Change of Sacral Slope according to the Surgical Position in Total Hip Arthroplasty.

Purpose: Pelvis tilting in sagittal plane influences the acetabular cup position. Majority of total hip arthroplasty (THA) are performed in lateral decubitus surgical position. This study is to assess whether there is any difference in sacral slope between standing and lateral decubitus position and influence of this variation in planning acetabular cup anteversion.

Prevention of Pernicious Vascular Event: Acetabular Component Screw Impinging on External Iliac Vessels - A Unique Case Report.

Introduction: Revision total hip arthroplasty requires meticulous planning and execution to achieve the desired outcome. Pelvic vessel injury following total hip arthroplasty is rare, but a well-known and serious complication, having a very high morbidity (15%) and mortality (7%). This case demonstrates the rare occurrence of acetabular screw abutment to the external iliac vessels, which if removed during revision hip surgery without releasing the adhesions around it, will lead to avulsion injury of the vessels and a catastrophic event.

A larger sized cup accelerates cartilage erosion of acetabulum after bipolar hemiarthroplasty in elderly with femur neck fracture.

Bipolar hemiarthroplasty (BHA) is one of the common procedures done for the treatment of femur neck fracture. One of the frequently encountered complication with this surgery is erosion of the acetabular cartilage. This study was conducted to investigate acetabular erosion after BHA according to the difference in diameter between femoral head and implanted cup at minimum 10-year follow-up.

Usefulness of Synthetic Osteoconductive Bone Graft Substitute with Zeta Potential Control for Intramedullary Fixation with Proximal Femur Nail Antirotation in Osteoporotic Unstable Femoral Intertrochanteric Fracture.

Purpose: This study was conducted in order to examine the usefulness of osteoconductive bone substitutes with zeta potential control (geneX® ds; Biocomposites, England) by comparing the complications and radiographic evaluation with or without geneX® ds augmentation for internal fixation with proximal femur nail antirotation (PFNA) for treatment of osteoporotic unstable intertrochanteric fractures.

Materials And Methods: A retrospective study of 101 patients who underwent fixation with PFNA in osteoporotic unstable intertrochanteric fractures was conducted from December 2015 to August 2020. The radiographic evaluation and complication rates were compared between patients with geneX® ds (Group A: 41 cases) and those without geneX® ds (Group B: 60 cases).

Comparison of the postoperative analgesic effect for infiltration between the popliteal artery and the capsule of the posterior knee and that of periarticular multimodal drug injection in total knee arthroplasty: retrospective study in the immediate postoperative period.

Background: The aim of this study is to compare the postoperative analgesic effect of infiltration between the popliteal artery and the capsule of the knee (IPACK) and the effect of periarticular multimodal drug injection (PMDI) in addition to adductor canal block (ACB) after total knee arthroplasty.

Methods: Among patients who received total knee arthroplasty from June 2017 to December 2017, 50 who underwent ACB with additional IPACK and 50 who received ACB with additional PMDI were selected for this study. We compared the postoperative pain numerical rating scale (NRS), the number of times patient-controlled analgesia was administered and the amount administered, the total amount of opioids given, and complications associated with the procedure between the two groups.

Comparison of Functional Outcomes and Associated Complications in Patients Who Underwent Total Hip Arthroplasty for Femoral Neck Fracture in Relation to Their Underlying Medical Comorbidities.

Purpose: In patients with independent mobility, full hip range of motion and sufficient muscle strength for daily life without cognitive impairment, treatment of a femoral neck fracture with total hip arthroplasty (THA) may be a better option compared to bipolar hip hemiarthroplasty. Here, functional outcomes and complications in patients who underwent THA for femoral neck fracture based on their comorbidity status were analyzed.

Materials And Methods: Between January 2013 and December 2018, 110 patients were treated with THA for femoral neck fractures at our institution.

Total Hip Arthroplasty: Past, Present, and Future. What Has Been Achieved?

In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA.

Assessment of Korea's Orthopedic Research Activities in the Top 15 Orthopedic Journals, 2008-2017.

Background: Bibliometrics is increasingly used to assess the quantity and quality of scientific research output in many research fields worldwide. This study aims to update Korea's worldwide research productivity in the field of orthopedics using bibliometric methods and to provide Korean surgeons and researchers with insights into such research.

Methods: Articles published in the top 15 orthopedic journals between 2008 and 2017 were retrieved using the Web of Science.

Pseudotumor and Subsequent Implant Loosening as a Complication of Revision Total Hip Arthroplasty with Ceramic-on-Metal Bearing: A Case Report.

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.

Increased Serum Ion Levels After Ceramic-on-Metal Bearing Total Hip Arthroplasty: Influence of an Asian Lifestyle.

Background: Recent clinical studies have suggested that systemic metal ion levels are significantly elevated at midterm follow-up in patients with ceramic-on-metal (COM) bearing. However, it is not clear whether there is a correlation between patient-related factors including the lifestyle and elevated levels of serum metal ions following COM total hip arthroplasty (THA).

Methods: Serum metal levels were measured in 201 patients (234 hips) including 121 COM patients (140 hips) and 80 non-COM patients (94 hips).

Acetabular Defect Reconstruction with Trabecular Metal Augments: Study with Minimum One-year Follow-up.

Purpose: High rates of mechanical failure have been reported in type III acetabular defects. Recently porous trabecular metal augments have been introduced with, excellent biomechanical characteristics and biocompatibility, allowing early stability and greater bone ingrowth. The aim of the study was to assess the short term clinical and radiological outcome of the trabecular metal augments.

Ganglion cyst of the hip mimicking lumbar disk herniation - A case report.

Sciatic nerve compression due to a ganglion cyst around the posterior aspect of the hip joint is not commonly described in literature. We report a rare case of a 63-year-old man with a ganglion cyst around his hip joint, who presented with symptoms of sciatica. After excision of the cyst, the patient was symptom free.

Locking attachment plate fixation around a well-fixed stem in periprosthetic femoral shaft fractures.

Introduction: Periprosthetic fractures are difficult to manage. Plating technique has been considered a reliable form of management of periprosthetic fractures with a well-fixed stem, but a dependable and stable method of plate fixation to the bone is lacking. This study reports the clinical results using a locking attachment plate (LAP) instead of cable fixation to fix locking plates to a periprosthetic femoral shaft fracture.

Healing Process of Osteonecrotic Lesions of the Femoral Head Following Transtrochanteric Rotational Osteotomy: A Computed Tomography-Based Study.

Background: Transtrochanteric rotational osteotomy (TRO) is a controversial hip-preserving procedure with a variable success rate. The healing process of femoral head osteonecrosis after TRO has been poorly explained till now. This study aimed to evaluate the healing process of previously transposed necrotic lesion after a TRO for nontraumatic osteonecrosis of the femoral head using computed tomography (CT).

Acetabular Reconstruction in Total Hip Arthroplasty.

The difficulties encountered in dealing with the bone deficient acetabulum are amongst the greatest challenges in hip surgery. Acetabular reconstruction in revision total hip arthroplasty can successfully be achieved with hemispherical components featuring a porous or roughened ingrowth surface and options for placement of multiple screws for minor acetabular defect. Acetabular component selection is mostly based on the amount of bone loss present.

Is two-stage reimplantation effective for virulent pathogenic infection in a periprosthetic hip? A retrospective analysis.

Aim: To investigate the effectiveness of two-stage reimplantation using antibiotic-loaded bone cement (ALBC) and the risk factors associated with failure to control periprosthetic joint infection (PJI).

Methods: We retrospectively reviewed 38 consecutive hips managed using two-stage reimplantation with ALBC. The mean follow-up period was 5.

A Rare Case of Femoral Neuropathy Associated with Ilio-Psoas Bursitis After 10 Years of Total Hip Arthroplasty.

We describe a case of femoral nerve palsy caused due to non-infective large iliopsoas bursitis after 10 years of cementless ceramic-on-metal THA. Bursectomy and exploration of femoral nerve were done to relieve the compressive symptoms of femoral nerve. Patient neurological symptoms were recovered within six months.

Radiologic healing of lateral femoral wall fragments after intramedullary nail fixation for A3.3 intertrochanteric fractures.

Introduction: Intramedullary nail fixation is a useful treatment option for A3 intertrochanteric fractures. Occasionally, we have encountered displaced lateral femoral wall (LFW) fragment during surgery with intramedullary nail system. We investigated the postoperative spontaneous reduction of displaced LFW fragments without further fixation and the factors that affected the spontaneous reduction of displaced LFW fragments.

Management of Periprosthetic Hip Joint Infection.

Total hip joint replacement offers dramatic improvement in the quality of life but periprosthetic joint infection (PJI) is the most devastating complication of this procedure. The infection threatens the function of the joint, the preservation of the limb, and occasionally even the life of the patient due to long term hospitalization and high cost. For the surgeon it is a disastrous burden, which requires repeated, complicated procedures to eradicate infection and to provide a mobile joint without pain.

Efficacy of Debridement for Early Periprosthetic Joint Infection after Hip Arthroplasty.

Purpose: In early prosthetic joint infection after hip arthroplasty, debridement with prosthesis retention may be performed for implant salvage, but the reported success rates are highly variable. Hence we reviewed the outcome of radical debridement and retention of prosthesis using established diagnostic criteria and surgical procedures in relation to significant variables including clinical characteristics, pathogenicity, and antibiotic treatment.

Materials And Methods: We retrospectively reviewed 20 patients (11 men and 9 women) with early prosthetic joint infection after unilateral hip arthroplasty, treated by radical debridement with retention of prosthesis from January 2000 to May 2011.

Can pelvic tilting be ignored in total hip arthroplasty?

Introduction: The orientation of acetabular component is influenced by pelvic tilt, body position and individual variation in pelvic parameters. Most post-operative adverse events may be attributed to malposition of the component in the functional position. There is evidence that orientation of the pelvis changes from the supine to standing position.

Minimally invasive plate osteosynthesis using a helical plate for metadiaphyseal complex fractures of the proximal humerus.

Minimally invasive plate osteosynthesis (MIPO) has been used for humeral shaft fractures, but concerns exist about soft tissue injuries. The purpose of this study was to report the surgical technique and clinical outcomes of MIPO using a helical plate for metadiaphyseal complex humeral shaft fractures. Twelve patients with acute displacement involving proximal and middle third humeral shaft fractures (AO type C) were treated using the MIPO technique with a helical plate.

Can ulnar variance be used to detect overstuffing after radial head arthroplasty?

Background: Overstuffing of the radiocapitellar joint during metallic radial head arthroplasty has been reported to cause loss of elbow flexion, capitellar erosion, and early-onset osteoarthritis. Although this is known, there is no agreed-on measurement approach to determine whether overstuffing has occurred.

Questions/purposes: We therefore hypothesized that overlengthening the radial head during radial head arthroplasty changes the ulnar variance in the wrist.

Oxford phase III meniscal bearing fracture: case report.

Meniscal bearing fracture is a rare complication of phase III Oxford unicompartmental knee replacement (UKR). We report a case of a meniscal bearing fracture that occurred 7 years after phase III Oxford medial UKR. The meniscal bearing showed uneven delamination of the polyethylene in the thinnest articular surface and an impingement lesion.