ABSTRACT
BACKGROUND: The Nottingham Adjustment Scale-Japanese version (hereinafter referred to as NAS-J) was developed to measure psychological adaptation to visually impairment. Several disease-specific modified versions have been developed in Japan. The purpose of this study was to develop and test the reliability, validity, and responsiveness of the NAS-J for hip osteoarthritis patients. METHODS: Patients with osteoarthritis of the hip managed as outpatients at the Department of Orthopaedic Surgery of one university hospital gave informed written consent to be enrolled in this study. Subjects were asked to complete a questionnaire consisting of the NAS-J--Hip edition (hereinafter referred to as NAS-J-HIP), health-related QOL (Short Form 36). Subjects' medical and treatment histories, and the Japanese Hip Society's Evaluation Chart of Hip Joint Functions (hereinafter referred to as the JOA score) were also collected from their medical records. Psychometric analyses were conducted to test reliability, validity, and responsiveness. RESULTS: A total of 231 patients agreed to participate in the survey, and responses were obtained from 168 (72.7%). Their mean +/- SD age was 52.5 +/- 12.4 years, and the mean JOA score was 80.9 points. By factor analysis using the principal factor method, seven factors were extracted: (1) anxiety/depression, (2) self-esteem, (3) attitude, (4) locus of control, (5) acceptance, (6) self-efficacy, and (7) attributional style. Concurrent validity was the result according to the near hypothesis. Cronbach's alpha-coefficient ranged from 0.68 to 0.83, indicating high internal consistency. CONCLUSIONS: For hip osteoarthritis patients, construct validity was confirmed for NAS-J-HIP. Furthermore, seven factors comprising 27 items with high internal consistency were incorporated into NAS-J-HIP. This scale can be used to assess the psychological adaptation of hip osteoarthritis patients.
Subject(s)
Adaptation, Psychological , Osteoarthritis, Hip/psychology , Surveys and Questionnaires , Adult , Aged , Factor Analysis, Statistical , Female , Health Status Indicators , Humans , Japan , Male , Middle Aged , PsychometricsSubject(s)
Hemangioma , Spinal Cord Compression , Spinal Neoplasms , Surgery, Computer-Assisted , Thoracic Vertebrae , Aged , Female , Hemangioma/complications , Hemangioma/diagnostic imaging , Hemangioma/surgery , Humans , Spinal Cord Compression/diagnostic imaging , Spinal Cord Compression/etiology , Spinal Cord Compression/surgery , Spinal Neoplasms/complications , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/surgery , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/surgery , Treatment Outcome , UltrasonographyABSTRACT
We studied the radiographic results of bipolar revision hip arthroplasty in 25 patients (25 hips). These patients had suffered from osteoarthrosis of the hip due to acetabular dysplasia and had undergone total hip replacement using smooth threaded acetabular components. In the revision surgery, these components were replaced by bipolar cups; autografts were implanted in 23 patients and hydroxyapatite grains were added in 7. At the time of follow-up, the severity of migration was radiographically graded from I to IV: grade I, 5 mm or less; grade II, 6 to 10 mm; grade III, 11 to 15 mm; and grade IV, 16 mm or more. Five to 11 years (average, 7.0 years) after surgery, 9 patients were classified as grade I, 6 as grade II, 4 as grade III, and 6 as grade IV. Among the 6 individuals with grade IV migration, hydroxyapatite grains had been used in 5. There was a significant negative correlation between the distance of migration and the increase in size of the threaded acetabular components used in the primary total hip replacement and the bipolar cups in the revision surgery. Because of the tendency to migrate, we concluded that this procedure has a limited role in revision surgery.
Subject(s)
Acetabulum/diagnostic imaging , Acetabulum/surgery , Arthroplasty, Replacement, Hip/adverse effects , Osteoarthritis, Hip/surgery , Reoperation/methods , Adult , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/methods , Durapatite/pharmacology , Female , Follow-Up Studies , Humans , Joint Instability/etiology , Joint Instability/surgery , Male , Middle Aged , Osteoarthritis, Hip/diagnosis , Prosthesis Design , Radiography , Range of Motion, Articular/physiology , Recovery of Function , Retrospective Studies , Treatment OutcomeABSTRACT
Leiomyosarcoma usually arises in the uterus, gastrointestinal tract, retroperitoneum, or soft tissue. Primary leiomyosarcoma of bone is rare. We encountered two patients with primary leiomyosarcoma of the femur; one was a 24-year-old woman and the other, a 41-year-old woman. Bone destruction observed on plain radiographs was minimal in both patients. Magnetic resonance imaging (MRI) showed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, with these areas being much larger than the findings to be expected from the plain radiographs. Histological examination revealed spindle-cell sarcoma, with an interlacing pattern, acidophilic cytoplasm and blunt-ended or "cigar-shaped" nuclei, in both patients. In both patients, immunohistochemical examination showed positive staining for vimentin, desmin, and alpha-smooth muscle actin. Extensive examination of the gastrointestinal tract and uterus revealed no primary lesion. Therefore, the leiomyosarcoma in the femur was considered to be primary rather than metastatic. Histological examination, including immunohistochemistry, and the exclusion of an extraskeletal primary lesion, is necessary in diagnosing primary leiomyosarcoma of bone.
