• Title/Summary/Keyword: knee arthroplasty

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Prospective Study of Central versus Peripheral Obesity in Total Knee Arthroplasty

  • Armstrong, John G.;Morris, Tyler R.;Sebro, Ronnie;Israelite, Craig L.;Kamath, Atul F.
    • Knee surgery & related research
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    • v.30 no.4
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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.

Influence of Interferential Current Therapy and Laser Therapy on Functional Recovery after Total Knee Replacement

  • Oh, Seung-Keun;Kim, Yong-Nam
    • The Journal of Korean Physical Therapy
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    • v.26 no.3
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    • pp.175-181
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    • 2014
  • Purpose: The purpose of this study is to investigate the effects of interference current therapy and laser therapy on functional recovery after total knee arthroplasty by measuring the Berg balance scale and range of motion. Methods: Subjects were 30 patients who were admitted to G Hospital after total knee arthroplasty. They were randomly assigned to experimental group I in which interference current therapy was applied (n=10), experimental group II in which laser therapy was applied (n=10), or the control group (n=10). The Berg balance scale and range of motion of the subjects were measured before, after 2 weeks, and after 4 weeks of therapy. Results: There was a statistically significant change (p<0.05) in the Berg balance scale and range of motion before and after therapy intervention among the laser therapy group and the interference current therapy group. There was also a significant change between the groups in the Berg balance scale and range of motion. Tukey's post hoc comparison showed a statistically significant difference between the control group and experimental group I and between the control group and experimental group II (p<0.05). Conclusion: The application of interference current therapy and laser therapy resulted in a significant change in both the Berg balance scale and range of motion among patients with total knee arthroplasty. The findings of this study can be used as preliminary clinical data in evaluating functional recovery in patients with total knee arthroplasty in a post-clinic setting.

Arthrodesis of the Knee with Vascularized Fibular Graft - A Case of Infected Total Knee Arthroplasty - (혈관 부착 비골 전위술을 이용한 슬관절 유합술 - 슬관절 전치환술 후 감염이 합병된 증례 -)

  • Chung, Duke-Whan;Han, Chung-Soo;Lee, Jae-Hoon;Jeong, Sun-Teak;Park, Jin-Sung
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.111-116
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    • 2006
  • An infection after total knee arthroplasty has many complications such as severe bone defect, skin and soft tissue problems, devastated general condition, so arthrodesis is preferred as treatment option. However, poor bony contact due to severe bone defect and inadequate conditions of the soft tissue often cause nonunion or severe limb shortening after arthrodesis. More over these conditions, it is not easy to choose appropriate fixative devices. In these situations, the arthrodesis using vascularized fibular graft can be the solution. Vascularized fibular graft (VFG) can playa role as a suitable material for the treatment of bone defects. And VFG can overcome poor blood circulation caused by scar tissues, and can be relatively more durable and adequate length. In the long term, VFG can be hypertrophied by weight bearing, and will give mechanical stablility. The purpose of the paper is to report the successful results of arthrodesis using VFG in a patient who got extensive bone defect after failed revision total knee arthroplasty with infection.

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Factors Influencing Health-related Quality of Life among Knee or Hip Arthroplasty Patients (하지 인공관절 치환술 환자의 건강 관련 삶의 질 영향요인)

  • Kang, Mi Kyung;Kim, Geun Jin;Kim, Hye Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.3
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    • pp.209-218
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    • 2017
  • Purpose: The purpose of this research was to identify factors that influence health-related quality of life of patients who have had knee or hip arthroplasty. Factors included sleep disorders, pain, activities of daily living, and depression. Methods: The participants in this research were 97 patients within one year after receiving knee or hip arthroplasty surgery and who regularly visited a hospital outpatient department. Data were analyzed using descriptive statistics, t-test, ANOVA, and stepwise regression analysis with the SPSS program. Results: Sleep disorders, pain, activities of daily living, and depression had significant correlations with health related quality of life. Factors influencing health-related quality of life among arthroplasty patients were the length of time since surgery, sleep disorders, activities of daily living, and depression. These factors explained 58% of the participants' health-related quality of life. Conclusion: The results show that various factors can affect patients' health-related quality of life following joint replacement surgery. The findings indicate that sleep disorders and depression should receive continued attention after the arthroplasty. It is also necessary to develop appropriate nursing intervention programs to lower depression and increase patient participation in daily living activities.

The Effect of an Exercise Program with Patella Mobilization on Range of Motion, Muscle Strength and Gait in Patients with Total Knee Arthroplasty (무릎뼈 관절가동술을 동반한 운동프로그램이 무릎관절 전치환술 환자의 관절가동범위, 근력, 보행에 미치는 영향)

  • Lee, Jaehong;Min, Dongki;Lee, Sangjae
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.1
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    • pp.1-14
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    • 2020
  • Purpose : The purpose of this study was to investigate the effect of an exercise program with patella mobilization on range of motion, muscle strength, and gait in patients with total knee arthroplasty. Methods : Thirty patients under the age of 65 who visited the T hospital in Daegu Metropolitan City and underwent total knee arthroplasty surgery were selected for this study. Fifteen patients were randomly assigned to the experimental group and took part in an exercise program with patella mobilization, and fifteen patients were randomly assigned to the control group and took part in just the exercise program. Each group took part in their intervention three times a week for four weeks. The measurement tools used included a goniometer, handheld dynamometer, and 10-meter walking test. In the statistical analysis results, to compare the about pre and post test differences within each group, a paried t-test was used, and to compare the differences between each group, an independent t-test was used. Results : There was a significant difference (p<.05) in the range of motion, muscle strength of the quadriceps femoris and, hamstrings, and 10-meter walking test within each individual group and between the two groups before and after the intervention (p<.05). Conclusion : All the results for the experimental group were significant. Therefore, it is expected that an exercise program with patella mobilization will be helpful for the recovery of the knee joint in patients who have undergone total knee arthroplasty.

Arteriography and Embolization of Lateral Inferior Genicular Artery of Recurrent Spontaneous Hemarthrosis after Total Knee Arthroplasty (인공 슬관절 치환술 후 발생한 재발성 혈관절증의 치료를 위해 시행한 혈관조영술 및 하외슬동맥색전술)

  • Chon, Je-Gyun;Kang, Jong-Won;Yoon, Ja-Yeong;Jeong, Uitak
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.173-177
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    • 2021
  • Recurrent spontaneous hemarthrosis is a relatively rare complication of total knee arthroplasty. This paper reports a case of a patient treated with arterial embolization for recurrent spontaneous hemarthrosis even after undergoing arthroscopic surgery. The patient had several relapses after total knee arthroplasty.

Simulation of Three Dimensional Motion of the Knee Joint in Total Knee Arthroplasty (인공 무릎 관절의 3차원 운동 시뮬레이션)

  • Moon, Byung-Young;Son, Kwon;Kim, Ki-Bum;Seo, Jung-Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.9
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    • pp.188-195
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    • 2004
  • Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

Arthroscopic Diagnosis of Polyethylene Wear of Meniscal Bearing in Unicompartmental Knee Arthroplasty - A Case Report - (인공 슬관절 단일구획 치환술 후 폴리에틸렌 마모의 관절경적 진단 - 증례 보고 -)

  • Kang, Kyu-Bok;Yoon, Jung-Ro;Park, Sung-Chul;Song, Seungyeop;Yang, Jae-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.190-194
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    • 2012
  • The role of arthroscopy for the diagnosis of polyethylene wear after total knee arthroplasty has been reported previously. In this report, we demonstrate a case of wear of meniscal bearing in unicompartmental knee arthroplasty (UKA) and recurrent meniscal bearing subluxation which was diagnosed by arthroscopy. Arthroscopic examination has its role in diagnosing the wear and subluxation of polyethylene bearing after UKA.

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Evaluation of Biomechanical Stability of Newly Developed Revision Total Knee Arthroplasty through Strain and Stress Distribution Analysis within the Tibia: Finite Element Analysis (경골 내 변형률 및 응력 분포 특성 분석을 통한 새로이 개발된 재치환용 인공슬관절의 생체역학적 안정성 평가: 유한요소해석)

  • Han, Paul;Jang, Young-Woong;Yoo, Oui Sik;Kim, Jung Sung;Kim, Han Sung;Lim, Dohyung
    • Journal of Biomedical Engineering Research
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    • v.34 no.1
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    • pp.14-23
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    • 2013
  • In this study, biomechanical stability of the newly developed revision total knee arthroplasty (rTKA) was evaluated through strain and stress distribution analysis within the implanted proximal tibia using a three-dimensional finite element (FE) analysis. 2000N of compressive load (about 3 times body weight) was applied to the condyle surface on spacer, sharing by the medial (60%) and lateral (40%) condyles simulating a stance phase before toe-off. The results showed that PVMS within the revision total knee arthroplasty and the proximal tibia were less than yield strength considering safe factor 4.0 (rTKA: less than 10%, Cortical bone: less than 70%, Cancellous bone: less than 70%). The materials composed of them and the strain and stress distributions within the proximal tibia were generally well matched with those of a traditional revision total knee arthoplasty (Scorpio TS revision system, Stryker Corp., Michigan, USA) without the critical damage strain and stress, which may reduce the capacity for bone remodeling, leading to bone degeneration. This study may be useful to design parameter improvement of the revision total knee arthoplasty in biomechanical stability point of view beyond structural stability of revision total knee arthoplasty itself.