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Article ; Online: Comparison of time courses in postoperative functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty with propensity score matching.

Oka, Tomohiro / Wada, Osamu / Mizuno, Kiyonori

Archives of orthopaedic and trauma surgery

2023 Volume 144, Issue 1, Page(s) 369–375

Abstract: Introduction/objectives: No consensus has been reached on which is better in terms of functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty (TKA). As patient characteristics, such as age, sex, and body mass index, ... ...

Abstract	Introduction/objectives: No consensus has been reached on which is better in terms of functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty (TKA). As patient characteristics, such as age, sex, and body mass index, have significant effects on functional outcomes after TKA, these factors should be matched before comparisons are made. This study aimed to compare time courses in functional outcomes between simultaneous bilateral TKA and unilateral TKA after matching the patient characteristics. Materials and methods: In this retrospective study, the clinical records of patients admitted to a hospital were reviewed. Of 425 patients, 43 underwent simultaneous bilateral TKA, whereas 382 underwent unilateral TKA. Propensity score matching was performed for age, sex, and body mass index between simultaneous bilateral and unilateral TKA patients. Therapists measured pain intensity, knee extensor strength, and knee-specific functional outcomes by using the new knee society score, including total score, symptoms, patient satisfaction, patient expectations, and functional activities preoperatively and 3 and 12 months postoperatively. Two-way repeated analysis of variance was performed to compare the time courses in functional outcomes between simultaneous bilateral and unilateral TKA. Results: After propensity score matching, 40 patients each for underwent bilateral TKA and unilateral TKA were selected. Knee extensor strength in simultaneous bilateral TKA patients was significantly lower than that in unilateral TKA patients at 3 months postoperatively (p = 0.04). A significant interaction was observed between the effects of time and group on knee extensor strength (F [1, 78] = 3.338; interaction: p = 0.042; η Conclusions: Patients who underwent simultaneous bilateral TKA should undergo postoperative rehabilitation focused on alleviating delayed recovery in knee extensor strength during the acute phase.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee ; Retrospective Studies ; Propensity Score ; Osteoarthritis, Knee/surgery ; Knee Joint/surgery ; Treatment Outcome
Language	English
Publishing date	2023-09-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-05065-9
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Article ; Online: Contralateral knee pain exacerbation after total knee arthroplasty and its impact on functional activity.

Kamitani, Tsukasa / Wada, Osamu / Mizuno, Kiyonori / Kurita, Noriaki

Archives of orthopaedic and trauma surgery

2023 Volume 144, Issue 4, Page(s) 1713–1720

Abstract: Introduction: The purposes of the present study were to (1) describe the prevalence of contralateral knee pain exacerbation after total knee arthroplasty (TKA), (2) explore the risk factors for pain exacerbation, and (3) verify the association of ... ...

Abstract	Introduction: The purposes of the present study were to (1) describe the prevalence of contralateral knee pain exacerbation after total knee arthroplasty (TKA), (2) explore the risk factors for pain exacerbation, and (3) verify the association of contralateral knee pain with future functional activity. Materials and method: We consecutively recruited outpatients with osteoarthritis of both knees who had primary TKA planned. The contralateral knee pain using a Numerical Rating Scale (NRS) and the functional activities subdomain of the new Knee Society Knee Scoring System (KSS) were assessed preoperatively and at 1, 3, and 6 months postoperatively. Among patients with < 5 NRS points preoperatively, we described the frequency of the contralateral knee pain exacerbation, defined as a ≥ 2-point increase from preoperative pain at each postoperative visit. An exploratory analysis was performed to identify preoperative risk factors for contralateral knee pain exacerbation. A linear mixed model was fit to examine the association of the contralateral knee pain with KSS functional activities at subsequent visits. Results: Among 315 patients, 14.6%, 24.1%, and 27.6% of patients experienced contralateral knee pain exacerbation at 1, 3, and 6 months postoperatively, respectively. The identified preoperative risk factors were low quadriceps strength and higher Kellgren-Lawrence grade on the non-operative knee, along with severe pain on the operative knee. The magnitude of the association between contralateral knee pain and worsening KSS functional activities increased with subsequent visits (p for interaction < 0.001). Conclusion: The frequency and impact of pain exacerbation on the contralateral knee increase after TKA and should be carefully evaluated for a prolonged period of time.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee/adverse effects ; Treatment Outcome ; Knee Joint/surgery ; Osteoarthritis/surgery ; Pain/etiology ; Osteoarthritis, Knee/surgery ; Osteoarthritis, Knee/etiology
Language	English
Publishing date	2023-12-23
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-05163-8
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Article ; Online: Comparison of Acute-Phase Pain Intensity, Pain Trajectory, and the Number of Analgesics Administered between Total and Unicompartmental Knee Arthroplasties.

Oka, Tomohiro / Imai, Ryota / Wada, Osamu / Mizuno, Kiyonori

The journal of knee surgery

2022 Volume 36, Issue 7, Page(s) 785–791

Abstract: We aimed to compare the variables of pain intensity, pain trajectory, and the number of analgesics administered during the acute phase between total and unicompartmental knee arthroplasties. This prospective cohort study recruited 445 patients who ... ...

Abstract	We aimed to compare the variables of pain intensity, pain trajectory, and the number of analgesics administered during the acute phase between total and unicompartmental knee arthroplasties. This prospective cohort study recruited 445 patients who planned to undergo knee arthroplasty. Pain intensity was evaluated during hospitalization, and 1 month postoperatively using a numerical rating scale. Pain trajectory (slope and intercept) was calculated using pain intensity data from postoperative days 1 to 4. The number of analgesics administered for worsening pain was monitored during hospitalization. Multiple linear regression analysis with adjustment for potential confounders was conducted to investigate the impact of surgery type on pain variables. Data for 208 and 189 patients who had undergone total and unicompartmental knee arthroplasties, respectively, were included in this study. Pain intensity and pain trajectory were similar between the two surgeries. The number of analgesics administered on postoperative day 3 (
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee ; Pain Measurement ; Prospective Studies ; Treatment Outcome ; Analgesics/therapeutic use ; Pain, Postoperative/drug therapy ; Osteoarthritis, Knee/surgery
Chemical Substances	Analgesics
Language	English
Publishing date	2022-02-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2075354-8
ISSN	1938-2480 ; 1538-8506 ; 0899-7403
ISSN (online)	1938-2480
ISSN	1538-8506 ; 0899-7403
DOI	10.1055/s-0042-1743228
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Article: Comparison of Acute-Phase Pain Intensity, Pain Trajectory, and the Number of Analgesics Administered between Total and Unicompartmental Knee Arthroplasties

Oka, Tomohiro / Imai, Ryota / Wada, Osamu / Mizuno, Kiyonori

The Journal of Knee Surgery

2022 Volume 36, Issue 07, Page(s) 785–791

Abstract	We aimed to compare the variables of pain intensity, pain trajectory, and the number of analgesics administered during the acute phase between total and unicompartmental knee arthroplasties. This prospective cohort study recruited 445 patients who planned to undergo knee arthroplasty. Pain intensity was evaluated during hospitalization, and 1 month postoperatively using a numerical rating scale. Pain trajectory (slope and intercept) was calculated using pain intensity data from postoperative days 1 to 4. The number of analgesics administered for worsening pain was monitored during hospitalization. Multiple linear regression analysis with adjustment for potential confounders was conducted to investigate the impact of surgery type on pain variables. Data for 208 and 189 patients who had undergone total and unicompartmental knee arthroplasties, respectively, were included in this study. Pain intensity and pain trajectory were similar between the two surgeries. The number of analgesics administered on postoperative day 3 ( p = 0.01) and day 4 ( p = 0.03), as well as total number ( p = 0.01), were lower for unicompartmental knee arthroplasty than for total knee arthroplasty. Multiple linear regression analysis showed that the type of surgery affected the total number of analgesics administered (β = − 1.24, p < 0.01, 95% confidence interval: −1.80 to −0.62). This study suggests that pain characteristics observed during the acute phase differ between total and unicompartmental knee arthroplasties. Postoperative pain should be managed, and rehabilitation should be provided at similar levels after the second postoperative day in total and unicompartmental knee arthroplasty patients.
Keywords	total knee arthroplasty ; unicompartmental knee arthroplasty ; acute postoperative pain ; number of analgesics administered
Language	English
Publishing date	2022-02-18
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2075354-8
ISSN	1938-2480 ; 1538-8506 ; 0899-7403
ISSN (online)	1938-2480
ISSN	1538-8506 ; 0899-7403
DOI	10.1055/s-0042-1743228
Database	Thieme publisher's database

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Article ; Online: Structural severity, phase angle, and quadriceps strength among patients with knee osteoarthritis: the SPSS-OK study.

Wada, Osamu / Kurita, Noriaki / Yamada, Minoru / Mizuno, Kiyonori

Clinical rheumatology

2020 Volume 39, Issue 10, Page(s) 3049–3056

Abstract: Introduction/objectives: The associations between severity of knee osteoarthritis (KOA) and phase angle (PhA) and between PhA and quadriceps strength in patients with KOA are unclear. This study examined (1) whether the structural severity of KOA ... ...

Abstract	Introduction/objectives: The associations between severity of knee osteoarthritis (KOA) and phase angle (PhA) and between PhA and quadriceps strength in patients with KOA are unclear. This study examined (1) whether the structural severity of KOA affects PhA and (2) whether PhA affects quadriceps strength in patients with KOA. Method: Data of 1093 patients with KOA, obtained from Screening for People Suffering Sarcopenia in the Orthopedic cohort of Kobe study, were analyzed. PhA was determined by bioimpedance. Quadriceps strength was measured using a handheld dynamometer. Structural severity of KOA was determined using Kellgren-Lawrence radiographic grading scale. A series of general linear models were fitted to estimate the magnitude of differences in PhA by differences in KOA severity and quadriceps strength by differences in PhA. Results: The mean age of the patients was 72.8 years, and 78% were women. Increasing KOA severity was associated with decreasing PhA, especially in men. In women, only grade 4 KOA was associated with a decrease in PhA (P for interaction = 0.048). PhA per leg was positively associated with quadriceps strength per leg, independent of age, sex, leg muscle mass, pain, and KOA severity (mean difference per 1° increase = 7.54 Nm, 95% confidence interval = 5.51-9.57 Nm). The association between PhA and quadriceps strength differed neither by sex nor by KOA severity (P for interaction = 0.133 and 0.185, respectively). Conclusions: PhA decreased with increasing KOA severity, and increasing PhA was associated with increasing quadriceps strength. Clinicians should, therefore, evaluate PhA to assess quadriceps strength in patients with KOA. Key Points • PhA gradually decreased with increasing severity of KOA, especially in men. • Increasing PhA was associated with increasing quadriceps strength. • Clinicians should focus on increasing muscle mass and PhA.
MeSH term(s)	Aged ; Female ; Humans ; Leg ; Male ; Muscle Strength ; Muscle, Skeletal ; Osteoarthritis, Knee/diagnostic imaging ; Quadriceps Muscle/diagnostic imaging
Language	English
Publishing date	2020-04-27
Publishing country	Germany
Document type	Journal Article
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-020-05056-w
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Article ; Online: U-TEST, a simple decision support tool for the diagnosis of sarcopenia in orthopaedic patients: the Screening for People Suffering Sarcopenia in Orthopedic cohort of Kobe study (SPSS-OK).

Kamitani, Tsukasa / Wakita, Takafumi / Wada, Osamu / Mizuno, Kiyonori / Kurita, Noriaki

The British journal of nutrition

2021 Volume 126, Issue 9, Page(s) 1323–1330

Abstract: We aimed to develop and validate a new simple decision support tool (U-TEST) for diagnosis of sarcopenia in orthopaedic patients. We created seventeen candidate original questions to detect sarcopenia in orthopaedic patients with sarcopenia through ... ...

Abstract	We aimed to develop and validate a new simple decision support tool (U-TEST) for diagnosis of sarcopenia in orthopaedic patients. We created seventeen candidate original questions to detect sarcopenia in orthopaedic patients with sarcopenia through expert opinions and a semi-structured interview. To derive a decision support tool, a logistic regression model with backward elimination was applied to select variables from the seventeen questions, age and underweight (BMI < 18·5 kg/m2). Sarcopenia was defined by Asian Working Group for Sarcopenia 2019 criteria. After assigning a score to each selected variable, the sum of scores was calculated. We evaluated the diagnostic performance of the new tool using a logistic regression model. A bootstrap technique was used for internal validation. Among a total of 1334 orthopaedic patients, sixty-five (4·9 %) patients were diagnosed with sarcopenia. We succeeded in developing a 'U-TEST' with scores ranging from 0 to 11 consisting of values for BMI (Underweight), age (Elderly) and two original questions ('I can't stand up from a chair without supporting myself with my arms' (Strength) and 'I feel that my arms and legs are thinner than they were in the past' (Thin)). The AUC was 0·77 (95 % CI 0·71, 0·83). With the optimal cut-off set at 3 or greater based on Youden's index, the sensitivity and the specificity were 76·1 and 63·6 %, respectively. In orthopaedic patients, our U-TEST scoring with two questions and two simple clinical variables can help to screen for sarcopenia.
MeSH term(s)	Aged ; Cross-Sectional Studies ; Humans ; Mass Screening ; Muscle Strength ; Orthopedics ; Sarcopenia/diagnosis ; Thinness
Language	English
Publishing date	2021-01-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	280396-3
ISSN	1475-2662 ; 0007-1145
ISSN (online)	1475-2662
ISSN	0007-1145
DOI	10.1017/S0007114521000106
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Article ; Online: Association between phase angle and functional disability among patients with lumbar spinal stenosis: The SPSS-OK study.

Wada, Osamu / Yamada, Minoru / Kamitani, Tsukasa / Mizuno, Kiyonori / Tadokoro, Kou / Kurita, Noriaki

Journal of back and musculoskeletal rehabilitation

2022 Volume 36, Issue 2, Page(s) 399–405

Abstract: Background: Whether the lower phase angle associated with worse physical function is a result of pain and muscle weakness in patients with lumbar spinal stenosis (LSS) is unclear.: Objective: To evaluate the association between phase angle and back ... ...

Abstract	Background: Whether the lower phase angle associated with worse physical function is a result of pain and muscle weakness in patients with lumbar spinal stenosis (LSS) is unclear. Objective: To evaluate the association between phase angle and back pain-specific disabilities in patients with LSS. Methods: In this single-center, cross-sectional study, 491 participants with LSS were enrolled. The phase angle and back pain-specific disability were measured using bioelectrical impedance analysis and the Oswestry Disability Index, respectively. General linear models were used to examine associations between phase angle and the Oswestry Disability Index with or without adjustment for age, sex, low back and lower limb pain, numbness in the lower extremities, total fat mass, and lower limb muscle mass. Results: The mean (SD) phase angle was 4.4∘ (1.0∘), and the mean Oswestry Disability Index was 36.1 (14.1) points. Greater phase angles were associated with less Oswestry Disability Index points (p= 0.037) independent of fat mass, low back pain, and hip or lower limb pain. Conclusions: A lower phase angle was associated with worse functional disability. Low phase angle may be an indicator of functional impairment due to low back pain associated with LSS.
MeSH term(s)	Humans ; Spinal Stenosis/complications ; Low Back Pain ; Cross-Sectional Studies ; Lumbar Vertebrae ; Back Pain
Language	English
Publishing date	2022-09-22
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1184721-9
ISSN	1878-6324 ; 1053-8127
ISSN (online)	1878-6324
ISSN	1053-8127
DOI	10.3233/BMR-220038
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Article ; Online: Implications of evaluating leg muscle mass and fat mass separately for quadriceps strength in knee osteoarthritis: the SPSS-OK study.

Wada, Osamu / Kurita, Noriaki / Kamitani, Tsukasa / Mizuno, Kiyonori

Clinical rheumatology

2019 Volume 39, Issue 5, Page(s) 1655–1661

Abstract: Objective: To examine the influence of obesity on quadriceps strength by separately analyzing body mass index (BMI) as fat mass and leg muscle mass in patients with knee osteoarthritis (KOA).: Methods: The Screening for People Suffering Sarcopenia in ...

Abstract	Objective: To examine the influence of obesity on quadriceps strength by separately analyzing body mass index (BMI) as fat mass and leg muscle mass in patients with knee osteoarthritis (KOA). Methods: The Screening for People Suffering Sarcopenia in Orthopedic cohort of Kobe (SPSS-OK) study was a single-center cross-sectional study that recruited 906 patients with KOA. Fat mass and leg muscle mass were measured by bio-impedance. Isometric knee extension torque (Nm) was measured as quadriceps strength. A series of general linear models were fitted to estimate the continuous associations of BMI and fat mass with quadriceps strength, with adjustment of confounders. In the fitted models, both BMI and fat mass were treated as restricted cubic spline functions. Results: A continuous, non-linear relationship between BMI and quadriceps strength was found (P = 0.008 for non-linearity). In patients with a BMI of 16-25 kg/m Conclusion: Our study suggests that there are independent associations between the leg muscle mass, fat mass, and quadriceps strength. It is difficult to easily predict quadriceps strength using only BMI. Key points: • An increase in body mass index (BMI) up to 25 kg/m
MeSH term(s)	Aged ; Aged, 80 and over ; Body Composition ; Body Mass Index ; Cross-Sectional Studies ; Electric Impedance ; Female ; Humans ; Leg ; Male ; Muscle Strength ; Muscle, Skeletal/pathology ; Muscle, Skeletal/physiopathology ; Organ Size ; Osteoarthritis, Knee/physiopathology ; Quadriceps Muscle/pathology ; Quadriceps Muscle/physiopathology
Language	English
Publishing date	2019-12-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-019-04879-6
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Article: U-TEST, a simple decision support tool for the diagnosis of sarcopenia in orthopaedic patients: the Screening for People Suffering Sarcopenia in Orthopedic cohort of Kobe study (SPSS-OK)

Kamitani, Tsukasa / Wakita, Takafumi / Wada, Osamu / Mizuno, Kiyonori / Kurita, Noriaki

British journal of nutrition. 2021 Nov. 14, v. 126, no. 9

2021

Abstract	We aimed to develop and validate a new simple decision support tool (U-TEST) for diagnosis of sarcopenia in orthopaedic patients. We created seventeen candidate original questions to detect sarcopenia in orthopaedic patients with sarcopenia through expert opinions and a semi-structured interview. To derive a decision support tool, a logistic regression model with backward elimination was applied to select variables from the seventeen questions, age and underweight (BMI < 18·5 kg/m²). Sarcopenia was defined by Asian Working Group for Sarcopenia 2019 criteria. After assigning a score to each selected variable, the sum of scores was calculated. We evaluated the diagnostic performance of the new tool using a logistic regression model. A bootstrap technique was used for internal validation. Among a total of 1334 orthopaedic patients, sixty-five (4·9 %) patients were diagnosed with sarcopenia. We succeeded in developing a ‘U-TEST’ with scores ranging from 0 to 11 consisting of values for BMI (Underweight), age (Elderly) and two original questions (‘I can’t stand up from a chair without supporting myself with my arms’ (Strength) and ‘I feel that my arms and legs are thinner than they were in the past’ (Thin)). The AUC was 0·77 (95 % CI 0·71, 0·83). With the optimal cut-off set at 3 or greater based on Youden’s index, the sensitivity and the specificity were 76·1 and 63·6 %, respectively. In orthopaedic patients, our U-TEST scoring with two questions and two simple clinical variables can help to screen for sarcopenia.
Keywords	decision support systems ; elderly ; nutrition ; orthopedics ; people ; regression analysis ; sarcopenia ; underweight
Language	English
Dates of publication	2021-1114
Size	p. 1323-1330.
Publishing place	Cambridge University Press
Document type	Article
ZDB-ID	280396-3
ISSN	1475-2662 ; 0007-1145
ISSN (online)	1475-2662
ISSN	0007-1145
DOI	10.1017/S0007114521000106
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Article: Effect of self-calf massage on the prevention of deep vein thrombosis after total knee arthroplasty: A randomized clinical trial.

Oka, Tomohiro / Wada, Osamu / Nitta, Shingo / Maruno, Hideto / Mizuno, Kiyonori

Physical therapy research

2020 Volume 23, Issue 1, Page(s) 66–71

Abstract: Objective: Deep vein thrombosis (DVT) is a severe complication after total knee arthroplasty (TKA). Performing self-calf massage may decrease the incidence of DVT. The purpose of this study was to investigate whether self-calf massage is effective for ... ...

Abstract	Objective: Deep vein thrombosis (DVT) is a severe complication after total knee arthroplasty (TKA). Performing self-calf massage may decrease the incidence of DVT. The purpose of this study was to investigate whether self-calf massage is effective for preventing DVT after TKA. Method: In all, 165 patients participated in the present study. Patients were randomized to one of two groups: the self-calf massage group or the control group. In the control group, patients started regular physical therapy. In the self-calf massage group, in addition to regular physical therapy, patients were instructed to massage their calf muscles 30 times from the distal to proximal side. This procedure was repeated three times and was completed in 2 mins during the 2 days following TKA. All patients were evaluated for DVT on postoperative day 3 using lower limb vein ultrasonography. Results: The incidence of DVT was significantly lower in the self-calf massage group than in the control group. Self-calf massage was associated with a lower incidence of DVT, whereas age and female sex were risk factors for DVT. Conclusion: This study showed that the self-calf massage may be beneficial for the prevention of DVT after TKA.
Language	English
Publishing date	2020-02-25
Publishing country	Japan
Document type	Journal Article
ISSN	2189-8448
ISSN	2189-8448
DOI	10.1298/ptr.E10014
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