Factors affecting cartilage repair after medial opening-wedge high tibial osteotomy.

Purpose: This study documented the healing potential of degenerated articular cartilage after opening-wedge valgus high tibial osteotomy (HTO) in patients with osteoarthritis of the knee. It was hypothesized that regeneration of articular cartilage is affected by several factors, including preoperative cartilage degeneration grade, difference between the medial femoral condyle (MFC) and the medial tibial condyle (MTC), and postoperative knee alignment.

Methods: Medial opening-wedge valgus HTO was performed in 131 knees of 100 patients (mean age 66 ± 7.

Clinical results of unicompartmental arthroplasty for knee osteoarthritis using a tibial component with screw fixation.

Purpose: Unicompartmental knee prostheses with screw fixation into the proximal tibia were employed and postoperative clinical results for osteoarthritis of the knee, especially regarding relief of pain, range of motion and satisfactory limb alignment are reported and discussed.

Methods: A total of 140 knees (131 medial and 9 lateral) of 85 patients (21 men and 64 women) were followed up for two to 17 years with an average of 7.0 ± 3.

A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee.

Background: The choice of surgical treatments for unicompartmental osteoarthritis (OA) of the knee is still somewhat controversial. Midterm results from cases treated using unicompartmental knee arthroplasty (UKA) or open wedge high tibial osteotomy (OWHTO) were evaluated retrospectively.

Methods: Twenty-seven knees of 24 patients with varus deformities underwent OWHTO and 30 knees of 18 patients underwent UKA surgeries for the treatment of medial compartmental osteoarthritis (OA).

Clinical features and classification of bipartite or tripartite patella.

The purposes of this study were to report clinical features of the developmental anomaly of ossification type bipartite or tripartite patella using a large series and to propose a new classification for the developmental anomaly of ossification type bipartite or tripartite patella. The first author prospectively examined 111 patients with symptomatic or asymptomatic bipartite (131 knees) or tripartite (8 knees) patellae. Eighty-six (77%) were male and 25 (23%) were female.

In vitro stability of open wedge high tibial osteotomy with synthetic bone graft.

It has been predicted that significant stress will be applied to the plate and lateral cortical hinge of an osteotomy site when early full weight bearing is commenced after an open wedge high tibial osteotomy. We hypothesized that the stress concentration on the plate or at the lateral cortical hinge would be reduced by inserting bone substitutes into the osteotomy gap. Two different types of tibia model were investigated: Group A, fixation with TomoFix with the osteotomy site left as an open space; and Group B, two beta-TCP wedges are inserted into osteotomy site and fixed with TomoFix.

Osteotomy around young deformed knees: 38-year super-long-term follow-up to detect osteoarthritis.

Since 1969 corrective osteotomy has been performed at our institute in young patients (under 40 years) with bowlegs, knock knees and flexion or rotational deformities around the knee. Fifty-seven knees (29 left, 28 right) of 45 patients (19 boys, 26 girls) were followed-up for a period ranging from 30 to 38 years in seven patients with seven knees, from 20 to 29 years in nine patients with 11 knees, and from ten to 19 years in 29 patients with 39 knees. Supracondylar femoral osteotomy was performed on 12 knees (11 patients), high tibial osteotomy above the tibial tuberosity on eight knees (six patients) and below the tuberosity on 37 knees (28 patients).

Clinical results of a valgus high tibial osteotomy for the treatment of osteoarthritis of the knee and the ipsilateral ankle.

The treatment of patients with osteoarthritic knees accompanied by ipsilateral osteoarthritic ankles is not well documented. We here report both clinical results and radiographic evaluations of such patients treated using a high tibial osteotomy (HTO). HTO was performed on 16 knees of 10 patients (all women with a mean age; 68 years; range 58 to 73 years) who had a varus deformity of both their legs as a result of medial compartmental osteoarthritis of their knees.

Bone scintigraphy in patients with bipartite patella.

This study was performed to assess the diagnostic value of bone scintigraphy to differentiate symptomatic bipartite patella from asymptomatic bipartite patella. Thirty-seven bipartite patellae (15 symptomatic and 22 asymptomatic) were evaluated by bone scintigraphy. Bone scintigraphic activity in bipartite patella was classified into the following four groups.

Histopathological abnormalities in painful bipartite patellae in adolescents.

The purpose of this study was to clarify the etiology of painful bipartite patella in adolescents by histopathological examination of excised specimens. We performed excision of a fragment of painful bipartite or tripartite patella from six patients (six knees). The articular cartilage, interposed tissue, bone, and bone marrow of the excised specimens were histologically examined.

[Nerve distribution in synovium of osteoarthritic knees].

Neural elements are widely distributed in synovium of osteoarthritic knees. In medial compartmental osteoarthritic knees, medial synovium is exposed to mechanical stimuli due to osteophytes and lateral thrust, which may accumulate neuropeptides, especially substance P, in free nerve endings. Free nerve endings containing a large amount of substance P may provoke pain sensation in synovium, and release substance P to the surrounding tissue in subsynovial tissue, which induces synovitis.

Repair of articular cartilage defect by autologous transplantation of basic fibroblast growth factor gene-transduced chondrocytes with adeno-associated virus vector.

Objective: To examine the effects of basic fibroblast growth factor (bFGF) gene-transduced chondrocytes on the repair of articular cartilage defects.

Methods: LacZ gene or bFGF gene was transduced into primary isolated rabbit chondrocytes with the use of a recombinant adeno-associated virus (AAV) vector. These gene-transduced chondrocytes were embedded in collagen gel and transplanted into a full-thickness defect in the articular cartilage of the patellar groove of a rabbit.

Fifteen to twenty-eight years' follow-up results of high tibial valgus osteotomy for osteoarthritic knee.

A long-term follow-up study was performed on 75 knees of 53 patients after high tibial valgus osteotomy. The earlier results have previously been reported. There were 15 knees in 11 men and 60 knees in 42 women.

Transepicondylar line and condylar line as parameters for axial alignment in knee arthroplasty.

In order to investigate the reliability of the transepicondylar line and the condylar line as indicators for lower limb alignment in knee arthroplasty, the femorotibial angle (FTA), and the angle between the transepicondylar line and the tangential line of tibial plateau (angle epsilon) and condylar-plateau angle (CPA) were measured in 107 (78 patients) full-length standing X-ray films of lower limbs. The mean FTA was measured to be 178.0+/-9.

15-year follow-up study of total knee arthroplasty in patients with rheumatoid arthritis.

In 25 patients with rheumatoid arthritis, 36 cases of cemented Kinematic total knee arthroplasty were reviewed clinically and radiographically at 13 to 19 years after surgery. The mean age at the time of surgery was 51.6 +/- 8.

Provoked anterior knee pain in medial osteoarthritis of the knee.

The incidence and the causes of provoked anterior knee pain in medial osteoarthritis (OA) of the knee were investigated clinically and radiographically. A retrospective study was performed in 179 primary osteoarthritic knees of 129 patients. Provocative tests were conducted on the patellofemoral (PF) joint to induce retropatellar crepitation, grating pain, tenderness around the patella, and pain on deviating the patella.

Articular cartilage repair of rabbit chondral defect: promoted by creation of periarticular bony defect.

This study investigated the stimulatory effect of bone healing on cartilage regeneration. Full-thickness osteochondral defects, 5 mm wide x 3 mm deep, were created in the patellar groove of the right distal end of the femur in 60 mature Japanese white rabbits. The bone defect was made in the medial condyle of the ipsilateral tibia in the experimental group.

Regeneration of degenerated articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis of the knee.

The aim of the current study was to document regeneration of the articular cartilage after correction of varus deformity for osteoarthritis of the knee. The repair of articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis was observed in 146 knees of 115 patients. The mean age of the patients at osteotomy was 65+/-7 years (range 47-80).

Radiologic evaluation of the rheumatoid hand after synovectomy and extensor carpi radialis longus transfer to extensor carpi ulnaris.

Purpose: In this study we radiologically evaluated the effects of extensor carpi radialis longus (ECRL) tendon transfer on the stability and deformity of joints of rheumatoid hands in cases with a postoperative period of more than 5 years.

Methods: Synovectomy concomitant with tendon transfer of the ECRL to the extensor carpi ulnaris (Clayton's procedure) was performed in 28 wrists of 23 patients with rheumatoid arthritis. The follow-up period was 8.

Decrease of osteosclerosis in subchondral bone of medial compartmental osteoarthritic knee seven to nineteen years after high tibial valgus osteotomy.

Osteosclerosis of the subchondral bone was measured by densitometer on plain radiographs in 55 medial compartmental osteoarthritic knees of 40 patients who were treated with high tibial valgus osteotomy for correction of varus deformity. The ratio of the osteosclerosis value of the medial side of the knee to that of the lateral side (Medial/Lateral ratio) was calculated and used as a parameter. The Medial/Lateral ratio of osteosclerosis decreased rapidly within three years after osteotomy at the reference points of the femur and the tibia.

CD44 expression in synovial lining and cartilage of rat knees induced by intraarticular injection of synthetic lipid A.

Abstract To study the effect of synthetic lipid A on the expression of the adhesion molecule CD44 in synovium and cartilage, synthetic lipid A (10 μg/ml, 0.5 ml) diluted in 0.025% triethylamine (TEA) was injected into the left knee of male Wistar rats.

Fibroblast growth factor 2 in synovial fluid from an osteoarthritic knee with cartilage regeneration.

The levels of fibroblast growth factor 2 (FGF2) in synovial fluid of osteoarthritic knees were measured. The correlation between FGF2 and the severity of cartilage degeneration in varus-deformed knees with medial compartmental osteoarthritis or the articular cartilage regeneration that occurs after high tibial osteotomy (HTO) were investigated. Knees that underwent total knee arthroplasty (TKA) were categorized as either mildly or severely degenerated according to a modified Outerbridge's grading system for degeneration of articular cartilage.

Medial opening-wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee.

Background: The aims of this study were to investigate the results of opening-wedge high tibial valgus osteotomy in patients with medial compartment osteoarthritis of the knee and to examine the usefulness of hydroxyapatite wedges as the supporting material.

Methods: Medial opening-wedge osteotomy was performed in twenty-one osteoarthritic knees in eighteen patients who had a mean age of 66.6 years.

Effect of femoral nerve resection on progression of cartilage degeneration induced by anterior cruciate ligament transection in rabbits.

The purpose of this study was to evaluate the effect of femoral nerve resection on the progression of cartilage degeneration in an anterior cruciate ligament transection (ACLT) and partial meniscectomy (PM) model in rabbits. To induce degeneration of articular cartilage, PM and ACLT were performed on the bilateral knees of 24 rabbits, and femoral sensory nerve selective resection (FNR) was additionally performed on the left knee. Six rabbits each were killed 6 and 10 weeks after surgery to observe early cartilage degeneration and 17 and 24 weeks after surgery to evaluate the late phase.

Cemented ceramic YMCK total knee arthroplasty in patients with severe rheumatoid arthritis.

Total knee arthroplasty (cemented) using a ceramic Yokohama Medical Ceramic Knee (YMCK) (Kyocera Corp; Kyoto, Japan) prosthesis was evaluated in 90 knees of 64 patients with severe rheumatoid arthritis, with a mean age of 59 +/- 11 years. The mean follow-up period was 56 +/- 20 months (range, 27 to 97 months). Larsen's grading of rheumatoid arthritis revealed grade 2 in 3, grade 3 in 36, grade 4 in 36, and grade 5 in 15 of 90 knees.

Underestimation of varus angulation in knees with flexion deformity.

In order to investigate the change in limb alignment in cases of knee flexion deformity, 17 male volunteers aged from 25 to 35 years with no complaints and no knee disorders were selected. The femorotibial angle (FTA), which is the lateral angle at the intersection between the femoral axis and the tibial axis in an anteroposterior radiograph, was employed as an index of limb alignment. FTA in standing on one leg with and without knee flexion was measured.