The risk of postoperative complications after resection of soft-tissue sarcoma in the medial thigh is higher than in other locations. This study investigated whether a vessel sealing system (VSS) could help reduce the risk of postoperative complications after wide resection of soft-tissue sarcoma in the medial thigh. Of 285 patients who underwent wide resection for soft-tissue sarcoma between 2014 and 2021 at our institution, 78 patients with tumours in the medial thigh were extracted from our database. Information on clinicopathological characteristics, preoperative treatment, surgical treatment (use of VSS, blood loss volume, operating time), and postoperative course (complications, postoperative haemoglobin changes, total drainage volume, and drainage and hospitalization durations) were obtained from medical records. We statistically compared clinical outcomes between patients whose surgery did or did not use VSS (VSS and non-VSS groups, respectively).Aims
Methods
Various types of tibial alignment guides exist, the results in performing the tibial resection in total knee arthroplasty (TKA) are more or less than we desired. In addition, it is difficult to estimate the accuracy of tibial component alignment with radiograph because it is difficult to get true frontal and lateral view. In this study, we use new tibial alignment guide and estimate tibial component alignment by using postoperative CT scan. 30 knees underwent TKA using an accelerometer-based, portable navigation device (KneeAlign 2) and postoperative CT scans were obtained. Postoperative CT scans of the lower limbs analysed by 3D digital template system (Athena), demonstrated that 96.6% of the tibial components were placed within 90°± 2°to the mechanical axis in the coronal plane, and 96.6% of the components were placed within 3°± 2°to the mechanical axis in the sagittal plane. As a result of this study, an accelerometer-based, portable navigation device can expect to decrease outliers in tibial component alignment.
Biologic agents (BIO) drastically changed the rheumatoid arthritis (RA) therapy from starting to use biologics at 2003 in Japan. The rate of orthopaedic surgery, especially total joint arthroplasty (TJA) may reflect trends in disease severity, management and health outcomes. We surveyed the number and rate of orthopaedic surgeries and TJA in RA treatment with BIO in the last decade, so called BIO-era.Objectives
Methods
It is very important for implanting tibial component to prevent bearing dislocation in Oxford UKA. One of the keys is accurate rotational position of tibia. But the problem remains what is accurate rotation of tibia in UKA. Oxford Signature decided the rotation of tibia component from MRI images. We measured the component rotation of tibia using CT after operation. 14 patients were operated by Oxford Signature and 11 patients were operated by Microplasty method. Patients were examined by CT 2 or 3 weeks later after operation. We compared component axis of tibia and A-P axis by best fit circle, Akagi's line. In Oxford Signature group, component angle were 7.1 degree external rotation compared with A-P axis by best fit circle and were 3.6 degree external rotation compared with Akagi's line. In Microplasty group, component angle were 8.1 degree external rotation compared with A-P axis by best fit circle and were 3.8 degree external rotation compared with Akagi's line.Patients and Methods
Results
MISTKA resulted earlier recovery of ROM, muscle power and shorter incision. But bleeding after operation did not decrease compared with conventional TKA. We compared MISTKA results between several approach mini arthrotomy, mini midvastus and mini subvastus. There were no difference in these series. We thought extramedullary femoral guide may be less invasive than intramedullary femoral guide system. 34 cases were performed by minisubvastus approach. 17 cases were using intramedullary method. 17 cases were using extramedullary method. We compared JOA score, ROM, muscle power, blood examination, X ray, and operation time. Total protein(TP), albumin(alb), prealbumin(prealb), hemoglobin(Hb), total lymphocyte content(TLC) and CRP were examined. There was no difference in JOA score, ROM and recovery of muscle power. But there were statistically difference in prealbumine at 1 week after operation and TLC at 2 week after operation. Extramedullary group showed earlier recovery than intramedullary group. MIS TKA does not discuss about approach but also system of bone cut. Navigation system is very good method but it is very expensive and takes more time at operation. Extramedullary system we developed is simple and low technology method and useful for MISTKA.
We reconstructed defects in the infraspinatus tendon using polytetrafluoroethylene (PTFE) felt grafts in 31 beagle dogs and examined the mechanical responses and histocompatibility. Except for one infected specimen, all the reconstructed infraspinatus tendons healed. We examined eight specimens each immediately after surgery and at six and 12 weeks. The ultimate tensile strength of the reconstructed tendons was 60.84 N, 172.88 N, and 306.51 N immediately after surgery and at six and 12 weeks, respectively. The stiffness of the specimens at the PTFE felt-bone interface was 9.61 kN/m, 64.67 kN/m, and 135.09 kN/m immediately after surgery and at six and 12 weeks, respectively. Six tendons were examined histologically at three, six, 12 and 24 weeks. Histological analysis showed that there was ingrowth of fibrous tissue between the PTFE fibres. Foreign-body reactions were found at the margin of the PTFE-bone interface between 12 and 24 weeks. The mechanical recovery and tissue affinity of PTFE felt to bone and to tendon support its use for reconstruction of the rotator cuff. The possible development of a foreign-body reaction should be borne in mind.
We treated 12 shoulders in ten patients with irreparable rotator-cuff tears by transfer of the latissimus dorsi. There were nine men and one woman. Their average age was 64.0 years and the average follow-up was 35.6 months (26 to 42). The results were excellent in four shoulders, good in four, fair in one, and poor in three. Active forward flexion improved from a preoperative average of 99° to a postoperative average of 135°. Osteoarthritic changes appeared in five shoulders and proximal migration of the humeral head progressed in six. EMG revealed that nine of the 12 transferred muscles showed activity which was synergistic with the supraspinatus on external rotation with abduction. We conclude that latissimus dorsi transfer can be effective in restoring shoulder function after massive irreparable tears of the rotator cuff.
