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14. Intraoperative reliability of the tibial anteroposterior axis 'Akagi's Line' in total knee arthroplasty

Author

Kohei Kawaguchi, Ryota Yamagami, Kono Kenichi, Tomofumi Kage, Ryo Murakami, Takahiro Arakawa, Hiroshi Inui, Shuji Taketomi, and Sakae Tanaka

Subjects
Akagi's line, anteroposterior axis, clinical outcome, functional outcome, navigation system, pain, Orthopedic surgery, RD701-811
Abstract

Abstract Purpose The tibial anatomical anteroposterior (AP) axis “Akagi's line” was originally defined on computed tomography (CT) in total knee arthroplasty (TKA); however, its intraoperative reproducibility remains unknown. This study aimed to evaluate the intraoperative reproducibility of the Akagi's line and its effect on postoperative clinical outcomes. Methods This prospective study included 171 TKAs. The rotational angle of the intraoperative Akagi's line relative to the original Akagi's line (RAA) defined on CT was measured. The RAA was calculated based on the tibial component rotational angles relative to the intraoperative Akagi's line measured using the navigation system and CT. The effects of RAA on postoperative clinical outcomes and rotational alignments of components were also evaluated. Results The mean absolute RAA (standard deviation) value was 5.5° (3.9°). The range of RAA was 22° internal rotation to 16° external rotation. Intraoperative Akagi's line outliers (RAA > 10°) were observed in 14% of the knees (24 knees). In outlier analysis, the tibial component rotation angle was externally rotated 6.5° (5.6°) in the outlier group and externally rotated 3.7° (4.2°) in the nonoutlier group (≤10°), with a significant difference between the two groups. Additionally, the outlier group (RAA > 10°) showed lower postoperative clinical outcomes. Conclusion The original Akagi's line defined on CT showed insufficient reproducibility intraoperatively. The poor intraoperative detection of Akagi's line could be the reason for the tibial component rotational error and worse postoperative clinical outcomes. Level of Evidence Level IV, case series.

Published
2024
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16. Efficacy of Corticosteroid Therapy for HTLV-1-Associated Myelopathy: A Randomized Controlled Trial (HAMLET-P).

Author

Yamauchi, Junji, Tanabe, Kenichiro, Sato, Tomoo, Nakagawa, Masanori, Matsuura, Eiji, Tsuboi, Yoshio, Tamaki, Keiko, Sakima, Hirokuni, Ishihara, Satoshi, Ohta, Yuki, Matsumoto, Naoki, Kono, Kenichi, Yagishita, Naoko, Araya, Natsumi, Takahashi, Katsunori, Kunitomo, Yasuo, Nagasaka, Misako, Coler-Reilly, Ariella, Hasegawa, Yasuhiro, Araujo, Abelardo, Jacobson, Steven, Grassi, Maria, Galvão-Castro, Bernardo, Bland, Martin, Taylor, Graham, Martin, Fabiola, and Yamano, Yoshihisa

Subjects
HTLV-1-associated myelopathy, human T-lymphotropic virus type 1, methylprednisolone, prednisolone, randomized controlled trial, Adrenal Cortex Hormones, Aged, Disabled Persons, Female, Human T-lymphotropic virus 1, Humans, Male, Methylprednisolone, Middle Aged, Motor Disorders, Paraparesis, Tropical Spastic, Prednisolone, Prospective Studies, Treatment Outcome
Abstract

Corticosteroids are most commonly used to treat HTLV-1-associated myelopathy (HAM); however, their clinical efficacy has not been tested in randomized clinical trials. This randomized controlled trial included 8 and 30 HAM patients with rapidly and slowly progressing walking disabilities, respectively. Rapid progressors were assigned (1:1) to receive or not receive a 3-day course of intravenous methylprednisolone in addition to oral prednisolone therapy. Meanwhile, slow progressors were assigned (1:1) to receive oral prednisolone or placebo. The primary outcomes were a composite of ≥1-grade improvement in the Osame Motor Disability Score or ≥30% improvement in the 10 m walking time (10 mWT) at week 2 for rapid progressors and changes from baseline in 10 mWT at week 24 for slow progressors. In the rapid progressor trial, all four patients with but only one of four without intravenous methylprednisolone achieved the primary outcome (p = 0.14). In the slow progressor trial, the median changes in 10 mWT were -13.8% (95% CI: -20.1--7.1; p < 0.001) and -6.0% (95% CI: -12.8-1.3; p = 0.10) with prednisolone and placebo, respectively (p for between-group difference = 0.12). Whereas statistical significance was not reached for the primary endpoints, the overall data indicated the benefit of corticosteroid therapy. (Registration number: UMIN000023798, UMIN000024085).

Published
2022

34. The Association Between the Perception of Exercise Benefits and Barriers and Exercise Self-Efficacy During the Induction Phase of Dialysis in Patients with End-Stage Kidney Disease: A Cross-Sectional Study.

Author

Hirano, Yuma, Fujikura, Tomoyuki, Yamaguchi, Tomoya, Kato, Akihiko, Kono, Kenichi, Ohashi, Naro, Yasuda, Hideo, and Yamauchi, Katsuya

Abstract

Background/Objectives: The physical function of patients with chronic kidney disease gradually declines as kidney function deteriorates, and this decline becomes more pronounced after the initiation of dialysis. Encouraging the development of exercise habits from the initiation phase of dialysis is crucial. Increased exercise self-efficacy is essential for establishing these habits. However, the related factors at this stage are unclear. This study hypothesized that perceptions of exercise benefits and barriers are related to exercise self-efficacy and aimed to investigate this association. Methods: This single-center, cross-sectional study included 72 patients and assessed the stages of exercise behavior change, perceptions of exercise benefits and barriers, and exercise self-efficacy. Multiple regression analysis was used to examine the association between exercise self-efficacy and perceptions of the benefits and barriers of exercise. Results: Perceptions of exercise benefits were still significantly associated with self-efficacy for exercise after adjustment for age, gender, history of cardiovascular disease, diabetic kidney disease, living alone, employment, and physical function (β = 0.474, p < 0.001). Similarly, perceptions of exercise barriers were also significantly associated with self-efficacy for exercise (β = −0.410, p = 0.001). A subgroup analysis that only examined participants without exercise habits revealed a similar association. Conclusions: Perceptions of exercise benefits and barriers may be associated with exercise self-efficacy in patients with end-stage kidney disease during the initiation phase of dialysis. As patients are temporarily hospitalized during this phase, it provides an opportunity for intervention. Exercise education and supportive environments during hospitalization may enhance perceptions of exercise benefits, reduce perceptions of exercise barriers, and improve exercise self-efficacy. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Intrinsic Risk Factors for Noncontact Anterior Cruciate Ligament Injury in Young Female Soccer Players: A Prospective Cohort Study.

Author

Taketomi, Shuji, Kawaguchi, Kohei, Mizutani, Yuri, Takei, Seira, Yamagami, Ryota, Kono, Kenichi, Murakami, Ryo, Arakawa, Takahiro, Kage, Tomofumi, Kobayashi, Takashi, Furukawa, Yuri, Arino, Yusuke, Fujiwara, Sayaka, Tanaka, Sakae, and Ogata, Toru

Subjects
HAMSTRING muscle physiology, QUADRICEPS muscle physiology, SPORTS injury prevention, SOCCER injury prevention, RISK assessment, ANTERIOR cruciate ligament injuries, WOMEN athletes, T-test (Statistics), DATA analysis, SPORTS injuries, CALF muscles, DESCRIPTIVE statistics, MANN Whitney U Test, LONGITUDINAL method, MUSCLE strength, STATISTICS, ANTHROPOMETRY, CONFIDENCE intervals, PSYCHOSOCIAL factors, RANGE of motion of joints, MUSCLE contraction, DISEASE risk factors, ADOLESCENCE, ADULTS
Abstract

Background: Previous studies have attempted to determine prognostic factors for predicting the occurrence of noncontact anterior cruciate ligament (ACL) injuries. However, studies on risk factors for noncontact ACL injuries in Asian female soccer players are limited. Purpose: To identify intrinsic risk factors for noncontact ACL injuries among young female Asian soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: This study evaluated 145 female Japanese soccer players for potential risk factors for noncontact ACL injury during the preseason medical assessment. In total, 25 variables were examined—including anthropometric data, joint range of motion, muscle flexibility, muscle strength, and balance measurements. Participants were monitored throughout a single season for noncontact ACL injuries diagnosed by physicians. Results: Noncontact ACL injuries occurred in 13 knees of 13 players (9%). Lower hamstring-to-quadriceps ratio (0.44 ± 0.07 vs 0.50 ± 0.10; P =.04), greater knee extension muscle strength (3.2 ± 0.5 vs 2.7 ± 0.5 N·m/kg; P <.01), and longer playing experience (10.8 ± 3 vs 8.1 ± 4.2 years; P =.02) were significantly associated with new-onset noncontact ACL injuries in young female soccer players. No statistically significant between-group differences were found for any other variables. Conclusion: New-onset noncontact ACL injury in young female soccer players was significantly associated with lower hamstring-to-quadriceps ratio, greater knee extension muscle strength, and longer soccer experience. These findings will help develop strategies for preventing noncontact ACL injuries among female soccer players. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Basic Study for 3D Kinematic Measurement of Patella from Single-Plane Fluoroscopic Image Using Intensity-Based 2D/3D Registration

Author

Yamazaki, Takaharu, Hayashi, Yuichi, Tomita, Tetsuya, Kono, Kenichi, Sato, Yoshinobu, Sugamoto, Kazuomi, Magjarevic, Ratko, Editor-in-Chief, Ładyżyński, Piotr, Series Editor, Ibrahim, Fatimah, Series Editor, Lacković, Igor, Series Editor, Rock, Emilio Sacristan, Series Editor, Lhotska, Lenka, editor, Sukupova, Lucie, editor, and Ibbott, Geoffrey S., editor

Published
2019
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