Morphology of the femoral neck in Japanese persons: Analysis using CT data

Introduction: The purpose of this study was to analyze proximal femoral morphology in Japanese persons using computed tomography (CT) data.Materials and methods: Data from 19 normal hips (N group) and 19 dysplastic hips (DH group) in women who underwent total hip arthroplasty were randomly selected from a CT database. The femur 3D model created by computer software was imported to a computer-aided design software package to analyze the medullary morphology. Center edge angle (CE angle), Sharp angle, femoral head diameter (FHD), and the offset were measured. The femoral neck isthmus space (FNIS), which is the narrowest part of the femoral neck, at neck-shaft angles of 125°, 130°, and 135°, was also measured.Results: In the N group, CE angle was 36.2°, Sharp angle was 39.8°, FHD was 42.6 mm, and offset was 39.5 mm. In the DH group, CE angle was 24.7°, Sharp angle was 46.1°, FHD was 45.2 mm, and offset was 33.6 mm. Each parameter was significantly different between the groups. FNIS was 21.8 mm, 22.1 mm, and 22.1 mm, respectively, in the N group and 21.7 mm, 21.6 mm, and 21.5 mm, respectively, in the DH group.Discussion: This is the first report to clarify the medullary morphology of the proximal femur in Japanese women. Results show that there is sufficient space for currently available implant to fit in. This study also elucidated the morphologic characteristics of dysplastic hip, which will be useful information in developing hip prostheses and fixation devices suitable for Asian patients

Effects of attentional bias modification on chronic low back pain in older outpatients

Objectives: In the present study, the effect of attentional bias modification (ABM) on older outpatients, with chronic low back pain, was examined.Design: This was a single-center, randomized, single-blinded, crossover trial and patients were randomly divided in a 1:1 allocation ratio into two groups: an ABM Leading group and an ABM Trailing group.Participants: Forty-three outpatients with chronic low back pain participated.Interventions: Patients were evaluated four times and the treatments were ABM + Normal intervention or Normal intervention only.Outcomes: Outcome measures included pain intensity on the Numerical Rating Scale, the Pain Catastrophizing Scale, Fear-Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, Somatic Symptom Scale-8, and EuroQol 5 Dimension-3 levels questionnaire. In addition, we performed the 30-second Chair-Stand test and the Timed Up & Go test for physical function evaluations.Results: There was no change in pain intensity due to ABM. However, the total Pain Catastrophizing Scale score was significantly decreased, and the EuroQol 5 Dimension-3 levels questionnaire and 30-second chair-stand test were significantly improved (P <.05).Trial registration: The Health Science Ethics Committee, Graduate School of Biomedical Sciences, Nagasaki University (permit number: 17060861), and the clinical trial was registered with UMIN (UMIN000029424)

Radiological evaluation of joint space width in medial knee osteoarthritis

Background. Although joint space width on weight-bearing radiographs of the knee is critical for early diagnosis and grading knee osteoarthritis, the optimal method with which to accurately measure this value remains controversial. The purpose of this study was to investigate and quantify the effects of the radiographic technique on joint space width in medial knee osteoarthritis.Materials and Methods. We compared maximum plateau gaps and minimum joint space widths on bilateral weight-bearing plain radiographs acquired using three different methods in 31 patients with medial knee osteoarthritis (56 knee joints): standing with the knee extended (standard imaging); SynaFlexer method; and Rosenberg method. Measured values were compared statistically, with values of P < 0.05 considered significant.Results. Maximum plateau gap in the medial compartment was significantly lower with the SynaFlexer method (3.2 ± 1.5 mm) and Rosenberg method (2.2 ± 1.2 mm) than with standard imaging (4.7 ± 2.2 mm; P < 0.05 each). Minimum width of the medial joint space was also significantly lower with the SynaFlexer method (3.1 ± 1.4 mm) and Rosenberg method (2.3 ± 1.4 mm) than with standard imaging (4.1 ± 1.4 mm; P < 0.05 each).Conclusion. The Rosenberg method appears beneficial for diagnosing early knee osteoarthritis, while the SynaFlexer method seems more appropriate for assessing disease severity or progression in patients with painful intermediate to severe knee osteoarthritis

Progression of microstructural deterioration in load-bearing immobilization osteopenia

PurposeImmobilization osteopenia is a major healthcare problem in clinical and social medicine. However, the mechanisms underlying this bone pathology caused by immobilization under load-bearing conditions are not yet fully understood. This study aimed to evaluate sequential changes to the three-dimensional microstructure of bone in load-bearing immobilization osteopenia using a fixed-limb rat model.Materials and methodEight-week-old specific-pathogen-free male Wistar rats were divided into an immobilized group and a control group (n = 60 each). Hind limbs in the immobilized group were fixed using orthopedic casts with fixation periods of 1, 2, 4, 8, and 12 weeks. Feeding and weight-bearing were freely permitted. Length of the right femur was measured after each fixation period and bone microstructure was analyzed by micro-computed tomography. The architectural parameters of cortical and cancellous bone were analyzed statistically.ResultsFemoral length was significantly shorter in the immobilized group than in the control group after 2 weeks. Total area and marrow area were significantly lower in the immobilized group than in the control group from 1 to 12 weeks. Cortical bone area, cortical thickness, and polar moment of inertia decreased significantly after 2 weeks. Some cancellous bone parameters showed osteoporotic changes at 2 weeks after immobilization and the gap with the control group widened as the fixation period extended (P < 0.05).ConclusionThe present results indicate that load-bearing immobilization triggers early deterioration of microstructure in both cortical and cancellous bone after 2 weeks

Characterization of Individuals with Sacroiliac Joint Bridging in a Skeletal Population: Analysis of Degenerative Changes in Spinal Vertebrae

Theaimof this study was to characterize the individualswith sacroiliac joint bridging (SIB) by analyzing the degenerative changes intheirwhole vertebral column and comparing themwith the controls.Atotal of 291modern Japanesemale skeletons,with an averageage at death of 60.8 years, were examined macroscopically. They were divided into two groups: individuals with SIB and thosewithout bridging (Non-SIB).The degenerative changes in their whole vertebral column were evaluated, and marginal osteophytescores (MOS) of the vertebral bodies and degenerative joint scores in zygapophyseal jointswere calculated. SIBwas recognized in 30individuals froma total of 291 males (10.3%).The average of age at death in SIB group was significantly higher than that in Non-SIBgroup. The values ofMOS in the thoracic spines, particularly in the anterior part of the vertebral bodies, were consecutively higherin SIB group than in Non-SIB group. Incidence of fused vertebral bodies intervertebral levels was obviously higher in SIB groupthan in Non-SIB group. SIB and marginal osteophyte formation in vertebral bodies could coexist in a skeletal population of men.Some systemic factors might act on these degenerative changes simultaneously both in sacroiliac joint and in vertebral column

ダイガクセイ ニ タイスル ゲートキーパー ヨウセイ コウザ ノ ヨビテキ ケンキュウ : ミヤギケン ワカモノ ココロ ノ シエン モデル ジギョウ ノ トリクミ

宮城県では、若者こころの支援モデル事業を発足し、県内大学生に対して自殺予防に関する理解促進に向けたゲートキーパー養成講座の実施を図っている。本稿では、2019年度に試験的に試みた大学生に対するゲートキーパー養成講座（以下、講座）の実施について報告した。A大学の心理学を専攻する1年生に対して、週に1回約90分の講座を3コマ実施した。講座の実施前後およびその2か月後に質問紙調査を実施し、45名から回答を得た。その結果、対象者のゲートキーパー自己効力感は講座実施後において向上し、かつ2か月後においてもその効果は維持されていた。自殺予防プログラムは各地で散見されるものの、実証的な効果検証は十分に行われていない。今後も若者の自殺予防プログラムを推進するとともに、効果検証についても合わせて行い、さらにはその効果の維持についての実証的な知見を蓄積していく必要があるだろう

Effect of surface roughness of biomaterials on Staphylococcus epidermidis adhesion

Background: Implant-related infections are caused by adhesion of bacteria to the surface of biomaterials. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis (ATCC35984) to adhere to the surface of solid biomaterials at different levels of roughness below 30 nm Ra and investigated the minimum level of roughness required to promote bacterial adhesion on five kinds of biomaterials: oxidized zirconium-niobium alloy (Oxinium), cobalt-chromium-molybdenum alloy (Co-Cr-Mo), titanium alloy (Ti-6Al-4 V), commercially pure titanium (Cp-Ti) and stainless steel (SUS316L), samples of which were categorized into a fine group and a coarse group according to surface roughness. The test specimens were physically analyzed and the viable bacterial density of the adhered bacteria was quantitatively determined (n = 20).Results: The amount of bacteria that adhered to the biomaterials in the coarse group was higher than those in the fine group. Oxinium, Ti-6Al-4 V and SUS316L in particular demonstrated statistically significant differences between the two groups (P < 0.05). Of the materials, the Co-Cr-Mo specimens exhibited significantly lower amounts of adhered bacteria than the Ti-6Al-4 V, Cp-Ti and SUS316L specimens in the fine group. Similarly, the Co-Cr-Mo specimens in the coarse group exhibited significantly lower values than the other four materials.Conclusions: These results suggest that minimum level of roughness affecting initial bacterial adherence activity differs according to the type of biomaterial used, and that even a surface roughness of below 30 nm Ra in Oxinium, Ti-6Al-4 V and SUS316L can promote bacterial adhesion. Relative hydrophobic Co-Cr-Mo surfaces were less susceptible to bacterial adherence

Early Staphylococcal Biofilm Formation on Solid Orthopaedic Implant Materials: In Vitro Study

Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromium-molybdenum alloy (Co-Cr-Mo), titanium alloy (Ti-6Al-4V), commercially pure titanium (cp-Ti) and stainless steel. A bacterial suspension of Staphylococcus epidermidis strain RP62A (ATCC35984) was added to the surface of specimens and incubated. The stained biofilms were imaged with a digital optical microscope and the biofilm coverage rate (BCR) was calculated. The total amount of biofilm was determined with the crystal violet assay and the number of viable cells in the biofilm was counted using the plate count method. The BCR of all the biomaterials rose in proportion to culture duration. After culturing for 2-4 hours, the BCR was similar for all materials. However, after culturing for 6 hours, the BCR for Co-Cr-Mo alloy was significantly lower than for Ti-6Al-4V, cp-Ti and stainless steel (P0.05). These results suggest that surface properties, such as hydrophobicity or the low surface free energy of Co-Cr-Mo, may have some influence in inhibiting or delaying the two-dimensional expansion of biofilm on surfaces with a similar degree of smoothness