Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Multicenter Study
Lumbar spinal stenosis associated with peripheral arterial disease: a prospective multicenter observational study.
Intermittent claudication is a common symptom of both lumbar spinal stenosis (LSS) and peripheral arterial disease (PAD) in middle-aged and elderly people. However, the prevalence and clinical characteristics of LSS with PAD (LSSPAD) have not been investigated in a multicenter study. The aim of this study was to investigate the prevalence and clinical characteristics of LSS associated with PAD. ⋯ Advanced age, diabetes, and a history of cerebrovascular disorder and ischemic heart disease were associated with LSSPAD. Because LSSPAD patients show less improvement in QOL than patients with LSS but without PAD do, clinicians should consider the coexistence of PAD in LSS patients.
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Anterior decompression with fusion (ADF) for patients with cervical ossification of the posterior longitudinal ligament (OPLL) is reportedly associated with a higher incidence of complications than is laminoplasty. However, the frequency of perioperative complications associated with ADF for cervical OPLL has not been fully established. The purpose of this study was to investigate the incidence of perioperative complications, especially neurological complications, following ADF performed to relieve compressive cervical myelopathy due to cervical OPLL. ⋯ The incidences of deterioration in upper- and lower-extremity functions were 13.3 % and 2.0 %, respectively. Patients with a high occupying ratio of OPLL are at higher risk of developing neurological deterioration.
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Comparative Study
Bipolar hemiarthroplasty compared with internal fixation for unstable intertrochanteric fractures in elderly patients.
The optimal treatment for unstable intertrochanteric fractures in elderly patients remains controversial. We aimed to compare internal fixation and bipolar hemiarthroplasty for the treatment of unstable intertrochanteric fractures in elderly patients. ⋯ Internal fixation with good reduction and fixation quality should be the preferred therapeutic method for elderly unstable intertrochanteric fractures, even when severe osteoporosis is present.
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The concept of the locomotive syndrome (LS), first proposed in Japan in 2007, has become widely accepted, and the 25-question Geriatric Locomotive Function Scale (GLFS-25), a quantitative, evidence-based diagnostic tool for LS, has been developed. However, the association between the GLFS-25 score and the outcome of physical capacity tests has never been investigated. Furthermore, which physical tests are good indices for evaluating and monitoring the severity of locomotive syndrome have not been identified. In addition, the impact of knee and low back pain on locomotive syndrome is unclear. The purpose of this study is to confirm the validity of GLFS-25 by demonstrating its significant correlation with the outcome of physical function tests and to determine which tests are good indicators for monitoring the severity of LS. The secondary aim of the project is to investigate how much influence knee and low back pain may have on the LS of the middle-aged and elderly. ⋯ We confirmed the validity of GLFS-25 by demonstrating a significant correlation and association of its score with the outcome of a series of functional performance tests. One-leg standing time with eyes open, timed up-and-go test and grip strength proved to be easy, reliable and safe performance tests to evaluate and monitor an individual's severity of LS as a complement to the GLFS-25. We also proved that knee and low back pain significantly impact the degree of LS.