Identification of Essential Features in Developing a Novel Femoral Stem Reflecting Anatomical Features of East Asian Population: A Morphological Study.

: Recent advancements in hip arthroplasty aim to enhance the stability, longevity, and functionality of femoral implants. However, the distal fitting of femoral stems, often caused by metaphyseal-diaphyseal mismatch, remains a significant issue, particularly in patients with Dorr type A femora. Such mismatches can result in suboptimal implant performance, leading to potential complications.

Should the diameter of the proximal femoral nail be large enough to fill the canal in the treatment of intertrochanteric femoral fracture in patients over fifty?

Purpose: Many studies have been conducted to evaluate the effects of nail shape, design, or length on the treatment of intertrochanteric fractures. However, the clinical implications of the nail diameter remain unclear.

Methods: This study was conducted with 191 patients aged ≥ 50 years with unilateral intertrochanteric fractures treated with the same type of short cephalomedullary nail and followed for at least one year.

Hip Resurfacing Arthroplasty after Failure of Tantalum Rod Insertion in Patients with Osteonecrosis of the Femoral Head.

Purpose: The purpose of this study was to examine the clinical outcomes and efficacy of hip resurfacing arthroplasty (HRA) in patients with osteonecrosis of the femoral head after the failure of porous tantalum rod insertion without rod removal.

Materials And Methods: Conversion to hip resurfacing arthroplasty was performed in 10 patients (11 hips) with a mean period of 14.9 months after the primary surgery.

Patterns of labral tears and cartilage injury are different in femoroacetabular impingement and dysplasia.

The aim of this study was to assess injury patterns and risk factors of the acetabular labrum and associated cartilage in patients with femoroacetabular impingement (FAI) versus dysplasia. We retrospectively reviewed 137 patients diagnosed with labral tears and FAI or dysplasia (74 or 63 cases, respectively) through an arthroscopic procedure. Labral and concomitant cartilage injuries were evaluated.

Favorable mid-to-long-term results of impaction bone grafting using a fresh frozen allograft bone with cemented stem for the treatment of Paprosky IV femoral bone defects.

Background: Femoral revision surgery in patients with substantial bone loss is challenging. Impaction bone grafting using a cemented stem can be a good solution for reconstruction of the femur with poor bone stock and extensive bone loss. This study aimed to evaluate the mid-to-long-term clinical and radiographic results of impaction bone grafting using a cemented stem for Paprosky IV femoral bone defects.

The reasons for ceramic-on-ceramic revisions between the third- and fourth-generation bearings in total hip arthroplasty from multicentric registry data.

This study aimed to evaluate (1) the overall reasons for first revision in CoC THAs; (2) whether the reasons for revision differ between third-generation and fourth-generation CoC THAs; and (3) the specific factors associated with bearing-related problems as the reason for revision. We retrospectively reviewed 2045 patients (2194 hips) who underwent first revision THA between 2004 and 2013, among which 146 hips with CoC bearings underwent revision. There were 92 hips with third-generation ceramic bearings and 54 hips with fourth-generation ceramic bearings.

Age and sex-related distribution of alpha angles and the prevalence of the cam morphology of the hip in Asians do not differ from those of other ethnicities.

Purpose: This study was performed to evaluate the effects of age on the alpha angle and the incidence of asymptomatic cam morphology.

Methods: The radiographs of asymptomatic individuals between ages 8 and 22 were retrospectively collected. A total of 1417 individuals were included and grouped according to age: 8-12 (Group A), 13-18 (Group B), and 19-22 (Group C) years.

Critical differences between subtrochanteric and diaphyseal atypical femoral fractures: analyses of 51 cases at a single institution in Korean population.

Unlabelled: There still remains controversy on the pathomechanism of atypical femoral fracture (AFF). The angle of lateral bowing and bone mineral density showed significant differences between subtrochanteric and diaphyseal atypical fracture groups. In addition to the use of bisphosphonate, mechanical factors might play important roles in the occurrence of AFFs.

Periprosthetic femoral fracture as cause of early revision after short stem hip arthroplasty-a multicentric analysis.

Background: The objective of this study was to analyze the prevalence and causes of early re-operation after hip replacement surgery using short bone-preserving stems in a large multicentre series. Specifically, we evaluated the clinical features of periprosthetic fractures occurring around short stems.

Methods: A total of 897 patients (1089 hips) who underwent primary total hip arthroplasty or bipolar hemiarthroplasty from January 2011 to February 2015 using short bone-preserving femoral stems were recruited.

Novel Antibiotic-Loaded Cement Femoral Head Spacer for the Treatment of Advanced Pyogenic Arthritis in Adult Hip.

Background: The aim of this study is to present a treatment for end-stage pyogenic arthritis of the hip using a novel cement spacer. This spacer caused less damage to the proximal femoral bone and made the conversion to total hip arthroplasty (THA) more convenient while maintaining the advantages of current cement spacers loaded with antibiotics.

Methods: We retrospectively reviewed 10 consecutive cases of hip pyogenic arthritis with joint destruction.

Acetabular Insufficiency Fracture Following Prolonged Alendronate Use and the Failure of Total Hip Arthroplasty in "Frozen" Bone: Two Cases Report.

Atypical insufficiency fracture of the femur following prolonged bisphosphonate use is well described. Regardless of the cause, insufficiency fracture of the acetabulum is extremely rare, and no reports have described insufficiency fractures of the acetabulum that are associated with prolonged bisphosphonate use. This report demonstrates the possibility of insufficiency fracture at the acetabulum following long-term alendronate use and the necessity of particular care in managing insufficiency fractures in "frozen" bone.

High incidence of early subtrochanteric lateral cortical atrophy after hip arthroplasty using bone-conserving short stem.

Purpose: Load transfer to the bone is believed to be more physiological around the short stem in total hip arthroplasty (THA). However, we found unusual bony remodeling around the shortened tapered stem. This study was performed to investigate the extent and frequency of this phenomenon and to find the possible risk factors of it.

Effect of ligamentum teres tear on the development of joint instability and articular cartilage damage: an in vivo rabbit study.

The contribution of the ligamentum teres to the stabilization of the hip joint and the clinical influence of a compromised ligamentum teres are not well known. This study aimed to investigate joint stability and cartilage damage in a rabbit model by surgically inducing a complete ligamentum teres tear. Twenty adult New Zealand rabbits were used in this study.

Dissociation of Polyethylene Liner of the Dual Mobility Acetabular Component after Closed Reduction of Dislocation: A Case Report.

A dual mobility acetabular component has a structure that combines a polyethylene liner and a femoral head, unlike the general design of acetabular cups, making the dissociation of a polyethylene liner highly unlikely. In addition, it increases the range of motion and reduces the possibility of dislocations by increasing a jump distance. A fifty-one-year-old male who had received total hip arthroplasty with the dual mobility acetabular component visited a hospital for a posterior hip dislocation 10 weeks after the operation.

Surgical outcome of intramedullary nailing in patients with complete atypical femoral fracture: A multicenter retrospective study.

Background: Management of atypical femoral fracture on bisphosphonate therapy still remains controversy and is reported high rate of complications. The aim of this study was to evaluate the outcome of intramedullary nailing in patients with atypical femoral fracture who took bisphosphonate more than one year through the multicenter retrospective study.

Methods: We gathered 75 atypical femoral fractures from seven institutions between 2009 and 2014.

Cell morphology, viability, osteocalcin activity, and alkaline phosphatase activity in milled versus unmilled surface of the femoral head.

Purpose: To evaluate cellular activity in milled versus unmilled surface of the femoral head in 21 patients who underwent robot-assisted total hip arthroplasty(THA).

Methods: The femoral head of 21 consecutive patients who underwent robot-assisted THA for osteonecrosis was used. 10 cc of trabecular bone from the entire milled surface was obtained using a curette.

Distal femoral cortical hypertrophy after hip arthroplasty using a cementless doubletapered femoral stem.

Purpose: To review 437 hips in 404 patients who underwent total hip arthroplasty (THA) or hemiarthroplasty using the Accolade TMZF stem to determine the incidence and risk factors of distal femoral cortical hypertrophy (DFCH).

Methods: Records of 437 hips in 169 men and 235 women aged 26 to 100 (mean, 65.7) years who underwent THA (n=293) or hemiarthroplasty (n=144) using the Accolade TMZF femoral stem by 2 senior surgeons and were followed up for a mean of 54.

High union rates of locking compression plating with cortical strut allograft for type B1 periprosthetic femoral fractures.

Purpose: Unified classification system (UCS) type B1 periprosthetic femoral fractures are associated with many complications, and management decisions continue to be controversial. The purpose of this study was to evaluate outcomes of UCS type B1 periprosthetic femoral fractures treated by locking compression plating with strut allograft augmentation.

Materials And Methods: We retrospectively reviewed 17 consecutive UCS type B1 periprosthetic femoral fractures treated by open reduction and internal fixation using a lateral locking compression plate supplemented with an anterior cortical strut allograft.

Amyloid Arthropathy of the Hip Joint Associated with Multiple Myeloma: A Case Report.

Amyloidosis is a disease characterized by the deposition of non-soluble fibrous protein in multiple tissues with a number of possible causes. This protein deposition can occur in any tissue, yet is most commonly seen in kidneys, heart, and gastrointestinal tracts. However, invasion to bone tissues is not often reported.

Does the Time of Postoperative Bisphosphonate Administration Affect the Bone Union in Osteoporotic Intertrochanteric Fracture of Femur?

Purpose: This study was designed to investigate the effect of bisphosphonate administration starting time on bone healing and to identify the best administration time following surgical treatment of osteoporotic intertrochanteric fractures.

Materials And Methods: Two hundreds and eighty four patients (284 hips; 52 males, 232 females) who underwent surgery following osteoporotic intertrochanteric fracture from December 2002 to December 2012 were retrospectively analyzed. The average follow-up period was 68.

Aspergillus Septic Arthritis of the Hip in an Immunocompetent Middle-aged Female with Undiagnosed Recurrent Pulmonary Aspergillosis.

We present a case of Aspergillus septic hip arthritis in an immunocompetent patient with undiagnosed recurrent pulmonary aspergillosis who underwent arthroscopic surgery. Biopsy specimens of synovium revealed fungal hyphae, confirming Aspergillus infection. Aspergillus septic hip arthritis can occur in immunocompetent patients, and arthroscopy can be a noninvasive surgical option in these cases.

Periprosthetic Insufficiency Fracture around Radiographically Loose Cemented Stem: A Report of Two Cases.

As the osteoporotic patient population grows, various periprosthetic fractures that cannot be classified appropriately can occur around the femur after hip arthroplasty. We experienced two cases of periprosthetic insufficiency fractures at subtrochanteric area of the femurs around radiographically loose cemented femoral stems. The ages of the patients were 75 years and 83 years.

Fracture of Fully-coated Femoral Stem after Primary Total Hip Arthroplasty for Nonunion of Intertrochanteric Fracture: A Case Report.

Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture.