The purpose of this study is to evaluate the cause, size, number, nature and locaton of loose bodies in the knee joint and to describe the proper arthroscopic technique to remae the loose bodies according to the location of them. We retrospectively analysed thirty-three operations of arthroscopic removal of loose bodies from the knee. Eleven males and 22 females were included with average age of 38(range 7-71). Total number of removed loose bodies were more than sixty. The loose bodies were found most commonly at anterior intercondylar notch area. The most common associated pathology was degenerative arthritis. The most common size of loose bodies was in the range of 5mm to 10mm in diameter. The most common nature of loose bodies was osteochondral. The loose bodies located in suprapatellar pouch, medial gutter, lateral gutter. anterior intercondylar notch or posterior intercondylar notch were removed using standard portals such as anteromedial, anterolateral, superomedial and posteromedial portals. The removal of loose bodies located in upper portion of posteromedial or posterolateral compartment were greatly enhanced using posterior trans-septal portal. The proper portals for the visualization and removal of loose bodies were identified according to the location of loose bodies in the knee joint. More skill in the use of the arthroscope is required for the removal of loose bodies than for simple diagnostic arthroscopy.
Kim, Kyung Tae;Lee, Song;Kim, Jin Hak;Lee, Ho Young;Kim, Myung Jin
Journal of the Korean Orthopaedic Association
/
v.56
no.1
/
pp.34-41
/
2021
Purpose: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in elderly patients older than 70 years by analyzing cases that have been implanted for >10 years ago. Materials and Methods: The long-term follow-up results were evaluated in 39 patients (46 cases) who underwent medial UKA from March 2002 to February 2004. The mean age of the patients at the time of surgery was 74.0 years, and the preoperative diagnosis was degenerative arthritis of the knee in all cases. Results: Of the 46 cases, reoperation occurred due to the complications in four cases. In 22 cases without 14 cases of death and six cases of follow-up loss, follow-up more than 10 years was possible. The mean Knee Society knee and function scores improved significantly from 53.0 and 52.5 points pre-operatively to 89.4 and 80.9 points at the last follow-up, respectively (p<0.001). The mean range of motion of the knee recovered to 132.5°, and the mean tibiofemoral angle changed to 5.9° of valgus at the last follow-up. Complications following the UKA occurred in four cases; the most prevalent complication was mobile bearing dislocation (n=2). One case of failure occurred due to aseptic loosening and degenerative arthritis of the lateral compartment, respectively. The cumulative survival rate of the implants was 95.0% at 10 years and 85.7% at 15 years. Of the 40 cases, excluding six cases of follow-up loss, 36 cases (90.0%) could be used without reoperation until death or at the last follow-up after surgery. Conclusion: These results showed the outstanding functions of the knee and satisfactory long-term survivorship after UKA. Therefore, UKA could be a useful method for the treatment of osteoarthritis of the knee in elderly patients older than 70 years of age.
This study was done to determine differences in effect of postoperative pain control in patients receiving auricular electroacustimulation vs transcutaneous electrical nerve stimualtion following total knee replacement surgery. Thirty-one cases referred to physical therapy department after treated by total knee replacement surgery by orthopedic surgery department at the Pohang St. Mary's Hospital from January 1993 through June 1994. Of 31 total knee replacement cases, 13 cases were auricular electroacustimulation group, 11 cases were transcutaneous electrical nerve stimulation group, and 7 cases were control group. The results of the study summerized are as follows: Thirty-one total knee replacement cases(male in 12 cases, female in 19 cases), ranging in age from 34 to 61 years(mean${\pm}$SD=49.90 7.56) with diagnoses of degenerative arthritis(20 cases), rheumatoid arthritis(9 cases), and other(2 cases). In auricular electroacustimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In transcutaneous electrical nerve stimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In control group, did not show significant pre-posttreatment differences in pain intensity, unpleasantness, active range of motion(p>0.05). The mean change in pain intensity and unpleasantness, active range of motion from pretreatment baseline for the 3 groups. Auricular electroacustimulation group showed the large magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. Transcutaneous electrical nerve stimulation group showed small magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. No significant changes were observed in control group. Highly significant differences in pain intensity, unpleasantness, and active rage of motion were found using an ANOVA measures between treatment groups and control group(p<0.01). The squares correlation coefficients of pain and function measures pretreatment-posttreatment differences for each group. In treatment group, there was significant correlation between pain scale and function(p<0.001). In control group, there was no correlation between the pain scale and function (p>0.05). The continuous study is needd for many interesting issues of auricular electroacustimulation in new future.
Ji, Sang-Goo;Kim, Myung-Kwon;Lee, Dong-Geol;Cha, Hyun-Kyu
The Journal of the Korea Contents Association
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v.12
no.3
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pp.222-232
/
2012
This study was conducted to compare the task-oriented exercise and weight-shifting exercise program has effectiveness on the static and dynamic balance in patients with total knee replacement. The participants were allocated randomly into 2 group : task-oriented exercise group(n=12) and weight-shifting exercise group(n=12). To evaluate the effects of exercise, subjects were evaluated by using Gaitveiw System and functional reaching test for static balance and Balance System for dynamic balance test. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance. Static balance test and dynamic balance test in task-oriented exercise had statistical significance than weight-shifting exercise program(p<0.05). So this results were suggested that the task-oriented exercise was effective on static and dynamic balance in patients with total knee replacement.
Purpose: The purpose of this study was to determine the asymmetrical difference between the use of leg muscles on the surgical and non-surgical sides during initial lower extremity ergometer exercise after unilateral knee arthroplasty. Methods: Twelve elderly patients diagnosed with degenerative arthritis of the knee and who underwent unilateral arthroplasty were included in this study. The leg length of each subject was taken into account when setting the application distance of the lower extremity ergometer. The same pedal resistance, strength, and speed were used for all the subjects. The total angle of use of the ergometer (360°) was analyzed by dividing it into an extension section and a flexion section. Using a surface electromyography system, the activities of the muscles of the surgical and non-surgical sides were converted into maximal voluntary isometric contraction (MVIC) and analyzed using the paired t-test. Results: When the activities of the muscles on the surgical and non-surgical sides were compared, it was found that the rectus femoris and biceps femoris had significant differences in the flexion and extension sections (p < .05), and that the tibialis anterior significantly differed in the flexion section (p < .05). There was no significant difference in the extension section of the tibialis anterior muscle, or in the flexion and extension sections of the gastrocnemius (p >.05). Conclusion: The results of this study confirm that the rectus femoris, tibialis anterior, biceps femoris, and gastrocnemius on the surgical side act in an opposite manner to those on the non-surgical side during pedaling in the same section.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.2
/
pp.422-428
/
2018
This study was conducted to investigate the effects of trunk stability exercise on knee function, balance and gait in patients who underwent total knee arthroplasty. The subjects of this study were recruited from individuals diagnosed with degenerative arthritis who had undergone total knee arthroplasty. Overall, 24 patients were randomly divided into a control groups and an experimental groups (12 each). The trunk stability exercise was conducted for 4 weeks with three exercises developed in a previous study. The measurement tools used were knee function measurements based on the Lysholm knee score, balance ability measured using a test of TUG and OLS, and a walking ability test measured using a 10MWT. Pre and post test results were within groups were compared using the paired t-test, whole differences between groups were compared using the independent t-test. The experimental group showed significantly enhanced results relative to the control group (p<0.05). Based on these results, trunk stability exercise in parallel with knee joint therapy effectively improves the recovery of patients with total knee arthroplasty.
Journal of Physiology & Pathology in Korean Medicine
/
v.21
no.5
/
pp.1154-1162
/
2007
This study was to investigate the effects of Bee-venom Treatment on the monosodium iodoacetate(MIA)- induced osteoarthritis in rats. Arthritis was induced by injection of MIA(0.5 mg) into knee joints of rats. Arthritic rats were divided into control(n=8) and treated(n=8) group. Control group was injected with normal saline once a day for 20 days, while treated group was injected with Bee-venom extract once a day for same duration. Body weights were measured at 0, 5, 10, 15, 20 days after injection. At the end of experiment, gross and histopathological examination on the articular cartilages of the knee joints were performed. Proteoglycan contents of articular cartilages were analysed by safranine O staining method. The contents of $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 in synovial fluids were analysed by ELISA method. And also, COX-2 and iNOS immunohistochemical examination on the knee joints were performed. Body weights of the treated group were increased compared with control group at 20 days after injection. Grossly, the severity of osteoarthritis in the treated group were alleviated compared with control group. PG contents in articular cartilages of the treated group were significantly increased compared with control group. Histopathologically, degenerative and necrotic lesion of articular cartilages in the treated group were alleviated compared with those of the control group. $TNF-{\alpha}$ contents in synovial fluids of the treated group were decreased compared with control group. Positive reactions of COX-2 in chondrocytes and synovial membranes of the treated group were decreased compared with the control group. On the basis of these results, we concluded that Bee-venom treatment has anti-arthritic effects on the monosodium iodoacetate-induced osteoarthritis in rats. And it's effects were related with reduced secretion of $TNF-{\alpha}$ and COX-2 from osteoarthritic chondrocytes and synovial membranes.
The purpose of this study was to investigate the functional changes of the vastus medialis while the neuromuscular electrical stimulation(NMES) was performed in elderly women with knee osteoarthritis. The subjects of this study were 30 women who were diagnosed degenerative arthritis, 15 in the experimental group and 15 in the control group. The experimental group performed conventional physical therapy and neuromuscular electrical stimulation, and the control group received only conventional physical therapy, five times per week for four weeks. Outcome measures were assessed before and after 4weeks using the VAS(pain), quadriceps femoris strength, thigh circumference, and Q-angle. The data of the quadriceps femoris strength and thigh circumference were significantly increased in experimental group(p<0.05). The data the pain was significantly decreased in both the two groups(p<0.05). There were statistically significant differences in quadriceps femoris strength and thigh circumference between the two groups(p<0.05). As the result, the application of neuromuscular electrical stimulation of the vastus medialis could be more effective for decrease pain and improving muscle function in patients with knee osteoarthritis.
The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.
Objectives The purpose of this review is to analyze results of case studies and controlled studies about Carthmi-Flos pharmacopuncture. Based on the review, authors desire to suggest the study model including precise information and evident the effect of Carthmi-Flos pharmacopuncture objectively in treating clinical disorders. Methods We search 44 studies about Carthmi-Flos pharmacopuncture from 6 Korean web databases, using words 'Carthmi-Flos pharmacopuncture' in Korean alphabet. This study had been conducted throughout 1 month (July, 2017). We selected case studies and controlled trials in investigated 44 thesis, excluding experimental research and thesis not using the Carthmi-Flos pharmacopuncture for major treatment. Results We analyze 13 case reports and 7 controlled trials. As a result, Carthmi-Flos Pharmacopuncture was used mostly in musculoskeletal, neurological diseases. But this can be applied to internal diseases. Disorders reported effectively were carpal tunnel syndrome, degenerative knee joint arthritis, posterior neck pain, low back pain, radial nerve palsy, shoulder pain, lumbar compression fracture, alopecia areata, chronic daily headache, duverney fracture, oligomenorrhea, cervical disc herniation, rheumatoid arthritis and cervical headache. Conclusions As we analyzed, Carthmi-Flos pharmacopuncture is specifically effective in musculoskeletal and neurologic diseases. But there are various problems in study design. To design accurately, the study design should include much more specific information. And the result can be more precise by excluding other methods.
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