Faculty Profiles - OZAKI Toshifumi

Papers - OZAKI Toshifumi

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Kinematic analysis of total knee joint by means of navigation system Reviewed

T. Inoue, N. Abe, S. Miyazawa, K. Fujiwara, Y. Nakajima, N. Sugita, M. Mitsuishi, T. Ozaki, Z. Chen

Transactions of the JSME 81 ( 830 ) 15-00229 - 00229-15-00229 2015

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japan Society of Mechanical Engineers

For additional functionality of artificial knee joint, the kinematics of knee has been evaluated using 2D/3D image registration technique after total knee arthroplasty. To evaluate the knee kinematics of implant, it is important how to adjust the ligament balancing around knee joint during surgery. In the kinematics evaluation of image matching, it is difficult to feed back the ligament balancing of knee because the information from image matching will be available after surgery only. Therefore, we developed a CT-based navigation system with the function of measurement of knee motion during surgery, which has been normally applied to enhance the accuracy of implant setting for target bone. The kinematics of knee has been evaluated with position of implant setting and ligament balancing which were obtained by this system during surgical operation. As a result, (1) The knee kinematics showed different trends between bone and implant based coordinate system, (2) Increasing 2mm thickness of insert between femoral and tibia component of artificial knee joint, the anterior-posterior shift of implant with knee flexion was decreased by changing the ligament tension around knee joint. In conclusion, it is possible to measure the knee kinematics with consideration of ligament balancing using the developed navigation system during surgery.

DOI： 10.1299/transjsme.15-00229

Erratum. Venous Thromboembolism after Total Hip Arthroplasty Diagnosed by Enhanced Computed Tomography:Comparison of Selective Thromboprophylaxis and No Thromboprophylaxis. Reviewed

Okada Y, Endo H, Tanaka T, Mitani S, Fujiwara K, Tetsunaga T, Kagawa Y, Fujii Y, Kunisada T, Ozaki T

Acta medica Okayama 69 ( 5 ) 325 - 325 2015

Language：English

Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15%, 9.0%, 6.0%, and 6.4%, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0%), minor bleeding in 2 cases (2.0%), persistent wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0%) and progression of anemia in 1 case (1.0%). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.

DOI： 10.18926/AMO/53680

microRNAs and Soft Tissue Sarcomas. Reviewed International journal

Fujiwara T, Kunisada T, Takeda K, Ozaki T

Advances in experimental medicine and biology 889 179 - 199 2015

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

Soft tissue sarcomas are a highly heterogenous group of malignant tumors that originate from mesenchymal tissues including muscle, adipose and fibrous tissues, blood vessels, and peripheral nerves. A large variety of histological subtypes that current diagnostic approaches recognize present a diagnostic challenge because their clinical and histopathological characteristics are not always distinct. One of the important clinical problems is a lack of useful biomarkers; therefore, the discovery of biomarkers that can be used to detect tumors or predict tumor response to chemotherapy or radiotherapy could help clinicians provide more effective clinical management. Recent reports on microRNAs (miRNAs) in soft tissue sarcomas have provided clues to solve the problem. Evidence for miRNAs in tumor tissues as well as circulating miRNAs in patients' blood is accelerating the potential to transform clinical applications. In this chapter, we summarize the emerging evidence of dysregulated miRNAs in tumor tissues and patients' blood and discuss the potential of miRNAs as novel biomarkers and therapeutic targets.

DOI： 10.1007/978-3-319-23730-5_10

Immunotherapy for Bone and Soft Tissue Sarcomas. Reviewed International journal

Uehara T, Fujiwara T, Takeda K, Kunisada T, Ozaki T, Udono H

BioMed research international 2015 820813 - 820813 2015

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

Although multimodal therapies including surgery, chemotherapy, and radiotherapy have improved clinical outcomes of patients with bone and soft tissue sarcomas, the prognosis of patients has plateaued over these 20 years. Immunotherapies have shown the effectiveness for several types of advanced tumors. Immunotherapies, such as cytokine therapies, vaccinations, and adoptive cell transfers, have also been investigated for bone and soft tissue sarcomas. Cytokine therapies with interleukin-2 or interferons have limited efficacy because of their cytotoxicities. Liposomal muramyl tripeptide phosphatidylethanolamine (L-MTP-PE), an activator of the innate immune system, has been approved as adjuvant therapeutics in combination with conventional chemotherapy in Europe, which has improved the 5-year overall survival of patients. Vaccinations and transfer of T cells transduced to express chimeric antigen receptors have shown some efficacy for sarcomas. Ipilimumab and nivolumab are monoclonal antibodies designed to inhibit immune checkpoint mechanisms. These antibodies have recently been shown to be effective for patients with melanoma and also investigated for patients with sarcomas. In this review, we provide an overview of various trials of immunotherapies for bone and soft tissue sarcomas, and discuss their potential as adjuvant therapies in combination with conventional therapies.

DOI： 10.1155/2015/820813

Venous thromboembolism after total hip arthroplasty diagnosed by enhanced computed tomography:comparison of selective thromboprophylaxis and no thromboprophylaxis. Reviewed

Okada Y, Endo H, Mitani S, Fujiwara K, Tetsunaga T, Kagawa Y, Fujii Y, Kunisada T, Ozaki T

Acta medica Okayama 69 ( 4 ) 205 - 212 2015

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

Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15%, 9.0%, 6.0%, and 6.4%, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0%), minor bleeding in 2 cases (2.0%), persistent wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0%) and progression of anemia in 1 case (1.0%). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.

DOI： 10.18926/AMO/53556

Diagnostic value of Thallium-201 scintigraphy in differentiating malignant bone tumors from benign bone lesions. Reviewed

Ryota Inai, Takayoshi Shinya, Akihiro Tada, Shuhei Sato, Tomohiro Fujiwara, Ken Takeda, Toshiyuki Kunisada, Hiroyuki Yanai, Toshifumi Ozaki, Susumu Kanazawa

Annals of nuclear medicine 29 ( 8 ) 674 - 681 2015

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

OBJECTIVE: This retrospective study aims to evaluate the diagnostic capacity of thallium-201 (201Tl) scintigraphy for differentiating malignant bone tumors from benign bone lesions. METHODS: Between January 2006 and December 2012, 279 patients with bone lesions (51 malignant and 228 benign) underwent 201Tl scintigraphy before treatment. To evaluate 201Tl uptake, we investigated tumor-to-background contrast (TBC) as well as TBC washout rate (WR). The differences of TBC on early and delayed images and WR were estimated by the Mann-Whitney U test. Receiver operating characteristic (ROC) analyses were used to determine the cut-off TBC values for differentiating malignant bone tumors from benign bone lesions. RESULTS: There were statistically significant differences in median TBC between malignant tumors and benign lesions. These differences occurred for early imaging (1.57 vs. 0.09, p < 0.001) as well as for delayed imaging (0.83 vs. 0.07, p < 0.001). However, there was no statistical difference in WR between malignant tumors and benign lesions (44 vs. 43 %, NS). The chosen TBC cut-off value was 0.68 for early imaging and 0.38 for delayed imaging. Using these cut-off values, the prediction of malignancy had a 77 % sensitivity, 74 % specificity, and 75 % accuracy for early imaging and an 80 % sensitivity, 76 % specificity, and 77 % accuracy for delayed imaging. CONCLUSIONS: 201Tl scintigraphy may have the ability to distinguish malignant bone tumors from benign bone lesions.

DOI： 10.1007/s12149-015-0990-6

Both a visual and a semiquantitative analysis for differentiating benign from malignant chondrogenic bone tumors using Tc-99m (V) DMSA scintigraphy: a prospective study. Reviewed International journal

Takayoshi Shinya, Shuhei Sato, Toshiyuki Kunisada, Ryota Inai, Hiroyuki Yanai, Toshifumi Ozaki, Susumu Kanazawa

Nuclear medicine communications 36 ( 8 ) 802 - 807 2015

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

OBJECTIVE: The aims of this prospective study were to assess the relationship between tumor aggressiveness and Tc-99m (V) dimercaptosuccinic acid (DMSA) uptake in chondrogenic bone tumors and the value of Tc-99m (V) DMSA scintigraphy for differentiating benign from malignant tumors. METHODS: Twenty-four patients with chondrogenic tumors (19 benign and five malignant) underwent Tc-99m DMSA (V) scintigraphy. Radiopharmaceutical uptake was classified using a three-point scale to allow a visual-only analysis, and a tumor-to-background contrast (TBC) was computed using regions of interest to provide a semiquantitative analysis. Spearman's correlation coefficient was used to assess the correlation between tumor aggressiveness and TBC. The difference in TBC between benign and malignant tumors was analyzed with the Mann-Whitney U-test. An appropriate cutoff value of TBC was chosen for the diagnosis of malignancy of a tumor using receiver operating characteristic analysis. RESULTS: Six benign tumors showed negative uptake (uptake score 0), whereas 13 benign tumors showed positive uptake (n=10 uptake score 1; n=3 uptake score 2). All chondrosarcomas showed positive uptake (n=2 uptake score 1; n=3 uptake score 2). A significant correlation was found between tumor aggressiveness and TBC. A significant difference was seen in TBC between benign and malignant tumors. With the chosen cutoff value of TBC equal to 0.611, the sensitivity was 80.0%, specificity was 78.9%, the positive predictive value was 50.0%, and the negative predictive value was 93.8%. CONCLUSION: Tc-99m (V) DMSA scintigraphy may have the potential to improve diagnostic methods for detecting chondrosarcomas using visual and/or semiquantitative analyses.

DOI： 10.1097/MNM.0000000000000328

The figure-of-nine leg position for anatomic anterior cruciate ligament reconstruction Reviewed

T. Furumatsu, M. Fujii, T. Tanaka, S. Miyazawa, T. Ozaki

Revue de Chirurgie Orthopedique et Traumatologique 101 ( 3 ) 249 2015

Language：French Publishing type：Research paper (scientific journal) Publisher：Elsevier Masson SAS

Anatomic double-bundle anterior cruciate ligament (ACL) reconstruction can restore the function and kinematics of the knee in ACL-deficient patients. Several outside-in drilling systems for accurate femoral tunnel creations have been developed. However, the femoral tunnel creation at the lower position of the intercondylar notch can be difficult in an usual leg position with the knee flexed at 90° without varus stress. This technical note describes that the figure-of-nine leg position provides a better arthroscopic view to safely clean up the ACL femoral footprint located at the lower area of the lateral intercondylar wall. This position is useful to create the optimal femoral tunnels using the outside-in drilling technique, without damaging the lateral meniscus posterior root, lateral tibial eminence, and supplemental fibers that bridge the gap between the lateral meniscus and the ACL tibial insertion.

DOI： 10.1016/j.rcot.2014.12.013

Role of Rho Small GTPases in Meniscus Cells Reviewed

Tomoko Kanazawa, Takayuki Furumatsu, Emi Matsumoto-Ogawa, Ami Maehara, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC RESEARCH 32 ( 11 ) 1479 - 1486 2014.11

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

We previously reported that mechanical stretch regulates Sry-type HMG box (SOX) 9-dependent 1(II) collagen (COL2A1) expression in inner meniscus cells. This study examined the role of the small Rho guanosine 5' triphosphatase Rac1 and Rho-associated kinase (ROCK) in the regulation of stretch-induced SOX9 gene expression in cultured human inner meniscus cells. COL2A1 and SOX9 gene expression was assessed by real-time PCR after application of uni-axial cyclic tensile strain (CTS) in the presence or absence of ROCK and Rac1 inhibitors. The subcellular localization of SOX9 and the Rac1 effector cyclic AMP response element-binding protein (CREB), the phosphorylation state of SOX9, Rac1 activation, and the binding of CREB to the SOX9 promoter were assessed. CTS increased the expression of COL2A1 and SOX9, which was suppressed by inhibition of Rac1. ROCK inhibition enhanced COL2A1 and SOX9 gene expression in the absence of CTS. CTS stimulated the nuclear translocation and phosphorylation of SOX9, and increased Rac1 activation. CTS also increased the binding of CREB to the SOX9 promoter. The results suggest that mechanical stretch-dependent upregulation of SOX9 by CREB in inner meniscus cells depends on the antagonistic activities of ROCK and Rac1. (c) 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1479-1486, 2014.

DOI： 10.1002/jor.22703

乳がん骨転移における非定型大腿骨骨折の発生率の検討

中田英二, 杉原進介, 尾崎敏文

中部日本整形外科災害外科学会雑誌 57 ( 6 ) 1245 - 1246 2014.11

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

2004年11月〜2013年10月の間にビスフォスフォネート(BP)を24ヵ月以上静脈内投与した乳がん骨転移患者142名(全例女性、平均年齢69歳)を対象に、非定型型大腿骨骨折(AFF)の発生率について検討した。BP投与回数は24〜103回(中央値36回)、投与期間は16〜101ヵ月(中央値36ヵ月)であった。その結果、1)経過観察期間中に大腿骨病的骨折を11例に認められた。このうちAFFは2例で、1例は右側、他の1例は両側に発生していた。2)発生時のBP投与はそれぞれ41回と83回、投与期間は37・79ヵ月で、2例とも内固定術(髄内釘)が施行されたが、髄腔が硬化し髄内釘の挿入が困難なため骨折部を直視下に整復して挿入した。尚、術後合併症や遷延癒合は認められなかった。3)乳がん患者においてBPを2年以上使用した症例の非定型型大腿骨骨折の発生率は1.4%であるが、3年以上にわたり骨修飾薬を投与した症例中、大腿部痛が出現とともにX線像上で大腿骨外側部に骨皮質に肥厚を認めた場合は非定型型大腿骨骨折の可能性を考えるべきである。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J00831&link_issn=&doc_id=20150123090015&doc_link_id=10.11359%2Fchubu.2014.1245&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2014.1245&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Spinal Metaplastic Meningioma with Osseous Differentiation in the Ventral Thoracic Spinal Canal Reviewed

Kentaro Yamane, Masato Tanaka, Yoshihisa Sugimoto, Kouichi Ichimura, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 68 ( 5 ) 313 - 316 2014.10

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

Ossified meningioma is classified histologically as a phenotype of metaplastic meningioma, and it is extremely rare. There are only 12 cases involving ossified spinal meningiomas in the literature. We present the case of a 61-year-old female with a primary tumor within the ventral spinal canal at T12. Although we performed a total tumor excision using an ultrasonic bone aspirator, a temporary deterioration of motor evoked potentials (MEPs) was observed during curettage with a Kerrison rongeur. The neurologic findings worsened immediately after surgery. Histologically, the tumor was diagnosed as a metaplastic meningioma with osseous differentiation. In order to avoid spinal cord injury, great care must be taken when removing an ossified meningioma located on the ventral spinal cord.

CBTスクリュー刺入部の3次元解析

瀧川朋亨, 田中雅人, 杉本佳久, 荒瀧慎也, 鉄永倫子, 尾崎敏文

Journal of Spine Research 5 ( 10 ) 1452 - 1455 2014.10

Language：Japanese Publisher：(一社)日本脊椎脊髄病学会

本研究の目的はCBTスクリューの挿入可能な角度とスクリュー長、そのCT値を求めることである。64椎体の腰椎CTデータを用いて、4.5mm径の仮想スクリューが刺入可能な角度、スクリュー長およびスクリュー挿入部位のCT値を解析した。腰椎CBTスクリューは下位になるほどより尾外側方向で、より長いスクリューが刺入可能であった。CBTスクリュー挿入部位のCT値は椎弓根スクリューの約2倍であった。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J05510&link_issn=&doc_id=20141104100020&doc_link_id=%2Ffg7spine%2F2014%2F000510%2F021%2F1452-1455%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg7spine%2F2014%2F000510%2F021%2F1452-1455%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Dorsal defect of the patellaの1例

三宅孝昌, 藤原智洋, 武田健, 国定俊之, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 3 ) 460 - 460 2014.10

【運動器を評価する-現場で使える最新評価法活用術-】希少重要疾患の評価法軟部腫瘍の診療における評価法の活用

藤原智洋, 国定俊之, 武田健, 尾崎敏文

関節外科 33 ( 10月増刊 ) 184 - 203 2014.10

小児に生じた単発性骨嚢腫による大腿骨近位部病的骨折

杉生和久, 武田健, 藤原智洋, 国定俊之, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 3 ) 460 - 460 2014.10

Long-term follow-up of resection-replantation for sarcoma in the distal radius Reviewed

Eiji Nakada, Shinsuke Sugihara, Toshiyuki Kunisada, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC SCIENCE 19 ( 5 ) 832 - 837 2014.9

RPN2 Gene Confers Osteosarcoma Cell Malignant Phenotypes and Determines Clinical Prognosis Reviewed

Tomohiro Fujiwara, Ryou-u Takahashi, Nobuyoshi Kosaka, Yutaka Nezu, Akira Kawai, Toshifumi Ozaki, Takahiro Ochiya

MOLECULAR THERAPY-NUCLEIC ACIDS 3 e189 2014.9

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

Drug resistance and metastasis are lethal characteristics of tumors. We previously demonstrated that silencing of ribophorin II (RPN2), which is part of the N-oligosaccharyl transferase complex, efficiently induced apoptosis and reduced resistance to docetaxel in human breast cancer cells. Here, we report the clinical and functional correlations of RPN2 expression in osteosarcoma. Immunohistochemical evaluation of 35 osteosarcoma patient biopsies revealed that RPN2 was moderately to highly expressed in all specimens, and higher RPN2 mRNA expression was significantly correlated with poor prognosis. To investigate whether lethal phenotypes of osteosarcoma could be reduced by regulating the expression of RPN2, we conducted a study of RNAi-induced RPN2 knockdown in highly metastatic human osteosarcoma cells. The results indicated that RPN2 silencing reduced cell proliferation, sphere formation, cell invasion, and sensitized drug response in vitro. Mice bearing RPN2-silenced highly metastatic osteosarcoma xenografts showed reduced tumor growth and lung metastasis, and survived longer than mice bearing control tumor xenografts. Taken together, our data suggest that RPN2 silencing contributes to regulation of lethal osteosarcoma phenotypes and could be a novel target for RNAi-based therapeutics against osteosarcoma.

DOI： 10.1038/mtna.2014.35

切除縁評価法の問題点切除縁評価法の問題点悪性骨腫瘍

国定俊之, 武田健, 藤原智洋, 柳井広之, 尾崎敏文

日本整形外科学会雑誌 88 ( 9 ) 588 - 594 2014.9

Language：Japanese Publisher：(公社)日本整形外科学会

2005年〜2011年に治療した初診時遠隔転移を認めない高悪性骨腫瘍52例を対象に、最近の症例について検討し、悪性骨腫瘍の切除縁評価法に関する疑問点・問題点について検討した。組織型は骨肉腫34例、軟骨肉腫12例、Ewing肉腫3例等であった。52例の切除縁評価は2cm wide margin以上45例、1cm wide margin 4例、marginal margin以下3例であった。1cm wide marginとなった4例は血管温存目的(2例)および術前化学療法効果著効例での関節温存目的(2例)であった。marginal margin以下となった3例は骨盤発生、脊椎発生、大腿骨巨大腫瘍で、広範囲切除縁確保が困難であった。再発は4例に認め、2cm wide margin以上1例、marginal margin以下3例であった。最初の問題点は反応層の定義で、反応層をもう少し詳細に分類する必要がある。2番目の問題点は術前画像での切除縁設定の基準を決めることで、全国で統一した安全な切除縁設定の基準を決める必要があると思われた。

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01133&link_issn=&doc_id=20141006030026&doc_link_id=%2Ffj2ortho%2F2014%2Fs08809%2F005%2F0588-0594%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffj2ortho%2F2014%2Fs08809%2F005%2F0588-0594%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

仙骨発生骨巨細胞腫の治療成績

藤原智洋, 国定俊之, 武田健, 尾崎敏文

中部日本整形外科災害外科学会雑誌 57 ( 秋季学会 ) 248 - 248 2014.9

Two-Directional Arthrographic Assessment for Treating Bilateral Development Dislocation of the Hips in Children after Walking Age Reviewed

Hirosuke Endo, Hirofumi Akazawa, Shigeru Mitani, Yoshiki Okada, Kentaro Yamane, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 68 ( 4 ) 201 - 206 2014.8

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

We reviewed the treatment outcome in 14 hips of 7 patients who were diagnosed as having bilateral developmental dislocation of the hip (DDH) after walking age and could be followed up until they were at least 14 years of age. Based on the results of two-directional arthrography of the hip, closed reduction was performed in 2 hips, and open reduction was performed without osteotomy in 12 hips. The final radiographic evaluations were made according to the Kalamchi and MacEwen classification and Severin classification. The mean age at the initial visit was 1 year and 9 months (range, 1 year and 5 months to 3 years). The outcome was satisfactory for one hip in Group I and 2 hips in Group II according to the Kalamchi and MacEwen classification, and in 83% of the Severin Class I and II hips. Arthrography was useful for identifying asymmetry, demonstrating the usefulness of a treatment strategy based on arthrography of the hip.

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