Pub Date : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.47
K. Kim, J. Roh, Sang Bum Kim, W. Lee, Y. Won, Dong-Sik Chae
Purpose: We wanted to measure the femoral neck anteversion (FNA) angles using a 3D CT scan that perpendicularly cut the mechanical axis of the femur and to assess the accuracy and reproducibility of different measuring methods. Materials and Methods: We obtained 95 cases of 3D CT images of the cross-section perpendicular to the mechanical axis of the femur. The methods used to measure the FNA angles included a method using the CT image of the area where the femoral neck is confluent to the greater trochanter (method 1), a method using the CT image taken from the neck base immediately prior to the beginning of the area of the lesser trochanter (method 2) and a method by which measurements are made after putting 3D bone models on a horizontal plane in virtual space (method 3). The reference axes of the distal femur we used were the anatomical transepicondylar axis, the surgical transepicondylar axis and the real posterior condylar axis. Results: The FNA angles measured by method 1 were 4.79±6.41。to the anatomical transepicondylar axis (ATEA), 6.09±6.58。to the surgical transepicondylar axis (STEA) and 7.96±6.81。to the real posterior condylar axis (rPCA). The FNA angles measured by method 2 were 16.01±8.31。to the ATEA, 19.52±8.38。to the STEA and 21.79± 8.52。to the rPCA. The FNA angles measured by method 3 were 20.15±12.89。to the rPCA. Conclusion: The measurement of the FNA angle using a 3D CT scan perpendicular to the mechanical axis is reproducible. The measurement method on the neck base level is more reliable than the one on the proximal neck confluence, and more similar to the measurement method by classic definition.
{"title":"Femoral Neck Anteversion Measured Using a 3D CT Scan Perpendicular to the Mechanical Axis of the Femur","authors":"K. Kim, J. Roh, Sang Bum Kim, W. Lee, Y. Won, Dong-Sik Chae","doi":"10.5371/JKHS.2011.23.1.47","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.47","url":null,"abstract":"Purpose: We wanted to measure the femoral neck anteversion (FNA) angles using a 3D CT scan that perpendicularly cut the mechanical axis of the femur and to assess the accuracy and reproducibility of different measuring methods. Materials and Methods: We obtained 95 cases of 3D CT images of the cross-section perpendicular to the mechanical axis of the femur. The methods used to measure the FNA angles included a method using the CT image of the area where the femoral neck is confluent to the greater trochanter (method 1), a method using the CT image taken from the neck base immediately prior to the beginning of the area of the lesser trochanter (method 2) and a method by which measurements are made after putting 3D bone models on a horizontal plane in virtual space (method 3). The reference axes of the distal femur we used were the anatomical transepicondylar axis, the surgical transepicondylar axis and the real posterior condylar axis. Results: The FNA angles measured by method 1 were 4.79±6.41。to the anatomical transepicondylar axis (ATEA), 6.09±6.58。to the surgical transepicondylar axis (STEA) and 7.96±6.81。to the real posterior condylar axis (rPCA). The FNA angles measured by method 2 were 16.01±8.31。to the ATEA, 19.52±8.38。to the STEA and 21.79± 8.52。to the rPCA. The FNA angles measured by method 3 were 20.15±12.89。to the rPCA. Conclusion: The measurement of the FNA angle using a 3D CT scan perpendicular to the mechanical axis is reproducible. The measurement method on the neck base level is more reliable than the one on the proximal neck confluence, and more similar to the measurement method by classic definition.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115257433","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 : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.25
J. Yi, W. Shon, C. Huh, H. Yun, Young-Jae Huh
time of the index arthroplasty was 52.3 years (26~74 years), and the average body mass index was 24.2±2.75 (19.1~29.8). The average follow up period was 80.7 months (64~109 months). All the hips were evaluated clinically by the Harris hip score and the thigh pain, and they were radiologically assessed by the cement grade and the presence of osteolysis around the femoral stem, as well as the presence of stress shielding of the proximal femur. Results: At the final follow up, the Harris hip score for all the patients had improved from preoperative 58.9 (17-83) to post operative 91.7 (72~100). The cement grade was measured using Barrack’s method. Of the 95 hips, 45 (47.3%) cases were grade A, 48 (50.5%) cases were grade B and 2 (2.1%) cases were grade C1 at the final follow up. There was 1 case of definite loosening. Stress shielding was noted in 65 (68.4%) cases of the zero grade and 19 (20.0%) cases of the 1st grade. Conclusion: In this study, the cemented polished femoral stem showed excellent results at the mid term with a minimum follow up of 5 years. But a longer-term follow-up study will be needed for further understanding the implications of cemented polished femoral stem.
{"title":"Follow-up Study of the Cemented Polished Femoral Stem for More than Five Years","authors":"J. Yi, W. Shon, C. Huh, H. Yun, Young-Jae Huh","doi":"10.5371/JKHS.2011.23.1.25","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.25","url":null,"abstract":"time of the index arthroplasty was 52.3 years (26~74 years), and the average body mass index was 24.2±2.75 (19.1~29.8). The average follow up period was 80.7 months (64~109 months). All the hips were evaluated clinically by the Harris hip score and the thigh pain, and they were radiologically assessed by the cement grade and the presence of osteolysis around the femoral stem, as well as the presence of stress shielding of the proximal femur. Results: At the final follow up, the Harris hip score for all the patients had improved from preoperative 58.9 (17-83) to post operative 91.7 (72~100). The cement grade was measured using Barrack’s method. Of the 95 hips, 45 (47.3%) cases were grade A, 48 (50.5%) cases were grade B and 2 (2.1%) cases were grade C1 at the final follow up. There was 1 case of definite loosening. Stress shielding was noted in 65 (68.4%) cases of the zero grade and 19 (20.0%) cases of the 1st grade. Conclusion: In this study, the cemented polished femoral stem showed excellent results at the mid term with a minimum follow up of 5 years. But a longer-term follow-up study will be needed for further understanding the implications of cemented polished femoral stem.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"170 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129416061","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 : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.39
Y. Sung, S. Jo
Purpose: This study was performed to review the results of PFNA (Proximal Femoral Nail Antirotation) for treating unstable femoral intertrochanteric fractures. Materials and Methods: Forty-seven out of 187 hips treated from September 2006 to March 2010 with PFNA for unstable femoral pertrochanteric fractures were enrolled in this study. The mean duration to radiologic bone union, the functional status and the complications were assessed. The Cleveland index, the tip apex distance, the sliding distance of the blade and the change in the neck-shaft angle were also measured. Results: The mean duration to radiologic bone union was 15.8 weeks and 66% of the patients recovered to a premorbid functional status. The average amount of blade sliding was 5.5 mm and the mean change of the neck-shaft angle was varus 4.4。 . There were 2 cases of penetration of the blade tip, 2 cases of impending penetration, one case of posttraumatic osteonecrosis of the femoral head and 2 cases of lateral wall fractures. Conclusion: PFNA would be preferable for unstable femoral intertrochanteric fractures in terms of the short operation time, the rapid ambulatory recovery and the reduced complications. Yet careful handling is required to avoid a grave complication such as head penetration.
{"title":"Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture","authors":"Y. Sung, S. Jo","doi":"10.5371/JKHS.2011.23.1.39","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.39","url":null,"abstract":"Purpose: This study was performed to review the results of PFNA (Proximal Femoral Nail Antirotation) for treating unstable femoral intertrochanteric fractures. Materials and Methods: Forty-seven out of 187 hips treated from September 2006 to March 2010 with PFNA for unstable femoral pertrochanteric fractures were enrolled in this study. The mean duration to radiologic bone union, the functional status and the complications were assessed. The Cleveland index, the tip apex distance, the sliding distance of the blade and the change in the neck-shaft angle were also measured. Results: The mean duration to radiologic bone union was 15.8 weeks and 66% of the patients recovered to a premorbid functional status. The average amount of blade sliding was 5.5 mm and the mean change of the neck-shaft angle was varus 4.4。 . There were 2 cases of penetration of the blade tip, 2 cases of impending penetration, one case of posttraumatic osteonecrosis of the femoral head and 2 cases of lateral wall fractures. Conclusion: PFNA would be preferable for unstable femoral intertrochanteric fractures in terms of the short operation time, the rapid ambulatory recovery and the reduced complications. Yet careful handling is required to avoid a grave complication such as head penetration.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130253110","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 : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.83
Jai-Hyung Park, Hyung-soo Kim, Soo-Tae Chung, J. Yoo, Joo-Hak Kim, S. Cha, Jin-Ha Jung
34세 남자 환자로 내원 10년 전에 등산한 이후부터 시 작된 우측 고관절의 동통이 활동량이 많을 경우 일년에 두 세 차례 증상의 호전과 악화가 반복되어 개인 병원에서 대 증적 치료를 받았었지만 증상 지속되어 내원하였다. 과거 력과 가족력상 특이소견은 없으며 이학적 검사상 우측 고 관절 주위의 종창은 관찰되지 않았으나 보행시 중등도의 통증을 호소하였고 휴식시에 통증은 경미하였다. 우측 고 관절의 운동범위는 굴곡과 신전을 제외하고는 전반적으 로 감소되어으며 특히 내회전 10。, 외전 30。로 건측에 비 해 크게 감소된 것이 관찰되었고 내회전시에 중등도의 통 증을 호소하였으며 Patrick검사도 양성이었다. 고관절의 단순 방사선 소견에서는 우측 대퇴골두의 상 외측과 하내측부의 연부조직의 음영 및 골의 미란을 관찰 할 수 있었다(Fig. 1). 자기공명영상촬영상 우측 고관절의 전반적인 지방성 신호와 동일하거나 약간 감소를 보이는 종괴와 국소적으로 골수의 부종, 대퇴 골두와 비구의 부종 및 낭종이 관찰되었고 Tc-99 MDP 골주사 검사상에서는 우측 고관절의 흡수가 증가된 소견이 관찰되었다(Fig. 2, 3). 전신 마취하에 앙와위 자세에서 근위대퇴부의 전상장 골극에서 슬개골의 외측을 향하여 13 cm의 피부절개후에 봉공근과 대퇴근막장근사이를 절개 한 후 대퇴직근을 외 측으로 당겨 고관절을 노출시키고 관절낭을 절개하였다. Submitted: September 19, 2010 1st revision: November 15, 2010 2nd revision: November 29, 2010 Final acceptance: December 3, 2010
34岁男性患者，10年前登山后开始的右侧骨关节疼痛活动量大的情况下，一年2 ~ 3次反复症状好转和恶化，虽然在私人医院接受了大证性治疗，但症状仍在持续而来院。过去史和家族史上没有特别的诊断，理学检查上没有观察到右侧高关节周围的脓疮，但步行时出现中等程度的疼痛，休息时疼痛轻微。除弯曲和神殿外，右高关节的运动范围全面减少，特别是内旋转10。，外传30。与洛根相比有显著减少，我旋转时出现中度痛症，帕特里克检查也呈阳性。根据骨关节的单纯放射线观察，可以观察到右侧大腿骨的上外侧和下内侧软组织的阴影及骨的糜损(Fig)。1)。核磁共振成像摄影奖右侧高官节整体表现出地方性信号和相同或略有减少的钟块和局部骨髓水肿,股骨两比丘的水肿和南纸观察了,tc - 99 mdp节骨扫描检查上右侧高官吸收增加的目光观察了(fig。2,3)在全身麻醉下，从仰卧姿势到近卫大腿前状长骨极，向膝盖骨外侧切开13厘米的皮肤，然后切开棒孔肌和大腿根狗血近似，然后将大退休肌向外侧拉，露出骨关节，切开关节囊。Submitted: September 19, 2010 1st revision: November 15, 2010 2nd revision: November 29, 2010 Final acceptance: December 3, 2010
{"title":"Lipoma Arborescens in the Hip Joint: A Case Report","authors":"Jai-Hyung Park, Hyung-soo Kim, Soo-Tae Chung, J. Yoo, Joo-Hak Kim, S. Cha, Jin-Ha Jung","doi":"10.5371/JKHS.2011.23.1.83","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.83","url":null,"abstract":"34세 남자 환자로 내원 10년 전에 등산한 이후부터 시 작된 우측 고관절의 동통이 활동량이 많을 경우 일년에 두 세 차례 증상의 호전과 악화가 반복되어 개인 병원에서 대 증적 치료를 받았었지만 증상 지속되어 내원하였다. 과거 력과 가족력상 특이소견은 없으며 이학적 검사상 우측 고 관절 주위의 종창은 관찰되지 않았으나 보행시 중등도의 통증을 호소하였고 휴식시에 통증은 경미하였다. 우측 고 관절의 운동범위는 굴곡과 신전을 제외하고는 전반적으 로 감소되어으며 특히 내회전 10。, 외전 30。로 건측에 비 해 크게 감소된 것이 관찰되었고 내회전시에 중등도의 통 증을 호소하였으며 Patrick검사도 양성이었다. 고관절의 단순 방사선 소견에서는 우측 대퇴골두의 상 외측과 하내측부의 연부조직의 음영 및 골의 미란을 관찰 할 수 있었다(Fig. 1). 자기공명영상촬영상 우측 고관절의 전반적인 지방성 신호와 동일하거나 약간 감소를 보이는 종괴와 국소적으로 골수의 부종, 대퇴 골두와 비구의 부종 및 낭종이 관찰되었고 Tc-99 MDP 골주사 검사상에서는 우측 고관절의 흡수가 증가된 소견이 관찰되었다(Fig. 2, 3). 전신 마취하에 앙와위 자세에서 근위대퇴부의 전상장 골극에서 슬개골의 외측을 향하여 13 cm의 피부절개후에 봉공근과 대퇴근막장근사이를 절개 한 후 대퇴직근을 외 측으로 당겨 고관절을 노출시키고 관절낭을 절개하였다. Submitted: September 19, 2010 1st revision: November 15, 2010 2nd revision: November 29, 2010 Final acceptance: December 3, 2010","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127115332","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 : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.72
Young Hoon Park, T. Yoon, Kyung-Soon Park, Y. Shin
Liver transplantation has improved the survival of patients with end stage liver disease. As the rates of success of liver transplantation continue to increase, more patients who have a liver transplant will become candidates for joint replacement due to osteonecrosis. The incidence of osteonecrosis has been variously reported as from 2% to 8.2% after liver transplantation. However, there are only three reports in the English medical literature about total hip arthroplasty for osteonecrosis of the femoral head following liver transplantation, and especially there has not been such a report from Asian countries. We report here on two patients with transplanted livers and who then underwent total hip arthroplasty.
{"title":"Total Hip Arthroplasty in Patient with Osteonecrosis of the Femoral Head Following Liver Transplantation - Case Report -","authors":"Young Hoon Park, T. Yoon, Kyung-Soon Park, Y. Shin","doi":"10.5371/JKHS.2011.23.1.72","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.72","url":null,"abstract":"Liver transplantation has improved the survival of patients with end stage liver disease. As the rates of success of liver transplantation continue to increase, more patients who have a liver transplant will become candidates for joint replacement due to osteonecrosis. The incidence of osteonecrosis has been variously reported as from 2% to 8.2% after liver transplantation. However, there are only three reports in the English medical literature about total hip arthroplasty for osteonecrosis of the femoral head following liver transplantation, and especially there has not been such a report from Asian countries. We report here on two patients with transplanted livers and who then underwent total hip arthroplasty.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128260557","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 : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.79
Soonsi Kwon, I. Jung, D. H. Kim
Tuberculous infection of the ischium is a rare condition. It is recommended that antituberculosis chemotherapy is combined with surgical intervention. The patient in this case had an abscess on his right gluteal region and he had undergone an operation without antituberculosis chemotherapy. After eight years, an abscess recurred in the same area and he was treated with surgical resection. Antituberculosis chemotherapy was administered following histopathological confirmation of tuberculosis. At 1 year postoperatively, the patient had no pain and there was no evidence of recurrence.
{"title":"Tuberculosis Infection of the Ischial Tuberosity and That Recurred after 8 Years: A Case Report","authors":"Soonsi Kwon, I. Jung, D. H. Kim","doi":"10.5371/JKHS.2011.23.1.79","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.79","url":null,"abstract":"Tuberculous infection of the ischium is a rare condition. It is recommended that antituberculosis chemotherapy is combined with surgical intervention. The patient in this case had an abscess on his right gluteal region and he had undergone an operation without antituberculosis chemotherapy. After eight years, an abscess recurred in the same area and he was treated with surgical resection. Antituberculosis chemotherapy was administered following histopathological confirmation of tuberculosis. At 1 year postoperatively, the patient had no pain and there was no evidence of recurrence.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117068523","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 : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.1
I. Yang
골용해나 무균성해리는 1960년대 초 John Charnley가 술 후 1년 에 서 3년 이 내 에 재 치 환 술 이 필 요 했 던 polytetrafluoroethylene (PTFE) 비구삽입물에서 처음 보고하였으며, polyethylene cup으로 전환된 후에는 마 모의 정도가 줄어들었고, 이에 따른 재치환술도 감소하였 다고 하였다. 초기 치환술의 주된 실패 원인으로는 시멘 트 실패(cement failure)와 기계적, 구조적 불안정이 원인 으로 여겨졌으나, 이후 Willert와 Semlitsch, Mirra, Goldring 등 많은 연구자들이 재치환술시 삽입물 주변 조직에서 얻은 마모입자의 조직배양 실험을 통해 마모입 자의 영향으로 삽입물 주변조직 세포에서 섬유조직 형성 이나 파골세포의 골흡수를 자극하는 효소, prostaglandin, cytokine 등이 분비된다고 하였다. 이 초기 연구 당시, 인 공관절술은 주로 시멘트 고정방식이었으므로, 연구자들 은 시멘트의 PMMA 마모입자들이 골용해와 무균성 해리 의 원인이라고 판단하여, 이를‘cement disease’라고 명 하기도 하였다. 그러나 2세대, 3세대로 cementing technique이 발전하였고, 무시멘트 인공 삽입물도 도입 되었으나, 골용해와 무균성 해리의 문제는 계속 지속되었 다. 이에따라 새로운 마모입자들에 관심을 기울이게 되었 고, 이제는 ultra-high-molecular-weight-polyethylene (UHMWPE)이나 금속입자가 주 원인이라고 밝히고 있다.
{"title":"Pathophysiology of Osteolysis","authors":"I. Yang","doi":"10.5371/JKHS.2011.23.1.1","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.1","url":null,"abstract":"골용해나 무균성해리는 1960년대 초 John Charnley가 술 후 1년 에 서 3년 이 내 에 재 치 환 술 이 필 요 했 던 polytetrafluoroethylene (PTFE) 비구삽입물에서 처음 보고하였으며, polyethylene cup으로 전환된 후에는 마 모의 정도가 줄어들었고, 이에 따른 재치환술도 감소하였 다고 하였다. 초기 치환술의 주된 실패 원인으로는 시멘 트 실패(cement failure)와 기계적, 구조적 불안정이 원인 으로 여겨졌으나, 이후 Willert와 Semlitsch, Mirra, Goldring 등 많은 연구자들이 재치환술시 삽입물 주변 조직에서 얻은 마모입자의 조직배양 실험을 통해 마모입 자의 영향으로 삽입물 주변조직 세포에서 섬유조직 형성 이나 파골세포의 골흡수를 자극하는 효소, prostaglandin, cytokine 등이 분비된다고 하였다. 이 초기 연구 당시, 인 공관절술은 주로 시멘트 고정방식이었으므로, 연구자들 은 시멘트의 PMMA 마모입자들이 골용해와 무균성 해리 의 원인이라고 판단하여, 이를‘cement disease’라고 명 하기도 하였다. 그러나 2세대, 3세대로 cementing technique이 발전하였고, 무시멘트 인공 삽입물도 도입 되었으나, 골용해와 무균성 해리의 문제는 계속 지속되었 다. 이에따라 새로운 마모입자들에 관심을 기울이게 되었 고, 이제는 ultra-high-molecular-weight-polyethylene (UHMWPE)이나 금속입자가 주 원인이라고 밝히고 있다.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132029844","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 : 2010-12-01DOI: 10.5371/JKHS.2010.22.4.253
B. Lim, Y. Moon, Seung-Jae Lim, H. Lee, Youn-Soo Park
Purpose: The purpose of this study was to report on the results of performing modular cementless total hip arthroplasty with a simultaneous subtrochanteric shortening osteotomy in patients with high hip dislocation. Materials and Methods: We evaluated 23 patients (24 hips) with high hip dislocation and who had undergone total hip arthroplasty using a proximally modular cementless stem in combination with a subtrochanteric shortening osteotomy in order to place the acetabular cup at the level of the anatomic hip center between May 1996 and June 2008. There were 6 males and 17 females with a mean age of 44 years. The mean duration of follow-up was 5.6 years. Results: The mean Harris hip score improved from 53 points preoperatively to 88 points at the time of final followup (P<0.001), and there were good or excellent results in 21 hips (87.5%). There was one instance of isolated loosening of the acetabular component. With the exception of one hip requiring revision surgery at 12 years postoperatively because of polyethylene wear and cup loosening, all the remaining components were well-fixed at the time of the last follow-up. A total of 4 hips (17%) had complications during follow-up; one dislocation, two transient femoral nerve palsies and one nonunion of the subtrochanteric osteotomy site. Conclusion: Modular cementless total hip arthroplasty with a subtrochanteric shortening osteotomy in patients with high hip dislocation was associated with excellent clinical outcomes while it minimized additional fixation of the osteotomy site.
{"title":"Modular Cementless Total Hip Arthroplasty with Subtrochanteric Shortening Osteotomy in Patients with High Hip Dislocation","authors":"B. Lim, Y. Moon, Seung-Jae Lim, H. Lee, Youn-Soo Park","doi":"10.5371/JKHS.2010.22.4.253","DOIUrl":"https://doi.org/10.5371/JKHS.2010.22.4.253","url":null,"abstract":"Purpose: The purpose of this study was to report on the results of performing modular cementless total hip arthroplasty with a simultaneous subtrochanteric shortening osteotomy in patients with high hip dislocation. Materials and Methods: We evaluated 23 patients (24 hips) with high hip dislocation and who had undergone total hip arthroplasty using a proximally modular cementless stem in combination with a subtrochanteric shortening osteotomy in order to place the acetabular cup at the level of the anatomic hip center between May 1996 and June 2008. There were 6 males and 17 females with a mean age of 44 years. The mean duration of follow-up was 5.6 years. Results: The mean Harris hip score improved from 53 points preoperatively to 88 points at the time of final followup (P<0.001), and there were good or excellent results in 21 hips (87.5%). There was one instance of isolated loosening of the acetabular component. With the exception of one hip requiring revision surgery at 12 years postoperatively because of polyethylene wear and cup loosening, all the remaining components were well-fixed at the time of the last follow-up. A total of 4 hips (17%) had complications during follow-up; one dislocation, two transient femoral nerve palsies and one nonunion of the subtrochanteric osteotomy site. Conclusion: Modular cementless total hip arthroplasty with a subtrochanteric shortening osteotomy in patients with high hip dislocation was associated with excellent clinical outcomes while it minimized additional fixation of the osteotomy site.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133019386","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 : 2010-12-01DOI: 10.5371/JKHS.2010.22.4.298
Ji Wan Kim, J. Chang, J. Bae, Jung Jae Kim
Purpose: We wanted to assess the clinical results and the complications of treating femoral head fractures. Materials and Methods: Twenty patients with femoral head fractures and who had a minimum 1 year follow up were enrolled in this study from April 2004 to June 2008. The clinical outcomes were evaluated according to the mechanism of injury, the reduction time, the Pipkin classification, the treatment methods, the surgical approach and the complications. Results: There were 5 cases of Pipkin type I and 2 cases of Pipkin type II, 1 case of Pipkin type III and 12 cases of Pipkin type IV. All the patients underwent operation except 1 patient; there were 5 excisions, 7 internal fixations, 1 prosthesis, and 6 internal fixations of combined acetabular fixation without surgery for the femoral head fractures. The average Harris hip score at 1 year after operation was 80.0 (range: 57~99): there were 4 excellent, 7 good, 5 fair and 4 poor results. The complications of the femoral head fractures were 2 cases of avascular necrosis and 2 cases of posttraumatic osteoarthritis. Conclusion: Internal fixation of the femoral head with using Herbert screws showed a favorable outcome, while excision of the femoral head fragments did not. Internal fixation of Pipkin type 1 or 2 fractures could be performed by the anterior approach. The posterior approach combined with surgical dislocation is especially useful in internal fixation of concurrent posterior acetabular fractures, and it has the advantage of preserving the blood supply to the femoral head.
{"title":"Outcomes of Treatment for Femoral Head Fractures with Hip Dislocation - Review of 20 Cases -","authors":"Ji Wan Kim, J. Chang, J. Bae, Jung Jae Kim","doi":"10.5371/JKHS.2010.22.4.298","DOIUrl":"https://doi.org/10.5371/JKHS.2010.22.4.298","url":null,"abstract":"Purpose: We wanted to assess the clinical results and the complications of treating femoral head fractures. Materials and Methods: Twenty patients with femoral head fractures and who had a minimum 1 year follow up were enrolled in this study from April 2004 to June 2008. The clinical outcomes were evaluated according to the mechanism of injury, the reduction time, the Pipkin classification, the treatment methods, the surgical approach and the complications. Results: There were 5 cases of Pipkin type I and 2 cases of Pipkin type II, 1 case of Pipkin type III and 12 cases of Pipkin type IV. All the patients underwent operation except 1 patient; there were 5 excisions, 7 internal fixations, 1 prosthesis, and 6 internal fixations of combined acetabular fixation without surgery for the femoral head fractures. The average Harris hip score at 1 year after operation was 80.0 (range: 57~99): there were 4 excellent, 7 good, 5 fair and 4 poor results. The complications of the femoral head fractures were 2 cases of avascular necrosis and 2 cases of posttraumatic osteoarthritis. Conclusion: Internal fixation of the femoral head with using Herbert screws showed a favorable outcome, while excision of the femoral head fragments did not. Internal fixation of Pipkin type 1 or 2 fractures could be performed by the anterior approach. The posterior approach combined with surgical dislocation is especially useful in internal fixation of concurrent posterior acetabular fractures, and it has the advantage of preserving the blood supply to the femoral head.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126881242","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 : 2010-12-01DOI: 10.5371/JKHS.2010.22.4.312
K. Hwang, B. Yoo, Yeesuk Kim, I. Choi, Young-Ho Kim
Purpose: The purpose of this study was to evaluate the effects of alendronate on bone mineral density (BMD) and to determine the persistency and side effects of alendronate treatment after hip fractures. Materials and Methods: 452 patients who underwent surgery for hip fractures from March 2000 to February 2007 were retrospectively included. The hip fractures consisted of 218 cases of femur neck fractures and 234 cases of intertrochanteric fractures. There were 254 women and 198 men with a mean age of 73.4 years (range: 60~95 years) at the time of surgery. The BMD was assessed in 398 patients and 348 were diagnosed with osteoporosis, while 102 received alendronate for treatment. The persistency with alendronate treatment and change of the BMD were evaluated annually. We also evaluated the side effects and reasons for discontinuation. Results: The prescription rate of alendronate was 29.3% and the persistency rate over 1 year was 33%. The annual BMD of the lumbar spine showed a 9.11% increase the first year, a 4.5% increase the second year and a 3.5% increase the third year, while negative changes were noted in the proximal femur as a 1.89% decrease the first year, a 1.38% decrease the second year and a 0.97% decrease the third year. The BMD changes were 11%(L: Lumbar spine) and 1.1%(F: Femur) for the T-scores -3.0, respectively. The BMD changes in the patients with femur neck fractures and who were treated with hemiarthroplasty were 15.6%(L) and -3.9%(F). The BMD changes in the patients with intertrochanteric hip fractures and who were treated with compression hip screws or hemiarthroplasty were 18.7%(L), 0.77%(F), 24.2%(L) and 1.19%(F), respectively. Gastrointestinal problems(19.1%) were the most common cause for discontinuation of alendronate. Conclusion: It is important for doctors to approach osteoporosis more carefully and educate patients to follow the prescriptions in order to improve the low prescription and persistency rates for the management of osteoporotic hip fractures. Administration of alendronate may have a positive influence on the BMD of the proximal femur by lowering the rate of decreased BMD more than would be expected.
{"title":"Persistency and Change of the Bone Mineral Density with Alendronate Treatment after Hip Fracture","authors":"K. Hwang, B. Yoo, Yeesuk Kim, I. Choi, Young-Ho Kim","doi":"10.5371/JKHS.2010.22.4.312","DOIUrl":"https://doi.org/10.5371/JKHS.2010.22.4.312","url":null,"abstract":"Purpose: The purpose of this study was to evaluate the effects of alendronate on bone mineral density (BMD) and to determine the persistency and side effects of alendronate treatment after hip fractures. Materials and Methods: 452 patients who underwent surgery for hip fractures from March 2000 to February 2007 were retrospectively included. The hip fractures consisted of 218 cases of femur neck fractures and 234 cases of intertrochanteric fractures. There were 254 women and 198 men with a mean age of 73.4 years (range: 60~95 years) at the time of surgery. The BMD was assessed in 398 patients and 348 were diagnosed with osteoporosis, while 102 received alendronate for treatment. The persistency with alendronate treatment and change of the BMD were evaluated annually. We also evaluated the side effects and reasons for discontinuation. Results: The prescription rate of alendronate was 29.3% and the persistency rate over 1 year was 33%. The annual BMD of the lumbar spine showed a 9.11% increase the first year, a 4.5% increase the second year and a 3.5% increase the third year, while negative changes were noted in the proximal femur as a 1.89% decrease the first year, a 1.38% decrease the second year and a 0.97% decrease the third year. The BMD changes were 11%(L: Lumbar spine) and 1.1%(F: Femur) for the T-scores -3.0, respectively. The BMD changes in the patients with femur neck fractures and who were treated with hemiarthroplasty were 15.6%(L) and -3.9%(F). The BMD changes in the patients with intertrochanteric hip fractures and who were treated with compression hip screws or hemiarthroplasty were 18.7%(L), 0.77%(F), 24.2%(L) and 1.19%(F), respectively. Gastrointestinal problems(19.1%) were the most common cause for discontinuation of alendronate. Conclusion: It is important for doctors to approach osteoporosis more carefully and educate patients to follow the prescriptions in order to improve the low prescription and persistency rates for the management of osteoporotic hip fractures. Administration of alendronate may have a positive influence on the BMD of the proximal femur by lowering the rate of decreased BMD more than would be expected.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114753091","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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