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, 2022.
(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.
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, 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.
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, 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.
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.