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1.
Takaaki Ohmori Tamon Kabata Yoshitomo Kajino Daisuke Inoue Tadashi Taga Takashi Yamamoto Tomoharu Takagi Junya Yoshitani Takuro Ueno Ken Ueoka Hiroyuki Tsuchiya 《Journal of orthopaedic science》2019,24(3):474-481
BackgroundThere have been no studies on the differences in impingement-free angle that result from different combined anteversion (CA) patterns. The aim of this study was to find the optimal CA pattern for achieving a favorable impingement-free angle, including bony and prosthetic impingement, in total hip arthroplasty.MethodsWe evaluated 100 patients with no hip arthritis. We investigated the impingement-free angle (flexion, internal rotation with 90° flexion, extension, and external rotation) after changing the stem and cup anteversions to satisfy several CA patterns [cup anteversion + stem anteversion = 30°, 40°, 50°, and 60°; cup anteversion + 0.7 × stem anteversion = 37.3° (:Widmer's theory); and cup anteversion + 0.77 × stem anteversion = 43.3° (:Yoshimine's theory)] using 3-dimensional templating software.ResultsThe impingement-free angle changed dramatically among the various CA patterns. The optimal CA was changed by various stem anteversion. Only CA: Widmer with stem anteversion of 20° satisfied daily-life range of motion (ROM) requirements (flexion ≥130°, internal rotation with 90° flexion ≥ 45°, extension ≥ 40°, external rotation ≥ 40°).ConclusionGood impingement-free angle cannot be obtained with single fixed CA. Different CA patterns should be used, depending on the differences in the stem anteversion. A CA of 30° with 0° ≤ stem anteversion ≤10°; a CA:Widmer with 20° of stem anteversion; a CA of 40° or Widmer with 30° of stem anteversion. When stem anteversion is ≥40°, CA should be decided by each patient's state. Among them, a stem anteversion of 20° with cup anteversion of 23.3° was found to be the best CA pattern. 相似文献
2.
Norio Yamamoto Katsuhiro Hayashi Hiroyuki Tsuchiya 《Journal of orthopaedic science》2019,24(3):387-392
Bone defect reconstruction with artificial materials may produce good functional recovery in the short term. Over time, the durability of artificial materials becomes an issue, and therefore, artificial materials cannot be considered a permanent solution to reconstruction. For long-term outcomes, the goal is to regain function, permanence, and form that are as close to normal as possible. Thus, physiological materials are desirable for use in reconstruction.Biological reconstruction involves the use of materials that are modified in vivo following reconstruction of bone defects. The goal is to achieve bone union, bone revival and remodeling, with biointegration of soft tissue and bone. Allograft use has been the mainstay of bone defect reconstruction in most parts of the world, although in some countries like Japan, allogeneic bone is difficult to obtain due to socio-religious concerns. Therefore, we developed new biological reconstruction techniques to overcome this problem.Bone derived from distraction osteogenesis is autologous bone, which must be an ideal reconstruction material for its biological affinity, strength, resilience, and immunity to infection. When applying this method to patients with malignant disease however, it is important to preserve as much of the local soft tissue as possible, and the clinician must be especially careful of infection and callus formation. Liquid nitrogen treatment of tumor-bearing bone produces equal, if not better, bone revitalization compared to other forms of treatment to date. Reconstruction with liquid nitrogen-treated bone involves resecting the diseased bone and returning it to the body following liquid nitrogen treatment (free-freezing method). Another method involves dislocating the joint proximal to the tumor, or cutting the bone while the distal side remains attached to the body and the limb inverted and treated with liquid nitrogen (pedicle freezing method). When both methods are possible, the pedicle freezing method is preferable since it is performed with minimal osteotomy.Our recent research has looked into the possible role of adipose-derived stem cells in promoting bone fusion and revitalization. This method has produced promising results for the future of biological reconstruction. 相似文献
3.
Norio Imai Ryota Takubo Hayato Suzuki Hayato Shimada Dai Miyasaka Kazuki Tsuchiya Naoto Endo 《Journal of orthopaedic science》2019,24(3):482-487
BackgroundIn obese patients, malpositioning of the acetabular cup increases the risk of dislocation in total hip arthroplasty (THA). The aim of this study was to determine whether obesity affects the accuracy of acetabular cup positioning using a computed tomography (CT)-based navigation system.MethodsWe retrospectively evaluated 226 consecutive patients who underwent cementless primary THAs assisted by the CT-based hip navigation system. We divided the patients into three groups according to body mass index (BMI) and examined the difference between preoperative planning and postoperative implantation angles from CT data.ResultsThere was no significant correlation between BMI and both inclination and anteversion differences (R = 0.028 and R = 0.045, respectively). There were no significant differences among the BMI < 25, 25 ≦ BMI < 30, and BMI ≧ 30 groups (p value: 0.725, 0.934, respectively); between the BMI < 25 and BMI ≧ 25 groups (p value: 0.542, 0.697, respectively); and between the BMI < 30 and BMI ≧ 30 groups with regard to inclination and anteversion (p value: 0.859, 0.456, respectively). Moreover, similar findings were observed with regard to the distance between the preoperative planning and postoperative cup positioning for the transverse, anteroposterior, and craniocaudal axes of the pelvis.ConclusionWe found that the accuracy of acetabular cup placement using CT based-navigation in THA was not affected in obese patients. Therefore, THAs with a CT-based navigation system are considered useful in obese patients. 相似文献
4.
Takashi Hida Ryuzo Okuda Toshito Yasuda Tsuyoshi Jotoku Hiroaki Shima Masashi Neo 《Journal of orthopaedic science》2017,22(6):1054-1059
Background
Detailed information regarding differences in plantar pressure distribution between hallux valgus and healthy feet is unavailable. The purposes of the present study were to clarify the characteristics of the plantar pressure distribution in patients with hallux valgus compared with healthy matched controls and to determine whether hallux valgus leads to dysfunction of the great toe during walking.Methods
The study consisted of 25 patients with symptomatic moderate-to-severe hallux valgus (HV group) and 13 healthy matched volunteers (C group) without hallux valgus. All patients and volunteers were women. The HV and C groups did not differ significantly in age, height, weight, and body mass index. Plantar pressure during walking was measured using F-scan. The plantar aspect of the foot was divided into eight regions. The peak pressure (Peak-P), maximum force (Max-F), contact time (Con-T), contact area (Con-A), and force time integral (FTI) were measured in each region.Results
The Peak-P of the great toe did not differ significantly between the HV and C groups. However, all other parameters: Max-F, Con-T, Con-A, and FTI of the great toe in the HV group were significantly lower than in the C group. In the central forefoot, the Peak-P and Max-F in the HV group were significantly higher than in the C group.Conclusion
The present study demonstrated that a moderate-to-severe hallux valgus deformity leads to dysfunction of the great toe during walking and may increase mechanical loading on the central forefoot. 相似文献5.
Atsunori Murase Masahiro Nozaki Masaaki Kobayashi Hideyuki Goto Masahito Yoshida Sanshiro Yasuma Tetsuya Takenaga Yuko Nagaya Jun Mizutani Hideki Okamoto Hirotaka Iguchi Takanobu Otsuka 《Journal of orthopaedic science》2017,22(5):874-879
Background
Recently several authors have reported on the quantitative evaluation of the pivot-shift test using cutaneous fixation of inertial sensors. Before utilizing this sensor for clinical studies, it is necessary to evaluate the accuracy of cutaneous sensor in assessing rotational knee instability. To evaluate the accuracy of inertial sensors, we compared cutaneous and transosseous sensors in the quantitative assessment of rotational knee instability in a cadaveric setting, in order to demonstrate their clinical applicability.Methods
Eight freshly frozen human cadaveric knees were used in this study. Inertial sensors were fixed on the tibial tuberosity and directly fixed to the distal tibia bone. A single examiner performed the pivot shift test from flexion to extension on the intact knees and ACL deficient knees. The peak overall magnitude of acceleration and the maximum rotational angular velocity in the tibial superoinferior axis was repeatedly measured with the inertial sensor during the pivot shift test. Correlations between cutaneous and transosseous inertial sensors were evaluated, as well as statistical analysis for differences between ACL intact and ACL deficient knees.Results
Acceleration and angular velocity measured with the cutaneous sensor demonstrated a strong positive correlation with the transosseous sensor (r = 0.86 and r = 0.83). Comparison between cutaneous and transosseous sensor indicated significant difference for the peak overall magnitude of acceleration (cutaneous: 10.3 ± 5.2 m/s2, transosseous: 14.3 ± 7.6 m/s2, P < 0.01) and for the maximum internal rotation angular velocity (cutaneous: 189.5 ± 99.6 deg/s, transosseous: 225.1 ± 103.3 deg/s, P < 0.05), but no significant difference for the maximum external rotation angular velocity (cutaneous: 176.1 ± 87.3 deg/s, transosseous: 195.9 ± 106.2 deg/s, N.S).Conclusions
There is a positive correlation between cutaneous and transosseous inertial sensors. Therefore, this study indicated that the cutaneous inertial sensors could be used clinically for quantifying rotational knee instability, irrespective of the location of utilization. 相似文献6.
Shinya Tanaka Akira Yoshida Shinjiro Kono Manabu Ito 《Journal of orthopaedic science》2017,22(3):536-541
Background
Evidence related to the effectiveness of combination drug therapy for the treatment of osteoporosis is currently considered insufficient. Therefore, this study was performed to clarify the effects of monotherapy, and combination therapy, with a bisphosphonate (minodronic acid hydrate), a bone resorption inhibitor, and calcitonin (elcatonin), which is effective for the alleviation of pain due to vertebral fractures in osteoporotic patients.Methods
Study participants comprised of 51 female subjects with post-menopausal osteoporosis, whose main complaint was acute lower back pain caused by vertebral fractures. Subjects were randomly allocated into three groups and then administered with either intramuscular injections of elcatonin at a dose of 20 units weekly, minodronic acid hydrate at a dose of 1 mg daily, or a combination of these two drugs. As primary endpoints, time-dependent changes in levels of pain were assessed using a visual analog scale from baseline to 6 months of duration. In addition, we examined the effects of monotherapies, and a combination therapy on bone resorption, with changes in bone mineral density at 4 sites and advanced hip assessment parameters from baseline to 6 months. A two-tailed significance level of 5% was used for hypothesis testing.Results
Elcatonin monotherapy showed some alleviation of pain immediately after any vertebral fractures, which was more than in the minodronic acid hydrate monotherapy group. In addition, the minodronic acid hydrate monotherapy group experienced more effective inhibited bone resorption than the elcatonin monotherapy group. In the combination therapy, the efficacy for alleviating pain and inhibiting bone resorption was equivalent to the effect observed in the elcatonin and minodronic acid hydrate monotherapy groups respectively, with further improved values of bone mineral density observed in the femoral neck and lumbar vertebrae, and in parameters of advanced hip assessment compared with both monotherapy groups.Conclusions
Combination therapy with elcatonin and minodronic acid hydrate appears to be an effective treatment for osteoporosis patients with lower back pain, caused by fresh vertebral fractures. 相似文献7.
Shunsuke Fujibayashi Bungo Otsuki Hiroaki Kimura Shimei Tanida Kazutaka Masamoto Shuichi Matsuda 《Journal of orthopaedic science》2017,22(3):420-424
Background
Performing the minimally invasive lateral lumbar interbody fusion (LIF), such as the extreme lateral interbody fusion (XLIF) and oblique lateral interbody fusion (OLIF), through a retroperitoneal approach has become increasingly popular. Although urological injury is a major complication of LIF, the anatomical location of the ureter and its risk of injury have not been assessed. The purpose of this study was to evaluate the efficacy of dual-phase contrast-enhanced computed tomography for assessing the location of the ureter and risk of its injury in consecutive LIF cases.Methods
27 cases (12 men and 15 women) were enrolled in the study. Dual-phase contrast-enhanced CT was performed preoperatively, and the risk of ureteral injury was assessed. The location of the ureter was classified using the psoas muscle and vertebral body as reference structures for OLIF and XLIF procedures, respectively. During the OLIF procedures, the location of the ureter was additionally assessed with direct vision and manual palpation in all cases. Simultaneously, potential vascular anomalies were assessed with both 3D and axial images of CT.Results
A total of 125 among 162 ureters, excluding 13 with insufficient enhancement and 24 (44.4%) within the kidney at the L2–L3 level, were assessed preoperatively; 113 ureters (90.4%) were classified as anatomically close to the surgical corridor for OLIF, and 20 ureters (16.0%) as having a potential risk of injury during XLIF. In one case, OLIF was converted to a conventional posterior procedure because of a vascular anomaly. Intraoperative findings showed that ureters moved anteriorly with the peritoneum in all cases, as assessed by manual palpation under direct vision.Conclusions
Dual-phase contrast-enhanced CT is useful in assessing the location of the ureter, kidney, and vascular structures simultaneously. Both OLIF and XLIF have a potential risk of urological injury. 相似文献8.
The distribution of vascular endothelial growth factor in human meniscus and a meniscal injury model
Zhichao Lu Takayuki Furumatsu Masataka Fujii Ami Maehara Toshifumi Ozaki 《Journal of orthopaedic science》2017,22(4):715-721
Background
The meniscus plays an important role in controlling the complex biomechanics of the knee. Meniscus injury is common in the knee joint. The perimeniscal capillary plexus supplies the outer meniscus, whereas the inner meniscus is composed of avascular tissue. Angiogenesis factors, such as vascular endothelial growth factor (VEGF), have important roles in promoting vascularization of various tissues. VEGF-mediated neovascularization is beneficial to the healing of injured tissues. However, the distribution and angiogenic role of VEGF remains unclear in the meniscus and injured meniscus. We hypothesized that VEGF could affect meniscus cells and modulate the meniscus healing process.Methods
Menisci were obtained from total knee arthroplasty patients. Meniscal injury was created ex vivo by a microsurgical blade. VEGF mRNA and protein expression were detected by the polymerase chain reaction and immunohistochemical analyses, respectively.Results
In native meniscal tissue, the expression of VEGF and HIF-1α mRNAs could not be detected. However, VEGF and HIF-1α mRNAs were found in cultured meniscal cells (VEGF: outer > inner; HIF-1α: outer = inner). Injury increased mRNA levels of both VEGF and HIF-1α, with the increase being greatest in the outer area. Immunohistochemical analyses revealed that VEGF protein was detected mainly in the outer region and around injured areas of the meniscus. However, VEGF concentrations were similar between inner and outer menisci-derived media.Conclusions
This study demonstrated that both the inner and outer regions of the meniscus contained VEGF. HIF-1α expression and VEGF deposition were high in injured meniscal tissue. Our results suggest that injury stimulates the expression of HIF-1α and VEGF that may be preserved in the extracellular matrix as the healing stimulator of damaged meniscus, especially in the outer meniscus. 相似文献9.
Dongmin Xu Hiroshi Koyama Hiroki Furuhashi Shoichi Nishikino Hironobu Hoshino Yukihiro Matsuyama 《Journal of orthopaedic science》2017,22(6):1102-1106
Background
In total hip arthroplasty (THA) surgery, hip muscle preservation is important in strengthening the stability of the hip and improving the activities of the patient. However, whether the type of femoral stem affects the recovery of the hip muscles remains unknown. The aim of this study was to compare the postoperative hip muscle recovery among femoral stem varieties after THA.Methods
The computed tomography (CT) images of 44 patients (44 hips) who underwent THA using an anterolateral approach were reviewed. Twenty-two patients received a fit-and-fill (FF) stem and 22 received the tapered-wedge (TW) stem. The volumes of the gluteus maximus (GMA), gluteus medius (GME), and obturator internus (OI) were measured on three-dimensional models reconstructed using preoperative and 6-month postoperative CT images. Relationships between muscle volume changes and factors including the femoral stem length were evaluated.Results
The GMA and GME volumes increased postoperatively by 8.2% and 8.3%, respectively, in the FF stem group and 7% and 6%, respectively, in the TW stem group, with no group differences. In contrast, the OI volume decreased postoperatively by 17.8% in the FF group and was preserved in TW group (p < 0.001). Moreover, OI volume was decreased in 19 patients (86%) in the FF group and in 11 patients (50%) in the TW group (p = 0.01). The normalized stem length was significantly associated with the postoperative change in OI volume (r = ?0.45, p = 0.002).Conclusions
The TW stem showed a significant advantage over the FF stem in terms of OI preservation. Surgeons should pay close attention during surgery to avoid OI injury when using different femoral stem types. We suggest that a short and reduced lateral shoulder femoral stem is a better choice for the preservation of external rotation muscles. 相似文献10.
Yu Sasaki Nobuyasu Ochiai Arata Nakajima Takahisa Sasho Tomonori Kenmoku Takeshi Yamaguchi Takehiro Kijima Eiko Hashimoto Yasuhito Sasaki Seiji Ohtori 《Journal of orthopaedic science》2018,23(5):834-841
Background
Rotator cuff tears are the most common shoulder injury, and little is known about the underlying etiology of fatty infiltration after rotator cuff tear. Previous studies speculated that rotator cuff tears lead to neural injury due to tethering of the suprascapular nerve at the notch. This study aimed to evaluate fatty infiltration after suprascapular nerve injury and rotator cuff tears.Methods
Ninety adult male Sprague–Dawley rats were used and were divided into four groups: sham, tendon transection only, suprascapular nerve ligation, and tendon transection plus suprascapular nerve ligation. The suprascapular nerve injury models were created by tying the suprascapular nerve. At 2, 4, and 8 weeks postoperatively, histological analysis and biomechanical testing were performed to evaluate fatty infiltration and elastic change in the supraspinatus muscles.Results
The amount of fatty infiltration in the supraspinatus muscle was significantly higher in both the suprascapular nerve ligation and tendon transection plus suprascapular nerve ligation groups than in the tendon transection only group at 2, 4, and 8 weeks. The ultimate failure load and tensile strength were significantly different among the tendon transection only, suprascapular nerve ligation, and tendon transection plus suprascapular nerve ligation groups at 8 weeks postoperatively. Furthermore, the mean Young's modulus of the muscle was significantly greater in the tendon transection plus suprascapular nerve ligation group than in both the tendon transection only and suprascapular nerve ligation groups at 8 weeks postoperatively.Conclusions
In this study, based on the results of histological and biomechanical examinations in our rat models, the etiology of fatty infiltration after massive rotator cuff tear might be different from the suprascapular nerve injury. 相似文献11.
Yoshihiro Hagiwara Takuya Sekiguchi Yutaka Yabe Yumi Sugawara Takashi Watanabe Kenji Kanazawa Masashi Koide Nobuyuki Itaya Masahiro Tsuchiya Ichiro Tsuji Eiji Itoi 《Journal of orthopaedic science》2017,22(3):442-446
Background
The Great East Japan Earthquake and devastating Tsunami hit hard everything on the northeastern coast of Japan. This study aimed to determine socio-psychological factors for “subjective shoulder pain” of the survivors at 2 years evaluated by a self-report questionnaire.Methods
Between November 2012 to February 2013, survivors replied to the self-report questionnaire, and 2275 people consented to join this study. Living status was divided into 5 categories (1. same house as before the earthquake (reference group), 2. temporary small house, 3. apartment, 4. house of relatives or acquaintance, 5. new house) and economic hardship was divided into 4 categories (1. normal (reference group), 2. a little bit hard, 3. hard, 4. very hard). Gender, age, body mass index, living areas, smoking and drinking habits, complications of diabetes mellitus and cerebral stroke, working status, and walking time were considered as the confounding factors. Kessler Psychological Distress Scale of ≥10/24 and Athens Insomnia Scale of ≥6/24 points were defined as a presence of psychological distress and sleep disturbance, respectively. We used multiple logistic regression analysis to examine the association of shoulder pain with living environment, economic hardship, psychological distress, and sleep disturbance at 2 years after the earthquake.Results
There were significant differences in the risk of having shoulder pain in those with “apartment” (OR = 1.74, 95% CI = 1.03–2.96), “house of relatives or acquaintance” (OR = 2.98, 95% CI = 1.42–6.25), economic hardship of “hard” (OR = 1.71, 95% CI = 1.08–2.7) and “very hard” (OR = 2.51, 95% CI = 1.47–4.29), and sleep disturbance (OR = 2.96, 95% CI = 2.05–4.27).Conclusions
Living status of “apartment” and “house of relatives or acquaintance”, economic hardship of “hard” and “very hard”, and “sleep disturbance” were significantly associated with shoulder pain. 相似文献12.
Shunichiro Kambara Hiroshi Nakayama Motoi Yamaguchi Akio Matsumoto Ken Sasaki Kaori Kashiwa Tomoya Iseki Shinichi Yoshiya 《Journal of orthopaedic science》2017,22(3):481-487
Purpose
To comparatively analyze the geometry of the posterolateral femoral (PL) tunnel in double-bundle ACL reconstruction between far anteromedial transportal (TP) and outside-in (OI) drilling techniques based on three-dimensional computed tomography (3DCT) image analysis.Methods
Forty patients who underwent anatomic double-bundle hamstring ACL reconstruction using the TP (n: 20) or OI (n: 20) method with postoperative CT data available were included in the study. The analyzed parameters were as follows: location of the intraarticular tunnel aperture, tunnel length, bending angle (angulation of the graft at the intraarticular tunnel aperture), and long axis of the tunnel aperture/drill diameter ratio as a parameter of ellipsoidal geometry.Results
Anatomical tunnel placement was achieved in both groups. Coalition of the AM and PL tunnel apertures was found in 3 knees in the TP group and 1 knee in the OI group, though no significant difference in the rate of this problem was demonstrated between the groups (P: 0.30). The tunnel length was not significantly different between the groups, while the graft bending angle at the tunnel aperture was significantly larger in the OI group than the TP group (99.4° vs. 63.6°). The long axis/drill diameter ratio averaged 1.23 in the TP group and 1.13 in the OI group with significant intergroup difference.Conclusion
When drilling the PL femoral tunnel in double-bundle ACL reconstruction, anatomic placement of the intraarticular tunnel aperture was feasible in both the TP and OI techniques. The tunnel aperture was rounder and the graft bending angle in knee extended position at the intraarticular aperture was more acute in the OI technique than the TP technique.Level of evidence
Level IV (retrospective comparison of the two patient groups treated at different hospitals). 相似文献13.
Shinji Yoshioka Shunji Nakano Yutaka Kinoshita Masaru Nakamura Tomohiro Goto Daisuke Hamada Koichi Sairyo 《Journal of orthopaedic science》2018,23(6):967-972
Background
The use of 3-dimensional highly porous acetabular cups is increasing. Their structure and mechanical properties mimic those of natural bone; therefore, they should promote stronger biological fixation. In our experience with total hip arthroplasty, radiolucent lines are observed when a 3-dimensional highly porous cup (Stryker Tritanium) is used. We compared the clinical and radiographic results between a Tritanium cup and a conventional cup (Stryker Trident HA) over a short time period.Method
We retrospectively compared consecutive cases of primary total hip arthroplasty using a Tritanium cup (130 cases in 118 patients) and a matched cohort using a Trident cap (130 cases in 130 patients) between January 2011 and December 2014.Results
The mean follow-up duration was 41.3 and 38.1 months (p = 0.06) for the Tritanium and Trident groups, respectively. There were significant differences between the groups for radiolucent lines, cup abduction angle, and cup-center-edge angle. There were no significant differences in the clinical results. Radiolucent lines increased in the Tritanium group (36.1% at 3 months and 60.7% at final follow-up), whereas they decreased in the Trident group (2.5% at 3 months and 0.8% at final follow-up). The occurrence of radiolucent lines was significantly higher in the Tritanium group than in the Trident group at each follow-up period. Radiolucent lines were seen in 36.1% of patients in the Tritanium group during follow-up, without initial gaps. One cup loosening in the Tritanium group was identified at the final follow-up evaluation.Conclusion
Both groups showed successful clinical results over short-term follow-up; however, the Tritanium group had a significantly higher rate of radiolucent line occurrence around the cups than did the Trident group. Thus, radiolucent lines can occur when using highly porous titanium cups; these lines indicate the possibility of future cup loosening. Longer follow-up and assessment of the results of using this implant are necessary. 相似文献14.
15.
Takanobu Nishizuka Katsuyuki Iwatsuki Shigeru Kurimoto Michiro Yamamoto Hitoshi Hirata 《Journal of orthopaedic science》2017,22(2):289-294
Background
A forearm band is frequently used for lateral epicondylitis worldwide. However, evidence regarding its efficacy has been insufficient. The objective of this prospective, randomized, controlled trial was to analyze the effects of a forearm band for treatment of lateral epicondylitis at 1, 3, 6, and 12 months.Methods
Patients with lateral epicondylitis were randomly allocated into a band (n = 55) or non-band (n = 55) group. Patients in the band group were instructed to wear a forearm band for more than 6 h daily for at least 6 months. Patients in both groups were instructed to perform wrist extensor stretching exercises for 30 s, 3 times daily, for 6 months. Hand10, pain, and satisfaction scores, and proportions of positive physical examinations, including tenderness assessment, Thomsen test, and middle finger extension test, were evaluated at 1, 3, 6, and 12 months after enrollment.Results
There were no significant differences between the band and non-band groups with regard to Hand10, pain, or satisfaction scores at 1, 3, 6, and 12 months. Likewise, there was no significant difference in proportions of positive physical examinations between groups at 1, 3, 6, and 12 months.Conclusion
The results of the current study suggest that a forearm band may have no more than a placebo effect, and do not support the use of a forearm band based on its effectiveness. 相似文献16.
Taiki Murakami Makoto Enokida Kei Kawaguchi Ryoji Otsuki Hideki Nagashima 《Journal of orthopaedic science》2017,22(2):318-324
Objective
Medial radial displacement (MRD) of the medial meniscus is a feature proving a dysfunction in the medial meniscus in osteoarthritis (OA) of the knee. MRD was measured in radiographic pre-OA knee and early osteoarthritis of the knee (early-OA) longitudinally using ultrasound (US) to investigate the characteristics involved in the onset and progression of OA.Methods
Fifty-five patients with pain on the medial side of the knee participated in the present study. It was possible to follow-up 46 patients for 5 years, and, thus, they were divided into 32 pre-OA patients (female: 59%, mean age: 69.0 years) and 14 early-OA patients (female: 78%, mean age: 74.4 years) based on radiography at the baseline time-point. MRD was measured in standing and supine positions at baseline and after 1 and 5 years using US. MRD corrected with the skeletal size, i.e., the medial displacement index (MDI), was analyzed. The pre- and early-OA groups were divided into subgroups at 5 years: stable and OA progression groups, following the Kellgren/Lawrence classification, and ⊿MDI (gap of the MDI between the standing and supine positions) were retrospectively compared between the subgroups at baseline, 1 and 5 years.Results
In the overall pre-OA group, MDI increased by 7% and 10% at 5 years in the supine and standing position, showing a significant increase (P = 0.044, 0.0147). ⊿MDI was significantly greater in the subgroup with OA progression in the pre- and early-OA groups (P = 0.02 and 0.03, respectively), and was continuously 6–7% in the pre-OA progression group, showing that the displacement rate was 2-fold or higher than in the stable group.Conclusion
An increase in ⊿MDI on US may be an important risk factor for the disease stage progression of OA and useful as a feature predicting the onset of radiographic knee OA. 相似文献17.
Takashi Tsuji Morio Matsumoto Masaya Nakamura Takeshi Miyamoto Mitsuru Yagi Nobuyuki Fujita Eijiro Okada Narihito Nagoshi Osahiko Tsuji Kota Watanabe 《Journal of orthopaedic science》2018,23(6):878-883
Background
Metabolomics is one of the “omics” technologies, and is a comprehensive analysis of small molecule metabolites which include amino acid, nucleotides, carbohydrates and fatty acid. The purpose of the present study was to compare the differences of metabolite profiling between patients with ossification of the posterior longitudinal ligament (OPLL) and control subjects.Methods
We analyzed plasma metabolites in patients with cervical OPLL (n = 10) and in control subjects (n = 10). Ionic metabolites were analyzed using capillary electrophoresis time-of-flight mass spectrometry (CE-TOFMS) and lipophilic metabolites were analyzed using liquid chromatograph time-of-flight mass spectrometry (LC-TOFMS).Results
A total of 259 metabolites (144 metabolites in CE-TOFMS and 115 metabolites in LC-TOFMS) were detected. Among the 259 metabolites, six metabolites, namely acylcarnitine (AC) (14:0), palmitoylcarnitine, AC (18:2), fatty acid (FA) (24:2), thyroxine, thiaproline were significantly larger in OPLL group, even in analyzes excluding patients with diabetes mellitus and hyperlipidemia.Conclusions
We examined the metabolite profiling in patients with OPLL for the first time and detected six metabolites showing suggestive association with disease. These results of the present study could lead to new insights into clarifying the molecular pathomechanisms of OPLL. 相似文献18.
Kazunori Tanaka Munehiro Ogawa Yusuke Inagaki Yasuhito Tanaka Hitoshi Nishikawa Koji Hattori 《Journal of orthopaedic science》2017,22(3):488-494
Background
The Lachman test is clinically considered to be a reliable physical examination for anterior cruciate ligament (ACL) deficiency. However, the test involves subjective judgement of differences in tibial translation and endpoint quality. An auscultation system has been developed to allow assessment of the Lachman test. The knee joint sound during the Lachman test was analyzed using fast Fourier transformation. The purpose of the present study was to quantitatively evaluate knee joint sounds in healthy and ACL-deficient human knees.Methods
Sixty healthy volunteers and 24 patients with ACL injury were examined. The Lachman test with joint auscultation was evaluated using a microphone. Knee joint sound during the Lachman test (Lachman sound) was analyzed by fast Fourier transformation. As quantitative indices of the Lachman sound, the peak sound (Lachman peak sound) as the maximum relative amplitude (acoustic pressure) and its frequency were used.Results
In healthy volunteers, the mean Lachman peak sound of intact knees was 100.6 Hz in frequency and ?45 dB in acoustic pressure. Moreover, a sex difference was found in the frequency of the Lachman peak sound. In patients with ACL injury, the frequency of the Lachman peak sound of the ACL-deficient knees was widely dispersed. In the ACL-deficient knees, the mean Lachman peak sound was 306.8 Hz in frequency and ?63.1 dB in acoustic pressure. If the reference range was set at the frequency of the healthy volunteer Lachman peak sound, the sensitivity, specificity, positive predictive value, and negative predictive value were 83.3%, 95.6%, 95.2%, and 85.2%, respectively.Conclusion
Knee joint auscultation during the Lachman test was capable of judging ACL deficiency on the basis of objective data. In particular, the frequency of the Lachman peak sound was able to assess ACL condition. 相似文献19.
20.
Hiroyuki Enomoto Shinji Fujikoshi Toshinaga Tsuji Nao Sasaki Hirofumi Tokuoka Yuji Uchio 《Journal of orthopaedic science》2018,23(6):1019-1026