Journal of Orthopaedic Science最新文献

{"title":"Influence of changes in pelvic anteversion during gait on walking ability and physical function in patients with adult spinal deformity: A cross-sectional study","authors":"Keita Sato ,&nbsp;Toshikazu Ito ,&nbsp;Tatsuya Endo ,&nbsp;Takuya Miura ,&nbsp;Masumi Iwabuchi ,&nbsp;Osamu Shirado","doi":"10.1016/j.jos.2023.12.005","DOIUrl":"10.1016/j.jos.2023.12.005","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Evaluation of gait posture using a three-dimensional motion analysis system (3DMAS) revealed that elderly patients with adult spinal deformity (ASD) experience pelvic anteversion while walking. The purpose of this study was to investigate the influence of changes in pelvic anteversion during gait on walking ability and physical function in patients with ASD.</div></div><div><h3>Methods</h3><div>Fifty-four patients with ASD aged 50 years or older who were admitted to our hospital between March 2016 and December 2021 were included in the study. The 6-min walking distance (6MWD) was used to evaluate walking ability, and trunk and hip extensor strength were measured to evaluate physical function in the subjects. The 3DMAS was used to measure the subject's changes in pelvic anteversion during gait. After measuring the changes in pelvic anteversion, the median value of the study subjects was calculated, according to which the subjects were divided into two groups (small anteversion [S] group, large anteversion [L] group). Walking ability and physical function were compared between the two groups.</div></div><div><h3>Results</h3><div>The number of subjects in each group was 27. Comparisons of walking ability and physical function between the groups revealed significant differences in 6MWD (S group, 333.6 ± 111.2 m; L group, 238.0 ± 106.3 m) and hip extensor strength (S group, 15.8 ± 3.8 kgf; L group, 13.4 ± 4.4 kgf). No significant differences regarding trunk extensor strength were observed between the groups (S group, 15.2 ± 4.0 kgf; L group, 12.9 ± 4.8 kgf).</div></div><div><h3>Conclusion</h3><div>The results of the present study revealed that ASD patients with greater pelvic anteversion associated with walking have lower walking ability and physical function. These results suggest the importance of evaluating the posture of ASD patients not only by using radiographic findings but also by assessing movement, such as gait posture.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 25-31"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nationwide multicenter study of the cost effectiveness of five leading drugs for pharmacological management of cervicobrachial symptoms","authors":"Norimitsu Wakao ,&nbsp;Takeo Furuya ,&nbsp;Toshitaka Yoshii ,&nbsp;Hideyuki Arima ,&nbsp;Yu Yamato ,&nbsp;Hiroaki Nakashima ,&nbsp;Shiro Imagama ,&nbsp;Yasuaki Imajo ,&nbsp;Hiroshi Miyamoto ,&nbsp;Gen Inoue ,&nbsp;Masayuki Miyagi ,&nbsp;Shunsuke Kanbara ,&nbsp;Yoichi Iizuka ,&nbsp;Hirotaka Chikuda ,&nbsp;Kei Watanabe ,&nbsp;Kazuyoshi Kobayashi ,&nbsp;Mikito Tsushima ,&nbsp;Masashi Miyazaki ,&nbsp;Mitsuru Yagi ,&nbsp;Satoshi Suzuki ,&nbsp;Hirotaka Haro","doi":"10.1016/j.jos.2023.12.004","DOIUrl":"10.1016/j.jos.2023.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Cervicobrachial pain frequently affects the quality of life (QOL) of the general public and has a significant economic impact on the health care systems of various countries. There are a number of treatment options for this disease, including widely-used drug therapy, but the effectiveness of each option is indeterminate, and there have been no published cost-effectiveness analysis studies so far. This prospective observational study aimed to examine the cost-effectiveness of drug treatment for cervicobrachial symptoms.</div></div><div><h3>Methods</h3><div>A 6-month medication regimen for each of five frequently-prescribed drugs for cervicobrachial symptoms was administered to 322 patients at 24 centers in Japan. Outcome measures, including of the EuroQol Group 5D, Short Form-8, and Visual Analog Scale (VAS), were investigated at baseline and every month thereafter. Incremental cost-effectiveness ratios (ICERs) of the drug cost to quality-adjusted life years (QALYs) were calculated. A stratified analysis of patient characteristics was also performed to identify baseline factors potentially affecting cost-effectiveness.</div></div><div><h3>Results</h3><div>The ICER of entire drug treatment for cervicobrachial symptoms was 7,491,640 yen. Compared with the reference willingness-to-pay, the ICER was assumed to not be cost-effective. A certain number of QALYs were gained during the first 3 months after the treatment intervention, but almost no QALYs were gained during the following 3 months. Stratified analysis showed that cost-effectiveness was extremely low for patients with high baseline VAS and high QOL.</div></div><div><h3>Conclusions</h3><div>The available medications for cervicobrachial symptoms did not have excellent cost-effectiveness. Although a certain number of QALYs were gained during the first 3 months after medication, no QALYs were gained in the latter half of the study period, suggesting that it is not advisable to continue the medication needlessly.</div></div><div><h3>Level of evidence</h3><div>II, prospective cohort study.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 18-24"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative glycemic control reduces the risk of retear in diabetic patients following arthroscopic rotator cuff repair: A meta-analysis","authors":"Junwen Liang ,&nbsp;Qianrun Liang ,&nbsp;Xihao Wang ,&nbsp;Xiangdong Yun","doi":"10.1016/j.jos.2024.01.003","DOIUrl":"10.1016/j.jos.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have associated diabetes with reduced shoulder motion, increased pain, and higher postoperative retear risk after arthroscopic rotator cuff repair (ARCR). However, the impact of glycemic control, measured by hemoglobin A1c (HbA1c) levels, on retear and revision rates after ARCR in diabetic patients remains unclear.</div></div><div><h3>Methods</h3><div>This systematic review was conducted using the PubMed, Cochrane Library, Web of Science, and Embase databases according to the preferred reporting conventions for systematic reviews and meta-analyses. Only studies that compared retears and revisions in ARCR patients with documented HbA1c levels between controlled and uncontrolled diabetes groups were included. Relevant data were extracted and analyzed using STATA software. The methodological index for nonrandomized studies was employed to assess the risk of bias in the selected studies. Additionally, heterogeneity tests and sensitivity analyses were conducted to evaluate potential heterogeneity within the samples, and publication bias was also detected.</div></div><div><h3>Results</h3><div>Six studies (4395 patients), including five retrospective cohort studies and one case‒control study, were included. Four of these studies assessed retears involving 253 patients. Lower HbA1c levels, indicating better glycemic control, were significantly associated with reduced retear rates after ARCR in diabetic patients (<em>P</em> = 0.000; odds ratio = 0.242, 95 % confidence interval: 0.128–0.454; <em>I</em>² = 25 %). For revision evaluations, two studies, with a total of 4142 patients, found no significant difference in rates between controlled and uncontrolled diabetes groups, and no publication bias was detected.</div></div><div><h3>Conclusion</h3><div>Following ARCR in diabetic patients, effective glycemic control significantly reduces retear rates without affecting revisions, and maintaining glycemic control in the postoperative period may contribute to rotator cuff healing.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 78-84"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic effectiveness of continuous versus single-injection adductor canal block in addition to continuous popliteal sciatic nerve block for bimalleolar and trimalleolar ankle fracture surgery: Prospective randomized controlled trial","authors":"Young Uk Park ,&nbsp;Han Bum Joe ,&nbsp;Jong Wha Lee ,&nbsp;Young Wook Seo","doi":"10.1016/j.jos.2024.01.002","DOIUrl":"10.1016/j.jos.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><div>The adductor canal block is a well-known procedure for controlling postoperative pain after medial malleolus fracture surgery. Continuous nerve block is a viable option for blocking pain for a longer period although the literature on this subject is scarce. Therefore, this study aimed to compare continuous adductor canal block (cACB) group to single-injection adductor canal block (sACB) group in those with bimalleolar or trimalleolar ankle fractures. The procedure was performed in addition to a continuous sciatic nerve block for postoperative pain relief and patient satisfaction.</div></div><div><h3>Methods</h3><div>The study included 57 patients who had bimalleolar or trimalleolar ankle fractures and underwent open reduction and internal fixation between August 2016 and June 2018. Each patient received a continuous sciatic nerve block and was divided into two groups: those who received cACB and those who received sACB. Each postoperative pain was scored at 4, 8, 12, 24, 48, and 72 h after surgery. Additionally, the consumption of rescue medications and patient satisfaction were evaluated.</div></div><div><h3>Results</h3><div>The two groups displayed no disparity in medial side ankle pain at 4 h and 8 h after surgery, but significantly higher pain in the sACB group at 12, 24, 48, and 72 h after surgery. However, there was no difference in the pain at the lateral side of ankle and consumption of rescue medication. In addition, the cACB group showed more satisfaction than the sACB group did.</div></div><div><h3>Conclusion</h3><div>CACB is better than sACB in terms of postoperative pain control and patient satisfaction. cACB can be used for postoperative pain control in ankle fractures involving the medial malleolus.</div></div><div><h3>Level of evidence</h3><div>Prospective Randomized Controlled Trial, Level 2.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 159-163"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139692133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative assessment of muscle activity of back and lower extremities, whole body sagittal alignment, body sway, and health-related quality of life in adult spinal deformity patients before and after spinopelvic correction surgery: From the standpoint of the “cone of economy”","authors":"Mikio Muraoka ,&nbsp;Kazuhiro Hasegawa ,&nbsp;Michiko Sakai ,&nbsp;Shun Hatsushikano ,&nbsp;Kei Watanabe","doi":"10.1016/j.jos.2024.02.006","DOIUrl":"10.1016/j.jos.2024.02.006","url":null,"abstract":"<div><h3>Background and aims</h3><div>Pain and muscle fatigue in the low back and lower extremity associated with adult spinal deformity (ASD) markedly limit daily activities and affect quality of life. This study aimed to clarify if spinal correction surgery decreases the muscle activity requirements in relation to alignment and balance parameters.</div></div><div><h3>Methods</h3><div>Integrated electromyogram (I-EMG) studies of the low back and lower extremity in addition to whole body alignment, body sway, and health-related quality of life (HRQOL) were evaluated in 16 patients with ASD before and after surgery. Sixteen healthy volunteers were included as control subjects. Muscle activities of the bilateral lumbar paravertebral, biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior were measured using surface electromyogram in both resting and working standing positions. Surgical outcomes were based on improvements in muscle fatigue using the sum of the whole muscle I-EMGs and body sway. HRQOL was evaluated by SRS-22r, which measures 4 domains (function, pain, self-image, mental health) and subtotal scores.</div></div><div><h3>Results</h3><div>In controls, the sum of the 10 whole I-EMGs (mVms; mean ± SD) was 3316 ± 1247 in the resting standing position and 5625 ± 2065 in the working standing position. The I-EMG values were higher in ASD patients than in healthy subjects; in the resting standing position, the sum of the whole 10 I-EMGs significantly decreased from baseline (9125 ± 3529) to 3 (6088 ± 1793) and 6 (6381 ± 1776) months postoperatively (p &lt; 0.01). In the working standing position, the sum in ASD patients also significantly decreased from baseline (14,160 ± 5474) to 3 (8085 ± 2540) and 6 (8557 ± 3025) months postoperatively (p &lt; 0.01). I-EMG values did not differ significantly between the 3- and 6-month time points in either condition. Body sway was also improved postoperatively at 3 months and maintained at 6 months along with the amelioration of whole-body sagittal alignment, and 4 domains and subtotal SRS-22r scores significantly increased postoperatively.</div></div><div><h3>Conclusion</h3><div>Following spinopelvic correction surgery, whole body sagittal alignment was improved, and muscle activity based on I-EMG and body sway were significantly decreased. The SRS-22r scores after surgery also indicated significant improvement, suggesting that muscle fatigue in the standing position was ameliorated, i.e., the “cone of economy” was normalized.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 58-65"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point of care ultrasound combined with CTS-6 to diagnose idiopathic carpal tunnel syndrome","authors":"Hiroo Kimura ,&nbsp;Ryogo Furuhata ,&nbsp;Tomoki Matsuo ,&nbsp;Taku Suzuki ,&nbsp;Noboru Matsumura ,&nbsp;Kazuki Sato ,&nbsp;Takuji Iwamoto","doi":"10.1016/j.jos.2024.01.007","DOIUrl":"10.1016/j.jos.2024.01.007","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to demonstrate the effectiveness of our new diagnostic chart using point of care ultrasound combined with CTS-6 for diagnosing idiopathic carpal tunnel syndrome.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of the data of patients who visited our department and received point of care ultrasound combined with CTS-6 from 2020 to 2023. Data regarding age, sex, initial and final diagnosis, cross-sectional area of the median nerve, CTS-6 score, and electrodiagnostic severity were obtained and statistically analyzed.</div></div><div><h3>Results</h3><div>Of the 177 wrists included in our study, 138 (78 %) were diagnosed with carpal tunnel syndrome, while 39 (22 %) were not (non-carpal tunnel syndrome). With our diagnostic method, 127 wrists (72 %) were diagnosed initially with carpal tunnel syndrome, 23 wrists (13 %) with non-carpal tunnel syndrome, and the rest 27 wrists (15 %) as borderline. Our initial diagnoses of carpal tunnel syndrome and non-carpal tunnel syndrome were maintained in all cases except for two. Cross-sectional area, CTS-6 score, and electrodiagnostic severity showed a positive correlation. A <em>post hoc</em> analysis showed that the new scoring system (CTS-6 score + 2 × cross-sectional area) with a cutoff value of 31.25 points showed a sensitivity as high as 95 % and a specificity of 100 %.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that most suspected idiopathic carpal tunnel syndrome cases can be diagnosed correctly using the diagnostic chart. Although additional tools, including electrodiagnostic studies, may be needed for borderline cases, the use of point of care ultrasound combined with CTS-6 may be a recommendable first-line confirmatory test because point of care ultrasound and CTS-6 could be complementary tools, and this chart may be especially beneficial for atypical or outlier cases.</div></div><div><h3>Level of evidence</h3><div>Diagnostic III.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 85-90"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for intraoperative femoral fractures in cementless bipolar hip arthroplasty for femoral neck fracture in multicenter: The TRON group study","authors":"Hiroaki Ido,&nbsp;Yasuhiko Takegami,&nbsp;Yusuke Osawa,&nbsp;Masanori Okamoto,&nbsp;Hiroki Iida,&nbsp;Shiro Imagama","doi":"10.1016/j.jos.2024.01.005","DOIUrl":"10.1016/j.jos.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative femoral fractures are more common in cementless bipolar hip arthroplasty (BHA) for displaced femoral neck fractures than they are in cemented BHA and remain one of the major concerns. This study aimed to investigate the risk factors for intraoperative femoral fractures in cementless BHA.</div></div><div><h3>Methods</h3><div>The study included 1,392 patients who underwent cementless BHA for displaced femoral neck fractures from January 2015 to December 2019 in 14 hospitals of the Trauma Research Group. They were divided into two groups according to the presence or absence of intraoperative femoral fractures, and factors associated with intraoperative fractures were statistically examined.</div></div><div><h3>Results</h3><div>Forty (2.9 %) intraoperative and 28 (2.0 %) postoperative, totally 68 (4.9 %) femoral fractures occurred. The mean age of the patients, presence of opposite-side proximal femoral fracture, approach, and cementless stem design were significantly different between the two groups (P &lt; 0.05). The logistic regression analysis model showed that a fully HA-coated stem (odds ratio, 4.12; 95 % confidence interval, 1.43–11.9) was an independent factor associated with intraoperative femoral fractures.</div></div><div><h3>Conclusion</h3><div>This study investigated the risk factors associated with intraoperative fractures and showed that fully HA-coated stems were an independent factor associated with intraoperative femoral fractures. Surgeons should be cautious in the early stages of introducing fully HA-coated stems.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 101-106"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return-to-play outcomes after full-endoscopic spine surgery under local anesthesia in professional baseball players: Comparison by timing of surgery","authors":"Shutaro Fujimoto ,&nbsp;Takashi Inokuchi ,&nbsp;Shunsuke Tamaki ,&nbsp;Kosuke Sugiura ,&nbsp;Makoto Takeuchi ,&nbsp;Masatoshi Morimoto ,&nbsp;Fumitake Tezuka ,&nbsp;Kazuta Yamashita ,&nbsp;Junzo Fujitani ,&nbsp;Koichi Sairyo","doi":"10.1016/j.jos.2024.01.006","DOIUrl":"10.1016/j.jos.2024.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Full-endoscopic spine surgery via a transforaminal approach (TF-FESS) is minimally invasive and could help athletes quickly return to play. When treating professional athletes, we have to consider their season schedule. In this study, we investigated the characteristics of Japanese professional baseball players who underwent TF-FESS and examine how the timing of surgery influenced their postoperative course.</div></div><div><h3>Methods</h3><div>Ten players who underwent TF-FESS (discectomy, foraminoplasty, or thermal annuloplasty according to their diagnosis) under local anesthesia were analyzed. Multilevel surgeries were performed at the same time in patients with lesions at multiple levels. The patients were divided into three groups according to timing of surgery (pre/during/post-season). Time to complete return to play and duration of official game loss were compared between the three groups.</div></div><div><h3>Results</h3><div>All players (100 %) could return to their original level of professional play after FESS surgery. Seven of the 10 patients underwent two-level surgery. The mean time until complete return to play was 4.6 months (range, 2–8 months) and the mean duration of game loss was 1.5 months (range, 0–4 months). The mean duration of game loss was shorter in the post-season group than in the other groups (0.9 vs 2,4 months), and 4 of 6 patients in the post-season group did not miss any games.</div></div><div><h3>Conclusions</h3><div>TF-FESS is a good technique for achieving a quick return to play in professional baseball players. In particular, surgery performed during the post-season could allow players to return to play after adequate rehabilitation with no game loss.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 39-43"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of the Risser+ grade for assessment of bone maturity in pediatric scoliosis cases: Investigation using standing and supine whole-spine radiograph","authors":"Takahiro Mui,&nbsp;Hideki Shigematsu,&nbsp;Masaki Ikejiri,&nbsp;Sachiko Kawasaki,&nbsp;Yasuhito Tanaka","doi":"10.1016/j.jos.2023.12.007","DOIUrl":"10.1016/j.jos.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Although several radiography-based systems for assessing skeletal maturity are available to clinicians, the classical Risser grading system remains a clinical gold standard. For scoliosis follow-up, a standing whole-spine radiograph is usually used. However, in our clinical practice, we have occasionally encountered cases in which ossification of the iliac crest is seen differently in the standing and supine whole-spine radiography. Here, we aimed to clarify the reliability of the Risser+ grading system for supine versus standing position radiographs.</div></div><div><h3>Methods</h3><div>This study recruited patients with all types of scoliosis who had been radiographed in both the standing and supine positions. We retrospectively evaluated the Risser+ grade of standing and supine whole-spine radiographs taken consecutively. Kappa statistics were computed to investigate the agreement between standing and supine Risser+ grades for this study.</div></div><div><h3>Results</h3><div>We evaluated 111 patients (age: 12.6 ± 2.0; male-to-female = 23:88). The Kappa value for the standing and supine Risser+ grade systems was 0.74. The degree of agreement between the two positions for each Risser+ grade revealed high agreement for grades 0 and 5 in all cases, whereas grades 2 and 3 had low agreement.</div></div><div><h3>Conclusions</h3><div>Overall, there was substantial agreement between the Risser+ grades assigned to standing and supine position radiographs. However, disagreement was observed between standing and supine position radiographs assigned Risser+ grades of 2 or 3. Therefore, we have found a wide range in the visibility of iliac apophysis ossification of the iliac depending on the posture, and there are limitations in assessing bone maturity using the Risser+ grade alone. Clinicians should use other evaluation systems, in addition to the Risser+ system, to achieve a more accurate bone maturity assessment, especially for cases with standing position radiographs assigned Risser grades of 2 or 3.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 73-77"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a compression staple on correction of varus deformity during arthroscopic ankle arthrodesis","authors":"Tomoyuki Nakasa ,&nbsp;Yasunari Ikuta ,&nbsp;Shingo Kawabata ,&nbsp;Satoru Sakurai ,&nbsp;Dan Moriwaki ,&nbsp;Nobuo Adachi","doi":"10.1016/j.jos.2024.03.003","DOIUrl":"10.1016/j.jos.2024.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Arthroscopic ankle arthrodesis (AAA) has become popular because of its higher rate of bone union, lower invasiveness, and shorter hospital stays compared to those of open arthrodesis. However, postoperative malalignment is often observed for severe varus deformity, which can cause nonunion, pain, and adjacent joint arthrosis. A compression staple can provide a persistent, strong compressive force on the bone surface. This study aimed to clarify the difference in alignment correction in AAA by comparing a compression staple and screws fixation with screws-only fixation pre- and postoperatively.</div></div><div><h3>Methods</h3><div>Seventy ankles in 67 patients undergoing AAA were retrospectively reviewed. AAA with three screws through the distal tibia was performed in 53 ankles, and 17 ankles underwent AAA with a compression staple and two screws. After the preparation of the joint surface arthroscopically, patients in the S group had three canulated cancellous screws inserted through the medial tibia. Patients in the CS group had a compression staple placed at the lateral aspect of the tibiotalar joint and two screws inserted through the medial side. Clinical scores and pre-and postoperative alignment on plain radiographs were compared between the two procedures.</div></div><div><h3>Results</h3><div>There were no significant differences in the pre-and postoperative Japanese Society for Surgery of the Foot scale. One ankle in the S group exhibited nonunion. There were no significant differences in talar tilt and tibiotalar angles between the groups. The tibial plafond angle in the CS group was significantly lower than that in the S group (p &lt; 0.05). Postoperatively, talar tilt and tibiotalar angles on the coronal image, and the lateral tibiotalar angle in the CS group were significantly lower than those in the S group (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>AAA with a compression staple and two-screw fixations could obtain more optimal alignments than AAA with screw-only fixation, even in cases with severe varus deformity.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 113-118"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}