1.Sciatic Nerve Compression Secondary Due to Ischial Tuberosity Osteochondroma.
Hyeon Jun KIM ; Sung Soo KIM ; Chul Hong KIM ; Hyo Jong KIM
Journal of the Korean Hip Society 2012;24(1):65-69
Ostehochondroma is a common primary benign bone tumor, and is mostly asymptomatic. Symptoms are related complications due to compression on the adjacent nerve. The sciatic nerve compression secondary to osteochondroma has rarely been reported. A 21 year-old man had right hip pain radiated to the right lower extremity. In a radiological evaluation, bone mass was detected at the right ischial tuberosity. After dynamic ultrasonography, we excised the bone mass and decompressed the sciatic nerve. The bone mass was diagnosed as osteochondroma by pathologic evaluation. We report the case with a review of the literature.
Hip
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Lower Extremity
;
Osteochondroma
;
Sciatic Nerve
2.Repeated Ceramic Head Fracture after Ceramic-on-ceramic Total Hip Arthroplasty.
Myung Sik PARK ; Sun Jung YOON ; Myung Jae YOO
Journal of the Korean Hip Society 2012;24(1):59-64
Alumina ceramic-on-ceramic total hip arthroplasty is a widely-adopted option, especially for younger patients, due low wear, scratch resistance, the wettable characteristics of alumina ceramics, and because of the relatively low biological reactivites of ceramic wear particles. However, fracture remains a significant problem because ceramics are inherently brittle, and few reports have been issued on short head fractures. In the described case, a ceramic head fracture occurred only 8 months after replacing the original head and with a new 28 mm head and liner. Both of these incidents may have been caused by head-to-liner impingement due to excessive anteversion of the metal shell. During the second revision surgery, this situation was managed successfully using a conventional elevated-polyethylene liner and a CoCr metal head, while retaining all metal implants.
Aluminum Oxide
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Arthroplasty
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Ceramics
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Head
;
Hip
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Humans
3.Coincidence of Diagnosis of Osteoporosis at the Site of the Proximal Femur, Lumbar Spine and Distal Radius.
Myung Rae CHO ; Jae Seok AHN ; Seung Bum CHAE ; Sang Wook LEE
Journal of the Korean Hip Society 2012;24(1):53-58
PURPOSE: The purpose of this study is to evaluate correlation according to sites measured from women diagnosed with osteoporosis without other factors influencing osteoporosis. MATERIALS AND METHODS: Two hundred patients diagnosed with osteoporosis using dual-energy X-ray absorptiometry from January 2006 to January 2007 were evaluated. All patients were measured at the hip joint (Femur neck, Ward triangle, and great trochanter), lumbar spine body (L1-4), and distal radius. Results of measurements were then evaluated for determination of coincidence. RESULTS: Mean bone mineral density was lowest at Ward's triangle(-2.93+/-0.95) and radius midshaft(-2.95+/-1.21). The rate of disconcordance between hip joint and lumbar spine was 37%, between hip joint and distal radius, 34%, and, between the lumbar spine and distal radius, 38%. With increase in age, a greater decrease in bone mineral density was observed, and markedly decreased bone mineral density was observed between the ages of 60 and 70-years. CONCLUSION: Rate of disconcordance of bone mineral density among hip joint, lumbar spine, and distal radius was significant. To prevent further fracture, all sites (hip joint, lumbar spine, and distal radius) must inevitably be measured.
Absorptiometry, Photon
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Bone Density
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Female
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Femur
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Hip Joint
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Humans
;
Joints
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Neck
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Osteoporosis
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Radius
;
Spine
4.Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients.
Sung Hwan KIM ; Soo Won LEE ; Gyu Min KONG ; Mid Um JEAGAL
Journal of the Korean Hip Society 2012;24(1):45-52
PURPOSE: This study was performed to compare the clinical results and complications of bipolar hemiarthroplasty and internal fixation using proximal femur nail antirotation (PFNA) for unstable elderly femoral intertrochanteric fractures. MATERIALS AND METHODS: From May 2008 to September 2010, 74 patients older than 65 years who underwent bipolar hemiarthroplasty(33 patients) or PFNA(41 patients) and followed for more than 1 year after surgery were enrolled in this study. The mean blood loss during operation, mean operation time, radiological results, clinical results, and complications were analyzed by the Student t-test and Chi-square test to compare the two groups. RESULTS: The volume of blood loss during the operation was statistically lesser in the PFNA group (P<0.05) and operation time was not statistically different between the two groups (p=0.73). The bipolar hemiarthroplasty group showed a statistically better outcome than the PFNA group in the beginning of weight bearing (p<0.05), the hospital stay (p<0.05). The degradations of Koval score and modified Harris hip score of the bipolar hemiarthroplasty group were statistically better than those of the PFNA group (p=0.03, p=0.02). The bipolar hemiarthroplasty group showed a statistically lower incidence of mechanical(9.1%, p=0.01) and general(12.1%, p=0.00) complications than the PFNA group. CONCLUSION: In elderly patients, bipolar hemiarthroplasty is thought to be one of the effective treatments for unstable femoral intertrochanteric fracutures when considering complications and clinical outcomes.
Aged
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Femur
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Hemiarthroplasty
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Hip
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Hip Fractures
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Humans
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Incidence
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Length of Stay
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Nails
;
Weight-Bearing
5.Treatment of Unstable Intertrochanteric Fractures of the Femur Using an Anti-Hypersliding Compression Hip Screw and TSP.
Myung Rae CHO ; Sang Hwa LEE ; Dae Won CHO ; Sang Bong KO
Journal of the Korean Hip Society 2012;24(1):37-44
PURPOSE: This study evaluated the result of fixation of unstable intertrochanteric fractures using an anti-hypersliding compressive hip screw and a trochanter stabilizing plate. MATERIALS AND METHODS: One hundred patients with unstable intertrochanteric fractures who were given an anti-hypersliding compressive hip screw (Group A) or conventional compressive hip screw (Group B) were analyzed. The mean follow-up period was 23.5 months. Radiographic evaluation included the changes of neck-shaft angle, lateral displacement of proximal fragment, distal migration of the lag screw, fixation failure, and union time using plain radiographs taken at postoperative and last follow-up time. RESULTS: Lateral displacement of the proximal fragment averaged 1.62 mm in Group A and 3.97 mm in Group B, which was statistically significant (p<0.05). The neck-shaft angle was increased in Group B, but has no significance. The average of the Harris hip score and walking ability after surgery is higher in Group A than B, but there was no significant difference. The complication rate was significantly lower in Group A. But union time showed no difference in each group. CONCLUSION: Anti-hypersliding compression hip screw with a TSP, which reduces sliding of the lag screw and extreme change of the moment arm, is a another good option for the treatment of intertrochanteric femoral fractures against an increase of the failure rate from the hypersliding of the lag screw.
Arm
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Displacement (Psychology)
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Femoral Fractures
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Femur
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Follow-Up Studies
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Hip
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Hip Fractures
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Humans
;
Walking
6.Cementless Total Hip Arthroplasty in Dysplastic Hips.
Dae Hee KIM ; Chae Hyun LIM ; Sang Ho AHN ; Min Wook KIM ; Young Yool CHUNG
Journal of the Korean Hip Society 2012;24(1):32-36
PURPOSE: To evaluate the clinical and radiological results after cementless total hip arthroplasty in dysplastic hips. MATERIALS AND METHODS: This study included 36 cases that underwent total hip arthroplasty using a cementless prosthesis in our hospital from July 1990 to May 2008. The average time of of follow-up was 103.7 months. In total, 27 cases about 24 patients were women, and 8 cases about 7 patients were men. The average age at the time of operation was 55.7 years(29-80 years). In total, 26 cases were Crowe type I and 8 cases were Crowe type II. One case was Crowe type IV. Acetabular cup angles and the contact ratio between the acetabular cup and the host bone were measured, and the grafting bone was observed for absorption in the follow-up radiographs. Revision of components was defined as a failure. RESULTS: Harris hip score was improved from 55.1 points pre-operatively to 86.1 points in the last follow-up. Revision was done in 12 cases(33.3%). Altogether, 10 cases revised the acetabular cup for osteolysis and polyethylene wear and 2 cases exchanged a polyethylene liner for only liner wear. CONCLUSION: Total hip arthroplasty in the dysplastic hip using a cementless acetabular cup, not a hydroxyapatite-coated acetabular cup, showed good clinical and radiological results when the contact ratio between acetabular cup and bone was above 70%.
Absorption
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Arthroplasty
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Crows
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Female
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Follow-Up Studies
;
Hip
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Humans
;
Male
;
Osteolysis
;
Polyethylene
;
Prostheses and Implants
;
Survival Rate
;
Transplants
7.Comparative Analysis of Two Cementless Stems in Total Hip Arthroplasties in Patients with Osteonecrosis of Femoral Head: Summit(R) Stem and Bencox(R) Stem.
Young Wook LIM ; Kee Haeng LEE ; Sung Ho BAE ; Soon Yong KWON
Journal of the Korean Hip Society 2012;24(1):25-31
PURPOSE: We compared the clinical and radiological outcomes of total hip arthroplasty (THR) using Summit and Bencox stems. MATERIALS AND METHODS: The patients who underwent cementless total hip arthroplasty were recruited with a satisfactory condition of a minimum three years of follow-ups after THR. Those patients were divided into two groups, those with Summit stems and those with Bencox stems. Summit stems were in 36 patients(40 hips), and Bencox stems in 36 patients(48 hips). Summit and Bencox stems had 78 months and 42.2 months as a mean follow-up, respectively. The clinical and radiological evaluations of femoral components were performed. RESULTS: There was no difference in clinical results between the two groups. Under the radiological findings, there were no osteolytic changes or loosening. Osseointegration was detected at an average of 6.4 months(3-12 months) in the Bencox stem on the distal portion of the femoral stem, and cortical hypertrophy was detected on 6 hips with a Summit stem. CONCLUSION: The clinical and radiological evaluations in both systems showed excellent outcomes at the three year follow-ups, and there was no statistical difference on the clinical and radiological results between the two groups. Thigh pain and cortical hypertrophy were not detected in the Bencox stem, and that wound would be caused by surface treatment methods of the femoral stem, and morphological differences.
Arthroplasty
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Follow-Up Studies
;
Hip
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Humans
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Hypertrophy
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Osseointegration
;
Osteonecrosis
;
Thigh
8.Hip Arthroplasty Using Collarless Polished Tapered Stem: Minimum 2 Years Follow-up Results.
Yerl Bo SUNG ; Jung Yun CHOI ; Su Chan OH
Journal of the Korean Hip Society 2012;24(1):18-24
PURPOSE: This study evaluated the clinical and radiologic results of total hip arthroplasty and bipolar hemiarthroplasty using collarless polished tapered femoral stem. MATERIALS AND METHODS: We retrospectively reviewed the results of 33 patients who underwent THA and BHA using cemented CPT femoral stem from November 2006 to April 2009. The mean follow-up period was 33 months. The clinical results were evaluated with a Harris Hip Score (HSS), and radiographic results were assessed with cement grade, osteolysis, loosening, stress shielding and subsidence methods. RESULTS: Mean HSS improved with 91 points. Postoperative cement grade was A in 14 cases, B in 14 cases, C1 in 5 cases and D in none. Aseptic loosening was not found, while focal radiolucency in zone 8 was found. 70% of stems showed grade 1 and 2 stress shielding according to Engh's criteria. Subsidence of the femoral stem was less than 1 mm in 32 cases, and was 1.47 mm in another case. Ectopic ossification was observed in 13 cases, class I in 11 cases, and class II in 2 cases, using Brooker's classification. CONCLUSION: This study showed the good clinical and radiographic results of THA and BHA with a cemented CPT femoral stem at the mid-term follow-up. However, a long-term follow-up study will be needed to evaluate the more precise clinical and radiographic outcomes.
Arthroplasty
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Butylated Hydroxyanisole
;
Follow-Up Studies
;
Hemiarthroplasty
;
Hip
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Humans
;
Ossification, Heterotopic
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Osteolysis
;
Retrospective Studies
;
Tacrine
9.Osteotomy around the Hip Joint.
Yoon Je CHO ; Sang Joon KWAK ; Hwan Jin KIM ; Sang Hoon LEE
Journal of the Korean Hip Society 2012;24(1):2-17
Hip joint preserving osteotomy surgery is the treatment of choice for young patients with early symptomatic structural abnormalities of the acetabulum and proximal femur. This is true even in the absence of severe secondary degenerative changes. These disorders can include hip instability from classic developmental dysplasia, post-traumatic acetabular dysplasia, hip impingement from retrotorsional acetabular deformities, or, rarely, post-traumatic problems. During the past 20 years, various techniques of acetabular and proximal femoral reorientation have evolved, making the procedure reliable, reproducible, and durable. In this report, the current indications and results of acetabular and proximal femoral osteotomies in patients with symptomatic acetabular structural problems will be discussed.
Acetabulum
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Congenital Abnormalities
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Femur
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Hip
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Hip Joint
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Humans
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Osteotomy