Formulation of Japanese Orthopaedic Association (JOA) clinical practice guideline for the management of low back pain- the revised 2019 edition.

Background: The latest clinical guidelines are mandatory for physicians to follow when practicing evidence-based medicine in the treatment of low back pain. Those guidelines should target not only Japanese board-certified orthopaedic surgeons, but also primary physicians, and they should be prepared based entirely on evidence-based medicine. The Japanese Orthopaedic Association Low Back Pain guideline committee decided to update the guideline and launched the formulation committee.

Surgical and general complications in 2,961 Japanese patients with cervical spondylotic myelopathy: Comparison of different age groups.

Details of surgical and general complications for patients with cervical spondylotic myelopathy (CSM) are still uncertain. The purpose of this study was to describe surgeries and their complications among Japanese patients with CSM. The Japanese Society for Spine Surgery and Related Research performed a nationwide survey on spine surgery and complications in 2011.

Complications of spinal surgery for elderly patients with lumbar spinal stenosis in a super-aging country: An analysis of 8033 patients.

Background: The Japanese Society for Spine Surgery and Related Research (JSSR) performed a third study on complications in spinal surgery in 2011. The purpose was to present information about surgery and complications in a large amount of elderly patients aged 65 years with lumbar spinal stenosis (LSS) without coexisting spondylolisthesis, spondylolysis, or scoliosis, and to compare patients aged ≥80 years to those aged 65-79 years.

Methods: A recordable optical disc for data storage was sent by JSSR in January 2012 to 1105 surgeons certified by the JSSR in order to collect surgical data.

Japanese 2011 nationwide survey on complications from spine surgery.

Background: The Japanese Society for Spine Surgery and Related Research (JSSR) previously carried out two nationwide surveys in 1994 and 2001 on complications from spine and spinal cord surgery. More than 10 years have now elapsed since 2001. Rapidly ageing populations have major impacts on society, particularly in the medical field.

Tibial tubercle osteotomy with screw fixation for total knee arthroplasty.

This study investigated the efficacy of tibial tubercle osteotomy (TTO) with screw fixation as part of the surgical treatment of primary complicated total knee arthroplasty (TKA) and revision TKA. From January 2000 to April 2011, 15 patients (15 knees) underwent revision TKA and 20 patients (21 knees) underwent primary TKA. The average patient age was 68.

Satisfactory results at 8 years mean follow-up after ADVANCE® medial-pivot total knee arthroplasty.

Background: Although good overall results have been reported with TKA, certain problems and limitations remain, primarily due to postoperative differences in joint kinematics, when compared with the normal knee. ADVANCE® Medial-Pivot TKA involves replicating the medial pivoting behavior observed in normal knees. Here, we aimed to investigate the clinical and radiological results and complications of TKA using this implant, at mid-term follow-up.

Energy consumption during prosthetic walking and physical fitness in older hip disarticulation amputees.

The objective of this study is to investigate energy consumption during prosthetic walking and physical fitness in older hip disarticulation (HD) subjects and to examine the ambulatory outcome in a community setting. The subjects were seven unilateral HD amputees with an average age of 67.7 +/- 3.

No difference between double-high insert and medial-pivot insert in TKA.

Purpose: To compare the clinical midterm results in ADVANCE total knee arthroplasty (TKA) with double-high (DH) insert, with same type implant with medial-pivot (MP) insert.

Method: Forty ADVANCE TKAs were randomly divided into two groups, and two different design insert, DH insert, and MP insert were used in each group. At midterm, 4-5 years after surgery, Knee Society Scores (KSS), Knee Society Functional Scores (KSFS), range of motion (ROM), and UCLA activity score were assessed and reported in this study.

In vivo comparisons of patellofemoral kinematics before and after ADVANCE Medial-Pivot total knee arthroplasty.

Purpose: ADVANCE Medial-Pivot (MP) (Wright Medical Technology, Arlington, TN, USA) total knee arthroplasty (TKA) was developed to replicate normal tibiofemoral knee joint kinematics, allowing medial-pivot knee motion. The design concept of the prosthesis is unique; therefore, the influence on the patellofemoral knee joint remains unclear at present. The purpose of this study was to determine the in vivo patellofemoral kinematics with ADVANCE MP TKA and compare them with the pre-operative conditions.

Neurogenic bladder associated with pure cervical spondylotic myelopathy: clinical characteristics and recovery after surgery.

Study Design: Retrospective study.

Objective: To examine the prevalence of lower urinary tract symptoms (LUTS) and neurogenic bladder (NB), and surgical outcomes in pure cervical spondylotic myelopathy.

Summary Of Background Data: The inclusion of various types of cervical diseases, NB, and no obvious definition of NB provided the wide range of NB prevalence frequency among previous reports.

Grade three disc degeneration is a critical stage for anterior spondylolisthesis in lumbar spine.

Introduction: Little is known about when and how progressive spondylolisthesis occurs. In this report segmental motion related to age and disc degeneration at L4/5 disc was investigated.

Materials And Methods: 637 patients with low back and/or leg pain underwent radiologic and MRI examinations simultaneously.

Intimate relationship between instability and degenerative signs at L4/5 segment examined by flexion-extension radiography.

Relationship between lumbar disc degeneration and segmental instability has remained controversial. Using instability factors that found close relations with symptoms in flexion-extension radiographic study, their relationship with degenerative findings was examined. More than (≥) 3 mm slip in neutral position (SN), ≥3 mm translation (ST), and ≥10° angulation (SA) at L4/5 segment were defined as instability factors and were applied on 447 patients who had low back and/or leg pain and satisfied inclusion criteria for accurate measurements.

Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty.

Purpose: This is a randomised controlled trial to examine whether intra-articular injection of tranexamic acid (TXA) decreases blood loss, as well as reducing leg swelling after total knee arthroplasty (TKA).

Methods: We performed 100 TKA in osteoarthritis patients. At closure, a total of 2,000 mg/20 ml TXA was injected into the knee joint through a closed suction drain (TXA group).

Mid-term outcomes of computer-assisted total knee arthroplasty.

Purpose: The aim of this study is to investigate the clinical results of total knee arthroplasty (TKA) using a navigation system after a minimum of 5 years.

Method: Thirty cases of posterior-stabilized, TKA-implanted using a computed tomography-free navigation system were compared with 30 cases having matched TKA of the same type implanted via a classical, manual technique. At mid term, a minimum of 5 years after surgery, Knee Society scores (KSSs), Knee Society Functional scores (KSFSs), range of motion (ROM), and radiographic results of 27 patients in each group were assessed and reported in this study.

Thermal necrosis after simultaneous tibial osteotomy and total knee arthroplasty using press-fit extension-stem.

One-staged tibial corrective osteotomy and total knee arthroplasty is a challenging but effective treatment for arthritic knees with extra-articular deformity. Although osteocutaneous thermal necrosis is accepted as a complication of intramedullary reamed nailing following long bone fractures, only 15 cases have been reported in the English literature at present. This report illustrates a rare case of thermal necrosis in a patient undergoing tibial corrective osteotomy coincident with long-stemmed total knee arthroplasty.

The influence of sagittal instability factors on clinical lumbar spinal symptoms.

Study Design: Cross-sectional and prospective study.

Objective: To find the critical order of 3 radiographic factors observed in standing flexion-extension films and to discover their combined effect on lumbar symptoms.

Summary Of Background Data: Many previous reports have described relationships between degenerative change in the lumbar disc and segmental instability; however, few reports have attempted to show any relationship between instability and symptoms.

Delayed dural laceration by hydroxyapatite spacer causing tetraparesis following double-door laminoplasty.

Object: The authors describe 4 cases of delayed dural laceration by hydroxyapatite (HA) spacer causing tetra-paresis following double-door laminoplasty. There are few reports of iatrogenic spinal cord lesions developing after double-door laminoplasty, although some complications such as postoperative C-5 paralysis or axial symptoms have been reported. The purpose of this report is to draw attention to the possibility of delayed dural laceration and its triggering mechanism.

Hypermethylated promoter region of DR3, the death receptor 3 gene, in rheumatoid arthritis synovial cells.

Objective: To examine the promoter activity and protein expression of the death receptor 3 gene DR3, a member of the apoptosis-inducing Fas gene family, with particular reference to the methylation status of its promoter region in rheumatoid arthritis (RA).

Methods: Genomic DNA was prepared from peripheral blood mononuclear cells obtained from healthy individuals and from patients with RA and synovial cells obtained from patients with RA and osteoarthritis. The methylation status of the DR3 promoter was analyzed by bisulfite genomic sequencing and methylation-specific polymerase chain reaction techniques.

Lumbar instability and clinical symptoms: which is the more critical factor for symptoms: sagittal translation or segment angulation?

Background: The relationship between radiologic instability and its symptoms is controversial. Previous authors consider flexion-extension radiographs to be of little value in evaluating instability; however, the current authors consider the variation of results in evaluating radiologic instability to be the result of limitations in previous researchers' methods.

Methods: In this report, sagittal translation and angulation at the L4-L5 segment were measured in flexion-extension films in 1,090 outpatients with low back and/or leg pain using a three-landmark measuring method.

Age distribution of three radiologic factors for lumbar instability: probable aging process of the instability with disc degeneration.

Study Design: Cross-sectional study of 880 outpatients with low back and/or leg pain regarding age distribution of three radiologic factors.

Objectives: To investigate the proportion and relationship of three individual radiologic factors with age on segmental instability in sagittal plane in consecutive age groups.

Summary Of Background Data: Previous studies revealed relationships between radiologic factors for instability and symptoms; however, little is known about the relationship between factors and age except in degenerative spondylolisthesis.

Radiculopathy due to ossification of the yellow ligament at the lower lumbar spine.

Study Design: A case report.

Objectives: To report a rare case of a 27-year-old female with ossification of yellow ligament at the lower lumbar spine presenting radiculopathy with a drop foot.

Summary Of Background Data: The majority of cases of ossification of yellow ligament occur at the lower third of the thoracic or the thoracolumbar spine.