• 제목/요약/키워드: Osteoarthritis of knee

검색결과 484건 처리시간 0.028초

근위골절술을 위한 Staple 설계 (A Newly Designed Miniplate Staple for High Tibial Osteotomy)

  • 문무성;배대경
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1995년도 춘계학술대회
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    • pp.19-22
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    • 1995
  • A biomechanical study was made to demonstrate the superior mechanical performance of the newly designed Miniplate staple to the conventional Coventry staple in high tibial osteotomy(HTO). Using twenty fresh porcine tibiae, the fixational strengh of the two different types of staple in HTO was compared. To minimize the error due to the specimen-to-specimen individuality, the bone mineral density of the tibiae was measured with a bone densitometry (Dual photon absorptionometer, Luner, USA) and those with $0.8\;{\sim}\;1.2\;gm/cm^2$ at the proximal tibia was used in the biomechanical test. Testing was performed on a material testing system (Autogram ET-5, Shimatzu, Japan) with aid of a commercial data processor (IBM 80386/ ASYST). Using two differant loading modes, 'pull-out' and 'push-out', the maximum resistant force required to release the staple from the substrate bone was recorded. In the pull-out test, ten non-osteotomized specimens were used and the staple was pullout by subjecting an axial tension on the head of the staple inserted. While in the pull-out test where ten tibiae osteotomized in the usual way of HTO were used, the staple was not directly loaded. In this testing, as a mimic condition of the natural knee, the distal part of the specimen tibia was pushed horizontally in order for the staple to be pulled out while the proximal tibia was fixed. The pull-out strength of Coventry staple and miniplate staple were found to be $27.88\;{\pm}\;5.12\;kgf$ and $182.47\;{\pm}\;32.75\;kgf$, respectively. The push-out strength of Coventry staple and miniplate staple were $18.40\;{\pm}\;4.47\;kgf$ and $119.95\;{\pm}\;19.06\;kgf$, respectively. The result revealed that miniplate staple had the pull-out/ push-out strength at least fivetimes higher than Coventry staple. Based on the measured data, it was believed that the newly designed miniplate staple could provide much better postoperative fixation in HTO. The postoerative application of long leg casting may not be needed after HTO surgery.

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슬관절 전치환술(TKA) 환자를 대상으로 다리거상과 냉치료 적용이 부종에 미치는 영향 (The Effects of Cryotherapy Treatment with Leg Elevation on Swelling of Patient Who had an TKA)

  • 이재홍;이진환;민동기;이재광;김종우
    • 대한정형도수물리치료학회지
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    • 제23권2호
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    • pp.45-49
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    • 2017
  • Background: The purpose of this study was to investigate the effect of structured cryotherapy on edema of patients who had a total knee arthroplasty (TKA). Methods: The subjects were 58 patients who were diagnosed with osteoarthritis and had total knee arthroplasty in D hospital. In total, 29 people were in the leg elevation cryotherapy group (LECTG), 29 people were in the control group (CTG). After TKA, the patients' swelling on post operation days (POD) 3 were checked. After the post OP checking, LECTG was treated with cryotherapy with leg elevation for 12 days but CTG was cryo therapy with sit on chair. Results: Swelling show significant difference within the group (p<.05), but did not show signigicant difference between groups (p>.05). Conclusions: Base on the results, it was found the cryo therapy of $-78^{\circ}C$ improved swelling after TKA. Accordingly, it is thought that cryo therapy of $-78^{\circ}C$ has positive effect on swelling in the process of recovery after operation. but It did not approve that the leg elevation was even more effective. For this study, the reserch developed to enhance the effectiveness of the cryotherapy, would make it possible to apply to an effective cryotherapy posture.

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일 상급종합병원 노인 환자의 가정간호 서비스 이용 현황 분석 (Analysis of the Current State of Home Health Nursing for Elderly Patients in Advanced General Hospital)

  • 박성혜;장연수;김수진
    • 임상간호연구
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    • 제25권3호
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    • pp.275-284
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    • 2019
  • Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

전방 십자 인대 재건술 후 골관절염의 발생 빈도 및 위험 인자들에 대한 비교 - 자가 슬개건과 자가 슬괴건을 이용한 방법 - (Comparison of the Incidence and Risk Factors for Developing Osteoarthritis after ACL Reconstruction - Patellar Versus a Hamstring Autograft -)

  • 송은규;선종근;김형순;강경도;변재욱
    • 대한정형외과스포츠의학회지
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    • 제9권1호
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    • pp.48-57
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    • 2010
  • 목적: 자가 골-슬개건-골과 자가 슬괵건을 이용한 전방 십자 인대 재건술 후, 골관절염의 발생률과 위험인자를 비교하고자 하였다. 대상 및 방법: 8년 이상 추시가 가능하였던, 자가 슬개건 53예 및 자가 슬괵건 40예를 이용한 전방 십대 인대 재건술을 시행한 총 93예를 대상으로 하였다. Kellgren and Lawrence의 분류에 따라 방사선상의 골관절염의 변화를 관찰하였고, 슬관절의 임상적 기능 (Lysholm 슬관절 점수, Tegner 운동 지수), 신체검사상의 전방 이완 정도 (Lachman 검사, Pivot-Shift 검사) 및 $Telos^{(R)}$ 기구를 이용한 전방 이완 정도를 비교 평가하였다. 결과: 자가 골-슬개건-골을 이용한 대상 중 24예 (45.3%)에서, 자가 슬괵건을 이용한 대상 중 14예 (35.0%)에서 방사선 검사상 골관절염 변화가 확인되었다. 동반된 연골판 손상 (골-슬개건-골 군 p<0.001, 슬괵건군 p=0.091), 수상에서 재건술까지 12개월 이상 경과 (골-슬개건-골 군 p=0.037, 슬괵건 군 p=0.021), 재건술 당시 연령 25세 이상 (골-슬개건-골 군p=0.003, 슬괵건 군 p=0.048) 등이 골관절염의 유의한 위험 인자로 나타났다. 하지만, 골관절염의 발생과 임상적 결과, 방사선적 안정성과의 연관성은 없었다. 결론: 자가 골-슬개건-골 및 자가 슬괵건을 이용한 전방 십자 인대 재건술 후 평균 10년 추시상 두 군 모두에서 임상적으로 양호한 결과를 얻었으나, 상당한 비율에서 방사선적 골관절염 변화가 관찰되었다. 또한 동반된 연골판 손상, 수상 후 재건술까지의 지연된 시간, 25세 이상의 연령 등의 다양한 인자가 이에 관련됨을 알 수 있었다.

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굴 패각 추출물이 Papain으로 유도된 골관절염 C57BL/6J Mice에 미치는 영향 (Effects of Oyster Shell Extract on Papain-induced Osteoarthritis in C57BL/6J Mice)

  • 이세영;김학주;한지숙
    • 한국식품영양과학회지
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    • 제42권8호
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    • pp.1183-1189
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    • 2013
  • 연구에서는 굴 패각 추출물이 papain으로 유도된 골관절염 동물 모델에 미치는 영향을 살펴보았다. 8주령의 C57BL/6J 마우스 우측 슬관절강에 papain $6{\mu}L$를 투여하여 골관절염을 유발하였다. 실험군은 각 군당 체중이 고르게 8마리씩 배정하여 총 다섯군으로 분류하였다. 정상군은 우측 슬관절강에 생리식염수 $6{\mu}L$ 주사하고 20일간 1일 1회 생리식염수 0.2 mL씩 경구투여 하였다. 대조군, 약물투여군, 굴 패각 추출물 투여군은 골관절염을 유발 후 각각 생리식염수, diclofenac sodium 2 mg/kg/bw, OSE 100, 200 mg/kg/bw를 20일 동안 매일 1회 정해진 시간에 경구투여 하였다. 실험기간 동안 체중을 측정하였으며, 실험 20일에 부검하여 슬관절의 병리조직학적 관찰, 관절연골 내 proteoglycan 함유율, 골관절염 지수의 변화, 혈액내 TNF-${\alpha}$, IL-$1{\beta}$, IL-6 함량을 측정하였다. 체중은 실험기간 동안 모든 개체 간의 유의적 차이가 없었다. 관절연골 내 proteoglycan 함유율은 DS 및 OSE 투여군이 papain 투여 대조군보다 유의성(P<0.05)있게 높았으며, 특히 OSE-200 투여군은 약물 투여군과 유사한 proteoglycan 함유율을 나타냈다. H&E 염색을 통하여 관찰한 결과, 골관절염이 유발된 마우스에 굴 패각추출물을 경구 투여하였을 때 관절연골의 파괴와 골 침식 등 연골의 변성이 약물 처리군과 유사한 것을 보아 굴 패각 추출물이 골관절염 치료에 효과가 있는 것을 확인할 수 있었다. 병리조직학적으로 골관절염 지수는 DS 및 OSE 투여군이 papain 투여 대조군보다 유의성(P<0.05) 있게 낮았으며, OSE-200 투여군이 OSE-100 투여군보다 낮았다. 혈액 내 TNF-${\alpha}$, IL-$1{\beta}$, IL-6 함량은 papain 투여 대조군이 정상군에 비해 유의적(P<0.05)으로 증가하였으며, DS 및 OSE 투여군은 대조군보다 유의성(P<0.05) 있게 낮았다. 특히 TNF-${\alpha}$ 및 IL-6 함량은 OSE-200 투여군이 약물 투여군과 유사한 감소 효과를 나타내었다. 이와 같은 결과는 굴 패각 추출물이 papain으로 유도된 골관절염에서 연골의 변성을 줄이고 염증을 억제함으로써 골관절염 치료에 효과가 있는 것으로 사료된다. 굴 패각은 탄산칼슘이 풍부하기 때문에 골관절염 개선에 효과가 있는 것으로 사료되나, 굴 패각 추출물 중 어떠한 기능성 물질이 골관절염 개선 효과를 나타내었는지에 대해 향후 심도 있는 연구가 필요하다.

Decay-Accelerating Factor Differentially Associates With Complement-Mediated Damage in Synovium After Meniscus Tear as Compared to Anterior Cruciate Ligament Injury

  • V. Michael Holers;Rachel M. Frank;Michael Zuscik;Carson Keeter;Robert I. Scheinman;Christopher Striebich;Dmitri Simberg;Michael R. Clay;Larry W. Moreland;Nirmal K. Banda
    • IMMUNE NETWORK
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    • 제24권2호
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    • pp.17.1-17.16
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    • 2024
  • We have reported that anterior cruciate ligament (ACL) injury leads to the differential dysregulation of the complement system in the synovium as compared to meniscus tear (MT) and proposed this as a mechanism for a greater post-injury prevalence of post traumatic osteoarthritis (PTOA). To explore additional roles of complement proteins and regulators, we determined the presence of decay-accelerating factor (DAF), C5b, and membrane attack complexes (MACs, C5b-9) in discarded surgical synovial tissue (DSST) collected during arthroscopic ACL reconstructive surgery, MT-related meniscectomy, osteoarthritis (OA)-related knee replacement surgery and normal controls. Multiplexed immunohistochemistry was used to detect and quantify complement proteins. To explore the involvement of body mass index (BMI), after these 2 injuries, we examined correlations among DAF, C5b, MAC and BMI. Using these approaches, we found that synovial cells after ACL injury expressed a significantly lower level of DAF as compared to MT (p<0.049). In contrast, C5b staining synovial cells were significantly higher after ACL injury (p<0.0009) and in OA DSST (p<0.039) compared to MT. Interestingly, there were significantly positive correlations between DAF & C5b (r=0.75, p<0.018) and DAF & C5b (r=0.64 p<0.022) after ACL injury and MT, respectively. The data support that DAF, which should normally dampen C5b deposition due to its regulatory activities on C3/C5 convertases, does not appear to exhibit that function in inflamed synovia following either ACL injury or MT. Ineffective DAF regulation may be an additional mechanism by which relatively uncontrolled complement activation damages tissue in these injury states.

Genome-wide Association Study Identified TIMP2 Genetic Variant with Susceptibility to Osteoarthritis

  • Keam, Bhum-Suk;Hwang, Joo-Yeon;Go, Min-Jin;Heo, Jee-Yeon;Park, Mi-Sun;Lee, Ji-Young;Kim, Nam-Hee;Park, Miey;Oh, Ji-Hee;Kim, Dong-Hyun;Jeong, Jin-Young;Lee, Jong-Young;Han, Bok-Ghee;Lee, Ju-Young
    • Genomics & Informatics
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    • 제9권3호
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    • pp.121-126
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    • 2011
  • Osteoarthritis (OA) is the most common degenerative joint disorder in the elderly population. To identify OA-associated genetic variants and candidate genes, we conducted a genome-wide association study (GWAS). A total 3,793 samples (476 cases: wrist + knee and 3317 controls) from a community-based epidemiological study were genotyped using the Affymetrix SNP 5.0. An intronic SNP (rs4789934) in the TIMP2 (tissue inhibitor of metalloproteinase-2) showed the most significance with OA (odd ratio [OR] = 2.06, 95% confidence interval [CI] = 1.52-2.81, p = $4.01{\times}10^{-6}$). Furthermore, a poly-morphism (rs1352677) in the NKAIN2 ($Na^+/K^+$ transporting ATPase interacting 2) was suggestively associated with OA (OR = 1.43, CI = 1.22-1.66, p = $7.01{\times}10^{-6}$). The present study provides new insights into the identification of genetic predisposing factors for OA.

지역사회기반의 자기관리지지중재가 골관절염 의료급여수급자의 환자활력, 관절유연성 및 건강 관련 삶의 질에 미치는 단기효과 (Short-Term Effects of an Self-Management Support Intervention on Patient Activation, Joint Flexibiltiy and Health-related Quality of Life among Korean Medical Aid Beneficiaries with Osteoarthritis)

  • 안양희;허재복;최은희
    • 한국노년학
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    • 제36권3호
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    • pp.595-609
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    • 2016
  • 이 연구의 목적은 지역사회기반의 자기관리지지중재가 골관절염 의료급여수급자의 환자활력, 관절유연성 및 건강 관련 삶의 질에 미치는 단기효과를 확인하기 위함이었다. 연구 설계는 자기관리지지중재의 효과를 검증하기 위하여 무작위 대조군 전후설계를 활용하였으며, 이 연구는 자기주도적 관절염질병관리 역량강화연구의 일부이다. 연구대상은 일 지역 고위험군 의료급여수급자 중에서 60명의 골관절염환자를 대상으로 실험군(n=30)과 대조군(n=30)에 무작위 할당하였다. 8회기로 구성된 자기관리지지중재는 대상자 중심의 케어를 전략으로 인지 정서 행위기술을 활용하였으며, 교육 훈련된 의료급여관리사에 의하여 제공되었다. 연구도구는 구조화된 설문지, 관절각도기 및 줄자를 활용하였다. 자료 분석방법은 기술적 통계와 ${\chi}^2-test$, Fisher's exact test, t-test, ANCOVA를 활용하였다. 실험군은 대조군에 비하여 자기관리를 위한 환자활력, 관절유연성이 유의하게 증가되었으나 건강 관련 삶의 질 수준은 유의한 차이가 없었다. 향후에는 자기관리지지중재에 대한 장기(9 and 12-month follow up) 효과가 제시될 필요가 있다.

Work-related Musculoskeletal Disorders among Agricultural Workers

  • Lee, Soo-Jin;Park, Hwan-Jin
    • 대한인간공학회지
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    • 제30권4호
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    • pp.525-534
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    • 2011
  • This paper describes the current status of musculoskeletal disorders(MSDs) and its ergonomic risk factors, including the preventive intervention in terms of the working conditions and health promotion among agricultural workers. Korean agricultural workers have been exposed to the poor working condition. They have suffered from a variety of work-related injury and diseases more than the general population or the other occupational group. MSDs are one of the most prevalent problems threatening the agricultural worker's health and quality of life. Low back pain, osteoarthritis of hip and knee joint and carpal tunnel syndrome are well known MSDs that was found easily and frequently among agricultural workers. MSDs are worsened by poor ergonomic working conditions such as heavy weight lifting, repetitive movement and awkward posture which involves squatting with long sitting work on the ground, long working hours and heavy workload which are inherent in the greater part of agricultural works. Even though Korean agricultural workers are very weak population in terms of occupational safety and health, no many studies were conducted in the past and no many social and institutional supports were provided sufficiently. We need more interests and efforts in agricultural fields to improve its working condition and to promote health status of agricultural workers.

보행 중 인위적 다리길이 차이에 따른 3차원적 골반 가동범위의 특성 (Characteristics of Pelvic Ranges According to Artificial Leg Length Discrepancy During Gait: Three-Dimensional Analysis in Healthy Individuals)

  • 김용욱
    • 대한통합의학회지
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    • 제7권2호
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    • pp.59-67
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    • 2019
  • Purpose : The purpose of this study was to analyze the dynamic range of motion (ROM) of pelvic and translation of center of mass (COM) when wearing different shoe insole lifts according to leg length discrepancy (LLD) during free speed gait. Methods : Thirty-five healthy adults were participated in this study. Kinematic data were collected using a Vicon motion capture system. Reflective and cluster 40 markers attached to participants lower extremities and were asked to walk in a 6 m gait way under three different shoe lift conditions (without any insole, 1 cm insole, and 2 cm insole). The pelvic ROM and COM translation in three planes were sorted using a Nexus software, and a Visual3D motion analysis software was used to coordinate all kinematic data. Results : There were significantly increased maximal pelvic elevation and total pelvic range in coronal plane when wearing a standard shoe with 2 cm insole lift during gait (p<.05). When wearing a standard shoe with 2 cm insole lift, the total range of the pelvic segment were significantly different in all three motion planes (p<.05). Conclusion : Although LLD of less than 2 cm develops abnormal movement pattern of the pelvis and may cause of musculoskeletal diseases such as low back pain, hip and knee joint osteoarthritis, therefore intensive various physical therapy interventions for LLD are needed.