• Journal of the Korean Society for Precision Engineering
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• v.24 no.2 s.191
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• pp.140-148
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• 2007

THRA(Total Hip Replacement Arthroplasty) has been widely used for several decades as a viable treatment of otherwise-unsolved hip problems. In THRA surgery, cement mantle thickness is critical to long-term implant survival of femoral stem fixed with cement. Numerous studies reported thin or incomplete cement mantle causes osteolysis, loosening, and the failure of implant. To analyze the effect of femoral stem rotation on cement thickness, in this study, we select two most popular stems used in THRA. Using CAD models obtained from a 3D scanner, we measure the cement mantle thickness developed by the rotation of a femoral stem in the virtual space created by broaching. The study shows that as the femoral stem deviates from the target coordinates, the minimum thickness of cement decreases. Therefore, we recommend development of a new methodology for accurate insertion of a femoral stem along the broached space. Also, modification of the stem design robust to the unintentional movement of a femoral stem in the broached space, can alleviate the problem.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• Journal of the Korean Society for Precision Engineering
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• v.29 no.6
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• pp.680-685
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• 2012

Ceramic femoral heads are now widely used in Total Hip Replacement (THR). Due to their high biocompatibility and low ductility, ceramic femoral heads are considered to be suitable for young and active patients. However, as in testing the mechanical stability of the femoral head, the conventional proof test (standard ISO 7206-10) has its limit of showing axisymmetric stress distribution on the contact surface, while non-uniformed stress distribution is expected after THR. Since non-uniformed stress distribution can result in the increased probability of ceramic femoral head fracture, it is considerable to evaluate the stress distribution in vivo-like conditions. Therefore, this study simulated the ceramic femoral heads under in vivo-like conditions using finite element method. The maximum stress decreased when increasing the size of the femoral head and stress distribution was concentrated on superior contact surface of the taper region.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.2
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• pp.239-247
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• 2003

Purpose: The purpose of this study is to examine how well patients who had hip arthroplasty comply with medical regimens given to them after the operation. Method: The subjects of the study were patients who had arthroplasty at P Hospital between April 1, 2001 and August 30, 2002. 20 patients of the subjects experienced complications after the operation and the other 20 did not. Data from a survey using the qustionnaire were statistically analyzed in terms of real number, percentage point, mean and standard deviation by using $X^2$-test, t-test and ANOVA. Result: 1) the surveyed patients were significantly different in the compliance of medical regimen among them according to their education background as one of the subjects general characteristics. 2) It was found that the group of complication was higher in the compliance of medical regimen than that of non-complication. The two groups showed statistically significant difference with each other in the degree of compliance with therapeutic instructions than the experimental group in terms of the maintenance of abduction after the operation, training instructions on step-by-step basis, urination cotrol on bed, accurate use of crutch, compliance with medication, balance among medical treatment, training, leisure, rest and nutrition, instructions by physicians, nurses and physical therapists, use of low armchairs and toilet bowels and no bending of the body forward, and use of a non-operated leg in case of go upstairs or downstairs. Conclusion: It seems necessary to develop systematic and sessional education programs for improving the compliance of medical regimen, ultimately reducing complications following hip arthroplasty.

• Proceedings of the KSME Conference
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• 2001.06c
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• pp.482-484
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• 2001

In orthopedics, hip arthroplasty is the operation that replaces damaged hip joint to artificial joint. In hip arthroplasty, quite better result can be achieved if robot is applied to machine cavity in bone, especially when cementless stem is used. So several kinds of robots were introduced for hip arthroplasty, but they used MRI, CT Scan, vision analysis and real time tracking of bone position for registration of robot. To overcome shortage of conventional robot surgery, gauge based registration method was proposed and small robot was designed. In this method, small robot is mounted on femur, and its position is determined by gauge registration method. Operation procedure was performed on model femur and result was analyzed. This robotic hip surgery system is expected to more adaptable in operation room.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.7
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• pp.31-37
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• 2009

• Journal of Yeungnam Medical Science
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• v.9 no.2
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• pp.218-223
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• 1992

Serum C-reactive protein(CRP) levels and erythrocyte sedimentation rates(ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.3-7
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• 2014

Purpose SPECT/CT scan to be performed attenuation correction on the basis of CT induce an overestimation of the site due to the beam hardening artifact by metal cover and reduce the images quality. Therefore, this study using a phantom that has been inserted artificial hip joint investigated that effect on the SPECT/CT image causing by metal artifact for varying the parameters of the Attenuation Map. Materials and Methods Siemens Symbia T16 SPECT/CT equipment was used. Artificial hip joint was inserted to SPECT/PET phantom, 17 mm sphere of Bright Streak area in CT image was filled with Tc-99m so that the radiation activity was 8 times compared to background. And then Hot and Background was measured in varying Wide Beam Coefficient on Attenuation Map and RBR (Region to Background Ratio) of Metal and Non-Metal was calculated and analyzed depending on the presence or absence of the hip joint. Results It tended to hot count of Non-Metal and Metal to increase as the value of the manual mode is increased, hot count ratio with the group of both manual mode 0.5 and 0.4 is the best match. Also, in automatic mode, the ratio of RBRNon-Metal and RBRMetal was 1.135, statistically significant difference was not observed in the manual mode 0.5 and 0.4. Conclusion In the automatic mode of Wide Beam Coefficient in attenuation correction map, it was found that it is over-correction by 13.52%, it was possible to minimize the over-correction by the artifact in 0.5 and 0.4 of manual mode. Further studies should be performed in order to apply to a patient with the help of this and it is considered possible to reduce the over-correction by the metal artifact of an artificial hip joint for Hip-Resurfacing Arthroplasty patients, and to improve the diagnostic performance.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.30-36
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• 2019

Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.115-122
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• 2018

The success of the total hip arthroplasty is revealed as initial stability, range of motion, and long term pain, etc. Depending upon choice of implantation options such as femoral neck offset, diameter of the femoral head, the lateral opening tilt. Especially the impingement between femoral head component and acetabular cup limits the range of motion of the hip. In this sense, estimation or evaluation of the range of motion before and after the total hip arthroplasty is important. This study provides the details of a computer simulation technique for the hip range of motion of intact hip as well as arthroplasty. The suggested method defines the hip rotation center and rotation axes for flexion and abduction, respectively. The simulation uses CT-based reconstructed 3D models and an STL treating software. The abduction angle of the hip is defined as the superolateral rotation angle from sagittal plane. The flexion angle of the hip is defined as the superoanterior angle from the coronal plane. The maximum abduction angle is found as the maximum rotation angle by which the femoral head can rotate superolaterally about the anterior-posterior axis without impingement. The maximum flexion angle is found as the maximum rotation angle by which the femoral head can rotate superoanteriorly about the medial-lateral axis without impingement. Compared to the normal hip, the total hip replacement hip showed decreased abduction by 60 degrees and decreased flexion by 4 degrees. This measured value implies that the proposed measurement technique can make surgeons find a modification of increase in the femoral neck offset or femoral head, to secure larger range of motion.