Pub Date : 2024-09-01DOI: 10.1016/j.jos.2024.06.006
Background
Some young physicians decide their ultimate life goals early in life. The purpose of this article is to convey the message with feeling that because everyone lives only once, I want them to try many various things.
Method
The author introduces several unpredictable episodes that became watershed moments for him, and describes how he each behaved.
Results
Although all of the episodes were unexpected, they all shared a common thread that ultimately led the author in a positive direction. I made the decision to not build walls for myself before I even began, and to think about how I wanted to be a more evolved version of myself in the future than I am today.
Conclusion
I would like to convey this message to young physicians to encourage them. To act, you must be determined, and to resolve, you must have a dream. As long as you have a dream and work hard, you can achieve your dreams.
{"title":"“As long as you have a dream and as long as you work hard, your dream will come true”","authors":"","doi":"10.1016/j.jos.2024.06.006","DOIUrl":"10.1016/j.jos.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><p>Some young physicians decide their ultimate life goals early in life. The purpose of this article is to convey the message with feeling that because everyone lives only once, I want them to try many various things.</p></div><div><h3>Method</h3><p>The author introduces several unpredictable episodes that became watershed moments for him, and describes how he each behaved.</p></div><div><h3>Results</h3><p>Although all of the episodes were unexpected, they all shared a common thread that ultimately led the author in a positive direction. I made the decision to not build walls for myself before I even began, and to think about how I wanted to be a more evolved version of myself in the future than I am today.</p></div><div><h3>Conclusion</h3><p>I would like to convey this message to young physicians to encourage them. To act, you must be determined, and to resolve, you must have a dream. As long as you have a dream and work hard, you can achieve your dreams.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1159-1161"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jos.2024.04.011
{"title":"Comment on Ohyama et al.: Does vacuum phenomenon at non-fused discs affect the postoperative course after transforaminal lumbar interbody fusion in patients showing a positive value of difference in lumbar lordosis?","authors":"","doi":"10.1016/j.jos.2024.04.011","DOIUrl":"10.1016/j.jos.2024.04.011","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1329-1330"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jos.2023.08.001
Background
Kinematic and mechanical alignment outcomes in total knee arthroplasty remain controversial. This study compared the clinical and radiological outcomes of total knee arthroplasty using kinematic and mechanical alignments.
Methods
We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled trials and cohort studies published before November 2022. The data of interest were extracted and analyzed using Review Manager V.5.4.
Results
Nineteen randomized controlled trials and cohort studies involving 880 kinematic alignment total knee arthroplasties and 965 mechanical alignment total knee arthroplasties were included. In this meta-analysis, the kinematic alignment group achieved better knee joint function scores, including the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, and Knee Society Score, and better flexion angles. No statistical differences were detected in the Western Ontario and McMaster Universities Osteoarthritis Index, extension angle, Forgotten Joint Score, European Quality of Life five-dimension measure, hip–knee–ankle angle, or complications between the kinematic and mechanical alignment groups.
Conclusion
This meta-analysis indicated that kinematic alignment total knee arthroplasty provides clinical benefits in terms of the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, Knee Society Score (knee), Knee Society Score (function), and better flexion angles. In addition, kinematic alignment total knee arthroplasty led to similar clinical outcomes as mechanical alignment total knee arthroplasty without increasing complications.
背景全膝关节置换术中的运动学对位和机械对位结果仍存在争议。本研究比较了使用运动学对位和机械对位的全膝关节置换术的临床和放射学结果。方法我们系统地检索了PubMed、EMBASE、Web of Science和Cochrane Library数据库中2022年11月之前发表的随机对照试验和队列研究。结果纳入了19项随机对照试验和队列研究，涉及880例运动学配位全膝关节置换术和965例机械配位全膝关节置换术。在这项荟萃分析中，运动学对位组获得了更好的膝关节功能评分，包括牛津膝关节评分、膝关节损伤和骨关节炎结果评分、膝关节社会评分，以及更好的屈曲角度。在西安大略和麦克马斯特大学骨关节炎指数、伸展角度、遗忘关节评分、欧洲生活质量五维测量、髋关节-膝关节-踝关节角度或并发症方面，运动对齐组和机械对齐组之间未发现统计学差异。结论这项荟萃分析表明，在牛津膝关节评分、膝关节损伤和骨关节炎结果评分、膝关节社会评分（膝关节）、膝关节社会评分（功能）和更好的屈曲角度方面，运动学对位全膝关节置换术具有临床优势。此外，运动定位全膝关节置换术的临床效果与机械定位全膝关节置换术相似，且并发症不会增加。系统综述注册http://www.crd.york.ac.uk/PROSPERO/CRD42022373227。
{"title":"Kinematic and mechanical alignments in total knee arthroplasty: A meta-analysis with ≥1-year follow-up","authors":"","doi":"10.1016/j.jos.2023.08.001","DOIUrl":"10.1016/j.jos.2023.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Kinematic and mechanical alignment outcomes in total knee arthroplasty remain controversial. This study compared the clinical and radiological outcomes of total knee arthroplasty using kinematic and mechanical alignments.</p></div><div><h3>Methods</h3><p>We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled trials<span> and cohort studies published before November 2022. The data of interest were extracted and analyzed using Review Manager V.5.4.</span></p></div><div><h3>Results</h3><p>Nineteen randomized controlled trials and cohort studies involving 880 kinematic alignment total knee arthroplasties and 965 mechanical alignment total knee arthroplasties were included. In this meta-analysis, the kinematic alignment group achieved better knee joint function scores, including the Oxford Knee Score<span><span><span>, Knee Injury and Osteoarthritis Outcome Score, and </span>Knee Society Score, and better flexion angles. No statistical differences were detected in the </span>Western Ontario and McMaster Universities Osteoarthritis Index<span>, extension angle, Forgotten Joint Score, European Quality of Life five-dimension measure, hip–knee–ankle angle, or complications between the kinematic and mechanical alignment groups.</span></span></p></div><div><h3>Conclusion</h3><p>This meta-analysis indicated that kinematic alignment total knee arthroplasty provides clinical benefits in terms of the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, Knee Society Score (knee), Knee Society Score (function), and better flexion angles. In addition, kinematic alignment total knee arthroplasty led to similar clinical outcomes as mechanical alignment total knee arthroplasty without increasing complications.</p></div><div><h3>Systematic review registration</h3><p><span><span>http://www.crd.york.ac.uk/PROSPERO/CRD42022373227</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1226-1234"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jos.2023.08.012
Background
Antegrade homodigital neurovascular island flap (AHIF) is one of the methods used in fingertip amputations to cover the defect area, preserve finger length and obtain a painless and sensitive fingertip. The aim of this study was to evaluate the functional and sensory outcomes in patients who underwent AHIF for fingertip amputation and to analyze the relationship between patient satisfaction and outcome measures.
Methods
Twenty patients with a mean age of 37 (18–63) years were analyzed retrospectively. The patients were evaluated in terms of hook nail development, active interphalangeal joint movements, cold intolerance, and sensory function of the flap covered area. Static two-point discrimination test and Semmes Weinstein monofilament test were performed for sensory evaluation.
Results
All flaps survived completely at the end of follow-up (mean, 36 months; range 11–64 months). Five patients had cold intolerance and two had hook nails. In total, proximal interphalangeal or distal interphalangeal joint flexion contracture developed in 25 % of the patients. The mean static two-point discrimination score was 4.6 ± 1.6 (2–8) and Semmes–Weinstein monofilament test score was 3.48 ± 0.6 (2.44–4.17). Subjective satisfaction levels of the patients were found to be high and did not show a statistical relationship with the measured clinical outcome parameters (p > 0.05).
Conclusions
Since AHIF contains a solid and continuous neurovascular pedicle, the probability of necrosis and loss of sensation is low in AHIF. In addition, the graft need of the donor area is not high. Its disadvantage is the rate of restriction of joint movements.
{"title":"Outcomes of antegrade homodigital neurovascular island flap in fingertip amputations","authors":"","doi":"10.1016/j.jos.2023.08.012","DOIUrl":"10.1016/j.jos.2023.08.012","url":null,"abstract":"<div><h3>Background</h3><p>Antegrade homodigital neurovascular island flap (AHIF) is one of the methods used in fingertip amputations to cover the defect area, preserve finger length and obtain a painless and sensitive fingertip. The aim of this study was to evaluate the functional and sensory outcomes in patients who underwent AHIF for fingertip amputation and to analyze the relationship between patient satisfaction and outcome measures.</p></div><div><h3>Methods</h3><p>Twenty patients with a mean age of 37 (18–63) years were analyzed retrospectively. The patients were evaluated in terms of hook nail development, active interphalangeal joint<span> movements, cold intolerance, and sensory function of the flap covered area. Static two-point discrimination test and Semmes Weinstein monofilament test were performed for sensory evaluation.</span></p></div><div><h3>Results</h3><p>All flaps survived completely at the end of follow-up (mean, 36 months; range 11–64 months). Five patients had cold intolerance and two had hook nails. In total, proximal interphalangeal or distal interphalangeal joint flexion contracture developed in 25 % of the patients. The mean static two-point discrimination score was 4.6 ± 1.6 (2–8) and Semmes–Weinstein monofilament test score was 3.48 ± 0.6 (2.44–4.17). Subjective satisfaction levels of the patients were found to be high and did not show a statistical relationship with the measured clinical outcome parameters (p > 0.05).</p></div><div><h3>Conclusions</h3><p>Since AHIF contains a solid and continuous neurovascular pedicle, the probability of necrosis and loss of sensation is low in AHIF. In addition, the graft need of the donor area is not high. Its disadvantage is the rate of restriction of joint movements.</p></div><div><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1203-1207"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jos.2023.08.007
Background
Limb immobilization is considered to contribute to limb pain including hyperalgesia. Approximately 50% of patients with such chronic limb pain complain that their abnormal pain worsens after exposure to cold. However, there have been few studies on the relationship between limb immobilization and cold hypersensitivity. The aim of this study was to examine whether limb immobilization induces cold hypersensitivity, and whether physical exercise such as ankle stretching prevents its induction in model mice.
Method
We used forty-four 8-week-old male C57Bl/6J mice, consisting of 32 immobilized mice and 12 control mice. The bilateral hind limbs of the mice were immobilized by a thermoplastic cast. After limb-immobilization for 1 week, changes in mechanical, thermal and cold hypersensitivity, and the expression levels of TRPV1, TRPA1, TRPM8, IL-1β, IL-6, and TNFα in the spinal cord, dorsal root ganglia and the affected hind paw were evaluated in comparison with those in the control mice. In addition, we examined the effect of ankle stretching on the hypersensitivity and expression levels in the limb-immobilized mice.
Results
Mechanical, thermal and cold hypersensitivity were significantly increased in the limb-immobilized mice. In addition, ankle stretching during the immobilization period significantly prevented the increases in those hypersensitivities. There were no significant differences in the expression levels of TRPV1, TRPA1 and TRPM8 among the control, and limb-immobilized mice with and without ankle stretching. The expression levels of IL-1 and IL-6 were significantly increased in the immobilized hind limb paw. Furthermore, ankle stretching significantly prevented the increases in their expression levels.
Conclusion
Limb-immobilization induced cold hypersensitivity as well as mechanical and thermal hypersensitivity, and ankle stretching significantly prevented the hypersensitivity induction in the model mice. It would be of great interest to clarify whether a patient with limb-immobilization experiences cold hypersensitivity and whether ankle stretching might prevent hypersensitivity induction in the future.
{"title":"Static stretching of the ankle prevents cold hypersensitivity associated with limb immobilization in model mice","authors":"","doi":"10.1016/j.jos.2023.08.007","DOIUrl":"10.1016/j.jos.2023.08.007","url":null,"abstract":"<div><h3>Background</h3><p>Limb immobilization is considered to contribute to limb pain including hyperalgesia<span>. Approximately 50% of patients with such chronic limb pain complain that their abnormal pain worsens after exposure to cold. However, there have been few studies on the relationship between limb immobilization and cold hypersensitivity. The aim of this study was to examine whether limb immobilization induces cold hypersensitivity, and whether physical exercise such as ankle stretching prevents its induction in model mice.</span></p></div><div><h3>Method</h3><p><span><span>We used forty-four 8-week-old male C57Bl/6J mice, consisting of 32 immobilized mice and 12 control mice. The bilateral hind limbs of the mice were immobilized by a thermoplastic cast. After limb-immobilization for 1 week, changes in mechanical, thermal and cold hypersensitivity, and the expression levels of </span>TRPV1, TRPA1, </span>TRPM8<span><span>, IL-1β, IL-6, and TNFα in the spinal cord, dorsal root ganglia and the affected </span>hind paw were evaluated in comparison with those in the control mice. In addition, we examined the effect of ankle stretching on the hypersensitivity and expression levels in the limb-immobilized mice.</span></p></div><div><h3>Results</h3><p><span>Mechanical, thermal and cold hypersensitivity were significantly increased in the limb-immobilized mice. In addition, ankle stretching during the immobilization period significantly prevented the increases in those hypersensitivities. There were no significant differences in the expression levels of TRPV1, TRPA1 and </span>TRPM8 among the control, and limb-immobilized mice with and without ankle stretching. The expression levels of IL-1 and IL-6 were significantly increased in the immobilized hind limb paw. Furthermore, ankle stretching significantly prevented the increases in their expression levels.</p></div><div><h3>Conclusion</h3><p>Limb-immobilization induced cold hypersensitivity as well as mechanical and thermal hypersensitivity, and ankle stretching significantly prevented the hypersensitivity induction in the model mice. It would be of great interest to clarify whether a patient with limb-immobilization experiences cold hypersensitivity and whether ankle stretching might prevent hypersensitivity induction in the future.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1306-1312"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10382135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Proximal femoral fractures in geriatric patients are a major challenge in orthopedics, often leading to major functional impairment. Early surgical intervention is crucial for improving patient recovery and overall health outcomes. Thus, Japan's Ministry of Health, Labour and Welfare initiated a reimbursement policy in April 2022 to encourage early surgery for these fractures in patients aged ≥75 years. This study investigated the impact of this policy on early surgery rates in Japan and identified factors influencing the timing of surgical interventions.
Methods: We retrospectively analyzed the data of patients who underwent surgery for proximal femoral fractures at our institution between April 2022 and March 2023. Patients were categorized into two groups based on the timing of surgery relative to the injury: ≤48 h and >48 h. Demographic and clinical data, including age, sex, fracture type, and various health- and admission-related factors, were assessed.
Results: Of the 192 patients, 152 were included in the study. Among them, 38% underwent early surgery (≤48 h), and 15% of the patients arrived more than 48 h post-injury. Significant differences were found in admission routes and residence types between the groups. The ≤48 h group had shorter intervals from injury to admission and surgery than the >48 h group. Factors such as the admission process, day of the week, and C-reactive protein levels significantly influenced the timing of surgery.
Conclusions: After introducing incentives for early surgery in Japan, 38% of patients with proximal femoral fractures underwent surgery within 48 h of injury. Factors contributing to patients not receiving early surgery included transport from another hospital, weekend hospitalization, and elevated CRP levels. These findings suggest that achieving surgery within 48 h of injury is challenging through hospital efforts alone, and the time criteria might be more appropriate if changed to "admission to surgery."
{"title":"Factors influencing the achievement of early surgery in proximal femoral fractures under a Japanese incentive policy.","authors":"Yutoku Yamada, Toshiaki Kotani, Shunji Kishida, Yosuke Ogata, Shun Okuwaki, Shuhei Ohyama, Shuhei Iwata, Yasushi Iijima, Shohei Ise, Tsuyoshi Sakuma, Keisuke Ueno, Daisuke Kajiwara, Risa Moriyasu, Takako Nakajima, Shohei Minami, Eiko Hashimoto, Nobuyasu Ochiai, Seiji Ohtori","doi":"10.1016/j.jos.2024.08.001","DOIUrl":"https://doi.org/10.1016/j.jos.2024.08.001","url":null,"abstract":"<p><strong>Background: </strong>Proximal femoral fractures in geriatric patients are a major challenge in orthopedics, often leading to major functional impairment. Early surgical intervention is crucial for improving patient recovery and overall health outcomes. Thus, Japan's Ministry of Health, Labour and Welfare initiated a reimbursement policy in April 2022 to encourage early surgery for these fractures in patients aged ≥75 years. This study investigated the impact of this policy on early surgery rates in Japan and identified factors influencing the timing of surgical interventions.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients who underwent surgery for proximal femoral fractures at our institution between April 2022 and March 2023. Patients were categorized into two groups based on the timing of surgery relative to the injury: ≤48 h and >48 h. Demographic and clinical data, including age, sex, fracture type, and various health- and admission-related factors, were assessed.</p><p><strong>Results: </strong>Of the 192 patients, 152 were included in the study. Among them, 38% underwent early surgery (≤48 h), and 15% of the patients arrived more than 48 h post-injury. Significant differences were found in admission routes and residence types between the groups. The ≤48 h group had shorter intervals from injury to admission and surgery than the >48 h group. Factors such as the admission process, day of the week, and C-reactive protein levels significantly influenced the timing of surgery.</p><p><strong>Conclusions: </strong>After introducing incentives for early surgery in Japan, 38% of patients with proximal femoral fractures underwent surgery within 48 h of injury. Factors contributing to patients not receiving early surgery included transport from another hospital, weekend hospitalization, and elevated CRP levels. These findings suggest that achieving surgery within 48 h of injury is challenging through hospital efforts alone, and the time criteria might be more appropriate if changed to \"admission to surgery.\"</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We aimed to evaluate the intra- and interrater measurement reliability of the lateral ankle ligament attachment locations using three-dimensional magnetic resonance imaging.
Methods: We analysed 54 participants with a mean age of 43 years who underwent three-dimensional ankle magnetic resonance imaging and had normal lateral ligaments. Bony landmarks of the distal fibula, talus, and calcaneus were identified in the reconstructed images. The centers of the anterior talofibular ligament and calcaneofibular ligament attachments were also identified. The distances between the landmarks and attachments were measured. Two raters performed the measurements twice, and intra- and interrater intraclass correlation coefficients were calculated.
Results: The intrarater intraclass correlation coefficient values were between 0.71 and 0.96 for the anterior talofibular ligament attachment measurements and between 0.77 and 0.95 for the calcaneofibular ligament attachments. The interrater intraclass correlation coefficient was higher than 0.7, except for the distance between the anterior talofibular ligament superior bundle and fibular obscure tubercle. The fibular attachment of a single-bundle anterior talofibular ligament was located 13.3 mm from the inferior tip and 43% along the anterior edge of the distal fibula. The superior and inferior bundles of the double-bundle ligament were located at 43% and 23%, respectively. The calcaneofibular ligament fibular attachment was 5.5 mm from the inferior tip, at 16% along the anterior edge of the distal fibula.
Conclusion: The measurements of anterior talofibular ligament and calcaneofibular ligament attachment locations identified on three-dimensional magnetic resonance imaging were sufficiently reliable. This measurement method provides in vivo anatomical data on the lateral ankle ligament anatomy.
{"title":"Intra- and interrater measurement reliability of lateral ankle ligament attachment locations using three-dimensional magnetic resonance imaging.","authors":"Yuriko Yoshimoto, Satoshi Yamaguchi, Seiji Kimura, Kaoru Kitsukawa, Koji Matsumoto, Yuki Shiko, Manato Horii, Shotaro Watanabe, Takahisa Sasho, Seiji Ohtori","doi":"10.1016/j.jos.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.jos.2024.08.002","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate the intra- and interrater measurement reliability of the lateral ankle ligament attachment locations using three-dimensional magnetic resonance imaging.</p><p><strong>Methods: </strong>We analysed 54 participants with a mean age of 43 years who underwent three-dimensional ankle magnetic resonance imaging and had normal lateral ligaments. Bony landmarks of the distal fibula, talus, and calcaneus were identified in the reconstructed images. The centers of the anterior talofibular ligament and calcaneofibular ligament attachments were also identified. The distances between the landmarks and attachments were measured. Two raters performed the measurements twice, and intra- and interrater intraclass correlation coefficients were calculated.</p><p><strong>Results: </strong>The intrarater intraclass correlation coefficient values were between 0.71 and 0.96 for the anterior talofibular ligament attachment measurements and between 0.77 and 0.95 for the calcaneofibular ligament attachments. The interrater intraclass correlation coefficient was higher than 0.7, except for the distance between the anterior talofibular ligament superior bundle and fibular obscure tubercle. The fibular attachment of a single-bundle anterior talofibular ligament was located 13.3 mm from the inferior tip and 43% along the anterior edge of the distal fibula. The superior and inferior bundles of the double-bundle ligament were located at 43% and 23%, respectively. The calcaneofibular ligament fibular attachment was 5.5 mm from the inferior tip, at 16% along the anterior edge of the distal fibula.</p><p><strong>Conclusion: </strong>The measurements of anterior talofibular ligament and calcaneofibular ligament attachment locations identified on three-dimensional magnetic resonance imaging were sufficiently reliable. This measurement method provides in vivo anatomical data on the lateral ankle ligament anatomy.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To evaluate the relationship between the pattern and severity of metatarsophalangeal (MTP) joint dislocation in the lesser toes and severity of joint destruction in rheumatoid forefoot deformities.
Methods: Participants comprised of 13 patients (16 feet) who underwent resection arthroplasty of the metatarsal head of the lesser toes for rheumatoid arthritis of the MTP joints. Correlations between preoperative radiographic findings and histological grades second to fifth metatarsal heads taken intraoperatively were analyzed.
Results: In 62 metatarsal heads, complete dislocation of the MTP joint in the lesser toes significantly resulted in severe joint destruction compared to mild or moderate dislocation (P < 0.05). The proportion of severe cartilage damage in MTP joints with complete dislocation was 100 % in the 5th MTP joint, 83.3 % in the 4th MTP joint, and 58.3 % in the 2nd and 3rd MTP joints. Moreover, complete dislocation of the MTP joints in the lateral column showed the most severe joint destruction compared to that in the medial column (P = 0.03).
Conclusion: Complete dislocation of the MTP joint in the lateral column is related to joint destruction in rheumatoid forefoot deformities.
{"title":"Higher association of articular surface destruction with rheumatoid forefoot deformity arising from dislocation of the metatarsophalangeal joints in the lateral column.","authors":"Yuki Suzuki, Tomohiro Onodera, Koji Iwasaki, Masatake Matsuoka, Masanari Hamasaki, Eiji Kondo, Norimasa Iwasaki","doi":"10.1016/j.jos.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.jos.2024.07.010","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the relationship between the pattern and severity of metatarsophalangeal (MTP) joint dislocation in the lesser toes and severity of joint destruction in rheumatoid forefoot deformities.</p><p><strong>Methods: </strong>Participants comprised of 13 patients (16 feet) who underwent resection arthroplasty of the metatarsal head of the lesser toes for rheumatoid arthritis of the MTP joints. Correlations between preoperative radiographic findings and histological grades second to fifth metatarsal heads taken intraoperatively were analyzed.</p><p><strong>Results: </strong>In 62 metatarsal heads, complete dislocation of the MTP joint in the lesser toes significantly resulted in severe joint destruction compared to mild or moderate dislocation (P < 0.05). The proportion of severe cartilage damage in MTP joints with complete dislocation was 100 % in the 5th MTP joint, 83.3 % in the 4th MTP joint, and 58.3 % in the 2nd and 3rd MTP joints. Moreover, complete dislocation of the MTP joints in the lateral column showed the most severe joint destruction compared to that in the medial column (P = 0.03).</p><p><strong>Conclusion: </strong>Complete dislocation of the MTP joint in the lateral column is related to joint destruction in rheumatoid forefoot deformities.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This study was performed to evaluate changes in patellar tendon tissue after medial open wedge high tibial osteotomy (MOWHTO) using shear wave elastography (SWE) and to clarify the factors contributing to patellar height changes after MOWHTO.
Methods: The study cohort comprised 24 knees of 24 patients. Patellar tendon length, thickness, and elasticity were evaluated using SWE preoperatively, 2 weeks postoperatively, and 3, 6, and 12 months postoperatively. The Caton-Deschamps index (CDI) was also measured at these time points. Lower limb alignment and factors related to sequential changes in patellar height were evaluated.
Results: The CDI was significantly different between preoperatively and 2 weeks postoperatively and between 2 week postoperatively and 3, 6, and 12 months postoperatively (p < 0.05 for all) The patellar tendon length at 12 months postoperatively was significantly shorter than that at 2 weeks postoperatively. The postoperative patellar tendon thickness was thicker than preoperative patellar tendon at all sites. The postoperative patellar tendon thickness significantly increased from preoperatively at middle and distal sites. The only factor associated with Δpre-post2WCDI (preCDI - post2WCDI) was ΔMPTA(medial proximal tibial angle) (postoperative MPTA - preoperative MPTA) (p = 0.042). The significant predictor of Δpost2W-post12MCDI was Δpost2W-post12 M distal elasticity (p = 0.022).
Conclusion: Patellar height changed sequentially after MOWHTO. The factors that caused patellar height change were related to the change in patellar tendon quality after OWHTO.
{"title":"Patellar height changes sequentially after medial open wedge high tibial osteotomy: Evaluation using shear wave elastography.","authors":"Yuki Kudo, Akira Maeyama, Tetsuro Ishimatsu, Taiki Matsunaga, Shizuhide Nakayama, Takuaki Yamamoto","doi":"10.1016/j.jos.2024.07.008","DOIUrl":"https://doi.org/10.1016/j.jos.2024.07.008","url":null,"abstract":"<p><strong>Background: </strong>This study was performed to evaluate changes in patellar tendon tissue after medial open wedge high tibial osteotomy (MOWHTO) using shear wave elastography (SWE) and to clarify the factors contributing to patellar height changes after MOWHTO.</p><p><strong>Methods: </strong>The study cohort comprised 24 knees of 24 patients. Patellar tendon length, thickness, and elasticity were evaluated using SWE preoperatively, 2 weeks postoperatively, and 3, 6, and 12 months postoperatively. The Caton-Deschamps index (CDI) was also measured at these time points. Lower limb alignment and factors related to sequential changes in patellar height were evaluated.</p><p><strong>Results: </strong>The CDI was significantly different between preoperatively and 2 weeks postoperatively and between 2 week postoperatively and 3, 6, and 12 months postoperatively (p < 0.05 for all) The patellar tendon length at 12 months postoperatively was significantly shorter than that at 2 weeks postoperatively. The postoperative patellar tendon thickness was thicker than preoperative patellar tendon at all sites. The postoperative patellar tendon thickness significantly increased from preoperatively at middle and distal sites. The only factor associated with Δpre-post2WCDI (preCDI - post2WCDI) was ΔMPTA(medial proximal tibial angle) (postoperative MPTA - preoperative MPTA) (p = 0.042). The significant predictor of Δpost2W-post12MCDI was Δpost2W-post12 M distal elasticity (p = 0.022).</p><p><strong>Conclusion: </strong>Patellar height changed sequentially after MOWHTO. The factors that caused patellar height change were related to the change in patellar tendon quality after OWHTO.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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