Intraoperative fluoroscopic confirmation of the knee improves the accuracy of stem anteversion in total hip arthroplasty with direct anterior approach using traction table.

Background: Stem anteversion (SA) in total hip arthroplasty (THA) is crucial for postoperative outcomes, affecting dislocation risk and hip function. Accurate SA placement is challenged by intraoperative estimation methods, with discrepancies reported between predicted and true SA. This study investigates the effect of conventional methods and intraoperative fluoroscopic confirmation on SA accuracy in THA performed with a direct anterior approach using a traction table.

Comparison study of bone strength of the proximal femur with and without hip osteoarthritis by computed tomography-based finite element analysis.

Proximal femoral fractures are common in elderly osteoporosis patients; however, its prevalence is clinically rare in hip fracture patients with hip osteoarthritis (OA). This study aimed to evaluate bone strength of the proximal femur with or without hip OA and proximal femoral fracture risk using computed tomography (CT)-based finite element analysis (FEA). A retrospective analysis was done on CT data of 20 patients who underwent total hip arthroplasty for unilateral hip OA.

Ratio of dislocation types of the proximal interphalangeal joint of the fingers: A new classification system for initial therapy.

Background: We proposed a new system named the sagittal, coronal, axial, rotational and fracture (SCARF) classification, which can simply explain any condition of proximal interphalangeal (PIP) joint dislocations of the fingers. The purpose of this study was to verify that this classification would contribute to management of PIP joint dislocations at the initial therapy. We determined ratios of five factors in PIP dislocations with SCARF by interpreting radiographs and assessed the interobserver and intraobserver variability.

Predictive value of magnetic resonance imaging for multifocal osteonecrosis screening associated with glucocorticoid therapy.

The goals of this study were to elucidate the distribution of multifocal osteonecrosis associated with glucocorticoid therapy using magnetic resonance imaging (MRI) and to establish a MRI screening method. Between 1986 and 2018, 107 patients underwent MRI screening of their hips, knees, shoulders and ankle joints (856 joints in total) after systemic glucocorticoid therapy. Osteonecrosis was observed in hip (68%), knee (44%), ankle (17%) and shoulder (15%) joints.

Finite element analysis of the femoral diaphysis of fresh-frozen cadavers with computed tomography and mechanical testing.

Background: The purpose of this study was to validate a diaphyseal femoral fracture model using a finite element analysis (FEA) with mechanical testing in fresh-frozen cadavers.

Methods: We used 18 intact femora (9 right and 9 left) from 9 fresh-frozen cadavers. Specimens were obtained from 5 males and 4 females with a mean age of 85.

Diffusion tensor imaging of the sciatic and femoral nerves in unilateral osteoarthritis of the hip and osteonecrosis of femoral head: Comparison of the affected and normal sides.

The aim was to compare the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the sciatic and femoral nerves in patients with unilateral osteoarthritis of the hip (OA) and osteonecrosis of the femoral head (ONFH) using diffusion tensor imaging (DTI) and to investigate the mechanism of hip pain. Forty-four patients (22 OA and 22 ONFH) underwent DTI of the sciatic and femoral nerves at the level of the hip joint and the S1 roots to visualize the tractography and quantify the FA and ADC values. The tractography of the femoral and the sciatic nerves on the affected side with OA and ONFH were similar to those on the normal side.

Anatomical Features of the Descending Genicular Artery to Facilitate Surgical Exposure for the Subvastus Approach-A Cadaveric Study.

Background: The purpose of this cadaveric study was to clarify the proximal limit for the subvastus approach (SVA) in total knee arthroplasty to decrease potential vascular injury.

Methods: Seventy embalmed knees underwent a modified SVA using a 14-cm oblique medial incision. Anatomical features of the descending genicular artery (DGA) were investigated with regard to variation, distance of the vessels from surgical landmarks, and sex differences.

Transitional changes in the incidence of osteonecrosis in systemic lupus erythematosus patients: focus on immunosuppressant agents and glucocorticoids.

Objective: The purpose of this study was to investigate transitional changes in the incidence of glucocorticoid-associated osteonecrosis in SLE patients, with a focus on immunosuppressive agent and glucocorticoid consumption.

Methods: We retrospectively registered 185 SLE patients with 740 joints, who were newly diagnosed and hospitalized for initial high-dose glucocorticoid therapy from 1986 to 2015. Immunosuppressive agent, glucocorticoid dose, age, sex, organ lesion at hospitalization, complement (C3, C4, CH50) and anti-DNA antibody before initial glucocorticoid therapy, the frequency of use of anticoagulant and antilipidemic drugs, and incidence of osteonecrosis were documented.

Interobserver and Intraobserver Reliability of Computed Tomography-Based Three-Dimensional Preoperative Planning for Primary Total Knee Arthroplasty.

Background: Preoperative planning is an important factor for total knee arthroplasty (TKA). The aim of this study is to document the interobserver and intraobserver reliability of computed tomography (CT)-based 3-dimensional (3D) preoperative planning for primary TKA.

Methods: Twenty knees (10 with osteoarthritis and 10 with rheumatoid arthritis) were studied independently by 6 orthopedic surgeons using a CT-based 3D planning system.

Prediction of fracture load and stiffness of the proximal femur by CT-based specimen specific finite element analysis: cadaveric validation study.

Background: Finite element analysis (FEA) of the proximal femur has been previously validated with large mesh size, but these were insufficient to simulate the model with small implants in recent studies. This study aimed to validate the proximal femoral computed tomography (CT)-based specimen-specific FEA model with smaller mesh size using fresh frozen cadavers.

Methods: Twenty proximal femora from 10 cadavers (mean age, 87.

Diffusion tensor imaging and tractography of the sciatic and femoral nerves in healthy volunteers at 3T.

Background: The aim was to clarify the normal fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the sciatic and femoral nerves at the level of the hip joint and to visualize the neural tracts with diffusion tensor imaging (DTI).

Methods: Twenty-four healthy volunteers (12 men and 12 women, age 20-29 years) underwent DTI for visualization with tractography and quantification of FA and ADC values on a 3 Tesla MRI (b value = 800 s/mm, motion probing gradient, 11 directions, time to repeat/echo time = 9000/72.6 ms, axial slice orientation, slice thickness = 3.

Interobserver and Intraobserver Reliability of Three-Dimensional Preoperative Planning Software in Total Hip Arthroplasty.

Background: The purpose of this study is to clarify interobserver and intraobserver reliabilities of the three-dimensional (3D) templating of total hip arthroplasty (THA).

Methods: We selected preoperative computed tomography from 60 hips in 46 patients (14 men and 32 women) who underwent primary THA. To evaluate interobserver and intraobserver reliability, 6 orthopedic surgeons performed 3D templating twice over a 4-week interval.