Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at 7 years. No significant differences in the rate of graft rupture or contralateral anterior cruciate ligament rupture were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at 7 years after surgery; therefore, the authors preferred hamstring tendons as the primary graft choice in anterior cruciate ligament reconstructions.

Object Incidental durotomy (dural tear) is a common complication of lumbar spine surgery. The purpose of this study was to clarify the anatomical location of and the specific causative factors for incidental durotomy during primary lumbar spine surgery. Methods The authors retrospectively reviewed 1014 consecutive cases involving patients (412 women and 602 men; mean age 57 years; age range 11–97 years) who underwent a surgical procedure for treatment of degenerative lumbar spinal disease at their institution between 2002 and 2008. In total, 1261 disc levels were treated surgically. Disease at the treated levels included 544 disc herniations, 453 instances of spinal canal stenosis without spondylolisthesis, 188 instances of lumbar spinal canal stenosis with spondylolisthesis (degenerative spondylolisthesis), 49 instances of combined stenosis (stenosis with disc herniation), and 22 juxtafacet cysts. In 5 of the treated levels, the condition was classified as “other” disease. Treatment included fenestration with discectomy in 547 levels, fenestration alone in 626, fenestration with resection of juxtafacet cysts in 22, unilateral recapping laminoplasty in 20, posterolateral spinal fusion or posterior lumbar interbody fusion in 17, microscopic discectomy with tubular retractor in 14, and “other” in 15. Results Unintended durotomy occurred in 4% of cases and in 3.3% of disc levels. The incidence of dural tear was significantly higher in women (5.6%) than in men (3%). The incidence of dural tear was 2% in disc levels with lumbar disc herniation, 1.8% with lumbar spinal canal stenosis without spondylolisthesis, 9% with degenerative spondylolisthesis, and 18.2% with juxtafacet cysts; the incidence was significantly higher in levels with degenerative spondylolisthesis or levels with juxtafacet cysts, than in those with other diseases. Incidental durotomy occurred in 4 critical anatomical zones, namely, the caudal margin of the cranial lamina, cranial margin of the caudal lamina, herniated disc level, and medial aspect of the facet joint adjacent to the insertion of the hypertrophic ligamentum flavum. Conclusions Risk factors for unintended durotomy were female sex, older age, degenerative spondylolisthesis, and juxtafacet cysts. In this study, the authors identified 4 high-risk anatomical zones that spine surgeons should be aware of to avoid dural tears.

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[Purpose] We tested the reliability and validity of the Japanese version of the Short Questionnaire to Assess Health-enhancing Physical Activity scale in asymptomatic older adults and sought to confirm discriminator validity in women with osteoarthritis. [Subjects] The participants included an asymptomatic comparison group (men and women) and women with knee or hip osteoarthritis. [Methods] The test-retest method was used to assess reliability. The International Physical Activity Questionnaire was chosen to assess criterion-related validity. Discriminator validity was assessed by comparing the asymptomatic and osteoarthritis groups. [Results] Mean age for the asymptomatic groups was 63 ± 6 years for men (n = 23) and 61 ± 7 years for women (n = 51), and it was 63 ± 9 years for the osteoarthritis group (n = 32). The total score and scores for all items, except for heavy housework items, were significantly correlated with the retest. Criterion-related validity showed significantly weak to moderate correlations between the respective scale categories. For discriminator validity, the total scores and scores for bicycle commuting, light housework, and three leisure items differed significantly between the asymptomatic and osteoarthritis groups. [Conclusion] The Short Questionnaire to Assess Health-enhancing Physical Activity scale is a reliable and valid measure in asymptomatic older adults, and can discriminate between osteoarthritic and asymptomatic women.

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Grazing incidence X-ray scattering measurements have been carried out on c-axis aligned crystalline-indium gallium zinc oxide (CAAC-IGZO) film and nanocrystalline category-indium gallium zinc oxide (NC-IGZO) film and the following results were obtained: (1) the characteristic layered structure of the IGZO crystal did not hold its shape and the X-ray scattering profile showed only a relatively sharp first peak at the wave vector (Q) = 21.8 for CAAC film and 23.1 nm ¹1 for NC film, respectively, and additional weak broad peaks were observed at a higher angle. (2) In the case of the CAAC film, tiny peaks were observed at Q = 7 and 14 nm ¹1 , corresponding to the positions of the 003 and 006 reflections, respectively, of the IGZO crystal. Such tiny peaks were not detected in the case of NC film but the asymmetry of the first peak at the low angle side was clearly observed. (3) These structural features implied that more than three polyhedral units, such as InO x (x = 46), GaO y (y = 46), and ZnO z (z = 46), were likely to coexist. It is appropriate to call this structural feature as cluster-1. (4) A composite-type structure formed by combining these polyhedral units is also likely to exist and leads to middle-range ordering. This structure is called cluster-2. The size of such cluster-2 has been estimated to be 2.2 nm for CAAC film and 1.8 nm for NC film using the measured pair distribution function. To gain insights into the structural features of IGZO films, realistic atomic-scale models were obtained to fit not only the ordinary interference function of grazing incidence X-ray scattering but also the environmental interference function of the anomalous X-ray scattering (AXS) with Zn-absorption edge using reverse Monte Carlo (RMC) simulation. (5) The resultant models indicated the complex and irregular atomic arrangements of two types of IGZO films, which are well characterized by nanometer-sized crystalline clusters. This characteristic feature may be referred to as crystallineclustercomposite (triple C) structure.