Background There is limited information regarding the cause of revision TKA in Asia, especially Japan. Owing to differences in patient backgrounds and lifestyles, the modes of TKA failures in Asia may differ from those in Western countries. Questions/purposes We therefore determined (1) causes of revision TKA in a cohort of Japanese patients with revision TKA and (2) whether patient demographic features and underlying diagnosis of primary TKA are associated with the causes of revision TKA. Methods We assessed all revision TKA procedures performed at five major centers in Hokkaido from 2006 to 2011 for the causes of failures. Demographic data and underlying diagnosis for index primary TKA of the revision cases were compared to those of randomly selected primary TKAs during the same period. Results One hundred forty revision TKAs and 4047 primary TKAs were performed at the five centers, indicating a revision burden of 3.3%. The most common cause of revision TKA was mechanical loosening (40%) followed by infection (24%), wear/osteolysis (9%), instability (9%), implant failure (6%), periprosthetic fracture (4%), and other reasons (8%). The mean age of patients with periprosthetic fracture was older (77 versus 72 years) and the male proportion in patients with infection was higher (33% versus 19%) than those of patients in the primary TKA group. There was no difference in BMI between primary TKAs and any type of revision TKA except other causes. Conclusions The revision burden at the five referral centers in Hokkaido was 3.3%, and the most common cause of revision TKA was mechanical loosening followed

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We report the discovery of an X-ray counterpart of the unidentified very high energy gamma-ray source HESS J1427-608. In the sky field coincident with HESS J1427-608, an extended source was found in the 2-8 keV band, and was designated as Suzaku J1427-6051. Its X-ray radial profile has an extension of σ = 0. ′ 9 ± 0. ′ 1 if approximated by a Gaussian. The spectrum was well fitted by an absorbed power-law with N H = (1.1 ± 0.3) × 10 23 cm −2 , Γ = 3.1 +0.6 −0.5 , and the unabsorbed flux F X = (9 +4 −2 ) × 10 −13 erg s −1 cm −2 in the 2-10 keV band. Using XMM-Newton archive data, we found seven point sources in the Suzaku source region. However, because their total flux and absorbing column densities are more than an order of magnitude lower than those of Suzaku J1427-6051, we consider that they are unrelated to the Suzaku source. Thus, Suzaku J1427-6051 is considered to be a truly diffuse source and an X-ray counterpart of HESS J1427-608. The possible nature of HESS J1427-608 is discussed based on the observational properties.

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