Background: Fall prevention is important for reducing hip fractures. The aim of this study was to determine the relationship between variables related to hip fractures according to sex and season. Methods: This study included patients admitted for fragility hip fractures between 2012 and 2021. Patients were interviewed by a junior resident before discharge. Data on sex, age, diagnosis, osteoporosis treatment, direction, voiding problems, ambulatory function, seasons, weather, time of day, place, location, floor condition, activity during fall, and perceived reason for fall were collected and analyzed. Results: A total of 1,118 patients were included (279 males and 839 females). In both sexes, indoor falls were prevalent throughout all seasons, but males showed a higher proportion of outdoor falls, especially in winter during cloudy or snowy weather. Rooms and walking were the most common locations and activities during falls. The poor ambulatory function was associated with a higher prevalence of indoor falls. Osteoporosis treatment rates were low and did not differ according to Koval stage. Winter was associated with higher osteoporosis non-treatment group. Urgency/incontinence in female patients caused a higher proportion of falls during the evening time. Conclusions Strategies for indoor fall prevention and vigilant osteoporosis diagnosis and treatment are important for all seasons, especially for frail elderly patients. Outdoor fall prevention emphasized for male patients, and education around nighttime falls should be provided for female patients with voiding dysfunction.

BACKGROUND: Sarcopenia causes loss of muscle mass in the elderly and is associated with development of metabolic syndrome in those with obesity. This study evaluated the prevalence of sarcopenic obesity (SO) in healthy Korean elderly women. METHODS: This study was based on data from the Korea National Health and Nutrition Examination Survey IV and V, 2008–2011. Whole body dual energy X-ray absorptiometry and body mass index measurement were performed for all patients. Women aged 65 years or older were included in this study. Total appendicular extremity muscle mass was used to determine the skeletal muscle mass index. RESULTS: Of 2,396 women aged 65 years or older, a total of 1,491 (62.2%) were underweight, normal weight, or overweight, while 905 (37.8%) were obese. The prevalence of sarcopenia using a cut-off value of 5.4 kg/m2 was 64.9% (63/97) in underweight women, 38.2% (320/838) in normal weight women, 17.1% (95/556) in overweight women, and 6.1% (55/905) in obese women. CONCLUSIONS: The prevalence of sarcopenia was different among groups. The prevalence rate in obese women was lower than that in non-obese women. SO is a new category of obesity in older adults with high adiposity coupled with low muscle mass. The prevalence of SO was lower than that in previous studies because of differences in the definition. A consensus definition of SO needs to be established.
Absorptiometry, Photon ; Adiposity ; Adult ; Aged ; Body Mass Index ; Consensus ; Cross-Sectional Studies ; Extremities ; Female ; Humans ; Korea ; Muscle, Skeletal ; Nutrition Surveys ; Obesity ; Overweight ; Prevalence ; Sarcopenia ; Thinness

In this article, The author's name and Table 1 should be corrected.

Background: Patient perception is a key element in improving compliance with medications for osteoporosis. This study evaluated the awareness, perception, sources of information, and knowledge of osteoporosis among Korean women with osteoporosis. Methods: A questionnaire survey was conducted from July 22, 2021 to 13 August 2021. Patients who were followed up in endocrinology (Endo), orthopedic surgery (OS), and gynecology (GY) were recruited (N=40, 40, and 20 in each group). Patients were allocated according to their age, as follows: 15, 15, and 10 patients in their 60s, 70s, and 80s for Endo and OS, and 10 and 10 patients in their 60s and 70s for GY. The questionnaire was composed of the following topics: patient journey to the hospital, drug-related issues, communication with medical doctors, patient knowledge, and sources of information about osteoporosis. Results: The results of medical check-ups were the most common reason for patient visits to the hospital for an initial diagnosis of osteoporosis (61%). A knowledge gap regarding mortality, refracture, and drug-induced osteoporosis was observed. Doctors were the most preferred and trustful source of information, while health-related TV shows were the second most common source of information. Patients with OS reported lower perceived severity and higher drug discontinuation, along with a higher proportion of fractures, as the initial reasons for hospital visits for osteoporosis. Conclusions Variations in perceptions according to the issue and group were identified. These should be considered during patient consultations to improve compliance with osteoporosis treatment.

Background: Spine-hip discordance (SHD) increases fracture risk. However, its prevalence and clinical implications have not been investigated in patients with hip fractures. This study determined the prevalence and association of SHD with mortality and investigated the cause of SHD in patients with hip fractures. Methods: This study included patients admitted for fragility hip fractures between 2011 and 2020. All patients underwent dual energy X-ray absorptiometry and anteroposterior and lateral views of the lumbosacral spine during admission. Data on demographics, diagnosis, American Society of Anesthesiologists score, and mortality were collected. A T-score difference of more than 1.5 between L1-4 and the femur neck was considered discordant, and 3 groups (lumbar low [LL] discordance, no discordance [ND], and femur neck low [FL] discordance) were compared. In the discordance group, lumbar radiographs were reviewed to determine the cause of discordance. Results: Among 1,220 eligible patients, 130 were excluded due to patient refusal or bilateral hip implantation; therefore, this study included 1,090 patients (271 male and 819 female). The prevalence of LL, ND, and FL was 4.4%, 66.4% and 29.2% in men and 3.9%, 76.1%, and 20.0% women. Mortality was not associated with discordance. The most common causes of discordance were physiological in the LL group and pathological in the FL group for both sexes. Conclusions Patients with hip fractures showed lower rates of ND and higher rates of FL compared to the general population. True discordance should be carefully judged for pathological and artifact reasons. The clinical implications of SHD require further investigation.

Background: Our purpose in this study was to evaluate any deficiency of protein intake for different types of sarcopenia, including osteosarcopenia and sarcopenic obesity and to establish a cut-off value for the relationship between malnutrition, sarcopenia, and osteosarcopenia. Methods: The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. A total of 4,020 participants (men, 1,698 and women, 2,322) were analyzed in the present study. Sarcopenia is defined according to the criteria for the Asia Working Group for Sarcopenia. To evaluate the adequacy of protein intake, the value obtained by dividing the amount of protein consumed through food by the daily recommended protein amount (50 g/day) of Korean males was defined as the nutrient intake ratio. Results: Total protein (P<0.001 in men, P<0.001 in women) and low dietary intake protein (P<0.001 in men, P=0.046 in women) were significantly lower in the sarcopenia group than in the normal group, and were significantly lower in the osteosarcopenia group than in the normal group for both men and women. The cut-off value of the adjusted weight of protein intake for sarcopenia was 0.58 g/kg/day in men and 0.98 g/kg/day in women. The cut-off value for adjusted weight of protein intake for osteo-sarcopenia was 0.8 g/kg/day in men and 0.5 g/kg/day in women. Conclusions A comprehensive dietary assessment to detect nutritional deficits that predispose one to or aggravate muscle atrophy is important for establishing a treatment plan for patients with malnutrition.

OBJECTIVES: The purpose of this study to examine if the levels of anxiety(emotional, cognitive, and behavioral measures) during performance are influenced by interaction of both achievement related self discrepancy(=psychological vulnerability variable) and evaluative threat stress(=stressor) based on vulnerabilitystress model in order to identify the mechanism of development of performance anxiety and furthermore to suggest psychological intervention strategies to reduce and prevent it effectively. METHOD: High and low self discrepancy subjects consisted of students from the upper(n=40) and lower 15%(n=40) on achievement related self discrepancy scale, respectively. They were randomly assigned to either evaluative threat condition or neutral condition, and then all subjects took intellective task(verbal reasoning test and digit symbol test). RESULTS: The results were as follows; 1) High self discrepancy subjects under evaluative threat reported significantly higher level of state anxiety during performance than low self discrepancy subjects under any condition and also experienced higher degreee of state anxiety with marginal significance than high self discrepancy subjects under neutral condition, whereas there were no significant effects on the anxiety level of group variable under neutral condition or of stress variable in low self discrepancy subjects. 2) High self discrepancy subjects reported more cognitive interference during performance than low self discrepancy subjects regardless of the level of stress. 3) High self discrepancy subjects performed marginally significantly more poorly in digit symbol test than low self discrepancy subjects regardless of the level of stress, whereas there were no significant effects on verbal reasoning test. CONCLUSION: The hypothesis that performance anxiety could be affected by achievement related self discrepancy and stress, and specially by interaction between self discrepancy and stress was relatively strongly supported by the results on emotional measure of performance anxiety. In addition, this hypothesis received partial support by the results on cognitive and behavioral measures. We might conclude that it is important to consider achievement-related self discrepancy and evaluative threat stress together to understand the mechanism of development of performance anxiety and to reduce or prevent this anxiety effectively.
Anxiety ; Humans ; Performance Anxiety*

BACKGROUND: Concerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients? METHODS: Details of sexual activity and concerns were obtained using a questionnaire designed specifically for the study. The questionnaire was administered to 64 patients in a face-to-face interview at an outpatient clinic. RESULTS: Preoperatively, 53.1% of patients experienced difficulties, primarily due to hip pathology and limitations of motion. The median time to the resumption of sexual activity was 3 months postoperatively, and most patients had no increase in the frequency of sexual activity after the total hip replacement. In 39.1% of patients were seen having difficulties with leg positioning following total hip replacement, and they were likely to change coital positions. The most common concern regarding sexual activity of patients was the fear of dislocation. Furthermore, patients with a higher stress level had lower satisfaction rates. Most patients were unable to obtain information on sexual activity following the total hip arthroplasty, and they did not consult with a physician due to the private nature of the topic. CONCLUSIONS: Dislocation was the most common concern of patients during sexual activity following a total hip arthroplasty, and a higher stress level was found to be associated with a lower satisfaction rate. Because most patients were unprepared to consult a physician, the provision of appropriate information before a consultation might be beneficial.
Adult ; Aged ; Arthroplasty, Replacement, Hip/adverse effects/*methods/*psychology ; Female ; Hip Dislocation/psychology ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Preoperative Period ; Questionnaires ; Republic of Korea ; Retrospective Studies ; Sexual Behavior/*psychology ; Young Adult

PURPOSE: To evaluate the MRI appearance of Kienbock's disease and correlate this with radiographic findings. MATERIALS AND METHODS: Thirteen clinically confirmed cases of 12 patients with kienbock's disease wereretrospectively reviewed. The significance of signal intensity and pattern of Kienbock's disease on MR images was evaluated and the findings on MR images were compared with radiographic stages classified by Lichtman. Enhanced MR images were abtained in four cases. RESULTS: Lichtman's stage I accounted for one case; stage II, two; stage III, eight; stage IV, two. On T1-weighted MR images, the lunate showed focal low signal intensity in the stage I caseand in one of the two stage II case. Eleven wrists demonstrated a generalized loss of lunate signal. On T2-weighted images, the stage I case showed focal high signal intensity. In stage II, one showed focal low signal intensity and the other exhibited generalized low signal intensity with a high spot area. In stage III, five ofeight cases showed generalized low signal intensity, and one demonstrated high signal intensity. Two showed a high spot area within the generalized low signal intensity. In stage IV, one showed generalized low signal intensity and the other exhibited high signal intensity. No enhancement was seen in the three lesions with focal orgeneralized low signal intensity both on T1 and T2-weighted images. Conversely, one lesion with low signalintensity on T1-weighted imaes and high signal intensity on T2-weighted images showed contrast enhancement. CONCLUSION: Low signal intensity of the lunate on T1-weighted images is a consistent findings of Kienbock's disease. However, further studies such as follow-up MRIs, or pathologic correlation studies and MR contrast enhancement studies will be necessary to evaluate the sighificance of high signal intensity on T2-weighted images.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Osteonecrosis* ; Statistics as Topic ; Wrist

PURPOSE: To report our early experience of hip arthroscopy. MATERIALS AND METHODS: Forty one patients (45 hips) who underwent hip arthroscopy from November 2007 to February 2009 were enrolled in the study. The population was divided into 3 groups in sequence. The operation time, fluoroscopic time, traction time, and complications were analyzed. RESULTS: There was no significant difference in operation time and traction time between the three groups. The fluoroscopic time decreased from 41 minutes in group I to 11 minutes in group III (p<0.01). There were four cases of nerve palsy; 2 pudendal nerve palsy in group I, 1 pudendal nerve palsy in group II, and 1 peroneal nerve palsy in Group III. All cases recovered completely within few days after surgery. Iatrogenic labral injury occurred in 4, 3 and 0 hips in group I, II and III, respectively. Iatrogenic cartilage damage to the femoral head occurred in 2, 3 and 1 hip in group I, II and III, respectively, which did not affect the outcomes. CONCLUSION: Definite improvement in the hip arthroscopy technique was observed in the fluoroscopic time. No serious complications, such as death or permanent nerve palsy, were encountered.
Arthroscopy ; Cartilage ; Head ; Hip ; Hip Joint ; Humans ; Paralysis ; Peroneal Nerve ; Pudendal Nerve ; Traction