• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.177-182
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• 2017

Schwannomas are benign nerve sheath tumors that are typically located in soft tissue. Occasionally, schwannomas involve osseous structures. These intraosseous schwannomas are generally benign neoplasms that account for less than 0.2% of primary bone tumors. Schwannomas are very rarely observed in long bones. We present a case of a schwannoma affecting the proximal femur with a coincident subchondral fracture of the femoral head. A 38-year-old-male presented with left hip pain without deteriorating locomotor function. Plain film radiographs displayed a lobulating contoured lesion within the intertrochanteric portion of the femur. The magnetic resonance imaging (MRI) scans showed a tumor occupying the intertrochanteric region. Diffuse bone marrow edema, especially in the subchondral and head portions of the femur that was possibly due to the subchondral insufficiency fracture was also noted. The lesion was surgically excised and bone grafting was performed. Histologically, there was diffuse infiltrative growth of the elongated, wavy, and tapered cells with collagen fibers, which are findings that are characteristic of intraosseous schwannoma. Although very rare, intraosseous schwannoma should be included in the differential diagnosis of radiographically benign-appearing, non-aggressive lesions arising in the femur. The concomitant subchondral fracture of the femoral head confounded the correct diagnosis of intraosseous schwannoma in this case.

• Investigative Magnetic Resonance Imaging
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• v.12 no.2
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• pp.153-160
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• 2008

Purpose : To evaluate if at the time of diagnosis of Legg-Calve-Perthes disease, MR imaging is superior to radiographs for identifying patients with a favorable long term prognosis as determined by maintenance of a spherical configuration of the femoral head epiphysis on follow-up radiographs. Materials and Methods : We retrospectively analyzed plain radiographs and MR images of 48 femoral heads in 41 patients with Legg-Calve-Perthes disease at time of diagnosis. Femoral head involvement was estimated on initial plain radiographs and MR images using the Catterall classification. Prognosis as determined by maximum femoral head deformity was determined on follow-up radiographs evaluated according to Stulberg classification. Results: Catterall classification of greater than 1 at MR imaging had 100% sensitivity (14/14) for detecting patients with a poor prognosis as indicated by deformity of the femoral head on follow-up radiographs (Stulberg class > 2). Initial radiographs had a lower sensitivity of 57% (8/14) for detecting patients with poor prognosis. Specificity for MR imaging was 21% (7/34) which was not significantly different from 32% (11/34) specificity for initial radiographs. Conclusion: Catterall group 1 at initial MR imaging indicates favorable prognosis for Legg-Calve-Perthes disease. Patients with more extensive involvement of the femoral head can have a good outcome, however they are at risk for loss of spherical configuration of the femoral head and subsequent osteoarthritis in adulthood. MR imaging may be superior to radiographs for identifying a subgroup of patients with favorable prognosis.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.405-412
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• 1999

Purpose: It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. Materials and Methods: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. Results: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). Conclusion: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.

• Journal of radiological science and technology
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• v.26 no.1
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• pp.83-89
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• 2003

The accurate measurement of the femoral anteversion is very important to the practice of orthopedic and osteotomy. It is measured by means of the axis of head and neck of the femur and the knee axis. At the present time, widely used computed tomography method of measuring anteversion on femoral necks of patients. Measurement by the manual method and image viewer of computed tomography to determine the anteversion of femoral head were carried out on both femurs. In September and October 2002, 5 patients 28 to 36 years of age were randomly selected from Seoul National University Hospital. The purpose of this paper was to introduce a new method to measure femoral anteversion angle utilizing PACS image viewer program in the MR imaging. Significant difference was observed between the right and left side the image viewer measurement of femoral anteversion. In conclusion, MR imaging very usefulness in the measured the angle of the femoral anteversion.

• Tribology and Lubricants
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• v.13 no.1
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• pp.82-87
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• 1997

The modern orthopaedics frequently uses the total hip replacement in the artificial hip joint. The wear in this joint requires a re-replacement of hip joints because it is under the severe load and friction conditions. To solve these problems the previous studies have been mainly focussed on the development of new materials. The research of new materials, however, needs much time and effort since it should be experimented for its bio-compatibility, friction, and wear characteristics. To reduce the work, in this study, the finite element analysis is applied to find new combinations of bio-materials in the total hip replacement which has the excellent contact characteristics. A non-linear FEM program MARC with 5-node axisymmetric element was used for analyzing the contact stresses between the hip joints. The computed results show that in case of acetabulum UHMWP has good characteristics, in femoral head, $Al_2O_3$, and in stem, Ti6Al4V.

• 대한두경부종양학회:학술대회논문집
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• 1986.11a
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• pp.10.1-10.1
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• 1986

• Journal of the Korean Orthopaedic Association
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• v.54 no.6
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• pp.519-527
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• 2019

Purpose: To evaluate the treatment result in polyostotic fibrous dysplasia classified according to the involvement of the femoral head. Materials and Methods: Twenty-three patients from March 1987 to March 2014 were reviewed retrospectively. Patients with no involvement of the physeal scar in the femoral head were classified as Type I, and those with involvement of the physeal scar were classified as Type II. A plain radiograph was used to measure the femoral neck shaft angle, articulo-trochanteric distance (ATD), and anterior bowing through the lateral view. A teleoroentgenogram of the lower limb was used to measure the leg length discrepancy and lower extremity mechanical axis. The pre- and postoperative femoral neck-shaft angle and ATD were compared to assess the degree of correction of the deformity. Results: Among a total of 46 cases (23 patients), 28 cases (23 patients) had lesions in the proximal femur. Type I were 16/28 cases (15/23 patients) and Type II were 12/28 cases (9/23 patients). The preoperative proximal femoral neck-shaft angle was 116.8° in Type I and 95.3° in Type II. The ATD was 12.08 mm in Type I and -5.54 mm in Type II. The deformity correction showed significant improvement immediately after surgery, the deformity correction was lost in Type II (neck shaft angle Type I: 133.8°-130.8°, Type II: 128.6°-116.9°, and ATD Type I: 17.66-15.72 mm, Type II: 7.44-4.16 mm). The extent of anterior bowing was 12.74° in Type I and 20.19° in Type II. The mean differences of 12 mm between the 9 patients who showed a leg length discrepancy and the lower extremity mechanical axis showed 4 cases of lateral deviation and 7 cases of medial deviation. Conclusion: In polyostotic fibrous dysplasia, when the femur head is involved, the femur neck shaft angle, ATD, and anterior bowing of the femur had more deformity, and the postoperative correction of deformity was lost, suggesting that the involvement of the femoral head was an important factor in the prognosis of the disease.

• Journal of Acupuncture Research
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• v.35 no.1
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• pp.21-27
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• 2018

Background: Examination of the effects of deer antler, old antler, and antler glue on postmenopausal osteoporosis in an ovariectomized Sprague-Dawley rat model. Methods: The study involved 7 experimental groups; SHAM (sham-operated rats), OVX (ovariectomized rats), E2 (ovariectomized rats with estradiol $10{\mu}g/kg$ daily, orally), DA (ovariectomized rats with deer antler extract 5.83 mg/kg), OA (ovariectomized rats with old antler extract 3.8 mg/kg), low-AG (ovariectomized rats with low dose of antler glue powder 12.5 mg/kg), high-AG (ovariectomized rats with high dose of antler glue powder 37.5 mg/kg). After 6 weeks of treatment, body weight, blood calcium, phosphorus, estradiol, liver [alkaline phosphatase (ALP), aspartate transaminase (AST), alanine transaminase (ALT)] and kidney [blood urea nitrogen (BUN)/creatinine ratio] function, and femoral bone mineral density (BMD) were measured. Results: The body weights of DA, OA, low-AG, and high-AG groups did not significantly differ from OVX group. Blood estradiol levels were significantly increased in the DA, low-AG, and high-AG groups compared to the OVX group. Blood calcium, phosphorus, ALP, AST, and ALT levels and BUN/creatinine ratio did not show significant changes in the DA, OA, low-AG, and high-AG groups. BMDs of the femur, and femoral head and neck were significantly increased in the low-AG group. In the OA group, the BMD of the femoral head and neck was significantly increased. Conclusion: Treatment with deer antler, or antler glue for 6 weeks was effective for increasing estradiol and femoral BMD in ovariectomized rats, suggesting that this may be of therapeutic benefit for osteoporosis.

• 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.

• Molecules and Cells
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• v.26 no.5
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• pp.490-495
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• 2008

Thrombophilia and hypofibrinolysis have been implicated in the pathogenesis of osteonecrosis of the femoral head (ONFH). Tissue factor pathway inhibitor (TFPI), a multivalent protease inhibitor, is an important regulator of the tissue factor-mediated blood coagulation pathway. Mutations of the TFPI gene can increase the risk of thrombin generation and venous thrombosis. The aim of this study was to evaluate the association of TFPI gene polymorphisms with ONFH. All exons and their boundaries of the TFPI gene, including the -1,500 bp promoter region, were directly sequenced in 24 Korean individuals and four sequence variants were identified. These four polymorphisms [-51096 G > A (C-399T), -50984A > G (T-287C), + 24999A > G (Int7 -33T > C), + 37339T > A] were genotyped in 474 ONFH patients and 349 control subjects. The association of genotyped SNPs with ONFH was not found in the present study. The haplotype AAAT of TFPI was significantly associated with total, alcohol-induced, and idiopathic ONFH (p = 0.003, 0.021, and 0.007, respectively), and the haplotype GAAT was significantly associated with total and alcohol ONFH (p = 0.022 and 0.009, respectively). In addition, a new SNP + 37339 T > A in the 3'-UTR of the TFPI gene, was found in the Korean population. To date, this study is the first to show that haplotypes of the TFPI gene are associated with an increased susceptibility for ONFH. The results suggest that genetic variations in TFPI may play an important role in the pathogenesis and risk factors of ONFH.