Pub Date : 2024-11-12DOI: 10.1016/j.jos.2024.10.001
Makoto Iwasa, Ichiro Nakahara, Hidenobu Miki
Background: Dislocation is a major complication of total hip arthroplasty (THA). This study aimed to assess the dislocation rate after THA using the combined strategy of using CT-based navigation, large diameter heads, and posterior soft tissue repair in a large cohort.
Methods: We included 1410 patients who had undergone primary cementless THA using the CT-based navigation system. The posterior approach was used by a single surgeon for all patients. The participants included 143 (10.1 %) men and 1267 (89.9 %) women, with a mean age of 65 years. The mean body mass index was 24 kg/m2. Additionally, the incidence rate of postoperative dislocation per year was calculated. The dislocation onset was classified as early when the dislocation occurred within 2 years of the primary THA and late when it occurred more than 2 years after the primary THA. Recurrence and revision rates in patients with dislocations were investigated.
Results: The postoperative dislocation rate was 0.56 % (8 patients). The mean time to dislocation onset was 11.2 (0.5-20.0) months postoperatively. All postoperative dislocations occurred in the early phase whereas none in the late phase, showing a significant difference (p < 0.01). Six (0.43 %) patients experienced recurrent dislocations or required revision.
Conclusions: THA using the combined strategy resulted in low dislocation rates, especially without late dislocation.
{"title":"Large cohort study on prevention strategies for dislocation in total hip arthroplasty.","authors":"Makoto Iwasa, Ichiro Nakahara, Hidenobu Miki","doi":"10.1016/j.jos.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.001","url":null,"abstract":"<p><strong>Background: </strong>Dislocation is a major complication of total hip arthroplasty (THA). This study aimed to assess the dislocation rate after THA using the combined strategy of using CT-based navigation, large diameter heads, and posterior soft tissue repair in a large cohort.</p><p><strong>Methods: </strong>We included 1410 patients who had undergone primary cementless THA using the CT-based navigation system. The posterior approach was used by a single surgeon for all patients. The participants included 143 (10.1 %) men and 1267 (89.9 %) women, with a mean age of 65 years. The mean body mass index was 24 kg/m2. Additionally, the incidence rate of postoperative dislocation per year was calculated. The dislocation onset was classified as early when the dislocation occurred within 2 years of the primary THA and late when it occurred more than 2 years after the primary THA. Recurrence and revision rates in patients with dislocations were investigated.</p><p><strong>Results: </strong>The postoperative dislocation rate was 0.56 % (8 patients). The mean time to dislocation onset was 11.2 (0.5-20.0) months postoperatively. All postoperative dislocations occurred in the early phase whereas none in the late phase, showing a significant difference (p < 0.01). Six (0.43 %) patients experienced recurrent dislocations or required revision.</p><p><strong>Conclusions: </strong>THA using the combined strategy resulted in low dislocation rates, especially without late dislocation.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622308","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: Locomotive syndrome (LS) presents symptoms related to decreased mobility due to musculoskeletal disorders. Knee osteoarthritis (KOA) is a significant public health concern linked to age-related musculoskeletal issues and is among the conditions contributing to LS. Age-related lower extremity muscle weakness exacerbates knee pain in KOA, but the impact of LS on knee pain is not clear, prompting the present investigation.
Methods: We conducted a cross-sectional study of 76 participants (152 knee joints) with bilateral severe KOA scheduled for total knee arthroplasty. The study investigated the association between the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscale and LS using a multiple linear regression model, which included covariates and scaled estimated regression coefficients.
Results: LS had a negative impact on KOOS pain (β: 0.35, 95 % confidence interval [CI]: 24.08; -6.05) (p < 0.05) and high self-efficacy had a positive impact (β: 0.25, 95%CI: 1.27; 16.34) (p < 0.05). Age, gender, BMI, Kellgren-Lawrence grade, and Central Sensitization did not influence KOOS pain.
Conclusions: Our findings demonstrate that LS negatively affected knee pain while self-efficacy positively affected it. LS has been attracting attention in relation to mobility, but the fact that it also affected the knee pain in severe KOA is an important clinical finding. Further research is required to focus on the relationship between the prevention and improvement of LS, and knee pain in severe KOA.
背景：运动综合征（LS）表现出与肌肉骨骼疾病导致的活动能力下降有关的症状。膝关节骨性关节炎（KOA）是与年龄相关的肌肉骨骼问题引起的重大公共健康问题，也是导致运动综合征的病症之一。与年龄相关的下肢肌无力会加剧 KOA 患者的膝关节疼痛，但 LS 对膝关节疼痛的影响尚不明确，这促使我们进行了本次调查：我们对 76 名计划进行全膝关节置换术的双侧重度 KOA 患者（152 个膝关节）进行了横断面研究。研究采用多元线性回归模型，包括协变量和按比例估算的回归系数，调查了膝关节损伤和骨关节炎结果评分（KOOS）疼痛分量表与 LS 之间的关联：结果：LS对KOOS疼痛有负面影响（β：0.35，95%置信区间[CI]：24.08；-6.05）（p 结论：我们的研究结果表明，LS对膝关节疼痛有负面影响：我们的研究结果表明，LS 对膝关节疼痛有负面影响，而自我效能感对膝关节疼痛有正面影响。LS对活动能力的影响一直备受关注，但它对严重KOA患者膝关节疼痛的影响也是一个重要的临床发现。需要进一步研究 LS 的预防和改善与严重 KOA 患者膝关节疼痛之间的关系。
{"title":"Effect of locomotive syndrome on knee pain in severe knee osteoarthritis.","authors":"Tatsuru Sonobe, Takuya Nikaido, Miho Sekiguchi, Yoichi Kaneuchi, Tadashi Kikuchi, Yoshihiro Matsumoto","doi":"10.1016/j.jos.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.010","url":null,"abstract":"<p><strong>Background: </strong>Locomotive syndrome (LS) presents symptoms related to decreased mobility due to musculoskeletal disorders. Knee osteoarthritis (KOA) is a significant public health concern linked to age-related musculoskeletal issues and is among the conditions contributing to LS. Age-related lower extremity muscle weakness exacerbates knee pain in KOA, but the impact of LS on knee pain is not clear, prompting the present investigation.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 76 participants (152 knee joints) with bilateral severe KOA scheduled for total knee arthroplasty. The study investigated the association between the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscale and LS using a multiple linear regression model, which included covariates and scaled estimated regression coefficients.</p><p><strong>Results: </strong>LS had a negative impact on KOOS pain (β: 0.35, 95 % confidence interval [CI]: 24.08; -6.05) (p < 0.05) and high self-efficacy had a positive impact (β: 0.25, 95%CI: 1.27; 16.34) (p < 0.05). Age, gender, BMI, Kellgren-Lawrence grade, and Central Sensitization did not influence KOOS pain.</p><p><strong>Conclusions: </strong>Our findings demonstrate that LS negatively affected knee pain while self-efficacy positively affected it. LS has been attracting attention in relation to mobility, but the fact that it also affected the knee pain in severe KOA is an important clinical finding. Further research is required to focus on the relationship between the prevention and improvement of LS, and knee pain in severe KOA.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622264","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: Patients with developmental dysplasia of the hip (DDH) undergo curved periacetabular osteotomy (CPO) to prevent progressive osteoarthritis. The acetabulum's morphology varies with in each DDH type. Therefore, developing a three-dimensional preoperative plan is important in CPO. However, the optimal rotation angle of the osteotomized bone remains unclear. This study aimed to examine the contact pressure (CP) of the acetabular cartilage in each DDH type using the finite element analysis and the optimal rotation angle of the osteotomized bone in surgical simulation.
Methods: This study included 23 patients (24 hips) with DDH who underwent CPO. The DDH type was determined based on a previously reported DDH type classification using radar charts. Four patients, with each patient presenting with one deficiency type, were selected for analysis. The preoperative computed tomography scan data of each patient were analyzed using a finite element analysis software. Based on each DDH type, the following CPO models were established: the preoperative model, the model rotated 10°, 20°, 30°, and 40° laterally, each lateral rotation model with 10° anterior rotation, and each lateral rotation model with 10° external rotation. Furthermore, the acetabular cartilage and the femoral head cartilage were created. The mesh model based on a 4-mm tetrahedron was generated from the CPO model. The load was set in the one-leg standing position (femur: 500 N, grater trochanter: 1000 N). The medial pubic bone, distal femur, and superior rim of the ilium were constrained. The CP of the acetabular cartilage and the number of contact surfaces in each model were evaluated. The rotation angle that was most effective in reducing the CP was examined.
Results: According to the mean CP, the optimal rotation angles of the osteotomized bone in mild, anterior, posterior, and global type deficiencies were 20° laterally, 30° laterally, 30° laterally with 10° anterior rotation, and 30° laterally with 10° anterior rotation, respectively. Based on the contour diagram, the CPO models rotated anteriorly or externally increased the contact surface. The CP of the models rotated 40° laterally did not improve to greater extent than that of the models rotated 30° laterally.
Conclusions: The optimal rotation angle of the osteotomized bone should be determined based on the DDH type.
{"title":"Surgical simulation of curved periacetabular osteotomy in four types of developmental dysplasia of the hip using finite element analysis and identification of the optimal rotation angle of the osteotomized bone.","authors":"Takahiro Igei, Satoshi Nakasone, Masato Ishihara, Masamichi Onaga, Fumiyuki Washizaki, Sakura Kuniyoshi, Kotaro Nishida","doi":"10.1016/j.jos.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.008","url":null,"abstract":"<p><strong>Background: </strong>Patients with developmental dysplasia of the hip (DDH) undergo curved periacetabular osteotomy (CPO) to prevent progressive osteoarthritis. The acetabulum's morphology varies with in each DDH type. Therefore, developing a three-dimensional preoperative plan is important in CPO. However, the optimal rotation angle of the osteotomized bone remains unclear. This study aimed to examine the contact pressure (CP) of the acetabular cartilage in each DDH type using the finite element analysis and the optimal rotation angle of the osteotomized bone in surgical simulation.</p><p><strong>Methods: </strong>This study included 23 patients (24 hips) with DDH who underwent CPO. The DDH type was determined based on a previously reported DDH type classification using radar charts. Four patients, with each patient presenting with one deficiency type, were selected for analysis. The preoperative computed tomography scan data of each patient were analyzed using a finite element analysis software. Based on each DDH type, the following CPO models were established: the preoperative model, the model rotated 10°, 20°, 30°, and 40° laterally, each lateral rotation model with 10° anterior rotation, and each lateral rotation model with 10° external rotation. Furthermore, the acetabular cartilage and the femoral head cartilage were created. The mesh model based on a 4-mm tetrahedron was generated from the CPO model. The load was set in the one-leg standing position (femur: 500 N, grater trochanter: 1000 N). The medial pubic bone, distal femur, and superior rim of the ilium were constrained. The CP of the acetabular cartilage and the number of contact surfaces in each model were evaluated. The rotation angle that was most effective in reducing the CP was examined.</p><p><strong>Results: </strong>According to the mean CP, the optimal rotation angles of the osteotomized bone in mild, anterior, posterior, and global type deficiencies were 20° laterally, 30° laterally, 30° laterally with 10° anterior rotation, and 30° laterally with 10° anterior rotation, respectively. Based on the contour diagram, the CPO models rotated anteriorly or externally increased the contact surface. The CP of the models rotated 40° laterally did not improve to greater extent than that of the models rotated 30° laterally.</p><p><strong>Conclusions: </strong>The optimal rotation angle of the osteotomized bone should be determined based on the DDH type.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622318","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: Chronic mechanical stress on the second metatarsal head (2 MH) can be a risk factor for osteoarthritis (OA) and dislocation of the second metatarsophalangeal joint (2MTPJ) in hallux valgus (HV). This study aimed to investigate the stress distribution of the 2 MH in HV patients and determine the factors associated with dislocation and OA of the 2MTPJ.
Methods: In total, 115 feet with HV were retrospectively reviewed and divided into two groups: those with subluxation or dislocation of the 2MTPJ (group D, 27 feet) and those without (group N, 88 feet). The control group (group C) included 33 feet without HV. Group N was divided into OA and non-OA (NOA) groups according to the presence or absence of OA of the 2MTPJ. The Hounsfield Unit (HU) value of the subchondral bone of the 2 MH was measured on sagittal slices of the preoperative computed tomography images and divided by the HU value of the navicular region (HU ratio). The relationship between the HU ratios and radiographic parameters was compared.
Results: The HU ratios were significantly higher in group N than those in groups C and D. In group N, the protrusion of the second metatarsal relative to the third and fourth metatarsals (M2-M3, M2-M4) was positively correlated with the dorsal and central HU ratios, respectively. Group D had a significantly larger HV angle (HVA) and M2-M3 than group N. HVA, the first-second intermetatarsal angle, M2-M3, M2-M4, and dorsal and central HU ratios were significantly larger in the OA group than in the NOA group. The cutoff value of M2-M3 was 5.5 mm when comparing groups D and N, and 4.4 mm when comparing the OA and NOA groups.
Conclusions: Severe HV and a longer M2-M3 and M2-M4 may be associated with a high risk of dislocation and OA of the 2MTPJ.
Level of evidence: Ⅲ.
背景：第二跖骨头（2 MH）上的慢性机械应力可能是导致拇指外翻（HV）患者骨关节炎（OA）和第二跖趾关节脱位（2MTPJ）的危险因素。本研究旨在调查 HV 患者第二跖趾关节的应力分布，并确定与第二跖趾关节脱位和 OA 相关的因素：方法：对总共 115 例 HV 足进行回顾性研究，并将其分为两组：2MTPJ 下脱位或脱位组（D 组，27 例）和非脱位组（N 组，88 例）。对照组（C 组）包括 33 只没有 HV 的脚。N 组根据 2MTPJ 是否存在 OA 分为 OA 组和非 OA 组（NOA）。在术前计算机断层扫描图像的矢状切片上测量 2 MH 软骨下骨的 HU 值，然后除以舟骨区域的 HU 值（HU 比值）。比较了 HU 比值与放射学参数之间的关系：在 N 组中，第二跖骨相对于第三和第四跖骨（M2-M3、M2-M4）的突出分别与背侧和中央的 HU 比值呈正相关。OA 组的 HVA、第一-第二跖骨间角、M2-M3、M2-M4 以及背侧和中央 HU 比率均明显大于 NOA 组。比较 D 组和 N 组时，M2-M3 的临界值为 5.5 毫米，比较 OA 组和 NOA 组时，临界值为 4.4 毫米：结论：严重HV、M2-M3和M2-M4较长可能与2MTPJ脱位和OA的高风险有关：Ⅲ.
{"title":"The difference in second - third metatarsal length is associated with the risk of dislocation or arthritic change in the second metatarsophalangeal joint in patients with hallux valgus.","authors":"Dan Moriwaki, Tomoyuki Nakasa, Yasunari Ikuta, Shingo Kawabata, Satoru Sakurai, Saori Ishibashi, Nobuo Adachi","doi":"10.1016/j.jos.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.005","url":null,"abstract":"<p><strong>Background: </strong>Chronic mechanical stress on the second metatarsal head (2 MH) can be a risk factor for osteoarthritis (OA) and dislocation of the second metatarsophalangeal joint (2MTPJ) in hallux valgus (HV). This study aimed to investigate the stress distribution of the 2 MH in HV patients and determine the factors associated with dislocation and OA of the 2MTPJ.</p><p><strong>Methods: </strong>In total, 115 feet with HV were retrospectively reviewed and divided into two groups: those with subluxation or dislocation of the 2MTPJ (group D, 27 feet) and those without (group N, 88 feet). The control group (group C) included 33 feet without HV. Group N was divided into OA and non-OA (NOA) groups according to the presence or absence of OA of the 2MTPJ. The Hounsfield Unit (HU) value of the subchondral bone of the 2 MH was measured on sagittal slices of the preoperative computed tomography images and divided by the HU value of the navicular region (HU ratio). The relationship between the HU ratios and radiographic parameters was compared.</p><p><strong>Results: </strong>The HU ratios were significantly higher in group N than those in groups C and D. In group N, the protrusion of the second metatarsal relative to the third and fourth metatarsals (M2-M3, M2-M4) was positively correlated with the dorsal and central HU ratios, respectively. Group D had a significantly larger HV angle (HVA) and M2-M3 than group N. HVA, the first-second intermetatarsal angle, M2-M3, M2-M4, and dorsal and central HU ratios were significantly larger in the OA group than in the NOA group. The cutoff value of M2-M3 was 5.5 mm when comparing groups D and N, and 4.4 mm when comparing the OA and NOA groups.</p><p><strong>Conclusions: </strong>Severe HV and a longer M2-M3 and M2-M4 may be associated with a high risk of dislocation and OA of the 2MTPJ.</p><p><strong>Level of evidence: </strong>Ⅲ.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622419","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 : 2024-11-08DOI: 10.1016/j.jos.2024.10.007
Masahiro Iinuma, Tsutomu Akazawa, Yoshiaki Torii, Jun Ueno, Atsuhiro Yoshida, Ken Tomochika, Takahiro Hideshima, Naoki Haraguchi, Hisateru Niki
Background: Preoperative nutritional status significantly affects postoperative outcomes in patients with metastatic spinal tumors. Understanding the relationship between nutritional status and survival rates can help optimize treatment strategies and improve patient outcomes.
Methods: This retrospective study was performed on 57 patients who underwent palliative surgery between May 2009 and April 2023. Various indicators of nutritional status including the Japanese-modified Glasgow Prognostic Score (JmGPS), C-reactive protein-to-albumin ratio (CAR), and prognostic nutrition index (PNI) were evaluated.
Results: Results showed that a lower JmGPS and CAR and a higher PNI were associated with a longer survival after surgery. Patients with a JmGPS score of 0 had a better postoperative performance status, higher likelihood of postoperative chemotherapy, and a greater median survival (>1 year). Further, CAR and PNI were predictive indicators of a better postoperative performance status and the implementation of chemotherapy.
Conclusion: Assessing preoperative nutritional status can predict survival and postoperative outcomes in patients with metastatic spinal tumors. The current findings underscore the importance of nutritional assessment in optimizing treatment strategies and improving outcomes.
{"title":"Impact of nutritional status in patients with metastatic spinal tumors who underwent palliative surgery.","authors":"Masahiro Iinuma, Tsutomu Akazawa, Yoshiaki Torii, Jun Ueno, Atsuhiro Yoshida, Ken Tomochika, Takahiro Hideshima, Naoki Haraguchi, Hisateru Niki","doi":"10.1016/j.jos.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.007","url":null,"abstract":"<p><strong>Background: </strong>Preoperative nutritional status significantly affects postoperative outcomes in patients with metastatic spinal tumors. Understanding the relationship between nutritional status and survival rates can help optimize treatment strategies and improve patient outcomes.</p><p><strong>Methods: </strong>This retrospective study was performed on 57 patients who underwent palliative surgery between May 2009 and April 2023. Various indicators of nutritional status including the Japanese-modified Glasgow Prognostic Score (JmGPS), C-reactive protein-to-albumin ratio (CAR), and prognostic nutrition index (PNI) were evaluated.</p><p><strong>Results: </strong>Results showed that a lower JmGPS and CAR and a higher PNI were associated with a longer survival after surgery. Patients with a JmGPS score of 0 had a better postoperative performance status, higher likelihood of postoperative chemotherapy, and a greater median survival (>1 year). Further, CAR and PNI were predictive indicators of a better postoperative performance status and the implementation of chemotherapy.</p><p><strong>Conclusion: </strong>Assessing preoperative nutritional status can predict survival and postoperative outcomes in patients with metastatic spinal tumors. The current findings underscore the importance of nutritional assessment in optimizing treatment strategies and improving outcomes.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622282","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}
Keloid formation in toes area is rare. However, occurrence of this phenomenon in toes after the surgery of syndactyly repair has been reported. Risk factors of keloid formation in toes after syndactyly reconstructions are currently unknown. This study aimed to investigate the risk factors of keloid formation after the surgery of syndactyly repair of the toes.
Methods
We retrospectively reviewed our case series including patients who were treated surgically at our institution. We hypothesized some key factors of keloid formation and analyzed each of them statistically.
Results
A total of 105 patients were treated surgically at our hospital, and 9 patients were involved keloid formations after operations. Among our hypothesized key factors, the results of multivariate logistic regression analysis revealed the number of affected web spaces (OR 0.031; 95%CI 0.001–0.684; p = 0.028) was significantly different. Digital enlargement was not a significant factor (OR 17.731; 95%CI 0.686–458.174; p = 0.091).
Conclusion
Involving multiple web space was associated with keloid formation after syndactyly release, on the other hand, toe enlargement did not show a significant difference. However, the digital enlargement showed high Odds ratio, we could not deny its high relativity for keloid formation. Further investigations are needed to clarify the key risk factors of keloid formation after the surgery of syndactyly repair of the toes.
{"title":"What are the key risk factors of keloid formation after repair of syndactyly of the toe?","authors":"Tatsuya Ishigaki , Shinsuke Akita , Akikazu Udagawa , Hiroyuki Suzuki , Nobuyuki Mitsukawa","doi":"10.1016/j.jos.2023.10.001","DOIUrl":"10.1016/j.jos.2023.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Keloid formation in </span>toes<span> area is rare. However, occurrence of this phenomenon in toes after the surgery of syndactyly repair has been reported. Risk factors of keloid formation in toes after syndactyly reconstructions are currently unknown. This study aimed to investigate the risk factors of keloid formation after the surgery of syndactyly repair of the toes.</span></div></div><div><h3>Methods</h3><div>We retrospectively reviewed our case series including patients who were treated surgically at our institution. We hypothesized some key factors of keloid formation and analyzed each of them statistically.</div></div><div><h3>Results</h3><div>A total of 105 patients were treated surgically at our hospital, and 9 patients were involved keloid formations after operations. Among our hypothesized key factors, the results of multivariate logistic regression analysis revealed the number of affected web spaces (OR 0.031; 95%CI 0.001–0.684; p = 0.028) was significantly different. Digital enlargement was not a significant factor (OR 17.731; 95%CI 0.686–458.174; p = 0.091).</div></div><div><h3>Conclusion</h3><div>Involving multiple web space was associated with keloid formation after syndactyly release, on the other hand, toe enlargement did not show a significant difference. However, the digital enlargement showed high Odds ratio, we could not deny its high relativity for keloid formation. Further investigations are needed to clarify the key risk factors of keloid formation after the surgery of syndactyly repair of the toes.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1406-1410"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41203825","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 : 2024-11-01DOI: 10.1016/j.jos.2023.10.002
Abdulmajeed Alzakri
Background
The Scoliosis Research Society SRS-22 questionnaire is a standard tool to assess the Health-Related Quality of Life (HRQoL) in scoliosis patients but, because of cultural differences limited use among Arabic patients. The aim is to perform a cross-cultural adaptation and validation of Arabic version of Scoliosis Japanese Questionnaire-27 and test it on Saudi patients with adolescent idiopathic scoliosis (AIS).
Methods
This a cross sectional study run between July 2021 and December 2022 recruited 194 patients. The cross-cultural adaptation process was performed using the American Association of Orthopedic Surgeons (AAOS) Outcomes Committee method. All patients had completed the Arabic version of Scoliosis Japanese Questionnaire-27 and SF-12 preoperatively and 3-month postoperatively. The validity and internal consistency were tested using the Intraclass correlation coefficient (ICC), Cronbach alpha, Pearson correlation coefficient, and confidence interval (CI).
Results
We analyzed the result of 194 female adolescent patients. The average age is 14 ± 2.4 years (range from 10 to 21 years). The majority of patients have a Lenke type 1 curve (54 %). The overall Cronbach alpha (CA) of all domains of Scoliosis Japanese Questionnaire-27 is 0.92. However, the Cronbach alpha for the mental health (Q17,18,20,21,23,24) and, self-image (Q12-14,22,25,26) are 0.93 and 0.84 respectively.
Conclusion
The Arabic version of Scoliosis Japanese Questionnaire-27 is a reliable and valid instrument and can be applied to evaluate the quality of life in patients with AIS.
{"title":"Reliability and validity of an adapted Arabic version of Scoliosis Japanese Questionnaire-27 in Saudi Arabia","authors":"Abdulmajeed Alzakri","doi":"10.1016/j.jos.2023.10.002","DOIUrl":"10.1016/j.jos.2023.10.002","url":null,"abstract":"<div><h3>Background</h3><div>The Scoliosis<span><span><span> Research Society SRS-22 questionnaire is a standard tool to assess the Health-Related Quality of Life (HRQoL) in scoliosis patients but, because of cultural differences limited use among Arabic patients. The aim is to perform a cross-cultural adaptation and validation of Arabic version of </span>Scoliosis Japanese Questionnaire-27 and test it on Saudi patients with </span>adolescent idiopathic scoliosis (AIS).</span></div></div><div><h3>Methods</h3><div><span>This a cross sectional study<span><span> run between July 2021 and December 2022 recruited 194 patients. The cross-cultural adaptation process was performed using the American Association of Orthopedic Surgeons (AAOS) Outcomes Committee method. All patients had completed the Arabic version of </span>Scoliosis Japanese Questionnaire-27 and SF-12 preoperatively and 3-month postoperatively. The validity and </span></span>internal consistency<span><span> were tested using the Intraclass correlation coefficient (ICC), </span>Cronbach alpha, Pearson correlation coefficient, and confidence interval (CI).</span></div></div><div><h3>Results</h3><div>We analyzed the result of 194 female adolescent patients. The average age is 14 ± 2.4 years (range from 10 to 21 years). The majority of patients have a Lenke type 1 curve (54 %). The overall Cronbach alpha (CA) of all domains of Scoliosis Japanese Questionnaire-27 is 0.92. However, the Cronbach alpha for the mental health (Q17,18,20,21,23,24) and, self-image (Q12-14,22,25,26) are 0.93 and 0.84 respectively.</div></div><div><h3>Conclusion</h3><div>The Arabic version of Scoliosis Japanese Questionnaire-27 is a reliable and valid instrument and can be applied to evaluate the quality of life in patients with AIS.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1341-1345"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482770","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}
We aimed to assess the prevalence of lumbopelvic pain (LPP), including low back pain (LBP) and/or pelvic girdle pain (PGP), consultation rate, and desire for treatment of postnatal Japanese women.
Methods
We performed a cross-sectional study of 98 postnatal Japanese women within 1 year of childbirth. We retrospectively evaluated the prevalence of LBP before and during pregnancy and the prevalence of LPP after childbirth using a self-administered questionnaire. We used the distribution of pain to differentiate LBP and/or PGP after childbirth and its intensity was assessed using a visual analogue scale. The effects of LPP on daily life were assessed using the Oswestry disability index (ODI). In addition, we assessed the consultation rate for LPP and the desire to consult a healthcare professional, using self-administered questionnaires.
Results
The prevalence of LPP after childbirth was 66%. Women with a history of LBP before and during pregnancy were more likely to have LPP following childbirth (both P < 0.001). The consultation rate among the postnatal women with LPP was 9%, but 56% of the women wished to consult a healthcare professional. The ODI score was significantly higher in postnatal women who wanted to consult a healthcare professional than in those who did not (P < 0.01).
Conclusions
Two thirds of the postnatal Japanese women who participated in this study had LPP, but the consultation rate was low. However, more than half of these women had the desire to consult a healthcare professional.
{"title":"Gap between the prevalence of and consultation rate for lumbopelvic pain in postnatal Japanese women","authors":"Tomoe Inoue-Hirakawa , Saki Iguchi , Daisuke Matsumoto , Yuu Kajiwara , Tomoki Aoyama , Rika Kawabe , Hideshi Sugiura , Yasushi Uchiyama","doi":"10.1016/j.jos.2023.10.006","DOIUrl":"10.1016/j.jos.2023.10.006","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to assess the prevalence of lumbopelvic pain (LPP), including low back pain (LBP) and/or pelvic girdle pain (PGP), consultation rate, and desire for treatment of postnatal Japanese women.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional study of 98 postnatal Japanese women within 1 year of childbirth. We retrospectively evaluated the prevalence of LBP before and during pregnancy and the prevalence of LPP after childbirth using a self-administered questionnaire. We used the distribution of pain to differentiate LBP and/or PGP after childbirth and its intensity was assessed using a visual analogue scale. The effects of LPP on daily life were assessed using the Oswestry disability index (ODI). In addition, we assessed the consultation rate for LPP and the desire to consult a healthcare professional, using self-administered questionnaires.</div></div><div><h3>Results</h3><div>The prevalence of LPP after childbirth was 66%. Women with a history of LBP before and during pregnancy were more likely to have LPP following childbirth (both <em>P</em> < 0.001). The consultation rate among the postnatal women with LPP was 9%, but 56% of the women wished to consult a healthcare professional. The ODI score was significantly higher in postnatal women who wanted to consult a healthcare professional than in those who did not (<em>P</em> < 0.01).</div></div><div><h3>Conclusions</h3><div>Two thirds of the postnatal Japanese women who participated in this study had LPP, but the consultation rate was low. However, more than half of these women had the desire to consult a healthcare professional.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1353-1358"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osteoporosis is a global issue with a worldwide prevalence of 18.3%, and the presence of coexisting fragility fractures can reduce the survival rate by approximately 20%. In Japan, the prevalence of osteoporosis is estimated to be 12.8 million, and the annual occurrence of hip fractures is approximately 193,400. Remarkably, coexisting hip or spinal fragility fractures caused by slight external force meet the Japanese diagnostic criterion for osteoporosis regardless of bone mineral density. However, only 191 deaths due to osteoporosis were published in 2021 in Japan. With the concern that some cases of hip and spinal fragility fractures were assigned an underlying cause of death of traumatic fracture instead of osteoporosis, this study aimed to elucidate the actual number of deaths due to osteoporosis in Japan.
Methods
We used the data from Japan in 2018. First, the number of deaths due to osteoporosis and hip or spinal fractures was reviewed using published vital statistics. Second, we calculated the number of elderly deaths (age ≥80 years) resulting from hip or spinal fractures caused by falls on the same level using data from approximately 1.4 million annual individual death certificates. Combining the above data, the actual number of deaths due to osteoporosis was estimated.
Results
Only 190 deaths due to osteoporosis were reported in the published data. The individual certificate data revealed 3437 elderly deaths due to hip or spinal fractures caused by falls on the same level, which could meet the criteria of osteoporotic fragility fractures. Accordingly, the estimated number of deaths caused by osteoporosis was calculated as 3,627, approximately 19 times the published value.
Conclusions
After researching the individual death certificate data focusing on the coexisting hip or spinal fragility fracture, it was implied that osteoporosis may have a higher mortality rate in Japan than what is published.
{"title":"Deaths caused by osteoporotic fractures in Japan: An epidemiological study","authors":"Koki Abe , Kazuhide Inage , Kensuke Yoshimura , Daisuke Sato , Keishi Yamashita , Masaomi Yamashita , Toshihide Sasaki , Akiyoshi Yamaoka , Yasuhiro Shiga , Yawara Eguchi , Sumihisa Orita , Seiji Ohtori","doi":"10.1016/j.jos.2023.10.013","DOIUrl":"10.1016/j.jos.2023.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis is a global issue with a worldwide prevalence of 18.3%, and the presence of coexisting fragility fractures can reduce the survival rate by approximately 20%. In Japan, the prevalence of osteoporosis is estimated to be 12.8 million, and the annual occurrence of hip fractures is approximately 193,400. Remarkably, coexisting hip or spinal fragility fractures caused by slight external force meet the Japanese diagnostic criterion for osteoporosis regardless of bone mineral density. However, only 191 deaths due to osteoporosis were published in 2021 in Japan. With the concern that some cases of hip and spinal fragility fractures were assigned an underlying cause of death of traumatic fracture instead of osteoporosis, this study aimed to elucidate the actual number of deaths due to osteoporosis in Japan.</div></div><div><h3>Methods</h3><div>We used the data from Japan in 2018. First, the number of deaths due to osteoporosis and hip or spinal fractures was reviewed using published vital statistics. Second, we calculated the number of elderly deaths (age ≥80 years) resulting from hip or spinal fractures caused by falls on the same level using data from approximately 1.4 million annual individual death certificates. Combining the above data, the actual number of deaths due to osteoporosis was estimated.</div></div><div><h3>Results</h3><div>Only 190 deaths due to osteoporosis were reported in the published data. The individual certificate data revealed 3437 elderly deaths due to hip or spinal fractures caused by falls on the same level, which could meet the criteria of osteoporotic fragility fractures. Accordingly, the estimated number of deaths caused by osteoporosis was calculated as 3,627, approximately 19 times the published value.</div></div><div><h3>Conclusions</h3><div>After researching the individual death certificate data focusing on the coexisting hip or spinal fragility fracture, it was implied that osteoporosis may have a higher mortality rate in Japan than what is published.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1477-1482"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate factors associated with frailty in rheumatoid arthritis (RA) patients.
Methods
A total of 656 RA patients were evaluated using data from an observational study in 2022. Among these patients, 152 with frailty were assigned to the frailty group, and 504 without frailty were assigned to the non-frailty group. Patient characteristics were compared between the two groups by univariate analysis, and factors associated with frailty were assessed by logistic regression analysis. Patient characteristics were also compared between patients with RA-associated interstitial lung disease (RA-ILD) (n = 102) and those without RA-ILD (n = 554).
Results
The frailty group was older (mean: 73.6 vs. 66.8 years) and had a higher DAS28-ESR (3.67 vs. 2.66), a higher HAQ-DI (1.13 vs. 0.32), and a higher rate of RA-ILD (25.0 vs. 12.7 %) than the non-frailty group. Age (OR: 1.03, 95 % CI: 1.01–1.05), HAQ-DI (3.22, 2.28–4.56), DAS28-ESR (1.44, 1.19–1.75), and RA-ILD (2.21, 1.24–3.94) were associated with frailty. RA patients with RA-ILD were older (73.3 vs. 67.5 years) and had a higher DAS28-ESR (3.30 vs. 2.80), a higher HAQ-DI (1.19 vs. 0.32), a higher proportion of frail patients (37.3 vs. 20.6 %), lower MTX use (26.5 vs. 62.9 %), and higher steroid use (44.1 vs. 26.8 %) than those without RA-ILD.
Conclusions
Maintaining reasonable control of disease activity is necessary for RA patients, including those with RA-ILD, to recover from frailty.
背景:本研究旨在探讨类风湿关节炎(RA)患者虚弱的相关因素。方法:使用2022年一项观察性研究的数据对656例RA患者进行评估。其中152例衰弱患者被分配到衰弱组，504例无衰弱患者被分配到非衰弱组。采用单因素分析比较两组患者的特征，采用logistic回归分析评估与虚弱相关的因素。还比较了ra相关间质性肺病(RA-ILD)患者(n = 102)和非RA-ILD患者(n = 554)的患者特征。结果:与非衰弱组相比，衰弱组年龄更大(平均:73.6比66.8岁)，DAS28-ESR更高(3.67比2.66)，HAQ-DI更高(1.13比0.32)，RA-ILD发生率更高(25.0比12.7%)。年龄(OR: 1.03, 95% CI: 1.01-1.05)、HAQ-DI(3.22, 2.28-4.56)、DAS28-ESR(1.44, 1.19-1.75)和RA-ILD(2.21, 1.24-3.94)与衰弱相关。RA- ild的RA患者年龄较大(73.3岁vs. 67.5岁)，DAS28-ESR较高(3.30 vs. 2.80)， HAQ-DI较高(1.19 vs. 0.32)，体弱患者比例较高(37.3 vs. 20.6%)， MTX使用较低(26.5% vs. 62.9%)，类固醇使用较高(44.1% vs. 26.8%)。结论:保持合理的疾病活动控制对于RA患者，包括RA- ild患者，从虚弱中恢复是必要的。
{"title":"Associations of frailty with RA-ILD and poor control of disease activity in patients with rheumatoid arthritis: A multi-center retrospective observational study","authors":"Yoshifumi Ohashi , Nobunori Takahashi , Yasumori Sobue , Mochihito Suzuki , Ryo Sato , Masataka Maeda , Daisuke Kihira , Kenji Kishimoto , Kenya Terabe , Shuji Asai , Shiro Imagama","doi":"10.1016/j.jos.2023.11.012","DOIUrl":"10.1016/j.jos.2023.11.012","url":null,"abstract":"<div><h3>Background</h3><div><span>This study aimed to investigate factors associated with frailty in </span>rheumatoid arthritis (RA) patients.</div></div><div><h3>Methods</h3><div><span>A total of 656 RA patients were evaluated using data from an observational study in 2022. Among these patients, 152 with frailty were assigned to the frailty group, and 504 without frailty were assigned to the non-frailty group. Patient characteristics were compared between the two groups by </span>univariate analysis<span>, and factors associated with frailty were assessed by logistic regression analysis<span>. Patient characteristics were also compared between patients with RA-associated interstitial lung disease (RA-ILD) (n = 102) and those without RA-ILD (n = 554).</span></span></div></div><div><h3>Results</h3><div>The frailty group was older (mean: 73.6 vs. 66.8 years) and had a higher DAS28-ESR (3.67 vs. 2.66), a higher HAQ-DI (1.13 vs. 0.32), and a higher rate of RA-ILD (25.0 vs. 12.7 %) than the non-frailty group. Age (OR: 1.03, 95 % CI: 1.01–1.05), HAQ-DI (3.22, 2.28–4.56), DAS28-ESR (1.44, 1.19–1.75), and RA-ILD (2.21, 1.24–3.94) were associated with frailty. RA patients with RA-ILD were older (73.3 vs. 67.5 years) and had a higher DAS28-ESR (3.30 vs. 2.80), a higher HAQ-DI (1.19 vs. 0.32), a higher proportion of frail patients (37.3 vs. 20.6 %), lower MTX use (26.5 vs. 62.9 %), and higher steroid use (44.1 vs. 26.8 %) than those without RA-ILD.</div></div><div><h3>Conclusions</h3><div>Maintaining reasonable control of disease activity is necessary for RA patients, including those with RA-ILD, to recover from frailty.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1496-1502"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477958","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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