The Journal of Arthroplasty 28 (2013) 1699–1700
Contents lists available at ScienceDirect
The Journal of Arthroplasty journal homepage: www.arthroplastyjournal.org
Foreword
The Journal of Arthroplasty has published the Asia-Pacific issue biennially since 2005 (vol. 20, no. 5, 2005; vol. 22, no. 7, 2007; vol. 24, no. 8, 2009; vol. 26, no. 7, 2011). The current one (vol. 28, no. 10, 2013) is the fifth issue. The Asia-Pacific issues of The Journal of Arthroplasty have been organized to inform the surgeons and researchers specializing in arthroplasty around the globe about the issues and prospects of arthroplasty in the Asia-Pacific region. The ultimate goal of this issue is to contribute to the advancements in arthroplasty not only in Asia but also around the world. We are confident that our endeavor has contributed to the vital exchange of knowledge in arthroplasty among researchers with various perspectives. The academic progress and achievement related to the arthroplasty in Asia are evident from the increased number of articles published from Asia and the large scale of international meetings held in Asia. As mentioned in the foreword in the previous issues, the articles published from the Asia-Pacific region in The Journal of Arthroplasty were 25.4% (2002–2005) and 25.9% (2006–2010). As of now, during the period from 2011 to June 2013, 28.1% of articles were published from the Asia-Pacific region, a certain growth from the past. Among the articles published from the Asia-Pacific region since the last issue, 26.9% were from Japan, 23.7% from Korea, and 19.4% from Australia. Remarkably, the increase in publications from China was found, from 5.0% (2006–2011) to 13.8% (2011 to present). Considering the population in China (1.36 billion) and India (1.28 billion) and their economic advancements, further development in research and their contributions are to be expected. While the advancement of the arthroplasty is evident in the AsiaPacific region, the current situations from some countries, such as an unequal development between urban and rural areas, gap between the rich and the poor, insufficient insurance system, deficit in welltrained surgeons, and inadequate surgical facilities, etc., may adversely affect the results of the arthroplasty in terms of following the standardized procedures. From this perspective, it is important to strive to make the standardization of arthroplasty possible and achieve the cost-related efficacy in the Asia-Pacific region. In this regard, the current efforts of this issue such as comparative investigations across the results of arthroplasty among the countries in Asia and also from the Western countries should be meaningful. On the other hand, we should make efforts to have the surgical procedures and facilities standardized and to provide young surgeons with more opportunities to receive a systematic training in arthro-
0883-5403/2810-0001$36.00/0 – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.arth.2013.09.009
plasty. Furthermore, each country's society of arthroplasty should foremost establish the national registry. This will lead to systematic collection and management of the arthroplasty-related data from each country, contributing to an establishment of standardized protocols in the Asia-Pacific area. Among the publications from the Asia-Pacific area in The Journal of Arthroplasty since the previous issue, the articles related to basic research were approximately 8.3%. More basic research will be required for further specialization in designs, materials, and surgical techniques for Asian patients, considering that most of the development in arthroplasty was based on the results from Western patients. As constantly stated in previous issues, the characteristics of Asian patients (e.g., their specific anatomies and lifestyles, daily routines requiring a particularly large range of motion, and a large proportion of young patients) differ from those of the Western patients and such difference should be considered as the most important issue in arthroplasty in Asia. From this point of view, it is crucial to reduce the wear and impingement in total hip arthroplasty (THA) in Asian patients. For instance, the results of the conventional polyethylene in Asian patients were poorer than those in Western patients. Accordingly, alternative bearing surfaces have been predominantly used for THA in the Asia-Pacific region. Among the alternative bearing surfaces, metal-on-metal bearing surface, often used for resurfacing or THA, has been associated with risk of osteolysis, local soft tissue reactions, tissue and bone necrosis, and potential long-term toxicity. These adverse effects led to substantial decrease in use of this bearing surface for arthroplasty, giving rise to more concerns among Asian patients. Thus, it is critical to seek and develop an ideal bearing surface and to establish appropriate surgical techniques to further reduce the wear and impingement in THA in Asian patients, along with carrying out more basic research. The articles in the current issue of The Journal of Arthroplasty cover from basic investigations to up-to-date practical techniques in terms of hip and knee research in the Asia-Pacific region, just as the previous issues. In addition, this issue includes articles regarding implant design in hip and knee arthroplasty, surgical techniques, computerassisted orthopaedic surgery related topics, templating methods, bearing surfaces and resurfacing, epidemiological studies, and complication-related topics such as clunk syndrome after total knee arthroplasty, osteolysis, deep vein thrombosis, infection, pain, and bleeding.
1700
Editorial / The Journal of Arthroplasty 28 (2013) 1699–1700
From the current issue, surgeons and researchers specializing in arthroplasty across the world will recognize the focus of arthroplasty and witness the progress and advancements in the Asia-Pacific region. I hope that this issue provides insightful guidelines for research and standardization in arthroplasty, making the future of arthroplasty more promising. I am deeply grateful to Editor-in-Chief William J. Hozack, MD and Emeritus Editor Richard H. Rothman, MD, PhD, who made this issue possible with their excellent vision and firm support, and Editorial
Manager Taylor Bowen for enthusiastically devoting to this issue. I also thank all of the authors and researchers who contributed to this issue.
Jun-Dong Chang MD, PhD Arthroplasty Center Dongtan Sacred Heart Hospital Hallym University College of Medicine South Korea
Contents lists available at ScienceDirect
The Journal of Arthroplasty journal homepage: www.arthroplastyjournal.org
Foreword
The Journal of Arthroplasty has published the Asia-Pacific issue biennially since 2005 (vol. 20, no. 5, 2005; vol. 22, no. 7, 2007; vol. 24, no. 8, 2009; vol. 26, no. 7, 2011). The current one (vol. 28, no. 10, 2013) is the fifth issue. The Asia-Pacific issues of The Journal of Arthroplasty have been organized to inform the surgeons and researchers specializing in arthroplasty around the globe about the issues and prospects of arthroplasty in the Asia-Pacific region. The ultimate goal of this issue is to contribute to the advancements in arthroplasty not only in Asia but also around the world. We are confident that our endeavor has contributed to the vital exchange of knowledge in arthroplasty among researchers with various perspectives. The academic progress and achievement related to the arthroplasty in Asia are evident from the increased number of articles published from Asia and the large scale of international meetings held in Asia. As mentioned in the foreword in the previous issues, the articles published from the Asia-Pacific region in The Journal of Arthroplasty were 25.4% (2002–2005) and 25.9% (2006–2010). As of now, during the period from 2011 to June 2013, 28.1% of articles were published from the Asia-Pacific region, a certain growth from the past. Among the articles published from the Asia-Pacific region since the last issue, 26.9% were from Japan, 23.7% from Korea, and 19.4% from Australia. Remarkably, the increase in publications from China was found, from 5.0% (2006–2011) to 13.8% (2011 to present). Considering the population in China (1.36 billion) and India (1.28 billion) and their economic advancements, further development in research and their contributions are to be expected. While the advancement of the arthroplasty is evident in the AsiaPacific region, the current situations from some countries, such as an unequal development between urban and rural areas, gap between the rich and the poor, insufficient insurance system, deficit in welltrained surgeons, and inadequate surgical facilities, etc., may adversely affect the results of the arthroplasty in terms of following the standardized procedures. From this perspective, it is important to strive to make the standardization of arthroplasty possible and achieve the cost-related efficacy in the Asia-Pacific region. In this regard, the current efforts of this issue such as comparative investigations across the results of arthroplasty among the countries in Asia and also from the Western countries should be meaningful. On the other hand, we should make efforts to have the surgical procedures and facilities standardized and to provide young surgeons with more opportunities to receive a systematic training in arthro-
0883-5403/2810-0001$36.00/0 – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.arth.2013.09.009
plasty. Furthermore, each country's society of arthroplasty should foremost establish the national registry. This will lead to systematic collection and management of the arthroplasty-related data from each country, contributing to an establishment of standardized protocols in the Asia-Pacific area. Among the publications from the Asia-Pacific area in The Journal of Arthroplasty since the previous issue, the articles related to basic research were approximately 8.3%. More basic research will be required for further specialization in designs, materials, and surgical techniques for Asian patients, considering that most of the development in arthroplasty was based on the results from Western patients. As constantly stated in previous issues, the characteristics of Asian patients (e.g., their specific anatomies and lifestyles, daily routines requiring a particularly large range of motion, and a large proportion of young patients) differ from those of the Western patients and such difference should be considered as the most important issue in arthroplasty in Asia. From this point of view, it is crucial to reduce the wear and impingement in total hip arthroplasty (THA) in Asian patients. For instance, the results of the conventional polyethylene in Asian patients were poorer than those in Western patients. Accordingly, alternative bearing surfaces have been predominantly used for THA in the Asia-Pacific region. Among the alternative bearing surfaces, metal-on-metal bearing surface, often used for resurfacing or THA, has been associated with risk of osteolysis, local soft tissue reactions, tissue and bone necrosis, and potential long-term toxicity. These adverse effects led to substantial decrease in use of this bearing surface for arthroplasty, giving rise to more concerns among Asian patients. Thus, it is critical to seek and develop an ideal bearing surface and to establish appropriate surgical techniques to further reduce the wear and impingement in THA in Asian patients, along with carrying out more basic research. The articles in the current issue of The Journal of Arthroplasty cover from basic investigations to up-to-date practical techniques in terms of hip and knee research in the Asia-Pacific region, just as the previous issues. In addition, this issue includes articles regarding implant design in hip and knee arthroplasty, surgical techniques, computerassisted orthopaedic surgery related topics, templating methods, bearing surfaces and resurfacing, epidemiological studies, and complication-related topics such as clunk syndrome after total knee arthroplasty, osteolysis, deep vein thrombosis, infection, pain, and bleeding.
1700
Editorial / The Journal of Arthroplasty 28 (2013) 1699–1700
From the current issue, surgeons and researchers specializing in arthroplasty across the world will recognize the focus of arthroplasty and witness the progress and advancements in the Asia-Pacific region. I hope that this issue provides insightful guidelines for research and standardization in arthroplasty, making the future of arthroplasty more promising. I am deeply grateful to Editor-in-Chief William J. Hozack, MD and Emeritus Editor Richard H. Rothman, MD, PhD, who made this issue possible with their excellent vision and firm support, and Editorial
Manager Taylor Bowen for enthusiastically devoting to this issue. I also thank all of the authors and researchers who contributed to this issue.
Jun-Dong Chang MD, PhD Arthroplasty Center Dongtan Sacred Heart Hospital Hallym University College of Medicine South Korea
