• 대한기계학회:학술대회논문집
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• 대한기계학회 2008년도 추계학술대회A
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• pp.1473-1474
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• 2008

In the total knee arthroplasty (TKA), kinematic benefic of a mobile-bearing total knee prosthesis is still arguing. Main reasons for implant failure are loosening and polyethylene wear and should be solved with new designs with mob ile bearings. The kinematics of the knee prosthesis also affects the implant failure. Recently, a second generation of p rostheses with a mobile-bearing was developed. The current study aimed to assess the kinematic path of the 2nd generation mobile knee prosthesis compared to the normal knees. Using 3D/2D registration method, CT-derived 3D knee models were fitted to sequential 2D X-ray images during knee flexion. 3D kinematics of the femur and the tibia were analyzed. The 2nd generation mobile-bearing TKA prosthesis (e.motion, Aesculap, Germany) knees showed less external rotation and knee flexion range compared to the normal knee, but the trend of external rotation was similar each other.

• 근관절건강학회지
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• 제19권2호
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• pp.161-172
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• 2012

Purpose: This study was to identify the factors influencing depression among patients with degenerative arthritis after total knee arthroplasty. Methods: The subjects were 108 patients who admitted or visited K hospital in K city after total knee arthroplasty. Data were analyzed using SPSS WIN 18.0 program. Results: The level of depression was 2.72 with a possible range of 1 to 5. Social support was 3.71 out of a total score 5. Self-efficacy was 64.47 ranged from 10 to 100. Self-esteem was 2.59 ranged from 1 to 5. The associated factors with depression were marital status, length of illness, perceived health status, pain, social support, self-efficacy, and self-esteem. Marital status, length of illness, and perceived health status accounted for 5.8% of depression. Next, all variables including pain, social support, self-efficacy and self-esteem accounted for 66.4% of depression. Conclusion: The level of depression among the subjects significantly be related to marital status, length of illness, perceived health status, pain, social support, self-efficacy and self-esteem. It indicates a need to develop nursing interventions for them to decrease depression and develop quality of life during recovery.

• The Korean Journal of Pain
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• 제34권3호
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• pp.271-287
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• 2021

Background: Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. Methods: We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Conclusions: Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2005년도 춘계학술대회 논문집
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• pp.896-902
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• 2005

An orthopedic surgeon normally gets the operational parameters of total knee arthroplasty from medical images(CT, MRI). Anatomical axis, mechanical axis, the width and height of femur, or tibia are the most important parameters related with accomplishment of TKA. This paper presents a methodology of simulation that virtually operates TKA according to 2D medical images. Using this simulator, some important parameters for operation can be achieved before hand. The simulator provides the 3D computational model of a knee joint and then derives the proper size of implant corresponding to the joint. The whole process of TKA can be simulated such as clipping a knee joint, assembling the joint and its implants, visualizing all the operation steps, deriving some crucial parameters such as anatomical axis and cutting thickness, and predicting the result of TKA. Some examples are given and discussed to validate the methodology.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2012년도 춘계학술대회 논문집
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• pp.1157-1158
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• 2012

• 대한정형외과학회지
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• 제53권6호
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• pp.478-489
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• 2018

슬관절의 골관절염 환자에서 슬관절 전치환술은 통증 경감 및 기능 회복에 도움이 되는 치료법으로 많이 시행되고 있다. 최근 수술 술기 및 과학 기술의 발달로 인하여 내비게이션 장치를 이용하여 슬관절 전치환술 후 하지 정렬과 치환물의 위치 및 정렬을 호전시키려는 노력이 지속적으로 이루어지고 있다. 이러한 내비게이션 장치를 이용할 경우 수술 중에 신전, 굴곡 시 내외측 간격, 하지 및 치환물의 정렬에 대하여 실시간 추적이 가능하다는 장점이 있다. 하지만 고식적인 방법에 비해 추적기 사용에 따른 추가적 절개로 인한 감염 및 골절 등의 합병증 발생 가능성이 있고 수술 시간이 길어지는 단점 및 비용 부담 등이 지적되어 왔다. 지금까지 많은 연구들이 진행되어 왔으나 임상적 효용성에 대해서는 아직까지 논란이 있다. 하지만 많은 연구들에서 관상면 상에서 역학적 축 내, 외반 $3^{\circ}$이내의 정렬 빈도를 높여주는 것으로 보고되고 있다. 이번 종설에서는 내비게이션 장치를 이용한 슬관절 전치환술의 수술 방법 및 수술 시 주의사항, 최근 연구들의 임상적 결과 및 방사선적 결과, 내비게이션 장치의 유용성과 최근 동향에 대하여 기술하고자 한다.

• 디지털융복합연구
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• 제14권9호
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• pp.563-569
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• 2016

본 연구를 통해 슬관절 전치환술 수술을 받은 노인의 삶의 만족도를 높이기 위한 다양한 방안을 모색하는 중재프로그램을 개발하는데 기초자료를 제공하고자 한다. 2015년 9월 25일부터 10월31일까지 G광역시에 소재한 S병원 정형외과에서 슬관절 전치환술을 받은 후 1년 미만의 입원 또는 외래를 방문한 115명의 설문을 실시하였다. 연구결과, 슬관절 전치환술을 받은 노인의 삶의 만족도에 영향을 미치는 요인으로 사회적 지지와 우울이 확인되었다. 따라서 이러한 연구결과를 바탕으로 추후 추가적인 연구를 통해 슬관절 전치환술을 받은 노인의 삶의 만족도를 높이기 위해서 사회적 지지체계 구축을 위한 인프라 마련과 우울을 줄여줄 수 있는 프로그램 개발을 고려해볼 필요가 있다.

• 대한물리의학회지
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• 제13권1호
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• pp.107-119
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• 2018

PURPOSE: This research was intended to investigate the influence to function recovery at the early stage after surgery, by conducting Multipath Electrical Simulation and isometric exercise treatment as early stage medical treatment method for Total knee arthroplasty patients. METHODS: The subject of 30 patients having Unilateral Total knee arthroplasty over age 65, Multipath Electrical Simulation and isometric exercise (experiment group I), Conventional Electrical Simulation and isometric exercise (experiment group II) and isometric exercise (control group). The intervention was performed in 5 times per a week and 60 minutes per a day during 4 weeks. We performed research by conducting Neuromuscular Electrical Stimulation and isometric exercise together and measured pain, range of motion, muscle strength and gait ability before and after intervention. RESULTS: The result showed therapeutic improvement in experiment group I, experiment group II and control group, but Multipath Electrical Simulation and isometric exercise showed significant improvement in function recovery of early stage compared to Conventional Electrical Simulation and isometric exercise, only isometric exercise. CONCLUSION: Based on research result, in order for early state function recovery of Total knee arthroplasty patients, when conducting neuromuscular electrical stimulation and isometric exercise together, especially when applying Multipath Electrical Stimulation, we could know that it showed more significant improvement to function recovery after surgery. Also, we suggest that Multipath Electrical Simulation may become a useful tool as a method for intervention and performing in various diseases for weakening of Quadriceps muscle.

• 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.

• PNF and Movement
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• 제20권1호
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• pp.91-101
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• 2022

Purpose: The purpose of this study was to examine the effect of cycle ergometer exercise inducing movement of the affected side on knee joint function after total knee arthroplasty (TKA). Methods: The primary experiment was conducted on 19 members of the cycle ergometer exercise group to measure the muscle activity of the rectus femoris, hamstring, tibialis anterior, and gastrocnemius muscles during cycle ergometer exercise that induced the affected side's movement. In the second experiment, after receiving physiotherapeutic intervention for 30 min, the general bicycle exercise group and cycle ergometer exercise group performed the corresponding exercise for 15 min, 5 times per week, for 2 weeks. The ROM, muscle strength, pain, and balance were then measured and compared between the two groups. Results: In the results of the primary experiment, cycle ergometer exercise inducing movement of the affected side showed a significantly larger increase in the activity of leg muscles (rectusfemoris, hamstring, tibialis anterior, gastrocnemius) on the affected side than the general bicycle exercise (p <0.05). In the second experiment, the cycle ergometer exercise group showed a significantly larger increase in range of movement of affected side knee flexion and muscle strength of affected side knee flexion, knee extension, and plantarflexion than the general bicycle exercise (p <0.05). No significant between-group difference was observed in pain and balance before or after the intervention (p >0.05). Conclusion: Cycle ergometer exercise inducing movement of the affected side increases use of the muscles around the affected side knee joint after TKA more than general bicycle exercise and produces better effects for enhancing muscle strength. The application of cycle ergometer exercise inducing movement of the affected side is expected to reduce the patients' unbalanced use during the early postoperative period and help them to quickly return to normal daily life through rapid muscle strength recovery.