Accuracy of Acetabular Cup Implantation, as a Function of Body Mass Index and Soft-tissue Thickness, with a Mechanical Intraoperative Support Device: A Retrospective Observational Study

HipCOMPASS, a mechanical intraoperative support device used in total hip arthroplasty (THA), improves the cup-alignment accuracy. However, the alignment accuracy achieved by HipCOMPASS has not been specifically examined in obese patients. In this study, we retrospectively evaluated the relation between alignment accuracy and several obesity-related parameters in 448 consecutive patients who underwent primary THA using HipCOMPASS. We used computed tomography (CT) to measure the preoperative soft-tissue thickness of the anterior-superior iliac spine (ASIS) and pubic symphysis and the differences between preoperative and postoperative cup angle based on the cup-alignment error. We found significant correlations between the absolute value of radiographic anteversion difference and body mass index (r = 0.205), ASIS thickness (r = 0.419), and pubic symphysis thickness (r = 0.434). The absolute value of radiographic inclination difference was significantly correlated with ASIS (r = 0.257) and pubic symphysis thickness (r = 0.202). The receiver operating characteristic curve showed a pubic symphysis thickness of 37.2 mm for a ≥ 5° implantation error in both radiographic inclination and anteversion simultaneously. The cup-alignment error for HipCOMPASS was large in patients whose pubic symphysis thickness was ≥ 37.2 mm on preoperative CT. Our results indicate that methods other than HipCOMPASS, including computed tomography-based navigation systems, might be preferable in obese patients

Bone Histomorphometry of Femoral Head Cancellous Bone in Patients Who Underwent Total Hip Arthroplasties due to Destructive Hip in Rheumatoid Arthritis

Rheumatoid arthritis (RA) affects the hip joints. The microarchitecture of the cancellous bone in RA-affected hip joints has been unclear. Here we investigated the bone metabolism changes in the subcapital cancellous bone of destructive hips of RA patients (n=26 patients; 28 hip joints) which were classified by Larsen grade on X-ray into the groups: destructive hip (Des) (Larsen grade IV, n=18) and neck fracture (Fx) (Larsen grade 0 or 1, n=10). The femoral heads of the Des-group showed significantly higher trabecular thickness versus those of the Fx-group (179±30.8 vs. 151±23.5 μm, p=0.02). The Des-group had significantly higher osteoid volume/tissue volume (OV/TV) and osteoid volume/bone volume (OV/BV) ratios than the Fx-group (OV/TV: 0.72±0.70% vs. 0.27±0.32%, p=0.028; OV/BV: 2.96±2.85% vs. 1.24±1.31%, p=0.039). The osteoblast and osteoclast surface areas of the Des-group were remarkably higher than those of the Fx-group (9.80±10.9 vs. 0.15±0.15%, p=0.0005; 0.34±0.48 vs. 0.06±0.06%, p=0.0285, respectively). The T-scores of hip (femoral neck) bone mineral density (BMD) of the Fx-group were significantly lower versus those of the Des-group (−3.1±0.76 vs. −1.6±1.17, p<0.01). Increased osteoid and resorption parameters and higher femoral neck BMD demonstrate a high bone-turnover state in response to destructive changes in the hips of RA patients

Multidisciplinary Approach to Reduce Postoperative Complications and Improve the Activity of Patients with Hip Fracture: A 24-month Follow-up Survey

Multidisciplinary approaches such as fracture liaison services (FLS) have been introduced in some countries to reduce medical complications and secondary fractures in patients with fragility hip fracture. We aimed to investigate outcomes in patients with fragility hip fracture following the introduction of FLS. Patients > 50 years old who experienced fragility hip fractures between January 1, 2015 and December 31, 2017 were enrolled, and divided into a control group (without FLS; 94 patients) and FLS group (373 patients). We found that the time from injury to surgery decreased significantly from 2.42 to 1.83 days (p = 0.003), the proportion of patients who underwent surgery within 36 h of injury increased significantly (p = 0.014), and the number of cases with complications after admission decreased significantly (p = 0.004) in the FLS group. Patients with a Barthel index ≥ 80 were more common in the FLS than the control group at 6 , 12, and 24 months following injury (p = 0.046 , 0.018, and 0.048, respectively). Multiple logistic regression analysis revealed the factors associated with postoperative complications and death within 12 or 24 months after injury. Our results indicate that FLS contributed to earlier recovery, rehabilitation following surgery and rehabilitation of medical complications following admission; improved patient activity; and decreased secondary hip fractures

The Effects of Self-directed Home Exercise with Serial Telephone Contacts on Physical Functions and Quality of Life in Elderly People at High Risk of Locomotor Dysfunction

Exercise is essential for maintaining quality of life (QOL) in elderly individuals. However, adherence to exercise programs is low. Here, we assessed the effectiveness of a self-directed home exercise program with serial telephone contacts to encourage exercise adherence among elderly individuals at high risk of locomotor dysfunction. We recruited community-dwelling adults (ｧ65 years) in Niigata, Japan, who were targets of the long-term care prevention project for locomotor dysfunction but did not participate in the government-sponsored prevention programs. The study was conducted from November 2011 to October 2012. Participants received exercise instruction and performed exercises independently for 3 months with serial telephone contacts. The single-leg stance and five-times sit-to-stand tests were used to assess physical function. The SF-8 was used to measure health-related QOL. Ninety-seven participants were enrolled in the study, representing 2.5ｵ of eligible people;87 completed the intervention. Scores from physical function tests were significantly improved by the intervention, as were 7 of eight SF-8 subscales. Adherence was 85.4ｵ for the single-leg standing exercise and 82.1ｵ for squatting. Thus, self-directed home exercise with serial telephone contacts improved physical function and health-related QOL, representing a promising model for preventing the need for long-term care due to locomotor dysfunction

Fabrication and Fracture Toughness of CNTs/Alumina Composites with Fine Microstructures

ArticleKey Engineering Materials. 617: 205-208 (2014)journal articl

Three-dimensional Assessment of Femoral Head Coverage in Normal and Dysplastic Hips: A Novel Method

The acetabular coverage of the femoral head has been assessed in two-dimensions as the projected covered area or the covered angle on plain radiographs. We present a novel method of the three-dimensional assessment of femoral head coverage obtained by evaluating the covered volume of the femoral head in both normal and dysplastic hips. We also assessed the covered angles on the vertical slices passing through the center of the femoral head. The mean covered volume of the femoral head was 57.4% in normal hips and 26.6% in dysplastic hips. In dysplastic hips, the L-CE, A-CE, and P-CE angles were 7.7°, 21.8°, and 95.8°, respectively, while the acetabular angle was 27.5°. In normal hips, the CE angles were 34.0°, 56.8°, and 109.4°, respectively, while the acetabular angle was 7.2°. Our study suggests the usefulness of a novel 3D assessment for acetabular coverage of the femoral head. This assessment provided the precise 3D information necessary to diagnose hip dysplasia and assess the deficiency of acetabular coverage in these patients. Moreover, we may detect a cut-off between normal and dysplastic hips in the 3D assessment by assessing a large number of dysplastic hips both morphologically and using the new assessment

Zyxin is a novel interacting partner for SIRT1

<p>Abstract</p> <p>Background</p> <p>SIRT1 is a mammalian homologue of NAD+-dependent deacetylase sirtuin family. It regulates longevity in several model organisms and is involved with cell survival, differentiation, metabolism among other processes in mammalian cells. SIRT1 modulates functions of various key targets via deacetylation. Recent studies have revealed SIRT1 protects neurons from axonal degeneration or neurodegeneration. Further, SIRT1 null mice exhibit growth retardation and developmental defects, suggesting its critical roles in neurons and development.</p> <p>Results</p> <p>To identify novel binding partners for SIRT1 in the central nervous system, we performed yeast two-hybrid screening on human fetal brain cDNA library and found that zyxin is a possible binding partner. SIRT1 and zyxin transcript were both preferentially expressed in developmental mouse brain. Zyxin accumulates in the nucleus where it is co-localized with SIRT1 after treatment with leptomycin B in COS-7 cells. Furthermore, SIRT1 deacetylates zyxin, suggesting SIRT1 could interact with nuclear-accumulated zyxin and modulate its function through deacetylation.</p> <p>Conclusion</p> <p>Zyxin could be a novel interacting partner of SIRT1. Zyxin is an adaptor protein at focal adhesion plaque, regulating cytoskeletal dynamics and signal transduction to convey signal from the ECM (extracellular matrix) to the nucleus. Our results raise the possibility that SIRT1 regulates signal transmission from ECM to the nucleus by modulating the functions of zyxin via deacetylation.</p

Deposition of Apatite on Carbon Nanofibers in Simulated Body Fluid

Carbon nanofibers (CNFs) were soaked in 1.5 simulated body fluid (1.5 SBF) in which inorganic ion concentrations are 1.5 times as high as those in the standard SBF. The influence of the CNFs content in 1.5 SBF and pretreatment of the CNFs on the biomimetical deposition of apatite were investigated. The spherical bone-like apatite particles were deposited on the pristine CNFs soaked in 1.5 SBF. Amount of deposited apatite per a unit of CNFs increased with a decrease in the CNFs content in 1.5 SBF, and it decreased markedly when the CNFs were pretreated with concentrated sulfuric acid/nitric acid (3 : 1 v/v) mixture for longer periods. Such results suggest that too many nucleation sites of apatite, which were functional groups, such as carboxyl and hydroxyl groups, existed on the CNFs in the 1.5 SBF, and most embryos formed on the sites could not grow to critical nuclei and furthermore did not grow to apatite.ArticleJOURNAL OF NANOMATERIALS. 2011:935320 (2011)journal articl

Minimally Invasive Spinal Stabilization with Denosumab before Total Spondylectomy for a Collapsing Lower Lumbar Spinal Giant Cell Tumor

A 21-year-old man consulted our hospital for treatment of a spinal giant cell tumor (GCT) of Enneking stage III. Lower lumbar-spine tumors and severe spinal canal stenosis are associated with high risk for surgical mor-bidity. Stability was temporarily secured with a percutaneous pedicle screw fixation in combination with deno-sumab, which shrank the tumor. Total en bloc spondylectomy was then performed 6 months after initiation of denosumab, and the patient was followed for 3 years. There was no local recurrence, and bony fusion was obtained. Minimally invasive surgery and denosumab allowed safer and easier treatment of a collapsing lower lumbar extra-compartmental GCT