• Title/Summary/Keyword: osteoarthritis of knee

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A Newly Designed Miniplate Staple for High Tibial Osteotomy (근위골절술을 위한 Staple 설계)

  • Mun, Mu-Seong;Bae, Dae-Kyung
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.05
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    • pp.19-22
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    • 1995
  • A biomechanical study was made to demonstrate the superior mechanical performance of the newly designed Miniplate staple to the conventional Coventry staple in high tibial osteotomy(HTO). Using twenty fresh porcine tibiae, the fixational strengh of the two different types of staple in HTO was compared. To minimize the error due to the specimen-to-specimen individuality, the bone mineral density of the tibiae was measured with a bone densitometry (Dual photon absorptionometer, Luner, USA) and those with $0.8\;{\sim}\;1.2\;gm/cm^2$ at the proximal tibia was used in the biomechanical test. Testing was performed on a material testing system (Autogram ET-5, Shimatzu, Japan) with aid of a commercial data processor (IBM 80386/ ASYST). Using two differant loading modes, 'pull-out' and 'push-out', the maximum resistant force required to release the staple from the substrate bone was recorded. In the pull-out test, ten non-osteotomized specimens were used and the staple was pullout by subjecting an axial tension on the head of the staple inserted. While in the pull-out test where ten tibiae osteotomized in the usual way of HTO were used, the staple was not directly loaded. In this testing, as a mimic condition of the natural knee, the distal part of the specimen tibia was pushed horizontally in order for the staple to be pulled out while the proximal tibia was fixed. The pull-out strength of Coventry staple and miniplate staple were found to be $27.88\;{\pm}\;5.12\;kgf$ and $182.47\;{\pm}\;32.75\;kgf$, respectively. The push-out strength of Coventry staple and miniplate staple were $18.40\;{\pm}\;4.47\;kgf$ and $119.95\;{\pm}\;19.06\;kgf$, respectively. The result revealed that miniplate staple had the pull-out/ push-out strength at least fivetimes higher than Coventry staple. Based on the measured data, it was believed that the newly designed miniplate staple could provide much better postoperative fixation in HTO. The postoerative application of long leg casting may not be needed after HTO surgery.

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The Effects of Cryotherapy Treatment with Leg Elevation on Swelling of Patient Who had an TKA (슬관절 전치환술(TKA) 환자를 대상으로 다리거상과 냉치료 적용이 부종에 미치는 영향)

  • Lee, Jae-hong;Lee, Jin-hwan;Min, Dong-ki;Lee, Jae-kwang;Kim, Jong-woo
    • 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.

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Analysis of the Current State of Home Health Nursing for Elderly Patients in Advanced General Hospital (일 상급종합병원 노인 환자의 가정간호 서비스 이용 현황 분석)

  • Park, Sung Hye;Jang, Yeon Soo;Kim, Su Jin
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.275-284
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    • 2019
  • Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

Comparison of the Incidence and Risk Factors for Developing Osteoarthritis after ACL Reconstruction - Patellar Versus a Hamstring Autograft - (전방 십자 인대 재건술 후 골관절염의 발생 빈도 및 위험 인자들에 대한 비교 - 자가 슬개건과 자가 슬괴건을 이용한 방법 -)

  • Song, Eun-Kyoo;Seon, Jong-Keun;Kim, Hyung-Soon;Kang, Kyung-Do;Byun, Jae-Wook
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.48-57
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    • 2010
  • Purpose: To compare the incidence and risk factors for osteoarthritis after anterior cruciate ligament (ACL) reconstruction between two groups using bone-patellar tendon-bone (BPTB) and hamstring tendon (HT) autograft. Materials and Methods: 53 cases of ACL reconstruction using patellar tendon and 40 cases using hamstring tendon were followed up at least 8 years. Radiographic evaluation was done according to the Kellgren and Lawrence's classification. Clinical functional testing (Lysholm Knee Scores, the Tegner activity scores) and laxity testing (Lachman, pivot shift tests), and the instrumented laxity testing with $Telos^{(R)}$ were all examined in relation to the development of osteoarthritis. Results: Radiographic osteoarthritic changes were detected in 24 patients (45.3%) in BPTB group and 14 patients (35.0%) in HT group. Accompanying meniscal injury (BPTB p<0.001; HT p=0.091), intervals from the injury to reconstruction of > 12 months (BPTB p=0.037; HT p=0.021), and patient's age at reconstruction of > 25 years (BPTB p=0.003; HT p=0.048) were found to be significant independent predictors of osteoarthritis. However, no statistically significant correlations were found between the development of osteoarthritis and the clinical outcome or the radiographic stability in both groups. Conclusion: Although ACL reconstruction using BPTB or HT autograft had good clinical results at an average follow-up of 10 years, considerable incidence of radiographic osteoarthritic changes were noted. Various factors such as accompanying meniscal injury, protracted time from injury to reconstruction, more than 25 years old at the time of reconstruction were related to radiographic osteoarthritic changes.

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Effects of Oyster Shell Extract on Papain-induced Osteoarthritis in C57BL/6J Mice (굴 패각 추출물이 Papain으로 유도된 골관절염 C57BL/6J Mice에 미치는 영향)

  • Lee, Se-Young;Kim, Hak-Ju;Han, Ji-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.8
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    • pp.1183-1189
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    • 2013
  • We investigated the effects of oyster shell extract (OSE) on papain-induced osteoarthritis in C57BL/6J mice. Osteoarthritis was induced in mice by a papain injection into the knee joint. The mice were divided into a total of five groups (n=8). The normal group was untreated, whereas the papain group (negative control) was induced with osteoarthritis and treated with water daily. The papain+DS group (positive control) was treated with diclofenac sodium. Papain+OSE groups were treated with OSE concentrations of 100 and 200 mg/kg/bw for 20 days. Proteoglycan content in articular cartilage was analyzed through safranine-O fast green staining and H&E staining. The histopathological changes in cartilage were measured by the Rudolphi score approach. The contents of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin (IL)-$1{\beta}$, and IL-6 in plasma were analyzed by the ELISA method. After experiments, body weights of the treated groups were not significantly different compared with the normal group. Cartilage loss and joint instability significantly improved in a dose-dependent manner in the OSE-treated group compared with the papain group (P<0.05). Proteoglycan content was significantly higher in the OSE-treated group than the papain group (P<0.05). Osteoarthritis scores of the OSE-treated group were significantly decreased compared with the papain group (P<0.05). TNF-${\alpha}$, IL-$1{\beta}$, and IL-6 content in the plasma of the papain+OSE treated groups significantly decreased in a dose-dependent manner compared with the papain group (P<0.05). These results suggest that OSE treatment might have anti-arthritic effects on papain-induced osteoarthritis in C57BL/6J mice.

Decay-Accelerating Factor Differentially Associates With Complement-Mediated Damage in Synovium After Meniscus Tear as Compared to Anterior Cruciate Ligament Injury

  • V. Michael Holers;Rachel M. Frank;Michael Zuscik;Carson Keeter;Robert I. Scheinman;Christopher Striebich;Dmitri Simberg;Michael R. Clay;Larry W. Moreland;Nirmal K. Banda
    • IMMUNE NETWORK
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    • v.24 no.2
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    • pp.17.1-17.16
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    • 2024
  • We have reported that anterior cruciate ligament (ACL) injury leads to the differential dysregulation of the complement system in the synovium as compared to meniscus tear (MT) and proposed this as a mechanism for a greater post-injury prevalence of post traumatic osteoarthritis (PTOA). To explore additional roles of complement proteins and regulators, we determined the presence of decay-accelerating factor (DAF), C5b, and membrane attack complexes (MACs, C5b-9) in discarded surgical synovial tissue (DSST) collected during arthroscopic ACL reconstructive surgery, MT-related meniscectomy, osteoarthritis (OA)-related knee replacement surgery and normal controls. Multiplexed immunohistochemistry was used to detect and quantify complement proteins. To explore the involvement of body mass index (BMI), after these 2 injuries, we examined correlations among DAF, C5b, MAC and BMI. Using these approaches, we found that synovial cells after ACL injury expressed a significantly lower level of DAF as compared to MT (p<0.049). In contrast, C5b staining synovial cells were significantly higher after ACL injury (p<0.0009) and in OA DSST (p<0.039) compared to MT. Interestingly, there were significantly positive correlations between DAF & C5b (r=0.75, p<0.018) and DAF & C5b (r=0.64 p<0.022) after ACL injury and MT, respectively. The data support that DAF, which should normally dampen C5b deposition due to its regulatory activities on C3/C5 convertases, does not appear to exhibit that function in inflamed synovia following either ACL injury or MT. Ineffective DAF regulation may be an additional mechanism by which relatively uncontrolled complement activation damages tissue in these injury states.

Genome-wide Association Study Identified TIMP2 Genetic Variant with Susceptibility to Osteoarthritis

  • Keam, Bhum-Suk;Hwang, Joo-Yeon;Go, Min-Jin;Heo, Jee-Yeon;Park, Mi-Sun;Lee, Ji-Young;Kim, Nam-Hee;Park, Miey;Oh, Ji-Hee;Kim, Dong-Hyun;Jeong, Jin-Young;Lee, Jong-Young;Han, Bok-Ghee;Lee, Ju-Young
    • Genomics & Informatics
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    • v.9 no.3
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    • pp.121-126
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    • 2011
  • Osteoarthritis (OA) is the most common degenerative joint disorder in the elderly population. To identify OA-associated genetic variants and candidate genes, we conducted a genome-wide association study (GWAS). A total 3,793 samples (476 cases: wrist + knee and 3317 controls) from a community-based epidemiological study were genotyped using the Affymetrix SNP 5.0. An intronic SNP (rs4789934) in the TIMP2 (tissue inhibitor of metalloproteinase-2) showed the most significance with OA (odd ratio [OR] = 2.06, 95% confidence interval [CI] = 1.52-2.81, p = $4.01{\times}10^{-6}$). Furthermore, a poly-morphism (rs1352677) in the NKAIN2 ($Na^+/K^+$ transporting ATPase interacting 2) was suggestively associated with OA (OR = 1.43, CI = 1.22-1.66, p = $7.01{\times}10^{-6}$). The present study provides new insights into the identification of genetic predisposing factors for OA.

Short-Term Effects of an Self-Management Support Intervention on Patient Activation, Joint Flexibiltiy and Health-related Quality of Life among Korean Medical Aid Beneficiaries with Osteoarthritis (지역사회기반의 자기관리지지중재가 골관절염 의료급여수급자의 환자활력, 관절유연성 및 건강 관련 삶의 질에 미치는 단기효과)

  • Ahn, Yang Heui;Hur, Jae Bock;Choi, Eun Hee
    • 한국노년학
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    • v.36 no.3
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    • pp.595-609
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    • 2016
  • The purpose of this study was to test the effectiveness of an eight session self-management support program for improvement of patient activation, joint flexibility and health-related quality of life among medical aid beneficiaries with osteoarthritis. This study was part of a randomized and controlled research of a self-management support intervention. Participants were 60 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=30) or control group (n=30). The 8-session and tailored program led by a trained case manager with the patient-centered approaches and cognitive-emotional-behavioral skills. Analysis included change in scores, ${\chi}^2-test$, Fisher's exact test, t-test and ANCOVA. The results showed significant increase in patient activation, joint flexibility (shoulder and right knee) except health-related quality of life in the experimental group compared to the control group. The self-management support program indicated an effect on patient activation and joint flexibility. Further research is needed to examine the outcome in the long term(9 and 12-month follow up).

Work-related Musculoskeletal Disorders among Agricultural Workers

  • Lee, Soo-Jin;Park, Hwan-Jin
    • Journal of the Ergonomics Society of Korea
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    • v.30 no.4
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    • pp.525-534
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    • 2011
  • This paper describes the current status of musculoskeletal disorders(MSDs) and its ergonomic risk factors, including the preventive intervention in terms of the working conditions and health promotion among agricultural workers. Korean agricultural workers have been exposed to the poor working condition. They have suffered from a variety of work-related injury and diseases more than the general population or the other occupational group. MSDs are one of the most prevalent problems threatening the agricultural worker's health and quality of life. Low back pain, osteoarthritis of hip and knee joint and carpal tunnel syndrome are well known MSDs that was found easily and frequently among agricultural workers. MSDs are worsened by poor ergonomic working conditions such as heavy weight lifting, repetitive movement and awkward posture which involves squatting with long sitting work on the ground, long working hours and heavy workload which are inherent in the greater part of agricultural works. Even though Korean agricultural workers are very weak population in terms of occupational safety and health, no many studies were conducted in the past and no many social and institutional supports were provided sufficiently. We need more interests and efforts in agricultural fields to improve its working condition and to promote health status of agricultural workers.

Characteristics of Pelvic Ranges According to Artificial Leg Length Discrepancy During Gait: Three-Dimensional Analysis in Healthy Individuals (보행 중 인위적 다리길이 차이에 따른 3차원적 골반 가동범위의 특성)

  • Kim, Yongwook
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.2
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    • pp.59-67
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    • 2019
  • Purpose : The purpose of this study was to analyze the dynamic range of motion (ROM) of pelvic and translation of center of mass (COM) when wearing different shoe insole lifts according to leg length discrepancy (LLD) during free speed gait. Methods : Thirty-five healthy adults were participated in this study. Kinematic data were collected using a Vicon motion capture system. Reflective and cluster 40 markers attached to participants lower extremities and were asked to walk in a 6 m gait way under three different shoe lift conditions (without any insole, 1 cm insole, and 2 cm insole). The pelvic ROM and COM translation in three planes were sorted using a Nexus software, and a Visual3D motion analysis software was used to coordinate all kinematic data. Results : There were significantly increased maximal pelvic elevation and total pelvic range in coronal plane when wearing a standard shoe with 2 cm insole lift during gait (p<.05). When wearing a standard shoe with 2 cm insole lift, the total range of the pelvic segment were significantly different in all three motion planes (p<.05). Conclusion : Although LLD of less than 2 cm develops abnormal movement pattern of the pelvis and may cause of musculoskeletal diseases such as low back pain, hip and knee joint osteoarthritis, therefore intensive various physical therapy interventions for LLD are needed.