Journal of Orthopaedic Science最新文献

{"title":"Gap between the prevalence of and consultation rate for lumbopelvic pain in postnatal Japanese women","authors":"Tomoe Inoue-Hirakawa ,&nbsp;Saki Iguchi ,&nbsp;Daisuke Matsumoto ,&nbsp;Yuu Kajiwara ,&nbsp;Tomoki Aoyama ,&nbsp;Rika Kawabe ,&nbsp;Hideshi Sugiura ,&nbsp;Yasushi Uchiyama","doi":"10.1016/j.jos.2023.10.006","DOIUrl":"10.1016/j.jos.2023.10.006","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to assess the prevalence of lumbopelvic pain (LPP), including low back pain (LBP) and/or pelvic girdle pain (PGP), consultation rate, and desire for treatment of postnatal Japanese women.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional study of 98 postnatal Japanese women within 1 year of childbirth. We retrospectively evaluated the prevalence of LBP before and during pregnancy and the prevalence of LPP after childbirth using a self-administered questionnaire. We used the distribution of pain to differentiate LBP and/or PGP after childbirth and its intensity was assessed using a visual analogue scale. The effects of LPP on daily life were assessed using the Oswestry disability index (ODI). In addition, we assessed the consultation rate for LPP and the desire to consult a healthcare professional, using self-administered questionnaires.</div></div><div><h3>Results</h3><div>The prevalence of LPP after childbirth was 66%. Women with a history of LBP before and during pregnancy were more likely to have LPP following childbirth (both <em>P</em> &lt; 0.001). The consultation rate among the postnatal women with LPP was 9%, but 56% of the women wished to consult a healthcare professional. The ODI score was significantly higher in postnatal women who wanted to consult a healthcare professional than in those who did not (<em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Two thirds of the postnatal Japanese women who participated in this study had LPP, but the consultation rate was low. However, more than half of these women had the desire to consult a healthcare professional.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1353-1358"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deaths caused by osteoporotic fractures in Japan: An epidemiological study","authors":"Koki Abe ,&nbsp;Kazuhide Inage ,&nbsp;Kensuke Yoshimura ,&nbsp;Daisuke Sato ,&nbsp;Keishi Yamashita ,&nbsp;Masaomi Yamashita ,&nbsp;Toshihide Sasaki ,&nbsp;Akiyoshi Yamaoka ,&nbsp;Yasuhiro Shiga ,&nbsp;Yawara Eguchi ,&nbsp;Sumihisa Orita ,&nbsp;Seiji Ohtori","doi":"10.1016/j.jos.2023.10.013","DOIUrl":"10.1016/j.jos.2023.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis is a global issue with a worldwide prevalence of 18.3%, and the presence of coexisting fragility fractures can reduce the survival rate by approximately 20%. In Japan, the prevalence of osteoporosis is estimated to be 12.8 million, and the annual occurrence of hip fractures is approximately 193,400. Remarkably, coexisting hip or spinal fragility fractures caused by slight external force meet the Japanese diagnostic criterion for osteoporosis regardless of bone mineral density. However, only 191 deaths due to osteoporosis were published in 2021 in Japan. With the concern that some cases of hip and spinal fragility fractures were assigned an underlying cause of death of traumatic fracture instead of osteoporosis, this study aimed to elucidate the actual number of deaths due to osteoporosis in Japan.</div></div><div><h3>Methods</h3><div>We used the data from Japan in 2018. First, the number of deaths due to osteoporosis and hip or spinal fractures was reviewed using published vital statistics. Second, we calculated the number of elderly deaths (age ≥80 years) resulting from hip or spinal fractures caused by falls on the same level using data from approximately 1.4 million annual individual death certificates. Combining the above data, the actual number of deaths due to osteoporosis was estimated.</div></div><div><h3>Results</h3><div>Only 190 deaths due to osteoporosis were reported in the published data. The individual certificate data revealed 3437 elderly deaths due to hip or spinal fractures caused by falls on the same level, which could meet the criteria of osteoporotic fragility fractures. Accordingly, the estimated number of deaths caused by osteoporosis was calculated as 3,627, approximately 19 times the published value.</div></div><div><h3>Conclusions</h3><div>After researching the individual death certificate data focusing on the coexisting hip or spinal fragility fracture, it was implied that osteoporosis may have a higher mortality rate in Japan than what is published.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1477-1482"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of frailty with RA-ILD and poor control of disease activity in patients with rheumatoid arthritis: A multi-center retrospective observational study","authors":"Yoshifumi Ohashi ,&nbsp;Nobunori Takahashi ,&nbsp;Yasumori Sobue ,&nbsp;Mochihito Suzuki ,&nbsp;Ryo Sato ,&nbsp;Masataka Maeda ,&nbsp;Daisuke Kihira ,&nbsp;Kenji Kishimoto ,&nbsp;Kenya Terabe ,&nbsp;Shuji Asai ,&nbsp;Shiro Imagama","doi":"10.1016/j.jos.2023.11.012","DOIUrl":"10.1016/j.jos.2023.11.012","url":null,"abstract":"<div><h3>Background</h3><div><span>This study aimed to investigate factors associated with frailty in </span>rheumatoid arthritis (RA) patients.</div></div><div><h3>Methods</h3><div><span>A total of 656 RA patients were evaluated using data from an observational study in 2022. Among these patients, 152 with frailty were assigned to the frailty group, and 504 without frailty were assigned to the non-frailty group. Patient characteristics were compared between the two groups by </span>univariate analysis<span>, and factors associated with frailty were assessed by logistic regression analysis<span>. Patient characteristics were also compared between patients with RA-associated interstitial lung disease (RA-ILD) (n = 102) and those without RA-ILD (n = 554).</span></span></div></div><div><h3>Results</h3><div>The frailty group was older (mean: 73.6 vs. 66.8 years) and had a higher DAS28-ESR (3.67 vs. 2.66), a higher HAQ-DI (1.13 vs. 0.32), and a higher rate of RA-ILD (25.0 vs. 12.7 %) than the non-frailty group. Age (OR: 1.03, 95 % CI: 1.01–1.05), HAQ-DI (3.22, 2.28–4.56), DAS28-ESR (1.44, 1.19–1.75), and RA-ILD (2.21, 1.24–3.94) were associated with frailty. RA patients with RA-ILD were older (73.3 vs. 67.5 years) and had a higher DAS28-ESR (3.30 vs. 2.80), a higher HAQ-DI (1.19 vs. 0.32), a higher proportion of frail patients (37.3 vs. 20.6 %), lower MTX use (26.5 vs. 62.9 %), and higher steroid use (44.1 vs. 26.8 %) than those without RA-ILD.</div></div><div><h3>Conclusions</h3><div>Maintaining reasonable control of disease activity is necessary for RA patients, including those with RA-ILD, to recover from frailty.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1496-1502"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477958","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":"Outcomes and complications after treatment for anteromedial facet fracture of the coronoid process: A systematic review","authors":"Du-Han Kim,&nbsp;Beom-Soo Kim,&nbsp;Ji-Hoon Kim,&nbsp;Chul-Hyun Cho","doi":"10.1016/j.jos.2023.11.002","DOIUrl":"10.1016/j.jos.2023.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Fracture of the anteromedial facet (AMF) of the coronoid process is associated with varus posteromedial rotatory instability (VPMRI). However, there is still controversy regarding the optimal treatment for AMF fracture. The purpose of this study is to report on a systematic review of the outcomes and complications after treatment for AMF fracture.</div></div><div><h3>Methods</h3><div>This study was conducted using electronic databases, PubMed, EMBASE and Scopus. Studies reporting outcome scores and complications were included. Studies that did not utilize O'Driscoll classification for AMF fractures were excluded. Through conduct of a thorough review of included studies, definite VPMRI were identified and cases involving other injury mechanisms were excluded.</div></div><div><h3>Results</h3><div><span>Fifteen articles reporting on 246 patients were included. According to O'Driscoll classification, 6.2% of cases were anteromedial subtype I, 73.7% were subtype II, and 20.1% were subtype III. Two-hundred sixteen patients (87.8%) were treated surgically and 30 patients (12.2%) were treated conservatively. Lateral collateral ligament<span><span> (LCL) injuries were 76.2% (157/206) and medial collateral ligament injuries were 16.9% (33/195). Among 216 cases who underwent surgical treatment, depending on the fragment size, displacement, and instability, coronoid fixation was performed in 189 cases and LCL repair alone was performed in 27 cases. The mean final </span>Mayo Elbow Performance Score was 92.1 and the Broberg &amp; Morrey score was 89.5. The overall complication and </span></span>reoperation rates were 17.7% (41/232) and 12.9% (26/202).</div></div><div><h3>Conclusions</h3><div>Both surgical and conservative treatment for AMF fractures resulted in satisfactory final clinical outcomes. However, high complication and reoperation rates were observed.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1489-1495"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209758","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":"Digital skin defect management: Hand and wrist volar flap solutions","authors":"Takuya Tsumura ,&nbsp;Taiichi Matsumoto ,&nbsp;Toshihide Imanaka ,&nbsp;Hiromu Ito","doi":"10.1016/j.jos.2023.11.009","DOIUrl":"10.1016/j.jos.2023.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Selecting the optimal flap for managing digit skin defects is challenging, particularly for inexperienced surgeons, given the numerous reconstructive options and insufficient evidence supporting one flap type's superiority over another. This retrospective study introduces four efficacious hand flaps to address volar skin defects and transverse and oblique cuts, examines the optimal flap advancement distance, and discusses effective management.</div></div><div><h3>Methods</h3><div><span>Patients with digit skin defects who underwent flap surgery between 2009 and 2022 were included. Fifty-four patients treated with oblique triangular, volar VY advancement (unilateral and bilateral pedicled volar VY advancement flaps for fingers and thumbs, respectively), reverse homodigital island, and </span>radial artery superficial palmar branch flaps were included. We evaluated the flap advancement distance, flap length, range of motion, complications, and Semmes–Weinstein monofilament test and Disabilities of the Arm, Shoulder, and Hand questionnaire results.</div></div><div><h3>Results</h3><div><span>The median flap advancement distances for triangular oblique (19 patients), unilateral (11 patients), and bilateral pedicled (5 patients) volar VY advancement flaps were 1.3, 1.8, and 2.0 cm, respectively. The flap lengths for the reverse digital island (8 patients) and radial artery superficial palmar branch (11 patients) flaps were 2.4 and 5.0 cm, respectively. Five, three, and one cases of proximal interphalangeal flexion contractures of ≥ -20° were observed in the VY advancement, reverse digital island, and radial artery superficial palmar branch flaps, respectively. One unilateral VY advancement flap case caused severe numbness and </span>neuroma. All complication cases featured &gt;15 and &gt; 20 mm defect lengths on the fingers and thumb, respectively.</div></div><div><h3>Conclusions</h3><div>To minimize sensory disruption and contractures, we recommend oblique triangular and unilateral pedicle volar VY advancement flaps for finger skin defects up to 12 mm and defects sized 12–15 mm, respectively. Advancement flaps are unsuitable for &gt;15 and &gt; 20–25 mm defects on the fingers and thumb, respectively.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1395-1400"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440893","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":"Differences in the microstructural and mechanical qualities of semitendinosus tendon grafts between skeletally immature and mature patients in anterior cruciate ligament reconstruction","authors":"Kazuki Asai ,&nbsp;Junsuke Nakase ,&nbsp;Toru Kuzumaki ,&nbsp;Tatsuya Ishikawa ,&nbsp;Noriyuki Ozaki ,&nbsp;Hiroyuki Tsuchiya","doi":"10.1016/j.jos.2023.11.004","DOIUrl":"10.1016/j.jos.2023.11.004","url":null,"abstract":"<div><h3>Background</h3><div><span>This study aimed to investigate the microstructural and mechanical properties of semitendinosus tendon graft tissues during </span>anterior cruciate ligament reconstruction and the clinical outcomes in skeletally immature and mature patients.</div></div><div><h3>Methods</h3><div>Twenty-two patients who underwent primary anterior cruciate ligament reconstruction<span><span><span> using a hamstring tendon graft were analyzed and divided into skeletally immature (n = 7) and mature groups (n = 15) based on magnetic resonance imaging findings of the </span>epiphyseal plate<span> of the distal femur. Tissue samples were collected from the mid-portion of the semitendinosus tendon. The </span></span>collagen fibril diameter, maximum stress, and strain at maximum stress point in the semitendinosus tendon tissues were calculated for comparison of the microstructural and mechanical properties between the two groups. Postoperative outcomes were also assessed between the two groups.</span></div></div><div><h3>Results</h3><div>The mean and 60th and 80th percentiles of fibril diameters in the skeletally immature group were significantly smaller than those in the mature group (65.9 ± 13.0, 73.5 ± 19.3, and 91.3 ± 27.4 nm in the skeletally immature group; and 90.3 ± 14.7, 94.0 ± 18.4, and 125.3 ± 19.9 nm in the skeletally immature group; p = 0.001, 0.024, and 0.004, respectively). Additionally, the strain at maximum stress was higher in the skeletally immature group (237.2 ± 102.4% vs. 121.5 ± 51.9%, p = 0.024). However, there was no difference in maximum stress between the skeletally immature and mature groups (19.9 ± 14.3 MPa vs. 24.5 ± 23.4 MPa, p = 0.578). Strain was negatively correlated with the mean fibril diameter and the 60th and 80th percentiles of fibril diameters, whereas stress was positively correlated with the mean fibril diameter. The skeletally immature group had a higher pivot shift test-positive rate than the mature group at the last follow-up (p = 0.023).</div></div><div><h3>Conclusion</h3><div>Semitendinosus tendon graft tissues differed microstructurally and mechanically between skeletally immature and mature patients.</div></div><div><h3>Level of evidence</h3><div>Level Ⅳ</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1430-1437"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176442","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":"Hip joint stress distribution changes depending on three-dimensional pelvic orientation: Finite-element analysis","authors":"Yumiko Ojima ,&nbsp;Yusuke Matsuura ,&nbsp;Sei Yano ,&nbsp;Seiji Ohtori","doi":"10.1016/j.jos.2023.11.015","DOIUrl":"10.1016/j.jos.2023.11.015","url":null,"abstract":"<div><h3>Background</h3><div>Pelvis experiences changes in its orientation due to the alignment of the hip joint and spine, and its orientation might affect both joints. Pelvic tilt on the sagittal plane has been widely discussed; however, the pelvis is oriented also on the coronal and horizontal planes. This study aimed to examine how stress distribution on intact hip joint changes under the three-dimensional pelvic orientation.</div></div><div><h3>Methods</h3><div>Computed tomography<span> data of five patients with unilateral pelvic girdle<span> were analyzed. Thirteen models were evaluated by the MECHANICAL FINDER: neutral position at 0°; 10° and 20° anterior and posterior pelvic tilt; 10° and 20° pelvic hike and drop; 10° and 20° pelvic forward and backward rotation. Stress assessment was performed in four parts of the acetabulum: anterosuperior, posterosuperior, posteroinferior, and central parts.</span></span></div></div><div><h3>Results</h3><div>Compared with the neutral position, the mean value of the equivalent stress and maximum principal stress in the anterosuperior part significantly increased by 1.51 times and 1.57 times at 20° posterior tilt, respectively. The maximum principal stress in the anterosuperior part significantly increased by 1.44 times at 20° hike. A significant increase of 1.45 times was found in the maximum principal stress in the anterosuperior part at 20° forward rotation.</div></div><div><h3>Conclusions</h3><div>Local stress accumulated in the anterosuperior acetabulum at the posterior pelvic tilt, pelvic hike, and pelvic forward rotation, which might lead to hip overload. The effect of posterior pelvic tilt appears to be greater for the hip joint than at the pelvic hike or forward rotation.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1462-1468"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138568244","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":"Superior gluteal artery injury in pelvic ring injury and acetabular fracture: Single center observational study","authors":"Hoon Kwon ,&nbsp;Jae Hoon Jang ,&nbsp;Nam Hoon Moon ,&nbsp;Seung Joon Rhee ,&nbsp;Dong Yeon Ryu ,&nbsp;Tae Young Ahn","doi":"10.1016/j.jos.2023.10.007","DOIUrl":"10.1016/j.jos.2023.10.007","url":null,"abstract":"<div><h3>Background</h3><div><span><span><span><span>Intrapelvic hemorrhage following pelvic fractures, including pelvic ring and </span>acetabular fractures, originates from the </span>venous system and the fracture. </span>Arterial injury often causes significant bleeding and </span>hemodynamic instability. The superior gluteal artery (SGA) is a frequently injured artery in patients with pelvic fractures. This study investigated the incidence and pattern of SGA injuries associated with pelvic fractures.</div></div><div><h3>Methods</h3><div><span>We retrospectively reviewed the medical records<span> of patients with pelvic fractures who visited our institution between January 2016 and April 2022. Patients who underwent angiography for suspected arterial injury and </span></span>SGA embolization were identified. Furthermore, the demographics and patterns of pelvic fractures were evaluated.</div></div><div><h3>Results</h3><div>In total, 2042 patients with pelvic fractures visited our trauma emergency department<span> and 498 patients (24.4%) underwent embolization for arterial injuries. Of these, 30 patients (1.5% of the total and 6.0% of the patients who underwent procedures) received embolization therapy of the main trunk of the SGA. The mean age of patients was 51.2 (23–85 years), and the injury mechanisms were all high-energy injuries. There were 19 pelvic ring injuries, eight acetabular fractures, and three combined injuries. Acetabular fractures involved mostly both columns. The three combined injuries were lateral compression involving both columns, vertical shear involving both columns, and lateral compression with T-type fractures. Twelve (40.0%) occurred through the sciatic notch of different patterns.</span></div></div><div><h3>Conclusions</h3><div>SGA injury occurred in 1.5% of all pelvic fractures and was identified in 6% of patients receiving embolization. SGA injury occurs through various injury mechanisms and fracture patterns, even in the absence of a fracture in the sciatic notch. However, no conclusions could be drawn in this study on the association between SGA injuries, injury mechanisms, and fracture patterns. Since the prediction of SGA injury by fracture pattern is limited, angiography should be performed regardless of fracture pattern when an injury is suspected.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1483-1488"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49691066","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":"The survey of bone allograft transplantation in a Japanese regional bone bank","authors":"Takamune Asamoto ,&nbsp;Yusuke Osawa ,&nbsp;Yasuhiko Takegami ,&nbsp;Genta Takemoto ,&nbsp;Daigo Komatsu ,&nbsp;Taisuke Seki ,&nbsp;Shiro Imagama","doi":"10.1016/j.jos.2023.11.001","DOIUrl":"10.1016/j.jos.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><div>In reconstructive surgery<span><span> for large bone defects, the demand for </span>bone allografts<span> has increased over the years; however, it is unclear how the supply and demand in Japanese regional bone banks have evolved over time. This study investigated the 15-year supply and demand of bone allografts stored in a regional bone bank, along with assessing the screening process's effectiveness.</span></span></div></div><div><h3>Methods</h3><div>The target period was 15 years from April 2005 to March 2020. The period was subdivided into three 5-year periods: first, second, and third. The study items included the number of bone allografts donated, the number of bone allografts used, donor and user facilities, surgical methods using bone allografts, and the number of bone allografts discarded. We used the Cochran-Armitage test for statistical analysis.</div></div><div><h3>Results</h3><div>A total of 1852 bone allografts were donated to the bone bank, and a total of 1721 were used. A total of 677 bone allografts grafts were provided in the first period, 738 in the second period, and 525 in the third period, indicating a decreasing trend. The average number of allografts per surgery was 2.8 in the first, 3.1 in the second, and 1.7 in the third, showing a decreasing trend. Concerning the percentage of each surgery using bone allografts, spine fusion<span> decreased in the third period but not significantly, whereas primary hip arthroplasty increased significantly in the third period. The total number of discarded bone allografts was 4.8% of the total number of donated bone allografts, largely because of a lack of screening tests.</span></div></div><div><h3>Conclusion</h3><div>Although the number of allogeneic bone surgeries has been increasing over time, the number of allogeneic bone donations has shown a decreasing trend, and there is a need to develop a system that can provide surgeons with sufficient bone allografts.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1528-1533"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89718748","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":"Lateral ulnar collateral ligament reconstruction enhancing secondary stabilizers in chronic PLRI of the elbow provides good to excellent clinical results with no recurrent instability","authors":"Nikolay Dimitrov,&nbsp;Tsvetan Tsenkov","doi":"10.1016/j.jos.2023.11.013","DOIUrl":"10.1016/j.jos.2023.11.013","url":null,"abstract":"<div><h3>Purpose</h3><div>The adopted treatment for chronic elbow PLRI is lateral ulnar collateral ligament reconstruction. However, the most frequently reported complication after primary reconstruction is recurrent instability – up to 25 %. It was thus hypothesized that enhancing the secondary stabilizers will provide successful results with a lower rate of recurrent instability in comparison to techniques with primary reconstruction only. This study aimed to demonstrate a novel surgical technique involving secondary stabilizers.</div></div><div><h3>Methods</h3><div>In this retrospective study of 29 cases with chronic PLRI the mean duration of symptoms was 39.6 ± 4.9 months. The mean age was 47.9 years with mainly male patients. The surgeries were performed by one senior surgeon at a single institution. The Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) were recorded.</div></div><div><h3>Results</h3><div>The mean follow-up was 36.8 ± 7.7 months. The MEPS score improved significantly from 59.8 ± 13.1 to 84.7 ± 7.6 (p &lt; 0.001). 23/29 patients (79.2 %) had converted to good and excellent results (MEPS &gt;75 points). The DASH score improved from 40.8 ± 4.6 to 20.9 ± 7.2 (p &lt; 0.001). The total complication rate was 10.3 % (N = 3). No recurrent instability was recorded in comparison to 12.2 % for primary reconstruction only, as reported in the literature (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Enhancing the secondary stabilizers by utilizing an adjacently located autograft provided good and excellent results with no recurrent instability. This novel surgical procedure is easy to reproduce and provides a safe and reliable alternative in cases of chronic PLRI when compared to techniques with primary reconstruction only.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1401-1405"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477961","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}