS) was used for the measurement of the level of pain. The timed up and go test (TUG) was conducted to measure functional activity. A paired t-test was performed to compare within-group changes before and after the PNF exercise. Differences between the experimental group and control group were analyzed by an independent t-test. For all tests, the level of statistical significance was set at ${\alpha}=0.05$. Results: After the exercise, there was a significant within-group change in VAS and TUG scores in the experimental group and control group (p<0.01). There was also a significant between-group difference in VAS and TUG scores after the intervention (p<0.05). Conclusion: General rehabilitation exercise is commonly applied as a treatment for TKA patients and is relatively effective. The application of PNF exercise may be useful in such patients, considering its effects on ROM improvement, pain reduction, and functional enhancement.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.343-347
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• 2020

May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

• Korean Journal of Radiology
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• v.22 no.8
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• pp.1341-1351
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• 2021

Objective: To compare the quality of various polychromatic and monochromatic images with or without using an iterative metal artifact reduction algorithm (iMAR) obtained from a dual-energy computed tomography (CT) to evaluate total knee arthroplasty. Materials and Methods: We included 58 patients (28 male and 30 female; mean age [range], 71.4 [61-83] years) who underwent 74 knee examinations after total knee arthroplasty using dual-energy CT. CT image sets consisted of polychromatic image sets that linearly blended 80 kVp and tin-filtered 140 kVp using weighting factors of 0.4, 0, and -0.3, and monochromatic images at 130, 150, 170, and 190 keV. These image sets were obtained with and without applying iMAR, creating a total of 14 image sets. Two readers qualitatively ranked the image quality (1 [lowest quality] through 14 [highest quality]). Volumes of high- and low-density artifacts and contrast-to-noise ratios (CNRs) between the bone and fat tissue were quantitatively measured in a subset of 25 knees unaffected by metal artifacts. Results: iMAR-applied, polychromatic images using weighting factors of -0.3 and 0.0 (P_-0.3i and P_0.0i, respectively) showed the highest image-quality rank scores (median of 14 for both by one reader and 13 and 14, respectively, by the other reader; p < 0.001). All iMAR-applied image series showed higher rank scores than the iMAR-unapplied ones. The smallest volumes of low-density artifacts were found in P_-0.3i, P_0.0i, and iMAR-applied monochromatic images at 130 keV. The smallest volumes of high-density artifacts were noted in P_-0.3i. The CNRs were best in polychromatic images using a weighting factor of 0.4 with or without iMAR application, followed by polychromatic images using a weighting factor of 0.0 with or without iMAR application. Conclusion: Polychromatic images combined with iMAR application, P_-0.3i and P_0.0i, provided better image qualities and substantial metal artifact reduction compared with other image sets.

• Physical Therapy Korea
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• v.23 no.1
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• pp.20-30
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• 2016

Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC ($n_1$=19) or the QIIC ($n_2$=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.2
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• pp.31-35
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• 2012

Purpose : The purpose of this study was to investigate the effect of kinematic variables by analysis of a gait in older. Methods : This study selected nine in older adults with osteoarthritis. The Kinematic variables during walk were compared analyzed using motion analysis. Results : The findings of this study are as follows. Stance time showed significant difference within-subject groups and interaction within-subjects and time. The swing and stride time showed a no significant interaction within-subjects and time. Swing time showed a no significant difference according to time and within-subjects. Stride time showed a significant difference according to time. But, stride time showed a no significant difference according to within-subjects. Conclusion : These findings of this study indicate that when the patients with total knee arthroplasty decreased stability. Therefore, stance and stride time showed increase when walking, because to decrease the weight bearing that is delivered to knee. And swing time showed decrease.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.92-96
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• 2017

Postoperative infection from total knee arthroplasty (TKA) is an issue drawing great attention, which can manifest as a local or general infection. Its development into sepsis has also occasionally been reported. Such sepsis is a critical complication that can spread to various parts of the body, which can ultimately lead to mortality. However, the cases where infection has spread to the spine do not have clear clinical signs, making diagnosis difficult. These cases are not found in the literature. Therefore, this is a case study on both postoperative infection from TKA that has developed into sepsis and spread to the spine.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.18-31
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• 1999

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.39-44
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• 2014

The patellar clunk syndrome is one of the patellofemoral complication, caused by formation of the fibrous nodule at the suprapatellar region after total knee arthroplasty. The symptom involves painful catching, crepitus and clunk during knee extension. It has been mainly but not exclusively associated with the posterior stabilized total knee system. The fibrous nodule is entrapped in the femoral intercondylar notch of the femoral component during flexion and as the knee is extended, it displaces back to the trochlear groove abruptly and the typical symptoms occur. The risk of developing this complication is primarily related to the design of the femoral component and higher incidence was noted with earlier designs of posterior stabilized knee prosthesis. Modifications have been made to the femoral component to optimize the kinematics of the patellofemoral joint and thereby reduced the incidence of patellar clunk syndrome but did not eliminate the problem completely. Clinical examination is the gold standard of diagnosis and imaging study has been used as a possible adjunct to diagnosis. Especially ultrasonography is an imaging modality, which can be easily performed to detect the fibrous nodule on the quadriceps tendon. We report a case of patellar clunk syndrome which was diagnosed with ultrasonography.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.527-533
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• 2020

Purpose: This study compared the effects of a buprenorphine transdermal patch (BTDP) on the chest and knee for pain control after total knee arthroplasty (TKA). Materials and Methods: A retrospective case-control study was conducted from August 2018 to August 2019 on 231 patients who underwent TKA. Two hundred cases were selected considering age, sex, and body mass index. Before and after applying the BTDP, the Numeric Rating Scale (NRS), adverse effects and compliance were measured. All measurements in the chest application group (group A=100) and knee application group (group B=100) were compared. Results: NRS was similar in rest between the groups treated with BTDP, but at two days and three days afternoon, five, six, and seven days postoperatively in group B, the NRS was significantly lower than that of group A. The adverse effects of the central nervous system and gastrointestinal system after applying BTDP were significantly lower in group B than in group A. No significant differences in adverse effects of the cardiovascular system and skin were observed between the two groups. Regarding the maintenance of BTDP, group B was significantly higher than group A. Conclusion: The direct application of BTDP after TKA to painful knee joints showed excellent results in early postoperative pain control and can be a useful method for increasing patient compliance by reducing the frequency of adverse effects.

• Journal of Biomedical Engineering Research
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• v.29 no.6
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• pp.451-456
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• 2008

Total knee arthroplasty(TKA) using computer-assisted navigation has been increased in order to improve the accuracy of femoral and tibial components implantation. Recently, a few clinical studies have reported on the femoral stress fracture after TKA using computer-assisted navigation. The purpose of this study is to investigate the stress concentration around the femoral pin-hole for different pin-hole diameter, the modes of pin penetration by finite element analysis to understand the effects of pin-hole parameters on femoral stress fracture risk. A three-dimensional finite element model of a male femur was reconstructed from 1 mm thick computed tomography(CT) images. The bone was rigidly fixed to a 25 mm above the distal end and 1500 N of axial compressive force and 12 Nm of axial torsion were applied at the femoral head. For all cases, transcortical pin penetration mode showed the highest stress fracture risk and unicortical pin penetration mode showed the lowest stress concentration. Pin-hole diameter increased the stress concentration, but pin number did not increase the stress dramatically. The results of this study provided a biomechanical guideline for pin-hole fracture risk of the computer navigated TKA.