1.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
2.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
3.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
4.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
5.Clinical and MR Predictors of Retro-Odontoid Pseudotumor Regression Following Posterior Fixation in Patients with Atlantoaxial Instability
Jisu KIM ; Youngjune KIM ; Eugene LEE ; Joon Woo LEE
Journal of the Korean Society of Radiology 2024;85(4):754-768
Purpose:
To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability.
Materials and Methods:
We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann–Whitney and Fisher’s exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression.
Results:
We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31–84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression (p = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression.
Conclusion
Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.
6.Clinical and MR Predictors of Retro-Odontoid Pseudotumor Regression Following Posterior Fixation in Patients with Atlantoaxial Instability
Jisu KIM ; Youngjune KIM ; Eugene LEE ; Joon Woo LEE
Journal of the Korean Society of Radiology 2024;85(4):754-768
Purpose:
To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability.
Materials and Methods:
We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann–Whitney and Fisher’s exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression.
Results:
We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31–84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression (p = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression.
Conclusion
Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.
7.Clinical and MR Predictors of Retro-Odontoid Pseudotumor Regression Following Posterior Fixation in Patients with Atlantoaxial Instability
Jisu KIM ; Youngjune KIM ; Eugene LEE ; Joon Woo LEE
Journal of the Korean Society of Radiology 2024;85(4):754-768
Purpose:
To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability.
Materials and Methods:
We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann–Whitney and Fisher’s exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression.
Results:
We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31–84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression (p = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression.
Conclusion
Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.
8.Exploring the Potential of GlycolyticModulation in Myeloid-Derived Suppressor Cells for Immunotherapy and Disease Management
Jisu KIM ; Jee Yeon CHOI ; Hyeyoung MIN ; Kwang Woo HWANG
Immune Network 2024;24(3):e26-
Recent advancements in various technologies have shed light on the critical role of metabolism in immune cells, paving the way for innovative disease treatment strategies through immunometabolism modulation. This review emphasizes the glucose metabolism of myeloid-derived suppressor cells (MDSCs), an emerging pivotal immunosuppressive factor especially within the tumor microenvironment. MDSCs, an immature and heterogeneous myeloid cell population, act as a double-edged sword by exacerbating tumors or mitigating inflammatory diseases through their immune-suppressive functions. Numerous recent studies have centered on glycolysis of MDSC, investigating the regulation of altered glycolytic pathways to manage diseases. However, the specific changes in MDSC glycolysis and their exact functions continue to be areas of ongoing discussion yet. In this paper, we review a range of current findings, including the latest research on the alteration of glycolysis in MDSCs, the consequential functional alterations in these cells, and the outcomes of attempts to modulate MDSC functions by regulating glycolysis. Ultimately, we will provide insights into whether these research efforts could be translated into clinical applications.
9.The Comparison of Cepstral Peak Prominence by Using Speech Tool and Praat for Voice Analysis of Patients With Vocal Cord Palsy
Jisu KIM ; Min Young CHO ; Dong Young KIM ; Woongsang SUNWOO ; Woori PARK ; Joo Hyun WOO
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2023;34(2):45-49
Background and Objectives:
This study aimed to evaluate the voice of patients with vocal cord palsy using the Praat compared to Speech tool.Materials and Method The medical record of the patients with vocal cord palsy from 2013 to 2021 was analyzed retrospectively to validate Praat as a voice evaluation modality compared to the speech tool. Total 60 patients were enrolled in this study. Thirty control and 30 vocal cord palsy patients were selected to undergo recording of voice samples. The voice samples, /a/ and “Sancheck” were evaluated both groups and cepstral peak prominence was analyzed with both modalities; Praat and speech tool.
Results:
Statistically significant differences were observed between the control and vocal cord palsy groups in the speech tool and Praat. There was also a significant difference between pre- and post-treatment values in the vocal cord palsy group. A similar change in the voice value was observed using both methods. The Praat showed a lower value in 1st visit of patients with vocal cord palsy in the vowel test. The Praat vowel test may sensitively represent voice problems in patients with vocal cord palsy. This could contribute to decision-making regarding the treatment modality for vocal cord palsy.
Conclusion
Praat is open-access software that is freely available. It can be easily and sufficiently used for voice evaluation in patients with vocal cord palsy.
10.Machine Learning-Based Proteomics Reveals Ferroptosis in COPD PatientDerived Airway Epithelial Cells Upon Smoking Exposure
Jung-Ki YOON ; Sungjoon PARK ; Kyoung-Hee LEE ; Dabin JEONG ; Jisu WOO ; Jieun PARK ; Seung-Muk YI ; Dohyun HAN ; Chul-Gyu YOO ; Sun KIM ; Chang-Hoon LEE
Journal of Korean Medical Science 2023;38(29):e220-
Background:
Proteomics and genomics studies have contributed to understanding the pathogenesis of chronic obstructive pulmonary disease (COPD), but previous studies have limitations. Here, using a machine learning (ML) algorithm, we attempted to identify pathways in cultured bronchial epithelial cells of COPD patients that were significantly affected when the cells were exposed to a cigarette smoke extract (CSE).
Methods:
Small airway epithelial cells were collected from patients with COPD and those without COPD who underwent bronchoscopy. After expansion through primary cell culture, the cells were treated with or without CSEs, and the proteomics of the cells were analyzed by mass spectrometry. ML-based feature selection was used to determine the most distinctive patterns in the proteomes of COPD and non-COPD cells after exposure to smoke extract.Publicly available single-cell RNA sequencing data from patients with COPD (GSE136831) were used to analyze and validate our findings.
Results:
Five patients with COPD and five without COPD were enrolled, and 7,953 proteins were detected. Ferroptosis was enriched in both COPD and non-COPD epithelial cells after their exposure to smoke extract. However, the ML-based analysis identified ferroptosis as the most dramatically different response between COPD and non-COPD epithelial cells, adjusted P value = 4.172 × 10−6 , showing that epithelial cells from COPD patients are particularly vulnerable to the effects of smoke. Single-cell RNA sequencing data showed that in cells from COPD patients, ferroptosis is enriched in basal, goblet, and club cells in COPD but not in other cell types.
Conclusion
Our ML-based feature selection from proteomic data reveals ferroptosis to be the most distinctive feature of cultured COPD epithelial cells compared to non-COPD epithelial cells upon exposure to smoke extract.

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