Hideki Sonoda

Over 5-Year Follow-up of Total Knee Replacement with the Okayama University Type (Mark II )

We have operated on patients complaining of severe knee joint dysfunction (52 joints) from osteo-arthritic changes using Okayama University type (Mark II) or over 5 years. And Post-operative knee function is evaluated clinically and roentgenologically in 12 patients (13 joints). Results are as follows: femoro-tibial angle (170°-177°), medial tibial angle (85°-90°), posterior tibial angle (82°-90°), and clinical evalution is good.In spite of clinically good function, sinking of the tibial component is shown roentgenologically in only one patient (1 joint).

Frequency of Occurrence and Radiological Study of Lumbosacral Transitional Vertebrance

We found fifty-two Lumbosacral Transitional Vertebrae in eleven hudred sixty-eight IVP (Intravenous Pyelography) X-ray films during recent two years. We classified thease into four groups according to Jinnaka and investigated the frequency of occurrence.Thype I was observed in 14 cases (1.20%), Type II in 17 cases (1.11%), Type III in 11 cases (0.94%), and Type IV in 14 cases (1.20%).

Two Cases of Phrenic Nerve Palsy in a Cervical Myelopathy Caused by Ossification of Posterior Longitudinal Ligament

Two cases of phrenic nerve palsy in an ossification of posterior longitudinal ligament (OPLL) were admitted and underwent operations on cervical spine. A 57-year-old man had been performed cervical laminoplasty (C2-C7). A month after surgery, he was weaned from artificial respirator, and gained vital capacity by 1, 230ml, and %vc, 36.6%. Seven months post-Operation he was discharged on his feet.A 55-year-old woman had been operated (C2-C7) on due to left phrenic palsy and myelopathy in OPLL. Three months after surgery the neurological deficits were almost fully recovered.Cervical X-ray films of Both cases revealed the peak of OPLL to be on the third cervical spine and the myelogram showed block at C2-3 level. In case of upper cervical OPLL, we need an attention to phrenic nerve palsy.

A Clinical Review of the Deceased from Cervical Spinal Cord Injury

We have reviewed three cases of the cervical spinal cord injiry who died within three months after the onset. One of them was diagnosed as DIC by the autopsy. The another case was suspected of DIC on its clinical course.

Two Cases of Foreign Bodies in the Knee. (Arthroscopic removal)

Arthroscopic surgery was performed in two cases of knee joints containing foreign bodies.Case 1: 46-year-old female. Broken glass penetrated into her right knee joint and 6 years later, her right knee suffered from septic arthritis, so we performed arthroscopic removal of the glass.Case 2: 6-year-old male. A needle penetrated into his left knee joint, so we performed arthroscopic removal of the needle.Arthroscopic removal of foreign bodies in the knee joint is more useful than large incision removal.

Total Hip Replacement combined with Acetabuloplasty

We performed total hip replacement combined with bone grafting acetabulopasty on 16 hips and reviewed them. Grafted bones were survived and remodeled in all cases and middle term results of them were almost good. But in a few cases which bone was unsuitably grafted to, acetabular remodeling was unsatisfactory.

Middle Term Result of Pelvic Osteotomy (Chiari) to Adolescent Dysplasial Hip

Middle term results, over 5 years after surgery, were reported in 8 hips treated by Pelvic Osteotomy (Chiari).Ages of cases at operation were 15 years old in average.Plastic effects for dysplasial acetabular edge were satisfactory in all cases; in radiogram at follow-up time, CE angle became to 34.1° from minus 11.0° at pre-operation, Sharp angle became to 39.8° from 54.6° and Acetabular Head Index became to 97.6% from 41.0% in average.All patients showed normal range of motion and good activities of daily living. Only one case showed slightly Trendelenburg limping and another one case complained of slight pain of the hip after long gait.

Short Term Results of Prosthesis of the Rotation Type Femoral Head

A follow-up study was performed on 30 hips in 29 cases.The age at the time of operation ranged between 29 and 77 years, 61 years in average.The duration of follow-up was 12 months to 3 years and 11 months, 2 years and 3 months in average.Satisfactory results were obtained in 26 hips (86%), especially fresh fracture of femur neck was excellent.Proximal migration was found in 12 hips (40%) and the result was poor than the cases which had no proximal migration.Ectopic ossification was seemed in 9 hips and the result was good.

Total Hip Replacement with K. Y. M. Rotation Type Prosthesis (Modification of Weber-Huggler Type) and it's Short Term Results

Total hip replacement surgery with K. Y. M. rotation type prosthesis were performed on 44 hips in 37 cases. The head of this prosthesis is made of high density polyethylen.The replacement surgery was done in 19 hips with ostheoarthritis, 7 hips with rheumatoid arthritis, 3 hips with aseptic necrosis of the femur head, 8 hips with femur neck fracture and 6 hips with weared high density polyethylen artificial head.Short term results on 18 hips, from 3 years to 4 years after operation, showed fairly good result except one case with cup loosening.

Complications of Total Hip Replacement Surgery with K. Y. M. Rotation Type Prosthesis (Modification of Weber-Huggler Type)

The complication of total hip replacement surgery (K. Y. M. rotation type) were found in 7 out of 44 operated hips.2 cases of them were loosening of the cup which were found 1 year after and 4 years after surgery. Breakage of the C. O. P. femur stem was occured in one case at 1.5 years after operation.Wear of the neck of H. D. P. prosthesis, causing to ectopic ossification, was found in one case. Immediate postoperative dislocation of the prosthetic head were found in 3 cases. After reduction, they were fixed in plaster cast in 3 weeks. Thereafter, they were brought in succesful course.