http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Using Illness Rating Systems to Predict Discharge Location Following Total Knee Arthroplasty
Sarah Rudasill,Jonathan R. Dattilo,Jiabin Liu,Ari Clements,Charles L. Nelson,Atul F. Kamath 대한슬관절학회 2018 대한슬관절학회지 Vol.30 No.1
Purpose: Total knee arthroplasty (TKA) is increasing in frequency and cost. Optimization of discharge location may reduce total expenditure while maximizing patient outcomes. Although preoperative illness rating systems—including the American Society for Anesthesiologists Physical Classification System (ASA), severity of illness scoring system (SOI), and Mallampati rating scale (MP)—are associated with patient morbidity and mortality, their predictive value for discharge location, length of stay (LOS), and total costs remains unclear. Materials and Methods: We conducted a retrospective analysis of 677 TKA patients (550 primary and 127 revision) treated at a single institution. The influence of ASA, SOI, and MP scores on discharge locations, LOS, and total costs was assessed using multivariable regression analyses. Results: None of the systems were significant predictors of discharge location following TKA. SOI scores of major or higher (β=2.08 days, p<0.001) and minor (β=–0.25 days, p=0.009) significantly predicted LOS relative to moderate scores. Total costs were also significantly predicted by SOI scores of major or higher (β=$6,155, p=0.022) and minor (β=–$1,163, p=0.007). Conclusions: SOI scores may be harnessed as a predictive tool for LOS and total costs following TKA, but other mechanisms are necessary to predict discharge location.
( Joshua T. Steere ),( Michael C. Sobieraj ),( Christopher J. Defrancesco ),( Craig L. Israelite ),( Charles L. Nelson ),( Atul F. Kamath ) 대한슬관절학회 2018 대한슬관절학회지 Vol.30 No.3
Purpose: Obesity is a risk factor for aseptic loosening after total knee arthroplasty (TKA). Prophylactic use of tibial stems may enhance tibial fixation in obese patients. The aim of this study was to determine whether a tibial stem extension decreases rates of early failure in obese patients. Materials and Methods: This study included 178 consecutive primary TKAs (143 patients) with a body mass index ≥35 kg/m<sup>2</sup>. Fifty TKAs were performed with the use of a 30 mm tibial stem extension, and 128 TKAs were performed with a standard tibial component. Patients with twoyear clinical follow-up were included. The primary outcome was revision for aseptic loosening. Secondary outcomes were all-cause revision and radiolucent lines (RLLs) on radiographs. Results: Average follow-up was 34 months (range, 24 to 46 months). No failures for aseptic loosening occurred. The occurrence of secondary procedures was not significantly different between groups. Quantification of RLLs revealed no difference between groups. Conclusions: At early follow-up, no difference was measured in revision rates, need for subsequent procedures, or RLLs between groups.
Atul F. Kamath,John G. Horneff,Angela Forsyth,Valdet Nikci,Charles L. Nelson 대한정형외과학회 2012 Clinics in Orthopedic Surgery Vol.4 No.2
Background: Hemophiliacs have extrinsic tightness from quadriceps and fl exion contractures. We sought to examine the effectof a focused physical therapy regimen geared to hemophilic total knee arthroplasty. Methods: Twenty-four knees undergoing intensive hemophiliac-specifi c physical therapy after total knee arthroplasty, at an averageage of 46 years, were followed to an average 50 months. Results: For all patients, fl exion contracture improved from −10.5 degrees preoperatively to −5.1 degrees at fi nal follow-up (p =0.02). Knees with preoperative fl exion less than 90 degrees were compared to knees with preoperative fl exion greater than 90degrees. Patients with preoperative fl exion less than 90 degrees experienced improved fl exion (p = 0.02), along with improved arcrange of motion (ROM) and decreased fl exion contracture. For those patients with specifi c twelve-month and fi nal follow-up datapoints, there was a signifi cant gain in fl exion between twelve months and fi nal follow-up (p = 0.02). Conclusions: Hemophiliacs with the poorest fl exion benefi ted most from focused quadriceps stretching to a more functionallength, with gains not usually seen in the osteoarthritic population. This data may challenge traditional views that ROM gains arenot expected beyond 12-18 months.
Science Goal of the Diagnostic Coronagraph on the International Space Station
Su-Chan Bong,Yeon-Han Kim,Kyung-Suk Cho,Jae-Ok Lee,Jungjoon Seough,Young-Deuk Park,Jeffrey S. Newmark,Natchimuthuk Gopalswamy,Nicholeen M. Viall,Spiro Antiochos,Charles N. Arge,Seiji Yashiro,Nelson L. 한국천문학회 2018 天文學會報 Vol.43 No.2