• 제목/요약/키워드: 슬관절전치환술

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Factors affecting the Length of Stay in Patients with Total Knee Arthroplasty (슬관절 전치환술 환자의 재원일수에 영향을 주는 요인)

  • Lee, Hye-Seung;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.201-208
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    • 2020
  • The purpose of this study was to analyze the claim data of Health Insurance Review & Assessment Service to determine what factors affected the length of stay in patients aged 65 and older and undergoing total knee arthroplasty due to the principal diagnosis of gonarthrosis by the type of medical institutions. As a result of making an analysis, gender, age, medical security type, severity, residential area and the number of sickbeds were identified as the factors that influenced the length of stay in each type of medical institutions. At this point in time when an increase in the elderly population triggered by population aging and another subsequent increase in medical expenses put a heavy strain on household and national economy, it's necessary to consider how to shorten the length of stay and how to ensure the efficient management of sickbeds based on the findings of this study. In addition, this study is of significance in that it could be used as basic data on quality life-care for elderly patients by the introduction of a systematic management system geared toward lessening patient burden for medical expenses.

Aging Effect on Femoral Stress Fracture Risk in Pin-hole after Computer-navigated Total Knee Arthroplasty (컴퓨터 네비게이션 슬관절 전치환술에서 노화에 따른 핀 홀에서의 대퇴골 골절 위험성)

  • Park, Hyung-Kyun;Park, Won-Man;Kim, Yoon-Hyuk
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1518-1520
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    • 2008
  • Recent clinical studies have shown that computer navigation for total knee arthroplasty (TKA) provides improved component alignment accuracy. However, femoral stress fracture after computernavigated TKA have been reported due to the pin hole and we hypothesized that osteoporosis would be one of the key factors in pin hole fracture after computer-navigated TKA. We investigated the von-Mises stress around the femoral pin-hole for different elastic modulli and ultimate stresses and four different pin penetration modes to understand the aging effect on femoral stress fracture risk after computer-navigated TKA by finite element analysis. In this study, aging effect was shown to increase the femoral stress fracture risk for all pin penetration modes. Especially, aging effect was shown dramatically in the transcortical pin penetration mode.

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Determination of Total Knee Replacement Parameter by Simulation (시뮬레이션을 이용한 슬관절 수술 변수 결정)

  • Yoon Y.S.;Park S.H.;Lee S.H.;Choi K.W.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.881-887
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    • 2005
  • A total knee replacement is an extremely 'position-sensitive' operation; a malposition or a malalignment of the components will lead to a breakage of the component, a fracture around the knee prosthesis, and the limitation of range of the motion, etc. In a conventional total knee replacement, surgeons have to select an appropriate prosthesis according to the shape of the surgical region. A wrong selection may give rise to side effects or to need re-operation. Nevertheless, it is so difficult to choose the most proper prosthesis out of various kinds of prosthesis. This paper presents a surgical planning system for the total knee replacement with an operation simulating method in order to determine the parameters for the total knee replacement operation. We select an alignment axis and a resection angle as major operation parameters in the total knee replacement operation, and introduce the method to determine the major operation parameters with the operation simulator we developed. The simulator is used to determine operation parameters for optimized operations, to select the most appropriate prosthesis, and to analyze the prospective problems of the operation.

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May-Thurner Syndrome with Deep Vein Trombosis after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 메이-터너 증후군 및 심부정맥 혈전증)

  • Lee, Hwa-Sung;Kim, Yong-Woo;Jung, Se-Hoon;Lee, Se-Won
    • 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.

Factors Influencing Depression Among Patients with Chronic Degenerative Arthritis after Total Knee Arthroplasty (인공슬관절 전치환술을 받은 만성 퇴행성관절염 환자의 우울 영향요인)

  • Ju, Yeong-Ju;Kim, Hee-Kyung
    • Journal of muscle and joint health
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    • v.19 no.2
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    • pp.161-172
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    • 2012
  • Purpose: This study was to identify the factors influencing depression among patients with degenerative arthritis after total knee arthroplasty. Methods: The subjects were 108 patients who admitted or visited K hospital in K city after total knee arthroplasty. Data were analyzed using SPSS WIN 18.0 program. Results: The level of depression was 2.72 with a possible range of 1 to 5. Social support was 3.71 out of a total score 5. Self-efficacy was 64.47 ranged from 10 to 100. Self-esteem was 2.59 ranged from 1 to 5. The associated factors with depression were marital status, length of illness, perceived health status, pain, social support, self-efficacy, and self-esteem. Marital status, length of illness, and perceived health status accounted for 5.8% of depression. Next, all variables including pain, social support, self-efficacy and self-esteem accounted for 66.4% of depression. Conclusion: The level of depression among the subjects significantly be related to marital status, length of illness, perceived health status, pain, social support, self-efficacy and self-esteem. It indicates a need to develop nursing interventions for them to decrease depression and develop quality of life during recovery.

The Effectiveness of Arthroscopy in Complicated Knee Arthroplasty (합병증이 병발된 슬관절 치환술에 시행한 관절경술의 효용성)

  • Kim, Kyung-Tae;Lee, Song;Ko, Dong-Oh;Kim, Kwan-Soo;Kim, Tae-Woo;Park, Soon-Youl
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.39-45
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    • 2009
  • Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

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Treatment Methods for Functional Recovery after Total Knee Arthroplasty (슬관절 전치환술 후 기능 회복을 위한 치료법)

  • Kim, Young-mo;Joo, Yong-bum;Park, Il-young
    • 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.

Effects of Elastic Band Exercise on Pain, Range of Motion, and Fear of Falling in Patients with Total Knee Replacement (탄성밴드운동이 슬관절전치환술 환자의 통증, 관절가동범위, 낙상두려움에 미치는 효과)

  • Yeo, Hyung Nam;Kim, Yeong Kyeong;Kang, Mi Ae;Shin, Jung Sun
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.266-275
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    • 2015
  • Purpose: The objective of this study was to verify the effects of elastic-band exercise on pain, range of motion, and fear of falling in patients with total knee replacement. Methods: The study design was a nonequivalent control group non-synchronized quasi-experimental design. Data were collected from December 10, 2014 to January 10, 2015 in an orthopedic specialty hospital located in the C city. Forty-eight patients participated in the study, and each twenty-four were assigned to the experimental group and the control group. The elastic-band exercise was used with the experimental group for 10 days. The numeric rating scale was used to measure pain, goniometer to measure range of motion, and a questionnaire to measure fear of falling. The data were analyzed using $x^2-test$, Fisher's exact, t-test and paired t-test. Results: Compared to the control group, pain in the experimental group decreased (t=-2.89, p=.006), range of motion increased (t=2.98, p=.005), and fear of falling decreased (t=-4.63 p<.001). Conclusion: The elastic-band exercise for total knee replacement patients is considered to be an effective nursing intervention to decrease pain and fear of falling, and to increase range of motion.

Ultrasonographic Diagnosis of the Patellar Clunk Syndrome after Posterior Stabilized Total Knee Arthroplasty - A Case Report - (후방 안정형 인공 관절 전치환술 후 슬개골 덜컹 증후군의 초음파적 진단 - 증례 보고 -)

  • Yoo, Jae Doo;Kim, Nam Ki;Chung, Jae Yoon
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.39-44
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    • 2014
  • The patellar clunk syndrome is one of the patellofemoral complication, caused by formation of the fibrous nodule at the suprapatellar region after total knee arthroplasty. The symptom involves painful catching, crepitus and clunk during knee extension. It has been mainly but not exclusively associated with the posterior stabilized total knee system. The fibrous nodule is entrapped in the femoral intercondylar notch of the femoral component during flexion and as the knee is extended, it displaces back to the trochlear groove abruptly and the typical symptoms occur. The risk of developing this complication is primarily related to the design of the femoral component and higher incidence was noted with earlier designs of posterior stabilized knee prosthesis. Modifications have been made to the femoral component to optimize the kinematics of the patellofemoral joint and thereby reduced the incidence of patellar clunk syndrome but did not eliminate the problem completely. Clinical examination is the gold standard of diagnosis and imaging study has been used as a possible adjunct to diagnosis. Especially ultrasonography is an imaging modality, which can be easily performed to detect the fibrous nodule on the quadriceps tendon. We report a case of patellar clunk syndrome which was diagnosed with ultrasonography.

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