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The purpose of this paper is to prove the reliability of artificial hip joints’ surface generated by the electrolytically treated grinding process; the evaluation was carried out in a hip simulator and animal tests. The evaluation indicated that the fabricated hyper-hemispherical shaped artificial hip joints presented a high quality smoother surface than 10 nm in Ra. The fabricated surface also showed its ability to prevent crystalline phase transition during the hip simulation test, suggesting that the stably modified layer was generated via grinding process. The results of animal test showed that the fabricated surface could have a highly-improved biocompatibility. more...

Toolpath generation for a multi-axis medical machine tool is a challenging task. In surgical procedures, it is difficult to apply industrial CAM technology owing to the requirement for quick toolpath generation and the likelihood of tool interference with complex structures of the target area. The objectives of this study are to optimize the initial position and posture of the cutting tool for performing the ideal skin incision and to minimize contact between the cutting tool and the surrounding area. We propose a novel toolpath strategy based on geometric models. It can be potentially applied to general machine-assisted surgeries. more...

Optimal control of the machining process in orthopedic surgery can not only increase productivity but also ensure safety during tool usage. The authors have developed a technology for a force control system. The system has two modes of operation: the “air-cutting mode” and the “force control mode.” In the air-cutting mode, tool feed is scheduled by predicting the air and bone-cutting zones from the CAD/CAM system. In the force control mode, the software monitors the cutting force and the cutting temperature, and it controls the feed override according to the difference between the real and the desired cutting force. The software is installed on a robot controller, and its effectiveness is evaluated with a urethane bone. more...

In successful knee arthroplasty, the femur and the tibia must be shaped to fit an artificial joint. The recent trend towards MIS (Minimally Invasive Surgery) to decrease the length of the required incision in the skin has increased surgical difficulty, since the open access area is small. The developed system consists of (1) a preplanning system providing a CAD function, (2) a multi-axis CAM system which avoids cutting the skin and the ligament, and keeps the cutting time within acceptable limits, and (3) a 7-axis machine tool that assures the safety of the patient and the surgeon, and enables MIS. more...

Bone cutting experiments were conducted on a cadaver using a newly developed machine tool. The effectiveness of the system was evaluated by comparing the planned shape for the mating surface between the femur and an artificial joint with the cutting result. It is desirable to know the machining phenomena and characteristics at the microscale because the material and the tissue structure are anisotropic in both cortical and cancellous bones. In the paper, the influence of the material characteristics on machining is discussed for cortical bone. Pig cortical bone was used in the experiment for visualizing 2-dimensional micro-cutting. more...

Regional gene therapy, which involves the delivery of growth factors to a specific anatomic site, has the potential to enhance bone formation in clinical application. Helper-dependent adenoviral vectors, which have deleted all of the viral coding regions, have been shown to be safe and highly efficient with long-lasting transgene expression. In this study, we constructed a helper-dependent adenoviral vector producing bone morphogenetic protein-2 (AdHDBMP-2). The AdHDBMP-2 increased the alkaline phosphatase activity of W-20-17 cells in vitro. In addition, when AdHDBMP-2 infected rat bone marrow cells were implanted into the hindlimbs of SCID mice, orthotopic bone formation was shown at 2 weeks. To our knowledge, this is the first study to demonstrate bone formation with the helper-dependent adenoviral vector with the BMP-2 expression cassette. This type of gene therapy vector could prove to be highly useful for bone augmentation in patients with bone loss associated with trauma, revision total joint arthroplasty, or cancer. more...

We measured the cross-sectional area (CSA) of the semitendinosus tendon (SMT) in 79 anterior cruciate ligament (ACL)-injured patients using magnetic resonance imaging (MRI) to scrutinize their appropriateness for ACL grafts. Measurements of the CSAs of the SMT with MRI were closely correlated with intraoperative direct measurement (y = 0.697). The mean CSAs of the SMT measured with MRI ranged from 6.3 to 15.0 mm2 with a mean of 10.1+/-2.1 mm2. The CSA of the SMT measured with MRI proved to be a useful indicator to determine preoperatively whether the SMT graft would be of adequate dimensions (7 mm or more in diameter, 60 mm or more in length) for ACL reconstruction. If the CSA of the SMT was more than 11 mm2, a sufficiently thick and long graft could be prepared with a tripled or quadrupled SMT in 89% of cases. We conclude that tissue CSA measurements using MRI could potentially be implemented as a useful tool for determining the most appropriate donor autograft tissue preoperatively, thus minimizing harvest-site morbidity. more...

Clinical and radiographic studies were performed on 228 hips of 145 patients with avascular necrosis of the femoral head (ANFH). The patients were divided into three groups: group A consisted of 33 patients with systemic lupus erythematosus (SLE) who had been treated with systemic corticosteroids (59 hips); group B consisted of 41 patients with a history of corticosteroid treatment, excluding patients with SLE (69 hips); and group C consisted of 71 patients with no history of corticosteroid use (100 hips). Of the 228 hips, 80 hips at an early stage of the necrosis, but not showing collapse, were selected and classified by the criteria of the Japanese Investigation Committee (JIC) to define the natural history of the disease. In the SLE patients (group A), there was a predisposition to bilateral involvement and multiple sites of bone necrosis. Eighty percent of the femoral heads followed at an early stage had collapsed at the end of the follow-up, the incidence of collapse in group A being higher than that in the other groups. The collapses in group A were predominantly types 1C, 2, and 3B according to the JIC criteria. The incidence of collapse was significantly lower in type 1A and type 3A than in the other types. The classification proposed by the JIC, in terms of types with regard to size and location of the necrotic area on antero-posterior radiographs, was very useful for evaluation of the risk of collapse as well as for selecting appropriate treatment modalities, either conservative or surgical, during the early stages of ANFH. more...

We have cloned and characterized cDNAs encoding the alpha 1 chain of type XV collagen from a human placenta library. Using primer extension cloning we extended the cDNAs to the 5' end of the mRNA and determined the complete deduced primary structure of the human alpha 1(XV) chain. The polypeptide chain contains nine triple helical domains separated by eight non-triple helical regions and flanked by large amino-terminal (555 amino acid residues) and carboxyl-terminal (256 amino acid residues) non-triple helical domains. Comparison of amino acid sequences of the human alpha 1(XV) chain with those of mouse alpha 1(XVIII) collagen showed remarkable similarity within both amino- and carboxyl-terminal non-triple helical domains. Within the carboxyl third of the amino-terminal domain a tandem repeat structure is found with an about 45-amino acid residue sequence repeated four times. This amino acid sequence has a strikingly high similarity to rat cartilage proteoglycan core protein. Northern blot analysis of human embryonic RNA revealed that alpha 1(XV) mRNA is expressed predominantly in internal organs such as the adrenal gland, kidney, and pancreas. more...

Type IX collagen is a newly discovered collagen molecule that is associated with Type II-containing collagen fibrils in cartilage, vitreous and embryonic cornea. It consists of three distinct chains: alpha 1(IX), alpha 2(IX) and alpha 3(IX). The alpha 1(IX) chain has been to be synthesized in two different forms, which are generated by alternative transcription and splicing. In this manuscript we describe the isolation and sequencing of a cDNA coding for the entire coding region of the long form of mouse alpha 1(IX) chain. Nucleotide sequence analysis of this cDNA determined for the first time the primary structure of the entire long form of the mouse alpha 1(IX) chain. RT-PCR was used to examine collagen gene expression during limb development from day 10 to 18 in mouse embryos. Collagen I and II mRNA levels gradually increased all through the developmental stages. Collagen X expression increased further after day 16 in limb development, whereas the alpha 1(IX)mRNA level dropped at this time. This could be due to active bone formation relative to cartilage synthesis in the embryonic limb bud around day 16 in mouse development. more...

We have isolated mouse cDNA clones that encode a newly discovered collagenous polypeptide. Four overlapping cDNA clones contained an open reading frame of 1140 amino acid residues of collagenous and non-collagenous domains. The predicted polypeptide consists of 10 collagenous domains of various length that are interrupted by 11 noncollagenous domains. The overall structural arrangement differed significantly from reported collagen chains of 17 different types. Northern-blot analyses showed hybridization of the cDNA to 5.6kb and 4.8kb mRNA species in liver and kidney that are due to utilization of the two poly (A) signals. more...