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Futoshi Kuga

Osteoarthritis of the Knee

Osteoarthritis is noninflammatory degenerative type of arthritis marked by degeneration of the articular cartilage, overgrowth of bone at the margins, and changes in the synovial membrane. Pathological definition is chronic, progressive and degenerative joint disease characterized by a mix of growth phase and wear phase. There are many different causes, particularly aging or overweight is an important factor. The incidence increases with age.
The main symptom is pain. Osteoarthritis pain is usually characterized by start-up pain (discomfort getting up from a seated position), but over time can become sharp knee pain when walking up or down stairs (especially down at the time). And the disease progresses further, patient will have difficulty in daily life by restricting movement.
If physical therapy or medication is ineffective, joint replacement surgery or high tibial osteotomy in young and active patients may be required in advanced cases.

High Tibial Osteotomy

Total Knee Arthroplasty

Osteoarthritis of the Hip

Osteoarthritis of the hip also known as degenerative arthritis or degenerative joint disease marked by degeneration of the articular cartilage and reactive overgrowth of bone (bone sclerosis, osteophyte and so on) at the margins. There are two types of hip osteoarthrosis. Primary osteoarthritis of the hip joint has no remarkable cause. Secondary osteoarthritis is caused by another disease or condition (e.g. congenital disorders of joints, diabetes, inflammatory disease, chronic forms of arthritis, injury of joint and obesity).
The main symptom is hip joint pain. The pain flares in active and gets better in rest. Without treatment of arthritis of the hip, the condition keeps getting worse until resting no longer relieves the pain.
Hip osteoarthrosis is classified into four stage according to the modified radiographic staging system of the Japanese Orthopaedic Association: Stage 1 (prearthritis stage) is characterized by no osteoarthritic change; Stage 2 (early stage) has slight narrowing of the joint space (2 mm or greater joint space remaining); Stage 3 (advanced stage) has narrowing of the joint space (less than 2 mm joint space remaining); and Stage 4 (end stage) has complete loss of the joint space.
In our institute, Curved Periacetabular Osteotomy is performed for Stage 1 or 2. Joint replacement surgery or Chiari’s osteotomy and femoral vulgus osteotomy are required in advanced cases.

Total Hip Arthroplasty

Total hip Arthroplasty which consists of replacing both the acetabulum and the femoral head is most commonly used to treat advanced hip osteoarthrosis. There are several different incisions, defined by their relation to the gluteus medius.

＜After Surgery＞

Minimally Invasive Hip Replacement Surgery

Total hip Arthroplasty surgery has been performed through a large incision typically 7-10 inches in length. Minimally invasive Hip Replacement Surgery can reduce the size of this incision to as little as 3-4 inches.
Moreover, Direct Anterior Minimally Invasive Hip Replacement utilizes a latest surgical approach in our hospital. The implant is inserted without cutting any of the muscles around the hip. Only an experienced hip surgeon should perform this procedure. Special training is required. Dr. Kuga has not only achieved this level and has often been asked to teach other doctors on this Direct Anterior Minimally Invasive Hip Replacement.