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花村 聡, 神宮司 誠也, 野口 康男, 宮原 寿明, 今村 寿宏, 岩本 幸英
1999 年 48 巻 1 号 p.
208-211
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
29 hips (follw-up rate: 44%) underwent hemiarthropathy for the treatment of osteonecrosis of the femoral head (ONFH). Bipolar hemiarthroplasty (Kyocera Physiohip type) was carried out for all the patients. The average age at operation was 47 years old (24-65), and the mean follow-up interval was 6.4 years (2.8-10.9). 1 was at stage 2, 14 at stage 4 at operation. 4 hips receired a second operation due to the failure of rotational osteotomy, and 1 was unknown. The JOA score was evaluated. The pain, ROM, walk and ADL scores were 35 (20-40), 17 (13-20), 13 (5-20), and 16 (820) respectively. The mean total score was 81 (65-100). Femoral head migration was observed in 7 hips (29%). The distance of migration of most hips was within 5mm. 1 hip which had acetabular reaming at operation showed central migration. There was a tendency for migration in most hips at stage 4 at operation. This study showed that bipolar heimarthroplastyis a promising treatment for ONFH hip although further evaluation is required.
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南島 広治, 樋口 冨士男, 久保 学, 大川 孝治, 井上 明生
1999 年 48 巻 1 号 p.
212-215
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed 26 cases of Bioceram cemented total hip replacements for the rapidly destructive coxarthrosis. The long term results of the operation were evaluated in terms of function and radiology. Of 26 cases, 15 cases (57%) were found to be clear zone at the acetabular component Loosening in 6 hips (23%) and revision in 3 hips (12%) were found in an average follow up of 106 months.
As the cystic change of the acetabulum appeared more clearly in the preoperative radiographs, the clear zone around the acetabular component after total hip replacement tended to appear higher in the last follow-up.
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清水 秀樹, 大久保 英朋
1999 年 48 巻 1 号 p.
216-219
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Acetabular bone graft in cementless THA for 31 hip joints with acetabular dysplasia was reviewed. The average age was 53 years, ranging from 44 to 68 years. The follow-up period ranged from 2 years and 4 months to 4 years, with a mean of 3 years. They were evaluated both clinically and radiologically. The mean JOA hip score improved from 44.4 points to 85.2 points. In all cases, the grafted bone was unioned but resorbed. The mean change of the socket angle was 0.6° and radiological findings such as socket migration, and loosening were not observed. Radiolucent line was seen at zone 1 in 2 hips and at zone 3 in 2 hips.
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永芳 郁文, 田村 裕昭, 井原 秀俊, 川嶌 眞人, 佐々木 誠人, 村上 太三
1999 年 48 巻 1 号 p.
220-224
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We conducted radiological examination on the femoral bone in 26 hips of 25 patients who had received a non-cemented hip prosthesis. In 15 hips the Bateman modified stem (B group) was used, in 3 hips the AML-CDH type (A group) was used, and in 8 hips the Perfecta stem (P group) was used.
The average follow-up period of group B was 4.9 years, that of group A was 5.5 years, and that of group P showed 3 unstable cases. Osteolysis of the proximal femoral bone occured in 8 cases. Groups A and P were all stable fixations.
The results sugges the importance of stem design and porous coating.
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田丸 卓弥, 大賀 正義, 有馬 準一, 生田 光, 本山 達男, 井手 康人, 松尾 篤, 佐々木 和司, 冨重 守
1999 年 48 巻 1 号 p.
225-227
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Total hip arthroplasty was performed with the use of Harris Garante cementless hip system in 58 hips and followed up for a minimum of 5 years (Mean 7 years). The mean age of the patients at the time of the operation was 57 years old. 37 hips had stable by bone ingrowth 13 hips had stable by fibrous ingrowth, and 13 hips were unstable. Rediolucent lines were indentified at 16 months in the bone in growth cases, but at 5 months in unstable cases. Appearance of radiolucent line represents stem initial stability.
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江副 正光, 内藤 正俊, 蒲原 光義, 高橋 克伸, 緒方 公介
1999 年 48 巻 1 号 p.
228-231
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Limb length inequality (LLI) is a comon complication of total hip arthroplasty (THA). The abductor moment-arm (AMA) affects the joint reactive force, implant load, and rotational stresses on the femoral stem. In order to minimize postoperative LLI and restore nomal abductor moment arm, we used a Steinmann pin, wire bent at 90 degrees, adjustable length caliper, and two movable connectors. A Steinmann pin was percutaneously insertd through the ilium for an iliac reference point. A small mark was made on the greater trochanter for a femoral reference point. The calier had a movable connector that was attached to a Steinmann pin for LLI measurement. The Steinmann pin also had a movable connector. The connector of the Steinmann pin was fixed in contact with the caliper's connector and was used for the measurement of the horizontal change of the greater trochanter. Both the vertical and horizontal distances between the two reference points were repeatedly measured and final assessment for the inplantation was carried out Postoperatively, LLI and AMA both improved in eignteen patients. The present results suggest that our simple technique prevents postoperative LLI and over-lenghening.
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久保 学, 樋口 富士男, 小山 耕一, 中村 英智, 大川 孝治, 井上 明生
1999 年 48 巻 1 号 p.
232-237
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report the clinical outcome from acetabular reconstruction using the Kerboull cross plate in 35 hips, during the period from June. 1993 to November 1997. Their mean age was 65 years (ranging from 41 to 82 years). The mean follow-up period was 1.8 years (ranging from 6 months to 4 years). At first, we performed an allograft for fitting the plate in cases with large bone deficit in the loading area, and then fixed the plate. Next, we performed a graft for chipped cancellous bone (mainly autograft) for any bone deficit at the base of the acetabulum, coated this surface with fibrin glus made duration until union of the grafted bone was 12.2 months (ranging from 6 months to 2 years). At the most recent follow-up, the position of the plate was excellent in 12 hips, only fair in 21 hips, and unclear in 2 hips. All the excellent cases were stable. 4 of the other 21 hips were displaced to some extent, and 1 required revision surgery.
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小田 裕造, 藤尾 圭司, 山中 三知夫, 土屋 隆之, 後藤 公志
1999 年 48 巻 1 号 p.
238-241
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
4 cases were diagnosed as acetabular deficiency and operated with the Kerboull cross plate between 1996 and 1998. The patients were 1 male and 3 femalse. The ages of the patients ranged from 52 to 80 years with an average of 65.8 years. 2 patients were classified into type 1 AAOS and the others type 3.
Acetabular deficiencies were reconstructed with the Kerboull cross plate and AW glass ceramics, and acetabular components were inserted with cement. The follow-up periods averaged 12 months. The average JOA score improved from 45 to 78. Use of the Kerboull cross plate and bone graft with AW glass ceramics enabled steady reconstruction of the acetabulum and better clinical result.
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池尻 洋史, 帖佐 悦男, 柏木 輝行, 松岡 知己, 結城 祥一, 田島 直也
1999 年 48 巻 1 号 p.
242-246
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Acetabular reconstructions using acetabular reinforcement ring with hook were analyzed after an average follow-up period of 19.6 months (range: 2-28 months) in 9 patients/hips. The deficiencies, according to the American Academy of Orthopaedic Surgeons classification, were 2 segmental, 4 cavitary and 3 combined cavitary and segmental. Bone grafts were packed into bone defects, a hook was placed around the bone in the acetabular notch and then a reinforcement ring was fixed with cancellous screws. Postoperative management was with partial weight-bearing on 2 crutches usually starting one week after surgery. Radiographic evaluation revealed acetabular component migration of more than 2mm in 1 hip. The overall Japan Orthopaedic Association score (JOA score) of 36.5 points improved to a follow-up examination score of 73.6 points. Short-term results were good. In arthroplasty with bone stock of poor quality and quantity, the reinforcement ring with hook serres as a good method for reconstructing the acetabulum.
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蒲原 光義, 内藤 正俊, 緒方 公介, 諸岡 正明, 平良 肇, 岩城 彰
1999 年 48 巻 1 号 p.
247-249
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Since 1990, we perfomed 275 total hip arthroplasties. Intra-and post-operative periprosthetic femoral fractures occurred in 7 cases (2.5%). Intra-operative fractures occurred in 5 cases (3 cases in revision) and post operative fractures occurred in 2 cases (1 case in revision). According to the classification of AAOS Committee on the Hip, Type III occurred in 1 case, Type IV A in 1 case, Type V in 2 cases, and Type VI in 3 cases. All the fractires were treated with internal fixation with cerclage wires, screws, cables, conventional plates, Judet bracelet, Mennen plate, revision with long-stem implants, and with a wave-plate. All the fractures united. In 1 case (Type VI), we performed internal fixations 4 times; 3 times using conventional plates and finally with wave-plate with autografting bone. Periprosthetic femoral fractures present a difficult treatment challenge. Wave plate with auto-grafting bone is a useful treatment option in periprosthetic femoral fracture.
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岡野 邦彦, 田口 厚, 河野 昌文, 中村 智, 本岡 勉, 安倍 徹
1999 年 48 巻 1 号 p.
250-253
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
166 total hip arthroplasties were performed between 1991 and 1997 in our hospital, and 15 deslocations occured. The rate of deslocation was relatve high in patients with reumatoid arthritis compared with osteoarthritis. 6 hips were deslocated once, while the remaining 9 more than once. Repeated dislocation was often observed in patients with low activity prior to operation. All the dislocations were reducted manually. Revision was however required in 3 to prevent repeated dislocation. The first dislocation occured in the hospital in 13 patients. 12 patients had no repeated deslocation without revision. Post-operative education is considered important for the prevention of the dislocation of prosthesis.
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梶山 史郎, 高橋 克郎, 榎本 寛, 橋口 隆, 木寺 健一, 杉谷 勇二, 乗松 崇裕, 進藤 裕幸
1999 年 48 巻 1 号 p.
254-258
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed 3 cases who under went salvage treatment of recurrently dislocating charnley total hip prosthesis using a Wroblewski acetabular stabilizing wedge (WASW). They were followed up both clinically and radiographically for 1 year 1 month to 3 year 5 months (average: 1 year 11 months). Their ages ranged from 59 to 83 (average: 69 years) old at the treatment. These patients had additional factors contributing to the instability of the implant, including THA socket migration, muscle weakness about the involved hip joint and resection or pseudoarthrosis of the greater trochanter.
Subsequent dislocation occurred only once in 1 of the 3 patients in the seated position at 10 months after the treatment. There were neither failures of the WASW device itself nor acceleration of the THA socket loosening at the time of review. The use of a WASW is considered to be effective with less complications for those with recurrent THA dislocation especially related to muscle weakness or imbalance of the involved hip joint.
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野口 康男, 窪田 秀明, 神宮司 誠也, 首藤 敏秀, 中島 康晴, 宮西 圭太, 末永 英慈, 岩本 幸英
1999 年 48 巻 1 号 p.
259-263
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We combined Tanabe's extensive anterolateral-approach open reduction involving 360-degree circumferential capsulotomy with Pemberton pericapsular osteotomy and/or femoral osteotomy for the reduction of 7 dislocated hip joints in 5 toddlers. patients were placed in the lateral decubitus position. After Tanabe's original procedure of open reduction, femoal osteotomy (shortening/derotation/varus) and/or Pemberton's pericapsular osteotomy were performed easily via this approach. After surgery, X-ray showed the femoral head to be perfectly reduced and excellent acetabular coverage. The latest follow-up X-ray demonstrated no sign of avascular necrosis of the femoral head or acetabulum, and that excellent reduction and acetabular coverage had been maintained. The combination of Tanabe's open reduction with femoral and/or Pemberton pericapsular osteotomies thus appears to present a feasible, safe, practical option in treating hip dislocation in children who have already begun walking.
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本岡 勉, 河野 昌文, 矢次 登, 岡野 邦彦, 安倍 徹, 鳥越 雄史, 田口 厚, 中村 智
1999 年 48 巻 1 号 p.
264-267
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report a case of congenital dislocation of the knee. The patient was a girl with pelvic presentation in the uterus and born by cesarean section. She was pointed her back knees out right after birth. The roentgenographic findings were grade 3 dislocation of the Drehmann's classification. Most cases of congenital dislocation of the knee are treated conservatively. But in our case, conservative treatment (ex. brace, Pavlik harness) was not effective and therefore operative treatment was performed when she was 1 year and 1 month old. We desquamed the adhesive muscles, cut the capsules at the bilateral side, flexed the knees to about 90 degree and fixed them by Kirschnner wires. As a result, she could walk by herself when she was 1 year and 9 months old.
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乗松 崇裕, 松本 智子, 進藤 裕幸, 弦本 敏行, 上谷 雅孝
1999 年 48 巻 1 号 p.
268-272
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
To know the changing of the hand in patients with early-staged Rheumatoid arthritis (RA), we performed fat-suppressed Gd-enhanced MR imaging and investigated the usefulness. We studied 10 patients (2 men, 8 women; age range 37-73 years) with RA which fullfilled the American College of Rheumatology criteria. MR imaging was performed within one year after the onset of RA All patients showed Gd-enhanced T1 weighted spin echo with fat suppression. A high signal intensity of synovia in the intercarpal bone joint, MP or PIP joint was obtained in all 10 patients. The flexor tendon sheaths were also enhanced in 6 ont of 10 patients. These findings show that the inflammation of the synovia and flexor tendon sheath were the main focus in the hands of early stage RA patients and that fat-suppressed MR imaging was useful to describe these changes.
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中村 智, 田口 厚, 河野 昌文, 岡野 邦彦, 本岡 勉, 安倍 徹
1999 年 48 巻 1 号 p.
273-277
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Cementless total knee arthroplasty (MG II) was performed on 94 knees affected by rheumatoid arthritis. 42 knees were available for follow up. The mean age was 59.2 years old and the mean follow-up period was 59.1 months. Loosening occurred in 5 knees and none had patellar dislocation. Revision surgery was performed in 1 knee. The setting position of all components did not show any marked changes in roentogenogram in the follow-up period. Femoro-tibial angle was the most impotant factor in the further loosening of the components.
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安藤 徹, 小牧 一麿, 田島 直也, 帖佐 悦男, 川越 正一, 蛯原 啓文, 黒木 龍二
1999 年 48 巻 1 号 p.
278-281
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report two cases treated with posterior thigh flap for reconstruction following wide resection of tumor around the hip joint.
Case-1:
A 49-years-old man was diagnosed with a giant cell tumor on the rt. acetabular in 1965. In 1979 the tumor was treated with resection and radiotherapy. Postoperative infection was complicated and its status did not improve despite continuous irrigation for the lesion at several clinics. In 1997 we performed curretage and musclocutaneus flap transfer with the rt. first profunda perforater of the deep femoral artery to cover the surgical defect.
Case-2
A 78-years-old woman was diagnosed as leiomyosarcoma around the greater trochanter in 1995. Although the tumor was treated with resection, MR imaging showed postoperative relapse on the same lesion and invasion to the lt. greater trochanter. In 1997 we performed surgical resection and hip reconstruction using the Huckstep system and musclocutaneus flap with the lt. descending branch of the inferior gluteal artery to cover the surgical defect.
The two cases showed good appearance and functional improvements. The posterior thigh flap was effective for large defects following the resection of tumors around the hip joint.
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藤澤 基之, 森久 喜八郎, 西島 宗孝, 堤 義明, 稲留 辰郎, 進 訓央
1999 年 48 巻 1 号 p.
282-287
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We reported two cases of soft tissue tumor whose diagnosis was difficult to determine as whether malignant or benign in preoperative examinations.
1 case was a 70-year-old female. 2 painless soft tissue masses 10cm and 3cm in diameter were found in her left inguinal region. Magnetic resonance imaging (MRI) demonstrated clear border without adhesion to the surrounding tissues. No typical tumor atain was obtained on angiogram. Although a needle biopsy demonstrated no evidence of malignancy, postoperative diagnosis was malignant lymphoma, non-Hodgkin myxoid cell type.
The other case was a 53-years-old male. A painless soft tissue mass 5cm in diameter was found in his left axillary region, MRI demonstrated clear border without adhesion to the surrounding tissues. Gadolinium enhanced images demonstrated low to high intensity specles, which suggested neurilemoma. The biopsy specimen showed neurological cells and no evidence of malignancy. Post operative diagnosis was benign neurilemoma.
We concluded that preoperative image examinations for example MRI provides considerable reference for surgical location, which was however insufficient for histological diagnosis, and a study on the false-negative of the histology by needle biopsy was necessary for preoperative diagnosis. Laboratory data is also important for cases of malignant lymphoma prior to operation.
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山下 武士, 米村 憲輔, 西田 公明, 薬師寺 俊剛, 加藤 悌二, 鬼木 泰成, 高木 克公
1999 年 48 巻 1 号 p.
288-290
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report a rare case of atypical lipoma in childhood. A 13 year-old boy had a 3-month history of the left thigh nodule. When he visited our hospital, the tumor was seen at the lateral aspect of the left thigh and was 7×6cm in size. Computed tomography showed a subcutaneous mass indicating low and iso density. Magnetic resonance imaging showed an abnormal shadow, indicating low and high signal intensity on T1 weighted images. Surgical excision of the tumor was performed. Microscopic examination of the tumor showed that the lesion composed of mature adipocytes with considerable variation in size and shape, containing many atypical spindle cells and pleomorphic giant cells. We believe that the clinicopathological feature fulfills the criteria of atypical lipoma. This type of tumor is considered a superficially located well- differentiated liposarcoma, and may recur locally, but has a minimal chance to metastasize.
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陣林 伯禎, 小西 宏明, 原 真一郎, 鳥越 雄喜, 高須賀 良一, 北原 博之, 山口 和博, 馬場 洋, 宮本 力
1999 年 48 巻 1 号 p.
291-295
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Exdtradual angiolipoma of the spine is a rare tumor. In this paper, we report the case of a 69 year-old man who was admitted with an almost 7-year history of hypestesia below the Th. 9 dermatome level and gait disturbance. On examination, increased ATR and PTR were bilateral. Magnetic resonance imaging of the thoracic spine revealed a space-occuping mass in the ventral epidural space at the Th5-Th8 level. Histologically, the tumor was composed of fatty tissues, thin-walled vessel spaces, and small vessels, diagnosed as extradual angiolipoma of the spine.
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西田 公明, 米村 憲輔, 加藤 悌二, 薬師寺 俊剛, 高木 克公
1999 年 48 巻 1 号 p.
296-299
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
4 patients with soft tissue sarcoma of the thigh underwent wide resection of the tumor followed by vascular reconstruction. These patients were all female with ages ranging from 41 to 57 years (average, 51 years). The histological diagnosis of the tumors was as follows: 3 cases of liposarcoma and 1 case of malignant fibrous histiocytoma. Arterial reconstruction was performed with a saphenous vein in all patients and venous reconstruction in 3 cases. The duration of follow-up ranged from 10 to 28 months (mean 18 months). The revasculized vessels were found to be patent in all patients. MR angiography (MRA) was performed to evaluate the reconstructed vessels. Limitation of ROM around thigh and edema of the leg were observed postoperatively, while no local recurrence was seen. Vascular reconstruction for limb salvage in soft tissue sarcomas is preferable and MRA is useful for evaluating the reconstructed vessels.
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深水 優, 城戸 正喜, 松崎 昭夫, 中村 宏
1999 年 48 巻 1 号 p.
300-303
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Two cases of periosteal chondroma are reported.
In one case (case-1), the tumor developed in the left heel, and in other case (case-2), in the right middle finger.
In case-1, a smooth surface and elastic hard tumor measuring 8.5×5.0cm was observed in the medial side of her left heel, and in case 2, a smooth surface and elastic hard tumor with tenderness measuring 2.5×1.8cm was observed in the dorso-ulnar side her right middle finger.
Roentgenograms showed calcification in both tumors and compression deformity and sclerosis in the ulnar side of the proximal phalanx in case-2.
Histologically, the tumor was lobulated and composed of hyaline cartilage in both cases. Myxoid and cystic changes were noted in case-1 and mild cytologic atypia in case 2.
Pathological diagnosis was myxochondroma in case-1 and periosterial chondroma in case-2.
No local recurrences were seen in both cases.
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米村 憲輔, 西田 公明, 薬師寺 俊剛, 梅村 武寛, 加藤 悌二, 高木 克公
1999 年 48 巻 1 号 p.
304-307
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
A retrospective study of 20 patients with 21 metastatic bone tumors of the proximal femur was conducted to compare surgical data, pain-relief, functional recovery, and the rate of survival. The patients were divided into two groups, patients who underwent either a wide excision and reconstruction by endoprosthetic replacement (group 1), or an intralesional excision and internal fixation supplemented by methylmetacrylate (group 2). 9 patients in group 1 had metastases from primary tumors in the following locations: kindney (3), prostate (2), lung (2), etc., and 11 patients in group 2 had: lung (4), multiple myeloma (3), breast (2), etc.
The average blood loss was 696g in group 1 and 1190g in group 2, and the average surgical time was 238 minutes in group 1 and 133 minutes in group 2. Pain relief was classified as excellent or good in most cases (95%). All the cases in group 1 were classified as excellent with regard to the ability to walk postoperatively, while only 58% of the patients in group 2 were classified as excellent or good. Furthermore, the prognosis for the survival of the patients in group 1 was considerably superior to that of the patients in group 2. These results revealed that the surgical invasiveness was almost equal between the two groups and that the patients in group 1 exceeded those in group 2 in terms of pain-relief, function, and the rate of survival.
The results confirmed that patients should be treated by wide excision of the metastatic tumor and reconstruction by endoprosthetic replacement for long-term survival.
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吉川 尚秀, 福島 明, 高須 宣行, 高橋 敏明, 上山 高尚
1999 年 48 巻 1 号 p.
308-311
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Two cases of pubic osteolysis are reported.
Case 1: A female aged 74 years sufferd from right coxalgia. Plain radiographs revealed an osteolytic lesion in the right pubic bone and bone scan demonstrated high uptake in the same region. An open biopsy was performed and pathological findings were consistent with pubic osteolysis.
Case 2: A female aged 71 years sufferd from right groin pain after trauma for 2 months. Plain radiographs revealed an osteolytic and sclerotic lesion in the right pubic bone. An open biopsy was performed and pathological findings were consistent with pubic osteolysis.
The initial complaints of pain of the pelvis gradually subsided with conservative treatment.
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森 啓介, 小宮 節郎, 平岡 弘二, 井上 明生
1999 年 48 巻 1 号 p.
312-316
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Two patients with osteoid osteoma treated by a percutaneous excision under a X-ray-guided technique are described. They include a 13-year-old boy with osteoid osteoma in the femoral neck and a 13-year-old boy with tumor in the tibia. After inserting a Kirschner-wire to the nidus under X-ray guidance, a 7mm-diameter trephine needle was advanced through the wire. Nidus was successfully resected into a fan-shape without causing any problems, and no recurrence was seen. Our technique is simple, safe, and minimum to treat patients with osteoid osteoma.
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前田 剛, 篠原 典夫, 横山 庫一郎, 末永 英慈, 佐藤 陽昨
1999 年 48 巻 1 号 p.
317-319
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report 13 cases of fibrous dysplasia treated by free auto-fibular grafts from 1990 to 1997. Their mean age was 16 years (ranging from 6 to 38 years). The mean follow-up period was 2 years and 10 months. The grafts of free auto-fibular cortical bone were used. The objectives of relief of pain and prevention of deformity were achieved in all 13 patients. 1 patient required an arthrodesis of the hip due to aseptic necrosis. None of the patients had important deformity and no one complained after the resection of the fibula.
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平 博文, 吉田 盛治, 高下 光弘, 鳥巣 岳彦
1999 年 48 巻 1 号 p.
320-323
発行日: 1999/03/25
公開日: 2010/02/25
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フリー
We report the clinical results of surgical intervention for eosinophilic granuloma arising from extraspinal bones. All 8 cases were diagnosed by open biopsy. The average age of the patient at first the presentation is 19.8 years old, and postoperative follow-up period is about 69 months. The site of the lesion was femur in 4 patients, rib in 2 and tibia and humerus in 1 each. All the patients were treated surgically. Specifically, curettage and bone graft were administered in 5 patients, total resection in 2, and bipolar hip arthroplasty in 1. Functional results after each operation were good and 5 osteolytic lesions treated with curettage and bone graft gradually healed within 4.6 months. The clinical results of surgical intervention for solitary eosinophilic granuloma of bone was reported to be quite good, but appropriate indications such as the following should be observed; patient with pathological fracture, severe deformity, and para-articular location.
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藤原 明, 緒方 公介, 原 道也, 佐伯 和彦, 松浦 一平, 金宮 毅, 毛利 正玄, 吉村 一朗, 古賀 敬
1999 年 48 巻 1 号 p.
324-328
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
The use of autogenous bone patellar tendon bone graft (BTB) has been well established in anterior cruciate ligament (ACL) reconstruction.
A round shaped drill hole at the femur and tibia is commonly used for ACL reconstruction. BTB is on the other hard rectangularly shaped. Therefore, a gap fwms between BTB and bone tunnels. In this study, we attempted rectangular bone tunnel (RBT) for ACL reconstruction. Between 1996 and 1997, RBT for ACL reconstruction was carried out in 43 patients (22 males, 21 females). It suggests that RBT has two advantages, RBT is effective for preventing tunnel enlargement of the tibia, and reproduction of graft rotation is possible by RBT.
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鬼木 泰成, 中村 英一, 水田 博志, 白石 稔, 工藤 智志, 水本 圭彦, 中村 孝文, 高木 克公
1999 年 48 巻 1 号 p.
329-332
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We investigated the tendon length of the semitendinosus, the relationship between its length and height, femoral length and the preoperative hamstring strength of the injured side in 34 patients (15 males and 19 females) with unilateral ACL insufficiency. They underwent reconstructive surgery of the multistranded medial hamstring tendon. We also estimated the strand numbers of the individual tendon graft based on their tendon length. In the operation, we measured the harvested semitendinosus tendon length that could be used for the graft composition. The average length (range) in males and females was 24.8 (18.0-29.1) and 22.6 (18.0-28.2) cm, respectively. The correlation between their length and height was statistically significant in both genders. Correlation in the length between the tendon and femur was seen in males, but not in females. That between the length and hamstring strength was not significant. Although there was a tendency for greater possibility to create the quadrupled tendon graft with the increase in height, we could not accurately estimate the strand numbers because of considerable standard errors. Our data therefore showed that the precise tendon length of the semitendinosus and the accurate graft strand number cannot be estimated preoperatively, due to wide individual variation in spite of the correlation between the tendon length and height.
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萩原 博嗣, 中家 一寿, 小澤 慶一, 城野 修, 真鍋 尚至
1999 年 48 巻 1 号 p.
333-335
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
The results of 27 anterior cruciate ligament (ACL) reconstructions were evaluated after a follow-up of 9 to 54 months. The central one third of the pateller tendon with proximal and distal bone plug was grafted through a small arthrotomy incision (open technique) to reconstruct the ACL in all cases.
The mean age of the patients was 22.7 years old. (renge, 15 to 43 years) The mean postoperative knee score of the Japanese Orthopaedic Association was 95.8 points. Relatively lower scores were seen in cases who already had degenerative osteoarthritis of the knee in the period of operation.
Testing with KT-1000 arthrometer was performed at 89N.
It revealed that the difference in the anterior laxity between the involved knee and contralateral knee improved from an average of 5.2mm preoperatively to 1.1mm postoperatively. All patients expressed satisfaction with the outcome.
Small arthrotomy incision showed no evidence of being a disadvantage to the results of the operation.
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井原 秀俊, 永芳 郁文, 川嶌 眞人
1999 年 48 巻 1 号 p.
336-339
発行日: 1999/03/25
公開日: 2010/02/25
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フリー
Loose bodies located under the meniscus are relatirely rare findings in arthroscopic examinations. 3 cases are presented in this paper. Case 1 was a 25-year-old man who had aloose body lying beneath the anterior segment of the torn lateral discoid meniscus. Case 2 was a 33-year-old woman with a loose body underneath the anterior segment of the lateral meniscus. Case 3 was a 37-year old woman who had a loose body located under the body of the lateral discoid meniscus. Even during arthroscopy, the loose body of 1 case was invisible and removed through arthrotomy. The loose bodies of the other 2 cases were probed, hooked, and brought out from underneath the meniscus. The recognition of these locations of loose bodies seems to be important from a clinial point of view.
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近間 英明, 大木 實, 松永 浩隆, 山野 耕一郎
1999 年 48 巻 1 号 p.
340-344
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Ganglion cysts arising from cruciate ligaments are unusual lesions. We reports 3 cases and describe their MR appearance and clinical findings. In 2 cases the cyst was homogeneously hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging relative to the ACL. Exacervation of the pain occurred when standing over long periods of time, extreme flexion, extending the knee from a flexed position. It should be suspected in patients having chronic pain with extremes of motion. MR finding are diagnostic and help to guide arthroscopy.
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駿河 保彰, 重盛 廉, 行田 義仁, 小柴 民子
1999 年 48 巻 1 号 p.
345-347
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Patellar tendon rupture is relatively rare injury. We report the case of bilateral spontaneous patellar tendon rupture in a 34 year-old man. This patient has no concomitant systemic disease. But histological findings of his patellar tendon show chronic inflammatory change. Bilateral spontaneous patellar tendon ruptures in healthy patients are probably associated with the local change of the patellar tendon.
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金井 成行, 谷口 典正, 薄 竜太郎
1999 年 48 巻 1 号 p.
348-350
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Osteoarthropathy (OA) of the Knee occurs in the elderly and requires long term treatment.
We investigated the degree of severity by X-ray and surface temperature using thermography for knee.
The surface temperature of knees in the moderate severity group showed low temperatures compared with the normal group.
The results of this study indicate the usefulness of thermography according to the degree of OA in patients with knee pain.
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