106 results on '"Nozaka K"'
Search Results
2. The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration
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Tsuchie, H., Miyakoshi, N., Iba, K., Kasukawa, Y., Nozaka, K., Dohke, T., Kosukegawa, I., Aizawa, T., Maekawa, S., Abe, H., Takeshima, M., Tomite, T., Segawa, T., Ouchi, K., Kinoshita, H., Suzuki, M., Yamashita, T., and Shimada, Y.
- Published
- 2018
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3. Strength and behavior of anchoring devices of CFRP rods for steel girder strengthening
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Nozaka, K, primary, Tsukiyama, A, additional, Matsumura, M, additional, Ochi, N, additional, Ishikawa, T, additional, and Hisabe, N, additional
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- 2012
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4. Ultrasonographic assessment of synovitis with lessor toe deformity in rheumatoid arthritis
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Kashiwagura, T., primary, Kimura, Y., additional, Wakabayashi, I., additional, Fujii, M., additional, Aonuma, H., additional, Nozaka, K., additional, Miyakoshi, N., additional, and Shimada, Y., additional
- Published
- 2017
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5. Anatomical positions facilitating of anterocentral portal for ankle arthroscopy on ultrasonography
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Chida, S., primary, Kura, H., additional, Kashiwakura, T., additional, Nozaka, K., additional, and Shimada, Y., additional
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- 2017
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6. Comparison of ultrasonographic synovitis of the foot and clinical parameters in rheumatoid arthrititis
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Kashiwagura, T., primary, Kimura, Y., additional, Wakabayashi, I., additional, Fujii, M., additional, Aonuma, H., additional, Nozaka, K., additional, Miyakoshi, N., additional, and Shimada, Y., additional
- Published
- 2017
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7. Rectal cancer metastasis to the metatarsal: A case report
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Shibata, N., primary, Urayama, M., additional, Maekawa, S., additional, Shimada, Y., additional, Kashiwagura, T., additional, Nozaka, K., additional, and Chida, S., additional
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- 2017
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8. FRI0577 Clinical characteristics of spontaneus fractures in the bedridden patients unintentionally caused by caregivers
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Kashiwagura, T, primary, Kimura, Y, additional, Wakabayashi, I, additional, Fujii, M, additional, Nozaka, K, additional, Miyakoshi, N, additional, and Shimada, Y, additional
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- 2017
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9. Ultrasonographic assessment of the midfoot and hindfoot joints in RA patients
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Kashiwagura, T., primary, Kimura, Y., additional, Wakabayashi, I., additional, Yuasa, Y., additional, Nozaka, K., additional, and Miyakoshi, N., additional
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- 2016
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10. AB1092 Assessing Forefoot Calluses in Rheumatoid Arthritis Using 3D Volume Rendering
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Kashiwagura, T., primary, Kimura, Y., additional, Wakabayashi, I., additional, Ono, Y., additional, Miyamoto, S., additional, Nozaka, K., additional, Miyakoshi, N., additional, and Shimada, Y., additional
- Published
- 2015
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11. AB1091 Power Doppler Ultrasonographic Assessment of Foot and Ankle Synovitis in Rheumatoid Arthritis
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Kashiwagura, T., primary, Kimura, Y., additional, Wakabayashi, I., additional, Ono, Y., additional, Miyamoto, S., additional, Nozaka, K., additional, Miyakoshi, N., additional, and Shimada, Y., additional
- Published
- 2015
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12. A Case of Descending Colon Cancer with Colocolic Fistula and Jejunocolic Fistula
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Takebayashi, M., primary, Toyota, N., additional, Nozaka, K., additional, Wakatsuki, T., additional, Kamasako, A., additional, and Tanida, O., additional
- Published
- 2006
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13. Microleakage of composite resins in cavities of upper primary molars
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Nozaka, K., primary, Suruga, Y., additional, and Amari, E., additional
- Published
- 1999
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14. Immobilization in external rotation after shoulder dislocation reduces the risk of recurrence. A randomized controlled trial.
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Itoi E, Hatakeyama Y, Sato T, Kido T, Minagawa H, Yamamoto N, Wakabayashi I, Nozaka K, Itoi, Eiji, Hatakeyama, Yuji, Sato, Takeshi, Kido, Tadato, Minagawa, Hiroshi, Yamamoto, Nobuyuki, Wakabayashi, Ikuko, and Nozaka, Koji
- Abstract
Background: An initial anterior dislocation of the shoulder becomes recurrent in 66% to 94% of young patients after immobilization of the shoulder in internal rotation. Magnetic resonance imaging and studies of cadavera have shown that coaptation of the Bankart lesion is better with the arm in external rotation than it is with the arm in internal rotation. Our aim was to determine the benefit of immobilization in external rotation in a randomized controlled trial.Methods: One hundred and ninety-eight patients with an initial anterior dislocation of the shoulder were randomly assigned to be treated with immobilization in either internal rotation (ninety-four shoulders) or external rotation (104 shoulders) for three weeks. The primary outcome measure was a recurrent dislocation or subluxation. The minimum follow-up period was two years.Results: The follow-up rate was seventy-four (79%) of ninety-four in the internal rotation group and eighty-five (82%) of 104 in the external rotation group. The compliance rate was thirty-nine (53%) of seventy-four in the internal rotation group and sixty-one (72%) of eighty-five in the external rotation group (p = 0.013). The intention-to-treat analysis revealed that the recurrence rate in the external rotation group (twenty-two of eighty-five; 26%) was significantly lower than that in the internal rotation group (thirty-one of seventy-four; 42%) (p = 0.033) with a relative risk reduction of 38.2%. In the subgroup of patients who were thirty years of age or younger, the relative risk reduction was 46.1%.Conclusions: Immobilization in external rotation after an initial shoulder dislocation reduces the risk of recurrence compared with that associated with the conventional method of immobilization in internal rotation. This treatment method appears to be particularly beneficial for patients who are thirty years of age or younger. [ABSTRACT FROM AUTHOR]- Published
- 2007
15. Bleaching effect on pulpless tooth with simultaneous use of Nd:YAG laser
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Nozaka, K., Satoh, T., Namioka, A., and Hirose, Y.
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LASERS , *BLEACHING (Chemistry) - Abstract
The purpose of this study is to report some knowledge gained from experiments in which we tried tooth bleaching using laser and bleaching agents on pulpless tooth due to trauma. We conducted in vitro experiments using extracted teeth of lower permanent central incisors with the following four conditions: (1) using 30% hydrogen peroxide (H2O2) and Nd:YAG laser, without Indian ink; (2) in addition to the condition of (1), with Indian ink; (3) using laser in conjunction with H2O2 and sodium perborate, without Indian ink; (4) in addition to the conditions of (3), with Indian ink. The bleaching agents that used 30% H2O2 and sodium perborate had more bleaching effects than the one with 30% H2O2 only. Furthermore, translucency was not lost in the cases in which Indian ink was not used. Obtaining above results, we conducted clinical trials under condition (3). In three trial cases, changes in shade were observed after the bleaching treatment. Largely satisfactory results were gained with over three times radiation in two clinical cases. After the bleaching treatment, the patients had no perceptive or apparent symptoms. Little recurrence of discoloration was found. [Copyright &y& Elsevier]
- Published
- 2003
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16. Strengthening Effects of Steel Truss Bridge Members with Carbon Fibre Reinforced Plastics Sheets
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Yamaguchi, Y., primary, Kawamura, H., additional, Fujisawa, S., additional, Yotsui, S., additional, Nozaka, K., additional, and Izuno, K., additional
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17. Varus-valgus native knee laxity in extension displays an almost rectangular pattern and does not correlate with lower limb alignment.
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Akagawa M, Saito H, Takahashi Y, Tsukamoto H, Abe K, Iwamoto Y, Yoshikawa T, Abe T, Kijima H, Kasukawa Y, Nozaka K, and Miyakoshi N
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- Humans, Male, Female, Adult, Young Adult, Lower Extremity physiopathology, Lower Extremity diagnostic imaging, Radiography, Range of Motion, Articular, Joint Instability physiopathology, Knee Joint physiopathology, Knee Joint diagnostic imaging, Knee Joint surgery
- Abstract
Optimal ligament balance is crucial for successful total knee arthroplasty (TKA), which is a standard procedure for managing end-stage knee osteoarthritis. However, the reported values of ligament balance vary due to different methodologies and population differences, which requires further studies. This study aimed to investigate the varus-valgus ligament balance in healthy knees of Japanese individuals and its relationship with lower limb alignment. The studyanalyzed64 knees from 33 healthy young adults using stress radiographs to measure varus-valgus laxity. The mechanical hip-knee-ankle angle, medial proximal tibial angle, and lateral distal femoral angles were determined using digital long-leg radiographs. Varus and valgus laxities were compared, and the relationship between ligament balance and alignment parameters was analyzed. Mean varus laxity (3.6°± 1.3°) was significantly greater than mean valgus laxity(2.9°± 1.0°) (p<0.0001). No significant association was observed between ligament balance and alignment parameters. Healthy knees of Japanese individuals exhibited slightly greater varus laxity (0.7°) than valgus laxity, with no correlation observed between ligament balance and lower limb alignment. The finding underscores the importance of recognizing alignment diversity while noting that alignment does not influence ligament balance; this is particularly relevant in modern TKA techniques focusing on patient-specific joint and ligament reconstructions. The study's findings could help formulate strategies benefiting knee osteoarthritis management., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Akagawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
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18. Pediatric femoral shaft fracture requiring revision surgery for nonunion associated with vitamin D and K deficiencies: a case report.
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Igarashi S, Nozaka K, Shirahata T, Kijima H, Saito H, Saito K, Kawano T, and Miyakoshi N
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- Female, Humans, Child, Reoperation methods, Vitamin D therapeutic use, Bone Nails, Fracture Healing, Vitamins, Treatment Outcome, Retrospective Studies, Fracture Fixation, Intramedullary methods, Femoral Fractures diagnostic imaging, Femoral Fractures surgery, Hypokalemia
- Abstract
Background: Nonunion of femoral shaft fractures in children is rare, and there is no clear treatment protocol. In this case report, a pediatric femoral shaft fracture that developed in nonunion due to vitamin deficiency after osteosynthesis, which was successfully treated with vitamin augmentation and replacement with a rigid antegrade intramedullary nail, is described., Case Presentation: The patient is an 11-year-old Japanese girl. She injured her right femoral shaft fracture when she hit a wall after kickboarding down a hill and underwent osteosynthesis with a titanium elastic nail. Six months postoperatively, she developed nonunion, was found to be deficient in vitamins D and K, and was started on vitamin supplementation. She underwent replacement with a rigid antegrade intramedullary nail at 7 months postoperatively, and bone union was achieved 3 months after reoperation., Conclusion: When delayed union of a fracture is observed postoperatively, even in children without underlying disease, the cause of the problem must be investigated and treated promptly., (© 2024. The Author(s).)
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- 2024
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19. Factors Affecting the Second Complete Atypical Femoral Fracture after the First Atypical Fracture.
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Tsuchie H, Kasukawa Y, Nozaka K, Kinoshita H, Sasaki K, Aizawa T, Mita M, Ouchi K, Yuasa Y, Miura T, Tomite T, Maekawa S, Abe H, Akagawa M, Shibata N, Fujii M, Takeshima M, Inoue J, Saito H, and Miyakoshi N
- Subjects
- Humans, Diphosphonates therapeutic use, Femur, Pain drug therapy, Bone Density Conservation Agents therapeutic use, Femoral Fractures diagnostic imaging, Femoral Fractures surgery, Femoral Fractures drug therapy
- Abstract
Objectives: Atypical femoral fracture (AFF) is an atypical low-energy subtrochanteric and diaphyseal femoral fracture. Even if bone fusion is achieved in patients with AFF, the risk of AFF in the contralateral femur must be considered. This study aimed to investigate the factors affecting complete AFF in the contralateral femur and conservatively treated incomplete AFF., Subject and Methods: Radiographs of 111 femurs in 104 AFF cases were examined, and the femurs were classified as follows: 85 contralateral femurs with complete AFF; 18 contralateral femurs with incomplete AFF; 8 femurs with incomplete AFF without surgical treatment. Various patients' clinical data were collected, and we investigated the factors affecting the second complete AFF., Results: Complete fractures occurred in 10 (9.7%) of 103 femurs without incomplete AFF at the first visit and in 3 (37.5%) of 8 femurs with incomplete AFF. The Kaplan-Meier curve revealed that lateral cortical bone thickening and thigh pain were associated with significantly poorer prognoses (p = 0.026 and p = 0.013, respectively). Multivariate analyses revealed that eldecalcitol usage after AFF onset (p = 0.0094) and previous use of bisphosphonate or denosumab (p = 0.0126) were protective factors for second complete AFF and that the presence of thigh pain (p = 0.0134) was a risk factor for second complete AFF., Conclusions: Eldecalcitol administration after bone union of first AFF may prevent AFF recurrence. In addition, painful incomplete AFF has a high risk of developing a complete fracture., (© 2023 The Author(s). Published by S. Karger AG, Basel.)
- Published
- 2024
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20. Skip Fusion With Sacral-Alar-Iliac Screw Fixation for Pelvic Ring and Lumbar Fractures: A Case Report.
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Kimura R, Kasukawa Y, Hongo M, Kudo D, Mita M, Nozaka K, and Miyakoshi N
- Abstract
Pelvic ring fractures are associated with high-energy trauma and high mortality owing to critical blood loss and concomitant injuries. If there is a concurrent lumbar fracture, the postoperative range of motion will be limited owing to the increased fusion range. Here, we report a case in which skip fusion with sacral-alar-iliac screw fixation was effective as a minimally invasive procedure for treating pelvic ring and lumbar fractures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kimura et al.)
- Published
- 2023
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21. Teriparatide and etelcalcetide improve bone, fibrosis, and fat parameters in chronic kidney disease model rats.
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Igarashi S, Kasukawa Y, Nozaka K, Tsuchie H, Abe K, Saito H, Shoji R, Kasama F, Harata S, Okamoto K, Oya K, and Miyakoshi N
- Abstract
Objectives: Chronic kidney disease (CKD) complicated by secondary hyperparathyroidism (SHPT) is associated with an increased risk of fragility fractures. Etelcalcetide (EC) is a treatment for SHPT that reduces serum parathyroid hormone (PTH) levels. However, the effects of combined treatment with osteoporosis drugs such as teriparatide (TPTD) remain unclear. This study investigates the combined effects of EC and TPTD on bone in CKD model rats., Methods: The CKD model was established in 8-week-old male Wistar rats by feeding them a 0.75% adenine diet for 4 weeks. At 20 weeks of age, the rats were divided into 4 groups (N = 9-10 in each group): CKD group (vehicle administration), TPTD group (30 μg/kg, 3 times/week), EC group (0.6 mg/kg, daily), and Comb group (TPTD and EC combined). EC was injected for 12 weeks starting at 20 weeks of age, and TPTD was injected for 8 weeks starting at 24 weeks of age. After treatment, the followings were evaluated: bone mineral density, bone strength, biochemical tests, bone and fat histomorphometry, and micro-computed tomography., Results: In CKD model rats, the combination of EC and TPTD was more effective in increasing cortical bone thickness and bone strength and inhibiting porosity. In addition, the combined treatment decreased bone marrow adiposity and fibrosis, and it increased bone mass and improved bone microstructure in trabecular bone., Conclusions: With the observed benefits such as improved bone mass, bone strength, structural properties, and bone marrow adiposity, combination therapy may be a potential way to improve bone fragility in CKD., Competing Interests: The authors declare no competing interests., (© 2023 The Korean Society of Osteoporosis. Publishing services by Elsevier B.V.)
- Published
- 2023
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22. Effects of bisphosphonates and treadmill exercise on bone and kidney in adenine-induced chronic kidney disease rats.
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Harata S, Kasukawa Y, Nozaka K, Tsuchie H, Shoji R, Igarashi S, Kasama F, Oya K, Okamoto K, and Miyakoshi N
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- Humans, Rats, Male, Animals, Aged, Diphosphonates pharmacology, X-Ray Microtomography, Rats, Wistar, Alendronate pharmacology, Kidney, Bone Density, Lumbar Vertebrae, Fibrosis, Bone Density Conservation Agents pharmacology, Renal Insufficiency, Chronic
- Abstract
Introduction: The increasing prevalence of osteoporosis and chronic kidney disease (CKD) due to the aging of society has highlighted the need for development of effective treatments for elderly patients. This study examined whether the combination of treadmill exercise therapy and alendronate (ALN) can improve bone mineral density (BMD) and bone strength without worsening renal function in adenine-induced CKD model rats., Materials and Methods: 8-week-old male Wistar rats (n = 70) were divided into experimental groups based on the treatment protocol, i.e., non-CKD (control), vehicle only (CKD), ALN only, exercise only, and combined ALN plus exercise. A 0.75% adenine diet was used to induce CKD. Groups were killed at either 20 or 30 weeks of age. Comprehensive assessments included serum and urine biochemistry tests, renal histology, bone histomorphometry, BMD measurement, micro-computed tomography examinations, and biomechanical testing., Results: Blood biochemistry tests, urine analyses and histological evaluations of the kidney demonstrated that ALN treatment did not worsen renal function or kidney fibrosis in moderate-stage CKD model rats. Both ALN and treadmill exercise significantly suppressed bone resorption (p < 0.05-p < 0.01). Moreover, ALN monotherapy and combined ALN and treadmill exercise significantly improved BMD of the lumbar spine and femur, bone microstructure, and trabecular bone strength (p < 0.05-p < 0.01). Treadmill exercise was also shown to decrease cortical porosity at the mid-diaphysis of the femur and improve kidney fibrosis., Conclusion: The combination of ALN and treadmill exercise is effective in improving BMD, the microstructure of trabecular and cortical bone, and bone strength, without compromising renal function in adenine-induced CKD model rats., (© 2023. The Japanese Society Bone and Mineral Research.)
- Published
- 2023
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23. The successful treatment of a Gustilo-Anderson type IIIc distal leg injury with a large bone defect in elderly patient with severe osteoporosis: a case report.
- Author
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Nozaka K, Miyakoshi N, Mita M, and Shimada Y
- Subjects
- Male, Humans, Aged, Teriparatide therapeutic use, Treatment Outcome, External Fixators, Retrospective Studies, Leg Injuries, Tibial Fractures complications, Tibial Fractures diagnostic imaging, Tibial Fractures surgery, Osteoporosis complications
- Abstract
Background: Gustilo-Anderson type IIIc tibial open fracture with large bone defects in elderly patients with severe osteoporosis is a rare injury that may be a challenging clinical scenario., Case Presentation: This study presents the case of a 68-year-old Japanese man who sustained a Gustilo-Anderson type IIIc open tibial fracture with a large bone defect. The patient had severe osteoporosis and the bone was contaminated; therefore, we determined that the bone could not be returned to the tibia. The patient underwent acute limb shortening and gradual lengthening with an Ilizarov external fixator combined with low-intensity pulsed ultrasound and teriparatide administration for limb reconstruction, which allowed immediate full weight-bearing capacity. The fixator was removed at 12 months postoperatively, and by this time, the fracture had completely healed. At the most recent 5-year follow-up after the injury, the patient reported full weight-bearing capacity without walking aids and had full knee and ankle range of motion., Conclusions: To the best of our knowledge, this is the first study to report the use of combined Ilizarov technique, low-intensity pulsed ultrasound, and teriparatide for limb reconstruction of Gustilo-Anderson type IIIc open tibial fractures with large bone defects in elderly patients with severe osteoporosis., (© 2023. BioMed Central Ltd., part of Springer Nature.)
- Published
- 2023
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24. Evaluation of Medial Meniscal Extrusion Using Radiography.
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Murata S, Kijima H, Saito K, Saito H, Miura T, Akagawa M, Tsukamoto H, Sasaki K, Ebina T, Nozaka K, and Miyakoshi N
- Abstract
Recently, there has been increasing interest in medial meniscal extrusion (MME), but few reports have evaluated MME via X-ray. In this study, the amount of MME and meniscal height at the medial border of the tibia were measured via X-ray with gradation processing. The extrusion length divided by the meniscal height yields the meniscal extrusion ratio, which was used as an index. In addition, the medial meniscal length of the part protruding from the medial border of the tibia on MRI was measured as an absolute value. Then, the correlation between the meniscal extrusion ratio and the amount of MME on MRI was examined, and there was a strong correlation between the meniscal extrusion ratio via X-ray and the amount of MME on MRI (correlation coefficient 0.860, p < 0.0001). The cut-off value of the meniscal extrusion ratio via X-ray for positive meniscal extrusion on MRI was 0.50, with an AUC of 0.9825, sensitivity of 0.9063, and specificity of 0.8663. From the present study, it was possible to measure the extrusion length and meniscal height via gradation processing, with X-ray and without MRI, and to calculate the meniscal extrusion ratio, which strongly correlates with the amount of MME on MRI.
- Published
- 2023
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25. Effects of Soft Tissue Sarcoma and Doxorubicin on Bone Metabolism in Mice.
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Kasama F, Tsuchie H, Nagasawa H, Hongo M, Kasukawa Y, Nozaka K, Kudo D, Shoji R, Igarashi S, Harata S, Okamoto K, Oya K, and Miyakoshi N
- Subjects
- Mice, Animals, X-Ray Microtomography, Doxorubicin adverse effects, Femur diagnostic imaging, Tibia diagnostic imaging, Tibia pathology, Bone Density, Sarcoma drug therapy, Sarcoma pathology, Soft Tissue Neoplasms drug therapy, Soft Tissue Neoplasms pathology
- Abstract
Background/aim: This study aimed to evaluate the effects of doxorubicin (Dox) on bone microstructure and metabolism in a mouse model of soft tissue sarcoma., Materials and Methods: CCRF S-180II cells (2-4×10
5 cells/0.2 ml) were injected subcutaneously into the back of mice. The mice were divided into four groups according to tumor and treatment status and were reared and sacrificed after 2 or 4 weeks. Micro-computed tomography (CT) was performed to calculate the architecture of the femoral bone. The proximal tibia was double stained with tartrate-resistant acid phosphatase (TRACP) and alkaline phosphatase (ALP), and bone morphometry was performed., Results: Trabecular bone mass was significantly reduced in the Sarcoma and Sarcoma+Dox groups. Cortical bone thickness was reduced in the DOX group, with a stronger effect observed in the Sarcoma+Dox group. In bone morphometry, osteoclast number at the bone surface (Oc.N/BS) was significantly lower in the Dox, Sarcoma, and Sarcoma+Dox groups than in the Control group at 2 weeks. The osteoblast surface at the bone surface (Ob.S/BS) was significantly lower in the Dox and Sarcoma groups than in the Control group at 2 weeks. At 4 weeks, the differences were smaller for both Oc.N/BS and Ob.S/BS., Conclusion: The use of doxorubicin alone worsened the cortical bone structure; however, the presence of both soft-tissue sarcoma and doxorubicin use worsened both cortical and trabecular bone structures from an early stage., (Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)- Published
- 2023
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26. Intravascular Administration of Acridine Orange and Zoledronate in a Bone Metastasis Model of Breast Cancer.
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Shoji R, Tsuchie H, Nagasawa H, Hongo M, Kasukawa Y, Nozaka K, Kudo D, Saito H, Abe K, Igarashi S, Harata S, Kasama F, and Miyakoshi N
- Subjects
- Animals, Female, Mice, Acridine Orange therapeutic use, Diphosphonates, DNA Nucleotidylexotransferase, Imidazoles therapeutic use, X-Ray Microtomography, Zoledronic Acid therapeutic use, Bone Density Conservation Agents therapeutic use, Bone Neoplasms drug therapy, Bone Neoplasms secondary, Osteolysis drug therapy, Breast Neoplasms drug therapy
- Abstract
Background/aim: This study evaluated the effect of haematogenous administration of acridine orange (AO) alone and in combination with zoledronate (ZOL) on bone metastases., Materials and Methods: E0771 cells (1.0×10
5 cells/10 μl) were injected directly into the right femur of female mice. The mice were divided into five groups according to treatment (drugs and irradiation) and were reared and sacrificed after 6 weeks. Micro-computed tomography (μCT) was performed to calculate the destruction rate of the femur bone. We measured tumour weight and volume at sacrifice and performed terminal deoxynucleotidyl transferase dUTP Nick-End Labelling staining of tumours., Results: At 4 weeks, the bone destruction rate was lower in the AO+ZOL group than in the radiation group. At 6 weeks, the AO+ZOL group had a lower bone destruction rate than the control and radiation groups; the ZOL group had a lower rate than the radiation group. The AO and AO+ZOL groups had suppressed tumour weight and volume compared to the control and radiation groups. The number of extraosseous apoptotic cells was higher in the AO+ZOL group than in all other groups except the AO group., Conclusion: In a model of local bone metastasis of breast cancer, haematogenous administration of AO reduced tumour size and more so when combined with ZOL., (Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)- Published
- 2022
- Full Text
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27. Effects of teriparatide and low-intensity aerobic exercise on osteopenia in type 2 diabetes mellitus rats.
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Abe K, Miyakoshi N, Kasukawa Y, Nozaka K, Tsuchie H, Sato C, Saito H, Shoji R, and Shimada Y
- Subjects
- Animals, Bone Density, Rats, Bone Density Conservation Agents pharmacology, Bone Diseases, Metabolic therapy, Diabetes Mellitus, Type 2 therapy, Physical Conditioning, Animal, Teriparatide pharmacology
- Abstract
Introduction: In patients with type 2 diabetes mellitus (T2DM), bone fragility increases fracture risk. Teriparatide (TPTD) improves bone strength, and exercise therapy suppresses blood glucose levels in T2DM. In this study, the combined effects of TPTD and exercise therapy on trabecular and cortical bone were examined in advanced T2DM model rats., Materials and Methods: Thirty-week-old Otsuka Long-Evans Tokushima Fatty rats were divided into four groups (n = 9-10 in each group at two time points): Cont group (vehicle-treated control), TPTD group (TPTD 30 μg/kg injected subcutaneously, 3 times/week), Exe group (treadmill exercise, 10 m/min, 60 min/day, 5 times/week), and Comb group (TPTD-treated and treadmill exercise combined). Five and 10 weeks after treatment, bone mineral density (BMD), bone strength, and bone micro-architecture were measured., Results: TPTD and combined treatment significantly increased BMDs of the lumbar spine and femur compared to the Cont group (p < 0.05 to p < 0.01). In the three-point bending test of the femur, only combined treatment increased the maximum load at 5 weeks compared with the Cont and Exe groups (p < 0.01). In the compression test of the distal femoral metaphysis, both TPTD and combined treatment increased the trabecular bone strength compared with the Cont and Exe groups (p < 0.05 to p < 0.01). Although TPTD and combined treatment improved the micro-architecture of trabecular bone (p < 0.05 to p < 0.01), only combined treatment improved the micro-structures of cortical bone from 5 weeks of treatment (p < 0.05 to p < 0.01)., Conclusion: The combination of TPTD and treadmill exercise increased BMD and trabecular and cortical bone strength of the femur with improved micro-architecture in T2DM model rats., (© 2021. The Japanese Society Bone and Mineral Research.)
- Published
- 2022
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28. Analysis of bone in adenine-induced chronic kidney disease model rats.
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Saito H, Miyakoshi N, Kasukawa Y, Nozaka K, Tsuchie H, Sato C, Abe K, Shoji R, and Shimada Y
- Abstract
Objectives: The purpose of this study is to investigate the stage of chronic kidney disease (CKD) in adenine-induced CKD model rats by serum analyses, and to examine bone mineral density (BMD), bone strength, and microstructure of trabecular and cortical bone in these rats., Methods: Eight-week-old, male Wistar rats (n = 42) were divided into 2 groups: those fed a 0.75% adenine diet for 4 weeks until 12 weeks of age to generate CKD model rats (CKD group); and sham rats. The CKD and sham groups were sacrificed at 12, 16, and 20 weeks of age (n = 7 in each group and at 12, 16, and 20 weeks), and various parameters were evaluated, including body weight, renal wet weight, muscle wet weight, renal histology, biochemical tests, BMD, biomechanical testing, and micro-computed tomography (CT). The parameters were compared between the 2 groups at the various time points., Results: In the CKD model rats, at 20 weeks of age, serum creatinine, phosphorus, and intact-PTH levels were elevated, and serum calcium levels were normal, indicating that the CKD was stage IV and associated with secondary hyperparathyroidism. Decreased BMDs of the whole body and the femur were observed as bone changes, and micro-CT analysis showed deterioration of bone microstructure of the cortical bone that resulted in decreased bone strength in the cortical and trabecular bone., Conclusions: These CKD model rats showed stage IV CKD and appear appropriate for evaluating the effects of several treatments for CKD-related osteoporosis and mineral bone disorder., Competing Interests: The authors declare no competing interests., (© 2021 The Korean Society of Osteoporosis. Publishing services by Elsevier B.V.)
- Published
- 2021
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29. Open tibial shaft fracture in a boy with autism spectrum disorder treated using a ring external fixator: A case report.
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Mita M, Nozaka K, Miyakoshi N, and Shimada Y
- Abstract
Autism spectrum disorder covers a group of behaviorally defined disorders that may result in the patient having difficulty staying calm during medical treatments, due to anxiety-related overreactions. Tibial fractures are the third most common pediatric long-bone fracture. Conservative treatment is selected in many cases, but surgical treatment may be selected in cases of open fracture and no treatment policy has been established. We described the case of a 6-year-old boy with autism spectrum disorder who was unable to stay calm due to anxiety and required sedation. We diagnosed open tibial shaft fracture (Orthopaedic Trauma Association classification 42A1, 4F2A; Gustilo classification type 1). On the day of injury, we performed osteosynthesis using a ring external fixator and primary closure of the open wound. Full weight-bearing was permitted from immediately after surgery. No significant complications were observed postoperatively, and the external fixator was removed 84 days postoperatively. No abnormal alignment of the lower leg, leg-length discrepancy or range of motion disorder was identified. To the best of our knowledge, no other reports have described use of a ring external fixator for open tibial shaft fractures in children with autism spectrum disorder. Using a ring external fixator appears helpful for open tibial shaft fractures in children who are unable to stay calm due to autism spectrum disorder, because there is no need to limit weight-bearing immediately after surgery. For Gustilo classification type 1 pediatric open fracture, primary closure of the open wound is safe after sufficient bone fixation., (© 2021 The Authors.)
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- 2021
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30. Teriparatide and exercise improve bone, skeletal muscle, and fat parameters in ovariectomized and tail-suspended rats.
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Sato C, Miyakoshi N, Kasukawa Y, Nozaka K, Tsuchie H, Nagahata I, Yuasa Y, Abe K, Saito H, Shoji R, and Shimada Y
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- Absorptiometry, Photon, Animals, Biomarkers metabolism, Biomechanical Phenomena drug effects, Body Weight, Bone Density drug effects, Bone Density Conservation Agents pharmacology, Bone and Bones diagnostic imaging, Bone and Bones drug effects, Female, Femur diagnostic imaging, Femur drug effects, Femur metabolism, Humans, Muscle, Skeletal drug effects, Rats, Wistar, Teriparatide administration & dosage, Tibia diagnostic imaging, Tibia drug effects, Tibia physiology, X-Ray Microtomography, Rats, Adiposity drug effects, Bone and Bones physiology, Hindlimb Suspension, Muscle, Skeletal physiology, Ovariectomy, Physical Conditioning, Animal, Teriparatide pharmacology
- Abstract
Introduction: Although teriparatide (TPTD) and exercise may improve osteoporosis, muscle atrophy, and fat metabolism during ageing, the effects of treatment with a combination of TPTD and exercise on these factors remain unclear. Therefore, this study examined the effects of TPTD and exercise on bone, skeletal muscle, and fat in ovariectomized and tail-suspended rats., Materials and Methods: Seven-month-old female Wistar rats were ovariectomized and subjected to tail suspension. The rats were then randomized into one of the following four groups (n = 20/group) after 4 weeks: control group, treated with TPTD vehicle and no exercise; TPTD group (30 µg/kg TPTD, 3 days/week); Exercise group (treadmill at 12 m/min, 60 min/day, 5 days/week); and Combined group treated with TPTD and treadmill exercise. After 1 and 8 weeks of treatment, bone, skeletal muscle, and fat tissue parameters were evaluated., Results: TPTD improved bone mineral density (BMD), bone structure, bone strength at the femoral metaphysis, and the percentage of skeletal muscle mass, and decreased the percentage of fat mass and the adipose volume in the bone marrow. Treadmill exercise increased BMD, bone strength of cancellous bone, and the percentage of skeletal muscle mass, and decreased the percentage of fat mass as seen on dual-energy X-ray absorptiometry. Furthermore, combined treatment significantly affected BMD, bone structure, and bone strength of cortical bone at the femoral diaphysis., Conclusion: TPTD or treadmill exercise improved bone, skeletal muscle, and fat mass. Combination therapy with TPTD and exercise had synergistic effects on BMD, structure, and bone strength in ovariectomized, tail-suspended rats.
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- 2021
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31. Effectiveness of Ilizarov external fixation in elderly patients with pilon fractures.
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Nozaka K, Miyakoshi N, Saito H, Kijima H, Chida S, Tsuchie H, and Shimada Y
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- Aged, External Fixators, Follow-Up Studies, Fracture Fixation, Internal, Humans, Middle Aged, Range of Motion, Articular, Retrospective Studies, Treatment Outcome, Ankle Injuries, Ilizarov Technique, Tibial Fractures diagnostic imaging, Tibial Fractures surgery
- Abstract
Background: Pilon fractures are associated with soft tissue complications such as skin necrosis, and deep infections have been reported very often. This study retrospectively compared the treatment effects of Ilizarov external fixation and of internal fixation methods in elderly patients with pilon fractures., Methods: A total of 37 patients >60 years old with pilon fractures (AO classification type 43) were investigated. Patients were treated either with internal fixation (n = 15) or Ilizarov external fixation (n = 22). The patients' mean age was 74.2 (range, 60-78) years in the internal fixation group and 76.1 (range, 60-82) years in the Ilizarov external fixation group. Many patients in the internal fixation group received toe-touch to 1/3 partial weight-bearing at 2-4 weeks postoperatively and full weight-bearing by 6-8 weeks postoperatively. Many patients in the Ilizarov external fixation group received partial weight-bearing (as tolerated) 1 day postoperatively, 1/2 partial weight-bearing at 2 weeks postoperatively, and full weight-bearing at 4 weeks postoperatively., Results: The mean duration of hospitalization was 79.1 ± 30.1 days for the internal fixation group and 29.1 ± 18.8 days for the Ilizarov external fixation group (p < 0.05). Bone mineral density (T-score) was 2.6 ± 0.7 for the internal fixation group and 3.6 ± 1.2 for the Ilizarov external fixation group (p < 0.05). The incidence of skin disorders that required additional surgical treatment was 33.3% (5/15 patients) in the internal fixation group and 0% (0/22 patients) in the Ilizarov external fixation group (p < 0.05)., Conclusions: In elderly patients with periarticular fractures of the ankle, those who underwent Ilizarov external fixation had a shorter duration of hospitalization and fewer complications than those who underwent internal fixation., Competing Interests: Declaration of Competing Interest Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2021
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32. A phase II study of FOLFOXIRI plus bevacizumab as initial chemotherapy for patients with untreated metastatic colorectal cancer: TRICC1414 (BeTRI).
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Shinozaki K, Yamada T, Nasu J, Matsumoto T, Yuasa Y, Shiraishi T, Nagano H, Moriyama I, Fujiwara T, Miguchi M, Yoshida R, Nozaka K, Tanioka H, Nagasaka T, Kurisu Y, Kobayashi M, Tsuchihashi K, Inukai M, Kikuchi T, and Nishina T
- Subjects
- Adult, Aged, Bevacizumab administration & dosage, Bevacizumab adverse effects, Camptothecin administration & dosage, Camptothecin adverse effects, Camptothecin analogs & derivatives, Disease-Free Survival, Female, Fluorouracil administration & dosage, Fluorouracil adverse effects, Humans, Leucovorin administration & dosage, Leucovorin adverse effects, Male, Middle Aged, Organoplatinum Compounds administration & dosage, Organoplatinum Compounds adverse effects, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Colorectal Neoplasms drug therapy
- Abstract
Purpose: FOLFOXIRI plus bevacizumab is regarded as a first-line therapeutic option for selected patients with metastatic colorectal cancer (mCRC). Our aim was to assess the efficacy and safety of induction treatment with FOLFOXIRI plus bevacizumab in patients with untreated mCRC harboring UGT1A1 wild (*1/*1), or single-hetero (*1/*6 or *1/*28) genotypes., Methods: Twelve cycles of FOLFOXIRI plus bevacizumab were administered to patients with untreated mCRC. The primary endpoint was the overall response rate (ORR) assessed by central independent reviewers. Secondary endpoints included time to treatment failure (TTF), progression-free survival (PFS), overall survival (OS), relative dose intensity (RDI), R0 resection rate, and safety. The exploratory objectives were early tumor shrinkage (ETS) and depth of response (DoR)., Results: Of the 47 patients enrolled, 46 and 44 patients were eligible for the safety and efficacy analysis, respectively. The primary endpoint was met. The ORR was 63.6% (95% CI 47.8-77.6). At a median follow-up of 25.4 months, median TTF, PFS, and OS was 8.1, 15.5, and 34.4 months, respectively. The median RDI of 5-fluorouracil, irinotecan, oxaliplatin, and bevacizumab was 72, 69, 62, and 71%, respectively. R0 resection rate was 22.7%. Grade 3 or higher adverse events (≥ 10%) included neutropenia (65.2%), febrile neutropenia (26.1%), leukopenia (23.9%), anorexia (10.9%), nausea (10.9%), and diarrhoea (10.9%). No treatment-related deaths were observed. ETS and DoR were 70.5 and 45.4%, respectively., Conclusions: FOLFOXIRI plus bevacizumab induction treatment of Japanese patients was shown to be beneficial and manageable, although caution is required since the treatment causes febrile neutropenia.
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- 2021
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33. Evaluation of factors affecting the occurrence of second atypical fracture after bone union of the first atypical fracture.
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Tsuchie H, Miyakoshi N, Kasukawa Y, Nozaka K, Saito K, Kinoshita H, Kobatyashi M, Suzuki N, Aizawa T, Abe H, Maekawa S, Tomite T, Ono Y, Ouchi K, Shibata N, Nagahata I, Takeshima M, Akagawa M, Yuasa Y, Sato C, and Shimada Y
- Subjects
- Diphosphonates, Humans, Teriparatide, Bone Density Conservation Agents therapeutic use, Femoral Fractures diagnostic imaging, Femoral Fractures drug therapy, Osteoporosis diagnostic imaging, Osteoporosis drug therapy, Osteoporotic Fractures
- Abstract
Purpose: Teriparatide is sometimes used in the treatment of atypical femoral fracture (AFF). Even if bone union is achieved, orthopedic physicians must consider the risk of relapse. This study aimed to investigate the factors affecting AFF recurrence, and to determine the appropriate treatment for osteoporosis after bone union., Methods: One hundred thirty-one consecutive AFFs in 113 Japanese patients were included. Eleven patients had AFF in the unaffected limb (9 patients) after the first AFF or re-fracture at the original fracture site (2 patients) after bone union of the first AFF was confirmed. We divided all patients into two groups: the second fracture group (22 AFFs in 11 patients) and non-second fracture group (109 AFFs in 102 patients). We compared clinical information between the 2 groups and investigated the factors affecting AFF recurrence using the Student t-, Welch t-, and chi-square tests., Results: Although there was no significant difference in clinical characteristics between the 2 groups, multivariate analysis of factors associated with AFF recurrence identified short duration of treatment with teriparatide and active vitamin D
3 (p = 0.0408 and 0.0366, respectively) as risk factors. Even in the analysis excluding subtrochanteric AFF, short periods of teriparatide and active vitamin D3 administration were observed as risk factors (p = 0.0484 and 0.0346, respectively)., Conclusion: The administration of teriparatide for as long as possible after occurrence first AFF and the use of active vitamin D3 after completion of teriparatide therapy may be the most effective strategy to prevent the recurrence of AFF., (Copyright © 2020 Elsevier Inc. All rights reserved.)- Published
- 2021
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34. Evaluation of the Nature and Etiologies of Risk Factors for Diaphyseal Atypical Femoral Fractures.
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Tsuchie H, Miyakoshi N, Kasukawa Y, Nozaka K, Saito K, Kinoshita H, Kobayashi M, Suzuki N, Aizawa T, Abe H, Maekawa S, Tomite T, Ono Y, Ouchi K, Shibata N, Nagahata I, Takeshima M, Akagawa M, Yuasa Y, Sato C, and Shimada Y
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- Female, Femoral Fractures diagnostic imaging, Femoral Fractures epidemiology, Humans, Japan, Radiography, Risk Factors, Diaphyses, Femoral Fractures etiology, Femur diagnostic imaging, Osteoporosis
- Abstract
Objectives: Differences in mechanisms of subtrochanteric and diaphyseal atypical femoral fractures (AFFs) are speculated in studies that analyzed differences in the patients' background. However, the etiologies of each type of AFF have not been studied in detail. This study aimed to investigate the nature and etiologies of the risk factors for diaphyseal AFFs., Materials and Methods: Eighty consecutive Japanese patients with 91 diaphyseal AFFs (AFF group) and 110 age-matched women with osteoporosis (non-AFF control group) were included. Their clinical data were compared; factors affecting AFFs were investigated, and the etiologies of the risk factors for diaphyseal AFFs were examined., Results: Multivariate analysis revealed that femoral serrated changes, bisphosphonate or denosumab usage, and lateral and anterior femoral curvatures were risk factors for diaphyseal AFFs (p < 0.0011, p = 0.0137, and p < 0.0001, respectively). Multivariate analyses revealed that serrated changes and low serum 25(OH)D levels affected the lateral curvature (p = 0.0088 and 0.0205, respectively), while serrated changes affected the anterior curvature (p = 0.0006), each significantly affected the femoral curvature. High serum calcium (Ca) levels, lateral femoral curvature, and anterior femoral curvature were predictors of serrated changes (p = 0.0146, 0.0002, and 0.0098, respectively)., Conclusion: Risk factors for diaphyseal AFFs were bone resorption inhibitor usage, a strong femoral curvature, and serrated changes. Low serum 25(OH)D levels and serrated changes are risk factors for lateral curvature, while a high serum Ca level is a risk factor for serrated changes., (© 2021 The Author(s) Published by S. Karger AG, Basel.)
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- 2021
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35. A new double level osteotomy procedure to restore a joint line and joint angles in severe varus osteoarthritis. - Double level osteotomy associated with tibial condylar valgus osteotomy (DLOTO).
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Saito H, Yonekura A, Saito K, Shimada Y, Yamamura T, Sato T, Nozaka K, Kijima H, Fujii M, Kawano T, Murata S, and Miyakoshi N
- Abstract
High tibial valgus osteotomy (HTO) is a well-established surgical procedure to correct a varus malalignment and treat medial compartment osteoarthritis. Recently, double level osteotomy (DLO) was recommended for extensive varus knees as a single level osteotomy (SLO) approach may create an excessive joint line obliquity and eventually result in a new bony deformity. However, a severe varus knee in cases of advanced osteoarthritis involves not only a bony deformity (extra-articular deformity) but also a medial joint space narrowing with a widened lateral joint space (intra-articular deformity). A DLO alone cannot reduce this intra-articular deformity. However, tibial condylar valgus osteotomy (TCVO) can complement DLO as to reduce this intra-articular deformity. This technical note describes a novel modified DLO procedure associated with TCVO which can restore a normal alignment and a joint line and achieve joint preservation even in cases of extensive varus osteoarthritis., Competing Interests: The authors declare no conflicts of interest in relation to this study., (© 2020 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.)
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- 2020
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36. Effectiveness of circular hexapod external fixation with soft tissue reconstruction in treating severe knee dislocation due to burn scarring: a case report.
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Nozaka K, Miyakoshi N, Saito H, Kijima H, Mita M, and Shimada Y
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- Cicatrix complications, Cicatrix diagnostic imaging, External Fixators, Female, Fracture Fixation, Humans, Knee Joint, Middle Aged, Knee Dislocation complications, Knee Dislocation diagnostic imaging, Knee Prosthesis
- Abstract
Background: Severe varus deformity and soft tissue injury caused by a burn around a complex knee dislocation is a rare injury. Soft tissue reconstruction and deformity correction with circular hexapod external fixation of the knee and hinged total knee arthroplasty (TKA) are challenging and can lead to major complications if not performed appropriately. We present a case in which a combination of soft tissue reconstruction, circular hexapod external fixation, and TKA was used treat severe knee dislocation due to burn scarring., Case Presentation: We report the case of a 58-year-old woman who presented for knee surgery with soft tissue reconstruction, deformity correction with circular hexapod external fixation, and hinged TKA for a severe complex deformity and soft tissue injury caused by a burn injury at 6 months of age. The left leg was shorter by 35 mm in terms of functional leg length discrepancy. She walked with a limp, with a marked varus deformity of the left knee during the stance phase of walking. After a 3-stage repair, the patient was able to walk without assistance, confirming improvement of mobility., Conclusion: The treatment method was an effective use of a combination of soft tissue reconstruction, circular hexapod external fixation, and rehearsal surgery using a 3D printed bone model of the modular rotating hinge component of TKA, which was successfully used to treat a severe knee dislocation due to burn scarring. This staged surgery maintained the leg length and ultimately achieved a satisfactory alignment.
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- 2020
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37. Successful treatment of a habitual patellar dislocation after a total knee arthroplasty with a closing-wedge distal femoral varus osteotomy and medial patello-femoral ligament reconstruction.
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Saito H, Saito K, Shimada Y, Yamamura T, Sato T, Nozaka K, Kijima H, Fujii M, Kawano T, and Miyakoshi N
- Abstract
A 68-year-old female suffering from habitual patellar dislocations following a mal-positioned total knee arthroplasty (TKA) was successfully treated with a biplanar closed wedge distal femoral osteotomy (CWDFO) and medial patello-femoral ligament (MPFL) reconstruction. To the best of our knowledge, no such case has been previously described. Our experience with this case suggests that treatment for a patella dislocation following valgus mal-positioning of TKA should be considered positively. LEVEL OF EVIDENCE: V.
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- 2020
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38. Effectiveness of circular external fixator in periprosthetic fractures around the knee.
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Nozaka K, Miyakoshi N, Hongo M, Kasukawa Y, Saito H, Kijima H, Tsuchie H, Mita M, and Shimada Y
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- Aged, Aged, 80 and over, Bone Plates, Comorbidity, Female, Humans, Male, Middle Aged, Periprosthetic Fractures diagnostic imaging, Radiography, Reoperation, Retrospective Studies, Survival Rate, Tibial Fractures diagnostic imaging, Arthroplasty, Replacement, Knee, External Fixators, Fracture Fixation, Internal methods, Periprosthetic Fractures surgery, Tibial Fractures surgery
- Abstract
Background: The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. The usefulness of circular external fixation for periprosthetic fractures has been reported in several case studies. The aim of this study was to investigate the rate of union and complications associated with circular external fixation in periprosthetic fractures around the knee., Methods: We included 19 patients with periprosthetic femur and tibial fractures who underwent osteosynthesis using a circular external fixator and had at least 2 years of follow-up. All patients had comorbidities and high risks associated with anesthesia. Tourniquets were not used in any of the patients. There were no cases in which the skin incision was placed, and the closed reduction technique was used in all cases., Results: A 100% union rate was achieved with no serious complications. All fractures healed after a mean time of 14.3 ± 5.2 weeks (range, 8-38 weeks). The walking ability was the same level as before the injury in 13 cases., Discussion: There are many comorbidities associated with periprosthetic fractures in elderly patients. Double-plate or revision surgery were largely invasive and had high risks associated with anesthesia. Circular external fixation is a feasible and effective treatment option because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients who are treated for periprosthetic fractures., Conclusion: Circular external fixation is a safe and reliable method for periprosthetic fractures around the knee in elderly patients., Level of Evidence: Level IV, retrospective case series.
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- 2020
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39. Combined Use of Taylor Spatial Frame and Wake-up Test for Acute Correction of Idiopathic External Torsion of the Tibia: A Case Report.
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Nozaka K, Miyakoshi N, Saito H, Kijima H, and Shimada Y
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Introduction: We herein report a case of idiopathic unilateral external torsion of the tibia treated with Taylor spatial frame (TSF) fixation combined with performance of the wake-up test under anesthesia. The wake-up test is performed toward the end of a surgical procedure after all corrections have been made and hardware has been placed. The patient is slowly awakened and asked to move their feet. After recovery from anesthesia, patients do not remember performing this test., Case Report: A 17-year-old Japanese male patient complained of a gait disturbance because of external torsion of his foot. The patient was determined to have lateral tibial torsion with a pre-operative foot progression angle of 40.8°. Deformity correction using the TSF was considered to be safe. The tibia was derotated by -34.8°, and the patient had a post-operative foot progression angle of 7.0°. His symptoms and signs improved after derotation osteotomy at the low tibial portion. Two years postoperatively, the patient exhibited no leg length discrepancy or rotation malalignment of the lower extremities as measured both clinically and radiographically., Conclusion: To the best of our knowledge, there are no reports on the combined use of the TSF and wake-up test for acute correction of idiopathic external torsion of the tibia. Intraoperative use of the wake-up test with subsequent TSF fixation is effective and safe for acute correction of limb deformities., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)
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- 2020
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40. Ilizarov external fixation for a periprosthetic tibial fracture in severe osteoporosis: a case report.
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Nozaka K, Miyakoshi N, Sato T, and Shimada Y
- Subjects
- Aged, 80 and over, Female, Humans, Osteoporosis diagnostic imaging, Osteoporosis surgery, Osteoporotic Fractures diagnostic imaging, Periprosthetic Fractures diagnostic imaging, Periprosthetic Fractures etiology, Tibial Fractures diagnostic imaging, Arthroplasty, Replacement, Knee adverse effects, External Fixators, Osteoporotic Fractures surgery, Periprosthetic Fractures surgery, Severity of Illness Index, Tibial Fractures surgery
- Abstract
Background: The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is rising due to the increasing number of TKAs performed annually and the growing elderly population. A periprosthetic fracture of the proximal tibia following TKA is a rare injury that may be a challenging clinical scenario., Case Presentation: The case of an 84-year-old woman who sustained a periprosthetic tibial fracture 10 years after a TKA is presented. This patient had multiple risk factors. The fracture was not deemed amenable to conventional treatment because the bone fragment was too small. This patient underwent fixation of her tibial fracture above the TKA using a five-ring Ilizarov external fixator. This allowed immediate full weight-bearing. The fixator was removed at 12 weeks, at which time the fracture was solidly healed. At the most recent follow-up, 2 years from injury, she was fully weight-bearing without walking aids and had a knee range of motion (ROM) of 0-110°., Conclusion: To the best of our knowledge, this is the first report in which Ilizarov external fixation has been used for a periprosthetic tibial fracture after TKA.
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- 2020
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41. Effects of bazedoxifene and low-intensity aerobic exercise on bone and fat parameters in ovariectomized rats.
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Yuasa Y, Miyakoshi N, Kasukawa Y, Nagahata I, Akagawa M, Ono Y, Sato C, Tsuchie H, Nozaka K, Nagasawa H, Hongo M, and Shimada Y
- Subjects
- Absorptiometry, Photon, Animals, Biomechanical Phenomena, Body Weight drug effects, Bone Density drug effects, Female, Humans, Lumbar Vertebrae drug effects, Organ Size drug effects, Rats, Sprague-Dawley, Adiposity drug effects, Indoles pharmacology, Ovariectomy, Physical Conditioning, Animal
- Abstract
Introduction: Postmenopausal osteoporosis and dyslipidemia are well-known skeletal and metabolic changes in middle-aged women. We investigated the effects of combined treatments with a selective estrogen receptor modulator (SERM) and exercise on bone and fat parameters in ovariectomized (OVX) rats., Materials and Methods: Sixteen-week-old female Sprague-Dawley rats underwent bilateral ovariectomy, and rats were randomized to BZA (bazedoxifene at 0.3 mg/kg/day), Exe (treadmill exercise at 12-15 m/min, 60 min/day, 5 days/week), Comb (BZA and Exe), and Cont (control treated with vehicle and no exercise) groups 8 weeks after ovariectomy. After 4 or 8 weeks of treatment, bone mineral density (BMD) of the total femur and lumbar spine and whole-body percentage fat mass were determined by dual-energy X-ray absorptiometry, and mechanical testing of the femoral shaft, and bone and fat histomorphometric analyses of the proximal tibia were performed., Results: Treadmill exercise had decreased bone marrow adipocytes from 4 weeks of treatment and whole-body percentage fat mass at 8 weeks. BZA increased BMD at the lumbar spine and decreased the whole-body percentage fat mass from 4 weeks and bone marrow adipocytes at 8 weeks. Combination therapy increased BMD for the lumbar spine and decreased bone marrow adipocytes and whole-body percentage fat mass from 4 weeks., Conclusion: Combination therapy with BZA and exercise appears effective to improve bone and fat parameters in OVX rats.
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- 2020
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42. Screw Internal Fixation and Ilizarov External Fixation: A Comparison of Outcomes in Ankle Arthrodesis.
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Teramoto A, Nozaka K, Kamiya T, Kashiwagura T, Shoji H, Watanabe K, Shimada Y, and Yamashita T
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- Aged, Aged, 80 and over, Ankle Joint diagnostic imaging, External Fixators, Female, Humans, Male, Middle Aged, Radiography, Treatment Outcome, Ankle Joint surgery, Arthrodesis methods, Bone Screws, Ilizarov Technique instrumentation, Osteoarthritis surgery
- Abstract
The purpose of this study was to compare the mid-term clinical outcomes between screw internal fixation and Ilizarov external fixation in patients who underwent ankle arthrodesis and to elucidate the differences between the 2 fixation methods. This study investigated 43 ankles in 41 patients who underwent ankle arthrodesis at 1 of the 2 study institutions. There were 15 men and 26 women, and their mean age was 66.2 (range 49 to 87) years. The primary disease included osteoarthritis (OA) (79%), rheumatoid arthritis (RA) (16.3%), and Charcot joint (4.7%). Patients were divided into 2 groups depending on the surgical approach: the screw group (S) and the Ilizarov group (I). The following items were evaluated and compared between the 2 groups: patient characteristics, Tanaka-Takakura classification based on preoperative plain X-ray images, duration of surgery, blood loss, surgical complications, time to start weightbearing, and the Japanese Society of Surgery of the Foot (JSSF) standard rating system for the ankle-hindfoot. Duration of surgery was significantly shorter in the S group (162.3 versus 194.9 min), and the amount of blood loss was also significantly lower in the S group (29.2 versus 97.5 ml). Preoperative JSSF scale was significantly lower in the I group (44.8 versus 33), but postoperative JSSF scale was not significantly different between the 2 groups (82.1 versus 77.9). The S group had satisfactory clinical outcomes with a shorter duration of surgery and smaller amount of blood loss than the I group. However, severe patients in the I group achieved similar treatment outcomes., (Copyright © 2019 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
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- 2020
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43. Effectiveness of distal tibial osteotomy with distraction arthroplasty in varus ankle osteoarthritis.
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Nozaka K, Miyakoshi N, Kashiwagura T, Kasukawa Y, Saito H, Kijima H, Chida S, Tsuchie H, and Shimada Y
- Subjects
- Aged, Aged, 80 and over, Ankle Joint diagnostic imaging, Arthritis, Rheumatoid surgery, Arthroplasty instrumentation, Arthroscopy methods, Exercise, Female, Humans, Male, Middle Aged, Postoperative Complications, Recovery of Function, Severity of Illness Index, Synovectomy methods, Visual Analog Scale, Weight-Bearing, Ankle Joint surgery, Arthroplasty methods, External Fixators, Osteoarthritis surgery, Osteotomy methods
- Abstract
Background: In highly active older individuals, end-stage ankle osteoarthritis has traditionally been treated using tibiotalar arthrodesis, which provides considerable pain relief. However, there is a loss of ankle joint movement and a risk of future arthrosis in the adjacent joints. Distraction arthroplasty is a simple method that allows joint cartilage repair; however, the results are currently mixed, with some reports showing improved pain scores and others showing no improvement. Distal tibial osteotomy (DTO) without fibular osteotomy is a type of joint preservation surgery that has garnered attention in recent years. However, to our knowledge, there are no reports on DTO with joint distraction using a circular external fixator. Therefore, the purpose of this study was to examine the effect of DTO with joint distraction using a circular external fixator for treating ankle osteoarthritis., Methods: A total of 21 patients with medial ankle arthritis were examined. Arthroscopic synovectomy and a microfracture procedure were performed, followed by angled osteotomy and correction of the distal tibia; the ankle joint was then stabilized after its condition improved. An external fixator was used in all patients, and joint distraction of approximately 5.8 mm was performed. All patients were allowed full weight-bearing walking immediately after surgery., Results: The anteroposterior and lateral mortise angle during weight-bearing, talar tilt angle, and anterior translation of the talus on ankle stress radiography were improved significantly (P < 0.05). Signal changes on magnetic resonance imaging also improved in all patients. Visual analog scale and American Orthopedic Foot & Ankle Society scores improved significantly (P < 0.05), and no severe complications were observed., Conclusion: DTO with joint distraction may be useful as a joint-preserving surgery for medial ankle osteoarthritis in older patients with high levels of physical activity., Level of Evidence: Level IV, retrospective case series.
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- 2020
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44. Simultaneous Total Knee Arthroplasty and Ankle Arthrodesis for Charcot Neuroarthropathy.
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Nozaka K, Miyakoshi N, Yuasa Y, Mita M, and Shimada Y
- Abstract
Introduction: Charcot neuroarthropathy is a progressive, deforming pathology of the bone and joints, especially affecting the knees and ankles. Although it is rare, it leads to considerable morbidity. The treatment of Charcot arthropathy of the knee and ankle remains controversial. Many authors suggest that knee involvement is an absolute contraindication to total knee arthroplasty. In recent years, however, several studies have shown satisfactory results for total knee arthroplasty. In the ankle, external fixators have recently been advocated by many authors. Their main advantages are that they permit monitoring of soft tissue healing and avoidance of more invasive surgery. Simultaneous Charcot knee and ankle joint surgery involving total knee arthroplasty (TKA) and ankle arthrodesis is rare and challenging and can lead to major complications if not addressed appropriately., Case Presentation: The case of a 71-year-old woman who underwent simultaneous total knee arthroplasty and ankle arthrodesis for severe neurosyphilitic Charcot arthropathy (Eichenholtz classification stage III) and was evaluated three years after surgery is reported. Deformities of the left knee joint and ankle developed. The left leg was shorter by 20 mm, with a functional leg length discrepancy. The patient was limping, and marked varus instability of the left ankle was observed during the stance phase of walking. Postoperatively, the patient was able to walk without assistance, confirming improvement of mobility., Conclusion: To the best of our knowledge, this is the first report of combined, simultaneous neurosyphilitic Charcot knee and ankle joint surgery involving TKA and ankle arthrodesis. It was an effective surgical method that maintained leg length and achieved satisfactory alignment without an autologous iliac bone graft., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2019 Koji Nozaka et al.)
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- 2019
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45. Short-Term Results of Hybrid Closed-Wedge High Tibial Osteotomy: A Case Series with a Minimum 3-Year Follow-up.
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Saito H, Saito K, Shimada Y, Yamamura T, Yamada S, Sato T, Nozaka K, Kijima H, and Miyakoshi N
- Abstract
Purpose: High tibial valgus osteotomy (HTO) is a well-established surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closed-wedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the short-term results in a consecutive series of patients treated with hybrid CWHTO., Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average follow-up of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The Kellgren-Lawrence grading system and pre- and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed., Results: The FTA and MA significantly changed from 180.7° to 170.4° and from 22.0° to 60.2°, respectively. No significant differences were observed between the mean pre- and postoperative posterior tibial slope, Insall-Salvati ratio, or Caton-Deschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively., Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.
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- 2018
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46. Enhanced bone healing and decreased pain in sacral insufficiency fractures after teriparatide treatment: retrospective clinical-based observational study.
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Kasukawa Y, Miyakoshi N, Ebina T, Hongo M, Ishikawa Y, Kudo D, Nozaka K, and Shimada Y
- Abstract
The purpose of this retrospective clinical-based observational study was to evaluate the effects of teriparatide (TPTD) on clinical outcomes and radiologic findings of sacral insufficiency fractures (SIFs). Seven elderly women with SIFs received TPTD for at least 6 months. We evaluated the symptoms, pain, and radiological findings. At their initial clinic visit, 86% patients could not walk or sit. Computed tomography (CT) images revealed sacral wing fracture in 6 patients, and bone scintigram showed H-shaped uptake over the bilateral sacral wings in 1 patient. After the treatment, 5 patients could walk. Mean visual analog scale score was significantly lower after (12.9 mm) than before (87.4 mm) TPTD treatment (p < 0.0001). CT images revealed bone union (four patients) and sclerotic changes (three patients) at the fracture sites. Seven elderly women with SIFs had significant improvement in pain and demonstrated bone union or sclerotic changes at fracture sites by TPTD., Competing Interests: Competing interests The Authors declare that they have no competing interests.
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- 2017
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47. 3. Can Combined Therapy With Teriparatide and Low-Intensity Pulsed Ultrasound (LIPUS) Accelerate Fracture Healing?
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Nozaka K, Shimada Y, Miyakoshi N, Yamada S, Hongo M, Nagasawa H, Kasukawa Y, Saito H, Kijima H, and Tsuchie H
- Abstract
Background: It is an advantage for orthopaedic surgeons to remove an Ilizarov external fixator as early as possible after surgery. Although both teriparatide and low-intensity pulsed ultrasound (LIPUS) have been found to accelerate fracture-healing processes, the effect of the combination of teriparatide and LIPUS in clinical bone fracture management remains unclear., Subjects: From among 721 patients with a lower limb fracture on admission to our department who underwent surgical treatment for a lower limb fracture with an Ilizarov external fixator, 38 patients over 60-year-old were investigated. Patients were either treated with an Ilizarov external fixator alone (IEF alone, n = 20) or an Ilizarov external fixator combined with teriparatide and LIPUS (IEF combination, n = 18). The patients' mean age was 64.1 years (range, 60-79 years) in the IEF alone group and 67.2 years (range, 60-83 years) in the IEF combination group. Teriparatide (20 μg subcutaneous injection daily or 56.5 μg subcutaneous injection once-weekly) and LIPUS (20 min/d) were started immediately after surgery for the IEF combination group in an attempt to accelerate healing of the lower limb fracture with the Ilizarov external fixator., Results: The mean time to union was 111.9 days (range, 94-175 days) for IEF alone and 72.1 days (range, 68-141 days) for the IEF combination; it was significantly shorter with the IEF combination. Bone density (relative to young adult mean, YAM) was 61.3% (range, 38%-82%) for IEF alone and 52.1% (range, 30%-79%) for the IEF combination. The mean AOFAS score was 86.2 (range, 72-100) for IEF alone and 91.2 (range, 82-100) for the IEF combination., Discussion: In elderly patients with lower limb fractures, combined therapy (teriparatide and LIPUS) showed a shorter mean duration of union than the Ilizarov external fixator alone. Combined therapy with teriparatide and LIPUS may become a useful option in the treatment of elderly patients with lower limb fractures.
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- 2016
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48. Comminuted distal humeral fracture treated using the Ilizarov technique in a patient with rheumatoid arthritis and osteoporosis.
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Chida S, Nozaka K, Miyakoshi N, Yamada S, Miyamoto S, Nagasawa H, Kijima H, Sugimura Y, and Shimada Y
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The goal of treatment for distal humeral fractures in patients with rheumatoid arthritis (RA) is to obtain sufficient bone union and good elbow function. However, treating comminuted distal humeral fractures in patients with RA and osteoporosis is challenging. We present the case of a 58-year-old woman with RA and osteoporosis who suffered a comminuted distal humeral fracture and was successfully treated with the Ilizarov technique. The Ilizarov technique is minimally invasive compared with conventional open surgery, can obtain good stabilization, and allows earlier rehabilitation, even if the fractured bone is severely osteoporotic. The patient exhibited good elbow function and alignment at the final follow-up examination (18 postoperative months). To the best of our knowledge, the present case is the first in which a comminuted distal humeral fracture in a patient with RA and severe osteoporosis was successfully treated with an Ilizarov external fixator.
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- 2016
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49. Arthroscopic quadriceps tendon repair: two case reports.
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Saito H, Shimada Y, Yamamura T, Yamada S, Sato T, Nozaka K, Kijima H, and Saito K
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Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.
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- 2015
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50. Relationship between Pain and Medial Meniscal Extrusion in Knee Osteoarthritis.
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Kijima H, Yamada S, Nozaka K, Saito H, and Shimada Y
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Purpose. In knee osteoarthritis, the degree of pain varies despite similar imaging findings. If there were quantitative findings related to the pain of knee osteoarthritis, it could be used for diagnosis or screening. The medial meniscal extrusion was investigated as a candidate quantitative finding related to the pain of knee osteoarthritis. Methods. Seventy-six knees of 38 patients (mean age, 73 years) who received intra-articular injections of hyaluronic acid into unilateral knees at the time of diagnosis of knee arthritis were investigated. Cartilage thickness of the femoral medial condyle and medial meniscal extrusion of bilateral knees were measured by ultrasonography. Thirty-eight knees that had hyaluronic acid injections were compared with 38 other side knees from the same patients as the control group. Results. The average cartilage thicknesses of the knees with pain that received intra-articular injections and the knees without pain that received no injections were 1.02 and 1.05 mm, respectively (P = 0.6394). On the other hand, the average medial meniscal extrusions of the knees with and without pain were 7.58 and 5.88 mm, respectively (P = 0.0005); pain was associated with greater medial meniscal extrusions. Conclusion. Medial meniscal extrusion is a quantitative finding related to the pain of knee osteoarthritis.
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- 2015
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