ABSTRACT
The subscapularis tendon is the largest and most powerful muscle in the rotator cuff, playing a more important role in raising the arm than the supraspinatus or infraspinatus tendon. Subscapularis tendon tears are uncommon, but when it does occur, symptoms are often minimal and diagnosis can be delayed until severe atrophy occurs, leading to weakness of the shoulder muscles. Therefore, early diagnosis and surgical repair of suspected subscapularis tendon injury in athletes is very important for achieving the best functional outcome. Shoulder injuries in professional boxers have been reported to account for only about 3% of all boxing injuries, but there is no specific research on the specific location of these injuries. In this study, the authors report on a case of isolated subscapularis tendon injury that occurred during sparring in a professional boxer and discuss the mechanism of injury and treatment outcomes along with a review of the literature.
ABSTRACT
Objectives@#Korea’s National Health Insurance (NHI) coverage rate for dental services is 16.0%, far lower than the 33.0% average of OECD (Organization for Economic Co-operation and development) countries. In 2013, the government implemented a policy to pay for dental scaling service for adults over the age of 20. Then in 2017, the eligibility criteria was expanded to adults aged 19 or older the eligibility age was lowered expanded to 19 or older. @*Methods@#The study aimed to determine the effectiveness of the policy by comparing the number of times per person the dental scaling service was used before and after the implementation of the new applicants group compared to the existing application/applicants group. The analysis was conducted among patients aged 19 and 20 who visited the hospital with gingivitis and periodontal disease and who used the dental scaling service more than once per year as a preventive measure, using the customized database of the NHIC (National Health Insurance Corporation). As of July 1, 2017 when the dental scaling service was implemented by the National Health Insurance Service, the period was set as “before enforcement” (January 2016 to June 2017) and “after enforcement” (July 2017 to December 2018). To evaluate the policy effectiveness of expandingthe ages of individuals eligible for the dental scaling service, Difference-in-Differences (DiD) analysis was conducted to examine the number of times per person the service was used, changes in personal contributions, and policy effectiveness. @*Results@#Since the National Health Insurance policy to pay for dental scaling services, both the applicants group and the sustainable application group have increased the rate of inspection of preventive dental scaling services (19.82%→30.91%, 29.68%→31.18%). As a result of determining the pure effect of the NHI’s policy of covering the dental scaling service, it was found that the the number of times the dental scaling service was used per person increased significantly in the new application group (0.03 times, <.0001). @*Conclusions@#However, it was found that the cost of the dental scaling service per person while the cost of the dental scaling decreased was shown to decrease, it was not statistical significant. Therefore, additional policy support such as lowering the personal financial burden is needed for those who are unable to afford the service.
ABSTRACT
Objectives@#The high co-payment of dental care service providers reduces access to dental care and exacerbates health inequality among different social classes. Dental care services are affected by several socioeconomic factors including those related to the household, regional factors surrounding individuals, and individual factors. In this study, we identified household and regional factors that affect unmet dental care needs, after appropriately adjusting for individual-level and provided suggestions for improving the future coverage of dental and oral health care services. @*Methods@#Using the 2019 Korean Community Health Survey data, 101,718 middle-aged (40-64 years old) and 72,807 elderly (65 years and older) individuals were analyzed to identify the unmet needs of dental care services by age group. To identify factors affecting unmet dental care needs by age group, a multilevel analysis of the overall rate (T1) was conducted with three dependent variables: (a)availability, (b)economic accessibility, and (c) acceptability. @*Results@#The unmet need for dental care service rate (T1) was 15.43% for middle-aged individuals, 14.73% overall, and 13.00% for the elderly. The results of the multi-level analysis indicated that at the household level, the number of household members aged 19 years and above had an effect on the overall (T1) total unmet needs of dental care services and economic accessibility for the middleaged group. At the regional level, economic accessibility influenced the degree of financial independence and the number of dental hospitals and clinics per population. @*Conclusions@#In order to reduce the unmet needs of dental care services, it is necessary to comprehensively consider not only individual-level factors but also household-level factors and regionallevel factors according to age.
ABSTRACT
Objectives@#The high co-payment of dental care service providers reduces access to dental care and exacerbates health inequality among different social classes. Dental care services are affected by several socioeconomic factors including those related to the household, regional factors surrounding individuals, and individual factors. In this study, we identified household and regional factors that affect unmet dental care needs, after appropriately adjusting for individual-level and provided suggestions for improving the future coverage of dental and oral health care services. @*Methods@#Using the 2019 Korean Community Health Survey data, 101,718 middle-aged (40-64 years old) and 72,807 elderly (65 years and older) individuals were analyzed to identify the unmet needs of dental care services by age group. To identify factors affecting unmet dental care needs by age group, a multilevel analysis of the overall rate (T1) was conducted with three dependent variables: (a)availability, (b)economic accessibility, and (c) acceptability. @*Results@#The unmet need for dental care service rate (T1) was 15.43% for middle-aged individuals, 14.73% overall, and 13.00% for the elderly. The results of the multi-level analysis indicated that at the household level, the number of household members aged 19 years and above had an effect on the overall (T1) total unmet needs of dental care services and economic accessibility for the middleaged group. At the regional level, economic accessibility influenced the degree of financial independence and the number of dental hospitals and clinics per population. @*Conclusions@#In order to reduce the unmet needs of dental care services, it is necessary to comprehensively consider not only individual-level factors but also household-level factors and regionallevel factors according to age.
ABSTRACT
Objectives@#The purpose of this study was to assess the source and quality of information regarding cervical disc herniation available to patients on websites.Summary of Literature Review: Studies have shown that 92% of the Korean population regularly accesses and searches for medical information on websites. While a large amount of information exists on websites, there is a possibility that patients will be misled due to inaccurate information because there are no established criteria for qualitative evaluation. In addition, little research has been conducted on websites that provide information about cervical disc herniation. @*Materials and Methods@#The search term ‘‘cervical disc herniation’’ was entered into the three most popular search engines in Korea (Naver, Daum, and Google). The first 50 websites displayed by each engine were selected for inclusion in this study and were categorized as academic, commercial, physician, non-physician, government organization, and unspecified. Information was assessed in terms of DISCERN, accuracy, and exhaustivity scores, and a total summary score was calculated for each website. @*Results@#Among the theoretical total of 150 websites, 83 unique and relevant websites were identified. The distribution by source was as follows: non-physician, 34.9%; physician, 27.7%; commercial, 13.3%; unspecified, 10.8%; academic, 9.6%; and government, 3.6%. Academic and government websites obtained the highest total summary scores, with statistical significance when compared to other types (p=0.03). @*Conclusions@#Website information on cervical disc herniation is generally limited. Institutional improvement efforts are needed to foster an environment where patients can receive high-quality medical information, and physician groups should play a central role in this process.
ABSTRACT
OBJECTIVES@#To evaluate the radiological outcomes of direct lateral lumbar interbody fusion (DLIF).SUMMARY OF LITERATURE REVIEW: DLIF, as a minimally invasive spinal surgical procedure, is useful for degenerative spinal diseases. However, few reports have evaluated the clinical and radiological outcomes of DLIF in Korea.@*MATERIALS AND METHODS@#We analyzed 44 patients who underwent DLIF at our hospital from September 2015 to September 2017. Of these patients, 89 segments were included in this study. We measured preoperative and postoperative radiological values including the disc height, central canal area, height of the foramen, and segmental sagittal angle on magnetic resonance imaging. We also measured patients' visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores as clinical parameters.@*RESULTS@#Statistically significant improvements were found in the height of the left and right foramina (20.8% and 25.6%, respectively), the height of the intervertebral discs (86.0% and 84.3%, respectively), the cross-sectional area of the central nervous system (33.1%), lumbar lordosis, and the lumbar segmental angle (2.7° and 8.7°, respectively) after surgery. The VAS and ODI scores also showed significant improvements (65.7% and 67.7%, respectively) when compared with the preoperative level.@*CONCLUSIONS@#DLIF was found to be effective for the treatment of diseases such as foraminal stenosis, degenerative spondylolisthesis, and adjacent segment diseases through indirect neuro-decompression of the bilateral foramina and central vertebrae.
ABSTRACT
STUDY DESIGN: Retrospective study of prospectively-collected data.OBJECTIVES: To evaluate the radiological outcomes of direct lateral lumbar interbody fusion (DLIF).SUMMARY OF LITERATURE REVIEW: DLIF, as a minimally invasive spinal surgical procedure, is useful for degenerative spinal diseases. However, few reports have evaluated the clinical and radiological outcomes of DLIF in Korea.MATERIALS AND METHODS: We analyzed 44 patients who underwent DLIF at our hospital from September 2015 to September 2017. Of these patients, 89 segments were included in this study. We measured preoperative and postoperative radiological values including the disc height, central canal area, height of the foramen, and segmental sagittal angle on magnetic resonance imaging. We also measured patients' visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores as clinical parameters.RESULTS: Statistically significant improvements were found in the height of the left and right foramina (20.8% and 25.6%, respectively), the height of the intervertebral discs (86.0% and 84.3%, respectively), the cross-sectional area of the central nervous system (33.1%), lumbar lordosis, and the lumbar segmental angle (2.7° and 8.7°, respectively) after surgery. The VAS and ODI scores also showed significant improvements (65.7% and 67.7%, respectively) when compared with the preoperative level.CONCLUSIONS: DLIF was found to be effective for the treatment of diseases such as foraminal stenosis, degenerative spondylolisthesis, and adjacent segment diseases through indirect neuro-decompression of the bilateral foramina and central vertebrae.
Subject(s)
Animals , Humans , Central Nervous System , Constriction, Pathologic , Intervertebral Disc , Korea , Lordosis , Magnetic Resonance Imaging , Retrospective Studies , Spinal Diseases , Spinal Fusion , Spinal Stenosis , Spine , SpondylolisthesisABSTRACT
The cause of a pilonidal cyst is unclear, and treatment is still under debate. In Korea, the incidence of this disease is lower than that of Western countries, and it has often been misdiagnosed as a simple abscess. When pilonidal cysts are diagnosed, the principle of treatment is not to leave a residue, and a wide excision is needed to reduce the recurrence rate. This paper introduces a wide excision technique using Indigo-carmine dye to minimize the recurrence of a pilonidal cyst.
Subject(s)
Abscess , Incidence , Korea , Pilonidal Sinus , Recurrence , Sacrococcygeal RegionABSTRACT
BACKGROUND: Peripheral arterial disease (PAD) is known as the greatest risk factor affecting the amputation of diabetic foot. Thus, it is crucial to understand the epidemiology of PAD associated with diabetic foot and the relationship between PTA and amputation in predicting prognosis. However, no such multi-year data are available in Korea. Thus, the purpose of this study was to investigate trends of amputation involving diabetic foot based on vascular interventions for PAD in Korea. METHODS: This study was conducted using six-year data obtained from Health Insurance Review and Assessment Service from January 1, 2011 to December 31, 2016. Our study included data pertaining to diabetic foot, PAD, and vascular intervention codes (percutaneous transluminal angioplasty [PTA, M6597], percutaneous intravascular installation of stent-graft [PIISG, M6605], and percutaneous intravascular atherectomy [PIA, M6620]). We analyzed the number of vascular interventions and minor and major amputations each year. The relationship between annual amputation and vascular intervention was analyzed using χ² test. RESULTS: The overall number of vascular interventions increased from 253 (PTA, 111; PIISG, 140; and PIA, 2) in 2011 to 1,230 (PTA, 745; PIISG, 470; and PIA, 15) in 2016. During the same period, the number of minor amputations increased from 2,534 to 3,319 while major amputations decreased from 980 to 956. The proportion of minor amputations among patients who underwent vascular intervention was significantly increased from 19.34% in 2011 to 21.45% in 2016 while the proportion of major amputations among these patients was significantly reduced from 9.88% to 4.27%. In addition, the association between vascular intervention and amputation increased from 0.56 (spearman correlation coefficient) in 2011 to 0.62 in 2016. CONCLUSION: In diabetic foot patients, increase in vascular intervention resulted in a change in amputation pattern, showing statistically significant correlation.
Subject(s)
Humans , Amputation, Surgical , Angioplasty , Atherectomy , Diabetic Foot , Epidemiology , Insurance, Health , Korea , Lower Extremity , Peripheral Arterial Disease , Prognosis , Risk FactorsABSTRACT
PURPOSE: With advancements in antibiotics, the ability to treat pyogenic spondylitis is increasing. This study aimed to compare and analyze the outcomes between conservative and operative treatments. MATERIALS AND METHODS: Sixty patients (28 males and 32 females) with pyogenic spondylitis, who were hospitalized and treated between February 2008 and June 2016, were enrolled. Patients were divided according to the following: type of treatment – conservative or operative treatment, method of surgery, radiographic parameters, location of the affected spine. Clinical parameters as durations of hospital stay, intravenous antibiotics use, normalization in laboratory findings, and residual symptoms were analyzed. For statistical evaluation, independent-sample t-test, Mann-Whitney U-test, Pearson's chi-square test, one-way ANOVA, and Spearman correlation analysis were performed retrospectively. RESULTS: There was no significant difference in the duration of hospital stay, intravenous antibiotics use, normalization in laboratory findings, and residual symptoms between the conservative and operative treatment groups. CONCLUSION: In treating pyogenic spondylitis, conservative treatment can be considered as the first choice, and operative treatment can be chosen in refractory cases.
Subject(s)
Humans , Male , Anti-Bacterial Agents , Length of Stay , Methods , Retrospective Studies , Spine , SpondylitisABSTRACT
PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.
Subject(s)
Humans , Male , Follow-Up Studies , Hip , Methods , Sensation , Visual Analog ScaleABSTRACT
PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.
Subject(s)
Humans , Male , Follow-Up Studies , Hip , Methods , Sensation , Visual Analog ScaleABSTRACT
BACKGROUND: The purpose of this study was to compare the clinical and radiological results of 2 different tibial fixations performed using bioabsorbable screws with added hydroxyapatite (HA) and pure poly-L-lactic acid (PLLA) screws in anterior cruciate ligament (ACL) reconstruction. METHODS: A total of 394 patients who underwent arthroscopic ACL reconstruction between March 2009 and June 2012 were retrospectively reviewed. Of those, 172 patients who took the radiological and clinical evaluations at more than 2 years after surgery were enrolled and divided into 2 groups: PLLA group (n = 86) and PLLA-HA group (n = 86). Both groups were assessed by means of the Lysholm score, International Knee Documentation Committee (IKDC) subjective knee score, and Tegner activity score. Stability was evaluated using the KT-2000 arthrometer. Magnetic resonance imaging was performed to evaluate tibial tunnel widening, screw resorption, osteoingeration, and foreign body reactions. RESULTS: The PLLA-HA group showed significant reduction in the extent of tibial tunnel widening and foreign body reactions and significant increase in screw resorption compared to the pure PLLA group (p < 0.001 for both). In contrast, postoperative Lysholm score, Tegner activity score, IKDC score, and side-to-side difference on the KT-2000 arthrometer showed no significant differences between groups (p = 0.478, p = 0.906, p = 0.362, and p = 0.078, respectively). The PLLA group showed more significant widening in the proximal tibial tunnel than the PLLA-HA group (p = 0.001). In the correlation analysis, proximal tibial tunnel widening revealed a positive correlation with knee laxity (r = 0.866) and a negative correlation with Lysholm score (r = −0.753) (p < 0.01 for both). CONCLUSIONS: The HA added PLLA screws would be advantageous for tibial graft fixation by reducing tibial tunnel widening, improving osteointegration, and lowering foreign body reactions. Even though no clinically significant differences were noted between the pure PLLA group and PLLA-HA group, widening of the proximal area of the tibial tunnel showed a tendency to increase knee laxity measured using the KT-2000 arthrometer.
Subject(s)
Humans , Anterior Cruciate Ligament , Durapatite , Foreign Bodies , Knee , Lysholm Knee Score , Magnetic Resonance Imaging , Retrospective Studies , TransplantsABSTRACT
The optimal treatment for combined osteochondritis dissecans (OCD) with considerable bony defect of the lateral femoral condyle (LFC) and torn discoid lateral meniscus is unclear. We present a case of a 15-year-old female who was a gymnast and had a large OCD lesion in the LFC combined with deficiency of the lateral meniscus. The patient underwent the "one-step" technique of osteoperiosteal autologous iliac crest graft and lateral meniscus allograft transplantation after a failure of meniscectomy with repair at another hospital. Twenty-four months postoperatively, clinical results were significantly improved. Follow-up imaging tests and second-look arthroscopy showed well incorporated structured bone graft and fibrous cartilage regeneration as well as stabilized lateral meniscus allograft. She could return to her sport without any pain or swelling. This "one-step" surgical technique is worth considering as a joint salvage procedure for massive OCD lesions with torn discoid lateral meniscus.
Subject(s)
Adolescent , Female , Humans , Allografts , Arthroscopy , Autografts , Cartilage , Follow-Up Studies , Joints , Knee , Menisci, Tibial , Osteochondritis Dissecans , Regeneration , Sports , Tears , Transplantation , TransplantsABSTRACT
PURPOSE: This study aims to evaluate magnetic resonance imaging (MRI) findings in young adults with symptomatic Osgood-Schlatter disease (OSD) and compare those in young adults without OSD. MATERIALS AND METHODS: We compared MRI findings between young adults with OSD (OS group, n=30) and the equivalent number of young adults without OSD (control group). Visual analog scale scores and Kujala scores were evaluated and correlation analysis was performed in the OS group. RESULTS: In the OS group, MRI revealed that the patellar tendon was attached to the tibia more widely, resulting in a reduced free tendon portion, and more proximally to the articular surface (p<0.001). The correlation analysis between MRI findings and clinical scores showed statistically significant correlations (p<0.01). In the OS group, 43% presented with patellar tendinopathy or bone marrow edema at the distal attachments. CONCLUSIONS: Compared to the control group, the relatively small free portion and relatively proximal attachment of the patellar tendon were observed with MRI in the OS group. The free portion of the patellar tendon was positively correlated with the clinical scores. Patellar tendinopathy was also frequently encountered in the OS group.
Subject(s)
Humans , Young Adult , Bone Marrow , Edema , Knee , Magnetic Resonance Imaging , Osteochondrosis , Patellar Ligament , Tendinopathy , Tendons , Tibia , Visual Analog ScaleABSTRACT
BACKGROUND/AIMS: To evaluate a new monoclonal antibody for Helicobacter pylori urease in gastric tissue. METHODS: A total of 107 volunteers were enrolled. All subjects underwent a 13C-urea breath test and esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia. Six biopsy specimens in the gastric antrum and body were obtained for a rapid urease test and histology. The new monoclonal antibody-based H. pylori urease test (HPU) was performed to rapidly and qualitatively detect urease in two biopsy specimens. RESULTS: H. pylori infection was diagnosed in 73 subjects. The sensitivity and specificity of the HPU was 89% and 74%, respectively. The subjects were divided into two groups: one with true-positive and true-negative HPU results (n = 90) and the other with false-positive and false-negative HPU results (n = 17). Across all subjects, ammonia levels were 900.5 +/- 646.7 and 604.3 +/- 594.3 mumol/L (p > 0.05), and pH was 3.37 +/- 1.64 and 2.82 +/- 1.51 (p > 0.05). Sensitivity was higher in the presence of atrophic gastritis or intestinal metaplasia. CONCLUSIONS: HPU detected H. pylori in approximately 10 min. Gastric aspirate ammonia and pH levels did not affect the test results. Sensitivity was good in the presence of atrophic gastritis or intestinal metaplasia.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Antibodies, Monoclonal/immunology , Bacterial Proteins/analysis , Biomarkers/analysis , Biopsy , False Negative Reactions , False Positive Reactions , Gastritis, Atrophic/diagnosis , Helicobacter Infections/diagnosis , Helicobacter pylori/enzymology , Immunologic Tests , Metaplasia , Predictive Value of Tests , Pyloric Antrum/microbiology , Reproducibility of Results , Time Factors , Urease/analysis , WorkflowABSTRACT
Although the incidence of sciatic nerve palsy following total hip arthroplasty is low, this complication can cause devastating permanent nerve palsy. The authors experienced a case of sciatic nerve palsy caused by ruptured and contracted external rotator muscles following total hip arthroplasty in a patient suffering from osteonecrosis of the femoral head. We report this unusual case of sciatic nerve palsy with a review of the literature.
Subject(s)
Humans , Arthroplasty , Arthroplasty, Replacement, Hip , Head , Incidence , Muscles , Osteonecrosis , Paralysis , Sciatic NeuropathyABSTRACT
BACKGROUND/AIMS: The objective of this study was to evaluate a monoclonal antibody-based test to detect Helicobacter pylori-specific antigen in gastric aspirates from humans. METHODS: Sixty-one volunteers were enrolled in the study. All of the subjects underwent a 13C-urea breath test (UBT) before esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia and used for polymerase chain reaction (PCR), culture, and monoclonal antibody-based detection of H. pylori. Multiple biopsies of the gastric antrum and body were obtained for a rapid urease test (RUT) and histological evaluation. RESULTS: Thirty-six subjects were H. pylori-positive and 25 were H. pylori-negative according to the UBT results. Compared with the H. pylori-negative subjects, H. pylori-positive subjects had a higher pH (4.77+/-1.77 vs 3.49+/-1.30, p<0.05) and ammonia level (1,130.9+/-767.4 vs 184.2+/-126.3, p<0.0001). The sensitivities and specificities of the PCR test, RUT, culture test, and monoclonal antibody-based test were 100% and 72%, 89% and 100%, 47% and 100%, and 78% and 100%, respectively. CONCLUSIONS: The monoclonal antibody-based test for diagnosing H. pylori infection in gastric aspirates has increased sensitivity compared with the culture test and specificity as high as that of the RUT. The test may be useful as an additive test for examining gastric aspirates.
Subject(s)
Ammonia , Biopsy , Breath Tests , Endoscopy, Digestive System , Helicobacter , Helicobacter pylori , Hydrogen-Ion Concentration , Polymerase Chain Reaction , Pyloric Antrum , Sensitivity and Specificity , UreaseABSTRACT
Revision rates of total hip arthroplasty have decreased after introducing total hip arthroplasty (THA) using ceramic component, since ceramic components could reduce components wear and osteolysis. The fracture of a ceramic component is a rare but potentially serious event. Thus, ceramic on polyethylene articulation is gradually spotlighted to reduce ceramic component fracture. There are a few recent reports of ceramic head fracture with polyethylene liner. Herein, we describe a case of a ceramic head component fracture with polyethylene liner. The fractured ceramic head was 28 mm short neck with conventional polyethylene liner. We treated the patient by total revision arthroplasty using 4th generation ceramic on ceramic components.
Subject(s)
Adult , Female , Humans , Arthroplasty, Replacement, Hip/methods , Ceramics/therapeutic use , Hip Prosthesis , Polyethylene/therapeutic use , Prosthesis FailureABSTRACT
The authors experienced a case of early fracture of an alumina ceramic liner after ceramic-on-ceramic total hip arthroplasty, without any history of trauma. A 47-year-old male visited our center, due to a sudden crunching sound from the right hip at three weeks, after a ceramic-on-ceramic total hip arthroplasty for the osteonecrosis of right femoral head. Plain radiographs revealed multiple radio-opaque fragments around the displaced neck of the femoral stem. There were severely comminuted fracture of the ceramic liner with slight black staining of the surrounding tissue, and even damaged the surface of the ceramic head, on the operative field. The fractured liner and a damaged head were replaced with a new ceramic liner and head, after the removal of the fractured ceramic fragments, as completely as possible. Careful follow up with a caution for early ceramic liner fracture should be required in ceramic-on-ceramic total hip arthroplasty.