Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
-
Comparative Study
In vivo pre- and postoperative three-dimensional knee kinematics in unicompartmental knee arthroplasty.
Pre- and postoperative knee kinematics in unicompartmental knee arthroplasty (UKA) can be theoretically related to clinical outcome and longevity after UKA with regard to ligament function and the degree of arthritic changes. However, the preoperative knee kinematics of patients indicated for UKA remain to be elucidated, and it is also unclear whether the preoperative kinematics can be maintained by the UKA procedure. The objective of this study was to examine the in vivo pre- and postoperative three-dimensional knee kinematics in UKA while referencing the normal knee kinematics reported in our previous study. ⋯ Although the patterns of preoperative knee motion were similar to those seen in normal knees, the magnitude of this motion varied widely between patients, so it was not necessarily representative of normal knees. These variations may be due to the varying degrees of arthritic changes caused by osteoarthritis. Although the patterns of knee kinematics were largely maintained by the UKA procedure, the causes of the significant reductions in the magnitude of motion upon performing the UKA procedure should be investigated in subsequent studies with a larger number of patients.
-
Comparative Study
The complement of the load-sharing classification for the thoracolumbar injury classification system in managing thoracolumbar burst fractures.
The classification and therapeutic strategy for thoracolumbar burst fractures are controversial. The load-sharing classification (LSC) and thoracolumbar injury classification system (TLICS) are both quantitative evaluation systems for thoracolumbar burst fractures. We hypothesized that their combination would be helpful not only for surgical indications but also for deciding on the surgical approach. However, no reports have evaluated the relationship between them. The purpose of this study was to clarify the relationship between the LSC and TLICS and investigate the clinical usefulness of their combination. ⋯ Although the TLICS scores correlated with the LSC scores, a single application of TLICS might not be sufficient to identify those patients who have a TLICS score of 3 or less and an LSC score of 7 or more as surgically indicated. However, an additional LSC evaluation avoided deviations as the two classifications complemented each other, and it was useful in determining the best treatment options for thoracolumbar burst fractures.
-
Comparative Study
Infra-isthmal fracture is a risk factor for nonunion after femoral nailing: a case-control study.
The rates of nonunion after femoral nailing are currently reported to be 4.1-12.5 %. The purpose of this study was to identify the risk factors of noninfected nonunion after femoral nailing, focusing in particular on the effects of the length of the distal main fragment. ⋯ The elucidated risk factors of nonunion after femoral nailing were identified as open fracture, infra-isthmal femoral fracture, breakage of locking screw, and inappropriate dynamization. We believe that the surgeon should be consciously aware of the need for additional surgical fixation for the distal fragment when performing femoral nailing of infra-isthmal femoral fractures.
-
Multicenter Study Comparative Study
Validity, reliability and responsiveness of the Japanese version of the Neck Disability Index.
The Neck Disability Index (NDI) is one of the most widely used questionnaires for neck pain. The purpose of this study was to validate the Japanese NDI. ⋯ We demonstrated the validity, reliability and responsiveness of the Japanese NDI. The modified NDI was more strongly correlated with numbness and mental health-related QOL.