Journal of Joint Surgery and Research最新文献

{"title":"Hip fracture and cancer: descriptive epidemiological study demonstrating a paradigm shift in common orthopedic trauma","authors":"Juri Teramoto ,&nbsp;Yasuhiro Homma ,&nbsp;Taiji Watari ,&nbsp;Koju Hayashi ,&nbsp;Tomonori Baba ,&nbsp;Nobuhiko Hasegawa ,&nbsp;Daisuke Kubota ,&nbsp;Tatsuya Takagi ,&nbsp;Muneaki Ishijima","doi":"10.1016/j.jjoisr.2024.11.002","DOIUrl":"10.1016/j.jjoisr.2024.11.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the increase both in patients with cancer and those with proximal femoral fractures (PFFs), details of the characteristics of non-pathological PFFs in patients undergoing cancer treatment are unknown. The purpose of this retrospective study was to investigate the characteristics and issues of patients with active cancer who have non-pathological PFFs.</div></div><div><h3>Methods</h3><div>This was a retrospective, observational, descriptive epidemiological study. A total of 376 patients were admitted to Juntendo University hospital with a diagnosis of PFF. Six of these patients had metastasis-related pathological fractures and were excluded from this study. The remaining 370 patients comprised 100 men and 270 women.</div></div><div><h3>Results</h3><div>The mean patient age was 78.6 ​± ​11.2 years. Fractures included 141 trochanteric femoral fractures and 229 femoral neck fractures. Of these, 39 (10.5%) of the patients had active cancer, 55 (14.9%) has a history of past cancer, and 276 (74.6%) had no cancer. Among the 39 patients with active cancer, 13 (33.3%) received glucocorticoids; furthermore, 10 (76.9%) of these 13 patients were not receiving medications to prevent osteoporosis. Lastly, 9 of the 39 falls were hospitalization-related, but 6 (66.7%) of these 9 patients did not undergo rehabilitation during hospitalization.</div></div><div><h3>Conclusions</h3><div>Approximately one in ten patients with PFF in this study were undergoing cancer treatment. Moreover, one in four patients with PFF were cancer-related. Therefore, orthopedic surgeons should have basic knowledge about cancer management in hip fracture.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 17-20"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis","authors":"Akira Morita ,&nbsp;Emi Kamono ,&nbsp;Tadashi Oyama ,&nbsp;Hyonmin Choe ,&nbsp;Yutaka Inaba ,&nbsp;Naomi Kobayashi","doi":"10.1016/j.jjoisr.2024.11.001","DOIUrl":"10.1016/j.jjoisr.2024.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to compare and rank the efficacy of different drugs for bone mineral density (BMD) loss prevention at 1 year after total hip arthroplasty (THA) using a network meta-analysis (NMA) of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>A literature search was conducted based on the PRISMA statement. The searched databases included MEDLINE (through PubMed), Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing &amp; Allied Health Literature (CINAHL). Only RCTs exploring the efficacy of currently available osteoporosis drugs in preventing periprosthetic BMD loss were included. A multivariate random-effects NMA was conducted to combine direct and indirect comparisons of agents using a frequentist consistency model. Regarding the efficacy rank, the frequentist analog to the surface under the cumulative ranking (SUCRA) probabilities, called the P-score, was used.</div></div><div><h3>Result</h3><div>In total, 17 RCTs were extracted. According to the pairwise mean difference (95% confidence interval) in BMD change, the efficacy of teriparatide was highest in both zones 1 and 7. From the predicted treatment rankings for BMD changes, teriparatide was ranked as the best intervention in zone 1 (P-score ​= ​0.8844) and zone 7 (P-score ​= ​0.9044)</div></div><div><h3>Conclusions</h3><div>The results suggest that teriparatide, zoledronic acid, alendronate, and etidronate may be options for the prevention of periprosthetic BMD loss in zones 1 and 7 ​at 1 year after THA.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 8-16"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accurate acetabular cup placement using a smartphone-based digital alignment guide in total hip arthroplasty","authors":"Yuki Teranishi ,&nbsp;Yusuke Okanoue ,&nbsp;Junpei Dan ,&nbsp;Dai Ohira ,&nbsp;Masahiko Ikeuchi","doi":"10.1016/j.jjoisr.2024.10.002","DOIUrl":"10.1016/j.jjoisr.2024.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Successful total hip arthroplasty (THA) requires accurate positioning of the acetabular cup. Although computed tomography (CT)-based navigation technology enables more accurate placement, most navigation systems are bulky, expensive, and often inaccessible due to cost and complexity. The purpose of this study was to introduce a smartphone-based digital cup alignment guide to improve placement accuracy and provide a cost-effective and accessible solution for THA.</div></div><div><h3>Methods</h3><div>A smartphone application for acetabular cup placement in THA using built-in gyroscope and accelerometer sensors was developed. The application calculates and displays the cup inclination angle to ensure surgical accuracy. A prospective study was conducted to verify and validate the new guide by assessing the difference between the target pre-operative planned angles and the post-operative placement angles in 87 patients. Differences between the displayed intra-operative angles and the post-operative placement angles were compared between the new guide and CT-based navigation in 20 of the 87 cases.</div></div><div><h3>Results</h3><div>The post-operative cup inclination and anteversion angles were 40.4 ​± ​2.9° (range 35–47°) and 13.7 ​± ​4.4° (range 5–27°). Differences between the intra-operative target and post-operative cup inclination and anteversion angles were 1.8 ​± ​1.9° (range 0–7°) and 2.8 ​± ​2.5° (range 0–10°), respectively. The application demonstrated no significant difference in cup inclination and anteversion angle accuracy compared with CT-based navigation.</div></div><div><h3>Conclusions</h3><div>The smartphone-based guide provides a practical alternative for cup placement in THA, especially in settings where CT-based navigation is not available. Challenges include the need to manage intra-operative pelvic alignment and rotational errors, which suggest room for improvement. However, it is a cost-effective and accessible tool that can improve the accuracy of acetabular cup placement in THA.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meniscus tears in the setting of anterior cruciate ligament injury","authors":"Koji Nukuto ,&nbsp;Efstathios Konstantinou ,&nbsp;Anja Maximiliane Wackerle ,&nbsp;Jaren C. Lagreca ,&nbsp;Camila Grandberg ,&nbsp;Yunseo Linda Park ,&nbsp;Brooke Collins ,&nbsp;Volker Musahl","doi":"10.1016/j.jjoisr.2024.10.003","DOIUrl":"10.1016/j.jjoisr.2024.10.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Meniscus tears in the setting of anterior cruciate ligament (ACL) injury can affect post-operative outcomes and stability when not treated correctly. To reduce post-operative osteoarthritis and to improve outcomes, accurate diagnosis and treatment options must be selected. The purpose of this review was to review recent evidence regarding biomechanics and diagnosis of meniscus injury as well as treatment options for meniscus tears, which are often complicated by ACL injuries.</div></div><div><h3>Methods</h3><div>Studies and topics on concomitant meniscus tears in the presence of ACL injury were searched.</div></div><div><h3>Results</h3><div>Various risk factors have been identified for meniscus tears associated with ACL injuries. As some meniscus tears are difficult to identify on magnetic resonance imaging (MRI), arthroscopic diagnosis of meniscal pathology plays a crucial role. Indications for meniscectomy should be limited due to subsequent exacerbation of post-operative instability and contribution to osteoarthritic changes. Although meniscal repair is the standard treatment for bucket handle tears, ramp lesions, lateral meniscus posterior root tears, and lateral meniscus oblique radial tears, non-operative treatment may be also effective to a certain extent for stable meniscal tears. However, the indication for non-operative treatment should be carefully considered owing to potential enlargement of the torn area.</div></div><div><h3>Conclusions</h3><div>Inadequate treatment of concomitant meniscus tears can result in residual instability and poor outcomes despite successful ACL reconstruction. High-quality evidence on the long-term outcomes of meniscus tears complicating ACL injuries is scarce and hence future studies are required.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 180-188"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the cortical bone reaction around the stem after uncemented total hip replacement using short tapered wedge stem","authors":"Hao Dinh Anh Hoang ,&nbsp;Hironobu Hoshino ,&nbsp;Mitsuru Hanada ,&nbsp;Yukihiro Matsuyama","doi":"10.1016/j.jjoisr.2024.10.001","DOIUrl":"10.1016/j.jjoisr.2024.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div>This study examined the relationship between stem alignment and the cortical bone area around the distal end of the femoral component using three-dimensional computed tomography (3D-CT) images after uncemented total hip arthroplasty (THA).</div></div><div><h3>Methods</h3><div>A total of 59 patients who underwent primary THA using an uncemented short tapered wedge stem from 2019 to 2021 were followed for at least 24 months. Patients were divided into groups based on stem position. Changes in stem position and cross-sectional area of femoral cortical bone at the distal end of the stem were examined using 3D-CT at 12 months and 24 months post-operatively and were compared with pre-operative values.</div></div><div><h3>Results</h3><div>The 12-month post-operative cortical bone area around the stem showed significant differences compared with the pre-operative area in the anterior, posterior, and lateral zone 1. Differences at these same points were noted when comparing the 24-month post-operative area with the pre-operative area. No significant difference was found in the change in the cortical bone area over time among the neutral, flexed, and extended stem groups. In the varus stem group, a significant increase in cortical bone area over time was observed in lateral zone 2. In the valgus stem group, a significant increase in the cortical bone area over time was observed in medial zone 1.</div></div><div><h3>Conclusions</h3><div>Stem alignment may affect periprosthetic cortical bone changes after THA using an uncemented short tapered wedge stem. Cortical bone reaction was revealed laterally to the stem tip in the varus-aligned stem, and medially to the stem tip in the valgus-aligned stem.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 173-179"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain characteristics in patients with hip osteoarthritis","authors":"Toru Nishiwaki,&nbsp;Hisatoshi Ishikura,&nbsp;Tatsuya Yamamoto","doi":"10.1016/j.jjoisr.2024.09.003","DOIUrl":"10.1016/j.jjoisr.2024.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Exacerbations of osteoarthritis (OA) pain significantly impair activities of daily living and walking, thereby reducing quality of life. Despite various treatments, persistent pain remains a challenge, particularly in patients with hip OA, where pain perception mechanisms extend beyond nociceptive pain. This study examined the pain characteristics in patients with hip OA, with an emphasis on neuropathic pain and central sensitization (CS).</div></div><div><h3>Methods</h3><div>A total of 421 patients scheduled for unilateral total hip arthroplasty were analyzed using the painDETECT score and Central Sensitization Inventory to classify the pain types as nociceptive (Noc), CS, neuropathic (Neu), or neuropathic with CS (NeuCS).</div></div><div><h3>Results</h3><div>The results indicated that 72.9% of patients experienced Noc pain, while 5.0% experienced combined NeuCS pain. The Neu and NeuCS groups exhibited significantly lower modified Harris Hip Score and EuroQol-5 Dimensions Questionnaire (EQ-5D) scores than the Noc group, indicating worse clinical outcomes and quality of life. Neu pain was more intense at rest, and when combined with CS it significantly diminished the quality of life.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need for mechanism-based pain treatment strategies, such as Neu pain and CS components, which independently and cumulatively affect clinical scores and quality of life. This study highlights the importance of early recognition and targeted treatment of these pain mechanisms in patients with hip OA. Future research should focus on evaluating therapeutic interventions for Neu pain and CS to optimize patient outcomes.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 168-172"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of physical function recovery in patients with rheumatoid arthritis and those with osteoarthritis after total knee arthroplasty","authors":"Eriko Mashimoto ,&nbsp;Manabu Nankaku ,&nbsp;Gakuto Kitamura ,&nbsp;Kohei Nishitani ,&nbsp;Shinichiro Nakamura ,&nbsp;Shinichi Kuriyama ,&nbsp;Ryosuke Ikeguchi ,&nbsp;Shuichi Matsuda","doi":"10.1016/j.jjoisr.2024.08.001","DOIUrl":"10.1016/j.jjoisr.2024.08.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Patients with rheumatoid arthritis (RA) who have undergone primary total knee arthroplasty (TKA) have a different recovery process of walking ability compared with patients with osteoarthritis (OA). However, how this relates to pain and other physical functions is unknown. This study aimed to evaluate and compare physical function after TKA in patients with RA and knee OA.</p></div><div><h3>Methods</h3><p>This study enrolled 146 patients (24 with RA and 122 with OA) who underwent primary TKA. Data on the following were collected pre- and post-TKA (3 weeks and 1 year): 10 Meter Walk Test (10MWT), Timed Up and Go (TUG) test, knee pain, physical activity, isometric knee extensor and flexor strength, passive knee extension and flexion angle, and one-leg standing time. Two-way repeated measures analysis of variance (ANOVA) with Bonferroni <em>post hoc</em> comparisons was performed to examine the influence of the different diseases on post-operative changes in physical function over time.</p></div><div><h3>Results</h3><p>The RA group had a significantly more severe pre-operative pain score than the OA group (<em>p</em> ​&lt; ​0.05). A two-way repeated measures ANOVA showed a significant group ​× ​time interaction in the TUG test and 10MWT time. The RA group had a slower pre-operative time in these tests than the OA group (<em>p</em> ​&lt; ​0.01). However, the TUG test and 10MWT time at 3 weeks and 1 year post-TKA were not significantly different between the two groups.</p></div><div><h3>Conclusion</h3><p>In patients with RA, walking ability significantly improved at 3 weeks following TKA, and showed recovery from 3 weeks up to 1 year similar to patients with OA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 163-167"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000227/pdfft?md5=9060ad885107605c6f477c92faae18a9&pid=1-s2.0-S2949705124000227-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142242107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are the most difficult steps in total hip arthroplasty for early-career surgeons and how can future technology help most? A survey of the American Association of Hip and Knee Surgeons Young Arthroplasty Group","authors":"Ken Tashiro ,&nbsp;Yasuhiro Homma ,&nbsp;Jesse Wolfstadt ,&nbsp;Christopher M. Melnic ,&nbsp;Muneaki Ishijima ,&nbsp;Atul F. Kamath","doi":"10.1016/j.jjoisr.2024.09.002","DOIUrl":"10.1016/j.jjoisr.2024.09.002","url":null,"abstract":"<div><h3>Purpose</h3><p>While technology in total hip arthroplasty (THA) is generally developed by experienced surgeons, particular difficulties in surgical steps and technical demands experienced by early-career surgeons remain important. This study investigated the challenges early-career surgeons currently face in THA in order to obtain insights into how they perceive future innovative technologies might reduce the difficulties and complications associated with THA.</p></div><div><h3>Methods</h3><p>Members of the American Association of Hip and Knee Surgeons Young Arthroplasty Group were surveyed. The perceived degree of difficulty with key THA surgical steps and the utility of adjunctive technology were recorded (scale 1–10, from no difficulty/not important to very difficult/very important).</p></div><div><h3>Results</h3><p>The membership response rate was 16.1%. The most common THA approach was the direct anterior approach (DAA) (67.4%). Four of the top five most difficult surgical steps were associated with cup preparation/placement. Fluoroscopy was the most used technology (56.7%), followed by no technology use (21.2%) and robot arm assistance (12.1%). With respect to the importance of technology, accurate cup placement ranked first. Dislocation and stem subsidence were the top two complications for which technological advances were thought to be most beneficial. Subgroup analysis based on surgical approach suggested that DAA users had significantly more difficulty with direction of stem rasping than non-DAA users (<em>p</em> ​&lt; ​0.0001).</p></div><div><h3>Conclusion</h3><p>This is the first survey to reveal data about perceived difficulties in THA surgical steps from the perspective of early-career arthroplasty surgeons and the role of technology in mitigating these complications. Future technological developments may take these needs of early-career surgeons into account.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 157-162"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000239/pdfft?md5=ec3389e929d99dfbe76509b80d584033&pid=1-s2.0-S2949705124000239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plain radiograph evaluation of concurrent filling of tibial peg holes with bone in cementless total knee arthroplasty","authors":"Kazue Hayakawa,&nbsp;Hideki Date,&nbsp;Sho Nojiri,&nbsp;Yosuke Kaneko,&nbsp;Kohei Shibata,&nbsp;Nobuyuki Fujita","doi":"10.1016/j.jjoisr.2024.09.001","DOIUrl":"10.1016/j.jjoisr.2024.09.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to evaluate the effectiveness of a novel technique for securing the tibial component in cementless total knee arthroplasty (TKA) by utilizing resected cancellous bone to fill the peg holes. It was hypothesized that this method would reduce the incidence of radiolucent lines (RLLs) on plain radiographs. To test this hypothesis, a retrospective comparison of plain radiographs from patients who underwent the bone-filling technique (bone filling group) versus those who did not receive this treatment (conventional group) was conducted.</p></div><div><h3>Methods</h3><p>Participants were 151 patients (213 joints) who underwent TKA with the NexGen trabecular metal (TM) modular tibia (Zimmer Biomet) from 2011 to 2016 [bone filling group, 54 patients (69 joints); conventional group, 100 patients (144 joints); 3 patients had 1 joint in each group]. Clinical evaluations, plain radiographs, and operative time were compared between groups.</p></div><div><h3>Results</h3><p>The mean follow-up period was 5 years and 5 months. Knee Society Scores and Knee Society Functional Scores did not differ significantly between groups; however, the bone filling group had a significantly lower incidence of RLLs (<em>p</em> ​&lt; ​0.05) and significantly more longitudinal trabecular thickening below the pegs (<em>p</em> ​&lt; ​0.05). Multiple logistic regression analysis with the presence/absence of RLLs as the dependent variable revealed a significant effect of bone filling (odds ratio ​= ​2.820, 95% confidence interval 1.033–7.700; <em>p</em> ​&lt; ​0.05).</p></div><div><h3>Conclusion</h3><p>Concurrent peg hole bone filling significantly reduces the incidence of RLLs and significantly increases longitudinal trabecular thickening below the pegs during TKA with the NexGen TM modular tibial component.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 151-156"},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000240/pdfft?md5=16cac605b90a9f1a297352fca61334b7&pid=1-s2.0-S2949705124000240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical intervention should be considered for sciatic nerve palsy following total hip arthroplasty using a posterolateral approach","authors":"Kazunari Ishida ,&nbsp;Nao Shibanuma ,&nbsp;Tomoyuki Matsumoto ,&nbsp;Yuichi Kuroda ,&nbsp;Naoki Nakano ,&nbsp;Masahiro Kurosaka ,&nbsp;Ryosuke Kuroda ,&nbsp;Shinya Hayashi","doi":"10.1016/j.jjoisr.2024.07.002","DOIUrl":"10.1016/j.jjoisr.2024.07.002","url":null,"abstract":"<div><h3>Purpose</h3><p>This single-center study aimed to determine whether surgical neurolysis influences muscle power recovery in sciatic nerve palsy following total hip arthroplasty (THA).</p></div><div><h3>Methods</h3><p>Among 1912 THAs performed between 2007 and 2019, a total of 1575 THAs using a posterolateral approach (primary THA, 1483 cases; revision THA, 92 cases) were retrospectively reviewed. Subjects who showed sciatic nerve palsy with motor disturbance were extracted. Demographic data, muscle power, and sensory disturbance at the onset of palsy and at final follow-up were examined. Subjects were divided into two groups (conservative treatment group and surgical treatment group) and clinical outcomes were compared between the two groups. Positive recovery was defined as muscle power greater than Manual Muscle Test grade 3.</p></div><div><h3>Results</h3><p>Thirteen cases (0.8%), including eight in the conservative treatment group and five in the surgical treatment group, showed post-operative sciatic nerve palsy. Four cases (80.0%) in the surgical treatment group achieved full muscle power recovery. All three subjects who received surgical treatment on the day of onset of palsy achieved full muscle power and sensory recovery. More patients recovered muscle power in the surgical treatment group than in the conservative treatment group.</p></div><div><h3>Conclusion</h3><p>Muscle power recovery was found in 80.0% of cases in the surgical treatment group and 12.5% of the conservative treatment group. All cases that received surgical intervention on the onset day of palsy achieved full muscle power and sensory recovery, whereas no cases achieved full muscle power recovery in the conservative treatment group. Immediate surgical intervention should be considered for sciatic nerve palsy following THA using a posterolateral approach.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 146-150"},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000215/pdfft?md5=08c81a049526a2576c2f4645c9801d56&pid=1-s2.0-S2949705124000215-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}