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Takayama K, Ito H. Association between the canal filling ratio and bone resorption in trabecular metal stems in reverse total shoulder arthroplasty: a radiographic analysis using tomosynthesis. JSES Int 2024; 8:1077-1086. [PMID: 39280137 PMCID: PMC11401559 DOI: 10.1016/j.jseint.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Abstract
Background Several factors affect the incidence of osteopenia with cortical narrowing (CNO) in reverse shoulder arthroplasty. This study aimed to compare the incidence of CNO with different fixation methods (cemented or cementless) using a single implant (trabecular metal humeral stem) evaluated using tomosynthesis and to analyze the factors affecting the incidence of CNO for cementless stem fixation. Methods A total of 109 patients (cementless: 75 cases; cemented: 34 cases) who underwent reverse total shoulder arthroplasty were included in this study. The patients were divided into 2 groups (cementless or cemented), and the incidence of CNO was compared. In addition, patients in the cementless group were divided into 2 groups (canal filling ratio [CFR] of ≥ 0.7 or < 0.7), the incidence of CNO was compared, and the Cramer's coefficient of association between CNO and CFR > 0.7 (and 0.8) was calculated. Results No significant difference was observed in the incidence of CNO between the cementless and cemented groups (7/75 vs. 3/35, P value = 1.0). The association between CNO and the CFR using Cramer's coefficient of association showed that there were few correlations (coefficient: 0.14, P value = .59). Conclusion Cementless reverse total shoulder arthroplasty with a trabecular metal stem has a similar low incidence of CNO as cemented fixation, and the incidence of CNO with a trabecular metal stem was lower than that reported in previous studies. A CFR > 0.7 was not associated with the incidence of CNO.
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Affiliation(s)
| | - Hiromu Ito
- Department of Orthopaedics, Kurashiki Central Hospital, Japan
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Takayama K, Ito H. Both angled bony-increased offset and metal-augmented baseplates provide satisfactory bone incorporation to the glenoid in reverse total shoulder arthroplasty: a radiographic evaluation using tomosynthesis. J Shoulder Elbow Surg 2024; 33:1058-1067. [PMID: 37848155 DOI: 10.1016/j.jse.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/17/2023] [Accepted: 09/03/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Angled bony-increased offset and metal-augmented baseplate have recently been used to achieve neutral to inferior inclination of the glenoid implant. Nonetheless, bone incorporation is difficult to evaluate using computed tomography or other conventional methods owing to the presence of metal artifacts; therefore, whether bone incorporation between the grafted bone and glenoid or between the graft and baseplate implant can be achieved remains unclear. Several studies have reported the effectiveness of tomosynthesis in reducing metal artifacts for the evaluation of implant loosening, bone resorption, and spot welds. We aimed to evaluate and compare the bone incorporation rates between angled bony-increased offset and metal-augmented implants using tomosynthesis with metal artifact reduction technology. We hypothesized that a high bone incorporation rate would be obtained with angled bony-increased offset and a metal-augmented baseplate. METHODS A total of 52 patients who underwent reverse total shoulder arthroplasty (TSA) with angled bony-increased offset and 42 patients who underwent reverse total shoulder arthroplasty with metal-augmented baseplate were assessed and followed up for a minimum of 2 years. The bone incorporation and implant loosening rates were compared between the 2 groups, and the sites of spot welds and trabeculation were recorded according to zones. Bone incorporation between the bone and prosthesis was defined as a confirmation of spot welds connecting the porous area and bone in more than three zones. Bone incorporation between the native bone and grafted bone was defined as an observation of trabeculation. Glenoid loosening was defined as the presence of at least 1 mm radiolucency around the prosthesis in more than 2 zones. RESULTS Both the angled bony-increased offset and metal-augmented baseplate groups achieved sufficient bone incorporation rates (98% [51/52 cases] vs. 100% [42/42 cases], P = 1.0) and low implant loosening rates (2% [1/52 cases] vs. 0% [0/42 cases], P = 1.0). Spot welds and trabeculation were likely to be confirmed in the lower parts of the glenoid. CONCLUSION The two groups did not show any significant differences regarding bone incorporation rates. Considering the complexity of performing the procedure with angled bony-increased offset, the use of a metal-augmented baseplate can serve as an alternative treatment to avoid superior inclination in reverse total shoulder arthroplasty.
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Affiliation(s)
- Kazumasa Takayama
- Department of Orthopaedics, Kurashiki Central Hospital, Okayama, Japan.
| | - Hiromu Ito
- Department of Orthopaedics, Kurashiki Central Hospital, Okayama, Japan
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Hooper G, Thompson D, Frampton C, Lash N, Sharr J, Fulker D, Gilchrist N. Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total Hip Arthroplasty: A 3-Arm Prospective Randomized Controlled Trial. J Bone Joint Surg Am 2024; 106:508-516. [PMID: 38113306 DOI: 10.2106/jbjs.23.00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Femoral stem design affects periprosthetic bone mineral density (BMD), which may impact long-term survival of cementless implants in total hip arthroplasty (THA). The aim of this study was to examine proximal femoral BMD in 3 morphologically different uncemented femoral stem designs to investigate whether any particular design resulted in better preservation of BMD. METHODS A total of 119 patients were randomized to receive a proximally coated collarless dual-taper wedge stem, a proximally coated collarless anatomic stem, or a fully coated collarless triple-taper stem. All surgeries were performed via the posterior approach, with mobilization on the day of surgery. Dual x-ray absorptiometry scans (Lunar iDXA, GE Healthcare) assessed BMD across the 7 Gruen zones preoperatively and at 6 weeks and 2 years postoperatively; if available, the native contralateral femur was also assessed as a control. Patient-reported outcomes of pain, function, and health were also assessed at these follow-ups. RESULTS Averaged across all stems, BMD increased in zones 1 (2.5%), 2 (17.1%), 3 (13.0%), 5 (10%), and 6 (17.9%) at 2 years. Greater preservation of BMD was measured on the lateral cortex (zone 2) for both the dual-taper wedge and anatomic stems (p = 0.019). The dual-taper wedge stem also demonstrated preservation of BMD in the medial calcar (zone 7), while the anatomic and triple-taper stems declined in this region; however, the difference did not reach significance (p = 0.059). Averaged across all stems, BMD decreased in the mid-diaphysis region, distal to the stem tip (zone 4). All stems performed similarly at the time of final follow-up with respect to the patient-reported outcomes. CONCLUSIONS This study demonstrated maintenance of femoral BMD after use of 3 different cementless femoral stem designs, with all achieving excellent improvements in patient-reported outcomes. The stems designed to load the proximal metaphyseal region resulted in higher BMD in that region. No significant stress-shielding was observed; however, longer follow-up is required to elucidate the impact of this finding on implant survivorship. LEVEL OF EVIDENCE Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Gary Hooper
- CGM Research Trust, Christchurch, South Island, New Zealand
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, South Island, New Zealand
| | | | - Christopher Frampton
- Department of Medicine, University of Otago, Christchurch, South Island, New Zealand
| | - Nicholas Lash
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, South Island, New Zealand
| | - Jonathan Sharr
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, South Island, New Zealand
| | - David Fulker
- Stryker Australia, St Leonards, Sydney, Australia
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Segi N, Nakashima H, Shinjo R, Kagami Y, Machino M, Ito S, Ouchida J, Imagama S. Reply to "Letter to the Editor Concerning 'Trabecular Bone Remodeling as a New Indicator of Osteointegration After Posterior Lumbar Interbody Fusion.' by Segi et al.". Global Spine J 2024; 14:353-354. [PMID: 36880152 PMCID: PMC10676159 DOI: 10.1177/21925682231162860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Affiliation(s)
- Naoki Segi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Orthopedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryuichi Shinjo
- Department of Orthopedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Yujiro Kagami
- Department of Orthopedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Masaaki Machino
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sadayuki Ito
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun Ouchida
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Asari T, Wada K, Kumagai G, Sasaki E, Okano R, Oyama T, Tsukuda M, Ota K, Ishibashi Y. Usefulness of digital tomosynthesis in diagnosing cervical ossification of the posterior longitudinal ligament: a comparative study with other imaging modalities. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:3470-3476. [PMID: 36273327 DOI: 10.1007/s00586-022-07430-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/13/2022] [Accepted: 10/16/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The diagnosis and classification of ossification of the posterior longitudinal ligament (OPLL) can be difficult with radiography alone; therefore, computed tomography (CT) is also usually performed. There are many reports on the usefulness of digital tomosynthesis (DTS) for image analysis in orthopedics. This study aimed to compare the accuracy of DTS with radiography and CT for the diagnosis and classification of cervical OPLL (C-OPLL). MATERIALS AND METHODS We included 31 patients with OPLL and 30 with cervical spondylotic myelopathy. The patients' cervical spine radiography, DTS, and CT images were each evaluated twice by three specialists and three residents. RESULTS In the intra-observer reliability study, there was one observer with a fair level of kappa values for radiography and DTS among three residents. The kappa values for CT were the best for all observers. In the inter-observer reliability study, the interclass correlation coefficient (ICC) values were high for both diagnosis and classification by specialists at the almost perfect level for all three imaging modalities. On the other hand, the ICC values for both diagnosis and classification for radiography by the residents were lower than those for DTS and CT. CONCLUSIONS This study revealed that DTS may be an alternative to CT for the diagnosis and classification of C-OPLL by specialists. Caution should be exercised in diagnosing and classifying C-OPLL using radiography and DTS by residents, and the use of CT is recommended.
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Affiliation(s)
- Toru Asari
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan.
| | - Kanichiro Wada
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
| | - Gentaro Kumagai
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
| | - Eiji Sasaki
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
| | - Rino Okano
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
| | - Tetsushi Oyama
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
| | - Manami Tsukuda
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
| | - Kento Ota
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan
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Wang J, Guo RT, Bi ZX, Chen X, Hu X, Pan WG. A review on TiO 2-x-based materials for photocatalytic CO 2 reduction. NANOSCALE 2022; 14:11512-11528. [PMID: 35917276 DOI: 10.1039/d2nr02527b] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Photocatalytic CO2 reduction technology has a broad potential for dealing with the issues of energy shortage and global warming. As a widely studied material used in the photocatalytic process, titanium dioxide (TiO2) has been continuously modified and tailored for more desirable application. Recently, the defective/reduced titanium dioxide (TiO2-x) catalyst has attracted broad attention due to its excellent photocatalytic performance for CO2 reduction. In this perspective review, we comprehensively present the recent progress in TiO2-x-based materials for photocatalytic CO2 reduction. In detail, the review starts with the fundamentals of CO2 photocatalytic reduction. Then, the synthesis of a defective TiO2 structure is introduced for the regulation of its photocatalytic performance, especially its optical properties and dissociative adsorption properties. In addition, the current application of TiO2-x-based photocatalysts for CO2 reduction is also highlighted, such as metal-TiO2-x, oxide-TiO2-x and TiO2-x-carbon-based photocatalysts. Finally, the existing challenges and possible scope of photocatalytic CO2 reduction over TiO2-x-based materials are discussed. We hope that this review can provide an effective reference for the development of more efficient and reasonable photocatalysts based on TiO2-x.
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Affiliation(s)
- Juan Wang
- College of Energy and Mechanical Engineering, Shanghai University of Electric Power, Shanghai, China.
| | - Rui-Tang Guo
- College of Energy and Mechanical Engineering, Shanghai University of Electric Power, Shanghai, China.
- Shanghai Engineering Research Center of Power Generation Environment Protection, Shanghai, China
| | - Zhe-Xu Bi
- College of Energy and Mechanical Engineering, Shanghai University of Electric Power, Shanghai, China.
| | - Xin Chen
- College of Energy and Mechanical Engineering, Shanghai University of Electric Power, Shanghai, China.
| | - Xing Hu
- College of Energy and Mechanical Engineering, Shanghai University of Electric Power, Shanghai, China.
| | - Wei-Guo Pan
- College of Energy and Mechanical Engineering, Shanghai University of Electric Power, Shanghai, China.
- Shanghai Engineering Research Center of Power Generation Environment Protection, Shanghai, China
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