Total Hip Arthroplasty in Hip Osteoarthritis with Subtrochanteric Localized Periosteal Thickening: Preoperative Planning Using Finite Element Analysis to Determine the Optimal Stem Length.

Owing to the risk of atypical femoral fractures, total hip arthroplasty presents unique challenges for patients with ipsilateral osteoarthritis and localized periosteal thickening in the femoral subtrochanteric region. Stem length selection is critical for minimizing stress concentration in the thickened cortex to avoid such fractures. Herein, we report the case of a 78-year-old woman with ipsilateral hip osteoarthritis and localized subtrochanteric periosteal thickening.

Removal of a broken Kuntscher intramedullary nail for a femoral diaphyseal nonunion 17 years after injury.

Introduction: In treating nonunion, the removal of a broken nail is often difficult. We report a technique for removing a broken Kuntscher intramedullary nail. In this technique, a chisel is inserted into the lumen of the intramedullary nail, and the nail is rotated.

Bone mineral density changes around the stem correlate with stress changes after total hip arthroplasty: A study using thermoelastic stress analysis.

Purpose: Thermoelastic stress analysis (TSA) was used to evaluate stress changes over the entire surface of a specimen. This study aimed to assess the relationship between femoral stress distribution, analysed using TSA and changes in bone mineral density (BMD) after total hip arthroplasty (THA).

Methods: Stress changes in the simulated bone before and after taper-wedge stem insertion were measured using the TSA.

Safety and feasibility of in-hospital autonomous transportation using a driverless mobility for patients with musculoskeletal disorders: preliminary clinical study to achieve mobility as a service in medical care.

Background: Recent advancements in and the proliferation of autonomous mobility technology, such as intelligent wheelchairs, have made it possible to provide mobility services for patients with reduced mobility due to musculoskeletal disorders. In the present study, we conducted a preliminary clinical study to assess the safety and feasibility of in-hospital autonomous transportation using a driverless mobility (wheelchair) for patients with musculoskeletal disorders.

Methods: From January to February 2022, 51 patients with musculoskeletal disorders exhibiting gait disturbance who presented to our institution were included in the present study.

A favorable suture method for size-mismatched nerve transfer: comparison with standard perineural suture in an experimental rat study.

Background: In nerve transfer for peripheral nerve injury, it is sometimes necessary to suture size-mismatched nerves. In 1993, a favorable suture method called the Ochiai suture method for size-mismatched nerve transfer was reported. However, there is currently a lack of substantial evidence beyond the original report.

Effects of bone marrow-derived mesenchymal stem cell transplantation in piglet Legg-Calve-Perthes disease models: a pilot study.

This preliminary study investigated the efficacy and safety of bone marrow-derived mesenchymal stem cell transplantation in a piglet Legg-Calve-Perthes disease (LCPD) model. The LCPD model was induced in two Landrace piglets (6- and 7-week-old, weighing 12 and 17 kg, respectively) by ligaturing the femoral neck. In the first piglet, the natural LCPD course was observed.

Primary Stability of Collared and Collarless Cementless Femoral Stems - A Finite Element Analysis Study.

Background: Primary stability of the femoral stem is important for the long-term results of cementless total hip arthroplasty. Cementless collared stems have been known to have higher stability than collarless stems when there is a contact between the collar and the calcar. The purpose of this study was to compare the stabilities of collared stem and collarless stem in 2 loading conditions: 1) flat walking and 2) stair climbing.

Relationship of Pelvic Positional Change with Leg Length and Offset Measurement in Experimental Total Hip Arthroplasty.

Objective: During total hip arthroplasty (THA), both pelvic and femur positions affect leg length (LL) and offset (OS) measurements because LL and OS calipers depend on the fixed reference points on the pelvis and femur, respectively. However, LL and OS measurement errors because of pelvic positional changes have not been described. This study aimed to clarify the effects of pelvic positional changes on LL and OS measurements in relation to the pelvic reference using a THA simulator.

Hemiarthroplasty for tumor-induced osteomalacia caused by tumor localized in femoral head: a case report.

Tumor-induced osteomalacia (TIO) is a rare tumor-associated syndrome in which osteomalacia is induced by a tumor. A 67-year-old male patient presented for the first time with low back pain, weakness of the lower extremities and difficulty in walking. Six years earlier, he had nonspecific symptoms such as low back pain, and blood tests showed high alkaline phosphatase and low phosphorus.

Gluteal compartment syndrome after laparoscopic surgery in lateral jackknife position: a case report.

We present a case of a 42-year-old obese female with a body mass index of 38.4 kg/m. Laparoscopic tumor resection of a left nonfunctioning adrenal tumor was performed in the lateral jackknife position, and the operative time was over 5 h.

Total Hip Arthroplasty After Failed Hip-Preserving Surgery with Concentrated Autologous Bone Marrow Aspirate Transplantation for Osteonecrosis of the Femoral Head: A Retrospective Study.

Purpose: Since 2003, a hip-preserving technique-concentrated autologous bone marrow aspirate transplantation (CABMAT)-has been applied to treat osteonecrosis of the femoral head (ONFH). We investigated intraoperative and postoperative outcomes of total hip arthroplasty (THA) in patients who underwent CABMAT as hip-preserving surgery for ONFH but developed secondary hip osteoarthritis after progressive femoral head collapse.

Methods: A total of 456 hips in 282 patients underwent CABMAT in our hospital between April 2003 and December 2018; 108 hips required THA (THA conversion rate, 23.

Comparison Between Concentrated Autologous Bone Marrow Aspirate Transplantation as a Hip Preserving Surgery and Natural Course in Idiopathic Osteonecrosis of the Femoral Head.

Purpose The purpose is to compare the therapeutic efficacy of concentrated autologous bone marrow aspirate transplantation (CABMAT) with that of observation alone for osteonecrosis of the femoral head (ONFH). Methods This single-center study included patients with idiopathic ONFH that were either treated with CABMAT (CABMAT group) or managed through observation alone (observation group) over a >2-year follow-up period. The Japanese Investigation Committee classification was used to diagnose and classify ONFH.

Development of a Self-made Cement Bead Maker and Its Clinical Application for the Treatment of Periprosthetic Joint Infection.

Antibiotic-loaded acrylic cement beads have a large surface area and excellent sustained-release properties. However, there are some difficulty manufacturing reasonably sized beads and their careful handling. We developed a self-made cement bead maker using a mold of a sphere with a diameter of 8 and 10 mm with a 2-mm-diameter connecting hole.

An exploratory clinical trial for concentrated autologous bone marrow aspirate transplantation in the treatment of osteonecrosis of the femoral head.

Purpose: This study evaluated the efficacy and safety of a novel treatment for osteonecrosis, in which concentrated autologous bone marrow aspirate transplantation (CABMAT) is followed by low-intensity pulsed ultrasound (LIPUS) stimulation for 3 months. The study was designed as a prospective, uncontrolled, open-label phase II clinical study.

Methods: This study included 16 cases of osteonecrosis of the femoral head (ONFH), including 26 hips.

Stress analysis of total hip arthroplasty with a fully hydroxyapatite-coated stem: comparing thermoelastic stress analysis and CT-based finite element analysis.

Purpose: The aim of this study was to evaluate the stress distribution in a synthetic femur that was implanted with a fully hydroxyapatite-coated stem using thermoelastic stress and finite element analyses, and to clarify the differences in the stress distributions between these two methods.

Methods: Thermoelastic stress analysis is a stress-analysis technique that employs the thermoelastic effect. Sinusoidal vertical loads were applied to the head of the stem placed on the synthetic femur, and surface stress distribution images were acquired using an infrared stress measurement system.

Feasibility and Safety of a Novel Leg Exercise Apparatus for Venous Thromboembolism Prophylaxis after Total Joint Arthroplasty of the Lower Extremities-A Pilot Study.

Venous thromboembolism (VTE) is a severe complication in orthopedic surgeries. Herein, we developed a novel leg exercise apparatus (LEX) to encourage postoperative limb movement in bedridden patients to prevent VTE. We aimed to evaluate its feasibility and safety in individuals at risk of VTE.

New Evaluation Method for Bone Formation around a Fully Hydroxyapatite-Coated Stem Using Digital Tomosynthesis: A Retrospective Cross-Sectional Study.

Digital tomosynthesis (DTS) is a new imaging technique derived from radiography, and its usefulness has been gradually reported in the field of orthopedic diagnosis in recent years. A fully hydroxyapatite (HA)-coated stem, which is used for total hip arthroplasty (THA), is a type of cementless stem that has been widely used recently and reported to have good results. However, stem loosening on plain radiographs is difficult to determine in some cases due to cancellous condensation around the stem.

Stress distribution of cementless stems with unique flanges in a rectangular cross-section: thermoelastic stress imaging study.

In this study, thermoelastic stress analysis was conducted to clarify the surface stress distribution of a femur in which a BiCONTACT E stem was inserted. The contact sites between the stem and femur were examined to investigate the association with the range of stress distribution. BiCONTACT E was set up using two synthetic femurs that mimic the morphology and mechanical properties of living bone.

Effects of lower limb and pelvic pin positions on leg length and offset measurement errors in experimental total hip arthroplasty.

Background: Leg length (LL) and offset (OS) are important factors in total hip arthroplasty (THA). Because most LL and OS callipers used in THA depend on fixed points on the pelvis and the femur, limb position could affect measurement error. This study was conducted on a THA simulator to clarify the effects of lower limb position and iliac pin position on LL and OS errors and to determine the permissible range of limb position for accurate LL and OS measurement.

Concentrated autologous bone marrow aspirate transplantation versus conservative treatment for corticosteroid-associated osteonecrosis of the femoral head in systemic lupus erythematosus.

To compare the outcomes of steroid-associated osteonecrosis of the femoral head in patients with systemic lupus erythematosus who underwent conservative treatment and concentrated autologous bone marrow aspirate transplantation Osteonecrosis of the femoral head was classified according to the Japanese Investigation Committee system. Concentrated autologous bone marrow aspirate transplantation was performed by aspirating the bone marrow from both iliac crests and then transplanting it to the necrotic area after the core decompression. Patients with >2-year follow-up after the concentrated autologous bone marrow aspirate transplantation in our institution (Group I) and those with >2-year follow-up after the first hospital visit in a cooperative institution (Group II) were included in this study.

Isolated Distal Fibular Stress Fracture after Total Hip Arthroplasty in a Patient with Developmental Dysplasia of the Hip.

Stress fractures following total hip arthroplasty in the lower limbs away from the surgical area are very rare. We report a case of stress fracture in the isolated distal fibula that presented five months after total hip arthroplasty in a patient with developmental dysplasia of the hip. A 67-year-old woman diagnosed with coxarthrosis of the right hip joint, classified as Crowe's group 3, underwent total hip arthroplasty with acetabular reconstruction using a bulk bone graft.

Ten-year results of 55 dysplasia hips of hip offset and leg length reconstruction in total hip arthroplasty with cementless tapered stems having a high offset option designed for dysplastic femur.

Purpose: In developmental dysplasia of the hip (DDH), the centers of hip rotation move in the superior and lateral direction. In total hip arthroplasty for such cases, movement of the center of hip rotation is in the inferior and medial direction. It causes an increase in leg length and a decrease in acetabular offset.

Ten-year results of concentrated autologous bone marrow aspirate transplantation for osteonecrosis of the femoral head: a retrospective study.

Background: Idiopathic osteonecrosis of the femoral head (ONFH) occurs at a relatively younger age. It is therefore important to prevent the resultant femoral head collapse and requirement of total hip arthroplasty in these patients. In 2003, we initiated concentrated autologous bone marrow aspirate transplantation (CABMAT), a joint-preserving treatment for ONFH, at our institution.