Yang Kyu-hyun, director of Gangnam Bedro Hospital, announces a study on hip dislocation patients during sports activities
Oct 22, 2024
Yang Kyu-hyun, head of the orthopedic surgery department at Gangnam Bedro Hospital, presented a thesis on the developmental relationship between hip dislocation and acetabular posterior wall during sports activities at the 68th Autumn International Conference of the Korean Orthopedic Society.
The study, led by Director Yang Kyu-hyun, involved patients with hip posterior dislocation and atrial dislocation (incomplete dislocation) that occur during sports activities such as running. Within their hip joint structure, the degree to which the acetabular posterior wall surrounds the femoral head from the rear was clearly revealed, and the focus was on laying the foundation for injury prevention and treatment taking this into account.
The hip joint consists of the upper part of the thigh bone 'the femoral head' and a type of socket that surrounds it from both sides of the pelvic bone 'the acetabulum'. In particular, the stability of the hip joint depends on how sufficiently the 'rear acetabular wall' covers the femoral head. In fact, in the normal hip joint, it can be seen that the posterior acetabular wall edge is remarkably developed compared to the anterior. As such, 'Hip posterior dislocation', in which the femoral head exits backward, is often caused by strong shocks such as traffic accidents. However, sometimes cases of posterior hip dislocation during weak impact have been reported. In this case, the research team established a hypothesis that the size and inclination angle of the rear acetabular wall may not be sufficient and began to prove it.
The research team first collected acetabular structure data from 21 patients who experienced a posterior hip dislocation or atrophy during sports activities. Since radiography alone makes it difficult to identify the exact structure of the entwined acetabular and femoral head, the edges of the anterior and posterior acetabular walls were precisely observed with 3D-CT (3D computed tomography), and the oblique angle and femoral head cover range of the posterior acetabular wall were analyzed based on these data values. In particular, in this study, the point where the femoral head escapes during dislocation was defined as 'FCL (Facture Center Level)', and the positional relationship of the front and rear acetabular wall at the FCL point was expressed using 'P-A index'. This is the world's first research technique attempted by director Yang Kyu-hyun's research team.
As a result of the analysis, in fact, many of them were found to have insufficient development of the posterior acetabular wall. In particular, at the point where dislocation occurs, it was possible to observe that the acetabular anterior inclination angle ' decreased and the rear wall was relatively poor in development.
More than half of the patients, 14 patients, showed 'crossover sign' in which the anterior acetabulum protruded more than the posterior, and 'posterior wall sign' in which the posterior acetabulum was insufficient also appeared in 10 patients. The acetabular anterior inclination angle also showed a difference from the normal structure. Usually, the acetabular tilt angle is around 12 to 20 degrees, but 12 patients showed a low angle level of less than 12 degrees. In particular, in seven of the patients, the anterior tilt angle of the FCL site was significantly lower, less than 5 degrees, and two of them showed symptoms of 'true tilt angle reversal'.
The paper also demonstrated the accuracy of hip structure analysis through 3D-CT imaging. All 21 patients who participated in the study showed positive signs of posterior wall on general radiography, but accurate measurements through 3D CT scans confirmed that 10 of them were actually positive. Based on this, the research team recommended that more accurate tests be conducted through 3D-CT imaging if positive signs of the posterior wall in the hip joint structure are suspected.
In recognition of its value, Director Yang Kyu-hyun's thesis was approved for publication in the English journal of Korean orthopedic surgery, 'Clinics in Orthopaedic Surgery'. The field presentation at the conference also attracted attention as a major research case with expertise and depth. In particular, there was a positive response to the content that increased the accuracy of the study by clearly grasping and analyzing the structure of the hip joint with 3D-CT images compared to previous similar studies. Professor Yang Kyu-hyun plans to continue to conduct more precise studies on hip dislocation patients in the future thanks to limited interest in this study.
Yang Kyu-hyun, director of Gangnam Bedro Hospital, said "As we find out through actual patient case analysis that structural problems in the hip joint can cause hip dislocation, we think it will be meaningful to prevent related injuries in the future and to establish precise treatment plans."We will continue to analyze and study various clinical cases in depth and strive for the development of the orthopedic surgery sector."
The study, led by Director Yang Kyu-hyun, involved patients with hip posterior dislocation and atrial dislocation (incomplete dislocation) that occur during sports activities such as running. Within their hip joint structure, the degree to which the acetabular posterior wall surrounds the femoral head from the rear was clearly revealed, and the focus was on laying the foundation for injury prevention and treatment taking this into account.
The hip joint consists of the upper part of the thigh bone 'the femoral head' and a type of socket that surrounds it from both sides of the pelvic bone 'the acetabulum'. In particular, the stability of the hip joint depends on how sufficiently the 'rear acetabular wall' covers the femoral head. In fact, in the normal hip joint, it can be seen that the posterior acetabular wall edge is remarkably developed compared to the anterior. As such, 'Hip posterior dislocation', in which the femoral head exits backward, is often caused by strong shocks such as traffic accidents. However, sometimes cases of posterior hip dislocation during weak impact have been reported. In this case, the research team established a hypothesis that the size and inclination angle of the rear acetabular wall may not be sufficient and began to prove it.
The research team first collected acetabular structure data from 21 patients who experienced a posterior hip dislocation or atrophy during sports activities. Since radiography alone makes it difficult to identify the exact structure of the entwined acetabular and femoral head, the edges of the anterior and posterior acetabular walls were precisely observed with 3D-CT (3D computed tomography), and the oblique angle and femoral head cover range of the posterior acetabular wall were analyzed based on these data values. In particular, in this study, the point where the femoral head escapes during dislocation was defined as 'FCL (Facture Center Level)', and the positional relationship of the front and rear acetabular wall at the FCL point was expressed using 'P-A index'. This is the world's first research technique attempted by director Yang Kyu-hyun's research team.
As a result of the analysis, in fact, many of them were found to have insufficient development of the posterior acetabular wall. In particular, at the point where dislocation occurs, it was possible to observe that the acetabular anterior inclination angle ' decreased and the rear wall was relatively poor in development.
More than half of the patients, 14 patients, showed 'crossover sign' in which the anterior acetabulum protruded more than the posterior, and 'posterior wall sign' in which the posterior acetabulum was insufficient also appeared in 10 patients. The acetabular anterior inclination angle also showed a difference from the normal structure. Usually, the acetabular tilt angle is around 12 to 20 degrees, but 12 patients showed a low angle level of less than 12 degrees. In particular, in seven of the patients, the anterior tilt angle of the FCL site was significantly lower, less than 5 degrees, and two of them showed symptoms of 'true tilt angle reversal'.
The paper also demonstrated the accuracy of hip structure analysis through 3D-CT imaging. All 21 patients who participated in the study showed positive signs of posterior wall on general radiography, but accurate measurements through 3D CT scans confirmed that 10 of them were actually positive. Based on this, the research team recommended that more accurate tests be conducted through 3D-CT imaging if positive signs of the posterior wall in the hip joint structure are suspected.
In recognition of its value, Director Yang Kyu-hyun's thesis was approved for publication in the English journal of Korean orthopedic surgery, 'Clinics in Orthopaedic Surgery'. The field presentation at the conference also attracted attention as a major research case with expertise and depth. In particular, there was a positive response to the content that increased the accuracy of the study by clearly grasping and analyzing the structure of the hip joint with 3D-CT images compared to previous similar studies. Professor Yang Kyu-hyun plans to continue to conduct more precise studies on hip dislocation patients in the future thanks to limited interest in this study.
Yang Kyu-hyun, director of Gangnam Bedro Hospital, said "As we find out through actual patient case analysis that structural problems in the hip joint can cause hip dislocation, we think it will be meaningful to prevent related injuries in the future and to establish precise treatment plans."We will continue to analyze and study various clinical cases in depth and strive for the development of the orthopedic surgery sector."
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