• PNF and Movement
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• 제9권1호
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• pp.39-45
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• 2011

Purpose : The purpose of this article was to review the literature on change of knee position sense after total knee replacement intervention in knee rehabilitation. Methods : This review outlines scientific findings regarding different literature data in knee rehabilitation, and discusses proprioceptive change of knee joints after total knee replacement intervention. Result : Severe pain and diminished joint sensation may precipitate degenerative changes of knees joint, and a strong association between decreased proprioception and function has been identified in elderly patients with knee osteoarthritis. Total knee replacement(TKR) of the knee joint are effective surgical procedures in osteoarthritis patients, resulting in decreased pain, and improved physical function and quality of life in patients. After total knee replacement, joint position sensation is partially recovered, which may improve functional stability of the knee, but aspects of physical functioning are not fully restored to preoperative status. Conclusions : Thus, recovery rate in proprioception after TKR also is considered to be important because it may be a significant risk factor in failure of total knee replacement and knee rehabilitation intervention.

• 한국CDE학회논문집
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• 제16권5호
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• pp.315-322
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• 2011

The goal of total knee replacement (TKR) surgery is to replace patient's knee joint with artificial implants in order to restore normal knee joint functions. Since mismatched knee implants often cause a critical balancing problem and short durability, designing a well-fitted implant to a patient's knee joint is essential to improve surgical outcomes. We developed a software system that three-dimensionally (3D) simulates TKR surgery based upon 3D knee models reconstructed from computed tomography (CT) imaging. The main task of the system was to extract precise 3D anatomical parameters of a patient's knee that were directly used to determine a custom fit implant and to virtually perform TKR surgery. The virtual surgery was simulated by amputating a 3D knee model and positioning the determined implant components on the amputated knee. The test result shows that it is applicable to derive surgical parameters, determine individualized implant components, rehearse the whole surgical procedure, and train medical staff or students for actual TKR surgery. The feasibility and verification of the proposed system is described with examples.

• The Journal of Korean Physical Therapy
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• 제36권1호
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• pp.27-32
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• 2024

Purpose: This study was conducted to verify the effect of applying a pressure biofeedback unit on walking ability and knee joint function while performing knee joint extensor strengthening exercises using resistance exercise equipment in total knee replacement (TKR) patients. Methods: This study was conducted on twelve patients receiving rehabilitation treatment after being admitted to a rehabilitation hospital post-TKR. Of these, six were allocated to a feedback group with a pressure biofeedback unit, and the other 6 were allocated to a control group without a pressure biofeedback unit. The subjects performed an exercise program for 45 minutes per session, five times a week, for two weeks. Walking ability and knee joint function were evaluated and analyzed before and after exercise. Results: The feedback group showed significantly better improvements in walking speed, gait cycle, step length on the non-operation side, time on the foot on the operation side, K-WOMAC stiffness, and K-WOMAC function than the control group (p<0.05). Conclusion: When strengthening the knee joint extensor muscles using resistance exercise equipment in TKR patients, the provision of a pressure biofeedback unit was found to improve walking ability and knee joint function by inducing concentric-eccentric contraction of the knee joint extensor muscles. Therefore, the study shows that exercise based on the provision of a pressure biofeedback unit should be considered when strengthening knee joint extensor muscles to improve the walking ability and knee joint function of TKR patients in clinical practice.

• 한방재활의학과학회지
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• 제30권4호
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• pp.219-231
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• 2020

The objective of this study is to propose a Korean medical rehabilitation protocol for total knee replacement (TKR) and to report its effectiveness. This study was conducted as a retrospective study which analyzes the medical records of 4 patients undergoing Korean medical rehabilitation with protocol and continuous passive motion exercise for more than two weeks after TKR. We evaluated the outcome checking physical examination findings of the knee joint, numeric rating scale (NRS), Lysholm knee score (LKS) and walking state. After the treatment, we observed that the function of knee joint, NRS, LKS, walking state of patients were improved. This study showed that Korean medical rehabilitation protocol has effect on knee joint recovery after TKR. The limitation of this study was the insufficient number of cases and short-term follow up. Further studies should be done steadily to report the effectiveness of a Korean Medical rehabilitation protocol for TKR.

• 한방재활의학과학회지
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• 제25권2호
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• pp.197-203
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• 2015

Objectives The objective of this study is to report the deep vein thrombosis (DVT) after total knee replacement (TKR) in a patient undergoing Korean medical rehabilitation. Methods A female patient who had total knee replacement (TKR) was treated by Korean medical rehabilitation with protocol. After fifteen days treatment, deep vein thrombosis (DVT) was suspected. Therefore, CT venography was performed. Results After Korean medical rehabilitation, pain was decreased. But also occurred deep vein thrombosis (DVT) as a complication. Conclusions We present a case of deep vein thrombosis (DVT) after total knee replacement (TKR) in a patient undergoing Korean medical rehabilitation. There is a limit that this study hasn't sufficient number of cases. Further studies will be needed.

• 대한물리치료과학회지
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• 제24권2호
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• pp.53-60
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• 2017

Purpose: This study aimed to investigate the effect of physiotherapy on the range of motion (ROM) of patients with hemophilic arthropathy after total knee replacement (TKR) during treadmill gait. Method: Nineteen patients (age range, 30-61 years) who received physiotherapy at the Korea Hemophilia Foundation (KHF) Clinic in Seoul between 2011 and 2013 after TKR were recruited. Protocol rehabilitation was performed (KHF Clinic, Department of Physiotherapy) with an average follow-up of 70 days (range, 6-141 days). Result: Physiotherapy after TKR improved the ROM parameters, including the post-operative average ROM. The post-operative and follow-up ROM also significantly increased. Conclusion: Patients with hemophilia require different physiotherapeutic techniques and need dedicated post-operative care in comparison with the general population.

• 대한임상전기생리학회지
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• 제11권1호
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• pp.21-29
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• 2013

Purpose : The purpose of this study was to determine the changes in ultrasound imaging of the lower limbs in patients with degenerative osteoarthritis who received a total knee replacement (TKR). Methods : The participants for the study were ten patients who were to receive a total knee replacement. Measurements were taken a total of three times: before receiving a total knee replacement, and one week and two weeks after receiving a total knee replacement. The vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle were measured using ultrasound imaging. Results : Muscle thickness of the vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. White area index (WAI) and density of vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. Conclusion : In conclusion, lower quality muscles were due to a decrease in muscle fiber and an increase in fat fiber. Therefore, initial physical therapy after total knee replacement should consider this point and be designed appropriately as a therapeutic approach for total knee replacement patients.

• 대한정형도수물리치료학회지
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• 제27권2호
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• pp.69-76
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• 2021

Background: Degenerative arthritis accounts for a large portion of the elderly, causing a lot of inconvenience in daily life. Total knee replacement (TKR) are performed to relieve pain in the knee joint. The purpose of this study was to determine whether knee joint stabilization exercises are effective in improving balance and walking ability in degenerative arthritis patients who have undergone TKR. Methods: A total of 30 TKR patients participated in this study. They were assigned to two groups. The experimental group, the group that underwent knee stabilization exercises, joint mobilization and general physical therapy. On the other hand, and the controlled group, the group that underwent joint mobilization and general physical therapy. All exercises were conducted thrice a week, for four weeks. The main balance outcomes were evaluated using the posture balance training system, while walking ability was assessed using a wireless 3-axis accelerometer. Results: The experimental group had significantly higher scores in postural stability testing (PST), limits stability testing, and waling ability. The post-intervention evaluation, there were significant differences in all variables between the two groups. However, no significant difference was noted in the foam eyes closed test in PST. Conclusion: This study suggests that knee joint stabilization exercises effectively improve the balance and walking ability of TKR patients. Thus, it could be presented as useful in clinical practice.

• 대한물리의학회지
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• 제18권2호
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• pp.93-101
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• 2023

PURPOSE: The Western Ontario and McMaster Universities Arthritis (WOMAC) index has been used to measure the outcome of total knee replacement (TKR), but studies on its reliability and validity are limited. The present study examined the reliability and validity of this index for patients with knee osteoarthritis who underwent TKR. METHODS: Seventy-one inpatients and outpatients who underwent bilateral TKR for knee osteoarthritis were included in this study. The pain assessment scale and WOMAC index were used to evaluate the participants every two weeks to examine the test-retest reliability, internal consistency, and construct validity. RESULTS: The test-retest reliability scores for pain, stiffness, and physical function were .75-.92, .85-.90, and .75-.95, respectively. The corresponding intraclass correlation coefficients were .75-.88, .76-.88, and .71-.95, respectively. The internal consistency score in the first and second examinations was .92. Furthermore, the construct validity scores for pain, stiffness, and physical function were .83, .41, and .58, respectively. CONCLUSION: The application of the WOMAC index in patients who underwent TKR showed high test-retest reliability and internal consistency with the use of the WOMAC index and good validity with the use of the pain assessment scale.

• 대한물리치료과학회지
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• 제5권4호
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• pp.809-816
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• 1998

This study was conducted to evaluated the effects adding continuous passive motion(CPM) each day to the entire postoperative program of patients who received a total knee replacement(TKR). A retrospective chart review was completed for 31 patients(12 with bilateral involvement, totaling 44 knees)who received a TKR between 1996 and 1998. The data analysis compared the following variables for 28 patients who received CPM and 16 patients who received no CPM: the length of hospital stay(LOS), the frequency of postoperative complications, the number of post-operative days(PODs) range of motion (ROM). The CPM Group showed significant decreases in the frequency of complication(p<0.05), the LOS(p < 0.05), and No difference was demonstrated in the ROM of the two groups. We concluded that CPM was an effective adjunct to physical therapy care of patients undergoing total knee replacement.