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( Shuji Nakagawa ),( Yuji Arai ),( Hiroaki Inoue ),( Hiroyuki Kan ),( Manabu Hino ),( Shohei Ichimaru ),( Kazuya Ikoma ),( Hiroyoshi Fujiwara ),( Fumimasa Amaya ),( Teiji Sawa ),( Toshikazu Kubo ) 대한슬관절학회 2016 대한슬관절학회지 Vol.28 No.3
Purpose: This study compared the analgesic effects of local infiltration analgesia (LIA) and femoral nerve block (FNB) after total knee arthroplasty (TKA) and assessed factors associated with analgesia obtained by these two methods. Materials and Methods: Study subjects included 66 patients (72 knees) who underwent TKA for osteoarthritis of the knee. Pain visual analogue scale (VAS), the amount of analgesics used, number of days to achieve 90o of flexion of the knee joint, date of initiating parallel-bar walking, range of motion of the knee joint at discharge, and adverse events were investigated. Results: The VAS scores did not differ significantly between two groups, whereas the amount of analgesics used was significantly lower in the LIA group. Preoperative flexion contracture was significantly more severe in the LIA group with high VAS compared with low VAS. No serious adverse event occurred in the LIA or FNB group. Conclusions: The lower analgesic usage in the LIA group than the FNB group indicates that the analgesic effect of LIA was greater than that of singleshot FNB after TKA. There were no serious complications in either group. The postoperative analgesic effect of LIA was smaller in patients with severe than less severe preoperative flexion contracture.
Shuji Nakagawa,Yuji Arai,Kunio Hara,Hiroaki Inoue,Manabu Hino,Toshikazu Kubo 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.4
We describe a patient who underwent arthroscopic pullout fixation for a posterior cruciate ligament (PCL) avulsion fracture. A 46-year-old female, injured in a fall while riding a motorcycle, was diagnosed with a right knee PCL tibial attachment avulsion fracture and underwent arthroscopic osteosynthesis. A Kirschner wire was drilled to a point just medial to the medial border of the anterior tibial bony bed. A suture wire was folded into a loop and introduced into the posteromedial compartment via the bone tunnel. A fixation thread was inserted from the posteromedial portal, through the medial and lateral loop wires, and into the posteromedial compartment. The lateral and medial loop wires attached to the thread were pulled to the outside, and the thread was fixed onto the tibia. Three months post-surgery, she returned to her job. This procedure represents a minimally invasive method of treating avulsion fractures of the tibial attachment of the PCL.
( Nobuyuki Hiraoka ),( Shuji Nakagawa ),( Eigo Otakara ),( Hiroaki Inoue ),( Kenji Takahashi ),( Yuji Arai ) 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-
Background: Hybrid closed-wedge high tibial osteotomy (hybrid CWHTO) is an effective surgical treatment for medial compartment osteoarthritis of the knee. Our study investigated whether the combination of a lateral locking plate and a single medial screw promoted bone union after hybrid CWHTO. Methods: The study cohort consisted of 30 patients (15 men and 15 women) who underwent hybrid CWHTO for medial compartment osteoarthritis or spontaneous osteonecrosis of the knee. Sixteen knees were fixed with a lateral locking plate (LP group), and 17 were fixed with both a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia (LPS group). The times to bone union, radiolucency, and callus formation at the osteotomy site were evaluated radiographically. Results: The mean postoperative time to radiographic confirmation of bone union was 5.5 ± 2.6 months in the LP group and 3.4 ± 1.5 months in the LPS group. Radiolucency at the osteotomy site and excess callus formation on the posterior side of the tibia were lower in the LPS group than in the LP group. Conclusions: This modified hybrid CWHTO combining a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia improves the stability of the osteotomy site and shortens the period of bone union.
( Nobuyuki Hiraoka ),( Shuji Nakagawa ),( Eigo Otakara ),( Hiroaki Inoue ),( Kenji Takahashi ),( Yuji Arai ) 대한슬관절학회 2021 대한슬관절학회지 Vol.33 No.-
Background: Hybrid closed-wedge high tibial osteotomy (hybrid CWHTO) is an effective surgical treatment for medial compartment osteoarthritis of the knee. Our study investigated whether the combination of a lateral locking plate and a single medial screw promoted bone union after hybrid CWHTO. Methods: The study cohort consisted of 30 patients (15 men and 15 women) who underwent hybrid CWHTO for medial compartment osteoarthritis or spontaneous osteonecrosis of the knee. Sixteen knees were fixed with a lateral locking plate (LP group), and 17 were fixed with both a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia (LPS group). The times to bone union, radiolucency, and callus formation at the osteotomy site were evaluated radiographically. Results: The mean postoperative time to radiographic confirmation of bone union was 5.5 ± 2.6 months in the LP group and 3.4 ± 1.5 months in the LPS group. Radiolucency at the osteotomy site and excess callus formation on the posterior side of the tibia were lower in the LPS group than in the LP group. Conclusions: This modified hybrid CWHTO combining a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia improves the stability of the osteotomy site and shortens the period of bone union.
Medial and Lateral Discoid Menisci of Both Knees
( Hiroyuki Kan ),( Yuji Arai ),( Shuji Nakagawa ),( Hiroaki Inoue ),( Ginjiro Minami ),( Kazuya Ikoma ),( Hiroyoshi Fujiwara ),( Toshikazu Kubo ) 대한슬관절학회 2016 대한슬관절학회지 Vol.28 No.4
Discoid menisci on both the medial and lateral sides are rare, and there are very few reports on cases involving both sides. We report a case of a 52-year-old female with medial and lateral discoid menisci in both knees. Arthroscopy revealed the lateral menisci of both knees were complete discoid menisci, and partial meniscectomy was performed. The medial menisci were incomplete discoid menisci, but there were no findings of abnormal mobility or injury; therefore, the medial menisci were observed without treatment. At six months postoperatively, her pain and range of motion restrictions disappeared.
Arai Yuji,Hara Kunio,Inoue Hiroaki,Kanamura Hitoshi,Nakagawa Shuji,Atsumi Satoru,Mikami Yasuo 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-
We use magnetic resonance angiography to evaluate the difference of vascular ingrowth to the bone tunnel on the anterior and posterior walls quantitatively after anterior cruciate ligament reconstruction.One hundred patients underwent anterior cruciate ligament reconstruction with multi-stranded semitendinosus tendons. They were retrospectively divided into those who underwent magnetic resonance angiography 2, 3, 4 to 6, and ≥ 7 months after surgery. The mean signal-to-noise ratios of the bone tunnel walls in the femur and tibia from the digital data were measured and compared for the anterior and posterior walls.The signal-to-noise ratio of the posterior wall of the femoral bone tunnel was significantly higher than that of the anterior wall in each group. On the tibial side, the signal-to-noise ratio of the anterior wall was significantly higher than that of the posterior wall at ≥4 months after surgery.This study showed that the blood flow after anterior cruciate ligament reconstruction to the femoral bone tunnel is maintained from the posterior wall, and is maintained to the tibial side from the anterior wall 4 months postoperatively. Revascularization to the bone tunnel wall after anterior cruciate ligament reconstruction may relate to the distance from the vessels.
( Hiroyuki Kan ),( Yuji Arai ),( Masashi Kobayashi ),( Shuji Nakagawa ),( Hiroaki Inoue ),( Manabu Hino ),( Shintaro Komaki ),( Kazuya Ikoma ),( Keiichiro Ueshima ),( Hiroyoshi Fujiwara ),( Toshikazu 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.1
Purpose: The fixed flexion view (FFV) of the knee is considered useful for evaluating the joint space when assessing the severity of osteoarthritis (OA) of the knee. To clarify the usefulness of FFV for evaluation of the joint space and severity of knee OA, this study evaluated changes in the joint space on the FFV and standing extended view (SEV) in patients with knee OA. Materials and Methods: The SEV and FFV images were acquired in 567 patients (1,102 knees) who visited the hospital with a chief complaint of knee joint pain. Medial joint space width (MJSW) and Kellgren-Lawrence (K-L) classification assessed using the SEV and FFV images were compared. Results: Mean MJSW was significantly smaller when assessed on the FFV than on the SEV (3.02±1.55 mm vs. 4.31±1.30 mm; p<0.001). The K-L grade was the same or higher on the FFV than on the SEV. Conclusions: The FFV is more useful than the SEV for evaluating the joint space in OA knees. Treatment strategies in patients with knee OA should be determined based on routinely acquired FFV images.
Simultaneous Determination of Free Capsorubin and Capsanthin in Red Pepper Powder Using u-HPLC
Shim, You-Shin,Kim, Ki-Jin,Seo, Dongwon,Ito, Masahito,Nakagawa, Hiroaki,Arai, Shohei,Ha, Jaeho Oxford University Press 2013 Journal of AOAC International Vol.96 No.2
<B>Abstract</B><P>A simultaneous ultra-HPLC (u-HPLC) method for the determination of free capsorubin and capsanthin in red pepper powder was validated in terms of its precision, accuracy, and linearity. The u-HPLC separation was performed on an RP C18 column (particle size 2 μm, id 2 mm length 100 mm) and with a photodiode-array detector. The recoveries of capsorubin were greater than 83.8 ± 1.7%; the LOD and LOQ of the u-HPLC analyses were 0.043 and 0.129 mg/kg, respectively. The intraday and interday precisions for capsorubin were less than 9.01%. The recoveries of capsanthin were greater than 87.7 ± 1.5%, and the LOD and LOQ were 0.101 and 0.306 mg/kg, respectively. The intraday and interday precisions for capsanthin were less than 12.66%. All calibration curves for capsorubin and capsanthin exhibited good linearity (r2 = 0.99) within the tested ranges.</P>
Shim, You -Shin,Kim, Ki-Jin,Seo, Dongwon,Ito, Masahito,Nakagawa, Hiroaki,Ha, Jaeho Oxford University Press 2012 Journal of AOAC International Vol.95 No.2
<B>Abstract</B><P>A rapid and novel ultra-HPLC (u-HPLC) method for the determination of vitamins A (retinol) and E (α-, γ-, and δ-tocopherol) in foods was validated in terms of its precision, accuracy, and linearity. The u-HPLC separation was performed on an RP C18 column (particle size 2 μm, id 2 mm, and length 75 mm), followed by fluorescence detection. The recovery of retinol was more than 84.58%; the LOD and LOQ of the u-HPLC analysis were 0.015 and 0.045 mg/kg, respectively. The intraday and interday precision was less than 9.12%. The recoveries of α-, γ-, and δ-tocopherol were more than 81.37%; the LOD and the LOQ were 0.014, 0.002, and 0.001 mg/kg and 0.042, 0.005, and 0.004 mg/kg, respectively. All calibration curves had good linearity (r2 = 0.99) within the test ranges. The novel, rapid method coupled to u-HPLC can provide significant improvements in the speed, sensitivity, and resolution compared with a conventional HPLC method.</P>