• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.527-533
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• 2020

Purpose: This study compared the effects of a buprenorphine transdermal patch (BTDP) on the chest and knee for pain control after total knee arthroplasty (TKA). Materials and Methods: A retrospective case-control study was conducted from August 2018 to August 2019 on 231 patients who underwent TKA. Two hundred cases were selected considering age, sex, and body mass index. Before and after applying the BTDP, the Numeric Rating Scale (NRS), adverse effects and compliance were measured. All measurements in the chest application group (group A=100) and knee application group (group B=100) were compared. Results: NRS was similar in rest between the groups treated with BTDP, but at two days and three days afternoon, five, six, and seven days postoperatively in group B, the NRS was significantly lower than that of group A. The adverse effects of the central nervous system and gastrointestinal system after applying BTDP were significantly lower in group B than in group A. No significant differences in adverse effects of the cardiovascular system and skin were observed between the two groups. Regarding the maintenance of BTDP, group B was significantly higher than group A. Conclusion: The direct application of BTDP after TKA to painful knee joints showed excellent results in early postoperative pain control and can be a useful method for increasing patient compliance by reducing the frequency of adverse effects.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.190-194
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• 2012

The role of arthroscopy for the diagnosis of polyethylene wear after total knee arthroplasty has been reported previously. In this report, we demonstrate a case of wear of meniscal bearing in unicompartmental knee arthroplasty (UKA) and recurrent meniscal bearing subluxation which was diagnosed by arthroscopy. Arthroscopic examination has its role in diagnosing the wear and subluxation of polyethylene bearing after UKA.

• 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.

• 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.

• Journal of muscle and joint health
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• v.18 no.2
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• pp.203-214
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• 2011

Purpose: The purpose of the study was to identify the effects for 4-weeks muscle strengthening exercise program on pain, fatigue, and physical function(muscle strength of leg, walking competence, balance, flexibility of patella) in elderly women with total knee arthroplasty(TKA). Method: Utilizing a quasi-experimental design, 30 TKA patients consisted of the experimental group (n=15) and control group (n=15). The experimental group participated in the muscle strengthening exercise program, twice a day for 4 weeks. Data were analyzed with SPSS WIN 18.0 program, using repeated measure ANOVA. Result: As time goes by, There were significant differences in muscle strength of leg (F=6.60, p<.001), walking competence(F=7.15, p<.001), and balance(F=17.55, p<.001) between the experimental and the control groups. Conclusion: The findings of this study revealed the positive effects of muscle strengthening exercise program in elderly women with TKA.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.413-421
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• 1999

Purpose: This study was performed to evaluate the usefulness of $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy Materials and Methods: The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age. 65 years) who had total knee replacement arthroplasty. After injection of $^{99m}Tc$-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection. Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. Results: Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positives, one false positive and three true negatives in Group B, and six true negatives and two false positives in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively Conclusion: $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.62-70
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• 2020

Purpose: External tibia torsion and proximal tibial vara have been reported in severe varus deformed osteoarthritis, which is a tibio-femoral angle of more than 20°. The radiology measurements were compared with those of control group and the preoperative and follow-up radiology and clinical results were examined. Materials and Methods: From January 2007 to March 2016, 43 knees from 37 persons, who underwent total knee arthroplasty for a severe varus deformity of more than 20° on the tibio-femoral angle on the standing radiographs and had a follow-up period more than two years, were examined. The mean follow-up period was 45.7 months. The control group, who underwent conservative treatments, had Kellgren-Lawrence grade three osteoarthritis and a tibio-femoral angle of less than 3° varus. The external tibial torsion of enrolled patients and control group were estimated using the proximal tibio-fibular overlap length and the tibial torsion values on computed tomography. The proximal tibia vara was measured using the proximal tibial tilt angle. The preoperative and postoperative proximal tibio-fibular overlap length, tibial torsion value, proximal tibial tilt angle, and hospital for special surgery (HSS) score were evaluated. Results: The mean proximal tibio-fibular overlap length was 18.6 mm preoperatively and 11.2 mm (p=0.031) at the follow-up. The control group had a mean proximal tibio-fibular overlap length of 8.7 mm (p=0.024). The mean tibial torsion value was 13.8° preoperatively and 14.0° (p=0.489) at the follow-up. The control group had a mean tibial torsion value of 21.9° (p=0.012). The mean proximal tibial tilt angle was 12.2° preoperatively and 0° (p<0.01) at the follow-up. The control group had a mean proximal tilt angle of 1.2° (p<0.01). The preoperative tibiofemoral angle and mechanical axis deviation were corrected from preoperative 28.3° and medial 68.4 mm to postoperative 0.7° and medial 3.5 mm (p<0.01, p<0.01), respectively. The HSS scores increased from 34 points of preoperatively to 87 points at the last follow-up (p=0.028). Conclusion: Patients with advanced osteoarthritis with a severe varus deformity of more than 20° had significant increases in the external tibial torsion and varus of the proximal tibia. The tibial torsion value before and after surgery in the enrolled patients was not changed statistically, but good clinical results without complications were obtained.