The sacroiliac joint is an important source of low back pain and may be influenced by pathologies in adjoining structures such as the hip or the spine. This study aimed to investigate the influence of hip osteoarthritis on sacroiliac joint degeneration by examining the sacroiliac joints of hip osteoarthritis patients, focusing on the localization and quantity of vacuum phenomena. The preoperative computed tomography (CT) of 31 female hip replacement candidates (mean age 69.1) and pelvic CT of 34 age-matched controls (mean age 67.9) were used to reconstruct the sacroiliac joints three-dimensionally. The degeneration score of the sacroiliac joints on axial view, as well as the location and volume of vacuum phenomena in the three-dimensionally reconstructed sacroiliac joints, were analyzed. The total sacroiliac joint degeneration scores were similar in hip osteoarthritis patients and controls but the breakdown of the score revealed that joint space narrowing and vacuum phenomena in the sacroiliac joint increase in hip osteoarthritis, while osteophytes decrease. Three-dimensional reconstruction revealed that the volume of vacuum phenomena in the sacroiliac joint was significantly larger in the hip osteoarthritis group and the vacuum areas were localized in the antero-superior region of the sacroiliac joint. Our results suggest that hip osteoarthritis and sacroiliac joint degeneration are related, and that with further investigation, the sacroiliac joint may become a new treatment target in hip osteoarthritis.

Summary: In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose: The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods: Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results: The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion: In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

Objectives: To compare functional recovery during inpatient rehabilitation, assessed by Functional Independence Measure (FIM) gain and FIM efficiency, between the pre-pandemic and COVID-19 pandemic periods in older adults after hip fracture. Methods: This retrospective observational study included patients aged ≥65 years who underwent hip fracture surgery between January 2016 and December 2022 and were admitted to a convalescent rehabilitation ward. Patients were categorized into the pre-pandemic (2016–2019) and pandemic (2020–2022) periods. Functional outcomes included total, motor, and cognitive FIM gain and FIM efficiency. Multiple linear regression analyses were performed to identify factors associated with rehabilitation outcomes. Results: A total of 650 patients were analyzed. Admission motor and total FIM scores were significantly lower during the pandemic, whereas cognitive FIM scores were similar between groups. After multivariable adjustment, total FIM gain and total FIM efficiency did not differ significantly between periods. Exploratory analyses showed no significant associations between the pandemic period and motor or cognitive FIM gain or efficiency. Conclusions: Although motor and total FIM scores at admission were lower during the pandemic period, no statistically significant differences in adjusted total FIM gain or total FIM efficiency were observed between the pre-pandemic and pandemic periods.