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1.
Atsushi Nakano Choman Ryu Ichiro Baba Takashi Fujishiro Yoshiharu Nakaya Masashi Neo 《Journal of orthopaedic science》2017,22(4):622-629
Background
The optimal treatment of neurological deficits following osteoporotic vertebral collapse (OVC) is controversial, owing to complications that result from fragile bone quality. In the present study, we assessed surgical results following posterior spinal fusion without decompression. We achieved stable fusion over a short segment of the spinal column using pedicle screws and spinous process plates, maximizing the use of the preserved posterior elements.Methods
We reviewed surgical data, perioperative complications, clinical outcomes, and radiographic data of 20 consecutively recruited patients with delayed neurological deficits following OVC, who experienced posterior short fusion without neural decompression. The average follow-up period was 24.3 months. The spine was typically stabilized with pedicle screws and spinous process plates from one level above to one level below the collapsed vertebrae, without using neural decompression or considerable correction of kyphosis.Results
All patients experienced relief from back pain and neurological improvements of at least one modified Frankel grade. Bone unions of the collapsed vertebrae were achieved in all patients, and spinal fusions of the instrumented segments were achieved in all but one patient. The mean loss of correction was 5.9°, and the average spinal canal compromise by bone fragments was 32.4% before surgery as against 26.0% at the final follow-up time point. Fractures in adjacent or upper instrumented vertebrae were observed in four cases (20%).Conclusions
Rigid augmentation by spinous process plates and an enough bed for the bone grafts were available in patients with severe osteoporosis, without neural decompression. All patients had satisfactory neurological recovery regardless of the extent of spinal canal remodeling, demonstrating that dynamic factors are the primary contributor to neurological deficits following OVC. 相似文献2.
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3.
Takayoshi Suzuki Hirohisa Katagiri Tatsuya Noda Shusuke Ota Hideki Murata Junji Wasa Seiichi Hosaka Tetsuo Shimoyama Mitsuru Takahashi 《Journal of orthopaedic science》2017,22(3):405-410
Objective
The purpose of this study was to investigate the differences between spinal metastasis and osteoporotic compression fractures on plain X-ray images, focusing on asymmetrical vertebral collapse and fracture level.Materials and methods
This study included 180 patients with pathological collapse from spinal metastasis (188 vertebrae) who were treated at our institution and 70 patients (92 vertebrae) with osteoporotic compression fractures. Anteroposterior X-ray images of the lower thoracic and lumbar spine were evaluated for asymmetrical collapse deformity.Results
Asymmetrical collapse was found in 134 vertebrae (71.3%) with metastasis, and in 20 osteoporotic vertebrae (21.7%); this difference was significant (p < 0.0001). The asymmetrical collapse angle in spinal metastasis patients ranged from 0 to 18°, with a mean of 7.0 and a standard deviation (SD) of 4.5. In contrast, the asymmetrical collapse angle in patients with osteoporotic fractures ranged from 0 to 13°, with a mean of 3.1 and a SD of 2.8. The difference in collapse angle between the two groups was statistically significant (p < 0.001). The cutoff value to suspect spinal metastasis was determined to be 5° or more (sensitivity 0.67, specificity 0.74). Fracture at Th10 or below L3 was found in 20.2% of spinal metastasis patients; only 3% of osteoporotic fractures occurred at these levels.Conclusion
Asymmetrical collapse with an angle of 5° or more and fractures at atypical levels on plain radiographs can be useful clues to spinal metastasis. 相似文献4.
Toshio Nakamae Yoshinori Fujimoto Kiyotaka Yamada Takeshi Hiramatsu Takashi Hashimoto Kjell Olmarker Nobuo Adachi 《Journal of orthopaedic science》2017,22(2):201-206
Background
With aging of the population, the numbers of osteoporotic vertebral fractures with intravertebral cleft have been increasing. However, the details of clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft are poorly understood. The purpose of this study was to evaluate the relationship between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings.Methods
Two hundred seventeen patients with single-level osteoporotic vertebral fractures with intravertebral cleft were examined. Clinical symptoms were evaluated using Numerical Rating Scale for back pain and the Oswestry Disability Index for physical disability. The presence of delayed neurologic deficit was also detected. Radiography and computed tomography were used to measure local kyphotic angle and vertebral instability and to detect the presence of posterior wall fracture of the vertebral body. Correlations between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings were investigated.Results
Mean Numerical Rating Scale and Oswestry Disability Index were 7.4 and 58.0%, respectively. Delayed neurologic deficit occurred in 41 patients (19%). The mean local kyphotic angle, vertebral instability, and rate of posterior wall fracture of the vertebral body were 19.4°, 7.3°, and 91%, respectively. Numerical Rating Scale and Oswestry Disability Index were statistically correlated with vertebral instability but not with local kyphotic angle and presence of posterior wall fracture. In the patients with delayed neurologic deficit, vertebral instability was significantly higher and posterior wall fractures were significantly more frequent than in the patients without delayed neurologic deficit. Local kyphotic angle was not correlated with delayed neurologic deficit.Conclusions
Vertebral instability is a factor causing symptoms of osteoporotic vertebral fractures with intravertebral cleft. In addition, vertebral instability may be the predominant cause of delayed neurologic deficit. To manage osteoporotic vertebral fractures with intravertebral cleft and delayed neurologic deficit efficiently, it may be important to control vertebral instability of osteoporotic vertebral fractures. 相似文献5.
Aim
To examine the relationship between social and material deprivation and mandibular fractures.Method
Three hundred and forty three consecutive patients who underwent mandibular fracture fixation were selected for the study. After exclusions, 290 were divided into age groups and ranked according to their Index of Multiple Deprivation (IMD) score. Rankings were determined using postcodes, and divided into quintiles for statistical analysis.Results
Ages ranged from 7 to 82 with 146 (50%) patients aged between 20 and 29. Males accounted for 85% of cases. The most common site of fracture was the angle (n = 195) and assault was shown to be the most common mechanism of injury (63.3%). A strong relationship was demonstrated between fractures of the mandible and worsening deprivation, with the most striking relationship seen with fractures sustained as a consequence of assault. Females were less likely than males to sustain a fracture of the mandible as a consequence of assault; however, when assault was the mechanism of injury they were also likely to be from a deprived background.Conclusion
This study has demonstrated that a strong relationship exists between deprivation and the incidence of mandibular fractures in our catchment area. Fractures that resulted from interpersonal violence were shown to have a particularly strong correlation with deprivation. 相似文献6.
Michael G. Jakubietz Laura Mages Robert K. Zahn Werner Kenn Rafael G. Jakubietz Rainer H. Meffert 《Journal of orthopaedic science》2017,22(3):434-437
Background
Intraarticular fractures of the distal radius present a challenging problem for surgeons. While preoperative CT scans are considered helpful to understand the type of fracture and to choose an adequate approach, the role of postoperative CT scans is not yet clearly defined. The aim of this study was to analyze indications for postoperative CT scans and to evaluate its potential therapeutic consequence in regard to detection of complications and its influence on revision rates in intraarticular fractures. These findings were used to establish an algorithm to help identifying patients that benefit from a postoperative CT scan.Patients and methods
Ninety-two patients with intraarticular fractures were included. AO type C fractures were seen in about 90% of patients, with type C3 being present in 55% of the patients. According to Frykman's classification type 7 and 8 fractures were found in 93%. Data was analyzed in regard to radiographic results, complications and indication for a postoperative CT scan.Results
Six patients underwent revision surgery. When analyzing data in regard to correlation of radiographs and CT Scans a statistically significant correlation was found.Conclusions
A high correlation between both imaging techniques can be shown. In inconclusive radiographs, CT scans are recommended to rule out intraarticular screw placement or step offs. Due to the number of patients and the retrospective design, further studies are needed. 相似文献7.
Hiroshi Hagino Naoto Endo Atsushi Harada Jun Iwamoto Tasuku Mashiba Satoshi Mori Seiji Ohtori Akinori Sakai Junichi Takada Tetsuji Yamamoto 《Journal of orthopaedic science》2017,22(5):909-914
Background
A nationwide survey of hip fractures by the Japanese Orthopaedic Association (JOA) from 1998 to 2008 found a drastic increase in incidence. The aims of this study were to elucidate the status of hip fractures from 2009 to 2014 and to survey the causes for delayed surgery.Methods
A tally of all hip fractures that occurred in patients from 2009 to 2014 was conducted in hospitals authorized by the JOA or in clinics with inpatient facilities of the Japanese Clinical Orthopaedic Association (JCOA). A survey of the causes for delay in surgery was conducted at 849 sites and 526 sites participated.Results
A total of 488,759 hip fractures were registered. Increases in incidence from 2009 to 2014 were prominent in the 90–94-year-old age group among women and the 85–89-year-old age group among men. More trochanteric fractures than neck fractures occurred; however, the neck/trochanter ratio increased over time. The mean duration of preoperative hospital stay was 4.8 and 4.5 days, and the mean duration of hospitalization was 40.5 and 36.8 days in 2009 and 2014, respectively. There were significant differences between patients who waited for surgery up to 3 days and those who waited longer than 3 days in date of hospitalization, fracture type, comorbidities, anticoagulant use, surgical procedure, type of physician who administered anesthesia, type of anesthesia, and operating room schedule. Physicians in charge of each patient who waited for surgery for more than 3 days most frequently cited difficulties in securing operating rooms as the cause for delayed surgery.Conclusion
A drastic increase occurred in the number of patients with hip fractures with time in Japan. One problem in the treatment of hip fractures is the long waiting time from hospitalization to surgery resulting from difficulties in securing operating rooms. 相似文献8.
Terufumi Kokabu Masahiko Takahata Nobuhisa Ishiguro Norimasa Iwasaki 《Journal of orthopaedic science》2017,22(5):822-827
Background
Hematogenous vertebral osteomyelitis (HVO) has a generally favorable prognosis if appropriate treatment is initiated in its early phase; however, some intractable cases with HVO can develop neurological impairment as well as spinal deformity during the course of treatment and these sequelae may lead to impaired quality of life (QOL). In this study, we aimed to evaluate the long-term relapse rate, mortality, and QOL of patients with HVO.Methods
In this retrospective case series study, medical records of 60 patients with HVO with a mean follow-up period of 8 years (5–23 years) were reviewed to assess demographic data, details of infection, and clinical course. Mortality rate was assessed using a Kaplan–Meier plot. QOL was measured using the EuroQol 5 Dimension (EQ-5D) questionnaire and residual pain using a numeric rating scale (NRS).Results
HVO relapsed in 4 of 60 patients (7%). Overall 5-year survival rate in 60 patients with HVO was 85%. The factors associated with increased mortality were malignant tumor, diabetes mellitus, chronic use of glucocorticoids, and drug-resistant strains of staphylococcus. Female-to-male ratio, NRS, prevalence of neurological impairment were significantly higher in patients with low EQ-5D score (poor health) compared to those with high EQ-5D score (good health).Conclusions
Patients with HVO have shorter life expectancy if they have malignancy, diabetes mellitus, chronic use of glucocorticoids, and a history of drug-resistant strains of staphylococcus infection. Female gender, residual neurological defects and persistent back pain are associated with impaired QOL in patients with HVO. 相似文献9.
Ahmed El-Bakoury Hazem Hosny Mark Williams Jonathan Keenan Rathan Yarlagadda 《The Journal of arthroplasty》2017,32(2):541-545
Background
Periprosthetic fracture following total hip arthroplasty is a significant problem faced by hip surgeons, and its management in elderly patients remains a considerable challenge.Methods
We retrospectively reviewed 28 Vancouver B2 and B3 periprosthetic femoral fractures (PFF) treated with revision of the femoral stems by distally locked, hydroxyapatite-coated uncemented stems (Cannulok). Patients were aged 75 years or older at the time of surgery.Results
The mean follow-up was 44.6 months (range, 24-102). The mean postoperative Oxford hip score was 30.1 (range, 10-46). The rate of fracture union was 95.8%, and the survivorship of the stem was 100% at the end of follow-up.Conclusion
The management of PFF in elderly is associated with increased postoperative morbidity and mortality. The use of a distally locked, hydroxyapatite-coated femoral stem is a valid option for the treatment of PFF to achieve fracture union with a low rate of revision. 相似文献10.
Background
De novo gastric cancer is a rare complication of liver transplantation.Methods
Surgical treatments of 16 cases with different outcomes were reported in the English literature.Results
De novo gastric cancer (stage II) was diagnosed as the result of epi-gastric discomfort in a recipient 10 years after liver transplantation. The patient received chemotherapy alone and remained well for 26 months.Conclusions
De novo gastric cancer of liver transplantation recipients is a severe complication; early detection and relevant intervention will benefit these recipients. 相似文献11.
Hiroki Oba Jun Takahashi Takahiro Tsutsumimoto Shota Ikegami Hiroshi Ohta Mutsuki Yui Hidemi Kosaku Takayuki Kamanaka Hiromichi Misawa Hiroyuki Kato 《Journal of orthopaedic science》2017,22(4):641-646
Background
Lumbar decompression surgery is often used to treat neurological symptoms of the lower extremity as a result of lumbar disease. However, this method also leads to the improvement of the accompanying low back pain (LBP). We studied the extent of LBP improvement after lumbar decompression surgery without fusion and the associated preoperative factors.Methods
Patients (n = 140) with lumbar spinal stenosis (n = 90) or lumbar disc herniation (n = 50) were included. To evaluate the change in LBP, VAS scores and the Oswestry disability index scores were measured before surgery and 2 weeks, 3 months, and 6 months after surgery. The predictors of residual LBP were investigated using logistic regression analyses.Results
In total, 140 patients were examined. The VAS scores for LBP before surgery and 2 weeks, 3 months, and 6 months after surgery were 4.4 ± 3.0 (mean ± standard deviation), 1.1 ± 1.5, 1.3 ± 1.8, and 1.9 ± 2.2, respectively. LBP significantly improved 2 weeks after surgery (P < 0.001), stabilized between 2 weeks and 3 months after surgery, but was significantly aggravated 3–6 months after surgery (P < 0.001). At 6 months after surgery, 67 (47.9%) patients had a VAS score of >1. The predictors of residual LBP included severe preoperative LBP, degenerative scoliosis and the size of the Cobb angle. The independent predictors, determined by multivariate analysis were degenerative scoliosis and the size of the Cobb angle.Conclusions
LBP was alleviated at 2 weeks after lumbar decompression surgery for lumbar disc herniation and lumbar spinal stenosis. The predictors of residual LBP after decompression included more severe LBP at baseline, degenerative scoliosis and the size of Cobb angle.Level of evidence
Level 3. 相似文献12.
Efthymios Iliopoulos Natasha Morrissey Seok Cho Arshad Khaleel 《Journal of orthopaedic science》2017,22(4):783-786
Aim
The use of circular frame is widely accepted. This is an outcome review on use of circular Ilizarov frame in elderly patients.Materials & methods
Data from all patients treated with an Ilizarov circular frame between January 2002 and December 2014, who were 65 years of age or over at surgery was collected. Seventy Ilizarov circular frames were applied during this period in our unit at a mean age of 71.2 years. Clinical, radiological and quality of life questionnaire (SF-12) data were gathered. Mortality, complication and revision data were also collected.Results
Indications of application of Ilizarov frame were fractures (53%), non-unions (19%), deformity correction (7%) and ankle fusions (21%). Mean period of time in the frame was 184.4 ± 84.2 days. Mortality and complication rates were low (5–7%) at a mean follow-up 4.2 years. There was no case of septic arthritis or newly induced deep infection. Physical and Mental components of SF-12 questionnaire returned to normal for that age group. There was no difference between the subgroups (tibia plateau fractures, pilon fractures, ankle fusions, non-unions, deformity correction and miscellaneous trauma) concerning the physical and mental subjective (PCS and MCS SF-12 component) outcomes (p > 0.05).Conclusions
Ilizarov circular frame as a definitive treatment of many kinds of trauma and orthopaedic conditions can be safely and reliably used in the elderly with good quality of life results. 相似文献13.
Yu Yamato Yukihiro Matsuyama Kazuhiro Hasegawa Yoichi Aota Tsutomu Akazawa Takahiro Iida Kazumasa Ueyama Koki Uno Tokumi Kanemura Noriaki Kawakami Toshiaki Kotani Masashi Takaso Jun Takahashi Masato Tanaka Hiroshi Taneichi Taichi Tsuji Hideo Hosoe Joji Mochida Morio Matsumoto 《Journal of orthopaedic science》2017,22(2):237-242
Background
Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society.Methods
This study was a review of retrospectively collected data from 18 spine scoliosis centers belonging to the Japanese Scoliosis Society. Patients who underwent corrective fusion surgery for ASD between 2011 and 2013 were included. Demographics, comorbidities, surgical data, and complications were investigated.Results
A total of 1192 patients (mean age, 57.7 years) were included in this study. Of these, 611 patients were aged less than 65 years and 581 patients were aged 65 years or greater. The age distribution had two peaks, in the third and eighth decades. Deformities caused by degeneration represented 67% of the pathology in patients aged over 65 years; however, non-degenerative disease such as adult idiopathic scoliosis and syndromic or congenital deformity represented over 60% of pathology in patients aged less than 65 years. The iatrogenic deformity and reoperation rates were both less than 3%. The mean operation time and estimated blood loss were 370 min and 1642 ml, respectively. Major perioperative complications occurred in 160 patients (14.5%). The incidence of complications was significantly higher in patients aged over 65 years, including neurological deficits, hemorrhagic shock, hematoma, heart failure, and surgical site infection (p < 0.05).Conclusions
Older (aged over 65 years) ASD patients showed greater rates of deformity due to the occurrence of degeneration and vertebral fractures, as well as a higher incidence of peri-and postoperative complications. Efforts to reduce perioperative complications are therefore imperative, especially for elderly ASD patients in our aging society. 相似文献14.
Ben J.R.F. Bolland Matthew J. Wilson Jonathan R. Howell Matthew J.W. Hubble A. John Timperley Graham A. Gie 《The Journal of arthroplasty》2017,32(4):1318-1322
Background
Between 1991 and 2008, approximately 80 cases of fracture (neck or stem) have been reported. This study aimed at determining factors predisposing to implant fracture.Methods
Clinical, surgical, radiological, and retrieval data were collated. Risk factors associated with fracture were categorized to patient related (weight and activity levels), surgical related (poor medial support, component size, and placement), and anatomic/implant related (head size/offset).Results
Data was available on 60 patients (32 stem and 28 neck fractures). Mean patient age at fracture was similar for both neck and stem fractures (69 years, 67 years, respectively). Also, 77% neck and 52% stem fractures occurred in men. Mean weight was 107 kg in neck and 96.5 kg in stem fractures with 68% neck and 38% stem fractures either obese or morbidly obese. Mean time to fracture was 78 months (range, 36-144 months) for neck and 76 months (range, 2-155 months) for stem fractures. 44#2 and 44#3 were the most common sizes associated with neck fractures. Stem fractures occurred more commonly (84%) in the smaller sizes (35.5 to 44#1). Elongated femoral heads were used in 69% neck and 14% stem fractures.Conclusion
Neck fractures were most commonly associated with patient-related (increased weight and activity) and implant-related (use of an elongated femoral head) factors. Stem fractures were most commonly associated with correctable surgical-related causes, predominantly secondary to stem undersizing or inadequate medial support (84%). 相似文献15.
Yasuaki Imajo Toshihiko Taguchi Masashi Neo Koji Otani Tadanori Ogata Hiroshi Ozawa Naohisa Miyakoshi Hideki Murakami Tetsuhiro Iguchi 《Journal of orthopaedic science》2017,22(1):10-15
Background
The Japanese Society for Spine Surgery and Related Research (JSSR) performed a third study on complications in spinal surgery in 2011. The purpose was to present information about surgery and complications in a large amount of elderly patients aged 65 years with lumbar spinal stenosis (LSS) without coexisting spondylolisthesis, spondylolysis, or scoliosis, and to compare patients aged ≥80 years to those aged 65–79 years.Methods
A recordable optical disc for data storage was sent by JSSR in January 2012 to 1105 surgeons certified by the JSSR in order to collect surgical data. Data were returned by the end of May 2012.Results
Data were accumulated for 8033 patients aged 65 years. The incidence of surgical complications was 10.8%, and did not differ significantly between age groups. The incidence of general complications was 2.7%, and differed significantly between age groups (p < 0.005). The highest incidence of surgical complications was for dural tear (DT) (3.6%), followed by deep wound infection (DWI) (1.4%), neurological complications (1.3%), and epidural hematoma (1.3%). Spinal instrumentation was applied in 30.3%. Incidences of surgical complications in instrumented and noninstrumented surgery were 17.3% and 8.8%. In instrumented surgery, incidences of surgical and general complications were higher in the ≥80 year age group than in the 65–79 year age group. Logistic regression analyses showed patients with microendoscopic surgery at increased risk of DT. Patients with diabetes mellitus and instrumented surgery showed increased risks of DWI.Conclusions
Incidences of surgical complications did not differ significantly between age groups. Attention should be paid to both surgical and general complications, particularly for postoperative mental disease in instrumented surgery for patients≥80 years old. 相似文献16.
W.M. Bennett E.L. Simonich A.M. Garre K.M. McEvoy M.A. Farinola T.D. Batiuk 《Transplantation proceedings》2017,49(8):1779-1782
Introduction
Between January 2013 and September 2015, 135 consecutive renal transplant patients were screened prospectively with ultrasound for renal cell carcinoma (RCC).Results
Eighteen ultrasound abnormalities were identified with 4 solid lesions detected. Fifty-six other patients were screened retrospectively by referring nephrology groups, with 6 additional malignancies found.Conclusion
As a result of our data, we recommend and have instituted annual ultrasound screening of native kidneys in all renal transplant patients. 相似文献17.
Shinji Takahashi Masatoshi Hoshino Tadao Tsujio Hidetomi Terai Akinobu Suzuki Takashi Namikawa Minori Kato Akira Matsumura Kazushi Takayama Hiroaki Nakamura 《Journal of orthopaedic science》2017,22(5):834-839
Background
Osteoporotic vertebral fractures (OVFs) are the most common cause of intractable back pain and reduced activities of daily living (ADL), which may affect cognitive function. However, no previous studies have reported a change in cognitive function after OVFs. The purpose was to reveal cognitive function changes after OVFs and investigate the risk factors for cognitive decline.Methods
Consecutive patients with symptomatic OVFs were enrolled in a prospective multicenter cohort study. The inclusion criteria were age >65 years, diagnosis of acute or subacute OVF, and back pain onset within 2 months prior to presentation. Cognitive function was assessed with the mini-mental state examination. Medical history, radiological findings, and ADL were investigated as risk factors for cognitive decline.Results
We recruited a sample of 339 patients (58 men and 281 women) who met the inclusion criteria. Patients underwent examinations and completed questionnaires at both the time of enrollment and at 6-month follow-up. At 6-month follow-up, cognitive decline was observed in 26 (7.7%) patients. Medical history, including comorbidities and sports activities, did not affect odds ratios (ORs). However, elevated ORs were associated with delayed union (OR: 4.67, 95% Confidence interval: 1.22–17.87). In addition, significantly increased ORs were associated with reduced ADL at 6-month follow-up.Conclusions
The current results revealed the incidence of cognitive decline after the onset of OVF. Delayed union and reduced ADL at 6-month follow-up were associated with cognitive decline. Patients with cognitive decline experienced significantly reduced quality of life. These results highlight the importance of preventing cognitive impairment in patients with symptomatic OVF. Physical treatment or early surgical treatment may provide appropriate options, particularly for patients with suspected delayed union. 相似文献18.
Ritesh R. Shah Jeffrey M. Goldstein Nancy E. Cipparrone Alexander C. Gordon Matthew L. Jimenez Wayne M. Goldstein 《The Journal of arthroplasty》2017,32(10):3157-3162
Background
Reports of implant fracture at the modular junction have been seen in modular neck designs, stem-sleeve modular femoral stems, and diaphyseal engaging bi-body modular stems. To date, however, there has never been a direct comparison between 2 different implant designs from the same modular family. The purpose of this study is to compare the rate of implant failure of 2 such stem-sleeve modular femoral stem designs, the S-ROM and Emperion, to further identify factors which increase the risk of this mode of failure.Methods
A retrospective, single surgeon, review of our institutional database was performed to compare the 2 groups of patients.Results
A total of 1168 total hip arthroplasty procedures were included in our analysis, 547 (47%) with Emperion and 621 (53%) with S-ROM. Eight (1.5%) fractures in 7 patients occurred in the Emperion group compared to 1 (0.2%) fracture in the S-ROM group (P = .015).Conclusion
The precise cause of the stem fractures in our study remains unknown and is likely multifactorial. Given the unexpectedly high rate of catastrophic implant failures in the form of stem fracture at the stem-sleeve junction, we recommend more judicious use of modularity in primary total hip arthroplasty. 相似文献19.
Kenji Takagishi Tetsuya Matsuura Takashi Masatomi Etsuo Chosa Tsuyoshi Tajika Mikihiko Watanabe Tetsu Iwama Toshiro Otani Katsunori Inagaki Hiroyasu Ikegami Mitsuhiro Aoki Ko Kato Toru Okuwaki Koichi Sairyo Yasushi Kameyama Akira Maeda Moroe Beppu 《Journal of orthopaedic science》2017,22(4):682-686
Background
Despite recommendations on how to prevent baseball injuries in youths by the Japanese Society of Clinical Sports Medicine, shoulder and elbow pain still frequently occurs in young baseball players. We conducted a questionnaire survey among baseball players at elementary schools across the country to understand the practice conditions of players, examining the risk factors of shoulder and elbow pain in baseball players.Methods
The questionnaire survey was conducted among elementary school baseball players as members of the Baseball Federation of Japan in September 2015.Results
A total of 8354 players belonging to 412 teams (average age: 8.9) responded to the survey. Among 7894 players who did not have any shoulder and/or elbow pain in September 2014, elbow pain was experienced in 12.3% of them, shoulder pain in 8.0% and shoulder and/or elbow pain in 17.4% during the previous one year. A total of 2835 (39.9% of the total) practiced four days or more per week and 97.6% practiced 3 h or more per day on Saturdays and Sundays. The risk factors associated shoulder and elbow pain included a male sex, older age, pitchers and catchers, and players throwing more than 50 balls per day.Conclusions
It has been revealed that Japanese elementary school baseball players train too much. Coaches should pay attention to older players, male players, pitchers and catchers in order to prevent shoulder and elbow pain. Furthermore, elementary school baseball players should not be allowed to throw more than 50 balls per day.Study design
Retrospective cohort study. 相似文献20.
Shigeo Fukunishi Shoji Nishio Yu Takeda Tomokazu Fukui Yuki Fujihara Shohei Okahisa Shinichi Yoshiya 《Journal of orthopaedic science》2017,22(5):898-904