Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Diagnosis of bone metastases would be hastened if they could be detected on plain radiographs obtained at the first visit to an orthopedic surgeon. However, lesions are often undetectable on plain radiography. Bone metastasis is diagnosed at the first visit in only a few patients, and diagnosis is delayed in many cases. We investigated the diagnostic performance of plain radiography that used a new image processing method, Dynamic Visualization II (DV), to diagnose bone metastases. METHODS: We enrolled 29 patients with symptomatic pelvic bone metastases who visited our hospital between April 2018 and March 2021. The evaluation images were created by processing the original plain radiography data with the default settings for DV (Presets 1-4). Processing with Preset 1 resulted in an image converted to conventional film parameters, whereas Presets 2-4 utilized different DV processing methods. The readers were six orthopedic trainees, and the reading time was 30 seconds per image. The rate of correct answers for images processed with Preset 1 was compared to the rates for those processed with the other presets. Additionally, the rate of correct answers was analyzed in relation to clinical variables. RESULTS: The correct answer rate was significantly higher for Preset 3 (43.7%) and Preset 4 (42.5%) than for Preset 1 (28.7%). Correct answer rates for Presets 3 and 4 were significantly higher for elderly patients, male patients, patients with innominate bone lesions, patients with osteolytic bone metastases, and patients with a normal body weight. CONCLUSIONS: Image processing by DV improved diagnosis of bone metastases by plain radiography. DV might hasten diagnosis of bone metastases and help prevent associated complications.

DOI： 10.1272/jnms.JNMS.2025_92-108

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Language：English   Publishing type：Research paper (scientific journal)  

Endoscopic lumbar discectomy (ELD) is a key advancement in minimally invasive spinal surgery, particularly for lumbar disc herniation. Interlaminar endoscopic lumbar discectomy (IELD) and transforaminal endoscopic lumbar discectomy (TELD) are the two major methods used for FED. TELD, while less familiar to spine surgeons inexperienced in endoscopic surgery, presents challenges in visualizing the dura mater, a crucial aspect for reducing surgical complications. The hand down outside-in (HDOI) technique introduced by Dezawa enhances this visualization by positioning the cannula tip dorsally on the intervertebral disc and maneuvering it between the dura mater and disc to the spinal canal's midpoint. The cannula is then flipped to directly visualize the dura mater, enabling safe removal of the prolapsed disc material. A comparative study involving 20 patients treated from April 2020 to April 2022 examined the efficacy of the HDOI technique against conventional TELD. Each group, comprising ten patients, underwent ELD for lumbar disc herniation. While both groups showed similar improvements in clinical outcomes, as assessed using the Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) for pain, the HDOI group exhibited a 100% success rate for dura mater visualization, and this rate is significantly higher than the 60% observed in the conventional TELD group. Additionally, the time required for dura mater visualization was notably shorter for the HDOI technique. These results indicate that the HDOI technique not only enhances the safety and efficacy of TELD but may also encourage its wider use in clinical settings.

DOI： 10.3390/jpm14070679

PubMed

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Language：Japanese   Publisher：(一社)日本関節病学会  

66歳女性。55歳時の人工股関節置換術(THA)後、外来にて経過観察していた。65歳時の外来受診時に単純X線・CTでカップの弛みを認めた。CRP軽度陽性であったため、CRP陰性を3回連続して確認後に手術を行った。術中、ステムの安定性は良好で、カップ側のみ抜去・洗浄・掻爬して二期的再置換とした。セメントスペーサーはアウター形状でバンコマイシン混入の物を作成し、その中央に抜去したヘッド部分を埋込んだ。術後1年半現在、疼痛や可動域制限は認めない。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J05177&link_issn=&doc_id=20220112310019&doc_link_id=%2Ffd8kanse%2F2021%2F004004%2F019%2F0439-0441%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffd8kanse%2F2021%2F004004%2F019%2F0439-0441%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：日本股関節学会  

大腿骨転子部骨折術後にlag screwがカットアウトし、再手術を行った10例を対象に、受傷時3D-CT中野分類やTAD、手術時間、合併症、術前後のADLを調査した。その結果、初回の観血的整復固定術(OR/IF)は、sliding hip screwが2例、short femoral nailが8例であった。TADが25mm以上のlag screw刺入位置不良例は7例であった。再手術までの期間は平均133日で、9例に人工股関節全置換術、1例に人工骨頭置換術を行った。使用ステムは2例にMODULUS、7例にAlloclassic、1例にVerSysを使用した。Alloclassic使用7例中4例はCable-Readyを併用した。合併症は1例が手術翌日に肺塞栓症を発症して死亡し、1例が出血性ショックを発症した。ADLは8例が手術翌日から車椅子移乗を開始し、平均4週で全荷重を開始したが、4例が屋外車椅子となった。以上より、再手術は遠位固定型ステムの使用により関節機能は回復するが、手術侵襲は高いと考えられた。

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Language：Japanese   Publisher：東日本整形災害外科学会  

人工股関節再々置換術後,サポートリング(KT-プレートS)が骨盤内に迷入し治療に難渋した症例を経験した.インプラント抜去時の術前検査で,尿管・血管損傷のリスクを危惧し,泌尿器科および心臓血管外科と協議し合同手術を施行することで合併症を回避することが可能であった.術前にリスクを評価することが非常に重要であり,各科と密に連携して治療方針を決定する必要がある.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J03098&link_issn=&doc_id=20210715250007&doc_link_id=%2Fdx3eastj%2F2021%2F003302%2F007%2F0137-0141%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdx3eastj%2F2021%2F003302%2F007%2F0137-0141%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：東日本整形災害外科学会  

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Language：Japanese   Publisher：関東整形災害外科学会  

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Language：Japanese   Publisher：東日本整形災害外科学会  

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Language：Japanese   Publisher：東日本整形災害外科学会  

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Language：Japanese   Publisher：東日本整形災害外科学会  

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