Yoshitaka Tani

Sociodemographic factors and failure of hip arthroplasty

Abstract To identify the sociodemographic and lifestyle factors related to development of aseptic loosening after a cemented total hip arthroplasty (THA), 151 consecutive primary THAs performed at a single hospital in a rural district of Japan, at a mean follow-up of 7.5 years, were reviewed. Based on the medical records collected during hospital admission for THA, in which sociodemographic and lifestyle backgrounds had been recorded by the nurse, answers regarding residence, education, employment, engagement in agricultural work, marital status, family members living together, religion, recreational activity, smoking, and alcohol intake were analyzed in relation to the development of loosening, using a multivariate Cox proportional hazards model. With adjustment for cementing technique, diagnosis, age, and sex, agricultural work had a significant relation with prosthetic loosening (relative risk =2.85, P=0.03). Restriction of physical work in agriculture for patients undergoing THA should be considered.Résumé Afin d’identifier les habitudes de vie et les facteurs sociodemographiques relies au developpement d’un descellement aseptique apres une arthroplastie totale scellee de la hanche (THA), ont été recensées 151 THA primaires consécutives realisees dans un hopital de region rurale au Japon, avec observation moyenne de 7.5 annees. Sur la base des dossiers médicaux des patients admis pour une THA, dans lesquels des données avaient été recueillies en entrevue par les infirmieres sur les facteurs sociodemographiques et sur les habitudes de vie (type de residence, education, emploi, activites agricoles, etat civil, cohabitation des membres de la famille, religion, activites récreatives, consommation de tabac et d’alcool), ces donnees furent analysées en relation avec le developpement d’un descellement, a l’aide du Modèle de regression a effet proportionnel et a variantes multiples de Cox. Apres ajustements en fonction de la technique de scellement, du diagnostic, de l’age et du sexe, une relation significative entre le descellement et l’engagement dans des activites agricoles a été trouvée (risque relatif=2.85, P=0.03). Des restrictions au niveau du travail physique agricole devraient etre envisagees pour les personnes ayant subi une THA.

Intramedullary fibular graft for supracondylar fracture of the femur following total knee arthroplasty

We describe a successful treatment, intramedullary fibular grafting, for a patient with a supracondylar fracture of the femur following total knee arthroplasty in which the fracture region was comminuted and a segmental large bone defect was present. Free autogenous fibular was inserted into the medullary cavity from the intercondylar region and fixed to the proximal fragment of the femur with augmented fixation using a small plate and screws. Our procedure makes it easy to perform large segmental bone grafting and internal fixation at the same time for such a condition.

Serum IgA1 and IgA2 subclass antibodies against collagens in patients with ankylosing spondylitis.

We measured IgA1 and IgA2 subclass antibody levels against human type I, II, III and IV collagens in patients with ankylosing spondylitis (AS) by enzyme linked immunosorbent assay (ELISA). Significant elevations of IgA1 antibodies against type II collagen (p < 0.01) and IgA2 antibodies against type I (p < 0.001), III (p < 0.001), and IV (p < 0.01) collagens were observed in AS patients compared with those of healthy controls. These findings suggest that serum IgA antibodies against type I, III and IV collagens were mainly produced in secretory lesions in AS patients.