• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.503-510
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• 2020

Purpose: Bipolar hemiarthroplasty is used as an alternative to open reduction and internal fixation for unstable intertrochanteric fractures in elderly patients. Recent advances in medical systems and technologies have resulted in increased survival rates after intertrochanteric fractures of the femur, requiring selection of the appropriate femoral stems considering the mid- to long-term duration of survival. Hemiarthroplasty was performed for unstable intertrochanteric fractures using a double tapered quadrilateral femoral stem (C2 stem), and the clinical and radiological results were evaluated as a five-year follow-up post-surgery. Materials and Methods: From January 2004 to December 2013, 43 patients (43 hips) who underwent hemiarthroplasty with a C2 stem were enrolled in this study. Their mean age was 78.6 years (range, 70-84 years), and the mean follow-up period was 85.4 months (range, 60-96 months). During the follow-up period, clinical parameters, such as the changes in pain, walking ability, and functional status, were examined. Radiologically, changes in the proximal femur, such as osteoporosis and bone resorption of cortical bone, were noted. Complications that occurred during the follow-up period, such as dislocation and prosthetic features, were also reviewed. Results: Initially, the pain was relieved postoperatively, but it increased four years after surgery. The walking ability was reduced by two steps in nine patients after 60 months, and the Harris hip score was reduced significantly postoperatively after two to three years. Radiologically, cortical osteoporosis occurred in 14 patients. Five patients developed cortical bone resorption. Four of them showed nonunion of the trochanteric fracture fragments, and three of them suffered reverse oblique fractures. Conclusion: Careful selection considering the general health condition and remaining lifespan of the patient would be necessary for primary hip hemiarthroplasty using a 3C type cementless femoral stem for unstable intertrochanteric fractures in elderly patients with osteoporosis.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.1
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• pp.47-59
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• 2023

Objectives This paper is an analysis of domestic and foreign trends for the Korean medical treatment of avascular necrosis of the femoral head. Methods Domestic and foreign databases were searched and analyzed for Korean medical treatment interventions, research types, and treatment effects for avascular necrosis of the femoral head. Results There were 10 case reports in Korea, 2 case reports and 3 randomized controlled studies abroad. A total of 12 treatment interventions were used, and the types include acupuncture, herbal medicine, phamacopunture, electroacupuncture, cupping, physical therapy, chuna, acupotomy, moxibustion, warm acupuncture, laser acupuncture, and motion style treatment. As for the evaluation index, visual analogue scale, range of motion and harris hip score were the most common with 7 cases each. Conclusions Through this study, it was possible to understand the trends of domestic and foreign research on the treatment of avascular necrosis of the femoral head with Korean medicine. However, due to the small number of literature and no randomized control studies in Korea, treatment evidence is insufficient. It is considered that further research is needed in the future.