The Early Result of Cementless Arthroplasty for Femur Neck Fracture in Elderly Patients with Severe Osteoporosis / 대한고관절학회지

PURPOSE: The purposes of the current study were to assess the early results of cementless hip arthroplasty (HA) for femoral neck fractures in elderly patients with severe osteoporosis and to compare the clinical outcomes between those who underwent total HA (THA) or bipolar hemiarthroplasty (BHA). MATERIALS AND METHODS: From April 2011 to May 2012, we performed 87 cementless HAs for displaced femoral neck fractures in elderly patients (> or =65 years) with severe osteoporosis. Among them, we studied 70 hips that were able to be followed-up for >24 months. Of these, 34 underwent THA and 36 underwent BHA. Clinical results were evaluated using the Harris hip score (HHS), Koval classification, and radiographs. RESULTS: Only one instance of femoral stem loosening was observed. Additionally, no dislocations were observed and no revision surgeries were required. The mean changes in the functional items of the HHS scores were 2.8 and 5.2 for those who underwent THA and BHA, respectively (P<0.05). According to the Koval classification used for the ambulatory status analysis, the mean perioperative change in the grade was 0.8 (0-4), with no significant differences noted between the THA and BHA groups. CONCLUSION: The early results of cementless HA for femur neck fractures in elderly patients with osteoporosis were satisfactory, and THA was found to have a functional advantage over BHA.

Giant Intramuscular Lipoma in the Back after a Blunt Trauma: A Case Report

STUDY DESIGN: Case report. OBJECTIVES: To report a case of a giant intramuscular lipoma after a blunt trauma. SUMMARY OF LITERATURE REVIEW: Lipomas are the most frequent benign tumor of the mesenchymal tissue. Although the etiopathogenesis is not complete understood yet, it is known that lipoma develope with a 1% rate after traumas in the related localizations. Traumata induce hematoma and initiates inflammatory reactions in fatty tissue and can trigger the development of lipoma. MATERIALS AND METHODS: 2 years after a blunt trauma a 56years male patient developed a back mass. A massive lipoma was confirmed clinical and radiological. RESULTS: A total excision was performed and the result was histopathologic confirmed. CONCLUSIONS: Patients who develop hematoma after a trauma need a close lipoma progress observation which decrease the invasive treatment of post-trauma hematoma.

Primary Cementless Total Hip Arthroplasty with a Sandwich Type in Ceramic-Ceramic Articulation (Minimum 10-Year Follow up Results)

PURPOSE: To evaluate the minimum 10-year follow up results of primary total hip arthroplasty (THA) performed using a sandwich-type (alumina-polyethylene-titanium) ceramic bearing. MATERIALS AND METHODS: Thirty four patients (40 hips) who underwent a THA with sandwich typed liners from November 1998 to December 2000 were analyzed. Among the 34 patients, 25 were men and nine were women. Mean follow-up was 134 months (range, 120~145 months) and mean patient age at the time of THA was 47.1 years (range, 24~65 years). The clinical results were evaluated using the Harris hip score and level of thigh pain with a limping gait. The radiographic evaluation was done in terms of the endosteal new bone formation, radiolucent line, subsidence of the stem, migration of the acetabular cup, and proof of loosening. RESULTS: The mean preoperative Harris hip score of 50.2 points (range, 31~87 points) was improved to 90.9 points (range, 75~99 points) at the final follow-up and thigh pain with limping gait in one case. All cases had fixation by bony ingrowth. No radiographically detectable loosening was observed in any hip. Fracture of ceramic liner in one case required change of the polyethylene liner. CONCLUSION: At the minimum 10-year follow up, survival rate as the end-point was favorable. However, fracture of the ceramic is still a major problem. Satisfactory results can be obtained by more precise surgical technique for acerabular inclincation and anteversion, and by improving the quality of the ceramic.

Modular Cementless Total Hip Arthroplasty with Subtrochanteric Shortening Osteotomy in Patients with High Hip Dislocation

PURPOSE: The purpose of this study was to report on the results of performing modular cementless total hip arthroplasty with a simultaneous subtrochanteric shortening osteotomy in patients with high hip dislocation. MATERIALS AND METHODS: We evaluated 23 patients (24 hips) with high hip dislocation and who had undergone total hip arthroplasty using a proximally modular cementless stem in combination with a subtrochanteric shortening osteotomy in order to place the acetabular cup at the level of the anatomic hip center between May 1996 and June 2008. There were 6 males and 17 females with a mean age of 44 years. The mean duration of follow-up was 5.6 years. RESULTS: The mean Harris hip score improved from 53 points preoperatively to 88 points at the time of final follow-up (P<0.001), and there were good or excellent results in 21 hips (87.5%). There was one instance of isolated loosening of the acetabular component. With the exception of one hip requiring revision surgery at 12 years postoperatively because of polyethylene wear and cup loosening, all the remaining components were well-fixed at the time of the last follow-up. A total of 4 hips (17%) had complications during follow-up; one dislocation, two transient femoral nerve palsies and one nonunion of the subtrochanteric osteotomy site. CONCLUSION: Modular cementless total hip arthroplasty with a subtrochanteric shortening osteotomy in patients with high hip dislocation was associated with excellent clinical outcomes while it minimized additional fixation of the osteotomy site.

Analysis of Early Failures in Total Knee Arthroplasty / 대한정형외과학회잡지

PURPOSE: To analyze the cause of failure and average period in patients who had revision surgery within 5 years of their primary total knee arthroplasty (TKA). MATERIALS AND METHODS: 786 total knee arthroplasties were performed between August 1994 and May 2003. During the period, there were 38 cases, 36 females and 2 males, of revision surgery within 5 years. The mean age was 66 years. The most common causes of disease in revision were degenerative arthritis. We analyzed the reasons for early failure retrospectively. RESULTS: Revision TKA were performed at average 2 years after primary TKA. The causes of revision were polyethylene wear in 18 cases (47.4%), deep infection in 16 (42.1%), instability in 2, and aseptic loosening in 1, dissociation of patella component in 1. The degree of varus in tibial cutting was 5.1degrees in average in polyethylene wear group. The obliquity of the tibial joint line was more than 3degreesvarus in 14 cases (82.4%). Most patients had their knee in hyperflexion and squatting position during activities of daily living. CONCLUSION: Thirty eight cases (4.8%) were performed revision surgery within 5 years of primary TKA. Polyethylene wear and deep infection were the common causes of early failure of primary TKA. The component malalignment, hyperflexion and squatting position during activities of daily living may be related to polyethylene wear. Diabetes mellitus and long term steroid application, may be related to infection.

Physical Features, Karyotypes and Dermatoglyphics of 113 Children with Down Syndrome

No abstract available.

A Clinical Review of Congenital Anomalies in Neonates

No abstract available.

Two Cases of Patau Syndrome

No abstract available.