Kazuo Takabatake

Morphology of the synovium during its differentiation and development in the mouse knee joint

SummaryThe prenatal and postnatal development of the mouse knee joint was investigated by transmission and scanning electron microscopy. In the prenatal stage, following the appearance of a narrow intercellular cleft between two skeletal elements on the 16th fetal day, clefting extended into the lateral synovial mesenchyme. In some regions, the extension of the cleft was very rapid, but in a certain region (future fat pad region), it was somewhat slower. Macrophage-like cells appeared in the synovial mesenchyme on the 16th fetal day, and then increased in number, and were distributed as if they were clustering around the presumptive clefting zone in the future fat pad region on the 17th–18th fetal day. This suggests that macrophage-like cells may participate in joint development, as they phagocytize and remove some kinds of solid extracellular matrix, and facilitate the cleft extension. In the early postnatal stage, scanning electron microscopic observations showed that there were two different types of cell in the synovial lining. One of them exhibited a surface morphology corresponding to that of macrophages: a spherical cell body and numerous pseudopodia. The other type of cell exhibited various cell shapes with many cytoplasmic processes extending along the synovial surface.

Degenerative Lumbosacral Kyphosis in Elderly Patients

A flexed posture is seen to develop in association with increasing age. Patients with such a flexed posture have several problems, and it is difficult to treat these favorably. To treat this type of deformity, we must understand the alignment of the patients spine.We classified lumbosacral kyphosis into three types depending on sacral inclination and disc degeneration in the lower lumbar spine. Patients with a deformity due to loss of sacral inclination and malalignment in lower lumbar spine showed marked disability in daily life and had severe lumbago.Sacral inclination seemed to be an important factor in the treatment of patients with deformity both surgically and non-surgically. We may operate on them using lumbosacral fusion and correction using Galveston technique with ISOLA instrumentation.