Journal of Joint Surgery and Research最新文献

{"title":"Comparison of the cost analysis in total hip arthroplasty of anterior versus posterior approaches: A propensity score-matched cohort study in a single center","authors":"Tetsuya Tachibana ,&nbsp;Hiroki Katagiri ,&nbsp;Hideyuki Koga ,&nbsp;Takahisa Ogawa ,&nbsp;Moe Suzuki ,&nbsp;Tetsuya Jinno","doi":"10.1016/j.jjoisr.2023.10.001","DOIUrl":"10.1016/j.jjoisr.2023.10.001","url":null,"abstract":"<div><h3>Purpose</h3><p>The advantage of total hip arthroplasty (THA) in an anterior approach compared with a posterior approach in terms of early postoperative pain and function and lowering dislocation risks is controversial. This study aimed to identify whether THA using the anterior approach lowers costs compared with the posterior approach.</p></div><div><h3>Methods</h3><p>We identified 294 patients who underwent primary THA and compared the cost of total inpatient stay, inpatient length of stay (LOS), cost of operating room, and the rates of discharged patients, complications, and reoperation between the anterior and posterior approaches using propensity score matching analysis.</p></div><div><h3>Results</h3><p>One-to-one matching resulted in 135 pairs of patients who underwent THA using both approaches. The cost of total inpatient stay was significantly lower in the anterior approach (anterior vs. posterior [1,322,800 vs. 1,445,219 yen]; <em>p</em> ​= ​0.04). Furthermore, in the anterior approach, the inpatient LOS was shorter (anterior vs. posterior [19.9 vs. 25.0 days]; <em>p</em> ​&lt; ​0.001). However, there was no significant difference in the cost of the operating room and the rates of patients discharged home, total complications (anterior vs. posterior [5.2 vs. 11.1 ​%]; <em>p</em> ​= ​0.08), or revisions between the two approaches.</p></div><div><h3>Conclusions</h3><p>Using propensity score matching, the current study demonstrated that THA in the anterior approach shortened inpatient LOS and rendered an 8 ​% reduction in the total inpatient cost compared with the posterior approach.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 222-227"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000348/pdfft?md5=2a8d5de5d251f16fac6150875f67cb22&pid=1-s2.0-S2949705123000348-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194757","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 treatment of cartilage lesions in the knee: A narrative review","authors":"Takehiko Matsushita ,&nbsp;Takeo Tokura ,&nbsp;Kenjiro Okimura,&nbsp;Shohei Sano,&nbsp;Kyohei Nishida,&nbsp;Kanto Nagai,&nbsp;Yuichi Hoshino","doi":"10.1016/j.jjoisr.2023.02.001","DOIUrl":"10.1016/j.jjoisr.2023.02.001","url":null,"abstract":"<div><h3>Purpose</h3><p>The treatment of cartilage injury is challenging owing to its low self-healing capacity. Here we describe a literature review of the current diagnostic methods, surgical treatment options, and techniques for knee cartilage injuries, including possible future treatments and augmentations.</p></div><div><h3>Methods</h3><p>Studies describing surgical techniques for knee cartilage injuries were searched and arbitrarily selected in PubMed. Possible future treatments and augmentations, growth factors, and cell-based treatments are also discussed.</p></div><div><h3>Results</h3><p>Surgical options for cartilage injury, such as microfracture, osteochondral autografts or allografts, and autologous chondrocyte implantation, are well-established methods with overall satisfactory short- and long-term outcomes. However, the limitations and disadvantages of these treatments, such as repair with fibrous cartilage, donor site morbidity, and two-step surgery, have raised concerns. Various surgical treatments or augmentations have been developed to overcome these limitations, including autologous matrix-induced chondrogenesis, bone marrow aspirate concentrate, particulate chondrocyte implantation, and particulate juvenile allograft chondrocytes, and promising short-to mid-term results have been reported. Additionally, numerous studies are underway on the augmentation of biological healing including growth factor and stem cell therapies.</p></div><div><h3>Conclusions</h3><p>Although treating cartilage injuries remains challenging, advancements have been made. It is advisable for surgeons and clinicians to update their surgical techniques and knowledge of cartilage repair and regeneration to better treat patients with knee cartilage injuries.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 70-79"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000075/pdfft?md5=30c8205fb529781d9f9d592a3b9a3b78&pid=1-s2.0-S2949705123000075-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194868","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":"Anterior cruciate ligament reconstruction: Recent evolution and technical improvement","authors":"Kiminari Kataoka,&nbsp;Yuichi Hoshino,&nbsp;Koji Nukuto","doi":"10.1016/j.jjoisr.2023.02.002","DOIUrl":"10.1016/j.jjoisr.2023.02.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Anterior cruciate ligament (ACL) injury is one of the most common knee injuries in young and active patients. ACL reconstruction has been usually recommended to restore anterior-posterior as well as rotatory knee stability. However, there are still some issues to be addressed in ACL reconstruction. Therefore, the purpose of this review was to summarize the current literature regarding recent evolution and technical improvement of ACL reconstruction.</p></div><div><h3>Methods</h3><p>We performed a comprehensive review of the literature regarding graft selection in ACL reconstruction, surgical technique (especially double-bundle ACL reconstruction), and additional procedures.</p></div><div><h3>Results</h3><p>There is still no gold standard for graft selection, while it should be individualized for each patient. Hamstrings tendon autograft and bone-patellar tendon-bone autograft are often chosen, although quadriceps tendon autograft has increased in popularity. Double-bundle ACL reconstruction was introduced to restore normal knee kinematics by closely mimicking the native anatomy. Although clinical advantages of double-bundle ACL reconstruction such as improved clinical outcome and better anteroposterior and rotatory stability have been reported, current global trend of ACL reconstruction technique is unfavourable due to technical difficulty and surgical complications. Further evolution and technical improvement are required to achieve “true” double-bundle ACL reconstruction. An additional procedure such as lateral extra-articular tenodesis, anterolateral ligament reconstruction, and anterior closing wedge osteotomy, may be considered for ACL reconstruction, especially for revision ACL reconstruction, to prevent a graft re-rupture.</p></div><div><h3>Conclusion</h3><p>ACL reconstruction has evolved over time in terms of technique, graft selection, and additional procedures. However, there is still room for improvement.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 97-102"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000087/pdfft?md5=da00f71c45228dc21792fb38a32d2ca0&pid=1-s2.0-S2949705123000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194870","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 evaluation of knee joint diseases","authors":"Kohei Nishitani,&nbsp;Shinichiro Nakamura,&nbsp;Shinichi Kuriyama","doi":"10.1016/j.jjoisr.2022.12.003","DOIUrl":"10.1016/j.jjoisr.2022.12.003","url":null,"abstract":"<div><h3>Purpose</h3><p>This article aimed to comprehensively introduce clinical scoring of pathological conditions of the knee.</p></div><div><h3>Methods</h3><p>Review articles on the clinical scores of knee joints were searched. The frequency of the clinical scores used in said articles are presented as whole-knee pathological conditions or according to specific knee diseases. Frequently used scoring systems are separately explained in terms of validity and clinically important values.</p></div><div><h3>Results</h3><p>Of 132 review articles, 95 were included in this review. Among these 95, the top five frequently used scoring systems were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee Subjective Knee Form (IKDC subjective score), Knee Society Score (KSS), and Lysholm Knee Scoring Scale. Patient-reported outcome measures to evaluate patients’ health-related quality of life, such as the EuroQol 5 dimensions (EQ5D), MOS 36-Item Short-Form Health Survey (SF-36), and SF-12 Health Survey (SF-12), were frequently used. Activity and functional ratings, such as the Tegner activity score and University of California Los Angeles (UCLA) Activity Scale, were also frequently used. Usage trends of scoring systems differed according to the pathological conditions of the knee, and some disease-specific scoring systems, such as the Kujala score for patellofemoral problems or Forgotten Joint Score for arthroplasty, have been reported.</p></div><div><h3>Conclusions</h3><p>Various scoring systems are used for pathological conditions of the knee. Even for knee diseases, trends in scoring systems differ according to pathological conditions, necessitating the selection of appropriate scoring systems.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 9-17"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705122000032/pdfft?md5=13bdb6d6880a18b925fb302ac23dfa6b&pid=1-s2.0-S2949705122000032-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194908","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":"A plain radiography may underestimate the steep posterior tibial slope of the medial condyle in elderly Japanese with varus knee osteoarthritis undergoing arthroplasties","authors":"Kohei Nishitani,&nbsp;Shinichi Kuriyama,&nbsp;Shinichiro Nakamura,&nbsp;Taisuke Yabe,&nbsp;Young-Dong Song,&nbsp;Hiromu Ito,&nbsp;Shuichi Matsuda","doi":"10.1016/j.jjoisr.2023.06.002","DOIUrl":"10.1016/j.jjoisr.2023.06.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Understanding the native posterior tibial slope (PTS) is important especially in cruciate ligament retaining total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA). This study investigated the efficacy of PTS with lateral knee radiograph (radiographic PTS) by comparing it with PTS of medial and lateral tibial condyles (MPTS and LPTS) by computed tomography (CT).</p></div><div><h3>Methods</h3><p>In patients who underwent TKA and UKA on varus knee osteoarthritis, radiographic PTS, MPTS, and LPTS were measured. Spearman's correlation was used to compare the radiographic PTS and PTS on CT. More than 3° delta PTS (CT PTS - radiographic PTS) were defined as positive outliers.</p></div><div><h3>Results</h3><p>Three-hundred and twenty-six osteoarthritic knees (278 TKAs and 48 UKAs) were evaluated. The mean radiographic PTS, MPTS, LPTS was 8.0 ​± ​2.9°, 10.2 ​± ​4.2°, and 8.3 ​± ​3.3°, respectively. Plain radiograph tended to underestimate steep MPTS, and its correlations to LPTS (ρ ​= ​0.65, p ​&lt; ​0.001) and MPTS (ρ ​= ​0.54, p ​&lt; ​0.001) were moderate. The positive outliers were observed in 136/326 (42%) and 36/326 (12%) knees in medial and lateral condyles, respectively. Even in UKA, the positive outliers were observed in 13/48 (28%) knees in medial condyle.</p></div><div><h3>Conclusions</h3><p>Radiographic PTS better reproduced LPTS, but did not accurately reproduce MPTS in varus knee osteoarthritis. Radiographic PTS may not detect steep medial PTS. Surgeons should be cautious because the actual PTS of the medial tibial condyle may be different from that preoperatively measured on plain radiographs.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 139-144"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000191/pdfft?md5=172cc9567cf1419d58a050202bc124f2&pid=1-s2.0-S2949705123000191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195369","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":"Does lateral incision reduce perceptual deficits and improve postoperative kneeling ability after total knee arthroplasty?","authors":"Yutaka Suetomi ,&nbsp;Hiroshi Fujii ,&nbsp;Atsunori Tokushige ,&nbsp;Patricio Ⅲ Dumlao ,&nbsp;Takashi Sakai","doi":"10.1016/j.jjoisr.2023.05.003","DOIUrl":"10.1016/j.jjoisr.2023.05.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Kneeling is often difficult after a total knee arthroplasty. However, the reasons behind kneeling difficulties are not yet fully understood. According to several studies, a lateral incision reduces perceptual deficits and improves kneeling performance. This study compared two different skin incisions (lateral and midline) as they relate to postoperative perceptual deficits, as well as kneeling on a mat or in daily life following TKA, and demonstrates the advantage of the lateral incision in postoperative kneeling ability.</p></div><div><h3>Methods</h3><p>This study included 99 patients with lateral incisions and 104 patients with midline incisions. Sensory disturbance was evaluated with a brush on the nine subdivisions of the kneeling area. Patients were tested in the outpatient clinic to determine whether they could kneel on a mat. The level of discomfort in the kneeling area was assessed using a visual analog scale. Questionnaires were used to assess kneeling ability.</p></div><div><h3>Results</h3><p>Compared to a midline incision, a lateral incision significantly reduced the perceptual deficits in the center of the kneeling area and the discomfort associated with kneeling on a mat. There was no significant difference between the two groups in kneeling on a mat in the clinic or kneeling in daily activities. However, less than 30% of patients in both groups could kneel in daily living. The reasons for being unable to kneel were mainly anxiety and pain, rather than numbness.</p></div><div><h3>Conclusion</h3><p>Lateral incisions alone did not improve kneeling in patients' daily living following TKA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 158-162"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000178/pdfft?md5=e56e2e80d944c2355f9d72e75bb3ad8b&pid=1-s2.0-S2949705123000178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195370","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":"Contemporary posterior surgical approach with standard cemented total hip arthroplasty for femoral neck fracture in patients of age 60 years and older: Still a safe option?","authors":"Kevin Syam ,&nbsp;P Nithin Unnikrishnan ,&nbsp;Akmal Turaev ,&nbsp;Jeremy Oakley ,&nbsp;Henry Wynn Jones ,&nbsp;Nikhil Shah","doi":"10.1016/j.jjoisr.2023.08.002","DOIUrl":"10.1016/j.jjoisr.2023.08.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The ideal operative treatment of displaced intracapsular femoral neck fractures in the active elderly is contentious. Recent literature favours a better outcome with the use of total hip arthroplasty (THA). Dislocation remains a major concern with THA, especially when a posterior approach is used. More recently, the concept of dual mobility cups is being promoted to avoid dislocations. The aim of the present study was to look at the outcomes of cemented THA utilising the posterior approach for these patients using a 28 ​mm (mm) femoral head.</p></div><div><h3>Methods</h3><p>This study retrospectively analysed the outcome of 108 primary cemented THA, performed by specialist hip surgeons, using a posterior approach with robust soft tissue repair in patients of age 60 years and older presenting with displaced intra capsular femoral neck fractures using a 28 ​mm head.</p></div><div><h3>Result</h3><p>At mean follow-up of 5.2 years (2.0–10.5 years), there were 2 dislocations (1.9%). One underwent manipulation under anaesthesia and the other had application of a posterior lip augmentation device. No other revisions were performed during the follow up period. The 30 day mortality was nil and no post-operative deep infections. Hundred patients (93%) at 1 year follow-up were independently mobilising.</p></div><div><h3>Conclusions</h3><p>With optimal patient selection, an excellent outcome can be achieved for patients with displaced femoral neck fractures using the standard cemented THA via the posterior approach with 28 ​mm head. A robust soft tissue repair and a specialist hip surgeon is recommended for this cohort of patients.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 192-196"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000270/pdfft?md5=39a27efc17a44aecadcb1461425d8f87&pid=1-s2.0-S2949705123000270-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195378","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":"Effectiveness of single leg standing up exercise for recovery of knee muscle strength and lower extremity motion function following anterior cruciate ligament reconstruction","authors":"Koichi Kamiike ,&nbsp;Takahisa Mori ,&nbsp;Shinichi Yoshiya ,&nbsp;Kotaro Kawaguchi ,&nbsp;Shigeo Fukunishi","doi":"10.1016/j.jjoisr.2023.07.006","DOIUrl":"10.1016/j.jjoisr.2023.07.006","url":null,"abstract":"<div><h3>Purpose</h3><p>We investigated the effectiveness of single-leg standing exercise (SLSE) as a home-based self-exercise for the recovery of knee joint muscle strength and lower limb motor function after anterior cruciate ligament (ACL) reconstruction.</p></div><div><h3>Methods</h3><p>In addition to postoperative rehabilitation, 55 patients who underwent ACL repair were asked to begin SLSE as a home-based self-exercise 50 times per day using a platform elevated at 40 ​cm for 2 months, 30 ​cm at 3 months, 20 ​cm at 4 months, and 10 ​cm at 5 months (intervention group). Sixty-four patients who underwent ACL reconstruction and followed the existing rehabilitation protocol were included in the control group. Isokinetic knee extension and flexion at 60° angular velocity at 3, 8, and 10 months after surgery and lower limb motor function performance at 8 and 10 months after surgery were compared within and between the two groups.</p></div><div><h3>Results</h3><p>Knee extension and flexion muscle strength and lower-extremity motor function recovered over time in both groups. There were no significant differences in knee extension and flexion muscle strength between the two groups at 3 months after surgery. However, knee extension strength, flexion strength, and triple hop test (THT) results were significantly higher in the intervention group (<em>p</em> ​&lt; ​0.01) 8 months after surgery. In addition, knee flexion strength and THT were significantly higher in the intervention group (<em>p</em> ​&lt; ​0.01) 10 months after surgery.</p></div><div><h3>Conclusions</h3><p>The results of this study suggest that SLSE can be an effective exercise for recovering knee joint muscle strength and lower limb motor function.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 179-185"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000257/pdfft?md5=bb1fcd5352697d56ec09e8438f6094c8&pid=1-s2.0-S2949705123000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195379","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}