Yuichi Mochida

Yokohama City University, Yokohama, Kanagawa, Japan

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Publications (26)100.42 Total impact

  • K. Ishii · Y. Mochida · Y. Yamada · N. Mitsugi · T. Saito

    No preview · Article · Jun 2014 · Annals of the Rheumatic Diseases
  • Y. Mochida · K. Ishii · Y. Yamada · N. Mitsugi · T. Saito
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    ABSTRACT: Background In advanced cases of rheumatoid arthritis (RA), Swanson implant have been widely used for hallux valgus deformity. Although the results of this surgery were acceptable, relatively high incidence of recurrence of hallux valgus deformity were reported. In this study, we analyzed the incidence of the recurrence of hallux valgus deformity after Swanson implant surgery, then analyzed for the factors which affect the recurrence of the hallux valgus. Objectives Post-operative radiological results of implant surgery for hallux in RA with the minimum follow-up of 12 months after surgery were analyzed in 54 cases, 87 joints (3 male cases, 51 female cases). The mean age at the time of surgery was 67.7±6.9 years (53–84). The mean duration after surgery was 40.8±21.6 months (12–93). Methods Post-operative hallux valgus angle (HVA) was analyzed at pre-, immediate after surgery, 6 months after surgery, and final follow-up. The change of HVA between immediate after surgery and the final follow-up was calculated. The radiological results were evaluated using modified Granberry's grading. The toe lengths of hallux including soft tissue shadow after surgery were divided into three groups using the radiographical of each toe as follows; Type 1 (hallux length is 3 mm longer than 2nd toe length), Type 3 (hallux length is 3 mm shorter than 2nd toe length), and Type 2 (hallux length is within 3 mm of 2nd toe length). Results The averaged HVA was significantly decreased after surgery, and maintained during follow-up period. There were no statistical correlation between the changes of HVA and follow-up period, pre-operative HVA, and HVA at immediate after surgery. For the toe lengths of hallux, 24 cases were Type 1, 20 cases were Type 2, and 11 cases were Type 3. Type 3 showed significantly less changes of HVA when compared to Type 1. Also, with the shortening of the length of hallux by toe lengths type, the HVA at the final follow-up was significantly decreased. There were no relationship between HVA and Granberry's grading. Conclusions Improvement of disease activity of RA, total number of RA surgery, especially for large joints has been decreasing. In contrast, the numbers of surgeries for small joints such as finger and toe arthroplasty are increasing. Based on this recent trend of changes of surgery, better clinical and radiological results for small joints will be needed to improve patients' quality of life. Our result clearly showed that the shorter the lengths of hallux, significantly less changes of HVA and HVA at the final follow-up, that may reflect better surgical results of hallux valgus deformity. Disclosure of Interest Y. Mochida Grant/research support: Bristol-Myers Squibb, Takeda Pharmaceutical Company Limited, Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Teijin Limited, Chugai Pharmaceutical Co., Ltd, Astellas Pharma Inc., K. Ishii: None declared, Y. Yamada: None declared, N. Mitsugi: None declared, T. Saito: None declared DOI 10.1136/annrheumdis-2014-eular.1090
    No preview · Article · Jun 2014 · Annals of the Rheumatic Diseases
  • K. Harigane · Y. Mochida · K. Ishii · Y. Yamada · N. Mitsugi · T. Saito
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    ABSTRACT: Background Some studies reported that patients with rheumatoid arthritis (RA) have a high risk of falls compared with healthy aged people1)2). Pain in the lower extremities and impairment in walking were reported to be associated with falls in patients with RA2)3). Orthopaedic lower limb surgeries are often performed for joint pain or deformation. After surgery, the incidence of falls might decrease, however, there were few studies about the incidences and risk factors of falls in patients with RA after lower limb surgeries. Objectives The aims of current study were to examine the incidences of falls and to analyze the risk for falls in RA patients in association with lower limb surgeries. Methods Self-reported questionnaires were performed for 141 patients (121 female and 20 male) who came to our hospital for regular visit from July 2010 to April 2011. Patients who underwent surgery within a year or could not walk were excluded. The incidences of falls in patients who underwent lower limb surgeries (71 cases, 115 surgeries) were compared to patients with no history of surgery (70 cases). With regard to procedures, total knee arthroplasty was performed in 44 cases, toe plasty was in 28 cases, total hip arthroplasty was in 14 cases, and others were 29 cases. Results The incidence rate of falls in patients who underwent lower limb surgery was significantly fewer than in patients with no history of surgery (9.8% vs. 38.6%, p<0.01). Among the patients with history of surgery, Disease Activity Score (DAS) 28-CRP(4) was significantly higher in the fall group than in the no-fall group (3.53 vs. 2.68, p<0.01). Tender joint counts was also significantly higher in the fall group than in the no-fall group (2.6 vs. 1.5, p<0.05). There was no correlation between types of surgery and the frequency of falls. The frequency of falls decreased after surgery in 30% of the patients, on the other hand, it increased in 6% of the patients. As for walking ability, 34% of the patients answered that walking ability was improved after surgery, in contrast, 7% of the patients answered walking ability was impaired. Multivariate logistic regression analysis revealed that tender joint counts (Odds ratio 2.03, p<0.05) and DAS28-CRP(4) (Odds ratio 5.71, p<0.05) were significant risk factors for falls, in contrast, the history of lower limb surgery was negative risk factor (Odds ratio 0.04, p<0.01). Conclusions The rate of falls was decreased in 30% of the patients after surgery. Also, walking ability clearly improved after surgery in 34% of the patients, which may resulted in decreased incidence of falls. Some patients had high disease activity even after surgery, which may be the reason why the frequenciy of falls increased in 6% of the patients after surgery. Tender joint counts and DAS28-CRP(4) were significant risk factors for falls, on the other hand, history of lower limb surgery was negative risk factor. Disclosure of Interest None Declared
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
  • K. Ishii · Y. Mochida · K. Harigane · Y. Yamada · N. Mitsugi · T. Saito
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    ABSTRACT: Background Recent studies showed that biologic agents (biologics) may increase the risk of perioperative complications. However, there were limited reports that investigated detailed perioperative clinical features in patients with rheumatoid arthritis (RA) treated with biologics. Objectives The purposes of this study were to investigate perioperative clinical features and complications in RA patients treated with biologics. These data were compared to patients treated without biologics. Clinical features and complications were also analyzed according to surgical procedure. Methods Between 2007 and 2011, patients who underwent orthopaedic surgeries treated with biologics were reviewed (Group A; 53 females and 4 males). We also selected patients who were treated without biologics during same time period with adjusting the age and the ratio of male and female (Group B; 55 females and 3 males). In addition, patients in Group A were divided into major surgery (28 patients; total hip, knee, elbow, and ankle arthroplasty) or with minor surgery (29 patients; other orthopaedic joint surgery). In both groups, perioperative general conditions and orthopaedic complications (surgical site infection; SSI, delayed wound healing) were investigated. As the assessments of perioperative clinical features, the levels of C-reactive protein (CRP), white blood cell (WBC), total protein (TP), albumin (Alb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine (Cr), and MMP-3 were examined. As the assessments of recovery of patient’s general status after surgery, the %recovery of TP (%TP), %recovery of Alb (%Alb), and %recovery of Hb (%Hb) were examined. The %recovery was defined as follows: (2-week postoperative level/preoperative level)×100%. Results Perioperative laboratory data showed no statistical significant difference between two groups at any study period. There were also no statistical significant differences in %TP, %Alb, and %Hb between two groups. In Group A, mean level of CRP at 1 week after surgery (3.9mg/dl) were significantly higher in patients with major surgery than in patients with minor surgery (1.1mg/dl) (p<0.01), but there was no statistical significant difference at 2 and 4 weeks after surgery. SSI were observed in 3 patients in Group A (major surgery: 2, minor surgery: 1), but no patient had SSI in Group B. Delayed wound healings were observed in 1 patient in Group A (1.8%; minor surgery) and 4 patients in Group B (6.9%; 3 patients in major surgery and 1 in minor surgery). The rate of occurrence in delayed wound healing was observed with no statistical significant difference between two groups. In patients with SSI or delayed wound healing, perioperative laboratory data showed no statistical significant difference when compared with the data in patients without SSI or delayed wound healing. Conclusions Most of orthopaedic surgeries in RA patients treated with biologics were performed safely when compared with the patients treated without biologics. In patients treated with biologics, perioperative complications and clinical features showed no conspicuous difference regardless of surgical procedure. The treatment with biologics also did not affect the recovery of patient’s general status after surgery. Disclosure of Interest None Declared
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
  • Y. Mochida · K. Ishii · K. Harigane · Y. Yamada · N. Mitsugi · T. Saito
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    ABSTRACT: Background Recent treatment of rheumatoid arthritis (RA) was dramatically improved after introducing biological agents. Although there are limited number of reports that analyzed the effect of biological agents from the view point of histopathology, the specific findings and the significance of biological agents on histological changes of joint synovium is remained uncertain. Objectives The purpose of this study was to compare the histopathological findings of synovium in patients with RA between 2 groups with and without use of the biological agents. Methods 79 biopsy specimens of synovium were obtained during joint surgery from 67 cases of RA. The histopathological findings of synovium in each specimen were evaluated and scored for detailed findings such as synoviocyte hyperplasia, fibrosis, proliferating blood vessels, perivascular infiltrates of lymphocytes, focal aggregates of lymphocytes, and diffuse infiltrates of lymphocytes using the histological score of the synovium by Rooney et al. For immunohistochemistry, tissue sections were stained with TNF-a mouse monoclonal antibody and IL-6 rabbit polyclonal antibody. Then each microscope slides was assessed and compared between two groups. Group with the use of biological agents (Group A) included 30 cases with 39 joint specimens. In Group A, 12 cases (15 joints) used etanercept, 12 cases (15 joints) used infliximab, 3 cases (4 joints) used tocilizumab, and 3 cases (5 joints) used adalimumab at the time of surgery. Group without use of biological agents (Group B) included 37 cases with 37 joints. These cases underwent surgery during same study period as Group A. The variations of surgery in both group was similar. The background data such as age, averaged duration of disease, CRP, MMP-3, DAS-28 score, and mean dose of methotrexate (MTX) and prednisolone (PSL) were not different between two groups. Results Group A showed significantly decreased scores in synovial hyperplasia, perivascular infiltrates of lymphocytes, focal aggregates of lymphocytes, diffuse infiltrates of lymphocytes and also total score than in the Group B. In contrast, Group A showed significantly increased scores in fibrosis. No correlation between total Rooney’s score and age, Larsen’s classification, Steinblocker’s classification, duration of disease, or preoperative values of CRP and MMP-3 was found in each group. In Group A, no difference of total Rooney’s score was found by variety of biologics, additionally, there was no correlation between total Rooney’s score and the duration of administration of biologics. Although no correlation was found between mean dose of MTX and total Rooney’s score in each group, Group A showed negative correlation between dose of PSL and total Rooney’s score (p=0.015). The results of immunohistochemistry showed that Group A had significantly less cases stained with TNF-a than in Group B (p<0.01). For IL-6 stain, no difference was observed between two groups. Conclusions Based on these results, fibrosis around the synovium was thought to be one of specific findings of the effect of biological agents for RA. The negative correlation between dose of PSL and total Rooney’s score in Group A may suggest some synergistic effect of PSL and biologics. Disclosure of Interest None Declared
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
  • K. Ishii · Y. Mochida · Y. Yamada · N. Mitsugi · T. Saito
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    ABSTRACT: Background In rheumatoid arthritis (RA), the arthritis in metacarpophalangeal (MCP) joints often cause dislocation of the MCP joints and ulnar deviation of the fingers. Arthroplasty with silicone implant for MCP joint is one of the most frequently performed procedure to improve hand function, appearance, and relief of chronic joint pain. However, there are limited reports for detailed analysis of postoperative radiological changes of ulnar deviation angle with different implants. Objectives The purpose of this study was to investigate the factors influenced in radiological changes of ulnar deviation in RA patients who underwent MCP joint arthroplasty using silicone implants. We also investigated postoperative range of motion (ROM), ulnar deviation, and patient-reported satisfaction in a randomized trial of two different MCP joint implants. Methods A total of 24 RA patients who underwent MCP arthroplasty of all 4 fingers: 11 cases received Swanson implants, and 13 cases received Avanta implants. Ulnar deviation angle, correction of ulnar deviation angle, and loss of correction angle at 6 months after surgery were analyzed. Additionally, all data was divided into two groups, radial fingers group and ulnar fingers group, and then statistically analyzed. Postoperative patient-reported satisfaction was assessed using visual analogue scale (VAS) and the Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) Questionnaire. Results Mean ulnar deviation angle was corrected significantly from 43.1°preoperatively to 9.5° immediate postoperatively; however, ulnar deviation angle was progressed to 13.7° at 6 months after surgery. Mean correction angle of immediate postoperatively was 33.6°, and loss of correction angle at 6 months after surgery was 4.2°. There was no correlation between preoperative ulnar deviation angle and loss of correction angle, correction angle and loss of correction angle. For preoperative ulnar deviation angle and loss of correction angle at 6 months after surgery, there was no statistical difference between radial fingers and ulnar fingers. However, at 6 months after surgery, mean ulnar deviation angle in radial fingers was 18.3°, which was significantly higher than that of in ulnar fingers (9.2°, p<0.01). At final follow-up, Avanta group achieved significantly greater active MCP joint flexion than in Swanson group (64.3° and 45.5° respectively, p<0.01). On the other hand, active MCP joint extension was greater in Swanson group (p<0.01). Although there was no significant difference in postoperative VAS and the Quick DASH between two groups, the Avanta group showed greater mean VAS (83 points for Avanta and 70 points for Swanson group). Conclusions The Avanta group demonstrated superior MCP flexion, whereas the Swanson group had better angle in MCP extension. In clinical and patient-reported satisfaction, both implants groups showed good results after surgery. From current study, slight progression of postoperative ulnar deviation in radial fingers was observed regardless of the implants. This ulnar deviation in radial fingers will be due to postoperative improved pinch movement after surgery. Therefore, tight and enough soft tissue reconstruction for radial fingers was thought to be very important. Disclosure of Interest None Declared
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Background The mobile bearing knee system was introduced to lessen contact stress on the articular bearing surface and reduce polyethylene wear. The purpose of the current study was to investigate the mid-term results of patients undergoing total knee arthroplasties (TKAs) using Scorpio Plus Mobile Bearing Knee System (Stryker, Mahwah, NJ), and compare the outcomes between patients with osteoarthritis and osteonecrosis (OA·ON group) and patients with rheumatoid arthritis (RA group). Methods Eight males and 58 females were followed up for a period of 4.4- 7.6 years from June 1, 2003 to December 31, 2005. There were 53 knees with osteoarthritis, 17 knees with rheumatoid arthritis, and 6 knees with osteonecrosis. Clinical and radiographic follow- up was done using The Japanese Orthopedic Association knee rating score (JOA score) and Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Results With regard to the JOA score, there was significant improvement in both groups. The postoperative range of motion was between 0.8°and 116.8° in OA·ON group, and between 0.0° and 113.7° in RA group. There were no significant differences with the radiographic evaluation between two groups. Spontaneous dislocation of a polyethylene insert occurred in one patient, and deep infection was occurred in one patient. Conclusion There was significant improvement with regard to the clinical and radiographic results of patients undergoing TKAs using the model. The risk of polyethylene insert dislocation related to the mobile bearing TKA is a cause for concern.
    Full-text · Article · Oct 2012 · Sports Medicine Arthroscopy Rehabilitation Therapy & Technology
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    Katsushi Ishii · Yutaka Inaba · Yuichi Mochida · Tomoyuki Saito
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    ABSTRACT: Synovectomy is an effective procedure for management of the rheumatoid elbow at radiographically early stages (Larsen grades 1 and 2). However, its efficacy for advanced stages (Larsen grades 3-5) is controversial. We investigated the outcome of synovectomy for advanced stages of the rheumatoid elbow. Between May 1985 and September 1994, synovectomy was performed for 67 rheumatoid elbows in 59 patients (mean age 52 (26-72) years, 54 women). 3 elbows (3 patients) were lost to follow-up after mean 15 (10-23) years. Thus, 64 elbows were evaluated clinically and radiographically. The mean Mayo elbow performance score (MEPS) improved from 42 (15-75) points preoperatively to 78 (45-100) points at the final follow-up examination. In cases of Larsen grade 5, the mean MEPS at final follow-up examination (69 points) was lower than those of Larsen grade 3 and 4 cases (80 and 79 points, respectively) (p < 0.01). Recurrence of synovitis was obvious in 20/67 elbows. 12 cases had a total elbow arthroplasty mean 13 years after the synovectomy. The 10-year, 15-year, and 20-year survival rates were 97%, 75%, and 70%, respectively. Our findings suggest that synovectomy for the rheumatoid elbow gives a good long-term outcome for radiographically judged destroyed joints of Larsen grades 3-4.
    Preview · Article · Aug 2012 · Acta Orthopaedica
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    ABSTRACT: Objectives Porous tantalum is a biomaterial newly applied for artificial joints. We present here 5-years follow-up report of a multicenter clinical trial of total hip arthroplasties (THA) with porous tantalum modular acetabular component (modular PTC). Methods Study participants received 82 hips in 79 cases, with 61.2 months follow-up on average. Age at operation was 60.9 years. Clinical results were evaluated using Merle d’Aubigne Postel score. Presence of implant loosening, periacetabular radiolucency, osteolysis, and gap filling were examined for radiographic results. Results Merle d’Aubigne Postel score improved from 10.0 to 16.4 points. All PTC were radiographically stable, with no evidence of progressive radiolucencies. Average polyethylene wear rate was 0.004 mm/year, with no periacetabular osteolysis. Fifteen hips (18.3%) showed a gap >1 mm; however, all showed bone filling within 12 months. PTC with oversized reaming was significantly less likely to have a gap. No implant failure was noted related to modularity. Resulting survival rate of modular PTC was 100% at 5 years. Conclusions Modular PTC showed excellent results at 5-years of follow-up. Some hips showed periacetabular gaps, which were filled with bone within 1 year. Further follow-up was needed to determine long-term efficacy.
    No preview · Article · Mar 2012 · Modern Rheumatology
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    ABSTRACT: We simultaneously assessed ultrasonography (US) and magnetic resonance imaging (MRI) in comparison with histopathological changes in the knee joints of long-lasting arthritis patients. We studied 15 patients with rheumatoid arthritis and 5 patients with osteoarthritis, who underwent total knee arthroplasty. On the day before surgery, the joints were examined by US and contrast-enhanced MRI. In US, synovitis was graded with 0-3 grey scale (GSUS) and power Doppler (PDUS). In MRI, synovitis was graded according to OMERACT-RAMRIS (grade 0-3). Synovial tissue samples were obtained during arthroplasty and evaluated on the basis of inflammatory cell infiltrates (grade 0-3), synovial lining layer thickness (grade 0-3) and vascularity (grade 0-3). Positive findings of PDUS and contrast-enhanced MRI were 45% and 85% of 20 operated joints, respectively. GSUS, PDUS and MRI synovitis were well correlated with overall histopathological grades of synovitis (Spearman correlation coefficients 0.48, 0.84 and 0.48, p<0.05, p<0.01 and p<0.05, respectively). Moreover, positive PDUS findings were closely associated with all pathological comportments of synovitis including inflammatory cell infiltrates, synovial lining layer thickness and vascularity. The present study revealed that positive PDUS findings more faithfully illustrated active synovitis than MRI, whereas contrast-enhanced MRI was more sensitive in detecting synovitis in patients with long-lasting arthritis. It is important to understand distinct features of the both modalities for clinical assessment of chronic joint diseases.
    No preview · Article · Jan 2012 · Clinical and experimental rheumatology
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    ABSTRACT: The purpose of this study was to evaluate the change in pelvic tilt angle (PA) in the sagittal plane in the standing and supine positions for 2 to 4 years after total hip arthroplasty (THA). Anteroposterior pelvic radiographs of 21 male and 65 female patients were investigated before and after THA yearly over 2 to 4 years. Both the standing and supine PA significantly posteriorly tilted after THA. The difference in PA between the standing and supine positions (dPA) significantly increased after THA. Although the PA in the standing and supine positions plateaued 1 year after THA, the dPA gradually increased. In addition, the percentage of patients who showed a difference of more than 10° in dPA tended to increase yearly. In particular, elderly female patients who showed posterior tilt in PA in the standing or supine positions or a large dPA before THA tended to show a dPA of more than 10° after THA.
    No preview · Article · Nov 2011 · The Journal of arthroplasty
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    ABSTRACT: Since biologic agents were introduced to treat rheumatoid arthritis (RA) in 2003, the number of orthopedic surgical procedures under treatment with biologic agents has been increasing in Japan. However, whether biologic agents cause an increase in the prevalence of postoperative complications is as yet unknown. The Committee on Arthritis of the Japanese Orthopedic Association investigated the prevalence of postoperative complications in patients with RA in teaching hospitals in Japan. Between January 2004 and November 2008, surveillance forms about medications and surgical procedures in patients with RA were sent to 2,019 teaching hospitals. Data were analyzed by the Rheumatoid Arthritis Committee. Biologic agents were administered to RA patients in 632 of 1,245 hospitals (50.8%); 430 of the 1,245 hospitals (34.5%) used surgical intervention under treatment with biologic agents. The number of surgical procedures under treatment with biologic agents was 3,468, and the prevalence of infection was 1.3% (46 cases). The prevalence of infection was 1.0% (567 procedures) in 56,339 procedures under treatment with nonbiologic disease-modifying anti-rheumatic drugs. There were no significant differences between biological and nonbiological treatment groups with respect to the prevalence of infection. In the joint arthroplasty group, the number of procedures under biological and nonbiological treatment was 1,626 and 29,903, and the prevalence of infection was 2.1% (34 procedures) and 1.0% (298 procedures), respectively. There was a significant difference between groups. The odds ratio was 2.12 (95% confidence interval 1.48-3.03, P < 0.0001). The chance of having biological treatment with joint arthroplasty was more than twofold greater in patients with surgical-site infections compared with those treated with nonbiologic agents. Caution is required for surgical procedure, perioperative course, and obtaining consent for joint arthroplasty for patients with RA undergoing surgery under biological agents.
    No preview · Article · Aug 2011 · Journal of Orthopaedic Science
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    ABSTRACT: Total elbow arthroplasty (TEA) with the GSB III prosthesis was performed in 32 patients (36 elbows) with rheumatoid arthritis between 2001 and 2009. At final follow-up, 31 patients (35 TEAs) were available for clinical and radiological evaluation. The mean follow-up period was 6.3 (2.0-10.3) years, with a minimum follow-up of 2 years. The mean Mayo elbow performance score was significantly improved from 48 points preoperatively to 83 points at final follow-up. The radiographic loosening rate was 14.3% for humeral components and 5.7% for ulnar components. There were 4 cases of intraoperative fracture and 1 case of humeral shaft fracture at 4 months after surgery. The rates for loosening and fracture were relatively low when compared with those in other studies of linked TEA. There were 2 cases of ulnar nerve palsy, but there was no deep infection or triceps disruption. The clinical results of TEA using the GSB III prosthesis in patients with rheumatoid arthritis were found to be satisfactory.
    No preview · Article · Aug 2011 · Modern Rheumatology
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    ABSTRACT: The correction angle after high tibial osteotomy (HTO) depends on an accurate preoperative planning and an accurate intraoperative technique. We hypothesized that the use of a navigation system in opening wedge HTO would improve the intraoperative target angles in the coronal and sagittal planes. Postoperative femoro-tibial angle (FTA) and tibial posterior slope (TPS) in 28 knees with navigated opening wedge HTO were compared to those in 31 knees with the conventional method. Intraoperative correction angle was determined by the predicted medial opening width in the conventional group, and by the change of hip-knee-ankle angle in the navigated group. We defined lateral unstable knee as the knees with lateral cortex breakage or lateral tibial plateau fracture. Mean postoperative FTA was higher in the conventional group than in the navigated group (P < 0.037). In the conventional group, 4 lateral unstable knees were corrected to 174.6°. In the navigated group, 5 lateral unstable knees were corrected to 170.3° and no knees showed FTA > 173°. Mean change in TPS was greater in the conventional group than in the navigated group (P = 0.001). The navigation system in opening wedge HTO might reduce undercorrection in the knees with lateral cortex breakage or lateral tibial plateau fracture, and provide the better intraoperative FTA and TPS. III.
    No preview · Article · Jul 2011 · Knee Surgery Sports Traumatology Arthroscopy
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    ABSTRACT: We report a rare case of dystrophic calcinosis in a patient with rheumatoid arthritis in bilateral buttock lesions and the right elbow joint. The calcinosis was surgically removed because it caused severe local pain, possible infection, and difficulty in sitting. Because no recommended standard pharmacotherapy exists for dystrophic calcinosis, surgical treatment should be taken into consideration when calcinosis causes severe local pain or restricts activities of daily life.
    Full-text · Article · Feb 2011 · Modern Rheumatology
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    ABSTRACT: We report a case of primary cervical epidural malignant lymphoma with rheumatoid arthritis. Because of the acute progression of paralysis in both legs, surgical decompression and stabilization of the cervical spine were performed. The resected specimen showed proliferation of lymphoblastic cells diagnosed as malignant lymphoma. Four series of chemotherapy were administered after surgery, and the patient recovered from paralysis.
    No preview · Article · Feb 2007 · Modern Rheumatology
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    ABSTRACT: We performed total hip arthroplasty using the non-cement impaction auto-bone-grafting method with the resected femoral head for acetabular protrusion that is not combined with the destruction of acetabular rim or dysplasia of the hip joint. Ten patients (eight women and two men) with rheumatoid arthritis who showed acetabular protrusion underwent total hip arthroplasty using this method. All patients were able to walk with full weight within 5 days after surgery. The short-term results of our cases were very good. The postoperative periods of the radiographic-bone incorporation of the grafting bone were 2 months after surgery in four joints, 3 months after surgery in four joints, and 4 months after surgery in three joints. There were no cases that showed any migration or radiolucency around the acetabular component at the time of follow-up. Our operative technique is simple and easy, and it is a useful method for the treatment of protrusion in patients with rheumatoid arthritis.
    Full-text · Article · Feb 2007 · Modern Rheumatology
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    ABSTRACT: Orthopedic wear debris has been thought to be an important factor associated with osteolysis and loosening of total joint arthroplasties. Previous in vitro studies have reported that particles of wear debris induce the release of pro-inflammatory cytokines and other inflammatory mediators from macrophages and other cells. Several recent investigations, however, have suggested that the wear particles themselves may not be primarily responsible for the inflammatory cellular responses, but that the observed cytokine release in vitro may be caused by endotoxin adsorbed to commercially available particle preparations. The intracellular pathways involved in macrophage signal transduction also are poorly understood. The purposes of this study are to use isolated orthopedic wear debris particles to evaluate pro-inflammatory cytokine release and nuclear factor kappa B (NFkappaB) activation from macrophages. Cells from human monocyte/macrophage cell line (THP-1) were differentiated and incubated with particles of debris that had been isolated from a failed human total hip arthroplasty. The titanium-alloy particles did not evoke release of TNF-alpha or IL-1beta whereas lipopolysaccharide (LPS) or LPS-treated debris particles induced both TNF-alpha and IL-1beta. LPS-treated particles, but not particles alone, stimulated NFkappaB activation. Our results suggest that at the concentrations tested in this study, endotoxin-free wear debris particles may not themselves initiate inflammatory cellular responses in differentiated THP-1 cells. It is unclear whether adsorbed endotoxin is clinically associated with osteolysis and/or loosening in total joint arthroplasties, but several factors, including adsorbed endotoxin, need to be investigated to explore the cellular responses responsible for osteolysis and/or loosening.
    No preview · Article · Apr 2002 · Journal of Biomedical Materials Research
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    ABSTRACT: Orthopedic wear debris has been thought to be an important factor associated with osteolysis and loosening of total joint arthroplasties. Previous in vitro studies have reported that particles of wear debris induce the release of pro-inflammatory cytokines and other inflammatory mediators from macrophages and other cells. Several recent investigations, however, have suggested that the wear particles themselves may not be primarily responsible for the inflammatory cellular responses, but that the observed cytokine release in vitro may be caused by endotoxin adsorbed to commercially available particle preparations. The intracellular pathways involved in macrophage signal transduction also are poorly understood. The purposes of this study are to use isolated orthopedic wear debris particles to evaluate pro-inflammatory cytokine release and nuclear factor kappa B (NFκB) activation from macrophages. Cells from human monocyte/macrophage cell line (THP-1) were differentiated and incubated with particles of debris that had been isolated from a failed human total hip arthroplasty. The titanium-alloy particles did not evoke release of TNF-α or IL-1β whereas lipopolysaccharide (LPS) or LPS-treated debris particles induced both TNF-α and IL-1β. LPS-treated particles, but not particles alone, stimulated NFκB activation. Our results suggest that at the concentrations tested in this study, endotoxin-free wear debris particles may not themselves initiate inflammatory cellular responses in differentiated THP-1 cells. It is unclear whether adsorbed endotoxin is clinically associated with osteolysis and/or loosening in total joint arthroplasties, but several factors, including adsorbed endotoxin, need to be investigated to explore the cellular responses responsible for osteolysis and/or loosening. © 2001 Wiley Periodicals, Inc. J Biomed Mater Res 59: 507–515, 2002
    No preview · Article · Mar 2002 · Journal of Biomedical Materials Research
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    ABSTRACT: We histologically analyzed tissue biopsy specimens obtained from 4 cases of revised cementless ceramic knee prostheses. Particles were isolated from the specimens, and their size and composition were determined. Implants were removed for aseptic loosening at an average of 64 months. Histologically, polyethylene particles were seen in all cases. The concentration of the particles showed wide variation among cases. The concentration of the particles also showed a wide variation among different biopsy locations, suggesting that the particles were not distributed uniformly around the knee prostheses. Although we analyzed only 4 cases, our results show good correlation between radiographic evidence of geographic osteolysis and the concentration of wear particles. Multiple biopsy specimens may be necessary to characterize adequately particle migration around knee prostheses.
    No preview · Article · Feb 2002 · The Journal of Arthroplasty