• Title/Summary/Keyword: Osteoarthritis patient

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Deep Vein Thrombosis Prophylaxis after Total Hip Arthroplasty in Asian Patients

  • Kim, Jun-Shik
    • Hip & pelvis
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    • v.30 no.4
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    • pp.197-201
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    • 2018
  • In Western patient populations, the reported incidence of imaging-demonstrated deep vein thrombosis (DVT) after total hip arthroplasty (THA) is as high as 70% without prophylaxis. The reported rates of symptomatic pulmonary embolism (PE) after THA in recent studies range from 0.6% to 1.5%, and the risk of fatal PE ranges from 0.11% to 0.19% in the absence of prophylaxis. Predisposing factors to DVT in western patients include advanced age, previous venous insufficiency, osteoarthritis, obesity, hyperlipidemia, dietary and genetic factors. However, Asian patients who have undergone THA have a strikingly low prevalence of DVT and virtually no postoperative PE. Some authors suggest low clinical prothrombotic risk factors and the absence of some DVT-related genetic factors in Asian patient populations decrease the risk of DVT, PE or both. In Korea, the prevalence of DVT after THA without thromboprophylaxis have ranges from 6.8% to 43.8%, and asymptomatic PE have ranges from 0% to 12.9%; there have been only two reported cases of fatal PE. Deep-wound infections resulting from postoperative hematomas or prolonged wound drainage have been reported with routine thromboprophylaxis. The prevalence of DVT differs varies based on patient ethnicity. Guidelines for the use of thromboprophylaxis were altered and focus on the potential value of outcomes compared with possible complications (e.g., bleeding).

Clinical Efficacy and Safety of Gyebutang Granules Combined with Acupuncture for the Treatment of Knee Osteoarthritis: Protocol for a Multicenter, Randomized, Assessor-blinded, 2-armed Parallel, Controlled Trial

  • Lee, Cham-Kyul;Kang, Ha-Ra;Lee, Yeon-Sun;Sung, Won-Suk;Lim, Chi-Yeon;Jung, Chan-Yung;Kim, Eun-Jung;Seo, Byung-Kwan;Baek, Yong-Hyeon;Kim, Kyung-Ho;Lee, Eun-Young
    • Journal of Acupuncture Research
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    • v.37 no.2
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    • pp.102-109
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    • 2020
  • Background: Due to the aging population in Korea, knee osteoarthritis (KOA) has become an increasingly common condition. Many patients with KOA prefer analgesics, herbal medicines, acupuncture, or exercise, rather than arthroscopic surgery or a knee replacement. Gyebutang (GB) granules are a herbal extract widely used to treat KOA in traditional Korean medicine, but there is insufficient evidence of its efficacy and safety. Methods: A multicenter, randomized, assessor-blinded, 2-armed parallel, controlled clinical trial has been designed to investigate the efficacy and safety of GB combined with acupuncture for the treatment of KOA. There will be 100 patients with KOA enrolled in the study from 3 traditional Korean medicine hospitals. The participants will be randomly allocated to an experimental group (GB and acupuncture) or a control group (celecoxib and acupuncture) in a 1:1 ratio. Both groups will receive acupuncture treatment once a week for 6 weeks; one group will receive GB and the other will receive celecoxib for the same duration. Results: The primary outcome will be the change of knee osteoarthritic pain, based on scores on a 100 mm visual analog scale. The secondary outcomes will be scores on a numeric rating scale, the Western Ontario and McMaster Universities osteoarthritis index, patient global assessment, European quality of life 5-dimension 5-level scale, and adverse events. Conclusion: The results of this study will provide evidence of efficacy and safety of GB as a treatment for patients with KOA.

Bee-Venom Acupuncture Treatment of Hip Osteoarthritis in a Dog (개에서 둔부 골관절염의 봉침 치료)

  • Kim Tae-Hwa;Kim Byung-Young;Kim Won-Bae;Kim Kwang-Shik;Liu Jianzhu;Kim Duck-Hwan;Rogers Phil A.M.
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.190-193
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    • 2006
  • Two weeks of therapy with intra-articular hyaluronic acid and oral caprofen failed to improve the clinical signs of hip osteoarthritis radiologically confirmed in a dog. Then, over the period of 30 days (7 sessions at 5-day intervals), bee- venom acupuncture (BV-AP, injection of bee venom at acupoints, also called apitoxin-aquapuncture) plus Trigger Point (TP) therapy was used. Five acupoints on the affected right limb were injected each time: GB30(as local point), plus ST35, GB33, BL40 and LIV08 (as distant points). The injection mixture (0.2 ml/point; total 1 ml/session) was saline + apitoxin + 2% lidocaine, so that the injected solution contained $100{\mu}g$ apitoxin diluted in 0.2% lidocaine-saline solution/ml. The total dose of apitoxin used was, therefore, $100{\mu}g/session$, divided over the 5 acupoints. One TP in the middle of the right quadriceps muscle was injected with 2% lidocaine (0.2 ml/point) each time. BV-AP improved the clinical signs rapidly; lameness and ataxia were disappear after 7 sessions (30 days); the right hind limb muscular atrophy was much improved and the hip radiograph was almost normal two weeks after 7 sessions (44 days). The present patient was a case with canine hip osteoarthritis which showed favorable therapeutic response by BV-AP plus TP therapy.

The Validity of Computed to Mography in Diagnosis of Temporomandibular Joint Osteoarthritis (측두하악관절 골관절염 진단에 있어 전산화 단층촬영의 유용성)

  • Jeon, Young-Mi;Choi, Jong-Hoon;Kim, Seong-Taek;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.195-204
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    • 2008
  • Osteoarthritis is caused by joint degeneration, a process that includes progressive loss of articular cartilage accompanied by attempted repair of articular cartilage, remodeling and sclerosis of subchondral bone, and osteophyte formation. The most common causative factor that either causes or contributes to osteoarthritis is overloading of the articular structures of the joint. The diagnosis of temporomandibular joint(TMJ) osteoarthritis is based on the patient's history and clinical findings such as limited mandibular opening, crepitation and tenderness to palpation on TMJ. The diagnosis is usually confirmed by TMJ radiographs, which will reveal evidence of structural changes in the subarticular bone of the condyle or fossa. Plain radiography techniques such as panoramic, transcranial, transpharyngeal views can be used in most dental offices for evaluation of the TMJs. However, plain radiographs are often limited due to overlapping and distortion of anatomical structures. The aim of this study was to compare the clinical examination and panoramic view with computed tomography for diagnosis of temporomandibular degenerative joint disease, and to compare the findings of condylar bony changes through panoramic radiography with that of computed tomography, hence, to confirm the limitations of clinical and panoramic radiography, and the validity of the computed tomography for diagnosis of temporomandibular degenerative joint disease. The pathophysiology of the TMJ osteoarthritis remains poorly understood, and current treatments are based more on speculation than science, and symptomatic treatments often fail to provide satisfactory pain relief. For diagnosis of TMJ osteoarthritis, clinical examination and radiographic examination for confirmation of the bony changes are essential, and computed tomography are clearly superior to plain radiographs for their limitations.

A CLINICAL CASE OF ALLOPLASTIC CONDYLE REPLACEMENT WITH CONDYLAR PROSTHESIS IN SEVERE DEGENERATIVE JOINT DISEASE (심한 퇴행성 악관절 질환 환자에서 보철성 과두를 이용한 하악과두 재건술의 치험례)

  • Jeon, Yong-Min;Kim, Chang-Hyun;Cha, Jeong-Seop;Min, Kyung-Gi;Kwon, Jong-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.162-167
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    • 2010
  • This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

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

  • Song, Eun-Kyoo;Seon, Jong-Keun;Kim, Hyung-Soon;Kang, Kyung-Do;Byun, Jae-Wook
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.48-57
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    • 2010
  • Purpose: To compare the incidence and risk factors for osteoarthritis after anterior cruciate ligament (ACL) reconstruction between two groups using bone-patellar tendon-bone (BPTB) and hamstring tendon (HT) autograft. Materials and Methods: 53 cases of ACL reconstruction using patellar tendon and 40 cases using hamstring tendon were followed up at least 8 years. Radiographic evaluation was done according to the Kellgren and Lawrence's classification. Clinical functional testing (Lysholm Knee Scores, the Tegner activity scores) and laxity testing (Lachman, pivot shift tests), and the instrumented laxity testing with $Telos^{(R)}$ were all examined in relation to the development of osteoarthritis. Results: Radiographic osteoarthritic changes were detected in 24 patients (45.3%) in BPTB group and 14 patients (35.0%) in HT group. Accompanying meniscal injury (BPTB p<0.001; HT p=0.091), intervals from the injury to reconstruction of > 12 months (BPTB p=0.037; HT p=0.021), and patient's age at reconstruction of > 25 years (BPTB p=0.003; HT p=0.048) were found to be significant independent predictors of osteoarthritis. However, no statistically significant correlations were found between the development of osteoarthritis and the clinical outcome or the radiographic stability in both groups. Conclusion: Although ACL reconstruction using BPTB or HT autograft had good clinical results at an average follow-up of 10 years, considerable incidence of radiographic osteoarthritic changes were noted. Various factors such as accompanying meniscal injury, protracted time from injury to reconstruction, more than 25 years old at the time of reconstruction were related to radiographic osteoarthritic changes.

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The Evaluation of Bone Scan and SPECT Before and After Treatment of TMD Patients (골관절염을 가진 측두하악장애 환자의 치료 전, 후 골스캔과 SPECT의 평가)

  • Kim, Byeong-Soo;Ahn, Yong-Woo;Ko, Myung-Yun;Park, June-Sang
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.57-67
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    • 2005
  • The aim of this study was to evaluate bone scan(SUR) and SPECT(hot spot) in patients with TMJ osteoarthritis. 99mTc-MDP bone scan and SPECT were done in 27 patients, total 54 temporomandibular joints were examined with clinical examination, plain radiography. 42 TMJs were osteoarthritis and 12 TMJs were normal case, clinically diagnosed. We compared osteoarthritis group and control group of bone scan(SUR) and SPECT(hot spot). thus we compared before and after treatment of bone scan(SUR) and bone SPECT(hot spot) according to history, contributing factor, symptom degree, treatment, treatment period. The obtained results were as follows. 1. Bone scan(SUR) and SPECT(hot spot) activity of osteoarthritis group were higher than control group(P<0.05, P<0.01). 2. Bone scan(SUR) and SPECT(hot spot) activity were decreased after treatment at TMJ with osteoarthritis(P<0.01). 3. Bone scan(SUR) and SPECT(hot spot) activity were decreased at treatment group with splint(P<0.01, P<0.05). 4. Bone scan(SUR) and SPECT(hot spot) activity were decreased at Chronic group(P<0.01, P<0.05). 5. Bone scan(SUR) and SPECT(hot spot) activity were decreased at low noise NAS(<6) group(P<0.01,P<0.05). 6. Bone scan(SUR) and SPECT(hot spot) activity were decreased at TMD patient with parafunctional habit and without trauma history, psychosocial factor. 7. Bone scan(SUR) and SPECT(hot spot) activity were higher at before treatment required more treatment period.

Familial Osteonecrosis of Femoral Condyle -Atypical Spontaneous Osteonecrosis of the Knee Involving Medial & Lateral Condyles in Young Patient with Familial Occurence- (비전형적 대퇴골과 자발성 골괴사증(증례 보고))

  • Lee, Myung Chul;Jo, Hyun Chul;Kim, Tae Gyun;Seong, In Ho;Seong, Sang Cheol
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.185-188
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    • 1998
  • Spontaneous osteonecrosis of the knee was first described by Ahlbck et al in 1968 as the spontaneous and sudden onset of severe pain, usually on the medial side of the knee joint, in old age(>60 years) with no specific etiologic factors. They differentiate the disease from osteochondritis dissecans, osteoarthritis, fracture, infection, neuropathic joint and secondary osteonecrosis of the knee joint. So far many investigators described this disease but had never observed cases developed in young patient with familial occurrence. The report presented here is a case of spontaneous osteonecrosis of both medial and lateral femoral condyles involving the bilateral knee joint that were treated by arthorscopic loose body removal and multiple drilling.

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Time-frequency Analysis of Vibroarthrographic Signals for Non-invasive Diagnosis of Articular Pathology (비침습적 관절질환 진단을 위한 관절음의 시주파수 분석)

  • Kim, Keo-Sik;Song, Chul-Gyu;Seo, Jeong-Hwan
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.4
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    • pp.729-734
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    • 2008
  • Vibroarthrographic(VAG) signals, emitted by human knee joints, are non-stationary and multi-component in nature and time-frequency distributions(TFD) provide powerful means to analyze such signals. The objective of this paper is to classify VAG signals, generated during joint movement, into two groups(normal and patient group) using the characteristic parameters extracted by time-frequency transform, and to evaluate the classification accuracy. Noise within TFD was reduced by singular value decomposition and back-propagation neural network(BPNN) was used for classifying VAG signals. The characteristic parameters consist of the energy parameter, energy spread parameter, frequency parameter, frequency spread parameter by Wigner-Ville distribution and the amplitude of frequency distribution, the mean and the median frequency by fast Fourier transform. Totally 1408 segments(normal 1031, patient 377) were used for training and evaluating BPNN. As a result, the average value of the classification accuracy was 92.3(standard deviation ${\pm}0.9$)%. The proposed method was independent of clinical information, and showed good potential for non-invasive diagnosis and monitoring of joint disorders such as osteoarthritis and chondromalacia patella.

A Case Report on Osgood-Schlatter Disease Treatment Using Complex Korean Medicine Therapy Including Chuna Therapy (추나 요법을 포함한 복합 한방치료를 이용한 오스굿-슐라터 병의 치료 증례보고)

  • Ji-Won Lee;Youn-Seok Ko;Min-Su Ju
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.2
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    • pp.51-62
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    • 2022
  • Objectives This case study aimed to investigate the effect of complex Korean medicine therapy and fascia Chuna therapy on Osgood-Schlatter disease. Methods Hospitalization treatment was performed on a 13-year-old Osgood-Schlatter patient who visited Woosuk University Korean Medicine Hospital. The patient complained of pain in both the tibial tuberosity and restriction on the range of knee joint movement. The results were evaluated using the visual analogue scale, knee injury and osteoarthritis outcome score, and range of motion. Results After treatment, knee pain decreased and range of movement angle improved. Conclusions This study suggests that complex Korean medicine therapy, including myofascial Chuna therapy, are effective in improving the range of motion and improving pain in early Osgood-Schlatter disease. The limitation of this study is that the subject of the study was limited to one case. Further clinical studies are required.