Purpose: The aim of this study was to evaluate the short-term outcome of physiotherapy in patients with acetabular labral tears and to assess the effectiveness of physiotherapy according to the severity of the labral tear. Materials and Methods: Thirty-five patients who underwent physiotherapy for treatment of symptomatic acetabular labral tears were enrolled. We evaluated the severity of the acetabular labral tears, which were classified based on the Czerny classification system using 3-T MRI. Clinical findings of microinstability and extra-articular pathologies of the hip joint were also examined. The International Hip Outcome Tool 12 (iHOT12) was use for evaluation of outcome scores pre- and post-intervention. Results: The mean iHOT12 score showed significant improvement from 44.0 to 73.6 in 4.7 months. Compared with pre-intervention scores, significantly higher post-intervention iHOT12 scores were observed for Czerny stages I and II tears (all P<0.01). However, no significant difference was observed between pre-intervention and post-intervention iHOT12 scores for stage III tears (P=0.061). In addition, seven patients (20.0%) had positive microinstability findings and 22 patients (62.9%) had findings of extra-articular pathologies. Of the 35 patients, eight patients (22.9%) underwent surgical treatment after failure of conservative management; four of these patients had Czerny stage III tears. Conclusion: The iHOT12 score of patients with acetabular labral tears was significantly improved by physiotherapy in the short-term period. Improvement of the clinical score by physiotherapy may be poor in patients with severe acetabular labral tears. Determining the severity of acetabular labral tears can be useful in determining treatment strategies.
Jesse W.P. Kuiper;Steven J. Verberne;Pim W. van Egmond;Karin Slot;Olivier P.P. Temmerman;Constantijn J. Vos
Hip & pelvis
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제34권4호
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pp.236-244
/
2022
Purpose: The most recent diagnostic criteria for periprosthetic joint infection (PJI) include the use of the alpha-defensin (AD) lateral-flow (LF) test, but hip and knee arthroplasties were usually combined in previous studies. This prospective study was designed to examine the accuracy of the AD-LF test for diagnosis of PJI in chronic painful total hip arthroplasties (THA). Materials and Methods: Patients with chronic painful hip arthroplasties were prospectively enrolled between March 2018 and May 2020. Exclusion criteria included acute PJI or an insufficient amount of synovial fluid. The modified Musculoskeletal Infection Society (MSIS) criteria were primarily used for PJI diagnosis. Fifty-seven patients were included in the analysis group. Revision surgery was not performed in 38 patients, for different reasons (clinical group); these patients remain "Schrödinger's hips": in such cases PJI cannot be excluded nor confirmed until you "open the box". Results: The result of the AD-LF test was positive in nine patients and negative in 48 patients. Six patients were diagnosed with PJI. AD-LF sensitivity (MSIS criteria) was 83% (95% confidence interval [CI] 36-100%) and specificity was 92% (95% CI 81-98%). The positive and negative predictive value were 56% and 98%, respectively. Conclusion: The AD test is useful in addition to the existing arsenal of diagnostic tools, and can be helpful in the decision-making process. Not all patients with chronical painful THA will undergo revision surgery. Consequently, in order to determine the reliable diagnostic accuracy of this test, future PJI diagnostic studies should include a second arm of "Schrödinger's hips".
Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
The Journal of the Korean bone and joint tumor society
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제9권1호
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pp.115-123
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2003
Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.
The purpose of this study was to analyze the punching movement at the horseback riding stance, one of the basic movements in Taekwondo, with 3D images and further the kinetic variables such as time, velocity, angle, angular velocity, and angular acceleration according to the types. It also aimed to examine the characteristics of each type and suggest instructional methods for the right punching movement. For those purposes, three members from the College Taekwondo Poomse Demonstration Squad were put to the test. The research findings led to the following conclusions: 1. Performance Time of the Punching Movement : In Section 1, Type 1 and 2 recorded $0.24{\pm}0.07s$ and $0.42{\pm}0.08s$, respectively, for the punching movement at the horseback riding stance. While Type 1 took less performance time in the punching movement, Type 2 took less time for take back according to each section's percentage in the total performance time. 2. Variables of Linear Velocity and Linear Acceleration : Each type recorded different linear velocity for each aspect, but the highest linear velocity represented the moment of impact for each type. Type 2 recorded the highest linear velocity in Aspect 4, which was the moment of impact. 3. Variable of Joint Angle : There were no big outer differences in the joint angle during the punching movement between Type 1 in the aspect of impact and Type 2, but the individuals assumed dynamic positions in the punching movement of Type 2 with more diverse changes to the joint angle. 4. Variables of Angular Velocity and Angular Acceleration During the punching movement of Type 1, the Aspect 3 in the moment of impact recorded angular velocity of $0.79{\pm}0.02deg/s$, $0.91{\pm}0.04deg/s$, and $5.24{\pm}0.09deg/s$ at the pelvis, shoulder, and wrist respectively. During the punching movement of Type 2, the Aspect 3 in the moment of impact recorded angular velocity of $1.32{\pm}0.03deg/s$, $0.21{\pm}0.03deg/s$, and $4.98{\pm}0.08deg/$ at the shoulder, wrist, and pelvis, respectively. In the Aspect 3 in the moment of impact in Type 2, the angular acceleration at the right wrist joint was $176.24{\pm}1.11deg/s^2$, which was bigger than that in the moment of impact in Type 1.
The purpose of this study was to investigate the muscle mechanical properties of the pelvic axial pre-rotational movement for the Jireugi in the Taekwondo Juchumseogi stance. Eleven elite Taekwondo Poomsae athletes participated. Each participant performed 5 right hand Jireugi in Juchumseogi stance as fast and strong as possible while their motion was recorded by a 3D motion analysis system and the ground reaction forces by two force plates. The power and work of the muscular group surrounding the waist were analyzed to verify the effect of the stretch-shortening cycle (SSC) theory. The cause of the greater power seems to be the application of the SSC by the muscles surrounding the waist during the preparation phase of the pre-rotation group. For the none pre-rotation group, they only used the concentric contraction of the muscles surrounding the waist. Because the pre-rotation group used the SSC theory, they had the effect of shortening of the range of movement, creating a fast and more powerful rotation, thus anticipating the increase the magnitude of impact.
The Journal of the Korean bone and joint tumor society
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제5권3호
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pp.183-189
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1999
Ewing's sarcoma is an uncommon malignant neoplasm of the long bone and it has a poor prognosis due to its early metastasis and aggressive local spread. It is mostly found before the age of 30 and it is rare in extraskeletal sites. Extraskeletal Ewing's sarcoma has been reported to occur in various sites including the larynx, scalp, nasal fossa, neck, chest wall, lung, pelvis, perineum, arm, finger, leg and toe, but it is extremely rare as a primary epidural tumor of the spine. We experienced a case of extraosseous epidural Ewing's sarcoma arising in the lumbar spinal canal at L3-L5 level in a 9-year-old boy. Following total laminectomy from L3 to L5 with a lumbar vertebrae and mass excision, he received chemotherapy with complete remission.
It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.
Two subjects, an expert and a novice, were carefully selected based upon their foot speed. Three dimensional videography was used in the assessment of roundhouse kicking of the Tae-kwon-Do. The local reference frames were imbedded at the trunk, pelvis, thigh and shank. Anatomical angular displacement at the joints were measured by projecting the upper segment's local axes to the lower segment's local reference planes. The local axes again projected to the global reference frames and absolved each segment's movement. The peaks of the anatomical angular displacement curve assessed as the countermovements and the angular movements of the segments in the global space absolved in light of the occurrence of the countermovements. The expert showed larger and more countermovements than the novice at the all segments. The counterrnovement occured more clearly at the trunk than the hip and knee joint and during the preparative movement phase. These countermovements occurrence were due to either by turning upper or lower segments and controlled by the turning direction and sequence of the two nearby segments. It was revealed that the countermovements of the trunk during the preparative movement phase was the important factor of the power kicking.
The Journal of the Korean bone and joint tumor society
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제7권2호
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pp.64-67
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2001
Epithelioid sarcoma has been well characterized as a distincitve entity. In the classic form, it occurs in the distal extremities of young adults. However, in the proximal form, it was found mostly in the pelvis, perineum, and genital tract of young to middle-aged adults. Morphologically, the tumor cells had promient epithelioid or rhabdoid features with marked cytologic atypia, and grew in a multinodular pattern. Immunohistochemically, cytokeratin, epithelial membrane antigen, and vimentin were positive in the tumor cells. This reports dealt with 32-year-old male lesion on his perineum. The tumor shows typical features of proximal type epithelioid sarcoma. We also discussed pathological differential diagnosis and prognosis on this particular disease.
This study was performed in 41 dogs with unilateral or bilateral medial patella luxation (MPL) and/or cranial cruciate ligament rupture (CCLR). These dogs were classified into 4 groups according to MPL grading system. Radiographic evaluation was performed for pelvis and stifle joint in the dogs. Norberg, inclination, quadriceps and femoral varus angle were measured and analyzed with MPL grading and the existence of cranial cruciate ligament rupture. The Norberg and inclination angle showed no differences between 4 grading groups and between CCLR and no CCLR groups. However, quadriceps and femoral varus angle were statistically different between grade 1, 2 and grade 3, 4 groups. They also have shown the statistical difference between CCLR and no CCLR group. Further studies for how these parameters affect the prognosis and the results of surgical treatment of MPL should be needed.
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