Purpose: the efficacy and safety of using a suspensory button for femoral fixation in anatomical anterior cruciate ligament (ACL) reconstruction with bonepatellar tendon-bone (BPtB) graft have not been established. the purpose of the current study was to evaluate bone plug integration onto the femoral socket and migration of the bone plug and the EndoButton (EB) (smith & nephew, Andover, MA, UsA) after rectangular tunnel ACL reconstruction with BPtB autograft. Methods: thirty-four patients who underwent anatomical rectangular ACL reconstruction with BPtB graft using EB for femoral fixation and in whom three-dimensional (3D) computed tomography (Ct) was performed one week and one year after surgery were included in this study. Bone plug integration onto the femoral socket, bone plug migration, soft tissue interposition, EB migration and EB rotation were evaluated on 3D Ct. the clinical outcome was also assessed and correlated with the imaging outcomes. Results: the bone plug was integrated onto the femoral socket in all cases. the incidence of bone plug migration, soft tissue interposition, EB migration and EB rotation was 15, 15, 9 and 56%, respectively. no significant association was observed between the imaging outcomes. the postoperative mean Lysholm score was 97.1 ± 5.0 points. the postoperative side-toside difference, evaluated using a Kt-2000 arthrometer, averaged 0.5 ± 1.3 mm. there were no complications associated with EB use. imaging outcomes did not affect the postoperative Kt side-to-side difference. Conclusions: the EB is considered a reliable device for femoral fixation in anatomical rectangular tunnel ACL reconstruction with BPtB autograft. Level of evidence: Level iV, therapeutic case series.

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Case series, Level IV.

Background: Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models.

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Formation of amino acids from mixtures of methanol, ammonia and water in various phases by γ-rays and UV irradiation were quantitatively verified. A wide variety of amino acids were detected in every hydrosate of the product. Each G-value (the number of formed molecules per deposit energy of 100 eV) was around 10−2 order, which was independent from the phase of the starting materials and kind of the energy.

Coronal plane alignment of the knee (CPAK) has recently been proposed as a simple and universal classification system to determine the suitability of a particular phenotype of the knee to a specific alignment strategy for knee replacement surgery. Although racial differences may affect knee alignment, there are no reports on the racial distribution of this classification system. We aimed to clarify the distribution of CPAK classification in patients with osteoarthritis who underwent total knee arthroplasty (TKA) in Japan. Consecutive patients who underwent primary TKA were analyzed retrospectively. The knees were categorized according to the CPAK classification system which comprised of two independent variables (arithmetic hip–knee–ankle [aHKA] angle and joint-line obliquity [JLO]) with three respective subgroups to create the following nine phenotypes of the knee: type I (varus aHKA and apex distal JLO), type II (neutral aHKA and apex distal JLO), type III (valgus aHKA and apex distal JLO), type IV (varus aHKA and neutral JLO), type V (neutral aHKA and neutral JLO), and type VI (valgus aHKA and neutral JLO), type VII (varus aHKA and apex proximal), type VIII (neutral aHKA and apex proximal), and type IX (valgus aHKA and apex proximal). The distribution of the phenotypes in the Japanese population was investigated as a primary outcome. To accurately compare the results with previous studies conducted on non-Japanese patients, a sex-matched distribution was investigated as a secondary outcome. A total of 570 knees were investigated of which 500 knees were examined after exclusions. The most common distribution was type I (53.8%), followed by type II (25.4%), type III (8.2%), type IV (7.2%), type V (4.4%), and type VI (1.0%). Types VII, VIII, and IX were not distributed. The sex-matched distribution was nearly identical to the overall distribution in Japan. The majority of patients with knee osteoarthritis in Japan had medially tilted joints with constitutional varus alignment.