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Bone & Joint Research
Vol. 7, Issue 7 | Pages 485 - 493
1 Jul 2018
Numata Y Kaneuji A Kerboull L Takahashi E Ichiseki T Fukui K Tsujioka J Kawahara N

Objective

Cement thickness of at least 2 mm is generally associated with more favorable results for the femoral component in cemented hip arthroplasty. However, French-designed stems have shown favorable outcomes even with thin cement mantle. The biomechanical behaviors of a French stem, Charnley-Marcel-Kerboull (CMK) and cement were researched in this study.

Methods

Six polished CMK stems were implanted into a composite femur, and one million times dynamic loading tests were performed. Stem subsidence and the compressive force at the bone-cement interface were measured. Tantalum ball (ball) migration in the cement was analyzed by micro CT


Bone & Joint Research
Vol. 6, Issue 5 | Pages 351 - 357
1 May 2017
Takahashi E Kaneuji A Tsuda R Numata Y Ichiseki T Fukui K Kawahara N

Objectives

Favourable results for collarless polished tapered stems have been reported, and cement creep due to taper slip may be a contributing factor. However, the ideal cement thickness around polished stems remains unknown. We investigated the influence of cement thickness on stem subsidence and cement creep.

Methods

We cemented six collarless polished tapered (CPT) stems (two stems each of small, medium and large sizes) into composite femurs that had been reamed with a large CPT rasp to achieve various thicknesses of the cement mantle. Two or three tantalum balls were implanted in the proximal cement in each femur. A cyclic loading test was then performed for each stem. The migration of the balls was measured three-dimensionally, using a micro-computed tomography (CT) scanner, before and after loading. A digital displacement gauge was positioned at the stem shoulder, and stem subsidence was measured continuously by the gauge. Final stem subsidence was measured at the balls at the end of each stem.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 314 - 314
1 Dec 2013
Fukui K Kaneuji A Sugimori T Ichiseki T Matsumoto T
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Background

The rotational acetabular osteotomy (RAO), that was developed in Japan, has been used successfully in patients with developmental dysplasia of the hip (DDH) (Figure 1). However there are some patients who are forced to have a total hip arthroplasty (THA) due to the progression of osteoarthritis. It is unknown if a RAO poses technical difficulties or increases the chances of complications if a THA must be performed afterwards becausethere is not much data on patients who underwent a THA after a previous RAO.

Objectives

The purpose of this study was to investigate the mid-term results of a THA after a RAO.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_VIII | Pages 26 - 26
1 Mar 2012
Fukui K Kaneuji A Sugimori T Ichiseki T Kitamura K Kominami R Shinohara H Matsumoto T
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Introduction

The objective of this study was to identify fat emboli in the arterioles of the femoral bone marrow by Scanning Electron Microscopy (SEM) after glucocorticoid administration.

Methods

Female adult rabbits weighing 3.5 to 4.0 kg received a single injection of prednisolone at a dose of 4 mg/kg body weight. The day after injection was designated as day 1. Control rabbits were injected with only physiological saline and euthanized on day 14. The femoral bone marrow was obtained on days 5, 8, and 14, and processed for SEM. Aortic blood serum was passed through a filter, and the filter was processed for SEM. Some SEM specimens were embedded in a plastic resin and sectioned for correspondence of SEM-photomicroscopy or SEM-TEM.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_VIII | Pages 28 - 28
1 Mar 2012
Kitamura K Ichiseki T Kaneuji A Fukui K Matsumoto T
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Introduction

The mechanism for development of corticosteroid-induced osteonecrosis of the femoral head remains to be understood. Elucidation of the mechanism and the establishment of preventive methods have been critical issues. To establish a clinical method for prevention of corticosteroid-induced osteonecrosis, we have examined the suppressive effect of reduced glutathione (GSH) in a corticosteroid-induced rabbit model.

Methods

Female Japanese white rabbits were separated into five groups: Group S4, a single intramuscular 4 mg/kg methyl prednisolone acetate (MPSL) administration in the gluteus; Group G4, administration of a 5 mg/kg regular dose GSH for 5 consecutive days starting on the day of a single 4 mg/kg MPSL administration; Group S20, a single intramuscular administration of 20 mg/kg MPSL in the gluteus; Group G20, administrations of 5 mg/kg GSH for 5 consecutive days starting on the day of a single 20 mg/kg MPSL administration; and Group N, control group with no treatment. All rabbits were sacrificed 14 days after MPSL administration. Histopathological analyses were performed by hematoxylin-eosin staining. Immunohistological analyses were performed using anti-lectinlike oxidized LDL reseptor-1 antibody (anti-LOX-1 antibody).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_VIII | Pages 29 - 29
1 Mar 2012
Ichiseki T Kaneuji A Sugimori T Fukui K Kitamura K Mikami T Nakagawa S Matsumoto T
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Introduction

Recently, oxidative stress has been implicated in the development of osteonecrosis. Here we focused on vitamins with marked antioxidant potency to see whether their use might prevent the development of osteonecrosis associated with corticosteroid administration.

Methods

Fifteen male Japanese white rabbits weighing about 3.5 kg were injected once into the right gluteal muscle with methylprednisolone (MPSL) 40 mg/kg (S Group). Ten other rabbits, in addition, received consecutive daily intravenous injections of vitamin E 50 mg/kg starting from the day of MPSL administration (E Group), and 10 other animals similarly received consecutive daily intravenous injections of vitamin C 30 mg/kg (C Group). All animals were euthanized 2 weeks after MPSL administration, and femurs were extracted, and stained with hematoxylin-eosin. Blood levels of glutathione (GSH) were also measured.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 305 - 305
1 May 2006
Kabata T Matsumoto T Kaneuji A Sugimori T Ichiseki T Ebara H Maeda T Sakagoshi D Tomita K
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Introduction: The purpose of this study was to evaluate the clinical results of Sugioka’s transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head.

Materials and Methods: We reviewed 54 hips in 49 patients who underwent TRO between 1986 and 1998 (follow-up rate was 90%). The mean age of patients was thirty-six years. The average duration of follow-up was 116 months (range, 60 to 201 months). Risk factors for osteonecrosis was steroids in 23 patients, idiopathic in 15 patients, alcohol in 13 patients, and others in three patients. Using the staging system of The Japanese Investigation Committee of the Ministry of Health and Welfare, 16 hips were in Stage 2, 23 hips in Stage 3A, 13 hips in Stage 3B, and two hips in Stage 4. Clinical assessments were made according to the Japanese Orthopaedics Association hip scoring system (JOA score).

Results: The overall results were excellent (JOA score of 90 to 100 points) in 22 hips (40.7%), good (80 to 89 points) in 16 hips (29.6%), fair (65 to 79 points) in 3 hips (5.5%), and poor (fewer than 64 points) in 13 hips (24.1%). The result was influenced by post-operative complications, the ratio of transposed intact femoral articular surface to the acetabular weight-bearing area after TRO, and the pre-operative stage. All hips with a ratio less than 40% showed progressive collapse. All Stage 2 hips with the ratio more than 40% showed excellent or good results. Conversely, 19% and 25% of the hips were fair or poor in Stage 3A and 3B hips even though the ratio was more than 40%. All Stage 4 hips had poor results.

Discussion: We conclude that satisfactory results can be achieved using TRO by maintaining exact surgical technique and by limiting the surgical indications. The hips in early or intermediate stages with sufficient intact area are good candidates for TRO.