• Hip & pelvis
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• v.34 no.2
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• pp.122-126
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• 2022

Tumoral calcinosis is a rare disease characterized by massive subcutaneous soft tissue deposits of calcium phosphate around large joints in patients with chronic kidney disease. Invasion of bone by tumoral calcinosis is rare. We experienced a case involving a femoral neck pathologic fracture due to bony invasion of tumoral calcinosis in a 46-year-old female with chronic kidney disease who had been on dialysis for 15 years. Successful outcomes were obtained by performance of total hip arthroplasty for treatment of the pathologic fracture of the femoral neck. Careful precaution is necessary to prevent pathologic fractures in patients with tumoral calcinosis around the hip joint.

• Hip & pelvis
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• v.35 no.2
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• pp.142-146
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• 2023

Stenotrophomonas maltophilia, a well-established opportunistic bacterium, primarily impacts healthcare settings. Infection of the musculoskeletal system with this bacterium is rare. We report on the first known case of hip periprosthetic joint infection (PJI) caused by S. maltophilia. The potential for development of a PJI caused by this pathogen should be considered by orthopaedic surgeons, particularly in patients with multiple severe comorbidities.

• Korea Journal of Hospital Management
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• v.14 no.1
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• pp.23-35
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• 2009

The objectives of the present study is to examine the validity of Charlson Comorbidity Index(CCI) based on medical record data; to utilize the index to determine outcome indexes such as mortality, length of stay and cost for the domestic patients whose have received total hip arthroplasty. Based on medical record date, 1-year Mortality was analyzed to be 0.664 of C statistic. The $R^2$ for the predictability for length of stay and the cost was about 0.0181, 0.1842. Fee of national health insurance and total cost including the cost not covered by insurance, also had statistically significance above 3 points of Charlson point score(p=0.0290, 0.0472; $p.{\le}0.05$). The 1-year mortality index, length of stay and cost of the total hip arthroplasty patients which was obtained utilizing CCI have a limitative prediction power and therefore should be carefully analyzed for use.

• Hip & pelvis
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• v.36 no.2
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• pp.108-119
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• 2024

Purpose: The incidence of deep vein thrombosis (DVT) following total hip arthroplasty (THA) without chemoprophylaxis could be as high as 50% in Caucasians. However, according to several subsequent studies, the incidence of venous thromboembolic events (VTE) in Asians was much lower. The routine use of chemoprophylaxis, which could potentially cause increased bleeding, infection, and wound complications, has been questioned in low-incidence populations. The objective of this study is to determine the incidence of VTE after primary THA without chemoprophylaxis in an Asian population using a fast-track rehabilitation protocol and to verify the safety profile for use of 'mechanical prophylaxis alone' in patients with standard risk of VTE. Materials and Methods: This is a retrospective cohort study of 542 Hong Kong Chinese patients who underwent primary THA without chemoprophylaxis. All patients received intermittent pneumatic compression and graduated compression stockings as mechanical prophylaxis. Multimodal pain management was applied in order to facilitate early mobilisation. Routine duplex ultrasonography was performed between the fourth and seventh postoperative day for detection of proximal DVT. Results: All patients were Chinese (mean age, 63.0±11.9 years). Six patients developed proximal DVT (incidence rate, 1.1%). None of the patients had symptomatic or fatal pulmonary embolism. Conclusion: The incidence of VTE after primary THA without chemical prophylaxis can be low in Asian populations when following a fast-track rehabilitation protocol. Mechanical prophylaxis alone can be regarded as a reasonably safe practice in terms of a balanced benefit-to-risk ratio for Asian patients with standard risk of VTE.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.281-286
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• 2019

Avascular necrosis (AVN) is defined as the cellular death of bone and bone marrow components due to the loss of blood supply, and associated with post-traumatic or non-traumatic events. AVN usually involves the epiphysis of a long bone, such as the femoral and humeral heads, which are susceptible to osteonecrosis. Many studies have been conducted but they were restricted to investigations of femoral head avascular necrosis. The presence of osteonecrosis in the proximal femur may impair biological fixation after total hip arthroplasty. We report a 56-year-old male patient with avascular necrosis located not only at the femoral head, but also in the entire femur, including the medullary cavity, who underwent total hip arthroplasty 2 years earlier along with a review of the relevant literature.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.17-28
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• 2024

PURPOSE: This study was conducted to investigate the effect of gluteal muscle strengthening exercises (GMSE) with ankle joint pumping exercises (AJPE) on thigh swelling, gait ability, and pain level in patients who underwent total hip arthroplasty. METHODS: A total of 38 patients who had undergone total hip replacement surgery >1 week prior participated in this study. Participants were randomly assigned to a group that performed only GMSE (CG; n = 19) and a group that performed GMSE and AJPE (EG; n = 19). The CG group performed GMSE for 30 min, and the EG group performed GMSE for 30 min followed by AJPE for 15 min. Exercises were performed five times a week, for a total of 20 times over 4 weeks in both groups. Thigh swelling (thigh size), 10 m walking test (10MWT) and timed up and go test (TUG) results, pain level (visual analogue scale, VAS) scores, Short Form 36 health survey (SF-36), and hip outcome scale (HOS) scores were evaluated before and after the intervention. RESULTS: After 4 weeks of intervention, significant differences were observed in the thigh size, 10MWT, TUG, VAS, SF-36, HOS before and after intervention in both groups (p < . 05). However, only thigh size showed a significant interaction between group and measurement time (p < . 05). CONCLUSION: GMSE combined with AJPE might be effective in improving the gait ability and pain level in patients with total hip arthroplasty, and GMSE may be more effective in improving thigh swelling and gait ability than GMSE without AJPE.

• Journal of Korean Physical Therapy Science
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• v.30 no.1
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• pp.1-9
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• 2023

Background: The advantages of robotic therapy have recently been attempted several times in the rehabilitation of total hip arthroplasty (THA) patients. Therefore, this study also aims to report a case of how robot therapy affects the function of THA patients due to developmental dysplasia of the hip (DDH). Design: Case Study. Method: This study used the A-B-A' design. Period A is before robotic therapy, period B is robotic therapy, and period A' is after robotic therapy. The subjects performed physical therapy and occupational therapy for five days each during the baseline period A and A'. In intervention period B, robotic therapy was performed for five days along with the baseline intervention. This study was conducted for a total of fifteen days. The subjects' sit to stand (STS), timed up and go (TUG), and 10 metre walk (10MW) were evaluated. Result:: STS and TUG were significantly improved in periods B and A' compared to period A (p<0.05), and STS was significantly improved in period A' compared to period B (p<0.05). 10MW showed no significant improvement in periods B and A' compared to period A. Conclusions: This study confirmed that robot therapy was an effective intervention in improving the function of women in their 30s who underwent THA due to DDH. In the future, a study comparing the control group should be performed.

• Proceedings of the Korean Society of Life Science Conference
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• 2008.10a
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• pp.33.1-33.1
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• 2008

• Journal of Institute of Control, Robotics and Systems
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• v.8 no.9
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• pp.788-794
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• 2002

To improve surgical result of total hip arthroplasty (THA), there has been some approaches using a robotic milling system, which can make a precise cavity in the femur. Usually, to carve a femur, the surgical robot is controlled by a pre-programmed tool-path regardless of a surgeon's experience and Judgment. This paper presents a control method of a surgical robot for THA, which can be used as an advanced surgical tool. With a master/slave combined surgical robot, surgeon can directly control the motion and velocity of a surgical robot. The master/slave-combined robot is controlled to display a specific admittance for a surgeon's force to the surgical robot velocity. To prevent the over-carving of a femur, virtual hard wall is displayed on the surgical boundary. To evaluate the proposed control method of the master/slave-combined surgical robot, 2-DOF master/slave-combined manipulator is used in experiment.

• Hip & pelvis
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• v.36 no.1
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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.