• Title/Summary/Keyword: 인공 슬관절

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Linked (Semi-constrained) Total Elbow Arthroplasty (연결형(반구속형) 주관절 인공 관절 치환술)

  • Jung, Hong Jun;Jeon, In-Ho;Chun, Jae-Myeung;Lee, Tae Kyoon
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.170-177
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    • 2013
  • Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

Prognostic Factors after Arthroscopic Treatment of Infectious Knee Arthritis (감염성 슬관절염의 관절경적 치료 이후 예후 인자에 대한 분석)

  • Kang, Sang-Woo;Choi, Eui-Sung;Kim, Dong-Soo;Jung, Ho-Seung;Hong, Seok-Hyun;Go, Ban-Suk
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.30-36
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    • 2019
  • Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

Linked Semi-constrained or Unlinked TER: What We Should Know Before We Use? (연결형, 반구속형 또는 비연결형, 비구속형 주관절 인공 관절 성형술: What We Should Know Before We Use?)

  • Jung, Hong-Jun;Jeon, In-Ho;Chun, Jae-Myeung
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.99-104
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    • 2011
  • Purpose: Total elbow arthroplasty (TEA) is still in its infancy as compared with other forms of arthroplasty. TEA designs have evolved with experience, but comparatively little long-term outcome data is available. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Material and Method: The designs of total elbow prostheses can be subdivided into three categories: unlinked, linked, and convertible. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Results and Conclusion: By proper patient selection and by utilizing implant design advances, improvements in cementation techniques, a meticulous surgical technique, and appropriate postoperative rehabilitation, total elbow arthroplasty can provide a high level of patient satisfaction and pain relief.

Simulation of Three Dimensional Motion of the Knee Joint in Total Knee Arthroplasty (인공 무릎 관절의 3차원 운동 시뮬레이션)

  • Moon, Byung-Young;Son, Kwon;Kim, Ki-Bum;Seo, Jung-Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.9
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    • pp.188-195
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    • 2004
  • Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

Finite Element Analysis for the Contact Stress of Ultra-high Molecular Weight Polyethylene in Total Knee Arthroplasty (전 슬관절 치환 성형술에 사용되는 초고분자량 폴리에틸렌 삽입물의 접촉응력에 관한 유한요소해석)

  • Jo, Cheol-Hyeong;Choe, Jae-Bong;Choe, Gwi-Won;Yun, Gang-Seop;Gang, Seung-Baek
    • Journal of Biomedical Engineering Research
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    • v.20 no.1
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    • pp.37-44
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    • 1999
  • Because of bone resorption, wear of ultra-high molecular weight polyethylene(UHMWPE) in total knee arthroplasty has been recognized as a major factor in long-term failure of knee implant. The surface damage and the following harmful wear debris of UHMWPE is largely related to contact stress. Most of the previous studies focused on the contact condition only at the articulating surface of UHMWPE. Recently, contact stress at the metal-backing interface has been implicated as one of major factors in UHMWPE wear. Therefore, the purpose of the is study is to investigate the effect of the contact stress for different thickness, conformity friction coefficient, and flexion degree of the UHMWPE component in total knee system, considering the contact conditions at both interfaces. In this study, a two-dimensional non-linear plane strain finite element model was developed. The results showed that the maximum value of von-Mises stress occurred below the articulating surface and the contact stress was lower for the more conforming models. All-polyethylene component showed lower stress distribution than the metal-backed component. With increased friction coefficient on the tibiofemoral contact surface, the maximum shear stress increased about twofold.

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Effects of Defecation Encouragement Program in Patients Undergoing total Knee Replacement Arthroplasty (배변 격려 프로그램이 인공 슬관절 전치환술 환자의 배변에 미치는 효과)

  • Park, Jeong Hee;Cheon, Sung Joo;Gwon, Yeong Hee;Park, Hyeon Suk;Kim, Mi Na;Park, Mi Ran;Choi, Hye Jin
    • Journal of muscle and joint health
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    • v.29 no.2
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    • pp.81-90
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    • 2022
  • Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program for patients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing best practice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC) in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedic clinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patients with the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercise therapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72 subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days in experimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipation assessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to control group (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and the experimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was proved to be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursing problem that can be sufficiently prevented if nurses are interested and encourage defecation.

Long-term Follow-up after Implantation of Autologous Adipose Tissue Derived Mesenchymal Stem Cells to Treat a Dog with Stifle Joint Osteoarthrosis (골관절증을 보이는 개에서 자가지방 유래 줄기세포 치료 증례)

  • Yoon, Hun-Young;Lee, Jung-Ha;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.82-86
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    • 2012
  • A 5-year-old castrated male Chihuahua weighing 1.54 kg was examined because of a several month history of progressive right hind limb lameness. Physical examination of the stifle joints revealed pain and a grade IV medial patellar luxation on the right stifle joint. The right and left stifle joints were associated with a lameness of grade 2 and grade 0, respectively. Radiography revealed osteophytes or subchondral cystic lesions on the right and left stifle joints. Osteoarthrosis (OA) scores for the right and left stifle joints were 20 and 12 respectively. Combination of surgery and implantation of autologous adipose tissue derived mesenchymal stem cells (aAT-MSCs) was determined with informed consent. $1{\times}10^6$ aAT-MSCs suspended in PBS and 0.6 mL of hyaluronic acid were injected in the right stifle joint postoperatively. Osteoarthrosis scores and the lameness grade for the right and left stifle joints were 19 and 13, and 0 and 0 19 months after treatment, respectively, and 14 and 15, and 0 and 0 five years after treatment, respectively. This case report shows radiographical evidence of a decrease in osteophytes and subchondral cystic lesions on the stifle joint with OA after aAT-MSCs injection.

Radiologic Evaluation of Change of Ankle Joint after Total Knee Arthroplasty (인공 슬관절 치환술 후 족관절 변화에 대한 방사선학적 연구)

  • Bae, Su-Young;Kim, Hee-Chun;Park, Young-Soo;Lee, Sang-Eun;Lee, Don-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.135-140
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    • 2007
  • Purpose: To evaluate the incidence and describe radiologic pattern of ankle arthritis following change of mechanical loading axis by total knee arthroplasty. Materials and Methods: We reviewed radiographs of 419 cases, 243 patients underwent total knee arthroplasy from January 2002 to October 2006 retrospectively. We described radiologic parameters around the ankle joint and measured the amount of change of knee varus or valgus angle by comparing preoperative and postoperative anteroposterior standing lower extremities AP X-rays. We divided cases into two groups, one with radiologically arthritic change of the ankle joint and the other one without any radiologic change after surgery. We compared two groups in each parameters and analyzed statistically (SPSS v13.0). Results: Three hundred eighty one cases were divided into varus group and 38 cases in valgus group. 125 cases were divided into ankle arthritic change-positive subgroup among the varus group and 251 cases were in negative subgroup. The amount of varus angle correction by total knee arthroplasty showed significant difference between two subgroups. There was no significant difference in each parameters between subgroups within 38 valgus cases. Conclusion: Ankle arthritis can be aggravated after total knee arthroplasty because of the change of mechanical loading axis onto the ankle joint. Therefore it may be needed to evaluate symptoms and function of ankle joints before performing total knee arthroplasties especially in patients with huge varus deformities of knee joints.

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