• Journal of Bone Metabolism
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• v.25 no.4
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• pp.227-233
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• 2018

Background: Few studies have investigated the effects of sarcopenia on postoperative outcomes including mortality rates following surgery for osteoporotic hip fractures. The purpose of the present study was to determine the prevalence of sarcopenia and the relationship between sarcopenia and 1- and 5-year mortality rates in a consecutive series of patients with osteoporotic hip fractures. Methods: Among patients who underwent hip surgery for osteoporotic hip fractures, this study included 91 patients subjected to abdominal computed tomography within 1 year of hip surgery. We defined sarcopenia using sex-specific cut-off points for the skeletal muscle index at the level of the third lumbar vertebra. All patients were divided into 2 groups according to the presence or absence of sarcopenia and the 1- and 5-year mortality rates were compared. To confirm factors affecting mortality in addition to sarcopenia, we examined patient age, sex, American Society of Anesthesiologists grade, location of fracture, type of surgery, and bone mineral density. Results: The 1- and 5-year mortality rates were 20.9% and 67.2%, respectively. Among the 45 patients with sarcopenia, the 1- and 5-year mortality rates were 22.2% and 82.7%, respectively. Of the 46 patients without sarcopenia, the 1- and 5-year mortality rates were 19.6% and 52.7%, respectively. Results of the Kaplan-Meier analysis showed that sarcopenia did not affect the 1-year mortality rate (P=0.793), but had a significant effect on the 5-year mortality rate (P=0.028). Both perioperative sarcopenia (P=0.018) and osteoporosis (P=0.000) affected the 5-year mortality rate. Conclusions: Sarcopenia increases the risk of 5-year mortality in patients with osteoporotic hip fractures.

• Hip & pelvis
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• v.35 no.3
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• pp.157-163
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• 2023

Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.

• International Journal of Safety
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• v.4 no.1
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• pp.1-7
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• 2005

The direction of the applied load and displacement rate on the femur during falls may be an important factors in the etiology of hip fractures. Nonetheless, previous studies did not consider these two factors simultaneously for falling condition. Therefore, in the present study, an impact test system is developed to simulate the falling condition and the influence of impact angle on the deformation pattern changes of proximal femur is investigated. The results showed that a slight variation in impact angle quite affects deformation pattern of the proximal femur. Along with bone mineral density and trabaecular morphology, the impact angle can be another important factor affecting the structural capacity of the proximal femur.

• Biomaterials and Biomechanics in Bioengineering
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• v.5 no.1
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• pp.11-23
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• 2020

Total hip prosthesis is used for the patients who have hip fracture and are unable to recover naturally. To de-sign highly durable prostheses one has to take into account the natural processes occurring in the bone. Finite element analysis is a computer based numerical analysis method which can be used to calculate the response of a model to a set of well-defined boundary conditions. In this paper, the static load analysis is based, by se-lecting the peak load during the stumbling activity. Two different implant materials have been selected to study appropriate material. The results showed the difference of maximum von Misses stress and detected the frac-ture of the femur shaft for different model (Charnley and Osteal) implant with the extended finite element method (XFEM), and after the results of the numerical simulation of XFEM for different was used in deter-mining the stress intensity factors (SIF) to identify the crack behavior implant materials for different crack length. It has been shown that the maximum stress intensity factors were observed in the model of Charnley.

• Structural Engineering and Mechanics
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• v.66 no.1
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• pp.37-43
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• 2018

In orthopedic surgery and in particular in total hip arthroplasty, the implant fixation is carried out using a surgical cement called polymethylmethacrylat (PMMA). This cement has to insure a good adhesion between implant and bone and a good load distribution to the bone. By its fragile nature, the cement can easily break when it is subjected to a high stress gradient by presenting a craze zone in the vicinity of inclusion. The focus of this study is to analyze the effect of inclusion in some zone of cement in which the loading condition can lead to the crack opening leading to their propagation and consequently the aseptic loosening of the THR. In this study, the fracture behavior of the bone cement including a strange body (bone remain) from which the onset of a crack is supposed. The effect of loading condition, the geometry, the presence of both crack and inclusion on the stress distribution and the fracture behavior of the cement. Results show that the highest stresses are located around the sharp tip of bony inclusion. Most critical cracks are located in the middle of the cement mantle when they are subjected to one leg standing state loading during walking.

• Journal of Preventive Medicine and Public Health
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• v.35 no.4
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• pp.305-312
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• 2002

Objectives : The reproductive history of women has been suggested to have a possible influence on the risk of osteoporotic fractures. The purpose of this study was to assess the association between reproductive history and hip fractures in the elderly women. Methods : The study subjects were drawn from women members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, whose reproductive histories were available, and who were beneficiaries of the Korea Medical Insurance Corporation (KMIC) in 1993 and lived in Busan city, Korea. The information on reproductive histories, and possible confounders, were collected from mailed questionnaires. Potential hip fracture cases were collected from the claims data obtained between 1993 and 1998, with a hospital survey conducted to confirm the final diagnoses. Rate ratios and their 95% confidence intervals, were calculated using a Cox's proportional hazard model. Results : Following up 5,215 women for 6 years, 51 cases were confirmed with hip fractures. When adjusted for age, weight and physical activity, the rate ratio of hip fractures in women who had given birth three or more times was 0.56 (95% CI: 0.25-1.25), compared with those who had given birth two or less times. When adjusted for age, number of births, weight and physical activity, the rate ratio in women who first gave birth when younger than 22 years was 0.60 (95% CI: 0.34-1.08) compared with those who had giving birth at 22 years or older. Conclusions : According to these findings, an early age when first giving birth might decrease the risk of hip fractures in elderly Korean women.

• Hip & pelvis
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• v.30 no.4
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• pp.233-240
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• 2018

Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.

• Journal of Powder Materials
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• v.6 no.2
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• pp.152-162
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• 1999

The present study is concerned with the effect of PM process variables on the microstructure by using atomized superalloy powders. It is suggested that the inhomogeneity of composition is strongly dependent on the process variables. The contents of segregation elements of plasma rotating electrode process (PREP) powders are larger than those of Ar atomization (AA) powders. As HIP treatment temperature in-increases, the secondary phases on the prior particle boundaries (PPB) have continuous,uniform distribution and high density, but the amount of PPB decreases suddenly at 1150$^{\circ}$C. Segregated phases on the PPB are identified to be MC type carbide. Brittle MC type carbides on the PPB provide fracture initiation sites and preferred fracture path, thereby leading to intergranular type brittle fracture.

• Women's Health Nursing
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• v.18 no.4
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• pp.237-247
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• 2012

Purpose: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. Methods: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX$^{(R)}$ to calculate 10-year probability of major osteoporotic and hip fracture. Results: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. Conclusion: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.70-73
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• 2023

The hip is a stable ball-and-socket joint. Bilateral anterior dislocations of the native hip joints account for fewer than 1% of all dislocations. We present a unique case of a bilateral anterior dislocation in a patient who presented to our institution within 6 hours of trauma. The dislocations were promptly reduced under propofol anesthesia in the operating room. The patient did not suffer a concurrent fracture. After the procedure, we performed regular X-ray examinations for 2 years to rule out the development of avascular necrosis of the head of the femur. The course of the patient was unremarkable.