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Biomedical subjects

Y Takatori

Publications and source records attributed to Y Takatori.

At least 19 recordsLinked to original sources
PubMed2001

Combined intertrochanteric valgus and rotational acetabular osteotomy.

Results are reported for combined intertrochanteric valgus and rotational acetabular osteotomies in 18 dysplastic hips (17 patients), involving two types of femoral head and neck deformities, after an average followup of 13 years (range, 8.9-22.6 years). The mean age of the patients at the time of surgery was 25 years (range, 11-36 years). Pain was the indication for surgery in all patients. The preoperative deformities were classified into two groups. Hips in Group I had an angular head and a normal or valgus neck. Hips in Group II had an ovoid head, a short neck in varus angulation, and relative overgrowth of the greater trochanter. There were seven hips (seven patients) in Group I, and 11 hips (10 patients) in Group II. The sum of the most recent pain score and gait score of Merle d'Aubigné (a full score of 12 points) was 11 to 12 points for seven of 11 hips of Group II, and 11 to 12 points for only one of the seven hips of Group I. For patients with hip pain in Group II, this operation fairly consistently relieves pain for at least an average of 13 years, but whether the rate of development of osteoarthrosis is retarded is not known.

Acetabulum↗
PubMed2000

Long-term results of rotational acetabular osteotomy in young patients with advanced osteoarthrosis of the hip.

Between 1974 and 1987, we performed 38 rotational acetabular osteotomies to treat advanced coxarthrosis caused by acetabular dysplasia in 38 patients who were aged 40 years old or less at the time of surgery. Of these patients, 28 were followed-up for more than 10 years after surgery. The preoperative severity of coxarthrosis was graded as stage III in 21 hips and as stage IV in 7 hips, according to our modification of the classification of coxarthrosis advocated by the Japanese Orthopaedic Association. At the time of follow-up, 27 patients retained their own hip joints on the operated side 10 to 18 years (average, 13 years) after surgery, and the remaining patient had had a secondary total hip replacement 7 years after the surgery. Of the 27 patients who retained their own hip joints on the operated side, 20 had little or no pain and none suffered from severe pain in the operated hip; the severity of coxarthrosis was graded as stage II in 4 hips, as stage III in 9 hips, and as stage IV in 14 hips. We conclude that rotational acetabular osteotomy can be a useful procedure in young patients who have advanced coxarthrosis secondary to acetabular dysplasia.

Acetabulum↗
PubMed1999

Colonna capsular arthroplasty: a 33-year follow-up of four patients.

We evaluated the results of Colonna capsular arthroplasty in 4 patients with unilateral congenital dislocation of the hip. All of these patients were female, aged 10-14 years at the time of surgery, and 42-50 years at the time of follow-up. The most striking finding in this study was the good ability to walk. Although radiographs showed considerable joint degeneration, all of these patients had only mild to moderate pain in the hip.

Adolescent↗
PubMed1999

Rotational acetabular osteotomy using biodegradable internal fixation.

We used biodegradable poly-L-lactide screws in rotational acetabular osteotomy in 41 hips of 41 patients, and studied the complications after an average follow-up of 4.9 years (range 1.0-7.7 years). There were 39 females and 2 males, their average age at the time of the operation was 32 years (range 12-55 years). A small subcutaneous abscess appeared around the non-absorbable sutures in 2 patients after surgery. There was 1 case of thrombophlebitis and 1 of local dermatitis. The small subcutaneous abscess resolved after the removal of the suture material in the 2 cases, and the thrombophlebitis resolved with aspirin. The local dermatitis persisted but was cured by local steroid therapy over 5.8 years. The incidence of local dermatitis after the use of biodegradable implants should be further investigated.

Absorbable Implants↗
PubMed1999

Rotational acetabular osteotomy for the treatment of dysplastic hips with end-stage osteoarthrosis--a biological alternative to total hip arthroplasty?

We evaluated the results of rotational acetabular osteotomy (RAO) for the treatment of dysplastic hips with end-stage osteoarthrosis. Sixteen patients, aged 15-45 years at the time of surgery, were reviewed at a mean follow-up of 8 years (range 3-17 years). Remodeling of the hip joint occurred in half of the patients, with significant clinical improvement. A subsequent total hip arthroplasty, however, was done within 2 years after RAO in two other patients who had had large bone cysts in the femoral head and acetabulum. We suggest that RAO may be the procedure of choice for selected young patients, especially teenage patients, to postpone total hip arthroplasty.

Acetabulum↗
PubMed1998

Long-term outcome of rotational acetabular osteotomy: 145 hips followed for 10-23 years.

We report the long-term outcome of rotational acetabular osteotomy in 145 dysplastic hips of 131 patients after an average follow-up of 13 (10-23) years. The mean age at operation was 28 (11-52) years. The radiographic severity of osteoarthrosis before operation, according to the criteria of the Japanese Orthopaedic Association, was stage I (no degenerative change) in 63 hips, stage II (early degenerative stage) in 49, stage III (progressive stage) in 21 and stage IV (end stage) in 12. The clinical outcome based on the Merle d'Aubigné and Postel score was excellent or good for 90 (80%) of the 112 hips which had stage I or II osteoarthrosis preoperatively, and was excellent or good for only 9 of the 33 hips which had stage III or IV osteoarthrosis (p < 0.001, chi-square test). The radiographic severity of osteoarthrosis at the most recent review was stage I or II for 79 (70%) of the 112 hips which had stage I or II osteoarthrosis preoperatively. The long-term outcome of rotational acetabular osteotomy was satisfactory for a dysplastic hip with little, if any, osteoarthrosis, but was unsatisfactory for a hip with more advanced osteoarthrosis.

Adolescent↗
PubMed1996

Complete endoscopic carpal tunnel release in long-term haemodialysis patients.

The roof of the carpal tunnel (or canal) consists of the distal portion of the flexor retinaculum, the flexor retinaculum (or the transverse carpal ligament) and the proximal portion of the flexor retinaculum. We tried to determine which anatomical structures were relevant to complete endoscopic carpal tunnel decompression in long-term haemodialysis patients with carpal tunnel syndrome. Carpal tunnel pressure was measured using the continuous infusion technique before and after endoscopic release of the flexor retinaculum, distal portion of the flexor retinaculum and the proximal portion of the flexor retinaculum respectively in 257 hands. We concluded that release of the distal portion of the flexor retinaculum, in addition to the flexor retinaculum, is essential for complete carpal tunnel decompression in long-term haemodialysis patients.

Adult↗
PubMed1996

Complete endoscopic carpal canal decompression.

We made a model of the endoscopic decompression of the carpal canal in clinical cases. The model entailed the release of the transverse carpal ligament, ie, the flexor retinaculum, first; then the transverse fibers: deep layer of the midpalmar fascia or distal portion of the flexor retinaculum; and, finally, release of the forearm fascia. Carpal canal pressure was measured using the continuous infusion technique, and the carpal canal was observed endoscopically at each step. Carpal canal pressure data were analyzed by using the Wilcoxon matched pairs signed-rank test. When the transverse carpal ligament and the transverse fibers were divided, carpal canal pressure was significantly statistically lower than that with release of the transverse carpal ligament alone. We conclude that release of both the transverse carpal ligament and the transverse fibers are essential for complete decompression of the carpal canal in endoscopic surgery.

Adult↗
PubMed1996

Long-term follow-up results of rotational acetabular osteotomy in painful dysplastic hips: efficacy in delaying the onset of osteoarthritis.

We evaluated the results of rotational acetabular osteotomies in 13 severely dysplastic hips (11 patients) with subluxation. All of the patients were women, aged 20 to 35 years at the time of surgery, and 40 years or more at the time of follow-up. At a minimum follow-up period of 10 years, the patients had minimal or no pain. Of the 13 hips, 12 showed no significant findings of osteoarthritis. Comparing the outcome of these patients with the natural evolution of severely dysplastic hips, we concluded that rotational acetabular osteotomy may prevent the onset of osteoarthritis.

Acetabulum↗
PubMed1995

Evaluation of carpal canal pressure in carpal tunnel syndrome.

Preoperative electrophysiologic testing and intraoperative carpal canal pressure measurements were performed on 957 hands in 647 patients with clinical signs of carpal tunnel syndrome. Fifty-five symptomatic hands in 48 patients were normal in both distal sensory latency and distal motor latency preoperatively. Carpal canal pressure was, however, significantly elevated compared to control data in all 55 hands. After complete subcutaneous release of the carpal canal using the Universal Subcutaneous Endoscope system, carpal canal pressure was reduced to within the normal control range. Clinical symptoms of carpal tunnel syndrome improved in all 55 hands. Postoperative electrophysiologic data remained within normal range in patients who agreed to receive electrophysiologic examinations.

Adult↗
PubMed1993

[Avascular necrosis of the femoral head: staging by MR imaging].

Magnetic resonance (MR) images and conventional radiographs were compared in 142 hips with avascular necrosis, and a staging system for the disease based on MR imaging was developed. MR images were classified into three patterns: class I: a band of low signal intensity, class II: an area of low signal intensity with internal spot (s) of high signal, and class III: an area of low signal intensity without internal spots of high signal. Most MR class I lesions were in radiographic stage I (normal) or II (sclerotic or cystic changes without collapse). Most MR class II lesions were in radiographic stage III (segmental collapse), and most MR class III lesions were in stage III or IV (secondary degenerative changes). The MR image classification was closely correlated with radiographic staging (p < 0.01, using chi square test). We considered that this classification closely reflected the different stages of the disease according to the histopathology of the bone marrow.

Adult↗
PubMed1993

Avascular necrosis of the femoral head. Natural history and magnetic resonance imaging.

We studied the prognostic value of MRI in 32 radiographically normal, asymptomatic hips in 25 patients at risk of osteonecrosis from glucocorticoids or alcoholism. The early findings were band-like hypointense zones on spin-echo images. No operations were performed. Life-table survival curves showed that femoral heads in which the hypointense zone traversed the middle portion of the head were most at risk of subsequent segmental collapse.

Adolescent↗
PubMed1993

Polylactide screws in acetabular osteotomy. 28 dysplastic hips followed for 1 year.

Absorbable polylactide screws were used for internal fixation of rotational acetabular osteotomy (RAO) in 28 dysplastic hips. No cast was used and the patients were allowed to walk with partial weight bearing 1 month after surgery. Clinical and radiographic results were evaluated after 14 (6-24) months. Union occurred in all cases within 4 months without displacement of the osteotomy. No foreign-body inflammatory reaction on radiographs was observed, nor were there any local reactions, such as redness or swelling. Polylactide screws seem to provide sufficient strength for the internal fixation of RAO. Further observation is necessary to identify any late foreign body reaction.

Acetabulum↗
PubMed1993

Results of endoscopic management of carpal-tunnel syndrome in long-term haemodialysis versus idiopathic patients.

The purpose of this paper is to compare the results of our endoscopic management of carpal-tunnel syndrome caused by long-term haemodialysis to that with no apparent cause (idiopathic). We have operated on 551 hands in 370 patients using the Universal Subcutaneous Endoscope system under local anaesthesia without a pneumatic tourniquet on an out-patient basis since 1986. Ninety-six hands in 64 patients who suffered from carpal-tunnel syndrome from long-term haemodialysis and 85 hands in 52 patients who suffered from carpal-tunnel syndrome for no apparent cause were statistically analysed using complete pre- and postoperative electrophysiological and clinical studies for periods of time ranging from over 6 months to 4.8 years (mean 16.9 months). Electrophysiological and clinical results showed that our endoscopic management in long-term haemodialysis patients is effective, safe and yields the same results as in patients who suffered from carpal-tunnel syndrome for no apparent cause.

Adult↗
PubMed1993

Results of endoscopic management of carpal tunnel syndrome.

This paper is a retrospective study of 27 women with carpal tunnel syndrome (39 hands) who underwent a new endoscopic operative procedure utilizing the Universal Subcutaneous Endoscope system developed by the lead author. Operations on 199 hands were performed under local anesthesia on an outpatient basis. The etiology was considered idiopathic in all cases. Complete preoperative and postoperative clinical and electrophysiologic data were analyzed in 39 hands. The follow-up period ranged from 12 to 45.8 months (mean, 18.3 months). Symptoms of sensory disturbances disappeared in an average of 20 weeks in all patients. Electrophysiologic studies showed definite improvement when compared with preoperative studies. No complications were recorded. Clinical and electrophysiologic results showed that the less-invasive management of carpal tunnel syndrome by endoscopy is safe and effective.

Ambulatory Surgical Procedures↗
PubMed1992

Coracoacromial ligament release for shoulder impingement syndrome using the Universal Subcutaneous Endoscope system.

We developed a new operative procedure of coracoacromial ligament release for shoulder impingement syndrome. The operative procedure was confirmed by cadaveric studies and applied to clinical cases in 40 shoulders of 37 patients who suffered from shoulder impingement without bony abnormalities. The subacromial space was observed under local anesthesia using the Universal Subcutaneous Endoscope (USE) system on an outpatient basis. A popping phenomenon was observed between the coracoacromial ligament and the greater tuberosity of the humerus, which was covered by the rotator cuff, and the coracoacromial ligament was resected with a rongeur under endoscopic visualization in all shoulders. Resection of the coracoacromial ligament relieved the impingement and clinical signs, as in open or arthroscopic resection of the coracoacromial ligament. Resection of the coracoacromial ligament using the USE system is a safe and less-stressful surgical invasion than open or standard arthroscopic resection of the coracoacromial ligament.

Anesthesia, Local↗
PubMed1992

Magnetic resonance imaging and scintigraphy of avascular necrosis of the femoral head. Prediction of subsequent segmental collapse.

For the purpose of an effective management of patients at high risk for nontraumatic avascular necrosis of the femoral head (ANFH), it is expedient to examine the femoral heads of patients most likely to undergo subsequent segmental collapse. The purpose of this study was to evaluate the ability of magnetic resonance imaging (MRI) and radionuclide bone scanning (RS) to predict segmental collapse of the femoral head at the roentgenographically normal stage. Fifty-five hips in 37 patients at risk for ANFH and having normal roentgenograms were included in this study. Magnetic resonance imaging was performed in all hips and RS in 29 hips. The patients were observed during a period of more than two years without any invasive intervention, and nine femoral heads manifested collapse during this period. Predictive values for subsequent segmental collapse of a positive test of MRI and RS were 31% and 13%, respectively, whereas those indicative of a negative test were 100% and 76%, respectively. Magnetic resonance imaging was more useful than RS in detecting patients in need of intensive follow-up examination. In particular, a bandlike area of low intensity that traversed the femoral head in midcoronal slices on MR images seemed to be a significant indicator of subsequent collapse.

Adult↗