• 대한의용생체공학회:의공학회지
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• 제29권6호
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• pp.431-435
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• 2008

Quantitative information of a three dimensional(3D) kinematics of joint is very useful in knee joint surgery, understanding how knee kinematics related to joint injury, impairment, surgical treatment, and rehabilitation. In this paper, an automated 2D/3D image matching technique was developed to estimate the 3D in vivo knee kinematics using dual X-ray images. First, a 3D geometric model of the knee was reconstructed from CT scan data. The 3D in vivo position and orientation of femoral and tibial components of the knee joint could be estimated by minimizing the pixel by pixel difference between the projection images from the developed 3D model and the given X-ray images. The accuracy of the developed technique was validated by an experiment with a cubic phantom. The present 2D/3D image matching technique for the estimation of in vivo joint kinematics could be useful for pre-operative planning as well as post-operative evaluation of knee surgery.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.101-104
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• 2014

Reconstruction of soft tissue defects of the knee has always been a challenging task for plastic surgeons. Various reconstructive choices are available depending on the location, size, and depth of the defect relative to the knee joint. Defects on the knee joint have several characteristic features. The use of a free flap is preferred for reconstructions involving obliteration of large-cavity defects, but recipient pedicle isolation can be difficult because of the extent of the injury zone. Furthermore, the true defect during knee joint flexion is larger than during knee joint extension, and a durable flap is necessary for joint movement. We report for the first time on the use of pedicled perforator flaps for reconstruction of bilateral knee defects in a 76-year-old woman. The operative procedure required skeletonizing the perforators of an antero-lateral thigh flap and antero-medial thigh flap and rotating the flap in the defect. The patient returned to normal daily activity and had a full range of motion two months after the accident. The shorter operating time with decreased donor site morbidity and its durability make this flap a valuable alternative for soft tissue reconstruction of the knee.

• 한국정밀공학회지
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• 제29권2호
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• pp.239-244
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• 2012

The prevalence of knee osteoarthritis was higher people with lower limb amputation. This was identified that transfemoral amputees have a greater external knee adduction moment than ablebodied subjects by biomechanical studies. Therefore, they need rehabilitative intervention for prevention and reduction of knee osteoarthritis. The purpose of this study was to determine the effect of lateral wedge insole used in the treatment of knee osteoarthritis. This study was participated in fourteen unilateral transfemoral amputees and we were analyzed the difference gait variables between without lateral wedge insole and with $5^{\circ}$ and $10^{\circ}$ lateral wedge insole during gait. Our results showed that step length ratio was more symmetrical and, hip adduction and ankle inversion angle were more close to normal value, and knee adduction moment was decreased as the wedge angle increases. We proposed that these data would be utilized conservative treatment of knee osteoarthritis in lower limb amputees.

• Advances in biomechanics and applications
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• 제1권4호
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• pp.269-277
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• 2014

In skin-marker based motion analysis, knee translation measurement is highly dependent on a pre-selected reference point (functional center) on each segment determined by the location of anatomical landmarks. However, the placement of skin markers on palpable anatomical landmarks (i.e., femoral epicondyles) has limited reproducibility. Thus, it produces large variances in knee translation measurement among different subjects, as well as across studies. In order improve the repeatability of knee translation measurement, in this study an optimization method was introduced, by which the femoral functional center was numerically determined. At that point the knee anteroposterior translation during the stance phase of walking was minimized. This new method was tested on 30 healthy subjects during walking in gait lab with motion capture system. Using this new method, the impact of skin marker position (at anatomical landmarks) on the knee translation measurement has been minimized. In addition, the ranges of anteroposterior knee translations during stance phase were significantly (p<0.001) smaller than those measured by conventional method which relies on a pre-selected functional center ($11.1{\pm}3.5mm$ vs. $19.9{\pm}5.5mm$). The results of anteroposterior translation using this new method were very close to a previously reported knee translation (12.4 mm) from dual fluoroscopic imaging technique. Moreover, this new method increased the reproducibility of knee translation measurement by 50%.

• 한방재활의학과학회지
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• 제28권2호
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• pp.105-111
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• 2018

Objectives The purpose of this study was to examine the effects muscle fatigue at the knee muscles on balance during standing in healthy adults. Methods Thirty healthy adults were recruited along with their written informed consent. Subjects were randomly assigned to knee extensor group (fatigue on knee extensor, KE), and knee flexor group (fatigue on knee flexor, KF). And subjects performed exercise with each muscle group until muscle fatigue was induced. They were assessed balance ability by functional reaching test (FRT), limit of stability (LOS), and postural sway (one leg standing, normal eye open (NO), normal eye close (NC), pillow with eye open (FO), and pillow with eye close (FC)) before and after fatigue. Results There were significant group differences balance performances in FRT, anterior of limit of stability, one leg standing, and the muscle fatigue of knee muscles were decreased balance performances. The balance performance was affected by visual sense and proprioception. Conclusions These results show that the muscle fatigue of knee muscles decreased balance performance. Therefore, balance exercise program should be trained without muscle fatigue.

• 대한기계학회논문집A
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• 제28권11호
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• pp.1664-1671
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• 2004

It is necessary to have a model that describes the feature of the knee Joint with a sufficient accuracy. Koreans, however, do not have their own knee joint model to be used in the total knee replacement arthroplasty. They have to use European or American models which do not match Koreans. Three-dimensional visualization techniques are found to be useful in a wide range of medical applications. Three-dimensional imaging studies such as CT(computed tomography) and MRI(magnetic resonance image) provide the primary source of patient-specific data. Three-dimensional knee joint models were constructed by image processing of the CT data of 10 subjects. Using the constructed model, the dimensions of Korean knee joint were measured. And this study proposed a three-dimensional model and data, which can be helpful to develop Korean knee implants and to analyze knee joint movements.

• Knee surgery & related research
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• 제30권4호
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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.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.1-7
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• 2022

Objective: The purpose of this study was to assess the validity of the global rating of knee function as a measure of participation restrictions experienced during activities of daily living and sports by patients with a history of anterior cruciate ligament reconstruction (ACLR). Design: Cross-sectional study. Methods: Forty-three subjects (33 males, 10 females, age=20.3 ± 1.3 years), at a mean of 31.2 ± 14.4 months following ACLR, participated in this study. During testing, subjects were first asked to provide a global rating of function by assessing their level of knee function on a 0 to 100 scale, with 0 points representing complete loss of function due to their knee injury and 100 points representing their level of function prior to their knee injury. After providing a global rating of function, subjects completed the Knee Outcome Survey (KOS) Activities of Daily Living Scale (ADLS) and Sports Activity Scale (SAS), which served as the measure of participation restrictions in this study. Results: Pearson product correlations revealed moderate relationships between the global rating of function and the ADLS (r=0.66, p<0.0001) and SAS (r=0.69, p<0.0001). Conclusions: The global rating of knee function provides a valid measure of participation restrictions experienced during activities of daily living and sports by patients with a history of ACLR.

• 디지털융복합연구
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• 제16권6호
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• pp.213-222
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• 2018

본 연구의 목적은 밸런스 테이핑 요법이 노인의 무릎 통증과 관절가동범위에 미치는 효과를 검증하고자 시도하였다. 연구방법은 비동등성 대조군 전후설계의 유사실험연구로 자료수집은 2014년 12월 5일부터 10일까지 시행되었다. 연구대상은 노인여가복지시설을 이용하며 무릎 통증이 있는 60세 이상의 노인을 대상으로 하였다. 실험군(n=21)에게는 슬관절 밸런스 테이핑을 적용하였고, 대조군(n=19)에게는 테이핑 적용을 하지 않았다. 두 군의 무릎 통증 및 관절가동범위를 중재 전, 중재 1시간 후, 중재 24시간 후에 측정하였다. 통계분석은 SPSS/WIN 21.0 프로그램을 이용하였으며, ${\chi}^2$ test, Fisher's exact test, Mann-Whitney test, t-test, 반복측정 분산분석을 실시하였다. 연구결과 대조군에 비해 슬관절 밸런스 테이핑 요법을 받은 실험군에서 무릎 통증이 유의하게 감소하였고(F=34.03, p<.001), 무릎 관절가동범위가 유의하게 증가하였다(F=7.83, p=.006). 본 연구를 통해 슬관절 밸런스 테이핑 요법이 노인의 무릎 통증에 적용 가능한 독자적인 간호중재임을 확인하였다.

• 한국운동역학회지
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• 제25권3호
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• pp.275-281
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• 2015

Objective : In order for Taekwondo athletes to perform destructive kicking performance, they are expected to have Taekwondo-specific muscle properties such as high muscle strength and power. The purpose of this study was to investigate the joint angle-dependent force-producing property of Taekwondo athletes' knee extensor muscles, which is one of the primary muscle groups involved in kicking performance. Method : Ten Taekwondo male athletes (age: $19.9{\pm}0.7yrs$, height: $180.6{\pm}6.2cm$, body mass: $75.9{\pm}8.9kg$, career: $9.2{\pm}2.9yrs$.) and 10 healthy male non-athletes (age: $26.3{\pm}2.6yrs$, height: $174.2{\pm}4.8cm$, body mass: $72.8{\pm}7.7kg$) participated in this study. Subjects performed maximum isometric knee extension at knee joint angles of $40^{\circ}$, $60^{\circ}$, $80^{\circ}$, and $100^{\circ}$ (the full knee extension was set to $0^{\circ}$) with the hip joint angles of $0^{\circ}$ and $80^{\circ}$ (the full extension was set to $0^{\circ}$). During the contractions, knee extension torque using an isokinetic dynamometer simultaneously with muscle activities of the rectus femoris (RF), and the vastus lateralis (VL) and vastus medialis (VM) using surface electromyography were recorded. Based on the torque values at systematically different knee-hip joint angles, the joint torque-angle relationships were established and then the optimal joint angle for the knee extensor was estimated. Results : The results of this study showed that the isometric knee extension torque values were greater for the Taekwondo athletes compared with the non-athlete group at all hip-knee joint angle combinations (p<.05). When the hip joint was set at $80^{\circ}$, the peak isometric torque was greater for the Taekwondo athletes compared with the non-athlete group ($313.61{\pm}36.79Nm$ and $221.43{\pm}35.92Nm$, respectively; p<.05) but the estimated optimum knee joint angles were similar ($62.33{\pm}5.71^{\circ}$ and $62.30{\pm}4.67^{\circ}$ for the Taekwondo athletes and non-athlete group, respectively). When the hip joint was set at $0^{\circ}$, the peak isometric torque was greater for the Taekwondo athletes compared with the non-athlete group ($296.29{\pm}45.13Nm$ and $199.58{\pm}25.23Nm$, respectively; p<.05) and the estimated optimum knee joint angle was larger for the Taekwondo athletes compared with the non-athlete group ($78.47{\pm}5.14^{\circ}$ and $67.54{\pm}5.77^{\circ}$, respectively; p<.05). Conclusion : The results of this study suggests that, compared with non-athletes, Taekwondo athletes have stronger knee extensor strength at all hip-knee joint angle combinations as well as longer optimum muscle length, which might be optimized for the event-specific required performance through prolonged training period.