Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Multicenter Study
Prevalence of neuropathic pain in cases with chronic pain related to spinal disorders.
The incidence and characteristics of neuropathic pain associated with spinal disorders have not yet been fully clarified. The purpose of this study was to investigate the prevalence of neuropathic pain and the degree of deterioration of quality of life (QOL) in patients with chronic pain associated with spinal disorders who visited orthopedic outpatient clinics. ⋯ The frequency of neuropathic pain tended to be higher in patients with diseases associated with spinal cord damage and lower in patients with diseases that primarily manifested as somatic pain. A bias toward allodynia symptoms in the screening questionnaire may have resulted in the failure to diagnose neuropathic pain in some patients with radiculopathy. Poor QOL, primarily from the aspect of physical functioning, was demonstrated in patients with neuropathic pain associated with spinal disorders.
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The Japanese Orthopaedic Association (JOA) has proposed the term "locomotive syndrome" (LS) to designate a condition in people from high-risk groups with musculoskeletal disease who are highly likely to require nursing care at some point. This syndrome is caused by weakening of the musculoskeletal organs such as bone, joint, and muscle. The current study investigated factors that influence quality of life (QOL) loss caused by LS, which builds upon our previous study showing that LS affects individuals' QOL. ⋯ Low back and knee pain proved to be significant contributors to individuals' QOL. TUG might be the most valuable function test for effectively evaluating an individual's QOL.
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An outcome measure to evaluate the neurological function of patients with cervical myelopathy was proposed by the Japanese Orthopaedic Association (JOA score) and has been widely used in Japan. However, the JOA score does not include patients' satisfaction, disability, handicaps, or general health, which can be affected by cervical myelopathy. In 2007, a new outcome measure, the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), which is a self-administered questionnaire, was developed. However, the influence of age and gender on the scores has not been fully examined. The purpose of this study was to establish the standard value of the JOACMEQ by age using healthy volunteers. ⋯ The standard values of the JOACMEQ by age were established. Differences in the scores were found among different generations. Patients with cervical myelopathy should be evaluated with this new self-administered questionnaire taking into account the standard values according to different ages.
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Randomized Controlled Trial
The effect of two different trochanteric nail lag-screw designs on fixation stability of four-part intertrochanteric fractures: a clinical and biomechanical study.
To compare lag-screw sliding characteristics and fixation stability of two cephalomedullary nails (CMN) with different lag-screw designs (solid and telescopic), we conducted a biomechanical study and an analysis of clinical results. ⋯ Both designs are acceptable devices for stabilization of intertrochanteric fractures. Clinical and biomechanical data demonstrate greater lateral sliding in the solid lag-screw group, making for greater potential for lateral-sided hip pain in CMNs with solid lag screws as opposed to telescoping lag screws.
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Since its introduction, intraoperative three-dimensional (3D) imaging has enabled the analysis of articular fractures and implant positions during fracture surgery. The purpose of this study was to evaluate the usefulness of intraoperative 3D imaging in locating anatomic structures, correcting errors, and preventing revision surgery. ⋯ Intraoperative 3D imaging is useful for correcting errors and may prevent a second operation. Three-dimensional imaging may be especially helpful in intra-articular fractures, iliosacral screw fixation, and syndesmotic injury.