Does Degree of the Pelvic Deformity Affect the Accuracy of Computed Tomography-Based Hip Navigation?

Although some navigation systems have been used for improvement of component positioning, there have been few reports regarding cases of severe pelvic deformity. We performed a retrospective review of 25 cases of total hip arthroplasty with a computed tomography-based navigation system in patients with severe pelvic deformities and estimated acetabular component position and angle between severe deformity group and mild dysplastic group as a control. There were no significant differences in accuracy of navigation system between 2 groups in terms of 3-dimensional component position or angle. Accuracy of computed tomography-based hip navigation does not depend on the degree of pelvic deformity, and this system is also useful to identify acetabular orientation and for precise component implantation in cases of pelvic deformity. © 2012 Elsevier Inc

Hyperostosis around the bilateral acetabulum associated with hypoparathyroidism

We report the case of a 57-year-old woman with hyperostosis around the bilateral acetabulum associated with untreated secondary hypoparathyroidism. She presented with gait disturbance and inability to walk. Radiographs showed abnormal ossification around her hips. We resected the ossifications to improve joint function. One year after surgery, radiographs showed no recurrence of ossification. When radiographs show excessive hyperostosis, it is important to exclude presence of metabolic bone disease. © Japan College of Rheumatology 2012.This is the pre-peer reviewed version of the following article: [Full cite], which has been published in final form at [link to final article]

Quantitative analysis of the Trendelenburg test and invention of a modified method

Background While the Trendelenburg test has been used for 120 years to detect hip abductor muscle weakness, the methodology has not been standardised. Purposes This study undertook to quantitatively analyze the relation between abductor muscle activity and pelvic tilt angle in the Trendelenburg one-leg stance, examine the pitfalls associated with performing the T-test, and develop a modified method that will produce reliable results. Methods A convenience sample of 15 healthy males was asked to assume a one-leg stance in ten different postures, five with mild flexion on the unsupported side, and five with severe flexion. Trunk sway angle, pelvic tilt angle, and the pelvic on femur (POF) angle were measured for each posture. Statistical analysis was used to assess differences in hip abductor activity and public tilt angle between the control posture and the test postures. Results With minimum trunk sway, hip abductor muscle activity increases when the pelvis is elevated and decreases when it is dropped. With trunk sway toward the test side, abductor muscle activity decreased when the pelvis was elevated; with trunk sway toward the non-test side, muscle activity stayed approximately constant when the pelvis was dropped. Conclusions Based on the results we developed a modified T-test methodology that would improve reliability. This test should be performed with minimum trunk sway and severe flexion on the non-test side. The assessment of muscle weakness is based on whether the patient can keep the single-leg standing posture when forced to elevate the pelvis, not simply on the pelvic drop. In future research, we will perform the modified T-test on patients with a suspected hip abductor deficiency, and assess the usefulness of the modified test. © 2016 The Japanese Orthopaedic Associatio

Risk factors for postoperative deep infection in bone tumors

金沢大学医薬保健研究域医学系Background: Postoperative deep infection after bone tumor surgery remains a serious complication. Although there are numerous reports about risk factors for postoperative deep infection in general surgery, there is only a small number of reports about those for bone tumor surgery. This retrospective study aimed to identify risk factors for postoperative deep infection after bone tumor resection. Methods: We reviewed data of 681 patients (844 bone tumors) who underwent surgery. Associations between variables, including age, recurrent tumor, pathological fracture, surgical site (pelvis/other), chemotherapy, biological reconstruction, augmentation of artificial bone or bone cement, the use of an implant, intraoperative blood loss, operative time, additional surgery for complications, and postoperative deep infection were evaluated. Results: The rate of postoperative deep infection was 3.2% (27/844 tumors). A pelvic tumor (odds ratio [OR]: 3.4, 95% confidence interval [CI]: 1.0–11.3) and use of an implant (OR: 9.3, 95% CI: 1.9–45.5) were associated with an increased risk of deep infection. Conclusions: This retrospective study showed that pelvic tumor and use of an implant were independent risk factors for deep infection. This information will help surgeons prepare an adequate surgical plan for patients with bone tumors. © 2017 Miwa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

独自の抗菌ヨード担持加工とCAOS技術を融合したカスタムメイドインプラントの開発

金沢大学附属病院我々が独自に開発したヨード担持加工技術は、金属インプラントの表面に形成した特殊な酸化被膜の微細孔の中にポピドンヨードを担持することで、抗菌性と骨親和性を同時に付加するこれまでにない革新的な技術である。本研究期間内に、ヨード担持加工インプラントの表面加工前後における表面粗さの変化の検証、加工前後におけるインプラントサイズの変化の検証、各種の滅菌工程前後におけるヨード担持量の変化量の検証を実施した。これらのデータは薬事承認に向けてのインプラントの基本的特性に関する重要な結果であり、新しい知見を得ることができた。Iodine supported implant is the novel technology with a special oxide layer and countless micro pore. It holds both antimicrobial activity and osteoinductive activity. Three kinds of examinations were performed during this research period. Relationship between the surface roughness of the metal implant and antibacterial iodine-supported process, relationship between the change of the size of the metal implant and antibacterial iodine-supported process, and relationship between the sterilization process and the antibacterial iodine-supported process. These are important results for approval of the developed product.研究課題/領域番号:15K19990, 研究期間(年度):2015-04-01 - 2017-03-3