Preventing Loss of Femoral Periprosthetic Bone Mineral Density in Cementless Total Hip Arthroplasty Using a Tapered Wedge Stem: A Retrospective, Cohort Study in Osteoporotic Patients Treated with Denosumab.

Purpose Bone quality is an important issue in elderly osteoporotic patients who undergo total hip arthroplasty (THA) because periprosthetic fracture or aseptic loosening of implant caused by periprosthetic bone loss is a serious concern. Denosumab has been approved for osteoporosis patients. Thus, the purpose of this study was to investigate whether denosumab prevents loss of proximal femoral periprosthetic bone mineral density (BMD) in cementless THA using a tapered wedge stem in patients with osteoporosis.

Characteristics and Treatment Strategies for Basicervical and Transcervical Shear Fractures of the Femoral Neck.

This study aimed to define basicervical and transcervical shear fractures using area classification and to determine the optimal osteosynthesis implants for them. The clinical outcomes of 1042 proximal femur fractures were investigated. A model of the proximal femur of a healthy adult was created from computed tomography images, and basicervical and transcervical shear fractures were established in the model.

Preoperative medications is one of the factor affecting patient-reported outcomes after total hip arthroplasty.

Although the reported clinical outcomes of total hip arthroplasty (THA) for hip osteoarthritis are satisfactory, not all patients are completely satisfied. Thus, there is interest in predicting postoperative satisfaction before surgery. The influence of comorbidities and preoperative medications on the incidence of complications and duration of hospitalization following THA has become apparent.

Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem.

Background: Because the tapered wedge-shaped type cementless stem has a small anteroposterior width and a low occupation rate in the medullary space, postoperative rotational instability and stem subsidence due to inadequate proximal fixation are concerns. The purpose of this study was to clarify the relationship between the rotational instability of the tapered wedge-shaped type cementless stem and femoral canal shape.

Methods: A total of 61 primary total hip arthroplasties with the tapered wedge-shaped type cementless stem Accolade® TMZF (11 males, 50 females; mean age 60 years) from January 2012 to June 2015 who underwent computed tomography before surgery and within 4 weeks and 1 year after surgery were evaluated.

The Differences in Imaging Findings Between Painless and Painful Osteoarthritis of the Hip.

Purpose: In osteoarthritis of the hip, the pain may be strong even if the deformity is mild, but the pain may be mild even if the deformity is severe. If the factors related to the pain can be identified on imaging, reducing such factors can alleviate the pain, and effective measures can be taken for cases where surgery cannot be performed. In addition, imaging findings related to the pain are also important information for determining the procedures and the timing of surgery.

A Comparison of the Incidences of Venous Thromboembolism after Total Hip Arthroplasty between the Direct Anterior Approach and the Direct Lateral Approach, Especially in the Early Period after Introduction of the Direct Anterior Approach.

Objective: To compare the incidence of venous thromboembolism (VTE) after total hip arthroplasty (THA) using the direct anterior approach (DAA) with that using the direct lateral approach (DLA). In addition, patient background characteristics and the incidence of VTE were compared between the first half and the latter half of the period after introducing DAA and against DLA.

Method: This was a retrospective, multicenter study involving 109 patients (116 hips) who had undergone primary unilateral THA.

The location of the fracture determines the better solution, osteosynthesis or revision, in periprosthetic femoral fractures.

Purpose: Periprosthetic femoral fractures are difficult to treat, but few reports have included many periprosthetic femoral fractures. The purpose of this study was to investigate the trends and characteristics of a large number of periprosthetic femoral fractures and to determine the best treatment strategy for such fractures.

Methods: The fracture type according to the Vancouver classification, the stem fixation style of previous surgery, the elapsed time from previous surgery, and the treatment method for periprosthetic fractures of 51 patients with periprosthetic femoral fractures who were seen between 2006 and 2018 were investigated.

Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area.

Purpose: Proximal femoral fractures involving both the subcapital area and the trochanteric or subtrochanteric area have rarely been reported, but they are not uncommon. However, few studies have reported the incidence or clinical outcomes of such fractures. This study investigated such fractures.

The Status of Assessments and Treatments for Osteoporosis in Patients 5 Years after Total Hip Arthroplasty: A Cross-Sectional Survey of 194 Post-THA Patients.

Background: Assessments for osteoporosis in patients who have undergone total hip arthroplasty (THA) are very important with respect to the clinical results. However, few studies have investigated the status of the assessments and treatments for osteoporosis in post-THA patients. The purpose of this multicenter study was to investigate the status of assessments and treatments for osteoporosis in post-THA patients.

Relationship between clinical results of total hip replacement and postoperative activities including weeding and snow shovelling.

Introduction: Weeding or snow shovelling is indispensable for life in farm villages of northern countries. Clarifying the relationships between the degrees of these activities after total hip replacement (THR) and the clinical results of THR may enable us to predict the results of THR for high-level activity patients. The relationships between work activities after THR and the results were investigated.

A Case of Fracture-Redislocation of the Hip Caused by a Depressed Fracture of the Femoral Head Similar to a Hill-Sachs Lesion.

The present case shows a case of fracture-redislocation of the hip caused by a depressed fracture of the femoral head similar to a Hill-Sachs lesion. A 59-year-old man fell from a roof and his left hip joint was dislocated posteriorly. He was admitted to a nearby hospital, and he was referred to our hospital more than 24 hours after injury.

Osteolysis of the Greater Trochanter Caused by a Foreign Body Granuloma Associated with the Ethibond® Suture after Total Hip Arthroplasty.

The present case shows a case of progression of osteolysis of the greater trochanter caused by a foreign body granuloma associated with the number 5 Ethibond suture in cementless THA with the direct lateral approach that was completely healed by removal of the Ethibond suture. A 55-year-old Japanese woman with secondary osteoarthritis caused by acetabular dysplasia underwent left cementless THA with the direct lateral approach. After setting of the total hip prosthesis, the gluteus medius muscle and vastus lateralis muscle were reattached to the greater trochanter through two bone tunnels using number 5 Ethibond EXCEL sutures.

The choice of internal fixator for fractures around the femoral trochanter depends on area classification.

Purpose: In femoral trochanteric fractures, fractures whose fracture lines extend to the basal neck or to the subtrochanteric part have high instability. Area classification can identify such instable fractures. The best choices of internal fixators for femoral trochanteric fractures were investigated according to area classification.

Clinical diagnosis of upper lumbar disc herniation: Pain and/or numbness distribution are more useful for appropriate level diagnosis.

Objective: The purpose of this study is to disclose the characteristic symptoms and signs in L2, L3 and L4 nerve root disturbance.

Materials And Methods: Fifty eight patients who underwent lateral herniotomy were analyzed. Breakdowns are 15 patients with L2/3 lateral disc herniation (group A), 20 patients with L3/4 lateral disc herniation (group B), and 23 patients with L4/5 lateral disc herniation (group C).

Negative magnetic resonance imaging in femoral neck stress fracture with joint effusion: a case report.

Femoral neck stress fracture (FNSF) is well documented in the orthopedic literature and is generally associated with strenuous activities such as long-distance running and military training. The diagnostic yield of magnetic resonance imaging (MRI) for FNSF was reported to be 100 %, and early MRI is recommended when this fracture is suspected. We encountered a 16-year-old male long-distance runner with FNSF in whom the left femoral neck showed no signal changes on MRI although an effusion was detected in the left hip joint.

The reliability of classifications of proximal femoral fractures with 3-dimensional computed tomography: the new concept of comprehensive classification.

The reliability of proximal femoral fracture classifications using 3DCT was evaluated, and a comprehensive "area classification" was developed. Eleven orthopedists (5-26 years from graduation) classified 27 proximal femoral fractures at one hospital from June 2013 to July 2014 based on preoperative images. Various classifications were compared to "area classification.

Effects of combined therapy of alendronate and low-intensity pulsed ultrasound on metaphyseal bone repair after osteotomy in the proximal tibia of aged rats.

Bisphosphonates and low-intensity pulsed ultrasound (LIPUS) are both known to maintain or promote callus formation during diaphyseal fracture healing. However, the effect of these treatments on the repair of metaphyseal fractures has not been elucidated. To evaluate the effects of bisphosphonates and/or LIPUS on cancellous bone healing, an osteotomy was performed on the proximal tibial metaphysis of 9-month-old Sprague-Dawley rats (n = 64).

Effects of a vitamin D analog, alfacalcidol, on bone and skeletal muscle in glucocorticoid-treated rats.

Glucocorticoids cause secondary osteoporosis and myopathy. The efficacy of vitamin D on osteoporotic fractures is thought to be through direct effects on bone and indirect effects on muscles that help to prevent falls. However, effects of vitamin D on muscles under glucocorticoid treatment remain unclear.

Intermittent weekly administration of human parathyroid hormone (1-34) improves bone-hydroxyapatite block bonding in ovariectomized rats.

Hydroxyapatite (HA) blocks have been widely used for the reconstruction of bone defects and as a bone substitute. Bone-implant bonding depends on both implant-related factors and patient variables. Intermittent human parathyroid hormone (h-PTH) has a strong anabolic effect on bone formation.

Effects of single and cyclical local injections of basic fibroblast growth factor on cancellous bone defects in rabbits.

Background: Local administration of basic fibroblast growth factor (bFGF) has anabolic effects on bone formation. A delivery system for local treatment is required to increase efficacy because of its short half-life. However, little is known about the effects of cyclical local injection of bFGF.

Relationships between falls, spinal curvature, spinal mobility and back extensor strength in elderly people.

Spinal mobility and back extensor strength (BES) are important in determining quality of life (QOL) for elderly people. However, the impact of spinal factors on falls remains unclear. The purpose of this study was to clarify spinal factors related to falls in elderly people, including deformity of spinal curvature, spinal mobility and BES.