• Physical Therapy Rehabilitation Science
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• v.8 no.3
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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.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.112-117
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• 2006

Deep vein thrombosis and pulmonary embolism are serious fatal complication after orthopedic surgery. Most of them occur after large operation such as total knee/hip arthroplasty. Some reports about deep vein thrombosis after simple arthroscopic procedure were on the Western literatures, but there was no report on the Korean literature. So we report two cases of pulmonary embolism after knee arthroscopic procedures.

• Journal of Korean Academy of Nursing
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• v.43 no.3
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• pp.352-360
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• 2013

Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

• Journal of East-West Nursing Research
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• v.17 no.2
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• pp.96-102
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• 2011

Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.17-23
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• 2018

Objective: Opioid analgesics, for postoperative pain management, are an indispensable group of medication; however, they also have a variety of adverse drug reactions (ADR). Multimodal methods, combining non-opioid analgesics with opioid analgesics, have been investigated to increase the effects of analgesics and reduce ADR with opioid-sparing effects. The purpose of this study was to compare the effects of patient-controlled analgesia (PCA) with fentanyl alone, and PCA with fentanyl and intravenous (i.v.) propacetamol to determine the effects of pain control, cumulative opioid usage, and opioid ADR. Methods: The subjects were patients who underwent total knee arthroplasty at the Seoul Veterans hospital from January 1, 2015 to December 31, 2016. The study period was from postoperative day 0 (POD0) to day 3 (POD3), and the retrospective study was conducted using electronic medical records. Results: Pain severity was significantly low at POD1 (p = 0.017), POD2 (p = 0.003), and POD3 (p = 0.002) in the multimodal group. The fentanyl only group frequently reported both moderate and severe pain at a statistically significant level. This was consistent with the analysis of the pro re nata (PRN) intramuscular analgesia usage at the time of numerical rating scale (NRS) 4 and above. The opioid-sparing effect confirmed that the average opioid dose equivalent to i.v. morphine dose was 9.4 mg more than that used for the multimodal group in the fentanyl only group. The ADRs and length of stay between the two groups were not statistically different. Conclusion: The results of this study suggest that the combination therapy of fentanyl and i.v. propacetamol is superior to fentanyl monotherapy.

• Journal of muscle and joint health
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• v.21 no.3
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• pp.215-223
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• 2014

Purpose: The purpose of this study was to examine the effect of a progressive lower-extremity exercise program on pain, efficacy of exercise, and the life satisfaction among older women with TKRA. Methods: This study was a nonequivalent control group non synchronized design and was conducted from 12 September 2012 to 05 February 2014 in G-university hospital located in J-city. The sample was composed of an experimental group (n=20) and a control group (n=20). The progressive lower extremity exercise program was applied to the experimental group for 13 days. NRS scale was used to measure the pain, self-efficacy of exercise was measured by Exercise Self Efficacy, and life satisfaction was measured by 8 item questionnaire. Results: The experimental group was significantly lower in the degree of pain (F=73.53, p<.001), higher in the degree of self-efficacy of exercise (F=61.42, p<.001) and life satisfaction (F=80.91, p<.001) than the control group. Conclusion: The progressive lower-extremity exercise program for TKRA patients was useful to reduce pain and improve self-efficacy of exercise and life satisfaction, To reduce the pain and th improve the life satisfaction of older women with TKRA, we need to provide the progressive exercise at bedside during the postoperative recovery phase.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.45-49
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• 2017

Background: The purpose of this study was to investigate the effect of structured cryotherapy on edema of patients who had a total knee arthroplasty (TKA). Methods: The subjects were 58 patients who were diagnosed with osteoarthritis and had total knee arthroplasty in D hospital. In total, 29 people were in the leg elevation cryotherapy group (LECTG), 29 people were in the control group (CTG). After TKA, the patients' swelling on post operation days (POD) 3 were checked. After the post OP checking, LECTG was treated with cryotherapy with leg elevation for 12 days but CTG was cryo therapy with sit on chair. Results: Swelling show significant difference within the group (p<.05), but did not show signigicant difference between groups (p>.05). Conclusions: Base on the results, it was found the cryo therapy of $-78^{\circ}C$ improved swelling after TKA. Accordingly, it is thought that cryo therapy of $-78^{\circ}C$ has positive effect on swelling in the process of recovery after operation. but It did not approve that the leg elevation was even more effective. For this study, the reserch developed to enhance the effectiveness of the cryotherapy, would make it possible to apply to an effective cryotherapy posture.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.170-177
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• 2013

Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.411-417
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• 2019

Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.

• Journal of Biomedical Engineering Research
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• v.20 no.1
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• pp.37-44
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• 1999

Because of bone resorption, wear of ultra-high molecular weight polyethylene(UHMWPE) in total knee arthroplasty has been recognized as a major factor in long-term failure of knee implant. The surface damage and the following harmful wear debris of UHMWPE is largely related to contact stress. Most of the previous studies focused on the contact condition only at the articulating surface of UHMWPE. Recently, contact stress at the metal-backing interface has been implicated as one of major factors in UHMWPE wear. Therefore, the purpose of the is study is to investigate the effect of the contact stress for different thickness, conformity friction coefficient, and flexion degree of the UHMWPE component in total knee system, considering the contact conditions at both interfaces. In this study, a two-dimensional non-linear plane strain finite element model was developed. The results showed that the maximum value of von-Mises stress occurred below the articulating surface and the contact stress was lower for the more conforming models. All-polyethylene component showed lower stress distribution than the metal-backed component. With increased friction coefficient on the tibiofemoral contact surface, the maximum shear stress increased about twofold.