Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Randomized Controlled Trial Multicenter Study
Prevention of postoperative venous thromboembolism in Japanese patients undergoing total hip or knee arthroplasty: two randomized, double-blind, placebo-controlled studies with three dosage regimens of enoxaparin.
Enoxaparin is a low-molecular-weight heparin indicated in Europe and North America for the prevention of venous thromboembolism (VTE) in patients undergoing major orthopedic surgery. Registration trials of enoxaparin have been conducted primarily in Caucasian populations, and the efficacy and safety of enoxaparin in Japanese patients have not been demonstrated. We evaluated three dosage regimens of postoperative enoxaparin in Japanese patients undergoing elective total hip or knee arthroplasty. ⋯ Our findings support the use of enoxaparin (20 mg bid daily, commencing 24-36 h postoperatively) in Japanese patients undergoing total hip or knee arthroplasty.
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Satisfactory results have been reported from long-term studies on bipolar hemiarthroplasty for femoral neck fracture. However, long-term results of this procedure for osteoarthritis of the hip (OA) and idiopathic necrosis of the femoral head (ION) have given rise to pessimism. These poor results have often reported migration of the bipolar head, but few had described the direction of this migration. The purpose of the present study was to conduct a long-term follow-up analysis of bipolar hemiarthroplasty for OA and ION, including the direction of migration. ⋯ The long-term results of bipolar hemiarthroplasty for OA and ION are not favorable. If a sufficient centripetal position is obtained with reaming, the bipolar head tends to migrate superomedially, subsequently requiring revision.
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The radiographic evaluation of the response to preoperative chemotherapy for bone and soft tissue sarcomas is based mostly on the change in primary tumor size before and after chemotherapy, as is done for many solid cancers. Its prognostic correlation, however, has hardly been validated. ⋯ The JOA criteria, based on the change in primary tumor size, is valid for malignant bone tumors but invalid for soft tissue sarcomas. Other new evaluation modalities of the response to preoperative chemotherapy using innovative functional imaging techniques are needed for soft tissue sarcomas.
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The Japanese Orthopaedic Association decided to revise the JOA score for low back pain and to develop a new outcome measure. In February 2002, the first survey was performed with a preliminary questionnaire consisting of 60 evaluation items. Based on findings of that survey, 25 items were selected for a draft of the JOA Back Pain Evaluation Questionnaire (JOABPEQ). The second survey was performed to confirm the reliability of the draft questionnaire. This article further evaluates the validity of this questionnaire and establishes a measurement scale. ⋯ We confirmed the validity of the JOA Back Pain Evaluation Questionnaire and established a measurement scale.
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This study was carried out to evaluate the effectiveness of anterior plating with subsequent percutaneous iliosacral screwing for the management of unstable pelvic ring injuries. ⋯ Anterior plating with subsequent percutaneous iliosacral screwing may be a useful method of treatment for unstable pelvic ring injuries, and the reduction quality and residual neurological signs were important in its functional outcome.