Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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The sacroiliac joint (SIJ) can be a source of low back and lower limb pain. The SIJ pain can originate not only from the joint space but also from the ligaments supporting the joint. Its diagnosis has been difficult because the physical and radiological examinations have proved less than satisfactory. Thus, to know the specific sites of SIJ pain, if these exist, could be very useful for making the diagnosis. The purpose of the present study was to identify the main site of SIJ pain according to the patient's pointing with one finger and to confirm the site by a pain-provocation test and periarticular lidocaine injection. ⋯ Our study clearly indicated that when patients point to the PSIS or within 2 cm of it as the main site of low back pain, using one finger, the SIJ should be considered as the origin of their low back pain.
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As hydroxyapatite (HA) has good osteoconductive properties, HA is used as coating material for the implants in cementless arthroplasty. However, its effect is not sufficient for osteoporotic bone. Parathyroid hormone (PTH) is known to have anabolic effects on bone formation. Intermittent administration of PTH increases both cancellous and cortical bone mass. The aim of this study was to confirm the effect of the fixation strength of HA-coated implants in the osteoporotic condition with a mechanical test and a bone histomorphometric method. ⋯ Intermittent administration of PTH has an effect to increase new bone formation on the surface of HA-coated implants in the osteoporotic condition. This finding suggests that PTH administration is useful to improve the initial fixation of HA-coated implants even in osteoporotic patients.