• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.37-44
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• 2019

Purpose: Tumor infiltration around the knee joint or skip metastasis, repeated infection sequelae after tumor prosthesis implantation, regional recurrence, and mechanical failure of the megaprosthesis might require combined distal femur and proximal tibia replacement (CFTR). Among the aforementioned situations, there are few reports on the indication, complications, and implant survival of CFTR in temporarily arthrodesed patients who had a massive bony defect on either side of the knee joint to control infection. Materials and Methods: Thirty-four CFTR patients were reviewed retrospectively and 13 temporary arthrodesed cases switched to CFTR were extracted. All 13 cases had undergone a massive bony resection on either side of the knee joint and temporary arthrodesis state to control the repeated infection. This paper describes the diagnosis, tumor location, number of operations until CFTR, duration from the index operation to CFTR, survival of CFTR, complications, and Musculoskeletal Tumor Society (MSTS) score. Results: According to Kaplan-Meier plot, the 5- and 10-year survival of CFTR was 69.0%±12.8%, 46.0%±20.7%, respectively. Six (46.2%) of the 13 cases had major complications. Three cases underwent removal of the prosthesis and were converted to arthrodesis due to infection. Two cases underwent partial change of the implant due to loosening and periprosthetic fracture. The remaining case with a deep infection was resolved after extensive debridement. At the final follow-up, the average MSTS score of 10 cases with CFTR was 24.6 (21-27). In contrast, the MSTS score of 3 arthrodesis cases with failed CFTR was 12.3 (12-13). The average range of motion of the 10 CFTR cases was 67° (0°-100°). The mean extension lag of 10 cases was 48° (20°-80°). Conclusion: Although the complication rates is substantial, conversion of an arthrodesed knee to a mobile joint using CFTR in a patient who had a massive bony defect on either side of the knee joint to control infection should be considered. The patient's functional outcome was different from the arthrodesed one. For successful conversion to a mobile joint, thorough the eradication of scar tissue and creating sufficient space for the tumor prosthesis to flex the knee joint up to 60° to 70° without soft tissue tension.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2010.11a
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• pp.977-978
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• 2010

• The Journal of Korean Academic Society of Nursing Education
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• v.14 no.1
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• pp.20-29
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• 2008

Purpose: This research was conducted to compare the effects of a muscle strengthening exercise program on pain, straight leg raising ability, passive range of motion, independent walking time and satisfaction with total knee arthroplasty(TKA). Method: A nonequivalent control group posttest only design was used for this study. A total of 62 patients were randomly divided into the experimental group(31) and the control group (31). The experimental group received a 1-hour exercise intervention, while the control group received the usual care. Data was analyzed by t-test using the SPSS/WIN 11.0. Results: The experimental group showed significant improvement in pain score, straight leg raising ability, passive range of motion of knee joint, independent walking time, and the patient's satisfaction. Conclusion: The muscle strengthening exercise program was effective on decreasing pain and increasing mobility and satisfaction in patients with TKA.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.117-126
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• 2020

Total knee arthroplasty is performed widely in degenerative arthritis of the knee joint, and the frequency of use is increasing. Efforts should be made to achieve functional recovery, such as returning to daily life, and the recovery of strength and range of motion after surgery. The procedure should be approached from a range of perspectives, such as patient factors, surgical technique and rehabilitation. The patient's age, degree of obesity, sex, and strength of the quadriceps muscle can affect the functional recovery after surgery. In addition, the patient's mental state, such as expectation value and satisfaction, can also have an effect. For functional recovery, patient education, pain control, and strengthening of the quadriceps muscle can be performed prior to surgery. Postoperative physiotherapy, such as icing and compression, transcutaneous electrical nerve stimulation therapy, neuromuscular electrical stimulation therapy, low frequency low intensity magnetic field therapy, strengthening of quadriceps muscle, and range of motion exercise can also be applied. In recent years, hydrotherapy, which restores the strength and balance of the leg, is being performed increasingly. These treatments are not only performed shortly after surgery, but are also performed continuously. In addition, the surgeon should apply it appropriately considering the patient's condition, compliance, and social and psychological conditions.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.06a
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• pp.896-902
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• 2005

An orthopedic surgeon normally gets the operational parameters of total knee arthroplasty from medical images(CT, MRI). Anatomical axis, mechanical axis, the width and height of femur, or tibia are the most important parameters related with accomplishment of TKA. This paper presents a methodology of simulation that virtually operates TKA according to 2D medical images. Using this simulator, some important parameters for operation can be achieved before hand. The simulator provides the 3D computational model of a knee joint and then derives the proper size of implant corresponding to the joint. The whole process of TKA can be simulated such as clipping a knee joint, assembling the joint and its implants, visualizing all the operation steps, deriving some crucial parameters such as anatomical axis and cutting thickness, and predicting the result of TKA. Some examples are given and discussed to validate the methodology.

• Journal of muscle and joint health
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• v.22 no.1
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• pp.48-56
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• 2015

Purpose: The purpose of this study was to verify the effects of visual information on nursing management to elderly total knee arthroplasty (TKA) patients. Methods: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used in this study. Participants of this study were 60 elderly patients with TKA admitted to one hospital: the control group (30) between July and September, 2013, and the experimental group (30) between April and July, 2013. Anxiety and uncertainty were determined at baseline and at 3 days after TKA in both groups. Results: Two days after the visual information, the experimental group showed a significant decrease in anxiety and uncertainty compared with the control group. Conclusion: The results of this study show that providing visual information was effective in decreasing postoperative patient anxiety and uncertainty in elderly TKA patients. Therefore, when an elderly patient is hospitalized for TKA, positive and systematic provision of visual information may provide a positive effect by reducing postoperative patient anxiety and uncertainty.

• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.253-265
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• 2012

Purpose: The focus of this research was a systematic review of published articles and theses for a degree in Korea and foreign countries on rehabilitation therapy for patients with total knee arthroplasty (TKA). Methods: The literature until December in 2011 were searched and the data basis included Medline, CINAHL, KERIS, National Library of Korea, and National Assembly Library web sites. Words for the search were TKA or TKA and rehabilitation. Studies included randomized controlled and non-equivalent control group pretest-posttest design. 31 studies were analyzed focusing on type, application method, dependant variable and effect using descriptive statistics. Results: Seventeen rehabilitation therapies and forty-nine dependant variables were used. The application methods of rehabilitation therapy were diverse. The most frequently used rehabilitation type was an exercise therapy and a pain/discomfort was the most frequently used dependant variable. The effects of rehabilitation therapy were inconsistent. Conclusion: The individualized rehabilitation therapy must be comprised of type, time, frequency, period and duration. Attention must be made as to the research design, especially the better measurement of the dependent variables. This review may serve as a base for future research.

• Korean Journal of Adult Nursing
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• v.19 no.2
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• pp.207-216
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• 2007

Purpose: The purpose of this study was to ascertain the effects of preoperative information on postoperative state anxiety, plasma cortisol, and pain for patients under total knee arthroplasty, and to provide generic data with nursing intervention for total knee arthroplasty. Methods: Data were collected from 34 patients who had total knee arthroplasty from January 3, 2003 to January 15, 2004. An experiment group of 17 patients was provided with pre-operative information prepared by the researchers; a control group of another 17 patients was provided with general information. Data were analyzed through Chi-squared test, t-test, paired t-test and ANCOVA using SPSS WIN 11.0. Results: There was no significant differences between the experiment group and the control group in post operative state anxiety(p=.612). However, there was statistically a significant difference between the above two groups in post operative plasma cortisol(p=.012). There was a statistically significant difference between the above two groups in post operative pain(p=.041). Conclusion: According to the results of the study, the authors concluded that the preoperative information for patients under total knee arthroplasty had the effect on the decrease of postoperative plasma cortisol and pain.

• Proceedings of the KSME Conference
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• 2001.06a
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• pp.951-955
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• 2001

The experimental comparison between bonded and unbonded types stem-cement interface was carried out on axisymmetric stem-cement-aluminum model of the femoral component of a total hip replacement. Human femur was modeled in non-tapered and tapered($7.5^{\circ}$) aluminum hollow cylinders to emulate the diaphyseal and metaphyseal segments of the femur. For unbonded type, we tested stems with three different taper angles($5^{\circ},\;7.5^{\circ},\;10^{\circ}$). In every case, the cement-aluminum interface was designed to endure 8MPa shear strength. (a measured value at cement-bone interface) We tested aluminum models under axial loading for both cases. As an experimental result, it was found that unbonded stem sustained more axial load as bonded stem in both cases, diaphyseal and metaphyseal models. The unbonded types failed in cement mantle under axial compressive load, while the bonded ones failed in shear at cement-aluminum interface. These results suggest that a polished stem will sustain much higher axial load than a roughened stem. And a polished stem will make more stable cement-bone interface that may promote better osteosythesis around the stem.

• Journal of muscle and joint health
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• v.21 no.3
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• pp.206-214
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• 2014

Purpose: The aim of this study was to explore the elderly women patients' experience of treatment for total knee replacement. Methods: The participants in this study are 10 elderly women age 65 and over who were discharged after total knee replacement. The data were collected from August 5, to September 20, 2012, and it has been done by in-depth interview. Data were analyzed the phenomenological method of Colaizzi. Results: In this study, four categories were extracted: 'Suffering due to intolerable pain', 'A stable mind and body', 'Retrospection about old wounds', 'A desire for a new life'. Conclusion: This study provides the useful basic data to understand the elderly women patients who have experienced total knee replacement. Nursing intervention is required for pain control after surgery in order to improve the quality of life. In addition, nursing care through individual counseling and emotional support during the recovery period is very important. Therefore, various programs should be developed for elderly women patients to help their body recovery as well as psychological support after total knee replacement surgery.