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1.
Yuta Sakemi Keisuke Komiyama Kensei Yoshimoto Kyohei Shiomoto Miho Iwamoto Yasuharu Nakashima 《Journal of orthopaedic science》2019,24(2):269-274
Background
Due to anterior bone defects, high and/or posterior placement of an acetabular cup is often required to achieve sufficient coverage in patients with hip dysplasia. We examined whether posterior cup placement affected the postoperative range of motion (ROM) in primary total hip arthroplasty (THA).Methods
Using computer software, bone coverage and ROM were examined in 32 patients with unilateral osteoarthritis of the hip with Crowe type II or III hip dysplasia. We determined the cup position to satisfy cup center-edge (Cup-CE) angle ≥0° and the required ROM. The cup was placed at the anatomic hip center and moved in 2-mm increments anteroposteriorly and 10-mm increments vertically.Results
At vertical anatomic hip center, less than 68.8% hips fulfilled Cup-CE ≥0° regardless of anteroposterior position. Significantly more hips at higher hip center with posterior cup placement achieved Cup-CE ≥0° than hips at vertical anatomic hip center, and 10 mm higher hip center was the most suitable for achieving bone coverage. However, posterior and superior cup placement significantly decreased the flexion and IR due to early bone impingement, whereas ER and extension were not affected. A smoothing spline curve demonstrated that more posterior cup placement than 4.8 mm and 3.6 mm did not satisfy the required ROM at 10 mm and 20 mm higher hip center, respectively.Conclusions
Posterosuperior cup placement gained more bone coverage but decreased the range of hip flexion and internal rotation. Consequently, posterosuperior cup placement did not satisfy the required ROM. 相似文献2.
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3.
4.
Kenichi Oe Hirokazu Iida Fumito Kobayashi Narumi Ueda Tomohisa Nakamura Naofumi Okamoto Takanori Saito 《Journal of orthopaedic science》2018,23(6):992-999
Background
The optimum approach in total hip arthroplasty (THA) should reduce the risk of postoperative dislocation or limping, be applicable in every case, and be reusable in the future. The purpose of this study was to introduce our transgluteal approach for THA and to evaluate the type and frequency of complications around the greater trochanter.Methods
This study retrospectively evaluated 892 THA cases between January 2010 and March 2015 performed using our transgluteal approach that osteotomized only the lateral anteroinferior greater trochanter. The trochanteric fragment was reattached using one of three different protocols: Group A, three non-absorbable polyester sutures; Group B, two non-absorbable polyester sutures and one ultra-high molecular weight polyethylene (UHMWPE) fiber cable; or Group C, two UHMWPE fiber cables. Postoperative complications were assessed and recorded, and univariate logistic regression analyses were performed to determine whether risk factors and radiological complications around the greater trochanter were correlated.Results
None of the hips required revision for infection, dislocation, or limping. The rate of radiological complications around the greater trochanter at 1 year was 19.2% in Group A, 16.3% in Group B, and 7.9% in Group C (p < 0.001). Risk factors for radiological complications included the patient's disease or the surgeon's experience in Group A and the patient's age or the surgeon's experience in Group C. In the relationship between postoperative pain around the greater trochanter and radiological complications, there were no significant differences in all groups; no group interaction was observed (p= 0.3875).Conclusion
The UHMWPE fiber cable was effective to reduce complications of the reattached osteotomized greater trochanter in THA. 相似文献5.
Satoshi Ikebe Motoki Sonohata Masaru Kitajima Shunsuke Kawano Masaaki Mawatari 《Journal of orthopaedic science》2018,23(3):532-537
Background
Complications associated with re-implantation of total hip arthroplasty (THA) after resection arthroplasty for the treatment of primary septic hip arthritis or infected THA and bipolar hemiarthroplasty (BHA) are not well-documented. Furthermore, no comparison has been made between septic arthritis (SA) and infected THA and BHA. We divided subjects into two groups for evaluation: a SA group and an infected THA or BHA group.Methods
Nineteen hips in 19 patients (12 in the SA group, 7 in the infected THA or BHA group) with an average of 77 months of follow-up from the time of re-implantation THA were retrospectively evaluated.Results
The average Japanese Orthopaedic Association hip score improved from 50 points (range, 30 to 73 points) preoperatively to 80 points (range: 64 to 96 points) at the time of the final follow-up (p < 0.01). Intra- and postoperative complications occurred in 11 cases, including intraoperative fracture in 1 hip, deep infection in 6 hips, dislocation in 7 hips, and septic loosening of acetabular component in 2 hips. Following re-implantation, further surgical revision was required in four cases. Two revisions were performed for recurrent infection: one patient had recurrent dislocation of one hip, and one patient had recurrent infection and dislocation. The number of hips with relapsed infection in the infected THA or BHA group (5 hips) was significantly higher than that in the SA group (1 hip) (p < 0.05).Conclusions
Re-implantation after septic hip arthritis or infected THA or BHA was an effective treatment for improving the activity of daily life, especially the gait function. Furthermore, 94.7% of patients were free of infection at the latest follow-up. However, the rate of recurrence of infection was 31.6%, and re-implantation after resection arthroplasty following infected THA or BHA led to a lower rate of infection control than that after primary SA. 相似文献6.
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
7.
Vahit Emre Ozden Goksel Dikmen Burak Beksac Ismail Remzi Tozun 《Journal of orthopaedic science》2018,23(3):525-531
Background
Placement of acetabular cup in the dysplastic hip is a challenging procedure. Using bulk femoral head autograft to increase the bony coverage of the cup is one of the techniques, which have been described. The impact of cup position on cup and autograft survival is a controversial issue. We aimed to determine whether the position of cementless acetabular cup used in conjunction with femoral head autograft in dysplastic hips affected the autograft-host incorporation with its final radiographic appearance and the cup survivorship into the second decade.Methods
Thirty-eight dysplastic hips with varying Crowe types in 31 patients (30 women and one man) were included. The mean age was 47 years (range, 29–64 years) and the mean follow-up was 20.3 years (range, 14.8–25.9 years). The initial postoperative and final radiographs were evaluated. The survival rate of the cups was analysed using Kaplan–Meier statistics and the log-rank test. Multivariate analysis was used to evaluate the effect of variables (Crowe type, radiographic initial host bone coverage over the cup and position of the cup) on survivorship.Results
The acetabular cups were positioned anatomical in 27/38 hips according to Ranawat measurement technique. Trabecular bridging at graft–host interface was seen in all cases at an average 22.1 months. Neither acetabular cup position nor initial host bone coverage over acetabular cup less than 50% had any significant effect on either cup survival or final radiographic appearance of the graft. The 20-year cup survival rate without aseptic revision was 66% (95 CI, 52%–84%). No revision was performed due to graft resorption.Conclusion
Twenty-year survival rate of the cementless cup combination with femoral head autograft showed no significant differences whether it was placed at high or anatomic hip centre. The final radiographic appearance of the autograft was not affected from either the cup location or the initial radiographic horizontal host bone coverage. 相似文献8.
Mitchell R. Klement Colin T. Penrose Abiram Bala Cynthia L. Green Richard C. Mather Samuel S. Wellman Michael P. Bolognesi Thorsten M. Seyler 《Journal of orthopaedic science》2017,22(2):295-299
Purpose
Solid organ transplants (SOT) continue to increase with recipients living longer than ever before. The lifelong immunosuppression in these patients also may place them at increased risk for postoperative complications. The efficacy of total hip arthroplasty (THA) in this patient population is undisputed but previous studies investigating the complication profiles in these patients often are underpowered to identify rare complications as well as make comparisons between individual organs. The purpose of this study was to use a large database to compare complications of a combined SOT cohort as well as each individual organ to a control population.Methods
A search of the entire Medicare database from 2005 to 2011 was performed using International Classification of Disease version 9 (ICD-9) codes to identify patients who underwent THA after one or more solid organ transplants. A large cohort of patients served as a control with minimum 2-year follow-up. Post-operative complications at 30-day, 90-day, and overall time points were investigated.Results
Transplant patients carry more medical comorbidities and are prone to increased medical complications, dislocations (OR 1.45, p < 0.001), need for irrigation and debridement (OR 1.90, p < 0.001), and periprosthetic infection (OR 1.69, p < 0.001) compared to patients without SOT. Total hip arthroplasty after renal transplantation has the worst complication profile of the individual organs whereas lung and pancreas transplants were no different than control with regard to overall surgical complications.Conclusions
The complications of THA after SOT vary by individual organ and these results may aid in patient selection and perioperative patient counseling. 相似文献9.
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10.
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11.
Kazunari Ishida Nao Shibanuma Kazuki Kodato Akihiko Toda Hiroshi Sasaki Koji Takayama Shinya Hayashi Shingo Hashimoto Takehiko Matsushita Takahiro Niikura Masahiro Kurosaka Ryosuke Kuroda Tomoyuki Matsumoto 《Journal of orthopaedic science》2018,23(6):1005-1010
Background
This study aimed to determine the appropriate administration duration of edoxaban 15 mg (a factor Xa inhibitor) for the prevention of deep vein thrombosis (DVT) after total knee arthroplasty (TKA).Methods
Our study comprised 202 patients who underwent TKA (excluding bilateral TKA) at our institution between 2014 and 2015. The subjects received edoxaban 15 mg daily for 1 (n = 93) or 2 (n = 109) weeks; group assignment was random. B-mode ultrasonography was performed 7 and 14 days post-TKA for the detection of DVT. We compared the incidence of DVT between the groups and examined for side effects.Results
The demographic data of the patients in the 1- and 2-week administration groups were similar at baseline. DVT incidence did not differ significantly between the groups at 1 week post-TKA. However, it was significantly lower in the 2-week administration group (n = 0) than in the 1-week administration group (n = 7; p = 0.004) at 2 weeks post-DVT. Neither group exhibited symptomatic DVT. A total of six patients withdrew during the study period because of hepatic dysfunction.Conclusions
Our results show that the administration of edoxaban 15 mg is more effective in preventing DVT after TKA when administered for 2 weeks than for 1 week. 相似文献12.
Kanji Mori Toshiyuki Kasahara Tomohiro Mimura Kazuya Nishizawa Akira Nakamura Shinji Imai 《Journal of orthopaedic science》2017,22(1):38-42
Background
The epidemiology and etiology of diffuse idiopathic skeletal hyperostosis (DISH) remain obscure. To date, to the best of our knowledge, there is no study that precisely evaluated the prevalence of thoracic DISH based on computed tomography (CT) data in large number of non-operated cohort with wide age distribution.Methods
The participants of this study were the consecutive patients who have undergone chest CT for the examination of pulmonary diseases in our institute. The patients with previous thoracic spine surgery and younger than 15 years old were excluded. Chest CT data were reconstructed in the condition suitable for bone evaluation by the software application. Definitive diagnosis of DISH was determined according to the criteria established by Resnick and Niwayama. Prevalence and distribution of thoracic DISH were reviewed and the data was statistically analyzed.Results
Total 3013 patients (1261 females and 1752 males) with the mean age of 65 years were recruited. The CT-based evidence of thoracic DISH was noted in 261 individuals (31 females and 230 males) (8.7%), and their mean age was 73 years. Statistical analyses revealed that thoracic DISH had a significant male preponderance. The mean age of thoracic DISH positive individuals was significantly higher than that of thoracic DISH negative individuals. There was significant difference of bone mass index (BMI) between thoracic DISH positive and negative individuals. Thoracic DISH was noted after the age of 40s with the highest distribution found at the age of 70s. No thoracic DISH localizes only higher thoracic region was found.Conclusions
The CT-based prevalence of thoracic DISH in Japanese was 8.7%. Thoracic DISH has a significant predisposition to elderly male with high BMI. 相似文献13.
Kanji Mori Takafumi Yayama Kazuya Nishizawa Akira Nakamura Tomohiro Mimura Shinji Imai 《Journal of orthopaedic science》2019,24(1):30-34
Background
The development and etiology of diffuse idiopathic skeletal hyperostosis (DISH) were far from complete understanding. Even the precise mechanism of the development of its typical right-sided ossification of the anterior longitudinal ligament (OALL) frequently compared to ‘flowing candle wax’, a hallmark of DISH, remains unknown.Methods
The participants of this study were 261 individuals (31 females and 230 males) diagnosed as DISH according to the criteria established by Resnick and Niwayama extracted from a consecutive 3013 patients who have undergone chest CT for the examination of pulmonary diseases in our institute. The patients with previous thoracic spine surgery and younger than 15 years old were excluded. Chest CT data were converted to the condition suitable for bone evaluation by the software application. The positional relationship between thoracic aorta and OALL, the morphology of the OALL adjacent to the aorta and the presence of calcification of the aortic wall adjacent to the OALL were studied.Results
Of 261 individuals with DISH, we found that thoracic aorta was localized adjacent to the OALL (AD-group) in 123 cases (47%), whereas 138 cases (53%) were not (NAD-group). All OALL in AD-group was localized between T6 and T12. The shape of the OALL adjacent to the aorta was either flat or concave except for one. No case showed obvious calcification of the aortic wall adjacent to the OALL in AD-group.Conclusions
The aortic pulsation might play an important role in inhibit the development of the OALL toward the aorta in DISH. It is likely that establishment of the optimal condition of the pulsation stress simulating aortic pulsation and its delivery system can achieve arresting, slowing the progression and/or changing the morphology of the ossified lesions. 相似文献14.
Seiya Miyamoto Takehiko Sugita Toshimi Aizawa Naohisa Miyatake Akira Sasaki Ikuo Maeda Masayuki Kamimura Atsushi Takahashi 《Journal of orthopaedic science》2018,23(5):801-806
Background
The efficacy of morphine added to periarticular multimodal drug injection (PMDI) for pain management after total knee arthroplasty (TKA) is controversial. Adding morphine to spinal anesthesia has reportedly improved pain relief for the first 24 h. We examined the effect of morphine added to PMDI or spinal anesthesia on pain management and functional recovery after TKA.Methods
A total of 97 patients were randomized into three groups: in Group A (34 patients), 10 mg morphine was added to PMDI; Group B (31 patients), 0.1 mg morphine was added to spinal anesthesia; and Group C (32 patients), morphine was added to neither the PMDI nor spinal anesthetic. To evaluate the efficacy of added morphine for pain management, we assessed rest pain, the number of times analgesics were used, and the time period until the first analgesic use. The adverse effects of morphine were assessed by counting the numbers of times vomiting occurred and antiemetics were used. Functional recovery was evaluated by recording the range of motion of the knee and the date of ability to walk.Results
Rest pain was the least in Group B at 6 and 12 h after operation. The number of times analgesics were used was the least in Group B. The time period until the first analgesic use was the longest in Group B. The number of vomiting episodes was the least in Group C. The number of times antiemetics were used was higher in Group A than in Group C. There were no significant differences in the range of motion and date of ability to walk among the three groups.Conclusions
The efficacy of morphine added to PMDI was limited, and that of morphine added to spinal anesthesia disappeared within 20 h postoperatively. Adding morphine to PMDI or spinal anesthesia did not improve functional recovery and caused some adverse effects. 相似文献15.
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16.
Shunsuke Kawano Motoki Sonohata Shuichi Eto Masaru Kitajima Masaaki Mawatari 《Journal of orthopaedic science》2019,24(4):658-662
BackgroundThe silver oxide-containing hydroxyapatite-coated socket (KYOCERA, Osaka, Japan) is a cementless antibacterial implant that has both the osteoconductivity of the HA and the antibacterial activity of silver. The silver oxide-containing hydroxyapatite coating was shown to have good osteoconductivity and new bone formation in vitro and in vivo. However, the histological bone ongrowth of this implant has not been proven in a clinical study.MethodsWe analyzed bone ongrowth using two silver oxide-containing hydroxyapatite-coated sockets that were removed in revision total hip arthroplasty for recurrent dislocation. A histomorphometric analysis was performed using a scanning electron microscope (SEM) connected to a CCD camera and an elemental analysis was performed by energy-dispersive elemental spectrometry (EDS).ResultA white structure thought to be osseous tissue was attached to the retrieved socket surface macroscopically, and histological bone ongrowth of the silver oxide-containing hydroxyapatite coating of the socket was confirmed by SEM. In addition, the presence of silver in the silver oxide-containing hydroxyapatite coating was confirmed in an elemental analysis by EDS.ConclusionHistologically, the silver oxide-containing hydroxyapatite-coated socket presented bone ongrowth in this clinical study. 相似文献
17.
Norio Imai Tomoyuki Ito Ken Suda Dai Miyasaka Naoto Endo 《Journal of orthopaedic science》2017,22(4):726-730
Background
Venous thromboembolism is one of the general complications following total hip arthroplasty, wherein various preventive treatments have been recommended. Several studies reported that venous thromboembolism incidence after total hip arthroplasty was similar in patients who were administered prophylaxis with a conventional mechanical procedure alone, and those who were administered pharmacological anticoagulation therapy. Therefore, the optimum methods of prophylaxis are still controversial. The purpose of this study was to investigate whether manual calf massage and passive ankle motion could lower the risk for venous thromboembolism after total hip arthroplasty.Methods
We retrospectively reviewed the data of 126 consecutive patients undergoing elective primary unilateral total hip arthroplasty wherein manual calf massage and passive ankle motion were performed after the surgery at our hospitals between January and October 2014. The 138 patients of the control group underwent total hip arthroplasty using the same surgical approach and pre- and postoperative protocols without this mechanical prophylaxis between January and December 2013. This mechanical prophylaxis was performed simultaneously 30 times during approximately 10 s; these procedures were repeated thrice immediately after total hip arthroplasty. Duplex ultrasonography was performed to observe the veins of both legs in all the patients on postoperative day 7.Results
The incidence of deep vein thrombosis was 6.52% and 0.79% in the control and manual calf massage and passive ankle motion groups, respectively. The odds ratio for the manual calf massage and passive ankle motion groups was 8.72. Performing this mechanical prophylaxis reduced the incidence of venous thromboembolism after total hip arthroplasty. This mechanical prophylaxis is not only simple and easy, but is also safe and inexpensive.Conclusions
We therefore recommend that manual calf massage and passive ankle motion be performed in patients who will undergo total hip arthroplasty, if deep vein thrombosis does not exist before the surgery. 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.
Tadashi Hattori Yutaka Inaba Sadafumi Ichinohe Toshio Kitano Daisuke Kobayashi Takashi Saisu Toshifumi Ozaki 《Journal of orthopaedic science》2017,22(1):121-126