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Nakamura J, Fukushima W, Ando W, Hagiwara S, Kawarai Y, Shiko Y, Kawasaki Y, Sakai T, Ito K, Arishima Y, Chosa E, Fujimoto Y, Fujiwara K, Hasegawa Y, Hayashi S, Imagama T, Inaba Y, Ishibashi Y, Ishidou Y, Ito H, Ito H, Ito J, Jinno T, Kabata T, Kaku N, Kaneuji A, Kishida S, Kobayashi S, Komiya S, Kubo T, Majima T, Mashima N, Mawatari M, Miki H, Miyatake K, Motomura G, Nagoya S, Nakamura H, Nakamura Y, Nakanishi R, Nakashima Y, Nakasone S, Nishii T, Nishiyama T, Ohta Y, Ohzono K, Osaki M, Sasaki K, Seki T, Shishido T, Shoji T, Sudo A, Takagi M, Takahashi D, Takao M, Tanaka S, Tanaka T, Tetsunaga T, Ueshima K, Yamamoto K, Yamamoto T, Yamamoto Y, Yamasaki T, Yasunaga Y, Sugano N. Time elapsed from definitive diagnosis to surgery for osteonecrosis of the femoral head: a nationwide observational study in Japan. BMJ Open 2024; 14:e082342. [PMID: 38553078 PMCID: PMC10982743 DOI: 10.1136/bmjopen-2023-082342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES This study documents the time elapsed from the diagnosis of osteonecrosis of the femoral head (ONFH) to surgery, exploring the factors that influence ONFH severity. DESIGN Retrospective observational study of a nationwide database. SETTING The Kaplan-Meier method with log-rank tests was applied to examine the period from definitive diagnosis of ONFH to surgery using any surgery as the end point. For bilateral cases, the date of the first surgery was the endpoint. PARTICIPANTS This study included 2074 ONFH cases registered in 34 university hospitals and highly specialised hospitals of the multicentre sentinel monitoring system of the Japanese Investigation Committee between 1997 and 2018. MAIN OUTCOME MEASURE The primary outcome was the time from diagnosis to surgery. The secondary outcome was the proportion of subjects remaining without surgery at 3, 6 and 9 months, and at 1, 2 and 5 years after diagnosis. RESULTS The median time to surgery was 9 months (IQR 4-22 months) after diagnosis of ONFH. The time to surgery was significantly shorter in the alcohol alone group and the combined corticosteroid and alcohol group than in the corticosteroid alone group (p=0.018 and p<0.001, respectively), in early stage ONFH with no or mild joint destruction (stages II and III, p<0.001), and with joint preserving surgery (p<0.001). The proportion without surgery was 75.8% at 3 months, 59.6% at 6 months, 48.2% at 9 months, 40.5% at 1 year, 22.2% at 2 years and 8.3% at 5 years. CONCLUSION ONFH has been considered to be an intractable disease that often requires surgical treatment, but the fact that surgery was performed in more than half of the patients within 9 months from diagnosis suggests severe disease with a significant clinical impact. TRIAL REGISTRATION NUMBER Chiba University ID1049.
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Affiliation(s)
- Junichi Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Wakaba Fukushima
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Shigeo Hagiwara
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuya Kawarai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Centre, Chiba University Hospital, Chiba, Japan
- Faculty of Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan
| | - Takashi Sakai
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Kazuya Ito
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Yoshiya Arishima
- Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan
| | - Etsuo Chosa
- Department of Orthopaedic Surgery, Miyazaki University, Miyazaki, Japan
| | - Yusuke Fujimoto
- Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan
| | - Kazuo Fujiwara
- Department of Orthopaedic Surgery, Okayama University, Okayama, Japan
| | | | - Shinya Hayashi
- Department of Orthopaedic Surgery, Kobe University, Kobe, Japan
| | - Takashi Imagama
- Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Yutaka Inaba
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | | | - Yasuhiro Ishidou
- Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan
| | - Hideya Ito
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Ito
- Department of Orthopaedic Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Juji Ito
- Department of Orthopaedic Surgery, Yamagata University, Yamagata, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tamon Kabata
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Nobuhiro Kaku
- Department of Orthopaedic Surgery, Oita University, Yufu, Japan
| | - Ayumi Kaneuji
- Department of Orthopaedic Surgery, Kanazawa Medical University, Kahoku-gun, Japan
| | - Shunji Kishida
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Seneki Kobayashi
- Department of Orthopaedic Surgery, Suwa Red Cross Hospital, Suwa, Japan
| | - Setsuro Komiya
- Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan
| | - Toshikazu Kubo
- Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tokifumi Majima
- Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan
| | - Naohiko Mashima
- Department of Orthopaedic Surgery, Ehime University, Toon, Japan
| | | | - Hidenobu Miki
- Department of Orthopaedic Surgery, Osaka National Hospital, Osaka, Japan
| | - Kazumasa Miyatake
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Goro Motomura
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - Satoshi Nagoya
- Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka Metropolitan University, Osaka, Japan
| | | | - Ryosuke Nakanishi
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
| | | | - Satoshi Nakasone
- Department of Orthopaedic Surgery, Ryukyu University, Nakagami-gun, Japan
| | - Takashi Nishii
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Yoichi Ohta
- Department of Orthopaedic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Kenji Ohzono
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Makoto Osaki
- Department of Orthopaedic Surgery, Nagasaki University, Nagasaki, Japan
| | - Kan Sasaki
- Department of Orthopaedic Surgery, Yamagata University, Yamagata, Japan
| | - Taisuke Seki
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan
- Depatrment of Orthopedic Surgery, Aichi Medical University Medical Centre, Okazaki, Japan
| | - Takaaki Shishido
- Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Shoji
- Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University, Tsu, Japan
| | - Michiaki Takagi
- Department of Orthopaedic Surgery, Yamagata University, Yamagata, Japan
| | - Daisuke Takahashi
- Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan
| | - Masaki Takao
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Orthopaedic Surgery, Ehime University, Toon, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Takeyuki Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | | | - Keiichiro Ueshima
- Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kengo Yamamoto
- Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
- Department of Orthopaedic Surgery, Fukuoka University, Fukuoka, Japan
| | - Yuji Yamamoto
- Department of Orthopaedic Surgery, Hirosaki University, Hirosaki, Japan
| | - Takuma Yamasaki
- Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan
| | - Yuji Yasunaga
- Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
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Sakai S, Kutsuna T, Kono K, Kinoshita T, Mashima N, Takao M. Femoral head translation in borderline and definite dysplastic hips during weight-bearing: 2D/3D image registration analysis. J Exp Orthop 2023; 10:126. [PMID: 38019419 PMCID: PMC10686934 DOI: 10.1186/s40634-023-00707-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/18/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE The aims of this study were to 1) assess femoral head translation during weight-bearing in symptomatic developmental dysplasia of the hip (DDH) and 2) compare it between borderline DDH and definite DDH. METHODS The study included four individuals with borderline DDH and nine with definite DDH, scheduled for periacetabular osteotomy. Anteroposterior X-ray images of the hip joint were obtained in the standing position, and computed tomography images of the pelvis were obtained in the supine position. Femoral head translation from the supine to a standing position was measured using 2D/3D X-ray image registration. RESULTS From a supine to a standing position, the femoral head translated 0.3 mm laterally, 0.5 mm anteriorly, and 0.5 mm superiorly on average. The mean femoral head translation in 3D between the supine and standing positions was 1.5 mm. The 3D femoral head translation in the borderline DDH group was significantly greater than that in the definite DDH group. In the definite DDH group, there was a significant correlation between the center edge (CE) angle and 3D femoral head translation (ρ = -0.78, P = 0.012). CONCLUSIONS Symptomatic DDH showed femoral head translation in the anterior, lateral, and superior directions during weight-bearing. In definite DDH, the amount of femoral head translation was negatively correlated with the CE angle. The amount of 3D translation in patients with borderline DDH was larger than that in definite DDH. Dynamic joint instability during weight-bearing was observed in borderline DDH as well as definite DDH. Treatment to enhance joint stability during weight-bearing is important in both cases.
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Affiliation(s)
- Shinichiro Sakai
- Department of Bone and Joint Surgery, Graduate School of Medicine, Shitsukawa, Ehime University, Toon City, Ehime 791-0295, Japan
| | - Tatsuhiko Kutsuna
- Department of Bone and Joint Surgery, Graduate School of Medicine, Shitsukawa, Ehime University, Toon City, Ehime 791-0295, Japan
| | - Kohei Kono
- Department of Bone and Joint Surgery, Graduate School of Medicine, Shitsukawa, Ehime University, Toon City, Ehime 791-0295, Japan
| | - Tomofumi Kinoshita
- Department of Bone and Joint Surgery, Graduate School of Medicine, Shitsukawa, Ehime University, Toon City, Ehime 791-0295, Japan
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Graduate School of Medicine, Shitsukawa, Ehime University, Toon City, Ehime 791-0295, Japan
| | - Masaki Takao
- Department of Bone and Joint Surgery, Graduate School of Medicine, Shitsukawa, Ehime University, Toon City, Ehime 791-0295, Japan.
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Fujikawa T, Takahashi S, Shinohara N, Mashima N, Koda M, Takahashi H, Yasunaga Y, Sankai Y, Yamazaki M, Miura K. Early Postoperative Rehabilitation Using the Hybrid Assistive Limb (HAL) Lumbar Type in Patients With Hip Fracture: A Pilot Study. Cureus 2022; 14:e22484. [PMID: 35371681 PMCID: PMC8943782 DOI: 10.7759/cureus.22484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: To extend life expectancy after surgery, patients with hip fractures need to improve their mobility quickly through postoperative rehabilitation. Voluntary hip joint motion supported by the hybrid assistive limb (HAL) lumbar type, an exoskeleton robot suit characterized by its ability to detect the wearer’s intentions through the bioelectrical signals and assist hip extension motions at an optimal timing, may be effective to improve mobility in patients with hip joint dysfunction after surgery. We aimed to introduce rehabilitation using the HAL lumbar type in the early period after hip fracture surgery. Methods: Patients who underwent internal fixation for hip fracture at a single institution were prospectively enrolled. They received early postoperative rehabilitation (forward and backward bending of the lumbar spine, pelvic tilt forward and backward, standing up, and squatting) using the HAL lumbar type (six times a week for 15 min per session). Five-times-sit-to-stand (FTSS) and timed-up-and-go (TUG) tests were conducted at baseline before HAL rehabilitation (pre-HAL) and after the HAL rehabilitation (post-HAL) intervention. Results: We enrolled 14 patients (one man, 13 women) in this study. There were no adverse events, and all patients were able to complete the entire rehabilitation program. Post-HAL FTSS showed significant improvement compared with pre-HAL and had a large effect size of 1.81 (95% CI = 0.93 to 2.66) and sufficient power. Conclusions: Robotic rehabilitation with HAL lumbar type could be introduced without adverse events, even in the early postoperative period following surgery for hip fracture. Further study is needed to develop an appropriate rehabilitation protocol using the HAL lumbar type.
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Motomura G, Mashima N, Imai H, Sudo A, Hasegawa M, Yamada H, Morita M, Mitsugi N, Nakanishi R, Nakashima Y. Effects of porous tantalum on periprosthetic bone remodeling around metaphyseal filling femoral stem: a multicenter, prospective, randomized controlled study. Sci Rep 2022; 12:914. [PMID: 35042918 PMCID: PMC8766592 DOI: 10.1038/s41598-022-04936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/23/2021] [Indexed: 11/09/2022] Open
Abstract
Periprosthetic bone loss due to adaptive bone remodeling is an important unresolved issue in cementless total hip arthroplasty (THA). The use of porous tantalum on the proximal surface of the femoral stem is expected to decrease postoperative bone loss around the prosthesis through early fixation. We conducted a multicenter randomized controlled study to determine if porous tantalum could reduce periprosthetic bone loss after THA. From October 2012 to September 2014, 118 patients (mean age, 61.5 years; 107 females and 11 males) were prospectively enrolled and were randomly allocated at a ratio of 1:1 to either a metaphyseal filling stem with a proximal porous tantalum coating (Trabecular Metal) or a conventional metaphyseal filling stem with fiber mesh coating (VerSys). Patients underwent dual-energy x-ray absorptiometry scans within 1 week after surgery (baseline) and at 6, 12, and 24 months after surgery to assess periprosthetic bone mineral density (BMD) in the 7 Gruen zones. In addition, the Japanese Orthopaedic Association hip score was assessed before surgery and at 6, 12, and 24 months after surgery. In the proximal periprosthetic region (zones 1 and 7), the Trabecular Metal group had significantly smaller reductions in BMD than the VerSys group throughout the study period. In the VerSys group, significant reductions in BMD compared to baseline were seen at each measurement point in all regions, except in zone 6 at 24 months. In the Trabecular Metal group, no significant reductions in BMD relative to baseline were seen in zones 1, 5, or 6 throughout the study period. Both groups demonstrated similar improvement in Japanese Orthopaedic Association hip scores over the study period. This study demonstrated that a proximally coated stem with porous tantalum has superior results over a conventional stem with titanium fiber mesh in terms of periprosthetic bone remodeling.
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Affiliation(s)
- Goro Motomura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Naohiko Mashima
- Department of Regeneration of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Hiroshi Imai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, 791-0295, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Masahiro Hasegawa
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Harumoto Yamada
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Aichi, 470-1192, Japan.,Department of Orthopedic Surgery, Nisshin Orido Hospital, 110, Nishidamen, Orido-cho, Nisshin, Aichi, 470-0115, Japan
| | - Mitsuhiro Morita
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Aichi, 470-1192, Japan
| | - Naoto Mitsugi
- Department of Orthopedic Surgery, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami, Yokohama, Kanagawa, 232-0024, Japan.,Department of Orthopedic Surgery, Osada Hospital, 2-10, Maruyamadai, Minatominami-ku, Yokohama, Kanagawa, 233-0013, Japan
| | - Ryosuke Nakanishi
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, Showa University School of Medicine, 1-30 Fujigaoka Aobaku, Yokohama, 227-8501, Japan.,Department of Orthopedic Surgery, Shizuoka Medical Center, 762-1, Nagasawa, Shimizu-cho, Sunto District, Shizuoka, 411-8611, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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Yamada K, Ito YM, Akagi M, Chosa E, Fuji T, Hirano K, Ikeda S, Ishibashi H, Ishibashi Y, Ishijima M, Itoi E, Iwasaki N, Izumida R, Kadoya K, Kamimura M, Kanaji A, Kato H, Kishida S, Mashima N, Matsuda S, Matsui Y, Matsunaga T, Miyakoshi N, Mizuta H, Nakamura Y, Nakata K, Omori G, Osuka K, Uchio Y, Ryu K, Sasaki N, Sato K, Senda M, Sudo A, Takahira N, Tsumura H, Yamaguchi S, Yamamoto N, Nakamura K, Takashi Ohe. Reference values for the locomotive syndrome risk test quantifying mobility of 8681 adults aged 20-89 years: A cross-sectional nationwide study in Japan. J Orthop Sci 2020; 25:1084-1092. [PMID: 32173180 DOI: 10.1016/j.jos.2020.01.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/28/2019] [Accepted: 01/06/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND The locomotive syndrome risk test was developed to quantify the decrease in mobility among adults, which could eventually lead to disability. The purpose of this study was to establish reference values for the locomotive syndrome risk test for adults and investigate the influence of age and sex. METHODS We analyzed 8681 independent community dwellers (3607 men, 5074 women). Data pertaining to locomotive syndrome risk test (the two-step test, the stand-up test, and the 25-question geriatric locomotive function scale [GLFS-25]) scores were collected from seven administrative areas of Japan. RESULTS The reference values of the three test scores were generated and all three test scores gradually decreased among young-to-middle-aged individuals and rapidly decreased in individuals aged over 60 years. The stand-up test score began decreasing significantly from the age of 30 years. The trajectories of decrease in the two-step test score with age was slightly different between men and women especially among the middle-aged individuals. The two physical test scores were more sensitive to aging than the self-reported test score. CONCLUSION The reference values generated in this study could be employed to determine whether an individual has mobility comparable to independent community dwellers of the same age and sex.
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Affiliation(s)
- Keiko Yamada
- Departments of Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Department of Planning, Information and Management, University of Tokyo Hospital, Tokyo, Japan; "Locomo Challenge!" Promotion Council, Tokyo, Japan.
| | - Yoichi M Ito
- Department of Statistical Data Science, The Institute of Statistical Mathematics, Tokyo, Japan.
| | - Masao Akagi
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka, Japan.
| | - Etsuo Chosa
- Department of Orthopaedic Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, Japan.
| | - Takeshi Fuji
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Department of Orthopaedic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan.
| | | | - Shinichi Ikeda
- Department of Orthopaedic Surgery, Oita University, Oita, Japan.
| | - Hideaki Ishibashi
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Department of Orthopedic Surgery, Ina Hospital, Saitama, Japan.
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
| | - Muneaki Ishijima
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Norimasa Iwasaki
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
| | - Ryoichi Izumida
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Keiyu Joint Reconstruction Center, Edogawa Hospital, Tokyo, Japan.
| | - Ken Kadoya
- Department of Advanced Medicine for Locomotor System, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
| | - Masayuki Kamimura
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Arihiko Kanaji
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Hiroyuki Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Nagano, Japan.
| | - Shunji Kishida
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan.
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Ehime, Japan.
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Aichi, Japan.
| | - Toshiki Matsunaga
- Department of Rehabilitation Medicine, Akita University Hospital, Akita, Japan.
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
| | - Hiroshi Mizuta
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | | | - Ken Nakata
- Medicine for Sports and Performing Arts, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Go Omori
- Department of Sports and Health, Faculty of Health and Science, Niigata University of Health and Welfare, Nigata, Japan.
| | | | - Yuji Uchio
- Department of Orthopaedic Surgery, Shimane University, Shimane, Japan.
| | | | | | - Kimihito Sato
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Sato Orthopaedic Clinic, Tokyo, Japan.
| | - Masuo Senda
- Okayama University Hospital, Division of Physical Medicine and Rehabilitation, Okayama, Japan.
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan.
| | - Naonobu Takahira
- Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Kanagawa, Japan.
| | - Hiroshi Tsumura
- Department of Orthopaedic Surgery, Oita University, Oita, Japan.
| | - Satoshi Yamaguchi
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Collage of Liberal Arts and Sciences, Chiba University, Chiba, Japan.
| | | | - Kozo Nakamura
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Towa Hospital, Tokyo, Japan.
| | - Takashi Ohe
- "Locomo Challenge!" Promotion Council, Tokyo, Japan; Department of Orhtopaedic Surgery, NTT Medical Center, Tokyo, Japan.
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Imai H, Kamada T, Miyawaki J, Maruishi A, Mashima N, Miura H. Outcomes of computer-assisted peri-acetabular osteotomy compared with conventional osteotomy in hip dysplasia. Int Orthop 2020; 44:1055-1061. [PMID: 32342143 PMCID: PMC7260271 DOI: 10.1007/s00264-020-04578-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/17/2020] [Indexed: 11/28/2022]
Abstract
Aim of the study To compare the outcomes after computer-assisted peri-acetabular osteotomy (PAO) and conventional PAO performed for hip dysplasia (DDH). Methods Ninety-one patients (98 hips) were enrolled in this study. In each case, DDH was treated with either conventional PAO, in which the angle and direction of the osteotomy was determined by intra-operative X-ray examination, or with computer-assisted PAO, which used the 3D navigation system. Forty hips underwent conventional PAO and 58 hips underwent computer-assisted PAO. Results Japanese Orthopaedic Association hip scores improved significantly from 70.0 points pre-operatively to 90.7 points post-operatively in patients with conventional PAO, and from 74.5 points pre-operatively to 94.2 points post-operatively in patients with computer-assisted PAO. In all patients with computer-assisted PAO, the post-operative AHI and VCA angle were within the radiographic target zone. Some patients with conventional PAO had post-operative AHI and VCA angle outside of the target zone. We performed total hip arthroplasty (THA) on five of the 98 PAO hips (5.1%) after an average follow-up period of 5.4 years. None of 58 hips (0%) with computer-assisted PAO was revised. Discussion Computer-assisted PAO enabled intra-operative confirmation of osteotomy sites, and the position of the osteotomized bone fragment could be confirmed in real time. Adequate anterior and lateral coverage of the femoral head in patients with computer-assisted PAO resulted in no need for early conversion to THA, in contrast to conventional PAO. Conclusion Computer-assisted PAO not only improved accuracy and safety but also achieved sufficient anterior and lateral displacement to prevent the progression of DDH.
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Affiliation(s)
- Hiroshi Imai
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
| | - Tomomi Kamada
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Joji Miyawaki
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Akira Maruishi
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Hiromasa Miura
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
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7
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Uesugi Y, Sakai T, Seki T, Hayashi S, Nakamura J, Inaba Y, Takahashi D, Sasaki K, Motomura G, Mashima N, Kabata T, Sudo A, Jinno T, Ando W, Nagoya S, Yamamoto K, Nakasone S, Ito H, Yamamoto T, Sugano N. Quality of life of patients with osteonecrosis of the femoral head: a multicentre study. Int Orthop 2018; 42:1517-1525. [PMID: 29572640 DOI: 10.1007/s00264-018-3897-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/13/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Quality-of-life (QOL) assessments in patients with osteonecrosis of the femoral head (ONFH) have rarely been reported. This multicentre study aimed to elucidate the relationship between disease severity, including necrotic lesion type and radiological staging, and QOL, as well as between patients' characteristics and QOL. METHODS Two hundred seventy-four patients with ONFH (108 females, 166 males; median age, 46 years) were asked to complete self-assessment QOL questionnaires including the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire, Oxford Hip Score, and SF-12v2. RESULTS Patients with large necrotic lesion type or collapsed ONFH had low QOL scores. Among patients with non-collapsed lesions, patients with alcohol-associated ONFH had lower QOL scores than those with steroid-associated ONFH, those with bilateral ONFH had lower mental scores, and male patients had worse social condition scores. Among patients with collapsed lesions, middle-aged patients exhibited lower mental QOL, and a strong correlation was observed between social activity and mental health. CONCLUSION Collapsed ONFH was associated with low QOL scores. Among patients with non-collapsed lesions, alcohol-associated ONFH, bilateral disease, and male sex were linked to low QOL scores.
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Affiliation(s)
- Yuko Uesugi
- Department of International Health, Graduate School of Health Science, Kobe University, 7-10-2, Tomogaoka, Suma-Ku, Kobe, 654-0142, Japan
| | - Takashi Sakai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, 565-0871, Japan.
| | - Taisuke Seki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Nagoya University, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Shinya Hayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Junichi Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba, 260-8670, Japan
| | - Yutaka Inaba
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Daisuke Takahashi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-Ku, Sapporo, 060-8638, Japan
| | - Kan Sasaki
- Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, 2-2-2, Iida-Nishi, Yamagata, 990-9585, Japan
| | - Goro Motomura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Naohiko Mashima
- Department of Orthopaedic Surgery, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, 791-0295, Japan
| | - Tamon Kabata
- Department of Orthopaedic Surgery, Graduate School of Medical science, Kanazawa University, 13-1, Takaramachi, Kanazawa, 920-8641, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Mie University, 2-174, Edobashi, Tsu, 514-8507, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, 113-8510, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Kansai-Rosai Hospital, 3-1-69, Inabaso, Amagasaki, 660-8511, Japan
| | - Satoshi Nagoya
- Department of Orthopaedic Surgery, Sapporo Medical University, Minami-1, Nishi-17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Kengo Yamamoto
- Department of Orthopaedic Surgery, School of Medicine, Tokyo Medical University, 6-7-1, Nishishinjyuku, Shinjyuku-Ku, Tokyo, 160-0023, Japan
| | - Satoshi Nakasone
- Department of Orthopaedic Surgery, Graduate School of Medicine, University of the Ryukus, 207 Uehara, Nishihara, Nakagami-Gun, 903-0215, Japan
| | - Hiroshi Ito
- Department of Orthopaedic Surgery, School of Medicine, Asahikawa Medical University, 1-1-1, Midorigaoka-Higahi 2jou, Asahikawa, 078-8510, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jounan-Ku, Fukuoka, 814-0180, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, 565-0870, Japan
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Hamai S, Nakashima Y, Mashima N, Yamamoto T, Kamada T, Motomura G, Imai H, Fukushi JI, Miura H, Iwamoto Y. Comparison of 10-year clinical wear of annealed and remelted highly cross-linked polyethylene: A propensity-matched cohort study. J Mech Behav Biomed Mater 2015; 59:99-107. [PMID: 26751705 DOI: 10.1016/j.jmbbm.2015.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/15/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
Abstract
No previous studies comparing the clinical wear rates of the two different kinds of cross-linked ultra-high-molecular-weight polyethylene (XLPE), annealed and remelted, are available. We compared the creep and steady wear rates of 36 matched pairs (72 hips in total) adjusting for baseline characteristics with propensity score matching techniques. Zirconia femoral heads with 26-mm diameter were used in all cases. The femoral-head cup penetration was measured digitally on radiographs. Significantly greater creep (p=0.006) was detected in the remelted (0.234mm) than annealed (0.159mm) XLPE. However, no significant difference (p=0.19) was found between the steady wear rates (0.003 and 0.008mm/year, respectively) of the annealed and remelted XLPE. Multiple regression analyses showed that remelted XLPE is significant independent variable (p<0.001) that is positively associated with creep. However, the patient age and body weight, cup size, the liner thickness, cup inclination, follow-up periods, and postoperative Merle d'Aubigné hip score had no significant effects (p>0.05) on the steady wear rates. No patients exhibited above the osteolysis threshold of 0.1mm/year, progressive radiolucencies, osteolysis, or polyethylene fracture. This propensity-matched cohort study document no significant difference in wear resistant performances of annealed and remelted XLPE over an average period of 10 years.
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Affiliation(s)
- Satoshi Hamai
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Artificial Joints and Biomaterials, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tomomi Kamada
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Goro Motomura
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hiroshi Imai
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Jun-Ichi Fukushi
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hiromasa Miura
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Kamada T, Imai H, Mashima N, Takeba J, Okumura H, Miura H. Long term results with the interlocking uncemented long stem in revision hip arthroplasty: a mean 15-year follow-up. J Arthroplasty 2015; 30:835-9. [PMID: 25637474 DOI: 10.1016/j.arth.2014.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/02/2014] [Accepted: 12/28/2014] [Indexed: 02/01/2023] Open
Abstract
Stem fixation is difficult to achieve in severe proximal bone loss in revision hip surgery. In this study, we sought to present the results of distally-locked stem with screws (HUCKESTEP HIP stem) in 21 revision hips with mean follow-up period of 15 years. The preoperative mean Japanese Orthopaedic Association hip score had improved from 54 to 75 points. Further revisions were required for 2 stems, in one because of infection and the other because of screws fracture and subsidence. With removal of the stem for any reason as an end-point, the cumulative survival at 15 years was 90.4%. While this study had small number, the use of this interlocking stem for revision hips with extensive proximal bone defects provided satisfactory 15-year clinical and radiographic results.
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Affiliation(s)
- Tomomi Kamada
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Hiroshi Imai
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Jun Takeba
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Hideo Okumura
- Department of Orthopaedic Surgery, Rakuyo Hospital, Sakyo-ku, Kyoto, Japan
| | - Hiromasa Miura
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
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10
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Kamada T, Mashima N, Nakashima Y, Imai H, Takeba J, Miura H. Mid-term clinical and radiographic outcomes of porous tantalum modular acetabular components for hip dysplasia. J Arthroplasty 2015; 30:607-10. [PMID: 25443360 DOI: 10.1016/j.arth.2014.11.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 10/15/2014] [Accepted: 11/01/2014] [Indexed: 02/01/2023] Open
Abstract
It is still challenging to perform successful cementless cup fixation during total hip arthroplasty for hip dysplasia. In this multicenter study we evaluated the clinical results of porous tantalum modular acetabular cups (TM cups) in 45 dysplastic hips with a mean follow-up period of 9.8 years. The mean Japanese Orthopaedic Association hip score improved from 48.2 preoperatively to 92.1 at the most recent follow-up. All of the cups were radiographically stable with no evidence of progressive radiolucencies or osteolysis regardless of bone grafting. Sixteen hips with bone grafts showed the integration of grafted bone without any radiolucencies. There were no revisions of TM cups. The use of TM cups for dysplastic hips provided satisfactory 10-year clinical and radiographic results.
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Affiliation(s)
- Tomomi Kamada
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Kyushu University School of Medicine, 1-3-3 Maidashi, Higashi-ku, Fukuoka, Japan
| | - Hiroshi Imai
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Jun Takeba
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Hiromasa Miura
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
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11
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Ishimaru M, Hino K, Onishi Y, Iseki Y, Mashima N, Miura H. A three-dimensional computed tomography study of distal femoral morphology in Japanese patients: gender differences and component fit. Knee 2014; 21:1221-4. [PMID: 25450008 DOI: 10.1016/j.knee.2014.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 08/22/2014] [Accepted: 09/17/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous anthropometric studies have reported gender differences in distal femoral morphology. However, to date, very few studies have investigated the knee morphology of Japanese adults and possible gender differences. The purpose of this study was to examine the distal femoral morphology of Japanese patients, to characterize anatomical differences between male and female, and to evaluate the need to create gender-specific knee prostheses. MATERIAL AND METHODS We evaluated 80 knees in 40 male and 40 female Japanese patients scheduled for total knee arthroplasty (TKA). The mediolateral (ML) and anteroposterior (AP) dimensions of the knees at different levels were measured preoperatively using three-dimensional computed tomography, and ML/AP aspect ratios were calculated. RESULTS On the distal femoral cut surface, the mean ML widths were 74.9 mm for male and 65.1mm for female, and the mean AP lengths were 63.4mm for male and 58.9 mm for female. Such values were generally smaller compared to data from European and North American studies. In this study, the mean ML/AP aspect ratios were 1.31 for male and 1.25 for female, higher than those from non-Asian regions. The ML/AP ratios of Japanese patients were negatively correlated with distal femoral AP length. CONCLUSIONS Japanese female had a relatively narrower femoral width for a given AP length than male. Our study suggests the utility of Japanese-specific implants and provides useful insights for manufacturers to design components of appropriate sizes and aspect ratios for Japanese TKA patients.
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Affiliation(s)
- Masami Ishimaru
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Japan
| | - Kazunori Hino
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Japan
| | - Yoshio Onishi
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Japan
| | - Yasutake Iseki
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Japan
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Japan
| | - Hiromasa Miura
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Japan.
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12
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Nakashima Y, Mashima N, Imai H, Mitsugi N, Taki N, Mochida Y, Owan I, Arakaki K, Yamamoto T, Mawatari T, Motomura G, Ohishi M, Doi T, Kanazawa M, Iwamoto Y. Clinical and radiographic evaluation of total hip arthroplasties using porous tantalum modular acetabular components: 5-year follow-up of clinical trial. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0618-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yasuharu Nakashima
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Naohiko Mashima
- Department of Bone and Joint Surgery, Ehime University,
Shizugawa, Toon 791-0295, Japan
| | - Hiroshi Imai
- Department of Bone and Joint Surgery, Ehime University,
Shizugawa, Toon 791-0295, Japan
| | - Naoto Mitsugi
- Department of Orthopaedic Surgery, Yokohama City University Medical Center,
4-57 Urafune, Minamiku, Yokohama 232-0024, Japan
| | - Naoya Taki
- Department of Orthopaedic Surgery, Yokohama City University Medical Center,
4-57 Urafune, Minamiku, Yokohama 232-0024, Japan
| | - Yuichi Mochida
- Department of Orthopaedic Surgery, Yokohama City University Medical Center,
4-57 Urafune, Minamiku, Yokohama 232-0024, Japan
| | - Ichiro Owan
- Department of Orthopedic Surgery, University of the Ryukyu,
207 Uehara, Nishihara 903-0215, Japan
| | - Kaoru Arakaki
- Department of Orthopedic Surgery, University of the Ryukyu,
207 Uehara, Nishihara 903-0215, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Taro Mawatari
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Goro Motomura
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Masanobu Ohishi
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Toshio Doi
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Masayuki Kanazawa
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Kyushu University,
1-3-3 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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13
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Imai H, Kamada T, Takeba J, Shiraishi Y, Mashima N, Miura H. Anterior coverage after eccentric rotational acetabular osteotomy for the treatment of developmental dysplasia of the hip. J Orthop Sci 2014; 19:762-9. [PMID: 24953502 PMCID: PMC4169651 DOI: 10.1007/s00776-014-0592-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/26/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND In periacetabular osteotomy for the treatment of developmental dysplasia of the hip, impairments in ADL due to limitations in hip flexion can occur when anterior displacement is added to lateral displacement in order to obtain sufficient femoral head coverage. This study was conducted to determine, by the range of motion (ROM) simulation based on CT images, the minimum angle of hip flexion and internal rotation at 90° of flexion that is necessary to avoid ADL impairments after eccentric rotational acetabular osteotomy (ERAO) and to estimate the angles of anterior femoral head coverage on plain radiography that enable the above flexion. METHODS Of 47 hips treated with ERAO at our hospital from December 2007 to May 2012, 27 hips without progressive osteoarthritis which could be CT scanned were examined and included. The mean age at the time of surgery was 40.7 years (SD 1.8). The postoperative follow-up period was 30.2 months (SD 3.6). Two hips were in male patients and 25 hips were in female patients. The disease stage prior to surgery was pre-osteoarthritis in 5 hips, early in 11 hips, and progressive in 11 hips. We checked whether the patients were capable of activities that require deep hip flexion for the evaluation of postoperative ADL. Radiographic examination was performed before and one year after surgery to calculate LCE angle, Sharp angle, AHI, and VCA angle. The angle at which impingement of the displaced fragment of the bone and the femur appeared was measured using 3D CAD software, and the relationship between this angle and the physical findings, ADL impairment, or radiographic findings, were also examined. RESULTS 22 out of 27 hips that were capable of 116° or more of flexion or 42° or more of internal rotation at 90° of flexion in ROM simulation showed the absence of ADL impairment and a postoperative VCA angle ≤42°, whereas 5 hips with 110° or less of flexion or 40° or less of internal rotation at 90° of flexion in ROM simulation had ADL impairments associated with limitations in hip flexion and a postoperative VCA angle ≥46°. CONCLUSIONS Anterior and lateral coverage requires a postoperative VCA angle of ≥20° to achieve anterior structural stability and an LCE angle of >25° to obtain adequate superior lateral coverage of the femoral head. A VCA angle ≤42° is required to avoid impingement during deep flexion. A VCA angle ≥46° is a probable risk factor for pincer FAI syndrome after ERAO.
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Affiliation(s)
- Hiroshi Imai
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan,
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14
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Nakashima Y, Mashima N, Imai H, Mitsugi N, Taki N, Mochida Y, Owan I, Arakaki K, Yamamoto T, Mawatari T, Motomura G, Ohishi M, Doi T, Kanazawa M, Iwamoto Y. Clinical and radiographic evaluation of total hip arthroplasties using porous tantalum modular acetabular components: 5-year follow-up of clinical trial. Mod Rheumatol 2012; 23:112-8. [PMID: 22395477 DOI: 10.1007/s10165-012-0618-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 02/13/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Porous tantalum is a biomaterial newly applied for artificial joints. We present here 5-years follow-up report of a multicenter clinical trial of total hip arthroplasties (THA) with porous tantalum modular acetabular component (modular PTC). METHODS Study participants received 82 hips in 79 cases, with 61.2 months follow-up on average. Age at operation was 60.9 years. Clinical results were evaluated using Merle d'Aubigne Postel score. Presence of implant loosening, periacetabular radiolucency, osteolysis, and gap filling were examined for radiographic results. RESULTS Merle d'Aubigne Postel score improved from 10.0 to 16.4 points. All PTC were radiographically stable, with no evidence of progressive radiolucencies. Average polyethylene wear rate was 0.004 mm/year, with no periacetabular osteolysis. Fifteen hips (18.3%) showed a gap >1 mm; however, all showed bone filling within 12 months. PTC with oversized reaming was significantly less likely to have a gap. No implant failure was noted related to modularity. Resulting survival rate of modular PTC was 100% at 5 years. CONCLUSIONS Modular PTC showed excellent results at 5-years of follow-up. Some hips showed periacetabular gaps, which were filled with bone within 1 year. Further follow-up was needed to determine long-term efficacy.
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Affiliation(s)
- Yasuharu Nakashima
- Department of Orthopaedic Surgery, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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15
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Imai H, Mashima N, Takahashi T, Yamamoto H. The relationship between increased hip range of motion, wear, and locking mechanism failure in the Harris-Galante acetabular component. J Arthroplasty 2009; 24:892-7. [PMID: 18848428 DOI: 10.1016/j.arth.2008.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Accepted: 07/09/2008] [Indexed: 02/01/2023] Open
Abstract
We performed both clinical and radiographic evaluations of 178 patients (190 hips) who had undergone cementless total hip arthroplasties using Harris-Galante I/II porous cups after an average 12-year follow-up period (range, 8-18 years). We revised 15 Harris-Galante I/II porous cups (7.8%), and the locking mechanism was broken in 10 revised cups (67%). There was a significant association between locking mechanism failure and linear polyethylene wear. We observed a significant positive correlation between linear polyethylene wear and increased ranges of motion such as flexion, adduction, and external rotation at the last follow-up visit after the primary operation. Increased ranges of motion seen in Asians induced higher linear polyethylene wear and locking mechanism failure due to impingement of the neck and cup.
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Affiliation(s)
- Hiroshi Imai
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Ehime, Japan
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16
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Mashima N, Yamamoto H, Tsuboi I, Tsuchiya H, Tanaka Y, Watanabe S. Correction of hallux valgus deformity using the center of rotation of angulation method. J Orthop Sci 2009; 14:377-84. [PMID: 19662470 DOI: 10.1007/s00776-009-1345-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 03/16/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND To correct a hallux valgus (HV) deformity quantitatively and prevent unexpected postoperative deformity, the center of rotation of angulation (CORA) method was applied during HV surgery. To correct a hallux valgus (HV) deformity quantitatively and prevent unexpected postoperative deformity, the center of rotation of angulation (CORA) method was applied during HV surgery. METHODS To create a normal foot model, radiographs of 64 normal female feet were measured. Points A and B were defined as the intersection of the intermetatarsal angle and the HV angle. CORA1 and CORA2 were defined as the intersection of the axes of the first metatarsal and the first proximal phalanx in the normal and HV models, respectively. Procedures to correct HV deformity using the CORA method were devised and were applied to HV feet, which underwent a focal dome osteotomy or medial wedge osteotomy. RESULTS Point A was 2.3 times the length of the second metatarsal proximally from the top of the second metatarsal head, and point B was 0.17 times the length of the first metatarsal proximally from the top of the first metatarsal head. Two methods were used to correct the deformity. With one method, a focal dome osteotomy was performed at the first metatarsal on the circle at the CORA1 and the distal fragment was moved to the standard first metatarsal axis. The first proximal phalanx was then moved around the metatarsal head to the standard axis of the first proximal phalanx at the CORA2. With the other method, a medial wedge osteotomy was performed on or proximal to the CORA2, and the distal fragment was moved to the first standard metatarsal axis. CONCLUSIONS We propose a preoperative plan to use the CORA method to correct deformities that prevent translation of the axis or an angulation deformity. HV deformity can be corrected effectively using the CORA method.
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Affiliation(s)
- Naohiko Mashima
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
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Iseki Y, Takahashi T, Takeda H, Tsuboi I, Imai H, Mashima N, Watanabe S, Yamamoto H. Defining the load bearing axis of the lower extremity obtained from anterior-posterior digital radiographs of the whole limb in stance. Osteoarthritis Cartilage 2009; 17:586-91. [PMID: 19013082 DOI: 10.1016/j.joca.2008.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2007] [Accepted: 10/09/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the reliability of inter-and intra-observer assessments of the mechanical alignment of the lower extremities with digitally computed radiographs of an anterior-posterior view of the whole leg using a new computer-assisted method. METHOD Load bearing axis deviation of the lower extremities was quantitatively measured by three examiners in 105 knees of 73 subjects who had osteoarthritis of the knee with a Kellgren-Lawrence grade of 1 or more. A line representing the load bearing axis was drawn from the center of the femoral head to the center of the ankle and the alignment of the leg was assessed by measuring the width of the proximal tibia and the perpendicular distance from the middle of the proximal tibial condyle to the load bearing axis (Fujifilm OP-A). A ratio of the values was calculated and expressed as a percentage. RESULTS The inter-observer mean difference was 2.9 % (SD, 2.7), and the intra-observer mean difference was 2.1% (SD, 2.2). The mean intraclass correlation coefficient (ICC) for inter-observer trials was 0.96; that for intra-observer trials was 0.99. CONCLUSION Our computer-assisted method was reproducible, and should be considered an alternative method for the measurement of the alignment of the whole leg.
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Affiliation(s)
- Y Iseki
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine Shitsukawa, Toon, Ehime 791-0295, Japan
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Sakayama K, Mashima N, Kidani T, Miyazaki T, Yamamoto H, Masuno H. Effect of cortisol on cell proliferation and the expression of lipoprotein lipase and vascular endothelial growth factor in a human osteosarcoma cell line. Cancer Chemother Pharmacol 2007; 61:471-9. [PMID: 17549480 DOI: 10.1007/s00280-007-0492-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2006] [Accepted: 03/27/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study is to investigate whether cortisol inhibited cell proliferation and the expressions of lipoprotein lipase (LPL), a key enzyme involved in the energy metabolism in tumor cells, and vascular endothelial growth factor (VEGF), a potent angiogenic factor in the tumor, in cultures of OST cells, a human osteosarcoma cell line. METHODS OST cells were treated for 48 h with or without cortisol. To examine the effect of cortisol on cell proliferation, the expression of proliferating cell nuclear antigen (PCNA) was examined by Western blotting, and the amount of (3)H-thymidine incorporated into DNA during the last 30 min of the 48-h treatment period was measured. To examine the effect of cortisol on the expression of LPL, the activity and mass of LPL were measured in the extract of acetone/ether powder of cells, and the amount of (35)S-methionine incorporated into LPL during the last 2 h of the 48-h treatment period was measured by immunoprecipitation. The expression of VEGF was examined by immunohistochemistry and Western blotting. RESULTS The amount of (3)H-thymidine incorporated into DNA and the level of PCNA were lower in the cortisol-treated cultures than in the untreated cultures, thus indicating that cortisol inhibited the proliferation of OST cells. The synthetic rate and activity of LPL were lower in the cortisol-treated cultures than in the untreated cultures but no difference in the specific activity of LPL between the two cultures was observed, thus indicating that cortisol inhibited LPL synthesis, thereby resulting in a decreased LPL activity. The expression of VEGF was lower in the cortisol-treated cultures than in the untreated cultures. CONCLUSION Cortisol not only has the ability to inhibit cell proliferation but also the ability to inhibit the expressions of LPL and VEGF in cultures of OST cells.
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Affiliation(s)
- Kenshi Sakayama
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
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Abstract
STUDY DESIGN Retrospective study on the results of surgical treatment of compressive cervical myelopathy in patients more than 75 years of age. OBJECTIVES To investigate clinical features and surgical outcomes of compressive cervical myelopathy in aged patients and to discuss the role of surgical treatment. SUMMARY OF BACKGROUND DATA There are few data focused on the outcomes of surgery in patients with cervical myelopathy who are more than 75 years of age. METHODS Seventeen patients with compressive cervical myelopathy who underwent surgery were reviewed. The average age at the time of surgery was 77.2 years. Posterior decompression in 15 patients and anterior decompression in 2 patients were performed. Neurologic deficits before and after surgery were assessed using a scoring system proposed by the Japanese Orthopaedic Association (JOA score). Independence of daily living was evaluated. Radiologic features were examined with radiographs and magnetic resonance imaging. Clinical results were compared with those of patients less than 65 years old as a control. RESULTS The preoperative mean JOA score was 6.1, the postoperative maximum JOA scores averaged 11.4, and the recovery rate was 48.4%. These were significantly inferior to scores in those less than 65 years of age. All seven of the patients who could not walk even with aids before surgery became independent in daily activities after surgery. At the final follow-up, the mean JOA score had decreased to 10.7 and the recovery rate to 39.1%. Five of nine patients whose follow-up periods were more than 5 years showed decreases in JOA score, although all patients were still ambulatory. CONCLUSIONS Surgical decompression for cervical myelopathy appears to be beneficial, even in patients more than 75 years of age, in improving neurologic function and ability to engage in activities of daily living.
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Affiliation(s)
- Y Matsuda
- Department of Orthopaedic Surgery, Ehime University School of Medicine, Japan
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Matsuda Y, Sakayama K, Okumura H, Kawatani Y, Mashima N, Shibata T. Percutaneous autologous bone marrow transplantation for nonunion of the femur. Nihon Geka Hokan 1998; 67:10-7. [PMID: 10401231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Percutaneous bone marrow injections were performed on 7 nonunions of the femur. There were 6 hypervascular nonunions and one avascular nonunion. Two nonunions presented with active infections. One other patient had a history of infection which had subsided. One nonunion received the injection twice. After the site of nonunion was curetted and the bone surface was scored, 150 ml of bone marrow aspirated from the iliac bone was injected. Complete union occurred in 4 patients within 9 months; all of them were uninfected hypervascular nonunions following intramedullary nail fixation. One nonunion with a bone defect united partially leaving a 1 x 1 cm defect. The two infected femoral nonunions failed to unite. The results show that percutaneous autologous bone marrow injection for femoral nonunions can be considered for uninfected hypervascular nonunions following intramedullary nail fixation. In these cases stimulation of healing processes of fracture leading to consolidation can be expected from bone marrow injection. However, femoral nonunion with an active infection and loss of fixation is considered to be a contraindication for this technique.
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Affiliation(s)
- Y Matsuda
- Department of Orthopaedic Surgery, School of Medicine, Ehime University, Japan
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