Short-Term Results of Hybrid Closed-Wedge High Tibial Osteotomy: A Case Series with a Minimum 3-Year Follow-up

PURPOSE: High tibial valgus osteotomy (HTO) is a well-established surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closed-wedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the short-term results in a consecutive series of patients treated with hybrid CWHTO. MATERIALS AND METHODS: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average follow-up of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The Kellgren-Lawrence grading system and pre- and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed. RESULTS: The FTA and MA significantly changed from 180.7° to 170.4° and from 22.0° to 60.2°, respectively. No significant differences were observed between the mean pre- and postoperative posterior tibial slope, Insall-Salvati ratio, or Caton-Deschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. CONCLUSIONS: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.

Primary health care in a rural district, Akita prefecture / 日本農村医学会雑誌

Investigation was made into the health care conditions in a rural district in Akita Prefecture. Topographically, the district is divided into two parts-one characterized by mountain and the other by flat terrain.<BR>1. In remote, depopulated villages, per capita cost of public health is on the increase.<BR>2. The number of health personell, particularly public health nurses, is not enough to carry on various health programs.<BR>3. With the prospect of greater numbers of the aged in society, there is an urgent need for increased medical services along with the consolidation of primary health care. In order to meet the need, it is necessary to establish a regional community health system comprised of a hospital as a nucleus and neighborhood medical instituions such as clinics and health centers.

Health problems of women in mixed-farm households / 日本農村医学会雑誌

Investigations were made into the actual working and living conditions of adults, both men and women, in the families engaged in mixed farming.<BR>The working conditions were analyzed according to the types of crops farmers are growing. The work study was necessary to probe into the causes of farmers' health disturbances.<BR>A questionnaire revealed that farmers are short of sleep during the busiest season. Especially housewives are forced to cut down on their sleeping hours.<BR>It also found that some farmers spray pesticides in quantity and expose themselves to the potentially health injurious chemicals with alarming frequency.<BR>There was evidence to show that some ailments, notably low back pain, had been reduced due to imporovements on farmwork and working environment.<BR>Health checkups showed that the incidences of hypercholesterolemia and obesity remain high. There was imbalance between carolic intake and consumption.