• 제목/요약/키워드: THA

검색결과 171건 처리시간 0.019초

Risk Factors of Neuropathic Pain after Total Hip Arthroplasty

  • Maeda, Kazumasa;Sonohata, Motoki;Kitajima, Masaru;Kawano, Shunsuke;Mawatari, Masaaki
    • Hip & pelvis
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    • 제30권4호
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    • pp.226-232
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    • 2018
  • Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA. Results: The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA. Conclusion: THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

Mobile IP 에서의 계층적인 Home Agent Handover 기법 (Hierarchical Home Agent Handover in Mobile IP)

  • 김현석;박성한
    • 대한전자공학회논문지TC
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    • 제43권12호
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    • pp.89-94
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    • 2006
  • Mobile IP 에서 이동호스트(Mobile Host)의 움직임은 Correspond Node (CN)가 Home Agent (HA)를 거쳐 통신을 하게 하기 때문에 패킷이 긴 전송경로로 통신하게 되는 원인이 된다. 기존의 방식은 이동호스트 주변의 Foreign Agent (FA)를 Temporary Home Agent (THA)로 생각하여 패킷의 비효율적인 전송을 줄이고자 하고 있다 그러나 기존의 방식에서는 FA가 통신한 적이 없는 THA에서 이동호스트가 이동해 온 경우 핸드오버를 위하여 FA와 THA의 거리를 계산하기 때문에 불필요한 Signaling Cost를 발생시킨다. 본 논문에서는 FA와 THA 간의 계층적 구조를 이용하여 이동호스트가 어디로 이동하더라도 FA와 THA의 거리를 계산하지 않고 자신의 가진 테이블만을 검색하는 Hierarchical Home Agent Handover in Mobile IP(HHH-MIP) 알고리즘을 제안하고자 한다.

Can Functional Assessment Tools Reflect Balance Abilities at 3 Months after Total hip Arthroplasty?

  • Kim, Min-Woo;Ryu, Young-Uk
    • 대한물리의학회지
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    • 제13권4호
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    • pp.51-58
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    • 2018
  • PURPOSE: This study was conducted to determine if the Harrison hip score (HHS), a tool for assessing hip joint function, and the Burg balance scale (BBS), a general balance assessment tool, actually reflect the balance ability of total hip arthroplasty (THA) patients 3 months after surgery. In addition, this study investigated the initial weight distribution strategy for bilateral lower extremity after THA surgery to understand the balance of THA patients. METHODS: Fourteen 3-month THA patients performed static dual standing and sit-to-stand (STS) tasks. Ground reaction forces on each leg were collected to calculate the weight distribution symmetricity (SWD), and the HHS, functional HHS (f-HHS), and BBS were evaluated. Correlation analyses between SWD and the HHS (also f-HHS) and BBS were then applied to the THA patients. RESULTS: The correlations between functional evaluation tools (HHS, f-HHS, BBS) and SWD were weak strength for the static balance task, but moderate for the dynamic STS task. Among the evaluation tools used in the present study, f-HHS was most useful for evaluation of dynamic balance ability. CONCLUSION: The results suggest that use of HHS, f-HHS, and BBS as functional evaluation tools does not provide meaningful information regarding balance ability, but that they are useful for evaluating dynamic balance ability of THA patients. The dynamic balance ability at 3 months after THA seems to be under development.

Recent updates for biomaterials used in total hip arthroplasty

  • Hu, Chang Yong;Yoon, Taek-Rim
    • 생체재료학회지
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    • 제22권4호
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    • pp.259-270
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    • 2018
  • Background: Total hip arthroplasty (THA) is probably one of the most successful surgical interventions performed in medicine. Through the revolution of hip arthroplasty by principles of low friction arthroplasty was introduced by Sir John Charnley in 1960s. Thereafter, new bearing materials, fixation methods, and new designs has been improved. The main concern regarding failure of THA has been the biological response to particulate polyethylene debris generated by conventional metal on polyethylene bearing surfaces leading to osteolysis and aseptic loosening of the prosthesis. To resolve these problems, the materials of the modern THA were developed since then. Methods: A literature search strategy was conducted using various search terms in PUBMED. The highest quality articles that met the inclusion criteria and best answered the topics of focus of this review were selected. Key search terms included 'total hip arthroplasty', 'biomaterials', 'stainless steel', 'cobalt-chromium', 'titanium', 'polyethylene', and 'ceramic'. Results: The initial search retrieved 6921 articles. Thirty-two articles were selected and used in the review. Conclusion: This article introduces biomaterials used in THA and discusses various bearing materials in currentclinical use in THA as well as the newer biomaterials which may even further decrease wear and improve THA survivorship.

단순화 모델에서의 응답스펙트럼과 시간이력 내진해석 결과를 활용한 해양플랜트용 매니폴드 실제품의 내진강도 평가 (Seismic Access of Offshore Subsea Manifold using RSA and THA Seismic Analysis Results for Simplified Model)

  • 이은호;곽시영
    • 한국전산구조공학회논문집
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    • 제32권1호
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    • pp.7-16
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    • 2019
  • 본 논문에서는 해양플랜트용 매니폴드 구조물의 내진해석을 위해, 단순화 모델에 대해 응답스펙트럽해석(RSA) 및 시간이력해석(THA)을 여러 조건으로 진행하여 비교 검토하였다. 응답스펙트럼해석은 ISO19901-2에 따른 내진설계 절차를 이용하였다. 시간이력해석의 경우, 응답스펙트럼으로 가속도와 변위에 대한 지진이력을 인공적으로 만든뒤 Explicit와 Implicit 솔버를 사용하여 해석하였다. 단자유도 모델을 사용하여 해석방법을 검증하였으며, 매니폴드 구조물을 단순화한 모델에서 시간이력해석과 응답스펙트럼해석법의 차이를 분석하였다. 복잡한 실제 구조물에 대해서 직접적인 시간이력해석은 불가능하므로 응답스펙트럼해석법을 적용하였고, 단순화 모델에서 분석한 결과 차이를 활용하여 실제 구조물의 안전성을 판단하였다.

단순접번 교합기의 모형부착 방법에 관한 연구 (A Study of Simple Hinge Articulator Mounting Method)

  • 조홍규
    • 대한치과기공학회지
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    • 제25권1호
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    • pp.95-102
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    • 2003
  • The purpose of this study was to show occlusion on the simple hinge articulator optionally mounted. Modelling of upper-lower jaw and simple hinge articulator were developed. This modelling of upper-lower jaw inserting wax bite was mounted imaginary on the modelling of simple hinge articulator by use of the computer simulation. From changes of THA(transverse horizontal axis)-incisor distance, Balkwill angle and THA deviation, eight types were mounted respectively. After removal of wax bite, upper-lower jaw position changing were compared with centric jaw relation. The results were as follows: 1. The change of THA-incisor distance had influence on mostly a vertical shift of upper jaw. 2. The change of Balkwill angle had influence on mostly a horizontal shift of upper jaw. 3. Inferior type in the THA deviations was the least shift of upper jaw. The above results suggest that the simple hinge articulator optionally mounted effect a shift of upper jaw.

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Efficacy of Pericapsular Nerve Group Block for Pain Reduction and Opioid Consumption after Total Hip Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

  • Eunsoo Kim;Won Chul Shin;Sang Min Lee;Min Jun Choi;Nam Hoon Moon
    • Hip & pelvis
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    • 제35권2호
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    • pp.63-72
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    • 2023
  • The aim of this study was to conduct a meta-analysis of randomized controlled trials (RCTs) for comparison of the effectiveness of pericapsular nerve group (PENG) block with that of other analgesic techniques for reduction of postoperative pain and consumption of opioids after total hip arthroplasty (THA). A search of records in the PubMed, Embase, and Cochrane Library, and ClinicalTrials.gov databases was conducted in order to identify studies comparing the effect of the PENG block with that of other analgesics on reduction of postoperative pain and consumption of opioids after THA. Determination of eligibility was based on the PICOS (participants, intervention, comparator, outcomes, and study design) criteria as follows: (1) Participants: patients who underwent THA. (2) Intervention: patients who received a PENG block for management of postoperative pain. (3) Comparator: patients who received other analgesics. (4) Outcomes: numerical rating scale (NRS) score and opioid consumption during different periods. (5) Study design: clinical RCTs. Five RCTs were finally included in the current meta-analysis. Significantly lower postoperative opioid consumption at 24 hours after THA was observed in the group of patients who received the PENG block compared with the control group (standard mean difference=-0.36, 95% confidence interval -0.64 to -0.08). However, no significant reduction in NRS score at 12, 24, and 48 hours after surgery and opioid consumption at 48 hours after THA was observed. The PENG block showed better results for opioid consumption at 24 hours after THA compared with other analgesics.

Deep Vein Thrombosis Prophylaxis after Total Hip Arthroplasty in Asian Patients

  • Kim, Jun-Shik
    • Hip & pelvis
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    • 제30권4호
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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).

구조화된 운동 프로그램이 인공고관절 전치환술 환자의 고관절 통증, 신체기능 및 삶의 질에 미치는 효과 (Effects of Structured Exercise Program on Hip Pain, Physical Function and Quality of Life in Patients with Total Hip Arthroplasty)

  • 권은희;이해정;이성화
    • 근관절건강학회지
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    • 제25권2호
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    • pp.122-134
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    • 2018
  • Purpose: The purpose of this study was to develop a 12-week structured exercise program (12-week-SEP) and evaluate its effects on pain, physical function and quality of life in patients with total hip arthroplasty (THA). Methods: A nonequivalent control group non-synchronized design was utilized to examine the effects of the 12-week-SEP on patients' outcomes after THA. A total of 46 adult patients (experimental group=25, control group=21) who had THA were recruited for the study. The 12-week-SEP consisted of education, exercise (muscle strengthening and progressive walking), and feedback. Data were analyzed by SPSS/WIN 21.0 using the $x^2$ test and repeated measures ANOVA. Results: The mean age of the participants was 60.9 years and 25 men (54.5%) and 21 women (45.7%) were included in the study. There were significant intervention effects on pain reduction and increased physical function but no effects on quality of life. Conclusion: The 12-week-SEP provided pain relief and enhanced physical function in patients underwent THA. Clinical application of the 12-week-SEP can improve postoperative nursing practices for patients with THA. Future research with larger sample is of necessity to obtain greater generalizability of the empirical evidences of the 12-week-SEP.

컴퓨터 응용 인공고관절 모사 시술 방법 연구 (A Study on Computer Aided Surgical Simulation Method for Total Hip Arthroplasty)

  • 김상후;한승무
    • 대한의용생체공학회:의공학회지
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    • 제25권6호
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    • pp.455-464
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    • 2004
  • 현재 인공고관절 전치환 수술 과정의 높은 난이도 때문에 숙련된 의사의 경험에 상당히 의존하고 있는 실정이다. 비구컵과 대퇴 임플란트의 위치 선정은 수술의 성공 여부와 밀접한 관계가 있지만 아직까지는 의사의 눈대중에 의해 이루어지는 경우가 많다. 이러한 이유로 인하여 인공삽입물(비구컵, 대퇴시스템) 삽입의 정확성이 낮아서 재치환술을 해야 하는 경우가 자주 발생한다. 본 연구에서는 환자 골반골(pelvis)과 대퇴골(femur)의 3차원적인 고유 기하학적 정보를 이용하는 모사 시술을 통하여 비구컵과 대퇴 임플란트의 정확한 위치를 선정하는 방법을 결정하였다. 이를 위하여 우선 비구컵의 위치 변화에 따른 대퇴 전염각 및 대퇴 경간각의 변화 양상을 살펴보았고 또한 대퇴 임플란트의 삽입 위치에 따른 대퇴스템 경부 길이 및 대퇴스템각의 변화 양상을 조사하였다. 본 연구에서 다양한 모사 시술을 통한 기하학적 정보의 분석 결과 비구컵과 대퇴 임플란트의 정확한 위치 선정이 가능함을 확인하였다. 본 연구의 모사 시술 방법을 이용하여 의사가 인공고관절 수술을 선행한다면 수술의 정확도와 숙련도를 향상시킬 수 있을 것으로 기대된다.