Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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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.
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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.
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Comparative Study
Different analgesic effects of adenosine between postoperative and neuropathic pain.
Adenosine is an endogenous neuromodulator in both the peripheral and central nervous systems. Adenosine inhibits pain signals by hyperpolarizing neuronal membrane. ⋯ These results suggest that adenosine effectively inhibits pain signals in neuropathic pain but is less effective in postoperative pain because of the decrease in adenosine A1 receptors.