• 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.

• Journal of Life Science
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• v.14 no.3
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• pp.385-390
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• 2004

Chitosan is abundant polysaccharide polymer in nature Chitosan has been the subject of much research regarding its potential as a nutritional adjunct and pharmaceutical ingredient. In the present study, we examined fracture-healing process with chitosan administration and low calcium diet in rats. Left femur was fractured and fixed with intramedullary pin. The rats were fed normal diet or low calcium diet and administered chitosan with the doses of 0, 50, 100 and 150ng/ml orally 5 times a week for 10 weeks. Soft X-ray and mechanical testing of all fractured femora was taken. Radiographical finding showed that the callus formation and process of fracture healing was present in all the fractured femora. Mechanical testing indicated that the maximum load and stiffness of femur in rat fed low calcium diet was lower than those of that in rat fed normal diet. No difference in maximum load and stiffness of fractured femora in chitosan treated rat were observed as compared to vehicle treated rat. Chitosan or/and low calcium diet did not affect the ratio of fractured/unfractured femur about maximum load and stiffness. The results suggest that chitosan dose not affect the bone mechanical strength and the process of fracture healing. Low calcium diet does decrease the bone mechanical strength.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.7-13
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• 2014

Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

• Journal of the Korean Society for Nondestructive Testing
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• v.35 no.2
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• pp.103-111
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• 2015

The present study investigated the influence of thick cortical endplates on the ultrasonic properties of trabecular bone in a femur with a high fracture risk. Twelve trabecular bone samples were prepared from bovine femurs, and acrylic plates with thicknesses of 1.25, 1.80, and 2.75 mm were manufactured to simulate the cortical endplates using acrylic with a density and a sound speed similar to cortical bone. Although the thickness of the acrylic plates attached to the two sides of the trabecular bone increased, high correlations were observed between the speed of sound and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.80-0.86. High correlations were also observed between the attenuation coefficient at 0.5 MHz and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.84-0.91. These results suggest that the speed of sound and attenuation coefficient at a specific frequency measured in a femur with relatively thick cortical endplates compared to the calcaneus could be used as indices for predicting the bone mineral density of the femur.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.35 no.6
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• pp.601-607
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• 2002

The present study was designed to examine how sea tangle intake contributes to the content of bone calcium and breaking force of femur with growing female rats. Weaned rats were fed on experimental diets consisting in four levels of sea tangle powder; $0\%$ (control), $0.5\%$, $1.0\%$ and $1.5\%$ for 4 and 8 weeks. Body weight gain and feed intake were not significantly affected by added amount of sea tangle. Bone breaking strength, ash content and calcium levels of the femur of rats fed on diets with sea tangle were higher than those of control groups (p<0.05). But moisture content weight and length of femur did not show any significant difference among groups. TP, ALB, TC, TG, AIP, osteocalcin, GOT and GPT levels in serum did not show any significant difference through the total feeding period but calcium and phosphorus contents of serum increased with increase in feeding period, significantly in $0.05\%$ level by added amounts of sea tangle. Calcium levels in feces increased significantly (P<0.05), but ash levels were not changed significantly by added amount of sea tangle. We could expect from this results that the ingestion of sea tangle (Kjellemaniella crassifolia) could be helpfull to increase bone calcium content and calcium absorption as well as to intensify the femur stength and to increase the calcium content of rats.

• Journal of the Korea Society of Computer and Information
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• v.26 no.8
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• pp.209-220
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• 2021

The effect of body composition such as lean mass and fat mass on bone mineral density (BMD) is complex and still controversial. In this study, we investigated the relationship between body composition and bone mineral density using nation-wide data from 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES) in 2,139 men and 2,193 postmenopausal women aged 50 years or older. Subjects with history of medication for osteoporosis or with diseases or malignancy affecting bone metabolism were excluded. Data of anthropometric measurements and demographic characteristics were collected by trained examiner. Fasting blood sample was obtained for blood chemistry analysis. BMD of the lumbar spine, total femur, and femoral neck, and body composition such as total lean mass (TLM), total fat mass (TFM), truncal fat mass (TrFM) were measured using dual-energy X-ray absorptiometry (DXA). There were significant positive correlations between body composition indices such as lean mass and fat mass with BMD. In multiple regression analysis, TLM was positively associated with BMD after adjusting age, body mass index, monthly house income, education level, physical activity, daily calcium intake and vitamin D concentration in both men and postmenopausal women. BMD at lumbar spine and femur in lowest quartile of TLM was significantly lower than other quartiles after adjusting those confounding factors in both gender. TrFM was negatively associated with total femur BMD in male and femur neck BMD in postmenopausal women after adjusting confounding factors. In conclusion, TLM is very important factor in maintaining BMD in subjects aged 50 years or older in men and postmenopausal women.

• 대한치주과학회:학술대회논문집
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• 2005.11a
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• pp.84-86
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• 2005

• The Journal of the Korean dental association
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• v.18 no.2 s.131
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• pp.109-114
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• 1980

• The Journal of the Korean bone and joint tumor society
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• v.7 no.2
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• pp.73-79
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• 2001

Giant cell tumor is usually found around the knee joint, especially in the distal femur or proximal tibia. Despite being classified as benign, it has unusual biological behavior of local aggressiveness and tend to have severely destructive lesion and develop rare pulmonary metastasis. Therefore, when the patient is presented to the physician with an expansile lytic lesion of challenging clinicopathologic entity extending to subchondral bone, the physician faces up to difficulties in treatment. We report a case of 25 years old patient having recurrent giant cell tumor in the right distal femur which developed metastasis to lung. The primary bone lesion was treated with local curettage and fillings with methylmethacrylate, but when he returned to the hospital two years later, the recurrence had developed with lung metastasis.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.128-130
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• 2010

Femoral avulsion fracture of posterior cruciate ligament (PCL) is rare, especially in adult. We experienced a case of femoral bony avulsion fracture of PCL. The patient was seventy one year old man with limitation of motion in the knee joint due to previous trauma and he was injured by fall down from 2 m height. We took CT scan and MRI study. We treated with arthroscopic repair technique using transfemoral two wire sutures. Second look arthroscopy was done for removal of the wires at postoperative one year.