：この手順は、均等の詳細な情報についてはTornier株式会社を参照してくださいTornier社による補綴物の総肩を逆用いて行った<a href="http://www.tornier-us.com/">http://www.tornier-us.com/</a> 。

1。はじめに： 肩甲上腕関節は複雑な関節です。それは、最小限の骨の制約があり、正常な機能のための軟組織を支えるとの間の緊張の複雑なバランスに依存しています。この本質的な関係は、肩の動きの大きな機能的な範囲を持つことができます。このバランスが非結合されている場合、機能障害の程度の差が発生します。このような大規模な涙のような腱板の機能の喪失は、関節窩に対する上腕骨頭の優れた翻訳を引き起こす可能性があります。この変更は肩甲上腕関節の回転中心と続いて、残りの筋肉の緊張と瞬間の腕は、減少関数。また、上腕骨頭と接触圧力のその後の変化の位置の変化は、関節軟骨とその結果痛みを伴う関節炎の進行性の損傷につながることができます。これらの場合における標準的な肩関節形成術の使用が最適でないと、時には致命的な結果を提供しています。 逆合計肩関節形成術（RTSA）は、運動と機能の痛み、範囲の大幅な改善を提供するこれらの複雑な問題に対する解決策を提供。 RTSAの設計は、回転の中心をmedializesと、より下の位置に上腕骨をもたらします。生体力学の変化が空間にアームを移動するために三角筋の能力を向上させる、三角筋の腹と機能的なレバーアームの張力を復元します。また、痛みを伴う関節炎の軟骨が著しく、患者の痛みの改善、プロセスで削除されます。 2。ケースプレゼンテーション： この患者は15年前の&quot;ミニオープン&quot;腱板の歴史を持つ71歳、健康な女性です。ここ数年、彼女は動きの彼の範囲内の対応する減少と彼女の肩に増加した痛みや弱さを経験している。彼女のアクティブな拉致は30 °であった、アクティブな前屈は40 °であった、アクティブな外旋は10 °と彼女の臀筋へのアクティブな内部回転だった。彼女の改変強く抱き締めるのテストでは、肩甲下筋腱の最小限の弱点を明らかにし、彼女は否定的なホーンブロワーの記号と負のラグテストができた。動きの彼女の受動的な範囲は、正のドロップアームテストで前屈の75 °を示した。神経血管試験は、それ以外の場合は、通常だと、以前の回旋の腱板修復に関連した感染の兆候はなかった。 3。治療/診断の手順： この患者の初期のX線評価では、肩甲骨アウトレットビュー、Grasheyビュー、および腋窩ビューを含める必要があります。関節窩の外観に応じて、CTスキャンによるさらなる研究は、骨の浸食、形成異常の有無と利用可能な骨の株式の量を評価する必要があります。私たちの患者では、初期のX線写真では減少した肩峰、上腕骨の距離によって証明上腕骨の優れた移行を中程度の変性変化を示した。関節窩に関連付けられている重要な骨の損失がありませんでした。患者の病歴、身体検査およびX線分析の組み合わせはpseudoparalysisと腱板関節症と一致している。さらに診断の研究は、この患者で示されることはありません。 前にどんな患者に大きな関節形成術の検討に保守的な対策の講座が実施されるべきである。これらは、通信肩峰下や関節包内のスペースと強化と可動域のための理学療法に抗炎症薬による治療、コルチコステロイド注射を含める必要があります。治療のこのコースの後、患者は彼らの痛み、現在の関数、現実的な機能的なニーズや要望、生活の質と関連する合併症のために評価する必要があります。手続きに伴うリスクがベネフィットを期待患者のために許容可能であると判断された場合、逆方向積算肩関節形成術のフォロー手法を使用することができます。 4。全肩​​関節形成術を逆に<ol><li>患者は、ビーチチェアの位置に配置されており、アームは、整形処理し、標準的なやり方でフリー掛けている。 </li><li>標準deltopectoral切開とアプローチは、腱板と肩峰下スペースを公開して行われます。鈍的切開は、基礎となる組織に任意の癒着から下面の三角筋を解放するために使用されます。 </li><li>腱板は断裂について検査し、修復の可能性を評価されます。組織を修復できるように見える場合は、修理と従来の人工関節置換術を考慮することができます。そうでなければ、どんな無駄なカフを切除することができます</li><li>腋窩神経を同定し、肩甲下筋腱が原点を放出することなく識別し、小結節から放出され、腱が何らかの癒着から近位に解放され保護されています</li><li>劣るカプセルは、上腕骨近位から解放され、上腕骨は外部からtを脱臼回転させ彼関節から上腕骨頭</li><li>延髄の運河は、上腕骨頭の切除のガイドによって置き換えられ、近位上腕骨のカットは、バージョンの0 °で行われているエントリの千枚通しを使って位置しています。髄内のガイドは、カットを完了するために削除する必要があります。 </li><li>骨幹端および骨幹リーマは、患者の解剖学的構造に適切なサイズで行われます。 </li><li>トライアルのコンポーネントは、関節窩の準備のためにカットプロテクターとの適切なバージョンで組み立てられ、上腕骨に配置されています</li><li>唇を切除され、前と劣るカプセルは関節窩から解放され、リトラクターは、関節を露出配置されています</li><li>ドリルガイドは、6ミリメートルドリルを使用して中央のドリル穴を配置するために使用されます</li><li>関節窩は、周囲の溝を作成し、ベース板の準備のためにリーマーさ</li><li>中央の穴は、8ミリメートル中央のペグについては7.5ミリメートルに拡大され、ベースプレートが配置され、リーマ関節窩と同じ高さに影響を与え</li><li>ネジは、トランス皮質固定とベースプレートに配置されます。前部と後部のネジは、配置のための30 °の円弧を持っており、標準的な皮質のネジです。優れたと劣ったネジはそれぞれ優れたと劣る面で30 °の円弧でネジをロックして固定されています</li><li> glenosphereは、ベースプレートの上に影響され、中央のネジはglenosphereを確保締め付けられる</li><li>トライアルのライナーは、トライアルの上腕骨ステムに配置され、肩が削減されます。 ROMと安定のための検査は、行われ、調整は必要に応じて行われる</li><li>トライアルインプラントをして上腕骨から除去される、最後のコンポーネントは、適切なバージョンで組み立てられ、挿入され、上腕骨に影響されています</li><li>肩が軽減され、ROMと安定性の最終試験が行われます</li><li>肩甲下筋腱は、上腕骨近位に修復され、傷は標準的なやり方でクローズされます</li></ol> 5。アウトカム： 6ヶ月でフォローアップこの患者は、10のゼロアウトなどのビジュアルアナログスケールで彼女の手術後の痛みをランク付け。動きの彼女のアクティブな範囲が140℃、彼女の大臀筋に25 °と内部回転のアクティブな外旋に前屈が含まれています。この患者はフォローアップの最後では術中や術後の合併症はなかった。 6。結論： 著者の経験では、RTSAは、信頼性の疼痛緩和と運動と機能的転帰の範囲の改善と腱板関節症患者を提供します。この患者はこの手術の結果に満足した。

<ol>
	<li>Boileau, P., Sinnerton, R. J., Choinard, C., Walch, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Arthroplasty+of+the+Shoulder.">Arthroplasty of the Shoulder.</a> J Bone Joint Surgery Br. 88, 562-575 (2006).</li><li>Boileau, P., Watkinson, D., Hatzidakis, A. M., Hovorka, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neer+Award+2005:+The+Grammont+reverse+shoulder+prosthesis:results+in+cuff+tear+arthritis,+fracture+sequelae,+and+revision+arthroplasty.">Neer Award 2005: The Grammont reverse shoulder prosthesis:results in cuff tear arthritis, fracture sequelae, and revision arthroplasty.</a> J Shoulder Elbow Surg. 15, 527-540 (2006).</li><li>Boileau, P., Watkinson, D. J., Hatzidakis, A. M., Balg, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Grammont+reverse+prosthesis:+design,+rationale,+and+biomechanics.">Grammont reverse prosthesis: design, rationale, and biomechanics.</a> J Shoulder Elbow Surg. 14, 147S-161S (2005).</li><li>Cuff, D., Pupello, D., Virani, N., Levy, J., Frankle, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reverse+shoulder+arthroplasty+for+the+treatment+of+rotator+cuff+deficiency.">Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency.</a> J Bone Joint Surg Am. 90, 1244-1251 (2008).</li><li>Edwards, T. B., Boulahia, A., Kempf, J. F., Boileau, P., Nemoz, C., Walch, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+influence+of+rotator+cuff+disease+on+the+results+of+shoulder+arthroplasty+for+primary+osteoarthritis:+results+of+a+multicenter+study.">The influence of rotator cuff disease on the results of shoulder arthroplasty for primary osteoarthritis: results of a multicenter study.</a> J Bone Joint Surg Am. 84, 2240-2248 (2002).</li><li>Frankle, M., Siegal, S., Pupelo, D., Saleem, A., Mighell, M., Vasey, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=There+reverse+shoulder+prosthesis+for+glenohumeral+arthritis+associated+with+severe+rotator+cuff+deficiency.+A+minimum+two-year+follow-up+study+of+sixty+patients.">There reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients.</a> J Bone Joint Surg Am. 87, 1697-1705 (2005).</li><li>Guery, J., Favard, L., Sirveaux, F., Oudet, D., Mole, D., Walch, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reverse+total+shoulder+arthroplasty.+Survivorship+analysis+of+eighty+replacements+followed+for+five+to+ten+years.">Reverse total shoulder arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years.</a> J Bone Joint Surg Am. 88, 1742-1747 (2006).</li><li>Martin, T. G., Lanotti, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reverse+total+shoulder+arthroplasty+for+acute+fractures+and+failed+management+after+proximal+humerus+fractures.">Reverse total shoulder arthroplasty for acute fractures and failed management after proximal humerus fractures.</a> Orthop Clin North Am. 39, 451-457 (2008).</li><li>Wall, B., Nove-Josserand, L., O'Conner, D. P., Edwards, T. B., Walch, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reverse+total+shoulder+arthroplasty:+a+review+of+results+according+to+etiology.">Reverse total shoulder arthroplasty: a review of results according to etiology.</a> J Bone Joint Surg Am. 89, 1476-1485 (2007).</li><li>Werner, C. M., Steinmann, P. A., Gilbart, M., Gerber, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+painful+pseudoparesis+due+to+irreparable+rotator+cuff+dysfunction+with+the+delta+III+reverse-ball-and-socket+total+shoulder+prosthesis.">Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the delta III reverse-ball-and-socket total shoulder prosthesis.</a> J Bone Joint Surg Am. 87, 1476-1486 (2005).</li></ol>

利害の衝突は宣言されません。

回旋腱板関節症のためのRTSAを使用すると、痛みの大幅な改善、運動と機能的転帰のスコアの範囲を提供します。全体的な患者の満足度は、現在の文学の百分の80から95の範囲であったしました。すべてのプロシージャと同様に、RTSAは、リスクがないわけではありません。合併症の初期の報告では60％にもなった。技術が向上したとして、合併症発生率は減少している。

<table border="1"><tbody><tr><td> 試薬の名前 </td><td> 会社 </td><td> カタログ番号 </td><td> コメント </td></tr><tr><td>均等のは、肩を逆</td><td> Tornier、（株） </td><td>なし</td><td>より多くの情報訪問のための<a href="http://www.tornier-us.com/">http://www.tornier-us.com/</a> </td></tr></tbody></table>

reverse total shoulder arthroplasty

逆合計肩関節形成術は、最初は回旋腱板関節症での使用を承認され、よく腱移行術の再建のための適切ではなかった患者の関節炎のない慢性pseudoparalysisとしてれました。これらの患者のための伝統的な手術のオプションは限られていたと機能的な結果はサブ最適と時間に壊滅的でした。逆肩関節形成術の使用が効果的にこれらの患者の機能を復元し、それらの疾患に伴う症状を軽減することが判明している。手順は、次の2つのアプローチ、deltopectoralまたは上外側で行うことができます。補綴物の使用に伴う合併症の率が得ている経験と低い傾向より多くの最近の報告で80から60パーセントの範囲であったしました。プロテーゼ失敗した逆の肩のためのオプションが限られており、しばしば重要な関連する障害を持って復旧させてください。このプロテーゼの使用のための適応は、リビジョンの関節形成術、上腕骨近位端骨折や腫瘍のためのその使用を含めて評価され続けている。慎重な患者選択が原因プロシージャに関連付けられている重大なリスクの不可欠です。

Watch this Scientific Journal Video about Reverse Total Shoulder Arthroplasty at JoVE.com

Reverse Total Shoulder Arthroplasty

逆合計肩関節形成術は、従来の人工関節置換術または他のプロシージャで処理することができない状態の治療に使用されています。これらは主に肩の正常な生体力学カップリングの回復不能な腱板と損失と変性としなくなる条件が含まれています。

全肩​​関節形成術を逆に

Reverse total shoulder arthroplasty was initially approved for use in rotator cuff arthropathy and well as chronic pseudoparalysis without arthritis in ...

Research

JoVE Journal

Medicine

43.0K ビュー.  Case Western Reserve University. 逆合計肩関節形成術は、従来の人工関節置換術または他のプロシージャで処理することができない状態の治療に使用されています。これらは主に肩の正常な生体力学カップリングの回復不能な腱板と損失と変性としなくなる条件が含まれています。

ビデオ: Reverse Total Shoulder Arthroplasty

Implantation of the Syncardia Total Artificial Heart

With advances in technology, the use of mechanical circulatory support devices for end stage heart failure has rapidly increased. The vast majority of such patients are generally well served by left ventricular assist devices (LVADs). However, a subset of patients with late stage biventricular failure or other significant anatomic lesions are not adequately treated by isolated left ventricular mechanical support. Examples of concomitant cardiac pathology that may be better treated by resection and TAH replacement includes: post infarction ventricular septal defect,&#160;aortic root aneurysm / dissection, cardiac allograft failure, massive ventricular thrombus, refractory malignant arrhythmias (independent of filling pressures), hypertrophic / restrictive cardiomyopathy, and complex congenital heart disease. Patients often present with cardiogenic shock and multi system organ dysfunction. Excision of both ventricles and orthotopic replacement with a total artificial heart (TAH) is an effective, albeit extreme, therapy for rapid restoration of blood flow and resuscitation. Perioperative management is focused on end organ resuscitation and physical rehabilitation. In addition to the usual concerns of infection, bleeding, and thromboembolism common to all mechanically supported patients, TAH patients face unique risks with regard to renal failure and anemia. Supplementation of the abrupt decrease in brain natriuretic peptide following ventriculectomy appears to have protective renal effects. Anemia following TAH implantation can be profound and persistent. Nonetheless, the anemia is generally well tolerated and transfusion are limited to avoid HLA sensitization. Until recently, TAH patients were confined as inpatients tethered to a 500 lb pneumatic console driver. Recent introduction of a backpack sized portable driver (currently under clinical trial) has enabled patients to be discharged home and even return to work. Despite the profound presentation of these sick patients, there is a 79-87% success in bridge to transplantation.

The purpose of this manuscript is to briefly review indications, management, and outcomes for the total artificial heart. Video operative techniques for device implantation are presented.

Syncardia完全人工心臓の植え込み

With advances in technology, the use of mechanical circulatory support devices for end stage heart failure has rapidly increased. The vast majority of ...

医学

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction

In orthopedic patients, foreign body-associated infections, especially periprosthetic joint infections (PJIs), are a devastating complication of arthroplasty. Infection requires complex treatment, may result in long hospitalization and causes considerable costs. Multiple surgical revisions can be necessary in these patients, with a loss in function as well as in quality of life.
The routine preoperative diagnostics include blood examination for C-reactive protein (CRP) and other biomarkers, as well as joint aspirate analysis for cell count, differentiation, and culture. Intraoperative specimens for histology and microbiology are also standard procedure. The microbiological examination of removed implants with sonication, in combination with the implementation of molecular biology techniques in microbiology, represent two novel techniques currently employed to enhance the differential diagnostics of PJI.
We present here the step-wise procedure of analyzing joint aspirate and sonication fluid, using a cartridge-based multiplex polymerase chain reaction (PCR) system. Results were matched against conventional cultures and consensus criteria for PJI. Conventional microbiological cultures from tissue biopsies, joint aspirate and sonication fluid showed a sensitivity of 66.7%, 66.7%, and 88.9%, respectively, and a specificity of 82.3%, 54.6%, and 61.5%, respectively. The PCR diagnostic of the sonication fluid and the joint fluid showed a sensitivity of 50.0% and 55.6%, respectively, and both a specificity of 100.0%. Both PCR diagnostics combined had a sensitivity of 66.7% and a specificity of 100.0%. The multiplex PCR therefore presents a rapid diagnostic tool with moderate sensitivity but high specificity in diagnosing PJI.

Differential diagnostics in painful arthroplasty is crucial for treatment success. Joint aspiration is routinely performed preoperatively. Multiplex polymerase chain reaction of the joint aspirate and the sonication fluid, a feasible tool for quick pathogen detection from these samples is described.

リビジョン人工で新規診断: 超音波処理と多重ポリメラーゼの連鎖反応のインプラント

In orthopedic patients, foreign body-associated infections, especially periprosthetic joint infections (PJIs), are a devastating complication of ...

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Bone- and soft-tissue sparing short stems are increasingly used in total hip arthroplasty (THA). However, there are a large variety of models of short stems, differing in design and function. Calcar-guided short stems provide an anatomical curvature in the medial calcar region, thus, positioning is done individually alongside the calcar in the "round-the-corner" technique. Depending on the level of the neck's osteotomy, stems can be aligned individually in a large bandwidth of varus- and valgus anatomies. This differs from conventional total hip arthroplasty and potentially includes a severe learning curve. Given that a great variety of caput-collum-diaphyseal (CCD)-angles can be retained, the reconstruction of femoro-acetabular offsets can be achieved precisely. However, particularly extensive varus- and valgus positioning has raised concerns in regard to stability and bone remodeling. The purpose of the present manuscript is to showcase the implantation technique in calcar-guided short-stem THA and to summarize short-term clinical and radiological results.

This protocol describes the round-the-corner technique and the individualized stem-positioning of calcar-guided short stems alongside the medial calcar, depending on the level of the osteotomy. This differs from conventional total hip arthroplasty and includes a learning curve.

個別のカルカル誘導短幹人工股関節のステム位置決め

Bone- and soft-tissue sparing short stems are increasingly used in total hip arthroplasty (THA). However, there are a large variety of models of short ...

Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents

To better understand the left ventricular (LV) reverse remodeling (RR), we describe a rodent model wherein, after aortic banding-induced LV remodeling, mice undergo RR upon removal of the aortic constriction. In this paper, we describe a step-by-step procedure to perform a minimally invasive surgical aortic debanding in mice. Echocardiography was subsequently used to assess the degree of cardiac hypertrophy and dysfunction during LV remodeling and RR and to determine the best timing for aortic debanding. At the end of the protocol, terminal hemodynamic evaluation of the cardiac function was conducted, and samples were collected for histological studies. We showed that debanding is associated with surgical survival rates of 70-80%. Moreover, two weeks after debanding, the significant reduction of ventricular afterload triggers the regression of ventricular hypertrophy (~20%) and fibrosis (~26%), recovery of diastolic dysfunction as assessed by the normalization of left ventricular filling and end-diastolic pressures (E/e&#39;&#160;and LVEDP). Aortic debanding is a useful experimental model to study LV RR in rodents. The extent of myocardial recovery is variable between subjects, therefore, mimicking the diversity of RR that occurs in the clinical context, such as aortic valve replacement. We conclude that the aortic banding/debanding model represents a valuable tool to unravel novel insights into the mechanisms of RR, namely the regression of cardiac hypertrophy and the recovery of diastolic dysfunction.

Here we describe a step-by-step protocol of surgical aorta debanding in the well-established mice model of aortic-constriction. This procedure not only allows studying the mechanisms underlying the left ventricular reverse remodeling and regression of hypertrophy but also to test novel therapeutic options that might accelerate myocardial recovery.

げっ歯類における大動脈デベンディングによる左心室逆改造の研究

To better understand the left ventricular (LV) reverse remodeling (RR), we describe a rodent model wherein, after aortic banding-induced LV remodeling, ...

The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report

The technology of 3D printing and visualization of anatomical structures is rapidly growing in various fields of medicine. A custom-made implant and mixed reality were used to perform complex revision hip arthroplasty in January 2019. The use of mixed reality allowed for a very good visualization of the structures and resulted in precise implant fixation. According to the authors' knowledge, this is the first described case report of the combined use of these two innovations. The diagnosis preceding the qualification for the procedure was the loosening of the left hip's acetabular component. Mixed reality headset and holograms prepared by engineers were used during the surgery. The operation was successful, and it was followed by early verticalization and patient rehabilitation. The team sees opportunities for technology development in joint arthroplasty, trauma, and orthopedic oncology.

A complex revision hip arthroplasty was performed using a custom-made implant and mixed reality technology. According to the authors&#39; knowledge, this is the first report of such procedure described in the literature.

カスタムメイドの修正人工股関節形成術における複合現実感の使用:最初の症例報告

The technology of 3D printing and visualization of anatomical structures is rapidly growing in various fields of medicine. A custom-made implant and mixed ...

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty

Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage anteromedial osteoarthritis (AMOA). The key to UKA is the flexion-extension gap balance, which is closely related to postoperative complications such as bearing dislocation, bearing wear, and arthritis progression. The traditional gap balance assessment is performed by indirectly sensing the tension of the medial collateral ligament by a gap gauge. It relies on the surgeon's feel and experience, which is imprecise and difficult for beginners. To accurately assess the flexion-extension gap balance of UKA, we developed a wireless sensor combination consisting of a metal base, a pressure sensor, and a cushion block. After osteotomy, the insertion of a wireless sensor combination allows the real-time measurement of intra-articular pressure. It accurately quantifies the flexion-extension gap balance parameters to guide further femur grinding and tibia osteotomy, to improve the accuracy of gap balance. We conducted an in vitro experiment with the wireless sensor combination. the results showed that there was a difference of 11.3 N after applying the traditional method of flexion-extension gap balance performed by an experienced expert.

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty

This protocol presents a cadaveric study of a wireless sensor used in medial unicompartmental knee arthroplasty. The protocol includes the installation of an angle measuring device, standardized Oxford unicompartmental knee arthroplasty osteotomy, preliminary assessment of flexion-extension balance, and application of the sensor to measure flexion-extension gap pressure.

インビトロ 単一区画型膝関節形成術の屈曲-伸展ギャップバランスにおける無線センサの応用

Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage anteromedial osteoarthritis (AMOA). The key to UKA is the ...

ラットモデルにおける五十肩のためのTuina療法

Tuina in a Frozen Shoulder Rat Model: An Efficient and Reproducible Protocol

Frozen shoulder (FS) is a common condition with no defined optimal therapy. Tuina therapy, a traditional Chinese medicine (TCM) technique used to treat FS patients in Chinese hospitals, has demonstrated excellent results, but its mechanisms are not fully understood. Building on a previous study, this work aimed to develop a Tuina protocol for an FS rat model. We randomly divided 20 SD rats into control (C; n = 5), FS model (M; n = 5), FS model Tuina treatment (MT; n = 5), and FS model oral treatment (MO; n = 5) groups. This study used the cast immobilization method to establish the FS rat model. The effect of Tuina and oral dexamethasone on the glenohumeral range of motion (ROM) was evaluated, and the histological findings were assessed. Our study showed that Tuina and oral dexamethasone were able to improve shoulder active ROM and preserve the structure of the capsule, with Tuina therapy proving to be more effective than oral dexamethasone. In conclusion, the Tuina protocol established in this study was highly effective for FS.

著者スポットライト:五十肩に対するTuina療法の有効性の調査 

This study develops an efficient and reproducible Tuina protocol for treating frozen shoulder established in a rat model. This approach will help to study the Tuina therapy treatment method for frozen shoulders.

凍結肩甲ラットモデルの推拿:効率的で再現性のあるプロトコル

Frozen shoulder (FS) is a common condition with no defined optimal therapy. Tuina therapy, a traditional Chinese medicine (TCM) technique used to treat FS ...

五十肩の治療におけるスモールニードルナイフ療法の治療効果

Clinical Efficacy of Small Needle Knife Therapy on Stage I-II Frozen Shoulder

Frozen shoulder is a kind of aseptic inflammatory disease of the shoulder caused by strain, trauma, and other reasons, resulting in shoulder joint pain and limited function. The protocol presented here demonstrates the operation of a small needle knife in treating frozen shoulders, including patient management, material preparation, positioning, operation, and postoperative care. The purpose of this protocol is to relieve the pain and functional limitations and improve the living ability of patients with frozen shoulders. In our study, 76 stage I-II frozen shoulder patients who met the inclusion criteria were randomly divided into a control group and a treatment group (n=38). Patients in the control group received functional exercise, while the treatment group received small needle knife therapy with functional exercise. The visual analogue scores (VAS), the Constant and Murley scores (CMS), and the thickness of the coracohumeral ligament (CHL) under ultrasound were evaluated. After small needle knife therapy, the VAS score was significantly lower in the treatment group (5.11 &plusmn; 0.89) than in the control group (5.49 &plusmn; 0.65; t=-2.065, p&lt;0.05); the CMS score was significantly higher in the treatment group (64.72 &plusmn; 4.78) than in the control group (60.97 &plusmn; 6.00; t=2.947, p&lt;0.05); the CHL thickness was significantly decreased in the treatment group (2.38 &plusmn; 0.36) than in the control group (2.57 &plusmn; 0.42; t=-2.117, p&lt;0.05). These results indicate that the small needle knife significantly relieved the pain symptoms, improved the shoulder function, reduced the CHL thickness, and improved the quality of life and, therefore, had significant therapeutic efficacy in stage I-II frozen shoulder patients.

著者スポットライト:小さな針ナイフ療法による五十肩の治療 

The protocol presented here describes the detailed operation method and proves the effectiveness of a small needle knife in the treatment of frozen shoulders.

ステージI-IIの五十肩に対する小針ナイフ療法の臨床効果

Frozen shoulder is a kind of aseptic inflammatory disease of the shoulder caused by strain, trauma, and other reasons, resulting in shoulder joint pain ...

全肩​​関節形成術を逆に

全肩関節形成術を逆に