Evaluation of the accuracy of resected bone thickness based on patient-specific instrumentation during total knee arthroplasty.

Background: In total knee arthroplasty (TKA) using patient-specific instrumentation (PSI), the correlation between the preoperative surgical plan and intraoperative resection size is unclear. The aims of this study were to evaluate whether the computed tomography (CT)-based PSI surgical plan can be executed accurately and to determine the accuracy of bone resection in TKA using PSI.

Methods: Data of 45 consecutive knees undergoing TKA using CT-based PSI were retrospectively evaluated.

Prosthetic Accuracy Depends on the Design of Patient-Specific Instrumentation: Results of a Retrospective Study Using Three-Dimensional Imaging.

To determine accuracy of patient-specific instrumentation (PSI), the preoperative three-dimensional (3D) plan should be superimposed on the postoperative 3D image to compare prosthetic alignment. We aimed to compare prosthetic alignment on a preoperative 3D computed tomography (CT) plan and postoperative 3D-CT image, and evaluate the accuracy of PSI during total knee arthroplasty (TKA). Thirty consecutive knees (30 patients) who underwent TKA using PSI were retrospectively evaluated.

Periprosthetic Loss of Bone Mineral Density After Cementless Porous Tantalum and Cemented Total Knee Arthroplasties: A Mean of 11-Year Concise Follow-Up of a Previous Report.

Background: Our previous study showed that the decrease in relative change of bone mineral density (BMD) in the lateral part of the tibia was significantly less in the group treated with the cementless porous tantalum component than in the group treated with the cemented cobalt-chromium tibial component up to 5 years after the operation. However, the long-term benefits of porous tantalum tibial component on BMD have not been proven. The aim of this study was to update a matched cohort study at a minimum of 6 years' follow-up period.

Intraoperative manipulation for flexion contracture during total knee arthroplasty.

Background: Joint gap unbalancing during total knee arthroplasty (TKA) induces flexion contracture. Flexion contracture is one of the most serious complications of TKA. When flexion contracture is found during surgery, intraoperative manipulation is often empirically performed.

A Case of Osteomyelitis after Calcaneal Fracture Treated by Antibiotic-Containing Calcium Phosphate Cements.

Calcaneal osteomyelitis (CO) is considered to be difficult to cure when it turned into a chronic phase. We report one case of calcaneal osteomyelitis which arises after the operation of calcaneal fracture. Remission was obtained by performing curettage of the infected cancellous bone of the calcaneal body and filling antibiotic-containing calcium phosphate cements (CPC) within its bone defect.

Intraoperative Manipulation for Flexion Contracture During Total Knee Arthroplasty.

Joint gap balancing during total knee arthroplasty (TKA) is important for ensuring postoperative joint stability and range of motion. Although the joint gap should be balanced to ensure joint stability, it is not easy to achieve perfect balancing during TKA. In particular, relative extension gap shortening can induce flexion contracture.

Reconstructive Osteotomy for Ankle Malunion Improves Patient Satisfaction and Function.

Treatment of chronic symptoms caused by a malunion is a difficult problem in orthopedic surgery. We encountered a case of ankle malunion at our hospital about 1 year after the first operation. The patient had been unable to walk with weight-bearing but regained the ability to walk after reconstructive osteotomy of the fibula.

Total Hip Arthroplasty for Rapidly Destructive Coxarthrosis in a Patient with Severe Platelet Deficiency due to Liver Cirrhosis and Immune Thrombocytopenic Purpura.

Rapidly destructive coxarthrosis (RDC) causes rapid and extreme destruction of the hip joint, which was reported by Postel and Kerboull. RDC is commonly unilateral and occurs mostly in elderly women. Immune thrombocytopenic purpura (ITP) is characterized by a low platelet count that is the result of both immune-mediated platelet destruction and suppression of platelet production.

Osteonecrosis of femoral head occurred after stent placement of femoral artery.

We present a case of osteonecrosis of femoral head (ONFH) that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO) of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

No difference in in vivo polyethylene wear particles between oxidized zirconium and cobalt-chromium femoral component in total knee arthroplasty.

Purpose: Polyethylene wear particle generation is one of the most important factors affecting mid- to long-term results of total knee arthroplasties. Oxidized zirconium was introduced as a material for femoral components to reduce polyethylene wear generation. However, an in vivo advantage of oxidized zirconium on polyethylene wear particle generation is still controversial.

Porous tantalum tibial component prevents periprosthetic loss of bone mineral density after total knee arthroplasty for five years-a matched cohort study.

In 21 knees receiving porous tantalum tibial component and 21 knees receiving a cemented cobalt-chromium tibial component, dual x-ray absorptiometry scans were performed for five years post-operatively. The postoperative decrease in the bone mineral density in the lateral aspect of the tibia was significantly less in knees with porous tantalum tibial components (11.6%) than in knees with cemented cobalt-chromium tibial components (29.

Pseudoaneurysm Accompanied by Crowe Type IV Developmental Dysplasia of the Hip: A Case Report.

We report the case of a 72-year-old woman whose pseudoaneurysm was difficult to diagnose and treat. The patient had a history of congenital dislocated hip and was undergoing anticoagulation therapy with warfarin due to the mitral valve replacement. Her chief complaint was pain and enlargement of the left buttock, and the laboratory tests revealed severe anemia.

Accuracy of cup height and medialization in THA for dysplastic hip osteoarthritis using an imageless navigation system.

In total hip arthroplasty (THA) for dysplastic hip osteoarthritis, bony deformity makes it difficult to identify the correct cup height and medialization. The authors developed a new technique for registration and navigation of cup position for dysplastic hips using an imageless navigation system. Eighty dysplastic hips (Crowe type I, n=58; type II, n=18; type III, n=4) underwent THA.

Prope tolerance to heart allografts in mice associated with persistence of donor interleukin-10-transduced stem cells.

Background: We previously reported that transduction of the human interleukin (IL)-10 gene into the total fetal liver stem cells (hIL-10-TFLs) of mice protects against their rejection in an allogeneic host. In this study, we explored the effects of these cells in two different models of organ transplantation.

Methods: Balb/c mice were sublethally irradiated before receiving skin or vascularized heterotopic heart grafts from C57Bl/6 mice.

Elevation of the femur in THA through a direct anterior approach: cadaver and clinical studies.

Background: The direct anterior approach in THA is an intermuscular approach that requires no muscle detachment. However, it is difficult to elevate the proximal femur for access to the femoral canal.

Questions/purposes: We asked (1) which part of the capsule should be released to allow effective elevation of the proximal femur; (2) whether the release of the internal obturator tendon allows elevation; and (3) whether hip hyperextension reduces the ability to elevate the femur.

Comparison of bone mineral density between porous tantalum and cemented tibial total knee arthroplasty components.

Background: Porous tantalum was recently introduced as a metallic implant material for total knee arthroplasty. Its porosity, low modulus of elasticity, and high frictional characteristics were expected to provide physiologic load transfer and relative preservation of bone stock. However, to our knowledge, the effect of a Trabecular Metal tibial component on bone mineral density has not been reported.

In vivo comparison of wear particles between highly crosslinked polyethylene and conventional polyethylene in the same design of total knee arthroplasties.

Reduction of wear with highly crosslinked polyethylene (HXLPE) has been reported in in vitro and in vivo studies of total hip prostheses. However, use of HXLPE in total knee prostheses is still controversial. The aim of this study was to compare in vivo polyethylene wear particle generation of HXLPE with that of conventional polyethylene in total knee prostheses of the same design.

[Significance of tuberculosis screening of outpatients in areas with high prevalence of tuberculosis].

Objective: The Osaka Socio-Medical Center Hospital is a medical care facility located in the Airin area of Osaka city where the prevalence of tuberculosis is high, and treats day laborers and homeless people mainly, either free of charge or with a small fee. To investigate whether this hospital can play a role to reduce the prevalence of tuberculosis in this area, we investigated the case rate of active tuberculosis in outpatients of the hospital.

Subjects And Methods: Of 1673 patients who first visited the Orthopaedic Outpatient Clinic between March 31, 2005 and June 15, 2006, 538 patients consented to undergo screening and underwent chest X-ray examination (screening group).