• Journal of the Korean Orthopaedic Association
• /
• v.55 no.6
• /
• pp.527-533
• /
• 2020

Purpose: This study compared the effects of a buprenorphine transdermal patch (BTDP) on the chest and knee for pain control after total knee arthroplasty (TKA). Materials and Methods: A retrospective case-control study was conducted from August 2018 to August 2019 on 231 patients who underwent TKA. Two hundred cases were selected considering age, sex, and body mass index. Before and after applying the BTDP, the Numeric Rating Scale (NRS), adverse effects and compliance were measured. All measurements in the chest application group (group A=100) and knee application group (group B=100) were compared. Results: NRS was similar in rest between the groups treated with BTDP, but at two days and three days afternoon, five, six, and seven days postoperatively in group B, the NRS was significantly lower than that of group A. The adverse effects of the central nervous system and gastrointestinal system after applying BTDP were significantly lower in group B than in group A. No significant differences in adverse effects of the cardiovascular system and skin were observed between the two groups. Regarding the maintenance of BTDP, group B was significantly higher than group A. Conclusion: The direct application of BTDP after TKA to painful knee joints showed excellent results in early postoperative pain control and can be a useful method for increasing patient compliance by reducing the frequency of adverse effects.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.28 no.3
• /
• pp.79-87
• /
• 2022

Background: The purpose of this study was to examine the effect of transcranial direct current stimulation (tDCS) on the pain and balance of patients who receive total knee arthroplasty (TKA). Methods: This study subjects were 24 patients in Hospital T, located in Daegu, South Korea who received TKA after being diagnosed with degenerative arthritis. The subjects were randomly divided into and experimental group and a control group, with each group including 12 patients. Both group received superfical thermal therapy, interferential current therapy (ICT), and continue passive motion (CPM), which are conventional knee therapy on the knee joint. The experimental group received the tDCS treatment three times a week for three weeks, from October 1st to October 20th. The visual analogue scale and Wii Balance Board system were used to measure the pain and balancing ability, respectively, of both groups. In the statistical result analysis, to compare about pre and post test difference in each groups was accomplished. Statistical analysis of independent t-test and paired t-test were conducted using SPSS version 23.0. Results: After three weeks of intervation, there were significantly difference in balance ability in pre and post test in the tDCS group. VAS decreased significantly in both groups(p<.05), There was a significantly difference in pain, balance ability in the tDCS group compared to the sham group. Conclusion: These results indicate that applying tDCS together with conventional knee joint therapy for TKA patients is effective in promoting the patients' recovery.

• Knee surgery & related research
• /
• v.30 no.4
• /
• pp.334-340
• /
• 2018

Purpose: The purposes of this study were to compare clinical results after total knee arthroplasty (TKA) using the Attune and PFC Sigma knee designs and to investigate whether the use of the Attune prosthesis increased the risk of patellar injury in Asian patients. Materials and Methods: Three hundred knees that underwent TKA using Attune (group A) were compared to 300 knees that underwent TKA using PFC Sigma (group B). The Knee Society Knee Score (KS) and Function Score (FS), and range of motion (ROM) were compared. The residual patellar thickness was compared to evaluate the risk of patellar injury. Results: The postoperative KS and ROM of group A were better than those of group B (93.1 vs. 88.8, p<0.001 and $131.4^{\circ}$ vs. $129.0^{\circ}$, p=0.008, respectively). The postoperative FS did not differ significantly between the two groups (80.9 vs. 78.7, p=0.427). The residual patella was thinner in group A (14.8 mm vs. 15.7 mm, p=0.003), which made up a higher proportion of the high-risk group for patellar fractures with a residual thickness of <12 mm (7.5% vs. 2.1%, p=0.003). Conclusions: TKA using the Attune prosthesis provided more favorable clinical results than TKA using PFC Sigma. However, the risk of injury in the residual patella was increased with use of the Attune prosthesis in Asian patients.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.30 no.2
• /
• pp.85-94
• /
• 2024

Background: This study aimed to investigate the effects of joint mobilization with movement (MWM) on pain, ankle joint range of motion, balance, and gait in patients who underwent total knee arthroplasty (TKA) and exhibited ankle joint inversion. Methods: We divided 35 patients who had undergone TKA into experimental and control groups. The intervention involved a 40-min session three times a week over 4 weeks. The control group received general physical therapy, ankle pumping exercises, Q-setting exercises, knee joint range of motion exercises, and gravity-controlled gait training. In addition to these treatments, the experimental group received MWM to evaluate knee pain, ankle joint angle, balance, and gait pre- and post-intervention. Results: Both groups experienced a decrease in pain levels, with no significant difference between the groups. Both groups also showed a significant decrease in ankle joint inversion angle, with notable differences between them. Additionally, both groups significantly increased their mean dorsiflexion angles and balance, with a significant difference observed between the groups. Although walking decreased in both groups, there was no significant difference observed between them. Conclusion: The group that received MWM treatment showed significant effects on inversion angle, dorsiflexion angle, balance, and gait. These results provide valuable insights into the potential benefits of MWM as a post-TKA intervention, while highlighting the importance of long-term follow-up studies on post-TKA lower limb alignment interventions.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2011.06a
• /
• pp.285-286
• /
• 2011

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2012.05a
• /
• pp.1213-1214
• /
• 2012

• PNF and Movement
• /
• v.20 no.1
• /
• pp.91-101
• /
• 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.

• Physical Therapy Korea
• /
• v.23 no.1
• /
• pp.20-30
• /
• 2016

Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC ($n_1$=19) or the QIIC ($n_2$=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.

• Journal of Korean Physical Therapy Science
• /
• v.28 no.3
• /
• pp.88-97
• /
• 2021

Purpose: Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. This study aimed to investigate the effect of complex balance exercises on unstable ground, on the gait, balance, and daily living ability of patients with total knee arthroplasty. Design: Randomized controlled trial. Methods: The participants consisted of 30 patients placed into two groups of 15 each: a experimental group (complex balance exercise) and a control group (physical therapy exercise). Both group exercise was applied for 3 times a week for 30 minutes for four weeks. Force plate for balance ability and Timed up and go (TUG) test were the primary outcome measures. The secondary outcome measures included 10-m walk test (10MWT) and the daily living ability using the Knee Outcome Survey Activities of Daily Living scale (KOS-ADL). Results: The result of this study showed that the experimental group had a significant difference in TUG and 10MWT than the control group, and balance was significantly different in CEA, CPL, and CAV. There was a significant difference in daily living ability between the experimental and control groups. This study confirms that the physical therapy with complex balance exercise on unstable surfaces has positive effects on balance, gait and daily living ability in patients with total knee arthroplasty. Conclusion: As a result of this study, complex balance exercise on unstable surface was more effective in improvement gait, balance and daily living ability in total knee arthroplasty. From this study, physical therapy with complex balance exercises on unstable ground may be proposed as and effective intervention method for improving gait, balance, and daily living ability in patients with early total knee arthroplasty.

• Journal of Medicine and Life Science
• /
• v.20 no.2
• /
• pp.60-66
• /
• 2023

Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet^® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin^® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.