• Title/Summary/Keyword: 고관절 탈구

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Proteomic-determined Alteration of Synovial Fluid on Induced Model of Transected Ligament of Head of Femur (개의 대퇴골두인대 절단 모델에서 프로테오믹스로 관찰한 관절액의 변화)

  • Kim, Se-Hoon;Shin, Ki-Uk;Ji, Joong-Ryong;Shim, Kwan-Seob;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.679-685
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    • 2010
  • Many animal models of osteoarthritis (OA) have been developed, aimed at understanding the long-term progression of OA and difficulty of identifying patients in the initial stage of the disease. In canines, coxofemoral luxation and hip dysplasia are common orthopedic ailments related to OA in the hip joint. Transecting the ligament of the head of the femur (LHF) aids in diagnosis of coxofemoral joint OA. Presently, mobility of this joint was increased by transected LHF in 10 mature, 2-3-year-old (average $2.57{\pm}0.20$ years), healthy male beagles. The animals were normally gaited 1-week post-operatively. During the experimental period, examinations including X-ray, complete blood count and serum chemistry were unremarkable. Proteomic examination revealed protein alterations in synovial fluid, with significant increases in Vitamin D-binding protein precursor (ANOVA, p < 0.004) and Kinogen-1 (ANOVA, p < 0.039). Both proteins correlated with arthritis.

Cementless Total Hip Arthroplasty Using Ceramic Femoral Head on Cross-Linked Ultra-High-Molecular Weight Polyethylene Liner in Patients Older than 65 Years: Minimum Five-Year Follow-Up Results (세라믹 대퇴 골두 및 교차결합 초고분자량 폴리에틸렌 라이너를 이용한 65세 이상 무시멘트형 인공 고관절 전치환술: 최소 5년 중기 추시 결과)

  • Yun, Ho Hyun;Cheong, Ji Young;Sim, Hyun Bo;Park, Jae Hong
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.490-497
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    • 2018
  • Purpose: To evaluate the utility of ceramic-on-polyethylene articular bearing surface when cementless total hip arthroplasty is performed in patients older than 65 years through an analysis of the minimum five-year follow-up results using the ceramic femoral head and cross-linked polyethylene liner. Materials and Methods: From March 2010 to September 2012, 51 patients (56 hips) who were older than 65 years were enrolled in this retrospective study. The mean age at surgery was $70.9{\pm}5.1years$ old. A clinical assessment was analyzed using the Harris hip score. For the radiographic assessment, the cup inclination and anteversion, stem alignment, and wear amount were measured. The postoperative complications were also determined. Results: The mean Harris hip score was improved from preoperative 48 points to postoperative 87 points (p<0.05). The mean cup inclination was $40.9^{\circ}{\pm}6.4^{\circ}$ and the mean cup anteversion was $20.3^{\circ}{\pm}8.1^{\circ}$. The mean cup anteversion of the elevated liner-used group (16 cases) was $14.3^{\circ}{\pm}7.9^{\circ}$ and the mean cup anteversion of the neutral liner used group (40 cases) was $22.4^{\circ}{\pm}9.1^{\circ}$ (p<0.05). The mean stem alignment angle was $0^{\circ}$ (range, varus $4^{\circ}$-valgus $4^{\circ}$). The mean linear wear amount was $0.458{\pm}0.041mm$ and the average annual linear wear rate was $0.079{\pm}0.032mm/yr$. Six cases (10.7%) of intraoperative periprosthetic femoral fractures were encountered. Conclusion: Based on these results, the use of a ceramic-on-polyethylene articular bearing surface in elderly patients with cementless total hip arthroplasty is beneficial. On the other hand, careful effort is needed to prevent intraoperative periprosthetic femoral fractures.

Modified External Skeletal Fixation for Craniodorsal Coxofemoral Luxation in 5 Dogs (개의 전배측 고관절 탈구에서 변형된 외골격 고정 적용 5례)

  • Jung, Chang-Su;Lim, Ji-Hey;Byeon, Ye-Eun;Kim, Wan-Hee;Yoon, Jung-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.631-635
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    • 2007
  • Luxation of the hip is the most common luxation seen in small animals. Luxations are classified by the direction in which the femoral head lies in relation to the acetabulum and craniodorsal luxations are the most common type. Recommendations for treatment are based on the presence of preexisting disease, the type and duration of luxation and severity of concurrent injuries. In this study modified external skeletal fixation was used for craniodorsal coxofemoral luxation in 5 dogs. Luxated head Joint was reduced and fixator pins were applied into the greater trochanter, the middle point of iliac body and the lateral surface of sacroiliac joint in a closed fashion. Reduction was successful in 4 of the 5 operated limbs. Complications noted in this study included pin tract drainage, pin loosening and secondary fracture at the pin insertion site.

Radiographic Evaluation of Hip Conformation in the Dogs with Medial Patella Luxation (개에서 내측슬개골 탈구 등급에 따른 고관절 이상과의 상관관계에 대한 방사선학적 평가)

  • Lee, Ki-Ja;Park, Eun-Jeong;Kwon, Young-Hang;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.30 no.4
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    • pp.278-282
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    • 2013
  • This study was performed in 41 dogs with unilateral or bilateral medial patella luxation (MPL) and/or cranial cruciate ligament rupture (CCLR). These dogs were classified into 4 groups according to MPL grading system. Radiographic evaluation was performed for pelvis and stifle joint in the dogs. Norberg, inclination, quadriceps and femoral varus angle were measured and analyzed with MPL grading and the existence of cranial cruciate ligament rupture. The Norberg and inclination angle showed no differences between 4 grading groups and between CCLR and no CCLR groups. However, quadriceps and femoral varus angle were statistically different between grade 1, 2 and grade 3, 4 groups. They also have shown the statistical difference between CCLR and no CCLR group. Further studies for how these parameters affect the prognosis and the results of surgical treatment of MPL should be needed.

Radiological Evaluation on Dislocation of the Hip with Spastic Cerebral Palsy (경직형 뇌성마비 아동의 고관절 탈구에 대한 방사선학적 평가)

  • Kim, Jeong-Hwan;Kim, Yong-Nam
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.2 no.1
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    • pp.9-17
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    • 2004
  • The purpose of this study are to determine the proper radiographic measurements for hip deformity in spastic cerebral palsy patients, and the correlation of hip deformity with neurological involvement, ability of ambulation. Thirty children with cerebral palsy(22 males, 8 females) were evaluated by measurement of the migration index, acetabular index, center edge angle from bilateral hip APs(anterior posterior view). The result are as follows; 1. The incidence of hip dislocation, among the thirty children fifteen children were found to be dislocated, and more significantly high in non-walking group than in walking group(p<0.05) and in quadriplegia than in diplegia(p<0.05). 2. When compared to normal hip and dislocation hip, the migration index was significantly higher(p<0.01) and the center edge angle was lower in the dislocation hip than in the normal hip. 3. Correlation of radiological findings in right and left hip, the migration index and the center edge angle were highly correlated(p<0.01). We recommand regular intervals X-ray study for early diagnosis and management of hip dislocation in spastic cerebral palsy.

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Phenotypic and Cytogenetic Delineation of Six Korean Children with Kabuki Syndrome (한국인 Kabuki 증후군 환아들의 임상적 표현형 및 세포유전학적 양상)

  • Ko, Jung-Min;Hwang, Jeong-Min;Kim, Hyon-Ju
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.37-44
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    • 2010
  • Purpose : Kabuki syndrome is a multiple congenital malformation syndrome with mental retardation. It was named after its characteristic appearance, a face resembling that of an actor in a Kabuki play. To date, six Korean cases of Kabuki syndrome have ever been reported. Here, we present the phenotypic and genetic characteristics of six patients with Kabuki syndrome. Materials and Methods : Between 2003 and 2009, six Korean girls have been diagnosed and followed up as Kabuki syndrome at Center for Genetic Diseases of Ajou University Hospital. Their clinical and laboratory data were collected and analyzed by the retrospective review of medical records. Results : All six patients showed the characteristic facial dysmorphism and developmental delay. Persistent fingertip pads were also found in all patients. Most patients showed postnatal growth retardation (83.3%) and hypotonia (83.3%). Opthalmologic problems were common, particularly for strabismus (83.3%). Congenital heart defects were present in three patients (50%). Skeletal abnormalities including 5th finger shortening (83.3%), clinodactyly (50%), joint hypermobility (50%) and hip dislocation (16.7%) were also observed. There was no patient who had positive family history for Kabuki syndrome. Cytogenetic and molecular cytogenetic analyses including karyotyping and array CGH could not reveal any underlying genetic cause of Kabuki syndrome. Conclusion : Korean patients with Kabuki syndrome showed a broad spectrum of clinical features affecting multiple organ systems. Although clinical manifestations of Kabuki syndrome have been well established, our results failed to detect recurrent chromosome aberrations which could cause Kabuki syndrome. Its natural history and genetic background remains to be further studied for providing appropriate management and genetic counseling.

Factors for Survival and Complications of Malignant Bone Tumor Patients with a Total Femoral Replacement (대퇴골 전치환술 받은 악성 골종양 환자의 생존인자와 합병증)

  • Cho, Wan Hyeong;Jeon, Dae-Geun;Song, Won Seok;Park, Hwan Seong;Nam, Hee Seung;Kim, Kyung Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.244-252
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    • 2020
  • Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.