ABSTRACT
A 68-year-old man underwent surgery for renal cell carcinoma half a year ago, and developed low back and hip pain. The pain did not respond to antibiotics. Collagen disease, in particular ankylosing spondylitis, was suspected and steroids were administered, resulting in the improvement of the symptoms. polymyalgia rheumatica (PMR) was diagnosed.As all symptoms improved following resection of the metastatic lymph nodes, he was diagnosed with paraneoplastic syndrome. A biological preparation (pazopanib) was administered for renal cell carcinoma, but colon cancer was diagnosed, followed by extirpation of the colon tumor. Although the patient had recurrent thigh pain, he was able to leave the hospital temporarily with walking aids.This is the first report of PMR as paraneoplastic syndrome after surgery for renal cell carcinoma in a patient with colon cancer.
ABSTRACT
Purpose：Good functional results have been reported for arthroscopic repair of rotator cuff tears (ARCR) by several orthopedic surgeons, but few studies have examined the factors affecting rehabilitation outcomes.This study was conducted to identify the factors associated with clinical outcome and the duration of rehabilitation after ARCR.Subjects and methods：This was a retrospective evaluation of 576 patients who underwent ARCR between January 2009 and December 2013 (Men：331, Women：245；mean age：63.9±12.3 years).Patients were divided into groups based on the duration of rehabilitation：less than or more than 6 months. Preoperative and postoperative evaluations, including outcome assessments and physical examination parameters, were reviewed：① type of insurance, ② duration of illness, ③ pain on motion, ④ Japanese Orthopaedic Association Score, ⑤ site of cuff tear, ⑥ thickness of cuff tear, ⑦ repair conditions, ⑧ range of motion (ROM) before surgery, ⑨ ROM at 3 months after surgery, ⑩ ROM at 6 months after surgery, ⑪ muscle strength before surgery, and ⑫ muscle strength at 6 months after surgery．Results：Factors influencing the duration of rehabilitation included traffic accident and workman's compensation insurance coverage, thickness of tear, range of motion of flexion and external rotation at 3 months after surgery, and strength on abduction at 6 months after surgery.Conclusions：When beginning rehabilitation, the type of insurance and thickness of tear must be considered；during rehabilitation, ROM at 3 months and strength at 6 months after surgery must be considered.
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Purpose：The purpose of this study was to identify the determinants of walking ability on the first day after total hip arthroplasty (THA).Methods：We conducted a retrospective study of 78 joints that had undergone primary hemilateral side THA. We calculated the percentage of patients who successfully walked on the first day after THA and then performed a multiple logistic regression analysis, with walking condition on the first day after THA as the dependent variable and age, sex, body mass index, preoperative JOA score, intraoperative blood loss, and difference between preoperative and postoperative hemoglobin levels as independent variables.Result：Fifty-eight percent of the subjects started walking on the first day after surgery, with orthostatic hypotension listed as the most common reason for difficulty in walking. The multiple regression analysis revealed that intraoperative blood loss was significantly associated with walking ability on the first day after THA (p＜0.05).Conclusion：Walking ability on the first day after THA was more dependent on intraoperative blood loss than physical characteristics or preoperative hip function. Results of this study suggest that the amount of intraoperative blood loss is an important factor in determining the safety of early mobilization in THA patients.
ABSTRACT
Purpose：The purpose of this study was to identify the determinants of walking ability on the first day after total hip arthroplasty (THA).Methods：We conducted a retrospective study of 78 joints that had undergone primary hemilateral side THA. We calculated the percentage of patients who successfully walked on the first day after THA and then performed a multiple logistic regression analysis, with walking condition on the first day after THA as the dependent variable and age, sex, body mass index, preoperative JOA score, intraoperative blood loss, and difference between preoperative and postoperative hemoglobin levels as independent variables.Result：Fifty-eight percent of the subjects started walking on the first day after surgery, with orthostatic hypotension listed as the most common reason for difficulty in walking. The multiple regression analysis revealed that intraoperative blood loss was significantly associated with walking ability on the first day after THA (p＜0.05).Conclusion：Walking ability on the first day after THA was more dependent on intraoperative blood loss than physical characteristics or preoperative hip function. Results of this study suggest that the amount of intraoperative blood loss is an important factor in determining the safety of early mobilization in THA patients.
ABSTRACT
<p>［Purpose］This study aimed to evaluate the differences in the immediate postoperative muscle strength around the hip and knee joints, joint range of motion, pain, and mobility between the anterolateral-supine (AL-S) approach, as a form of minimally invasive total hip arthroplasty (THA), and the posterior approach (PA), as a form of small-incision THA.</p><p>［Methods］The subjects were 68 patients with hip osteoarthritis who underwent unilateral THA for the first time. Maximal isometric muscle strength around the hip and knee joints, joint range of motion, walking ability, and pain were measured before surgery, and on Day 10, Day 21, and 2 months after surgery.</p><p>［Results］Significant interactions were found between the time and the type of surgery for hip abduction, external rotation, and extension strength. Interaction was also found between the surgical approach and the time required to achieve optimal hip extension range of motion.</p><p>［Conclusion］The differences in the functional recovery after AL-S approach and PA were most likely caused by differences in muscle damage. Therefore, it is necessary to customize rehabilitation programs according to the characteristics of each approach.</p>