• Korean Journal of Adult Nursing
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• v.18 no.5
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• pp.819-827
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• 2006

Purposes: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery. Methods: We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA. Results: The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation. Conclusions: Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

• Journal of Biomedical Engineering Research
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• v.23 no.2
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• pp.119-130
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• 2002

The nonlinear finite element program has been developed to analyze the design performance of an artificial hip prosthesis and long term behavior of a treated femur with stems made of composite material after cementless total hip arthroplasty(THA). The authors developed the three dimentional FEM models of femoral bone with designed composite stem which was taken with elliptic cross section of 816 brick elements under hip contact load and muscle farce in simulating single leg stand. Using the program, density changes, stress distributions and micromotions of the material femoral bone were evaluated by changing fiber orientation of stems for selected manufacturing method such as plate cut and bend mold. The results showed that the composite materials such as AS4/PEEK and T300/976 gave less bone resorption than the metallic material such as cobalt chrome alloy, titanium alloy and stainless steal. It was found that increasing the long term stability of the prosthesis in the femur could be obtained by selecting the appropriate ply orientation and stacking sequence of composite.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.107-114
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• 2018

Long-term complications such as loosening, wear, osteolytic lesion and granulomatous reaction by foreign bodies can occur, after total hip arthroplasty. The implantation alignment effects dislocation and wear, according to its amount and direction. Wear particles in total hip arthroplasty brings about biochemical complications such as osteolysis or send wear. In this sense, it is important to regularly check wear and alignment of total hip replacement. Because the wear in followup of 10 years may remain in a small amount, like a 1 or 2 mm generally, somewhat precise measurement tool has to be established. The wear and alignment measurement softwares commercially available currently lack in project saving or reproducibility. This study suggests a reliable method for the measurement using an X-ray image and a CAD software. The proposed method can be executed only if having a CAD software under most of current general clinical radiographical environment. The proposed was revealed through tests for the method to have accuracy of 0.06 mm with precision of 0.05 mm for wear measurement, and precision of 0.27 degrees for tilt measurement.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.71-81
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• 2005

Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.153-164
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• 2016

The objective of this study was to propose a rehabilitation protocol for total hip replacement in Korean medicine and to report its effectiveness. Three patients who had undergone total hip replacement were treated using the rehabilitation protocol in Korean medicine. We evaluated the outcome evaluating physical examination findings of the hip joint, numeric rating scale, pain disability index, Harris hip score, and walking state. After the treatment, we observed that hip movement and muscular strength improved. Moreover numeric rating scale, pain disability index, Harris hip score, and walking state of patients improved. A rehabilitation in Korean medicine can be effectively used for total hip replacement patients. The limitation of this study was the insufficient number of cases. Further studies are needed to design a rehabilitation protocol in Korean medicine.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.317-326
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• 2019

Purpose: To compare and analyze the rate of prevention of two venous thromboembolism prophylaxis guidelines in patients with artificial joint arthroplasty and hip joint fracture. Proper prophylaxis for preventing thromboembolism in orthopedic surgery is significant because of this fetal complication. Materials and Methods: This study compared and retrospective analyzed the rate of prevention using the medical records and radiographs of patients who underwent orthopedic surgery from March 2009 to February 2011 according to the American College of Chest Physicians (ACCP) guidelines and from March 2012 to February 2014 according to the American Academy of Orthopedic Surgeons (AAOS) guidelines. Results: The guidelines for venous thromboembolism prophylaxis have been applied to patients with artificial joint replacement and hip joint fracture, the compliance rate of the ACCP guidelines was 56.0% before surgery, 67.0% after surgery with chemical prophylaxis, and 80.5% with mechanical prophylaxis. In addition, the compliance rate of the AAOS guidelines was 74.1% with chemical prophylaxis, and 88.3% with mechanical prophylaxis, which was higher than the ACCP guidelines. The compliance rates of mechanical and chemical prophylaxis before and after surgery of the ACCP guidelines, and the compliance rate of mechanical and chemical prophylaxis of the AAOS guidelines were compared and analyzed. The results revealed statistical significance (p<0.05) before and after total knee replacement arthroplasty and hip joint fracture internal fixation and total high risk orthopedic surgery. Conclusion: Raising the compliance rate of prophylaxis of venous thromboembolism in high risk orthopedic surgery is necessary and people should follow the guidelines for a unified direction depending on which situation they are in.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.35-43
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• 2012

Purpose : PET/CT performed CT-based attenuation correction generates the beam hardening artifact by metallic implant. The attenuation correction causes over or underestimate of the area adjacent to metallic hip prosthetic material and change of $^{18}F$-FDG uptake. Also, the image quality and the diagnosability on genitourinary disease are reduced. Therefore, this study will evaluate the usefulness of MAR (Metal Artifact Reduction) algorithm method to improve the image quality on PET/CT. Materials and Methods : PET/CT was performed by fixing hip prosthesis in SPECT/PET phantom. In PET images with and Without MAR algorithm, the Bright streak, Dark streak, Metal region and Background area that appeared on CT were confirmed, and the change of each SUV (standardized uptake value) was analyzed. Also, in 15 patients who underwent total hip arthroplasty, each MAR algorithm and Without MAR algorithm and non attenuation correction was evaluated. Results : In PET image Without MAR algorithm, SUV of Bright streak region was $0.98{\pm}0.48$ g/ml; Dark streak region was $0.88{\pm}0.02$ g/ml; Metal region was $0.24{\pm}0.16$ g/ml, Background area was $0.91{\pm}0.18$ g/ml. In SUV of PET image with MAR algorithm, Bright streak region was $0.88{\pm}0.49$ g/ml, Dark streak region was $0.63{\pm}0.21$ g/ml, Metal region was $0.06{\pm}0.07$ g/ml, Background was $0.90{\pm}0.02$ g/ml. SUV generally decreased when applying MAR algorithm. In PET image Without MAR algorithm, SUVs of Bright region were higher than those measured in the Background, and it was false positive uptake. But, in PET image with MAR algorithm, SUVs of Bright region were similar to the Background, and false positive uptake disappeared. Conclusion : MAR algorithm could reduce an increase of $^{18}F$-FDG uptake due to attenuation correction in the hip surrounding tissue. However, decrease of SUV in Dark streak region should be considered in the future. Therefore, this study propose that the diagnostic accuracy can be improved in genitourinary diseases adjacent to metallic hip prosthesis, if provided PET images with and Without MAR algorithm, and non attenuation correction images at the same time.

• Journal of Korean Academy of Nursing
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• v.47 no.4
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• pp.456-466
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• 2017

Purpose: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. Methods: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. Results: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG ($x^2=6.15$, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. Conclusion: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.

• 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.

• Journal of radiological science and technology
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• v.43 no.5
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• pp.331-336
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• 2020

In this study, we would like to examine the effect of the location of the magnification marker and the change in the stitching range on the magnification marker and the expansion of the anatomical structure in the examination of femoral stitching radiation using the stitching technique, and to find out the usability of the femoral stitching radiation examination in the preoperative examination for THRA. The measured values measured by 5 researchers were summed and presented through descriptive statistics. When the position of the magnification marker was changed, the average value of the measured value was in the range of 113.54 to 113.90 mm. The anatomical structures of the femur were measured in the range of 57.24 to 57.78 mm, 27.20 to 27.56 mm, and 70.11 to 70.81 mm, respectively. This showed a similar deviation from the expansion rate of previous related papers using markers. Therefore, it is considered that femoral stitching X-ray examination using magnification markers can be used for preoperative examination for THRA.