• Title/Summary/Keyword: total hip joint replacement

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Factors Affecting the Healthcare Utilization of Spinal and Joint Surgery in Elderly Patients (65세 이상 노인의 척추·관절 수술별 의료이용에 미치는 영향요인 분석)

  • Jeong, Soon Hyun;Gu, Yeo Jeong;Yoo, Ki-Bong
    • Health Policy and Management
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    • v.30 no.1
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    • pp.62-71
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    • 2020
  • Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

Total Hip Replacement in a Jindo Dog with Dorsal Acetabular Rim Deficiency: a Case Report (등쪽 관골절구 결손을 가진 진도견의 인공 대퇴 관절 전치환술)

  • Heo, Su-Young;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.121-124
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    • 2014
  • A 7-year-old, intact female Jindo dog was presented for assessment of weight-bearing lameness of the right hindlimb. On physical examination, crepitus and pain was noted in the right coxofemoral joint upon extension. Radiographs revealed a craniodorsal luxation of the right coxofemoral joint and degenerative joint disease (DJD) of both coxofemoral joints. Total hip replacement (THR) was performed for the right coxofemoral joint. Intraoperatively, dorsal acetabular rim (DAR) deficiency was noted, which can be related to a high risk for acetabular cup implant dislocation. Deficiency of the dorsal acetabular rim realigned with the acetabular cup using universal locking plate (ULP) and polymethylmethacrylate (PMMA) bone cement. After surgery, the patient had an uneventful course and a successful outcome. The ROM and thigh girth were dramatically improved. There were no complications associated with prosthesis implants. Hip luxation with dorsal acetabular rim deficiency in a dog was successfully repaired with THR and dorsal acetabular rim augmentation using ULP and PMMA bone cement. This technique should be considered when conventional THR is precluded by dorsal acetabular rim deficiency.

The Effect of adding Hip Abductor Strengthening to Conventional Rehabilitation on Muscular Strength and Physical Function following Total Knee Replacement

  • Kim, San-Han;Park, Hye-Kang;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.16-23
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    • 2022
  • Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

Changes in Lower Extremity Joint Angles after Total Knee Replacement (무릎관절 전치환술에 따른 하지의 관절 각도 변화)

  • Kim, Sang-Yeong;Yoon, Se-Won
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.11 no.1
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    • pp.39-44
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    • 2013
  • Purpose : The purpose of present study is to evaluate the joint angles of legs in the standing posture for six patients with unilateral knee osteoarthritis. Methods : The participants underwent unilateral total knee replacement. A motion analysis was used to measure the joint angles of the hip, knee, and ankle. The measurements were taken before the surgery, one week and two weeks after the surgery. Both sides of the legs were evaluated. Results : This result showed that after a certain healing period, both hip joint angles showed a significant difference while there was no significant difference in the knee and ankle joint angles. After surgery, the angle of ankle dorsiflexion was smaller on the operated side than the opposite side compared to the pre-surgery measurements. Conclusion : After surgery, the asymmetry in a standing position left unchanged due to contracture of the knee joint and tightness in the hamstring muscle. Therefore, when physiotherapists plan an initial exercise programs for TKR patients, it is essential to apply adequate exercises which consider the contracture of the leg joints.

The Problem-Solving Approach for Improving Walking Ability in Patient with Total Hip Replacement: Applied ICF Tool for Case Study (고관절 인공관절 치환술 환자의 보행능력 증진을 위한 문제해결 접근: ICF Tool을 적용한 단일사례연구)

  • Song, Hyun-seung;Kim, Suhn-yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.21 no.2
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    • pp.63-71
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    • 2015
  • Background: The purpose of the study, using the ICF Tool in the process of rehabilitation of artificial joint replacement surgery of the hip joint, goal setting and understanding of the problem, through the process of creating intervention strategies, useful clinical practical course for rehabilitation I try to present the data. Methods: Fracture was the left total hip replacement (THR) surgery due to women of 76 years old. I proceed in order screening, evaluation, diagnosis, prognosis, treatment planning and intervention, re-screening. Needs of the patient was walking short distances for using the toilet. In order to improve was carried out arbitration, after you have created a list of issues that limit the ability to walk short distances. Results: It was revealed improved results in self-paced walk test (SPWT) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to examine whether the goals. In addition, MMT VAS, DGI, and TUG is a detailed goal was improved. Conclusions: It can be shown objectively the results of interventions performed for the purpose of solving the problem which is grasped through clinical Practical course for short-range walking ability enhance patient THR. I considered practical clinical course using the ICF Tool would be useful.

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The Effects of Manual Therapy using Pelvic Compression Belt on Hip Abductor Strength and Balance Ability in Total Knee Replacement Patients. (골반압박벨트를 착용한 상태에서의 도수치료가 슬관절 전치환술 환자의 고관절 외전근과 균형에 미치는 영향)

  • Shin, Young-il;Kim, Tae-won;Jeon, Jae-guk
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.1
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    • pp.77-83
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    • 2018
  • Background: The purpose of this study is to investigate that effect of manual therapy using pelvic compression belt on hip abductor strength and balance ability in total knee replacement (TKR) patients. Methods: The subjects consisted of twenty two post-TKR patients. Participants were randomly assigned to a pelvic belt group (n=11) and a placebo group (n=11). All participants underwent manual therapy including range of motion exercise, soft tissue mobilization around knee joint, strengthening exercise (Quad set, SLR, sidelying hip abduction, standing hamstring curls, sitting knee extension, step-up, wall slide to $45^{\circ}$ knee flexion). Manual therapy was executed five times a week for 2 weeks. Outcome measures included hip abductor strength by using Biodex system 4 pro, anterior to posterior balance, medial to lateral balance, total balance by using Biodex balance system SD. Results: After the completion of the manual therapy, hip abductor strength was showed statistically significant improvements in pelvic belt group (p<.05). Anterior to posterior balance, medial to lateral balance, total balance were showed statistically significant improvements in pelvic belt group and placebo group (p<.05). There was a statistically significant difference between the two groups in hip abductor strength and there was no statistically significant difference in balance. Conclusions: This results suggest that manual therapy using pelvic compression belt has could be used for selective muscle activation of the hip abductor muscle and has useful in hip abductor strength and balance ability in TKR patients.

Correlation between anterior thigh pain and morphometric mismatch of femoral stem

  • Chung, Haksun;Chung, So Hak
    • Journal of Yeungnam Medical Science
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    • v.37 no.1
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    • pp.40-46
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    • 2020
  • Background: Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint. Methods: The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain. Results: Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain. Conclusion: Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

Dual Mobility Cup for Revision of Dislocation of a Hip Prosthesis in a Dog with Chronic Hip Dislocation

  • Jaemin Jeong;Haebeom Lee
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.390-394
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    • 2022
  • A 6-year-old, 36.5 kg castrated male Golden Retriever presented for revision surgery for left total hip replacement. The patient underwent removal of the cup and head implants due to unmanageable prosthetic hip dislocation, despite revision surgery. On physical examination, the dog showed persistent weight-bearing lameness after exercise of the left hindlimb with mild muscle atrophy. Radiographic examination revealed dorsolateral displacement of the femur with a remnant stem and bony proliferation around the cranial and caudal acetabulum rims. The surgical plan was to apply the dual mobility cup to increase the range of motion and jump distance to correct soft tissue elongation and laxity caused by a prolonged period of craniodorsal dislocation of the femur. The preparation of the acetabulum for cup fixation was performed with a 29-mm reamer, and the 29.5-mm outer shell was fixed with five 2.4-mm cortical screws. The head and medium neck of the dual-mobility system were placed on the cup, and the hip joint was reduced between the neck and stem. The dog exhibited slight weight bearing on a controlled leash walk the day after surgery. The patient was discharged 2 weeks postoperatively without any complications. Six months postoperatively, osseointegration and a well-positioned cup implant were observed, and the dog showed excellent limb function without hip dislocation until 18 months of phone call follow-up.