Effect of heel lift insertion on gait function in a patient with total hip arthroplasty with patient-perceived leg length difference: a case report.

[Purpose] The effect of heel lift insertion on gait in patients who have undergone total hip arthroplasty (THA) with patient-perceived leg length difference is seldom referenced in the literature. We used an AB design to investigate the alterations of gait function before and after inserting a heel lift on the non-operative side. [Participant and Methods] The participant had a patient-perceived leg length difference after THA and presented with gait disturbance. The survey phase was 10 days (phase A: normal physiotherapy for five days, and phase B: normal physiotherapy and heel lift insertion for another five days) from the 17th day following THA. The ambulatory task was conducted at a self-determined, comfortable pace and objectively assessed using an inertial sensor. [Results] The insertion of a heel lift partially improved the gait symmetry and the ratio of lumbar acceleration in three directions; it also corrected the patient-perceived leg length difference. [Conclusion] An investigation was carried out to examine the impact of a heel lift on gait in a single case of THA with patient-reported leg length difference. The application of a heel lift may enhance the relationship between the patient-perceived leg length difference, gait symmetry, and the ratio of lumbar acceleration in three dimensions.

Relationship of early postoperative perceived leg length discrepancy to the progression of osteoarthritis in the contralateral hip after unilateral total hip arthroplasty-a retrospective cohort study using propensity score matching.

[Purpose] This study aimed to identify the relationship between the early postoperative perceived leg length discrepancy after unilateral total hip arthroplasty and the progression of osteoarthritis in the contralateral hip. [Participants and Methods] This was a retrospective cohort study of 65 patients who underwent primary unilateral total hip arthroplasty for bilateral hip osteoarthritis. The minimum joint space width of the contralateral hip was measured preoperatively. The change in minimum joint space width one year postoperatively compared with preoperatively was measured. At three weeks postoperatively, patients were divided into the perceived and non-perceived leg length discrepancy groups using the block test. Patients with a perceived leg length discrepancy of 2 mm or more and less than 2 mm were grouped into the perceived and non-perceived leg length discrepancy groups, respectively. Before and after propensity score matching, the change in minimum joint space width between the two groups from the preoperative period to one year postoperatively was compared. [Results] In the pre-propensity matching sample, there was no significant difference in the change in minimum joint space width between the two groups. In the post-propensity matching sample, the change in minimum joint space width in the perceived leg length discrepancy group was significantly larger than that in the non-perceived leg length discrepancy group. [Conclusion] The early postoperative perceived leg length discrepancy after unilateral total hip arthroplasty may affect the progression of osteoarthritis in the contralateral hip.

Proposal of blood-collecting needle approach to semi-invasive method.

Many diabetic patients carry a portable self-monitoring of blood glucose (SMBG)-analyzer in order to collect their own blood and examine their glucose levels; this allows them to determine such factors as insulin dose, diet and exercise to stay healthy. However, the test causes physical and mental stress for the subjects. The authors aim to develop a semi-invasive blood-collecting needle which does not need a power source for the pump mechanism. In this study, we fabricated a capillary action needle that can collect the blood sample automatically. A blood-collecting needle was fabricated from 25 gage sized medical needle (diameter of 0.5 mm, stainless steel) by cutting process, and it had a half-opened crevice in the tip. In order to evaluate the physical characteristics of the blood-collecting needle, the relationship between the size and suction time and/or suction volume were measured using an isotonic sodium chloride solution, whole rabbit blood, and whole human blood with anticoagulant. Next, in order to evaluate the degree of invasion, the diameters of erythema in auricles of rabbits were observed for 2 days using a CCD camera-type microscope. The mean suction time of the isotonic sodium chloride solution and the whole rabbit blood were 1.5 s (n = 10) and 9.0 s (n = 5), respectively. Selection of a suitable size of the blood-collecting needle enabled the collection of 0.1 microL of whole human blood in 10 s. Moreover, it was shown, by comparing the observed diameter of the erythema, that the invasiveness of the blood-collecting needle was smaller than for commercial needles of the equal diameter. It became clear that this fulfils the fundamental functions of a semi-invasive blood-collecting needle.

Trial of very cold neutron radiography in Kyoto University reactor.

A practical very cold neutron (VCN) radiography using a neutron imaging plate was carried out in VCN facility, Kyoto University Reactor (KUR: 5MW). The neutron flux from the VCN bender with the characteristic wavelength of 4.8 nm gives a good image with 5 min irradiation time when CNS was operated. The macroscopic total cross sections of water were measured by imaging plates. It is Sigma(th)=0.87 cm(-1) measured in KUR E2 thermal neutron radiography facility and that of VCN is Sigma(VCN)=9.4 cm(-1). The resolution of water thickness is less than 0.1 mm for VCN radiography and close to the positional resolution of an imaging plate. VCN radiography can show the change of water quantity in gypsophila during a drying procedure.