• Hip & pelvis
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• v.30 no.4
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• pp.276-281
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• 2018

Pseudotumors are not uncommon complications after total hip arthroplasty (THA) and may occur due to differences in bearing surfaces of the head and the liner ranging from soft to hard articulation. The most common causes of pseudotumors are foreign-body reaction, hypersensitivity and wear debris. The spectrum of pseudotumor presentation following THA varies greatly-from completely asymptomatic to clear implant failure. We report a case of pseudo-tumor formation with acetabular cup aseptic loosening after revision ceramic-on-metal hip arthroplasty. The patient described herein underwent pseudotumor excision and re-revision complex arthroplasty using a trabecular metal shell and buttress with ceramic-on-polyethylene THA. Surgeons should be aware of the possibility of a pseudotumor when dealing with revisions to help prevent rapid progression of cup loosening and implant failure, and should intervene early to avoid complex arthroplasty procedures.

• Hip & pelvis
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• v.34 no.3
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• pp.172-176
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• 2022

A 58-year-old-male patient presented with worsening pain and restricted movements of his right hip after undergoing multiple procedures for treatment of an inter-trochanteric fracture. Secondary arthrosis and an incorporated intramedullary fibular cortical bone graft which caused severe narrowing of the medullary canal were observed by imaging. Total hip arthroplasty (THA) using knee arthroscopic tools was performed for preparation of the severely narrowed femoral canal. A satisfactory clinical outcome was achieved and stable components were observed on radiographs at the 11-year follow-up. The technique described here may be considered when attempting to perform a conversion THA for preparation of a severely narrowed femoral canal using a fibular strut in order to minimize morbidity and prevent structural destabilization.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.419-431
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• 2013

Purpose: This study was to evaluate the effect of supportive nursing care program for patients with total hip arthroplasty. Methods: Forty-two patients with total hip arthroplasty were enrolled in this study from September, 20, 2011 to January, 3, 2012. The participants were assigned to one of two groups: Twenty-six subjects in the experimental group were provided with supportive nursing care program which comprised of 6 nurse visits pre and post operation and 4 follow-up phone calls after discharge. Another 26 subjects received conventional nursing care program as a control group. Hip function, anxiety, and uncertainty were evaluated before the intervention, and 5 weeks after completion of the intervention. The analysis included descriptive statistics, Chi-square test, and t-test by SPSS 18.0. Results: Hip function was significantly increased in the experimental group (t=-3.31, p<.002). Anxiety and uncertainty group was significantly lower in the experimental group (t=7.12, p<.001 and t=4.66, p<.001). Conclusion: The results of this study indicate that the supportive care intervention for patients receiving total hip arthroplasty could be utilized as a nursing intervention to improve hip function and to reduce anxiety and uncertainty of patients receiving total hip arthroplasty.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.4
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• pp.105-117
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• 2020

Objectives The objective of this study is to assess the effectiveness of electroacupuncture for patients with hip arthroplasty. Methods According to participants, intervention, comparison, outcome, study design, we searched for clinical studies that conducted electroacupuncture for patients with hip arthroplasty. Results Finally 11 randomized controlled trials were chosen for systemic review and meta-analysis. The frequently used evaluation tools were Incidence of postoperative cognitive dysfunction (POCD), heart rate, blood pressure. Almost studies showed electroacupuncture has effects for patients with hip arthroplasty. Through meta analysis, Electoacupuncture showed statistically significant effect of reducing the anesthetic dosage and incidence of postoperative psychonosema and adverse reactions in intra-operation period, reducing the incidence of POCD in peri-operation period, incidence of deep venous thrombosis in post-operation period. Conclusion 11 studies reported that electroacupuncture has significant effects on hip arthroplasty. But, many studies were assessed in a probable high risk of bias. And all studies published in one overseas country. So, it requires attention to comprehend this study. To make up for this limitaion, more well designed clinical research are needed.

• Hip & pelvis
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• v.34 no.3
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• pp.140-149
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• 2022

The increase in the number of primary total hip arthroplasties that will be performed over the next several decades will lead to an increase in the incidence of periprosthetic fractures around the femoral stem. A search of targeted articles was conducted using on-line databases of PubMed (National Library of Medicine) and articles were obtained from January 2008 to November 2021. Reliable prediction of treatment can be achieved using the Vancouver classification; internal fixation is indicated in fractures involving a stable implant and revision arthroplasty is indicated in those with unstable prostheses. To the best of our knowledge, relatively fewer studies regarding periprosthetic proximal femur fractures of cemented stems have been reported. The focus of this review is on the risk factors and strategies for treatment of these fractures for periprosthetic femoral fractures around a cemented hip arthroplasty.

• Hip & pelvis
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• v.34 no.4
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• pp.211-218
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• 2022

Purpose: We report on the 10-year clinical hip function and radiologic outcomes of patients who underwent hip arthroplasty using a COREN stem. Materials and Methods: A consecutive series of 224 primary cementless hip arthroplasty implantations were performed using a COREN stem between 2009 and 2011; among these, evaluation of 128 hips was performed during a minimum follow-up period of 10 years. The mean age of patients was 65.4 years (range, 40-82 years) and the mean duration of follow-up was 10.8 years (range, 10-12 years). Evaluation of clinical hip function and radiologic implant outcomes was performed according to clinical score, thigh pain, and radiologic analysis. Results: Dramatic improvement of the mean Harris hip score (HHS) from 59.4 preoperatively to 93.5 was observed at the final follow-up (P≤0.01). Stable fixation was demonstrated for all implants with no change in position except for one case of Vancouver type B2 periprosthetic femur fracture. A radiolucent line (RLL) was observed in 16 hips (12.5%). Thigh pain was observed in only two hips (1.6%) at the final follow-up. There were no cases of osteolysis around the stem. The survival rate for the COREN stem was 97.7%. Conclusion: Good long-term survival with excellent clinical and radiological outcomes can be achieved using the COREN femoral stem regardless of Dorr type.

• Hip & pelvis
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• v.34 no.3
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• pp.127-139
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• 2022

There is still controversy regarding clinical outcomes following primary hip arthroplasty after solid organ transplantation (SOT). The aim of this study was to determine whether clinical outcomes after hip arthroplasty differ between previous SOT recipients and control subjects with no history of undergoing SOT. We conducted a systematic search of MEDLINE, Embase, and the Cochrane Library for studies comparing the clinical outcomes after hip arthroplasty following SOT published up to January 5, 2022. A comparison of medical and surgery-related complications, as well as the readmission rate and 90-day mortality rate between previous SOT recipients and control subjects was performed. Subgroup analyses of the SOT types, liver transplantation (LT) and kidney transplantation (KT), were also performed. Ten studies that included 3,631,861 cases of primary hip arthroplasty were included; among these, 14,996 patients had previously undergone SOT and 3,616,865 patients had not. Significantly higher incidences of cardiac complications, pneumonia, and acute kidney injury were observed in the SOT group compared with the control group. Regarding surgical complications, a higher transfusion rate was observed in the SOT group. The readmission rate and 90-day mortality rate were also significantly higher in the SOT group. A significantly higher incidence of deep vein thrombosis was observed in the KT subgroup compared with the control group. A higher risk of medical and surgical complications, as well as higher readmission and mortality rates after hip arthroplasty was observed for previous SOT recipients compared to patients with no history of SOT.

• Biomaterials Research
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• v.22 no.4
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• pp.259-270
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• 2018

Background: Total hip arthroplasty (THA) is probably one of the most successful surgical interventions performed in medicine. Through the revolution of hip arthroplasty by principles of low friction arthroplasty was introduced by Sir John Charnley in 1960s. Thereafter, new bearing materials, fixation methods, and new designs has been improved. The main concern regarding failure of THA has been the biological response to particulate polyethylene debris generated by conventional metal on polyethylene bearing surfaces leading to osteolysis and aseptic loosening of the prosthesis. To resolve these problems, the materials of the modern THA were developed since then. Methods: A literature search strategy was conducted using various search terms in PUBMED. The highest quality articles that met the inclusion criteria and best answered the topics of focus of this review were selected. Key search terms included 'total hip arthroplasty', 'biomaterials', 'stainless steel', 'cobalt-chromium', 'titanium', 'polyethylene', and 'ceramic'. Results: The initial search retrieved 6921 articles. Thirty-two articles were selected and used in the review. Conclusion: This article introduces biomaterials used in THA and discusses various bearing materials in currentclinical use in THA as well as the newer biomaterials which may even further decrease wear and improve THA survivorship.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.1
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• pp.77-91
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• 2019

Objectives : The purpose of this study was to investigate the effects of using acupuncture and moxibustion for the treatment of hip arthroplasty. Methods : We searched a total of six Korean and international databases (OASIS, KISS, RISS, Pubmed, Cochrane library, and CNKI) up to March 2019, and included randomized controlled trials which investigated the treatment effects of acupuncture and moxibustion in patients with hip arthroplasty. Results : In total, 29 studies were selected and included in the analysis. These studies conducted interventions, with the most frequently conducted methods being electroacupuncture (24.1%) and auricular acupuncture (20.7%). The most frequently used acupoints were the Ashi-, Lower four-, and Lower five points. VAS (48.9%) and Harris scores (22.2%) were commonly used to evaluate treatment effects. In total, 27 studies (93.1%) reported favorable treatment effects following acupuncture and moxibustion treatment, compared to the control group. Conclusions : These results may suggest that acupuncture and moxibustion have favorable effect on Hip arthroplasty.

• Hip & pelvis
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• v.35 no.2
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• pp.108-121
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• 2023

Purpose: The primary objective of the current study is to demonstrate the trochanteric wiring technique. A secondary objective is to evaluate the clinico-radiological outcomes of use of the wiring technique during primary arthroplasty for treatment of unstable and failed intertrochanteric fractures. Materials and Methods: A prospective study including follow-up of 127 patients with unstable and failed intertrochanteric fractures who underwent primary hip arthroplasty using novel multi-planar trochanteric wiring was conducted. The average follow-up period was 17.8±4.7 months. Clinical assessment was performed using the Harris hip score (HHS). Radiographic evaluation was performed for assessment of union of the trochanter and any mechanical failure. P<0.05 was considered statistically significant. Results: At the latest follow-up, the mean HHS showed significant improvement from 79.9±1.8 (at three months) to 91.6±5.1 (P<0.05). In addition, no significant difference in the HHS was observed between male and female patients (P=0.29) and between fresh and failed intertrochanteric fractures (P=0.08). Union was achieved in all cases of fractured trochanter, except one. Wire breakage was observed in three patients. There were five cases of limb length discrepancy, three cases of lurch, and three cases of wire-related bursitis. There were no cases of dislocation or infection. Radiographs showed stable prosthesis in situ with no evidence of subsidence. Conclusion: Use of the proposed wiring technique was helpful in restoring the abductor level arm and multi-planar stability, which enabled better rehabilitation and resulted in excellent clinical and radiological outcomes with minimal risk of mechanical failure.