• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.39-45
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• 2009

Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

• The Korea Journal of Herbology
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• v.29 no.4
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• pp.45-52
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• 2014

Objectives : The purpose of this study was to evaluate the efficacy of HT008 on pain relief and functional improvement in participants with mild knee osteoarthritis (OA) in comparison with that of glucosamine sulfate. Methods : This randomized double-blind trial was conducted at Kyung Hee University Medical Center in Seoul where participants with knee pain for more than 6 months and degenerative osteoarthritis were enrolled. The 100 participants were received either HT008 or glucosamine sulfate 750 mg twice daily for 8 weeks and evaluated at baseline, 4 and 8 weeks after the treatment. We primarily evaluated the differences between two groups with respect to changes in the visual analogue score (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score from baseline to week 8. Secondarily the difference between and within two groups with respect to changes in WOMAC stiffness and physical function score, and Lequesne Functional Severity Index (LFI) were also evaluated. Results : At week 8, treatment with HT008 resulted in a significant reduction of the VAS for pain and WOMAC pain scores compared to the glucosamine sulfate (both p=0.003). Patients receiving HT008 experienced statistically significantly greater improvements in WOMAC physical function scores and LFI (p = 0.014 and p=0.016, respectively) than glucosamine sulfate-treated group. The within-group change in WOMAC physical function and stiffness, and LFI during the 8-week intervention revealed significant improvements in HT008-treated group. Conclusions : HT008 treatment allows significant pain reduction and functional improvement compared with glucosamine sulfate. These data confirm HT008 as an effective and safe symptomatic drug for knee OA.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2008.06a
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• pp.41-42
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• 2008

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.19-27
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• 2019

PURPOSE: This study examined which stretching exercise had the most positive effect on increasing the range of motion (ROM) of the knee joint in healthy people and whether there was a difference between continuous stretching and intermittent stretching. METHODS: This study included 30 healthy university students from OOO University. The subjects were asked to sit on a mat and perform hamstring-stretching exercise during which the ROM and muscle tone were measured with pre and post-tests. Each subject was assigned randomly to a continuous stretching group (stretching without relaxation time group, n=10, G1) or intermittent stretching group (stretching with 10s relaxing time group, n=10, G2; and stretching with 20s relaxing time group, n=10, G3). The participants conducted hamstring stretching exercises with a sit-and-reach box at three different rest times (0s, 10s, and 20s). Subsequently, they underwent passive knee extension (PKE) tests, in which the ROM of the knee joint was measured with a goniometer, and the muscle tone was evaluated using a MyotonPro. RESULTS: Significant differences in muscle tone, stiffness, and ROM were observed between pre-test and post-test in each groups (p<.05). Although the post hoc tests indicated no significant differences in muscle tone and ROM between the continuous stretching group and intermittent stretching group (p>.05), the rate of change of the ROM showed that the intermittent stretching group developed more effective maintenance of the hamstring flexibility. CONCLUSION: No significant differences in the muscle tone of the hamstring and ROM of the knee joint were observed according to the hamstring stretching exercises with three different rest times. On the other hand, the rate of change of the ROM showed that intermittent stretching maintained the hamstring flexibility more effectively.

• Physical Therapy Korea
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• v.15 no.2
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• pp.20-29
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• 2008

The purpose of this study was to examine the validity and reliability of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-VA3.0 in patients with hip and knee osteoarthritis (OA). The sample consisted of 301 patients who had received treatments at the physical therapy units of 5 medical institutions in Andong City in june 2006. Questionnaires on the WOMAC were recruited by 12 physical therapists. The internal structure and reliability of the scales were evaluated by means of item-internal consistency (Cronbach's alpha coefficient: ${\alpha}$), item-discriminant validity, and Pearson's relation coefficient. To explore construct validity, we conducted a principal component factor analysis with varimax rotation analysis. The criterion for factor extraction was an eigenvalue >1.0. The average age of the patients was 62.1 years. All WOMAC subscales (pain, stiffness, and physical function) were internally consistent with Cronbach's coefficients of .81, .91, and .80, respectively. The internal consistency reliability of item-each scale were also internally consistent with Cronbach's coefficient of .89 (Pearson's correlation coefficient: .71~.84), .93 (.89~.91), and .96 (.67~.91), respectively. However, high correlation was found among 3 items (.66~.83, .66~.67, and .67~.83), so the item-discriminant validity was low (${\alpha}$ coefficient: .81, .91, .80, respectively). The construct validity by factor analysis was low because it was not consistent With WOMAC-VA3.0. In conclusion, the results reported here confirm the reliability of the WOMAC in patients with OA of the hip and knee. The collection of information on the hip and knee osteoarthritis using this instrument was acceptable to patients. A further prospective multi-center study will be necessary to prove the construct validity.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.11-18
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• 2002

Large soft tissue defects around the knee joint are known to significantly diminish joint function. Severe soft tissue defects on the anterior aspect of the knee joint especially bring on significant joint motion limitation. Although simple split skin grafts can cover the skin defect, the progressing scar contracture of the grafted skin causes joint stiffness. One of the best solutions of large soft tissue defects around the knee joint is covering the defect with a good quality skin flap. Separated flaps with one vascular pedicle are good candidates for covering anterior and posterior aspects of the joint for example. Authors performed 12 cases of combined scapular and latissimus dorsi free flaps from 1984 to 2000. Among them, we experienced 5 cases of knee joint defect covering using the double free flap for coverage of the soft tissue defect with preservation of the knee joint function and satisfactory results. The system of flaps based on the subscapular artery and vein provides a variety of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flap, the serratus anterior and latissimus dorsi muscular flap, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available for multiple tissue defects or complex defects because it can be incorporated with skin, muscle and bone flaps. A main advantage is the independent vascular pedicles of each component, which allow freedom in orientation of each components. Consequently it can be freely applied to any form of three dimensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in five patients to reconstruct massive defects on the extremities with resultant improved joint function. There was no flap failure and minimal complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed. All of the five flaps survived and there was no scar contracture affecting the joint motion.

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.64-70
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• 2023

Background: This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). Methods: In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. Results: A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. Conclusions: Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI. Level of evidence: III.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.56-61
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• 2003

This is a review article about range of motion, stretching, and aerobic exercise in accelerated rehabilitation of knee and shoulder. If the joint was immobilized for a long time after injury, it would cause stiffness and atrophy. Therefore, this program includes various exercise techniques; range of motion for joint stiffness, and stretching for muscle relaxation, and cardiovascular training (e.g., swimming, upper body extremity, stationary bicycle) for prevention of cardiopulmonary function decrease. In accelerated rehabilitation, It is very important factor to make interaction between clinical exercise specialist and patients. Also, we recommend that they should discuss with sports medicine doctor as a team members the following; pain, adaptation of exercise, fitness level, and progression of program.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.82-89
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• 2014

Purpose: This study was conducted in order to develop an instrument for the Korean Osteoarthritis Impact Measurement scale (KAIMS) in hip and knee osteoarthritis patients. Methods: A sample of 426 subjects was recruited in Ulsan metropolitan city (six hospitals and clinics) and Andong city (five hospitals and clinics) from June 2010 to May 2011. Item internal consistency and item discriminant validity were analyzed on the item-level, and floor (%) and ceiling (%) effect were analyzed on the scale-level. Exploratory factor analysis was performed for construction of items in the KAIMS instrument; confirmative factor analysis was also performed to test the fit of the model. Results: In 426 respondents, age was 64.3 years. The reliability for r coefficient 0.90 (mobility) and 0.89 (pain and stiffness) (Cronbach's alpha 0.95, 0.95 respectively) was high in the test-retest, and there was no significant difference in paired t-test (p>0.05). Item internal consistency (${\alpha}=0.92$, ${\alpha}=0.87$ respectively) was also high. It was constructed of two factors (mobility, pain and stiffness dimension) and nine items in explanatory factor analysis; results of confirmatory factor analysis also indicated that the dimensional structure model was fitted well in the test of model fit (${\chi}^2=83.83$, df=26, p=0.000; RMR=0.05; GFI=0.96; AGFI=0.83). Conclusion: In conclusion, the results of this study showed that the KAIMS that was developed was a reliable and valid instrument for measurement of osteoarthritis (OA) patients. We recommend further research for additional development of the instrument on OA in Korea.

• Journal of Acupuncture Research
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• v.23 no.6
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• pp.239-254
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• 2006

The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.