• Title/Summary/Keyword: Joint replacement

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Behavior of Steel Fiber-Reinforced Concrete Exterior Connections under Cyclic Loads (반복하중을 받는 강섬유 보강 철근콘크리트 외부 접합부의 거동 특성)

  • Kwon, Woo-Hyun;Kim, Woo-Suk;Kang, Thomas H.K.;Hong, Sung-Gul;Kwak, Yoon-Keun
    • Journal of the Korea Concrete Institute
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    • v.23 no.6
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    • pp.711-722
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    • 2011
  • Beam-column gravity or Intermediate Moment frames subjected to unexpected large displacements are vulnerable when no seismic details are provided, which is typical. Conversely, economic efficiency of those frames is decreased if unnecessary special detailing is applied as the beam and column size becomes quite large and steel congestion is caused by joint transverse reinforcement in beam-column connections. Moderate seismic design is used in Korea for beam-column connections of buildings with structural walls, which are to be destroyed when the unexpected large earthquake occurs. Nonetheless, performance of such beamcolumn connections may be substantially improved by the addition of steel fibers. This study was conducted to investigate the effect of steel fibers in reinforced concrete exterior beam-column connections and possibility for the replacement of some joint transverse reinforcement. Ten half-scale beam-column connections with non-seismic details were tested under cyclic loads with two cycles at each drift up to 19 cycles. Main test parameters used were the volume ratio of steel fibers (0%, 1%, 1.5%) and joint transverse reinforcement amount. The test results show that maximum capacity, energy dissipation capacity, shear strength and bond condition are improved with the application of steel fibers to substitute transverse reinforcement of beam-column connections. Furthermore, several shear strength equations for exterior connections were examined, including the proposed equation for steel fiber-reinforced concrete exterior connections with non-seismic details.

Surgical Treatments of Osteosarcoma around the Knee in Children (소아 슬관절 주위 골육종의 수술적 치료)

  • Nam, Kwang-Woo;Lee, Sang-Hoon;Kim, Han-Soo;Oh, Joo-Han;Cho, Whan-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.1-12
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    • 2004
  • Purpose: The current study was performed to analyze the oncological and functional results, and the patient, the limb and the prosthesis survival of osteosarcoma around the knee in children according to the treatment options. Materials and Methods: From 1982 to 2002, 63 patients with osteosarcoma around the knee underwent surgical treatments before 16 years of age. Surgical treatment options were amputation, endoprosthetic replacement, and implantation of low heat-treated autogenous bone graft after wide resection of tumor. The mean age of patients was 11.5 years (4.4~16), and the mean follow-up period was 6.1 years (2.1~16.8). All patients had neoadjuvant and adjuvant chemotherapy. All endoprosthses were extendible types. Anatomical locations of osteosarcoma were distal femur in 40 patients, and proximal tibia in 23 patients. As regard to Enneking stage, 4 patients had stage $II_A$, 50 patients had stage $II_B$, and 9 patients had stage III tumors. Results: The 5 year survival rate of stage $II_B$ patients was 72.7% in amputation, 83.7% in endoprosthesis, and 100% in low heat-treated autogenous bone graft. The 5 year survival rate of salvaged limb was 84.4% in endoprosthesis, and 80% in low heat-treated autogenous bone graft. The survival rate of prosthesis was 92.7% at 5 years, 67.4% at 10 years in endoprosthesis, and 75% at 5 years in low heat-treated autogenous bone graft. Mean functional outcome scores were 8.7 points in amputation, 20.6 points in endoprosthesis, and 16 points in low heat-treated autogenous bone graft. Distant metastasis occurred 15.8% in amputation, 27% in endoprosthesis and local recurrence occurred 8.1% in endoprosthesis, 14.3% in low heat-treated autogenous bone graft. Major complications happened 26.3% in amputation, 35.1% in endoprosthesis, and 28.6% in low heat-treated autogenous bone graft. Conclusion: Limb salvage procedure had functionally better results than amputation in children with osteosarcoma around the knee. Reconstruction with endoprosthesis after resection of tumor had good results in children as adults. In certain circumstances as too small bone for endoprosthesis or minimal bony destruction or too skeletally immature patient, low heat-treated autogenous bone graft may be a good treatment option. Low heat-treated autogenous bone graft may be considered as not only a substitute for endoprosthesis but also a temporary method before endoprosthesis.

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Comparison of Inpatient Medical Use between Non-specialty and Specialty Hospitals: A Study Focused on Knee Replacement Arthroplasty (전문병원과 비전문병원 입원환자의 의료이용 비교 분석: 인공관절치환술(슬관절)을 대상으로)

  • Mi-Sung Kim;Hyoung-Sun Jeong;Ki-Bong Yoo;Je-Gu Kang;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.78-86
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    • 2024
  • Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

Functional and Radiological Results of Intermediate-term Follow Up in $MUTARS^{(R)}$ Tumor Endoprostheses ($MUTARS^{(R)}$ 종양 대치물을 이용한 사지 구제술의 기능적 및 방사선학적 중기 추시 결과)

  • Kang, Dong-Joon;Kim, Jeung-Il;Oh, Jong-Seok;Moon, Tae-Yong;Lee, In-Sook
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.1
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    • pp.36-43
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    • 2011
  • Purpose: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system ($MUTARS^{(R)}$) used in patients with a malignant bone tumor. Materials and Methods: Thirty one cases which used $MUTARS^{(R)}$ tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. Results: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. Conclusion: Our results suggest limb salvage with the $MUTARS^{(R)}$ endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.

Detailed Analysis of Vertical Connector in Modular Roadway Slab Under Temperature and Lifting Loading (온도하중과 인양하중에 영향을 받는 모듈러 도로 슬래브 수직연결부의 상세해석)

  • Kim, WooSeok;Nam, Jeonghee;Min, Geunhyeong;Kim, Kyeongjin;Lee, Jaeha
    • Journal of the Korea Concrete Institute
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    • v.28 no.5
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    • pp.509-517
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    • 2016
  • In terms of bridge construction, the concrete deck slab is weak members compared to beam members of the bridge supports. Deck slabs must be sound to support and distribute vehicle loads. If slabs are not enough to support the loads, it should be replaced. Bridge deck replacement has been an important industry over the world since the construction is simplified to shorten construction time and to save construction costs. Slab module provides a quickly, easily and reliably construction method in order to avoid high cost and minimum traffic disruption. in addition, slab module shows high reliability since they are factory products. However, slab module should be considered in the performance under various loads. In this study, structural analysis is performed to evaluate the performance of slab module under vehicle loads and temperature loads. Spiral rebar is also utilized around the vertical joints to improve the structural integrity under the lifting loads. In order to confirm the weak area of slab module for the lift condition, numerical analysis has been performed.

THE EXPERIMENTAL STUDY ON THE CHANGES OF CONDYLAR HEAD FOLLOWING UNILATERAL DISCECTOMY IN RABBIT (가토 편측 악관절원판 제거 후 하악 과두 변화에 관한 실험적 연구)

  • Park, Kwang-Jin;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.758-770
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    • 1996
  • Discectomy is the oldest and most commonly performed operation for the painful temporomandibular joint with internal derangement. It is the one operation for which there are longest follow-up study, with Eriksson, Silver, and Tolvanen et al reporting good results in patients about 30 years after discectomy. About 80% to 90% of patients clinically experience relief from pain and dysfunction after discectomy, and interestingly, the results may improve with time. However such as Myrhaug found headache and Poswillo supposed pain and limitation of movement as postoperative complications, even though this operation had the longest follow-up term, several aspects of discectomy remain unclear. The controversies to discectomy for TMJ with pain and dysfunction have laid emphasis only upon clinical results, and then the histomorphological study was planned to evaluate the morphologic change of TMJ after discectomy. To clarify the nature of the change through an observation on the morphologic changes of articular cartilage and subchondral bone of the condyle resulting from experimental unilateral discectomy in rabbit, the author excised the left articular discs of 12 male rabbits(control 4 rabbits), weighing about 3kg, and at 1, 3, 6, 9 weeks following surgery, harvested both(left surgical site and right nonsurgical sits) TMJ. The specimens were examined with light microscope after H-E and MT stain and the obtained results were as follows. 1. Histopathological features showed thickening of articular zone and active proliferation of fibrocartilaginous zone associated with slight proliferative zone in surgical site than control group. Also replacement of chondrocytes in calcified cartilaginous zone into bone cells was observed. 2. There were thinning of thickness of each zone of articular cartilage except calcified cartilagnous zone was observed in nonsurgical site. 3. In MT stain of condylar trabeculae, there was increased calcification in nonsurgical site than control and surgical site and the degree of calcification was similar in surgical site and control group. 4. In both site of experimental group no features of degenerative changes were observed. From the above results, it is presumed that the morphologic changes of surgical site discectomy are compensatory remodeling process characterized by an hyperplastic reaction of the articular zone and fibrocartilaginous zone filling the void created by removing the disc, and the bone changes are secondary to changes in the cartilage. Increased degree of calcification seen in condylar trabeculae of nonsurgical site results from the excessive use of condyle of that site.

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Wheelchair Usage and Satisfaction Survey of Elderly Patients (노인 환자들의 휠체어 사용 실태와 만족도 조사 연구)

  • Park, S.H.;Shin, J.I.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.9 no.4
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    • pp.257-263
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    • 2015
  • The purpose of this study was to survey the elderly patients through Basic information, Problems Wheelchair, Wheelchair Satisfaction, Usage and Requirements. The meaning of purpose is identify the problems and difficulties of wheelchair use in geriatric patients and an alternative for the correct use of wheelchairs elderly patients. The study investigated through questionnaires. That used questionnaires to modified to Gu Hyeon-Mo questionnaire (2005) and Quebec User Evaluation of Satisfaction with assistive Technology 2.0. 120 of 150 questionnaires were collected and one of them is excluded. Analysis results suggest the following. It was often feel joint pain results from physical damage. In addition when you use a wheelchair it was often feel discomfort in lower back and pelvis. And it feels uncomfortable when moving the tilt. Wheelchair satisfaction of the participants responded to the most 'Normal'. Results of the wheelchair operation ability is as follows. In the case of manual wheelchairs was feeling the difficulty to cross the threshold, Wheel lying, Stairs usage. Also In the case of an electric wheelchair was feeling the difficulty to use Tilt and Decline, Separate from the motor, and Replacement battery. In conclusion, To reduce of back pain and hip joints of elderly patients need to modify design and appearance of the wheelchair. In a later study will find to reduce discomfort and to improve satisfaction of the elderly who use wheelchairs. It will have to periodically examine the usage and satisfaction with them.

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The Kinetic Analysis of Arabesque Turn Motion in Modern Dance by Upper Extremity Usage (상지이용유무에 따른 현대무용 아라베스크 턴 동작의 운동역학적 분석)

  • Park, Yang-Sun;Kim, Ji-Hye
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.457-466
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    • 2009
  • This study puts the purpose in providing the scientific basis of dance motion as an artistic expression by analyzing the kinematic variable and the distribution factor of power affecting the motion, which is connected to the turn, right after the arabesque motion according to the existence and non existence of using the arm in the arabesque motion of modern dance. As a result of this study, arabesque turn motion, not using the upper limbs, used more turning force of head and body than the arabesque turn motion, using the upper limbs, and arabesque turn using the upper limbs obtained the turning force, using the right shoulder. The range of the hip joint on the left and the position change of left tiptoe in the Arabesque turn motion using the upper limbs is largely ascended to the vertical axis, while, the position of tiptoe in the Arabesque turn motion, not using the upper limbs is dropped to the lower part of each event. In the replacement of body center, Arabesque turn motion using the upper limbs is moved more to the turning axis than arabesque turn motion not using the upper limbs. As a result of maximum vertical ground reaction force, Arabesque turn motion using the upper limbs appeared to be a lower value than the Arabesque turn motion not using the upper limbs.

Utilization of Waste Bone Powders as Adhesive Fillers for Plywood (합판용 접착제의 충전제로서 폐기 골분의 이용)

  • Ko, Jae Ho;Roh, JeongKwan
    • Journal of the Korean Wood Science and Technology
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    • v.43 no.4
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    • pp.528-537
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    • 2015
  • To reuse the waste bone from restaurants or butcher houses, the possibility of using waste bone powder after cooking as a filler for wood adhesives used in manufacturing plywood was investigated. Radiata pine (Pinus radiata D. Don) plywoods were manufactured by using commonly used wood adhesives such as urea-melamine formaldehyde (UMF) resin, urea-formaldehyde (UF) resin, and phenol-formaldehyde (PF) resin and the prepared fillers from cattle bone powder, pig bone powder, and seashell powder. Plywood fabricated by using cattle bone powder, pig bone powder, and seashell powder showed weaker performance in dry and wet glue-joint shear strength and wood failure than those of the plywood with wheat flour. The result showed that it was hard to use only bone powder for the replacement of wheat flour. However, the filler mixed with wheat flour and bone powders showed equivalent dry bonding strength and better water resistance than the wheat flour, indicating that bone powders mixed with wheat flour might be used for the manufacture of plywood. When bone powders were mixed with wheat flour as adhesive fillers the shell powder showed the lowest bonding properties and there was no big difference between the cattle bone powder and the pig bone powder.

Treatment Methods for Functional Recovery after Total Knee Arthroplasty (슬관절 전치환술 후 기능 회복을 위한 치료법)

  • Kim, Young-mo;Joo, Yong-bum;Park, Il-young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.117-126
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    • 2020
  • Total knee arthroplasty is performed widely in degenerative arthritis of the knee joint, and the frequency of use is increasing. Efforts should be made to achieve functional recovery, such as returning to daily life, and the recovery of strength and range of motion after surgery. The procedure should be approached from a range of perspectives, such as patient factors, surgical technique and rehabilitation. The patient's age, degree of obesity, sex, and strength of the quadriceps muscle can affect the functional recovery after surgery. In addition, the patient's mental state, such as expectation value and satisfaction, can also have an effect. For functional recovery, patient education, pain control, and strengthening of the quadriceps muscle can be performed prior to surgery. Postoperative physiotherapy, such as icing and compression, transcutaneous electrical nerve stimulation therapy, neuromuscular electrical stimulation therapy, low frequency low intensity magnetic field therapy, strengthening of quadriceps muscle, and range of motion exercise can also be applied. In recent years, hydrotherapy, which restores the strength and balance of the leg, is being performed increasingly. These treatments are not only performed shortly after surgery, but are also performed continuously. In addition, the surgeon should apply it appropriately considering the patient's condition, compliance, and social and psychological conditions.