• 제목/요약/키워드: Hip replacement arthroplasty

검색결과 50건 처리시간 0.024초

라이프케어를 위한 관절 치환술 환자의 의료이용에 관한 연구 (A Study on the Medical Use of Total Replacement Arthroplasty Patients for Life Care)

  • 이경화;김환희
    • 한국엔터테인먼트산업학회논문지
    • /
    • 제13권8호
    • /
    • pp.661-670
    • /
    • 2019
  • 본 연구는 만성 퇴행성관절염인 슬관절과 고관절 전치환술 환자의 수혈에 영향을 주는 요인을 분석하고, 수혈이 관절 치환술 환자의 의료이용에 미치는 영향을 연구하여 양질의 의료를 위한 기초자료로 활용하고자 한다. 연구대상은 심평원의 환자표본자료(HIRA- NIS-2017) 중 입원개시일자가 2017년 1월 1일부터 12월 30일까지 단측 전치환술을 시행한 환자 중 65세 이상 슬관절 전치환술(N2072)과 고관절 전치환술(N0711)로 청구된 코드만을 대상으로 총 분석 대상은 1,580건이었다. 연구결과는 다음과 같다. 첫째 슬관절 전치환술이 병원특성 및 환자특성별로 수혈여부에 유의한 차이가 있는지 비교하였다. 유의한 변수로는 의료기관종류, 시도, 병상수준, 성별, 빈혈에서 통계학적으로 유의한 연관이 있는 것으로 나타났다. 둘째, 고관절 전치환술의 병원특성 및 환자특성별로 수혈여부에 유의한 차이가 있는 지 비교하였다. 유의한 변수로는 의료기관종류, 병상수준에서 유의한 연관이 있는 것으로 나타났다. 셋째, 슬관절 전치환술의 병원특성 및 환자특성별로 당뇨병 유무에 유의한 차이가 있는 지 비교하였다. 유의한 변수로는 의료기관종류, 병상규모, 빈혈에서 유의한 연관이 있는 것으로 나타났다. 넷째, 수혈여부에 영향을 미치는 요인을 파악하기 위해 로지스택 회귀분석을 실시한 결과, 수혈에 영향을 주는 요인 분석 결과 슬관절 전치환술의 수혈여부에 유의한 영향을 미치는 독립변수는 의료기관 종류, 기관소재지, 성별, 빈혈이었다. 고관절 전치환술의 수혈여부에 유의한 영향을 미치는 독립변수는 의료기관 종류, 성별로 나타났다

하지 인공관절 치환술 환자의 건강 관련 삶의 질 영향요인 (Factors Influencing Health-related Quality of Life among Knee or Hip Arthroplasty Patients)

  • 강미경;김근진;김혜영
    • 기본간호학회지
    • /
    • 제24권3호
    • /
    • pp.209-218
    • /
    • 2017
  • Purpose: The purpose of this research was to identify factors that influence health-related quality of life of patients who have had knee or hip arthroplasty. Factors included sleep disorders, pain, activities of daily living, and depression. Methods: The participants in this research were 97 patients within one year after receiving knee or hip arthroplasty surgery and who regularly visited a hospital outpatient department. Data were analyzed using descriptive statistics, t-test, ANOVA, and stepwise regression analysis with the SPSS program. Results: Sleep disorders, pain, activities of daily living, and depression had significant correlations with health related quality of life. Factors influencing health-related quality of life among arthroplasty patients were the length of time since surgery, sleep disorders, activities of daily living, and depression. These factors explained 58% of the participants' health-related quality of life. Conclusion: The results show that various factors can affect patients' health-related quality of life following joint replacement surgery. The findings indicate that sleep disorders and depression should receive continued attention after the arthroplasty. It is also necessary to develop appropriate nursing intervention programs to lower depression and increase patient participation in daily living activities.

슬관절과 고관절 전치환술 환자의 수혈에 영향을 미치는 병원특성 요인 분석 (The Analysis of Hospital Characteristics affecting Blood Transfusion to the patients under Knee or Hip Total Replacement Arthroplasty)

  • 오지영;김상미;이성아
    • 한국산학기술학회논문지
    • /
    • 제16권6호
    • /
    • pp.4031-4039
    • /
    • 2015
  • 저출산 고령화로 헌혈인구는 감소하고, 노년층의 혈액사용량은 증가할 것으로 예상되어 혈액부족과 수혈의 안정성 문제가 대두되고 있다. 이에 본 연구에서는 만성 퇴행성관절염인 슬관절과 고관절 전치환술 환자의 수혈에 영향을 주는 요인을 분석하고자 하였다. 이를 위해 건강보험심사평가원의 2011년 환자표본자료 중 입원환자 5,370명을 대상으로 하였으며, SPSS 20 프로그램을 이용하여 로지스틱 회귀분석을 실시하였다. 독립변수로 사용된 변수는 병원특성과 환자특성으로 병원특성은 의료기관 종류, 설립구분, 기관소재지와 가동병상수를, 환자특성으로는 성, 연령, 중증도, 전신마취유무, 주 진단, 빈혈유무와 의료보험종류로 구분하였다. 분석결과, 슬관절전치환술 환자의 수혈에 유의한 영향을 미치는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 주 진단, 빈혈유무였으며, 고관절전치환술 환자의 수혈에 유의한 영향을 주는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 전신마취유무, 빈혈유무였다. 수혈현황과 영향요인을 분석한 본 연구는 비용 효과적이며, 양질의 의료를 위한 기초자료로 활용될 수 있을 것으로 기대한다.

고관절 치환술 후 추나치료 효과: 체계적 문헌고찰 및 메타분석 (Effects of Chuna Manual Therapy after Hip Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials)

  • 이은별;김현지;김채영;안희덕
    • 한방재활의학과학회지
    • /
    • 제32권2호
    • /
    • pp.95-103
    • /
    • 2022
  • Objectives This study was conducted to assess the effect of chuna manual therapy after hip arthroplasty. Methods We searched across 9 electronic databases (PubMed, Cochrane Library, Wangfang data, China National Knowledge Infrastructure [CNKI], Oriental Medicine Advanced Searching Integrated System [OASIS], National Digital Science Library [NDSL], Korean Medical Database [KMBASE], Koreanstudies Information Service System [KISS], Research Information Sharing Service [RISS]) to find randomized controlled clinical trials for chuna manual therapy after hip arthroplasty. Results On inclusion criteria, 11 appropriate studies were included and analyzed. The deep vein thrombosis incidence of the chuna manual therapy group was statistically lower than the conventional treatment group (p=0.0002). Chuna manual therapy significantly improved the Harris hip score compared with conventional treatment (p<0.00001). Also, chuna manual therapy combined with herbal fumigation therapy significantly elevated the hip joint function score of Harris hip score compared with the conventional therapy group (p<0.00001). Conclusions The systematic review showed that chuna manual therapy had significant effects on hip arthroplasty. Nonetheless, considering the high risk of bias and geographic bias, further research with well-designed studies is required to support the effectiveness of chuna manual therapy.

Risk Factors of Neuropathic Pain after Total Hip Arthroplasty

  • Maeda, Kazumasa;Sonohata, Motoki;Kitajima, Masaru;Kawano, Shunsuke;Mawatari, Masaaki
    • Hip & pelvis
    • /
    • 제30권4호
    • /
    • pp.226-232
    • /
    • 2018
  • Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA. Results: The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA. Conclusion: THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

Stress Analysis of Femoral Stems on Non-Cemented Total Hip Replacement - A Three-Dimensional Finite Element Analysis -

  • Kim, Sung-Kon;Chae, Soo-Won;Jeong, Jung-Hwan
    • 대한의용생체공학회:학술대회논문집
    • /
    • 대한의용생체공학회 1997년도 추계학술대회
    • /
    • pp.263-266
    • /
    • 1997
  • Three dimensional numerical model based on the finite element method(FEM) were developed to predict the mechanical behavior of hip implants. The purpose of this study is to investigate the stress distribution of two types of cementless total hip replacement femoral component -a straight stem and a curved stem, and to compare their effect on the stress shielding between two types by three dimensional finite element method. The authors analyzed von Mises stress in the cortex & stem and compared the stress between the straight and the curved stem. In comparison of stresses between two different design of femoral stem, there was 25% more decrease of stress in straight stem than curved stem in the medial cortex at proximal region. The straight stem had consistently much lower stresses than the curved stem throughout the whole medial cortex with maximum 70% reduction of stress. However, there was little change in stress between nature and 2 implanted femur throughout the lateral cortex. Stress of femoral stem was much higher in the straight stem than the curved stem up to 60%. The straight stem had more chance of stress shielding and a risk of fatigue fracture of the stem compared with the curved stem in noncement hip arthroplasty. In design of femoral stem still we have to consider to develop design to distribute more even stress on the proximal medial cortex.

  • PDF

고관절전치환 성형술 후 관절주위 골형성 예방을 위한 수술 후 방사선 요법 (Postoperative Irradiation for Prevention of Heterotopic Bone Formation after Total Hip Replacement Arthroplasty)

  • 박우윤;김일한;하성환;박찬일
    • Radiation Oncology Journal
    • /
    • 제4권1호
    • /
    • pp.75-80
    • /
    • 1986
  • 관절주위 골형성은 고관절치환 성형술을 시행받은 환자의 $0.6\~61.7\%$에서 생친 수 있는 합병증이다. 저자들은 1981년 1월부터 1985년 5월까지 서울대학교병원 치료방사선과에서 고관절전치환 성형술 후 관절주위 골형성 예방을 위하여 방사선요법을 시행받은 4명의 환자(8개의 고관절)를 분석하였다. 방사선요법은 수술후 $6\~10$일이내 시작하였으며 2,000cGy를 10회 분할 조사하였다. Modified Brooker system에 의하여 7계의 고관절에서는 Grade(1개 의고관절에서는 Grade) 2의 결과를 얻었다. 저자들의 이번 연구결과 및 문헌조사에 의하면 고관절 성형술 후 관절주위 골형성 예방을 위하여 호발군에 있어서의 방사선요법은 효과적이라고 하겠다.

  • PDF

Mid-term Results of Total Hip Arthroplasty for Posttraumatic Osteoarthritis after Acetabular Fracture

  • Sharath K. Ramanath;Tejas Tribhuvan;Uday Chandran;Rahul Hemant Shah;Ajay Kaushik;Sandesh Patil
    • Hip & pelvis
    • /
    • 제36권1호
    • /
    • pp.37-46
    • /
    • 2024
  • Purpose: The prognosis of total hip replacement (THR) after open reduction and internal fixation (ORIF) versus THR following non-operative treatment of acetabular fractures is unclear. Few studies have been conducted in this regard. Therefore, the purpose of the current study was to perform an assessment and compare the functional outcomes for study subjects in the ORIF and non-ORIF groups during the follow-up period compared to baseline. Materials and Methods: This longitudinal comparative study, which included 40 patients who underwent THR for either posttraumatic arthritis after fixation of an acetabular fracture or arthritis following conservative management of a fracture, was conducted for 60 months. Twenty-four patients had undergone ORIF, and 16 patients had undergone nonoperative/conservative management for acetabular fractures. Following THR, the patients were followed up for monitoring of functional outcomes for the Harris hip score (HHS) and comparison between the ORIF and non-ORIF groups was performed. Results: The HHS showed significant improvement in both ORIF and non-ORIF groups. At the end of the mean follow-up period, no significant variation in scores was observed between the groups, i.e., ORIF group (91.61±6.64) compared to non-ORIF group (85.74±11.56). A significantly higher number of re-interventions were required for medial wall fractures and combined fractures compared to posterior fractures (P <0.05). Conclusion: THR resulted in improved functional outcome during follow-up in both the groups; however, the ORIF group was observed to have better functional outcome. Re-intervention was not required for any of the posterior fractures at the end of the mean follow-up period.