Jeong Joon Yoo

Han Jin Lee, MD, You Jung Kim, MD, Jeong Joon Yoo, MD, PhD, Hong Seok Kim, MD, PhD. Hip Pelvis 2026;38:93-100. https://doi.org/10.5371/hp.2026.38.1.93

Background/Objectives: Hip fracture patients commonly exhibit impaired nutritional status, including low serum albumin levels related to sarcopenia, which may affect recovery. This study evaluated the effect of branched-chain amino acid (BCAA) supplementation on serum albumin levels in hip fracture patients. Methods: This retrospective analysis was conducted at a single tertiary referral center on a cohort of patients with hip fractures including femoral neck and intertrochanteric fractures who visited the emergency department between January 2022 and November 2023. After propensity score matching, 106 patients were analyzed (BCAA: n = 53; control: n = 53); prior to matching, 67 treated and 110 control patients were eligible. Patients receiving BCAA supplementation were administered three times daily for six weeks postoperatively and they were matched with controls based on clinical and demographic variables. Controls received standard perioperative care without BCAA supplementation, and no placebo was administered. Serum albumin levels were measured before the surgery and 6 weeks postoperatively. After propensity score matching, 53 patients from each cohort were analyzed. The primary outcome was the difference in serum albumin levels; secondary outcomes were the length of hospital stay (LOS), blood transfusions (Tf), and the incidence of delirium. Results: The matched cohorts exhibited comparable baseline characteristics. Analysis revealed a significant increase in serum albumin levels among patients who received BCAA supplementation compared to the matched control group. No differences were found in terms of LOS, Tf, and the incidence of delirium during the index admission. Conclusions: This preliminary study suggests a potential positive effect of BCAA supplementation on serum albumin levels in patients with hip fractures. Further prospective investigations with larger sample sizes are warranted to validate these findings and elucidate the clinical implications for nutritional support in this population.

Background: Effective bone-cartilage integration remains a challenge in orthopedic surgery. Conventional methods often fail to reconstruct the native osteochondral interface. This study explores a scaffold-mediated approach utilizing co-cultured osteoblasts and chondrocytes, with platelet-rich plasma (PRP) as a potential promotor for bone-cartilage interface healing. Methods: We developed a co-culture system integrating both osteoblasts and chondrocytes on PLGA scaffolds, either with or without PRP supplementation. Cell phenotype maintenance was evaluated by RT-PCR, while morphological analysis was performed by scanning electron microscopy and fluorescence microscopy. To assess healing potential, we created a gap-mimic construct comprising bone, scaffold, and cartilage layers, which was implanted subcutaneously in BALB/c-nude mice. Gap healing was evaluated at 4 and 8 weeks through macroscopic examination, quantitative adhesion analysis, and histological assessment of cellular invasion. Results: Co-cultured osteoblasts and chondrocytes maintained their phenotypes on PLGA scaffolds, with PRP significantly enhancing cell adhesion (215% increase for chondrocytes, 120% for osteoblasts) and proliferation. In vivo, cell-containing scaffolds demonstrated significantly greater attachment at the bone-cartilage interface compared to acellular constructs. PRP-treated scaffolds exhibited higher attachment rates (82.3% vs 76.7%) and cellular invasion (5/6 vs 3/6 constructs) at 8 weeks, with invasion observed as early as 4 weeks in the PRP group, suggesting accelerated remodeling. Conclusion: This study demonstrates the feasibility of developing transplantable scaffolds containing co-cultured osteoblasts and chondrocytes while preserving their phenotypes. These scaffolds exhibit significant potential in promoting healing at the bone-cartilage interface, with PRP further enhancing proliferation and improving the scaffold’s ability to promote bone-cartilage interface healing.

Introduction: The interpretation of plain hip radiographs can vary widely among physicians. This study aimed to develop and validate a deep learning-based screening model for distinguishing normal hips from severe hip diseases on plain radiographs. Methods: Electronic medical records and plain radiograph from 2004 to 2012 were used to construct two patient groups: the hip disease group (those who underwent total hip arthroplasty) and normal group. A total of 1,726 radiographs (500 normal hip radiographs and 1,226 radiographs with hip diseases, respectively) were included and were allocated for training (320 and 783), validation (80 and 196), and test (100 and 247) groups. Four different models were designed–raw image for both training and test set, preprocessed image for training but raw image for the test set, preprocessed images for both sets, and change of backbone algorithm from DenseNet to EfficientNet. The deep learning models were compared in terms of accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1-score, and area under the receiver operating characteristic curve (AUROC). Results: The mean age of the patients was 54.0 ± 14.8 years in the hip disease group and 49.8 ± 14.9 years in the normal group. The final model showed highest performance in both the internal test set (accuracy 0.96, sensitivity 0.96, specificity 0.97, PPV 0.99, NPV 0.99, F1-score 0.97, and AUROC 0.99) and the external validation set (accuracy 0.94, sensitivity 0.93, specificity 0.96, PPV 0.95, NPV 0.93, F1-score 0.94, and AUROC 0.98). In the gradcam image, while the first model depended on unrelated marks of radiograph, the second and third model mainly focused on the femur shaft and sciatic notch, respectively. Conclusion: The deep learning-based model showed high accuracy and reliability in screening hip diseases on plain radiographs, potentially aiding physicians in more accurately diagnosing hip conditions.

Park BK, et al. Clin Orthop Surg. 2025 Oct;17(5):773-778. https://doi.org/10.4055/cios25096

Kim JH, et al. Clin Orthop Surg. 2024 Apr;17:e31. https://doi.org/10.4055/cios24425

Kim HJ, et al. Clin Orthop Surg. 2025 Feb;17:e24. https://doi.org/10.4055/cios24358

Seung-Hoon Baek, MD, PhD, Seungbae Oh, MD, PhD, Bum-Jin Shim, MD, PhD, Jeong Joon Yoo, MD, PhD, Jung-Mo Hwang, MD, PhD, Tae-Young Kim, MD, PhD, Seung-Cheol Shim, MD, PhD. Hip Pelvis 2024;36:234-49. https://doi.org/10.5371/hp.2024.36.4.234

Background: Recent advancements in hip arthroplasty aim to enhance the stability, longevity, and functionality of femoral implants. However, the distal fitting of femoral stems, often caused by metaphyseal–diaphyseal mismatch, remains a significant issue, particularly in patients with Dorr type A femora. Such mismatches can result in suboptimal implant performance, leading to potential complications. This study focuses on evaluating the anatomical compatibility of five representative single-tapered wedge mid–short stems with the mediolateral (ML) anatomy of the proximal femur in an East Asian population, where these mismatches are often more pronounced. Methods: A total of 742 patients from two hospitals, all of whom underwent unilateral primary total hip arthroplasty, were included in the study. The contralateral proximal femur was confirmed to have normal anatomy in each patient. Hip anteroposterior radiographs were used for measurements, which were standardized in conjunction with CT images. Key anatomical parameters were measured, including proximal and distal medial–lateral canal dimensions, vertical offset, and medial offset. Five femoral stem designs—Tri-lock^®, Taperloc^®, Anthology^®, Accolade II^®, and Fit^®—were evaluated. R programming was employed for a detailed fit analysis to match stem sizes with patient anatomy, categorizing the fit as proximal, simultaneous proximal–distal, or distal engagement. Results: Among the femoral stems analyzed, the Fit^® stem demonstrated the closest alignment with the regression line for ML widths in the study population (slope = 0.69; population ML slope = 0.38). This was followed by Accolade II^®, which had a slope of 0.83. In terms of offset options, the Accolade II^® offered the largest offset coverage, making it particularly suitable for this population. The fit analysis revealed that the Fit^® stem had the highest suitable fit rate (90.56%), followed by Accolade II^® (73.04%). Taperloc^®, Anthology^®, and Tri-lock^® had similar fit rates of approximately 59%. Overall, optimal results were obtained for 92.05% of the population in the automated fitting trial, regardless of the product type. Conclusions: When designing modern cementless femoral stems intended for press-fit fixation, it is crucial to account for the anatomical variations specific to the target population. In this study, Fit^® and Accolade II^® femoral components demonstrated superior compatibility with the femoral anatomy of the East Asian population, particularly in those with a higher incidence of Dorr type A femora. These stems, characterized by slimmer distal dimensions and high-offset options, appear to minimize metaphyseal–diaphyseal mismatch and associated complications.