PURPOSE: To know the effect of elastic stocking on reducing edema and preventing deep vein thrombosis(DVT) after total knee arthroplasty(TKA). MATERIALS AND METHODS: One hundred patients who had received simultaneous bilateral TKA was prospectively evaluated. One extremity was accoutered with elastic stocking while the other, not. The lower extremity circumference was measured at postopertive 2, 5, 7 and 10 days. The patient's satisfaction was asked by means of a questionnaire. We evaluated the DVT case also. RESULTS: The thigh and calf circumferences of elastic stocking side were average 0.70 cm and 0.58 cm shorter than those of non-stocking side, this was found to be statiscally insignificant(p>0.05). Satisfaction rate was 76%. One case of DVT occurred in each of the two groups. CONCLUSION: Elastic stocking application after TKA cannot be expected to reduce lower extremity edema or to prevent DVT. However, the satisfaction rate was high.
Arthroplasty* ; Edema ; Extremities ; Humans ; Knee* ; Lower Extremity ; Prospective Studies ; Surveys and Questionnaires ; Stockings, Compression* ; Thigh ; Veins

PURPOSE: This study examined the factors affecting pain, the pattern of pain, as well as the intensity and duration after a total knee arthroplasty. MATERIALS AND METHODS: As a prospective study, 69 osteoarthritic knee patients who underwent total knee arthroplasty from Jan. 2004 to Nov. 2004, were examined using a visual analogue scale (VAS) in order to determine the pain intensity, duration, pain character and pattern at 6 weeks, 3 months, 6 months and 1 year after surgery. We checked for possible factors such as height, body weight, body mass index (BMI), HSS score, deformity, range of motion preoperatively, prosthesis type and operation procedure intraoperatively, the HSS score and range of motion at postoperative one year. The Pearson correlation test and Kruskal-Wallis test were used for statistical analysis. RESULTS: The mean preoperative and 1-year postoperative HSS score was 61.4 and 94.6, respectively. The height, body weight, body mass index (BMI), HSS score, deformity, range of motion, prosthesis type and surgical procedure were not related to the intensity and duration of the pain. The mean postoperative VAS score at 6 weeks and 3, 6 and 12 months was 4.3+/-1.0, 2.7+/-0.9, 1.6+/-0.4, 1.3+/-0.4, respectively. Five patients had mild pain until postoperative one year. CONCLUSION: The pain after total knee arthroplasty disappeared with time. However, mild knee pain sometimes remained even 1 year after surgery.
Arthroplasty* ; Body Height ; Body Weight ; Congenital Abnormalities ; Humans ; Knee* ; Prospective Studies ; Prostheses and Implants ; Range of Motion, Articular

PURPOSE: This study was performed to evaluate the effect and complications of an intraoperative regional analgesic injection in primary total knee replacement arthroplasty (TKRA). MATERIALS AND METHODS: As a prospective study, 50 patients who underwent bilateral TKRA were injected with 50 cc of mixed analgesics (morphine, norepinephrine and epinephrine) into the joint capsule, muscles around the knee joint on one side (study side) and the same amount of the normal saline on the other side (control side) before closure. The level of postoperative pain was evaluated in the visual analogue scale (VAS) at postoperative 4 hours, 12 hours, 1, 2, 4, 7, 14 days. The range of motion at postoperative 4, 7, and 14 days, the amount of hemovac drainage and the patients preference were also evaluated. RESULTS: There was a significant decrease in the VAS on the study side at postoperative 4 hours, 12 hours and 1 day (p<0.05). There was no difference in the VAS thereafter. Patients preferred the injection site in 90% (45 side). The ROM at 4, 7, 14 days and hemovac drainage were similar in both sides (p>0.05). CONCLUSION: An intraoperative regional analgesic injection in primary TKRA is effective in reducing the level of acute postoperative knee pain with minimal complications with the majority of patients preferring it.
Analgesics ; Arthroplasty* ; Arthroplasty, Replacement, Knee ; Drainage ; Humans ; Joint Capsule ; Knee Joint ; Knee* ; Muscles ; Norepinephrine ; Pain, Postoperative ; Prospective Studies ; Range of Motion, Articular

PURPOSE: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample. MATERIALS AND METHODS: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively. RESULTS: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period. CONCLUSION: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.
Biopsy ; Chemoradiotherapy* ; Disease-Free Survival ; Follow-Up Studies ; Glioblastoma* ; Humans ; Korea* ; Methylation ; Radiotherapy ; Retrospective Studies* ; Survival Rate