• Journal of Acupuncture Research
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• v.39 no.2
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• pp.134-138
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• 2022

Distal femur osteotomy (DFO) is a controlled surgical break of the femur performed to allow realignment of the limb. Redistribution of the load aims to correct the abnormal mechanical weight-bearing axes in patients with abnormal alignment of the lower extremities, and degenerative changes in the knee joint. This report describes a complex Korean medicine treatment for a patient complaining of knee pain and stiffness following a DFO. Post-operative care for the patient lasted 78 days with treatment including pharmacopuncture, acupuncture, herbal medicine, cupping therapy, and physiotherapy. The effectiveness of the treatments was evaluated using the numerical rating scale, range of motion of the knee, and by physical examination. After treatment, these evaluation indicators improved, suggesting that the complex Korean medicine treatment received by the patient was an appropriate treatment for knee pain and stiffness following a DFO.

• Journal of Convergence Korean Medicine
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• v.1 no.1
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• pp.35-44
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• 2021

Objectives: The purpose of this study is to investigate the effect of ultrasound therapy on left knee pain and instability diagnosed with Baker's cyst in a 25-year-old male patient. Methods: Patient was treated with Radio frequency ablation treatment on left knee from Naeseulan (EX-LE4) to Wijoong (BL40). The effect of radio frequency ablation was assessed by Visual Analog Scale (VAS), Western Ontario and McMaster Universities (WOMAC) and Euro Qol-5 Dimension Index (EQ-5D Index). The treatment was executed one time a day everyday form May 28th to June 1st of 2020. Patient was observed from May 26th to June 1st. Results: After five sessions of radio frequency ablation, VAS of left posterior knee pain was improved while no improvement was discovered at left medial knee. In Korean WOMAC scale, only subscale of weight bearing and walking around plain were improved. EQ-5D did not show any improvement. Conclusion: The results suggest that radio frequency ablation treatment can be a valuable option in treating knee pain and daily living function. Further study seems to be needed based on long-term intervention.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.191-201
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• 2022

Background: This study aimed to assess the efficacy of the adductor canal block (ACB) in comparison to intra-articular steroid-lidocaine injection (IASLI) to control chronic knee osteoarthritis (KOA) pain. Methods: A randomized, single-blinded trial in an outpatient rehabilitation clinic recruiting chronic KOA with pain ≥ 6 months over one year. Following randomization, subjects received either a single ACB or IASLI under ultrasound guidance. Numerical rating scale (NRS) scores for pain, and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were recorded at baseline, 1 hour, 1 month, and 3 months postinjection. Results: Sixty-six knees were recruited; 2 were lost to follow-up. Age was normally distributed (P = 0.463), with more female subjects in both arms (P = 0.564). NRS scores improved significantly for both arms at 1 hour, with better pain scores for the IASLI arm (P = 0.416) at 1st month and ACB arm at 3rd month (P = 0.077) with larger effect size (Cohen's d = 1.085). Lower limb function improved significantly in the IASLI arm at 1 month; the ACB subjects showed greater functional improvement at 3 months (Cohen's d = 0.3, P = 0.346). Quality of life (QoL) improvement mirrored the functional scores whereby the IASLI group fared better at the 1st month (P = 0.071) but at the 3rd month the ACB group scored better (Cohen's d = 0.08, P = 0.710). Conclusions: ACB provides longer lasting analgesia which improves function and QoL in chronic KOA patients up to 3 months without any significant side effects.

• Journal of Acupuncture Research
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• v.38 no.3
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• pp.205-218
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• 2021

Background: Korean medicine treatment was assessed in patients with knee osteoarthritis (OA) according to subgroups of: sex, age, cause of knee OA, body mass index, hospitalization period, history, OA compartment, phenotype, and comorbidity. Methods: A retrospective review was performed of 122 inpatients who were admitted to the Hospital of Korean Medicine for Korean medicine treatment of knee pain, and were diagnosed with knee OA based on magnetic resonance imaging findings. Analysis of patient subgroups (sex, age, cause of knee OA, body mass index, hospitalization period, history, OA compartment, phenotype, and comorbidity) was carried out and treatments including acupuncture, cupping, pharmacopuncture, herbal medicine, chuna therapy, medicinal steaming therapy, manual therapy, and extracorporeal shock wave therapy were listed. The numeric rating scale (NRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 5-level EuroQol- 5 Dimension (EQ-5D-5L) scores were measured before and after treatment to assess the effects of treatment on pain and quality of life. Results: Seventeen males and 105 females were included in this study. Most patients were in their 60s. In the total study population, NRS, WOMAC, and EQ-5D-5L scores were improved statistically significant when comparing before and after treatment. The NRS and WOMAC scores improved statistically significant in the medial, patellofemoral, medial + patellofemoral, medial + lateral + patellofemoral compartment. Conclusion: Korean medicine treatment significantly reduced pain, stiffness, and physical dysfunction, and improved the quality of life of patients with knee OA, suggesting that it may be an effective alternative to the current conservative treatments.

• The Journal of Korean Physical Therapy
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• v.20 no.2
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• pp.11-17
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• 2008

Purpose: This study examined the application of electric stimulation to the auricle acupoint (frequency 2 Hz, stimulation level: noxious) with 30 elderly people over 65 years that received treatment in a rural hospital to determine the influence of pain, gait and balance in the aged with knee joint disease. Methods: The subjects were divided into three groups; the degenerative joint diseases (DJD) group (1 male, 9 females), the total knee replacement (TKR) group (1 male, 9 females) and the control group (1 male, 9 females). Auricualr electrical stimulation (AES) was applied with low frequency, high intensity transcutaneous electrical nerve stimulation for 10 seconds per each point. Results: 1. For the change of pain according to AES, there was interaction in the resting period (p<0.001) and gait (p<0.001) and pain of the DJD group and TKR group was decreased. 2. The range of motion (ROM) of the knee joint showed a significant difference in interaction for each group of elderly people (p<0.001) and the ROM for the DJD group and TKR group of elderly people was increased. 3. In the analysis of gait speed changes, there was a significant difference in interaction for each group of elderly people (p<0.001) and for gait speed in the DJD group and TKR group of elderly people. 4. It was found in the change of static balance that there was a significant difference in interaction for each group of elderly people (p<0.01) and balance capacity in the DJD group and TKR group of elderly people was increased. Conclusion: The aged with knee joint disease have pain, and a decreased function of gait and balance. AES was an excellent treatment for control of pain, and an excellent treatment to enhanced joint functions. AES was useful for improving gait and balance due to decreased pain.

• Korean Journal of Acupuncture
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• v.30 no.1
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• pp.64-72
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• 2013

Objectives : The aim of this study was to investigate whether warm-needling is more effective than acupuncture in relieving the pain and improving the symptoms of knee osteoarthritis(OA). Methods : 76 volunteers with knee OA participated in the study. The subjects were randomly assigned to one of two groups. One group received warm-needling(n=38), while the other group received acupuncture(n=38). Sixteen sessions of warm-needling or acupuncture were conducted on the pain region of each problematic knee over a period of 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) scores, physical health score based on the 36-Item Short-Form Health Survey(SF-36) and the Global Assessment(PGA) was measured. Results : Compared to the acupuncture group, the warm-needling group showed a significant decrease in pain, function, and total WOMAC scores according to the Mann-Whitney U-test. The PGA scores of the warm-needling group also showed a significant improvement compared to the acupuncture group. Conclusions : Warm-needling showed a greater pain relief effect on knee OA compared to the acupuncture group. These findings suggest that warm-needling may be a promising alternative therapy for treating knee OA.

• Journal of Korean Foot and Ankle Society
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• v.22 no.3
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• pp.100-104
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• 2018

Purpose: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. Materials and Methods: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0~100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. Results: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p<0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch. Conclusion: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.

• The Korean Journal of Pain
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• v.32 no.1
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• pp.30-38
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• 2019

Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

• Fashion & Textile Research Journal
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• v.22 no.3
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• pp.271-286
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• 2020

This study evaluated designs via the consumers' function and design preferences survey for using product design images, virtual avatar wearing images and product explanations that identified consumers' function and design preferences for knee protection pads as well as to develop movement assistive knee pad designs. We developed Design A for men and Design B for women. For Design A, the front of the knee supports muscles and alleviates pain with a hole. Mesh material with good ventilation was applied to enhance wearing comfort. The color was achromatic for a modern style, and the hook fastener and loops enabled easy wear and removal of the pad while controlling size and pressure strength. For Design B, taping details seamlessly support muscles in the knee area with fabrics less than 0.1 cm thick and with long sleeves in the diverse sizes. The design's satisfaction assessment showed that potential consumers were satisfied with Design A and Design B for overall design and functional features. Over 77% wanted to use/wear and purchase designs; in addition, over 78% expected it would help with walking and relieve knee pain. The results can be helpful for designers when deciding designs for manufacturing and commercializing kneepad products.

• Journal of Acupuncture Research
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• v.23 no.1
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• pp.155-164
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• 2006

Objectives : The aim of this study is to validate the correlation between Assessment Instruments of Knee OA and digital infrared thermographic imaging(DITI) and to find out the methods to assess knee OA by DITI. Methods : 60 subjects were evaluated. They were asked to answer VAS pain scale, WOMAC, KHAQ and LFI. Correlation was assessed by examining the spearman's rank correlation coefficients. Results : VAS, WOMAC and LFI was correlated with not only the thermal difference between Ant. knee and Post. knee, but also the lowest temperature of Ant. knee. Conclusion: DITI value was useful for evaluating the degree of OA. And we should find out that decrease of pain is correlated with change of DITI value.