Takeshi Sawaguchi - Academia.edu (original) (raw)
Papers by Takeshi Sawaguchi
The Author(s) 2011. This article is published with open access at Springerlink.com Background The... more The Author(s) 2011. This article is published with open access at Springerlink.com Background The Japanese Orthopaedic Association Hip Score is widely used in Japan, but this tool is designed to reflect the viewpoint of health-care providers rather than that of patients. In gauging the effect of medical therapies in addition to clinical results, it is necessary to assess quality of life (QOL) from the viewpoint of patients. However, there is no tool evaluating QOL for Japanese patients with hip-joint disease. Methods With the aim of more accurately classifying QOL for Japanese patients with hip-joint disease, we pre-pared a questionnaire with 58 items for the survey derived from 464 opinions obtained from approximately 100 Jap-anese patients with hip-joint disease and previously
Clinical calcium, 2015
Many risk factors have been identified for hip fracture, including female, advanced age, osteopor... more Many risk factors have been identified for hip fracture, including female, advanced age, osteoporosis, previous fractures, low body weight or low body mass index, alcohol drinking, smoking, family history of fractures, use of glucocorticoid, factors related to falls, and bone strength. The factors related to falls are number of fall, frail, post stroke, paralysis, muscle weakness, anti-anxiety drugs, anti-depression drugs, and sedatives. Dementia and respiratory disease and others have been reported to be risk factors for secondary hip fracture.
Journal of Orthopaedic Science
The Central Japan Journal of Orthopaedic Surgery & Traumatology, 2000
The Central Japan Journal of Orthopaedic Surgery & Traumatology, 2003
Non-operative management remains the treatment of choice for the large majority of fragility frac... more Non-operative management remains the treatment of choice for the large majority of fragility fractures of the pelvis. For decision-making, a careful evaluation of the patient and its fracture including patient history as well as clinical and radiological evaluation are very important. Duration and severity of pain, the patient’s level of activity before injury and comorbidities are other aspects, which may influence choice of treatment. All patients with FFP should be admitted to the ward and kept in bed until the pain is under control and the patient can start mobilization. Prolonged bed rest should be avoided. Early mobilization under good pain control is recommended. Pain control is another priority. Centrally acting analgesics, such as paracetamol and opioids should be used until pain resolves. When pain subsides, patients are allowed to start mobilization with weight bearing as tolerated. It usually takes a few days in FFP Type I fractures and 1 week to 10 days in FFP Type II f...
Osteotomies for Posttraumatic Deformities, 2008
... I would like to mention my secretary Evelien Goekoop and Angelique Janssen (the secretary of ... more ... I would like to mention my secretary Evelien Goekoop and Angelique Janssen (the secretary of Ronald J van Heerwaarden), Roy Orie ... Hospital Hansjörg Wyss/AO Professor Harvard Medical School WAC 527, 15 Parkman Street Boston, MA 02114 USA Gino Kerkhoffs, Dr, MD ...
Bone & Joint Open
Aims To evaluate whether low-intensity pulsed ultrasound (LIPUS) accelerates bone healing at oste... more Aims To evaluate whether low-intensity pulsed ultrasound (LIPUS) accelerates bone healing at osteotomy sites and promotes functional recovery after open-wedge high tibial osteotomy (OWHTO). Methods Overall, 90 patients who underwent OWHTO without bone grafting were enrolled in this nonrandomized retrospective study, and 45 patients treated with LIPUS were compared with 45 patients without LIPUS treatment in terms of bone healing and functional recovery postoperatively. Clinical evaluations, including the pain visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score, were performed preoperatively as well as six weeks and three, six, and 12 months postoperatively. The progression rate of gap filling was evaluated using anteroposterior radiographs at six weeks and three, six, and 12 months postoperatively. Results The pain VAS and JOA scores significantly improved after OWHTO in both groups. Although the LIPUS group had better pain scores at six weeks and three mont...
Objective: To study potential predictors of functional outcome six months after the injury in eld... more Objective: To study potential predictors of functional outcome six months after the injury in elderly patients who sustained a hip fracture and who had been able to go out alone. Design: Prospective Multi-center Cohort Study Setting: 14 Hospitals in Japan Patients and Methods: A cohort was consisted of 387 patients with a mean age of 81 who had a hip fracture, between December 2004 and January 2006. Inclusion criteria were that patients were at least sixty-five years old and who had been able to go out independently. Level of activity of daily living, medical complications, residential environment and family structure at injury was interviewed from the patient, the relatives and a nursing caretaker and recorded. Advancement of mobility was also recorded during the hospital stay. Patients were contacted or interviewed again by the investigator at six months following injury to assess functional outcomes. Primary outcome of interest was changes in mobility to go out independently at s...
The extensor retinaculum performs a specific guiding and Technical function. Potentially, it coul... more The extensor retinaculum performs a specific guiding and Technical function. Potentially, it could be used to augment ligament reconstruction
The Central Japan Journal of Orthopaedic Surgery & Traumatology, 2001
Fragestellung: Das knöcherne Becken ist eine komplexe anatomische Struktur mit zentraler Bedeutun... more Fragestellung: Das knöcherne Becken ist eine komplexe anatomische Struktur mit zentraler Bedeutung für die Mobilität des Menschen. Das genaue Verständnis der anatomischen und biomechanischen Gegebenheiten ist Voraussetzung für die adäquate Behandlung traumatischer sowie[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung: Trans-sakrale Implantate finden vermehrt klinische Anwendung, insbesondere in der ... more Fragestellung: Trans-sakrale Implantate finden vermehrt klinische Anwendung, insbesondere in der Behandlung von Fragilitätsfrakturen des Sakrums. Jedoch ist eine Positionierung eines solchen Implantates in einigen Individuen durch die anatomischen Verhältnisse nicht möglich. Ziel dieser[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Japan is a super-aging society, the geriatric care system establishment for hip fractures is at a... more Japan is a super-aging society, the geriatric care system establishment for hip fractures is at an urgent task. This report described our concept of multidisciplinary care model for geriatric hip fractures and 5-year outcomes at the Toyama City Hospital, Japan. In this retrospective cohort study, a multidisciplinary treatment approach was applied for elderly patients with hip fracture since 2014. These patients (n = 678, males: n = 143, mean age: 84.6 ± 7.5 years), were treated per the multidisciplinary care model. Time to surgery, length of hospital stays, complications, osteoporosis treatment, mortality, and medical costs were evaluated. The mean time to surgery was 1.7 days. Overall, 78.0% patients underwent surgery within 2 days. The mean duration of hospital stay was 21.0 ± 12.4 days. The most frequent complication was deep venous thrombosis (19.0%) followed by dysuria (14.5%). Severe complications were pneumonia 3.4%, heart failure 0.8% and pulmonary embolism 0.4%. The in-hosp...
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2017
PURPOSE To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (O... more PURPOSE To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (OWHTO) with respect to the patellofemoral joint and to assess whether patellofemoral osteoarthritis (OA) progression and alignment changes after OWHTO affect clinical outcomes. METHODS Inclusion criteria were consecutive patients who underwent OWHTO from March 2005 to September 2013. Exclusion criteria were loss to follow-up within 2 years and absence of second-look arthroscopy findings at the time of plate removal. The clinical parameters, including anterior knee pain while climbing stairs, Japanese Orthopedic Association score, and Oxford Knee Score, were evaluated. Radiological outcomes, including weight-bearing line ratio, modified Blackburne-Peel ratio, posterior tibial slope, tilting angle, lateral shift ratio, and patellofemoral OA (Kellgren-Lawrence grade), were evaluated preoperatively and at the final follow-up. Cartilage status (International Cartilage Repair Society grade) was evaluated at the initial HTO and at plate removal. RESULTS Fifty-three patients (60 knees) were included in this study. The mean follow-up was 58.2 ± 22.4 months. Two knees (3%) presented with mild anterior knee pain after OWHTO. The mean Japanese Orthopedic Association score (66.9 ± 11.2 to 91.2 ± 9.7) significantly improved (P < .001), and the mean Oxford Knee Score at the final follow-up was 42.0 ± 5.3. The mean modified Blackburne-Peel ratio (0.9 ± 0.1 to 0.7 ± 0.1, P < .001) and tilting angle (6.8 ± 3.7 to 5.6 ± 3.4, P = .033) significantly decreased after OWHTO, whereas no significant changes in posterior tibial slope (P = .511) and lateral shift ratio (P = .522) were observed. Radiologically, patellofemoral OA had progressed in 15 knees (27%), and arthroscopically patellofemoral cartilage degeneration had progressed in 27 knees (45%). However, there was no significant correlation between changes in patellofemoral alignment and clinical outcomes. CONCLUSIONS Changes in patellofemoral alignment and patellofemoral OA progression did not affect the clinical outcomes of OWHTO at mid-term follow-up. LEVEL OF EVIDENCE Level IV, therapeutic case series.
The Hip, Feb 1, 1985
A critical analysis of the results reveals the following major factors in determining the outcome... more A critical analysis of the results reveals the following major factors in determining the outcome of an individual acetabular disruption: The damage to the acetabular articular surface, which is reflected by the pattern of fracture and its degree of comminution, impaction, and osteoporosis, and associated damage of the femoral head The adequacy of the reduction, which is reflected by intraoperative inspection and postoperative radiographs The associated complications of the fracture and treatment (e.g., avascular necrosis, sciatic palsy, and heterotopic ossification) We recommend principles of treatment of acetabular fractures comparable to those employed for most other displaced intraarticular fractures, namely an anatomic reduction, stable internal fixation, and early motion, to realize reproducibly optimal results. The principal contraindications to open reduction are osteoporosis and generalized comminution to a degree that precludes a reasonable likelihood for the surgical team to achieve a stable anatomic reduction. We have provided guidelines for the surgical approach, techniques of reduction, and methods of fixation, and an analysis of results, which provide the basis for the successful treatment of these difficult intraarticular injuries.
Injury, 2014
Asian patients with osteoporosis suffer from an increased incidence of hip fracture and a potenti... more Asian patients with osteoporosis suffer from an increased incidence of hip fracture and a potentially increased risk of fixation failure due to anatomical differences compared to Caucasians. To cope with these differences, an Asian size- and geometry-adapted Proximal Femoral Nail Antirotation (PFNA-II) was developed. The objective of this prospective multicenter study was to assess the risk of fracture fixation complications (FFCs), the occurrence of mismatch and the quality of life status of patients treated with the PFNA-II. 176 Japanese patients with an isolated, unstable, closed trochanteric fracture were treated with the PFNA-II. Patients were prospectively screened for anticipated complications and classified accordingly; complications were centrally reviewed by a complication review board to avoid bias by the treating surgeon, and categorized using a standardized reporting system. Outcome measurements included the occurrence and evaluation of FFCs, the radiological assessment...
Archives of Orthopaedic and Trauma Surgery, 2010
With the high incidence of knee osteoarthritis (OA) in Japan, there is a strong need not only for... more With the high incidence of knee osteoarthritis (OA) in Japan, there is a strong need not only for surgical therapies, but also for validated outcome measures. For this study, we completed cross-cultural adaptation, testing and validation of the Oxford knee score (OKS) for prospective use in national and international clinical studies involving Japanese patients. The Japanese version of the OKS was developed according to the standard cross-cultural adaptation guidelines. For validation, the OKS was tested on 54 patients diagnosed with OA, osteonecrosis, ligament or meniscus injury. Reliability was tested using the intraclass correlation coefficient (ICC). Internal consistency or homogeneity was assessed using Cronbach's alpha. The correlation between the Japanese OKS, WOMAC and SF-36 questionnaires was used to assess construct validity. No major difficulties were encountered with the translation and pre-testing stages. For reliability and validity, the Japanese OKS was completed without any missed responses by 53 (98.15%) and 52 (96.30%) patients at the first and second distribution, respectively. The total OKS showed good reliability with an ICC of 0.85. Internal consistency was strong (Cronbach's alpha = 0.90). Strong construct validity (ICC values of 0.51-0.84) was obtained against the WOMAC and SF-36 (physical functioning, role-physical, bodily pain, and social functioning subscales) scores. Notable "ceiling" effects of the OKS were reported for 11 of the 12 questionnaire items. The Japanese OKS has proven to be a reliable and valid instrument for the self-assessment of knee pain and function in Japanese speaking patients with knee OA and other knee complaints.
Journal of Orthopaedic Science, 2016
Tip-apex distance (TAD) is reported as a good predictor for cut-outs of lag screws and spiral bla... more Tip-apex distance (TAD) is reported as a good predictor for cut-outs of lag screws and spiral blades in the treatment of intertrochanteric fractures, and surgeons are advised to strive for TAD within 20 mm. However, the femoral neck axis and the position of the lower limb in the lateral radiograph are not clearly defined and can lead to measurement errors. We propose a refined TAD by defining these factors. The objective of this study was to analyze the reliability of this refined TAD. The radiographs of 130 prospective cases with unstable trochanteric fractures were used for the analysis of the refined TAD. The refined TAD was independently measured by 2 raters with clinical experience of more than 10 years (rater 1, 2) and 2 raters with much less clinical experience (rater 3, 4) after they received a training about the new measurement method. Intraclass correlation coefficient (ICC [2,4]) was calculated to assess the interrater reliability. The mean refined TADs were 18.2:18.4:18.2:18.2 mm for rater 1:2:3:4. There was a strong correlation among all four raters (ICC 0.998, (95% CI: 0.998, 0.999). Regardless of the clinical experience of raters, the refined TAD is a reliable tool and can be used to develop new TAD recommendations for predicting failure of fixation. Future studies with larger samples are needed to evaluate the predictive value of the refined TAD.
The Author(s) 2011. This article is published with open access at Springerlink.com Background The... more The Author(s) 2011. This article is published with open access at Springerlink.com Background The Japanese Orthopaedic Association Hip Score is widely used in Japan, but this tool is designed to reflect the viewpoint of health-care providers rather than that of patients. In gauging the effect of medical therapies in addition to clinical results, it is necessary to assess quality of life (QOL) from the viewpoint of patients. However, there is no tool evaluating QOL for Japanese patients with hip-joint disease. Methods With the aim of more accurately classifying QOL for Japanese patients with hip-joint disease, we pre-pared a questionnaire with 58 items for the survey derived from 464 opinions obtained from approximately 100 Jap-anese patients with hip-joint disease and previously
Clinical calcium, 2015
Many risk factors have been identified for hip fracture, including female, advanced age, osteopor... more Many risk factors have been identified for hip fracture, including female, advanced age, osteoporosis, previous fractures, low body weight or low body mass index, alcohol drinking, smoking, family history of fractures, use of glucocorticoid, factors related to falls, and bone strength. The factors related to falls are number of fall, frail, post stroke, paralysis, muscle weakness, anti-anxiety drugs, anti-depression drugs, and sedatives. Dementia and respiratory disease and others have been reported to be risk factors for secondary hip fracture.
Journal of Orthopaedic Science
The Central Japan Journal of Orthopaedic Surgery & Traumatology, 2000
The Central Japan Journal of Orthopaedic Surgery & Traumatology, 2003
Non-operative management remains the treatment of choice for the large majority of fragility frac... more Non-operative management remains the treatment of choice for the large majority of fragility fractures of the pelvis. For decision-making, a careful evaluation of the patient and its fracture including patient history as well as clinical and radiological evaluation are very important. Duration and severity of pain, the patient’s level of activity before injury and comorbidities are other aspects, which may influence choice of treatment. All patients with FFP should be admitted to the ward and kept in bed until the pain is under control and the patient can start mobilization. Prolonged bed rest should be avoided. Early mobilization under good pain control is recommended. Pain control is another priority. Centrally acting analgesics, such as paracetamol and opioids should be used until pain resolves. When pain subsides, patients are allowed to start mobilization with weight bearing as tolerated. It usually takes a few days in FFP Type I fractures and 1 week to 10 days in FFP Type II f...
Osteotomies for Posttraumatic Deformities, 2008
... I would like to mention my secretary Evelien Goekoop and Angelique Janssen (the secretary of ... more ... I would like to mention my secretary Evelien Goekoop and Angelique Janssen (the secretary of Ronald J van Heerwaarden), Roy Orie ... Hospital Hansjörg Wyss/AO Professor Harvard Medical School WAC 527, 15 Parkman Street Boston, MA 02114 USA Gino Kerkhoffs, Dr, MD ...
Bone & Joint Open
Aims To evaluate whether low-intensity pulsed ultrasound (LIPUS) accelerates bone healing at oste... more Aims To evaluate whether low-intensity pulsed ultrasound (LIPUS) accelerates bone healing at osteotomy sites and promotes functional recovery after open-wedge high tibial osteotomy (OWHTO). Methods Overall, 90 patients who underwent OWHTO without bone grafting were enrolled in this nonrandomized retrospective study, and 45 patients treated with LIPUS were compared with 45 patients without LIPUS treatment in terms of bone healing and functional recovery postoperatively. Clinical evaluations, including the pain visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score, were performed preoperatively as well as six weeks and three, six, and 12 months postoperatively. The progression rate of gap filling was evaluated using anteroposterior radiographs at six weeks and three, six, and 12 months postoperatively. Results The pain VAS and JOA scores significantly improved after OWHTO in both groups. Although the LIPUS group had better pain scores at six weeks and three mont...
Objective: To study potential predictors of functional outcome six months after the injury in eld... more Objective: To study potential predictors of functional outcome six months after the injury in elderly patients who sustained a hip fracture and who had been able to go out alone. Design: Prospective Multi-center Cohort Study Setting: 14 Hospitals in Japan Patients and Methods: A cohort was consisted of 387 patients with a mean age of 81 who had a hip fracture, between December 2004 and January 2006. Inclusion criteria were that patients were at least sixty-five years old and who had been able to go out independently. Level of activity of daily living, medical complications, residential environment and family structure at injury was interviewed from the patient, the relatives and a nursing caretaker and recorded. Advancement of mobility was also recorded during the hospital stay. Patients were contacted or interviewed again by the investigator at six months following injury to assess functional outcomes. Primary outcome of interest was changes in mobility to go out independently at s...
The extensor retinaculum performs a specific guiding and Technical function. Potentially, it coul... more The extensor retinaculum performs a specific guiding and Technical function. Potentially, it could be used to augment ligament reconstruction
The Central Japan Journal of Orthopaedic Surgery & Traumatology, 2001
Fragestellung: Das knöcherne Becken ist eine komplexe anatomische Struktur mit zentraler Bedeutun... more Fragestellung: Das knöcherne Becken ist eine komplexe anatomische Struktur mit zentraler Bedeutung für die Mobilität des Menschen. Das genaue Verständnis der anatomischen und biomechanischen Gegebenheiten ist Voraussetzung für die adäquate Behandlung traumatischer sowie[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung: Trans-sakrale Implantate finden vermehrt klinische Anwendung, insbesondere in der ... more Fragestellung: Trans-sakrale Implantate finden vermehrt klinische Anwendung, insbesondere in der Behandlung von Fragilitätsfrakturen des Sakrums. Jedoch ist eine Positionierung eines solchen Implantates in einigen Individuen durch die anatomischen Verhältnisse nicht möglich. Ziel dieser[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Japan is a super-aging society, the geriatric care system establishment for hip fractures is at a... more Japan is a super-aging society, the geriatric care system establishment for hip fractures is at an urgent task. This report described our concept of multidisciplinary care model for geriatric hip fractures and 5-year outcomes at the Toyama City Hospital, Japan. In this retrospective cohort study, a multidisciplinary treatment approach was applied for elderly patients with hip fracture since 2014. These patients (n = 678, males: n = 143, mean age: 84.6 ± 7.5 years), were treated per the multidisciplinary care model. Time to surgery, length of hospital stays, complications, osteoporosis treatment, mortality, and medical costs were evaluated. The mean time to surgery was 1.7 days. Overall, 78.0% patients underwent surgery within 2 days. The mean duration of hospital stay was 21.0 ± 12.4 days. The most frequent complication was deep venous thrombosis (19.0%) followed by dysuria (14.5%). Severe complications were pneumonia 3.4%, heart failure 0.8% and pulmonary embolism 0.4%. The in-hosp...
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2017
PURPOSE To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (O... more PURPOSE To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (OWHTO) with respect to the patellofemoral joint and to assess whether patellofemoral osteoarthritis (OA) progression and alignment changes after OWHTO affect clinical outcomes. METHODS Inclusion criteria were consecutive patients who underwent OWHTO from March 2005 to September 2013. Exclusion criteria were loss to follow-up within 2 years and absence of second-look arthroscopy findings at the time of plate removal. The clinical parameters, including anterior knee pain while climbing stairs, Japanese Orthopedic Association score, and Oxford Knee Score, were evaluated. Radiological outcomes, including weight-bearing line ratio, modified Blackburne-Peel ratio, posterior tibial slope, tilting angle, lateral shift ratio, and patellofemoral OA (Kellgren-Lawrence grade), were evaluated preoperatively and at the final follow-up. Cartilage status (International Cartilage Repair Society grade) was evaluated at the initial HTO and at plate removal. RESULTS Fifty-three patients (60 knees) were included in this study. The mean follow-up was 58.2 ± 22.4 months. Two knees (3%) presented with mild anterior knee pain after OWHTO. The mean Japanese Orthopedic Association score (66.9 ± 11.2 to 91.2 ± 9.7) significantly improved (P < .001), and the mean Oxford Knee Score at the final follow-up was 42.0 ± 5.3. The mean modified Blackburne-Peel ratio (0.9 ± 0.1 to 0.7 ± 0.1, P < .001) and tilting angle (6.8 ± 3.7 to 5.6 ± 3.4, P = .033) significantly decreased after OWHTO, whereas no significant changes in posterior tibial slope (P = .511) and lateral shift ratio (P = .522) were observed. Radiologically, patellofemoral OA had progressed in 15 knees (27%), and arthroscopically patellofemoral cartilage degeneration had progressed in 27 knees (45%). However, there was no significant correlation between changes in patellofemoral alignment and clinical outcomes. CONCLUSIONS Changes in patellofemoral alignment and patellofemoral OA progression did not affect the clinical outcomes of OWHTO at mid-term follow-up. LEVEL OF EVIDENCE Level IV, therapeutic case series.
The Hip, Feb 1, 1985
A critical analysis of the results reveals the following major factors in determining the outcome... more A critical analysis of the results reveals the following major factors in determining the outcome of an individual acetabular disruption: The damage to the acetabular articular surface, which is reflected by the pattern of fracture and its degree of comminution, impaction, and osteoporosis, and associated damage of the femoral head The adequacy of the reduction, which is reflected by intraoperative inspection and postoperative radiographs The associated complications of the fracture and treatment (e.g., avascular necrosis, sciatic palsy, and heterotopic ossification) We recommend principles of treatment of acetabular fractures comparable to those employed for most other displaced intraarticular fractures, namely an anatomic reduction, stable internal fixation, and early motion, to realize reproducibly optimal results. The principal contraindications to open reduction are osteoporosis and generalized comminution to a degree that precludes a reasonable likelihood for the surgical team to achieve a stable anatomic reduction. We have provided guidelines for the surgical approach, techniques of reduction, and methods of fixation, and an analysis of results, which provide the basis for the successful treatment of these difficult intraarticular injuries.
Injury, 2014
Asian patients with osteoporosis suffer from an increased incidence of hip fracture and a potenti... more Asian patients with osteoporosis suffer from an increased incidence of hip fracture and a potentially increased risk of fixation failure due to anatomical differences compared to Caucasians. To cope with these differences, an Asian size- and geometry-adapted Proximal Femoral Nail Antirotation (PFNA-II) was developed. The objective of this prospective multicenter study was to assess the risk of fracture fixation complications (FFCs), the occurrence of mismatch and the quality of life status of patients treated with the PFNA-II. 176 Japanese patients with an isolated, unstable, closed trochanteric fracture were treated with the PFNA-II. Patients were prospectively screened for anticipated complications and classified accordingly; complications were centrally reviewed by a complication review board to avoid bias by the treating surgeon, and categorized using a standardized reporting system. Outcome measurements included the occurrence and evaluation of FFCs, the radiological assessment...
Archives of Orthopaedic and Trauma Surgery, 2010
With the high incidence of knee osteoarthritis (OA) in Japan, there is a strong need not only for... more With the high incidence of knee osteoarthritis (OA) in Japan, there is a strong need not only for surgical therapies, but also for validated outcome measures. For this study, we completed cross-cultural adaptation, testing and validation of the Oxford knee score (OKS) for prospective use in national and international clinical studies involving Japanese patients. The Japanese version of the OKS was developed according to the standard cross-cultural adaptation guidelines. For validation, the OKS was tested on 54 patients diagnosed with OA, osteonecrosis, ligament or meniscus injury. Reliability was tested using the intraclass correlation coefficient (ICC). Internal consistency or homogeneity was assessed using Cronbach's alpha. The correlation between the Japanese OKS, WOMAC and SF-36 questionnaires was used to assess construct validity. No major difficulties were encountered with the translation and pre-testing stages. For reliability and validity, the Japanese OKS was completed without any missed responses by 53 (98.15%) and 52 (96.30%) patients at the first and second distribution, respectively. The total OKS showed good reliability with an ICC of 0.85. Internal consistency was strong (Cronbach's alpha = 0.90). Strong construct validity (ICC values of 0.51-0.84) was obtained against the WOMAC and SF-36 (physical functioning, role-physical, bodily pain, and social functioning subscales) scores. Notable "ceiling" effects of the OKS were reported for 11 of the 12 questionnaire items. The Japanese OKS has proven to be a reliable and valid instrument for the self-assessment of knee pain and function in Japanese speaking patients with knee OA and other knee complaints.
Journal of Orthopaedic Science, 2016
Tip-apex distance (TAD) is reported as a good predictor for cut-outs of lag screws and spiral bla... more Tip-apex distance (TAD) is reported as a good predictor for cut-outs of lag screws and spiral blades in the treatment of intertrochanteric fractures, and surgeons are advised to strive for TAD within 20 mm. However, the femoral neck axis and the position of the lower limb in the lateral radiograph are not clearly defined and can lead to measurement errors. We propose a refined TAD by defining these factors. The objective of this study was to analyze the reliability of this refined TAD. The radiographs of 130 prospective cases with unstable trochanteric fractures were used for the analysis of the refined TAD. The refined TAD was independently measured by 2 raters with clinical experience of more than 10 years (rater 1, 2) and 2 raters with much less clinical experience (rater 3, 4) after they received a training about the new measurement method. Intraclass correlation coefficient (ICC [2,4]) was calculated to assess the interrater reliability. The mean refined TADs were 18.2:18.4:18.2:18.2 mm for rater 1:2:3:4. There was a strong correlation among all four raters (ICC 0.998, (95% CI: 0.998, 0.999). Regardless of the clinical experience of raters, the refined TAD is a reliable tool and can be used to develop new TAD recommendations for predicting failure of fixation. Future studies with larger samples are needed to evaluate the predictive value of the refined TAD.