• 제목/요약/키워드: Femoral bone loss

검색결과 53건 처리시간 0.029초

Management of Severe Bone Defects in Femoral Revision following Total Hip Arthroplasty

  • Yicheng Li;Li Cao
    • Hip & pelvis
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    • 제36권2호
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    • pp.101-107
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    • 2024
  • Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porous-coated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.

한국형 Femoral IM Nail 설계를 위한 표준 Lateral 휨각도 분석 (Design of A Femoral IM Nail by analysis of Lateral Curve Angle)

  • 김성민;박성윤;이만표
    • 한국정밀공학회지
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    • 제22권11호
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    • pp.190-195
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    • 2005
  • A Femur is the longest and largest bone which supports body in human musculoskeletal structure. Therefore, it may cause heavy loss of blood when it is suffered by a simple or complex fracture, and the complication is very dangerous with a possibility of severe tissue damage. In this study, the femoral cancellous angle change is estimated in order to design the Korean femoral IM nail. Generally, it is various in the size and curvature of femoral cancellous bone depending on patient's body dimension. Therefore surgeon has difficulty in fitting this femoral IM nail to the patient in the surgical procedure. In our study, we tries to estimate femoral lateral curve angle with more precise method based on CT image of the femur and utilize this information on the design of femoral IM nail for Korean patients.

일부 초등학생의 어머니를 대상으로 한 성인 여성의 골밀도에 영향을 미치는 요인에 관한 연구 (A Study on the Factors Affecting Bone Mineral Density in Adult Women - Based on the Mothers of Elementary School Students-)

  • 김기랑
    • Journal of Nutrition and Health
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    • 제33권3호
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    • pp.241-249
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    • 2000
  • The bone mineral density(vertebrae Ll-4, femoral neck, Ward's triangle and trochanter) of 160 healthy adult women aged 29-45 was measured and general characteristics, anthropomentric measurements, and dietary intake were also studied to determine the main factors affecting the bone mineral density(BMD) of adult women. The nutrient intake of the subjects was adequate to RDA level except energy, Ca, Fe, and vit A. The BMD of vertebrae L24 showed significant positive association with nutrient intake such as animal protein, P, Ca(animal) and Fe(animal). The BMD of the femoral neck correlated significantly with anthropometric measurements such as height, weight, waist circumference, hip circumference, body fat and body mass index. The BMD of both sites(vertebrae L24 and femoral neck) were significantly related to vertebrae L24 was daily Ca intake and that of femoral neck was daily energy expenditure. In conclusion, adequate nutrient intake, especially protein, P, Ca and Fe as well as increases in physical activity were suggested to prevent the loss of bone mineral density in adult women.

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골다공증의 진단시 파노라마 방사선사진 유용성에 대한 연구 (Usefulness of panoramic radiography in the diagnosis of osteoporosis)

  • 이병도;이상래
    • Imaging Science in Dentistry
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    • 제31권2호
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    • pp.67-71
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    • 2001
  • Purpose: To assess the possibility of using panoramic indices as an indicator of jaw osteoporosis. Methods: Mandibular cortical width (MCW), degree of mandibular alveolar bone resorption (ABR) and morphology of mandibular inferior cortex (MIC) on panoramic radiograph were used as panoramic indices. These panoramic indices were compared with bone mineral density (BMD) of lumbar (L1-L4) and femoral neck measured by dual energy X-ray absorptiometry. We also compared MCW and ABR of young men with those of postmenopausal women. Results : There was a significant correlation between ABR and BMD of lumbar and femoral neck. And also significant correlation between MIC and BMD of lumbar and femoral neck. ANOVA test of BMD of lumbar and femoral neck showed significant differences according to morphologic classification of inferior cortex. There was significant difference in MCW and ABR between young men and postmenopausal women. Conclusion: Our results suggested that ABR and MIC on panoramic radiograph could be reliable in screening of osteoporosis.

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종골 외측 1/2 이상의 결손을 동반한 개방성 골절의 동종 대퇴골두 이식과 유리 피판술을 이용한 치료 (1예 보고) (Treatment of Open Calcaneal Fracture with Massive Bone Loss using Femoral Head Allograft and Myocutaneous Free Flap (A Case Report))

  • 성기선;은상수;문구현
    • 대한족부족관절학회지
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    • 제11권1호
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    • pp.111-114
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    • 2007
  • Open calcaneal fracture with more than lateral half of bone loss and soft tissue defect occurred in 17 year-old male patient due to motor vehicle accident. Soft tissue defect included heel pad, peroneal tendon. Bone loss involved mainly most part of inferior tuberosity but not subtalar joint. Open dressing and debridement were done daily in operating room and antibiotics administration was started. After granulation tissue formed, femoral head allograft was performed and fixed with 6.0 mm screws to replace bone defect. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap. No sign of infection nor major osteolysis was observed in 15 months follow up period. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap.

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한국 남성의 연령에 따른 부위별 골밀도 변화 및 골 소실률 (Age-Related Bone Mineral Density, Accumulated Bone Loss Rate at Multiple Skeletal Sites in Korean Men)

  • 김영란;이태용;이지현
    • 한국산학기술학회논문지
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    • 제15권6호
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    • pp.3781-3788
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    • 2014
  • 국민건강영양조사 제 5기 1 2차년도에 참여한 남성을 대상으로 연령에 따른 부위별 골밀도 변화, 골 소실률에 대해서 알아보고자 시도 하였다. 연령에 따른 골밀도 변화를 가장 잘 보여 주기 위해 Cubic regression을 사용하였고, 척추, 대퇴경부, 대퇴골 전자부, Ward 부위 골밀도 차이는 분산분석을 이용하여 분석하였다. 연구결과, 요추, 대퇴골 전체, 대퇴경부, 대퇴골 전자부, Ward 부위의 최대 골밀도는 20-24세였으며, 75-79세에서 골 소실률이 가장 높았다. 따라서, 남성에서는 75세 이상에서 골다공증의 집중적인 관리가 필요할 것이며, 남성에서의 골다공증 진단기준은 국제 임상 골밀도 학회(The International Society for Clinical Densitometry; ISCD)의 지침을 따르는 방안을 고려해 봐야 할 것이다.

무시멘트형 대퇴스템에서 원위부 압박 정도에 따른 생체역학적 특성 (Biomechanical characteristics of the distal filling effects in cementless femoral stem)

  • 박상석;박재원;채수원
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2000년도 춘계학술대회논문집A
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    • pp.387-392
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    • 2000
  • In cementless total hip replacement(THR), an initial stability of the femoral component is important to long term fixation of femoral stem. The initial stability has close relationship with the relative displacement of prosthesis and spongy bone at the proximal of femur. After implantation of the prosthesis. the surrounding bone is partially shielded from load carrying and starts to resort. Stress shielding is the cause of the loss of proximal bone. Assessing stress distribution of femur is important to predict stress shielding. The initial stability and the stress shielding were investigated for two loading conditions approximating a single leg stance and a stair climbing. Three types of stems were studied by the finite element method to analyze the biomechanical effects of distal filling of cementless femoral stems, Three types of stems employed are a distal filling stem, a distal flexible stem, and a distal tapered stem.

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Inhibitory effect of Ssanghwa-tang on bone loss in ovariectomized rats

  • Shim, Ki-Shuk;Lee, Ji-Hye;Ma, Choong-Je;Lee, Yoon-Hee;Choi, Sung-Up;Lee, Jae-Hoon;Ma, Jin-Yeul
    • Animal cells and systems
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    • 제14권4호
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    • pp.283-289
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    • 2010
  • Ssanghwa-tang (SHT) is a traditional Korean herbal medicine widely prescribed to decrease fatigue following an illness. The purpose of this study was to investigate the effects of SHT on osteoclast differentiation in vitro, and on bone loss in ovariectomized (OVX) rats in vivo. SHT significantly reduced the receptor activator for the nuclear factor ${\kappa}B$ (NF-${\kappa}B$) ligand (RANKL)-induced tartrate-resistant acid phosphatase (TRAP) activity, and multinucleated osteoclast formation in RAW264.7 cells without affecting cell viability. In addition, SHT significantly attenuated RANKL-induced mRNA expression levels of c-Src and cathepsin K. To examine the in vivo effect of SHT on OVX-induced bone loss in OVX rats, we administered SHT (0.6 g/kg BID) orally to OVX rats for 12 weeks. SHT administration significantly blocked OVX-induced decrease of femoral bone mineral density (BMD) and femoral trabeculae in OVX rats. In conclusion, these results suggest that SHT treatment effectively prevents OVX-induced bone loss, and this effect may result from its inhibitory effect on osteoclast differentiation.

유한요소법을 이용한 인공고관절 주대형태의 개선에 대한 연구 (A Study for Improvement of the Femoral Stem Type using the Finite Element Analysis)

  • 윤경렬;원예연;이수훈
    • 한국CDE학회논문집
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    • 제5권2호
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    • pp.122-126
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    • 2000
  • A major mechanical problem with total hip replacement is the loosening of the femoral component. The loss of proximal support, with firm fixation distally, has been thought to be a major caused of fatigue failure of femoral stems. While many causes have been proposed, the most frequently suggested cause of the calcar resorption is the disuse atrophy of the cortex of the calcar due to the stress shielding of the proximal bone by the metal femoral stem. In this research, the new-designed stem(modified collar stem) was considered which made a hole inside stem and had a 3 mm thickness. Using the 3-dimensional finite element methods, the common collar stem and the modified colla stem was modeled and analysed. Also, the two models was compared. The results showed that the modified collar stem decreased the stress-shielding and it made a effective load transfer at the entire femoral region.

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Fermented soybeans by Rhizopus oligosporus reduce femoral bone loss in ovariectomized rats

  • Yoo, Hyun-Wook;Chang, Moon-Jeong;Kim, Sun-Hee
    • Nutrition Research and Practice
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    • 제8권5호
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    • pp.539-543
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    • 2014
  • BACKGROUND/OBJECTIVES: Soy isoflavones are structurally similar to estrogen and bind to estrogen receptors, suggesting that they exhibit estrogenic activities; therefore, they are referred to as phytoestrogens. Fermentation may affect the bioavailability of isoflavones altering soy isoflavone glycosides in the form of aglycones. Thus, this study investigated the effects of fermented soybeans by Rhizopus oligosporus on bone metabolism in both young rats as a pilot test and in ovariectomized (ovx) old rats as a model of menopause. MATERIALS/METHODS: In the pilot test, a total of 24 seven-week-old female Sprague-Dawley (SD) rats were fed one of three diets for a period of four weeks: casein, unfermented soybean product, or fermented soybean product by R. oligosporus. In the ovx rat model, 20-week-old SD rats weighing 260-290 g underwent either sham-operation (n = 10) or bilateral ovariectomy (n = 30) and were then fed the AIN-93M diet for one week. Thereafter, rats were fed sham-casein, ovx-casein, ovx-soybean, or ovx-fermented soybean diet for five weeks. After decapitation, femoral bones were isolated and preserved in 9% formalin for assessment of bone mineral density (BMD), bone mineral content (BMC), and bone-breaking strength (BBS). RESULTS: Ovx rats showed significantly increased weight gain and decreased uterine wet weight. Of particular interest, ovx rats fed fermented soybeans showed increased uterine wet weights compared to control rats. Fermented soybean diet caused a significant increase in plasma 17-${\beta}$ estradiol concentrations in young rats, and 17-${\beta}$ estradiol levels were enhanced in ovx rats to match those of sham-operated ones. Significantly lower femoral BMD and BMC were observed in ovx rats compared to sham-operated controls, whereas bone areas did not differ statistically among the groups. In addition, BBS tended to be increased in ovx rats fed soybeans and fermented soybeans. CONCLUSIONS: Supplementation of fermented soybeans could have preventive and therapeutic effects against osteoporosis in postmenopausal women.