Journal of Orthopaedic Science最新文献

{"title":"Histological evaluation of medial collateral ligament bursa injection, a new conservative treatment, in a rabbit model of medial meniscus horizontal tear.","authors":"Tomoyuki Kanayama, Junsuke Nakase, Kazuaki Yoshioka, Yasushi Takata, Yoshihiro Ishida, Yusuke Yanatori, Naoki Takemoto, Satoru Demura","doi":"10.1016/j.jos.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.010","url":null,"abstract":"<p><strong>Background: </strong>The ultrasound-guided medial collateral ligament bursa injection technique is safe, reproducible, and effective in treating symptomatic degenerative medial meniscal tears. However, the mechanisms of action and optimal drug combinations remain unclear. This study aimed to evaluate and compare the histological changes caused by injections of corticosteroids and hyaluronic acid into the medial collateral ligament bursa in a rabbit model of medial meniscus horizontal tears. Furthermore, we compared neovascularization and neurogenesis between different treatments.</p><p><strong>Methods: </strong>The medial meniscus horizontal tear rabbit model was created. Medial collateral ligament bursa injection with triamcinolone acetonide, purified sodium hyaluronate, saline, or needle alone was performed after model creation. The area of the medial collateral ligament bursa was measured. Immunostaining validation (cluster of differentiation31, smooth muscle alpha-actin, calcitonin gene-related peptide, and 4',6-diamidino-2-phenylindole) of the medial collateral ligament bursa injections was performed 2 and 4 weeks after injection.</p><p><strong>Results: </strong>The group injected with triamcinolone acetonide had a smaller area of the medial collateral ligament bursa than did the other groups. The groups injected with triamcinolone acetonide and purified sodium hyaluronate had lower neovascularization levels than did the other groups. The calcitonin gene-related peptide count was lower in the group injected with triamcinolone acetonide than in the other groups. Corticosteroid and hyaluronic acid injections into the medial collateral ligament bursa suppressed neovascularization and calcitonin gene-related peptide expression, while steroid injections caused adipose tissue and synovial tissue atrophy.</p><p><strong>Conclusions: </strong>The present study revealed that ultrasound-guided triamcinolone or hyaluronic injections into the medial collateral ligament bursa inhibited neovascularization within it and concomitantly reduced calcitonin gene-related peptide release from neurogenesis. Hence, medial collateral ligament bursa injection should be considered a new treatment option for symptomatic horizontal meniscal tears.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854557","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":"Reproducibility of dynamic balance and anterior tibiofibular gap measurements in men and women: A menstrual cycle-based longitudinal study.","authors":"Rami Mizuta, Noriaki Maeda, Tsubasa Tashiro, Miki Kawai, Sakura Oda, Ayano Ishida, Rurina Yoshiara, Satoshi Arima, Yukio Urabe","doi":"10.1016/j.jos.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.008","url":null,"abstract":"<p><strong>Background: </strong>The reproducibility of dynamic balance is an essential component of athletic performance and injury prevention, although it is affected by sex differences. This study aimed to confirm the reproducibility of repeated dynamic balance measurements and ultrasonography assessments of the anterior tibiofibular gap that may contribute to changes in dynamic balance for each sex.</p><p><strong>Methods: </strong>This was a longitudinal study involving 48 feet, with 12 men and 12 women. Measurements for men were obtained four times, approximately once a week, and for women, once during each of the four periods of the menstrual cycle (menstrual, follicular, ovulation, and luteal phases). The measures included dynamic balance in a single-leg jump with forward landing and the anterior tibiofibular gap measurement in standing and sitting positions; rate of change in the anterior tibiofibular gap was calculated from the values in standing and sitting positions.</p><p><strong>Results: </strong>The intraclass correlation coefficient for dynamic balance was excellent for men at 0.936 (0.881-0.969) and good for women at 0.843 (0.708-0.925). Regarding the anterior tibiofibular gap, the intraclass correlation coefficient for standing and sitting were 0.999 (0.997-0.999) and 0.998 (0.996-0.999), respectively, in men; and 0.976 (0.955-0.988) and 0.991 (0.984-0.996), respectively, in women, with excellent values for both sexes. Whereas no significant changes in dynamic balance and rate of change in the anterior tibiofibular gap were observed in the four measurements in men (p > 0.05), there was a significant variation in women (p < 0.05).</p><p><strong>Conclusions: </strong>While reproducibility of dynamic balance and anterior tibiofibular gap measurements was high overall, it was lower in women than in men. Women exhibited variations in these measurements during each period of the menstrual cycle, peaking during ovulation. Recognizing these fluctuations could inform injury prevention strategies tailored to sex-specific differences in dynamic balance and ligament extensibility.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854572","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":"Comparison of dynamic compression plate systems with oblique osteotomy and locking plate fixation versus transverse osteotomy and non-locking plate fixation for ulnar shortening osteotomy.","authors":"Yusuke Miyashima, Takuya Uemura, Mitsuhiro Okada, Kosuke Saito, Hiroaki Nakamura","doi":"10.1016/j.jos.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>Ulnar shortening osteotomy (USO) is a well-established surgical technique for ulnar impaction syndrome and triangular fibrocartilage complex injuries, but complications like delayed union and nonunion are often encountered. Transverse and oblique osteotomy techniques are commonly used, yet direct comparisons using advanced implants are limited. This study aims to compare the clinical and radiological outcomes of USO using the Jplate with a transverse osteotomy device and the APTUS Wrist Ulna Shortening System 2.5 with an oblique osteotomy device.</p><p><strong>Methods: </strong>We retrospectively reviewed 37 patients who underwent USO (15 and 22 treated with the Jplate and APTUS systems, respectively) from July 2009 to October 2022. Clinical outcomes were measured using the visual analog scale (VAS), grip strength, range of motion, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and Hand20 scores. Radiological outcomes included time to bone union, delayed union, and nonunion rates. Statistical analyses involved Mann-Whitney and Kruskal-Wallis tests and multivariable linear regression models adjusted for age, sex, and smoking status.</p><p><strong>Results: </strong>Time to union was faster in the APTUS group compared to the Jplate group, with a significantly higher delayed union rate in the Jplate group than in the APTUS group. Postoperative pain reduction was significantly greater in the APTUS group compared to the Jplate group. Improvements in Hand20 scores were also significantly higher in the APTUS group compared to the Jplate group. Multivariable regression analyses confirmed that the APTUS system significantly shortened time to union and improved VAS and Hand20 scores.</p><p><strong>Conclusions: </strong>The APTUS system provides superior clinical and radiological outcomes compared to the Jplate, with significant reductions in delayed union rates and postoperative pain and earlier bone healing. This system enables oblique osteotomy and compression of the osteotomy site with a single device, which may have contributed to the observed differences in our study.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807431","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":"Delirium following total hip or knee arthroplasty: A retrospective, single-center study.","authors":"Takenori Tomite, Hidetomo Saito, Hiroaki Kijima, Yuji Hatakeyama, Hiroshi Tazawa, Toru Wachi, Naohisa Miyakoshi","doi":"10.1016/j.jos.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a postoperative complication that may occur in older patients. This study aimed to investigate the incidence of postoperative delirium and its risk factors in patients who had undergone total hip arthroplasty (THA) or total knee arthroplasty (TKA). Few reports have addressed the occurrence of delirium when different methods of pain control are used following total joint arthroplasty, and, therefore, whether its incidence varied depending on differences in pain control was investigated.</p><p><strong>Methods: </strong>The study included 500 patients (250 cases of THA and 250 of TKA). They were divided into two groups according to the occurrence of postoperative delirium, and risk factors for delirium (patient factors and operative factors) were investigated. As pain control, all patients were given a Ranawat cocktail injection, with the concomitant use of one of epidural anesthesia, nerve block, or intravenous patient-controlled analgesia (IVPCA), and the occurrence of delirium in patients using each method was investigated.</p><p><strong>Results: </strong>On univariate analysis, advanced age, low serum albumin, nonbenzodiazepine use, and anti-parkinsonian drug use were identified as patient factors, and low postoperative minimum hemoglobin, non-use of epidural anesthesia, and non-use of nerve block were identified as operative factors associated with a significantly higher incidence of delirium. A receiver-operating characteristic curve was created for age and delirium, and the cutoff age was 77 years. On binomial logistic regression analysis for age ≥77 years, epidural anesthesia, IVPCA, and nerve block, the only factor associated with the occurrence of delirium was age, irrespective of the type of pain relief used, and the odds ratio for the occurrence of delirium at age ≥77 years was 4.64.</p><p><strong>Conclusions: </strong>To prevent delirium following total joint arthroplasty, it is important to improve anemia and nutritional status, check and manage regular medications, and provide appropriate pain control while avoiding opioid use.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785604","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":"Do elevated preoperative serum inflammatory markers influence surgical site or periprosthetic joint infections following primary total hip arthroplasty?","authors":"Daisuke Inoue, Tamon Kabata, Yoshitomo Kajino, Yu Yanagi, Musashi Ima, Takahiro Iyobe, Naoya Fujimaru, Satoru Demura","doi":"10.1016/j.jos.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.003","url":null,"abstract":"<p><strong>Background: </strong>We aimed to determine whether elevated preoperative serum inflammatory markers influence surgical site infections (SSIs) and periprosthetic joint infections (PJIs) after primary total hip arthroplasty (THA).</p><p><strong>Methods: </strong>In this retrospective single-institution study, 1115 patients who underwent primary THA were enrolled. Cases of SSI/PJI were identified. The enrolled patients were classified into three groups: Group 1 [both C-reactive protein (CRP) ≦0.3 mg/dL and erythrocyte sedimentation rate (ESR) ≦20 mm/h], Group 2 (either 0.3 mg/dL < CRP≦1.0 mg/dL or ESR>20 mm/h), and Group 3 (both CRP>1.0 mg/dL and ESR>20 mm/h). Logistic univariate analysis was performed to calculate the hazard ratio for the incidence of SSI/PJI among the three groups. Next, the patients in Group 3 were propensity score-matched with those in Groups 1 and 2 using 1:2 nearest-neighbor matching for age, sex, body mass index, American Society of Anesthesiologists Physical Status, hip disorder etiology, and past history of autoimmune diseases. After matching, we compared the incidence rates of SSIs/PJIs among the three groups.</p><p><strong>Results: </strong>Overall, 18 cases, including SSI in eight hips (0.7 %) and PJI in 10 hips (0.9 %), were included. Logistic univariate analysis revealed that elevated preoperative ESR and CRP levels were risk factors for SSI/PJI in this cohort (odds ratio 13.5; 95 % confidence interval, 4.19-43.5; P < 0.001). After propensity score-matching for patient factors, the incidence rates of SSI/PJI were four hips (8.9 %) in Group 3, one hip (1.1 %) in Group 1, and four hips (4.4 %) in Group 2. SSI/PJI were more likely to occur in Group 3, although incidence rates were not significant among the groups (P = 0.04).</p><p><strong>Conclusion: </strong>Elevated preoperative serum inflammatory markers may increase the incidence of SSI/PJI following primary total hip arthroplasty. Surgeons should recognaize patients with C-reactive protein >1.0 mg/dL and erythrocyte sedimentation rate >20 mm/h as high-risk group of SSI/PJI.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755269","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":"Effectiveness of ultra-early balloon kyphoplasty at one year after osteoporotic vertebral fracture.","authors":"Masatoshi Teraguchi, Yukihiro Nakagawa, Tomohiro Nakatani, Masakazu Minetama, Yoshio Enyo, Takahiro Maeda, Ryo Taiji, Takahide Sasaki, Yoshio Yamamoto, Masafumi Nakagawa, Hiroshi Yamada","doi":"10.1016/j.jos.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.005","url":null,"abstract":"<p><strong>Introduction: </strong>Balloon kyphoplasty (BKP) for osteoporotic vertebral fracture (OVF) has been reported to maintain quality of life (QOL). This study aimed to investigate the effectiveness of ultra-early BKP performed within two weeks of injury (ultra-early group) to cases after two to four weeks post-injury (early group) and over four weeks (conventional group), assessing radiographic assessment such as subsequent fracture etc, questionarre such as QOL and back pain-related activities of daily living (ADL) one year after surgery.</p><p><strong>Methods: </strong>Ninety cases of OVF treated with BKP (23 males, 67 females, average age 78.0 years) were included. Radiographic assessments were examined and QOL parameters (SF-36 and EQ-5D-5L) and back pain-related ADL (ODI score) were assessed using self-administered questionnaires before and one year after surgery. Analysis of Variance (ANOVA) was used to compare changes in evaluation parameters among 3 groups. When significant differences were detected, post-hoc multiple comparisons were performed using the Steel-Dwass test.</p><p><strong>Results: </strong>The mean follow-up duration was 16.6 months. The ultra-early group consisted of 29 cases (10 males, 19 females, average age 77.0 years), the early group consisted of 39 (6 males, 33 females, average age 79.3 years), while the conventional group consisted of 22 cases (7 males, 15 females, average age 80.0 years). There was no significant difference in the preoperative score of SF-36, EQ-5D-5L, and ODI score. At the 1 year follow up, presence of subsequent fracture was significantly difference among 3 groups (3.4 % vs. 10.3 % vs. 31.8 %) (ANOVA, p < 0.05). Moreover, subsequent Steel-Dwass multiple comparisons also revealed that ultra-early group showed significantly less subsequent fracture compared to the conventional group (p < 0.05). Furthermore, Significant differences were observed in the changes of bodily pain in SF-36, EQ-5D-5L and ODI among 3 groups (ANOVA, p < 0.05). Steel-Dwass multiple comparisons also revealed that ultra-early group showed significantly greater improvement in EQ-5D-5L compared to the early group and conventional group (p < 0.05). ODI scores in ultra-early group also showed greater recover compared to the conventional group (p < 0.005).</p><p><strong>Conclusions: </strong>Ultra early BKP within two weeks of OVF demonstrates effectiveness for less complication such as subsequent fracture, QOL and back pain-related ADL one year post-surgery, enabling early return to society.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750908","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":"Mechanical studies for the rotational stability of a cemented stem in cases with stem anteversion adjustment in the cement mantle.","authors":"Ariha Goshi, Yu Takeda, Takuya Nakai, Shigeo Fukunishi","doi":"10.1016/j.jos.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.006","url":null,"abstract":"<p><strong>Introduction: </strong>The cemented stem can accommodate various shapes of femurs and is a stable stem with long-term results. Additionally, the cemented stem is a highly versatile stem that can be used to adjust stem anteversion in patients with variable femoral anteversion. On the other hand, rotating a stem with increasing cement viscosity may result in reduced postoperative rotational stability.</p><p><strong>Materials and methods: </strong>Rotational stability was compared using two different cementing techniques via in vitro models. Six stems in Group S (Static) were inserted and fixed until the cement was completely hardened. Six stems in Group R (Rotation) were inserted and then rotated 15° before the cement had fully cured. After the cement had completely set, a static rotation testing was performed in which the stem was rotated at a rate of 1°/sec to 20° while a vertical load of 600 N was applied. For the dynamic testing, a vertical load of 600 N and 10,000 cycles of repetitive rotation were applied at 10° around the stem axis at 0.1 Hz. After 10,000 cycles, maximum torque was compared between Groups S and R.</p><p><strong>Results: </strong>In both groups, the torque value increased proportionally to the rotation angle. There were no significant differences in resistance to static rotation between Groups S and R (P = 0.599). In the dynamic testing, there was no significant difference between Groups S and R in both minimum torque and maximum torque in any of the cycles. There were no differences in the rotational torque between Groups S and R at 10,000 cycles (P = 0.693).</p><p><strong>Conclusions: </strong>The rotational stability of the cemented stems did not decrease in vitro when stem version control was performed up to 15° before the cement had completely hardened.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739848","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":"Validation of the Japanese version of the scoliosis research society-30 questionnaire for adult patients with spinal deformity.","authors":"Hideyuki Arima, Yu Yamato, Yosuke Shibata, Hiroki Oba, Jun Takahashi, Kei Watanabe, Ryo Sugawara, Katsushi Takeshita, Yasuhisa Arai, Tomoyuki Asada, Satoru Demura, Toru Doi, Akira Matsumura, Satoshi Suzuki, Shinji Takahashi, Takumi Takeuchi, Haruki Ueda, Naobumi Hosogane","doi":"10.1016/j.jos.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>The Scoliosis Research Society-30 (SRS-30) is a questionnaire that was originally developed from the SRS-22r questionnaire and is used to evaluate adolescent idiopathic scoliosis (AIS). It comprises two sections, with Section 1 containing 22 items related to the SRS-22r questionnaire and 1 item regarding self-image and Section 2 containing 7 items specifically related to postoperative status. The SRS-30 has been also found useful in evaluating spinal disorders or deformity in adults. However, the Japanese version of the SRS-30 (Japanese SRS-30) has been validated for adolescent idiopathic scoliosis, but not for adult spinal deformity (ASD). This study aimed to assess the internal consistency and external validity of the Japanese SRS-30 for ASD.</p><p><strong>Methods: </strong>Of the 30 questions on the SRS-30, 8 questions added from the SRS-22r were translated and back-translated to create the Japanese SRS-30. The Japanese SRS-30 was used to survey patients with ASD who underwent corrective fusion surgery within 1 postoperative year. The internal consistency of the responses was evaluated using Cronbach α coefficient. Additionally, we performed Spearman correlation analysis of the Oswestry Disability Index (ODI) and SRS-22r with the Japanese SRS-30.</p><p><strong>Results: </strong>We included 120 patients (20 males and 100 females; mean age at surgery, 53.3 years). The mean preoperative Cobb angle, sagittal vertical axis, and pelvic incidence minus lumbar lordosis were 36.9°, 81.8 mm, and 24.0°, respectively. The Cronbach α coefficient for the overall SRS-30 was 0.941, indicating high internal consistency. Moreover, the coefficients for each domain were as follows: function/activity, 0.864; pain, 0.783; self-image/appearance, 0.858; mental health, 0.916; and satisfaction, 0.763. The total SRS-30 score was significantly correlated with the total SRS-22r score (r = 0.966, P < 0.001) and ODI (r = -0.752, P < 0.001). The SRS-30 domains showed strong correlations with the corresponding SRS-22r domains, with the r values ranging from 0.878 to 1.000 (all P < 0.001 except mental health).</p><p><strong>Conclusions: </strong>The Japanese SRS-30 demonstrated good internal and external validity. The Japanese SRS-30 can be used to assess health-related quality of life in patients with ASD.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729611","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":"Radiological features of the carpometacarpal joint in hamate body fracture on anteroposterior hand X-ray image.","authors":"Yusuke Kubo, Kazuhiko Sonoda, Takahiro Ushijima, Tatsuhiko Miura, Toshihiko Hara","doi":"10.1016/j.jos.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>Hamate body fractures are rare and can be overlooked due to the diagnostic difficulty on X-ray. We focused on the carpometacarpal joint space width (CMC-JSW) and examined the features of this fracture on versatile anteroposterior hand X-ray images, initially taken for hand trauma cases.</p><p><strong>Methods: </strong>Ten patients (nine males and one female; mean age, 34 years) diagnosed with a hamate body fracture on CT in our facility between January 2013 and October 2023 were included in this study. The fracture types were dorsal type in six cases and shear type in four cases. The 4th and 5th CMC-JSWs were measured on anteroposterior hand radiography and CT sagittal sections. If the metacarpal and hamate bones appeared to overlap due to depression, the width was expressed as a negative value (overlap sign). CMC-JSWs were compared between the types or unaffected sides using the Mann-Whitney U test. The correlation with X-ray and CT measurements was analyzed using the Spearman test.</p><p><strong>Results: </strong>The average CMC-JSWs (IV: -0.52 mm, V: -1.33 mm) in hamate body fractures on X-ray were minus and these values were significantly lower than unaffected side (IV: 1.51 mm, V: 1.48 mm) (p < 0.05, p < 0.001). CMC-JSW (IV: -1.64 mm) and CMC-JSW (V: -2.70 mm) of dorsal type were significantly lower than shear type (IV: 1.17 mm, V: 0.72 mm) (p < 0.05). CMC-JSW values on X-ray were positively correlated with those on CT (IV: ρ = 0.796, V: ρ = 0927).</p><p><strong>Conclusions: </strong>Decreased CMC-JSW, correlated with CT sagittal sections, and \"overlap sign\" on anteroposterior hand X-ray were possible radiological characteristics of hamate body fracture. Care should be taken to avoid overlooking shear-type fractures because of subtle CMC-JSW decreases.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695615","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":"Prevalence and associated factors for primary osteoarthritis of the thumb carpometacarpal joint in the general elderly population: A cohort survey randomly sampled from a basic resident registry of a small rural town in Japan.","authors":"Itsuo Joko, Hiroyuki Kato, Masanori Hayashi, Shota Ikegami, Yo Kitamura, Hiroko Iwakawa, Kentaro Nakayama, Kazutaka Uemura, Shigeharu Uchiyama, Jun Takahashi","doi":"10.1016/j.jos.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.012","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis of the thumb carpometacarpal joint often presents pain and affects activity of daily life. There is no consensus regarding prevalence of primary radiographic osteoarthritis and symptomatic osteoarthritis of the thumb carpometacarpal joint, and their associated factors are not well investigated. The purpose of this study is to evaluate the prevalence and associated factors of primary radiographic and symptomatic osteoarthritis of the thumb carpometacarpal joint in a resident cohort.</p><p><strong>Methods: </strong>A total of 1297 residents aged 50 to 89 were randomly sampled from a small rural town in Japan, and their demographic data and questionnaire regarding lifestyle and job were obtained. All participants underwent posteroanterior radiographs of the bilateral hands. Participants with thumb carpometacarpal joint radiographic osteoarthritis were diagnosed if one of their thumb carpometacarpal joints was Kellgren-Lawrence grade 2, 3, or 4. Symptomatic osteoarthritis was diagnosed by tenderness or positive motion pain at the thumb base. Associated factors for the thumb carpometacarpal joint radiographic osteoarthritis were statistically analyzed.</p><p><strong>Results: </strong>A total of 646 thumbs with 323 participants (153 male and 170 female) were investigated. The mean age was 69.1 (range 50-89) years, The prevalence of thumb carpometacarpal joint radiographic osteoarthritis was 17.3 % (13.7 % males and 20.6 % females) and that of thumb carpometacarpal joint symptomatic osteoarthritis was 3.1 %. Associated factors for thumb carpometacarpal joint radiographic osteoarthritis were presence of finger joint radiographic osteoarthritis in the ipsilateral hand, increasing age, and female in order of degree of relevance. Dominant hand, body mass index, smoking history, heavy manual or agriculture work, use of vibrating tools, racket or bat sports, or scaphotapeziotrapezoidal joint radiographic osteoarthritis were not associated factors for thumb carpometacarpal joint radiographic osteoarthritis.</p><p><strong>Conclusions: </strong>The prevalence of thumb carpometacarpal joint primary radiographic osteoarthritis in general Japanese elderly aged 50-89 years was 17.3 %, most of carpometacarpal joint radiographic osteoarthritis was asymptomatic.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695563","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}