• Transactions of the Korean Society of Mechanical Engineers A
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• v.28 no.11
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• pp.1664-1671
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• 2004

It is necessary to have a model that describes the feature of the knee Joint with a sufficient accuracy. Koreans, however, do not have their own knee joint model to be used in the total knee replacement arthroplasty. They have to use European or American models which do not match Koreans. Three-dimensional visualization techniques are found to be useful in a wide range of medical applications. Three-dimensional imaging studies such as CT(computed tomography) and MRI(magnetic resonance image) provide the primary source of patient-specific data. Three-dimensional knee joint models were constructed by image processing of the CT data of 10 subjects. Using the constructed model, the dimensions of Korean knee joint were measured. And this study proposed a three-dimensional model and data, which can be helpful to develop Korean knee implants and to analyze knee joint movements.

• Journal of Korean Physical Therapy Science
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• v.1 no.1
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• pp.145-163
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• 1994

This study was done to determine differences in effect of postoperative pain control in patients receiving auricular electroacustimulation vs transcutaneous electrical nerve stimualtion following total knee replacement surgery. Thirty-one cases referred to physical therapy department after treated by total knee replacement surgery by orthopedic surgery department at the Pohang St. Mary's Hospital from January 1993 through June 1994. Of 31 total knee replacement cases, 13 cases were auricular electroacustimulation group, 11 cases were transcutaneous electrical nerve stimulation group, and 7 cases were control group. The results of the study summerized are as follows: Thirty-one total knee replacement cases(male in 12 cases, female in 19 cases), ranging in age from 34 to 61 years(mean${\pm}$SD=49.90 7.56) with diagnoses of degenerative arthritis(20 cases), rheumatoid arthritis(9 cases), and other(2 cases). In auricular electroacustimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In transcutaneous electrical nerve stimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In control group, did not show significant pre-posttreatment differences in pain intensity, unpleasantness, active range of motion(p>0.05). The mean change in pain intensity and unpleasantness, active range of motion from pretreatment baseline for the 3 groups. Auricular electroacustimulation group showed the large magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. Transcutaneous electrical nerve stimulation group showed small magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. No significant changes were observed in control group. Highly significant differences in pain intensity, unpleasantness, and active rage of motion were found using an ANOVA measures between treatment groups and control group(p<0.01). The squares correlation coefficients of pain and function measures pretreatment-posttreatment differences for each group. In treatment group, there was significant correlation between pain scale and function(p<0.001). In control group, there was no correlation between the pain scale and function (p>0.05). The continuous study is needd for many interesting issues of auricular electroacustimulation in new future.

• Journal of Life Science
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• v.14 no.3
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• pp.484-489
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• 2004

Artificial joint replacement is one of the major surgical advances of the 21th century. The primary purpose of a TKA (Total Knee Arthroplasty) is to restore normal knee Auction. Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from a chair or climbing stairs;(b) allow the same range of motion as an complete knee; and (c) provide adequate knee joint stability. Four individuals (2 peoples after surgery one year and 2 peoples after surgery three years) participated in this study. All they were prescreened for health and functional status by the same surgeon who performed the operations. Two days of accommodation practice occurred prior to the actual strength testing. The isometric strength (KIN-COM III) of the quadriceps and hamstring were measured at 60$^\circ$ and 30$^\circ$ of knee flexion, respectively. During isokinetic concentric testing, the range of motion was between 10$^\circ$ to 80$^\circ$ of knee flexion (stand-to-sit) and extension (sit-to-stand). for a given test, the trial exhibiting maximum torque was analyzed. A 16-channel MYOPACTM EMG system (Run Technologies, Inc.) was used to collect the differential input surface electromyographic (EMG) signals of the vastus medialis (VM), vastus lateralis(VL), rectus femoris (RF) during sit-to-stand and stand-to-sit tests. Disposable electrodes (Blue SensorTM, Medicotest, Inc.) were used to collect the EMG signals. The results were as follows; 1. Less maximum concentric (16% and 21% less for 1 yew man and 3 years mm, respectively) and isometric (12% and 29%, respectively) quadriceps torque for both participants. 2.14% less maximum hamstrings concentric torque for 1 year man but 16% greater torque for 3 years mm. However, 1 year man had similar hamstring isometric peak torque for both knees. 3. Less quadriceps co-contraction by 1 year man except for the VM at 10$^\circ$-20$^\circ$ and 30$^\circ$-50$^\circ$ range of knee flexion.

• Journal of muscle and joint health
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• v.3 no.2
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• pp.135-150
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• 1996

This study was performed to analyze the patient's experience during the progress of disease in the patients with osteoarthritis, who are taken the replacement surgery of knee Joint. The examine was consisted of five patients with osteoarthritis, who are taken the replacement surgery of knee joint from Dec. 4. 1995 to May, 20, 1996 at C university hospital. After hospitalization, the physical and psycho-logical status of the patients during preoperation, postoperation and discharge was examined. The data were examined according to the ethnographic method. The results are as follows. The patients experienced the periods of embarrasment, conflict, before surgery suffering, acceptance period after surgery. In the embarrasment period, the patients take a multiple medication therapy including hospital treatment, oriental medication and folk medication to ameliorate joint pain after first diagnosis on arthritis. The embarrasment period includes compulsive drug medication, oriental medication, folk medication, trouble some, sadness and survey of hospitals. In the conflict period, the patients consider the operation of knee because of working difficulty and severe Joint Pain, while they feel anxiety about the surgery. They condemn their physical situations. They have the conflict and anxiety on surgical operation. they consider the quality of life. They hope the surgery makes patients to improve walking ability. This period includes self-condemned, sorry, tiresomeness, expectation, worrisomeness, anxiety and hesitance. In the suffering period, the patients experience post operation physical discomfort after the total knee replacement. They do physical exercise, including extension and straight leg raising to maintain walking ability, while they endure to wait approximately 6 months for normal walking movements and they are also unstable to environmental people's sight. This period includes postoperative pain, continuous discomfort, inability and communication difficulty to other's people. In the acceptance period, the patients consider longerity of artificial Joint and also endure mild remaining joint pain. Some of them have religions for their wellbeing of life. This period include a self-protesting policy, abandonment, self-consolation, dependence on religions. According to the result from this study I suggested these shown below. 1) After replacement surgery of knee joint, continuous investigation on outcome patient is necessary. 2) It is also necessary to analyze on patient's experiences, who are taken the replacement surgery of hip Joint. 3) Study on disease experiences of patients with rhematoid arthritis, who take drug medication and physical therapy alone without surgery, is necessary. 4) Investigation on patient's favorable folk medication may be helpful to analyze disease experience of patients with osteoarthritis.

• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.151-179
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• 2003

The purpose of this study was to examine the influence of total knee replacement to arthritis patients in pain intensity and functional impairment. For this study, over 50-year-old 30 patients who had osteoarthritis and 69 patients who got total knee replacement at the one of the departments of orthopedics in Daegu were interviewed from June, 2002 to March, 2003. The results of this study were as follows : First, pain intensity was decreased to experimental group after operation than control group(P<.01) And the presence of crepitation was also decreased to them(P<.05). On the other hand there's no significant difference was noted in the presence of stiffness, degree of flexion contracture and extension contracture between two groups. Second, over 91 days group after operation and visitor's group of physiotherapy unit were better than others in Level of knee function(P<.01). Third, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Barthel Index of knee function(P<.01). Forth, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Level of IADL(P<.05). Fifth, over 91 days group after operation and visitor‘s group of physiotherapy unit were higher than others in Katz Index of knee function(P<.01). Sixth, although Old Ages' Activity Index seemed to get better as time goes by, there's no statistical difference. Seventh, over 91 days group after operation and visitor's group of physiotherapy unit were higher than admission group and under 30 days group after operation in Social Activity Index(P<.05). Eighth, the function of the knee was connected with the abilities in the activity of the old and the social skill. The Barthel index was connected with the function of the knee joint and the activities of the old and Katz index. IADL function was connected with the activities of the old and the social activity. The Katz index was connected with the Barthel index. The activity of the old was connected with the Barthel index, the functional score of the knee joint andthe IADL score. The ability of social skill was connected with the activity of the old, IADL score and the function of the knee.

• Journal of Biomedical Engineering Research
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• v.28 no.1
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• pp.108-116
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• 2007

Recently, it has been reported that the posterior stabilized implant, which is clinically used for the total knee replacement (TKR), may have failure risk such as wear or fracture by the contact pressure and stress on the tibial post. The purpose of this study is to investigate the influence of the mal alignment of the posterior stabilized implant on the tibial post by estimating the distributions of contact pressure and von-Mises stress on a tibial post and to analyze the failure risk of the tibial post. Finite element models of a knee joint and an implant were developed from 1mm slices of CT images and 3D CAD software, respectively. The contact pressure and the von-Mises stress applying on the implant were analyzed by the finite element analysis in the neutral alignment as well as the 8 malalignment cases (3 and 5 degrees of valgus and varus angulations, and 2 and 4 degrees of anterior and posterior tilts). Loading condition at the 40% of one whole gait cycle such as 2000N of compressive load, 25N of anterior-posterior load, and 6.5Nm of torque was applied to the TKR models. Both the maximum contact pressure and the maximum von-Mises stress were concentrated on the anterior-medial region of the tibial post regardless of the malalignment, and their magnitudes increased as the degree of the malalignment increased. From present result, it is shown that the malalignment of the implant can influence on the failure risk of the tibial post.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.93-101
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• 2023

PURPOSE: The Western Ontario and McMaster Universities Arthritis (WOMAC) index has been used to measure the outcome of total knee replacement (TKR), but studies on its reliability and validity are limited. The present study examined the reliability and validity of this index for patients with knee osteoarthritis who underwent TKR. METHODS: Seventy-one inpatients and outpatients who underwent bilateral TKR for knee osteoarthritis were included in this study. The pain assessment scale and WOMAC index were used to evaluate the participants every two weeks to examine the test-retest reliability, internal consistency, and construct validity. RESULTS: The test-retest reliability scores for pain, stiffness, and physical function were .75-.92, .85-.90, and .75-.95, respectively. The corresponding intraclass correlation coefficients were .75-.88, .76-.88, and .71-.95, respectively. The internal consistency score in the first and second examinations was .92. Furthermore, the construct validity scores for pain, stiffness, and physical function were .83, .41, and .58, respectively. CONCLUSION: The application of the WOMAC index in patients who underwent TKR showed high test-retest reliability and internal consistency with the use of the WOMAC index and good validity with the use of the pain assessment scale.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.343-347
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• 2020

May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

• YAKHAK HOEJI
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• v.52 no.2
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• pp.101-110
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• 2008

Total Knee Replacement (TKR) surgery is one of the invasive procedures for patients with late-stage knee joint disorders. In the present study, economic efficiency was compared between uses of the 2nd and 3rd generation cephalosporins for the prophylaxis before and after the surgery using frequency analysis in terms of various factors such as medication costs, the number of days of antibiotic use and hospitalization due to TKR surgery. The results showed that the 3rd generation cephalosporins did not reduce the infection rate and total medication costs, but rather raised antibiotic cost in comparison with the 2nd ones. A frequent use of the 3rd ones is closely related to emergence of resistant bacterial strains. Therefore, we suggest that unnecessary prescriptions for the broad spectrum antibiotics should be avoided.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.88-97
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• 2021

Purpose: Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. This study aimed to investigate the effect of complex balance exercises on unstable ground, on the gait, balance, and daily living ability of patients with total knee arthroplasty. Design: Randomized controlled trial. Methods: The participants consisted of 30 patients placed into two groups of 15 each: a experimental group (complex balance exercise) and a control group (physical therapy exercise). Both group exercise was applied for 3 times a week for 30 minutes for four weeks. Force plate for balance ability and Timed up and go (TUG) test were the primary outcome measures. The secondary outcome measures included 10-m walk test (10MWT) and the daily living ability using the Knee Outcome Survey Activities of Daily Living scale (KOS-ADL). Results: The result of this study showed that the experimental group had a significant difference in TUG and 10MWT than the control group, and balance was significantly different in CEA, CPL, and CAV. There was a significant difference in daily living ability between the experimental and control groups. This study confirms that the physical therapy with complex balance exercise on unstable surfaces has positive effects on balance, gait and daily living ability in patients with total knee arthroplasty. Conclusion: As a result of this study, complex balance exercise on unstable surface was more effective in improvement gait, balance and daily living ability in total knee arthroplasty. From this study, physical therapy with complex balance exercises on unstable ground may be proposed as and effective intervention method for improving gait, balance, and daily living ability in patients with early total knee arthroplasty.