Introduction: The purpose of this study was to investigate revision with a Kerboull-type plate through the posterior approach (PA) and direct anterior approach (DAA) and compare the clinical outcome. Subjects and methods: Fifty-four patients (56 hip joints) underwent revision surgery in which acetabular reconstruction was performed concomitantly using the Kerboull-type plate and allogeneic bone. Revision surgery through DAA was performed in 21 hip joints and these were compared with 34 hip joints treated through PA. There was no significant difference in the patient demographics between the DAA and PA. Results: There was no significant difference between the operative times in the DAA and PA groups (203.2 ± 43.5 and 211.7 ± 41.8 min). There was a significant difference between the intraoperative blood loss in the DAA and PA groups (503.9 ± 223.7 mL and 703.8 ± 329.6 mL, respectively, p < 0.05). There was no significant difference between the modified Harris Hip Score in the DAA and the PA groups. The loosening of the acetabular component was observed in four cases (11.8%) in the PA group. In the DAA and PA groups, the 5-year survival rates were 100 and 85.7%, respectively. Recurrent dislocation of the hip was observed in six cases (one case in the DAA group (4.8%) and five cases in the PA group (14.7%)). Conclusions: It was verified that the difference in the surgical approach of acetabular reconstruction concomitantly using the Kerboull-type plate and allogeneic bone graft influenced the postoperative outcome.

Introduction: When the postoperative outcome of primary total hip arthroplasty (THA) was compared with the direct anterior approach (DAA) and the posterior approach (PA), there was no significant difference of the clinical outcome at 6 months to 1 year after surgery in many studies. This study was performed to compare the medium-term outcome of THA via the DAA or PA and clarify which approach achieves better quality of life (QOL).Methods: We investigated 61 hips receiving primary THA (30 via DAA and 31 via PA), using hip function scores such as the Harris Hip Score (HHS) and patient-reported outcomes such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), and the Forgotten Joint Score-12 (FJS).Results: The mean duration of postoperative follow-up was 36.8 months in the DAA group and 40.5 months in the PA group. There was no difference in preoperative or postoperative HHS between the two groups. Although there was no difference of postoperative WOMAC and JHEQ, the postoperative FJS-12 score was significantly higher in the DAA group than in the PA group (75.2 ± 15.9 versus 60.1 ± 24.4, p = 0.01).Conclusion: When forgetting the artificial joint in daily life is the target, better QOL can be achieved by performing THA via the DAA.

Recent studies have shown that superoxide dismutase 1 (SOD1), SOD2, and SOD3 are significantly decreased in human osteoarthritic cartilage. SOD activity is a marker that can be used to comprehensively evaluate the enzymatic capacities of SOD1, SOD2, and SOD3; however, the trend of SOD activity in end-stage osteoarthritic tissues remains unknown. In the present study, we found that SOD activity in end-stage osteoarthritic synovium of the knee was significantly lower than that in control synovium without the influence of age. The SOD activity was significantly lower in the end-stage knee osteoarthritic cartilage than in the control, but a weak negative correlation was observed between aging and SOD activity. However, SOD activity in end-stage hip osteoarthritic cartilage was significantly lower than that in control cartilage without the influence of aging. The relationship between osteoarthritis and SOD activity was stronger than the relationship between aging and SOD activity. These results indicate that direct regulation of SOD activity in joint tissues may lead to suppression of osteoarthritis progression.

Lumbar artery branches coursed vertically over the middle third and the posterior third of the lateral sides of the intervertebral discs in approximately 3 and 30 % of subjects, respectively.

Purpose: The purpose of this study was to investigate the surgical outcomes of total hip arthroplasty (THA) through direct anterior approach (DAA) performed by beginners by comparing the outcomes after the introduction of DAA-THA between using a normal operating table and a traction table. Methods: The total subjects were 200 patients, there were 120 cases from the introduction of three surgeons using a normal table and 80 cases from two surgeons using a traction table. The surgical procedure was standardized, and a surgeon skilled in DAA entered the operating room and instructed the novice surgeons of DAA in all cases. Results: The mean operative time was no significant difference between the two groups ( p = 0.093). The difference in slope of the operative time was no significant difference between the two groups ( p value = 0.089). The mean fluoroscopy time and the mean blood loss were significant difference between the two groups ( p < 0.05). The difference in slope of the fluoroscopy time and blood loss were significant difference between the two groups ( p < 0.05). There were no intraoperative complications and no reoperations for any reason. Conclusions: At the facility with a surgeon skilled in DAA, the use of a traction table in DAA did not increase the complication rate compared with the use of a normal operating table when the exclusion criteria for DAA were set and surgery was performed using intraoperative fluoroscopy under supervision by a skilled surgeon.