Pub Date : 2011-09-01DOI: 10.5371/JKHS.2011.23.3.206
U. Yoon, H. Min, J. Seo, Jinsoo Kim, B. Lim, Joon Yub Kim, Hyun Seok Oh, J. Seok, S. Y. Baek
인공관절 전치환술시 폴리에틸렌의 마모와 마모된 입자 에 의한 체내 면역계의 생물학적 반응은 골용해와 삽입물 의 해리를 가져와 인공관절의 수명에 주요한 영향을 미치 게 된다. 이러한 문제들을 줄이기 위한 노력으로 시도된 세라믹-세라믹 관절면은 높은 탄성계수와 경도를 가지며, 마찰계수가 생체 관절면에 비슷하고 생체와는 거의 반응 하지 않는 특성을 가지고 있다. 1971년 프랑스의 Pierre Boutin이 알루미나 세라믹을 관절면에 이용한 것이 시 초라 할 수 있으며 초기의 세라믹은 약한 비구 고정력에 의한 비구컵의 해리, 낮은 순도와 큰 입자크기 때문에 발 생하는 세라믹의 파괴가 많아 사용에 제한이 있었으나, 최근 제조 공정의 발전으로 매우 작은 미세입자 크기가 가 능해짐에 따라 고순도와 고밀도에 의한 경도(hardness), 강도(strength)와 같은 기계적 특성이 우수해졌으며 비구 컵에 금속 shell를 적용하고 골두와 티타늄 대퇴 삽입물간 에 Morse-taper 잠금장치를 도입하여 고정력을 향상시키 게 되었다. 하지만 세라믹은 경도와 마모특성은 우수한 반면 취성(brittleness)이 강하여 부품의 파손 가능성이 높 다. 이에 저자들은 세라믹-세라믹 관절면의 단점인 취성 을 감소시키기 위해 고안된 세라믹 라이너에 폴리에틸렌 을 부착시킨 샌드위치형 세라믹-세라믹 관절면을 이용한 Submitted: April 25, 2011 1st revision: June 30, 2011 2nd revision: August 18, 2011 3rd revision: August 22, 2011 4rd revision: September 7, 2011 Final acceptance: September 14, 2011
人工关节前置置换手术时，聚乙烯的磨损和因磨损粒子引起的体内免疫系统的生物学反应，会导致骨溶解和插入物的解离，对人工关节的寿命产生主要影响。为了减少这些问题而尝试的陶瓷-陶瓷关节面具有较高的弹性系数和硬度，摩擦系数与生物关节面相似，具有与生物几乎没有反应的特性。1971年法国的Pierre Boutin将铝或陶瓷利用在关节面可能是寒酸的陶瓷，早期的陶瓷是由较弱的比丘固定力引起的比丘杯的解解，由于纯度低和粒子大而产生的陶瓷破坏较多，使用受到限制;最近制造工程的发展,很善于做小微粒子大小随着高纯度和高密度的硬度(hardness)、强度(strength)和同样的机械特性变得优秀,比丘杯子适用金属shell,两个进球和钛插入大腿之间莫尔斯- taper水要引入锁定装置固定力,提高了。但是陶瓷的硬度和磨损特性都很优秀，而脆性(brittleness)较强，因此配件的破损可能性较高。作者将聚乙烯附在陶瓷衬垫上，用于减少陶瓷关节的缺点。Submitted: April 25, 2011 1st revision: June 30, 2011 2nd revision: August 18, 2011 3rd revision:August 22, 2011 4rd revision: September 7, 2011 Final acceptance: September 14, 2011
{"title":"Primary Cementless Total Hip Arthroplasty with a Sandwich Type in Ceramic-Ceramic Articulation (Minimum 10-Year Follow up Results)","authors":"U. Yoon, H. Min, J. Seo, Jinsoo Kim, B. Lim, Joon Yub Kim, Hyun Seok Oh, J. Seok, S. Y. Baek","doi":"10.5371/JKHS.2011.23.3.206","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.3.206","url":null,"abstract":"인공관절 전치환술시 폴리에틸렌의 마모와 마모된 입자 에 의한 체내 면역계의 생물학적 반응은 골용해와 삽입물 의 해리를 가져와 인공관절의 수명에 주요한 영향을 미치 게 된다. 이러한 문제들을 줄이기 위한 노력으로 시도된 세라믹-세라믹 관절면은 높은 탄성계수와 경도를 가지며, 마찰계수가 생체 관절면에 비슷하고 생체와는 거의 반응 하지 않는 특성을 가지고 있다. 1971년 프랑스의 Pierre Boutin이 알루미나 세라믹을 관절면에 이용한 것이 시 초라 할 수 있으며 초기의 세라믹은 약한 비구 고정력에 의한 비구컵의 해리, 낮은 순도와 큰 입자크기 때문에 발 생하는 세라믹의 파괴가 많아 사용에 제한이 있었으나, 최근 제조 공정의 발전으로 매우 작은 미세입자 크기가 가 능해짐에 따라 고순도와 고밀도에 의한 경도(hardness), 강도(strength)와 같은 기계적 특성이 우수해졌으며 비구 컵에 금속 shell를 적용하고 골두와 티타늄 대퇴 삽입물간 에 Morse-taper 잠금장치를 도입하여 고정력을 향상시키 게 되었다. 하지만 세라믹은 경도와 마모특성은 우수한 반면 취성(brittleness)이 강하여 부품의 파손 가능성이 높 다. 이에 저자들은 세라믹-세라믹 관절면의 단점인 취성 을 감소시키기 위해 고안된 세라믹 라이너에 폴리에틸렌 을 부착시킨 샌드위치형 세라믹-세라믹 관절면을 이용한 Submitted: April 25, 2011 1st revision: June 30, 2011 2nd revision: August 18, 2011 3rd revision: August 22, 2011 4rd revision: September 7, 2011 Final acceptance: September 14, 2011","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129344577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-09-01DOI: 10.5371/JKHS.2011.23.3.192
J. O. Kim, B. Park, Hong-Man Cho, Ju Han Kim
Purpose: Cementless total hip arthroplasty was performed to treat primary osteoarthritis of the hip and avascular necrosis of the femoral head. The clinical and radiological results of the acetabular cups and femoral stems were compared. Materials and Methods: The subjects were 84 cases who underwent primary cementless total hip arthroplasty from March 1992 to May 2001. The 84 cases were followed up for at least eight years. The patients were divided into the following two groups: group (A), 38 cases of degenerative osteoarthritis of the hip; and group (B), 46 cases of avascular necrosis of the hip. The clinical evaluation was conducted based on the Harris Hip Score (HHS). A radiological assessment was performed to determine if osteolysis or acetabular loosening had occurred. The results were analyzed statistically. Results: The postoperative HHS of groups A and B at the final follow-up were 92.1 and 91.2, respectively (p=0.483). The radiological results revealed 9 and 15 cases of acetabular osteolysis (p=0.671) and 1 and 3 cases of vertical migration of the acetabular cups in the group A and B, respectively. Eight and 7 complications (p=0.572) were encountered in group A and B, respectively. Among these, 4 and 5 cases of revisional total hip arthroplasty were performed in group A and B, respectively. The results of survival analysis were similar in the two groups (p=0.969). Conclusion: The clinical and radiological features of the acetabular cups and stems were similar in the two groups. Nevertheless, further studies will be needed due to the high rate of polyethylene liner wear and osteolysis around the acetabular cups or femoral stems.
{"title":"The Results of Cementless Total Hip Arthroplasty for Primary Osteoarthritis Compared with Avascular Necrosis of the Femoral Head","authors":"J. O. Kim, B. Park, Hong-Man Cho, Ju Han Kim","doi":"10.5371/JKHS.2011.23.3.192","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.3.192","url":null,"abstract":"Purpose: Cementless total hip arthroplasty was performed to treat primary osteoarthritis of the hip and avascular necrosis of the femoral head. The clinical and radiological results of the acetabular cups and femoral stems were compared. Materials and Methods: The subjects were 84 cases who underwent primary cementless total hip arthroplasty from March 1992 to May 2001. The 84 cases were followed up for at least eight years. The patients were divided into the following two groups: group (A), 38 cases of degenerative osteoarthritis of the hip; and group (B), 46 cases of avascular necrosis of the hip. The clinical evaluation was conducted based on the Harris Hip Score (HHS). A radiological assessment was performed to determine if osteolysis or acetabular loosening had occurred. The results were analyzed statistically. Results: The postoperative HHS of groups A and B at the final follow-up were 92.1 and 91.2, respectively (p=0.483). The radiological results revealed 9 and 15 cases of acetabular osteolysis (p=0.671) and 1 and 3 cases of vertical migration of the acetabular cups in the group A and B, respectively. Eight and 7 complications (p=0.572) were encountered in group A and B, respectively. Among these, 4 and 5 cases of revisional total hip arthroplasty were performed in group A and B, respectively. The results of survival analysis were similar in the two groups (p=0.969). Conclusion: The clinical and radiological features of the acetabular cups and stems were similar in the two groups. Nevertheless, further studies will be needed due to the high rate of polyethylene liner wear and osteolysis around the acetabular cups or femoral stems.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114884225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.151
B. Park, Ju-Oh Kim, Hong-Man Cho, J. Sim
We report a rare case of a complete disassembly of the inner head from the bipolar cup without polyethylene wear and locking system failure. An 84-year-old man who had a femur neck fracture of the right hip underwent a replacement of the bipolar prosthesis 4 months ago. He fell down from a height of a chair and felt a sudden sharp pain in the right hip. Roentgenograms revealed that the inner head was dislocated from the outer cup; subsequently, a revision surgery was carried out. When the outer head was removed from the acetabulum, the bearing insert and locking ring were not deformed. Because there was no evidence of loosening of the femoral stem, identicallysized bipolar cup and metal head replacement was performed. At a 6 months follow-up, he had mild hip pain but had returned fully to daily living.
{"title":"Traumatic Disassembly of a Bipolar Hip Prosthesis - A Case Report -","authors":"B. Park, Ju-Oh Kim, Hong-Man Cho, J. Sim","doi":"10.5371/JKHS.2011.23.2.151","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.151","url":null,"abstract":"We report a rare case of a complete disassembly of the inner head from the bipolar cup without polyethylene wear and locking system failure. An 84-year-old man who had a femur neck fracture of the right hip underwent a replacement of the bipolar prosthesis 4 months ago. He fell down from a height of a chair and felt a sudden sharp pain in the right hip. Roentgenograms revealed that the inner head was dislocated from the outer cup; subsequently, a revision surgery was carried out. When the outer head was removed from the acetabulum, the bearing insert and locking ring were not deformed. Because there was no evidence of loosening of the femoral stem, identicallysized bipolar cup and metal head replacement was performed. At a 6 months follow-up, he had mild hip pain but had returned fully to daily living.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114145014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.95
Tae-Young Kim, Seung-Hwan Cha, O. Maidar, S. S. Lee
The Smith-Petersen anterior approach and the Watson-Jones anterolateral approach are the two most renowned anterior approaches for hip surgery. The anterior approach offers several advantages, including a reduced dislocation risk as compared with that associated with the posterior approach. The post-operative dislocation rate after total hip arthroplasty is known to be 2~3 times lower than that of the posterior approach. However, a more extensive skin incision and poor anatomical visualization are some of the disadvantages of the anterior approach. Nevertheless, since this approach preserves the circulation to the femoral head, the ability to perform the anterior approach is imperative for hip surgeons.
{"title":"Anterior Approaches in Hip Surgery","authors":"Tae-Young Kim, Seung-Hwan Cha, O. Maidar, S. S. Lee","doi":"10.5371/JKHS.2011.23.2.95","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.95","url":null,"abstract":"The Smith-Petersen anterior approach and the Watson-Jones anterolateral approach are the two most renowned anterior approaches for hip surgery. The anterior approach offers several advantages, including a reduced dislocation risk as compared with that associated with the posterior approach. The post-operative dislocation rate after total hip arthroplasty is known to be 2~3 times lower than that of the posterior approach. However, a more extensive skin incision and poor anatomical visualization are some of the disadvantages of the anterior approach. Nevertheless, since this approach preserves the circulation to the femoral head, the ability to perform the anterior approach is imperative for hip surgeons.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116216683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.103
Joo Yup Lee, Joo-Hyoun Song, C. Kim
최근 인공 고관절에 사용되는 기구와 수술 술기는 우수 한 통증 감소와, 거의 정상에 가까운 기능 회복을 얻을 수 있도록 하기에, 의학 분야에서 매우 우수한 수술 중의 하 나로 자리매김 하였다. 이전에 비해 인공 관절의 재료, 고정 방법 그리고 관절면의 개선이 뚜렷하여 젊고 활동적 인 환자에서도 인공 고관절 치환이 가능해졌으며, 나아가 더욱 작은 절개와 적은 연부조직 손상으로 조기 기능회복 을 얻기 위해 노력하고 있다. 인공 고관절의 또 다른 개발 분야로서, 기구 삽입의 정확도를 높이기 위한, 소위 ‘CAOS (Computer Assisted Orthopedic Surgery)’가 도입 되고 있다. CAOS를 옹호하는 학자들은 이를 이용하 여 인공 고관절 치환술을 시행하면 기구 삽입의 정확도와 일관성을 향상시켜, 부정확한 기구 삽입으로 인한 탈구의 위험, 조기 관절면의 마모 그리고 충돌 등을 줄일 수 있고, 다리 길이와 오프셋의 조절이 용이 하다고 주장 한다. 컴퓨터를 이용하는 인공 고관절 전치환술은 수술 전 전 산화단층 촬영을 이용하는 CT-based navigation, 수술 중 영상증폭장치를 이용하는 intraoperative fluoroscopy navigation 그리고 해부학적 landmark를 이용하는 imageless navigation, 세 가지로 나누어 진다. 이 세 가지 방법들을 이용한 인공 고관절 전치환술의 결과가 우수한다는 많은 보고가 있으나 CAOS의 장점뿐만 이 아니라 단점과 한계를 알아보고 개선 방향을 연구하여, 인공고관절의 치료 성적을 극대화시키는 것이 필요하다.
{"title":"Do You Need CAOS (Computer Assisted Orthopedic Surgery) in THA? - From a Negative Perspective -","authors":"Joo Yup Lee, Joo-Hyoun Song, C. Kim","doi":"10.5371/JKHS.2011.23.2.103","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.103","url":null,"abstract":"최근 인공 고관절에 사용되는 기구와 수술 술기는 우수 한 통증 감소와, 거의 정상에 가까운 기능 회복을 얻을 수 있도록 하기에, 의학 분야에서 매우 우수한 수술 중의 하 나로 자리매김 하였다. 이전에 비해 인공 관절의 재료, 고정 방법 그리고 관절면의 개선이 뚜렷하여 젊고 활동적 인 환자에서도 인공 고관절 치환이 가능해졌으며, 나아가 더욱 작은 절개와 적은 연부조직 손상으로 조기 기능회복 을 얻기 위해 노력하고 있다. 인공 고관절의 또 다른 개발 분야로서, 기구 삽입의 정확도를 높이기 위한, 소위 ‘CAOS (Computer Assisted Orthopedic Surgery)’가 도입 되고 있다. CAOS를 옹호하는 학자들은 이를 이용하 여 인공 고관절 치환술을 시행하면 기구 삽입의 정확도와 일관성을 향상시켜, 부정확한 기구 삽입으로 인한 탈구의 위험, 조기 관절면의 마모 그리고 충돌 등을 줄일 수 있고, 다리 길이와 오프셋의 조절이 용이 하다고 주장 한다. 컴퓨터를 이용하는 인공 고관절 전치환술은 수술 전 전 산화단층 촬영을 이용하는 CT-based navigation, 수술 중 영상증폭장치를 이용하는 intraoperative fluoroscopy navigation 그리고 해부학적 landmark를 이용하는 imageless navigation, 세 가지로 나누어 진다. 이 세 가지 방법들을 이용한 인공 고관절 전치환술의 결과가 우수한다는 많은 보고가 있으나 CAOS의 장점뿐만 이 아니라 단점과 한계를 알아보고 개선 방향을 연구하여, 인공고관절의 치료 성적을 극대화시키는 것이 필요하다.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129559031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.142
H. Yun, J. Yi, Deuk-Soo Lim, Sung Chul Park, Seongrok Oh
Purpose: We evaluated the usefulness of radiographic parameters for osteoporosis by analyzing the results of radiographic parameters determined by digital hip radiographs and bone mineral density T-scores, as assessed by Dual Energy X-ray Absorptiometry (DEXA). Materials and Methods: The authors reviewed 100 subjects in the hip fracture group and 50 in the non-fracture control group. Digital hip radiographs were assessed to determine the values of Singh index, Canal-to-Calcar Ratio, and Cortical Thickness Index (CTI). Bone mineral density was assessed by DEXA. Results: Intraclass Correlation Coefficient (ICC) results of the CTI were above 0.8 in the fracture group. Compared to the control group, the fracture group showed higher ICCs. Interobserver ICCs were especially lower in the control group. There were statistically significant correlations between CTI and DEXA (r=0.50~0.58, p<0.05). In the analysis of ROC curves, a mean threshold for CTI set a value of 0.54 (0.53~0.55), and mean sensitivity and specificity were 75.5% (69~79%) and 67.8% (65~78%), respectively. Conclusion: CTI showed reasonable reliability and correlation with DEXA results. CTI was a useful radiographic parameter to alert the surgeon to recommend referral for osteoporosis evaluation in elderly hip fracture patients.
{"title":"Reliability of the Radiologic Measurement Methods for Assessment of Osteoporosis Using the Digital Hip Radiograph","authors":"H. Yun, J. Yi, Deuk-Soo Lim, Sung Chul Park, Seongrok Oh","doi":"10.5371/JKHS.2011.23.2.142","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.142","url":null,"abstract":"Purpose: We evaluated the usefulness of radiographic parameters for osteoporosis by analyzing the results of radiographic parameters determined by digital hip radiographs and bone mineral density T-scores, as assessed by Dual Energy X-ray Absorptiometry (DEXA). Materials and Methods: The authors reviewed 100 subjects in the hip fracture group and 50 in the non-fracture control group. Digital hip radiographs were assessed to determine the values of Singh index, Canal-to-Calcar Ratio, and Cortical Thickness Index (CTI). Bone mineral density was assessed by DEXA. Results: Intraclass Correlation Coefficient (ICC) results of the CTI were above 0.8 in the fracture group. Compared to the control group, the fracture group showed higher ICCs. Interobserver ICCs were especially lower in the control group. There were statistically significant correlations between CTI and DEXA (r=0.50~0.58, p<0.05). In the analysis of ROC curves, a mean threshold for CTI set a value of 0.54 (0.53~0.55), and mean sensitivity and specificity were 75.5% (69~79%) and 67.8% (65~78%), respectively. Conclusion: CTI showed reasonable reliability and correlation with DEXA results. CTI was a useful radiographic parameter to alert the surgeon to recommend referral for osteoporosis evaluation in elderly hip fracture patients.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114927973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.116
D. Moon, J. Choi, Dong Whan Kim, Kwang Hee Kim
Purpose: We wanted to evaluate the clinical and radiographic results of ceramic on ceramic bearing cementless total hip arthroplasty with a minimum of 10-years follow up. Materials and Methods: This study was performed on 44 patients and 51 hips, and the patients were recruited among the patients who underwent ceramic-ceramic type cementless total hip arthroplasty from August 1998 to February 2000 and they were available for 10-years or longer follow up. The gender ratio was 28 males and 16 females, and the mean age at the time of surgery was 49 years (range: 26~77 years). Regarding the causality of disease, osteonecrosis was noted in 36 cases, degenerative arthritis was noted in 4 cases, acetabular dysplasia was noted in 4 cases and septic or tuberculous hip sequelae was noted in 7 cases. The clinical evaluation was performed according to the Harris hip score, and for the radiological evaluation of the femoral component, we assessed the degree of subsidence and the presence of periprosthetic osteolysis, endosteal new bone formation and cortical hypertrophy, and the final fixation state of the implant. In the cases with an acetabular cup osteoscleostic line in the vicinity of the acetabular cup, endosteal new bone formation, acetabular osteolysis and the vertical migration as well as the horizontal migration of the acetubular cup were assessed. Results: Regarding the clinical outcomes, the Harris hip score was improved from an average 59 points to 93 points at the final follow up. For the radiological results, osteolysis was not detected in the acetabular and femoral components, the subsidence of femoral stem was not beyond 2 mm on average and significant subsidence was not detected. In regard to complications, linear fracture during surgery was noted in 6 cases and postoperative hip dislocation was noted in 1 case. A ceramic head fracture occurred in one case and a ceramic liner fracture occurred in 2 cases. Conclusion: This type of articulation is a promising option at a minimum of 10-years follow up of 51 hips that underwent ceramic-ceramic bearing cementless total hip arthroplasty. However, our results demonstrated that surgeons should be aware of the potential risks of ceramic fracture when using ceramic-on-ceramic bearing surfaces. Additional longer-term follow-up is necessary.
{"title":"Ceramic on Ceramic Total Hip Arthroplasty - The Results of a Minimum 10-Years Follow up -","authors":"D. Moon, J. Choi, Dong Whan Kim, Kwang Hee Kim","doi":"10.5371/JKHS.2011.23.2.116","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.116","url":null,"abstract":"Purpose: We wanted to evaluate the clinical and radiographic results of ceramic on ceramic bearing cementless total hip arthroplasty with a minimum of 10-years follow up. Materials and Methods: This study was performed on 44 patients and 51 hips, and the patients were recruited among the patients who underwent ceramic-ceramic type cementless total hip arthroplasty from August 1998 to February 2000 and they were available for 10-years or longer follow up. The gender ratio was 28 males and 16 females, and the mean age at the time of surgery was 49 years (range: 26~77 years). Regarding the causality of disease, osteonecrosis was noted in 36 cases, degenerative arthritis was noted in 4 cases, acetabular dysplasia was noted in 4 cases and septic or tuberculous hip sequelae was noted in 7 cases. The clinical evaluation was performed according to the Harris hip score, and for the radiological evaluation of the femoral component, we assessed the degree of subsidence and the presence of periprosthetic osteolysis, endosteal new bone formation and cortical hypertrophy, and the final fixation state of the implant. In the cases with an acetabular cup osteoscleostic line in the vicinity of the acetabular cup, endosteal new bone formation, acetabular osteolysis and the vertical migration as well as the horizontal migration of the acetubular cup were assessed. Results: Regarding the clinical outcomes, the Harris hip score was improved from an average 59 points to 93 points at the final follow up. For the radiological results, osteolysis was not detected in the acetabular and femoral components, the subsidence of femoral stem was not beyond 2 mm on average and significant subsidence was not detected. In regard to complications, linear fracture during surgery was noted in 6 cases and postoperative hip dislocation was noted in 1 case. A ceramic head fracture occurred in one case and a ceramic liner fracture occurred in 2 cases. Conclusion: This type of articulation is a promising option at a minimum of 10-years follow up of 51 hips that underwent ceramic-ceramic bearing cementless total hip arthroplasty. However, our results demonstrated that surgeons should be aware of the potential risks of ceramic fracture when using ceramic-on-ceramic bearing surfaces. Additional longer-term follow-up is necessary.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126749574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.155
Jong Won Kim, Hyun-Soo Park, J. Rha, Young-Soo Jang, J. Jung, Jin-Phil Yang, Jae-Hyuk Choi
Multiple drilling of the femoral head is a commonly-used surgical technique for the treatment of osteonecrosis. Several holes are drilled into the femoral head using a small-diameter Steinmann pin. This decompression technique promotes revascularization and regeneration of necrotic tissue in the femoral head. Known complications are heterotopic ossification and femoral subtrochanteric fractures, although these have only been rarely reported. Our case study focuses on a subtrochanteric fracture 6 weeks after a multiple drilling operation.
{"title":"Subtrochanteric Femur Fracture after Multiple Drilling for Treatment of Nontraumatic Osteonecrosis of the Femoral Head - A Case Report -","authors":"Jong Won Kim, Hyun-Soo Park, J. Rha, Young-Soo Jang, J. Jung, Jin-Phil Yang, Jae-Hyuk Choi","doi":"10.5371/JKHS.2011.23.2.155","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.155","url":null,"abstract":"Multiple drilling of the femoral head is a commonly-used surgical technique for the treatment of osteonecrosis. Several holes are drilled into the femoral head using a small-diameter Steinmann pin. This decompression technique promotes revascularization and regeneration of necrotic tissue in the femoral head. Known complications are heterotopic ossification and femoral subtrochanteric fractures, although these have only been rarely reported. Our case study focuses on a subtrochanteric fracture 6 weeks after a multiple drilling operation.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123344529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.161
Jong Seok Park, J. Kim, W. Kim, Sang-Wook Choi, S. Cho, Byung-Woong Jang
Heterotopic ossification (HO) is a frequent complication associated with spinal cord injury and can lead to significant problems during rehabilitation. Surgical resection of HO could be applied to patients who do not respond to conservative treatment. To reduce the risk of recurrence after the operation, radiation therapy and NSAID or bisphosphonate administration may be utilized. We report the case of a 48-year-old male with a T3-sparing spinal cord injury who underwent successful treatment of immature HO in the iliacus muscle with a combination of surgical resection, radiation therapy, and NSAID administration.
{"title":"Immature Heterotopic Ossification in the Iliacus Muscle in Spinal Cord Injury - A Case Report -","authors":"Jong Seok Park, J. Kim, W. Kim, Sang-Wook Choi, S. Cho, Byung-Woong Jang","doi":"10.5371/JKHS.2011.23.2.161","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.161","url":null,"abstract":"Heterotopic ossification (HO) is a frequent complication associated with spinal cord injury and can lead to significant problems during rehabilitation. Surgical resection of HO could be applied to patients who do not respond to conservative treatment. To reduce the risk of recurrence after the operation, radiation therapy and NSAID or bisphosphonate administration may be utilized. We report the case of a 48-year-old male with a T3-sparing spinal cord injury who underwent successful treatment of immature HO in the iliacus muscle with a combination of surgical resection, radiation therapy, and NSAID administration.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132557109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.108
J. Kim, Young Wan Moon
Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength, predisposing an individual to increased fracture risk. Many factors can lead to the development of osteoporosis. It is usually asymptomatic unless osteoporotic fracture and secondary changes of bone structure occur. Early radiographs show normal findings; however, osteopenic appearance, fracture, cortical bone thinning, and roughening of bone trabeculae can be found according to severity of osteoporosis. These symptoms are most frequently found in the spine and proximal femur. Bone mineral density (BMD) is the standard method used to diagnose osteoporosis, and dual energy X-ray absorptiometry (DXA), one of the measurement tools for BMD, is particularly regarded as the appropriate tool applicable to WHO criteria, which defines osteoporosis as a T-score of less than 2.5 SDs below the mean of young adult women. Peripheral densitometry is less useful in predicting the risk of fractures of the spine and proximal femur, and it is not enough to diagnose and treat osteoporosis. Biochemical bone markers have demonstrated utility in clinical research and trials; however, they cannot replace BMD as a diagnostic tool. WHO recently developed FRAX, a novel method we can use to more conveniently evaluate osteoporotic fracture risk.
{"title":"Diagnosis of Osteoporosis","authors":"J. Kim, Young Wan Moon","doi":"10.5371/JKHS.2011.23.2.108","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.108","url":null,"abstract":"Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength, predisposing an individual to increased fracture risk. Many factors can lead to the development of osteoporosis. It is usually asymptomatic unless osteoporotic fracture and secondary changes of bone structure occur. Early radiographs show normal findings; however, osteopenic appearance, fracture, cortical bone thinning, and roughening of bone trabeculae can be found according to severity of osteoporosis. These symptoms are most frequently found in the spine and proximal femur. Bone mineral density (BMD) is the standard method used to diagnose osteoporosis, and dual energy X-ray absorptiometry (DXA), one of the measurement tools for BMD, is particularly regarded as the appropriate tool applicable to WHO criteria, which defines osteoporosis as a T-score of less than 2.5 SDs below the mean of young adult women. Peripheral densitometry is less useful in predicting the risk of fractures of the spine and proximal femur, and it is not enough to diagnose and treat osteoporosis. Biochemical bone markers have demonstrated utility in clinical research and trials; however, they cannot replace BMD as a diagnostic tool. WHO recently developed FRAX, a novel method we can use to more conveniently evaluate osteoporotic fracture risk.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129744164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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