38 results on '"Ueoka, Ken"'
Search Results
2. Five-year clinical and radiographic outcomes of Accolade TMZF and Accolade II stem use
- Author
-
Ueoka, Ken, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Yamamuro, Yuki, Taninaka, Atsushi, Kataoka, Tomoyuki, Yanagi, Yu, Saiki, Yoshitomo, Ima, Musashi, and Tsuchiya, Hiroyuki
- Published
- 2024
- Full Text
- View/download PDF
3. Large intraosseous chronic expanding hematoma after total hip arthroplasty presenting with chronic disseminated intravascular coagulation: a case report and literature review
- Author
-
Yamamuro, Yuki, Kabata, Tamon, Takeuchi, Akihiko, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Yoshitani, Junya, Ueno, Takuro, Ueoka, Ken, Taninaka, Atsushi, Kataoka, Tomoyuki, Saiki, Yoshitomo, and Tsuchiya, Hiroyuki
- Published
- 2022
- Full Text
- View/download PDF
4. Comparison of mid-term clinical results between cementless and cemented femoral stems in total hip arthroplasty with femoral shortening osteotomy for Crowe type IV hips
- Author
-
Inoue, Daisuke, Kabata, Tamon, Kajino, Yoshitomo, Ohmori, Takaaki, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Published
- 2021
- Full Text
- View/download PDF
5. Association between total hip arthroplasty following periacetabular osteotomy and acetabular component overhang
- Author
-
Ueno, Takuro, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Yoshitani, Junya, Ueoka, Ken, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Published
- 2020
- Full Text
- View/download PDF
6. Correlation between lag screw route and the ideal insertion point of the intramedullary nail
- Author
-
Yoshitani, Junya, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Ueoka, Ken, Yamamuro, Yuki, Taninaka, Atsushi, and Tsuchiya, Hiroyuki
- Published
- 2021
- Full Text
- View/download PDF
7. The Accuracy of the Computed Tomography-Based Navigation System in Total Hip Arthroplasty Is Comparable With Crowe Type IV and Crowe Type I Dysplasia: A Case-Control Study
- Author
-
Ueoka, Ken, Kabata, Tamon, Kajino, Yoshitomo, Yoshitani, Junya, Ueno, Takuro, and Tsuchiya, Hiroyuki
- Published
- 2019
- Full Text
- View/download PDF
8. Antibacterial Activity in Iodine-coated Implants Under Conditions of Iodine Loss: Study in a Rat Model Plus In Vitro Analysis
- Author
-
Ueoka, Ken, Kabata, Tamon, Tokoro, Masaharu, Kajino, Yoshitomo, Inoue, Daisuke, Takagi, Tomoharu, Ohmori, Takaaki, Yoshitani, Junya, Ueno, Takuro, Yamamuro, Yuki, Taninaka, Atsushi, and Tsuchiya, Hiroyuki
- Published
- 2021
- Full Text
- View/download PDF
9. Safety range for acute limb lengthening in primary total hip arthroplasty
- Author
-
Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Yoshitani, Junya, Ueno, Takuro, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Published
- 2019
- Full Text
- View/download PDF
10. Effect of changing femoral head diameter on bony and prosthetic jumping angles
- Author
-
Ohmori, Takaaki, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Taga, Tadashi, Yamamoto, Takashi, Takagi, Tomoharu, Yoshitani, Junya, Ueno, Takuro, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Published
- 2019
- Full Text
- View/download PDF
11. The effect of flexion alignment in total hip arthroplasty with a cementless tapered-wedge femoral stem
- Author
-
Yoshitani, Junya, Kabata, Tamon, Kajino, Yoshitomo, Takagi, Tomoharu, Ohmori, Takaaki, Ueno, Takuro, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Published
- 2018
- Full Text
- View/download PDF
12. Patellofemoral Osteoarthritis Progression and Alignment Changes after Open-Wedge High Tibial Osteotomy Do Not Affect Clinical Outcomes at Mid-term Follow-up
- Author
-
Goshima, Kenichi, Sawaguchi, Takeshi, Shigemoto, Kenji, Iwai, Shintaro, Nakanishi, Akira, and Ueoka, Ken
- Published
- 2017
- Full Text
- View/download PDF
13. Periodic injections of adipose-derived stem cell sheets attenuate osteoarthritis progression in an experimental rabbit model
- Author
-
Takagi, Tomoharu, Kabata, Tamon, Hayashi, Katsuhiro, Fang, Xiang, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Ueno, Takuro, Yoshitani, Junya, Ueoka, Ken, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Published
- 2020
- Full Text
- View/download PDF
14. Combinational therapy with antibiotics and antibiotic-loaded adipose-derived stem cells reduce abscess formation in implant-related infection in rats
- Author
-
Yoshitani, Junya, Kabata, Tamon, Arakawa, Hiroshi, Kato, Yukio, Nojima, Takayuki, Hayashi, Katsuhiro, Tokoro, Masaharu, Sugimoto, Naotoshi, Kajino, Yoshitomo, Inoue, Daisuke, Ueoka, Ken, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Published
- 2020
- Full Text
- View/download PDF
15. Patient-reported outcomes following primary total hip arthroplasty in Crowe type III or IV developmental dysplasia are comparable to those in Crowe type I: a case-control study of 96 hips with intermediate-term follow-up
- Author
-
Ueoka, Ken, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Ueno, Takuro, Yoshitani, Junya, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Published
- 2020
- Full Text
- View/download PDF
16. Risk factors for pressure ulcers from the use of a pelvic positioner in hip surgery: a retrospective observational cohort study in 229 patients
- Author
-
Ueno, Takuro, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Yoshitani, Junya, Ueoka, Ken, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Published
- 2020
- Full Text
- View/download PDF
17. Tilt-adjusted Cup Anteversion in Patients with Severe Backward Pelvic Tilt is Associated with the Risk of Iliopsoas Impingement: A Three-dimensional Implantation Simulation
- Author
-
Ueno, Takuro, Kabata, Tamon, Kajino, Yoshitomo, Ohmori, Takaaki, Yoshitani, Junya, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Published
- 2019
- Full Text
- View/download PDF
18. Chondroprotective Effects of Chondrogenic Differentiated Adipose-Derived Mesenchymal Stem Cells Sheet on Degenerated Articular Cartilage in an Experimental Rabbit Model.
- Author
-
Taninaka, Atsushi, Kabata, Tamon, Hayashi, Katsuhiro, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Ueoka, Ken, Yamamuro, Yuki, Kataoka, Tomoyuki, Saiki, Yoshitomo, Yanagi, Yu, Ima, Musashi, Iyobe, Takahiro, and Tsuchiya, Hiroyuki
- Subjects
MESENCHYMAL stem cells ,CELL sheets (Biology) ,ENDOCHONDRAL ossification ,ARTICULAR cartilage ,CARTILAGE ,VITAMIN C ,PLATELET-rich plasma ,INTRA-articular injections - Abstract
Adipose-derived stem cells (ADSCs) have been studied for many years as a therapeutic option for osteoarthritis (OA); however, their efficacy remains insufficient. Since platelet-rich plasma (PRP) induces chondrogenic differentiation in ADSCs and the formation of a sheet structure by ascorbic acid can increase the number of viable cells, we hypothesized that the injection of chondrogenic cell sheets combined with the effects of PRP and ascorbic acid may hinder the progression of OA. The effects of induction of differentiation by PRP and formation of sheet structure by ascorbic acid on changes in chondrocyte markers (collagen II, aggrecan, Sox9) in ADSCs were evaluated. Changes in mucopolysaccharide and VEGF-A secretion from cells injected intra-articularly in a rabbit OA model were also evaluated. ADSCs treated by PRP strongly chondrocyte markers, including type II collagen, Sox9, and aggrecan, and their gene expression was maintained even after sheet-like structure formation induced by ascorbic acid. In this rabbit OA model study, the inhibition of OA progression by intra-articular injection was improved by inducing chondrocyte differentiation with PRP and sheet structure formation with ascorbic acid in ADSCs. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
19. Importance of Three-Dimensional Evaluation of Surgical Transepicondylar Axis in Total Knee Arthroplasty.
- Author
-
Ohmori, Takaaki, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ueno, Takuro, Taga, Tadashi, Yamamoto, Takashi, Takagi, Tomoharu, Yoshitani, Junya, Ueoka, Ken, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Published
- 2022
- Full Text
- View/download PDF
20. Antibacterial Activity in Iodine-coated Implants Under Conditions of Iodine Loss: Study in a Rat Model Plus In Vitro Analysis.
- Author
-
Ken Ueoka, Tamon Kabata, Masaharu Tokoro, Yoshitomo Kajino, Daisuke Inoue, Tomoharu Takagi, Takaaki Ohmori, Junya Yoshitani, Takuro Ueno, Yuki Yamamuro, Atsushi Taninaka, Hiroyuki Tsuchiya, Ueoka, Ken, Kabata, Tamon, Tokoro, Masaharu, Kajino, Yoshitomo, Inoue, Daisuke, Takagi, Tomoharu, Ohmori, Takaaki, and Yoshitani, Junya
- Subjects
ANIMAL disease models ,GRAM-positive bacteria ,IODINE ,BACTERIAL colonies ,RATS ,JOINT infections ,STAPHYLOCOCCAL disease prevention ,INFECTION prevention ,PROSTHETICS ,IN vitro studies ,BIOLOGICAL models ,BIOFILMS ,METHICILLIN-resistant staphylococcus aureus ,BIOMEDICAL materials ,INFECTION ,STAPHYLOCOCCAL diseases ,PSEUDOMONAS diseases ,PSEUDOMONAS ,TITANIUM ,COMPLICATIONS of prosthesis ,ANTIBIOTICS ,ANIMALS ,PHARMACODYNAMICS - Abstract
Background: We developed iodine-coated titanium implants to suppress microbial activity and prevent periprosthetic joint infection (PJI); their efficacy was demonstrated in animal and in vitro models. The iodine content in iodine-coated implants naturally decreases in vivo. However, to our knowledge, the effect of reduced iodine content on the implant's antimicrobial activity has not been evaluated to date.Questions/purposes: (1) How much does the iodine content on the implant surface decrease after 4 and 8 weeks in vivo in a rat model? (2) What effect does the reduced iodine content have on the antimicrobial effect of the implant against multiple bacteria in an in vitro model?Methods: This experiment was performed in two parts: an in vivo experiment to determine attenuation of iodine levels over time in rats, and an in vitro experiment in which we sought to assess whether the reduced iodine content observed in the in vivo experiment was still sufficient to deliver antimicrobial activity against common pathogens seen in PJI. For the in vivo experiment, three types of titanium alloy washers were implanted in rats: untreated (Ti), surface-anodized to produce an oxide film (Ti-O), and with an iodine layer on the oxidation film (Ti-I). The attenuation of iodine levels in rats was measured over time using inductively coupled plasma-mass spectrometry. Herein, only the Ti-I washer was used, with five implanted in each rat that were removed after 4 or 8 weeks. For the 4- and 8-week models, two rats and 15 washers were used. For the in vitro study, to determine the antibacterial effect, three types of washers (Ti, Ti-O, and Ti-I) (nine washers in total) were implanted in each rat. Then, the washers were removed and the antibacterial effect of each washer was examined on multiple bacterial species using the spread plate method and fluorescence microscopy. For the spread plate method, six rats were used, and five rats were used for the observation using fluorescence microscopy; further, 4- and 8-week models were made for each method. Thus, a total of 22 rats and 198 washers were used. Live and dead bacteria in the biofilm were stained, and the biofilm coverage percentage for quantitative analysis was determined using fluorescence microscopy in a nonblinded manner. Ti-I was used as the experimental group, and Ti and Ti-O were used as control groups. The total number of rats and washers used throughout this study was 24 and 213, respectively.Results: Iodine content in rats implanted with Ti-I samples decreased to 72% and 65% after the in vivo period of 4 and 8 weeks, respectively (p = 0.001 and p < 0.001, respectively). In the in vitro experiment, the Ti-I implants demonstrated a stronger antimicrobial activity than Ti and Ti-O implants in the 4- and 8-week models. Both the median number of bacterial colonies and the median biofilm coverage percentage with live bacteria on Ti-I were lower than those on Ti or Ti-O implants for each bacterial species in the 4- and 8-week models. There was no difference in the median biofilm coverage percentage of dead bacteria. In the 8-week model, the antibacterial activity using the spread plate method had median (interquartile range) numbers of bacteria on the Ti, Ti-O, and Ti-I implants of 112 (104 to 165) × 105, 147 (111 to 162) × 105, and 55 (37 to 67) × 105 of methicillin-sensitive Staphylococcus aureus (Ti-I versus Ti, p = 0.026; Ti-I versus Ti-O, p = 0.009); 71 (39 to 111) × 105, 50 (44 to 62) × 105, and 26 (9 to 31)× 105 CFU of methicillin-resistant S. aureus (Ti-I versus Ti, p = 0.026; Ti-I versus Ti-O, p = 0.034); and 77 (74 to 83) × 106, 111 (95 to 117) × 106, and 30 (21 to 45) × 106 CFU of Pseudomonas aeruginosa (Ti-I versus Ti, p = 0.004; Ti-I versus Ti-O, p = 0.009). Despite the decrease in the iodine content of Ti-I after 8 weeks, it demonstrated better antibacterial activity against all tested bacteria than the Ti and Ti-O implants.Conclusion: Iodine-coated implants retained their iodine content and antibacterial activity against methicillin-sensitive S. aureus, methicillin-resistant S. aureus, and P. aeruginosa for 8 weeks in vivo in rats. To evaluate the longer-lasting antibacterial efficacy, further research using larger infected animal PJI models with implants in the joints of both males and females is desirable.Clinical Relevance: Iodine-coated titanium implants displayed an antibacterial activity for 8 weeks in rats in vivo. Although the findings in a rat model do not guarantee efficacy in humans, they represent an important step toward clinical application. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
21. Anterior pelvic plane tilt poorly estimates the sagittal body alignment due to internal rotation of innominate bone.
- Author
-
Ueno, Takuro, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Yoshitani, Junya, Ueoka, Ken, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Subjects
ACETABULUM (Anatomy) ,TOTAL hip replacement ,COMPUTED tomography ,ANATOMICAL planes ,ROTATIONAL motion ,BONES - Abstract
This study investigated the influence of the rotation of innominate bone on anterior pelvic plane (APP) tilt, the angle formed by the APP, and coronal plane of the body to determine whether the provision of proper information about the sagittal balance of the body by the value of the APP tilt (APPT). In total, 244 patients (171 females, 73 males) who were candidates for total hip or knee arthroplasty, periacetabular osteotomy, or shelf arthroplasty were included. The rotational angle of the innominate bone was quantified using computed tomography images at the level of the anterior superior, and anterior inferior iliac spine, and ischiopubic portion. Clustering analysis was performed to identify subtypes of innominate bone rotation. High, intermediate, and low internal rotational alignment groups were identified in females, characterized by rotational angles. Males were treated as one group, and no intergroup differences were observed in sacral slope (SS) and pelvic incidence. However, intergroup differences in APPT were found, indicating a variation in APPT irrespective of sagittal body balance. A negligible relationship between SS and APPT was observed in the high‐internal‐rotation group, intermediate‐internal‐rotation group, and male group, whereas a moderate correlation found in the low‐internal‐rotation group (r =.59). The results could suggest surgeons that the value of the APPT provides no information on the sagittal balance; therefore, it may be ignored for acetabular component positioning during preoperative planning for total hip arthroplasty. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
22. The feasibility of iodine-supported processing for titanium with different surfaces.
- Author
-
Ueoka, Ken, Kajino, Yoshitomo, Kabata, Tamon, Inoue, Daisuke, Yoshitani, Junya, Ueno, Takuro, Yamamuro, Yuki, Shirai, Toshiharu, and Tsuchiya, Hiroyuki
- Subjects
- *
DECONTAMINATION of food , *SURFACE roughness , *METALLIC surfaces , *SCANNING electron microscopes , *TEETH polishing , *PLASMA spraying , *X-ray fluorescence - Abstract
Background: The reduction of microbial infections can substantially improve the success of implant surgery. The iodine-supported implants that were developed by us for infection prevention were featured at the recent International Consensus Meeting on Musculoskeletal Infection and were partly incorporated into the consensus guidelines. For future clinical application, we examined (1) whether iodine can be added to metals with different surface roughness, (2) differences in surface roughness before and after processing, and (3) the effect of sterilization on the iodine content.Methods: Four Ti-6Al-4V metals were prepared with different surface roughness values by polishing, blasting and plasma spraying. Before and after processing, the surface structure of metals was observed using a scanning electron microscope and stylus instruments. Before and after sterilization, iodine contents were measured by X-ray fluorescence spectroscopy.Results: After processing, sufficient iodine contents with an antimicrobial effect were detected for each metal. These iodine contents decreased after sterilization but were higher than the lowest content of iodine observed to have an antimicrobial effect in a previous study, indicating that the antimicrobial effect persists even after sterilization. After processing, surface roughness was greater for polishing metal. With general surface processing, iodine processing was possible.Conclusions: Our results indicated that surface roughness is affected by the processing method and that the iodine content should be set according to the sterilization method. Considering these factors, iodine processing can be used for clinical applications. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
23. Postsurgical infection from using a computed tomography-based hip navigation system during total hip arthroplasty.
- Author
-
Inoue, Daisuke, Kabata, Tamon, Kajino, Yoshitomo, Ohmori, Takaaki, Ueno, Takuro, Taga, Tadashi, Takagi, Tomoharu, Yoshitani, Junya, Ueoka, Ken, Yamamuro, Yuuki, and Tsuchiya, Hiroyuki
- Subjects
HIP joint radiography ,ARTIFICIAL joints ,COMPARATIVE studies ,COMPUTED tomography ,HIP joint ,PATIENT aftercare ,OSTEOARTHRITIS ,RADIOGRAPHY ,RISK assessment ,SURGICAL site infections ,TIME ,TOTAL hip replacement ,DISEASE incidence ,TREATMENT duration ,DESCRIPTIVE statistics ,DISEASE risk factors - Abstract
Purpose: A computed tomography (CT)-based hip navigation system is a useful tool for achieving precise implant alignment angle. However, it has the disadvantage of prolonged procedure duration. A prolonged procedure duration may increase the incidence of postoperative surgical site infection (SSI) or periprosthetic joint infection (PJI) following primary THA. Studies identifying whether CT-based hip navigation system increases the incidence of SSI and PJI compared to the free-hand technique for total hip arthroplasty (THA) are rare. The study aimed to assess whether the CT-based hip navigation system can cause SSI and PJI compared to the free-hand technique. Methods: We investigated 366 patients with osteoarthritis who completed the minimum 2-year follow-up and underwent primary THAs (n = 435), including 70 hips in 62 patients of the non-navigation group and 365 hips in 304 patients of the navigation group. We compared the incidence rate of SSI and PJI between the non-navigation group and navigation group. Results: Only three patients in the navigation group (0.8%) developed SSI or PJI, while no patient developed SSI or PJI in the non-navigation group. There was no significant difference in the incidence rate of SSI or PJI between the two groups (P = 1.0), although the mean operation time in the navigation group was about 20 min longer. Conclusions: CT-based hip navigation system may not be associated with SSI or PJI after primary THA, although it prolongs the operation time. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
24. Anatomic stem inserted according to native anteversion could reproduce the native anterior distance of the femoral head and decrease bony impingement in total hip arthroplasty.
- Author
-
Yoshitani, Junya, Kabata, Tamon, Kajino, Yoshitomo, Ueno, Takuro, Ueoka, Ken, Yamamuro, Yuki, and Tsuchiya, Hiroyuki
- Subjects
TOTAL hip replacement ,FEMUR head ,TOTAL shoulder replacement ,HEMIARTHROPLASTY ,COMPUTED tomography - Abstract
Purpose: To investigate whether anatomic and straight stems could reproduce the anteroposterior distance (AD) of the native femoral head and evaluate the effect of AD of the femoral head on range of motion (ROM) and bony impingement.Methods: This retrospective simulation study included 64 patients who had undergone primary total hip arthroplasty between 2012 and 2014. Using computed tomography (CT)-based templating software, anatomic and straight stems were inserted with same alignment. AD of the head centre was compared between the two stems and native anatomy. Furthermore, post-operative ROM was calculated, and correlation between AD and ROM was assessed.Results: There was a strong positive correlation between native anteversion (mean 21.9°) and anatomic stem anteversion (mean 22.5°) (R = 0.975, P < 0.001). There was no significant difference in AD between the native and anatomic stems (mean 37.7 and 38.8 mm, respectively), but AD of the straight stem was significantly lower than that of the native and anatomic stems. The straight stem showed a significantly lower ROM in flexion and internal rotation angles with 90° flexion (IR) than the anatomic stem (P < 0.05 and P < 0.001, respectively). AD showed a stronger correlation with ROM of IR than with stem anteversion.Conclusions: The anatomic stem could reproduce AD of the native femoral head centre, but the head centre of the straight stem in the same anteversion with anatomic stem translated significantly posterior, significantly decreasing the ROM of flexion and IR and increasing bony impingement of IR. To avoid bony impingement and acquire sufficient ROM, reproducing AD was important. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
25. The use of density mapping in the analysis of thigh pain after total hip arthroplasty in patients with well-fixed tapered wedge stems.
- Author
-
Junya Yoshitani, Tamon Kabata, Yoshitomo Kajino, Takaaki Ohmori, Takuro Ueno, Ken Ueoka, Hiroyuki Tsuchiya, Yoshitani, Junya, Kabata, Tamon, Kajino, Yoshitomo, Ohmori, Takaaki, Ueno, Takuro, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Published
- 2020
- Full Text
- View/download PDF
26. Tilt-adjusted Cup Anteversion in Patients with Severe Backward Pelvic Tilt is Associated with the Risk of Iliopsoas Impingement: A Three-dimensional Implantation Simulation.
- Author
-
Takuro Ueno, Tamon Kabata, Yoshitomo Kajino, Takaaki Ohmori, Junya Yoshitani, Ken Ueoka, Hiroyuki Tsuchiya, Ueno, Takuro, Kabata, Tamon, Kajino, Yoshitomo, Ohmori, Takaaki, Yoshitani, Junya, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Subjects
GROIN pain ,ANATOMICAL planes ,CONGENITAL hip dislocation ,LOGISTIC regression analysis ,GOODNESS-of-fit tests ,ODDS ratio - Abstract
Background: Anterior overhang of the acetabular component is associated with iliopsoas impingement, which may cause groin pain and functional limitations after THA. However, little is known about the relationship between component overhang and functional alignment of the acetabular component. CT-based image simulation may be illuminating in learning more about this because CT images are more effective than radiographs for evaluating the component's overhang and position.Questions/purposes: Using CT simulations based on preoperative data of nondysplastic and dysplastic hips, we asked: (1) What are the differences in the amount of component overhang, defined as the mediolateral distance from the component's edge to the native acetabular bony boundary on axial images (axial overhang), and as the AP distance on sagittal images (sagittal overhang) among pelvises with neutral and posterior tilt (in which the cephalad portion of the pelvis is more posterior than the caudad portion in the sagittal plane) in patients with dysplastic hips and those with nondysplastic hips? (2) Are increments in the amount of component overhang associated with a difference in the likelihood that the iliopsoas tendon will impinge against the edge of the acetabular component, after controlling for native acetabular abduction and anteversion and the presence of dysplasia?Methods: A total of 128 hips (dysplastic group: 73 hips; nondysplastic group: 55 hips) were evaluated. We defined a dysplastic hip as one with a lateral center-edge angle of less than 20° on AP radiographs. Pelvic models with neutral (0°) and 10° and 20° of posterior tilt were created from CT data. In simulations, acetabular component models were implanted into the true acetabulum with a tilt-adjusted orientation angle that was defined as the component's angle based on a reference for the functional pelvic plane (coronal plane of the body) in each pelvic model. Axial and sagittal component overhang were measured on CT images. Axial overhang of at least 12 mm and sagittal overhang of at least 4 mm were defined as thresholds increasing the likelihood of iliopsoas impingement according to previous studies. When determining the amount of overhang of the acetabular component, we controlled for abduction and anteversion of the native acetabulum and the presence of dysplasia by performing a multivariable logistic regression analysis.Results: In dysplastic hips, axial overhang increased by a mean ± SD of 5 ± 1 mm (Bonferroni adjusted p < 0.001; 95% CI, 4.7-5.1) from 0° to 10° of posterior tilt and by 5 ± 1 mm (p < 0.001; 95% CI, 4.9-5.3) from 10° to 20° of posterior tilt. Sagittal overhang increased by 1 ± 0 mm (p < 0.001; 95% CI, 1.0-1.0) from 0° to 10° of posterior tilt and by 1 ± 0 mm (p < 0.001; 95% CI, 1.0-1.0) from 10° to 20° of posterior tilt. In nondysplastic hips, axial overhang increased by a mean of 5 ± 0 mm (p < 0.001; 95% CI, 4.7-5.0) from 0° to 10° of posterior tilt and by 5 ± 1 mm (p < 0.001; 95% CI, 4.6-5.0) from 10° to 20° of posterior tilt. Sagittal overhang increased by 1 ± 0 mm (p < 0.001; 95% CI, 1.0-1.1) from 0° to 10° of posterior tilt and by 1 ± 0 mm (p < 0.001; 95% CI, 1.0-1.1) from 10° to 20° of posterior tilt. After controlling for the presence of dysplasia, we found that native acetabular abduction and anteversion and posterior pelvic tilt, presence of dysplasia (p = 0.030; adjusted odds ratio [OR], 2.2; 95% CI, 1.1-4.6), native acetabular anteversion (p < 0.001; adjusted OR, 1.4; 95% CI, 1.3-1.5), and 10° and 20° of backward tilt compared with 0° of tilt (10° of posterior tilt: p < 0.001; adjusted OR, 15; 95% CI, 5.5-41; 20° of posterior tilt: p < 0.001; adjusted OR, 333; 95% CI, 96-1157) were independently associated with axial overhang of at least 12 mm; the model showed high goodness of fit (Nagelkerke's r = 0.68). In contrast, native acetabular anteversion (p < 0.001; adjusted OR, 1.2; 95% CI, 1.1-1.2) and 20° of backward tilt compared with 0° of tilt (p = 0.015; adjusted OR, 2.2; 95% CI, 1.2-4.0) were independently associated with sagittal overhang of at least 4 mm; the model had low goodness of fit (Nagelkerke's r = 0.20).Conclusions: Acetabular component overhang is more severe when the pelvis tilts posteriorly. Moreover, posterior pelvic tilt, the presence of dysplasia, and higher native acetabular anteversion were independently associated with an increased risk of component overhang. When 20° of posterior tilt was adjusted, the risk of severe overhang was especially increased.Clinical Relevance: Based on these results, surgeons can attempt to prevent severe overhang in patients with posterior pelvic tilt by increasing component anteversion and abduction; when component anteversion is increased by 8° and abduction is increased by 2° from the target angle of 15° of anteversion and 40° of abduction in patients with posterior tilt of 20°, the risk of severe overhang is reduced to by approximately one-twentieth. However, it is still unclear how much the degree of component anteversion should be increased when surgeons attempt to prevent anterior prosthetic dislocation at the same time. Future studies such as prospective clinical trials evaluating both prosthetic dislocation and iliopsoas impingement in patients with posterior tilt might clarify this issue. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
27. The influence of pre-operative antiplatelet and anticoagulant agents on the outcomes in elderly patients undergoing early surgery for hip fracture.
- Author
-
Ueoka, Ken, Sawaguchi, Takeshi, Goshima, Kenichi, Shigemoto, Kenji, Iwai, Shintaro, and Nakanishi, Akira
- Subjects
- *
HEMIARTHROPLASTY , *HIP surgery , *HIP fractures , *OLDER patients , *BLOOD loss estimation , *PLATELET aggregation inhibitors , *ANTICOAGULANTS , *COMBINATION drug therapy , *BONE fractures , *HEMORRHAGE , *HIP joint injuries , *PREOPERATIVE care , *SURGICAL complications , *SURGICAL blood loss - Abstract
Background: Early surgery improves the prognosis of elderly patients with hip fractures. However, many patients take antiplatelet and anticoagulant therapies for comorbidities. This study compared perioperative outcomes and 1-year mortality rates with early surgery in elderly patients with hip fractures taking or not taking these agents preoperatively.Methods: Among 418 patients undergoing surgery for hip fractures at our institution from 2014 to 2016, 266 patients over 65 years who had surgery within 48 hours of admission were enrolled. We excluded patients with high-energy injuries, multiple or pathological fractures, and patients undergoing osteosynthesis for femoral neck fractures. The study population was divided into those who underwent hemiarthroplasty for neck fractures and those who underwent osteosynthesis for trochanteric fractures. We also divided the population into patients receiving chronic anticoagulation therapy (medicated group: 19 hemiarthroplasty, 70 osteosynthesis) and patients not receiving anticoagulation therapy (non-medicated group: 47 hemiarthroplasty, 130 osteosynthesis). Comorbidities, intraoperative blood loss, estimated blood loss from admission to the first and seventh day after surgery, transfusions, length of stay, complications, and 1-year mortality rates were evaluated.Results: Diabetes mellitus and cerebrovascular disorders were significantly more common in the medicated group for both surgery types. In the osteosynthesis group, estimated blood loss on the first day was 710 ml in the medicated group and 572 ml in the non-medicated group (P = 0.015). In the hemiarthroplasty group, corresponding values were 668 and 480 ml, respectively (P = 0.016). Estimated blood loss on the seventh day, complications, length of stay and 1-year mortality rate were not increased significantly.Conclusions: The medicated group had an increase in estimated blood loss on the first day. However, there was no significant increase in transfusions, complications and 1-year mortality rates. Early surgery for elderly patients with hip fractures is recommended, even for those taking antiplatelet and anticoagulant agents. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
28. A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty.
- Author
-
Ohmori, Takaaki, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Taga, Tadashi, Yamamoto, Takashi, Takagi, Tomoharu, Yoshitani, Junya, Ueno, Takuro, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Subjects
TOTAL knee replacement ,TIBIA ,POSTERIOR cruciate ligament ,ANATOMICAL axis ,ANATOMICAL planes - Abstract
Purpose: During total knee arthroplasty, few rotating reference axes can be reliably used after tibial resection. We speculated that a line that passes through the lateral edge of the posterior cruciate ligament (PCL) at its tibial attachment after resection and the most prominent point of the tibial tubercle [after-tibial resection (ATR) line] will provide a good reference axis. In this study, we aimed to evaluate the association between ATR and Akagi’s lines. Materials and methods: In this case–control simulation study, we retrospectively evaluated 38 patients with varus knee and 28 patients with valgus knee. We defined the reference cutting plane as 10 mm distal from the lateral articular surface of the tibia in varus group and as 7 mm distal from the medial articular surface in the valgus group. We measured angles between Akagi’s line and the ATR line (ATR line angle) as well as between Akagi’s line and 1/3 Akagi’s line (1/3 Akagi’s line angle), which passes through the midpoint of PCL and the medial third of the patellar tendon. We used paired t-tests to determine the significance of differences between these angles, with p < 0.05 indicating statistical significance. Intra- and interclass correlation coefficients for the reproducibility of 1/3 Akagi’s line angle and ATR line angle were analyzed by two surgeons. Results: We found that 1/3 Akagi’s line angle was 10.2° ± 1.3° in the varus group and 10.9° ± 1.3° in the valgus group (p = 0.017). The ATR line was positioned externally compared with Akagi’s line in all patients. Mean ATR line angles at 0°, 3° and 7° posterior slopes were 6.1° ± 1.9°, 5.8° ± 2.0° and 6.0° ± 1.7° in the varus group and 6.3° ± 2.3°, 6.2° ± 2.3° and 5.4° ± 2.1° in the valgus group, respectively. There were no significant differences in the ATR line angle between the varus and valgus groups. (p = 0.34–0.67) Intra- and interclass correlation coefficients for the reproducibility of 1/3 Akagi’s line angle were 0.936 and 0.986 and those for the reproducibility of ATR line angle were 0.811 and 0.839. Conclusions: The ATR line was positioned between Akagi’s line and 1/3 Akagi’s line in all patients and was a valid option for evaluating rotational tibial alignment after tibial resection. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
29. Assessment of Unloading Effects After Open Wedge High Tibial Osoteotomy Using Quantitative Bone Scintigraphy
- Author
-
Goshima, Kenichi, Sawaguchi, Takeshi, Shigemoto, Kenji, Iwai, Shintaro, Nakanishi, Akira, and Ueoka, Ken
- Published
- 2017
- Full Text
- View/download PDF
30. Effect of Low-Intensity Pulsed Ultrasound on Bone Healing at Osteotomy Sites After Open Wedge High Tibial Osteotomy.
- Author
-
Goshima, Kenichi, Sawaguchi, Takeshi, Shigemoto, Kenji, Iwai, Sintaro, Nakanishi, Akira, and Ueoka, Ken
- Published
- 2017
- Full Text
- View/download PDF
31. The efficacy of total hip arthroplasty on locomotive syndrome and its related physical function in patients with hip osteoarthritis.
- Author
-
Ohmori, Takaaki, Kabata, Tamon, Kato, Satoshi, Takagi, Tomoharu, Kajino, Yoshitomo, Inoue, Daisuke, Taga, Tadashi, Yamamoto, Takashi, Kurokawa, Yuki, Yoshitani, Junya, Ueno, Takuro, Ueoka, Ken, Yamamuro, Yuki, Yahata, Tetsutaro, and Tsuchiya, Hiroyuki
- Subjects
- *
TOTAL hip replacement , *PHYSICAL mobility , *HIP osteoarthritis , *LOCOMOTIVES - Abstract
Background: Locomotive syndrome (LS) is a predictive factor of future motor dysfunction. Our aim was to evaluate the change in the total LS grade and, its the association with the Japanese Orthopaedic Association (JOA) hip score after total hip arthroplasty (THA) among patients with hip osteoarthritis.Methods: This was a prospective case-control study of 72 patients who underwent primary THA. The functional outcomes were measured before, and at 6 and 12 months after THA. LS was evaluated using the following tests: stand-up test, 2-step test, and 25-question Geriatric Locomotive Function Scale (GLFS-25). In addition, factors affecting the improvement of LS grade were examined.Results: Prior to THA, 7% and 93% of patients were classified as LS grades 1 and 2. At 6 months after THA, an improvement in the total LS grade was observed in 57% of patients, with this percentage further increasing to 65% at 1 year. Only the preoperative GLFS-25 was correlated with the preoperative JOA hip scores. The postoperative GLFS-25 and the two-step test were correlated with the postoperative JOA hip scores. The preoperative functional reach test (FRT) was significantly correlated with the total LS grade improvement.Conclusions: THA can improve the total LS grade in 65% of patients at 1 year postoperatively. Improvement was largely achieved in the first 6 months after THA, with a change from LS grade 2 to grade 1. FRT could be used an indicator of the total LS grade improvement. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
32. Assessment of unloading effects after open wedge high tibial osteotomy using quantitative bone scintigraphy.
- Author
-
Goshima, Kenichi, Sawaguchi, Takeshi, Shigemoto, Kenji, Iwai, Shintaro, Nakanishi, Akira, and Ueoka, Ken
- Subjects
- *
OSTEOARTHRITIS , *CARTILAGE regeneration , *OSTEOTOMY , *POSTOPERATIVE pain , *KNEE pain , *VISUAL analog scale - Abstract
Introduction: We evaluated changes in bone tracer uptake (BTU) in open wedge high tibial osteotomy (OWHTO) and determined if BTU correlates with clinical symptoms, postoperative alignment, or cartilage regeneration after OWHTO.Materials and Methods: Seventy-five knees in 64 patients who underwent OWHTO for medial compartment osteoarthritis were enrolled in this retrospective study. All cases were assessed preoperatively and at plate removal using bone scintigraphy. Visual analog scale (VAS), Japanese Orthopedic Association (JOA) score, Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and the weight-bearing line ratio (WBLR) were assessed preoperatively and at plate removal. In addition, cartilage regeneration was evaluated at plate removal. We assessed changes in BTU for the medial and lateral compartment after OWHTO and the correlations between BTU of the medial compartment and all other parameters were analyzed.Results: Postoperatively, all outcome measures significantly improved: mean VAS 61.4 ± 18.3 to 9.5 ± 8.2, mean JOA score 65.1 ± 11.5 to 94.7 ± 6.0, mean OKS 29.4 ± 8.1 to 42.3 ± 4.1, mean KOOS 57.0 ± 14.3 to 83.7 ± 9.6, mean WBLR 22.8 ± 10.9 to 70.0 ± 9.4. Cartilage regeneration was observed in 53 knees (70.7%). BTU of the medial compartment significantly decreased after OWTHO, whereas no increased postoperative BTU was found in the lateral compartment. Postoperative BTU of the medial compartment significantly correlated with VAS, KOOS, and WBLR. No statistically significant associations were found between BTU and cartilage regeneration.Conclusions: OWHTO significantly decreased BTU of the medial compartment, which correlated with knee pain and postoperative mechanical alignment. Unloading effects of OWHTO led to pain relief after surgery, regardless of cartilage regeneration. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
33. The optimal combined anteversion pattern to achieve a favorable impingement-free angle in total hip arthroplasty.
- Author
-
Ohmori, Takaaki, Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Taga, Tadashi, Yamamoto, Takashi, Takagi, Tomoharu, Yoshitani, Junya, Ueno, Takuro, Ueoka, Ken, and Tsuchiya, Hiroyuki
- Subjects
- *
TOTAL hip replacement - Abstract
Background: There have been no studies on the differences in impingement-free angle that result from different combined anteversion (CA) patterns. The aim of this study was to find the optimal CA pattern for achieving a favorable impingement-free angle, including bony and prosthetic impingement, in total hip arthroplasty.Methods: We evaluated 100 patients with no hip arthritis. We investigated the impingement-free angle (flexion, internal rotation with 90° flexion, extension, and external rotation) after changing the stem and cup anteversions to satisfy several CA patterns [cup anteversion + stem anteversion = 30°, 40°, 50°, and 60°; cup anteversion + 0.7 × stem anteversion = 37.3° (:Widmer's theory); and cup anteversion + 0.77 × stem anteversion = 43.3° (:Yoshimine's theory)] using 3-dimensional templating software.Results: The impingement-free angle changed dramatically among the various CA patterns. The optimal CA was changed by various stem anteversion. Only CA: Widmer with stem anteversion of 20° satisfied daily-life range of motion (ROM) requirements (flexion ≥130°, internal rotation with 90° flexion ≥ 45°, extension ≥ 40°, external rotation ≥ 40°).Conclusion: Good impingement-free angle cannot be obtained with single fixed CA. Different CA patterns should be used, depending on the differences in the stem anteversion. A CA of 30° with 0° ≤ stem anteversion ≤10°; a CA:Widmer with 20° of stem anteversion; a CA of 40° or Widmer with 30° of stem anteversion. When stem anteversion is ≥40°, CA should be decided by each patient's state. Among them, a stem anteversion of 20° with cup anteversion of 23.3° was found to be the best CA pattern. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
34. The effect of a multidisciplinary approach on geriatric hip fractures in Japan.
- Author
-
Shigemoto, Kenji, Sawaguchi, Takeshi, Goshima, Kenichi, Iwai, Shintarou, Nakanishi, Akira, and Ueoka, Ken
- Subjects
- *
HOSPITAL costs , *GERIATRIC surgery , *MEDICAL care costs , *HOSPITAL mortality , *INDIVIDUAL differences , *SURGICAL complications - Abstract
Background: This study aimed to report results of the multidisciplinary treatment approach for geriatric hip fractures and evaluate its effectiveness compared with conventional treatment. Patients aged 65 years and older who presented with a hip fracture at our hospital on or after 2014 were treated according to a multidisciplinary approach.Method: Two groups of patients with hip fracture were compared. Group I (n = 364) was treated according to the new multidisciplinary approach in 2014-2016, and Group II (n = 105) which received conventional treatment in 2012. Time to surgery, length of hospital stay, postoperative complications, osteoporosis treatment, functional recovery, in-hospital mortality, 90-day mortality, and 1-year mortality were evaluated. The medical costs of multidisciplinary treatment were compared with those in other hospitals every year.Results: There were no significant differences in the time to surgery between Group I and Group II, but each was considerably shorter than the average time in other Japanese hospitals. The length of hospital stay was longer in Group I. The overall postoperative complication rate was lower in Group I, but there was no significant difference for each individual complication. The rate of anti-osteoporosis pharmacotherapy administration at the time of discharge was significantly higher in Group I. Moreover, the proportion of patients who recovered to their pre-injury functional level was significantly higher in Group I. The mortality rates did not significantly differ year on year. The total hospitalization medical cost per patient for the multidisciplinary treatment was lower than other hospital costs every year.Conclusions: Multidisciplinary treatment produced no significant improvement in time to surgery, length of hospital stay, or postoperative complications. However, the use of the multidisciplinary treatment approach led to a significant increase in osteoporosis treatment rate and better functional recovery. Furthermore, the total medical costs for multidisciplinary treatment were lower than the acute care hospital costs. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
35. The prevalence and impact of sarcopenia in females undergoing total hip arthroplasty: A prospective study.
- Author
-
Ueoka K, Kabata T, Kajino Y, Inoue D, Ohmori T, Ueno T, Yoshitani J, Yamamuro Y, Taninaka A, Kato S, Yahata T, and Tsuchiya H
- Subjects
- Female, Hand Strength, Humans, Prevalence, Prospective Studies, Arthroplasty, Replacement, Hip adverse effects, Sarcopenia diagnosis, Sarcopenia epidemiology, Sarcopenia etiology
- Abstract
Objectives: Although both sarcopenia and hip disease decrease physical function, few studies have investigated the association. We investigated the prevalence of sarcopenia in patients awaiting total hip arthroplasty for osteoarthritis and examined the impact of sarcopenia on pre- and postoperative outcomes., Methods: This prospective study included 96 females. Participants were classified using two criteria. Cases defined as having sarcopenia by the Asian Working Group for Sarcopenia (AWGS) criteria were categorized as the AWGS-sarcopenia (A-S) group, and others were categorized as the AWGS-non-sarcopenia (A-NS) group. Those classified by hand grip strength (HGS) constituted the lower-HGS (L-H) and normal-HGS (N-H) groups. Patient demographics, physical function, and Japanese Orthopaedic Association (JOA) score were compared between each group., Results: The prevalence of the AWGS sarcopenia was 33.3%. In the pre- and postoperative analyses, the L-H group had significantly poorer physical function and JOA score than the N-H group. Postoperatively, the A-S group only demonstrated poorer HGS., Conclusion: Preoperative physical function and JOA score was significantly poorer in the L-H group; physical function was significantly poorer even postoperatively. A HGS test is useful for detecting a decline in the pre- and postoperative physical function in females with hip osteoarthritis., (© 2021 Japan College of Rheumatology.)
- Published
- 2022
- Full Text
- View/download PDF
36. Change in leg length after open-wedge high tibial osteotomy can be predicted from the opening width: A three-dimensional analysis.
- Author
-
Yamamuro Y, Kabata T, Goshima K, Kajino Y, Inoue D, Ohmori T, Ueno T, Takagi T, Yoshitani J, Ueoka K, Taninaka A, and Tsuchiya H
- Subjects
- Aged, Arthroplasty, Replacement, Knee, Female, Humans, Knee surgery, Leg diagnostic imaging, Leg surgery, Male, Middle Aged, Postoperative Period, Retrospective Studies, Tibia diagnostic imaging, Tomography, X-Ray Computed, Virtual Reality, Leg anatomy & histology, Osteotomy methods, Tibia surgery
- Abstract
Background: The purpose of this study was to evaluate true change in leg length after open-wedge high tibial osteotomy (OWHTO) using three-dimensional (3D) assessments, examine the factors that influence leg lengthening and verify their validity in clinical practice., Methods: Study 1: a retrospective case series simulation study, included 46 patients (55 knees) that underwent knee arthroplasty or HTO. OWHTO was simulated from preoperative computed tomography using 3D preoperative planning software. Uni- and multivariate regression analyses were conducted to identify predictors related to change in leg length. Study 2: a retrospective case series study, included 53 patients (55 knees) that underwent OWHTO in another institution. Change in leg length was measured preoperatively and 1 year postoperatively and was compared with the predicted change in leg length calculated using the formula obtained from Study 1., Results: Study 1: the true change in leg length significantly increased and showed a strong correlation with the opening width. The change in leg length was predicted using the formula "change in leg length = opening width × 0.75-1.5." Study 2: the predicted change in leg length showed no significant difference from the change in leg length 1 year postoperatively and a strong correlation with the measured change., Conclusions: The true change in leg length after OWHTO was predicted using the formula obtained from the 3D model. Predicting the change in leg length preoperatively can be a basis to consider other HTOs., Competing Interests: Declaration of Competing Interest Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article., (Copyright © 2021 Elsevier B.V. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
37. The use of density mapping in the analysis of thigh pain after total hip arthroplasty in patients with well-fixed tapered wedge stems.
- Author
-
Yoshitani J, Kabata T, Kajino Y, Ohmori T, Ueno T, Ueoka K, and Tsuchiya H
- Subjects
- Aged, Arthroplasty, Replacement, Hip methods, Female, Humans, Male, Middle Aged, Pain, Postoperative etiology, Prosthesis Design, Retrospective Studies, Thigh, Tomography, X-Ray Computed methods, Arthroplasty, Replacement, Hip adverse effects, Femur diagnostic imaging, Femur surgery, Hip Prosthesis adverse effects, Pain, Postoperative prevention & control
- Abstract
Purpose: The mechanisms underlying thigh pain in patients with well-fixed cementless femoral components after total hip arthroplasty (THA) remains unclear. We hypothesized that the thigh pain is correlated with the initial contact state of the stem and aimed to investigate the relation between thigh pain and the initial contact state., Materials and Methods: A total of 209 hips of 184 patients were analysed in this retrospective case-control study. The patients were divided into a thigh pain group ( n = 13 hips) and a control group (without thigh pain, n = 196). Post-operative stem contact images were three-dimensionally visualized by a density mapping function using computed tomography data, which quantified the stem contact area according to Gruen zones. Thigh pain was defined as anterior or anterolateral pain upon loading at 3-month post-operatively., Results: Thirteen hips (6.2%) had thigh pain; however, all the hips demonstrated stable bony ingrowth radiographically. The thigh pain group had a significantly lower contact area in zone 2 ( p = 0.014). The multivariate logistic regression analysis showed that the contact area of zone 2 was negatively correlated with thigh pain [odds ratio (OR): 0.858, p = 0.018], and the canal flare index was negatively correlated with the development of thigh pain (OR: 0.336, p = 0.026)., Conclusions: We identified an association between the initial contact state and post-operative thigh pain. Our data demonstrated that proper lateral contact prevents the occurrence of thigh pain in THA using a tapered wedge stem.
- Published
- 2020
- Full Text
- View/download PDF
38. Three-dimensional limb lengthening after total knee arthroplasty in a simulation study.
- Author
-
Ohmori T, Kabata T, Kajino Y, Inoue D, Taga T, Yamamoto T, Takagi T, Yoshitani J, Ueno T, Ueoka K, and Tsuchiya H
- Subjects
- Aged, Computer Simulation, Contracture surgery, Female, Humans, Knee Joint surgery, Male, Arthroplasty, Replacement, Knee methods, Bone Lengthening methods, Imaging, Three-Dimensional methods, Leg Length Inequality diagnostic imaging, Leg Length Inequality etiology, Lower Extremity diagnostic imaging, Lower Extremity pathology, Osteoarthritis, Knee surgery
- Abstract
Objectives: Limb lengthening after total knee arthroplasty (TKA) has been reported in some cases, all of which were evaluated using two-dimensional images. To our knowledge, no case has been evaluated using three-dimensional (3D) images. We investigated 3D limb lengthening after TKA., Methods: We simulated 100 varus knees using 3D templating software. Virtual TKA was performed to maintain the original joint line by conducting a measured-resection technique. We examined the relationships of 3D distance between the femoral head center and ankle center before and after TKA, degree of hip-knee-ankle angle (HKA) improvement, and degree of flexion contracture angle improvement., Results: All cases showed limb lengthening (average, 9.4 ± 6.0 mm). The coefficients of correlation with limb lengthening and the degree of HKA improvement and the degree of flexion contracture angle improvement were good (0.730 and 0.751, respectively). The correlation between the degree of total improvement (the degree of HKA improvement + the degree of flexion contracture angle improvement) and limb lengthening was strong (r = 0.896)., Conclusion: The expected limb lengthening when performing measured-resection TKA is expressed as 0.58 × (the degree of HKA improvement + the degree of flexion contracture angle improvement) mm and is a useful index.
- Published
- 2018
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.