Hiroo Sato

Critical Path in Rotator Cuff Tear

We applied critical path to rotator cuff tears. At the introduction of the path, we decided the criteria for discharge. The criteria were the removal of shoulder abduction brace and the activity level of patients for face-washing and eating. At the programming of the critical path, we improved the process in our hospital. After anesthesia, patients remained asleep for 6 hours, and antibiotics administration stopped 2 days after surgery. The surgical wounds were fixed with tape so that the thread did not need to be removed.We examined the patients who were 8 before and 9 after introduction of critical path. We examined the duration of brace use, average number of days of hospital stay, and JOA score.After the introduction of the critical path, the duration of wearing brace use and average number of days in the hospital became shorter. Doctors, nurses, and patients were all satisfied with the critical path.

Non-collar Fixation and Early Ambulation after Cervical Laminoplasty

We have been trying non-collar fixation and early ambulation after cervical laminoplasty since July 1998.The aim of this report is to evaluate this postoperative physical treatment.In the radiological evaluation, the range of motion of the neck after operation was more or less the same as before operation.This group did not complain of post operative neck pain and showed no complications.The course of postoperative rehabilitation without collar fixation was shorter than traditional rehabilitation.

Inconsistency between Preoperative and Postoperative Correction Angles in High Tibial Osteotomy

This study was performed to assess the accuracy of the operative correction angle in high tibial osteotomy and consider the possible causes for inconsistency between the preoperative and post operative correction the angles.We studied 40 knees in 31 cases (9 males and 22 females) treated by high tibial osteotomy between 1996 and 1998. The mean age was 66.2 years (45 to 81). We used five kirschner wires (∅ 1.8mm as the osteotomy guide, inserted them roentgenographically and performed interlocking wedge osteotomy. Preoperative and postoperative correction angles were measured and the postoperative correction angle was subtracted preoperatively. The inconsistency between the preoperative and postoperative correction angles was within ±2° in 31 knees (77.5%), +3° in 5 knees (12.5%), +4° in 2 knees (5.0%), +5° in 1 knee (2.5%), and -4° in 1 knee (2.5%). Satisfactory results were obtained in a majority of the patients.High tibial osteotomy requires operative technique taking into consideration inconsistency between the preoperative and postoperative correction angles.