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HOSHINO YuichiUniversity Hospital / Orthopedic SurgeryAssociate Professor
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■ Award- Sep. 2018 Japanese Orthopaedic Society for Sports Medicine, Outstanding Performance Award, Concomitant lateral meniscus tear in the anterior cruciate ligament injured knee should be repaired to avoid remaining pivot-shift.
- Jun. 2017 International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Jan I. Gillquist Scientific Research Award, Aggravated rotational Laxity Due to the Concomitant Meniscus Tear in the Anterior Cruciate Ligament-Injured Knees Detected by the Quantitative Measurement of the Pivot-Shift Test.International society
- Mar. 2016 Orthopaedics Research Society (ORS), The Best of ORS posters in Knee Category, Investigation of the Impact of the Concomitant Meniscus Injury o the Rotational Laxity in the Anterior Cruciate Ligament Injured Knees Using the Quantitative Measurement of the Pivot-shift Test
- Cancer stem cells (CSCs) have been implicated as critical mediators in the progression, chemoresistance and metastatic capabilities of diverse malignancies, including osteosarcoma (OS). The authors have succeeded in generating CSC‑like cells (MG‑OKS) from the OS cell line MG‑63 by transducing defined factors. A significant increase in small proline‑rich protein 1A (SPRR1A) expression, a cross‑linked envelope protein in keratinocytes, was observed in MG‑OKS cells. Therefore, SPRR1A could be involved in tumor initiation, growth and poor OS progression. However, its specific role in OS remains unclear. The present study aimed to evaluate the role of SPRR1A in OS both in vitro and in vivo using MG‑OKS cells. Three experimental groups were established: MG‑OKS cells transfected with SPRR1A small interfering (si)RNA (siMG‑OKS), untransfected MG‑OKS cells and MG‑OKS cells transfected with scrambled siRNA (scMG‑OKS) as controls. SPRR1A expression, morphological changes, cell proliferation and migration were assessed in these groups. RNA sequencing was performed to examine the genetic changes caused by SPRR1A suppression. To evaluate tumorigenicity in vivo, cells from each group were subcutaneously transplanted into the backs of nude mice. Tumor volume and Ki‑67 expression were assessed and compared among the three groups at four weeks post‑transplantation. The siMG‑OKS group exhibited altered cell morphology, reduced cell proliferation and decreased migratory abilities in vitro. RNA sequencing revealed suppression of genes involved in cell adhesion in the siMG‑OKS group. Furthermore, the in vivo tumorigenicity of siMG‑OKS was lower than that of the other two experimental groups. These findings suggest that SPRR1A is one of the key cell adhesion‑related molecules involved in OS progression, potentially serving as a therapeutic target for this refractory tumor. However, further research is needed to fully elucidate the mechanisms by which SPRR1A influences OS pathogenesis and to explore its clinical potential.Feb. 2025, Oncology reports, 53(2) (2), English, International magazineScientific journal
- BACKGROUND: Knee osteoarthritis (KOA) is a globally prevalent condition leading to joint pain and disabilities. Surgical interventions such as opening-wedge high tibial osteotomy (OWHTO) and opening-wedge distal tuberosity osteotomy (OWDTO) aim to alleviate symptoms and delay disease progression. Quadriceps strength, crucial for knee function, may decline postoperatively, affecting patient outcomes. However, little is known about quadriceps strength variation after OWHTO and OWDTO. This study investigated changes in quadriceps strength before and after OWHTO and OWDTO. METHODS: This retrospective study included patients who underwent OWHTO or OWDTO between 2016 and 2022. Quadriceps strength and demographic and surgical data were collected preoperatively and at 6 and 12 months postoperatively. Statistical analyses were performed to compare changes in quadriceps strength over time. RESULTS: Of 120 knees, 52 (OWHTO, 27; OWDTO, 25) were included in this study. Quadriceps strength increased over 12 months post-OWHTO, significantly improving at 12 months compared to the preoperative and 6-month values. In OWDTO, the strength improved but not significantly. CONCLUSIONS: Quadriceps strength improved following OWHTO and OWDTO, with OWHTO showing significant enhancements. Future studies should investigate the relationship between quadriceps strength and functional outcomes and guide rehabilitation strategies for improved postoperative recovery.Dec. 2024, The Knee, 51, 258 - 267, English, International magazineScientific journal
- Distal femoral osteotomy (DFO) is performed alone or with high tibial osteotomy (HTO) for patients with osteoarthritis and distal femur deformities. DFO is technically demanding, particularly when creating an anterior flange. Herein, we examined the morphological characteristics of the distal femur based on the cortical shape as a surgical reference for biplanar DFO. Computed tomography images of 50 valgus and 50 varus knees of patients who underwent biplanar DFO or total knee arthroplasty were analyzed. Axial slices at the initial level of the transverse osteotomy in the DFO and slices 10 mm proximal and 10 mm distal to that level were selected. The medial and lateral cortical angles and heights (MCLA, LCLA, MCH, and LCH) were measured on axial slices. Statistical comparisons were performed between the medial and lateral cortices and valgus and varus knees. MCLA and MCH were significantly smaller and lower, respectively, than LCLA and LCH (P < 0.01). The MCLA and MCH of varus knees were significantly smaller and lower, respectively, than those of valgus knees (P < 0.01). Surgeons should carefully observe morphological differences in the distal femur cortex, distinguishing between medial and lateral knees and varus and valgus knees during the creation of the anterior flange in the DFO.May 2024, Scientific reports, 14(1) (1), 12130 - 12130, English, International magazineScientific journal
- Elsevier BV, May 2024, AJPM Focus, 100236 - 100236Scientific journal
- BACKGROUND: Postoperative rotator cuff retear after arthroscopic rotator cuff repair (ARCR) is still a major problem. Various risk factors such as age, gender, and tear size have been reported. Recently, magnetic resonance imaging-based stump classification was reported as an index of rotator cuff fragility. Although stump type 3 is reported to have a high retear rate, there are few reports on the risk of postoperative retear based on this classification. Machine learning (ML), an artificial intelligence technique, allows for more flexible predictive models than conventional statistical methods and has been applied to predict clinical outcomes. In this study, we used ML to predict postoperative retear risk after ARCR. METHODS: The retrospective case-control study included 353 patients who underwent surgical treatment for complete rotator cuff tear using the suture-bridge technique. Patients who initially presented with retears and traumatic tears were excluded. In study participants, after the initial tear repair, rotator cuff retears were diagnosed by magnetic resonance imaging; Sugaya classification types IV and V were defined as re-tears. Age, gender, stump classification, tear size, Goutallier classification, presence of diabetes, and hyperlipidemia were used for ML parameters to predict the risk of retear. Using Python's Scikit-learn as an ML library, five different AI models (logistic regression, random forest, AdaBoost, CatBoost, LightGBM) were trained on the existing data, and the prediction models were applied to the test dataset. The performance of these ML models was measured by the area under the receiver operating characteristic curve. Additionally, key features affecting retear were evaluated. RESULTS: The area under the receiver operating characteristic curve for logistic regression was 0.78, random forest 0.82, AdaBoost 0.78, CatBoost 0.83, and LightGBM 0.87, respectively for each model. LightGBM showed the highest score. The important factors for model prediction were age, stump classification, and tear size. CONCLUSIONS: The ML classifier model predicted retears after ARCR with high accuracy, and the AI model showed that the most important characteristics affecting retears were age and imaging findings, including stump classification. This model may be able to predict postoperative rotator cuff retears based on clinical features.Apr. 2024, Journal of shoulder and elbow surgery, 33(4) (4), 815 - 822, English, International magazineScientific journal
- BACKGROUND: To assess the incidence of anterolateral ligament (ALL) and Kaplan fiber of the iliotibial band (KF) injuries in patients with acute anterior cruciate ligament (ACL) injury on magnetic resonance imaging (MRI), and to investigate the association between these injuries and the magnitude of preoperative pivot-shift test. METHOD: One-hundred and five patients with primary ACL injury were retrospectively reviewed. ALL injury and KF injury were assessed by preoperative MRI, and subjects were allocated into four groups: Group A, neither injury; Group B, only ALL injury; Group C, only KF injury; Group D, simultaneous ALL and KF injuries. Before ACL reconstruction, tibial acceleration during the pivot-shift test was measured by an electromagnetic measurement system, and manual grading was recorded according to the International Knee Documentation Committee (IKDC) guideline. RESULTS: In MRI, the ALL was identified in 104 patients (99.1%) and KF in 99 patients (94.3%). ALL and KF injuries were observed in 43 patients (43.9%) and 23 patients (23.5%), respectively. Patient distribution to each group was as follows; Group A: 43 patients (43.9%), Group B: 32 patients (32.7%), Group C: 12 patients (12.2%), Group D: 11 patients (11.2%). No significant differences were observed in tibial acceleration, and manual grading among the four groups. CONCLUSION: Simultaneous injury to both ALL and KF was uncommon, and preoperative pivot-shift phenomenon did not increase even in those patients. The finding suggests that the role of ALL and KF in controlling anterolateral rotatory knee laxity may be less evident in the clinical setting compared to a biomechanical test setting.Apr. 2024, Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology, 36, 40 - 44, English, International magazineScientific journal
- BACKGROUND: Psychological readiness to return to sports (RTS) has been associated with second anterior cruciate ligament (ACL) injury. However, this relationship is controversial because covariates such as anatomic and knee function characteristics have not been adequately considered. PURPOSE/HYPOTHESIS: To investigate whether psychological readiness in the early postoperative period can predict the occurrence of a second ACL injury within 24 months after primary ACL reconstruction (ACLR) using propensity score analysis. It was hypothesized that patients with high ACL-RSI after injury (ACL-RSI) scores at 3 months postoperatively would have a second ACL injury within the projected postoperative period. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Included were 169 patients who underwent primary ACLR using hamstring tendon autografts between November 2017 and July 2021 and also underwent knee functional assessments at 3 months postoperatively. The ACL-RSI scale was used to assess psychological readiness for RTS. A second ACL injury was defined if ipsilateral or contralateral ACL injury was confirmed by examination within 24 months postoperatively. Based on a previous study showing that 65 was the highest cutoff value for the ACL-RSI score for RTS, we classified patients into 2 groups: those with high ACL-RSI scores (≥65; group H) and those with low ACL-RSI scores (<65; group L). We generated 1-to-1 matched pairs using propensity score analysis and used log-rank testing to compare the rate of second ACL injury between the 2 groups. RESULTS: More patients returned to any sports activities within 12 months in group H than in group L (90% vs 73%; P = .03). A second ACL injury within 24 months postoperatively was identified in 7% of patients (13/169). The rate of second ACL injury was significantly higher in group H than in group L (17.6% vs 3.4%; P = .001). In 43 matched pairs extracted using propensity scoring, the rate of second ACL injury was also higher in group H than in group L (18.6% vs 4.7%; P = .04). CONCLUSION: Patients with a higher ACL-RSI score at 3 months exhibited a significantly higher incidence of second ACL injury within 24 months after primary ACLR.Apr. 2024, Orthopaedic journal of sports medicine, 12(4) (4), 23259671241239325 - 23259671241239325, English, International magazineScientific journal
- PURPOSE: To examine the biological changes in the joints of patients with knee osteoarthritis (OA) before and after around-knee osteotomy (AKO), focusing on synovial fluid (SF) and synovial pathological changes. METHODS: Patients who underwent AKO for medial compartment knee OA between 2019 and 2021 were examined. SF and synovium were obtained at the time of AKO and plate removal after bone union (mean, 16.8 months [range: 11-38 months] postoperatively). SF volume and interleukin (IL)-6 concentrations in SF were assayed using enzyme-linked immunosorbent assay. Synovitis was assessed histologically using a semiquantitative scoring system. Macrophage infiltration was assessed by immunohistochemistry using a semiquantitative score for F4/80 expression. The M1/M2 ratio was calculated using percentage of cells positive for CD80 and CD163. The expression of proinflammatory cytokines was assessed by the percentage of IL-1β- and IL-6-positive cells. The number of vascular endothelial growth factor-positive luminal structures was counted to assess angiogenesis. The change in each parameter was compared before and after AKO using the Wilcoxon matched-pairs signed-rank test. RESULTS: Twenty-four knees of 21 patients were included. SF volume and IL-6 concentration significantly decreased postoperatively (12.6 ± 2.1 mL vs 4.2 ± 0.6 mL; P < .0001 and 50.5 ± 8.6 pg/mL vs 20.7 ± 3.8 pg/mL; P = .0001, respectively). A significant reduction in synovitis score (P = .0001), macrophage infiltration (P < .0003), M1/M2 ratio (P < .0007), angiogenesis (P < .0001), and the percentage of IL-1β- and IL-6-positive cells in the intima (P < .008 and P < .002, respectively) was found after AKO. CONCLUSIONS: SF volume and IL-6 concentrations in the SF decreased and inflammatory synovium pathology improved after AKO. In addition to biomechanical changes, the biological environment of the joint can be improved after AKO. LEVEL OF EVIDENCE: Level IV, retrospective therapeutic case series.Mar. 2024, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 40(3) (3), 830 - 843, English, International magazineScientific journal
- BACKGROUND: The relationship between the severity of preoperative varus deformity and the amount of its correction in unicompartmental knee arthroplasty (UKA) as well as the thickness of the insert has not been well known. METHODS: One hundred and three patients who underwent medial fixed-bearing UKA with the use of the spacer block method were assessed. After the component gap in extension was measured using a UKA tensor, the pre-osteotomy gap was calculated from the thickness of the bone cuts. The relationship between the preoperative hip-knee-ankle (HKA) angle as well as the pre-osteotomy gap and the amount of change in HKA angle were analysed. Also, preoperative HKA angle and the thickness of the bone cuts were compared among groups by the insert thickness. RESULTS: The mean preoperative HKA angle was 7.7 ± 3.1° varus. Patients with more varus deformity and those with a wider pre-osteotomy gap showed a more valgus change in HKA angle. As for the thickness of the insert, the preoperative HKA angle of the patients with the thinnest insert was significantly smaller (less varus) than that of those with the thicker insert while no statistically significant difference was found among the insert groups regarding the amount of the bone cuts. CONCLUSIONS: The severity of the preoperative varus deformity as well as the intraoperative pre-osteotomy gap related to the amount of change in HKA angle. As thick inserts tended to be used in severe varus knees, the tibial bone cut can be reduced in such cases.Jan. 2024, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 29(1) (1), 183 - 187, English, Domestic magazineScientific journal
- BACKGROUND/OBJECTIVE: Arthroscopic lateral ligament repair (ALLR) for chronic lateral ankle instability (CLAI) has been improving with technical innovations. However, there is a lack of information regarding mid- and/or long-term clinical outcomes after the introduction of ALLR. This study aimed to report mid-term clinical outcomes of ALLR with a knotless anchor. METHODS: Thirty-two patients (11 men and 21 women; mean age, 28 ± 14 years) who underwent ALLR with a knotless anchor from December 2015 to October 2020 were included. The mean follow-up period was 31 ± 11 months. The Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) were used for clinical evaluation preoperatively and at the 2-year follow-up. Surgical complications, particularly knot irritation, were also examined. RESULTS: The JSSF scale scores were significantly improved, from 71.3 ± 13.1 preoperatively to 96.6 ± 5.1 postoperatively (P < 0.05), and the SAFE-Q showed similar improvement in all subscales (P < 0.05). One case had a complication of persistent pain around the lateral portal (3.1%). CONCLUSION: ALLR using a knotless anchor provided satisfactory clinical outcomes over 2 years, and no major complications, such as knot irritation, were observed. CASE SERIES: Level of Evidence, 4.Jan. 2024, Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology, 35, 15 - 19, English, International magazineScientific journal
- BACKGROUND: Advanced glycation end products (AGEs) are compounds formed due to aging and diabetes mellitus (DM). They activate NADPH oxidase (NOX) by binding to their receptors, thereby increasing the production of reactive oxygen species (ROS), which cause oxidative stress. In this study, we investigated the effects of AGEs on the tissues of the shoulder joint (such as rotator cuff synovium, and capsule) in patients with DM having rotator cuff tears. METHODS: This study included eight patients with DM who underwent surgical treatment for rotator cuff tears with contracture. The rotator cuff, synovium, and joint capsule were harvested at the time of surgery and evaluated by hematoxylin-eosin staining. Furthermore, immunostaining was used for evaluating AGEs and receptor for AGEs (RAGE), cell activity, ROS, and apoptosis. Quantitative real-time polymerase chain reaction (qPCR) was employed for the cellular evaluation of NOX, interleukins, RAGE, and collagen. RESULTS: The AGEs and RAGE staining as well as the ratio of ROS and apoptosis were in the following order: rotator cuff > joint capsule > synovium. In contrast, the cellular activity was significantly higher in the synovium than in the other regions. The type I collagen expression (as shown by qPCR) as well as the RAGE and NOX expressions were as follows: rotator cuff > joint capsule > synovium. Conversely, the expression of inflammatory cytokines (i.e., IL-6 and IL-1β) was higher in the synovium than in the other regions. CONCLUSIONS: Our study is among the first to evaluate the effects of AGEs on each tissue of the shoulder joint in patients with DM having rotator cuff tears and contractures. The accumulation of AGEs in each tissue of the shoulder joint could reveal the locations affected by DM, which can lead to a better understanding of the pathophysiology of DM-related shoulder diseases.Dec. 2023, Molecular biology reports, 50(12) (12), 10339 - 10349, English, International magazineScientific journal
- PURPOSE: This study aimed to investigate the relationship between periprosthetic osteolysis around the talar component and the amount of talar component subsidence after total ankle arthroplasty (TAA). METHODS: This study included forty patients who underwent TAA with a mean follow-up of 67.5 ± 17.0 months. The patients were divided into two groups based on the amount of osteolysis around the talar component, as measured by computed tomography at the latest clinic visit: none to 2 mm (N group, n = 20) and greater than or equal to 2 mm (O group, n = 20). The average amount of talar component subsidence, clinical outcomes, and complications were compared between the two groups. In the O group, the correlation between osteolysis and talar component subsidence was evaluated. RESULTS: The average talar component subsidence was significantly different between the N (0.22 ± 0.94 mm) and O groups (2.12 ± 2.28 mm). Five out of 20 ankles in the O group required revision surgery owing to talar component subsidence. The Japanese Society for Surgery of the Foot scores in the N and O groups were significantly different: 93.5 ± 7.7 and 85.3 ± 15.4, respectively. In the O group, we found that osteolysis tended to develop on the lateral side, and the amount of osteolysis was positively correlated with the talar component subsidence (r = 0.59, P = .007). CONCLUSION: In the O group, a positive correlation between osteolysis and talar component subsidence was found, and five patients required revision surgery.Oct. 2023, European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 33(7) (7), 2987 - 2993, English, International magazineScientific journal
- Oct. 2023, The American journal of sports medicine, 51(12) (12), NP48-NP49, English, International magazineScientific journal
- (一社)日本臨床スポーツ医学会, Oct. 2023, 日本臨床スポーツ医学会誌, 31(4) (4), S298 - S298, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2023, 日本臨床スポーツ医学会誌, 31(4) (4), S301 - S301, Japanese
- (一社)中部日本整形外科災害外科学会, Sep. 2023, 中部日本整形外科災害外科学会雑誌, 66(5) (5), 869 - 869, Japanese前十字靱帯再建術後感染に対して持続局所抗菌薬灌流療法を行い,移植腱を温存し得たプロサッカー選手の1例
- The number of advanced-age patients with spinal metastases is rising. This study was performed to clarify the characteristics and surgical outcomes of spinal metastases in advanced-age patients. We prospectively analyzed 216 patients with spinal metastases from 2015 to 2020 and divided them into three age groups: <70 years (n = 119), 70-79 years (n = 73), and ≥80 years (n = 24). Although there were no significant intergroup differences in preoperative characteristics and surgery-related factors except for age, patients aged ≥80 years tended to have a worse performance status (PS), Barthel index, and EuroQol-5 dimension (EQ-5D) before and after surgery than the other two groups. Although the median PS, mean Barthel index and mean EQ-5D greatly improved postoperatively in each group, the median PS and mean Barthel index at 6 months and the mean EQ-5D at 1 month postoperatively were significantly poorer in the ≥80-year group than the 70-79-year group. The rates of postoperative complications and re-deterioration of the EQ-5D were significantly higher in the oldest group than in the other two groups. Although surgery for spinal metastases improved the PS, Barthel index, and EQ-5D regardless of age, clinicians should be aware of the poorer outcomes and higher complication rates in advanced-age patients.Jul. 2023, Journal of clinical medicine, 12(14) (14), English, International magazineScientific journal
- PURPOSE: This study compared the predictive ability of each independent predictor with that of a combination of predictors for quadriceps strength recovery one year after anterior cruciate ligament (ACL) reconstruction. METHODS: Patients who underwent primary ACL reconstruction using hamstring autografts were enrolled. Quadriceps strength, hamstring strength, and anterior tibial translation were measured, and the limb symmetry index (LSI) of the quadriceps and the hamstrings was calculated preoperatively and one year after surgery. Patients were classified into two groups according to the LSI of the quadriceps strength at one year postoperatively (≥ 80% or < 80%). Multivariate logistic regression analysis identified the independent predictors of quadriceps strength recovery, and the cut-off value was calculated using the receiver operating characteristic curve. A model assessing predictive ability of the combination of independent predictors was created, and the area under the curve (AUC) for each independent predictor was calculated by using the receiver-operating characteristic curves and the DeLong method. RESULTS: Of the 646 patients, 414 (64.1%) had an LSI of at least 80% for quadriceps strength one year after surgery, and 232 patients (35.9%) had an LSI of < 80%. Age, sex, body mass index (BMI), preinjury sport level, and LSI of preoperative quadriceps strength were independently associated with quadriceps strength recovery one year after ACL reconstruction. The cut-off values were age: 22.5 years; sex: female; BMI: 24.3 kg/m2; preinjury sport level: no sport; and LSI of preoperative quadriceps strength: 63.3%. The AUC of the model assessing the predictive ability of the combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength was significantly higher (0.73) than that of similar factors of preoperative quadriceps strength (AUC: 0.63, 0.53, 0.56, 0.61, and 0.68, p < 0.01, respectively). CONCLUSION: The combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength had a superior predictive ability for quadriceps strength recovery at one year after ACL reconstruction than these predictors alone. Multiple factors, including patient characteristics and preoperative quadriceps strength, should be considered when planning rehabilitation programs to improve quadriceps strength recovery after ACL reconstruction. LEVEL OF EVIDENCE: III.Jun. 2023, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, English, International magazineScientific journal
- INTRODUCTION: Patients with nonidiopathic scoliosis often have a high risk associated with general anesthesia because of cardiac or pulmonary dysfunction secondary to underlying diseases. Base excess has been reported as a predictor in the management of trauma and cancer, although not yet in scoliosis. This study was performed to clarify the surgical outcomes and the association of perioperative complications with base excess in patients with nonidiopathic scoliosis who have a high risk associated with general anesthesia. METHODS: Patients with nonidiopathic scoliosis who were referred to our institution from 2009 to 2020 because of their high risk associated with general anesthesia were retrospectively enrolled. High-risk factors for anesthesia were determined by a senior anesthesiologist and categorized into circulatory or pulmonary dysfunction. Perioperative complications were analyzed using the Clavien-Dindo classification; severe complications were defined as grade ≥III. We investigated high-risk factors for anesthesia, underlying diseases, preoperative and postoperative Cobb angle, surgery-related factors, base excess, and postoperative management. These variables were statistically compared between patients with and without complications. RESULTS: Thirty-six patients (mean age, 17.9 years old; range, 11-40 years old) were enrolled (two patients declined surgery). High-risk factors were circulatory dysfunction in 16 patients and pulmonary dysfunction in 20 patients. The mean Cobb angle improved from 85.1° (36°-128°) preoperatively to 43.6° (9°-83°) postoperatively. Three intraoperative complications and 23 postoperative complications occurred in 20 (55.6%) patients. Severe complications occurred in 10 (27.8%) patients. All patients underwent postoperative intensive care unit management after posterior all-screw construction. A large preoperative Cobb angle (p=0.021) and base excess outliers (>3 or <-3 mEq/L) (p=0.005) were significant risk factors for complications. CONCLUSIONS: Patients with nonidiopathic scoliosis who have a high risk associated with general anesthesia have a higher complication rate. Preoperative large deformity and base excess (>3 or <-3 mEq/L) could be predictors of complications.May 2023, Spine surgery and related research, 7(3) (3), 268 - 275, English, Domestic magazineScientific journal
- Advanced glycation end-products (AGEs) play a critical supportive role during musculoskeletal disorders via glycosylation and oxidative stress. Though apocynin, identified as a potent and selective inhibitor of NADPH oxidase, has been reported to be involved in pathogen-induced reactive oxygen species (ROS), its role in age-related rotator cuff degeneration has not been well clarified. Therefore, this study aims to evaluate the in vitro effects of apocynin on human rotator cuff-derived cells. Twelve patients with rotator cuff tears (RCTs) participated in the study. Supraspinatus tendons from patients with RCTs were collected and cultured. After the preparation of RC-derived cells, they were divided into four groups (control group, control + apocynin group, AGEs group, AGEs + apocynin group), and gene marker expression, cell viability, and intracellular ROS production were evaluated. The gene expression of NOX, IL-6, and the receptor for AGEs (RAGE) was significantly decreased by apocynin. We also examined the effect of apocynin in vitro. The results showed that ROS induction and increasing apoptotic cells after treatment of AGEs were significantly decreased, and cell viability increased considerably. These results suggest that apocynin can effectively reduce AGE-induced oxidative stress by inhibiting NOX activation. Thus, apocynin is a potential prodrug in preventing degenerative changes of the rotor cuff.Apr. 2023, Current issues in molecular biology, 45(4) (4), 3434 - 3445, English, International magazineScientific journal
- BACKGROUND: In knee arthroscopic surgery, fibrin clot (FC) and leukocyte-rich platelet-rich fibrin (L-PRF) may be used in augmentation for meniscal repair. Studies have investigated growth factors released from FC and L-PRF; however, it is difficult to compare FC and L-PRF between different studies. Direct comparison of growth factors that may support meniscal healing released from FC and L-PRF may be beneficial in deciding whether to use FC or L-PRF. If no significant difference is seen, the surgeon may decide to use FC which is easier to prepare compared to L-PRF. The purpose of this pilot study is to investigate the release amount and pattern of basic fibroblast growth factor (bFGF), platelet-derived growth factor AB (PDGF-AB), transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF), and stromal cell-derived factor 1 (SDF-1) from FC and L-PRF. METHOD: Twenty milliliters (ml) of whole blood was collected from each of the four volunteers. Ten milliliters of whole blood was allocated for preparation of FC and 10 ml for L-PRF. FC and L-PRF were separately placed in 5 ml of culture media. Five milliliters of the culture media was sampled and refilled at 15 min, 1 day, 3 days, 1 week and 2 weeks. The collected culture was used to quantify bFGF, PDGF-AB, TGF-β1, VEGF, and SDF-1 release by Enzyme-linked immune-sorbent assay (ELISA). Mann-Whitney U test was performed to assess significance of differences in amount of each growth factor released between FC and L-PRF. Significance was accepted at P value less than 0.05. RESULTS: At two weeks, the cumulative release of TGF-β1 was the highest among all the growth factors in both FC and L-PRF (FC:19,738.21 pg/ml, L-PRF: 16,229.79 pg/ml). PDGF-AB (FC: 2328 pg/ml, L-PRF 1513.57 pg/ml) had the second largest amount, followed by VEGF (FC: 702.06 pg/ml, L-PRF 595.99 pg/ml) and bFGF (FC: 23.48 pg/ml, L-PRF 18.2 pg/ml), which order was also common in both FC and L-PRF. No significant difference in final release amount and pattern was seen between FC and L-PRF. CONCLUSION: The current pilot study showed that cumulative release amount and release pattern of PDGF-AB, VEGF, TGF-β1, and bFGF did not significantly differ between FC and L-PRF during the two weeks of observation.Mar. 2023, Journal of orthopaedic surgery and research, 18(1) (1), 238 - 238, English, International magazineScientific journal
- Background: Symptomatic spinal metastasis (SSM) decreases the activities of daily living (ADL) and quality of life of cancer patients. However, the risk factors for SSM onset remain unclear. This prospective cohort study aimed to statistically analyze the significant risk factors. Methods: From 2016 to 2018, 210 consecutive patients with spinal metastases were prospectively registered. Patients with SSM at the first consultation and those who were unable to be followed-up owing to poor general condition were excluded. The demographic factors (age, sex, primary cancer, performance status, and ADL), clinical factors (radiation therapy, chemotherapy, molecularly targeted drugs, and bone-modifying agents (BMAs)), and Spinal Neoplastic Instability Score (SINS) were evaluated. Multivariate analysis was performed to identify the risk factors for SSM onset. Furthermore, the threshold was calculated from the receiver operating characteristic curve using the Youden index. Results: Thirty-nine patients who presented with SSM at the first consultation and 43 patients who were unable to be followed-up owing to poor general condition were excluded. Finally, 128 asymptomatic patients were included. Thirty-seven patients (28.9%) developed SSM during the follow-up period. The total SINS (OR: 1.739; 95% CI: 1.345-2.250) was identified as the most significant factor. The cut-off value of the SINS was 9.5 (sensitivity: 67.6%; specificity: 83.5%). Twenty-five (62.5%) of the forty patients with a SINS ≥ 10 developed SSM within a mean of 5.5 months (95% CI: 1.17-9.83). Furthermore, all patients with a SINS ≥ 13 developed SSM (n = 5) within a mean of 1.37 months (95% CI: 0.0-3.01). Conclusions: This study identified the significant risk factors for SSM onset and the threshold of the SINS. If long-term survival is expected, patients with a SINS ≥ 10 should be considered for intervention to prevent SSM.Feb. 2023, Cancers, 15(4) (4), English, International magazineScientific journal
- BACKGROUND: Medical screening using ultrasonography (US) has been performed on young baseball players for early detection of osteochondritis dissecans (OCD) of the humeral capitellum. Deep learning (DL) and artificial intelligence (AI) techniques are widely adopted in the medical imaging research field. PURPOSE/HYPOTHESIS: The purpose of this study was to calculate the diagnostic accuracy using DL for US images of OCD. We hypothesized that using DL for US imaging would improve the prediction accuracy of OCD. STUDY DESIGN: Cohort study (Diagnosis); Level of evidence, 2. METHODS: A total of 40 elbows (mean age of patients, 12.1 years) that were suspected of having OCD at a medical checkup and later confirmed by radiographs and magnetic resonance imaging were included in the study. The affected elbows were used as the OCD group and the contralateral elbows as the control group. From US videos, 100 images per elbow were captured from different angles, and 4000 images of the elbows were prepared for both groups. Of these, 80% were randomly selected by DL models and used as training data; the remaining were used as test data. Transfer learning was conducted using 3 pretrained DL models. The confusion matrix and the area under the receiver operating characteristic curve (AUC) were used to evaluate the model, and the visualization of the areas deemed important by the DL models was also performed. Furthermore, OCD regions were detected using an automatic image recognition model based on DL. RESULTS: Classification of the OCD image by the DL model was performed; the best accuracy score was 0.87; the recall was 1.00. AUC was high for all DL models. Visualization of important features showed that AI predicted the presence of OCD by focusing on the irregularity or discontinuity of the surface of subchondral bone. In the detection of OCD task, the mean average precision was 0.83. CONCLUSION: The DL on US images identified OCD with high accuracy. The important features detected by the DL models correspond to the areas used by clinicians in screening the US images. The OCD was also detected with high accuracy using the object detection model. The AI model may be used in medical screening for OCD.Feb. 2023, The American journal of sports medicine, 51(2) (2), 358 - 366, English, International magazineScientific journal
- BACKGROUND AND OBJECTIVE: Anterior cruciate ligament (ACL) reconstruction has been widely used for ACL injury for a long time. However, residual rotational instability and osteoarthritic changes after ACL reconstruction have been identified as problems. Thus, anatomic reconstruction techniques, various types of grafts and additional procedures have been desired to improve the clinical outcomes and knee instability. Although clinical outcomes and knee stability are better than in the past, ipsilateral graft failures still occur in 4-17% and osteoarthritic changes are seen in about 20% of patients after ACL reconstruction. To remedy these problems, it is necessary to improve the understanding of various surgical techniques and grafts and to pursue further improvement of surgical techniques. Therefore, the objective of this review is to summarize the advantages and disadvantages of various surgical techniques and graft selection, and additional procedures for ACL injury. METHODS: A literature review was conducted on the surgical procedures for ACL injury. Recent trends in surgical techniques, graft selection, and additional procedures for ACL injury were described. We performed a literature search in PubMed for studies published from origin to May 8, 2023. Studies were required to be English-language articles. KEY CONTENT AND FINDINGS: Although many reports indicate that double-bundle ACL reconstruction is comparable to anatomic single-bundle (SB) reconstruction, intraoperative complications such as tunnel coalition exist in double-bundle reconstruction, and the technique needs to be improved. ACL repair has shown good short-term results, but long-term results need to be examined in the future. Quadriceps tendon autograft is being used more frequently, but hamstrings tendon autograft and bone-patellar tendon-bone autograft also have good results. In addition, in higher-risk cases, lateral extra-articular tenodesis (LET) and anterolateral ligament (ALL) reconstruction can be performed with good results. CONCLUSIONS: To further improve clinical outcomes, more anatomical reconstructions should be pursued. Autografts are better than allografts and synthetic grafts, but further study is needed to determine which graft is better. Additional procedures should be performed in highly unstable cases and in revision cases.2023, Annals of joint, 8, 39 - 39, English, International magazineScientific journal
- (一社)兵庫県理学療法士会, Dec. 2022, 理学療法兵庫, (28) (28), 43 - 44, Japanese
- INTRODUCTION: The introduction of tyrosine kinase inhibitors has revolutionized treatment strategies for metastatic renal cell carcinoma (RCC) and has improved survival rates. The number of patients with bone metastases from RCC requiring surgery will increase as survival rates improve. However, there is insufficient evidence to standardize the treatment of bone metastases after the introduction of targeted therapy for metastatic RCC. We aimed to determine the outcomes of palliative surgical treatment of bone metastases in the extremities of patients with metastatic RCC. MATERIALS AND METHODS: We retrospectively reviewed 26 lesions from 17 patients who underwent surgery for extremity and acetabular bone metastases and were treated with targeted therapies for advanced RCC between 2008 and 2020. The median follow-up duration was 19 months (range, 4-76). We assessed the patients' activities of daily living, quality of life, and pain and analyzed their postoperative values relative to preoperative values. Postoperative overall survival (OS), local progression-free survival (LPFS), and the factors affecting them were evaluated using the Kaplan-Meier method and log-rank test. RESULTS: The 5-year OS and LPFS rates were 39.5% and 65.6%, respectively. The factors affecting OS were sex, Katagiri score, visceral metastases, and preoperative targeted therapy, while the factors affecting LPFS were pathologic fractures and surgical technique. CONCLUSION: In this study, the postoperative outcomes of palliative surgery for bone metastases from metastatic RCC were good. We suggest that systemic treatment should be prioritized over local control for advanced bone metastasis in RCC and surgery before pathological fracture should be performed for local control.Nov. 2022, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 49(5) (5), 928 - 933, English, International magazineScientific journal
- Ewing sarcoma (ES) is an aggressive primary malignant bone tumor that predominantly affects children and young adults. Multimodal treatment approaches have markedly improved the survival of patients with localized ES. However, local recurrence and distant metastasis following curative therapies remain a main concern for patients with ES. Recent studies have suggested that slow‑cycling cells (SCCs) are associated with tumor progression, local recurrence and distant metastasis in various types of cancers. According to the results of these studies, it was hypothesized that SCCs may play a critical role in tumor progression, chemoresistance and local/distal recurrence in patients with ES. The present study applied a label‑retaining system using carboxyfluorescein diacetate succinimidyl ester (CFSE) to identify and isolate SCCs in ES cell lines. In addition, the properties of SCCs, including sphere formation ability, cell cycle distribution and chemoresistance, in comparison with non‑SCCs were investigated. RNA sequencing also revealed several upregulated genes in SCCs as compared with non‑SCCs; the identified genes not only inhibited cell cycle progression, but also promoted the malignant properties of SCCs. On the whole, the present study successfully identified SCCs in ES cells through a label‑retaining system using CFSE. Moreover, to the best of our knowledge, the present study is the first to describe the characteristic properties of SCCs in ES. The findings of this study, if confirmed, may prove to be useful in elucidating the underlying molecular mechanisms and identifying effective therapeutic targets for ES.Nov. 2022, International journal of oncology, 61(5) (5), English, International magazineScientific journal
- Springer Science and Business Media LLC, Oct. 2022, Calcified Tissue International, 112(1) (1), 55 - 65Scientific journal
- (一社)日本臨床スポーツ医学会, Oct. 2022, 日本臨床スポーツ医学会誌, 30(4) (4), S212 - S212, Japanese
- BACKGROUND: Our objective was to evaluate the location of popliteal artery (PA) in osteotomy planes during high tibial osteotomy (HTO) and to determine a safer angle for screw drilling to the tibial tuberosity during distal tuberosity osteotomy (DTO). METHODS: Twenty knees in 20 patients who underwent contrast-enhanced computed tomography for cardiovascular diseases were examined. Osteotomy planes for open-wedge HTO (OWHTO) and hybrid closed-wedge HTO (hybrid CWHTO) were created using three-dimensional bone models. The distance from the posterior cortex of the tibia to the PA (dPC-PA) in the osteotomy planes was measured in the virtual osteotomy planes. The dangerous point (Point D1) was defined as the point 17.5 mm away from PA, setting the working length of the bone saw as 35 mm. The distance between the most medial point of the tibial cortex (Point M) and Point D1 in OWHTO and the most lateral point (Point L) and Point D1 in hybrid CWHTO were examined (dM-D1 and dL-D1, respectively). The location of Point D1 to the osteotomy line (%D1) was expressed as percentage, setting the start and end of the osteotomy line as 0% and 100%, respectively. To determine the safe angle for screw drilling in DTO, the angle between the line tangential to the medial cortex of the tibia and that passing through the center of the tibial tuberosity and PA were measured. RESULTS: In OWHTO and hybrid CWHTO, the mean dPC-PA was 10.6 mm (6.9-16.5 mm) and 10.2 mm (7.3-15.4 mm), respectively. The mean dM-D1 in OWHTO was 25.9 mm (24.6-27.2 mm) and dL-D1 in hybrid CWHTO was 5.1 mm (2.9-7.4 mm). The mean %D1 was 47.6 ± 3.7% in OWHTO and 9.3 ± 4.1% in hybrid CWHTO, respectively. The minimal angle between the two lines in DTO was 35.2°. CONCLUSION: PAs could run within 10 mm from the posterior cortex in the osteotomy planes of HTO. Therefore, proper posterior protection is necessary when cutting posterior cortex. An angle of less than 35° against the medial cortex line would be safe for screw fixation to avoid vascular injury in DTO.May 2022, Knee surgery & related research, 34(1) (1), 25 - 25, English, International magazineScientific journal
- Background: The relationship between meeting return-to-sport criteria and psychological readiness after anterior cruciate ligament (ACL) reconstruction is unknown. Purposes: To examine (1) whether patients who met 1 of the criteria for return to sport had higher psychological readiness than those who did not meet any of the criteria and (2) if those who met more criteria had higher psychological readiness. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study included 144 patients who underwent unilateral ACL reconstruction. All patients had regularly participated in some sport activities before an ACL rupture. At 12 months postoperatively, each patient completed 3 knee function tests (isokinetic quadriceps strength, isokinetic hamstring strength, and single-leg hop distance) and 2 self-reported measures (International Knee Documentation Committee [IKDC] 2000 subjective form and ACL-Return to Sport after Injury [ACL-RSI] scale); the ACL-RSI scale was used to measure psychological readiness to return to sport. The 4 criteria for return to sport were a limb symmetry index (LSI) ≥90% for each of the 3 function tests in addition to an IKDC score ≥90. Multivariate regression analysis was used to determine the association between meeting the individual criteria and the ACL-RSI score. In addition, the patients were divided into 5 groups according to the number of criteria met, and the Kruskal-Wallis and Steel-Dwass tests were used to compare the ACL-RSI scores among the groups. Results: Overall, 23 patients (16.0%) met none of the criteria for return to sport, 27 (18.7%) met 1 of the criteria, 34 (23.6%) met 2 criteria, 35 (24.3%) met 3 criteria, and 25 (17.4%) met all 4 criteria. Meeting the criteria for the hamstring strength LSI (P = .002), single-leg hop distance LSI (P = .004), and IKDC subjective score (P < .001) was each associated with higher ACL-RSI scores. Significant differences in ACL-RSI scores were found between patients who met none versus 2, 3, and 4 of the return-to-sport criteria (P < .001 for all) and between patients who met 1 versus 4 criteria (P < .001). Conclusion: Meeting return-to-sport criteria was positively associated with psychological readiness, and the patients who met multiple criteria had higher psychological readiness.May 2022, Orthopaedic journal of sports medicine, 10(5) (5), 23259671221093985 - 23259671221093985, English, International magazineScientific journal
- BACKGROUND: Advanced glycation end products (AGEs) are end products of protein glycation that bind to the receptor for AGEs (RAGE) and activate nicotinamide adenine dinucleotide phosphate oxidase (NOX), resulting in increased oxidative stress and rotator cuff fragility. Stump classification using the signal intensity ratio of the tendon rupture site to the deltoid muscle in the coronal view of T2-weighted fat-suppressed magnetic resonance imaging (MRI) scans is an indicator of clinical outcomes after rotator cuff repair surgery. Comparing the signal intensities of the deltoid (D) and rotator cuff tears (C), Ishitani et al. classified C/D <0.8 as type 1, 0.8 to 1.3 as type 2, and >1.3 as type 3. HYPOTHESIS/PURPOSE: It was hypothesized that the oxidative stress and collagen degeneration that occur in the rotator cuff due to accumulation of AGEs can be assessed on MRI scans (stump classification). Therefore, this study aimed to compare AGE-related factors in the rotator cuff tear site tissues based on stump classification. STUDY DESIGN: Descriptive laboratory study. METHODS: The authors included 30 patients (11 with type 1, 9 with type 2, and 10 with type 3; mean age, 62.3 years) who underwent surgery for complete rotator cuff tears at our hospital. Tendon tissue was harvested from the torn rotator cuff site during surgery for tissue and cell evaluation. RESULTS: There was no significant difference in the mean age according to stump classification. The number of patients with diabetes was significantly larger in type 3 than in the other types (P < .05). Tissue evaluation showed significantly higher expression of AGE and RAGE staining in type 3 than in the other types (~6.7-fold; P < .01). Cell evaluation showed that the expression rates of reactive oxygen species and apoptosis were significantly higher in type 3 than in the other types (~4.3-fold; P < .01). Gene expression by real-time polymerase chain reaction showed significantly higher RAGE (~5.1-fold), NOX (~5.3-fold), and IL (~3.0-fold) in type 3 than in the other types (P < .05). CONCLUSION: Stump classification type 3 exhibited the highest accumulation of AGEs and the highest oxidative stress and apoptosis, suggesting a high degree of degeneration and inflammation. Imaging based on stump classification reflects the degeneration and fragility of the torn rotator cuff site. CLINICAL RELEVANCE: This study provides evidence of a relationship between stump classification, which reflects rotator cuff fragility on MRI, and pathologies related to advanced glycation end products.Apr. 2022, The American journal of sports medicine, 3635465221090649 - 3635465221090649, English, International magazineScientific journal
- PURPOSE: The coronal lateral collateral ligament (LCL) sign has been reported to be associated with deviated position of the tibia on MRI due to anterior cruciate ligament (ACL) injuries. However, the relationships between LCL sign and clinical knee laxity evaluations are still unclear. The purpose of the study was to investigate the relationship between the coronal LCL sign and knee laxity measurements. METHODS: A retrospective review of unilateral ACL injured patients who underwent ACL reconstruction was performed. The coronal LCL sign was determined using magnetic resonance imaging (MRI). Clinical grading of the pivot-shift test, KT-1000 measurements, and quantitative measurements of the Lachman test and the pivot-shift test using an electromagnetic system, were compared between patients with positive and negative coronal LCL sign. A subgroup analysis of different age groups was then performed, dividing patients to adolescent (age ≤ 18 years) and adult (age > 18 years) groups. RESULTS: A total of 85 patients were enrolled, of which 45 patients had coronal LCL signs. The coronal LCL sign was not associated with the pivot-shift test clinical grading (n.s), KT-1000 measurement (n.s), the tibial translation during the Lachman test (n.s), or with tibia acceleration (n.s) and translation (n.s) during the pivot-shift test. The subgroup analysis also showed that the aforementioned parameters were not associated with the coronal LCL sign in either adolescent or adult subgroups. CONCLUSION: The occurrence of coronal LCL sign in MRI did not imply greater clinical knee laxity evaluations in patients with ACL tears. The knee laxity should routinely be evaluated regardless the coronal LCL sign. LEVEL OF EVIDENCE: Level III.Apr. 2022, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, English, International magazineScientific journal
- BACKGROUND: Total ankle arthroplasty (TAA) has become one of the standard surgical treatments for patients with end-stage ankle osteoarthritis (OA). In recent years, TAA with total talar prosthesis (combined TAA) has been used for ankle OA patients with talar osteonecrosis, with severe talar collapse, or with subtalar joint OA. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA, compared with conventional TAA. METHODS: Forty-six ankles (44 patients, 32 women/12 men) that underwent conventional TAA with mean follow-up of 42 months, and 26 ankles (25 patients, 18 women/7 men) that underwent combined TAA with mean follow-up of 46 months were included. Clinical outcomes, which included ankle range of motion (ROM), the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Self-Administered Foot Evaluation Questionnaire (SAFE-Q), and complications were compared between the groups. RESULTS: The preoperative ROM was significantly worse in combined TAA for both dorsiflexion and plantarflexion; however, in the final ROM, there was no significant difference between the groups. There was no significant difference in JSSF scale and SAFE-Q between the groups. Revision rate was 10.9% in conventional TAA and 0% in combined TAA. CONCLUSION: In this small series, at an average of 3.5 years, we found no significant difference in clinical results between conventional TAA and combined TAA; however, the revision rate was higher in conventional TAA. LEVEL OF EVIDENCE: Level III, retrospective cohort study.Apr. 2022, Foot & ankle international, 43(4) (4), 529 - 539, English, International magazineScientific journal
- INTRODUCTION: Although anterior cruciate ligament reconstruction (ACLR) is considered a successful procedure, residual pivot-shift after surgery remains to be solved. The purpose of this study was to comprehensively evaluate the risk factors of residual pivot-shift after anatomic double-bundle (DB) ACLR. MATERIALS AND METHODS: A total of 164 patients who underwent primary anatomic DB-ACLR between January 2014 and December 2019 and screw removal after the index ACLR in our hospital were included in this retrospective case-control study. The manual pivot-shift test was performed under general anesthesia during screw removal surgery, and patients with grade 1 or higher pivot-shift were classified as the positive pivot-shift group, and those with grade 0 were defined as the negative pivot-shift group. Univariate and logistic regression analyses were performed to identify the factors associated with postoperative residual pivot-shift. Assessment included sex, age, time to surgery, preoperative Tegner activity scale, preoperative pivot-shift grade, preoperative anterior tibial translation by the KT-2000 arthrometer measurement, meniscus injury and its surgical procedure, knee hyperextension, cartilage damage, Segond fracture, medial and lateral posterior tibial slope, lateral-medial slope asymmetry, participation in pivoting sport/activity at the time of injury, and return to sports at postoperative one year line. RESULTS: Postoperative positive pivot-shift was observed in 14 (8.5%) of 164 patients. The KT-2000 measurement at 1-year postoperatively was significantly higher in the residual pivot-shift-positive group than in the negative group (P < 0.05). Logistic regression analysis revealed that age of patients < 20 years [P < 0.05, odds ratio (OR): 6.1)], preoperative pivot-shift grade (P < 0.05, OR: 4.4), and hyperextended knee (P < 0.05, OR: 11.8) were risk factors of postoperative pivot-shift. There were no statistically significant differences between other variables. CONCLUSIONS: Patients < 20 years of age, with high-grade preoperative pivot-shift, or hyperextended knees had a higher risk of residual postoperative pivot-shift.Apr. 2022, Archives of orthopaedic and trauma surgery, English, International magazineScientific journal
- Background/objective: The purpose of this study was to report the outcomes of a clinical trial conducted in Japan to assess the safety and effectiveness of third-generation autologous chondrocyte implantation (ACI) using IK-01 (CaReS™), which does not require flap coverage, in the treatment of patients with focal cartilage injury of the knee. Methods: This was an open label, exploratory clinical trial. Patients were enrolled between June 2012 and September 2016. The primary endpoint of the study was the International Knee Documentation Committee (IKDC) score at 52 weeks after implantation. The IKDC, Lysholm, and visual analog scale (VAS) scores were evaluated at the time of screening and at 4, 12, 24, 36, and 52 weeks after implantation. Improvements from the baseline scores were evaluated using the equation "(postoperative score) - (preoperative score)." Magnetic resonance imaging (MRI) was performed at 2, 12, 24, and 52 weeks after implantation, and MRI measurements were evaluated using T1 rho and T2 mapping. Results: Nine patients were enrolled in this study and were examined for safety. Product quality did not satisfy the specification in one patient, and bacterial joint infection occurred in one patient. As a result, seven patients were included in the outcome analyses. The mean IKDC score significantly improved from 36.4 preoperatively to 74.1% at 52 weeks after implantation (p < 0.0001). The mean Lysholm and VAS scores also significantly improved from 39.6 to 57.4 to 89.6 and 22.9, respectively, after surgery. In the MRI evaluation, the T1 rho and T2 values of the implanted area were similar to those of the surrounding cartilage at 52 weeks after implantation. Conclusions: Third generation ACI (IK-01) can be an effective treatment option for focal cartilage defects of the knee; however, surgeons must pay careful attention to the risk of postoperative joint infection.Apr. 2022, Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology, 28, 6 - 12, English, International magazineScientific journal
- BACKGROUND: Most degenerative rotator cuff tears (RCTs) are associated with a limited range of motion (ROM) of the shoulder joint. Additionally, patients with diabetes mellitus (DM) show a higher frequency of limited ROM. Recently, advanced glycation end products (AGEs) of proteins have been observed to cause tissue fibrosis, primarily through abnormal collagen cross-linking and oxidative stress. In this study, we investigated the effect of AGEs on ROM limitation in the shoulder capsule and its relationship with DM in the patients with RCTs. METHODS: Sixteen patients (eight in the DM and non-DM groups) who underwent arthroscopic surgery for RCT with limited shoulder ROM were included in this study. AGE-related pathologies in both groups were compared, and the relationship between AGE accumulation and shoulder joint ROM was evaluated. Shoulder capsule tissue was harvested and subjected to histological and in vitro evaluation. RESULTS: The DM group displayed high levels of AGEs and reactive oxygen species (ROS), and reduced cell viability. There was a significant positive correlation between ROS expression, apoptosis, and preoperative hemoglobin A1c. ROS expression, apoptosis, and ROM of the shoulder joint showed a negative correlation. The NADPH oxidase (NOX) expression and collagen III/I ratio were significantly higher in the DM group than in the non-DM group. CONCLUSIONS: The DM group showed significant AGEs deposition in the shoulder capsule. Additionally, there was a significant association between AGEs and ROM limitation. Collectively, the findings suggest that the oxidative stress induced by AGEs deposition, which leads to fibrosis and local inflammation, might contribute to the limited ROM of the shoulder joint in patients with RCTs accompanied by DM.Mar. 2022, BMC musculoskeletal disorders, 23(1) (1), 271 - 271, English, International magazineScientific journal
- BACKGROUND: A link between tendinopathy and oxidative stress has been recently reported. Nicotinamide mononucleotide (NMN) is a precursor of nicotinamide adenine dinucleotide, which plays an important role in cell redox homeostasis. The aim of this study was to evaluate the antioxidant effect of NMN on tendinopathy in vitro and in vivo. METHODS: Tenocytes from healthy Sprague-Dawley rats were cultured in regular glucose (RG) and high-glucose (HG) conditions with or without NMN, and were divided into four groups: RG NMN(-), RG NMN(+), HG NMN(-), and HG NMN(+). Cell viability, reactive oxygen species (ROS) accumulation, apoptotic rate, and mRNA expression of nicotinamide adenine dinucleotide phosphate oxidase (NOX)1, NOX4, interleukin (IL)6, sirtuin (SIRT)1, and SIRT6 were investigated. In addition, rats with collagenase-induced tendinopathy were treated with or without NMN. Immunostaining of NOX1 and NOX4; mRNA expression of SIRT1, SIRT6, and IL6; and superoxide dismutase (SOD) activity measurements in the Achilles tendon were performed. RESULTS: NMN increased the expression of SIRT1 and SIRT6 in rat tenocytes, but decreased the levels of NOX1, NOX4, IL6, ROS, and apoptosis. In Achilles tendons with collagenase-induced tendinopathy, NMN increased the mRNA expression of SIRT1 and SIRT6, as well as SOD activity; while suppressing protein expression of NOX1 and NOX4, and mRNA expression of IL6. CONCLUSION: The in vitro and in vivo results of this study show that NMN exerts an antioxidant effect on tendinopathy by promoting the expression of SIRT while inhibiting that of NOX.Mar. 2022, BMC musculoskeletal disorders, 23(1) (1), 249 - 249, English, International magazineScientific journal
- Although electromyography is the routine diagnostic method for cubital tunnel syndrome (CuTS), imaging diagnosis by measuring cross-sectional area (CSA) with ultrasonography (US) has also been attempted in recent years. In this study, deep learning (DL), an artificial intelligence (AI) method, was used on US images, and its diagnostic performance for detecting CuTS was investigated. Elbow images of 30 healthy volunteers and 30 patients diagnosed with CuTS were used. Three thousand US images were prepared per each group to visualize the short axis of the ulnar nerve. Transfer learning was performed on 5000 randomly selected training images using three pre-trained models, and the remaining images were used for testing. The model was evaluated by analyzing a confusion matrix and the area under the receiver operating characteristic curve. Occlusion sensitivity and locally interpretable model-agnostic explanations were used to visualize the features deemed important by the AI. The highest score had an accuracy of 0.90, a precision of 0.86, a recall of 1.00, and an F-measure of 0.92. Visualization results show that the DL models focused on the epineurium of the ulnar nerve and the surrounding soft tissue. The proposed technique enables the accurate prediction of CuTS without the need to measure CSA.Mar. 2022, Diagnostics (Basel, Switzerland), 12(3) (3), English, International magazineScientific journal
- Both acromioclavicular joint (ACJ) cysts and hemarthrosis of the shoulder are rare conditions of massive rotator cuff tear that eventually lead to cuff tear arthropathy. We herein report the first case of a patient with co-occurring ACJ cyst and hemarthrosis of the shoulder. An 80-year-old right-hand-dominant man presented to our outpatient department with a six-month history of repeatable right shoulder pain and swelling. Clinical examination revealed a 5 x 5 x 5 cm elastic hard or hard shoulder lump overlying the ACJ on skin with subcutaneous bleeding and swelling of the shoulder. Shoulder pain at rest and a fully reduced active range of motion (ROM), particularly in flexion and abduction, were also noted. Radiographs demonstrated moderate degeneration of the glenohumeral joint including a bone cyst of the humeral head. Magnetic resonance imaging (MRI) revealed a massive rotator cuff tear with atrophy of the supraspinatus, infraspinatus, and subscapularis muscles. The T2-weighted MRI images showed that the cyst was in direct contact with the markedly degenerated glenohumeral joint. Based on these findings, the patient was diagnosed with massive rotator cuff tear with ACJ cyst and hemarthrosis of the shoulder. The patient underwent distal clavicle resection and reverse total shoulder arthroplasty (RSA). At 12-month follow-up, the patient showed no pain symptoms, no recurrence of the cyst, and excellent ROM. We experienced a very rare case of ACJ cyst and hemarthrosis of the shoulder occurring simultaneously with rotator cuff tear arthropathy. This report is very valuable in that it suggests that RSA is useful for both ACJ cysts and hemarthrosis of the shoulders associated with rotator cuff tear arthropathy.Mar. 2022, Cureus, 14(3) (3), e23353, English, International magazine
- BACKGROUND: While the precise measurement of the range of motion (ROM) of the elbow joint is important for clinical assessment and rehabilitation, problems include low accuracy and reproducibility in goniometer measurements due to the influence of soft tissue. The purpose of this study was to validate elbow joint motion analysis using a three-dimensional electromagnetic sensor system (EMS). METHODS: The accuracy and reproducibility of the EMS system were evaluated at four angles (0°, 45°, 90°, and 135°) using a model bone of the humerus and forearm. In addition, the maximum extension and maximum flexion of six elbows of six healthy volunteers were assessed by radiographic and EMS measurements. Accuracy was assessed by calculating the mean value of the measurement angle, standard deviation, Pearson's correlation coefficient, and the Bland-Altman method. Reproducibility was assessed by calculating the intra-rater and inter-rater reliabilities using intraclass correlation coefficients. RESULTS: In the model bone evaluation, the mean angles of the EMS measurement were 1.2° ± 2.0°, 45.4° ± 2.1°, 91.7° ± 2.4°, and 134.6° ± 2.7° at 0°, 45°, 90°, and 135°, respectively. In the in vivo evaluation, the elbow angles at the maximum extension with the EMS and radiographic angles were 4.7° ± 3.0° and 2.7° ± 2.0°, respectively, and the angles at maximum flexion were 131.8° ± 13.0° and 130.8° ± 4.5°, respectively. There were statistically significant correlations between the EMS and radiographic measurements; the Bland-Altman plots indicated that the two methods were almost in agreement for both extension and flexion. CONCLUSIONS: This method of measuring ROM of the elbow joint using EMS showed high accuracy, reliability, and reproducibility. The current results demonstrated the possibility of using the electromagnetic system to provide an accurate evaluation of the elbow joint in clinical settings.Jan. 2022, Journal of orthopaedic surgery and research, 17(1) (1), 60 - 60, English, International magazineScientific journal
- The triangular fibrocartilage complex (TFCC) is a significant stabilizer of the distal radioulnar joint. Diagnosing TFCC injury is currently difficult, but ultrasonography (US) has emerged as a low-cost, minimally invasive diagnostic tool. We aimed to quantitatively analyze TFCC by performing motion analysis by using US. Twelve healthy volunteers, comprising 24 wrists (control group), and 15 patients with TFCC Palmer type 1B injuries (injury group) participated. The US transducer was positioned between the ulnar styloid process and triquetrum and was tilted ulnarly 30° from the vertical line. The wrist was then actively moved from 10° of radial deviation to 20° of ulnar deviation in a 60-rounds-per-minute rhythm that was paced by a metronome. The articular disc displacement velocity magnitude was analyzed by using particle image velocimetry fluid measurement software. The mean area of the articular discs was larger on ulnar deviation in the control group. The mean articular disc area on radial deviation was larger in the injury group. The average articular disc velocity magnitude for the injury group was significantly higher than that for the control group. The results suggest that patients with TFCC injury lose articular disc cushioning and static stability, and subsequent abnormal motion can be analyzed by using US.Jan. 2022, Sensors (Basel, Switzerland), 22(1) (1), English, International magazineScientific journal
- (一社)日本スポーツ理学療法学会, 2022, スポーツ理学療法学, 2(Suppl.) (Suppl.), OS - 02, Japanese膝前十字靱帯再建術後3ヵ月時点のACL-RSI scaleと術後2年以内の再損傷の関連
- 2022, Isokinetics and Exercise Science, 30(2) (2), 127 - 133Scientific journal
- Purpose: Soft tissue sarcomas (STSs) constitute a group of rare, heterogeneous tumors representing approximately 1% of all cancers. Owing to the rarity and pathological diversity of the disease, unplanned excision (UE) has often been performed for STS, resulting in an unfavorable prognosis. This study aimed to clarify clinical outcomes and prognostic factors in STS patients who underwent UE. Patients and Methods: In a retrospective review of the medical records of patients with STS who underwent surgery at our institution between 1999 and 2015, patients were enrolled to either a UE group or a planned excision (PE) group. An analysis was then conducted to identify factors associated with prognosis after UE. Results: Of 134 patients undergoing surgery for STS, 110 were enrolled to the PE group and 24 to the UE group. The median size of the primary tumor was significantly smaller, and more lesions were located in the superficial layer in the UE group than in the PE group. In addition, plastic reconstruction after additional radical resection was required significantly more often in the UE group than in the PE group. No significant difference in overall survival, local recurrence-free survival, or disease-free survival (DFS) between the UE and PE groups was observed; however, metastasis-free survival was significantly better in the UE group. In the UE group, poorer DFS was associated with older age (≥61 years) and a larger primary tumor (≥2.9 cm). Conclusion: A prognosis similar to that in patients undergoing PE could be achieved by appropriate additional surgeries in patients initially undergoing UE. However, UE for STS should be avoided, especially in older patients and those with a larger primary tumor.2022, Cancer management and research, 14, 1815 - 1824, English, International magazineScientific journal
- (一社)日本理学療法学会連合, Dec. 2021, 理学療法学, 48(Suppl.1) (Suppl.1), 4 - 4, Japanese前十字靱帯再建術術前の膝伸展筋力と術後1年でのスポーツ復帰およびプレーに対する満足度の関連
- (公社)日本理学療法士協会-近畿ブロック, Dec. 2021, 近畿理学療法学術大会, 61回, S - 2, Japanese膝前十字靱帯再建術後の膝伸展筋力回復を予測する予測スコアの開発および検証
- (一社)日本理学療法学会連合, Dec. 2021, 理学療法学, 48(Suppl.1) (Suppl.1), 4 - 4, Japanese前十字靱帯再建術術前の膝伸展筋力と術後1年でのスポーツ復帰およびプレーに対する満足度の関連
- (公社)日本理学療法士協会-近畿ブロック, Dec. 2021, 近畿理学療法学術大会, 61回, S - 2, Japanese膝前十字靱帯再建術後の膝伸展筋力回復を予測する予測スコアの開発および検証
- Dec. 2021, Knee, 33, 282 - 289Scientific journal
- PURPOSE: To compare the biomechanical strength of different fixation configurations using suspensory buttons in a soft-tissue quadriceps tendon (QT) grafts in anterior cruciate ligament (ACL) reconstruction. METHODS: Forty bovine QTs, 6-cm long and 10-mm wide, were allocated into four groups with different suture configurations using suspensory buttons (n = 10 in each group): Group A, a baseball suture with a knot tied to the continuous loop with a suspensory button; Group B, same configuration as in Group A but with the knot tied at the opposite end of the baseball suture; Group C, a continuous loop with a suspensory button stitched directly to the QT with simple sutures, and Group D, a baseball suture tied directly to a suspensory button. Biomechanical testing was performed by preloading followed by cyclic loading for 500 cycles between 10 and 100 N. The length of elongation (mm) and maximum load to failure (N) were recorded, and compared among the four groups. RESULTS: Group C showed significantly smaller elongation (4.1 mm [95% CI 3.1-5.2]) than Group A (8.2 mm [95% CI 7.0-9.4]), Group B (10.5 mm [95% CI 7.7-13.3]), and Group D (8.5 mm [95% CI 7.0-9.9]) (A-C; P = 0.004, B-C; P = 0.0001, C-D; P = 0.0018). The maximum load to failure in Group C (386 N [95%CI 306-466]) was significantly higher than that in Group A (196 N [95% CI 141-251]), Group B (226 N [95% CI 164-289]), and Group D (212 N [95%CI 171-253]) (A-C; P = 0.0001, B-C; P = 0.0009, C-D; P = 0.0002). No significant differences were observed between Group A, B, and D in terms of elongation and maximum load to failure. CONCLUSION: The soft-tissue QT graft fixation configuration stitched directly to a continuous loop with suspensory button using simple sutures exhibits small elongation and high maximum load to failure among the four configurations. Regarding clinical relevance, direct suturing of the soft-tissue QT to a continuous loop with a suspensory button may be advantageous for femoral fixation in ACL reconstruction from a biomechanical perspective, and warrant future development of a novel fixation device using this principle.Nov. 2021, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, English, International magazineScientific journal
- Osteolytic bone metastasis leads to skeletal‑related events, resulting in a decline in the patient activities and survival; therefore, it is important to understand the mechanism underlying bone metastasis. Recent studies have suggested that microRNAs (miRNAs or miRs) are involved in osteoclast differentiation and/or osteolytic bone metastasis; however, the roles of miRNAs have not been elucidated. In the present study, the roles of miRNAs in bone destruction caused by breast cancer metastasis were investigated in vitro and in vivo. miR‑16, miR‑133a and miR‑223 were transfected into a human breast cancer cell line, MDA‑MB‑231. The expression of osteolytic factors in conditioned medium (miR‑CM) collected from the culture of transfected cells was assessed. To evaluate the effects of miRNAs on osteoclast differentiation and activities, tartrate‑resistant acid phosphatase (TRAP) staining and bone resorptive assays were performed in osteoclasts following miR‑CM treatment. To create in vivo bone metastasis models for histological and morphometric evaluation, miRNA‑transfected MDA‑MB‑231 cells were transplanted into the proximal tibia of nude mice. Expression of osteolytic factors, including receptor activator for nuclear factor‑κB ligand (RANKL), interleukin (IL)‑1β, IL‑6, parathyroid hormone‑related protein (PTHrP), and tumor necrosis factor (TNF), was increased in miR‑16‑CM, whereas it was decreased in both miR‑133a‑CM and miR‑223‑CM. TRAP staining and bone resorptive assays revealed that osteoclast function and activities were promoted by miR‑16‑CM treatment, whereas they were suppressed by miR‑133a‑CM and miR‑223‑CM. Consistent with in vitro findings, in vivo experiments revealed that the overexpression of miR‑16 increased osteoclast activities and bone destruction in MDA‑MB‑231 cells, whereas the opposite results were observed in both miR‑133a‑ and miR‑223‑transfected MDA‑MB‑231 cells. Our results indicated that miR‑16 promoted osteoclast activities and bone destruction caused by breast cancer metastasis in the bone microenvironment, whereas miR‑133a and miR‑223 suppressed them. These miRNAs could be potential biomarkers and therapeutic targets for breast cancer bone metastasis.Nov. 2021, International journal of oncology, 59(5) (5), English, International magazineScientific journal
- Background: The Segond fracture can be observed in patients with an anterior cruciate ligament (ACL) tear. It is unclear whether the Segond fracture affects clinical outcomes after ACL reconstruction. Purpose: To investigate whether the presence of a concomitant Segond fracture affects clinical outcomes after ACL reconstruction and to compare clinical outcomes when a Segond fracture is repaired surgically or left unrepaired. Study Design: Systematic review; Level of evidence, 4. Methods: Three databases (PubMed, Embase, Cochrane Library) were searched in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on July 27, 2020. Relevant studies regarding ACL injury with concomitant Segond fracture treated by primary ACL reconstruction were screened in duplicate. Data regarding patient characteristics and clinical outcomes were extracted. Descriptive data are presented, and a random-effects model was used to pool amenable data. Results: A total of 5 studies examining 2418 patients (987 female; 40.8%), mean age 25.4 years, were included in this study. There were 304 patients with a Segond fracture (mean age, 28.1 years; 35.9% female) and 2114 patients without a Segond fracture (mean age, 25.1 years; 41.5% female). Four studies directly compared outcomes between patients with an unrepaired Segond fracture and no Segond fracture. One study reported 12 patients who underwent ACL reconstruction and repair of a Segond fracture. Among 4 studies, 11 of 292 (3.8%) graft failures/revision surgeries were reported in the groups that had Segond fracture, whereas 145 of 2114 (6.9%) graft failures/revision surgeries were reported in groups that did not have Segond fracture. No significant difference was observed in the risk of graft failure between the 2 groups, with a pooled risk ratio of 0.59 (95% CI, 0.32-1.07; P = .08; I2 = 0%). No clinically significant differences were observed with regard to International Knee Document Committee score, Lysholm score, Tegner activity scale, and postoperative knee laxity between the group with Segond fracture and those without. Conclusion: An unrepaired Segond fracture does not appear to have any significant negative effect on postoperative stability or risk of graft failure or revision surgery after ACL reconstruction. Future prospective studies may be warranted to confirm the finding that patients with combined ACL injury and Segond fracture may have outcomes comparable with those of ACL-injured patients without a Segond fracture when isolated ACL reconstruction is performed.SAGE Publications, Oct. 2021, The American Journal of Sports Medicine, 51(2) (2), 525 - 533Scientific journal
- (一社)日本臨床スポーツ医学会, Oct. 2021, 日本臨床スポーツ医学会誌, 29(4) (4), S174 - S174, Japanese
- BACKGROUND: It is generally believed that contraction of the soft tissue structures on the medial side may occur in the knee with severe varus deformity. However, the relationship between the severity of varus deformity of the knee and the intraoperative soft tissue balance in unicompartmental knee arthroplasty (UKA) has not been well reported thus far. METHODS: One hundred and three consecutive medial UKAs were enrolled. After the femoral trial prosthesis was placed, the component gap was measured at 10° (extension) and 120° (flexion) of flexion using a UKA tensor. The pre-osteotomy gap was then calculated from the thickness of the bone cut. Paired Student's t-test was used to compare the component gap, as well as the pre-osteotomy gap, in extension and those in flexion. The relationship between the preoperative Hip-Knee-Ankle (HKA) angle and the pre-osteotomy gap was analysed using Pearson's correlation coefficient and simple linear regression analysis. RESULTS: The component gap in extension was significantly smaller than that in flexion while the pre-osteotomy gap in extension was significantly wider than that in flexion. There was a positive correlation between the severity of varus deformation in preoperative knee and the pre-osteotomy gap in extension, while there was no correlation between the preoperative HKA angle and the pre-osteotomy gap in flexion. CONCLUSIONS: The tension of the medial tightness does not correlate with the degree of preoperative varus deformity in UKA.Oct. 2021, The Knee, 32, 90 - 96, English, International magazineScientific journal
- Oct. 2021, International Journal of Molecular Sciences, 22(19) (19)Scientific journal
- THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, Sep. 2021, The Central Japan Journal of Orthopaedic Surgery & Traumatology, 64(5) (5), 609 - 610, Japanese
- (一社)中部日本整形外科災害外科学会, Sep. 2021, 中部日本整形外科災害外科学会雑誌, 64(秋季学会) (秋季学会), 38 - 38, Japanese膝関節における再生医療の基礎と臨床 当科における軟骨損傷および変形性膝関節症に対する再生医療の基礎と臨床
- (一社)中部日本整形外科災害外科学会, Sep. 2021, 中部日本整形外科災害外科学会雑誌, 64(秋季学会) (秋季学会), 244 - 244, Japanese巨大な骨嚢胞を伴う距骨骨軟骨損傷に対する治療経験
- (公社)日本整形外科学会, Aug. 2021, 日本整形外科学会雑誌, 95(8) (8), S1566 - S1566, Japanese
- (公社)日本整形外科学会, Aug. 2021, 日本整形外科学会雑誌, 95(8) (8), S1634 - S1634, Japanese
- (公社)日本整形外科学会, Aug. 2021, 日本整形外科学会雑誌, 95(8) (8), S1728 - S1728, Japanese
- (公社)日本整形外科学会, Aug. 2021, 日本整形外科学会雑誌, 95(8) (8), S1790 - S1790, Japanese
- (公社)日本整形外科学会, Aug. 2021, 日本整形外科学会雑誌, 95(8) (8), S1793 - S1793, Japanese
- (公社)日本整形外科学会, Aug. 2021, 日本整形外科学会雑誌, 95(8) (8), S1795 - S1795, Japanese
- BACKGROUND: The accurate assessment of distal radioulnar joint (DRUJ) instability is still challenging as there is no established objective evaluation method. This study aimed to develop a noninvasive measurement method using a three-dimensional electromagnetic sensor system (EMS) to quantitatively assess and characterize the normal DRUJ movement in healthy volunteers. METHODS: The DRUJ movement was mimicked using both a block model and saw bone. Movement of the models was measured by EMS, and the accuracy and reproducibility of the measurements were assessed. In vivo measurement was performed in a sitting position with the elbow flexed and the forearm pronated. One sensor each was attached to the distal radial shaft and the ulnar head. The examiners fixed the distal radius and the carpal bones, moved the ulnar head from the dorsal to the volar side and measured the dorsovolar translation. The volar translation was measured by EMS and ultrasonography, and the correlation coefficient was calculated. The dorsovolar translation was evaluated in 14 healthy volunteers (7 men and 7 women) by three hand surgeons. The intraclass and inter-rater correlation coefficients (ICCs), the differences between the dominant and non-dominant sides and between men and women were assessed. RESULTS: The accuracy and reproducibility assessment results of the EMS showed high accuracy and reproducibility. In the comparison between EMS and ultrasonography, the correlation coefficient was 0.920 (p = 0.16 × 10-3). The ICC (1,5) for the intra-rater reliability was 0.856, and the ICC (2,5) for inter-rater reliability was 0.868. The mean ulnar head translation and difference between dominant and non-dominant sides were 6.00 ± 1.16 mm (mean ± SD) and - 0.12 ± 0.40 mm, respectively. There were no significant differences between any of the parameters. CONCLUSIONS: A new measurement method using EMS could evaluate DRUJ movement with high accuracy, reproducibility, and intra- and inter-rater reliability. In healthy volunteers, the dorsovolar ulnar head translation was 6.00 mm. The difference between the dominant and non-dominant sides was < 1.0 mm with no significant difference. EMS provided an objective, non-invasive, real-time assessment of dynamic changes in the DRUJ. These findings could be useful in the treatment of patients with DRUJ instability.Jul. 2021, Journal of orthopaedic surgery and research, 16(1) (1), 452 - 452, English, International magazineScientific journal
- BACKGROUND: Few studies have addressed the impact of palliative surgery for cervical spine metastasis on patients' performance status (PS) and quality of life (QOL). We investigated the surgical outcomes of patients with cervical spine metastasis and the risk factors for a poor outcome with a focus on the PS and QOL. METHODS: We prospectively analyzed patients with cervical spine metastasis who underwent palliative surgery from 2013 to 2018. The Eastern Cooperative Oncology Group PS (ECOGPS) and EuroQol 5-Dimension (EQ5D) score were assessed at study enrollment and 1, 3, and 6 months postoperatively. Neurological function was evaluated with Frankel grading. Univariate and multivariate analyses were performed to identify the risk factors for a poor surgical outcome, defined as no improvement or deterioration after improvement of the ECOGPS or EQ5D score within 3 months. RESULTS: Forty-six patients (mean age, 67.5 ± 11.7 years) were enrolled. Twelve postoperative complications occurred in 11 (23.9%) patients. The median ECOGPS improved from PS3 at study enrolment to PS2 at 1 month and PS1 at 3 and 6 months postoperatively. The mean EQ5D score improved from 0.085 ± 0.487 at study enrolment to 0.658 ± 0.356 at 1 month and 0.753 ± 0.312 at 3 months. A poor outcome was observed in 18 (39.1%) patients. The univariate analysis showed that variables with a P value of < 0.10 were sex (male), the revised Tokuhashi score, the new Katagiri score, the level of the main lesion, and the Frankel grade at baseline. The multivariate analysis identified the level of the main lesion (cervicothoracic junction) as the significant risk factor (odds ratio, 5.00; P = 0.025). CONCLUSIONS: Palliative surgery for cervical spine metastasis improved the PS and QOL, but a cervicothoracic junction lesion could be a risk factor for a poor outcome.Jul. 2021, Journal of orthopaedic surgery and research, 16(1) (1), 423 - 423, English, International magazineScientific journal
- (株)医学書院, Jun. 2021, 臨床整形外科, 56(6) (6), 789 - 794, Japanese
- BACKGROUND: The relationship between the femoral component design in total knee arthroplasty (TKA) and the patellofemoral contact force, as well as the soft tissue balance, has not been well reported thus far. METHODS: Twenty-eight mobile-bearing posterior-stabilized (PS) TKAs using the traditional model (PFC Sigma) and 27 mobile-bearing PS TKAs using the latest model (Attune) were included. Surgeries were performed using the measured resection technique assisted with the computed tomography (CT)-based free-hand navigation system. After all the trial components were placed, patellar contact forces on the medial and lateral sides were measured using two uniaxial ultrathin force transducers with the knee at 0°, 10°, 30°, 60°, 90°, 120°, and 135° of flexion. The joint component gap and the varus ligament balance of the femorotibial joint were also measured. The non-paired Student's t-test was conducted to compare the values of the two groups. RESULTS: The medial patellar contact force was significantly lower for Attune group than for PFC Sigma group at 120° of knee flexion (P = 0.0058). The lateral patellar contact force was also significantly lower for Attune group than PFC Sigma group at 120° and 135° of knee flexion (P = 0.0068 and P = 0.036). The joint component gap, as well as the varus ligament balance, showed no statistically significant difference between the two groups. CONCLUSIONS: Reduced thickness and width of the anterior flange of the femoral component in the Attune may play a role in low patellar contact force.Jun. 2021, The Knee, 30, 1 - 8, English, International magazineScientific journal
- 関西関節鏡・膝研究会, Mar. 2021, 関西関節鏡・膝研究会プログラム・演題抄録, 33回, 33 - 33, Japanese骨端線閉鎖前の習慣性膝蓋骨脱臼に対してproximal realignment法と内側膝蓋大腿靱帯再建術の併用により良好な成績を得た一例
- 関西関節鏡・膝研究会, Mar. 2021, 関西関節鏡・膝研究会プログラム・演題抄録, 33回, 41 - 41, Japanese膝蓋骨脱臼・不安定症の治療戦略 大腿骨滑車部低形成を伴う症例に対する治療
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(2) (2), S199 - S199, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(2) (2), S226 - S226, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(3) (3), S631 - S631, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(3) (3), S808 - S808, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(3) (3), S842 - S842, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(3) (3), S845 - S845, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(3) (3), S851 - S851, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(3) (3), S1095 - S1095, Japanese
- (公社)日本整形外科学会, Mar. 2021, 日本整形外科学会雑誌, 95(3) (3), S1096 - S1096, Japanese
- (一社)中部日本整形外科災害外科学会, Mar. 2021, 中部日本整形外科災害外科学会雑誌, 64(春季学会) (春季学会), 14 - 14, Japanese前十字靱帯損傷の治療戦略 正常膝機能を取り戻すために
- (一社)中部日本整形外科災害外科学会, Mar. 2021, 中部日本整形外科災害外科学会雑誌, 64(春季学会) (春季学会), 122 - 122, Japanese整形外科勤務医における内側半月板後根損傷の認知度および治療に関するアンケート調査
- (一社)中部日本整形外科災害外科学会, Mar. 2021, 中部日本整形外科災害外科学会雑誌, 64(春季学会) (春季学会), 135 - 135, Japanese大きな欠損部を伴うアキレス腱再断裂に対してPercutaneous Achilles Repair Systemを用いて治療した1例
- BACKGROUND: The purpose of this study was to investigate the influence of a selected plane on the evaluation of tibial tunnel locations following anterior cruciate ligament reconstruction (ACLR) between two planes: the plane parallel to the tibial plateau (Plane A) and the plane perpendicular to the proximal tibial shaft axis (Plane B). METHODS: Thirty-four patients who underwent double-bundle ACLR were included. Three-dimensional model of tibia was created using computed tomography images 2 weeks postoperatively, and tibial tunnels of the anteromedial bundle (AMB) and posterolateral bundle (PLB) were extracted. To evaluate tibial tunnel locations, two planes (Planes A and B) were created. The locations of the tibial tunnel apertures of each bundle were evaluated using a grid method and compared between Planes A and B. The difference in coronal alignment between Planes A and B were also assessed. RESULTS: The AMB and PLB tunnel apertures in Plane A were significantly more laterally located than in Plane B (mean difference; AMB, 1.5%; PLB, 1.7%, P < 0.01). There were no significant differences in the anteroposterior direction between the planes. Coronal alignment difference between the planes was 16.8 ± 2.2°; Plane B was more valgus than Plane A. CONCLUSION: Although tibial tunnel locations were not significantly influenced by the selected planes in the AP direction, subtle but statistically significant differences were found in the ML direction between the Planes A and B in double-bundle anterior cruciate ligament reconstruction. The findings suggest that both Planes A and B can be used in the assessment of tibial tunnel locations after anterior cruciate ligament reconstruction.Mar. 2021, The Knee, 29, 298 - 304, English, International magazineScientific journal
- Management of bone metastasis is becoming increasingly important. Thus, local and systemic treatment options have been developed for control. Although systemic administration of anticancer agents is effective for bone metastasis, it is often stopped because of poor general conditions or side effects. Therefore, it is highly desirable to develop a more effective and safer local treatment for bone metastasis. The purpose of the current study was to investigate the antitumor effects and safety of gelatin hydrogel microspheres incorporating cisplatin (GM-CDDP), which we developed as a sustained release system without harmful substances. First, we assessed GM-CDDP for its in vitro degradability and potential for sustained release. Second, in vivo antitumor and side effects were evaluated using a murine bone metastasis model of MDA-MB-231 human breast cancer cells incorporating GFP. In vitro, initial bursts were observed within 2 h and CDDP was released gradually with gelatin hydrogel degradation, which reached 100% at 48 h. In vivo, local administration of GM-CDDP (2 mg/kg) significantly suppressed tumor growth and bone osteolysis compared with the control, and local and systemic administration of free CDDP (2 mg/kg; p < 0.05). Local administration of GM-CDDP significantly reduced loss of body weight and elevation of blood urea nitrogen compared with the systemic administration of free CDDP (p < .05). The current study suggests that local administration of GM-CDDP achieves higher antitumor effects with a potential for lesser side effects compared with local or systemic administration of free CDDP.Mar. 2021, Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 39(3) (3), 525 - 535, English, International magazineScientific journal
- INTRODUCTION: Previous studies have reported that alignment changes depend on the patient's position in orthopedic surgery. However, it has not yet been well examined how the patient's position affects the preoperative planning in high-tibial osteotomy (HTO). Therefore, the aim of this study was to investigate the effects of the patient's position on preoperative planning in HTO. MATERIALS AND METHODS: A total of 60 knees in 55 patients who underwent HTO were retrospectively examined. Virtual preoperative planning for medial open-wedge HTO (OWHTO), lateral closed-wedge HTO (CWHTO), and hybrid CWHTO were performed by setting the percentage of the weight-bearing line (%WBL) at 62% as an optimal alignment. The correction angle differences between the supine and standing radiographs were measured. The virtual %WBL (v%WBL) was determined by applying the correction angle obtained from the standing radiograph to the supine radiograph. The %WBL discrepancy (%WBLd) was calculated as v%WBL - 62 (%) to predict the possible correction errors during surgeries. A single regression analysis was performed to examine the correlation between the correction angle difference and %WBLd. RESULTS: The mean correction angle was significantly higher when the preoperative planning was based on standing radiographs than when based on supine radiographs (P < 0.001), and the mean difference was 2.2 ± 1.5°. The difference between the two conditions in the medial opening gaps for OWHTO, lateral wedge sizes (mm) for CWHTO, and hybrid CWHTO were 2.6 ± 2.0, 2.3 ± 1.6, and 1.9 ± 1.4, respectively. The mean v%WBL was 71.2% ± 7.3%, and the mean %WBLd was 10.1% ± 7.4%. A single regression analysis revealed a linear correlation between the correction angle difference and %WBLd (%WBLd = 4.72 × correction angle difference + 0.08). No statistically significant difference in the parameters was found between the supine and standing radiographs postoperatively. CONCLUSIONS: We found significant differences in the estimated correction angles between the supine and standing radiographs in the planning for HTO. Therefore, surgeons should carefully consider the difference between supine and standing radiographs and estimate the possible correction error during surgery when planning a HTO.Mar. 2021, Knee surgery & related research, 33(1) (1), 8 - 8, English, International magazineScientific journal
- PURPOSE: To investigate how the femoral sagittal cutting plane affects evaluation of the bone tunnel position after anterior cruciate ligament (ACL) reconstruction using the quadrant method in three-dimensional computed tomography (CT) imaging. METHODS: Thirty patients who underwent primary anatomic double-bundle ACL reconstruction and CT 2 weeks after surgery were enrolled. Three sagittal cutting planes with respect to the condylar axis were created using the CT images: at the top of the intercondylar notch (C-plane), 5% medial (M-plane), and 5% lateral (L-plane). The center of the bone tunnel position regarding depth and height of the anteromedial (AMB) and posterolateral bundle (PLB) were quantitatively evaluated using the quadrant method on the three different planes. RESULTS: The mean depths of AMB and PLB were 27.4 ± 4.4% and 39.7 ± 5.1%, 27.0 ± 4.2% and 37.6 ± 4.9%, and 27.4 ± 4.5% and 38.5 ± 6.0%, at the M, C and L planes, respectively. The mean heights of AMB and PLB were 30.8 ± 6.3% and 56.2 ± 5.6%, 30.4 ± 6.2% and 56.6 ± 5.6%, and 25.4 ± 7.0% and 52.9 ± 6.9% at the M, C, and L planes, respectively. Both AMB and PLB bone tunnels were evaluated as higher positions in the L-plane than the C-plane (p < 0.01, p = 0.02, respectively) and M-plane (p < 0.01, p = 0.04, respectively), but there were no significant differences between the C-plane and M-plane (n.s.). There was no significant difference in the anteroposterior direction for all planes. CONCLUSION: In evaluations of the bone tunnel position with the quadrant method using three-dimensional CT, the bone tunnel position depends on the femoral sagittal cutting plane. A consistent evaluation method should be used when evaluating the bone tunnel position after ACL reconstruction to enable correct evaluation clinically. LEVEL OF EVIDENCE: Case-control study, Level III.Feb. 2021, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 29(2) (2), 398 - 404, English, International magazineScientific journal
- BACKGROUND/AIM: This study aimed to evaluate the association of clinical characteristics with treatment outcomes to ascertain the appropriate treatment options for soft tissue sarcomas (STS) patients with brain metastasis (BM). PATIENTS AND METHODS: Medical records of STS patients with BM who were treated in our institutions were retrospectively reviewed, and analyzed to identify the factors associated with post-BM survival. RESULTS: Among the 509 STS patients, BM occurred in five patients (0.98%). The median survival after BM was 1.5 months. Histological subtypes of the primary lesions in the five BM patients were: two synovial sarcomas, one myxoid liposarcoma, one alveolar soft part sarcoma, and one rhabdomyosarcoma. Among the five BM patients, the post-BM survival of two patients, who underwent surgery and postoperative radiotherapy, was longer than that of the other patients (p<0.01). CONCLUSION: Combined surgery and postoperative radiotherapy effectively managed symptoms and prolonged survival in STS patients with BM.Feb. 2021, Anticancer research, 41(2) (2), 1027 - 1034, English, International magazineScientific journal
- PURPOSE: To evaluate the effect of tibial tunnel coalition on knee rotatory laxity and clinical outcomes after double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. METHODS: Forty-one patients who underwent anatomic DB ACL reconstruction were included prospectively. Three-dimensional computed tomography of the knee joint was obtained at approximately 1 year postoperatively to determine if tunnel coalition occurred. After excluding seven cases of femoral tunnel coalition, two groups were established based on the existence of a tibial tunnel coalition. The pivot-shift test was quantitatively evaluated on the basis of tibial acceleration preoperatively and at 1 year postoperatively. Two subjective scores, the International Knee Documentation Committee (IKDC) subjective and Lysholm scores, were also collected. The pivot-shift measurement and subjective scores were compared between the ACL-reconstructed knees with and without tibial tunnel coalition. The independent t test, Pearson's chi-square test, and Student t tests were used in data analysis. RESULTS: Twenty-one knees had tibial tunnel coalition (group C), whereas 13 knees did not have tunnel coalition(group N). Pivot-shift was significantly diminished postoperatively in both groups on the basis of the clinical examination and quantitative evaluations (p < 0.05). However, there was a small but significant difference in tibial acceleration demonstrating larger pivot-shift in group C (1.0 ± 0.6 m/s2) than in group N (0.5 ± 0.3 m/s2, p < 0.05). No significant difference was observed in the IKDC subjective and Lysholm scores (both n.s.). CONCLUSION: When the tibial tunnel coalition occurs after DB ACL reconstruction, knee rotatory laxity may not be restored in ACL-reconstructed knees, as expected in those without tunnel coalition. It is recommended that two tibial tunnels should be created separately when performing DB-ACL reconstruction to achieve better control of rotatory knee laxity. LEVEL OF EVIDENCE: III.Jan. 2021, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, English, International magazineScientific journal
- (一社)日本スポーツ理学療法学会, 2021, スポーツ理学療法学, 1(Suppl.) (Suppl.), OS - 03, Japanese
- Routledge, 2021, Sports Biomechanics, EnglishScientific journal
- 関西関節鏡・膝研究会, 2021, 関西関節鏡・膝研究会誌, 33(1) (1), np7 - np9, Japanese骨端線閉鎖前の習慣性膝蓋骨脱臼に対してproximal realignment法と内側膝蓋大腿靱帯再建術の併用により良好な成績を得た一例
- BACKGROUND: Previous studies have reported that glenohumeral internal rotation deficit (GIRD) may increase the risk of throwing shoulder injuries. The purpose of this study was to analyze the conditions of throwing shoulder in professional baseball pitchers with GIRD by comparing with those in pitchers without GIRD. METHODS: In total, 26 male professional baseball pitchers participated in this study. We evaluated the passive range of motion (ROM) and isometric muscle strength at internal rotation (IR) and external rotation (ER) at 90° abduction, as well as the muscle thickness of the supraspinatus (SSP) and infraspinatus (ISP) by ultrasound. The pitchers were divided into two groups as follows: GIRD group who exhibit a loss of 20° or more in the throwing shoulder IR2, and the remaining participants who did not, in the non-GIRD group. RESULTS: In the GIRD group, the total range of motion (TRM) deficit (throwing - non-throwing) (p < 0.001), the muscle thickness ratio (throwing:non-throwing) of the SSP and ISP (p = 0.017 and p = 0.014, respectively), and the muscle strength ratio (throwing:non-throwing) of ER (p = 0.028) were significantly lower than those of the non-GIRD group. In contrast, the muscle strength ratio (throwing:non-throwing) of the IR (p = 0.0064) in the GIRD group was significantly higher than that in the non-GIRD group. CONCLUSIONS: We showed that GIRD had significant correlations with several conditions, such as atrophy of the SSP and ISP, weakness of ER strength, enhancement of IR strength, limitation of the TRM, and throwing side, all of which could be important factors for throwing shoulder injuries. LEVEL OF EVIDENCE: Level III; Cross-Sectional Case-Control Design; Prognosis Study.Dec. 2020, Journal of shoulder and elbow surgery, 30(9) (9), 2073 - 2081, English, International magazineScientific journal
- AIMS: With recent progress in cancer treatment, the number of advanced-age patients with spinal metastases has been increasing. It is important to clarify the influence of advanced age on outcomes following surgery for spinal metastases, especially with a focus on subjective health state values. METHODS: We prospectively analyzed 101 patients with spinal metastases who underwent palliative surgery from 2013 to 2016. These patients were divided into two groups based on age (< 70 years and ≥ 70 years). The Eastern Cooperative Oncology Group (ECOG) performance status (PS), Barthel index (BI), and EuroQol-5 dimension (EQ-5D) score were assessed at study enrolment and at one, three, and six months after surgery. The survival times and complications were also collected. RESULTS: In total, 65 patients were aged < 70 years (mean 59.6 years; 32 to 69) and 36 patients were aged ≥ 70 years (mean 75.9 years; 70 to 90). In both groups, the PS improved from PS3 to PS1 by spine surgery, the mean BI improved from < 60 to > 80 points, and the mean EQ-5D score improved from 0.0 to > 0.7 points. However, no significant differences were found in the improvement rates and values of the PS, BI, and EQ-5D score at any time points between the two groups. The PS, BI, and EQ-5D score improved throughout the follow-up period in approximately 90% of patients in each group. However, the improved PS, BI, and EQ-5D scores subsequently deteriorated in some patients, and the redeterioration rate of the EQ-5D was significantly higher in patients aged ≥ 70 than < 70 years (p = 0.027). CONCLUSION: Palliative surgery for spinal metastases improved the PS, activities of daily living, and quality of life, regardless of age. However, clinicians should be aware of the higher risk of redeterioration of the quality of life in advanced-age patients. Cite this article: Bone Joint J 2020;102-B(12):1709-1716.Dec. 2020, The bone & joint journal, 102-B(12) (12), 1709 - 1716, English, International magazineScientific journal
- PURPOSE: To compare the postoperative rotatory knee laxity between ACL-reconstructed knees with different meniscus treatments using an electromagnetic pivot-shift measurement. METHODS: Forty-six patients with unilateral ACL reconstructions were enrolled (21 males/25 females, 25 ± 12 y.o.). Concomitant meniscus tears, if any, were repaired whenever possible during primary ACL reconstruction. At 1 year postoperatively, pivot-shift test was performed under anaesthesia during screw removal surgery and quantitatively evaluated by tibial acceleration using an electromagnetic system. The acceleration was compared between ACL-reconstructed knees with different meniscal treatments: intact, repaired and unrepaired. RESULTS: A concomitant meniscus tear was found in 28 knees preoperatively: lateral tears in 11 knees, medial tears in 11 knees and both medial and lateral tears in 6 knees. Postoperatively, 19 ACL-reconstructed knees had a repaired meniscus for either medial, lateral or bilateral menisci tears, and 18 knees had intact menisci pre- and post-operatively. Meanwhile, nine lateral meniscus tears were irreparable and treated by partial meniscectomy or left in situ. ACL-reconstructed knees with unrepaired lateral menisci had significantly larger pivot-shift acceleration (0.9 ± 0.7 m/s2) than those with intact menisci (0.5 ± 0.2 m/s2, p < 0.05), whereas rotatory knee laxity was similar between the knees with fully repaired menisci (0.6 ± 0.3 m/s2) and intact menisci (n.s.). CONCLUSION: An unrepaired lateral meniscus tear in an ACL-reconstructed knee could lead to remaining pivot-shift postoperatively. A concomitant meniscus tear should be repaired during ACL reconstruction to restore normal rotational laxity. LEVEL OF EVIDENCE: Therapeutic Study, Level III.Nov. 2020, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 28(11) (11), 3504 - 3510, English, International magazineScientific journal
- The loss of nucleus pulposus (NP) notochordal cells is one of the key initial hallmarks of age-related intervertebral disc degeneration. Although the transmembrane mechanoreceptor integrin α5β1 is important in the process of disc degeneration, the relationship between integrin α5β1 and notochordal cell disappearance remains unclear. The purpose of this study was to elucidate the role of integrin α5β1 in the homeostasis of notochordal cells using an ex-vivo dynamic loading culture system that we developed. Rat tail functional spinal units (n = 80 from 40 rats) were cultured under unloading or 1.3-MPa, 1.0-Hz dynamic compressive loading for 48 or 144 h with or without an integrin α5β1 inhibitor. Disc histomorphology, cell viability, apoptosis, senescence, and phenotypic expression were investigated. Consequently, histological degenerative disc changes with decreased cell viability and increased cell apoptosis and senescence were observed with an extended loading duration. Immunofluorescence revealed that the expression of notochordal cell markers, CD24 and brachyury, and chondrocyte markers, collagen type II and SRY-box 9, declined with loading. In particular, reduction in notochordal cell marker expression was more dramatic than that in chondrocyte marker expression. Apoptotic terminal deoxynucleotidyl transferase dUTP nick-end labeling positivity was also higher in brachyury-positive notochordal cells. Furthermore, all these changes were delayed by inhibiting integrin α5β1. Findings of our dynamic loading regimen with a relatively high pressure suggest reproducibility of the cellularity and phenotypic disappearance of NP notochordal cells during adolescence, the susceptibility of notochordal cells to mechanical stimuli partially through the integrin α5β1 pathway, and future potential treatment of integrin regulation for intervertebral disc disease.Oct. 2020, Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 39(9) (9), 1933 - 1944, English, International magazineScientific journal
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S197 - S197, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S195 - S195, Japanese
- (一社)中部日本整形外科災害外科学会, Oct. 2020, 中部日本整形外科災害外科学会雑誌, 63(秋季学会) (秋季学会), 213 - 213, Japanese弾発現象を伴った長母趾屈筋腱の絞扼性腱鞘滑膜炎に対して後足部内視鏡手術で治療した一例
- (一社)中部日本整形外科災害外科学会, Oct. 2020, 中部日本整形外科災害外科学会雑誌, 63(秋季学会) (秋季学会), 220 - 220, Japanese膝前十字靱帯再建術後脛骨骨髄炎に対し抗生剤入りセメント充填術を施行した一例
- Background: Predicting when athletes can return to play after muscle strains is not always simple because of difficulties in evaluating the severity of such injuries. Purpose/Hypothesis: The purpose of this study was to evaluate the use of magnetic resonance imaging (MRI) to classify lower extremity muscle strains in Japanese professional baseball players. The hypothesis was that MRI grading can be used to diagnose the severity of muscle strains in the lower extremity and predict return to play in athletes. Study Design: Case series; Level of evidence, 4. Methods: A total of 55 muscle strains occurred in the lower extremity of players on a professional baseball team between the 2006 and 2015 seasons; all players had undergone MRI examination. Age, player position, location of injury, cause of injury, and duration until return to play (in days) were extracted from the medical records. MRI scans were classified using the following system: grade 0, no abnormal findings; grade 1a, T2-weighted high intensity only between muscles; grade 1b, T2-weighted high intensity between muscles and in muscle belly; grade 2, injury of musculotendinous junction; and grade 3, rupture of tendon insertion. Results: The sites of injuries were distributed as follows: hamstrings (n = 33), quadriceps (n = 6), hip adductors (n = 6), and calves (n = 10). MRI findings revealed 9 muscle strains (16%), 19 grade 1a (34%), 19 grade 1b (34%), and 8 grade 2 muscle strains (16%). The length of time until return to training and competition, respectively, was 15 and 26 days for grade 1a injuries, 19 and 36 days for grade 1b injuries, and 55 and 69 days for grade 2 injuries. Conclusion: Players with grade 1 injuries took 4 to 5 weeks to return to play, whereas players with grade 2 injuries took 10 weeks to return. MRI can be useful for diagnosing lower extremity muscle strains and predicting the time to return to play.Oct. 2020, Orthopaedic journal of sports medicine, 8(10) (10), 2325967120956569 - 2325967120956569, English, International magazineScientific journal
- (一社)中部日本整形外科災害外科学会, Sep. 2020, 中部日本整形外科災害外科学会雑誌, 63(5) (5), 829 - 830, Japanese
- (一社)日本関節病学会, Sep. 2020, 日本関節病学会誌, 39(3) (3), 253 - 253, Japanese半月板温存療法の最先端 半月板切除後の自然経過
- (公社)日本整形外科学会, Sep. 2020, 日本整形外科学会雑誌, 94(8) (8), S1925 - S1925, JapaneseACL損傷膝に合併する半月板損傷が膝不安定性に与える影響の定量評価による検討
- (公社)日本整形外科学会, Sep. 2020, 日本整形外科学会雑誌, 94(8) (8), S1929 - S1929, Japanese魚鱗由来高強度コラーゲンフィブリル線維による膝靱帯修復促進効果の検討
- (公社)日本整形外科学会, Sep. 2020, 日本整形外科学会雑誌, 94(8) (8), S2026 - S2026, Japanese膝前十字靱帯解剖学的二重束再建術での脛骨骨孔重複のリスク因子についての検討
- PURPOSE: There is paucity in studies regarding double-bundle anterior cruciate ligament reconstruction (DB-ACLR) in teenagers. The purpose of this study is to investigate clinical outcome after DB-ACLR and analyze whether any differences exist between teenagers and young adults. METHODS: A retrospective study was performed between 2009 and 2017. Teenagers were defined as patients between 15 and 19 years and young adults between 20 and 25 years old. Isolated anterior cruciate ligament (ACL) injuries with DB-ACLR with minimum two-year follow up were included. Pre and post-operative Lysholm score, Tegner activity scale, KT-2000 arthrometer, manual pivot-shift grade, were assessed with post-operative one-leg hop test, isokinetic knee extensor strength test at 60°/sec, International Knee Documentation Committee Score (IKDC score), and re-injury rate. RESULTS: One-hundred and thirty-one patients, 75 patients in the teenage group (Group A) and 56 patients in the young adult group (Group B), were enrolled. Lysholm score was significantly lower in Group A (89.6 ± 21.1) compared to Group B (95.9 ± 4.6) (p = 0.04). Side to side difference in KT-2000 arthrometer (2.3 ± 2.2 mm vs 1.0 ± 2.3 mm, Group A vs Group B, respectively, p < 0.01) and ratio of post-operative positive pivot shift was significantly greater in Group A (30.7%) compared to Group B (7.1%) (p < 0.01). No significant difference was seen in re-injury rate (n.s.). CONCLUSION: Teenage patients have a greater tendency for residual knee joint laxity after DB-ACLR. Although teenagers and patients in the early twenties are close in age, characteristic in knee joint laxity may be different and, therefore, may require attention upon surgery and post-operative follow-up. LEVEL OF EVIDENCE: III.Aug. 2020, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 28(8) (8), 2663 - 2667, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Sex-related differences of plantar pressure distribution during activities should be thoroughly inspected as it can help establish treatment and prevention strategies for foot and ankle problems. In-shoe measurement systems are preferable without space and activity restrictions; however, previously reported systems are still heavy and bulky and induce unnatural movement. Therefore, a slim and light plantar pressure sensor was newly developed to detect the effect of sex difference on plantar pressure during standing and walking. METHODS: One-hundred healthy adult volunteers (50 women and 50 men) were recruited. Ten plantar pressure sensors were implanted in a 1-mm thick insole, with a total weight of 29 g. Plantar pressure was recorded with 200 Hz during 3 s of standing and while walking 10 steps. The maximum loads during standing and walking were analyzed in each sensor, and the results were compared between different areas of the foot in the antero-posterior direction and the medio-lateral direction and between different time points. The movement of the center of pressure (COP) during walking was also evaluated. Analyses were adjusted for body mass index and gait speed. RESULTS: The movement of COP was constant for both sexes. In all cases, the maximum load was observed on the medial of the foot. Women had a significantly higher peak pressure on the hallux, toes, forefoot, and medial aspect of the foot compared to men while standing and walking (p < .05). CONCLUSIONS: A newly introduced in-shoe plantar pressure sensor demonstrated a typical loading transition pattern of the foot. Furthermore, higher plantar pressure in the forefoot was detected in healthy women as compared to men during standing and walking activities.Jul. 2020, Journal of foot and ankle research, 13(1) (1), 40 - 40, English, International magazineScientific journal
- Background: The tie-grip suture can fix radial tears more rigidly than simple conventional sutures. However, one shortcoming is the residual gap at the central margin of the tear. The tie-grip suture was modified to address this issue and named the "cross tie-grip suture." Purpose/Hypothesis: The purpose of this study was to compare the suture stability and strength among 4 suturing techniques: the original tie-grip, cross tie-grip, and 2 conventional sutures (double horizontal and cross). It was hypothesized that the cross tie-grip suture would show the least displacement and resist the greatest maximum load. Study Design: Controlled laboratory study. Methods: A total of 40 fresh-frozen porcine knees were dissected to acquire 80 menisci; 20 menisci were tested in each suture group. A radial tear was created at the middle third of the meniscal body. Repair was performed with the following: original tie-grip, cross tie-grip, double horizontal, and cross sutures. The mechanical strength of sutured menisci was evaluated using a tensile testing machine. All menisci underwent submaximal loading and load to failure. The gap distance and ultimate failure load were compared using analysis of variance. The failure mode was recorded after load-to-failure testing. Results: Displacement after 500 cycles was significantly smaller in the cross tie-grip group (0.4 ± 0.3 mm) compared with the tie-grip (0.9 ± 0.6 mm), double horizontal (1.2 ± 0.7 mm), and cross suture groups (1.4 ± 0.6 mm) (P < .05). The ultimate failure load was significantly greater in the cross tie-grip (154.9 ± 29.0 N) and tie-grip (145.2 ± 39.1 N) groups compared with the double horizontal (81.2 ± 19.9 N) and cross suture groups (87.3 ± 17.7 N) (P < .05). Tissue failure was the most common mode of failure in all groups. Conclusion: Upon repair of radial meniscal tears, the cross tie-grip suture showed less displacement compared with that of the tie-grip, double horizontal, and cross sutures and demonstrated equivalent load to failure to that of the tie-grip suture at time zero. Clinical Relevance: The cross tie-grip suture provided high resistance to displacement after repair of radial tears and may be advantageous in healing for radial meniscal tears.Jul. 2020, Orthopaedic journal of sports medicine, 8(7) (7), 2325967120935810 - 2325967120935810, English, International magazineScientific journal
- CONTEXT: Some studies have discussed postoperative quadriceps strength recovery after anterior cruciate ligament reconstruction (ACLR). However, the effect of preoperative quadriceps strength deficit on longitudinal postoperative quadriceps strength recovery after ACLR with hamstring autograft is unknown. OBJECTIVE: To reveal the longitudinal postoperative quadriceps strength recovery after ACLR with hamstring autograft among patient groups stratified by preoperative quadriceps strength deficit. DESIGN: Retrospective cohort study. SETTING: Single center. PATIENTS: In total, 420 patients (222 men and 218 women; age at the time of surgery 23.1 [8.9] y) who underwent ipsilateral ACLR with hamstring autograft and completed knee function tests preoperatively and 3, 6, and 12 months postoperatively were included in this study. INTERVENTION: The authors measured quadriceps strength at 60°/s, tested 1-leg hop performance (distance and anxiety), and calculated the quadriceps strength index (QSI) and limb symmetry index for 1-leg hop distance. Patients were divided into the following 4 groups according to their preoperative QSI: >80% (Excellent group), 80% to 60% (Good group), 60% to 40% (Moderate group), and ≤40% (Poor group). MAIN OUTCOME MEASURES: Postoperative QSI at 3, 6, and 12 months and 1-leg hop performance at 12 months after the surgery. RESULTS: The Excellent group had the highest postoperative QSI at all periods. Based on the 1-leg hop performance, the Poor group had the lowest limb symmetry index and significantly greater anxiety during jump performance in comparison with the Excellent and Good groups. CONCLUSION: The present study shows a longitudinal recovery process and the average postoperative quadriceps strength after ACLR with hamstring autograft in patient groups stratified by preoperative QSI. The results indicate that the difference in preoperative QSI affects not only the longitudinal postoperative QSI recovery but also high-level 1-leg hop performance after ACLR using hamstring autograft.Jul. 2020, Journal of sport rehabilitation, 29(5) (5), 602 - 607, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Component subsidence is considered as a cause of revision surgery. The talar component subsidence may be a risk factor for revision surgery; however, there are no reports regarding talar component placement and subsidence amount following total ankle arthroplasty (TAA). We therefore investigated the relationship between talar component placement and subsidence amount. METHODS: Fifty-two ankles from 49 patients (age: 71 years [range 62-83], 13 male/ 36 female), who underwent TAA with mean follow-up of 36 months (range 12-83), were included. The subjects were divided into two groups based on talar component placement: anterior placement (n = 20, group A) and posterior placement (n = 32, group P) using weight-bearing lateral plain radiographs. The amount of the talar component subsidence and clinical outcomes, which included the Japanese Society for Surgery of the Foot (JSSF) scale, range of the motion (ROM) and the revision rate, were compared between the groups. RESULTS: Talar component subsidence was significantly higher in group A (2.1 ± 2.0 mm) than in group P (0.6 ± 1.4 mm, P = .017). There was no significant difference in the JSSF scale and ROM between group A and group P. The revision rate was 10.0% in group A and 6.3% in group P, albeit not statistically significant. CONCLUSION: Greater talar component subsidence was observed when the talar component was placed more anteriorly, suggesting that anterior placement of the talar component may need to be avoided during the surgery in order to minimize the postoperative talar component subsidence.Jun. 2020, Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, English, International magazineScientific journal
- The pivot shift test is utilized for assessment of rotatory instability in the anterior cruciate ligament (ACL) deficient knee. There are multiple reports of the pivot shift maneuver, and there is a lack of consensus among clinicians as to a standardized maneuver. Measurement devices are a feasible option to evaluate rotatory knee instability, objectively or quantitatively. Traditionally, measurement systems have been invasive systems. More recently, electromagnetic system, inertial sensor, or imaging analysis systems, specifically with the utilization of a tablet computer, have emerged as noninvasive, and more importantly, validated options. It is important to recognize that anatomic structures other than the ACL contribute to rotatory knee stability. Addressing the tibial slope, anterolateral structures of the knee, specifically the iliotibial band, and menisci during ACL surgery may decrease residual pivot shift in an attempt to improve clinical outcomes and prevent reinjury. This review article describes the pivot shift maneuver, objective measurement tools, and clinical applications of the pivot shift test.Jun. 2020, Sports medicine and arthroscopy review, 28(2) (2), 36 - 40, English, International magazineScientific journal
- PURPOSE: To investigate the influences of time from injury to surgery and meniscal injuries on knee rotational laxity in anterior cruciate ligament (ACL)-deficient knees using the electromagnetic system retrospectively. METHODS: Ninety-four unilateral ACL-injured patients (44 male and 50 female, mean age: 27.3 ± 11.8 years) were included. The pivot-shift test was performed before ACL reconstruction, as was a quantitative evaluation using the electromagnetic system to determine tibial acceleration. Patients were divided into 4 groups according to the chronicity: group 1, within 3 months (22 patients); group 2, between 3 and 6 months (29 patients); group 3, between 6 and 12 months (23 patients); and group 4, more than 12 months (20 patients). The presence of meniscal injuries was examined arthroscopically. RESULTS: The tibial acceleration was significantly greater in group 4. There was a positive correlation between tibial acceleration and the time from injury to surgery (r = 0.47, P = .02). In groups 1, 2 and 3, the tibial acceleration in patients with a lateral meniscal injury was significantly greater than in patients with a medial meniscal injury and without meniscal injury. When patients with lateral meniscal injury were excluded (leaving those with medial meniscus injury or without meniscal injury), group 4 had significantly greater accelerations than other groups. CONCLUSIONS: In ACL-deficient knees, rotational laxity increased with time and the increased rotational laxity was evident more than 1 year after injury whereas it increased with concomitant lateral meniscal injuries within 1 year after injury. LEVEL OF EVIDENCE: Ⅳ, diagnostic study of nonconsecutive patients.May 2020, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 36(5) (5), 1398 - 1406, English, International magazine[Refereed]Scientific journal
- 関西関節鏡・膝研究会, Mar. 2020, 関西関節鏡・膝研究会プログラム・演題抄録, 32回, 21 - 21, Japanese膝関節 骨端線閉鎖前のACL損傷膝に対するTibial Tunnelを作成しないSBによるPhyseal-Sparing Techniquesを用いた2症例の治療成績
- PURPOSE: To compare rotational laxity in anterior cruciate ligament (ACL)-reconstructed knees retrospectively with and without concomitant anterolateral capsule (ALC) injury confirmed by magnetic resonance imaging (MRI) prior to ACL reconstruction. METHODS: Sixty-two ACL-reconstructed knees (26 men, 36 women; median age 20 (range 13-59)) were included. Pivot-shift test was performed before ACL reconstruction and 1 year postoperatively under anesthesia with both clinical grading and quantitative measurement simultaneously. Clinical grading was determined according to the International Knee Documentation Committee (IKDC) criteria (none, glide, clunk, or gross), and an electromagnetic measurement system was used to provide tibial acceleration as a quantitative parameter. The resence of concomitant ALC injury was confirmed retrospectively by MRI. The pivot-shift test was compared between ACL-reconstructed knees with and without ALC injury test for clinical grading and the independent t test for quantitative evaluation. RESULTS: ALC injury was identified in 26 of 62 (42%) knees. Before ACL reconstruction, there was no difference in the pivot-shift test results between the ACL-deficient knees with and without ALC injury in IKDC grading (n.s.) or tibial acceleration (1.1 ± 0.7 m/s2 and 1.4 ± 1.1 m/s2, respectively, n.s.). At 1 year postoperatively, no difference was observed between groups (IKDC, p = 0.90; tibial acceleration, 0.6 ± 0.3 m/s2 and 0.8 ± 0.6 m/s2, n.s.). CONCLUSIONS: Concomitant ALC injury at the time of ACL injury had no effect on the rotational laxity of the knee in the postoperative course after ACL reconstruction. Therefore, additional treatment for ALC injury may not be warranted. LEVEL OF EVIDENCE: IV.Feb. 2020, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 28(2) (2), 489 - 494, English, International magazine[Refereed]Scientific journal
- OBJECTIVE: Previous findings suggest that silent information regulator 2 ortholog 1 (SIRT1) plays essential roles in chondrocytes and prevents osteoarthritis (OA) development. The purpose of this study was to investigate the effects of intraperitoneal (i.p.) and intra-articular (i.a.) administration of the SIRT1 activator SRT2104, which has been approved for use in humans. DESIGN: OA was induced by destabilizing the medial meniscus in the knee joint of 12-week-old CL57BL/6J mice. The mice were divided into 3 groups, that is, the control group, SRT2104 i.p.-injection group, and SRT2104 i.a.-injection group. Tissues were harvested at 4, 8, 12, and 16 weeks postsurgery. OA progression was evaluated using the Osteoarthritis Research Society International (OARSI) score. The production of OA-related proteins in cartilage and synovium was examined by immunohistochemistry. RESULTS: OARSI scores in the control group were significantly higher at 8 and 12 weeks compared with other 2 groups. Immunohistochemical analysis showed that Sirt1 and type-2 collagen significantly increased, whereas MMP-13, ADAMTS-5, IL-1β, IL-6, cleaved caspase 3, PARP p85, acetylated NF-κB p65, and iNOS decreased significantly in cartilage tissues from the i.p. and i.a, SRT2104 groups. In the synovium, more iNOS-positive M1-like macrophages were observed in the control group than in the i.p. and i.a, SRT2104 groups, whereas more CD206-positive M2-like macrophages were detected in the i.p. and i.a. SRT2104 groups. CONCLUSIONS: Both i.p. and i.a. SRT2104 injection reduced OA progression in the mouse OA model, suggesting that SRT2104 can serve as a new treatment for OA.Jan. 2020, Cartilage, 1947603519900795 - 1947603519900795, English, International magazine[Refereed]Scientific journal
- スポーツ傷害フォーラム, 2020, スポーツ傷害, 25, 38 - 38, Japaneseスポーツ選手における半月板単独損傷に対する半月板縫合術の治療成績
- スポーツ傷害フォーラム, 2020, スポーツ傷害, 25, 43 - 43, Japanese半月板損傷治療の最前線 内側半月板損傷
- 琉球医学会, 2020, 琉球医学会誌, 39(1-4) (1-4), 94 - 94, Japanese健常成人における男性と女性の静止時及び歩行時の足底圧の評価 In shoe systemを用いた解析
- BACKGROUND: The biomechanical function of the anterolateral structure (ALS), which includes the anterolateral joint capsule and anterolateral ligament (ALL), remains a topic of debate. HYPOTHESIS: The ALS contributes to knee joint stability during the Lachman test and the pivot-shift test in anterior cruciate ligament (ACL)-deficient knees. STUDY DESIGN: Controlled laboratory study. METHODS: Fourteen fresh-frozen hemipelvis lower limbs were used. For 7 specimens, the anterior one-third of the ALS and the residual ALS were cut intra-articularly with a radiofrequency device. Subsequently, the ACL was cut arthroscopically. For the other 7 specimens, the ACL was cut first, followed by the anterior one-third of the ALS and the residual ALS intra-articularly. During the procedures, the iliotibial band (ITB) was kept intact. At each condition, the anterior tibial translation (ATT) during the manual Lachman test and the acceleration of posterior tibial translation (APT) and the posterior tibial translation (PTT) during the manual pivot-shift test were measured quantitatively with an electromagnetic measurement system. The mean values of those parameters were compared among 6 groups (ACL intact, one-third ALS cut, all ALS cut, ACL cut, ACL/one-third ALS cut, and ACL/all ALS cut). RESULTS: The mean ATTs during the Lachman test and the mean APTs and PTTs in the ACL-cut conditions (ACL cut, ACL/one-third ALS cut, and ACL/all ALS cut) were significantly larger than those under the ACL-intact conditions (ACL intact, one-third ALS cut, all ALS cut) (P < .01). However, no statistically significant differences were observed among the intact, one-third ALS-cut, and all ALS-cut conditions, within the ACL-intact or ACL-cut conditions. CONCLUSION: Intra-articular dissection of the ALS did not increase the ATT during the Lachman test or the APT and PTT during the pivot-shift test under the intact condition of the ITB, regardless of the integrity of the ACL. When the ITB is intact, the ALS does not have a significant role in either anterior or dynamic rotatory knee stability, while the ACL does. CLINICAL RELEVANCE: Recent growing interest about ALL reconstruction or ALS augmentation may not have a large role in controlling either anterior or dynamic rotatory knee instability in isolated ACL-deficient knees.Dec. 2019, The American journal of sports medicine, 47(14) (14), 3381 - 3388, English, International magazine[Refereed]Scientific journal
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S173 - S173, Japanese
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S249 - S249, Japanese
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S250 - S250, Japanese
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S171 - S171, Japanese
- PURPOSE: The purpose of this study was to quantitatively compare the results of pivot-shift test between knees with anterior cruciate ligament (ACL) injury with and without anterolateral capsule (ALC) injury detected on MRI. ALC injury was hypothesized to worsen rotatory knee laxity. METHODS: 82 patients with unilateral ACL injury were enrolled in this study. The pivot-shift test was performed under anesthesia before ACL reconstruction. Two evaluations were conducted simultaneously: IKDC clinical grading and the quantitative evaluation using an electromagnetic measurement system that determined tibial acceleration (m/s2). Two examiners identified the ALC injury on magnetic resonance imaging (MRI) and stratified patients into two groups: ALC-injured (ALC+) and ALC-intact (ALC-). ALC injury was diagnosed if the signal intensity on coronal T2-weighted sequences is increased. After confirming the reliability of the MRI, the difference in the pivot-shift between two groups was assessed. RESULTS: Because of the poor agreement between examiners with respect to the ALC evaluations (κ coefficient of 0.25 and 58.5% concordance), the result from each examiner was analyzed separately. Examiner 1 found ALC injury in 42/82 knees (51%). The two groups had similar clinical grading (glide/clunk/gross: ALC+ group 21/18/3cases vs. ALC- group 21/16/3cases) (n.s.). Tibial acceleration during pivot-shift was also similar in the ALC+ (1.4 ± 1.2 m/s2) and ALC- (1.7 ± 1.3 m/s2) groups (n.s.). Examiner 2 found ALC injury in 28/82 knees (34%). Differences in clinical grading were not observed (glide/clunk/gross: ALC+ group 16/9/3 vs. ALC- group 26/25/3) (n.s.). However, the tibial acceleration in the ALC+ group (1.2 ± 0.8 m/s2) was significantly lower than that in the ALC- group (1.7 ± 1.3 m/s2, p = 0.03). CONCLUSION: Concomitant ALC injury in knees with ACL injury was not consistently detected on MRI and did not affect rotatory knee laxity. LEVEL OF EVIDENCE: Case-control study, level III.Nov. 2019, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 27(11) (11), 3426 - 3431, English, International magazine[Refereed]Scientific journal
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1684 - S1684, Japaneseマウス変形性膝関節症モデルにおけるSIRT1活性化薬剤SRT2014投与による変形性関節症進行抑制効果
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1771 - S1771, Japanese健常成人における歩行中の足底圧評価 In shoe systemを用いた解析
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1847 - S1847, Japanese内反型変形性膝関節症患者における立位と臥位の下肢アライメントの違い 高位脛骨骨切り術の術前計画に及ぼす影響
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1920 - S1920, Japanese半月板横断裂に対するcross tie grip sutureと従来縫合法の力学試験による比較
- (公社)日本理学療法士協会, Aug. 2019, 理学療法学, 46(Suppl.1) (Suppl.1), P4 - 6, Japanese前十字靱帯再々建術または反対側再建術後1年における膝関節筋力と主観的評価の関連[Refereed]
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2019, JOSKAS, 44(3) (3), 882 - 888, Japanese体操競技に必要な倒立と身体因子との関係
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 353 - 353, English倒立時の上肢障害予防に着目した練習方法の筋活動の検討(Muscle Activity Analysis of Exercise Methods Focusing on The Prevention of Upper Limb Disorders During a Handstand)
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 260 - 260, JapaneseACL損傷膝におけるPivot-shift testのEMS計測時の脛骨前後移動の波形解析
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 300 - 300, English膝半月板横断裂に対するTie Grip Sutureと新たに開発したCross Tie Grip Sutureの強度比較試験(Biomechanical Evaluation of Cross Tie Grip Suture for Radial Meniscal Tears)
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 362 - 362, JapaneseMasquelet法により治療したサッカー選手に生じた両恥骨骨髄炎の1例
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 463 - 463, Japanese膝前十字靱帯解剖学的二重束再建術におけるOutside-in法とTrans-portal法でのGraft bending angleの比較
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 487 - 487, Japanese内反型変形性膝関節症患者における下肢長尺X線像の立位と臥位の違い 高位脛骨骨切り術の術前計画におよぼす影響
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 564 - 564, JapaneseACL遺残組織温存の賛否 前十字靱帯再建術における遺残組織に含まれる血管由来細胞の治癒能
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 698 - 698, Japanese電磁気センサーを用いた足関節前方引き出しテストの定量評価法の検証
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 700 - 700, Japanese巨大なsubchondral cystを伴う変形性足関節症に対して鏡視下外側靱帯修復術を施行しcystが縮小した1例
- (一社)中部日本整形外科災害外科学会, May 2019, 中部日本整形外科災害外科学会雑誌, 62(3) (3), 585 - 586, Japanese内側円板状半月板損傷の1症例
- PURPOSE: To identify parameters associated with deterioration of patellofemoral (PF) cartilage after open-wedge high tibial osteotomy (OWHTO) and determine predictive values. It was hypothesized that cartilage injuries in PF joints would progress after OWHTO in patients who need a large alignment correction. METHODS: Fifty-two knees in 47 patients who underwent bi-planer OWHTO for the treatment of medial compartment osteoarthritis from 2012 to 2017 and received a second-look arthroscopy at the time of plate removal (mean 14 months post-OWHTO) were assessed. Clinical outcomes were evaluated by the Knee Society Scores. Cartilage status in PF joints were evaluated arthroscopically using the International Cartilage Repair Society (ICRS) grading system. Patients were divided into two groups and patients who had progressed PF cartilage injury (progressed group) were compared with those who did not have progressed PF cartilage injuries (non-progressed group) using various parameters. The relationships between medial opening gap or change in the medial proximal tibial angle (ΔmPTA) and progression of PF cartilage injuries were examined by receiver operating characteristic (ROC) curve analysis. RESULTS: The mean Knee Society Scores were significantly improved after surgery (P < 0.01). The grades for the patella and trochlea progressed in 12 (23.0%) and 16 knees (30.8%), respectively. The mean preoperative hip-knee-ankle (HKA) angle, mechanical axis, and mPTA in the progressed group were significantly smaller than those in the non-progressed group (P < 0.01). The mean medial opening gap and ΔmPTA in the progressed group were significantly larger than those in the non-progressed group (P < 0.01). ROC curve analysis showed that the cut-off values of the medial opening gap and ΔmPTA for progression of PF cartilage injuries were 13 mm and 9°, respectively. Progression of PF cartilage injuries was more frequently observed in knees with a medial opening gap ≥ 13 mm (P = 0.019, odds ratio = 4.60) or a ΔmPTA ≥ 9° (P = 0.003, odds ratio 6.93) than knees with those of < 13 mm or 9°, respectively. CONCLUSIONS: Cartilage injuries in PF joints tended to progress after OWHTO in patients with medial opening gap ≥ 13 mm or ΔmPTA ≥ 9°. If medial opening gap is ≥ 13 mm or ΔmPTA is ≥ 9° in planning for OWHTO, other type of surgery may need to be considered to avoid early progression of PF cartilage injuries. LEVEL OF EVIDENCE: Level IV, therapeutic case series.Apr. 2019, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 27(4) (4), 1347 - 1354, English, International magazine[Refereed]Scientific journal
- (株)南江堂, Apr. 2019, 別冊整形外科, (75) (75), 100 - 103, Japanese
- (一社)日本移植学会, Mar. 2019, 移植, 53(6) (6), 381 - 381, Japanese
- (一社)中部日本整形外科災害外科学会, Mar. 2019, 中部日本整形外科災害外科学会雑誌, 62(春季学会) (春季学会), 228 - 228, Japanese大腿骨遠位骨切り術および高位脛骨骨切り術(Double-level osteotomy)後に発生したCheckrein変形の一例
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(3) (3), S727 - S727, Japanese人工足関節置換術(TAA)における距骨コンポーネント設置位置が術後の沈下量に及ぼす影響についての検討
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(3) (3), S728 - S728, Japanese人工足関節置換術後における脛骨・距骨componentの設置角度のX線学的検討
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(2) (2), S165 - S165, Japanese異なる2つの面による膝前十字靱帯解剖学的二重束再建術後の脛骨骨孔評価
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(2) (2), S324 - S324, JapaneseACL再建術の基礎と臨床 ACL再建術の向上を目指したpivot-shiftを定量的に評価するための基礎研究と臨床応用
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(2) (2), S325 - S325, Japanese膝前十字靱帯損傷の治療戦略
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(2) (2), S433 - S433, Japanese変形性足関節症に対する治療戦略 人工足関節置換術の適応と手術成績
- Mar. 2019, 関西関節鏡・膝研究会プログラム・演題抄録 31回, 28, Japanese巨大なsubchondral cystを伴う変形性足関節症に対する治療経験Research society
- Mar. 2019, 関西関節鏡・膝研究会プログラム・演題抄録 31回, 44, JapaneseACL再建術の現状と展望 膝関節不安定性の定量的評価に基づいたACL再建術の改良Research society
- PURPOSE: Concomitant meniscus injuries in the anterior cruciate ligament (ACL) have been suggested to exacerbate rotational laxity. However, the effect is supposed to be so small, if any, that some quantitative pivot-shift measurement is needed. The purpose of this prospective study was to determine the effect of meniscus tear on rotational laxity in ACL-deficient knees by an quantitative measurement. It was hypothesized that a concomitant meniscus tear, especially a lateral one, would induce greater pivot shift. METHODS: Fifty-seven unilateral ACL-injured patients (26 men and 31 women, mean age: 24 ± 10 years) were included. The pivot-shift test was performed prior to ACL reconstruction, while a quantitative evaluation using an electromagnetic system to determine tibial acceleration and a clinical grading according to the IKDC were performed. Meniscus injuries were diagnosed arthroscopically, and concomitant meniscus tear was confirmed in 32 knees. RESULTS: The clinical grade was not different between the ACL-injured knees of patients with and without meniscus tear (n.s.). Tibial acceleration did not show a statistical significant difference (meniscus-injured knees: 1.6 ± 1.1 m/s2 versus meniscus-intact knees: 1.2 ± 0.7 m/s2, n.s.). However, the subgroup analysis demonstrated that there was increased tibial acceleration in ACL-deficient knees with lateral meniscus tear (2.1 ± 1.1 m/s2, n = 13) compared with meniscus-intact knees (p < 0.05), whereas rotational laxity did not increase in the medial meniscus-injured and bilateral-injured knees (1.2 ± 0.9 m/s2, n = 12, n.s. and 1.4 ± 1.1 m/s2, n = 7, n.s., respectively). CONCLUSION: A concomitant meniscus tear, especially a lateral meniscus tear, has a significant impact on rotational laxity in ACL-injured knees. When a large pivot shift is observed in the ACL-injured knee, a concomitant meniscus tear should be suspected and an aggressive treatment would be considered. Meniscus injuries should be inspected carefully when substantial pivot shift is encountered in ACL-injured knees. LEVEL OF EVIDENCE: Diagnostic study, Level III.Feb. 2019, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 27(2) (2), 646 - 651, English, International magazine[Refereed]Scientific journal
- Jan. 2019, Journal of Orthopaedic Surgery, 27(1) (1)Scientific journal
- Background: It is still uncertain how surgical reconstruction of the anterior cruciate ligament (ACL) is able to restore rotatory laxity of the involved joint. The desired amount of restraint applied by the ACL graft, as compared with the healthy knee, has not been fully clarified. Purpose: To quantify the ability of single-bundle anatomic ACL reconstruction using hamstring tendons in reducing the pivot-shift phenomenon immediately after surgery under anesthesia. Study Design: Case series; Level of evidence, 4. Methods: An inertial sensor and image analysis were used at 4 international centers to measure tibial acceleration and lateral compartment translation of the knee, respectively. The standardized pivot-shift test was quantified in terms of the side-to-side difference in laxity both preoperatively and postoperatively with the patient under anesthesia. The reduction in both tibial acceleration and lateral compartment translation after surgery and the side-to-side difference were evaluated using the Wilcoxon signed-rank test. Alpha was set at P < .05. Results: A total of 107 patients were recruited for the study, and data were available for 89 patients. There was a statistically significant reduction in quantitative rotatory knee laxity between preoperatively (inertial sensor, 2.55 ± 4.00 m/s2; image analysis, 2.04 ± 2.02 mm) and postoperatively (inertial sensor, -0.54 ± 1.25 m/s2; image analysis, -0.10 ± 1.04 mm) between the involved and healthy joints, as measured by the 2 devices (P < .001 for both). Postoperatively, both devices detected a lower rotatory laxity value in the involved joint compared with the healthy joint (inertial sensor, 2.45 ± 0.89 vs 2.99 ± 1.10 m/s2, respectively [P < .001]; image analysis, 0.99 ± 0.83 vs 1.09 ± 0.92 mm, respectively [P = .38]). Conclusion: The data from this study indicated a significant reduction in the pivot shift when compared side to side. Both the inertial sensor and image analysis used for the quantitative assessment of the pivot-shift test could successfully detect restoration of the pivot shift after anatomic single-bundle ACL reconstruction. Future research will examine how pivot-shift control is maintained over time and correlation of the pivot shift with return to full activity in patients with an ACL injury.Dec. 2018, Orthopaedic journal of sports medicine, 6(12) (12), 2325967118812364 - 2325967118812364, English, International magazine[Refereed]
- (一社)日本臨床スポーツ医学会, Nov. 2018, 日本臨床スポーツ医学会誌, 26(4) (4), S183 - S183, Japanese
- (一社)日本臨床スポーツ医学会, Nov. 2018, 日本臨床スポーツ医学会誌, 26(4) (4), S257 - S257, Japanese
- Nov. 2018, 日本臨床スポーツ医学会誌, 26(4号) (4号), S255, Japanese前十字靱帯再建術後スポーツ復帰者の主観的評価に影響を及ぼす因子の検討Research society
- Nov. 2018, 日本臨床スポーツ医学会誌, 26(4号) (4号), S256, Japanese前十字靱帯再建術後6ヵ月での客観的指標の目標値達成と術後1年時のスポーツ復帰およびその満足度との関連[Refereed]Research society
- Nov. 2018, 日本臨床スポーツ医学会誌, 26(4号) (4号), S257, Japanese骨端線閉鎖前患者における二重束前十字靱帯再建術の術後成績Research society
- Nov. 2018, 日本臨床スポーツ医学会誌, 26(4号) (4号), S168, Japaneseスポーツ選手・愛好家における自家培養軟骨移植術の術後臨床成績Research society
- Oct. 2018, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, English, Domestic magazine[Refereed]Scientific journal
- PURPOSE: Studies have found anatomic variation in the coronal position of the insertion site of anteromedial (AM) bundle of the anterior cruciate ligament (ACL) on the tibia, which can lead to questions about tunnel placement during ACL reconstruction. The purpose of this study was to determine how mediolateral placement of the tibial AM graft tunnel in double-bundle ACL reconstructions affects knee biomechanics. METHODS: Two different types of double-bundle ACL reconstructions were performed. The AM tibial tunnel was placed at either the medial or lateral portion of tibial AM footprint. Nine cadaveric knees were tested with the robotic/universal force-moment sensor system with the use of (1) an 89.0-N anterior tibial load at full extension (FE), 30°, 60° and 90° of knee flexion and (2) a combined 7.0-Nm valgus torque and 5.0-Nm internal tibial rotation torque at FE, 15°, 30°and 45° of knee flexion. RESULTS: Both medial (2.6 ± 1.2 mm) and lateral (1.6 ± 0.9 mm) double-bundle reconstructions reduced the anterior tibial translation (ATT) to less than the intact value (3.9 ± 0.7 mm) at FE. At all other flexion angles, there was no significant different in ATT between the intact knee and the reconstructions. At FE, the ATT for the medial AM reconstruction was different from that of the lateral AM construction and closer to the intact ACL value. CONCLUSION: The coronal tibial placement of the AM tunnel had only a slight effect on knee biomechanics. In patients with differing AM bundle coronal positions, the AM tibial tunnel can be placed anatomically at the native insertion site.Oct. 2018, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 26(10) (10), 2960 - 2965, English, International magazine[Refereed]
- PURPOSE: Several non-invasive devices have been developed to obtain quantitative assessment of the pivot-shift test in clinical setting using similar but diverse measurement parameters. However, the clinical usability of those measurements has yet to be closely investigated and compared. The purpose of this study was to compare the diagnostic accuracy of three non-invasive measurement devices for the pivot-shift test. METHODS: Thirty patients with unilateral anterior cruciate ligament (ACL) injury were enrolled. The pivot-shift test was performed under general anaesthesia. Three devices, an accelerometer system (KiRA), an image analysis iPad application (iPad), and electromagnetic measurement system (EMS), were used simultaneously to provide two parameters, namely tibial acceleration monitored using KiRA and EMS, and tibial translation recorded using iPad and EMS. Side-to-side differences in each parameter and correlation between the measurements were tested, and a receiver-operating characteristic (ROC) curve analysis was conducted to compare their measurement accuracy. RESULTS: Significant side-to-side differences were successfully detected using any of the measurements (all p < 0.01). KiRA demonstrated moderate correlation with the EMS for tibial acceleration (r = 0.54; p < 0.01), while poor correlation was observed between iPad and the EMS for the translation (r = 0.28; p < 0.01). The ROC curve analysis demonstrated better accuracy for the detection of ACL insufficiency in the EMS than KiRA and iPad for tibial acceleration and translation, respectively. CONCLUSIONS: Although all three measurements were similarly capable of detecting ACL deficiency, the EMS has the advantage of comprehensive evaluation of the pivot-shift test by evaluating both tibial acceleration and translation with higher accuracy than those of KiRA and iPad. It could be suggested that any of those measurement tools might improve the clinical diagnosis of ACL insufficiency. LEVEL OF EVIDENCE: Diagnostic study of consecutive patients with a universally applied gold standard, Level Ib.Sep. 2018, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 26(9) (9), 2835 - 2840, English, International magazine[Refereed]Scientific journal
- (一社)日本整形外科スポーツ医学会, Aug. 2018, 日本整形外科スポーツ医学会雑誌, 38(4) (4), 596 - 596, Japaneseジュニア体操競技における倒立時の疼痛調査
- PURPOSE: To investigate whether an increased magnitude of quantitative rotatory knee laxity is associated with a greater level of generalized joint laxity in ACL-injured and contralateral knees. METHODS: A total of 103 patients were enrolled across four international centers to undergo anatomic ACL reconstruction. Rotatory knee laxity was evaluated preoperatively, both in the awake state and under anesthesia, using the standardized pivot shift test. Two devices were used to quantify rotatory knee laxity; an inertial sensor, measuring the joint acceleration, and an image analysis system, measuring the lateral compartment translation of the tibia. The presence of generalized joint laxity was determined using the Beighton Hypermobility Score. The correlation between the level of generalized joint laxity and the magnitude of rotatory knee laxity was calculated for both the involved knee and the non-involved knee. Further, patients were dichotomized into low (0-4) or high (5-9) Beighton Score groups. Alpha was set at < 0.05. RESULTS: Ninety-six patients had complete datasets, 83 and 13 in the low and high Beighton Score groups respectively. In anesthetized patients, there was a significant correlation between the degree of Beighton Score and quantitative pivot shift when analyzing the non-involved knee using the image analysis system (r = 0.235, p < 0.05). When analyzing the same knee, multivariate analysis adjusted for meniscal injury, age and gender revealed an increased odds ratio for patients with increased lateral compartment translation to be part of the high Beighton Score group (OR 1.86, 95% CI 1.10-3.17, p < 0.05). No other correlation was significant. When analyzing the dichotomized subgroups, no significant correlations could be established. CONCLUSION: The findings in this study suggest that there is a weak correlation between generalized joint laxity and the contralateral healthy knee, indicating increased rotatory knee laxity in these patients. Generalized joint laxity does not appear to correlate with rotatory knee laxity in ACL-injured knees. LEVEL OF EVIDENCE: Prospective cohort study; level of evidence, 2.Aug. 2018, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 26(8) (8), 2362 - 2370, English, International magazine[Refereed]
- Aug. 2018, 日本整形外科学会雑誌, 92(8号) (8号), S1619, Japanese問題解決に向けた膝前十字靱帯の基礎研究 ACL再建術後に残存する膝動的不安定性撲滅のためのpivot-shift testの定量的評価[Invited]Research society
- Aug. 2018, 日本整形外科学会雑誌, 92(8号) (8号), S1918, Japanese電磁気センサーを用いた足関節可動域の定量評価法の開発[Refereed]Research society
- Aug. 2018, 日本整形外科スポーツ医学会雑誌, 38(4号) (4号), 515, Japanese足関節と足 慢性外側足関節不安定性に対する関節鏡下外側靱帯修復(Ankle and Foot Athroscopic lateral ligament repair for chronic lateral ankle instability)(英語)Research society
- Springer Verlag, Jun. 2018, Knee Surgery, Sports Traumatology, Arthroscopy, 1 - 8, English[Refereed]Scientific journal
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2018, JOSKAS, 43(4) (4), 226 - 226, Japanese器械体操に必要な倒立姿勢と身体因子との関連性
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2018, JOSKAS, 43(4) (4), 456 - 456, JapaneseCutting Edge on Clinical Management of Chronic Lateral Ankle Instability 足関節外側不安定症に対する鏡視下外側靱帯修復術
- Springer Verlag, May 2018, Knee Surgery, Sports Traumatology, Arthroscopy, 26(5) (5), 1414 - 1419, English[Refereed]Scientific journal
- May 2018, JOSKAS, 43(4号) (4号), 290, Japanese大腿骨遠位内反骨切り術前後における膝蓋大腿関節の関節鏡視評価Research society
- May 2018, JOSKAS, 43(4号) (4号), 715, Japanese足関節外側不安定症に伴う足根洞症候群に対する鏡視下外側靱帯修復術Research society
- May 2018, JOSKAS, 43(4号) (4号), 324, Japanese前十字靱帯解剖学的二重束再建術におけるOutside-in法とTransportal法の骨孔評価 三次元コンピューター断層撮影を用いた解析Research society
- May 2018, JOSKAS, 43(4号) (4号), 715, JapaneseOs subfibulareを伴う足関節外側不安定症に対する鏡視下外側靱帯修復術の手術成績Research society
- May 2018, JOSKAS, 43(4号) (4号), 456, JapaneseCutting Edge on Clinical Management of Chronic Lateral Ankle Instability 足関節外側不安定症に対する鏡視下外側靱帯修復術Research society
- May 2018, JOSKAS, 43(4号) (4号), 327, JapaneseACL再建術後のPivot-shiftに対する前外側関節包合併損傷の影響の定量的評価による検討Research society
- (一社)日本整形外科スポーツ医学会, May 2018, 日本整形外科スポーツ医学会雑誌, 38(2号) (2号), 133 - 136, Japanese前十字靱帯損傷膝に生じるpivot-shift現象に及ぼす半月板合併損傷の影響[Refereed]Scientific journal
- PURPOSE: Final tunnel location in the anterior cruciate ligament (ACL) reconstruction is unpredictable due to tunnel widening and/or transposition. The mechanical stress around the tunnel aperture seems to be a major factor but is not fully investigated. The purpose of this study was to measure the stress from the ACL graft around the tunnel aperture when the ACL graft tension reaches its peak. METHODS: Six cadaveric knees were used. Single-bundle ACL reconstruction was performed using a hamstrings graft. Both femoral and tibial tunnels were created at the centre of the original ACL footprint. A 7-mm-internal-diameter aluminium cylinder with pressure sensors was placed in the femoral tunnel. Hamstrings graft with a microtension sensor was inserted. After fixation, passive extension-flexion was performed while monitoring the tunnel aperture pressure and the graft tension simultaneously. The pressure on the femoral tunnel aperture when the ACL graft tension reach its peak was compared between four directions. RESULTS: The ACL graft tension peaked (67 ± 49 N) at full extension (-5.8 ± 4.1°). Pressure at the femoral tunnel aperture was different between different directions (p < 0.01). Distal part had significantly larger pressure (1.7 ± 1.3 MPa) than the other directions (p < 0.01). Second largest pressure was carried in the anterior part (0.6 ± 0.5 MPa), followed by proximal and posterior parts (0.4 ± 0.3, 0.2 ± 0.2 MPa respectively). CONCLUSION: The stress distribution at the femoral tunnel aperture is not equal in different directions, while the distal part dominantly bears the stress from the ACL graft. Surgeons should pay close attention to the distal edge of the femoral tunnel which should be inside the anatomic ACL footprint eventually.Apr. 2018, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 26(4) (4), 1145 - 1151, English, International magazine[Refereed]Scientific journal
- BACKGROUND: A fluoroscopic guidance method for medial patellofemoral ligament (MPFL) reconstruction has been widely used to determine the anatomic femoral attachment site. PURPOSE: To examine the graft length change patterns in MPFL reconstruction with a fluoroscopic guidance method. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Forty-four knees of 42 patients who underwent MPFL reconstruction for the treatment of recurrent patellar dislocation were examined prospectively. During surgery, suture anchors were inserted into the proximal one-third and center of the patella. A guide pin for the femoral tunnel was inserted into the position reported by Schöttle et al based on the true lateral view of the knee under fluoroscopic control. Changes in graft length patterns of the proximal and center anchors were examined through 0° to 120° of knee flexion. Favorable changes in length patterns were defined as meeting 2 of 3 criteria: (1) not long during flexion (≤3 mm between 30° and 120° of flexion) and either (2) nearly isometric during flexion between 0° and 90° or (3) slightly long during maximum extension (≤3 mm). Other patterns were considered unfavorable. If the change in length pattern was unfavorable, then the pin for the femoral tunnel was moved to different positions until it was favorable. Knees were separated into the favorable group and the unfavorable group. Differences between the groups regarding radiographic parameters were assessed. Student t test or chi-square test was used for statistical analysis. RESULTS: Of the 44 knees, 31 (70.5%) showed favorable patterns. However, 13 knees (29.5%) showed unfavorable patterns; therefore, the position of the pin was changed. The mean ± SD distance from the original position to the final position was 5.3 ± 1.1 mm distal for 7 patients and 5.2 ± 0.4 mm posterodistal for 6 patients. Technical errors, including a nontrue lateral view and the tip of the wire not being in the determined area, were found for 4 of 13 knees in the unfavorable group. There was no statistical difference in radiographic parameters between the groups. CONCLUSION: The graft length change pattern could be nonphysiologic at the position determined through the fluoroscopic guidance method; thus, caution may be necessary. The change in length pattern should be checked before graft fixation. If the length change pattern is unfavorable, then it is advisable to move it approximately 5 to 7 mm distally or posterodistally from the first position.Apr. 2018, The American journal of sports medicine, 46(5) (5), 1150 - 1157, English, International magazine[Refereed]Scientific journal
- 関西関節鏡・膝研究会, Mar. 2018, 関西関節鏡・膝研究会プログラム・演題抄録, 30回, 28 - 28, Japanese外傷後の大腿骨内反変形を伴った変形性膝関節症に対して大腿骨遠位外反骨切り術を施行した1例
- 関西関節鏡・膝研究会, Mar. 2018, 関西関節鏡・膝研究会プログラム・演題抄録, 30回, 43 - 43, Japanese膝関節再生の現状と展望
- Mar. 2018, 日本整形外科学会雑誌, 92(3号) (3号), S1092, Japanese膝前十字靱帯損傷の治療Research society
- Mar. 2018, 日本整形外科学会雑誌, 92(2号) (2号), S433, Japanese半月板温存を目指した治療 半月水平断裂に対する治療戦略[Invited]Research society
- Mar. 2018, 日本整形外科学会雑誌, 92(3号) (3号), S672, Japanese当科における人工足関節置換術(TAA)での、術後骨溶解(osteolysis)のZone分類と評価[Refereed]Research society
- Mar. 2018, 日本整形外科学会雑誌, 92(3号) (3号), S670, Japanese当科における人工距骨併用人工足関節置換術(combined TAA)の治療成績と適応の検討Research society
- Mar. 2018, 日本整形外科学会雑誌, 92(2号) (2号), S387, Japanese足部・足関節疾患および外傷に対する保存療法-Evidence based conservative treatment- アキレス腱断裂に対する保存療法[Refereed]Scientific journal
- Mar. 2018, 日本整形外科学会雑誌, 92(2号) (2号), S445, Japanese前十字靱帯再建術-Update- 回旋不安定性の評価に基づくACL再建術の進歩[Invited]Research society
- Mar. 2018, 日本整形外科学会雑誌, 92(3号) (3号), S672, Japanese人工足関節置換術後における距骨下関節代償機能のX線学的検討Research society
- Springer-Verlag Berlin Heidelberg, Jan. 2018, Return to Play in Football: An Evidence-based Approach, 237 - 244, EnglishIn book
- スポーツ傷害フォーラム, Jan. 2018, スポーツ傷害, 23, 5 - 5, JapaneseRevision ACL再建術の臨床成績
- スポーツ傷害フォーラム, Jan. 2018, スポーツ傷害, 23, 10 - 10, Japaneseアキレス腱付着部症に対してsuture bridge法にPercutaneous Achilles Repair System(PARS)を併用して加療した2例
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S169 - S169, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S193 - S193, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S245 - S245, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S246 - S246, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S247 - S247, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S252 - S252, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S181 - S181, Japanese
- PURPOSE: The main goal of this work was to evaluate the pivot shift test in awake and anesthetized patients by using two different quantitative methodologies and comparing the results with the standard clinical grading, taking advantage of a multicenter international study. METHODS: Patients between 16 and 50 years of age undergoing primary unilateral single-bundle anterior cruciate ligament (ACL) reconstruction were considered eligible. The pivot shift test was performed pre-operatively, with the patient awake and again with the patient under general anaesthesia. The pivot shift test was clinically graded as defined by the International Knee Documentation Committee. The instrumented assessment was performed by using two non-invasive acquisition systems; specifically, a system exploiting an inertial sensor and a video-based application developed on a commercial tablet using skin markers. Lateral compartment translation and the tibial acceleration reached during joint reduction were used as quantitative parameters. RESULTS: A total of 103 patients were enrolled in the study. Statistically significant difference was found between the distributions of clinical grade evaluated in awake patients and those under general anaesthesia (P < 0.01). Comparing awake patients to those under general anaesthesia, lower values were found both for tibial acceleration (3.7 ± 1.5 vs 6.0 ± 4.6 m/s2, P < 0.01) and lateral compartment translation of the involved limb (2.2 ± 1.7 vs 3.0 ± 2.2 mm, P < 0.01). CONCLUSIONS: This study indicated that significant differences in the grading of the pivot shift test exist between awake and anesthetized patients, regardless of the use of quantitative instruments during the evaluation. Actual clinical assessment reported indeed its weakness, presenting subjective variability and dependence on tester's experience. However, several factors might influence the validity of awake examination such as experience level of examiner and cultural factors, as seen in this international multicenter study. LEVEL OF EVIDENCE: Prospective comparative study, Level II.Oct. 2017, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 25(10) (10), 3004 - 3011, English, International magazine[Refereed]
- (一社)中部日本整形外科災害外科学会, Sep. 2017, 中部日本整形外科災害外科学会雑誌, 60(秋季学会) (秋季学会), 83 - 83, Japanese前十字靱帯不全膝における術前待機期間がpivot shift test脛骨整復時の加速度に及ぼす影響
- (一社)日本整形外科スポーツ医学会, Aug. 2017, 日本整形外科スポーツ医学会雑誌, 37(4) (4), 592 - 592, Japanese高等学校におけるスポーツ活動支援事業の利用状況とその意義
- (一社)日本整形外科スポーツ医学会, Aug. 2017, 日本整形外科スポーツ医学会雑誌, 37(4) (4), 394 - 394, JapaneseACL損傷膝に合併する前外側関節包損傷のMRI評価の限界
- (一社)日本整形外科スポーツ医学会, Aug. 2017, 日本整形外科スポーツ医学会雑誌, 37(4) (4), 522 - 522, Japanese前十字靱帯損傷に生じる膝回旋不安定性に及ぼす半月板合併損傷の影響
- (公社)日本整形外科学会, Aug. 2017, 日本整形外科学会雑誌, 91(8) (8), S1800 - S1800, Japanese三次元CTを用いたquadrant法による膝前十字靱帯解剖学的二重束再建術後骨孔評価方法の信頼性の検討
- [Purpose] The present study was to validate the importance of the trunk function evaluated by trunk righting test (TRT) with motor function in patients with knee osteoarthritis (OA) and to show the clinical use of TRT. [Subjects and Methods] This study included 50 patients with knee osteoarthritis who underwent total knee arthroplasty in our hospital. Correlations between physical functional test, such as muscle strength, balance function, and performance and TRT were statistically evaluated. [Results] The independent factors for ipsilateral TRT were maximal isometric knee extensor strength test and ipsilateral step test. The operator and non-operator side TRT were significantly associated with TUG. [Conclusion] The results showed that the physical functions are correlated with the trunk function evaluated by TRT of patients with knee OA, suggesting that healthcare workers must take into consideration the trunk function, as well as lower extremity function to improve physical function.Jun. 2017, Journal of physical therapy science, 29(6) (6), 996 - 1000, English, Domestic magazine[Refereed]
- Jun. 2017, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 33(6) (6), 1204 - 1210, English, International magazine[Refereed]Scientific journal
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2017, JOSKAS, 42(4) (4), 239 - 239, JapaneseACL再建術後の動的不安定性残像の撲滅を目指して 残存する動的不安定性の撲滅のためのPivot shift testの客観・定量的評価
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2017, JOSKAS, 42(4) (4), 240 - 240, JapaneseACL再建術後の動的不安定性残像の撲滅を目指して 膝関節前外側支持機構の生体力学的解析 屍体膝実験からの知見をふまえて
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2017, JOSKAS, 42(4) (4), 247 - 247, Japanese関節の再生医療2017 軟骨細胞による再生医療
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2017, JOSKAS, 42(4) (4), 418 - 418, Japaneseアキレス腱付着部障害に対してsuture bridge法にPercutaneous Achilles Repair System(PARS)を併用して加療した1例
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2017, JOSKAS, 42(4) (4), 559 - 559, Japanese前十字靱帯不全膝における術前待機期間がpivot shift test脛骨整復時の加速度に及ぼす影響
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2017, JOSKAS, 42(4) (4), 696 - 696, Japanese三次元CTを用いたQuadrant法による膝前十字靱帯解剖学的二重束再建術後骨孔評価方法の信頼性の検討
- Apr. 2017, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 25(4) (4), 1279 - 1289, English, International magazine[Refereed]Scientific journal
- 関西関節鏡・膝研究会, Mar. 2017, 関西関節鏡・膝研究会プログラム・演題抄録, 29回, 24 - 24, Japanese前十字靱帯断裂に伴う前外側関節包(ALC)損傷の回旋不安定性に対する影響についての調査
- (公社)日本整形外科学会, Mar. 2017, 日本整形外科学会雑誌, 91(2) (2), S214 - S214, Japanese前十字靱帯断裂に伴う前外側関節包靱帯損傷の回旋不安定性に対する影響についての検討
- (公社)日本整形外科学会, Mar. 2017, 日本整形外科学会雑誌, 91(2) (2), S239 - S239, JapaneseX線透視下大腿骨骨孔位置同定法を用いた内側膝蓋大腿靱帯再建術における再建靱帯の長さ変化
- W.B. Saunders, Mar. 2017, Operative Techniques in Orthopaedics, 27(1) (1), 14 - 19, English[Refereed]Scientific journal
- The Influence of Meniscal and Anterolateral Capsular Injury on Knee Laxity in Patients With Anterior Cruciate Ligament Injuries.BACKGROUND: The role of the anterolateral capsule (ALC) as a secondary restraint to quantitative rotatory laxity of patients with an anterior cruciate ligament (ACL) injury is currently debated. PURPOSE/HYPOTHESIS: The purpose was to determine the influence of concomitant ALC injuries as well as injuries to other soft tissue structures on rotatory knee laxity in patients with an ACL injury. It was hypothesized that a concomitant ALC injury would be associated with increased rotatory knee laxity as measured during a quantitative pivot-shift test. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Forty-one patients with an ACL injury (average age, 23 ± 6.9 years) were enrolled. Two blinded musculoskeletal radiologists reviewed magnetic resonance imaging (MRI) scans for the presence of ACL injuries and concomitant soft tissue injuries including the ALC, medial collateral ligament, lateral collateral ligament, posterolateral corner, medial meniscus, and lateral meniscus. A standardized pivot-shift test was performed under anesthesia, and rotatory laxity was quantified according to anterior translation of the lateral tibial compartment during the pivot-shift maneuver. The Student t test was used to analyze the data. Statistical significance was set at P < .05. RESULTS: A complete ACL rupture was confirmed in all of the patients. MRI evidence of an ALC injury was observed in 21 (51%) of the patients. Patients with MRI evidence of an ALC injury had significantly higher rotatory knee laxity (3.6 ± 1.5 mm) compared with those without an ALC injury (2.7 ± 1.5 mm; P = .04). Lateral and medial meniscus injuries were detected in 17 (41%) and 19 (46%) patients, respectively. Patients with MRI evidence of either a medial meniscus injury or lateral meniscus injury had significantly higher rotatory knee laxity compared with patients without these injuries (medial meniscus: 3.7 ± 1.4 mm vs 2.7 ± 1.6 mm, respectively; lateral meniscus: 3.7 ± 1.7 mm vs 2.7 ± 1.3 mm, respectively) (P = .03 for both). CONCLUSION: MRI evidence of a concomitant injury to the ALC, medial meniscus, or lateral meniscus is associated with increased knee rotatory laxity in patients with an ACL injury. These structures may function as important secondary stabilizers in an ACL-injured knee. Careful assessment and proper treatment of injuries to these secondary stabilizers should be considered, especially in knees with a high level of the pivot shift.Dec. 2016, The American journal of sports medicine, 44(12) (12), 3126 - 3131, English, International magazine[Refereed]
- PURPOSE: To evaluate the effect of knee flexion angle for hamstring graft fixation, full extension (FE), or 30°, on acceleration of the knee motion during pivot-shift testing after either anatomic or nonanatomic anterior cruciate ligament (ACL) reconstruction using triaxial accelerometry. METHODS: Two types of ACL reconstructions (anatomic and nonanatomic) using 2 different angles of knee flexion during graft fixation (FE and 30°) were performed on 12 fresh-frozen human knees making 4 groups: anatomic-FE, anatomic-30°, nonanatomic-FE, and nonanatomic-30°. Manual pivot-shift testing was performed at ACL-intact, ACL-deficient, and ACL-reconstructed conditions. Three-dimensional acceleration of knee motion was recorded using a triaxial accelerometer. RESULTS: The anatomic-30° group showed the smallest overall magnitude of acceleration among the ACL-reconstructed groups (P = .0039). There were no significant differences among the anatomic-FE group, the nonanatomic-FE group, and the nonantomic-30° group (anatomic-FE vs nonanatomic-FE, P = .1093; anatomic-FE vs nonanatomic-30°, P = .8728; and nonanatomic-FE vs nonanatomic-30°, P = .1093). After ACL transection, acceleration was reduced by ACL reconstruction with the exception of the nonanatomic-FE group that did not show a significant difference when compared with the ACL-deficient (P = .4537). CONCLUSIONS: The anatomic ACL reconstruction with the graft fixed at 30° of knee flexion better restored rotational knee stability compared with FE. An ACL graft fixed with the knee at FE in anatomic position did not show a significant difference compared with the nonanatomic ACL reconstructions. CLINICAL RELEVANCE: Knee flexion angle at the time of graft fixation for ACL reconstruction can be considered to maximize the rotational knee stability.Nov. 2016, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 32(11) (11), 2322 - 2328, English, International magazine[Refereed]
- BACKGROUND: Prior attempts to quantify the pivot-shift examination have been too invasive or impractical for clinical use. A noninvasive method for quantifying rotatory knee laxity is needed. HYPOTHESIS: Greater quantitative measurements of rotatory knee laxity (both of the involved knee as well as compared with the contralateral healthy knee) are associated with an increasing clinical pivot-shift grade. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 103 patients undergoing anatomic single-bundle anterior cruciate ligament (ACL) reconstruction at 4 international centers underwent a standardized pivot-shift test preoperatively on both knees while anesthetized. Clinical grading of the pivot shift was performed according to the International Knee Documentation Committee (IKDC) knee ligament rating system. Two different quantitative technologies were used to measure rotatory knee laxity: an inertial sensor and an image analysis were independently used to measure tibial acceleration and lateral compartment translation, respectively, during the pivot-shift test. Patients were dichotomized to "high-grade" (abnormal and severely abnormal) or "low-grade" (normal and nearly normal) rotatory knee laxity groups based on the clinical pivot-shift test result of the involved side. Tibial acceleration and lateral compartment translation of the involved knee and the side-to-side difference between the involved and contralateral knees were separately compared between the high- and low-grade rotatory knee laxity groups utilizing t tests; significance was set at P < .05. RESULTS: Forty-three patients were in the low-grade rotatory knee laxity group, and 60 patients were in the high-grade rotatory knee laxity group. Patients in the high-grade knee laxity group had significantly higher lateral compartment translation as measured with the image analysis (involved knee: 3.8 ± 2.3 mm; side-to-side difference: 2.5 ± 2.4 mm) compared with patients in the low-grade group (involved knee: 2.0 ± 1.4 mm; side-to-side difference: 1.4 ± 1.5 mm) (both P < .01). As measured with the inertial sensor, tibial acceleration for patients in the high-grade group was significantly higher (involved knee: 7.2 ± 5.3 m/s(2); side-to-side difference: 4.2 ± 5.4 m/s(2)) compared with patients in the low-grade group (involved knee: 4.2 ± 1.6 m/s(2); side-to-side difference: 1.2 ± 1.2 m/s(2)) (both P < .01). CONCLUSION: The inertial sensor and image analysis techniques were able to detect differences between low- and high-grade pivot-shift test results. A quantitative assessment of the pivot-shift test could augment the diagnosis of an ACL injury and improve the ability to detect changes in rotatory knee laxity over time.Sep. 2016, The American journal of sports medicine, 44(9) (9), 2393 - 8, English, International magazine[Refereed]
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2016, JOSKAS, 41(4) (4), 411 - 411, Japanese内側膝蓋大腿靱帯再建術におけるX線透視下に決定した大腿骨骨孔位置での再建靱帯の長さ変化の検討
- Jul. 2016, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 32(7) (7), 1359 - 66, English, International magazine[Refereed]Scientific journal
- PURPOSE: Arthroscopic images are subject to distortion, which may increase when using arthroscope lenses with greater reflecting angles and/or viewing structures at oblique angles. The purpose of this study was to determine the magnitude of image distortion experienced when using arthroscopes with different lens angles and when the line-of-sight (i.e., viewing angle) is not directly perpendicular to the target. METHODS: A dot calibration target was captured through 0°, 30°, and 70° arthroscopes from straight (i.e., directly perpendicular) and 30° oblique viewing angles. Distortions in horizontal and vertical distances in deep (located at 87.5 % length of arthroscopic image diameter) or shallow (12.5 % diameter length) regions were calculated, from which a deformity ratio (horizontal/vertical distance) was determined. RESULTS: From the straight viewing angle (0°), both horizontal and vertical distances were artificially reduced (i.e., <100 % magnification) in the shallow and deep regions. The deformity ratio was ~100 % in the central region, declining to ~80 % peripherally. From the oblique viewing angle (30°), magnification was below 100 % in the deep area but exceeded 100 % in the shallow area, with increasing distortion associated with increasing lens angle (0° < 30° < 70°). For all lens angles, the deformity ratio was ~50 % in the deep area but neared 100 % in the shallow region. CONCLUSIONS: Arthroscopic image distortion in peripheral regions should be considered when using angled-lens arthroscopes, especially when the viewing angle is not straight. As viewing the femoral ACL footprint through the anterolateral portal involves using an oblique viewing angle, visualization through the anteromedial portal is recommended.Jun. 2016, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 24(6) (6), 2065 - 71, English, International magazine[Refereed]
- PURPOSE: Distortion in arthroscopic views can interfere with accurate graft placement in ACL reconstruction, yet the effect of arthroscopic lens angle and portal location on image distortion is unknown. The purpose of this study was to quantify the image distortion resulting from the use of angulated arthroscope lenses through multiple portals, thereby identifying the optimal parameters to minimize distortion. METHODS: A uniform grid of dots was attached to the lateral wall of the intercondylar notch of a Sawbones(®) knee model. The inferior half of the lateral wall was divided equally along the distoproximal axis into three regions-shallow, central, and deep. Each region was imaged using five different arthroscopic configurations [0° arthroscope through anteromedial (AM) portal, 30° arthroscope through AM and anterolateral (AL) portals, 70° arthroscope through AM and AL portals]. For each configuration, the differences in magnification and deformity ratios between the three regions were calculated. RESULTS: Less than 100 % of central region magnification was observed in the deep region, while more than 100 % was found in the shallow region. The AL approach produced larger magnification errors in the shallow region, as compared to the AM approach. Deformity ratios less than 100 % were found with both 0° and 30° arthroscopes, whereas deformity ratios exceeding 100 % were found with 70° arthroscopes. CONCLUSIONS: The least distorted and the most consistent image of the femoral ACL insertion is provided through the AM portal using either a 30° or 70° arthroscope lens. Surgeons should carefully select the arthroscope and portal to minimize image distortion and ensure accurate surgical procedure.Jun. 2016, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 24(6) (6), 2072 - 8, English, International magazine[Refereed]
- Current reconstructive methods used after anterior cruciate ligament (ACL) injury do not entirely restore native knee kinematics. Evaluation of dynamic knee laxity is important to accurately diagnose ACL deficiency, to evaluate reconstructive techniques, and to construct treatment algorithms for patients with ACL injury. The purpose of this study is to present recent progress in evaluation of dynamic knee laxity through utilization of the pivot shift test. A thorough electronic search was performed and relevant studies were assessed. Certain dynamic knee laxity measurement methods have been present for over 10 years (Navigation system, Electromagnetic sensor system) while other methods (Inertial sensor, Image analysis system) have been introduced recently. Methods to evaluate dynamic knee laxity through the pivot shift test are already potent. However, further refinement is warranted. In addition, to correctly quantify the pivot shift test, the involved forces need to be controlled through either standardization or mechanization of the pivot shift test.Jun. 2016, Current reviews in musculoskeletal medicine, 9(2) (2), 148 - 59, English, International magazine[Refereed]
- The pivot-shift test is an important examination to assess the rotational laxity in the anterior cruciate ligament (ACL) injured and reconstructed knees. Because this examination is related to subjective knee function, we may still see cases that have residual rotational laxity after ACL reconstruction. Quantitative evaluation of the pivot-shift test is preferable to the clinical pivot-shift test but is difficult to attain mainly due to complicated movements of the pivot-shift. The electromagnetic tracking system was developed to evaluate knee kinematics during the pivot-shift, providing information related to 6-degree-of-freedom knee kinematics with a high sampling rate. Through this device, the abnormal movement of the pivot-shift is characterized in two phases: an increased anterior tibial translation and a boosted acceleration of tibial posterior reduction. Since its invention, this system has been utilized to assess rotational laxity for clinical follow-up and research after the ACL reconstruction.Jun. 2016, Current reviews in musculoskeletal medicine, 9(2) (2), 164 - 9, English, International magazine[Refereed]
- Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai), Mar. 2016, Rigakuryoho Kagaku, 31(1) (1), 49 - 52, Chinese[Refereed]Scientific journal
- 関西関節鏡・膝研究会, Mar. 2016, 関西関節鏡・膝研究会プログラム・演題抄録, 28回, 37 - 37, Japanese膝離断性骨軟骨炎 若年者膝離断性骨軟骨炎の治療
- Feb. 2016, Information (Japan), 19(2) (2), 695 - 704An evaluation method of hardness on quantitative measurement system for lachman test using force sensorScientific journal
- (一社)理学療法科学学会, Feb. 2016, 理学療法科学, 31(1) (1), 49 - 52, Japanese
- Springer International Publishing, Jan. 2016, Rotatory Knee Instability: An Evidence Based Approach, 269 - 276, EnglishIn book
- The pivot shift test is a commonly used clinical examination by orthopedic surgeons to evaluate knee function following injury. However, the test can only be graded subjectively by the examiner. Therefore, the purpose of this study is to develop software for a computer tablet to quantify anterior translation of the lateral knee compartment during the pivot shift test. Based on the simple image analysis method, software for a computer tablet was developed with the following primary design constraint - the software should be easy to use in a clinical setting and it should not slow down an outpatient visit. Translation of the lateral compartment of the intact knee was 2.0 ± 0.2 mm and for the anterior cruciate ligament-deficient knee was 8.9 ± 0.9 mm (p < 0.001). Intra-tester (ICC range = 0.913 to 0.999) and inter-tester (ICC = 0.949) reliability were excellent for the repeatability assessments. Overall, the average percent error of measuring simulated translation of the lateral knee compartment with the tablet parallel to the monitor increased from 2.8% at 50 cm distance to 7.7% at 200 cm. Deviation from the parallel position of the tablet did not have a significant effect until a tablet angle of 45°. Average percent error during anterior translation of the lateral knee compartment of 6mm was 2.2% compared to 6.2% for 2 mm of translation. The software provides reliable, objective, and quantitative data on translation of the lateral knee compartment during the pivot shift test and meets the design constraints posed by the clinical setting.2016, Computer methods in biomechanics and biomedical engineering, 19(2) (2), 217 - 28, English, International magazine[Refereed]Scientific journal
- Oct. 2015, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 23(10) (10), 2876 - 81, English, International magazine[Refereed]Scientific journal
- Sep. 2015, 日本整形外科学会雑誌, 89(8号) (8号), S1744, Japaneseバイオメカニクスによる運動器疾患の病態解明 前十字靱帯損傷膝の定量評価[Refereed][Invited]Research society
- Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai), Jun. 2015, Rigakuryoho Kagaku, 30(2) (2), 329 - 332, English[Refereed]Scientific journal
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2015, JOSKAS, 40(4) (4), 232 - 232, Japanese体幹の荷重支持機能の左右差がジャンプ動作に与える影響
- Jun. 2015, JOSKAS, 40(4号) (4号), 203, Japanese軟骨再生の臨床経験[Invited]Research society
- [Purpose] To investigate whether an objective evaluation method for trunk function, namely the "trunk righting test", is reproducible and reliable by testing on different observers (from experienced to beginners) and by confirming the test-retest reliability. [Subjects] Five healthy subjects were evaluated in this correlation study. [Methods] A handheld dynamometer was used in the assessments. The motor task was a trunk righting motion by moving the part with the sensor pad 10 cm outward from the original position. During measurement, the posture was held at maximum effort for 5 s. Measurement was repeated three times. Interexaminer reproducibility was examined in two physical therapists with 1 year experience and one physical therapist with 7 years of experience. The measured values were evaluated for reliability by using intraclass correlation coefficients (ICC 1.1) and interclass correlation coefficients (ICC 2.1). [Results] The test-retest reliability ICC 1.1 and ICC 2.1 were all high. The ICC 1.1 was >0.90. The ICC 2.1 was 0.93. [Conclusion] We developed the trunk righting test as a novel objective evaluation method for trunk function. As the study included inexperienced therapists, the results suggest that the trunk righting test could be used in the clinic, independent of the experience of the therapists.May 2015, Journal of physical therapy science, 27(5) (5), 1633 - 6, English, Domestic magazine[Refereed]
- May 2015, Journal of Advanced Computational Intelligence and Intelligent Informatics, 19(3) (3), 372 - 380[Refereed]Scientific journal
- Mar. 2015, 日本整形外科学会雑誌, 89(3号) (3号), S744, Japanese前十字靱帯解剖学的二重束再建術において大腿骨側骨孔間距離が術後骨孔拡大に及ぼす影響[Refereed]Research society
- BACKGROUND: The morphology of the supraspinatus tendon may affect tear propagation. It was hypothesized that tears located in the anterior third of the supraspinatus tendon would propagate more readily and would require lower loads to reach critical amounts of tear propagation than those located in the middle third of the supraspinatus tendon. METHODS: Twenty-three fresh-frozen human cadaveric shoulders were tested under increasing levels of cyclic loading. Tears were created in the anterior third (Group A, n=10) or the middle third (Group M, n=13) of the supraspinatus tendon. The maximum load at which a critical tear retraction was reached and the tear area for the final loading set were compared between groups. A correlation analysis was also performed for age compared with maximum load. RESULTS: No significant differences were found between the anterior-third tear group (Group A) and the middle-third tear group (Group M) in maximum load (p=0.09) or tear area (p=0.6). However, Group A first reached a 100% increase in tear size at a significantly lower load than Group M (p=0.03). Strong negative correlations were detected between age and maximum load in Group A (τ=-0.82) and Group M (r=-0.63). CONCLUSIONS: Other factors being equal, tears in the anterior supraspinatus tendon may propagate more readily than tears in the tendon's middle part. Age may be a factor for tear propagation. CLINICAL RELEVANCE: Older patients and patients with tears in the anterior supraspinatus should be followed especially carefully.Feb. 2015, The Journal of bone and joint surgery. American volume, 97(4) (4), 273 - 8, English, International magazine[Refereed]Scientific journal
- Fuji Technology Press, 2015, Journal of Advanced Computational Intelligence and Intelligent Informatics, 19(6) (6), 778 - 784, EnglishScientific journal
- Springer Berlin Heidelberg, Jan. 2015, Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Second Edition, 831 - 839, English[Refereed]In book
- (一社)日本臨床スポーツ医学会, Oct. 2014, 日本臨床スポーツ医学会誌, 22(4) (4), S157 - S157, Japanese
- Sep. 2014, IEEE International Conference on Fuzzy Systems, 1831 - 1836[Refereed]International conference proceedings
- UNLABELLED: The pivot shift test is the only physical examination test capable of predicting knee function and osteoarthritis development after an ACL injury. However, because interpretation and performance of the pivot shift are subjective in nature, the validity of the pivot shift is criticized for not providing objective information for a complete surgical planning for the treatment of rotatory knee laxity. The aim of ACL reconstruction was eliminating the pivot shift sign. Many structures and anatomical characteristics can influence the grading of the pivot shift test and are involved in the genesis and magnitude of rotatory instability after an ACL injury. The objective quantification of the pivot shift may be able to categorize knee laxity and provide adequate information on which structures are affected besides the ACL. A new algorithm for rotational instability treatment is presented, accounting for patients' unique anatomical characteristics and objective measurement of the pivot shift sign allowing for an individualized surgical treatment. LEVEL OF EVIDENCE: V.Sep. 2014, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 22(9) (9), 1966 - 75, English, International magazine[Refereed]
- BACKGROUND: The femoral and tibial bone tunnel enlargement after anatomic double-bundle anterior cruciate ligament reconstruction (ACL-R) has not been fully documented. PURPOSE: To evaluate the region-specific bone tunnel volume changes and those transpositions using 3-dimensional multidetector-row computed tomography (MDCT) after anatomic double-bundle ACL-R. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Eleven patients who underwent unilateral double-bundle ACL-R with hamstring tendon autografts were included in this study. MDCT scanning of their knees was performed at 3 weeks and 1 year after surgery. The bone tunnel regions were extracted from the MDCT images, and the longitudinal axis of each bone tunnel was divided into 3 equal sections. The centroids of the outside and the articular thirds were then extracted from the bone tunnel position. Changes in the bone tunnel volume and the transposition of the articular third were calculated and compared. RESULTS: At 1 year postoperatively, as compared with the 3-week postoperative value (set at 100%), the femoral bone tunnel volume of the anteromedial bundle (AMB) and posterolateral bundle (PLB) changed to 77.4% ± 15.3% and 102.3% ± 19.2% in the outside third and 122.3% ± 31.8% and 112.5% ± 34.4% in the articular third, respectively. The tibial bone tunnel volume of the AMB and the PLB changed to 108.6% ± 28.7% and 105.4% ± 22.6% in the tibial articular third and 54.9% ± 25.8% and 52.5% ± 26.9% in the outside third, respectively. The femoral outside third of the AMB and the tibial outside third of both the AMB and PLB were significantly reduced in bone tunnel volume. The centroid of the femoral articular third of the AMB moved 13°, 1.1 ± 0.6 mm posterodistally, and that of the PLB moved 35°, 0.8 ± 0.4 mm anterodistally. Furthermore, the centroid of the tibial articular third of the AMB moved 14°, 2.0 ± 1.6 mm posterolaterally, and that of the PLB moved 72°, 1.0 ± 1.3 mm posterolaterally. CONCLUSION: Compared with 3 weeks postoperatively, the articular side outlets of the femoral and tibial bone tunnels at 1 year postoperatively had enlarged slightly but statistically maintained their volume, and they had moved a little in the direction that the grafts were pulled.Sep. 2014, The American journal of sports medicine, 42(9) (9), 2234 - 41, English, International magazine[Refereed]Scientific journal
- Sep. 2014, Journal of Advanced Computational Intelligence and Intelligent Informatics, 18(5) (5), 830 - 838[Refereed]Scientific journal
- Jul. 2014, Orthopaedic Journal of Sports Medicine, 2[Refereed]Scientific journal
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2014, JOSKAS, 39(4) (4), 98 - 98, JapaneseACL損傷に対する治療の現状と今後の戦略 膝前十字靱帯(ACL)損傷の術前・術後評価法
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2014, JOSKAS, 39(4) (4), 391 - 391, JapaneseMDCTを用いた前十字靱帯解剖学的二重束再建術後骨孔拡大の検討
- PURPOSE: Recently, single-bundle (SB) anterior cruciate ligament (ACL) reconstruction has been advanced by the anatomic concept, but the biomechanical outcome of the anatomic method has not been fully investigated, especially for rotational instability. Anatomic SB and the single over-the-top procedures are the treatment of choice for primary cases and revision or skeletally immature cases, respectively. The purpose of this study was to investigate the dynamic rotational instability of anatomic SB and over-the-top reconstruction during a pivot shift test using triaxial accelerometry. METHODS: Eight fresh frozen human cadaveric knees were used in this study. Rotational instability measurement was conducted during a pivot shift test by the use of a triaxial accelerometer attached to the tibia. The tests were performed in the ACL-intact, ACL-deficient and ACL-reconstructed knees with two different procedures (anatomic SB and over-the-top). The acceleration in three directions and the magnitude of acceleration were measured to evaluate rotational instability and compare between four different knee states. RESULTS: The overall magnitude of acceleration was significantly different (P < 0.01) between the ACL-intact knees and the ACL-deficient knees. Both anatomic SB and over-the-top ACL reconstruction significantly reduced the overall magnitude of acceleration compared to the ACL-deficient knees, but still had larger accelerations compared to the ACL-intact knees. There was no significant difference for the overall magnitude of acceleration between anatomic SB and over-the-top reconstruction procedure. CONCLUSION: Over-the-top reconstruction provides comparable result to anatomic SB reconstruction in terms of controlling the dynamic rotational stability. Over-the-top reconstruction might be one of the options for revision cases and in skeletally immature patients.May 2014, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 22(5) (5), 972 - 8, English, International magazine[Refereed]
- PURPOSE: To compare the tunnel enlargement of double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) with and without suturing of autologous ruptured tissue to hamstring graft in patients with subacute anterior cruciate ligament injury. METHODS: Ten patients with subacute (≤3 months after injury) anterior cruciate ligament rupture were randomly allocated to undergo DB ACLR with suturing of the ruptured tissue to hamstring graft (n = 5) or conventional DB ACLR (n = 5). When autologous ruptured tissue was used, remnant ruptured tissue was then harvested, divided into 4 pieces, placed between the loops at the distal and proximal portions of the graft, and secured with the suture. As the primary endpoint, tunnel volume assessment by 3-dimensional multi-detector row computed tomography (MDCT) was performed 1 year after ACLR. To assess the efficacy of these procedures, the Lysholm score, anterior tibial translation (measured with a KT-1000 arthrometer [MEDmetric, San Diego, CA]), and rotational instability (measured by the pivot-shift test) were evaluated after 2 years. RESULTS: Tunnel volume enlargement between 3 weeks and 1 year after ACLR as assessed by 3-dimensional MDCT was significantly less for ACLR using ruptured tissue than for conventional ACLR, especially at the femoral site (P < .05). However, the postoperative Lysholm score, anterior stability of the knee measured with the KT-1000 arthrometer, and rate of negative manual pivot-shift test results did not differ significantly between the 2 groups. There was no correlation to the clinical outcomes in terms of tunnel size. CONCLUSIONS: The Lysholm score, anterior laxity measured with the KT-1000 arthrometer, and rotational instability according to the pivot-shift test did not differ significantly between ACLR using ruptured tissue and the conventional technique. However, ACLR using ruptured tissue produced less femoral tunnel enlargement as assessed by MDCT, warranting further long-term follow-up to elucidate its effectiveness. LEVEL OF EVIDENCE: Level II, prospective comparative study.Apr. 2014, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 30(4) (4), 468 - 74, English, International magazine[Refereed]Scientific journal
- (公社)日本整形外科学会, Mar. 2014, 日本整形外科学会雑誌, 88(3) (3), S1001 - S1001, Japanese3D-MDCTを用いた前十字靱帯再建術後骨孔拡大の検討 解剖学的一重束再建術と二重束再建術との比較
- Feb. 2014, 2014 Joint 7th International Conference on Soft Computing and Intelligent Systems, SCIS 2014 and 15th International Symposium on Advanced Intelligent Systems, ISIS 2014, 741 - 744[Refereed]International conference proceedings
- 2014, PROCEEDINGS OF THE FIFTH INTERNATIONAL SYMPOSIUM ON TEST AUTOMATION & INSTRUMENTATION, VOLS 1 AND 2, 262 - 267, EnglishReal-time 3D reconstruction of endoscopy and microfiber line laser[Refereed]International conference proceedings
- 2014, 2014 WORLD AUTOMATION CONGRESS (WAC): EMERGING TECHNOLOGIES FOR A NEW PARADIGM IN SYSTEM OF SYSTEMS ENGINEERING, EnglishAutomated Extraction of Tibial Eminence in CT Image Using Shape Matching[Refereed]International conference proceedings
- 2014, 2014 IEEE INTERNATIONAL CONFERENCE ON SYSTEMS, MAN AND CYBERNETICS (SMC), 3936 - 3940, EnglishAn Evaluation of Bimodality on Quantitative Measurement System for Lachman Test Using Force Sensor[Refereed]International conference proceedings
- 2014, 2014 IEEE INTERNATIONAL CONFERENCE ON FUZZY SYSTEMS (FUZZ-IEEE), 1831 - 1836, EnglishAn Automated Determination of Blumensaat Line Using Fuzzy System Based on Physician Experience from Femur CT Image[Refereed]International conference proceedings
- Sep. 2013, International Journal of Intelligent Computing in Medical Sciences and Image Processing, 5(2) (2), 105 - 113, English[Refereed]Scientific journal
- BACKGROUND: Rotational kinematics has become an important consideration after ACL reconstruction because of its possible influence on knee degeneration. However, it remains unknown whether ACL reconstruction can restore both rotational kinematics and normal joint contact patterns, especially during functional activities. QUESTIONS/PURPOSES: We asked whether knee kinematics (tibial anterior translation and axial rotation) and joint contact mechanics (tibiofemoral sliding distance) would be restored by double-bundle (DB) or single-bundle (SB) reconstruction. METHODS: We retrospectively studied 17 patients who underwent ACL reconstruction by the SB (n = 7) or DB (n = 10) procedure. We used dynamic stereo x-ray to capture biplane radiographic images of the knee during downhill treadmill running. Tibial anterior translation, axial rotation, and joint sliding distance in the medial and lateral compartments were compared between reconstructed and contralateral knees in both SB and DB groups. RESULTS: We observed reduced anterior tibial translation and increased knee rotation in the reconstructed knees compared to the contralateral knees in both SB and DB groups. The mean joint sliding distance on the medial compartment was larger in the reconstructed knees than in the contralateral knees for both the SB group (9.5 ± 3.9 mm versus 7.5 ± 4.3 mm) and the DB group (11.1 ± 1.3 mm versus 7.9 ± 3.8 mm). CONCLUSIONS: Neither ACL reconstruction procedure restored normal knee kinematics or medial joint sliding. CLINICAL RELEVANCE: Further study is necessary to understand the clinical significance of abnormal joint contact, identify the responsible mechanisms, and optimize reconstruction procedures for restoring normal joint mechanics after ACL injury.Sep. 2013, Clinical orthopaedics and related research, 471(9) (9), 2924 - 31, English, International magazine[Refereed]
- PURPOSE: To enable comparison of test results, a widely available measurement system for the pivot shift test is needed. Simple image analysis of lateral knee joint translation is one such system that can be installed on a prevalent computer tablet (e.g. iPad). The purpose of this study was to test a novel iPad application to detect the pivot shift. It was hypothesized that the abnormal lateral translation in ACL deficient knees would be detected by the iPad application. METHODS: Thirty-four consecutive ACL deficient patients were tested. Three skin markers were attached on the following bony landmarks: (1) Gerdy's tubercle, (2) fibular head and (3) lateral epicondyle. A standardized pivot shift test was performed under anaesthesia, while the lateral side of the knee joint was monitored. The recorded movie was processed by the iPad application to measure the lateral translation of the knee joint. Lateral translation was compared between knees with different pivot shift grades. RESULTS: Valid data sets were obtained in 20 (59 %) ACL deficient knees. The remaining 14 data sets were invalid because of failure to detect translation or detection of excessive translation. ACL deficient knees had larger lateral translation than the contra-lateral knees (p < 0.01). In the 20 valid data sets, which were graded as either grade 1 (n = 10) or grade 2 (n = 10), lateral translation was significantly larger in the grade 2 pivot shift (3.6 ± 1.2 mm) than the grade 1 pivot shift (2.7 ± 0.6 mm, p < 0.05). CONCLUSION: Although some technical corrections, such as testing manoeuvre and recording procedure, are needed to improve the image data sampling using the iPad application, the potential of the iPad application to classify the pivot shift was demonstrated.Apr. 2013, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 21(4) (4), 975 - 80, English, International magazine[Refereed]
- PURPOSE: Conventional transtibial technique fails to restore the rotational knee stability in spite of successful anterior laxity, while anatomic anterior cruciate ligament reconstruction using the anteromedial portal technique has been developed expecting better rotational kinematics because of closer reproduction of the native anterior cruciate ligament anatomy. However, the rotational instability after those two procedures has not been fully examined especially in terms of dynamic component of the rotational stability. The purpose was to assess the effect of anatomic versus non-anatomic tunnel placement on rotational knee stability after anterior cruciate ligament reconstruction using triaxial accelerometry. METHODS: Sixteen porcine knees underwent a manual pivot-shift test at four different conditions: (1) anterior cruciate ligament intact, (2) anterior cruciate ligament deficient, (3) non-anatomic transtibial reconstruction, and (4) anatomic anteromedial portal reconstruction. The three-dimensional acceleration of knee motion during the pivot-shift test was recorded using a triaxial accelerometer. RESULTS: Both anterior cruciate ligament reconstructions decreased significantly the acceleration of the pivot-shift test from the increased level in the anterior cruciate ligament-deficient condition. However, the transtibial technique fails to reach the intact level of acceleration, while the anteromedial portal technique reduced the acceleration to even less than the intact level. CONCLUSION: The transtibial anterior cruciate ligament reconstruction could not restore the dynamic rotational stability of the intact knee, whereas the anteromedial portal technique restored the dynamic rotational stability closer to the intact level. LEVEL OF EVIDENCE: III.Mar. 2013, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 21(3) (3), 589 - 95, English, International magazine[Refereed]
- BACKGROUND: As a result of recent studies describing the double-bundle anterior cruciate ligament (ACL), selected ACL augmentation procedures, either anteromedial (AM) or posterolateral (PL), have been introduced as the treatment of choice for partial ACL ruptures. The preserved mechanoreceptor and vascularity of the remnant ACL are considered to provide additional biological benefits. Although enhanced knee joint proprioception in ACL augmented patients has been previously reported, there is no study assessing biological healing advantages of the graft after the ACL augmentation procedure. HYPOTHESIS: Selected ACL augmentation for partial tears can accelerate the healing process of the grafted tendon, which promotes better biomechanical recovery of the tendon, compared with conventional ACL reconstruction of complete tears. STUDY DESIGN: Controlled laboratory study. METHODS: Two rat models were established in this study: an ACL augmentation partial tear model and conventional ACL reconstruction for a complete tear. Biological assessments of cellularity and angiogenesis were measured by hematoxylin and eosin staining and immunostaining, respectively. Additionally, rat-specific type III collagen and α-smooth muscle actin were evaluated by immunohistochemical staining to analyze the healing process, whereas anti-rat neurofilament antigen was assessed to examine proprioceptive recovery. Biological assessments of the augmented and reconstructed grafts were conducted postoperatively at week 2, whereas biomechanical testing was performed postoperatively at week 8. RESULTS: An increase in cellularity and angiogenesis was observed in the augmented grafts compared with the conventionally reconstructed grafts. Also, increased amounts of rat-specific type III collagen, α-smooth muscle actin, and anti-rat neurofilament antigen were expressed in the augmented grafts. Biomechanical testing showed that failure to load was significantly higher in the augmentation group compared with the conventional reconstruction group (augmentation, 15.9 ± 1.0; reconstruction, 7.0 ± 1.3; P < .01). CLINICAL RELEVANCE: Selected ACL augmentation could be a good choice for the repair of partial ACL injury by preserving the uninjured portion of the ACL, which in turn could maintain the anatomic position of the ligament and its biomechanical function.Feb. 2013, The American journal of sports medicine, 41(2) (2), 365 - 73, English, International magazine[Refereed]Scientific journal
- The anterior cruciate ligament (ACL) is one of strong ligaments in the knee. The ACL has a role to prevent excessive internal rotation and forwarding movement of the tibia. Lachman test is one of manual tests for examining the ACL. An examiner discriminates an injured degree of the ACL by feeling finger stress. Some measurement devices for Lachman test have been reported. However, these devices aim to analyze not the stress but the motion of the knee joint. Therefore, we set the goal of this study to develop a measurement system for the finger stress with force sensor during Lachman test. A quantitative measurement system during Lachman test with force sensor was developed. A basic experiment before numerical analysis of Endpoint revealed that the inclination of force can separate characteristics of string and elastic. Lachman test was measured by using this system on intra-examiner, inter-examiner and nonexpert. This result may indicate that this analysis method and the system have usefulness so that the bimodality or multi-modality were observed over half data. A future work is to apply the injured knees.Japan Society for Fuzzy Theory and Intelligent Informatics, 2013, Proceedings of the Fuzzy System Symposium, 29, 58 - 58, Japanese
- 2013, Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 8011(3) (3), 508 - 515, English[Refereed]International conference proceedings
- 2013, 2013 IEEE INTERNATIONAL CONFERENCE ON SYSTEMS, MAN, AND CYBERNETICS (SMC 2013), 2157 - 2162, English[Refereed]International conference proceedings
- 2013, 2013 INTERNATIONAL CONFERENCE ON SIGNAL-IMAGE TECHNOLOGY & INTERNET-BASED SYSTEMS (SITIS), 842 - 847, English[Refereed]International conference proceedings
- 2013, ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE, 1(1) (1), 1 - 6, English[Refereed]Scientific journal
- 金原出版(株), Oct. 2012, 整形・災害外科, 55(11) (11), 1383 - 1389, Japanese
- PURPOSE: Rotational instability in ACL insufficient knee addresses the symptom or the abnormal motion which can be reproduced and subjectively evaluated in the clinical exam. Clinically available quantitative measurement for this instability has not been established due to mixed testing maneuvers and complex kinematics. The purpose was to measure knee kinematics during three manually performed rotational tests and to determine the optimal method to detect the abnormality in ACL deficient knees. METHOD: Thirteen unilateral ACL deficient patients were tested by internal and external pure rotational stress tests and pivot shift test under anesthesia before scheduled ACL reconstructions. Rotation and coupled motion, i.e., tibial anteroposterior translation, were measured using an electromagnetic measurement system. Additionally, the acceleration of the tibial posterior translation during pivot shift test was calculated. The differences of these parameters between ACL intact and deficient knees were tested. RESULTS: Knee rotation is not different between ACL intact and deficient during both pure rotational stress test and pivot shift test. The coupled anterior tibial translation during pivot shift test was significantly different between ACL intact, 13.5 ± 4.1 mm, and deficient knees, 23.1 ± 4.4 mm, (P < 0.01) as well as the acceleration of the tibial posterior translation (1.1 ± 0.4 m/sec(2) in intact knees, 3.2 ± 1.5 m/sec(2) in deficient knees; P < 0.01). The coupled motion during pure rotational stress tests was similar regardless of ACL condition. CONCLUSION: The rotational instability of the ACL deficiency was reproduced only by the pivot shift test and detected only by measuring the tibial anteroposterior translation and acceleration of the tibial posterior reduction. Level of evidence Diagnostic study, Level III.Jul. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(7) (7), 1323 - 30, English, International magazine[Refereed]Scientific journal
- PURPOSE: Tibio-femoral kinematics are clearly influenced by the bony morphology of the femur. Previous morphological studies have not directly evaluated relationships between morphology and knee kinematics. Therefore, the purpose of this study was to examine the relationship between distal femur bony morphology and in vivo knee kinematics during running. It was hypothesized that the posterior offset of the transcondylar axis would be related to the magnitude of anterior/posterior tibio-femoral translation and that the rotational angle of the transcondylar axis would be related to the magnitude of internal/external knee rotation. METHODS: Seventeen contralateral (uninjured) knees of ACL-reconstructed patients were used. Distal femoral geometry was analyzed from 3D-CT data by determining the anteroposterior location (condyle offset ratio--COR) and rotational angle (condylar twist angle--CTA) of the femoral transcondylar axis. Six degree-of-freedom knee kinematics were obtained during running using a dynamic stereo radiograph system. Knee kinematics were correlated with the femoral morphologic measures (COR and CTA) to investigate the influence of femoral geometry on dynamic knee function. RESULTS: Significant correlations were identified between distal femur morphology and knee kinematics. Anterior tibial translation was positively correlated with the condyle offset ratio (R(2) = 0.41, P < 0.01). Internal tibial rotation was positively correlated with the condylar twist angle (R(2) = 0.48, P < 0.01). CONCLUSIONS: Correlations between knee kinematics and morphologic measures describing the position and orientation of the femoral transcondylar axis suggest that these specific measures are valuable for characterizing the influence of femur shape on dynamic knee function. LEVEL OF EVIDENCE: III.Jul. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(7) (7), 1331 - 8, English, International magazine[Refereed]
- PURPOSE: Although extensive research has been conducted on rotational kinematics, the internal/external rotation of the tibio-femoral joint is perhaps less important for protecting joint health than its effect on joint contact mechanics. The purpose of this study was to evaluate tibio-femoral joint contact paths during a functional activity (running) and investigate the relationship between these arthrokinematic measures and traditional kinematics (internal/external rotation). METHODS: Tibio-femoral motion was assessed for the contralateral (uninjured) knees of 29 ACL-reconstructed individuals during downhill running, using dynamic stereo X-ray combined with three-dimensional CT bone models to produce knee kinematics and dynamic joint contact paths. The joint contact sliding length was estimated by comparing femoral and tibial contact paths. The difference in sliding length between compartments was compared to knee rotation. RESULTS: Sliding length was significantly larger on the medial side (10.2 ± 3.8 mm) than the lateral side (2.3 ± 4.0 mm). The difference in sliding length between compartments (mean 7.8 ± 3.0 mm) was significantly correlated with internal tibial rotation (P < 0.01, R (2) = 0.74). CONCLUSION: The relationship between rotational knee kinematics and joint contact paths was specifically revealed as greater tibial internal rotation was associated with larger magnitude of sliding motion in the medial compartment. This could suggest that lateral pivot movement occurs during running. CLINICAL RELEVANCE: Rotational kinematics abnormality should be treated for restoring normal balance of joint sliding between medial and lateral compartments and preventing future osteoarthritis. LEVEL OF EVIDENCE: Prognostic studies, Level II.Jul. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(7) (7), 1268 - 75, English, International magazine[Refereed]
- PURPOSE: The variation of distal femur morphology has been often reported, especially in relation to ACL injury. However, it remains unknown how morphological differences affect knee kinematics and ACL function. The location of the transcondylar axis, a common anatomical reference line, may be a significant aspect of morphological variation. It was hypothesized that the location of this axis would be different between genders, and between ACL-injured and non-injured subjects. METHODS: 3D CT scans of contralateral healthy femurs in 38 unilateral soft tissue injured patients (20 men/18 women, 26 ACL injury/12 non-ACL injury (7 with PCL injuries and 5 with medial meniscus root tears)) were analyzed three-dimensionally. Condyle offset was calculated as the distance between the transcondylar axis and the anatomical axis of the femur. Condyle offset ratio (COR) was then calculated by dividing the condyle offset by the condyle radius. Gender and ACL-injured and non-injured group differences were assessed. RESULTS: Larger COR was found in women, 1.10 ± 0.14, than men, 0.96 ± 0.08. In women, the ACL-injured group had significantly larger COR than the non-ACL injury group, but no difference was found in men. CONCLUSION: COR is a unique morphological feature which is measureable from 3D CT. COR is larger in women, and could be a possible risk indicator for ACL injury in the female population. LEVEL OF EVIDENCE: III.Jul. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(7) (7), 1282 - 8, English, International magazine[Refereed]
- (一社)日本整形外科スポーツ医学会, May 2012, 日本整形外科スポーツ医学会雑誌, 32(2) (2), 131 - 134, JapaneseACL再建術の術後評価 前十字靱帯(ACL)再建術の術前後評価 3次元電磁気センサーによる評価
- Apr. 2012, Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology, 4(1) (1), English[Refereed]Scientific journal
- Apr. 2012, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 20(4) (4), 692 - 697, English[Refereed]Scientific journal
- Apr. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(4) (4), 601 - 2, English, International magazine[Refereed]
- PURPOSE: Although various kinematic measurements with advanced technology have been used for quantitative evaluation of the pivot shift test, there is no clinically available quantification method of the pivot shift test. The purpose was to describe a novel image analysis technique for quantitative assessment of the pivot shift test using universally available and affordable devices. METHODS: Five ACL deficient knees were tested during examination under anesthesia. Three skin markers were attached to bony landmarks on the lateral side of the knee joint, (1) Gerdy's tubercle, (2) fibular head, and (3) lateral epicondyle. A standard digital video camera captured motion of the lateral aspect of the knee during the pivot shift test. The image was processed into a 2-dimensional (2-D) coordinate system with Image J software (National Institute of Health, USA) to trace the three landmarks. The anteroposterior (AP) position of the femur was calculated on consecutive still images extracted from the video recording. AP translation over time was reported. RESULTS: The reduction phase of the pivot shift could be tracked consistently by a sudden anterior translation of the distal femur. The sudden anterior translation of the lateral epicondyle was on average 3.7 ± 2.1 mm and occurred within 0.2 ± 0.1 s from the start of this anterior translation till the end. CONCLUSION: The sudden shift of the lateral compartment of the knee joint was successfully detected by this newly developed image analysis measurement method. This image analysis technique facilitates a simple and affordable method to evaluate the lateral pivot shift test. LEVEL OF EVIDENCE: Diagnostic studies, Level IV.Apr. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(4) (4), 703 - 7, English, International magazine[Refereed]
- PURPOSE: The variability of the pivot shift test techniques greatly interferes with achieving a quantitative and generally comparable measurement. The purpose of this study was to compare the variation of the quantitative pivot shift measurements with different surgeons' preferred techniques to a standardized technique. The hypothesis was that standardizing the pivot shift test would improve consistency in the quantitative evaluation when compared with surgeon-specific techniques. METHODS: A whole lower body cadaveric specimen was prepared to have a low-grade pivot shift on one side and high-grade pivot shift on the other side. Twelve expert surgeons performed the pivot shift test using (1) their preferred technique and (2) a standardized technique. Electromagnetic tracking was utilized to measure anterior tibial translation and acceleration of the reduction during the pivot shift test. The variation of the measurement was compared between the surgeons' preferred technique and the standardized technique. RESULTS: The anterior tibial translation during pivot shift test was similar between using surgeons' preferred technique (left 24.0 ± 4.3 mm; right 15.5 ± 3.8 mm) and using standardized technique (left 25.1 ± 3.2 mm; right 15.6 ± 4.0 mm; n.s.). However, the variation in acceleration was significantly smaller with the standardized technique (left 3.0 ± 1.3 mm/s(2); right 2.5 ± 0.7 mm/s(2)) compared with the surgeons' preferred technique (left 4.3 ± 3.3 mm/s(2); right 3.4 ± 2.3 mm/s(2); both P < 0.01). CONCLUSION: Standardizing the pivot shift test maneuver provides a more consistent quantitative evaluation and may be helpful in designing future multicenter clinical outcome trials. LEVEL OF EVIDENCE: Diagnostic study, Level I.Apr. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(4) (4), 732 - 6, English, International magazine[Refereed]
- PURPOSE: Studies have reported that knee kinematics and rotational laxity are not restored to native levels following traditional anterior cruciate ligament (ACL) reconstruction. This has led to the development of anatomic ACL reconstruction, which aims to restore native knee kinematics and long-term knee health by replicating normal anatomy as much as possible. The purpose of this review is to give an overview of current dynamic knee laxity measurement devices with the purpose of investigating the significance of dynamic laxity measurement of the knee. Gait analysis is not included. METHODS: The subject was discussed with experts in the field in order to perform a level V review. MEDLINE was searched according to the discussions for relevant articles using multiple different search terms. All found abstracts were read and scanned for relevance to the subject. The reference lists of the relevant articles were searched for additional articles related to the subject. RESULTS: There are a variety of techniques reported to measure dynamic laxity of the knee. Technical development of methods is one important part toward better understanding of knee kinematics. Validation of devices has shown to be difficult due to the lack of gold standard. Different studies use various methods to examine different components of dynamic laxity, which makes comparisons between studies challenging. CONCLUSION: Several devices can be used to evaluate dynamic laxity of the knee. At the present time, the devices are continuously under development. Future implementation should include primary basic research, including validation and reliability testing, as well as part of individualized surgery and clinical follow-up. LEVEL OF EVIDENCE: Diagnostic study, Level V.Apr. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(4) (4), 621 - 32, English, International magazine[Refereed]
- Static load-displacement measurement is unrelated to the dynamic knee function of anterior cruciate ligament (ACL) insufficiency. Performing an accurate, dynamic functional evaluation is necessary not only for the primary ACL injury, but also as an outcome measurement in ACL reconstruction. The pivot shift test is commonly used for assessing dynamic rotatory knee laxity in ACL-insufficient knees and is related to subjective knee function. Residual pivot shift after ACL reconstruction is a crucial factor related to poor clinical outcome. However, the pivot shift test is subjectively determined by the examiners' hands. Not only 3-dimensional (3D) position displacement but also its 3D acceleration should be measured for quantitative evaluation of the pivot shift test and is currently feasible by using recent advanced technology, i.e., electromagnetic devices. We summarize the basic knowledge and current concepts of quantitative exploration of the dynamic knee movement during the pivot shift test.Apr. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(4) (4), 686 - 91, English, International magazine[Refereed]Scientific journal
- PURPOSE: The use of several different maneuvers for the pivot shift test has resulted in inconsistent quantitative measurements. The purpose of this study was to describe, analyze, and group several surgeon-specific techniques for the pivot shift test and to propose a standardized pivot shift test. METHODS: Twelve expert surgeons examined a whole lower cadaveric extremity with their preferred technique and assigned a clinical grade, I-III. Anterior tibial translation and acceleration were measured using an electromagnetic system. The test was repeated after watching an instructional video focused on a standardized pivot shift technique. Measurements were repeated and compared with the preferred technique. RESULTS: The expert surgeons utilized valgus stress unanimously in addition to fixed internal rotation (n = 5), fixed external rotation (n = 1), a motion-allowing technique (n = 3), a dislocation-type maneuver (n = 2), and a fixed anterior drawer type of maneuver in extension (n = 1). Anterior tibial translation measured was on average 15.9 ± 3.7 mm. Average tibial acceleration was 3.3 ± 2.1 mm/s(2). Average clinical grading was 2.3 ± 0.5. There were no differences in average clinical grading when using high stress (2.5 ± 0.6) versus low stress (2.3 ± 0.5, n.s.), or using fixed rotation (2.2 ± 0.5) versus a motion-allowing technique (2.3 ± 0.6; n.s.). CONCLUSIONS: Clinical grading, tibial translation, and acceleration vary between examiners performing the pivot shift test. High forces and extremes of rotation are not necessary to produce a clinical detectable pivot shift. In the future, a standardized pivot shift test-which can be performed universally and utilizes only gentle forces allowing motion to occur-may be beneficial when assessing differences in outcome following ACL reconstruction.Apr. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(4) (4), 724 - 31, English, International magazine[Refereed]
- PURPOSE: Recently, different measurement systems have been developed to quantitatively measure the pivot shift in vivo. These systems lack validation and a large inter-examiner variability for the manually performed pivot shift test exists. The purpose of this study was to perform objective measurements of the pivot shift using three different measurement devices and to examine the correlation of the measurements with clinical grading of the pivot shift. METHODS: A cadaver knee on a whole lower body specimen was prepared to display a high-grade pivot shift. The pivot shift tests were performed three times by 12 blinded expert surgeons using their preferred technique. Simultaneous data samplings were recorded using three different measurement devices: (1) electromagnetic tracking system using bone-attached and skin-fixed sensors, respectively, (2) triaxial accelerometer system, and (3) simple image analysis. The surgeons graded the knee clinically using pivot shift grades I-III. Correlations were calculated using the Spearman's rank correlation coefficient. RESULTS: The expert surgeons average clinical grading was 2.3 (SD ± 0.5). Clinical grading displayed best correlation with the acceleration of reduction as measured by electromagnetic tracking system with bone-attached sensors (r = 0.67, P < 0.05). Similar correlation coefficient was found for the acceleration of reduction (r = 0.58, P = 0.05) and the "jerk" component of acceleration (r = 0.61, P < 0.05) measured by means of the triaxial accelerometer system. CONCLUSION: The pivot shift can be quantified by several in vivo measurement devices. Best correlation with clinical grading was found with tibial acceleration parameters. Future studies will have to analyze how quantitative parameters can be utilized to standardize clinical grading of the pivot shift. LEVEL OF EVIDENCE: Diagnostic study, Level II.Apr. 2012, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 20(4) (4), 708 - 12, English, International magazine[Refereed]
- (公社)日本整形外科学会, Feb. 2012, 日本整形外科学会雑誌, 86(2) (2), S56 - S56, Japanese膝前十字靱帯不全膝(機能不全膝)の回旋不安定性の定量的評価方法の検討
- Mosaicplasty is one of the surgeries for knee cartilage damage. It transplants the bone autograft with the cartilage to the injured area. In this surgery, it is important to harvest the cartilage graft vertically and transplant it vertically by using a harvester for preventing area around transplant from discontinuous of the cartilage surface. This study set the goal to develop a system to estimate the pose of harvester against the articular surface in considering with a force distribution measured by a force sensor. The proposed method measures a force distribution on the cartilage surface by using eight force sensors which are attached to the front edge of the harvestor of the surfical instrument. It estimates the angle between the articular surface and harvester based on the force distribution. The experiment used a portable force tester for loading, and estimated the angle of the harvester. The result shows the maximum of the angle estimation error was 8 degrees. The experiment of angle estimation performed multiple times, it was confirmed reproducibility. As a future work, angle of estimation is displayed in real time.Japan Society for Fuzzy Theory and Intelligent Informatics, 2012, Proceedings of the Fuzzy System Symposium, 28, 362 - 367, Japanese
- Lachman test is one of the manual tests for examining the anterior cruciate ligament (ACL). An examiner discriminates a degree of the ACL injury by feeling of a stress on the finger. Because the feeling is subjective consideration, the dicrimination depends much on past experiences. However, a non-expert examiner makes a deviation about the discrimination due to insufficient experiences. In addition, the feeling is not so constant, it results in another deviation even though an expert examiner performs. Hence, this study has developed a quantitative measurement system for Lachman test to reduce the deviation, and to provide an objective criterion. This measurement system consists of finger braces and force sensors on each fingers. Although a pressure sensor needs to calibrate in general, the calibration value of this system depends on difference of finger diameters. Keeping system accuracy requires a stable calibration method. This study proposes a calibration method adopted to the finger diameters by using Fuzzy Control. In the experiment, the proposed system examined both hands of young male, resulted high accuracy in low loading. A futur work is to evaluate reliability of this system in clinical situation.Japan Society for Fuzzy Theory and Intelligent Informatics, 2012, Proceedings of the Fuzzy System Symposium, 28, 324 - 329, Japanese
- Currently, doctors determine a treatment way of recurrent patellar dislocation with total consideration for the knee condition by using image discrimination and/or palpation. However, the determination depends much on the doctors. It results in variations of the judgment among them. Therefore, this study aims to propose an automated evaluation method that can provide a criterion of the subluxation knee for determination of a treatment to support doctors without subjective experiences. The proposed method analyzes an abnormal degree of patellofemoral surface by calculating a femoral pose from the medial and lateral epicondyles and detecting a patellar displacement and a profile of the groove. Then, it can provide a value represents a risk of the subluxation by considering them totally.Japan Society for Fuzzy Theory and Intelligent Informatics, 2012, Proceedings of the Fuzzy System Symposium, 28, 320 - 323, Japanese
- Anterior Cruciate Ligament (ACL) is one of the important ligaments in the knee. The ligament connects the femur and tibia, and has a role to prevent an excessive forward movement of the tibia. In the clinical sports medicine, ACL reconstruction is often preformed about the injured knee. The ACL reconstruction aims to recover the function of the knee. Although some study have reports tension pattern of the reconstructed knee during knee bending, no reports have reported an evaluation method of the normal tension pattern. This study tries to define the normality of the normal knee in considering the tension pattern. The experiment used an imitation bone with an imitation ligament for measuring the tension pattern by using our developed micro-measurement system, and evaluated the normality of the tension pattern. Future works are to apply this evaluation to cadaver knees.Japan Society for Fuzzy Theory and Intelligent Informatics, 2012, Proceedings of the Fuzzy System Symposium, 28, 314 - 319, Japanese
- 2012, PROCEEDINGS 2012 IEEE INTERNATIONAL CONFERENCE ON SYSTEMS, MAN, AND CYBERNETICS (SMC), 2605 - 2609, EnglishChallenge of Normality Evaluation by using Micro-Size Tension Measurement Device in Anterior Cruciate Ligament Reconstruction[Refereed]International conference proceedings
- 2012, PROCEEDINGS 2012 IEEE INTERNATIONAL CONFERENCE ON SYSTEMS, MAN, AND CYBERNETICS (SMC), 237 - 241, EnglishCalculation of Graft Bending Angle in Anterior Cruciate Ligament Reconstruction[Refereed]International conference proceedings
- 2012, PROCEEDINGS 2012 IEEE INTERNATIONAL CONFERENCE ON SYSTEMS, MAN, AND CYBERNETICS (SMC), 3269 - 3274, EnglishA Development of Surgery Instrument Pose Support System for Mosaicplasty by Using Force Distribution[Refereed]International conference proceedings
- BACKGROUND: The Lachman and pivot-shift tests are 2 standard manual tests to diagnose anterior cruciate ligament (ACL) insufficiency. However, the global variation of these testing procedures is not known. PURPOSE: To survey currently used testing techniques and to measure the knee movement during manual tests among various expert surgeons from across the globe. STUDY DESIGN: Controlled laboratory study. METHODS: Part 1: descriptive survey. A questionnaire asking about testing procedures of Lachman and pivot-shift tests was conducted among 33 ACL surgeons. Part 2: knee kinematics comparison. Lachman and pivot-shift tests were performed on a unilateral ACL-injured patient by 5 surgeons, while knee kinematics was recorded by an electromagnetic system. Tibial translation was measured during the Lachman test, while tibial translation, rotation, and pivot-shift acceleration were calculated during the pivot-shift test. RESULTS: Part 1: Tibial anterior drawer by a medially placed hand was widely advocated for the Lachman test. Flexion type of the pivot-shift test maneuver was supported by two thirds, while extension type was supported by one third. However, the "feeling" of subluxation or reduction during the pivot shift was the primary evaluation method used by the vast majority of surgeons. Part 2: Increased tibial translation during the Lachman test was observed in the ACL-injured knee with significant variation between examiners (P < .01). Tibial translation and pivot-shift acceleration during the pivot-shift test increased in the ACL-injured side (P < .01), but tibial rotation was too diverse to find any trend (P = .31). Tibial translation and acceleration of the pivot shift in the ACL-injured knee showed no significant difference between examiners (P > .05). CONCLUSION: The Lachman test can display a wide variation of actual movement despite maneuver similarity, while the pivot-shift test could possibly be measurable by tibial translation and/or acceleration beyond their procedural variation. CLINICAL RELEVANCE: We should recognize the limitations of these manual tests and the possibilities of their objective measurement.Jan. 2012, The American journal of sports medicine, 40(1) (1), 91 - 9, English, International magazine[Refereed]Scientific journal
- Anatomic study related to the anterior cruciate ligament (ACL) reconstruction surgery has been developed in accordance with the progress of imaging technology. Advances in imaging techniques, especially the move from two-dimensional (2D) to three-dimensional (3D) image analysis, substantially contribute to anatomic understanding and its application to advanced ACL reconstruction surgery. This paper introduces previous research about image analysis of the ACL anatomy and its application to ACL reconstruction surgery. Crucial bony landmarks for the accurate placement of the ACL graft can be identified by 3D imaging technique. Additionally, 3D-CT analysis of the ACL insertion site anatomy provides better and more consistent evaluation than conventional "clock-face" reference and roentgenologic quadrant method. Since the human anatomy has a complex three-dimensional structure, further anatomic research using three-dimensional imaging analysis and its clinical application by navigation system or other technologies is warranted for the improvement of the ACL reconstruction.2012, Anatomy research international, 2012, 569704 - 569704, English, International magazine[Refereed]
- PURPOSE: To measure the acceleration in multiple directions of the rotational instability in ACL deficient models using porcine knees. METHODS: Ten porcine knees were tested with ACL intact and tear models. The pivot shift test was performed manually, and the acceleration of the pivot shift phenomenon was recorded by the use of a triaxial accelerometer. Tests were repeated in four different ACL states: (1) intact; (2) partial AM deficient; (3) complete AM deficient, and (4) complete ACL (AM and PL) deficient. The acceleration in three directions and the magnitude of acceleration were measured to evaluate rotational instability and compare between different ACL conditions. RESULTS: Significantly increased accelerations were observed in the complete deficient ACL model, while the partial ACL tear models demonstrated a slight increase without statistical significance. The accelerometer detected stepwise increases in the acceleration with the extent of ACL tear. Additionally, the PL bundle exhibited the largest contribution for rotational instability (80.4%) when compared with the AM (19.5%) bundles. CONCLUSION: Triaxial accelerometer could serve as a quantitative evaluation of rotational instability. The present study demonstrated that PL bundle has the most important contribution for rotational instability (80.4%) when compared to IM bundle (0.01%) and AM bundle (19.5%) in porcine knee model.Aug. 2011, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 19(8) (8), 1233 - 8, English, International magazine[Refereed]
- Anterior cruciate ligament reconstruction is a frequently performed orthopaedic procedure. Although short-term results are generally good, long-term outcomes are less favorable. Thus, there is renewed interest in improving surgical techniques. Recent studies of anterior cruciate ligament anatomy and function have characterized the 2-bundle structure of the native ligament. During non-weightbearing conditions, the anteromedial (AM) and posterolateral (PL) bundles display reciprocal tension patterns. However, during weightbearing, both the AM and PL bundles are maximally elongated at low flexion angles and shorten significantly with increasing knee flexion. Conventional single-bundle reconstruction techniques often result in nonanatomic tunnel placement, with a tibial PL to a femoral "high AM" tunnel position. In vitro studies have demonstrated that these nonanatomic single-bundle reconstructions cannot completely restore normal anterior-posterior or rotatory laxity. Cadaveric studies suggest that anatomic single-bundle and anatomic double-bundle reconstruction may better restore knee stability. Although many cadaver studies suggest that double-bundle reconstruction techniques result in superior stability when compared with single-bundle techniques, others failed to demonstrate a clear benefit of this more complex procedure. Cadaver studies generally do not apply physiologically relevant loads and provide only a "time-zero" assessment that ignores effects of healing and remodeling after anterior cruciate ligament reconstruction. In vivo, dynamic studies offer the most comprehensive assessment of knee function after injury or reconstruction, as they can evaluate dynamic stability during functional joint loading. Studies of knee kinematics during activities such as gait and running suggest that nonanatomic single-bundle anterior cruciate ligament reconstruction fails to restore preinjury knee function under functional loading conditions. Similar studies of more anatomic single- and double-bundle surgical approaches are in progress, and preliminary results suggest that these anatomic techniques may be more effective for restoring preinjury knee function. However, more extensive, well-designed studies of both kinematics and long-term outcomes are warranted to characterize the potential benefits of more anatomic reconstruction techniques for improving long-term outcomes after anterior cruciate ligament reconstruction.Aug. 2011, The American journal of sports medicine, 39(8) (8), 1789 - 99, English, International magazine[Refereed]
- PURPOSE: The purpose of this study was to obtain more than 2 years' follow-up after surgery to investigate the effect of the difference in rotatory stability based on our previous data on the clinical outcome among 3 groups: double-bundle (DB) reconstruction group, anteromedial (AM) single-bundle reconstruction group, and posterolateral (PL) single-bundle reconstruction group. METHODS: We randomly separated 55 patients with anterior cruciate ligament rupture into 3 groups: 18 in DB group, 18 in AM group, and 19 in PL group. The mean follow-up period is 33.7 months for the DB group, 31.9 months for the AM group, and 33.2 months for the PL group. We evaluated the Lysholm score, Tegner score, anterior laxity with the KT-1000 arthrometer (MEDmetric, San Diego, CA), rotator instability with the pivot-shift test, and muscle strength with knee extensor and flexor isokinetic peak torques at 60°/s. RESULTS: There were no significant differences in postoperative Lysholm score and Tegner score. Anterior stability of the knee, as measured by the KT-1000 arthrometer, was significantly better in the DB group than the PL group (P < .05). The negative rate of the manual pivot-shift test in the DB group was significantly superior to the PL group (P < .05). Muscle strength of the extensor in the DB group was significantly superior to that in the AM group (P < .05), and muscle strength of the flexor in the PL group was significantly inferior to that in both the DB and AM groups (P < .05). Two patients in the PL group had rerupture; however, there was no graft failure in the other groups. CONCLUSIONS: At 2 years' follow-up, patients undergoing DB anterior cruciate ligament reconstruction had greater extension strength than patients receiving an AM single-bundle reconstruction. The DB and AM groups had greater flexion strength than the PL group. The DB and AM groups had a similar rate of negative pivot-shift test results, whereas the PL group had fewer negative pivot-shift test results than the DB group. There were no KT-1000 side-to-side differences between the DB and AM groups, whereas the DB group had better results than the PL group. Overall, the clinical outcome as measured by Lysholm and Tegner scores was not different between groups. LEVEL OF EVIDENCE: Level II, prospective comparative study.Jul. 2011, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 27(7) (7), 906 - 13, English, International magazine[Refereed]Scientific journal
- PURPOSE: The purpose of this study was to assess quantitative anterior/posterior values during the Lachman test by an electromagnetic measurement system and to compare data with KT-1000 arthrometric measurements (MEDmetric, San Diego, CA), as well as the measurement of radiologic laxity by dynamic radiographs. METHODS: We used an electromagnetic device to quantitatively evaluate anterior knee displacements. We tested 82 knees in 41 patients (30 isolated anterior cruciate ligament [ACL]-deficient, 11 ACL-reconstructed, and 41 contralateral ACL-intact knees). Anterior displacements during the Lachman test were calculated by the electromagnetic measurement system and fluoroscopic measurement, and anterior displacements were also measured by the KT-1000 arthrometer. Anterior/posterior displacements measured by these methods were compared, and correlations were assessed. RESULTS: In ACL-deficient knees, mean anterior/posterior displacement (±SE) was 22.4 ± 0.8 mm in electromagnetic measurements, 22.0 ± 0.7 mm in fluoroscopic measurements, and 15.0 ± 0.6 mm in KT-1000 measurements. In contralateral ACL-intact knees, it was 15.7 ± 0.6 mm, 15.6 ± 0.5 mm, and 9.9 ± 0.4 mm, respectively. In ACL-reconstructed knees, it was 15.7 ± 0.7 mm, 16.2 ± 0.8 mm, and 11.2 ± 0.6 mm, respectively. In all knee conditions, significant differences between fluoroscopic measurements and KT-1000 measurements were detected (P < .01). Significant differences were also detected between electromagnetic measurements and KT-1000 measurements (P < .01). No significant differences were detected between fluoroscopic measurements and electromagnetic measurements. A strong correlation was obtained between KT-1000 measurements and fluoroscopic measurements (r = 0.62, P < .01) and between electromagnetic measurements and KT-1000 measurements (r = 0.64, P < .01). However, the strongest correlation was observed between electromagnetic measurements and fluoroscopic measurements (r = 0.96, P < .01). CONCLUSIONS: An electromagnetic measurement system to test anterior/posterior tibial translation determined that quantification of the Lachman test could be performed as accurately as fluoroscopic measurements. LEVEL OF EVIDENCE: Level II, development of diagnostic criteria on basis of consecutive patients with universally applied reference gold standard.Jun. 2011, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 27(6) (6), 792 - 802, English, International magazine[Refereed]Scientific journal
- PURPOSE: Different tunnel configurations have been used for double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. However, controversy still exists as to whether three-tunnel DB with double-femoral tunnels and single-tibial tunnel (2F-1T) or with single-femoral tunnel and double-tibial tunnels (1F-2T) better restores intact knee biomechanics than single-bundle (SB) ACL reconstruction. The purpose was to compare the knee kinematics and in situ force in the grafts among SB and two types of three-tunnel DB ACL reconstructions performed in an anatomic fashion. METHODS: Twenty-four porcine knees were subjected to an 89-N anterior tibial load (simulated KT-1000 test) at 30°, 60°, and 90° of flexion and to a 4-Nm internal tibial torque and 7-Nm valgus torque (simulated pivot-shift test) at 30° and 60° of flexion. The resulting knee kinematics and in situ force in the ACL or replacement grafts were measured using a robotic system for (1) ACL-intact, (2) ACL-deficient, and (3) three ACL reconstructed knees: SB; DB 2F-1T; and DB 1F-2T. RESULTS: During the simulated pivot-shift test, the DB grafts more closely restored the in situ force in the intact ACL at low flexion angle than the SB graft. There were no significant differences in knee kinematics between SB and DB ACL reconstruction. The DB 2F-1T reconstruction did not show a significant difference in knee kinematics or in situ force when compared to the DB 1F-2T technique. CONCLUSION: The in situ force in the ACL is better restored with an anatomic three-tunnel DB reconstruction in response to the simulated pivot-shift test at low flexion angle when compared to an anatomic SB reconstruction. Both three-tunnel DB ACL reconstructions performed in an anatomic fashion had similar biomechanical behavior. As long as it is performed anatomically, DB ACL reconstruction could be better alternative than SB ACL reconstruction, no matter which three-tunnel procedure, 2F-1T or 1F-2T, is used.May 2011, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 19(5) (5), 728 - 35, English, International magazine[Refereed]
- We conducted a prospective randomised study of anatomical single-bundle (A-SB group) versus double-bundle (A-DB group) anterior cruciate ligament (ACL) reconstruction using the hamstrings tendons. Twenty patients with unilateral ACL deficiency were randomised into two groups. We created the bone tunnels at the position of the original insertion of the anteromedial bundle footprint and posterolateral bundle footprint in the A-DB group and at the central position between these two bundles in the A-SB group. All of the patients were tested before ACL reconstruction and one year after surgery. The KT-1000 measurements, isokinetic muscle peak torque and heel-height difference were evaluated and the general knee condition was assessed by Lysholm score. For pre- and postoperative stability assessment, we used the six-degrees-of-freedom of knee kinematic measurement system using an electromagnetic device (the EMS) for quantitative assessment during the Lachman test and the pivot shift test. There were no significant differences in the KT-1000 measurements, isokinetic muscle peak torque, heel-height difference, and Lysholm score at one-year follow-up between these two groups. The EMS data showed there were significant differences in the acceleration of the pivot shift test between the operated knee and the contralateral normal knees in the A-SB group. In conclusion, clinical outcomes were equally good in both groups. However, the EMS data showed the anatomical double-bundle ACL reconstruction tended to be biomechanically superior to the single-bundle reconstruction.Mar. 2011, International orthopaedics, 35(3) (3), 439 - 46, English, International magazine[Refereed]Scientific journal
- Sep. 2010, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 26(9) (9), 1147 - 8, English, International magazine[Refereed]
- (公社)日本整形外科学会, Apr. 2010, 日本整形外科学会雑誌, 84(4) (4), S263 - S263, Japanese膝前十字靱帯損傷の徒手検査における検者間での違い アンケート調査と電磁センサーシステムを用いた計測より
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Mar. 2010, JOSKAS, 35(1) (1), 82 - 83, Japanese
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Mar. 2010, JOSKAS, 35(1) (1), 88 - 89, Japanese
- Mar. 2010, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 15(2) (2), 269 - 76, English, Domestic magazine[Refereed]
- Jan. 2010, The American journal of sports medicine, 38(1) (1), NP3; author reply NP3-4, English, International magazine[Refereed]
- Graft tunnel placement is the factor with most influence on the outcome of double-bundle anterior cruciate ligament (ACL) reconstruction. However the final decision for the graft location has to be decided subjectively under arthroscopy, and can be misplaced due to the effect of the knee flexion angle. The displacement of the estimated placement by surgeons from the ACL anatomical attachment is due to the knee's differing knee flexion angle. Eight cadaveric knees and an electromagnetic position recording system were employed. After digitizing the anatomical location of AM and PL bundle center, four experienced surgeons estimated the graft placement repeatedly at 70 degrees , 90 degrees and 110 degrees of knee flexion. The displacements between these two positions were calculated and analyzed separately in antero-posterior and disto-proximal directions. The displacements of the estimated AM bundle placements were 4.7 +/- 3.4 mm at 70 degrees , 4.3 +/- 2.2 mm at 90 degrees , and 6.0 +/- 2.6 mm at 110 degrees , while those of the PL bundle were 4.0 +/- 2.2 mm at 70 degrees , 3.4 +/- 1.9 mm at 90 degrees , and 4.2 +/- 2.5 mm at 110 degrees . The best results were obtained at 90 degrees of knee flexion. Additionally, the estimated placements for both AM and PL bundle were located more distally as the flexion angle increased. Our results imply that the knee should be set at 90 degrees when determining the graft placement in double-bundle reconstruction to prevent misplacement of the graft usually in a disto-proximal direction.Sep. 2009, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 17(9) (9), 1052 - 60, English, International magazine[Refereed]Scientific journal
- (公社)日本整形外科学会, Aug. 2009, 日本整形外科学会雑誌, 83(8) (8), S1222 - S1222, Japanese膝前十字靱帯部分断裂症例の動作解析 三次元電磁気計測システムを用いた定量的評価
- (株)文光堂, Jul. 2009, 臨床スポーツ医学, 26(7) (7), 757 - 760, Japanese
- (公社)日本整形外科学会, Mar. 2009, 日本整形外科学会雑誌, 83(3) (3), S607 - S607, JapaneseACL再建術の生体力学 前十字靱帯再建前後の膝安定性評価 電磁気センサーによる三次元解析
- The aim of this study is to investigate and compare the three dimensional bending angle of the graft at the femoral tunnel aperture in the transtibial and the far anteromedial portal technique. Seven fresh-frozen human cadaveric knees were used. Six degrees-of-freedom of knee kinematics and knee position data were measured using an electromagnetic device and the three dimensional bending angles of the each graft at the femoral tunnel aperture were calculated by computer simulation. Additionally, in order to assess the stress on the graft, the length change between the femoral and tibial attachment sites of the AM and PL bundle were calculated. The maximum length of each bundle was detected at full extension of the knee. The relative change of the length of the PL bundle in the range of 70 degrees -0 degrees of knee flexion was significantly larger than that of the AM bundle. (P < 0.05) Maximum graft bending angles in both techniques were obtained at full extension where the graft was fully stretched. The AM and PL graft bending angles in the transtibial technique were significantly larger than in the far anteromedial portal technique at low flexion angle (AM: 0 degrees -10 degrees , PL: 0 degrees -50 degrees ) (P < 0.01). This suggests use of the far anteromedial portal technique might result in lower stress on the graft at the femoral tunnel aperture and therefore might reduce graft damage.Mar. 2009, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 17(3) (3), 270 - 6, English, International magazine[Refereed]
- (公社)日本整形外科学会, Feb. 2009, 日本整形外科学会雑誌, 83(2) (2), S120 - S120, Japanese膝前十字靱帯解剖学的一重束再建術と解剖学的二重束再建術の術後成績の検討 三次元電磁気計測システムを用いた定量的評価
- (公社)日本整形外科学会, Feb. 2009, 日本整形外科学会雑誌, 83(2) (2), S143 - S143, Japanese膝前十字靱帯1ルート再建術を施行し得た部分断裂症例の動作解析 三次元電磁気計測システムでの定量的評価
- 2009, 2009 IEEE INTERNATIONAL CONFERENCE ON SYSTEMS, MAN AND CYBERNETICS (SMC 2009), VOLS 1-9, 1334 - +, EnglishAn Evaluation Method of EndoButton Position in MDCT Image After Anterior Cruciate Ligament Reconstruction.[Refereed]International conference proceedings
- 2009, 2009 IEEE INTERNATIONAL CONFERENCE ON FUZZY SYSTEMS, VOLS 1-3, 933 - +, EnglishAutomated Extraction Method of Bone Tunnel after the Anterior Cruciate Ligament Reconstruction from a Knee MDCT Image by using Fuzzy Inference[Refereed]International conference proceedings
- (一社)日本臨床スポーツ医学会, Oct. 2008, 日本臨床スポーツ医学会誌, 16(4) (4), S184 - S184, Japanese解剖学的二重束前十字靱帯再建術における大腿骨孔出口での移植腱の曲げ角度の検討 Far anteromedial portal techniqueとtranstibial techniqueの比較
- Jul. 2008, OPERATIVE TECHNIQUES IN SPORTS MEDICINE, 16(3) (3), 125 - 130, English[Refereed]Scientific journal
- (公社)日本整形外科学会, Mar. 2008, 日本整形外科学会雑誌, 82(3) (3), S614 - S614, Japanese三次元電磁気センサーを用いたLachman testの定量的計測 KT-1000およびX線学的計測との比較
- ACL reconstruction is performed to recover the injured knee which often happens in sports activity such as football, and basketball. The ACL reconstruction makes two bone tunnels in the femur and tibia. Then, the harvested graft passes the bone tunnels so that the femur and tibia are connected. However, the bone tunnel is enlarged with time. The bone tunnel enlargement can cause instability of the knee. To examine relationship of the bone tunnel enlargement and clinical results, the bone tunnel should be evaluated quantitatively and three-dimensionally. In MDCT image, intensity distribution around the bone tunnel is unclear so that it is difficult to extract the volume of the bone tunnel with error by simple thresholding method or region growing method. Then, manual extraction needs a lot of time and energy for examiners, because the data size of MDCT image is huge. Therefore, this study proposes an automated extraction method of the bone tunnel from MDCT image by using active contour model. In the experiment, the proposed method and the manual extraction method were applied for six patients who were performed ACL reconstruction. As a result, the proposed method could extract the bone tunnel with the error of 3.5 % in comparing to the manual extraction method.Japan Society for Fuzzy Theory and intelligent informatics, Feb. 2008, J. SOFT, 20(1) (1), 53 - 65, Japanese
- W.B. Saunders, 2008, Operative Techniques in Orthopaedics, 18(3) (3), 190 - 195, English[Refereed]Scientific journal
- 2008, 2008 WORLD AUTOMATION CONGRESS PROCEEDINGS, VOLS 1-3, 1 - +, EnglishREPRODUCIBILITY OF REAL-TIME KNEE KINEMATICS MEASUREMENT SYSTEM USING ELECTROMAGNETIC DEVICE[Refereed]International conference proceedings
- (一社)日本臨床スポーツ医学会, Oct. 2007, 日本臨床スポーツ医学会誌, 15(4) (4), S201 - S201, Japanese3次元電磁センサーを用いたLachman testの定量的評価
- (一社)中部日本整形外科災害外科学会, Sep. 2007, 中部日本整形外科災害外科学会雑誌, 50(秋季学会) (秋季学会), 169 - 169, Japanese鏡視下前十字靱帯再建術において膝屈曲角度は大腿骨骨孔位置の決定にどのように影響するか?
- In vivo measurement of the pivot-shift test in the anterior cruciate ligament-deficient knee using an electromagnetic device.BACKGROUND: The pivot-shift test is commonly used for assessing dynamic instability in anterior cruciate ligament-insufficient knees, which is related to subjective knee function, unlike static load-displacement measurement. Conventional measurements of 3-dimensional position displacement cannot assess such dynamic instability in vivo and produce comparable parameters. Not only 3-dimensional position displacement but also its 3-dimensional acceleration should be measured for quantitative evaluation of the pivot-shift test. HYPOTHESIS: Knees with a positive pivot-shift test result have increased tibial anterior translation and acceleration of its subsequent posterior translation, and they are correlated with clinical grading. STUDY DESIGN: Controlled laboratory study. MATERIALS AND METHODS: Thirty patients with isolated anterior cruciate ligament injury were included. Pivot-shift tests were evaluated under anesthesia manually and experimentally using an electromagnetic knee 6 degrees of freedom measurement system. From 60 Hz of 6 degrees of freedom data, coupled tibial anterior translation was calculated, and acceleration of posterior translation was computed by secondary derivative. RESULTS: All anterior cruciate ligament-deficient knees demonstrated a positive pivot-shift test result. The coupled tibial anterior translation was 7.7 and 15.6 mm in anterior cruciate ligament-intact and -deficient knees, respectively. The acceleration of posterior translation was -797 and -2001 mm/s(2), respectively. These differences were significant (P < .01). The coupled tibial anterior translation and acceleration of posterior translation in the anterior cruciate ligament-deficient knee were larger in correlation with clinical grading (P = .03 and P < .01, respectively). CONCLUSION: The increase of tibial anterior translation and acceleration of subsequent posterior translation could be detected in knees with a positive pivot-shift result, and this increase was correlated to clinical grading. CLINICAL RELEVANCE: These measurements can be used for quantified evaluation of dynamic instability demonstrated by the pivot-shift test.Jul. 2007, The American journal of sports medicine, 35(7) (7), 1098 - 104, English, International magazine[Refereed]
- The effect of graft tensioning in anatomic 2-bundle ACL reconstruction on knee joint kinematics.Recently, double bundle ACL reconstruction, in which the two bundles thought to have different effects on knee kinematics are reconstructed separately, is widely believed to more favorably restore normal knee kinematics than conventional single bundle ACL reconstruction. However, rotational kinematics during physiological movement after double bundle reconstruction has rarely been tested. The purpose of this study was to measure the kinematics of the ACL deficient and reconstructed knees using two different tensioning conditions in double bundle reconstruction, and to examine the effects of each graft on knee kinematics. Six cadaveric knees were used. Six degrees-of-freedom of knee kinematics and the tension of each graft were monitored during simulated knee extension with the ACL intact, resected, and reconstructed under two different tensioning conditions: 50 N on anteromedial bundle and 0 N on posterolateral bundle (AM-favored condition); 0 N on anteromedial bundle and 50 N on posterolateral bundle (PL-favored condition). Tibial translation: After ACL reconstruction, the tibia overcorrected posteriorly in both conditions. Such an overcorrection in the AM-favored condition was larger than in the PL-favored condition. Tibial rotation: The tibia was significantly externally rotated after ACL reconstruction at a low flexion angle in both conditions. However, at a high flexion angle, tibial external rotation was shown only in the AM-favored condition. Graft tension: While total tensions were similar between the two conditions, the AM bundle shared more tension in the AM-favored condition than in the PL-favored condition. A total of 50 N of tension force was assumed to be excessive for normalizing knee kinematics at a low flexion angle even if double bundle reconstruction was used. Additionally, the AM-favored tensioning reconstruction made the tibia rotate externally and translate posteriorly even at a high flexion angle. Further research is needed to normalize knee kinematics after ACL reconstruction, however it is recommended that a moderate tensioning force is applied to the PL bundle and a minimal tensioning force to the AM bundle in double bundle reconstruction to obtain better knee kinematics.May 2007, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 15(5) (5), 508 - 14, English, International magazine[Refereed]
- 2005, INTERNATIONAL CONFERENCE ON SYSTEMS, MAN AND CYBERNETICS, VOL 1-4, PROCEEDINGS, 1949 - 1954, EnglishJoint surface geometry based standardization for the ACL insertion by using fuzzy logic[Refereed]International conference proceedings
- (一社)日本脊椎脊髄病学会, May 2004, 日本脊椎脊髄病学会雑誌, 15(1) (1), 214 - 214, Japanese
- Unstable pelvic insufficiency fracture in a patient with rheumatoid arthritis.The occurrence of pelvic insufficiency fractures in patients with rheumatoid arthritis has not previously been well emphasized. These fractures are difficult to detect clinically, and appropriate radiological investigation is necessary for diagnosis. A 72-year-old woman with rheumatoid arthritis presented with severe left groin pain. Pelvic radiographs showed parasymphyseal fractures, and marked instability of these fractures was observed at the follow-up 2 weeks later. Computed tomographic scan of the sacrum showed a widened linear fracture gap in the left sacral ala. Because the patient's pain was so severe that she could not change position, external fixation was performed to achieve rapid pain relief and early mobilization. Although most patients with these fractures respond well to simple conservative treatments, parasymphyseal fractures combined with sacral fractures may cause disruption of the pelvic ring and occasionally need operative management.Jan. 2004, Rheumatology international, 24(1) (1), 46 - 9, English, International magazine[Refereed]
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S188 - S188, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S195 - S195, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S197 - S197, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S203 - S203, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S203 - S203, Japanese
- (一社)日本臨床スポーツ医学会, Oct. 2020, 日本臨床スポーツ医学会誌, 28(4) (4), S262 - S262, Japanese
- (一社)中部日本整形外科災害外科学会, Oct. 2020, 中部日本整形外科災害外科学会雑誌, 63(秋季学会) (秋季学会), 213 - 213, Japanese弾発現象を伴った長母趾屈筋腱の絞扼性腱鞘滑膜炎に対して後足部内視鏡手術で治療した一例
- (一社)中部日本整形外科災害外科学会, Oct. 2020, 中部日本整形外科災害外科学会雑誌, 63(秋季学会) (秋季学会), 220 - 220, Japanese膝前十字靱帯再建術後脛骨骨髄炎に対し抗生剤入りセメント充填術を施行した一例
- (公社)日本整形外科学会, Sep. 2020, 日本整形外科学会雑誌, 94(8) (8), S1925 - S1925, Japanese
- (公社)日本整形外科学会, Sep. 2020, 日本整形外科学会雑誌, 94(8) (8), S1929 - S1929, Japanese
- (公社)日本整形外科学会, Sep. 2020, 日本整形外科学会雑誌, 94(8) (8), S2026 - S2026, Japanese
- (一社)中部日本整形外科災害外科学会, Sep. 2020, 中部日本整形外科災害外科学会雑誌, 63(5) (5), 829 - 830, Japanese
- (一社)中部日本整形外科災害外科学会, May 2020, 中部日本整形外科災害外科学会雑誌, 63(3) (3), 503 - 503, Japanese前十字靱帯再建術後再鏡視膝関節鏡術後に生じた仮性動脈瘤の1例
- (一社)中部日本整形外科災害外科学会, Apr. 2020, 中部日本整形外科災害外科学会雑誌, 63(春季学会) (春季学会), 25 - 25, Japanese半月板修復術の今までの限界と今後の可能性 スポーツ選手の半月板損傷
- (一社)中部日本整形外科災害外科学会, Apr. 2020, 中部日本整形外科災害外科学会雑誌, 63(春季学会) (春季学会), 195 - 195, Japanese高位脛骨骨切り術における術後立位・臥位での下肢アライメントの検討
- (一社)日本臨床スポーツ医学会, Apr. 2020, 日本臨床スポーツ医学会誌, 28(2) (2), 298 - 306, Japanese
- 関西関節鏡・膝研究会, Mar. 2020, 関西関節鏡・膝研究会プログラム・演題抄録, 32回, 32 - 32, JapanesePatellofemoral Instability-Case-based discussion 内側膝蓋大腿靱帯再建術を中心とした治療
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(2) (2), S21 - S21, Japanese膝前十字靱帯再建の過去・現在・未来
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(2) (2), S322 - S322, Japanese造影CTによる高位脛骨骨切り術と脛骨粗面下骨切り術における膝窩動脈損傷のリスク評価
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(2) (2), S405 - S405, Japanese半月板損傷のバイオメカニクスupdate 半月板損傷がACL損傷・再建膝のバイオメカニクスに及ぼす影響
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(2) (2), S465 - S465, Japanese足関節・足部疾患に対する鏡視下手術の最先端 後足部疾患に対する後足部内視鏡手術の最先端
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(2) (2), S473 - S473, Japaneseわが国の人工足関節置換術の治療戦略-2020- Combined TAA人工足関節の実際
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(3) (3), S738 - S738, Japanese3DMRIによる足関節外側靱帯損傷術前後の踵腓靱帯の画像評価に対する検者間信頼性の検討
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(3) (3), S952 - S952, Japanese重度の内反動揺性を伴う足関節不安定症に対する鏡視下外側靱帯修復術の治療成績
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(3) (3), S1062 - S1062, Japanese人工距骨併用人工足関節置換術後の踵骨および舟状骨における骨嚢胞性変化
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(3) (3), S1062 - S1062, Japanese変形性足関節症の病期分類と人工足関節置換術後の臨床成績の関係
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(3) (3), S1063 - S1063, Japanese当科における人工足関節置換術(TAA)と人工距骨併用人工足関節置換術(combined TAA)の治療成績の比較
- (公社)日本整形外科学会, Mar. 2020, 日本整形外科学会雑誌, 94(3) (3), S1188 - S1188, Japanese人工足関節置換術(TAA)による荷重軸の変化について
- 関西関節鏡・膝研究会, Mar. 2020, 関西関節鏡・膝研究会プログラム・演題抄録, 32回, 21 - 21, Japanese膝関節 骨端線閉鎖前のACL損傷膝に対するTibial Tunnelを作成しないSBによるPhyseal-Sparing Techniquesを用いた2症例の治療成績
- 関西関節鏡・膝研究会, Mar. 2020, 関西関節鏡・膝研究会プログラム・演題抄録, 32回, 32 - 32, JapanesePatellofemoral Instability-Case-based discussion 内側膝蓋大腿靱帯再建術を中心とした治療
- 琉球医学会, 2020, 琉球医学会誌, 39(1-4) (1-4), 94 - 94, Japanese健常成人における男性と女性の静止時及び歩行時の足底圧の評価 In shoe systemを用いた解析
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S171 - S171, Japanese前十字靱帯再建術術前の膝伸展筋力と術後1年でのスポーツ復帰の関連
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S173 - S173, JapaneseACL再建によってPivot-shiftが消失した膝における過制動の有無の調査
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S188 - S188, Japaneseジュニア体操競技選手における段階づけた倒立練習方法の有用性
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S194 - S194, Japaneseジュニア期の体操競技選手における手関節痛と関連因子の検討
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S210 - S210, Japaneseアメリカンフットボールにおける脳振盪発生時の状況 動画による解析
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S210 - S210, Japaneseアメリカンフットボールにおける脳振盪発生時の接触状況 動画による解析
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S249 - S249, Japaneseスポーツ選手における半月板単独損傷に対する半月板縫合術の治療成績
- (一社)日本臨床スポーツ医学会, Nov. 2019, 日本臨床スポーツ医学会誌, 27(4) (4), S250 - S250, Japanese膝前十字靱帯解剖学的二重束再建術における骨孔重複が主観的膝機能に及ぼす影響の調査
- (一社)日本関節病学会, Oct. 2019, 日本関節病学会誌, 38(3) (3), 225 - 225, Japanese変形性膝関節症に対する骨切り術の最先端 骨軟骨柱移植を併用した高位脛骨骨切り術
- (一社)日本関節病学会, Oct. 2019, 日本関節病学会誌, 38(3) (3), 225 - 225, Japanese変形性膝関節症に対する骨切り術の最先端 骨軟骨柱移植を併用した高位脛骨骨切り術
- (一社)中部日本整形外科災害外科学会, Sep. 2019, 中部日本整形外科災害外科学会雑誌, 62(5) (5), 943 - 944, Japanese
- (一社)中部日本整形外科災害外科学会, Sep. 2019, 中部日本整形外科災害外科学会雑誌, 62(5) (5), 943 - 944, Japanese大腿骨遠位骨切り術および高位脛骨骨切り術(double-level osteotomy)後に発生したcheckrein変形の1例
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1684 - S1684, Japaneseマウス変形性膝関節症モデルにおけるSIRT1活性化薬剤SRT2014投与による変形性関節症進行抑制効果
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1771 - S1771, Japanese健常成人における歩行中の足底圧評価 In shoe systemを用いた解析
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1847 - S1847, Japanese内反型変形性膝関節症患者における立位と臥位の下肢アライメントの違い 高位脛骨骨切り術の術前計画に及ぼす影響
- (公社)日本整形外科学会, Sep. 2019, 日本整形外科学会雑誌, 93(8) (8), S1920 - S1920, Japanese半月板横断裂に対するcross tie grip sutureと従来縫合法の力学試験による比較Summary national conference
- (株)メディカ出版, Aug. 2019, 整形外科Surgical Technique, 9(4) (4), 470 - 476, Japanese若手医師のための経験すべき"領域別"手術講座 膝(PART 1) 前十字靱帯再建術(屈筋腱を用いる方法)
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 391 - 391, Japanese10代患者における解剖学的二重束前十字靱帯再建術の術後成績
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 422 - 422, Japanese足関節外側靱帯損傷に対する治療 スポーツ選手には手術が必要か? スポーツ選手の足関節外側靱帯に対する低侵襲手術
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 424 - 424, Japanese半月板手術 スポーツ選手適応 温存手術か保存手術か? 半月板切除術
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 492 - 492, Japanese当科における足関節外側靱帯損傷に対する鏡視下外側靱帯修復術の臨床成績
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 558 - 558, JapaneseACL損傷に対する治療〜エビデンスとアート ACL損傷に対する治療 アートをエビデンスにする
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 391 - 391, Japanese10代患者における解剖学的二重束前十字靱帯再建術の術後成績
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 422 - 422, Japanese足関節外側靱帯損傷に対する治療 スポーツ選手には手術が必要か? スポーツ選手の足関節外側靱帯に対する低侵襲手術
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 424 - 424, Japanese半月板手術 スポーツ選手適応 温存手術か保存手術か? 半月板切除術
- (一社)日本整形外科スポーツ医学会, Aug. 2019, 日本整形外科スポーツ医学会雑誌, 39(4) (4), 558 - 558, JapaneseACL損傷に対する治療〜エビデンスとアート ACL損傷に対する治療 アートをエビデンスにする
- (株)メディカ出版, Aug. 2019, 整形外科Surgical Technique, 9(4) (4), 470 - 476, Japanese若手医師のための経験すべき"領域別"手術講座 膝(PART 1) 前十字靱帯再建術(屈筋腱を用いる方法)
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 564 - 564, JapaneseACL遺残組織温存の賛否 前十字靱帯再建術における遺残組織に含まれる血管由来細胞の治癒能
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2019, JOSKAS, 44(4) (4), 378 - 378, Japanese膝関節疾患における再生医療の最前線 軟骨再生の基礎、臨床研究
- (株)南江堂, Apr. 2019, 別冊整形外科, (75) (75), 100 - 103, Japanese【整形外科診療における最先端技術】診断、評価 動的評価 電磁気センサを用いた関節運動の動的評価
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(2) (2), S357 - S357, Japanese
- (公社)日本整形外科学会, Mar. 2019, 日本整形外科学会雑誌, 93(2) (2), S357 - S357, Japaneseラグビーワールドカップ2019のメディカルサポート ジャパンラグビー・トップチームのメディカルサポート
- スポーツ傷害フォーラム, 2019, スポーツ傷害, 24, 30 - 30, Japanese少年サッカーチームにおけるスポーツ外傷・障害の調査 保護者アンケートによる調査
- Sep. 2018, 中部日本整形外科災害外科学会雑誌, 61(秋季学会) (秋季学会), 197, Japanese広範囲のステロイド誘発性大腿骨内顆骨壊死に対して腸骨骨移植と骨軟骨柱移植術を併用して治療を行った一例[Refereed]Meeting report
- (一社)日本整形外科スポーツ医学会, Aug. 2018, 日本整形外科スポーツ医学会雑誌, 38(4) (4), 596 - 596, Japaneseジュニア体操競技における倒立時の疼痛調査
- (一社)日本関節鏡・膝・スポーツ整形外科学会, May 2018, JOSKAS, 43(4) (4), 226 - 226, Japanese器械体操に必要な倒立姿勢と身体因子との関連性
- May 2018, JOSKAS, 43(4号) (4号), 646, Japanese大腿四頭筋腱を用いた内側膝蓋大腿靱帯再建術と脛骨粗面移行術を併用して再手術を施行した2例Meeting report
- 国立大学リハビリテーション療法士協議会, Mar. 2018, 国立大学リハビリテーション療法士学術大会誌, 39回, 76 - 81, Japanese前十字靱帯再建術後に復帰したスポーツに対する満足度と関連する要因の検討
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S175 - S175, Japaneseトップリーグ所属のラグビーチームにおける4年間の傷害報告 肉離れを中心に
- (一社)日本臨床スポーツ医学会, Oct. 2017, 日本臨床スポーツ医学会誌, 25(4) (4), S211 - S211, Japanese
- Jul. 2017, 日本骨代謝学会学術集会プログラム抄録集, (35回) (35回), 128, Japanese骨格のバイオロジーと疾患病態にせまる 軟骨変性の制御因子と制御機構[Refereed]Meeting report
- (公社)日本整形外科学会, Mar. 2017, 日本整形外科学会雑誌, 91(3) (3), S762 - S762, Japanese膝関節前外側支持機構の生体力学的解析
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2016, JOSKAS, 41(4) (4), 367 - 367, Japanese臨床使用可能な3機器を用いたPivot shift定量的評価方法の有用性についての比較調査
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2016, JOSKAS, 41(4) (4), 368 - 368, Japanese主観的膝機能を反映する定量的pivot-shift test評価項目の検討
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2016, JOSKAS, 41(4) (4), 392 - 392, Japanese人工膝関節全置換術後1年から2年の膝関節機能と身体機能の変化が満足度の変化に与える影響
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2016, JOSKAS, 41(3) (3), 1068 - 1074, Japanese体幹の荷重支持機能の左右差がジャンプ動作に与える影響
- 金原出版(株), May 2016, 整形・災害外科, 59(6号) (6号), 817 - 821, Japanese[Invited]Introduction commerce magazine
- (公社)日本整形外科学会, Mar. 2016, 日本整形外科学会雑誌, 90(3) (3), S480 - S480, JapaneseACL不全膝・再建膝の評価 膝前十字靱帯不全膝・再建膝の評価 三次元電磁気センサーを用いた評価
- SAGE Publications Ltd, 01 Jul. 2015, Orthopaedic Journal of Sports Medicine, 3(7) (7), 1 - 2, EnglishReport scientific journal
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2015, JOSKAS, 40(4) (4), 129 - 129, Japanese膝蓋骨不安定症の病態と治療 高度脱臼素因例への対応
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2015, JOSKAS, 40(4) (4), 323 - 323, Japanese膝前十字靱帯損傷への取り組み 膝前十字靱帯(ACL)再建膝評価 スポーツ復帰に向けた取り組み
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2015, JOSKAS, 40(4) (4), 354 - 354, Japanese前十字靱帯再建術における前方制動性と関節内靱帯張力を適正する為の初期固定張力の検討
- (公社)日本整形外科学会, Mar. 2015, 日本整形外科学会雑誌, 89(3) (3), S745 - S745, Japanese内側膝蓋大腿靱帯再建術においてX線透視下に決定した大腿骨骨孔位置で再建靱帯は適切な長さ変化を示すか
- (一社)日本臨床スポーツ医学会, Oct. 2014, 日本臨床スポーツ医学会誌, 22(4) (4), S213 - S213, Japanese
- (公社)日本整形外科学会, Aug. 2014, 日本整形外科学会雑誌, 88(8) (8), S1607 - S1607, Japaneseバイオメカニクスと手術・リハビリテーションへの応用 前十字靱帯損傷膝の定量評価
- (公社)日本整形外科学会, Aug. 2014, 日本整形外科学会雑誌, 88(8) (8), S1611 - S1611, Japanese膝前十字靱帯再建術における移植腱初期固定張力の関節内への伝達率の検討
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2014, JOSKAS, 39(4) (4), 137 - 137, JapaneseTibial tuberosity-trochlear groove distance高値患者における内側膝蓋大腿靱帯再建術術後成績
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2014, JOSKAS, 39(4) (4), 369 - 369, Japanese解剖学的前十字靱帯再建術の大腿骨骨孔周辺にかかる圧分布の評価
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jul. 2014, JOSKAS, 39(4) (4), 371 - 371, Japanese膝前十字靱帯再建術における初期固定張力の関節内への伝達率の検討
- 金原出版, Apr. 2014, 整形・災害外科, 57(4) (4), 411 - 416, JapaneseEvaluation of the knee instability related to anterior cruciate ligament reconstruction
- (公社)日本整形外科学会, Mar. 2014, 日本整形外科学会雑誌, 88(2) (2), S343 - S343, Japanese膝蓋骨不安定症の病態と治療 内側膝蓋大腿靱帯再建術術後成績評価と成績に及ぼす因子の検討
- (公社)日本整形外科学会, Mar. 2014, 日本整形外科学会雑誌, 88(3) (3), S1006 - S1006, Japanese三次元電磁気センサーを用いた前十字靱帯損傷膝における遺残組織の関節制動性評価
- (一社)日本臨床スポーツ医学会, Oct. 2013, 日本臨床スポーツ医学会誌, 21(4) (4), S242 - S242, Japanese競技レベルの高いスポーツ選手の膝半月板単独損傷に対する半月板縫合術の治療成績
- SAGE Publications Ltd, 01 Sep. 2013, Orthopaedic Journal of Sports Medicine, 1(4) (4), EnglishReport scientific journal
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2013, JOSKAS, 38(4) (4), 249 - 249, Japanese当科における前十字靱帯再建術時に半月板縫合術を行った症例の治療成績
- (一社)日本関節鏡・膝・スポーツ整形外科学会, Jun. 2013, JOSKAS, 38(4) (4), 251 - 251, Japanese当科での膝半月板単独損傷に対する半月板縫合術の治療成績
- Mar. 2013, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 21(3) (3), 749 - 749, EnglishOthers
- Mar. 2013, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 21(3) (3), 748 - 748, EnglishOthers
- 関西関節鏡・膝研究会, Mar. 2013, 関西関節鏡・膝研究会プログラム・演題抄録, 25回, 40 - 40, Japanese正常ACL機能再現に向けての我々の再建術式 当科における解剖学的二重束ACL再建術及びACL補強術
- (公社)日本整形外科学会, Mar. 2013, 日本整形外科学会雑誌, 87(2) (2), S467 - S467, Japanese前十字靱帯部分損傷に対する後外側線維束補強術の術後臨床成績
- (公社)日本整形外科学会, Mar. 2013, 日本整形外科学会雑誌, 87(3) (3), S531 - S531, Japanese未来への扉 膝 前十字靱帯部分損傷に対する術前、術後評価、補強術
- (公社)日本整形外科学会, Mar. 2013, 日本整形外科学会雑誌, 87(3) (3), S956 - S956, Japanese前十字靱帯損傷による膝の不安定性と再建術後の不安定性の残存に関与する潜在的不安定性の定量的評価
- 全日本病院出版会, Feb. 2013, Monthly book medical rehabilitation, (154) (154), 7 - 11, Japanese膝の動的不安定性評価 : 電磁気センサーを用いた計測 (特集 膝靱帯損傷の治療およびリハビリテーション)
- 2013, 17TH INTERNATIONAL CONFERENCE IN KNOWLEDGE BASED AND INTELLIGENT INFORMATION AND ENGINEERING SYSTEMS - KES2013, 22, 590 - 598, English[Refereed]
- Fuji Technology Press, 2013, Journal of Advanced Computational Intelligence and Intelligent Informatics, 17(6) (6), 818 - 827, English
- (一社)日本臨床スポーツ医学会, Oct. 2012, 日本臨床スポーツ医学会誌, 20(4) (4), S209 - S209, Japanese前十字靱帯部分損傷に対する後外側線維束補強術の術後臨床成績
- (一社)日本臨床スポーツ医学会, Oct. 2012, 日本臨床スポーツ医学会誌, 20(4) (4), S211 - S211, Japanese三次元電磁気センサーを用いた膝前十字靱帯再建術による機能改善の定量的評価
- (一社)日本臨床スポーツ医学会, Oct. 2012, 日本臨床スポーツ医学会誌, 20(4) (4), S211 - S211, Japanese前十字靱帯損傷膝における三次元電磁気センサーを用いたPivot shift testの定量的評価
- 2012, 中部日本整形外科災害外科学会雑誌, 55(2) (2)診断に難渋した膝関節滑膜性骨軟骨腫症の1例
- It is important to examine the knee joint for understanding clinical outcome. The conventional methods have been reported an analysis method of the six degree of freedom of the knee joint. However, the conventional methods have not been reported the automatic process to classify the knee joint into the femur and tibia which is necessary for the automation of the analysis method. Therefore, we have developed an automatic analysis method of the six degree of freedom for the knee joint used the automatic classification of the femur and tibia by the fuzzy inference. The proposal method was applied to six knees. As a result, the proposed method can analysed the knee joint automatically.Japan Society for Fuzzy Theory and Intelligent Informatics, 2011, Proceedings of the Fuzzy System Symposium, 27(0) (0), 163 - 163, Japanese
- 2010, ファジィシステムシンポジウム講演論文集(CD-ROM), 26th, ROMBUNNO.TA3-3, Japanese
- 2010, 日本知能情報ファジィ学会北信越支部シンポジウム講演論文集, 19th, 17 - 20, Japanese前十字靭帯再建術後の膝MDCT画像中におけるScrew位置の解析法
- 10 Oct. 2009, 日本知能情報ファジィ学会北信越支部シンポジウム講演論文集, 18th, 51 - 54, Japanese前十字靭帯再建術後の膝MDCA画像中におけるEndoButtonの移動に関する研究
- 25 Oct. 2008, 関節鏡, 33(3) (3), 170 - 170, JapaneseDouble bundle ACL reconstruction : Surgical technique and mid-term results
- 日本臨床スポーツ医学会, 25 Aug. 2007, Japanese journal of clinical sports medicine, 15(3) (3), 454 - 459, JapaneseInfections after Arthroscopic Anterior Cruciate Ligament Reconstruction
- 2007, 2007 IEEE/ICME International Conference on Complex Medical Engineering, CME 2007, 503 - 506[Refereed]
- 01 Jun. 2006, 関節鏡 = ARTHROSCOPY Society magazine guidance & Contribution rules, 31(1) (1), 172 - 172, JapaneseAnalysis of the Drill Hole Orientation of Posterolateral Bundle in Anatomic ACL Reconstruction : far anterior medial versus transtibial
- 01 Jun. 2006, 関節鏡 = ARTHROSCOPY Society magazine guidance & Contribution rules, 31(1) (1), 66 - 66, JapaneseThe effect of initial tensioning in the anatomic 2-bundle ACL reconstruction on knee joint motion
- 20 Oct. 2005, 膝 = The knee, 30(1) (1), 17 - 20, JapaneseLength change of the anterior cruciate ligament in deep knee flexion : Forced full flexion exercise may endanger ACL graft
- 01 Jun. 2005, 日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine, 25(1) (1), 69 - 69, JapanesePresent Status and Future Aspect of a Team Doctor Support for College American Football
- 01 Jun. 2005, 日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine, 25(1) (1), 168 - 168, JapaneseReturn to Sports Activity after Arthroscopic Partial Menisectomy in Athletes
- 01 Jun. 2005, 日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine, 25(1) (1), 35 - 35, JapaneseNew Method for the Standardization of the ACL Foot Print Location
- 01 Jun. 2005, 日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine, 25(1) (1), 19 - 19, JapaneseA Quantitative Assessment of the End Point During the Lachman Test
- 01 Jun. 2005, 日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine, 25(1) (1), 49 - 49, JapaneseComparison of ACL Reconstruction Using Single or Double Bundle Procedures
- Others, Springer-Verlag Berlin, 2018, EnglishReturn to Play in Football. An evidence based approach / Quadriceps Strength Recovery After ACL Reconstruction Using Hamstrings Tendon Autograft and Return to Play.Scholarly book
- Others, Springer International Publishing Switzerland, 2017, EnglishRotatory Knee Instability. An Evidence Based Approach. / Quantifying the Forces During the Pivot Shift Test.Scholarly book
- Others, Springer International Publishing Switzerland, 2017, EnglishRotatory Knee Instability. An Evidence Based Approach. / Development of Electromagnetic Tracking for the Pivot Shift.Scholarly book
- ACL study group, Jan. 2020, EnglishThe coalition of tibial tunnels in anatomic double bundle ACL reconstruction, does it matter? Investigation using an electromagnetic pivot-shift measurement.Oral presentation
- 第46回臨床バイオメカニクス学会 学術集会, Nov. 2019, JapaneseACL損傷・再建膝の不安定性評価と動作解析Nominated symposium
- 63rd Annual Congress of the Korean Orthopaedic Association, Oct. 2019, English, International conferenceWhat does it take to improve the current ACL reconstruction?[Invited]Nominated symposium
- 17th Korea-Japan combined meeting of orthopaedic sports medicine, Sep. 2019, English, International conferenceQuantitative evaluation of the pivot-shift is a key to improve current ACL treatment.[Invited]Nominated symposium
- 第45回日本整形外科スポーツ医学会学術集会, Aug. 2019, Japanese, Domestic conferenceACL損傷に対する治療 アートをエビデンスにする[Invited]Nominated symposium
- 第11回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2019, Japanese, Domestic conferenceIf you can’t measure it, you can’t improve it.[Invited]Nominated symposium
- 12th Biennial Congress International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, May 2019, English, International conferenceRemaining Pivot-Shift Was Observed in the ACL Reconstructed Knee with Unrepaired Lateral Meniscus Tear.Oral presentation
- 12th Biennial Congress International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, May 2019, English, International conferenceHow to Organize a Multicenter Clinical Trial.Nominated symposium
- 12th Biennial Congress International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS), May 2019, English, International conferenceDiagnosis/Objective Measurement of the Rotational Laxity.Nominated symposium
- 第31回関西関節鏡・膝研究会, Mar. 2019, Japanese, 関西関節鏡・膝研究会, 大阪, Domestic conference巨大なsubchondral cystを伴う変形性足関節症に対する治療経験Oral presentation
- AAOS annual meeting 2019, Mar. 2019, English, American academy of orthopaedic surgeons, Las Vegas, International conferenceThe Multifactorial Genesis of Rotatory Knee LaxityPoster presentation
- 第49回日本人工関節学会, Feb. 2019, Japanese, 日本人工関節学会, 東京, Domestic conference人工足関節置換術(TAA)における距骨コンポートネント設置位置が術後の沈下量に及ぼす影響についての検討Oral presentation
- 第49回日本人工関節学会, Feb. 2019, Japanese, 日本人工関節学会, 東京, Domestic conference高度内反変形における人工足関節置換術の術後成績Oral presentation
- The 65th Annual Meeting of Orthopaedic Research Society, Feb. 2019, English, Orthopaedic Research Society, Austin, International conferenceInhibition of the osteoarthritis progression by administration of SIRT1 activator SRT2104 in micePoster presentation
- The 65th Annual Meeting of the Orthopaedic Research Society, Feb. 2019, English, Orthopaedic Research Society, Austin, International conferenceEvaluation of the Tibial Bone Tunnel Position after Double-bundle Anterior Cruciate Ligament Reconstruction Based on Two Different PlanesPoster presentation
- The 65th Annual Meeting of the Orthopaedic Research Society, Feb. 2019, English, Orthopaedic Research Society, Austin, International conferenceBiomechanical Evaluation of Cross Tie Grip Suture for Radial Meniscal TearsPoster presentation
- The 65th Annual Meeting of the Orthopaedic Research Society, Feb. 2019, English, Orthopaedic Research Society, Austin, International conferenceA newly developed non-invasive evaluation of ankle joint motion using an electromagnetic system is comparable to the radiographic assessmentPoster presentation
- 第24回スポーツ傷害フォーラム, Jan. 2019, Japanese, スポーツ傷害フォーラム, 大阪, Domestic conference少年サッカーチームにおけるスポーツ外傷・障害の調査-保護者アンケートによる調査-Oral presentation
- 第45回日本臨床バイオメカニクス学会, Nov. 2018, Japanese, 日本臨床バイオメカニクス学会, 秋田, Domestic conference電磁気センサーを用いた足関節前方引き出しテストの定量評価法Oral presentation
- 第45回日本臨床バイオメカニクス学会, Nov. 2018, Japanese, 日本臨床バイオメカニクス学会, 秋田, Domestic conference電磁気センサーを用いた足関節可動域の定量評価法の開発Oral presentation
- 第45回日本臨床バイオメカニクス学会, Nov. 2018, Japanese, 日本臨床バイオメカニクス学会, 秋田, Domestic conference電磁気センサーによる定量的評価方法を用いた前十字靱帯損傷膝に対する徒手検査の比較Oral presentation
- 第29回日本臨床スポーツ医学会学術集会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conference前十字靱帯再建術後６ヶ月での客観的指標の目標値達成と術後１年時のスポーツ復帰およびその満足度との関連Oral presentation
- 第29回日本臨床スポーツ医学会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conference前十字靱帯再建術後スポーツ復帰者の主観的評価に影響を及ぼす因子の検討Oral presentation
- 第29回日本臨床スポーツ医学会学術集会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conference前十字靱帯再建術後スポーツ復帰者の主観的評価に影響を及ぼす因子の検討Oral presentation
- 第29回日本臨床スポーツ医学会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conference前十字靱帯再建術後6 ヶ月での客観的指標の目標値達成と術後1年時のスポーツ復帰およびその満足度との関連.Oral presentation
- 第45回日本臨床バイオメカニクス学会, Nov. 2018, Japanese, 日本臨床バイオメカニクス学会, 秋田, Domestic conference前十字靱帯解剖学的二重束再建術におけるOutside-in法とTrans-portal法でのGraft bending angleの比較Oral presentation
- 第29回日本臨床スポーツ医学会学術集会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conference骨端線閉鎖前患者における二重束前十字靱帯再建術の術後成績Oral presentation
- 第45回日本臨床バイオメカニクス学会, Nov. 2018, Japanese, 日本臨床バイオメカニクス学会, 秋田, Domestic conference異なる２つの面による膝前十字靱帯解剖学的二重束再建術後の脛骨骨孔評価Oral presentation
- 第29回日本臨床スポーツ医学会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conferenceラグビー選手のハムストリングス肉離れに対してノルディック・ハムストリングスを導入した予防効果の検討.Oral presentation
- 第29回日本臨床スポーツ医学会学術集会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conferenceラグビー選手のハムストリングス肉離れに対してノルディック・ハムストリングスを導入した予防効果の検討Oral presentation
- 第29回日本臨床スポーツ医学会学術集会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conferenceスポーツ選手・愛好家における自家培養軟骨移植術の術後臨床成績Oral presentation
- 第33回日本臨床リウマチ学会, Nov. 2018, Japanese, 日本臨床リウマチ学会, 東京, Domestic conferenceRAにおける足部の外科的治療Public symposium
- The 21st International Conference on Mechanics in Medicine and Biology, Nov. 2018, English, Taiwanese Society of Biomechanics, Taipei, International conferenceBiomechanical evaluation of the knee rotational instability for the anterior cruciate ligament injury and treatment using advanced technologies.[Invited]Invited oral presentation
- 第45回日本臨床バイオメカニクス学会, Nov. 2018, Japanese, 日本臨床バイオメカニクス学会, 秋田, Domestic conferenceACL損傷膝におけるPivot-shift testのEMS計測時の脛骨前後移動の波形解析Oral presentation
- 第29回日本臨床スポーツ医学会学術集会, Nov. 2018, Japanese, 日本臨床スポーツ医学会, 札幌, Domestic conference10代患者における解剖学的二重束前十字靱帯再建術の術後成績Oral presentation
- 第33回日本整形外科学会基礎学術集会, Oct. 2018, Japanese, 日本整形外科学会, 奈良, Domestic conference電磁気センサーを用いた足関節可動域の定量評価法の開発Oral presentation
- 第131回中部日本整形外科災害外科学会・学術集会, Oct. 2018, Japanese, 中部日本整形外科災害外科学会, 倉敷, Domestic conference広範囲のステロイド誘発性大腿骨内顆骨壊死に対して腸骨骨移植と骨軟骨柱移植術を併用して治療を行った一例Oral presentation
- 第33回日本整形外科学会基礎学術集会, Oct. 2018, Japanese, 日本整形外科学会, 奈良, Domestic conferenceACL再建術後に残存する膝動的不安定性撲滅のためのpivot-shift testの定量的評価Public symposium
- 第37回日本運動器移植・再生医学研究会, Sep. 2018, Japanese, 日本運動器移植・再生医学研究会, 札幌, Domestic conferenceスポーツ選手・愛好家における自家培養軟骨移植術の術後臨床成績Oral presentation
- 第44回日本整形外科スポーツ医学会学術集会, Sep. 2018, English, 日本整形外科スポーツ医学会, 徳島, Domestic conferenceArthroscopic lateral ligament repair for chronic lateral ankle ligament[Invited]Nominated symposium
- 第55回兵庫県膝関節研究会, Sep. 2018, Japanese, 兵庫県膝関節研究会, 神戸, Domestic conference10代患者における解剖学的二重束前十字靱帯再建術の術後成績[Invited]Invited oral presentation
- 第7回日本Knee Osteotomy フォーラム, Jul. 2018, Japanese, 日本Knee Osteotomy フォーラム, 札幌, Domestic conference内反型変形性膝関節症患者における下肢長尺X線像の立位と臥位の違い～高位脛骨骨切り術の術前計画におよぼす影 響～Poster presentation
- 第7回日本Knee Osteotomy フォーラム, Jul. 2018, Japanese, 日本Knee Osteotomy フォーラム, 札幌, Domestic conference大腿骨遠位内反骨切り術前後における膝蓋大腿関節の関節鏡視評価Oral presentation
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, Japanese, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conference大腿骨遠位内反骨切り術前後における膝蓋大腿関節の関節鏡視評価Poster presentation
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, Japanese, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conference足関節外側不安定症に伴う足根洞症候群に対する鏡視下外側靭帯修復術Oral presentation
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, Japanese, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conference足関節外側不安定症に対する鏡視下外側靭帯修復術[Invited]Nominated symposium
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, Japanese, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conference前十字靭帯解剖学的二重束再建術におけるOutside-in法とTransportal法の骨孔評価～三次元コンピューター断層撮影を用いた解析～Poster presentation
- JACC Certified Doctor’s Meeting in Fukuoka, Jun. 2018, Japanese, 株式会社ジャパン・ティッシュ・エンジニアリング, 福岡, Domestic conferenceスポーツ選手・愛好家とJACC[Invited]Invited oral presentation
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, English, 福岡, Domestic conferenceStrategy of Treatment of knee dislocation and Multiple Knee Ligament InjuriesInvited oral presentation
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, English, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conferenceQuantitative Measurements for Dynamic Instability of Knees[Invited]Nominated symposium
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, Japanese, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conferenceOs subfibulareを伴う足関節外側不安定症に対する鏡視下外側靭帯修復術の手術成績Oral presentation
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, Japanese, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conferenceMuscle strains of lower extremities in professional baseball players -10years follow up-Oral presentation
- 第10回日本関節鏡・膝・スポーツ整形外科学会, Jun. 2018, Japanese, 日本関節鏡・膝・スポーツ整形外科学会, 福岡, Domestic conferenceACL再建術後のPivot-shiftに対する前外側関節包合併損傷の影響の定量的評価による検討Poster presentation
- 第91回日本整形外科学会学術集会, May 2018, Japanese, 日本整形外科学会, 神戸, Domestic conference膝前十字靭帯損傷の治療[Invited]Invited oral presentation
- 第91回日本整形外科学会学術集会, May 2018, Japanese, 日本整形外科学会, 神戸, Domestic conference半月水平断裂に対する治療戦略Public symposium
- 第91回日本整形外科学会学術集会, May 2018, Japanese, 日本整形外科学会, 神戸, Domestic conference当科における人工足関節置換術(TAA)での、術後骨溶解(osteolysis)のZone分類と評価Oral presentation
- 第91回日本整形外科学会学術集会, May 2018, Japanese, 日本整形外科学会, 神戸, Domestic conference当科における人工距骨併用人工足関節置換術（combinedTAA)の治療成績と適応の検討Oral presentation
- 第91回日本整形外科学会学術集会, May 2018, Japanese, 日本整形外科学会, 神戸, Domestic conference人工足関節置換術後における距骨下関節代償機能のX線学的検討Oral presentation
- 第91回日本整形外科学会学術集会, May 2018, Japanese, 日本整形外科学会, 神戸, Domestic conference回旋不安定性の評価に基づくACL再建術の進歩Public symposium
- 第91回日本整形外科学会学術集会, May 2018, Japanese, 日本整形外科学会, 神戸, Domestic conferenceアキレス腱断裂に対する保存療法Public symposium
- APKASS Biannual Congress 2018, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceThe unrepaired meniscus tear causes residual rotational laxity after the anterior cruciate ligament reconstruction.Oral presentation
- APKASS Biannual Congress 2018, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceThe Role of the Rotation Stabilities of the Knee after Anterior Cruciate Ligaments Reconstruction with Anterolateral Capsule injuryPoster presentation
- The 18th European Society of Sports Traumatology, Knee Surgery & Arthroscopy Congress, May 2018, English, The European Society of Sports Traumatology, Knee Surgery & Arthroscopy, Scotland, International conferenceThe effects of time from injury to surgery and meniscal injury on rotational knee laxity in anterior cruciate ligament-deficient kneesOral presentation
- 18th ESSKA Congress, May 2018, English, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, Glasgow, International conferenceThe effects of time from injury to surgery and meniscal injury on rotational knee laxity in anterior cruciate ligament-deficient kneesOral presentation
- APKASS Biannual Congress 2018, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceSurgical Treatment for Insertional Calcific Achilles Tendinopathy using Percutaneous Achilles Repair System (PARS) combined with bridging suture technique – a report of 2 cases -Poster presentation
- APKASS Biannual Congress 2018, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceDoes Medial Patellofemoral Ligament Reconstruction Negatively Affect Knee Extensor Strength?Oral presentation
- APKASS Biannual Congress 2018, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceComparison Of Bone Tunnel Position Between Outside-in And Transportal Techniques After Anatomic Double-bundle Anterior Cruciate Ligament Reconstruction Using Three-dimensional Computed TomographyPoster presentation
- The 18th European Society of Sports Traumatology, Knee Surgery & Arthroscopy Congress, May 2018, English, The European Society of Sports Traumatology, Knee Surgery & Arthroscopy, Scotland, International conferenceComparison of bone tunnel position between outside-in and transportal techniques after anatomical double-bundle anterior cruciate ligament reconstruction using three-dimensional computed tomography.Poster presentation
- 18th ESSKA Congress, May 2018, English, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, Glasgow, International conferenceComparison of bone tunnel position between outside-in and transportal techniques after anatomical double-bundle anterior cruciate ligament reconstruction using three-dimensional computed tomographyPoster presentation
- APKASS Biannual Congress 2018, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceClinical Outcomes After Revision Anterior Cruciate Ligament ReconstructionPoster presentation
- 2018 Asia-Pacific Knee, Arthroscopy and Sports Medicine Society, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceChanges of Patellofemoral Arthritis After Medial Open-Wedge High Tibial OsteotomyPoster presentation
- The 18th European Society of Sports Traumatology, Knee Surgery & Arthroscopy Congress, May 2018, English, The European Society of Sports Traumatology, Knee Surgery & Arthroscopy, Scotland, International conferenceBiomechanical function on Anterolateral Structure of Knee:Quantitative Evaluation Using the Electromagnetic Measurement SystemOral presentation
- 2018 Asia-Pacific Knee, Arthroscopy and Sports Medicine Society, May 2018, English, Asia-Pacific Orthopaedic Society for Sports Medicine, Sydney, International conferenceArthroscopic Broström procedure for sinus tarsi syndrome associated with lateral ankle instabilityPoster presentation
- The 30th Annual Meeting of Kansai Arthroscopy and Knee Society, Mar. 2018, Japanese, Kansai Arthroscopy and Knee Society, 大阪, Domestic conference膝関節再生の現状と展望[Invited]Nominated symposium
- The 30th Annual Meeting of Kansai Arthroscopy and Knee Society, Mar. 2018, Japanese, Kansai Arthroscopy and Knee Society, 大阪, Domestic conference外傷後の大腿骨内反変形を伴った変形性膝関節症に対して大腿骨遠位外反骨切り術を施行した1例Oral presentation
- The 64th Annual Meeting of the Orthopaedic Research Society, Mar. 2018, English, The Orthopaedic Research Society, New Orleans, USA, International conferenceThe postoperative impact of the concomitant ALC injury on the rotational laxity in the ACL reconstructed knees -Quantitative evaluation of the pivot-shift test at one year follow-up after ACL reconstruction-Poster presentation
- The 48th Annual Meeting of the Japanease Society for Replacement Arthroplasty, Feb. 2018, Japanese, The Japanese Society for Replacement Arthroplasty, 東京, Domestic conferenceClinical results of periprosthetic osteolysis after total ankle arthroplastyOral presentation
- The 48th Annual Meeting of the Japanease Society for Replacement Arthroplasty, Feb. 2018, Japanese, The Japanese Society for Replacement Arthroplasty, 東京, Domestic conferenceThe Flexibility of Subtalar Joint after Total Ankle Arthroplasty with Total Talar ProsthesisOral presentation
- The 23th Annual Meeting of Sports Injuries Forum, Jan. 2018, Japanese, Sports Injuries, 大阪, Domestic conferenceSurgical Treatment for Insertional Calcific Achilles Tendinopathy using Percutaneous Achilles Repair System (PARS) combined with bridging suture technique – a report of 2 cases -Oral presentation
- The 23th Annual Meeting of Sports Injuries Forum, Jan. 2018, Japanese, Sports Injuries, 大阪, Domestic conferenceRevision ACL再建術の臨床成績Oral presentation
- The 30th Annual Meeting of the Japan society for endoscopic surgery, Dec. 2017, Japanese, Annual Meeting of the Japan society for endoscopic surgery, 京都, Domestic conference半月板縫合術の適応と限界[Invited]Nominated symposium
- 日本knee osteotomyフォーラム, Nov. 2017, Japanese, 日本knee osteotomyフォーラム, 金沢, Domestic conference両側内側半月後角損傷と大腿骨内顆骨壊死に対して、骨軟骨柱移植術を併用した高位脛骨骨切り術にて治療した1例Poster presentation
- 第28回日本臨床スポーツ医学会学術集会, Nov. 2017, Japanese, 日本臨床スポーツ医学会, 東京, Domestic conference膝前十字靭帯再建術 －Joint Instability Measurement Interfaceの開発経験より－Others
- The 44th Annual Meeting of the Japanese Society for Clinical Biomechanics, Nov. 2017, Japanese, Japanese Society for Clinical Biomechanics, 松山, Domestic conference反復性膝蓋骨脱臼患者における内側膝蓋大腿靭帯再建術前後の膝伸展筋力の変化Oral presentation
- The 28th Annual Meething of the Japanese Society of Clinical Sports Medicine, Nov. 2017, Japanese, Japanese Society of Clinical Sports Medicine, 東京, Domestic conference反復性膝蓋骨脱臼患者における内側膝蓋大腿靭帯再建術前後の膝伸展筋力の変化Oral presentation
- The 28th Annual Meething of the Japanese Society of Clinical Sports Medicine, Nov. 2017, Japanese, Japanese Society of Clinical Sports Medicine, 東京, Domestic conferenceArthroscopic Brostrom procedure for sinus tarsi syndrome associated with lateral ankle instabilityOral presentation
- The 44th Annual Meeting of the Japanese Society for Clinical Biomechanics, Nov. 2017, Japanese, Japanese Society for Clinical Biomechanics, 松山, Domestic conference電磁気センサーによる定量的評価を用いた 前十字靭帯再建による回旋不安定性と患者立脚型臨床評価の改善度の相関関係について調査Oral presentation
- The 28th Annual Meeting of Japanese Society of Clinical Sports Medicine, Nov. 2017, Japanese, Japanese Society of Clinical Sports Medicine, 東京, Domestic conferenceThe effect of gender on the rotatory laxity in patients with isolate anterior cruciate ligament injuryOral presentation
- The 28th Annual Meeting of the Japanese Society of Clinical Sports Medicine, Nov. 2017, Japanese, The Japanese Society of Clinical Sports Medicine, 東京, Domestic conferenceThe concomitant meniscus tear causes remaining knee rotational laxity after the anterior cruciate ligament reconstructionOral presentation
- The 28th Annual Meeting of the Japanese Society of Clinical Sports Medicine, Nov. 2017, Japanese, The Japanese Society of Clinical Sports Medicine, 東京, Domestic conferenceThe postoperative impact of the concomitant ALC injury on the rotational laxity in the ACL reconstructed knees -Quantitative evaluation of the pivot-shift test at one year follow-up after ACL reconstruction-Oral presentation
- The 44th Annual Meeting of the Japanese Society for Clinical Biomechanics, Nov. 2017, Japanese, Japanese Society for Clinical Biomechanics, 松山, Domestic conferenceAnalysis of Quadrant Method for Bone Tunnel Position in Anterior Cruciate Ligament Reconstruction Using 3-dimensional Computed TomographyOral presentation
- The 44th Annual Meeting of the Japanese Society for Clinical Biomechanics, Nov. 2017, Japanese, Japanese Society for Clinical Biomechanics, 松山, Domestic conferenceProblems and solutions of the anterior cruciate ligament reconstruction from the viewpoint of rotational instability[Invited]Nominated symposium
- The 129th Meeting of the Central Japan Association of Orthopaedic Surgery and Traumatology, Oct. 2017, Japanese, The Central Japan Association of Orthopaedic Surgery and Traumatology, 富山, Domestic conferenceThe relationship between time from injury to surgery and tibial acceleration during the pivot shift test in anterior cruciate ligament-deficient knees.Oral presentation
- The 32nd Annual Research Meeting of the Japanese Orthopaedic Association, Oct. 2017, Japanese, The Japanese Orthopaedic Association, 沖縄, Domestic conferenceAnalysis of Quadrant method for bone tunnel position in anterior cruciate ligament reconstruction using 3-dimensional computed tomographyPoster presentation
- 兵庫県膝関節研究会, Sep. 2017, Japanese, 兵庫県膝関節研究会, 神戸, Domestic conference両側内側半月後角損傷と大腿骨内顆骨壊死に対して、骨軟骨柱移植術を併用した高位脛骨骨切り術にて治療した1例Oral presentation
- The 43rd Annual Meeting of Japanease Orthopaedic Society for Sports Medicine, Sep. 2017, Japanese, Japanese Orthopaedic Society for Sports Medicine, 宮崎, Domestic conferenceThe effect of the concomitant meniscus tear on the rotational laxity in the anterior cruciate ligament injured kneesOral presentation
- The 43rd Annual Meeting of Japanease Orthopaedic Society for Sports Medicine, Sep. 2017, Japanese, Japanease Orthopaedic Society for Sports Medicine, 宮崎, Domestic conferenceLimited clinical value in MRI evaluation of anterolateral capsule injury in ACL injured- kneesOral presentation
- 2017 Annual Meeting of American Orthopaedic Society for Sports Medicine, Jul. 2017, English, The American Orthopaedic Society for Sports Medicine, Toronto, Canada, International conferenceConcomitant Lateral Meniscus Injury Aggravates Rotational Laxity of the Anterior Cruciate Ligament-Injured KneesPoster presentation
- 2017 Annual Meeting of American Orthopaedic Society for Sports Medicine, Jul. 2017, English, The American Orthopaedic Society for Sports Medicine, Tronto, Canada, International conferenceAnterolateral Capsule Injury Did Not Aggravate Rotational Laxity of the Anterior Cruciate Ligament Injured Knees Measured by Quantitative Pivot-shift EvaluationPoster presentation
- The 9th of Annual Meething of Japanese Orthopaedic Society of Knee,Arthroscopy and Sports Medicine, Jun. 2017, Japanese, The Japanese Orthopaedic Society of Knee,Arthroscopy and Sports Medicine, 札幌, Domestic conference軟骨細胞による再生医療Public symposium
- The 9th Annual Meeting of Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine, Jun. 2017, Japanese, Japanese Orthopaedic Society of Knee,Arthroscopy and Sports Medicine, 札幌, Domestic conferenceThe relationship between time from injury to surgery and tibial acceleration during the pivot shift test in anterior cruciate ligament-deficient knees.Oral presentation
- The 9th Annual Meeting of Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine, Jun. 2017, Japanese, Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine, 札幌, Domestic conferenceQuantitative measurement of the pivot shift test for complete elimination of the remaining dynamic instability after the ACL reconstruction[Invited]Nominated symposium
- The 9th Annual Meeting of Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine, Jun. 2017, Japanese, Japanese Orthopaedic Society of Knee,Arthroscopy and Sports Medicine, 札幌, Domestic conferenceAnalysis of Quadrant Method for Bone Tunnel Position in Anterior Cruciate Ligament Reconstruction Using 3-dimensional Computed TomographyPoster presentation
- The 11th Biennial International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress, Jun. 2017, English, International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, Shanghai, China, International conferenceThe impact of the anterolateral capsule injury on the rotational laxity in the anterior cruciate ligament injured-knees. A result of clinical quantitative evaluation of the pivot-shift testOral presentation
- The 11th Biennial International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress, Jun. 2017, English, International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine, Shanghai, China, International conferenceAggravated Rotational Laxity Due to the Concomitant Meniscus Tear in the Anterior Cruciate Ligament-Injured Knees Detected by the Quantitative Measurement of the Pivot-Shift TestOral presentation
- The 9th Annual Meeting of Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine, Jun. 2017, Japanese, Japanese Orthopaedic Society of Knee,Arthroscopy and Sports Medicine, 札幌, Domestic conferenceACL再建術後の動的不安定性残像の撲滅を目指して 膝関節前外側支持機構の生体力学的解析 屍体膝実験からの知見をふまえて[Invited]Nominated symposium
- The 90th Annual Meeting of the Japanese Orthopaedic Association, May 2017, Japanese, The Japanese Orthopaedic Association, 仙台, Domestic conferenceＸ線透視下大腿骨骨孔同定法を用いた内側膝蓋大腿靭帯再建術における再建靭帯の長さ変化の解析.Oral presentation
- The 90th Annual Meeting of the Japanese Orthopaedic Association, May 2017, Japanese, The Japanese Orthopaedic Association, 仙台, Domestic conferenceBiomechanical function on Anterolateral Structure of Knee ~Quantitative Evaluation Using the Electromagnetic Measurement System~Oral presentation
- The 90th Annual Meeting of the Japanese Orthopaedic Association, May 2017, Japanese, The Japanese Orthopaedic Association, 仙台, Domestic conferenceThe impact of the anterolateral capsule injury on the rotational laxity in the anterior cruciate ligament injured-knees. A result of clinical quantitative evaluation of the pivot-shift testPoster presentation
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 01 Apr. 2021 - 31 Mar. 2025膝前十字靭帯再建術後の再損傷予測モデルの構築および機械学習による応用令和3年度は臨床予測モデルの構築にあたり必要となるデータの収集を主に行った。データとして、カルテ上より年齢、性別、身長、体重、手術日、受傷前の活動レベル、術式、Graftの種類、内側半月板および外側半月板損傷の有無、軟骨損傷の有無を、レントゲン上から骨形態である脛骨後方傾斜角を聴取測定した。 併せて、これまでに測定してきた膝関節機能（膝関節伸展・屈曲筋力、脛骨前方動揺性）および自覚的評価について、データを整理するとともに令和３年度にも追加で測定を行った。 また床反力計については新規に購入し、臨床現場での導入に向けてシステムの設定を行った。
- 学術研究助成基金助成金／国際共同研究加速基金(国際共同研究強化), 2018 - 2020, Principal investigatorCompetitive research funding
- 学術研究助成基金助成金／基盤研究(C), Apr. 2016 - Mar. 2019, Principal investigatorCompetitive research funding