Objective: This study aimed to clarify the characteristics of the patients who had hip osteoarthritis (hip OA) of more than K-L grade 3 and did not need total hip replacement (THR) two years after the diagnosis.Methods: Twenty-four patients who were followed up for at least 2 years were included and classified into surgical and non-surgical groups depending on the need for THR. Pain (rest pain, motion pain, gait pain), hip range of motion, performance tests (time up and go test (TUG), 10 m gait speed, 2-step test, one-leg standing time, chair standing-5 (CS-5)), and Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) were evaluated at the initial visit.Results: Rest pain was significantly lower in non-surgical group compared to surgical group (p<0.01). JHEQ pain score (p<0.01), motor score (p=0.03), and mental health score (p<0.01) were significantly higher in non-surgery group than those in surgery group.Conclusion: Even if you have end-stage hip OA, those with low rest pain and a high JHEQ score at the time of initial diagnosis may be able to live for two years without undergoing surgery. In patients with hip OA of more than K-L grade 3, low rest pain and a high JHEQ score at the initial visit were associated with avoiding THR for two years.

Ankle exercises are useful for preventing deep vein thrombosis, as they increase venous blood flow velocity. The cause for the increased venous blood flow velocity during ankle exercises may be the skeletal-muscle pump, but the mechanism is not clearly understood. The purpose of this study was to investigate the effects of the dorsiflexion angle and gastrocnemius muscle contraction on venous blood flow velocity during ankle exercises and to investigate the mechanism of the increase in venous blood flow velocity. The blood flow velocity in the popliteal vein, ankle joint angle, and surface electromyographic activity of the gastrocnemius muscle were measured at rest and during ankle exercises in the prone position in young healthy volunteers. The significant increase in venous blood flow velocity was observed during dorsiflexion phase, max dorsiflexion and during planter flexion phase. The peak venous blood flow velocity was different in each subject and classified into four types. The correlations of venous blood velocity to ankle joint angle and with the surface electromyographic activity of the gastrocnemius muscle were not statistically significant. These findings suggest that venous blood flow velocity increases not only during plantar flexion and dorsiflexion.

The purpose of this study was to compare changes in oxygenation in the Vastus Lateralis (VL) and Rectus Femoris (RF) muscles during a ramp-loaded bicycle exercise. Twelve healthy males participated in the experiment. The test consisted of a leg arterial occlusion at rest and a ramp-loaded exercise (20 watts/min) using a bicycle ergometer until exhaustion. The changes in deoxygenation in each muscle was measured by near infrared spectrometer (NIRS) . The probes of NIRS were placed on VL and RF approximately 12 cm above the right knee. Oxy-Hb/Mb signals from NIRS were calculated as 100% at rest, with 0 % being the lowest value during the leg arterial occlusion. Pulmonary gas exchanges (VE, VO₂, VCO₂) were measured with an expiratory gas analyzer. In 10 subjects, muscle oxygenation level in VL decreased linearly until the deoxygenation limiting point (DOLP) -the point in exercise at which the deoxygenation rate decreases noticeably. However, in 2 subjects, the DOLP was not detected, and the muscle oxygenation level decreased linearly until exhaustion. The muscle oxygenation level in RF also decreased linearly until 70%VO₂max, although the deoxygenation rate was smaller than that in VL. Thereafter, the muscle oxygenation level in RF continued to decrease until exhaustion. No DOLP was found in any subjects in RF. Compared with the muscle oxygenation level in RF at any points during the exercise, those in VL were lower until 90%VO₂max (P<0.001) . However, the difference in muscle oxygenation levels between VL and RF at exhaustion was not noted. This study indicated that the patterns of deoxygenation in VL and RF during a ramploaded bicycle exercise were different.