• 대한족부족관절학회지
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• 제15권3호
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• pp.119-123
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• 2011

본 연구는 내반 족관절 퇴행성관절염에서 선열에 대하여 고찰하고, 과상부 절골술의 적응증과 수술술기에 대하여 고찰하였다. 초기 족관절 퇴행성 관절염에서 경골 천장 및 후족부의 선열은 상당히 다양한 형태를 보이며, 과상부 절골술은 거골 경사가 경미하고, 후족부 선열이 중립이거나 내반인 경우가 적응증이다.

• 대한정형도수물리치료학회지
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• 제12권2호
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• pp.1-10
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• 2006

The purpose are to assess the efficacy of a contact lateral-wedged insole with strapping on the femorotibial angle in patients with varus deformity osteoarthritis of the knee after treatment period. 25 outpatients with knee osteoarthritis (OA) were randomized to be treated with a contact lateral-wedge insole with strapping. Standing radiographs were used to analyze the femorotibial angle for each subject. The result of repeated two-way ANOVA's reveled that a contact lateral-wedged insole with strapping produced significantly differences in the femorotibial angle between groups after treatment period (P<0.05). and repeated one-way ANOVA's reveled that it produced significantly differences in the femorotibial angle between experimental groups after treatment period (P<0.05). We suggest that these results may be beneficial for manufacturing foot orthotic devices, such as wedged insoles, to control medial and later compartment forces in the knee varus-valgus deformity.

• 한국전문물리치료학회지
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• 제14권3호
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• pp.23-31
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• 2007

The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 $kg/m^2$) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.

• 대한정형도수물리치료학회지
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• 제13권1호
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• pp.26-35
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• 2007

The purpose are to demonstrate the pain, stiffness, and physical function by the Korean Western Ontario MacMaster University(KWOMAC) score of the patients with varus deformity osteoarthritis of the knee after treatment period. Twenty outpatients with knee osteoarthritis(OA) were randomized and divided into the control(n=10) and wedge(n=10) groups. The remission scores of the KWOMAC index of severity for knee OA were compared between the groups. The result of repeated two-way ANOVA's revealed that a contact lateral-wedged insole with strapping produced significantly differences in the pain and physical function score between groups after treatment period(P<0.05), but it was not significant differences in the stiffness score between groups(P>0.05). These results suggest that the pain relief and improvement in function reported by patients with osteoarthritis while using lateral-wedged insole with strapping may be achieved by a reduction in external varus moment and medial compartment load.

• 한국전문물리치료학회지
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• 제11권4호
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• pp.31-41
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• 2004

The purpose of this study was to examine the effect of the angle of a wedged insole on knee varus torque during walking. Fifteen healthy subjects were recruited. Knee varus torque was measured using three-dimensional motion analysis (Elite). Knee varus torque was normalized to gait cycle (0%: initial contact; 100%: ipsilateral initial contact) and stance phase (0%: initial contact; 100%: ipsilateral toe off). The average peaks of knee varus torque during the stance phase of the gait cycle according to the different insole angles (10 or 15 degrees) were compared using one-way ANOVA with repeated measures. The results showed that in the early stance phase, the average peak knee varus torque increased significantly for both the medial 10 and 15 degree wedged insole conditions and decreased significantly for both the lateral 10 and 15 degree wedged insole conditions as compared with no insole (p<.05). However, there were no significant differences between the 10 and 15 degree wedged insole conditions with either the medial or lateral wedged insole (p>.05). In the late stance phase, the average peak knee varus torque increased significantly for the medial 10 and 15 degree wedged insole conditions (p<.05), but not for the lateral 10 and 15 degree wedged insole conditions as compared with no insole (p>.05). We suggest that these results may be beneficial for manufacturing foot orthotic devices, such as wedged insoles, to control medial and lateral compartment forces in the knee varus-valgus deformity. Further studies of the effects of wedged insole angle on knee varus torque in patients with medial-lateral knee osteoarthritis are needed.

• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.65-73
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• 2005

Osteoarthritis has been considered a disease of the elderly because it is uncommon before the age of 40 years and is seen in approximately 80% of United States citizens older than 65 years. general population on kuri city in korea revealed that prevalence of knee osteoarthritis is 10.2%, increasing with age. High level of physical activity in men and age, post-menopause and obesity in women can be risk factor. Osteoarthritis is no evidence that a acquired process initiated much earlier in life through mechanical, metabolic, genetic, or other origins. A high tibial osteotomy alters static lower extremity alignment thereby decreasing medial compartment loading. As well, conservative treatment strategies, such as knee braces and valgus heel wedges, affect lover limb mechanics and attempt to reduce medial compartment loading. It was hypothesized that valgus heel wedges and modified orthoses would shift the center of pressure laterally on the foot during level walking, reducing the moment arm of the adduction moment in the frontal plane, thereby resulting in a decrease in the knee adduction moment. In the 1980s, the effect of wearing a laterally wedged insole on osteoarthritic patients with a varus deformity of the knee was firsted, and since then, kinematic and kinetic analyses concerning this condition have mainly focused on a static standing position. Since the early 1990s, the beneficial effect of wearing a laterally wedged insole to treat osteoarthritis of the knee has also been reported in dynamic conditions, but these studies did not answer the question of the kinematic and kinetic mechanisms that resulted in the reduced symptoms in patents with knee osteoarthritis. therefore, the effect of wearing laterally wedged insole has not been sufficiently studied.

• 대한의용생체공학회:의공학회지
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• 제25권4호
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• pp.289-293
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• 2004

본 연구에서는 경사각도가 다른 내, 외측 후족 왯지를 착용하고 보행하는 동안 삼차원 동작분석시스템과 무선가속도측정시스템을 이용하여 무릎관절의 내번토크와 내외측 방향 가속도를 측정하였다. 내번토크와 외측 가속도는 하중수용기와 전유각기에서 각각 양의 절정값을 나타내었다. 하중수용기에 내측 왯지의 경우 내번토크와 외측 가속도가 맨발에 비하여 증가되었으며, 외측 왯지의 경우 내번토크와 외측 가속도값이 감소하였다. (p<0.05). 이러한 변화는 왯지의 경사각이 커질수록 더욱 뚜렷한 상관성을 보였다(p<0.05). 그러나 전유각기에서는 왯지의 방향과 경사에 따른 무릎의 내번토크와 내외측 가속도의 상관성을 확인할 수 없었다. 본 연구의 견과를 통하여 외측 왯지 사용 시 무릎관절의 내번토크가 감소되어 퇴행성 무릎관절염의 치료에 도움을 줄 수 있다. 또한, 보행 중 무릎관절의 내번토크 대신에 외측방향 가속도를 측정함으로써 간단히 왯지의 효과를 결정할 수 있을 것이다.

• 대한족부족관절학회지
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• 제18권4호
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• pp.141-146
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• 2014

Low tibial osteotomy is an extra-articular procedure that realigns the mechanical axis, restoring ankle function. It is also an alternative surgical procedure to manage early osteoarthritis of the ankle joint. This can mainly address ankle varus/valgus, as well as procurvatum/ recurvatum, internal/external rotation, equinus, calcaneus, and limb length discrepancy. The authors describe the history, mechanism, indications, and limitations of low tibial osteotomy focused on osteoarthritis of the ankle with varus malalignment reviewing several articles published thus far.

• 대한족부족관절학회지
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• 제21권4호
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• pp.122-127
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• 2017

This paper reviews the indications and surgical technique of supramalleolar osteotomy as one of the treatments for moderate degenerative ankle osteoarthritis. Although it is technically demanding and requires extensive preoperative planning, supramalleolar osteotomy will be a good treatment option for moderate degenerative ankle osteoarthritis. The osteotomy is designed to shift the weight bearing axis to the lateral side of the ankle joint and unload the medial side of the joint. In our experience, a supramalleolar osteotomy is effective to the treatment of moderate ankle osteoarthritis with a small amount of preoperative talar tilt and varus or normal heel alignment.

• Knee surgery & related research
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• 제30권4호
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• pp.311-318
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• 2018

Purpose: The purpose of this study was to evaluate changes in the coronal alignment of the knee and ankle joints after open wedge high tibial osteotomy (OWHTO) to determine factors related to the recurrence (R) of the varus deformity by serial analysis. Materials and Methods: Sixty-four OWHTOs were enrolled in this study. The weight bearing line (WBL) ratio, joint line convergence angle (JLCA), knee joint inclination, mechanical axis-tibial plateau angle, talar inclination (TI), and distal tibia articular angle (DTAA) were serially assessed. Serial correlation analysis between all parameters was performed. Patients were divided into R group and no recurrence (NR) group according to the WBL ratio (55%) at postoperative one year. Results: The preoperative WBL ratio showed significantly negative correlation with serial changes of JLCA, TI, and DTAA (p<0.05). The JLCA, TI, and DTAA as well as WBL ratio showed a significantly larger degree of varus alignment in the R group than in NR group at postoperative 6 weeks and 1 year after OWHTO (p<0.05). Conclusions: Sufficient correction of the WBL and restoration of the JLCA during OWHTO are essential to prevention of the R of varus deformity after the surgery because they are the only modifiable factors during surgery. Level of Evidence: IV, Case series.