Kobe University Orthopaedic Adult Reconstruction and Joint Replacement Division are conducted by five faculties: Dr. Tomoyuki Matsumoto, Dr. Shinya Hayashi, Dr. Shingo Hashimoto, and Dr. Koji Takayama. Our main treatment and research target is osteoarthritis of the knee and hip joints. Therefore, cartilage biology study, such as regenerative medicine and biomechanics study for end-staged osteoarthritis, which needs knee and hip replacement surgery, is mainly focused in our group.
Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are mainly performed for end-stage osteoarthritis (OA). To obtain excellent postoperative outcomes, modified navigation system and an original offset-type tensor has been developed.
The modified navigation system enables not only accurate osteotomy, but also 3-D motion analysis. In addition, 3-D preoperative planning software is introduced to improve its accuracy. The offset-type tensor enables the assessment of soft tissue balance throughout range of motion (ROM) in the physiologic knee after TKA, with a reduced patellofemoral (PF) joint and femoral component in place. The accuracy of measurement and clinical relevance of this tensor have been reported, and this tensor has received high praise in Japan and all over the world. Together with this tensor and modified navigation system, accurate osteotomy and appropriate soft tissue balance are now available simultaneously. Furthermore evaluating the relationship between 3-D motion analysis, soft-tissue balance, and postoperative outcomes is possible.
To date, we have reported that intraoperative soft tissue balance is related to postoperative soft tissue balance and clinical outcomes. We have also reported the clinical outcomes with navigation system, patient satisfaction after TKA using the 2011 Knee Society Score (KSS), and the cause and treatment of prosthetic joint infection (PJI).
We have also evaluated the ligament balance in UKA using a tensor developed for UKA and studied the relationship between the ligament balance and postoperative clinical outcomes. In addition, we conducted a large-scale survey of Japanese lower limb alignment and reported changes in lower limb alignment due to age and knee osteoarthritis in the Japanese population.
Based on these research results, we are working on further improvement of postoperative outcomes and patient satisfaction.