Daisuke Hamada, Sampson R Eric, Maynard D Robert and Zuscik J Michael : Surgical induction of posttraumatic osteoarthritis in the mouse, 2014.
4.
Daisuke Hamada, Sampson R Eric, Maynard D Robert and Zuscik J Michael : Surgical induction of posttraumatic osteoarthritis in the mouse, 2014.
学術論文(審査論文):
1.
Yasuaki Tamaki, Tomohiro Goto, Keizo Wada, Yasuyuki Ohmichi, Daisuke Hamada and Koichi Sairyo : Robotic arm-assisted total hip arthroplasty via a minimally invasive anterolateral approach in the supine position improves the precision of cup placement in patients with developmental dysplasia of the hip., Journal of Orthopaedic Science, Vol.29, No.2, 559-565, 2024.
(要約)
The mean absolute error of the inclination angle and the anteversion angle between the preoperative planning and the postoperative measurement was significantly smaller in the RA-THA group (inclination, 1.1° ± 0.9; anteversion, 1.3° ± 1.0) than in the NA-THA group (inclination, 2.2° ± 1.5; anteversion, 3.3° ± 2.5). For acetabular cup positioning, the mean discrepancy between the preoperative planning and the postoperative measurement was 1.3 ± 1.3 mm on the transverse axis, 2.0 ± 2.0 mm on the longitudinal axis, and 1.3 ± 1.7 mm on the sagittal axis in the RA-THA group and 1.6 ± 1.4 mm, 2.6 ± 2.3 mm, and 1.8 ± 1.3 mm, respectively, in the NA-THA group. High precision of cup positioning was observed in both groups with no statistically significant difference.
Yasuyuki Ohmichi, Noriaki Mima, Keizo Wada, Ryo Okada, Yasuaki Tamaki, Daisuke Hamada, Tomohiro Goto, Masatoshi Morimoto, Tsutomu Enomoto, Hiroki Hayashi and Koichi Sairyo : Can TBS reference values be a valid indicator for clinical vertebral fracture? A cross-sectional study., Journal of Bone and Mineral Metabolism, Vol.42, No.1, 60-68, 2024.
(要約)
The reference value for low TBS (≤ 1.23) was useful as an indicator for CVF, especially in patients with osteoporosis. It is expected that reference values for TBS will be established in official guidelines in the future.
(キーワード)
Humans / Female / Spinal Fractures / Cross-Sectional Studies / Reference Values / Cancellous Bone / Osteoporosis / Bone Density / Absorptiometry, Photon / Lumbar Vertebrae / Osteoporotic Fractures
Yasuyuki Ohmichi, Daisuke Hamada, Keizo Wada, Yasuaki Tamaki, Shota Shigekiyo and Koichi Sairyo : Robotic-assisted total knee arthroplasty improved component alignment in the coronal plane compared with navigation-assisted total knee arthroplasty: a comparative study., Journal of Robotic Surgery, Vol.17, No.6, 2831-2839, 2023.
(要約)
The purpose of this study was to directly compare implant placement accuracy and postoperative limb alignment between robotic-assisted total knee arthroplasty and navigation-assisted total knee arthroplasty. This retrospective case-control study included a consecutive series of 182 knees (robotic-assisted group, n = 103 knees; navigation-assisted group, n = 79). An image-free handheld robotic system (NAVIO) or an image-free navigation system (Precision N) was used. Component and limb alignment were evaluated on three-dimensional computed tomography scans and full-length standing anterior-posterior radiographs. We compared the errors between the final intraoperative plan and the postoperative coronal and sagittal alignment of the components and the hip-knee-ankle angle between the two groups. The orientation of the femoral and tibial components in the coronal plane were more accurate in the robotic-assisted group than in the navigation-assisted group (p < 0.05). There was no significant difference in the orientation of the femoral and tibial component in the sagittal plane between the two groups. There were fewer outliers in the tibial coronal plane in the robotic-assisted group (p < 0.05). There was also no significant difference in the frequency of outlying values for coronal or sagittal alignment of the femoral component or sagittal alignment of the tibial component or the hip-knee-ankle angle between the two groups. Robotic-assisted total knee arthroplasty using a handheld image-free system improved component alignment in the coronal plane compared with total knee arthroplasty using an image-free navigation system. Robotic surgery helps surgeons to achieve personalised alignment that may result in better clinical outcomes.
Yasuaki Tamaki, Tomohiro Goto, Keizo Wada, Yasuyuki Ohmichi, Daisuke Hamada and Koichi Sairyo : Increased hip flexion angle and protrusion of the anterior acetabular component can predict symptomatic iliopsoas impingement after total hip arthroplasty: a retrospective study., Hip International, Vol.33, No.6, 985-991, 2023.
(要約)
An increased hip flexion angle and protrusion of the anterior acetabular component predicted symptomatic IPI. The threshold cup protrusion length suggesting mild IPI might be about 3.9 mm and could be useful for identifying candidates for conservative treatment.
Yasuyuki Ohmichi, Daisuke Hamada, Ryo Okada, Keizo Wada, Yasuaki Tamaki, Shinichiro Yamada, Tomohiro Goto and Koichi Sairyo : Hematogenous prosthetic knee joint infection with Klebsiella pneumoniae caused by asymptomatic gallbladder abscess: a case report and literature review, Journal of Surgical Case Reports, Vol.2023, No.6, 2023.
(要約)
that occurred as a result of an asymptomatic gallbladder abscess. The patient was a 78-year-old man who underwent bilateral total knee arthroplasty 6 years ago. He had pain and swelling in his right knee. The synovial fluid culture of the right knee revealed
Yasuaki Tamaki, Daisuke Hamada, Keizo Wada, Tomoya Takasago, Akihiro Nitta, Yasuyuki Ohmichi, Tomohiro Goto, Yoshihiro Tsuruo and Koichi Sairyo : Kinematic comparison between the knee after bicruciate stabilized total knee arthroplasty and the native knee: A cadaveric study., The Knee, Vol.42, 289-296, 2023.
(要約)
Kinematics of BCS-TKA is close to that of the native knee. However, there is a statistically significant difference in AP position of the femur during mid flexion and initial rotational position of the tibia between the BCS-TKA knee and the native knee.
Yasuyuki Ohmichi, Tomohiro Goto, Keizo Wada, Yasuaki Tamaki, Daisuke Hamada and Koichi Sairyo : Impact of the hip-spine relationship and patient-perceived leg length discrepancy after total hip arthroplasty: A retrospective study., Journal of Orthopaedic Science, 2023.
(要約)
Sixty-nine patients were classified as having type 1 PO (rising toward the unaffected side) and 26 were classified as having type 2 PO (rising toward the affected side). Eight patients with type 1 PO and seven with type 2 PO had PLLD postoperatively. In the type 1 group, patients with PLLD had larger preoperative and postoperative PO values and larger preoperative and postoperative RLLD than those without PLLD (p = 0.01, p < 0.001, p = 0.01, and p = 0.007, respectively). In the type 2 group, patients with PLLD had larger preoperative RLLD, larger amount of leg correction, and a larger preoperative L1-L5 angle than those without PLLD (p = 0.03, p = 0.03, and p = 0.03, respectively). In type 1, postoperative PO was significantly associated with postoperative PLLD (p = 0.005), but spinal alignment was not an indicator of postoperative PLLD. The area under the curve (AUC) for postoperative PO was 0.883 (good accuracy) with a cut-off value was 1.90° CONCLUSION: Rigidity of the lumbar spine might lead to postoperative PO as a compensatory movement, resulting in PLLD after THA in type 1. Further research on the relationship between flexibility of the lumbar spine and PLLD is needed.
Akihiro Nitta, Keizo Wada, Daisuke Hamada, Koichi Oba, Hiroshi Mikami and Koichi Sairyo : Insertion of a spacer block translates the tibia anteriorly during evaluation of soft tissue balance in cruciate-retaining total knee arthroplasty., The Knee, Vol.42, 125-129, 2023.
(要約)
The mean sagittal location of the tibial center relative to the femoral center in knee flexion was 5.16 (range, -2.4, 16.3) mm at insertion of the spacer block and 6.60 (range, -1.4, 15.1) mm after CR TKA, and this difference was significant (p = 0.016).
Yasuaki Tamaki, Tomohiro Goto, Jyoji Iwase, Keizo Wada, Yasuyuki Ohmichi, Daisuke Hamada, Yoshihiro Tsuruo and Koichi Sairyo : Relationship between iliopsoas muscle surface pressure and implant alignment after total hip arthroplasty: a cadaveric study., Scientific Reports, Vol.13, No.1, 2023.
(要約)
Iliopsoas impingement after total hip arthroplasty is caused by the implant irritating the iliopsoas muscle, but changes in the iliopsoas muscle have not been quantitatively evaluated. This study assessed changes in the surface pressure of the iliopsoas muscle when the implant alignment was varied. Total hip arthroplasty was performed in 10 fresh-frozen cadaveric hips. We evaluated the maximum and mean surface pressure of the iliopsoas muscle with the hip in 20° and 10° extension, the neutral position, and 10° flexion when the anterior cup protrusion length (ACPL), stem version, and stem offset were varied. When the ACPL was changed to 0, 3, and 6 mm in 20° extension, the maximum surface pressure was significantly increased for ACPL of 6 mm compared with 0 mm. Decreased stem anteversion resulted in a significant reduction in both the maximum and mean surface pressure compared with native anteversion from 20° extension to the neutral position. Increased stem offset resulted in significant increases in the maximum and mean surface pressure of the iliopsoas muscle compared with decreased stem offset in 20° extension. Not only large ACPL but also changes in stem version and offset affected the maximum surface pressure of the iliopsoas muscle.
(キーワード)
Humans / Arthroplasty, Replacement, Hip / Prostheses and Implants / Plastic Surgery Procedures / Cadaver / Muscles
Yasuaki Tamaki, Tomohiro Goto, Jyoji Iwase, Keizo Wada, Daisuke Hamada, Yoshihiro Tsuruo and Koichi Sairyo : Contributions of the ischiofemoral ligament, iliofemoral ligament, and conjoined tendon to hip stability after total hip arthroplasty : a cadaveric study, Journal of Orthopaedic Research, Vol.40, No.12, 2885-2893, 2022.
(要約)
An adequate soft tissue balance is important in total hip arthroplasty (THA). This study assessed the contribution of the iliofemoral ligament, ischiofemoral ligament, and conjoined tendon to the range of hip rotation after THA and hip stability in response to axial traction. THA was performed in eight fresh-frozen cadaveric specimens via an anterolateral approach using a navigation system. The ischiofemoral ligament, the medial arm of the iliofemoral ligament, and the conjoined tendon were resected in that order. The ranges of external and internal rotation and the amount of movement of the femoral head in response to axial traction were measured with the hip in 10° of extension, the neutral position, and in 10°, 30°, and 60° of flexion. Resection of the medial arm of the iliofemoral ligament significantly increased the range of external rotation in 10° of extension, the neutral position, and in 10°, 30°, and 60° of flexion. The conjoined tendon was the most important inhibitor of internal rotation from 10° of extension to 30° of flexion. Although each single element had a minor role in stabilizing the hip when axial traction was applied, resection of two or more elements significantly affected joint stability. The iliofemoral ligament and conjoined tendon are the main inhibitors of external rotation and internal rotation, respectively, when THA is performed using an anterior or anterolateral approach. Resection of two or more elements could greatly affect hip stability when axial traction is applied.
(キーワード)
Humans / Arthroplasty, Replacement, Hip / Biomechanical Phenomena / Cadaver / Ligaments, Articular / Range of Motion, Articular / Tendons
Yasuaki Tamaki, Tomohiro Goto, Tomoya Takasago, Keizo Wada, Daisuke Hamada and Koichi Sairyo : Clinical and radiological outcomes of total hip arthroplasty using a highly porous titanium cup or a conventional hydroxyapatite-coated titanium cup: A retrospective study in Japanese patients., Journal of Orthopaedic Science, Vol.27, No.1, 163-168, 2022.
(要約)
The clinical outcome was excellent in both groups. The incidence of RLLs was 12.9% at 3 months, 20.8% at 6 months, 23.8% at 12 months, and 22.8% at 24 months after surgery in the OsseoTi group; there were no cases of RLL at any time after surgery in the Trident group. The RLLs were mainly distributed in zone 2. Despite the high rate of RLL in the OsseoTi group, the RLL were narrow and only 5% had a width of >1 mm at 24 months postoperatively. There were no cases with RLLs in all three zones.
Tomoya Takasago, Tomohiro Goto, Keizo Wada, Daisuke Hamada and Koichi Sairyo : Postoperative radiographic evaluation and simulation study for optimal cup placement in high-hip centre total hip arthroplasty., Hip International, Vol.31, No.3, 335-341, 2021.
(要約)
Even in severe DDH, a high-hip centre positioned approximately 25 mm superior to the inter-teardrop line was sufficient to achieve optimal bone coverage, which could lead to more secure cup fixation.
Yutaka Kinoshita, Shunji Nakano, Shinji Yoshioka, Masaru Nakamura, Tomohiro Goto, Daisuke Hamada and Koichi Sairyo : A Rare Case of Extremely Severe Heterotopic Ossification after Primary Total Hip Arthroplasty due to Persistent Mild Periprosthetic Joint Infection., Case Reports in Orthopedics, Vol.2021, 2021.
(要約)
infection in a 78-year-old male patient. The patient had poorly controlled diabetes mellitus with no diabetic complications. The patient had no previous history of hip surgery, hip injury, or systemic bacterial infection. Immediately after the initial THA, he developed intermittent low-grade fever (37°C), which persisted for 3 months; consequently, he also reported mild hip pain during walking. He experienced a gradual decrease in hip range of motion within 5 years after the surgery, with progressive gait impairment. Two revision surgeries were required for the successful treatment of this difficult case. The patient's hip function improved, and the PJI was controlled following the second revision surgery. Based on the clinical course, CNS-caused PJI may lead to severe HO. This possibility warrants verification from an accumulated number of cases.
Tomoya Takasago, Daisuke Hamada, Keizo Wada, Akihiro Nitta, Yasuaki Tamaki, Tomohiro Goto, Yoshihiro Tsuruo and Koichi Sairyo : Insufficient lateral joint laxity after bicruciate-retaining total knee arthroplasty potentially influences kinematics during flexion: A biomechanical cadaveric study., The Knee, Vol.28, 311-318, 2021.
(要約)
Knee joint laxity after BCR TKA under varus-valgus movement, anterior translation, and internal-external rotation loadings was similar to that of the native knee. However, lateral joint laxity was decreased during flexion in some cases. BCR TKA-treated knees with decreased lateral joint laxity at 90° of flexion demonstrated more limited tibial internal rotation in deep flexion than the native knee (p < 0.05). The loss of internal rotation in deep flexion was partly recovered by using a lateral insert with a posterior slope of +3°.
Yasuaki Tamaki, Tomohiro Goto, Keizo Wada, Daisuke Hamada, Yoshihiro Tsuruo and Koichi Sairyo : Anatomic evaluation of the insertional footprints of the iliofemoral and ischiofemoral ligaments: a cadaveric study., BMC Musculoskeletal Disorders, Vol.21, No.1, 828, 2020.
(要約)
The mean length of the distal medial arm of the ILFL footprint was 17.9 mm and the mean width was 9.0 mm. The mean length of the distal lateral arm of the ILFL footprint was 23.0 mm and the mean width was 9.7 mm. For the footprint of the medial arm, the insertion was in the distal third of the intertrochanteric line and that of the lateral arm was in the proximal 42% of this line. The mean distance from the lesser trochanter to the footprint of the medial arm was 24.6 mm. The mean length of the distal ISFL footprint was 11.3 mm and the mean width was 6.9 mm. The footprint of the distal ISFL was located forward of the femoral neck axis in all specimens.
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue, Shinji Kashiwaguchi, Takenobu Iwase, Daisuke Hamada and Koichi Sairyo : Long-term Outcomes of Arthroscopic Debridement With or Without Drilling for Osteochondritis Dissecans of the Capitellum in Adolescent Baseball Players: A 10-year Follow-up Study., Arthroscopy : the Journal of Arthroscopic & Related Surgery, Vol.36, No.5, 1273-1280, 2020.
(要約)
Twenty-three elbows of 23 baseball players (mean age, 14.7 [range, 13-17] years) underwent arthroscopic debridement for capitellar OCD. Mean follow-up duration was 11.5 (range, 10-13) years. Twenty patients (87%) returned to competitive baseball at their preoperative level; of these, 15 were non-pitchers and returned to the same position but only 1 of 5 pitchers returned to playing pitcher. One patient with a large defect and drilling underwent reoperation 11 years after the initial operation. Mean change in extension was 4.3° and that in flexion was 3.7°. Timmerman/Andrews score improved significantly from 160 (95% confidence interval 146.7-173.3) to 195 (95% confidence interval 185.2-204.8) at the most recent follow-up (p˂.0001). Osteochondral defects detected on preoperative radiographs were small in 10 patients, moderate in 7, and large in 6. There was no significant between-group difference in extension, flexion, or Timmerman/Andrews score preoperatively or at the most recent follow-up.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Akihiro Nitta, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Joint distraction force changes the three-dimensional articulation of the femur and tibia in total knee arthroplasty: a cadaveric study., Knee Surgery, Sports Traumatology, Arthroscopy, Vol.28, No.5, 1488-1496, 2020.
(要約)
Regardless of PCL resection, the joint center gap became larger (p = 0.002, p = 0.020) and varus ligament balance became more varus (p = 0.002, p = 0.002) with increasing joint distraction force, whereas the tibia was more internally rotated (p = 0.015, p = 0.009) and more anteriorly located (p = 0.004, p = 0.009). The tibia was more internally rotated (p = 0.015) and more posteriorly located (p = 0.026) after PCL resection than before resection.
Yasuaki Tamaki, Tomohiro Goto, Tomoya Takasago, Keizo Wada, Daisuke Hamada and Koichi Sairyo : Proximal Femoral Rotational Osteotomy for Symptomatic Femoral Retroversion : A Case Report, The Journal of Medical Investigation : JMI, Vol.67, No.1.2, 214-216, 2020.
(要約)
The Rotational osteotomy for femoral retroversion has been extremely rare despite the known association between femoral neck retroversion, hip pain, and osteoarthritis. Here, we describe a case of femoral neck retroversion for which proximal femoral rotation osteotomy. A 16-year-old boy with a past history of developmental dysplasia of the both hip treated conservatively presented with a complaint of pain in left hips. On physical examination, flexion of the left hip was limited to 90° with terminal pain. Internal rotation was also limited to 10°. Computed tomography (CT) showed -7.1° anteversion of the left femur. We performed rotational osteotomy to increase femoral anteversion because conservative treatment was not effective. The postoperative course was uneventful. At 12 postoperative months, his left hip pain was completely disappeared and femoral anteversion was 34° on CT scans. Retroversion of the femur is a distinct dynamic factor that should be considered in the evaluation of mechanical causes of hip pain. Restoring the normal rotational alignment of the hip resulted in cure of the impingement due to femoral retroversion. J. Med. Invest. 67 : 214-216, February, 2020.
Yasuaki Tamaki, Daisuke Hamada, Tadashi Mitsuhashi, Tokio Kasai, Takuya Mishiro, Takahiko Tsutsui, Kenichiro Kita and Koichi Sairyo : Intraligamentous Hematoma of the Anterior Cruciate Ligament., Case Reports in Orthopedics, Vol.2019, 2019.
(要約)
Lesions of the anterior cruciate ligament (ACL) are rare entities in clinical practice. Here, we present the case of an intraligamentous hematoma of the ACL. A 20-year-old man (height 173 cm, weight 62.9 kg, body mass index 21) with no significant past medical history developed progressively worsening pain and limitation of range of motion in the left knee due to minor trauma. No abnormality was found on plain radiography; however, magnetic resonance imaging revealed a cystic lesion in the intercondylar fossa that was hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging. We performed knee arthroscopy, made a longitudinal incision in the anterior aspect of the ACL, and identified a hematoma. The patient's postoperative course was uneventful. There is no evidence of recurrence at one year after surgery. Although the ACL is a relatively hypovascular structure, it does contain microscopic blood vessels. In this case, we speculate that the intraligamentous hematoma was the result of rupture of these very small blood vessels in response to a minor injury.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Rotational and varus-valgus laxity affects kinematics of the normal knee: A cadaveric study., Journal of Orthopaedic Surgery (Hong Kong), Vol.27, No.3, 2309499019873726, 2019.
(要約)
The present study revealed that the rotation angle of the tibia was correlated to the intermediate angle of IE laxity at 0°, 30°, 60°, and 90° of knee flexion and the coronal alignment of the lower limb also correlated to the intermediate angle of VV laxity. These findings provide important reference data on soft tissue laxity and kinematics of the normal knee.
The rotation angles of the tibia in BCR-XP were significantly different from those of the native knees both in the early flexion phase (p = 0.002 at minimum knee flexion, p = 0.002 at 0°, p = 0.041 at 10°, p = 0.009 at 20°, p = 0.026 at 30°) and in the late flexion phase (p = 0.015 at 130°, p = 0.015 at maximum knee flexion), whereas the rotational angles of the tibia in BCR-AS were similar to those of the native knee.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Mitsuhiro Kamada, Tomohiro Goto, Yoshihiro Tsuruo and Koichi Sairyo : Intraoperative analysis of the kinematics of the native knee including two-dimensional translation of the femur using a navigation system : a cadaveric study., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 367-371, 2019.
(要約)
The aim of this cadaveric study was to evaluate the intraoperative kinematics of the native knee including two-dimensional translation of the femur using a navigation system. Eight native knees of 4 fresh-frozen whole-body cadavers were used for the study. The kinematics of each knee were analyzed intraoperatively using the navigation system. Although anterior-posterior translation could not be assessed directly, it could be calculated using a formula derived from the parameters in the navigation system. The native knee showed external rotation of the femur in early knee flexion, transient internal rotation in mid flexion, and gradual external rotation in late flexion. There was no marked change in the coronal rotation angle of the mechanical axis during knee flexion. The femoral center moved anteriorly in early knee flexion and posteriorly in late flexion. The distance moved in the medial-lateral direction was relatively smaller than that in the anterior-posterior direction. Two-dimensional translation of the surgical epicondylar axis showed a medial pivot-like motion. In this cadaveric study, the kinematics of the native knee, including two-dimensional translation of the femur, could be satisfactorily assessed intraoperatively using a navigation system. The intraoperative kinematics of the knee can be analyzed in more detail using this methodology. J. Med. Invest. 66 : 367-371, August, 2019.
Yuta Uemura, Yoko Sakai, Yasuo Tsutsumi, Nami Kakuta, Chiaki Murakami, Shiho Satomi, Takuro Oyama, Naohiro Ohshita, Tomoya Takasago, Daisuke Hamada, Koichi Sairyo and Katsuya Tanaka : Postoperative nausea and vomiting following lower limb surgery :a comparison between single-injection intraarticular anesthesia and continuous epidural anesthesia., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 303-307, 2019.
(要約)
Study Objective : the incidence of postoperative nausea and vomiting (PONV) following single-injection intraarticular anesthesia was compared to that following continuous epidural anesthesia. Design : Prospective, double-blind, randomized study. Setting : University-affiliated teaching hospital. Patients : Forty-eight patients finally participated in this study, and each group contained twenty-four patients. Interventions : Patients scheduled to undergo lower limb surgery under general anesthesia were randomly allocated into two groups, to receive either single-injection intraarticular or continuous epidural anesthesia for postoperative analgesia. Measurements : The incidence and severity of PONV, complete response rates (i.e., no vomiting or rescue antiemetic use), and pain scores were recorded 2, 24, and 48 h postoperatively. Main results : No significant differences between groups were observed in the incidence and severity of PONV, rescue antiemetic use, or complete response rate at any of the time points, but only the use of rescue analgesics was significantly less in continuous epidural anesthesia group during the 2-24h postoperative period (P=0.04). Conclusion : While the use of single-injection intraarticular anesthesia following lower limb surgery did not prevent PONV more than continuous epidural anesthesia in this study, the intraarticular technique still provides greater simplicity, safety, and cost-effectiveness. J. Med. Invest. 66 : 303-307, August, 2019.
Shinji Yoshioka, Shunji Nakano, Yutaka Kinoshita, Masaru Nakamura, Tomohiro Goto, Daisuke Hamada and Koichi Sairyo : Comparison of a highly porous titanium cup (Tritanium) and a conventional hydroxyapatite-coated porous titanium cup: A retrospective analysis of clinical and radiological outcomes in hip arthroplasty among Japanese patients., Journal of Orthopaedic Science, Vol.23, No.6, 967-972, 2018.
(要約)
The mean follow-up duration was 41.3 and 38.1 months (p = 0.06) for the Tritanium and Trident groups, respectively. There were significant differences between the groups for radiolucent lines, cup abduction angle, and cup-center-edge angle. There were no significant differences in the clinical results. Radiolucent lines increased in the Tritanium group (36.1% at 3 months and 60.7% at final follow-up), whereas they decreased in the Trident group (2.5% at 3 months and 0.8% at final follow-up). The occurrence of radiolucent lines was significantly higher in the Tritanium group than in the Trident group at each follow-up period. Radiolucent lines were seen in 36.1% of patients in the Tritanium group during follow-up, without initial gaps. One cup loosening in the Tritanium group was identified at the final follow-up evaluation.
Daisuke Hamada, Keizo Wada, Tomoya Takasago, Tomohiro Goto, Akihiro Nitta, Kousaku Higashino, Yoshihiro Fukui and Koichi Sairyo : Native rotational knee kinematics are lost in bicruciate-retaining total knee arthroplasty when the tibial component is replaced., Knee Surgery, Sports Traumatology, Arthroscopy, Vol.26, No.11, 3249-3256, 2018.
(要約)
The rotational kinematics of the native knee are not always preserved after BCR TKA. Native rotational kinematics are preserved after meniscectomy and femoral replacement, but are lost after tibial replacement in BCR TKA. Surgeons should pay close attention to maintain the anteroposterior stabilizing function of the ACL in BCR TKA, rather than to restore the native rotational kinematics.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Akihiro Nitta, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Native rotational knee kinematics is restored after lateral UKA but not after medial UKA., Knee Surgery, Sports Traumatology, Arthroscopy, Vol.26, No.11, 3438-3443, 2018.
(要約)
The rotation angles of the tibia in the early flexion phase of medial UKA were significantly larger than those of native knees (p = 0.008 at minimum knee flexion, p = 0.008 at 0° knee flexion). The rotational kinematics of lateral UKA was similar to those of the native knees throughout knee flexion. There were no significant differences in varus/valgus kinematics between native and UKA knees.
Koichi Iwaki, Toshinori Sakai, Daisuke Hamada, Yohei Hayashi, Nanae Inoue, Miyuki Mitsumoto, Yusuke Hattori, Tsuyoshi Goto, Koichi Sairyo and Shuichiro Tsuji : Physical features of pediatric patients with lumbar spondylolysis and effectiveness of rehabilitation., The Journal of Medical Investigation : JMI, Vol.65, No.3.4, 177-183, 2018.
(要約)
The purpose of this study was to evaluate the physical features of pediatric patients with lumbar spondylolysis (LS), factors that increase the load during compensatory movements at the lumbar spine, and the outcomes of rehabilitation. Twenty patients were included. Fifteen items were used:fingertip-to-floor distance (FFD), straight leg raising (SLR), heel-to-buttock distance (HBD), tightness of the rectus femoris, the lateral and medial rotator muscles, iliopsoas, tensor fascia lata, adductor muscles, soleus muscle, and latissimus dorsi, and trunk rotation, sit-ups and endurance of the abdominal and back muscles. Initial findings were judged as positive or negative using previously reported cut-off values and were re-evaluated 2 or 3 months later. Positive tests were found for HBD and tightness of the rectus femoris in 85% of the patients, for endurance of the abdominal muscles in 75%, SLR and sit-ups in 70%, and FFD and tightness of the external rotator muscles in 60%. The physical features varied according to the type of sport played, and some patients were refractory to rehabilitation. Only 17.6%, 33.3%, and 40.0% of patients with initially positive findings for HBD, tightness of the external rotator muscles, and endurance of the abdominal muscles, respectively, achieved improvements after rehabilitation. J. Med. Invest. 65:177-183, August, 2018.
Ichiro Tonogai, Daisuke Hamada and Koichi Sairyo : Morphology of the Incisura Fibularis at the Distal Tibiofibular Syndesmosis in the Japanese Population., The Journal of Foot and Ankle Surgery, Vol.56, No.6, 1147-1150, 2017.
(要約)
The morphology of the distal tibiofibular syndesmosis can determine the pathology and mechanism of syndesmotic injury. The present study assessed measurements obtained from computed tomography (CT) images of the normal distal tibiofibular syndesmosis in Japanese subjects. CT scans of 120 right feet with a normal distal tibiofibular syndesmosis obtained from January 2009 to December 2016 were retrospectively assessed at the level 10 mm proximal to the tibial plafond. The incisura fibularis was considered concave when its depth was ≥4 mm and shallow when its depth was <4 mm. The depth of the incisura fibularis, anterior tibiofibular distance (TFD), posterior TFD, and longitudinal/transverse length of the distal fibula were measured. The incisura fibularis was concave in 64.2% of the feet and shallow in 35.8%. The mean anterior TFD was 2.2 ± 0.8 mm (2.4 ± 0.8 mm in males; 2.1 ± 0.8 mm in females; 2.1 ± 0.8 mm for concave; 2.2 ± 0.9 mm for shallow). The mean posterior TFD was 5.9 ± 1.6 mm (6.7 ± 2.1 in males; 5.7 ± 1.3 mm in females; 5.5 ± 1.3 mm for concave; 6.5 ± 1.9 mm for shallow). The mean longitudinal/transverse length of the distal fibula at the level of the syndesmosis was 1.2 mm (1.3 mm in males; 1.2 mm in females; 1.1 mm for concave; 1.3 mm for shallow). The mean posterior TFD was significantly greater than the mean anterior TFD and was also significantly greater in males than in females. Significant differences were found in the body mass index, posterior TFD, and longitudinal/transverse length of the distal fibula according to whether the incisura fibularis was concave or shallow. The present study has provided measurements of the normal tibiofibular syndesmosis in the Japanese population. These data suggest that the morphology of the syndesmosis varies, especially with respect to whether the incisura fibularis is concave or shallow.
Keizo Wada, Tomohiro Goto, Tomoya Takasago, Daisuke Hamada and Koichi Sairyo : Piriformis muscle syndrome with assessment of sciatic nerve using diffusion tensor imaging and tractography: a case report., Skeletal Radiology, Vol.46, No.10, 1399-1404, 2017.
(要約)
Piriformis muscle syndrome (PMS) is difficult to diagnose by objective evaluation of sciatic nerve injury. Here we report a case of PMS diagnosed by diffusion tensor imaging (DTI) and tractography of the sciatic nerve, which can assess and visualize the extent of nerve injury. The patient was a 53-year-old man with a 2-year history of continuous pain and numbness in the left leg. His symptoms worsened when sitting. Physical examination, including sensorimotor neurologic tests, the deep tendon reflex test, and the straight leg raise test, revealed no specific findings. The hip flexion adduction and internal rotation test and resisted contraction maneuvers for the piriformis muscle were positive. There were no abnormal findings on magnetic resonance imaging (MRI) of the lumbar spine. The transverse diameter of piriformis muscle was slightly thicker in affected side on MRI of the pelvis. A single DTI sequence was performed during MRI of the pelvis. Fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) of the sciatic nerve were quantified at three levels using the fiber-tracking method. FA values were significantly lower and ADC values were significantly higher distal to the piriformis muscle. We performed endoscopic-assisted resection of the piriformis tendon. Intraoperatively, the motor-evoked potentials in the left gastrocnemius were improved by resection of the piriformis tendon. The patient's symptoms improved immediately after surgery. There was no significant difference in FA or ADC at any level between the affected side and the unaffected side 3 months postoperatively. MRI-DTI may aid the diagnosis of PMS.
Takahiko Tsutsui, Tomohiro Goto, Keizo Wada, Tomoya Takasago, Daisuke Hamada and Koichi Sairyo : Efficacy of a computed tomography-based navigation system for placement of the acetabular component in total hip arthroplasty for developmental dysplasia of the hip., Journal of Orthopaedic Surgery (Hong Kong), Vol.25, No.3, 2017.
(要約)
THA using a CT-based navigation system achieved quite high accuracy of cup alignment angles and spatial cup positioning in primary THA for patients with DDH.
Ichiro Tonogai, Daisuke Hamada, Yuhei Yamasaki, Keizo Wada, Tomoya Takasago, Takahiko Tsutsui, Tomohiro Goto and Koichi Sairyo : Custom-Made Alumina Ceramic Total Talar Prosthesis for Idiopathic Aseptic Necrosis of the Talus: Report of Two Cases., Case Reports in Orthopedics, 2017.
(要約)
Two women aged 65 years and 78 years presented to our center with idiopathic necrosis of the talus. In both cases, imaging examinations showed collapse and sclerotic changes of the talar body caused by the necrosis. Both women underwent resection and placement of a third-generation custom-made alumina ceramic total talar prosthesis. Immobilization of the ankle in a short-leg cast for 3 weeks was followed by early rehabilitation. One year and 6 months after surgery, both women were able to walk without pain. Their Japanese Society for Surgery of the Foot ankle-hindfoot scale scores improved from 22 and 29/100 points to 90 and 95/100 points, respectively. To the best of our knowledge, the successful treatments of these two rare cases of idiopathic necrosis of the talus are among only a few reported cases of using a third-generation alumina ceramic prosthesis.
Ichiro Tonogai, Tetsuya Matsuura, Toshiyuki Iwame, Keizo Wada, Tomoya Takasago, Tomohiro Goto, Daisuke Hamada, Yohei Kawatani, Eiki Fujimoto, Tetsuya Kitagawa, Shoichiro Takao, Seiji Iwamoto, Moriaki Yamanaka, Masafumi Harada and Koichi Sairyo : Pseudoaneurysm of the Anterior Tibial Artery following Ankle Arthroscopy in a Soccer Player., Case Reports in Orthopedics, 2017.
(要約)
Ankle arthroscopy carries a lower risk of vascular complications when standard anterolateral and anteromedial portals are used. However, the thickness of the fat pad at the anterior ankle affords little protection for the thin-walled anterior tibial artery, rendering it susceptible to indirect damage during procedures performed on the anterior ankle joint. To our knowledge, only 11 cases of pseudoaneurysm involving the anterior tibial artery after ankle arthroscopy have been described in the literature. Here we reported a rare case of a 19-year-old soccer player who presented with pseudoaneurysm of the anterior tibial artery following ankle arthroscopy using an ankle distraction method and underwent anastomosis for the anterior tibial artery injury. Excessive distraction of the ankle puts the neurovascular structures at greater risk for iatrogenic injury of the anterior tibial artery during ankle arthroscopy. Surgeons should look carefully for postoperative ankle swelling and pain after ankle arthroscopy.
Kazuaki Mineta, Masahiko Okada, Soshi Matsumoto, Daisuke Hamada, Tomohiro Goto and Koichi Sairyo : Fracture of the Tibial Baseplate 16 Years after Miller-Galante II Total Knee Arthroplasty., Case Reports in Orthopedics, 2017.
(要約)
We report a rare case of tibial baseplate fracture of Miller-Galante II (MG II) prosthesis. We examine the factors that may cause such late fracture and review the literature on radiographic analysis and retrieval studies. A 76-year-old woman, who had undergone bilateral MG II total knee arthroplasty due to rheumatoid arthritis 16 years earlier, presented to our department with a 3-month history of left knee pain. Plain radiographs revealed severe distortion of the medial tibial component. During revision knee arthroplasty, we observed severe metallosis in the knee joint, polyethylene insert deformation, and posteromedial coronal baseplate fracture. After removal of the fractured tray, a bone deficit due to osteolysis was noted. The revision prosthesis (LCCK, Zimmer-Biomet) was implanted uneventfully. Four months after revision surgery, the patient was ambulating and had no complications. The implants on the right side had survived without complications for 17 years. We speculate that the primary causative factor of the fatigue fracture of the base plate due to loss of bony support most likely secondary to osteolysis was varus malalignment at primary implantation. This case highlights the importance of paying close attention to the correct alignment of each component at primary implantation.
Ichiro Tonogai, Daisuke Hamada and Koichi Sairyo : Radiographic changes in coronal alignment of the ankle joint immediately after primary total knee arthroplasty for varus knee osteoarthritis., The Foot and Ankle Online Journal, Vol.10, No.2, 2, 2017.
35.
Keizo Wada, Hiroshi Mikami, Daisuke Hamada, Takaharu Yamazaki, Tetsuya Tomita and Koichi Sairyo : Can intraoperative kinematic analysis predict postoperative kinematics following total knee arthroplasty? A preliminary., The Journal of Medical Investigation : JMI, Vol.65, No.1.2, 21-26, 2017.
(要約)
The preliminary study analyzed the relationship between intraoperative navigation-based kinematics and postoperative 2-dimensional/3-dimensional (2D/3D) image registration-based kinematics in total knee arthroplasty (TKA). Six knees in 5 patients were analyzed. All TKA procedures were performed using an image-free knee navigation system. Tibial internal rotation was assessed by intraoperative knee kinematics. At 1 year after surgery, tibial internal rotation was evaluated using a 2D/3D image registration technique under loaded and unloaded conditions. The correlation between intraoperative and postoperative data for the tibial internal rotation angle at 10 increments of knee flexion was then assessed. Difference in the knee flexion angle between the intraoperative and postoperative evaluations was adjusted to account for the sagittal cutting angle of the distal femur and proximal tibia. A correlation was found between the intraoperative and postoperative data for loaded knee flexion with this adjustment (Pearson's r = 0.725, p = 0.012). However, intraoperative kinematics was not significantly correlated with postoperative kinematics in the absence of loading. Larger adequately powered prospective studies are now needed to confirm our preliminary finding that postoperative loaded kinematics can be predicted by intraoperative evaluation. J. Med. Invest. 65:21-26, February, 2018.
Daisuke Hamada, Keizo Wada, Hiroshi Mikami, Shunichi Toki, Tomohiro Goto, Takahiko Tsutsui, Tomoya Takasago, Akihiro Nagamachi and Koichi Sairyo : The Posterior Condylar Cartilage Affects Rotational Alignment of the Femoral Component in Varus Knee Osteoarthritis., The Journal of Medical Investigation : JMI, Vol.64, No.1.2, 24-29, 2017.
(要約)
Rotational alignment of the femoral component in total knee arthroplasty (TKA) is important for patellar tracking and ligament balance. Preoperative planning based on radiography might have a potential risk for over-rotation because these X-ray based measurements can not detect asymmetric cartilage wear on posterior condyle. The purpose of this study is to evaluate the effect of the posterior condylar cartilage of varus osteoarthritic knee on rotational alignment of the femoral component in TKA. We established two different condylar twist angles (CTA) from intraoperative multiplanar reconstruction (MPR) images and intraoperative information of navigation system. The CTA measured by a navigation system that includes the cartilage (4.8±2.0°) was smaller than those measured by MPR images, which does not include the cartilage (6.6±2.1°) (p<0.05). The difference between these two angles that corresponds to the remaining posterior condylar cartilage was 1.7±1.2°. This result demonstrated that the posterior condylar cartilage might lead to over-rotational of the femoral component in varus osteoarthritic knee. Therefore, when determining rotational alignment of the femoral component, surgeons should consider the effect of the remaining posterior condylar cartilage to avoid the over-rotation of the femoral component, especially in severe varus knees. J. Med. Invest. 64: 24-29, February, 2016.
Kazuaki Mineta, Tomohiro Goto, Keizou Wada, Yasuaki Tamaki, Daisuke Hamada, Ichiro Tonogai, Kousaku Higashino and Koichi Sairyo : CT-based morphological assessment of the hip joint in Japanese patients: association with radiographic predictors of femoroacetabular impingement., The Bone & Joint Journal, Vol.98-B, No.9, 1167-1174, 2016.
(要約)
The prevalence of radiographic FAI was common in Japanese patients who are generally considered to have dysplastic hips. Cite this article: Bone Joint J 2016;98-B:1167-74.
(キーワード)
Acetabulum / Adult / Age Distribution / Aged / Aged, 80 and over / Femoracetabular Impingement / Femur Head / Hip Dislocation / Humans / Imaging, Three-Dimensional / Japan / Middle Aged / Observer Variation / Predictive Value of Tests / Prevalence / Range of Motion, Articular / Retrospective Studies / Severity of Illness Index / Sex Distribution / Tomography, X-Ray Computed / Young Adult
Tomoya Takasago, Tomohiro Goto, Keizo Wada, Daisuke Hamada, Toshiyuki Iwame, Tetsuya Matsuura, Akihiro Nagamachi and Koichi Sairyo : Metallosis after Exchange of the Femoral Head and Liner following Ceramic Acetabular Liner Dissociation in Total Hip Arthroplasty with a Modular Layered Acetabular Component., Case Reports in Orthopedics, Vol.2016, 2016.
(要約)
The type of bearing material that should be used in revision surgery after the failure of ceramic-on-ceramic total hip arthroplasty (THA) remains controversial. In the case of ceramic fracture, the residual ceramic particles can cause consequent metallosis when metal implants are used for revision THA. On the other hand, in the case of THA failure without ceramic fracture, revision THA with a metal femoral head provides satisfactory results. We report an unusual case of progressive osteolysis due to metallosis that developed after revision THA for ceramic liner dissociation without a liner fracture performed using a metal femoral head and polyethylene liner. The residual metal debris and abnormal pumping motion of the polyethylene liner due to the breakage of the locking system or the aspherical metal shell being abraded by the ceramic head seemed to be the cause of the progressive osteolysis.
Keizo Wada, Tomohiro Goto, Fumitake Tezuka, Shunsuke Tamaki, Daisuke Hamada, Takahiko Tsutsui and Koichi Sairyo : Variations in the obturator artery around the obturator foramen assessed by three-dimensional computed tomographic angiography and prevention of vascular-related complications in rotational acetabular osteotomy., International Orthopaedics, Vol.41, No.1, 133-139, 2016.
(要約)
The prevalence of arterial anastomosis of the obturator artery (corona mortis) was 14.3 %, with the obturator artery being located closer to the superior pubic ramus and the osteotomy site in these subjects.
Kazuaki Mineta, Tomohiro Goto, Keizo Wada, Yasuaki Tamaki, Daisuke Hamada, Kousaku Higashino and Koichi Sairyo : Comparison of femoroacetabular impingement-related radiographic features in a convenience sample of Japanese patients with and without herniation pits., Skeletal Radiology, Vol.45, No.8, 1079-1088, 2016.
(要約)
Intraclass and interclass reproducibility of all radiographic measurements was acceptable (ICC: 0.71-0.98). The prevalence of HPs was 13.9 % in all subjects and was significantly higher in men (18.1 %) than in women (7.8 %; p < 0.001). HPs were larger in male (p < 0.001) and elderly subjects (p < 0.005). In subjects with HPs, the alpha angle was larger and femoral head-neck offset and offset ratio were smaller in the cohort overall and in men. Logistic regression analysis revealed the association between radiological cam-type FAI and HPs in all subjects (odds ratio: 1.86, p < 0.001).
Tomohiro Goto, Kazuaki Mineta, Keizo Wada, Yasuaki Tamaki, Daisuke Hamada, Tomoya Takasago, Kousaku Higashino and Koichi Sairyo : Correlation between coxa profunda and morphological parameters of acetabular coverage in a Japanese cohort: A CT study., Journal of Orthopaedic Science, Vol.21, No.5, 667-672, 2016.
(要約)
Coxa profunda is a common radiographic feature in Japanese patients, especially in women. Coxa profunda may be less useful for diagnosing acetabular overcoverage because of its common occurrence with various hip morphologies and its poor specificity for detecting acetabular overcoverage. However, men with coxa profunda have greater acetabular coverage, so coxa profunda may contribute to acetabular coverage in men. We should take into account that coxa profunda may have different implications between the sexes.
Daisuke Hamada, R Maynard, E Schott, CJ Drinkwater, JP Ketz, SL Kates, JH Jonason, MJ Hilton, MJ Zuscik and RA Mooney : Suppressive effects of insulin on tumor necrosis factor-dependent early osteoarthritic changes associated with obesity and type 2 diabetes mellitus, Arthritis & Rheumatology, Vol.68, No.6, 1392-1402, 2016.
(要約)
Obesity is a state of chronic inflammation that is associated with insulin resistance and type 2 diabetes mellitus (DM), as well as an increased risk of osteoarthritis (OA). This study was undertaken to define the links between obesity-associated inflammation, insulin resistance, and OA, by testing the hypotheses that 1) tumor necrosis factor (TNF) is critical in mediating these pathologic changes in OA, and 2) insulin has direct effects on the synovial joint that are compromised by insulin resistance. The effects of TNF and insulin on catabolic gene expression were determined in fibroblast-like synoviocytes (FLS) isolated from human OA synovium. Synovial TNF expression and OA progression were examined in 2 mouse models, high-fat (HF) diet-fed obese mice with type 2 DM and TNF-knockout mice. Insulin resistance was investigated in synovium from patients with type 2 DM. Insulin receptors (IRs) were abundant in both mouse and human synovial membranes. Human OA FLS were insulin responsive, as indicated by the dose-dependent phosphorylation of IRs and Akt. In cultures of human OA FLS with exogenous TNF, the expression and release of MMP1, MMP13, and ADAMTS4 by FLS were markedly increased, whereas after treatment with insulin, these effects were selectively inhibited by >50%. The expression of TNF and its abundance in the synovium were elevated in samples from obese mice with type 2 DM. In TNF-knockout mice, increases in osteophyte formation and synovial hyperplasia associated with the HF diet were blunted. The synovium from OA patients with type 2 DM contained markedly more macrophages and showed elevated TNF levels as compared to the synovium from OA patients without diabetes. Moreover, insulin-dependent phosphorylation of IRs and Akt was blunted in cultures of OA FLS from patients with type 2 DM. TNF appears to be involved in mediating the advanced progression of OA seen in type 2 DM. While insulin plays a protective, antiinflammatory role in the synovium, insulin resistance in patients with type 2 DM may impair this protective effect and promote the progression of OA.
Keizo Wada, Daisuke Hamada, Shunsuke Tamaki, Kousaku Higashino, Yoshihiro Fukui and Koichi Sairyo : Influence of Medial collateral ligament release for internal rotation of tibia in posterior stabilized total knee arthroplasty: a cadaveric study, The Journal of Arthroplasty, Vol.32, No.1, 270-273, 2016.
(要約)
Previous studies suggested that changes in kinematics in total knee arthroplasty (TKA) affected satisfaction level. The aim of this cadaveric study was to evaluate the effect of medial collateral ligament (MCL) release by multiple needle puncture on knee rotational kinematics in posterior-stabilized TKA. Six fresh, frozen cadaveric knees were included in this study. All TKA procedures were performed with an image-free navigation system using a 10-mm polyethylene insert. Tibial internal rotation was assessed to evaluate intraoperative knee kinematics. Multiple needle puncturing was performed 5, 10, and 15 times for the hard portion of the MCL at 90° knee flexion. Kinematic analysis was performed after every 5 punctures. After performing 15 punctures, a 14-mm polyethylene insert was inserted, and kinematic analysis was performed. The tibial internal rotation angle at maximum knee flexion without multiple needle puncturing was significantly larger (9.42°) than that after 15 punctures (3°). Negative correlation (Pearson r = -0.715, P < .001) between tibial internal rotation angle at maximum knee flexion and frequency of puncture was observed. The tibial internal rotation angle with a 14-mm insert was significantly larger (7.25°) compared with the angle after 15 punctures. Tibial internal rotation during knee flexion was reduced by extensive MCL release using multiple needle puncturing and was recovered by increasing of medial tightness. From the point of view of knee kinematics, medial tightness should be allowed to maintain the internal rotation angle of the tibia during knee flexion which might lead to patient satisfaction.
Tetsuya Kimura, Tomohiro Goto, Daisuke Hamada, Takahiko Tsutsui, Keizo Wada, Shoji Fukuta, Akihiro Nagamachi and Koichi Sairyo : Subchondral insufficiency fracture of the femoral head caused by excessive lateralizatioin of the acetabular rim, Case Reports in Orthopedics, 2016.
(要約)
We present a case of a 53-year-old woman with subchondral insufficiency fracture (SIF) of the femoral head without history of severe osteoporosis or overexertion. Plain radiographs showed acetabular overcoverage with excessive lateralization of the acetabular rim. A diagnosis of SIF was made by typical MRI findings of SIF. The lesion occurred at the antipodes of the extended rim. Increased mechanical stress over the femoral head due to impingement against the excess bone was suspected as a cause of SIF. The distinct femoral head deformity is consistent with this hypothesis. This is the first report of SIF associated with acetabular overcoverage.
Keizo Wada, Hiroshi Mikami, Daisuke Hamada, Hiroshi Yonezu, Koichi Oba and Koichi Sairyo : Measurement of rotational and coronal alignment in total knee arthroplasty using a navigation system is reproducible., Archives of Orthopaedic and Trauma Surgery, Vol.136, No.2, 271-276, 2016.
(要約)
Fifty-one knees in 45 patients who received TKA, performed by a single surgeon (the senior consultant) with the resident, were included in this retrospective study. There were 7 men and 38 women and the mean age was 74.3 years. Cruciate retaining (CR) type and posterior stabilized (PS) type implants were inserted into 38 and 13 knees. The senior consultant and the resident analyzed initial kinematics, the axial rotation of the tibia and the coronal alignment of the lower limb, three times in each knee on manual passive knee flexion intraoperatively using the navigation system. Intra-class correlation coefficients (ICC) with 95 % confidence intervals were calculated to determine the reproducibility of this analysis.
Toshiyuki Iwame, Tetsuya Matsuura, Naoto Suzue, Shinji Kashiwaguchi, Takenobu Iwase, Shoji Fukuta, Daisuke Hamada, Tomohiro Goto, Takahiko Tsutsui, Keizo Wada, Hiroshi Egawa, Akihiro Nagamachi and Koichi Sairyo : Outcome of an elbow check-up system for child and adolescent baseball players., The Journal of Medical Investigation : JMI, Vol.63, No.3-4, 171-174, 2016.
(要約)
About 30% of youth baseball players had episodes of elbow pain, and 64.1% of players with elbow pain had abnormal findings on physical examination. Furthermore, 85.2% of subjects who underwent radiographic examination exhibited radiographic abnormalities. About 4% of young baseball players had an abnormal finding on initial ultrasonography screening, and nearly 50% of them had OCD of the capitellum on radiographs. J. Med. Invest. 63: 171-174, August, 2016.
Shinji Kawaguchi, Shoji Fukuta, Takahiko Tsutsui, Tetsuya Matsuura, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Ryo Miyagi, Keizo Wada, Kenichiro Kita, Shunsuke Tamaki, Toshihiko Matsumura, Akihiro Nagamachi and Koichi Sairyo : Arthroscopic excision of unstable os acromiale associated with impingement syndrome: a case report., The Journal of Medical Investigation : JMI, Vol.63, No.1-2, 131-134, 2016.
(要約)
Os acromiale is a rare anatomical variant that is caused by failure of fusion of the acromial apophysis and is usually asymptomatic. We report a case of impingement syndrome of the left shoulder secondary to unstable os acromiale, which was initially overlooked and confirmed only during arthroscopic examination. Arthroscopic excision of the unstable fragment was successful without residual dysfunction of the deltoid muscle. J. Med. Invest. 63: 131-134, February, 2016.
Subash Jha C, Shoji Fukuta, Keizo Wada, Kousaku Higashino, Rui Amari-Kita, Takahiko Tsutsui, Tomohiro Goto, Daisuke Hamada, Naoto Suzue, Tetsuya Matsuura, Toshihiko Nishisho, Mitsunobu Abe, Yoichiro Takata, Toshinori Sakai, Akihiro Nagamachi and Koichi Sairyo : Optimizing baseplate position in reverse total shoulder arthroplasty in small-sized Japanese females: technical notes and literature review., The Journal of Medical Investigation : JMI, Vol.63, No.1-2, 8-14, 2016.
(要約)
The management of cuff tear arthropathy (CTA) has always been a challenge for shoulder surgeons. Introduction of reverse total shoulder arthroplasty (RTSA) helped in providing pain relief and improved shoulder function in patients with CTA. In this study, we aimed to evaluate the short-term clinical results and some clinical details regarding the types of available prosthesis, positioning, and size of the components for RTSA in a population of short-stature female Japanese. In our seven cases, the average glenoid size was 23.9 mm in width and 34.2 mm in height. The average width was smaller than the size of all available baseplates. We implanted reverse shoulder prostheses with baseplate that measured 28 mm in diameter and two locking screws. The center of the baseplate was shifted to allow slight anterior overhang relative to the anatomical center to avoid breakage of the posterior cortex and to achieve firm fixation. One case of humeral shaft fracture occurred while inserting the humeral stem and required encircling wiring. In our experience, the short term clinical results of RTSA were excellent, but a new prosthesis that is designed to fit the short stature of Asians with smaller glenoid and humerus should be considered. J. Med. Invest. 63: 8-14, February, 2016.
Daisuke Hamada, Tetsuya Matsuura, Kosuke Sugiura, Tadahiro Higuchi, Naoto Suzue, Tomohiro Goto, Takahiko Tsutsui, Keizo Wada, Shoji Fukuta and Koichi Sairyo : An Unusual Cause of Posterior Elbow Impingement: Detachment of a Hypertrophied Posterior Fat Pad., Case Reports in Orthopedics, Vol.2015, 2015.
(要約)
We report a case of a 47-year-old woman who developed posterior impingement of the elbow due to detachment of a hypertrophied posterior fat pad. She reported acute left elbow pain after leaning back onto a hard object with her hand and subsequently experienced a "catching" sensation. Comparison with the magnetic resonance images of a normal elbow revealed a hypertrophied posterior fat pad interposed between the olecranon and olecranon fossa in both elbows, with the fat pad in the left elbow located more inferiorly than that in the right elbow. Elbow arthroscopy showed the olecranon fossa covered by the fat pad, a portion of which was detached from the rest of the pad. Debridement of the detached portion was performed until no impingement was evident. Postoperatively, full extension of the elbow did not elicit pain. Clinicians should include this pathology among the differential diagnoses for posterior elbow pain.
Shoji Fukuta, Takahiko Tsutsui, Tetsuya Matsuura, Naoto Suzue, Daisuke Hamada, Tomohiro Goto and Koichi Sairyo : Detached Anterior Horn of the Medial Meniscus Mimicking a Parameniscal Cyst., Case Reports in Orthopedics, Vol.2015, 2015.
(要約)
We report a case of a detached anterior horn of the medial meniscus with anterior knee pain. Preoperative magnetic resonance images of the knee were initially interpreted as a parameniscal cyst. Arthroscopic examination revealed subluxation of the anterior horn of the medial meniscus due to detachment from its anterior tibial insertion. Arthroscopic fixation with a suture anchor was successful and the cystic lesion was no longer visible on postoperative images.
Tomoya Takasago, Tomohiro Goto, Takahiko Tsutsui, Kenji Kondo, Daisuke Hamada, Ichiro Tonogai, Keizo Wada and Koichi Sairyo : A Huge Capital Drop with Compression of Femoral Vessels Associated with Hip Osteoarthritis., Case Reports in Orthopedics, Vol.2015, 2015.
(要約)
A capital drop is a type of osteophyte at the inferomedial portion of the femoral head commonly observed in hip osteoarthritis (OA), secondary to developmental dysplasia. Capital drop itself is typically asymptomatic; however, symptoms can appear secondary to impinge against the acetabulum or to irritation of the surrounding tissues, such as nerves, vessels, and tendons. We present here a case of unilateral leg edema in a patient with hip OA, caused by a huge bone mass occurring at the inferomedial portion of the femoral head that compressed the femoral vessels. We diagnosed this bone mass as a capital drop secondary to hip OA after confirming that the mass occurred at least after the age of 63 years based on a previous X-ray. We performed early resection and total hip arthroplasty since the patient's hip pain was due to both advanced hip OA and compression of the femoral vessels; moreover, we aimed to prevent venous thrombosis secondary to vascular compression considering the advanced age and the potent risk of thrombosis in the patient. A large capital drop should be considered as a cause of vascular compression in cases of unilateral leg edema in OA patients.
Tomohiro Goto, Kazuaki Mineta, Tomoya Takasago, Daisuke Hamada and Koichi Sairyo : Pseudotumor associated with cemented bipolar hemiarthroplasty: an unusual presentation as a granulomatous thigh mass., Skeletal Radiology, Vol.44, No.10, 1541-1545, 2015.
(要約)
Although polyethylene wear-induced osteolysis is a common complication of hip arthroplasty, extensile osteolysis developing into a large granulomatous thigh mass at a site distant from the joint is rare. We report a case of a thigh pseudotumor 25 years after cemented bipolar hemiarthroplasty, in which x-rays revealed a radiolucent line around the stem at the proximal site only, not at the diaphysis of the femur. We initially suspected a real tumor because it had a unique appearance, as if the mass resorbed the posterior cortex of the femur, and it was located at a site distant from the proximal osteolytic lesions. We clearly showed the existence of a connection between the thigh mass and the joint space by performing intra-articular injection of contrast medium with continuous pressure. It seemed that polyethylene wear particles were transported distally along the stem-cement interface by fluid pressure, and an osteolytic reaction against polyethylene wear particles had occurred at the posterior middle third of the stem where the cement mantle was nonuniform and polyethylene particles first came into contact with the bone. Our findings suggest that nonuniform cemented prosthesis with osteolysis, even if it is low grade in a limited area, carries the risk of extensile osteolysis with asymptomatic development of an extra-articular granulomatous mass.
Koichi Sairyo, Akihiro Nagamachi, Tetsuya Matsuura, Kousaku Higashino, Toshinori Sakai, Naoto Suzue, Daisuke Hamada, Yoichiro Takata, Tomohiro Goto, Toshihiko Nishisho, Yuichiro Goda, Takahiko Tsutsui, Ichiro Tonogai, Ryo Miyagi, Mitsunobu Abe, Masatoshi Morimoto, Kazuaki Mineta, Tetsuya Kimura, Akihiro Nitta, Tadahiro Higuchi, Shingo Hama, Jha C. Subash, Rui Takahashi and Shoji Fukuta : A review of the pathomechanism of forward slippage in pediatric spondylolysis : The Tokushima theory of growth plate slippage, The Journal of Medical Investigation : JMI, Vol.62, No.1,2, 11-18, 2015.
(要約)
Spondylolysis is a stress fracture of the pars interarticularis, which in some cases progresses to spondylolisthesis (forward slippage of the vertebral body). This slip progression is prevalent in children and occurs very rarely after spinal maturation. The pathomechanism and predilection for children remains controversial despite considerable clinical and basic research into the disorder over the last three decades. Here we review the pathomechanism of spondylolytic spondylolisthesis in children and adolescents, and specifically the Tokushima theory of growth plate slippage developed from our extensive research findings. Clinically, we have observed the slippage site near the growth plate on MRI; then, using fresh cadaveric spines, we found the weakest link against forward shear loading was the growth plate. We subsequently developed an immature rat model showing forward slippage after growth plate injury. Moreover, finite element analysis of the pediatric spine clearly showed increased mechanical stress at the growth plate in the spondylolytic pediatric spine model compared with the intact pediatric spine. Thus, spondylolysis progresses to spondylolisthesis (forward slippage) in children and adolescents with the growth plate as the site of the slippage. Repetitive mechanical loading on to the growth plate may serve to separate the growth plate and subsequently progress to spondylolisthesis.
Jha C. Subash, Ichiro Tonogai, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino, Tetsuya Matsuura, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Toshihiko Nishisho, Takahiko Tsutsui, Yuichiro Goda, Mitsunobu Abe, Kazuaki Mineta, Tetsuya Kimura, Akihiro Nitta, Shingo Hama, Tadahiro Higuchi, Shoji Fukuta and Koichi Sairyo : Percutaneous Endoscopic Lumbar Discectomy for a Huge Herniated Disc Causing Acute Cauda Equina Syndrome : A Case Report, The Journal of Medical Investigation : JMI, Vol.62, No.1,2, 100-102, 2015.
(要約)
Microsurgery for lumbar disc herniation that requires surgical intervention has been well described. The methods vary from traditional open discectomy to minimally invasive techniques. All need adequate preanesthetic preparation of patients as general anesthesia is required for the procedure, and nerve monitoring is necessary to prevent iatrogenic nerve injury. Conventional surgical techniques sometimes require the removal of the corresponding lamina to assess the nerve root and herniated disc, and this may increase the risk for posterior instability of the vertebral body. Should this occur, fusion surgery may be needed, further increasing morbidity and cost. We present here a case of lumbar herniated disc fragments causing acute cauda equina syndrome that were endoscopically resected through a transforaminal approach in an awake patient under local anesthesia. Percutaneous endoscopic discectomy under local anesthesia proved to be a better alternative to open back surgery as it made immediate intervention possible, was associated with fewer perioperative complications and morbidity, minimized soft tissue damage, and allowed early rehabilitation with a better outcome and greater patient satisfaction. In addition to these advantages, percutaneous endoscopic discectomy protects other approaches that may be needed in subsequent surgeries, whether open or minimally invasive.
Athletes sometimes experience overuse injuries. To diagnose these injuries, ultrasonography is often more useful than plain radiography, computed tomography (CT), or magnetic resonance imaging (MRI). Ultrasonography can show both bone and soft tissue from various angles as needed, providing great detail in many cases. In conditions such as osteochondrosis or enthesopathies such as Osgood-Schlatter disease, Sinding-Larsen-Johansson disease, bipartite patella, osteochondritis dissecans of the knee, painful accessory navicular,and jumper's knee, ultrasonography can reveal certain types of bony irregularities or neovascularization of the surrounding tissue. In patients of enthesopathy, ultrasonography can show the degenerative changes at the insertion of the tendon. Given its usefulness in treatment, ultrasonography is expected to become essential in the management of overuse injuries affecting the lower limb in athletes. J. Med. Invest. 62: 109-113, August, 2015.
Yoshiji Kanematsu, Tetsuya Matsuura, Shinji Kashiwaguchi, Takenobu Iwase, Naoto Suzue, Toshiyuki Iwame, Shoji Fukuta, Daisuke Hamada, Tomohiro Goto and Koichi Sairyo : Epidemiology of shoulder injuries in young baseball players and grading of radiologic findings of Little Leaguer's shoulder., The Journal of Medical Investigation : JMI, Vol.62, No.3-4, 123-125, 2015.
(要約)
Relatively few epidemiological studies have examined shoulder injuries. This study aimed to investigate the epidemiology of such injuries in young baseball players. A total of 2,055 players aged 9-12 years who participated in a regional championship between 1983 and 1985 were the subjects of this investigation. They were assessed by questionnaire and radiographic examination. Prevalence of shoulder pain was determined according to position, years of baseball playing experience, and training hours per week. Radiographic examination was recommended to all players who complained of shoulder pain. Of the 2,055 subjects, 275 (13.4%) reported episodes of pain in the throwing shoulder. Years of baseball experience, but not player position or training hours per week, was significantly associated with shoulder pain. Forty-one of the 275 subjects reporting shoulder pain agreed to undergo radiography and 15 exhibited findings of Little Leaguer's shoulder. Their lesions could be classified into three distinct grades based on radiographic findings: grade I, widening of the epiphyseal plate in the lateral area (n=9); grade II, widening at all areas of the epiphyseal plate and demineralization of the metaphysis (n=5); and grade III, a slipped epiphysis (n=1). J. Med. Invest. 62: 123-125, August, 2015.
Ichiro Tonogai, Mitsuhiko Takahashi, Takahiko Tsutsui, Tomohiro Goto, Daisuke Hamada, Naoto Suzue, Tetsuya Matsuura, Natsuo Yasui and Koichi Sairyo : Forearm lengthening by distraction osteogenesis: A report on 5 limbs in 3 cases., The Journal of Medical Investigation : JMI, Vol.62, No.3-4, 219-222, 2015.
(要約)
Radioulnar length discrepancy causes pain and decreases function of the wrist, forearm, and elbow. Limb lengthening, which has been used in the treatment of various deformities of the forearm, is necessary to restore balance between the ulna and radius. We treated 5 limbs in 3 patients (2 boys, 1 girl; mean age 9.3 years old) with radioulnar length discrepancy by distraction osteogenesis of either the ulna or radius using external fixators. We dissected the interosseous membrane between the ulna and radius in 3 limbs in 2 cases and did not do so in 2 limbs of 1 case. These cases include 2 cases with hereditary multiple exostoses, and 1 case with multiple epiphyseal dysplasia. The results were investigated and evaluated in this study, using appropriate clinical and radiographic parameters, noting the state of the interosseous membrane, which has an important role in forearm stability. The mean fixation period was 113 days. The mean distraction distance was 22.8 mm. The mean follow-up period was 637.7 days. The mean ulnar shortening and radial articular angle respectively improved from 7.4 mm and 30.2° preoperatively to -0.1 mm and 34.8° postoperatively. Balance between the ulna and radius was restored, and the results showed significant improvements in range of motion of the joints. However, 2 unintended radial head subluxations occurred in 2 limbs without dissection of the interosseous membrane. In addition, a keloid remained in 1 limb due to pin site infection. Forearm lengthening by distraction osteogenesis was useful in our cases. It is important to recognize the function of the interosseous membrane when lengthening is performed by osteotomy of the proximal ulna by gradual distraction with an external fixator. J. Med. Invest. 62: 219-222, August, 2015.
Mitsunobu Abe, Yoichiro Takata, Kousaku Higashino, Toshinori Sakai, Tetsuya Matsuura, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Toshihiko Nishisho, Yuichiro Goda, Takahiko Tsutsui, Ichiro Tonogai, Ryo Miyagi, Masatoshi Morimoto, Kazuaki Mineta, Tetsuya Kimura, Akihiro Nitta, Shingo Hama, Tadahiro Higuchi, Subash Jha C, Rui Takahashi, Shoji Fukuta and Koichi Sairyo : Foraminoplastic transforaminal percutaneous endoscopic discectomy at the lumbosacral junction under local anesthesia in an elite rugby player., The Journal of Medical Investigation : JMI, Vol.62, No.3-4, 238-241, 2015.
(要約)
Percutaneous endoscopic discectomy (PED) is the least invasive disc surgery available at present. The procedure can be performed under local anesthesia and requires only an 8 mm skin incision. Furthermore, damage to the back muscle is considered minimal, which is particularly important for disc surgery in athletes. However, employing the transforaminal (TF) PED approach at the lumbosacral junction can be challenging due to anatomical constraints imposed by the iliac crest. In such cases, foraminoplasty is required in addition to the standard TF procedure. A 28-year-old man who was a very active rugby player visited us complaining of lower back and left leg pain. His visual analog scale (VAS) score for pain was 8/10 and 3/10, respectively. MRI revealed a herniated nucleus pulposus at L5-S level. TF-PED was planned; however, the anatomy of the iliac crest was later found to prevent access to the herniated mass. Foraminoplasty was therefore performed to enlarge the foramen, thereby allowing a cannula to be passed through the foramen into the canal without causing exiting nerve injury. The herniated mass was then successfully removed via the TF-PED procedure. Pain resolved after surgery, and his VAS score decreased to 0/10 for both back and leg pain. The patient returned to full rugby activity 8 weeks after surgery. In conclusion, even with an intracanalicular herniated mass at the lumbosacral junction, a TF-PED procedure is possible if additional foraminoplasty is adequately performed to enlarge the foramen. J. Med. Invest. 62: 238-241, August, 2015.
Takahiko Tsutsui, Tomohiro Goto, Daisuke Hamada, Ichiro Tonogai, Kazuaki Mineta, Mitsunobu Abe, Tetsuya Matsuura, Naoto Suzue, Shoji Fukuta and Koichi Sairyo : Successful Outcomes Using Interlocking Prostheses for Periprosthetic Fractures with Loose Femoral Components., The Journal of Medical Investigation : JMI, Vol.62, No.3-4, 242-244, 2015.
(要約)
Periprosthetic femoral fractures with implant loosening are difficult to treat, especially when accompanied by severe bone loss. We report here the treatment outcomes of 4 patients (1 man, 3 women; age range 69-86 years) with periprosthetic femoral fractures and implant loosening after bipolar hemiarthroplasty. Fractures were classified according to the Vancouver classification as type B2 and B3, with adequate or compromised bone stock, respectively. One patient was initially treated conservatively but symptoms due to implant loosening persisted and revision surgery was required. All patients underwent revision using a long-stem cementless implant with interlocking screws as well as a cancellous allograft to augment the bone stock. At final follow-up (mean, 25 months), all patients had stable implant fixation, bony union of the fracture, and marked recovery of the proximal femoral bone stock through allograft use. This revision procedure achieved implant fixation and fracture healing with reconstitution of the femur even in the short term and even in cases with severe bone deficiency. J. Med. Invest. 62: 242-244, August, 2015.
Kosuke Sugiura, Naoto Suzue, Tetsuya Matsuura, Daisuke Hamada, Tomohiro Goto, Yoichiro Takata and Koichi Sairyo : Ganglion cyst arising from the infrapatellar fat pad in a child., The Journal of Medical Investigation : JMI, Vol.62, No.3-4, 245-247, 2015.
(要約)
A ganglion cyst is a cystic lesion containing myxoid matrix and lined by a pseudomembrane. A ganglion cyst arising from the infrapatellar fat pad is very rare, with only a few reports appearing in the literature, and the present case is the first report of this lesion in a child. A 10-year-old boy presented with right knee pain that showed no improvement despite resting from sports activity for 1 month. Magnetic resonance imaging revealed a multilobular mass between the infrapatellar fat pad and anterior cruciate ligament. Arthroscopic excision of the mass was performed. The mass was noted to arise from the infrapatellar fat pad and was filled with myxoid matrix. The histological diagnosis was a ganglion cyst. In active pediatric patients with pain or limited range of motion in the knee, physicians should consider the possibility of a ganglion cyst from the infrapatellar fat pad, despite its rarity. J. Med. Invest. 62: 245-247, August, 2015.
Shingo Hama, Daisuke Hamada, Tomohiro Goto, Takahiko Tsutsui, Ichiro Tonogai, Naoto Suzue, Tetsuya Matsuura and Koichi Sairyo : Revision total knee arthroplasty for unexplained pain after unicompartmental knee arthroplasty: a case report., The Journal of Medical Investigation : JMI, Vol.62, No.3-4, 261-263, 2015.
(要約)
In this report, we present a case of a 64-year-old woman who underwent revision of knee arthroplasty after failed unicompartmental knee arthroplasty (UKA). She underwent UKA (Biomet Oxford Phase 3) for right localized medial knee pain at the age of 53 and the postoperative course had been uneventful. Eight years after UKA, she had right knee pain that gradually worsened. Tenderness was present over the medial femorotibial and patellofemoral (PF) joints. Plain radiograph showed small osteophytes on the intercondylar eminence and in the lateral compartment. However, these findings were not severe. Although several causes of knee pain after UKA have been reported, none of those causes were found in this case, so the diagnosis of unexplained pain was made. We performed knee arthroscopy and it revealed severe osteoarthritis of the PF joint, bone attrition and exposure of subchondral bone of the medial part of the lateral condyle together with severe synovitis. Revision surgery was performed in the same operation. The postoperative course was excellent and the severe knee pain resolved after surgery. Several registries revealed that revision for unexplained pain was more common after UKA than after total knee arthroplasty. We pointed out the possible causes of unexplained pain including pathological conditions, which were present in our case. Revision surgery may be unsuccessful if the cause of failure is not adequately considered. J. Med. Invest. 62: 261-263, August, 2015.
Yoichiro Takata, Toshinori Sakai, Kousaku Higashino, Tetsuya Matsuura, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Toshihiko Nishisho, Takahiko Tsutsui, Yuichiro Goda, Masatoshi Morimoto, Mitsunobu Abe, Kazuaki Mineta, Tetsuya Kimura, Akihiro Nitta, Shingo Hama, Tadahiro Higuchi, Subash Jha C, Rui Takahashi, Shoji Fukuta and Koichi Sairyo : State of the art: Intraoperative neuromonitoring in spinal deformity surgery., The Journal of Medical Investigation : JMI, Vol.62, No.3-4, 103-108, 2015.
(要約)
Application of deformity correction spinal surgery has increased substantially over the past three decades in parallel with improvements in surgical techniques. Intraoperative neuromonitoring (IOM) techniques,including somatosensory evoked potentials (SEPs), muscle evoked potentials (MEPs), and spontaneous electromyography (free-run EMG), have also improved surgical outcome by reducing the risk of iatrogenic neural injury. In this article, we review IOM techniques and their applications in spinal deformity surgery. We also summarize results of selected studies including hundreds of spinal correction surgeries. These studies indicate that multimodal IOM of both motor and sensory responses is superior to either modality alone for reducing the incidence of neural injury during surgery. J. Med. Invest. 62: 103-108, August, 2015.
Tomoya Takasago, Tomohiro Goto, Shunichi Toki, Daisuke Hamada, Shinji Yoshioka, Ichiro Tonogai, Takahiko Tsutsui, Yasuaki Tamaki, Keizo Wada and Koichi Sairyo : Intrapelvic migration of the lag screw in intramedullary nailing., Case Reports in Orthopedics, Vol.2014, 519045, 2014.
(要約)
Internal fixation with intramedullary devices has gained popularity for the treatment of intertrochanteric femoral fractures, which are common injuries in the elderly. The most common complications are lag screw cut out from the femoral head and femoral fracture at the distal tip of the nail. We report here a rare complication of postoperative lag screw migration into the pelvis with no trauma. The patient was subsequently treated with lag screw removal and revision surgery with total hip arthroplasty. This case demonstrated that optimal fracture reduction and positioning of the lag screw are the most important surgical steps for decreasing the risk of medial migration of the lag screw. Furthermore, to prevent complications, careful attention should be paid to subsequent steps such as precise insertion of the set screw.
Ichiro Tonogai, Daisuke Hamada, Tomohiro Goto, Tomoya Takasago, Takahiko Tsutsui, Naoto Suzue, Tetsuya Matsuura and Koichi Sairyo : Retrograde intramedullary nailing with a blocking pin technique for reduction of periprosthetic supracondylar femoral fracture after total knee arthroplasty: technical note with a compatibility chart of the nail to femoral component., Case Reports in Orthopedics, Vol.2014, 856853, 2014.
(要約)
Periprosthetic fractures after total knee arthroplasty (TKA) present a clear management challenge, and retrograde intramedullary nails have recently gained widespread acceptance in treatment of these fractures. In two cases, we found a blocking screw technique, first reported by Krettek et al., was useful in the reduction of the fractures. Both patients attained preinjury mobility after intramedullary nailing. Moreover, we present a chart summarizing the notch designs of various femoral components because some prosthetic knee designs are not amenable to retrograde nailing. We hope this will be helpful in determining indications for retrograde nailing in periprosthetic fractures after TKA.
Takeuchi Makoto, Tomohiro Goto, Kiminori Yukata, Naoto Suzue, Daisuke Hamada, Toshihiko Nishisho, Ichiro Tonogai, Tetsuya Matsuura and Koichi Sairyo : Nonunion of the First Sternocostal Synchondrosis Accompanied by Sternoclavicular Joint Synovitis, Case Reports in Orthopedics, Vol.2014, 798329, 2014.
(要約)
Injury to the sternocostal synchondrosis of the first rib is quite rare. We report one such case in a 50-year-old man with nonunion of the first sternocostal synchondrosis accompanied by synovitis of the sternoclavicular joint. He first underwent arthroscopic surgery of the left sternoclavicular joint. Postoperatively, the patient's symptoms decreased by half, but another pain and crepitus at the inferior lateral portion of the sternoclavicular joint developed. Since MRI and functional CT reexaminations revealed nonunion of the first sternocostal synchondrosis, resection arthroplasty of the first sternocostal joint was performed. This resulted in immediate resolution of the symptoms. At 2-year follow-up, his symptoms disappeared entirely with no limited range of motion of the shoulder.
Ichiro Tonogai, Tomohiro Goto, Daisuke Hamada, Toshiyuki Iwame, Shinji Yoshioka, Takahiko Tsutsui, Yuichiro Goda, Hiroshi Egawa and Koichi Sairyo : Bilateral atypical femoral fractures in a patient with multiple myeloma treated with intravenous bisphosphonate therapy., Case Reports in Orthopedics, Vol.2014, 452418, 2014.
(要約)
Bisphosphonates are currently the standard approach to managing bone disease in multiple myeloma. Bisphosphonates have high bone affinity that inhibits osteoclastic activity and additionally reduces the growth factors released from malignant or osteoblastic cells, thereby impairing abnormal bone remodeling which leads to osteolysis. However, patients of multiple myeloma may be at a higher risk of atypical femoral fractures because the treatment for malignant myeloma requires notably higher cumulative doses of bisphosphonates. Here we present a patient with bilateral atypical femoral fractures and multiple myeloma treated with intravenous bisphosphonate therapy.
Yasuaki Tamaki, Tomohiro Goto, Daisuke Hamada, Toshihiko Nishisho, Kiminori Yukata, Naoto Suzue, Hiroshi Egawa and Koichi Sairyo : Massive femoral osteolysis secondary to loosening of a cemented roughened long stem: a case report., Case Reports in Orthopedics, Vol.2014, 840267, 2014.
(要約)
The surface finish of a femoral stem plays an important role in the longevity of cemented total hip arthroplasty. In efforts to decrease the rate of aseptic loosening, some prostheses have been designed to have a roughened surface that enhances bonding between the prosthesis and cement, but clinical outcomes remain controversial. We present a rare case of massive osteolysis with extreme femoral expansion that developed after cemented revision total hip arthroplasty. The destructive changes in the femur were attributable to abnormal motion of the stem and were aggravated by the roughened precoated surface of the long femoral component. Revision surgery using a total femur prosthesis was performed because there was insufficient remaining bone to fix the new prosthesis. The surgical technique involved wrapping polypropylene meshes around the prosthesis to create an insertion for the soft tissue, which proved useful for preventing muscular weakness and subsequent dislocation of the hip.
Kosuke Sugiura, Ichiro Tonogai, Tetsuya Matsuura, Kousaku Higashino, Toshinori Sakai, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Yoichiro Takata, Toshihiko Nishisho, Yuichiro Goda, Ryosuke Sato, Kenji Kondo, Fumitake Tezuka, Kazuaki Mineta, Makoto Takeuchi, Mitsuhiko Takahashi, Hiroshi Egawa and Koichi Sairyo : Discoscopic findings of high signal intensity zones on magnetic resonance imaging of lumbar intervertebral discs., Case Reports in Orthopedics, Vol.2014, 245952, 2014.
(要約)
A 32-year-old man underwent radiofrequency thermal annuloplasty (TA) with percutaneous endoscopic discectomy (PED) under local anesthesia for chronic low back pain. His diagnosis was discogenic pain with a high signal intensity zone (HIZ) in the posterior corner of the L4-5 disc. Flexion pain was sporadic, and steroid injection was given twice for severe pain. After the third episode of strong pain, PED and TA were conducted. The discoscope was inserted into the posterior annulus and revealed a migrated white nucleus pulposus which was stained blue. Then, after moving the discoscope to the site of the HIZ, a migrated slightly red nucleus pulposus was found, suggesting inflammation and/or new vessels penetrating the mass. After removing the fragment, the HIZ site was ablated by TA. To our knowledge, this is the first report of the discoscopic findings of HIZ of the lumbar intervertebral disc.
Koichi Sairyo, Hiroshi Egawa, Tetsuya Matsuura, Mitsuhiko Takahashi, Kousaku Higashino, Toshinori Sakai, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Yoichiro Takata, Toshihiko Nishisho, Yuichiro Goda, Ryosuke Sato, Takahiko Tsutsui, Ichiro Tonogai, Kenji Kondo, Fumitake Tezuka, Kazuaki Mineta, Kosuke Sugiura, Makoto Takeuchi and Akira Dezawa : State of the Art: Transforaminal Approach for Percutaneous Endoscopic Lumbar Discectomy under Local Anesthesia., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 217-225, 2014.
(要約)
Minimally invasive percutaneous endoscopic discectomy (PED) with a transforaminal approach under local anesthesia was started in the late 20th century. As the procedure requires a skin incision of only 8 mm, it is the least invasive disc surgery procedure at present, and owing to advances in instruments and optics, the use of this technique has gradually spread. In Japan, Dr. Dezawa from Teikyo University Mizonokuchi Hospital introduced this technique in 2003. Thanks to his efforts, the number of surgeons who can perform PED has increased, although the number of active PED surgeons is still only around 20. The first author (K.S.) started PED in 2010. In this review article, we explain the state-of-the-art PED transforaminal technique for minimally invasive disc surgery and present three successful cases. J. Med. Invest. 61: 217-225, August, 2014.
Tomohiro Goto, Daisuke Hamada, Kazuaki Mineta, Ichiro Tonogai, Hiroshi Egawa, Tetsuya Matsuura, Mitsuhiko Takahashi, Kousaku Higashino, Toshinori Sakai, Naoto Suzue, Yoichiro Takata, Toshihiko Nishisho, Yuichiro Goda, Ryosuke Sato, Fumitake Tezuka, Kenji Kondo, Makoto Takeuchi, Kousuke Sugiura and Koichi Sairyo : The state of the art in arthroscopic hip surgery., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 226-232, 2014.
(要約)
Hip arthroscopy is among the most rapidly evolving arthroscopic techniques in the last decade and offers the benefits of being both a minimally invasive procedure and an excellent diagnostic tool. Improvements in instrumentation and surgical skills have advanced our ability to accurately diagnose and treat various conditions of the hip joint, and hip arthroscopy has elucidated several pathologies that cause disabling symptoms. Many of these conditions were previously unrecognized and left untreated. The indications for hip arthroscopy include the management of early osteoarthritis, synovial disorders (e. g., synovial osteochondromatosis), labral tears, chondral lesions, and femoroacetabular impingement (FAI), which is increasingly recognized as a disorder that can lead to the development of early cartilage and labral injury. A better understanding of hip arthroscopy, including the anatomy, improved surgical techniques, indications, and complications of the procedure, is essential for its success. This review article discusses the state of the art of arthroscopic hip surgery. J. Med. Invest. 61: 226-232, August, 2014.
Tetsuya Matsuura, Hiroshi Egawa, Mitsuhiko Takahashi, Kousaku Higashino, Toshinori Sakai, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Yoichiro Takata, Toshihiko Nishisho, Yuichiro Goda, Ryosuke Sato, Ichiro Tonogai, Kenji Kondo, Fumitake Tezuka, Kazuaki Mineta, Kosuke Sugiura, Makoto Takeuchi and Koichi Sairyo : State of the art: elbow arthroscopy: review of the literature and application for osteochondritis dissecans of the capitellum., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 233-240, 2014.
(要約)
Elbow arthroscopy has become a safe and effective treatment option for a number of elbow disorders. The most rewarding and successful indication is the removal of loose bodies. Loose bodies are often a result of osteochondritis dissecans (OCD) of the capitellum, and arthroscopy in this case is useful for performing debridement, thereby eliminating the need for a more extensive open procedure associated with complications. In this review, we describe our arthroscopic technique for OCD of the capitellum. We usually conduct arthroscopy in the supine position, and use 2.9-mm arthroscopes of 30° and 70°. The 70° arthroscope provides a greater operative field than the 30° arthroscope. Arthroscopic treatment for OCD may require 2 anterior and 2 posterior portals. Loose bodies are commonly found in the radial fossa, coronoid fossa, and in the olecranon fossa. Once the loose bodies are removed, all unstable cartilage of the capitellum lesion is removed to create a stable bed. If any sclerotic changes to the lesion bed are observed, we create microfractures in the lesion bed. The most significant complication in arthroplasty is neurovascular injury. However, we have never experienced this devastating complication, which can be avoided by paying careful attention to detail. J. Med. Invest. 61: 233-240, August, 2014.
Koichi Sairyo, Tetsuya Matsuura, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Yuichiro Goda, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Toshihiko Nishisho, Ryosuke Sato, Takahiko Tsutsui, Ichiro Tonogai and Kazuaki Mineta : Surgery Related Complications in Percutaneous Endoscopic Lumbar Discectomy under Local Anesthesia., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 264-269, 2014.
(要約)
The minimally invasive percutaneous endoscopic discectomy (PED) as the postero-lateral approach with the local anesthesia was started in the late 20th century. The procedure only requires 8 mm of skin incision; thus, it is the least invasive disc surgery presently. The surgery related complications were reviewed in the initial 100 cases from the single surgeon (K. S., first author). Two cases showed exiting nerve irritation, and complained of leg paresthetic pain for 6 to 12 weeks after the surgery (2.0%). The symptoms got better with medicines. One showed post-surgical epidural hematoma, and required surgical removal of the mass (1.0%). Two cases complained neck pain during surgery (2.0%). Surgeons would be aware of the specific complications for the postero-lateral approach of PED procedure. J. Med. Invest. 61: 264-269, August, 2014.
Naoto Suzue, Tetsuya Matsuura, Toshiyuki Iwame, Daisuke Hamada, Tomohiro Goto, Yoichiro Takata, Takenobu Iwase and Koichi Sairyo : Prevalence of childhood and adolescent soccer-related overuse injuries., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 369-373, 2014.
(要約)
The majority of players who had experienced pain and were found to have osteochondrosis had severe injuries such as osteochondritis dissecans or lumbar spondylolysis. We suggest many of the players involved in this study receive further radiographic or ultrasonic examination. J. Med. Invest. 61: 369-373, August, 2014.
Yoichiro Takata, Tetsuya Matsuura, Kousaku Higashino, Toshinori Sakai, Takuya Mishiro, Naoto Suzue, Hirofumi Kosaka, Daisuke Hamada, Tomohiro Goto, Toshihiko Nishisho, Yuichiro Goda, Ryosuke Sato, Takahiko Tsutsui, Ichiro Tonogai, Fumitake Tezuka, Kazuaki Mineta, Tetsuya Kimura, Akihiro Nitta, Tadahiro Higuchi, Shingo Hama and Koichi Sairyo : Hybrid technique of cortical bone trajectory and pedicle screwing for minimally invasive spine reconstruction surgery: A technical note., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 388-392, 2014.
(要約)
The pedicle screw (PS) system is widely used for spinal reconstruction. Recently, screw insertion using the cortical bone trajectory (CBT) technique has been reported to provide increased holding strength of the vertebra, even in an osteoporotic spine. CBT is also beneficial due to its low invasiveness. We have been performing hybrid reconstruction with CBT at the cranial level and PS at the caudal level based on the concept of minimal invasiveness. We applied this hybrid technique to 6 cases of degenerative spondylolisthesis. Surgery was completed with a small skin incision of around 5-6 cm, which is shorter than that of the conventional PS procedure. The mean percent slippage before surgery was 19.8%, and this was reduced to 3.9% after surgery and almost maintained 3 months after surgery. Furthermore, no major surgical complications were observed. Here, we introduce the minimally invasive hybrid technique of CBT-PS. Surgeons should be aware of the procedure as an option for minimally invasive lumbar spine reconstructive surgery. J. Med. Invest. 61: 388-392, August, 2014.
Tomohiro Goto, Daisuke Hamada, Toshiyuki Iwame, Naoto Suzue, Makoto Takeuchi, Hiroshi Egawa and Koichi Sairyo : Medial Patellofemoral Ligament Reconstruction for Patellar Dislocation due to Rupture of the Medial Structures after Total Knee Arthroplasty: A Case Report and Review of the Literature., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 409-412, 2014.
(要約)
Patellar dislocation is a well-recognized major complication after total knee arthroplasty (TKA). Treatment of this injury is determined according to the cause of the dislocation. In particular, proximal realignment, distal realignment, and lateral retinaculum release are options if patellar instability is not caused by prosthetic malposition. Here we report a case of patellar dislocation following TKA due to rupture of the medial structures that was treated by medial patellofemoral ligament reconstruction and lateral retinacular release. In addition, we provide a brief review of the related literature. J. Med. Invest. 61: 409-412, August, 2014.
Naoto Suzue, Toshiyuki Iwame, Kenji Kato, Shoichiro Takao, Tomohiko Tateishi, Yoshitsugu Takeda, Daisuke Hamada, Tomohiro Goto, Yoichiro Takata, Tetsuya Matsuura and Koichi Sairyo : Plantar fascia rupture in a professional soccer player., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 413-416, 2014.
(要約)
We report the case of a 29-year-old male professional soccer player who presented with symptoms of plantar fasciitis. His symptoms occurred with no remarkable triggers and gradually worsened despite conservative treatments including taping, use of insoles, and physical therapy. Local corticosteroid injection was given twice as a further intervention, but his plantar fascia partially ruptured 49 days after the second injection. He was treated conservatively with platelet-rich plasma, and magnetic resonance imaging showed regenerative change of the ruptured fascia. Five months after the rupture, he returned to his original level of training. If professional athletes find it difficult to refrain from athletic activity, as in the present case, the risk of rupture due to corticosteroid injection should not be overlooked. J. Med. Invest. 61: 413-416, August, 2014.
Makoto Takeuchi, Naoto Suzue, Tetsuya Matsuura, Kousaku Higashino, Toshinori Sakai, Daisuke Hamada, Tomohiro Goto, Yoichiro Takata, Toshihiko Nishisho, Yuichiro Goda, Ryosuke Sato, Ichiro Tonogai, Kazuaki Mineta and Koichi Sairyo : Reconstruction of chronic Achilles tendon rupture using the semitendinosus tendon: a case report., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 417-420, 2014.
(要約)
Achilles tendon rupture is a common trauma requiring surgical management. For chronic Achilles tendon rupture in particular, reconstructive surgery is desirable and several methods have been described. Here we present a case of chronic Achilles tendon rupture reconstructed using the semitendinosus tendon because of the difficulty in pulling down the proximal stump to reach the distal stump and due to an insufficient margin for hooking a suture to the distal stump. Postoperatively, the patient had a fully functional tendon and resumed his normal activities of daily living. Using this surgical technique, we expect favorable outcomes in cases of Achilles tendon rupture. J. Med. Invest. 61: 417-420, August, 2014.
Kazuaki Mineta, Tomohiro Goto, Daisuke Hamada, Takahiko Tsutsui, Ichiro Tonogai, Naoto Suzue, Tetsuya Matsuura, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Toshihiko Nishisho, Ryousuke Sato, Yuichiro Goda, Tadahiro Higuchi, Shingo Hama, Tetsuya Kimura, Akihiro Nitta and Koichi Sairyo : Efficacy of hip arthroscopy in the diagnosis and treatment of synovial osteochondromatosis: a case report and literature review., The Journal of Medical Investigation : JMI, Vol.61, No.3-4, 436-441, 2014.
(要約)
Here we report a rare case of synovial osteochondromatosis of the hip and provide a brief review of the literature. A 37-year-old woman was referred to our department with a 3-year history of right hip pain. At initial consultation, she complained of pain upon standing and when sitting down, occasional pain at rest and nocturnal pain in the right hip, and worsening of the pain at premenstruum. The range of motion of the affected hip was totally limited by pain. Plain radiography revealed a slightly calcified (or ossified) lesion at the acetabular fossa of the right hip. Computed tomography showed clusters of loose bodies filling the acetabular fossa. Synovial osteochondromatosis was suspected and she underwent hip arthroscopic surgery. Complete resection was performed using the lateral and anterior portals. Postoperatively, her symptoms disappeared entirely and she was discharged 4 days after surgery. The patient regained full range of motion of the right hip and follow-up CT revealed no remaining loose bodies in the right hip. Hip arthroscopy is considered to be effective for the diagnosis and treatment of synovial osteochondromatosis of the hip and is minimally invasive. J. Med. Invest. 61: 436-441, August, 2014.
Daisuke Hamada, Hiroshi Egawa, Tomohiro Goto, Tomoya Takasago and Michihiro Takai : Navigation-Assisted Total Knee Arthroplasty for Osteoarthritis with Extra-Articular Femoral Deformity and/or Retained Hardware., Case Reports in Orthopedics, 2013.
(要約)
Total knee arthroplasty (TKA) for osteoarthritis (OA) patients with extra-articular deformity is still challenging because angular deformity, canal sclerosis, or the retained hardware that precludes the use of the traditional intramedullary guide. In addition, atypical bone cut for intra-articular correction leads to imbalanced soft tissue gap. Furthermore, corrective osteotomy should be considered for severe deformity or para-articular deformity cases. Recently, navigation-assisted TKA has been reported to increase the accuracy of prosthetic positioning and limb alignment. This system can calculate mechanical axis regardless of extra-articular deformity, canal sclerosis, or retained hardware. Accordingly, navigation surgery has been considered to be a powerful option especially in TKAs with extra-articular deformity cases. Here, we report 3 successful navigation-assisted TKAs for osteoarthritis with extra-articular deformities and/or retained hardware. Navigation-assisted TKA is an effective and reliable alternative for patients with extra-articular deformities.
Jason Inzana, Min Kung, Lei Shu, Daisuke Hamada and LP Xing : Immature mice are more susceptible to the detrimental effects of high fat diet on cancellous bone in the distal femur., Bone, Vol.57, No.1, 174-183, 2013.
(要約)
With the increasing prevalence of obesity among children and adolescents, it is imperative to understand the implications of early diet-induced obesity on bone health. We hypothesized that cancellous bone of skeletally immature mice is more susceptible to the detrimental effects of a high fat diet (HFD) than mature mice, and that removing excess dietary fat will reverse these adverse effects. Skeletally immature (5weeks old) and mature (20weeks old) male C57BL/6J mice were fed either a HFD (60% kcal fat) or low fat diet (LFD; 10% kcal fat) for 12weeks, at which point, the trabecular bone structure in the distal femoral metaphysis and third lumbar vertebrae were evaluated by micro-computed tomography. The compressive strength of the vertebrae was also measured. In general, the HFD led to deteriorations in cancellous bone structure and compressive biomechanical properties in both age groups. The HFD-fed immature mice had a greater decrease in trabecular bone volume fraction (BVF) in the femoral metaphysis, compared to mature mice (p=0.017 by 2-way ANOVA). In the vertebrae, however, the HFD led to similar reductions in BVF and compressive strength in the two age groups. When mice on the HFD were switched to a LFD (HFD:LFD) for an additional 12weeks, the femoral metaphyseal BVF in immature mice showed no improvements, whereas the mature mice recovered their femoral metaphyseal BVF to that of age-matched lean controls. The vertebral BVF and compressive strength of HFD:LFD mouse bones, following diet correction, were equivalent to those of LFD:LFD mice in both age groups. These data suggest that femoral cancellous metaphyseal bone is more susceptible to the detrimental effects of HFD before skeletal maturity and is less able to recover after correcting the diet. Negative effects of HFD on vertebrae are less severe and can renormalize with LFD:LFD mice after diet correction, in both skeletally immature and mature animals.
Inui Ami, Shunji Nakano, Yoshioka Shinji, Tomohiro Goto, Daisuke Hamada, Yoshiteru Kawasaki, Hiroshi Egawa and Natsuo Yasui : Subchondral cysts in dysplastic osteoarthritic hips communicate with the joint space: analysis using three-dimensional computed tomography, European Journal of Orthopaedic Surgery & Traumatology, Vol.23, No.7, 791-795, 2012.
(要約)
INTRODUCTION: Bone cyst formation in hips increases as osteoarthritis worsens. Although bone cysts in hips have been described in many studies, their etiology remains unclear and under debate. The purpose of this study was to investigate the communication between a bone cyst and the joint space, as well as the relationship between the severity of osteoarthritis and the formation of subchondral bone cysts in dysplastic hips. METHOD: We studied bone cysts from 150 dysplastic hips in 97 patients by computed tomography (CT) and plain radiography. We investigated the distribution of the bone cysts and the presence or absence of a communication path between the cysts and the joint space by three-dimensional (3D) CT. RESULT: Of the 150 hips, 94 acetabula and 55 femoral heads were found to contain cysts. Of the 94 hips containing acetabular cysts, 89 and 5 hips showed black lines and gray lines connecting the cyst and the joint space, respectively, on 3D-CT. The rate of cyst presentation in the hip increased as the joint space became narrower. The number of hips that possessed cysts in the anterior and/or middle portion was significantly higher than that in the posterior portions. CONCLUSION: Bone cysts in dysplastic osteoarthritic hips were found to communicate with the joint space in all cases. This suggests that the formation and enlargement of the cysts in dysplastic hips may be greatly influenced by the joint fluid. Cyst formation was initially observed in the anterior acetabulum, gradually progressing to involve the entire joint, including the posterior acetabulum and the femoral head, with worsening of the osteoarthritis.
(キーワード)
Acetabulum / Adolescent / Adult / Aged / Bone Cysts / 女性 (female) / Femur Head / Hip Dislocation / Humans / Imaging, Three-Dimensional / 男性 (male) / Middle Aged / Osteoarthritis, Hip / Tomography, X-Ray Computed / Young Adult
Yoshiteru Kawasaki, Hiroshi Egawa, Daisuke Hamada, Shoichiro Takao, Shunji Nakano and Natsuo Yasui : Location of intrapelvic vessels around the acetabulum assessed by three-dimensional computed tomographic angiography: prevention of vascular-related complications in total hip arthroplasty., Journal of Orthopaedic Science, Vol.17, No.4, 397-406, 2012.
(要約)
During total hip arthroplasty (THA), the external iliac, femoral, and obturator vessels are at risk of vascular injury when penetrating the inner cortex of the pelvis. The purpose of this study was to clarify the location of these vessels using three-dimensional computed tomographic angiography (3DCT-A). We enrolled 100 subjects (200 hips) without hip disease and performed examinations on the following. (1) External iliac-femoral vessels: we measured the shortest distance from these vessels to the pelvis on axial CT images and investigated the factors affecting distance. The anatomical course of the iliac artery was classified as straight, curved, or tortuous, and the correlation between course and age was established. (2) Obturator vessels: we measured the shortest distance from the obturator vessels to the quadrilateral surface on axial CT images. (3) Visualization of pelvic vessels was through the pelvis by dual-phase 3DCT-A. (1) The external iliac vein was located significantly closer to the pelvis than the artery, especially on the left side and in aged and female subjects. The single-curved and tortuous double-curved vessel types were found in aged subjects, and external iliac vessels of these types were closer to the pelvis than vessels of the straight type. In 36 subjects, the external iliac veins lay directly on the osseous surface of the pelvis (right 16, left 36). Of these 36 subjects, only one had straight-type vessels. (2) Obturator vessels were located just behind the acetabulum near the obturator foramen. (3) Reconstructed 3DCT images enabled us to visualize the pelvic vessels and demonstrated the danger area for penetrating the inner cortex of the pelvis. Understanding the anatomical orientation of the pelvic vessels around the acetabulum using 3DCT-A could be helpful for preventing vascular injury during THA.
Kazumasa Nishimoto, Yuta Kochi, Katsunori Ikari, Kazuhiko Yamamoto, Akari Suzuki, Kenichi Shimane, Yusuke Nakamura, Koichiro Yano, Noriko Iikuni, So Tsukahara, Naoyuki Kamatani, Hiroshi Okamoto, Hirotaka Kaneko, Yasushi Kawaguchi, Masako Hara, Yoshiaki Toyama, Takahiko Horiuchi, Kayoko Tao, Koji Yasutomo, Daisuke Hamada, Natsuo Yasui, Hiroshi Inoue, Mitsuo Itakura, Hisashi Yamanaka and Shigeki Momohara : Association study of TRAF1-C5 polymorphisms with susceptibility to rheumatoid arthritis and systemic lupus erythematosus in Japanese., Annals of the Rheumatic Diseases, Vol.69, No.2, 368-373, 2009.
(要約)
The primary aim of this study was to investigate the association of polymorphisms of TRAF1-C5, a newly identified rheumatoid arthritis (RA) risk locus in Caucasians, with susceptibility to RA and systemic lupus erythematosus (SLE) in Japanese populations. Gene expression levels of TRAF1 and C5 to assess the functional significance of genotypes were also analysed. A multicentre association study consisting of 4 RA case-control series (4397 cases and 2857 controls) and 3 SLE case-control series (591 cases and 2199 shared controls) was conducted. Genotyping was performed using TaqMan genotyping assay for two single nucleotide polymorphisms (SNPs) that showed the best evidence of association in the previous Caucasian studies. Quantifications of TRAF1 and C5 expression were performed with TaqMan expression assay. Significant differences in allele frequency for both SNPs were observed between RA and control subjects (combined odds ratio = 1.09), while no significant difference was detected between patients with SLE and controls. Interestingly, alleles rs3761847 A and rs10818488 G had increased the risk for RA in the present study, while they decreased the risk in the original studies. A significant difference was found between risk allele carriers and non-carriers of rs10818488 for the expression level of TRAF1 in phorbol myristate acetate-stimulated lymphoblastoid cell lines (p = 0.04). Association of TRAF1-C5 locus with RA susceptibility was detected in the Japanese populations with modest magnitude, while no significant association was observed for SLE. Significant positive effect of genotype on the expression of TRAF1 might support the genetic association between TRAF1 and RA.
(キーワード)
Arthritis, Rheumatoid / Asian Continental Ancestry Group / Autoantibodies / Case-Control Studies / Cell Line / Complement C5 / Female / Genetic Predisposition to Disease / Genome-Wide Association Study / Genotype / Hand Joints / Humans / Lupus Erythematosus, Systemic / Male / Middle Aged / Polymorphism, Single Nucleotide / TNF Receptor-Associated Factor 1
Yoshitaka Hamada, Shinsuke Katoh, Naohito Hibino, Hirofumi Kosaka, Daisuke Hamada and Natsuo Yasui : Effects of monofilament nylon coated with basic fibroblast growth factor on endogenous intrasynovial flexor tendon healing., The Journal of Hand Surgery, Vol.31, No.4, 530-540, 2006.
(要約)
We developed a monofilament nylon thread that can release various growth factors to enhance intrinsic reparative processes after flexor tendon injury. We evaluated the properties of this thread in vitro and in vivo. Nylon threads were coated with gelatin that subsequently was cross-linked in glutaraldehyde. The thread was soaked in basic fibroblast growth factor (bFGF) solution (400 microg/mL). Exogenous bFGF in the thread was released constantly over the course of 1 week. The biologic activity of bFGF and the biomechanical strength of the thread were examined in vitro and its efficacy was investigated in an in vivo rabbit tendon repair model after early flexion exercises. The sutured sites were examined histologically (hematoxylin-eosin, immunohistochemistry, in situ hybridization), biochemically (Western blot test), and biomechanically (ultimate load) after surgery. This gelatin-coated thread absorbed iodine 125-labeled bFGF in a time-dependent manner. The total amount of bFGF absorbed by the thread within the tendon tissue was between 3 and 15 mug depending on the concentration of bFGF solution. Basic fibroblast growth factor protein was delivered selectively-not in the surrounding scar but in the repaired tendon-for 3 weeks. Histologic analysis showed that the cellular density at the repaired site increased in accordance with the expression of bFGF messenger RNA and protein in the tendon. Endogenous bFGF expression seemed to be enhanced transiently by exogenous bFGF during the first few weeks. The epitenon showed a vigorous fibroblastic response to the coated thread and the ultimate load also was increased significantly at 3 weeks after surgery. This bFGF-coated nylon suture gave excellent results in delivering a drug selectively to tendon; it also induced an increase of biomechanical strength and a thickening of the epitenon layer in vivo during a 3-week period, thereby accelerating cellular proliferation, initially peripherally and later centrally. This system may become a therapeutic tool to be used in hand surgery.
Hiroshi Egawa, Shunji Nakano, Daisuke Hamada, Ryosuke Sato and Natsuo Yasui : Total hip arthroplasty in osteopetrosis using computer-assisted fluoroscopic navigation., The Journal of Arthroplasty, Vol.20, No.8, 1074-1077, 2005.
(要約)
Hybrid total hip arthroplasty with computer-assisted fluoroscopic navigation was performed on a patient with osteoarthritis due to an autosomal dominant form of osteopetrosis. The surgical procedures were difficult because the bone was extremely hard and brittle with obliteration of the medullary cavity. Especially, preparation of a femoral canal for the stem was technically challenging and required changes from a conventional surgical procedure. Therefore, we used a computer-assisted fluoroscopic navigation system to create the femoral cavity for the stem, and an accurate placement of the prosthesis was achieved. Navigation guidance can be a useful tool when performing arthroplasty in patients with hip osteoarthritis associated with osteopetrosis.
(キーワード)
Arthroplasty, Replacement, Hip / Fluoroscopy / Hip Prosthesis / Humans / Male / Middle Aged / Osteopetrosis / Radiography, Interventional / Surgery, Computer-Assisted
Yasuaki Tamaki and Daisuke Hamada : Comparison of the evaluation methods of soft tissue balance in robotic assisted TKA; a cadaveric study, ESSKA 2024, May 2024.
2.
Yasuaki Tamaki, Tomohiro Goto, Jyoji Iwase, Daisuke Hamada, Keizo Wada and Koichi Sairyo : Contributions of the ischiofemoral ligament, iliofemoral ligament, and conjoined tendon to hip stability after total hip arthroplasty: a cadaveric study, ORS2023, Feb. 2023.
3.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Joint Distraction Force Changes the Three-Dimensional Position of the Femur and the Tibia in Total Knee Arthroplasty: a Cadaveric Study, The 19th European Federation of National Associations of Orthopaedics and Traumatology(May 30-June 1,2018), Barcelona, May 2018.
4.
Tomoya Takasago, Daisuke Hamada, Keizo Wada, Tomohiro Goto, Akihiro Nitta, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Retention of the anterior cruciate ligament increase the joint stability in anterior, external rotation and varus directions in TKA, A biomechanical cadaveric study, 18th ESSKA congress(May 9-12,2018), Glasgow, May 2018.
5.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Knee kinematics after lateral UKA are closer to native knee kinematics compared to those after medial UKA, a cadaveric study, 18th ESSKA congress(May 9-12,2018), Glasgow, May 2018.
6.
Daisuke Hamada, Keizo Wada, Tomoya Takasago, Akihiro Nitta, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Native rotational kinematics are lost in bicruciate-retaining total knee arthroplasty when the tibial component is replaced: an in vitro study, 18th ESSKA congress(May 9-12,2018), Glasgow, May 2018.
7.
Daisuke Hamada, Tomohiro Goto and Koichi Sairyo : The effect of posterior condylar cartilage on the rotational alignment of the femoral component in knee osteoarthritis and rheumatoid arthritis, ISTA 2014 Annual Meeting (September 25-27, Kyoto, Japan), Kyoto, Sep. 2014.
8.
Daisuke Hamada, Robert Maynard, Fransworth Christopher, Kilchoe Brittanie and Stephen Kates : Selective Insulin-Dependent Suppression of TNF-Induced Catabolic Enzymes in Osteoarthritic Fibroblast-like Synoviocytes, ORS 2014 Annual Meeting (March 15-18, New Orleans, LA, USA), New Orleans, Mar. 2014.
9.
Daisuke Hamada : Selective Insulin-dependent Suppression of TNF-induced Catabolic Gene Expression in Fibroblast-like Synoviocytes, Third Annual CMSR Symposium, Rochester, NY, Sep. 2013.
10.
浜田 大輔, Maynard Robert, Hoff Robert, Ye Haobin, Kates L Stephen, Hilton J Matthew, Zuscik J Michael, Mooney A Robert : Insulin Suppresses MMP1, 13 and ADAMTS4 Gene Expression in TNF-stimulated Osteoarthritic Fibroblast-like Synoviocytes, ORS 2013 Annual Meeting (January 26-29,2013,San Antonio, Texas, USA ), サンアントニオ, 2013年1月.
11.
Daisuke Hamada, Ye Haobin, Maynard Robert, Kates L Stephen, Rosier N Randy, Hilton J Matthew, Zuscik J Michael and Mooney A Robert : Insulin Suppresses ADAMTS4 and BMP2 Expression in Osteoarthritic Fibroblast-like Synoviocytes, ASBMR 2012 Annual Meeting (October 12-15,2012,Minneapolis, Minnesota, USA)(poster), Minneapolis, Oct. 2012.
12.
Tamaki Yasuaki, Tomohiro Goto, Daisuke Hamada and Hiroshi Egawa : Unusual huge femoral osteolysis secondary to loosening of cemented roughened long stem, The 25th International Society for Technology in Arthroplasty, Sydney, Oct. 2012.
13.
Tomohiro Goto, Hiroshi Egawa, Daisuke Hamada, Takasago Tomoya and Tamaki Yasuaki : Computed tomography analysis of herniation pits in the general population in Japan: Association with morphological indicators of femoroacetabular impingement, The 25th International Society for Technology in Arthroplasty, Sydney, Oct. 2012.
14.
Hiroshi Egawa, Tomohiro Goto, Daisuke Hamada and Natsuo Yasui : Accuracy of the three dimensional planning for the uncemented tapered wedge femoral stem., The 24th International Society for Technology in Arthroplasty, Brugge, Belgium, Sep. 2011.
15.
Daisuke Hamada, Tomohiro Goto, Hiroshi Egawa and Natsuo Yasui : Navigation-assisted total knee arthroplasty in patient with extra-articular valgus deformity of the femur., The 23rd International Society for Technology in Arthroplasty (October 6-9, 2010), Dubai, UAE, Oct. 2010.
16.
Hiroshi Egawa, Daisuke Hamada, Yoshiteru Kawasaki and Natsuo Yasui : Accuracy of CT based navigation system for acetabular component placement in cementless total hip arthroplasty., The 23rd International Society for Technology in Arthroplasty (October 6-9, 2010), Dubai, UAE, Oct. 2010.
17.
Yoshiteru Kawasaki, Daisuke Hamada, Hiroshi Egawa and Natsuo Yasui : Visualization of the pelvic vascular structures through the pelvis using 3D-CT angiography., The 77th Annual Meeting of the American Academy of Orthopaedic Surgeons (March 10-13), New Orleans, USA,, Mar. 2010.