[Total joint arthroplasty].

Control of the disease activity is enabled due to the progress of drug therapy for rheumatoid arthritis. However, surgical treatments are necessary for unresponsive cases to the drug or for achieving higher QOL, and we can attain more tight control or cure by combination of drug therapy and surgical treatments. Total joint arthroplasty provides indolence, mobility, stability and is an useful joint reconstruction method.

Modular megaprosthesis in metastatic bone disease of the femur.

The treatment of bone metastases is frequently palliative, aiming to achieve satisfactory pain control and to prevent or treat pathological fractures. For lesions involving the femur, internal fixation frequently fails; therefore, prosthetic reconstruction may be the optimal choice for treatment. This article retrospectively reviews our experience with femoral bone metastases between 1999 and 2008.

Recent trends in orthopedic surgery performed in Japan for rheumatoid arthritis.

The aim of this report was to review the use of orthopedic surgeries performed to manage rheumatoid arthritis (RA). Our review of studies published in English indicates that there has been a decrease in RA-associated surgeries in Western countries. Improvements in medical treatment may partly explain the reduction in numbers of orthopedic joint surgeries, which also suggests a worldwide trend toward improved long-term outcomes.

Observation of retrieved ceramic-on-ceramic articular surface: a case of revised total hip arthroplasty due to failure of the support ring.

We report the case of a 63-year-old woman who required revision surgery for ceramic-on-ceramic total hip arthroplasty (THA) due to failure of the support ring. We retrieved the ceramic cup and head, observed it macroscopically and measured it to determine its shape condition (sphere diameter, sphericity, and circularity) and surface condition (surface roughness by scanning electronic microscopy). Although abrasion was not found at the sliding surface of either the cup or head, it was observed at the edges of the cup and at one part of the head.

Results of total hip arthroplasty with bone graft and support ring for protrusio acetabuli in rheumatoid arthritis.

We evaluated 19 hips of 15 rheumatoid arthritis patients with protrusio acetabuli that had been surgically treated with total hip arthroplasty (THA) using a support ring; four hips were replaced with a TACT cup supporter, one hip with a Kerboull plate, six hips with a Ganz ring, and eight hips with a Müller ring. The average age was 60.2 years (range 48-75 years), and the average follow-up was 38 months (range 6-74 months).