Incidence of and risk factors for hip fracture in Nagasaki, Japan from 2005 to 2014.

The annual incidence of new hip fractures increased from 2005 to 2014 in Nagasaki and females were much more affected. High-risk factors were identified as age ≥ 80 years, winter, indoors, living room, Monday, and early morning. Seven days after admission, most patients remained hospitalized and had been treated surgically. INTRODUCTION: Hip fractures are major osteoporotic fractures that reduce quality of life. In Japan, the incidence of hip fractures increased steadily from 1986 to 2014 and the number of hip fractures could be 7.3-21.3 million by 2050. This study aimed to determine the incidence of hip fractures from 2005 to 2014 in Nagasaki Prefecture and to analyze the characteristics of and risk factors for hip fracture. METHODS: Hip fractures that occurred in Nagasaki Prefecture between 2005 and 2014 were analyzed using emergency transportation records. Fracture type, age, sex, location in which fracture occurred, and risk factors for hip fracture were clarified. RESULTS: The total number of new hip fractures among individuals ≥ 35 years old was 17,395 (mean age, 82.6 years old) and the annual incidence per 100,000 population increased from 147.9 in 2005 to 235.0 in 2014. Females (79.6%) were much more commonly affected than males (20.4%) and cervical fractures were more common than trochanteric fractures in all age groups. Hip fracture tended to be associated with age ≥ 80 years, winter rather than summer, indoors rather than outdoors, and living room rather than the bathroom or toilet. Other high-risk factors were Monday as day of the week, and early morning as the time of day. Seven days after admission, 97.3% of patients were hospitalized and 78.1% of hip fractures had been treated surgically. CONCLUSION: Information on actual situations and valid preventive measures relevant to hip fracture are urgently needed.

Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy.

BACKGROUND: The purpose of this study was to compare radiological features between high tibial osteotomy (HTO) and tibial condylar valgus osteotomy (TCVO), in order to define the radiological indication criteria for TCVO. METHODS: Thirty-two cases involving 35 knees that had undergone HTO and the same number that had undergone TCVO for knee osteoarthritis were retrospectively evaluated. Characteristics of both groups did not differ significantly. Lower limb alignment, bone morphology, joint congruity, and joint instability were measured in standing full-length leg and knee radiographs obtained before and after surgery. RESULTS: Radiological features in the TCVO group included greater frequencies of advanced knee OA grade, varus lower limb malalignment, depression of the medial tibial plateau, and varus-valgus joint instability compared to the HTO group before surgery. However, tibial morphology, alignment of the lower limb, and joint instability improved to comparable levels after surgery in both groups. CONCLUSIONS: TCVO appears preferable in cases with advanced knee OA, destroyed or inclined medial tibial plateau, widened and subluxated lateral joint, and high varus-valgus joint instability.

Factors contributing to airborne particle dispersal in the operating room.

BACKGROUND: Surgical-site infections due to intraoperative contamination are chiefly ascribable to airborne particles carrying microorganisms. The purpose of this study is to identify the actions that increase the number of airborne particles in the operating room. METHODS: Two surgeons and two surgical nurses performed three patterns of physical movements to mimic intraoperative actions, such as preparing the instrument table, gowning and donning/doffing gloves, and preparing for total knee arthroplasty. The generation and behavior of airborne particles were filmed using a fine particle visualization system, and the number of airborne particles in 2.83 m3 of air was counted using a laser particle counter. Each action was repeated five times, and the particle measurements were evaluated through one-way analysis of variance multiple comparison tests followed by Tukey-Kramer and Bonferroni-Dunn multiple comparison tests for post hoc analysis. Statistical significance was defined as a P value ≤ .01. RESULTS: A large number of airborne particles were observed while unfolding the surgical gown, removing gloves, and putting the arms through the sleeves of the gown. Although numerous airborne particles were observed while applying the stockinet and putting on large drapes for preparation of total knee arthroplasty, fewer particles (0.3-2.0 µm in size) were detected at the level of the operating table under laminar airflow compared to actions performed in a non-ventilated preoperative room (P < .01). CONCLUSIONS: The results of this study suggest that surgical staff should avoid unnecessary actions that produce a large number of airborne particles near a sterile area and that laminar airflow has the potential to reduce the incidence of bacterial contamination.

11. Bactericidal Activity of Photocatalytic TiO2 Excited by Low Intensity Pulsed Ultrasound (LIPUS): An In Vitro Study.

Photocatalysis with anatase-type titanium dioxide (TiO2) under ultraviolet has a well-recognized bactericidal effect. The purpose of the present study was to evaluate the photocatalytic bactericidal effects of TiO2 on Staphylococcus epidermidis (ATCC35984) caused by Low Intensity Pulsed Ultrasound (LIPUS) associated with bio-implant-related infections. The photocatalytic properties of the TiO2 films were confirmed by the degradation of an aqueous solution of methylene blue. The disks were seeded with cultured Staphylococcus epidermidis and irradiated by LIPUS. The bactericidal effect of the TiO2 films was evaluated by counting the surviving colonies. The viability of the bacteria on the photocatalytic TiO2 film coated titanium was suppressed significantly to 63% after 2 hours of LIPUS treatment (P < 0.05). The photocatalytic bactericidal effect of TiO2 under LIPUS is useful for sterilizing the contaminated and infected surfaces of metal bio-implants.