Background: Giant cell tumor of the bone (GCTB) occurs most often in younger individuals aged between 20 and 40 years. However, it also occurs in a small proportion of elderly people. Therefore, it is necessary to det...Background: Giant cell tumor of the bone (GCTB) occurs most often in younger individuals aged between 20 and 40 years. However, it also occurs in a small proportion of elderly people. Therefore, it is necessary to determine the clinical characteristics of GCTB in elderly people, as only few reports have completely examined the characteristics of GCTB in elderly patients. Methods: This retrospective study enrolled 69 patients with benign GCTB. Patients’ information on age, sex, anatomical location and size, Campanacci grade, pathological fracture, treatment for primary tumors, local and distant relapse, and outcome was collected. We compared these clinical courses between the younger and older groups. We divided the age groups into three subgroups: ≤54 years and ≥55 years, ≤59 years and ≥60 years, and ≤64 years and ≥65 years. We compared the two groups in each subgroup. In addition, we examined factors affecting local recurrence and distant metastasis. Results: Tumor size was significantly larger in the older group between the two subgroups of 55 and 60 years. Kaplan-Meier curves for local recurrence-free survival and distant metastasis-free survival between the two subgroups of 65 years showed significant differences (<span style="color:#4D4D4D;font-family:-apple-system, " font-size:16px;white-space:normal;background-color:#ffffff;"=""><i></i></span><i><span style="font-family:Verdana;">p<span style="white-space:normal;color:#4D4D4D;font-family:-apple-system, " font-size:16px;background-color:#ffffff;"=""></span></span></i><span style="white-space:normal;"></span><i><span style="font-size:10.0pt;font-family:;" "=""> </span></i><span style="font-family:Verdana;">=</span><span style="font-size:10pt;font-family:;" "=""> </span><span style="font-family:Verdana;">0.0183 and </span><i><span style="color:#000000;"><span style="font-family:Verdana;color:#000000;"><span style="color:#000000;">p</span></span></span></i><i><span style="font-size:10.0pt;font-family:;" "=""> </span></i><span style="font-family:V展开更多
Background: Although abduction of the acetabular component is considered to predict factors for polyethylene wear attributable to osteolysis, other radiographic factors have yet to be elucidated. The purpose of the pr...Background: Although abduction of the acetabular component is considered to predict factors for polyethylene wear attributable to osteolysis, other radiographic factors have yet to be elucidated. The purpose of the present study was to evaluate whether anteversion or change in implantation angle of the acetabular component influences polyethylene linear wear by using standing and supine radiographs of the hip joint. Methods: Standing and supine plain anteroposterior radiographs of 62 hip joints in which cementless total hip arthroplasty was performed were examined for polyethylene linear wear rate (mm/year), pelvic inclination, and radiological inclination and anatomic anteversion of the acetabular component. Results: All correlation coefficients of measurements of polyethylene linear wear, pelvic inclination angle, anatomical anteversion angle and radiological inclination angle were calculated highly. And by the three-dimensional numerical analysis, anatomic anteversion of the acetabular component had at least some effect on the degree of polyethylene wear. Conclusion: This study suggests that increased anteversion of the acetabular component reduces polyethylene linear wear in metal-on-polyethylene total hiparthroplasty.展开更多
Non-traumatic osteonecrosis of the femoral head (ONFH) is believed to be avascular necrosis. Certainly, a disruption of a supplying artery induces necrosis in the supplying artery-dominant region. However, when an abn...Non-traumatic osteonecrosis of the femoral head (ONFH) is believed to be avascular necrosis. Certainly, a disruption of a supplying artery induces necrosis in the supplying artery-dominant region. However, when an abnormality such as cell apoptosis, or another reason, is developed in the supplying artery-dominant region, it induces a disruption of the supplying artery. Therefore, to prove that ONFH is avascular necrosis, it is necessary to demonstrate the disruption of the supplying artery prior to histological osteonecrosis development. Here we investigate histologically, using a rat model, whether disruption of the supplying artery occurs before the initial development of ONFH following corticosteroid treatment. Rats were given imiquimod and methylprednisolone, and were sacrificed 1, 2, 3, 7 or 14 days after the last injection. At the sacrifice, the rat was perfused with 20 ml black Indian ink through the left ventricle. ONFH was observed in the Imiquimod + Methylprednisolone group at 7 and 14 days. The osteonecrotic area was not stained with perfused black Indian ink. However, the lateral portion of the femoral head near the superior retinacular artery was stained with the ink. In conclusion, the present study shows that the superior retinacular artery did not occlude before the initial development of ONFH histologically in rats.展开更多
文摘Background: Giant cell tumor of the bone (GCTB) occurs most often in younger individuals aged between 20 and 40 years. However, it also occurs in a small proportion of elderly people. Therefore, it is necessary to determine the clinical characteristics of GCTB in elderly people, as only few reports have completely examined the characteristics of GCTB in elderly patients. Methods: This retrospective study enrolled 69 patients with benign GCTB. Patients’ information on age, sex, anatomical location and size, Campanacci grade, pathological fracture, treatment for primary tumors, local and distant relapse, and outcome was collected. We compared these clinical courses between the younger and older groups. We divided the age groups into three subgroups: ≤54 years and ≥55 years, ≤59 years and ≥60 years, and ≤64 years and ≥65 years. We compared the two groups in each subgroup. In addition, we examined factors affecting local recurrence and distant metastasis. Results: Tumor size was significantly larger in the older group between the two subgroups of 55 and 60 years. Kaplan-Meier curves for local recurrence-free survival and distant metastasis-free survival between the two subgroups of 65 years showed significant differences (<span style="color:#4D4D4D;font-family:-apple-system, " font-size:16px;white-space:normal;background-color:#ffffff;"=""><i></i></span><i><span style="font-family:Verdana;">p<span style="white-space:normal;color:#4D4D4D;font-family:-apple-system, " font-size:16px;background-color:#ffffff;"=""></span></span></i><span style="white-space:normal;"></span><i><span style="font-size:10.0pt;font-family:;" "=""> </span></i><span style="font-family:Verdana;">=</span><span style="font-size:10pt;font-family:;" "=""> </span><span style="font-family:Verdana;">0.0183 and </span><i><span style="color:#000000;"><span style="font-family:Verdana;color:#000000;"><span style="color:#000000;">p</span></span></span></i><i><span style="font-size:10.0pt;font-family:;" "=""> </span></i><span style="font-family:V
文摘Background: Although abduction of the acetabular component is considered to predict factors for polyethylene wear attributable to osteolysis, other radiographic factors have yet to be elucidated. The purpose of the present study was to evaluate whether anteversion or change in implantation angle of the acetabular component influences polyethylene linear wear by using standing and supine radiographs of the hip joint. Methods: Standing and supine plain anteroposterior radiographs of 62 hip joints in which cementless total hip arthroplasty was performed were examined for polyethylene linear wear rate (mm/year), pelvic inclination, and radiological inclination and anatomic anteversion of the acetabular component. Results: All correlation coefficients of measurements of polyethylene linear wear, pelvic inclination angle, anatomical anteversion angle and radiological inclination angle were calculated highly. And by the three-dimensional numerical analysis, anatomic anteversion of the acetabular component had at least some effect on the degree of polyethylene wear. Conclusion: This study suggests that increased anteversion of the acetabular component reduces polyethylene linear wear in metal-on-polyethylene total hiparthroplasty.
文摘Non-traumatic osteonecrosis of the femoral head (ONFH) is believed to be avascular necrosis. Certainly, a disruption of a supplying artery induces necrosis in the supplying artery-dominant region. However, when an abnormality such as cell apoptosis, or another reason, is developed in the supplying artery-dominant region, it induces a disruption of the supplying artery. Therefore, to prove that ONFH is avascular necrosis, it is necessary to demonstrate the disruption of the supplying artery prior to histological osteonecrosis development. Here we investigate histologically, using a rat model, whether disruption of the supplying artery occurs before the initial development of ONFH following corticosteroid treatment. Rats were given imiquimod and methylprednisolone, and were sacrificed 1, 2, 3, 7 or 14 days after the last injection. At the sacrifice, the rat was perfused with 20 ml black Indian ink through the left ventricle. ONFH was observed in the Imiquimod + Methylprednisolone group at 7 and 14 days. The osteonecrotic area was not stained with perfused black Indian ink. However, the lateral portion of the femoral head near the superior retinacular artery was stained with the ink. In conclusion, the present study shows that the superior retinacular artery did not occlude before the initial development of ONFH histologically in rats.