• 대한간호
• /
• 제27권2호통권145호
• /
• pp.53-57
• /
• 1988

• Radiation Oncology Journal
• /
• 제4권1호
• /
• pp.75-80
• /
• 1986

관절주위 골형성은 고관절치환 성형술을 시행받은 환자의 $0.6\~61.7\%$에서 생친 수 있는 합병증이다. 저자들은 1981년 1월부터 1985년 5월까지 서울대학교병원 치료방사선과에서 고관절전치환 성형술 후 관절주위 골형성 예방을 위하여 방사선요법을 시행받은 4명의 환자(8개의 고관절)를 분석하였다. 방사선요법은 수술후 $6\~10$일이내 시작하였으며 2,000cGy를 10회 분할 조사하였다. Modified Brooker system에 의하여 7계의 고관절에서는 Grade(1개 의고관절에서는 Grade) 2의 결과를 얻었다. 저자들의 이번 연구결과 및 문헌조사에 의하면 고관절 성형술 후 관절주위 골형성 예방을 위하여 호발군에 있어서의 방사선요법은 효과적이라고 하겠다.

• 근관절건강학회지
• /
• 제25권2호
• /
• pp.122-134
• /
• 2018

Purpose: The purpose of this study was to develop a 12-week structured exercise program (12-week-SEP) and evaluate its effects on pain, physical function and quality of life in patients with total hip arthroplasty (THA). Methods: A nonequivalent control group non-synchronized design was utilized to examine the effects of the 12-week-SEP on patients' outcomes after THA. A total of 46 adult patients (experimental group=25, control group=21) who had THA were recruited for the study. The 12-week-SEP consisted of education, exercise (muscle strengthening and progressive walking), and feedback. Data were analyzed by SPSS/WIN 21.0 using the $x^2$ test and repeated measures ANOVA. Results: The mean age of the participants was 60.9 years and 25 men (54.5%) and 21 women (45.7%) were included in the study. There were significant intervention effects on pain reduction and increased physical function but no effects on quality of life. Conclusion: The 12-week-SEP provided pain relief and enhanced physical function in patients underwent THA. Clinical application of the 12-week-SEP can improve postoperative nursing practices for patients with THA. Future research with larger sample is of necessity to obtain greater generalizability of the empirical evidences of the 12-week-SEP.

• Hip & pelvis
• /
• 제36권3호
• /
• pp.204-210
• /
• 2024

Purpose: The purpose of this study was to determine whether the rates of (1) in-hospital lengths of stay (LOS), (2) readmissions, (3) medical complications, and (4) costs of care are higher for patients with depressive disorder (DD) undergoing primary total hip arthroplasty (THA) for treatment of femoral neck fractures (FNFs). Materials and Methods: A retrospective query of a national administrative claims database for patients undergoing primary THA from 2006 to 2014 was conducted. Patients with DD undergoing THA for treatment of FNF were 1:5 ratio propensity score matched to a cohort (DD=6,758, controls=33,708). Primary endpoints included LOS, 90-day medical complications, 90-day readmissions, and healthcare reimbursements. A P-value less than 0.05 was considered statistically significant. Results: Longer LOS were observed for patients with DD compared to those without DD (5.6 days vs. 5.4 days, P<0.001). Similar readmission rates (29.9% vs. 25.0%, odds ratio [OR] 1.03, P=0.281) were observed between groups. The odds of 90-day medical complications were higher for patients with DD compared to control subjects (60.6% vs. 21.4%, OR 1.57, P<0.0001). Within the 90-day episode of care interval, patients with a history of DD incurred significantly higher healthcare expenditures ($21,382 vs. $19,781, P<0.001). Conclusion: Our findings showed longer LOS, higher odds of 90-day medical complications, and higher healthcare expenditures within the 90-day episode of care following a primary THA for treatment of FNF for patients with DD compared to the matched cohort. Thus, accordingly, patients with DD should receive counseling prior to undergoing surgery.

• Hip & pelvis
• /
• 제36권1호
• /
• pp.37-46
• /
• 2024

Purpose: The prognosis of total hip replacement (THR) after open reduction and internal fixation (ORIF) versus THR following non-operative treatment of acetabular fractures is unclear. Few studies have been conducted in this regard. Therefore, the purpose of the current study was to perform an assessment and compare the functional outcomes for study subjects in the ORIF and non-ORIF groups during the follow-up period compared to baseline. Materials and Methods: This longitudinal comparative study, which included 40 patients who underwent THR for either posttraumatic arthritis after fixation of an acetabular fracture or arthritis following conservative management of a fracture, was conducted for 60 months. Twenty-four patients had undergone ORIF, and 16 patients had undergone nonoperative/conservative management for acetabular fractures. Following THR, the patients were followed up for monitoring of functional outcomes for the Harris hip score (HHS) and comparison between the ORIF and non-ORIF groups was performed. Results: The HHS showed significant improvement in both ORIF and non-ORIF groups. At the end of the mean follow-up period, no significant variation in scores was observed between the groups, i.e., ORIF group (91.61±6.64) compared to non-ORIF group (85.74±11.56). A significantly higher number of re-interventions were required for medial wall fractures and combined fractures compared to posterior fractures (P <0.05). Conclusion: THR resulted in improved functional outcome during follow-up in both the groups; however, the ORIF group was observed to have better functional outcome. Re-intervention was not required for any of the posterior fractures at the end of the mean follow-up period.

• Hip & pelvis
• /
• 제34권1호
• /
• pp.62-67
• /
• 2022

Posterior wall fractures are the most common type of acetabular fractures. Treatment can be conservative or surgical. Operative treatment is indicated for acetabular fractures that result in hip joint instability and/or incongruity, as well injuries with incarceration of fragments of bone or soft tissue within the hip joint. Surgical treatment can range from open reduction and osteosynthesis to hip arthroplasty. Arthroscopy has recently been used as the main surgical technique or as a reduction aid. In this case a 26-year-old male with a fracture of the posterior wall who underwent a posterior miniinvasive approach, followed by hip arthroscopy. This allowed joint wash, removal of the loose body, confirmation of reduction and absence of intra-articular hardware. Excellent clinical and radiological results were obtained. This case demonstrates the advantage of using hip arthroscopy in assessment of fracture reduction, the absence of intra-articular hardware or fragments, as well as a less invasive approach.

• KSTLE International Journal
• /
• 제2권1호
• /
• pp.55-58
• /
• 2001

The most widely-used orthopaedic grade polymer bearing liner material, ultrahigh molecular weight polyethylene (UHMWPE), for the total joint arthroplasty degrades after gamma-irradiation sterilization through the progressive oxidation in a shelf and in vivo. Oxidative degradation makes UHMWPE brittle and leads to decrease in mechanical properties. In this study the relationship between post-gamma-irradiation aging time and wear of UHMWPE was investigated. Six retrieved polyethylene hip liners implanted for 3-16 years and then stored in air for 1.5-6.5 years until tests were used. Two types of pin-on-disk wear testing were conducted by the uni-directional repeat pass rotating and by the linear reciprocating stainless steel disks against stationary polyethylene pins under 4Mpa at 1Hz with bovine serum lubrication in ambient environment. Wear of retrieved polyethylene hip liners does not have direct correlation with in vivo or total aging time. Linear reciprocal sliding motion generated more remarkable wear than uni-directional repeat pass sliding motion. It indicates that kinematic motion affects very crucially on the wear of aged UHMWPE having brittle white band region.

• Journal of Mechanical Science and Technology
• /
• 제17권9호
• /
• pp.1332-1338
• /
• 2003

To estimate the true wear rate of polyethylene acetabular cups used in total hip arthroplasty, the dynamic compressive creep deformation of ultra-high molecular weight polyethylene (UHMWPE) was quantified as a function of time, load amplitude, and radial location of the specimen in the extruded rod stock. These data were also compared with the creep behavior of polyethylene observed under static loading. Total creep strains under dynamic loading were only 64％, 70％, and 61％ of the total creep strains under static loading at the same maximum pressures of 2 MPa,4 MPa, and 8 MPa, respectively. Specimens cut from the periphery of the rod stock demonstrated more creep than those cut from the center when they were compressed in a direction parallel to the extrusion direction (vertical loading) whereas the opposite was observed when specimens were compressed in a direction perpendicular to the extrusion direction (transverse loading). These findings show that creep deformation of UHMWPE depends upon the orientation of the crystalline lamellae.

• Clinics in Shoulder and Elbow
• /
• 제10권2호
• /
• pp.246-250
• /
• 2007

주관절 전 치환술은 슬관절이나 고관절의 전 치환술에 비하면 매우 드물게 시행되고 있는 수술이다. 더욱이 주관절의 골성 강직에 대한 주관절 전 치환술은 증례가 비교적 드물며, 아직 그 결과도 좋지 않은 것이 보통이다. 저자들은 주관절 관절 고정술 후 12년 만에 외상에 의해 발생한 골절에 대한 치료로서 주관절 전 치환술을 함으로써 주관절의 가동성을 성공적으로 얻게 된 예가 있어 이를 보고하는 바이다.

• 대한의용생체공학회:의공학회지
• /
• 제23권2호
• /
• pp.119-130
• /
• 2002

무시멘트 인공 고관절 전치환술 후, 복합재료 스템을 갖는 대퇴골의 장기 거동과 인공 대퇴 보철물의 설계 성능을 분석하기 위하여 비선형 유한요소 프로그램이 개발되었다. 한 발로 서 있을 때의 관절 접촉 하중과 근육하중이 적용되었고, 816개의 brick요소를 갖는 타원형 단면의 복합재료 스템으로 치환된 대퇴골이 3차원 유한요소로 모델링 되었다. 프로그램을 사용하여 대퇴골의 밀도 변화, 응력분포, 상대미소운동이 plate cut과 bend mold와 같은 제작 방법에 대한 스템의 적층 각도 변경에 따라서 평가되었다. 결과는 코발트 크롭 합금, 티타늄 합금, 스테인레스 강과 같은 금속 재료보다 AS4/PEEK, T300/976과 같은 복합재료가 적은 골 흡수를 보였다. 대퇴골 보철물의 장기 안정성 증대는 적당한 복합재료의 적층과 적층 각도의 선택에 의하여 얻어질 수 있었다.