The aim of this study was to show a concrete setting landmark in two component types of round and anatomical oval shapes using three-dimensional (3D) simulation analyses in total knee arthroplasty (TKA).
Methods
The patellar resection surface was simulated three-dimensionally using preoperative CT data of 54 patients (68 knees) who underwent TKA with varus knee osteoarthritis. The mediolateral position of the original patellar ridge was examined. The round and anatomical oval patellar components were aligned in the following cases: medial edge setting, patellar ridge setting, maximal size setting. The component ridge position from the medial edge and size in each case were examined.
Results
The original patellar ridge was located nearly 40% from the medial edge. In aligning the component to reproduce the original patellar ridge, the medial bone width uncovered with the component was nearly 4 mm in both designs. The component size was significantly smaller as the component was placed more medially. In selecting the maximal size, the round component was aligned more laterally than the original patellar ridge. In contrast, the anatomical oval component enabled to be concomitant with a more appropriate position and size.
Conclusion
The position where the medial bone width uncovered with the component was nearly 4 mm, not the medial edge, was found as the best place to reproduce the original patellar ridge in both round and anatomical oval components. Specifically, the anatomical oval component might be more favorable with respect to the component position and size.
{"title":"Anatomical landmark for medialized patellar component in TKA","authors":"Ryosuke Tsurui , Shinya Kawahara , Satoshi Hamai , Yukio Akasaki , Hidetoshi Tsushima , Yasuhiko Kokubu , Taro Mawatari , Yasuharu Nakashima","doi":"10.1016/j.jjoisr.2023.12.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2023.12.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to show a concrete setting landmark in two component types of round and anatomical oval shapes using three-dimensional (3D) simulation analyses in total knee arthroplasty (TKA).</p></div><div><h3>Methods</h3><p>The patellar resection surface was simulated three-dimensionally using preoperative CT data of 54 patients (68 knees) who underwent TKA with varus knee osteoarthritis. The mediolateral position of the original patellar ridge was examined. The round and anatomical oval patellar components were aligned in the following cases: medial edge setting, patellar ridge setting, maximal size setting. The component ridge position from the medial edge and size in each case were examined.</p></div><div><h3>Results</h3><p>The original patellar ridge was located nearly 40% from the medial edge. In aligning the component to reproduce the original patellar ridge, the medial bone width uncovered with the component was nearly 4 mm in both designs. The component size was significantly smaller as the component was placed more medially. In selecting the maximal size, the round component was aligned more laterally than the original patellar ridge. In contrast, the anatomical oval component enabled to be concomitant with a more appropriate position and size.</p></div><div><h3>Conclusion</h3><p>The position where the medial bone width uncovered with the component was nearly 4 mm, not the medial edge, was found as the best place to reproduce the original patellar ridge in both round and anatomical oval components. Specifically, the anatomical oval component might be more favorable with respect to the component position and size.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 26-30"},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000415/pdfft?md5=4f2c65830304a8f8e6f50c20e22e10db&pid=1-s2.0-S2949705123000415-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139548394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-13DOI: 10.1016/j.jjoisr.2024.01.001
{"title":"Appreciation to reviewers in 2022–2023","authors":"","doi":"10.1016/j.jjoisr.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.01.001","url":null,"abstract":"","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Page 25"},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512400001X/pdfft?md5=8be41d889bfa5cc5eef3dd0fb67673f7&pid=1-s2.0-S294970512400001X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This prospective multicenter study investigated the implant fixation of a cementless cup in primary total hip arthroplasty (THA) for osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) in Japanese patients.
Methods
Ten hospitals in Japan were enrolled in this study. The cohort comprised 267 hips in 228 Japanese patients who underwent primary THA for OA secondary to DDH. An acetabular cup with advanced in-growth, GRIPTION™ coating, was used in all patients. Mean age at surgery was 66.9 (range 45–89) years, and 201 patients (239 hips) were female. Of these patients, 89.1 % (238/267) was Crowe group I. Radiolucent lines around the cup, osteolysis, cup migration, grafted bone status, and clinical scores were evaluated preoperatively and at 6 months, 1 year, and 2 years postoperatively. Adverse events were evaluated throughout the study. Implant survivorship was assessed using the Kaplan–Meier method.
Results
Nine hips had radiolucent lines ≥2 mm that resolved by 6 months. All cups showed bone in-growth and no cups loosened. At 2 years, the bone grafts had remodeled and incorporated in 68 % (43/63) of hips. There were four systemic and five surgical site events, and one procedure-related dislocation. The survivorship with cup revision as the endpoint was 99.6 % (95 % confidence interval, 97.3–99.9). All clinical scores were improved at 2 years compared with preoperatively (p < 0.01).
Conclusions
An advanced in-growth coated cup showed good fixation without complications in primary THA, even in patients with OA secondary to DDH.
{"title":"Implant fixation of primary total hip arthroplasty using a cementless cup for osteoarthritis secondary to developmental dysplasia of the hip: A prospective multicenter study in Japan","authors":"Ayumi Kaneuji , Hiroshi Imai , Ryo Sugama , Yoichi Ohta , Kiyokazu Fukui , Eiji Takahashi , Haruhiko Akiyama , Takaki Miyagawa , Junya Yoshitani , Hideki Fujii , Ayano Amagami , Minoru Watanabe , Takayuki Honda , Akihiko Maeda , Yoshihiro Nakamura , Naofumi Taniguchi , Jiro Ichikawa , David W. Fawley , Junko Yasuda","doi":"10.1016/j.jjoisr.2023.12.001","DOIUrl":"10.1016/j.jjoisr.2023.12.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This prospective multicenter study investigated the implant fixation of a cementless cup in primary total hip arthroplasty (THA) for osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) in Japanese patients.</p></div><div><h3>Methods</h3><p>Ten hospitals in Japan were enrolled in this study. The cohort comprised 267 hips in 228 Japanese patients who underwent primary THA for OA secondary to DDH. An acetabular cup with advanced in-growth, GRIPTION™ coating, was used in all patients. Mean age at surgery was 66.9 (range 45–89) years, and 201 patients (239 hips) were female. Of these patients, 89.1 % (238/267) was Crowe group I. Radiolucent lines around the cup, osteolysis, cup migration, grafted bone status, and clinical scores were evaluated preoperatively and at 6 months, 1 year, and 2 years postoperatively. Adverse events were evaluated throughout the study. Implant survivorship was assessed using the Kaplan–Meier method.</p></div><div><h3>Results</h3><p>Nine hips had radiolucent lines ≥2 mm that resolved by 6 months. All cups showed bone in-growth and no cups loosened. At 2 years, the bone grafts had remodeled and incorporated in 68 % (43/63) of hips. There were four systemic and five surgical site events, and one procedure-related dislocation. The survivorship with cup revision as the endpoint was 99.6 % (95 % confidence interval, 97.3–99.9). All clinical scores were improved at 2 years compared with preoperatively (p < 0.01).</p></div><div><h3>Conclusions</h3><p>An advanced in-growth coated cup showed good fixation without complications in primary THA, even in patients with OA secondary to DDH.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 19-24"},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000403/pdfft?md5=3a333e15021afbbfe592774ef589e352&pid=1-s2.0-S2949705123000403-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139111578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although good mid-term results of the first- and second-generation cementless stems have been reported, no study has compared outcomes between generations. This study aimed to compare the mid-term results of Accolade Ti–12Mo–6Zr–2Fe (TMZF) and Accolade II over a 5-year period.
Methods
This retrospective, single-institution, single-surgeon observational study included patients who underwent primary total hip arthroplasty using the Accolade TMZF (n = 71, group I) or Accolade II (n = 73, group II) between January 2009 and July 2015. Revision and conversion cases were excluded. Functional evaluations were performed using the Japanese Orthopaedic Association hip (JOA) score. Radiographic evaluations were performed using anteroposterior radiographs. Spot welds, radiolucency, cortical hypertrophy, and stress shielding around the stem were assessed for each Gruen zone. Subsidence and stem alignment were evaluated.
Results
The 5-year postoperative stem survival rate was 100% in both groups. The JOA score improved from 44.0 ± 10.2 to 90.6 ± 7.6 in group I and from 49.1 ± 10.1 to 91.7 ± 6.6 in group II. There were no significant differences in preoperative and postoperative JOA scores and subscale scores in either group. Significant spot welds were observed in group II in Gruen zones 3 and 5. Stress shielding progressed over time in both groups, and the prevalence of grade 3 shielding was significantly lower in group II (p = 0.028).
Conclusion
Both stems had a survival rate of 100%. The incidence of severe stress shielding seemed to be lower with Accolade II, but further investigations should be needed.
{"title":"Five-year clinical and radiographic outcomes of Accolade TMZF and Accolade II stem use","authors":"Ken Ueoka , Tamon Kabata , Yoshitomo Kajino , Daisuke Inoue , Takaaki Ohmori , Yuki Yamamuro , Atsushi Taninaka , Tomoyuki Kataoka , Yu Yanagi , Yoshitomo Saiki , Musashi Ima , Hiroyuki Tsuchiya","doi":"10.1016/j.jjoisr.2023.09.004","DOIUrl":"10.1016/j.jjoisr.2023.09.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Although good mid-term results of the first- and second-generation cementless stems have been reported, no study has compared outcomes between generations. This study aimed to compare the mid-term results of Accolade Ti–12Mo–6Zr–2Fe (TMZF) and Accolade II over a 5-year period.</p></div><div><h3>Methods</h3><p>This retrospective, single-institution, single-surgeon observational study included patients who underwent primary total hip arthroplasty using the Accolade TMZF (n = 71, group I) or Accolade II (n = 73, group II) between January 2009 and July 2015. Revision and conversion cases were excluded. Functional evaluations were performed using the Japanese Orthopaedic Association hip (JOA) score. Radiographic evaluations were performed using anteroposterior radiographs. Spot welds, radiolucency, cortical hypertrophy, and stress shielding around the stem were assessed for each Gruen zone. Subsidence and stem alignment were evaluated.</p></div><div><h3>Results</h3><p>The 5-year postoperative stem survival rate was 100% in both groups. The JOA score improved from 44.0 ± 10.2 to 90.6 ± 7.6 in group I and from 49.1 ± 10.1 to 91.7 ± 6.6 in group II. There were no significant differences in preoperative and postoperative JOA scores and subscale scores in either group. Significant spot welds were observed in group II in Gruen zones 3 and 5. Stress shielding progressed over time in both groups, and the prevalence of grade 3 shielding was significantly lower in group II (p = 0.028).</p></div><div><h3>Conclusion</h3><p>Both stems had a survival rate of 100%. The incidence of severe stress shielding seemed to be lower with Accolade II, but further investigations should be needed.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 7-12"},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000324/pdfft?md5=72147711666367a3c038fd66d6ca3e8c&pid=1-s2.0-S2949705123000324-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138502044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-06DOI: 10.1016/j.jjoisr.2023.09.005
Seiju Hayashi, Satoshi Miyazaki
Purpose
No previous report has compared the differences in postoperative functional outcomes between posterior cruciate ligament (PCL)-retaining (CR-) and PCL-sacrificing (CS-) total knee arthroplasty (TKA) with detailed intraoperative consideration of joint gap and balance. The purpose of this study was to evaluate the in vivo function of preserved PCL in TKA by comparing postoperative functional outcomes between CR- and CS-TKA with a cruciate-substituting insert (CS-insert), considering intraoperative influence factors, such as the posterior tibial slope, posterior condylar offset, joint gap, joint balance, and joint laxity.
Methods
A total of 55 knees in 38 patients (27 knees from 18 patients in the CR group, and 28 knees from 20 patients in the CS group) were analyzed. Fluoroscopic evaluation under anesthesia in sagittal laxity, rollback amount, and the maximum flexion angles were compared between the groups.
Results
There were no significant differences in intraoperative or postoperative all measurement values between the two groups, but the sagittal laxity was significantly smaller in the CR group [5.4% ± 4.5% (2.4 ± 2.1 mm)] than in the CS group [9.0 ± 3.8% (4.0 ± 1.7 mm)] (P < 0.01). There were no significant differences in the amount of rollback and postoperative maximum knee flexion angle between the groups.
Conclusions
Preserved PCL in TKA with a CS-insert contributed to knee sagittal stability, but not to rollback and deep knee flexion.
{"title":"Preserved posterior cruciate ligament contributed to knee sagittal stability, but not to rollback and deep knee flexion in cruciate-retaining total knee arthroplasty with a cruciate-substituting insert","authors":"Seiju Hayashi, Satoshi Miyazaki","doi":"10.1016/j.jjoisr.2023.09.005","DOIUrl":"10.1016/j.jjoisr.2023.09.005","url":null,"abstract":"<div><h3>Purpose</h3><p>No previous report has compared the differences in postoperative functional outcomes between posterior cruciate ligament (PCL)-retaining (CR-) and PCL-sacrificing (CS-) total knee arthroplasty (TKA) with detailed intraoperative consideration of joint gap and balance. The purpose of this study was to evaluate the in vivo function of preserved PCL in TKA by comparing postoperative functional outcomes between CR- and CS-TKA with a cruciate-substituting insert (CS-insert), considering intraoperative influence factors, such as the posterior tibial slope, posterior condylar offset, joint gap, joint balance, and joint laxity.</p></div><div><h3>Methods</h3><p>A total of 55 knees in 38 patients (27 knees from 18 patients in the CR group, and 28 knees from 20 patients in the CS group) were analyzed. Fluoroscopic evaluation under anesthesia in sagittal laxity, rollback amount, and the maximum flexion angles were compared between the groups.</p></div><div><h3>Results</h3><p>There were no significant differences in intraoperative or postoperative all measurement values between the two groups, but the sagittal laxity was significantly smaller in the CR group [5.4% ± 4.5% (2.4 ± 2.1 mm)] than in the CS group [9.0 ± 3.8% (4.0 ± 1.7 mm)] (<em>P</em> < 0.01). There were no significant differences in the amount of rollback and postoperative maximum knee flexion angle between the groups.</p></div><div><h3>Conclusions</h3><p>Preserved PCL in TKA with a CS-insert contributed to knee sagittal stability, but not to rollback and deep knee flexion.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 13-18"},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000336/pdfft?md5=4bf3b70b626b9483a7eb3bddeacd08eb&pid=1-s2.0-S2949705123000336-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138502045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-06DOI: 10.1016/j.jjoisr.2023.11.003
Ben Langley , Henrike Greaves , Chris Whelton , Richard Page , Mary Cramp , Stewart C. Morrison , Paola Dey , Tim Board
Purpose
The aim of the study was to determine the test-retest reliability of lower limb kinematic waveforms derived from 3D gait analysis (3DGA) in patients following total hip arthroplasty (THA).
Methods
Eight (7 M:1F; age: 70 ± 7 years; height: 1.68 ± 0.11 m; mass: 85 ± 20 kg) adults with a unilateral THA attended test and retest sessions. 3DGA was undertaken with participants walking at a self-selected pace along a 7 m walkway within each session. The standard error or the measurement (SEM) was calculated for hip, knee and ankle joint angles in all three planes, over the walking gait cycle.
Results
The SEM ranged from 2.9 to 4.1°, 2.7–3.7° and 1.9–3.9°, in the sagittal, frontal and traverse planes at the hip. At the knee the SEM ranged from 1.6 to 4.2°, 1.0–1.9° and 1.3–2.9° in the sagittal, frontal and transverse planes, respectively. While the SEM ranged from 0.7 to 2.0°, 1.2–2.3° and 2.9–4.0° in the sagittal, frontal and transverse planes at the ankle.
Conclusions
The findings demonstrate that 3DGA provides a reliable means of quantifying lower limb kinematics over the walking gait cycle in patients following THA, with all SEM values below the 5° threshold previously suggested to identify clinically meaningful differences. The SEM values reported may aid in the interpretation of changes in lower limb kinematics in patients following THA.
{"title":"Reliability of kinematic waveforms during gait analysis with total hip arthroplasty patients","authors":"Ben Langley , Henrike Greaves , Chris Whelton , Richard Page , Mary Cramp , Stewart C. Morrison , Paola Dey , Tim Board","doi":"10.1016/j.jjoisr.2023.11.003","DOIUrl":"10.1016/j.jjoisr.2023.11.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of the study was to determine the test-retest reliability of lower limb kinematic waveforms derived from 3D gait analysis (3DGA) in patients following total hip arthroplasty (THA).</p></div><div><h3>Methods</h3><p>Eight (7 M:1F; age: 70 ± 7 years; height: 1.68 ± 0.11 m; mass: 85 ± 20 kg) adults with a unilateral THA attended test and retest sessions. 3DGA was undertaken with participants walking at a self-selected pace along a 7 m walkway within each session. The standard error or the measurement (SEM) was calculated for hip, knee and ankle joint angles in all three planes, over the walking gait cycle.</p></div><div><h3>Results</h3><p>The SEM ranged from 2.9 to 4.1°, 2.7–3.7° and 1.9–3.9°, in the sagittal, frontal and traverse planes at the hip. At the knee the SEM ranged from 1.6 to 4.2°, 1.0–1.9° and 1.3–2.9° in the sagittal, frontal and transverse planes, respectively. While the SEM ranged from 0.7 to 2.0°, 1.2–2.3° and 2.9–4.0° in the sagittal, frontal and transverse planes at the ankle.</p></div><div><h3>Conclusions</h3><p>The findings demonstrate that 3DGA provides a reliable means of quantifying lower limb kinematics over the walking gait cycle in patients following THA, with all SEM values below the 5° threshold previously suggested to identify clinically meaningful differences. The SEM values reported may aid in the interpretation of changes in lower limb kinematics in patients following THA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000397/pdfft?md5=926b9ef5d567638b8f62039493ab1ca1&pid=1-s2.0-S2949705123000397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138502043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gram staining of joint fluid for the diagnosis of postoperative joint infection after total knee arthroplasty is considered to have limited efficacy because of the low sensitivity. However, the specificity of the gram staining is reported to be high in most reports. This study aimed to evaluate the sensitivity and specificity of the gram staining when used on the aspirated joint fluid in patients with suspected postoperative knee joint infection after total knee arthroplasty.
Methods
We retrospectively reviewed the reports of synovial fluid samples retrieved from suspected infected joints at eight hospitals between 2012 and 2019. A total of 179 samples of aspirated joint fluid from knee joints (80 culture-positive samples and 99 culture-negative samples) were evaluated in this study.
Results
Of the 80 gram stains performed on samples from infected patients, there were 60 true positives and 20 false negatives. In contrast, of the 99 stains performed on samples from aseptic knees, there were 99 true negatives and no false positives. The sensitivity and specificity for detecting periprosthetic knee infections were 75.0% and 100.0%, respectively. Further, we divided infected samples into the early aspiration group (within 14 days) and the late aspiration group (15 days or more) based on the duration between the onset of symptoms and aspiration. The sensitivity of the gram staining was 84.2% and 41.2% in the first and second groups, respectively.
Conclusions
In this study, gram staining of preoperatively aspirated joint fluid for the infected periprosthetic knee joint with short-lived symptoms showed high sensitivity.
{"title":"Gram staining of the preoperative joint aspiration for the diagnosis of infection after total knee arthroplasty","authors":"Yasuo Kunugiza , Masashi Tamaki , Takashi Miyamoto , Shigeyoshi Tsuji , Koichiro Takahi , Masataka Nishikawa , Ayanori Yoshida , Koji Nomura , Keiji Iwamoto , Toshitaka Fujito , Kentaro Toge , Teruya Ishibashi , Seiji Okada , Tetsuya Tomita","doi":"10.1016/j.jjoisr.2023.07.005","DOIUrl":"10.1016/j.jjoisr.2023.07.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Gram staining of joint fluid for the diagnosis of postoperative joint infection after total knee arthroplasty is considered to have limited efficacy because of the low sensitivity. However, the specificity of the gram staining is reported to be high in most reports. This study aimed to evaluate the sensitivity and specificity of the gram staining when used on the aspirated joint fluid in patients with suspected postoperative knee joint infection after total knee arthroplasty.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed the reports of synovial fluid samples retrieved from suspected infected joints at eight hospitals between 2012 and 2019. A total of 179 samples of aspirated joint fluid from knee joints (80 culture-positive samples and 99 culture-negative samples) were evaluated in this study.</p></div><div><h3>Results</h3><p>Of the 80 gram stains performed on samples from infected patients, there were 60 true positives and 20 false negatives. In contrast, of the 99 stains performed on samples from aseptic knees, there were 99 true negatives and no false positives. The sensitivity and specificity for detecting periprosthetic knee infections were 75.0% and 100.0%, respectively. Further, we divided infected samples into the early aspiration group (within 14 days) and the late aspiration group (15 days or more) based on the duration between the onset of symptoms and aspiration. The sensitivity of the gram staining was 84.2% and 41.2% in the first and second groups, respectively.</p></div><div><h3>Conclusions</h3><p>In this study, gram staining of preoperatively aspirated joint fluid for the infected periprosthetic knee joint with short-lived symptoms showed high sensitivity.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 175-178"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000245/pdfft?md5=44b38f6c2828ad122957d2e1ef340181&pid=1-s2.0-S2949705123000245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In Japan's super-aged society, medical care supporting the patients' quality of life (QOL) is becoming increasingly important. This study aimed to evaluate the current applications of patient-reported outcome measures (PROMs), with a focus on Japanese patients with hip osteoarthritis (OA) undergoing total hip arthroplasty (THA).
Methods
We reviewed the literature on PROMs, with a focus on (i) available guidelines, (ii) validated questionnaires in Japanese-version, and (iii) methods to assess responsiveness and interpretation.
Results
Several guidelines were available, including a checklist for methodological quality, the study protocol, and reporting of PROMs. The Short-Form 36/12-Item Health Survey is used for multidimensional evaluation. The EuroQol 5 dimension (EQ-5D) is the most commonly used preference-based utility. To assess disease-specific QOL in patients with hip OA undergoing THA, the Western Ontario and McMaster Universities Osteoarthritis Index, Oxford Hip Score, Hip Disability and Osteoarthritis Outcome Score, Forgotten Joint Score-12, and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire are used. The Central Sensitization Inventory can be used to assess central sensitivity syndrome. Ikigai-9 is used to assess ikigai (a comprehensive concept that gives meaning to life) and is also validated in English. The smallest detectable change (SDC) can be used to evaluate responsiveness. The minimal important change, minimal clinically important difference, and patient acceptable symptom state can be used to aid in interpreting results.
Conclusions
Several instruments and techniques are established to facilitate shared decision-making for Japanese patients undergoing THA to support their QOL. This review provides a broad overview of PROMs that can benefit future studies.
{"title":"Clinical evaluation of hip joint diseases: total hip arthroplasty to support patients’ quality of life","authors":"Satoshi Yamate , Satoshi Hamai , Stephen Lyman , Toshiki Konishi , Shinya Kawahara , Ryosuke Yamaguchi , Daisuke Hara , Goro Motomura","doi":"10.1016/j.jjoisr.2022.12.004","DOIUrl":"10.1016/j.jjoisr.2022.12.004","url":null,"abstract":"<div><h3>Purpose</h3><p>In Japan's super-aged society, medical care supporting the patients' quality of life (QOL) is becoming increasingly important. This study aimed to evaluate the current applications of patient-reported outcome measures (PROMs), with a focus on Japanese patients with hip osteoarthritis (OA) undergoing total hip arthroplasty (THA).</p></div><div><h3>Methods</h3><p>We reviewed the literature on PROMs, with a focus on (i) available guidelines, (ii) validated questionnaires in Japanese-version, and (iii) methods to assess responsiveness and interpretation.</p></div><div><h3>Results</h3><p>Several guidelines were available, including a checklist for methodological quality, the study protocol, and reporting of PROMs. The Short-Form 36/12-Item Health Survey is used for multidimensional evaluation. The EuroQol 5 dimension (EQ-5D) is the most commonly used preference-based utility. To assess disease-specific QOL in patients with hip OA undergoing THA, the Western Ontario and McMaster Universities Osteoarthritis Index, Oxford Hip Score, Hip Disability and Osteoarthritis Outcome Score, Forgotten Joint Score-12, and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire are used. The Central Sensitization Inventory can be used to assess central sensitivity syndrome. Ikigai-9 is used to assess <em>ikigai</em> (a comprehensive concept that gives meaning to life) and is also validated in English. The smallest detectable change (SDC) can be used to evaluate responsiveness. The minimal important change, minimal clinically important difference, and patient acceptable symptom state can be used to aid in interpreting results.</p></div><div><h3>Conclusions</h3><p>Several instruments and techniques are established to facilitate shared decision-making for Japanese patients undergoing THA to support their QOL. This review provides a broad overview of PROMs that can benefit future studies.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 18-25"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705122000044/pdfft?md5=574098424c9ffbc3caaf139348a2e670&pid=1-s2.0-S2949705122000044-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Residual anterior knee pain following total knee arthroplasty was reported to be related to high patellofemoral contact force. This study tried to show the relationship between patellar height and patellofemoral contact force in vivo, which has been demonstrated only in vitro thus far.
Methods
Fifty-five patients who had undergone a primary mobile-bearing posterior-stabilized total knee arthroplasty (28 cases using PFC Sigma and 27 cases using Attune) were included. After all the trial prostheses were placed, the patellar contact forces on the medial and lateral sides were measured using specially designed two uniaxial ultrathin force transducers at 0°–135° of knee flexion guided by the navigation system. Correlations between the pre-operative Insall-Salvati index and the medial or lateral patellar contact force in each flexion angle were analyzed using linear regression. Correlations between each patellar contact force and postoperative flexion angle were also assessed.
Result
There was a positive correlation between Insall-Salvati index and the lateral patellar contact force at 135° of flexion in all the patients, at 120° and 135° of flexion in patients with PFC Sigma and 135° of flexion in patients with Attune. The lateral patellar contact force at 120° and 135° of flexion in patients with PFC Sigma inversely correlated with postoperative flexion angle.
Conclusions
Patients with patella alta tended to demonstrate high lateral patellar contact force in deep knee flexion after total knee arthroplasty, which can affect the post operative flexion angle and should be treated to prevent residual anterior knee pain.
{"title":"The influence of patellar height on patellofemoral contact force during total knee arthroplasty","authors":"Naoki Nakano , Yuichi Kuroda , Masanori Tsubosaka , Tomoyuki Kamenaga , Kazunari Ishida , Shinya Hayashi , Takehiko Matsushita , Yuichi Hoshino , Ryosuke Kuroda , Tomoyuki Matsumoto","doi":"10.1016/j.jjoisr.2023.08.001","DOIUrl":"10.1016/j.jjoisr.2023.08.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Residual anterior knee pain following total knee arthroplasty was reported to be related to high patellofemoral contact force. This study tried to show the relationship between patellar height and patellofemoral contact force <em>in vivo</em>, which has been demonstrated only <em>in vitro</em> thus far.</p></div><div><h3>Methods</h3><p>Fifty-five patients who had undergone a primary mobile-bearing posterior-stabilized total knee arthroplasty (28 cases using PFC Sigma and 27 cases using Attune) were included. After all the trial prostheses were placed, the patellar contact forces on the medial and lateral sides were measured using specially designed two uniaxial ultrathin force transducers at 0°–135° of knee flexion guided by the navigation system. Correlations between the pre-operative Insall-Salvati index and the medial or lateral patellar contact force in each flexion angle were analyzed using linear regression. Correlations between each patellar contact force and postoperative flexion angle were also assessed.</p></div><div><h3>Result</h3><p>There was a positive correlation between Insall-Salvati index and the lateral patellar contact force at 135° of flexion in all the patients, at 120° and 135° of flexion in patients with PFC Sigma and 135° of flexion in patients with Attune. The lateral patellar contact force at 120° and 135° of flexion in patients with PFC Sigma inversely correlated with postoperative flexion angle.</p></div><div><h3>Conclusions</h3><p>Patients with patella alta tended to demonstrate high lateral patellar contact force in deep knee flexion after total knee arthroplasty, which can affect the post operative flexion angle and should be treated to prevent residual anterior knee pain.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 186-191"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000269/pdfft?md5=b235e08070319fd41e7584becd4cb00d&pid=1-s2.0-S2949705123000269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this study was to clarify the effect on medial and lateral soft tissue balance for different rotational positions of the balancer.
Methods
A total of 65 patients who were operated using a rotational mobile bearing total knee arthroplasty (TKA) have been evaluated. A new balancer was made so that the insert trial could be rotated on the paddle. We measured the angle of deviation to varus or valgus and the rotational angle of the insert trial at Akagi's line (group 0), at 20° of internal rotation from the Akagi's line (group IR), and at 20° of external rotation from the Akagi's line (group ER).
Results
The IR group had a significantly medial tightness than the other two groups. The ER group had a significantly lateral tightness than the other two groups. All cases were divided into three groups by the position of the insert (neutral, internal rotation and external rotation) on the balancer with respect to Akagi's line after range of motion (ROM) technique. In extension, a significant negative correlation was found between mean varus/valgus balance and rotation of the insert.
Conclusion
In mobile bearing TKA, it is possible to obtain the optimal medial and lateral soft tissue balance if the misalignment is within the possible range of rotation allowed by the design of the insert. Anatomical landmarks should also be referenced when determining tibial rotational alignment using the ROM technique, as it was easily influenced by medial and lateral soft tissue balance.
{"title":"Rotational position of ligament balancer affects medial and lateral soft tissue balance in total knee arthroplasty","authors":"Toru Yoshioka , Tokifumi Majima , Nobukazu Okimoto , Makoto Kawasaki , Yoshiaki Ikejiri , Takurou Ban , Fumihisa Saito , Hisanori Fujiwara","doi":"10.1016/j.jjoisr.2023.11.002","DOIUrl":"10.1016/j.jjoisr.2023.11.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to clarify the effect on medial and lateral soft tissue balance for different rotational positions of the balancer.</p></div><div><h3>Methods</h3><p>A total of 65 patients who were operated using a rotational mobile bearing total knee arthroplasty (TKA) have been evaluated. A new balancer was made so that the insert trial could be rotated on the paddle. We measured the angle of deviation to varus or valgus and the rotational angle of the insert trial at Akagi's line (group 0), at 20° of internal rotation from the Akagi's line (group IR), and at 20° of external rotation from the Akagi's line (group ER).</p></div><div><h3>Results</h3><p>The IR group had a significantly medial tightness than the other two groups. The ER group had a significantly lateral tightness than the other two groups. All cases were divided into three groups by the position of the insert (neutral, internal rotation and external rotation) on the balancer with respect to Akagi's line after range of motion (ROM) technique. In extension, a significant negative correlation was found between mean varus/valgus balance and rotation of the insert.</p></div><div><h3>Conclusion</h3><p>In mobile bearing TKA, it is possible to obtain the optimal medial and lateral soft tissue balance if the misalignment is within the possible range of rotation allowed by the design of the insert. Anatomical landmarks should also be referenced when determining tibial rotational alignment using the ROM technique, as it was easily influenced by medial and lateral soft tissue balance.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 246-252"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000385/pdfft?md5=ccfba5d8919dd7d00959042914742d08&pid=1-s2.0-S2949705123000385-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138395808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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