Cementless Bipolar Hemiarthroplasty for Femoral Neck Fractures in Elderly Patients / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate clinicoradiological outcomes after cementless bipolar hemiarthroplasty in elderly patients with femoral neck fractures. MATERIALS AND METHODS: Eighty hips-all in patients greater than 70 years of age-were followed for more than 2 years after undergoing cementless bipolar hemiarthroplasty with a tapered cementless stem (Lima SPH-C2(R)). The mean age was 76 years, and the mean follow-up period was 37 months. The Harris hip score and postoperative hip pain were analyzed clinically. The radiological results were assessed using various radiological indices. RESULTS: At last follow-up, the mean Harris hip score was 80.2 points. There was one case of significant hip pain. Fifty-five cases (68.7%) showed no decrease in ambulation capacity postoperatively. Radiologically, there were 47 cases (58.7%) of bone ingrowth and 33 cases (41.3%) of stable fibrous fixation. There were no cases of osteolysis, and 30 cases (37.5%) exhibited new bone formation around the stem. All stems were stable without significant alignment change or progressive subsidence. CONCLUSION: Short-term outcomes proved to be satisfactory in elderly patients undergoing cementless bipolar hemiarthroplasty for femoral neck fractures.

Analysis of Correction Loss after Pedicle Subtraction Osteotomy in Patients with Sagittal Imbalance: Radiologic Aspects / 대한정형외과학회잡지

PURPOSE: To validate the surgical principles by analyzing the cause of a correction loss after pedicle subtraction osteotomy in patients with a sagittal imbalance in the radiological aspects, retrospectively. MATERIALS AND METHODS: Forty cases were analyzed radiographycally according to the presence (Group A) or absence (Group B) of the lower mobile segment and anterior column support performed (Group A2) or not (Group A1), respectively. RESULTS: The overall correction loss of the total fused part appeared to increase in group A (p=0.025) and the degree of lordosis of the osteotomy site showed an almost zero correction loss in group A and B. No statistic difference of the correction loss of the upper segment of the osteotomy site between the two groups was found (p=0.138). The correction loss of the lower segment of osteotomy site increased statistically more in goup A (p=0.014). The correction loss in group A occurred more in the lower segment than in the upper segment and the correction loss of the lower segment in group A1 appeared to have a better correlation than group A2 (p=0.012). CONCLUSION: Correction loss occurs at the intervertebral disc of the mobile segment. It is considered desirable to have anterior column support to all lower segment of the osteotomy site, because the correction loss increases more in the lower segment than in the upper segment.

The Results of Pedicle Subtraction Osteotomy in Iatrogenic Flat Back Syndrome / 대한정형외과학회잡지

PURPOSE: To analyze the results of radiologic and clinical outcomes after pedicle subtraction osteotomy in iatrogenic flat back syndrome. MATERIALS AND METHODS: We reviewed 12 surgical cases of iatrogenic flat back syndrome from January 1998 to July 2001 with a follow-up of more than 12 months. All cases were females and an average age was 59.8 years (48-66 years). An average follow-up period was20.4 months (12-37 months). Initial diagnosis were as follows: lumbar degenerative kyphosis, in 5 cases; spinal stenosis, in 5 cases; spondylolisthesis, in 2 cases. For clinical evaluation, 10-point pain scale and 5-point scale for activity level, cosmesis and subjective satisfaction were used. Lumbar lordotic angles and sagittal vertical axis (SVA) were measured. RESULTS: In radiologic results, an average lumbar lordotic angle at preoperative, postoperative and the last follow-up were 5.13+/-21.69 degree, -31.33+/-16.32 degree, -27.50+/-16.73 degree respectively. And average SVA at preoperative, postoperative and the last follow-up were 8.46+/-6.04 cm, 0.62+/-2.24 cm, 2.82+/-2.81 cm respectively. In clinical results, preoperative pain (6), activity (2) and cosmesis (1.8) were improved to 3.2, 3 and 3.2respectively at the last follow-up. Subjective satisfaction was 3.9. CONCLUSION: Pedicle subtraction osteotomy seemed to be very useful surgical option for improvement of clinical results through recovering of lumbar lordotic angle and sagittal balance in cases of iatrogenic flat back syndrome.