ABSTRACT
Objective: This study aimed to examine differences in platelet-rich plasma (PRP) soak-loaded volumes of β-tricalcium phosphate (β-TCP) with or without a unidirectional porous structure.Materials and Methods: Leukocyte-rich PRP was extracted from 15 healthy volunteers by centrifugation. Two types of artificial bones were soaked for either ten seconds or ten minutes. The volume ratios of PRP soak-loaded onto the artificial bone and soaked area ratios were evaluated. Statistical analyses were performed using the Tukey-Kramer HSD test and the Games-Howell method. A P-value of <0.05 was considered statistically significant.Results: Regardless of the soaking time, the PRP soak-loaded volume ratio and soaked area ratio were significantly higher in the unidirectional porous β-TCP (UDPTCP) group than in the spherical porous β-TCP (SPTCP) group.Conclusion: PRP can be soak-loaded faster and in larger amounts onto UDPTCP compared to SPTCP. Understanding the basic biology of β-TCP soak-loaded with PRP can help develop more novel and effective β-TCP treatments for orthopedic surgery.
ABSTRACT
Objectives: To evaluate the feasibility and efficacy of treatment for the recovery of knee joint function after total knee arthroplasty (TKA) using a robotic suit.Patients and Methods: Knee joint extension exercise sessions were started with a robotic suit (single-joint hybrid assistive limb [HAL-SJ, Cyberdyne, Inc., Tsukuba, Japan]) in one group of patients after TKA. Patients who underwent standard rehabilitation were enrolled in the control group. To evaluate feasibility and safety, we assessed the adverse events, the number of training sessions, and training time. We compared the changes in knee joint pain and extension lag (°) between the groups.Results: The average age was 71.3 ± 6.2 years in the HAL-SJ group and 74.9 ± 8.7 years in the control group. There were no severe adverse events. In the HAL-SJ group, training was performed 2.9 times, on average, and lasted 18.8 min. In the HAL-SJ group, there was a reduction in the visual analog scale (VAS) for pain after training, which was not significant. In the control group, the VAS score worsened after the sessions. The extension lag significantly improved in the HAL-SJ group after the 2nd and 3rd sessions, and this was more due to improvements in their active extension range of motion than their passive extension range of motion.Conclusions: HAL-SJ-based training is safe and effective, and leads to instantaneous improvement of extension lag, without worsening knee joint pain. HAL-SJ-based knee extension training could represent a viable novel post-TKA rehabilitation modality.
ABSTRACT
Introduction: Unidirectional porous β-tricalcium phosphate (UDPTCP) consists of a novel porous artificial bone that is structurally different from conventional artificial bone comprised of spherical porous β-tricalcium phosphate (SPTCP).Case presentation: We present our first four clinical cases of opening-wedge high tibial osteotomy (OWHTO) using UDPTCP and SPTCP together. The patients’ mean age was 54.5 ± 5.9 years, and the mean observation period was 20.8 ± 2.8 months. In OWHTO, two wedge shaped pieces of UDPTCP and SPTCP were cut to fit the gap and implanted parallel to each other in the anterior and posterior parts, respectively. We evaluated the correction loss and bone remodeling for UDPTCP and SPTCP over time using radiography and computed tomography, and evaluated the clinical outcomes.Conclusion: There was no correction loss reported in any case, and early bone remodeling was observed with UDPTCP. All patients achieved satisfactory clinical results with no adverse events.
ABSTRACT
The purpose of this study was to elucidate the effects of whole-body vibration training (WBVT) on knee function and physical performance in middle-aged and older Japanese women who suffered from knee osteoarthritis (OA) and knee pain. Thirty-eight middle-aged and older Japanese women (aged 50-73 years) with knee OA and knee pain were divided into two groups: (1) a WBVT group (n = 29) engaging in WBVT 3 times a week for 8 weeks, and (2) a control group (C group, n = 9) performing exercises at home. The WBVT program consisted of a warm-up, strength training mainly of the quadriceps and their surrounding muscles and cool-down exercises. In the WBVT group, there were no dropouts, and there were significant improvements in the physical function (Cohen’s <i>d</i> = 0.28) and total score (Cohen’s <i>d</i> = 0.25) of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were also statistically significant improvements in all lower-extremity function tests (5-times sit-to-stand, timed up and go, standing time from a long sitting position, sit and reach, 4-way choice reaction time; Cohen’s <i>d</i> = 0.34-1.24). The item that changed significantly in the C group, however, was only the sit and reach (Cohen’s <i>d</i> = 0.52). In addition, all items in the Japanese Orthopaedic Association Score (JOA score) improved significantly (Cohen’s <i>d</i> = 0.63-0.67) in the WBVT group. In conclusion, the 8-week WBVT program can safely improve knee function and physical performance in middle-aged and older Japanese women who suffer from knee OA and knee pain.