Pub Date : 2023-12-01DOI: 10.1016/j.jjoisr.2023.03.001
Umito Kuwashima
Purpose
High tibial osteotomy (HTO) is an effective treatment for knee osteoarthritis (OA) with varus deformity and has recently become one of the most prominent surgical techniques. The present study reviewed the past, current topics, and problems associated with HTO.
Methods
The history of HTO, long-term outcomes, associated factors after HTO, and current issues and topics are discussed.
Results
HTO can achieve relatively stable mid-to long-term results in OA with varus alignment. However, results for >15 years remain uncertain, with several studies reporting poor results after HTO at long-term follow-up. Factors associated with poorer clinical results include insufficient alignment correction resulting in varus deformity and advanced OA severity at initial surgery.
Conclusions
HTO is required to achieve stable and better long-term results to be adopted more widely in the future. To establish long-term HTO outcomes, more evidence is warranted, and treatment procedures, including combination therapies, must be improved.
{"title":"High tibial osteotomy: The past, present, and future","authors":"Umito Kuwashima","doi":"10.1016/j.jjoisr.2023.03.001","DOIUrl":"10.1016/j.jjoisr.2023.03.001","url":null,"abstract":"<div><h3>Purpose</h3><p>High tibial osteotomy (HTO) is an effective treatment for knee osteoarthritis (OA) with varus deformity and has recently become one of the most prominent surgical techniques. The present study reviewed the past, current topics, and problems associated with HTO.</p></div><div><h3>Methods</h3><p>The history of HTO, long-term outcomes, associated factors after HTO, and current issues and topics are discussed.</p></div><div><h3>Results</h3><p>HTO can achieve relatively stable mid-to long-term results in OA with varus alignment. However, results for >15 years remain uncertain, with several studies reporting poor results after HTO at long-term follow-up. Factors associated with poorer clinical results include insufficient alignment correction resulting in varus deformity and advanced OA severity at initial surgery.</p></div><div><h3>Conclusions</h3><p>HTO is required to achieve stable and better long-term results to be adopted more widely in the future. To establish long-term HTO outcomes, more evidence is warranted, and treatment procedures, including combination therapies, must be improved.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 103-107"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000105/pdfft?md5=7579af84884b4a0c12a867c0a059a393&pid=1-s2.0-S2949705123000105-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194869","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}
Following total hip arthroplasty (THA), anxiety about dislocation often limits patient's quality of life. However, the factors that cause anxiety about dislocation remain unclear. This study was an investigation of whether limited range of motion (ROM) at the hip before surgery is associated with anxiety about dislocation after THA.
Methods
A retrospective cohort study was performed using questionnaires and medical records. Questionnaires were mailed to 796 female patients who underwent THA at our hospital between April 2015 and August 2020. The questionnaire was to be self-administered and asked participants to select their level of anxiety about dislocation during activities of daily living from the following answer choices: non-anxious, anxious, and extremely anxious. Hip ROM was measured within 3 days before surgery. The association between anxiety about dislocation and hip ROM was evaluated using logistic regression analysis after adjusting for potentially relevant factors.
Results
In total, 513 (64.4%) patients responded to the questionnaire and were included in the analysis. Those patients who reporting feeling extremely anxious about dislocation after THA had limited hip flexion ROM. This association was independent of surgical approach and postoperative follow-up duration. A ROM of less than 80° during hip flexion was used to identify those respondents who reported extreme anxiety about dislocation.
Conclusion
The results of this study suggest that patients with a limited hip flexion ROM before THA may be extremely anxious about dislocation after THA.
{"title":"Relationship between preoperative hip range of motion and anxiety about dislocation after total hip arthroplasty","authors":"Atsushi Shinonaga , Hiromi Matsumoto , Mana Uekawa , Akiho Kuramoto , Shigeru Mitani , Hiroshi Hagino","doi":"10.1016/j.jjoisr.2023.07.001","DOIUrl":"10.1016/j.jjoisr.2023.07.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Following total hip arthroplasty (THA), anxiety about dislocation often limits patient's quality of life. However, the factors that cause anxiety about dislocation remain unclear. This study was an investigation of whether limited range of motion (ROM) at the hip before surgery is associated with anxiety about dislocation after THA.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was performed using questionnaires and medical records. Questionnaires were mailed to 796 female patients who underwent THA at our hospital between April 2015 and August 2020. The questionnaire was to be self-administered and asked participants to select their level of anxiety about dislocation during activities of daily living from the following answer choices: non-anxious, anxious, and extremely anxious. Hip ROM was measured within 3 days before surgery. The association between anxiety about dislocation and hip ROM was evaluated using logistic regression analysis after adjusting for potentially relevant factors.</p></div><div><h3>Results</h3><p>In total, 513 (64.4%) patients responded to the questionnaire and were included in the analysis. Those patients who reporting feeling extremely anxious about dislocation after THA had limited hip flexion ROM. This association was independent of surgical approach and postoperative follow-up duration. A ROM of less than 80° during hip flexion was used to identify those respondents who reported extreme anxiety about dislocation.</p></div><div><h3>Conclusion</h3><p>The results of this study suggest that patients with a limited hip flexion ROM before THA may be extremely anxious about dislocation after THA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 152-157"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000208/pdfft?md5=f6e2fb44d93b3a132256db1811f4b033&pid=1-s2.0-S2949705123000208-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195376","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 : 2023-12-01DOI: 10.1016/j.jjoisr.2023.10.002
Yasushi Oshima, Norishige Iizawa, Tokifumi Majima
Purpose
As postoperative knee instability has been reported to be one of the critical reasons for early failure in total knee arthroplasty (TKA), obtaining optimal knee stability—especially in medial—was indispensable for successful TKA. We hypothesized that preserving medial soft tissue structures was the key to maintain physiological medial knee stability. Thus, TKAs with preserving primary medial static stabilizer ligaments technique were performed, and the postoperative knee kinematics was evaluated.
Methods
Primary knee osteoarthritis patients with varus knee deformity and planed for primary TKA were enrolled. However, patients with severe varus knee deformities, valgus knee deformities, and rheumatoid arthritis were excluded. TKAs were performed by removing medial femoral and tibial osteophytes; however, the primary medial static stabilizer ligaments—the superficial medial collateral ligament (MCL), deep MCL, and posterior oblique ligament—were not released. The cruciate-retaining (CR), posterior-stabilized (PS), and medial-pivot (MP) inserts were implanted, and the knee kinematics was measured. These data were statistically analyzed using analysis of variance. The institutional review board approved the study.
Results
From full extension to maximum flexion, the lateral femoral condyle moved backward, greater than the medial femoral condyle, and consequently the femur external rotated on the tibia. These kinematics patterns were shown in CR, PS, and MP groups.
Conclusion
As the knee kinematics of CR and PS are similar to that of MP, which has been reported to demonstrate physiological knee kinematics, preserving primary medial static stabilizer ligaments technique could potentially preserve physiological knee kinematics.
{"title":"Preserving primary medial static stabilizer ligaments achieves physiological knee kinematics in total knee arthroplasty","authors":"Yasushi Oshima, Norishige Iizawa, Tokifumi Majima","doi":"10.1016/j.jjoisr.2023.10.002","DOIUrl":"10.1016/j.jjoisr.2023.10.002","url":null,"abstract":"<div><h3>Purpose</h3><p>As postoperative knee instability has been reported to be one of the critical reasons for early failure in total knee arthroplasty (TKA), obtaining optimal knee stability—especially in medial—was indispensable for successful TKA. We hypothesized that preserving medial soft tissue structures was the key to maintain physiological medial knee stability. Thus, TKAs with preserving primary medial static stabilizer ligaments technique were performed, and the postoperative knee kinematics was evaluated.</p></div><div><h3>Methods</h3><p>Primary knee osteoarthritis patients with varus knee deformity and planed for primary TKA were enrolled. However, patients with severe varus knee deformities, valgus knee deformities, and rheumatoid arthritis were excluded. TKAs were performed by removing medial femoral and tibial osteophytes; however, the primary medial static stabilizer ligaments—the superficial medial collateral ligament (MCL), deep MCL, and posterior oblique ligament—were not released. The cruciate-retaining (CR), posterior-stabilized (PS), and medial-pivot (MP) inserts were implanted, and the knee kinematics was measured. These data were statistically analyzed using analysis of variance. The institutional review board approved the study.</p></div><div><h3>Results</h3><p>From full extension to maximum flexion, the lateral femoral condyle moved backward, greater than the medial femoral condyle, and consequently the femur external rotated on the tibia. These kinematics patterns were shown in CR, PS, and MP groups.</p></div><div><h3>Conclusion</h3><p>As the knee kinematics of CR and PS are similar to that of MP, which has been reported to demonstrate physiological knee kinematics, preserving primary medial static stabilizer ligaments technique could potentially preserve physiological knee kinematics.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 228-233"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512300035X/pdfft?md5=c6ba4f5b760577f9f0b2e3bdec4e2b1b&pid=1-s2.0-S294970512300035X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92046708","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 : 2023-12-01DOI: 10.1016/j.jjoisr.2022.12.001
Goro Motomura
Purpose
Osteotomy is a joint-preserving procedure for the treatment of osteonecrosis of the femoral head. This article aimed to present current knowledge on the two types of femoral osteotomy, namely transtrochanteric rotational osteotomy of the femoral head and curved varus osteotomy of the proximal femur.
Methods
This clinical review summarizes the basic knowledge of each type of osteotomy and reviews the surgical outcomes.
Results
The most essential requirement for successful femoral osteotomy is adequate transposition of the intact articular surface of the femoral head to the weight-bearing portion of the hip joint. Appropriate surgical indications and accurate surgical techniques that replicate preoperative planning are required to achieve long-term success.
Conclusions
There will always be young patients for whom osteotomy is indicated. Therefore, we must continue to verify the results of the surgery and refine the techniques involved.
{"title":"Femoral osteotomy for osteonecrosis of the femoral head","authors":"Goro Motomura","doi":"10.1016/j.jjoisr.2022.12.001","DOIUrl":"10.1016/j.jjoisr.2022.12.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Osteotomy is a joint-preserving procedure for the treatment of osteonecrosis of the femoral head. This article aimed to present current knowledge on the two types of femoral osteotomy, namely transtrochanteric rotational osteotomy of the femoral head and curved varus osteotomy of the proximal femur.</p></div><div><h3>Methods</h3><p>This clinical review summarizes the basic knowledge of each type of osteotomy and reviews the surgical outcomes.</p></div><div><h3>Results</h3><p>The most essential requirement for successful femoral osteotomy is adequate transposition of the intact articular surface of the femoral head to the weight-bearing portion of the hip joint. Appropriate surgical indications and accurate surgical techniques that replicate preoperative planning are required to achieve long-term success.</p></div><div><h3>Conclusions</h3><p>There will always be young patients for whom osteotomy is indicated. Therefore, we must continue to verify the results of the surgery and refine the techniques involved.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 2-8"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705122000019/pdfft?md5=7fa83833cf2722427bf33f97c08d9dc8&pid=1-s2.0-S2949705122000019-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194871","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 : 2023-12-01DOI: 10.1016/j.jjoisr.2023.01.004
Hironobu Hoshino
Purpose
There are various pathologies of sports injuries that cause hip and groin pain. Sports-related hip pain is often difficult to diagnose and necessitates long-term suspension of sports activities. The purpose of this review is to provide an overview of sports-related hip pathologies and the results of various treatments in young athletes.
Methods
A systematic search was conducted to assess English-language articles indexed in the PubMed database within the past 15 years. The search terminology including sports, young athletes, femoroacetabular impingement (FAI), borderline dysplasia, labrum, and ligamentum teres was used to search for all relevant articles.
Results
The search identified 189 articles. After reviewing the articles, 61 articles were included in this literature review. Hip labrum injury, FAI, and ligamentum teres injury were common sports-related hip pathologies. Hip arthroscopic surgery was found to be a successful procedure in treating FAI and labral tears in young athletes.
Conclusions
Hip arthroscopic surgery is minimally invasive and serves both for diagnosis and treatment. Athletes undergoing arthroscopic hip surgery in the setting of hip labrum injury, FAI, and ligamentum teres injury exhibit significant functional improvement.
{"title":"Hip injuries in young athletes: intra-articular hip pathologies and treatments","authors":"Hironobu Hoshino","doi":"10.1016/j.jjoisr.2023.01.004","DOIUrl":"10.1016/j.jjoisr.2023.01.004","url":null,"abstract":"<div><h3>Purpose</h3><p>There are various pathologies of sports injuries that cause hip and groin pain. Sports-related hip pain is often difficult to diagnose and necessitates long-term suspension of sports activities. The purpose of this review is to provide an overview of sports-related hip pathologies and the results of various treatments in young athletes.</p></div><div><h3>Methods</h3><p>A systematic search was conducted to assess English-language articles indexed in the PubMed database within the past 15 years. The search terminology including sports, young athletes, femoroacetabular impingement (FAI), borderline dysplasia, labrum, and ligamentum teres was used to search for all relevant articles.</p></div><div><h3>Results</h3><p>The search identified 189 articles. After reviewing the articles, 61 articles were included in this literature review. Hip labrum injury, FAI, and ligamentum teres injury were common sports-related hip pathologies. Hip arthroscopic surgery was found to be a successful procedure in treating FAI and labral tears in young athletes.</p></div><div><h3>Conclusions</h3><p>Hip arthroscopic surgery is minimally invasive and serves both for diagnosis and treatment. Athletes undergoing arthroscopic hip surgery in the setting of hip labrum injury, FAI, and ligamentum teres injury exhibit significant functional improvement.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 41-45"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512300004X/pdfft?md5=956ba841808416ca33386fc03c443353&pid=1-s2.0-S294970512300004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194905","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}
Graft failure or recurrence of instability without obvious trauma remains one of the problems following anterior cruciate ligament (ACL) reconstruction. This retrospective study aimed to identify risk factors for abnormal knee laxity after anatomical ACL reconstruction.
Methods
A total of 291 patients who underwent primary anatomical ACL reconstruction were included in this study. Sex, age, body mass index (BMI), time to surgery, medial meniscal status, lateral meniscal status, graft materials, initial graft tension protocol, preoperative and postoperative pivot shift test and side-to-side differences in anterior tibial translation using the arthrometer were reviewed. Abnormal knee laxity was defined as constituting one or both of the following criteria: (i) a side-to-side difference of ≥3 mm by arthrometer; and (ii) a positive pivot shift test, being “glide,” “clunk”, or “gross”.
Results
Abnormal knee laxity occurred in 30 patients (10.3%) at a median follow-up of 25 months. Results of univariate analysis indicated that a higher likelihood of abnormal knee laxity was associated with female sex, greater BMI, longer time to surgery, higher initial graft tension protocol, and lateral meniscus resection. Multivariate logistic regression analysis showed that abnormal knee laxity was significantly associated with time to surgery [1-month increase; odds ratio (OR), 1.01], higher initial graft tension protocol (vs. lower tension; OR, 3.5), and lateral meniscus resection (vs. intact and repaired lateral meniscus; OR, 12.8).
Conclusion
Higher initial graft tension protocol, chronicity of ACL deficiency, and lateral meniscus resection were risk factors for abnormal knee laxity after anatomical ACL reconstruction.
{"title":"Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction","authors":"Shuji Taketomi, Ryota Yamagami, Kohei Kawaguchi, Kenichi Kono, Ryo Murakami, Tomofumi Kage, Takahiro Arakawa, Hiroshi Inui, Sakae Tanaka","doi":"10.1016/j.jjoisr.2022.12.005","DOIUrl":"10.1016/j.jjoisr.2022.12.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Graft failure or recurrence of instability without obvious trauma remains one of the problems following anterior cruciate ligament (ACL) reconstruction. This retrospective study aimed to identify risk factors for abnormal knee laxity after anatomical ACL reconstruction.</p></div><div><h3>Methods</h3><p>A total of 291 patients who underwent primary anatomical ACL reconstruction were included in this study. Sex, age, body mass index (BMI), time to surgery, medial meniscal status, lateral meniscal status, graft materials, initial graft tension protocol, preoperative and postoperative pivot shift test and side-to-side differences in anterior tibial translation using the arthrometer were reviewed. Abnormal knee laxity was defined as constituting one or both of the following criteria: (i) a side-to-side difference of ≥3 mm by arthrometer; and (ii) a positive pivot shift test, being “glide,” “clunk”, or “gross”.</p></div><div><h3>Results</h3><p>Abnormal knee laxity occurred in 30 patients (10.3%) at a median follow-up of 25 months. Results of univariate analysis indicated that a higher likelihood of abnormal knee laxity was associated with female sex, greater BMI, longer time to surgery, higher initial graft tension protocol, and lateral meniscus resection. Multivariate logistic regression analysis showed that abnormal knee laxity was significantly associated with time to surgery [1-month increase; odds ratio (OR), 1.01], higher initial graft tension protocol (<em>vs.</em> lower tension; OR, 3.5), and lateral meniscus resection (<em>vs.</em> intact and repaired lateral meniscus; OR, 12.8).</p></div><div><h3>Conclusion</h3><p>Higher initial graft tension protocol, chronicity of ACL deficiency, and lateral meniscus resection were risk factors for abnormal knee laxity after anatomical ACL reconstruction.</p></div><div><h3>Level of evidence</h3><p>Level III retrospective prognostic study.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 26-31"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705122000056/pdfft?md5=96802dcf050a28c65d71cc1a764acf2f&pid=1-s2.0-S2949705122000056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194808","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}
Clinical evidence of risk factors for union failure at osteotomy sites after total hip arthroplasty (THA) using subtrochanteric shortening osteotomy (SSO) in patients with high hip dislocations is limited because of the rarity of this dislocation type. The aim of this study was to identify the factors influencing bone union at osteotomy sites in patients with high hip dislocations undergoing this procedure.
Methods
This retrospective, case-control study included a total of 28 hips of 24 patients with high hip dislocations who had undergone THA using SSO at a single institution from 1993 to 2018. Fourteen hips were categorized into the union-failure group at 6 months after surgery and compared with a control group including the other 14 hips. We compared various demographic, clinical, and radiological characteristics between the two groups, including age, sex, body mass index, cement usage of stem, stem bypass characteristics, clinical evaluations, and implant survival.
Results
The union-failure group had inferior results for clinical evaluations and implant survival. Multivariable analysis found that the stem bypass ratio was significantly shorter in the union-failure group than in the control group (48 vs 64%; odds ratio, 1.18; 95% confidence interval, 1.02 to 1.38; p = .028).
Conclusion
Our results demonstrated that shorter stem bypasses were related to union failure at osteotomy sites in patients with high hip dislocations who underwent THA using SSO. We recommend that the femoral stem be inserted more than 50% of the stem length below the osteotomy site, especially for cemented THA.
{"title":"Association between stem bypass and union failure of subtrochanteric shortening osteotomy in total hip arthroplasty for high hip dislocations","authors":"Kazuya Makida, Taisuke Seki, Yasuhiko Takegami, Yusuke Osawa, Shiro Imagama","doi":"10.1016/j.jjoisr.2023.03.002","DOIUrl":"10.1016/j.jjoisr.2023.03.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Clinical evidence of risk factors for union failure at osteotomy sites after total hip arthroplasty (THA) using subtrochanteric shortening osteotomy (SSO) in patients with high hip dislocations is limited because of the rarity of this dislocation type. The aim of this study was to identify the factors influencing bone union at osteotomy sites in patients with high hip dislocations undergoing this procedure.</p></div><div><h3>Methods</h3><p>This retrospective, case-control study included a total of 28 hips of 24 patients with high hip dislocations who had undergone THA using SSO at a single institution from 1993 to 2018. Fourteen hips were categorized into the union-failure group at 6 months after surgery and compared with a control group including the other 14 hips. We compared various demographic, clinical, and radiological characteristics between the two groups, including age, sex, body mass index, cement usage of stem, stem bypass characteristics, clinical evaluations, and implant survival.</p></div><div><h3>Results</h3><p>The union-failure group had inferior results for clinical evaluations and implant survival. Multivariable analysis found that the stem bypass ratio was significantly shorter in the union-failure group than in the control group (48 vs 64%; odds ratio, 1.18; 95% confidence interval, 1.02 to 1.38; p = .028).</p></div><div><h3>Conclusion</h3><p>Our results demonstrated that shorter stem bypasses were related to union failure at osteotomy sites in patients with high hip dislocations who underwent THA using SSO. We recommend that the femoral stem be inserted more than 50% of the stem length below the osteotomy site, especially for cemented THA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 80-85"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000117/pdfft?md5=7a0bd43fa08c59ac2e5da5228f5618e6&pid=1-s2.0-S2949705123000117-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194865","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 : 2023-12-01DOI: 10.1016/j.jjoisr.2023.01.003
Shuichi Matsuda
{"title":"A new journal for joint surgery!","authors":"Shuichi Matsuda","doi":"10.1016/j.jjoisr.2023.01.003","DOIUrl":"10.1016/j.jjoisr.2023.01.003","url":null,"abstract":"","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Page 1"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000038/pdfft?md5=4a5668504b05c68f0ef2f9e70407ab54&pid=1-s2.0-S2949705123000038-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194872","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}
Postoperative periprosthetic femoral fracture (PPFF) is one of the major complications following total hip arthroplasty (THA). The purpose of this study was to investigate the epidemiology of early PPFF (within 90 days) after THA.
Methods
Primary THA was performed for hip osteoarthritis through a direct anterior approach in 6769 cases. Among these, we retrospectively investigated the occurrence of postoperative PPFF that required surgical intervention.
Results
Postoperative PPFF was seen in 29 hips (29/6769; 0.43%), and the mean period from primary THA to fracture occurrence was 9.2 ± 8.5 days. Of these, 13 (13/2170; 0.60%) fractures were observed in prosthesis with flat tapered-wedge stems, 7 (7/1652; 0.42%) in straight tapered stems, 4 (4/1082; 0.37%) in cemented stems, and 1 (1/1.060; 0.09%) in collared fully hydroxyapatite-coated stem. The prevalence of PPFF in collared fully hydroxyapatite-coated stems was significantly lower than that of flat tapered-wedge stems. Five hips (5/29; 17.2%) required re-surgical intervention.
Conclusion
Our results indicate that, compared to the flat tapered-wedge stem, use of the collared fully hydroxyapatite-coated stem decreases the risk of early postoperative PPFF following direct anterior THA.
{"title":"Collared fully hydroxyapatite-coated stem decreases the risk of early postoperative periprosthetic femoral fracture after direct anterior total hip arthroplasty","authors":"Tatsuya Tamaki , Tetsuya Kimura , Yoko Miura , Kazuhiro Oinuma","doi":"10.1016/j.jjoisr.2023.05.002","DOIUrl":"10.1016/j.jjoisr.2023.05.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Postoperative periprosthetic femoral fracture (PPFF) is one of the major complications following total hip arthroplasty (THA). The purpose of this study was to investigate the epidemiology of early PPFF (within 90 days) after THA.</p></div><div><h3>Methods</h3><p>Primary THA was performed for hip osteoarthritis through a direct anterior approach in 6769 cases. Among these, we retrospectively investigated the occurrence of postoperative PPFF that required surgical intervention.</p></div><div><h3>Results</h3><p>Postoperative PPFF was seen in 29 hips (29/6769; 0.43%), and the mean period from primary THA to fracture occurrence was 9.2 ± 8.5 days. Of these, 13 (13/2170; 0.60%) fractures were observed in prosthesis with flat tapered-wedge stems, 7 (7/1652; 0.42%) in straight tapered stems, 4 (4/1082; 0.37%) in cemented stems, and 1 (1/1.060; 0.09%) in collared fully hydroxyapatite-coated stem. The prevalence of PPFF in collared fully hydroxyapatite-coated stems was significantly lower than that of flat tapered-wedge stems. Five hips (5/29; 17.2%) required re-surgical intervention.</p></div><div><h3>Conclusion</h3><p>Our results indicate that, compared to the flat tapered-wedge stem, use of the collared fully hydroxyapatite-coated stem decreases the risk of early postoperative PPFF following direct anterior THA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 128-132"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000166/pdfft?md5=d74344d55edf511e8617659eff5cf530&pid=1-s2.0-S2949705123000166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194873","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}
Attempts have been made to enhance knee prostheses design to improve clinical outcomes including bi-cruciate stabilized (BCS) TKA design and single-radius (SR) femoral component design. The complication rate of first generation BCS (fBCS) TKA was higher than that of standard TKA. Regarding BCS TKA, modification of the fBCS TKA system to the second-generation BCS (sBCS) TKA system was performed to avoid complications. This study aimed to compare the midterm clinical results of sBCS TKA and SR TKA.
Methods
We retrospectively reviewed data from TKA patients. A total of 142 patients who were followed up for at least 5 years were enrolled: 61 TKAs using sBCS and 81 TKAs using the posterior stabilized (PS) single-radius (SR) design. The clinical results at 6 months, 2 years, and 5 years postoperatively were compared between the sBCS and SR PS groups.
Results
At 6 months postoperatively, the maximum flexion angle (MFA) of the sBCS group was larger than that of the SR PS group. At 2 years, MFA, KOOS subscales of pain and ADL in the sBCS group were better and at 5 years, the MFA, KOOS subscales of pain and QOL in the sBCS group were better than those in the SR group. There was no significant differences of the ratios of complications and revision surgeries between the two groups.
Conclusion
The midterm clinical results of sBCS TKA were better than those of SR PS TKA in terms of the MFA and KOOS subscales of pain and QOL.
{"title":"Midterm clinical results of bi-cruciate stabilized total knee arthroplasty compared with posterior stabilized total knee arthroplasty with single radius design","authors":"Hiroshi Inui , Ryota Yamagami , Kenichi Kono , Kohei Kawaguchi , Shuji Taketomi , Kazuo Saita , Sakae Tanaka","doi":"10.1016/j.jjoisr.2023.04.001","DOIUrl":"10.1016/j.jjoisr.2023.04.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Attempts have been made to enhance knee prostheses design to improve clinical outcomes including bi-cruciate stabilized (BCS) TKA design and single-radius (SR) femoral component design. The complication rate of first generation BCS (fBCS) TKA was higher than that of standard TKA. Regarding BCS TKA, modification of the fBCS TKA system to the second-generation BCS (sBCS) TKA system was performed to avoid complications. This study aimed to compare the midterm clinical results of sBCS TKA and SR TKA.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed data from TKA patients. A total of 142 patients who were followed up for at least 5 years were enrolled: 61 TKAs using sBCS and 81 TKAs using the posterior stabilized (PS) single-radius (SR) design. The clinical results at 6 months, 2 years, and 5 years postoperatively were compared between the sBCS and SR PS groups.</p></div><div><h3>Results</h3><p>At 6 months postoperatively, the maximum flexion angle (MFA) of the sBCS group was larger than that of the SR PS group. At 2 years, MFA, KOOS subscales of pain and ADL in the sBCS group were better and at 5 years, the MFA, KOOS subscales of pain and QOL in the sBCS group were better than those in the SR group. There was no significant differences of the ratios of complications and revision surgeries between the two groups.</p></div><div><h3>Conclusion</h3><p>The midterm clinical results of sBCS TKA were better than those of SR PS TKA in terms of the MFA and KOOS subscales of pain and QOL.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 117-122"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000142/pdfft?md5=cede56a722cc7d6c7515deb04906ca92&pid=1-s2.0-S2949705123000142-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194875","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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