• Hip & pelvis
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• 제36권1호
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• pp.12-25
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• 2024

Protrusio acetabuli, or abnormal protrusion of the femoral head into the acetabulum, requires performance of a total hip arthroplasty (THA) for which various reconstruction techniques and outcomes have been described. The aim of this systematic review is to provide a comprehensive analysis of the current evidence, evaluate treatment efficacy, compare surgical techniques, and identify topics for future research along with improving evidence-based decision-making, improving patient outcomes in the management of this condition. A thorough systematic review of the PubMed, Embase, Cochrane Library databases, and Scopus library was conducted, and articles describing techniques of THA for treatment of protrusion acetabuli were extracted. The initial search generated 751 results. After exclusion, 18 articles were included. Of these, eight were prospective studies and 10 were retrospective. Surgery was performed on 783 hips with a mean age of 60 years; 80% of females who mostly had inflammatory arthritis were followed up for 8.86 years (range, 2-15.4 years). Good outcomes have been achieved with THA using uncemented cups with bone graft; however, no conclusion could be drawn with regard to the femoral side. It can be concluded that the concept of restoration of the anatomical hip center of rotation is paramount for good outcome and better survival of the implant is important when using uncemented cups with a bone graft. In addition, screw augmentation for fixation is not recommended unless absolutely necessary. The most common complications were aseptic loosening and heterotopic ossification. While the former required revision, conservative management was administered for the latter.

• Hip & pelvis
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• 제34권3호
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• pp.185-190
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• 2022

Septic arthritis (SA) is a joint inflammation that develops secondary to infectious causes. SA in children is associated with a high rate of morbidity and mortality; therefore, it is regarded as an orthopedic emergency. Because SA of the hip joint usually mimics other musculoskeletal diseases, diagnosis remains challenging. Although this lesion usually shows a good outcome, treatment at an inappropriate time, neglect, or inadequate treatment could lead to poor outcomes. We report on the case of a healthy adolescent who complained of episodes of fever and chills, weight loss, pain in his left hip, and limping. After performing necessary workups, two differential diagnoses of tumor and SA were made. The results of Gram stain and culture of the synovial fluid after surgical excision showed Klebsiella pneumoniae and Enterobacter cloacae complex. To the best of our knowledge, this is the first report of SA due to co-infection with K. pneumoniae and E. cloacae in a healthy patient.

• Hip & pelvis
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• 제34권2호
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• pp.79-86
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• 2022

Purpose: The purpose of this study was to determine whether the direct anterior approach (DAA) can be applied to hemiarthroplasty for treatment of unstable femoral intertrochanteric fractures in elderly patients. Materials and Methods: We conducted a retrospective review of 34 cases (34 patients) who underwent bipolar hemiarthroplasty using a DAA from February 2019 to April 2020. The mean age of the patients was 82.68 years (range, 67-95 years). A cementless distal fixation hip system was used in all cases. Operation time, total amount of blood loss, intraoperative and postoperative fractures, infections, and reoperations were measured. The patients performed weight-bearing walking as tolerated immediately after surgery. Measurement of migration of the greater trochanter (GT) and progressive subsidence of the femoral stem was performed using follow-up radiographs. Results: The mean operative time was 83.50 minutes (range, 60-120 minutes). The mean amount of bleeding was 263.53 mL (range, 112-464 mL). Walking started a mean of 3.03 days (range, 3-4 days) after surgery. There was no case of progressive migration of the GT more than 5 mm even though it was not fixed. There were no cases of infection, dislocation, or reoperation. Conclusion: Bipolar hemiarthroplasty using the DAA for treatment of unstable femoral intertrochanteric fractures could be considered a useful option that provides many advantages in elderly patients.

• 대한물리치료과학회지
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• 제8권1호
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• pp.893-906
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• 2001

The purposes of this study were to compare pelvic tilt. range of motion(ROM) of hip rotation, and leg length difference before and after manipulation and to investigate correlation between changes of each variables after manipulation of sacroiliac pint in 31 low back pain patients(11 males, 20 females) with sacroiliac pint dysfunction. The sacroiliac pint of patients was manipulated on the side of anterior pelvic tilt, using the technique described by Stoddard(1962) and Greenmann (1996). I used this technique because it usually eliminated sacroiliac Pint dysfunction in one treatment session. SPSS for window computer system was used to analyze the data. Also t-test was performed for comparison of the variables before and after manipulation, and Pearson product-moment correlation analysis and regression analysis were performed for changes of each variables after manipulation. The result were as follows: 1. The pelvic tilt after manipulation was significantly decreased(mean=$2.79^{\circ}$) compared with the pelvic tilt before manipulation(p=.001). 2. The PROM of hip internal rotation ipsilateral to anterior pelvic tilt after manipulation significantly decreased (mean = $1.88^{\circ}$) compared with hip internal rotation before manipulation (p=.008). The PROM of hip internal rotation ipsilateral to posterior pelvic tilt after manipulation significantly increased(mean = $1.29^{\circ}$) compared with hip internal rotation before manipulation (p=.029). 3. The PROM of hip external rotation ipsilateral to anterior pelvic tilt after manipulation significantly increased(mean=$2.42^{\circ}$) compared with the hip external rotation before manipulation(p=$2.42^{\circ}$) compared with the hip external rotation ipsilateral to posterior pelvic tilt after manipulation significantly decreased(mean = $1.84^{\circ}$) compared with the hip external rotation before manipulation (p=.008). 4. Leg length difference after manipulation significantly decreased(mean=2.15 mm) compared with leg length difference before manipulation (p=.008). Regression analysis revealed that a fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(p=.009). 5. Pearson product-moment correlation coefficient was used to assess differences of the variables after manipulation. A fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(r=.462, p<.01). A fair correlation was found between change in anterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.397, p<.05) and between change in anterior pelvic tilt and change in hip external rotation ipsilateral to anterior pelvic tilt(r=.516, p<.01). A fair correlation was found between change in posterior pelvic tilt and changes in hip internal rotation ipsilateral to posterior pelvic tilt (r=.441, p<.05) and between change in posterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.361, p<.05). A fair correlation was found between change in hip internal rotation ipsilateral to anterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.388, p<.05) and between change in hip internal rotation ipsilateral to posterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.426. p<.05).

• Hip & pelvis
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• 제30권4호
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• pp.260-268
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• 2018

Purpose: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). Materials and Methods: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015. The average age at surgery was $11.02{\pm}3.43$ years. According to the Tonnis classification, there were 10, 14, 22, and 31 patients in grades 1, 2, 3, and 4, respectively. The pelvic procedure utilized in this study was triple osteotomy (47 hips) followed by double and Salter osteotomy (18 and 12 hips, respectively). Postoperative evaluations were conducted using the modified MacKay's scoring system (functional outcomes) and Severin's scoring method (radiological assessment). Results: Postoperatively, there were 38 (49.4%), 19 (24.7%), 14 (18.2%), and 6 (7.8%) hips in Severin grade I, II, III and IV, respectively. According to the modified McKay criteria, there were 22 hips (28.6%) in excellent condition, 44 (57.1%) in good condition, 9 (11.7%) in fair condition and 2 (2.6%) in poor condition. Both patients with poor outcomes had an unstable, painful hip with evidence of avascular necrosis of the femoral head. Conclusion: Based on the results presented here, we recommend the single stage procedure of open reduction, femoral shortening and pelvic osteotomy for treatment of DDH in older children with good to excellent functional and radiological outcomes.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.213-226
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• 2015

Objectives : This study was aimed to show the effect of electroacupuncture combined with magnetic acupuncture on abdominal obesity without patient dieting, exercise or use of herbal medication. Methods : Women over 85 cm in waist circumference were treated with electroacupuncture combined with magnetic acupuncture. Acupuncture points were located at the abdomen ($CV_{12}$, $CV_6$, $ST_{25}$, $ST_{21}$, $SP_{15}$, $SP_{14}$), extremities ($LI_4$, $LI_{11}$, $ST_{36}$, $ST_{44}$) and were stimulated 30 minutes with 2.1~3 Gaus, 500 Hz, tolerable strength. The Interference wave forms were by Whata 153 (Medi Lab, Korea). Two or three treatment sessions per week (five or ten sessions in total) were done. Before treatment, and after the last treatment, we measured waist circumference, hip circumference, waist hip ratio, thickness of abdominal subcutaneous fat, body weight, body mass index, body fat ratio, visceral fat area, free fat mass, body fat mass and skeletal muscle mass. We also measured the subcutaneous temperature of the abdomen($CV_{12}$, $ST_{25}(Rt)$, $ST_{25}(Lt)$, $CV_6$) by using digital infrared thermal imaging(DITI). Results : In this study, significant reductions were shown in waist circumference, hip circumference, thickness of abdominal subcutaneous fat, body weight, body mass index, body fat ratio and body fat mass. There were no significant differences in waist hip ratio, free fat mass or skeletal muscle mass. There were also significant increases of the subcutaneous temperature on $CV_{12}$, $ST_{25}(Rt)$, $ST_{25}(Lt)$. Conclusions : From the above results, electroacupuncture combined with magnetic acupuncture might be an effective treatment for abdominal obesity.

• 한국전문물리치료학회지
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• 제2권1호
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• pp.36-43
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• 1995

The purpose of this study was to determine whether the vastus medialis oblique muscle(VMO) had greater electrical activity than the vastus lateralis muscle(VL) when hip adduction and knee extension exercise were performed. Electrical activity of the VMO and VL was measured on 42 healthy subjects (28 men, 14 women) during maximal voluntary isometric contractions of hip adduction and knee extension by an EMG-BIOFEEDBACK. The results showed that the electromyographic activity of the VMO was significantly greater than that of the VL during the hip adduction exercise. Differences noted with knee extension by performing hip adduction exercises. Isometric hip adduction exercises, therefore, may be advisable in the treatment of patients with patellofemoral pain.

• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.193-197
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• 2023

Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient's pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.

• 대한물리치료과학회지
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• 제15권4호
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• pp.35-42
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• 2008

Background : To assess the effect of a pelvic compression belt on the strength of hip flexor in healthy young individuals. Study design: Pre- and post-treatment measurement design on one factor was used. Methods : 30 healthy volunteers (male: 15, female: 15) participated in this study. Dynamometer was used to measure the strength of hip flexor, and measurements were performed before and after the application of the pelvic compression belt at neutral position of hip joint and at 30 cm raised position from floor with straight leg in supine. Results : After the application of the pelvic compression belt, the strengths of hip flexor measured at both positions were significantly increased when compared with before the application (p<.05). However, at neutral position of hip joint and at 30cm raised position from floor, there were significantly different in the changing patterns in the strengths of hip flexor between men and women (p>.05). Conclusion : The findings suggest that the pelvic compression belt is helpful in strengthening hip muscles. With easy application, it is sufficiently feasible for clinical use.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.393-397
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• 2018

Background: The purpose of our study was to evaluate the usefulness of hip arthroscopy including extensive capsulectomy for synovial chondromatosis of the hip. Methods: From 2008 to 2016, 13 patients with synovial chondromatosis of the hip were treated with arthroscopic removal of loose bodies and synovectomy using three arthroscopic portals. An extensive capsulectomy was performed to allow the remaining loose bodies to be out of the extracapsular space, and the excised capsule was not repaired. All patients were assessed by clinical scores and the radiographs were reviewed to determine whether the remaining loose bodies disappeared at the last follow-up. Results: Eight men and two women were followed up for a minimum of 1 year (mean, 3.8 years; range, 1 to 6.8 years) after hip arthroscopy. Clinical outcomes such as modified Harris hip score, University of California Los Angeles score, and Western Ontario and McMaster Universities Osteoarthritis Index score improved at the last follow-up. Although seven hips had remaining loose bodies after arthroscopic surgery, the remaining loose bodies disappeared in five hips (71.4%) at the last follow-up. Conclusions: Arthroscopic surgery was useful to treat synovial chondromatosis of the hip. In spite of limited removal of loose bodies, arthroscopic procedures including extensive capsulectomy could be effective for the treatment of synovial chondromatosis of the hip.