Kenji Yokoyama, Tetsuya Matsuura, Nobutoshi Takamatsu, Joji Iwase and Koichi Sairyo : Bilateral os cuneo-I metatarsale-I dorsale: a rare case in which serial imaging suggested a localized ossification disturbance, Skeletal Radiology, 55, 9, 2385-2389, 2026.
(要約)
Os cuneo-I metatarsale-I dorsale is an exceptionally rare accessory bone located on the dorsal aspect of the medial cuneiform. This report describes a case of symptomatic bilateral os cuneo-I metatarsale-I dorsale in a 9-year-old boy who was a competitive kendo practitioner. Longitudinal imaging revealed development of a superficial subchondral irregularity into a distinct ossified fragment over a 1-year interval, providing novel evidence that an ossification disorder contributes to the etiology of os cuneo-I metatarsale-I dorsale. Unlike the cutaneous nerve entrapment typically associated with an accessory bone around the medial cuneiform, the clinical, intraoperative, and magnetic resonance imaging findings in this case showed that mechanical impingement of the extensor hallucis longus tendon was the primary source of pain. Surgical excision was effective, resulting in complete resolution of symptoms and a full return to sports. This report affords a rare longitudinal insight into the pathogenesis of this accessory bone and underscores the importance of accurately determining the source of pain by physical examination.
(キーワード)
Accessory bone / Medial cuneiform / Os cuneo-I metatarsale-I dorsale
Jyoji Iwase, Tetsuya Matsuura, Toshiyuki Iwame, Kenji Yokoyama, Nobutoshi Takamatsu, Koichi Tomita and Koichi Sairyo : Increased contact pressure at the radiocapitellar joint with anterior and posterior osteochondral defects in the sagittal section of the humeral capitellum: a cadaveric study., Journal of Shoulder and Elbow Surgery, 2026.
(要約)
In osteochondritis dissecans of the humeral capitellum, defect location and size were important in surgical planning. Recently, it was reported that posterior or large osteochondral defects of the humeral capitellum on pre-operative sagittal computed tomography affected outcomes of arthroscopic débridement for osteochondritis dissecans in adolescent baseball players. Here, we investigated radiocapitellar joint contact pressure for anterior and posterior osteochondral defect positions in the sagittal section of the humeral capitellum.An anterior or posterior osteochondral defect of the humeral capitellum (10 mm in diameter) was created on each side in 7 matched pairs of fresh-frozen cadavers. Radiocapitellar joint contact pressure was measured with and without valgus stress at 0°, 30°, 60°, and 90° of elbow flexion and with and without varus stress at 0° of elbow extension.In the posterior defect group, comparison of radiocapitellar joint contact pressure was significantly greater when the elbow joint was at 0° extension and 90° flexion than at other angles with valgus and varus stress (P < .05). Lower locations in posterior defects in the sagittal section showed significantly greater radiocapitellar joint contact pressure at 0° extension and 90° flexion of elbow joint with valgus stress (both P < .05).Radiocapitellar joint contact pressure with valgus and varus stress was significantly greater with a posterior osteochondral defect than with an anterior defect when the elbow joint was at 0° extension and 90° flexion. For posterior defects, the contact pressure increased at lower locations in defects in the sagittal section.
Kaito Suzuki, Taku Matsuda, Keijiro Hara, Kazumi Nakamura, Megumi Kuno, Kazuhisa Miyake, Masaaki Korai, Nori Sato, Tetsuya Matsuura and Yasushi Takagi : Posttraumatic cerebrospinal fluid leak with cognitive dysfunction, especially visual memory disturbance: illustrative case, Journal of Neurosurgery. Case Lessons, 11, 10, 2026.
(要約)
Cerebrospinal fluid (CSF) leaks are associated with various clinical and neurological manifestations. Although cognitive dysfunction has been reported in patients with a CSF leak, its detailed characteristics and cognitive profile remain unclear. A 17-year-old male patient developed progressive cognitive decline after minor head trauma. The initial neuroimaging findings were unremarkable; however, over several months, he exhibited memory impairment, academic decline, and personality changes. Neuropsychological testing has demonstrated significant deficits in visual memory, reduced working memory, and reduced processing speed. A detailed interview revealed a subtle orthostatic headache that had been present since the head injury, prompting further evaluation. Spinal MRI and CT myelography confirmed a CSF leak in the cervical spine. The patient underwent placement of a blind lumbar epidural blood patch, which resulted in immediate headache relief and gradual cognitive improvement, particularly in visual memory. CSF leaks can manifest primarily as cognitive dysfunction, even without typical headache or imaging findings, leading to diagnostic delays and potential misdiagnosis of psychiatric illnesses. Visual memory impairment might represent a characteristic and underrecognized feature of a CSF leak. Comprehensive neuropsychological assessment with domain-specific testing is essential for accurate diagnosis of atypical presentations. https://thejns.org/doi/10.3171/CASE25939.
Taiki Furumoto, Daisuke Hamada, Keizo Wada, Ken Tomonari, Yasuaki Tamaki, Shota Shigekiyo, Tetsuya Matsuura and Koichi Sairyo : Cutoff values of knee extensor strength for stair ascent and descent after bicruciate-stabilized total knee arthroplasty., Journal of Orthopaedics, 75, 279-284, 2026.
(要約)
Patient satisfaction after total knee arthroplasty (TKA) is strongly influenced by the ability to ascend and descend stairs. Although knee extensor strength is considered essential for stair negotiation, the specific functional threshold values required for stair ascent and descent after bicruciate-stabilized (BCS) TKA remain unclear. This study aimed to identify functional factors associated with stair ascent and descent after BCS TKA and to determine cutoff values for knee extensor strength. This prospective cohort study included 94 patients (117 knees) who underwent unilateral BCS TKA between October 2017 and January 2023. Stair ascent and descent abilities were evaluated at 1 year postoperatively using a three-step staircase. Patients were classified into a normal ability group or a reduced ability group based on their stair negotiation pattern. Knee extensor strength, knee range of motion, and demographic variables were assessed. Multiple logistic regression analyses were performed separately for stair ascent and stair descent. Cutoff values were determined using receiver-operating characteristic (ROC) curve analysis. For stair ascent, knee extensor strength, age, and sex were independently associated with stair ascent ability. The cutoff value of knee extensor strength required for normal stair ascent was 1.04 Nm/kg (area under the curve [AUC] = 0.76). For stair descent, knee extensor strength was the only independent factor associated with performance. The cutoff value required for normal stair descent was 1.10 Nm/kg (AUC = 0.86). Successful stair ascent and descent after BCS TKA require sufficient knee extensor strength. The identified cutoff values may serve as clinically useful reference targets for postoperative rehabilitation aimed at improving stair negotiation ability.
Taiki Furumoto, Daisuke Hamada, Keizo Wada, Ken Tomonari, Yasuaki Tamaki, Shota Shigekiyo, Tetsuya Matsuura and Koichi Sairyo : Cutoff values of knee extensor strength for stair ascent and descent after bicruciate-stabilized total knee arthroplasty., Journal of Orthopaedics, 75, 279-284, 2026.
(要約)
Patient satisfaction after total knee arthroplasty (TKA) is strongly influenced by the ability to ascend and descend stairs. Although knee extensor strength is considered essential for stair negotiation, the specific functional threshold values required for stair ascent and descent after bicruciate-stabilized (BCS) TKA remain unclear. This study aimed to identify functional factors associated with stair ascent and descent after BCS TKA and to determine cutoff values for knee extensor strength.This prospective cohort study included 94 patients (117 knees) who underwent unilateral BCS TKA between October 2017 and January 2023. Stair ascent and descent abilities were evaluated at 1 year postoperatively using a three-step staircase. Patients were classified into a normal ability group or a reduced ability group based on their stair negotiation pattern. Knee extensor strength, knee range of motion, and demographic variables were assessed. Multiple logistic regression analyses were performed separately for stair ascent and stair descent. Cutoff values were determined using receiver-operating characteristic (ROC) curve analysis.For stair ascent, knee extensor strength, age, and sex were independently associated with stair ascent ability. The cutoff value of knee extensor strength required for normal stair ascent was 1.04 Nm/kg (area under the curve [AUC] = 0.76). For stair descent, knee extensor strength was the only independent factor associated with performance. The cutoff value required for normal stair descent was 1.10 Nm/kg (AUC = 0.86).Successful stair ascent and descent after BCS TKA require sufficient knee extensor strength. The identified cutoff values may serve as clinically useful reference targets for postoperative rehabilitation aimed at improving stair negotiation ability.
Ken Tomonari, Yasuaki Tamaki, Takashi Saito, Motomu Kamada, Yuka Sugiyama, Megumi Yamada, Tomohiro Goto, Yasuyuki Omichi, Keizo Wada, Shota Shigekiyo, Yuto Sugimine, Tetsuya Matsuura and Koichi Sairyo : Preoperative factors associated with long-distance walking ability one year after total hip arthroplasty: a prospective cohort study, International Orthopaedics, 2026.
(キーワード)
Hip / Rehabilitation / Six-minute walk distance / Total hip arthroplasty / Walking capacity
Shin Kondo, Masakazu Goto, Takashi Saito, Motomu Kamada, Seiya Inoue, Satoshi Fujiwara, Nori Sato, Hiromitsu Takizawa and Tetsuya Matsuura : Postoperative Step Count Predicts Unplanned Readmission After Radical Esophagectomy: A Retrospective Cohort Study., Annals of Surgical Oncology, 2025.
(要約)
Unplanned readmission after esophagectomy is associated with increased health care costs and poorer survival outcomes. Postoperative physical activity during hospitalization may help mitigate this risk. This study evaluated the association between postoperative step count and 90-day unplanned readmission after curative thoracic esophagectomy and identified an optimal step count threshold for predicting readmission.This retrospective cohort study analyzed 128 participants who underwent curative thoracic esophagectomy between 2016 and 2024. Step counts were recorded using a wearable activity tracker during the final 7 days before discharge. The primary outcome was unplanned readmission within 90 days after discharge. Multivariable logistic regression was used to identify independent predictors of readmission. A receiver operating characteristic curve determined the optimal step count cutoff.Unplanned readmission occurred for 27 participants (21.1%). Multivariable analysis indicated that a higher step count was independently associated with reduced readmission risk (odds ratio, 0.76 per 1000 steps; 95% confidence interval, 0.58-0.99 per 1000 steps; p = 0.044). The optimal cutoff for predicting readmission was 2446 steps per day (area under the curve, 0.691; sensitivity, 59.3%; specificity, 76.2%).A lower pre-discharge step count independently predicted unplanned readmission after thoracic esophagectomy. A threshold of approximately 2500 or more steps per day may represent a practical target for postoperative rehabilitation and strategies to prevent readmission.
Yasuko Ichihara, Hiroyasu Mori, Motomu Kamada, Tetsuya Matsuura, Koichi Sairyo, Mizusa Hyodo, Rie Tsutsumi, Hiroshi Sakaue, Ken-ichi Aihara, Makoto Funaki, Akio Kuroda and Munehide Matsuhisa : Effects of high-intensity interval walking training on muscle strength, walking ability, and health-related quality of life in people with diabetes accompanied by lower extremity weakness: A randomized controlled trial., Journal of Diabetes Investigation, 16, 4, 646-655, 2025.
(要約)
At the end of the intervention, there was no significant difference in the degree of change in isometric knee extension strength between the two groups. However, there was a significant increase in changes in gait speed and physical QOL in the IWT group (gait speed, P < 0.01; physical QOL, P < 0.05).
Hiroshi Ohmae, Shin Kondo, Takashi Saito, Wataru Sano, Yuka Sugiyama, Ayane Tomari, Motomu Kamada, Yuka Nakanowatari, Maki Fujimoto, Megumi Yamada, Nori Sato, Kimiko Umemura, Ryoma Morigaki, Yasushi Takagi and Tetsuya Matsuura : Phase angle is a predictor of functional outcomes at discharge in patients with acute ischemic stroke, The Journal of Medical Investigation : JMI, 72, 1.2, 148-155, 2025.
(要約)
The aim of this study was to investigate the association between phase angle (PhA) at admission and functional outcomes at discharge in patients with acute ischemic stroke. This single-center, prospective cohort study measured PhA and skeletal muscle index (SMI) in patients with acute ischemic stroke using bioelectrical impedance analysis (BIA). Functional outcomes were assessed using the modified Rankin Scale (mRS) at discharge, with mRS scores of 3-5 difined as poor functional outcomes. The association between PhA or SMI and poor functional outcomes was analyzed for male and female patients. This study included 287 patients (195 males, 92 females). Logistic regression indicated that PhA, but not SMI, was independently correlated with poor functional outcomes at discharge (males : OR : 0.58, 95% confidence interval [CI] : 0.34-0.98, p = 0.041, females : OR : 0.31, 95% CI : 0.12-0.80, p = 0.015). Receiver operating characteristic curve analysis determined PhA cutoff values for poor functional outcomes : 4.70 in males (sensitivity : 0.627, specificity : 0.680, area under curve [AUC] : 0.674) and 3.70 in females (sensitivity : 0.467, specificity : 0.830, AUC : 0.712). PhA was identified an independent predictor of poor functional outcomes at discharge in patients with acute ischemic stroke, and it was superior to SMI in this regard. J. Med. Invest. 72 : 148-155, February, 2025.
Kenji Yokoyama, Tetsuya Matsuura, Joji Iwase and Koichi Sairyo : Focused extracorporeal shockwave therapy for bilateral fatigue fractures of the proximal phalanges in the great toes: A case report, The Journal of Medical Investigation : JMI, 72, 1.2, 207-210, 2025.
(要約)
We report a case of a 14-year-old male sprinter with bilateral fatigue fractures of the proximal phalanges in the great toes. The patient and his guardian wished for an early return to sports; therefore, focused extracorporeal shockwave therapy (FSW) was administered instead of the traditional surgical treatment for bilateral cases. Four weeks after starting treatment, tenderness had disappeared, and he was able to return to sports. Computed tomography at 24 weeks after starting FSW revealed bone healing, and there was no recurrence of the fatigue fractures at the 48-week follow-up. The lesson learned from this case is that FSW offers a novel, less invasive treatment option for athletes with bilateral fatigue fractures of the proximal phalanges in the great toes who wish for an early return to sports without surgery. FSW has analgesic effects and promotes bone healing, resulting in optimal treatment outcomes. FSW should be considered a standard treatment option for this type of fracture. J. Med. Invest. 72 : 207-210, February, 2025.
(キーワード)
case report / extracorporeal shock wave therapy / fatigue fracture / great toe / metatarsophalangeal joint
Hiroshi Oomae, Taku Matsuda, Maki Fujimoto, Yuka Nakanowatari, Megumi Yamada, Nori Sato, Kimiko Umemura, Ryoma Morigaki, Tetsuya Matsuura and Yasushi Takagi : Safety and Selection Criteria of Single-joint Hybrid Assistive Limb for Upper Limb Paralysis After Stroke: A Phase I Trial, Neurologia Medico-Chirurgica, 65, 1, 15-21, 2024.
(要約)
Robotic rehabilitation is a high-intensity intervention for upper limb paralysis after a stroke. This study explored the safety and feasibility of using a single-joint hybrid assistive limb (HAL-SJ) exoskeletal device for upper limb paralysis in patients with acute stroke. In total, 11 patients with stroke (6 with moderate paralysis and 5 with severe paralysis) were enrolled between October 2021 and October 2023 in a stroke care unit. The patients underwent HAL training 3 times a week for 6 sessions. No serious adverse events related to HAL-SJ occurred, and participants demonstrated significant improvements in the Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) (pre- vs. post-intervention; p < 0.05). The minimal clinically important difference (MCID) for FMA-UE was surpassed in 5 patients (83.3%) with moderate paralysis and 2 (40.0%) with severe paralysis. Regarding ARAT, 4 patients (66.7%) with moderate paralysis exceeded the MCID, whereas none (0.0%) with severe paralysis did. These findings suggest that HAL-SJ is both safe and feasible, particularly for individuals with moderate paralysis.
Hiroshi Ohmae, Taku Matsuda, Maki Fujimoto, Yuka Nakanowatari, Megumi Yamada, Nori Sato, Kimiko Umemura, Ryoma Morigaki, Tetsuya Matsuura and Yasushi Takagi : Safety and Selection Criteria of Single-joint Hybrid Assistive Limb for Upper Limb Paralysis After Stroke: A Phase I Trial., Neurologia Medico-Chirurgica, 65, 1, 15-21, 2024.
(要約)
Robotic rehabilitation is a high-intensity intervention for upper limb paralysis after a stroke. This study explored the safety and feasibility of using a single-joint hybrid assistive limb (HAL-SJ) exoskeletal device for upper limb paralysis in patients with acute stroke. In total, 11 patients with stroke (6 with moderate paralysis and 5 with severe paralysis) were enrolled between October 2021 and October 2023 in a stroke care unit. The patients underwent HAL training 3 times a week for 6 sessions. No serious adverse events related to HAL-SJ occurred, and participants demonstrated significant improvements in the Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) (pre- vs. post-intervention; p < 0.05). The minimal clinically important difference (MCID) for FMA-UE was surpassed in 5 patients (83.3%) with moderate paralysis and 2 (40.0%) with severe paralysis. Regarding ARAT, 4 patients (66.7%) with moderate paralysis exceeded the MCID, whereas none (0.0%) with severe paralysis did. These findings suggest that HAL-SJ is both safe and feasible, particularly for individuals with moderate paralysis.
Kenji Yokoyama, Tetsuya Matsuura, Joji Iwase, Toshiyuki Iwame and Koichi Sairyo : Sagittal computed tomography evaluation of osteochondritis dissecans of the capitellum correlates with clinical outcomes of arthroscopic debridement in adolescent baseball players, Journal of ISAKOS, 9, 6, 100301, 2024.
(要約)
To investigate the relationship between the size and location of osteochondral defects in capitellar osteochondritis dissecans (OCD) measured on coronal and sagittal reconstructed computed tomography (CT) images and the clinical outcomes of arthroscopic debridement in adolescent baseball players. This retrospective study investigated the clinical outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players with ≥24 months of follow-up after surgery between 2008 and 2020. On preoperative coronal CT images, medial and lateral distance (%) were used to evaluate the location of the defect. Defect size (%) was also evaluated. On preoperative sagittal CT images, superior and inferior angles (deg) were used to evaluate the location of the defect. The size of the defect was evaluated using the defect angle (deg). Outcome measures were determined using the Timmerman-Andrews score at the latest follow-up. Spearman's rank correlation coefficient was used to examine relationships between these parameters and the Timmerman-Andrews score. Statistical significance was set at p < 0.05. Thirty players [mean age, 14 (range, 11-16) years] underwent arthroscopic debridement: 5 were pitchers, 7 were catchers, 13 were infielders, and 5 were outfielders. Mean follow-up duration was 26 (range, 24-66) months. The median Timmerman-Andrews score at the latest follow-up was 193 [interquartile range (IQR), 181-200] points. Inferior angle showed statistically significant positive correlations with Timmerman-Andrews score (rs = 0.520, p < 0.01), pain (rs = 0.478, p < 0.01), and sagittal arc of motion (rs = 0.409, p = 0.025). Defect angle showed statistically significant negative correlations with Timmerman-Andrews score (rs = -0.462, p = 0.010) and flexion contracture (rs = -0.424, p = 0.020). Medial distance, lateral distance, defect size, and superior angle were not correlated with the Timmerman-Andrews score or any of its subscores. Posterior or large osteochondral defects of the humeral capitellum on preoperative sagittal CT images affected the outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players. Level V, case series.
(キーワード)
Arthroscopic debridement / Clinical outcomes / Osteochondritis dissecans of the elbow / Sagittal computed tomography evaluation
Tetsuya Matsuura, Naoto Suzue, Toshiyuki Iwame, Jyoji Iwase, Kenji Yokoyama, Shoichiro Takao, Susumu Nishio and Koichi Sairyo : Prevalence of osteochondritis dissecans of the capitellum in elementary school baseball players based on ultrasonographic screening: a 15-year overview in Tokushima, Japan., JSES International, 8, 3, 661-666, 2024.
(要約)
Although several operative procedures have evolved for capitellar osteochondritis dissecans (OCD), the best outcome is achieved by early detection and conservative treatment. The objective of this study was to clarify changes in the prevalence of capitellar OCD in young baseball players over a long-term period based on consistent criteria in Tokushima, Japan between 2006 and 2020.The number of players who underwent screening and the discovery rate of capitellar OCD during the study period were investigated. School grade and radiographic stage were also evaluated.The confirmation rate was significantly higher when ultrasonographic screening was performed than when screening was based on physical findings (65.8% vs. 1.9%, P < .001). The overall incidence of OCD in elementary school players based on ultrasonographic screening was 1.4% during the 10-year study period. Twenty-one (10.8%) of the 195 players identified to have OCD had experienced lateral elbow pain. When classified radiographically, the lesion was stage I in 73.3% of cases, stage II in 24.1%, and stage III in 2.6%. No cases of OCD were diagnosed before the fourth grade. The prevalence rates increased gradually from the fourth grade to the sixth grade.Ultrasonographic screening could be more effective for detecting capitellar OCD than screening based on physical findings. The overall prevalence of OCD among elementary school players was 1.4% over 10 years. The prevalence rates increased gradually from the fourth grade onwards.
Seiya Inoue, Masakazu Goto, Satoshi Fujiwara, Takahiro Yoshida, Fuyumi Izaki, Taihei Takeuchi, Hiroyuki Sumitomo, Mariko Aoyama, Hiroaki Toba, Hiromitsu Takizawa, Yasuhiro Hamada, Tetsuya Matsuura, Keiko Aota and Hidenori Takano : Achievements of perioperative assist team medical care in esophageal cancer surgery, Tokushima University Hospital, The Journal of Medical Investigation : JMI, 71, 3,4, 279-285, 2024.
(要約)
Radical esophagectomy is highly invasive and associated with many postoperative complications. A decline in postoperative QOL is a serious issue for patients, and comprehensive perioperative management through multidisciplinary cooperation is necessary. Our institution has established a perioperative assist team (OPERA) to address this need since 2017. This study included 109 patients with esophageal cancer who underwent neoadjuvant chemotherapy and esophagectomy from 2009 to 2018. O group, means OPERA intervention group, included 57 patients, and N group, means Non-OPERA intervention group, included 52 patients. The effects of the OPERA intervention on reducing chemotherapy-related adverse events and improving postoperative outcomes were retrospectively investigated. The OPERA intervention significantly reduced the incidence of chemotherapy-related adverse events (P=0.002). In particular, anorexia and diarrhea, febrile neutropenia were significantly reduced (P<0.001, P=0.002, P=0.025, respectively). Postoperatively, the start date of walking was significantly earlier (P<0.001), the incidence of pneumonia was lower (P=0.022). At the time of postoperative discharge, N group was significantly greater weight loss compared to O group (P=0.002). The 5-year survival rate was longer in O group (P=0.003). The OPERA intervention reduced the incidence of chemotherapy-related adverse events and postoperative complications and helped improved prognosis. J. Med. Invest. 71 : 279-285, August, 2024.
(キーワード)
Humans / Esophageal Neoplasms / 男性 (male) / 女性 (female) / Middle Aged / Aged / Esophagectomy / Retrospective Studies / Hospitals, University / Postoperative Complications / Perioperative Care / Patient Care Team / Neoadjuvant Therapy / 日本 (Japan)
Yu Saitou, Yuji Morine, Tetsuya Ikemoto, Shin-ichiro Yamada, Hiroki Teraoku, Sonoko Yasui-Yamada, Maki Nishi, Hiroshi Sakaue, Motomu Kamada, Tetsuya Matsuura and Mitsuo Shimada : Preoperative Weight Loss Program for Hepatocellular Carcinoma Patients with High Body Mass Index in Hepatectomy., World Journal of Surgery, 47, 12, 3348-3355, 2023.
(要約)
This study aimed to investigate the usefulness of a weight-loss program (WLP) in patients with a high body mass index (BMI) prior to liver resection (Hx) for hepatocellular carcinoma (HCC). Among 445 patients with HCC who underwent initial Hx between 2000 and 2020, 19 with a high BMI (25.0) were enrolled in our WLP since 2014. For calorie restriction, the amount of energy consumed was calculated as the standard body weight (SBW) kg × 20-25 kcal/day. Protein mass was calculated as SBW kg × 1.0-1.2 g/day to maintain skeletal muscle mass. Patients also performed both aerobic and resistance exercises. The before-and-after changes were compared, and the effect of WLP on the short- and long-term results was investigated. The average length of WLP was 21 days, and weight loss was successfully achieved in all patients. Body fat mass was reduced during the program, while skeletal muscle mass was maintained. WLP led to improvements in liver function and fibrotic markers, without tumor progression. There were no postoperative complications (Clavien-Dindo [CD] III). A retrospective comparison between with and without WLP using propensity score-matching analysis revealed that WLP group showed better NLR value, however, there were no significant differences in both short and long-term outcomes after Hx based on participation in the WLP. WLP with multidisciplinary intervention improved immune-nutrition status and liver function of obese patients. WLP had not affected both short and long-term outcomes after Hx.
(キーワード)
Humans / Carcinoma, Hepatocellular / Hepatectomy / Liver Neoplasms / Body Mass Index / Weight Reduction Programs / Retrospective Studies / Propensity Score / Treatment Outcome / Laparoscopy
Tetsuya Okahisa, Tetsuya Matsuura, Ken Tomonari, Kouji Komatsu, Kenji Yokoyama, Jyoji Iwase, Megumi Yamada and Koichi Sairyo : Between-day reliability and minimum detectable change of the Conventional Gait Model 2 and Plug-in Gait Model during running., Gait & Posture, 100, 171-178, 2023.
(要約)
The between-day reliability of CGM2 was mostly good to excellent for lower limb kinematics and kinetics during running. We believe that CGM2 can more accurately assess kinematic differences between the coronal and transverse planes than the PiG.
Shin Kondo, Tatsuro Inoue, Takashi Saito, Takashi Fujikawa, Motomu Kamada, Seiya Inoue, Satoshi Fujiwara, Masakazu Goto, Nori Sato, Rei Ono, Toshihiro Akisue, Shinsuke Katoh, Hiromitsu Takizawa and Tetsuya Matsuura : Impact of postoperative physical activity on the development of pneumonia in the subacute phase after esophagectomy in patients with esophageal cancer: A retrospective cohort study, European Journal of Oncology Nursing, 62, 2023.
(要約)
Physical activity is important to improve recovery following surgery. This study investigated the impact of physical activity on the development of pneumonia after radical esophagectomy in patients with thoracic esophageal cancer in the subacute phase from postoperative day 11 to hospital discharge. This retrospective cohort study included 83 patients who underwent radical esophagectomy for esophageal cancer between 2016 and 2022. Physical activity was measured using an activity tracker, and the average number of steps between postoperative days 8 and 10 was examined. The primary outcome was pneumonia (Clavien-Dindo classification 2 or higher) developing between postoperative day 11 and hospital discharge. We used the receiver operating characteristic (ROC) curve analysis to calculate the optimal cutoff value of physical activity that can predict the development of pneumonia and define low physical activity. We used logistic regression analysis to investigate the impact of low physical activity on postoperative pneumonia. Pneumonia developed in 10 patients (12.0%) during the observation period. The optimal cutoff value of physical activity for predicting pneumonia was 1494 steps per day (sensitivity: 60.0%, specificity: 89.0%, area under the curve: 0.743). In multivariate analysis, low physical activity was an independent predictor of incident pneumonia [odds ratio: 12.10, 95% confidence interval: 2.21-65.90, p = 0.004], with adjustment for age, gastric tube reconstruction route, and postoperative recurrent nerve palsy. Physical activity following radical esophagectomy in patients with thoracic esophageal cancer was an independent predictor of the development of pneumonia in the subacute phase after radical esophagectomy.
Toshiyuki Iwame, Tetsuya Matsuura, Naoto Suzue, Sakurako Katsuura-Kamano, Shoichiro Takao, Jyoji Iwase and Koichi Sairyo : One-year follow-up ultrasonographic study of the subchondral bone surface of the distal femoral epiphysis in children aged 9-11 years., Journal of Pediatric Orthopaedics. Part B, 31, 2, e174-e179, 2022.
(要約)
Subchondral bone surface irregularity of the distal femoral epiphysis was more common on US in growing children aged 9-11 years, and transition from an irregular to a smooth outline accelerated after age 10 years. US is a reliable method for assessing the morphology of the distal femoral epiphysis and could be a useful screening tool for detecting OCD.
Shin Kondo, Yuya Ueda, Kouji Komatsu, Rei Ono, Nori Sato, Tetsuya Matsuura and Shinsuke Katoh : Characteristics of the stand-to-sit motion in healthy older women : Evaluation of sitting impact by measurement of ground reaction forces., The Journal of Medical Investigation : JMI, 69, 3.4, 278-286, 2022.
(要約)
Objectives : The aims of this study were to examine the biomechanics of StandTS movements in older adults and to identify their optimal StandTS motion by measuring sitting impact forces. Methods : Healthy older women (n = 17) and healthy young women (n = 18) were asked to perform SitTS and StandTS motions at a natural speed using a chair. We measured the ground reaction forces from the participants' feet and the chair, the angle of the trunk and ankle, vertical velocity, and postural muscle activities using a force plate, motion analyzer, and electromyography, respectively. Results : Sitting impact force was significantly greater in the older women than in the young women during the StandTS motion. There was a significant difference between the trunk angle and the ankle angle during the StandTS motion and sitting impact force had a significant negative correlation with the ankle joint motion in the older women. Conclusions : The ankle joint strategy was characterized by body sway resembling a single-segment-inverted pendulum and suggests that this response is less developed in the older adult. These results indicate that the ankle joint strategy may be an important factor involved in the sitting impact force. J. Med. Invest. 69 : 278-286, August, 2022.
Tetsuya Matsuura, Yuki Takata, Toshiyuki Iwame, Jyoji Iwase, Kenji Yokoyama, Shoichiro Takao, Susumu Nishio, Kokichi Arisawa and Koichi Sairyo : Limiting the Pitch Count in Youth Baseball Pitchers Decreases Elbow Pain., Orthopaedic Journal of Sports Medicine, 9, 3, 2021.
(要約)
A pitch count limit of 70 pitches per day for baseball pitchers 12 years could be more protective against elbow pain and reduced flexion than a limit of 7 innings per day, but it may not be effective for reducing the risk of capitellar OCD.
Toshiyuki Iwame, Tetsuya Matsuura, T Okahisa, S Katsuura-Kamano, Keizo Wada, Jyoji Iwase and Koichi Sairyo : Quadriceps strength to body weight ratio is a significant indicator for initiating jogging after anterior cruciate ligament reconstruction., The Knee, 28, 240-246, 2021.
(要約)
QS/BW is a significant indicator for safely initiating jogging 3 months after ACL reconstruction. The cut-off value of QS/BW for initiating jogging was 1.45 Nm/kg.
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, 36, 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.
Tetsuya Matsuura, Toshiyuki Iwame, Jyoji Iwase and Koichi Sairyo : Osteochondritis Dissecans of the Capitellum :Review of the Literature., The Journal of Medical Investigation : JMI, 67, 3.4, 217-221, 2020.
(要約)
Osteochondritis dissecans (OCD) of the capitellum is a leading cause of elbow disability in adolescent baseball players. Previous studies have not found an association of player position with capitellar OCD. Elbow pain and a longer playing history might be related to progression of capitellar OCD but do not in themselves increase the risk of development of the condition. The cause of capitellar OCD is likely to include a combination of repetitive microtrauma and internal factors, such as ischemia and genetic predisposition. A combination of radiography, computed tomography, magnetic resonance imaging, and ultrasonography have aided our understanding of the pathology of capitellar OCD. Screening using ultrasonography enables early detection and provides an opportunity for successful conservative treatment. Treatment has conventionally included both operative and nonoperative measures based on the stage and size of the lesion, skeletal maturity, subjective symptoms, and structural integrity of the cartilage. Early-stage lesions respond better to nonoperative treatment than those in more advanced stages. Operative indications include persistent symptoms despite nonoperative treatment, symptomatic loose bodies, and displacement or detachment of fragments. J. Med. Invest. 67 : 217-221, August, 2020.
Toshiyuki Iwame, Tetsuya Matsuura, Tetsuya Okahisa, Jyoji Iwase, Hirokazu Uemura and Koichi Sairyo : Factors correlating with recovery of quadriceps strength after double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts., European Journal of Orthopaedic Surgery & Traumatology, 30, 2, 307-312, 2020.
(要約)
Postoperative quadriceps strength index at 6 months after double-bundle ACL reconstruction with hamstring tendon autografts was affected by preoperative quadriceps strength index. Adequate preoperative quadriceps strength may need to be considered in order to facilitate better recovery of quadriceps strength after ACL reconstruction and to support an earlier return to sports activities.
Toshiyuki Iwame, Tetsuya Matsuura, Naoto Suzue, Jyoji Iwase, Hirokazu Uemura and Koichi Sairyo : Factors Associated With Knee Pain and Heel Pain in Youth Soccer Players Aged 8 to 12 Years., Orthopaedic Journal of Sports Medicine, 7, 11, 2019.
(要約)
In this study of youth soccer players, knee pain was associated with older age and more years of play, but heel pain was not significantly associated with any factor.
Shoji Fukuta, Katsutoshli Miyatake, Tetsuya Matsuura and Koichi Sairyo : Two Cases of Spontaneous Recurrent Hemarthrosis of the Shoulder with Acromial Erosion Associated with Impingement Syndrome., Case Reports in Orthopedics, 2019, 2019.
(要約)
Spontaneous recurrent hemarthrosis of the shoulder is rare. Most previously reported cases were associated with massive rotator cuff tear and degenerative glenohumeral arthritis. We described two cases of recurrent hemarthrosis without osteoarthritis of the shoulder. Both cases had bony erosion of the acromion, which was confirmed arthroscopically as the origin of bleeding. Arthroscopic coagulation, acromioplasty, and drainage were successful and there was no recurrence of hemorrhage.
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue, Shoichiro Takao, Susumu Nishio, Kokichi Arisawa and Koichi Sairyo : Cumulative Incidence of Osteochondritis Dissecans of the Capitellum in Preadolescent Baseball Players., Arthroscopy : the Journal of Arthroscopic & Related Surgery, 35, 1, 60-66, 2019.
(要約)
The risk of OCD of the capitellum developing within a 1-year period in preadolescent baseball players was 1.8%. Players aged 10 to 11 years had a significantly greater risk of capitellar OCD development than those aged 6 to 9 years.
Toshiyuki Iwame, Tetsuya Matsuura, Joji Iwase, Shoichiro Takao, Hiroshi Egawa and Koichi Sairyo : Two Years of Follow-up Magnetic Resonance Imaging for Osteochondral Injury of the Lateral Femoral Condyle in an Adolescent Basketball Player., The Journal of Medical Investigation : JMI, 66, 1.2, 213-217, 2019.
(要約)
Chondral and osteochondral injuries of the femoral condyle are rare, and relatively few cases have been reported. Therefore, the mechanism, treatment, and findings on follow-up of these injuries are not well described. Here, we report the case of an adolescent basketball player who sustained a sports-related traumatic osteochondral injury of the lateral femoral condyle. He was treated with open reduction and internal fixation with the pull-out suture technique. Two years later, he was able to resume sporting activities at his pre-injury level with no symptoms. Magnetic resonance imaging (MRI) confirmed survival of the fixed osteochondral fragment and restoration of the congruity of the articular cartilage with no sign of delamination. This report describes the clinical outcome of this osteochondral injury of the lateral femoral condyle as seen on MRI at the 2-year follow-up and discuss the mechanism and treatment of this injury. J. Med. Invest. 66 : 213-217, February, 2019.
Ichiro Tonogai, Fumio Hayashi, Toshiyuki Iwame, Tomoya Takasago, Tetsuya Matsuura and Koichi Sairyo : Platelet-rich plasma does not reduce skeletal muscle fibrosis after distraction osteogenesis., Journal of Experimental Orthopaedics, 5, 1, 26, 2018.
(要約)
The amount and area of collagenous tissue increased in both the PRP and control groups following distraction osteogenesis, but the changes were not significantly different between both groups at all time points (p = 0.89, 0.45, 0.33 and 0.52 at 4, 6, 8 and 10 weeks).
Toshiyuki Iwame, Tetsuya Matsuura, Naoto Suzue, Shunsuke Tamaki, Kenji Yokoyama and Koichi Sairyo : Two-year follow-up study of subchondral surface irregularities of the capitellum on ultrasonography in baseball players under the age of 10 years, Skeletal Radiology, 46, 11, 1499-1505, 2017.
(要約)
To determine whether subchondral surface irregularities of the capitellum on ultrasonography in baseball players under the age of 10 years are indicative of early osteochondritis dissecans (OCD) of the capitellum. A total of 321 players aged 6-9 years underwent ultrasonographic examination, and the findings for the subchondral bone of the capitellum on the throwing side were graded as 0, 1a, 1b, 2, or 3. Subjects classified as grade 1a or 1b showed irregularities of the subchondral bone surface and were investigated radiographically for OCD. All players continued to throw and were re-examined by ultrasonography after 1 and 2 years. At the first examination, 11/321 (3.4%) had irregularities at the subchondral surface of the capitellum [grade 1a in 7/321 (2.2%); grade 1b in 4/321 (1.2%)]. The seven players with grade 1a showed no evidence of OCD or Panner's disease on radiography and were reclassified as grade 0 at the 2-year follow-up. All four players with grade 1b were reclassified as grade 0 at follow-up 1 and 2 years later. Subchondral bone surface irregularities of the capitellum on ultrasonography in children under the age of 10 years may not be indicative of disease, but rather represent variation of ossification during normal development.
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue, Jyoji Iwase, Shunsuke Tamaki, Kenji Yokoyama and Koichi Sairyo : Clinical Outcome of Arthroscopic Treatment for Posteromedial Elbow Impingement in Adolescent Baseball Players., Arthroscopy : the Journal of Arthroscopic & Related Surgery, 34, 1, 105-110, 2017.
(要約)
This retrospective study evaluated the clinical outcome of arthroscopic treatment for posteromedial elbow impingement in adolescent baseball players. Patients were eligible for participation if they had undergone surgery at least 2 years earlier and excluded if they had arthritis, loose bodies, osteochondritis dissecans, ulnar collateral ligament tear, flexor/pronator injuries or medial epicondylitis, or nerve problems. Patients were also excluded if they had undergone prior elbow surgery, were younger than 13 years, or were older than 19 years. Arthroscopic treatment included debridement of posteromedial synovitis, fragment removal, and olecranon spur excision. At a mean follow-up of 26.7 (range 24-42) months, patients were evaluated based on a questionnaire, examination, and the previously reported elbow outcome score.
Tetsuya Matsuura, Keizo Wada, Naoto Suzue, Toshiyuki Iwame, Shoji Fukuta and Koichi Sairyo : Bilateral osteochondritis dissecans of the capitellum in fraternal twins: A case report, JBJS Case Connector, 7, 3, e44, 2017.
(要約)
We report the cases of 15-year-old male fraternal twins with bilateral osteochondritis dissecans (OCD) of the capitellum in the absence of syndromic features. At the time of presentation, they had been actively engaged in competitive rhythmic gymnastics for 3 years. Both patients had chronic symptoms in the right elbow, and both underwent arthroscopic evaluation and management. The cases of these 2 patients provide evidence to support the theory that the etiology of OCD may have a genetic background.
Shingo Hama, Ichiro Tonogai, Toshinori Sakai, Yuichiro Goda, Fumitake Tezuka, Tetsuya Matsuura, Naoto Suzue, Rui Takahashi, Tomoya Terai, Kousaku Higashino, Shoji Fukuta, Akihiro Nagamachi and Koichi Sairyo : Pediatric isthmic spondylolisthesis showing radiologic evidence of slippage after physis injury., Journal of Pediatric Orthopaedics. Part B, 26, 4, 388-392, 2017.
(要約)
The pathogenesis of slippage in pediatric spondylolisthesis is still unclear, although epiphyseal injury may account for many cases based on preclinical studies. However, no reports have described a pediatric case of isthmic spondylolisthesis showing radiologic evidence of epiphyseal injury. We report such evidence in a 13-year-old boy with low-back pain. Radiography revealed rounding of the S1 surface, a fracture line below the S1 endplate surface, and a bone marrow lesion in addition to slippage. Slippage and the rounding deformity were partially reversed (from 20 to 14% and from 42 to 27%, respectively) with conservative treatment and natural bone remodeling.
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.
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue, Kokichi Arisawa and Koichi Sairyo : Risk factors for shoulder and elbow pain in youth baseball players., The Physician and Sportsmedicine, 45, 2, 140-144, 2017.
(要約)
This study sought to quantify the 1-year cumulative incidence of shoulder and elbow pain among youth baseball players and identify risk factors associated with the occurrence of shoulder and elbow pain. In total, 900 youth baseball players (aged 7-11 years) were enrolled in a 1-year prospective follow-up study. One year later, the players were asked whether they had experienced episodes of shoulder or elbow pain and the following risk factors for such pain were investigated: age, position, length of baseball experience, training hours per week, and history of shoulder or elbow pain. Data for the groups with and without shoulder or elbow pain were analyzed using multivariate logistic regression models. Episodes of shoulder pain were reported by 18.3% of players and episodes of elbow pain were reported by 35.2% of players. Multivariate analysis showed that shoulder pain was associated with pitcher position, catcher position, longer training hours per week, and history of shoulder and elbow pain, and that elbow pain was associated with age, pitcher position, catcher position, longer training hours per week, and history of elbow pain. Length of baseball experience was not associated with shoulder or elbow pain. History of elbow pain, pitcher position, catcher position, and longer training hours per week were associated with both types of pain. History of shoulder pain was associated with shoulder pain but not elbow pain. Age was associated with elbow pain but not shoulder pain.
Chandra Subash Jha, Toshihiko Nishisho, Tetsuya Matsuura, Makoto Takeuchi, Ryo Miyagi, Shoichiro Takao, Naoto Suzue, Shunichi Toki, Akihiro Nagamachi and Koichi Sairyo : Pigmented villonodular synovitis of the knee joint in a 5-year-old girl treated with combined open and arthroscopic surgery: a case report., Journal of Pediatric Orthopaedics. Part B, 25, 6, 564-569, 2016.
(要約)
Pigmented villonodular synovitis is an extremely rare disease in skeletally immature patients. Erosive destruction of the involved joint leads to early arthritis, and its high recurrence rate makes treatment challenging. Multiple surgical approaches exist, but it is unclear as to which among them achieves the lowest possible recurrence rate and morbidity. We report the case of a 5-year-old girl with left knee pain and swelling who was diagnosed with diffuse pigmented villonodular synovitis of the left knee based on MRI findings. Combined open and arthroscopic surgery was performed to completely remove the tumor. Postoperative histopathological examination confirmed the diagnosis of diffuse pigmented villonodular synovitis. The postoperative course was uneventful, with a gradual improvement in symptoms. There were no signs of recurrence on postoperative MRI performed at the 8-month follow-up, with neither knee pain nor limitation of range of motion. The favorable outcome in this case suggests that combined open and arthroscopic surgery may be an effective method for treating pigmented villonodular synovitis in skeletally immature patients.
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, 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.
Tetsuya Matsuura, Naoto Suzue, Toshiyuki Iwame, Kokichi Arisawa, Shoji Fukuta and Koichi Sairyo : Epidemiology of shoulder and elbow pain in youth baseball players., The Physician and Sportsmedicine, 44, 2, 97-100, 2016.
(要約)
In over 1000 baseball players aged 7 to 12 years, 15.9% reported episodes of shoulder pain, while 29.2% reported elbow pain in the throwing arm. The associated risk factors were different for each type of pain. Shoulder pain was associated with increased age while elbow pain was associated with increased age, increased years of baseball experience, and playing catcher.
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, 63, 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.
Kazuaki Mineta, Naoto Suzue, Tetsuya Matsuura and Koichi Sairyo : Efficacy of Achilles Suture Bridge Technique for Insertional Achilles Tendinosis in an Obese and Athletic Patient., The Journal of Medical Investigation : JMI, 63, 3-4, 310-314, 2016.
(要約)
Here, we report the efficacy of the suture bridge technique for treating insertional Achilles tendinosis in an obese and athletic patient. A 48-year-old man presented to our department with a 6-month history of left posterior heel pain. The patient was an athlete (triathlon) and appeared obese (height: 197 cm, body weight: 120 kg, body mass index: 30.9). A diagnosis of insertional Achilles tendinosis was made. Because 6 months of conservative treatments had failed, we performed open resection of the calcaneal exostosis and Haglund's deformity along with debridement of the degenerative tissue of the tendon. Wide detachment of the insertion of the Achilles tendon was necessary, and reattachment of the tendon was performed using the Arthrex SpeedBridge(TM) system (Arthrex, Inc., Naples, FL). Six weeks postoperatively, this patient was allowed to walk with full weight bearing. Twelve weeks after surgery, this patient started jogging with neither pain nor evidence of Achilles tendon rupture. The suture bridge technique was effective for the reconstruction of the Achilles tendon in an obese and athletic patient. J. Med. Invest. 63: 310-314, 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, 63, 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, 63, 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, 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, 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.
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, 62, 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, 62, 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.
Yoshiji Kanematsu, Tetsuya Matsuura, Shinji Kashiwaguchi, Takenobu Iwase, Naoto Suzue, Toshiyuki Iwame and Koichi Sairyo : Radiographic follow-up study of Little Leaguer's shoulder., Skeletal Radiology, 44, 1, 73-76, 2015.
(要約)
The healing process of Little Leaguer's shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination.
Tetsuya Enishi, Tetsuya Matsuura, Naoto Suzue and Koichi Sairyo : Fracture of a persistent olecranon physis in an adult, Trauma Case Reports, 1, 1,2, 9-12, 2015.
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, 62, 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, 62, 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, 62, 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, 62, 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, 62, 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, 62, 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, 62, 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.
Tetsuya Enishi, Tetsuya Matsuura, Naoto Suzue, Yoshinori Takahashi and Koichi Sairyo : Cartilage degeneration at symptomatic persistent olecranon physis in adolescent baseball players., Advances in Orthopedics, 2014, 545438, 2014.
(要約)
Background. Elbow overuse injuries are common in adolescent baseball players, but symptomatic persistent olecranon physis is rare, and its pathogenesis remains unclear. Purpose. To examine the histopathological and imaging findings of advanced persistent olecranon physis. Methods. The olecranon physes of 2 baseball pitchers, aged 14 and 15 years, were examined by preoperative magnetic resonance imaging (MRI), and surgical specimens were examined histologically. Results. T2-weighted MRI revealed alterations in the intrachondral signal intensity possibly related to collagen degeneration and increased free water content. Histological findings of specimens stained with hematoxylin-eosin showed complete disorganization of the cartilage structure, hypocellularity, chondrocyte cluster formation, and moderately reduced staining. All these findings are hallmarks of osteoarthritis and are suggestive of cartilage degeneration. Conclusion. Growth plate degeneration was evident in advanced cases of symptomatic persistent olecranon physis. These findings contribute to understanding the pathogenesis of this disease.
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, 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, 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.
Tetsuya Matsuura, Naoto Suzue, Toshiyuki Iwame, Susumu Nishio and Koichi Sairyo : Prevalence of Osteochondritis Dissecans of the Capitellum in Young Baseball Players: Results Based on Ultrasonographic Findings., Orthopaedic Journal of Sports Medicine, 2, 8, 2014.
(要約)
The prevalence of OCD of the capitellum was 2.1% in 1000 baseball players aged 10 to 12 years, with no differences in prevalence according to age or player position.
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, 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, 61, 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, 61, 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, 61, 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, 61, 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, 61, 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, 61, 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.
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, 61, 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, 61, 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, 61, 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.
Kousaku Higashino, Tetsuya Matsuura, Katsuyoshi Suganuma, Kiminori Yukata, Toshihiko Nishisho and Natsuo Yasui : Early changes in muscle atrophy and muscle fiber type conversion after spinal cord transection and peripheral nerve transection in rats., Journal of Neuroengineering and Rehabilitation, 10, 1, 46, 2013.
(要約)
BACKGROUND: Spinal cord transection and peripheral nerve transection cause muscle atrophy and muscle fiber type conversion. It is still unknown how spinal cord transection and peripheral nerve transection each affect the differentiation of muscle fiber type conversion mechanism and muscle atrophy. The aim of our study was to evaluate the difference of muscle weight change, muscle fiber type conversion, and Peroxisome proliferator-activated receptor-gamma coactivatior-1alpha (PGC-1alpha) expression brought about by spinal cord transection and by peripheral nerve transection. METHODS: Twenty-four Wistar rats underwent surgery, the control rats underwent a laminectomy; the spinal cord injury group underwent a spinal cord transection; the denervation group underwent a sciatic nerve transection. The rats were harvested of the soleus muscle and the TA muscle at 0 week, 1 week and 2 weeks after surgery. Histological examination was assessed using hematoxylin and eosin (H&E) staining and immunofluorescent staing. Western blot was performed with 3 groups. RESULTS: Both sciatic nerve transection and spinal cord transection caused muscle atrophy with the effect being more severe after sciatic nerve transection. Spinal cord transection caused a reduction in the expression of both sMHC protein and PGC-1alpha protein in the soleus muscle. On the other hand, sciatic nerve transection produced an increase in expression of sMHC protein and PGC-1alpha protein in the soleus muscle. The results of the expression of PGC-1alpha were expected in other words muscle atrophy after sciatic nerve transection is less than after spinal cord transection, however muscle atrophy after sciatic nerve transection was more severe than after spinal cord transection. CONCLUSION: In the conclusion, spinal cord transection diminished the expression of sMHC protein and PGC-1alpha protein in the soleus muscle. On the other hand, sciatic nerve transection enhanced the expression of sMHC protein and PGC-1alpha protein in the soleus muscle.
Tetsuya Matsuura, Shinji Kashiwaguchi, Takenobu Iwase, Tetsuya Enishi and Natsuo Yasui : The Value of Using Radiographic Criteria for the Treatment of Persistent Symptomatic Olecranon Physis in Adolescent Throwing Athletes., The American Journal of Sports Medicine, 38, 1, 141-145, 2010.
(要約)
Previously published reports present a variety of nonoperative and operative treatments for a persistent olecranon physis. However, the radiographic indication for the operative treatment is not clear. Our radiographic classification of persistent olecranon physis is helpful in formulating treatment decisions. Cohort study; Level of evidence, 3. Sixteen male baseball players with persistent olecranon physis were retrospectively evaluated. The mean age at first presentation was 14.7 years (range, 12-17 years). The lesion was classified into 2 stages based on radiographic appearance. Stage I demonstrated widening of the olecranon epiphyseal plate when compared with the contralateral elbow on the lateral view. Sclerotic change indicated stage II. All patients underwent nonoperative treatment for at least 3 months. Follow-up radiographs were taken at 1-month intervals. Operative treatment was provided to the patients whose condition had failed to improve after nonoperative treatment. Of the 16 patients, 12 had stage I lesions and 4 had stage II lesions. Nonoperative management produced healing in 91.7% of patients with stage I lesions and none of the patients with stage II lesions. Our radiographic classification of persistent olecranon physis is useful for treatment decision making. In addition, our results demonstrated that sclerotic change is a high predictive indicator of the need for operative treatment.
Tetsuya Matsuura, Shinji Kashiwaguchi, Takenobu Iwase, Yoshitsugu Takeda and Natsuo Yasui : Conservative treatment for osteochondrosis of the humeral capitellum., The American Journal of Sports Medicine, 36, 5, 868-872, 2008.
(要約)
BACKGROUND: Conservative treatment is recommended for the early stage of osteochondrosis of the humeral capitellum. However, the outcome of conservative treatment has not been well documented. HYPOTHESIS: Osteochondrosis of the humeral capitellum detected at an early stage responds well to conservative treatment. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively reviewed 176 patients with osteochondrosis of the humeral capitellum. There were 134 lesions that were stage I (radiolucent area) in patients with a mean age of 11.5 years and 42 lesions that were stage II (nondisplaced fragments) in patients with a mean age of 13.9 years based on anteroposterior radiographs of the elbow in 45 degrees of flexion. Conservative treatment was performed on 101 patients. The remaining 75 patients did not follow the authors' advice. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Follow-up radiographs were taken at 1-month intervals. At a mean follow-up of 24 months, all patients were evaluated clinically and radiographically. RESULTS: Conservative management produced healing in 90.5% of stage I lesions and 52.9% of stage II lesions. The mean period required for healing was 14.9 months in stage I and 12.3 months in stage II. Sixty-six of 84 (78.6%) stage I patients and 9 of 17 (52.9%) stage II patients returned to competitive-level baseball. Of the 75 patients who did not follow our advice, healing was observed in 17 (22.7%). The healing rate was higher for the 101 patients who followed our advice as opposed to the 75 patients who did not. CONCLUSION: Osteochondrosis of the humeral capitellum can be successfully treated conservatively if treatment is begun in an early stage of the disease.
Yoshitsugu Takeda, Shinji Kashiwaguchi, Kenji Endo, Tetsuya Matsuura and Takahiro Sasa : The Most Effective Exercise for Strengthening the Supraspinatus Muscle, --- Evaluation by Magnetic Resonance Imaging ---, The American Journal of Sports Medicine, 30, 3, 374-381, 2002.
(要約)
Electromyography has been used to determine the best exercise for strengthening the supraspinatus muscle, but conflicting results have been reported. Magnetic resonance imaging T2 relaxation time appears to be more accurate in determining muscle activation. To determine the best exercises for strengthening the supraspinatus muscle. Criterion standard. Six male volunteers performed three exercises: the empty can, the full can, and horizontal abduction. Immediately before and after each exercise, magnetic resonance imaging examinations were performed and changes in relaxation time for the subscapularis, supraspinatus, infraspinatus, teres minor, and deltoid muscles were recorded. The supraspinatus muscle had the greatest change among the studied muscles in relaxation time for the empty can (10.5 ms) and full can (10.5 ms) exercises. After the horizontal abduction exercise the change in relaxation time for the supraspinatus muscle (3.6 ms) was significantly smaller than that for the posterior deltoid muscle (11.5 ms) and not significantly different from that of the other muscles studied. The empty can and full can exercises were most effective in activating the supraspinatus muscle.
Tetsuya Matsuura, Takaaki Ikata, Shinjiro Takata, Shinji Kashiwaguchi, Mineo Niwa, Takayuki Sogabe and Keiko Koga : Effect of weight bearing on recovery from nerve injury in skeletal muscle, Journal of Applied Physiology, 91, 5, 2334-2341, 2001.
(要約)
We examined the effect of weight bearing (WB) on muscle recovery after nerve injury. Rats were housed in individual cages for 2 wk under WB or hindlimb suspension (HS) after being subjected to sciatic nerve compression for 1 wk. Sham operated on rats served as controls (sham group). We used 31P- and 19F-nuclear magnetic resonance spectroscopy combined with histochemical, physiological, and biochemical techniques to assess the outcome in the three groups. Creatine kinase-BB (CK-BB) mRNA levels expression, CK activity, and type I fiber density in the WB group were elevated compared with those in the HS group. In addition, sciatic functional index, tetanic tension, energy state, and local circulation dynamics of the WB group were greater than those of the HS group. These results suggested that WB plays an important role in muscle regeneration, inhibits the reduction of CK activity, and facilitates the activation of neural recovery, energy state, and local circulation dynamics.
(キーワード)
weight bearing / sciatic nerve compression / energy state
Naoyuki Yoshida, Takaaki Ikata, Koichi Sairyo, Tetsuya Matsuura, Takahiro Sasa, Keiko Koga and Mari Fukunaga : Evaluation of Disuse Atrophy of Rat Skeletal Muscle Based on Muscle Energy Metabolism Assessed by 31P-MRS, Journal of Physiological Anthropology and Applied Human Science, 20, 4, 247-252, 2001.
(要約)
The purpose of this study was to evaluate disuse atrophy of skeletal muscle using a hind-limb suspension model, with special reference to energy metabolism. Twenty-four Sprague-Dawley rats were divided into four groups: control group (C), hind-limb suspended for 3 days (HS-3), for 7 days (HS-7) and for 14 days (HS-14). The gastrocnemius-plantaris-soleus (GPS) muscles in each group were subjected to the following measurements. After a 2-min rest, contraction of the GPS muscles was induced by electrical stimulation of the sciatic nerve at 0.25 Hz for 10 min, then the frequency was increased to 0.5 and 1.0 Hz every 10 min. During the stimulation, twitch forces were recorded by a strain gauge, and 31P-MRS was performed simultaneously. Maximum tension was measured at the muscle contraction induced at 0.25 Hz; the wet weight of the whole and each muscle in the GPS muscles was also measured. From the 31P-MR spectra during muscle contraction, the oxidative capacity was calculated and compared among the groups. The weights of the whole GPS muscles in C, HS-3, HS-7 and HS-14, were 2.66 +/- 0.09, 2.39 +/- 0.21, 2.34 +/- 0.21 and 2.18 +/- 0.14 (g) respectively. Thus, the muscle mass significantly decreased with time (p < 0.05). Among the GPS muscles, the decrease in weight of the soleus muscle was especially remarkable; in the HS-14 group its weight decreased to 60% of that in the C group. We evaluated maximum tension and oxidative capacity as the muscle function. The maximum tensions in C, HS-3, HS-7 and HS-14 were 519 +/- 43, 446 +/- 66, 450 +/- 23 and 465 +/- 29 (g), respectively. This was significantly greater in the C group than in any other groups, however there were no significant differences among the three HS groups. The oxidative capacity during muscle contraction in the C group was higher than in any HS group and it did not further decrease even if the suspension of the limbs was prolonged beyond 3 days. The present study showed that in disuse atrophy, muscle mass and muscle function did not change simultaneously. Thus, it is necessary to develop countermeasures to prevent muscle atrophy and muscle function deterioration independently.
(キーワード)
Animals / Atrophy / Electric Stimulation / Energy Metabolism / Hindlimb / Magnetic Resonance Spectroscopy / Male / Muscle Contraction / Muscle, Skeletal / Oxygen Consumption / Phosphorus Isotopes / Rats / Rats, Sprague-Dawley
Shinjiro Takata, Takaaki Ikata, Yoshihiro Hayashi, Tetsuya Matsuura and Iwao Miura : Effect of aging on energy metabolism of rat hindlimb muscles evaluated by phosphorus-31 magnetic resonance spectroscopy, Journal of Orthopaedic Science, 1, 4, 286-290, 1996.
(キーワード)
aging / skeletal muscle / energy metabolism / phosphorus-31 magnetic resonance spectroscopy
Kenji Takagishi, Tetsuya Matsuura and Koichi Sairyo : Shoulder and elbow pain in elementary school baseball players: The results from a nation-wide survey in Japan, Journal of Orthopaedic Science, 22, 4, 682-686, 2017.
(要約)
Despite recommendations on how to prevent baseball injuries in youths by the Japanese Society of Clinical Sports Medicine, shoulder and elbow pain still frequently occurs in young baseball players. We conducted a questionnaire survey among baseball players at elementary schools across the country to understand the practice conditions of players, examining the risk factors of shoulder and elbow pain in baseball players. The questionnaire survey was conducted among elementary school baseball players as members of the Baseball Federation of Japan in September 2015. A total of 8354 players belonging to 412 teams (average age: 8.9) responded to the survey. Among 7894 players who did not have any shoulder and/or elbow pain in September 2014, elbow pain was experienced in 12.3% of them, shoulder pain in 8.0% and shoulder and/or elbow pain in 17.4% during the previous one year. A total of 2835 (39.9% of the total) practiced four days or more per week and 97.6% practiced 3 h or more per day on Saturdays and Sundays. The risk factors associated shoulder and elbow pain included a male sex, older age, pitchers and catchers, and players throwing more than 50 balls per day. It has been revealed that Japanese elementary school baseball players train too much. Coaches should pay attention to older players, male players, pitchers and catchers in order to prevent shoulder and elbow pain. Furthermore, elementary school baseball players should not be allowed to throw more than 50 balls per day. Retrospective cohort study.
Among the1605participants,31．1% reported episodes of elbow pain. Limits of70pitches per day may protect elbow injuries in younger than 12 years old pitchers. Even in the asymptomatic early stage capitellar osteochondritis dissecans(OCD), it is desirable to stop throwing until the healing is observed. Arthroscopic debridement of capitellar OCD resulted in a functional elbow with subjective symptom relief for the majority of patients.
OMAE Hiroshi, Momotani Kanta, Ryoma Morigaki, Tetsuya Matsuura and Yasushi Takagi : The correlation between motor activity log and objective assessments in patients with attention deficits following a stroke, 19th World Federation of Occupational Therapists International Congress 2026, Feb. 2026.
2.
Kenji Yokoyama, Tetsuya Matsuura, Jyoji Iwase, Toshiyuki Iwame and Koichi Sairyo : CT Sagittal Image Evaluation for Osteochondritis Dissecans of the Elbow Correlates with Clinical Outcomes of Arthroscopic Debridement in Adolescent Baseball Players., 2023 International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, Jun. 2023.
3.
OMAE Hiroshi, Ryoma Morigaki, Kazuhisa Miyake, Taku Matsuda, 中野渡 友香, Megumi Kuno, Tetsuya Matsuura and Yasushi Takagi : Cognitive changes due to subthalamic nucleus deep brain stimulation in elderly Parkinson's Disease, The 13th Scientific meeting of Asian Australasian Society for Stereotactic and Functional Neurosurgery (AASSFN 2023), Osaka, Apr. 2023.
4.
Tetsuya Matsuura, Toshiyuki Iwame, Jyoji Iwase, Kenji Yokoyama 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, ISAKOS, Nov. 2021.
5.
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue, Jyoji Iwase, Shunsuke Tamaki and Kenji Yokoyama : Cumulative Incidence of Osteochondritis Dissecans of the Capitellum in Pre-Adolescent Baseball Players, 12th Biennial ISAKOS Congress, May 2019.
6.
Toshiyuki Iwame, Tetsuya Matsuura and Koichi Sairyo : Exceeding pitch count recommendations in youth baseball increases the elbow injuries, American Orthopaedic Society for Sports Medicine 2018(July 5-8,2018), San Diego, Jul. 2018.
7.
Tetsuya Matsuura, Toshiyuki Iwame and Koichi Sairyo : Exceeding Pitch Count Recommendatios in Youth Baseball Increase the Elbow Injuries, American Academy of Orthopaedic Surgeons 2018 Annual Meeting (March 6-March 10,2018), New Orleans, Mar. 2018.
8.
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue and Koichi Sairyo : Long term results of arthroscopic debridement of osteochondritis dissecans in adolescent athletes, American Orthopaedic Society for Sports Medicine Annual Meeting 2017, 5(7 suppl6), Jul. 2017.
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue and Koichi Sairyo : Outcome of Asymptomatic Osteochondritis Dissecans of the Capitellum in Adolescent Baseball Players: A 2-year Follow-up Study, American Orthopaedic Society for Sports Medicine 2017 Specialty Day, San Diego, Mar. 2017.
10.
Toshiyuki Iwame, Tetsuya Matsuura, Naoto Suzue and Koichi Sairyo : Cumulative Incidence of Osteochondritis Dissecans of the Capitellum in Child and Adolescent Baseball Players, American Orthopaedic Society for Sports Medicine Annual Meeting 2016, Jul. 2016.
11.
Tetsuya Matsuura, Naoto Suzue, Toshiyuki Iwame and Koichi Sairyo : Risk factors for osteochondritis dissecans of the capitellum in young baseball players, The 13th International Congress of Shoulder and Elbow Surgery, PP6-5, May 2016.
12.
Tetsuya Matsuura, Naoto Suzue, Toshiyuki Iwame and Koichi Sairyo : Prevalence of osteochondritis dissecans of the capitellum in young baseball players based on ultrasonographic findings, American Orthopaedic Society for Sports Medicine 2015 Specialty Day, 3, 3, Mar. 2015.
Tetsuya Matsuura, Naoto Suzue, Toshiyuki Iwame, Toshinori Sakai, Kousaku Higashino, Yoichiro Takata, Yuichiro Goda and Koichi Sairyo : Prevalence of osteochondritis dissevcans of the capitellum in young baseball players on ultrasonographic findings, The 12th Korean-Japan Joint meeting of Orthopedic Sports Medicine, Sep. 2014.
14.
Tetsuya Matsuura : Elbow check-up system for young baseball players, 12th International Congress of Shoulder and Elbow Surgery, 138, Apr. 2013.
15.
Tetsuya Matsuura : Elbow check-up system for young baseball players, 12th International Congress of Shoulder and Elbow Surgery, 138, Apr. 2013.
Tetsuya Matsuura, Jyoji Iwase, Kenji Yokoyama and Koichi Sairyo : JOA/AAOS combined symposium : Screening for early detection of capitellar OCD, 第98回日本整形外科学会学術集会, May 2025.
横山 賢二, 松浦 哲也, 岩瀬 穣志, 岩目 敏幸, 西良 浩一 : Computed Tomography is More Useful for Accurate Measuring Osteochondral Defects of Osteochondritis Dissecans of the Elbow than Radiography., JOSKAS-JOSSM 2022【開催期間:2022年6月16日-18日】, 2022年6月.
Tetsuya Matsuura, Naoto Suzue, T Iwame, Shinji Kashiwaguchi, T Iwase and Natsuo Yasui : Prospective study of elbow pain and verification of guideline in schoolchild baseball players, 第61回東日本整形災害外科学会(H24.9.21-22), Sep. 2012.