Clinical results of arthroscopic polyglycolic acid sheet patch graft for irreparable rotator cuff tears

AbstractThe high retear rates after surgery for irreparable rotator cuff tears can be explained by the healing capacity potential of tendons and the native rotator cuff enthesis characterised by complex morphological structures, called direct insertion. Many experimental researches have focused on biologically augmenting the rotator cuff reconstruction and improving tendon–bone healing of the rotator cuff. The results of the experimental study showed that the polyglycolic acid sheet scaffold material allows for the regeneration of not only tendon-to-tendon, but also tendon-to-bone interface in an animal model. We performed a clinical study of the arthroscopic polyglycolic acid sheet patch graft used for the repair of irreparable rotator cuff tears. One-year clinical results of the repair of irreparable rotator cuff tears by arthroscopic patch graft with a polyglycolic acid sheet demonstrated improved shoulder function and a significantly lower retear rate, compared with patients treated with a fascia lata patch

Opening Remarks

IPSHU Research Report Series No.33 : The First International symposium 2017 hosted by Institute for Peace Science, Hiroshima University “The Atomic Bombs and War Memories: Heritage of Peace in an Uncertain Age”, Part1: English Version, Editor: Luli van der DOE

巻頭言

IPSHU Research Report Series No.33 : 平成29年度第1回広島大学平和科学研究センター主催国際シンポジウム「原爆体験・戦争記憶の継承〜託す平和遺産」, パートII : 日本語版, Editor: Luli van der DOE

Developing stem cell-based therapeutic strategies in orthopaedic surgery

open5siEDITORIAL - Developing Stem Cell-Based Therapeutic Strategies in Orthopaedic SurgeryopenAtesok, Kivanc; Ochi, Mitsuo; Baldini, Nicola; Schemitsch, Emil; Liebergall, MeirAtesok, Kivanc; Ochi, Mitsuo; Baldini, Nicola; Schemitsch, Emil; Liebergall, Mei

Liposarcoma Arising in the Foot: A Case Report

Liposarcoma is categorized as a soft tissue sarcoma and most commonly appears in the lower extremities and rarely in the foot during adulthood. We present a very rare case report of a primary well-differentiated liposarcoma arising in the foot on a 60-year-old female. Marginal resection of the tumor with metatarsal ray amputation was eventually performed. The patient's postoperative course was uneventful without recurrence 5 years after the original operation. The authors review the literature and also report on the low incidence of this tumor arising in the foot

Comparison of flexion and extension protocol for testing knee joint position sense

新しい固有感覚測定装置使用のための基礎データを得る目的で膝関節の運動方向の違いが位置覚測定の結果に与える影響を調べた.対象は,膝関節疾患および外傷の既往がない大学生8名とした.位置覚測定は設定角度を膝屈曲15°として,設定角度まで膝屈曲30°から伸展させるタスクと,膝完全伸展位から屈曲させるタスクを行った.2つのタスク間で再現角度,定数誤差値および絶対誤差値の平均値に差があるかを確かめたが,いずれも有意差を認めなかった.その結果,運動方向の違いは,位置覚測定では測定結果に影響を与えないことが示唆された.これは,位置覚測定において運動方向を任意に選択しても結果に影響しないことを示している.膝関節構成体は運動方向の違い,即ち屈曲と伸展で異なった刺激を受けていると考えられるが測定結果に有意差を認めなかったことからメカノレセプターの機能を再考する必要があると考えた.今後はACL 損傷者と健常者とを比較することにより,位置覚測定で運動方向の違いがACL 中のメカノレセプターに与える影響を明らかにすることができると考える.It is reported that the anterior cruciate ligament (ACL) has a sensitive function that regulates proprioception. The partial or total rupture of ACL could reduce proprioception. In this study, we investigated whether the direction of joint motion has an affect on proprioceptive sensibility. Eight subjects (5 men and 3 women) who did not have any history of previous injury or surgery to either knee joint participated. Two kinds of tasks for knee joint position sense were examined using a specially made article to record target joint angles and to calculate reproduced angles after limb movement. Task A involved extension from a 30°flexed position and task B involved flexion from a totally extended position. The repositioning angle departed from target angle (15°) within one degree in each task. Mean real error indicated a tendency to underestimate reproduced joint angles in all tasks, although the magnitude of the error was small. Absolute error was around two degrees. No significant difference was found in repositioning angle, real error or absolute error between task A and task B. These data show that direction of joint motion does not affect knee joint position sense. It is suggested that joint direction can be chosen at will in the measurement of knee joint position sense. Further investigations may include measurements of ACL injured patients to clarify the influence of ACL mechanoreceptors by comparison with the present study as a control group

Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft

<p>Abstract</p> <p>Background</p> <p>Preservation of the Anterior Cruciate Ligament (ACL) remnant is important from the biological point of view as it enhances revascularization, and preserves the proprioceptive function of the graft construct. Additionally, it may have a useful biomechanical function. Double bundle ACL reconstruction has been shown to better replicate the native ACL anatomy and results in better restoration of the rotational stability than single bundle reconstruction.</p> <p>Methods</p> <p>We used the far anteromedial (FAM) portal for creation of the femoral tunnels, with a special technique for its preoperative localization using three dimensional (3D) CT. The central anteromedial (AM) portal was used to make a longitudinal slit in the ACL remnant to allow visualization of the tips of the guide pins during anatomical creation of the tibial tunnels within the native ACL tibial foot print. The use of curved hemostat allow retrieval of the wire loop from the apertures of the femoral tunnels through the longitudinal slit in the ACL remnant thereby, guarding against impingement of the reconstruction graft against the ACL remnant as well as the roof of the intercondylar notch.</p> <p>Conclusion</p> <p>Our technique allows for anatomical double bundle reconstruction of the ACL while maximally preserving the ACL remnant without the use of intra-operative image intensifier.</p

Effect of aging on pancreatic exocrine function -Aging and fecal chymotrypsin activity-

膵外分泌機能に及ぼす加齢の影響を検討する目的で，健常人43名，非膵疾患患者41名，老人ホーム入居者39名を対象として比色法により糞便中キモトリプシン活性（FCA）を測定し，以下の結論を得た。1）FCAは逐齢的に低下し，60歳以上は60歳未満より有意の低値を示した。しかし，分布図のretrospectiveな検討からは，膵外分泌機能の低下は，実際には65～70歳あたりから明らかになることが示唆された。2）FCAの正常下限値を14.5U/gに定めたが，高齢者の診療にあたってはこの正常値のみを根拠にして疾病の有無を判定すべきではない。3）老人ホーム入居者のFCAは特に低値を取ったがその主要因は高齢者が多いためと考えられた。To examine the effect of aging on the pancreatic exocrine function, fecal chymotrypsin activity (FCA) was measured by the photometric method in 43 healthy controls, 39 controls in an old-age home and 41 patients with non-pancreatic diseases. Following conclusions were obtained. 1) Pancreatic exocrine function showed a significant decrease with aging as indicated by the present prospective study : ① a significantly lower FCA in the B group of 22 healthy controls (≧ 60 years of age) than the A group of 21 healthy controls (< 60 years of ago) ; ② significant correlationship between aging and FCA in the 43 healthy controls and also in the 41 patients with non-pancreatic diseases. 2) FCA in controls in an old-age home was especially low. Presumably it was due to their far-advanced aging. 3) The calculated lower limit of normal in FCA was 14.5U/g. However, the diagnosis of pancreatic diseases should not be coined solely on the basis of decreased FCA value