• Hip & pelvis
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• v.36 no.1
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• pp.62-69
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• 2024

Purpose: To assess current practice in the treatment of osteoporosis in patients who underwent treatment for hip fracture in South Korea. Materials and Methods: A survey of 97 members of the Korean Hip Society, orthopedic hip surgeons who administer treatment for hip fractures in South Korea, was conducted. The survey was conducted for assessment of demographic data and perceptions regarding the management of osteoporosis in patients who have undergone treatment for hip fracture. Analysis of the data was performed using descriptive statistical methods. Results: The majority of participants were between the age of 41 and 50 years, and 74% were practicing in tertiary hospitals. Testing for serum vitamin D levels (82%) was the most commonly performed laboratory test. Calcium and vitamin D were prescribed for more than 80% of patients by 47% and 52% of participants, respectively. Denosumab was the most commonly used first-line treatment option for osteoporosis in hip fracture patients. Bisphosphonate was most often perceived as the cause of atypical femoral fractures, and the most appropriate time for reoperation was postoperative 12 months. Teriparatide was most preferred after cessation of bisphosphonate and only prescribing calcium and vitamin D was most common in high-risk patients for prevention of atypical femoral fracture. Conclusion: The results of this study that surveyed orthopedic hip surgeons showed that most participants followed the current strategy for management of osteoporosis. Because the end result of osteoporosis is a bone fracture, active involvement of orthopedic surgeons is important in treating this condition.

• Hip & pelvis
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• v.35 no.4
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• pp.238-245
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• 2023

Purpose: Elderly patients with degenerative diseases undergo treatment for the hip and spine; these patients present with various symptoms. This study focused on patients with residual symptoms, predominantly pain, even after receiving treatment for their spinal lesions. Materials and Methods: Patients who underwent total hip arthroplasty (THA) between 2016 and 2022 at a single tertiary hospital were included in the study. Of the 417 patients who underwent primary THA, a retrospective review of 40 patients with previous lesions of the spine was conducted. Patients were stratified to two cohorts: Patients with symptoms related to the spine (Group A), and those with hip-related symptoms (Group B). Preand postoperative comparisons of groups A and B were performed. Results: Improvements in patients' symptoms were observed in groups A and B after THA. In Group A, the mean preoperative visual analog scale (VAS) score was 5.10±0.876, which showed a postoperative decrease to 2.70±1.767. In Group B, the mean preoperative VAS score was 5.10±1.539, which showed a postoperative decrease to 2.67±1.493. Conclusion: According to the findings, promising results were achieved with THA in treatment of debilitating diseases of the hip for both the prognosis of the disease, as well as the patients' symptoms. In addition, in some cases elderly patients with dual pathologies underwent treatment for spinal lesions without performance of any evaluation related to the hip. Thus, evaluation of a patient's hip must be performed and performance of THA in patients with symptoms even after treatment of spinal lesions is recommended.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.119-129
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• 2022

Objectives This study aimed to evaluate the effects of Integrative treatment of traditional Korean medicine (TKM) on 7 hospitalized patients after hip fracture surgery, and to identify significant herbs and co-prescribed herbs by using network analysis and association rule mining. Methods A retrospective chart review of the 7 hospitalized patients treated for postoperative hip fractures between January and December 2021 was performed. All TKM treatments for the patients were identified and Wilcoxon signed-rank test was performed to compare hip pain and mobility on admission and discharge. We visualized the network of herbal medicines and complications. By using network analysis, we also identified the significant herbs (high centrality of degree, eigenvector, and sub-graph). Co-prescription patterns for the hip fracture patients were further analyzed by association rule mining. Results We found that TKM treatment significantly relieved hip pain and improved mobility. Accompanying symptoms reported by the patients were general weakness, anorexia, dizziness, delirium, edema, sputum, sore throat, cough, rhinorrhea, and chills. Herbs composed of Sagunja-tang and Samul-tang showed high centralities and high associations with other herbs. In addition, Gupan, Nokyong, Yukjongyong, Useul, and Hyunhosaek were identified as important herbs for postoperative hip fracture patients. Conclusions This study provides evidence for clinical TKM use as an effective postoperative treatment for pain relief and improvement of mobility in patients with hip fractures. In addition, herbs that can be considered in the treatment of patients after hip fracture surgery were identified through network analysis and association rule mining.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.1
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• pp.77-91
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• 2019

Objectives : The purpose of this study was to investigate the effects of using acupuncture and moxibustion for the treatment of hip arthroplasty. Methods : We searched a total of six Korean and international databases (OASIS, KISS, RISS, Pubmed, Cochrane library, and CNKI) up to March 2019, and included randomized controlled trials which investigated the treatment effects of acupuncture and moxibustion in patients with hip arthroplasty. Results : In total, 29 studies were selected and included in the analysis. These studies conducted interventions, with the most frequently conducted methods being electroacupuncture (24.1%) and auricular acupuncture (20.7%). The most frequently used acupoints were the Ashi-, Lower four-, and Lower five points. VAS (48.9%) and Harris scores (22.2%) were commonly used to evaluate treatment effects. In total, 27 studies (93.1%) reported favorable treatment effects following acupuncture and moxibustion treatment, compared to the control group. Conclusions : These results may suggest that acupuncture and moxibustion have favorable effect on Hip arthroplasty.

• Hip & pelvis
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• v.35 no.1
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• pp.15-23
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• 2023

Purpose: Hip microinstability is defined as hip pain with a snapping and/or blocking sensation accompanied by fine anatomical anomalies. Arthroscopic capsular plication has been proposed as a treatment modality for patients without major anatomic anomalies and after failure of properly administered conservative treatment. The purpose of this study was to determine the efficacy of this procedure and to evaluate potential predictors of poor outcome. Materials and Methods: A review of 26 capsular plications in 25 patients was conducted. The mean postoperative follow-up period for the remaining patients was 29 months. Analysis of data included demographic, radiological, and interventional data. Calculation of pre- and postoperative WOMAC (Western Ontario and McMaster Universities Osteoarthritis) index was performed. Pre- and postoperative sports activities and satisfaction were also documented. A P<0.05 was considered significant. Results: No major complications were identified in this series. The mean pre- and postoperative WOMAC scores were 62.6 and 24.2, respectively. The WOMAC index showed statistically significant postoperative improvement (P=0.0009). The mean satisfaction rate was 7.7/10. Four patients with persistent pain underwent a periacetabular osteotomy. A lateral center edge angle ≤21° was detected in all hips at presentation. We were not able to demonstrate any difference in postoperative evolution with regard to the presence of hip dysplasia (P>0.05), probably because the sample size was too small. Conclusion: Capsular plication can result in significant clinical and functional improvement in carefully selected cases of hip microinstability.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.2
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• pp.155-162
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• 2022

The purpose of this clinical case is to evaluate the efficacy of the Korean medical treatment on a ligamentum teres tear of the hip. One patient, admitted to Daejeon Jaseng Hospital of Korean Medicine was diagnosed with a ligamentum teres tear of the hip by hip magnetic resonance imaging. We treated the patient using the Korean medical treatments, including acupunture, pharmacopuncture, herbal medication, and cupping. We measured the numerical rating scale (NRS), passive range of motion (PROM) and the changes of symptoms. After 13 days, NRS decreased from 8 to 1 respectively, PROM of hip joint has recovered, and the symptoms of the patient improved. In conclusion, this study shows that Korean medical treatment might be effective in treating the patient with a ligamentum teres tear of the hip.

• Hip & pelvis
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• v.36 no.1
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• pp.1-11
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• 2024

Gout is triggered by the accumulation of uric acid in the body, leading to hyperuricemia. Genetic, metabolic, and environmental factors can influence this condition. Excessive uric acid buildup results in the formation of monosodium urate (MSU) crystals, which precipitate in specific areas of the body, including the joints, where they can cause symptoms of gout. While the acute and chronic symptoms of gout have been well-documented, diagnosis of gout affecting the hip joint poses significant challenges. The global incidence of gout, the most prevalent form of inflammatory arthritis, is on the rise. Evaluation of the clinical signs, laboratory results, and imaging results is generally required for diagnosis of gout in cases where MSU crystals have not been detected. Hyperuricemia is considered a primary cause of arthritis symptoms, and comprehensive guidelines for treatment are available. Therefore, the choice of medication is straightforward, and moderate effectiveness of treatment has been demonstrated. Gout is a chronic disease, requiring lifelong uric acid-lowering medications, thus application of a treatment strategy based on the target blood uric acid concentration is necessary. Consequently, cases of gout will likely be observed more frequently by hip surgeons in clinical scenarios in the future. The objective of this review is to provide an overview of the pathophysiology of gout and subsequently examine recent advances in diagnostic methods and therapeutic agents based on an understanding of its underlying mechanisms. In addition, literature on gout-related issues affecting the hip joint, providing a useful reference for hip surgeons is examined.

• Journal of the Korean Crystal Growth and Crystal Technology
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• v.28 no.6
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• pp.250-255
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• 2018

The CoCrMo as-built alloys prepared by 3D-printing process are studied on tensile strength, wear resistance, crystal structure and microstructure after complex heat-treatment including HIP. In this study, HIP treatment for removing micropores, ambient heat-treatment for formation of metal carbides, and solution heat-treatment for homogenization of the created metal carbides were tried and characterized for applying to artificial joint. The complex heat-treatment effects of the CoCrMo as-built alloys prepared by 3D-printing process were owing to the densification during HIP, formation of metal carbides and homogenization of the created metal carbides. The effects of the complex heat-treatment were confirmed by XRD, FE-SEM and EDS.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.9 no.2
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• pp.125-132
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• 2014

Objectives : The Purpose of this study is to investigate the clinical application of conservative Korean treatment including hip joint MST for Bilateral Sacroillitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis. Methods : Patient is hospitalized at Dept. of Korean Internal Medicine, Jaseng Korean Medicine Hospital, diagnosed as Bilateral Sacroilitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis, and treated by herbal medicine, acupuncture, moxibustion, and hip joint MST. This study was measured by NRS(Numeric Rating Scale), SLRT(Straight leg raising test), Patrick test, and Blood test(ESR, CRP). Result : After conservative treatment, the patient's pain was controlled and NRS score was decreased. SLRT score also improved. Patrick test unchanged. ESR, CRP score was decreased. Conclusion : As seen in this one case, conservative Korean treatment including hip joint MST has a positive effect to control pain with Bilateral Sacroillitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis.

• Hip & pelvis
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• v.35 no.2
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• pp.133-141
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• 2023

Purpose: Isolated acetabular fractures can occur as a result of a high energy impact on the hip joint. Surgery is required for most patients with an isolated acetabular fracture in order to alleviate pain, restore joint stability, and regain hip function. This study was conducted in order to examine the course of hip function in patients after surgical treatment of an isolated traumatic acetabular fracture. Materials and Methods: This prospective series of consecutive cases included patients who underwent surgery for treatment of an isolated acetabular fracture in a European level one trauma center between 2016 and 2020. Patients with relevant concomitant injuries were excluded. Scoring of hip function was performed by a trauma surgeon using the Modified Merle d'Aubigné and Postel score at six-week, 12-week, six-month, and one-year follow-up. Scores between 3-11 indicate poor, 12-14 fair, 15-17 good, and 18 excellent hip function. Results: Data on 46 patients were included. The mean score for hip function was 10 (95% confidence interval [CI] 7.09-12.91) at six-week follow-up (23 patients), 13.75 (95% CI 10.74-16.76) at 12-week follow-up (28 patients), 16 (95% CI 13.40-18.60) at six-month follow-up (25 patients), and 15.50 (95% CI 10.55-20.45) at one-year follow-up (17 patients). After one-year follow-up, the scores reflected an excellent outcome in 11 patients, good in five patients, and poor in one patient. Conclusion: This study reports on the course of hip function in patients who have undergone surgical treatment for isolated acetabular fractures. Restoration of excellent hip function takes six months.