The Associated Risk Factors for Entrapment Neuropathy in the Upper Extremity: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS)

Purpose: Although carpal tunnel syndrome (CTS) and cubital tunnel syndrome (CuTS) are the most common neuropathies in the upper extremities, there have been few studies describing the etiology and associated factors in the general population. The purpose of this study was to investigate and clarify the etiology and associated factors for CTS and CuTS in the Japanese general population. Methods: A total of 1875 participants, who participated in health checkups conducted in rural areas in Japan in 2010, were enrolled. The prevalence of CTS and CuTS was investigated. Logistic regression models were performed to examine the relationship between CTS and CuTS and correlated factors such as occupational status, smoking and alcohol preferences, and medical characteristics. Results: The overall prevalence of CTS and CuTS was 2.0% and 2.2%, respectively. With regards to CTS, female subjects showed 7.33-times higher risk of CTS compared with male subjects. In addition, hypertension was also at high risk of CTS (5.56-times higher in borderline and 4.55-times higher in definite hypertension compared with normal blood pressure). However, there were no significant associations between CuTS and age, gender, occupation, smoking and alcohol preferences, or metabolic factors. Conclusions: CTS was associated with female gender and hypertension, whereas there was no obvious risk factor contributing to the onset of CuTS.

Changes in Attitudes toward Lumbar Spinal Stenosis Treatment

As the environment surrounding healthcare continues to evolve, there is a need to revise outcome assessment criteria. A shift is being demanded in diagnosis and treatment outcome assessment practices from objective to subjective assessment and from evaluation by doctors to assessment that is based on the patient’s own perspective. Therefore, lumbar diseases must now be assessed from multiple perspectives. Some major indices for evaluation are pain and numbness, functional status, general health status, disability, and patient satisfaction. An effective assessment method for lumbar spinal stenos is that examines symptoms, quality of life, and healthcare economics as key assessment factor is reviewed.

MRI Observations of Patellar Tendon Length Change after ACL Reconstruction with Hamstring Autografts

The post-operative patellar tendon length was studied to evaluate the possible tendon length change after anterior cruciate ligament（ACL） reconstruction with hamstring autografts. The Insall-Salvati index, modified Insall-Salvati index, curved modified Insall-Salvati index and Caton-Deschamps index were observed by MRI during a follow-up period of 12 weeks on 20 ACL reconstructed knees. The results showed no patellar baja or alta pre-existed on those ACL injured patients. After a follow-up period of 12 weeks, no patellar tendon length change was observed. It is suggested that the change of patella was not the primary reason that may contribute to the premature patellofemoral joint osteoarthritis after ACL reconstruction.