• Title/Summary/Keyword: Proximal femur

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Evaluation of Prosthetic Reconstruction in Lower Extremity (하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Koo, Ki-Hyoung;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.1-11
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    • 2002
  • Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

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Study of Deformity by the Involvement of the Femoral Head of the Proximal Femur in Polyostotic Fibrous Dysplasia (다발성 섬유성 이형성증에서 근위 대퇴골두 침범 여부에 따른 변형 정도)

  • Na, Bo Ram;Jung, Sung Taek;Cho, Yong Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.519-527
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    • 2019
  • Purpose: To evaluate the treatment result in polyostotic fibrous dysplasia classified according to the involvement of the femoral head. Materials and Methods: Twenty-three patients from March 1987 to March 2014 were reviewed retrospectively. Patients with no involvement of the physeal scar in the femoral head were classified as Type I, and those with involvement of the physeal scar were classified as Type II. A plain radiograph was used to measure the femoral neck shaft angle, articulo-trochanteric distance (ATD), and anterior bowing through the lateral view. A teleoroentgenogram of the lower limb was used to measure the leg length discrepancy and lower extremity mechanical axis. The pre- and postoperative femoral neck-shaft angle and ATD were compared to assess the degree of correction of the deformity. Results: Among a total of 46 cases (23 patients), 28 cases (23 patients) had lesions in the proximal femur. Type I were 16/28 cases (15/23 patients) and Type II were 12/28 cases (9/23 patients). The preoperative proximal femoral neck-shaft angle was 116.8° in Type I and 95.3° in Type II. The ATD was 12.08 mm in Type I and -5.54 mm in Type II. The deformity correction showed significant improvement immediately after surgery, the deformity correction was lost in Type II (neck shaft angle Type I: 133.8°-130.8°, Type II: 128.6°-116.9°, and ATD Type I: 17.66-15.72 mm, Type II: 7.44-4.16 mm). The extent of anterior bowing was 12.74° in Type I and 20.19° in Type II. The mean differences of 12 mm between the 9 patients who showed a leg length discrepancy and the lower extremity mechanical axis showed 4 cases of lateral deviation and 7 cases of medial deviation. Conclusion: In polyostotic fibrous dysplasia, when the femur head is involved, the femur neck shaft angle, ATD, and anterior bowing of the femur had more deformity, and the postoperative correction of deformity was lost, suggesting that the involvement of the femoral head was an important factor in the prognosis of the disease.

Metastasising Recurrent Giant Cell Tumor - A Case Report - (폐 전이를 일으킨 재발성 거대세포종 - 증례 보고 -)

  • Kim, Tae-Seung;Park, Jun-Sic
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.73-79
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    • 2001
  • Giant cell tumor is usually found around the knee joint, especially in the distal femur or proximal tibia. Despite being classified as benign, it has unusual biological behavior of local aggressiveness and tend to have severely destructive lesion and develop rare pulmonary metastasis. Therefore, when the patient is presented to the physician with an expansile lytic lesion of challenging clinicopathologic entity extending to subchondral bone, the physician faces up to difficulties in treatment. We report a case of 25 years old patient having recurrent giant cell tumor in the right distal femur which developed metastasis to lung. The primary bone lesion was treated with local curettage and fillings with methylmethacrylate, but when he returned to the hospital two years later, the recurrence had developed with lung metastasis.

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Incidence of Osteopenia in Female HBV Carrier and its Correlation with Liver Function Test (B형 간염 보균자에서 골감소증의 빈도 및 간기능검사와의 연관성)

  • Na, Eun-Hui;Park, Jae-Yeong;Kim, Sang-In
    • Journal of Korea Association of Health Promotion
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    • v.3 no.2
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    • pp.181-188
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    • 2005
  • Background : Osteopenia has been recognized as one of potential complication of chronic liver diseases. Its correlation with hepatits B virus(HBV) carrier, however, has not been reported. Thus this study was aimed to clarify the relationship between the osteopenia and HBV carrier. Methods : Bone densities in 192 HBV carrier women and 200 healthy women were measured; the lumbar spine and three sites of the proximal femur(neck, Ward's triangle, greater trochanter) by dual-photon absorptiometry. And liver function tests(AST, ALT, Albumin, GGT, ALP) were also performed. Results : Bone densities at the four sites measured, were significantly correlated with one another(r=0.34 to 0.99, P<0.01). Compared with control group, HBV carriers had significant decreases in bone densities of femur(P<0.05), particularly marked at Ward's triangle. A negative correlations between bone densities and serum total alkaline phosphatase were also found(r=-0.44, P<0.01). Conclusions : Osteopenia was more prevalent in HBV carrier, particularly in the groups before-fifties. Serum total alkaline phosphatase was higher in those with reduced bone densities Thus measurement of bone densities seems to be necessary in female HBV carriers.

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The effects of royal jelly protein on bone mineral density and strength in ovariectomized female rats

  • Hattori, Satoshi;Omi, Naomi
    • Korean Journal of Exercise Nutrition
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    • v.25 no.2
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    • pp.33-37
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    • 2021
  • [Purpose] Sex hormones deficiency leads to dramatically bone loss in particular postmenopausal women. Royal jelly has anti-osteoporosis effect due to maintain bone volume in that condition. We hypothesized that royal jelly protein (RJP, a latent residue after extracting royal jelly) also prevents bone deficient in ovariectomized (OVX) female rats, the animal model of postmenopausal women. [Methods] Female Sprague-Dawley rats (n = 30, 6 weeks age old) were sham operated (Sham; sham operated group, n = 7), OVX control group (OC, n = 7), OVX with low RJP intake group (ORL, n = 8), and OVX with high RJP intake group (ORH, n = 8) during 8 weeks experimental periods. In the end point of this experiment, the bone samples (lumbar spine, tibia, and femur) were surgically removed under anesthesia. These bone samples were evaluated bone mineral density (BMD) and bone strength. [Results] BMD of lumbar spine in RJP intake groups (ORL, ORH) were higher than that in OC group (p < 0.05 and p < 0.01) in RJP intake volume dependent manner. BMD of tibial proximal metaphysis and diaphysis in RJP intake groups were also higher than these in OC group (p < 0.01 and p < 0.01 / p < 0.05 and p < 0.001). In addition, breaking force of femur in RJP intake groups were significantly increase compared with that in OC group (p < 0.001 respectively). [Conclusion] These findings indicate that RJP contribute to prevent sex hormone related bone abnormality.

Treatment of Benign Bone Tumor with Xenograft (이종골 이식을 이용한 양성 골 종양 치료)

  • Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.189-193
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    • 1995
  • The authors reviewed 49 cases(48 patients) of benign bone tumor who had surgical treatment with xenograft at department of orthopedic surgery, Seoul National University Hospital from May, 1980 to May, 1994. Materials consist of 21 males and 27 females. The mean age at operation was 20.1 years(range : 4 -55 years) and the mean follow up period was 25.4 months(range : 7 - 85 months). We did xenograft only in 34 cases and xenograft mixed with autograft in 15 cases(14 cases, from ilium, 1 case from femur). The used materials for xenograft were $Lubboc^{(R)}$ in 29 cases, $Surgibone^{(R)}$ in 17 cases and $Pyrost^{(R)}$ in 3 cases. The average durations when bony union was achieved in radiograph were 13.8 weeks in whole cases, 12.5 weeks(range : 8 - 24 weeks) in $Lubboc^{(R)}$ graft cases and 15.7 weeks(range : 6 - 24 weeks) in $Surgibone^{(R)}$ graft cases. The tumor recurred in 4 cases, 1 case was recurred giant cell tumor at distal femur treated with mixed auto and $Lubboc^{(R)}$ graft and 2 cases were large cystic lesions at the proximal humerus diagnosed as simple bone cyst and at distal tibia diagnosed as fibrous dysplasia treated with $Surgibone^{(R)}$ graft and 1 case was aneurysmal bone cyst of the proximal tibia treated with $Lubboc^{(R)}$ graft. Wound infection occurred in 1 case. More transfusion was done in the cases that the lesion was larger than 5cm, the lesions were in the ilium or femur and the cases that were treated with mixed with autograft. This study implies that benign bone tumor is successfully treqated with curettage and xenograft or xenograft mixed with autograft. And also this method will reduce morbidity of donor site, intraoperative bleeding and post-transfusion complications.

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Marrow Conversion Pattern of the Femora and Acetabulum Around Hip Joints According to Age Group : MR Evaluation (연령에 따른 고관절주위 대퇴골 및 절구뼈 골수전환 양상 : MR 평가)

  • Lee, In-Sook;Choi, Hyun-Wook;Seo, Im-Jeong;Woo, Sung-Ku;Moon, Tae-Yong
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.63-69
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    • 2006
  • Purpose : Marrow edema and fatty degeneration of the hip joint bones could be initial and late signs in hip joint and its bone diseases respectively, which might be differentiated from age-related marrow conversion pattern. So authors have investigated normal marrow conversion pattern of the femur and acetabulum around the hip joints. Materials and methods : Three coronal MR images of 288 hip joint bones in 144 subjects, aged 2 days to 76 years divided to 8 groups every 10 years, were retrospectively analysed for the location and appearance of the converted yellow marrow. The converted yellow marrow were divided to head, neck, and trochanter in the proximal femur and below and above 50% in acetabulum of the hip. Results : The most common type of marrow conversion is the converted yellow marrow in the entire proximal femur and below 50% of acetabulum of the hip. We observed the start of marrow conversion in just before and after 2 years old and stopped at just before and after 20 years old. Conclusion : The understanding of age-related marrow conversion pattern of the hip joint bones would provide some information for differentiation from pathologic condition of them such as edema, fatty degeneration, metastasis, or leukemia.

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Functional and Radiological Results of Intermediate-term Follow Up in $MUTARS^{(R)}$ Tumor Endoprostheses ($MUTARS^{(R)}$ 종양 대치물을 이용한 사지 구제술의 기능적 및 방사선학적 중기 추시 결과)

  • Kang, Dong-Joon;Kim, Jeung-Il;Oh, Jong-Seok;Moon, Tae-Yong;Lee, In-Sook
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.1
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    • pp.36-43
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    • 2011
  • Purpose: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system ($MUTARS^{(R)}$) used in patients with a malignant bone tumor. Materials and Methods: Thirty one cases which used $MUTARS^{(R)}$ tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. Results: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. Conclusion: Our results suggest limb salvage with the $MUTARS^{(R)}$ endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.

Malignant Transformation of Giant Cell Tumor Not Associated with Radiotherapy (방사선 조사 없이 속발한 거대 세포종의 악성 전환)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Ahn, Jun-Hwan;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.12-19
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    • 2002
  • Purpose : Giant cell tumors(GCT) sometimes undergo malignant transformation after the radiotherapy, but very rarely do without radiotherapy. We reviewed the clinical experiences of the malignant transformation of GCT to suggest the guidelines for diagnosis and treatment of them. Materials and Methods : We examined four patients of pathologically proven malignant transformation of GCT, which occurred after the operative treatment alone without radiation, from September 1985 to January 2001. The mean follow-up period after the malignant transformation was 2.4 years(range, 1.3~4 years). Results : The mean time-interval from the initial diagnosis to the malignant transformation was 6.9 years(range, 2.2~13.5 years). The locations of tumors were soft tissues of proximal upper arm, proximal femur, distal femur and proximal tibia. The histology of malignant GCT was osteosarcoma in 3 cases and malignant fibrous histiocytoma in 1 case. Local recurrence developed in 1 patient and the pulmonary metastasis developed in 3 patients which transformed to osteosarcoma. Conclusion : Thorough sampling of the surgical specimen appears to be a very important factor for diagnosing the malignant transformation of GCT. In case of suspicion of malignancy in radiographs, the incisional biopsy should be followed by definite treatment rather than the improper resection.

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Painful Snapping Shoulder Complicating Soft Tissue Pseudotumor Secondary to Rib Osteochondroma: A Case Report (늑골의 골연골종에 속발된 가성 연부조직 종괴에 합병한 통증성발음성 견갑증상증후군)

  • Moon, Myung-Sang;Jeon, Dal-Jae;Kim, Sung-Soo;Yoon, Min Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.27-31
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    • 2014
  • Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the $6^{th}$ rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.