• The Korean Journal of Pain
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• v.36 no.4
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• pp.450-457
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• 2023

Background: Genicular nerve neurolysis with phenol and radiofrequency ablation (RFA) are two interventional techniques for treating chronic refractory knee osteoarthritis (KOA) pain. This study aimed to compare the efficacy and adverse effects of both techniques. Methods: Sixty-four patients responding to diagnostic blockade of the superior medial, superior lateral, and inferior medial genicular nerve under ultrasound guidance were randomly divided into two groups: Group P (2 mL phenol for each genicular nerve) and Group R (RFA 80℃ for 60 seconds for each genicular nerve). The numeric rating scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate the effectiveness of the interventions. Results: RFA and phenol neurolysis of the genicular nerves provided effective analgesia within groups at 1 week, 1 month, and 3 months compared to baseline. There was no significant difference between the groups in terms of NRS and WOMAC scores at all measurement times. At the 3rd month follow-up, 50% or more pain relief was observed in 53.1% of patients in Group P and 50% of patients in Group R. The rate of transient paresthesia was 34.4% in Group P and 6.3% in Group R, and this was significantly higher in Group P. Conclusions: Neurolysis of the genicular nerves with both RFA and phenol is effective in the management of KOA pain. Phenol may be a good alternative to RFA. Further studies are needed on issues such as dose adjustment to prevent transient paresthesia response.

• Journal of Medicine and Life Science
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• v.20 no.2
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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.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.387-397
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• 2021

Objective: The purpose of this case study was to investigate selective region high-frequency diathermy at trigger points with therapeutic exercises on pain, function, balance and gait in older patients with degenerative knee osteoarthritis (DKO). Design: A case report. Methods: The patient who participated in this study was a 71-year-old woman, who had been diagnosed with moderate osteoarthritis with grade II Kellgren & Lawrence grading scale. The intervention consisted of selective region high-frequency diathermy at trigger points, with hip and knee stretching and strengthening exercises. The participant was given assessments before and after every intervention session using the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Timed Up and Go test (TUG) and the 10 Meter Walk Test (10MWT). The participant performed the intervention 18 times for a total of 30 minutes each. Results: As a result of this study, the patient VAS decreased to 3 points, and the WOMAC decreased to 53 points. In addition, the TUG decreased to 3.25 s and the 10MWT decreased to 1.14 s. Conclusions: The results of this study suggest that selective region high-frequency diathermy at trigger points with therapeutic exercises may be an effective intervention to decrease pain, improve knee function, balance and gait in patients with DKO. The selective region high-frequency diathermy with therapeutic exercises may be feasible and provide potential benefits for rehabilitation of DKO.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.2
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• pp.35-44
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• 2016

Objective : The objective of this study is to report the effect of Korean Rehabilitation Treatment with CHUNA Manual Therapy and Exercise Therapy on Postoperative Anterior Cruciate Ligament rupture of knee. Methods : Two patients were treated by Korean Rehabilitation with CHUNA Manual Therapy and Exercise Therapy at knee. We evaluated the effectiveness by Visual Analog Scale(VAS) and Western Ontario and McMaster Universities Arthritis Index(WOMAC) and Range of motion(ROM) Results : Both patients had significant improvement on Knee ROM, VAS score and WOMAC index. Also physical examination of Knee was improved. Conclusions : This study showed that Korean Rehabilitation Treatment with CHUNA Manual Therapy and Exercise Therapy has meaningful effect on Postoperative of anterior cruciate ligament rupture of knee. But there is a limit on this study due to sufficient number of cases. Further studies will be needed.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.225-232
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• 2006

Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.1
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• pp.175-184
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• 2018

The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.2
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• pp.55-62
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• 2020

연구 목적 이 연구는 내측 반월상 연골판 손상으로 인한 무릎 통증을 호소하는 5명의 환자에서 한의학적 치료, 특히 신바로 약침으로 인한 통증 개선이 있었기에 보고함이다. 연구 방법 무릎 통증으로 본원 입원치료를 받은 환자 중, MRI 영상 검사상 내측 반월상 연골 파열 진단을 받은 환자들의 차트를 분석하였다. 슬관절 통증 호전 및 기능 개선은 Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), 슬관절 Range Of Motion(ROM) 및 special tests 측정으로 판단하였다. 연구 결과 5증례에서 NRS는 평균 3.4의 호전, WOMAC Index는 평균 64.4%의 호전을 보였다. 슬관절 ROM 측정에서 환자 모두 입원시보다 증가되었으나, 무릎에 손상에 사용되는 보편적 검사인 Stress valgus, Stress varus, Drawer test, Apley compression test, Mcmurray's test 상 전후비교에서 4명의 환자는 호전되었고, 1명 환자에서는 변화가 없었다. 결과 이 연구는 내측 반월상 연골판 손상에 대한 신바로 약침을 포함한 한의학적 치료 후 단기간 내 통증 및 기능 향상을 보여주었다.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.167-174
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• 2012

Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.404-412
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• 2021

Purpose: This study examined the degree of cartilage regeneration by performing second-look arthroscopy in a group of patients who underwent high tibial osteotomy and microfractures for unicompartmental osteoarthritis of the medial knee joint and to determine the factors affecting cartilage regeneration. In addition, this study analyzed whether there is a relationship between the degree of cartilage regeneration and functional results. Materials and Methods: From 2007 to 2015, this study evaluated 81 cases who underwent second-look arthroscopy at the time of plate removal after a microfracture and high tibial osteotomy with a minimum two-year follow-up. The degree of femoral cartilage injury before surgery was classified by ICRS (International Cartilage Research Society), and all were grade III and IV. After second-look arthroscopy, cartilage regeneration was classified into a well-regenerated group (grade I, II) and a poorly regenerated group (grade III, IV). The independent factors influencing cartilage regeneration were identified through multivariate logistic regression analysis. In addition, the functional results were compared before and after surgery between the two groups using the Knee Society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). Results: Age, sex, body mass index, postoperative radiologic factors, and preoperative joint condition did not affect the degree of cartilage regeneration significantly. The large cartilage defect (≥2.0 cm²) (p=0.011) and the presence of kissing lesions (p=0.027) were associated with poor cartilage regeneration. No significant difference in the KSS and WOMAC scores was observed between the group with good and poor cartilage regeneration. Conclusion: The presence of a large cartilage defect and kissing lesions is associated with poor cartilage regeneration after high tibial osteotomy and microfracture. On the other hand, the degree of the regenerated cartilage did not show any correlation with the functional outcome.

• Journal of Acupuncture Research
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• v.22 no.4
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• pp.35-45
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• 2005

Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index. Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, and degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ, VAS were not correlated with the thermal differences of each region. Conclusion : Futher study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.