Revision Total Hip Arthroplasty Using a Cementless Cup Supporter and Iliac Autograft: A Minimum of 15-Year Follow-Up.

Background: Bone deficiency in revision total hip arthroplasty is a surgical challenge. The Murata-Chiba cup supporter (MC support ring) is an acetabular component supporter for a cementless porous-coated cup. The purpose of this study is to examine the clinical and radiographic outcomes of reconstruction of acetabular bone deficiency using iliac autografts supported by an MC support ring in a revision setting with minimum 15-year follow-up.

The rectangular flexion gap is associated with an increased knee flexion angle in a cruciate-sacrificing rotating platform mobile-bearing total knee arthroplasty.

Background: The knee flexion angle after a total knee arthroplasty is an important indicator of clinical outcome. However, there is little appropriate information about the correlation between the ligament balancing and knee flexion angle after total knee arthroplasty. The purpose of this study was to investigate the effect of the ligamentous balance in extension and flexion on knee flexion angle one year after posterior cruciate ligament sacrificing rotating platform total knee arthroplasty.

Case-related factors affecting cutting errors of the proximal tibia in total knee arthroplasty assessed by computer navigation.

Purpose: The aim of this study was to determine factors that contribute to bone cutting errors of conventional instrumentation for tibial resection in total knee arthroplasty (TKA) as assessed by an image-free navigation system. The hypothesis is that preoperative varus alignment is a significant contributory factor to tibial bone cutting errors.

Methods: This was a prospective study of a consecutive series of 72 TKAs.

An investigation of factors related to the use of respite care services for children with severe motor and intellectual disabilities (SMID) living at home in Japan.

Limited time away from the child is cited as the main factor that increases the burden for the primary caregiver of severely disabled children. The aim of this study was to quantitatively elucidate the factors related to the desire to use social services and the actual use of respite care services by the primary caregivers of severely disabled children in Japan. In this study, we investigated the use of respite care services in accordance with the primary caregivers' wishes by examining inhibiting or promoting factors associated with respite care service use only among those who wished to use social services.

The distance from the extramedullary cutting guide rod to the skin surface as a reference guide for the tibial slope in total knee arthroplasty.

Background: Although sagittal tibial alignment in total knee arthroplasty (TKA) is important, no landmarks exist to achieve a reproducible slope. The purpose of this study was to evaluate the clinical usefulness of the distance from the guide rod to the skin surface for the tibial slope in TKA.

Methods: Computer simulation studies were performed on 100 consecutive knees scheduled for TKA.

Varus and valgus stress tests after total knee arthroplasty with and without anesthesia.

Introduction: Retrospective studies demonstrated inadequate soft tissue balance is associated with the long-term outcome of total knee arthroplasty (TKA). However, most of these studies have evaluated the joint laxity only postoperatively without anesthesia. Therefore information about the effect of anesthesia on knee laxity is important for soft tissue balancing at the time of surgery.

Exploring the beliefs of Japanese mothers caring for a child with disabilities.

The purpose of this study was to describe the beliefs of Japanese mothers caring for a child with disabilities to advance knowledge about beliefs of Japanese families experiencing illness. A semistructured interview was conducted with eight mothers who had a child with disabilities (physical, intellectual, and/or developmental). The interview invited their reflections about "mutual thoughts of family members" and family relationships in the context of daily life of caring for a child with disabilities.

A Useful Anatomical Reference Guide for Stem Anteversion during Total Hip Arthroplasty in the Dysplastic Hip.

Computed tomography scans of 50 dysplastic hips were obtained and reconstructed using preoperative planning software for total hip arthroplasty. The anteversion of the stem implanted parallel to the line connecting the trochanteric fossa and the middle of the medial cortex of the femoral neck (T line) was measured. The cutting heights of 5mm and 10mm above the lesser trochanter were simulated.

Accuracy of the second metatarsal as a landmark for the extramedullary tibial cutting guide in total knee arthroplasty.

Purpose: The purpose of this study was to evaluate the accuracy of the second metatarsal (MT2) as a landmark for proximal tibial cutting in total knee arthroplasty (TKA). It was hypothesized that the accuracy of the MT2 is not high, especially in rheumatoid arthritis (RA) patients whose foot joints are apt to be involved.

Methods: Computer simulation studies on 48 RA knees and 45 osteoarthritis (OA) knees were performed.

Influence of antiplatelet therapy on postoperative recurrence of chronic subdural hematoma: a multicenter retrospective study in 719 patients.

Objective: The present study tested the hypothesis of whether antiplatelet agents (APA) induce chronic subdural hematoma (CSDH) recurrence via a platelet aggregation inhibitory effect.

Method: We examined risk factors for CSDH recurrence, focusing on APA, in 719 consecutive patients who admitted to three tertiary hospitals and underwent burr-hole craniostomy and irrigation for CSDH. This was a multicenter, retrospective, observational study.

The T-line as an intraoperative landmark for reproducing the native femoral anteversion during hip arthroplasty.

Introduction: Three-dimensional computed tomographic (CT)-based preoperative planning for total hip arthroplasty (THA) enabled us to evaluate the cut surface of the femoral neck osteotomy. When we planned the stem placement in 20° of anteversion, we noticed that the line connecting the trochanteric fossa and the middle of the medial cortex of the femoral neck (T line) was coincident with the component torsion in many cases. We attempted to evaluate the accuracy of the T line for reproducing the native femoral anteversion during THA comparing it with the midcortical line, the reference guide previously reported by Suh.

The effect of the posterior slope of the tibial plateau osteotomy with a rotational error on tibial component malalignment in total knee replacement.

We performed a CT-based computer simulation study to determine how the relationship between any inbuilt posterior slope in the proximal tibial osteotomy and cutting jig rotational orientation errors affect tibial component alignment in total knee replacement. Four different posterior slopes (3°, 5°, 7° and 10°), each with a rotational error of 5°, 10°, 15°, 20°, 25° or 30°, were simulated. Tibial cutting block malalignment of 20° of external rotation can produce varus malalignment of 2.

Effectiveness of deep vein thrombosis screening on admission to a rehabilitation hospital: a prospective study in 1043 consecutive patients.

Introduction: The diagnosis and treatment of deep vein thrombosis/pulmonary embolism (DVT/PE) are important issues not only in acute-care hospitals, but also in rehabilitation hospitals. To test the hypothesis that DVT/PE occurring at rehabilitation hospitals is carried over from acute-care hospitals, we evaluated a method of DVT screening on admission that combined D-dimer (D-D) measurement and compression ultrasound (CUS).

Material And Methods: This prospective single-center observational study included 1043 patients who were admitted to our rehabilitation hospital between August 1, 2007, and August 1, 2011, after excluding those meeting the exclusion criteria.

The effect of rotational fixation error of the tibial cutting guide and the distance between the guide and the bone on the tibial osteotomy in total knee arthroplasty.

Computed tomography based computer simulation studies were made on fifty consecutive patients with osteoarthritis scheduled for TKA. Proximal tibial cutting was simulated with the cutting guide placed at different rotational errors (-10°, 0°, 10° and 20° of internal rotation) and different distances (4 cm and 8 cm) between the alignment rod and the bone. Only ten degrees of rotation error with 8 cm of distance resulted in over 3° of varus or valgus tibial cut.

The effect of a sagittal cutting error of the distal femur on the flexion-extension gap difference in total knee arthroplasty.

The aim of this study was to determine how much a distal femoral cutting error would affect the flexion-extension gap difference (flexion gap minus extension gap) in total knee arthroplasty (TKA). We evaluated 15 knees using a computer-simulation technique. Bone cutting errors of -2°, 2° and 4° of extension were simulated in three TKA systems.

Mirror observation of finger action enhances activity in anterior intraparietal sulcus: a functional magnetic resonance imaging study.

Mirror therapy can be used to promote recovery from paralysis in patients with post-stroke hemiplegia, There are a lot of reports that mirror-image observation of the unilateral moving hand enhanced the excitability of the primary motor area (M1) ipsilateral to the moving hand in healthy subjects. but the neural mechanisms underlying its therapeutic effects are currently unclear. To investigate this issue, we used functional magnetic resonance imaging to measure activity in brain regions related to visual information processing during mirror image movement observation.

The tibial crest as a practical useful landmark in total knee arthroplasty.

Background: The middle one-third of the tibial crest in the coronal plane and the fibula in the sagittal plane are known as landmarks for extramedullary guides in total knee arthroplasty (TKA). However, there are few foundational anatomic studies about them. We conducted this study to confirm whether these landmarks are reliable.

Sagittal flexion of the femoral component affects flexion gap and sizing in total knee arthroplasty.

The purpose of this study was to determine how much sagittal rotation of the femoral component affects the flexion gap and femoral component sizing using a computer-simulation technique. The study comprised 25 knees scheduled for total knee arthroplasty (TKA). The femoral component was positioned at -2°, 0°, 2°, 4°, or 6° of flexion to the anterior femoral cortex, and the resected portion of the posterior medial femoral condyle was measured for 3 total knee systems.

Changes in the brain activation balance in motor-related areas after constraint-induced movement therapy; a longitudinal fMRI study.

Primary Objective: This study investigated the longitudinal changes in brain activation balance in motor-related areas after Constraint-Induced Movement Therapy (CIMT).

Methods And Procedures: The subjects included seven ischemic stroke patients with mild right hemiparesis. Eight normal subjects were also included.

Results of revision total hip arthroplasty with Anatomic BR stem: 10-year minimum follow-up.

Twenty cementless total hip revision arthroplasties using Anatomic BR stems were performed in 20 patients. Fourteen patients, with a mean age of 62.6 years (range 41-74 years) at time of revision surgery, were followed retrospectively for a minimum of 10 years (range 11-15 years).

The pattern of distribution of PGP 9.5 and TNF-alpha immunoreactive sensory nerve fibers in the labrum and synovium of the human hip joint.

To date, there has been no report clarifying the existence of sensory nerve fibers as the origin of the hip joint pain of osteoarthritis. We examined the existence of sensory nerve fibers in osteoarthritis (OA), osteonecrosis of the femoral head (ONFH), and femoral neck fracture of the human hip joint. Ten labra of 10 human hip joints were harvested during a total hip arthroplasty.

[A family of dentatorubral-pallidoluysian atrophy: clinical and neuroradiologic studies].

We described a family of dentatorubral-pallidoluysian atrophy (DRPLA). The mother presented with cerebellar ataxia at 35 years of age and thereafter her neurological symptoms became exacerbated. Her daughter had mental retardation during the preschool period and epilepsy at 10 years.

[Murata-Chiba (MC) support ring for acetabular defect in rheumatoid hip].

Acetabular protrusion presents a particular challenge in rheumatoid arthritis. Our surgical plan is (1) to use autologous bone grafts for reconstruction of the acetabulum (2) to locate the correct anatomic position of the acetabulum, (3) to use a uncemented porous socket with rigid screw fixation. From 1991 we began to use MC (Murata-Chiba) support ring which was assembled with Harris-Galante porous socket for highly deformed hip such as acetabular protrusion.

MRI changes and deficits of higher brain functions in preterm diplegia.

Forty-one preterm children (29 with spastic diplegia and 12 without motor deficits) who had a normal verbal IQ were studied to clarify the clinical significance of neuroanatomical abnormalities disclosed by T1-weighted and T2-weighted magnetic resonance imaging (MRI). Both types of images clearly showed abnormalities in the frontal corona radiata of the children with spastic diplegia, while there were no abnormalities in the children without motor deficits. We compared the T1-weighted imaging findings with deficits of higher brain functions, evaluated by the performance subtests of the Wechsler Intelligence Scale.