• 근관절건강학회지
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• 제29권2호
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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.

• 한국병원경영학회지
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• 제29권3호
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• pp.1-10
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• 2024

Purposes: When rehabilitation services are provided remotely using information and communication technologies to patients living at home, there is an advantage in providing rehabilitation services to individuals in their everyday social and physical environment, which can improve functional outcomes and satisfaction. The purpose of this study was to analyze the effectiveness of the pilot project by analyzing the outpatient and inpatient medical use and expenses of patients who participated in the rehabilitation patient home-based care pilot project. Methodology: To analyze the effectiveness of the home-based care pilot project for rehabilitation patients, health insurance claims data from the Health Insurance Review and Assessment Service was used. The subjects of analysis were patients who had undergone major lower extremity joint replacement surgery, including hip, knee, and ankle joint replacement surgery, and patients who had lower extremity fracture surgery, which were the targets of the rehabilitation patient home-based care pilot project. To compare medical use and expenses between patients participating in the rehabilitation patient home-based care pilot project and those not participating, chi-square test, t-test, and multiple regression analysis were performed. Findings: As a result of analyzing the number of medical use cases and expenses of patients who participated and those who did not participate in the rehabilitation patient home-based care pilot project, the average outpatient medical use and outpatient medical expenses per person for participating patients were lower than those for patients who did not participate. The average hospitalization cost per person and the average length of stay per person were also lower than those of patients who did not participate. Practical Implications: Home-based care for rehabilitation patients continues to provide medical services at home, not at medical institutions, and can be expected to reduce readmissions and complications by resolving patients' emergency situations at home or on their own, thereby reducing medical use.

• 대한골관절종양학회지
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• 제3권1호
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• pp.18-25
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• 1997

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2

• 한국농촌건축학회논문집
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• 제13권1호
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• pp.37-44
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• 2011

The maintenance works for brick-structured buildings are a new field in Korea, and practical cases are yet inadequate so that such works may cause adverse effects of damaging the buildings after all. Therefore, this study has extracted a preservation technology believed to be most desirable in minimizing the damage to the original state of the buildings and preserving the value as the cultural assets through maintenance work details from 1986 to 2010 regarding brick-structured buildings designated as cultural properties. Firstly, a brick replacement method of using the brick used at the time of construction is efficient in replacement and repair of brick material for preserving value of cultural assets and minimizing damage of the original form. Secondly, use of lime mortar through material analysis is effective in repair of masonry joint and mortar but it is not used often due to high experimental cost. Finally, reinforcement of structure using a form for a building with severe damage is most efficient when considering additional problems. However, damage on the original form of a building can be minimized and value of a building can be preserved only when consideration on sufficient case analysis, materials to be used, and conditions of a building is supported.

• Journal of Yeungnam Medical Science
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• 제37권1호
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• pp.40-46
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• 2020

Background: Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint. Methods: The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain. Results: Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain. Conclusion: Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

• 약학회지
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• 제52권2호
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• pp.101-110
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• 2008

Total Knee Replacement (TKR) surgery is one of the invasive procedures for patients with late-stage knee joint disorders. In the present study, economic efficiency was compared between uses of the 2nd and 3rd generation cephalosporins for the prophylaxis before and after the surgery using frequency analysis in terms of various factors such as medication costs, the number of days of antibiotic use and hospitalization due to TKR surgery. The results showed that the 3rd generation cephalosporins did not reduce the infection rate and total medication costs, but rather raised antibiotic cost in comparison with the 2nd ones. A frequent use of the 3rd ones is closely related to emergence of resistant bacterial strains. Therefore, we suggest that unnecessary prescriptions for the broad spectrum antibiotics should be avoided.

• 한국구조물진단유지관리공학회 논문집
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• 제6권4호
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• pp.209-217
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• 2002

The effects on structures caused by the replacement of the bridge bearings are investigated in this study. The bearings of the bridge are seriously deteriorated because of the breakage of lower concrete and the corrosion of the bearing itself. Also, the negative reaction states are created at some bearings on the abutment. Then, the bridge has occurred excessive vibrations and severe noise and impact whenever heavy trucks pass the above joints. The existing bearings are replaced using the adjustable bearing. The height of the bearings is adjusted to minimize the level difference of above joint and also to induce the appropriate distribution of live loads The effects of replacing the bearings are investigated by measuring the behaviors of the bridge without and with replacing works. The results without replacing the bearing show that the distribution of displacements and stresses is distorted in comparison with the analytical results. Also the bridge without replacing the bearing shows that the impact and vibration from the heavy trucks are larger than those with replacing the bearing. Load carrying capacity of the bridge increase about 1.8 times through replacing the bearing. The above results show that the structural performance of the bridge is improved by replacing only bridge bearings.

• 한국임상수의학회지
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• 제39권6호
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• pp.390-394
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• 2022

A 6-year-old, 36.5 kg castrated male Golden Retriever presented for revision surgery for left total hip replacement. The patient underwent removal of the cup and head implants due to unmanageable prosthetic hip dislocation, despite revision surgery. On physical examination, the dog showed persistent weight-bearing lameness after exercise of the left hindlimb with mild muscle atrophy. Radiographic examination revealed dorsolateral displacement of the femur with a remnant stem and bony proliferation around the cranial and caudal acetabulum rims. The surgical plan was to apply the dual mobility cup to increase the range of motion and jump distance to correct soft tissue elongation and laxity caused by a prolonged period of craniodorsal dislocation of the femur. The preparation of the acetabulum for cup fixation was performed with a 29-mm reamer, and the 29.5-mm outer shell was fixed with five 2.4-mm cortical screws. The head and medium neck of the dual-mobility system were placed on the cup, and the hip joint was reduced between the neck and stem. The dog exhibited slight weight bearing on a controlled leash walk the day after surgery. The patient was discharged 2 weeks postoperatively without any complications. Six months postoperatively, osseointegration and a well-positioned cup implant were observed, and the dog showed excellent limb function without hip dislocation until 18 months of phone call follow-up.

• Clinics in Shoulder and Elbow
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• 제27권3호
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• pp.353-360
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• 2024

Background: Total shoulder arthroplasty (TSA) in patients with rheumatoid arthritis (RA) can present unique challenges. The aim of this study was to compare both systemic and joint-related postoperative complications in patients undergoing primary TSA with RA versus those with primary osteoarthritis (OA). Methods: Using the TriNetX database, Current Procedural Terminology and International Classification of Diseases, 10th edition codes were used to identify patients who underwent primary TSA. Patients were categorized into two cohorts: RA and OA. After 1:1 propensity score matching, postoperative systemic complications within 90 days following primary TSA and joint-related complications within 5 years following anatomic TSA (aTSA) and reverse shoulder arthroplasty (RSA) were compared. Results: After propensity score matching, the RA and OA cohorts each consisted of 8,523 patients. Within 90 days postoperation, RA patients had a significantly higher risk of total complications, deep surgical site infection, wound dehiscence, pneumonia, myocardial infarction, acute renal failure, urinary tract infection, mortality, and readmission compared to the OA cohort. RA patients had a significantly greater risk of periprosthetic joint infection and prosthetic dislocation within 5 years following aTSA and RSA, and a greater risk of scapular fractures following RSA. Among RA patients, RSA had a significantly higher risk of prosthetic dislocation, scapular fractures, and revision compared to aTSA. Conclusions: Following TSA, RA patients should be considered at higher risk of systemic and joint-related complications compared to patients with primary OA. Knowledge of the risk profile of RA patients undergoing TSA is essential for appropriate patient counseling and education.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.151-179
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• 2003

The purpose of this study was to examine the influence of total knee replacement to arthritis patients in pain intensity and functional impairment. For this study, over 50-year-old 30 patients who had osteoarthritis and 69 patients who got total knee replacement at the one of the departments of orthopedics in Daegu were interviewed from June, 2002 to March, 2003. The results of this study were as follows : First, pain intensity was decreased to experimental group after operation than control group(P<.01) And the presence of crepitation was also decreased to them(P<.05). On the other hand there's no significant difference was noted in the presence of stiffness, degree of flexion contracture and extension contracture between two groups. Second, over 91 days group after operation and visitor's group of physiotherapy unit were better than others in Level of knee function(P<.01). Third, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Barthel Index of knee function(P<.01). Forth, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Level of IADL(P<.05). Fifth, over 91 days group after operation and visitor‘s group of physiotherapy unit were higher than others in Katz Index of knee function(P<.01). Sixth, although Old Ages' Activity Index seemed to get better as time goes by, there's no statistical difference. Seventh, over 91 days group after operation and visitor's group of physiotherapy unit were higher than admission group and under 30 days group after operation in Social Activity Index(P<.05). Eighth, the function of the knee was connected with the abilities in the activity of the old and the social skill. The Barthel index was connected with the function of the knee joint and the activities of the old and Katz index. IADL function was connected with the activities of the old and the social activity. The Katz index was connected with the Barthel index. The activity of the old was connected with the Barthel index, the functional score of the knee joint andthe IADL score. The ability of social skill was connected with the activity of the old, IADL score and the function of the knee.