Journal of Joint Surgery and Research最新文献

{"title":"Comorbid frailty and sarcopenia in older patients after total hip arthroplasty: An observational study","authors":"Takashi Ikeda ,&nbsp;Kazunari Ninomiya ,&nbsp;Koji Suzuki ,&nbsp;Kazuo Hirakawa","doi":"10.1016/j.jjoisr.2024.06.004","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Frailty and sarcopenia may progressively worsen physical function, and studies have noted the frequent presence of sarcopenia in patients who undergo total hip arthroplasty (THA). This study aimed to examine the prevalence of comorbid frailty and sarcopenia in older patients undergoing THA and to determine the impact of these conditions on lower limb strength and hip function.</p></div><div><h3>Methods</h3><p>Patients aged ≥65 years who had undergone THA at least 1 year previously were divided into five groups according to the presence and severity of frailty and sarcopenia. Lower limb strength [hip abductor (HA) and knee extensor (KE)], balance, and hip function were compared.</p></div><div><h3>Results</h3><p>Sarcopenia and frailty affected lower limb muscle strength and hip function in a staircase-like manner, with mean ​± ​standard deviation values for the five groups as follows: HA muscle strength (in Nm/body weight), robust 0.80 ​± ​0.23, pre-frail ​+ ​non-sarcopenia 0.69 ​± ​0.17, pre-frail ​+ ​sarcopenia 0.58 ​± ​0.20, frail ​+ ​non-sarcopenia 0.54 ​± ​0.16, frail ​+ ​sarcopenia 0.50 ​± ​0.16; KE muscle strength (in kgf/body weight), robust 1.17 ​± ​0.23, pre-frail ​+ ​non-sarcopenia 1.03 ​± ​0.32, pre-frail ​+ ​sarcopenia 0.90 ​± ​0.31, frail ​+ ​non-sarcopenia 0.84 ​± ​0.27, frail ​+ ​sarcopenia 0.74 ​± ​0.21; and Harris Hip Score, robust 96.8 ​± ​4.6, pre-frail ​+ ​non-sarcopenia 94.3 ​± ​7.9, pre-frail ​+ ​sarcopenia 88.6 ​± ​9.6, frail ​+ ​non-sarcopenia 87.5 ​± ​10.3, frail ​+ ​sarcopenia 83.5 ​± ​8.6.</p></div><div><h3>Conclusion</h3><p>Progression of sarcopenia and frailty affects lower limb muscle strength and physical function in a staircase-like fashion, suggesting the need to assess the cumulative effects of the two. Among this population, rather than interventions to improve muscle strength and balance in specific areas, interventions to maintain a comprehensive level of physical fitness and muscle mass (including nutrition and lifestyle changes) may be necessary.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 123-128"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000161/pdfft?md5=d6caafb120ee35126f7cd6387954bd1a&pid=1-s2.0-S2949705124000161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540017","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":"Clinical course and risk factors for post-operative onset lateral hinge fracture following medial opening-wedge distal tibial tuberosity osteotomy","authors":"Hiroyasu Ogawa ,&nbsp;Yutaka Nakamura ,&nbsp;Masaya Sengoku ,&nbsp;Tetsuya Shimokawa ,&nbsp;Kazuichiro Ohnishi ,&nbsp;Haruhiko Akiyama","doi":"10.1016/j.jjoisr.2024.06.006","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.006","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate the clinical outcomes of and risk factors for post-operative onset lateral hinge fracture (LHF) following medial opening-wedge distal tibial tuberosity osteotomy (DTO).</p></div><div><h3>Methods</h3><p>A total of 68 patients who underwent DTO were stratified into non-LHF and post-operative onset LHF groups. The groups were compared in terms of radiographic parameters, including the hip–knee–ankle (HKA) angle, and were clinically evaluated using the Knee Society Score (KSS) and 2011KSS. Multiple logistic regression analysis was performed to identify risk factors for post-operative onset LHF.</p></div><div><h3>Results</h3><p>The non-LHF and post-operative onset LHF groups included 53 and 15 patients, respectively. The post-operative HKA angle was significantly smaller (valgus) in the post-operative onset LHF group than in the non-LHF group (<em>P</em> ​= ​0.005). Knee and function scores were significantly lower in the post-operative onset LHF group than the non-LHF group at 6 months (<em>P</em> ​= ​0.002 for each comparison). All 2011KSS subscores were significantly lower in the post-operative onset LHF group than the non-LHF group at 6 months (<em>P</em> ​= ​0.001, 0.010, 0.013, and 0.013, respectively). Post-operative HKA angle was a risk factor for post-operative onset LHF (odds ratio ​= ​0.589, 95% confidence interval 0.392–0.886; <em>P</em> ​= ​0.011).</p></div><div><h3>Conclusions</h3><p>Post-operative weight bearing may be delayed to prevent post-operative onset LHF, especially in patients with post-operative large valgus knee alignment.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 117-122"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000185/pdfft?md5=d82304c216faad030de78a274f01bd86&pid=1-s2.0-S2949705124000185-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540016","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":"Prognostic power of criteria for symptomatic early knee osteoarthritis from a 2-year longitudinal observation of the Iwaki cohort study","authors":"Eiji Sasaki ,&nbsp;Daisuke Chiba ,&nbsp;Seiya Ota ,&nbsp;Yuka Kimura ,&nbsp;Gentaro Kumagai ,&nbsp;Eiichi Tsuda ,&nbsp;Yoshiko Takahashi ,&nbsp;Takuro Iwane ,&nbsp;Yasuyuki Ishibashi","doi":"10.1016/j.jjoisr.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate whether symptomatic early knee osteoarthritis (EKOA) effectively predicts the incidence of definitive knee osteoarthritis (DKOA) in the general Japanese population.</p></div><div><h3>Methods</h3><p>A total of 133 women from the Japanese Iwaki cohort study were enrolled and followed-up over 2 years in order to calculate the rate of progression of EKOA to DKOA. Weight-bearing anteroposterior bilateral knee radiographs and magnetic resonance imaging (MRI) were conducted at baseline and follow-up. Radiographs were classified according to the Kellgren–Lawrence grade. The presence of cartilage lesion, bone marrow lesions, attrition, cysts, osteophytes, and meniscal lesions was evaluated according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Logistic regression analyses were performed to determine the predictive power of EKOA.</p></div><div><h3>Results</h3><p>Of 25 women with EKOA, 15 (60%) progressed to DKOA over 2 years, showing a relative risk (RR) of 1.44 compared with the non-osteoarthritis (non-OA) group (<em>P</em> ​= ​0.120). Logistic regression analysis showed associations of EKOA (<em>P</em> ​= ​0.048) and high body mass index (<em>P</em> ​&lt; ​0.001) with progression to DKOA. Combined EKOA and meniscal lesions increased the RR for osteoarthritis incidence to 2.32 (<em>P</em> ​= ​0.004) compared with the non-OA group. Also, meniscus and bone marrow lesion scores on MRI of the EKOA group maintained high scores over 2 years.</p></div><div><h3>Conclusions</h3><p>The prognostic power of EKOA criteria was confirmed with a RR of 1.44. The combination of symptomatic EKOA criteria and MRI-detected meniscal lesions was a valuable predictor of progression to DKOA over 2 years in women without radiographic abnormalities.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 111-116"},"PeriodicalIF":0.0,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000136/pdfft?md5=d2d3103c771c3c030ce30917fe9999cf&pid=1-s2.0-S2949705124000136-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444355","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":"Relationship between intra-operative joint gap and knee flexion angle after posterior-stabilized total knee arthroplasty","authors":"Sachiyuki Tsukada,&nbsp;Hiroyuki Ogawa,&nbsp;Masayoshi Saito,&nbsp;Takuya Kusakabe,&nbsp;Masahiro Nishino,&nbsp;Naoyuki Hirasawa","doi":"10.1016/j.jjoisr.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Conflicting evidence exists about the appropriate intra-operative soft tissue balance in posterior-stabilized (PS) total knee arthroplasty (TKA). The purpose of this prospective observational study was to investigate the impact of intra-operative soft tissue balance on post-operative knee flexion angle.</p></div><div><h3>Methods</h3><p>A single surgeon performed 164 TKAs using a single brand of PS prosthesis via the subvastus approach without using a pneumatic tourniquet. Intra-operative soft tissue balance was quantified as the gaps between the femoral component and tibial osteotomy surface with the knee flexed at 0°, 30°, 90°, and 120° with the patellofemoral joint reduced. Multiple regression analyses were employed to identify independent predictors of knee flexion angle 1 year after TKA.</p></div><div><h3>Result</h3><p>The pre-operative knee flexion angle and the gap difference between 120° and 0° flexion were positively correlated with knee flexion angle 1 year after TKA [β ​= ​0.37, 95% confidence interval (CI) 0.26–0.48, <em>P</em> ​&lt; ​0.001; and β ​= ​1.09, 95% CI 0.04–2.14, <em>P</em> ​= ​0.042, respectively]. There was no correlation with knee flexion angle 1 year after TKA for the gap difference between 30° flexion and 0° flexion and between 90° flexion and 0° flexion.</p></div><div><h3>Conclusions</h3><p>Intra-operative soft tissue balance at 120° flexion may affect the post-operative knee flexion angle in PS-TKA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 106-110"},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512400015X/pdfft?md5=5afcdc345e59204c6de612f700599430&pid=1-s2.0-S294970512400015X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444354","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":"Accuracy of acetabular cup placement in total hip arthroplasty using an augmented reality navigation “pin-less” system: A pilot study","authors":"Tetsuya Kimura ,&nbsp;Tatsuya Tamaki ,&nbsp;Hiroyuki Ogawa","doi":"10.1016/j.jjoisr.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Currently, there is limited information regarding the utilization of pin-less augmented reality (AR) assistance in total hip arthroplasty (THA). This preliminary study aimed to evaluate the precision of acetabular cup placement in THA utilizing the AR Navigation “Pin-less” System (Pin-less AR navigation, prototype).</p></div><div><h3>Methods</h3><p>A total of 72 consecutive primary THAs in 58 patients were categorized into two groups: the Pin-less AR navigation group and the conventional group. All THAs were conducted via the direct anterior approach. First, the absolute value of difference between the intra-operative and post-operative angles (<em>absolute difference</em>) was calculated in the Pin-less AR navigation group. Second, the absolute value of error between the post-operative angles and the target angles (<em>absolute target error</em>) was assessed both in the Pin-less AR navigation group and the conventional group.</p></div><div><h3>Results</h3><p>The <em>absolute difference</em> in inclination and anteversion angles was 2.2 ​± ​1.4° and 2.4 ​± ​1.5°, respectively. The <em>absolute target error</em> in the Pin-less AR navigation group versus the conventional group was 1.9 ​± ​1.5° versus 4.2 ​± ​2.7° in inclination (<em>P</em> ​&lt; ​0.001) and 2.3 ​± ​1.5° versus 3.1 ​± ​2.1° in anteversion (<em>P</em> ​= ​0.092). The percentage of acetabular cups placed within ±5° from the target angles was significantly higher in the Pin-less AR navigation group (90.3%) compared with the conventional group (52.6%) (<em>P</em> ​&lt; ​0.001).</p></div><div><h3>Conclusions</h3><p>This study demonstrates that Pin-less AR navigation yielded generally accurate acetabular cup positioning, surpassing the conventional method. Further research is warranted to thoroughly evaluate Pin-less AR navigation.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 94-98"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000148/pdfft?md5=9d4448de3dec090280fd22203e88600e&pid=1-s2.0-S2949705124000148-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433836","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":"Method for defining the horizontal plane in fluoroscopic kinematic analysis","authors":"Takahiro Arakawa ,&nbsp;Kenichi Kono ,&nbsp;Tetsuya Tomita ,&nbsp;Takaharu Yamazaki ,&nbsp;Masashi Tamaki ,&nbsp;Shoji Konda ,&nbsp;Teruya Ishibashi ,&nbsp;Ryota Yamagami ,&nbsp;Kohei Kawaguchi ,&nbsp;Tomofumi Kage ,&nbsp;Ryo Murakami ,&nbsp;Hiroshi Inui ,&nbsp;Shuji Taketomi ,&nbsp;Sakae Tanaka","doi":"10.1016/j.jjoisr.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.05.002","url":null,"abstract":"<div><h3>Purpose</h3><p><em>In vivo</em> kinematics of skeletal joints and prostheses is affected by gravity; therefore, absolute tilt must be taken into account. However, current fluoroscopic kinematic analysis cannot measure the tilt. This study introduces and validates a method for defining the horizontal plane in fluoroscopy systems to measure the tilt of an object.</p></div><div><h3>Methods</h3><p>A rectangular metal plate (200 ​× ​200 ​× ​10 ​mm) with a flatness of 0.03/100 ​mm was horizontally adjusted using a leveler (sensitivity of 0.02° and accuracy of ±0.06°), and its three-dimensional coordinate was calculated from a two-dimensional fluoroscopic image. A coordinate calculation formula was developed, with precision and accuracy assessed via computer simulations. Actual fluoroscopic tests included four aspects: accuracy under the same condition; accuracy under different X-ray tube height; reproducibility when changing X-ray tube height; and reproducibility when the flat panel was tilted and returned.</p></div><div><h3>Results</h3><p>The theoretical measurement error indicated by the computer simulations was 0.0 ​± ​0.2° on the <em>xy</em>-plane and 0.0 ​± ​0.0° on the <em>yz</em>-plane. The actual experimental results showed that the horizontal plane tilt was measured to be −0.2 ​± ​0.1° tilt on the <em>xy</em>-plane and 0.3 ​± ​0.0° tilt on the <em>yz</em>-plane for the device used in this study. The <em>F</em>-test showed no significant differences between the computer simulations and the actual experiments. There were no significant differences between the four actual tests.</p></div><div><h3>Conclusions</h3><p>This method enables the horizontal plane to be defined and the tilt of an object to be measured in fluoroscopic kinematic analysis.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 99-105"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000124/pdfft?md5=8b505a1b580116ed9979df6473ddb3bc&pid=1-s2.0-S2949705124000124-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141439349","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":"Soft tissue balance in total knee arthroplasty: Clinical value of intra-operative measurement","authors":"Tomoyuki Matsumoto ,&nbsp;Naoki Nakano ,&nbsp;Masanori Tsubosaka ,&nbsp;Hirotsugu Muratsu","doi":"10.1016/j.jjoisr.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.05.001","url":null,"abstract":"<div><h3>Purpose:</h3><p>Considering successful clinical outcomes, accurate osteotomy/implantation and soft tissue balancing are essential in total knee arthroplasty (TKA). However, intra-operative assessment of soft tissue balance remains difficult, and management is left much to the surgeon's subjective feel and experience. The aim of this paper was to review various soft tissue balance assessments and their relationship with pre- and intra-operative factors and clinical outcomes.</p></div><div><h3>Methods:</h3><p>Literature regarding the history of soft tissue balance measurement, various types of measurement tools, theory of recent measurement, influence of various factors on soft tissue balance, and influence of soft tissue balance on clinical outcomes in TKA was reviewed using the PubMed database.</p></div><div><h3>Results:</h3><p>Soft tissue balance measurement has switched from the unphysiological condition, i.e., with assessment between bone cut surfaces and patellar eversion, to the physiological condition, i.e. with femoral component placement and patellofemoral joint reduction. Type of prosthesis, implant design, surgical technique, and pre-operative factors affect intra-operative soft tissue balance. Intra-operative soft tissue balance also affects post-operative range of motion and patient-reported outcome measures.</p></div><div><h3>Conclusions:</h3><p>Intra-operative quantitative soft tissue balance measurement and management with physiological knee condition, which is closely influenced by various pre-operative and intra-operative factors, is important for the achievement of high knee function and patient satisfaction.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 85-93"},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000112/pdfft?md5=fb3ff533ef933a920f183cba4ca6e02a&pid=1-s2.0-S2949705124000112-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239938","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":"Pre- and post-operative knee alignment phenotypes in restricted kinematic alignment, mechanical alignment total knee arthroplasty, and unicompartmental knee arthroplasty","authors":"Shotaro Araki,&nbsp;Takafumi Hiranaka,&nbsp;Takaaki Fujishiro,&nbsp;Koji Okamoto","doi":"10.1016/j.jjoisr.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The coronal plane alignment of the knee (CPAK) classification has been introduced as a simple system to classify knee phenotypes based on leg alignment [hip–knee–ankle angle (HKA) and joint line obliquity (JLO)]. Differences in post-operative phenotype between mechanical alignment (MA) and kinematic alignment (KA) total knee arthroplasty (TKA) have been reported, but not the phenotypes after unicompartmental knee arthroplasty (UKA). Moreover, most studies have focused upon Western populations. This study compared pre- and post-operative knee phenotypes between MA-TKA, KA-TKA, and UKA in a Japanese cohort.</p></div><div><h3>Methods</h3><p>In this study, 230 knees in 165 patients who underwent UKA, 124 knees in 80 patients who underwent MA-TKA, and 80 knees in 51 patients who underwent restricted KA-TKA in Takatsuki General Hospital between March 2019 and January 2021 were retrospectively investigated. Pre- and post-operative lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were measured, and JLO (MPTA ​+ ​LDFA) and arithmetic HKA (aHKA) (MPTA – LDFA) were calculated and compared between the surgeries.</p></div><div><h3>Results</h3><p>Pre-operative JLO and aHKA did not significantly differ between the three groups (pre. JLO, <em>p</em> ​= ​0.164; pre. aHKA, <em>p</em> ​= ​0.13). Pre-operatively, 62.0% of knees were categorized as type I (varus leg alignment and medially sloped joint line). After UKA, 59.1% of type I inherited the pre-operative phenotype, whereas most cases were altered in MA-TKA and KA-TKA (4.8% and 30.0%, respectively, inherited the pre-operative phenotype).</p></div><div><h3>Conclusions</h3><p>The pre-operative phenotype was mostly inherited after UKA and to a lesser extent after KA-TKA, whereas it tended to be altered after MA-TKA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 77-83"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000094/pdfft?md5=e5284da5a6b5c64404050b5fe95436de&pid=1-s2.0-S2949705124000094-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083351","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":"Impact of prognostic nutritional index on the occurrence of post-operative delirium after total knee arthroplasty","authors":"Kensuke Hotta,&nbsp;Mitsuru Hanada,&nbsp;Yukihiro Matsuyama","doi":"10.1016/j.jjoisr.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Delirium has been reported to cause delayed functional recovery, prolonged hospitalization, future institutionalization, increased mortality, and increased healthcare costs. However, there are no reports on how prognostic nutritional index (PNI), Controlling Nutritional Status (CONUT) score, and geriatric nutritional risk index (GNRI) are related to delirium after total knee arthroplasty (TKA). This study aimed to identify risk factors for post-operative delirium after TKA using various pre-operative nutritional assessments (PNI, CONUT score, and GNRI).</p></div><div><h3>Methods</h3><p>In total, 289 patients who underwent primary TKA between September 2011 and April 2022 in our institute (Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan) were enrolled. Patients were divided into two groups: those who developed post-operative delirium (Group D), and those who did not (Group ND). Pre-operative risk factors, including nutritional indices, for post-operative delirium were evaluated.</p></div><div><h3>Results</h3><p>Group D comprised 16 participants, while Group ND comprised 273 participants. Comparisons between the two groups revealed significant differences in age, PNI, CONUT score, GNRI, and history of cerebrovascular disease. Multiple logistic regression analysis revealed that significant risk factors for delirium after TKA were age, PNI, and history of cerebrovascular disease. A receiver operating characteristic curve indicated that the cutoff values for delirium were 47.4 for PNI (sensitivity, 0.810; specificity, 0.875) and 78.5 years for age (sensitivity, 0.813; specificity, 0.722).</p></div><div><h3>Conclusions</h3><p>Risk factors for post-operative delirium after TKA were PNI &lt;47.4, age &gt;78.5 years, and history of cerebrovascular disease. Patients exceeding these pre-operative cutoff values or with a history of cerebrovascular disease should receive counseling about delirium before surgery.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 71-76"},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000100/pdfft?md5=4fc7f0e0e6dc526e38580c8fff16fbfa&pid=1-s2.0-S2949705124000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141068849","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":"Significant improvement in locomotive functions after total knee arthroplasty but worse than those of independent ambulatory community dwellers","authors":"Seiya Miyamoto ,&nbsp;Takehiko Sugita ,&nbsp;Naohisa Miyatake ,&nbsp;Nozomi Itou ,&nbsp;Akira Sasaki ,&nbsp;Ikuo Maeda ,&nbsp;Masayuki Kamimura ,&nbsp;Takashi Aki ,&nbsp;Toshimi Aizawa","doi":"10.1016/j.jjoisr.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This study investigated the adequacy of improvements in locomotive syndrome (LS) and other clinical outcomes after total knee arthroplasty (TKA) for medial knee osteoarthritis.</p></div><div><h3>Methods</h3><p>A total of 74 patients who underwent unilateral primary TKA were evaluated pre-operatively and 3, 6, and 12 months post-TKA using the 25-question Geriatric Locomotive Function Scale (GLFS-25) to evaluate the severity of LS, the Japanese Knee Osteoarthritis Measure (JKOM), the Knee Society Score (KSS), the timed up and go (TUG) test, and range of motion of the knee joint (ROM). The GLFS-25 score and the severity of LS were compared between these patients and independent ambulatory community dwellers (273 males and 477 females).</p></div><div><h3>Results</h3><p>The GLFS-25, JKOM, KSS, TUG scores, and ROM significantly improved post-operatively. The pre-operative incidence of LS stage 3, indicating the worst locomotive function, decreased from 81.1% to 24.3% at the final follow-up. However, the median (interquartile range) GLFS-25 score of 13 (6–23) seemed much worse, and the incidence of LS stage 3 of 24.3% seemed much higher even 12 months post-TKA compared with independent ambulatory community dwellers.</p></div><div><h3>Conclusions</h3><p>The GLFS-25 score and other clinical outcome scales significantly improved after TKA. However, improvements in locomotive functions were not adequate as approximately 25% of patients remained with LS stage 3. Besides ordinary rehabilitation programmes after TKA, some interventions, such as more rigorous muscle exercises, would be necessary to obtain greater improvements in LS.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 66-70"},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000070/pdfft?md5=c0bef383cc57bbd227e0c90559980b2f&pid=1-s2.0-S2949705124000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645523","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}