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Endoscopic anterior cruciate ligament reconstruction using a computer-assisted fluoroscopic navigation system 总被引:3,自引:0,他引:3
Hisatada Hiraoka Sou Kuribayashi Akira Fukuda Naoshi Fukui Kozo Nakamura 《Journal of orthopaedic science》2006,11(2):159-166
Background During anterior cruciate ligament (ACL) reconstruction, placement of the reconstructed ligament affects the clinical results.
To accomplish accurate and reproducible placement of the tibial bone tunnel, we employed a fluoroscopic navigation system
for endoscopic ACL reconstruction. In this study, preciseness of the tibial tunnel placement was evaluated, and the advantages
and disadvantages of this navigation system for endoscopic ACL reconstruction are discussed.
Methods Altogether, 16 knees of 16 patients who had undergone ACL reconstruction using this system (navi group) were evaluated regarding
the positioning of the tibial tunnel against Blumensaat's line using X-p and the route of the graft by magnetic resonance
imaging (MRI). Another 16 knees of 16 patients who underwent endoscopic ACL reconstruction without the navigation system were
the controls (control group).
Results At the 1-year follow-up, maximally extended lateral knee X-p revealed that the anterior edge of the tibial tunnel and Blumensaat's
line were almost aligned and that roof impingement was avoided; the T2-weighted MR images showed that the graft was placed
close to and parallel to the intercondylar roof in all the knees of the navi group. The ratio of the distance between Blumensaat's
line and the anterior edge of the tibial tunnel at the level of the tibial plateau to the anteroposterior width in fully extended
true lateral radiographs was 2.7% ± 3.4% in the navi group and 8.4% ± 7.4% in the control group.
Conclusions The computer-assisted fluoroscopic navigation system improves accuracy and decreases dispersion of the tibial tunnel placement
against Blumensaat's line in single-bundle ACL reconstruction. This innovative device renders the reconstruction procedure
more reliable, eliminating the problem of skeletal variation among patients. However, the function of this navigation system
for femoral tunnel placement is insufficient at present. Further refinement of the system is necessary, and the method of
application requires improvement. 相似文献
4.
Yasuyuki Suzuki Kazuyuki Daitoku Masahito Minakawa Kozo Fukui Ikuo Fukuda 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(1):44-46
We report the case of a 4-year-old girl who had quadricuspid aortic valve regurgitation with tetralogy of Fallot and pulmonary
atresia. This combination is very uncommon. Aortic valve replacement was performed successfully due to aortic regurgitation
which had progressed one year after the total repair. The dilated aortic annulus plus quadricuspid aortic valve may result
in progressive aortic regurgitation for a short period. 相似文献
5.
H S Ozaki K Iwahashi M Tsubaki Y Fukui Y Ichikawa Y Takeuchi 《Journal of neuroscience research》1991,28(4):518-524
The presence of cytochrome P-45011 beta in rat brain was studied by immunohistochemistry using polyclonal rabbit antibodies raised against purified bovine adrenocortical P-45011 beta, which is involved in the steroid 11 beta-hydroxylation and glucocorticoid formation. The results showed that cytochrome P-45011 beta immunoreactivity is selectively localized to the tracts of myelinated fibers throughout the brain. The specificity of immunohistochemical stainings with P-45011 beta antibodies was established by control tests including nonimmune rabbit immunoglobulin Gs and P-45011 beta antibodies absorbed with purified antigen. Western immunoblots of homogenates from different brain areas with P-45011 beta antibodies, together with biochemical enzymatic assays for cytochrome P-45011 beta monooxygenase activity in these homogenates, confirmed the selective localization of this enzyme observed with immunohistochemistry. Cytochrome P-45011 beta and 11 beta-hydroxylase activity were detected in a homogenate from the cortical white matter (brain area rich in myelinated fibers) as in that from the rat adrenal, but were not detectable in a homogenate from the cerebral cortex (brain area poor in myelinated fibers). Furthermore, quantitation of the P-45011 beta bands on the immunoblots by the areal density revealed that the cortical white matter contains approximately 1.4 pmol of cytochrome P-45011 beta/mg of tissue protein, the value of which was about one sixth of the corresponding value estimated in the rat adrenal. This relatively high content of cytochrome P-45011 beta was also reflected in a relatively high level of 11 beta-hydroxylase activity measured in a homogenate of this brain area by biochemical enzymatic assays using [4-14C]-11-deoxycorticosterone.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
6.
Keijiro Sunada Hironori Yamamoto Hiroto Kita Tomonori Yano Tomohiko Miyata Yutaka Sekine Akiko Kuno Nobuki Onishi Michiko Iwamoto Atsuhiro Sasaki Kenichi Ido Kentaro Sugano 《Digestive endoscopy》2004,16(3):237-240
The requirement for endoscopic access to a stricture is a major limitation of the endoscopic dilatation for the treatment of strictures in the gastrointestinal tract. We have developed the double‐balloon enteroscopy method that enables visualization of the entire small bowel. In addition, double‐balloon enteroscopy has a potential for the interventional therapy including dilatation of strictures. We present here a case of jejunal strictures in a 47‐year‐old woman with Crohn's disease successfully treated with a balloon catheter in combination with double‐balloon enteroscopy. Balloon dilation with double‐balloon enteroscopy is a promising method for the treatment of small bowel strictures in Crohn's disease. 相似文献
7.
Yuhei Okubo Junji Yonese Satoru Kawakami Sinya Yamamoto Yoshinobu Komai Hideki Takeshita Yuichi Ishikawa Iwao Fukui 《International journal of urology》2007,14(9):854-855
Renal cell carcinoma (RCC) causes many kinds of symptoms such as hypercalcemia, hypertension, polycythemia and fever. Here we describe a rare case of RCC presenting with a persistent cough. After radical nephrectomy, the obstinate cough disappeared. When the tumor recurred locally, the cough also recurred. Furthermore, the cough disappeared completely again after the removal of the recurrent tumor. Although all the clinical findings suggested that the RCC caused the cough, we could not identify a specific humoral substance responsible for the cough. 相似文献
8.
Takanori Kikuchi Naoshi Fukui Tomohiro Sakuta Toshijiro Yamaguchi Hiroya Sakai Hiromi Oda 《Journal of orthopaedic science》1997,2(1):31-39
The midportion of the anterior cruciate ligament (ACL) of rabbits was partially transected, and the effect of hyaluronan (HA) on its healing was determined. A 1% solution of HA (HA group) or physiological phosphate-buffered saline (control group) was administered intraarticularly, at 0.1 ml/kg body weight, once a week from 1 week after the operation. Two, 4, and 6 weeks after the initiation of HA administration, the ACLs were examined grossly, histologically and immunohistochemically. At 2 weeks, the lacerated portions were completely covered with scar-like tissue in both groups. These tissue areas were smaller in the HA group than in the control group. Histologically in the HA group, the regularity of collagen fibers (indicating the maturity of regenerated collagen fibers) had increased compared to findings in the control group, and the number of fibroblastic cells decreased gradually at a significantly faster rate. The number of inflammatory cells and blood vessels decreased gradually in both groups, with these values being lower in the HA group at each time point but not significantly so. Immunohistochemical examination of the repaired tissue revealed strong staining with anti-chondroitin sulfate proteoglycan antibody in the HA group 2 weeks after the first HA administration. The staining gradually became reduced, with the rate of reduction being faster in the HA group than in the control group. The stimulation of chondroitin sulfate proteoglycan production and the faster reduction of it in the HA group suggests that HA facilitated tissue repair and inhibited the formation of scar tissue. 相似文献
9.
Motohiko Kimura Toshifumi Sugiura Yoshihito Fukui Morio Togawa Yukio Harada† 《Artificial organs》1990,14(5):390-391
Carbon fibers with fibrin glue were used as electrodes for diaphragm pacing. The electrodes were applied to three mongrel dogs and the effectiveness was tested. The carbon leads were glued to phrenic nerves by means of the fibrinogen and thrombin bilaterally. The tidal volumes and threshold current level for stimulation were measured at various time up to 9 weeks after implantation. Effective contraction of diaphragm were observed for 9 weeks. By using this electrode, the exfoliation of the nerve is not necessary, the nerve can be maintained in an intact state, and the risk of the implanting operation can be minimized. 相似文献
10.