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Murakami K, Hamai S, Moro-Oka T, Okazaki K, Higaki H, Shimoto T, Ikebe S, Nakashima Y. Variable tibiofemoral articular contact stress in fixed-bearing total knee arthroplasties. Orthop Traumatol Surg Res 2018; 104:177-183. [PMID: 29274859 DOI: 10.1016/j.otsr.2017.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/14/2017] [Accepted: 11/17/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rotational allowance at the tibiofemoral joint would be required during deep flexion. However, the amount of flexion and rotation has not been investigated in modern total knee arthroplasty (TKA) designs. The present study aimed to determine the contact stress in five posterior-stabilized fixed-bearing TKA designs. HYPOTHESIS We hypothesized that the contact area and stresses at the tibiofemoral articular surfaces vary according to the type of implant design and tested condition. MATERIALS AND METHODS The contact area and mean and peak contact stresses at the tibiofemoral articular surfaces were determined when a compressive load of 1200N was applied to a NexGen LPS Flex, Scorpio NRG, Genesis II, PFC Sigma, and Foundation implant. Measurements were performed at 0° and 45° flexion with 0°, 5°, 10°, and 15° rotation, and at 90° and 135° flexion with 0, 5°, 10°, 15°, and 20° rotation. RESULTS The LPS Flex showed that the femoral component could not achieve 20° rotation at 135° flexion. The Scorpio NRG showed less than 20MPa of contact stress at all conditions. The Genesis II showed higher contact stress than 20MPa at 135° flexion with 20° rotation. The PFC Sigma showed that the femoral component could not achieve >10° rotation at any flexion angle. The Foundation showed more than 20MPa of contact stress at 90° flexion with 20° rotation and at 135° flexion with 10°, 15°, and 20° rotation. DISCUSSION Surgeons should be more aware of the variable contact conditions of the tibiofemoral articular surfaces in individual TKA designs. LEVEL OF EVIDENCE Level IV, basic science study.
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Affiliation(s)
- K Murakami
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan
| | - S Hamai
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan.
| | - T Moro-Oka
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan; Moro-oka orthopaedic hospital, 101-3, Katawana Nakagawa-machi, 811-1201 Chikushi-gun, Fukuoka, Japan
| | - K Okazaki
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan
| | - H Higaki
- Department of biorobotics, faculty of engineering, Kyushu Sangyo university, 2-3-1, Matsugadai, 813-8583 Higashi-ku, Fukuoka, Japan
| | - T Shimoto
- Department of information and systems engineering, faculty of information engineering, Fukuoka institute of technology, 3-30-1, Wajiro-higashi, 811-0295 Higashi-ku, Fukuoka, Japan
| | - S Ikebe
- Department of biorobotics, faculty of engineering, Kyushu Sangyo university, 2-3-1, Matsugadai, 813-8583 Higashi-ku, Fukuoka, Japan
| | - Y Nakashima
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan
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Takeuchi N, Okada T, Kozono N, Shimoto T, Higaki H, Iwamoto Y. Symmetric Peripheral Running Sutures are Superior to Asymmetric Peripheral Running Sutures for Increasing the Tendon Strength in Flexor Tendon Repair. J Hand Surg Asian Pac Vol 2017; 22:208-213. [PMID: 28506161 DOI: 10.1142/s0218810417500265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The fatigue strength of three peripheral suture techniques for flexor tendon repair was compared by cyclic loading of the repairs in the porcine flexor digitorum tendon. METHODS Thirty-six tendons were sutured using only peripheral sutures with 6-0 Nylon. An initial cyclic load of 10 N for 500 cycles was applied and increased by 10 N for an additional 500 cycles at each new load until rupture. RESULTS The fatigue strength of the symmetric running peripheral suture was 85.0% and 144.8% greater than that of the two kinds of the asymmetric running peripheral sutures. CONCLUSIONS Symmetric running sutures can enhance the suture strength and appears to be a useful technique for increasing the strength of the peripheral suture.
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Affiliation(s)
- N Takeuchi
- * Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan
| | - T Okada
- * Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan
| | - N Kozono
- * Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan
| | - T Shimoto
- † Department of Information and System Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, Japan
| | - H Higaki
- ‡ Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, Fukuoka, Japan
| | - Y Iwamoto
- * Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan
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Kozono N, Okada T, Takeuchi N, Hanada M, Shimoto T, Iwamoto Y. Asymmetric six-strand core sutures enhance tendon fatigue strength and the optimal asymmetry. J Hand Surg Eur Vol 2016; 41:802-8. [PMID: 26896454 DOI: 10.1177/1753193416631454] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 09/30/2015] [Indexed: 02/03/2023]
Abstract
Under cyclic loading, we recorded the fatigue strength of a six-strand tendon repair with different symmetry in the lengths of suture purchase in two stumps of 120 dental rolls and in 30 porcine tendons. First, the strengths of the repairs with 1, 2, 3, 4 and 5 mm asymmetry were screened using the dental rolls. The asymmetric core suture repairs were then made with a Kessler repair of equal suture purchase (10 mm) in two tendon stumps, and shifting two other Kessler repairs by 1, 3 or 5 mm, respectively, along the longitudinal axis of the tendon in relation to the first (symmetric) Kessler repair. The core repairs with 3 mm or more asymmetry in suture purchases in two tendon ends showed significantly greater fatigue strength and significantly smaller gaps compared with 1 mm asymmetry in core suture repair. Our results support that asymmetric placement of core sutures in two tendon ends favour resisting gapping at the repair site and 3 mm or more asymmetry is needed to produce such beneficial effects.
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Affiliation(s)
- N Kozono
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - T Okada
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - N Takeuchi
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - M Hanada
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan Department of Plastic Surgery, Kyushu University, Fukuoka, Japan
| | - T Shimoto
- Department of Information and System Engineering, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Y Iwamoto
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
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Kawahara S, Matsuda S, Fukagawa S, Mitsuyasu H, Nakahara H, Higaki H, Shimoto T, Iwamoto Y. Upsizing the femoral component increases patellofemoral contact force in total knee replacement. ACTA ACUST UNITED AC 2012; 94:56-61. [PMID: 22219248 DOI: 10.1302/0301-620x.94b1.27514] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In posterior stabilised total knee replacement (TKR) a larger femoral component is sometimes selected to manage the increased flexion gap caused by resection of the posterior cruciate ligament. However, concerns remain regarding the adverse effect of the increased anteroposterior dimensions of the femoral component on the patellofemoral (PF) joint. Meanwhile, the gender-specific femoral component has a narrower and thinner anterior flange and is expected to reduce the PF contact force. PF contact forces were measured at 90°, 120°, 130° and 140° of flexion using the NexGen Legacy Posterior Stabilized (LPS)-Flex Fixed Bearing Knee system using Standard, Upsized and Gender femoral components during TKR. Increasing the size of the femoral component significantly increased mean PF forces at 120°, 130° and 140° of flexion (p = 0.005, p < 0.001 and p < 0.001, respectively). No difference was found in contact force between the Gender and the Standard components. Among the patients who had overhang of the Standard component, mean contact forces with the Gender component were slightly lower than those of the Standard component, but no statistical difference was found at 90°, 120°, 130° or 140° of flexion (p = 0.689, 0.615, 0.253 and 0.248, respectively). Upsized femoral components would increase PF forces in deep knee flexion. Gender-specific implants would not reduce PF forces.
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Affiliation(s)
- S Kawahara
- Graduate School of Medical Sciences, Kyushu University, Department of Orthopaedic Surgery, 3-1-1, Maidashi Higashi-ku, Fukuoka City 812-8582, Japan
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Takeuchi N, Mitsuyasu H, Kikuchi K, Shimoto T, Higaki H, Iwamoto Y. The biomechanical assessment of gap formation after flexor tendon repair using partial interlocking cross-stitch peripheral sutures. J Hand Surg Eur Vol 2011; 36:584-9. [PMID: 21546417 DOI: 10.1177/1753193411406632] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The gap formation of five core plus peripheral suture techniques for flexor tendon repair was evaluated by cyclic load testing. Fifty pairs of dental roll tendon models were sutured using six-strand Pennington modified Kessler core suture with 4-0 Polypropylene. One-half or three-fourths circumferential interlocking cross-stitch, or three complete circumferential peripheral suture techniques were performed using 6-0 Polypropylene. An initial cyclic load of 10 N for 500 cycles was applied and increased by 5 N for an additional 500 cycles at each new load until rupture. The complete circumferential interlocking cross-stitch had the greatest fatigue strength. The partial circumferential cross-stitches resulted in significantly larger gap formations at both the repaired and unrepaired sides than the complete circumferential sutures, and were also associated with early rupture. The full circumference of the cut tendon must be sutured using an interlocking cross-stitch peripheral suture to improve strength and avoid gap formation.
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Affiliation(s)
- N Takeuchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Hamai S, Miura H, Higaki H, Shimoto T, Matsuda S, Iwamoto Y. Evaluation of impingement of the anterior tibial post during gait in a posteriorly-stabilised total knee replacement. ACTA ACUST UNITED AC 2008; 90:1180-5. [PMID: 18757957 DOI: 10.1302/0301-620x.90b9.20298] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Mechanical failure because of wear or fracture of the polyethylene tibial post in posteriorly-stabilised total knee replacements has been extensively described. In this study of 12 patients with a clinically and radiologically successful NexGen LPS posteriorly-stabilised prosthesis impingement of the anterior tibial post was evaluated in vivo in three dimensions during gait using radiologically-based image-matching techniques. Impingement was observed in all images of the patients during the stance phase, although the NexGen LPS was designed to accommodate 14 degrees of hyperextension of the component before impingement occurred. Impingement arises as a result of posterior translation of the femur during the stance phase. Further attention must therefore be given to the configuration of the anterior portion of the femoral component and the polyethylene post when designing posteriorly-stabilised total knee replacements.
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Affiliation(s)
- S Hamai
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Umeno T, Higaki H, Nakanishi Y, Shimoto T, Hara T. Change in servo-control ability with postural stability on aging. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)84974-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sudo T, Bessho H, Miyamoto M, Kanazawa H, Yasuda C, Uchida T, Kawamura M, Shimoto T, Kuyama T. Effect of glucagon on bile acid metabolism after resection of liver cancer in patients with cirrhosis. Nihon Geka Hokan 1990; 59:217-23. [PMID: 1966664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
After hepatectomy patients with cirrhosis and liver cancer may develop progressive hepatic dysfunction and eventually hepatic failure. Insulin and glucagon are often used to treat certain kinds of hepatic dysfunction and hepatic insufficiency. We investigated the effect of glucagon on bile acid metabolism and pancreatic endocrine function. In 7 patients with severe cirrhosis and cancer of the liver, 1 mg of glucagon was injected intravenously pre- and post-operatively, and total bile acids, C-AMP, and bile acid fractions were determined. In the pre-operative glucagon tolerance test, the C-AMP level rose from a baseline of 14 +/- 0.8 PMol/ml to 362 +/- 94 PMol/ml 30 min after the injection of glucagon (p less than 0.01); and the level of total bile acids decreased from a baseline of 28 +/- 9 microMol/ml to 11 +/- 3 microMol/ml 60 min after the injection of glucagon. The post-operative C-AMP level increased from a baseline of 13 +/- 1 PMol/ml to 192 +/- 58 PMol/ml level of 30 min after the injection of glucagon (p less than 0.01), and the post-operative level of total bile acids decreased from a baseline of 64 +/- 20 microMol/ml to 26 +/- 7 microMol/ml 60 min after the injection of glucagon. There was a significant correlation between the 5-min increment ratio of C-AMP and the decrement ratio of total bile acids (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T Sudo
- Second Department of Surgery, Kinki University School of Medicine, Sayama, Japan
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Sudo T, Shobu R, Bessho H, Miyamoto M, Nishimori A, Tsubakimoto R, Fukunishi K, Yasuda C, Kawamura M, Shimoto T. [Intussusception of the small intestine caused by villous adenoma: a case report]. Nihon Geka Hokan 1988; 57:568-72. [PMID: 3268069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Sudo T, Shobu R, Kanazawa H, Bessho H, Tsubakimoto R, Miyamoto M, Fuji Y, Kawamura M, Shimoto T, Kuyama T. Hepatocellular carcinoma with extrahepatic growth: a case report and review of the Japanese literature. Gastroenterol Jpn 1988; 23:312-7. [PMID: 2841183 DOI: 10.1007/bf02779476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of extrahepatically growing hepatocellular carcinoma is reported, and the Japanese literature is reviewed. A 42-year-old man was admitted to our hospital on December 27, 1985 complaining of epigastralgia and nausea. Ultrasonography and computerized tomography showed a large tumor in the right hepatic lobe. This Was removed surgically and examined histologically.
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Affiliation(s)
- T Sudo
- Second Department of Surgery, Kinki University School of Medicine, Osaka, Japan
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Sudo T, Shobu R, Kanazawa H, Tsubakimoto R, Fujii Y, Kawamura M, Umemura H, Shiraha S, Kuyama T, Shimoto T. [Extrahepatic hepatocellular cancer]. Nihon Geka Hokan 1986; 55:732-40. [PMID: 3034183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Tsuge S, Shibata K, Shimoto T, Terai S. [Case of central giant cell tumor of the maxilla]. Iryo 1970; 24:161-5. [PMID: 5443811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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