• Journal of Trauma and Injury
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• v.37 no.1
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• pp.89-96
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• 2024

The indications for total hip replacement are increasing and not limited to osteoarthritis. Total hip replacement may also be done for trauma and pathological fractures in patients otherwise physiologically fit and active. This trend has led to an inevitable rise in complications such as periprosthetic femoral fracture. Periprosthetic femoral fracture can be challenging due to poor bone quality, osteoporosis, and stress fractures. We present a case of periprosthetic femoral fracture in a 71-year-old woman with some components of an atypical femoral fracture. The fracture was internally fixed but was subsequently complicated by infection, implant failure needing revision, and later stress fracture. She was on a bisphosphonate after her index total hip replacement surgery for an impending pathological left proximal femur fracture, and this may have caused the later stress fracture. Unfortunately, she then experienced implant breakage (nonunion), which was treated with a biplanar locking plate and bone grafting. The patient finally regained her premorbid mobility 13 months after the last surgery and progressed satisfactorily towards bony union.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.24 no.3
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• pp.209-218
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• 2017

Purpose: The purpose of this research was to identify factors that influence health-related quality of life of patients who have had knee or hip arthroplasty. Factors included sleep disorders, pain, activities of daily living, and depression. Methods: The participants in this research were 97 patients within one year after receiving knee or hip arthroplasty surgery and who regularly visited a hospital outpatient department. Data were analyzed using descriptive statistics, t-test, ANOVA, and stepwise regression analysis with the SPSS program. Results: Sleep disorders, pain, activities of daily living, and depression had significant correlations with health related quality of life. Factors influencing health-related quality of life among arthroplasty patients were the length of time since surgery, sleep disorders, activities of daily living, and depression. These factors explained 58% of the participants' health-related quality of life. Conclusion: The results show that various factors can affect patients' health-related quality of life following joint replacement surgery. The findings indicate that sleep disorders and depression should receive continued attention after the arthroplasty. It is also necessary to develop appropriate nursing intervention programs to lower depression and increase patient participation in daily living activities.

• Journal of Korean Clinical Nursing Research
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• v.26 no.3
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• pp.365-373
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• 2020

Purpose: The purpose of this study was to evaluate the effect of preoperative warming to prevent hypothermia in surgery for patients undergoing total hip replacement arthroplasty under spinal anesthesia. Methods: A randomized experimental study was conducted. Data were collected at an S University hospital in Gyeonggido from December 3, 2019 to March 31, 2020. A random allocation program was used to randomize participants into intervention and control groups. A total of 90 participants were assigned to the study: 30 people were randomized to a pre-warming group using Bair Hugger forced-air warming blankets(Model 505) 30 minutes before surgery, 30 to a pre-warming group 15 minutes before surgery, or 30 to a control group. The findings from 88 participants were analyzed. For data analysis, χ2 test and ANOVA were used utilizing the SPSS 21.0 program. Results: The pre-warming group 30 minutes before surgery had significantly higher body temperature than the control group, from 30 minutes after inducing anesthesia to the end of anesthesia. Body temperature over anesthesia time showed significant differences among the three groups, but there were no statistically significant differences in interactions between time and groups. Conclusion: Warming patients' body for 30 minutes before surgery was effective in maintaining normal body temperature while preventing intraoperative hypothermia.

• Hip & pelvis
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• v.35 no.1
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• pp.24-31
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• 2023

Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

• Hip & pelvis
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• v.35 no.2
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• pp.99-107
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• 2023

Purpose: Bipolar hemiarthroplasty has recently been acknowledged as an effective option for treatment of unstable intertrochanteric fracture. Trochanteric fragment nonunion can cause postoperative weakness of the abductor muscle and dislocation; therefore, reduction and fixation of the fragment is essential. The purpose of this study was to perform an evaluation and analysis of the outcomes of bipolar hemiarthroplasty using a useful wiring technique for management of unstable intertrochanteric fractures. Materials and Methods: A total of 217 patients who underwent bipolar hemiarthroplasty using a cementless stem and a wiring technique for management of unstable intertrochanteric femoral fractures (AO/OTA classification 31-A2) at our hospital from January 2017 to December 2020 were included in this study. Evaluation of clinical outcomes was performed using the Harris hip score (HHS) and the ambulatory capacity reported by patients was classified according to Koval stage at six months postoperatively. Evaluation of radiologic outcomes for subsidence, breakage of wiring, and loosening was also performed using plain radiographs at six months postoperatively. Results: Among 217 patients, five patients died during the follow-up period as a result of problems unrelated to the operation. The mean HHS was 75±12 and the mean Koval category before the injury was 2.5±1.8. A broken wire was detected around the greater trochanter and lesser trochanter in 25 patients (11.5%). The mean distance of stem subsidence was 2.2±1.7 mm. Conclusion: Our wiring fixation technique can be regarded as an effective additional surgical option for fixation of trochanteric fracture fragments during performance of bipolar hemiarthroplasty.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.05a
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• pp.519-520
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• 2006

The aim of this study was biomechanical analysis of shelf operation in patients with dysplastic hip joint by finite element contact analysis. Two dimensional CT images were used to construct the finite element models to analyze the contact pressure, and the 3D expansion of the Ninomiya's method was used in the calculation of the resultant force in the hip joint. The surgery recovered the center-edge angles to the normal anatomical range and increased the contact areas in two patients. The maximum contact pressures and von-mises stresses were decreased. The present study provides the biomechanical guideline of optimal surgical parameters to maximize the surgical efficiency and the clinical outcomes in dysplastic hip joint using the shelf operation.

• Hip & pelvis
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• v.35 no.3
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• pp.164-174
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• 2023

Purpose: This study investigates the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), albumin, and 2-year mortality in elderly patients having hemiarthroplasty for displaced femoral neck fracture (FNF). Materials and Methods: We retrospectively reviewed 284 elderly patients who underwent hemiarthroplasty for Garden type IV FNF from September 2014 to September 2020. Using the receiver operating characteristic curve, optimal cutoff values for LCR, NLR, and albumin were established, and patients were categorized as low or high. Associations with 2-year mortality were evaluated through univariate and multivariate Cox regression analyses. Results: Of the 284 patients, 124 patients (45.9%) died within 2 years post-surgery. The optimal cutoff values were: LCR at 7.758 (specificity 58.5%, sensitivity 25.0%), NLR at 3.854 (specificity 39.2%, sensitivity 40.0%), and albumin at 3.750 (specificity 65.9%, sensitivity 21.9%). Patients with low LCR (<7.758), high NLR (≥3.854), and low albumin (<3.750) had a statistically significant reduced survival time compared to their counterparts. Conclusion: Lower preoperative LCR and albumin levels, along with higher NLR, effectively predict 2-year mortality and 30-day post-surgery complications in elderly patients with Garden type IV FNF undergoing hemiarthroplasty.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.45-52
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• 2009

Simple radiography, CT and MRI were used for the diagnosis of the hip disease. However ultrasonography could be a good diagnostic tool for the lesion of tendons and bursae. Another advantage of ultrasonography is its usefulness for the follow-up of these lesions. Nowadays hip ultrasonography expanded the horizon to the follow-up study of total hip arthroplasty. However, the limitation of ultrasonography is that there is disparity in results according to the physician's experiences. In this article ultrasonographic findings of normal structures and pathologic lesions of the hip joint are introduced and explained briefly.

• 제어로봇시스템학회:학술대회논문집
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• 2000.10a
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• pp.540-540
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• 2000

This paper explores design and control methods of a surgical robot for total hip replacement surgery which can be easily maneuvered by a surgeon Like an advanced surgical tool. The 3-DOF in-parallel surgical robot is fixed directly onto patient's femur by the bone clamp during surgery. With the master/slave combined surgical robot, the surgeon can directly control the motion of the surgical robot with surgeon's experience and judgment during operation. For the easiness of operation, the master/slave combined robot is controlled using admittance control paradigm. And for the precise operation, the robot motion is restricted at the surgical boundary using virtual hard wall display.

• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.191-199
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• 2021

Osteonecrosis of the femoral head usually affects young or middle-aged adults and frequently leading to femoral head collapse and hip arthritis. This review reports the updated treatments of the disease.