• 대한간호학회지
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• 제50권4호
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• pp.554-570
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• 2020

Purpose: This study aimed to develop and test a structural equation model of health-related quality of life among older women following bilateral total knee replacement based on a literature review and Wilson and Cleary's model of health-related quality of life. Methods: One hundred ninety three women who were diagnosed with osteoarthritis, were older than 65 years, and were between 13 weeks and 12 months of having a bilateral total knee replacement were recruited from an outpatient clinic. Data were collected from July 2017 to April 2018 using a structured questionnaire and medical records. Data were analyzed using SPSS/WIN 22.0, AMOS 22.0, and Smart PLS 3.2.4. Results: The fitness of the hypothetical model was good, with coefficients of determination (R²) ranging between .28 and .75 and predictive relevance (Q²) between .26 and .73. The standardized root mean square residual of the model fit indices for the hypothetical model was .04; which explained 64.2% of physical and 62.5% of mental health-related quality of life. Self-efficacy, symptom status, functional status, and general health perceptions had a significant direct effect on physical health-related quality of life, while social support, symptom status, and general health perceptions had a significant direct effect on participants' mental-health-related quality of life. Conclusion: To improve the physical and mental quality of life of older women who receive bilateral knee replacement, nursing-based intervention strategies that reduce symptoms, improve functional status, and increase health perceptions, self-efficacy, and social support are needed. The most important factor is the symptom status.

• The Korean Journal of Pain
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• 제21권3호
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• pp.211-216
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• 2008

Background: Postoperative pain after bilateral total knee replacement (TKR) is expected to be more severe than unilateral TKR. Intravenous patient-controlled analgesia (IV PCA) is less effective than other methods of pain management especially immediately after an operation even though it is an easily controlled method for managing pain. This study was designed to evaluate the effect of femoral nerve blocks combined with IV PCA after bilateral TKR for postoperative pain control. Methods: The patients in group I (n = 20) were given only IV PCA with morphine and group II (n = 20) were given bilateral femoral nerve blocks with 12 ml of 0.25% bupivacaine and epinephrine 1 : 400,000 before extubation followed by an IV PCA. Main outcome measures included numerical rating pain score, cumulative opioid consumption, hourly dose during each time interval, and side effects. Results: The pain score in group II was significantly lower than that in group I immediately after recovery of awareness and at 3, 6, 12 hours postoperatively. Cumulative opioid consumption was significantly decreased in group II during the first 48 hours postoperatively. The hourly dose in group II was also significantly lower than that in group I until 12 hours postoperatively. There was no difference in side effects between the groups. Conclusions: We concluded that bilateral femoral nerve blocks improve analgesia and decrease morphine use during IV PCA after bilateral TKR.

• 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.

• 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.

• Physical Therapy Rehabilitation Science
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• 제8권3호
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• pp.170-174
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• 2019

Objective: The objective of this study was to investigate the differences in the quality of life between two groups of patients who received or did not receive total knee replacement (TKR) surgery after being diagnosed with knee osteoarthritis (OA), and to investigate changes in the quality of life for persons who had TKR surgery. Design: Cross-sectional study. Methods: The subjects were randomized into a surgery group (n=70) and a non-surgery group (n=65). Subjects were selected from individuals diagnosed with knee OA from Himchan Hospital in Seoul, South Korea. Their sex, age, weight, height, body mass index, unilateral or bilateral, and quality of life were evaluated. Changes in the quality of life was measured using the Short Form-36 Health Survey (SF-36). Seventy out of 135 patients had TKR surgery, and their quality of life was evaluated at 6 months and 12 months after the surgery. Results: SF-36 scores were significantly improved at 6 months and 12 months after the surgery compared to the scores before the surgery (p<0.05). Also, the comparison between 6 and 12 months after surgery showed that the Vitality and Social Function scores in the SF-36 were significantly increased (p<0.05). Conclusions: The findings of this study showed that TKR surgery has a positive effect on the quality of life for persons with knee OA as a therapeutic intervention.

• 대한정형외과학회지
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• 제52권1호
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• pp.92-96
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• 2017

슬관절 전치환술 후 감염은 큰 관심을 가지는 문제로 국소 부위 및 전신적 감염의 형태로 나타날 수 있으며, 때로는 패혈증으로 진행되는 사례가 보고되고 있다. 이러한 패혈증은 신체의 다양한 부위로 전파될 수 있으며 사망에까지 이르게 하는 중대한 합병증이다. 하지만 감염 후 척추로 전이된 경우는 임상 증상이 뚜렷하지 않아 진단이 어려우며, 이러한 증례에 대한 보고는 어떠한 문헌에도 없었다. 이에 양측 슬관절 전치환술 후 감염으로 인하여 패혈증으로 진행되어 척추로 전이된 증례를 보고하고자 한다.