• Title/Summary/Keyword: Femoral bone loss

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Management of Severe Bone Defects in Femoral Revision following Total Hip Arthroplasty

  • Yicheng Li;Li Cao
    • Hip & pelvis
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    • v.36 no.2
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    • pp.101-107
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    • 2024
  • Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porous-coated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.

Design of A Femoral IM Nail by analysis of Lateral Curve Angle (한국형 Femoral IM Nail 설계를 위한 표준 Lateral 휨각도 분석)

  • Kim, Sung-Min;Park, Sung-Yun;Lee, Man-Pyo
    • Journal of the Korean Society for Precision Engineering
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    • v.22 no.11 s.176
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    • pp.190-195
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    • 2005
  • A Femur is the longest and largest bone which supports body in human musculoskeletal structure. Therefore, it may cause heavy loss of blood when it is suffered by a simple or complex fracture, and the complication is very dangerous with a possibility of severe tissue damage. In this study, the femoral cancellous angle change is estimated in order to design the Korean femoral IM nail. Generally, it is various in the size and curvature of femoral cancellous bone depending on patient's body dimension. Therefore surgeon has difficulty in fitting this femoral IM nail to the patient in the surgical procedure. In our study, we tries to estimate femoral lateral curve angle with more precise method based on CT image of the femur and utilize this information on the design of femoral IM nail for Korean patients.

A Study on the Factors Affecting Bone Mineral Density in Adult Women - Based on the Mothers of Elementary School Students- (일부 초등학생의 어머니를 대상으로 한 성인 여성의 골밀도에 영향을 미치는 요인에 관한 연구)

  • 김기랑
    • Journal of Nutrition and Health
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    • v.33 no.3
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    • pp.241-249
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    • 2000
  • The bone mineral density(vertebrae Ll-4, femoral neck, Ward's triangle and trochanter) of 160 healthy adult women aged 29-45 was measured and general characteristics, anthropomentric measurements, and dietary intake were also studied to determine the main factors affecting the bone mineral density(BMD) of adult women. The nutrient intake of the subjects was adequate to RDA level except energy, Ca, Fe, and vit A. The BMD of vertebrae L24 showed significant positive association with nutrient intake such as animal protein, P, Ca(animal) and Fe(animal). The BMD of the femoral neck correlated significantly with anthropometric measurements such as height, weight, waist circumference, hip circumference, body fat and body mass index. The BMD of both sites(vertebrae L24 and femoral neck) were significantly related to vertebrae L24 was daily Ca intake and that of femoral neck was daily energy expenditure. In conclusion, adequate nutrient intake, especially protein, P, Ca and Fe as well as increases in physical activity were suggested to prevent the loss of bone mineral density in adult women.

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Usefulness of panoramic radiography in the diagnosis of osteoporosis (골다공증의 진단시 파노라마 방사선사진 유용성에 대한 연구)

  • Lee Byeong-Do;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.31 no.2
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    • pp.67-71
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    • 2001
  • Purpose: To assess the possibility of using panoramic indices as an indicator of jaw osteoporosis. Methods: Mandibular cortical width (MCW), degree of mandibular alveolar bone resorption (ABR) and morphology of mandibular inferior cortex (MIC) on panoramic radiograph were used as panoramic indices. These panoramic indices were compared with bone mineral density (BMD) of lumbar (L1-L4) and femoral neck measured by dual energy X-ray absorptiometry. We also compared MCW and ABR of young men with those of postmenopausal women. Results : There was a significant correlation between ABR and BMD of lumbar and femoral neck. And also significant correlation between MIC and BMD of lumbar and femoral neck. ANOVA test of BMD of lumbar and femoral neck showed significant differences according to morphologic classification of inferior cortex. There was significant difference in MCW and ABR between young men and postmenopausal women. Conclusion: Our results suggested that ABR and MIC on panoramic radiograph could be reliable in screening of osteoporosis.

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Treatment of Open Calcaneal Fracture with Massive Bone Loss using Femoral Head Allograft and Myocutaneous Free Flap (A Case Report) (종골 외측 1/2 이상의 결손을 동반한 개방성 골절의 동종 대퇴골두 이식과 유리 피판술을 이용한 치료 (1예 보고))

  • Sung, Ki-Sun;Eun, Sang-Soo;Mun, Goo-Hyoun
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.111-114
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    • 2007
  • Open calcaneal fracture with more than lateral half of bone loss and soft tissue defect occurred in 17 year-old male patient due to motor vehicle accident. Soft tissue defect included heel pad, peroneal tendon. Bone loss involved mainly most part of inferior tuberosity but not subtalar joint. Open dressing and debridement were done daily in operating room and antibiotics administration was started. After granulation tissue formed, femoral head allograft was performed and fixed with 6.0 mm screws to replace bone defect. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap. No sign of infection nor major osteolysis was observed in 15 months follow up period. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap.

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Age-Related Bone Mineral Density, Accumulated Bone Loss Rate at Multiple Skeletal Sites in Korean Men (한국 남성의 연령에 따른 부위별 골밀도 변화 및 골 소실률)

  • Kim, Young-Ran;Lee, Tae-Yong;Lee, Ji-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3781-3788
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    • 2014
  • This study examined the age-related bone mineral density (BMD), accumulated bone loss rate (ABLR) at different skeletal sites in Korean men using the data from the Korea National Health and Nutrition Examination Survey (KNHANES)(the 1st (2010), 2nd (2010) and the year at the 5th survey). The cubic regression model was found to be the best for describing the age-related changes in BMD. The lumbar spine, total hip, femoral neck, trochanter, Ward's triangle in the bone mineral density difference were analyzed by ANOVA. The peak BMD was at 20-24 years at the lumbar spine, total hip, femoral neck, trochanter, Ward's triangle, and the 75-79 years of age group had the highest Accumulated Bone Loss Rate. Therefore, intensive management will be necessary for men over 75 years, and a diagnosis of osteoporosis in Korean men should be made according to The International Society for Clinical Densitometry; ISCD.

Biomechanical characteristics of the distal filling effects in cementless femoral stem (무시멘트형 대퇴스템에서 원위부 압박 정도에 따른 생체역학적 특성)

  • Park, Sang-eok;Park, Jae-Won;Chae, Soo-Won
    • Proceedings of the KSME Conference
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    • 2000.04a
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    • pp.387-392
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    • 2000
  • In cementless total hip replacement(THR), an initial stability of the femoral component is important to long term fixation of femoral stem. The initial stability has close relationship with the relative displacement of prosthesis and spongy bone at the proximal of femur. After implantation of the prosthesis. the surrounding bone is partially shielded from load carrying and starts to resort. Stress shielding is the cause of the loss of proximal bone. Assessing stress distribution of femur is important to predict stress shielding. The initial stability and the stress shielding were investigated for two loading conditions approximating a single leg stance and a stair climbing. Three types of stems were studied by the finite element method to analyze the biomechanical effects of distal filling of cementless femoral stems, Three types of stems employed are a distal filling stem, a distal flexible stem, and a distal tapered stem.

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Inhibitory effect of Ssanghwa-tang on bone loss in ovariectomized rats

  • Shim, Ki-Shuk;Lee, Ji-Hye;Ma, Choong-Je;Lee, Yoon-Hee;Choi, Sung-Up;Lee, Jae-Hoon;Ma, Jin-Yeul
    • Animal cells and systems
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    • v.14 no.4
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    • pp.283-289
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    • 2010
  • Ssanghwa-tang (SHT) is a traditional Korean herbal medicine widely prescribed to decrease fatigue following an illness. The purpose of this study was to investigate the effects of SHT on osteoclast differentiation in vitro, and on bone loss in ovariectomized (OVX) rats in vivo. SHT significantly reduced the receptor activator for the nuclear factor ${\kappa}B$ (NF-${\kappa}B$) ligand (RANKL)-induced tartrate-resistant acid phosphatase (TRAP) activity, and multinucleated osteoclast formation in RAW264.7 cells without affecting cell viability. In addition, SHT significantly attenuated RANKL-induced mRNA expression levels of c-Src and cathepsin K. To examine the in vivo effect of SHT on OVX-induced bone loss in OVX rats, we administered SHT (0.6 g/kg BID) orally to OVX rats for 12 weeks. SHT administration significantly blocked OVX-induced decrease of femoral bone mineral density (BMD) and femoral trabeculae in OVX rats. In conclusion, these results suggest that SHT treatment effectively prevents OVX-induced bone loss, and this effect may result from its inhibitory effect on osteoclast differentiation.

A Study for Improvement of the Femoral Stem Type using the Finite Element Analysis (유한요소법을 이용한 인공고관절 주대형태의 개선에 대한 연구)

  • 윤경렬;원예연;이수훈
    • Korean Journal of Computational Design and Engineering
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    • v.5 no.2
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    • pp.122-126
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    • 2000
  • A major mechanical problem with total hip replacement is the loosening of the femoral component. The loss of proximal support, with firm fixation distally, has been thought to be a major caused of fatigue failure of femoral stems. While many causes have been proposed, the most frequently suggested cause of the calcar resorption is the disuse atrophy of the cortex of the calcar due to the stress shielding of the proximal bone by the metal femoral stem. In this research, the new-designed stem(modified collar stem) was considered which made a hole inside stem and had a 3 mm thickness. Using the 3-dimensional finite element methods, the common collar stem and the modified colla stem was modeled and analysed. Also, the two models was compared. The results showed that the modified collar stem decreased the stress-shielding and it made a effective load transfer at the entire femoral region.

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Fermented soybeans by Rhizopus oligosporus reduce femoral bone loss in ovariectomized rats

  • Yoo, Hyun-Wook;Chang, Moon-Jeong;Kim, Sun-Hee
    • Nutrition Research and Practice
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    • v.8 no.5
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    • pp.539-543
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    • 2014
  • BACKGROUND/OBJECTIVES: Soy isoflavones are structurally similar to estrogen and bind to estrogen receptors, suggesting that they exhibit estrogenic activities; therefore, they are referred to as phytoestrogens. Fermentation may affect the bioavailability of isoflavones altering soy isoflavone glycosides in the form of aglycones. Thus, this study investigated the effects of fermented soybeans by Rhizopus oligosporus on bone metabolism in both young rats as a pilot test and in ovariectomized (ovx) old rats as a model of menopause. MATERIALS/METHODS: In the pilot test, a total of 24 seven-week-old female Sprague-Dawley (SD) rats were fed one of three diets for a period of four weeks: casein, unfermented soybean product, or fermented soybean product by R. oligosporus. In the ovx rat model, 20-week-old SD rats weighing 260-290 g underwent either sham-operation (n = 10) or bilateral ovariectomy (n = 30) and were then fed the AIN-93M diet for one week. Thereafter, rats were fed sham-casein, ovx-casein, ovx-soybean, or ovx-fermented soybean diet for five weeks. After decapitation, femoral bones were isolated and preserved in 9% formalin for assessment of bone mineral density (BMD), bone mineral content (BMC), and bone-breaking strength (BBS). RESULTS: Ovx rats showed significantly increased weight gain and decreased uterine wet weight. Of particular interest, ovx rats fed fermented soybeans showed increased uterine wet weights compared to control rats. Fermented soybean diet caused a significant increase in plasma 17-${\beta}$ estradiol concentrations in young rats, and 17-${\beta}$ estradiol levels were enhanced in ovx rats to match those of sham-operated ones. Significantly lower femoral BMD and BMC were observed in ovx rats compared to sham-operated controls, whereas bone areas did not differ statistically among the groups. In addition, BBS tended to be increased in ovx rats fed soybeans and fermented soybeans. CONCLUSIONS: Supplementation of fermented soybeans could have preventive and therapeutic effects against osteoporosis in postmenopausal women.