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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_1 | Pages 1 - 1
1 Feb 2020
Nagoya S Kosukegawa I Tateda K Yamashita T
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Background

Well-fixed cementless stems are sometimes needed to be extracted in patients with complications including periprosthetic infection, stem-neck breakage or trunnionosis. The purpose of this study was to report the clinical outcome in patients undergoing re-implantation surgery following removal of a well-fixed porous-coated cementless stem by the femoral longitudinal split (FLS) procedure(Fig.1, Fig.2).

Methods

We conducted a retrospective study and radiographic review of 16 patients who had undergone re-implantation following the FLS procedure to remove a well-fixed stem due to periprosthetic infection, stem-neck breakage or trunnionosis. The study group consisted of 2 men and 14women with an average age of 68.4 years. Mean follow-up was 33.1± 25.0 months. Operation time, intraoperative bleeding, complications, causes of re-operation and clinical score were evaluated and the Kaplan-Meier method was used to evaluate the longevity of the stem.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_11 | Pages 337 - 337
1 Jul 2014
Onodera T Yamashita T Iwasaki N Sasazawa F
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Summary Statement

The deletion of gangliosides enhanced OA development by elevating MMP-13 and ADAMTS-5 expression and accelerating chondrocyte apoptosis. Gangliosides possibly play suppressive roles in IL-1α-induced inflammatory signaling cascades.

Introduction

We have previously reported that glycosphingolipids (GSLs) play chondroprotective roles in the cartilage degradation process [1]. Gangliosides, one of the series of GSLs, are known to be important in intercellular signal transduction and cell-to-cell recognition [2]. Therefore, we hypothesised that gangliosides are important in cartilage metabolisms among the GSLs species. The purpose of this study was to determine the functional role of gangliosides in the development of OA in murine models.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_11 | Pages 300 - 300
1 Jul 2014
Miyakawa T Takebayashi T Terasima Y Ohgon I Yamashita T
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Summary Statement

TRPA1 antagonist reduced spontaneous excitatory postsynaptic currents of substantia gelatinosa neuron in spinal cord dorsal horn by in vivo patch-clamp analysis. TRPA1 may act as a mediator of excitatory synaptic transmission.

Introduction

Little is known about the pathophysiological mechanisms of radicular pain. The substantia gelatinosa (SG) in the spinal cord dorsal horn receives primary afferent inputs, which predominantly convey nociceptive sensations. Nociceptive information is modified and integrated in the SG, suggesting that the SG may be a therapeutic target for treating radicular pain. Electrophysiological study using in vivo patch-clamp recording from SG neurons is a useful method to analyze functional properties in synaptic transmission. Transient receptor potential ankyrin 1 (TRPA1) has been widely identified in the central and peripheral nervous system such as peripheral nociceptor, dorsal root ganglion (DRG), and spinal cord dorsal horn, and is considered that they are involved in synaptic transmission of pain. However, it is still unknown about its functional role and mechanism of pain transmission in spinal cord dorsal horn. The purpose of this study is to investigate changes in excitatory synaptic transmission of SG neurons with TRPA1 antagonist and to clarify the potential role of TRPA1 in the rat spinal cord dorsal horn using in vivo patch-clamp analysis.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_4 | Pages 36 - 36
1 Jan 2013
Ohwada T Yamashita T Miwa T Sakaura H
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Introduction

Recently various type of spinal instrumentation was applied, and they are essential in modern spinal fusion surgery. Whereas several authors reported increased possibility of complication and degeneration on adjacent segment. We tried PLIF without instrumentation with box type intervertebral cages.

Method

Forty-one cases of degenerative lumbar diseases were treated by PLIF with carbon cages without spinal instrumentation. There were 17 males and 24 females, and age averaged 71.4 years. Thirty-two cases were degenerative spondylolisthesis, five were spinal stenosis, and four were disc herniation. Single PLIF was performed on forty cases, and double segment in one, with additional decompression on other segment in twenty. Bilateral facet joint were preserved to avoid lateral instability. Two pieces of cage were inserted with local bone graft. Post-op. follow-up period were 12 to 24 months, 15 months on average.


Bone & Joint Research
Vol. 1, Issue 9 | Pages 198 - 204
1 Sep 2012
Iwase T Takebayashi T Tanimoto K Terashima Y Miyakawa T Kobayashi T Tohse N Yamashita T

Objectives

In order to elucidate the influence of sympathetic nerves on lumbar radiculopathy, we investigated whether sympathectomy attenuated pain behaviour and altered the electrical properties of the dorsal root ganglion (DRG) neurons in a rat model of lumbar root constriction.

Methods

Sprague-Dawley rats were divided into three experimental groups. In the root constriction group, the left L5 spinal nerve root was ligated proximal to the DRG as a lumbar radiculopathy model. In the root constriction + sympathectomy group, sympathectomy was performed after the root constriction procedure. In the control group, no procedures were performed. In order to evaluate the pain relief effect of sympathectomy, behavioural analysis using mechanical and thermal stimulation was performed. In order to evaluate the excitability of the DRG neurons, we recorded action potentials of the isolated single DRG neuron by the whole-cell patch-clamp method.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_VIII | Pages 23 - 23
1 Mar 2012
Nagoya S Okazaki S Tateda K Nagao M Wada T Kukita Y Kaya M Sasaki M Kosukegawa I Yamashita T
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Introduction

The purpose of this study was to evaluate the outcome of vascularized iliac bone grafting for idiopathic osteonecrosis of the femoral head.

Methods

We reviewed the clinical and radiological results of 35 operations performed on 29 patients who had osteonecrosis of the femoral head (ONFH) in which a pedicle iliac bone grafting was performed for minimum follow-up of 10 years. The average age was 35 years (range, 17 to 62 years). According to the Japanese Orthopaedic Association classification for ONFH, there were 28 stage 2, 7 stage 3-A, 17 type C-1 hips, and 18 type C-2 hips. After a bone tunnel of 1.5 × 5 cm was made in the anterior aspect of the femoral head and curettage of necrotic lesion was performed, the pedicle bone with the deep circumflex iliac artery (DCIA) was inserted into the anterolateral portion of the femoral head. The average follow-up period was 13 years and 6 months. Weight bearing was not allowed for 2 months after the operation. Survival rate of the femoral head was calculated by Kaplan-Meier methods, and collapse of the femoral head and configuration of the femoral head was investigated at final follow-up.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_VIII | Pages 57 - 57
1 Mar 2012
Okazaki S Matsumoto H Nagoya S Kaya M Sasaki M Tateda K Kosukegawa I Yamashita T
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Introduction

Although osteonecrosis of the femoral head has been observed in young adult patients with autoimmune diseases such as SLE and MCTD that are treated by corticosteroids, the pathogenesis of the osteonecrosis remains unclear. We established a rat model with osteonecrosis of the femoral head by injecting lipopolysaccharide (LPS) and corticosteroid, and assessed consequences of the histopathological alteration of the femoral head, the systemic immune response, and the lipid synthesis.

Methods

Male Wistar rats were given 2 mg/kg LPS intravenously on days 0 and 1 and intramuscularly 20 mg/kg methylprednisolone on days 2, 3, and 4. The animals were sacrificed 1, 2, 3, or 4 weeks after the last injection of the methylprednisolone. Histopathological and biochemical analyses were performed every week. The bone samples were then processed for routine hematoxylin and eosin staining to assess the general architecture and injury of the tissue. The triglyceride and the total cholesterol concentrations in the PRP were measured. The levels of various cytokines (IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, GM-CSF, IFN-γ, TNF-α) in blood samples were measured.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 96 - 97
1 Mar 2010
Kamikawa K Toyone T Watanabe A Ozawa T Yamashita T Matsuki K Matsumoto N Wada Y
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Introduction: ‘Fit and fill’ of the femoral component was originally thought essential for stability of cement-less stems. However, the Zweymuller stem was designed for ‘fit without fill’,(particularly flat tapered stem) and remains highly successful since its inception in 1979. We have performed primary cementless THA with the Profemur Z system (Wright Medical Technology, Inc.) mainly for dysplastic hip. The concept of Profemur Z stem with a modular neck system is the same as the Zweymuller grit-blasted titanium femoral stem. Traditional templating for dysplastic hips often led to errors in sizing, cup positioning and femoral stem direction. A CT-based surgical planning system called Hip-Op is a three dimensional planning software program that uses DICOM images to represent the relevant anatomical objects by means of multiple views. The purpose of this study was to evaluate the utility of the Hip-Op system to accurately predict implant size, insertion angle and the fixation manner of the femoral stem.

Materials and methods: One hundred and three non-selected, consecutive THA in 96 patients were performed as primary cementless THA with the Profemur Z system by the same surgeon. There were 81 women and 15 men in this group, with a mean age at surgery of 63 years (range 35 to 87 years). Postoperatively, the predicted implant sizes planned with Hip-Op system and with standard X-ray templates were compared to the actual components selected at the time of surgery. Clinical evaluation was done by using Harris Hip Score (HHS). The femoral stem was evaluated in both the anterior posterior and lateral projections of the radiographs. Insertion angle and the fixation manner of the femoral stem were also examined postoperatively using X-ray and CT.

Results: 3D templating with Hip-Op system accurately predicted the exact size of the femoral component 65% of the time, was within 1 size 96% of the time and within 2 sizes 100% of the time. Acetabuli were correctly predicted 80% of the time, within 1 size 98% and within 2 sizes 100% of the time. Conventional templating predicted the exact size 48% of the time in femoral components, and 66% in acetabuli, within 1 size 76% and 82%, within 2 sizes 89% and 92%, respectively. The average preoperative HHS was 46.3 points and the latest HHS was 83.2 points on average. Three patients required slow physiotherapy due to greater trochanteric fractures. Two patients were suffering from anterior dislocation. There was no femoral component subsidence. The insertion angle from neutral position of the stem was 0.4 degree in A-P view, and 1.6 degree in profile view. The fixation manner of the Zweymuller stem in the canal was obtained by contact with the four corners of the stem in 6.7%, three corners in 16.7%, two corners in 70%, respectively.

Discussion: The Zweymuller stem design provides primary axial stability through its dual longitudinal taper and primary rotational stability through contact with the corners of the stem to cortical bone in the canal. This study clearly shows the advantages of CT-based 3D templating over conventional X-ray templates. The surgical planning performed with Hip-Op system is accurate and useful, especially for dysplastic hip.