• 제목/요약/키워드: Total hip replacement arthroplasty

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투시하에 시행한 고관절 확대계측 촬영술의 유용성에 관한 분석 (A Study on the Usefulness of Total Hip Replacement Arthroplasty Using Fluoroscopy)

  • 이희정;손순룡;엄준용;진정헌;김건중
    • 대한방사선기술학회지:방사선기술과학
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    • 제22권1호
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    • pp.21-26
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    • 1999
  • To make a comparative analysis for clinical application of total hip replacement arthroplasty(THRA) using fluoroscopy, we have performed total hip replacement arthroplasty making 30 patients an object with general radiography and fluoroscopy respectively. The results are as follows : 1) Reexamination rate was 80% of patients and mean 3.9 sheets in the general radiography, where as it was 46.7% and 0.37 sheets in the fluoroscopy(p<0.01) 2) Add examination was 2 cases in the general radiography, but fluoroscopy was no add examination. 3) The total film sheet used was mean 10.16 in the general radiography and 6.73 in the fluoroscopy. 4) In the cause of reexmination and add examination, inaccurate position of patient accounted for 72.6% in the general radiography and poor exposure condition accounted for 45.5% in the fluoroscopy. Total hip replacement arthroplasty using the fluoroscopy decreased reexamination and add examination rate, for these reasons, this method was effective abatement of pain, exposured radiation dose, and examination time and so on.

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인공 고관절 수술 환자에서 지지간호중재가 고관절 기능, 불안 및 불확실성에 미치는 효과 (Effects of Supportive Nursing Care Program on Hip Function, Anxiety and Uncertainty for Patients with Total Hip Arthroplasty)

  • 김선화;이혜진
    • 임상간호연구
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    • 제19권3호
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    • pp.419-431
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    • 2013
  • Purpose: This study was to evaluate the effect of supportive nursing care program for patients with total hip arthroplasty. Methods: Forty-two patients with total hip arthroplasty were enrolled in this study from September, 20, 2011 to January, 3, 2012. The participants were assigned to one of two groups: Twenty-six subjects in the experimental group were provided with supportive nursing care program which comprised of 6 nurse visits pre and post operation and 4 follow-up phone calls after discharge. Another 26 subjects received conventional nursing care program as a control group. Hip function, anxiety, and uncertainty were evaluated before the intervention, and 5 weeks after completion of the intervention. The analysis included descriptive statistics, Chi-square test, and t-test by SPSS 18.0. Results: Hip function was significantly increased in the experimental group (t=-3.31, p<.002). Anxiety and uncertainty group was significantly lower in the experimental group (t=7.12, p<.001 and t=4.66, p<.001). Conclusion: The results of this study indicate that the supportive care intervention for patients receiving total hip arthroplasty could be utilized as a nursing intervention to improve hip function and to reduce anxiety and uncertainty of patients receiving total hip arthroplasty.

인공 고관절 전치환술 환자의 낙상 이후 발생된 심인성 보행불리 1례 (A Clinical Study about Psychogenic Gait Disturbance of the Patient Who Operated THRA(Total Hip Replacement Arthroplasty) after Falling on her Buttocks)

  • 배효상;조성규
    • 사상체질의학회지
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    • 제17권2호
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    • pp.115-120
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    • 2005
  • l. Objectives To analyse gait disturbance of patient who was operated Total Hip Replacement Arthroplasty(THRA). 'This study is reported to emphasize on psychological stability and balance of vital dynamics. 2. Methods This patient was treated by the remedy of Soyangin, who was diagnosed as Soyangin. We used visual analogue scale(V AS) for the assessment of Rt. femoral pain. 3. Results The patients operated THRA are needed not only rehabilitation of gait, but also psychological stability and balance of vital dynamics. 4. Conclusions We suggest that patients operated THRA are needed not only rehabilitation of gait, but also psychological stability and balance of vital dynamics.

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Spinopelvic Motion: A Simplified Approach to a Complex Subject

  • Cale A. Pagan;Theofilos Karasavvidis;Jonathan M. Vigdorchik;Charles A. DeCook
    • Hip & pelvis
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    • 제36권2호
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    • pp.77-86
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    • 2024
  • Knowledge of the relationship between the hip and spine is essential in the effort to minimize instability and improve outcomes following total hip arthroplasty (THA). A detailed yet straightforward preoperative imaging workup can provide valuable information on pelvic positioning, which may be helpful for optimum placement of the acetabular cup. For a streamlined preoperative assessment of THA candidates, classification systems with a capacity for providing a more personalized approach to performance of THA have been introduced. Familiarity with these systems and their clinical application is important in the effort to optimize component placement and reduce the risk of instability. Looking ahead, the principles of the hip-spine relationship are being integrated using emerging innovative technologies, promising further streamlining of the evaluation process.

Incidence of Venous Thromboembolism after Primary Total Hip Arthroplasty with Mechanical Prophylaxis in Hong Kong Chinese

  • Daniel Wai-Yip Wong;Qunn-Jid Lee;Chi-Kin Lo;Kenneth Wing-Kin Law;Dawn Hei Wong
    • Hip & pelvis
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    • 제36권2호
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    • pp.108-119
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    • 2024
  • Purpose: The incidence of deep vein thrombosis (DVT) following total hip arthroplasty (THA) without chemoprophylaxis could be as high as 50% in Caucasians. However, according to several subsequent studies, the incidence of venous thromboembolic events (VTE) in Asians was much lower. The routine use of chemoprophylaxis, which could potentially cause increased bleeding, infection, and wound complications, has been questioned in low-incidence populations. The objective of this study is to determine the incidence of VTE after primary THA without chemoprophylaxis in an Asian population using a fast-track rehabilitation protocol and to verify the safety profile for use of 'mechanical prophylaxis alone' in patients with standard risk of VTE. Materials and Methods: This is a retrospective cohort study of 542 Hong Kong Chinese patients who underwent primary THA without chemoprophylaxis. All patients received intermittent pneumatic compression and graduated compression stockings as mechanical prophylaxis. Multimodal pain management was applied in order to facilitate early mobilisation. Routine duplex ultrasonography was performed between the fourth and seventh postoperative day for detection of proximal DVT. Results: All patients were Chinese (mean age, 63.0±11.9 years). Six patients developed proximal DVT (incidence rate, 1.1%). None of the patients had symptomatic or fatal pulmonary embolism. Conclusion: The incidence of VTE after primary THA without chemical prophylaxis can be low in Asian populations when following a fast-track rehabilitation protocol. Mechanical prophylaxis alone can be regarded as a reasonably safe practice in terms of a balanced benefit-to-risk ratio for Asian patients with standard risk of VTE.

Correlation between anterior thigh pain and morphometric mismatch of femoral stem

  • Chung, Haksun;Chung, So Hak
    • Journal of Yeungnam Medical Science
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    • 제37권1호
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    • pp.40-46
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    • 2020
  • Background: Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint. Methods: The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain. Results: Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain. Conclusion: Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

라이프케어를 위한 관절 치환술 환자의 의료이용에 관한 연구 (A Study on the Medical Use of Total Replacement Arthroplasty Patients for Life Care)

  • 이경화;김환희
    • 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

고관절 치환술에 침구치료를 적용한 국내외 연구에 대한 동향 분석 (A Review on the trends of acupuncture and moxibustion treatment for Hip arthroplasty)

  • 오은미;이은정
    • 척추신경추나의학회지
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    • 제14권1호
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    • pp.77-91
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    • 2019
  • Objectives : The purpose of this study was to investigate the effects of using acupuncture and moxibustion for the treatment of hip arthroplasty. Methods : We searched a total of six Korean and international databases (OASIS, KISS, RISS, Pubmed, Cochrane library, and CNKI) up to March 2019, and included randomized controlled trials which investigated the treatment effects of acupuncture and moxibustion in patients with hip arthroplasty. Results : In total, 29 studies were selected and included in the analysis. These studies conducted interventions, with the most frequently conducted methods being electroacupuncture (24.1%) and auricular acupuncture (20.7%). The most frequently used acupoints were the Ashi-, Lower four-, and Lower five points. VAS (48.9%) and Harris scores (22.2%) were commonly used to evaluate treatment effects. In total, 27 studies (93.1%) reported favorable treatment effects following acupuncture and moxibustion treatment, compared to the control group. Conclusions : These results may suggest that acupuncture and moxibustion have favorable effect on Hip arthroplasty.

Factors Influencing Physical Activity after Discharge from Hospital for Total Hip Arthroplasty Patients

  • Ju Young Kim;Mi Yang Jeon
    • Physical Therapy Rehabilitation Science
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    • 제11권4호
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    • pp.535-545
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    • 2022
  • Objective: This study was conducted to identify predictive factors of physical activity in total hip arthroplasty patients, and to provide basic data for the developing physical activity promotion program for total hip arthroplasty patients. Design: Descriptive correlational research. Methods: Data were collected from August 2017 to May 2018. Surveys were distributed to 60 patients in a G university hospital located at J city, Gyeongsangnam-do. Data were analyzed by frequency, mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, multiple regression analysis using SPSS 24 Win program. Results: The variables affecting the 4-week physical activity after discharge were age (β=.07), residence after discharge (β=-.22), cerebrovascular disease (β=-.13), mental and behavioural disease (β=-.11), taking antibiotic (β=-.26), walking ability (β=.41), nutritional status (β=.25), depression (β=.05). The eight variables accounted for 39.4% in the 4-week physical activity (F=4.49 p=.001). The variables affecting the 8-week physical activity after discharge were age (β=.06), waking ability (β=.34), nutritional status (β=.20), exercise self-efficacy (β=.05), depression (β=-.05). The six variables accounted for 28.0% in the 8-week physical activity (F=4.58, p<.001). Conclusions: The walking ability in discharge important to improve the physical activity, there is a need to develop an program to improve walking ability before discharge, in total hip arthroplasty. There is a need to develop a physical activity program to consistently participate in a community.

Preoperative Serum Albumin Levels Predict Treatment Cost in Total Hip and Knee Arthroplasty

  • Rudasill, Sarah E.;Ng, Andrew;Kamath, Atul F.
    • Clinics in Orthopedic Surgery
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    • 제10권4호
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    • pp.398-406
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    • 2018
  • Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.