• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.06a
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• pp.1310-1315
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• 2003

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 true in the clinical cases. In this study the motions 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 while it showed only rotation for other flexion angles. Physiologic external rotation of the tibia near full extension 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 motions as well as different contact forces.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.135-140
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• 2007

Purpose: To evaluate the incidence and describe radiologic pattern of ankle arthritis following change of mechanical loading axis by total knee arthroplasty. Materials and Methods: We reviewed radiographs of 419 cases, 243 patients underwent total knee arthroplasy from January 2002 to October 2006 retrospectively. We described radiologic parameters around the ankle joint and measured the amount of change of knee varus or valgus angle by comparing preoperative and postoperative anteroposterior standing lower extremities AP X-rays. We divided cases into two groups, one with radiologically arthritic change of the ankle joint and the other one without any radiologic change after surgery. We compared two groups in each parameters and analyzed statistically (SPSS v13.0). Results: Three hundred eighty one cases were divided into varus group and 38 cases in valgus group. 125 cases were divided into ankle arthritic change-positive subgroup among the varus group and 251 cases were in negative subgroup. The amount of varus angle correction by total knee arthroplasty showed significant difference between two subgroups. There was no significant difference in each parameters between subgroups within 38 valgus cases. Conclusion: Ankle arthritis can be aggravated after total knee arthroplasty because of the change of mechanical loading axis onto the ankle joint. Therefore it may be needed to evaluate symptoms and function of ankle joints before performing total knee arthroplasties especially in patients with huge varus deformities of knee joints.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.93-99
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• 2005

In spite of proper maneuver of total knee replacement arthroplasty, some patients suffer from skin necrosis just above the implant. From Mar. 2000 to Jan. 2004, the authors performed reconstruction of knee skin defects after total knee replacement athroplasty. Total 6 cases of flap surgery were performed and patients ranged between 43-years-old to 82-years-old. Rectus femoris perforator based reversed adipofascial flaps were used in 2 cases, medial gastrocnemius muscular island flaps were used in 2 cases and sural artery based on adipofascial rotation flap was used in 1 case. One patient with extended necrosis underwent reconstruction with dual flaps of sural artery based adipofascial rotation flap and medial gastrocnemius muscular island flap. There were no distinctive complication needing additional procedure in all cases during the long term follow up. Reconstruction of necrosis following total knee replacement arthroplasty had several characteristics different from simple knee defect. The patients might have the history of long term steroid usages, excessive skin tension due to implants, underlying disease such as diabetes, rheumatoid disease, and etc. In addition, the early ambulation is mandatory in these patients of total knee replacement arthroplasty. With regards to these special considerations, a single stage and reliable operation must be needed. The authors introduce various reconstruction methods and algorithm that may aid easy decision making.

• Physical Therapy Rehabilitation Science
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• v.4 no.2
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• pp.79-86
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• 2015

Objective: This study was carried out to compare changes in pain, swelling and range of motion (ROM) between the two groups according to physical therapy intervention. Design: Randomized controlled trial. Methods: There were a total of 20 elderly subjects ages 65-75 years old who have been admitted to the hospital for a total knee arthroplasty. After surgery, the experimental group (n=10) carried out quadriceps femoris muscle strengthening exercise, hamstring stretching exercises and gastrocnemius stretching exercise with a physical therapist for 30 minutes and additionally, received ice pack therapy for 20 minutes once a day. The control group (n=10) carried out continuous passive motion for 30 minutes and received ice pack therapy for 20 minutes once a day. The experimental group and control group carried out each intervention program for 2 weeks 3 times a week. The Visual Analogue Scale was used to assess pain, tape measurements were taken to assess swelling, and a steel goniometer was used to assess knee joint ROM. Results: As a result, the experimental group showed a statistically significant decrease in the pain and swelling, and a significant increase in knee flexion ROM after the intervention, compared to the control group (p<0.05). There was a significant improvement in pain, edema, and knee flexion and extension ROM in all subjects after intervention (p<0.05). Conclusions: According the results of this study, exercise in the experimental group is effect on the pain, swelling and ROM for total knee arthroplasty.

• Journal of Korean Clinical Nursing Research
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• v.24 no.3
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• pp.283-292
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• 2018

Purpose: This study was conducted to evaluate the effects of early knee joint exercise education program on pain, knee ROM, and satisfaction among patients with a total knee replacement arthroplasty. Methods: An experimental study with non-equivalent groups was conducted using 32 patients for an experimental group and 32 patients for a control group. The experimental group received knee joint exercise education including systemic continuous passive motion (CPM) exercise and knee exercise. The control group received conventional CPM exercise. Pain, flexion and flexion contracture range of motion, and patient satisfaction were evaluated by $x^2$ test, Fisher's exact test, t-test, and repeated measures ANOVA using the SPSS 23.0 Windows program. Results: There were a significant improvement in patients' knee flexion and satisfaction in the experimental group compared to the control group. There was no significant difference in pain and flexion contracture between the two groups. Conclusion: The findings suggest that the proposed education program is efficient and effective when providing nursing care after a total knee replacement arthroplasty.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.35-47
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• 2021

Objectives This study was conducted to evaluate the therapeutic effect of herbal medicine after total knee arthroplasty. Methods Key words such as total knee arthroplasty and herbal medicine were searched in 10 databases (Ovid-Medline, Ovid-EMBASE, Ovid-AMED, Cochrane Library, China National Knowledge Infrastructure [CNKI], National Digital Science Library [NDSL], Koreanstudies Information Service System [KISS], Oriental medicine Advanced Searching Integrated System [OASIS], KoreaMed, KMBASE), and only suitable randomized controlled trials (RCTs) were selected. Results 8 RCTs were finally selected, and herbal medicine showed positive results for pain relief and functional recovery after total knee arthroplasty. However, the analyzed 8 RCTs showed a high overall risk of bias. Conclusions In the future, RCTs with a higher level of evidence on the effect of herbal medicine after total knee arthroplasty need to be continuously conducted.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.175-181
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• 2014

Purpose: The purpose of this study is to investigate the effects of interference current therapy and laser therapy on functional recovery after total knee arthroplasty by measuring the Berg balance scale and range of motion. Methods: Subjects were 30 patients who were admitted to G Hospital after total knee arthroplasty. They were randomly assigned to experimental group I in which interference current therapy was applied (n=10), experimental group II in which laser therapy was applied (n=10), or the control group (n=10). The Berg balance scale and range of motion of the subjects were measured before, after 2 weeks, and after 4 weeks of therapy. Results: There was a statistically significant change (p<0.05) in the Berg balance scale and range of motion before and after therapy intervention among the laser therapy group and the interference current therapy group. There was also a significant change between the groups in the Berg balance scale and range of motion. Tukey's post hoc comparison showed a statistically significant difference between the control group and experimental group I and between the control group and experimental group II (p<0.05). Conclusion: The application of interference current therapy and laser therapy resulted in a significant change in both the Berg balance scale and range of motion among patients with total knee arthroplasty. The findings of this study can be used as preliminary clinical data in evaluating functional recovery in patients with total knee arthroplasty in a post-clinic setting.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.111-116
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• 2006

An infection after total knee arthroplasty has many complications such as severe bone defect, skin and soft tissue problems, devastated general condition, so arthrodesis is preferred as treatment option. However, poor bony contact due to severe bone defect and inadequate conditions of the soft tissue often cause nonunion or severe limb shortening after arthrodesis. More over these conditions, it is not easy to choose appropriate fixative devices. In these situations, the arthrodesis using vascularized fibular graft can be the solution. Vascularized fibular graft (VFG) can playa role as a suitable material for the treatment of bone defects. And VFG can overcome poor blood circulation caused by scar tissues, and can be relatively more durable and adequate length. In the long term, VFG can be hypertrophied by weight bearing, and will give mechanical stablility. The purpose of the paper is to report the successful results of arthrodesis using VFG in a patient who got extensive bone defect after failed revision total knee arthroplasty with infection.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.1-14
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• 2020

Purpose : The purpose of this study was to investigate the effect of an exercise program with patella mobilization on range of motion, muscle strength, and gait in patients with total knee arthroplasty. Methods : Thirty patients under the age of 65 who visited the T hospital in Daegu Metropolitan City and underwent total knee arthroplasty surgery were selected for this study. Fifteen patients were randomly assigned to the experimental group and took part in an exercise program with patella mobilization, and fifteen patients were randomly assigned to the control group and took part in just the exercise program. Each group took part in their intervention three times a week for four weeks. The measurement tools used included a goniometer, handheld dynamometer, and 10-meter walking test. In the statistical analysis results, to compare the about pre and post test differences within each group, a paried t-test was used, and to compare the differences between each group, an independent t-test was used. Results : There was a significant difference (p<.05) in the range of motion, muscle strength of the quadriceps femoris and, hamstrings, and 10-meter walking test within each individual group and between the two groups before and after the intervention (p<.05). Conclusion : All the results for the experimental group were significant. Therefore, it is expected that an exercise program with patella mobilization will be helpful for the recovery of the knee joint in patients who have undergone total knee arthroplasty.

• 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.