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대한고관절학회> Hip & Pelvis(구 대한고관절학회지)

Hip & Pelvis(구 대한고관절학회지) update

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  • : 대한고관절학회지(~2012)→Hip & Pelvis(2012~)

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수록범위 : 1권1호(1989)~32권1호(2020) |수록논문 수 : 1,363
Hip & Pelvis(구 대한고관절학회지)
32권1호(2020년 03월) 수록논문
최근 권호 논문
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KCI등재

1Three-dimensional-printing Technology in Hip and Pelvic Surgery: Current Landscape

저자 : Seong-hwan Woo , Myung-jin Sung , Kyung-soon Park , Taek-rim Yoon

발행기관 : 대한고관절학회 간행물 : Hip & Pelvis(구 대한고관절학회지) 32권 1호 발행 연도 : 2020 페이지 : pp. 1-10 (10 pages)

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The use of three-dimensional (3D) printing is becoming more common, including in the field of orthopaedic surgery. There are currently four primary clinical applications for 3D-printing in hip and pelvic surgeries: (i) 3Dprinted anatomical models for planning and surgery simulation, (ii) patient-specific instruments (PSI), (iii) generation of prostheses with 3D-additive manufacturing, and (iv) custom 3D-printed prostheses. Simulation surgery using a 3D-printed bone model allows surgeons to develop better surgical approaches, test the feasibility of procedures and determine optimal location and size for a prosthesis. PSI will help inform accurate bone cuts and prosthesis placement during surgery. Using 3D-additive manufacturing, especially with a trabecular pattern, is possible to produce a prosthesis mechanically stable and biocompatible prosthesis capable of promoting osseointergration. Custom implants are useful in patients with massive acetabular bone loss or periacetabular malignant bone tumors as they may improve the fit between implants and patient-specific anatomy. 3D-printing technology can improve surgical efficiency, shorten operation times and reduce exposure to radiation. This technology also offers new potential for treating complex hip joint diseases. Orthopaedic surgeons should develop guidelines to outline the most effective uses of 3D-printing technology to maximize patient benefits.

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2Timing of Hip-fracture Surgery in Elderly Patients: Literature Review and Recommendations

저자 : Yoon Jae Seong , Won Chul Shin , Nam Hoon Moon , Kuen Tak Suh

발행기관 : 대한고관절학회 간행물 : Hip & Pelvis(구 대한고관절학회지) 32권 1호 발행 연도 : 2020 페이지 : pp. 11-16 (6 pages)

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The incidence of hip fractures is rapidly increasing with an aging population and is now one of the most important health concerns worldwide due to a high mortality rate. The effect of delayed surgery on postoperative outcomes has been widely discussed. Although various treatment guidelines for hip fractures in the elderly exist, most institutions recommend that operations are conducted as soon as possible to help achieve the most favorable outcomes. While opinions differ on the relationship between delayed surgery and postoperative mortality, a strong association between earlier surgery and improvement in postoperative outcomes (e.g., length of hospital stay, bedsore occurrence, return to an independent lifestyle), has been reported. Taken together, performing operations for hip fractures in the elderly within 48 hours of admission appears to be best practice. Importantly, however, existing evidence is based primarily on observational studies which are susceptible to inherent bias. Here, we share the results of a literature search to summarize data that helps inform the most appropriate surgical timing for hip fractures in the elderly and the effects of delayed surgery on postoperative outcome. In addition, we expect to be able to provide a more accurate basis for these correlations through a largescale randomized controlled trial in the future and to present data supporting recommendations for appropriate surgical timing.

KCI등재

3Midterm-clinical Outcomes after Hip Arthroscopy in Middle-aged Patients with Early Osteoarthritis

저자 : Jeong-kil Lee , Deuk-soo Hwang , Chan Kang , Jung-mo Hwang , Gi-soo Lee , Long Zeng , Young-cheol Park

발행기관 : 대한고관절학회 간행물 : Hip & Pelvis(구 대한고관절학회지) 32권 1호 발행 연도 : 2020 페이지 : pp. 17-25 (9 pages)

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Purpose: Although the number of hip arthroscopies is rapidly increasing in non-elderly patients, outcomes of this procedure in middle-aged patients are not well documented or clearly understood. The purpose of this study was to evaluate the clinical and radiological outcomes after hip arthroscopy in middle-aged patients with early osteoarthritis.
Materials and Methods: This retrospective study analyzed 189 patients with early osteoarthritis of various diagnoses aged 40 years or older who underwent hip arthroscopy between January 2010 and December 2015. Clinical (e.g., modified Harris hip score [mHHS], hip outcome score-activities of daily living [HOS-ADL], visual analogue scale [VAS] for pain, range of motion) and radiological (change of Tönnis grade) outcomes were assessed at a minimum of 3-year follow-up.
Results: The mean preoperative and final mHHS and HOS-ADL improved from 61.2 and 60.6 to 79.5 and 81.8, respectively, while the VAS pain score decreased from 6.3 to 3.2 (P<0.001). Although the mean range of internal rotation and flexion increased from 14.2 and 100.7。preoperatively to 30.4 and 110.6。at 1-year postoperatively, they decreased slightly to 27.4 and 105.4。at the final follow-up, respectively. Eight cases (4.2%) underwent revision arthroscopic surgery and three cases (1.6%) were converted to total hip arthroplasty.
Conclusion: Patients with early-stage osteoarthritis of various diagnoses achieved improved clinical outcomes. Therefore, using hip arthroscopy in middle-aged patients with early osteoarthritis, it is possible to achieve good surgical options.

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4Staged Revision of Infected-hip Arthroplasty Using an Antibiotics-loaded Intra-articular Cement Spacer: Impact on Cemented and Cementless Stem Retention

저자 : Kyu-sub Um , Joong-won Lee , Byung-ho Yoon , Yerl-bo Sung

발행기관 : 대한고관절학회 간행물 : Hip & Pelvis(구 대한고관절학회지) 32권 1호 발행 연도 : 2020 페이지 : pp. 26-34 (9 pages)

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Purpose: Currently, standard management of a peri-prosthetic infection is a two-stage revision precedure. However, removal of well-fixed cement is technically demanding and associated with numerous potential complications. For theses reasons, two-stage revision with preservation of the original femoral stem can be considered and several previous studies have achieved successful results. While most prior studies used cemented stems, the use of cementless stems during arthroplasty has been gradually increasing; this study aims to assess the comparative effectiveness of a two-stage revision of infected hip arthroplasties at preserving cemented and cementless stems. 
Materials and Methods: Between December 2001 and February 2017, Inje University Sanggye Paik Hospital treated 45 cases of deep infections following hip arthroplasty with a two stage revisional arthroplasty using antibiotics-loaded cement spacers. This approach was applied in an effort to preserve the previously implanted femoral stem. Of these 45 cases, 20 were followed-up for at least two years and included in this analysis. Perioperative clinical symptoms, radiological findings, function and complications during insertion of an antibioticsloaded cement spacer were analyzed in this study.
Results: Peri-prothetic infections were controlled in 19 of the 20 included cases. Clinical outcomes, as assessed using the Harris hip score, Western Ontario and McMaster University score, also improved. Importantly, similarly improved outcomes were achieved for both cemented and cementless femoral stems.
Conclusion: In cases of deep infection following hip arthroplasty, two-stage revision arthroplasty to preserve the previously implanted femoral stem (cemented or cementless) effectively controls infections and preserves joint function.

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5Does Arthroscopic Repair of Femoroacetabular Impingement Pathology Affect Clinical Outcomes after Ipsilateral Total Hip Arthroplasty?

저자 : Surajudeen A. Bolarinwa , Jomar N. Aryee , Lawal A. Labaran , Brian C. Werner , James A. Browne

발행기관 : 대한고관절학회 간행물 : Hip & Pelvis(구 대한고관절학회지) 32권 1호 발행 연도 : 2020 페이지 : pp. 35-41 (7 pages)

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Purpose: Arthroscopy for repair of femoroacetabular impingement (FAI) and related conditions is technically challenging, but remains the preferred approach for management of these hip pathologies. The incidence of this procedure has increased steadily for the past few years, but little is known about its potential long-term effects on future interventions. The purpose of this study was to evaluate whether prior arthroscopic correction of FAI pathology impacts postoperative complication rates in patients receiving subsequent ipsilateral total hip arthroplasty (THA) on a national scale.
Materials and Methods: A commercially available national database - PearlDiver Patients Records Database - identified primary THA patients from 2005 to 2014. Patients who had prior arthroscopic FAI repair (post arthroscopy group) were separated from those who did not (native hip group). Prior FAI repair was examined as a risk factor for complications following THA and a multivariable logistic regression analysis was applied to identify risk factors for complications following THA.
Results: A total of 11,061 patients met all inclusion and exclusion criteria; 10,951 in the native hip group and 110 in the post arthroscopy group. Prior FAI repair was not significantly associated with higher rates of 90-day readmission (P=0.585), aseptic dislocation/revision within 3 years (P=0.409), surgical site infection within 3 years (P=0.796), or hip stiffness within 3 years (P=0.977) after THA.
Conclusion: Arthroscopic FAI repair is not an independent risk factor for complications following subsequent ipsilateral THA (level of evidence: III).

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6Anatomic Evaluation of the Interportal Capsulotomy Made with the Modified Anterior Portal versus Standard Anterior Portal: Comparable Utility with Decreased Capsule Morbidity

저자 : Alexander E. Weber , Ram K. Alluri , Eric C. Makhni , Ioanna K. Bolia , Ms Phdc Eric N. Mayer , Joshua D. Harris , Shane J. Nho

발행기관 : 대한고관절학회 간행물 : Hip & Pelvis(구 대한고관절학회지) 32권 1호 발행 연도 : 2020 페이지 : pp. 42-49 (8 pages)

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Purpose: To identify potential differences in interportal capsulotomy size and cross-sectional area (CSA) using the anterolateral portal (ALP) and either the: (i) standard anterior portal (SAP) or (ii) modified anterior portal (MAP).
Materials and Methods: Ten cadaveric hemi pelvis specimens were included. A standard arthroscopic ALP was created. Hips were randomized to SAP (n=5) or MAP (n=5) groups. The spinal needle was placed at the center of the anterior triangle or directly adjacent to the ALP in the SAP and MAP groups, respectively. A capsulotomy was created by inserting the knife through the SAP or MAP. The length and width of each capsulotomy was measured using digital calipers under direct visualization. The CSA and length of the capsulotomy as a percentage of total iliofemoral ligament (IFL) side-to-side width were calculated.
Results: There were no differences in mean cadaveric age, weight or IFL dimensions between the groups. Capsulotomy CSA was significantly larger in the SAP group compared with the MAP group (SAP 2.16±0.64 cm2 vs. MAP 0.65±0.17 cm2, P=0.008). Capsulotomy length as a percentage of total IFL width was significantly longer in the SAP group compared with the MAP group (SAP 74.2±14.1% vs. MAP 32.4±3.7%, P=0.008).
Conclusion: The CSA of the capsulotomy and the percentage of the total IFL width disrupted are significantly smaller when the interportal capsulotomy is performed between the ALP and MAP portals, compared to the one created between the ALP and SAP. Surgeons should be aware of this fact when performing hip arthroscopy.

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7A Comparison of U-blade Gamma3 and Gamma3 Nails Used for the Treatment of Intertrochanteric Fractures

저자 : Hyung-gon Ryu , Youn-taek Choi , Sang-min Kim , Jae-sung Seo

발행기관 : 대한고관절학회 간행물 : Hip & Pelvis(구 대한고관절학회지) 32권 1호 발행 연도 : 2020 페이지 : pp. 50-57 (8 pages)

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Purpose: To compare outcomes (i.e., clinical and radiological findings, postoperative complication) in the fixation of intertrochanteric fractures with U-blade Gamma3 and Gamma3 nails.
Materials and Methods: A review of 162 patients (both male and female) treated for intertrochanteric fractures between December 2012 and December 2018 was conducted. All patients were older than 65 years of age and treated with U-blade Gamma3 (n=90) or Gamma3 (n=72) nails. Evaluations included: (i) screw-head position, (ii) fracture-reduction status, (iii) time to union, (iv) cases of cut-out, (v) tip-apex distance, and (vi) lag screw sliding distance. Differences in pre- and postoperative ambulatory ability was also investigated.
Results: There were no significant differences in baseline demographics between the two groups. While the lagscrew sliding distance was significantly shorter in U-blade Gamma3 nail group (4.7 mm vs. 3.6 mm; P=0.025), the mean time to union was similar between the groups (P=0.053). Three and six cases of cut-out were noted in the U-blade Gamma3 and Gamma3 nail groups, respectively (P=0.18), however no other postoperative complications were noted in either group. Lastly, there was no difference between the change from pre- to postoperative activity level between the groups (P=0.753).
Conclusion: Of all the clinical and radiological outcomes assessed, the only significant improvement between those treated with U-Blade Gamma and Gamma3 nails was a shorter lag-screw sliding distance. These findings should benefit clinicians when deciding between the use of U-Blade Gamma or Gamma3 nails.

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