• Title/Summary/Keyword: Hip surgery

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Total Hip Arthroplasty with Cemented Dual Mobility Cup into a Fully Porous Multihole Cup with Variable Angle Locking Screws for Acetabular Fractures in the Frail Elderly

  • Mathias van den Broek;Kris Govaers
    • Hip & pelvis
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    • v.35 no.1
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    • pp.54-61
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    • 2023
  • Purpose: The purpose was to examine the clinical and radiological outcomes after surgical treatment of acetabular fractures with total hip arthroplasty with a dual mobility cup cemented into a porous multihole cup in the population of frail elderly patients. Materials and Methods: A retrospective review of 16 patients who underwent surgery (mean age, 76.7 years) with a mean follow-up period of 36.9 months was conducted. Following surgery, patients underwent postoperative follow-up at six weeks, three, six, and 12 months and clinical and radiological examinations were performed. Results: Classification of fractures was based on the Letournel classification. Following surgery, all patients were allowed weight-bearing as tolerated immediately postoperative. Fourteen patients showed maintenance of preoperative mobility status at one year. The mean Harris hip score was 64.8 (range, 34.7-82.8) and 80.0 (range, 60.8-93.8) at three months and one year, respectively. The mortality rate was 12.5% at one year (2/16). Complications included heterotopic ossification (2/16), deep venous thrombosis (1/16), heamatoma (1/16), and femoral revision due to a Vancouver B2 fracture (1/16). No case of deep infection, dislocation, or implant loosening was reported. Conclusion: Total hip arthroplasty using a dual mobility cup cemented into a porous multihole cup with locking screws resulted in a stable construct with a capacity for immediate weight-bearing as tolerated with rapid relief of pain. The findings of this study suggest that this procedure can be regarded as a safe method that has shown promising clinical and radiological outcomes for treatment of patients with medical frailty.

The Effects of COVID-19 Pandemic on the Recovery of Hip Fracture Patients

  • Young Yool Chung;Sung Nyun Baek;Tae Gyu Park;Min Young Kim
    • Hip & pelvis
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    • v.35 no.4
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    • pp.253-258
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    • 2023
  • Purpose: To figure out how complete control of family visits to prevent infection of coronavirus disease 2019 (COVID-19) affected the activity recovery of hip fracture patients admitted to nursing hospitals. Materials and Methods: Eighty-one patients with hip surgery in the two years prior to COVID-19 pandemic were classified as Group A, and 103 patients in the next two years were designated as Group B. The subjects' walking ability was evaluated by using the modified Koval index (MKI). In order to analyze the impact of the family visit control to the subjects, each group was classified into two different groups: (1) inpatients group who admitted to nursing hospitals and (2) home-treated patients. Additionally, statistical elements were processed in consideration of other factors that may affect the results of the experiment. Results: The MKI evaluated at 6 months postoperative was 3.31±1.79 in Group A and 2.77±1.91 in Group B, and it was meaningfully low after the pandemic (P=0.04). There was significantly low among both of Group A 2.74±1.76 and Group B 1.93±1.81 after the pandemic (P=0.03) among those treated at the nursing hospital. The rate of deterioration of the MKI was 35 (43.2%) in Group A and 57 (55.3%) in Group B, which increased by 12.1% after the pandemic. Conclusion: The pandemic had a negative effect on the recovery of postoperative activities of elderly hip fracture patients who admitted to nursing hospitals when family access was completely restricted to prevent infection.

Ultrasonography-Guided Multiple Needling for the Treatment of Calcific Tendinitis Around Hip Joint: 4 Cases Report (초음파 감시하 다발성 천공술을 이용한 고관절 주위 석회화 건염의 치료: 4례 보고)

  • Kwon, Yong-Wook;Lee, Kyung-Jae;Min, Byung-Woo;Bae, Ki-Cheor;Cho, Chul-Hyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.89-93
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    • 2012
  • Although calcific tendinitis around hip joint is a rare condition, patients with symptomatic calcific tendinitis serve very severe pain and are disturbed their daily activities. We report four calcific tendinitis patients who had acute pain around the hip with limitation of motion of the joint and were treated with ultrasonography-guided multiple needling with dramatic pain relief.

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Erythrocyte Sedimentation Rate and C-reactive Protein Values in Patients with Hip Arthroplasty (인공고관절 치환술 전후의 CRP 및 ESR의 변화)

  • Kim, Se-Dong;Lee, Dong-Chul;Park, Dong-Gu
    • 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.

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Ultrasonographic Findings of Normal Hip Joint and Painful Hip due to Soft Tissue Problem (고관절 초음파의 정상 소견 및 고관절 주위 질환의 초음파 소견)

  • Nam, Woo-Dong;Nam, Shin Woo;Han, Kye Young
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.38-46
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    • 2010
  • The lesions around hip joint including bone, joint and soft tissue can cause the pain. For diagnosis of these lesions, physical examination and simple X-ray were accomplished primarily. Some special cases, CT or MRI was a useful tool. However ultrasonography could provide non-invasive and dynamic images for the lesions of tendon and bursa, and it could be a useful tool for follow up after hip surgery. Due to the deep location of hip joint, ultrasonography is not easy for physician to examine and its application was impossible in some obese patients. This article deals with the normal and pathologic ultrasonographic findings of the hip joint and various applications using ultrasonography.

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Treatment of Reverse Oblique Trochanteric Fracture with Compression Hip Screw (대퇴골 전자부 역사상 골절의 압박고 나사를 이용한 치료)

  • Kim, Dong-Hui;Lee, Sang-Hong;Ha, Sang-Ho;You, Jae-Won
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.1-5
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    • 2010
  • Purpose: To investigate the results of treatment of reverse oblique trochanteric fractures with compression hip screw. Methods: We reviewed the results of 12 cases of reverse oblique trochanteric fracture treated with compression hip screw from January 2000 to December 2006 which could be followed up for more than 1 year. The mean follow up period was 26 months (15~40). The mean age was 48 years old. Injury mechanism was composed of 6 cases of traffic accident and 6 cases of fall down. 8 persons were man. We investigated the union time, degree of neck-shaft angle change, amount of sliding of compression hip screw, complications, functional and clinical results. Results: 10 cases were united and the mean union time were 5 months (3~8). The mean neck-shaft angle change was 3.5 degrees (0~12). The amount of sliding of compression hip screw was 8.9 mm (2~24). There were six coxa vara, six leg due to coxa vara shortening, two nonunion, and one superficial infection. Unsatisfactory results of Jensen's social function score and Parker and Palmer's mobility score were studied. Conclusion: The results of treatment of reverse oblique trochanteric fractures with compression hip screw were relatively unsatisfied.

Factors Affecting the Healthcare Utilization of Spinal and Joint Surgery in Elderly Patients (65세 이상 노인의 척추·관절 수술별 의료이용에 미치는 영향요인 분석)

  • Jeong, Soon Hyun;Gu, Yeo Jeong;Yoo, Ki-Bong
    • Health Policy and Management
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    • v.30 no.1
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    • pp.62-71
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    • 2020
  • Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

Clinical and Functional Outcomes of the Exeter V40 Short Stem in Primary and Revision Arthroplasty: Does the Indication Affect Outcomes in the Short Term?

  • Nemandra Amir Sandiford;Scott M. Bolam;Irrum Afzal;Sarkhell Radha
    • Hip & pelvis
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    • v.35 no.1
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    • pp.40-46
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    • 2023
  • Purpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA. Materials and Methods: This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years. Results: In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups. Conclusion: Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.

Functional Status and Health Care Utilization among Elders with Hip Fracture Surgery from a Fall (낙상후 대퇴골절 수술 노인의 신체기능, 의료이용 및 낙상의 두려움)

  • Oh, Hee-Young;Im, Young-Mi
    • Korean Journal of Adult Nursing
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    • v.15 no.3
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    • pp.432-440
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    • 2003
  • Purpose: The purposes of this study were to examine 1) functional status at 2 months after hip fracture surgery 2) health care utilization after a fall episode and 3) fear of falling experienced during first 2 months after a fall episode. Method: With a convenient sample of 99 elderly from six university or general hospitals with hip fracture from a fall, data were collected at 2-3 days before discharge and at 2 months after hip fracture surgery. Result: 1) At 2 months after hip fracture from a fall, significant proportion (25.3%) of elderly was not able to walk indoors. 2) Average length of hospital stay was 27.6 days with a range of 8 to 86 days. About 51% subjects received physical therapy during hospital stay, and only 6.1% subjects received physical therapy following discharge from the hospital. 3) Significant proportion (72.7%) had fear of falling after the fall episode. About 51% reported that they restricted their activities because they had fear of falling. Conclusion: Fall is a dreaded event which result in loss of independence and restriction of activity. Development and application of fall prevention program is critical especially for those with risk factors of fall.

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Korean Medical Treatment including Phototherapy after Hip Fracture Surgery: Three Case Reports (고관절 골절 수술 이후 광선치료를 포함한 한방치료 3예 보고)

  • Chang, Hokyung;Kim, Hyungsuk;Kim, Soojeon;Kim, Seyoon;Park, Jae-Hyun;Bae, Jun-hyeong;Shin, Woochul;Yoon, Ye-Ji;Lee, Hansol;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.113-124
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    • 2018
  • This study is designed to report three cases of postoperative care after hip surgery using conventional Korean Medicine treatments including phototherapy. Three patients undergone hip fracture surgery were treated with acupuncture, herbal medicine, and phototherapy. We used Visual analogue scale (VAS), EuroQol five dimension scale (EQ-5D), and hip disability and osteoarthritis outcome score (HOOS) to evaluate treatment effectiveness. After the treatment, VAS score was improved in all three cases, while EQ-5D and HOOS showed different results by items. EQ-5D (pain/discomfort) and HOOS (pain, symptoms, activities of daily living) were improved in all three cases. EQ-5D (self-care) and HOOS (quality of life) showed improvements in two cases. EQ-5D (mobility, usual activities, anxiety/depression) and HOOS (sports/recreation) were improved in one case. Conventional Korean Medicine treatments including phototherapy can be effectively used to alleviate pain and symptoms after hip fracture surgery.