• 대한의용생체공학회:의공학회지
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• 제34권1호
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• pp.14-23
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• 2013

In this study, biomechanical stability of the newly developed revision total knee arthroplasty (rTKA) was evaluated through strain and stress distribution analysis within the implanted proximal tibia using a three-dimensional finite element (FE) analysis. 2000N of compressive load (about 3 times body weight) was applied to the condyle surface on spacer, sharing by the medial (60%) and lateral (40%) condyles simulating a stance phase before toe-off. The results showed that PVMS within the revision total knee arthroplasty and the proximal tibia were less than yield strength considering safe factor 4.0 (rTKA: less than 10%, Cortical bone: less than 70%, Cancellous bone: less than 70%). The materials composed of them and the strain and stress distributions within the proximal tibia were generally well matched with those of a traditional revision total knee arthoplasty (Scorpio TS revision system, Stryker Corp., Michigan, USA) without the critical damage strain and stress, which may reduce the capacity for bone remodeling, leading to bone degeneration. This study may be useful to design parameter improvement of the revision total knee arthoplasty in biomechanical stability point of view beyond structural stability of revision total knee arthoplasty itself.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2010년도 추계학술대회 논문집
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• pp.977-978
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• 2010

• 대한정형외과학회지
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• 제56권2호
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• pp.173-177
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• 2021

재발성 혈관절증은 인공 슬관절 치환술의 합병증 중 상당히 드문 합병증으로 본 연구에서는 인공 슬관절 치환술 시행 후 발생한 혈관절증이 수차례 재발하여 관절경 수술을 받았음에도 증상이 지속된 환자를 동맥색전술을 시행하여 치료한 증례를 보고하고자 한다.

• 한국정밀공학회지
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• 제21권9호
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• pp.188-195
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• 2004

Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

• 임상간호연구
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• 제20권1호
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• pp.28-39
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• 2014

Purpose: The purpose of this study was to investigate the effect of preoperative education about patient controlled analgesia (PCA) on postoperative pain control for elderly after total knee arthroplasty. Methods: The study applied a quasi-experimental design. To prevent communication between experimental group and control groups, data from control group were collected before provision of preoperative education for the experimental group. A total of 50 elderly patients who underwent total knee arthroplasty and older than 65 years old participated in this study. The preoperative education about PCA was provided for the experimental group before surgery. The preoperative education program consisted of fifteen minute education about pain control, and PCA use, as well as demonstration of PCA use. Results: The experimental group had higher knowledge score about pain and PCA use, and more positive attitudes toward pain and use of analgesics after surgery than the control group. There was no significant difference in use of additional analgesics after surgery between the two groups. The experimental group had significantly lower pain score at 8, 24 and 36 hours after surgery than the control group. The experimental group had higher level of satisfaction about PCA use than the control group. Conclusion: The preoperative education about PCA, customized for elderly patients could be an effective nursing intervention for postoperative pain control after total knee arthroplasty.

• 한국엔터테인먼트산업학회논문지
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• 제13권8호
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• pp.661-670
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• 2019

본 연구는 만성 퇴행성관절염인 슬관절과 고관절 전치환술 환자의 수혈에 영향을 주는 요인을 분석하고, 수혈이 관절 치환술 환자의 의료이용에 미치는 영향을 연구하여 양질의 의료를 위한 기초자료로 활용하고자 한다. 연구대상은 심평원의 환자표본자료(HIRA- NIS-2017) 중 입원개시일자가 2017년 1월 1일부터 12월 30일까지 단측 전치환술을 시행한 환자 중 65세 이상 슬관절 전치환술(N2072)과 고관절 전치환술(N0711)로 청구된 코드만을 대상으로 총 분석 대상은 1,580건이었다. 연구결과는 다음과 같다. 첫째 슬관절 전치환술이 병원특성 및 환자특성별로 수혈여부에 유의한 차이가 있는지 비교하였다. 유의한 변수로는 의료기관종류, 시도, 병상수준, 성별, 빈혈에서 통계학적으로 유의한 연관이 있는 것으로 나타났다. 둘째, 고관절 전치환술의 병원특성 및 환자특성별로 수혈여부에 유의한 차이가 있는 지 비교하였다. 유의한 변수로는 의료기관종류, 병상수준에서 유의한 연관이 있는 것으로 나타났다. 셋째, 슬관절 전치환술의 병원특성 및 환자특성별로 당뇨병 유무에 유의한 차이가 있는 지 비교하였다. 유의한 변수로는 의료기관종류, 병상규모, 빈혈에서 유의한 연관이 있는 것으로 나타났다. 넷째, 수혈여부에 영향을 미치는 요인을 파악하기 위해 로지스택 회귀분석을 실시한 결과, 수혈에 영향을 주는 요인 분석 결과 슬관절 전치환술의 수혈여부에 유의한 영향을 미치는 독립변수는 의료기관 종류, 기관소재지, 성별, 빈혈이었다. 고관절 전치환술의 수혈여부에 유의한 영향을 미치는 독립변수는 의료기관 종류, 성별로 나타났다

• Knee surgery & related research
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• 제30권4호
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• pp.319-325
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• 2018

Purpose: Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA. Materials and Methods: We prospectively enrolled 67 patients undergoing primary TKA. Correlation coefficients were used to evaluate the associations of tourniquet time, a surrogate of surgical difficulty, with BMI, pre- and intraoperative anthropometric measurements, and radiographic knee alignment. Similarly, Knee Injury and Osteoarthritis Outcome Score (KOOS) was compared to BMI. Results: Tourniquet time was significantly associated with preoperative inferior knee circumference (p=0.025) and ankle circumference (p=0.003) as well as the intraoperative depth of incision at the quadriceps (p=0.014). BMI was not significantly associated with tourniquet time or any of the radiographic parameters or KOOS scores. Conclusions: Inferior knee circumference, ankle circumference, and depth of incision at the quadriceps (measures of peripheral obesity) are likely better predictors of surgical difficulty than BMI. Further study of alternative surgical indicators should investigate patients that may be deterred from TKA for high BMI, despite relatively low peripheral obesity.

• 근관절건강학회지
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• 제12권2호
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• pp.143-154
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• 2005

Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.422-428
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• 2018

본 연구는 퇴행성 관절염으로 인해 무릎관절 전치환술을 실시한 환자를 대상으로 체간 안정화 운동이 무릎기능, 균형, 보행능력 향상에 어떠한 영향을 미치는지 알아보고자 한다. 본 연구 대상자는 퇴행성 관절염으로 진단 받아 무릎관절 전치환술을 실시한 환자 24명을 선정하여, 무작위 배분으로 일반 물리치료를 실시한 대조군 12명, 체간 안정화 운동을 실시한 실험군 12명으로 구성하였다. 체간 안정화 운동은 선행 연구를 참고하여 구성한 3가지 운동을 총 4주간 실시하였다. 측정도구로는 무릎기능 측정은 무릎관절 주관적 기능 점수 척도를, 균형능력은 일어나 걷기 검사, 한발 서기 검사를 보행능력은 10미터 걷기 검사를 이용하였다. 통계학적 분석은 각 그룹 내 비교는 대응표본 t-검정, 각 그룹 간 비교는 독립표본 t-검정으로 분석하였다. 본 연구 결과 중재 후 실험군이 대조군에 비해 모든 측정 결과가 유의하게 향상되어 나타났다(p<.05). 이와 같은 결과를 바탕으로 무릎관절 전치환술 환자를 대상으로 무릎관절 치료와 함께 체간 안정화 운동을 실시한다면, 환자의 무릎기능, 균형, 보행에 좀 더 효과적이라고 판단된다.

• 한국간호교육학회지
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• 제14권1호
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• pp.20-29
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• 2008

Purpose: This research was conducted to compare the effects of a muscle strengthening exercise program on pain, straight leg raising ability, passive range of motion, independent walking time and satisfaction with total knee arthroplasty(TKA). Method: A nonequivalent control group posttest only design was used for this study. A total of 62 patients were randomly divided into the experimental group(31) and the control group (31). The experimental group received a 1-hour exercise intervention, while the control group received the usual care. Data was analyzed by t-test using the SPSS/WIN 11.0. Results: The experimental group showed significant improvement in pain score, straight leg raising ability, passive range of motion of knee joint, independent walking time, and the patient's satisfaction. Conclusion: The muscle strengthening exercise program was effective on decreasing pain and increasing mobility and satisfaction in patients with TKA.