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Bone & Joint Research
Vol. 5, Issue 6 | Pages 247 - 252
1 Jun 2016
Tabuchi K Soejima T Murakami H Noguchi K Shiba N Nagata K

Objectives

The objective of this study was to determine if the use of fascia lata as a tendon regeneration guide (placed into the tendon canal following harvesting the semitendinosus tendon) would improve the incidence of tissue regeneration and prevent fatty degeneration of the semitendinosus muscle.

Materials and Methods

Bilateral semitendinosus tendons were harvested from rabbits using a tendon stripper. On the inducing graft (IG) side, the tendon canal and semitendinosus tibial attachment site were connected by the fascia lata, which was harvested at the same width as the semitendinosus tendon. On the control side, no special procedures were performed. Two groups of six rabbits were killed at post-operative weeks 4 and 8, respectively. In addition, three healthy rabbits were killed to obtain normal tissue. We evaluated the incidence of tendon tissue regeneration, cross-sectional area of the regenerated tendon tissue and proportion of fatty tissue in the semitendinosus muscle.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_16 | Pages 94 - 94
1 Apr 2013
Shirahama M Nagata K Matugaki T Kawasaki Y
Full Access

Objective

We reviewed clinical results with minimally invasive method and using a new developed plate for unstable pelvic ring fractures, especially vertically unstable sacral fractures.

Materials & Methods

Between 2002 and 2010, 35 patients with vertically unstable sacral fractures were treated with minimally invasive method and using an M-Shaped transiliac plate which was developed by the author. This plate is anatomically designed for posterior pelvic ring, and achieved rigid fixation. Patients included 19 male and 16 female, with the mean age of 46.2 (range, 17∼79) years old. According to the AO classification, 23 patients had a C1 injury, 9 had a C2 fracture, and 3 patients sustained a C3 injury of the pelvic ring. Functional outcome was assessed using the Majeed's functional evaluation and radiography. Minimum follow-up was one year.


Bone & Joint Research
Vol. 1, Issue 9 | Pages 218 - 224
1 Sep 2012
Tabuchi K Soejima T Kanazawa T Noguchi K Nagata K

Objectives

The purpose of this study was to evaluate chronological changes in the collagen-type composition at tendon–bone interface during tendon–bone healing and to clarify the continuity between Sharpey-like fibres and inner fibres of the tendon.

Methods

Male white rabbits were used to create an extra-articular bone–tendon graft model by grafting the extensor digitorum longus into a bone tunnel. Three rabbits were killed at two, four, eight, 12 and 26 weeks post-operatively. Elastica van Gieson staining was used to colour 5 µm coronal sections, which were examined under optical and polarised light microscopy. Immunostaining for type I, II and III collagen was also performed.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_IV | Pages 438 - 438
1 Nov 2011
Kanesaki K Yokosuka K Mitsui Y Kaieda T Nagata K
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We have been operating TKA for the deformity of OA and RA knee using OrthoPilot kinematic navigation system manufactured by Aesculap (Germany, Tutulingen) since 2005. It has the technology of ligament balance check capability, of which intra-operative registration is not so troublesome and also has the guidance system to achieve the correct bony cutting to the mechanical axis. Although we only have short-term results so far, we have evaluated our results and made some observations.

We have 151 cases at our institution composed of 114 OAs and 37 RAs, with 29 males and 122 females. Among them, 95 cases were able to follow-up over one year.

Limited only to three cases, we had to discontinue the usage of this system due to the loosening of the rigid body during surgery, which we had to change the maneuver to use manual instrument.

The average age at the time of surgery was 73.8 years (range, 38 to 90), and the average BMI was 24.5 (range, 15.6 to 37.7). The average femoral axis, which is the angle between the femoral mechanical axis and the femoral joint surface in the coronal plane, was 2.06 degrees (range, −9 to 10). The average pre-bone-cutting tibiofemoral axis was −8.04 degrees (range, −31 to 15), which after implantation became −0.18 degrees (range, −6 to 6). Tibial proximal cutting has to be perpendicular to the mechanical axis of the lower leg in the coronal plane. The average tibial medial cut was 1.61mm (range, 8 to −11) and tibial lateral cut was 6.78mm (range, 15 to −2). This difference of about 5mm indicates that the shape of tibia had varus deformity to the mechanical axis of the lower leg. On the femoral side, the average femoral medial cut was 9.72mm (range, 19 to 1) and femoral lateral cut was 8.23mm (range, 16 to 1). This almost identical cutting thickness indicates that there was almost no deformity to the mechanical axis on the femoral side. The final X-ray in the follow up period had not changed from the post-operative one. There was no change in VAS comparison three months post-operative.

The results of this study seem to indicate that the kinematic navigation system for TKA will lead to good results of patients’ satisfaction and long durability even for OA and RA knees.


Purpose: Extruded tissue specimens excised during surgery on human intervertebral disc hernia and chondrocytes established and cultured from the excised tissue were observed via electron microscopy. Macrophages confirmed by CD68 immunostaining were added to the chondrocyte culture, and observed via electron microscopy. To observe, using an electron microscope, disc hernia degeneration at the cellular level as expressed in extruded tissue from a human intervertebral disc and cultured chondrocytes, and to investigate the mechanism of spontaneous regression and the effects of macrophages.

Materials and Methods: Tissues excised during surgery were fixed in various fixatives for electron microscopy and immune electron microscopy to avoid divided and treated with collagenase, and chondrocytes were then isolated and cultured. Human heparinized peripheral blood was separated using Ficoll and cultured. After culture, macrophages were collected and confirmed by CD68 immunostaining. These macrophages were added to the chondrocyte culture and observed under an electron microscope.

Results: Chondrocytes in the hernia is extruded region markedly differed from cultured chondrocytes. The tissue extruded from the intervertebral disc showed obvious degeneration such as changes in osmotic pressure. Macrophages were observed as the mechanism of spontaneous regression.

Discussion: In a previous study, we used ELISA to measure MMP-3 levels and TIMP-1 levels in both mRNA and serum in patients, and found a correlation between the two. In this study, we observed the pathological state of a disc hernia at the cellular level. When chondrocytes from the same tissue were cultured under conditions similar to those in the intervertebral disc, the extruded tissue showed a clear difference. It was considered that membrane osmotic pressure affects intervertebral disc hernia in humans and that protein transmission occurs in endoplasmic reticulum. It was also considered that spontaneous regression is due to the infiltration of macrophages.