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Objective We aimed to assess the diagnostic utility of the linguistically validated Japanese version of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale ( LANSS-J) as a screening tool for neuropathic pain in the clinical setting. Methods Patients with neuropathic pain or nociceptive pain who were 20 to 85 years of age were included. Sensitivity and specificity using the original cutoff value of 12 were assessed to evaluate the diagnostic utility of the LANSS-J. Sensitivity and specificity with possible cutoff values were calculated, along with area under the receiver operating characteristic curve. We then evaluated agreement regarding assessment of the LANSS-J by two investigators. We used the intraclass correlation coefficient ( ICC) for the total score and Cohen's kappa coefficient for each item. Results Data for patients with neuropathic pain ( n = 30) and those with nociceptive pain ( n = 29) were analyzed. With a cutoff of 12, the sensitivity was 63.3% (19/30) and the specificity 93.1% (27/29). Sensitivity improved substantially with a cutoff of ≤ 11 (≥ 83.3%, 25/30). High specificity (93.1%, 27/29) was sustained with a cutoff of 9 to 12. The ICC for the total score was 0.85, indicating sufficient agreement. Kappa coefficients ranged from 0.68 to 0.84. Conclusions The LANSS-J is a valid screening tool for detecting neuropathic pain. Our results suggest that employing the original cutoff value provides high specificity, although a lower cutoff value of 10 or 11 (with its high specificity maintained) may be more beneficial when pain attributed to neuropathic mechanisms is suspected in Japanese patients. [ABSTRACT FROM AUTHOR]

To ensure that the femoral stem is placed in the proper position during total hip arthroplasty, the authors developed a patient-specific instrument. A total of 10 total hip arthroplasties were performed with the assistance of the patient-specific instrument during this study. The mean accuracy of stem tilt, varus/valgus, and anteversion was 2.1°±4.1°, 1.0°±0.7°, and 4.7°±1.2°, respectively. No complications were observed and no reoperations were required for any of the patients who underwent surgery included in this study. The results support the feasibility of this patient-specific instrument for use during stem placement in total hip arthroplasty. [Orthopedics. 2017; 40(2):e374-e377.]. [ABSTRACT FROM AUTHOR]

In spinal surgery, a surgeon often needs to remove some parts of the spine to relieve the pressure on the spinal cord or other nerves. In this procedure, the surgeon needs to cut and drill some holes in the spine. This operation is very risky because there are some nerves beneath the target bones, and this procedure therefore requires a skilled and experienced surgeon. However, if the cutting tool could detect penetration of the bone autonomously, the safety of the procedure would be improved drastically. This study presents a hand-held bone cutting tool system that detects the penetration of the workpiece. The system learns the cutting states and motion states from demonstrations by a surgeon, and it autonomously detects the penetration of the workpiece and stops the actuation of the cutting tool immediately before total penetration. The proposed scheme for penetration detection does not require knowledge of the shape and the position of the workpiece and, therefore, it does not require any costly systems, such as robotic arms and position sensor systems. In addition, the proposed scheme can be easily applied to various shapes of the cutting tool, such as drills and saws. The developed system was evaluated through experiments. The results showed that the performance of the developed system was satisfactory in both a motorized and a hand-held setup. [ABSTRACT FROM PUBLISHER]

ABSTRACT To prevent periprosthetic osteolysis and subsequent aseptic loosening of artificial hip joints, we recently developed a novel acetabular highly cross-linked polyethylene (CLPE) liner with graft polymerization of 2-methacryloyloxyethyl phosphorylcholine (MPC) on its surface. We investigated the wear resistance of the poly(MPC) (PMPC)-grafted CLPE liner during 20 million cycles in a hip joint simulator. We extended the simulator test of one liner to 70 million cycles to investigate the long-term durability of the grafting. Gravimetric, surface, and wear particle analyses revealed that PMPC grafting onto the CLPE liner surface markedly decreased the production of wear particles and showed that the effect of PMPC grafting was maintained through 70 million cycles. We believe that PMPC grafting can significantly improve the wear resistance of artificial hip joints. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:369-376, 2014. [ABSTRACT FROM AUTHOR]