Ryuh Sup Kim

Lipoma arborescens associated with osseous/chondroid differentiation in subdeltoid bursa

Lipoma arborescens (LA) is a rare benign lesion of unknown etiology. It is characterized histologically by villous proliferation of the synovial membrane and diffuse replacement of the subsynovial tissue by mature fat cells. This condition affects the knee joint most commonly. Cases involving other locations including glenohumeral joint,[1] hip,[2] elbow,[3] hand[4] and ankle[5] have been rarely described. Involvement of the subdeltoid bursa has also been reported, but to date no case has described LA with osseous/chondroid differentiation of this bursa. Another significant finding in our case was the coexistence of LA with intermuscular lipoma, SLAP lesion and labral cyst.

Total hip arthroplasty using S-ROM prosthesis for dysplastic hip.

Purpose The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a dysplastic hip. Materials and Methods Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after undergoing primary total hip arthroplasty using an S-ROM proximal modular femoral stem. The average follow-up was 80 months (range: 60 to 96 months). Clinical and radiological assessments were performed based on the Harris hip score and the radiological changes around the prosthesis. Results The average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up. Forty-one hips (91.9%) revealed excellent or good clinical results at the most recent follow-up. Conclusion For advanced secondary coxarthrosis, total hip arthroplasty with the use of the proximal modular femoral stem yielded good mid-term results with respect to the clinical and radiological criteria.

Change of Periprosthetic Bone Mineral Density after Cementless Total Hip Arthroplasty - Using Extensively Porous Coated Femoral Stem -

Purpose : To investigate the annual change of bone mineral density (BMD) around the femoral stem and identified the factors that influence the stress shielding effect in patients who have received extensively porous coated cementless stem. Materials and Methods : We reviewed seventy-four patients who were followed up for longer than three years after unilateral primary total hip replacement arthroplasty. The BMD was measured annually using a DEXA QDR on the proximal femur according at the Gruen zone. We analyzed the relationship between the results and the possible variates of periprosthetic bone remodeling. Results : In first year after operation, the BMDs of all Gruen zone decreased significantly. From the second year, the BMDs in Gruen zones 1, 2, and 7 were decreased significantly, but those in Gruen zones 3, 5, and 6 were increased. After three years, the BMD showed no significant change. Among the examined variables including sex, patient’s age, stem size, and preoperative Singhs index, stem size and age were found to have strong predictive value. Conclusion : Our findings suggest that periprosthetic BMD decreased in all areas over first postsurgical year. From the third year, the BMD stabilized.