Preoperative degree of deformity and underlying disease affect the postoperative deformity of joint-preserving hallux valgus surgery.

Background: The combination of distal osteotomy with lateral dissection in joint-preserving surgery for severe hallux valgus deformity has recently begun to yield encouraging results. We examined the frequency of complications and risk factors of those for joint-preserving surgery in patients with and without rheumatoid arthritis (RA).

Methods: A retrospective, observational study of 72 feet (27 patients with RA) was performed.

Association of the Clinical and Radiographic Findings at Onset With Future Joint Destruction in Patients With Rheumatoid Arthritis.

Objectives: Since inflammation can cause joint destruction in patients with rheumatoid arthritis (RA), it is assumed that joints that are symptomatic at onset are at higher risk of joint destruction; however, this theory remains controversial. This study aimed to investigate whether the progression of joint destruction in hands and feet could be predicted from the clinical and radiographic findings at onset.

Methods: This study included 75 patients who visited our hospital within one year after the onset of RA with at least 12 months of follow-up.

Modified Scarf Osteotomy with Medial Capsular Interposition Combined with Metatarsal Shortening Offset Osteotomy: A Comparison of Patients with Noninflammatory Arthritis and Rheumatoid Arthritis of the Foot.

Background: Patients who have noninflammatory arthritis of the feet may develop destructive changes on the first metatarsal head and painful dislocation of the metatarsophalangeal (MTP) joint of 1 or more lesser toes. This aim of this study was to compare feet with noninflammatory arthritis and those with rheumatoid arthritis (RA) with respect to the clinical and radiographic outcomes after treatment of these destructive deformities with a modified Scarf osteotomy with medial capsular interposition into the newly formed first MTP joint, combined with metatarsal shortening offset osteotomy.

Methods: A retrospective observational study of 93 feet (31 with noninflammatory arthritis and 62 with RA) was performed.

Arthroscopic Partial Excision of the Radial Head for Advanced Rheumatoid Elbow.

We treated humeroradial joint disorder in rheumatoid elbows with arthroscopic partial excision of the radial head, in which the radial head is minimally resected under arthroscopy to ensure adequate joint space and articular congruity. To examine the effect of this method, we investigated outcomes using a retrospective case series. The hypothesis of this study was that this method decreases symptoms related to the humeroradial joint and ensures articular congruity.

Modified Anterolateral Approach for Total Ankle Arthroplasty.

Level V.

Combination of Modified Scarf Osteotomy and Metatarsal Shortening Offset Osteotomy for Rheumatoid Forefoot Deformity.

With the progress of medical treatment for rheumatoid arthritis (RA), several joint-preserving forefoot surgical procedures have been established and performed. In this situation, we have been choosing the combined surgery: modified scarf osteotomy for the great toe and metatarsal shortening offset osteotomy for the lesser toes in RA cases. A retrospective observational study of 53 RA patients (mean follow-up period: 4.

Bayesian analysis of the association between effective strategies of multimodal nonpharmacological intervention and characteristics of cognitive function in nursing home residents with cognitive impairment: A cross-sectional study.

The cognitive function of nursing home (NH) residents with cognitive impairment (CI) tends to decline over time. An effective multimodal non-pharmacological intervention (MNPI) strategy is needed to improve the cognitive function of NH residents with CI.The aim of this study was to clarify the cognitive function characteristics of NH residents with CI in whom a non-pharmacological intervention (NPI) can be implemented, consisting of MNPI using a Bayesian analysis, and to incorporate suggestions to make the MNPI strategy as effective as possible.

Abdominal Aortic Calcification Is a Significant Poor Prognostic Factor for Clinical Outcomes After Decompressive Laminotomy for Lumbar Spinal Canal Stenosis.

Study Design: Retrospective study.

Objective: To examine whether the presence of chronic kidney disease (CKD) or advanced abdominal aortic calcification (AAC) negatively affects clinical outcomes after decompression surgery for lumbar spinal canal stenosis (LSCS).

Methods: The subjects comprised 143 patients who underwent decompressive laminotomy for LSCS and were followed for ≥2 years.

Arthroscopic release for the severely stiff elbow.

Background: Arthroscopic release for the stiff elbow has been widely used, but there are no reports limited to severe stiffness. The purpose of this study was to investigate the outcomes of severe cases.

Materials And Methods: Ten patients with 10 severely stiff elbows defined by a limited arc of ≤ 60° underwent this arthroscopic release.

Bone stock reconstruction for huge bone loss using allograft-bones, bone marrow, and teriparatide in an infected total knee arthroplasty.

Bone stock reconstruction using allograft-bones, bone marrow (BM), and teriparatide (TPTD) is reported. Huge and extensive bone losses occurred in the medullary cavity of the femur and tibia of a 55-year-old female rheumatoid arthritis patient with severe osteoporosis after debridement of her infected total knee arthroplasty. Because of the risks of unstable prosthetic fixation and intra-operation fracture, we first reconstructed the bone stock.

Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity.

Background: Arthrodesis of the first metatarsophalangeal (MTP) joint has been recommended for severe hallux valgus deformity in patients with rheumatoid arthritis. We developed an alternative procedure that preserves motion of the first MTP joint while restoring alignment and balance to the forefoot. This procedure was shown to be effective in a series of 60 patients with a 3-year follow-up.

The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab.

To evaluate the effectiveness of add-on iguratimod (IGU) in patients with rheumatoid arthritis (RA) who showed an inadequate response to tocilizumab (TCZ), especially patients who were intolerant of an effective dose of methotrexate (MTX). Thirty-one patients with RA (22 women, age 62.4 years, disease duration 13.

Chronological Changes in Axial Alignment of the Ipsilateral Hip and Knee After Total Hip Arthroplasty.

Background: Internal rotation of the hip and lateral patellar tilt increases after total hip arthroplasty (THA). However, it remains unknown whether these parameters change with time after the index THA.

Methods: A total of 91 patients undergoing 2-stage bilateral primary THAs between January 2008 and May 2014 were included to assess the association of chronological changes in internal rotation of the hip or lateral patellar tilt with anthropometric and perioperative parameter and changes in alignment after the index THA.

Outcomes of modified metatarsal shortening offset osteotomy for forefoot deformity in patients with rheumatoid arthritis: Short to mid-term follow-up.

Objectives: Advances in drug therapy for rheumatoid arthritis (RA) have been encouraging us to preserve the metatarsopharangeal (MTP) joint in correction of forefoot deformities, and original metatarsal shortening offset osteotomy was recommended as one of the conventional surgical options for forefoot deformities in RA cases. The objective of this study was to evaluate short- to mid-term outcomes of modified metatarsal shortening offset osteotomy.

Methods: A retrospective observational study was completed for 80 RA cases (mean follow-up period: 3.

The efficacy and safety of additional administration of tacrolimus in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab.

Objectives: Tocilizumab (TCZ) shows good retention in patients with rheumatoid arthritis (RA), but no previous reports demonstrated hopeful treatment options against inadequate response to TCZ. Tacrolimus (TAC) has proved to show efficacy against inadequate response to tumor necrosis factor alpha inhibitors, yet its add-on effects on TCZ remain unknown.

Methods: Twenty patients with RA (17 women, age 58.

Changes in axial alignment of the ipsilateral hip and knee after total hip arthroplasty.

Aims: We investigated changes in the axial alignment of the ipsilateral hip and knee after total hip arthroplasty (THA).

Patients And Methods: We reviewed 152 patients undergoing primary THA (163 hips; 22 hips in men, 141 hips in women) without a pre-operative flexion contracture. The mean age was 64 years (30 to 88).

Acquired permanent dislocation of the patella in a patient with rheumatoid genu valgum.

A case of acquired permanent dislocation of the patella associated with severe genu valgum in a patient with rheumatoid arthritis (RA) is herein reported. The pain and genu valgum progressed because of poor RA control. The patient had no history of major trauma of the knee before or after the onset of RA.

Characterizations of the α1-adrenoceptor subtypes mediating contractions of the human internal anal sphincter.

Human internal anal sphincter (IAS) is contracted by α1-adrenoceptor stimulation and thus α1-adrenoceptor agonists may be useful in treating fecal incontinence. This study characterizes the contribution of α1-adrenoceptor subtypes in contraction of human IAS and to investigate the age-related risk of patients with fecal incontinence. IAS and inferior mesenteric artery (IMA), as a predictor of systemic arterial pressure, were obtained from 11 patients.

Eight-year preservation of knee function with radiographic healing phenomena after anti-tumor necrosis factor-α therapy for a severely erosive knee in a young patient with rheumatoid arthritis.

A 23-year-old woman developed rheumatoid arthritis (RA). The pain in her right knee was aggravated and anti-tumor necrosis factor (TNF)-α therapy was selected at the age of 35. The range of motion and Larsen grade were 5º to 120º and 4, respectively.

Preoperative morphometric differences in the distal femur are based on skeletal size in Japanese patients undergoing total knee arthroplasty.

Purpose: The objectives of this study were to measure the morphometric parameters of preoperative distal femurs to determine the differences by diagnosis and gender after accounting for skeletal size.

Methods: One-hundred and seventy-nine Japanese patients who underwent total knee arthroplasty (TKA) (25 males and 154 females) were assessed. The anteroposterior length (AP), mediolateral width (ML), aspect ratio (AR), surgical epicondylar axis (SEA) to posterior condylar axis (PCA) angle, and Whiteside to SEA angle were measured on preoperative computed tomography scans.

Disease activity, knee function, and walking ability in patients with rheumatoid arthritis 10 years after primary total knee arthroplasty.

Purpose: To evaluate disease activity, knee function, and walking ability of patients with rheumatoid arthritis (RA) over 10 years after total knee arthroplasty (TKA).

Methods: Four men and 26 women (mean age, 59.9 years) underwent 42 TKAs for RA with a mean duration of 151.

Role of computerized tomographic cisternography in idiopathic normal pressure hydrocephalus.

Background: We prospectively evaluate the role of computerized tomographic cisternography (CTC) in idiopathic normal pressure hydrocephalus (iNPH).

Methods: The cerebrospinal fluid kinetics of 70 patients who passed the entry criteria for the Study of iNPH on Neurological Improvement (SINPHONI) and underwent insertion of a shunt were studied.

Results: Stasis of the contrast medium at the lateral ventricles over 24 h (positive ventricular stasis) was observed in 60 patients and at the Sylvian fissure or parietal sulci over 48 h (positive surface stasis) in 59 patients.

Late infection of total knee arthroplasty inflamed by anti-TNFalpha, Infliximab therapy in rheumatoid arthritis.

We report a case of sudden onset of late infection after TKA inflamed by anti-TNFalpha therapy, Infliximab, in a 54-year-old woman with RA. Infliximab therapy was started 3 years and 8 months after TKAs as a result of multiple arthritides showing high inflammation of RA. One week after the third administration of Infliximab, the patient suffered sudden knee pain and infectious clinical symptoms, and bacteria (MSSA) were detected by joint effusion culture.

Replacement of the first metatarsophalangeal joint with a Swanson implant accompanied by open-wedge osteotomy of the first metatarsal bone for hallux valgus in rheumatoid arthritis.

Hallux valgus is very common in rheumatoid arthritis (RA) and mostly accompanied by varus deformity of the first metatarsal bone, which is often corrected in surgeries for hallux valgus in nonarthritic condition, but rarely in RA. We performed the replacement of the first metatarsophalangeal (MTP) joint with a Swanson hinge toe implant accompanied with open-wedge osteotomy of the first metatarsal bone, aiming at reconstruction of a functioning first MTP joint without recurrence of hallux valgus. Fifteen feet of 11 patients with RA were studied with a mean follow-up period of 45.