Reference values for the locomotive syndrome risk test quantifying mobility of 8681 adults aged 20–89 years: A cross-sectional nationwide study in Japan

Background The locomotive syndrome risk test was developed to quantify the decrease in mobility among adults, which could eventually lead to disability. The purpose of this study was to establish reference values for the locomotive syndrome risk test for adults and investigate the influence of age and sex. Methods We analyzed 8681 independent community dwellers (3607 men, 5074 women). Data pertaining to locomotive syndrome risk test (the two-step test, the stand-up test, and the 25-question geriatric locomotive function scale [GLFS-25]) scores were collected from seven administrative areas of Japan. Results The reference values of the three test scores were generated and all three test scores gradually decreased among young-to-middle-aged individuals and rapidly decreased in individuals aged over 60 years. The stand-up test score began decreasing significantly from the age of 30 years. The trajectories of decrease in the two-step test score with age was slightly different between men and women especially among the middle-aged individuals. The two physical test scores were more sensitive to aging than the self-reported test score. Conclusion The reference values generated in this study could be employed to determine whether an individual has mobility comparable to independent community dwellers of the same age and sex

<症例>経皮的自家骨髄注入による大腿骨偽関節の治療

Percutaneous bone marrow injections were performed on 7 nonunions of the femur. There were 6 hypervascular nonunions and one avascular nonunion. Two nonunions presented with active infections. One other patient had a history of infection which had subsided. One nonunion received the injection twice. After the site of nonunion was curetted and the bone surface was scored, 150 ml of bone marrow aspirated from the iliac bone was injected. Complete union occurred in 4 patients within 9 months; all of them were uninfected hypervascular nonunions following intramedullary nail fixation. One nonunion with a bone defect united partially leaving a 1×1 cm defect. The two infected femoral nonunions failed to unite . The results show that percutaneous autologous bone marrow injection for femoral nonunions can be considered for uninfected hypervascular nonunions following intramedullary nail fixation. In these cases, stimulation of healing processes of fracture leading to consolidation can be expected from bone marrow injection. However, femoral nonunion with an active infection and loss of fixation is considered to be a contraindication for this technique.7例の大腿骨偽関節症例に対して経皮的自家骨髄移植を施行した. Weber の分類法で, 7例中6例は hypervascular nonunion, 1例は avascular nonunion であった. 2例は感染を合併しており, 他の2例は感染の既往があった. 方法として, 経皮的に偽関節部の一部を掻爬し, 腸骨から吸引した骨髄 150 ml を直ちに注入した. 1例には2回の自家骨髄注入を行った. 髄内釘手術後の, 感染を合併していなかった4例に9ヵ月以内に骨癒合が得られたが, 感染のあった2例では癒合が得られなかった. この結果から, 髄内釘施行後の感染の徴候を示さない大腿骨偽関節例に対して, 経皮的自家骨髄移植は, より侵襲の少ない有用な治療方法と考えられた

Femoral head translation in borderline and definite dysplastic hips during weight‐bearing: 2D/3D image registration analysis

Abstract Purpose The aims of this study were to 1) assess femoral head translation during weight‐bearing in symptomatic developmental dysplasia of the hip (DDH) and 2) compare it between borderline DDH and definite DDH. Methods The study included four individuals with borderline DDH and nine with definite DDH, scheduled for periacetabular osteotomy. Anteroposterior X‐ray images of the hip joint were obtained in the standing position, and computed tomography images of the pelvis were obtained in the supine position. Femoral head translation from the supine to a standing position was measured using 2D/3D X‐ray image registration. Results From a supine to a standing position, the femoral head translated 0.3 mm laterally, 0.5 mm anteriorly, and 0.5 mm superiorly on average. The mean femoral head translation in 3D between the supine and standing positions was 1.5 mm. The 3D femoral head translation in the borderline DDH group was significantly greater than that in the definite DDH group. In the definite DDH group, there was a significant correlation between the center edge (CE) angle and 3D femoral head translation (ρ = ‐0.78, P = 0.012). Conclusions Symptomatic DDH showed femoral head translation in the anterior, lateral, and superior directions during weight‐bearing. In definite DDH, the amount of femoral head translation was negatively correlated with the CE angle. The amount of 3D translation in patients with borderline DDH was larger than that in definite DDH. Dynamic joint instability during weight‐bearing was observed in borderline DDH as well as definite DDH. Treatment to enhance joint stability during weight‐bearing is important in both cases