• Title/Summary/Keyword: Total Knee arthroplasty

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Evaluation of Biomechanical Stability of Newly Developed Revision Total Knee Arthroplasty through Strain and Stress Distribution Analysis within the Tibia: Finite Element Analysis (경골 내 변형률 및 응력 분포 특성 분석을 통한 새로이 개발된 재치환용 인공슬관절의 생체역학적 안정성 평가: 유한요소해석)

  • Han, Paul;Jang, Young-Woong;Yoo, Oui Sik;Kim, Jung Sung;Kim, Han Sung;Lim, Dohyung
    • Journal of Biomedical Engineering Research
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    • v.34 no.1
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    • pp.14-23
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    • 2013
  • In this study, biomechanical stability of the newly developed revision total knee arthroplasty (rTKA) was evaluated through strain and stress distribution analysis within the implanted proximal tibia using a three-dimensional finite element (FE) analysis. 2000N of compressive load (about 3 times body weight) was applied to the condyle surface on spacer, sharing by the medial (60%) and lateral (40%) condyles simulating a stance phase before toe-off. The results showed that PVMS within the revision total knee arthroplasty and the proximal tibia were less than yield strength considering safe factor 4.0 (rTKA: less than 10%, Cortical bone: less than 70%, Cancellous bone: less than 70%). The materials composed of them and the strain and stress distributions within the proximal tibia were generally well matched with those of a traditional revision total knee arthoplasty (Scorpio TS revision system, Stryker Corp., Michigan, USA) without the critical damage strain and stress, which may reduce the capacity for bone remodeling, leading to bone degeneration. This study may be useful to design parameter improvement of the revision total knee arthoplasty in biomechanical stability point of view beyond structural stability of revision total knee arthoplasty itself.

Arteriography and Embolization of Lateral Inferior Genicular Artery of Recurrent Spontaneous Hemarthrosis after Total Knee Arthroplasty (인공 슬관절 치환술 후 발생한 재발성 혈관절증의 치료를 위해 시행한 혈관조영술 및 하외슬동맥색전술)

  • Chon, Je-Gyun;Kang, Jong-Won;Yoon, Ja-Yeong;Jeong, Uitak
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.173-177
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    • 2021
  • Recurrent spontaneous hemarthrosis is a relatively rare complication of total knee arthroplasty. This paper reports a case of a patient treated with arterial embolization for recurrent spontaneous hemarthrosis even after undergoing arthroscopic surgery. The patient had several relapses after total knee arthroplasty.

Simulation of Three Dimensional Motion of the Knee Joint in Total Knee Arthroplasty (인공 무릎 관절의 3차원 운동 시뮬레이션)

  • Moon, Byung-Young;Son, Kwon;Kim, Ki-Bum;Seo, Jung-Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.9
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    • pp.188-195
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    • 2004
  • Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

The Effect of Preoperative Education about Patient Controlled Analgesia on Postoperative Pain Control of Elderly Receiving Total Knee Arthroplasty (수술 전 통증자가조절기 교육이 슬관절치환술 노인의 수술 후 통증에 미치는 효과)

  • Lee, Ji Heun;Kim, Hwa Soon;Lee, Young Whee;Kim, Soo Hyun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.28-39
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    • 2014
  • Purpose: The purpose of this study was to investigate the effect of preoperative education about patient controlled analgesia (PCA) on postoperative pain control for elderly after total knee arthroplasty. Methods: The study applied a quasi-experimental design. To prevent communication between experimental group and control groups, data from control group were collected before provision of preoperative education for the experimental group. A total of 50 elderly patients who underwent total knee arthroplasty and older than 65 years old participated in this study. The preoperative education about PCA was provided for the experimental group before surgery. The preoperative education program consisted of fifteen minute education about pain control, and PCA use, as well as demonstration of PCA use. Results: The experimental group had higher knowledge score about pain and PCA use, and more positive attitudes toward pain and use of analgesics after surgery than the control group. There was no significant difference in use of additional analgesics after surgery between the two groups. The experimental group had significantly lower pain score at 8, 24 and 36 hours after surgery than the control group. The experimental group had higher level of satisfaction about PCA use than the control group. Conclusion: The preoperative education about PCA, customized for elderly patients could be an effective nursing intervention for postoperative pain control after total knee arthroplasty.

A Study on the Medical Use of Total Replacement Arthroplasty Patients for Life Care (라이프케어를 위한 관절 치환술 환자의 의료이용에 관한 연구)

  • Lee, Kyung-Hwa;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.8
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    • pp.661-670
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    • 2019
  • The purpose of this study was to analyze influential factors for blood transfusion for patients undergoing total knee arthroplasty and total hip arthroplasty, which are chronic degenerative arthritis, using the 2017 sample data of Health Insurance Review & Assessment Service, to research the impact of blood transfusion on the usage of medical services among arthroplasty patients, and ultimately to provide some information on how to offer quality medical services. The findings of the study were as follows: First, whether there were any significant differences in the use or nonuse of transfusion during total knee arthroplasty according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution, the level of sickbed, gender and anemia were found to have been statistically significantly related. Second. whether there were any significant differences in the use or nonuse of transfusion during total hip arthroplasty according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution and the level of sickbed were found to have been statistically significantly related. Third, whether there were any significant differences in the presence or absence of diabetes among the total knee arthroplasty patients according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution, the number of sickbed and anemia were found to have been statistically significantly related. In the case of the total hip arthroplasty patients, there were no variables that were significantly related.

Prospective Study of Central versus Peripheral Obesity in Total Knee Arthroplasty

  • Armstrong, John G.;Morris, Tyler R.;Sebro, Ronnie;Israelite, Craig L.;Kamath, Atul F.
    • Knee surgery & related research
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    • v.30 no.4
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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.

The Effects of Home Care Exercise Program on Knee Joint Function and Quality of Life in Patients with Total Knee Replacement Arthroplasty (슬관절 전치환술 환자의 조기퇴원 후 가정간호 운동 프로그램이 슬관절기능 상태와 삶의 질에 미치는 효과)

  • Lee, Mi-Kyoung;Lee, In-Hee;Ju, Jung-Hea;Hwang, Mun-Suk;Seo, Jai-Gon;Sung, Young-Hee
    • Journal of muscle and joint health
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    • v.12 no.2
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    • pp.143-154
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    • 2005
  • Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.

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The Effects of Trunk Stability Exercise on Knee function, Balance, Gait in patients after Total Knee Arthroplasty (체간 안정화 운동이 무릎관절 전치환술 환자의 무릎기능, 균형, 보행에 미치는 영향)

  • Lee, Jae-Hong;Min, Dong-Ki;Lee, Sang-Jae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.422-428
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    • 2018
  • This study was conducted to investigate the effects of trunk stability exercise on knee function, balance and gait in patients who underwent total knee arthroplasty. The subjects of this study were recruited from individuals diagnosed with degenerative arthritis who had undergone total knee arthroplasty. Overall, 24 patients were randomly divided into a control groups and an experimental groups (12 each). The trunk stability exercise was conducted for 4 weeks with three exercises developed in a previous study. The measurement tools used were knee function measurements based on the Lysholm knee score, balance ability measured using a test of TUG and OLS, and a walking ability test measured using a 10MWT. Pre and post test results were within groups were compared using the paired t-test, whole differences between groups were compared using the independent t-test. The experimental group showed significantly enhanced results relative to the control group (p<0.05). Based on these results, trunk stability exercise in parallel with knee joint therapy effectively improves the recovery of patients with total knee arthroplasty.

Effects of a Muscle Strengthening Exercise Program after Total Knee Arthroplasty (슬관절 전치환술 후 하지 근육강화 운동 프로그램 효과)

  • Chung, Myung-Sill;Kwak, Hye-Sun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.14 no.1
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    • pp.20-29
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    • 2008
  • Purpose: This research was conducted to compare the effects of a muscle strengthening exercise program on pain, straight leg raising ability, passive range of motion, independent walking time and satisfaction with total knee arthroplasty(TKA). Method: A nonequivalent control group posttest only design was used for this study. A total of 62 patients were randomly divided into the experimental group(31) and the control group (31). The experimental group received a 1-hour exercise intervention, while the control group received the usual care. Data was analyzed by t-test using the SPSS/WIN 11.0. Results: The experimental group showed significant improvement in pain score, straight leg raising ability, passive range of motion of knee joint, independent walking time, and the patient's satisfaction. Conclusion: The muscle strengthening exercise program was effective on decreasing pain and increasing mobility and satisfaction in patients with TKA.