Updated on 2024/04/30

写真a

 
NAKAMURA Hiroaki
 
Organization
Director, Osaka Metropolitan University Hospital
Title
Director, Osaka Metropolitan University Hospital
Affiliation
President etc.
Profile
整形外科学全般にわたって、診療、研究、教育、管理運営を行っている。診療の専門領域である脊椎脊髄学では、特に内視鏡脊椎手術を本邦でもいち早く取り入れ、その普及に努めている。また研究面では、動物実験にて実臨床に還元できる、あるいは臨床現場で生じた疑問を基礎的研究で解明している。同時に臨床研究にも力を注ぎ、特に高齢者疾患について、前向き観察研究を実施している。

Position

  • Director, Osaka Metropolitan University Hospital  2022.10 - Now

  • Graduate School of Medicine Department of Clinical Medical Science 

    Professor  2022.04 - 2022.09

  • School of Medicine Department of Medical Science 

    Professor  2022.04 - 2022.09

Degree

  • Doctor of Medicine ( Others )

Research Areas

  • Life Science / Orthopedics  / Orthopaedic Surgery

Research Interests

  • Orthopaedic Surgery

  • Spine Surgery

  • Less invasive spine surgery

  • Prospective cohort study for motor dysfunction in aged society

Research subject summary

  • 脊椎疾患は、脊髄、馬尾や神経根が圧排されて上下肢の機能障害や疼痛を生じる疾患である.保存的治療に抵抗する場合、手術的加療の適応となる。手術は内蔵手術とは異なり、病変部である神経要素を直接切除して補填することは不可能で、除圧や固定など周囲環境の整備を施行しているにすぎない。しかし神経組織周囲に到達するため、表層構造である皮膚や筋肉はその経路にあたるという理由だけで切開や圧排を余儀なくされ、これが術後の愁訴を誘発する可能性がある。これら病変と直接関係のない組織の切開や圧排を最小限にする手術するための研究を行っている.

Research Career

  • Endoscopic Spinal Surgery

    spinal surgery, minimally invasive surgery, endoscopic surgery  Individual

    1900.04 - Now 

  • 高齢者脊椎疾患に対する前向き観察研究

    高齢者脊椎疾患 

    2005 - Now 

  • Electrodiagrosis for spinal disorders

    Spinol Electrodigrosis  Individual

    1900.04 

  • Scoliosis

    Scoliosis  Individual

    1900.04 

  • Surgical teeatment for spinal disorders

    Spinal surgery  Individual

    1900.04 

Professional Memberships

  • 日本整形外科学会

      Domestic

  • The japanese Society for Spine Surgery and Related Research

      Domestic

  • 日本関節病学会

      Domestic

  • 日本整形外科バイオマテリアル研究会

      Domestic

  • The International society for the Study of the Lumbar Spine, Active Member

      Domestic

  • Pacific Asian Society of Minimally Invasive Spine surgery,

      Domestic

  • 日本腰痛学会

      Domestic

  • 日本関節病学会

      Domestic

  • 日本内視鏡外科学会

      Domestic

  • 日本整形外科スポーツ医学会

      Domestic

  • 日本リハビリテーション医学会

      Domestic

  • 中部日本整形災害外科学会

      Domestic

  • Societe Internationale de Recherche Orthopedique et de Traumatologie

      Overseas

  • 日本側弯症学会

      Domestic

  • 日本低侵襲脊椎外科学会

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Committee Memberships (off-campus)

  • 会長   第134回中部日本整形外科災害外科学会学術集会  

    2020 

  • 理事   日本腰痛学会  

    2019.09 - Now 

  • 会長   第45回日本整形外科スポーツ医学会学術集会  

    2019 

  • 理事長   日本脊椎脊髄病学会  

    2018.04 - Now 

  • 会長   第47回日本脊椎脊髄病学会学術集会  

    2018 

  • 理事   日本関節病学会  

    2017 - Now 

  • 2017president   アジア太平洋小侵襲脊椎外科学会  

    2017 

  • 理事   日本内視鏡外科学会  

    2016.12 - Now 

  • 理事   日本整形外科学会  

    2015.05 - 2017.05 

  • 理事   日本整形外科スポーツ医学会  

    2013.09 - 2017.09 

  • 副理事長   日本脊椎脊髄病学会  

    2010.04 - 2014.04 

  • 会長   日本内視鏡低侵襲脊椎外科学会  

    2007 

  • 評議員   日本脊椎脊髄病学会  

    2001 - Now 

  • 評議員   中部日本整形災害外科学会  

    1999 - Now 

  • 幹事   日本低侵襲脊椎外科学会  

    1998 - Now 

  • 代議員   日本整形外科学会  

  • active member   国際腰椎学会  

  • Board member   アジア太平洋小侵襲脊椎外科学会  

  • 代議員   日本リハビリテーション医学会  

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Awards

  • 大阪市医学会市長賞

    1993  

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    Country:Japan

  • The ISSLS prize for lumbar spine research 2019

    2019  

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    Country:Sweden

Job Career (off-campus)

  • 英国ロンドン大学ハマースミス病院   研修医

    1989.04 - 1990.03

  • オーストラリアアデレードクイーンエリザベス病院   整形外科   脊椎フェロー

    2002.04 - 2003.03

  • 大阪市立総合医療センター整形外科   部長

    2006.04 - 2008.03

Education

  • Osaka City University   Doctor's Course   Graduated/Completed

    - 1989

  • Osaka City University     Graduated/Completed

    - 1983

Papers

  • Effect of Preserving Paraspinal Muscles on Post Operative Axial Pain in the Selective Cervical Laminoplasty

    Spine   33 ( 14 )   E455-9   2008

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    Publishing type:Research paper (scientific journal)   Kind of work:Single Work  

  • Male elite soccer players have a higher incidence of accessory ossicles in the foot and ankle.

    Takuya Kinoshita, Yusuke Hashimoto, Kentaro Inui, Ryo Sugama, Takeshi Sugimoto, Yuichi Akizuki, Hiroaki Nakamura

    International orthopaedics   48 ( 4 )   1049 - 1055   2024.04( ISSN:0341-2695

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: Accessory ossicles are caused by the failure of the fusion of secondary ossification centres and are more likely to occur due to heavy loading during the growth period or improper treatment after injury. This study aimed to investigate the incidence of foot and ankle accessory ossicles in male professional soccer players. METHODS: This study included male professional soccer players who underwent medical checkups at our hospital between 2017 and 2023 as the soccer group. Medical checkups included radiographs of bilateral anteroposterior and oblique foot, as well as bilateral anteroposterior and lateral ankle. Male patients age-matched with the soccer group who visited our hospital undergoing anteroposterior and oblique foot or anteroposterior and lateral ankle radiography were included in the control group. The incidence of accessory ossicles was investigated and compared between the soccer and control groups. RESULTS: In this study, 276 ankles and 276 feet, as well as 121 ankles and 79 feet, were included in the soccer and control groups, respectively. The incidence of accessory ossicles in the soccer and control groups was as follows: accessory navicular 35.9%, 24% (P = .049), os peroneum 8.0%, 2.5% (P = .09); os supranaviculare 7.6%, 1.3% (P = .039); os infranaviculare 1.4%, 1.3% (P = .090); os calcaneus secundarius 4.3%, 0% (P = .059); os vesalianum 0%, 0%; os subfiblare 12.7%, 2.5% (P < .001); os subtibiale 18.1%, 2.5% (P = .001); and os trigonum 89%, 24% (P < .001). CONCLUSIONS: Male professional soccer players had a higher incidence of accessory navicular, os supranaviculare, os subfiblare, os subtibiale, and os trigonum.

    DOI: 10.1007/s00264-023-06074-4

    PubMed

  • Quadriceps Tendon With Bone Autograft Has Better Stability and Magnetic Resonance Imaging Maturation Than Hamstring Tendon Autograft After Anterior Cruciate Ligament Reconstruction in Patients With Knee Hyperextension.

    Shinya Yamasaki, Yusuke Hashimoto, Ken Iida, Changhun Han, Takuya Kinoshita, Kazuya Nishino, Yohei Nishida, Junsei Takigami, Hiroaki Nakamura

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association   40 ( 4 )   1234 - 1244   2024.04( ISSN:0749-8063

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To compare the clinical outcomes of anterior cruciate ligament (ACL) reconstruction between methods using quadriceps tendon with bone (QTB) and hamstring tendon (HT) in patients with hyperextension of the knee. METHODS: The medical records of patients with knee hyperextension greater than 8° who underwent arthroscopic ACL reconstruction between October 2010 and October 2020 with follow-up for at least 2 years (median, 3 years; interquartile range [IQR], 2.0-4.6 years) were retrospectively reviewed. Side-to-side difference in anterior translation, pivot-shift test grade, Lysholm score, and graft intensity using the Howell grade on magnetic resonance imaging at final follow-up were compared between the QTB and HT groups. RESULTS: The HT and QTB groups consisted of 42 patients and 21 patients, respectively. The overall mean age was 21.5 years (range, 14-48 years), and the median Tegner Activity Scale score was 6 (range, 3-9). Postoperatively, the median side-to-side difference in anterior translation was 1.75 mm (IQR, 1-3 mm) in the HT group and 1.0 mm (IQR, 0-1.75 mm) in the QTB group (P = .01). Pivot-shift testing showed grade 0 in 74.7%, grade 1 in 18.7%, and grade 2 in 6.6% of patients in the HT group and grade 0 in 85.7% and grade 1 in 14.3% of those in the QTB group (P = .03). The median postoperative Lysholm score was 99 in both groups. Graft signal intensity showed a significant between-group difference: grade I in 52%, grade II in 36%, and grade III in 12% of patients in the HT group versus grade I in 85.7%, grade II in 9.5%, and grade III in 4.8% of those in the QTB group (P = .03). CONCLUSIONS: In patients who underwent ACL reconstruction for hyperextension of the knee, QTB yielded better clinical outcomes than HT with respect to anterior stability, rotational stability, and graft signal intensity on median 2-year follow-up magnetic resonance imaging. LEVEL OF EVIDENCE: Level III, retrospective case-control study.

    DOI: 10.1016/j.arthro.2023.08.013

    PubMed

  • Neurological recovery rate and predictive factors of incomplete AIS grade C spinal cord injury in the older aged population.

    Koji Tamai, Hidetomi Terai, Hiroaki Nakamura, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Junichi Yamane, Kazuki Takeda, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori Terashima, Ryosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Shota Ikegami, Masashi Uehara, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Akiyoshi Kuroda, Gen Inoue, Kenichiro Kakutani, Yuji Kakiuchi, Katsuhito Kiyasu, Hiroyuki Tominaga, Hiroto Tokumoto, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Tetsuro Ohba, Bungo Otsuki, Shoji Seki, Masashi Miyazaki, Masayuki Ishihara, Seiji Okada, Shiro Imagama, Satoshi Kato

    Spinal cord   62 ( 4 )   149 - 155   2024.04( ISSN:1362-4393

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To define the prognosis and predictive factors for neurological improvement in older patients with incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale grade C (AIS-C). SETTINGS: Multi-institutions in Japan. METHODS: We included patients aged ≥65 years with traumatic SCI of AIS-C who were treated conservatively or surgically with >3 follow-up months. To identify factors related to neurological improvement, patients were divided into three groups according to their neurological status at the final follow-up, with univariate among-group comparisons of demographics, radiographic, and therapeutic factors. Significant variables were included in the multivariate logistic regression analysis. RESULTS: Overall, 296 older patients with SCI of AIS-C on admission were identified (average age: 75.2 years, average follow-up: 18.7 months). Among them, 190 (64.2%) patients improved to AIS-D and 21 (7.1%) patients improved to AIS-E at final follow-up. There were significant among-group differences in age (p = 0.026), body mass index (p = 0.007), status of pre-traumatic activities of daily living (ADL) (p = 0.037), and serum albumin concentrations (p = 0.011). Logistic regression analysis showed no significant differences in variables in the stratified group of patients who improved to AIS-D. Meanwhile, serum albumin was a significant variable in patients who improved to AIS-E (p = 0.026; OR: 6.20, pre-traumatic ADL was omitted due to data skewness). CONCLUSIONS: Most older patients with incomplete AIS-C SCI demonstrated at least 1 grade of neurological improvement. However, <10% of patients achieved complete recovery. Key predictors of complete recovery were high serum albumin levels on admission and independent pre-traumatic ADL. SPONSORSHIP: No funding was received for this study.

    DOI: 10.1038/s41393-024-00963-0

    PubMed

  • Is bone remodelling around fully hydroxyapatite-coated and tapered-wedge stems related to the stem fixation pattern?

    Ohyama Y, Minoda Y, Masuda S, Sugama R, Ohta Y, Nakamura H

    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie   2024.03( ISSN:1633-8065

  • Residual Paresthesia After Surgery for Degenerative Cervical Myelopathy: Incidence and Impact on Clinical Outcomes and Satisfaction.

    Koji Tamai, Hidetomi Terai, Masayoshi Iwamae, Minori Kato, Hiromitsu Toyoda, Akinobu Suzuki, Shinji Takahashi, Yuta Sawada, Yuki Okamura, Yuto Kobayashi, Hiroaki Nakamura

    Spine   49 ( 6 )   378 - 384   2024.03( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    STUDY DESIGN: Multicenter, prospective cohort study. OBJECTIVE: The current study aimed to identify the incidence of residual paresthesias after surgery for degenerative cervical myelopathy (DCM), and to demonstrate the impact of these symptoms on clinical outcomes and patient satisfaction. SUMMARY OF BACKGROUND DATA: Surgery for DCM aims to improve and/or prevent further deterioration of physical function and quality-of-life (QOL) in the setting of DCM. However, patients are often not satisfied with their treatment for myelopathy when they have severe residual paresthesias, even when physical function and QOL are improved after surgery. MATERIALS AND METHODS: The authors included 187 patients who underwent laminoplasty for DCM. All patients were divided into two groups based on their visual analog scale score for paresthesia of the upper extremities at one year postoperatively (>40 vs. ≤40 mm). Preoperative factors, changes in clinical scores and radiographic factors, and satisfaction scales at one year postoperatively were compared between groups. The authors used mixed-effect linear and logistic regression modeling to adjust for confounders. RESULTS: Overall, 86 of 187 patients had severe residual paresthesia at one year postoperatively. Preoperative patient-oriented pain scale scores were significantly associated with postoperative residual paresthesia ( P =0.032). A mixed-effect model demonstrated that patients with severe postoperative residual paresthesia showed significantly smaller improvements in QOL ( P =0.046) and myelopathy ( P =0.037) than patients with no/mild residual paresthesia. Logistic regression analysis identified that residual paresthesia was significantly associated with lower treatment satisfaction, independent of improvements in myelopathy and QOL (adjusted odds ratio: 2.5, P =0.010). CONCLUSION: In total, 45% of patients with DCM demonstrated severe residual paresthesia at one year postoperatively. These patients showed significantly worse treatment satisfaction, even after accounting for improvements in myelopathy and QOL. As such, in patients who experience higher preoperative pain, multidisciplinary approaches for residual paresthesia, including medications for neuropathic pain, might lead to greater clinical satisfaction. LEVEL OF EVIDENCE: 3.

    DOI: 10.1097/BRS.0000000000004907

    PubMed

  • Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury.

    Koji Tamai, Hidetomi Terai, Hiroaki Nakamura, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Junichi Yamane, Kazuki Takeda, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori Terashima, Ryosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Shota Ikegami, Masashi Uehara, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Akiyoshi Kuroda, Gen Inoue, Kenichiro Kakutani, Yuji Kakiuchi, Katsuhito Kiyasu, Hiroyuki Tominaga, Hiroto Tokumoto, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Tetsuro Ohba, Bungo Otsuki, Shoji Seki, Masashi Miyazaki, Masayuki Ishihara, Seiji Okada, Shiro Imagama, Satoshi Kato

    Scientific reports   14 ( 1 )   5853 - 5853   2024.03

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    This retrospective cohort study established malnutrition's impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk. Overall, 789 patients (mean follow-up: 20.1 months) were examined and 47 had major nutritional-related risks on admission. One-year mortality rate, median survival time, neurological recovery, and activities of daily living (ADL) at 1 year post-injury were compared between patients with major nutrition-related risk and matched controls selected using 1:2 propensity score matching to adjust for age, pre-traumatic neurological impairment, and activity. In the Kaplan-Meier analysis, the median survival times were 44.9 and 76.5 months for patients with major nutrition-related risk and matched controls, respectively (p = 0.015). Matched controls had more individuals with a neurological improvement of American Spinal Injury Association Impairment Scale ≥ 1 grade (p = 0.039) and independence in ADL at 1 year post-injury than patients with major nutrition-related risk (p < 0.05). In conclusion, 6% of older patients with cervical SCI had major nutrition-related risks; they showed a significantly higher 1 year mortality rate, shorter survival time, poorer neurological improvement, and lower ADL at 1 year post-injury than matched controls.

    DOI: 10.1038/s41598-024-56527-y

    PubMed

  • Comparison of cost, surgical time, and clinical results between arthroscopic transosseous rotator cuff repair with lateral cortical augmentation and arthroscopic transosseous equivalent suture bridge: A propensity score-matched analysis.

    Yoshihiro Hirakawa, Tomoya Manaka, Yoichi Ito, Katsumasa Nakazawa, Ryosuke Iio, Naoya Kubota, Hiroaki Nakamura

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   29 ( 2 )   529 - 536   2024.03( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    BACKGROUND: To reduce the healthcare burden, the clinical results of arthroscopic rotator cuff repair and the cost of the implants used have recently been focused upon. This study compared implant cost, surgical time, short-term clinical results, and cuff repair integrity 2 years postoperatively between arthroscopic transosseous rotator cuff repair using lateral cortical augmentation (TOA) and arthroscopic transosseous-equivalent suture bridge (TOE). METHODS: This study included 220 patients with rotator cuff repairs performed by a single surgeon between December 2013 and December 2018. Overall, 70 TOA and 68 TOE cases met the inclusion criteria. The same surgeon performed the procedures at two different hospitals, and the techniques differed between the facilities. A total of 42 TOA patients were matched with 42 TOE patients. The patients were matched using a propensity score analysis by gender, age, and cuff tear size. The minimum follow-up period was 2 years. Implant cost and surgical time were compared between the two methods. The range of motion, clinical outcomes, and visual analog scale were evaluated. Magnetic resonance imaging was performed to examine cuff repair integrity 2 years postoperatively. RESULTS: The follow-up rate was 81% (112/138 patients). Implant cost was significantly lower with TOA ($1,396 vs. $2,165; p < 0.001) than with TOE. The average surgical time in the TOA method was significantly shorter than that in the TOE method (82 vs. 109 min; p = 0.001). At a minimum 2-year follow-up, the mean active elevation, abduction, and clinical outcomes improved with both methods, although no improvements in external and internal rotations were observed with either method. There were no significant differences in the postoperative variables and retear rate (TOA, 12%; TOE, 19%; p = 0.548) between the two methods. CONCLUSIONS: TOA and TOE achieved comparable clinical results; however, TOA was more cost-effective and had a shorter surgical time than TOE. LEVEL OF EVIDENCE: Level Ⅲ, retrospective matched control study.

    DOI: 10.1016/j.jos.2023.02.003

    PubMed

  • Degeneration of Cervical Multifidus Muscles Negatively Affects Physical Activity-related Quality of Life After Laminoplasty for Degenerative Cervical Myelopathy.

    Masayoshi Iwamae, Koji Tamai, Akinobu Suzuki, Hidetomi Terai, Masatoshi Hoshino, Minori Kato, Hiromitsu Toyoda, Shinji Takahashi, Akito Yabu, Yuta Sawada, Hiroaki Nakamura

    Clinical spine surgery   2024.02( ISSN:2380-0186

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    STUDY DESIGN: A retrospective cohort study. OBJECTIVE: The study aimed to investigate the related factors affecting physical activity-related quality of life (QOL) after 2 years of cervical laminoplasty for degenerative cervical myelopathy (DCM), focusing on the degree of preoperative degeneration of the cervical multifidus muscles. SUMMARY OF BACKGROUND DATA: The association between paraspinal muscle degeneration and clinical outcomes after spinal surgery is being investigated. The effect of preoperative degeneration of the cervical multifidus muscles in patients undergoing cervical laminoplasty is ambiguous. METHODS: Patients who underwent laminoplasty for DCM and followed up for more than 2 years were reviewed. To evaluate physical QOL, the physical component summary (PCS) of the 36-Item Short-Form Health Survey (SF-36) was recorded at 2 years postoperatively. The degree of preoperative degeneration in the multifidus muscles at the C4 and C7 levels on axial T2-weighted magnetic resonance imaging (MRI) was categorized according to the Goutallier grading system. The correlation between 2-year postoperative PCS and each preoperative clinical outcome, radiographic parameter, and MRI finding, including Goutallier classification, was analyzed. Variables with a P value <0.10 in univariate analysis were included in multiple linear regression analysis. RESULTS: In total, 106 consecutive patients were included. The 2-year postoperative PCS demonstrated significant correlation with age (R=-0.358, P=0.002), preoperative JOA score (R=0.286, P=0.021), preoperative PCS (R=0.603, P<0.001), C2-C7 lordotic angle (R=-0.284, P=0.017), stenosis severity (R=-0.271, P=0.019), and Goutallier classification at the C7 level (R=-0.268, P=0.021). In multiple linear regression analysis, sex (β=-0.334, P=0.002), age (β=-0.299, P=0.013), preoperative PCS (β=0.356, P=0.009), and Goutallier classification at the C7 level (β=-0.280, P=0.018) were significantly related to 2-year postoperative PCS. CONCLUSIONS: Increased degeneration of the multifidus muscle at the C7 level negatively affected physical activity-related QOL postoperatively. These results may guide spine surgeons in predicting physical activity-related QOL in patients with DCM after laminoplasty. LEVEL OF EVIDENCE: Level III.

    DOI: 10.1097/BSD.0000000000001585

    PubMed

  • No Impact of Contact Between the Medial Collar of a Hydroxyapatite-Coated Triple-Tapered Stem and the Femoral Neck on Periprosthetic Bone Mineral Density.

    Kentaro Iwakiri, Yoichi Ohta, Yukihide Minoda, Shuhei Ueno, Akio Kobayashi, Hiroaki Nakamura

    The Journal of arthroplasty   2024.02( ISSN:0883-5403

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Hydroxyapatite-coated, triple-tapered, shorter-length stems with a medial collar have been reported with good results for a few years. We investigated whether contact between the medial collar and femoral neck affects clinical outcomes and changes in bone mineral density (BMD) in patients who have this type of stem in their total hip arthroplasty construct. METHODS: This was a retrospective, single-center study involving 62 patients scheduled for unilateral total hip arthroplasty using a hydroxyapatite-coated, triple-tapered, shorter-length stem who were followed for at least 1 year postoperatively. All patients had a Dorr type B femoral canal shape. Contact between the medial collar and the femoral neck was evaluated by computed tomography at the third postoperative month, and patients were classified into 2 groups. Postoperative clinical outcomes were investigated by the Western Ontario and McMaster Universities Arthritis Index and the Japanese Orthopaedic Association scores; radiological evaluation included stem fixation, spot welds and cortical hypertrophy, postoperative 3-dimensional stem alignment, and periprosthetic BMD changes. RESULTS: There were 51 patients in the Contact + group (collar and neck contact) and 11 in the Contact-group (no contact). There were no differences between the 2 groups in the improvement of Western Ontario and McMaster Universities Arthritis Index and Japanese Orthopaedic Association scores, stem fixation, occurrence of cortical hypertrophy, or 3-dimensional stem alignment. Radiolucent lines were present in zones 3, 4, and 5 in 6 patients (12%) in the Contact + group only, who had no statistical difference between the 2 groups. Bone mineral density (BMD) decreased most in zone 7 in both groups, with no difference between the 2 groups. CONCLUSIONS: The presence or absence of contact between the medial collar and femoral neck did not affect postoperative BMD changes or radiological or clinical results. LEVEL OF EVIDENCE: Therapeutic Level III.

    DOI: 10.1016/j.arth.2024.02.011

    PubMed

  • Age-based comparison of meniscal dimensions between an asymptomatic complete discoid lateral meniscus and normal meniscus: MRI evaluation.

    Yusuke Hashimoto, Kazuya Nishino, Takuya Kinoshita, Ken Iida, Nakamura Hiroaki

    Archives of orthopaedic and trauma surgery   144 ( 2 )   791 - 798   2024.02( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: This study aimed to evaluate the meniscal size of asymptomatic discoid lateral meniscus (DLM) and compare it with that of normal lateral meniscus (LM) and to compare changes in meniscal dimensions with age among patients with asymptomatic DLM and those with normal LM using magnetic resonance imaging (MRI). MATERIALS AND METHODS: We retrospectively reviewed the medical records, including MRI data, of patients with asymptomatic DLM (DLM group) or normal LM (control group). Width and extrusion of both DLM and normal LM and tibial length were measured and compared using mid-coronal and mid-sagittal MR images. Meniscal size and sagittal and coronal meniscal ratio according to age, as well as differences between DLM and normal menisci, were also evaluated. RESULTS: Thirty-four knees were included in the DLM group, whereas the control group comprised of 50 patients. The DLM group showed significantly less meniscal extrusion, greater coronal width, posterior capsule distance, sagittal meniscal length, and sagittal meniscal ratio than the control group (DLM: 0.1 ± 0.3 mm, 23.3 ± 2.2 mm, 5.4 ± 2.4 mm, 25.1 ± 2.8 mm, 61 ± 6%, and control: 0.4 ± 0.4 mm, 9.5 ± 2.3 mm, 2.5 ± 1.2 mm, 30.2 ± 2.6 mm, 71 ± 4%, respectively). The coronal meniscal ratio decreased with age in both the control (p = 0.001) and DLM (p = 0.037) groups. The sagittal meniscal ratio (p = 0.001) and minimum height (p = 0.04) decreased and the anterior capsule distance (p = 0.035), posterior capsule distance (p = 0.026), and entire sagittal length (p = 0.005) increased with age in the DLM group, while the distance between the meniscal inner margins (p = 0.019) increased with age in the control group. CONCLUSIONS: The meniscal ratio in the sagittal plane of the DLM group was significantly lower than that of the control group. The sagittal meniscal ratio of asymptomatic DLM decreased with age, indicating that the size of asymptomatic DLM does not change with age. LEVEL OF EVIDENCE: III: Retrospective comparative study.

    DOI: 10.1007/s00402-023-05084-6

    PubMed

  • Correction to: Age‑based comparison of meniscal dimensions between an asymptomatic complete discoid lateral meniscus and normal meniscus: MRI evaluation.

    Yusuke Hashimoto, Kazuya Nishino, Takuya Kinoshita, Ken Iida, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   144 ( 2 )   799 - 799   2024.02( ISSN:0936-8051

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    DOI: 10.1007/s00402-023-05157-6

    PubMed

  • Short-Term Risk Factors for Distal Junctional Kyphosis after Spinal Reconstruction Surgery in Patients with Osteoporotic Vertebrae.

    Yuta Sawada, Shinji Takahashi, Hidetomi Terai, Minori Kato, Hiromitsu Toyoda, Akinobu Suzuki, Koji Tamai, Akito Yabu, Masayoshi Iwamae, Hiroaki Nakamura

    Asian spine journal   18 ( 1 )   101 - 109   2024.02( ISSN:1976-1902

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    STUDY DESIGN: Level 3 retrospective cohort case-control study. PURPOSE: This study aimed to investigate the risk factors for distal junctional kyphosis (DJK) caused by osteoporotic vertebral fractures following spinal reconstruction surgery, with a focus on the sagittal stable vertebra. OVERVIEW OF LITERATURE: Despite the rarity of reports on DJK in this setting, DJK was reported to reduce when the lower instrumented vertebra (LIV) was extended to the sagittal stable vertebra in the posterior corrective fixation for Scheuermann's disease. METHODS: This study included 46 patients who underwent spinal reconstruction surgery for thoracolumbar osteoporotic vertebral fractures and kyphosis and were followed up for 1 year postoperatively. DJK was defined as an advanced kyphosis angle >10° between the LIV and one lower vertebra. The patients were divided into groups with and without DJK. The risk factors of the two groups, such as patient background, surgery-related factors, radiographic parameters, and clinical outcomes, were analyzed. RESULTS: The DJK and non-DJK groups included 14 and 32 patients, respectively, without significant differences in patient background. Those with instability in the distal adjacent LIV disc had a significantly higher risk of DJK occurrence (28.6% vs. 3.2%, p=0.027). DJK occurrence significantly increased in those with the sagittal stable vertebra not included in the fixation range (57.1% vs. 18.8%, p=0.020). Other preoperative radiographic parameters were not significantly different. Instability in the distal adjacent LIV disc (adjusted odds ratio, 14.50; p=0.029) and the exclusion of the sagittal stable vertebra from the fixation range (adjusted odds ratio, 5.29; p=0.020) were significant risk factors for DJK occurrence. CONCLUSIONS: Regarding spinal reconstruction surgery in patients with osteoporotic vertebral fractures, instability in the distal adjacent LIV disc and the exclusion of the sagittal stable vertebra from the fixation range were risk factors for DJK occurrence in the short term.

    DOI: 10.31616/asj.2023.0174

    PubMed

  • Impact of Incident Osteoporotic Vertebral Fractures on 5-Year Postoperative Outcomes and Spinal Alignment Following Lumbar Fusion Surgery.

    Hiroshi Taniwaki, Masatoshi Hoshino, Yuki Kinoshita, Akira Matsumura, Takashi Namikawa, Shinji Takahashi, Minori Kato, Hiroaki Nakamura

    Spine surgery and related research   8 ( 1 )   83 - 90   2024.01

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    INTRODUCTION: Osteoporotic vertebral fractures (OVFs) are a significant problem among older patients who are undergoing spine surgery. This study examined the influence of incident OVFs on clinical outcomes and spinal alignment 5 years following short-segment fusion (SSF) for lumbar spinal stenosis. METHODS: We studied 88 patients who underwent SSF (≤2-disc level) for lumbar spinal stenosis with instability and were followed up for more than 5 years postoperatively. Those with prior OVFs were excluded. We evaluated incident OVFs with plain whole-spine lateral radiography preoperatively (before) and at 5 years postoperatively (after). Using preoperative lumbar computed tomography, Hounsfield unit (HU) values were evaluated. The patients were classified into two groups according to the presence of incident OVFs. Repeated-measures analysis of variance was utilized to compare the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and the 36-item Short-Form Health Survey (SF-36), and spinal parameters were recorded before and after. Multiple linear regression analyses were employed to investigate the association between the incident OVFs and the clinical scores and spinal alignment recorded after. RESULTS: In the fracture group, the clinical course of low back pain score on the JOABPEQ, physical component summary SF-36 score, and spinal alignment including C7 sagittal vertical axis (SVA), thoracic kyphosis (TK), and pelvic tilt were significantly worse. Multiple linear regression revealed a significant correlation between incident OVFs and worse 5-year postoperative spinal alignment, which includes SVA and TK. The optimal threshold for the HU values for predicting the incidence of OVFs within 5 years postoperatively was 83.0 (area under the curve 0.701). CONCLUSIONS: Incident OVFs in patients following SSF were significantly correlated with the 5-year clinical outcomes and spinal alignment. Patients at risk of OVFs, especially those with HU values below 83, must take preventive measures against OVFs, as this could prevent deteriorating midterm postoperative clinical outcomes and spinal alignment. LEVEL OF EVIDENCE: 3.

    DOI: 10.22603/ssrr.2023-0160

    PubMed

  • Peripheral nerve regeneration by bioabsorbable nerve conduits filled with platelet-rich fibrin.

    Shunpei Hama, Takuya Yokoi, Kumi Orita, Takuya Uemura, Kiyohito Takamatsu, Mitsuhiro Okada, Hiroaki Nakamura

    Clinical neurology and neurosurgery   236   108051 - 108051   2024.01( ISSN:0303-8467

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    PURPOSE: To repair peripheral nerve defects and seek alternatives for autografts, nerve conduits with various growth factors and cells have been invented. Few pieces of literature report the effect of nerve conduits plus platelet-rich fibrin (PRF). This study aimed to investigate the effectiveness of nerve conduits filled with PRF. METHODS: The model of a 10 mm sciatic nerve gap in a rat was used to evaluate peripheral nerve regeneration. The thirty rats were randomly divided into one of the following three groups (n = 10 per group). Autogenous nerve grafts (autograft group), conduits filled with phosphate-buffered saline (PBS) (PBS group), or conduits filled with PRF group (PRF group). We assessed motor and sensory functions for the three groups at 4, 8, and 12 weeks postoperatively. In addition, axon numbers were measured 12 weeks after repair of the peripheral nerve gaps. RESULTS: Significant differences in motor function were observed between the autograft group and the other two groups at 12 weeks postoperatively. In the test to evaluate the recovery of sensory function, there were significant differences between the PBS group and the other two groups at all time points. The most axon number was found in the autograft group. The axon number of the PRF group was significantly more extensive than that of the PBS group. CONCLUSIONS: The nerve conduit filled with PRF promoted the axon regeneration of the sciatic nerve and improved sensory function.

    DOI: 10.1016/j.clineuro.2023.108051

    PubMed

  • Comparison of short-term clinical outcomes and radiographic changes in Grammont reverse shoulder arthroplasty between the French and Japanese populations: A propensity score-matched analysis.

    Yoshihiro Hirakawa, Tomoya Manaka, Yoichi Ito, Katsumasa Nakazawa, Ryosuke Iio, Naoya Kubota, Hiroaki Nakamura, Philippe Collin

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   29 ( 1 )   128 - 132   2024.01( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    BACKGROUND: Although Grammont-style reverse total shoulder arthroplasty (RSA) showed excellent clinical results in Europe, its utility for Asian populations remains unclear. This study aimed to compare the French and Japanese populations in terms of range of motion (ROM), functional outcomes, and scapular notching rates in patients who underwent standard Grammont-style RSA. We hypothesized that RSA for the Japanese population may not provide as good ROM and functional results at the final follow-up as that for the French population. METHODS: A total of 25 Japanese patients undergoing RSA were propensity score matched to 25 French patients undergoing RSA. The patients were matched for four different covariates using a propensity score analysis. The minimum follow-up period was 2 years. We investigated differences between the populations with respect to body size and shoulder joint ROM and Constant score (CS) measured preoperatively and at the final follow-up. Scapular notching was examined using radiographs at the final follow-up. RESULTS: The average height and weight of the French and Japanese patients were 164 cm and 70 kg and 152 cm and 56 kg, respectively. Anterior elevation (AE), external rotation (ER) at the side, internal rotation (IR), and CS total changed from 101° to 145°, 17° to 15°, 4.5 points to 5.5 points, and 36 points to 72 points, respectively, in the French population and from 63° to 119°, 8.5° to 13°, 4.6 points to 4 points, and 28 points to 58 points, respectively, in the Japanese population. AE improved in both the groups; ER and IR remained unchanged before and after surgery. The frequency of scapular notching (>grade 1) was higher in the Japanese population (56%) than in the French population (20%) (p = 0.019). CONCLUSIONS: Grammont-style RSA improved AE and CS in both the populations, but AE and CS were significantly higher in the French population than in the Japanese population at the final follow-up. Scapular notching frequently occurs in the Japanese population.

    DOI: 10.1016/j.jos.2022.11.008

    PubMed

  • Bone mineral density around cementless short stems after reverse shoulder arthroplasty: changes over time and its relationship to stem positioning.

    Katsumasa Nakazawa, Tomoya Manaka, Yoshihiro Hirakawa, Yoichi Ito, Ryosuke Iio, Naoki Oi, Hiroaki Nakamura

    JSES international   8 ( 1 )   119 - 125   2024.01

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    BACKGROUND: There are numerous reports of bone adaptation observed on plain radiography studies after the use of cementless short stems in reverse shoulder arthroplasty. However, reports on changes in bone mineral density (BMD) around the stem using dual-energy X-ray absorptiometry (DEXA) are prominently absent. In the present study, we measured BMD around the stem using DEXA and investigated changes over time from postoperative year 1 to year 2. Additionally, the relationship between BMD changes, filling ratio, and stem alignment was examined. METHODS: Forty-seven patients with short cementless stems who could be assessed via DEXA at 1-2 years postoperatively were included. After dividing the zones around the stem into 5, the BMD in each zone was measured, in addition to BMD changes and amount of change from postoperative year 1 to year 2. The relationship between filling ratio and stem alignment on postoperative plain radiography was assessed. RESULTS: A significant decrease in BMD in zone 3 was observed between postoperative year 1 and year 2 (P = .02). Regarding filling ratio and stem alignment, a negative correlation between valgus stem alignment and BMD change observed in zone 1 (r = -0.470, P < .01). In addition, stem valgus greater than 6° correlated with a significant decrease in BMD in zone 1. (P = .01). No significant differences were found in the other zones. Furthermore, there was no correlation between filling ratio and BMD change. CONCLUSION: In reverse shoulder arthroplasty cementless short stems, changes that that occurred between postoperative year 1 to year 2 demonstrated a decrease in BMD in zone 3. In addition, a decrease in BMD in zone 1 was observed with a stem alignment of valgus 6° or higher, suggesting that stem alignment within valgus 6° is required to prevent a decrease in BMD.

    DOI: 10.1016/j.jseint.2023.08.015

    PubMed

  • Lower preoperative Hounsfield unit values as a risk factor for poor 5-year clinical outcomes after lumbar spine surgery.

    Hiroshi Taniwaki, Masatoshi Hoshino, Yuki Kinoshita, Akira Matsumura, Takashi Namikawa, Minori Kato, Shinji Takahashi, Hiroaki Nakamura

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   33 ( 1 )   11 - 18   2024.01( ISSN:0940-6719

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: Hounsfield Unit (HU) value has been associated with future osteoporotic fractures and postoperative complications. However, no studies on the impact of low HU values on mid-term clinical outcomes following lumbar spine surgery have been reported. We aimed to evaluate the usefulness of preoperative HU values for 5-year clinical outcomes following lumbar spine surgery. METHODS: We enrolled 200 patients who underwent lumbar surgery (≤ 3-disc levels) for lumbar spinal stenosis. HU values were assessed using preoperative lumbar computed tomography as part of routine preoperative planning for lumbar surgery. Patients were divided into two groups based on the cutoff value of the HU values obtained from the receiver operating characteristic curve for the incidence of vertebral fractures within five years postoperatively. Clinical scores preoperatively and 1, 2, and 5 years postoperatively, including Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and Short Form-36 (SF-36), were compared using a mixed-effects model. RESULTS: Comparative analysis indicated that all domains of JOABPEQ, except for lumbar function, and the physical component summary of the SF-36 were significantly worse in the low HU group than in the high HU group. Using multiple regression analysis, low HU values were significantly correlated with worse 5-year postoperative scores in all domains of JOABPEQ and SF-36. CONCLUSION: Low preoperative HU values are a risk factor for poor 5-year clinical outcomes after lumbar spine surgery. HU values are not only a valuable tool for analyzing bone mineral density but also may be a valuable poor prognostic factor of postoperative clinical outcomes.

    DOI: 10.1007/s00586-023-07995-9

    PubMed

  • Low-Intensity Pulsed Ultrasound for Delayed Union of Distal Radius Fracture After Palmar Locking Plate Fixation: A Case Report.

    Shunpei Hama, Koji Moriya, Yoshiyuki Matsuyama, Yutaka Maki, Hiroaki Nakamura

    Cureus   16 ( 1 )   e51468   2024.01( ISSN:2168-8184

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    International / domestic magazine:International journal  

    Delayed union and non-union of distal radial fractures (DRFs) are rare, and there are a few reports of delayed union and nonunion of DRFs after palmar locking plate (PLP) fixation. A 68-year-old female patient presented to our hospital with left-sided wrist pain. Radiographs and computed tomography revealed a displaced DRF and ulnar styloid fracture. We performed open reduction and internal fixation with a PLP for the DRF and tension band wiring for the ulnar styloid fracture. However, bone union was not completed three months after the operation. We initiated low-intensity pulsed ultrasound (LIPUS) to achieve fracture healing. Complete bone union was confirmed radiographically five months after LIPUS. There have been few case reports on the delayed union or nonunion of DRFs after PLP fixation treated with LIPUS. LIPUS might be an effective option for the delayed union of DRFs after PLP fixation.

    DOI: 10.7759/cureus.51468

    PubMed

  • Impact of Incident Osteoporotic Vertebral Fractures on 5-Year Postoperative Outcomes and Spinal Alignment Following Lumbar Fusion Surgery(タイトル和訳中)

    Taniwaki Hiroshi, Hoshino Masatoshi, Kinoshita Yuki, Matsumura Akira, Namikawa Takashi, Takahashi Shinji, Kato Minori, Nakamura Hiroaki

    Spine Surgery and Related Research   8 ( 1 )   83 - 90   2024.01

  • Impact of constrained humeral liner on impingement-free range of motion and impingement type in reverse shoulder arthroplasty using a computer simulation.

    Katsumasa Nakazawa, Tomoya Manaka, Yukihide Minoda, Yoshihiro Hirakawa, Yoichi Ito, Ryosuke Iio, Hiroaki Nakamura

    Journal of shoulder and elbow surgery   33 ( 1 )   181 - 191   2024.01( ISSN:1058-2746

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Dislocation is a major complication of reverse total shoulder arthroplasty (RSA). The humeral liner may be changed to a constrained type when stability does not improve by increasing glenosphere size or lateralization with implants, and patients, particularly women with obesity, have risks of periprosthetic instability that may be secondary to hinge adduction on the thorax, but there are few reports on its impact on the range of motion (ROM). This study aimed to determine the influence of humeral liner constraint on impingement-free ROM and impingement type using an RSA computer simulation model. METHODS: A virtual simulation model was created using 3D measurement software for conducting a simulation study. This study included 25 patients with rotator cuff tears and rotator cuff tear arthropathy. Impingement-free ROM and impingement patterns were measured during flexion, extension, abduction, adduction, external rotation, and internal rotation. Twenty-five cases with a total of 4 patterns of 2 multiplied by 2, making a total of 100 simulations: glenosphere (38 mm normal type vs. lateralized type) and humeral liner constraint (normal type vs. constrained type). There were 4 combinations: normal glenosphere and normal humeral liner, normal glenosphere and constrained humeral liner, lateralized glenosphere and normal humeral liner, and lateralized glenosphere and constrained humeral liner. RESULTS: Significant differences were found in all impingement-free ROM in 1-way analysis of variance (abduction: P = .01, adduction: P < .01, flexion: P = .01, extension: P = .02, external rotation: P < .01, and internal rotation: P < .01). Tukey's post hoc tests showed that the impingement-free ROM was reduced during abduction, external rotation, and internal rotation with the combination of the normal glenosphere and constrained humeral liner compared with the other combinations, and improved by glenoid lateralization compared with the combination of the lateralized glenosphere and constrained humeral liner. In the impingement pattern, the Pearson χ2 test showed significantly greater proportion of impingement of the humeral liner into the superior part of the glenoid neck in abduction occurring in the combination of the normal glenosphere and constrained humeral liner group compared with the other groups (P < .01). Bonferroni post hoc tests revealed that the combination of the normal glenosphere and constrained humeral liner was significantly different from that of the lateralized glenosphere and constrained humeral liner (P < .01). Using constrained liners resulted in early impingement on the superior part of the glenoid neck in the normal glenosphere, whereas glenoid lateralization increased impingement-free ROM. CONCLUSION: This RSA computer simulation model demonstrated that constrained humeral liners led to decreased impingement-free ROM. However, using the lateralized glenosphere improved abduction ROM.

    DOI: 10.1016/j.jse.2023.06.038

    PubMed

  • Stem alignment with short tapered-wedge cementless stems affects bone mineral density continuously for at least 5 years after primary total hip arthroplasty.

    Sho Masuda, Kentaro Iwakiri, Yoichi Ohta, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura

    Hip international : the journal of clinical and experimental research on hip pathology and therapy   34 ( 1 )   57 - 65   2024.01( ISSN:1120-7000

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    AIM: This study aimed to assess the relationship between the three-dimensional (3D) alignment of short tapered-wedge cementless stems and bone mineral density (BMD) changes in patients followed up for 5 years after total hip arthroplasty (THA). METHODS: We retrospectively analysed the hips of 52 patients who underwent THA using short tapered-wedge cementless stems at our institution from 2013 to 2016 with complete 5-year follow-up data. We evaluated the relationship between stem alignment, measured using a 3D-templating software, and BMD changes in the 7 Gruen zones. RESULTS: After 1 year, significant negative correlations between varus insertion and a decrease in BMD in zone 7 and between flexed insertion and decreases in BMD in zones 3 and 4 were noted. After 5 years, significant negative correlations between varus insertion and a decrease in BMD in zone 7 and between flexed insertion and decreases in BMD zones 2, 3, and 4 were observed. With increased amounts of varus/flexion stem alignment, the amount of BMD loss decreased. There was no correlation between anteverted stem insertion and changes in BMD levels. CONCLUSIONS: Our data showed that stem alignment affects BMD based on 5-year follow-up data after surgery. Careful observation is necessary, especially when using short tapered-wedge cementless stems, as stem alignment may affect changes in BMD levels more than 5 years after surgery.

    DOI: 10.1177/11207000231178984

    PubMed

  • 経験と考察 腓骨変形を伴った脛骨遠位発生骨軟骨腫の臨床像

    星 学, 大戎 直人, 高田 尚輝, 岩井 正, 伴 祥高, 八百 花, 中村 博亮

    整形外科   75 ( 1 )   15 - 19   2024.01( ISSN:0030-5901

  • Upper Instrumented Vertebra Anchorの違いは成人脊柱変形手術におけるProximal Junctional Vertebral Fractureの発生に影響するか?

    柳井 亮介, 松村 昭, 並川 崇, 星野 雅俊, 谷脇 浩志, 木下 右貴, 中村 博亮

    Journal of Spine Research   15 ( 1 )   20 - 27   2024.01( ISSN:1884-7137

  • The Duration of Bone Healing and Nonunion Ratio After Ulnar Shortening Osteotomy Using a 5-Hole Forearm Compression Plate With Transverse Osteotomy.

    Shunpei Hama, Koji Moriya, Hisao Koda, Naoto Tsubokawa, Yutaka Maki, Hiroaki Nakamura

    Hand (New York, N.Y.)   15589447231218402 - 15589447231218402   2023.12( ISSN:1558-9447

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Ulnar shortening osteotomy using various osteotomy sites, osteotomy methods, and surgical techniques with a variety of implants has been reported, but nonunion rates and the duration of bone healing are not uniform by the authors. The purpose of this study was to investigate the duration of bone healing and nonunion ratio in patients who underwent ulnar shortening osteotomy by a 5-hole nonlocking plate with a simple transverse osteotomy for ulnar impaction syndrome and to determine the correlation between the gap length of the osteotomy site and the duration of bone healing. METHODS: We assessed patients who underwent ulnar shortening osteotomy for ulnar impaction syndrome using a 5-hole nonlocking plate fixation followed by a simple transverse osteotomy between July 2012 and October 2021. This study was a case series study, and the level of evidence was IV. RESULTS: A total of 80 patients were included. The mean age of the patients was 46.7 years, and 46 patients were men. The average bone union period was 41.8 ± 18.7 weeks. The correlation between the gap length of the osteotomy site and the duration of bone union of the osteotomy site was not significant. The nonunion ratio of our method was 2.5%. CONCLUSION: The nonunion rate of our ulnar shortening osteotomy with a simple transverse osteotomy and a 5-hole nonlocking plate was comparable to that in previous reports, but our method required slightly longer periods for bone union. There was no correlation between the gap length of the osteotomy and the duration of bone union. LEVEL OF EVIDENCE: Level IV (Case series).

    DOI: 10.1177/15589447231218402

    PubMed

  • Comparative analysis of discoid lateral meniscus size: a distinction between symptomatic and asymptomatic cases.

    Kazuya Nishino, Yusuke Hashimoto, Takuya Kinoshita, Ken Iida, Shuko Tsumoto, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   31 ( 12 )   5783 - 5790   2023.12( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: This study evaluated the differences in meniscal sizes and occupancy between symptomatic and asymptomatic patients diagnosed with discoid lateral meniscus (DLM) using magnetic resonance imaging (MRI) to understand how these variations relate to the presence of symptoms and the patients' age. METHODS: A retrospective review of 98 patients with DLM was conducted, excluding those with meniscal displacement. Both the width and extrusion of DLM and the percentage of the meniscus to the tibia were measured using mid-coronal and mid-sagittal MRI and compared between symptomatic and asymptomatic DLM groups. The relationships among each parameter, meniscal size, and patient age were evaluated. Symptomatic cases were divided into those with and without horizontal tears on MRI to compare the differences in meniscal morphology. RESULTS: A total of 92 knees from 74 patients were included. Sixty-one knees required surgical intervention for symptomatic DLM, while 31 were asymptomatic and included the contralateral side of symptomatic knees. The symptomatic group exhibited larger morphological variations than the asymptomatic group. Moreover, the sagittal meniscal ratio reduced with age in the asymptomatic group (r = - 0.54, p = 0.002) but remained constant in the symptomatic group. The symptomatic cases with horizontal tears demonstrated larger meniscal dimensions and smaller posterior capsule distances than those without tears. CONCLUSION: Symptomatic patients with DLM had larger knee morphological changes than asymptomatic ones. Age affected the meniscal occupancy in the sagittal plane only in asymptomatic patients. LEVEL OF EVIDENCE: III.

    DOI: 10.1007/s00167-023-07650-2

    PubMed

  • Nerve Grafting for Isolated Injury to the Intrinsic Motor Branch of the Ulnar Nerve due to a Stab Injury: A Case Report.

    Takuya Yokoi, Takuya Uemura, Mitsuhiro Okada, Kosuke Saito, Ema Onode, Hiroaki Nakamura

    Journal of hand and microsurgery   15 ( 5 )   395 - 398   2023.12( ISSN:0974-3227

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    Isolated injury to the deep motor branch of the ulnar nerve caused by stabbing is sporadic, with only one reported case in the English-language literature. We report one such case treated successfully using nerve grafting. A 33-year-old patient had sustained a stab wound to the right hypothenar eminence and showed a claw hand deformity. Needle electromyography study revealed denervation potentials with no voluntary motor unit action potentials (MUAPs) in the first dorsal interosseous (FDI) muscles. Nerve exploration revealed a neuroma-in-continuity in the intrinsic motor branch of the ulnar nerve. Intraoperative nerve stimulation confirmed the absence of compound muscle action potentials in the FDI. The damaged scarred nerve was resected, and the 15-mm defects were reconstructed with cable autografting. Two years and 5 months after the surgery, voluntary MUAPs were observed in the FDI. The pinch strengths recovered. Laceration of the deep branch of the ulnar nerve caused by stabbing can sometimes remain hidden as the hand sensation remains intact. Pre- and intraoperative electrophysiological examination is essential to assess the severity of the injured nerve and determine an appropriate surgical option. Even nerve grafting can facilitate satisfactory results as target intrinsic muscles are quite close to the repair site.

    DOI: 10.1055/s-0042-1749442

    PubMed

  • 橈骨遠位端骨折に対して遠位設置型もしくは関節縁型掌側ロッキングプレートによる内固定を施行した症例の術後手根管症候群発症オッズの比較

    濱 峻平, 森谷 浩治, 幸田 久男, 坪川 直人, 牧 裕, 中村 博亮

    日本手外科学会雑誌   40 ( 3 )   182 - 184   2023.12( ISSN:2185-4092

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    橈骨遠位端骨折に対する掌側ロッキングプレート(palmer locking plate:PLP)であるDual Loc Radiiシステム(メイラ社)のV3はV7よりも遠位に設置可能であるため,V3使用症例では術後に手根管症候群(carpal tunnel syndrome:CTS)の発症がV7使用症例よりも危惧される.本研究の目的は,橈骨遠位端骨折に対してV7またはV3を用いて内固定を行った症例の術後CTS発症オッズを比較することである.2019年12月から2022年5月にV7またはV3を用いて手術加療を行った患者を後ろ向きに調べた.V7群とV3群はそれぞれ128例,70例で,術後CTS発症数はV7群で6例,V3群で3例であった.多変量ロジスティック回帰分析で,V7群とV3群でCTS発症オッズに有意差はなかった.術後CTS発症率はV7群,V3群ともに4~5%で,過去のPLP術後CTS発症率の報告と同等の発症頻度であった.(著者抄録)

  • 新しいPatient Specific Instrument:MyHipを用いたTHAでの大腿骨頸部骨切りの精度評価

    洲鎌 亮, 箕田 行秀, 大田 陽一, 大山 洋平, 増田 翔, 中村 博亮

    日本人工関節学会誌   53   313 - 314   2023.12( ISSN:1345-7608

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    THAの術前にMyHipを用いてPatient specific instrument(PSI)を作成し、術中にこのPSIを利用して大腿骨頸部骨切りを行った68例の骨切り精度を評価した。評価方法は、手術計画で設定した「骨切り面から大腿骨頭最近位部の距離」と、手術中に実際に切り出された大腿骨頭を計測した「大腿骨頸部骨切り面と大腿骨頭最近位部の距離」を比較した。結果、「大腿骨頸部骨切り面と大腿骨頭最近位部の距離」は、手術計画で45.2±4.6mm、実際の計測値で45.3±5.0mmであった。ボーンソーの刃の厚みが1.27mmであることから、精度としては1.4±2.2mm、絶対値誤差は1.9±1.7mmとなった。症例個々にみると、手術計画との骨切りレベル誤差2mm以内で骨切りできたのは68例中42例(62%)、誤差3mm以内は53例(78%)であった。

  • Saucerization of complete discoid lateral meniscus is associated with change of morphology of the lateral femoral condyle and tibial plateau.

    Takuya Kinoshita, Yusuke Hashimoto, Kazuya Nishino, Ken Iida, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 12 )   7019 - 7026   2023.12( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To determine the effect of saucerization surgery on knee joint morphology associated with a complete discoid lateral meniscus (DLM) using magnetic resonance (MR) imaging. METHODS: This retrospective study included cases had undergone saucerization surgery for symptomatic DLM between 2007 and 2022. All cases were divided into two by age group: < 12 (U13) and > 13 (O13). The cases in the match group were randomly selected from preoperative cases in the O13 group matched with the age at the final follow-up (F/U) of cases in the U13 group. The following morphological parameters were evaluated using MR images preoperatively and at the final postoperative F/U in each group: anterior obliquity of the lateral tibial plateau (AOLTP), posterior obliquity of the lateral tibial plateau (POLTP), and the lowest point of the lateral femoral condyle (LPLFC). Each parameter was compared between the U13 preoperative (pre-OP) group and the O13 pre-OP group, the preoperative and final follow-up in the U13, and the U13 group at the final F/U and the match group preoperatively. RESULTS: A total of 77 cases were evaluated. 31 cases were in the U13 pre-OP group and 46 were in the O13 pre-OP group. With a minimal F/U of 2 years, 27 cases in the U13 group and 36 in the O13 group were included. The mean F/U period was 4.6 years in the U13 group and 3.2 years in the O13 group. 32 cases were included in the match group. In the match group, the inclination of the POLTP was significantly larger (P = 0.042) and the LPLFC was more lateral (P = 0.0034) than at the final F/U in the U13 group. CONCLUSIONS: Saucerization surgery for DLM in juvenile patients can prevent progression to the characteristic bone morphology DLM. These results could help the surgeon making the decision when the surgery would be performed for symptomatic DLM patients. LEVEL OF EVIDENCE: Retrospective comparative study; level of evidence, 3.

    DOI: 10.1007/s00402-023-04999-4

    PubMed

  • Reliability and validity of a new deltoid muscle area measurement method after reverse shoulder arthroplasty.

    Katsumasa Nakazawa, Tomoya Manaka, Yoshihiro Hirakawa, Yoichi Ito, Ryosuke Iio, Naoki Oi, Hiroaki Nakamura

    JSES international   7 ( 6 )   2500 - 2506   2023.11

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Accurate deltoid muscle assessment after reverse shoulder arthroplasty (RSA) is difficult using magnetic resonance imaging due to metal artifacts. We hypothesized that measuring the deltoid muscle area (DA) in the middle part of the deltoid's total length postoperatively would reduce metal artifacts and allow for an accurate assessment. This study aimed to assess the reliability and reproducibility of magnetic resonance imaging and evaluate its impact on postoperative outcomes. METHODS: The DA in the middle part of the muscle's total length was measured twice by four examiners using pre and postoperative magnetic resonance imaging in 60 patients who underwent RSA (22 men, 38 women; mean age: 77.4 years). The DA at the greater tuberosity was measured preoperatively, and its correlation with the middle part of the deltoid's total length was evaluated. The Constant-Murley Score was measured at 2 years postoperatively, and its correlation with the DA in the middle part of the deltoid's total length pre- and postoperatively was assessed. RESULTS: Intraclass correlation coefficients for intraobserver measurements of preoperative and postoperative DA in the middle part of the deltoid's total length were almost perfect, with mean values of 0.98 and 0.97, respectively. The intraclass correlation coefficients for interobserver reliability regarding the first and second DA measurements in the middle part of the deltoid's total length were 0.95 and 0.95 (preoperatively) and 0.89 and 0.90 (postoperatively). The Constant-Murley Score was assessed at 2 years postoperatively in 51 patients. Muscle strength was weakly and moderately correlated with preoperative DA (r = 0.33, P = .02) and postoperative DA (r = 0.49, P < .01), respectively. CONCLUSION: DA measurement in the middle part of the deltoid's total length after RSA was not affected by metal artifacts and had excellent reproducibility. This measurement method positively correlated with postoperative muscle strength, suggesting its usefulness for predicting postoperative muscle strength.

    DOI: 10.1016/j.jseint.2023.08.002

    PubMed

  • Optimal Prognostic Factors for Metastatic and Inoperable Sarcomas Treated With Pazopanib, Eribulin, and Trabectedin.

    Tadashi Iwai, Manabu Hoshi, Naoto Oebisu, Naoki Takada, Yoshitaka Ban, Hana Yao, Hiroaki Nakamura

    In vivo (Athens, Greece)   37 ( 6 )   2634 - 2641   2023.11( ISSN:0258-851X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND/AIM: The prognosis of metastatic and inoperable sarcomas is extremely poor, and intensive chemotherapy-based treatment is typically administered to prolong survival. Currently, pazopanib, eribulin, and trabectedin are key drugs used in patients with these sarcomas. The aim of the study was to identify prognostic factors for metastatic and inoperable bone and soft tissue sarcomas. PATIENTS AND METHODS: Clinicopathological data of 46 patients with metastatic and inoperable sarcomas treated with pazopanib, eribulin, and trabectedin between January 2013 and February 2022 at our institution were retrospectively analyzed. Age, sex, primary tumor location, adverse effects, history of doxorubicin and radiation therapy, performance status scores, maximum tumor response, and survival duration were evaluated. The significant prognostic factors were identified using Cox proportional hazards models. Moreover, the 5-year survival rate was evaluated using the Kaplan-Meier method. RESULTS: The median survival duration after treatment was 13.3 months, where the 5-year overall survival rate was estimated to be 9.85%. Both univariate and multivariate analyses revealed significant relationships among patient prognosis, performance status, and tumor response. CONCLUSION: Performance status scores and tumor response were significantly associated with patient prognosis. Therefore, regardless of age, sex, primary tumor location, adverse effects, and history of doxorubicin and radiation therapy, use of cutting-edge drugs, such as pazopanib, eribulin, and trabectedin, may be advantageous in patients with advanced sarcomas, if their drug response and performance status scores are good.

    DOI: 10.21873/invivo.13371

    PubMed

  • Mobile-bearing prosthesis suppresses the postoperative rotational mismatch and improves patient-reported outcome measurements better than fixed-bearing prosthesis: rotational analysis by 3D measurement in total knee arthroplasty.

    Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Susumu Takemura, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 11 )   6781 - 6790   2023.11( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: It is preferable to reduce postoperative excessive rotational mismatch between the femur and tibia that causes poor clinical results following total knee arthroplasty (TKA). The aim of this study is to compare postoperative rotational mismatches and clinical outcomes with mobile- and fixed-bearing prostheses. MATERIALS AND METHODS: This study classified 190 TKAs into two groups equally by propensity score matching: mobile-bearing group (n = 95) and fixed-bearing group (n = 95). Computed tomography images of the whole leg were taken at 2 weeks postoperatively. The component alignments, rotational mismatches between the femur and tibia, and rotations among components were measured three-dimensionally. The knee range of motion, New Knee Society Score (KSS) subjective sores, and Forgotten Joint Score (FJS-12) were assessed at the final follow-up. RESULTS: Rotational mismatch between the femur and tibia was significantly less in the mobile- (- 0.8° ± 7.3°) than in the fixed-bearing (3.3° ± 8.5°, p < 0.001) group. New KSS functional activity score was significantly poorer in patients with excessive rotational mismatch (61.3 ± 21.4) than in those without it (49.5 ± 20.6, p = 0.02). Comparing mobile-bearing prosthesis, the use of fixed-bearing prosthesis was a risk factor for postoperative excessive rotational mismatch (odds ratio: 2.32, p = 0.03). CONCLUSION: When compared to a fixed-bearing prosthesis, TKA using a mobile-bearing prosthesis could suppress the postoperative rotational mismatch between the femur and tibia that causes poor subjective functional activity score. However, since this study was conducted for PS-TKA, the results might not be applicable to other models.

    DOI: 10.1007/s00402-023-04971-2

    PubMed

  • Bilateral locking or triggering fingers due to intratendinous calcium pyrophosphate dihydrate crystal deposition: A case report(タイトル和訳中)

    Miyashima Yusuke, Uemura Takuya, Hama Shunpei, Konishi Sadahiko, Nakamura Hiroaki

    Journal of Orthopaedic Science   28 ( 6 )   1456 - 1460   2023.11( ISSN:0949-2658

  • Machine-learning-based approach for nonunion prediction following osteoporotic vertebral fractures.

    Takahashi S, Terai H, Hoshino M, Tsujio T, Kato M, Toyoda H, Suzuki A, Tamai K, Yabu A, Nakamura H

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   32 ( 11 )   3788 - 3796   2023.11( ISSN:0940-6719

  • The Impact of Multidisciplinary Approaches to Social Functioning on Surgical Outcomes After Surgery for Cervical Myelopathy.

    Koji Tamai, Hidetomi Terai, Shingo Watanabe, Yoji Tashiro, Toshimitsu Omine, Hiroshi Katsuda, Nagakazu Shimada, Yuto Kobayashi, Hiroaki Nakamura

    Spine   48 ( 19 )   1365 - 1372   2023.10( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    STUDY DESIGN: Prospective cohort study. OBJECTIVE: To identify the effects of multidisciplinary approaches (MAs) to improve social functioning (SF) on 1-year surgical outcomes in patients with cervical myelopathy. SUMMARY OF BACKGROUND DATA: Despite significant improvement in cervical myelopathy, a patient's quality of life (QOL) sometimes does not improve postoperatively. A previous study revealed that SF, rather than myelopathy severity, correlated with QOL improvement after decompression surgery for cervical myelopathy. PATIENTS AND METHODS: This study compared two prospective cohorts in Japan. Patients who underwent cervical laminoplasty for cervical myelopathy from 2018 to 2020 were enrolled in the control cohort. Patients who underwent the same surgery with the same indications between 2020 and 2021 were enrolled in the MA cohort. Patients in the control cohort were treated with a standard care protocol, and those in the MA cohort were treated with a multidisciplinary protocol that focused on SF improvement. The changes in the total Japanese Orthopedic Association (JOA) score and in the domains of the JOA scores (upper limb function, lower limb function, upper limb sensory, and lower limb sensory) from preoperatively to 1 year postoperatively were compared between the control and MA cohorts using a mixed-effect model. RESULTS: The control and MA cohorts comprised 140 and 31 patients, respectively. The improvement in the JOA score was significantly better in the MA cohort than in the control cohort ( P = 0.040). In analyses of each JOA score domain, the improvement of upper limb function was significantly better in the MA cohort than in the control cohort ( P = 0.033). Similarly, the MA cohort demonstrated significantly higher patient-reported outcomes for upper extremity function than the control cohort ( P < 0.001). In addition, the self-care domain of QOL score at 1 year postoperatively was significantly higher in the MA cohort than in the control cohort ( P = 0.047). CONCLUSION: MAs to improve/rebuild a patient's SF were effective in improving cervical myelopathy and the self-care domain of QOL. This study is the first to demonstrate the effectiveness of postoperative MAs in patients with cervical myelopathy. LEVEL OF EVIDENCE: Level 3.

    DOI: 10.1097/BRS.0000000000004764

    PubMed

  • Parathyroid Hormone Inhibits Fatty Infiltration and Muscle Atrophy After Rotator Cuff Tear by Browning of Fibroadipogenic Progenitors in a Rodent Model.

    Ryosuke Iio, Tomoya Manaka, Naoki Takada, Kumi Orita, Katsumasa Nakazawa, Yoshihiro Hirakawa, Yoichi Ito, Hiroaki Nakamura

    The American journal of sports medicine   51 ( 12 )   3251 - 3260   2023.10( ISSN:0363-5465

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Progressive fatty infiltration and muscle atrophy after rotator cuff tears lead to tendon repair failure and poor outcomes. Fibro-adipogenic progenitors (FAPs) are involved in fatty infiltration and muscle homeostasis of skeletal muscle. Inducing FAP differentiation into brown adipocyte-like "beige adipocytes" suppresses fatty infiltration and muscle atrophy. HYPOTHESIS: Parathyroid hormone (PTH) suppresses fatty infiltration and muscle atrophy after rotator cuff tears in a rat model by browning of FAPs. STUDY DESIGN: Controlled laboratory study. METHODS: PTH was administered subcutaneously for 4 or 8 weeks to a rotator cuff tear model in rats. After treatment, fatty infiltration of supraspinatus muscles was assessed using Oil Red O staining and muscle atrophy using wet muscle weight and muscle fiber cross-sectional area. Costaining of platelet-derived growth factor receptor α (FAP marker) and uncoupling protein 1 (browning marker) was performed to confirm FAP browning by PTH. Mouse-isolated FAPs were cultured with PTH and evaluated for browning-related gene expression and adipogenic differentiation using BODIPY staining. Myogenic differentiation of C2C12 myoblasts was evaluated using coculture of PTH-treated browning FAPs with C2C12. RESULTS: PTH inhibited fatty infiltration after rotator cuff tear at 8 weeks. Rotator cuff wet muscle loss of PTH-treated rats was inhibited at 4 and 8 weeks. Furthermore, PTH-treated rats demonstrated larger myofiber cross-sectional area than did untreated rats at 4 and 8 weeks. Costaining indicated colocalization of platelet-derived growth factor receptor α and uncoupling protein 1 and promoted PTH-induced FAP browning. PTH increased the expression of browning-related genes in FAPs and suppressed fat droplet accumulation in vitro. Coculture with PTH-treated FAPs promoted C2C12 cell differentiation into myotubes. CONCLUSION: PTH induced FAP-derived beige adipocytes by upregulating browning-related gene expression, and the browning effect of PTH on FAPs inhibited fatty infiltration and muscle atrophy in the rat rotator cuff tear model. PTH might have potential as a therapeutic drug for fatty infiltration and muscle atrophy after rotator cuff tears. CLINICAL RELEVANCE: PTH may expand treatment options for rotator cuff tears by reducing fatty infiltration and muscle atrophy after rotator cuff tears by browning of FAPs.

    DOI: 10.1177/03635465231190389

    PubMed

  • The modification of bone cut angle and joint line obliquity did not change the tibiofemoral kinematics and stability of knee joint after total knee arthroplasty.

    Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Yohei Ohyama, Sho Masuda, Mitsuhiko Ikebuchi, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 10 )   6345 - 6351   2023.10( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: Previous reports using cadaveric knees and musculoskeletal computer simulation have shown that kinematically aligned (KA) total knee arthroplasty (TKA) provides more natural and physiological tibiofemoral kinematic patterns than mechanically aligned (MA) TKA. These reports suggested that the modification of joint line obliquity improve the knee kinematics. This study aimed to determine whether joint line obliquity change the intraoperative tibiofemoral kinematics in TKA candidates with knee osteoarthritis. METHODS: Thirty consecutive knees with varus osteoarthritis that underwent TKA using a navigation system were evaluated. Two types of trial components were prepared: (1) MA TKA model: component trial in which articulating surface was parallel to the bone cut surface (2) KA TKA model: the femoral component trial, which mimicked the KA TKA method of Dossett et al. was designed 3° valgus and 3° internal rotation to the femoral bone cut surface, and the tibial component trial was designed 3° varus to the tibial bone cut surface. These two trials were set on the same knees during the operation, and the tibiofemoral rotational kinematics and varus-valgus laxity were measured from 0° to 120° of knee flexion using a navigation system. RESULTS: The joint gap was 20 ± 2 mm and 3° ± 1° varus in extension and 20 ± 2 mm and 3° ± 1°varus in flexion. The differences in femoral component rotation between KA TKA and MA TKA were not statistically significant for any knee flexion angle. The differences in varus-valgus laxity between KA TKA and MA TKA were also not statistically significant for any knee flexion angle. CONCLUSION: Although the degree of joint line obliquity varies widely in various KA TKA methods, this study, which mimicked the method of Dossett et al. showed that the modification of joint line obliquity did not change the tibiofemoral kinematics and stability of the knee joint in TKA candidates with knee osteoarthritis.

    DOI: 10.1007/s00402-023-04899-7

    PubMed

  • Risk of Revision After Vertebral Augmentation for Osteoporotic Vertebral Fracture: A Narrative Review.

    Shinji Takahashi, Hiroyuki Inose, Koji Tamai, Masayoshi Iwamae, Hidetomi Terai, Hiroaki Nakamura

    Neurospine   20 ( 3 )   852 - 862   2023.09( ISSN:2586-6583

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Osteoporotic vertebral fractures (OVFs) can hinder physical motor function, daily activities, and the quality of life in elderly patients when treated conservatively. Vertebral augmentation, which includes vertebroplasty and balloon kyphoplasty, is a commonly used procedure for OVFs. However, there have been reports of complications. Although serious complications are rare, there have been instances of adjacent vertebral fractures, cement dislocation, and insufficient pain relief due to cement failure, sometimes necessitating revision surgery. This narrative review discusses the common risks associated with vertebral augmentation for OVFs, such as cement leakage and adjacent vertebral fractures, and highlights the risk of revision surgery. The pooled incidence of revision surgery was 0.04 (0.02-0.06). The risks for revision are reported as follows: female sex, advanced age, diabetes mellitus, cerebrovascular disease, dementia, blindness or low vision, hypertension, hyperlipidemia, split type fracture, large angular motion, and large endplate deficit. Various treatment strategies exist for OVFs, but they remain a subject of controversy. Current literature underscores the lack of substantial evidence to guide treatment strategies based on the risks of vertebral augmentation. In cases with a high risk of failure, other surgeries and conservative treatments should also be considered as treatment options.

    DOI: 10.14245/ns.2346560.280

    PubMed

  • Long-duration upper extremity surgery under brachial plexus block combined with intravenous dexmedetomidine sedation without an anesthesiologist.

    Yusuke Miyashima, Takuya Uemura, Sadahiko Konishi, Hiroaki Nakamura

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS   84   107 - 114   2023.09( ISSN:1748-6815

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Dexmedetomidine (DEX) provides a unique conscious sedation without respiratory depression. We examined the usefulness of intravenous (IV) DEX sedation combined with brachial plexus block for long-duration upper extremity surgery without an anesthesiologist. METHODS: We retrospectively reviewed 90 limbs of 86 patients and measured the actual operative time course in detail. The adverse events and the patient-reported outcomes regarding intraoperative pain and depth of sedation were evaluated. RESULTS: The mean total time of the operation, tourniquet use, and the IV DEX sedation were 150 min, 132 min, and 117 min, respectively. The mean time between discontinuation of IV DEX sedation and completion of the operation was 51 min. The intraoperative adverse events involved bradycardia (21%), hypotension (18%), and oxygen desaturation (3%). The mean visual analog scale scores of pain during brachial plexus block, surgical site pain, tourniquet pain, and depth of the sedation were 23.4 mm, 0.14 mm, 4.2 mm, and 6.6 mm, respectively. Furthermore, 96% patients expressed a preference for receiving anesthesia as brachial plexus block with IV DEX sedation. CONCLUSIONS: Long-duration upper extremity surgery, even longer than 2 h, was feasible under brachial plexus block combined with IV DEX sedation without an anesthesiologist. For patients with low blood pressure and/or low heart rate, it is recommended to adjust the continuous infusion of IV DEX to less than 0.4 µg/kg/h. To ensure that the patients are able to promptly leave the operating room fully awake, IV DEX infusion should be stopped at least 30 min before finishing the operation.

    DOI: 10.1016/j.bjps.2023.05.040

    PubMed

  • 寒冷凝集素症患者に人工関節置換術を施行した1例

    田中 和幸, 家口 尚, 笹岡 隆一, 馬野 雅之, 谷 亮佑, 中村 博亮

    中部日本整形外科災害外科学会雑誌   66 ( 5 )   835 - 836   2023.09( ISSN:0008-9443

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    84歳女、5年前に近医で貧血を指摘され、当院血液内科の精査で寒冷凝集素症と診断された。今回、左変股症の症状が増悪したため、人工股関節置換術を施行した。周術期の寒冷曝露を避けるため、室温を30℃に設定するとともに、術中は温風式加温装置を用い、輸液や洗浄液も加温水を使用した。その結果、急激な溶血を起こすことなく安全に手術を施行できた。

  • Assessment of Prevalence and Risk Factors for Central Sensitization Related to Shoulder Osteoarthritis and Rotator Cuff Tears Using the Central Sensitization Inventory: A Cross-Sectional Study in Shoulder Surgery Patients.

    Ryosuke Iio, Tomoya Manaka, Katsumasa Nakazawa, Yoshihiro Hirakawa, Yoichi Ito, Ayako Ogura, Hiroaki Nakamura

    Journal of clinical medicine   12 ( 17 )   2023.08( ISSN:2077-0383

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Shoulder disorders occasionally cause intractable pain. Central sensitization (CS) may be involved in such pain. Identifying risk factors associated with CS is crucial for effective pain control. This study aimed to determine the effects of shoulder osteoarthritis and rotator cuff tears (RCT) on CS and associated factors. This study included patients evaluated for CS using the Central Sensitization Inventory (CSI) before surgery for shoulder osteoarthritis, RCT, or cuff tear arthropathy. Patients with a CSI score of 40 or higher were defined as having CS. The relationships between glenohumeral osteoarthritis (GHOA), RCT size, and CS were statistically analyzed. Multiple regression analysis was performed to examine the factors affecting CSI scores. Subjects included 167 patients: 131 patients had RCT without GHOA, 23 had GHOA with RCT, and 13 had GHOA without RCT. The GHOA group had a significantly higher CSI score (27.5 [10.8-40.5] vs. 18.0 [10.0-27.5]) and CS prevalence (27.8% vs. 8.4%) than the RCT without GHOA group. There was no significant correlation between RCT size and CSI scores. Multiple regression analysis showed that female sex, severe pain, and long pain duration were associated with higher CSI scores. Considering the risk factors for CS might be helpful in shoulder treatment.

    DOI: 10.3390/jcm12175633

    PubMed

  • Posterior subtotal meniscectomy revealed the worst scenario for the progression of osteocartilaginous damage in cases of juvenile discoid lateral meniscus with peripheral tear.

    Yusuke Hashimoto, Kazuya Nishino, Shinya Yamasaki, Yohei Nishida, Tomohiro Tomihara, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 8 )   5157 - 5165   2023.08( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: We compared subtotal meniscectomy and saucerization with stabilization for osteocartilaginous damage based on injured location and further examined the factors related to osteocartilaginous damage in juvenile discoid lateral meniscus (DLM) with peripheral tear after a follow-up period of at least 5 years. MATERIALS AND METHODS: We retrospectively reviewed juvenile DLM patients with peripheral tear who underwent arthroscopic surgery with more than 5 years of follow-up. Osteocartilaginous damage, which was identified by osteochondritis dissecans (OCD) development and the whole-organ magnetic resonance imaging score (WORMS) of cartilage grade ≥ 3, was compared between subtotal meniscectomy and saucerization with stabilization. A subgroup analysis examining the location of the tear site was performed. Factors for osteocartilaginous damage were analyzed between the damaged and non-damaged groups. RESULTS: Forty-one patients, including 29 who underwent saucerization with stabilization and 12 who underwent subtotal meniscectomy, were included in this study. Seven patients developed OCD lesions; six patients showed cartilage WORMS of more than grade 3. Overall, there was a significant difference in the total cartilage and meniscus WORMS between the two groups at the final follow-up. The subgroup analysis demonstrated more severe osteocartilaginous damage developed in posterior subtotal meniscectomy than in posterior stabilization following saucerization. The damaged group showed significant difference compared to the non-damaged group in terms of age (p = 0.003), sex (p = 0.036), and posterior subtotal meniscectomy (p < 0.001). CONCLUSIONS: Posterior subtotal meniscectomy revealed the worst scenario for the progression of osteocartilaginous damage in cases of juvenile DLM with peripheral tear over a minimum follow-up period of 5 years.

    DOI: 10.1007/s00402-022-04747-0

    PubMed

  • Arthroscopic surgery for symptomatic discoid lateral meniscus improves meniscal status assessed by magnetic resonance imaging T2 mapping.

    Kazuya Nishino, Yusuke Hashimoto, Yohei Nishida, Shinya Yamasaki, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 8 )   4889 - 4897   2023.08( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: Discoid lateral meniscus (DLM) is an anatomic knee variant associated with increased tears and degeneration. This study aimed to quantify meniscal status with magnetic resonance imaging (MRI) T2 mapping before and after arthroscopic reshaping surgery for DLM. MATERIALS AND METHODS: We retrospectively reviewed the records of patients undergoing arthroscopic reshaping surgery for symptomatic DLM with ≥ 2-year follow-up. MRI T2 mapping was performed preoperatively and at 12 and 24 months postoperatively. T2 relaxation times of the anterior and posterior horns of both menisci and of the adjacent cartilage were assessed. RESULTS: Thirty-six knees from 32 patients were included. The mean age at surgery was 13.7 years (range 7-24), and the mean follow-up duration was 31.0 months. Saucerization alone was performed on five knees and saucerization with repair on 31 knees. Preoperatively, the T2 relaxation time of the anterior horn of the lateral meniscus was significantly longer than that of the medial meniscus (P < 0.01). T2 relaxation time significantly decreased at 12 and 24 months postoperatively (P < 0.01). Assessments of the posterior horn were comparable. The T2 relaxation time was significantly longer in the tear versus non-tear side at each time point (P < 0.01). There were significant correlations between the T2 relaxation time of the meniscus and that of the corresponding area of the lateral femoral condyle cartilage (anterior horn: r = 0.504, P = 0.002; posterior horn: r = 0.365, P = 0.029). CONCLUSIONS: The T2 relaxation time of symptomatic DLM was significantly longer than that of the medial meniscus preoperatively, and it decreased 24 months after arthroscopic reshaping surgery. The meniscal T2 relaxation time of the tear side was significantly longer than that of the non-tear side. There were significant correlations between the cartilage and meniscal T2 relaxation times at 24 months after surgery.

    DOI: 10.1007/s00402-023-04819-9

    PubMed

  • Partial tibial nerve transfer for iatrogenic peroneal nerve palsy after endovenous laser ablation for varicose veins of the lower extremity: A case report.

    Takuya Uemura, Yusuke Miyashima, Sadahiko Konishi, Kiyohito Takamatsu, Hiroaki Nakamura

    Microsurgery   43 ( 5 )   507 - 511   2023.07( ISSN:0738-1085

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    International / domestic magazine:International journal  

    Postprocedural peroneal nerve palsy after endovenous laser ablation (EVLA) for varicose veins is rare and is associated with poor functional recovery. There have been no reports using tibial nerve transfer for iatrogenic peroneal nerve palsy after EVLA. Herein, we present a case with peroneal nerve injury after EVLA, which was successfully treated by partial tibial nerve transfer for the first time. A 75-year-old female presented with a right foot drop immediately after EVLA of the lesser saphenous vein. The ankle and toe dorsiflexion had a muscle grade of M0 on the British Medical Research Council muscle scale, without voluntary motor unit action potentials (MUAP) in the tibialis anterior (TA) muscle on the needle electromyography. Three months after the injury, surgical nerve exploration revealed a damaged common peroneal nerve with discoloration and scarring at the fibular head. Intraoperative deep peroneal nerve stimulation confirmed the absence of compound muscle action potentials in the TA. The best functioning motor fascicles of the tibial nerve were transferred to the deep peroneal main trunk involving motor branches of the TA, extensor digitorum longus, and extensor hallucis longus (EHL) through the interosseous membrane. The postoperative course was uneventful, with no complications. After 3 months of surgery, nascent MUAP appeared in the TA. After 24 months, the patient regained the TA and EHL muscle function and ambulation without an ankle-foot orthosis and tibial nerve deficits. Thus, our procedure may serve as an alternative to nerve grafting, tendon transfer, and orthoses for better management of the major neural complications associated with EVLA.

    DOI: 10.1002/micr.31023

    PubMed

  • Bone Marrow-Derived Fibrin Clots Stimulate Healing of a Knee Meniscal Defect in a Rabbit Model.

    Takuya Kinoshita, Yusuke Hashimoto, Kumi Orita, Ken Iida, Shinji Takahashi, Hiroaki Nakamura

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association   39 ( 7 )   1662 - 1670   2023.07( ISSN:0749-8063

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To determine the in vivo effectiveness of bone marrow aspirate-derived (BMA) fibrin clots for avascular meniscal defect healing in a rabbit model. METHODS: In 42 Japanese white rabbits, a 2.0-mm cylindrical defect was introduced into the avascular zone of the anterior part of the medial meniscus in the bilateral knees. The rabbits were grouped according to implantation of a BMA fibrin clot (BMA group) or a peripheral blood (PB)-derived clot (PB group) into the defect and nonimplantation (control group). Macroscopic and histological assessments were performed using a scoring system at 4 and 12 weeks after surgery. At 12 weeks after surgery, compressive stress was analyzed biomechanically. RESULTS: The meniscal score in the BMA group (12.1) was greater than that in the PB group (5.5; P = .031) and control group (4.4; P = .013) at 4 weeks. The meniscal score in the BMA group (13.1) was greater than that in the control group (6.4; BMA = 13.1; P = .0046) at 12 weeks. In the biomechanical analysis, the BMA group demonstrated significantly higher compressive strength than the PB group (6.6 MPa) (BMA = 15.4 MPa; P = .0201) and control group (3.6 MPa; BMA = 15.4 MPa; P = .007). CONCLUSIONS: Implantation of BMA fibrin clots into the meniscal defect of the avascular zone in a rabbit model improved the meniscal score at 4 weeks and strengthened the reparative meniscal tissue at 12 weeks compared with the implantation of PB fibrin clots. CLINICAL RELEVANCE: Healing in the avascular zone of the meniscus can be problematic. Approaches to improving this healing response have had variable results. This study provides additional information that may help improve the outcomes in patients with these injuries.

    DOI: 10.1016/j.arthro.2022.12.013

    PubMed

  • COVID-19アウトブレイク後の高齢者におけるロコモティブシンドローム発症 12000名以上を対象とした集団ベース横断研究(Development of locomotive syndrome in elderly population after COVID-19 outbreak: A population-based cross-sectional study with over 12,000 participants)

    Terai Hidetomi, Tamai Koji, Takahashi Shinji, Katsuda Hiroshi, Shimada Nagakazu, Hori Yusuke, Kobayashi Yuto, Nakamura Hiroaki

    Journal of Orthopaedic Science   28 ( 4 )   895 - 900   2023.07( ISSN:0949-2658

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    COVID-19アウトブレイク前後における高齢者のロコモティブシンドローム(LS)の有病率の変化とリスク因子を検討した。COVID-19パンデミック前後に5項目Geriatric Locomotive Function Scale(GLFS-5)質問票に回答が得られた65歳以上の高齢者12197名を対象に横断サーベイ研究を行った。GLFS-5に基づいて2~3点をLSステージ1、4~5点をステージ2、6点以上をステージ3と判定し、パンデミック期間中のライフスタイルの変化を評価した。LSの有病率はパンデミック前が41.3%、パンデミック後が47.1%と増加しており、パンデミック後の新規LS発症は765名(6.3%)、LS-3発症は296名であった。LS発症群と非LS群の比較では、LS群には女性および75歳超が多く、運動習慣の減少が生じていた。多重ロジスティック回帰分析では、パンデミック後のLS発症のリスク因子として高齢、女性、運動レベル低下が抽出された。また、LS-3発症群ではLS-1/2群と比較して年齢が高く、運動習慣が著明に減少しており、多重ロジスティック回帰分析では高齢と運動習慣の減少がLS-3発症と有意に関連していた。このほか、腰痛、関節痛、しびれの有病率はLSの新規発症群、LS-3発症群において有意に高値を示していた。今回の解析結果から、日本人全体ではCOVID-19パンデミック後に約200万人の高齢者がLSを新規に発症し、軽度~中等度のLS患者のうち10%ほどが重症に移行したと推測された。

  • A new accelerometer-based portable navigation system provides high accuracy of acetabular cup placement in total hip arthroplasty in both the lateral decubitus and supine positions.

    Yohei Ohyama, Ryo Sugama, Yuha Kim, Yoichi Ohta, Yukihide Minoda, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 7 )   4473 - 4480   2023.07( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: No studies have compared the accuracy of acetabular cup placement in total hip arthroplasty (THA) in the supine and lateral decubitus positions using the same portable navigation system. Thus, this study aimed to compare the accuracy of acetabular cup placement using a new accelerometer-based portable navigation system combined with an infrared stereo camera and inertial measurement unit between the supine and lateral decubitus positions. MATERIALS AND METHODS: This retrospective study compared 45 THAs performed in the supine position (supine group) and 44 THAs performed in the lateral decubitus position (lateral group) using the same portable navigation system. The primary outcome was the absolute errors of cup placement angles, defined as the absolute values of the differences between cup radiographic inclination and anteversion angles displayed on the navigation system and those measured on postoperative computed tomography images. RESULTS: No significant difference in the median absolute error of the cup inclination angle (supine group 1.7° [interquartile range 0.8°-3.1°] vs. lateral group 2.1° [interquartile range 1.0°-3.7°]; p = 0.07) was found between the two groups. Similarly, no significant difference in the median absolute error of the anteversion angle (supine group 1.9° [interquartile range 0.8°-3.4°] vs. lateral group 2.1° [interquartile range 0.9°-3.1°]; p = 0.42) was found. CONCLUSION: This new accelerometer-based portable navigation system may provide high accuracy of the cup placement in THA in the lateral decubitus and supine positions.

    DOI: 10.1007/s00402-022-04675-z

    PubMed

  • A double tapered fully hydroxyapatite-coated stem has less contact area to femoral cortical bone than a tapered-wedge stem: a three-dimensional computed tomography-based density mapping analysis.

    Yohei Ohyama, Yukihide Minoda, Yoichi Ohta, Ryo Sugama, Susumu Takemura, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 7 )   4465 - 4472   2023.07( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: It is clinically important to analyze the initial contact state between an implant and femoral cortical bone as it affects clinical outcomes, such as stress shielding, stem subsidence, thigh pain, and patient-reported outcomes after total hip arthroplasty. Whether the initial contact state of a double-tapered fully hydroxyapatite (HA)-coated stem is achieved with the preserved cancellous or cortical bone remains to be established. This study aimed to compare the contact area with the femoral cortical bone between a double-tapered fully HA-coated stem (HA group) and a tapered wedge cementless stem (TW group) using three-dimensional computed tomography (3DCT)-based templating software. MATERIALS AND METHODS: Forty-seven total hip arthroplasties in the HA and TW groups each were retrospectively analyzed. The contact area between the implant and femoral cortical bone in the whole stem and at each Gruen zone was measured using density mapping with 3DCT-based templating software. RESULTS: The demographic data were not significantly different between the two groups. The contact area in the whole stem area was lower in the HA group (HA 5.4 ± 1.8% vs. TW 9.0 ± 4.8%, p < 0.01). The HA group had a lower contact area in zone 2 (HA 6.7 ± 6.5% vs. TW 15.6 ± 10.8%, p < 0.01) and zone 6 (HA 1.8 ± 3.5% vs. TW 6.3 ± 3.6%, p < 0.01) than the TW group. The implant type (β = 0.41, p < 0.01) and stem coronal alignment (β = - 0.29, p < 0.01) were significant predictors of the contact area in the whole stem area in a multiple regression analysis (adjusted R2 = 0.27, p < 0.01). CONCLUSION: The contact area of the double-tapered fully HA-coated stem was significantly lower than that of the tapered wedge cementless stem.

    DOI: 10.1007/s00402-022-04655-3

    PubMed

  • Lateral meniscus autograft transplantation using hamstring tendon with a sandwiched bone marrow - derived fibrin clot: A case report.

    Ken Iida, Yusuke Hashimoto, Kazuya Nishino, Yohei Nishida, Hiroaki Nakamura

    International journal of surgery case reports   108   108444 - 108444   2023.07( ISSN:2210-2612

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    International / domestic magazine:International journal  

    INTRODUCTION AND IMPORTANCE: Tendon autograft is a durable solution for the sub/total meniscus; however it is still considered a temporary solution. CASE PRESENTATION: We report the case of a 17-year-old woman with history of subtotal lateral meniscectomy performed 6 years ago. We treated her with lateral meniscus autograft transplantation using a hamstring tendon with a sandwiched bone marrow aspirate (BMA)-derived fibrin clot. T2 relaxation times of the anterior and posterior horns of both menisci and of the cartilage were assessed. CLINICAL DISCUSSION: Lateral meniscus autograft transplantation using a hamstring tendon with a sandwiched BMA clot improved clinical and radiographic outcomes at the 24-month follow-up. These findings suggest that the lateral meniscus autograft transplantation using a hamstring tendon with a sandwiched BMA clot transformed into a meniscus-like tissue and resulted in preservation of the articular cartilage. CONCLUSION: Lateral meniscus autograft transplantation using a hamstring tendon with a sandwiched BMA clot can function as a meniscal transplant after total or subtotal meniscectomy in young patients.

    DOI: 10.1016/j.ijscr.2023.108444

    PubMed

  • Factors Predicting the Final Diagnosis in Image-Guided Percutaneous Needle Biopsy for Suspected Spinal Tumors.

    Makoto Oka, Akinobu Suzuki, Hidetomi Terai, Minori Kato, Hiromitsu Toyoda, Shinji Takahashi, Koji Tamai, Hiroaki Nakamura

    Journal of clinical medicine   12 ( 13 )   2023.06( ISSN:2077-0383

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    In cases of suspected spinal tumors on imaging studies, a biopsy is often necessary for establishing the diagnosis. Predictive factors for tumors or malignancies may help in scheduling biopsies or avoiding unnecessary ones. However, there have been few studies on determining these factors. We aimed to determine the factors associated with the final diagnosis in cases requiring spinal biopsy. This study included 117 patients who underwent image-guided (fluoroscopy- or computed tomography [CT]-guided) needle biopsy of the spine. Data on patient demographic, pathological diagnoses, and final diagnoses were retrospectively collected from the medical records. The imaging features and location of lesions were also evaluated on CT and magnetic resonance imaging. Furthermore, factors related to tumors or malignancies were analyzed. The diagnostic accuracy of biopsy was 94.0%, and there was no difference in the diagnostic accuracy between the fluoroscopic and CT-guided biopsies. Sixty-six and fifty-six patients were diagnosed with spinal tumors and malignant tumors, respectively. Multivariate analysis revealed that a history of malignant tumors and the presence of pedicle lesions and/or extravertebral lesions were related factors for both tumors or malignancy in the final diagnosis. These findings can help determine the necessity for or timing of biopsy in patients with suspected spinal tumors.

    DOI: 10.3390/jcm12134292

    PubMed

  • Three-dimensional adipose-derived stem cell spheroids exert potent therapeutic effects on rat femur osteochondral defects.

    Hideki Ueyama, Tadashi Okano, Kumi Orita, Kenji Mamoto, Yutaro Yamada, Hiroaki Nakamura

    The Knee   42   382 - 389   2023.06( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Spheroids can allow three-dimensional (3D) cell culture without scaffolds, potentially promoting the production of growth factors from adipose-derived stem cells (ADSCs). We hypothesized that ADSC spheroids exert more favourable effects on osteochondral defects than ADSCs in two-dimensional (2D) cultures. The purpose of this study was to compare the therapeutic effects of 2D and 3D cultures of ADSCs on osteochondral defects using animal models. METHODS: Rat femoral osteochondral defects were created. When creating osteochondral defects, phosphate-buffered saline, 2D ADSCs, or ADSC spheroids as a 3D culture were administered on to the lesion. At 2, 4, 6, 8, 10 and 12 weeks post-surgery, knee tissues were harvested and evaluated via histological examination. The expression of genes related to growth factors and apoptosis were compared between 2D and 3D ADSCs. RESULTS: Histologically, the repair of osteochondral defects was significantly enhanced in 3D ADSCs than in 2D ADSCs in terms of the Wakitani score and cartilage repair rate. In 3D ADSCs, TGF-β1, VEGF, HGF and BMP-2 were significantly upregulated, while apoptosis was suppressed in the early phase. CONCLUSION: The therapeutic effects of 3D ADSC spheroids on osteochondral defects were more potent than those of 2D ADSCs. The upregulated expression of growth factors and suppression of apoptosis could contribute to promoting these therapeutic effects. Overall, ADSC spheroids can help treat osteochondral defects.

    DOI: 10.1016/j.knee.2023.04.017

    PubMed

  • 歩数計を用いたウォーキング促進プログラムにおける金銭的インセンティブの有効性(Effectiveness of Financial Incentives for a Pedometer-based Walking Promotion Program)

    Komiya Eriko, Taniuchi Satsuki, Shiba Masatsugu, Shintani Ayumi, Nakamura Hiroaki

    Osaka City Medical Journal   69 ( 1 )   31 - 39   2023.06( ISSN:0030-6096

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    インセンティブを伴うウォーキング促進プログラムの医療費削減効果について検討した。2016年10月~2018年3月に、大阪府高石市在住の40~75歳の市民16816名を対象に、毎日の歩数に応じてインセンティブが付与される歩行促進プログラムを実施した。参加希望者は市に参加登録し、自身のスマートフォンか活動量計のどちらかを選択、市内各地に設置された歩数登録端末を使用して自らの歩数を集計した。医療費データは国民健康保険のデータを使用した。プログラム参加群(1945名)と年齢・性別・医療費をマッチングさせた対照群(1945名)を設定し、年間医療費を比較した。順序ロジスティック回帰分析の結果、高石市在住者のサンプルにおいて、インセンティブを伴うウォーキング促進プログラムへの参加は1年間の医療費削減と相関していた。プログラム参加群と対照群の1年間における医療費の差は21261324円/年であった。インセンティブを伴うウォーキング促進プログラムは医療費削減の観点から有効な政策であると考えられた。

  • Association between Opioid Requirement and Overall Survival in Patients with Spinal Metastases.

    Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Hiroaki Nakamura

    Spine surgery and related research   7 ( 3 )   235 - 241   2023.05

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    INTRODUCTION: Clinical evidence shows that opioid administration in cancer patients is associated with shorter survival. This study explored the impact of opioid requirement on overall survival of patients with spinal metastases. We also evaluated the association between opioid requirement and tumor-related spinal instability. METHODS: We retrospectively identified 428 patients who had been diagnosed with spinal metastases from February 2009 to May 2017. Those with an opioid prescription during the first 1 month after the diagnosis were included in this study. Patients given opioids were divided into two groups: the opioid requirement group [≥5 mg oral morphine equivalent (OME)/day] and the nonopioid group (<5 mg OME/day). Spinal instability due to metastases was evaluated using the Spinal Instability Neoplastic Score (SINS). Cox proportional hazards analysis was performed to evaluate the relationship between opioid use and overall survival. RESULTS: The most frequent primary cancer site was the lung, in 159 patients (37%), followed by the breast in 75 (18%) and the prostate in 46 (11%). Multivariate analyses showed that patients who required ≥5 mg OME/day were approximately twofold more likely to die after a spinal metastases diagnosis than those who required <5 mg OME/day (hazard ratio 2.13; 95% confidence interval 1.69-2.67; p<0.001). The SINS was significantly higher in the opioid requirement group than those in the nonopioid group (p<0.001). CONCLUSIONS: For patients with spinal metastases, opioid requirement was associated with shorter survival, independently of known prognostic factors. The patients were also more likely to have tumor-related spinal instability than those in the nonopioid group.

    DOI: 10.22603/ssrr.2021-0169

    PubMed

  • Anti-Tumor Effect and Neurotoxicity of Ethanol Adjuvant Therapy after Surgery of a Soft Tissue Sarcoma.

    Yoshitaka Ban, Manabu Hoshi, Naoto Oebisu, Kumi Orita, Tadashi Iwai, Hana Yao, Hiroaki Nakamura

    Current oncology (Toronto, Ont.)   30 ( 6 )   5251 - 5265   2023.05( ISSN:1198-0052

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Wide resection is the main treatment for sarcomas; however, when they are located near major nerves, their sacrifices might affect limb function. The efficacy of ethanol adjuvant therapy for sarcomas has not been established. In this study, the anti-tumor effect of ethanol, as well as its neurotoxicity, were assessed. In vitro anti-tumor effect of ethanol as evaluated using MTT, wound healing, and invasion assays on a synovial sarcoma cell line (HS-SY-II). In vivo, an assessment was conducted in nude mice (implanted with subcutaneous HS-SY-II) treated with different ethanol concentrations after surgery with a close margin. Sciatic nerve neurotoxicity was assessed with electrophysiological and histological examination. In vitro, ethanol concentrations at 30% and higher showed cytotoxic effects in MTT assay and markedly reduced migration and invasive ability of HS-SY-II. In vivo, both 30% and 99.5% ethanol concentrations, compared to 0% concentration, significantly reduced the local recurrence. However, in the group treated with 99.5% ethanol, nerve conduction tests showed prolonged latency and decreased amplitude, and morphological changes suggestive of nerve degeneration were observed in the sciatic nerve, while the 30% ethanol did not cause neurological damage. In conclusion, 30% is the optimal concentration for ethanol adjuvant therapy after close-margin surgery for sarcoma.

    DOI: 10.3390/curroncol30060399

    PubMed

  • Deep learning-based screening tool for rotator cuff tears on shoulder radiography.

    Ryosuke Iio, Daiju Ueda, Toshimasa Matsumoto, Tomoya Manaka, Katsumasa Nakazawa, Yoichi Ito, Yoshihiro Hirakawa, Akira Yamamoto, Masatsugu Shiba, Hiroaki Nakamura

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   2023.05( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    BACKGROUND: Early diagnosis of rotator cuff tears is essential for appropriate and timely treatment. Although radiography is the most used technique in clinical practice, it is difficult to accurately rule out rotator cuff tears as an initial imaging diagnostic modality. Deep learning-based artificial intelligence has recently been applied in medicine, especially diagnostic imaging. This study aimed to develop a deep learning algorithm as a screening tool for rotator cuff tears based on radiography. METHODS: We used 2803 shoulder radiographs of the true anteroposterior view to develop the deep learning algorithm. Radiographs were labeled 0 and 1 as intact or low-grade partial-thickness rotator cuff tears and high-grade partial or full-thickness rotator cuff tears, respectively. The diagnosis of rotator cuff tears was determined based on arthroscopic findings. The diagnostic performance of the deep learning algorithm was assessed by calculating the area under the curve (AUC), sensitivity, negative predictive value (NPV), and negative likelihood ratio (LR-) of test datasets with a cutoff value of expected high sensitivity determination based on validation datasets. Furthermore, the diagnostic performance for each rotator cuff tear size was evaluated. RESULTS: The AUC, sensitivity, NPV, and LR- with expected high sensitivity determination were 0.82, 84/92 (91.3%), 102/110 (92.7%), and 0.16, respectively. The sensitivity, NPV, and LR- for full-thickness rotator cuff tears were 69/73 (94.5%), 102/106 (96.2%), and 0.10, respectively, while the diagnostic performance for partial-thickness rotator cuff tears was low at 15/19 (78.9%), NPV of 102/106 (96.2%) and LR- of 0.39. CONCLUSIONS: Our algorithm had a high diagnostic performance for full-thickness rotator cuff tears. The deep learning algorithm based on shoulder radiography helps screen rotator cuff tears by setting an appropriate cutoff value. LEVEL OF EVIDENCE: Level III: Diagnostic Study.

    DOI: 10.1016/j.jos.2023.05.004

    PubMed

  • Risk Factors for Poor Outcome after Palliative Surgery for Metastatic Spinal Tumors.

    Suzuki A, Terai H, Takahashi S, Kato M, Toyoda H, Tamai K, Hori Y, Okamura Y, Nakamura H

    Journal of clinical medicine   12 ( 10 )   2023.05( ISSN:2077-0383

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  • Glenoid bone grafting with coracoid transfer in reverse shoulder arthroplasty for chronic anterior dislocation: a case report.

    Katsumasa Nakazawa, Tomoya Manaka, Yoichi Ito, Yoshihiro Hirakawa, Ryosuke Iio, Hiroaki Nakamura

    JSES reviews, reports, and techniques   3 ( 2 )   225 - 229   2023.05

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    International / domestic magazine:International journal  

    DOI: 10.1016/j.xrrt.2022.11.002

    PubMed

  • MRIの予後不良因子を持たない新鮮骨粗鬆症性椎体骨折の保存加療における腰痛遺残リスク

    岩前 真由, 寺井 秀富, 玉井 孝司, 星野 雅俊, 高橋 真治, 馬野 雅之, 小林 祐人, 勝田 紘史, 金田 国一, 島田 永和, 中村 博亮

    Journal of Spine Research   14 ( 5 )   786 - 793   2023.05( ISSN:1884-7137

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    はじめに:新鮮OVFのうちMRI予後不良因子(T2強調像で高信号限局型,低信号広範囲型)がないにも関わらず腰痛が遺残した症例について検討した.対象と方法:後ろ向きコホート研究.対象はOVFに対し保存加療を選択し,6ヶ月以上経過観察できた55例(平均年齢75.1歳,女性47例).MRIの予後不良因子を有する症例,馬尾・神経根の圧排を認める症例は除外した.6ヶ月時の腰痛VAS≧40の症例を腰痛遺残群(16例),その他を対照群(39例)に群分けした.評価項目は,初診時のX線動態撮影(座位・仰臥位側面)や全脊柱X線各種パラメーター,腰痛/臀部痛VAS,ODIを用いた.結果:単変量解析にて,初診時の臀部痛VAS(p=0.002),椎体可動角(p=0.047),TK(p=0.046),LL(p=0.031)に有意差があった.以上の有意な項目に年齢,性別,初診時腰痛VASを加えた多変量解析の結果,初診時の臀部痛VASが独立した腰痛遺残の危険因子であった(調整Odds比=1.526,p=0.019).結語:OVF受傷後6ヶ月時の腰痛遺残の危険因子は,初診時の臀部痛であった.(著者抄録)

  • 高齢のロコモティブシンドローム患者の検出に用いられる人工知能モデル 横断研究(Artificial intelligence model to identify elderly patients with locomotive syndrome: A cross-section study)

    Takahashi Shinji, Nonomiya Yuta, Terai Hidetomi, Hoshino Masatoshi, Ohyama Shoichiro, Shintani Ayumi, Nakamura Hiroaki

    Journal of Orthopaedic Science   28 ( 3 )   656 - 661   2023.05( ISSN:0949-2658

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    高齢のロコモティブシンドローム(LS)患者の検出に用いられる人工知能(AI)ベースの決定システムを開発し、その有用性について検討した。高齢者409名(男性164名、女性245名、平均73.5±5.4歳)を対象に、横断研究を実施して足部スキャン圧システムとして歩行中の足底圧分布を測定し、さらに画像処理システムには畳み込みニューラルネットワーク(CNN)を用いて足底圧をベースにLSの発症可能性を推定した。AIモデルのロジスティック回帰段階では、年齢、性別、身長、体重およびCNNの出力にもとづいて発症予測方程式を作成した。開発コホートの対象者は300名で、このうち104名(34.7%)がLSと診断された。三分割交差検証データセットの平均確度はトレーニングセットが0.71、検証セットが0.68を示しており、CNN出力はLS発症群の方が健常者群より有意に高かった。開発コホートにおける平均AUCは0.84、臨床モデルの平均AUCは0.80であった。足底圧分布をベースとしたAIモデルはLSのスクリーニングに有用なツールであることが示された。

  • 関節リウマチ患者における頸部痛とその関連因子(Neck pain and related factors in patients with rheumatoid arthritis)

    Suzuki Akinobu, Yamada Kentaro, Yabu Akito, Tamai Koji, Takahashi Shinji, Inui Kentaro, Okano Tadashi, Koike Tatsuya, Nakamura Hiroaki

    Modern Rheumatology   33 ( 3 )   503 - 508   2023.05( ISSN:1439-7595

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    関節リウマチ患者146例(女性82.9%、年齢24~87歳)を対象に、頸部痛がQOLに及ぼす影響と、頸部痛の関連因子について検討した。全例で立位および頸部側面のX線撮像を施行した。頸部痛は質問票と視覚的評価スケールにより評価し、頸部痛による機能障害度はneck disability index(NDI)により測定した。QOLの評価にはEuroQol-5 dimension(EQ-5D)を使用した。頸部痛は81例(55.5%)で認め、平均VASは36.0±20.0mmであった。頸部痛の陽性患者は陰性患者に比べてQOL値が有意に低く、NDIが有意に高かった(いずれもP<0.01)。X線で環軸関節亜脱臼(AAS)は46例(31.5%)で認め、垂直位亜脱臼(VS)は17例(11.6%)であった。多変量解析で年齢(OR 0.958、95%CI 0.924~0.993、P=0.018)、C7矢状垂直軸(OR 1.015、95%CI 1.001~1.029、P=0.036)、上頸部の亜脱臼(AASまたはVS)(OR 2.851、95%CI 1.162~6.993、P=0.022)、椎体終板の侵蝕像(OR 1.434、95%CI 1.021~2.015、P=0.038)が頸部痛の有意な関連因子であった。

  • 関節リウマチ患者における頸動脈プラークの新規発生率 TOMORROW研究の6年間の調査結果(Incidence of new carotid plaques in rheumatoid arthritis patients: 6-Year prospective results of the TOMORROW study)

    Anno Shohei, Okano Tadashi, Mamoto Kenji, Sugioka Yuko, Tada Masahiro, Inui Kentaro, Koike Tatsuya, Nakamura Hiroaki

    Modern Rheumatology   33 ( 3 )   481 - 489   2023.05( ISSN:1439-7595

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    頸動脈エコー検査を施行した関節リウマチ(RA)患者と健常者を対象に、頸動脈プラークの新規発生率を比較した。対象は、「RA患者の罹患率と死亡率を下げるためのリスク因子のトータルマネージメント」(TOMORROW研究)に登録されたRA患者208例と、年齢・性別を一致させた健常者205例で、2011年と2017年に頸動脈エコー検査を施行した。試験参加後に53例が脱落し、最終的にRA群175例(女性83.71%、平均58.9±12.7歳)と対照群185例(女性84.32%、平均58.47±12.52歳)を解析した。RA群の疾患活動性のコントロールは比較的に良好で、DAS28-CRPは平均で2.79±1.15、DAS28-CRPが5.1を超える高疾患活動性は僅か7例であった。2011年に頸動脈プラークの有病率はRA群(46.9%)の方が対照群(35.7%)より有意に高かったが、2017年までの6年間で頸動脈プラークの新規発生率に有意な群間差はなかった。多重ロジスティック回帰分析でRAは頸動脈プラークの新規発生のリスク因子でなかった(OR 0.708、95%CI 0.348~1.440)。

  • 診断に難渋した胸椎病的骨折の1例

    鈴木 摩耶, 豊田 宏光, 寺井 秀富, 玉井 孝司, 中村 博亮

    中部日本整形外科災害外科学会雑誌   66 ( 3 )   507 - 508   2023.05( ISSN:0008-9443

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    症例は54歳女性で、人間ドックにて全身に多発する骨硬化性病変を指摘され、精査目的に当院紹介となった。経過中に腰痛が出現し、MRIで第9胸椎に病的骨折を認めた。血液検査や骨生検では異常所見は認めず、入院後に硬性コルセット装着にて安静加療を行ったが、徐々に骨折部の圧壊の進行を認めたため、第21病日に第7~12胸椎の後方除圧固定術を施行した。術中迅速病理検査では急性骨髄炎の診断であったが、術後の病理組織検査では悪性リンパ腫を否定できず、その後の精査結果よりSAPHO症候群の診断に至った。

  • 腸管発生のデスモイド型線維腫症が転移悪性化したと考えられる1例

    田中 和幸, 家口 尚, 星 学, 伴 祥高, 笹岡 隆一, 中村 博亮

    中部日本整形外科災害外科学会雑誌   66 ( 3 )   391 - 392   2023.05( ISSN:0008-9443

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    症例は51歳女性で、横行結腸のデスモイド腫瘍切除術後半年で右腸腰筋内の複数病変が出現した。デスモイド腫瘍として経過観察したが、2年の経過で腫瘍が増悪し、切開生検を行った。病理診断は腸病変と同様のデスモイド腫瘍であり、VBL+MTX投与を開始したが、徐々に腫瘍の再増大と局所症状の増悪を認め、半年後に2度目の切開生検を行い、デスモイド型線維腫症の転移悪性化と診断した。陽子線治療を行い、腫瘍は軽度縮小するも、3ヵ月後に多発胸膜転移をきたし死亡した。

  • 脊椎転移患者におけるオピオイド所要量と全生存期間との関連(Association between Opioid Requirement and Overall Survival in Patients with Spinal Metastases)

    Dohzono Sho, Sasaoka Ryuichi, Takamatsu Kiyohito, Nakamura Hiroaki

    Spine Surgery and Related Research   7 ( 3 )   235 - 241   2023.05

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    脊椎転移患者にみられるオピオイド所要量が生存期間に及ぼす影響、オピオイド所要量と腫瘍関連脊椎不安定性との関連について検討した。脊椎転移と診断された428例を対象に診断後1ヵ月におけるオピオイド処方を調査して、経口モルヒネ当量5mg/日以上のオピオイド投与群193例(男性99例、女性94例、平均68.2歳)と5mg/日未満の非オピオイド投与群235例(男性124例、女性111例、平均67.2歳)に分類、脊椎不安定性腫瘍性スコア(SINS)をもとにした脊椎不安定性および全生存期間とオピオイド投与との関連を評価した。腫瘍原発部位は肺癌が159例と最も多く、乳癌が75例、前立腺癌が46例であり、転移部位は胸椎、腰椎、頸椎の順となっていた。全生存期間中央値はオピオイド投与群の方が非オピオイド投与群より有意に短く、多変量解析では死亡リスクはオピオイド投与群が非オピオイド投与群の約2倍に達していた。オピオイド投与群の方がSINSスコアが有意に高く、重度の脊椎不安定性を有することが明らかになった。

  • 肩甲骨翼状変形を呈した骨軟骨腫の1例

    足立 拓矢, 星 学, 八百 花, 伴 祥高, 大戎 直人, 中村 博亮

    中部日本整形外科災害外科学会雑誌   66 ( 3 )   477 - 478   2023.05( ISSN:0008-9443

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    症例は13歳男子で、2年前より誘因なく右肩甲部痛が出現し、野球の投球時に右肩甲部痛が強いため当科を受診した。初診時、右肩甲骨の翼状変形を認め、単純X線・3DCT・MRI所見より右肩甲骨の前面から発生した骨軟骨腫と診断し、骨腫瘍摘出術を施行した。病理所見は典型的な骨軟骨腫であり、術後は翼状変形や疼痛の改善が得られ、術後3ヵ月の時点で合併症や再発はみられず、良好に経過している。

  • Deep Learning Algorithm for Identifying Cervical Cord Compression Due to Degenerative Canal Stenosis on Radiography.

    Tamai K, Terai H, Hoshino M, Tabuchi H, Kato M, Toyoda H, Suzuki A, Takahashi S, Yabu A, Sawada Y, Iwamae M, Oka M, Nakaniwa K, Okada M, Nakamura H

    Spine   48 ( 8 )   519 - 525   2023.04( ISSN:0362-2436

  • Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture.

    Koji Tamai, Hidetomi Terai, Hiroaki Nakamura, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Junichi Yamane, Kazuki Takeda, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori Terashima, Ryosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Shota Ikegami, Masashi Uehara, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Akiyoshi Kuroda, Gen Inoue, Kenichiro Kakutani, Yuji Kakiuchi, Katsuhito Kiyasu, Hiroyuki Tominaga, Hiroto Tokumoto, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Tetsuro Ohba, Bungo Otsuki, Shoji Seki, Masashi Miyazaki, Masayuki Ishihara, Seiji Okada, Shiro Imagama, Satoshi Kato

    Journal of clinical medicine   12 ( 6 )   2023.03( ISSN:2077-0383

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    The number of elderly patients with cervical trauma is increasing. Such patients are considered to be at high risk for delirium, which is an acute neuropsychological disorder that reduces the patient's capacity to interact with their environment due to impairments in cognition. This study aimed to establish a risk score that predicts delirium in elderly patients with cervical SCI and/or cervical fracture regardless of treatment type. This retrospective cohort study included 1512 patients aged ≥65 years with cervical SCI and/or cervical fracture. The risk factors for delirium according to treatment type (surgical or conservative) were calculated using multivariate logistic regression. A delirium risk score was established as the simple arithmetic sum of points assigned to variables that were significant in the multivariate analyses. Based on the statistical results, the delirium risk score was defined using six factors: old age (≥80 years), hypoalbuminemia, cervical fracture, major organ injury, dependence on pre-injury mobility, and comorbid diabetes. The score's area under the curve for the prediction of delirium was 0.66 (p < 0.001). Although the current scoring system must be validated with an independent dataset, the system remains beneficial because it can be used after screening examinations upon hospitalization and before deciding the treatment strategy.

    DOI: 10.3390/jcm12062387

    PubMed

  • Perioperative Essential Amino Acid Supplementation Facilitates Quadriceps Muscle Strength and Volume Recovery After TKA: A Double-Blinded Randomized Controlled Trial.

    Hideki Ueyama, Narihiro Kanemoto, Yukihide Minoda, Yoshiki Taniguchi, Hiroaki Nakamura

    The Journal of bone and joint surgery. American volume   105 ( 5 )   345 - 353   2023.03( ISSN:0021-9355

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Perioperative essential amino acid (EAA) supplementation suppresses lower-limb muscle atrophy and promotes functional improvement in the first 4 weeks after total knee arthroplasty (TKA). However, its effect on the recovery of muscle volume and strength in the intermediate term is unclear. The aim of this study was to evaluate the effect of perioperative EAA supplementation on the recovery of lower-limb muscle volume and strength in the 2 years after TKA. METHODS: Sixty patients who underwent unilateral TKA for primary knee osteoarthritis were included in this double-blinded randomized controlled trial. After excluding dropouts, 26 patients assigned to the EAA group (9 g/day) and 26 assigned to the placebo group (powdered lactose, 9 g/day) were available for analysis. Patients received EAA supplementation or a placebo from 1 week prior to surgery to 2 weeks after it. The rectus femoris muscle area was measured using ultrasonography and quadriceps muscle strength was measured isometrically with a handheld dynamometer, preoperatively and periodically up to 2 years postoperatively. Knee pain, knee range of motion, functional mobility, and Knee Society Score 2011 subjective scores were measured at each time point. Perioperative management, except for supplementation, was identical in the 2 groups. RESULTS: Taking the baseline as 100%, the mean values in the EAA and placebo groups were 134% ± 31% and 114% ± 27%, respectively, for the rectus femoris muscle area and 159% ± 54% and 125% ± 40% for the quadriceps muscle strength, respectively, at 2 years after surgery. The differences were significant (p < 0.05). Clinical outcomes were not significantly different between the 2 groups. CONCLUSIONS: Perioperative EAA supplementation contributes to the recovery of rectus femoris muscle volume and quadriceps muscle strength in the 2 years after TKA. The EAA supplementation did not impact clinical outcomes. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

    DOI: 10.2106/JBJS.22.00675

    PubMed

  • 手関節に生じたLipofibromatous hamartomaの1例

    大西 裕真, 宅間 仁美, 森山 美知子, 新谷 康介, 細見 僚, 北野 利夫, 中川 敬介, 中村 博亮

    近畿小児整形外科   34   28 - 30   2023.03( ISSN:1345-1154

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    女児。3歳時に右手関節掌側から手掌部にかけての腫瘤を主訴として紹介来院した。MRIではT1・T2強調画像ともに高輝度の組織内に点在する低輝度部が見られ、手根管部でやや絞扼されたダンベル状腫瘤像(50mm×15mm×11mm)を認め、右正中神経に生じた脂肪線維性過誤腫と考えられた。MRIにて経過観察を行った。その結果、徐々に腫瘤の厚みが減少して扁平化し、7歳現在まで神経症状は出現せずに経過している。引き続き経過観察を行い、手根管症状群に準じた症状を呈するようになれば、手根管開放術を行う方針である。

  • Postoperative D-dimer levels predict venous thromboembolisms detected with contrast-enhanced computerized tomography in patients undergoing anterior cruciate ligament reconstruction.

    Yusuke Hashimoto, Eriko Komiya, Kazuya Nishino, Yohei Nishida, Atsushi Masuda, Hiroaki Nakamura

    BMC musculoskeletal disorders   24 ( 1 )   95 - 95   2023.02

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: In the literature, factors associated with postoperative venous thromboembolisms (VTEs) after anterior cruciate ligament reconstruction (ACLR) are limited. This study aimed to investigate the incidence of venous thromboembolisms (VTEs) after anterior cruciate ligament reconstruction (ACLR) and to identify risk and predictive factors for VTEs. METHODS: This retrospective study included 136 patients who underwent arthroscopic ACLR with mechanical prophylaxis between April 2012 and July 2022. Contrast-enhanced computed tomography (CT) was applied to detect VTEs comprising deep venous thromboses and pulmonary embolisms 7 days after surgery. Data including age, sex, body mass index, concomitant treatments, graft types, smoking status, operative and tourniquet times, postoperative D-dimer levels, and other laboratory test results, were collected for analyses. The incidence of radiographically confirmed VTEs and the associated risk factors, such as age, sex, body mass index, concomitant treatments, graft types, smoking status, operative and tourniquet times, postoperative D-dimer levels, and other laboratory test results, were analyzed. RESULTS: The overall incidence of radiographic VTEs was 11.0% (15 cases) in 136 patients. There was one symptomatic patient who had Homan's sign. Multivariable analysis indicated that postoperative D-dimer level was an independent factor related to a radiographic VTE after ACLR, although there was no association between radiographic VTEs and preoperative status or operation status. The optimal cutoff value for postoperative D-dimer level was 2.8 μg/ml according to the receiver operating characteristic curve analysis, with a sensitivity of 80.0% and specificity of 83.5%. CONCLUSION: The incidence of ACLR-associated radiographical VTEs (deep venous thrombosis and pulmonary embolism) under mechanical prophylaxis was 11.0% in this study. An elevated D-dimer level at 7 days after surgery is an independent predictor of VTE in patients undergoing ACLR. The postoperative D-dimer level is a more reliable marker for identifying VTE in patients who underwent ACLR.

    DOI: 10.1186/s12891-023-06212-4

    PubMed

  • Less-invasive decompression procedures can reduce risk of reoperation for lumbar spinal stenosis with diffuse idiopathic skeletal hyperostosis extended to the lumbar segment: analysis of two retrospective cohorts.

    Yamada K, Toyoda H, Hyakumachi T, Abe Y, Takahashi S, Suzuki A, Terai H, Nakamura H

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   32 ( 2 )   505 - 516   2023.02( ISSN:0940-6719

  • Relationship between body mass index and spinal pathology in community-dwelling older adults.

    Takeuchi Y, Takahashi S, Ohyama S, Hori Y, Tsujio T, Kotake S, Yabu A, Hoshino M, Terai H, Kobayashi A, Nakamura H

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   32 ( 2 )   428 - 435   2023.02( ISSN:0940-6719

  • Periostin increased by mechanical stress upregulates interleukin-6 expression in the ligamentum flavum.

    Akito Yabu, Akinobu Suzuki, Kazunori Hayashi, Yusuke Hori, Hidetomi Terai, Kumi Orita, Hasibullah Habibi, Hamidullah Salimi, Hiroshi Kono, Hiromitsu Toyoda, Takafumi Maeno, Shinji Takahashi, Koji Tamai, Tomonori Ozaki, Masayoshi Iwamae, Shoichiro Ohyama, Yuuki Imai, Hiroaki Nakamura

    FASEB journal : official publication of the Federation of American Societies for Experimental Biology   37 ( 2 )   e22726   2023.02( ISSN:0892-6638

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Ligamentum flavum (LF) hypertrophy is a major cause of lumbar spinal canal stenosis. Although mechanical stress is thought to be a major factor involved in LF hypertrophy, the exact mechanism by which it causes hypertrophy has not yet been fully elucidated. Here, changes in gene expression due to long-term mechanical stress were analyzed using RNA-seq in a rabbit LF hypertrophy model. In combination with previously reported analysis results, periostin was identified as a molecule whose expression fluctuates due to mechanical stress. The expression and function of periostin were further investigated using human LF tissues and primary LF cell cultures. Periostin was abundantly expressed in human hypertrophied LF tissues, and periostin gene expression was significantly correlated with LF thickness. In vitro, mechanical stress increased gene expressions of periostin, transforming growth factor-β1, α-smooth muscle actin, collagen type 1 alpha 1, and interleukin-6 (IL-6) in LF cells. Periostin blockade suppressed the mechanical stress-induced gene expression of IL-6 while periostin treatment increased IL-6 gene expression. Our results suggest that periostin is upregulated by mechanical stress and promotes inflammation by upregulating IL-6 expression, which leads to LF degeneration and hypertrophy. Periostin may be a pivotal molecule for LF hypertrophy and a promising therapeutic target for lumbar spinal stenosis.

    DOI: 10.1096/fj.202200917RR

    PubMed

  • コロナ禍において電話外来診療の継続に否定的であった腰椎変性疾患患者の特徴

    林 和憲, 田中 亨, 前野 考史, 坂和 明, 榎原 恒之, 田中 秀和, 窪田 穣, 中村 博亮

    Journal of Spine Research   14 ( 2 )   88 - 92   2023.02( ISSN:1884-7137

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    はじめに:コロナ禍に関連し,電話外来診療を導入した病院は多い.診療システムの継続性や発展性を考慮すると,ニーズの把握と適応症例の明確化が望まれる.本研究の目的は電話診療継続を希望しなかった患者群の特徴を明らかにすることである.対象と方法:電話診療を施行後,主要評価項目として今後の診療希望形態を収集した腰椎変性疾患患者293例を対象とした.質問票を用い,「常に電話診療」「通常の対面診療に電話診療をはさむ」「有事の際に電話診療」「常に対面診療」の4択での回答を依頼した.副次評価項目として患者背景,診療内容,症状の経過を診療記録から収集し,ロジスティック回帰分析を用いて「常に対面診療」を希望した例の特徴を検討した.結果:対面診療希望例は29%であった.他の回答例と比較し70歳代が多く(オッズ比:2.30),電話診療期間の腰痛NRSが高く(1.15),日常生活能力がJ1の例が少ない(0.40)ことがわかった.結語:腰痛の強い例やADLの低い例では,電話診療の継続を希望しない例が多かった.対面で痛みを医師に直接訴えたい例,触診や処置を希望する例が含まれる可能性が考えられる.(著者抄録)

  • The remaining parameters of patellar instability could be affected for osteoarthritic change after medial patellofemoral ligament reconstruction with or without anteromedialization of the tibial tubercle osteotomy for patellar instability: a retrospective cohort study.

    Yusuke Hashimoto, Kazuya Nishino, Tomihara Tomohiro, Shuko Tsumoto, Hiroaki Nakamura

    BMC musculoskeletal disorders   24 ( 1 )   56 - 56   2023.01

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: In literature, studies evaluating the factors associated the postoperative progression of patellofemoral (PF) osteoarthritis (OA) following patellar stabilization surgery are limited. This study aimed to compare the clinical outcomes after medial patellofemoral ligament reconstruction (MPFLR) as an isolated procedure (iMPFLR) and in combination with anteromedialization (AMZ) of the tibial tubercle osteotomy (TTO) and investigate the factors related to the postoperative progression of PFOA after patellar stabilization surgery. METHODS: Between 2009 and 2020, 30 knees of 23 consecutive patients underwent MPFLR with or without AMZ, using an autologous semitendinosus tendon graft; they were followed up for more than 2 years in the retrospective nature of the study. iMPFLR was performed in cases of recurrent patellar dislocation with normal tibial tubercle-trochlear groove (TT-TG) distance and no PFOA, and MPFLR+AMZ was performed for cases of excessive TT-TG distance, preoperative PFOA of recurrent patellar dislocation, or habitual patellar dislocation. Clinical findings and radiographs of the PF joint were evaluated pre- and postoperatively with PF alignment parameters and PFOA and were compared between surgical procedures. Factors for the postoperative progression of PFOA were compared between the OA progression and non-progression groups. RESULTS: Postoperative clinical score, radiographic parameters except for sulcus angle, TT-TG distance, and progression of PFOA were not significantly different between the iMPFLR and MPFLR+AMZ groups. Postoperative lateral patellar displacement (p = 0.001) and congruence angle (p = 0.017) were significantly different between the OA progression and non-progression groups. CONCLUSION: Similar to MPFLR for recurrent cases, MPFLR with AMZ can improve the clinical and radiographic outcomes in severe cases. The remaining parameters of patellar instability could be affected in the postoperative progression of PFOA after MPFL reconstruction with or without AMZ of TTO for patellar instability.

    DOI: 10.1186/s12891-022-06100-3

    PubMed

  • 神経性食思不振を原因とする痛風性膝関節炎に対する関節鏡下デブリードマン 1症例報告(Arthroscopic debridement for gouty arthritis of the knee caused by anorexia nervosa: A case report)

    Kinoshita Takuya, Hashimoto Yusuke, Okano Tadashi, Nishida Yohei, Nakamura Hiroaki

    Journal of Orthopaedic Science   28 ( 1 )   286 - 289   2023.01( ISSN:0949-2658

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    症例は44歳女性で、1年半前から二次性歩行障害と膝伸展制限を伴う左膝関節痛を呈しており、関節液吸引といった保存療法を受けるも症状は徐々に悪化していた。思春期より神経性食思不振(AN)をきたし、約10年前に閉経に至り、36歳時にアルコール中毒、37歳時に腎不全、42歳時に高尿酸血症と診断されアロプリノールを処方されていた。受診時の身体所見ではBMI 12.3kg/m2と著明なるい痩を認め、膝関節ROMは20~100°に制限されており、関節周囲に腫脹と圧痛がみられた。単純X線検査で軟部組織による透過性現象と左膝関節腔の狭小化、MRIで多量の関節滲出液、膝蓋上包と膝蓋下脂肪体における腫瘤を認め、臨床検査結果と合わせてANを原因とする痛風性膝関節炎と診断を下し、関節鏡下デブリードマンを施行した。関節鏡所見では大腿顆と滑膜軟骨に粉状の白色沈着物を認め、滑膜切除術と膝蓋上包、膝蓋下脂肪体および中外側溝の結節切除を行った。術後は早期に全荷重負荷とし、疼痛と関節伸展制限は著明に改善が得られた。術後1年、無症状で経過しており、膝関節ROMは0~125°を示し、自立歩行が可能となっている。

  • 高齢者の胸腰椎椎体骨折に対するBKP周術期の合併症頻度とその対策

    田中 和幸, 笹岡 隆一, 馬野 雅之, 谷 亮佑, 家口 尚, 中村 博亮

    中部日本整形外科災害外科学会雑誌   66 ( 1 )   23 - 24   2023.01( ISSN:0008-9443

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    骨粗鬆症性椎体骨折または転移性脊椎腫瘍に対しballoon kyphoplasty(BKP)単独、あるいは脊椎固定術併用BKPを施行した67例79椎体(男性26例、女性41例、平均年齢79.5歳)を対象に、周術期の合併症について検討した。その結果、BKP術後にセメント漏出は43例(54.4%)に認められ、うち血管内漏出は7例(8.9%)であった。BKP単独群57例では隣接椎体骨折を10例(17.5%)で生じ、その発生時期は平均24.4日であった。尚、隣接椎体骨折群は非骨折群と比較し、椎体楔状角の矯正角度が大きい傾向を示していた。

  • Measurement of spinopelvic sagittal alignment in the relaxed seated position rather than in the straight seated position is suitable for assessing spinopelvic mobility in patients before total hip arthroplasty.

    Yohei Ohyama, Kentaro Iwakiri, Yoichi Ohta, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura

    SICOT-J   9   2 - 2   2023( ISSN:2426-8887

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: The relationship between spinopelvic mobility and dislocation in total hip arthroplasty (THA) has recently attracted attention. This study aimed to investigate the differences in sacral slope (SS) between two types of upright seated positions and to determine which seated position was appropriate for assessing spinopelvic mobility (change in SS from standing to sitting) before THA. MATERIALS AND METHODS: This prospective cohort study included 75 hips from 75 patients who had undergone primary THA. Each patient underwent preoperative lateral spinopelvic radiography in standing (st) and two seated positions: relaxed (rs) and straight (ss). The change in SS between each position (Δ) was measured. RESULTS: Differences in all spinopelvic sagittal alignment parameters between the two seated positions were statistically significant (p < 0.001). The range, median, and mean values of ΔSSss-rs were -2.0° to 26.5°, 6.8°, and 8.3°, respectively. ΔSSss-rs was significantly correlated with SS, LLA, and PFA in the relaxed seated position (r = -0.52, -0.39, and 0.37; p < 0.001, p < 0.001, and p = 0.001, respectively), but was not correlated to these parameters in the straight seated position. Of the 52 patients with normal spinopelvic mobility in the relaxed seated position (ΔSSst-rs > 10°), 24 (46%) patients were misrepresented as having a stiff spine in the straight seated position (ΔSSst-ss < 10°). CONCLUSION: The change in SS from the straight to the relaxed seated position widely varied in patients before THA. The spinopelvic radiograph in the relaxed seated position is appropriate when evaluating spinopelvic mobility for preoperative planning.

    DOI: 10.1051/sicotj/2022051

    PubMed

  • Impact of the COVID-19 pandemic on bone and soft tissue tumor treatment: A single-institution study.

    Yoshitaka Ban, Manabu Hoshi, Naoto Oebisu, Akiyoshi Shimatani, Naoki Takada, Tadashi Iwai, Hiroaki Nakamura

    PloS one   18 ( 4 )   e0283835   2023

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: The spread of coronavirus disease 2019 (COVID-19) has caused a great deal of damage to daily medical care. We investigated the impact of the COVID-19 pandemic on bone and soft tissue tumor treatment at our hospital. METHODS: We conducted a retrospective comparative study of two groups of patients at Osaka City University Hospital during the period of increasing COVID-19 infections (February-December 2020, group C) and the same period the previous year (February- December 2019, group NC). Clinical data, including patient's age, gender, type of tumor, neoplasms, number of surgical cases for inpatients and outpatients, operation time, use of implants, length of hospital stay, inpatient hospital costs, number of inpatients receiving anticancer drugs, and postoperative complications in these two groups were retrospectively evaluated. RESULTS: The number of cases of malignant bone and soft tissue tumors that were resected during hospitalization was predominantly higher in group C than in group NC (P = 0.01). There were no significant differences in operation time, use of implants, and postoperative complications between group C and group NC, but there were significant differences in the length of hospital stay and hospital costs (P<0.001). CONCLUSIONS: The COVID-19 pandemic has been recognized throughout the world to have adverse effects in a variety of areas. It had a negative impact on hospital costs and the length of hospital stay in the field of bone and soft tissue tumor treatment.

    DOI: 10.1371/journal.pone.0283835

    PubMed

  • Efficacy of Early Rehabilitation for Severe Coronavirus Disease 2019 Pneumonia: Factor Analysis Using Machine Learning.

    Mitsuhiko Ikebuchi, Yoichi Ohta, Yukihide Minoda, Akiko Toki, Tamotsu Nakatsuchi, Hidetomi Terai, Hiroaki Nakamura, Ryoichi Kato, Sigeyoshi Nakajima

    Progress in rehabilitation medicine   8   20230027 - 20230027   2023

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    OBJECTIVES: Patients with severe coronavirus disease 2019 (COVID-19) who develop pneumonia face the risk of ventilatory muscle disuse in the acute phase, which can result in persistent respiratory impairments in the subacute phase. Although rehabilitation during the acute phase is considered effective, there are limited reports on this topic. Therefore, this study aimed to investigate the effectiveness of acute-phase rehabilitation in patients with severe COVID-19. METHODS: The study included 57 patients (45 men and 12 women; mean age: 63.2±12.1 years) admitted between April and June 2021, all of whom required intubation for respiratory management. Among them, 34 patients underwent acute-phase rehabilitation interventions based on the early goal-directed mobilization protocol. The primary objectives were to assess the occurrence of medical accidents related to acute-phase rehabilitation and evaluate their impact on survival and mobility upon hospital discharge. Statistical techniques and machine learning algorithms were employed for data analysis. RESULTS: Remarkably, no medical accidents occurred during the acute-phase rehabilitation among the patients. Furthermore, our findings indicated that acute-phase rehabilitation did not influence survival outcomes. However, it did have a positive impact on the mobility of patients upon hospital discharge. CONCLUSIONS: Acute-phase rehabilitation can be safely administered to patients with severe COVID-19 by following an early goal-directed mobilization protocol. This approach may also contribute to improved activities of daily living after discharge.

    DOI: 10.2490/prm.20230027

    PubMed

  • Efficacy of Early Rehabilitation for Severe Coronavirus Disease 2019 Pneumonia: Factor Analysis Using Machine Learning(タイトル和訳中)

    Ikebuchi Mitsuhiko, Ohta Yoichi, Minoda Yukihide, Toki Akiko, Nakatsuchi Tamotsu, Terai Hidetomi, Nakamura Hiroaki, Kato Ryoichi, Nakajima Sigeyoshi

    Progress in Rehabilitation Medicine   8   1 - 15   2023

  • 小児肘外傷における上腕骨遠位外側骨片の転位方向による簡易鑑別(第2報)

    中川 敬介, 日高 典昭, 久保 卓也, 新谷 康介, 鈴木 啓介, 細見 僚, 中村 博亮

    日本肘関節学会雑誌   30 ( 2 )   23 - 28   2023( ISSN:1349-7324

  • Is the Anterolateral or Posterolateral Approach More Effective for Early Postoperative Recovery after Minimally Invasive Total Hip Arthroplasty?

    Yoichi Ohta, Ryo Sugama, Yukihide Minoda, Shigekazu Mizokawa, Shinji Takahashi, Mitsuhiko Ikebuchi, Tamotsu Nakatsuchi, Hiroaki Nakamura

    Journal of clinical medicine   12 ( 1 )   2022.12( ISSN:2077-0383

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Currently, various minimally invasive surgical techniques are applied for total hip arthroplasty (THA). There are few studies comparing the early postoperative clinical outcomes of minimally invasive THA between anterolateral and posterolateral approaches. In this retrospective study, 62 patients underwent minimally invasive THA via either the anterolateral approach with an intermuscular exposure using the modified Watson-Jones approach (MIS-AL, 34 hips) or mini-incision THA with a posterolateral approach (MIS-PL, 28 hips). We analyzed intraoperative data, postoperative hematological data, postoperative radiographic findings, and the postoperative recovery of muscle strength. The mean surgical time was significantly longer in the MIS-PL than in the MIS-AL group. The mean postoperative serum C-reactive protein level was significantly higher in the MIS-PL group than in the MIS-AL group only on postoperative day 3. There were no significant between-group differences in the postoperative recovery rate of muscle strength during hip abduction. The recovery rate of muscle strength during hip extension was better in the MIS-AL group than in the MIS-PL group only on postoperative day 3. In conclusion, we found no obvious advantage in early postoperative recovery between the MIS-AL and MIS-PL approaches. Therefore, the benefit of rapid postoperative recovery was comparable between the MIS-AL and MIS-PL approaches.

    DOI: 10.3390/jcm12010139

    PubMed

  • High tartrate-resistant acid phosphatase (TRACP 5b) level in cystic fluid is a significant prognostic marker for postoperative recurrence in solitary bone cysts.

    Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Akiyoshi Shimatani, Naoki Takada, Yoshitaka Ban, Hiroaki Nakamura

    Journal of children's orthopaedics   16 ( 6 )   519 - 527   2022.12( ISSN:1863-2521

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: The pathogenesis of cystic fluid storage in solitary bone cysts remains unclear. We aimed to compare the results of the biochemical analysis of cystic fluid with clinical findings. We identified a significant marker of postoperative recurrence. METHODS: Twenty-seven male and eight female patients were studied; the median age at diagnosis was 11 (5-23) years. The mean follow-up period was 60 months (range: 14-146 months). Clinical information including sex, age, affected site, radiological findings of phase (active or latent), surgical procedure, outcome, and biochemical analysis of serum and cystic fluid was obtained. RESULTS: The 5-year healing rate was 64.0%. Biochemical analysis revealed that total protein and albumin values in the cystic fluid were significantly lower, compared to those in the serum. Levels of bone turnover markers, such as alkaline phosphatase, bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase 5b were remarkably elevated in the cystic fluid than in the serum. R values were 0.127, 0.076, and 0.095 for alkaline phosphatase, bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase 5b, respectively. Areas under the receiver operating characteristic curves, calculated to assess the association of alkaline phosphatase, bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase 5b levels in the cystic fluid with postoperative recurrence, were 0.57, 0.51, and 0.70, respectively. CONCLUSIONS: No clear correlation of bone turnover marker levels between the serum and cystic fluid was observed. The high tartrate-resistant acid phosphatase 5b level in the cystic fluid was associated with postoperative recurrence. The bone resorption caused by osteoclasts is considered to affect postoperative recurrence. LEVEL OF EVIDENCE: Level IV.

    DOI: 10.1177/18632521221129368

    PubMed

  • Review of the referral documents of patients with malignant soft tissue tumors.

    Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Akiyoshi Shimatani, Yoshitaka Ban, Naoki Takada, Hana Yao, Hiroaki Nakamura

    Scientific reports   12 ( 1 )   19527 - 19527   2022.11

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Fifteen years have passed since the soft tissue tumor practice guidelines were first published in Japan. Tumor size of ≥ 5 cm and tumor depth were key findings suggestive of malignant soft tissue tumors. We reviewed the referral documents provided by the referring physicians to see if these two findings were reported. The study was conducted from January 2007 to December 2021 and included 142 patients (83 men and 59 women; median age, 64 [6-94] years) with malignant soft tissue tumors. Patient referral documents from physicians were screened for descriptions of the tumor size and depth. The tumor size, depth, and both were described in 51.4%, 36.6%, and 23.2% of the referrals, respectively. Both findings were mentioned in 23.8%, 21.7%, and 25.0% of referrals in 2007-2011, 2012-2016, and 2017-2021, respectively. Of orthopedic surgeons and other physicians, 61.2% and 38.6%, respectively, described the tumor size. Whether the general physicians could follow the soft tissue tumor practice guidelines was difficult to conclude by reviewing patient referral documents. However, orthopedic surgeons seemed to pay more attention to tumor size. Awareness regarding soft tissue tumor practice guidelines should be increased to help diagnose malignant soft tissue tumors early.

    DOI: 10.1038/s41598-022-24158-w

    PubMed

  • Prevalence, risk factors, and potential symptoms of hyponatremia after spinal surgery in elderly patients.

    Kinoshita Y, Tamai K, Oka M, Habibi H, Terai H, Hoshino M, Toyoda H, Suzuki A, Takahashi S, Nakamura H

    Scientific reports   12 ( 1 )   18622   2022.11

  • Increased Surgical Experience in Microendoscopic Spinal Surgery Can Reduce Development of Postoperative Spinal Epidural Hematoma and Improve the Clinical Outcomes.

    Masayoshi Iwamae, Koji Tamai, Kunikazu Kaneda, Hidetomi Terai, Hiroshi Katsuda, Nagakazu Shimada, Hiroaki Nakamura

    Journal of clinical medicine   11 ( 21 )   2022.11( ISSN:2077-0383

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    No reports have previously evaluated the association between surgical technique and the incidence of postoperative spinal epidural hematoma (PSEH) following microendoscopic decompression surgery (MED). This study aimed to evaluate the association between the development of radiographic PSEH (rPSEH) following MED and microendoscopic surgical experience and postoperative clinical outcomes related to the quality of life (QoL). This retrospective cohort study included 3922 patients who had undergone MED performed by a single surgeon. rPSEH was defined as a hematoma that was identified via routine magnetic resonance images performed 3−4 days postoperatively. Patients were divided into rPSEH and control groups to identify the risk factor of rPSEH and assess clinical outcomes. In the multivariate analysis, age (p = 0.002), surgical experience (p = 0.003), surgical time (p = 0.038), multilevel decompression (p < 0.001), and diagnosis (p = 0.004) were identified as independent variables associated with rPSEH. Moreover, in mixed-effect models, the rPSEH group showed less improvement in Oswestry Disability Index (p = 0.014) than the control group. In conclusion, the surgical experience was identified as a risk factor for rPSEH that could lead to poor QoL. The sharing of microendoscopic surgical techniques among surgeons may reduce rPSEH incidence and improve patients’ QoL.

    DOI: 10.3390/jcm11216495

    PubMed

  • び漫性特発性骨増殖症関連化膿性脊椎炎患者における平均余命不良(Life Expectancy Is Poor in Patients with Diffuse Idiopathic Skeletal Hyperostosis-Related Pyogenic Vertebral Osteomyelitis)

    Yamada Kentaro, Ieguchi Makoto, Takahashi Shinji, Nakamura Hiroaki

    Spine Surgery and Related Research   6 ( 6 )   654 - 663   2022.11

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    化膿性脊椎炎(PVO)の治療後死亡率にび漫性特発性骨増殖症(DISH)が及ぼす影響について検討した。単施設で治療を受けたPVO患者55例(男性30例、女性25例、中央値73歳)を対象に後ろ向きコホート研究を実施し、DISH関連PVO群13例とDISH非関連PVO群42例に分類して死亡率の差を評価した。PVOの罹患部位は頸椎が4例(7%)、胸椎が12例(22%)、腰椎が39例(71%)で、起因菌が33例(60%)から検出され、黄色ブドウ球菌が最も多かった。静注抗生剤の投与期間中央値は6週間、手術を13例(24%)に施行し、経過観察期間中の死亡は18例(33%)となっていた。DISH関連PVO群の死亡率は62%で、88%が入院後1年以内の死亡であり、Kaplan-Meier生存曲線解析では2年死亡率はDISH関連PVO群の方がDISH非関連PVO群より高値を示していた。DISH関連PVO群の方が年齢が有意に高く、入院時のCRPも高値を示しており、敗血症が死因であったのはDISH関連PVO群が8例中6例、DISH非関連PVO群が10例中5例であった。このほか、PVO罹患中心部が椎体であったのはDISH関連PVO群が38%、DISH非関連PVO群が5%と有意差が認められた。DISH関連PVO患者の死亡率は高く、平均余命も短いことが明らかになった。

  • The Potential of Using an Autogenous Tendon Graft by Injecting Bone Marrow Aspirate in a Rabbit Meniscectomy Model.

    Ken Iida, Yusuke Hashimoto, Kumi Orita, Kazuya Nishino, Takuya Kinoshita, Hiroaki Nakamura

    International journal of molecular sciences   23 ( 20 )   2022.10

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Bone marrow aspirate (BMA) is an excellent source of cells and growth factors and has been used successfully for bone, cartilage, and soft-tissue healing. This study aimed to investigate the histological and biomechanical properties of autogenous tendon graft by injecting BMA and its protective effect against degenerative changes in a rabbit model of meniscal defects. Adult white rabbits were divided into untreated, tendon, and tendon + BMA groups, and meniscal defects were created in the knees. The tendon graft and articular cartilage status were evaluated by macroscopic and histological analysis at 4, 12, and 24 weeks postoperatively among the three groups. The tendon graft in the tendon and tendon + BMA groups were used for biomechanical evaluation at 4, 12, and 24 weeks postoperatively. The meniscal covering ratio in the tendon + BMA group was better than that in the tendon and untreated groups at 12 and 24 weeks postoperatively. The matrix around the central portion of cells in the tendon + BMA group was positively stained by safranin O and toluidine blue staining with metachromasia at 24 weeks. The histological score of the tendon graft in the tendon + BMA group was significantly higher than that in the untreated and tendon groups at 12 and 24 weeks postoperatively. In the tendon + BMA group, cartilage erosion was not shown at 4 weeks, developed slowly, and was better preserved at 12 and 24 weeks compared to the untreated and tendon groups. Histological scores for the articular cartilage were significantly better in the tendon + BMA group at 24 weeks. The compressive stress on the tendon graft in the tendon + BMA group was significantly higher than that in the tendon group at 12 weeks postoperatively. Transplantation of autogenous tendon grafts by injecting BMA improved the histologic score of the regenerated meniscal tissue and was more effective than the tendon and untreated group for preventing cartilage degeneration in a rabbit model of massive meniscal defects.

    DOI: 10.3390/ijms232012458

    PubMed

  • Microvascular neural blood flow assessment for a chronic nerve compression neuropathy mouse model by fluorescein angiography.

    Shunpei Hama, Takuya Yokoi, Mitsuhiro Okada, Takuya Uemura, Kiyohito Takamatsu, Hiroaki Nakamura

    Neurological research   44 ( 10 )   937 - 945   2022.10( ISSN:0161-6412

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND AND AIMS: Intraoperative fluorescence angiography with indocyanine green or fluorescein is used in ophthalmology and neurosurgery. However, there are few reports on the use of fluorescence angiography for peripheral neuropathy. This study aimed to assess the validity of fluorescein angiography (FAG) for peripheral nerve entrapment neuropathy. METHODS: We used an established model of chronic nerve compression (CNC) neuropathy in C57BL/6 mice by entrapping their left sciatic nerve with a silastic tube. Mice were assigned to the uninjured group (control), two-week CNC neuropathy group, four-week CNC neuropathy group, or six-week CNC neuropathy group. We then performed FAG to assess neural blood flow and quantified the peak of the luminance at the compression site with luminance analysis software. Following FAG, histological examinations using an anti-fluorescein antibody and Masson's trichrome staining were performed to evaluate the area of fluorescein distribution and epineural fibrosis. RESULTS: The luminance in the CNC neuropathy groups was significantly lower than that in the control group. Histological analysis revealed the fluorescein positive areas in the CNC neuropathy groups were significantly smaller than that in the control group, and the epineural fibrosis areas in the CNC neuropathy groups were significantly larger than that in the control group. CONCLUSION: We observed a significant decline of luminance in the CNC neuropathy groups, and the histological assessment was consistent with this result. FAG was found to be a valid method for assessing CNC neuropathy in mice.

    DOI: 10.1080/01616412.2022.2072101

    PubMed

  • 【上肢疾患の診断と治療の進歩(新鮮外傷を除く)】疾患各論 神経障害・末梢神経疾患 手根管症候群 有鉤骨鉤の解剖学的破格が鏡視下手根管開放術に与える影響

    斉藤 公亮, 岡田 充弘, 石河 恵, 中村 博亮

    別冊整形外科   ( 82 )   160 - 163   2022.10( ISSN:0287-1645

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    鏡視下手根管開放術(ECTR)を施行する際、有鉤骨鉤は手根骨の尺側縁として触知可能なランドマークであるが、有鉤骨鉤には解剖学的破格(低形成)が存在し注意を要する。今回、当科で2016~2020年にECTRを施行した53例56手を対象とし、有鉤骨鉤の低形成を認めた症例の割合と有害事象について調査した。低形成は6手(11%)に認めた。有害事象は、低形成を認めた2手に発生し、内訳は正中神経領域の一過性の痺れ1手、鈍棒挿入時における尺骨神経領域への放散痛1手で、いずれも保存的治療により改善した。このうち放散痛が生じた症例を提示した。

  • 上腕骨近位端骨折続発症に対するリバース型人工肩関節置換術の短期成績

    飯尾 亮介, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 中澤 克優, 山下 竜一, 岡田 彩夏, 中村 博亮

    肩関節   46 ( 2 )   309 - 312   2022.10( ISSN:0910-4461

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    上腕骨近位端骨折続発症に対するリバース型人工肩関節置換術(以下RSA)の短期成績について検討したので報告する.対象は上腕骨近位端骨折続発症に対して,RSAを施行し術後1年以上経過観察可能であった17肩である.評価項目は術後1年時の自動可動域(屈曲,外転,外旋,結帯動作),疼痛,日本整形外科学会肩関節疾患治療成績判定基準(以下JOAスコア)とし,既往手術・RSA術後の大結節の異常の有無と術後成績との関連についても検討した.術後屈曲,外転,JOAスコアは術前後で有意な改善を認めた.また,既往手術なし群はあり群と比較して術後外転可動域が有意に高い値であったが,大結節の異常の有無で術後臨床成績に有意差はなかった.上腕骨近位端骨折続発症に対するRSAは術後成績の改善を認めたが,手術の既往,大結節の治癒が術後成績に影響する可能性があり,初回の治療選択の見極めが重要であり,手術手技の工夫も要すると考えられた.(著者抄録)

  • 【上肢疾患の診断と治療の進歩(新鮮外傷を除く)】総論 侵襲的治療 人工関節手術 ナビゲーションシステムを用いたリバース型人工肩関節置換術の実際

    中澤 克優, 間中 智哉, 飯尾 亮介, 伊藤 陽一, 平川 義弘, 中村 博亮

    別冊整形外科   ( 82 )   51 - 55   2022.10( ISSN:0287-1645

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    RSA施行時にナビゲーションを使用した群15例(N群)と非使用群9例(C群)とで肩甲骨コンポーネントの設置状態を比較し、ナビゲーションの有用性について検討した。術中の肩甲骨コンポーネント目標設置位置は、肩甲骨関節窩前後捻角(GV)と肩甲骨関節窩傾斜角(GI)を0°、下方への張り出し(IO)を3mmとし、目標位置と実際の設置位置とのズレを調べた。結果、GVのズレはN群が3.4±2.3°、C群が7.1±4.3°で、N群のほうが有意に小さかった。GIのズレはN群3.2±1.6°、C群9.9±6.7°で、N群が有意に小さかった。IOのズレはN群1.4±0.9mm、C群2.6±2.6mmで、有意差は認められなかった。手術時間に有意な群間差はなかった。

  • Postoperative Physical Therapy Program Focused on Low Back Pain Can Improve Treatment Satisfaction after Minimally Invasive Lumbar Decompression.

    Hidetomi Terai, Koji Tamai, Kunikazu Kaneda, Toshimitsu Omine, Hiroshi Katsuda, Nagakazu Shimada, Yuto Kobayashi, Hiroaki Nakamura

    Journal of clinical medicine   11 ( 19 )   2022.09( ISSN:2077-0383

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Patient satisfaction is crucial in pay-for-performance initiatives. To achieve further improvement in satisfaction, modifiable factors should be identified according to the surgery type. Using a prospective cohort, we compared the overall treatment satisfaction after microendoscopic lumbar decompression between patients treated postoperatively with a conventional physical therapy (PT) program (control; n = 100) and those treated with a PT program focused on low back pain (LBP) improvement (test; n = 100). Both programs included 40 min outpatient sessions, once per week for 3 months postoperatively. Adequate compliance was achieved in 92 and 84 patients in the control and test cohorts, respectively. There were no significant differences in background factors; however, the patient-reported pain score at 3 months postoperatively was significantly better, and treatment satisfaction was significantly higher in the test than in the control cohort (-0.02 ± 0.02 vs. -0.03 ± 0.03, p = 0.029; 70.2% vs. 55.4%, p = 0.045, respectively). In the multivariate logistic regression analysis, patients treated with the LBP program tended to be more satisfied than those treated with the conventional program, independent of age, sex, and diagnosis (adjusted odds ratio = 2.34, p = 0.012). Postoperative management with the LBP program could reduce pain more effectively and aid spine surgeons in achieving higher overall satisfaction after minimally invasive lumbar decompression, without additional pharmacological therapy.

    DOI: 10.3390/jcm11195566

    PubMed

  • Nerve-End Capping Treatment with a Polyglycolic Acid Conduit for Rat Sciatic Neuroma: A Preliminary Report.

    Ema Onode, Takuya Uemura, Shunpei Hama, Takuya Yokoi, Mitsuhiro Okada, Kiyohito Takamatsu, Hiroaki Nakamura

    Journal of reconstructive microsurgery   38 ( 9 )   711 - 720   2022.09( ISSN:0743-684X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND:  The treatment of painful neuroma remains challenging. Recently, a nerve-end capping technique using a bioabsorbable nerve conduit was newly introduced to treat amputation neuroma. A collagen-coated polyglycolic acid (PGA) conduit has been commercially available for the reconstruction of peripheral nerve defects, yielding successful clinical outcomes. However, no experimental research has been conducted using this PGA nerve conduit as capping device for treating amputation neuroma. The purpose of this study was to investigate nerve-end capping treatment with the PGA conduit in the rat sciatic nerve amputation model, focusing on histological scar formation and neuroinflammation. METHODS:  Forty-seven rats were divided into two groups: no capping (transected nerve stump without capping; n = 25) and capping (nerve-end capping with collagen-coated PGA nerve conduit; n = 22). Twelve weeks after sciatic neurectomy, neuropathic pain was evaluated using the autotomy score. Stump neuromas were histologically evaluated or perineural scar and neuroinflammation. RESULTS:  While autotomy scores gradually exacerbated in both groups, they were consistently lower in the capping group at 4, 8, and 12 weeks postprocedure. Twelve weeks after surgery, the transected nerve stumps in the no-capping group had formed macroscopic bulbous neuromas strongly adhering to surrounding tissues, whereas they remained wrapped with the PGA nerve conduits loosely adhering to surrounding tissues in the capping group. Histologically, distal axonal fibers were expanded radially and formed neuromas in the no-capping group, while they were terminated within the PGA conduit in the capping group. Perineural scars and neuroinflammation were widely found surrounding the randomly sprouting nerve end in the no-capping group. In capped counterparts, scars and inflammation were limited to closely around the terminated nerve end. CONCLUSION:  Nerve-end capping with a collagen-coated PGA conduit after rat sciatic neurectomy might prevent neuroma formation by suppressing perineural scar formation and neuroinflammation around the nerve stump, potentially relieving neuropathic pain.

    DOI: 10.1055/s-0042-1757208

    PubMed

  • Intrameniscal degeneration and meniscotibial ligament loosening are associated factors with meniscal extrusion of symptomatic discoid lateral meniscus.

    Kazuya Nishino, Yusuke Hashimoto, Ken Iida, Takuya Kinoshita, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   31 ( 6 )   2358 - 2365   2022.09( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: This study aimed to compare the amount of extrusion of the discoid lateral meniscus (DLM), which was symptomatic and required surgery, with normal meniscuses and asymptomatic DLMs and examine factors associated with the extrusion of symptomatic DLM. METHODS: Medical records of participants with DLM or normal lateral meniscus (LM) were retrospectively reviewed using magnetic resonance imaging (MRI). DLM cases were divided into symptomatic and asymptomatic groups. The midbody meniscal extrusion was measured using mid-coronal MRI. The association between meniscal extrusion and MRI findings, including the meniscofemoral ligament, meniscotibial ligament (MTL), intrameniscal signal intensity of the peripheral rim, meniscal shift, and skeletal maturity, was evaluated. RESULTS: Eighty-six knees with DLM (63 symptomatic) were included. The control group included 31 patients. The symptomatic group showed significantly greater meniscal extrusion (mean ± standard deviation symptomatic DLM: 1.0 ± 1.1 mm, asymptomatic DLM: 0.1 ± 0.4 mm, and normal LM: 0.3 ± 0.6 mm, P < 0.001) and had a significantly higher incidence of MTL loosening (P = 0.02) and intrameniscal signal (P < 0.001) than the other two groups. In the symptomatic group, multivariable linear regression analysis showed that MTL loosening [β = 1.45, 95% confidence interval (CI) 1.03-1.86, P < 0.001] and intrameniscal signal (β = 0.49, 95% CI 0.09-0.90, P = 0.002) were independent associated factors. CONCLUSIONS: LM extrusion was significantly more common in patients with symptomatic DLM than in those with asymptomatic DLM or a normal LM. MTL loosening and intrameniscal high-signal intensity on MRI were independently associated with meniscal extrusion. These findings help explain the pathogenesis and diagnosis of symptomatic DLM. LEVEL OF EVIDENCE: III.

    DOI: 10.1007/s00167-022-07161-6

    PubMed

  • Change in Physical and Mental Quality-of-Life between the Short- and Mid-Term Periods after Cervical Laminoplasty for Cervical Spondylotic Myelopathy: A Retrospective Cohort Study with Minimum 5 Years Follow-up.

    Tamai K, Suzuki A, Terai H, Kato M, Toyoda H, Takahashi S, Yabu A, Sawada Y, Iwamae M, Nakamura H

    Journal of clinical medicine   11 ( 17 )   2022.09( ISSN:2077-0383

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  • Transplantation of Parathyroid Hormone-Treated Achilles Tendon Promotes Meniscal Regeneration in a Rat Meniscal Defect Model.

    Kazuya Nishino, Yusuke Hashimoto, Yohei Nishida, Kumi Orita, Junsei Takigami, Hiroaki Nakamura

    The American journal of sports medicine   50 ( 11 )   3102 - 3111   2022.09( ISSN:0363-5465

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Autologous tendon grafts are used for meniscal reconstruction of surgically removed knee joint meniscus. However, as meniscal reconstruction cannot prevent the progression of cartilage degeneration, additional procedures that confer meniscus-like histological properties to the transplanted tendon are required for improved outcomes. HYPOTHESES: Parathyroid hormone (PTH)(1-34) induces cartilage formation in the rat tendon, and transplantation of PTH-treated tendon promotes meniscal regeneration. STUDY DESIGN: Controlled laboratory study. METHODS: Rat Achilles tendon-derived cells were cultured with or without PTH for 28 days and stained with Alcian blue to determine chondrogenic differentiation. After 14 and 28 days of incubation, gene expression was assessed using quantitative real-time polymerase chain reaction. In an in vivo study, rat Achilles tendon was injected with PTH and then transplanted onto a medial meniscal defect. Macroscopic and histological assessments of the regenerated meniscus and of cartilage degeneration in the tibial plateau were performed at 4 and 8 weeks after surgery. RESULTS: In vitro, PTH-treated cells showed better staining with Alcian blue than the control (normal medium) group. PTH1R, Col2a1, Sox9, and RUNX2 were significantly upregulated in PTH-treated cells (P < .05). Macroscopically, the in vivo results revealed more prominent meniscal coverage and lesser progression of articular cartilage degeneration in the PTH group than in the phosphate-buffered saline-injected group. Histologically, toluidine blue staining revealed metachromasia in the PTH-injected tissue at 4 and 8 weeks. The PTH-treated regenerated meniscus showed positive immunostaining for type II collagen in the area exhibiting metachromasia. Moreover, PTH-treated tendon had an enhanced histological score compared with the untreated group at 4 and 8 weeks (P < .05). CONCLUSION: PTH(1-34) induced cartilage formation in the rat tendon. Transplantation of PTH(1-34)-treated Achilles tendon in a rat meniscal defect model induced meniscal regeneration and preserved knee articular cartilage. Macroscopically, PTH groups showed a greater coverage of the regenerated meniscus. Histologically, the regenerated meniscus had higher cartilaginous matrix content in rats transplanted with PTH-treated tendons. PTH(1-34) stimulated tendon-derived cells to promote chondrogenic differentiation. CLINICAL RELEVANCE: Meniscal transplantation using PTH-injected autologous tendon grafts might promote meniscal regeneration and prevent progression of cartilage degeneration by stimulating chondrogenic differentiation of tendon-derived cells.

    DOI: 10.1177/03635465221112954

    PubMed

  • ACL Graft Matching: Cadaveric Comparison of Microscopic Anatomy of Quadriceps and Patellar Tendon Grafts and the Femoral ACL Insertion Site.

    Takuya Kinoshita, Yusuke Hashimoto, Ken Iida, Hiroaki Nakamura

    The American journal of sports medicine   50 ( 11 )   2953 - 2960   2022.09( ISSN:0363-5465

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: The optimal graft choice between the bone-patellar tendon-bone (BPTB) and the quadriceps tendon remains controversial. Studies evaluating the microscopic anatomy of the quadriceps tendon-patellar bone (QTB) and BPTB grafts for anterior cruciate ligament (ACL) reconstruction are currently lacking. HYPOTHESIS: The relationship between post-ACL reconstruction graft bending angle (GBA) and the angle corresponding to the GBA (cGBA) would indicate that the BPTB can bend more than the QTB at the femoral tunnel aperture. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty paired human cadaveric knees fixed at <10° of knee joint flexion (mean age, 82.5 years) underwent histological sectioning and staining with Masson trichrome and toluidine blue. The femoral ACL insertion, QTB graft, and BPTB graft were microscopically analyzed. The width of the direct insertion, thickness of the uncalcified fibrocartilage and calcified fibrocartilage, ligament attachment angle, and cGBA for each group were measured. Eighteen patients who underwent ACL reconstruction with QTB or BPTB autograft were included for the evaluation of GBA using computed tomography images at 1 week postoperatively. RESULTS: The mean insertion widths of the femoral ACL, QTB, and BPTB were 7.81, 9.07, and 6.54 mm, respectively. The QTB was 16% wider than the ACL, while the BPTB was 16% narrower than the ACL. The mean insertion thicknesses of the femoral ACL, QTB, and BPTB were 0.53, 0.94, and 0.38 mm, respectively. The QTB was 77% thicker than the ACL (P < .001), while the BPTB was 28% thinner than the ACL (P = .017). The mean ligament attachment angles of the femoral ACL, QTB, and BPTB were 20.3°, 30.2°, and 33.3°, respectively, and the QTB and the BPTB were 49% and 64% larger, respectively, than the ACL. The mean cGBAs of the femoral ACL, QTB, and BPTB were 33.9°, 35.1°, and 12.3°, respectively. The BPTB was 64% smaller than the ACL, while there was no significant difference between the QTB and the ACL. The mean GBA was 57.7°. CONCLUSION: The insertion width and thickness were significantly greater and smaller in the QTB and BPTB grafts, respectively, than in the ACL. The relationship between GBA after ACL reconstruction and cGBA in knee extension indicates that at the femoral tunnel aperture, the BPTB can bend more than the QTB. CLINICAL RELEVANCE: QTB graft may allow more anatomic ACL reconstruction to be performed.

    DOI: 10.1177/03635465221110895

    PubMed

  • Decreased daily exercise since the COVID-19 pandemic and the deterioration of health-related quality of life in the elderly population: a population-based cross-sectional study.

    Tamai K, Terai H, Takahashi S, Katsuda H, Shimada N, Habibi H, Nakamura H

    BMC geriatrics   22 ( 1 )   678   2022.08

  • Prediction of the future leg length after rotationplasty in a 3-year-old boy with extraskeletal Ewing sarcoma and long follow-up until skeletal maturity: a case report.

    Hana Yao, Manabu Hoshi, Takashi Okamoto, Masatsugu Takami, Makoto Ieguchi, Hiroaki Nakamura

    Japanese journal of clinical oncology   52 ( 12 )   1436 - 1440   2022.08( ISSN:0368-2811

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Rotationplasty is a useful option for limb salvage surgery in pediatric patients with malignant bone and soft tissue tumors. However, bone growth after rotationplasty remains poorly characterized. We present a case of a 3-year-old boy with extraskeletal Ewing sarcoma who underwent multidrug chemotherapy (vincristine, doxorubicin, ifosfamide and etoposide), wide resection and functional reconstruction with rotationplasty. No radiotherapy was administered during the treatment course and the patient has been followed up for 16 years after rotationplasty. Leg length at skeletal maturity was predicted using postoperative radiograph measurements of the affected leg at the age of 4 years. Two conventional prediction methods, the multiplier and straight-line graph methods were used for prediction. The predicted leg length was compared with the actual leg length to assess bone growth after rotationplasty. Immediately after surgery, the lengths of the affected lower leg, femur and tibia were 32.5, 15.0 and 17.6 cm, respectively, and the predicted leg length of the affected leg at skeletal maturity using the multiplier and straight-line graph methods was 44.6 and 44.2 cm, respectively. However, the actual length of the affected leg at skeletal maturity was 49.8 cm, and the gap between actual and predicted lengths was more than 5 cm. In conclusion, the affected leg after rotationplasty showed more than expected bone overgrowth compared with the predictions of the conventional methods.

    DOI: 10.1093/jjco/hyac133

    PubMed

  • Comparison of postoperative knee flexion and patient satisfaction between newly and conventionally designed medial pivot total knee arthroplasty: a 5-year follow-up matched cohort study.

    Hideki Ueyama, Narihiro Kanemoto, Yukihide Minoda, Nobuo Yamamoto, Yoshiki Taniguchi, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   142 ( 8 )   2057 - 2064   2022.08( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: The medial pivot total knee arthroplasty (TKA) has good patients' satisfaction; however, there is likely the restriction of postoperative knee flexion. The 2nd generation medial pivot TKA prosthesis was designed to improve postoperative knee flexion. This study aimed to compare the clinical outcomes and patient satisfaction between the 2nd generation and 1st generation medial pivot TKA prostheses. MATERIALS AND METHODS: We conducted a retrospective study of 472 consecutive TKAs, performed using either the 2nd generation (EVOLUTION™), having smaller posterior femoral condyle and asymmetrical tibial tray, or 1st generation (ADVANCE™) prosthesis. The use of each system was historically determined. Patient age, sex and body mass index were matched between the two groups, with 157 cases ultimately included in each group. Measured clinical outcomes included: knee range of motion, the Knee Society Score, the rate of re-operation, and radiological parameters. Patient satisfaction was evaluated using the 12-item Forgotten Joint Score (FJS-12). RESULTS: The average follow-up period was 5.0 (3.7-6.3) years for the 2nd generation group and 8.7 (6.1-12.8) years for the 1st generation group (p < 0.01). The postoperative knee flexion range was 127° (80°-140°) for the 2nd generation and 118° (90°-135°) for the 1st generation at final follow-up (p < 0.01). On multivariate regression analysis, use of the 2nd generation prosthesis predicted greater postoperative knee flexion. The average FJS-12 score was 64 (0-100) for the 2nd generation and mean 57 (0-100) for the 1st generation (p < 0.01). Other clinical outcomes were similar between the two groups. CONCLUSIONS: Compared to the 1st generation, the 2nd generation medial pivot prosthesis provides greater postoperative knee flexion and patient satisfaction.

    DOI: 10.1007/s00402-021-04121-6

    PubMed

  • Two positioned MRI can visualize and detect the location of peripheral rim instability with snapping knee in the no-shift-type of complete discoid lateral meniscus.

    Hashimoto Y, Nishino K, Yamasaki S, Nishida Y, Takahashi S, Nakamura H

    Archives of orthopaedic and trauma surgery   142 ( 8 )   1971 - 1977   2022.08( ISSN:0936-8051

  • リバース型人工肩関節置換術後感染に対して持続的局所抗菌薬灌流を施行した一例

    橋村 剛, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 中澤 克優, 飯尾 亮介, 山下 竜一, 岡田 彩夏, 松田 淑伸, 中村 博亮

    肩関節   46 ( 1 )   236 - 240   2022.08( ISSN:0910-4461

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    リバース型人工肩関節置換術(RSA)後感染に対して持続的局所抗菌薬灌流(CLAP)を施行した1例を経験したので報告する.症例は87歳女性.6ヵ月前に右肩化膿性関節炎を発症し,鏡視下デブリドマン施行.抗菌薬治療後にRSAを施行した.術後3週で創部に感染兆候出現し,各種検査所見よりRSA術後人工関節周囲感染と診断.洗浄,デブリドマン,インプラント交換及びCLAPを施行.術後1年で感染の再燃なく経過良好である.(著者抄録)

  • Evaluation of the knee joint morphology associated with a complete discoid lateral meniscus, as a function of skeletal maturity, using magnetic resonance imaging.

    Takuya Kinoshita, Yusuke Hashimoto, Ken Iida, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 4 )   2095 - 2102   2022.07( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: A discoid lateral meniscus (DLM) is associated with increased risk for meniscal tears and progression of knee joint osteoarthritis. Our aim was to differentiate knee joint morphology between patients with and without a DLM, as a function of skeletal maturity, using magnetic (MR) imaging. MATERIALS AND METHODS: This was a retrospective analysis of MR images of the knee for 110 patients, 6-49 years of age. Of these, 62 were in the open physis group (38 with a DLM) and 48 in the closed physis group (23 with a DLM). The following morphological parameters were measured: anterior obliquity of the lateral tibial plateau (AOLTP), posterior obliquity of the lateral tibial plateau (POLTP), the lowest point of the lateral femoral condyle (LPLFC), and the posterior lateral condylar angle (PLCA). RESULTS: Regardless of skeletal maturity, a DLM was associated with a greater inclination of the POLTP, lateralization of the LPLFC, and smaller PLCA (p < 0.001 for all compared to that of the control group). In the DLM group, the inclination of the AOLTP and the POLTP were significantly smaller (p < 0.001) and the LPLFC was more lateral (p < 0.001) in the closed physis group than in the open physis group. In the control group, the inclination of the POLTP was larger (p < 0.001) and the PLCA smaller (p = 0.019) in the open than in the closed physis group. CONCLUSIONS: We identified a characteristic knee morphology among patients with a complete DLM using MR imaging, which was observed before physeal closure and persisted after skeletal maturity was attained. We also noted lateralization of the LPLFC in the presence of a DLM, with an increase in lateralization with skeletal maturation. LEVEL OF EVIDENCE: Case-control study, III.

    DOI: 10.1007/s00402-022-04538-7

    PubMed

  • Surgical Management of Discoid Lateral Meniscus With Anterior Peripheral Instability: Retaining an Adequate Residual Meniscus Volume.

    Yusuke Hashimoto, Shinya Yamasaki, Dan Guttmann, John B Reid 3rd, Sean Marvil, Takuya Kinoshita, Hiroaki Nakamura

    Arthroscopy techniques   11 ( 7 )   e1141 - e1147   2022.07( ISSN:2212-6287

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Discoid lateral meniscus (DLM) presents with differing pathoanatomy and may exhibit various types of tears. The treatment strategy is based on the presence and location of instability as a result of deficient capsular attachment. Recently, meniscal stabilization after saucerization has been recommended for DLM to preserve the meniscus shape, prevent extrusion, and mitigate against the progression of osteoarthritis. In addition to stabilization, the resection volume is important to prevent osteoarthritic changes. Although there was no tear and no displacement of the lateral meniscus on magnetic resonance imaging, some DLMs were found to have tears and peripheral instability during arthroscopy. Therefore, the assessment of peripheral instability during surgery is very important to achieve a desirable clinical outcome. This Technical Note describes an arthroscopic technique for anterior peripheral stabilization of the DLM, in which we highlight the surgical procedure for repair of the anterior horn, reassess the instability around the popliteal hiatus after the anterior horn is repaired, and the stabilization of the posterior horn, if necessary.

    DOI: 10.1016/j.eats.2022.02.021

    PubMed

  • Comparison of new and old all-inside suture devices in meniscal cyst formation rates after meniscal repair.

    Kinoshita T, Hashimoto Y, Nishino K, Nishida Y, Takahashi S, Nakamura H

    International orthopaedics   46 ( 7 )   1563 - 1571   2022.07( ISSN:0341-2695

  • Advanced glycation end products in musculoskeletal system and disorders.

    Suzuki A, Yabu A, Nakamura H

    Methods (San Diego, Calif.)   203   179 - 186   2022.07( ISSN:1046-2023

  • Characteristics of low back pain and its countermeasures among elderly population living in sub-urban area of Japan -Based on the results obtained from the longitudinal analysis of the Shiraniwa Study-

    Ohyama Shoichiro, Takahashi Shinji, Hoshino Masatoshi, Hori Yusuke, Yabu Akito, Tsujio Tadao, Takeuchi Yuichi, Terai Hidetomi, Nakamura Hiroaki

    Journal of Spine Research   13 ( 6 )   809 - 817   2022.06( ISSN:18847137 ( eISSN:24351563

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    <p>The Shiraniwa Study, a longitudinal observational study, has evaluated the physical symptoms, physical function, and radiological findings in 409 elderly people (aged 65 years or older) living in a suburban area since August 2016.</p><p>Cross-sectional analysis of the study data identified spinal sagittal imbalance, obesity, prevalent vertebral fractures, and anxiety as independent factors associated with low back pain. Interventions against these factors appeared to be effective in preventing low back pain. Longitudinal analysis revealed stage 2 locomotive syndrome (LS) as an independent predictor of deteriorating spinal sagittal imbalance. In addition, elderly in whom the locomotion level improved over time also showed weight loss, which suggests that weight loss may contribute to preventing the progression of spinal imbalance. Weight loss affects two factors associated with low back pain in the elderly (obesity and spinal imbalance) and might therefore be an effective countermeasure against low back pain in this population.</p>

    DOI: 10.34371/jspineres.2022-0602

  • A deep convolutional neural network for diagnosing osteoporotic vertebral fractures

    Yabu Akito, Takahashi Shinji, Terai Hidetomi, Hoshino Masatoshi, Nakamura Hiroaki

    Journal of Spine Research   13 ( 6 )   844 - 850   2022.06( ISSN:18847137 ( eISSN:24351563

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    <p>The prevalence of osteoporotic fractures continues to increase due to an aging society. In particular, osteoporotic vertebral fracture (OVF) affects activities of daily living and quality of life in elderly persons. Therefore, early diagnosis and treatment of OVF are important. Magnetic resonance (MR) image is useful in diagnosis, but it is sometimes difficult to diagnose whether fractures are fresh. In this review, we introduce our previous report and summarize previous papers on the diagnosis of OVF and artificial intelligence related to OVF. Our study included 814 patients with fresh OVF. A total of 1,624 slices of T1-weighted MR images were obtained and used for CNN training and validation. Furthermore, two spine surgeons independently evaluated 100 vertebrae, which were randomly extracted from the test data. To evaluate the performance of the CNN, we plotted a receiver operating characteristic (ROC) curve and calculated the area under the curve (AUC). We then compared the sensitivity, specificity, and accuracy of the diagnosis by CNN and that of the two spine surgeons. The AUC was 0.95. The evaluation metrics of the diagnosis (CNN/surgeon 1/surgeon 2) for 100 vertebrae were as follows: sensitivity 0.88 / 0.88 / 1.00; specificity 0.88 / 0.86 / 0.66; and accuracy 0.88 / 0.87 / 0.80. The performance of the CNN was comparable to that of the two spine surgeons in diagnosing fresh OVF on MR images. The performance of some diagnostic support tools using CNN has become comparable to that of specialists in various medical fields. Thus,such tools are expected to contribute to the highly accurate diagnosis of OVF in the near future.</p>

    DOI: 10.34371/jspineres.2022-0607

  • Development of locomotive syndrome in elderly population after COVID-19 outbreak: A population-based cross-sectional study with over 12,000 participants.

    Terai H, Tamai K, Takahashi S, Katsuda H, Shimada N, Hori Y, Kobayashi Y, Nakamura H

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   28 ( 4 )   895 - 900   2022.06( ISSN:0949-2658

  • Does Systemic Chemotherapy Influence Skeletal Growth of Young Osteosarcoma Patients as a Treatment-Related Late Adverse Effect?

    Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Yoshitaka Ban, Hiroaki Nakamura

    Current oncology (Toronto, Ont.)   29 ( 6 )   4081 - 4089   2022.06( ISSN:1198-0052

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    The aim of this study was to investigate the influence of systemic chemotherapy on the skeletal growth of young osteosarcoma patients as a treatment-related late adverse effect. We reviewed the height data of 20 osteosarcoma patients (13 males and 7 females) aged ≤18 years. The average (±SD) age at diagnosis was 14.5 (±3.3) years. The average follow-up interval was 89.6 months. After wide resection of the affected bones, reconstruction with tumor prostheses and auto-bone grafting was carried out in 11 and 9 cases, respectively. Pearson’s correlation coefficient was calculated to evaluate the association between actual and predicted (using Paley’s multiplier method) heights. Z-scores were used to compare the initial and final heights with the Japanese national growth curve. Actual and predicted heights were correlated according to Pearson’s correlation coefficient (R = 0.503). Z-analysis showed that statistical significance (p = 0.04) was noted for the height data Z-scores of patients between ≤10 years and >10 years at the final follow-up. Systemic chemotherapy did not reduce skeletal growth in young osteosarcoma patients as a late adverse effect based on two different evaluation methods. However, patients aged ≤10 years at diagnosis may develop a short stature after systemic chemotherapy.

    DOI: 10.3390/curroncol29060325

    PubMed

  • Association between Age and Trunk Muscle Area and Density in Patients with Spinal Metastases.

    Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Hiroaki Nakamura

    Asian spine journal   16 ( 5 )   677 - 683   2022.06( ISSN:1976-1902

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    STUDY DESIGN: A retrospective study. PURPOSE: This study aimed to evaluate the relationship between age and trunk muscle composition and between trunk muscle composition and overall survival in patients with spinal metastasis. OVERVIEW OF LITERATURE: A low skeletal muscle mass is associated with a poor overall survival in patients with cancer. However, no previous studies have evaluated the relative effects of age and disease on muscle mass and muscle quality in patients with advanced cancer. METHODS: This study included 539 patients diagnosed with spinal metastasis from February 2009 to July 2018. The patients were categorized into four groups based on age: <59, 60-69, 70-79, and ≥80 years. Differences in trunk muscle composition among age groups and among groups were classified on the basis of survival (< or >3 months after spinal metastasis diagnosis) were evaluated. RESULTS: In total, 515 patients (273 men, 242 women; mean age, 67.8 years) with complete medical records were included in the analysis. No significant differences were observed in the area of the psoas and paravertebral muscles among age groups in either sex. A significant trend toward a low muscle density with the increase in age was found for both sexes. Patients who survived less than 3 months had significantly smaller trunk muscle area than those who survived for more than 3 months in both sexes. CONCLUSIONS: The results suggest that the reduction in muscle density is associated with advanced age, whereas a decreased muscle area is associated with pathology. Additionally, a small trunk muscle area was associated with a short overall survival. Further studies are needed to elucidate the underlying mechanisms of age- versus cancer-related changes in the muscle area and their influence on overall survival.

    DOI: 10.31616/asj.2021.0192

    PubMed

  • Incidence of new carotid plaques in rheumatoid arthritis patients: 6-Year prospective results of the TOMORROW study.

    Shohei Anno, Tadashi Okano, Kenji Mamoto, Yuko Sugioka, Masahiro Tada, Kentaro Inui, Tatsuya Koike, Hiroaki Nakamura

    Modern rheumatology   33 ( 3 )   481 - 489   2022.06( ISSN:1439-7595

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVES: The purpose of this study was to evaluate the new incidence of carotid plaques in rheumatoid arthritis (RA) patients over a 6-year prospective follow-up and to assess the risk factors. METHODS: This is a 10-year prospective cohort study that included 208 RA patients and 205 age- and gender-matched controls. Ultrasound assessment of the bilateral carotid arteries was performed in 2011 and 2017. RESULTS: There were no differences in the incidence of new carotid atherosclerotic plaques over 6 years between the two groups (35.5% vs. 37.0%, respectively; p = .936). The mean Disease Activity Score 28-C-reactive protein over 6 years in RA patients was 2.73 ± 0.95. Multiple logistic regression analysis showed that RA was not a risk factor for new carotid atherosclerotic plaques (odds ratios, 0.708; 95% confidence interval, 0.348-1.440; p = .340). An average glucocorticoid dose of >1.8 mg/day over 6 years was a risk factor for new carotid atherosclerotic plaques (odds ratios, 8.54; 95% confidence interval, 1.641-44.455; p = .011). CONCLUSIONS: Incidence of new carotid atherosclerotic plaques was similar between well-controlled disease activity RA patients and control subjects. A mean glucocorticoid dose of >1.8 mg/day over 6 years was a risk factor for new carotid atherosclerotic plaques.

    DOI: 10.1093/mr/roac051

    PubMed

  • Bipedicled digital artery perforator volar adiposal turned-over flap for reconstruction of transverse fingertip amputation.

    Ema Onode, Kiyohito Takamatsu, Kenichi Kazuki, Hiroaki Nakamura

    JPRAS open   32   111 - 115   2022.06

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    International / domestic magazine:International journal  

    Different approaches to fingertip reconstructions are reported for cases in which microsurgical replantation is impossible. This report presents two cases of bipedicled digital artery perforator adiposal flaps for fingertip reconstruction after traumatic amputations. Adiposal flaps, including the radial and ulnar digital artery perforator vessels proximal to the distal interphalangeal joint, were elevated and turned to cover the fingertip defect. After donor-site skin closure, split-thickness skin was grafted onto the fingertip digital artery perforator adiposal flap. The technique is quick and easy to perform under loupe magnification and achieves good results in terms of healing, hand function, appearance, and patient satisfaction.

    DOI: 10.1016/j.jpra.2022.02.006

    PubMed

  • Pain and numbness one month after carpal tunnel release predict patient-reported outcome measures at sixth months.

    Shunpei Hama, Mitsuhiro Okada, Takuya Yokoi, Takuya Uemura, Hiroaki Nakamura

    Journal of plastic surgery and hand surgery   56 ( 3 )   167 - 171   2022.06( ISSN:2000-656X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    A number of outcome predictors for carpal tunnel release (CTR) for carpal tunnel syndrome (CTS) have been reported. However, some predictors are controversial, and few studies have referred to the early postoperative outcome prognostic factors after CTR. The aim of this study was to investigate whether pain and numbness at 1 month post-CTR were early postoperative predictors of clinical outcomes 6 months after surgery. Pain and numbness were evaluated using the visual analog scale (VAS) preoperatively and at 1 month post-surgery. Patient-reported outcome measures (PROMs), including the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) measure, the Hand20 questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ), were recorded for each patient 6 months after surgery. The BCTQ consisted of the Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Multivariable linear regression analysis was performed to investigate the association between the VAS scores and PROMs. We retrospectively identified 93 patients who underwent open carpal tunnel release (OCTR) or endoscopic carpal tunnel release. The mean age of the patients was 67.5 years, and 67 patients (72.0%) were female. Sixty patients were treated by OCTR (65.0%). With multivariable linear regression analysis, we found that pain and numbness, evaluated with VAS 1 month post-surgery had significant correlations with QDASH, Hand20, SSS and FSS 6 months after surgery. In conclusion, pain and numbness 1 month after CTR predict PROMs at 6 months.

    DOI: 10.1080/2000656X.2021.1953041

    PubMed

  • Decreased muscle mass and strength affected spinal sagittal malalignment.

    Miyagi M, Inoue G, Hori Y, Inage K, Murata K, Kawakubo A, Fujimaki H, Koyama T, Yokozeki Y, Mimura Y, Takahashi S, Ohyama S, Terai H, Hoshino M, Suzuki A, Tsujio T, Dohzono S, Sasaoka R, Toyoda H, Orita S, Eguchi Y, Shiga Y, Furuya T, Maki S, Shirasawa E, Saito W, Imura T, Nakazawa T, Uchida K, Ohtori S, Nakamura H, Takaso M

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   31 ( 6 )   1431 - 1437   2022.06( ISSN:0940-6719

  • Effect of Multimodal Cocktail Injection in Postoperative Analgesia after Cervical Laminoplasty: A Prospective Randomized Controlled Trial

    Terakawa Masaki, Yasuda Hiroyuki, Konishi Sadahiko, Nakamura Hiroaki

    Journal of Spine Research   13 ( 5 )   778 - 783   2022.05( ISSN:18847137 ( eISSN:24351563

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    <p><b>Introduction: </b>The analgesic effect and safety of multimodal cocktail injection after cervical laminoplasty were examined in a prospective randomized controlled trial.</p><p><b>Methods: </b>A total of 50 patients, who underwent cervical laminoplasty, were randomized into two groups. The cocktail group (25 patients) received intraoperative wound infiltration of local anesthetics, epinephrine, prednisolone, and nonsteroidal anti-inflammatory drugs at the end of surgery. The noncocktail group (25 patients) received only intraoperative wound infiltration of levobupivacaine. The outcome measures were amount of postoperative analgesic usage within 24 hours and visual analogue scale (VAS) for pain within 7 days and time to first analgesic demand.</p><p><b>Results: </b>Wound pain VAS was low in the cocktail group at all measurement points 6 hours after surgery, and significantly lower in the cocktail group 1, 3, 5, and 6 days after surgery (p = 0.01, 0.019, 0.024, 0.009). The total amount of postoperative analgesic usage in the first 24 hours was significantly lower in the cocktail group (p = 0.04). No complications, such as postoperative muscle paralysis or wound infection, were observed.</p><p><b>Conclusions: </b>Multimodal cocktail injection significantly reduced VAS for wound pain within 6 days and analgesic usage within 24 hours in postoperative analgesia with no increased side effects after cervical laminoplasty.</p>

    DOI: 10.34371/jspineres.2021-0067

  • Neck Pain and Related Factors in Patients with Rheumatoid Arthritis.

    Suzuki A, Yamada K, Yabu A, Tamai K, Takahashi S, Inui K, Okano T, Koike T, Nakamura H

    Modern rheumatology   33 ( 3 )   503 - 508   2022.05( ISSN:1439-7595

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  • Association of a Wider Medial Gap (Medial Laxity) in Flexion with Self-Reported Knee Instability After Medial-Pivot Total Knee Arthroplasty.

    Hideki Ueyama, Narihiro Kanemoto, Yukihide Minoda, Shigeru Nakagawa, Yoshiki Taniguchi, Hiroaki Nakamura

    The Journal of bone and joint surgery. American volume   104 ( 10 )   910 - 918   2022.05( ISSN:0021-9355

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Medial-pivot total knee arthroplasty (TKA) is designed with high articular conformity in the medial compartment in order to achieve stability. The subjective outcome of patients has been reported to be good postoperatively; however, the association between the objective and subjective knee stability and the influence of subjective stability on the overall outcomes of TKA remained unknown. Our hypothesis was that postoperative flexion joint-gap imbalance could affect subjective knee instability following TKA in medial-pivot prostheses. The purpose of this study was to analyze the association between the joint gap in flexion and subjective knee instability and between subjective knee instability and outcomes following medial-pivot TKA. METHODS: A total of 769 patients who underwent primary TKA with use of medial-pivot prostheses were enrolled. Clinical outcomes included knee range of motion, Knee Society Score-2011 (KSS-2011), Forgotten Joint Score-12 (FJS-12), patient-reported subjective knee instability, and axial knee radiography to assess flexion joint-gap balance measured at the final follow-up. Clinical outcomes were compared between patients with and without subjective knee instability. Moreover, associated factors were analyzed for postoperative subjective knee instability. RESULTS: Overall, 177 patients (23%) reported experiencing postoperative subjective knee instability. Knee flexion (p = 0.04); KSS-2011 symptom (p<0.001), satisfaction (p<0.001), expectation (p=0.008), and activity (p<0.001) subscales; and FJS-12 (p < 0.001) were significantly worse in patients with subjective knee instability. The KSS-2011 subjective score differences were greater than the minimal clinically important difference. Older age at the time of surgery (odds ratio, 1.04; p = 0.04) and a wider postoperative joint gap in flexion on the medial side (odds ratio, 1.21; p = 0.001) were significant risk factors for subjective knee instability. A gap angle of -2.9° (i.e., medial laxity) was the threshold to predict postoperative knee instability (sensitivity, 0.29; specificity, 0.91). CONCLUSIONS: Postoperative flexion joint-gap laxity on the medial side following medial-pivot TKA affected the patient-reported subjective knee instability scores. Postoperative KSS-2011 subjective scores following medial-pivot TKA were poorer in patients with subjective knee instability. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

    DOI: 10.2106/JBJS.21.01034

    PubMed

  • 3D-cultured small size adipose-derived stem cell spheroids promote bone regeneration in the critical-sized bone defect rat model.

    Yutaro Yamada, Tadashi Okano, Kumi Orita, Tomomi Makino, Fumiaki Shima, Hiroaki Nakamura

    Biochemical and biophysical research communications   603   57 - 62   2022.05( ISSN:0006-291X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Adipose-derived stem cells (ADSCs), due to their regenerative ability, have beneficial effects on bone and cartilage defects. In addition, spheroid formation of ADSCs obtained using three-dimensional (3D) culture accelerates the regenerative ability of ADSCs. The study investigated the regenerative effect of 3D-cultured small size ADSC spheroids without a scaffold in rats with defects in the critical-sized calvarial bone. ADSC-single cells, ADSC-spheroids, or PBS (as control) were implanted in rats, and radiological and histological assessment of bone regeneration was performed. Bone defects were significantly regenerated in the ADSC-spheroid group compared to that in the control group. ADSC-spheroids also showed the most significant bone regeneration in histological assessment. Immunohistochemistry assessment showed that ADSC-spheroids could survive 12 weeks after cell implantation. In vitro, cell apoptosis in ADSC-spheroids was significantly suppressed compared to that in ADSC-single cells. In addition, gene expression related to bone morphogenesis, angiogenesis, and stemness in ADSC-spheroids was elevated. The scaffold-free 3D-cultured small ADSC-spheroids survived in in vitro and in vivo conditions and promoted bone regeneration. Therefore, injectable small size ADSC-spheroids are a novel and less-invasive therapeutic option for treating bone defects.

    DOI: 10.1016/j.bbrc.2022.03.027

    PubMed

  • Longitudinal changes of residual muscles after wide resection for soft-tissue sarcomas of the thigh

    TAKADA Naoki

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   65 ( 3 )   467 - 468   2022.05( ISSN:00089443 ( eISSN:13490885

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  • Association of Postoperative Lateral Meniscal Extrusion With Cartilage Degeneration on Magnetic Resonance Imaging After Discoid Lateral Meniscus Reshaping Surgery.

    Kazuya Nishino, Yusuke Hashimoto, Ken Iida, Yohei Nishida, Shinya Yamasaki, Hiroaki Nakamura

    Orthopaedic journal of sports medicine   10 ( 5 )   23259671221091997 - 23259671221091997   2022.05( ISSN:2325-9671

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Although arthroscopic reshaping surgery for a discoid lateral meniscus (DLM) has good clinical results, it cannot completely prevent degeneration. The degree of DLM extrusion associated with degenerative changes is unclear. PURPOSE/HYPOTHESIS: To measure meniscal extrusion preoperatively and postoperatively in patients who underwent DLM-reshaping surgery and examine factors associated with knee articular cartilage degeneration. It was hypothesized that meniscal extrusion existed preoperatively, progressed postoperatively, and was related to knee joint degeneration. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: We retrospectively reviewed the medical records of patients who underwent DLM-reshaping surgery and attended ≥2 years of follow-up. Magnetic resonance imaging (MRI) was performed preoperatively and at 24 months postoperatively, and residual midbody meniscal extrusion was measured. Cartilage degeneration was detected when the Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the lateral compartment was grade ≥3 at 2 years postoperatively. Factors associated with MRI cartilage degeneration were evaluated. RESULTS: Included in this study were 48 knees in 39 patients; the mean patient age at the time of surgery was 12.0 years. The mean midbody meniscal extrusion significantly increased from 0.8 mm preoperatively to 1.6 mm at 24 months postoperatively (P < .001). According to the WORMS cartilage score, 16 patients were categorized as having MRI cartilage degeneration. Multivariate logistic analysis showed that an inferior preoperative Lysholm score (odds ratio, 0.89; P = .024) and postoperative extrusion (odds ratio, 6.18; P = .010) significantly increased the risk of cartilage degeneration. The receiver operating characteristic curve showed that a residual meniscal extrusion of 2.0 mm was the cutoff value indicating cartilage degeneration (sensitivity, 87.5%; specificity, 78.1%). CONCLUSION: DLM extrusion significantly increased from 0.8 mm preoperatively to 1.6 mm at 2 years postoperatively. Postoperative extrusion and a lower preoperative Lysholm score were factors related to MRI cartilage degeneration postoperatively. A postoperative extrusion of 2.0 mm was the cutoff value for MRI cartilage degeneration.

    DOI: 10.1177/23259671221091997

    PubMed

  • Usefulness of Preoperative Planning by Three-Dimensional Planning Software for Pedicle Screw Placement in Thoracolumbar Surgeries: Misplacement Rate and Associated Risk Factors(和訳中)

    Ozaki Tomonori, Yamada Kentaro, Nakamura Hiroaki

    Spine Surgery and Related Research   6 ( 3 )   279 - 287   2022.05

  • Mid-term changes in spinopelvic sagittal alignment in lumbar spinal stenosis with coexisting degenerative spondylolisthesis or scoliosis after minimally invasive lumbar decompression surgery: minimum five-year follow-up.

    Salimi H, Toyoda H, Terai H, Yamada K, Hoshino M, Suzuki A, Takahashi S, Tamai K, Hori Y, Yabu A, Nakamura H

    The spine journal : official journal of the North American Spine Society   22 ( 5 )   819 - 826   2022.05( ISSN:1529-9430

  • COVID-19肺炎治療中に膝関節偽痛風を併発し、肺炎の増悪との鑑別が必要であった1例

    林 和憲, 坂和 明, 榎原 恒之, 田中 亨, 窪田 穣, 中村 博亮

    中部日本整形外科災害外科学会雑誌   65 ( 3 )   365 - 366   2022.05( ISSN:0008-9443

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    82歳女性。前医にてCOVID-19肺炎の入院加療中に炎症所見上昇、発熱が認められ、第12病日に当院へ転院となった。入院時の胸部CTで両肺野に広範な肺炎像がみられ、デキサメサゾンの投与を漸減した。しかし、第15病日には炎症所見が再び上昇し、同時に右膝痛が出現した。胸部X線では肺炎像の増悪はみられず、第19病日に右膝関節穿刺を行ったところ、膝関節偽痛風と診断された。穿刺後は速やかに解熱し、関節痛の改善もみられ、第29病日に自宅退院となった。目下、発症から10ヵ月経過で偽痛風の再発はみられていない。

  • 大腿部悪性軟部腫瘍に対する広範切除後の残存筋の経時的変化の検討

    高田 尚輝, 星 学, 大戎 直人, 嶋谷 彰芳, 伴 祥高, 中村 博亮

    中部日本整形外科災害外科学会雑誌   65 ( 3 )   467 - 468   2022.05( ISSN:0008-9443

  • 頸椎椎弓形成術術後鎮痛における多剤カクテル注射の有効性の検討 前向き無作為化比較試験

    寺川 雅基, 安田 宏之, 小西 定彦, 中村 博亮

    Journal of Spine Research   13 ( 5 )   778 - 783   2022.05( ISSN:1884-7137

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    はじめに:頸椎椎弓形成術における多剤カクテル注射の術後鎮痛効果と安全性の検討を前向き無作為化比較試験で行った.対象と方法:頸椎椎弓形成術を施行した50例を無作為にカクテル群(ロピバカイン18ml,フルルビプロフェン1.25ml,0.1%アドレナリン0.1ml,水溶性プレドニン0.75ml)25例,対照群(レボブピバカイン0.5%20ml投与)25例に分けた.創部痛VAS(帰室時,術後3,6,12時間,術後1,2,3,5,6,7日目),帰室後鎮痛剤を使用するまでの時間,24時間以内の鎮痛剤使用回数を比較した.結果:創部痛VASは術後1,3,5,6日目においてカクテル群が有意に低かった(p=0.01,0.019,0.024,0.009).24時間以内の鎮痛剤使用回数はカクテル群で有意に使用回数が少なかった(p=0.04).術後合併症は認めなかった.結語:多剤カクテル注射はレボブピバカイン単剤の局所浸潤麻酔法と比較し,頸椎椎弓形成術後6日以内の創部痛VAS,24時間以内の鎮痛薬使用量を減少させた.多剤カクテル注射は頸椎椎弓形成術術後疼痛管理の一選択肢になると考える.(著者抄録)

  • Induction of chondrogenesis with a RANKL-binding peptide, WP9QY, in vitro and in vivo in a rabbit model.

    Yuriko Furuya, Hisashi Mera, Maki Itokazu, Shozaburo Terai, Hiroaki Nakamura, Shigeyuki Wakitani, Hisataka Yasuda

    Biochemical and biophysical research communications   602   98 - 104   2022.04( ISSN:0006-291X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    WP9QY (W9) is a receptor activator of nuclear factor-κB ligand (RANKL)-binding peptide that inhibits osteoclastogenesis by blunting the RANKL-RANK interaction, and also increases osteoblastogenesis via RANKL reverse signaling. W9 has dual effects on osteoclasts and osteoblasts; however, it is unknown whether the peptide has an effect on chondrocytes. Here, we report that W9 induces proliferation and differentiation of chondrocytes in vitro and repairs full-thickness articular cartilage defects in vivo. W9 stimulated chondrocyte differentiation in a two-dimensional (2D) culture of human mesenchymal stem cells (hMSCs), and transforming growth factor β3 (TGF-β3) showed synergistic effects with W9 on chondrogenesis. W9 enlarged the size of 3D pellet cultures of hMSCs and produced chondrocyte-specific matrices, especially in combined treatment with TGF-β3. The peptide also stimulated proliferation of hMSCs with induction of expression of chondrogenesis-related genes. Several RANKL inhibitors had no effect on chondrocytic differentiation. RANKL-knockdown experiments showed that W9 did not induce chondrogenesis through RANKL, but did induce osteoblastogenesis through RANKL. Intraarticular injection of W9 resulted in significant repair of full-thickness articular cartilage defects in rabbits. Taken together, these results suggest that W9 ameliorates the articular cartilage defects by increasing the volume of cartilaginous matrices with accompanying induction of proliferation and differentiation of chondrocytes via mechanisms independent of RANKL inhibition and RANKL reverse signaling. Since no pharmaceuticals are clinically available for treatment of cartilage damage such as osteoarthritis, our findings demonstrate the potential of W9 to address the unmet medical needs.

    DOI: 10.1016/j.bbrc.2022.03.019

    PubMed

  • 特集 末梢神経-Current Concept in 2022 Ⅰ.末梢神経再生の基礎 末梢神経再生におけるextrinsic growthとハイブリッド型人工神経の開発

    上村 卓也, 横井 卓哉, 高松 聖仁, 中村 博亮

    整形・災害外科   65 ( 5 )   479 - 484   2022.04( ISSN:03874095

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  • Author Correction: Local transplantation of adipose-derived stem cells has a significant therapeutic effect in a mouse model of rheumatoid arthritis.

    Hideki Ueyama, Tadashi Okano, Kumi Orita, Kenji Mamoto, Masaaki Ii, Satoshi Sobajima, Hideki Iwaguro, Hiroaki Nakamura

    Scientific reports   12 ( 1 )   6327 - 6327   2022.04

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    International / domestic magazine:International journal  

    DOI: 10.1038/s41598-022-10386-7

    PubMed

  • Thoracic Outlet Syndrome with Subclavian Artery Thrombosis Caused by Synostosis of the First and Second Ribs: A Case Report.

    Ema Onode, Kiyohito Takamatsu, Kenichi Kazuki, Hiroaki Nakamura

    JBJS case connector   12 ( 2 )   2022.04( ISSN:21603251

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    CASE: A 43-year-old woman presented with pain, paresthesia, and coldness of the right upper extremity suggestive of the diagnosis of thoracic outlet syndrome. Three-dimensional computed tomography angiography revealed that the right subclavian artery was constricted because it traveled over an abnormal first rib. After anticoagulation and antithrombotic therapy, the patient underwent resection of the abnormal first rib. Postoperative angiography documented improvement over time of the poststenotic dilatation and recanalization of the subclavian artery capable of delivering almost normal distal flow. CONCLUSION: Arterial reconstruction is not always necessary for the treatment of arterial thoracic outlet syndrome associated with poststenotic dilatation of the subclavian artery.

    DOI: 10.2106/JBJS.CC.21.00751

    PubMed

  • Evaluation of knee bone morphology in juvenile patients with complete discoid lateral meniscus using magnetic resonance imaging.

    Takuya Kinoshita, Yusuke Hashimoto, Yohei Nishida, Ken Iida, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   142 ( 4 )   649 - 655   2022.04( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: The characteristic two-dimensional bone morphology in patients with a discoid lateral meniscus (DLM) has been described. However, the associated three-dimensional imaging findings have not been characterized. This study was performed to identify differences in the knee bone morphology between juvenile patients with a DLM and those with a normal meniscus using magnetic resonance (MR) imaging. METHODS: The DLM group comprised 33 consecutive juvenile patients (33 knees) with a complete DLM, and the control group comprised 24 juvenile patients (24 knees) with normal menisci on the basis of MR imaging findings. Each MR image was evaluated to determine the anterior obliquity of the lateral tibial plateau (AOLTP), posterior obliquity of the lateral tibial plateau (POLTP), lowest point of the lateral femoral condyle (LPLFC), posterior lateral condylar angle (PLCA) and posterior medial condylar angle (PMCA). Statistical analyses were performed to determine the differences between the two groups. RESULTS: The POLTP was significantly larger, the LPLFC was significantly more lateral, and the PLCA was significantly smaller in the DLM group than in the control group (p < 0.001, p < 0.001 and p < 0.001 respectively). However, there was no statistically significant difference in the AOLTP or PMCA between the two groups (p = 0.429 and p = 0.148, respectively). CONCLUSIONS: Hypoplasia of the lateral femoral condyle and posterior lateral tibial plateau is recognized in juvenile patients with a complete DLM on coronal and axial MRI images. LEVEL OF EVIDENCE: Diagnostic study, Level III.

    DOI: 10.1007/s00402-021-03908-x

    PubMed

  • Is medial pivot total knee arthroplasty suitable for patients with valgus knee osteoarthritis?

    Kentaro Iwakiri, Yoichi Ohta, Yohei Ohyama, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura

    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie   32 ( 3 )   551 - 557   2022.04( ISSN:1633-8065

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: Medial pivot total knee arthroplasty (MP-TKA) is characterized by the ball-in-socket medial tibiofemoral articulation to achieve low wear and to reproduce the medial pivot motion similar to that in the normal knee, and there have been reports of favorable long-term postsurgical outcomes. However, most of these cases concerned varus knees, and the outcomes of MP-TKA in valgus knees are unknown. The objective of this study was to investigate the postoperative outcomes in end-stage valgus knee OA patients who underwent MP-TKA, through comparisons with those who underwent TKA using the same prosthesis for varus deformity. METHODS: This retrospective, single-center, cohort study analyzed 171 knees of 121 patients who were divided into two groups (valgus knee group: 15 knees (13 patients), varus knee group: 156 knees (109 patients)). Primary outcome measures included the knee joint range of motion (evaluated preoperatively and at every year postoperatively). Secondary outcomes included operative time, laboratory data, estimated blood loss, clinical outcome measures and adverse events. RESULTS: There were no significant differences in age, sex and body mass index, as well as in the postoperative primary and secondary outcome measures between the two groups. CONCLUSION: The use of MP-TKA featuring ball-in-socket medial tibiofemoral articulation in patients with valgus knee OA showed equally favorable clinical outcomes more than 2 years after surgery, compared to patients with varus knees who received MP-TKA.

    DOI: 10.1007/s00590-021-03007-y

    PubMed

  • Microendoscopic Lumbar Posterior Decompression Surgery for Lumbar Spinal Stenosis: Literature Review.

    Akinobu Suzuki, Hiroaki Nakamura

    Medicina (Kaunas, Lithuania)   58 ( 3 )   2022.03( ISSN:1010-660X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Lumbar spinal stenosis (LSS) is a common disease in the elderly, mostly due to degenerative changes in the lumbar spinal complex. Decompression surgery is the standard surgical treatment for LSS. Classically, total laminectomy-which involves resection of the spinous process, entire laminae and medial facet-has been the standard decompression technique; however, it can cause post-surgical instability. To overcome this disadvantage, various minimally invasive techniques that preserve the stabilization structures of the spine have been developed, and surgeons have begun to re-evaluate decompression surgery from the standpoint of reduced invasiveness and cost. More than two decades have passed since the introduction of microendoscopic spine surgery, and studies continue to shed light on its advantages and limitations as new knowledge becomes available. This article is a narrative review of the available literature, along with authors' experience, regarding the indications, surgical techniques, clinical outcomes, and limitations/complications of microendoscopic decompression for LSS.

    DOI: 10.3390/medicina58030384

    PubMed

  • Facet Joint Opening on Computed Tomography Is a Predictor of Poor Clinical Outcomes After Minimally Invasive Decompression Surgery for Lumbar Spinal Stenosis.

    Yamada K, Toyoda H, Takahashi S, Tamai K, Suzuki A, Hoshino M, Terai H, Nakamura H

    Spine   47 ( 5 )   405 - 413   2022.03( ISSN:0362-2436

  • Serum Cartilage Oligomeric Matrix Protein Detects Early Osteoarthritis in Patients With Anterior Cruciate Ligament Deficiency.

    Yohei Nishida, Yusuke Hashimoto, Kumi Orita, Kazuya Nishino, Takuya Kinoshita, Hiroaki Nakamura

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association   38 ( 3 )   873 - 878   2022.03( ISSN:0749-8063

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To investigate the ability of serum cartilage oligomeric matrix protein (COMP) to detect early osteoarthritis (OA) (International Cartilage Research Society [ICRS] grade 1 or 2 cartilage lesions) in patients with anterior cruciate ligament (ACL)-deficient patients. METHODS: Patients with an ACL injury of Kellgren-Lawrence grade 0 or 1 were enrolled. Serum samples for COMP measurement were obtained before surgery. The cartilage surfaces of 6 compartments were classified using the ICRS grading system. The patients were divided into groups with and without early OA according to the cartilage findings and diagnostic criteria for early OA. RESULTS: In total, 98 patients (mean age 23.7 years; range 12 to 49) were included, with 30 patients (30.6%) in the early OA group and 68 (69.4%) in the no early OA group. The 2 groups significantly differed in age, body mass index, preoperative Tegner activity scale, and serum COMP level. The cutoff value of serum COMP for the presence of early OA arthroscopic cartilage lesions was 152.0 ng/mL. Multiple logistic regression analysis revealed age (odds ratio 1.09; 95% confidence interval [CI] 1.02 to 1.16; P = .01) and serum COMP (odds ratio 1.02; 95% CI 1.01 to 1.04; P < .001) to be independent factors for the presence of early OA arthroscopic cartilage findings. CONCLUSIONS: The incidence of early OA arthroscopic cartilage findings was ∼30% in patients with ACL deficiency, and serum COMP levels were significantly higher in the early OA group than in the no early OA group. The optimum cutoff value for serum COMP was 152 ng/mL. Serum COMP can be used to detect early cartilage change in patients with ACL deficiency. LEVEL OF EVIDENCE: Ⅲ, retrospective comparative study.

    DOI: 10.1016/j.arthro.2021.06.019

    PubMed

  • Outcomes of Sarcopenia Treatment for Malignant Bone and Soft Tissue Tumors in Elderly Patients.

    Yoshitaka Ban, Hoshi Manabu, Naoto Oebisu, Akiyoshi Shimatani, Naoki Takada, Hiroaki Nakamura

    Cancer diagnosis & prognosis   2 ( 2 )   194 - 200   2022.03

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND/AIM: We determined the impact of sarcopenia on the treatment outcomes of malignant bone and soft tissue tumors in elderly patients. PATIENTS AND METHODS: We retrospectively reviewed 76 patients (age ≥65 years) who were treated for malignant bone and soft tissue tumors. Sarcopenia was assessed by measuring the cross-sectional area of the psoas muscles at the L3 vertebra from preoperative computed tomography images and categorized using the total psoas area/m 2 (TPA/m 2 ) ≤5.0 cm 2 /m 2 . The patients' clinical data were then evaluated. RESULTS: The operation time, length of hospital stay, and median overall survival were not different between the sarcopenia (n=41) and no-sarcopenia (n=35) groups. The local recurrence rate (p=0.01) and incidence of postoperative complications (p=0.02) significantly differed between both groups. The TPA/m 2  of both groups significantly decreased at the final follow-up. CONCLUSION: Sarcopenia negatively influenced wound healing and local recurrence, and was significantly exacerbated postoperatively in all elderly patients.

    DOI: 10.21873/cdp.10094

    PubMed

  • Expression and function of fibroblast growth factor 1 in the hypertrophied ligamentum flavum of lumbar spinal stenosis(和訳中)

    Habibi Hasibullah, Suzuki Akinobu, Hayashi Kazunori, Salimi Hamidullah, Hori Yusuke, Orita Kumi, Yabu Akito, Terai Hidetomi, Nakamura Hiroaki

    Journal of Orthopaedic Science   27 ( 2 )   299 - 307   2022.03( ISSN:0949-2658

  • 緊急で絞扼部切除術を施行した先天性内反足を伴う先天性絞扼輪症候群の1例

    中川 淳生, 中川 敬介, 中村 博亮, 大平 千夏, 新谷 康介, 細見 僚, 北野 利夫

    近畿小児整形外科   33   10 - 12   2022.03( ISSN:1345-1154

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    症例は生後20日の女児で、生下時から両内反足、両上下肢絞扼輪症候群を合併し、特に左下腿に強い絞扼と浮腫を認めた。Ponseti法による両先天性内反足の治療を開始し、右足は順調に経過したが、左足は強いリンパ浮腫のため矯正ギプス治療を継続できなかった。月齢が低く、サイズが小さいため、手術時期について検討しながら装具装着で待機していたが、生後2ヵ月時に急激な循環不全をきたし、左下腿の色調増悪を認めたため、緊急手術として絞扼輪切除術を行った。その後、左側外側接地した状態で安定した歩行を獲得できたため、1歳10ヵ月時に後内側解離術を行い、2歳0ヵ月時点で左足は軽度内反位を認めるもほぼ足底接地可能である。

  • 早期に腫瘍切除術を施行した足趾外骨腫の1例

    大平 千夏, 中川 敬介, 中村 博亮

    近畿小児整形外科   33   33 - 35   2022.03( ISSN:1345-1154

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    症例は2歳0ヵ月男児で、左第4趾の変形にて近医を受診し、腫瘍や外傷後の変形が疑われた。紹介受診時には左第4趾の遠位が外側に偏位していたが、発赤・発熱・圧痛などはみられず、単純X線では左第4趾の基節骨骨頭の骨性隆起と中節骨の外側への亜脱臼を認めた。MRI T2強調画像にて骨幹端から発生した腫瘍が関節面に及んでいたことから単発性外骨腫を疑い、dysplasia epiphyseal hemimelica(DEH)を否定した上で早期に腫瘍切除術を行った。術中、関節軟骨を被覆していた腫瘍と軟骨帽を可及的に切除し、PIP関節を整復してK-wireで固定した。その結果、術後6ヵ月で腫瘍の再発は認めず、PIP関節のアライメントも良好である。関節面に及んだ外骨腫に対しては、年齢や症状の有無によらず、早期に切除することが望ましいと考えられた。

  • A deep learning algorithm to identify cervical ossification of posterior longitudinal ligaments on radiography.

    Koji Tamai, Hidetomi Terai, Masatoshi Hoshino, Akito Yabu, Hitoshi Tabuchi, Ryo Sasaki, Hiroaki Nakamura

    Scientific reports   12 ( 1 )   2113 - 2113   2022.02

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    The cervical ossification of the posterior longitudinal ligament (cOPLL) is sometimes misdiagnosed or overlooked on radiography. Thus, this study aimed to validate the diagnostic yield of our deep learning algorithm which diagnose the presence/absence of cOPLL on cervical radiography and highlighted areas of ossification in positive cases and compare its diagnostic accuracy with that of experienced spine physicians. Firstly, the radiographic data of 486 patients (243 patients with cOPLL and 243 age and sex matched controls) who received cervical radiography and a computer tomography were used to create the deep learning algorithm. The diagnostic accuracy of our algorithm was 0.88 (area under curve, 0.94). Secondly, the numbers of correct diagnoses were compared between the algorithm and consensus of four spine physicians using 50 independent samples. The algorithm had significantly more correct diagnoses than spine physicians (47/50 versus 39/50, respectively; p = 0.041). In conclusion, the accuracy of our deep learning algorithm for cOPLL diagnosis was significantly higher than that of experienced spine physicians. We believe our algorithm, which uses different diagnostic criteria than humans, can significantly improve the diagnostic accuracy of cOPLL when radiography is used.

    DOI: 10.1038/s41598-022-06140-8

    PubMed

  • Artificial intelligence model to identify elderly patients with locomotive syndrome: A cross-section study.

    Takahashi S, Nonomiya Y, Terai H, Hoshino M, Ohyama S, Shintani A, Nakamura H

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   28 ( 3 )   656 - 661   2022.02( ISSN:0949-2658

  • Incidence of postoperative progressive segment degeneration at decompression and adjacent segments after minimally invasive lumbar decompression surgery: a 5-year follow-up study.

    Habibi H, Toyoda H, Terai H, Yamada K, Hoshino M, Suzuki A, Takahashi S, Tamai K, Salimi H, Hori Y, Yabu A, Nakamura H

    Journal of neurosurgery. Spine   37 ( 1 )   1 - 8   2022.02( ISSN:1547-5654

  • Eldecalcitol regulates the gene expressions of articular cartilage markers and differentiation markers in chondrocytes.

    Susumu Takemura, Yoichi Ohta, Ryo Sugama, Yukihide Minoda, Yohei Ohyama, Hiroaki Nakamura

    Biochemical and biophysical research communications   597   58 - 63   2022.02( ISSN:0006-291X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Vitamin D has been shown to reduce symptoms in patients with osteoarthritis (OA). In a previous study, local administration of eldecalcitol, an active vitamin D3 analog, reduced degenerative changes in articular cartilage in the early phase of experimental OA. However, the target of vitamin D in OA remains unknown. Here, we investigated the effect of eldecalcitol treatment on chondrocytes, which were divided into superficial zone chondrocytes (SZC), deep zone chondrocytes (DZC), and differentiated chondrocytes. SZC and DZC were cultured in monolayer and 3D pellet cultures treated with eldecalcitol. The gene expressions of articular cartilage and chondrocyte differentiation markers were evaluated. Histological analysis of SZC and DZC 3D pellet cultures was performed. The results showed that the articular cartilage markers ETS-related gene (Erg) and lubricin/proteoglycan 4 (PRG4) were significantly increased in SZC, but not in DZC, in the monolayer culture treated with eldecalcitol. The chondrocyte differentiation markers type X collagen and alkaline phosphatase (ALP) were significantly decreased in the DZC pellet culture treated with eldecalcitol. Immunochemical analysis also showed that Erg and lubricin/PRG4 expressions were elevated in the SZC pellet culture treated with eldecalcitol, while type X collagen and ALP expressions were decreased in the DZC pellet culture treated with eldecalcitol. In conclusion, this study showed that eldecalcitol upregulated articular cartilage markers in SZC and suppressed differentiation markers in DZC. Such regulation of chondrocytes by eldecalcitol could be potentially effective against OA progression.

    DOI: 10.1016/j.bbrc.2022.01.119

    PubMed

  • Galectin-3 promotes the adipogenic differentiation of PDGFRα+ cells and ectopic fat formation in regenerating muscle.

    Naoki Takada, Masaki Takasugi, Yoshiki Nonaka, Tomonori Kamiya, Kazuaki Takemura, Junko Satoh, Shinji Ito, Kosuke Fujimoto, Satoshi Uematsu, Kayo Yoshida, Takashi Morita, Hiroaki Nakamura, Akiyoshi Uezumi, Naoko Ohtani

    Development (Cambridge, England)   149 ( 3 )   2022.02( ISSN:0950-1991

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Worldwide prevalence of obesity is associated with the increase of lifestyle-related diseases. The accumulation of intermuscular adipose tissue (IMAT) is considered a major problem whereby obesity leads to sarcopenia and metabolic disorders and thus is a promising target for treating these pathological conditions. However, whereas obesity-associated IMAT is suggested to originate from PDGFRα+ mesenchymal progenitors, the processes underlying this adipogenesis remain largely unexplored. Here, we comprehensively investigated intra- and extracellular changes associated with these processes using single-cell RNA sequencing and mass spectrometry. Our single-cell RNA sequencing analysis identified a small PDGFRα+ cell population in obese mice directed strongly toward adipogenesis. Proteomic analysis showed that the appearance of this cell population is accompanied by an increase in galectin-3 in interstitial environments, which was found to activate adipogenic PPARγ signals in PDGFRα+ cells. Moreover, IMAT formation during muscle regeneration was significantly suppressed in galectin-3 knockout mice. Our findings, together with these multi-omics datasets, could unravel microenvironmental networks during muscle regeneration highlighting possible therapeutic targets against IMAT formation in obesity.

    DOI: 10.1242/dev.199443

    PubMed

  • The health-related quality of life of patients with musculoskeletal disorders after the COVID-19 pandemic.

    Terai H, Tamai K, Takahashi S, Hori Y, Iwamae M, Ohyama S, Yabu A, Hoshino M, Nakamura H

    International orthopaedics   46 ( 2 )   189 - 195   2022.02( ISSN:0341-2695

  • Surgical Treatment of Ulnar Cleft Hand with All Fingers - A Report of Two Patients.

    Keisuke Nakagawa, Shinichiro Takayama, Noriaki Hidaka, Hiroaki Nakamura

    The journal of hand surgery Asian-Pacific volume   27 ( 1 )   178 - 182   2022.02( ISSN:2424-8355

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    An ulnar cleft hand is a rare congenital deformity presenting with a cleft between the ring and little finger. It may be associated with the absence of a finger. The goals of treatment are cleft closure, increasing the length of the hypoplastic little finger and preservation of function. We report two patients with ulnar cleft hand without missing fingers. Both underwent cleft closure. One was treated by lengthening of the fifth metacarpal with an external fixator, and the other by finger translocation. Both patients achieved a near normal length of the little finger and a reasonable functional and aesthetic outcome. Level of Evidence: Level V (Therapeutic).

    DOI: 10.1142/S2424835522720043

    PubMed

  • Successful en bloc resection for femoral head clear cell chondrosarcoma without biopsy: A case report.

    Manabu Hoshi, Naoto Oebisu, Yoichi Ohta, Ayaka Tomimoto, Hiroaki Nakamura

    Molecular and clinical oncology   16 ( 2 )   26 - 26   2022.02( ISSN:2049-9450

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    International / domestic magazine:International journal  

    Clear cell chondrosarcoma (CCCS) is a rare, low-grade, malignant chondrogenic bone tumour. This tumour commonly affects the epiphysis of long bones, particularly in the proximal femur. The present study reported on the case of a 58-year-old male with right hip pain of five months duration. Plain radiography, magnetic resonance imaging and computed tomography scan revealed the characteristic appearance of chondroid mineralisation in the right femoral head, suggesting typical CCCS. Although biopsy is the gold standard for definite diagnosis prior to treatment, wide resection with removal of the biopsy tract is thought to negatively affect the surgical margin and postoperative hip function. Therefore, en bloc resection without any biopsy and a hip hemiarthroplasty were performed. The pathological diagnosis was CCCS and an adequate surgical margin was obtained. No local recurrence or distant metastases were detected and postoperative function was excellent at the final follow-up. The femoral head is a typical location of CCCS. Wide resection with adequate margins is the main treatment strategy for CCCS and when radiological features are typical, en bloc resection without a biopsy is an acceptable treatment option to improve patient outcomes.

    DOI: 10.3892/mco.2021.2459

    PubMed

  • No Difference in Postoperative Knee Flexion and Patient Joint Awareness Between Cruciate-Substituting and Cruciate-Retaining Medial Pivot Total Knee Prostheses: A 10-Year Follow-Up Study.

    Hideki Ueyama, Narihiro Kanemoto, Yukihide Minoda, Nobuo Yamamoto, Yoshiki Taniguchi, Hiroaki Nakamura

    The Journal of arthroplasty   37 ( 2 )   279 - 285   2022.02( ISSN:0883-5403

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: This study aimed to clarify differences in clinical results, including in patients' joint awareness, between cruciate-substituting (CS) and cruciate-retaining (CR) medial pivot total knee arthroplasty (TKA) over a 10-year follow-up. METHODS: A total of 333 TKAs were included in this study. There were 257 cases of CS and 76 cases of CR TKAs. Knee range of motion, Knee Society Score, and radiological outcomes were assessed. The patients' joint awareness was evaluated using the Forgotten Joint Score-12 at the final follow-up. The survival rate with respect to reoperation or revision was analyzed. RESULTS: The mean follow-up period was 10 ± 1.7 years, and the loss to follow-up was 5.4%. All clinical outcomes improved significantly after surgery in both groups (P < .001). Postoperative knee flexion was 118° ± 13° in the CS group and 116° ± 10° in the CR group (P = .10). The mean Forgotten Joint Score-12 scores were 57 ± 27 points in the CS group and 56 ± 28 points in the CR group (P = .59). Ten years after the operation, the survival rates for reoperation were 96.3% in the CS group and 94.2% in the CR group (P = .61), and those for revision were 98.4% and 98.7% in the CS and CR groups, respectively (P = .87). Other postoperative clinical results did not differ between the 2 groups. CONCLUSION: In this 10-year follow-up study, medial pivot TKA, regardless of polyethylene insert type, showed a high survival rate and good patient awareness of the prosthetic joint.

    DOI: 10.1016/j.arth.2021.11.016

    PubMed

  • Biochemical Characteristics and Clinical Result of Bone Marrow-Derived Fibrin Clot for Repair of Isolated Meniscal Injury in the Avascular Zone.

    Yusuke Hashimoto, Kazuya Nishino, Kumi Orita, Shinya Yamasaki, Yohei Nishida, Takuya Kinoshita, Hiroaki Nakamura

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association   38 ( 2 )   441 - 449   2022.02( ISSN:0749-8063

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To characterize bone marrow aspirate-derived fibrin clot (BMA clot) and evaluate the clinical result of meniscal repair with a BMA clot for isolated meniscal injury in the avascular zone. METHODS: Blood counts of total leukocytes, platelets, and concentrations of basic fibroblast growth factor (bFGF), transforming growth factor β (TGF-β), and stromal cell-derived factor 1 (SDF-1) were analyzed with BMA, peripheral blood (PB), BMA clot, and PB clot from 5 patients treated for meniscal repair. In addition, a retrospective analysis of 30 patients with isolated avascular meniscal injuries who underwent repair with a BMA clot was performed to assess rate failure. Avascular meniscal injury was identified as horizontal tear, radial tear, and flap tear. Clinical failure was defined as the presence of 1 or more of Barrett's criteria. Anatomic failure was defined as the existence of equivalent signal intensity to intra-articular fluid along the repair area on follow-up magnetic resonance imaging (MRI). Patients' demographic and clinical data were compared between the overall failure group and the success group. RESULTS: The bFGF, TGF-β, and SDF-1 levels of BMA clots were more highly concentrated compared with PB clots. The Lysholm scores and meniscal status evaluated by MRI were significantly improved from preoperatively to postoperatively (both P < .001). The Kellgren-Lawrence grading of knee radiographs did not significantly differ pre- and postoperatively (P = .140). Rates of clinical failure, anatomic failure, and retear were 10%, 6.7%, and 3.3%, respectively. The demographic characteristics and surgical and postoperative status did not significantly differ between the overall failure group and the success group. CONCLUSIONS: BMA clots had increased levels of cytokines compared to PB clots. The retrospective analysis revealed that the rates of clinical failure and anatomic failure after meniscal repair with a BMA clot for isolated avascular meniscal injury were 10% and 6.7%, respectively. LEVEL OF EVIDENCE: Level IV, case series.

    DOI: 10.1016/j.arthro.2021.05.026

    PubMed

  • Autologous Platelet-Rich Fibrin Membrane to Augment Healing of Microfracture Has Better Macroscopic and Histologic Grades Compared With Microfracture Alone on Chondral Defects in a Rabbit Model.

    Takuya Kinoshita, Yusuke Hashimoto, Kumi Orita, Yohei Nishida, Kazuya Nishino, Hiroaki Nakamura

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association   38 ( 2 )   417 - 426   2022.02( ISSN:0749-8063

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To determine the in vivo effectiveness of a single-stage surgical procedure that combines microfracture and an autologous platelet-rich fibrin (PRF) membrane for cartilage repair in a rabbit model. METHODS: Cartilage defects were created in the trochlear groove of the knees of adult white rabbits. Defects were divided into 2 treatment groups: microfracture only (control group) and microfracture covered by a PRF membrane (PRF group). To evaluate the repair cartilage, assessments were performed at 4, 12, and 24 weeks postoperatively using the International Cartilage Repair Society (ICRS) macroscopic scoring system and modified Wakitani histologic grading system. RESULTS: The mean ICRS macroscopic scores in the control and PRF groups were 4.1 and 5.8, respectively, at 4 weeks (P = .0623); 6.3 and 9.8, respectively, at 12 weeks (P = .006); and 6.5 and 10.3, respectively, at 24 weeks (P = .010). The mean modified Wakitani scores in the control and PRF groups were 4.0 and 3.9, respectively, at 4 weeks (P > .999); 5.3 and 10.4, respectively, at 12 weeks (P = .006); and 2.6 and 7.4, respectively, at 24 weeks (P = .012). CONCLUSIONS: The ICRS macroscopic scores and modified Wakitani scores showed that a single-stage surgical procedure combining microfracture and a PRF membrane was more effective than surgery with only microfracture for promoting cartilage repair. CLINICAL RELEVANCE: A single-stage surgical procedure combining microfracture and an autologous PRF membrane is a potentially beneficial treatment method for cartilage defects that does not require using any xenocollagen membrane.

    DOI: 10.1016/j.arthro.2021.04.055

    PubMed

  • A cemented mobile-bearing total knee prosthesis prevents peri-prosthetic bone mineral density loss around the femoral component: a consecutive follow-up at a mean of 11 years.

    Minoda Y, Ikebuchi M, Kobayashi A, Iwaki H, Nakamura H

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   30 ( 2 )   734 - 739   2022.02( ISSN:0942-2056

  • Efficacy of Pazopanib in the Treatment of Metastatic Malignant Giant Cell Tumor of Soft Tissue: A Case Report.

    Tadashi Iwai, Naoto Oebisu, Manabu Hoshi, Naoki Takada, Hiroaki Nakamura

    Current oncology (Toronto, Ont.)   29 ( 2 )   758 - 765   2022.01( ISSN:1198-0052

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Giant cell tumor of soft tissue (GCT-ST), histologically resembling the GCT of the bone, is a rare tumor. The tumor has been categorized to have low malignancy. Few reports of local recurrence or distant metastasis and the use of chemotherapeutic agents for metastatic GCT-ST exist. Herein, we report the efficacy of pazopanib in a 78-year-old Japanese woman with GCT in the intrinsic back musculature with both post-operative local recurrence and lung metastasis. The patient visited the hospital with a three-month history of a palpable mass in the intrinsic back musculature. Following magnetic resonance imaging, the tumor predominantly exhibited slight hyperintensity on T2-weighted images and intense heterogeneous enhancement on contrast-enhanced T1-weighted images. A percutaneous needle biopsy was performed, and the pathological diagnosis was GCT-ST. The patient underwent surgery, and three months later she presented with not only local recurrence but also multiple lung metastases. The patient was immediately treated with pazopanib 400 mg once daily. One month after initiating treatment, a partial response in the pulmonary lesions was observed, and stable disease (SD) effects lasted for 11 months without severe adverse effects. Therefore, pazopanib treatment for metastatic malignant giant cell tumor of soft tissue achieved reasonable success.

    DOI: 10.3390/curroncol29020064

    PubMed

  • Finite Element Analysis Could Predict and Prevent a Pathological Femoral Shaft Fracture after En Bloc Resection of a Large Osteoid Osteoma.

    Tadashi Iwai, Naoto Oebisu, Manabu Hoshi, Naoki Takada, Hiroaki Nakamura

    Children (Basel, Switzerland)   9 ( 2 )   2022.01( ISSN:2227-9067

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    International / domestic magazine:International journal  

    Osteoid osteoma is a benign tumor. Approximately 20% of these tumors are located in the femur. The tumor primarily occurs in children and is treated by surgical excision or radiofrequency ablation. Recently, bone-tumor resection using three-dimensional (3D) intraoperative imaging with an O-arm in combination with a navigation system has been reported to be effective. However, there is a risk of postoperative fracture because of the weakening of the bone after drilling for tumor resection. A 12-year-old Japanese girl presented with an osteoid osteoma in the left femoral shaft, which resulted in a fracture after en bloc resection and artificial bone grafting using a 3D image-guided (O-arm) assisted navigation system. Orthopedic oncologists should be aware of the risk of fracture. Moreover, they should consider the mechanical risk prediction of bone fracture using finite element analysis prior to treatment.

    DOI: 10.3390/children9020158

    PubMed

  • Impact of the COVID-19 Pandemic on Elderly Patients with Spinal Disorders.

    Terai H, Takahashi S, Tamai K, Hori Y, Iwamae M, Hoshino M, Ohyama S, Yabu A, Nakamura H

    Journal of clinical medicine   11 ( 3 )   2022.01( ISSN:2077-0383

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  • Comparison of Medical Costs, Including Nursing Care and Informal Care Costs, Involved in Balloon Kyphoplasty and Conservative Treatment for Osteoporotic Vertebral Fractures

    Takahashi Shinji, Terai Hidetomi, Hoshino Masatoshi, Nakamura Hiroaki

    Journal of Spine Research   13 ( 1 )   57 - 64   2022.01( ISSN:18847137 ( eISSN:24351563

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    <p><b>Introduction: </b>Osteoporotic vertebral fracture (OVF) is one of the most common fractures among the elderly, and its impact on the cost of care is a concern. Balloon kyphoplasty (BKP) is a widely used treatment for OVF. The purpose of this study is to estimate the cost of conservative treatment and BKP, including the cost of nursing care and the loss of productivity of caregivers, based on previous reports.</p><p><b>Methods: </b>For the distribution of activities of daily living (ADLs) after OVF, we used data from our multicenter prospective study that evaluated BKP and conservative treatment for 6 months in patients aged ≥65 years within 2 months of the onset. Estimates of nursing care costs and informal care costs were estimated mainly based on data published by the Ministry of Health, Labor and Welfare.</p><p><b>Results: </b>To compare nursing care costs, we summed up the distribution of ADLs, the level of nursing care required, and the level of independence in daily living at the end of 6 months of treatment. The per capita nursing care costs by level of nursing care required at the end of 6 months were 39,497 yen/month in the BKP group and 58,298 yen/month in the conservative therapy group with a difference of 18,801 yen/month. The per capita informal care costs by level of care required at the end of 6 months of treatment were 35,722 yen/month in the BKP group and 44,102 yen/month in the conservative therapy group, with a difference of 8,380 yen/month.</p><p><b>Conclusions: </b>For patients with OVF, improvement of ADL via BKP may reduce the cost of care and caregiver productivity loss.</p>

    DOI: 10.34371/jspineres.2021-0041

    CiNii Article

  • Staged Corrective Surgery for a Patient With Sagittal Malalignment Related to Noonan Syndrome: A Case Report.

    Masayoshi Iwamae, Akira Matsumura, Takashi Namikawa, Masatoshi Hoshino, Yusuke Hori, Hiroaki Nakamura

    JBJS case connector   12 ( 1 )   2022.01( ISSN:21603251

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    CASE: A 20-year-old man with Noonan syndrome had rigid cervical kyphosis caused by cervical myelopathy and thoracic lordosis caused by pulmonary disfunction. Two-staged corrective surgery, which involved initial posterior spinal fusion (PSF) in T2-L2 followed by PSF in C3-T2, had been performed without any complications. The radiographs before surgery and 2 years after surgery showed that cervical lordosis (C2-7) changed form -56° to -29°, and thoracic kyphosis (T5-12) improved from -49° to 10°. CONCLUSION: Initial realignment surgery in the caudal lesion should be better for improving global spinal alignment in patients with rigid spinal deformities at different locations.

    DOI: 10.2106/JBJS.CC.21.00559

    PubMed

  • Prognostic value of psoas major muscle density in patients with breast cancer metastases to bone: a retrospective single-center cohort study.

    Hana Yao, Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Hiroaki Nakamura

    Japanese journal of clinical oncology   52 ( 1 )   8 - 13   2022.01( ISSN:0368-2811

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: Although sarcopenia is associated with poor prognosis for cancer patients, the relationship between muscle quantity and quality, and prognosis of breast cancer patients with bone metastases is unclear. This study aims to evaluate the association of muscle parameters, muscle area and density, and overall survival (OS) from the diagnosis of bone metastases in breast cancer patients with bone metastases. METHODS: This study retrospectively investigated the prognostic value of muscle area and density in 90 women who were diagnosed with breast cancer with bone metastases between September 2005 and June 2018. We measured psoas major muscle and paravertebral muscle area and density on single axial computed tomography images at the L3 level and subgrouped the patients into higher or lower groups for each muscle measurement, using median values as cutoffs. We evaluated associations between OS and muscle parameters, using a Cox proportional hazards model adjusted by age and prognostic score for bone metastases (modified Katagiri score). RESULTS: Median OS among patients with lower psoas major muscle density (25 months) was significantly shorter than in the higher psoas major muscle density group (61 months; hazard ratio: 1.79, 95% confidence interval: 1.01-3.16, P = 0.045). However, muscle area and paravertebral muscle density were not associated with OS in this setting. CONCLUSION: Lower psoas major muscle density was a predictor of poor prognosis in patients with breast cancer metastases to bone. The association between psoas major muscle density and prognosis allows wider research into interventions that can prevent loss of muscle density.

    DOI: 10.1093/jjco/hyab166

    PubMed

  • Examination of 4 cases diagnosed with COVID-19 infection by screening test

    KUBOTA Yutaka

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   65 ( 1 )   79 - 80   2022.01( ISSN:00089443 ( eISSN:13490885

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  • 臨床室 脊椎術後に発生した鉱質コルチコイド反応性低ナトリウム血症の1例

    木下 右貴, 玉井 孝司, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 中村 博亮

    整形外科   73 ( 1 )   28 - 31   2022.01( ISSN:00305901 ( eISSN:24329444

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  • Posterior surgery for degenerative lumbar disease with intervertebral disc wedges and lateral slippage

    KATO Minori

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   65 ( 1 )   97 - 98   2022.01( ISSN:00089443 ( eISSN:13490885

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  • What should be kept in mind to obtain high patient satisfaction in teleconsultation for orthopedic diseases?

    HAYASHI Kazunori

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   65 ( 1 )   1 - 4   2022.01( ISSN:00089443 ( eISSN:13490885

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  • An analysis of tumor-related skin temperature differences in malignant soft-tissue tumors.

    Akiyoshi Shimatani, Manabu Hoshi, Naoto Oebisu, Naoki Takada, Yoshitaka Ban, Hiroaki Nakamura

    International journal of clinical oncology   27 ( 1 )   234 - 243   2022.01( ISSN:1341-9625

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    BACKGROUND: Soft tissue tumors are often accompanied with elevated skin temperature; however, studies concerning the relationship between soft-tissue tumors and skin temperature elevation are scarce. We aimed to evaluate the clinical significance of skin temperature elevation in soft-tissue tumors and identify factors related to skin temperature elevation. PATIENTS AND METHODS: This study comprised 118 patients at our hospital with soft-tissue tumors, excluding lipomatous tumors, whose pathological diagnosis was surgically confirmed between February 2017 and March 2021. Sixty-one and 57 patients had been diagnosed with benign lesions and malignant tumors, respectively (men, 64; women, 54; median age, 61 [range, 20-92] years). The relationship between skin temperature, monitored using a thermography camera, and the presence of soft-tissue malignancy was investigated. We reviewed clinical data to identify factors related to elevated skin temperature. RESULTS: Temperature differences ≥ 0.2 °C compared to the unaffected side were significantly associated with the presence of malignant tumors (p < 0.001). Logistic regression analysis indicated that intertumoral blood supply was associated with elevated skin temperature (OR 3.22, 95% CI 2.03-5.13; p < 0.001). CONCLUSIONS: Elevated skin temperature, influenced by intertumoral blood supply, may be an important adjunct to physical findings when diagnosing malignant soft-tissue tumors. CLINICAL RELEVANCE: Intertumoral blood supply influenced elevated skin temperature in malignant soft-tissue tumors. A skin temperature difference ≥ 0.2 °C compared to the unaffected side can help differentiate between benign and malignant tumors. Skin temperature differences may help in diagnosing malignant soft-tissue tumors.

    DOI: 10.1007/s10147-021-02044-1

    PubMed

  • Ultrasound and biopsy findings in arthritis with familial Mediterranean fever.

    Yutaro Yamada, Kentaro Inui, Tadashi Okano, Koji Mandai, Ryuta Nishikomori, Hiroaki Nakamura, Daisuke Tsuruta

    Journal of medical ultrasonics (2001)   49 ( 1 )   115 - 116   2022.01( ISSN:1346-4523

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    DOI: 10.1007/s10396-021-01157-4

    PubMed

  • Silicone Implant Arthroplasty for Severe Bony Ankylosis of the Proximal Interphalangeal Joints in Rheumatoid Arthritis.

    Takuya Uemura, Takeshi Egi, Mitsuhiro Okada, Tadashi Okano, Sadahiko Konishi, Hiroaki Nakamura

    Orthopedics   45 ( 1 )   e53 - e56   2022.01( ISSN:0147-7447

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Arthrodesis and prosthetic arthroplasty have been used to treat severe proximal interphalangeal (PIP) joint arthritis. Silicone implant arthroplasty is an established treatment for rheumatoid arthritis (RA) of the fingers. However, few studies have reported the application of silicone implant arthroplasty for the treatment of severe ankylosis of the PIP joint in RA patients. The authors report, for the first time, the case of a 46-year-old woman who presented with severe bony ankylosis of the right fourth and fifth PIP joints at greater than 90° of flexion. Proximal interphalangeal silicone arthroplasty in combination with reconstruction of the extensor mechanism was successfully performed in the affected joints. Four years after surgery, active flexion of the fourth and fifth PIP joints was 55° and 75°, respectively, with an extensor lag of only 5° without pain and joint instability. Proper repair of the extensor mechanism with shortening of the central slips and mobilization of the lateral bands dorsally was most important in maintaining the extended position of the PIP joints. Proximal interphalangeal silicone arthroplasty with intensive reconstruction of the extensor mechanism could become a potential treatment option to maintain joint mobility even in severe ankylosis of the PIP joints in RA patients. [Orthopedics. 2022;45(1):e53-e56.].

    DOI: 10.3928/01477447-20211101-02

    PubMed

  • Incidence of and risk factors for spondylolisthesis, scoliosis, and vertebral fracture in rheumatoid arthritis.

    Yamada K, Suzuki A, Takahashi S, Inui K, Koike T, Okano T, Yabu A, Hori Y, Toyoda H, Nakamura H

    Journal of bone and mineral metabolism   40 ( 1 )   120 - 131   2022.01( ISSN:0914-8779

  • Prognostic value of psoas major muscle density in patients with breast cancer metastases to bone: a retrospective single-center cohort study(和訳中)

    Yao Hana, Dohzono Sho, Sasaoka Ryuichi, Takamatsu Kiyohito, Nakamura Hiroaki

    Japanese Journal of Clinical Oncology   52 ( 1 )   8 - 13   2022.01( ISSN:0368-2811

  • Nerve capping technique with nerve conduit for treating painful digital neuroma: A case report(和訳中)

    Uemura Takuya, Onode Ema, Yokoi Takuya, Shintani Kosuke, Okada Mitsuhiro, Takamatsu Kiyohito, Konishi Sadahiko, Nakamura Hiroaki

    Journal of Orthopaedic Science   27 ( 1 )   284 - 287   2022.01( ISSN:0949-2658

  • Medial peg position of cementless porous tantalum tibial component affects bone mineral density around the prosthesis after total knee arthroplasty: 2-year follow-up study.

    Yukihide Minoda, Mitsuhiko Ikebuchi, Akio Kobayashi, Ryo Sugama, Yoichi Ohta, Susumu Takemura, Nobuo Yamamoto, Hiroaki Nakamura

    The Knee   34   55 - 61   2022.01( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Use of a porous tantalum tibial component for total knee arthroplasty (TKA) was reported to have beneficial effects on periprosthetic bone mineral density (BMD). In some cases, hexagonal peg is placed close to or in contact with the tibial cortex, which may result in stress-shielding around the peg. However, no studies have analyzed the relationship between peg position and BMD. The aim of this study was to compare the peg position and BMD around the peg in a porous tantalum tibial component after TKA. METHODS: Twenty-seven patients (27 knees) who underwent primary TKA with a cementless porous tantalum tibial component were investigated. BMD was measured by dual-energy X-ray absorptiometry for 2 years after the operation. The distance between the peg and the tibial cortex (peg distance) was measured on the medial and lateral sides. RESULTS: BMD was decreased in the medial region after the operation (p < 0.01). Relative change in BMD was lower in the medial region than in the central and lateral regions (p < 0.01). Multiple regression analysis showed that medial peg distance was negatively correlated with relative change of BMD in the medial part of the tibia (p = 0.04, R = 0.402). CONCLUSIONS: The medial peg position affected the postoperative relative change of BMD in the medial part of the tibia, but did not affect the longevity of the implant. As the tibial medial peg became closer to the medial tibial cortex, the BMD loss became larger in the medial part of the tibia at 2 years postoperatively.

    DOI: 10.1016/j.knee.2021.11.005

    PubMed

  • Incidence of and risk factors for spondylolisthesis, scoliosis, and vertebral fracture in rheumatoid arthritis(和訳中)

    Yamada Kentaro, Suzuki Akinobu, Takahashi Shinji, Inui Kentaro, Koike Tatsuya, Okano Tadashi, Yabu Akito, Hori Yusuke, Toyoda Hiromitsu, Nakamura Hiroaki

    Journal of Bone and Mineral Metabolism   40 ( 1 )   120 - 131   2022.01( ISSN:0914-8779

  • Improvements in Mental Well-Being and its Predictive Factors in Patients who Underwent Cervical versus Lumbar Decompression Surgery(和訳中)

    Tamai Koji, Suzuki Akinobu, Toyoda Hiromitsu, Terai Hidetomi, Hoshino Masatoshi, Takahashi Shinji, Hori Yusuke, Yabu Akito, Nakamura Hiroaki

    Spine Surgery and Related Research   6 ( 1 )   10 - 16   2022.01

  • Correction to: An analysis of tumor-related skin temperature differences in malignant soft-tissue tumors.

    Akiyoshi Shimatani, Manabu Hoshi, Naoto Oebisu, Naoki Takada, Yoshitaka Ban, Hiroaki Nakamura

    International journal of clinical oncology   27 ( 1 )   244 - 244   2022.01( ISSN:1341-9625

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    International / domestic magazine:Domestic journal  

    DOI: 10.1007/s10147-021-02055-y

    PubMed

  • 入院前スクリーニング検査にてCOVID-19感染症と診断された4例の検討

    窪田 穣, 林 和憲, 坂和 明, 榎原 恒之, 田中 亨, 中村 博亮

    中部日本整形外科災害外科学会雑誌   65 ( 1 )   79 - 80   2022.01( ISSN:0008-9443

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    当院の入院前スクリーニング検査でCOVID-19感染症と診断された4例(77歳男性、75歳女性、69歳女性、76歳女性)について検討した。その結果、炎症性疾患であった1例は発熱・高炎症反応を呈していたが、その他の症例はスクリーニング検査時に咳嗽や発熱などの臨床症状を認めず、炎症反応も正常値であった。4例における入院時スクリーニング検査陽性からPCR陰性化までの期間は平均4.25日であった。いずれの症例も特別な治療は行わず、経過観察のみで退院・一般病床への転棟となった。

  • 臨床室 脊椎術後に発生した鉱質コルチコイド反応性低ナトリウム血症の1例

    木下 右貴, 玉井 孝司, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 中村 博亮

    整形外科   73 ( 1 )   28 - 31   2022.01( ISSN:0030-5901

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    症例は77歳女性で、両下肢痛、両下肢しびれ、腰痛を主訴とした。腰部脊椎管狭窄症の診断でL4/L5前側方進入椎体間固定術を施行した。術後3日に低Na血症(129mEq/l)を認め、食塩経口負荷で一旦改善傾向を認めたが、術後12日のリハビリテーション後よりNa 116mEq/lの重篤な低Na血症を認めた。アンジオテンシンII受容体拮抗薬系降圧薬とNSAIDsを定期内服し、初回の腰椎後方除圧術後にも低Na血症で入院加療した既往が判明し、鉱質コルチコイド反応性低Na血症の可能性を考えた。イルベサルタン・アムロジピンベシル酸塩配合、セレコキシブの内服を中止し、1.7%生理食塩水投与を開始した。翌日にNa 124mEq/lまで改善したため1.2%生理食塩水投与に変更し、術後17日より食塩経口負荷を、術後19日よりフルドロコルチゾン酢酸エステル投与を開始した。術後22日にNa 133mEq/lで自宅退院し、退院後4ヵ月でフルドロコルチゾン酢酸エステルを終了した。

  • 骨粗鬆症性椎体骨折に対するBalloon Kyphoplastyと保存治療の医療費の比較 介護費とインフォーマルケア費の検討

    高橋 真治, 寺井 秀富, 星野 雅俊, 中村 博亮

    Journal of Spine Research   13 ( 1 )   57 - 64   2022.01( ISSN:1884-7137

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    はじめに:骨粗鬆症性椎体骨折(OVF)は高齢者の多くが罹患する骨折であり介護費用に与える影響が懸念される.一方でBalloon kyphoplasty(BKP)はOVFに対して広く行われている治療の一つである.本研究目的は過去の報告をもとに介護費用及び介護者の生産性損失を含めた保存治療およびBKPの費用を推計することである.対象と方法:OVF後のADL分布は,新規にOVFを発症した受傷後2ヵ月以内の65歳以上の者を対象としてBKPあるいは保存治療を実施した6ヵ月間の多施設前向き研究のデータを使用した.介護費用の推計やインフォーマルケア費用の推計について,主に厚生労働省が公表しているデータを基に推計した.結果:介護費用は,治療実施6ヵ月後時点のADL分布と要介護度と日常生活自立度の分布を基に算出した.治療実施6ヵ月後時点の要介護度別の1人あたり介護費は,BKP群39,497円/月,保存療法群58,298円/月,差分18,801円/月であった.インフォーマルケア費用の比較として,治療実施6ヵ月後時点の要介護度別の1人あたりインフォーマルケア費用は,BKP群で35,722円/月,保存療法群で44,102円/月,差分は8,380円/月であった.結語:BKPによるADLの改善が,介護費用および介護者の生産性損失を削減する可能性がある.(著者抄録)

  • 椎間楔状化や側方すべりを有する椎間への腰椎手術の検討

    加藤 相勲, 並川 崇, 松村 昭, 星野 雅俊, 中村 博亮

    中部日本整形外科災害外科学会雑誌   65 ( 1 )   97 - 98   2022.01( ISSN:0008-9443

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    3mm以上の側方すべりまたは5°以上の椎間楔状化を伴う腰椎変性疾患110例を対象に、顕微鏡視下片側進入両側除圧術を施行した71例(除圧群:女性29例、男性42例、平均71.4歳)、腰椎後方椎体間固定術を施行した39例(固定群:女性24例、男性15例、平均73.4歳)に分け、臨床成績を比較検討した。その結果、術後2年のJOAスコア改善率は除圧群52.9%、固定群57.4%と、両群間で有意差を認めなかった。VASやSF-36の改善量も両群間で有意差を認めなかった。再手術例は除圧群7例、固定群0例と、除圧群で再手術例が有意に多かった。再手術の原因は、椎間孔部狭窄6例、椎間変性の増悪1例で、再手術例のJOAスコア改善率は平均24%と成績不良であった。

  • 整形外科疾患に対する電話等診療において高い患者診療満足度を得るためには何に留意すべきか

    林 和憲, 田中 亨, 坂和 明, 榎原 恒之, 田中 秀和, 中村 博亮

    中部日本整形外科災害外科学会雑誌   65 ( 1 )   1 - 4   2022.01( ISSN:0008-9443

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    1回以上の電話診療を施行した670例を対象に、患者の満足度に影響した因子について検討した。患者診療満足度の質問票項目に、「とても満足していた」と回答した347例(高満足度群:男性45.2%、平均71.8歳)と、それ以外の回答であった323例(中・低満足度群:男性47.7%、平均70.0歳)の2群に分け、2群間で副次検討項目につき単変量解析を行った。その結果、患者の診療満足度は4段階評価で満点を選択したものが52%であり、とくに70歳代・80歳代で満足度が高い例が多かった。多変量解析では、患者年齢、「訴えの伝達」、「運動指導」が患者満足度に影響する因子であることが明らかとなった。

  • 悪性軟部腫瘍における腫瘍に関連した皮膚温度差の解析(An analysis of tumor-related skin temperature differences in malignant soft-tissue tumors)

    Shimatani Akiyoshi, Hoshi Manabu, Oebisu Naoto, Takada Naoki, Ban Yoshitaka, Nakamura Hiroaki

    International Journal of Clinical Oncology   27 ( 1 )   234 - 243   2022.01( ISSN:1341-9625

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    サーモグラフィーを用いて、悪性軟部腫瘍における皮膚温上昇の臨床的意義とそれに関連する因子を後方視的に検討した。2017年2月から2021年3月までに手術で病理診断が確定した脂肪腫性腫瘍を除く軟部腫瘍患者118例(年齢20〜92歳)を対象とした。良性病変は61例、悪性腫瘍は57例であった。サーモグラフィーにより患側の腫瘍全体を含む領域と健側の患側と対称的な領域の皮膚温を測定した。良性病変患者の皮膚温差は平均0.03±0.26℃であったが、悪性腫瘍患者の皮膚温差は平均0.35±0.42℃であった。ROC曲線解析の結果、良性病変と悪性腫瘍の皮膚温差のカットオフ値は0.2℃、曲線下面積(AUC)は0.75、オッズ比(OR)は6.71(感度66.7%、特異度77.0%)であった。良性病変では61例中14例、悪性腫瘍では57例中38例で、患側の皮膚温が健側と比較して0.2℃以上高かった。0.2℃以上の皮膚温の差は、悪性腫瘍の存在と有意に関連していた(p<0.001)。さらに、ロジスティック回帰分析により、腫瘍間血液供給は皮膚温上昇と関連していた(OR 3.22、95%CI 2.03〜5.13、p<0.001)。以上より、悪性軟部腫瘍では腫瘍間血液供給が皮膚温上昇に影響を与えることが示された。

  • Usefulness of Preoperative Planning by Three-Dimensional Planning Software for Pedicle Screw Placement in Thoracolumbar Surgeries: Misplacement Rate and Associated Risk Factors.

    Tomonori Ozaki, Kentaro Yamada, Hiroaki Nakamura

    Spine surgery and related research   6 ( 3 )   279 - 287   2022

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    INTRODUCTION: A number of imaging technologies have been developed to reduce the risk of pedicle screw (PS) misplacement. For example, preoperative three-dimensional (3D) planning can reportedly enhance implant placement accuracy in some orthopedic surgeries. However, no study has investigated the effect of preoperative 3D planning on PS placement without intraoperative 3D navigation. Thus, in this study, we aim to examine the accuracy of PS placement and identify the risk factors for PS misplacement in thoracolumbar surgeries performed using preoperative 3D planning software with intraoperative fluoroscopic guidance in a retrospective study. METHODS: In total, 25 consecutive patients (197 PSs) underwent thoracic or lumbar spinal fusion surgeries using preoperative 3D planning with intraoperative fluoroscopic guidance. PS misplacement was graded based on the degree of perforation (Grade 0, no perforation; Grade 1, <2 mm; Grade 2, 2-4 mm; Grade 3, >4 mm) observed in postoperative computed tomography (CT). Deviations between planned and actual PSs were evaluated by matching preoperative and postoperative CT volume images for each vertebra. RESULTS: The overall PS misplacement rate was 6.6% (Grade 1: 4.0%, Grade 2: 1.5%, Grade 3: 1.0%). The median linear deviations of PS entry points between planned and actual locations were determined to be 3.3 mm and 3.3 mm for the horizontal and vertical axes, respectively. The median angular deviations of the PS axis were 6.2° and 4.5° for the transverse and sagittal planes, respectively. Multivariate analysis revealed that horizontal deviation of the PS entry point was the sole factor associated with Grade ≥1 PS misplacement (odds ratio=2.47, p<0.001). CONCLUSIONS: Preoperative 3D planning software without intraoperative 3D navigation was able to achieve a relatively low PS misplacement ratio among the reported ratio of conventional techniques without navigation. Surgeons should carefully ensure that the entry point is consistent with preoperative planning, especially in the mediolateral direction to avoid misplacement in this method.

    DOI: 10.22603/ssrr.2021-0185

    PubMed

  • Tumor-skin invasion is a reliable risk factor for poor prognosis in superficial soft tissue sarcomas.

    Tadashi Iwai, Manabu Hoshi, Naoto Oebisu, Naoki Takada, Yoshitaka Ban, Hiroaki Nakamura

    PloS one   17 ( 9 )   e0274077   2022

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: Superficial soft tissue sarcomas are often left untreated unless they invade the skin and skin ulcers manifest. Progressive sarcomas frequently result in dismal oncological outcomes despite multidisciplinary treatment. This study aimed to identify prognostic factors for superficial soft tissue sarcomas. MATERIALS AND METHODS: This study retrospectively analyzed the clinicopathological data of 82 patients with superficial soft tissue sarcomas treated between August 2003 and December 2020 at our institution. A superficial soft tissue sarcoma was defined if the percentage of the area occupied by the tumor in the assessed region (skin, subcutaneous) was more than 50%. Age, sex, location, tumor size, tumor-skin invasion, tumor grade, and distant metastasis at initial diagnosis were evaluated as potential prognostic factors. Cox proportional hazards regression models were used to identify the prognostic factors. Five-year survival rates were assessed by the Kaplan-Meier method. RESULTS: The mean follow-up time was 60.1 months. The 5-year overall survival, 5-year local recurrence-free survival, and 5-year metastasis survival rates were 76.4%, 60.6%, and 71.0%, respectively. Univariate analysis showed significant relationships between poor prognosis and tumor size ≥5 cm, distant metastasis at initial diagnosis, and tumor-skin invasion. In the multivariate analysis, only the tumor-skin invasion was associated with worse overall survival. CONCLUSIONS: Superficial soft tissue sarcomas have biologically been considered a separate category due to their better prognosis. In this study, the tumor-skin invasion was the only significant factor associated with a poor prognosis. Therefore, all superficial soft tissue sarcomas without tumor-skin invasion should be treated as early as possible.

    DOI: 10.1371/journal.pone.0274077

    PubMed

  • Nerve-End Capping Treatment with a Polyglycolic Acid Conduit for Rat Sciatic Neuroma: A Preliminary Report

    Onode E.

    Journal of Reconstructive Microsurgery   2022( ISSN:0743684X

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  • Life Expectancy is Poor in Patients with Diffuse Idiopathic Skeletal Hyperostosis-Related Pyogenic Vertebral Osteomyelitis

    Yamada Kentaro, Ieguchi Makoto, Takahashi Shinji, Nakamura Hiroaki

    Spine Surgery and Related Research   advpub ( 0 )   654 - 663   2022( eISSN:2432261X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    <p><b>Introduction:</b> Pyogenic vertebral osteomyelitis (PVO) is an uncommon but life-threatening infectious disease. Diffuse idiopathic skeletal hyperostosis (DISH) is an age-related disorder and sometimes problematic in terms of spinal instability or high mortality, especially in cases of DISH-related fracture. Meanwhile, no reports have focused on the impact of DISH on the clinical outcomes after treatment for PVO. We hypothesized that PVO occurring at DISH-related segments might contribute to poor clinical results or high mortality rates. The purpose of this study was to investigate the impact of DISH on mortality after treatment for PVO in a retrospective cohort study.</p><p><b>Methods:</b> This study involved patients who were hospitalized and treated for PVO at a single institution. DISH-related PVO was defined as PVO within a segment ossified by DISH or PVO at the neighboring intervertebral level of the segment ossified by DISH. Differences in mortality between patients with DISH-related and non-DISH-related PVO were investigated.</p><p><b>Results:</b> This study included 55 patients. DISH-related PVO was observed in 13 patients. The mortality rate was significantly higher in patients with DISH-related PVO than in those with non-DISH-related PVO (62% and 23%, respectively; p = 0.016). Propensity score-adjusted analysis showed that DISH-related PVO was an independent risk factor for mortality (adjusted hazard ratio, 2.79; p = 0.034). The survival probability was significantly shorter in patients with DISH-related PVO than in those with non-DISH-related PVO (p = 0.006). PVO in which the intravertebral body was the center of involvement was significantly more common in DISH-related PVO than in non-DISH-related PVO (38% and 5%, respectively; p = 0.006).</p><p><b>Conclusions:</b> DISH-related PVO was associated with a higher mortality rate and shorter life expectancy than non-DISH-related PVO. Similar to advanced age, PVO at the segment ossified by DISH should be recognized as a risk factor for mortality when choosing the optimal treatment strategy.</p>

    DOI: 10.22603/ssrr.2022-0021

    PubMed

  • Improvements in Mental Well-Being and its Predictive Factors in Patients who Underwent Cervical versus Lumbar Decompression Surgery

    Tamai Koji, Suzuki Akinobu, Toyoda Hiromitsu, Terai Hidetomi, Hoshino Masatoshi, Takahashi Shinji, Hori Yusuke, Yabu Akito, Nakamura Hiroaki

    Spine Surgery and Related Research   6 ( 1 )   10 - 16   2022( eISSN:2432261X

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    <p>Introduction: Mental well-being is essential for patient satisfaction. Therefore, a better understanding of the changes in the mental well-being of patients following spinal surgery can be useful to surgeons. We compared the 2-year postoperative change in the mental well-being of patients who underwent cervical and lumbar decompression surgery. Additionally, the predictive factors for improvement in mental well-being associated with both methods were evaluated.</p><p>Methods: The patients who underwent spinal decompression surgery and were followed >2 years postoperatively were enrolled (lumbar cohort: n=111, cervical cohort: n=121). The 36-item Short-Form Health Survey (SF-36) mental component summary (MCS) was set as the mental well-being parameter, and the minimal clinically important difference (MCID) was defined as 4.0. After adjusting the cervical and lumbar cohorts using propensity scores, the improvements in the MCS were compared between the groups using a mixed-effect model. To identify predictors for improvements, the correlation between the MCS changes and preoperative clinical scores was evaluated. Subsequently, multivariate linear regression was applied, which included variables with p<0.10 in the former analysis as explanatory variables, and the change of MCS as the objective variable.</p><p>Results: There were no significant differences in the MCS improvement between the adjusted cervical and lumbar cohorts; 47% and 49%, respectively, had MCS improvement score >MCIDs. However, predictors for the improvement were different between the two cohorts: SF-36 Social functioning in cervical surgery and lower back pain and SF-36 Role physical in lumbar surgery.</p><p>Conclusions: Although there was no significant difference in the improvement in the mental well-being between patients who underwent either cervical or lumbar decompression surgery, less than half of the patients in both groups achieved a meaningful improvement. Preoperative back pain and personal activity were independent predictors in the lumbar cohort, while social functioning was the only predictor in the cervical cohort.</p><p>Level of evidence: III</p>

    DOI: 10.22603/ssrr.2021-0060

    PubMed

    CiNii Article

  • リバース型人工肩関節置換術後感染に対して持続的局所抗菌薬灌流を施行した一例

    橋村 剛, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 中澤 克優, 飯尾 亮介, 山下 竜一, 岡田 彩夏, 松田 淑伸, 中村 博亮

    肩関節   46 ( 1 )   236 - 240   2022( ISSN:09104461 ( eISSN:18816363

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    リバース型人工肩関節置換術(RSA)後感染に対して持続的局所抗菌薬灌流(CLAP)を施行した1例を経験したので報告する.症例は87歳女性.6か月前に右肩化膿性関節炎を発症し,鏡視下デブリドマン施行.抗菌薬治療後にRSAを施行した.術後3週で創部に感染兆候出現し,各種検査所見よりRSA術後人工関節周囲感染と診断.洗浄,デブリドマン,インプラント交換及びCLAPを施行.術後1年で感染の再燃なく経過良好である.

    DOI: 10.11296/katakansetsu.46.236

  • Risk Factors for Low Back Pain Increase in Rheumatoid Arthritis: Analysis of a 7-year Follow-up Study.

    Yamada K, Suzuki A, Takahashi S, Inui K, Koike T, Okano T, Yabu A, Hori Y, Toyoda H, Nakamura H

    Modern rheumatology   32 ( 6 )   1027 - 1034   2021.12( ISSN:1439-7595

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  • 経験と考察 新型コロナウイルス感染症(COVID-19)流行による生活様式の変化に対して運動指導を希望する整形外科患者の特徴

    馬野 雅之, 寺井 秀富, 玉井 孝司, 勝田 紘史, 島田 永和, 中村 博亮

    整形外科   72 ( 13 )   1327 - 1332   2021.12( ISSN:00305901 ( eISSN:24329444

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  • Surgical excision of heterotopic ossification associated with anti-N-methyl-d-aspartate receptor encephalitis: A case report.

    Ken Iida, Yusuke Hashimoto, Shiro Okazaki, Yohei Nishida, Hiroaki Nakamura

    International journal of surgery case reports   89   106643 - 106643   2021.12( ISSN:22102612

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION AND IMPORTANCE: Heterotopic ossification (HO) associated with Anti-N-methyl-d-aspartate (anti-NMDA) receptor encephalitis is rare and the treatment strategy is unclear. CASE PRESENTATION: We report the case of a 31-year-old female diagnosed with anti-NMDA receptor encephalitis from Osaka General Medical Center, Osaka, JAPAN that developed heterotopic ossification of the knees during prolonged coma. She was unable to walk because of pain and limited range of motion in both knees. Thirty months after the onset of the coma, surgical excision of the heterotopic bone in both knees was performed. The range of motion of both the knees improved markedly and she had no recurrence of heterotopic ossification on a three-year follow-up. Thus, this case can be used as a guide for surgeons with such patients. CONCLUSIONS: We reported a case of heterotopic bone formation in the periarticular region of both bilateral knees in a patient who suffered a 2-month coma following anti-NMDA receptor encephalitis. Surgical excision of the heterotopic bones significantly improved the passive range of motion in both knees. Three years after the operation, the patient had no complaints about her knees, and there was no recurrence of HO.

    DOI: 10.1016/j.ijscr.2021.106643

    PubMed

  • HipAlign Supine/HipAlign New Lateralを用いたTHAは、正確なカップ設置角度で、短期成績も良好

    洲鎌 亮, 箕田 行秀, 大田 陽一, 竹村 進, 山本 展生, 中村 卓, 上山 秀樹, 伊東 祐紀, 金 裕学, 中村 博亮

    日本人工関節学会誌   51   21 - 22   2021.12( ISSN:1345-7608

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    OrthAlign社製HipAlignは、従来のナビゲーションで必要であった大きな装置を必要とせず、単回使用の手のひらサイズのデバイスを用いて、術前計画なしに、手術中に簡便に使用できるポータブルナビゲーションシステムであり、仰臥位THAで用いるHipAlign Supineと側臥位THAで用いるHipAlign New Lateralがある。今回、HipAlign Supineを使用した20関節とHipAlign New Lateralを使用した20関節の短期成績について調査した。評価項目は「カップ設置角度の絶対値誤差」「JOAスコア」「合併症(脱臼・感染)の有無」とした。調査の結果、カップ設置角度の絶対値誤差はHipAlign Supine使用群が外方開角2.7±2.5度、前方開角2.6±2.0度、HipAlign New Lateral使用群が外方開角5.1±3.8度、前方開角3.4±2.4度であった。両群ともJOAスコアは改善し、脱臼・感染例はなかった。

  • Arthroscopic Repair for Parrot Beak Tear of Lateral Meniscus with Reduction Suture and Inside-Out Technique.

    Yusuke Hashimoto, Junsei Takigami, Tomohiro Tomihara, Hamidullah Salimi, Hiroshi Katsuda, Nagakazu Shimada, Hiroaki Nakamura

    Arthroscopy techniques   10 ( 12 )   e2633 - e2637   2021.12( ISSN:2212-6287

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Parrot beak tear is a white-white meniscal injury that often occurs in isolated injuries. Partial meniscectomy for parrot beak tears is often recommended, owing to the avascular zone; however, partial meniscectomy, especially with the lateral meniscus, has a high failure rate for return to sports, leading to residual meniscus extrusion and lateral compartment osteoarthritis. Thus, we have developed a repair technique to preserve the parrot beak tear of the avascular zone. This is a modification of the inside-out repair with additional reduction sutures. We recommend this procedure as a technique for repairing avascular parrot beak tears of the lateral meniscus.

    DOI: 10.1016/j.eats.2021.08.005

    PubMed

  • An Analysis of Compensatory Trunk Movements in Shoulder Joint Movements: Application to Healthy Individuals and Patients after Shoulder Joint Surgery(和訳中)

    Nakatsuchi Tamotsu, Ikebuchi Mitsuhiko, Nishinohara Takahiro, Nakajima Shigeyoshi, Nakamura Hiroaki

    Osaka City Medical Journal   67 ( 2 )   81 - 90   2021.12( ISSN:0030-6096

  • 経験と考察 新型コロナウイルス感染症(COVID-19)流行による生活様式の変化に対して運動指導を希望する整形外科患者の特徴

    馬野 雅之, 寺井 秀富, 玉井 孝司, 勝田 紘史, 島田 永和, 中村 博亮

    整形外科   72 ( 13 )   1327 - 1332   2021.12( ISSN:0030-5901

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    2020年11〜12月に大阪府内で行われた大規模アンケート調査から、COVID-19流行以後の生活様式の変化に対して運動指導を希望する整形外科患者の特徴について分析した。その結果、運動指導の希望がある患者は高齢、女性、膝関節疾患や股関節疾患、外出頻度が低下した患者、運動頻度が低下した患者、運動頻度が増加した患者で有意に多かった。また、運動指導の希望がない患者でも運動習慣の低下が約1/3、ADLの増悪が約1割の患者に存在することが明らかになった。

  • 特集 末梢神経の再建2021 人工神経の展望-iPS細胞を付加した人工神経の研究開発

    上村 卓也, 高松 聖仁, 中村 博亮

    臨床整形外科   56 ( 11 )   1343 - 1348   2021.11( ISSN:05570433 ( eISSN:18821286

  • Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression.

    Hidetomi Terai, Koji Tamai, Masayoshi Iwamae, Kunikazu Kaneda, Hiroshi Katsuda, Nagakazu Shimada, Hiroaki Nakamura

    Medicina (Kaunas, Lithuania)   57 ( 11 )   2021.11( ISSN:1010-660X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Background and Objectives: Although percutaneous laser disc decompression (PLDD) is one of the common treatment methods for patients with lumbar disc herniation (LDH), the recurrence of LDH after PLDD is estimated at 4-5%. This study compares the preoperative clinical data and clinical outcomes of patients who underwent primary microendoscopic discectomy (MED) or MED following PLDD. Materials and Methods: We retrospectively analyzed 2678 patients who underwent MED for LDH. The PLDD group included patients with previous PLDD history at the same level of LDH, and a matched control group was created using propensity score matching for age, sex, and body mass index. Preoperative data, preoperative radiographic findings, and surgical data of the groups were compared. To compare postoperative changes in clinical scores between the groups, a mixed-effect model was used. Results: As a result, 42 patients (1.6%) had previously undergone PLDD, and a control group with 42 patients were created. The disc degeneration severity was not significantly different between the groups. However, Modic changes were more frequent in the PLDD group than in the matched control group (p = 0.028). There were no significant differences in dural adhesion rate or surgery-related complications including dural injury, length of stay, and recurrence rate of LDH after surgery. In addition, the improvement of clinical scores did not significantly differ between the two groups (p = 0.112, 0.913, respectively). Conclusions: We concluded that patients with recurrent LDH after PLDD have advanced endplate degeneration, which may reflect endplate injury from a previous PLDD. However, a previous history of PLDD does not have a negative impact on the clinical result of MED.

    DOI: 10.3390/medicina57111225

    PubMed

  • Differences in the setting of acetabular component alignment guides between the supine and lateral positions for total hip arthroplasty.

    Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Susumu Takemura, Nobuo Yamamoto, Tamotsu Nakatsuchi, Hiroaki Nakamura

    Scientific reports   11 ( 1 )   21978 - 21978   2021.11

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    The acetabular component orientation in total hip arthroplasty is of critical importance to clinical results. Although navigation systems and surgical robots have been introduced, most surgeons still use acetabular component alignment guides. This study aimed to compare the accuracy between modern acetabular component alignment guides for the lateral position and those for the supine position. Thirteen alignment guides for the lateral position and 10 for the supine position were investigated. All the lateral position alignment guides indicated cup alignment in operative definition, and the supine position alignment guides indicated cup alignment in radiographic definition. For lateral position alignment guides, the anteversion actually indicated by the alignment guide itself was smaller than that indicated by the manufacturer by a mean of 6° (maximum, 9°), and the inclination actually indicated by alignment guides themselves was larger than that by the manufacturer (p < 0.01) by a mean of 2° (maximum, 4°). For supine position alignment guides, the inclination and anteversion indicated by the alignment guide itself were identical with those indicated by the manufacturer. The current study showed that the angles actually indicated and those stated by manufacturers were not identical for lateral position alignment guides.

    DOI: 10.1038/s41598-021-01420-1

    PubMed

  • Heated Tobacco Products Impair Cell Viability, Osteoblastic Differentiation, and Bone Fracture-Healing.

    Kazuya Nishino, Koji Tamai, Kumi Orita, Yusuke Hashimoto, Hiroaki Nakamura

    The Journal of bone and joint surgery. American volume   103 ( 21 )   2024 - 2031   2021.11( ISSN:0021-9355

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: The negative impact of cigarette smoking on bone union has been well documented. However, the impact of heated tobacco product (HTP) use on bone fracture-healing remains unclear. The present study investigated the effect of HTPs on preosteoblast viability, osteoblastic differentiation, and fracture-healing and compared the effects with those of conventional combustible cigarettes. METHODS: Cigarette smoke extracts (CSEs) were generated from combustible cigarettes (cCSE) and HTPs (hCSE). CSE concentrations were standardized by assessing optical density. Preosteoblast (MC3T3-E1) cells were incubated with normal medium, cCSE, or hCSE. The cell viability was assessed via MTT assay. After osteoblastic differentiation of CSE-exposed cells, alkaline phosphatase (ALP) activity was assessed. To assess the in vivo effects of CSEs, a femoral midshaft osteotomy was performed in a rat model; thereafter, saline solution, cCSE, or hCSE was injected intraperitoneally, and bone union was assessed on the basis of micro-computed tomography (μCT) and biomechanical analysis 4 weeks later. RESULTS: MC3T3-E1 cell viability was reduced in a time and concentration-dependent manner when treated with either cCSE or hCSE. ALP activity after osteoblastic differentiation of cCSE-treated cells was significantly lower than that of both untreated and hCSE-treated cells (mean and standard deviation, 452.4 ± 48.8 [untreated], 326.2 ± 26.2 [cCSE-treated], and 389.9 ± 26.6 [hCSE-treated] mol/L/min; p = 0.002). Moreover, the levels of osteoblastic differentiation in untreated and hCSE-treated cells differed significantly (p < 0.05). In vivo assessment of the femoral midshaft cortical region revealed that both cCSE and hCSE administration significantly decreased bone mineral content 4 weeks after surgery compared with levels observed in untreated animals (107.0 ± 11.9 [untreated], 94.5 ± 13.0 [cCSE-treated], and 89.0 ± 10.1 mg/cm3 [hCSE-treated]; p = 0.049). Additionally, cCSE and hCSE-exposed femora had significantly lower bone volumes than unexposed femora. Biomechanical analyses showed that both cCSE and hCSE administration significantly decreased femoral maximum load and elastic modulus (p = 0.015 and 0.019). CONCLUSIONS: HTP use impairs cell viability, osteoblastic differentiation, and bone fracture-healing at levels comparable with those associated with combustible cigarette use. CLINICAL RELEVANCE: HTP use negatively affects bone fracture-healing to a degree similar to that of combustible cigarettes. Orthopaedic surgeons should recommend HTP smoking cessation to improve bone union.

    DOI: 10.2106/JBJS.20.02227

    PubMed

  • High production of egc2-related staphylococcal enterotoxins caused a food poisoning outbreak.

    Umeda K, Ono HK, Wada T, Motooka D, Nakamura S, Nakamura H, Hu DL

    International journal of food microbiology   357   109366   2021.11( ISSN:0168-1605

  • Arthroscopic Saucerization With Inside-Out Repair and Anterocentral Shift of a Discoid Lateral Meniscus With Retention of Adequate Volume of Residual Meniscus.

    Yusuke Hashimoto, Shinya Yamasaki, John B Reid 3rd, Dan Guttmann, Kazuya Nishino, Hiroaki Nakamura

    Arthroscopy techniques   10 ( 11 )   e2553 - e2557   2021.11( ISSN:2212-6287

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    ABSTRACT: Preservation of the meniscus has been shown to influence the progression of osteoarthritic changes in the knee. Discoid lateral meniscus (DLM) is classified on the basis of the presence and location of instability resulting from deficient capsular attachments. Recently, meniscal stabilization after saucerization was recommended in cases of DLM to preserve the meniscus shape and avoid the progression of osteoarthritis. However, it is difficult to identify the accurate resection volume and residual meniscal width during surgery, especially when there is an anterocentral shift of the DLM. This Technical Note describes an arthroscopic technique for an anterocentral shift of the DLM in which we highlight the resection point and confirm the methods of retaining an adequate volume of residual meniscus to restore and maintain the shape and function of the meniscus. LEVEL OF EVIDENCE: Level 1, Knee; Level 2, Meniscus.

    DOI: 10.1016/j.eats.2021.07.039

    PubMed

  • Serum cartilage oligomeric matrix protein is correlated with quantitative magnetic resonance imaging and arthroscopic cartilage findings in anterior cruciate ligament deficient knees without osteoarthritic changes.

    Yohei Nishida, Yusuke Hashimoto, Kumi Orita, Kazuya Nishino, Takuya Kinoshita, Hiroaki Nakamura

    Clinical rheumatology   40 ( 11 )   4629 - 4638   2021.11( ISSN:0770-3198

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION/OBJECTIVES: To investigate the association between serum biomarker [cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase-3 (MMP-3)] levels and clinical, magnetic resonance imaging (MRI), and arthroscopic findings in anterior cruciate ligament (ACL)-deficient knees without osteoarthritic changes on radiographs. METHOD: Patients with ACL injury of Kellgren-Lawrence grade 0 or 1 were enrolled. Serum COMP and MMP-3 levels were measured preoperatively. Correlations of serum biomarker levels with age, body mass index (BMI), duration from time of injury, Tegner activity scale (TAS) score, Lysholm knee score, International Knee Documentation Committee score, KT-1000 arthrometer measurements, whole-organ MRI score (WORMS), MRI T2 relaxation time, and arthroscopic International Cartilage Research Society (ICRS) grade were assessed by calculating Spearman correlation coefficients. Associations between intraoperative findings (cartilage, meniscus) and serum biomarker levels were determined using the Mann-Whitney U test. Multiple regression analysis was performed to investigate the correlations between serum biomarker levels and MRI and arthroscopic findings. RESULTS: Ninety-eight patients with a mean age of 23.7 years were enrolled. Higher serum COMP level was correlated with older age and higher BMI, TAS score, serum MMP-3 level, WORMS, and T2 relaxation times (medial femur, medial tibia). Multivariate analysis showed that the serum COMP level was independently associated with WORMS and ICRS grade. CONCLUSIONS: The serum COMP level was correlated with age, BMI, TAS score, and MMP-3 level in ACL-deficient knees and was independently correlated with WORMS and ICRS grade. Thus, the serum COMP level can help detect cartilage degeneration even in patients without radiographic osteoarthritic changes. Key Points • Serum COMP correlated with WORMS and ICRS grade in ACL deficient knee. • The serum COMP level could help in detecting cartilage degeneration, even in patients with no radiographic osteoarthritic changes.

    DOI: 10.1007/s10067-021-05800-w

    PubMed

  • COVID-19パンデミックによる外出頻度の減少が脊椎疾患患者に及ぼす負の影響(Reductions in the Frequency of Going Out Due to the COVID-19 Pandemic Negatively Affect Patients with Spinal Disorders)

    Terai Hidetomi, Iwamae Masayoshi, Tamai Koji, Takahashi Shinji, Hori Yusuke, Ohyama Shoichiro, Yabu Akito, Hoshino Masatoshi, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 6 )   365 - 374   2021.11

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    COVID-19パンデミックに伴う外出頻度の減少が脊椎疾患患者に及ぼす影響を検討した。脊椎クリニックを受診する脊椎疾患患者855例を対象に多施設共同横断質問紙調査研究を実施した。外出頻度減少群160例と非減少群695例に分類し、運動習慣、ロコモティブシンドローム(LS)の有病率および健康関連QOL(HRQOL)をパンデミックの前後に評価した。その結果、HRQOLに関してEQ-5D-5Lスコアは外出減少群の方が非減少群より有意に低下していた。多変量ロジスティック回帰分析では、COVID-19パンデミック後に外出頻度が減少した患者においてパンデミック前と比較して、運動習慣の減少、LSの発症率増加、HRQOLの悪化が認められた。また、外出頻度の減少がみられた160例を軽度減少群116例と高度減少群44例に分けてサブ解析を実施したところ、脊椎疾患の重症度、運動習慣、LSの有病率およびHRQOLに関して有意な群間差はなかった。COVID-19パンデミックに伴う外出制限によって、脊椎疾患患者において運動習慣の有意な減少、LSの発症率増加、HRQOLの悪化が生じていた。

  • セメント強化椎弓根スクリュー留置後に生じた右房への大量セメントリークに対する経皮的血管内回収術(Percutaneous Endovascular Retrieval of Large Cement Leakage into the Right Atrium Following Cement-Augmented Pedicle Screw Instrumentation)

    Takahashi Shinji, Sohgawa Etsuji, Suzuki Akinobu, Yamamoto Akira, Sasaki Ryo, Tanaka Katsuaki, Terai Hidetomi, Hoshino Masatoshi, Toyoda Hiromitsu, Tamai Koji, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 6 )   446 - 449   2021.11

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    症例は78歳女性で、T12の骨粗鬆症性椎体骨折に対して椎体切除術が施行され、椎弓根スクリューのゆるみが生じる可能性が考えられたため、セメント注入型椎弓根スクリュー留置術を行うこととした。T10、T11、L1、L2にスクリューを挿入後、T10スクリュー内に骨セメントを注入し、数分後にL2スクリューにもセメント注入を行った。しかし、この時点でL2椎弓根スクリューから静脈への骨セメント漏出が認められ、セメントは徐々に頭側に移動して心臓レベルまで達したため手術を中止した。血圧、心拍数、心電図所見には変化はみられず、セメント周囲の血栓形成予防目的にヘパリンを投与し、肺動脈塞栓術を施行した。経食道心エコー検査では遊走したセメントは右房に流入して心房中隔に達していた。カテーテルを用いたセメント除去を計画し、超音波ガイド下に右大腿静脈を介して下大静脈に16Fシースを進め、回収カテーテルを右房まで到達させた。トリプルループスネアを用いて遊走セメントを捕捉することができ、長さ6.5cmで針状の外観を呈していた。術後の造影CTでは肺塞栓症や心穿孔は認められず、背部痛の改善が得られた。

  • 腰椎に進展するびまん性特発性骨増殖症患者の腰椎狭窄症に対する除圧術後の同レベルでの再手術のリスク因子(Risk Factors for Reoperation at Same Level after Decompression Surgery for Lumbar Spinal Stenosis in Patients with Diffuse Idiopathic Skeletal Hyperostosis Extended to the Lumbar Segments)

    Yamada Kentaro, Abe Yuichiro, Yanagibashi Yasushi, Hyakumachi Takahiko, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 6 )   381 - 389   2021.11

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    びまん性特発性骨増殖症(DISH)患者の腰椎狭窄症(LSS)に対する除圧術後の再手術の長期リスク因子を検討した。LSSに対して除圧術が施行された1150例のうち、術前の画像で腰椎への進展が認められた57例(男性48例、女性9例、平均69.5±6.4歳)を対象にサーベイ研究を実施し、初回手術と同レベルでの再手術に関わるリスク因子を評価した。その結果、初回手術と同レベルの再手術が施行されたのは10例(17.5%)であり、再手術までの期間は平均24.4±21.3ヵ月であった。再手術施行群と非施行群との比較では、DISHによる骨化セグメント数、腰痛骨化スコアに有意差は認められず、多変量解析でも有意なリスク因子は抽出されなかった。一方、減圧レベルでの差をみると、矢状回転角10°以上を示すのは再手術施行群の方が非施行群より有意に多く、CT上の椎間関節開大も再手術施行群に多く検出された。除圧レベル〜DISH下端部の距離と再手術との間に有意な関連はなく、Cox比例ハザード回帰分析では再手術の独立リスク因子として矢状回転角10°以上と椎間関節開大の2つが示された。

  • Prevalence of Restless Legs Syndrome and its Symptoms among Patients with Spinal Disorders.

    Terai H, Toyoda H, Hoshino M, Suzuki A, Takahashi S, Tamai K, Ohyama S, Yabu A, Nakamura H

    Journal of clinical medicine   10 ( 21 )   2021.10( ISSN:2077-0383

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  • 骨・軟部腫瘍のマネジメント(その2) Ⅲ.良性骨腫瘍・腫瘍類似疾患の治療 2)単純性骨嚢腫 単純性骨嚢腫の病因

    星 学, 大戎 直人, 岩井 正, 家口 尚, 高見 勝次, 中村 博亮

    別冊整形外科   1 ( 80 )   45 - 49   2021.10( ISSN:02871645

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  • 骨・軟部腫瘍のマネジメント(その2) Ⅴ.再建法,その他 4)その他 ナビゲーション支援下骨・軟部腫瘍手術

    家口 尚, 星 学, 大戎 直人, 伴 祥高, 高松 聖仁, 中村 博亮

    別冊整形外科   1 ( 80 )   130 - 134   2021.10( ISSN:02871645

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  • 骨・軟部腫瘍のマネジメント(その2) Ⅲ.良性骨腫瘍・腫瘍類似疾患の治療 3)類骨骨腫 類骨骨腫のマネジメント

    大戎 直人, 星 学, 岩井 正, 嶋谷 彰芳, 伴 祥高, 中村 博亮

    別冊整形外科   1 ( 80 )   63 - 66   2021.10( ISSN:02871645

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  • Relationship between facet joint opening on CT and facet joint effusion on MRI in patients with lumbar spinal stenosis: analysis of a less invasive decompression procedure.

    Yamada K, Toyoda H, Takahashi S, Tamai K, Suzuki A, Hoshino M, Terai H, Nakamura H

    Journal of neurosurgery. Spine   36 ( 3 )   1 - 9   2021.10( ISSN:1547-5654

  • Accuracy of pedicle screw implantation using 3D preoperative planning software

    Ozaki Tomonori, Yamada Kentaro, Nakamura Hiroaki

    Journal of Spine Research   12 ( 10 )   1246 - 1250   2021.10( ISSN:18847137 ( eISSN:24351563

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    <p><b>Introduction: </b>In spinal fusion surgery, deviation of the pedicle screw (PS) causes complications such as nerve and vascular injury and pedicle fracture. In this study, we investigated the accuracy of PS placement in thoracolumbar fusion using 3D preoperative planning software.</p><p><b>Methods: </b>Thirty-three patients (263 screws) who underwent a thoracolumbar fusion with PS from April 2019 to March 2020 were included in the study. The accuracy of PS insertion was evaluated by postoperative CT. The difference in the deviation rate according to the implantation method (percutaneous or open) and the surgeon (A; more than 10 years of experience in spine surgery, B; less than 5 years of experience in spine surgery, C; general orthopedic surgeon) was also examined.</p><p><b>Results: </b>A total of 12 PS deviations (4.6%) were observed, and no nerve or vascular injuries were observed. There was no significant difference in the deviation rate between percutaneous and open techniques when grade 1 or higher was defined as the deviation group (percutaneous 5.0% (6/119), open 4.2% (6/144). p=0.73). There was also no difference between surgeons (A 4.5% (7/157), B 4.3% (3/69), C 5.4% (2/37), p=0.96).</p><p><b>Conclusions: </b>Preoperative planning with 3D software can help to reduce the deviation rate in PS insertion.</p>

    DOI: 10.34371/jspineres.2021-1005

    CiNii Article

  • Three cases of thoracolumbar vertebral fracture with diffuse idiopathic skeletal hyperostosis stabilized using penetrating endplate screw technique -Discussion of the indication from case with poor outcomes-

    Yamada Kentaro, Ozaki Tomonori, Nakamura Hiroaki

    Journal of Spine Research   12 ( 10 )   1257 - 1263   2021.10( ISSN:18847137 ( eISSN:24351563

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    <p><b>Introduction: </b>Surgical treatment of thoracolumbar vertebral fractures with diffuse idiopathic skeletal hyperostosis (DISH) needs longer fixation than fractures without DISH, because the segments without ossification by DISH are exposed to higher mechanical stress due to a longer lever arm in the spinal column. Recently, the usefulness of penetrating endplate screw (PES) for patients with DISH have been reported in several reports. We have performed 3 cases using the PES technique for thoracolumbar vertebral fracture with DISH. The purpose of this report was to report the result of the surgery and discuss the indication of the PES technique.</p><p><b>Case report: </b>One case was fracture with acute phase and two cases were fractures with sub-acute phase. PES technique was used at the ossified segment by DISH and conventional pedicle screw technique was used non-ossified segment. Balloon kyphoplasty was used for fractures with sub-acute phase. The two cases showed good outcomes both in the clinical and radiological assessment. However, one case (T12 vertebral fracture with T8-12 DISH) showed screw loosening at the most caudal screw 1week after the surgery. Screw loosening was getting worse, and revision surgery of implant removal was performed 6 months after the index surgery.</p><p><b>Conclusions: </b>Screws with the PES technique have reportedly 1.4-fold pull-out strength compared with conventional pedicle screws. The poor outcome case in this study was set screws with PES technique in cranial 2 vertebrae and conventional pedicle screw in caudal two vertebrae, therefore, the reason of poor outcomes might arise from the difference of the screw fixation strength between cranial and caudal. PES technique is useful for fixation to the DISH segment. However, additional maneuver considering fixation strength of screws with the PES technique is necessary for fixation at non-ossified vertebra in case of the end fracture of ossification by DISH.</p>

    DOI: 10.34371/jspineres.2021-1007

    CiNii Article

  • Evaluation of regenerated cartilage using T2 mapping methods after opening-wedge high tibial osteotomy with microfracture at the cartilage defect: a preliminary study.

    Ken Iida, Yusuke Hashimoto, Yohei Nishida, Shinya Yamasaki, Hiroaki Nakamura

    Journal of experimental orthopaedics   8 ( 1 )   91 - 91   2021.10( ISSN:2197-1153

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: This study evaluated the regenerated cartilage after opening-wedge high tibial osteotomy (OWHTO) with concomitant microfracture by second-look arthroscopy, Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score and magnetic resonance imaging (MRI) T2 mapping. It was hypothesised that cartilage regeneration can be achieved by HTO, but the quality of regenerated cartilage is not normal cartilage. METHODS: OWHTO was performed in eight knees of seven patients (mean age, 57.6 ± 5.2 years). Microfracture for the cartilage defect was performed followed by OWHTO, and second-look arthroscopy was performed at the time of plate removal (14.1 ± 4.5 months after OWHTO). MRI was assessed at three months and one year after surgery. The status of articular cartilage regeneration was assessed by the ICRS grade, MOCART score and T2 value. RESULTS: The number of subjects in ICRS grade 1/2/3/4 changed significantly from 0/0/4/4 preoperatively to 0/2/6/0 postoperatively in the medial femoral condyle (MFC) (P < 0.05) and 0/0/0/8 preoperatively to 0/0/7/1 postoperatively in the medial tibial plateau (MTP) (P < 0.05). Mean MOCART scores for MFC and MTP at one year after surgery exhibited significant increases compared with the results at three months after surgery. Mean T2 values for MFC and MTP did not differ at three months and one year after surgery. CONCLUSION: The appearance and morphological evaluation by ICRS grade and MOCART score of regenerated cartilage were improved after OWHTO with concomitant microfracture. However, there were no significant qualitative differences in T2 values. This suggests that the regenerated cartilage tissue was likely to be insufficient cartilage. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

    DOI: 10.1186/s40634-021-00413-3

    PubMed

  • Pathological fracture of a solitary bone cyst in the calcaneus: a case series and literature review.

    Manabu Hoshi, Tadashi Iwai, Naoto Oebisu, Akiyoshi Shimatani, Naoki Takada, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   143 ( 3 )   1155 - 1162   2021.10( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: Solitary bone cysts in the calcaneus (calcaneal bone cysts) are often asymptomatic. Pathological fractures are rare, and few reports are available concerning its risk assessment. Therefore, the indication for operative interventions remains debatable, and further discussion on the treatment of symptomatic cysts and pathological fractures in calcaneal bone cysts is necessary. MATERIALS AND METHODS: Clinical data of 21 patients with calcaneal bone cysts (16 men and five women) was retrospectively reviewed. The average age was 13.3 (range, 7-23) years. Clinical data, such as concerning symptoms, radiological findings, pathological findings and outcomes, were investigated, and the pathogenesis of symptomatic cysts was studied. RESULTS: Thirteen cysts were symptomatic, and eight were incidentally discovered. Computed tomography revealed no fracture in 12 cases, microfracture in eight and complete fracture in one. The areas under the curves of the receiver operating characteristic curves calculated to establish an association between cyst size and symptoms and cyst size and pathological fractures (microfracture and complete fracture) were 0.78 and 0.71, respectively. Symptomatic cysts and pathological fractures were associated with the cyst ratio (cyst size/calcaneus ≥ 0.20). On magnetic resonance imaging (MRI), fluid levels were observed in 11 of 21 (52%) patients. At the time of surgery, blood from the haemorrhage was aspirated from 15 of 21 (71%) cysts. CONCLUSIONS: Orthopaedic surgeons should be aware that the cyst ratio is associated with clinical symptoms and pathological fractures. MRI and gross findings revealed haemorrhage in the cystic fluid. In calcaneal bone cysts, repeated microfractures and spontaneous healing might occur.

    DOI: 10.1007/s00402-021-04202-6

    PubMed

  • Delayed aortic injury after thoracic corrective osteotomy: a case report.

    Masuda S, Suzuki A, Takahashi S, Tamai K, Nakamura H

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   31 ( 12 )   3703 - 3707   2021.10( ISSN:0940-6719

  • 【骨・軟部腫瘍のマネジメント(その2)】再建法,その他 その他 ナビゲーション支援下骨・軟部腫瘍手術

    家口 尚, 星 学, 大戎 直人, 伴 祥高, 高松 聖仁, 中村 博亮

    別冊整形外科   ( 80 )   130 - 134   2021.10( ISSN:0287-1645

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    術中CTナビゲーション支援下に骨・軟部腫瘍手術を行った37例40手術を対象に、治療成績を後方視的に調査した。組織型は良性21例、悪性骨腫瘍5例、悪性軟部腫瘍骨浸潤11例であった。その結果、術後経過観察期間は平均37.0ヵ月であった。腫瘍最大径は平均40.1mmで、皮膚切開は平均8.1cmであった。手術時間は平均166分で、出血量は平均103mlであった。全例でナビゲーションの使用目的を達成できた。悪性腫瘍の広範切除はclear marginであった。経過観察期間内に良性の動脈瘤様骨嚢腫1例と骨内ガングリオン1例が再発したが、再手術を行った症例はなかった。悪性末梢神経鞘腫瘍の他院切除後再発の症例において再発を認め、再切除を行った。最終観察時に癌の転移を含めた悪性腫瘍の予後はCDF 9例、NED 4例、AWD 2例、DOD 1例であった。

  • PES法を用いて固定を行ったDISHを伴う胸腰椎椎体骨折の小経験 経過不良例を鑑みた適応に対する考察

    山田 賢太郎, 尾崎 友則, 中村 博亮

    Journal of Spine Research   12 ( 10 )   1257 - 1263   2021.10( ISSN:1884-7137

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    はじめに:DISHを伴う胸腰椎椎体骨折は骨性架橋の存在により骨折部に力学的ストレスがかかりやすく,長範囲に固定するなど工夫が必要である.近年,椎体終板を貫くPenetrating Endplate Screw(PES)法が考案され,良好な固定力や成績が報告されてきた.本症例報告の目的は当院でPES法を用いた3例の手術成績を報告するとともにPES法の適応について考察することである.症例:スクリューはDISH架橋椎体にはPES法で,非DISH架橋椎体には従来のpedicle screw(PS)軌道で設置した.2例は経過良好であったが,1例は術後1週で固定最尾側L2のスクリューの引き抜きが生じ,次第にゆるみが大きくなりL2根症状を呈し経過不良であった.経過不良であった1例はDISH架橋椎体最尾側の骨折であり,PES法を2aboveに従来のPSを2belowに設置していた.結語:経過不良の1例は脊椎アンカーの固定力に頭尾側で差があった事が原因と推察された.DISH架橋椎体内の骨折にはPES法は有用であるが,DISH非架橋椎体にも固定を行う必要のある症例に対しては,非架橋椎体の固定法の工夫が必要である.(著者抄録)

  • Nerve capping treatment using a bioabsorbable nerve conduit with open or closed end for rat sciatic neuroma.

    Shunpei Hama, Takuya Uemura, Ema Onode, Takuya Yokoi, Mitsuhiro Okada, Kiyohito Takamatsu, Hiroaki Nakamura

    Clinical neurology and neurosurgery   209   106920 - 106920   2021.10( ISSN:0303-8467

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND AND AIMS: Nerve capping treatment using bioabsorbable nerve conduits has recently been introduced for painful amputation neuroma. However, no clinical or experimental data are available for comparing nerve conduits with open distal ends and closed distal ends. Here, we investigated the nerve conduit with open or closed distal ends as the superior capping device, using a commercially available polyglycolic acid (PGA) nerve conduit in a rat sciatic nerve amputation model. METHODS: Ninety-one rats were assigned to three groups: no-capping (n = 30), capping the resected nerve stump with open ends (n = 31), and closed-end nerve conduits (n = 30). Twelve weeks after sciatic neurectomy, with or without capping, the evaluation of neuropathic pain using the autotomy score was performed. Stump neuromas with perineural scars and neuroinflammation were evaluated histologically. RESULTS: The mean autotomy scores in the closed-end nerve conduit group were significantly lower than those in the no-capping group. However, the difference between the open-end nerve conduit and the closed-end nerve conduit groups was insignificant. Histologically, distal axonal fibers expanded radially and formed neuromas in the no-capping group while they were terminated within the PGA conduit in both capping groups. In particular, the closed-end version of the PGA nerve conduit blocked scarring from intruding through the open end and protected the nerve stump with less neuroinflammation. Nerve capping with the closed-end version of the PGA nerve conduit most effectively suppressed perineural neuroinflammation and scar formation around the resected nerve stump. INTERPRETATION: Nerve capping with the PGA nerve conduit, particularly those with closed ends, after rat sciatic neurectomy prevented amputation neuroma and relieved neuropathic pain.

    DOI: 10.1016/j.clineuro.2021.106920

    PubMed

  • Morphological Changes in the Residual Meniscus After Reshaping Surgery for a Discoid Lateral Meniscus.

    Kazuya Nishino, Yusuke Hashimoto, Syuko Tsumoto, Shinya Yamasaki, Hiroaki Nakamura

    The American journal of sports medicine   49 ( 12 )   3270 - 3278   2021.10( ISSN:0363-5465

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Arthroscopic reshaping surgery is the first treatment option for a symptomatic discoid lateral meniscus (DLM) to preserve the peripheral rim. However, the degree of postoperative morphological change in the residual meniscus is unclear. PURPOSE/HYPOTHESIS: The purpose of this study was to measure the meniscus after reshaping surgery for a DLM, to verify when the morphological change occurred, and to examine the related risk factors. The hypothesis was that the residual meniscal width would decrease throughout the postoperative course. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: We retrospectively reviewed the medical records of patients who underwent reshaping surgery for a symptomatic DLM and had undergone follow-up for ≥2 years. Magnetic resonance imaging (MRI) was routinely performed preoperatively and at 3, 6, 12, and 24 months postoperatively, and the width, height, and extrusion of the residual meniscus were measured. According to the width of the midbody on final MRI scans, we compared the preoperative and postoperative data for the preserved group (≥5 mm) and decreased group (<5 mm). The associated risk factors for a decreased meniscal width (<5 mm) of the midbody were analyzed on final MRI scans. RESULTS: We included 61 knees of 54 patients in this study. The mean age at the time of surgery was 11.7 years. The intraobserver and interobserver reliabilities of the midbody width were 0.937 and 0.921, respectively. The width of the anterior horn, midbody, and posterior horn decreased significantly from 3 to 24 months after surgery (from 9.1 to 8.6 mm [P < .001], from 7.5 to 6.1 mm [P < .001], and from 9.5 to 8.9 mm [P = .001], respectively). Meniscal extrusion of the midbody did not change significantly (from 1.2 to 1.5 mm; P = .062). Overall, 46 knees (n = 20/32 in the preserved group and n = 26/29 in the decreased group) had longitudinal tears that required meniscal repair. Clinical outcomes did not differ significantly between the 2 groups. Multivariate logistic analysis showed that intrameniscal degeneration (odds ratio, 4.36; P = .023) significantly increased the risk of a decreased meniscal width. CONCLUSION: The width of the anterior horn, midbody, and posterior horn decreased significantly from 3 to 24 months after surgery. In particular, the average decrease rate of the midbody was 19%. No clinical difference was seen in patients with a decreased width and height or with peripheral extrusion. Increased intrameniscal signals on preoperative MRI scans were associated with an increased risk of a decreased meniscal width. Surgeons should consider this result to determine the amount of resection.

    DOI: 10.1177/03635465211033586

    PubMed

  • An adult case of spontaneous healing of concurrent osteochondritis dissecans of the lateral femoral condyle after saucerization with meniscal repair for discoid lateral meniscus: A case report.

    Kazuya Nishino, Yusuke Hashimoto, Yohei Nishida, Shinya Yamasaki, Hiroaki Nakamura

    International journal of surgery case reports   87   106427 - 106427   2021.10( ISSN:22102612

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: The treatment strategy for osteochondritis dissecans (OCD) with discoid lateral meniscus (DLM) in adults remains unclear. CASE PRESENTATION: A 22-year-old man presented with left knee pain after spraining his knee. Physical examination revealed lateral joint line tenderness and a positive McMurray test. Radiographic imaging showed OCD of the lateral femoral condyle classified as stage 3 on Brückl's classification. Magnetic resonance imaging showed complete DLM with anterocentral shift based on Ahn's classification and an OCD of 11 mm × 8 mm, grade 2 based on Nelson's classification. On computed tomography (CT), a demarcated fragment was observed in the lesion. Based on these findings, saucerization with meniscal repair was performed for unstable DLM. The OCD lesion presented with softening without any fissure and was diagnosed as grade 1. No surgical procedure was added. One year after surgery, the union of the fragment was confirmed on radiograph and CT. At the final follow-up five years after surgery, the Lysholm score had improved from 58 to 100 points. CONCLUSIONS: We experienced an adult case of stable OCD with concurrent DLM that achieved spontaneous healing after undergoing reshaping surgery for DLM, mimicking normal meniscal morphology, without additional treatment for the stable OCD lesion.

    DOI: 10.1016/j.ijscr.2021.106427

    PubMed

  • 3次元術前計画ソフトウェアを用いた椎弓根スクリューの刺入精度の検討

    尾崎 友則, 山田 賢太郎, 中村 博亮

    Journal of Spine Research   12 ( 10 )   1246 - 1250   2021.10( ISSN:1884-7137

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    はじめに:脊椎固定術において椎弓根スクリュー(PS)の逸脱は神経・血管損傷,椎弓根の骨折などの合併症を引き起こす.今回,3次元術前計画ソフトウェアを用いた胸腰椎の固定術におけるPSの刺入精度を調査したので報告する.対象と方法:対象は2019年4月から2020年3月までにPSによる胸腰椎の固定術を行った33例(263本)である.3次元ソフトウェア(ZedSpine,LEXI,Tokyo,Japan)を用いて全例に対しスクリュー径・長さ・刺入経路を術前に計画した.PSの刺入精度を術後CTで評価した.刺入方法(経皮的手技,open手技),術者(A;脊椎手術経験10年以上,B;脊椎手術経験5年未満,C;脊椎非専門整形外科医)による逸脱率の違いに関しても検討を行った.結果:PSの逸脱は合計12本(4.6%)あり,Grade 1が8例,Grade 2が3例,Grade 3が1例であった.PS逸脱例による神経,血管損傷は認めなかった.またGrade 1以上を逸脱群とした時,経皮的手技とopen手技とでは逸脱率に有意な差を認めなかった(経皮的手技5.0%(6/119),open 4.2%(6/144).p=0.73).術者間による差も認めなかった(A 4.5%(7/157),B 4.3%(3/69),C 5.4%(2/37),p=0.96).結論:3次元ソフトウェアによる術前計画はPS刺入において逸脱率を低下させる一助になる.(著者抄録)

  • Clinical outcomes of laminoplasty for patients with lysosomal storage disease including mucopolysaccharidosis and mucolipidoses: a retrospective cohort study.

    Terai H, Tamai K, Hoshino M, Toyoda H, Suzuki A, Takahashi S, Hori Y, Yabu A, Nakamura H

    Orphanet journal of rare diseases   16 ( 1 )   401   2021.09

  • Clinical Outcomes of Minimally Invasive Posterior Decompression for Lumbar Spinal Stenosis with Degenerative Spondylolisthesis.

    Kobayashi Y, Tamai K, Toyoda H, Terai H, Hoshino M, Suzuki A, Takahashi S, Hori Y, Yabu A, Nakamura H

    Spine   46 ( 18 )   1218 - 1225   2021.09( ISSN:0362-2436

  • Direct Lateral Corpectomy and Reconstruction Using an Expandable Cage Improves Local Kyphosis but Not Global Sagittal Alignment.

    Terai H, Takahashi S, Yasuda H, Konishi S, Maeno T, Kono H, Matsumura A, Namikawa T, Kato M, Hoshino M, Tamai K, Toyoda H, Suzuki A, Nakamura H

    Journal of clinical medicine   10 ( 17 )   2021.09( ISSN:2077-0383

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  • Impact of the COVID-19 pandemic on the development of locomotive syndrome.

    Terai H, Hori Y, Takahashi S, Tamai K, Iwamae M, Hoshino M, Ohyama S, Yabu A, Nakamura H

    Journal of orthopaedic surgery (Hong Kong)   29 ( 3 )   23094990211060967   2021.09( ISSN:1022-5536

  • A comparison of accuracy and safety between stem-first and cup-first total hip arthroplasty: a prospective randomised controlled trial.

    Kentaro Iwakiri, Yoichi Ohta, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura

    Hip international : the journal of clinical and experimental research on hip pathology and therapy   33 ( 2 )   11207000211039767 - 240   2021.08( ISSN:1120-7000

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: The combined anteversion theory to prevent impingement in total hip arthroplasty (THA) has been proposed. However, because stem-anteversion is influenced by the native femoral anteversion and the stem flexion/extension angle, it is often difficult to adjust stem anteversion during surgery. Therefore, the stem-first (combined anteversion) technique may be useful to adjust and achieve appropriate cup anteversion during surgery with respect to the implanted stem anteversion angle. However, the technique may adversely affect cup or stem angle accuracy and result in intra-operative bleeding, post-operative adverse events, and prolonged operative time. It is inconclusive whether either the stem-first or cup-first technique is safe or accurate. Therefore, this study assessed the accuracy and safety of stem-first THA compared to those of cup-first THA. MATERIALS AND METHODS: This prospective randomised controlled trial analysed 114 patients who were randomly divided into 2 groups (stem-first group: n = 57, cup-first group (control group): n = 57). Primary outcomes included cup and stem angle, the discrepancies from the targeted angle and combined anteversion (evaluated via CT at 3 months postoperatively). Secondary outcomes included intraoperative blood loss, operative time, WOMAC, and adverse events. RESULTS: There were no significant differences in age, gender, BMI or in the primary and secondary outcomes between the 2 groups. CONCLUSIONS: Performing stem-first in THA did not adversely affect cup and stem angle accuracy, or result in intraoperative bleeding, prolongation of operative time, or postoperative adverse events. Thus, performing stem-first may be advantageous for achieving combined anteversion theory. TRIAL REGISTRATION: University Hospital Medical Information Network (UMIN) registration number UMIN000025189.

    DOI: 10.1177/11207000211039767

    PubMed

  • Divergent Dislocation of the Elbow in an Adult with Ehlers-Danlos Syndrome: A Case Report.

    Ema Onode, Kiyohito Takamatsu, Takaaki Kuroda, Kenichi Kazuki, Hiroaki Nakamura

    JBJS case connector   11 ( 3 )   2021.08( ISSN:21603251

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    CASE: A 32-year-old man with Ehlers-Danlos syndrome (EDS) fell while snowboarding and injured his right elbow. Radiography revealed a posterior dislocation of the elbow and a proximal radioulnar joint dislocation. A diagnosis of transverse divergent dislocation of the elbow was established. Open reduction and repair of the annular ligament, anterior oblique ligament, and capsule was performed with good clinical results. CONCLUSION: This is the first report of divergent dislocation of the elbow in an adult with EDS. Dislocation occurred without a fracture that required open reduction and internal fixation. The presence of soft-tissue fragility, hyperextension, and joint laxity peculiar to EDS are likely contributing factors to this phenomenon.

    DOI: 10.2106/JBJS.CC.21.00159

    PubMed

  • Open-door laminoplasty with stand-alone autologous bone spacers: evaluation of enlarged laminar arch with CT-multiplanar reconstruction.

    Hiroshi Kono, Hideki Matsuda, Takafumi Maeno, Masayoshi Iwamae, Hiroaki Nakamura

    Journal of neurosurgery. Spine   35 ( 5 )   1 - 5   2021.08( ISSN:1547-5654

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: The authors aimed to determine the efficacy of open-door laminoplasty with stand-alone autologous bone spacer for preserving enlarged lamina in patients with cervical myelopathy. METHODS: Patients who underwent open-door laminoplasty for cervical myelopathy with stand-alone autologous bone spacer and underwent CT 1 week and 1 year after surgery were included in this study. There were 20 men and 13 women, with an average (range) age of 65.0 (37-86) years. Seventeen patients were younger than 70 years, and 16 patients were older than 70 years. Autogenous bone spacers made from spinous processes were used in all patients. Slits were made on both sides of the spacers. The lamina was raised with a curette, and a spacer was inserted without any sutures. Before surgery and 1 week and 1 year after surgery, the anteroposterior diameter (APD) of the spinal canal was measured using midsagittal-plane CT-multiplanar reconstruction. The bone union rate of the hinge side and autogenous bone spacer of each lamina was determined using CT images obtained 1 year after surgery. Results 1 year after surgery were evaluated using Japanese Orthopaedic Association (JOA) score. RESULTS: The mean ± SD APD increase rate was 56.3% ± 21.3% 1 week after surgery and 51.7% ± 20.6% 1 year later. The average APD decrease rate was 2.9% ± 3.8%. The bone union rate on the hinge side was 100%, and that of autologous bone spacer was 93.8% 1 year after surgery. The mean APD decrease rate was 3.3% in patients younger than 70 years and 2.3% in those older than 70 years. There was no significant difference between the two groups (p > 0.05, nonpaired t-test). The JOA score averaged 10.1 before surgery and 13.3 a year after surgery (total score 17). The average improvement rate was 46.3% ± 26.4%. CONCLUSIONS: The authors devised and implemented a technique for inserting an autologous bone spacer between the opened lamina and lateral mass without sutures. The enlarged spinal canal was maintained 1 year after surgery. This simple method does not require any instrumentation or additional cost to stabilize the opened lamina.

    DOI: 10.3171/2021.1.SPINE201633

    PubMed

  • 2種類のポータブルナビゲーションHipAlign SupineとHipAlign New Lateralを用いたTHAでのカップ設置角度の精度比較

    洲鎌 亮, 箕田 行秀, 大田 陽一, 竹村 進, 山本 展生, 中村 卓, 上山 秀樹, 金 裕学, 山下 竜一, 中村 博亮

    Hip Joint   47 ( 1 )   501 - 503   2021.08( ISSN:0389-3634

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    HipAlign New Supineを用いて側臥位で人工股関節全置換術(THA)を行った20関節(A群)と、その20関節に性別、年齢、病名をマッチさせたHipAlign Supineを用いて仰臥位THAを行った20関節(B群)を対象とした。術後1週にZed Hipを用いて三次元的に計測したカップ設置角(外方開角、前方開角)と術中に示した各ナビゲーションの表示角度との絶対値誤差を群間比較した。また、臨床成績としてJOA score、合併症(脱臼・感染)を群間比較した。その結果、JOA scoreは両群間で有意差がなく、全例に合併症を認めなかった。カップ設置角度の絶対値誤差が外方開角・前方開角ともに5°以内の差であった症例はA群65%、B群85%で、両群とも全ての症例で外方開角・前方開角とも10°以内の差で設置できていた。ポータブルナビゲーションのHipAlign SupineとHipAlign New Supineは、THAにおける正確なカップ設置と早期合併症予防に有用と考えられた。

  • Comparison of Occurrence of Bone Tunnel Laceration, Clinical Results, and Cuff Repair Integrity of Transosseous Arthroscopic Rotator Cuff Repair With and Without Lateral Cortical Augmentation.

    Yoshihiro Hirakawa, Tomoya Manaka, Yoichi Ito, Yoshinobu Matsuda, Katsumasa Nakazawa, Ryosuke Iio, Hiroaki Nakamura

    Arthroscopy, sports medicine, and rehabilitation   3 ( 4 )   e981 - e988   2021.08

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To compare the occurrence of bone tunnel laceration, the short-term clinical results, and cuff repair integrity of transosseous arthroscopic rotator cuff repair (ARCR) using a tunneling device, with and without lateral cortical augmentation. METHODS: A retrospective review of patients who underwent transosseous ARCR from May 2012 to December 2017 was conducted. The inclusion criterion was repairable medium- to massive-sized full-thickness rotator cuff tear. This study included 2 consecutive series of patients undergoing transosseous ARCR with and without lateral cortical augmentation, called the ITO method and AT method, respectively. The incidence of bone tunnel laceration was evaluated intraoperatively. Patients were assessed through a range of motion and Constant scores preoperatively and at final follow-up. Further, magnetic resonance imaging was performed at 24 months postoperatively to examine the repaired rotator cuff integrity. RESULTS: A total of 121 subjects were included: 33 in the AT group and 88 in the ITO group. The intraoperative bone tunnel laceration occurrence rate was 67% and 4% for the AT and ITO methods, respectively; the difference was significant (P = .001). Anatomic failure rate (Sugaya Ⅲ, Ⅳ, and Ⅴ) rate for medium- to large-sized tears was significantly lower for the ITO than for the AT method (29% vs 65%, P = .004), but not for massive tears (61% vs 69%, P = .515). The mean forward elevation, abduction, external rotation, internal rotation, and Constant score were significantly improved at final follow-up from preoperative values. There were no significant differences between the 2 methods. CONCLUSIONS: Transosseous ARCR using a tunneling device with and without lateral cortical augmentation is a reliable method of improving clinical results at a minimum follow-up of 2 years. The intraoperative occurrence rate of bone tunnel laceration occurrence rate and the anatomic failure rate of medium- to large-sized cuff tear were lower with lateral cortical augmentation than without it. LEVEL OF EVIDENCE: Level Ⅳ, therapeutic cases series.

    DOI: 10.1016/j.asmr.2021.02.004

    PubMed

  • Long-term survival of transplanted induced pluripotent stem cell-derived neurospheres with nerve conduit into sciatic nerve defects in immunosuppressed mice. Reviewed

    Takuya Yokoi, Takuya Uemura, Kiyohito Takamatsu, Ema Onode, Kosuke Shintani, Shunpei Hama, Yusuke Miyashima, Mitsuhiro Okada, Hiroaki Nakamura

    Biochemistry and biophysics reports   26   100979 - 100979   2021.07

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Since the advent of induced pluripotent stem cells (iPSCs), clinical trials using iPSC-based cell transplantation therapy have been performed in various fields of regenerative medicine. We previously demonstrated that the transplantation of mouse iPSC-derived neurospheres containing neural stem/progenitor cells with bioabsorbable nerve conduits promoted nerve regeneration in the long term in murine sciatic nerve defect models. However, it remains unclear how long the grafted iPSC-derived neurospheres survived and worked after implantation. In this study, the long-term survival of the transplanted mouse iPSC-derived neurospheres with nerve conduits was evaluated in high-immunosuppressed or non-immunosuppressed mice using in vivo imaging for the development of iPSC-based cell therapy for peripheral nerve injury. Complete 5-mm long defects were created in the sciatic nerves of immunosuppressed and non-immunosuppressed mice and reconstructed using nerve conduits coated with iPSC-derived neurospheres labeled with ffLuc. The survival of mouse iPSC-derived neurospheres on nerve conduits was monitored using in vivo imaging. The transplanted iPSC-derived neurospheres with nerve conduits survived for 365 days after transplantation in the immunosuppressed allograft models, but only survived for at least 14 days in non-immunosuppressed allograft models. This is the first study to find the longest survival rate of stem cells with nerve conduits transplanted into the peripheral nerve defects using in vivo imaging and demonstrates the differences in graft survival rate between the immunosuppressed allograft model and immune responsive allograft model. In the future, if iPSC-derived neurospheres are successfully transplanted into peripheral nerve defects with nerve conduits using iPSC stock cells without eliciting an immune response, axonal regeneration will be induced due to the longstanding supportive effect of grafted cells on direct remyelination and/or secretion of trophic factors.

    DOI: 10.1016/j.bbrep.2021.100979

    PubMed

  • Spontaneous Improvement of Postoperative Coronal Imbalance Following Selective Thoracolumbar-Lumbar Fusion in Lenke 5C Adolescent Idiopathic Scoliosis.

    Akira Matsumura, Masayoshi Iwamae, Takashi Namikawa, Minori Kato, Yusuke Hori, Noriaki Hidaka, Hiroaki Nakamura, Hidetomi Terai

    World neurosurgery   151   e241 - e249   2021.07( ISSN:1878-8750

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: To evaluate prevalence and prognosis of postoperative coronal imbalance (CIB) and factors related to its onset and spontaneous improvement in patients with Lenke 5C adolescent idiopathic scoliosis who underwent selective thoracolumbar-lumbar fusion. METHODS: We measured radiographic parameters and evaluated clinical outcomes using the Scoliosis Research Society-22 questionnaire in patients with Lenke 5C adolescent idiopathic scoliosis and a minimum 2-year follow-up. CIB was defined as >2 cm distance between C7 plumb line and central sacral vertical line. We compared parameters between patients with CIB (CIB group) and without CIB (coronal balanced group). RESULTS: Inclusion criteria were met by 29 patients (mean age at surgery:17.0 years; average follow-up period: 45.6 months). CIB was found in 10 patients 1 week after surgery (34.5%); this decreased to 6.9% at final follow-up. Comparative analysis indicated significant values as follows: age at surgery (17.5 years vs. 14.7 years, P = 0.005), lumbosacral curve (5.9° vs. 11.2°, P = 0.02), and L5 tilt (-3.6° vs. -8.1°, P = 0.02) in bending film. Greater changes of lowest instrumented vertebra disc angle, which means scoliotic angles between LIV and LIV+1, were significantly associated with spontaneous improvement of CIB (P = 0.04). Clinical outcomes were comparable between the coronal balanced and CIB groups. CONCLUSIONS: Although CIB was frequently detected in the early postoperative period after selective thoracolumbar-lumbar fusion, it mostly corrected spontaneously. Relatively younger age at surgery and less flexible lumbosacral curve may be related to postoperative CIB, and greater changes of LIV disc angle may be associated with spontaneous improvement of CIB.

    DOI: 10.1016/j.wneu.2021.04.024

    PubMed

  • Bilateral locking or triggering fingers due to intratendinous calcium pyrophosphate dihydrate crystal deposition: A case report.

    Yusuke Miyashima, Takuya Uemura, Shunpei Hama, Sadahiko Konishi, Hiroaki Nakamura

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   28 ( 6 )   1456 - 1460   2021.06( ISSN:0949-2658

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    International / domestic magazine:Domestic journal  

    DOI: 10.1016/j.jos.2021.05.008

    PubMed

  • A bone replacement-type calcium phosphate cement that becomes more porous in vivo by incorporating a degradable polymer.

    Akiyoshi Shimatani, Hiromitsu Toyoda, Kumi Orita, Yuta Ibara, Yoshiyuki Yokogawa, Hiroaki Nakamura

    Journal of materials science. Materials in medicine   32 ( 7 )   77 - 77   2021.06( ISSN:0957-4530

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    This study investigated whether mixing low viscosity alginic acid with calcium phosphate cement (CPC) causes interconnected porosity in the CPC and enhances bone replacement by improving the biological interactions. Furthermore, we hypothesized that low viscosity alginic acid would shorten the setting time of CPC and improve its strength. CPC samples were prepared with 0, 5, 10, and 20% low viscosity alginic acid. After immersion in acetate buffer, possible porosification in CPC was monitored in vitro using scanning electron microscopy (SEM), and the setting times and compressive strengths were measured. In vivo study was conducted by placing CPC in a hole created on the femur of New Zealand white rabbit. Microcomputed tomography and histological examination were performed 6 weeks after implantation. SEM images confirmed that alginic acid enhanced the porosity of CPC compared to the control, and the setting time and compressive strength also improved. When incorporating a maximum amount of alginic acid, the new bone mass was significantly higher than the control group (P = 0.0153). These biological responses are promising for the translation of these biomaterials and their commercialization for clinic applications.

    DOI: 10.1007/s10856-021-06555-1

    PubMed

  • 3. 今後の展望 4) iPS細胞を併用した人工神経の開発研究

    上村 卓也, 高松 聖仁, 中村 博亮

    人工臓器   50 ( 1 )   89 - 93   2021.06( ISSN:03000818 ( eISSN:18836097

  • The effect of minimally invasive lumbar decompression surgery on sagittal spinopelvic alignment in patients with lumbar spinal stenosis: a 5-year follow-up study.

    Salimi H, Toyoda H, Yamada K, Terai H, Hoshino M, Suzuki A, Takahashi S, Tamai K, Hori Y, Yabu A, Nakamura H

    Journal of neurosurgery. Spine   35 ( 2 )   1 - 8   2021.06( ISSN:1547-5654

  • Neuralgic amyotrophyの残存麻痺に対して、局所麻酔下でのwide awake hand surgeryによる腱移行術で機能再建を行った1例

    上村 卓也, 高松 聖仁, 小西 定彦, 中村 博亮

    末梢神経   32 ( 1 )   147 - 152   2021.06( ISSN:0917-6772

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    神経痛性筋萎縮症(neuralgic amyotrophy;NA)による右短母指外転筋の遺残麻痺・母指対立障害に対して、腱移行手術を施行した症例(63歳、男性)について報告する。発症後1年で局所麻酔によるwide awake surgeryを行い、環指の浅指屈筋を長母指伸筋と短母指外転筋に腱移行した。術後2年において右母指対立は可能で、母指の使いやすさも改善していた。NAで最終的に麻痺筋が残存した場合は腱移行術による機能再建が適応となるが、NAの筋力回復は多様で個々の症例によって異なるため、術中に手指の自動運動を確認できるwide awake surgeryによる腱移行術が有用であった。(著者抄録)

  • Differences in surgical outcome after anterior corpectomy and reconstruction with an expandable cage with rectangular footplates between thoracolumbar and lumbar osteoporotic vertebral fracture.

    Terai H, Takahashi S, Yasuda H, Konishi S, Maeno T, Kono H, Matsumura A, Namikawa T, Kato M, Hoshino M, Tamai K, Toyoda H, Suzuki A, Nakamura H

    North American Spine Society journal   6   100071   2021.06

  • 手根管症候群における手指感覚評価とCTSI-JSSH(CTSボストン質問表)との関連

    横井 卓哉, 岡田 充弘, 上村 卓也, 新谷 康介, 斧出 絵麻, 中村 博亮

    末梢神経   32 ( 1 )   100 - 105   2021.06( ISSN:0917-6772

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    手根管症候群に対する客観的な感覚評価における重症度と、患者立脚型質問表に反映される重症度との間の関連は明確ではない。本検討では、CTS患者の手指感覚障害をSemmes-Weinstein monofilament test・静的2点識別覚にて評価し、CTSI-JSSH質問表の各質問との関連を検討した。疾患特異性の高いCTSI-JSSH質問表の感覚に関する質問項目であっても、SWとs2PDとの間に相関関係はほとんどみられなかった。(著者抄録)

  • 特集 ロコモティブシンドロームの現況 Ⅳ.住民コホートによる評価 8.Shiraniwaスタディ

    大山 翔一朗, 高橋 真治, 寺井 秀富, 星野 雅俊, 中村 博亮

    整形外科   72 ( 6 )   642 - 645   2021.05( ISSN:00305901 ( eISSN:24329444

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  • Characteristics of Elderly Patients with Deteriorating Spinal Sagittal Imbalance

    Ohyama Shoichiro, Takahashi Shinji, Terai Hidetomi, Hoshino Masatoshi, Tsujio Tadao, Nakamura Hiroaki

    Journal of Spine Research   12 ( 5 )   759 - 765   2021.05( ISSN:18847137 ( eISSN:24351563

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    <p><b>Introduction: </b>Spinal sagittal imbalance is reported to be associated with a decline in patients' quality of life; however, the cause of its progression has not been investigated. The purpose of this study was to clarify the characteristics of elderly patients with deteriorating spinal sagittal imbalance over a 2-year period.</p><p><b>Methods: </b>A total of 321 participants (133 males and 188 females; mean age 72.9±4.9 years) from the Shiraniwa study were included in this analysis. Based on the SVA measured from whole spine radiographs, we classified the participants into the following three groups: SVA≤40 mm, 40 mm<SVA≤95 mm, and SVA>95 mm. Participants who showed disease progression from the first year to the third year were defined as the deteriorating spinal sagittal imbalance (DSI) group.</p><p>We compared the following items between DSI and non-DSI groups: the incidence of prevalent vertebral fractures, disc degeneration, and back muscle strength; locomotive syndrome (LS) stage 2; and sarcopenia. Using multiple logistic regression analysis, we investigated the predictors for DSI. Moreover, body composition measured using a bio-impedance analysis machine (BIA) was compared between the two groups.</p><p><b>Results: </b>Overall, 45 (14.0%) participants were classified into the DSI group. The prevalence of LS stage 2 was significantly higher in the DSI group than in the non-DSI group (55.6% vs. 28.0%; p<0.01). LS stage 2 was an independent predictor of DSI with an adjusted odds ratio of 2.35 (95% CI: 1.08-5.12). Regarding the body composition measured by BIA, the ratio of trunk muscle to trunk weight percentage was significantly lower in the DSI group (male: 74.1%/78.2%, p=0.02; women: 63.7%/70.9%, p<0.01).</p><p><b>Conclusions: </b>LS stage 2 was an independent predictor of deteriorating spinal sagittal imbalance over a 2-year period. Elderly patients with deteriorating spinal sagittal imbalance showed a significantly lower ratio of trunk muscle to trunk weight percentage.</p>

    DOI: 10.34371/jspineres.2021-0014

    CiNii Article

  • 特集 ロコモティブシンドロームの現況 Ⅵ.疾患とロコモ 3.脊柱アライメントと筋量,筋力

    堀 悠介, 高橋 真治, 大山 翔一朗, 星野 雅俊, 寺井 秀富, 中村 博亮

    整形外科   72 ( 6 )   667 - 670   2021.05( ISSN:00305901 ( eISSN:24329444

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  • 特集 骨粗鬆症性椎体骨折-難治例の診断・治療を中心に- 急性期骨粗鬆症性椎体骨折の診断-難治例の予測も含めて

    寺井 秀富, 高橋 真治, 星野 雅俊, 藪 晋人, 中村 博亮

    関節外科 基礎と臨床   40 ( 5 )   482 - 488   2021.05( ISSN:02865394

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  • 特集 骨粗鬆症性椎体骨折-難治例の診断・治療を中心に- 骨粗鬆症性椎体骨折に対するBKP治療-難治例への応用とピットフォール

    高橋 真治, 寺井 秀富, 星野 雅俊, 大山 翔一朗, 堀 悠介, 中村 博亮

    関節外科 基礎と臨床   40 ( 5 )   529 - 534   2021.05( ISSN:02865394

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  • Long-term, Time-course Evaluation of Ligamentum Flavum Hypertrophy Induced by Mechanical Stress: An Experimental Animal Study. Reviewed

    Yusuke Hori, Akinobu Suzuki, Kazunori Hayashi, Shoichiro Ohyama, Akito Yabu, Mohammad Hasib Maruf, Hasibullah Habibi, Hamidullah Salimi, Hiroaki Nakamura

    Spine   46 ( 9 )   E520 - E527   2021.05( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    STUDY DESIGN: Experimental animal study. OBJECTIVE: The aim of this study was to clarify chronological effects of mechanical stress on ligamentum flavum (LF) using a long-term fusion rabbit model. SUMMARY OF BACKGROUND DATA: LF hypertrophy is a major pathology of lumbar spinal stenosis (LSS), but its mechanism remains unclear. We previously demonstrated mechanical-stress-induced LF hypertrophy with a rabbit model. However, we only investigated LFs at a single time point in the short-term; the effects of long-term mechanical stress have not been elucidated. METHODS: Eighteen-week-old male New Zealand White rabbits were randomly divided into two groups: the mechanical stress group underwent L2-3 and L4-5 posterolateral fusion and resection of the L3-4 supraspinal muscle, whereas the control group underwent only surgical exposure. Rabbits were sacrificed 16 and 52 weeks after the procedure. Axial specimens of LFs at L3-4 were evaluated histologically. Immunohistochemistry for alpha-smooth muscle actin (α-SMA) was performed to assess the numbers of vessels and myofibroblasts. RESULTS: In the mechanical stress group, LFs at the L3-4 level exhibited hypertrophy with elastic fiber disruption and cartilage matrix production at 16 and 52 weeks. A trend test indicated that mechanical stress induced LF hypertrophy, elastic fiber disruption, and cartilage matrix production in a time-dependent manner, with the lowest levels before treatment and the highest at 52 weeks. Immunostaining for α-SMA showed similar numbers of vessels in both groups, whereas the percentage of myofibroblasts was significantly larger at 16 and 52 weeks in the mechanical stress group than in the control group. CONCLUSION: We demonstrated that long-term mechanical stress caused LF hypertrophy with progressive elastic fiber disruption and cartilage matrix production accompanied by enhanced myofibroblasts. In addition, the reported rabbit model could be extended to elucidate the mechanism of LF hypertrophy and to develop new therapeutic strategies for LSS by preventing LF hypertrophy.Level of Evidence: SSSSS.

    DOI: 10.1097/BRS.0000000000003832

    PubMed

  • Posttraumatic triggering of the extensor pollicis brevis tendon in de Quervain's disease successfully diagnosed with ultrasonography: A case report. Reviewed

    Takuya Uemura, Koichi Yano, Yusuke Miyashima, Sadahiko Konishi, Hiroaki Nakamura

    Journal of clinical ultrasound : JCU   49 ( 4 )   398 - 400   2021.05( ISSN:0091-2751

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Triggering due to de Quervain's disease is exceedingly rare. This is the first successfully diagnosed case of the snapping phenomenon of the extensor pollicis brevis (EPB) tendon in de Quervain's disease evaluated with preoperative dynamic ultrasonography, clearly demonstrated in an intraoperative video, and treated with decompression of EPB subcompartment only under a wide-awake surgery. Dynamic ultrasonographic images identified snapping caused by unsmooth excursion of an enlarged EPB tendon in a separate subcompartment. In snapping de Quervain's disease, ultrasonographic evaluations and wide-awake surgery are essential to exactly diagnose and successfully treat the snapping condition of the EPB and/or APL tendons.

    DOI: 10.1002/jcu.22934

    PubMed

  • Response to the Letter to the Editor: "Vertebral fracture prevalence in RA, likely medicinal intervention-related, suggests need for greater attention to osteoporosis-prevention".

    Akinobu Suzuki, Tadashi Okano, Hiroaki Nakamura

    The spine journal : official journal of the North American Spine Society   21 ( 5 )   885 - 886   2021.05( ISSN:1529-9430

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    International / domestic magazine:International journal  

    DOI: 10.1016/j.spinee.2021.01.013

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  • 脊柱インバランスが進行する高齢者の特徴は? 都市圏高齢者運動器コホート研究(Shiraniwa Study)2年経過の結果より

    大山 翔一朗, 高橋 真治, 寺井 秀富, 星野 雅俊, 辻尾 唯雄, 中村 博亮

    Journal of Spine Research   12 ( 5 )   759 - 765   2021.05( ISSN:1884-7137

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    はじめに:本研究の目的は脊柱インバランスが進行する高齢者の特徴を示すことである.対象と方法:Shiraniwa Study初年度,3年次のいずれにも参加した321名(男性133名,女性188名,平均72.9±4.9歳)を対象とした.全脊柱X線写真より計測したC7SVAより,≦40mm,40mm〜95mm,>95mmの3段階に分け,2年の経過で1段階以上増悪したものを進行群とし,その特徴を評価した.結果:14.0%(45名)が進行群に該当した.ロコモ度2該当者は進行群で有意に多く(55.6%/28.0%,p<0.01),調整オッズ比2.35(95%信頼区間:1.08〜5.12)と脊柱インバランス進行の独立した予測因子であった一方で,既存椎体骨折,椎間板変性,背筋力,サルコペニア有病率に有意差は認めなかった.また,体幹部重量に占める筋量が進行群で有意に低かった(男:74.1%/78.2%,p=0.02,女:63.7%/70.9%,p<0.01).結語:ロコモ度2は脊柱インバランス進行の予測因子であり,進行群で体幹部重量に占める筋量が有意に低かった.(著者抄録)

  • Gender-specific analysis for the association between trunk muscle mass and spinal pathologies. Reviewed

    Hori Y, Hoshino M, Inage K, Miyagi M, Takahashi S, Ohyama S, Suzuki A, Tsujio T, Terai H, Dohzono S, Sasaoka R, Toyoda H, Kato M, Matsumura A, Namikawa T, Seki M, Yamada K, Habibi H, Salimi H, Yamashita M, Yamauchi T, Furuya T, Orita S, Maki S, Shiga Y, Inoue M, Inoue G, Fujimaki H, Murata K, Kawakubo A, Kabata D, Shintani A, Ohtori S, Takaso M, Nakamura H

    Scientific reports   11 ( 1 )   7816   2021.04

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1038/s41598-021-87334-4

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  • Classification and prognostic factors of residual symptoms after minimally invasive lumbar decompression surgery using a cluster analysis: a 5-year follow-up cohort study Reviewed

    Toyoda Hiromitsu, Yamada Kentaro, Terai Hidetomi, Hoshino Masatoshi, Suzuki Akinobu, Takahashi Shinji, Tamai Koji, Ohyama Shoichiro, Hori Yusuke, Yabu Akito, Salimi Hamidullah, Nakamura Hiroaki

    EUROPEAN SPINE JOURNAL   30 ( 4 )   918 - 927   2021.04( ISSN:0940-6719

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00586-021-06754-y

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  • Clinical Comparison of Combined Cortical Bone Trajectory and Transarticular Surface Screw Versus Standard Pedicle Screw Insertion by Wiltse Approach for L5 Isthmic Spondylolisthesis. Reviewed

    Terai H, Tamai K, Takahashi S, Umano M, Iwamae M, Toyoda H, Suzuki A, Hoshino M, Nakamura H

    Clinical spine surgery   34 ( 10 )   E580 - E587   2021.03( ISSN:2380-0186

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BSD.0000000000001170

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  • Fate and contribution of induced pluripotent stem cell-derived neurospheres transplanted with nerve conduits to promote peripheral nerve regeneration in mice. Reviewed

    Takuya Yokoi, Takuya Uemura, Kiyohito Takamatsu, Kosuke Shintani, Ema Onode, Shunpei Hama, Yusuke Miyashima, Mitsuhiro Okada, Hiroaki Nakamura

    Bio-medical materials and engineering   32 ( 3 )   171 - 181   2021.03( ISSN:0959-2989

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: We previously demonstrated that a bioabsorbable nerve conduit coated with mouse induced pluripotent stem cell (iPSC)-derived neurospheres accelerated peripheral nerve regeneration in mice. OBJECTIVE: We examined the fate and utility of iPSC-derived neurospheres transplanted with nerve conduits for the treatment of sciatic nerve gaps in mice. METHODS: Complete 5-mm defects were created in sciatic nerves and reconstructed using nerve conduits that were either uncoated or coated with mouse iPSC-derived neurospheres. The survival of the neurospheres on the nerve conduits was tracked using an in vivo imaging. The localization of the transplanted cells and regenerating axons was examined histologically. The gene expression levels in the nerve conduits were evaluated. RESULTS: The neurospheres survived for at least 14 days, peaking at 4--7 days after implantation. The grafted neurospheres remained as Schwann-like cells within the nerve conduits and migrated into the regenerated axons. The expression levels of ATF3, BDNF, and GDNF in the nerve conduit coated with neurospheres were upregulated. CONCLUSIONS: Mouse iPSC-derived neurospheres transplanted with nerve conduits for the treatment of sciatic nerve defects in mice migrated into regenerating axons, survived as Schwann-like cells, and promoted axonal growth with an elevation in the expression of nerve regeneration-associated trophic factors.

    DOI: 10.3233/BME-201182

    PubMed

  • Using artificial intelligence to diagnose fresh osteoporotic vertebral fractures on magnetic resonance images. Reviewed

    Yabu A, Hoshino M, Tabuchi H, Takahashi S, Masumoto H, Akada M, Morita S, Maeno T, Iwamae M, Inose H, Kato T, Yoshii T, Tsujio T, Terai H, Toyoda H, Suzuki A, Tamai K, Ohyama S, Hori Y, Okawa A, Nakamura H

    The spine journal : official journal of the North American Spine Society   21 ( 10 )   1652 - 1658   2021.03( ISSN:1529-9430

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.spinee.2021.03.006

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  • Trunk Muscle Mass Measured by Bioelectrical Impedance Analysis Reflecting the Cross-Sectional Area of the Paravertebral Muscles and Back Muscle Strength: A Cross-Sectional Analysis of a Prospective Cohort Study of Elderly Population. Reviewed

    Salimi H, Ohyama S, Terai H, Hori Y, Takahashi S, Hoshino M, Yabu A, Habibi H, Kobayashi A, Tsujio T, Kotake S, Nakamura H

    Journal of clinical medicine   10 ( 6 )   1 - 10   2021.03( ISSN:2077-0383

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3390/jcm10061187

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  • Predictive signs of peripheral rim instability with magnetic resonance imaging in no-shift-type complete discoid lateral meniscus Reviewed

    Hashimoto Yusuke, Nishino Kazuya, Yamasaki Shinya, Nishida Yohei, Takahashi Shinji, Nakamura Hiroaki

    SKELETAL RADIOLOGY   50 ( 9 )   1829 - 1836   2021.03( ISSN:0364-2348

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00256-021-03753-4

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  • Biglycan expression and its function in human ligamentum flavum. Reviewed

    Hamidullah Salimi, Akinobu Suzuki, Hasibullah Habibi, Kumi Orita, Yusuke Hori, Akito Yabu, Hidetomi Terai, Koji Tamai, Hiroaki Nakamura

    Scientific reports   11 ( 1 )   4867 - 4867   2021.03( ISSN:2045-2322

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Hypertrophy of the ligamentum flavum (LF) is a major cause of lumbar spinal stenosis (LSS), and the pathology involves disruption of elastic fibers, fibrosis with increased cellularity and collagens, and/or calcification. Previous studies have implicated the increased expression of the proteoglycan family in hypertrophied LF. Furthermore, the gene expression profile in a rabbit experimental model of LF hypertrophy revealed that biglycan (BGN) is upregulated in hypertrophied LF by mechanical stress. However, the expression and function of BGN in human LF has not been well elucidated. To investigate the involvement of BGN in the pathomechanism of human ligamentum hypertrophy, first we confirmed increased expression of BGN by immunohistochemistry in the extracellular matrix of hypertrophied LF of LSS patients compared to LF without hypertrophy. Experiments using primary cell cultures revealed that BGN promoted cell proliferation. Furthermore, BGN induces changes in cell morphology and promotes myofibroblastic differentiation and cell migration. These effects are observed for both cells from hypertrophied and non-hypertrophied LF. The present study revealed hyper-expression of BGN in hypertrophied LF and function of increased proteoglycan in LF cells. BGN may play a crucial role in the pathophysiology of LF hypertrophy through cell proliferation, myofibroblastic differentiation, and cell migration.

    DOI: 10.1038/s41598-021-84363-x

    PubMed

  • Time Course of Physical and Mental Well-being Improvements After Cervical Surgery. Reviewed

    Tamai K, Suzuki A, Terai H, Hoshino M, Toyoda H, Takahashi S, Hori Y, Yabu A, Nakamura H

    Spine   46 ( 5 )   E303 - E309   2021.03( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BRS.0000000000003787

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  • Four-Millimeter Additional Bone Resection in the Distal Femur Does Not Result in an Equivalent Increase in the Extension Joint Gap in Total Knee Arthroplasty. Reviewed

    Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Hideki Ueyama, Susumu Takemura, Hiroaki Nakamura

    The Journal of arthroplasty   36 ( 3 )   958 - 962   2021.03( ISSN:0883-5403

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Additional bone resection in the distal femur is performed to increase the extension joint gap in total knee arthroplasty (TKA). The present study aimed to analyze the relationship between the amount of additional bone resection in the distal femur and the increase in the extension joint gap in TKA. METHODS: Fifty knees undergoing TKA for varus osteoarthritis were evaluated. Two femoral trial component models were prepared: (1) a normal model with 9-mm-thick distal and posterior femoral components and (2) an additional bone resection model with a 5-mm-thick distal femoral component (9 mm to 4 mm) and a 9-mm-thick posterior femoral component, which simulated an additional bone cut in the distal femur of 4 mm. The femoral trial component models were set before implantation, and the extension joint gap was measured using a tensor device that had a shape identical to that of the fixed-bearing tibial insert. RESULTS: The additional bone resection model had a larger joint gap than the normal model (P < .01). The mean extension gap increase in the additional bone resection model was 2 (standard deviation 1) mm, which was less than the thickness of the additional bone resection (4 mm) (P < .01). CONCLUSION: The amount of additional bone resection in the distal femur was not equal to the increase in the extension joint gap. Additional bone resection of 4 mm in the distal femur only increased the extension joint gap by a mean of 2 mm.

    DOI: 10.1016/j.arth.2020.09.002

    PubMed

  • MRI T2マッピングからみた半月板修復後治癒時期の検討

    山崎 真哉, 橋本 祐介, 西田 洋平, 中村 博亮

    JOSKAS   46 ( 1 )   38 - 39   2021.03( ISSN:1884-8842

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    半月板縫合後の治癒評価において、単純MRIでは損傷時の高輝度変化が術後長期間残存するため正確な評価は困難とされている。近年、軟骨や半月板の質的MRIが開発され、単純MRIでは特定できない異常を捉えることが可能になってきた。著者等は、質的MRIの一つであるT2マッピングを用いて半月板縫合後の治癒評価を行い、単純MRIに比べて有意に正確に評価できたことを以前報告した。今回、本法を用いて半月板縫合後治癒時期の検討を行った。対象はACL再建術施行時に半月板縫合を行った14例とした。検討方法は、術前のT2マッピングで損傷部位に認めたcolored meniscal tear line(CMTL)が、術後3・6・12ヵ月のうちどの時点で消失したか調べた。結果、術後3ヵ月で消失したものが4例、6ヵ月が5例、12ヵ月が5例であり、平均消失時期は術後7.3ヵ月であった。

  • 骨付き大腿四頭筋腱を用いた膝前十字靱帯再建術後の採取部痛の検討 エコー所見との関連

    山崎 真哉, 橋本 祐介, 西野 壱哉, 中村 博亮

    JOSKAS   46 ( 1 )   52 - 53   2021.03( ISSN:1884-8842

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    当院で2018〜2019年に骨付き大腿四頭筋腱を用いてACL再建術を行い術後12ヵ月以上観察しえた13例を対象とし、術後6ヵ月・12ヵ月時の「腱採取部痛」「大腿四頭筋力」「ハムストリング筋力」、術後12ヵ月時の「膝関節前方安定性」「腱採取部ドプラー信号強度」等について調査した。ドプラー信号強度は、grade 0(信号なし)、grade 1(spot状の信号)、grade 2(腱の厚みの半分以下の信号)、grade 3(腱の厚みの半分以上の信号)に分類し、grade別で「腱採取部痛」「筋力」を比較した。術後12ヵ月時の臨床成績は「関節安定性」「腱採取部痛」「筋力」とも良好であった。ドプラー信号強度は、grade 0または1が11例(85%)、grade 2が2例(15%)で、grade 3はなかった。grade 0・1群はgrade 2群に比べて「腱採取部痛」「筋力」の数値が良好であった。

  • Expression and function of fibroblast growth factor 1 in the hypertrophied ligamentum flavum of lumbar spinal stenosis. Reviewed

    Hasibullah Habibi, Akinobu Suzuki, Kazunori Hayashi, Hamidullah Salimi, Yusuke Hori, Kumi Orita, Akito Yabu, Hidetomi Terai, Hiroaki Nakamura

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   27 ( 2 )   299 - 307   2021.02( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    BACKGROUND: Fibrosis is one of the main pathologies caused by hypertrophy of the ligamentum flavum (LF), which leads to lumbar spinal stenosis (LSS). The fibroblast growth factor (FGF) family is a key mediator of fibrosis. However, acidic fibroblast growth factor (FGF-1) expression and function are not well understood in LF. This study sought to evaluate FGF-1 expression in the hypertrophied and non-hypertrophied human LF, and to investigate its function using primary human LF cell cultures. METHODS: We obtained hypertrophied lumbar LF from LSS patients and non-hypertrophied lumbar LF from control patients during surgery. Immunohistochemistry and qPCR were performed to evaluate FGF-1 expression in LF tissue. The function of FGF-1 and transforming growth factor beta 1 (TGF-β1) was also investigated using primary LF cell culture. The effects on cell morphology and cell proliferation were examined using a crystal violet staining assay and MTT assay, respectively. Immunocytochemistry, western blotting, and qPCR were performed to evaluate the effect of FGF-1 on TGF-β1-induced myofibroblast differentiation and fibrosis. RESULTS: Immunohistochemistry and qPCR showed higher FGF-1 expression in hypertrophied LF compared to control LF. Crystal violet staining and MTT assay revealed that FGF-1 decreases LF cell size and inhibits their proliferation in a dose-dependent manner, whereas TGF-β1 increases cell size and promotes proliferation. Immunocytochemistry and western blotting further demonstrated that TGF-β1 increases, while FGF-1 decreases, α-SMA expression in LF cells. Moreover, FGF-1 also caused downregulation of collagen type 1 and type 3 expression in LF cells. CONCLUSION: FGF-1 is highly upregulated in the LF of LSS patients. Meanwhile, in vitro, FGF-1 exhibits antagonistic effects to TGF-β1 by inhibiting cell proliferation and decreasing LF cell size as well as the expression of fibrosis markers. These results suggest that FGF-1 has an anti-fibrotic role in the pathophysiology of LF hypertrophy.

    DOI: 10.1016/j.jos.2021.01.004

    PubMed

  • Bioabsorbable nerve conduits three-dimensionally coated with human induced pluripotent stem cell-derived neural stem/progenitor cells promote peripheral nerve regeneration in rats. Reviewed

    Ema Onode, Takuya Uemura, Kiyohito Takamatsu, Takuya Yokoi, Kosuke Shintani, Shunpei Hama, Yusuke Miyashima, Mitsuhiro Okada, Hiroaki Nakamura

    Scientific reports   11 ( 1 )   4204 - 4204   2021.02( ISSN:2045-2322

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    Peripheral nerve regeneration using nerve conduits has been less effective than autogenous nerve grafts. To overcome this hurdle, we developed a tissue-engineered nerve conduit coated with mouse induced pluripotent stem cell (iPSC)-derived neurospheres, for the first time, which accelerated nerve regeneration in mice. We previously demonstrated the long-term efficacy and safety outcomes of this hybrid nerve conduit for mouse peripheral nerve regeneration. In this study, we investigated the therapeutic potential of nerve conduits coated with human iPSC (hiPSC)-derived neurospheres in rat sciatic nerve defects, as a translational preclinical study. The hiPSC-derived quaternary neurospheres containing neural stem/progenitor cells were three-dimensionally cultured within the nerve conduit (poly L-lactide and polycaprolactone copolymer) for 14 days. Complete 5-mm defects were created as a small size peripheral nerve defect in sciatic nerves of athymic nude rats and reconstructed with nerve conduit alone (control group), nerve conduits coated with hiPSC-derived neurospheres (iPS group), and autogenous nerve grafts (autograft group) (n = 8 per group). The survival of the iPSC-derived neurospheres was continuously tracked using in vivo imaging. At 12 weeks postoperatively, motor and sensory function and histological nerve regeneration were evaluated. Before implantation, the hiPSC-derived quaternary neurospheres that three-dimensional coated the nerve conduit were differentiated into Schwann-like cells. The transplanted hiPSC-derived neurospheres survived for at least 56 days after implantation. The iPS group showed non-significance higher sensory regeneration than the autograft group. Although there was no actual motor functional nerve regeneration in the three groups: control, iPS, and autograft groups, the motor function in the iPS group recovered significantly better than that in the control group, but it did not recover to the same level as that in the autograft group. Histologically, the iPS group demonstrated significantly higher axon numbers and areas, and lower G-ratio values than the control group, whereas the autograft group demonstrated the highest axon numbers and areas and the lowest G-ratio values. Nerve conduit three-dimensionally coated with hiPSC-derived neurospheres promoted axonal regeneration and functional recovery in repairing rat sciatic nerve small size defects. Transplantation of hiPSC-derived neurospheres with nerve conduits is a promising clinical iPSC-based cell therapy for the treatment of peripheral nerve defects.

    DOI: 10.1038/s41598-021-83385-9

    PubMed

  • Comparative Study of the Spinopelvic Alignment in Patients With Idiopathic Lumbar Scoliosis Between Adulthood and Adolescence. Reviewed

    Yusuke Hori, Akira Matsumura, Takashi Namikawa, Minori Kato, Masayoshi Iwamae, Hiroaki Nakamura

    World neurosurgery   149   e309 - e315   2021.02( ISSN:1878-8750

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Understanding the natural history of the spinopelvic alignment in adolescent idiopathic scoliosis (AIS) is important in developing surgical strategies for patients with adult idiopathic lumbar scoliosis (AdLS). Because it is challenging to follow individuals without any treatments, we sought to estimate its natural history by comparing radiographic characteristics of patients with AIS and AdLS. METHODS: We included patients with Lenke 5 AIS and patients with AdLS who were diagnosed with Lenke 5 AIS in adolescence. The Cobb angle of the curve and spinopelvic parameters were measured by whole spine radiographs. The AdLS patients were divided into 2 groups according to age <50 years (AdLS<50) or ≥50 years (AdLS≥50). Radiographic parameters were compared among the AIS, AdLS<50, and AdLS≥50 groups. The relationship between age and each parameter was analyzed using nonlinear regression analysis. RESULTS: We analyzed 40 patients with AIS (all female, mean age 16.8 ± 3.2 years) and 35 patients with AdLS (34 female and 1 male, mean age 55.4 ± 12.1 years). Thoracolumbar/lumbar curve and thoracolumbar kyphosis was significantly greater in the AdLS<50 group compared with the AIS group, without progression after age 50 years. Lumbar lordosis and pelvic tilt deteriorated linearly with age. AIS and AdLS<50 patients maintained sagittal balance, which deteriorated in AdLS≥50 patients. CONCLUSIONS: Our results may predict the following natural course of Lenke 5 AIS: (1) progression of scoliotic deformity of thoracolumbar/lumbar curve with increased thoracolumbar kyphosis; (2) subsequent lumbar hypolordosis followed by pelvic retroversion; and (3) sagittal imbalance after failure of compensation.

    DOI: 10.1016/j.wneu.2021.02.031

    PubMed

  • Expression and function of FGF9 in the hypertrophied ligamentum flavum of lumbar spinal stenosis patients. Reviewed

    Hasibullah Habibi, Akinobu Suzuki, Kazunori Hayashi, Hamidullah Salimi, Hidetomi Terai, Yusuke Hori, Koji Tamai, Kumi Orita, Shoichiro Ohyama, Akito Yabu, Mohammad Hasib Maruf, Hiroaki Nakamura

    The spine journal : official journal of the North American Spine Society   21 ( 6 )   1010 - 1020   2021.02( ISSN:1529-9430

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND CONTEXT: Ligamentum flavum (LF) hypertrophy plays a dominant role in lumbar spinal stenosis (LSS). A previous study found that fibroblast growth factor 9 (FGF9) was upregulated with mechanical stress in rabbit LF. However, the expression and function of FGF9 are not well understood in human LF. PURPOSE: To evaluate FGF9 expression and function in human LF with and without hypertrophy. STUDY DESIGN: This study employed a basic research study design utilizing human LF tissue for histological analyses. PATIENT SAMPLES: Hypertrophied LF tissue sample from patients with LSS, and nonhypertrophied (control) LFs from patients with lumbar disc herniation or other diseases were obtained during surgery. METHODS: LF specimens were histologically analyzed for FGF9 and vascular endothelial growth factor A (VEGF-A) by immunohistochemistry. The number of total and FGF9 immuno-positive cells and blood vessels were counted and compared between LF with and without hypertrophy. For functional analysis, the effect of FGF9 on cell proliferation and migration was examined using a primary cell culture of human LF. RESULTS: Histological studies revealed that the total cell number was significantly higher in the LF of patients with LSS than in the LF of control patients. Immunohistochemistry showed that the percentage of FGF9-positive cells was significantly higher in the LF of patients with LSS than in the controls, and it positively correlated with patients' age, regardless of disease. Double immune-positive cells for FGF9 and VEGF-A were often observed in vascular endothelial cells and fibroblasts in the fibrotic area of hypertrophied LF, and the number of double positive vessels was significantly higher in LF of LSS patients than in the LF of controls. Primary cell culture of human LF revealed that FGF9 promoted the proliferation and migration of LF cells. CONCLUSION: The present study demonstrated that FGF9 expression is highly upregulated in hypertrophied human LF. FGF9 potentially plays a pivotal role in the process of hypertrophy of LF, which is associated with mechanical stress, through cell proliferation and migration. CLINICAL SIGNIFICANCE: The results from this study partially reveal the molecular mechanisms of LF hypertrophy and suggest that FGF9 may be involved in the process of LF degeneration in elderly patients.

    DOI: 10.1016/j.spinee.2021.02.004

    PubMed

  • Wide-awake local anesthesia and temporary tourniquet for tendon surgery of the hand. Reviewed

    Yusuke Miyashima, Takuya Uemura, Sadahiko Konishi, Hiroaki Nakamura

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS   74 ( 7 )   1633 - 1701   2021.02( ISSN:1748-6815

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    DOI: 10.1016/j.bjps.2021.01.011

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  • Relationship between number of radiological risk factors for delayed union after osteoporotic vertebral fracture and clinical outcomes Reviewed

    Toyoda Hiromitsu, Hoshino Masatoshi, Takahashi Shinji, Terai Hidetomi, Namikawa Takashi, Kato Minori, Matsumura Akira, Suzuki Akinobu, Takayama Kazushi, Sasaoka Ryuichi, Yasuda Hiroyuki, Kanematsu Fumiaki, Kono Hiroshi, Tsujio Tadao, Nakamura Hiroaki

    ARCHIVES OF OSTEOPOROSIS   16 ( 1 )   20   2021.02( ISSN:1862-3522

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s11657-021-00884-y

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  • Magnetic Resonance Imaging T2 Relaxation Times of Articular Cartilage Before and After Arthroscopic Surgery for Discoid Lateral Meniscus. Reviewed

    Kazuya Nishino, Yusuke Hashimoto, Yohei Nishida, Shinya Yamasaki, Hiroaki Nakamura

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association   37 ( 2 )   647 - 654   2021.02( ISSN:0749-8063

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To quantitatively evaluate degeneration of articular cartilage using magnetic resonance imaging (MRI) T2 mapping before and after arthroscopic surgery for discoid lateral meniscus (DLM). METHODS: We retrospectively reviewed the medical records of patients who underwent arthroscopic reshaping surgery for symptomatic DLM from September 2013 to October 2017 and who had undergone follow-up for ≥2 years. MRI T2 relaxation examinations had been performed preoperatively and at 3, 6, 12, and 24 months postoperatively. The T2 relaxation times of the whole lateral femoral condyle and the tibial plateau were assessed. In addition, the lateral femoral condyle was divided into 3 subcompartmental areas: anterior, middle, and posterior. RESULTS: In total, 30 knees of 27 patients were included in this study. The patients' mean age at operation was 13.3 years (range 6-23 years), and the mean follow-up period was 31.6 months. Saucerization alone was performed in 3 knees and saucerization with repair in 27 knees. The T2 relaxation time of the whole lateral femoral condyle was significantly increased at 3 and 6 months postoperatively and significantly decreased at 12 and 24 months. The T2 relaxation time of the whole lateral tibial plateau was significantly increased at 3 months postoperatively and significantly decreased at 24 months. The T2 relaxation time of the posterior subcompartment of the lateral femoral condyle was significantly increased at 3 months and significantly decreased at 12 and 24 months. CONCLUSIONS: The T2 relaxation time of the lateral femorotibial joint cartilage increased at 3 and 6 months postoperatively and then had decreased at 12 and 24 months. Quantitative MRI allowed us to monitor the substantial changes in the cartilage during the early postoperative period and the recovery at the distant time point after reshaping surgery for DLM. LEVEL OF EVIDENCE: Level IV, case series.

    DOI: 10.1016/j.arthro.2020.09.036

    PubMed

  • The short-term outcomes of minimally invasive decompression surgery in patients with lumbar ossification or calcification of the ligamentum flavum. Reviewed

    Koji Tamai, Kunikazu Kaneda, Masayoshi Iwamae, Hidetomi Terai, Hiroshi Katsuda, Nagakazu Shimada, Hiroaki Nakamura

    Journal of neurosurgery. Spine   34 ( 2 )   203 - 210   2021.02( ISSN:1547-5654

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: Although minimally invasive endoscopic surgery techniques are established standard treatment choices for various degenerative conditions of the lumbar spine, the surgical indications of such techniques for specific cases, such as segments with ossification of the ligamentum flavum (OLF) or calcification of the ligamentum flavum (CLF), remain under investigation. Therefore, the authors aimed to demonstrate the short-term outcomes of minimally invasive endoscopic surgery in patients with degenerative lumbar disease with CLF or OLF. METHODS: This is a retrospective cohort study including consecutive patients who underwent microendoscopic posterior decompression at the authors' institution, where the presence of OLF and CLF did not influence the surgical indication. Fifty-nine patients with OLF and 39 patients with CLF on preoperative CT were identified from the database. Subsequently, two matched control groups (one each matched to the OLF and CLF groups) were created using propensity scores to adjust for age, sex, preoperative Japanese Orthopaedic Association (JOA) score and Oswestry Disability Index, and diagnosis. The background, surgical outcomes, and changes in clinical scores were compared between the matched groups. If there was a significant difference in the improvement of clinical scores, a multivariate linear regression model was applied. RESULTS: On performing univariate analysis, patients with OLF were found to have a higher body mass index (Mann-Whitney U-test, p = 0.001), higher incidence of preoperative motor weakness (chi-square test, p = 0.019), longer operative time (Mann-Whitney U-test, p < 0.001), and lower improvement in the JOA score (mixed-effects model, p = 0.023) than the matched controls. On performing multivariate analysis, the presence of OLF was identified as an independent variable associated with a poor recovery rate based on the JOA score (multivariate linear regression, p < 0.001). In contrast, there were no significant differences between patients with CLF and their matched controls in terms of preoperative and surgical data and postoperative improvements in clinical scores. CONCLUSIONS: Although the perioperative surgical outcomes, including the surgical complications, and the in-hospital period did not significantly differ, the short-term improvement in the JOA score was significantly lower in patients with degenerative lumbar disease accompanied by OLF than in the patients from the matched control group. In contrast, there were no significant differences in the short-term improvement in clinical scores and perioperative outcomes between patients with CLF and their matched control group. Thus, the surgical indications of minimally invasive posterior decompression for patients with CLF can be the same as those for patients without CLF; however, the indications for patients with OLF should be further investigated in future studies, including the other surgical methods.

    DOI: 10.3171/2020.6.SPINE20946

    PubMed

  • Risk Assessment for Pathological Fracture After Bone Tumour Biopsy. Reviewed

    Tadashi Iwai, Manabu Hoshi, Naoto Oebisu, Kumi Orita, Akiyoshi Shimatani, Naoki Takada, Hiroaki Nakamura

    Anticancer research   41 ( 2 )   679 - 686   2021.02( ISSN:0250-7005

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    AIM: This study aimed to identify the risk of pathological fractures after bone tumour biopsy. MATERIALS AND METHODS: Fifty rabbit femurs were divided into groups according to defect size: Control (no defect), type 1 (10% width), type 2 (20% width), type 3 (30% width), and type 4 (40% width). Another 20 were also divided into control, type A (27% length), type B (40% length), and type C (53% length) groups. Performing femoral head compression testing allowed each parameter (maximum load, displacement, elastic modulus, and fracture energy) to be calculated individually. RESULTS: Compressive maximum load was significantly higher for type 1 than for the other types when testing rectangular defects of different widths, while there were no significant differences between the three types when testing by defect length. CONCLUSION: It may be useful for orthopaedic oncologists to make a rectangular biopsy hole with a width measuring less than 10% of the circumference and to enlarge the hole longitudinally to avoid pathological fracture.

    DOI: 10.21873/anticanres.14819

    PubMed

  • Risk factors for subsequent vertebral fracture after acute osteoporotic vertebral fractures. Reviewed

    Hiroyuki Inose, Tsuyoshi Kato, Shoichi Ichimura, Hiroaki Nakamura, Masatoshi Hoshino, Daisuke Togawa, Toru Hirano, Yasuaki Tokuhashi, Tetsuro Ohba, Hirotaka Haro, Takashi Tsuji, Kimiaki Sato, Yutaka Sasao, Masahiko Takahata, Koji Otani, Suketaka Momoshima, Kunihiko Takahashi, Masato Yuasa, Takashi Hirai, Toshitaka Yoshii, Atsushi Okawa

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   30 ( 9 )   2698 - 2707   2021.01( ISSN:0940-6719

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To investigate the incidence and characteristics of subsequent vertebral fracture after osteoporotic vertebral fractures (OVFs) and identify risk factors for subsequent vertebral fractures. METHODS: This post-hoc analysis from a prospective randomized multicenter trial included 225 patients with a 48-week follow-up period. Differences between the subsequent and non-subsequent fracture groups were analyzed. RESULTS: Of the 225 patients, 15 (6.7%) had a subsequent fracture during the 48-week follow-up. The annual incidence of subsequent vertebral fracture after fresh OVFs in women aged 65-85 years was 68.8 per 1000 person-years. Most patients (73.3%) experienced subsequent vertebral fractures within 6 months. At 48 weeks, European Quality of Life-5 Dimensions, the Japanese Orthopedic Association Back Pain Evaluation Questionnaire pain-related disorder, walking ability, social life function, and lumbar function scores were significantly lower, while the visual analog scale (VAS) for low back pain was higher in patients with subsequent fracture. Cox proportional hazards analysis showed that a VAS score ≥ 70 at 0 weeks was an independent predictor of subsequent vertebral fracture. After adjustment for history of previous fracture, there was a ~ 67% reduction in the risk of subsequent vertebral fracture at the rigid-brace treatment. CONCLUSION: Women with a fresh OVF were at higher risk for subsequent vertebral fracture within the next year. Severe low back pain and use of soft braces were associated with higher risk of subsequent vertebral fractures. Therefore, when treating patients after OVFs with these risk factors, more attention may be needed for the occurrence of subsequent vertebral fractures. LEVEL OF EVIDENCE: III.

    DOI: 10.1007/s00586-021-06741-3

    PubMed

  • Costal osteochondral graft for a postoperative cartilage defect in a patient with polydactyly. Reviewed

    Keisuke Nakagawa, Noriaki Hidaka, Toshio Kitano, Hiroaki Nakamura

    BMJ case reports   14 ( 1 )   2021.01

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    We present a case of a postoperative cartilage defect in a patient with polydactyly who was treated with a costal osteochondral graft. Excision of the radial digit and ligamentous periosteal flap with longitudinal osteotomy were performed when the patient was 1 year old. The alignment of the interphalangeal joint was straight after surgery, but the deviation gradually developed. A revision surgery using a costal osteochondral graft was performed when the patient was 3 years old. A satisfactory outcome was obtained at the 3-year follow-up. The authors suggest that a costal osteochondral graft may be a reasonable option for revision surgery for a postoperative cartilage defect.

    DOI: 10.1136/bcr-2020-237823

    PubMed

  • Changes in patient-perceived leg length discrepancy following total hip arthroplasty. Reviewed

    Kentaro Iwakiri, Yoichi Ohta, Takashi Fujii, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura

    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie   31 ( 7 )   1355 - 1361   2021.01( ISSN:1633-8065

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: Leg length discrepancy (LLD) after total hip arthroplasty (THA) prevents functional recovery and reduces patient satisfaction. We investigated impact of changes in patient-perceived LLD on patient satisfaction and walking ability. METHODS: one hundred and forty-nine patients with unilateral hip osteoarthritis undergoing THA from 2014 to 2017, (125 women, 24 men; average age, 68.5 years) with an objective LLD < 1 cm were included. Outcome measures included the patient-perceived LLD, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, 10-m walking speed, and affected leg loading rate, assessed preoperatively and at 3 weeks, 3 months, and 1 year postoperatively. RESULTS: The absolute patient-perceived LLD (mean ± SD) (the number of patients with perceived LLD > 5 mm) were 6.4 ± 9.6 mm [88 patients (59%)] preoperatively; and 2.2 ± 4.0 mm [48 (32%); p < 0.001], 0.7 ± 2.3 mm [17 (11%); p < 0.001], and 0.4 ± 1.6 mm [10 (7%); p = 0.095] at 3 weeks, 3 months, and 1 year postoperatively, respectively. All outcome measures improved over time. One year postoperatively, a weak positive correlation between the patient-perceived LLD and WOMAC or 10-m walking speed (r = 0.24, 0.23, respectively) was found. The risk of patient-perceived LLD persisting > 1 year postoperatively was 5.5-fold higher in patients who exhibited it at 3 months and those with a WOMAC score > 10 at 3 months postoperatively, using multivariate logistic regression. CONCLUSION: Achieving a post-THA objective LLD < 1 cm significantly reduced the patient-perceived LLD up to 3 months postoperatively. The residual patient-perceived LLD at 1 year postoperatively was predicted from the WOMAC score or the presence of patient-perceived LLD at 3 months after THA. LEVEL OF EVIDENCE: Therapeutic level IV.

    DOI: 10.1007/s00590-021-02879-4

    PubMed

  • Relationship of back muscle and knee extensors with the compensatory mechanism of sagittal alignment in a community-dwelling elderly population. Reviewed

    Takahashi S, Hoshino M, Ohyama S, Hori Y, Yabu A, Kobayashi A, Tsujio T, Kotake S, Nakamura H

    Scientific reports   11 ( 1 )   2179   2021.01

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    DOI: 10.1038/s41598-021-82015-8

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  • A cemented mobile-bearing total knee prosthesis prevents peri-prosthetic bone mineral density loss around the femoral component: a consecutive follow-up at a mean of 11 years Reviewed

    Minoda Yukihide, Ikebuchi Mitsuhiko, Kobayashi Akio, Iwaki Hiroyoshi, Nakamura Hiroaki

    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY   2021.01( ISSN:0942-2056

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    DOI: 10.1007/s00167-021-06448-4

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  • Topical co-administration of zoledronate with recombinant human bone morphogenetic protein-2 can induce and maintain bone formation in the bone marrow environment. Reviewed

    Hideki Ueyama, Yoichi Ohta, Yuuki Imai, Akinobu Suzuki, Ryo Sugama, Yukihide Minoda, Kunio Takaoka, Hiroaki Nakamura

    BMC musculoskeletal disorders   22 ( 1 )   94 - 94   2021.01

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Bone morphogenetic proteins (BMPs) induce osteogenesis in various environments. However, when BMPs are used alone in the bone marrow environment, the maintenance of new bone formation is difficult owing to vigorous bone resorption. This is because BMPs stimulate the differentiation of not only osteoblast precursor cells but also osteoclast precursor cells. The present study aimed to induce and maintain new bone formation using the topical co-administration of recombinant human BMP-2 (rh-BMP-2) and zoledronate (ZOL) on beta-tricalcium phosphate (β-TCP) composite. METHODS: β-TCP columns were impregnated with both rh-BMP-2 (30 µg) and ZOL (5 µg), rh-BMP-2 alone, or ZOL alone, and implanted into the left femur canal of New Zealand white rabbits (n = 56). The implanted β-TCP columns were harvested and evaluated at 3 and 6 weeks after implantation. These harvested β-TCP columns were evaluated radiologically using plane radiograph, and histologically using haematoxylin/eosin (H&E) and Masson's trichrome (MT) staining. In addition, micro-computed tomography (CT) was performed for qualitative analysis of bone formation in each group (n = 7). RESULTS: Tissue sections stained with H&E and MT dyes revealed that new bone formation inside the β-TCP composite was significantly greater in those impregnated with both rh-BMP-2 and ZOL than in those from the other experimental groups at 3 and 6 weeks after implantations (p < 0.05). Micro-CT data also demonstrated that the bone volume and the bone mineral density inside the β-TCP columns were significantly greater in those impregnated with both rh-BMP-2 and ZOL than in those from the other experimental groups at 3 and 6 weeks after implantations (p < 0.05). CONCLUSIONS: The topical co-administration of both rh-BMP-2 and ZOL on β-TCP composite promoted and maintained newly formed bone structure in the bone marrow environment.

    DOI: 10.1186/s12891-021-03971-w

    PubMed

  • Presence of sarcopenia does not affect the clinical results of balloon kyphoplasty for acute osteoporotic vertebral fracture. Reviewed

    Ohyama S, Hoshino M, Takahashi S, Hori Y, Yasuda H, Terai H, Hayashi K, Tsujio T, Kono H, Suzuki A, Tamai K, Toyoda H, Dohzono S, Nakamura H

    Scientific reports   11 ( 1 )   122   2021.01

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    DOI: 10.1038/s41598-020-80129-z

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  • Impact of paravertebral muscle in thoracolumbar and lower lumbar regions on outcomes following osteoporotic vertebral fracture: a multicenter cohort study Reviewed

    Habibi Hasibullah, Takahashi Shinji, Hoshino Masatoshi, Takayama Kazushi, Sasaoka Ryuichi, Tsujio Tadao, Yasuda Hiroyuki, Kanematsu Fumiaki, Kono Hiroshi, Toyoda Hiromitsu, Ohyama Shoichiro, Hori Yusuke, Nakamura Hiroaki

    ARCHIVES OF OSTEOPOROSIS   16 ( 1 )   2   2021.01( ISSN:1862-3522

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    DOI: 10.1007/s11657-020-00866-6

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  • Factors related to postoperative coronal imbalance in adult lumbar scoliosis. Reviewed

    Akira Matsumura, Takashi Namikawa, Minori Kato, Yusuke Hori, Noriaki Hidaka, Hiroaki Nakamura

    Journal of neurosurgery. Spine   34 ( 1 )   66 - 72   2021.01( ISSN:1547-5654

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: The object of this study was to analyze the prevalence of postoperative coronal imbalance (CIB) and related factors in patients with adult lumbar scoliosis. METHODS: This was a retrospective single-center study of data from patients with adult spinal deformity (ASD) who had undergone corrective surgery performed by a single surgeon between 2009 and 2017. The inclusion criteria were as follows: 1) age at surgery > 40 years, 2) Cobb angles of the thoracolumbar/lumbar (TL/L) curve > 40°, 3) upper instrumented vertebra of T9 or T10, 4) lowest instrumented vertebra of L5 or the pelvis, and 5) minimum 2-year follow-up period. Radiographic parameters were measured before surgery, 2 weeks after surgery, and at the latest follow-up. Curve flexibility was also assessed using side bending radiographs. Clinical outcomes were evaluated using the 22-Item Scoliosis Research Society Outcomes Questionnaire (SRS-22) and the SF-36. CIB was considered to have occurred if the C7 plumbline was more than 2.5 cm lateral to the central sacral vertical line (i.e., coronal vertical axis [CVA] > 2.5 cm) at the final follow-up. Parameters between the patients with (CIB group) and without (coronal balance [CB] group) CIB were compared, and factors related to CIB were evaluated. RESULTS: From among 66 consecutively treated ASD patients, a total of 37 patients (mean age at surgery 66.3 years, average follow-up 63 months) met the study inclusion criteria. CIB was found in 6 patients at the final follow-up (16.2%), and the CVA of all patients in the CIB group shifted to the convex side of the TL/L curve. A comparative analysis between the CB and CIB groups, respectively, at the final follow-up indicated the following factors were related to CIB: lumbosacral (LS) curve, 11.0°/16.5° (p = 0.02); LS correction rate (CR), 61%/47% (p = 0.02); and CR ratio (LS vs TL/L), 0.93/0.67 (p = 0.0002). Regarding clinical outcomes, the satisfaction domain of the SRS-22 (CB 4.4 vs CIB 3.5) showed a significant difference between the CIB and CB groups (p = 0.02), and patients in the CB group tended to score better on the pain domain (CB 4.3 vs CIB 3.7), but the difference was not significant (p = 0.06). CONCLUSIONS: Postoperative CIB negatively impacted patients' HRQOL. An imbalanced correction ratio between the TL/L and LS curves may cause postoperative CIB. Therefore, adequate correction of the LS curve may prevent postoperative CIB.

    DOI: 10.3171/2020.6.SPINE20670

    PubMed

  • Ultrasound assessment, unlike clinical assessment, reflects enthesitis in patients with psoriatic arthritis. Reviewed

    Yutaro Yamada, Kentaro Inui, Tadashi Okano, Koji Mandai, Kenji Mamoto, Tatsuya Koike, Setsuko Takeda, Emi Yamashita, Yuko Yoshida, Chiharu Tateishi, Daisuke Tsuruta, Hiroaki Nakamura

    Clinical and experimental rheumatology   39 ( 1 )   139 - 145   2021.01( ISSN:0392-856X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVES: Enthesitis is a major musculoskeletal manifestation of psoriatic arthritis (PsA). It is conventionally assessed clinically, by the presence of tenderness, despite its low reliability. However, ultrasound (US) provides a sensitive and feasible method for evaluating enthesitis. We investigated enthesitis as assessed clinically and by US in patients with PsA. METHODS: Forty-seven patients with PsA underwent US examination of the bilateral humeral medial epicondyles and insertions of the triceps, distal quadriceps, proximal/distal patellae, Achilles tendons, and plantar fascia. These 14 entheses were also clinically evaluated by tenderness. The correspondence between US and clinical enthesitis was evaluated, as well as their associations with inflammatory markers (C-reactive protein [CRP], matrix metalloproteinase-3 [MMP-3]), disease activity indices (Disease Activity in Psoriatic Arthritis [DAPSA], Disease Activity Score 28 joints [DAS28-CRP], Psoriatic Arthritis Screening and Evaluation [PASE], Psoriasis Area Severity Index [PASI]), radiographic damage (modified Total Sharp Score [mTSS]), and functional status (health assessment questionnaire [HAQ]), and axial involvement. RESULTS: Among 47 patients with PsA, 37 and 23 had US and clinical enthesitis, respectively. US and clinical enthesitis had very low concordance (kappa coefficient 0.04), with no correlation between enthesitis counts (r=0.15, p=0.30). The US enthesitis count correlated only with the MMP-3 level (r=0.41, p=0.007), whereas the clinical enthesitis count correlated with the DAPSA, DAS28-CRP, HAQ, and PASE (r=0.50, p<0.001; r=0.44, p=0.002; r=0.41, p=0.008; r=0.54, p<0.001, respectively). CONCLUSIONS: US and clinical enthesitis are completely different entities. US enthesitis, but not clinical enthesitis, reflects inflammatory conditions.

    DOI: 10.55563/clinexprheumatol/u8qc6c

    PubMed

  • Risk factors of the poor long-term prognosis of osteoporotic vertebral fractures: A multicenter cohort study Reviewed

    Takahashi Shinji, Terai Hidetomi, Hoshino Masatoshi, Tsujio Tadao, Suzuki Akinobu, Namikawa Takashi, Kato Minori, Matsumura Akira, Takayama Kazushi, Toyoda Hiromitsu, Tamai Koji, Ohyama Shoichiro, Hori Yusuke, Yabu Akito, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SURGERY   29 ( 1 )   2309499021994969   2021.01( ISSN:1022-5536

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    DOI: 10.1177/2309499021994969

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  • Risk factors for postoperative graft laxity without re-injury after double-bundle anterior cruciate ligament reconstruction in recreational athletes Reviewed

    Yamasaki Shinya, Hashimoto Yusuke, Iida Ken, Nishino Kazuya, Nishida Yohei, Takigami Junsei, Takahashi Shinji, Nakamura Hiroaki

    KNEE   28   338 - 345   2021.01( ISSN:0968-0160

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    DOI: 10.1016/j.knee.2020.12.009

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  • Predictors of dropout from cohort study due to deterioration in health status, with focus on sarcopenia, locomotive syndrome, and frailty: From the Shiraniwa Elderly Cohort (Shiraniwa) study Reviewed

    Ohyama Shoichiro, Hoshino Masatoshi, Takahashi Shinji, Hori Yusuke, Yabu Akito, Kobayashi Akio, Tsujio Tadao, Kotake Shiro, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   26 ( 1 )   167 - 172   2021.01( ISSN:0949-2658

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    DOI: 10.1016/j.jos.2020.02.006

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  • Ultrasound assessment, unlike clinical assessment, reflects enthesitis in patients with psoriatic arthritis

    Yamada Y.

    Clinical and Experimental Rheumatology   39 ( 1 )   139 - 145   2021.01( ISSN:0392856X

  • 健康状態の悪化のうち特にサルコペニア、ロコモティブシンドローム、フレイルによるコホート研究からの脱落の予測因子 白庭高齢者コホート研究(Predictors of dropout from cohort study due to deterioration in health status, with focus on sarcopenia, locomotive syndrome, and frailty: From the Shiraniwa Elderly Cohort(Shiraniwa) study)

    Ohyama Shoichiro, Hoshino Masatoshi, Takahashi Shinji, Hori Yusuke, Yabu Akito, Kobayashi Akio, Tsujio Tadao, Kotake Shiro, Nakamura Hiroaki

    Journal of Orthopaedic Science   26 ( 1 )   167 - 172   2021.01( ISSN:0949-2658

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    高齢者コホート研究(白庭研究)に登録された被験者におけるサルコペニア、ロコモティブシンドローム(LS)およびフレイルの有病率について検討し、このような健康悪化状態がコホート研究からの脱落に及ぼす影響を評価した。2016年の第1回サーベイに参加した65歳以上の409名(男性164名、女性245名、平均73.5歳)を対象にサルコペニアなどの有病率を調査し、2017年の第2回サーベイに参加できなかった者を脱落者と判定、研究からの脱落に関わる予測因子を評価した。第1回サーベイの409名中、サルコペニアの有病率は4.4%、LSステージ2の有病率は40.1%、フレイルの有病率は14.2%であった。また、サルコペニア群のうち77.8%にLSステージ2、フレイル群のうち89.7%にLSステージ2の罹患が認められた。第2回サーベイに参加できなかったのは71名で、最終的にこのうち46名を脱落者と判定した。コホート研究からの脱落率はサルコペニア、LSステージ2およびフレイルの三つがいずれもみられなかった者が4.5%、LSステージ2を有する者が12.3%、フレイルを有する者が33.3%、サルコペニア、LSステージ2、フレイルの三つをすべて有する者が37.5%となっていた。多変量ロジスティック回帰分析では、脱落の独立予測因子としてLSステージ2とフレイルが抽出された。

  • Pediatric giant cell reparative granuloma of the lower clivus: A case report and review of the literature.

    Nakamura H, Morisako H, Ohata H, Kuwae Y, Teranishi Y, Goto T

    Journal of craniovertebral junction & spine   12 ( 1 )   86 - 90   2021.01( ISSN:0974-8237

  • Percutaneous Endovascular Retrieval of Large Cement Leakage into the Right Atrium Following Cement-Augmented Pedicle Screw Instrumentation Reviewed

    Takahashi Shinji, Sohgawa Etsuji, Suzuki Akinobu, Yamamoto Akira, Sasaki Ryo, Tanaka Katsuaki, Terai Hidetomi, Hoshino Masatoshi, Toyoda Hiromitsu, Tamai Koji, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 6 )   446 - 449   2021( eISSN:2432261X

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.22603/ssrr.2021-0011

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    CiNii Article

  • Ultrasound assessment, unlike clinical assessment, reflects enthesitis in patients with psoriatic arthritis Reviewed

    Yamada Y., Inui K., Okano T., Mandai K., Mamoto K., Koike T., Takeda S., Yamashita E., Yoshida Y., Tateishi C., Tsuruta D., Nakamura H.

    CLINICAL AND EXPERIMENTAL RHEUMATOLOGY   39 ( 1 )   139 - 145   2021( ISSN:0392-856X

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  • Risk Factors for Reoperation at Same Level after Decompression Surgery for Lumbar Spinal Stenosis in Patients with Diffuse Idiopathic Skeletal Hyperostosis Extended to the Lumbar Segments Reviewed

    Yamada Kentaro, Abe Yuichiro, Yanagibashi Yasushi, Hyakumachi Takahiko, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 6 )   381 - 389   2021( eISSN:2432261X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    <p>Introduction: Diffuse idiopathic skeletal hyperostosis (DISH) extended to the lumbar segments (L-DISH) reportedly has adverse effects on the surgical outcomes of lumbar spinal stenosis (LSS). However, the risk factors in patients with L-DISH have not been clarified. The purpose of this study was to investigate the long-term risk factors for reoperation at the same level after decompression surgery alone for LSS in patients with L-DISH in a retrospective cohort study.</p><p>Methods: A postoperative postal survey was sent to 1,150 consecutive patients who underwent decompression surgery alone for LSS from 2002 to 2010. Among all respondents, patients who exhibited L-DISH by preoperative total spine X-ray were included in this study. We investigated risk factors for reoperation at the same level as the initial surgery among various demographic and radiological parameters, including the lumbar ossification condition and computed tomography (CT) or magnetic resonance imaging findings.</p><p>Results: A total of 57 patients were analyzed. Reoperations at the same level as that of the index surgery were performed in 10 patients (17.5%) and at 11 levels within a mean of 9.2 years. Cox proportional hazard regression analysis indicated that the independent risk factors for reoperation were a sagittal rotation angle ≥10° (adjusted hazard ratio: 5.17) and facet opening on CT (adjusted hazard ratio: 4.82). Neither sagittal translation nor the ossification condition in the lumbar segments affected reoperations.</p><p>Conclusions: A sagittal rotation angle ≥10° and facet opening on preoperative CT were risk factors for reoperation at the same level as that of the index surgery in patients with L-DISH. The surgical strategy should be carefully considered in those patients.</p>

    DOI: 10.22603/ssrr.2020-0227

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    CiNii Article

  • Sports Activity after TKA

    Sugama Ryo, Minoda Yukihide, Ohta Yoichi, Takemura Susumu, Yamamoto Nobuo, Nakamura Hiroaki

    Japanese Journal of Orthopaedic Sports Medicine   41 ( 3 )   160 - 163   2021( ISSN:13408577 ( eISSN:24355828

  • Reductions in the Frequency of Going Out Due to the COVID-19 Pandemic Negatively Affect Patients with Spinal Disorders

    Terai Hidetomi, Iwamae Masayoshi, Tamai Koji, Takahashi Shinji, Hori Yusuke, Ohyama Shoichiro, Yabu Akito, Hoshino Masatoshi, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 6 )   365 - 374   2021( eISSN:2432261X

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    <p>Introduction: The coronavirus disease 2019 (COVID-19) pandemic has greatly changed the lifestyles of individuals due to the need to prevent disease spread. Globally, governments have enforced various policies, including travel bans, quarantine, home confinement, and lockdowns, as safety measures. Consequently, the frequency of individuals going out has decreased. This survey aimed to assess how decreasing the frequency of going out due to the COVID-19 pandemic impacts patients with spinal disorders.</p><p>Methods: This multicenter cross-sectional questionnaire survey included patients who visited four private spine clinics for any symptoms. Participants completed questionnaires pre- and post-pandemic that assessed the following topics: frequency of leaving home, exercise habits, locomotive syndrome, and health-related quality of life (HRQOL). Patients were divided into decreased and non-decreased frequency of going out groups, according to observed changes in their frequencies of leaving home. Both groups were statistically compared using univariate and multivariate logistic regression analyses to identify factors associated with the frequency of going out.</p><p>Results: Among 855 patients, 160 (18.7%; the decreased group) reported that they went out less frequently, and 695 (81.3%; the non-decreased group) reported that they left home equally frequently post- versus pre-pandemic. Multivariate analyses showed that exercise habits significantly decreased (adjusted odds ratio (aOR) = 2.67, p = 0.004), the incidence of locomotive syndrome significantly increased (aOR = 2.86, p = 0.012), and HRQOL significantly deteriorated (aOR = 4.14, p < 0.001) in the decreased group compared to the non-decreased group.</p><p>Conclusions: Restrictions regarding leaving home due to the COVID-19 pandemic significantly decreased exercise frequency, increased the occurrence of locomotive syndrome, and were associated with deterioration of HRQOL in patients with spine disorders. It may be beneficial for spine surgeons to encourage patients with spinal disorders to leave home at a frequency similar to what they did pre-pandemic while avoiding crowded areas, despite the presence of the COVID-19 pandemic.</p>

    DOI: 10.22603/ssrr.2021-0088

    PubMed

    CiNii Article

  • Prediction of Risk Factors for Pathological Fracture After Bone Tumor Biopsy Using Finite Element Analysis.

    Tadashi Iwai, Manabu Hoshi, Naoto Oebisu, Kumi Orita, Akiyoshi Shimatani, Naoki Takada, Hiroaki Nakamura

    Cancer management and research   13   3849 - 3856   2021( ISSN:1179-1322

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: We aimed to determine if finite element analysis (FEA) provides useful thresholds for bone biopsy practice patterns. METHODS: The femoral head compression test was performed on rabbit femurs, using FEA to identify the part of the bone that preferentially fractures (n=15/group). Four types of rectangular biopsy holes were made using finite element (FE) models. These models were divided into control (no defect), defect 1 (10% width), defect 2 (20% width), defect 3 (30% width), and defect 4 (40% width) groups (n=15 each). Three types of rectangular biopsy holes (defect A, 27% length; defect B, 40% length; defect C, 53% length) were also made using FE models (n=15 each). The load to failure was then predicted using FEA. RESULTS: Almost all femurs with no defect were fractured at the femoral shaft in both the femoral head compression test and FEA. The experimental load to failure in intact femurs was predicted well by the FE models (R2=0.74, p<0.001). There was also a strong linear correlation of stiffness between compression test in femurs with no defect and the FEA (R2=0.68, p<0.001). Therefore, the femoral shaft was targeted for FEA. The median predicted loads by FEA were significantly higher for defect 1 than for the other types when testing the widths of the rectangular defects, but there were no significant differences among the three types when testing for defect length. CONCLUSION: The FEA results correlated well with those of the femoral head compression test. A width <10% of the circumference length in bone biopsy holes helps minimize bone strength reduction using FEA. It may be useful for orthopedic doctors to perform FEA to avoid pathological fractures after bone tumor biopsy.

    DOI: 10.2147/CMAR.S307586

    PubMed

  • Interposed Trans-osseous法による骨孔式ARCRの治療成績

    松田 淑伸, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一, 岡田 彩夏, 中村 博亮

    肩関節   45 ( 3 )   448 - 448   2021( ISSN:09104461 ( eISSN:18816363

  • In vivo study on the healing of bone defect treated with non-thermal atmospheric pressure gas discharge plasma.

    Akiyoshi Shimatani, Hiromitsu Toyoda, Kumi Orita, Yoshihiro Hirakawa, Kodai Aoki, Jun-Seok Oh, Tatsuru Shirafuji, Hiroaki Nakamura

    PloS one   16 ( 10 )   e0255861   2021

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Medical treatment using non-thermal atmospheric pressure plasma (NTAPP) is rapidly gaining recognition. NTAPP is thought to be a new therapeutic method because it could generate highly reactive species in an ambient atmosphere which could be exposed to biological targets (e.g., cells and tissues). If plasma-generated reactive species could stimulate bone regeneration, NTAPP can provide a new treatment opportunity in regenerative medicine. Here, we investigated the impact of NTAPP on bone regeneration using a large bone defect in New Zealand White rabbits and a simple atmospheric pressure plasma (helium microplasma jet). We observed the recovery progress of the large bone defects by X-ray imaging over eight weeks after surgery. The X-ray results showed a clear difference in the occupancy of the new bone of the large bone defect among groups with different plasma treatment times, whereas the new bone occupancy was not substantial in the untreated control group. According to the results of micro-computed tomography analysis at eight weeks, the most successful bone regeneration was achieved using a plasma treatment time of 10 min, wherein the new bone volume was 1.51 times larger than that in the plasma untreated control group. Using H&E and Masson trichrome stains, nucleated cells were uniformly observed, and no inclusion was confirmed, respectively, in the groups of plasma treatment. We concluded the critical large bone defect were filled with new bone. Overall, these results suggest that NTAPP is promising for fracture treatment.

    DOI: 10.1371/journal.pone.0255861

    PubMed

  • Bone healing of distal radius nonunion treated with bridge plating with bone graft substitutes in combination with systemic romosozumab administration: A case report.

    Takuya Uemura, Koichi Yano, Kiyohito Takamatsu, Yusuke Miyashima, Hiroyuki Yasuda, Sadahiko Konishi, Hiroaki Nakamura

    Joint diseases and related surgery   32 ( 2 )   526 - 530   2021( ISSN:2687-4784

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Romosozumab is a humanized, anti-sclerostin monoclonal antibody used to treat osteoporosis, which increases bone formation and decreases bone resorption. It enhances fracture healing and systemic romosozumab administration may have therapeutic potentials for accelerating bone healing of even nonunion. Herein, a 61-year-old heavy smoker male with distal radius nonunion who achieved successful bone union by combination therapy of romosozumab and spanning distraction plate fixation with bone graft substitutes was presented. Through the dorsal approach, atrophic comminuted nonunion of the distal radius was sufficiently debrided. Reduction of the distal radius was performed using indirect ligamentotaxis, and a 14-hole locking plate was fixed from the third metacarpal to the radial shaft. A beta (β) tricalcium phosphate block was mainly packed into the substantial metaphyseal bone defect with additional bone graft from the resected ulnar head. Postoperatively, systemic administration of monthly romosozumab was continued for six months. Complete bone union was achieved 20 weeks postoperatively and the plate was, then, removed. Wrist extension and flexion improved to 75o and 55o, respectively, without pain, and grip strength increased 52 weeks postoperatively from 5.5 kg to 22.4 kg. During romosozumab treatment, bone formation marker levels increased rapidly and finally returned to baseline, and bone resorption marker levels remained low. In conclusion, combination of systemic romosozumab administration and grafting β-tricalcium phosphate with bridge plating provides an effective treatment option for difficult cases of comminuted distal radius nonunion with risk factors such as smoking, diabetes, and fragility.

    DOI: 10.52312/jdrs.2021.82661

    PubMed

  • Arthro Tunneler<SUP>TM</SUP> を用いた骨孔式鏡視下腱板修復術後における患者満足度に関連する因子の検討

    飯尾 亮介, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 山下 竜一, 岡田 彩夏, 中村 博亮

    肩関節   45 ( 3 )   449 - 449   2021( ISSN:09104461 ( eISSN:18816363

  • 3D 術前シミュレーションソフトウェアを用いたリバース型人工肩関節置換術の可動域 -Medialized 型とLateralized 型の比較-

    平川 義弘, 間中 智哉, 伊藤 陽一, 市川 耕一, 松田 淑伸, 中澤 克優, 飯尾 亮介, 山下 竜一, 岡田 彩夏, 中村 博亮

    肩関節   45 ( 3 )   435 - 435   2021( ISSN:09104461 ( eISSN:18816363

  • グレノスフィアのサイズがリバース型人工肩関節置換術後可動域に与える影響 -3次元可動域シミュレーションを用いた検討-

    間中 智哉, 平川 義弘, 伊藤 陽一, 市川 耕一, 松田 淑伸, 中澤 克優, 飯尾 亮介, 山下 竜一, 岡田 彩夏, 中村 博亮

    肩関節   45 ( 3 )   437 - 437   2021( ISSN:09104461 ( eISSN:18816363

  • 乾癬患者における関節症状の有無と皮膚病変の重症度およびBMIの関連について

    万代 幸司, 乾 健太郎, 岡野 匡志, 山田 祐太郎, 吉村 仁志, 小池 達也, 中村 博亮

    日本脊椎関節炎学会誌   8 ( 2 )   51 - 55   2021

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    当院通院中の乾癬患者94例(女性34例36%、年齢58.4±14.7歳)を対象に、関節症状の合併と皮膚病変の重症度およびBMIの関連について検討した。その結果、乾癬患者のうち関節症状を合併したPsA群は48例、合併なしのPsO群は46例であった。2群間でBMIに有意差はみられなかった。また、PsA群においてBMI、皮膚病変の重症度、関節症状の重症度は、いずれも有意な関連を認めなかった。

  • リバース型人工肩関節置換術におけるインプラント設置状態が可動域に与える影響 -3次元可動域シミュレーションを用いた検討-

    中澤 克優, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 山下 竜一, 岡田 彩夏, 中村 博亮

    肩関節   45 ( 3 )   436 - 436   2021( ISSN:09104461 ( eISSN:18816363

  • セメントレスshort-stemを用いたリバース型人工肩関節置換術後2年のインプラント周囲の単純X線変化

    山下 竜一, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 中澤 克優, 飯尾 亮介, 岡田 彩夏, 中村 博亮

    肩関節   45 ( 3 )   462 - 462   2021( ISSN:09104461 ( eISSN:18816363

  • スーチャーブリッジ法による鏡視下腱板修復術後における患者満足度に関連する因子の検討

    岡田 彩夏, 間中 智哉, 飯尾 亮介, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 山下 竜一, 中村 博亮

    肩関節   45 ( 3 )   444 - 444   2021( ISSN:09104461 ( eISSN:18816363

  • 特集 脊椎骨粗鬆症性椎体骨折に対する治療戦略-薬物療法を中心にUP TO DATE 骨粗鬆症性椎体骨折の保存療法の限界について-前向き多施設研究結果を踏まえて

    寺井 秀富, 高橋 真治, 星野 雅俊, 藪 晋人, 中村 博亮

    脊椎脊髄ジャーナル   33 ( 12 )   1052 - 1057   2020.12( ISSN:09144412

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  • Evaluation of FGFR inhibitor ASP5878 as a drug candidate for achondroplasia Reviewed

    Ozaki Tomonori, Kawamoto Tatsuya, Iimori Yuki, Takeshita Nobuaki, Yamagishi Yukiko, Nakamura Hiroaki, Kamohara Masazumi, Fujita Kaori, Tanahashi Masayuki, Tsumaki Noriyuki

    SCIENTIFIC REPORTS   10 ( 1 )   20915   2020.12( ISSN:2045-2322

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1038/s41598-020-77345-y

    PubMed

  • Futile complete recanalization: patients characteristics and its time course

    Kitano T.

    Scientific Reports   10 ( 1 )   2020.12

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  • Analysis of Gait in Stroke Patients with Hemiplegia Using a Wearable Accelerometer(和訳中) Reviewed

    Nakatsuchi Tamotsu, Ikebuchi Mitsuhiko, Nishikawa Tomoya, Sugahara Tetsuya, Nakajima Shigeyoshi, Morimoto Masanobu, Nakamura Hiroaki

    大阪市医学会 Osaka City Medical Journal   66   31 - 37   2020.12( ISSN:0030-6096

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    Publishing type:Research paper (scientific journal)  

    ウェアラブル加速度計(以下、加速度計)を用いて、脳卒中片麻痺患者の歩行中の頸部/腰部動揺と歩行能力との関連を評価した。さらに、当該患者の歩行能力を予測する客観的評価ツールとして加速度計を利用可能か評価した。足に関節障害のない脳卒中片麻痺患者(患者群)36名(男性29名、女性7名、平均69.9±9.1歳)と健常者(対照群)40名(男性26名、女性14名、平均27.7±7.7歳)を対象に、第7頸椎(C7)と第3腰椎(L3)に加速度計を装着した。歩行時の加速度は、3軸方向(内側、垂直、前後)で測定した。二乗平均平方根を算出し、頸部/腰部動揺の指標とした。これらの値とFunctional Ambulation Classification(FAC)スコアで測定した歩行自立度との関連を評価した。その結果、患者群では歩行自立度の低下に伴って頸部・腰部動揺が3軸方向とも有意に増加した。患者群では、歩行自立度が低いほど頸部動揺が大きくなったが、FAC3群では頸部動揺が腰部動揺より大きく、逆の現象が見られた。

  • 手根管症候群における定量的ring finger splittingの陽性率の検討 Reviewed

    横井 卓哉, 上村 卓也, 斧出 絵麻, 新谷 康介, 岡田 充弘, 中村 博亮

    (一社)日本手外科学会 日本手外科学会雑誌   37 ( 2 )   54 - 58   2020.12( ISSN:2185-4092

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    手根管症候群と診断し手術を施行した症例に対し,術前に知覚障害を定量的に評価し,環指正中線を境界とする知覚障害,いわゆるring finger splittingの陽性率と,電気生理学的重症度の違いによる陽性率の差について検討した.ring finger splittingは手根管症候群のおおよそ6-7割で陽性となり,その陽性率は電気学的重症度によらず不変であった.診断の際にはring finger splittingの陽性率を念頭におき診断を進めることが肝要である.(著者抄録)

  • Residual numbness of the upper extremity after cervical surgery in patients with cervical spondylotic myelopathy Reviewed

    Iwamae Masayoshi, Suzuki Akinobu, Tamai Koji, Terai Hidetomi, Hoshino Masatoshi, Toyoda Hiromitsu, Takahashi Shinji, Ohyama Shoichiro, Hori Yusuke, Yabu Akito, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   33 ( 6 )   734 - 741   2020.12( ISSN:1547-5654

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3171/2020.4.SPINE191566

    PubMed

  • Prediction of satisfaction after correction surgery for adult spinal deformity: differences between younger and older patients. Reviewed

    Kazunori Hayashi, Louis Boissière, Daniel Larrieu, Anouar Bourghli, Olivier Gille, Jean-Marc Vital, Fernando Guevara-Villazón, Ferran Pellisé, Francisco Javier Sánchez Pérez-Grueso, Frank Kleinstück, Emre Acaroglu, Ahmet Alanay, Hiroaki Nakamura, Ibrahim Obeid

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   29 ( 12 )   3051 - 3062   2020.12( ISSN:0940-6719

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: Achieving an adequate level of patient's satisfaction with results is one of the goals of adult spinal deformity (ASD) surgery. However, it is unclear whether the same factors affect satisfaction in all patient populations. Patients' age influences the postoperative course and prevalence of complications after ASD surgery. The purpose of this study was to determine the factors predicting satisfaction 2 years after ASD surgery in younger and older patients. METHODS: A total of 119 patients under 40 years old, 155 patients 40 to 65 years old, and 148 patients over 65 years old at surgery who were followed for a minimum of 2 years after surgery were included. Multivariate analysis was used to determine independent related factors with maximum AUC for satisfaction 2 years after surgery in each group. A propensity-matched cohort under equivalent demographic and clinical characteristics was used to confirm the results. RESULTS: Logistic regression analyses revealed satisfaction among the under-40 group corresponded to prior spine surgery, complications, and self-image. That among the 40-to-65 group corresponded to neurologic complication, revision surgery, pain, and sagittal vertical axis restoration. Among the over-65 group satisfaction correlated with revision surgery, standing ability, and lumbar lordosis index restoration. Propensity score matching confirmed that sagittal alignment correction led to substantial satisfaction. CONCLUSIONS: In younger patients, avoiding complications and improving patients' self-image were essential for substantial satisfaction levels. In older patients, revision, standing ability, as well as sagittal spinopelvic alignment restoration, were the key factors. Surgeons should consider the differences in goals of each patient.

    DOI: 10.1007/s00586-020-06611-4

    PubMed

  • Long-term clinical outcomes of medial pivot total knee arthroplasty for Asian patients: A mean 10-year follow-up study. Reviewed

    Hideki Ueyama, Narihiro Kanemoto, Yukihide Minoda, Nobuo Yamamoto, Yoshiki Taniguchi, Hiroaki Nakamura

    The Knee   27 ( 6 )   1778 - 1786   2020.12( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Many Asian populations have a unique floor-based lifestyle that might cause mechanical stress of the knees. It is important to clarify the longevity of a medial pivot total knee arthroplasty, as its prosthetic design could cause mechanical stress onto the insert. The purpose of this study was to clarify the clinical results of medial pivot total knee arthroplasty for Asian patients in a 10-year follow-up study. METHODS: Consecutive, primary total knee arthroplasties (n = 257) were analyzed in the study using the medial pivot knee system. The clinical outcomes were assessed preoperatively and at the final follow-up. The patient-reported Forgotten Joint Score-12 and radiological outcomes were measured at the final follow-up. The survival rate was assessed with reoperation or revision as the end-point. RESULTS: The mean follow-up period was 10.1 ± 1.7 years. The lost to follow-up was 4.5%. All clinical outcomes improved significantly after surgery (p < 0.001). The mean postoperative knee flexion was 118° ± 11° and the mean Forgotten Joint Score-12 was 59.7 ± 27 points. The radiolucent line was observed in 29 patients (11.3%), however there was no aseptic loosening noted. The survival rates with reoperation or revision were 96.3% or 98.4% at 10 years after the operation. CONCLUSIONS: Medial pivot total knee arthroplasty used for Asian patients showed good longevity and patient-reported outcome measurement in a mean 10-year follow-up study. Medial pivot total knee arthroplasty has long-term stability among patients who have a floor-based lifestyle. LEVEL OF EVIDENCE: III.

    DOI: 10.1016/j.knee.2020.09.009

    PubMed

  • Ehlers-Danlos症候群の成人に生じた肘関節分散脱臼の1例 Reviewed

    斧出 絵麻, 高松 聖仁, 香月 憲一, 中村 博亮

    (一社)日本手外科学会 日本手外科学会雑誌   37 ( 2 )   109 - 112   2020.12( ISSN:2185-4092

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    Publishing type:Research paper (scientific journal)  

    肘関節分散脱臼は腕尺関節,腕橈関節,近位橈尺関節の全てが脱臼する稀な疾患で,大半が小児例である.成人例の報告は本邦で4例,海外で7例と極めて珍しく,全例で観血的整復固定を要する骨折を合併していた.今回,極めて稀なEhlers-Danlos症候群の成人に発症した肘関節分散脱臼を経験したため報告する.症例は32歳,男性で,スノーボード中に後方へ転倒し,右肘関節伸展,前腕回外位で手をつき受傷した.近医で右肘関節分散脱臼と診断されたが,整復位保持が困難で当院紹介受診となり,受傷2週間後に手術を施行した.輪状靱帯と内側側副靱帯が断裂しており,同部位を縫合した.また脱臼に伴う関節包の著明な弛緩を認めたため,縫縮したところ,易脱臼性は改善された.術後3年の最終調査時において,肘関節の回内制限は残存しているが易脱臼性はなく,動揺性も認めていない.観血的整復固定を要する骨折を伴わない肘関節分散脱臼は成人例では極めて稀であり,本症例はEhlers-Danlos症候群に起因する軟部組織の脆弱性や過伸展性,関節の弛緩性を有していたことが原因ではないかと考えられた.(著者抄録)

  • Do rheumatoid arthritis patients have low back pain or radiological lumbar lesions more frequently than the healthy population? - Cross-sectional analysis in a cohort study with age and sex-matched healthy volunteers Reviewed

    Suzuki Akinobu, Tamai Koji, Takahashi Shinji, Yamada Kentaro, Inui Kentaro, Tada Masahiro, Okano Tadashi, Sugioka Yuko, Koike Tatsuya, Nakamura Hiroaki

    SPINE JOURNAL   20 ( 12 )   1995 - 2002   2020.12( ISSN:1529-9430

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.spinee.2020.06.020

    PubMed

  • 都市部で乳児股関節健診推奨項目の導入を目指す試み 発育性股関節形成不全(脱臼)診断遅延例を減らすための方策の検討

    中川 敬介, 宅間 仁美, 森山 美知子, 新谷 康介, 細見 僚, 北野 利夫, 中村 博亮

    日本小児整形外科学会雑誌   29 ( 2 )   324 - 328   2020.12( ISSN:0917-6950

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    日本小児整形外科学会および日本小児股関節研究会の取り組みにより、乳児股関節検診の推奨項目が作成され、全国的に実施している地域が増えてきている。ただし、都市部では、新生児数が多いことに伴う、二次検診施設の確保の憂いもあり、まだあまり導入が進んでいない。そこで、大阪府において推奨項目が導入できるかどうか評価するため、二つのアンケート調査を施行した。若手整形外科医師へのアンケート調査からは、一般整形外科医における乳児股関節二次検診はおおむね可能と考えられる結果であり、また、医療機関へのアンケート調査からは、多くの施設から受け入れ可との回答が得られた。より良い検診体制の構築に向けて、大阪府における乳児股関節検診推奨項目の導入は可能であると考える。一次健診医である小児科医および二次検診医となる整形外科医が勤務する施設と、緊密な連携体制を構築し、医療体制の充実を図る必要がある。(著者抄録)

  • Periprosthetic Loss of Bone Mineral Density After Cementless Porous Tantalum and Cemented Total Knee Arthroplasties: A Mean of 11-Year Concise Follow-Up of a Previous Report. Reviewed

    Yukihide Minoda, Akio Kobayashi, Mitsuhiko Ikebuchi, Hiroyoshi Iwaki, Fumiaki Inori, Hiroaki Nakamura

    The Journal of arthroplasty   35 ( 11 )   3156 - 3160   2020.11( ISSN:0883-5403

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    BACKGROUND: Our previous study showed that the decrease in relative change of bone mineral density (BMD) in the lateral part of the tibia was significantly less in the group treated with the cementless porous tantalum component than in the group treated with the cemented cobalt-chromium tibial component up to 5 years after the operation. However, the long-term benefits of porous tantalum tibial component on BMD have not been proven. The aim of this study was to update a matched cohort study at a minimum of 6 years' follow-up period. METHODS: Twenty patients with a porous tantalum tibial component and 18 patients with a cemented cobalt-chromium-alloy tibial component were investigated for more than 6 years in the present study. The mean follow-up period was 11.4 years. Dual X-ray absorptiometry was used to measure the BMD. RESULTS: The decrease in relative change of BMD in the lateral aspect of the tibia was significantly less with the porous tantalum tibial component than that with the cemented cobalt-chromium tibial component up to 5 years. However, at the final follow-up period, no significant difference was observed in the relative change of BMD between the 2 groups. No prosthetic migration or periprosthetic fracture was detected in either group. CONCLUSION: The present study is one of the studies with the longest follow-up period on BMD after total knee arthroplasty. Porous tantalum tibial component did not have a favorable effect on the BMD of the proximal tibia after total knee arthroplasty for long term.

    DOI: 10.1016/j.arth.2020.06.014

    PubMed

  • 多骨病変を伴った希な小児リンパ管腫症の1例 Reviewed

    家口 尚, 星 学, 大戎 直人, 伴 祥高, 高松 聖仁, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 6 )   915 - 916   2020.11( ISSN:0008-9443

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  • アンモニア濃度換算式Handheld odor meterを用いた骨軟部腫瘍の臭気強度測定 Reviewed

    高田 尚輝, 星 学, 大戎 直人, 岩井 正, 嶋谷 彰芳, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 6 )   909 - 910   2020.11( ISSN:0008-9443

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  • リバース型人工肩関節置換術後1年の臨床成績の年代別比較 Reviewed

    山下 竜一, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 飯尾 亮介, 富本 彩夏, 中村 博亮

    (一社)日本肩関節学会 肩関節   44 ( 2 )   409 - 412   2020.11( ISSN:0910-4461

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    リバース型人工肩関節置換術(以下,RSA)術後1年の臨床成績及び周術期合併症発生率を年代別に比較した.対象はRSAを施行した122肩である.術前,術後1年に肩関節自動可動域,Constant score,VASを評価した.手術時年齢を80歳未満群(以下,U群)85肩,80歳以上群(以下,O群)37肩の2群に分けて比較検討した.両群ともに術前と比較して術後1年で,屈曲,外転,Constant score,VASの有意な改善がみられた.術前から術後1年での臨床成績の改善値は,屈曲,外転,下垂位外旋,Constant score,VASでは両群に有意差を認めなかったが,結帯に関してはU群が有意に低下していた.周術期合併症発生率はU群で16.5%,O群で8.1%であった.術後1年の臨床成績の改善値は,結帯を除いて両群に有意差はなく,周術期合併症発生率も両群に有意差を認めなかった.(著者抄録)

  • リバース型人工肩関節置換術における術後3次元評価システムの精度検証 2次元計測との比較 Reviewed

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一, 富本 彩夏, 中村 博亮

    (一社)日本肩関節学会 肩関節   44 ( 2 )   425 - 428   2020.11( ISSN:0910-4461

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    リバース型人工肩関節置換術の術後CT画像を使用し,2次元(以下,2D)評価と3次元(以下,3D)評価を行い,検者間及び検者内信頼性を検証した.対象は12例.2D評価として,SYNAPSE VINCENTを用いて計測した.3D評価として,Zed Shoulderを用いた.肩甲骨関節窩傾斜角(以下,GI),肩甲骨関節窩前後捻角(以下,GV),ステム後捻角(以下,SR),上腕骨オフセット(以下,HO)を計測した.2名の整形外科医で,1ヵ月以上の間隔を空けて2回計測した.2D計測と3D計測の検者間及び検者内信頼性を級内相関係数(ICC)にて算出した.検者間信頼性において2D計測のGI,SRと3D計測のHOが低く,検者内信頼性において2D計測のGV,HOと3D計測のSR,HOが低かった.今後,3D評価のさらなる再現性と正確性の確立のため,3Dで各種パラメータを自動表示するために必要な肩甲骨及び上腕骨上の特徴的な点をとる方法を検討する必要がある.(著者抄録)

  • Vitamin E-infused highly cross-linked polyethylene did not reduce the number of in vivo wear particles in total knee arthroplasty. Reviewed

    Kumi Orita, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Hideki Ueyama, Susumu Takemura, Hiroaki Nakamura

    The bone & joint journal   102B ( 11 )   1527 - 1534   2020.11( ISSN:2049-4394

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    AIMS: Vitamin E-infused highly cross-linked polyethylene (E1) has recently been introduced in total knee arthroplasty (TKA). An in vitro wear simulator study showed that E1 reduced polyethylene wear. However there is no published information regarding in vivo wear. Previous reports suggest that newly introduced materials which reduce in vitro polyethylene wear do not necessarily reduce in vivo polyethylene wear. To assist in the evaluation of the newly introduced material before widespread use, we established an in vivo polyethylene wear particle analysis for TKA. The aim of this study was to compare in vivo polyethylene wear particle generation between E1 and conventional polyethylene (ArCom) in TKA. METHODS: A total of 34 knees undergoing TKA (17 each with ArCom or E1) were investigated. Except for the polyethylene insert material, the prostheses used for both groups were identical. Synovial fluid was obtained at a mean of 3.4 years (SD 1.3) postoperatively. The in vivo polyethylene wear particles were isolated from the synovial fluid using a previously validated method and examined by scanning electron microscopy. RESULTS: The total number of polyethylene wear particles obtained from the knees with E1 (mean 6.9, SD 4.0 × 107 counts/knee) was greater than that obtained from those with ArCom (mean 2.2, SD 2.6 × 107 counts/knee) (p = 0.001). The particle size (equivalent circle of diameter) from the knees with E1 was smaller (mean 0.5 μm, SD 0.1) than that of knees with ArCom (mean 1.5, SD 0.3 μm) (p = 0.001). The aspect ratio of particles from the knees with E1 (mean 1.3, SD 0.1) was smaller than that with ArCom (mean 1.4, SD 0.1) (p < 0.001 ). CONCLUSION: This is the first report of in vivo wear particle analysis of E1. E1 polyethylene did not reduce the number of in vivo polyethylene wear particles compared with ArCom in early clinical stage. Further careful follow-up of newly introduced E1 for TKA should be carried out. Cite this article: Bone Joint J 2020;102-B(11):1527-1534.

    DOI: 10.1302/0301-620X.102B11.BJJ-2020-0413.R1

    PubMed

  • Simultaneous Opposition Tendon Transfer with Median Nerve Decompression for Severe Bilateral Carpal Tunnel Syndrome in Adolescents with Hunter Syndrome: A Case Report. Reviewed

    Takuya Uemura, Mitsuhiro Okada, Hidetomi Terai, Takuya Yokoi, Ema Onode, Kosuke Shintani, Sadahiko Konishi, Hiroaki Nakamura

    Plastic and reconstructive surgery. Global open   8 ( 11 )   e3251   2020.11( ISSN:2169-7574

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    Although carpal tunnel syndrome (CTS) is exceedingly rare in children, its prevalence in those with Hunter syndrome, mucopolysaccharidosis type II, is high. With the advent of hematopoietic stem cell transplantation and enzyme replacement therapy, the survival of patients with Hunter syndrome has dramatically improved. With improved longevity in these patients, CTS continues to progress with age. However, most patients with Hunter syndrome with CTS have generally been treated with an open carpal tunnel release (OCTR) only, without considering the severity. Here, we present a mid-term follow-up of a 16-year-old patient with Hunter syndrome associated with severe bilateral CTS successfully treated by the simultaneous opposition tendon transfer with an OCTR to improve the thumb function. Intraoperatively, the median nerve was constricted and flattened with congestion by the transverse carpal ligament. External and internal neurolysis of the scarred median nerve were performed and found epineural fibrosis and tethered epineurium. An intraneural lipoma of the left median nerve was especially resected with epineurotomy. During neurolysis and tendon transfer, the soft tissue was very viscous, a characteristic of mucopolysaccharidoses. Transferring the tension of the palmaris longus tendon to the abductor pollicis brevis for the thumb palmar abduction should be stronger than routine adult patients because the soft tissue such as the tendon excursion is stickier and more contracted in patients with Hunter syndrome. Postoperatively, a thumb spica splint was applied for 3 weeks, and then active motion exercises were cautiously started to prevent joint contracture. Early recognition and surgical intervention for CTS are essential in patients with Hunter syndrome.

    DOI: 10.1097/GOX.0000000000003251

    PubMed

  • Posterior vertebral column resection with short-segment fusion for the patients with congenital kyphoscoliosis. Reviewed

    Akira Matsumura, Takashi Namikawa, Minori Kato, Yusuke Hori, Masayoshi Iwamae, Noriaki Hidaka, Hiroaki Nakamura

    Journal of pediatric orthopedics. Part B   29 ( 6 )   572 - 579   2020.11( ISSN:1060-152X

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    The purpose of this study was to assess the surgical outcomes of posterior vertebral column resection (PVCR) with short-segment fusion for pediatric patients with congenital kyphoscoliosis (CKS). The medical records of 12 consecutive pediatric patients with CKS due to hemivertebrae located in thoracolumbar and lumbar area that had undergone PVCR and presented for follow-up at a minimum of 2 years were retrospectively reviewed. The mean follow-up period was 56.2 months, and the mean age at the surgery was 9.2 years. We evaluated radiographic parameters using plain radiographs, and evaluated segmental correction using computed tomography imaging. The mean values of the preoperative Cobb angle (cranial curve, main curve, and caudal curve) were 16.0°, 41.3°, and 25.0°, respectively. The main curve was reduced 5.4° after surgery and was maintained at 6.3° at the time of the most recent follow-up. The overall correction rate of main curve was 86.6%. Spontaneous correction rate in the cranial curve and caudal curve were calculated as 55.9 and 80.8%, respectively. The mean segmental scoliosis in the osteotomized segments and fused segments at preoperative/postoperative/final follow-up (FFU) were 40.8°/7.8°/9.2° and 34.3°/3.9°/5.1°, respectively. The mean segmental kyphosis in the osteotomized segments and fused segments at the preoperative/postoperative/FFU were 36.0°/3.8°/4.0° and 27.5°/-1.3°/0.7°, respectively. Our data indicate that PVCR with short-segment fusion for CKS can provide good correction in the main curve and spontaneous correction in the compensatory curves after a minimum 2-year follow-up. Further investigation over the long term is mandatory for pediatric patients.

    DOI: 10.1097/BPB.0000000000000729

    PubMed

  • Can Conventional Magnetic Resonance Imaging Substitute Three-Dimensional Magnetic Resonance Imaging in the Diagnosis of Lumbar Foraminal Stenosis? Reviewed

    Hasib MM, Yamada K, Hoshino M, Yamada E, Tamai K, Takahashi S, Suzuki A, Toyoda H, Terai H, Nakamura H

    Asian spine journal   15 ( 4 )   472 - 480   2020.10( ISSN:1976-1902

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    DOI: 10.31616/asj.2020.0133

    PubMed

  • Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports. Reviewed

    Yusuke Miyashima, Takuya Uemura, Takuya Yokoi, Shunpei Hama, Mitsuhiro Okada, Sadahiko Konishi, Hiroaki Nakamura

    BMC musculoskeletal disorders   21 ( 1 )   672 - 672   2020.10

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    BACKGROUND: While some traumatic closed index extensor tendon ruptures at the musclotendinous junction have been previously reported, closed index extensor tendon pseudorupture due to intertendinous attenuation is exceedingly rare with only one case report of a gymnastics-related sports injury in the English literature. Herein, we report two non-sports injury related cases of traumatic index extensor tendon attenuation mimicking closed tendon rupture, including the pathological findings and intraoperative video of the attenuated extensor indicis proprius tendon. CASE PRESENTATION: A 28-year-old man and a 30-year-old man caught their hands in a high-speed drill and lathe, respectively, which caused a sudden forced flexion of their wrists. They could not actively extend the metacarpophalangeal joints of their index fingers. Intraoperatively, although the extensor indicis proprius and index extensor digitorum communes tendons were in continuity without ruptures, both tendons were attenuated and stretched. The attenuated index extensor tendons were reconstructed either with shortening by plication or step-cut when the tendon damage was less severe or, in severely attenuated tendons, with tendon grafting (ipsilateral palmaris longus) or tendon transfer. Six months after the operation, the active extension of the index metacarpophalangeal joints had recovered well. CONCLUSIONS: Two cases of traumatic index extensor tendon attenuation were treated successfully by shortening the attenuated tendon in combination with tendon graft or transfer. We recommend WALANT (wide-awake local anesthesia and no tourniquet) in the reconstruction surgery of index extensor tendon attenuation to determine the appropriate amount of tendon shortening or optimal tension for tendon grafting or transfer. Intraoperative voluntary finger movement is essential, as it is otherwise difficult to judge the stretch length of intratendinous elongation and extent of traumatic intramuscular damage affecting tendon excursion.

    DOI: 10.1186/s12891-020-03692-6

    PubMed

  • Factors Related to Postoperative Osteochondritis Dissecans of the Lateral Femoral Condyle After Meniscal Surgery in Juvenile Patients With a Discoid Lateral Meniscus Reviewed

    Hashimoto Yusuke, Nishino Kazuya, Reid John B. III, Yamasaki Shinya, Takigami Junsei, Tomihara Tomohiro, Takahashi Shinji, Shimada Nagakazu, Nakamura Hiroaki

    JOURNAL OF PEDIATRIC ORTHOPAEDICS   40 ( 9 )   E853 - E859   2020.10( ISSN:0271-6798

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    DOI: 10.1097/BPO.0000000000001636

    PubMed

  • Advanced glycation end products in musculoskeletal system and disorders. Reviewed

    Suzuki A, Yabu A, Nakamura H

    Methods (San Diego, Calif.)   2020.09( ISSN:1046-2023

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    DOI: 10.1016/j.ymeth.2020.09.012

    PubMed

  • The Severity of Cervical Disc Degeneration Does Not Impact 2-year Postoperative Outcomes in Patients With Cervical Spondylotic Myelopathy Who Underwent Laminoplasty Reviewed

    Habibi Hasibullah, Suzuki Akinobu, Tamai Koji, Ohyama Shoichiro, Hori Yusuke, Yabu Akito, Terai Hidetomi, Hoshino Masatoshi, Toyoda Hiromitsu, Takahashi Shinji, Ahmadi Sayed Abdullah, Nakamura Hiroaki

    SPINE   45 ( 18 )   E1142 - E1149   2020.09( ISSN:0362-2436

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    DOI: 10.1097/BRS.0000000000003528

    PubMed

  • Patients with a quadriceps tendon shorter than 60 mm require a patellar bone plug autograft in anterior cruciate ligament reconstruction. Reviewed

    Shinya Yamasaki, Yusuke Hashimoto, Changhun Han, Kazuya Nishino, Noriaki Hidaka, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   29 ( 6 )   1927 - 1935   2020.09( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: To assess the length and thickness of the quadriceps tendon (QT) and anterior cruciate ligament (ACL) to predict the required QT length for individual ACL reconstruction. METHODS: Thirty patients (9 females, 21 males; mean age 24.5 years; mean height 169.3 cm) who underwent ACL reconstruction using the QT with a bone plug autograft were enrolled. The length and thickness of the QT on preoperative magnetic resonance imaging (MRI) were compared with those measured under direct visualization. The ACL length was measured on preoperative MRI and three-dimensional computed tomography after ACL reconstruction. The QT length on MRI was compared with the required graft length, and the factors related to an adequate QT length were assessed. RESULTS: The mean QT length on MRI was 60.8 ± 1.3 mm and was significantly positively correlated with the QT length under direct visualization (P < 0.01). On MRI, the mean ACL length was 30.8 ± 1.2 mm and the mean QT thickness was 6.3 ± 0.2 mm. Although the mean QT was 0.1 mm longer than the mean required graft length, the QT on MRI was shorter than the required graft length in 37% of patients (11/30). Adequate QT length was related to a QT length of more than 60 mm, but not to age, sex, height, or ACL length. CONCLUSION: Although preoperative MRI predicted the required QT length for ACL reconstruction, 37% of patients lacked an adequate QT length, and a QT shorter than 60 mm required the addition of patellar bone. LEVEL OF EVIDENCE: III.

    DOI: 10.1007/s00167-020-06261-5

    PubMed

  • A new classification for coronal malalignment in adult spinal deformity: a validation and the role of lateral bending radiographs. Reviewed

    Kazunori Hayashi, Louis Boissière, Derek T Cawley, Daniel Larrieu, David Kieser, Pedro Berjano, Claudio Lamartina, Munich Gupta, Clément Silvestre, Themi Protopsaltis, Anouar Bourghli, Ferran Pellisé, Prokopis Annis, Elias C Papadopoulos, Gaby Kreichati, Javier Pizones, Hiroaki Nakamura, Christopher P Ames, Ibrahim Obeid

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   29 ( 9 )   2287 - 2294   2020.09( ISSN:0940-6719

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    PURPOSE: Coronal malalignment (CM) causes pain, impairment of function and cosmetic problems for adult spinal deformity (ASD) patients in addition to sagittal malalignment. Certain types of CM are at risk of insufficient re-alignment after correction. However, CM has received minimal attention in the literature compared to sagittal malalignment. The purpose was to establish reliability for our recently published classification system of CM in ASD among spine surgeons. METHODS: Fifteen readers were assigned 28 cases for classification, who represented CM with reference to their full-length standing anteroposterior and lateral radiographs. The assignment was repeated 2 weeks later, then a third assignment was done with reference to additional side bending radiographs (SBRs). Intra-, inter-rater reliability and contribution of SBRs were determined. RESULTS: Intra-rater reliability was calculated as 0.95, 0.86 and 0.73 for main curve types, subtypes with first modifier, and subtypes with two modifiers respectively. Inter-rater reliability averaged 0.91, 0.75 and 0.52. No differences in intra-rater reliability were shown between the four expert elaborators of the classification and other readers. SBRs helped to increase the concordance rate of second modifiers or changed to appropriate grading in cases graded type A in first modifier. CONCLUSIONS: Adequate intra- and inter-rater reliability was shown in the Obeid-CM classification with reference to full spine anteroposterior and lateral radiographs. While side bending radiographs did not improve the classification reliability, they contributed to a better understanding in certain cases. Surgeons should consider both the sagittal and coronal planes, and this system may allow better surgical decision making for CM.

    DOI: 10.1007/s00586-020-06513-5

    PubMed

  • 陳旧性肩関節前方脱臼に対するリバース型人工肩関節置換術の短期臨床成績 Reviewed

    松田 淑伸, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一, 中村 博亮

    (一社)日本肩関節学会 肩関節   44 ( 1 )   21 - 24   2020.09( ISSN:0910-4461

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    陳旧性肩関節前方脱臼に対して様々な治療法が報告されている.本研究の目的は陳旧性肩関節前方脱臼に対するリバース型人工肩関節置換術(以下RSA)の短期臨床成績を評価することである.対照は10例10肩,女性9肩,男性1肩で,手術時平均年齢は78.4歳であった.臨床成績は術前,術後1年時に評価し,肩関節自動可動域(屈曲,外転,下垂位外旋,内旋),日本整形外科学会肩関節疾患治療成績判定基準(以下JOAスコア),Constantスコアを測定した.肩関節自動可動域は屈曲が術前平均46.5度から術後1年で平均104度に,外転が術前平均46.5度から術後1年で平均92度に,下垂位外旋が術前平均-6.5度から術後1年で平均11.5度に,結帯スコアは術前平均1.6点が術後1年で平均4点に,JOAスコアは術前平均32.6点が術後1年で平均67.4点に,Constantスコアは術前平均23.3点が術後1年で平均50.3点に有意に改善みられた(全てp<0.05).陳旧性肩関節前方脱臼に対するRSAの術後1年での臨床成績は良好であった.(著者抄録)

  • 関節リウマチに伴う重度PIP関節強直に対して人工指関節(シリコンインプラント)置換術で治療した1例 Reviewed

    上村 卓也, 恵木 丈, 小西 定彦, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 5 )   737 - 738   2020.09( ISSN:0008-9443

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    46歳女。右環指・小指の変形を主訴に紹介受診した。右小指は約5年前、環指は約3年前に、それぞれPIP関節炎に伴う屈曲変形が出現し、その後関節強直に至っていた。患者はPIP関節屈曲変形の矯正だけでなく手指屈曲が可能な可動性のあるPIP関節を希望したため、環指・小指の人工PIP関節(シリコンインプラント)置換術を施行した。後療法ではPIP関節を伸展位に保持できるよう、PIP関節を伸展位で長めに外固定することにより良好な術後可動域が得られた。

  • 人工肩関節全置換術後の反復性肩関節後方脱臼に対してリバース型人工肩関節置換術を施行した一例 Reviewed

    富本 彩夏, 間中 智哉, 中澤 克優, 伊藤 陽一, 中村 博亮

    (一社)日本肩関節学会 肩関節   44 ( 1 )   213 - 217   2020.09( ISSN:0910-4461

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    人工肩関節全置換術(以下,TSA)術後の反復性肩関節後方脱臼に対して,リバース型人工肩関節置換術(以下,RSA)を施行した1例を経験したので報告する.症例は86歳女性で,肩関節単純X線でTSA後の上腕骨頭の上方化,CTでグレノイドコンポーネントの後捻と上腕骨頭の後方亜脱臼を認めた.ステムとグレノイドコンポーネントを抜去し,Norris法による腸骨移植を併用し,RSAを施行した.術後1年で再脱臼を認めることなく経過良好である.(著者抄録)

  • リバース型人工肩関節置換術における術前3次元評価システムの再現性評価 Reviewed

    中澤 克優, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 山下 竜一, 富本 彩夏, 中村 博亮

    (一社)日本肩関節学会 肩関節   44 ( 1 )   196 - 200   2020.09( ISSN:0910-4461

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    リバース型人工肩関節置換術の術前CT画像を使用し,2次元(以下,2D)評価と3次元(以下,3D)評価を行い,検者間及び検者内信頼性を検証した.対象は12例.3D評価として,術前に1mmスライスで撮像したCTのaxial像のDICOMデータをLEXI社Zed Shoulderに読み込み関節窩傾斜角(以下,GI),関節窩前後捻角(以下,GV),上腕骨後捻角(以下HR),関節窩最大高(以下,GH),関節窩最大幅(以下,GW)を計測した.一方,2D評価として単純CTを用い計測した.2名の整形外科医で,1ヵ月以上の間隔にて2回計測した.2D計測と3D計測の検者間及び検者内信頼性を級内相関係数(ICC)にて算出した.検者間信頼性において2D計測のGI,GVと3D計測のGI,GV,HRが低く,検者内信頼性において2D計測のGI,GVと3D計測のGIが低かった.今後,3D評価のさらなる再現性と正確性の確立のため,参照点デジタイズの方法の改良および座標系の再構築を行う必要性がある.(著者抄録)

  • Investigation of multiple primary cancers in patients with bone and soft tissue primary malignancies: A retrospective, institution-based study. Reviewed

    Akiyoshi Shimatani, Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Naoki Takada, Hiroaki Nakamura

    Molecular and clinical oncology   13 ( 3 )   17 - 6   2020.09( ISSN:2049-9450

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    In the aging society in Japan, the occurrence of multiple primary cancers has recently increased due to an increase in life expectancy and increased development in cancer diagnostic technology and improvement in treatment outcomes. However, few reports have focused on multiple primary cancers in patients with bone and soft tissue tumors. The present study aimed to analyze the clinical characteristics of patients with multiple malignancies of the bone and soft tissue. Between April 2008 and April 2017, among 973 patients treated at the Department of Orthopedic Surgery, Osaka City University Hospital, those with multiple primary cancers involving bone and soft tissue were identified. The number of cases with multiple cancers in the present study was 30/973 (3.08%), including 21 males and 9 females. The median age at diagnosis of patients with bone and soft tissue sarcoma was 73.5 years (range, 7-83 years). There were 22 patients with double cancers, and 5, 2 and 1 patients with triple, quadruple and quintuple cancers, respectively. Colorectal cancer was the most common primary cancer (n=9). In total, 28.6% of patients had simultaneous cancer, while 71.4% of patients had heterochronous cancer. The overall 5-year survival for all patients was 75.6%. The prognosis of patients with double cancer of bone and soft tissue sarcoma was not necessarily poor. However, it is necessary to pay attention to the possibility of secondary malignancy. Therefore, it is essential to be careful and well organized when selecting treatment modalities and to adopt a logistical approach for the care of patients with ongoing multiple malignancies.

    DOI: 10.3892/mco.2020.2088

    PubMed

  • Surgical outcomes of multilevel posterior lumbar interbody fusion versus lateral lumbar interbody fusion for the correction of adult spinal deformity: A comparative clinical study

    Iwamae M.

    Asian Spine Journal   14 ( 4 )   421 - 429   2020.08( ISSN:19761902

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  • Full HA compaction stemのPOLARSTEMの操作性は良好である Reviewed

    洲鎌 亮, 箕田 行秀, 大田 陽一, 上山 秀樹, 竹村 進, 飯田 健, 柳井 亮介, 中村 博亮

    日本股関節学会 Hip Joint   46 ( 1 )   291 - 294   2020.08( ISSN:0389-3634

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    当科でPOLARSTEMを使用した23例25関節を対象とし、術後1週間以内のX線像をもとに「ステムアライメント」「ステムの挿入深度」「Cancellous bedの有無」について調査した。また、術前X線でテンプレートした予想のステムサイズと実際に使用したステムサイズの違いについて調査した。ステムアライメントは、術中に内外反・屈曲伸展とも0°の挿入を目標とし、術後のX線計測では全例が内外反・屈曲伸展とも2°以内に設置されていた。ステムの挿入深度については、ラスプ深度と本物のステムの挿入深度の違いについて評価し、手術時の印象としてラスプ深度より本物のステムが浮いた症例はなかった。X線正面像でCancellous bedが確認できたのは16関節(64%)であった。術前X線でテンプレートしたステムサイズと実際のステムサイズの違いについては、実際のステムが1サイズ大きくなったものが1関節(4%)、1サイズ小さくなったものが3関節(12%)、違いはなく一致したものが21関節(84%)であった。

  • 骨粗鬆症性第4腰椎椎体骨折後遅発性麻痺に対してX-coreを用い後方要素を温存したShort fusionの治療経験 Reviewed

    佐々木 亮, 前野 考史, 河野 浩, 馬野 雅之, 中村 博亮

    (一社)日本脊椎脊髄病学会 Journal of Spine Research   11 ( 8 )   1038 - 1043   2020.08( ISSN:1884-7137

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    第4腰椎椎体骨折後遅発性麻痺に対して,X-coreを用いて後方棘突起列を温存した1 above 1 belowのShort fusionを3症例に行った.術後臨床成績は良好であり,術後局所前彎角や椎体間高は矯正され最終観察時まで維持できており,全例で骨癒合を認めた.骨粗鬆症性第4腰椎椎体骨折後遅発性麻痺に対して,本術式は選択肢の一つとなり得ると考えられた.(著者抄録)

  • 骨粗鬆症性椎体骨折に対するBalloon Kyphoplastyの適応と限界 Reviewed

    高橋 真治, 星野 雅俊, 中村 博亮

    (一社)日本骨粗鬆症学会 日本骨粗鬆症学会雑誌   6 ( 3 )   398 - 401   2020.08( ISSN:2189-8383

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    骨粗鬆症性椎体骨折に対するBalloon kyphoplasty(BKP)後、再手術になる症例について、術前の画像学的特徴を調査した。対象は、BKP後の再手術14例とBKP単独105例とした。再手術14例中10例は、後方固定の追加を行い、セメントを抜去せず、instrumentationと骨移植を行った。4例は前方後方同時固定術を行い、前方からの椎体亜全摘、セメント除去および骨移植を実施した。骨折形態についてはAO分類を用いた。脆弱性骨折については、椎体楔状角や動態撮影での椎体可動性、CTでの後壁損傷、椎弓根骨折、棘突起骨折、diffuse idiopathic skeletal hyperostosis(DISH)の存在、終板の欠損、Split typeなどの評価を行った。その結果、再手術群とBKP単独群において、術前の椎体可動性は、再手術群で有意に大きかった。術前椎体楔状角は、有意差がなかった。術直後の楔状角は、再手術群で有意に小さかった。DISHおよび、棘突起骨折や椎弓根骨折、後壁損傷は有意差がなかった。Split typeおよび終板欠損は、再手術で有意に頻度が高かった。ROC curveでは、再手術に関連する術前の椎体可動角のカットオフ値は14°であった。Split type、14°以上の椎体可動性、終板欠損が再手術の危険因子であった。

  • Surgical Outcomes of Multilevel Posterior Lumbar Interbody Fusion versus Lateral Lumbar Interbody Fusion for the Correction of Adult Spinal Deformity: A Comparative Clinical Study. Reviewed

    Masayoshi Iwamae, Akira Matsumura, Takashi Namikawa, Minori Kato, Yusuke Hori, Akito Yabu, Yuta Sawada, Noriaki Hidaka, Hiroaki Nakamura

    Asian spine journal   14 ( 4 )   421 - 429   2020.08( ISSN:1976-1902

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    STUDY DESIGN: A retrospective case control study. PURPOSE: The purpose of this study was to compare the surgical outcomes of multilevel lateral lumbar interbody fusion (LIF) and multilevel posterior lumbar interbody fusion (PLIF) in the surgical treatment of adult spinal deformity (ASD) and to evaluate the sagittal plane correction by combining LIF with posterior-column osteotomy (PCO). OVERVIEW OF LITERATURE: The surgical outcomes between multilevel LIF and multilevel PLIF in ASD patients remain unclear. METHODS: We retrospectively reviewed 31 ASD patients who underwent multilevel LIF combined with PCO (LIF group, n=14) or multilevel PLIF (PLIF group, n=17) and with a minimum 2-year follow-up. In the comparison between LIF and PLIF groups, their mean age at surgery was 69.4 vs. 61.8 years while the mean follow-up period was 29.2 vs. 59.3 months. We evaluated the transition of pelvic incidence-lumbar lordosis (PI-LL) and disc angle (DA) in the LIF group, in fulcrum backward bending (FBB), after LIF and after posterior spinal fusion (PSF) with PCO. The spinopelvic radiographic parameters were compared between LIF and PLIF groups. RESULTS: Compared with the PLIF group, the LIF group had less blood loss and comparable surgical outcomes with respect to radiographic data, health-related quality of life scores and surgical time. In the LIF group, the mean DA and PI-LL were unchanged after LIF (DA, 5.8°; PI-LL, 15°) compared with the values using FBB (DA, 4.3°; PI-LL, 15°) and improved significantly after PSF with PCO (DA, 8.1°; PI-LL, 0°). CONCLUSIONS: In the surgical treatment of ASD, multilevel LIF is less invasive than multilevel PLIF and combination of LIF and PCO would be necessary for optimal sagittal correction in patients with rigid deformity.

    DOI: 10.31616/asj.2019.0357

    PubMed

  • Intra-Articular Injection of Stromal Cell-Derived Factor 1α Promotes Meniscal Healing via Macrophage and Mesenchymal Stem Cell Accumulation in a Rat Meniscal Defect Model. Reviewed

    Yohei Nishida, Yusuke Hashimoto, Kumi Orita, Kazuya Nishino, Takuya Kinoshita, Hiroaki Nakamura

    International journal of molecular sciences   21 ( 15 )   1 - 17   2020.08( ISSN:16616596

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    The stromal-cell-derived factor-1α (SDF-1) is well-known for playing important roles in the regeneration of tissue by enhancing cell migration. However, the effect of SDF-1 in meniscal healing remains unknown. The purpose of this study is to investigate the effects of intra-articular injection of SDF-1 on meniscus healing in a rat meniscal defect model. The intra-articular SDF-1 injection was performed at meniscectomy and one week later. Macroscopic and histological assessments of the reparative meniscus were conducted at one, two and six weeks after meniscectomy in rats. In the macroscopic evaluation, the SDF-1 group showed an increase in the size of the reparative meniscus at six weeks after meniscectomy compared to the phosphate-buffered saline (PBS) injection (no-treatment) group. Histological findings showed that intra-articular injection of SDF-1 enhanced the migration of macrophages to the site of the regenerative meniscus at one and two weeks after meniscectomy. CD68- and CD163-positive cells in the SDF-1 group at one week after meniscectomy were significantly higher than in the no-treatment group. CD163-positive cells in the SDF-1 group at two weeks were significantly higher than in the no-treatment group. At one week after meniscectomy, there were cells expressing mesenchymal-stem-cell-related markers in the SDF-1 group. These results indicate the potential of regenerative healing of the meniscus by SDF-1 injection via macrophage and mesenchymal stem cell accumulation. In the present study, intra-articular administration of SDF-1 contributed to meniscal healing via macrophage, CD90-positive cell and CD105-positive cell accumulation in a rat meniscal defect model. The SDF-1-CXCR4 pathway plays an important role in the meniscal healing process. For potential clinical translation, SDF-1 injection therapy seems to be a promising approach for the biological augmentation in meniscal injury areas to enhance healing capacity.

    DOI: 10.3390/ijms21155454

    PubMed

  • HipAlign New Lateralを用いたカップ設置角度の精度検証 Reviewed

    柳井 亮介, 洲鎌 亮, 箕田 行秀, 大田 陽一, 上山 秀樹, 竹村 進, 飯田 健, 中村 博亮

    日本股関節学会 Hip Joint   46 ( 2 )   950 - 952   2020.08( ISSN:0389-3634

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    HipAlign New Lateral(本製品)を用いて行った側臥位人工股関節全置換術(THA)でのカップ設置角度の精度を検証した。本製品を用いてTHAを行った14例14関節(男性2例、女性12例、平均62.8歳)を対象とした。全例側臥位で手術を行い、アプローチの内訳は、anterolateralアプローチが8例、direct lateralアプローチが2例、OCMアプローチが4例であった。手術中に本製品を用いてカップ設置を行い、設置後に本製品が表示した角度を記録した。カップ設置角度の誤差は絶対値で外方開角5.1±3.4°、前方開角1.3±1.3°であった。カップ設置での的中率で考えると、外方開角・前方開角ともに5°以内の誤差で設置できた症例は57%、10°以内の誤差で設置できた症例は92%であった。本製品はTHAにおけるカップ設置に有用と結論づけることが可能と思われた。

  • Arthroscopic debridement for gouty arthritis of the knee caused by anorexia nervosa: A case report. Reviewed

    Kinoshita T, Hashimoto Y, Okano T, Nishida Y, Nakamura H

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   2020.07( ISSN:0949-2658

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    DOI: 10.1016/j.jos.2020.04.016

    PubMed

  • Arthroscopic debridement for gouty arthritis of the knee caused by anorexia nervosa: A case report.

    Kinoshita T, Hashimoto Y, Okano T, Nishida Y, Nakamura H

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   2020.07( ISSN:0949-2658

  • Abnormal displacement of discoid lateral meniscus with snapping knee detected by full extension and deep flexion MRI: Report of two cases. Reviewed

    Yusuke Hashimoto, Nishino Kazuya, Junsei Takigami, Shinya Yamasaki, Tomohiro Tomihara, Nagakazu Shimada, Hiroaki Nakamura

    Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology   21   1 - 4   2020.07( ISSN:2214-6873

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    We evaluated the abnormal displacement of a complete discoid lateral meniscus in two patients with symptoms of a large popping sound during knee flexion and extension, so-called "snapping", and no displacement of the discoid meniscus on routine Magnetic Resonance Imaging (MRI) analysis. MRI images indicated an anterocentral shift of the lateral discoid meniscus on knee deep flexion in one case and a posterocentral shift of the meniscus on knee full extension in the other case. Abnormal meniscal instability was confirmed under arthroscopy in both knees. After arthroscopic partial meniscectomy, one case of posterior horn instability was treated with an inside-out arthroscopic technique, whereas the other case of anterior horn instability was treated with an all-inside repair technique. We conclude that the symptom of a large popping sound during knee motion may indicate abnormal displacement of a complete discoid lateral meniscus and that further MRI analyses on knee full extension and deep flexion may reveal discernible meniscal displacement.

    DOI: 10.1016/j.asmart.2020.03.004

    PubMed

  • 脊椎肥厚性硬膜炎の1例 Reviewed

    大西 裕真, 北 輝夫, 佐々木 亮, 高山 和士, 坂中 秀樹, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 4 )   527 - 528   2020.07( ISSN:0008-9443

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    77歳男。1週間前より誘因なく出現した腰背部痛、左優位の両下肢筋力低下、臍部以下のしびれにて受診した。血液検査ではCRP上昇を認めたが、腫瘍、自己免疫疾患、血管炎マーカーは陰性であり、髄液検査では単核球優位の細胞数と総蛋白の上昇を呈した。画像検査ではMRIガドリニウム造影でTh9-L2の多椎間に連続し、硬膜を全周性に取り囲む占拠性病変を認めたことから肥厚性硬膜炎が疑われ、ステロイド治療が有効であったが、診断確定の目的で背側肥厚硬膜切除生検を行い、肥厚性硬膜炎と診断された。術後再発は認めず、術後1年経過時点で筋力は改善し、屋内伝い歩きが可能となった。

  • Initiating range of motion exercises within 24 hours following total knee arthroplasty affects the reduction of postoperative pain: A randomized controlled trial. Reviewed

    Kentaro Iwakiri, Yoichi Ohta, Yuuki Shibata, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura

    Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology   21   11 - 16   2020.07( ISSN:2214-6873

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    BACKGROUND: Postoperative limitations in the range of motion (ROM) after TKA may occur occasionally and restrict a patient's ADL. Although ROM exercise is a means of increasing the ROM after TKA, the optimal time of initiating ROM exercise is still unclear. The purpose of this study is to examine different initiation timings of postoperative ROM exercises after TKA and to compare the results in terms of postoperative pain, swelling, and ROM improvement to determine the optimal time of initiating ROM exercises following TKA. METHODS: This was a prospective, single-center, single-blinded randomized controlled trial involving 109 patients scheduled for unilateral TKA. All patients underwent the physiotherapist assisted passive and active same rehabilitation program that only differed in the starting time of ROM exercise on postoperative day 1 or day 7. Postoperative assessment was performed with all attending personnel blinded to group assignment. Visual analog scale (VAS) of pain, ROM, thigh swelling, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and adverse outcomes were compared between groups on postoperative days within 2 years after surgery. RESULTS: VAS scores during the postoperative period from 18 to 72 h were significantly lower in the group with starting time of ROM exercise on postoperative day 1. The ROM, laboratory data, thigh girth, WOMAC and the incidence of complications did not differ between the two groups at any postoperative time-point. CONCLUSIONS: The results of this study suggested that ROM exercises beginning in the early postoperative stage are advantageous in reducing the postoperative pain after TKA.

    DOI: 10.1016/j.asmart.2020.03.003

    PubMed

  • Clinical significance of thermal detection of soft-tissue tumors(和訳中) Reviewed

    Shimatani Akiyoshi, Hoshi Manabu, Oebisu Naoto, Iwai Tadashi, Takada Naoki, Nakamura Hiroaki

    シュプリンガー・ジャパン(株) International Journal of Clinical Oncology   25 ( 7 )   1418 - 1424   2020.07( ISSN:1341-9625

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    軟部組織腫瘍患者100例を対象とし、整形外科腫瘍医により、触診で認められる異常熱感部位の温度を測定し、皮膚温と悪性腫瘍との関連を調査した。なお、患側部と健側部の実測値の測定には非接触型赤外線温度計と赤外線サーモグラフィーカメラで計測した。その結果、整形外科腫瘍医の半数以上から、患側部と健側部間では0.2℃以上の温度差が検出され、軟部組織腫瘍患者100例中92例に対し、触診所見の一致が認められた。また、異常な温度分布に関しても、悪性腫瘍の有無との有意な関連性が示され、0.2℃以上の温度差は、悪性腫瘍と有意に関連することが明らかにされた。本検討により、整形外科腫瘍医による異常な温度分布の検出は、軟部組織病変で悪性腫瘍を示唆する、臨床的に重要な所見と判断された。

  • Clinical significance of thermal detection of soft-tissue tumors. Reviewed

    Akiyoshi Shimatani, Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Naoki Takada, Hiroaki Nakamura

    International journal of clinical oncology   25 ( 7 )   1418 - 1424   2020.07( ISSN:1341-9625

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    BACKGROUND: Soft-tissue tumors are often accompanied by abnormal temperature distribution detected during palpation. However, the assessment of temperature distribution is subjective, limiting its wide use in cancer screening. The aim of this study was to evaluate the clinical significance of the thermal detection of soft-tissue tumors. METHODS: This study involved 100 soft-tissue tumor patients, the pathological diagnosis of which was confirmed by surgery from February 2017 to March 2019 in our hospital. Sixty patients were diagnosed with benign lesions, while 40 patients had malignant tumors. The cohort consisted of 52 males and 48 females, with a median age of 62 (range 22-84). Temperature difference detection by orthopedic oncologists, as well as the consistency and accuracy of temperature distribution detection by orthopedic oncologists, were investigated. The relationship between abnormal temperature distribution and the presence of malignancy in soft tissue was also explored. RESULTS: We found that more than half of the orthopedic oncologists could detect a temperature difference of 0.2 °C or higher. All three surgeons reported consistent temperature distribution findings after palpation in 92 out of 100 soft-tumor patients. The presence of abnormal temperature distribution was significantly associated with the presence of malignancy (P < 0.0017). Temperature differences of 0.2 °C or higher were significantly associated with the presence of malignant tumors (P < 0.001). CONCLUSIONS: Diagnosis of abnormal temperature distribution by orthopedic oncologists could suggest the presence of malignancy in patients with soft-tissue lesions.

    DOI: 10.1007/s10147-020-01658-1

    PubMed

  • Predictors of residual low back pain after acute osteoporotic compression fracture. Reviewed

    Inose H, Kato T, Ichimura S, Nakamura H, Hoshino M, Togawa D, Hirano T, Tokuhashi Y, Ohba T, Haro H, Tsuji T, Sato K, Sasao Y, Takahata M, Otani K, Momoshima S, Yuasa M, Hirai T, Yoshii T, Okawa A

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   26 ( 3 )   453 - 458   2020.06( ISSN:0949-2658

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    DOI: 10.1016/j.jos.2020.04.015

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  • Facet joint opening on preoperative computed tomography is risk factor for revision surgery after less invasive decompression procedure for lumbar spinal stenosis

    Yamada Kentaro, Toyoda Hiromitsu, Tamai Koji, Takahashi Shinji, Suzuki Akinobu, Hoshino Masatoshi, Terai Hidetomi, Nakamura Hiroaki

    Journal of Spine Research   11 ( 6 )   936 - 941   2020.06( ISSN:18847137 ( eISSN:24351563

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    <p><b>Purpose: </b>There is no consensus of regarding the indication of surgical treatment of the less invasive decompression procedure for lumbar spinal stenosis (LSS). Although facet joint opening (FO) on preoperative computed tomography (CT) images has been reported as a parameter indicating segmental instability, there is no report on how FO affects on postoperative outcomes. The purpose of this study was to investigate risk factors for revision surgery after less invasive decompression surgery for LSS including FO by a minimum-5-year postoperative survey.</p><p><b>Materials and Methods: </b>A total of 244 patients who underwent microscopic or microendoscopic decompression surgery for LSS and followed for ≥5 years were included in this study. We investigated revision lumbar surgeries at the same levels or other lumbar levels based on medical records. Revision surgeries due to postoperative hematoma or infection were excluded. FO was defined as a ≥2 mm opening on preoperative axial CT images at each lumbar intervertebral level. We evaluated the FO at index decompression levels and sum of FO-positive levels from L1-2 to L5-S. Risk factors for further surgeries were investigated among demographics, preoperative symptoms, and radiological parameters other than FO using univariate and cox proportional hazard regression analysis.</p><p><b>Results: </b>There was 26 reoperations (10.7%) at a mean of 3.9 years after primary surgeries. FO at index decompression levels was significantly more frequent in patients with than without revision surgeries (69 and 39%, respectively, p=0.003). The sum of FO-positive levels among lumbar segments was significantly higher in patients with than without revision surgeries (2.0 and 1.2 levels, respectively, p=0.001). The cox proportional hazard regression analysis indicated that the sum of FO-positive levels among lumbar segments was one of the risk factors for revision surgery (p=0.003, adjusted hazard ratio: 1.47).</p><p><b>Conclusions: </b>The FO of index decompression levels and sum of FO were associated with the need for further lumbar surgeries after less invasive surgery. FO might indicate not only segmental instability but also predictive parameter for progression of degenerative change.</p>

    DOI: 10.34371/jspineres.2020-0512

    CiNii Article

  • Promising abscopal effect of combination therapy with thermal tumour ablation and intratumoural OK-432 injection in the rat osteosarcoma model. Reviewed

    Tadashi Iwai, Naoto Oebisu, Manabu Hoshi, Kumi Orita, Akira Yamamoto, Shinichi Hamamoto, Ken Kageyama, Hiroaki Nakamura

    Scientific reports   10 ( 1 )   9679 - 9679   2020.06( ISSN:2045-2322

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Treatment options for metastatic osteosarcoma are limited. The present study aimed to evaluate whether radiofrequency ablation (RFA) combined with intratumoural OK-432 injection induces systemic anti-tumour immunity in rat osteosarcoma model. Eighty of 145 rats were assigned to four groups to evaluate overall survival and tumour size: control (no treatment), RFA-only, OK-432, and RFA-OK-432. The remaining 65 were assigned for histological examination. Maximum diameters of tibial and lung tumours were determined. Tumour samples were histologically examined using haematoxylin-eosin and immunohistochemical staining. Overall survival was significantly prolonged in the RFA-OK-432 group compared to the RFA-only and OK-432 groups. Only rats in the RFA-OK-432 group exhibited significant decreases in maximum tumour diameter after treatment. Ki-67-positive tumour cells in the RFA-OK-432 group were significantly stained negative on immunohistochemical analysis as opposed to those in the RFA-only and OK-432 groups. The number of CD11c+, OX-62+, CD4+, and CD8 + cells significantly increased in the RFA-OK-432 group compared to the RFA-only group. RFA with intratumoural OK-432 injection resulted in distant tumour suppression, prolonged survival, and increased dendritic cells, cytotoxic T cells, IFN-γ, and TNF-α, whereas RFA or OK-432 alone did not produce this effect. This combination may induce an abscopal effect in human osteosarcoma.

    DOI: 10.1038/s41598-020-66934-6

    PubMed

  • 2020 Chitranjan S. Ranawat Award: Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty A PROSPECTIVE DOUBLE-BLIND RANDOMIZED CONTROLLED TRIAL Reviewed

    Ueyama H., Kanemoto N., Minoda Y., Taniguchi Y., Nakamura H.

    BONE & JOINT JOURNAL   102B ( 6 )   10 - 18   2020.06( ISSN:2049-4394

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    DOI: 10.1302/0301-620X.102B6.BJJ-2019-1370.R1

    PubMed

  • RHEUMATOID ARTHRITIS PATIENTS WITH HIGH DISEASE ACTIVITY AND TREATED WITH HIGH DOSE GLUCOCORTICOID FREQUENTLY FALL: NINE YEARS OF THE TOMORROW STUDY Reviewed

    Anno S., Sugioka Y., Mamoto K., Okano T., Tada M., Inui K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   79   597 - 597   2020.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2020-eular.2413

  • Peri-prosthetic bone mineral density after simultaneous bilateral total knee arthroplasty under oral bisphosphonate therapy - A comparison between mobile- and fixed-bearing prostheses. Reviewed

    Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Suguru Nakamura, Susumu Takemura, Hiroaki Nakamura

    The Knee   27 ( 3 )   767 - 776   2020.06( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Peri-prosthetic bone mineral density (BMD) decreases after total knee arthroplasty (TKA). We aimed to specifically compare peri-prosthetic BMD changes between mobile- and fixed-bearing prostheses in patients undergoing oral bisphosphonate therapy, hypothesizing that mobile-bearing components would have a favorable effect on postoperative peri-prosthetic BMD. METHODS: This prospective cohort study investigated 30 patients who underwent simultaneous bilateral TKA for primary knee osteoarthritis between December 2007 and September 2012. All patients underwent mobile-bearing TKA in one knee and fixed-bearing TKA in the other and received oral alendronate therapy at a dosage of 35 mg/week. Peri-prosthetic and lumbar spine BMDs were measured using dual X-ray absorptiometry scans, with peri-prosthetic BMD changes being compared between the two prostheses in each patient at six months and one, two, three, and five years post-operation. RESULTS: Clinical results did not significantly differ between two prostheses. Relative change of lumbar spine BMD was significantly greater at five years post-operation than at one year post-operation (p = 0.01), and was significantly correlated at five years post-operation with peri-prosthetic BMD in the central femur (r = 0.39, p = 0.002), posterior femur (r = 0.39, p = 0.002), and medial tibia (r = 0.42, p = 0.007). CONCLUSIONS: There was no difference in peri-prosthetic BMD changes between two prostheses in patients undergoing oral bisphosphonate therapy. Our results suggest that the influence of oral bisphosphonate therapy might offset the influence of prosthetic design. Thus, oral bisphosphonate therapy may be more effective than prosthetic design selection in preventing post-TKA peri-prosthetic BMD loss. LEVEL OF EVIDENCE: II.

    DOI: 10.1016/j.knee.2020.04.011

    PubMed

  • GLUCOCORTICOID USE IS ASSOCIATED WITH DETERIORATION OF MUSCLE QUALITY AND FUNCTION: FROM THE CHIKARA STUDY Reviewed

    Yamada Y., Tada M., Mandai K., Hidaka N., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   79   614 - 615   2020.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2020-eular.1617

  • EARLY IMPROVEMENT OF THE POWER DOPPLER SIGNAL CAN PREDICT TO CONTINUE THE BIOLOGICAL DMARDS AFTER 1 YEAR. Reviewed

    Okano T., Mamoto K., Yamada Y., Mandai K., Anno S., Inui K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   79   1404 - 1404   2020.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2020-eular.2794

  • DENOSUMAB INCREASE THE BONE MINERAL DENSITY REGARDLESS OF DISEASE ACTIVITY, THE BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUGS, THE CONCOMITANT TYPE OF VITAMIN D, AND PRETREATMENT OF OSTEOPOROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS. Reviewed

    Anno S., Okano T., Inui K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   79   1413 - 1414   2020.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2020-eular.2538

  • CTにおけるfacet joint openingは腰椎変性疾患に対する低侵襲除圧術の再手術の危険因子である Reviewed

    山田 賢太郎, 豊田 宏光, 玉井 孝司, 高橋 真治, 鈴木 亨暢, 星野 雅俊, 寺井 秀富, 中村 博亮

    (一社)日本脊椎脊髄病学会 Journal of Spine Research   11 ( 6 )   936 - 941   2020.06( ISSN:1884-7137

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    CTにおけるfacet joint opening(FO)は不安定性の指標になるとの報告がある一方で,腰椎変性疾患に対して低侵襲除圧術の限界について一定した見解がない.本研究は低侵襲除圧術で手術加療を行い最低5年の経過観察をしえた244例の再手術についてFOを含めて危険因子解析を行った.その結果,除圧椎間のFOのみならず,腰椎全体でFOをきたす椎間が多いことも再手術の危険因子であることが示された.(著者抄録)

  • AGEING IN RA PATIENTS DETERIORATED MODIFIED HEALTH ASSESSMENT QUESTIONNAIRE (MHAQ) OVER A 7-YEAR PERIOD INDEPENDENTLY FROM DISEASE ACTIVITY Reviewed

    Inui K., Sugioka Y., Okano T., Tada M., Mamoto K., Orita K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   79   280 - 281   2020.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2020-eular.2775

  • ADIPOCYTOKINE FLUCTUATES WITH INFLAMMATORY MARKERS OR DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS FROM FIVE-YEAR DATA OF TOMORROW STUDY Reviewed

    Mamoto K., Inui K., Okano T., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   79   948 - 949   2020.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2020-eular.4030

  • CTにおけるfacet joint openingは腰椎変性疾患に対する低侵襲除圧術の再手術の危険因子である

    山田 賢太郎, 豊田 宏光, 玉井 孝司, 高橋 真治, 鈴木 亨暢, 星野 雅俊, 寺井 秀富, 中村 博亮

    Journal of Spine Research   11 ( 6 )   936 - 941   2020.06( ISSN:1884-7137

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    CTにおけるfacet joint opening(FO)は不安定性の指標になるとの報告がある一方で,腰椎変性疾患に対して低侵襲除圧術の限界について一定した見解がない.本研究は低侵襲除圧術で手術加療を行い最低5年の経過観察をしえた244例の再手術についてFOを含めて危険因子解析を行った.その結果,除圧椎間のFOのみならず,腰椎全体でFOをきたす椎間が多いことも再手術の危険因子であることが示された.(著者抄録)

  • 2020 Chitranjan S. Ranawat Award: Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty.

    Ueyama H, Kanemoto N, Minoda Y, Taniguchi Y, Nakamura H

    The bone & joint journal   102-B ( 6_Supple_A )   10 - 18   2020.06( ISSN:2049-4394

  • Lumbar modifier A-Rの思春期特発性側彎症(Lenke 1 or 2)に対する後方矯正固定術 distal adding-on発生の危険因子の検討 Reviewed

    松村 昭, 並川 崇, 加藤 相勲, 堀 悠介, 岩前 真由, 中村 博亮

    (一社)日本脊椎脊髄病学会 Journal of Spine Research   11 ( 5 )   820 - 826   2020.05( ISSN:1884-7137

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    はじめに:Lenke 1,2 A-Rに対する矯正固定術後distal adding-on(DA)を評価した.対象と方法:術後2年以上の34例を対象とし各パラメータ,臨床成績を検討した.結果:DAは29.4%に発生し,LIVがLSTVより近位設置例で発生率が高かった.臨床成績はDA発生群で低かった.結語:Lenke 1,2 ARではLIVをLSTV以遠に設置しDAを予防しうる.(著者抄録)

  • 頸椎矢状面バランスが頸椎椎弓形成術の術後成績とアライメント変化に与える影響についての検討 Reviewed

    加藤 相勲, 並川 崇, 松村 昭, 大平 千夏, 日高 典昭, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 3 )   459 - 460   2020.05( ISSN:0008-9443

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    頸椎椎弓形成術を行った圧迫性頸髄症110例(男71例、女39例、平均手術時年齢67歳)を対象としてcervical SVA(C2-7SVA)を指標とした頸椎矢状面のバランスが術後成績とアライメントに及ぼす影響を検証した。術前C2-7SVA 35mm未満の96例を頸椎バランス良好群、35mm以上の14例を頸椎バランス不良群とし、臨床成績、患者立脚型評価、頸椎アライメントパラメーターの変化を比較した。その結果、JOA score改善率は頸椎バランス不良群で悪い傾向にあった(p=0.08)。SF-36 physical component summaryの術後2年間の変化量は頸椎バランス不良群の方が頸椎バランス良好群よりも有意に低下していた。術後頸部痛Visual Analogue Scaleは両群とも増悪傾向にあり、頸椎バランス不良群で頸椎バランス良好群よりも悪化する傾向にあった(p=0.08)。JOACMEQ頸椎機能は頸椎バランス不良群の方が頸椎バランス良好群よりも有意に低下していた。頸椎矢状面アライメントパラメータの変化量のうち、C2-7角が頸椎バランス良好群では減少、頸椎バランス不良群では増加し、C2-7角の変化量には両群間で有意差があった。その他の頸椎矢状面アライメントパラメータの変化量には有意差は認められなかった。以上、頸椎矢状面バランス不良を伴う圧迫性頸髄症に対する頸椎椎弓形成術の臨床成績は良好ではなかった。

  • 関節リウマチ群と非関節リウマチ群における超音波リアルタイム組織エラストグラフィーで測定した正中神経硬度の比較(Comparison of median nerve stiffness with and without rheumatoid arthritis by ultrasound real-time tissue elastography: A propensity score matching study) Reviewed

    Anno Shohei, Okano Tadashi, Mamoto Kenji, Sugioka Yuko, Takeda Setsuko, Hashimoto Ayumi, Yamashita Emi, Morinaka Rika, Ueda Hatsue, Inui Kentaro, Koike Tatsuya, Nakamura Hiroaki

    Taylor & Francis Modern Rheumatology   30 ( 3 )   481 - 488   2020.05( ISSN:1439-7595

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    関節リウマチ(RA)患者の正中神経硬度を手根管症候群症状のない非RA群と比較した。RA群201例の402手と非RA群111例の222手を対象に、超音波リアルタイム組織エラストグラフィーを行い、手根管入口部と手根管入口近位部の正中神経弾性として、外周、断面積、strain ratioを評価した。傾向スコアマッチング後、RA群104例(女性81.7%、平均65.5±12.1歳)と非RA群70例(女性82.9%、平均68.7±13.2歳)の各135手を解析した。正中神経の外周と断面積は両群間で有意差がなかった。手根管入口部でのみ、正中神経のstrain ratioは非RA群よりもRA群の方が有意に高かった。RA患者の屈筋腱と手首関節の炎症状態が正中神経における線維性変化を生じることが示唆された。

  • 脱分化型脂肪肉腫内に転移した進行期乳がんの1例 Reviewed

    家口 尚, 伴 祥高, 星 学, 大戎 直人, 高松 聖仁, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 3 )   405 - 406   2020.05( ISSN:0008-9443

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    58歳女。呼吸苦を主訴とした。左乳房に自壊した乳癌病変を認め、乳房生検で浸潤型進行期乳癌と病理診断された。胸部単純X線画像、CTで右胸水貯留と両肺内に多数の転移巣を認め、骨シンチでは多発骨転移の病巣が存在した。さらに右大腿部有痛性の巨大な軟部腫瘍を認め、造影MRIでT1/T2WIともに均一に高輝度、脂肪抑制を受ける部分と、T1WIで等輝度かつ不均一に造影されT2で高輝度の2病巣が存在し、脱分化型脂肪肉腫が疑われた。乳癌のホルモン療法と骨転移に対するデノスマブ投与により2週間で呼吸苦が改善し全身麻酔可能となったため、大腿部腫瘍広範切除を行った。病理診断で腫瘍内に脂肪肉腫と異なる原発病巣と似た上皮成分を認め、免疫組織でも乳癌の腫瘍内転移と診断された。大腿部の局所再発はなく術後11ヵ月通院加療中である。

  • 摘出手術により下肢痛の改善が得られた神経鞘腫症の1例 Reviewed

    大平 千夏, 加藤 相勲, 並川 崇, 松村 昭, 日高 典昭, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 3 )   467 - 468   2020.05( ISSN:0008-9443

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    59歳男。7ヵ月前より左臀部、大腿後外側部痛が出現した。MRIではT12〜L5レベルの硬膜管内にT1強調像で低〜等信号、T2脂肪抑制像で低信号、Gd造影T1強調像で造影効果を示す多数の腫瘤陰影(最大径22mm大)を認めた。多発性脊髄・馬尾腫瘍を生じる疾患として神経鞘腫症や神経線維腫症(NF)を鑑別に挙げ、家族歴やNFに特有の身体所見・画像所見がないことから神経鞘腫症を最も疑った。左L5神経根ブロックで除痛効果が得られたことより、L4レベルの最大腫瘍とその周辺の腫瘍を責任病変と考えてL4椎弓切除、L5上部椎弓切除を行い、硬膜管内の複数の神経原性様腫瘍を可及的に摘出した。病理組織学的診断はschwannomaであり、術後、左臀部と大腿後外側部痛は改善し、髄液漏などの合併症や残存腫瘍の増大は認めていない。

  • 多椎間の腰部脊柱管狭窄症に対する片側進入両側除圧術 変性側彎が出現し進行するのか? Reviewed

    谷脇 浩志, 辻尾 唯雄, 関 昌彦, 星野 雅俊, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 3 )   353 - 354   2020.05( ISSN:0008-9443

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    2015年以降に3椎間以上の腰部脊柱管狭窄症に対し顕微鏡視下片側進入両側除圧術を施行し術後2年以上経過観察した23例(男19例、女4例、平均年齢72.4歳)を対象に、術後成績と変性側彎の出現・進行の有無を検討し、年齢と性別を合わせた1椎間の23例を対照群として比較検討した。術前、術後2年の平均L1-L5側彎角は、単椎間でそれぞれ2.0°、2.6°、多椎間でそれぞれ3.7°、4.3°であり、両群ともに術前後の側彎角に有意差は認めなかった。単椎間および多椎間の平均JOAスコアはそれぞれ術前15.1、14.8、術後2年でそれぞれ25.8、26であり、両群とも術前後で有意差を認めなかった。以上より、3椎間以上の腰部脊柱管狭窄症に対する顕微鏡視下片側進入両側除圧術は、1椎間症例と差がなく、臨床成績も良好であった。

  • 内視鏡とナビゲーションを併用し低侵襲に治療しえたC2動脈瘤様骨嚢腫の1例 Reviewed

    河合 秀幸, 鈴木 亨暢, 寺井 秀富, 星野 雅俊, 豊田 宏光, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   63 ( 3 )   461 - 462   2020.05( ISSN:0008-9443

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    17歳男。頸部痛を主訴とした。多発性線維性骨異形成症による併存症、L2・L3の動脈瘤様骨嚢腫に対してハイドロキシアパタイト(HA)を用いた椎体形成術の既往があり、頸椎単純CTでは後頭骨・頭蓋底および各頸椎椎体のすりガラス状陰影、C2椎体に骨溶解像と後壁の菲薄化、病的骨折を疑わせる後壁の一部途絶を認めた。線維性骨異形成症に伴うC2動脈瘤様骨嚢腫による切迫骨折と診断して内視鏡と術中CT navigation下に頸椎前方アプローチでHAを用いたC2椎体形成術を選択し、最小侵襲で安全に椎体形成術を行うことができた。病理診断は線維性骨異形成症に伴う動脈瘤性骨嚢腫で、術後1週の単純CTではC2内にHAが充填されており、脱出や隣接椎体に明らかな骨折などは認めなかった。

  • 特集 脊椎脊髄疾患に対する分類・評価法 第2章 胸椎・胸腰椎 びまん性特発性骨増殖症(DISH)の診断基準

    高橋 真治, 中村 博亮

    脊椎脊髄ジャーナル   33 ( 4 )   320 - 325   2020.04( ISSN:09144412

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  • 鏡視下手術の進歩--小関節から脊椎まで Ⅱ.肩関節 L字型骨孔作製デバイスを用いた骨孔式鏡視下腱板修復術の実際

    平川 義弘, 間中 智哉, 伊藤 陽一, 市川 耕一, 松田 淑伸, 中村 博亮

    別冊整形外科   1 ( 77 )   51 - 56   2020.04( ISSN:02871645

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  • 特集 強直性脊椎炎・乾癬性関節炎とその周辺疾患 脊椎関節炎を見逃さないための留意点-若年者の持続する腰背部痛-

    乾 健太郎, 岡野 匡志, 中村 博亮

    関節外科 基礎と臨床   39 ( 4 )   414 - 424   2020.04( ISSN:02865394

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  • 習慣性膝蓋骨脱臼に対するMPFL再建術およびFulkerson法併用の手術成績 Reviewed

    津本 柊子, 橋本 祐介, 韓 昌勲, 山崎 真哉, 西田 洋平, 中村 博亮

    (一社)日本関節鏡・膝・スポーツ整形外科学会 JOSKAS   45 ( 2 )   504 - 505   2020.04( ISSN:1884-8842

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    習慣性膝蓋骨脱臼に対しMPFL再建術およびFulkerson法を併用した4例6膝(手術時平均年齢18.5歳)の術後成績について検討した。平均追跡期間29ヵ月の結果、Kujala scoreは術前66.3±7.9点から術後96.5±4.5点へ有意な改善が認められた。画像所見ではISR、CDIは術前後で有意な変化を認めず、TT-TG距離、CA、TAについては術後に有意な改善が認められた。尚、術後に再脱臼を生じた症例はみられなかった。

  • 関節症性変化を伴う反復性膝蓋骨脱臼に対するMPFL再建およびFulkerson法併用の手術成績 Reviewed

    津本 柊子, 橋本 祐介, 韓 昌勲, 山崎 真哉, 西田 洋平, 中村 博亮

    (一社)日本関節鏡・膝・スポーツ整形外科学会 JOSKAS   45 ( 2 )   506 - 507   2020.04( ISSN:1884-8842

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    関節症性変化を伴う反復性膝蓋骨脱臼に対しMPFL再建およびFulkerson法を併用した5例7膝(手術時平均年齢37.7歳)の術後成績について検討した。平均追跡期間54ヵ月の結果、Kujala total scoreは術前51.4±10.1点から術後95.3±4.3点へ有意に改善していた。画像所見でISR、CDIは術前後で有意な変化を認めなかったが、TT-TG距離、CA、TAについては術後に有意な改善が認められた。また、PF関節裂隙最短距離は術後に増加し、術後PFOAの進行はみられなかった。

  • Assessment of Meniscal Healing Status by Magnetic Resonance Imaging T2 Mapping After Meniscal Repair. Reviewed

    Shinya Yamasaki, Yusuke Hashimoto, Yohei Nishida, Takanori Teraoka, Shozaburo Terai, Junsei Takigami, Hiroaki Nakamura

    The American journal of sports medicine   48 ( 4 )   853 - 860   2020.03( ISSN:0363-5465

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Although the sensitivity and specificity of magnetic resonance imaging (MRI) for the diagnosis of primary meniscal tears are high, these values are lower for the assessment of healing status of repaired menisci. PURPOSE: To compare the accuracy of MRI T2 mapping and conventional MRI in assessing meniscal healing after repair. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: Patients who underwent meniscal repair with concurrent anterior cruciate ligament reconstruction between 2012 and 2016 and had a follow-up second-look arthroscopy were enrolled. The patients were divided into healed and incompletely/not healed groups based on the second-look arthroscopy findings. For the repaired menisci, the following were compared between the groups, (1) Stoller and Crues classification on conventional MRI with a proton density-weighted fat-saturated sequence and (2) the remaining colored meniscal tear line on T2 mapping coincident with the high signal line showing the primary tear on conventional MRI were compared. The change of T2 relaxation time (ΔT2) of the colored meniscal tear line pre- to postoperatively was compared between the groups. The mean T2 relaxation time of the whole area of the postoperative meniscus at each slice was also compared with that of control menisci to assess the whole quality of the repaired meniscus. RESULTS: A total of 26 menisci from 24 knees were assessed (16 healed menisci, 10 incompletely/not healed menisci). According to the Crues classification on conventional MRI, 8 of 16 healed menisci and 3 of 10 incompletely/not healed menisci improved from grade 3 to 2, with there being no significant difference between the groups (P = .43). However, the colored meniscal tear line remained in only 3 of the 16 healed menisci as compared with 9 of the 10 incompletely/not healed menisci, and the presence of this colored line allowed differentiation between healed menisci and incompletely/not healed menisci (sensitivity, 81.3%; specificity, 90.0%; odds ratio, 39.0; P = .001). The mean (SD) ΔT2 was -31.1 ± 3.2 and -19.9 ± 4.4 ms in the healed and incompletely/not healed groups, respectively (P < .001). Receiver operating characteristic curve analysis showed a cutoff ΔT2 value of -22.3 ms for separation of meniscal healing (P < .001). The T2 relaxation times of the whole area of the repaired menisci were 31.7 ± 3.4 and 32.8 ± 3.8 ms in the healed and incompletely/unhealed groups, respectively (P = .69), with these values being significantly longer than the 26.9 ± 2.2 ms in the controls (P < .001). CONCLUSION: MRI T2 mapping allowed the differentiation of healing status after meniscal repair, with high sensitivity and specificity as compared with conventional MRI.

    DOI: 10.1177/0363546520904680

    PubMed

  • 陳旧性肩関節後方脱臼骨折に対してリバース型人工肩関節置換術を施行した1例 Reviewed

    増田 翔, 間中 智哉, 中澤 克優, 飯尾 亮介, 中村 博亮

    (一社)日本骨折治療学会 骨折   42 ( 2 )   389 - 392   2020.03( ISSN:0287-2285

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    【緒言】陳旧性肩関節後方脱臼骨折に対して、リバース型人工肩関節置換術(以下、RSA)を施行した1例を経験したので報告する。【症例】73歳、女性。8ヵ月前に右肩を強打し、単純X線にて上腕骨大結節骨折を指摘され、保存的加療を行っていた。疼痛が持続するためにCTを撮影し、右肩関節後方脱臼骨折を認めたために前医紹介となり、観血的骨接合術を施行した。しかし、術後再脱臼を認めたために当科紹介となった。身体所見では右肩関節の著明な可動域制限、画像検査では上腕骨頭の後方脱臼、大結節の後内側転位、腱板の脂肪変性を認めた。本症例に対して、GPSナビゲーションを用いてRSAを施行した。【考察】本症例では脱臼期間が8ヵ月であること、腱板の脂肪変性を認めたこと、転位した大結節が修復困難であったことから、腱板機能不全例に対しても挙上動作の回復が可能となるRSAを選択し良好な成績を得た。(著者抄録)

  • 半月板縫合後の治癒評価にMRI-T2マッピングは有用である Reviewed

    山崎 真哉, 橋本 祐介, 西田 洋平, 寺岡 貴徳, 寺井 彰三郎, 瀧上 順誠, 中村 博亮

    (一社)日本関節鏡・膝・スポーツ整形外科学会 JOSKAS   45 ( 1 )   32 - 33   2020.03( ISSN:1884-8842

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    前十字靱帯再建時に半月板縫合を行った24例(男性9例、女性15例、平均年齢23.3歳)を対象に、半月板縫合後の治癒評価としてのMRI-T2マッピングの有用性を検討した。抜釘時の再鏡視所見から、完全治癒群(C群:16例)、不完全治癒/治癒不全群(I/N群:10例)に分類したところ、T2マッピングによるT2値減少量はC群とI/N群の間で有意差が認められた。更にROC曲線では半月板治癒のカットオフ値は5.2msecとなり、感度81.2%、特異度80%、オッズ比17.3であった。初回術前MRIでの損傷部そのもののT2値は平均65msecで、この値を示すマッピングが再鏡視時にも残存していた例はC群16例中3例、I/N群10例中9例と有意差がみられ、感度は81.%、特異度は90%、オッズ比は39.0であった。

  • A case series of seven patients with recurrent median nerve neuropathy treated by the revision surgery of median nerve neurolysis and wrapping with radial artery perforator adipose flap.

    Uemura T, Takamatsu K, Okada M, Yokoi T, Onode E, Miyashima Y, Konishi S, Nakamura H

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS   73 ( 3 )   453 - 459   2020.03( ISSN:1748-6815

  • Local transplantation of adipose-derived stem cells has a significant therapeutic effect in a mouse model of rheumatoid arthritis. Reviewed

    Hideki Ueyama, Tadashi Okano, Kumi Orita, Kenji Mamoto, Masaaki Ii, Satoshi Sobajima, Hideki Iwaguro, Hiroaki Nakamura

    Scientific reports   10 ( 1 )   3076 - 3076   2020.02

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    Adipose-derived stem cells (ADSCs) have anti-inflammatory and regenerative properties. The purpose of this study was to investigate the effect of locally administered ADSCs in a rheumatoid arthritis (RA) mouse model. In an in vivo experiment, single-cell ADSCs and three dimensionally-cultured ADSC spheroids were injected intra-articularly into the knees of RA model mice and histologically assessed. Marked improvement of synovial inflammation and articular cartilage regeneration was found in ADSC-treated mice. Proliferation, migration, and apoptosis assays of synovial fibroblasts incubated with single-cell and spheroid ADSCs were performed. The expression levels of total cytokine RNA in ADSC single cells, spheroids, and ADSC-treated inflammatory synovial fibroblasts were also evaluated by quantitative reverse transcription PCR. ADSCs suppressed the proliferation and migration of activated inflammatory cells and downregulated inflammatory cytokines. TSG-6 and TGFβ1 were significantly upregulated in ADSCs compared to controls and TGFβ1 was significantly upregulated in ADSC spheroids compared to single cells. The apoptosis rate of ADSC spheroids was significantly lower than that of single-cell ADSCs. These results indicated that intra-articular administration of ADSC single cells and spheroids was effective in an RA mouse model, offering a novel approach for the development of effective localized treatments for patients with RA.

    DOI: 10.1038/s41598-020-60041-2

    PubMed

  • The natural course of the paravertebral muscles after the onset of osteoporotic vertebral fracture Reviewed

    Takahashi S., Hoshino M., Takayama K., Sasaoka R., Tsujio T., Yasuda H., Kanematsu F., Kono H., Toyoda H., Ohyama S., Hori Y., Nakamura H.

    OSTEOPOROSIS INTERNATIONAL   31 ( 6 )   1089 - 1095   2020.02( ISSN:0937-941X

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    DOI: 10.1007/s00198-020-05338-8

    PubMed

  • Successful pre-operative local control of skin exposure by sarcoma using combination of systemic chemotherapy and Mohs' chemosurgery. Reviewed

    Manabu Hoshi, Tadashi Iwai, Naoto Oebisu, Hiroaki Nakamura

    World journal of surgical oncology   18 ( 1 )   36 - 36   2020.02

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    BACKGROUND: Sarcomas sometimes invade the skin and become exposed, producing malignant wounds characterized by bleeding, exudate, odor, and infection. Malignant cutaneous sarcomas are generally incurable and ultimately impair patients' quality of life. Mohs' chemosurgery is a previously published technique for chemical fixation of a cutaneous tumor and subsequent excision. CASE PRESENTATION: We present the case of a 44-year-old man with an undifferentiated pleomorphic sarcoma arising in the right chest wall and rupturing through the skin. The tumor manifested as a malignant wound with ulceration, bleeding, exudate, and a strong odor. Treatment with systemic chemotherapy and Mohs' chemosurgery was initiated. After repeated courses, the tumor demonstrated significant shrinkage. We were then able to perform wide resection and reconstruction with a rectus abdominis musculocutaneous flap. Pathologic examination of the resected specimen confirmed negative margins. CONCLUSIONS: Mohs' chemosurgery with concurrent systemic chemotherapy is an effective and reliable treatment option for achieving pre-operative local control of sarcomas that rupture through the skin.

    DOI: 10.1186/s12957-020-01815-w

    PubMed

  • Risk Factors of Nonunion After Acute Osteoporotic Vertebral Fractures: A Prospective Multicenter Cohort Study. Reviewed

    Hiroyuki Inose, Tsuyoshi Kato, Shoichi Ichimura, Hiroaki Nakamura, Masatoshi Hoshino, Daisuke Togawa, Toru Hirano, Yasuaki Tokuhashi, Tetsuro Ohba, Hirotaka Haro, Takashi Tsuji, Kimiaki Sato, Yutaka Sasao, Masahiko Takahata, Koji Otani, Suketaka Momoshima, Masato Yuasa, Takashi Hirai, Toshitaka Yoshii, Atsushi Okawa

    Spine   45 ( 13 )   895 - 902   2020.02( ISSN:0362-2436

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    STUDY DESIGN: Prospective cohort study. OBJECTIVE: To characterize a patient population with nonunion after acute osteoporotic vertebral fractures (OVFs) and compare the union and nonunion groups to identify risk factors for nonunion. SUMMARY OF BACKGROUND DATA: While OVFs are the most common type of osteoporotic fracture, the predictive value of a clinical assessment for nonunion at 48 weeks after OVF has not been extensively studied. METHODS: This prospective multicenter cohort study included female patients aged 65 to 85 years with acute one-level osteoporotic compression fractures. In the radiographic analysis, the anterior vertebral body compression percentage was measured at 0, 12, and 48 weeks. Magnetic resonance imaging (MRI) was performed at enrollment and at 48 weeks to confirm the diagnosis and union status. The patient-reported outcome measures included scores on the European Quality of Life-5 Dimensions (EQ-5D), a visual analogue scale for low back pain, and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) at 0, 12, and 48 weeks. RESULTS: In total, 166 patients completed the 12-month follow-up, 29 of whom had nonunion. Patients with nonunion at 48 weeks after OVF had lower EQ-5D and JOABPEQ walking ability, social life function, mental health, and lumbar function scores than those with union at 48 weeks after injury. The independent risk factors for nonunion after OVF in the acute phase were a diffuse low type pattern on T1-weighted MRI and diffuse low and fluid type patterns on T2-weighted MRI. The anterior vertebral body compression percentage and JOABPEQ social life function scores were independent risk factors at 12 weeks. CONCLUSION: A diffuse low type pattern on T1-weighted MRI and diffuse low and fluid type patterns on T2-weighted MRI were independent risk factors for nonunion in the acute phase. Patients who have acute OVFs with these risk factors should be carefully monitored for nonunion. LEVEL OF EVIDENCE: 2.

    DOI: 10.1097/BRS.0000000000003413

    PubMed

  • Surgical Management of Spinal Disorders in People with Mucopolysaccharidoses. Reviewed

    Terai H, Nakamura H

    International journal of molecular sciences   21 ( 3 )   2020.02( ISSN:16616596

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    DOI: 10.3390/ijms21031171

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  • 特集 骨粗鬆症性椎体骨折治療の最新知見 骨粗鬆症性椎体骨折による脊椎障害に対する手術治療

    寺井 秀富, 中村 博亮

    整形・災害外科   63 ( 2 )   187 - 194   2020.02( ISSN:03874095

  • 特集 骨粗鬆症性椎体骨折治療の最新知見 骨粗鬆症性椎体骨折治療体系における医療経済

    高橋 真治, 星野 雅俊, 中村 博亮

    整形・災害外科   63 ( 2 )   211 - 215   2020.02( ISSN:03874095

  • Patient-reported outcomes for cervical disease in end-stage renal disease patients: Propensity matching analysis using volunteer data. Reviewed

    Koji Tamai, Akito Yabu, Kazushi Takayama, Teruo Kita, Hideki Sakanaka, Akinobu Suzuki, Hiroaki Nakamura

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia   72   130 - 133   2020.02( ISSN:0967-5868

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    UNLABELLED: As the number of patients with end-stage renal disease (ESRD) has been increasing, the number of cervical spine surgeries for the patients with ESRD has also been increasing. The purpose is to identify the differences in cervical disease-specific patient-reported outcomes (PROs) between a healthy population and patients with ESRD, adjusting for subjects' age and physical activity. METHODS: The ESRD group included patients with ESRD who were treated with hemodialysis in our outpatient clinic and healthy volunteers were individuals who attended public health lectures. Volunteers with a history of cervical disease were excluded. All participants answered the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and questionnaires that evaluate the disability in performing physical activities. RESULTS: A total of 111 participants were enrolled and divided into the ESRD group (n = 40) and the control group (n = 71). After adjusting for age and sex using propensity score, cervical function (p = 0.008), lower-extremity function (p = 0.007), and QOL (p < 0.001) in patients in the adjusted ESRD group were significantly lower than those in the control group. In multivariate linear regression, the use of hemodialysis was a significant variable that was negatively related to lower-extremity function (p = 0.004) and QOL (p = 0.011) independent of age and disability in performing physical activity. CONCLUSION: The ESRD was a significant negative factor of lower-extremity function and QOL, independent of age, sex, and disability in performing physical activity. These results can help understand the cervical status of patients with ESRD and adjust the goal for such patients after cervical surgery.

    DOI: 10.1016/j.jocn.2019.12.045

    PubMed

  • Malrotation of the fixed-bearing posterior stabilized total knee prosthesis causes a postoperative rotational mismatch between the femur and tibia. Reviewed

    Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Kazumasa Yamamura, Suguru Nakamura, Susumu Takemura, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   28 ( 12 )   3810 - 3820   2020.01( ISSN:0942-2056

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    PURPOSE: This study aimed to identify factors associated with rotational mismatch after total knee arthroplasty (TKA) using fixed-bearing posterior stabilized prosthesis and to evaluate the impact of the rotational mismatch on clinical outcomes. METHODS: This retrospective cohort study included 159 cases that underwent TKA. Whole-leg computed tomography images were obtained 2 weeks after TKA, with three-dimensional measures of alignment. Rotational alignment of the femoral and tibial components and rotational mismatch between components and between the femur and tibia bones were evaluated. The new Knee Society Score (KSS) was obtained at the final outpatient visit, which was defined as the final follow-up timepoint. Predictive factors were identified for rotational mismatch of the lower extremity and poor new KSS. RESULTS: The mean follow-up period was 42 ± 16 months. Rotational mismatch ≥ 10° between bones was identified in 56 cases (35%), with a mean mismatch angle of 5.0° ± 9.1° of external rotation of the tibia relative to the femur. Rotational mismatch ≥ 10° between components was identified in three cases (2%; mean 0.3° ± 3.6° of internal tibial rotation). A multivariate regression analysis showed that component malrotation was predictive of post-operative rotational mismatch between bones (p < 0.01) and rotational mismatch ≥ 10° associated with poor new KSS (odds ratio 4.22; p < 0.01). CONCLUSION: Malrotation of the fixed-bearing posterior stabilized TKA causes a rotational mismatch between the femur and tibia bones. Excessive rotational mismatch between bones greater than 10° is a risk factor for poor postoperative functional outcome. Precise component positioning is essential for improving TKA outcomes. LEVEL OF EVIDENCE: III.

    DOI: 10.1007/s00167-020-05864-2

    PubMed

  • Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study. Reviewed

    Yutaro Yamada, Masahiro Tada, Koji Mandai, Noriaki Hidaka, Kentaro Inui, Hiroaki Nakamura

    Clinical rheumatology   39 ( 6 )   1757 - 1764   2020.01( ISSN:0770-3198

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    INTRODUCTION: Patients with rheumatoid arthritis (RA) are at higher risk of sarcopenia because of joint dysfunction and chronic inflammation. The present study aimed to investigate the predictors or risk factors for developing sarcopenia in RA patients using the prospective observational CHIKARA database. We hypothesized that older age, higher disease activity, lower physical function, and glucocorticoid (GC) use are risk factors for sarcopenia. METHODS: A total of 100 consecutive RA patients participated in the CHIKARA study. Their body compositions were examined using a body composition analyzer. Laboratory data, disease activity, physical function, and treatment were investigated. Sarcopenia was assessed at baseline and at 1 year. Predictors or risk factors for sarcopenia development at 1 year were investigated by univariate and multivariate analyses. RESULTS: Of 68 patients without sarcopenia at baseline, 9 (13.4%) developed sarcopenia over the year. Univariate analysis showed that age (r = 0.28, p = 0.022), average GC dose over the year (r = 0.25, p = 0.043), and body mass index (r = - 0.28, p = 0.019) were significantly associated with the development of sarcopenia. Average GC use at ≥ 3.25 mg/day was a significant factor on multivariate analysis (odds ratio 8.81, 95% confidence interval 1.14-67.9, p = 0.037). CONCLUSIONS: RA patients using GCs at an average dose ≥ 3.25 mg/day over 1 year were at higher risk for developing sarcopenia. Reduction or withdrawal of GCs may prevent sarcopenia.Key Points• Patients with RA are at higher risk of sarcopenia.• Predictors or risk factors for developing sarcopenia over 1 year in RA patients were investigated using the prospective observational CHIKARA database.• RA patients using GCs at an average dose ≥ 3.25 mg/day over 1 year were at higher risk for developing sarcopenia.• Reduction or withdrawal of GCs may be essential to prevent sarcopenia.

    DOI: 10.1007/s10067-020-04929-4

    PubMed

  • Bow hunter's syndrome after cervical laminoplasty in a patient with rheumatoid arthritis with bony ankylosis in the cervical spine: a case report. Reviewed

    Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Hiroaki Nakamura

    Modern rheumatology case reports   4 ( 1 )   11 - 15   2020.01

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    Bow hunter's syndrome, or rotational vertebral artery (VA) occlusion, refers to vertebrobasilar insufficiency due to mechanical occlusion of the VA. We present a case of surgical treatment for bow hunter's syndrome that occurred after cervical laminoplasty in a patient with rheumatoid arthritis with bony ankylosis of the facet joints. A 59-year-old female with rheumatoid arthritis experienced sudden incomplete left hemiplegia. Fifteen months earlier, the patient had undergone cervical decompression surgery between C3 and C7. MRI of the head showed cerebral infarction in the right VA area, while vertebral angiography with the head rotated to the right revealed that the right VA was occluded at the level of C3-C4. The patient was successfully treated via posterior cervical fusion from C2 to C7. Patients with rheumatoid arthritis have a potential risk of cervical bony ankyloses. Cervical laminoplasty for patients with cervical bony ankyloses can induce rotational VA occlusion due to spinal rotational instability.

    DOI: 10.1080/24725625.2019.1662985

    PubMed

  • 肘部管症候群に対する尺骨神経皮下前方移行術の術後成績 術前電気生理学的検査と臨床評価の関連の検討 Reviewed

    岡本 幸太郎, 横井 卓哉, 岡田 充弘, 斧出 絵麻, 中村 博亮

    (一社)日本手外科学会 日本手外科学会雑誌   36 ( 4 )   506 - 509   2020.01( ISSN:2185-4092

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    肘部管症候群に対して尺骨神経前方移行術を施行し,術後1年間経過観察可能であった30例30肘を対象とし,術前と術後1年で電気生理学的評価と,客観的な臨床評価(握力,ピンチ力による運動評価,尺骨神経領域のSemmes-Weinstein monofilaments test,静的2点識別覚による知覚評価,Quick DASH,Hand20による患者立脚型機能評価)を行い,術前と術後1年での電気生理学的評価と臨床評価を比較検討した.さらに,術前電気生理学的検査結果と,術前と術後1年における臨床評価との間に関連があるか検討した.術前電気生理学的検査結果は,術前・術後1年でいくつかの詳細な臨床評価と相関することを示した.すなわち,過去の報告と同様,術後良好な成績を得るためには電気生理学的な重症度が進行する前に手術を行う事が肝要である.(著者抄録)

  • Delayed-onset pneumothorax after posterior spinal fusion for idiopathic scoliosis: Report of two cases

    Terai H.

    Indian Spine Journal   3 ( 1 )   110 - 113   2020.01( ISSN:25895079

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  • Bow hunter's syndrome after cervical laminoplasty in a patient with rheumatoid arthritis with bony ankylosis in the cervical spine: a case report(和訳中) Reviewed

    Dohzono Sho, Sasaoka Ryuichi, Takamatsu Kiyohito, Nakamura Hiroaki

    Taylor & Francis Modern Rheumatology Case Reports   4 ( 1 )   11 - 15   2020

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    症例は59歳女性で、右向きで睡眠中に突然左半身麻痺となり搬送された。目眩、失神、悪心、構音障害、嚥下障害の既往はなかった。関節リウマチの既往があり、プレドニゾロン、サラゾスルファピリジン、レフルノミド、ゴリムマブを服用していた。15ヵ月前にC3椎弓切除およびC4-C7の頸椎椎弓形成術を受けた。受診時のMRIで右小脳橋部に梗塞所見を認めた。頸動脈超音波検査で頸部の右回旋で右椎骨動脈の血流量が顕著に低下し、左回旋で左椎骨動脈の血流量が低下した。CT画像の矢状面で左右の環軸関節およびC4-C5椎間関節に骨性強直を認めた。脊椎血管造影で頸部の右回旋時にC3-C4レベルで右椎骨動脈の血流遅延、また頸部の左回旋時に左椎骨動脈の血流遅延を認めた。頸部の非回旋時に椎骨動脈の閉塞または狭窄はなかった。頸椎X線検査でC3レベルに後方すべりを認め、C3-C4レベルで骨硬化性変化を認めた。頸部MRIで脊髄圧迫は見られなかった。以上の所見からBow hunter症候群と診断し、頸部回旋による椎骨動脈の狭窄により血栓が形成されたと判断した。頸椎後方固定術を施行し、保存的治療により1年後に歩行可能となった。

  • Surgical treatment of short fusion preserving posterior element with X-core for delayed paralysis after osteoporotic L4 vertebral fracture Reviewed

    Sasaki Ryo, Maeno Takafumi, Kono Hiroshi, Umano Masayuki, Nakamura Hiroaki

    The Japanese Society for Spine Surgery and Related Research, Journal of Spine Research   11 ( 8 )   1038 - 1043   2020( ISSN:1884-7137 ( eISSN:24351563

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    <p><b>Introduction: </b>Osteoporotic lower lumbar vertebral fracture causes loss of lumbar lordosis and abnormal spinal alignment, and to maintain the correction with osteoporotic bone, we need long fusion containing iliac bone. And, several clinical studies have reported poor surgical results of short fusion avoiding long fusion for elderly patient.</p><p><b>Purpose: </b>To investigate surgical outcomes of short fusion preserving posterior element with X-core which could produce sound anterior column support for delayed paralysis after osteoporotic L4 vertebral fracture in our institution.</p><p><b>Materials and Methods: </b>We retrospectively reviewed the patient records of 3 women, who were diagnosed with delayed paralysis after L4 osteoporotic vertebral fracture and performed anterior reconstruction and posterior fixation (1 above 1 below) with X-core. Their average age at the operation was 74.3 years old and average follow-up period was 17.3 months. Clinical results were evaluated by JOA score at the preoperative and final follow-up. Radiological results were evaluated by local lordosis (L3-L5), height of the inter-vertebral body (between caudal endplate of L3 to cranial endplate of L5), implant subsidence (more than 2 mm), pedicle screw loosening, and bone union.</p><p><b>Results: </b>Average JOA score was 7.3 at the preoperation and 23.7 at final follow-up. Average local lordosis was -3.2 degrees at the preoperation, 15.9 after surgery, and 16.0 at final follow-up. Average height of the inter-vertebral body was 28.5 mm at the preoperation, 35.9 after surgery, and 35.2 at final follow-up. 1 case showed implant subsidence and pedicle screw loosening, however, all cases showed bone union finally.</p><p><b>Discussion: </b>It is difficult to maintain tolerable spinal alignment after fixation for osteoporotic vertebral fracture. Anterior column reconstruction with X-core could correct kyphosis potently, and more, preserving posterior element reduce stress of posterior implants, as a result, correction was preserved.</p><p>Clinical results of short fusion preserving posterior element with X-core for delayed paralysis after osteoporotic L4 vertebral fracture were satisfactory, local lordosis was acquired and maintained.</p><p><b>Conclusions: </b>Short fusion preserving posterior element with X-core may be one of surgery for delayed paralysis after osteoporotic L4 vertebral fracture.</p>

    DOI: 10.34371/jspineres.2020-0807

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  • Past and Current Status in Diagnosis and Treatment Strategy Including Rehabilitation for Osteoporotic Vertebral Fracture Reviewed

    Takahashi Shinji, Hoshino Masatoshi, Nakamura Hiroaki

    The Japanese Association of Rehabilitation Medicine, The Japanese Journal of Rehabilitation Medicine   57 ( 9 )   836 - 844   2020( ISSN:1881-3526 ( eISSN:18818560

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    DOI: 10.2490/jjrmc.57.836

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  • Impact of cervical sagittal imbalance on laminoplasty in patients with cervical myelopathy Reviewed

    KATO Minori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 3 )   459 - 460   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.459

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  • 陳旧性肩関節前方脱臼に対するリバース型人工肩関節置換術の短期臨床成績 Reviewed

    松田 淑伸, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 1 )   21 - 24   2020( ISSN:0910-4461 ( eISSN:18816363

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    陳旧性肩関節前方脱臼に対して様々な治療法が報告されている.本研究の目的は陳旧性肩関節前方脱臼に対するリバース型人工肩関節置換術(以下RSA)の短期臨床成績を評価することである.対照は10例10肩,女性9肩,男性1肩で,手術時平均年齢は78.4才であった.臨床成績は術前,術後1年時に評価し,肩関節自動可動域(屈曲,外転,下垂位外旋,内旋),日本整形外科学会肩関節疾患治療成績判定基準(以下JOAスコア),Constantスコアを測定した.肩関節自動可動域は屈曲が術前平均46.5度から術後1年で平均104度に,外転が術前平均46.5度から術後1年で平均92度に,下垂位外旋が術前平均-6.5度から術後1年で平均11.5度に,結帯スコアは術前平均1.6点が術後1年で平均4点に,JOAスコアは術前平均32.6点が術後1年で平均67.4点に,Constantスコアは術前平均23.3点が術後1年で平均50.3点に有意に改善みられた(全てp < 0.05).陳旧性肩関節前方脱臼に対するRSAの術後1年での臨床成績は良好であった.

    DOI: 10.11296/katakansetsu.44.21

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  • Silicone implant arthroplasty for severe ankylosis of proximal interphalangeal joints in rheumatoid arthritis: A case report Reviewed

    UEMURA Takuya

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 5 )   737 - 738   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.737

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  • Breast carcinoma metastasis in dedifferentiated liposarcoma Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 3 )   405 - 406   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.405

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  • Hypertrophic spinal pachymeningitis: A case report Reviewed

    ONISHI Yuma

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 4 )   527 - 528   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.527

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  • 正常肩甲帯動態の加齢性変化 Reviewed

    市川 耕一, 富本 彩夏, 中村 博亮, 間中 智哉, 伊藤 陽一, 松田 淑伸, 平川 義弘, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 3 )   493 - 493   2020( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.44.493

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  • A case of schwannomatosis whose pain has decreased by surgical removal Reviewed

    OHIRA Chinatsu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 3 )   467 - 468   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.467

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  • 従来法とナビゲーション使用例におけるリバース型人工肩関節置換術後の肩甲骨コンポーネント設置状態の比較 Reviewed

    間中 智哉, 富本 彩夏, 中村 博亮, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 3 )   510 - 510   2020( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.44.510

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  • A rare case of lymphangioma with multiple bone lesions Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 6 )   915 - 916   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.915

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  • Minimally invasive decompression for multilevel lumbar spinal canal stenosis Reviewed

    TANIWAKI Hiroshi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 3 )   353 - 354   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.353

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  • One case of C2 aneurysmal bone cyst treated minimally invasive using endoscope and navigation Reviewed

    KAWAI Hideyuki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 3 )   461 - 462   2020( ISSN:0008-9443

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    DOI: 10.11359/chubu.2020.461

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  • Significance of trunk muscles in spinal pathologies Reviewed

    Hori Yusuke, Hoshino Masatoshi, Nakamura Hiroaki

    The Japanese Society for Spine Surgery and Related Research, Journal of Spine Research   11 ( 6 )   883 - 889   2020( ISSN:1884-7137 ( eISSN:24351563

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    <p>Low back pain and spinal deformity are issues to be overcome for Japan, aiming to extend healthy life expectancy. Trunk muscles play important roles in supporting the spinal column. However, few reports have investigated the relationship of the trunk muscle mass with lumbar spine disorder, and the clinical significance of the trunk muscle mass remains unclear. In this review, we introduce our previous report and summarize previous papers on trunk muscles. Our multicenter cross-sectional study included 1,738 patients (mean age: 70.2±11.0 years; 781 men and 957 women) who visited the spinal outpatient clinic. The trunk muscle mass showed a negative correlation with age (p < 0.001), and the decrease accelerated at approximately 70 years of age. The trunk muscle mass was significantly correlated with the the Oswestry Disability Index (ODI), visual analog scale (VAS) for low back pain, sagittal vertical axis (SVA), and EuroQol 5 Dimension (EQ5D) (p < 0.001). Patient deterioration was associated with a decrease in the trunk muscle mass, and the deterioration accelerated from approximately 23 kg. The trunk muscle mass may play an important role to elucidate and treat lumbar spinal dysfunction and spinal deformity. It is necessary to conduct longitudinal studies to prove a causal relationship and establish an effective intervention method to maintain trunk muscles in the future.</p>

    DOI: 10.34371/jspineres.2020-0503

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  • 人工肩関節全置換術後の反復性肩関節後方脱臼に対してリバース型人工肩関節置換術を施行した一例 Reviewed

    富本 彩夏, 間中 智哉, 中澤 克優, 伊藤 陽一, 中村 博亮

    日本肩関節学会 肩関節   44 ( 1 )   213 - 217   2020( ISSN:0910-4461 ( eISSN:18816363

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    人工肩関節全置換術(以下,TSA)術後の反復性肩関節後方脱臼に対して,リバース型人工肩関節置換術(以下,RSA)を施行した1例を経験したので報告する.症例は86歳女性で,肩関節単純X線でTSA後の上腕骨頭の上方化,CTでグレノイドコンポーネントの後捻と上腕骨頭の後方亜脱臼を認めた.ステムとグレノイドコンポーネントを抜去し,Norris法による腸骨移植を併用し, RSAを施行した.術後1年で再脱臼を認めることなく経過良好である.

    DOI: 10.11296/katakansetsu.44.213

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  • リバース型人工肩関節置換術後1年の臨床成績の年代別比較 Reviewed

    山下 竜一, 富本 彩夏, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 飯尾 亮介

    日本肩関節学会 肩関節   44 ( 2 )   409 - 412   2020( ISSN:0910-4461

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    リバース型人工肩関節置換術(以下,RSA)術後1年の臨床成績及び周術期合併症発生率を年代別に比較した.対象はRSAを施行した122肩である.術前,術後1年に肩関節自動可動域,Constant score,VASを評価した.手術時年齢を80歳未満群(以下,U群)85肩,80歳以上群(以下,O群)37肩の2群に分けて比較検討した.両群ともに術前と比較して術後1年で,屈曲,外転,Constant score,VASの有意な改善がみられた.術前から術後1年での臨床成績の改善値は,屈曲,外転,下垂位外旋,Constant score,VASでは両群に有意差を認めなかったが,結帯に関してはU群が有意に低下していた.周術期合併症発生率はU群で16.5%,O群で8.1%であった.術後1年の臨床成績の改善値は,結帯を除いて両群に有意差はなく,周術期合併症発生率も両群に有意差を認めなかった.

    DOI: 10.11296/katakansetsu.44.409

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  • リバース型人工肩関節置換術の術中術後合併症 -256例の経験- Reviewed

    伊藤 陽一, 富本 彩夏, 中村 博亮, 間中 智哉, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 3 )   508 - 508   2020( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.44.508

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  • リバース型人工肩関節置換術のインプラント設置位置は術後筋力に影響するか? Reviewed

    中澤 克優, 富本 彩夏, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 3 )   512 - 512   2020( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.44.512

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  • リバース型人工肩関節置換術における術後3次元評価システムの精度検証 -2次元計測との比較- Reviewed

    間中 智哉, 富本 彩夏, 中村 博亮, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 2 )   425 - 428   2020( ISSN:0910-4461 ( eISSN:18816363

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    リバース型人工肩関節置換術の術後CT画像を使用し,2次元(以下,2D)評価と3次元(以下,3D)評価を行い,検者間及び検者内信頼性を検証した.対象は12例.2D評価として,SYNAPSE VINCENT<SUP>&reg;</SUP>を用いて計測した.3D評価として,Zed Shoulder<SUP>&reg;</SUP>を用いた.肩甲骨関節窩傾斜角(以下,GI),肩甲骨関節窩前後捻角(以下,GV),ステム後捻角(以下,SR),上腕骨オフセット(以下,HO)を計測した.2名の整形外科医で,1か月以上の間隔を空けて2回計測した.2D計測と3D計測の検者間及び検者内信頼性を級内相関係数(ICC)にて算出した.検者間信頼性において2D計測のGI,SRと3D計測のHOが低く,検者内信頼性において2D計測のGV,HOと3D計測のSR,HOが低かった.今後,3D評価のさらなる再現性と正確性の確立のため,3Dで各種パラメータを自動表示するために必要な肩甲骨及び上腕骨上の特徴的な点をとる方法を検討する必要がある.

    DOI: 10.11296/katakansetsu.44.425

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  • リバース型人工肩関節置換術における術前3次元評価システムの再現性評価 Reviewed

    中澤 克優, 富本 彩夏, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 1 )   196 - 200   2020( ISSN:0910-4461 ( eISSN:18816363

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    リバース型人工肩関節置換術の術前CT画像を使用し,2次元(以下,2D)評価と3次元(以下,3D)評価を行い,検者間及び検者内信頼性を検証した.対象は12例.3D評価として,術前に1mmスライスで撮像したCTのaxial像のDICOMデータをLEXI社Zed Shoulder<SUP>&reg;</SUP>に読み込み関節窩傾斜角(以下,GI),関節窩前後捻角(以下,GV),上腕骨後捻角(以下HR),関節窩最大高(以下,GH),関節窩最大幅(以下,GW)を計測した.一方,2D評価として単純CTを用い計測した.2名の整形外科医で,1か月以上の間隔にて2回計測した.2D計測と3D計測の検者間及び検者内信頼性を級内相関係数(ICC)にて算出した.検者間信頼性において2D計測のGI,GVと3D計測のGI,GV,HRが低く,検者内信頼性において2D計測のGI,GVと3D計測のGIが低かった.今後,3D評価のさらなる再現性と正確性の確立のため,参照点デジタイズの方法の改良および座標系の再構築を行う必要性がある.

    DOI: 10.11296/katakansetsu.44.196

    CiNii Article

  • リバース型人工肩関節置換術における患者満足度に関連する因子の検討 Reviewed

    飯尾 亮介, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中澤 克優, 山下 竜一

    日本肩関節学会 肩関節   44 ( 3 )   509 - 509   2020( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.44.509

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  • リバース型人工肩関節全置換術の臨床成績 -利き手側の影響- Reviewed

    中澤 克優, 富本 彩夏, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   44 ( 3 )   511 - 511   2020( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.44.511

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  • Odor intensity measurement for soft-tissue tumors using the odor meter with ammonia concentration conversion function Reviewed

    TAKADA Naoki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   63 ( 6 )   909 - 910   2020( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2020.909

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  • Surgical Outcomes of a New Technique Using a Convex Rod Rotation Maneuver for Adolescent Idiopathic Scoliosis Reviewed

    Takahashi Shinji, Terai Hidetomi, Toyoda Hiromitsu, Hoshino Masatoshi, Suzuki Akinobu, Tamai Koji, Ohyama Shoichiro, Hori Yusuke, Yabu Akito, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 3 )   205 - 210   2020( eISSN:2432261X

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    <p>Introduction: Because of adolescent idiopathic scoliosis (AIS), most surgeons use rod rotation on the concave side for Lenke types 1 and 2 curves. Nevertheless, the accurate placement of pedicle screws within dysplastic pedicles, especially on the concave side, is sometimes challenging. Conversely, there is a concern that apical rotation might be exacerbated after convex rod rotation maneuver (RRM) because the rod is rotated in the same direction as vertebral rotation. This study aims to demonstrate the surgical technique and outcomes of a convex RRM with direct vertebral rotation (DVR) for the correction of AIS.</p><p>Technical Note: Multilevel pedicle screws were inserted into the vertebrae. The pre-bent pure titanium rod was set on the convex side and then derotated to nearly 90°. DVR was conducted for the desired vertebrae. Another pre-bent titanium alloy rod, for placement on the concave side, was contoured the same as the rod on the convex side. Using a reduction tube that allowed easier capture of the rod, the rod was connected to the concave side screws. DVR was again conducted for the desired vertebrae. Among the 59 patients, the correction rate of the main thoracic curve in Lenke types 1 and 2 AIS was 75.1% and 65.0%, respectively. The absolute value of the change in apical vertebral rotation between pre- and post-operative computed tomography (CT) scans in Lenke types 1 and 2 curves was 4.8° and 4.2°, respectively.</p><p>Conclusions: The convex RRM improved vertebral rotation in Lenke types 1 and 2 AIS. This procedure should be regarded as one of the surgical options for AIS, especially in patients with a narrow pedicle width on the concave side.</p>

    DOI: 10.22603/ssrr.2020-0185

    PubMed

    CiNii Article

  • Risk Factors of Distal Adding-On in Lenke 1 or 2 AIS Patients with AR Lumbar Modifiers Reviewed

    Matsumura Akira, Namikawa Takashi, Kato Minori, Hori Yusuke, Iwamae Masayoshi, Nakamura Hiroaki

    The Japanese Society for Spine Surgery and Related Research, Journal of Spine Research   11 ( 5 )   820 - 826   2020( ISSN:1884-7137 ( eISSN:24351563

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    <p><b>Introduction: </b>A previous study has shown that the incidence of postoperative distal adding-on (DA) in Lenke 1 or 2 adolescent idiopathic scoliosis (AIS) patients is higher in those with AR lumbar modifier than in those with AL lumbar modifier. However, the risk factors associated with DA in Lenke 1 or 2 AIS patients with AR lumbar modifier remain unclear. The purpose of this study was to determine the risk factors associated with DA in these patients.</p><p><b>Methods: </b>Thirty-six Lenke 1 or 2 AIS patients with AR lumbar modifier with a minimum of 2-year follow-up were recruited in this study (Lenke type 1: 13 patients and type 2: 21 patients; mean age at surgery: 15.2 years; average follow-up period: 44.1 months). We evaluated radiographic parameters before surgery (PreO), 1 week after surgery (PO), and at final follow-up (FFU). DA was defined as (1) an increase in Cobb angle of at least 5° and distalization of the end vertebra or (2) a change in disc angulation of 5° or greater below the lowest instrumented vertebra (LIV) from PO to FFU. LIV levels were also determined as the distance from neutral vertebra, stable vertebra, and last substantially touched vertebra (LSTV).</p><p><b>Results: </b>DA occurred in 10 patients (29.4%), and additional surgery was required in 1 patient. The mean age at surgery was 14.0 years in the DA (+) group and 15.7 years in the DA (−) group (P = 0.14). Radiographic parameters (PreO/PO/FFU) in the DA (+) group were as follows: PT: 39.2/18.8/19.5°, MT: 66.4/13.3/19.1°, TL/L: 31.1/3.9/9.2°, RSH: −10.5/10/8.9 mm, TAVT: 55.5/10.0/17.1 mm, LIV-tilt: 25.3/0.1/8.6°, L4-tilt: 25.3/0.1/8.6°, CVA: 11.9/−8.8/−2.9 mm, and TK: 11.0/18.5/18.5°. The parameters in the DA (−) group were as follows: PT: 33.6/14.1/14.6°, MT: 60.0/12.3/13.4°, TL/L: 29.8/4.7/5.2°, RSH: −14.0/10.1/8.4 mm, TAVT: 48.1/9.6/8.3 mm, LIV-tilt: 20.5/0.2/1.4°, L4-tilt: 25.3/0.1/8.6°, CVA: 10.2/−2.3/−1.0 mm, and TK: 11.0/17.0/17.5°. Regarding preoperative and postoperative parameters, there was no significant difference between the two groups. However, the statistical analysis of the LIV level indicated that LIV more proximal than LSTV was a significant risk factor for DA (P = 0.02).</p><p><b>Conclusions: </b>The incidence of DA was 29.4% in this series. An LIV level proximal to LSTV is a possible risk factor for postoperative DA in Lenke type 1 or 2 AIS patients with AR lumbar modifier.</p>

    DOI: 10.34371/jspineres.2019-0015

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  • Flexor tenosynovitis of the hand due to rare nontuberculous mycobacterium (Mycobacterium haemophilum) in an immunocompromised patient. Reviewed

    Takuya Yokoi, Kosuke Saito, Takuya Uemura, Etsuko Takizawa, Noriaki Hidaka, Mitsuhiro Okada, Hiroaki Nakamura

    Case reports in plastic surgery & hand surgery   7 ( 1 )   116 - 119   2020( ISSN:2332-0885

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    We report a case of purulent flexor tenosynovitis caused by Mycobacterium haemophilum in an immunosuppressed patient who received renal transplantation. Three synovial debridements and multiple antimicrobial administrations with clarithromycin, rifampicin, and moxifloxacin have been performed. No apparent recurrence has been observed two years after the final operation.

    DOI: 10.1080/23320885.2020.1830775

    PubMed

  • Facet joint opening on preoperative computed tomography is risk factor for revision surgery after less invasive decompression procedure for lumbar spinal stenosis Reviewed

    Yamada Kentaro, Toyoda Hiromitsu, Tamai Koji, Takahashi Shinji, Suzuki Akinobu, Hoshino Masatoshi, Terai Hidetomi, Nakamura Hiroaki

    The Japanese Society for Spine Surgery and Related Research, Journal of Spine Research   11 ( 6 )   936 - 941   2020( ISSN:1884-7137

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    <p><b>Purpose: </b>There is no consensus of regarding the indication of surgical treatment of the less invasive decompression procedure for lumbar spinal stenosis (LSS). Although facet joint opening (FO) on preoperative computed tomography (CT) images has been reported as a parameter indicating segmental instability, there is no report on how FO affects on postoperative outcomes. The purpose of this study was to investigate risk factors for revision surgery after less invasive decompression surgery for LSS including FO by a minimum-5-year postoperative survey.</p><p><b>Materials and Methods: </b>A total of 244 patients who underwent microscopic or microendoscopic decompression surgery for LSS and followed for ≥5 years were included in this study. We investigated revision lumbar surgeries at the same levels or other lumbar levels based on medical records. Revision surgeries due to postoperative hematoma or infection were excluded. FO was defined as a ≥2 mm opening on preoperative axial CT images at each lumbar intervertebral level. We evaluated the FO at index decompression levels and sum of FO-positive levels from L1-2 to L5-S. Risk factors for further surgeries were investigated among demographics, preoperative symptoms, and radiological parameters other than FO using univariate and cox proportional hazard regression analysis.</p><p><b>Results: </b>There was 26 reoperations (10.7%) at a mean of 3.9 years after primary surgeries. FO at index decompression levels was significantly more frequent in patients with than without revision surgeries (69 and 39%, respectively, p=0.003). The sum of FO-positive levels among lumbar segments was significantly higher in patients with than without revision surgeries (2.0 and 1.2 levels, respectively, p=0.001). The cox proportional hazard regression analysis indicated that the sum of FO-positive levels among lumbar segments was one of the risk factors for revision surgery (p=0.003, adjusted hazard ratio: 1.47).</p><p><b>Conclusions: </b>The FO of index decompression levels and sum of FO were associated with the need for further lumbar surgeries after less invasive surgery. FO might indicate not only segmental instability but also predictive parameter for progression of degenerative change.</p>

    DOI: 10.34371/jspineres.2020-0512

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  • Impact of Adjacent Vertebral Fractures on Clinical Outcomes Following Balloon Kyphoplasty and Development of a Scoring System for their Prediction Reviewed

    Takahashi Shinji, Hoshino Masatoshi, Nakamura Hiroaki

    The Japanese Society for Spine Surgery and Related Research, Journal of Spine Research   11 ( 5 )   811 - 819   2020( ISSN:1884-7137 ( eISSN:24351563

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    <p>Adjacent vertebral fractures (AVF) are well-known complications following balloon kyphoplasty. However, their clinical and radiological impact has not been formally elucidated. This review summarizes the findings of previous studies on AVF and introduces our previous report. We conducted a prospective cohort study to investigate in detail the clinical and radiological impact of AVF following balloon kyphoplasty for osteoporotic vertebral fractures and to establish a scoring system for predicting their incidence. In the study, 109 patients who underwent balloon kyphoplasty were analyzed and followed up for at least 6 months. Overall, 32 patients (29%) had AVFs. No significant difference was observed in each clinical outcome at the 6-month follow-up, although a higher visual analog scale score for back pain was observed at the 1-month follow-up in the AVF group than in the nonAVF group (p < 0.001). Multiple logistic regression model showed increased odds ratio of thoracic or thoracolumbar spine, presence of prior AVF, >25° kyphosis before surgery, and >10° correction for AVF. This study developed a simple scoring system for predicting AVF incidence. The total AVF score varied from 0 to 6. All the patients with total AVF scores of 5-6 showed AVF.</p>

    DOI: 10.34371/jspineres.2019-0021

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  • Anterior cruciate ligament reconstruction with anterior closing wedge osteotomy for failed high tibial osteotomy-A case report. Reviewed

    Kazuya Nishino, Yusuke Hashimoto, Yohei Nishida, Hiroaki Nakamura

    International journal of surgery case reports   73   116 - 120   2020( ISSN:2210-2612

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    BACKGROUND: Increased posterior tibial slope (PTS) is considered a risk factor for anterior cruciate ligament (ACL) injury. Previous studies revealed that medial opening wedge high tibial osteotomy (OWHTO) tends to increase PTS. However, knee instability from increased PTS is not a reported complication after OWHTO, and the treatment strategy is unclear. METHODS: A 55-year-old woman who complained of left knee pain underwent OWHTO for early-stage medial compartment osteoarthritis by another doctor. After the first surgery, her left knee pain decreased; however, 1 year after OWHTO, she began to feel left knee instability, and the primary doctor consulted our clinic. Physical examination revealed a positive Lachman's test, and radiographs showed that PTS had increased from 8 degrees to 15 degrees. According to these findings, we diagnosed an aggravated symptomatic knee instability secondary to increased PTS after OWHTO. We then performed ACL reconstruction using the quadriceps tendon and tibial anterior closing wedge osteotomy (ACWO), which is a newly-developed technique to correct PTS for revision ACL reconstruction. RESULTS: Postoperatively, PTS was corrected from 15 degrees to 7 degrees, and the patient's Lysholm score improved from 39 to 95, 1 year postoperatively. CONCLUSIONS: ACL reconstruction with ACWO is a possible treatment option for the PTS-increased knee after OWHTO.

    DOI: 10.1016/j.ijscr.2020.06.102

    PubMed

  • Evaluation of dual release of stromal cell-derived factor-1 and basic fibroblast growth factor with nerve conduit for peripheral nerve regeneration: An experimental study in mice. Reviewed

    Kosuke Shintani, Takuya Uemura, Kiyohito Takamatsu, Takuya Yokoi, Ema Onode, Mitsuhiro Okada, Yasuhiko Tabata, Hiroaki Nakamura

    Microsurgery   40 ( 3 )   377 - 386   2019.12( ISSN:0738-1085

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    BACKGROUND: The development of drug delivery systems has enabled the release of multiple bioactive molecules. The efficacy of nerve conduits coated with dual controlled release of stromal cell-derived factor-1 (SDF-1) and basic fibroblast growth factor (bFGF) for peripheral nerve regeneration was investigated. MATERIALS AND METHODS: Sixty-two C57BL6 mice were used for peripheral nerve regeneration with a nerve conduit (inner diameter, 1 mm, and length, 7 mm) and an autograft. The mice were randomized into five groups based on the different repairs of nerve defects. In the group of repair with conduits alone (n = 9), a 5-mm sciatic nerve defect was repaired by the nerve conduit. In the group of repair with conduits coated with bFGF (n = 10), SDF-1 (n = 10), and SDF-1/bFGF (n = 10), it was repaired by the nerve conduit with bFGF gelatin, SDF-1 gelatin, and SDF-1/bFGF gelatin, respectively. In the group of repair with autografts (n = 10), it was repaired by the resected nerve itself. The functional recovery, nerve regeneration, angiogenesis, and TGF-β1 gene expression were assessed. RESULTS: In the conduits coated with SDF-1/bFGF group, the mean sciatic functional index value (-88.68 ± 10.64, p = .034) and the axon number (218.8 ± 111.1, p = .049) were significantly higher than the conduit alone group, followed by the autograft group; in addition, numerous CD34-positive cells and micro vessels were observed. TGF-β1 gene expression relative values in the conduits with SDF-1/bFGF group at 3 days (7.99 ± 5.14, p = .049) significantly increased more than the conduits alone group. CONCLUSION: Nerve conduits coated with dual controlled release of SDF-1 and bFGF promoted peripheral nerve regeneration.

    DOI: 10.1002/micr.30548

    PubMed

  • Joint line elevation is not associated with mid-flexion laxity in patients with varus osteoarthritis after total knee arthroplasty. Reviewed

    Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Hideki Ueyama, Susumu Takemura, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   28 ( 10 )   3226 - 3231   2019.12( ISSN:0942-2056

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    PURPOSE: Previous cadaver studies showed that the additional bone cuts in the distal and posterior femur and joint line elevation resulted in laxity at mid-flexion after total knee arthroplasty (TKA). However, these results are not always applicable to TKA candidates because the related studies used cadaver knees with no osteoarthritis. It was hypothesized that the joint line elevation results in mid-flexion laxity after TKA in patients with knee osteoarthritis. The purpose of this study was to analyze the relationship between joint line elevation and mid-flexion laxity in patients with knee osteoarthritis. METHODS: 30 knees with varus osteoarthritis undergoing TKA were evaluated. Two femoral trial component models were prepared: (1) normal model with a thickness of the distal and posterior femoral components of 9 mm, and (2) 2-mm joint line elevation model with a thickness of the distal and posterior femoral components of 9 - 2 = 7 mm. This 2-mm joint line elevation model simulated an additional bone cut in the distal and posterior femur, and joint line elevation, without an additional bone cut. The femoral trial component models were set before implantation and measured the joint gap kinematics using a tensor device through the full knee range of motion. RESULTS: The differences in joint gap change from 30° to 90° were not statistically significant between the two models. However, the joint line elevation model decreased the joint gap laxity at 120° (p = 0.02) and at 145° (p = 0.01). CONCLUSIONS: This study showed that a 2-mm joint line elevation was not associated with mid-flexion laxity in patients with varus osteoarthritis in the knee. The results of this study differed from the results in previous cadaver studies. LEVEL OF EVIDENCE: Therapeutic study, level II, prospective comparative study.

    DOI: 10.1007/s00167-019-05828-1

    PubMed

  • Characteristic radiological findings for revision surgery after balloon kyphoplasty Reviewed

    Takahashi Shinji, Hoshino Masatoshi, Yasuda Hiroyuki, Hori Yusuke, Ohyama Shoichiro, Terai Hidetomi, Hayashi Kazunori, Tsujio Tadao, Kono Hiroshi, Suzuki Akinobu, Tamai Koji, Toyoda Hiromitsu, Dohzono Sho, Sasaoka Ryuichi, Kanematsu Fumiaki, Terakawa Masaki, Nakamura Hiroaki

    SCIENTIFIC REPORTS   9 ( 1 )   18513   2019.12( ISSN:2045-2322

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    DOI: 10.1038/s41598-019-55054-5

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  • The relationship between graft intensity on MRI and tibial tunnel placement in anatomical double-bundle ACL reconstruction. Reviewed

    Teraoka T, Hashimoto Y, Takahashi S, Yamasaki S, Nishida Y, Nakamura H

    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie   29 ( 8 )   1749 - 1758   2019.12( ISSN:1633-8065

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    DOI: 10.1007/s00590-019-02518-z

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  • Transplantation of autologous bone marrow-derived mesenchymal stem cells under arthroscopic surgery with microfracture versus microfracture alone for articular cartilage lesions in the knee: A multicenter prospective randomized control clinical trial. Reviewed

    Hashimoto Y, Nishida Y, Takahashi S, Nakamura H, Mera H, Kashiwa K, Yoshiya S, Inagaki Y, Uematsu K, Tanaka Y, Asada S, Akagi M, Fukuda K, Hosokawa Y, Myoui A, Kamei N, Ishikawa M, Adachi N, Ochi M, Wakitani S

    Regenerative therapy   11   106 - 113   2019.12

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    DOI: 10.1016/j.reth.2019.06.002

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  • 人工股関節全置換術後静脈血栓塞栓症に対する2種類のXa阻害剤の予防効果 FondaparinuxとEdoxabanの比較検討 Reviewed

    山本 展生, 洲鎌 亮, 箕田 行秀, 大田 陽一, 中村 卓, 上山 秀樹, 竹村 進, 村上 将一, 中村 博亮

    (一社)日本人工関節学会 日本人工関節学会誌   49   189 - 190   2019.12( ISSN:1345-7608

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    人工股関節全置換術(THA)症例225例(男性36例、女性189例、平均年齢65.2歳)を対象に、抗凝固薬fondaparinux(FP)とedoxaban(ED)のTHA術後静脈血栓塞栓症(VTE)に対する予防効果を比較検討した。内訳はFP群123例、ED群102例である。その結果、VTE発生率、Hb値、D-dimer値、推定出血量、出血合併症は2群間に有意差はなかった。

  • HipAlign Lateralが示す脚延長量およびオフセット変化量は正確か? Reviewed

    洲鎌 亮, 箕田 行秀, 大田 陽一, 中村 卓, 上山 秀樹, 竹村 進, 山本 展夫, 大山 洋平, 増田 翔, 中村 博亮

    (一社)日本人工関節学会 日本人工関節学会誌   49   687 - 688   2019.12( ISSN:1345-7608

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    HipAlign Lateral(HL)を用いて行った人工股関節全置換術(THA)での脚延長量・オフセット変化量について検討した。HLを用いてTHAを行った15例15関節(男性6例、女性9例、平均64.1歳)を対象とした。全例側臥位、前側方アプローチを用いTHAを行った。使用インプラントは、カップはG7 OsseTiで、ステムはTaperloc completeもしくはCMKであった。すべてのインプラント設置後にHLが表示した脚延長量・オフセット変化量を記録した。HLが示した脚延長量・オフセット変化量とレントゲンでの脚延長量・オフセット変化量の差は、絶対値で脚延長量24±2.6mm、オフセット変化量3.7±3.5mmであった。HLを用いることにより、手術中に簡便に脚延長量・オフセット変化量を知ることができ、より患者満足度が高い手術につながる可能性が示唆された。

  • Transplantation of autologous bone marrow-derived mesenchymal stem cells under arthroscopic surgery with microfracture versus microfracture alone for articular cartilage lesions in the knee: A multicenter prospective randomized control clinical trial(和訳中) Reviewed

    Hashimoto Yusuke, Nishida Yohei, Takahashi Shinji, Nakamura Hiroaki, Mera Hisashi, Kashiwa Kaori, Yoshiya Shinichi, Inagaki Yusuke, Uematsu Kota, Tanaka Yasuhito, Asada Shigeki, Akagi Masao, Fukuda Kanji, Hosokawa Yoshiya, Myoui Akira, Kamei Naosuke, Ishikawa Masakazu, Adachi Nobuo, Ochi Mitsuo, Wakitani Shigeyuki

    (一社)日本再生医療学会 Regenerative Therapy   11   106 - 113   2019.12

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    関節鏡視下で自家骨髄由来間葉系幹細胞(BMSC)移植術をマイクロフラクチャー法(MFX)と共に施行する治療の有効性を、MFX単独治療と比較する形で調査した。有症性の膝関節軟骨欠損を有する患者を、BMSCとMFXとで治療する実験群7名(女性4名、平均42.6±15.7歳)とMFXのみで治療する対照群4名(全員男性、平均46.3±9.4歳)とに無作為に割り付けた。その手術治療の前と48週後とで国際膝記録委員会の膝評価質問票、および膝関節損傷と変形性関節症転帰スコア(Knee injury and Osteoarthritis Outcome Score;KOOS)を用いて臨床結果を評価したが、実験群ではいずれの評価においても術前後で有意な差は観察されなかった。しかし群間比較した場合には、術後48週の時点で実験群が示したKOOSのQOLスコアは対照群よりも高い傾向にあることが示された(P=0.07)。48週後に軟骨修復組織の定量評価として測定した膝関節MRI画像のT2マッピング値には両群間で有意差は示されなかったが、定性評価とした軟骨修復組織の磁気共鳴観察(Magnetic Resonance Observation of Cartilage Repair Tissue;MOCART)の平均スコアは実験群の方が有意に高かった。

  • Possible pathogenesis of calcaneal bone cysts. Reviewed

    Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Akiyoshi Shimatani, Naoki Takada, Masanari Aono, Makoto Ieguchi, Masatsugu Takami, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   140 ( 10 )   1303 - 1310   2019.11( ISSN:0936-8051

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    INTRODUCTION: Recent literature indicates that calcaneal bone cysts have different clinical features compared to long bone cysts. Yet, previous studies have mainly focused on pathogenesis of long bone cysts. In this study, the pathogenesis of calcaneal bone cysts was investigated from radiological and pathological findings. MATERIALS AND METHODS: Patients comprised 18 males and 6 females diagnosed with calcaneal bone cysts at a median age ± standard deviation of 13.0 ± 3.6 years. Plain radiographs, computed tomography, magnetic resonance imaging, cystography, bone scintigraphy, and pathology were reviewed. RESULTS: All cysts occupied the central triangular area of the bone, with six extending posteriorly and two developing anteriorly. Fifteen of 20 cases (75%) showed the expanded foramen structures at the anterior margin of the posterior facet. According to cystography, four cysts showed absence of leakage to subtalar joint. Cystic fluid caused chronic haemorrhaging in 18 cases and pathologically detected cholesterol clefts were noted in 14 cases. DISCUSSION: The location of the expanded foramen structures was consistent with the nutrient foramens of the sinus tarsi artery in the unaffected population. Hence, initial cysts may originate from the collapse of the sinus tarsi artery. Subsequent haemorrhage may extend into the central triangle area, which is biomechanically free of stress. Because of poor bone remodelling, degenerative change of the haemorrhage is prolonged. The results of this study showed that circulation collapse of the sinus tarsi artery and mechanical factors are important in the formation of calcaneal bone cysts.

    DOI: 10.1007/s00402-019-03299-0

    PubMed

  • Improvement in Patient Mental Well-being After Surgery for Cervical Spondylotic Myelopathy. Reviewed

    Tamai K, Suzuki A, Terai H, Hoshino M, Toyoda H, Takahashi S, Ohyama S, Hori Y, Yabu A, Nakamura H

    Spine   45 ( 10 )   E568 - E575   2019.11( ISSN:0362-2436

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    DOI: 10.1097/BRS.0000000000003337

    PubMed

  • Impact of Sarcopenia on Clinical Outcomes of Minimally Invasive Lumbar Decompression Surgery. Reviewed

    Toyoda H, Hoshino M, Ohyama S, Terai H, Suzuki A, Yamada K, Takahashi S, Hayashi K, Tamai K, Hori Y, Nakamura H

    Scientific reports   9 ( 1 )   16619   2019.11

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    DOI: 10.1038/s41598-019-53053-0

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  • The case report of calcific myonecrosis

    NAGATA Hiroyuki

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 6 )   1077 - 1078   2019.11( ISSN:00089443 ( eISSN:13490885

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  • A case report; bone marrow metastases from rhabdomyosarcoma with less-revealing bone scintigraphy

    TAKADA Naoki

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 6 )   1061 - 1062   2019.11( ISSN:00089443 ( eISSN:13490885

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  • Two case of neurofibromatosis elephantiasis with prolonged healing after surgery

    HOSHI Manabu

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 6 )   1065 - 1066   2019.11( ISSN:00089443 ( eISSN:13490885

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  • Navigation assisted surgery for bone and soft tissue tumors

    IEGUCHI Makoto

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 6 )   1071 - 1072   2019.11( ISSN:00089443 ( eISSN:13490885

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  • 臨床室 術後深部感染後後弯変形に対する前・後・前方の3段階矯正固定術の1例

    澤田 雄大, 松村 昭, 並川 崇, 加藤 相勲, 岩前 真由, 中村 博亮

    整形外科   70 ( 12 )   1255 - 1258   2019.11( ISSN:00305901 ( eISSN:24329444

  • A case of pathological fracture with calcaneal bone cyst

    BAN Yoshitaka

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 6 )   1073 - 1074   2019.11( ISSN:00089443 ( eISSN:13490885

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  • A case report; Bone sarcoidosis of the phalanx which initial manifestation was refractory fistula

    TAKADA Naoki

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 6 )   1081 - 1082   2019.11( ISSN:00089443 ( eISSN:13490885

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  • Metastatic bone tumor of rectal gastrointestinal stromal tumor

    OKAZAKI Shirou

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 6 )   1057 - 1058   2019.11( ISSN:00089443 ( eISSN:13490885

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  • Cup alignment in total hip arthroplasty using the muscle-sparing modified Watson-Jones approach-comparison between lateral and supine positions. Reviewed

    Yuichi Kishimura, Yukihide Minoda, Shigekazu Mizokawa, Ryo Sugama, Yoichi Ohta, Hiroaki Nakamura

    International orthopaedics   43 ( 11 )   2477 - 2483   2019.11( ISSN:0341-2695

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    PURPOSE: The present study aimed to compare the cup alignment outliers in total hip arthroplasty (THA) using the same surgical approach with the patient in the supine position versus the lateral position. METHODS: THA using the muscle-sparing modified Watson-Jones approach was performed in 142 consecutive hips. THA was performed with the patient in the lateral position in 84 hips (lateral group) and in the supine position in 58 hips (supine group). The cup alignment was aimed at 40° inclination and 20° anteversion by referring to the mechanical alignment guide. Cup alignment and outliers (10° > aimed alignment) were assessed using post-operative 3D-CT. RESULTS: The absolute error from the aimed inclination was 6.0 ± 4.7° in the supine group and 4.2 ± 3.6° in the lateral group (p = 0.01). The absolute error from the aimed anteversion was 4.1 ± 3.2° in the supine group and 5.1 ± 3.7° in the lateral group (p = 0.12). The supine group showed a higher rate of outliers than the lateral group for the cup inclination (22% vs 5%; p < 0.01). Inclination and BMI were positively correlated in the spine position group (p < 0.01, R = 0.48), but were not correlated in the lateral position group. CONCLUSION: THA performed with the patient in the supine position has a higher risk of outliers of cup alignment compared with the lateral position, even when the same surgical approach is used. BMI affected the cup inclination in the supine position.

    DOI: 10.1007/s00264-019-04316-y

    PubMed

  • Clinical course of soft tissue sarcomas presenting as malignant wounds. Reviewed

    Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Makoto Ieguchi, Hiroaki Nakamura

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   24 ( 6 )   1088 - 1093   2019.11( ISSN:0949-2658

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    BACKGROUND: Soft tissue sarcomas can invade the skin and occasionally present as malignant wounds characterized by bleeding, exudate, odor, and infection. This study aimed to highlight the clinical problems associated with sarcomas with malignant wounds. METHODS: The patient group comprised 12 males and 1 female, with a median age at diagnosis of 75 (range 23-95) years old. The average follow-up was 28.3 months. Clinical information concerning the patients with soft tissue sarcomas presenting as malignant wounds was retrospectively investigated. RESULTS: Eleven out of 13 malignant wounds cases were male and over 65 years old. Tumors were located in the chest wall in 4 patients and the thigh in 4, respectively. The histology was high-grade in 12 patients. Persistent bleeding from malignant wounds was observed in 6 patients. The patients' pre-operative hemoglobin level was 7.5 ± 1.9 g/dl. For the purpose of temporary hemostasis, Mohs' paste was applied in 1 case and zinc oxide starch was applied in 3. Surgical removal was done in 10 patients, and amputation in 2. Six patients needed skin reconstruction. Post-operative surgical site infection was found in 5 patients, but the infection did not occur in the patients who underwent skin reconstruction of musculocutaneous flaps. The 5-year survival rate was 25.4%. CONCLUSIONS: Massive bleeding from the tumor impairs patients' quality of life and can be life-threatening. To avoid exacerbating the systemic condition of elderly cancer patients, urgent surgical removal is recommended, especially in cases of exposed tumors with persistent bleeding. Orthopedic oncologists should be aware of surgical site infection as a potential post-operative complication.

    DOI: 10.1016/j.jos.2019.07.010

    PubMed

  • Safety of Intra-articular Methotrexate Injection With and Without Electroporation for Inflammatory Small Joints in Patients With Rheumatoid Arthritis. Reviewed

    Masahiro Tada, Kentaro Inui, Tadashi Okano, Kenji Mamoto, Tatsuya Koike, Hiroaki Nakamura

    Clinical medicine insights. Arthritis and musculoskeletal disorders   12   1179544119886303 - 1179544119886303   2019.11( ISSN:1179-5441

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    The general disease activity of patients with rheumatoid arthritis (RA) is well controlled by disease-modifying antirheumatic drugs, but local inflammation often remains in a few small joints. Electroporation, making small pores in cell membranes, has proven useful for drug delivery. The safety of a combination therapy of methotrexate (MTX) and electroporation for local joint inflammation in RA was investigated in a prospective, randomized, double-blind, placebo-controlled, exploratory study (UMIN000016606). The patients were randomly allocated to groups receiving a combination of MTX and electroporation (True-EP) and MTX alone (False-EP) groups. The MTX solution was injected into finger joints under ultrasound guidance. The True-EP group underwent electroporation with MTX, and the False-EP group was given MTX but only pinched using the electrode. The ultrasound grade, disease activity, and safety were evaluated from baseline to 26 weeks. Five patients (3 True-EP and 2 False-EP) with a mean age of 57.4 years and disease duration of 10.2 years were enrolled. The grey-scale grade was unchanged in 3 cases (2 True-EP and 1 False-EP) and increased in 2 cases (1 True-EP and 1 False-EP). Disease activity was alleviated in 3 cases (2 True-EP and 1 False-EP). No patients experienced burned skin or electroshock. The combination therapy of electroporation and MTX was safe for RA patients.

    DOI: 10.1177/1179544119886303

    PubMed

  • 臨床室 術後深部感染後後彎変形に対する前・後・前方の3段階矯正固定術の1例 Reviewed

    澤田 雄大, 松村 昭, 並川 崇, 加藤 相勲, 岩前 真由, 中村 博亮

    (株)南江堂 整形外科   70 ( 12 )   1255 - 1258   2019.11( ISSN:0030-5901

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    71歳女性。他院にてL1椎体骨折偽関節に対しL1椎体形成併用Th11〜L3後方固定術を受けるも、術後深部感染(SSI)を発症した。VCMの投与、2度の掻爬、洗浄を施行されるもSSIは鎮静化せず、術後2ヵ月で脊椎インストゥルメントの抜去が行われた。抜釘後、SSIは鎮静化するも後彎変形が進行し、腰背部痛、右上肢のしびれが増強したため、手術目的で当科へ紹介となった。当科ではSSI後の後彎変形に対し前・後・前方の3段階矯正固定術を行った。その結果、術後の単純X線像およびCTで矢状面アライメントとバランスはともに改善し、局所後彎角は8°と良好に矯正されていた。最終観察時のJOAスコアは9点から20点に改善し、術後9ヵ月現在、術後感染の徴候はみられず、腰痛も改善している。

  • 骨転移をきたした直腸gastrointestinal stromal tumorの1例 Reviewed

    岡崎 史朗, 伴 祥高, 渡辺 享永, 家口 尚, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 6 )   1057 - 1058   2019.11( ISSN:0008-9443

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    84歳女性。4年前に直腸gastrointestinal stromal tumor(GIST)に対し腹会陰式直腸切除術を受けたが、術後4年に左大腿部痛が出現した。X線、CTで左大腿骨転子部に溶骨性病変と小転子骨折を認め、PETで同部位に腫瘍性病変を認めた。血液検査では腫瘍マーカーなどの異常は認めなかった。外来針生検で紡錘形細胞と核腫大を伴う類円形細胞の増殖を認め、免疫染色はCD34とc-kitが陽性、Ki67が10〜20%程度であり、直腸GISTの骨転移と診断した。Mirel's scoreは11点、新片桐スコアは2点であり、長期生存が見込めた。悪性腫瘍広範切除術および腫瘍用人工骨頭置換術を施行した。術後化学療法や放射線療法は患者や家族の希望で実施しなかった。術後10ヵ月の現在、再発や転移はなく、ウォーカーで歩行可能である。

  • 骨梁間型転移を示し、骨シンチグラフィー陰性を呈した横紋筋肉腫の1例 Reviewed

    高田 尚輝, 星 学, 大戎 直人, 岩井 正, 嶋谷 彰芳, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 6 )   1061 - 1062   2019.11( ISSN:0008-9443

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    62歳男性。右大腿軟部腫瘤を主訴とした。MRIで右大腿の長内転筋内に4.5×7.5×7.0mmの腫瘍を認め、針生検の診断は横紋筋肉腫(T2bN0M0 stage 3)であった。腫瘍広範切除術を施行し、病理診断は多発型横紋筋肉腫であった。術後8ヵ月にFDG-PET/CTで第11胸椎と左坐骨に転移を認め、転移巣に対し重粒子線療法と化学療法を行った。術後12ヵ月に肺転移を認め、骨転移もPDの状態となった。肺転移に対し化学療法と経皮的ラジオ波焼灼術を行い、骨転移に対してはストロンチウムの投与を計画し、骨シンチグラフィーを撮影した。骨シンチグラフィーの所見はFDG-PET/CTの所見と大きく乖離し、骨への異常集積を認めなかった。そのため、ストロンチウムの適応とならず、骨修飾薬を投与した。更に放射線療法とPazopanibの投与を行ったが、初診から約2年後に腫瘍死した。

  • 骨折を来した踵骨骨嚢腫の1例 Reviewed

    伴 祥高, 渡辺 享永, 山田 賢太郎, 家口 尚, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 6 )   1073 - 1074   2019.11( ISSN:0008-9443

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    13歳男性。階段から落下し、両踵の疼痛が出現した。CTで左踵骨三角部に24×22×18mmの比較的境界明瞭な溶骨性変化と骨折後変化を認め、骨腫瘍の踵骨内占拠率は矢状断で38%、冠状断で100%であった。MRIで多房性嚢胞性腫瘤とfluid-fluid levelを伴う高蛋白な液貯留を認めた。踵骨骨嚢腫により菲薄化した部位に、外傷を契機に強い外力が加わり骨折をきたしたと考え、受診後2週に手術を施行した。直径10mmの骨開窓を行い、嚢腫内部を掻爬して顆粒状β-TCPを充填した。術後、すぐに部分荷重を開始し、術後2週に全荷重を開始した。軽い運動は術後4週に許可し、術後2ヵ月から制限なしとした。術後1年の現在、再発を認めていない。

  • 難治性瘻孔を初発とした手指骨骨サルコイドーシスの1例 Reviewed

    高田 尚輝, 大戎 直人, 星 学, 岩井 正, 嶋谷 彰芳, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 6 )   1081 - 1082   2019.11( ISSN:0008-9443

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    32歳男性。3ヵ月前から持続する右示指の腫脹を主訴とした。前医で右示指骨腫瘍を指摘され、当科紹介受診となった。右示指中手指節関節以遠に腫脹を認め、背側に2ヶ所の瘻孔形成がみられた。前腕は皮疹を伴っていた。X線で中節骨に膨張性、溶骨性の変化を認め、骨シンチグラフィーで右示指中節骨、胸骨、右肋骨、左膝蓋骨、両側脛骨、右足関節に異常集積を認めた。FDG-PETで肺門、縦隔、全身リンパ節、骨に加え、右精巣上体に集積亢進を認めた。前医で皮疹の切開生検が行われていたことが分かり、病理組織を確認すると、類上皮細胞性の肉芽腫形成を認めた。サルコイドーシスや転移性腫瘍が鑑別に挙がり、泌尿器科で高位精巣摘出術、呼吸器科で経気管支肺生検が施行された。病理診断はいずれも類上皮肉芽腫であった。総合的にサルコイドーシスと診断し、専門的な治療が必要と判断し、転院となった。

  • 術後に創部遷延治癒を来した神経線維腫性象皮症の2例 Reviewed

    星 学, 大戎 直人, 岩井 正, 嶋谷 彰芳, 高田 尚輝, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 6 )   1065 - 1066   2019.11( ISSN:0008-9443

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    症例1は56歳男性で、腫瘍増大による歩行困難を主訴とした。幼少時から神経線維腫症を指摘されていた。両側の腰部から下腿にかけて著明な皮膚の肥厚を認め、針生検術の診断は神経線維腫であった。神経線維腫性象皮症の診断で右腰部から下腿にかけて腫瘍減量手術を施行し、短距離の歩行が可能となった。術後1年5ヵ月に左腰部から膝後面の腫瘍減量手術を施行したが、術後4日より創部が離開し、細菌培養で緑膿菌と黄色ブドウ球菌を検出した。感染巣が広範囲のためデブリドメントを施行し、創部が治癒した。症例2は30歳女性で、右踵部の腫瘍増大を主訴とした。既往歴に神経線維腫症があった。右踵部を中心に著明な皮膚の肥厚を認め、神経線維腫性象皮症と診断した。腫瘍減量手術を施行したが、術後8日より創部が離開し、細菌培養で黄色ブドウ球菌を検出した。患者に創部の消毒法を指導した後、自宅での処置を開始し、3ヵ月後に創部が治癒した。

  • 術中CTナビゲーション支援下骨軟部腫瘍手術 Reviewed

    家口 尚, 星 学, 大戎 直人, 伴 祥高, 高松 聖仁, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 6 )   1071 - 1072   2019.11( ISSN:0008-9443

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    術中CTナビゲーション支援下に骨軟部腫瘍手術を行った32例を対象に、治療成績を調査した。対象は良性17例、悪性15例で、良性は骨内ガングリオン3例、動脈瘤様骨嚢腫4例、線維性骨異形成症3例、骨軟骨腫2例、類骨骨腫2例などであった。悪性は骨髄腫2例、脊索腫2例、軟骨肉腫3例、軟部肉腫の骨浸潤6例などであった。平均経過観察期間は29.5ヵ月であった。その結果、平均皮膚切開長は8.8cmで、手術体位は仰臥位12例、腹臥位12例、側臥位8例であった。平均麻酔時間は263分、平均手術時間は156分、平均出血量は97gであった。CT撮影と確認に平均29分を要し、術中CTの撮影回数は1回28例、2回2例、3回1例であった。最終観察時の腫瘍的予後はCDFが7例、NEDが3例、AWDが3例、DODが1例であった。局所再発を良性2例に認め、内訳は動脈瘤様骨嚢腫1例、ガングリオン1例であった。悪性の再発は2例で、悪性末梢神経鞘腫瘍1例、平滑筋肉腫1例であった。

  • Calcific myonecrosis自験例の報告 Reviewed

    永田 浩之, 星 学, 大戎 直人, 岩井 正, 嶋谷 彰芳, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 6 )   1077 - 1078   2019.11( ISSN:0008-9443

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    症例1は76歳男性で、5年前から持続する右下腿の腫脹を主訴とした。既往歴に右脛骨骨折(50年前)があった。右下腿に10×7×3cmの圧痛のない弾性軟の腫瘤を触知し、右腓骨神経麻痺を認めた。生検の診断は石灰化であった。CTで右下腿に石灰化を伴う腫瘤を認め、腫瘤掻爬術を施行した。病理所見はヒアリン化した線維性組織やフィブリン、血塊で、異型細胞の増殖がなく、Calcific myonecrosisと診断した。症例2は58歳男性で、4年前に右下肢の血腫に対し掻爬術を受けたが、術後3年に疼痛が再燃した。既往歴に下腿の骨折(50年前)があった。右下肢前面に弾性硬、可動性良好な7cm大の腫瘤を触知し、CTで右下腿前面に石灰化を伴う腫瘤を認めた。血管造影で前脛骨動脈から腫瘍への血流を認めたため、術前に塞栓術を施行し、掻爬を施行した。病理所見は硝子化、石灰化した組織と血塊で、異型細胞の増殖がなく、Calcific myonecrosisと診断した。

  • Clinical course of soft tissue sarcomas presenting as malignant wounds(和訳中) Reviewed

    Hoshi Manabu, Oebisu Naoto, Iwai Tadashi, Ieguchi Makoto, Nakamura Hiroaki

    (公社)日本整形外科学会 Journal of Orthopaedic Science   24 ( 6 )   1088 - 1093   2019.11( ISSN:0949-2658

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    Malignant woundをきたした軟部組織肉腫患者の臨床経過について検討した。軟部組織肉腫患者13例(男性12例、女性1例、中央値75歳)を対象とした。組織病理に基づく最終診断は未分化型多形性肉腫が4例、粘液線維肉腫が3例、多形性脂肪肉腫が2例、肺胞軟部肉腫が1例、悪性末梢神経鞘腫が1例、類上皮肉腫が1例、高分化型脂肪肉腫が1例であった。MRI所見による最大径は3.7〜25.1cmで、局在部位は大腿が4例、胸壁が4例、下肢が2例、鼠径部が1例、上腕が1例、前腕が1例であった。出血性malignant woundを13例のうち6例に認め、術前ヘモグロビン値は7.5±1.9g/dLと非出血性malignant wound例と比較して有意に低値を示していた。局所治療に関して、切除不能と判定した1例は緩和治療とし、9例に広範切除、1例に断端切除を施行した。術後の局所再発の発症を2例に認めた。13例のうち3例にはドキソルビシンベースの化学療法を行ったが、最終観察時までに死亡の転帰に至った。また、腫瘍切除を行った12例のうち5例に手術部位感染症の発症を認め、有意な関連因子として年齢、腫瘍サイズ、術前ヘモグロビン値、皮膚再建の術式が挙げられた。最終アウトカムは無病生存が4例、有病生存が1例、原病死亡が7例、他病死亡が1例となり、5年生存率は25.4%、生存期間中央値は34.0ヵ月であった。

  • Mental health status and sagittal spinopelvic alignment correlate with self-image in patients with adult spinal deformity before and after corrective surgery. Reviewed

    Kazunori Hayashi, Louis Boissière, Fernando Guevara-Villazón, Daniel Larrieu, Anouar Bourghli, Olivier Gille, Jean-Marc Vital, Ferran Pellisé, Francisco Javier Sánchez Pérez-Grueso, Frank Kleinstück, Emre Acaroğlu, Ahmet Alanay, Hiroaki Nakamura, Ibrahim Obeid

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   29 ( 1 )   63 - 72   2019.10( ISSN:0940-6719

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    PURPOSE: Preoperative patient self-image (SI) in adult spinal deformity (ASD) is the most relevant factor for surgical decision-making. Postoperative SI has an important role in a patient's satisfaction with surgery. However, few studies are available to describe these variables. The aim was to investigate the factors that correlate with SI before and 2 years after ASD surgery. METHODS: This study was a retrospective review of prospectively collected multicentric data. Patients who underwent ASD surgery with a minimum follow-up of 2 years were enrolled (n = 391). They were divided into high-SI and low-SI groups, both preoperatively and postoperatively, according to SRS-22R SI/appearance subdomain scores at baseline and at 2 years, respectively. Independently related factors for SI were determined using logistic regression analysis. RESULTS: Crucial factors for SI at baseline were the scores on the SRS-22R function/activity (OR: 2.61), SRS-22R mental health (OR: 2.63) subdomains, and relative spinopelvic alignment (RSA, OR: 0.95). SF-36 MCS (OR: 1.07) at baseline as well as sagittal vertical axis (SVA, OR: 0.99) at 2 years, and complications (OR: 0.44) were independent predictive factors for SI at 2 years. The patients who transitioned from the preoperative low-SI group to the postoperative high-SI group achieved larger global sagittal alignment restoration and had lesser complications than those who did not. CONCLUSIONS: Mental status and sagittal spinopelvic alignment are key determinants of SI. The results indicate that considering mental status, preventing complications, and global sagittal alignment, restoration is crucial for achieving substantial SI scores after ASD surgery. These slides can be retrieved under Electronic Supplementary Material.

    DOI: 10.1007/s00586-019-06200-0

    PubMed

  • Fibroblast Growth Factor 9 Is Upregulated Upon Intervertebral Mechanical Stress-Induced Ligamentum Flavum Hypertrophy in a Rabbit Model. Reviewed

    Hayashi K, Suzuki A, Terai H, Ahmadi SA, Rahmani MS, Maruf MH, Habibi H, Hori Y, Yamada K, Hoshino M, Toyoda H, Takahashi S, Tamai K, Ohyama S, Imai Y, Nakamura H

    Spine   44 ( 20 )   E1172 - E1180   2019.10( ISSN:0362-2436

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    DOI: 10.1097/BRS.0000000000003089

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  • A case series of seven patients with recurrent median nerve neuropathy treated by the revision surgery of median nerve neurolysis and wrapping with radial artery perforator adipose flap. Reviewed

    Uemura T, Takamatsu K, Okada M, Yokoi T, Onode E, Miyashima Y, Konishi S, Nakamura H

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS   2019.10( ISSN:1748-6815

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    DOI: 10.1016/j.bjps.2019.09.051

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  • Increased advanced glycation end products in hypertrophied ligamentum flavum of diabetes mellitus patients Reviewed

    Maruf Mohammad Hasib, Suzuki Akinobu, Hayashi Kazunori, Habibi Hasibullah, Salimi Hamidullah, Terai Hidetomi, Tamai Koji, Hoshino Masatoshi, Toyoda Hiromitsu, Yamada Kentaro, Takahashi Shinji, Ohyama Shoichiro, Hori Yusuke, Nakamura Hiroaki

    SPINE JOURNAL   19 ( 10 )   1739 - 1745   2019.10( ISSN:1529-9430

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    DOI: 10.1016/j.spinee.2019.06.001

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  • Autogenic Rib Graft for Atlantoaxial and Occipitocervical Fixation in Pediatric Patients. Reviewed

    Akira Matsumura, Takashi Namikawa, Minori Kato, Yusuke Hori, Masayoshi Iwamae, Noriaki Hidaka, Sadahiko Konishi, Hiroaki Nakamura

    Asian spine journal   13 ( 5 )   713 - 720   2019.10( ISSN:1976-1902

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    STUDY DESIGN: Retrospective case series. PURPOSE: To evaluate surgical outcomes and effectiveness of an autogenic rib graft for upper cervical fixation in pediatric patients. OVERVIEW OF LITERATURE: Autogenic bone grafts have long been considered the 'gold standard' bone source for posterior cervical fusion in pediatric patients. However, there are some unsolved problems associated with donor-site morbidity and amount of bone grafting. METHODS: We studied five consecutive pediatric patients who underwent atlantoaxial fixation or occipitocervical fixation (OCF) using an autogenic rib graft with at least 2 years of follow-up (mean age, 9.8 years; mean follow-up period, 73.0 months). Two patients underwent OCF without screw-rod constructs and three patients with screw-rod constructs. Autogenic rib grafts were used in all patients. We evaluated the surgical outcomes including radiographic parameter, bony union, and perioperative complications. RESULTS: The atlantoaxial interval (ADI) was corrected from 11.6 to 6.0 mm, and the C1-2 angle was corrected -14.8° to 7.8°. The C2-7 angle was reduced from 31° to 9° spontaneously. Two patients with OCF required revision surgery due to loss of correction. Patients did not experience any complication associated with the donor sites (rib bone grafts). Six months postoperation X-rays clearly showed regeneration of the rib at the donor sites. Bony fusion was achieved in all patients; however, bony fusion occurred more slowly in patients without screw-rod constructs compared with patients with screw-rod constructs. Bone regeneration of the rib was observed in all patients with no complications at the donor site. CONCLUSIONS: Autogenic rib grafts have advantages of potential bone regeneration, high fusion rate, and low donor-site morbidity. In addition, a screw-rod construct provides better bony fusion in pediatric patients with OCF and atlantoaxial fixation.

    DOI: 10.31616/asj.2018.0312

    PubMed

  • Changes in viscoelastic properties of articular cartilage in early stage of osteoarthritis, as determined by optical coherence tomography-based strain rate tomography. Reviewed

    Suguru Nakamura, Mitsuhiko Ikebuchi, Souichi Saeki, Daisuke Furukawa, Kumi Orita, Nobuo Niimi, Yoshito Tsukahara, Hiroaki Nakamura

    BMC musculoskeletal disorders   20 ( 1 )   417 - 417   2019.09

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    BACKGROUND: Biomechanical changes in articular cartilage are associated with the onset of osteoarthritis. We developed an optical coherence tomography-based strain rate tomography method: stress relaxation optical coherence straingraphy (SR-OCSA). The purpose of this study was to establish an approach for measuring mechanical properties of articular cartilage using SR-OCSA, and to investigate the distribution of viscoelastic properties of articular cartilage in early osteoarthritis. METHODS: Anterior cruciate ligament transection surgery was performed on the left knees of 8-9-month-old New Zealand white rabbits. SR-OCSA was used to visualize and measure the viscoelastic properties of articular cartilage via attenuation coefficient of strain rate (ACSR). Using the same conditions as in the SR-OCSA test, an indentation test was conducted, and relaxation time was measured to evaluate the relationship between ACSR and relaxation time. RESULTS: SR-OCSA could nondestructively detect and visualize changes in the distribution of viscoelastic properties of articular cartilage in early osteoarthritis. SR-OCSA captured significant increases in ACSR in cartilage at 2 weeks after surgery, when a histologically slight osteoarthritis sign was present. As cartilage degeneration progressed, ACSR increased, whereas relaxation time decreased in a time-dependent manner. Moreover, ACSR negatively correlated with relaxation time. In particular, ACSR was elevated around the tidemark and the elevation tended to move as cartilage degeneration progressed. CONCLUSIONS: SR-OCSA could tomographically and nondestructively detect and visualize changes in the distribution of viscoelastic properties of articular cartilage in early osteoarthritis. The mechanical properties around the tidemark were degraded as cartilage degeneration progressed. Thus, SR-OCSA provides important data needed to understand the biomechanics of early osteoarthritis.

    DOI: 10.1186/s12891-019-2789-4

    PubMed

  • Prevalence, development, and factors associated with cyst formation after meniscal repair with the all-inside suture device Reviewed

    Terai Shozaburo, Hashimoto Yusuke, Yamasaki Shinya, Takahashi Shinji, Shimada Nagakazu, Nakamura Hiroaki

    ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY   139 ( 9 )   1261 - 1268   2019.09( ISSN:0936-8051

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    DOI: 10.1007/s00402-019-03176-w

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  • Sarcopenia is related to spinal sagittal imbalance in patients with spinopelvic mismatch Reviewed

    Ohyama Shoichiro, Hoshino Masatoshi, Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Takahashi Shinji, Hayashi Kazunori, Tamai Koji, Hori Yusuke, Nakamura Hiroaki

    EUROPEAN SPINE JOURNAL   28 ( 9 )   1929 - 1936   2019.09( ISSN:0940-6719

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    DOI: 10.1007/s00586-019-06066-2

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  • 腱板大断裂・広範囲断裂に対するスーチャーブリッジ法と骨孔法の比較(第2報) Reviewed

    松田 淑伸, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一, 中村 博亮

    (一社)日本肩関節学会 肩関節   43 ( 2 )   570 - 572   2019.09( ISSN:0910-4461

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    腱板大断裂・広範囲断裂に対する鏡視下腱板修復術においてsuture bridge法(以下SB法)と骨孔法(以下TO法)を比較検討した.対象は42例42肩,SB法は20肩,TO法は22肩であった.手術時間,術中使用したインプラント費用,術後1年時の臨床成績及び菅谷分類を用いた腱板修復状態を2群間で比較検討した.手術時間はSB法と比較してTO法で有意に短時間であった.インプラント費用はSB法と比較してTO法で有意に低額であった.術前と比較して術後1年時の臨床成績は両群ともに有意に改善みられたが,2群間で有意差は認めなかった.腱板再断裂率はSB法では36.8%,TO法では18.2%であったが,2群間で有意差は認めなかった.腱板大断裂・広範囲断裂に対するSB法とTO法の臨床成績,腱板修復状態は同等であったが,手術時間はTO法で有意に短時間であり,術中使用したインプラント費用はTO法で有意に低額であった.(著者抄録)

  • リバース型人工肩関節置換術におけるMPR解析を用いたベースプレート及びスクリュー設置状態の検討 Reviewed

    飯尾 亮介, 平川 義弘, 間中 智哉, 伊藤 陽一, 市川 耕一, 松田 淑伸, 清水 勇人, 中澤 克優, 山下 竜一, 中村 博亮

    (一社)日本肩関節学会 肩関節   43 ( 2 )   630 - 633   2019.09( ISSN:0910-4461

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    本研究の目的はリバース型人工肩関節置換術(Reverse shoulder arthroplasty:以下RSA)術後CTをMulti-planer reconstruction解析(以下MPR解析)することにより理想的なスクリュー長を検討することである.対象はRSAを施行し術後CTでMPR解析が可能であった19例19肩で,使用機種は全例Aequalis Ascend Flex(Wright Medical Inc,Memphis,USA)であった.術後CTを用いてベースプレートの設置位置とセンターペグ及びスクリュー挿入方向に存在する骨長をMPR解析する事により評価した.ベースプレートのセンターペグ方向への骨長はベースプレートから体側の骨皮質まで平均26.3mmであり,ベースプレート固定に用いた上方スクリュー方向,前方スクリュー方向,下方スクリュー方向,後方スクリュー方向への平均骨長はベースプレートから骨皮質までそれぞれ16.7mm,17.3mm,25.5mm,17.6mmであった.ベースプレート周囲には肩甲上神経が走行しており,骨長を大きく上回るスクリューは神経損傷を生じる可能性があり,最適なスクリュー長を決定する必要がある.(著者抄録)

  • 高度関節窩骨欠損症例に対するリバース型人工肩関節置換術の治療成績 Reviewed

    中澤 克優, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 山下 竜一, 中村 博亮

    (一社)日本肩関節学会 肩関節   43 ( 2 )   634 - 637   2019.09( ISSN:0910-4461

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    【目的】本研究の目的は,高度関節窩骨欠損症例に対するリバース型人工肩関節置換術(以下RSA)の対処法及び治療成績を検討することである.【対象と方法】対象は5肩で,平均関節窩骨欠損割合は関節面最大横径レベルで67%であった.高度関節窩骨欠損症例に対するRSAの対処法及び臨床成績を検討した.【結果】4肩において上腕骨頭を用いて移植骨を作成し,新鮮化した関節窩縁に圧着させ仮固定した後にベースプレートを設置した.1肩では,Norris法による腸骨移植を用いてベースプレートを設置した.1肩において,glenoid componentの上方傾斜を認めたが,glenoid componentのゆるみは認めず,自動可動域とJOAスコアは改善した.【考察・結論】高度関節窩骨欠損症例に対するRSAでは,骨欠損の形状に合わせた骨移植を併用しベースプレートを設置することが重要である.また,肩甲骨形態を正確に把握することが難しいため手術手技を工夫する必要がある.(著者抄録)

  • 誌上シンポジウム 整形外科治療の費用対効果 骨粗鬆症性椎体骨折に対するBalloon Kyphoplastyの費用対効果

    高橋 真治, 星野 雅俊, 中村 博亮

    臨床整形外科   54 ( 8 )   791 - 797   2019.08( ISSN:05570433 ( eISSN:18821286

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  • Exploration of the Optimal Shape for Bone Tumour Biopsy. Reviewed

    Tadashi Iwai, Manabu Hoshi, Naoto Oebisu, Kumi Orita, Akiyoshi Shimatani, Naoki Takada, Hiroaki Nakamura

    Anticancer research   39 ( 8 )   4191 - 4197   2019.08( ISSN:0250-7005

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    BACKGROUND/AIM: Biopsy hole for bone tumour biopsy may cause pathological fractures. This study aimed to identify the optimal shape of bone tumour biopsy hole using the rabbit femoral head compression test to avoid pathological fracture. MATERIALS AND METHODS: A compression test with no defect was performed to identify bone fracture location. Three shapes of biopsy holes (same size) were made artificially. Sixty rabbit femurs were randomly divided (n=15 each) into control (no defect), Shape 1 (round), Shape 2 (square), and Shape 3 (rectangular) groups. RESULTS: Twelve out of fifteen femurs were fractured on the femoral shaft; the femoral shaft was targeted for the compression test. Compressive maximum load and fracture energy were significantly higher for Shape 3 than for the other Shapes. CONCLUSION: A rectangular biopsy hole helps minimise reduction in bone strength. The defect width may be related to fragility of the affected bone.

    DOI: 10.21873/anticanres.13579

    PubMed

  • Prognostic value of low psoas muscle mass in patients with cervical spine metastasis. Reviewed

    Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Masatoshi Hoshino, Hiroaki Nakamura

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia   66   56 - 60   2019.08( ISSN:0967-5868

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    Morphometric analyses have shown that the psoas muscle mass is associated with mortality in cancer patients. Because of the low incidence of cervical spine metastasis, few studies have been reported in this population. The present study aimed to identify the prognostic value of a psoas muscle mass in predicting overall survival. We also evaluated factors associated with surgical intervention for cervical spine metastases. We retrospectively evaluated 97 patients (mean age 65.2 years) diagnosed with cervical spine metastases between February 2009 and July 2016. The psoas muscle area was measured at the L3 level on computed tomography at the time nearest the diagnosis of cervical spine metastasis. Cox proportional hazards analyses were performed to evaluate the relation between overall survival and the psoas muscle's composition. The mean overall survival for patients who underwent surgery was not significantly different from that for those without surgery. Multivariate analyses showed that the lowest percentage quartile (0%-25%) of the psoas muscle mass was associated with poor overall survival after adjusting for age and the prognostic predictive value (hazard ratio 1.93, 95% confidence interval 1.12-3.32; p = 0.017). Spinal cord compression, spinal instability, palsy, and the poor prognostic predictive value were factors associated with surgical intervention. In conclusion, a psoas muscle mass in the lowest quartile was independently associated with shorter survival among patients with cervical spine metastases. Although the poor prognostic predictive value was associated with surgical treatment, the overall survival was not different between patients who did or did not undergo surgery.

    DOI: 10.1016/j.jocn.2019.05.024

    PubMed

  • 椎間板楔状化はあるが椎間孔部狭窄を伴っていない腰部脊柱管狭窄症に対する顕微鏡視下片側進入両側除圧術(MBDU)の治療成績 Reviewed

    関 昌彦, 堀 悠介, 藪 晋人, 寺川 雅基, 中村 博亮

    (一社)日本脊椎脊髄病学会 Journal of Spine Research   10 ( 8 )   1167 - 1171   2019.08( ISSN:1884-7137

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    椎間孔部狭窄を伴わない1椎間の腰部脊柱管狭窄症97例に対し、顕微鏡視下片側進入両側除圧術を行い2年以上経過観察した。このうち3度以上の椎間板楔状化を伴っていた27例のJOAスコアは、術前平均15.7点が最終調査時25.0点に改善(改善率69.7%)した。一方、伴っていなかった70例は、術前16.6点が25.6点に改善(改善率71.3%)した。術後成績は両群で有意差を認めなかった。また椎間板部楔状角は術前平均4.3度が最終調査時3.6度と有意に減少した。(著者抄録)

  • 仰臥位THAにおけるポータブルナビゲーションのカップ設置角度の精度検証 Reviewed

    中村 卓, 洲鎌 亮, 箕田 行秀, 大田 陽一, 上山 秀樹, 竹村 進, 中村 博亮, 大山 洋平

    日本股関節学会 Hip Joint   45 ( 1 )   604 - 606   2019.08( ISSN:0389-3634

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    HipAlignを用いて仰臥位人工股関節全置換術を行った35例39関節を対象に、術中のHipAlignが示したカッブ設置角度と術後2週のCT画像をZedHipで三次元画像計測したカップ設置角度との差を算出した。カップ設置角度の差の絶対値を絶対値誤差と定義し、radiographic定義のinclinationとanteversionの絶対値誤差を計算した。その結果、inclinationの絶対値誤差は平均2.2°、anteversionの絶対値誤差は平均2.8°で、5°差以内の症例は33関節(84.6%)、10°差以内の症例は38関節(97.4%)であった。HipAlignの精度は高く、臨床的に信頼できるナビゲーションシステムと考えられた。

  • 人工股関節全置換術後静脈血栓塞栓症に対する2種類のXa阻害剤の予防効果 fondaparinuxとedoxabanの比較検討 Reviewed

    山本 展生, 洲鎌 亮, 箕田 行秀, 大田 陽一, 中村 卓, 上山 秀樹, 竹村 進, 村上 将一, 中村 博亮

    日本股関節学会 Hip Joint   45 ( 1 )   478 - 481   2019.08( ISSN:0389-3634

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    人工股関節全置換術60例を対象に、乱数表を用いてfondaparinux投与群30例とedoxaban投与群30例に分け、術後の静脈血栓塞栓症(VTE)に対する予防効果を比較した。2群とも術後3〜12日の計10日間に各薬剤を投与し、VTEは術後7日の造影CTで下肢深部静脈血栓症と肺血栓塞栓症を評価した。採血は術翌日、術後3日、7日、14日に行った。評価項目は術後VTEの発生率、Hb値、D-dimer値、推定出血量(体重×0.7×Hct値変化量、Mercuriali and Inghilleriの式を用いて計算)、出血性合併症の有無で、2群間で比較した。出血性合併症はmajor bleedingを薬剤投与後のHb値1以上の低下、minor bleedingを術後7日の便潜血陽性と定義した。その結果、いずれの項目も2群間に有意差を認めなかった。THA後のVTEに対するfondaparinuxとedoxabanの予防効果に差はないと考えられた。

  • Trilogy cupのTHA術後カップ周囲骨密度変化の検討 Reviewed

    洲鎌 亮, 箕田 行秀, 大田 陽一, 中村 卓, 上山 秀樹, 竹村 進, 山本 展夫, 村上 将一, 中村 博亮

    日本股関節学会 Hip Joint   45 ( 1 )   314 - 317   2019.08( ISSN:0389-3634

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    セメントレスカップによる人工股関節全置換術(THA)症例46関節(手術時平均年齢67.9歳、経過観察期間24〜96ヵ月、平均59.2ヵ月)を対象に、カップ周囲骨密度変化について検討した。骨密度はdual-energy X-ray absorptiometry(DEXA)法を用い、術後3週、6ヵ月、1年、2年、以後1年毎に測定し、カップ周囲全体及び各region of interest(ROI)での変化率を算出した。その結果、カップ周囲全体の骨密度は術後5年までは経時的に低下していた。各ROIについてはカップの裏側部分で低下が大きく、皮質骨に近い辺縁部分で低下が少なかった。

  • 特集 DISHの臨床 DISHの疫学

    豊田 宏光, 寺井 秀富, 山田 賢太郎, 中村 博亮

    脊椎脊髄ジャーナル   32 ( 7 )   653 - 660   2019.07( ISSN:09144412

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  • 特集 DISHの臨床 腰椎変性疾患とDISH

    山田 賢太郎, 豊田 宏光, 寺井 秀富, 中村 博亮

    脊椎脊髄ジャーナル   32 ( 7 )   685 - 692   2019.07( ISSN:09144412

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  • 臨床室 多椎間腰椎黄色靱帯石灰化症により神経根性疼痛をきたした1例

    津本 柊子, 玉井 孝司, 久保 卓也, 藪 晋人, 寺井 秀富, 中村 博亮

    整形外科   70 ( 8 )   857 - 860   2019.07( ISSN:00305901 ( eISSN:24329444

  • Development of a scoring system for predicting adjacent vertebral fracture after balloon kyphoplasty Reviewed

    Takahashi Shinji, Hoshino Masatoshi, Yasuda Hiroyuki, Hori Yusuke, Ohyama Shoichiro, Terai Hidetomi, Hayashi Kazunori, Tsujio Tadao, Kono Hiroshi, Suzuki Akinobu, Tamai Koji, Toyoda Hiromitsu, Dohzono Sho, Sasaoka Ryuichi, Kanematsu Fumiaki, Nakamura Hiroaki

    SPINE JOURNAL   19 ( 7 )   1194 - 1201   2019.07( ISSN:1529-9430

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    DOI: 10.1016/j.spinee.2019.02.013

    PubMed

  • Analysis of allergens in corn-dependent exercise-induced anaphylaxis. Reviewed

    Nakamura H, Nakamura M, Shimizu N, Matsunaga K, Kondo Y

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology   123 ( 1 )   103 - 105   2019.07( ISSN:1081-1206

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    DOI: 10.1016/j.anai.2019.04.005

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  • 臨床室 多椎間腰椎黄色靱帯石灰化症により神経根性疼痛をきたした1例 Reviewed

    津本 柊子, 玉井 孝司, 久保 卓也, 藪 晋人, 寺井 秀富, 中村 博亮

    (株)南江堂 整形外科   70 ( 8 )   857 - 860   2019.07( ISSN:0030-5901

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    71歳女性。右下肢痛が出現し、黄色靱帯石灰化症による右L2/L3椎間孔部狭窄症と診断され、L2/L3右椎間孔拡大術が施行された。その後、黄色靱帯石灰化症による右L3/L4椎間孔部狭窄症に対しL3/L4椎間孔拡大術を施行した。今回、右下肢痛、しびれが再度出現し、黄色靱帯石灰化症によるL2/L3、L3/L4腰部脊柱管狭窄を認めたため、L2/L3、L3/L4顕微鏡下後方除圧術を行った。その結果、術後は右下肢の疼痛は速やかに改善したが、しびれは残存した。

  • Design improvement in patient-specific instrumentation for total knee arthroplasty improved the accuracy of the tibial prosthetic alignment in the coronal and axial planes. Reviewed

    Kazumasa Yamamura, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Suguru Nakamura, Hideki Ueyama, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   28 ( 5 )   1560 - 1567   2019.06( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: The accuracy of patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) is still controversial, especially in the tibial prosthesis. It was hypothesized that the design modification of PSI improved the tibial prosthetic alignment and reduced the associated complications. The aim of this study was to compare the accuracy of a conventional PSI with that of a newly designed PSI for total knee arthroplasty (TKA) using a new three-dimensional (3D) measurement method. METHODS: Thirty TKAs each using the conventional and newly designed PSIs were studied. The postoperative 3D-computed tomography (3D CT) image was superimposed on the preoperative 3D CT plan. The absolute differences in the tibial prosthetic alignment between the preoperative and postoperative 3D CT images were directly measured in the coronal, sagittal, and axial planes. Knees in which the difference in the prosthetic alignment was > 3° were considered deviations. RESULTS: The new PSI showed less mean absolute differences and lower rate of deviations than the conventional PSI in the coronal and axial planes (p = 0.045 and p = 0.004, respectively). The deviations (> 3°) of the tibial prosthesis using the conventional PSI were 27, 30, and 63% and of those using the new PSI were 0, 20, and 20% in the coronal, sagittal, and axial planes, respectively. CONCLUSIONS: This is the first report to evaluate the effect of improvement in PSI design on the postoperative alignment using 3D method, and it clearly showed that the modification significantly improved the accuracy of alignment and reduced the deviations. LEVEL OF EVIDENCE: Therapeutic study, case-control study, Level III.

    DOI: 10.1007/s00167-019-05571-7

    PubMed

  • DIFFERENCES OF LIFESTYLE HABITS OF SMOKING, DRINKING ALCOHOL AND CAFFEINATED COFFEE CONSUMPTION BETWEEN RHEUMATOID ARTHRITIS PATIENTS AND HEALTHY CONTROL - TOMORROW STUDY- Reviewed

    Yoshimura Hitoshi, Inui Kentaro, Koike Tatsuya, Sugioka Yuko, Okano Tadashi, Mandai Koji, Yamada Yutaro, Mamoto Kenji, Tada Masahiro, Nakamura Hiroaki

    ANNALS OF THE RHEUMATIC DISEASES   78   645 - 645   2019.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2019-eular.4138

  • PREDICTING SARCOPENIA AND OBESITY BY MEASURING THIGH MUSCLE AND FAT THICKNESS BY ULTRASOUND IN PATIENTS WITH RHEUMATOID ARTHRITIS: FROM THE CHIKARA STUDY Reviewed

    Yamada Yutaro, Tada Masahiro, Mandai Koji, Hidaka Noriaki, Inui Kentaro, Nakamura Hiroaki

    ANNALS OF THE RHEUMATIC DISEASES   78   697 - 698   2019.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2019-eular.1430

  • MORTALITY RATE OF RHEUMATOID ARTHRITIS PATIENTS EVEN IN THE NEW ERA OF BIOLOGICS IS HIGHER THAN THE CONTROL GROUP: EIGHT YEARS OF THE TOMORROW STUDY Reviewed

    Mandai Koji, Koike Tatsuya, Sugioka Yuko, Inui Kentaro, Okano Tadashi, Yamada Yutaro, Tada Masahiro, Mamoto Kenji, Anno Shohei, Nakamura Hiroaki

    ANNALS OF THE RHEUMATIC DISEASES   78   1591 - 1592   2019.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2019-eular.1317

  • PREVALENCE AND SEVERITY OF CLINICAL AND IMAGING AXIAL SPONDYLOARTHRITIS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE Reviewed

    Okano Tadashi, Inui Kentaro, Mandai Koji, Yamada Yutaro, Sugioka Yuko, Koike Tatsuya, Nakamura Hiroaki

    ANNALS OF THE RHEUMATIC DISEASES   78   1827 - 1827   2019.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2019-eular.3587

  • 外側円板状半月板術後に残存半月板量減少をきたす症例の特徴と危険因子の検討 Reviewed

    西野 壱哉, 橋本 祐介, 西田 洋平, 山崎 真哉, 中村 博亮

    (一社)日本関節鏡・膝・スポーツ整形外科学会 JOSKAS   44 ( 3 )   718 - 724   2019.06( ISSN:1884-8842

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    【背景】外側円板状半月板(以下,DLM)に対する手術方法として,辺縁半月板を温存する形成切除術は全摘・亜全摘術と比べて術後後期の離断性骨軟骨炎や関節症性変化の発生を低下させる.一方で術後に形成した半月板幅の縮小を認めることが報告されているが,その詳細な経過や原因についてはまだ明らかでない.【目的】DLMに対して形成切除術もしくは形成縫合術を行った症例の,術後半月板形態の変化と,その時期,形態変化発生の関連因子を検討すること.【対象と方法】2009年から2015年に有症状性のDLMに対して手術を行い,2年以上経過観察しえた44膝(男性24膝,女性20膝,手術時平均年齢11.4歳)を対象とした.形成切除は全症例半月板幅を辺縁から6mm以上温存し,辺縁不安定症例には縫合を追加した.術後3,6,12,24ヵ月での外側半月板前中後節の幅と高さ,中節部逸脱量をMRI T2脂肪抑制矢状断中央像,冠状断中央像を用いて測定した.術後3ヵ月から24ヵ月にかけての中節幅の縮小率[(3ヵ月の計測値-24ヵ月の計測値)/3ヵ月の計測値]と逸脱量の相関関係を検討した.また,術後24ヵ月での中節幅が5mm未満(減少群)20例と5mm以上(温存群)24例の2群に分け,中節幅の推移とそれに関連する術前危険因子として年齢,性別,Tegner activity scale,Lysholm score,MRI所見;Ahn分類,半月板内部変性(T2高信号)の有無について検討を行った.【結果】術後残存半月板幅の縮小率は術後3ヵ月から24ヵ月の間で前節部11%,中節部20%,後節部7%であり,それぞれ有意に縮小した(p<.001).半月板逸脱量と中節幅の縮小率に正の相関を認めた(r=0.389,p=0.034).中節幅減少群は術後3ヵ月より5mm未満に縮小を認め(p<.001),術前MRIでの半月板内部変性が術後残存中節部幅の減少をきたす危険因子として検出された(オッズ比11.2,95%信頼区間1.15〜109,p=.038).【結語】DLMに対する形成切除,縫合術後残存半月板幅は術後3ヵ月から24ヵ月の間で7〜20%縮小した.術後24ヵ月時点で残存半月板中節部幅が5mm未満に縮小をきたす症例は術後3ヵ月時点で中節部幅が小さく,術前MRIにて半月板内部に変性を認める症例が多かった.(著者抄録)

  • THE LACK OF EXERCISE HABIT WAS A RISK FACTOR FOR CLINICAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS -TOMORROW STUDY- Reviewed

    Anno Shohei, Inui Kentaro, Sugioka Yuko, Mamoto Kenji, Okano Tadashi, Tada Masahiro, Koike Tatsuya, Nakamura Hiroaki

    ANNALS OF THE RHEUMATIC DISEASES   78   333 - 333   2019.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2019-eular.3427

  • RISK FACTORS FOR DEVELOPING SARCOPENIA IN PATIENTS WITH RHEUMATOID ARTHRITIS AT 2 YEARS: FROM THE CHIKARA STUDY Reviewed

    Yamada Yutaro, Tada Masahiro, Mandai Koji, Hidaka Noriaki, Inui Kentaro, Nakamura Hiroaki

    ANNALS OF THE RHEUMATIC DISEASES   78   352 - 353   2019.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2019-eular.1399

  • THE INCIDENCE AND RISK FACTOR OF NEW CAROTID PLAQUES AND THE PROGRESSION RATE OF CAROTID PLAQUES IN PATIENTS WITH RHEUMATOID ARTHRITIS IN 6 YEARS PROSPECTIVE CASE CONTROL STUDY. - TOMORROW STUDY- Reviewed

    Anno Shohei, Inui Kentaro, Okano Tadashi, Mamoto Kenji, Sugioka Yuko, Tada Masahiro, Koike Tatsuya, Nakamura Hiroaki

    ANNALS OF THE RHEUMATIC DISEASES   78   119 - 120   2019.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2019-eular.2925

  • Clinical Impact of Cervical Imbalance on Surgical Outcomes of Laminoplasty: A Propensity Score-Matching Analysis. Reviewed

    Tamai K, Suzuki A, Yabu A, Terai H, Hoshino M, Toyoda H, Takahashi S, Ohyama S, Hori Y, Nakamura H

    Clinical spine surgery   33 ( 1 )   E1 - E7   2019.05( ISSN:2380-0186

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    DOI: 10.1097/BSD.0000000000000849

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  • Low paravertebral muscle mass in patients with bone metastases from lung cancer is associated with poor prognosis. Reviewed

    Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Masatoshi Hoshino, Hiroaki Nakamura

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer   28 ( 1 )   389 - 394   2019.05( ISSN:0941-4355

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: Low skeletal muscle mass has been associated with poor prognosis in patients with advanced lung cancer. However, little is known about the relationship between skeletal muscle mass and overall survival in patients with bone metastases from lung cancer. The objective of the present study was to evaluate the prognostic value of low trunk muscle mass in predicting overall survival in these patients. METHODS: The data from 198 patients who were diagnosed with bone metastases from lung cancer from April 2009 to May 2017 were retrospectively reviewed. The areas of the psoas and paravertebral muscles were measured at the level of the third lumbar vertebra on computed tomography scans taken at the time nearest to the diagnosis of bone metastasis. Muscle area was evaluated for male and female cohorts separately using different cutoff points. Cox proportional hazards analysis was performed to evaluate the factors independently associated with overall survival. RESULTS: The overall survival of patients in the lowest quartile for psoas muscle area or paravertebral muscle area was significantly shorter than that of patients above the 25th percentile for muscle area (p < 0.001). Multivariate analyses showed that paravertebral muscle mass (hazard ratio, 1.73; 95% confidence interval, 1.17-2.56; p = 0.006), epidermal growth factor receptor-targeted therapy, and performance status were independent prognostic factors. CONCLUSIONS: Low paravertebral muscle mass was associated with shorter survival, independently of known prognostic factors.

    DOI: 10.1007/s00520-019-04843-9

    PubMed

  • Efficacy of continuous local cryotherapy following total hip arthroplasty. Reviewed

    Kentaro Iwakiri, Akio Kobayashi, Yuichi Takeuchi, Yusuke Kimura, Yoichi Ohta, Hiroaki Nakamura

    SICOT-J   5   13 - 13   2019.05( ISSN:2426-8887

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    BACKGROUND: Cryotherapy is rarely reported on the usefulness of cryotherapy applied after total hip arthroplasty (THA), and there are no reports about patient satisfaction against the cryotherapy following THA. The aim of this study was whether cryotherapy can be useful for relieving pain, reducing blood loss, and swelling, and improving patient satisfaction after THA. METHODS: Thirty patients who had undergone THA were treated by a controlled cooling device for 72 h following THA (defined as the cryotherapy group). The other 30 patients without cryotherapy were not treated with cryotherapy (defined as the control group). Blood samples (creatine kinase, and C-reactive protein), estimated blood loss, visual analog scale (VAS) of pain score, total doses of diclofenac sodium suppository used for pain relief, thigh swelling, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and adverse outcomes were compared between two groups. RESULTS: Thigh circumference, measured on only day 4 postoperatively, was significantly lower in the cryotherapy than in the control group. Furthermore, patient satisfaction on postoperative days 4 and 7 was significantly higher in the cryotherapy than in the control group. There were no significant differences in other outcomes between groups. CONCLUSIONS: These results support the potential benefit of cryotherapy for the reduction of swelling, and patient satisfaction during postoperative recovery of patients undergoing THA, even in the presence of periarticular injection and tranexamic acid administration for the prevention of postoperative pain and bleeding. Postoperative cryotherapy is a potentially simple, noninvasive, and relatively inexpensive option for post-THA management.

    DOI: 10.1051/sicotj/2019010

    PubMed

  • Effect of periarticular morphine injection for total hip arthroplasty: a randomised, double-blind trial. Reviewed

    Kentaro Iwakiri, Yoichi Ohta, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura

    Hip international : the journal of clinical and experimental research on hip pathology and therapy   29 ( 3 )   245 - 252   2019.05( ISSN:1120-7000

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    BACKGROUND: The periarticular multimodal cocktail injection is currently commonly used to treat postoperative pain after total hip arthroplasty (THA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent THA. MATERIALS AND METHODS: This was a prospective, single-centre, randomised controlled trial involving 100 patients scheduled for unilateral THA. A mixture of steroids, local anaesthetics, NSAIDs, and epinephrine with or without morphine (0.1 mg/kg), was injected into randomly assigned patients. Postoperative assessment was performed with all attending personnel and patients blind to group assignment. Visual analogue scale (VAS) of pain, range of motion (ROM), nausea numerical rating scale (NRS), the total dose of antiemetic drugs used and thigh swelling were compared between groups on postoperative days. RESULTS: Pain VAS scores both at rest and on motion did not differ between the 2 groups at any postoperative time-point. The nausea NRS scores during the postoperative period from 0 minutes to 1 hour and the total dose of antiemetic drugs administered were significantly higher in the morphine group. The thigh girth showed no difference between groups on any of the postoperative days. CONCLUSIONS: The results of this study suggested that addition of morphine to the multimodal cocktail injection after THA is not effective for relieving postoperative pain, alleviating swelling, or improving ROM, and results in nausea and vomiting. Randomised controlled trial registration number UMIN000022668.

    DOI: 10.1177/1120700018780067

    PubMed

  • ISSLS PRIZE IN CLINICAL SCIENCE 2019: clinical importance of trunk muscle mass for low back pain, spinal balance, and quality of lifea multicenter cross-sectional study Reviewed

    Hori Yusuke, Hoshino Masatoshi, Inage Kazuhide, Miyagi Masayuki, Takahashi Shinji, Ohyama Shoichiro, Suzuki Akinobu, Tsujio Tadao, Terai Hidetomi, Dohzono Sho, Sasaoka Ryuichi, Toyoda Hiromitsu, Kato Minori, Matsumura Akira, Namikawa Takashi, Seki Masahiko, Yamada Kentaro, Habibi Hasibullah, Salimi Hamidullah, Yamashita Masaomi, Yamauchi Tomonori, Furuya Takeo, Orita Sumihisa, Maki Satoshi, Shiga Yasuhiro, Inoue Masahiro, Inoue Gen, Fujimaki Hisako, Murata Kosuke, Kawakubo Ayumu, Kabata Daijiro, Shintani Ayumi, Ohtori Seiji, Takaso Masashi, Nakamura Hiroaki

    EUROPEAN SPINE JOURNAL   28 ( 5 )   914 - 921   2019.05( ISSN:0940-6719

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    DOI: 10.1007/s00586-019-05904-7

    PubMed

  • Comparison of a vitamin E-infused highly crosslinked polyethylene insert and a conventional polyethylene insert for primary total knee arthroplasty at two years postoperatively Reviewed

    Takemura S., Minoda Y., Sugama R., Ohta Y., Nakamura S., Ueyama H., Nakamura H.

    BONE & JOINT JOURNAL   101B ( 5 )   559 - 564   2019.05( ISSN:2049-4394

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    DOI: 10.1302/0301-620X.101B5.BJJ-2018-1355

  • Two-dimensional measurement misidentifies alignment outliers in total knee arthroplasty: a comparison of two- and three-dimensional measurements. Reviewed

    Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Kazumasa Yamamura, Suguru Nakamura, Susumu Takemura, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   27 ( 5 )   1497 - 1503   2019.05( ISSN:0942-2056

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    PURPOSE: Two-dimensional (2D) and three-dimensional (3D) measurements of prosthetic alignment and "outliers" after total knee arthroplasty (TKA) might not necessarily be comparable. The aim of this study was to compare the use of 2D and 3D measurements in the identification of prosthetic alignment and outliers after TKA. METHODS: This cross-sectional study included 159 consecutive TKAs. All patients underwent plain radiography, fluoroscopy-guided radiography, and computed tomography after TKA. The same baseline was used for 2D and 3D measurements. The reliability of prosthetic alignment and outlier identification (> 3° from neutral alignment) was compared between the 2D and 3D measurements. RESULTS: The mean prosthetic alignment and rate of outliers were not significantly different the between 2D and 3D measurements. The inter- and intra-observer reliabilities were higher for the 3D measurements than for the 2D measurements. The agreement between 2D and 3D measurements in outlier identification was poor, except for femoral coronal alignment. Cohen's κ coefficients were 0.19 in femoral sagittal (poor), 0.02 in tibial coronal (poor), and 0.10 in tibial sagittal (poor) on plain radiography. The values were 0.23 in tibial coronal (poor) and 0.002 in tibial sagittal (poor) on fluoroscopy-guided radiography. CONCLUSIONS: The agreement between 2D and 3D measurements in the identification of outliers was poor, even on fluoroscopy-guided radiography. Since 2D measurements have an inherent risk of misidentifying alignment outliers, this finding is clinically relevant. To properly analyze the correlation between outliers and clinical results, such as longevity, patient satisfaction, and patient-reported outcome, 3D measurements for prosthetic alignment are desirable. LEVEL OF EVIDENCE: III.

    DOI: 10.1007/s00167-018-5175-0

    PubMed

  • The Impact of Cervical Spinal Muscle Degeneration on Cervical Sagittal Balance and Spinal Degenerative Disorders. Reviewed

    Koji Tamai, Phillip Grisdela Jr, Joshua Romanu, Permsak Paholpak, Hiroaki Nakamura, Jeffrey C Wang, Zorica Buser

    Clinical spine surgery   32 ( 4 )   E206 - E213   2019.05( ISSN:2380-0186

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    STUDY DESIGN: This is a retrospective analysis of kinematic magnetic resonance images (kMRI). OBJECTIVE: To assess the association of cervical paraspinal muscle with cervical sagittal balance and degenerative spinal disorders. SUMMARY OF BACKGROUND DATA: Although the effects of spinal disorders and cervical imbalance on patient's symptoms have been well described, the relationship of the cervical muscle quality and volume to cervical imbalance or spinal disorders is not well established. MATERIALS AND METHODS: In total, 100 kMRI taken in a neutral weight-bearing position were analyzed. The adjusted cross-sectional area ratio (aCSA ratio: the value of muscle CSA divided by the vertebral CSA) and fat infiltration ratio of the transversospinalis muscles at C4 and C7 vertebral levels were measured using axial slice of kMRI. The correlation with cervical balance parameters [Oc-C2 angle, C2-C7 angle, C7-T1 angle, C7 slope, T1 slope, cranial tilt, cervical tilt, thoracic inlet angle (TIA), and neck tilt] and cervical degenerative disorders (disk degeneration, Modic change, and spondylolisthesis) were evaluated. RESULTS: The aCSA ratio at C4 correlated with C2-C7 angle (r=0.267), C7 slope (r=0.207), T1 slope (r=0.221), disk degeneration at C3-4, C4-5, C5-6 (r=-0.234, -0.313, -0.262) and spondylolisthesis at C3 (anterior: r=-0.206, posterior: r=-0.249). The aCSA ratio at C7 correlated with disk degeneration at C3-4, C4-5, C5-6, C6-7 (r=-0.209, -0.294, -0.239, -0.209). The fat infiltration ratio at C4 correlated with TIA (r=0.306) and neck tilt (r=0.353), likewise the ratio at C7 correlated with TIA (r=0.270) and neck tilt (r=0.405). All correlations above were statistically significant with P<0.05. CONCLUSIONS: The paraspinal muscle volume showed significant relationship with the cervical balance parameters and disk degeneration. While, paraspinal muscle quality related to the thoracic inlet parameters. Our findings can be an important step to develop the knowledge of the association between cervical muscle and cervical degenerative disorders, as well as the sagittal balance of the cervical spine. LEVEL OF EVIDENCE: Level III.

    DOI: 10.1097/BSD.0000000000000789

    PubMed

  • 整形外科診療における最先端技術 Ⅰ.診断,評価 1.新しい画像・機能診断 多機能OCTを用いた早期変形性関節症軟骨の粘弾性力学特性マイクロ断層診断

    池淵 充彦, 中村 卓, 箕田 行秀, 中村 博亮, 古川 大介, 佐伯 壮一

    別冊整形外科   1 ( 75 )   27 - 31   2019.04( ISSN:02871645

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  • 整形外科診療における最先端技術 Ⅰ.診断,評価 5.動的評価 2D-3Dマッチングを用いた肩甲骨三次元動態解析

    池淵 充彦, 箕田 行秀, 中村 博亮, 中土 保, 中島 重義

    別冊整形外科   1 ( 75 )   108 - 111   2019.04( ISSN:02871645

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  • Comparison of median nerve stiffness with and without rheumatoid arthritis by ultrasound real-time tissue elastography: A propensity score matching study. Reviewed

    Shohei Anno, Tadashi Okano, Kenji Mamoto, Yuko Sugioka, Setsuko Takeda, Ayumi Hashimoto, Emi Yamashita, Rika Morinaka, Hatsue Ueda, Kentaro Inui, Tatsuya Koike, Hiroaki Nakamura

    Modern rheumatology   30 ( 3 )   1 - 8   2019.04( ISSN:1439-7595

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    Objectives: This study aimed to compare median nerve stiffness measured by ultrasound real-time tissue elastography in patients with and without rheumatoid arthritis (RA and non-RA groups, respectively).Methods: Altogether, 402 hands of 201 RA group and 222 hands of 111 non-RA group were included in the study. Ultrasonography was performed to evaluate the circumference, cross-sectional area (CSA) and strain ratio as an elasticity of the median nerve at the inlet level of the carpal tunnel and the proximal portion of the carpal tunnel inlet. Using propensity score matching, the difference between RA and non-RA group were analyzed.Results: After propensity score matching, 135 hands in 104 RA group and 70 non-RA group were finally analyzed. There were no significant differences in the circumference and CSA of the median nerve between the two groups. The strain ratio of the median nerve was significantly higher in RA group than in non-RA group only at the inlet of the carpal tunnel level.Conclusions: The nerve stiffness in patients with RA measured by ultrasound real-time tissue elastography was higher than without RA. Inflammatory condition of the flexor tendon and wrist joint in patients with RA may generate fibrotic changes in the median nerve.Trial registration: University Hospital Medical Information Network Clinical Trials Registry: UMIN000015314.

    DOI: 10.1080/14397595.2019.1602914

    PubMed

  • Impact of Hemodialysis on Surgical Outcomes and Mortality Rate after Lumbar Spine Surgery: A Matched Cohort Study(和訳中) Reviewed

    Hori Yusuke, Takahashi Shinji, Terai Hidetomi, Hoshino Masatoshi, Toyoda Hiromitsu, Suzuki Akinobu, Hayashi Kazunori, Tamai Koji, Ohyama Shoichiro, Nakamura Hiroaki

    (一社)日本脊椎脊髄病学会 Spine Surgery and Related Research   3 ( 2 )   151 - 156   2019.04

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    腰椎手術後の臨床転帰と合併症率を血液透析(HD)の有無で比較した。2010年1月〜2015年12月に当施設で腰椎手術を施行されたHD患者と非HD患者を比較する後ろ向き対応コホート研究を実施した。臨床転帰は日本整形外科学会(JOA)スコアで、腰痛、下肢痛、下肢のしびれは視覚アナログスケール(VAS)で評価した。HD群29例(男性58.6%、平均69.7±6.8歳)と非HD群57例(男性57.9%、平均70.1±6.7歳)を比較した。HD群のJOAスコアは8.0改善し、非HD群の10.9よりも改善度が有意に低かった。腰痛、下肢痛、下肢のしびれに対するVASスコアの改善はHD群と非HD群で差はなかった。経過観察期間中、HD群では5例が死亡したのに対し、非HD群では死亡が認められず、死亡率はHD群が有意に高かった。再手術率はHD群が17.2%で非HD群の3.5%よりも有意に高かった。

  • Incidence and Risk Factors for Meniscal Cyst After Meniscal Repair Reviewed

    Nishino Kazuya, Hashimoto Yusuke, Nishida Yohei, Terai Shozaburo, Takahashi Shinji, Yamasaki Shinya, Nakamura Hiroaki

    ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY   35 ( 4 )   1222 - 1229   2019.04( ISSN:0749-8063

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    DOI: 10.1016/j.arthro.2018.11.039

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  • Prognostic value of paravertebral muscle density in patients with spinal metastases from gastrointestinal cancer. Reviewed

    Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Masatoshi Hoshino, Hiroaki Nakamura

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer   27 ( 4 )   1207 - 1213   2019.04( ISSN:0941-4355

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    PURPOSE: Morphometric analyses have shown that trunk muscle mass and density are associated with mortality in cancer patients. Because of the low incidence of spinal metastasis from gastrointestinal cancer and the limited life expectancy of these patients, few studies have been reported in this population. We evaluated the prognostic value of trunk muscle area and density in predicting overall survival. METHODS: The data from 78 patients with spinal metastases from gastrointestinal cancer, collected from February 2009 to July 2016, were evaluated. Psoas muscle and paravertebral muscle area and density were measured at the L3 level on CT scans taken at the time nearest to the diagnosis of spinal metastasis. Cox proportional hazards analysis was performed to evaluate the factors independently associated with overall survival. RESULTS: The mean patient age was 68.3 years (range, 42-88 years). The overall median survival time was 4.8 months: 2.2 months in the extremely rapid growth group (stomach, biliary tract, and pancreas) and 7.6 months in the rapid growth group (esophagus, liver, and colorectum). Multivariate analyses showed that lower paravertebral muscle density (HR 2.23 [95% CI 1.24-3.99], p = 0.007), extremely rapid growth group, presence of abnormal laboratory data, poor performance status, and chemotherapy after spinal metastasis were independent prognostic factors. CONCLUSIONS: Median overall survival was poor among patients with spinal metastases from gastrointestinal carcinoma, especially among those with gastric, biliary tract, or pancreatic cancer. Lower paravertebral muscle density was an independent poor prognostic factor in patients with spinal metastases from gastrointestinal cancer.

    DOI: 10.1007/s00520-018-4465-x

    PubMed

  • 膝前十字靱帯損傷患者における血清中の軟骨代謝マーカーの有用性 T2マッピングとの関連に注目して Reviewed

    西田 洋平, 橋本 祐介, 小宮 枝里子, 西野 壱哉, 中村 博亮

    (一社)日本関節鏡・膝・スポーツ整形外科学会 JOSKAS   44 ( 2 )   338 - 339   2019.04( ISSN:1884-8842

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    過去3年6ヵ月の前十字靱帯(ACL)再建術症例36例(男子11例、女性25例、手術時平均年齢21.8±8.8歳)を対象に、血清中の軟骨代謝マーカーであるCartilage oligomeric matrix protein(COMP)値と早期変形性膝関節症(早期OA)、MRI-T2マッピングとの関連を検討した。対象は術前単純X線でOAを認めない症例とした。検討内容は、術前の運動レベル、受傷から手術までの期間、半月板損傷の有無、KT-2000による不安定性の健患差、血清MMP-3値、MRIマッピングによるT2値との関連の有無であった。その結果、受傷から手術までの期間は平均8.6±19ヵ月(中央値3.6ヵ月)、血清COMP値は平均150.1±59.9ng/mlであった。血清COMP値はKT健患差、血清MMP-3値、大腿骨内顆及び脛骨内顆のT2で正に相関していた。

  • 膝前十字靱帯大腿骨付着部の組織学的評価 Reviewed

    橋本 祐介, 西田 洋平, 中村 博亮

    (一社)日本関節鏡・膝・スポーツ整形外科学会 JOSKAS   44 ( 2 )   408 - 409   2019.04( ISSN:1884-8842

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    受傷から6ヵ月以内の前十字靱帯再建術7例を対象に、術中に関節鏡視下で靱帯実質部付着部位とfan-like extension付着部位の組織採取を行い、部位別の組織評価を行った。遺残靱帯と軟骨縁の間のfan-like extension部位のAM束側をAP、PL束側をPPとし、mid-substance付着部位M束側をAC、PL束側をPCとした。線維軟骨が存在し、tidemarkが明瞭であるものをD type A、線維軟骨は存在するが、tidemarkが不明瞭であるものをD type B、腱が直接固着するものをIDとした。その結果、組織学的評価はACでD type Aが5例(71%)、D type Bが2例(29%)で、APでD type Bが2例(29%)、IDが5例(71%)であった。また、PCでD type Bが4例(57%)、IDが3例(43%)で、PPでIDが(100%)であった。前十字靱帯AM実質部付着部の組織はD type Aが多く、PL実質部付着部は必ずしもD type Aではなかった。fn-like extension部位はほぼIDであった。

  • Risk Factors for Proximal Junctional Fracture Following Fusion Surgery for Osteoporotic Vertebral Collapse with Delayed Neurological Deficits: A Retrospective Cohort Study of 403 Patients(和訳中) Reviewed

    Tamai Koji, Terai Hidetomi, Suzuki Akinobu, Nakamura Hiroaki, Watanabe Kei, Katsumi Keiichi, Ohashi Masayuki, Shibuya Yohei, Izumi Tomohiro, Hirano Toru, Kaito Takashi, Yamashita Tomoya, Fujiwara Hiroyasu, Nagamoto Yukitaka, Matsuoka Yuji, Suzuki Hidekazu, Nishimura Hirosuke, Tagami Atsushi, Yamada Syuta, Adachi Shinji, Yoshii Toshitaka, Ushio Shuta, Harimaya Katsumi, Kawaguchi Kenichi, Yokoyama Nobuhiko, Oishi Hidekazu, Doi Toshiro, Kimura Atsushi, Inoue Hirokazu, Inoue Gen, Miyagi Masayuki, Saito Wataru, Nakano Atsushi, Sakai Daisuke, Nukaga Tadashi, Ikegami Shota, Shimizu Masayuki, Futatsugi Toshimasa, Ohtori Seiji, Furuya Takeo, Orita Sumihisa, Imagama Shiro, Ando Kei, Kobayashi Kazuyoshi, Kiyasu Katsuhito, Murakami Hideki, Yoshioka Katsuhito, Seki Shoji, Hongo Michio, Kakutani Kenichiro, Yurube Takashi, Aoki Yasuchika, Oshima Masashi, Takahata Masahiko, Iwata Akira, Endo Hirooki, Abe Tetsuya, Tsukanishi Toshinori, Nakanishi Kazuyoshi, Watanabe Kota, Hikata Tomohiro, Suzuki Satoshi, Isogai Norihiro, Okada Eijiro, Funao Haruki, Ueda Seiji, Shiono Yuta, Nojiri Kenya, Hosogane Naobumi, Ishii Ken

    (一社)日本脊椎脊髄病学会 Spine Surgery and Related Research   3 ( 2 )   171 - 177   2019.04

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    骨粗鬆症性椎体圧潰(OVC)に対する外科的治療後のproximal junctional fracture(PJFr)の発生率と独立危険因子を同定した。Japan Association of Spine Surgeons with Ambitionに所属する機関の2016年の登録データを後ろ向きに解析した。T10以下のOVCによる神経障害に対して矯正手術を実施し、2年以上経過観察を行った403例(女性331例、男性72例、平均73.8±7.8歳)を解析した。63例にPJFrを認めた。多重ロジスティック回帰分析の結果、骨粗鬆症のグレードとlower instrumented vertebraレベルがPJFrの独立危険因子であった。受信者動作特性曲線解析では、腰椎骨密度が良好な予測能の有意な因子であったが、股関節骨密度は有意な因子ではなかった。初回手術後のPJFrの予測に対する最適カットオフ値は腰椎骨密度0.61g/cm2であった。

  • Prevention of Nerve Root Thermal Injury Caused by Bipolar Cauterization Near the Nerve Roots Reviewed

    Ohyama Shoichiro, Takahashi Shinji, Tamai Koji, Hori Yusuke, Hirakawa Yoshihiro, Hoshino Masatoshi, Suzuki Akinobu, Nakamura Hiroaki

    SPINE   44 ( 6 )   E321 - E328   2019.03( ISSN:0362-2436

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    DOI: 10.1097/BRS.0000000000002846

    PubMed

  • Nerve capping technique with nerve conduit for treating painful digital neuroma: A case report. Reviewed

    Takuya Uemura, Ema Onode, Takuya Yokoi, Kosuke Shintani, Mitsuhiro Okada, Kiyohito Takamatsu, Sadahiko Konishi, Hiroaki Nakamura

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   27 ( 1 )   284 - 287   2019.03( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    DOI: 10.1016/j.jos.2019.02.012

    PubMed

  • Answer to the Letter to the Editor concerning "The association of back muscle strength and sarcopenia-related parameters in the patients with spinal disorders" by Toyoda H, et al. (Eur Spine J; doi.org/10.1007/s00586-018-5858-8). Reviewed

    Toyoda H, Hoshino M, Ohyama S, Terai H, Suzuki A, Yamada K, Takahashi S, Hayashi K, Tamai K, Hori Y, Nakamura H

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   28 ( 5 )   1252 - 1253   2019.03( ISSN:0940-6719

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    DOI: 10.1007/s00586-019-05942-1

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  • Cost-Effectiveness of Balloon Kyphoplasty for Patients with Acute/ Subacute Osteoporotic Vertebral Fractures in the Super-Aging Japanese Society. Reviewed

    Takahashi S, Hoshino M, Yasuda H, Terai H, Hayashi K, Tsujio T, Kono H, Suzuki A, Tamai K, Ohyama S, Toyoda H, Dohzono S, Kanematsu F, Hori Y, Nakamura H

    Spine   44 ( 5 )   E298 - E305   2019.03( ISSN:0362-2436 ( eISSN:1528-1159

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    © 2019 Lippincott Williams and Wilkins. All rights reserved. Study Design.A propensity score matching study.Objective.The aim of this study was to assess the cost-effectiveness of balloon kyphoplasty (BKP) in Japan.Summary of Background Data.Osteoporotic vertebral fracture (OVF) is a common disease in elderly people. In Japan, the incidence of painful OVF in 2008 was estimated as 880,000, and approximately 40% of patients with painful OVF are hospitalized due to the severity of pain. Japan is the front runner among super-Aged societies and rising health care costs are an economic problem.Methods.BKP and nonsurgical management (NSM) for acute/subacute OVF were performed in 116 and 420 cases, respectively. Quality-Adjusted life years (QALY) and incremental costs were calculated on the basis of a propensity score matching study. QALY was evaluated using the SF-6D questionnaire. Finally, using a Markov model, incremental cost-effectiveness ratios (ICERs) were calculated for 71 matched cases.Results.In the comparison between BKP and NSM, mean patients age was 78.3 and 77.7 years, respectively (P=0.456). The BKP procedure cost 402,988 JPY more than NSM and the gains in QALY at the 6-month follow-up were 0.153 and 0.120, respectively (difference=0.033). ICERs for 3 and 20 years were 4,404,158 JPY and 2,416,406 JPY, respectively. According to sensitivity analysis, ICERs ranged from 652,181 JPY to 4,896,645 JPY (4418-33,168 GBP).Conclusion.This study demonstrated that BKP is a cost-effective treatment option for OVF in Japan. However, the effect might be blunted in patients aged > 80 years. Further research is necessary to elucidate the cost-effectiveness of BKP in this population.Level of Evidence: 4.

    DOI: 10.1097/BRS.0000000000002829

    PubMed

  • Does sagittal imbalance impact the surgical outcomes of short-segment fusion for lumbar spinal stenosis associated with degenerative lumbar scoliosis? Reviewed

    Hori Yusuke, Matsumura Akira, Namikawa Takashi, Kato Minori, Takahashi Shinji, Ohyama Shoichiro, Ozaki Tomonori, Yabu Akito, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   24 ( 2 )   224 - 229   2019.03( ISSN:0949-2658

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    DOI: 10.1016/j.jos.2018.10.005

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  • Does sagittal imbalance impact the surgical outcomes of short-segment fusion for lumbar spinal stenosis associated with degenerative lumbar scoliosis?(和訳中) Reviewed

    Hori Yusuke, Matsumura Akira, Namikawa Takashi, Kato Minori, Takahashi Shinji, Ohyama Shoichiro, Ozaki Tomonori, Yabu Akito, Nakamura Hiroaki

    (公社)日本整形外科学会 Journal of Orthopaedic Science   24 ( 2 )   224 - 229   2019.03( ISSN:0949-2658

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    Short segment fusion(SSF、3レベル未満)を受け、少なくとも2年間の追跡調査が可能であった腰椎変性側彎症(DLS)患者70例を対象に、後向きに考察した。術前(PreO)および最終追跡調査(FFU)時に、立位全脊柱X線検査によりPI-LL、PT、SVA、T1骨盤角(TPA)を測定した。腰痛(LBP)に関する日本整形外科学会スコア(JOAs)の改善に基づき手術転帰を評価し、視覚的アナログ尺度によりLBPレベルを評価した(LBP-VAS)。X線画像パラメータと手術転帰の間の関連を分析した。JOAsに基づき患者を3群(不良/普通/良好)に分けた。Jonckheere-Terpstra傾向検定による分析から、各群において以下のX線画像パラメータが手術転帰との有意な傾向が認められた。最終追跡調査時のLBP-VASについて、3群間に有意な相関が認められた。PreOとFFUいずれにおいても、JOAsの改善とPI-LL、SVA、TPAの間に有意な相関が認められた。

  • 恥骨坐骨関節結合部骨髄炎の1例 Reviewed

    家口 尚, 渡辺 亨永, 伴 祥高, 鳥飼 大剛, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 2 )   343 - 344   2019.03( ISSN:0008-9443

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    13歳女。5ヵ月前に発熱と左股関節痛が出現し、近医を受診した。化膿性股関節炎を疑われ、MRIを施行されたが異常は認められず、症状は一旦軽快したが、疼痛のため体育等を欠席しがちであった。今回、疼痛が増悪したため前医受診し、X線で恥骨の骨融解像、CTとMRIで骨髄内外の病変を認められ、恥骨腫瘍の診断で当科に紹介された。造影MRIで骨髄内から皮下に液体貯留を認め、膿瘍の被膜が造影された。骨髄炎による膿瘍形成と診断し、大陰唇付近の腫脹部を穿刺したところ白色膿汁が約15ml吸引された。慢性骨髄炎の亜急性転化と考え、レボフロキサシンを5日間投与した後、手術を行った。そのさい膿汁の排出を再び認めたため、恥骨の上枝下枝の開窓と骨髄内組織の徹底掻爬・洗浄を行った。術後にCEZを2日間投与し、症状・検査所見とも改善した。

  • 診断・治療に難渋した大腿骨骨腫瘍の1例 Reviewed

    高田 尚輝, 大戎 直人, 嶋谷 彰芳, 岩井 正, 星 学, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 2 )   249 - 250   2019.03( ISSN:0008-9443

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    36歳男性。近医にて左大腿骨腫瘍を指摘された。初診時、単純X線、MRIで左大腿骨骨幹部に溶骨性病変を認め、皮質骨の菲薄化を伴い切迫骨折の状態であった。患者の治療拒否により患肢免荷で経過観察としたが、初診時より約6ヵ月後に交通事故により病的骨折をきたした。術中迅速病理診断では判定不能であったため、二期的手術を行った。病理所見より、動脈瘤様骨嚢腫の最終診断が得られた。最終手術で拡大病巣掻爬術および人工骨・腸骨移植術、骨接合術を行った。術後10ヵ月現在、骨癒合傾向を認めた。

  • 骨肉腫の多発肺転移から続発性気胸を繰り返した1例 Reviewed

    宮島 佑介, 大戎 直人, 嶋谷 彰芳, 星 学, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 2 )   253 - 254   2019.03( ISSN:0008-9443

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    21歳女性。急激な呼吸困難を主訴とした。骨肉腫(UICC TNM分類stage IIb)に対する処理骨による患肢温存術、術後化学療法を行った。術後7ヵ月に右肺転移し肺部分切除、その後、骨肉腫が再発し腫瘍広範切除と腫瘍用人工関節置換を行い、初回手術より18ヵ月に化学療法DG療法を開始した。5コース終了後に仰臥位での呼吸苦が出現し、肺野単純X線、CTで気腫様変化した転移腫瘍の破裂による右気胸を認めた。胸腔ドレナージは効果がなく、化学療法のたびに気胸を繰り返し、気胸発症は計3回、肺部分切除を2回行った。

  • Association between MRI findings and back pain after osteoporotic vertebral fractures: a multicenter prospective cohort study. Reviewed

    Ahmadi SA, Takahashi S, Hoshino M, Takayama K, Sasaoka R, Tsujio T, Yasuda H, Kanematsu F, Kono H, Toyoda H, Nakamura H

    The spine journal : official journal of the North American Spine Society   19 ( 7 )   1186 - 1193   2019.02( ISSN:1529-9430

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    DOI: 10.1016/j.spinee.2019.02.007

    PubMed

  • Nerve capping with a nerve conduit for the treatment of painful neuroma in the rat sciatic nerve. Reviewed

    Ema Onode, Takuya Uemura, Kiyohito Takamatsu, Kosuke Shintani, Takuya Yokoi, Mitsuhiro Okada, Hiroaki Nakamura

    Journal of neurosurgery   132 ( 3 )   1 - 9   2019.02( ISSN:0022-3085

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    OBJECTIVE: Treatment of painful neuroma remains difficult, despite the availability of numerous surgical procedures. Recently, nerve capping treatment for painful neuroma using artificial nerve conduits has been introduced in clinical and basic research. However, the appropriate length of the nerve conduit and the pain relief mechanism have not been determined. In this study the authors aimed to investigate nerve capping treatment with a bioabsorbable nerve conduit using the rat sciatic nerve amputation model. Using histological analysis, the authors focused on the nerve conduit length and pain relief mechanism. METHODS: Sixteen Sprague Dawley rats were evaluated for neuropathic pain using an autotomy (self-amputation) score and gross and histological changes of the nerve stump 2, 4, 8, and 12 weeks after sciatic nerve neurectomy without capping. Forty-five rats were divided into 3 experimental groups, no capping (control; n = 15), capping with a 3-mm nerve conduit (n = 15), and capping with a 6-mm nerve conduit (n = 15). All rats were evaluated using an autotomy score and nerve stump histology 12 weeks after neurectomy. The nerve conduit was approximately 0.5 mm larger than the 1.5-mm diameter of the rat sciatic nerves to prevent nerve constriction. RESULTS: The autotomy scores gradually exacerbated with time. Without capping, a typical bulbous neuroma was formed due to random axonal regeneration 2 weeks after neurectomy. Subsequently, the adhesion surrounding the neuroma expanded over time for 12 weeks, and at the 12-week time point, the highest average autotomy scores were observed in the no-capping (control) group, followed by the 3- and the 6-mm nerve conduit groups. Histologically, the distal axonal fibers became thinner and terminated within the 6-mm nerve conduit, whereas they were elongated and protruded across the 3-mm nerve conduit. Minimal perineural scar formation was present around the terminated axonal fibers in the 6-mm nerve conduit group. Expressions of anti-α smooth muscle actin and anti-sigma-1 receptor antibodies in the nerve stump significantly decreased in the 6-mm nerve conduit group. CONCLUSIONS: In the rat sciatic nerve amputation model, nerve capping treatment with a bioabsorbable nerve conduit provided relief from neuroma-induced neuropathic pain and prevented perineural scar formation and neuroinflammation around the nerve stump. The appropriate nerve conduit length was determined to be more than 4 times the diameter of the original nerve.

    DOI: 10.3171/2018.10.JNS182113

    PubMed

  • Preoperative severity of facet joint degeneration does not impact the 2-year clinical outcomes and cervical imbalance following laminoplasty Reviewed

    Tamai Koji, Suzuki Akinobu, Yabu Akito, Takahashi Shinji, Toyoda Hiromitsu, Hoshino Masatoshi, Terai Hidetomi, Nakamura Hiroaki

    SPINE JOURNAL   19 ( 2 )   246 - 252   2019.02( ISSN:1529-9430

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    DOI: 10.1016/j.spinee.2018.06.343

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  • Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study. Reviewed

    Tsuyoshi Kato, Hiroyuki Inose, Shoichi Ichimura, Yasuaki Tokuhashi, Hiroaki Nakamura, Masatoshi Hoshino, Daisuke Togawa, Toru Hirano, Hirotaka Haro, Tetsuro Ohba, Takashi Tsuji, Kimiaki Sato, Yutaka Sasao, Masahiko Takahata, Koji Otani, Suketaka Momoshima, Ukihide Tateishi, Makoto Tomita, Ryuichi Takemasa, Masato Yuasa, Takashi Hirai, Toshitaka Yoshii, Atsushi Okawa

    Journal of clinical medicine   8 ( 2 )   2019.02( ISSN:2077-0383

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    While bracing is the standard conservative treatment for acute osteoporotic compression fracture, the efficacy of different brace treatments has not been extensively studied. We aimed to clarify and compare the preventive effect of the different brace treatments on the deformity of the vertebral body and other clinical results in this patient cohort. This multicenter nationwide prospective randomized study included female patients aged 65⁻85 years with acute one-level osteoporotic compression fractures. We assigned patients within four weeks of injury to either a rigid-brace treatment or a soft-brace treatment. The main outcome measure was the anterior vertebral body compression percentage at 48 weeks. Secondary outcome measures included scores on the European Quality of Life-5 Dimensions (EQ-5D), visual analog scale (VAS) for lower back pain, and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). A total of 141 patients were assigned to the rigid-brace group, whereas 143 patients were assigned to the soft-brace group. There were no statistically significant differences in the primary outcome and secondary outcome measures between groups. In conclusion, among patients with fresh vertebral compression fractures, the 12-week rigid-brace treatment did not result in a statistically greater prevention of spinal deformity, better quality of life, or lesser back pain than soft-brace.

    DOI: 10.3390/jcm8020198

    PubMed

  • The association of back muscle strength and sarcopenia-related parameters in the patients with spinal disorders Reviewed

    Toyoda Hiromitsu, Hoshino Masatoshi, Ohyama Shoichiro, Terai Hidetomi, Suzuki Akinobu, Yamada Kentaro, Takahashi Shinji, Hayashi Kazunori, Tamai Koji, Hori Yusuke, Nakamura Hiroaki

    EUROPEAN SPINE JOURNAL   28 ( 2 )   241 - 249   2019.02( ISSN:0940-6719

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    DOI: 10.1007/s00586-018-5858-8

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  • Balloon Kyphoplasty Versus Conservative Treatment for Acute Osteoporotic Vertebral Fractures with Poor Prognostic Factors: Propensity-Score-Matched Analysis Using Data From Two Prospective Multicenter Studies. Reviewed

    Hoshino M, Takahashi S, Yasuda H, Terai H, Watanabe K, Hayashi K, Tsujio T, Kono H, Suzuki A, Tamai K, Ohyama S, Toyoda H, Dohzono S, Kanematsu F, Hori Y, Nakamura H

    Spine   44 ( 2 )   110 - 117   2019.01( ISSN:0362-2436 ( eISSN:1528-1159

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    © 2018 Wolters Kluwer Health, Inc. Study Design.A multicenter, prospective, single-Arm, intervention study.Objective.The aim of this study was to investigate efficacy of balloon kyphoplasty (BKP) for acute osteoporotic vertebral fractures (OVFs) in patients with poor prognostic factors.Summary of Background Data.The indications for BKP remain unclear. Characteristic magnetic resonance imaging (MRI) findings (high-intensity or diffuse low-intensity area in fractured vertebrae on T2-weighted images) were reportedly predictive of delayed union.Methods.This study enrolled 106 patients with poor prognostic MRI findings who underwent BKP within 2 months after injury, and 116 controls with acute OVFs and the same poor prognostic factors who underwent conservative treatment. Patients were propensity score matched in a logistic regression model adjusted for age, sex, number of baseline old fractures, and fracture level. The primary outcome was reduction in activities of daily living (ADLs) at 6 months after fracture, and the secondary outcomes were improvement in short-form (SF)-36 subscales, back pain visual analog scale (VAS) score, and vertebral body deformity.Results.A decrease in ADLs occurred in 5.6% of patients in the BKP group and 25.6% of patients in the conservative treatment group (P<0.001). The SF-36 vitality subscale score improved by 26.9±25.9 points in the BKP group and 14.5±29.4 points in the control group (P=0.03). The VAS pain score improved by 43.4±34.4 in the BKP group and 52.2±29.8 in the control group (P=0.44). The vertebral body wedge angle improved by 5.5±6.2° in the BKP group and-6.3±5.0° in the control group (P<0.0001). The percent vertebral body height improved by 15.2±19.2% in the BKP group and-20.6±14.2% in the control group (P<0.0001).Conclusion.ADLs, quality of life, and vertebral deformity showed greater improvement with BKP intervention for acute OVF with poor prognostic factors than with conservative treatment at 6 months after injury. Our treatment strategy uses BKP intervention according to the presence or absence of poor prognostic MRI findings.Level of Evidence: 4.

    DOI: 10.1097/BRS.0000000000002769

    PubMed

  • Anatomical analysis of the human ligamentum flavum in the thoracic spine: Clinical implications for posterior thoracic spinal surgery Reviewed

    Ahmadi Sayed Abdullah, Suzuki Akinobu, Terai Hidetomi, Tamai Koji, Akhgar Javid, Hoshino Masatoshi, Toyoda Hiromitsu, Rahmani Mohammad Suhrab, Hayashi Kazunori, Ohyama Shoichiro, Takahashi Shinji, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   24 ( 1 )   62 - 67   2019.01( ISSN:0949-2658

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    DOI: 10.1016/j.jos.2018.08.023

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  • Diffuse idiopathic skeletal hyperostosis is associated with lumbar spinal stenosis requiring surgery Reviewed

    Yamada Kentaro, Satoh Shigenobu, Hashizume Hiroshi, Yoshimura Noriko, Kagotani Ryohei, Ishimoto Yuyu, Abe Yuichiro, Toyoda Hiromitsu, Terai Hidetomi, Masuda Takeshi, Muraki Shigeyuki, Nakamura Hiroaki, Yoshida Munehito

    JOURNAL OF BONE AND MINERAL METABOLISM   37 ( 1 )   118 - 124   2019.01( ISSN:0914-8779

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    DOI: 10.1007/s00774-017-0901-0

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  • Anatomical analysis of the human ligamentum flavum in the thoracic spine: Clinical implications for posterior thoracic spinal surgery(和訳中) Reviewed

    Ahmadi Sayed Abdullah, Suzuki Akinobu, Terai Hidetomi, Tamai Koji, Akhgar Javid, Hoshino Masatoshi, Toyoda Hiromitsu, Rahmani Mohammad Suhrab, Hayashi Kazunori, Ohyama Shoichiro, Takahashi Shinji, Nakamura Hiroaki

    (公社)日本整形外科学会 Journal of Orthopaedic Science   24 ( 1 )   62 - 67   2019.01( ISSN:0949-2658

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    防腐処理死体20検体を用いて、胸椎黄色靱帯の解剖学的解明を試みた。全椎体を採取後に椎弓根を垂直面で切断、T1/T2からT12/L1の黄色靱帯を造影剤で染色し、CT像によって形状と椎体骨構造との関係を評価した。その結果、胸椎の層間腔内に左右二つの黄色靱帯が存在しており、腹側でcranial laminae、背側でcaudal laminaeを被覆していた。正中における黄色靱帯の高さは頭側から尾側に向かって徐々に増大しており、平均高はT1/T2で11.8±1.6mm、T12/L1で15.1±0.1mmを示していた。黄色靱帯の幅も頭側から尾側にかけて緩やかに増加しており、平均幅はT1/T2で13.8±1.4mm、T12/L1で17.8±1.6mmであった。なお、いずれの脊椎レベルでも幅に有意な左右差はなかった。また、黄色靱帯によるcaudal laminaの被覆率は上位脊椎から下位脊椎に向かって徐々に増加し、平均被覆率はT1で31.7%、T12で41.7%であったが、cranial laminaの被覆率は減少しており、平均被覆率はT2で12.6%、L1で4.3%であった。黄色靱帯で被覆されない空白域に関して脊椎レベルでの差はなく、平均53.9±2.5%を示していた。胸椎椎間孔において、黄色靱帯は椎間関節をT2/T3からT12/L1のレベルで被覆していたが、T1/T2レベルでの被覆はみられなかった。

  • Ultrasonographic findings in a patient with reactive arthritis induced by intravesical BCG therapy for bladder cancer. Reviewed

    Hitoshi Yoshimura, Tadashi Okano, Kentaro Inui, Hiroaki Nakamura

    Journal of medical ultrasonics (2001)   46 ( 1 )   163 - 165   2019.01( ISSN:1346-4523

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    Intravesical bacillus Calmette-Guerin (BCG) therapy is an effective and safe immunotherapy for superficial bladder cancer. However, reactive arthritis (ReA) is reported as an adverse event in about 0.5-1% of patients receiving intravesical BCG therapy. ReA is known as a kind of spondyloarthritis, the main pathological finding of which is enthesitis. Here we report a patient with ReA induced by intravesical BCG therapy for bladder cancer, in whom the diagnosis of ReA was supported by ultrasonographic findings of enthesitis and synovitis. A 69-year-old male was diagnosed with carcinoma in situ of the bladder and treated with intravesical BCG therapy. After the third intravesical BCG injection, pain and swelling appeared in both wrists. Ultrasonographic examination revealed not only intra-articular synovitis in the bilateral wrist joint, wrist flexor tenosynovitis, and wrist extensor tenosynovitis, but also enthesitis of the flexor carpi radialis tendon (FCR). The severe enthesitis of the FCR in both wrists was considered to be an important finding that supported the diagnosis in this patient. Thus, we diagnosed this case as ReA induced by intravesical BCG therapy. In clinical practice, ReA is often difficult to distinguish from seronegative rheumatoid arthritis and other rheumatic diseases. Ultrasonographic findings of enthesitis may support a definitive diagnosis for these patients.

    DOI: 10.1007/s10396-018-0889-7

    PubMed

  • Secondary osteosarcoma in patients previously treated for childhood cancer: Three case reports. Reviewed

    Akiyoshi Shimatani, Masanari Aono, Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Naoki Takada, Junichi Hara, Chika Nitani, Hiroaki Nakamura

    Molecular and clinical oncology   10 ( 1 )   153 - 158   2019.01( ISSN:2049-9450

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    The prognosis of childhood cancers has improved markedly, and the proportion of long-term survivors has increased in recent years. However, with the increase in the number of long-term survivors, the development of latent treatment-related adverse effects, such as secondary malignancies, has generated new problems. Secondary cancer is defined as a histologically distinct malignancy that develops at least 2 months after the completion of treatment for primary cancer. Genetic factors and acquired conditions associated with treatment modalities are possible causes of secondary malignancy development. Genetic factors include the presence of Li-Fraumeni syndrome (LFS) and retinoblastoma. In terms of acquired factors, radiation and chemotherapy have been reported to be the most strongly associated with secondary malignancy development. The use of alkylating agents and topoisomerase II inhibitors for the treatment of childhood cancer increases the subsequent risk of secondary tumors. We herein investigated three cases of secondary osteosarcoma several years after treatment for primary cancer. In the three patients, the familial history did not appear to fit the clinical diagnostic criteria of LFS or retinoblastoma. The patients had not received previous radiation therapy to the anatomical site of the secondary cancer. However, high dosages of alkylating agents and topoisomerase II inhibitors had been administered for the treatment of primary cancer. The exact link between chemotherapy and secondary cancer remains elusive, but the possibility of an association should be considered. Following the development of multidisciplinary therapies, long-term follow-up and monitoring of latent adverse effects may be necessary for childhood cancer survivors.

    DOI: 10.3892/mco.2018.1752

    PubMed

  • 膀胱癌への膀胱内BCG療法により誘発された反応性関節炎患者の超音波所見(Ultrasonographic findings in a patient with reactive arthritis induced by intravesical BCG therapy for bladder cancer) Reviewed

    Yoshimura Hitoshi, Okano Tadashi, Inui Kentaro, Nakamura Hiroaki

    シュプリンガー・ジャパン(株) Journal of Medical Ultrasonics   46 ( 1 )   163 - 165   2019.01( ISSN:1346-4523

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    症例は69歳男性で、膀胱上皮内癌と診断され、膀胱内BCG療法が施行された。3回目の膀胱内BCG注射後に左手関節に疼痛と腫脹を呈し、翌週には左手関節症状の悪化と右手関節の疼痛と腫脹が認められた。超音波検査により、両手関節の関節内滑膜炎、手関節屈筋腱腱鞘炎および手関節伸筋腱鞘炎と橈側手根屈筋腱(FCR)の腱付着部炎が描出され、両手関節FCRの重度腱付着部炎から、膀胱内BCG療法で誘発された反応性関節炎(ReA)と確定診断された。NSAID療法で症状が改善されなかったため、メトトレキサート、サラゾスルファピリジンおよびプレドニゾロン投与を行ったところ、1ヵ月後に手関節痛と腫脹は軽減され、超音波検査でも炎症所見の改善が認められた。ReA治療の間も膀胱内BCG療法は継続して行い、3ヵ月後に治療終了した結果、6ヵ月後には、手関節症状と超音波像の炎症所見は概ね消失したことが確認された。本例から、膀胱内BCG療法の有害事象としてReAを考慮に入れ、ReAの確定診断に超音波検査が有用であることが示された。

  • 後方除圧術を実施した腰椎変性疾患例における質調整生存年(quality-adjusted life year:QALY) Reviewed

    加藤 相勲, 並川 崇, 松村 昭, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   62 ( 1 )   17 - 18   2019.01( ISSN:0008-9443

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    腰椎変性疾患に対し3椎間までの後方除圧術を実施した300例(男性151例、女性149例、平均70.1歳)を対象とし、術前と術後3ヵ月/1年/2年でのQOL効用値、術後1年/2年での獲得QALY(質調整生存年)を調査した。なお、QOL効用値はAraらが報告したpredicting SF-6Dを使用し、QOL効用値に生存年数を乗じて獲得QALYを算出した。その結果、全例におけるQOL効用値は術前0.516、術後3ヵ月0.569、術後1年0.57、術後2年0.568で、術後2年でのQOL効用値の改善は0.05であった。また、獲得QALYは全例において術後1年で0.047、術後2年で0.1であった。

  • 広汎性特発性骨増殖症は手術を必要とする腰部脊柱管狭窄症と関連する(Diffuse idiopathic skeletal hyperostosis is associated with lumbar spinal stenosis requiring surgery) Reviewed

    Yamada Kentaro, Satoh Shigenobu, Hashizume Hiroshi, Yoshimura Noriko, Kagotani Ryohei, Ishimoto Yuyu, Abe Yuichiro, Toyoda Hiromitsu, Terai Hidetomi, Masuda Takeshi, Muraki Shigeyuki, Nakamura Hiroaki, Yoshida Munehito

    (一社)日本骨代謝学会 Journal of Bone and Mineral Metabolism   37 ( 1 )   118 - 124   2019.01( ISSN:0914-8779

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    手術を必要とする腰部脊柱管狭窄症(LSS)患者とLSSの症状のない被験者における広汎性特発性骨増殖症(DISH)の有病率を調査し、手術を必要とするLSSとDISHとの関連を明らかにした。症候性LSSに対して手術を実施した患者2363例(男性49.8%、平均68.0±8.4歳)とLSSのない対照787例(男性33.4%、平均67.2±12.4歳)を調査した。DISHの有病率はX線検査でLSSのない無症候性対照では14.4%、X線検査でLSSのある無症候性対照では21.1%、手術を必要とするLSS患者では31.7%で、有意に増加した。DISHの分布は群間で同様であったが、手術を必要とするLSS患者では胸郭下部と上部中央腰椎域の頻度が高かった。年齢、性別、BMI、糖尿病の補正後、多変量解析ではDISHが手術を必要とするLSSに関連する独立因子であった。手術を必要とするLSS患者では、DISHのない患者よりも手術を必要とするDISH患者において、腰椎上部での狭窄と多層狭窄の高発生率が観察された。DISHによる下部可動域における減少によって、LSSの発症または重度が増加することが示唆された。

  • 平山病の長期悪化患者に対する外科的治療(Surgical Treatment of a Patient with Prolonged Exacerbation of Hirayama Disease) Reviewed

    Dohzono Sho, Toyoda Hiromitsu, Tamura Akiko, Hayashi Kazunori, Terai Hidetomi, Nakamura Hiroaki

    (一社)日本脊椎脊髄病学会 Spine Surgery and Related Research   3 ( 1 )   95 - 97   2019.01

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    症例は48歳女性で、右遠位上手部と前腕の進行性脱力を呈していた。症状は15歳時に始まり、右手の冷感も伴っていた。3年後には右手指の伸展が困難となり、寒冷気候中では巧緻運動障害も経験していた。筋力低下の悪化も進行し、近位同側下肢の緩徐な進行性脱力も現れたため当院に来院した。神経学的検査で、右遠位上肢の顕著な萎縮と鷲手変形が明らかとなり、罹患した前腕の尺骨側と手で中程度から重度の感覚障害が観察された。頸部MRIでは、C4-5、C5-6、C6-7レベルでのT2強調画像上に高輝度領域を伴う非対称な前後方向平坦化が見られ、屈位の頸部MRIでは後部硬膜壁の変位がない脊髄前方移動、当該脊髄のC4-5およびC5-6レベルでの圧迫が明らかとなった。C4-5およびC5-6レベルでの前方除圧固定術を行い、ポリエーテルエーテルケトンケージを各椎体間スペースに配置して頸椎前彎を達成した。術後2年で右足は完全な強さを維持しているが、右遠位上肢の顕著な萎縮と鷲手変形は残存している。

  • Preoperative Morphology of the Proximal Femoral Canal Did Not Affect the Postoperative Bone Mineral Density Change Around the Zweymüller-Type Stem. Reviewed

    Suguru Nakamura, Yukihide Minoda, Yoichi Ohta, Ryo Sugama, Kazumasa Yamamura, Hideki Ueyama, Hiroaki Nakamura

    Orthopedics   42 ( 5 )   E449 - E453   2019( ISSN:0147-7447

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    The bone mineral density (BMD) around a femoral component changes after total hip arthroplasty (THA). The aim of this study was to investigate the influence of the morphology of the preoperative proximal femoral canal on the postoperative BMD change of the femur around a Zweymüller-type stem. The authors performed a retrospective review of their institutional arthroplasty database. Patients were classified into following 3 groups according to canal flare index (CFI): CFI<3.0, stovepipe group; 3.0<CFI<4.7, normal group; and CFI>4.7, champagne-flute group. This study included 120 hips of 112 patients (26 hips with stovepipe femurs, 72 hips with normal femurs, and 22 hips with champagne-flute femurs) in patients who had undergone THA using the Zweymüller-type stem. The BMD of the proximal femur (Gruen's zones 1-7) was measured at 3 weeks and 6, 12, and 24 months postoperatively. At each follow-up period, the differences in the relative change in the BMD were not statistically significant in any regions of interest among the 3 groups. This study showed the lack of significant differences in the relative change in the BMD among the different morphologies of the proximal femoral canal. The preoperative morphology of the femoral canal did not affect the postoperative BMD change around the Zweymüller-type stem at 2 years postoperatively. [Orthopedics. 2019; 42(5):e449-e453.].

    DOI: 10.3928/01477447-20190604-04

    PubMed

  • Intraoperative bone tunnel laceration affects integrity of arthroscopic transosseous rotator cuff repair with a tunneling device Reviewed

    Hirakawa Yoshihiro, Manaka Tomoya, Ito Yoichi, Ichikawa Koichi, Matsuda Yoshinobu, Shimizu Hayato, Nakamura Hiroaki

    CURRENT ORTHOPAEDIC PRACTICE   30 ( 4 )   336 - 342   2019( ISSN:1940-7041

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BCO.0000000000000776

  • Impact of Hemodialysis on Surgical Outcomes and Mortality Rate after Lumbar Spine Surgery: A Matched Cohort Study Reviewed

    Hori Yusuke, Takahashi Shinji, Terai Hidetomi, Hoshino Masatoshi, Toyoda Hiromitsu, Suzuki Akinobu, Hayashi Kazunori, Tamai Koji, Ohyama Shoichiro, Nakamura Hiroaki

    Spine Surgery and Related Research   3 ( 2 )   151 - 156   2019( ISSN:2432-261X ( eISSN:2432261X

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    <p>Introduction: Despite ongoing improvements in both dialysis and surgical techniques, spinal surgery in patients undergoing hemodialysis (HD) is a challenge to surgeons because of the high mortality rate. However, no previous studies have examined clinical outcomes after lumbar surgery in HD patients. The purpose of this study is to compare clinical outcomes and complication rates after lumbar spinal surgery in patients with or without hemodialysis.</p><p>Methods: This retrospective, matched cohort study was conducted to compare surgical outcomes between HD vs non-HD patients who underwent lumbar surgery at our hospital. Controls were individually matched to cases at a ratio of 1:2. Clinical outcomes, complications, and mortality rates were compared between the two groups.</p><p>Results: Twenty-nine patients in the HD group and 57 in the non-HD group were included in the current study. Five patients in the HD group died during the follow-up period, whereas no patients died in the non-HD group (mortality rate, 17.2% vs. 0%, <i>P</i> = 0.003). Japanese Orthopaedic Association (JOA) scores were significantly less improved in the HD group than in the non-HD group (11.9 vs. 14.2 preoperatively, <i>P</i> = 0.001; 19.9 vs. 25.1 at final follow-up, <i>P</i> < 0.001). Five patients underwent repeat surgery in the HD group, which was significantly higher than the non-HD group (17.2% vs. 3.5%, <i>P</i> = 0.041).</p><p>Conclusions: The current study indicates that patients undergoing HD had poor outcomes after lumbar spinal surgery. Moreover, 5 of 29 patients died within a mean 2.4-years follow-up. The indications for lumbar spine surgery in HD patients must be carefully considered because of poor surgical outcomes and high mortality rate.</p>

    DOI: 10.22603/ssrr.2018-0025

    PubMed

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  • Risk Factors for Proximal Junctional Fracture Following Fusion Surgery for Osteoporotic Vertebral Collapse with Delayed Neurological Deficits: A Retrospective Cohort Study of 403 Patients Reviewed

    Tamai Koji, Terai Hidetomi, Suzuki Akinobu, Nakamura Hiroaki, Watanabe Kei, Katsumi Keiichi, Ohashi Masayuki, Shibuya Yohei, Izumi Tomohiro, Hirano Toru, Kaito Takashi, Yamashita Tomoya, Fujiwara Hiroyasu, Nagamoto Yukitaka, Matsuoka Yuji, Suzuki Hidekazu, Nishimura Hirosuke, Tagami Atsushi, Yamada Syuta, Adachi Shinji, Yoshii Toshitaka, Ushio Shuta, Harimaya Katsumi, Kawaguchi Kenichi, Yokoyama Nobuhiko, Oishi Hidekazu, Doi Toshiro, Kimura Atsushi, Inoue Hirokazu, Inoue Gen, Miyagi Masayuki, Saito Wataru, Nakano Atsushi, Sakai Daisuke, Nukaga Tadashi, Ikegami Shota, Shimizu Masayuki, Futatsugi Toshimasa, Ohtori Seiji, Furuya Takeo, Orita Sumihisa, Imagama Shiro, Ando Kei, Kobayashi Kazuyoshi, Kiyasu Katsuhito, Murakami Hideki, Yoshioka Katsuhito, Seki Shoji, Hongo Michio, Kakutani Kenichiro, Yurube Takashi, Aoki Yasuchika, Oshima Masashi, Takahata Masahiko, Iwata Akira, Endo Hirooki, Abe Tetsuya, Tsukanishi Toshinori, Nakanishi Kazuyoshi, Watanabe Kota, Hikata Tomohiro, Suzuki Satoshi, Isogai Norihiro, Okada Eijiro, Funao Haruki, Ueda Seiji, Shiono Yuta, Nojiri Kenya, Hosogane Naobumi, Ishii Ken

    Spine Surgery and Related Research   3 ( 2 )   171 - 177   2019( ISSN:2432-261X ( eISSN:2432261X

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    <p>Introduction: Approximately 3% of osteoporotic vertebral fractures develop osteoporotic vertebral collapse (OVC) with neurological deficits, and such patients are recommended to be treated surgically. However, a proximal junctional fracture (PJFr) following surgery for OVC can be a serious concern. Therefore, the aim of this study is to identify the incidence and risk factors of PJFr following fusion surgery for OVC.</p><p>Methods: This study retrospectively analyzed registry data collected from facilities belonging to the Japan Association of Spine Surgeons with Ambition (JASA) in 2016. We retrospectively analyzed 403 patients who suffered neurological deficits due to OVC below T10 and underwent corrective surgery; only those followed up for ≥2 years were included. Potential risk factors related to the PJFr and their cut-off values were calculated using multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis.</p><p>Results: Sixty-three patients (15.6%) suffered PJFr during the follow-up (mean 45.7 months). In multivariate analysis, the grade of osteoporosis (grade 2, 3: adjusted odds ratio (aOR) 2.92; p=0.001) and lower instrumented vertebra (LIV) level (sacrum: aOR 6.75; p=0.003) were independent factors. ROC analysis demonstrated that lumbar bone mineral density (BMD) was a predictive factor (area under curve: 0.72, p=0.035) with optimal cut-off value of 0.61 g/cm<sup>2</sup> (sensitivity, 76.5%; specificity, 58.3%), but that of the hip was not (p=0.228).</p><p>Conclusions: PJFr was found in 16% cases within 4 years after surgery; independent risk factors were severe osteoporosis and extended fusion to the sacrum. The lumbar BMD with cut-off value 0.61 g/cm<sup>2</sup> may potentially predict PJFr. Our findings can help surgeons select perioperative adjuvant therapy, as well as a surgical strategy to prevent PJFr following surgery.</p>

    DOI: 10.22603/ssrr.2018-0068

    PubMed

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  • A rare case report; Aneurysmal bone cyst of the femur with difficulties in diagnosis and treatment Reviewed

    TAKADA Naoki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 2 )   249 - 250   2019( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2019.249

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  • 20190918 Reviewed

    Matsuda Yoshinobu, Nakamura Hiroaki, Manaka Tomoya, Ito Yoichi, Ichikawa Koichi, Hirakawa Yoshihiro, Shimizu Hayato, Nakazawa Katsumasa, Iio Ryosuke, Yamashita Ryuichi

    Japan Shoulder Society, Katakansetsu   43 ( 2 )   570 - 572   2019( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.43.570

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  • Osteomyelitis of the ischiopubic synchondrosis: A case report Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 2 )   343 - 344   2019( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2019.343

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  • Quality-adjusted life year (QALY) on case of degenerative lumbar disease treated with decompression surgery Reviewed

    KATO Minori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 1 )   17 - 18   2019( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2019.17

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  • Gait analysis of total hip arthroplasty patients based on the spectral analysis results of trunk acceleration Reviewed

    YONEDA Masahiro, IKEBUCHI Mitsuhiko, FUKUDA Kanji, KATO Ryoichi, NAKATSUCHI Tamotsu, NAKAJIMA Shigeyoshi, NAKAMURA Hiroaki

    The Japan Society of Mechanical Engineers, Transactions of the JSME (in Japanese)   85 ( 877 )   19 - 00103-19-00103   2019( eISSN:21879761

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    <p>The purpose of this study is to investigate the gait improvement for patients after total hip arthroplasty (THA) by using accelerometers attached to the trunk of body before and after surgery (initial gait after THA, in hospital, at discharge, 3 months after THA, 6 months after THA, 1 year after THA). Thirty patients (mean age 61.1 ± 11.1 years old) were selected. Twelve healthy subjects (mean age 24.1 ± 2.6 years old) were also selected as a control group. Dynamic load factor (DLF) corresponding to the vertical walking force and lateral displacement of the trunk are calculated using power spectrum density for time history trunk signals measured by the accelerometers. The parameter PR in the fore and posterior directions is also obtained which is defined as the power spectrum ratio of 0.5<i>fw</i> to <i>fw</i> component where 0.5<i>fw</i> is half frequency component of the gait cycle <i>fw</i>. Based on these results, it was confirmed that the parameter PR in the fore and posterior directions, DLF in the vertical direction and lateral displacement of the trunk were the useful evaluation indices in order to evaluate the gait improvement for THA postoperative patients.</p>

    DOI: 10.1299/transjsme.19-00103

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  • 20190918 Reviewed

    Iio Ryosuke, Nakamura Hiroaki, Hirakawa Yoshihiro, Manaka Tomoya, Ito Yoichi, Ichikawa Koichi, Matsuda Yoshinobu, Shimizu Hayato, Nakazawa Katsumasa, Yamashita Ryuichi

    Japan Shoulder Society, Katakansetsu   43 ( 2 )   630 - 633   2019( ISSN:0910-4461

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    DOI: 10.11296/katakansetsu.43.630

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  • Repeating pneumothorax caused by pulmonary metastatic osteosarcoma, a case report Reviewed

    MIYASHIMA Yusuke

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   62 ( 2 )   253 - 254   2019( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2019.253

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  • リバース型人工肩関節置換術におけるインプラント接触圧の術中測定 Reviewed

    伊藤 陽一, 中村 博亮, 間中 智哉, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 中沢 克優, 山下 竜一

    日本肩関節学会 肩関節   43 ( 4 )   940 - 940   2019( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.43.940

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  • リバース型人工肩関節置換術におけるインプラント接触圧と術後早期可動域との関連性 Reviewed

    伊藤 陽一, 中村 博亮, 間中 智哉, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 飯尾 亮介, 中沢 克優, 山下 竜一

    日本肩関節学会 肩関節   43 ( 4 )   939 - 939   2019( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.43.939

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  • ピッグテール形状カテーテルを用いた持続斜角筋間ブロックにおけるカテーテル留置位置の比較検討 Reviewed

    清水 勇人, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 飯尾 亮介, 中澤 克優, 山下 竜一

    日本肩関節学会 肩関節   43 ( 4 )   944 - 944   2019( ISSN:0910-4461

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    DOI: 10.11296/katakansetsu.43.944

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  • リバース型人工肩関節置換術後1年経過例における上腕骨ステム周囲の単純X線評価 Reviewed

    平川 義弘, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 松田 淑伸, 清水 勇人, 中澤 克優, 飯尾 亮介, 山下 竜一

    日本肩関節学会 肩関節   43 ( 4 )   942 - 942   2019( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.43.942

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  • 肩関節鏡視下手術後の疼痛管理における新型カテーテルを用いた持続斜角筋間ブロックの有用性 -既存カテーテルとの比較検討- Reviewed

    清水 勇人, 中村 博亮, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 飯尾 亮介, 中沢 克優, 山下 竜一

    日本肩関節学会 肩関節   43 ( 4 )   945 - 945   2019( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.43.945

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  • 20190918 Reviewed

    Nakazawa Katsumasa, Nakamura Hiroaki, Manaka Tomoya, Ito Yoichi, Ichikawa Koichi, Hirakawa Yoshihiro, Matsuda Yoshinobu, Shimizu Hayato, Iio Ryosuke, Yamashita Ryuichi

    Japan Shoulder Society, Katakansetsu   43 ( 2 )   634 - 637   2019( ISSN:0910-4461 ( eISSN:18816363

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    DOI: 10.11296/katakansetsu.43.634

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  • Comparison of a Vitamin E-infused highly crosslinked polyethylene insert and a conventional polyethylene insert for primary total knee arthroplasty at two years postoperatively

    Takemura S.

    Bone and Joint Journal   101 B ( 5 )   559 - 564   2019( ISSN:20494394

  • ピッグテール形状カテーテルを用いた持続斜角筋間ブロックにおけるカテーテル留置位置の比較検討

    清水 勇人, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 飯尾 亮介, 中澤 克優, 山下 竜一, 中村 博亮

    肩関節   43 ( 4 )   944 - 944   2019( ISSN:09104461 ( eISSN:18816363

  • Diagnostic value of tumor-fascia relationship in superficial soft tissue masses on magnetic resonance imaging. Reviewed

    Tadashi Iwai, Manabu Hoshi, Naoto Oebisu, Masanari Aono, Masatugu Takami, Makoto Ieguchi, Hiroaki Nakamura

    PloS one   13 ( 12 )   e0209642   2018.12( ISSN:1932-6203

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    PURPOSE: Many surgeons participate in the management of superficial soft tissue masses, and a preoperative incorrect diagnosis frequently results in dismal oncological outcomes. The aim of this study was to identify distinguishing magnetic resonance imaging features between malignant and non-malignant lesions. METHODS: The clinicopathological data for 219 patients (men 114; women 105) with superficial soft tissue masses treated from January 2007 to December 2016 in our institution were retrospectively analyzed. The median age at the first visit was 55.6 years (range 1-90 years). MRI findings of tumor size, margin, lobulation, intratumoral hemorrhage, peritumoral edema, and tumor-fascia relationship were compared with the final histological diagnosis and tumor grade. RESULTS: Univariate analysis revealed significant relationships between histologically malignant lesions and tumor size ≥5 cm (p = 0.035), positive peritumoral edema (p = 0.031), and tumor-fascia relationship (p<0.001), but not margin (p = 0.107), lobulation (p = 0.071), and intratumoral hemorrhage (p = 0.17). In addition, using multivariate analysis, the tumor-fascia relationship (p<0.001) and tumor size were significant factors. A significant correlation between tumor-fascia relationship and malignancy (p<0.001) was observed; such a relationship was, however, not observed for tumor grade (p = 0.43). CONCLUSIONS: Tumors measuring ≥5 cm and the tumor-fascia relationship on magnetic resonance imaging are highly indicative of malignancy. When superficial soft tissue masses cross the superficial fascia and form obtuse angles with the fascia, sarcoma should be considered. The tumor-fascia relationship can offer surgeons useful information regarding the status of superficial soft tissue masses.

    DOI: 10.1371/journal.pone.0209642

    PubMed

  • Computer-Assisted Three-Dimensional Corrective Osteotomy for Malunited Fractures of the Distal Radius Using Prefabricated Bone Graft Substitute. Reviewed

    Kosuke Shintani, Kenichi Kazuki, Masahiro Yoneda, Takuya Uemura, Mitsuhiro Okada, Kiyohito Takamatsu, Hiroaki Nakamura

    The journal of hand surgery Asian-Pacific volume   23 ( 4 )   479 - 486   2018.12( ISSN:2424-8355

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    BACKGROUND: Three-dimensional computed tomography (3D-CT) imaging has enabled more accurate preoperative planning. The purpose of this study was to investigate the results of a novel, computer-assisted, 3D corrective osteotomy using prefabricated bone graft substitute to treat malunited fractures of the distal radius. METHODS: We investigated 19 patients who underwent the computer-assisted 3D corrective osteotomy for a malunited fracture of the distal radius after the operation was stimulated with CT data. A prefabricated bone graft substitute corresponding to the patient's bone defect was implanted and internal fixation was performed using a plate and screws. We compared postoperative radiographic parameters of the patient's operated side with their sound side and analyzed clinical outcomes using Mayo wrist score. RESULTS: All patients achieved bone union on X-ray imaging at final follow-up. The mean differences of palmar tilt, radial inclination and ulnar variance between the operation side and the sound side were 4.3°, 2.3° and 1.2 mm, respectively. The Mayo wrist score was fair in 4 patients and poor in 15 patients before surgery. At the final follow-up after surgery, the scores improved to excellent in 3 patients, good in 11 patients and fair in 5 patients. There were two patients with correction loss at the final follow-up, but no patient complained of hand joint pain. CONCLUSIONS: We believe that computer-assisted 3D corrective osteotomy using prefabricated bone graft substitute achieved good results because it worked as a guide to the accurate angle.

    DOI: 10.1142/S2424835518500467

    PubMed

  • Comparison of minimally invasive decompression and combined minimally invasive decompression and fusion in patients with degenerative spondylolisthesis with instability Reviewed

    Hayashi Kazunori, Toyoda Hiromitsu, Terai Hidetomi, Hoshino Masatoshi, Suzuki Akinobu, Takahashi Shinji, Tamai Koji, Ohyama Shoichiro, Hori Yusuke, Yabu Akito, Nakamura Hiroaki

    JOURNAL OF CLINICAL NEUROSCIENCE   57   79 - 85   2018.11( ISSN:0967-5868

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    DOI: 10.1016/j.jocn.2018.08.032

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  • 中空型生体吸収性人工神経による末梢神経の癒着防止効果 Reviewed

    新谷 康介, 上村 卓也, 高松 聖仁, 横井 卓哉, 岡田 充弘, 中村 博亮

    (一社)日本手外科学会 日本手外科学会雑誌   35 ( 2 )   1 - 5   2018.11( ISSN:2185-4092

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    末梢神経周囲組織に炎症が生じると,瘢痕や癒着による神経障害が問題となる.本研究では,ラットの坐骨神経癒着モデルを用いて,癒着防止材としての中空型生体吸収性人工神経の有用性について検証した.非癒着群,癒着群,人工神経群の3群を作製し,神経癒着と神経障害の程度を評価した.癒着群では組織学的に神経が周囲の瘢痕と強固に癒着し,神経伝導速度が低下していた.癒着した神経内にはマクロファージの浸潤が認められた.人工神経群は癒着群と比べて,癒着スコアと最大破断強度は有意に小さく,腓腹筋重量と神経伝導速度は有意に大きかった.我々が開発を進めている高柔軟性の中空型生体吸収性人工神経は,神経欠損部を架橋することで神経再生が得られるだけでなく,末梢神経の癒着防止材としても効果があった.(著者抄録)

  • 整形外科専門医による触診は有意義か? 軟部腫瘍の有するいわゆる"熱感"についての検討 Reviewed

    嶋谷 彰芳, 星 学, 大戎 直人, 岩井 正, 高田 尚輝, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   61 ( 6 )   1229 - 1230   2018.11( ISSN:0008-9443

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    整形外科医が感じる熱感の精度、熱感と良性・悪性の関係、表面温度と良性・悪性の関係について検討した。当施設で手術を施行した軟部腫瘍患者56例(男性28例、女性28例、中央値63.5歳)を対象とした。36℃に設定したincubatorと、盲目的に36.1℃から0.1℃刻みに36.5℃までランダムに設定したincubatorを並べ、5人の整形外科医がそれぞれ何度で熱感を感じるかを調査した。また、手術室で麻酔下に3人の整形外科医が実際に触診を行い、熱感の健患差の有無を記録し、検者間の一致率を調査した。Incubatorを用いた検査では0.2℃以上で熱感を感じる人数が増加した。実際の触診による熱感の有無に関して、整形外科医3人の一致率は91.1%であった。触診で一致した症例のうち熱感ありとしたものは良性が29例中1例、22例中8例で悪性腫瘍のほうが熱感を感じる症例が有意に多かった。ROC曲線に基づく良性腫瘍と悪性腫瘍の健患差のCut off値は0.2℃、odds比は16.6倍であった。

  • Spinopelvic Sagittal Alignment after Microendoscopic Laminotomy in Patients with Lumbar Degenerative Spondylolisthesis Reviewed

    Dohzono Sho, Toyoda Hiromitsu, Hori Yusuke, Takahashi Shinji, Suzuki Akinobu, Terai Hidetomi, Nakamura Hiroaki

    JOURNAL OF NEUROLOGICAL SURGERY PART A-CENTRAL EUROPEAN NEUROSURGERY   79 ( 6 )   479 - 485   2018.11( ISSN:2193-6315

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    DOI: 10.1055/s-0038-1666847

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  • 書評 MISt手技における側方経路椎体間固定術(LIF)入門-OLIF・XLIF®を中心に

    中村 博亮

    臨床整形外科   53 ( 10 )   938 - 938   2018.10( ISSN:05570433 ( eISSN:18821286

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  • 特集 歯突起後方偽腫瘍 関節リウマチに伴う歯突起後方偽腫瘍の臨床

    鈴木 亨暢, 堂園 将, 中村 博亮

    脊椎脊髄ジャーナル   31 ( 10 )   891 - 897   2018.10( ISSN:09144412

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  • Flexor pollicis longus tendon rupture by sandwiched underlying volar locking plate and distal radius Reviewed

    Uemura Takuya, Okano Tadashi, Onode Ema, Yokoi Takuya, Shintani Kosuke, Okada Mitsuhiro, Nakamura Hiroaki

    JOURNAL OF MEDICAL ULTRASONICS   45 ( 4 )   647 - 651   2018.10( ISSN:1346-4523

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    DOI: 10.1007/s10396-018-0882-1

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  • Two case reports of fair lower limb function after sciatic nerve sacrifice for the treatment of a malignant peripheral nerve sheath tumor. Reviewed

    Akiyoshi Shimatani, Masanari Aono, Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Naoki Takada, Hiroaki Nakamura

    International cancer conference journal   7 ( 4 )   137 - 141   2018.10( ISSN:2192-3183

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    Wide resection for malignant soft tissue tumors may require resection of a major nerve. When a limb salvage procedure is selected in these cases, the anticipated functional outcome of the procedure must be clearly discussed with the patient, as recovery of normal function cannot be expected. In this report, we describe our surgical management of two cases of malignant peripheral nerve sheath tumor, a 58-year-old man and a 10-year-old girl, requiring a limb salvage procedure with sacrifice of the sciatic nerve. Although both patients required a short-leg brace for walking, because of a drop foot, both patients reported satisfactory functional results and were able to perform their activities of daily living with only slight difficulties. Based on our experience, limb salvage surgery can be considered for the treatment of malignancies involving the sciatic nerve, with fair functional outcomes expected.

    DOI: 10.1007/s13691-018-0338-x

    PubMed

  • 下方に位置する橈骨遠位端掌側ロッキングプレートで挟まれた長母指屈筋腱断裂(Flexor pollicis longus tendon rupture by sandwiched underlying volar locking plate and distal radius) Reviewed

    Uemura Takuya, Okano Tadashi, Onode Ema, Yokoi Takuya, Shintani Kosuke, Okada Mitsuhiro, Nakamura Hiroaki

    シュプリンガー・ジャパン(株) Journal of Medical Ultrasonics   45 ( 4 )   647 - 651   2018.10( ISSN:1346-4523

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    症例は63歳男性で、右手母指指節間関節の屈曲が困難であったため来院した。他院で橈骨遠位端骨折の手術歴を有し、術後、右手母指指節間関節屈曲が不可能となった。掌側ロッキングプレートとして使用された器具は、Variable Angle-LCP Two-Column Distal Radius Plates 2.4で、X線画像により橈骨遠位端骨折治癒の確認後、掌側ロッキングプレート除去による長母指屈筋(FPL)腱断裂の外科的治療を行った。なお、術前検査ではFPL腱滑走の著しい制限が認められ、超音波所見ではプレートと橈骨遠位端間にFPL腱が埋込まれていることが確認された。術中所見により、FPL腱がプレート下に完全に埋込まれて、遠位ロッキングスクリューが貫通していたことが明らかにされたため、FPL腱断裂にはスクリューとプレート除去後、長母指腱移植を施行した。術後、最終的には骨折前と同様に親指が屈曲できるようになり回復が得られた。本例から、橈骨遠位端骨折治療に掌側ロッキングプレート固定術を行う場合には、術後合併症であるFPL腱断裂発症を防ぐためにも、日常的な超音波検査の必要性が提示された。

  • Two case reports of fair lower limb function after sciatic nerve sacrifice for the treatment of a malignant peripheral nerve sheath tumor(和訳中) Reviewed

    Shimatani Akiyoshi, Aono Masanari, Hoshi Manabu, Oebisu Naoto, Iwai Tadashi, Takada Naoki, Nakamura Hiroaki

    シュプリンガー・ジャパン(株) International Cancer Conference Journal   7 ( 4 )   137 - 141   2018.10

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  • Flexor pollicis longus tendon rupture by sandwiched underlying volar locking plate and distal radius.

    Uemura T, Okano T, Onode E, Yokoi T, Shintani K, Okada M, Nakamura H

    Journal of medical ultrasonics (2001)   45 ( 4 )   647 - 651   2018.10( ISSN:1346-4523

  • 特集 画像診断の別の貌-定量化と正常値のまとめ,適正使用と被曝 脊椎の画像評価-骨粗鬆症を中心に

    星野 雅俊, 中村 博亮

    脊椎脊髄ジャーナル   31 ( 9 )   795 - 801   2018.09( ISSN:09144412

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  • 整形トピックス iPS細胞由来神経前駆細胞を付加したハイブリッド型人工神経

    上村 卓也, 高松 聖仁, 中村 博亮

    整形外科   69 ( 10 )   1044 - 1044   2018.09( ISSN:00305901 ( eISSN:24329444

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  • Adipose Derived Stem Cell Suppressed Synovial Inflammation and Repaired Cartilage Destruction in Rheumatoid Arthritis Model Mice Reviewed

    Okano Tadashi, Inui Kentaro, Ueyama Hideki, Orita Kumi, Koike Tatsuya, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   70   2018.09( ISSN:2326-5191

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  • Promising effects of eribulin for cystic lung metastases of epithelioid sarcoma: a case report. Reviewed

    Tadashi Iwai, Manabu Hoshi, Naoto Oebisu, Akiyoshi Shimatani, Naoki Takada, Hiroaki Nakamura

    Anti-cancer drugs   29 ( 8 )   806 - 809   2018.09( ISSN:0959-4973

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    Epithelioid sarcoma (ES) is a rare and aggressive type of soft tissue sarcoma with resistance to systemic chemotherapy. Therefore, new treatment options are required for patients with advanced ES. Eribulin is a novel potential treatment option for patients with inoperative sarcoma. We herein report a case of a 27-year-old Japanese man with cystic lung metastases from an ES in the left forearm, resulting in long-term stable disease. A solid, metastatic sarcomatous nodule appeared in the right lung, as shown by computed tomography, within the first 2 months after surgery. After the lung metastasis was detected, he underwent a total of 37 cycles of chemotherapy in six regimens. However, multiple cystic lung metastases had progressed in segments S6 and S9/10; hence, eribulin treatment was initiated. After two courses of eribulin, the excess fluid density material in the cystic metastases was completely absorbed, and an additional four courses of treatment resulted in shrinkage of the cystic metastases. These effects lasted for 13 months without severe adverse effects. Cystic lung metastases are an extremely rare consequence of soft tissue sarcoma, and eribulin is one of the most promising options for the treatment of advanced ES.

    DOI: 10.1097/CAD.0000000000000657

    PubMed

  • Small C7-T1 lordotic angle and muscle degeneration at C7 level were independent radiological characteristics of patients with cervical imbalance: a propensity score-matched analysis Reviewed

    Tamai Koji, Romanu Joshua, Grisdela Phillip Jr., Paholpak Permsak, Zheng Pengfei, Nakamura Hiroaki, Buser Zorica, Wang Jeffrey C.

    SPINE JOURNAL   18 ( 9 )   1505 - 1512   2018.09( ISSN:1529-9430

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    DOI: 10.1016/j.spinee.2018.01.012

    PubMed

  • 変形性膝関節症で発見されたMazabraud症候群の1例 Reviewed

    大戎 直人, 星 学, 家口 尚, 岩井 正, 嶋谷 彰芳, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   61 ( 5 )   971 - 972   2018.09( ISSN:0008-9443

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    72歳女性。両膝関節痛を主訴とした。単純X線、CT、MRIで、末期のOA変化、脛骨近位内側に病変を認めた。骨腫瘍は良性と判断し約5年間の経過観察を行ったが、右膝関節痛が悪化した。人工膝関節置換術(TKA)前に骨腫瘍の生検を行ったところ、線維性骨異形成と診断された。右腋窩および鼠径部に腫瘤を認めたため、上腕と大腿部の軟部腫瘍切除術を行い、病理所見より筋肉内粘液腫と診断された。以上より、本症例はMazabraud症候群と判断した。その後、右膝TKAを行い、FDや粘液腫の再発は認めない。

  • リバース型人工肩関節置換術後の臨床成績評価 患者立脚型評価と医師主導型評価の違いから Reviewed

    平田 義弘, 間中 智哉, 伊藤 陽一, 市川 耕一, 松田 淑伸, 清水 勇人, 中村 博亮

    (一社)日本肩関節学会 肩関節   42 ( 2 )   559 - 562   2018.09( ISSN:0910-4461

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    目的はリバース型人工肩関節置換術(以下、RSA)の術前術後経過をShoulder 36(以下、Sh36)とJOA scoreを用いて評価し、その関連性を検討することである。対象はRSAを施行した33例34肩(男9例、女24例)である。手術時平均年齢は77歳(70歳〜90歳)であった。術前、術後6ヵ月、術後12ヵ月にSh36及びJOA scoreを評価した。各スコアの経時的な改善を評価し、各時期のJOA scoreとSh36ドメインの一致する各項目の相関関係を統計学的に評価した。JOA score、Sh36の全項目は術前から術後6ヵ月、1年で有意に改善した。JOA scoreの各項目とSh36の各ドメインの相関関係は評価時期により異なることが示唆された。(著者抄録)

  • 【整形外科領域における医療技術のいま】トモシンセシスを用いたリバース型人工肩関節置換術の骨欠損の検出における有用性の検討 Reviewed

    平川 義弘, 間中 智哉, 伊藤 陽一, 箕田 行秀, 市川 耕一, 中村 博亮

    産業開発機構(株) 映像情報Medical   50 ( 10 )   8 - 11   2018.09( ISSN:1346-1354

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    豚の肩甲骨を用いたリバース型人工肩関節置換術(RSA)のベースプレート周囲骨欠損の検出感度と特異度を単純X線像、CT、トモシンセシスで比較検討した。豚肩甲骨4体を使用してRSAを施行した。コントロールモデル、前方骨欠損モデル、後方骨欠損モデル、下方骨欠損モデルを作製し、全モデルに対して単純X線、CT、トモシンセシスにより画像撮像を行った。単純X線による判定では下方骨欠損モデルは感度、特異度ともに100%であったが、前方骨欠損、後方骨欠損の骨欠損検出感度は25%、9%と低い値であった。CTによる評価では骨欠損検出感度はコントロールで58%、前方骨欠損で25%、後方骨欠損で33%、下方骨欠損で50%とスクリューとベースプレートの金属のアーチファクトにより骨欠損の検出は低い値となった。一方、トモシンセシスでは、前方、後方の骨欠損ともに骨欠損部の輪郭を明瞭に確認することができ、前方骨欠損、後方骨欠損ともに骨欠損検出感度は83%と高い値になっていた。

  • リバース型人工肩関節置換術における各機種間の側方及び下方オフセットの比較検討 Reviewed

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    (一社)日本肩関節学会 肩関節   42 ( 2 )   563 - 566   2018.09( ISSN:0910-4461

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    様々な特徴のあるリバース型人工肩関節置換術(以下、RSA)が導入されており、インプラントデザインは機種ごとに異なるため、術後獲得されるオフセットも様々である。本研究の目的は、5機種のRSAの側方オフセット及び下方オフセットを比較検討することである。対象は45肩。使用機種はAequalis reverse(以下、AR)、SMR reverse(以下、SMR)、DELTA XTEND(以下、DX)、Aequalis Ascend Flex(以下、AAF)、Comprehensive reverse(以下、CR)であった。術後肩関節正面のX線を用いて側方と下方のオフセットを計測した。平均側方オフセットはAAF、CRがそれぞれAR、SMR、DXと有意差を認めた。平均下方オフセットは各機種間に有意差を認めなかった。AAFとCRで側方オフセットが有意に大きく、三角筋のモメントアームや関節への圧迫力の増大が期待された。(著者抄録)

  • Ultrasonographic Research of the Relationship between Nail Disorders and Peripheral Arthritis or Enthesitis in Patients with Psoriasis and Psoriatic Arthritis Reviewed

    Okano Tadashi, Inui Kentaro, Mandai Koji, Yamada Yutaro, Koike Tatsuya, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   70   2018.09( ISSN:2326-5191

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  • Clinical and radiologic analysis of on-demand use of etanercept for disease flares in patients with rheumatoid arthritis for 2 years: The RESUME study: A case-control study. Reviewed

    Kentaro Inui, Tatsuya Koike, Masahiro Tada, Yuko Sugioka, Tadashi Okano, Kenji Mamoto, Akira Sakawa, Kenzo Fukushima, Hiroaki Nakamura

    Medicine   97 ( 38 )   e12462   2018.09( ISSN:0025-7974

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    To reduce costs of biological disease-modifying antirheumatic drugs (bDMARDs), we evaluated the efficacy of repeated etanercept (ETN) discontinuation and restarting in rheumatoid arthritis (RA) patients in a case-control study.Thirty-one bDMARD-naive RA patients with moderate to high disease activity received ETN until low disease activity (LDA) was achieved, after which ETN was discontinued. Upon flaring, ETN was readministered with observation every 2 months for 2 years, and radiographically evaluated in comparison with a historical control group treated continuously with ETN. Statistical methods including Fisher exact test, analysis of variance (ANOVA), Kruskal-Wallis test, multiple regression analysis, and Student t test were conducted as appropriate.Thirteen patients with inadequate response to ETN were withdrawn from the study, and 5 had no flare-up after ETN discontinuation. In the remaining 13 patients, ETN was used on-demand to maintain LDA. Multivariate analysis revealed that MTX was significantly correlated with ETN. All 13 patients achieved LDA at final follow-up. Although joint damage progressed in patients using ETN on-demand, structural damage progression in the on-demand group was not significantly different from that in controls.On-demand use of ETN for flaring reduced disease activity but not structural damage in 50% of patients (though not significantly). However, inhibition of joint damage was achieved in 50% of patients after 2 years, supporting on-demand use of ETN as a treatment option for patients with RA who cannot afford bDMARD or targeted synthetic DMARD therapy.

    DOI: 10.1097/MD.0000000000012462

    PubMed

  • Protective effect of biodegradable nerve conduit against peripheral nerve adhesion after neurolysis. Reviewed

    Kosuke Shintani, Takuya Uemura, Kiyohito Takamatsu, Takuya Yokoi, Ema Onode, Mitsuhiro Okada, Hiroaki Nakamura

    Journal of neurosurgery   129 ( 3 )   815 - 824   2018.09( ISSN:0022-3085

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    OBJECTIVE Peripheral nerve adhesion caused by extraneural and intraneural scar formation after neurolysis leads to nerve dysfunction. The authors previously developed a novel very flexible biodegradable nerve conduit composed of poly(L-lactide) and poly(ε-caprolactone) for use in peripheral nerve regeneration. In the present study, they investigated the effect of protective nerve wrapping on preventing adhesion in a rat sciatic nerve adhesion model. METHODS Rat sciatic nerves were randomly assigned to one of the following four groups: a no-adhesion group, which involved neurolysis alone without an adhesion procedure; an adhesion group, in which the adhesion procedure was performed after neurolysis, but no treatment was subsequently administered; a nerve wrap group, in which the adhesion procedure was performed after neurolysis and protective nerve wrapping was then performed with the nerve conduit; and a hyaluronic acid (HA) group, in which the adhesion procedure was performed after neurolysis and nerve wrapping was then performed with a 1% sodium HA viscous solution. Six weeks postoperatively, the authors evaluated the extent of scar formation using adhesion scores and biomechanical and histological examinations and assessed nerve function with electrophysiological examination and gastrocnemius muscle weight measurement. RESULTS In the adhesion group, prominent scar tissue surrounded the nerve and strongly adhered to the nerve biomechanically and histologically. The motor nerve conduction velocity and gastrocnemius muscle weight were the lowest in this group. Conversely, the adhesion scores were significantly lower, motor nerve conduction velocity was significantly higher, and gastrocnemius muscle weight was significantly higher in the nerve wrap group than in the adhesion group. Additionally, the biomechanical breaking strength was significantly lower in the nerve wrap group than in the adhesion group and HA group. The morphological properties of axons in the nerve wrap group were preserved. Intraneural macrophage invasion, as assessed by the number of CD68- and CCR7-positive cells, was less severe in the nerve wrap group than in the adhesion group. CONCLUSIONS The nerve conduit prevented post-neurolysis peripheral nerves from developing adhesion and allowed them to maintain their nerve function because it effectively blocked scarring and prevented adhesion-related damage in the peripheral nerves.

    DOI: 10.3171/2017.4.JNS162522

    PubMed

  • 進行期悪性末梢神経鞘腫瘍に対してパゾパニブが緩和的化学療法として有用であった1例 Reviewed

    高田 尚輝, 大戎 直人, 星 学, 岩井 正, 嶋谷 彰芳, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   61 ( 5 )   1031 - 1032   2018.09( ISSN:0008-9443

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    69歳男性。6年前からの右大腿軟部腫瘍の増大を主訴とした。MRIで右大腿内側にT1強調像で等信号、T2強調像で不均一に高信号で内部造影効果を受ける約87×68×52mmの軟部腫瘍を認めた。切開生検で神経鞘腫と診断され、摘出術を行った。術後2年に局所再発と肺転移を認め、進行期悪性末梢神経鞘腫瘍(T2bN0M1、stage IV)と診断し、広範切除術と肺部分切除術を行った。初回手術後3年に局所再発を認め、追加広範切除術と術後化学療法を行った。初回手術後4年に肺転移と局所再発に対し、パゾパニブ400mg/dayの投与を開始し、10ヵ月間はSD(stable disease)であった。投与期間中に減量や休薬を要する様な有害事象は認めなかった。初回手術後6年に腹腔内リンパ節転移や肺転移の増大のため、パゾパニブは投与開始から2年1ヵ月で中止し、BSC(best supportive care)の方針となった。中止後1年4ヵ月にDOD(dead of disease)となった。

  • 誌上シンポジウム 椎弓形成術 アップデート 高齢者に対する頚椎椎弓形成術

    豊田 宏光, 鈴木 亨暢, 玉井 孝司, 中村 博亮

    臨床整形外科   53 ( 8 )   705 - 711   2018.08( ISSN:05570433 ( eISSN:18821286

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  • Effect of Different Types of Upper Instrumented Vertebrae Instruments on Proximal Junctional Kyphosis Following Adult Spinal Deformity Surgery: Pedicle Screw versus Transverse Process Hook. Reviewed

    Akira Matsumura, Takashi Namikawa, Minori Kato, Shoichiro Oyama, Yusuke Hori, Akito Yabu, Noriaki Hidaka, Hiroaki Nakamura

    Asian spine journal   12 ( 4 )   622 - 631   2018.08( ISSN:1976-1902

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    STUDY DESIGN: Retrospective comparative study. PURPOSE: To compare the incidence of proximal junctional kyphosis (PJK) between transverse process hooks (TPHs) and pedicle screws (PSs) at the upper instrumented vertebrae (UIV) following adult spinal deformity (ASD) surgery. OVERVIEW OF LITERATURE: The choice of UIV implant type may be important for avoiding PJK; however, few comparative clinical studies have evaluated the incidence of PJK according to the type of UIV implant used in ASD surgery. METHODS: We retrospectively reviewed 39 consecutive patients with ASD (mean age, 67 years; mean follow-up period, 41 months) who underwent corrective surgery between 2009 and 2013. TPH was used in 17 patients and PS in 22 patients. PJK was defined as the presence of a UIV or UIV±1 fracture, or a change in the proximal junctional angle (PJA) of &gt;20°. Data of patients with TPH and PS were compared. RESULTS: The TPH group had a PJK incidence of 17.6% compared with 27.3% in the PS group (p =0.47). In the TPH group, PJK was a result of UIV fracture in one patient, UIV-1 fracture in one patient, and ligamentous failure in one patient. In the PS group, six patients developed PJK because of UIV fracture. No differences in radiographic parameters were found between the two groups. After analyzing the PJA data in the patients with PJK, the changes in PJA were significantly higher in the PS group than in the TPH group (19.0°/5.0°, p =0.04). CONCLUSIONS: Our results show that using TPH as a UIV implant may not prevent PJK; however, using TPH as the UIV anchor may prevent vertebral collapse if cases of UIV fracture. The increased risk of UIV fracture collapse in the PS group may be a result of a higher mechanical load on UIV when using PS.

    DOI: 10.31616/asj.2018.12.4.622

    PubMed

  • Lymphoproliferative disorder with pathological fracture of the femur in a patient with rheumatoid arthritis treated with methotrexate: A case report. Reviewed

    Naoto Oebisu, Manabu Hoshi, Makoto Ieguchi, Tadashi Iwai, Sayaka Tanaka, Masahiko Osawa, Hiroaki Nakamura

    Molecular and clinical oncology   9 ( 2 )   187 - 191   2018.08( ISSN:2049-9450

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    Methotrexate (MTX) is the key drug for the treatment of rheumatoid arthritis (RA). MTX-treated RA has been associated with the development of lymphoproliferative disorders (LPDs). Notably, the hyperimmune state of RA itself or the immunosuppressive state induced by MTX administration may contribute to development of LPD. Furthermore, Epstein-Barr virus (EBV) has been indicated to contribute to the development of MTX-LPD. MTX-associated LPD (MTX-LPD) may affect nodal or extranodal sites, including the gastrointestinal tract, skin, lungs, kidneys, and soft tissues, at an almost equal frequency. However, it is rare for MTX-LPD to manifest as multiple bone tumors with a pathological fracture. The present study reported the case of a 46-year-old Japanese woman with RA who had complications of EBV-positive MTX-LPD during an approximate 5-year course of MTX therapy. The present study indicated a rare case in which the LPD had spread to multiple bones in a patient with a pathologic fracture. Notably, the LPD was subclassified as diffuse large B-cell lymphoma (DLBCL).

    DOI: 10.3892/mco.2018.1654

    PubMed

  • Impingement of the patellar component against the tibial post depends on the design of the post-cam mechanism: Comparison between 12 posterior stabilized total knee prostheses Reviewed

    Minoda Yukihide, Sugama Ryo, Ohta Yoichi, Ikebuchi Mitsuhiko, Nakamura Hiroaki

    KNEE   25 ( 4 )   676 - 681   2018.08( ISSN:0968-0160

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    DOI: 10.1016/j.knee.2018.05.008

    PubMed

  • HipAlign lateral systemを用いたカップ設置角度の精度検証 Reviewed

    鳥飼 大剛, 洲鎌 亮, 箕田 行秀, 大田 陽一, 山村 一正, 中村 卓, 上山 秀樹, 中村 博亮

    日本股関節学会 Hip Joint   44 ( 2 )   684 - 686   2018.08( ISSN:0389-3634

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    Publishing type:Research paper (scientific journal)  

    OrthAlign社製HipAlign lateralは、人工股関節全置換術(THA)において術前の計画なしに手術中に簡便に使用できるという特徴を持つシステムである。本研究では、HipAlign lateralを用いて行ったTHAでのカップ設置角度の精度を検証した。2016年12月〜2017年4月にHipAlign lateralを用いてTHAを行った15例15関節(男性6例、女性9例)を研究対象とし、術中にHipAlign lateralが示した値と術後の単純X線像でのカップ設置角度を比較した。カップ設置角度の誤差は、絶対値で外方開角6.0±3.6°、前方開角5.7±4.2°であった。HipAlign lateralと単純X線像での角度の差は、3例を除き全ての症例が10°以内の誤差で設置することができた。10°以上の誤差を生じた3例について考察するといずれも導入初期のテクニカルエラーと考えられ、これらの3例を除外するとカップ設置角度の誤差は絶対値で外方開角4.9±2.7°、前方開角4.4±2.8°であった。カップ設置での的中率で考えると、外方開角・前方開角ともに5°以内の誤差で設置できた症例は33.0%、10°以内の誤差で設置できた症例は100%であった。

  • トモシンセシスを用いたリバース型人工肩関節置換術後のスカプラノッチの検出 Reviewed

    平川 義弘, 間中 智哉, 伊藤 陽一, 箕田 行秀, 市川 耕一, 中村 博亮

    (株)島津製作所 MEDICAL NOW   ( 84 )   44 - 47   2018.08( ISSN:0916-8745

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    豚肩甲骨4体を用いてリバース型人工肩関節置換術を施行した。コントロールモデル、前方骨欠損モデル、後方骨欠損モデル、下方骨欠損モデルを作製し、単純X線、CTおよびトモシンセシスにて画像撮影を行った。整形外科医12名の画像判定による評価を検査、各モデルの骨欠損の有無を疾患の有無と見立て、検出感度と特異度を算出した。その結果、単純X線による判定では下方骨欠損モデルは感度、特異度ともに100%であったが、前方骨欠損および後方骨欠損モデルの骨欠損検出感度は25%、9%と低く、下方骨欠損しか判定できなかった。CTによる判定では骨欠損検出感度はコントロールモデル58%、前方骨欠損モデル25%、後方骨欠損モデル33%、下方骨欠損モデル50%で、スクリューとプレートの金属のアーチファクトにより骨欠損の検出は低い値となった。トモシンセシスでは前方骨欠損、後方骨欠損モデルともに骨欠損部の輪郭を明瞭に確認でき、骨欠損検出感度は83%と高い値となった。

  • An accelerometer-based portable navigation system improved prosthetic alignment after total knee arthroplasty in 3D measurements. Reviewed

    Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Kazumasa Yamamura, Suguru Nakamura, Susumu Takemura, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   27 ( 5 )   1580 - 1586   2018.07( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: This study aimed to compare prosthetic alignment using three-dimensional (3D) measurements following total knee arthroplasty (TKA) performed using an accelerometer-based portable navigation system (KneeAlign2) versus the conventional technique. METHODS: A total of 159 patients who had primary osteoarthritis of the knee with varus deformity underwent TKA. The KneeAlign2 system was used for distal femoral resection and tibial resection in 78 knees, and the conventional instrumentation (intramedullary for the femur and extramedullary for the tibia) was used in 81 knees. 3D computed tomography (CT) scans of the whole leg were taken after TKA. Femoral and tibial prosthetic alignments in the coronal, sagittal, and axial planes were measured using computer software. The operation time and estimated blood loss were calculated. Deep venous thrombosis (DVT) and pulmonary embolism (PE) were evaluated using the contrast-enhanced multi-detector row CT at 1 week after TKA. RESULTS: In the femoral coronal plane, the mean and standard deviation of prosthetic alignment from neutral alignment were 1.2° [95% confidence interval (CI) 1.0°-1.4°) in the navigation group and 1.6° (95% CI 1.3°-2.0°) in the conventional group (p = 0.03). The femoral component outliers (> 3° away from the goal alignment) using the navigation system and the conventional technique were 3 and 15%, respectively, in the coronal plane (p < 0.01), and 15 and 43%, respectively, in the sagittal plane (p < 0.01). The outliers in tibial coronal and tibial sagittal planes were not statistically different between the two groups. There were no statistically significant differences between the two groups in operation time, blood loss, DVT, and PE. CONCLUSION: Using an accelerometer-based portable navigation system decreased the outliers of prosthetic alignment in femoral coronal and sagittal planes, and did not increase the complications such as operation time, blood loss, DVT, and PE. To our knowledge, this study is the first to investigate the usefulness of an accelerometer-based portable navigation system using the validated 3D measurement. LEVEL OF EVIDENCE: III.

    DOI: 10.1007/s00167-018-5082-4

    PubMed

  • Bioabsorbable nerve conduits coated with induced pluripotent stem cell-derived neurospheres enhance axonal regeneration in sciatic nerve defects in aged mice Reviewed

    Yokoi Takuya, Uemura Takuya, Takamatsu Kiyohito, Shintani Kosuke, Onode Ema, Okada Mitsuhiro, Hidaka Noriaki, Nakamura Hiroaki

    JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART B-APPLIED BIOMATERIALS   106 ( 5 )   1752 - 1758   2018.07( ISSN:1552-4973

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    DOI: 10.1002/jbm.b.33983

    PubMed

  • 人工神経(リナーブ)によるnerve cappingで治療した有痛性断端神経腫の1例 Reviewed

    上村 卓也, 斧出 絵麻, 横井 卓哉, 玄 承虎, 新谷 康介, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   61 ( 4 )   875 - 876   2018.07( ISSN:0008-9443

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    症例は41歳女性で、右中指の軟部腫瘍に対する切除術後から右中指の疼痛と指腹部での強いTinel徴候が持続するため、1年後に紹介受診した。MRIでは橈側の指神経の腫大を認め、腫瘍切除に伴う橈側指神経損傷および有痛性断端神経腫と診断し、手術を行った。指神経はDIP関節の遠位で断裂し、近位の神経断端は神経腫を形成していた。神経腫を切除し、人工神経によるnerve cappingを行い、人工神経の遠位はopenとした。術後1年で疼痛は、安静時VASが術前62mm→10mm、圧痛時VASが術前100mm→32mmに軽減し、Tinel徴候も軽減していた。Quick DASHは術前43点→20点に、Hand 20は術前48点→17点に改善し、患者は満足していた。

  • 製造中止腫瘍用人工膝関節の緩みに対し再置換を行った2例 Reviewed

    家口 尚, 渡辺 亨永, 鳥飼 大剛, 谷 亮佑, 黒田 貴顕, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   61 ( 4 )   829 - 830   2018.07( ISSN:0008-9443

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    症例1は39歳男性で、21歳時に左大腿骨遠位の通常型高悪性度骨肉腫に対し腫瘍広範切除術とZ社製Modular Tumor System(MTS)を用いた人工膝関節全置換術を受けていた。術後15年に大腿骨ステム周囲の緩みによる疼痛が出現し、術後18年に再置換術を施行した。大腿骨ステムは容易に抜去できたが、脛骨コンポーネントの抜去は困難で、脛骨側面に皮質骨を開窓してセメントを抜去し、大腿骨骨頭抜去器で抜去した。骨欠損部は腸骨を移植した。その後、S社製GMRS+HMRSコンポジットを置換した。術後40日に退院し、元職に復帰した。症例2は47歳女性で、25歳時に右大腿骨遠位の通常型骨肉腫に対し腫瘍広範切除術とMTSを用いた人工膝関節全置換術を受けていた。術後22年に大腿骨ステム周囲の緩みによる疼痛が出現し、再置換術を施行した。症例1と同じ方法でGMRS+HMRSコンポジットを置換した。術後20日に退院し、元職に復帰した。

  • 若年者における2重束膝前十字靱帯再建術後再断裂のリスク因子の検討 Reviewed

    韓 昌勲, 富原 朋弘, 橋本 祐介, 谷内 政俊, 島田 永和, 中村 博亮

    (一社)日本整形外科スポーツ医学会 日本整形外科スポーツ医学会雑誌   38 ( 3 )   271 - 275   2018.07( ISSN:1340-8577

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    若年者(20歳未満)を対象とした2重束膝前十字靱帯(ACL)再建術後再断裂に関連するリスク因子を調査した。対象は膝屈筋腱を用いて2重束ACL再建術を行なった174例とした。再断裂例をA群、それ以外の症例をB群とした。検討項目は性別、body mass index(BMI)、受傷前のtegner activity scale(TAS)、半月損傷の有無、移植腱径、術後脛骨前方変位量(患健側差)、スポーツ種目(pivoting sports、non pivoting sports)とし、2群間で統計学的検討を行なった。A群13例(7.5%)、B群161例(92.5%)であった。単変量解析でpivoting sports、TASにおいて有意差を認めた。多重ロジスティック解析でTASにおいて有意差を認めた。ROC解析からTAS9以上の症例では高率に再断裂を認めた。2重束ACL再建術では、TAS9以上のスポーツ活動性が高い症例が再断裂のリスク因子として考えられた。(著者抄録)

  • The degeneration of adjacent intervertebral discs negatively influence union rate of osteoporotic vertebral fracture: A multicenter cohort study. Reviewed

    Rahmani MS, Takahashi S, Hoshino M, Takayama K, Sasaoka R, Tsujio T, Yasuda H, Kanematsu F, Kono H, Toyoda H, Nakamura H

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   23 ( 4 )   627 - 634   2018.07( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    BACKGROUND: With the increasing aging population in developed countries, there has been an associated increased prevalence of osteoporotic vertebral fracture (OVF). Many previous reports have attempted to predict the risk of delayed union associated with OVF. However, the role of endplate failure and the degeneration of adjacent intervertebral discs, and their association with delayed union has received little attention. The aim of this study was to evaluate the endplate fracture and disc degeneration rank as risk factors for delayed union. MATERIALS AND METHODS: Two hundred and eighteen consecutive patients with fresh OVF were enrolled in the study. MRI and X-ray were performed at the time of enrollment and at the 6 months follow-up. The MR images were used to assess the degeneration grade of adjacent intervertebral discs (using the modified Pfirrmann grading system), and endplate failure. Supine and weight-bearing radiographs were used to define angular motion and compression ratio of the anterior vertebral body wall. RESULTS: A total of 139 patients (112 female, 27 male) completed the 6 month follow-up (a 65.1% follow-up rate). The study revealed 27 cases of delayed union (19.4%). A healthier adjacent caudal disc with low grade degeneration was found to be associated with an increased risk of delayed union (P = 0.008). Bi-endplate injury and significant compression of the anterior vertebral body wall were significantly associated with delayed union (P = 0.019, and P = 0.001 respectively). Rapid progression of the adjacent cranial disc degeneration was observed at the end of the 6 month follow-up period (P = 0.001). CONCLUSION: Modified Pfirrmann grading system revealed that a healthier adjacent intervertebral disc at the caudal level and bi-endplate fracture were significantly associated with an increased risk of delayed union. These findings may influence the management strategy for patients with OVF.

    DOI: 10.1016/j.jos.2018.03.008

    PubMed

  • 隣接する椎間板変性は骨粗鬆症性脊椎骨折の癒合率に悪影響を及ぼす 多施設共同コホート研究(The degeneration of adjacent intervertebral discs negatively influence union rate of osteoporotic vertebral fracture: A multicenter cohort study) Reviewed

    Rahmani Mohammad Suhrab, Takahashi Shinji, Hoshino Masatoshi, Takayama Kazushi, Sasaoka Ryuichi, Tsujio Tadao, Yasuda Hiroyuki, Kanematsu Fumiaki, Kono Hiroshi, Toyoda Hiromitsu, Nakamura Hiroaki

    (公社)日本整形外科学会 Journal of Orthopaedic Science   23 ( 4 )   627 - 634   2018.07( ISSN:0949-2658

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    癒合遅延に対するリスク因子としての終板骨折および椎間板変性について検討した。新鮮骨粗鬆症性脊椎骨折(OVF)を有する患者を対象とした。登録時および6ヵ月目の追跡調査時にMRIおよびX線検査を実施した。隣接する椎間板の変性グレード(modified Pfirrmann grading systemを使用)および終板障害をMRIにより評価した。体重負荷時の仰臥位X線画像に基づき、椎体前壁の角運動および圧縮率を評価した。患者(女性112例、男性27例)が6ヵ月の追跡調査を完了した。癒合遅延が27例に認められた。低グレードの変性を伴うより健康な隣接尾側椎間板が癒合遅延のリスク増加と関連していた。両側の終板損傷および椎体前壁の著しい圧縮が癒合遅延と有意に関連していた。6ヵ月の追跡調査期間の終了時に、隣接する頭側椎間板変性の急速な進行が認められた。

  • COMPARISON OF BONE MINERAL DENSITY BETWEEN RHEUMATOID ARTHRITIS PATIENTS AND HEALTHY INDIVIDUALS OVER SEVEN YEARS FROM THE TOMORROW STUDY Reviewed

    Tada M., Inui K., Sugioka Y., Okano T., Yamada Y., Mandai K., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   1623 - 1624   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.2298

  • MATRIX METALLOPROTEINASE-3 IS A GOOD PREDICTOR FOR JOINT DESTRUCTION ONLY IN MALE PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Yamada Y., Inui K., Okano T., Orita K., Sugioka Y., Mamoto K., Koike T., Tada M., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   1338 - 1339   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.2835

  • INCREASED HOMOCYSTEINE LEVEL FOR 7 YEARS IN PATIENTS WITH RHEUMATOID ARTHRITIS: TOMORROW STUDY Reviewed

    Inui K., Koike T., Sugioka Y., Okano T., Mamoto K., Yamada Y., Mandai K., Tada M., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   289 - 290   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.1439

  • GLUCOCORTICOID USE IS AN INDEPENDENT RISK FACTOR FOR SARCOPENIA IN PATIENTS WITH RHEUMATOID ARTHRITIS - FROM THE CHIKARA STUDY Reviewed

    Yamada Y., Tada M., Mandai K., Hidaka N., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   308 - 309   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.1860

  • EFFECT OF AGING ON BONE MASS AND SKELETAL MUSCLE MASS IN ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS: TOMORROW STUDY Reviewed

    Inui K., Koike T., Sugioka Y., Okano T., Mamoto K., Yamada Y., Mandai K., Tada M., Nagata H., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   934 - 934   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.1780

  • COMPARISON OF CLINICAL FEATURES IN PATIENTS WITH PSORIATIC ARTHRITIS AND PATIENTS WITH SPONDYLOARTHRITIS WITH INFLAMMATORY BOWEL DISEASE Reviewed

    Uematsu M., Inui K., Okano T., Yamada Y., Mandai K., Sugikoka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   1566 - 1566   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.4473

  • RA腰椎病変を合併する腰部脊柱管狭窄症の手術成績 非RA患者とのMatched Case Control Study Reviewed

    山田 賢太郎, 鈴木 亨暢, 高橋 真治, 豊田 宏光, 星野 雅俊, 寺井 秀富, 中村 博亮

    (一社)日本脊椎脊髄病学会 Journal of Spine Research   9 ( 6 )   1044 - 1048   2018.06( ISSN:1884-7137

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    関節リウマチ(RA)の腰椎病変にはすべり・側彎・椎体骨折が含まれるが、これらはいずれも非RA患者でもみられる。本研究はRA腰椎病変を合併する脊柱管狭窄症手術を行った15例と年齢・性別・病態・手術術式をmatchさせた非RA患者25例の術後成績を比較検討した。その結果、術前画像が同様のRA群/非RA群で臨床成績に差がなかったものの固定後隣接椎間障害・除圧後すべり増強がRAで多くみられる傾向にあった。(著者抄録)

  • SEVERITY OF SKIN SYMPTOMS IS NOT ASSOCIATED WITH MUSCULOSKELETAL MANIFESTATIONS IN PATIENTS WITH PSORIASIS Reviewed

    Yamada Y., Inui K., Okano T., Sugioka Y., Yoshimura H., Mamoto K., Koike T., Tada M., Tateishi C., Yonezawa E., Natsumi A., Fukunaga Y., Tsuruta D., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   1603 - 1603   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.3516

  • SCREENING RESEARCH OF ULTRASONOGRAPHIC PERIPHERAL ARTHRITIS AND ENTHESITIS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE Reviewed

    Uematsu M., Okano T., Inui K., Yamada Y., Mandai K., Sugikoka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   1180 - 1180   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.2025

  • ULTRASONOGRAPHIC ASSESSMENT OF NAIL IN PSORIATIC DISEASE FOUND A LINK BETWEEN NAIL DISORDER AND SOFT TISSUE SWELLING AROUND THE NAIL Reviewed

    Okano T., Inui K., Yamada Y., Mandai K., Mamoto K., Sugioka Y., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   1600 - 1601   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.2895

  • ADIPOSE DERIVED STEM CELLSUPPRESSED SYNOVIAL INFLAMMATION IN SKG/JCL MICE IN VIVO AND INFLAMMATORY CYTOKINE IN SYNOVIAL FIBROBLAST IN VITRO Reviewed

    Ueyama H., Okano T., Orita K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   1252 - 1252   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.2915

  • THE COMPARISON OF THE ULTRASONOGRAPHIC SYNOVIAL FINDINGS BETWEEN INTRAVENOUS ADMINISTRATION AND SUBCUTANEOUS INJECTION OF TOCILIZUMAB Reviewed

    Okano T., Inui K., Yamada Y., Mandai K., Mamoto K., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   615 - 615   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.1851

  • THE EFFECT OF CONCOMITANT TYPE OF VITAMIN D, BIOLOGICAL DMARDS AND DISEASE ACTIVITY FOR THERAPEUTIC EFFECT OF DENOSUMAB IN OSTEOPOROSIS PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Anno S., Inui K., Okano T., Mamoto K., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   77   456 - 456   2018.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2018-eular.3321

  • Asymmetric Tibial Component Improved the Coverage and Rotation of the Tibial Component in a Medial Pivot Total Knee Prosthesis. Reviewed

    Yukihide Minoda, Mitsuhiko Ikebuchi, Shigekazu Mizokawa, Yoichi Ohta, Hiroaki Nakamura

    The journal of knee surgery   31 ( 5 )   416 - 421   2018.05( ISSN:1538-8506

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Malrotation of tibial components is one of the important causes of failure in total knee arthroplasty. The aim of this study is to determine the relationship between tibial rotational positioning and coverage of the tibial surface during the operation, using a symmetric and newly introduced asymmetric medial pivot tibial components. The coverage and overhang were compared between a symmetric component (Advance medial pivot) and a newly introduced asymmetric medial pivot tibial component (Evolution medial pivot) in 31 knees during the operation. When the tibial component was placed parallel to the anteroposterior (AP) axis, the uncovered width in the posteromedial part using a symmetric design was larger than that using an asymmetric design (p < 0.01). Overhang in the posterolateral part was observed in 42% for a symmetric design and 3% for an asymmetric design (p < 0.01). When the component was placed in malrotation (10 degrees internal to the AP axis), overhang in the posteromedial part was observed in 6% for a symmetric design and in 71% for an asymmetric design (p < 0.01). The tibial rotation parallel to the AP axis and maximizing coverage of the tibial surface conflict in a symmetric design, but are compatible in an asymmetric design. An asymmetric tibial component is expected to improve the coverage and the rotational positioning of medial pivot total knee prosthesis.

    DOI: 10.1055/s-0037-1604143

    PubMed

  • MRI kinematic analysis of T1 sagittal motion between cervical flexion and extension positions in 145 patients Reviewed

    Tamai Koji, Buser Zorica, Paholpak Permsak, Sessumpun Kittipong, Hsieh Patrick C., Nakamura Hiroaki, Wang Jeffrey C.

    EUROPEAN SPINE JOURNAL   27 ( 5 )   1034 - 1041   2018.05( ISSN:0940-6719

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    DOI: 10.1007/s00586-017-5385-z

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  • The accelerated effect of recombinant human bone morphogenetic protein 2 delivered by β-tricalcium phosphate on tendon-to-bone repair process in rabbit models. Reviewed

    Yoshihiro Hirakawa, Tomoya Manaka, Kumi Orita, Yoichi Ito, Koichi Ichikawa, Hiroaki Nakamura

    Journal of shoulder and elbow surgery   27 ( 5 )   894 - 902   2018.05( ISSN:1058-2746

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    BACKGROUND: Bone morphogenetic protein 2 (BMP-2) plays an important role in the tendon-to-bone repair process. However, there is no previous literature on acceleration of the tendon-to-bone repair process by BMP-2 delivered by β-tricalcium phosphate (β-TCP). The aim of this study was to investigate the accelerated effect of recombinant human BMP-2 (rhBMP-2) delivered by β-TCP on the tendon-to-bone repair process. METHODS: The infraspinatus tendon of elderly female Japanese white rabbits was detached from its insertion site on the humerus. A bone tunnel (4.2 mm) was created at the original insertion site of the tendon, which was repaired using the McLaughlin procedure after filling in β-TCP (porosity 75%) without BMP-2 (control group) or with 10 µg rhBMP-2 (BMP group). The rabbits were sacrificed at the second, fourth, and eighth weeks after surgery for histologic analysis and biomechanical testing. We also evaluated the maturity of the tendon-to-bone junction using the tendon-to-bone maturity score. RESULTS: Histologic analysis revealed no significant difference between the groups at 2 and 8 weeks but a more abundant organized fibrocartilage at the tendon-to-bone junction in the BMP group at 4 weeks. The tendon-to-bone maturity score improved sequentially. The interface of the BMP group at 4 weeks had significantly improved biomechanical properties than that of the control group. CONCLUSION: The tendon-to-bone repair process was facilitated by the use of rhBMP-2 delivered by β-TCP at 4 weeks.

    DOI: 10.1016/j.jse.2017.11.025

    PubMed

  • 踵骨単純性骨嚢腫の解剖学的位置に関する考察 Reviewed

    星 学, 大戎 直人, 岩井 正, 嶋谷 彰芳, 高田 尚輝, 中村 博亮

    (一社)中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   61 ( 3 )   477 - 478   2018.05( ISSN:0008-9443

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    画像診断により踵骨骨嚢腫の解剖学的位置について検討し、その発生メカニズムについて考察した。1996年4月〜2016年3月に当院にて画像診断により踵骨骨嚢腫と診断することのできた19例(男性14例、女性5例、中央値12歳)を対象とした。Diardの分類に準じて、単純X線側面像にて踵骨骨嚢腫の存在部位を観察した。主に骨嚢腫は中央三角部に位置していることが予測されたが、そこからの前後への広がりも検討した。また、MRI冠状断と横断像で踵骨骨嚢腫が内側、外側に偏在しているのか正中部分に存在しているのかを観察した。単純X線側面像では病変は19例全例で中央三角部に存在していた。なお、中央三角部から2例が後方へ、2例が前方へ拡大していた。MRIによる画像評価では、2例が外側に、1例が内側偏在していた。また、内側から外側に達するものが最も多く16例であった。踵骨骨嚢腫は内側にも外側にも偏在して存在しており、発生メカニズムとて血行破綻説が考えられた。

  • The evaluation of lumbar paraspinal muscle quantity and quality using the Goutallier classification and lumbar indentation value Reviewed

    Tamai Koji, Chen Jessica, Stone Michael, Arakelyan Anush, Paholpak Permsak, Nakamura Hiroaki, Buser Zorica, Wang Jeffrey C.

    EUROPEAN SPINE JOURNAL   27 ( 5 )   1005 - 1012   2018.05( ISSN:0940-6719

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    DOI: 10.1007/s00586-018-5485-4

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  • 予後不良因子を持つ骨粗鬆症性新鮮椎体骨折に対するBKPの有用性 多施設前向き介入研究(第1報)

    星野 雅俊, 高橋 真治, 安田 宏之, 寺井 秀富, 渡辺 享永, 林 和憲, 辻尾 唯雄, 河野 浩, 鈴木 亨暢, 玉井 孝司, 大山 翔一朗, 豊田 宏光, 笹岡 隆一, 堂園 将, 兼松 文昭, 白 隆光, 高山 和士, 加藤 相勲, 堀 悠介, 中村 博亮

    Journal of Spine Research   9 ( 5 )   959 - 964   2018.05( ISSN:1884-7137

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    予後不良因子(MRI・T2強調画像における高信号あるいは低信号広範)を持つ骨粗鬆症性新鮮椎体骨折に対するBKP早期介入の多施設単群前向き介入試験における中間解析では、BKP早期介入の45例は、同一の予後不良因子を持ち保存治療を受けた患者で性・年齢・骨折高位をマッチさせた45例との比較で、有意にADLの低下を防ぎ、QOLを回復させ、椎体変形を改善した。しかし隣接椎体骨折の発生は高率に認められた。(著者抄録)

  • Can C7 Slope Substitute the T1 slope? Reviewed

    Tamai Koji, Buser Zorica, Paholpak Permsak, Sessumpun Kittipong, Nakamura Hiroaki, Wang Jeffrey C.

    SPINE   43 ( 7 )   520 - 525   2018.04( ISSN:0362-2436

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    DOI: 10.1097/BRS.0000000000002371

    PubMed

  • An unusual presentation of pneumothorax associated with cystic lung metastasis from epithelioid sarcoma: A case report and review of the literature Reviewed

    Hoshi Manabu, Oebisu Naoto, Iwai Tadashi, Ieguchi Makoto, Ban Yoshitaka, Nakamura Hiroaki

    ONCOLOGY LETTERS   15 ( 4 )   4531 - 4534   2018.04( ISSN:1792-1074

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    DOI: 10.3892/ol.2018.7868

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  • 全人工膝関節置換術での関節周囲多剤カクテル療法におけるオピオイドの意義 両側TKA症例での検討

    洲鎌 亮, 小林 章郎, 岡島 良明, 羅 建華, 楊 裕健, 渭川 徹秀, 箕田 行秀, 大田 陽一, 山村 一正, 中村 卓, 上山 秀樹, 中村 博亮

    JOSKAS   43 ( 2 )   426 - 427   2018.04( ISSN:1884-8842

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    両側同時人工膝関節置換術を施行した32症例(平均72.5歳)を対象に、関節周囲多剤カクテル療法におけるオピオイドの局所投与の意義について検討した。片側(モルヒネ側)に塩酸モルヒネ含有薬液を、反対側(コントロール側)には塩酸モルヒネ非含有薬液を無作為に注射した。術後疼痛のVASは(モルヒネ側vsコントロール側)、術後1日目では有意差を認めなかった。しかし、術後2日目、術後5日目、術後10日目はモルヒネ側で有意に低かった。術後疼痛のvisual analog scale(VAS)の経時的変化に関して、統計学的に有意なのは術後2、5、10日目のみであるが、術後10日目までの術後早期においては、モルヒネ側でVASが低い傾向を示していた。患者の自己評価において、モルヒネ側の方がよいと評価した割合はコントロール側の方がよいと評価した割合よりも高かった。

  • 特集 アスリートの脊椎・脊髄障害-病態と早期復帰への工夫 スポーツ選手の腰椎椎間板ヘルニアに対する内視鏡下後方手術

    寺井 秀富, 金田 国一, 大嶺 俊充, 中村 博亮

    脊椎脊髄ジャーナル   31 ( 3 )   239 - 245   2018.03( ISSN:09144412

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  • Predictive factors for osteochondritis dissecans of the lateral femoral condyle concurrent with a discoid lateral meniscus Reviewed

    Takigami Junsei, Hashimoto Yusuke, Tomihara Tomohiro, Yamasaki Shinya, Tamai Koji, Kondo Kyoko, Nakamura Hiroaki

    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY   26 ( 3 )   799 - 805   2018.03( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00167-017-4451-8

    PubMed

  • Validity and Reproducibility of Various Measurement Methods for Craniocervical Sagittal Balance Reviewed

    Tamai Koji, Suzuki Akinobu, Takahashi Shinji, Hoshino Masatoshi, Toyoda Hiromitsu, Hayashi Kazunori, Ohyama Shoichiro, Kishimura Yuichi, Onode Ema, Umano Masayuki, Terai Hidetomi, Nakamura Hiroaki

    CLINICAL SPINE SURGERY   31 ( 2 )   80 - 85   2018.03( ISSN:2380-0186

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BSD.0000000000000617

    PubMed

  • 埋没した指輪による手指絞扼の1例 Embedded ring syndrome

    上村 卓也, 高松 聖仁, 横井 卓哉, 新谷 康介, 斧出 絵麻, 中村 博亮

    中部日本整形外科災害外科学会雑誌   61 ( 2 )   317 - 318   2018.03( ISSN:0008-9443

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    73歳女。20年以上前から左環指に指輪をはめていた。約10年前から体重の増加に伴い指輪が徐々に皮膚に食い込んできた。約1週間前に左手を打撲したのを契機として環指に腫脹・疼痛が出現し、受診した。指輪は指掌側の皮膚に完全に埋没しており、指輪の飾り部分のみが指背側の皮膚上に露出していた。指の血流障害は認めなかったが、知覚低下と痺れを認めた。また、埋没している部分から滲出液を認め、感染を併発していた。X線画像上、指輪は掌側の皮下に存在し、骨への侵食像は認めなかった。これらの所見から、埋没指輪による屈筋腱断裂と指神経損傷および感染の合併と診断し、手術を行った。伝達麻酔下に掌側zigzag切開で展開すると、皮下組織内に指輪が認められた。指輪は基節骨とほぼ接しており、橈尺側の神経血管束が指輪と基節骨の間で強く絞扼されていた。指輪には背側で元々の切れ目があり、容易に左右に開くことができ、背側から指輪を除去した。除去した部分の指神経は狭小化しており、深指屈筋腱は断裂していた。術後、抗生剤の内服を行い、感染は治癒した。術後1年7ヵ月の現在まで感染の再燃は認めておらず、指の痺れは消失している。

  • 造影CTを用いた鏡視下前十字靱帯再建術術後の深部静脈血栓症・肺塞栓症の発生率と危険因子についての検討

    西田 洋平, 橋本 祐介, 中村 博亮

    JOSKAS   43 ( 1 )   148 - 149   2018.03( ISSN:1884-8842

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    膝前十字靱帯(ACL)再建術後に造影CTを用いて静脈血栓塞栓症(VTE)の有無を調査し、その発生率と危険因子について検討した。ACL再建術を施行された症例のうち、20歳以上かつ術後7日目に造影CT検査を施行できた74例(男性47例、女性27例、平均31.9歳)を対象とした。半月板縫合を追加した症例は27例、複合靱帯再建を行った症例は3例であった。VTE発生数は7例9.5%であった。内訳は深部静脈血栓症が4例、肺塞栓症が3例で、全例無症候性であった。VTEの有無で各検討項目を比較したところ、術後Dダイマー値に有意差を認めた。循環器内科医の指示に則り、全例に抗凝固薬の投与を行った。いずれの症例においても抗凝固薬投与よる合併症(出血)はみられなかった。VTE発症の有無でDダイマー値のカットオフ値を求めると、2.90μg/mL(感度0.869、特異度0.833、AUC 0.835)であった。

  • 膝関節鏡手術における深部静脈血栓症・肺塞栓症の発生率 靱帯再建vs半月縫合術vs骨切り併用手術

    西田 洋平, 橋本 祐介, 中村 博亮

    JOSKAS   43 ( 1 )   146 - 147   2018.03( ISSN:1884-8842

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    膝関節鏡術後に造影CTを用いて静脈血栓塞栓症(VTE)の有無を調査し、前十字靱帯(ACL)再建術、半月板縫合術、骨切り併用手術での発生率について比較検討した。膝関節鏡手術を施行された症例のうち、20歳以上かつ術後7日目に造影CT検査を施行できた117例を対象とした。ACL再建術(74例:半月板縫合術併用例27例、内側側副靱帯同時再建術3例)、半月板縫合術(34例)、骨切り併用手術(9例:高位脛骨骨切り術6例、内側膝蓋大腿靱帯再建術+脛骨粗面移行術3例)の3群に分けて評価した。VTE発生数は靱帯再建術群が7例9.5%で、内訳は深部静脈血栓症(DVT)が4例、肺塞栓症(PE)が3例であった。半月板縫合術群が1例(2.9%:DVT1例)、骨切り併用術群が2例(22.2%:DVT1例、PE1例)に認め、全体では117例中10例(8.5%)であった。術式間の比較ではVTE発生率に有意差は認めなかった。VTEを生じた症例では、高年齢と術後7日目のDダイマーの高値がみられた。

  • 非アスリート前十字靱帯損傷患者における再建術後不安定症例の特徴

    山崎 真哉, 橋本 祐介, 西田 洋平, 池田 樹広, 新熊 孝文, 寺岡 貴徳, 寺井 彰三郎, 瀧上 順誠, 中村 博亮

    JOSKAS   43 ( 1 )   164 - 165   2018.03( ISSN:1884-8842

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    ハムストリング腱を用いた解剖学的2重束膝前十字靱帯(ACL)再建術症例のうち、術後1年以上経過観察可能で、かつ活動度の指標として用いたTegner activity scale 6以下の87例(男性45例、女性42例、平均25.8歳)を対象に、再建術後の不安定症例の特徴について検討した。術後1年の経過観察時に膝前方動揺性をKT2000で計測し、健患差3mm以上を不安定群、3mm未満を安定群と定義した。その結果、不安定群は13例で平均KT値健患差は3.7mm、安定群は74例で平均KT値健患差は0.7mmであった。両群間ともに平均骨孔径は前内側線維束5.5mm、後外側線維束5.5mmと同じであった。ロジスティック回帰分析では、両群間に有意差を認めた項目としては再再建症例、過伸展膝が不安定群に有意に多い結果となった。しかし、Lysholm scoreは不安定群術後1年時96、最終観察時96、安走群術後1年時94、最終観察時95と有意差を認めなかった。活動度の比較的低い非アスリートにおけるACL再建においても、再再建症例、過伸展膝症例では術後不安定性を生じる危険性があることが示されたが、明らかな自覚症状は生じなかった。

  • 経静脈的自己調節鎮痛法を用いた前十字靱帯再建術と半月板縫合術後の疼痛比較

    金 裕学, 西田 洋平, 橋本 祐介, 中村 博亮

    JOSKAS   43 ( 1 )   150 - 151   2018.03( ISSN:1884-8842

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    鏡視下膝前十字靱帯(ACL)再建術と鏡視下半月板縫合術において、経静脈的自己調節鎮痛法(IV-PCA)による術翌日迄の鎮痛効果を比較検討した。当院で鏡視下ACL再建術あるいは鏡視下半月板縫合術を施行したうち、術後鎮痛にIV-PCAを用い、術後2週間の経時的な疼痛NRS(numerical rating scale)を記録し得た107例107膝を対象とした。ACL再建術後は半月板縫合術後に比べ、術後18時間の時点で有意にNRSが高値となった。その他の時期に有意差は認めず、追加の鎮痛薬使用の有無については、塩酸ペンタゾシンが術当日(ACL2例、半月2例)、術翌日(ACL2例、半月0例)、ジクロフェナクNaは術当日(ACL19例、半月11例)、術翌日(ACL17例、半月6例)、術後2日目以降もいずれも有意差は認めず、術後8日目以降では鎮痛薬使用者はいなかった。また、IV-PCAの投与中止には至らなかったが7例に嘔気の訴えがあった。

  • 橈骨動脈穿通枝脂肪弁による正中神経のラッピング

    上村 卓也, 高松 聖仁, 岡田 充弘, 横井 卓哉, 新谷 康介, 斧出 絵麻, 中村 博亮

    日本マイクロサージャリー学会会誌   31 ( 1 )   8 - 12   2018.03( ISSN:0916-4936

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    過去に外傷や手根管開放術の初回手術を受けたが、その術後に正中神経障害が遷延または再発したため追加手術を施行した7例(男性4例、女性3例、42〜89歳)を対象とした。初回手術の内訳は、正中神経縫合3例、骨接合術(橈骨遠位端骨折)1例、手根管開放術3例であった。初回から追加手術までは平均21ヵ月であった。橈骨動脈穿通枝脂肪弁の大きさは平均1093(750〜1800)mm2で、正中神経のラッピングは十分に可能であった。疼痛VASは平均8.5→1.0に改善し、全例で手関節掌側のTinel様徴候は消失した。Quick DASHは平均47→19点、Hand 20は平均58→32点にそれぞれ改善した。術前にAPB-CMAPが導出不能であった3例は術後に導出可能となり、導出不能例をのぞいた遠位潜時は平均8.0→4.0msに改善した。合併症は、手関節掌側のわずかな色素沈着1例と表層感染1例を認めたが、いずれも保存的加療で改善した。

  • 上肢手術における静脈内区域麻酔法の有効性の検討

    信貴 政人, 岡田 充弘, 斧出 絵麻, 上村 卓也, 横井 卓哉, 中村 博亮

    日本手外科学会雑誌   34 ( 5 )   907 - 909   2018.02( ISSN:2185-4092

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    局所麻酔薬投与による合併症低減を目的に,リドカイン使用量を抑えて静脈内区域麻酔下に手術を施行した.静脈内区域麻酔下に外来手術で上肢手術を施行した25例を対象とした.麻酔薬は静脈内注射用2%リドカイン2mg/kgに生理食塩水を加え合計20mlとしたものを使用した.リドカイン使用量は平均123.2mgであり諸家の報告と比し低用量であった.術野の疼痛は認めず,ターニケットペインは平均VAS score 1.1cmであり,薬剤の追加投与を要さず手術可能であった.駆血解除後の副作用は認めず,全例で速やかに独歩での退室が可能であった.低濃度リドカインによる静脈内区域麻酔を使用した本法は上肢の外来手術において有用であり,かつ合併症を認めなかった.(著者抄録)

  • Effect of eldecalcitol on articular cartilage through the regulation of transcription factor Erg in a murine model of knee osteoarthritis. Reviewed

    Kazumasa Yamamura, Yoichi Ohta, Kenji Mamoto, Ryo Sugama, Yukihide Minoda, Hiroaki Nakamura

    Biochemical and biophysical research communications   495 ( 1 )   179 - 184   2018.01( ISSN:0006-291X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Clinical studies have reported an association between low blood levels of 25-hydroxyvitamin D and the progression of osteoarthritis (OA), but the mechanism and effects of vitamin D signaling on articular chondrocytes and cartilage remains unclear. The purpose of this study was to investigate the effects of vitamin D on articular cartilage degeneration using eldecalcitol (ED-71), which is an active vitamin D3 analog. Eight-week old male C57BL/6NCrSlc mice were subjected to experimental surgery to induce OA and local treatments with 10 μL ED-71 (0.5 μg/mL) were administered weekly. Four and 12 weeks after surgery, joints were evaluated using histological scoring systems. In addition, gene expression was analyzed in chondrocytes that were isolated from wildtype neonatal mice, cultured, and treated with ED-71 (10-8 M). Joints treated with ED-71 demonstrated slowed progression of OA at 4 weeks after surgery, but few effects were observed at 12 weeks after surgery. Ets-related gene (Erg) expression was upregulated in OA articular cartilage, and further increased by ED-71 treatment. In primary chondrocytes cultured with ED-71, the gene expression of Erg and lubricin/proteoglycan 4 significantly increased, as compared to that of cells cultured without ED-71. Local treatment with ED-71 reduced degenerative changes to the articular cartilage during the early phase of experimental OA. Regulation of Erg by ED-71 in articular cartilage could confer resistance to early osteoarthritic changes.

    DOI: 10.1016/j.bbrc.2017.10.155

    PubMed

  • Differences in short-term clinical and radiological outcomes depending on timing of balloon kyphoplasty for painful osteoporotic vertebral fracture. Reviewed

    Takahashi S, Hoshino M, Terai H, Toyoda H, Suzuki A, Tamai K, Watanabe K, Tsujio T, Yasuda H, Kono H, Sasaoka R, Dohzono S, Hayashi K, Ohyama S, Hori Y, Nakamura H

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   23 ( 1 )   51 - 56   2018.01( ISSN:0949-2658

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    BACKGROUND: Balloon kyphoplasty or vertebroplasty is widely performed as a surgical intervention for osteoporotic vertebral fracture (OVF) and the effects have been investigated in many previous studies. However, the influence of the timing of the procedure on patient outcomes has not been studied formally. The purpose of this study was to investigate differences in the surgical outcomes of OVFs according to the timing of balloon kyphoplasty. METHODS: This was a multicenter cohort study. Participants comprised 72 consecutive patients who underwent balloon kyphoplasty between January 2012 and January 2016. Patients were analyzed in two groups according to the timing of kyphoplasty after onset (Early group: ≤2 months; Late group: >2 months). Follow-up continued for more than 6 months. RESULTS: A total of 72 patients were effectively analyzed. Of these, 27 (38%) patients underwent kyphoplasty within 2 months after symptom onset. The Late group showed greater angular motion of fractured vertebrae (p = 0.005) and compression of anterior vertebral height (p = 0.001) before surgery. Final outcomes adjusted for age and preoperative outcome showed lower visual analog scale (VAS) scores for low back pain in the Early group than in the Late group (19.9 vs. 30.4, p = 0.049). Final relative anterior vertebral height and kyphotic angle were more preserved in the Early group than in the Late group (p = 0.002 and p = 0.020, respectively), although absolute differences were not significant. CONCLUSIONS: Vertebral height and kyphotic angle before and after balloon kyphoplasty were greater in patients who underwent kyphoplasty within 2 months after onset, and the VAS score for low back pain at final follow-up was better. Our results support kyphoplasty within 2 months.

    DOI: 10.1016/j.jos.2017.09.019

    PubMed

  • Minodronic acid induces morphological changes in osteoclasts at bone resorption sites and reaches a level required for antagonism of purinergic P2X2/3 receptors. Reviewed

    Tanaka M, Hosoya A, Mori H, Kayasuga R, Nakamura H, Ozawa H

    Journal of bone and mineral metabolism   36 ( 1 )   54 - 63   2018.01( ISSN:0914-8779

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    DOI: 10.1007/s00774-017-0814-y

    PubMed

  • The primary diagnosis and the coexisting anxiety disorders have no impact on the additional surgical procedure after spinal cord stimulators implantation: An analysis of 11,029 patients Reviewed

    Tamai Koji, Buser Zorica, Wang Christopher, Paholpak Permsak, Nakamura Hiroaki, Wang Jeffrey C., Hsieh Patrick C.

    JOURNAL OF CLINICAL NEUROSCIENCE   47   208 - 213   2018.01( ISSN:0967-5868

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    DOI: 10.1016/j.jocn.2017.10.016

    PubMed

  • 有痛性骨粗鬆症性椎体骨折に対するバルーン後彎形成術の時期に応じた短期臨床的および放射線学的転帰の差(Differences in short-term clinical and radiological outcomes depending on timing of balloon kyphoplasty for painful osteoporotic vertebral fracture) Reviewed

    Takahashi Shinji, Hoshino Masatoshi, Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Tamai Koji, Watanabe Kyoei, Tsujio Tadao, Yasuda Hiroyuki, Kono Hiroshi, Sasaoka Ryuichi, Dohzono Sho, Hayashi Kazunori, Ohyama Shoichiro, Hori Yusuke, Nakamura Hiroaki

    (公社)日本整形外科学会 Journal of Orthopaedic Science   23 ( 1 )   51 - 56   2018.01( ISSN:0949-2658

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    2012年1月-2016年1月にバルーン後彎形成術を受けた連続患者72例を対象とした多施設共同コホート研究を行った。患者を有痛性骨粗鬆症性椎体骨折(OVF)発症後の後彎形成術時期に応じた2群(早期群(2ヵ月以内):女性19名、男性8名、平均年齢79.9歳、晩期群(2ヵ月より後):女性31名、男性14名、平均年齢77.9歳)に分けて解析した。6ヵ月超継続して追跡した。晩期群では術前の骨折椎体の角運動と前方椎体高の圧迫が大きかった。年齢および術前転帰について調整した最終転帰では、早期群で晩期群よりも腰痛の視覚的アナログ尺度(VAS)スコアが低くなった。最終の相対前方椎体高および後彎角は、早期群で晩期群よりも大きく維持されたが、絶対差は有意ではなかった。

  • インドシアニングリーン蛍光法を用いた末梢神経絞扼性障害における末梢神経微小血管の描出

    横井 卓哉, 岡田 充弘, 斧出 絵麻, 上村 卓也, 新谷 康介, 中村 博亮

    日本手外科学会雑誌   34 ( 4 )   536 - 539   2018.01( ISSN:2185-4092

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    現在,脳神経外科等で,術中にインドシアニングリーン(ICG)蛍光法を用いて血流や血行動態の評価が行われ,その有効性が報告されている.本研究では,ICG蛍光法で末梢神経の微小血管の描出形態と術前電気生理学的検査との関連を検討した.末梢神経絞扼部の微小血管の描出形態は,術前重症度を反映している可能性が示唆された.(著者抄録)

  • 血管柄付肩甲骨による上腕骨近位部再建

    家口 尚, 星 学, 大戎 直人, 高松 聖仁, 中村 博亮

    中部日本整形外科災害外科学会雑誌   61 ( 1 )   83 - 84   2018.01( ISSN:0008-9443

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    血管柄付肩甲骨による上腕骨近位部再建を施行した1例を報告した。症例は14歳時に上腕骨近位の通常型骨肉腫に罹患した。Stage IIBであったため、術前術後の抗癌剤治療と放射線処理骨による再建を施行、術後半年で骨接合部の癒合が得られた。ところが約1年間の治療終了直後に、左大腿骨骨幹部遠位1/4に新たな病変が発生したため、再度治療を開始、同部位も処理骨による再建を行った。さらに約10年の経過で徐々に処理骨の骨吸収と骨頭の前方亜脱臼のため皮膚の菲薄化をきたしていたが、特に問題なく経過していた。しかし、患者自身が人工骨頭による皮膚の穿破を危惧して外来受診となった。肩甲骨の外側縁を用いたangular branchを利用した血管柄付き肩甲骨移植による上腕骨近位部再建を計画した。術後経過は良好で術後2週間で退院となった。術後1ヵ月後の造影CTで移植骨の血流を確認した。

  • 頸椎症性神経根症に対する装具12時間法の有用性

    岩前 真由, 加藤 相勲, 並川 崇, 松村 昭, 日高 典昭, 中村 博亮

    中部日本整形外科災害外科学会雑誌   61 ( 1 )   185 - 186   2018.01( ISSN:0008-9443

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    頸椎症性神経根症(CSR)に対し装具12時間法で加療した47例(男性33例、女性14例、平均年齢55歳)の臨床成績を調査し、その有効性について検討した。装具装着率は12時間装着が79%、夜間のみ装着が13%、装着なしが0%で、装具装着率は100%、装着平均時間は10.7時間であった。上肢症状の改善率は全47例で平均74%、初発例で平均80%、保存加療抵抗例で平均70%であった。有効率は全47例中43例が有効で有効率は91%、初発例は26例中24例が有効で有効率は92%、保存加療抵抗例は21例中19例が有効で有効率は90%であった。手術回避率は全例で93.6%、初発例で92%、保存加療抵抗例で95%であった。CSRに対する治療法として、簡便さやコンプライアンスの面からも装具12時間法は有用と考えられた。

  • ペグフィルグラスチムの投与にてFDG-PETでの骨転移評価が困難となった悪性末梢神経鞘腫瘍の1例

    高田 尚輝, 星 学, 嶋谷 彰芳, 岩井 正, 大戎 直人, 中村 博亮

    中部日本整形外科災害外科学会雑誌   61 ( 1 )   87 - 88   2018.01( ISSN:0008-9443

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    症例は37歳男性で、初診時の約1ヵ月前から背部腫瘤を自覚しており、前医のMRI検査にて悪性腫瘍が疑われたために当院紹介受診された。針生検術で円形細胞肉腫と診断し、術前化学療法(vincristine+doxorubicin+cyclophosphamide)を行ったが、腫瘍の縮小がみられなかったために、初診時より3ヵ月後に腫瘍切除術および胸椎後方固定術を施行した。切除標本の病理診断は悪性末梢神経鞘腫瘍であった。術後化学療法としてdoxorubicin 1コースとdoxorubicin+ifosfamide 3コースを行った。最終コース治療後に骨髄抑制が予測されたために、Day15にペグフィルグラスチム3.6mgの皮下注射を行った。その後に全身検索目的にFDG-PET検査を施行したが、ペグフィルグラスチム投与後3日目であり、全身骨にび漫性かつ均等に集積亢進が認められ、骨転移の評価が困難であった。

  • A case report; Administration of pegfilgrastim interfered detecting metastasis of malignant peripheral nerve sheath tumor on FDG-PET Reviewed

    TAKADA Naoki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 1 )   87 - 88   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.87

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  • Two revision surgeries of tumor endprosthesis for the distal femur Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 4 )   829 - 830   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.829

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  • Pedicled vascularized scapular bone grafting for the proximal humerus Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 1 )   83 - 84   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.83

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  • Radial Artery Perforator Adipose Flap for Coverage of the Neurolysed Median Nerve Reviewed

    UEMURA Takuya, TAKAMATSU Kiyohito, OKADA Mitsuhiro, YOKOI Takuya, SHINTANI Kosuke, ONODE Ema, NAKAMURA Hiroaki

    Japanese Society of Reconstructive Microsurgery, Journal of Japanese Society of Reconstructive Microsurgery   31 ( 1 )   8 - 12   2018( ISSN:0916-4936 ( eISSN:21859949

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    Adhesion neuropathy of the median nerve with persistent wrist pain can be challenging. In the present study, we introduced a novel method using a radial artery perforator (RAP) adipose flap for coverage of the neurolysed median nerve to minimize reformation of scar adhesion. Seven patients who had previously undergone median nerve surgeries, repair of a median nerve laceration or primary open carpal tunnel release were included. As all patients had substantial median nerve hypersensitivity, secondary neurolysis and coverage with the RAP adipose flap were performed. The average follow-up was 15 months (range 6-28 months). The RAP adipose flap size ranged from 750 to 1,800 mm&sup2; (average 1,093 mm&sup2;), and was sufficient to cover the exposed median nerve. After surgery, the positive Tinel sign at the wrist disappeared in all patients and the mean visual analogue pain scale score decreased. Furthermore, the average scores for the Quick DASH and Hand 20 improved postoperatively. The results of interposing the RAP adipose flap between dysesthetic volar wrist skin and the neurolysed median nerve were positive in terms of both pain relief and restoration of hand function.

    DOI: 10.11270/jjsrm.31.8

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  • An examination for thermal sense and temperature related to soft tissue tumors Reviewed

    SHIMATANI Akiyoshi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 6 )   1229 - 1230   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.1229

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  • Mazabraud syndrome with osteoarthritis of knee: A case report Reviewed

    OEBISU Naoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 5 )   971 - 972   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.971

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  • Embedded ring syndrome: A case report Reviewed

    UEMURA Takuya

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 2 )   317 - 318   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.317

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  • Basic Study on Tomographic Micro-Visualizing Mechanical Properties renceof Osteoarthritic Cartilage Reviewed

    SAEKI SOUICHI, FURUKAWA DAISUKE, NAKAMURA SUGURU, IKEBUCHI MITSUHIKO, NAKAMURA HIROAKI, NIIMI NOBUO, TSUKAHARA YOSHITO

    Japanese Society for Medical and Biological Engineering, Transactions of Japanese Society for Medical and Biological Engineering   56 ( 0 )   S20 - S20   2018( ISSN:1347-443X ( eISSN:18814379

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    <p>Many of the elderly are predisposed to develop osteoarthritis (OA), although it is quite difficult to diagnose the early-grade OA even by latest imaging modalities. The purpose of this study is to verify the diagnostic potential of early OA using D-OCSA, which is a visualizing method of the mechanical properties of cartilage from OCT images. ex vivo animal experiments applying D-OCSA were carried out using rabbit's OA cartilage caused by amputation of the rabbit's knee ACL. D-OCSA can show the attenuation coefficient distribution of compressive strain rate during stress relaxation, which can observe further increase in attenuation only for early OA cartilage. Therefore, it can be seen that there occurs a loss of visco-elastic properties as compared to normal cartilage. In summary, D-OCSA system could be effective to assessments of the early OA as "Micro Mechanical Biopsy"</p>

    DOI: 10.11239/jsmbe.Annual56.S20

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  • 人工臓器:ハイブリッド型人工神経による末梢神経再生と癒着予防材料への応用 Reviewed

    横井 卓哉, 上村 卓也, 高松 聖仁, 中村 博亮

    一般社団法人 日本人工臓器学会 人工臓器   47 ( 3 )   185 - 188   2018( ISSN:0300-0818 ( eISSN:18836097

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    DOI: 10.11392/jsao.47.185

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  • Treatment of painful amputation neuroma by nerve capping with nerve conduit: a case report Reviewed

    UEMURA Takuya

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 4 )   875 - 876   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.875

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  • リバース型人工肩関節置換術後の臨床成績評価<BR>-患者立脚型評価と医師主導型評価の違いから- Reviewed

    平川 義弘, 間中 智哉, 伊藤 陽一, 市川 耕一, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   42 ( 2 )   559 - 562   2018( ISSN:0910-4461 ( eISSN:18816363

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    目的はリバース型人工肩関節置換術(以下,RSA)の術前術後経過をShoulder36(以下,Sh36)とJOA scoreを用いて評価し,その関連性を検討する事である.対象はRSAを施行した33例34肩(男9例,女24例)である.手術時平均年齢は77歳(70歳~90歳)であった.術前,術後6カ月,術後12カ月にSh36及びJOA scoreを評価した.各スコアの経時的な改善を評価し,各時期のJOA scoreとSh36ドメインの一致する各項目の相関関係を統計学的に評価した.JOA score,Sh36の全項目は術前から術後6カ月,1年で有意に改善した.JOA scoreの各項目とSh36の各ドメインの相関関係は評価時期により異なる事が示唆された.

    DOI: 10.11296/katakansetsu.42.559

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  • リバース型人工肩関節置換術における各機種間の側方及び<BR>下方オフセットの比較検討 Reviewed

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   42 ( 2 )   563 - 566   2018( ISSN:0910-4461 ( eISSN:18816363

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    様々な特徴のあるリバース型人工肩関節置換術(以下,RSA)が導入されており,インプラントデザインは機種ごとに異なるため,術後獲得されるオフセットも様々である.本研究の目的は,5機種のRSAの側方オフセット及び下方オフセットを比較検討する事である.対象は45肩.使用機種はAequalis reverse(以下,AR),SMR reverse(以下,SMR),DELTA XTEND(以下,DX),Aequalis Ascend Flex(以下,AAF),Comprehensive reverse(以下,CR)であった.術後肩関節正面のX線を用いて側方と下方のオフセットを計測した.平均側方オフセットはAAF,CRがそれぞれAR,SMR,DXと有意差を認めた.平均下方オフセットは各機種間に有意差を認めなかった.AAFとCRで側方オフセットが有意に大きく,三角筋のモメントアームや関節への圧迫力の増大が期待された.

    DOI: 10.11296/katakansetsu.42.563

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  • Surgical Treatment of a Patient with Prolonged Exacerbation of Hirayama Disease Reviewed

    Dohzono Sho, Toyoda Hiromitsu, Tamura Akiko, Hayashi Kazunori, Terai Hidetomi, Nakamura Hiroaki

    Spine Surgery and Related Research   3 ( 1 )   95 - 97   2018( eISSN:2432261X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    DOI: 10.22603/ssrr.2018-0037

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  • Non-surgical treatment with a collar wearing 12 hours per day method for cervical radiculopathy Reviewed

    IWAMAE Masayoshi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 1 )   185 - 186   2018( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2018.185

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  • A case report; effective administration of pazopanib for a patient with advanced malignant peripheral nerve sheath tumor as palliative chemotherapy Reviewed

    TAKADA Naoki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 5 )   1031 - 1032   2018( ISSN:0008-9443 ( eISSN:13490885

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.11359/chubu.2018.1031

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  • Anatomical analysis of pathogenesis for calcaneal bone cyst Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   61 ( 3 )   477 - 478   2018( ISSN:0008-9443 ( eISSN:13490885

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.11359/chubu.2018.477

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  • インドシアニングリーン蛍光法を用いた末梢神経絞扼性障害における末梢神経微小血管の描出 Reviewed

    横井 卓哉, 岡田 充弘, 斧出 絵麻, 上村 卓也, 新谷 康介, 中村 博亮

    日本手外科学会雑誌   34   536 - 539   2018

  • 橈骨動脈穿通枝脂肪弁による正中神経ラッピング Reviewed

    上村 卓也, 高松 聖仁, 岡田 充弘, 横井 卓哉, 新谷 康介, 斧出 絵麻, 中村 博亮

    日本マイクロサージャリー学会会誌   31   8 - 12   2018

  • 人工神経(リナーブ)によるnerve cappingで治療した有痛性断端神経腫の1例 Reviewed

    上村 卓也, 斧出 絵麻, 横井 卓哉, 新谷 康介, 中村 博亮

    中部日本整形外科災害外科学会雑誌   31   875 - 876   2018

  • 中空型生体吸収性人工神経による末梢神経の癒着防止効果 Reviewed

    新谷 康介, 上村 卓也, 高松 聖仁, 横井 卓哉, 岡田 充弘, 中村 博亮

    日本手外科学会雑誌   35   1 - 5   2018

  • ハイブリッド型人工神経による末梢神経再生と癒着予防材料への応用 Reviewed

    横井 卓哉, 上村 卓也, 高松 聖仁, 中村 博亮

    人工臓器   47   185 - 188   2018

  • Understanding Conditionals in the East: A Replication Study of With Easterners.

    Nakamura H, Shao J, Baratgin J, Over DE, Takahashi T, Yama H

    Frontiers in psychology   9   505   2018( ISSN:1664-1078

  • Difference of clinical course between cases with bone union and those with delayed union following osteoporotic vertebral fractures. Reviewed

    Yasuda H, Hoshino M, Tsujio T, Terai H, Namikawa T, Kato M, Matsumura A, Suzuki A, Takayama K, Takahashi S, Nakamura H

    Archives of osteoporosis   13 ( 1 )   3 - 3   2017.12( ISSN:1862-3522

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    In this prospective multicenter study of osteoporotic vertebral fractures (OVFs), delayed union of OVF at 6-month follow-up caused prolonged pain, QOL impairment, ADL impairment, cognitive status deterioration, and vertebral collapse progression. PURPOSE: Delayed union following osteoporotic vertebral fracture displayed as an intravertebral cleft on plain X-rays was reported to be a factor for prolonged severe pain. However, the difference of clinical course between bone union and delayed union cases still remains unclear. The purpose of this study was to identify how OVF delayed union following conventional conservative treatment influences the clinical course with a prospective multicenter study. METHODS: A total of 324 OVF patients from 25 institutes in Osaka, Japan, were included in the study. At the 6-month follow-up after initial visit to each institute, the patients were classified into bone union and delayed union groups based on plain X-ray findings. The outcome assessments included a VAS for back pain, SF-36 for quality of life (QOL), severity of bed-ridden state for activities of daily living (ADL), MMSE for cognitive functions, and degree of vertebral collapse on plain X-rays. RESULTS: Overall, 280 patients were included into the union group and 44 into the delayed union group. The VAS score at 6 months was significantly worse in the delayed union group (p = 0.01). The scores for the SF-36 scales of physical functioning and bodily pain at 6 months were significantly lower in the delayed union group (p = 0.019, p = 0.01, respectively). The percentage of nearly or completely bed-ridden patients was significantly higher in the delayed union group. The percentage of newly developed cognitive impairment was significantly higher in the delayed union group (p = 0.02). Progression of vertebral collapse during the 6-month follow-up was more pronounced in the delayed union group (p < 0.01). CONCLUSION: The present results revealed that delayed union following OVF causes prolonged pain, QOL impairment, ADL impairment, cognitive status deterioration, and vertebral collapse progression.

    DOI: 10.1007/s11657-017-0411-7

    PubMed

  • 慢性腰痛のサイエンス 高齢者の腰痛 腰痛と骨粗鬆症性椎体骨折

    豊田 宏光, 星野 雅俊, 高橋 真治, 辻尾 唯雄, 中村 博亮

    臨床整形外科   52 ( 12 )   1153 - 1158   2017.12( ISSN:05570433 ( eISSN:18821286

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    当教室で行った骨粗鬆症性椎体骨折に対する多施設研究の結果について概説する.1回目の研究から,約80%は予後良好であるが,骨癒合不全に至ると臨床上の問題が増え,予後不良例の予測においては,装具や入院などの治療的介入よりも,後壁損傷を認めること,T2強調画像の特徴的な所見,運動習慣のないことなどの要因が重要であることが判明した.2回目の研究からは,MRIでの骨折部の信号変化は長期にわたり残存すること,椎体骨折後の腰痛の推移には4つのパターンがあり,骨折部の安定化が疼痛緩和に寄与することが判明した.(著者抄録)

    DOI: 10.11477/mf.1408200975

    Other URL: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01554&link_issn=&doc_id=20171214110008&doc_link_id=10.11477%2Fmf.1408200975&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1408200975&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

  • Local Efficacy of Periarticular Morphine Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Trial Reviewed

    Iwakiri Kentaro, Ohta Yoichi, Kobayashi Akio, Minoda Yukihide, Nakamura Hiroaki

    JOURNAL OF ARTHROPLASTY   32 ( 12 )   3637 - 3642   2017.12( ISSN:0883-5403

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.arth.2017.07.020

    PubMed

  • Efficacy of a Pelvic Lateral Positioner With a Mechanical Cup Navigator Based on the Anatomical Pelvic Plane in Total Hip Arthroplasty Reviewed

    Iwakiri Kentaro, Kobayashi Akio, Ohta Yoichi, Minoda Yukihide, Takaoka Kunio, Nakamura Hiroaki

    JOURNAL OF ARTHROPLASTY   32 ( 12 )   3659 - 3664   2017.12( ISSN:0883-5403

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.arth.2017.06.033

    PubMed

  • 書評 脊椎内視鏡下手術[Web動画付]

    中村 博亮

    臨床整形外科   52 ( 11 )   1106 - 1106   2017.11( ISSN:05570433 ( eISSN:18821286

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  • Waterless Hand Rub Versus Traditional Hand Scrub Methods for Preventing the Surgical Site Infection in Orthopedic Surgery Reviewed

    Iwakiri Kentaro, Kobayashi Akio, Seki Masahiko, Ando Yoshiyuki, Tsujio Tadao, Hoshino Masatoshi, Nakamura Hiroaki

    SPINE   42 ( 22 )   1675 - 1679   2017.11( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BRS.0000000000002200

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  • Anatomical analysis of human ligamentum flavum in the cervical spine: Special consideration to the attachments, coverage, and lateral extent Reviewed

    Rahmani Mohammad Suhrab, Terai Hidetomi, Akhgar Javid, Suzuki Akinobu, Toyoda Hiromitsu, Hoshino Masatoshi, Tamai Koji, Ahmadi Sayed Abdullah, Hayashi Kazunori, Takahashi Shinji, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   22 ( 6 )   994 - 1000   2017.11( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.jos.2017.07.008

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  • Restrictions of cervical flexion after laminoplasty increase in the mechanical stress at the occipitocervical junction in non-rheumatoid arthritis patients Reviewed

    Dohzono Sho, Toyoda Hiromitsu, Takahashi Shinji, Suzuki Akinobu, Terai Hidetomi, Nakamura Hiroaki

    JOURNAL OF CLINICAL NEUROSCIENCE   45   187 - 192   2017.11( ISSN:0967-5868

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.jocn.2017.06.001

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  • ヒト頸椎黄色靱帯の解剖学的解析 付着、被覆、横方向の広がりに関する特記事項(Anatomical analysis of human ligamentum flavum in the cervical spine: Special consideration to the attachments, coverage, and lateral extent) Reviewed

    Rahmani Mohammad Suhrab, Terai Hidetomi, Akhgar Javid, Suzuki Akinobu, Toyoda Hiromitsu, Hoshino Masatoshi, Tamai Koji, Ahmadi Sayed Abdullah, Hayashi Kazunori, Takahashi Shinji, Nakamura Hiroaki

    (公社)日本整形外科学会 Journal of Orthopaedic Science   22 ( 6 )   994 - 1000   2017.11( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    ヒト頸椎黄色靱帯(LF)の寸法、付着部、被覆範囲、LFと神経孔または椎間関節との関連性を検討した。ホルマリン固定死体15体(男性7体、女性8体、平均死亡時年齢83歳)から全脊柱を一塊として摘出し、椎弓根基部で2つに切離した。C2-C3〜C7-T1のLF90本を背側から測定した後、鉄材含有造影剤を塗布してCT撮影を行った。CT画像データから3次元CT画像を構築し、腰椎後方視認時の黄色靱帯の位置や、黄色靱帯と椎弓峡部、椎間間隙との正確な位置関係を計測した。LF高はC2-C3からC7-T1にかけて次第に長くなり、各レベルで内側部から外側部にかけて次第に縮小していた。LF幅およびLF厚は、頭側端から尾側端まで比較的一定であった。頸椎椎間関節の頭側端は平均4.6±0.7mmのLFで被覆されていたが、頸椎神経孔へのLFの進入はみられなかった。

  • 胸椎特発性側彎症における選択的胸椎固定術後distal adding-onの検討

    並川 崇, 松村 昭, 加藤 相勲, 藪 晋人, 尾崎 友則, 堀 悠介, 中村 博亮

    Journal of Spine Research   8 ( 11 )   1730 - 1734   2017.11( ISSN:1884-7137

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    選択的胸椎固定を施行したLenke 1,2 AIS 46例におけるdistal adding-on(DAO)について調査した。DAOは12例(26%)発生した。Lowest instrumented vertebra(LIV)-EVがDAO(-)で+1.1、DAO(+)で+0.4、LIV-stable vertebra(SV)が各々-0.6、-1.7であり、統計学的有意差があった。即ち、DAO(+)群はLIVがより近位にあった。DAO発生防止には適切なLIV選択が必要である。(著者抄録)

  • 除脂肪体重減少は関節リウマチ患者における低骨密度に影響を及ぼす TOMORROW研究の結果(Loss of lean body mass affects low bone mineral density in patients with rheumatoid arthritis: results from the TOMORROW study)

    Okano Tadashi, Inui Kentaro, Tada Masihiro, Sugioka Yuko, Mamoto Kenji, Wakitani Shigeyuki, Koike Tatsuya, Nakamura Hiroaki

    Modern Rheumatology   27 ( 6 )   946 - 952   2017.11( ISSN:1439-7595

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    関節リウマチ(RA)患者における骨粗鬆症の危険因子を特定するため、除脂肪体重減少と骨密度低下との関連を調べた。RA患者208例(女性85%、平均58.4±12.89歳)と、年齢・性別を一致させた健康対照205例(女性84%、平均57.4±13.1歳)の臨床データ、骨密度、骨代謝マーカー(BMM)、除脂肪体重などのデータを収集した。RA患者は除脂肪体重が有意に低く、体脂肪率が有意に高かった。RA患者は骨密度が有意に低く、BMMが有意に高かった。骨密度は除脂肪体重と正に相関し、体脂肪率と負に相関した。多変量統計解析では、骨密度に対して除脂肪体重は正の、罹患期間は負の独立因子であった。RA患者において、除脂肪体重は骨密度と正に相関し、除脂肪体重減少と罹患期間は骨密度低下に影響を及ぼした。

  • Mechanical stress induces elastic fibre disruption and cartilage matrix increase in ligamentum flavum Reviewed

    Hayashi Kazunori, Suzuki Akinobu, Ahmadi Sayed Abdullah, Terai Hidetomi, Yamada Kentaro, Hoshino Masatoshi, Toyoda Hiromitsu, Takahashi Shinji, Tamai Koji, Ohyama Shoichiro, Javid Akgar, Rahmani Mohammad Suhrab, Hasib Maruf Mohammad, Nakamura Hiroaki

    SCIENTIFIC REPORTS   7 ( 1 )   13092   2017.10( ISSN:2045-2322

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1038/s41598-017-13360-w

    PubMed

  • 特集 高齢者(75歳以上)の運動器変性疾患に対する治療 脊椎の変性疾患に対する高齢者治療 頸椎変性疾患 高齢者のmidcervical central cord syndromeに対する頸椎前方固定術

    寺井 秀富, 玉井 孝司, 中村 博亮

    別冊整形外科   1 ( 72 )   78 - 84   2017.10( ISSN:02871645

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  • 特集 高齢者脊椎疾患の診断・治療の最近の進歩 骨粗鬆症性 骨粗鬆症性椎体骨折(OVF)における遷延治癒・偽関節のリスク因子

    高橋 真治, 星野 雅俊, 中村 博亮

    関節外科   36 ( 14 )   98 - 104   2017.10( ISSN:02865394

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  • 80歳以上の患者における頸部手術に関連した合併症の危険因子(Risk factors of cervical surgery related complications in patients older than 80 years) Reviewed

    Tamai Koji, Terai Hidetomi, Suzuki Akinobu, Nakamura Hiroaki, Yamashita Masaomi, Eguchi Yawara, Imagama Shiro, Ando Kei, Kobayashi Kazuyoshi, Matsumoto Morio, Ishii Ken, Hikata Tomohiro, Seki Shoji, Aramomi Masaaki, Ishikawa Tetsuhiro, Kimura Atsushi, Inoue Hirokazu, Inoue Gen, Miyagi Masayuki, Saito Wataru, Yamada Kei, Hongo Michio, Endo Kenji, Suzuki Hidekazu, Nakano Atsushi, Watanabe Kazuyuki, Ohya Junichi, Chikuda Hirotaka, Aoki Yasuchika, Shimizu Masayuki, Futatsugi Toshimasa, Mukaiyama Keijiro, Hasegawa Masaichi, Kiyasu Katsuhito, Iizuka Haku, Nishida Kotaro, Kakutani Kenichiro, Nakajima Hideaki, Murakami Hideki, Demura Satoru, Kato Satoshi, Yoshioka Katsuhito, Namikawa Takashi, Watanabe Kei, Nakanishi Kazuyoshi, Nakagawa Yukihiro, Yoshimoto Mitsunori, Fujiwara Hiroyasu, Nishida Norihiro, Sakane Masataka, Yamazaki Masashi, Kaito Takashi, Furuya Takeo, Orita Sumihisa, Ohtori Seiji

    (一社)日本脊椎脊髄病学会 Spine Surgery and Related Research   1 ( 4 )   179 - 184   2017.10

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    80歳以上の高齢患者に頸部手術を施行する場合における手術合併症の危険因子を同定するため、多施設の登録症例データを後ろ向きに解析した。35施設にてdegenerative cervical myelopathyと診断され頸部手術を施行された80歳以上患者の登録症例66例(女性35例、年齢80〜91歳)の診療録を解析した。全合併症発生例は21例(32%)で、そのうち重大な合併症は7例(11%)、軽度の合併症は14例(21%)であった。年齢調整済みの多重ロジスティック回帰分析の結果、全合併症の発生に関する有意な危険因子として術前の脳血管障害の存在が、また重大な合併症の発生に関する有意な危険因子として癌の既往歴の存在が、それぞれ同定された。年齢、糖尿病の存在、診断疾患、の各因子は合併症の有意な予測因子とは認められなかった。

  • Resuscitative endovascular balloon occlusion of the aorta as an adjunct for hemorrhagic shock due to uterine rupture: a case report. Reviewed

    Okada A, Nakamoto O, Komori M, Arimoto H, Rinka H, Nakamura H

    Clinical case reports   5 ( 10 )   1565 - 1568   2017.10

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1002/ccr3.1126

    PubMed

  • Value of Matrix Metalloproteinase-3 Regarding Prediction for Joint Destruction at 1 Year Is Different between Sexes in Patients with Rheumatoid Arthritis Reviewed

    Yamada Yutaro, Inui Kentaro, Okano Tadashi, Sugioka Yuko, Mamoto Kenji, Orita Kazuki, Koike Tatsuya, Tada Masahiro, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   69   2017.10( ISSN:2326-5191

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  • 80歳以上の患者における頸部手術に関連した合併症の危険因子(Risk factors of cervical surgery related complications in patients older than 80 years)

    Tamai Koji, Terai Hidetomi, Suzuki Akinobu, Nakamura Hiroaki, Yamashita Masaomi, Eguchi Yawara, Imagama Shiro, Ando Kei, Kobayashi Kazuyoshi, Matsumoto Morio, Ishii Ken, Hikata Tomohiro, Seki Shoji, Aramomi Masaaki, Ishikawa Tetsuhiro, Kimura Atsushi, Inoue Hirokazu, Inoue Gen, Miyagi Masayuki, Saito Wataru, Yamada Kei, Hongo Michio, Endo Kenji, Suzuki Hidekazu, Nakano Atsushi, Watanabe Kazuyuki, Ohya Junichi, Chikuda Hirotaka, Aoki Yasuchika, Shimizu Masayuki, Futatsugi Toshimasa, Mukaiyama Keijiro, Hasegawa Masaichi, Kiyasu Katsuhito, Iizuka Haku, Nishida Kotaro, Kakutani Kenichiro, Nakajima Hideaki, Murakami Hideki, Demura Satoru, Kato Satoshi, Yoshioka Katsuhito, Namikawa Takashi, Watanabe Kei, Nakanishi Kazuyoshi, Nakagawa Yukihiro, Yoshimoto Mitsunori, Fujiwara Hiroyasu, Nishida Norihiro, Sakane Masataka, Yamazaki Masashi, Kaito Takashi, Furuya Takeo, Orita Sumihisa, Ohtori Seiji

    Spine Surgery and Related Research   1 ( 4 )   179 - 184   2017.10

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    80歳以上の高齢患者に頸部手術を施行する場合における手術合併症の危険因子を同定するため、多施設の登録症例データを後ろ向きに解析した。35施設にてdegenerative cervical myelopathyと診断され頸部手術を施行された80歳以上患者の登録症例66例(女性35例、年齢80〜91歳)の診療録を解析した。全合併症発生例は21例(32%)で、そのうち重大な合併症は7例(11%)、軽度の合併症は14例(21%)であった。年齢調整済みの多重ロジスティック回帰分析の結果、全合併症の発生に関する有意な危険因子として術前の脳血管障害の存在が、また重大な合併症の発生に関する有意な危険因子として癌の既往歴の存在が、それぞれ同定された。年齢、糖尿病の存在、診断疾患、の各因子は合併症の有意な予測因子とは認められなかった。

  • 脊椎カリエス後脊柱後彎変形に対して前方開大併用Posterior Vertebral Column Resectionを施行した1例

    尾崎 友則, 松村 昭, 並川 崇, 加藤 相勲, 堀 悠介, 中村 博亮

    Journal of Spine Research   8 ( 10 )   1671 - 1674   2017.10( ISSN:1884-7137

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    脊椎カリエス後脊柱後彎変形に対して骨切りを併用した後方矯正固定術を施行した1例を経験したので報告する。症例は36歳の女性。主訴は腰背部痛。4歳時に脊椎カリエスに罹患し、矢状面アライメント・バランス不良に伴う腰背部痛による強いADL障害を認めた。画像検査にてL2-5のレベルに70°のfixed kyphosisを認め、SVAは102mm前方に偏移していた。前方開大を併用したPVCRにより良好な矯正位が獲得され、症状の改善を認めた。(著者抄録)

  • 脳卒中片麻痺患者の歩行分析における加速度計の有用性の検討

    菅原 鉄矢, 森本 昌延, 藤井 良憲, 池渕 充彦, 中村 博亮, 中土 保, 中島 重義, 弓永 久哲

    臨床バイオメカニクス   38   319 - 323   2017.10( ISSN:1884-5274

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    介助なく歩行可能な片麻痺患者29名を対象としてwearable加速度計IMU-Z(ZMP社)による歩行分析を行い、健常者40名と群間比較した。IMU-Zは「3軸加速度」と「3軸ジャイロ」および「3軸磁気」を測定できるが、今回はこれらの中で「3軸加速度」の値を使うこととし、3軸X-Y-Zの方向がそれぞれ被験者の前後・左右・上下の方向に合うようにIMU-Zを装着した。分析の結果、片麻痺患者群は健常群に比べて前後・左右・上下の全方向で歩行時の動揺が大きく、特に左右の動揺の制御が不十分であることが示唆された。片麻痺患者群の中ではブルンストロームステージが高位であるほど動揺は小さかったが、それでも健常群よりは大きく、片麻痺患者の歩行分析における加速度計の有用性が示唆された。

  • Characterizing the course of back pain after osteoporotic vertebral fracture: a hierarchical cluster analysis of a prospective cohort study. Reviewed

    Toyoda H, Takahashi S, Hoshino M, Takayama K, Iseki K, Sasaoka R, Tsujio T, Yasuda H, Sasaki T, Kanematsu F, Kono H, Nakamura H

    Archives of osteoporosis   12 ( 1 )   82 - 82   2017.09( ISSN:1862-3522

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    This study demonstrated four distinct patterns in the course of back pain after osteoporotic vertebral fracture (OVF). Greater angular instability in the first 6 months after the baseline was one factor affecting back pain after OVF. PURPOSE: Understanding the natural course of symptomatic acute OVF is important in deciding the optimal treatment strategy. We used latent class analysis to classify the course of back pain after OVF and identify the risk factors associated with persistent pain. METHODS: This multicenter cohort study included 218 consecutive patients with ≤ 2-week-old OVFs who were enrolled at 11 institutions. Dynamic x-rays and back pain assessment with a visual analog scale (VAS) were obtained at enrollment and at 1-, 3-, and 6-month follow-ups. The VAS scores were used to characterize patient groups, using hierarchical cluster analysis. RESULTS: VAS for 128 patients was used for hierarchical cluster analysis. Analysis yielded four clusters representing different patterns of back pain progression. Cluster 1 patients (50.8%) had stable, mild pain. Cluster 2 patients (21.1%) started with moderate pain and progressed quickly to very low pain. Patients in cluster 3 (10.9%) had moderate pain that initially improved but worsened after 3 months. Cluster 4 patients (17.2%) had persistent severe pain. Patients in cluster 4 showed significant high baseline pain intensity, higher degree of angular instability, and higher number of previous OVFs, and tended to lack regular exercise. In contrast, patients in cluster 2 had significantly lower baseline VAS and less angular instability. CONCLUSIONS: We identified four distinct groups of OVF patients with different patterns of back pain progression. Understanding the course of back pain after OVF may help in its management and contribute to future treatment trials.

    DOI: 10.1007/s11657-017-0377-5

    PubMed

  • Comparison of in vivo polyethylene wear particles between mobile- and fixed-bearing TKA in the same patients Reviewed

    Minoda Yukihide, Hata Kanako, Ikebuchi Mitsuhiko, Mizokawa Shigekazu, Ohta Yoichi, Nakamura Hiroaki

    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY   25 ( 9 )   2887 - 2893   2017.09( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00167-016-4027-z

    PubMed

  • Radiographic Risk Factors of Reoperation Following Minimally Invasive Decompression for Lumbar Canal Stenosis Associated With Degenerative Scoliosis and Spondylolisthesis Reviewed

    Kato Minori, Namikawa Takashi, Matsumura Akira, Konishi Sadahiko, Nakamura Hiroaki

    GLOBAL SPINE JOURNAL   7 ( 6 )   498 - 505   2017.09( ISSN:2192-5682

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1177/2192568217699192

    PubMed

  • Risk factors for cognitive decline following osteoporotic vertebral fractures: A multicenter cohort study. Reviewed

    Takahashi S, Hoshino M, Tsujio T, Terai H, Suzuki A, Namikawa T, Kato M, Matsumura A, Takayama K, Nakamura H

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   22 ( 5 )   834 - 839   2017.09( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    BACKGROUND: Osteoporotic vertebral fractures (OVFs) are the most common cause of intractable back pain and reduced activities of daily living (ADL), which may affect cognitive function. However, no previous studies have reported a change in cognitive function after OVFs. The purpose was to reveal cognitive function changes after OVFs and investigate the risk factors for cognitive decline. METHODS: Consecutive patients with symptomatic OVFs were enrolled in a prospective multicenter cohort study. The inclusion criteria were age >65 years, diagnosis of acute or subacute OVF, and back pain onset within 2 months prior to presentation. Cognitive function was assessed with the mini-mental state examination. Medical history, radiological findings, and ADL were investigated as risk factors for cognitive decline. RESULTS: We recruited a sample of 339 patients (58 men and 281 women) who met the inclusion criteria. Patients underwent examinations and completed questionnaires at both the time of enrollment and at 6-month follow-up. At 6-month follow-up, cognitive decline was observed in 26 (7.7%) patients. Medical history, including comorbidities and sports activities, did not affect odds ratios (ORs). However, elevated ORs were associated with delayed union (OR: 4.67, 95% Confidence interval: 1.22-17.87). In addition, significantly increased ORs were associated with reduced ADL at 6-month follow-up. CONCLUSIONS: The current results revealed the incidence of cognitive decline after the onset of OVF. Delayed union and reduced ADL at 6-month follow-up were associated with cognitive decline. Patients with cognitive decline experienced significantly reduced quality of life. These results highlight the importance of preventing cognitive impairment in patients with symptomatic OVF. Physical treatment or early surgical treatment may provide appropriate options, particularly for patients with suspected delayed union.

    DOI: 10.1016/j.jos.2017.04.008

    PubMed

  • リバース型人工肩関節置換術術後の経時的動態解析

    平川 義弘, 間中 智哉, 伊藤 陽一, 池淵 充彦, 中島 重義, 市川 耕一, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   41 ( 2 )   581 - 585   2017.09( ISSN:0910-4461

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    肩関節運動は,肩甲胸郭リズムと肩甲上腕リズムの密接な関連性により構成されており,両リズムに肩甲骨運動は重要な役割を担っている.正常肩における肩甲骨の動態解析に関する報告は散見されるが,リバース型人工肩関節置換術(以下,RSA)術後の肩甲骨の動態解析に関する情報は渉猟し得ない.今回我々は,THAナビゲーションに用いられている2D-3Dマッチング法を応用し新たに開発された肩関節動態解析ソフト(以下,GANESHA)を利用して,経時的なRSA術後の動態解析を行ったので報告する.対象は当科においてRSAを施行し,術後12ヵ月以上の経過観察が可能であった5例5肩(女性2例,男性3例)手術時平均年齢75.2歳(70〜79歳)であった.術後3ヵ月,術後6ヵ月,術後12ヵ月に肩甲骨面上で,自動挙上0°,30°,60°,90°にて透視下にX線撮影を行った.術前のCT画像より得られた肩甲骨の三次元画像を利用しGANESHAを利用してセミオートマティックに肩甲骨の上方回旋角,外旋角,後方傾斜角の変化量の測定を行った.術後3ヵ月時,術後6ヵ月時,術後12ヵ月の自動挙上30°,60°,90°における肩甲骨3次元動態解析において,上方回旋角,外旋角,後方傾斜角に有意な差はみられなかった.RSA術後の経時的な肩関節挙上運動時の肩甲骨の動態解析により,術後肩甲骨の位置は術後3ヵ月以降に有意な変化はみられないと考えられた.(著者抄録)

  • 鏡視下腱板修復術におけるスーチャーブリッジ法と骨孔法の治療成績比較

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   41 ( 2 )   528 - 531   2017.09( ISSN:0910-4461

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    鏡視下腱板修復術においてスーチャーブリッジ(SB)法と骨孔(TO)法を比較検討した.対象は,37例.手術は同一術者が行い,SB法は16例でTO法は21例であった.手術時間,インプラント費用,術中合併症,術後12ヵ月の臨床成績及び腱板修復状態を両縫合法間で比較検討した.手術時間は,TO法ではSB法と比較して有意に短かった.インプラント費用は,TO法はSB法と比較して有意に低かった.術中合併症は,SB法3例でTO法1例であった.術前と比較して術後12ヵ月では,両縫合法で平均自動屈曲及び外転可動域とJOA scoreは有意に改善していたが,両縫合法間の臨床成績に有意な差は認めなかった.また,腱板修復状態も両縫合法間に有意な差は認めなかった.腱板断裂に対するSB法とTO法の治療成績及び腱板修復状態は同等であったが,手術時間はTO法の方が短く,インプラント費用もTO法の方が低かった.(著者抄録)

  • 良性骨腫瘍に対するナビゲーション手術

    家口 尚, 星 学, 大戎 直人, 高松 聖仁, 中村 博亮

    中部日本整形外科災害外科学会雑誌   60 ( 5 )   863 - 864   2017.09( ISSN:0008-9443

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    良性骨腫瘍に対するナビゲーション手術の治療成績を検討した。用いたナビゲーションシステムの変遷により、第1期として皮膚マーカーを使用し9例の手術を行い、第2期として2013年から15例に対しICTナビゲーションを用いた。対象は男性15例・女性9例・平均年齢30.2歳で、経過観察期間は平均37.5ヵ月であった。対象とした良性骨病変は類骨骨腫8例、ABC(再発を含む)4例、骨内ガングリオン3例、腫瘍性骨軟化症・骨軟骨腫が各2例、線維性骨異形成症・骨線維性異形成症・軟骨芽細胞腫が各1例であった。施行手術は切除を兼ねた生検が12例、隔壁等を有する病変の単純掻爬8例、切除4例であった。腫瘍の最大径は平均28.5mm、皮切の大きさは平均50mmであった。関節近傍のガングリオン2病変に症状のない再発を認めた。骨欠損を生じていた病変に対してはHAもしくはβ-TCPセメントを用いて充填を行った。

  • 類骨骨腫に対するRFA施行後の経時的画像変化を確認できた1例

    大戎 直人, 星 学, 家口 尚, 伴 祥高, 中村 博亮

    中部日本整形外科災害外科学会雑誌   60 ( 5 )   859 - 860   2017.09( ISSN:0008-9443

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    22歳男。約3年前より夜間痛を伴う左股関節痛を認め、近医にて内服加療を行うも改善なく、1年前に当科紹介となった。画像診断で類骨骨腫と診断し、NSAIDs継続となったが、半年の経過観察後も改善に乏しく、CTガイド下ラジオ波焼灼術(RFA)を施行した。RFA当日より夜間痛は消失し、約1週間後には疼痛は完全に消失した。以後外来にて経過観察を行い、疼痛の再燃はなく、RFA施行後1年のCTでは術前に認めたnidus様の所見は残存していたが、nidus内部の軟部陰影は完全に消失していた。また、MRIでは照射部周囲の浮腫性変化は認めるが、術前に認めた骨髄内の浮腫性変化は完全に消失していた。RFA施行後2年のCTでは内部に軽度の硬化性変化を認めるが、nidus様の変化は残存していた。MRIではRFA後の浮腫性変化は更に改善し、周囲の炎症性変化の出現は認めなかった。RFA施行後3年の現在、単純X線像でnidus様変化の残存は認めるが、症状の再燃はなく経過している。

  • 陳旧性上腕骨大結節骨折に対する鏡視下骨接合術の有用性

    濱 峻平, 平川 義弘, 間中 智哉, 市川 耕一, 松田 淑伸, 清水 勇人, 伊藤 陽一, 中村 博亮

    肩関節   41 ( 2 )   464 - 467   2017.09( ISSN:0910-4461

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    本研究の目的は陳旧性上腕骨大結節骨折に対して,鏡視下骨接合術(Arthroscopic reduction and internal fixation,以下ARIF)を施行した症例の術後1年以上経過した治療成績を検討することである.対象は陳旧性上腕骨大結節骨折に対してARIFを施行した8例8肩(男4例,女4例)で,平均年齢は62.1歳(50歳-72歳),術後平均観察期間は4.8年(1年-10年)であった.手術は大結節骨片を骨欠損部に適合するように形態をトリミングした後,整復操作し,5例はdouble row法,3例は骨孔法で行った.術前および最終診察時の肩関節自動可動域,日本整形外科学会肩関節治療成績判定基準(JOAスコア)について調査した.全例術後1年で骨癒合し,可動域・JOAスコアも有意に改善を認め,陳旧性上腕骨大結節骨折に対するARIFは低侵襲で有効な術式であった.(著者抄録)

  • 骨粗鬆症性椎体骨折後の認知機能低下の危険因子 多施設共同コホート研究(Risk factors for cognitive decline following osteoporotic vertebral fractures: A multicenter cohort study)

    Takahashi Shinji, Hoshino Masatoshi, Tsujio Tadao, Terai Hidetomi, Suzuki Akinobu, Namikawa Takashi, Kato Minori, Matsumura Akira, Takayama Kazushi, Nakamura Hiroaki

    Journal of Orthopaedic Science   22 ( 5 )   834 - 839   2017.09( ISSN:0949-2658

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    骨粗鬆症性椎体骨折患者339例(男性58例、女性281例)を対象に、認知機能の変化、認知機能低下の危険因子を前向き多施設共同コホート研究によって検討した。ミニメンタルステート検査(MMSE)を実施して認知機能を評価し、認知機能低下の危険因子として病歴、X線学的所見、ADLについて検討した。5例に外科術を施行し、234例が急性期に数日間の入院、109例が外来治療を受けていた。コルセットの装着は305例であった。ベースライン時、認知障害なしが283例(83.5%)、軽度認知障害が56例(16.5%)であり、6ヵ月後のフォローアップ時に認知機能低下をきたしたのは26例(7.7%)であった。認知機能低下群と非低下群に関して、年齢、性別、骨密度、教育レベル、喫煙習慣、スポーツ習慣に差はなく、ベースライン時のMMSEスコアにも差は認められなかった。病歴については、糖尿病患者の比率が認知機能低下群に高い傾向にあった。また、認知機能低下のオッズ比の上昇は骨折遷延治癒、6ヵ月後のADL低下と関連していた。骨粗鬆症性椎体骨折患者において、骨折遷延治癒とADL低下が認知機能低下の危険因子と成りうることが示された。

  • 肺癌転移性脊椎腫瘍の生命予後

    堂園 将, 笹岡 隆一, 高松 聖仁, 中村 博亮

    Journal of Spine Research   8 ( 9 )   1547 - 1551   2017.09( ISSN:1884-7137

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    肺癌転移性脊椎転移の生命予後および予後不良因子について英語論文9編をレビューした。症例の総数は1417例で6ヵ月生存率は18〜61%、12ヵ月生存率は3.8〜32%であった。多変量解析による予後不良因子はPerformance status不良、内臓臓器転移、歩行障害、多発骨転移、診断から放射線治療までの期間が15ヵ月以上、高カルシウム血症、低アルブミン血症であった。(著者抄録)

  • 変形性肩鎖関節症に対する鏡視下鎖骨遠位端切除術の術後5年での臨床成績と画像評価

    松田 淑伸, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 中村 博亮

    肩関節   41 ( 2 )   545 - 548   2017.09( ISSN:0910-4461

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    変形性肩鎖関節症に対する鏡視下鎖骨遠位端切除術の術後5年での臨床成績と画像評価を行った.対象は有痛性変形性肩鎖関節症に対して鏡視下鎖骨遠位端切除術を施行した31例34肩,女性18例,男性13例,平均年齢は62歳であった.臨床成績は,肩関節の自動屈曲・外転可動域,肩鎖関節部の圧痛,肩関節水平内転ストレスでの肩鎖関節痛の誘発の4つの項目を,術前,術後1年,術後5年時に評価した.画像評価は単純X線の肩正面像で術後早期と5年時に肩峰と鎖骨遠位断端の距離を計測し,その変化値も評価した.自動屈曲・外転可動域は術前から術後5年にかけて有意に改善した.術後5年では肩鎖関節部の圧痛は軽度残存7肩20.6%に,水平内転ストレスでの肩鎖関節痛の誘発は残存1肩2.9%に改善した.鎖骨の切除量は平均13.6mmで,術直後から術後5年にかけて切除部間隙は17肩56.7%で狭小化し,11肩36.7%で開大,2肩6.7%で変化なしであった.異所性骨化のような陰影を2肩6.7%に認めた.(著者抄録)

  • Overall survival and prognostic factors in patients with spinal metastases from lung cancer treated with and without epidermal growth factor receptor tyrosine kinase inhibitors Reviewed

    Dohzono Sho, Sasaoka Ryuichi, Takamatsu Kiyohito, Nakamura Hiroaki

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   22 ( 4 )   698 - 705   2017.08( ISSN:1341-9625

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s10147-017-1116-z

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  • Low second to fourth digit ratio in Dupuytren disease Reviewed

    Yokoi Takuya, Uemura Takuya, Kazuki Kenichi, Onode Ema, Shintani Kosuke, Okada Mitsuhiro, Nakamura Hiroaki

    MEDICINE   96 ( 33 )   e7801   2017.08( ISSN:0025-7974

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/MD.0000000000007801

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  • High titer of anti-citrullinated peptide antibody is a risk factor for severe carotid atherosclerotic plaque in patients with rheumatoid arthritis: the TOMORROW study Reviewed

    Okano Tadashi, Inui Kentaro, Sugioka Yuko, Sugioka Kenichi, Matsumura Yoshiki, Takahashi Shinji, Tada Masahiro, Mamoto Kenji, Wakitani Shigeyuki, Koike Tatsuya, Nakamura Hiroaki

    INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES   20 ( 8 )   949 - 959   2017.08( ISSN:1756-1841

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1111/1756-185X.13106

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  • Detection of bone defects around zirconium component after total knee arthroplasty Reviewed

    Minoda Yukihide, Yamamura Kazumasa, Sugimoto Kazutaka, Mizokawa Shigekazu, Baba Shingo, Nakamura Hiroaki

    KNEE   24 ( 4 )   844 - 850   2017.08( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.knee.2017.04.020

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  • 上皮増殖因子受容体チロシンキナーゼ阻害剤投与または未投与の肺癌脊椎転移患者における全生存と予後予測因子(Overall survival and prognostic factors in patients with spinal metastases from lung cancer treated with and without epidermal growth factor receptor tyrosine kinase inhibitors)

    Dohzono Sho, Sasaoka Ryuichi, Takamatsu Kiyohito, Nakamura Hiroaki

    International Journal of Clinical Oncology   22 ( 4 )   698 - 705   2017.08( ISSN:1341-9625

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    肺癌脊髄転移患者の全生存期間を組織型別に調べ、上皮増殖因子受容体チロシンキナーゼ阻害剤(EGFR-TKI)投与または非投与の患者における予後因子を分析した。2009年12月〜2016年3月に肺癌脊髄転移と診断された135例を後向きに評価した。腺癌患者88例をEGFR-TKI投与群(男性14例、女性29例)とEGFR-TKI非投与群(男性30例、女性15例)に分けて解析した。全生存期間中央値は、腺癌患者で11.3ヵ月、扁平上皮癌患者で5.3ヵ月、小細胞癌患者で3.9ヵ月であった。EGFR-TKI投与群において、EGFR-TKI非投与群と比較して全生存期間は有意に長いことが示された(中央値21.4ヵ月 vs. 6.1ヵ月)。単変量解析の結果、非EGFR-TKI群において一般状態不良は予後不良因子であったが、EGFR-TKI群では一般状態および他の変数は有意な予後因子ではなかった。

  • Sequentially annealed highly cross-linked polyethylene reduced in vivo wear particle generation in total knee arthroplasty. Reviewed

    Yukihide Minoda, Kanako Hata, Katsuko Goto, Tomonobu Itohara, Hiroaki Nakamura

    Journal of orthopaedic surgery (Hong Kong)   25 ( 2 )   2309499017718909 - 2309499017718909   2017.07( ISSN:2309-4990

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: Sequentially annealed highly cross-linked polyethylene (HXLPE) was recently introduced to reduce the wear in total knee arthroplasty (TKA). However, an in vivo advantage of sequentially annealed HXLPE on wear particle generation is still controversial. The purpose of this study is to compare the characteristics of in vivo wear particles between sequentially annealed HXLPE and conventional polyethylene after TKA. MATERIALS AND METHODS: Synovial fluid was obtained from the eight knees with sequentially annealed HXLPE and from eight knees with conventional polyethylene 12 months after the operation. Polyethylene particles were isolated and examined using a scanning electron microscope and image analyzer. RESULTS: Total number of wear particles in each knee was 2.1 ± 1.0 × 107 with sequentially annealed HXLPE (mean ± standard deviation) and 4.9 ± 3.6 × 107 with conventional polyethylene ( p = 0.036). Particle size (equivalent circle diameter) was 1.01 ± 0.26 μm with sequentially annealed HXLPE and 1.02 ± 0.20 μm with conventional polyethylene ( p = 0.674). Aspect ratio was 1.33 ± 0.04 with sequentially annealed HXLPE and 1.39 ± 0.10 with conventional polyethylene ( p = 0.462). CONCLUSIONS: The sequentially annealed HXLPE reduced the in vivo polyethylene wear particles by 58% compared with conventional polyethylene without the significant change of particle size and shape.

    DOI: 10.1177/2309499017718909

    PubMed

  • Radiologic Factors Associated With the Dynamic Change of Dural Sac Diameter in Lumbar Spine A Kinematic MRI Study Reviewed

    Takahashi Shinji, Lord Elizabeth L., Hayashi Tetsuo, Cohen Jeremiah R., Lao Lifeng, Yao Qingqiang, Suzuki Akinobu, Nakamura Hiroaki, Wang Jeffrey C.

    CLINICAL SPINE SURGERY   30 ( 6 )   E827 - E832   2017.07( ISSN:2380-0186

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  • Radiologic Factors Associated With the Dynamic Change of Dural Sac Diameter in Lumbar Spine: A Kinematic MRI Study. Reviewed

    Takahashi S, Lord EL, Hayashi T, Cohen JR, Lao L, Yao Q, Suzuki A, Nakamura H, Wang JC

    Clinical spine surgery   30 ( 6 )   E827 - E832   2017.07( ISSN:2380-0186

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    DOI: 10.1097/BSD.0000000000000403

    PubMed

  • THA後の術後疼痛管理 関節周囲多剤カクテル療法vs硬膜外ブロック

    洲鎌 亮, 箕田 行秀, 大田 陽一, 中村 博亮, 小林 章郎, 溝川 滋一, 原口 圭司, 高橋 信太郎

    日本関節病学会誌   36 ( 2 )   107 - 111   2017.07( ISSN:1883-2873

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    全人工股関節置換術(THA)での関節周囲多剤カクテル療法の有用性を硬膜外ブロックと比較した。対象は、THAを施行した43関節(男性5関節、女性38関節、手術時平均年齢64.5±12.4歳)とし、関節周囲多剤カクテル療法施行群(カクテル群)と硬膜外ブロック群(Epi群)に分けた。カクテル群には塩酸モルヒネ、ステロイド、局所麻酔薬、NSAIDs、ボスミンを含んだ薬液を、皮切り直前およびインプラント設置後に関節周囲の軟部組織に注射し、その他はすべての同一の手術手技とした。その結果、術後1日目のVisual Analog Scaleは、カクテル群で有意に低く、術後疼痛の経時的変化において、関節周囲多剤カクテル注射は、周術期を通して、疼痛軽減に有効であった。また、Patient control analgesiaで用いたフェンタニル使用量は、カクテル群の方が術後24時間で有意に少なかった。患者満足度において、カクテル群で高い傾向を示した。

  • DISTRICT DIFFERENCES BETWEEN THE SEXES OF PREDICTIVE VALUE OF MATRIX METALLOPROTEINASE-3 AT BASELINE REGARDING CHANGES IN MODIFIED TOTAL SHARP SCORE AT 1 YEAR IN PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Inui K., Okano T., Orita K., Sugioka Y., Mamoto K., Koike T., Tada M., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   76   1134 - 1134   2017.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2017-eular.2431

  • Impingement of the patellar component against the tibial post after posterior stabilized and constrained TKA: a pilot study. Reviewed

    Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   137 ( 6 )   861 - 865   2017.06( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: Patella-post impingement (PPI), contact of the patellar component with the tibial post, occurs during deep knee flexion after posterior stabilized total knee arthroplasty (TKA). PPI can cause anterior knee pain, increased patellar pressure, wear of the polyethylene patellar component and tibial post, and poor range of motion. There have been no reports on the relationship between PPI and tibial post design. The aim of this study was to compare different tibial post designs with regard to PPI incidence. MATERIALS AND METHODS: Five posterior stabilized total knee prostheses were implanted in full-length models of the femur and tibia (Sawbones) using a navigation system. The thickness of the tibial component was 10 mm in all prostheses. The patella was set on a transparent polypropylene sheet, which was fixed to the tibial tubercle. The distance between the lower edge of the patellar component and the cut surface of the tibia was defined as the tibial-patellar clearance (TPC), which represents the length of the patellar tendon. The TPC was varied from 18 to 40 mm and the knee was moved from full extension to deep flexion while the knee angle at which PPI occurred (PPI angle) was recorded. RESULTS: The PPI angle differed between tibial post designs (p < 0.05). Shorter TPCs resulted in smaller PPI angles and longer TPCs resulted in larger PPI angles (p < 0.05). CONCLUSIONS: This is the first study to analyze the relationship between PPI and the design of tibial post. Our results clearly show that tibial post design and TPC affect PPI. To avoid patellar component and tibial post impingement in deep flexion, appropriate TPC must be achieved during surgery. Improvements in tibial post design, especially in constrained prostheses, are also desirable. This study highlights the potential risk of PPI during deep flexion after TKA.

    DOI: 10.1007/s00402-017-2682-2

    PubMed

  • DO CHANGES IN ADIPOCYTOKINES CORRELATE WITH CHANGES TO DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS? FINDINGS FROM THE TOMORROW STUDY Reviewed

    Tada M., Inui K., Sugioka Y., Okano T., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   76   540 - 540   2017.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2017-eular.2833

  • CLINICAL FEATURES OF RHEUMATOID FACTOR- OR ANTI-CYCLIC CITRULLINATED PEPTIDES-POSITIVE PATIENTS WITH PSORIATIC ARTHRITIS Reviewed

    Inui K., Okano T., Yoshimura H., Sugioka Y., Mamoto K., Koike T., Tada M., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   76   1324 - 1324   2017.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2017-eular.1898

  • THE STIFFNESS OF MEDIAN NERVE MEASURED BY ELASTOSONOGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Anno S., Okano T., Sugioka Y., Mamoto K., Koike T., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   76   1023 - 1024   2017.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2017-eular.1632

  • THE COMPARISON OF ULTRASOUND SYNOVITIS AND ENTHESITIS FINDINGS AND CLINICAL FINDINGS IN PATIENTS WITH PSORIATIC ARTHRITIS AND SKIN PSORIASIS Reviewed

    Okano T., Inui K., Sugioka Y., Mamoto K., Yoshimura H., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   76   955 - 956   2017.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2017-eular.5028

  • THE HIGH DOSES GOLIMUMAB BRING BETTER SUPPRESSION OF ULTRASONOGRAPHIC SYNOVIAL INFLAMMATION IN PATIENTS WITH RHEUMATOID ARTHRITIS? Reviewed

    Okano T., Inui K., Sugioka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   76   1426 - 1426   2017.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2017-eular.1451

  • 矢状面脊柱アライメント不良を伴う腰部脊柱管狭窄症に対する顕微鏡視下片側進入両側除圧術の術後成績

    加藤 相勲, 並川 崇, 松村 昭, 藪 晋人, 中村 博亮

    Journal of Spine Research   8 ( 6 )   1142 - 1147   2017.06( ISSN:1884-7137

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    矢状面脊柱アライメント不良を伴う腰部脊柱管狭窄症に対する顕微鏡視下片側進入両側除圧術の臨床成績は、矢状面脊柱アライメント不良を伴わない例との比較において同等であった。棘上・棘間靱帯や傍脊柱筋などの後方要素を最大限に温存できる顕微鏡視下片側進入両側除圧術は除圧術後の矢状面脊柱アライメント悪化に対する影響が少ないと考えられた。しかし、術後にsagittal vertical axisが増悪した例では腰痛の改善が少なかった。(著者抄録)

  • 神経鞘腫による末梢神経の電気生理学的変化

    上村 卓也, 岡田 充弘, 横井 卓哉, 新谷 康介, 斧出 絵麻, 中村 博亮

    末梢神経   28 ( 1 )   73 - 77   2017.06( ISSN:0917-6772

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    末梢神経に発生した神経鞘腫は神経症状を呈することがあるが、発生元の神経に生じる電気生理学的変化についての詳細は明らかでない。そこで手術で組織学的に神経鞘腫と診断された症例のうち、術前に神経伝導検査が施行された9例の電気生理学的変化について検討した。腫瘍発生元の神経を経皮的に神経刺激した場合の支配筋の表面複合筋活動電位(CMAP)について、その振幅は、腫瘍の近位部を刺激した場合は腱側の68%で、腫瘍の遠位部を刺激した場合は健側の75%であり、いずれも健側と比べ統計学的に有意に低下していた。CMAPの潜時は、腫瘍の近位部を刺激した場合で健側の112%と有意に延長していた。また神経鞘腫が発生した部分の運動神経伝導速度は健側の85%で、感覚神経伝導速度は健側の87%であり、いずれも健側に比べ低下傾向であった。神経鞘腫が発生した末梢神経は、subclinicalなものも含めて全例で電気生理学的に異常所見が認められた。(著者抄録)

  • 関節リウマチ患者における椎体骨折の高い発生頻度と骨質の低さ TOMORROW研究の結果(High frequency of vertebral fracture and low bone quality in patients with rheumatoid arthritis: Results from TOMORROW study)

    Okano Tadashi, Inui Kentaro, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Wakitani Shigeyuki, Koike Tatsuya, Nakamura Hiroaki

    Modern Rheumatology   27 ( 3 )   398 - 404   2017.05( ISSN:1439-7595

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    関節リウマチ(RA)患者における既存の椎体骨折の罹患率を調べ、椎体骨折のリスク因子を明らかにした。RA患者198例(女性84.3%、平均59.6±12.7歳)と年齢・性別を一致させた対照202例(女性84.2%、平均58.4±13.0歳)のデータを解析した。既存椎体骨折の罹患率はRA群が45.5%、対照群が30%であった。二つ以上の椎体骨折はRA群では56.7%、対照では25.0%であった。半定量的評価ではグレード2/3がRA群では33.4%で対照では16.6%であった。ロジスティック回帰モデルでは、年齢とRAが既存椎体骨折の独立したリスク因子であった。カルボキシル化オステオカルシン低値と尿中ペントシジンが既存椎体骨折と独立して関連していた。低い骨質はRA患者における椎体骨折の高い有病率の原因であることが示唆された。

  • Anterior Cervical Discectomy and Fusion Provides Better Surgical Outcomes Than Posterior Laminoplasty in Elderly Patients With C3-4 Level Myelopathy Reviewed

    Tamai Koji, Terai Hidetomi, Suzuki Akinobu, Toyoda Hiromitsu, Hoshino Masatoshi, Takahashi Shinji, Hayashi Kazunori, Ohyama Shoichiro, Nakamura Hiroaki

    SPINE   42 ( 8 )   548 - 555   2017.04( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BRS.0000000000001874

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  • Incidence of Pleural Fluid and Its Associated Risk Factors After Posterior Spinal Fusion in Patients With Adolescent Idiopathic Scoliosis Reviewed

    Hayashi Kazunori, Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Hoshino Masatoshi, Tamai Koji, Ohyama Shoichiro, Nakamura Hiroaki

    SPINE   42 ( 8 )   603 - 609   2017.04( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BRS.0000000000001861

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  • Effect of Cervical Sagittal Balance on Laminoplasty in Patients With Cervical Myelopathy Reviewed

    Kato Minori, Namikawa Takashi, Matsumura Akira, Konishi Sadahiko, Nakamura Hiroaki

    GLOBAL SPINE JOURNAL   7 ( 2 )   154 - 161   2017.04( ISSN:2192-5682

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1177/2192568217694011

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  • Cervical lordotic alignment following posterior spinal fusion for adolescent idiopathic scoliosis: reciprocal changes and risk factors for malalignment Reviewed

    Hayashi Kazunori, Toyoda Hiromitsu, Terai Hidetomi, Suzuki Akinobu, Hoshino Masatoshi, Tamai Koji, Ohyama Shoichiro, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-PEDIATRICS   19 ( 4 )   440 - 447   2017.04( ISSN:1933-0707

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3171/2016.9.PEDS16298

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  • Clinical and Radiological Outcomes after Microscopic Bilateral Decompression via a Unilateral Approach for Degenerative Lumbar Disease: Minimum 5-Year Follow-Up Reviewed

    Dohzono Sho, Toyoda Hiromitsu, Matsumura Akira, Terai Hidetomi, Suzuki Akinobu, Nakamura Hiroaki

    ASIAN SPINE JOURNAL   11 ( 2 )   285 - 293   2017.04( ISSN:1976-1902

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.4184/asj.2017.11.2.285

    PubMed

  • The incidence of nerve root injury by high-speed drill can be reduced by chilled saline irrigation in a rabbit model Reviewed

    Tamai K., Suzuki A., Takahashi S., Akhgar J., Rahmani M. S., Hayashi K., Ohyama S., Nakamura H.

    BONE & JOINT JOURNAL   99B ( 4 )   554 - 560   2017.04( ISSN:2049-4394

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1302/0301-620X.99B4.BJJ-2016-0841.R1

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  • 大腿骨頸部骨折におけるprima hip screwの使用経験

    澤田 雄大, 谷浦 圭, 政田 俊明, 佐々木 健陽, 中村 博亮

    骨折   39 ( 2 )   330 - 333   2017.04( ISSN:0287-2285

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    大腿骨頸部骨折に対する骨接合術に用いられるインプラントとして様々なものが報告されている。今回我々はMDM社prima hip screwを用いて骨接合術を行ったので報告する。対象は当院にて2014年6月〜2015年9月までに大腿骨頸部骨折に対してprima hip screwを使用して骨接合術を行った17例中、6ヵ月以上追跡可能であった11例。受傷時平均年齢79.1歳、男性1例、女性10例、Garden分類stage I〜III(I:5例、II:5例、III:1例)、平均観察期間10.7ヵ月であった。術後の骨癒合、骨頭壊死、転子下骨折等の合併症の有無、最終観察時の短縮量とGarden alignment indexの変化量をX線にて評価した。全例で骨癒合が得られ、骨頭壊死や転子下骨折を含む合併症は認めなかった。また過度の短縮、Garden alignment indexの変化を認めなかった。Prima hip screwは、自験例において合併症を認めず良好な成績を認めた。(著者抄録)

  • 脛骨外側関節面に生じた離断性骨軟骨炎に関節鏡視下逆行性骨軟骨柱移植を施行した1例

    池田 樹広, 橋本 祐介, 谷内 政俊, 瀧上 順誠, 中井 秀和, 勝谷 洋文, 富原 朋弘, 島田 永和, 中村 博亮

    JOSKAS   42 ( 2 )   408 - 409   2017.04( ISSN:1884-8842

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    26歳男性。1年前、高所から飛び降りた際に右膝痛を自覚、1ヵ月前より疼痛が増強したため受診となった。受診時、単純X線およびCT、MRI所見より脛骨外側関節面の不安定型膝離断性骨軟骨炎(OCD)と診断し、関節鏡視下に半月板形成縫合と逆行性骨軟骨柱移植術を施行した。術後3ヵ月で骨癒合を認め、疼痛なく仕事復帰し、術後10ヵ月のX線にて関節症性変化の増悪は認めず、臨床スコアはLysholm score 100点、IKDC subjective score 85点であった。

  • 指節骨骨折に対する経皮的スクリュー固定による治療経験

    飯田 健, 祷 史明, 吉村 奉暢, 小西 定彦, 遠山 雅彦, 中村 博亮

    骨折   39 ( 2 )   204 - 206   2017.04( ISSN:0287-2285

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    指節骨骨折のうち、斜骨折、らせん骨折に対して経皮的スクリュー固定術を行っているので報告する。対象は2011年3月〜2015年8月までに、スクリューを用いて内固定手術を行った指節骨骨折のうち、経皮的手技で行った8例8指である。手術方法は、透視下に骨鉗子で経皮的に整復し、1〜3本の鋼線を骨折線と垂直になるよう挿入する。鋼線を1本ずつ抜去し、同位置にスクリューを挿入し固定した。後療法は、術後の外固定は行わず、術翌日より疼痛に応じた自動ROM訓練を開始し、術後3週程度から他動ROM訓練を追加した。平均観察期間は6.4ヵ月(2〜18ヵ月)で全例転位なく骨癒合を得た。最終平均可動域(自動)はPIP:屈曲95°、伸展-5°、DIP:屈曲80°、伸展-5°であった。この方法は、スクリューを皮下に埋没させるための感染の危険性が少なく、スクリューヘッドが伸展機構より内部に位置するため干渉の可能性が低く、低侵襲であり、癒着は起こりにくく、抜釘の必要が少ない。(著者抄録)

  • 当院における距骨骨軟骨損傷に対する鏡視下ドリリング併用骨軟骨摘出術と骨軟骨柱移植術の短期成績の検討

    瀧上 順誠, 松浦 健司, 富原 朋弘, 橋本 祐介, 谷内 政俊, 島田 永和, 中村 博亮

    JOSKAS   42 ( 2 )   396 - 397   2017.04( ISSN:1884-8842

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    OCL(距骨骨軟骨損傷)に対して鏡視下ドリリング併用骨軟骨摘出術を行った6例(D群)、鏡視下ドリリング併用骨軟骨柱移植術を行った7例(M群)の短期成績について比較検討した。その結果、平均病変面積(mm2)はD群84.7、M群95.3で有意差はみられなかった。術後AOFASスコアはD群94.5、M群93.9と両群間で有意差を認めず、2群ともに成績良好であった。不安定な病変部面積が150mm2以下の場合は、D群の方がが低侵襲で良好な成績が得られると考えられた。

  • Anatomical analysis of the relation between human ligamentum flavum and posterior spinal bony prominence Reviewed

    Akhgar Javid, Terai Hidetomi, Rahmani Mohammad Suhrab, Tamai Koji, Suzuki Akinobu, Toyoda Hiromitsu, Hoshino Masatoshi, Ikebuchi Mitsuhiko, Ahmadi Sayed Abdullah, Hayashi Kazunori, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   22 ( 2 )   260 - 265   2017.03( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.jos.2016.11.020

    PubMed

  • Novel alignment measurement technique for total knee arthroplasty using patient specific instrumentation. Reviewed

    Kazumasa Yamamura, Yukihide Minoda, Shigekazu Mizokawa, Yoichi Ohta, Ryo Sugama, Suguru Nakamura, Hideki Ueyama, Hiroaki Nakamura

    Archives of orthopaedic and trauma surgery   137 ( 3 )   401 - 407   2017.03( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: This study was designed to evaluate the true accuracy of patient specific instrumentation (PSI) for total knee arthroplasty (TKA) using a new 3D measurement method. MATERIALS AND METHODS: Consecutive 21 patients (30 knees) who underwent TKA using computed tomography (CT)-based PSI were retrospectively evaluated. Mean patient age was 69.2 years (62 to 77). The postoperative three-dimensional (3D) CT image were superimposed onto the preoperative 3D CT plan and measured the absolute difference in the prosthetic alignment using six parameters: coronal, sagittal, and axial alignment of the femoral and tibial prostheses. Cases in which the difference in the prosthetic alignment was greater than 3° were considered outliers. RESULTS: For the femoral prosthesis, mean absolute differences between the preoperative 3D CT plan and postoperative 3D CT image were not significantly different and the rates of outliers were 10.0, 33.3, 23.3% in the coronal, sagittal, and axial planes. For the tibial prosthesis, mean absolute differences were significantly larger in the axial plane than in the coronal and sagittal planes (p < 0.001) and the rates of outliers were 23.3, 36.7, 63.3% in the coronal, sagittal, and axial planes. The rates of outliers for the axial alignment of tibial prosthesis were significantly higher than for the other five planes (p = 0.006). CONCLUSIONS: The rotation of the tibial prosthesis with CT-based PSI was less accurate in the axial plane than in the other five planes.

    DOI: 10.1007/s00402-017-2628-8

    PubMed

  • Risk Factors Associated With Knee Joint Degeneration After Arthroscopic Reshaping for Juvenile Discoid Lateral Meniscus Reviewed

    Yamasaki Shinya, Hashimoto Yusuke, Takigami Junsei, Terai Shozaburo, Takahashi Shinji, Nakamura Hiroaki

    AMERICAN JOURNAL OF SPORTS MEDICINE   45 ( 3 )   570 - 577   2017.03( ISSN:0363-5465

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1177/0363546516668623

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  • Clinical results of alumina medial pivot total knee arthroplasty at a minimum follow-up of 10 years Reviewed

    Nakamura Suguru, Minoda Yukihide, Nakagawa Shigeru, Kadoya Yoshinori, Takemura Susumu, Kobayashi Akio, Mizokawa Shigekazu, Ohta Yoichi, Takahashi Sinji, Yamamura Kazumasa, Nakamura Hiroaki

    KNEE   24 ( 2 )   434 - 438   2017.03( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.knee.2016.12.011

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  • Circulating nucleated peripheral blood cells contribute to early-phase meniscal healing. Reviewed

    Shinya Yamasaki, Yusuke Hashimoto, Junsei Takigami, Shozaburo Terai, Masafumi Takahashi, Shigeyuki Wakitani, Hiroaki Nakamura

    Journal of tissue engineering and regenerative medicine   11 ( 3 )   609 - 617   2017.03( ISSN:1932-6254

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    The purpose of this study was to assess how peripheral blood cells (PBCs) contribute to meniscus repair, using a parabiotic rat model. Wild-type (WT) and green fluorescent protein (GFP) transgenic rats were conjoined at the torso. After 4 weeks, the anterior part of the medial meniscus of both groups of rats was removed. At 1, 2, 4, 8 and 12 weeks post-meniscectomy, repaired tissue was evaluated using stereomicroscopy, histology with toluidine blue staining, and immunofluorescence microscopy. Stereomicroscopic observations and confocal laser microscopy revealed that a high number of GFP-positive cells were present in the repaired meniscus of WT rats 1 week post-meniscectomy, and the number of GFP-positive cells decreased over time. Based on blood chimerism, the ratios of PBCs in the repaired meniscus were 20.5 ± 2.3% at 1 week, 8.3 ± 0.9% at 2 weeks, 4.4 ± 0.9% at 4 weeks, 2.1 ± 0.9% at 8 weeks, and 0.5 ± 0.4% at 12 weeks, post-meniscectomy. Histologically, fibrochondrocytes were observed in the repaired meniscus of WT rats after 4 weeks, some of which were GFP-positive. The chondrogenic marker, type II collagen, was merged within the PBCs in the repaired tissue. However, type-II-collagen-positive cell ratio and metachromasia in the repaired meniscus were not equivalent in normal meniscal tissue. This indicated that PBCs were present within the repaired meniscus at an early phase, replacing the excised meniscal cells, suggesting PBCs contributed to meniscal healing. The tissue repair contribution by these cells decreased at later phases. Copyright © 2014 John Wiley & Sons, Ltd.

    DOI: 10.1002/term.1955

    PubMed

  • Successful conservative treatment outcomes and clinical characteristics of congenital hypoplasia of the extensor tendon central slip Reviewed

    Hidaka N., Uemura T., Nakamura H.

    JOURNAL OF HAND SURGERY-EUROPEAN VOLUME   42 ( 3 )   295 - 300   2017.03( ISSN:1753-1934

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1177/1753193416676410

    PubMed

  • Favard分類E3タイプの腱板断裂性関節症に対してリバース型人工肩関節置換術を施行した1例

    八木 寛久, 間中 智哉, 伊藤 陽一, 市川 耕一, 中村 博亮

    肩関節   40 ( 3 )   1067 - 1070   2017.03( ISSN:0910-4461

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    症例は79歳男性で、当院初診の約1ヵ月前頃から右肩痛および右肩の腫脹が増悪したため前医を受診し、右肩関節穿刺を受け、約250mlの血腫を認めた。右肩痛および腫脹が改善せず、挙上困難も認めるため精査加療目的に当院紹介受診となった。腱板断裂性関節症および前胸部軟部腫瘍と診断し、上腕骨頭からの骨移植を併用したbony increased offset-reverse shoulder arthroplastyおよび広背筋移行術による外旋筋力の再建を行い、前胸部の腫瘤性病変に対しては腫瘍摘出術を施行した。30度の外転装具固定を行ったが、術後1週での単純X線とCTで前方脱臼を認めた。静脈麻酔下での非観血的整復術では整復困難であったため、全身麻酔下に観血的脱臼整復術とインプラントの再置換術を施行した。術後6ヵ月の肩関節自動可動域は、屈曲120度、外転70度、下垂位外旋20度、内旋臀部レベルに改善し、JOA scoreは79点であった。

  • MRI-T2マッピングを用いた外側円板状半月に対する術前後の軟骨評価

    西田 洋平, 橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 寺岡 貴徳, 新熊 孝文, 中村 博亮

    JOSKAS   42 ( 1 )   60 - 61   2017.03( ISSN:1884-8842

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    DLM(外側円板状半月)に対して鏡視下で半月形成切除術あるいは半月形成縫合術を行った17例17膝(男性6膝、女性11膝、手術時平均年齢13.2歳)を対象に、MRI-T2マッピングを用いて術前後の軟骨のT2値を計測・評価した。その結果、大腿骨外顆後方では術前と比べ、術後3ヵ月、6ヵ月には軟骨のT2値上昇を認めたが、術後12ヵ月では有意差がみられなかった。

  • MRI-T2マッピングを用いた外側円板状半月に対する術前後の半月評価

    西田 洋平, 橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 寺岡 貴徳, 新熊 孝文, 中村 博亮

    JOSKAS   42 ( 1 )   64 - 65   2017.03( ISSN:1884-8842

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    DLM(外側円板状半月)に対し鏡視下で半月形成切除術、あるいは半月形成縫合術を行った17例17膝(男性6膝、女性11膝、手術時平均年齢13.2歳)を対象に、MRI-T2マッピングを用いて術前後の半月のT2値を計測・評価した。その結果、術前における外側円板状半月のT2値は、内側半月よりも有意に高値を示していた。術後半月のT2値は、前節・後節ともに術後12ヵ月で有意な低下を認めた。非縫合部のT2値は術後12ヵ月で有意に低下したが、縫合部では経時的な有意差を認めず、縫合部と非縫合部間においても各時期で有意差を認めなかった。

  • ヒトの黄色靱帯と脊椎後方骨性隆起の関連についての解剖学的解析(Anatomical analysis of the relation between human ligamentum flavum and posterior spinal bony prominence)

    Akhgar Javid, Terai Hidetomi, Rahmani Mohammad Suhrab, Tamai Koji, Suzuki Akinobu, Toyoda Hiromitsu, Hoshino Masatoshi, Ikebuchi Mitsuhiko, Ahmadi Sayed Abdullah, Hayashi Kazunori, Nakamura Hiroaki

    Journal of Orthopaedic Science   22 ( 2 )   260 - 265   2017.03( ISSN:0949-2658

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    骨性隆起と黄色靱帯との正確な位置関係を明らかにした。20体のホルマリン固定屍体から脊柱を離断した後に椎弓根基部にて椎弓根を切離し、椎弓と黄色靱帯を取り出した。黄色靱帯と椎弓の位置関係を計測した後、CT撮影を行った。CT撮影で得られたDICOMデータを用いて三次元CT画像解析装置により解析し、腰椎を後方からみた場合の黄色靱帯の位置を視覚化した。また、黄色靱帯と脊椎後方骨性隆起との正確な位置関係を調べた。両側LFはV型であり、付随する椎弓の形に沿っていた。LFの形状は腰上部において変化が認められたが、L5-S1のLFの形状は他の位置のLFとは異なっており、L5-S1のLFは各例で多様であった。椎弓根の内側縁とLFの外側縁の平均幅は腰上部から腰下部にかけて拡大していた。正中部における層間の空間とLFの頭蓋境界との幅は徐々に拡大し、L1で8.2mm、L4で11.1mm、L5で9.3mmであった。コントラストLFおよび再構成CTを用いた解剖学的解析により、骨性隆起とLF境界との関連が明らかとなった。

  • 解剖学的前十字靱帯二重束再建術における脛骨側骨孔位置とMRI移植腱信号変化の関係

    寺岡 貴徳, 橋本 祐介, 寺井 彰三郎, 西田 洋平, 中村 博亮

    JOSKAS   42 ( 1 )   140 - 141   2017.03( ISSN:1884-8842

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    前十字靱帯(ACL)二重束再建術後のMRIにおける前内側線維(AM)束信号変化と脛骨側骨孔位置、前方不安定性、cyclops lesionとの関係を検討した。解剖学的ACL二重束再建術を施行した患者のうち、術後1年以上経過観察可能であり、術後1週時に3DCTを、術後1年時にMRIを撮像できた54例(男22例・女32例・平均年齢26.0歳)を対象とした。3D-CTによる骨孔計測は、脛骨関節面の前縁と内側縁に接線を引き、その前内側の交点を0%、後縁、外側縁を各々100%とした。術中脛骨側骨孔作成時に指標としたParson's knob、AM骨孔の前縁、AM骨孔の中心の前縁・内側縁からの距離を計測し記録した。移植腱の信号変化は、後十字靱帯の信号強度を基準とし、信号変化を30%以上認めたものをhigh群(H群)、30%未満のものをlow群(L群)とした。前方不安定性はKT-2000を用いて健患差(KT値健患差)にて評価し、MRIにおいて移植腱前方に占拠性病変として認めるものを陽性としてcyclops lesionを評価した。その結果、L群と比較してH群は脛骨側AM束骨孔が前方設置であり、cyclops lesionの発生率とKT値が有意に高いことが判明した。

  • 頸部神経根症に対する円筒形レトラクターを用いた顕微鏡視下除圧術

    山部 孝弘, 関 昌彦, 柴田 雄輝, 辻尾 唯雄, 中村 博亮

    中部日本整形外科災害外科学会雑誌   60 ( 2 )   445 - 446   2017.03( ISSN:0008-9443

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    1椎間の頸部神経根症に対し円筒形レトラクターを用いて顕微鏡視下頸椎後方除圧術を行った11例(男性3例、女性8例、平均年齢52.0歳)の治療成績について検討した。平均観察期間47ヵ月の結果、術前後の平均VASスコアは頸部が7.9点から0.3点、上肢部が8.1点から0.5点に改善していた。術前と術翌日のCK値は平均106U/lから平均208U/lと基準値以内の上昇であった。田中らの頸部神経根症治療成績判定基準による神経根スコアは平均5.5点から19.0点に改善し、改善率は92.0%であった。術後CTでは全例に十分な除圧が得られており、最終観察時の患者満足度は大変満足が8例、満足が3例であった。

  • 脊柱管内と椎間孔部に発生した腰椎傍椎間関節嚢腫の1例

    柴田 雄輝, 辻尾 唯雄, 関 昌彦, 藪 晋人, 中村 博亮

    中部日本整形外科災害外科学会雑誌   60 ( 2 )   431 - 432   2017.03( ISSN:0008-9443

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    75歳女。腰痛・左下肢後面痛を主訴とした。1ヵ月前より次第に増強し、初診時Kemp signは左側で陽性、SLRは左側で60°陽性であった。知覚は3/10に低下し、単純MRIにてL5/Sの脊柱管内左側に嚢胞性病変を認めた。顕微鏡視下にL5/S左側の椎間関節嚢腫摘出を施行し、病理所見より左脊柱管内の腰椎傍椎間関節嚢腫と診断した。術後3ヵ月より右下肢痛が出現し、単純X線側面像にてL5のすべりを認め、単純MRIにて右側椎間孔部に嚢胞性病変を認めた。右L5/S椎間孔部の傍椎間関節嚢腫と診断し、嚢胞摘出とL5/Sの腰椎後方椎体間固定術を施行した。病理所見は前回手術時と同様に変性した線維性結合織であり、明らかなsynovial lining cellは認めなかった。

  • 肩峰下滑液包内ガングリオン嚢胞に鏡視下手術を施行した1例

    山田 祐太郎, 間中 智哉, 伊藤 陽一, 市川 耕一, 中村 博亮

    肩関節   40 ( 3 )   1071 - 1073   2017.03( ISSN:0910-4461

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    症例は82歳女性で、当院受診の約1年前から右肩前面の腫瘤形成および動作時の疼痛を認めていた。近医にて穿刺吸引等の保存的加療を行うも再発を繰り返すために、当院紹介受診となった。画像所見から、右肩肩峰下滑液包内に発生した嚢胞(ガングリオン疑い)と診断し、疼痛を伴うため手術加療を行う方針とした。関節鏡視では肩甲上腕関節の軟骨菲薄化および骨棘形成を認め、関節症性変化をきたしていた。肩峰下滑液包鏡視では厚い被膜と黄色で粘稠性の液体を含むガングリオン嚢胞を認めた。肩鋒骨棘に対しては肩峰下除圧術を施行し、ガングリオン嚢胞を可及的に切除した。腫瘤は触知しなくなり同部位の疼痛は術後早期に消失した。術後1年の右肩関節自動可動域は、屈曲145度、外転140度、外旋40度、内旋L1と改善は乏しいものの疼痛の軽減が得られ、JOAスコアは78点まで改善した。

  • 広範囲腱板断裂に対するInterposed Trans-Osseous法による鏡視下腱板修復術の有用性

    伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   40 ( 3 )   951 - 954   2017.03( ISSN:0910-4461

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    広範囲腱板断裂に対しInterposed Trans-Osseousによる鏡視下腱板修復術を行った33例(ITO群)の治療成績について、従来法で鏡視下腱板修復術を行った28例(従来群)と比較検討した。その結果、手術時の骨孔亀裂割合は従来群の46%に対し、ITO群では9%と有意な減少を認めた。腱板再断裂率は、従来群で35.7%、ITO群で21.2%と、ITO群で減少傾向にあった。JOAスコアは両群ともに術後有意な改善を認め、両群間で有意差はみられなかった。以上より、広範囲腱板断裂に対するITO法は、概ね良好な臨床成績が得られる有効な治療法であると判断できた。

  • 巨大関節窩骨欠損を伴うCTAに対して上腕骨骨移植とRSAを施行した一例

    村上 将一, 平川 義弘, 伊藤 陽一, 間中 智哉, 中村 博亮

    肩関節   40 ( 3 )   1074 - 1077   2017.03( ISSN:0910-4461

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    症例は82歳女性で、数年前より右肩痛が増強し、近医にて右肩関節穿刺およびステロイド注射等の保存療法を受けていたが症状改善しなかった。右肩関節前後像では上腕骨頭は脱臼しており、CTでは肩甲骨関節窩前方成分の骨欠損を認めた。3D-CTでは関節窩の前後径に対して約52%の骨欠損を認めた。反復性肩関節脱臼に伴う著明な肩甲骨関節窩の骨欠損に対して、上腕骨頭からの骨移植を併用したリバース型人工肩関節置換術を施行した。術後療法は、4週間は外転位装具で固定を行い、理学療法は術翌日から術後4週まで他動可動域訓練のみ、術後4〜8週は介助下自動可動域訓練、術後8週以降は自動可動域訓練を行った。術後1年で自動可動域は屈曲140度、外転120度、下垂位外旋0度、内旋L5、JOAスコアは73.5点に改善した。

  • 外側半月板水平断裂に対する半月縫合術の臨床成績

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   42 ( 1 )   78 - 79   2017.03( ISSN:1884-8842

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    外側半月板水平断裂に対し半月板縫合術を行った19例(男性15例、女性4例、手術時平均年齢31.3歳、平均観察期間1.7年)の臨床成績について検討した。その結果、Lysholm scoreは術前平均64.9から術後平均93.1へ有意に改善していた。McMurray testでは、術前は全例陽性であったが、術後は17例が陰性となり、陽性は2例のみであった。術後合併症としては、術後3週間で発熱、関節内感染を1例で認め、洗浄、デブリドマンを施行した。術後MRI評価では、Type 1が4例、Type 2が11例、Type 3が4例であった。本検討ではfibrin clot挿入率が8割程度で全例ではなかったが、非再手術率は94%であり、比較的良好な成績が得られていた。

  • 外側円板状半月に対する形成・縫合術後に生じる関節症性変化の危険因子

    山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   42 ( 1 )   76 - 77   2017.03( ISSN:1884-8842

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    膝外側円板状半月板(DLM)に対し鏡視下半月板形成・縫合術を施行した40例45膝(平均年齢12歳)を対象に、術後の関節症性変化発生の危険因子について検討した。その結果、術後2年の臨床的評価では、Lysholm scoreは術前平均70点から術後平均97点へ有意に改善していた。Ikeuchi grading scaleではexcellentが28膝、goodが15膝、fairが2膝、poorが0膝であった。今回の検討では、術後半月残存量が小さく、半月逸脱が大きいものほど関節症性変化が生じやすく、特に残存中節幅5.0mmがそのカットオフ値となった。更にAhn分類のAC shiftは関節症性変化の危険因子と考えられた。

  • リバース型人工肩関節置換術におけるCT画像評価の有用性 肩甲骨関節窩形態及びグレノイドコンポーネント設置位置を中心に

    澤田 雄大, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   40 ( 3 )   1055 - 1058   2017.03( ISSN:0910-4461

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    CTを用いて術前の肩甲骨関節窩形態やリバース型人工肩関節置換術(RSA)後のグレノイドコンポーネント(GC)の設置位置を評価した。腱板断裂性関節症に対してRSAを施行した14肩14症例(女性8例、男性6例、平均79歳)を対象とした。評価項目は、肩甲骨関節窩およびGCの傾斜角、肩甲骨関節窩およびGCの前後捻角、GCの下方への張り出しとした。検討の結果、術前の肩甲骨関節窩傾斜角は5.7±8.5度、術後のGCの傾斜角は-6.9±8.1度であった。術前の肩甲骨関節窩の前後捻角は-1.2±8.5度、術後のGCの前後捻角は-2.1±9.2度、術後のGCの下方への張り出しは4.3±2.4mmであった。CTにて、術前の肩甲骨関節窩形態や術後のGCの設置評価が可能であった。

  • リバース型人工肩関節全置換術における、初回手術例と鏡視下手術術後再手術例間の短期臨床成績比較

    伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   40 ( 3 )   1043 - 1046   2017.03( ISSN:0910-4461

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    偽性麻痺を伴う広範囲鍵板断裂症例43例44肩に対するリバース型人工肩関節全置換術(RSA)初回手術例と鏡視下手術失敗後のRSA再手術例の短期臨床成績を比較検討した。25肩(男性9例、女性16例、平均76.3±6.4歳)は初回手術時にPrimary RSAを施行し、19肩(男性5例、女性14例、平均77.7±6.2歳)は偽性麻痺が持続し再手術としてSecondary RSAを施行した。検討の結果、屈曲および外転に関して、術後3、6ヵ月では術前比較で有意な改善を認め、明らかな群間差はなかった。術後6ヵ月での下垂位の外旋筋力、術前および術後6ヵ月での45度外転時の外旋筋力は、再手術群の方が初回手術群より有意に低値であった。JOA scoreは術後経時的に有意な改善を認めたが、両群間に有意差を認めなかった。偽性麻痺を伴う広範囲腱板断裂症例に対するRSAにおいて、初回手術例でも再手術例でも、自動屈曲および外転可動域は良好な改善が期待できると考えられた。

  • Facet Effusion without Radiographic Instability Has No Effect on the Outcome of Minimally Invasive Decompression Surgery Reviewed

    Tamai Koji, Kato Minori, Konishi Sadahiko, Matsumura Akira, Hayashi Kazunori, Nakamura Hiroaki

    GLOBAL SPINE JOURNAL   7 ( 1 )   21 - 27   2017.02( ISSN:2192-5682

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    DOI: 10.1055/s-0036-1583173

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  • Posterior corrective surgery with a multilevel transforaminal lumbar interbody fusion and a rod rotation maneuver for patients with degenerative lumbar kyphoscoliosis Reviewed

    Matsumura Akira, Namikawa Takashi, Kato Minori, Ozaki Tomonori, Hori Yusuke, Hidaka Noriaki, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   26 ( 2 )   150 - 157   2017.02( ISSN:1547-5654

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    DOI: 10.3171/2016.7.SPINE16172

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  • Intradural chondroma in the cervical spine: case report Reviewed

    Hori Yusuke, Seki Masahiko, Tsujio Tadao, Hoshino Masatoshi, Mandai Koji, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   26 ( 2 )   257 - 259   2017.02( ISSN:1547-5654

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    DOI: 10.3171/2016.8.SPINE16152

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  • Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in Patients with Spinal Disorders Reviewed

    Toyoda Hiromitsu, Terai Hidetomi, Yamada Kentaro, Suzuki Akinobu, Dohzono Sho, Matsumoto Tomiya, Nakamura Hiroaki

    ASIAN SPINE JOURNAL   11 ( 1 )   63 - 70   2017.02( ISSN:1976-1902

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    DOI: 10.4184/asj.2017.11.1.63

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  • Time course of osteoporotic vertebral fractures by magnetic resonance imaging using a simple classification: a multicenter prospective cohort study Reviewed

    Takahashi S., Hoshino M., Takayama K., Iseki K., Sasaoka R., Tsujio T., Yasuda H., Sasaki T., Kanematsu F., Kono H., Toyoda H., Nakamura H.

    OSTEOPOROSIS INTERNATIONAL   28 ( 2 )   473 - 482   2017.02( ISSN:0937-941X

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    DOI: 10.1007/s00198-016-3737-x

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  • Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: Four years of the TOMORROW study Reviewed

    Mamoto Kenji, Inui Kentaro, Okano Tadashi, Sugioka Yuko, Tada Masahiro, Koike Tatsuya, Nakamura Hiroaki

    MODERN RHEUMATOLOGY   27 ( 1 )   8 - 14   2017.01( ISSN:1439-7595

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    DOI: 10.1080/14397595.2016.1176625

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  • A case of asymptomatic bilateral massive pulmonary embolism after arthroscopic multiple knee ligament reconstruction Reviewed

    Takigami Junsei, Hashimoto Yusuke, Yamasaki Shinya, Terai Shozaburo, Nakamura Hiroaki

    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY   25 ( 1 )   260 - 262   2017.01( ISSN:0942-2056

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    DOI: 10.1007/s00167-014-3466-7

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  • Clinical features of soft tissue sarcoma presenting intra-tumour haematoma: case series and review of the literature Reviewed

    Hoshi Manabu, Oebisu Naoto, Ieguchi Makoto, Ban Yoshitaka, Takami Masatsugu, Nakamura Hiroaki

    INTERNATIONAL ORTHOPAEDICS   41 ( 1 )   203 - 209   2017.01( ISSN:0341-2695

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    DOI: 10.1007/s00264-016-3322-0

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  • A case of asymptomatic bilateral massive pulmonary embolism after arthroscopic multiple knee ligament reconstruction.

    Takigami J, Hashimoto Y, Yamasaki S, Terai S, Nakamura H

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   25 ( 1 )   260 - 262   2017.01( ISSN:0942-2056

  • 重粒子線治療後、長期経過観察した3例の四肢悪性腫瘍

    家口 尚, 星 学, 大戎 直人, 高松 聖仁, 中村 博亮

    中部日本整形外科災害外科学会雑誌   60 ( 1 )   57 - 58   2017.01( ISSN:0008-9443

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    症例1:48歳男。右下腿の粘液型/小円形型脂肪肉腫の診断で粒子線治療を行うこととし、炭素線照射を施行した。約12年後に再発を認め、広範切除と膝窩動脈再建を施行した。現在、PTB装具装着下で独歩可能で、150ヵ月無病生存している。症例2:41歳男。右大腿骨骨肉腫の診断で本人希望により粒子線治療を行うこととし、炭素線治療を施行した。以後通院歴はなく、約3年後に再発を認め大腿切断施行となった。再び受診が途絶えたものの、70ヵ月までNEDであった。症例3:48歳女。右肘関節部類上皮血管内皮腫に対し炭素線治療を施行したが、照射2年後から正中と後骨間神経障害症状が出現した。その後、神経剥離、脂肪筋膜弁移植等の手術を2度施行し、多少の改善は認めたが、正中神経と後骨間神経支配領域の麻痺による機能障害と知覚障害、異常知覚等が残存した。120ヵ月無病生存している。

  • 関節リウマチ患者と対照群の転倒発生率の比較および転倒の危険因子 4年間のTOMORROW研究の結果(Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: Four years of the TOMORROW study)

    Mamoto Kenji, Inui Kentaro, Okano Tadashi, Sugioka Yuko, Tada Masahiro, Koike Tatsuya, Nakamura Hiroaki

    Modern Rheumatology   27 ( 1 )   8 - 14   2017.01( ISSN:1439-7595

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    関節リウマチ(RA)患者を対象とした前向きコホート研究の一環として、転倒発生率とその危険因子を4年間の追跡データから解析した。Total Management Of Risk Factors in Rheumatoid Arthritis Patients to Lower Morbidity and Mortality(TOMORROW)研究に参加したRA患者208例(RA群)と、性別・年齢を一致させた非RA被験者205例(対照群)を対象とした。人・年当たりの転倒事故発生率は、RA群と対照群の間で有意差は見られなかった。ロジスティック回帰分析により、年齢、性別、BMI、転倒歴、調査開始時に下肢への人工関節植込みが転倒の有意な危険因子であった。RA群に限定した場合、抗環状シトルリン化ペプチド(抗CCP)抗体濃度が上位四分の一(>300.6U/ml)であることが転倒多発の最も強い予測因子であった。

  • Loss of lean body mass affects low bone mineral density in patients with rheumatoid arthritis - results from the TOMORROW study. Reviewed

    Tadashi Okano, Kentaro Inui, Masahiro Tada, Yuko Sugioka, Kenji Mamoto, Shigeyuki Wakitani, Tatsuya Koike, Hiroaki Nakamura

    Modern rheumatology   27 ( 6 )   946 - 952   2017( ISSN:1439-7595

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    OBJECTIVES: Osteoporosis is one of the complications for patients with rheumatoid arthritis (RA). Rheumatoid cachexia, the loss of lean body mass, is another. However, the relationship between decreased lean body mass and reduced bone mineral density (BMD) in patients with RA has not been well studied. METHODS: This study included 413 participants, comprising 208 patients with RA and 205 age- and sex-matched healthy volunteers. Clinical data, BMD, bone metabolic markers (BMM) and body composition, such as lean body mass and percent fat, were collected. Risk factors for osteoporosis in patients with RA including the relationship BMD and body composition were analyzed. RESULTS: Patients with RA showed low BMD and high BMM compared with controls. Moreover, lean body mass was lower and percent fat was higher in patients with RA. Lean body mass correlated positively and percent fat negatively with BMD. Lean body mass was a positive and disease duration was a negative independent factor for BMD in multivariate statistical analysis. CONCLUSION: BMD and lean body mass were significantly lower in patients with RA compared to healthy controls. Lean body mass correlated positively with BMD and decreased lean body mass and disease duration affected low BMD in patients with RA. TRIAL REGISTRATION: [UMIN Clinical Trials Registry, http://www.umin.ac.jp/ctr/ , UMIN000003876].

    DOI: 10.1080/14397595.2017.1289645

    PubMed

  • High frequency of vertebral fracture and low bone quality in patients with rheumatoid arthritis-Results from TOMORROW study. Reviewed

    Tadashi Okano, Kentaro Inui, Masahiro Tada, Yuko Sugioka, Kenji Mamoto, Shigeyuki Wakitani, Tatsuya Koike, Hiroaki Nakamura

    Modern rheumatology   27 ( 3 )   398 - 404   2017( ISSN:1439-7595

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    OBJECTIVES: Osteoporosis is one of the complications in patients with rheumatoid arthritis (RA). In this study, we researched the morbidity of existing vertebral fractures and the risk factors for vertebral fractures in patients with RA. METHODS: This study included 413 participants, 208 patients with RA, and 205 age- and sex-matched controls without RA. Clinical data, radiographic assessment of vertebral fracture from T4 to L4 in thoracic and lumber spine, bone mineral density (BMD), and bone metabolic markers (BMM) were analyzed. RESULTS: Vertebral fractures were observed more frequently, severe and multiple in patients with RA. In the logistic regression analysis, age (adjusted odds ratios (OR): 1.07, 95% confidence interval (CI): 1.04-1.09) and RA (adjusted OR: 1.72, 95% CI: 1.04-2.83) were risk factors for existing vertebral fracture. Moreover, two bone matrix-related markers, undercarboxylated osteocalcin (ucOC) (adjusted OR: 1.68, 95% CI: 1.02-2.78), and urinary pentocidine (adjusted OR: 2.51, 95% CI: 1.48-4.24) were associated with existing vertebral fracture. CONCLUSIONS: High frequent, multiple, and severe vertebral fractures were found in patients with RA compared to the controls. Low bone quality might be the cause of the frequent prevalence of vertebral fracture in patients with RA.

    DOI: 10.1080/14397595.2016.1213943

    PubMed

  • Comparison of Median Nerve Cross-sectional Area on 3-T MRI in Patients With Carpal Tunnel Syndrome Reviewed

    Ikeda Mikinori, Okada Mitsuhiro, Toyama Masahiko, Uemura Takuya, Takamatsu Kiyohito, Nakamura Hiroaki

    ORTHOPEDICS   40 ( 1 )   E77 - E81   2017( ISSN:0147-7447

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    DOI: 10.3928/01477447-20160915-04

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  • Evaluation on mechanical diagnosis of osteoarthritic cartilage using Dynamic Optical Coherence Straingraphy (D-OCSA) Reviewed

    Saeki Souichi, Kotani Kazuma, Hasegawa Kiichi, Ikebuchi Mitsuhiko, Nakamura Suguru, Nakamura Hiroaki, Niimi Nobuo, Tsukahara Yoshito

    Japanese Society for Medical and Biological Engineering, Transactions of Japanese Society for Medical and Biological Engineering   55 ( 5 )   493 - 493   2017( ISSN:1347-443X

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    <p>In this study, we have proposed D-OCSA which is a tomographically micro-visualizing method of mechanical properties estimated from continuous OCT images. This can provide temporal and spatial distribution of strain rate during a stress relaxation test and a dynamic viscoelasticity test. This was experimentally applied to comparatively both normal cartilages and cartilages degenerated by the collagenase enzyme treatment. The temporal attenuation and the sinusoidal variation of strain rate were locally observed to have characteristic viscoelastic behaviors around surface zone. In the former, the attenuation of strain rate was visualized to be lager in the superficial tangential zone than that in the middle zone. In the latter, the phase difference of sinusoidal time-varying strain rate corresponded to the degradation of viscoelasticity. Consequently, it is possible to diagnose the degeneration of the early-grade OA, taking the temporal attenuation of relaxation modulus and spatial gradient of phase delay into consideration.</p>

    DOI: 10.11239/jsmbe.55Annual.493

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  • Comprehensive verification on Mechanical Diagnosis of Osteoarthritic Cartilage using Dynamic Optical Coherence Straingraphy Reviewed

    SAEKI Souichi, FURUKAWA Daisuke, HASEGAWA Kiichi, KOTANI Kazuma, IKEBUCHI Mitsuhiro, NAKAMURA Suguru, NAKAMURA Hiroaki, NIIMI Nobuo, TSUKAHARA Yoshihito

    The Japan Society of Mechanical Engineers, The Proceedings of Mechanical Engineering Congress, Japan   2017 ( 0 )   J0210105   2017( eISSN:24242667

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    <p>Many of the elderly are predisposed to develop osteoarthritis (OA), although it is quite difficult to diagnose the early-grade OA even by latest imaging modalities. In this study, we have proposed Dynamic Mechanical Analyzing Optical Coherence Straingraphy, namely DMA-OCSA, which is a tomographically micro-visualizing method of visco-elastic properties estimated from continuous OCT images. This is based on the speckle tracking algorithm having high sensitivity and S/N under micrometer resolution, thus can provide temporal and spatial distribution of not only deformation velocity but also strain rate during a dynamic visco-elasticity test. This was experimentally applied to comparatively Osteoarthritic cartilage of animal models. Consequently, the sinusoidal time-varying strain rate was locally observed to have phase difference between the superficial tangential zone and middle zone, which could cause degradation of visco-elasticity.</p>

    DOI: 10.1299/jsmemecj.2017.J0210105

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  • Risk factors of cervical surgery related complications in patients older than 80 years Reviewed

    Tamai Koji, Terai Hidetomi, Suzuki Akinobu, Nakamura Hiroaki, Yamashita Masaomi, Eguchi Yawara, Imagama Shiro, Ando Kei, Kobayashi Kazuyoshi, Matsumoto Morio, Ishii Ken, Hikata Tomohiro, Seki Shoji, Aramomi Masaaki, Ishikawa Tetsuhiro, Kimura Atsushi, Inoue Hirokazu, Inoue Gen, Miyagi Masayuki, Saito Wataru, Yamada Kei, Hongo Michio, Endo Kenji, Suzuki Hidekazu, Nakano Atsushi, Watanabe Kazuyuki, Ohya Junichi, Chikuda Hirotaka, Aoki Yasuchika, Shimizu Masayuki, Futatsugi Toshimasa, Mukaiyama Keijiro, Hasegawa Masaichi, Kiyasu Katsuhito, Iizuka Haku, Nishida Kotaro, Kakutani Kenichiro, Nakajima Hideaki, Murakami Hideki, Demura Satoru, Kato Satoshi, Yoshioka Katsuhito, Namikawa Takashi, Watanabe Kei, Nakanishi Kazuyoshi, Nakagawa Yukihiro, Yoshimoto Mitsunori, Fujiwara Hiroyasu, Nishida Norihiro, Sakane Masataka, Yamazaki Masashi, Kaito Takashi, Furuya Takeo, Orita Sumihisa, Ohtori Seiji

    Spine Surgery and Related Research   1 ( 4 )   179 - 184   2017( ISSN:2432-261X ( eISSN:2432261X

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    <p>Introduction: With an aging population, the proportion of patients aged ≥80 years requiring cervical surgery is increasing. Surgeons are concerned with the high incidence of complications in this population, because "age" itself has been reported as a strong risk factor for complications. However, it is still unknown which factors represent higher risk among these elderly patients. Therefore, this study was conducted to identify the risk factors related to surgical complications specific to elderly patients by analyzing the registry data of patients aged ≥80 years who underwent cervical surgery.</p><p>Methods: We retrospectively studied multicenter collected registry data using multivariate analysis. Sixty-six patients aged ≥80 years who underwent cervical surgery and were followed up for more than one year were included in this study. Preoperative patient demographic data, including comorbidities and postoperative complications, were collected from multicenter registry data. Complications were considered as major if they required invasive intervention, caused prolonged morbidity, or resulted in prolongation of hospital stay. Logistic regression analysis was performed to analyze the risk factors for complications. A <i>p</i>-value of <0.05 was considered as statistically significant.</p><p>Results: The total number of patients with complications was 21 (31.8%), with seven major (10.6%) and 14 minor (21.2%) complications. Multivariate logistic regression analysis, after adjusting for age, revealed two significant risk factors: preoperative cerebrovascular disorders (OR, 6.337; p=0.043) for overall complications and cancer history (OR, 8.168; p=0.021) for major complications. Age, presence of diabetes mellitus, and diagnosis were not significant predictive factors for complications in this study.</p><p>Conclusions: Preoperative cerebrovascular disorders and cancer history were risk factors for complications after cervical surgery in patients over 80 years old. Surgeons should pay attention to these specific risk factors before performing cervical surgery in elderly patients.</p>

    DOI: 10.22603/ssrr.1.2017-0002

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  • Navigation asisted surgery for benign bone tumors Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   60 ( 5 )   863 - 864   2017( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2017.863

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  • A case of lumbar juxtafacet cyst at spinal canal and vertebral foramen Reviewed

    SHIBATA Yuki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   60 ( 2 )   431 - 432   2017( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2017.431

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  • Validation study on tomographic micro-diagnosis of Osteoarthritis applying Stress Relaxation Optical Coherence Straingraphy by estimated viscoelastic parameters Reviewed

    HASEGAWA Kiichi, SAEKI Souichi, FURUKAWA Daisuke, KOTANI Kazuma, NAKAMURA Hiroaki, IKEBUCHI Mituhiko, NAKAMURA Suguru, NIIMI Nobuo, TUKAHARA Yoshito

    The Japan Society of Mechanical Engineers, The Proceedings of the Bioengineering Conference Annual Meeting of BED/JSME   2017 ( 0 )   2D14   2017( eISSN:24242829

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    DOI: 10.1299/jsmebio.2017.29.2D14

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  • 変形性肩鎖関節症に対する鏡視下鎖骨遠位端切除術の<BR>術後5年での臨床成績と画像評価 Reviewed

    松田 淑伸, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   41 ( 2 )   545 - 548   2017( ISSN:0910-4461 ( eISSN:18816363

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    変形性肩鎖関節症に対する鏡視下鎖骨遠位端切除術の術後5年での臨床成績と画像評価を行った.対象は有痛性変形性肩鎖関節症に対して鏡視下鎖骨遠位端切除術を施行した31例34肩,女性18例,男性13例,平均年齢は62歳であった.臨床成績は,肩関節の自動屈曲・外転可動域,肩鎖関節部の圧痛,肩関節水平内転ストレスでの肩鎖関節痛の誘発の4つの項目を,術前,術後1年,術後5年時に評価した.画像評価は単純X線の肩正面像で術後早期と5年時に肩峰と鎖骨遠位断端の距離を計測し,その変化値も評価した.自動屈曲・外転可動域は術前から術後5年にかけて有意に改善した.術後5年では肩鎖関節部の圧痛は軽度残存7肩20.6%に,水平内転ストレスでの肩鎖関節痛の誘発は残存1肩2.9%に改善した.鎖骨の切除量は平均13.6mmで,術直後から術後5年にかけて切除部間隙は17肩56.7%で狭小化し,11肩36.7%で開大,2肩6.7%で変化なしであった.異所性骨化のような陰影を2肩6.7%に認めた.

    DOI: 10.11296/katakansetsu.41.545

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  • リバース型人工肩関節置換術術後の経時的動態解析 Reviewed

    平川 義弘, 間中 智哉, 伊藤 陽一, 池淵 充彦, 中島 重義, 市川 耕一, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   41 ( 2 )   581 - 585   2017( ISSN:0910-4461 ( eISSN:18816363

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    肩関節運動は,肩甲胸郭リズムと肩甲上腕リズムの密接な関連性により構成されており,両リズムに肩甲骨運動は重要な役割を担っている.正常肩における肩甲骨の動態解析に関する報告は散見されるが,リバース型人工肩関節置換術(以下,RSA)術後の肩甲骨の動態解析に関する情報は渉猟し得ない.今回我々は,THAナビゲーションに用いられている2D-3Dマッチング法を応用し新たに開発された肩関節動態解析ソフト(以下,GANESHA)を利用して,経時的なRSA術後の動態解析を行ったので報告する.対象は当科においてRSAを施行し,術後12カ月以上の経過観察が可能であった5例5肩(女性2例,男性3例)手術時平均年齢75.2歳(70~79歳)であった.術後3カ月,術後6カ月,術後12カ月に肩甲骨面上で,自動挙上0&deg;,30&deg;,60&deg;,90&deg;にて透視下にX線撮影を行った.術前のCT画像より得られた肩甲骨の三次元画像を利用しGANESHAを利用してセミオートマティックに肩甲骨の上方回旋角,外旋角,後方傾斜角の変化量の測定を行った.術後3カ月時,術後6カ月時,術後12カ月の自動挙上30&deg;,60&deg;,90&deg;における肩甲骨3次元動態解析において,上方回旋角,外旋角,後方傾斜角に有意な差はみられなかった.RSA術後の経時的な肩関節挙上運動時の肩甲骨の動態解析により,術後肩甲骨の位置は術後3カ月以降に有意な変化はみられないと考えられた.

    DOI: 10.11296/katakansetsu.41.581

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  • Using Accelerometer-Based Portable Navigation to Perform Accurate Total Knee Arthroplasty Bone Resection in Asian Patients Reviewed

    Ueyama Hideki, Matsui Yoshio, Minoda Yukihide, Matsuura Masanori, Nakamura Hiroaki

    ORTHOPEDICS   40 ( 3 )   E465 - E472   2017( ISSN:0147-7447

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    DOI: 10.3928/01477447-20170223-01

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  • The origin and distribution of CD68, CD163, and αSMA+ cells in the early phase after meniscal resection in a parabiotic rat model. Reviewed

    Shozaburo Terai, Yusuke Hashimoto, Kumi Orita, Shinya Yamasaki, Junsei Takigami, Takafumi Shinkuma, Takanori Teraoka, Yohei Nishida, Masafumi Takahashi, Hiroaki Nakamura

    Connective tissue research   58 ( 6 )   562 - 572   2017( ISSN:0300-8207

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    We previously reported that circulating peripheral blood-borne cells (PBCs) contribute to early-phase meniscal reparative change. Because macrophages and myofibroblasts are important contributors of tissue regeneration, we examined their origin and distribution in the reparative meniscus. Reparative menisci were evaluated at 1, 2, and 4 weeks post-meniscectomy by immunohistochemistry to locate monocytes and macrophages (stained positive for CD68 and CD163), and myofibroblasts (stained positive for αSMA). Of the total number of cells, 13% were CD68+ at 1 week post-meniscectomy, which decreased to 1% by 4 weeks post-meniscectomy; of these, almost half of CD68+ cells (49.4%: 98.8% as PBCs) were green fluorescent protein (GFP)-positive post-meniscectomy (1, 2, and 4 weeks), indicating that the majority of CD68+ cells were derived from PBCs. Of the total cells, 6% were CD163+ at 1 week post-meniscectomy, which decreased to 1% by week 4. Of the CD163+ cells, the majority were GFP-positive (42.5%: 85.0% as PBCs) after 1 week; however, this decreased significantly over time, which indicates that the majority of CD163+ cells are derived from PBCs during the early phase of meniscal reparative change, but are derived from resident cells at later time points. Of the total cells, 38% were αSMA+ at 1 week post-meniscectomy, which decreased to 3% by 4 weeks. The proportion of GFP-positive αSMA+ cells was 2.8% after 1 week, with no significant change over time, which indicates that the majority of αSMA+ cells originated from resident cells. Here, we describe the origin and distribution of macrophages and myofibroblasts during meniscal reparative change.

    DOI: 10.1080/03008207.2017.1284825

    PubMed

  • Pain Management After Total Hip Arthroplasty: Multimodal Local Periarticular Injections vs Continuous Epidural Infusions Reviewed

    SUGAMA Ryo

    Japanese Society for Joint Diseases, Japanese Journal of Joint Diseases   36 ( 2 )   107 - 111   2017( ISSN:1883-2873 ( eISSN:18849067

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    <p><b>Background:</b> In total hip arthroplasty (THA), postoperative pain control affects patient recovery and satisfaction. Periarticular injection with a multimodal protocol has been reported to be effective for pain control. There have been few studies describing only single periarticular injection using various kinds of medications for THA. In this study, we assessed the efficacy of single periarticular injection compared with epidural infusion on postoperative pain and analgesic requirements after THA.</p><p><b>Methods:</b> Forty-three patients were randomized into two groups to receive either intraoperative single periarticular injection with ropivacaine, morphine, epinephrine, methylprednisolone, ketoprofen, and saline (Cocktail group), or continuous epidural infusion for three days postoperatively (Epidural group). For rescue analgesia, intravenous patient-controlled analgesia with morphine was used for 24 hours postoperatively. The intensity of hip pain (0-100 mm on visual analog scale (VAS), for 1 to 21 days postoperatively), morphine requirements (for 24 hours), and satisfaction (0-100 mm on VAS, for 1 to 21 days postoperatively), were recorded.</p><p><b>Results:</b> VAS for pain at rest was lower in the Cocktail group than in Epidural group on postoperative day (POD) 1, which was statistically significant (7.5 vs 17.8, <i>P</i><0.05). On POD 2, POD 3, POD 5 and POD 7, the VAS in the Cocktail group was lower, but the differences were not statistically significant (<i>P</i>=0.215, 0.357, 0.140 and 0.133, respectively). After that, and up to POD 21, there was no further statistical difference of VAS for pain between the two groups. Morphine usage during the first 24 hours was lower in the Cocktail group compared to the Epidural group (0.24 vs 0.39 mg, <i>P</i><0.05). The VAS for satisfaction was generally higher in the Cocktail group, but there was no statistical difference between the two groups.</p><p><b>Conclusions:</b> Periarticular injection with multimodal medications provided superior pain relief and reduced morphine consumption compared with continuous epidural infusion after THA.</p>

    DOI: 10.11551/jsjd.36.107

    CiNii Article

  • The radiological outcome of radiofrequency ablation in patient with osteoid osteoma Reviewed

    OEBISU Naoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   60 ( 5 )   859 - 860   2017( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2017.859

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  • Microscopic cervical nerve root decompression using tubular retractor Reviewed

    YAMABE Takahiro

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   60 ( 2 )   445 - 446   2017( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2017.445

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  • 陳旧性上腕骨大結節骨折に対する鏡視下骨接合術の有用性 Reviewed

    濵 峻平, 平川 義弘, 間中 智哉, 市川 耕一, 松田 淑伸, 清水 勇人, 伊藤 陽一, 中村 博亮

    日本肩関節学会 肩関節   41 ( 2 )   464 - 467   2017( ISSN:0910-4461 ( eISSN:18816363

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    本研究の目的は陳旧性上腕骨大結節骨折に対して,鏡視下骨接合術(Arthroscopic reduction and internal fixation, 以下ARIF)を施行した症例の術後1年以上経過した治療成績を検討することである.対象は陳旧性上腕骨大結節骨折に対してARIFを施行した8例8肩(男4例,女4例)で,平均年齢は62.1歳(50歳-72歳),術後平均観察期間は4.8年(1年-10年)であった.手術は大結節骨片を骨欠損部に適合するように形態をトリミングした後,整復操作し,5例はdouble row法,3例は骨孔法で行った.術前および最終診察時の肩関節自動可動域,日本整形外科学会肩関節治療成績判定基準(JOAスコア)について調査した.全例術後1年で骨癒合し,可動域・JOAスコアも有意に改善を認め,陳旧性上腕骨大結節骨折に対するARIFは低侵襲で有効な術式であった.

    DOI: 10.11296/katakansetsu.41.464

    CiNii Article

  • 鏡視下腱板修復術におけるスーチャーブリッジ法と骨孔法の治療成績比較 Reviewed

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   41 ( 2 )   528 - 531   2017( ISSN:0910-4461 ( eISSN:18816363

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    鏡視下腱板修復術においてスーチャーブリッジ(SB)法と骨孔(TO)法を比較検討した.対象は,37例.手術は同一術者が行い,SB法は16例でTO法は21例であった.手術時間,インプラント費用,術中合併症,術後12カ月の臨床成績及び腱板修復状態を両縫合法間で比較検討した.手術時間は,TO法ではSB法と比較して有意に短かった.インプラント費用は,TO法はSB法と比較して有意に低かった.術中合併症は,SB法3例でTO法1例であった.術前と比較して術後12カ月では,両縫合法で平均自動屈曲及び外転可動域とJOA scoreは有意に改善していたが,両縫合法間の臨床成績に有意な差は認めなかった.また,腱板修復状態も両縫合法間に有意な差は認めなかった.腱板断裂に対するSB法とTO法の治療成績及び腱板修復状態は同等であったが,手術時間はTO法の方が短く,インプラント費用もTO法の方が低かった.

    DOI: 10.11296/katakansetsu.41.528

    CiNii Article

  • Carbon ion radiotherapy for 3 cases of extremity sarcomas Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   60 ( 1 )   57 - 58   2017( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2017.57

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  • 神経鞘腫による末梢神経の電気生理学的変化 Reviewed

    上村 卓也, 岡田 充弘, 横井 卓哉, 新谷 康介, 斧出 絵麻, 中村 博亮

    末梢神経   28   73 - 77   2017

  • Clinical Outcome of Cervical Laminoplasty and Postoperative Radiological Change for Cervical Myelopathy With Degenerative Spondylolisthesis Reviewed

    Suzuki Akinobu, Tamai Koji, Terai Hidetomi, Hoshino Masatoshi, Toyoda Hiromitsu, Takahashi Shinji, Hayashi Kazunori, Ohyama Shoichiro, Nakamura Hiroaki

    SPINE   41 ( 23 )   1808 - 1812   2016.12( ISSN:0362-2436

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    DOI: 10.1097/BRS.0000000000001706

    PubMed

  • Predicting delayed union in osteoporotic vertebral fractures with consecutive magnetic resonance imaging in the acute phase: a multicenter cohort study Reviewed

    Takahashi S., Hoshino M., Takayama K., Iseki K., Sasaoka R., Tsujio T., Yasuda H., Sasaki T., Kanematsu F., Kono H., Toyoda H., Nakamura H.

    OSTEOPOROSIS INTERNATIONAL   27 ( 12 )   3567 - 3575   2016.12( ISSN:0937-941X

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00198-016-3687-3

    PubMed

  • PS型TKAで術後2年屈曲角度の主な予測因子は何か

    南 義人, 箕田 行秀, 岸村 裕一, 中村 卓, 山村 一正, 糸数 万紀, 大田 陽一, 溝川 滋一, 中村 博亮

    日本人工関節学会誌   46   313 - 314   2016.12( ISSN:1345-7608

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    内側型変形性膝関節症に対してPS型TKAを施行した101膝(男性16膝、女性85膝)を対象に、術後2年の膝屈曲角度に影響を与える因子について検討した。その結果、術前屈曲角度と術中屈曲角度は術後2年目の屈曲角度と有意に相関し、特に術中屈曲角度は術後2年目の屈曲角度における重要な予測因子であることが示唆された。

  • Local co-application of zoledronate promotes long-term maintenance of newly formed bone induced by recombinant human bone morphogenetic protein 2 Reviewed

    Ichikawa Koichi, Ohta Yoichi, Mamoto Kenji, Mizokawa Shigekazu, Minoda Yukihide, Imai Yuuki, Takaoka Kunio, Nakamura Hiroaki

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   480 ( 3 )   314 - 320   2016.11( ISSN:0006-291X

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.bbrc.2016.10.034

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  • Decreased extension gap and valgus alignment after implantation of total knee prosthesis in primary varus knees. Reviewed

    Yukihide Minoda, Shigeru Nakagawa, Ryo Sugama, Tessyu Ikawa, Takahiro Noguchi, Masashi Hirakawa, Yoshio Matsui, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   24 ( 11 )   3642 - 3647   2016.11( ISSN:0942-2056 ( eISSN:1433-7347

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: It was hypothesised that implantation of a total knee prosthesis may change the size and shape of the joint gap. To test this hypothesis, a tensor device was used which was specifically designed to reproduce the conditions before and after implantation, including attachment of the polyethylene insert trial. This study aimed to compare the joint gaps before and after implantation of a total knee prosthesis using this new tensor device. METHODS: A total of 259 primary varus knees were included in this study. Knees were exposed using a medial parapatellar approach, and the anterior and posterior cruciate ligaments were resected. After the trial reduction, the intraoperative joint gap kinematics was measured using the tensor device. RESULTS: Implantation of a total knee prosthesis decreased the size of the extension joint gap and made it valgus, but did not influence the size or shape of the flexion joint gap. CONCLUSIONS: The present findings suggest that the classical gap technique, which creates equal and rectangular extension and flexion joint gaps in the bone cutting surface, results in an imbalance between the extension and flexion joint gaps after implantation. To achieve equal and rectangular extension and flexion joint gaps after implantation, the prepared extension joint gap should be about 2 mm larger than the flexion joint gap and slightly varus before implantation in primary varus knees. LEVEL OF EVIDENCE: Therapeutic study, Level II.

    DOI: 10.1007/s00167-014-3381-y

    PubMed

  • Mobile-bearing TKA improved the anteroposterior joint stability in mid-flexion range comparing to fixed-bearing TKA Reviewed

    Minoda Yukihide, Ikebuchi Mitsuhiko, Mizokawa Shigekazu, Ohta Yoichi, Nakamura Hiroaki

    ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY   136 ( 11 )   1601 - 1606   2016.11( ISSN:0936-8051

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00402-016-2567-9

    PubMed

  • Factors associated with retro-odontoid soft-tissue thickness in rheumatoid arthritis Reviewed

    Dohzono Sho, Suzuki Akinobu, Koike Tatsuya, Takahashi Shinji, Yamada Kentaro, Yasuda Hiroyuki, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   25 ( 5 )   580 - 585   2016.11( ISSN:1547-5654

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    DOI: 10.3171/2016.3.SPINE15787

    PubMed

  • Clinical Outcomes of Posterior Lumbar Interbody Fusion for Patients 80 Years of Age and Older with Lumbar Degenerative Disease: Minimum 2 Years' Follow-Up. Reviewed

    Hayashi K, Matsumura A, Konishi S, Kato M, Namikawa T, Nakamura H

    Global spine journal   6 ( 7 )   665 - 672   2016.11( ISSN:2192-5682

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1055/s-0036-1578806

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  • テリパラチド投与によって骨癒合が得られた尺骨短縮骨切り術後骨癒合不全の1例

    上村 卓也, 横井 卓哉, 新谷 康介, 斧出 絵麻, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 6 )   1247 - 1248   2016.11( ISSN:0008-9443

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    62歳男。40年間以上の喫煙歴があり、尺骨突き上げ症候群による右手関節尺側部痛に対して保存的加療を行うも、疼痛は改善せず、手関節鏡視下TFCC部分切除と尺骨短縮骨切り術が行われた。術後3ヵ月で超音波骨折治療法(LIPUS)を開始したが、術後10ヵ月で単純X線画像上骨切り部の骨癒合不全を認めたため、テリパラチド投与を開始したところ、投与開始後4週で骨切り部に骨形成が認められ、投与開始後10ヵ月で骨癒合が完成した。手術後3年3ヵ月でプレートの抜釘手術を行い、手関節尺側部痛は消失した。テリパラチドとLIPUSは骨形成に対して相加効果があり、喫煙者など骨癒合不全のリスクが高い症例や偽関節症例に対しては、LIPUSとテリパラチドの投与も骨癒合の獲得に有用な治療オプションになり得ると考えられた。

  • 複数回手術を要した軟骨粘液線維腫の1例

    山田 祐太郎, 星 学, 大戎 直人, 家口 尚, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 6 )   1151 - 1152   2016.11( ISSN:0008-9443

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    12歳男。左膝痛を主訴とした。X線で脛骨後面に境界不明瞭な骨溶解像を認め、辺縁は骨硬化性変化を伴っていた。MRIでは腫瘍は骨表面に存在しT1強調像で均一にやや低信号、T2強調像で均一に高信号を呈し、辺縁にのみ造影効果を認めた。CTでは腫瘍は辺縁の硬化に伴って皮質骨を非薄化するように一部髄内へ進展し、骨シンチグラフィーではcold in hot像を呈していた。切開生検の病理所見はmyxoidな背景に紡錘型の細胞が散在する粗な中央部の領域と辺縁は多核細胞を混じた細胞密度の高い領域から構成され、軟骨粘液線維腫と診断した。拡大病巣掻爬術を施行したが、12ヵ月で再発を認め、拡大病巣掻爬術を施行した。さらに90ヵ月で再々発を認め、アルコールおよび液体窒素処理を併用した拡大病巣掻爬術を施行した。3回目術後3ヵ月の時点で再発は認めていない。

  • 咽頭部違和感で発見された頸椎巨大神経鞘腫の1例

    林 和憲, 豊田 宏光, 寺井 秀富, 星野 雅俊, 鈴木 亨暢, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 6 )   1215 - 1216   2016.11( ISSN:0008-9443

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    16歳男。1ヵ月前より咽頭部違和感を自覚し、学校健診にて咽頭部腫瘤を指摘され、同時期より左上肢の脱力を自覚するようになった。喉頭内視鏡にて咽頭後壁、左側粘膜下に弾性硬の腫瘤を認め、各種画像所見よりEden分類type 3の頸椎砂時計腫と診断して摘出術を計画した。当科と耳鼻科との合同で前方後方進入を用いた切除術を施行し、病理診断は神経鞘腫であった。術後、一時的に右耳介後方C3領域に軽度の知覚低下を認めたが、術後1年の現在、知覚低下は改善し、筋力も術前MMT4からMMT5に回復した。

  • Median Nerve Stiffness Measured By Elastosonography in Patients with Rheumatoid Arthritis Is Higher Than Controls Reviewed

    Okano Tadashi, Inui Kentaro, Anno Shohei, Mamoto Kenji, Sugioka Yuko, Tada Masahiro, Koike Tatsuya, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   68   2016.10( ISSN:2326-5191

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  • Low Serum 25-Hydroxyvitamin D Level Is Not Associated with Decreased Bone Mass or Bone Quality in Patients with Rheumatoid Arthritis Reviewed

    Inui Kentaro, Koike Tatsuya, Sugioka Yuko, Okano Tadashi, Mamoto Kenji, Tada Masahiro, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   68   2016.10( ISSN:2326-5191

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  • High Retention Rates and Clinical Efficacy of Tocilizumab As First-Line Biologic Treatment in Patients with Rheumatoid Arthritis Reviewed

    Okano Tadashi, Inui Kentaro, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Koike Tatsuya, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   68   2016.10( ISSN:2326-5191

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  • Glucocorticoid Use and Low Thoracic Bone Mineral Density Are Predictors for Clinical Fractures in Patients with Rheumatoid Arthritis: Five-Year Findings of the Tomorrow Study Reviewed

    Mamoto Kenji, Inui Kentaro, Okano Tadashi, Sugioka Yuko, Tadao Masahiro, Koike Tatsuya, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   68   2016.10( ISSN:2326-5191

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  • Gender Difference Is Apparent in the Risk of Forefoot Deformity in Patients with Rheumatoid Arthritis Reviewed

    Inui Kentaro, Koike Tatsuya, Okano Tadashi, Mamoto Kenji, Orita Kazuki, Sugioka Yuko, Tada Masahiro, Nakamura Hiroaki, Incl Orita

    ARTHRITIS & RHEUMATOLOGY   68   2016.10( ISSN:2326-5191

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  • Anatomical Origins of Radial Artery Perforators Evaluated Using Color Doppler Ultrasonography Reviewed

    Onode Ema, Takamatsu Kiyohito, Shintani Kosuke, Yokoi Takuya, Uemura Takuya, Okada Mitsuhiro, Kazuki Kenichi, Nakamura Hiroaki

    JOURNAL OF RECONSTRUCTIVE MICROSURGERY   32 ( 8 )   594 - 598   2016.10( ISSN:0743-684X

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    DOI: 10.1055/s-0036-1584217

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  • Reducing the Dosage of Glucocorticoid to Zero Might Decrease Risk of Clinical Fractures in Patients with Rheumatoid Arthritis: Five-Year Findings of the Tomorrow Study Reviewed

    Mamoto Kenji, Inui Kentaro, Okano Tadashi, Sugioka Yuko, Tadao Masahiro, Koike Tatsuya, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   68   2016.10( ISSN:2326-5191

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  • Transplantation of Scaffold-Free Cartilage-Like Cell-Sheets Made from Human Bone Marrow Mesenchymal Stem Cells for Cartilage Repair: A Preclinical Study. Reviewed

    Maki Itokazu, Shigeyuki Wakitani, Hisashi Mera, Yoshihiro Tamamura, Yasushi Sato, Mutsumi Takagi, Hiroaki Nakamura

    Cartilage   7 ( 4 )   361 - 372   2016.10( ISSN:1947-6035

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: The object of this study was to determine culture conditions that create stable scaffold-free cartilage-like cell-sheets from human bone marrow-derived mesenchymal stem cells (hBMSCs) and to assess their effects after transplantation into osteochondral defects in nude rats. DESIGN: (Experiment 1) The hBMSCs were harvested from 3 males, the proliferative and chondrogenic capacities were assessed at passage 1, and the cells were expanded in 3 different culture conditions: (1) 5% fetal bovine serum (FBS), (2) 10% FBS, and (3) 5% FBS with fibroblast growth factor 2 (FGF-2). The cells were harvested and made chondrogenic pellet culture. The cell proliferation rate, glycosaminoglycan/DNA ratio, and safranin-O staining intensity of pellets cultured condition 3 were higher than those of conditions 1 and 2. (Experiment 2) The hBMSCs were expanded and passaged 3 times under culture condition 3, and fabricate the cell-sheets in chondrogenic medium either with or without FBS. The cell-sheets fabricated with FBS maintained their size with flat edges. (Experiment 3) The cell-sheets were transplanted into osteochondral defects in nude rats. Histological analysis was performed at 2, 4, and 12 weeks after surgery. RESULTS: The osteochondral repair was better after sheet transplantation than in the control group and significantly improved Wakitani score. Immunostaining with human-specific vimentin antibody showed that the transplanted cells became fewer and disappeared at 12 weeks. CONCLUSIONS: These results indicate that culture with FGF-2 may help to quickly generate sufficient numbers of cells to create stable and reliable scaffold-free cartilage-like cell-sheets, which contribute to the regeneration of osteochondral defects.

    DOI: 10.1177/1947603515627342

    PubMed

  • Arthro Tunnelerを用いた鏡視下腱板修復術術後1年の臨床成績

    平川 義弘, 伊藤 陽一, 間中 智哉, 市川 耕一, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   40 ( 2 )   735 - 737   2016.10( ISSN:0910-4461

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    Arthro Tunnelerを用いた骨孔式鏡視下腱板修復術(ARCR)を行い、術後1年経過した52例52肩を対象に、JOAスコア、自動可動域、術後MRI所見(菅谷分類)を検討した。手術時年齢は平均66.8歳で、腱板断裂の形状とサイズは部分断裂3肩(関節面断裂1肩、滑液包面断裂2肩)、全層断裂49肩(Cofield分類で小断裂4肩、中断裂7肩、大断裂19肩、広範囲断裂19肩)であった。その結果、自動屈曲可動域、自動外転可動域およびJOAスコアは術後に有意に改善した。術後1年のMRIで全症例の16.3%に再断裂を認め、広範囲断裂を除すると再断裂率は6.7%であった。以上、Arthro Tunnelerを用いた骨孔式ARCRの術後1年の臨床成績は概ね良好であると考えられた。

  • 人工肩関節置換術及び人工骨頭置換術術後10年以上の長期臨床成績

    市川 耕一, 伊藤 陽一, 間中 智哉, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   40 ( 2 )   688 - 693   2016.10( ISSN:0910-4461

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    人工肩関節置換術4例5肩(A群)と人工骨頭置換術5例5肩(B群)について、術後10年以上の長期臨床成績を検討した。術後経過観察は平均11.2年であった。検討項目として自動可動域(屈曲、外転)、JOA score、単純X線所見を、術前、術後1・3・6ヵ月、術後1・5・10年に調査した。その結果、2群とも術後に自動可動域とJOA scoreは改善したが、A群ではいずれも術後3年以降に徐々に低下を認め、JOA scoreの項目別では術後5年以降に可動域と機能に低下傾向を認めた。除痛については、2群とも継続的効果が得られていた。X線評価では、2群とも上腕骨側インプラントのlooseningは認めなかったが、A群の40%(2例)に術後10年で肩甲骨側インプラントのlooseningを認めた。B群では術後10年で重度のcentral migrationは生じなかった。以上、人工肩関節置換術、人工骨頭置換術の術式選択に際しては、長期的な経過を考慮した選択が重要であると考えられた。

  • 骨孔式ARCR施行時lateral protect implantによる骨孔亀裂の改善

    松田 淑伸, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 清水 勇人, 中村 博亮

    肩関節   40 ( 2 )   731 - 734   2016.10( ISSN:0910-4461

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    腱板全層性断裂に対し、Arthro Tunnelerを用いた骨孔式鏡視下腱板修復術(ARCR)時に大結節外側の骨孔にlateral protect implantを留置した174例179肩を対象に、術中の関節鏡所見より大結節外側の骨孔亀裂を調査した。手術時年齢は平均67.6歳であった。腱板断裂サイズ(Cofield分類)は、中断裂54肩、大断裂51肩、広範囲断裂74肩であった。なお、lateral protect implantを併用せずにArthro Tunnelerを用いた骨孔式ARCRを施行した、腱板全層性断裂を有する76例77肩を対照群とし比較した。その結果、骨孔亀裂が生じたのは179肩中4肩(2.2%)で、全例が女性(平均年齢79.3歳)、広範囲腱板断裂であった。骨孔亀裂の発生率をlateral protect implantの有無で対照群と比較したところ、発生率は対照群で有意に高かった。なお、腱板断裂サイズ別で骨孔亀裂の発生率に有意差はなかった。

  • 本邦におけるリバース型人工肩関節全置換術の上腕骨コンポーネントと上腕骨サイズの不適合性

    南 義人, 伊藤 陽一, 市川 耕一, 間中 智哉, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   40 ( 2 )   694 - 696   2016.10( ISSN:0910-4461

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    Tornier社のリバース型人工肩関節全置換術(RSA)を施行した42例43肩を対象に、術前CT画像で上腕骨解剖頸の内外側径と前後径を測定し、身長との相関を検討した。手術時年齢は平均76.3歳であった。その結果、内外側径は平均41.6mm、前後径は平均38.8mmで、いずれも女性に比べ男性で有意に大きかった。また、身長と内外側径、前後径の間には相関を認めた。近似直線において上腕骨頭径36mmに対応するのは、身長が140.87cmであった。以上、身長が140cm以下の症例では上腕骨解剖頸が36mm以下となることがあり、Tornier社のRSA上腕骨コンポーネントと適合しない可能性が示された。また、上腕骨頭径と身長に相関を認めたことから、低身長ではインプラントを安全に設置するために、より慎重な術前計画が必要であると考えられた。

  • 我々が経験したリバース型人工肩関節置換術の術中・術後合併症

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    肩関節   40 ( 2 )   701 - 704   2016.10( ISSN:0910-4461

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    リバース型人工肩関節置換術を施行した73例77肩を対象に、術中・術後合併症を検討した。検討項目は合併症率、再手術率、合併症の有無と患者背景因子、合併症が生じた状況、合併症の対処法とした。手術時年齢は平均76歳で、術後経過観察は平均9ヵ月であった。その結果、合併症の発生率は77肩中16例で20.8%であった。1肩においては術中・術後合併症が生じたため、術中合併症8肩、術後合併症9肩であった。再手術率は77肩中4肩で5.2%であった。術中合併症の内訳は、肩甲骨関節窩骨折2肩、上腕骨骨幹部骨折1肩、上腕骨近位部骨折4肩、ベースプレートの固定性不良1肩であった。術後合併症の内訳は、上腕骨骨折2肩、肩峰骨折2肩、脱臼2肩、術後神経麻痺2肩、術後動脈性出血1肩であった。なお、合併症の有無で、年齢、性別、診断、既往手術に有意な差は認めなかった。

  • Composition of long chain alkenones and alkenoates as a function of growth temperature in marine haptophyte Tisochrysis lutea Reviewed

    Nakamura Hideto, Sawada Ken, Araie Hiroya, Shiratori Takashi, Ishida Ken-ichiro, Suzuki Iwane, Shiraiwa Yoshihiro

    ORGANIC GEOCHEMISTRY   99   78 - 89   2016.09( ISSN:0146-6380

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.orggeochem.2016.06.006

  • Laminar closure after expansive open-door laminoplasty: fixation methods and cervical alignments impact on the laminar closure and surgical outcomes Reviewed

    Tamai Koji, Suzuki Akinobu, Terai Hidetomi, Toyoda Hiromitsu, Hoshino Masatoshi, Nakamura Hiroaki

    SPINE JOURNAL   16 ( 9 )   1062 - 1069   2016.09( ISSN:1529-9430

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.spinee.2016.04.018

    PubMed

  • 頸椎に発生した軟骨肉腫clear cell typeの1例

    小林 祐人, 鈴木 亨暢, 大山 翔一朗, 寺井 秀富, 星野 雅俊, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 5 )   1089 - 1090   2016.09( ISSN:0008-9443

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    58歳女性。頸部痛を主訴に近医を受診、頸椎X線にてC3脊椎腫瘍と診断され、紹介となった。MRIではT1強調像にて低信号、T2強調像にて等信号を示し、ガドリニウム造影およびCTでC3全周性に広がる造影効果の強い腫瘍が認められた。CTガイド下針生検の結果、grade Iの軟骨肉腫(通常型)と診断され、右椎骨動脈塞栓術を施行後、後方・前方からの椎骨動脈合併腫瘍全摘出術を行った。病理組織学的にgrade IIの軟骨肉腫(clear cell type)と判明し、術後3ヵ月で良好な骨癒合が得られたが、術後1年で同部位に再発を認めた。再切除後の再発が懸念されたため、インプラント抜去およびセパレーションサージェリー後に陽子線治療を行ったところ、照射後3ヵ月の時点で腫瘍の増大はみられず、経過は良好である。

  • 境界領域/知っておきたい 脊椎脊髄外科専門医制度-整形外科と脳神経外科の融合

    中村 博亮

    臨床整形外科   51 ( 8 )   736 - 739   2016.08( ISSN:05570433 ( eISSN:18821286

  • 臨床室 左傍脊柱筋内から発生した顆粒細胞腫の1例

    飯田 健, 星 学, 大戎 直人, 家口 尚, 鈴木 亨暢, 中村 博亮

    整形外科   67 ( 9 )   959 - 961   2016.08( ISSN:00305901 ( eISSN:24329444

  • Posterior reference guides do not always maintain the size of posterior femoral condyles in TKA. Reviewed

    Yukihide Minoda, Shigekazu Mizokawa, Yoichi Ohta, Mitsuhiko Ikebuchi, Maki Itokazu, Kazumasa Yamamura, Suguru Nakamura, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   24 ( 8 )   2489 - 2495   2016.08( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: Posterior reference guides are provided by many manufacturers. However, the true posterior femoral condyle bone resection thicknesses using posterior reference guides are not stated by the manufacturers. The purpose of this study was to analyse the influence of the posterior reference guide designs on the posterior femoral condyle bone resection thickness. METHODS: Thickness of posterior femoral condyle bone resection and thickness of prostheses were investigated in 8 types of total knee prostheses using the production drawings provided by the manufacturers. RESULTS: Posterior femoral condyle bone resection thickness differed between prostheses. Change in size of the medial posterior condyle ranged from -0.5 to 1.4 mm at 0° external rotation, from -2.9 to 1.4 mm at 3° external rotation, and from -5.3 to 1.4 mm at 6° external rotation. Change in size of lateral posterior condyle ranged from -0.5 to 1.4 mm at 0° external rotation, from -0.4 to 3.4 mm at 3° external rotation, and from -0.4 to 5.3 mm at 6° external rotation. CONCLUSIONS: This study showed that posterior femoral condyle bone resection thickness was different for each posterior reference guide. The rotation centre of posterior reference guides influenced the bone resection thickness in the posterior femoral condyle. The size of the posterior femoral condyles increased in some guides but decreased in other guides. The maximum differences in size changes of the posterior femoral condyles between the guides were 1.9 mm at 0° external rotation, 4.1 mm at 3° external rotation, and 6.3 mm at 6° external rotation. To control the size of posterior femoral condyles, the posterior reference guide design should be checked before use.

    DOI: 10.1007/s00167-015-3706-5

    PubMed

  • Anatomical landmarks of the distal femoral condyles are not always parallel to the tibial bone cut surface in flexion during total knee arthroplasty. Reviewed

    Maki Itokazu, Yukihide Minoda, Mitsuhiko Ikebuchi, Shigekazu Mizokawa, Yoichi Ohta, Hiroaki Nakamura

    The Knee   23 ( 4 )   725 - 729   2016.08( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Soft tissue balancing is crucial to the success of total knee arthroplasty (TKA). To create a rectangular flexion joint gap, the rotation of the femoral component is important. The purpose of this study is to determine whether or not anatomical landmarks of the distal femoral condyles are parallel to the tibial bone cut surface in flexion. METHODS: Forty-eight patients (three male and 45 female) with a mean age of 74years were examined. During the operation, we estimated the flexion joint gap with the following three techniques. 1) a three degree external cut to the posterior condylar line (MR1), 2) a parallel cut to the surgical transepicondylar axis (MR2), and 3) a parallel cut to the anatomical transepicondylar axis (MR3). RESULTS: The flexion joint gap was 1.1±3.0° (mean±standard deviation (SD)) in internal rotation in the case of MR1, 0.9±3.4° in internal rotation in the case of MR2, and 2.1±3.4° in external rotation in the case of MR3. An outlier (flexion joint gap >3.0°) was observed in 12 cases (25%) in MR1, 13 cases (27%) in MR2, and 15 cases (31%) in MR3. CONCLUSIONS: The anatomical landmarks of the distal femoral condyles are not always parallel to the tibial bone cut surface in flexion. To create a rectangular flexion joint gap, the rotation of the femoral component rotation is based not only on the anatomical landmarks but also on the ligament balance.

    DOI: 10.1016/j.knee.2015.11.018

    PubMed

  • Utility of Discography as a Preoperative Diagnostic Tool for Intradural Lumbar Disc Herniation Reviewed

    Matsumoto Tomiya, Toyoda Hiromitsu, Terai Hidetomi, Dohzono Sho, Hori Yusuke, Nakamura Hiroaki

    ASIAN SPINE JOURNAL   10 ( 4 )   771 - 775   2016.08( ISSN:1976-1902

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.4184/asj.2016.10.4.771

    PubMed

  • 人工股関節全置換術後の日常生活指導に関する実態調査

    三好 隆志, 池渕 充彦, 岩城 啓好, 中土 保, 箕田 行秀, 中村 博亮

    Hip Joint   42 ( 2 )   S280 - S283   2016.08( ISSN:0389-3634

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    著者らは前回(2008年)、人工股関節全置換術(THA)施行施設の指導者を対象に、THA後のADL指導に関するアンケート調査を行なった。今回、追跡調査を実施し、前回の調査結果と比較検討した。その結果、アンケート回収率は54%、有効回答数は50通(92.6%)であった。前回の調査と比較し、術式は後方アプローチが8%減少した一方、前方・(前)側方アプローチが10%増加していた。前方・(前)側方アプローチが多い施設では、ADL小項目のうちしゃがみ・和式トイレの制限が緩和されている傾向がみられた。余暇活動においても多くの小項目が許可されていたが、THAの長期生存率のエビデンスは乏しく、個別指導が必要と考えられた。尚、米国ガイドラインと今回の果を比較すると、スキー、テニスの推奨度についての見解が一致していなかった。

  • 転移性脊椎腫瘍に対するCTガイド局所麻酔下椎体形成術 当科での手技とその効果及び安全性

    鈴木 亨暢, 玉井 孝司, 寺井 秀富, 星野 雅俊, 豊田 宏光, 林 和憲, 大山 翔一郎, 中村 博亮

    Journal of Spine Research   7 ( 8 )   1313 - 1318   2016.08( ISSN:1884-7137

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    本研究の目的は転移性脊椎腫瘍に対する椎体形成術の当科での手法を報告し、その効果と問題点を明らかにすることである。局所麻酔下にCT下で椎体形成術を4例に施行し、術前後の疼痛、ADL、合併症について調査した。術後疼痛は全例で改善し、3例でADLの改善が認められた。セメントの脊柱管への漏出が3例に認められたが、重篤な合併症は認めなかった。転移性脊椎腫瘍に対する局麻下椎体形成術は低侵襲で有効な治療法となり得る。(著者抄録)

  • 臨床室 眼窩に発生し他科との治療連携を要した骨肉腫の1例

    高田 尚輝, 星 学, 大戎 直人, 家口 尚, 中村 博亮

    整形外科   67 ( 9 )   963 - 967   2016.08( ISSN:0030-5901

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    症例は47歳女性で、左眼の腫脹と疼痛を主訴とした。左眼球は前方へ突出し、失明状態であった。CTで左眼窩上壁・左蝶形骨大翼・前頭骨・頭頂骨にかけて骨破壊を伴う腫瘤性病変を認め、MRI T1強調でやや低信号、T2強調で不均一に高信号の55×45×40mmの腫瘤が眼窩内容を腹側へ圧排していた。術前化学療法の効果判定は不変であり、セカンドオピニオンとして重粒子治療施設を受診後に当院脳神経外科にて眼球摘出を含めた腫瘍切除術、形成外科で義眼装着のための遊離腹直筋皮弁による充填術が行われた。術後化学療法はメトトレキサート主体で行った。術後3年で再発や遠隔転移はなく、形成外科で頭蓋形成術、眼窩部の陥凹・義眼床の下垂外反に対し人工骨移植術を行った。

  • 臨床室 左傍脊柱筋内から発生した顆粒細胞腫の1例

    飯田 健, 星 学, 大戎 直人, 家口 尚, 鈴木 亨暢, 中村 博亮

    整形外科   67 ( 9 )   959 - 961   2016.08( ISSN:0030-5901

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    症例は70歳男性で、69歳時に背部痛、背部腫瘤出現で前医のMRI・CTにて左背部に軟部腫瘍を指摘され紹介受診した。左背部に6×7cmの弾性硬で可動性不良の腫瘤を触知し、MRI T1強調で筋肉と等信号、T2強調で中心部が低信号、辺縁が高信号、T1ガドリニウム造影で不均一に造影される腫瘤を左傍脊柱筋内に認めた。造影CTでは同部位に境界やや不明瞭な多房性腫瘤を認めた。切開生検で好酸性顆粒状の胞体を有する腫瘍細胞が胞巣状に増殖し、膠原線維の腫瘍細胞間への浸潤を認め、顆粒細胞腫と診断した。患者・家族との相談で経過観察としたが、半年後に腫瘍の増大と疼痛の増悪を認め、CTナビゲーション併用で腫瘍広範囲切除術を行った。術中に腫瘍は左L2神経根の枝から発生していたため、同神経根を合併切除した。術後の病理学的検索で断端陰性と判断された。

  • 椎体骨折癒合不全に伴う神経根症

    玉井 孝司, 豊田 宏光, 鈴木 亨暢, 寺井 秀富, 星野 雅俊, 高橋 真治, 林 和憲, 大山 翔一朗, 中村 博亮

    Journal of Spine Research   7 ( 8 )   1246 - 1250   2016.08( ISSN:1884-7137

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    骨粗鬆症性椎体骨折後癒合不全に起因する神経根症の頻度や推移を明らかにするため、椎体形成術を行った症例を後ろ向きに解析した。結果、椎体骨折後癒合不全の20%に根症状を伴っており、70%の症例で腰痛≦下肢痛であったが、90%の症例で罹患椎体単独の椎体形成術にて早期に根症状が消失していた。発症要因としては、静的因子である椎間孔狭窄などより、動的因子である椎体不安定性の関与が強い可能性が示唆された。(著者抄録)

  • 変性側彎や椎間楔状化を伴う腰部脊柱管狭窄症に対する顕微鏡視下片側進入両側除圧術の再手術危険因子

    加藤 相勲, 並川 崇, 松村 昭, 尾崎 友則, 堀 悠介, 中村 博亮

    Journal of Spine Research   7 ( 8 )   1231 - 1236   2016.08( ISSN:1884-7137

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    近年、腰椎変性疾患に対する傍脊柱筋や棘上・棘間靱帯、椎間関節などの後方要素温存を重視した顕微鏡や内視鏡を用いた低侵襲後方除圧術は、変性すべりや側彎を伴う腰部脊柱管狭窄症に手術適応を拡大している。しかし、未だその手術適応の基準について一定の見解は得られていない。今回、われわれは腰椎変性疾患に対する顕微鏡視下片側進入両側除圧術の再手術危険因子を前向きに調査し、側彎や椎間楔状化を伴う腰部脊柱管狭窄症への低侵襲後方除圧術の適応基準を検討することを目的に研究を行った。腰椎変性疾患に対し片側進入両側除圧術を実施した207例中、除圧椎間での再手術例は13例(6.3%)で、再手術例の最終診察時JOAスコア改善率は24.4%と成績不良であった。再手術危険因子は全椎間において側方すべり(相対危険度5.22)が、L4/5では椎間楔状化(相対危険度9.9)と側方すべり(相対危険度12.9)が有意な因子として検出された。これらの再手術危険因子を念頭に、側彎や椎間楔状化を伴う腰部脊柱管狭窄症に対して低侵襲後方除圧術の手術適応を決定することが重要であると考える。(著者抄録)

  • 【脊椎・脊髄外傷診療の最前線】 脊椎外傷の治療 骨粗鬆症性椎体骨折におけるMRIの有用性

    高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 中村 博亮

    整形外科   67 ( 8 )   788 - 793   2016.07( ISSN:00305901 ( eISSN:24329444

  • Factors associated with improvement in sagittal spinal alignment after microendoscopic laminotomy in patients with lumbar spinal canal stenosis Reviewed

    Dohzono Sho, Toyoda Hiromitsu, Takahashi Shinji, Matsumoto Tomiya, Suzuki Akinobu, Terai Hidetomi, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   25 ( 1 )   39 - 45   2016.07( ISSN:1547-5654

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3171/2015.12.SPINE15805

    PubMed

  • 頸部デスモイドの1例

    家口 尚, 星 学, 大戎 直人, 高松 聖仁, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 4 )   811 - 812   2016.07( ISSN:0008-9443

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    39歳女。約3ヵ月前からの頸部痛を主訴とした。MRIで甲状腺右葉後方から第4頸椎から第3胸椎の椎体前面にかけて広がる107×60×33mmの軟部腫瘍を認めた。また、C5、C7椎体前面に骨侵食像を認めた。切開生検を行い、デスモイド腫瘍と診断した。完全切除は困難と判断し、60Gyの粒子線治療を行ったところ、一旦腫瘍は縮小したが、照射後約6ヵ月で再び増大した。高容量の抗がん剤を投与したものの効果なく、低容量化学療法を開始し、VBL 10mg+MTX 25mgを2週に1度投与した。治療開始後6コース(3ヵ月)でstable diseaseとなり、12コース(6ヵ月)終了時には縮小の兆しがみられた。症状も改善し、更に投与を継続したところ、腫瘍は更に縮小した。投薬は14ヵ月で終了したが、その後5年間は経過観察だけで腫瘍は縮小した。現在も経過観察中である。

  • 【骨粗鬆症性椎体骨折-治療の現状と問題点】 骨粗鬆症性椎体骨折における後壁損傷の追跡調査

    星野 雅俊, 高橋 真治, 辻尾 唯雄, 寺井 秀富, 中村 博亮

    整形・災害外科   59 ( 7 )   903 - 907   2016.06( ISSN:03874095

  • PATIENTS WITH RHEUMATOID ARTHRITIS AND HIGH LEVELS OF ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODY UNDER TREATMENT WITH HIGH-DOSE GLUCOCORTICOID FREQUENTLY FALL: FIVE-YEAR FINDINGS OF THE TOMORROW STUDY Reviewed

    Anno S., Inui K., Mamoto K., Okano T., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   713 - 714   2016.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2016-eular.5226

  • NO RELATIONSHIP BETWEEN LOW SERUM 25-HYDROXYVITAMIN D LEVEL AND DECREASED BONE MASS OR BONE QUALITY IN PATIENTS WITH RHEUMATOID ARTHRITIS - TOMORROW STUDY Reviewed

    Inui K., Koike T., Sugioka Y., Okano T., Mamoto K., Tada M., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   214 - 215   2016.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2016-eular.1831

  • LOW THORACIC BONE MINERAL DENSITY AND GLUCOCORTICOID ARE RISK FACTORS FOR CLINICAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS: FIVE-YEAR FINDINGS OF THE TOMORROW STUDY Reviewed

    Yamada Y., Inui K., Mamoto K., Okano T., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   466 - 466   2016.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2016-eular.2849

  • FEMALE SEX INCREASES THE RISK OF FOREFOOT DEFORMITY IN PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Inui K., Orita K., Okano T., Mamoto K., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   969 - 969   2016.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2016-eular.1313

  • ACHIEVING FREEDOM FROM GLUCOCORTICOIDS MIGHT DECREASE RISK OF CLINICAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS: FIVE-YEAR FINDINGS OF THE TOMORROW STUDY Reviewed

    Anno S., Inui K., Mamoto K., Okano T., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   713 - 713   2016.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2016-eular.4142

  • PREVALENCE AND RISK FACTORS FOR NEW VERTEBRAL FRACTURES IN PATIENTS WITH RA: FIVE-YEAR FOLLOW-UP OF THE TOMORROW STUDY Reviewed

    Okano T., Inui K., Tada M., Sugioka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   220 - 220   2016.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2016-eular.1870

  • BONE MINERAL DENSITY OF WHOLE BODY CAN PREDICT FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS: FINDINGS FROM THE TOMORROW STUDY Reviewed

    Tada M., Inui K., Okano T., Sugioka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   479 - 479   2016.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2016-eular.2822

  • RETENTION RATES AND CLINICAL EFFICACY OF TOCILIZUMAB AS FIRST-LINE BIOLOGICS COMPARED TO SECOND-LINE IN PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Okano T., Inui K., Tada M., Sugioka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   75   1032 - 1033   2016.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2016-eular.1871

  • 人工神経に付加したiPS細胞由来神経前駆細胞による末梢神経再生の促進効果

    横井 卓哉, 上村 卓也, 高松 聖仁, 新谷 康介, 岡田 充弘, 中村 博亮

    末梢神経   27 ( 1 )   98 - 102   2016.06( ISSN:0917-6772

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    これまで我々は人工多能性幹細胞(Induced pluripotent stem cell以下iPS細胞)と神経再生誘導管(以下人工神経)を用いた末梢神経再生に関する基礎研究を行ってきた。本研究ではGFP遺伝子がノックインされたiPS細胞を用いてハイブリッド型人工神経を作製し、マウス坐骨神経欠損モデルを用いてiPS細胞由来神経前駆細胞付加による末梢神経再生の促進効果について検証した。人工神経に付加したiPS細胞由来神経前駆細胞は、マウスに移植後も少なくとも14日目まではシュワン様細胞として人工神経内、特に末梢側の再生軸索周囲に残存しており、軸索再生に寄与していた。(著者抄録)

  • 腰部脊柱管狭窄症例における脊柱矢状面アライメントと腰痛・健康関連QOLの関係

    加藤 相勲, 並川 崇, 松村 昭, 尾崎 友則, 堀 悠介, 中村 博亮

    Journal of Spine Research   7 ( 6 )   1014 - 1018   2016.06( ISSN:1884-7137

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    腰部脊柱管狭窄症234例(男性136例、女性98例、平均年齢71歳)において年代別の矢状面脊柱骨盤パラメーター値と脊柱矢状面アライメントと腰痛・健康関連QOLの関係を調査した。脊柱骨盤パラメーター値は高齢化に伴いSVAは有意に増加し、胸椎後彎とPI-LLは増加する傾向にあった。脊柱矢状面アライメント不良は腰痛・健康関連QOLに影響を与え、65歳以上の高年者においてその影響は大きかった。(著者抄録)

  • 腰椎椎弓部分切除術の術後疼痛に対して脊髄後枝内側枝ブロックを含めた術中ロピバカイン局所投与は有効である

    林 和憲, 星野 雅俊, 豊田 宏光, 高橋 真治, 寺井 秀富, 鈴木 亨暢, 玉井 孝司, 大山 翔一朗, 中村 博亮

    Journal of Spine Research   7 ( 6 )   1065 - 1069   2016.06( ISSN:1884-7137

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    腰椎除圧術に対し、脊髄後枝ブロックと皮神経ブロックを含めた、術中ロピバカイン局所注射法(DRCCR)を考案した。DRCCRを施行した20例と年齢性別手術椎間をマッチさせた対照群20例を比較検討。局注群で術後24時間まで有意に創部痛VASが少なく、14日目まで少ない傾向がみられた。局注に伴う重大な合併症は認めなかった。DRCCRは従来の鎮痛法と比較し術後早期の創部痛軽減に有効かつ簡便、安全であった。(著者抄録)

  • 鎖骨遠位端骨折に対するSCORPIONの治療成績

    山本 展生, 谷浦 圭, 政田 俊明, 佐々木 健陽, 中村 博亮

    骨折   38 ( 3 )   592 - 595   2016.06( ISSN:0287-2285

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    鎖骨遠位端骨折プレート(SCORPION、ai medic社製)の適応について第34回骨折治療学会で報告を行った。これまで遠位骨片のサイズ、粉砕に応じSCORPION、tension band wiring(TBW)、hook型plateを使用していたが、TBW、hook型plateでは種々の合併症が報告されており、SCORPIONに追加処置を併用し適応の拡大を考慮した。今回SCORPIONの適応の拡大をするために、(1)骨片間ラグスクリューの挿入、(2)エチボンド締結、(3)固定性に応じて三角巾+バストバンド固定を追加処置しその成績について検討した。対象は2007年1月〜2014年7月に当院で手術加療を行った鎖骨遠位端骨折患者48例中3ヵ月以上フォロー可能であった44例。男性34例、女性10例、受傷時平均年齢は47.4歳。術後全例転移認めず、半年以上フォローした42例に全例骨癒合を認め成績は良好であった。現在はさらに適応拡大し、遠位骨片にアームがかかり、lag screw挿入可能であるものはSCORPIONに追加処置を併用し骨接合行っている。今後適応、治療成績についてはさらなる検討が必要と考える。(著者抄録)

  • Effect of Spinal Fixation in Rabbits With Metastatic Tumor Using a Novel Spinal Fusion Model Reviewed

    Yamada Kentaro, Terai Hidetomi, Matsumoto Tomiya, Okabe Takahiro, Suzuki Akinobu, Toyoda Hiromitsu, Nakamura Hiroaki

    CLINICAL SPINE SURGERY   29 ( 4 )   E215 - E221   2016.05( ISSN:1536-0652

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  • Planning digital artery perforators using color Doppler ultrasonography: A preliminary report Reviewed

    Shintani Kosuke, Takamatsu Kiyohito, Uemura Takuya, Onode Ema, Okada Mitsuhiro, Kazuki Kenichi, Nakamura Hiroaki

    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY   69 ( 5 )   634 - 639   2016.05( ISSN:1748-6815

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.bjps.2016.01.003

    PubMed

  • Effect of Spinal Fixation in Rabbits With Metastatic Tumor Using a Novel Spinal Fusion Model. Reviewed

    Yamada K, Terai H, Matsumoto T, Okabe T, Suzuki A, Toyoda H, Nakamura H

    Clinical spine surgery   29 ( 4 )   E215 - 21   2016.05( ISSN:2380-0186

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BSD.0b013e3182693f56

    PubMed

  • 2つの側方経路腰椎椎体間固定(OLIF/XLIF)の手術成績の比較

    山田 祐太郎, 星野 雅俊, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 3 )   449 - 450   2016.05( ISSN:0008-9443

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    著者らは2椎間以内の側方経路腰椎椎体間固定を行った19例の短期成績について、術式別にOLIF群9例とXLIF群10例に分け、比較検討した。その結果、1)手術時間、総出血量、JOAスコア改善率は両群間で有意差がなく、術前症状は全例で改善が得られた。2)合併症はOLIF群で腹膜損傷を1例に認められた。術後1週時点の大腿部痛はOLIF群が3例、XLIF群が8例と、XLIF群で有意に多く認められたが、全例、術後3週以内に消失していた。3)画像評価として、椎間板高・椎間前彎角の変化量および脊柱管前後径拡大率には有意差を認められなかったが、OLIF群ではケージが前方に設置される傾向にあった。

  • 頸椎手術後に後彎変形が進行し頸椎前方・後方矯正固定術を行った関節リウマチの1例

    上田 昭一, 豊田 宏光, 寺井 秀富, 星野 雅俊, 鈴木 亨暢, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 3 )   499 - 500   2016.05( ISSN:0008-9443

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    66歳女性(関節リウマチ罹病歴19年)。脊髄症に対する椎弓形成術後4年目に脊髄麻痺症状が再燃し、入院となった。椎弓X線では頸椎後彎変形の進行がみられ、MRIおよびCTでは後彎、すべりの進行によりC3/4レベルの再圧迫が認められた。入院後はハローベストを装着することで、頸椎アライメントの改善が得られ。それに伴い、筋力もMMT 3から4程度に回復した。以後、臨床経過から頸椎後彎による脊髄症と診断され、頸椎前方・後方矯正固定術を施行した。その結果、術後MMTは上下肢ともに4から5レベルまで回復し、術後矯正損失は認めず、JOAスコアも術前の4点から術後9.5点まで改善した。

  • 膝前十字靱帯二重束再建術におけるGraft Length Changeの検討

    市川 俊介, 橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    日本整形外科スポーツ医学会雑誌   36 ( 2 )   155 - 160   2016.05( ISSN:1340-8577

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    解剖学的二重束前十字靱帯再建術の臨床成績は概ね良好といわれているが、解剖学的至適位置における靱帯関節内長変化(graft length change;GLC)は大きいといわれており、移植腱への負担が危惧される。そこで当院の二重束再建術の骨孔位置とGLCの関係を調査した。3D-CT画像にて評価した骨孔位置と、術中に計測した再建直後移植腱のGLCを計測した結果、骨孔位置は大腿骨側がhighでdeep、脛骨側がやや内側に位置し、GLCはAMBが比較的isometric、PLBが膝関節伸展に伴って伸張されるover-the-topパターンを示したが、正常膝におけるGLCより小さい値であった。(著者抄録)

  • EpCAM expression in breast cancer cells is associated with enhanced bone metastasis formation. Reviewed

    Hiraga T, Ito S, Nakamura H

    International journal of cancer   138 ( 7 )   1698 - 708   2016.04( ISSN:0020-7136

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    DOI: 10.1002/ijc.29921

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  • Arthroscopic treatment of an osteoid osteoma at the base of the coracoid process: A case report Reviewed

    Ueyama Hideki, Ito Yoichi, Manaka Tomoya, Matsumoto Isshin, Ichikawa Koichi, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   21 ( 2 )   245 - 249   2016.03( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.jos.2015.06.010

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  • Levels of interleukin-1 beta can predict response to tocilizumab therapy in rheumatoid arthritis: the PETITE (predictors of effectiveness of tocilizumab therapy) study. Reviewed

    Tadashi Okano, Kentaro Inui, Masahiro Tada, Yuko Sugioka, Kenji Mamoto, Shigeyuki Wakitani, Tatsuya Koike, Hiroaki Nakamura

    Rheumatology international   36 ( 3 )   349 - 357   2016.03( ISSN:0172-8172

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Predicting the responses of patients with rheumatoid arthritis (RA) to tocilizumab is difficult, because inflammatory markers such as C-reactive protein rapidly normalize regardless of clinical efficacy. We aimed to identify factors that could predict response to tocilizumab. Sixty-five patients completed 52 weeks of tocilizumab therapy. Serum fibrinogen, D-dimer and interleukin (IL)-1β levels were measured at baseline and after 4 weeks of therapy. Clinical responses to tocilizumab were assessed using disease activity score 28-erythrocyte sedimentation rate and the clinical disease activity index at baseline and after 52 weeks of therapy (UMIN Clinical Trials Registry No. UMIN000002246). Mean age was 60.5 years (range 22-85 years). Mean disease duration was 11.2 years (range 0-45 years). All patients had moderate-to-severe disease activity and were resistant to disease-modifying anti-rheumatic drugs and/or other biologics. Baseline IL-1β levels were significantly lower in responders than in non-responders (p = 0.045), but multiple logistic regression analysis found no significant difference (adjusted odds ratio 2.74; 95 % confidence interval 0.84-8.95; p = 0.096). Low D-dimer and IL-1β levels at 4 weeks predicted greater decrease in disease activity after 52 weeks of treatment (p = 0.005 and p < 0.001, respectively). Effects of tocilizumab at 52 weeks could be predicted from D-dimer and IL-1β levels after 4 weeks of tocilizumab treatment. These markers might be more useful than current inflammatory markers for early-stage prediction of response to tocilizumab in RA.

    DOI: 10.1007/s00296-015-3379-x

    PubMed

  • T2マッピングを用いた膝前十字靱帯再建同時半月縫合症例の半月板治癒判定

    山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 新熊 孝文, 中村 博亮

    JOSKAS   41 ( 1 )   124 - 125   2016.03( ISSN:1884-8842

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    膝十字靱帯(ACL)再建術に半月縫合を併用し、再鏡視とMRI-T2マッピング撮影が可能であった12症例(男性4例、女性8例、年齢14〜43歳、平均年齢23.2歳)を対象に半月縫合前後の半月T2値の変化について検討した。その結果、1)再鏡視所見では完全治癒群が6例、不完全治癒・治癒不全群が6例であった。2)Mink分類の術前後変化では、術前Grade 3から術後Grade 2に改善したものは完全治癒群が2例、不完全治癒・治癒不全群が1例であった。また、術後もGrade 3であったものは完全治癒群が4例、不完全治癒・治癒不全群が5例であり、両群間に有意差は認められなかった。3)損傷部T2値変化量は完全治癒群が平均-7.12ms、不完全治癒・治癒不全群が平均-2.18msで、有意差が認められた。一方、縫合術後半月全体T2値は完全治癒群が平均29.7ms、不完全治癒・治癒不全群が平均33.6msで、非損傷部T2値は完全治癒群が平均25.8ms、不完全治癒・治癒不全群が平均28.9msと、ともに完全治癒群で低値を示した。だが、有意差は認められなかった。

  • T2マッピングを用いた正常半月板の部位別・年代別評価

    寺岡 貴徳, 橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 新熊 孝文, 西田 洋平, 中村 博亮

    JOSKAS   41 ( 1 )   226 - 227   2016.03( ISSN:1884-8842

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    正常半月板75例92半月(男性36例、女性39例:平均年齢22.8歳)を対象に、MRI T2マッピングを用いて定量的評価を行った。なお、半月板の内訳は内側(MM)51半月、外側(LM)41半月である。その結果、T2値は半月板のzone間に差を認め、辺縁部に向かうにしたがって上昇した。年代別では加齢によるT2値の変化を示唆した。以上より、T2マッピングによる半月板の評価は、部位別、年代別定量的評価に有用性があると考えられた。

  • Snappingを伴う円板状半月に対する過伸展深屈曲MRIの有用性

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 新熊 孝文, 中村 博亮

    JOSKAS   41 ( 1 )   220 - 221   2016.03( ISSN:1884-8842

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    過去8年間のSnappingを伴う外側円板状半月の15歳以下の手術患者18例(男性2例、女性16例:手術時平均年齢12.4歳)を対象に、過伸展深屈曲MRIの有用性について検討した。MRIで撮像し、Ahnの分類(no shift type:N、Antero-central type:AC、posterio-central shift type:PC、Central type:C)を用いて半月板転位について評価した。その結果、18例中17例(94%)で術中辺縁部断裂を認めた。通常MRIではN:10例、AC:2例、PC:6例、C:0例であったが、過伸展深屈曲MRIを追加するとN:1例、AC:3例、PC:14例、C:0例となった。通常MRIでの半月転位と辺縁高輝度を含めた辺縁部損傷検出率は76%で、伸展深屈曲MRIを追加すると100%となった。以上より、術前の過伸展深屈曲MRIは、辺縁損傷部位を同定することが可能で有用性があると思われた。

  • MRI-T2マッピングを用いた外側円板状半月の術前・術後評価

    西田 洋平, 橋本 祐介, 寺井 彰三郎, 寺岡 貴徳, 山崎 真哉, 瀧上 順誠, 新熊 孝文, 中村 博亮

    JOSKAS   41 ( 1 )   224 - 225   2016.03( ISSN:1884-8842

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    過去1年8ヵ月間に、外側円板状半月(DLM)に対する鏡視下半月形成切除術または鏡視下半月形成縫合術を行った18例18膝(男性6膝、女性12膝:手術時平均年齢15.0歳)を対象に、MRI-T2マッピングを用いて術前後の評価を行った。対象の内訳は形成切除術症例6膝、形成縫合術症例12膝で、MRI-T2マッピングは術前、術後3・6・12ヵ月に行った。その結果、術前DLMのT2値は内側半月と比較して有意に高値であった。術前DLMのT2値は経時的に減少し、術後12ヵ月で有意差を認めた。縫合部と非縫合部のT2値の比較では、非縫合部で術後3ヵ月と術後1年の間に有意差を認めたが、縫合部は経時的な有意差を認めなかった。また、縫合の有無で有意差はなかった。

  • In situ preparation法を併用した四肢骨軟部悪性腫瘍手術における機能温存手術

    星 学, 大戎 直人, 家口 尚, 岩井 正, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 2 )   217 - 218   2016.03( ISSN:0008-9443

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    in situ preparation法(ISP法)は、血管・神経・骨などの重要臓器に近接して存在する四肢発生の肉腫に対して、血管・神経・骨を腫瘍とともに一塊にして安全な切除縁での切離を行い、腫瘍から血管・神経・骨を剥離する手術法である。2006年7月〜2015年8月迄の間にISP法を用いて腫瘍広範切除術を施行した肉腫症例は15名(男性7名、女性8名、年齢中央値53.1歳)であった。発生部位は大腿9、下腿2、上腕2、前腕2であった。術後局所再発をきたした症例はなかった。最終観察時の転帰は無病生存9名、病気確証なしでの生存2名、病死3名、有病生存1名で、5年後生存率は65.6%であった。術前に神経症状を認めていた2名ではいずれも該当神経を切断した。温存した臓器に関する合併症は認めなかった。

  • ACL再建術後における軟骨代謝マーカーとMRI T2マッピングの検討

    新熊 孝文, 橋本 祐介, 飯田 健, 高田 尚輝, 西田 洋平, 寺岡 貴徳, 寺井 彰三郎, 瀧上 順誠, 山崎 真哉, 中村 博亮

    JOSKAS   41 ( 1 )   122 - 123   2016.03( ISSN:1884-8842

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    軟骨変性を低侵襲で早期に検出できると思われる軟骨代謝マーカー法とMRI T2マッピング法を試行し、得られた値と膝不安定性との関係について検討した。対象は、当科で2012年2月〜7月に解剖学的2重束ACL再建術を施行した16例とし、軟骨代謝マーカー法による評価は術前と術後3日・2週・4週・3ヵ月時に行い、血清COMP(Cartilage oligomeric matrix protein)・ケラタン硫酸を測定した、MRI T2マッピング法は術前と術後3ヵ月時に行った。膝不安定性の評価方法は、術後1年時のKT-2000健患差を指標とし、2mm未満の群(11例)と2mm以上(5例)に分けて軟骨変性指標の値を比較検討した。結果、2mm以上群は術後3ヵ月時のCOMPが有意に高値で、他の指標に有意な群間差は認められなかった。COMP値の推移をみると、両群とも術前に比べて術後4週まで低値であり、2mm未満群は術後3ヵ月時も低値であったが、2mm以上群では術前より高値であった。これらの結果から血清COMP値は、膝不安定性による早期軟骨変性の予測マーカーとなる可能性が示唆された。

  • ACL再建時にFasT-Fixを用いた半月縫合後のcyst形成と半月治癒の検討

    飯田 健, 橋本 祐介, 新熊 孝文, 寺井 彰三郎, 瀧上 順誠, 山崎 真哉, 中村 博亮

    JOSKAS   41 ( 1 )   232 - 233   2016.03( ISSN:1884-8842

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    過去約4年間に、ACL再建時にFasT-Fixを用いて半月縫合し、再鏡視を行った症例18例(男性8例、女性10例:手術時平均年齢23.6歳)を対象に、cyst形成と半月治癒について検討した。再鏡視を行ったのは手術後平均17.4ヵ月であった。対象の内訳はcyst形成11例、非形成7例で、cyst形成群は平均年齢が有意に低く、FasT-Fixの使用本数が有意に多かった。半月治癒状態とT2値変化量の比較では、cyst非形成群で半月治癒状態が良好な傾向で、MRI T2値も改善傾向であった。

  • 半月損傷のない前十字靱帯再建患者に対するT2 mappingを用いた半月変性評価

    高田 尚輝, 橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 寺岡 貴徳, 新熊 孝文, 西田 洋平, 中村 博亮

    JOSKAS   41 ( 1 )   222 - 223   2016.03( ISSN:1884-8842

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    約2年間の、半月損傷を伴わない膝前十字靱帯再建患者8例(男性2例、女性6例:平均年齢20.6±8.2歳)を対象に、T2 mapping(T2)を用いて半月変性を評価した。術前、3・6・12ヵ月後にMRI-T2を行い、受傷からMRI撮影までは平均2.7±1.7ヵ月、受傷から手術までは平均3.0±1.7ヵ月であった。その結果、術後、平均KT-2000値の健患差は有意に改善したが、半月板のT2値は各測定部位、時期間で有意差を認めなかった。

  • 術前外側円板状半月に合併した離断性骨軟骨炎の術後経過と半月板温存量との関係

    瀧上 順誠, 橋本 祐介, 山崎 真哉, 寺井 彰三郎, 新熊 孝文, 富原 朋弘, 寺岡 貴徳, 西田 洋平, 中村 博亮

    JOSKAS   41 ( 1 )   228 - 229   2016.03( ISSN:1884-8842

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    過去14年間の15歳以上の有症状の完全型外側円板状半月(DLM)に合併した離断性骨軟骨炎(OCD)の手術症例9例11膝(男性8例10膝、女性1例1膝:平均年齢11.2歳)を対象に、術後経過と半月板温存量との関係について検討した。対象は辺縁温存群(形成切除と縫合の追加)9膝と辺縁切除術群(亜全摘)2膝に分類して比較した。その結果、OCDは11膝中4膝に悪化を認めた。術式別の悪化は辺縁温存群9膝中2膝(22.2%)、辺縁切除群は2膝中2膝であった。DLMの中節・後節辺縁切除でOCDの悪化を認め、中節・後節残存量と術後OCD面積に負の相関を認めた。以上より、DLMに合併したOCDの治療は、OCDの適切な処置および辺縁温存(特に中節・後節温存)が望ましいと考えられた。

  • 烏口突起の基部に生じた類骨骨腫の関節鏡治療 1症例の報告(Arthroscopic treatment of an osteoid osteoma at the base of the coracoid process: A case report)

    Ueyama Hideki, Ito Yoichi, Manaka Tomoya, Matsumoto Isshin, Ichikawa Koichi, Nakamura Hiroaki

    Journal of Orthopaedic Science   21 ( 2 )   245 - 249   2016.03( ISSN:0949-2658

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    症例は16歳男子で、外傷エピソードは無かったが、左肩の重度の夜間痛、運動時および安静時の軽度疼痛、および運動制限を訴えて受診した。左肩の烏口突起と腱板疎部に重度圧痛、および屈曲と外転の能動的関節可動域の160°の制限が認められた。疼痛はNon-Steroidal Anti-Inflammatory Drugにより初期には軽度改善したが、夜間痛はその後増悪した。MRIのT1およびT2強調画像において烏口突起基部に円形腫瘍、脂肪抑制T2強調画像において烏口突起内の顕著な骨髄浮腫および肩関節と烏口突起下の滑液貯留を認めた。9ヵ月後のMRI検査からも、腫瘍が確認された。肩関節鏡手術により腫瘍を完全に切除した。組織病理検査から類骨骨腫と診断された。術後数日以内に肩の夜間痛は大きく軽減し、運動時および安静時の疼痛も消失した。術後3ヵ月目に、能動的関節可動域の改善が認められ、腫瘍および肩関節内の滑液の消失がMRI検査から確認された。1年後の検査で腫瘍の再発は確認されなかった。

  • 有茎大腿筋膜張筋皮弁を用いて腹壁再建を行った軟部肉腫の1例

    斧出 絵麻, 星 学, 大戎 直人, 家口 尚, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 2 )   229 - 230   2016.03( ISSN:0008-9443

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    症例は帝王切開歴のある37歳女性で、左腹部腫瘤を自覚した。超音波検査で20mm大の腹壁腫瘍を指摘され、著者等の病院に紹介受診となった。左下腹部に7cm大の腫瘍性病変を触知した。性状は弾性軟、可動性不良で圧痛は認めなかった。単純MRIで左腹直筋内にT1強調画像で筋肉と等信号、T2強調画像で高信号の腫瘍を認め、6ヵ月で大きさが増大していた。PETでも左下腹部に異常集積を認めた。切開生検は平滑筋肉腫の診断であった。3cmの切除縁を含めた腫瘍広範切除術を施行し、有茎大腿筋膜張筋皮弁を用いて腹壁を再建した。病理組織では筋肉内に境界不明瞭な小型紡錘形から星芒状の異型細胞が疎に増殖しており、最終的に低悪性度fibromyxoid sarcomaと診断した。術後経過は良好であった。

  • 当院における初診時遠隔転移をともなう骨軟部肉腫治療経験

    大戎 直人, 星 学, 家口 尚, 岩井 正, 高見 勝次, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 2 )   219 - 220   2016.03( ISSN:0008-9443

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    初診時遠隔転移を認めた骨軟部腫瘍39名(男性25名、女性14名、年齢中央値56歳)の全累積生存期間を調べ、年齢および転移巣手術の有無、多剤併用化学療法の有無による生存期間について検討した。全累積生存期間中央値は25.7ヵ月、5年生存率は22.3%で予後不良であった。生存期間は骨腫瘍12名と軟部腫瘍27名で有意差を認めなかった。また、初診時年齢45歳未満と45歳以上で5年生存率に有意差を認めなかった。転移部位は肺転移のみ22名、肺および多臓器への多発転移10名、肺以外の転移7名であった。転移部位による生存率の差はなかった。転移巣に対する手術を施行された症例は転移巣手術なしの症例に比べて生存期間が延長する傾向があった。多剤併用化学療法を施行した25名の生存期間中央値は23.8ヵ月、施行なしの14名では46.0ヵ月で、有意差を認めなかった。

  • Reducing glucocorticoid dosage improves serum osteocalcin in patients with rheumatoid arthritis-results from the TOMORROW study Reviewed

    Tada M., Inui K., Sugioka Y., Mamoto K., Okano T., Koike T., Nakamura H.

    OSTEOPOROSIS INTERNATIONAL   27 ( 2 )   729 - 735   2016.02( ISSN:0937-941X

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00198-015-3291-y

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  • 大腿骨ステム周辺骨折Vancouver分類type Bに対する治療経験

    谷浦 圭, 政田 俊明, 佐々木 健陽, 中村 博亮

    骨折   38 ( 1 )   149 - 152   2016.02( ISSN:0287-2285

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    一般的に大腿骨ステム周辺骨折はVancouver分類を用い治療方針が決定される。特に、ステムにゆるみを認める症例では再置換術が推奨されているが、ゆるみの判断が困難な症例や、手術侵襲から人工関節の再置換術が困難な症例も多く、治療選択に難渋する。今回我々は、Vancouver分類type Bの症例に対し、全例骨接合術を行ったので報告する。対象は、2009年1月〜2014年9月まで当科で手術を行ったVancouver分類type Bのステム周辺骨折患者で、術後3ヵ月以上フォロー可能であった14例。ステムのゆるみが疑われた8例においても、ROMex開始後、全荷重開始後、術後3ヵ月にて全例、X線上ステムのゆるみの進行を認めず、ゆるみに起因する疼痛を認めなかった。我々は、手術侵襲も考慮し、原則としてVancouver分類type Bの症例に骨接合術を第一選択とし良好な成績を得た。(著者抄録)

  • New Predictive Index for Lumbar Paraspinal Muscle Degeneration Associated With Aging Reviewed

    Takayama Kazushi, Kita Teruo, Nakamura Hiroaki, Kanematsu Fumiaki, Yasunami Toshiya, Sakanaka Hideki, Yamano Yoshiki

    SPINE   41 ( 2 )   E84 - E90   2016.01( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BRS.0000000000001154

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  • L5/S椎間孔部狭窄に対し円筒型レトラクターを用い顕微鏡視下に行った外側開窓術の治療成績

    曽我部 祐輔, 関 昌彦, 藪 晋人, 寺川 雅基, 辻尾 唯雄, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 1 )   145 - 146   2016.01( ISSN:0008-9443

  • 円筒形レトラクターを用いて摘出した腰椎黄色靱帯内血腫の1例

    万代 幸司, 関 昌彦, 辻尾 唯雄, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 1 )   109 - 110   2016.01( ISSN:0008-9443

  • 腰椎後方すべり症に対する治療経験

    関 昌彦, 曽我部 祐輔, 寺川 雅基, 藪 晋人, 辻尾 唯雄, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 1 )   147 - 148   2016.01( ISSN:0008-9443

  • 脊椎疾患における坐位保持困難症例の臨床的特徴

    寺川 雅基, 関 昌彦, 藪 晋人, 曽我部 祐輔, 辻尾 唯雄, 中村 博亮

    中部日本整形外科災害外科学会雑誌   59 ( 1 )   137 - 138   2016.01( ISSN:0008-9443

  • Transtubular microsurgical treatment of foraminal stenosis at L5/S Reviewed

    SOGABE Yusuke

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 1 )   145 - 146   2016( ISSN:0008-9443 ( eISSN:13490885

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.11359/chubu.2016.145

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  • Less invasive surgical treatment using in situ preparation method for sarcoma in the extremities Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 2 )   217 - 218   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.217

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  • Favard分類E3タイプの腱板断裂性関節症に対して<BR>リバース型人工肩関節置換術を施行した1例 Reviewed

    八木 寛久, 間中 智哉, 伊藤 陽一, 市川 耕一, 中村 博亮

    日本肩関節学会 肩関節   40 ( 3 )   1067 - 1070   2016( ISSN:0910-4461 ( eISSN:18816363

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    79歳男性,Favard分類E3タイプの腱板断裂性関節症に対して非対称性の骨移植を併用したリバース型人工肩関節置換術を行った1例を報告する.術後1週で前方脱臼を認め,観血的脱臼整復術と再置換術を施行した.再置換後は安定化が得られ,術後短期だが経過良好である.Favard分類E3タイプでは,肩甲骨コンポーネントの上方傾斜設置を予防するために過剰なリーミングとなりやすく,lateral offsetが減少し術後脱臼のリスクになるため注意を要する.

    DOI: 10.11296/katakansetsu.40.1067

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  • 1F26 Fundamental Study of Tomographic Micro Visualization of Osteoarthritis using Arthroscopic Optical Coherence Tomography Reviewed

    KOTANI Kazuma, NAKAYAMA Hiroki, HASEGAWA Kiichi, SAEKI Souichi, NAKAMURA Suguru, IKEBUCHI Mitsuhiko, NAKAMURA Hiroaki, NIIMI Nobuo, TSUKAHARA Yoshito

    The Japan Society of Mechanical Engineers, The Proceedings of the Bioengineering Conference Annual Meeting of BED/JSME   2016 ( 0 )   _1F26 - 1_-_1F26-5_   2016

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    Many of the elderly are predisposed to develop osteoarthritis (OA), although it is quite difficult to diagnose the early-grade OA even by latest imaging modalities. The purpose of this study is the clinical development of D-OCSA arthroscopic system. The visualization system using Arthroscopic Optical Coherence Tomography (OCT) probe which is essential as a diagnostic system has been developed. In addition, ex vivo animal experiments applying D-OCSA were also carried out using rabbit's OA cartilage caused by amputation of the rabbit's left knee ACL. As an experimental result of Arthroscopic OCT probe, it was confirmed that the construed system could provide morphologic diagnosis of cartilage, e.g. tide mark. D-OCSA can show the attenuation coefficient distribution of compressive strain rate during relaxation test, which could find superior increase in attenuation only for early OA cartilage. Therefore, it can be seen that there is a loss of visco-elastic properties as compared to normal cartilage. In summary, Arthroscopic D-OCSA system could be effective to assessments of the early OA as "Micro Mechanical Biopsy".

    DOI: 10.1299/jsmebio.2016.28._1F26-1_

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  • Arthro Tunneler <SUP>TM</SUP> を用いた鏡視下腱板修復術術後1年の臨床成績 Reviewed

    平川 義弘, 伊藤 陽一, 間中 智哉, 市川 耕一, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 2 )   735 - 737   2016( ISSN:0910-4461 ( eISSN:18816363

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    本研究の目的はArthro Tunneler <SUP>TM</SUP> を用いたARCRの術後1年経過例の臨床成績を報告することである.対象は52例52肩(男性33例,女性19例).手術時平均年齢は66.8歳(36歳-83歳).腱板断裂の形状とサイズ別に,関節面側部分断裂1肩,滑液包側部分断裂2肩,全層断裂の内,小断裂4肩,中断裂7肩,大断裂19肩,広範囲断裂19肩であった.術後,大断裂以上で6週及び8週の外転位固定を行った.JOA score,自動屈曲及び自動外転可動域を評価した.平均JOA scoreは術前63.9点が術後1年で88.9点に有意に改善した.屈曲可動域は術前126度が術後6ヵ月で145度,術後1年で158度に,外転可動域は,術前114度が術後6ヵ月で143度,術後1年で158度に有意に改善した.Arthro Tunneler TMを用いたARCRの術後1年の臨床成績はおおむね良好であった.

    DOI: 10.11296/katakansetsu.40.735

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  • Anatomical Location of the Common Iliac Veins at the Level of the Sacrum: Relationship between Perforation Risk and the Trajectory Angle of the Screw Reviewed

    Akhgar Javid, Terai Hidetomi, Rahmani Mohammad Suhrab, Tamai Koji, Suzuki Akinobu, Toyoda Hiromitsu, Hoshino Masatoshi, Ahmadi Sayed Abdullah, Hayashi Kazunori, Nakamura Hiroaki

    BIOMED RESEARCH INTERNATIONAL   2016   1457219   2016( ISSN:2314-6133

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    DOI: 10.1155/2016/1457219

    PubMed

  • Comparative study of clinical outcomes of lateral lumbar interbody fusion (OLIF/XLIF) Reviewed

    YAMADA Yutaro

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 3 )   449 - 450   2016( ISSN:0008-9443

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    DOI: 10.11359/chubu.2016.449

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  • Successful bone healing of nonunion after ulnar shortening osteotomy treated with teriparatide: a case report Reviewed

    UEMURA Takuya

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 6 )   1247 - 1248   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.1247

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  • A case of chondromyxoid fibroma which required multiple operations Reviewed

    YAMADA Yutaro

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 6 )   1151 - 1152   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.1151

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  • Treatment of degenerative lumbar retrolisthesis Reviewed

    SEKI Masahiko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 1 )   147 - 148   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.147

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  • Clinical features of patients with difficulty of sitting position in degenerative lumbar disease Reviewed

    TERAKAWA Masaki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 1 )   137 - 138   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.137

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  • 肩甲骨の三次元的動態解析のリハビリテーションへの応用 Reviewed

    冨田 龍也, 池渕 充彦, 藤井 良憲, 伊藤 陽一, 中村 博亮

    公益社団法人 日本理学療法士協会 理学療法学Supplement   2015 ( 0 )   0324   2016

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    【はじめに,目的】近年,リバース型人工肩関節全置換術(以下RSA)が諸外国では盛んに行われるようになってきている。我が国においてもRSAを施行することが散見されるようになってきた。RSAの特徴は,上腕骨と肩甲骨の関係性が既存の人工関節とは異なり,関節中心が内側下方に移動することで,三角筋のレバーアームが延長し,三角筋のみで上肢挙上が可能になると言われており,その動作には肩甲骨の可動性が重要とされている。肩関節のリハビリテーションにおいても,肩甲骨の可動性が重要とされているが,RSA術後の肩甲骨に対するリハビリテーションに関する情報は少ない。そこで今回,RSA術後の肩甲骨動態解析を目的に,肩甲骨動態解析専用ソフトGANESHAを使用しRSA術後の肩甲骨を動態解析した。また,動態解析と共に肩関節外転ROMとの関係を比較した結果,簡易的に肩甲骨の評価が可能となり,リハビリテーションへ応用できる可能性を認めたので報告する。【方法】肩甲骨の動態解析には,大阪市立大学工学部で開発された肩甲骨動態解析専用ソフトGANESHAを使用した。対象は,腱板損傷後の,RSA術後6カ月の患者5人,平均78.4歳を,透視下で肩関節外転時に肩関節を撮影。正面写真を使用し肩甲骨の動態解析を行った。また,RSA術後患者の肩関節外転ROMの平均127°を基準に良好群と不良群で分けて比較した。【結果】RSA術後の肩甲骨動態解析では,不良群で非常に早期からの肩甲骨の動きが認められた。また,良好群と不良群での外転ROMの比較では有意差を認め,肩甲骨の動きで肩関節可動域を確保していた。【結論】RSAはGrammontにより初めてステムとソケットがデザインされ,我が国でも2014年に認可された。肩甲骨の運動は,肩関節のリハビリテーションを行う際には,欠くことのできない要素であるが,GANESHAを使用することで肩甲骨運動の三次元的動態解析を行い,客観的な肩甲骨の評価が可能となりリハビリテーション応用への可能性を認めた。理学療法の場面において,肩甲骨に対する運動療法を行う機会は非常に多いが,肩甲骨と肩関節を分けて判断することは困難である。D.WalkerはRSA術後の肩甲上腕リズムは1.3:1に変化すると報告しており,肩甲上腕関節に可動域制限がある際は,肩甲骨の動きで代償するとされている。今回,RSA術後の肩甲骨動態解析の結果から不良群で,非常に早期からの肩甲骨の動きが認められた。また,肩関節外転ROMの良好群と不良群で優位差が認められたのは,RSA術後の肩関節では,可動域を確保するために肩甲骨の動きが生じていると考えられた。今後は効果的なリハビリテーションを行うために,肩甲骨の客観的な評価を行い,肩関節の可動域向上を目指し,QOL,ADLの向上へ繋げたいと考える。

    DOI: 10.14900/cjpt.2015.0324

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  • 肩峰下滑液包内ガングリオン嚢胞に鏡視下手術を施行した1例 Reviewed

    山田 祐太郎, 間中 智哉, 伊藤 陽一, 市川 耕一, 中村 博亮

    日本肩関節学会 肩関節   40 ( 3 )   1071 - 1073   2016( ISSN:0910-4461 ( eISSN:18816363

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    肩峰下滑液包内に発生したガングリオン嚢胞に対して鏡視下手術を施行した1例を報告する.症例は82歳女性,MRI T2強調像で肩峰下滑液包前方に高信号で内部均一で多房性の嚢胞性病変を認めた.穿刺にて黄色で粘稠性の液体を採取したため,肩峰下滑液包内ガングリオン嚢胞と診断し,鏡視下デブリードマンを施行した.右肩前面の腫脹は消失し,術後再発を認めていない.本疾患に対し本術式は有効な低侵襲手術法である.

    DOI: 10.11296/katakansetsu.40.1071

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  • 第448回整形外科集談会京阪神地方会 Best Paper Award Reviewed

    小林 祐人, 鈴木 亨暢, 大山 翔一朗, 寺井 秀富, 星野 雅俊, 中村 博亮

    中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   59 ( 5 )   1089 - 1090   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.1089

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  • 本邦におけるリバース型人工肩関節全置換術の上腕骨コンポーネントと<BR>上腕骨サイズの不適合性 Reviewed

    南 義人, 伊藤 陽一, 市川 耕一, 間中 智哉, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 2 )   694 - 696   2016( ISSN:0910-4461 ( eISSN:18816363

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    2014年よりリバース型人工肩関節全置換術(以下RSA)が導入されたが,インプラントの設計は欧米人を対象とされており,体格の異なる日本人ではサイズに不一致が生じ得る.Tornier社のメタフィシスコンポーネントは36mm径であり,自験例においても上腕骨コンポーネント挿入時に上腕骨近位部に亀裂骨折を生じた経験がある.そこで本研究の目的はRSA症例の上腕骨サイズと体格を検討することである.対象はTornier社のRSAを施行した42例43肩であり,手術時年齢は平均76.3歳(53歳-89歳)である.術前CT画像より上腕骨頭解剖頚の内外側径と前後径を測定し,身長との相関を検討した.平均内外側径は41.6mm,平均前後径は38.8mmであり,両径ともに男性のほうが女性より有意に大きかった.また身長と内外側径,前後径はそれぞれ相関を認めた.近似直線より求められる解剖頚での径が36mm以下となる身長は約140cmであった.本研究より身長140cm以下の症例では解剖頚での径が36mm以下になる可能性があることが示唆された.

    DOI: 10.11296/katakansetsu.40.694

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  • Abdominal wall reconstruction with a tensor fascia lata flap after soft tissue sarcoma resection—A case report— Reviewed

    ONODE Ema

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 2 )   229 - 230   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.229

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  • 我々が経験したリバース型人工肩関節置換術の術中・術後合併症 Reviewed

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 2 )   701 - 704   2016( ISSN:0910-4461 ( eISSN:18816363

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    リバース型人工肩関節置換術(以下RSA)の術中・術後合併症を検討したので報告する.対象は,73症例77肩.合併症率,再手術率,合併症の有無と患者背景因子,発生原因及び対処法を検討した.合併症の発生率は77例中16例(20.8%)で再手術例は4例(5.2%)であった.術中合併症は合計8例で,関節窩骨折を2例,上腕骨骨幹部骨折を1例,上腕骨近位部骨折を4例に認めた.術後合併症は合計9例で,上腕骨骨折を2例,肩峰骨折を2例,脱臼を2例,ベースプレートの固定性不良を1例,術後神経麻痺を2例,術後血腫を1例に認めた.年齢,性別,診断,既往手術と合併症の有無の間に有意な差は認めなかった.RSAの合併症の発生率は20.8%で再手術率は5.2%あった.

    DOI: 10.11296/katakansetsu.40.701

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  • Treatment of bone and soft tissue sarcoma with metastasis Reviewed

    OEBISU Naoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 2 )   219 - 220   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.219

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  • 広範囲腱板断裂に対するInterposed Trans-Osseous法による<BR>鏡視下腱板修復術の有用性 Reviewed

    伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 3 )   951 - 954   2016( ISSN:0910-4461 ( eISSN:18816363

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    広範囲腱板断裂例におけるARCR後の術後成績は必ずしも優れていない.我々は近年開発されたArthro Tunneler<SUP>TM</SUP>を用いた骨孔式ARCRを,広範囲腱板断裂例に対して施行してきた.しかし同術式時に,大結節外側の骨孔亀裂による皮質骨損傷とL字型骨孔の変形による海綿骨損傷の問題を経験した.これらの解決目的に,外側骨孔にlateral protect implantが介在するInterposed Trans-Osseous法(ITO法)を考案し,その有用性を検討した.対象は従来法28肩(従来群)とITO法33肩(ITO群).手術時の骨孔亀裂割合は従来群の46%に対し,ITO群では9%と有意に減少した.腱板再断裂率は,従来群で35.7%,ITO群で21.2%であり,減少傾向を認めた.JOAスコアは両群ともに術後有意な改善を認めた.広範囲腱板断裂例に対するITO法は,有効な治療法であると判断できた.

    DOI: 10.11296/katakansetsu.40.951

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  • 巨大関節窩骨欠損を伴うCTAに対して上腕骨骨移植と<BR>RSAを施行した一例 Reviewed

    村上 将一, 平川 義弘, 伊藤 陽一, 間中 智哉, 中村 博亮

    日本肩関節学会 肩関節   40 ( 3 )   1074 - 1077   2016( ISSN:0910-4461 ( eISSN:18816363

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    <B>はじめに</B>:肩甲骨関節窩の大きな骨欠損は,リバース型人工肩関節全置換術(以下RSA)時のベースプレート固定が困難になる.今回我々は,反復性肩関節脱臼に伴う関節窩巨大骨欠損を合併した腱板断裂性関節症(CTA)に対して,上腕骨頭からの骨移植を併用してRSAを施行し,良好な短期成績が得られた1例を経験したので報告する.<BR><B>症例</B>:症例は82歳女性.明らかな誘引なく,右肩痛及び右肩関節水腫を認めた.近医受診し,右肩関節穿刺とステロイド注射等の保存的加療をするも症状改善せず,精査加療目的に当院を紹介受診した.初診時,右肩関節に著明な腫張と圧痛を認め,自動可動域は屈曲60度,外転60度,外旋:30度,内旋:殿部と著明な可動域制限と偽性麻痺を認めた.単純X線では,右肩関節は前方脱臼しており,他動的に屈曲すると容易に脱臼整復される反復性肩関節脱臼の状態であった.整復後の単純X線では,Hamada 分類4A,Favard分類E4のCTAを認め,CTでは,関節窩前方1/3に及ぶ巨大骨欠損を認めた.MRIでは広範囲腱板断裂と腱板筋委縮及び関節水腫を認めた.以上のことより反復性肩関節脱臼症状を呈する関節窩の巨大骨欠損を合併したCTAと診断し,症状発現後4ヶ月時に,上腕骨頭からの骨移植を併用してRSAを施行した.術中,関節窩前方の巨大骨欠損に対して,骨頭を4分割して移植骨を作成し,新鮮化した関節窩縁に圧着させ3.5mmCCSスクリュー2本で固定した.ベースプレートの後方2/3は残存関節窩に固定可能で,前方1/3は移植骨自体に固定可能であった.術後4週間30度外転位固定を行い,術後6ヶ月で,屈曲:160度,外転:120度,外旋:20度,内旋:L5に改善し,JOAスコアは術前30.5点から73.5点に改善した.また術後6ヶ月のCTで,移植骨の骨癒合が完了し,インプラントの設置位置も良好であった.<BR><B>結論</B>:関節窩の巨大骨欠損を合併したCTAに対して,上腕骨頭4分割の骨移植を併用したRSAは有効な治療法と判断できた.

    DOI: 10.11296/katakansetsu.40.1074

    CiNii Article

  • Large schwannoma on cervical spine with pharyngeal irritation; A case report Reviewed

    HAYASHI Kazunori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 6 )   1215 - 1216   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.1215

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  • Fundamental study on mechanical diagnosis of cartilage degeneration using Dynamic Mechanical Analyzing Optical Coherence Straingraphy Reviewed

    SAEKI Souichi, NAKAYAMA Hiroki, Hasegawa Kiichi, IKEBUCHI Mitsuhiro, NAKAMURA Suguru, NAKAMURA Hiroaki, NIIMI Nobuo, TSUKAHARA Yoshihito

    The Japan Society of Mechanical Engineers, The Proceedings of Mechanical Engineering Congress, Japan   2016 ( 0 )   S0220103   2016( eISSN:24242667

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    <p>Many of the elderly are predisposed to develop osteoarthritis (OA), although it is quite difficult to diagnose the earlygrade OA even by latest imaging modalities. In this study, we have proposed Dynamic Mechanical Analyzing Optical Coherence Straingraphy, namely DMA-OCSA, which is a tomographically micro-visualizing method of visco-elastic properties estimated from continuous OCT images. This is based on the speckle tracking algorithm having high sensitivity and S/N under micrometer resolution, thus can provide temporal and spatial distribution of not only deformation velocity but also strain rate during a dynamic visco-elasticity test. This was experimentally applied to comparatively both normal cartilages and cartilages degenerated by the collagenase enzyme treatment. Consequently, the sinusoidal time-varying strain rate was locally observed to have phase difference between the superficial tangential zone and middle zone, which could cause degradation of visco-elasticity.</p>

    DOI: 10.1299/jsmemecj.2016.S0220103

    CiNii Article

  • A case report of the lumbar ligamentum flavum hematoma, treatment by minimum invasive surgery Reviewed

    MANDAI Koji

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 1 )   109 - 110   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.109

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  • 人工肩関節置換術及び人工骨頭置換術術後10年以上の長期臨床成績 Reviewed

    市川 耕一, 伊藤 陽一, 間中 智哉, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 2 )   688 - 693   2016( ISSN:0910-4461 ( eISSN:18816363

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    人工肩関節置換術(TSA),人工骨頭置換術(HHR)の術後10年以上の長期成績を検討したので報告する.対象はTSA,HHRを施行した9例10肩,観察期間は平均11.2年である.自動可動域,JOA score,単純X線を経時的に評価した.自動屈曲はTSA(術前:82&deg;,10年:108&deg;),HHR(術前:68&deg;,10年:142&deg;)であり,外転はTSA(術前:66&deg;,10年:84&deg;),HHR(術前:41&deg;,10年:130&deg;)であった.JOA scoreはTSA(術前:42.8,10年:75.6),HHR(術前:38.0,10年:88.0)であった.TSAでは機能,可動域項目で5年以降に低下した.X線評価では肩甲骨インプラント周囲の透亮像を全例に認め,2例にlooseningを認めた.TSA,HHRの長期成績において除痛は継続的な効果が期待できるが,TSAでは機能,可動域は5年以降に低下した.

    DOI: 10.11296/katakansetsu.40.688

    CiNii Article

  • リバース型人工肩関節置換術におけるCT画像評価の有用性<BR>-肩甲骨関節窩形態及びグレノイドコンポーネント設置位置を中心に- Reviewed

    澤田 雄大, 間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 3 )   1055 - 1058   2016( ISSN:0910-4461 ( eISSN:18816363

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    リバース型人工肩関節置換術(以下RSA)において,術前の肩甲骨関節窩形態や術後のグレノイドコンポーネントの設置位置を正確に把握することは重要である.今回,RSAの術前・術後にCT評価を行い,肩甲骨関節窩形態やグレノイドコンポーネントの設置位置を評価したので報告する.対象は,14肩14症例.術前の肩甲骨関節窩傾斜角は5.7&plusmn;8.5&deg;で,術後のグレノイドコンポーネントの傾斜角は,-6.9&plusmn;8.1&deg;であった.術前の肩甲骨関節窩の前後捻角は,-1.2&plusmn;8.5&deg;で,術後のグレノイドコンポーネントの前後捻角は -2.1&plusmn;9.2&deg;であった.術後のグレノイドコンポーネントの下方への張り出しは,4.3&plusmn;2.4mmであった.CTにて術前の肩甲骨関節窩形態や術後のグレノイドコンポーネントの設置評価が可能であった.

    DOI: 10.11296/katakansetsu.40.1055

    CiNii Article

  • リバース型人工肩関節全置換術における,初回手術例と<BR>鏡視下手術術後再手術例間の短期臨床成績比較 Reviewed

    伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 松田 淑伸, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 3 )   1043 - 1046   2016( ISSN:0910-4461 ( eISSN:18816363

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    偽性麻痺を伴う広範囲腱板断裂症例に対する最終治療法として,リバース型人工肩関節全置換術(以下,RSA)が導入され,その有効性が期待されている.しかし,従来から行われてきた鏡視下腱板縫合術(以下ARCR)とRSAの術式選択は容易ではない.ARCRが不成功の場合でも,RSA再手術により十分な治療効果が得られるかを判断するために,RSA初回手術例:Primary RSA(P群)と鏡視下手術不成功後のRSA再手術例:Secondary RSA(S群)において,短期臨床成績を比較検討した.対象は43例44肩,P群25肩,S群19肩.評価は,患者背景,自動可動域,筋力,臨床成績を中心に,術前,術後3カ月及び6カ月に施行し,統計学的に検討した.患者背景に有意差を認めず,自動屈曲及び自動外転可動域は両群間に有意差を認めなかったが,自動外旋可動域及び外旋筋力は,S群において有意に低い値を示した.臨床成績は概ね良好な経過を示した.RSA初回手術例でも再手術例でも,自動屈曲及び外転可動域は良好な改善が期待できるが,外旋可動域及び外旋筋力の回復は再手術例において不良であった.

    DOI: 10.11296/katakansetsu.40.1043

    CiNii Article

  • Anterior and posterior fixation for cervical spondylosis of rheumatoid arthritis: a case report Reviewed

    UEDA Shoichi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 3 )   499 - 500   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.499

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  • 骨孔式ARCR施行時lateral protect implantによる骨孔亀裂の改善 Reviewed

    松田 淑伸, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 清水 勇人, 中村 博亮

    日本肩関節学会 肩関節   40 ( 2 )   731 - 734   2016( ISSN:0910-4461 ( eISSN:18816363

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    鏡視下に骨孔を作成して大結節の腱板footprint部に直接縫合糸を通して腱板修復を行う,骨孔式鏡視下腱板修復術(以下,骨孔式ARCR)では,大結節外側の骨孔亀裂をしばしば合併する.今回,外側骨孔にlateral protect implantを留置することで骨孔亀裂の発生が防止可能であるかを検討した.対象は骨孔式ARCRを施行した174例179肩(男性96名,女性78名),手術時平均年齢は67.6歳.腱板断裂サイズは小断裂0肩,中断裂54肩,大断裂51肩,広範囲断裂74肩であった.術中の関節鏡所見より確認した骨孔亀裂は,179肩中4肩(2.2%)であった.4例は全例女性の広範囲腱板断裂例で,平均年齢は79.3歳であった.骨孔式ARCR時にlateral protect implantを用いることで,大結節外側の骨孔亀裂の発生率は有意に減少し,その有用性が確認できた.

    DOI: 10.11296/katakansetsu.40.731

    CiNii Article

  • A case of extraabdominal desmoid tumor arising from the anterior neck Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 4 )   811 - 812   2016( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2016.811

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  • 1F26 Fundamental Study of Tomographic Micro Visualization of Osteoarthritis using Arthroscopic Optical Coherence Tomography

    KOTANI Kazuma, NAKAYAMA Hiroki, HASEGAWA Kiichi, SAEKI Souichi, NAKAMURA Suguru, IKEBUCHI Mitsuhiko, NAKAMURA Hiroaki, NIIMI Nobuo, TSUKAHARA Yoshito

    The Proceedings of the Bioengineering Conference Annual Meeting of BED/JSME   2016.28 ( 0 )   _1F26-1_ - _1F26-5_   2016( eISSN:24242829

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    Many of the elderly are predisposed to develop osteoarthritis (OA), although it is quite difficult to diagnose the early-grade OA even by latest imaging modalities. The purpose of this study is the clinical development of D-OCSA arthroscopic system. The visualization system using Arthroscopic Optical Coherence Tomography (OCT) probe which is essential as a diagnostic system has been developed. In addition, ex vivo animal experiments applying D-OCSA were also carried out using rabbit's OA cartilage caused by amputation of the rabbit's left knee ACL. As an experimental result of Arthroscopic OCT probe, it was confirmed that the construed system could provide morphologic diagnosis of cartilage, e.g. tide mark. D-OCSA can show the attenuation coefficient distribution of compressive strain rate during relaxation test, which could find superior increase in attenuation only for early OA cartilage. Therefore, it can be seen that there is a loss of visco-elastic properties as compared to normal cartilage. In summary, Arthroscopic D-OCSA system could be effective to assessments of the early OA as "Micro Mechanical Biopsy".

    DOI: 10.1299/jsmebio.2016.28._1f26-1_

    CiNii Article

  • 【よくわかる、臨床で使える「骨粗鬆症」アップデート】 骨粗鬆症の治療 椎体骨折の外科的治療(解説/特集)

    中村 博亮

    診断と治療   104   1287 - 1292   2016

  • 【新専門医制度に備えた必履修分野の教え方・学び方】 必履修分野の研修方法 頸椎(解説/特集)

    中村 博亮

    関節外科   35   42 - 52   2016

  • 【細胞移植と神経再生】 末梢神経 iPS細胞移植を併用したハイブリッド型人工神経によるマウス坐骨神経再生

    上村 卓也, 高松 聖仁, 中村 博亮

    Clinical Neuroscience   34   1166 - 1169   2016

  • 【脊椎領域におけるスポーツ医学の最近の話題】 スポーツ選手の腰椎椎間板ヘルニアに対する内視鏡下後方手術(解説/特集)

    中村 博亮

    関節外科   35   476 - 481   2016

  • 【骨粗鬆症性椎体骨折-治療の現状と問題点】 骨粗鬆症性椎体骨折における後壁損傷の追跡調査(解説/特集)

    中村 博亮

    整形・災害外科   59   903 - 907   2016

  • Comparative study of clinical outcomes of lateral lumbar interbody fusion (OLIF/XLIF)

    YAMADA Yutaro

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   59 ( 3 )   449 - 450   2016( ISSN:00089443 ( eISSN:13490885

  • 人工神経に付加したiPS細胞由来神経前駆細胞による末梢神経再生の促進効果 Reviewed

    横井 卓哉, 上村 卓也, 高松 聖仁, 新谷 康介, 岡田 充弘, 中村 博亮

    末梢神経   27   98 - 102   2016

  • Effect of the direct injection of bone marrow mesenchymal stem cells in hyaluronic acid and bone marrow stimulation to treat chondral defects in the canine model. Reviewed

    Shinya Yamasaki, Yusuke Hashimoto, Junsei Takigami, Shozaburo Terai, Hisashi Mera, Hiroaki Nakamura, Shigeyuki Wakitani

    Regenerative therapy   2   42 - 48   2015.12( ISSN:2352-3204

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    INTRODUCTION: The purpose of this study was to assess the direct injection of bone marrow-derived mesenchymal stem cells (BMSCs) suspended in hyaluronic acid (HA) combined with drilling as a treatment for chondral defects in a canine model. METHODS: Tibial bone marrow was aspirated, and BMSCs were isolated and cultured. One 8.0-mm diameter chondral defect was created in the femoral groove, and nine 0.9-mm diameter holes were drilled into the defect. BMSCs (2.14 × 107 cells) suspended in HA were injected into the defect. HA alone was injected into a similar defect on the contralateral knee as a control. Animals were sacrificed at 3 and 6 months. RESULTS: Although the percentage of coverage assessed macroscopically was significantly better at 6 months than at 3 months in both the BMSC (p = 0.02) and control (p = 0.001) groups, there were no significant differences in the International Cartilage Repair Society grades. The Wakitani histological score was significantly better at 6 months than at 3 months in the BMSC and control groups. While the control defects were mostly filled with fibrocartilage, several of the defects in the BMSC group contained hyaline-like cartilage. The mean Wakitani scores of the BMSC group improved from 7.0 ± 1.0 at 3 months to 4.6 ± 0.9 at 6 months, and those of the control group improved from 9.4 ± 1.2 to 6.0 ± 0.6. The BMSC group showed significantly better regeneration than the control group at 3 months (p = 0.04), but the difference at 6 months was not significant (p = 0.06). CONCLUSIONS: The direct injection of BMSCs in HA combined with drilling enhanced cartilage regeneration.

    DOI: 10.1016/j.reth.2015.10.003

    PubMed

  • イヌモデルにおける軟骨欠損の治療に対するヒアルロン酸内の骨髄間葉系幹細胞の直接注入と骨髄刺激の影響(Effect of the direct injection of bone marrow mesenchymal stem cells in hyaluronic acid and bone marrow stimulation to treat chondral defects in the canine model)

    Yamasaki Shinya, Hashimoto Yusuke, Takigami Junsei, Terai Shozaburo, Mera Hisashi, Nakamura Hiroaki, Wakitani Shigeyuki

    Regenerative Therapy   2   42 - 48   2015.12

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    軟骨欠損の治療に対して骨髄刺激と組み合わせてヒアルロン酸(HA)中に懸濁した骨髄間葉系幹細胞(BMSC)を直接注入し、その影響を骨髄刺激とHA注入のみによる治療と比較した。ビーグル犬から脛骨骨髄を吸引し、BMSCを分離して培養した。膝を曝露して大腿膝蓋溝に直径8mmの軟骨欠損を1ヶ所作製し、骨髄刺激として欠損に直径0.9mmの穴を9ヶ所に穿孔した。HA中に懸濁したBMSCを欠損に直接注入し、対照として反対側の膝に同様に作製した欠損にHAのみを注入した。3ヵ月後と6ヵ月後に組織再生を被覆域の比率とInternational Cartilage Repair Society(ICRS)スコアで肉眼によって評価し、膝の組織学的評価にWakitaniスコアを用いた。両群とも、3ヵ月と比較して6ヵ月で被覆率が有意に改善したが、対照とBMSC群では両時点ともに有意差がなかった。ICRSスコアは両群ともに3ヵ月と6ヵ月で有意差はなく、群間でも有意差はなかった。対照欠損はほとんど線維軟骨で満たされ、BMSC群ではいくつかの欠損が硝子質様軟骨を含んでいた。平均Wakitaniスコアは両群とも3ヵ月よりも6ヵ月で有意に改善した。3ヵ月ではBMSC群の方が対照よりも良好であったが、6ヵ月では有意差はなかった。穿孔と組み合わせたHA中のBMSCの直接注入によって軟骨再生が強化された。

  • Hyperleptinemia suppresses aggravation of arthritis of collagen-antibody-induced arthritis in mice Reviewed

    Okano Tadashi, Koike Tatsuya, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Inui Kentaro, Okihana Hiroyuki, Ebihara Ken, Nakao Kazuwa, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   20 ( 6 )   1106 - 1113   2015.11( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00776-015-0768-7

    PubMed

  • ArthroTunnelerを用いた鏡視下腱板修復術における骨孔亀裂の検討

    松田 淑伸, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 清水 勇人, 松本 一伸, 中村 博亮

    肩関節   39 ( 3 )   749 - 752   2015.11( ISSN:0910-4461

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    ArthroTunnelerを用いた鏡視下骨孔法は、上腕骨大結節の腱板付着部とその外側の2ヶ所に骨孔を作成して開通させ、その中に縫合糸を通すことで、アンカーを用いずに腱板を面で圧着縫合することが可能であるが、縫合糸の結紮時に大結節外側の骨孔が縫合糸でカットアウトしてしまう骨孔亀裂現象をしばしば経験する。今回、骨孔亀裂の発生頻度と要因について検討するため、当院と関連病院で2012年5月〜2013年4月にArthroTunnelerを用いた76例77肩(男性45例、女性31例)を対象とし、術中の鏡視で骨孔亀裂を認めた症例の割合を調べるとともに、「年齢」「性別」「断裂サイズ」との関連性について解析した。結果、術中の鏡視で骨孔亀裂を認めたのは35肩(45%)であった。年齢が64歳以下の群と65歳以上群で骨孔亀裂の発生率を比較すると、それぞれ21%、59%で、65歳以上群が有意に高かった。「性別」「断裂サイズ」と骨孔亀裂との間に有意な関連は認められなかった。

  • コラーゲン抗体誘発関節炎マウスにおける高レプチン血症は関節炎悪化を抑制する(Hyperleptinemia suppresses aggravation of arthritis of collagen-antibody-induced arthritis in mice)

    Okano Tadashi, Koike Tatsuya, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Inui Kentaro, Okihana Hiroyuki, Ebihara Ken, Nakao Kazuwa, Nakamura Hiroaki

    Journal of Orthopaedic Science   20 ( 6 )   1106 - 1113   2015.11( ISSN:0949-2658

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    コラーゲン抗体誘発関節炎(CAIA)モデルマウスを用いて、レプチントランスジェニック(LepTg)マウスの高レプチン血症が軟骨破壊、骨破壊、関節滑膜炎、血清サイトカイン値に及ぼす影響について検討した。6〜8週齢の雌性C57BL/6Jマウス(対照)とLepTgマウスに、II型コラーゲンに特異的なモノクローナル抗体カクテル5mgをday 0に腹腔内に投与し、day 3にリポ多糖類12.5mgを腹腔内投与した。関節炎の評価は14日間行い、後肢は臨床的および組織学的に評価した。血清サイトカイン値はday 0〜5まで測定した。LepTgマウスの血清レプチン値は対照マウスの約9倍であった。CAIAのLegTgマウスでは、四肢腫脹の重症度、関節炎スコア、滑膜過形成、軟骨損傷が抑制されていた。IL-1β、IL-17、IL-10、TNF-αの血清サイトカイン値は両マウスにおいて有意な変化がみられなかったが、LepTgマウスのIL-6値はday 5に抑制された。高レプチン血症はIL-6反応と関節炎の進展を抑制することが示された。

  • 腰部脊柱管狭窄症における脊柱矢状面アライメントと年齢・腰痛・HRQOLとの関係

    加藤 相勲, 並川 崇, 松村 昭, 大山 翔一朗, 臼井 俊方, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 6 )   1203 - 1204   2015.11( ISSN:0008-9443

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    下肢痛を主症状とする腰部脊柱管狭窄症(LCS)に対する顕微鏡下片側進入両側除圧術を行い、術前の立位前脊柱X線像および患者立脚型評価がある234例(男性136例、女性98例:平均手術時年齢71歳)を対象に、脊柱矢状面アライメントと年齢・腰痛・health-related quality of life(HRQOL)との関係について調査検討した。対象は64歳以下60例(A群)、65〜74歳82例(B群)、75歳以上92例(C群)に分類した。その結果、矢状面アライメントパラメーターSVAとPL-LLは高齢化するほど増加していた。矢状面アライメントは腰痛VASと有意に関連しておりB群で強かった。また、矢状面アライメントとHRQOL(SF-36)は有意に関連しC群で強かった。

  • 思春期特発性側彎症に対する剛性の異なる2種類の太径ロッドを用いた後方矯正固定術の矯正効果

    豊田 宏光, 寺井 秀富, 鈴木 亨暢, 林 和憲, 玉井 孝司, 中村 博亮

    Journal of Spine Research   6 ( 11 )   1607 - 1613   2015.11( ISSN:1884-7137

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    われわれは純チタン製の6.35mm径ロッドを先に凸側挿入し、変形矯正を行った後に、さらに剛性の強いチタン合金製の6.35mmロッドを挿入する術式を考案し、本術式の矯正効果と頂椎の回旋度についての評価を行った。矯正率は、胸椎カーブが主であるLenke 1、2、3群では74.5%、胸腰椎カーブが主であるLenke 5、6では75.8%であった。また、頂椎の回旋角度の改善も認められ、凸側から変形矯正を行っても回旋変形は悪化しないことが判明した。(著者抄録)

  • 広範囲腱板断裂修復術術後のprotective rehabilitationの可能性

    平川 義弘, 伊藤 陽一, 間中 智哉, 市川 耕一, 清水 勇人, 松本 一伸, 中村 博亮, 松田 淑伸, 村西 壽祥, 中野 禎

    肩関節   39 ( 3 )   810 - 813   2015.11( ISSN:0910-4461

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    広範囲断裂修復術後の可動域訓練や筋力訓練に制限を加えることで修復部を保護するprotective rehabilitation(以下PR)が、その後の腱板修復状態や可動域にどのような影響を及ぼすか検討した。方法は、鏡視下腱板修復術を施行した43例を対象とし、術後6週間の他動運動禁止および術後12週間の装具固定とする群(PR群14例)と、術後2週間の他動運動禁止および術後8週間の装具固定とする群(対照群29例)に振り分け、術後6ヵ月時の腱板修復状態(菅谷分類)と、術後6ヵ月・12ヵ月時の可動域を群間比較した。結果、腱板修復状態は、再断裂例の割合が対照群の34%に対してPR群は21%と低かった。関節可動域は両群とも術前に比べて有意に改善しており、明らかな群間差は認めなかった。

  • 三角筋内のデスモイド切除後に肩関節外転位拘縮を生じた一症例

    清水 勇人, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 中村 博亮, 松田 淑伸

    肩関節   39 ( 3 )   856 - 859   2015.11( ISSN:0910-4461

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    38歳女。当科受診の4年前、右三角筋内デスモイドに対して腫瘍広範切除術を受けた。術後3ヵ月頃から三角筋部の疼痛があり、徐々に肩関節外転位拘縮も出現し、改善しないため当科に紹介された。MRI検査で腫瘍の再発所見は認められず、肩峰下滑液包に滑液貯留を認めた。また、関節造影で関節内容量の低下を認め、関節内キシロカインブロックテストで除痛効果を認めたことから、外転位拘縮の原因は肩関節内と肩峰下滑液包内にあると判断し、鏡視下関節授動術を行ったが、拘縮の改善は不十分であった。術後1年時のMRIで三角筋内にデスモイドの再発と瘢痕索状物を認めたため、デスモイド再切除術と瘢痕索状物除去術を施行し、外転位拘縮は改善した。

  • 整形外科領域における移植医療 総論 新規人工材料の開発と課題 神経損傷に対する柔軟性の高い人工神経の開発 人工多能性幹細胞移植を併用したハイブリッド型人工神経による再生医療をめざして

    上村 卓也, 高松 聖仁, 中村 博亮

    別冊整形外科   1 ( 68 )   47 - 51   2015.10( ISSN:02871645

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  • Additional Intensive Treatment for Rheumatoid Arthritis Patients with Positive Power Doppler Signals Reduce the Radiological Joint Damage Even after Achieving Clinical Remission -SCRUM Study- Reviewed

    Okano Tadashi, Inui Kentaro, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Koike Tatsuya, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   67   2015.10( ISSN:2326-5191

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  • On-Demand Use of Etanercept Only for Disease Flares Reduced the Disease Activity Score and Structural Damage Equivalent to Fully-Use of Etanercept in RA Patients Reviewed

    Inui Kentaro, Koike Tatsuya, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Okano Tadashi, Sakawa Akira, Fukushima Kenzo, Nakamura Hiroaki

    ARTHRITIS & RHEUMATOLOGY   67   2015.10( ISSN:2326-5191

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  • Knee reconstruction with endoprosthesis after extraarticular and intraarticur resection of osteosarcoma Reviewed

    Ieguchi M., Hoshi M., Takada J., Oebisu N., Aono M., Ban Y., Nakamura H.

    EUROPEAN JOURNAL OF CANCER   51   S694 - S694   2015.09( ISSN:0959-8049

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  • Prognostic factors for elderly patients with primary malignant bone and soft tissue tumors Reviewed

    Iwai Tadashi, Hoshi Manabu, Takada Jun, Oebisu Naoto, Aono Masanari, Takami Masatsugu, Ieguchi Makoto, Nakamura Hiroaki

    ONCOLOGY LETTERS   10 ( 3 )   1799 - 1804   2015.09( ISSN:1792-1074

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    DOI: 10.3892/ol.2015.3432

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  • Arthro-tunnelerを用いた鏡視下腱板修復術後のMRI評価

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 松本 一伸, 中村 博亮, 松田 淑伸

    肩関節   39 ( 2 )   506 - 509   2015.09( ISSN:0910-4461

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    Arthro-tunnelerによる鏡視下腱板修復術を行った76例76肩(男性42例、女性34例:手術時平均年齢67.1歳)を対象に、術後の腱板修復状態と骨孔形態についてMRIで評価を行った。経過観察期間は1年以上(平均23.6ヵ月)であった。腱板断裂サイズは小断裂7肩、中断裂13例、大断裂27肩、広範囲断裂29肩で、腱板修復状態は菅谷分類type I:8肩、type II:27肩、type III:28肩、type IV:4肩、type V:9肩であった。再断裂率は全体で17.1%、広範囲断裂症例のみでは再断裂率31%で、棘上筋または棘下筋は脂肪変性が高度な(Goutallier分類Grade 3以上)症例で有意に再断裂が多かった。骨孔形態はL字型23%、カーブ型41%、直線型36%であった。

  • 延髄から胸髄まで広範囲信号変化と脊髄腫大を来し、脊髄炎との鑑別を要した頸椎後縦靱帯骨化症の1例

    柴田 雄輝, 林 和憲, 星野 雅俊, 豊田 宏光, 寺井 秀富, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 5 )   939 - 940   2015.09( ISSN:0008-9443

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    82歳女。歩行困難と巧緻運動障害を主訴とした。10年前より両上肢の痺れが出現し、半年前より歩行困難と巧緻運動障害が生じた。身体所見でRomberg徴候が強陽性であり、Hoffman反射は右側で陽性、Babinski反射は両側で陽性であった。MRIで延髄からT2高位にかけてT1強調像で低〜等信号、T2強調像で高信号の連続した髄内信号変化と脊髄腫大の所見を認め、CTでC6-7に後縦靱帯骨化がみられた。脊髄炎を疑い、各種ウイルス抗体検査、抗AQP抗体およびACEを含めた血液検査および髄液検査を施行した。しかし、検査結果は陰性であったため、頸椎後縦靱帯骨化症および脊髄浮腫と診断した。C3-6椎弓形成とC2、C7部分椎弓切除術を施行したところ、巧緻運動障害が改善した。また、術後1週のMRIで延髄からT2高位にかけて連続した脊髄内信号変化はC5/6に限局するまでに縮小し、脊髄腫大も改善した。術後3ヵ月に四点杖歩行が可能になるまで回復した。

  • 頸椎症性脊髄症に対するC3-6片開き式椎弓形成術後のlaminar closureが臨床成績に与える影響

    臼井 俊方, 加藤 相勲, 並川 崇, 松村 昭, 大山 翔一朗, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 5 )   913 - 914   2015.09( ISSN:0008-9443

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    2007年6月〜2012年4月に頸椎症性脊髄症に対しsuture anchorを使用してC3-C6椎弓形成術を施行した40例(男24例、女16例、平均年齢64.9歳)を対象に、laminar closure(LC)発生頻度と臨床成績への影響を検討した。LCの発生は4例(10%)であり、全対象の脊柱管前後径(APD)値の術直後の増加率は64.2%、術後1年におけるAPD値減少率は11.7%であった。術後1年でのJOA改善率は47.4%、SF-36 PCSとSF-36 MCSの改善量は各々8.7点と2.4点であった。上肢しびれおよび上肢痛評価スケール(VAS)の改善量はそれぞれ2.6mm・10.5mmであった。LCの有無での2群間比較においてJOAスコア改善率はLCなし群がLCあり群より有意差はないものの高い傾向にあり、SF-36PCS/SF-36MCS、上肢痛VAS、上肢しびれVASの改善量もLCなし群がLCあり群より有意差はないものの大きい傾向であった。以上、術後のLCが臨床成績を低下させる可能性が示唆された。

  • 拘縮肩に対する鏡視下関節授動術術後可動域改善の経時的評価

    平川 義弘, 伊藤 陽一, 間中 智哉, 市川 耕一, 清水 勇人, 松本 一伸, 中村 博亮, 松田 淑伸, 村西 壽祥, 中野 禎

    肩関節   39 ( 2 )   547 - 549   2015.09( ISSN:0910-4461

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    特発性拘縮肩に対して鏡視下関節授動術を行い、術後24週以上経過観察し得た39例を対象として術後可動域を経時的に検討した。その結果、屈曲角度は術前平均105°から術後24週で平均141°へ、外転角度は各々91°から平均130°へ、いずれも有意に改善した。術後24週の屈曲角度を基準とし、術後各時点での屈曲、外転、1st外旋角度との相関を検討したところ、術後4週および6週時点の外転、1st外旋で有意な相関を認め、特に術後4週時点の1st外旋と最も強い相関を認めた。

  • Successful Bone Healing of Nonunion After Ulnar Shortening Osteotomy for Smokers Treated With Teriparatide Reviewed

    Uemura Takuya, Okada Mitsuhiro, Yokoi Takuya, Shintani Kosuke, Nakamura Hiroaki

    ORTHOPEDICS   38 ( 8 )   E733 - E737   2015.08( ISSN:0147-7447

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    DOI: 10.3928/01477447-20150804-90

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  • 筋腱温存型MIS-THAにおける静脈血栓塞栓症の発生率 仰臥位/側臥位での発生率の検討

    中村 卓, 溝川 滋一, 箕田 行秀, 大田 陽一, 糸数 万紀, 山村 一正, 中村 博亮

    Hip Joint   41   786 - 788   2015.08( ISSN:0389-3634

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    筋腱温存型低侵襲人工股関節全置換術を行った168例を、仰臥位によるS群59例(女性53例、男性6例、平均年齢63.6歳)と、側臥位によるL群109例(女性89例、男性20例、平均年齢65.2歳)に分け、静脈血栓塞栓症(VTE)発症率を比較検討した。患者背景で両群間に有意差はなく、全例で間欠的空気圧迫法、弾性ストッキング着用、術後3〜12日に血栓予防薬投与を行った。VTEはS群で2例(3.4%、深部静脈血栓症:DVT、症候性肺塞栓症:PE各1例)、L群で16例(14.7%、DVT 11例、PE 7例)に認め、L群で有意に多かった。DVT発症側は8例(67%、全例L群)が患側、4例(33%、S群1例、L群3例)が健側であった。S群/L群の術後1週目のFDP値(μg/ml)は13.8/15.1、D-ダイマー値(μg/ml)は6.8/7.5といずれも有意差はなく、手術時間(分)は70.0/78.7、出血量(ml)は219/166といずれも有意差を認めた。

  • 顕微鏡視下腰椎片側進入両側除圧術(908例)における再手術例の検討 再手術の原因と画像的危険因子に着目して

    加藤 相勲, 並川 崇, 松村 昭, 大山 翔一朗, 中村 博亮

    Journal of Spine Research   6 ( 8 )   1262 - 1266   2015.08( ISSN:1884-7137

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    腰椎変性疾患に対し顕微鏡視下片側進入両側除圧術を施行した908例中、除圧椎間での再手術例は21例(2.3%)であった。再手術の原因は、椎間変性の増悪が9例、側彎や椎間楔状化の増悪による椎間孔部狭窄が8例、ヘルニアの新規発生が4例であった。再手術例の最終診察時JOAスコア改善率は24.4%であった。特に椎間孔部狭窄による再手術例については、再手術までの期間が短く、JOAスコア改善率は13.6%で臨床成績は不良であった。側彎や椎間楔状化、側方すべりなどの画像的危険因子を伴う椎間での再手術例が多かった。これらの画像的危険因子を伴う椎間への低侵襲除圧術の適応については、今後さらなる議論が必要である。(著者抄録)

  • 腰椎すべり症に対する内視鏡下椎弓切除術の治療成績 すべりのない腰部脊柱管狭窄症の治療成績との比較

    鈴木 亨暢, 豊田 宏光, 寺井 秀富, 林 和憲, 玉井 孝司, 中村 博亮

    Journal of Spine Research   6 ( 8 )   1325 - 1330   2015.08( ISSN:1884-7137

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    内視鏡下椎弓切除術を行い除圧レベルにすべりがあるすべり有群36例とすべり無群46例の2群にて術後成績を比較・検討した。術後JOA score及び各VAS値は両群共に術後有意な改善が認められたが、2群間には有意差を認めなかった。しかし改善率25%以下である成績不良例の症例はすべり有群にのみ3例8%に認められた。腰椎すべり症に対しても内視鏡下椎弓切除術の治療成績はすべりの無い症例と同等で概ね良好だが、成績不良例が少数存在する。(著者抄録)

  • Mobile-bearing prosthesis and intraoperative gap balancing are not predictors of superior knee flexion: a prospective randomized study. Reviewed

    Yukihide Minoda, Hiroyoshi Iwaki, Mitsuhiko Ikebuchi, Taku Yoshida, Shigekazu Mizokawa, Maki Itokazu, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   23 ( 7 )   1986 - 1992   2015.07( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: Range of motion is a crucial measure of the outcome of total knee arthroplasty. Gap balancing technique and mobile-bearing prosthesis can improve postoperative range of motion. The purpose of this study was to determine the factors that are predictive of the postoperative range of motion. METHODS: A total of 94 knees with varus osteoarthritis were prospectively randomized to receive either a posterior-stabilized mobile-bearing or a posterior-stabilized fixed-bearing prosthesis. All preoperative and postoperative protocols and operative techniques were identical in the two groups. Extension and flexion joint gaps were measured using a tensor device during the operation. Multiple regression analysis was conducted to determine the best predictors of the knee flexion angle 2 years after the operation. The independent variables were type of prosthesis (mobile-bearing or fixed-bearing), difference between flexion and extension joint gaps (mm), age, gender, body mass index (BMI), preoperative and intraoperative knee flexion angles, change in posterior condylar offset, and posterior tilt of the tibial plateau. RESULTS: The mean difference between flexion and extension joint gaps was 0.8 ± 1.3 (mean ± SD) mm for mobile-bearing and 0.8 ± 1.9 mm for fixed-bearing prosthesis. The mean flexion angle for mobile-bearing and fixed-bearing groups was 120 ± 16° and 116 ± 20° preoperatively (n.s.), 142 ± 9° and 141 ± 12° intraoperatively (n.s.), and 129 ± 10° and 128 ± 13° at 2 years postoperatively (p = 0.773), respectively. Predictors were identified in the following three categories: (1) preoperative flexion angle, (2) intraoperative radiographic flexion angle, and (3) BMI (R = 0.603, p < 0.001). CONCLUSIONS: Mobile-bearing prosthesis and optimal gap balancing did not result in superior postoperative flexion angle. Better preoperative and intraoperative flexion angles and lower BMI were the significant predictors for better postoperative flexion angle. LEVEL OF EVIDENCE: Therapeutic study, Level I.

    DOI: 10.1007/s00167-014-2838-3

    PubMed

  • Direct bone-to-bone integration between recombinant human bone morphogenetic protein-2-injected tendon graft and tunnel wall in an anterior cruciate ligament reconstruction model. Reviewed

    Junsei Takigami, Yusuke Hashimoto, Shinya Yamasaki, Shozaburo Terai, Hiroaki Nakamura

    International orthopaedics   39 ( 7 )   1441 - 1447   2015.07( ISSN:0341-2695

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: This study was performed to evaluate one-stage anterior cruciate ligament (ACL) reconstruction using a semitendinosus tendon graft injected with bone morphogenetic protein 2 (BMP-2) in a rabbit model. METHODS: We injected recombinant human BMP-2 (rhBMP-2) in the experimental group and phosphate-buffered saline in the control group at two sites of the semitendinosus tendon (15 μg in each site) to replace tendon with bone in the bone tunnel. Twenty minutes later, the injected tendon graft was transplanted for ACL reconstruction by passing the graft through the bone tunnel. The animals were harvested at four, eight, or 12 weeks postoperatively and examined by histological and biomechanical methods. RESULTS: Histological analysis revealed that the tendon graft was replaced with new bone in the tunnel of the experimental group. Characteristic features identical to the regenerated direct insertion morphology at the bone-tendon junction were acquired at eight or 12 weeks in the experimental group. Biomechanical pull-out testing revealed greater stiffness in the experimental than control group at 12 weeks, although the maximum load to failure showed no significant difference between the two groups at four, eight, or 12 weeks. CONCLUSION: These results indicate the potential for ACL reconstruction with regenerated direct insertion morphology.

    DOI: 10.1007/s00264-015-2774-y

    PubMed

  • The influence of preoperative spinal sagittal balance on clinical outcomes after microendoscopic laminotomy in patients with lumbar spinal canal stenosis Reviewed

    Dohzono Sho, Toyoda Hiromitsu, Matsumoto Tomiya, Suzuki Akinobu, Terai Hidetomi, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   23 ( 1 )   49 - 54   2015.07( ISSN:1547-5654

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    DOI: 10.3171/2014.11.SPINE14452

    PubMed

  • 前縦隔に発生した脂肪肉腫の1例

    斉藤 公亮, 星 学, 大戎 直人, 八木 寛久, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 4 )   739 - 740   2015.07( ISSN:0008-9443

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    64歳男。呼吸困難にて前医を受診し、縦隔腫瘍を指摘された。紹介受診時の胸部CTでは胸骨、大動脈弓部、左腕頭静脈および左第8、9肋骨、胸壁に接する充実性の腫瘤を認め、MRIでは巨大腫瘍は脂肪の信号強度を示し、内部には脱分化がみられた。また、内部の脂肪と異なる充実成分は不均一な造影効果を示し、針生検ではatypical lipomatous tumorの診断であった。PCPS補助下で腫瘍切除術、左腕頭静脈合併切除術を行い、術後病理診断はdedifferentiated liposarcomaであり、脱分化型脂肪肉腫と診断された。術後経過は概ね良好で術後1年での再発を認めていない。

  • 脱分化した仙骨脊索腫の1例

    家口 尚, 星 学, 大戎 直人, 伴 祥高, 高田 潤, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 4 )   733 - 734   2015.07( ISSN:0008-9443

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    58歳男。臀部痛の増悪と腫脹を主訴とした。仙骨部分に圧痛を伴い緊満感のある可動性のない腫瘤を触知し、単純レントゲン画像およびCT画像にてS3-5の骨融解を認めた。針生検では粘液基質を背景に担空胞細胞を多く認めた。脊索腫の診断で腫瘍切除術を行い、初回手術後に多発播種病巣を認めたが、それらの腫瘍の増大速度は非常にゆっくりしたものであった。しかし、6年経過後の再発時には比較的早い増大を認め、切除組織の病理所見は脊索腫とは全く異なる像であり、MPNST、滑膜肉腫、線維肉腫、横紋筋肉腫、中皮腫の肉腫変化などが鑑別診断に挙げられたが、どの腫瘍への分化も認めず、未分化高悪性紡錘形細胞肉腫と診断した。また、臨床的には脱分化脊索腫と診断され、治療開始後99ヵ月で腫瘍死した。

  • 完全円板状半月に対し半月形成術施行後再手術となった1例

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 富原 朋弘, 中村 博亮

    日本整形外科スポーツ医学会雑誌   35 ( 3 )   188 - 191   2015.07( ISSN:1340-8577

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    術前MRIで辺縁部断裂を認めず、術中半月実質断裂を伴わない外側円板状半月症例に対して半月形成術を施行するも、術後半月転位をきたし、再手術に至った1例を報告する。11歳男児。X-Pにて大腿骨外顆に骨透亮像、MRIにて完全型外側円板状半月と離断性骨軟骨炎(OCD)が認められた。術中、anteroinferior popliteomeniscal fascicles欠損が認められたが強い不安定性はなく半月形成術施行。OCDに対してドリリングを施行。術後3ヵ月MRIで半月板後節の前方転位がみられ、再手術施行。半月板後節部分は前節と癒着し、円板状半月形状を呈していた。前節部と後節部間を分離し、後節部分をinside-out法で10針縫合。再手術後にOCDは一時的に軽快したが、再手術1年後のMRIでOCD再発を認めた。現在疼痛なくスポーツ復帰している。(著者抄録)

  • ABATACEPT MIGHT NOT ALTER ANTI-CYCLIC CITRULLINATED PEPTIDE LEVELS IN ESTABLISHED RHEUMATOID ARTHRITIS PATIENTS - AIRTIGHT STUDY- Reviewed

    Anno S., Inui K., Mamoto K., Okano T., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   74   1058 - 1058   2015.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2015-eular.3779

  • MEDICATION INTERVAL OF ADALIMUMAB FOR RHEUMATOID ARTHRITIS PATIENTS MIGHT BE EXTENDED AFTER THE ACHIEVEMENT OF LOW DISEASE ACTIVITY -KABUKI STUDY- Reviewed

    Okano T., Inui K., Tada M., Sugioka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   74   471 - 471   2015.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2015-eular.2609

  • INFLUENCE OF BIOLOGIC AGENTS ON BONE MINERAL DENSITY AND BONE MINERAL MARKERS IN PATIENTS WITH RHEUMATOID ARTHRITIS: DATA FROM THE AIRTIGHT STUDY Reviewed

    Tada M., Inui K., Sugioka Y., Mamoto K., Okano T., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   74   441 - 442   2015.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2015-eular.2214

  • HIGH LEVELS OF ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODIES AND HIGH DOSES OF GLUCOCORTICOID ARE RISK FACTORS FOR FALLS IN PATIENTS WITH RHEUMATOID ARTHRITIS: FOURTH-YEAR RESULTS OF THE TOMORROW STUDY Reviewed

    Mamoto K., Inui K., Okano T., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   74   450 - 450   2015.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2015-eular.2931

  • Correlation between Fibrillin-1 Degradation and mRNA Downregulation and Myofibroblast Differentiation in Cultured Human Dental Pulp Tissue. Reviewed

    Yoshiba N, Yoshiba K, Ohkura N, Takei E, Edanami N, Oda Y, Hosoya A, Nakamura H, Okiji T

    The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society   63 ( 6 )   438 - 48   2015.06( ISSN:0022-1554

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    DOI: 10.1369/0022155415580622

    PubMed

  • ADDITIONAL INTENSIVE TREATMENT FOR RHEUMATOID ARTHRITIS PATIENTS WITH POSITIVE POWER DOPPLER SIGNALS EVEN AFTER ACHIEVING CLINICAL REMISSION MIGHT REDUCE THE RADIOLOGICAL JOINT DAMAGE -SCRUM STUDY Reviewed

    Okano T., Inui K., Tada M., Sugioka Y., Mamoto K., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   74   154 - 154   2015.06( ISSN:0003-4967

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    DOI: 10.1136/annrheumdis-2015-eular.2616

  • Proposed Referential Index to Resect Femoroacetabular Cam-Type Impingement During Arthroscopy Using a Cadaveric Hip Model Reviewed

    Yamasaki Shinya, Hashimoto Yusuke, Terai Shozaburo, Takigami Junsei, Takahashi Shinji, Nakamura Hiroaki

    ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY   31 ( 6 )   1069 - 1076   2015.06( ISSN:0749-8063

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    DOI: 10.1016/j.arthro.2014.12.024

    PubMed

  • SARCOPENIA IS APPARENT IN PATIENTS WITH RHEUMATOID ARTHRITIS, ESPECIALLY THOSE TREATED WITH BIOLOGICS - TOMORROW STUDY Reviewed

    Inui K., Koike T., Tada M., Sugioka Y., Mamoto K., Okano T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   74   1013 - 1013   2015.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2015-eular.1221

  • ULTRASONOGRAPHY AS A POTENT TOOL FOR PREDICTING RADIOGRAPHIC PROGRESSION IN RHEUMATOID ARTHRITIS TREATED WITH BIOLOGICAL AGENTS Reviewed

    Mamoto K., Inui K., Okano T., Sugioka Y., Tada M., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   74   676 - 676   2015.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2015-eular.2935

  • Preference of surgical procedure for the forefoot deformity in the rheumatoid arthritis patients--A prospective, randomized, internal controlled study. Reviewed

    Masahiro Tada, Tatsuya Koike, Tadashi Okano, Yuko Sugioka, Shigeyuki Wakitani, Kenji Mamoto, Kentaro Inui, Hiroaki Nakamura

    Modern rheumatology   25 ( 3 )   362 - 366   2015.05( ISSN:1439-7595

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVES: The deformed rheumatoid forefoot may be treated with resection of lesser metatarsal heads combined with arthrodesis or resection of the first metatarsophalangeal joint. Recurrent hallux valgus deformity has been reported by resection. We performed a prospective, randomized, internal-controlled study to compare results between arthrodesis and resection. METHODS: We resected the lesser metatarsal heads bilaterally and performed arthrodesis of the first metatarsophalangeal joint on one side and resection on the opposite side. We investigated 26 patients (52 feet) who were followed at least one year. Patients were assessed for clinical score, hallux valgus angle (HVA), angle between first and second metatarsals, and angle between first and fifth metatarsals preoperatively, postoperatively and at final follow-up. We evaluated callosities, claw toes, recurrences, and procedure preferences. RESULTS: The mean follow-up period was 4.1 years. No significant differences between arthrodesis and resection were seen, with the exception of HVA. That was significantly less on arthrodesis side (11.5°) than on resection side (17.0°, p < 0.05). Seven callosities on resection side and four on arthrodesis side were observed. On resection side, hallux valgus deformity often recurred (15.3%). Patients expressed a significant preference for arthrodesis over resection (p = 0.008). CONCLUSIONS: Arthrodesis provides better results for maintaining HVA.

    DOI: 10.3109/14397595.2014.956984

    PubMed

  • 当院における脊椎感染症の治療経験 在院日数と治療費に関する検討

    上山 秀樹, 北 輝夫, 高山 和士, 池田 樹広, 堀 悠介, 西野 壱哉, 薮 晋人, 坂中 秀樹, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 3 )   413 - 416   2015.05( ISSN:0008-9443

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    2010年4月〜2013年9月に脊椎感染症の診断で入院した16例を対象とし、保存的に治療しえた群(7例)と手術治療を要した群(9例)に分け、「在院日数」「治療費(診療報酬とDPC包括点数)」を比較検討した。結果、在院日数は保存的治療群が平均44日、手術治療群が85日であり、統計学的有意差はなかった。診療報酬/DPC点数は保存的治療群が平均132116/90243点、手術治療群が279871/149469点であり、診療報酬/DPC点数とも手術治療群のほうが有意に高かった。

  • 関節リウマチ患者の前足部変形に対する外科的手技の優先度 前向き無作為化同一固体間比較試験(Preference of surgical procedure for the forefoot deformity in the rheumatoid arthritis patients: A prospective, randomized, internal controlled study)

    Tada Masahiro, Koike Tatsuya, Okano Tadashi, Sugioka Yuko, Wakitani Shigeyuki, Mamoto Kenji, Inui Kentaro, Nakamura Hiroaki

    Modern Rheumatology   25 ( 3 )   362 - 366   2015.05( ISSN:1439-7595

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    母趾中足指節関節(MTP)の関節固定術と切除術の臨床成績とレントゲン成績を比較し、関節リウマチによる二つの有痛性の前足部変形を有する患者に対する同時外科的手技としての優先度を明らかにした。著者等は、両側の第2〜5中足骨頭を切除し、一方の母趾MTP関節には関節形成術、他方の母趾MTP関節には切除術を施行した。二つの有痛性RA前足部変形を有する26例(52足)を対象とし、臨床スコア、外反母趾角(HVA)、第1・第2中足骨角度、第1・第5中足骨角度を術前、術後、最終経過観察時に測定した。平均追跡期間は4.1年であった。関節形成術群と切除術群では、HVAを除いて有意差はみられなかった。最終経過観察時のHVAは、切除術群が関節形成術群に比べて有意に大きかった。術後の胼胝は、切除術群では7件、関節形成術群では4件で発生した。切除術群では外反母趾変形の再発率が高かった。母趾MTP関節に対する関節形成術は、HVAの維持という点で、切除術よりも良好な成績を得られることが示された。

  • 腰仙椎IPD(椎弓根間距離)の正常値

    関 昌彦, 万代 幸司, 堀 悠介, 辻尾 唯雄, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 3 )   461 - 462   2015.05( ISSN:0008-9443

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    当センターで2009〜2013年に腰椎椎間板ヘルニアの手術を施行した83例の術前に、腰椎CTを用いて腰仙椎IPDの計測を行った。得られた結果を「平均値(最小値〜最大値)mm」で示すと、L1は20.7(18〜24)、L2は21.3(18〜25)、L3は22.1(19〜25)、L4は23.3(20〜27)、L5は26.1(22〜31)、S1は29.8(25〜35)であった。当センターでは腰部脊柱管狭窄症に対して18mm径の円筒形レトラクターを用いた顕微鏡視下片側進入両側除圧術を主に行っているが、その際、下位椎のIPDが長い症例では対側の除圧が困難となるため、術式判断の決定にはIPD値を第一の判断材料としている。したがって、IPDの正常値を把握しておくことは意義がある。

  • 有茎後脛骨動脈低位穿通枝皮弁における皮弁挙上の工夫 カラードプラーエコーを用いた穿通枝の解剖学的検討を踏まえて

    飯田 健, 岡田 充弘, 新谷 康介, 横井 卓哉, 上村 卓也, 中村 博亮

    中部日本整形外科災害外科学会雑誌   58 ( 3 )   615 - 616   2015.05( ISSN:0008-9443

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    著者らは以前、健常成人20例40肢を対象として後脛骨動脈穿通枝の解剖学的検討をカラードプラー法で行った。方法は、足関節内果で後脛骨動脈を同定し、近位方向へプローブを動かしながら、後脛骨動脈から分布する穿通枝を確認し、筋膜を貫く位置で内果からの距離を計測した。その結果、全例で内果から近位5cm以内に1本以上の穿通枝が検出された。今回、足部の内側から後面にかけて軟部組織欠損を生じた患者2例に対して有茎後脛骨動脈低位穿通枝皮弁で再建を行う際、上記検討結果を踏まえて、内果から5cm以内の剥離操作を行わないようにした。その結果、低位穿通枝を自動的に皮弁内に含めることができ、長軸に沿った皮弁血流を温存することができた。さらに、穿通枝を剥離する操作が不要であるため、手術手技を簡略化することができた。

  • Pedicled Adipose Tissue for Treatment of Chronic Digital Osteomyelitis Reviewed

    Okada Mitsuhiro, Kamano Masayuki, Uemura Takuya, Ikeda Mikinori, Nakamura Hiroaki

    JOURNAL OF HAND SURGERY-AMERICAN VOLUME   40 ( 4 )   677 - 684   2015.04( ISSN:0363-5023

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    DOI: 10.1016/j.jhsa.2014.12.034

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  • The Relationship Between Cervical and Lumbar Spine Lesions in Rheumatoid Arthritis With a Focus on Endplate Erosion Reviewed

    Ibrahim Mohammad, Suzuki Akinobu, Yamada Kentaro, Takahashi Shinji, Yasuda Hiroyuki, Dohzono Sho, Koike Tatsuya, Nakamura Hiroaki

    JOURNAL OF SPINAL DISORDERS & TECHNIQUES   28 ( 3 )   E154 - E160   2015.04( ISSN:1536-0652

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  • The relationship between cervical and lumbar spine lesions in rheumatoid arthritis with a focus on endplate erosion. Reviewed

    Ibrahim M, Suzuki A, Yamada K, Takahashi S, Yasuda H, Dohzono S, Koike T, Nakamura H

    Journal of spinal disorders & techniques   28 ( 3 )   E154 - 60   2015.04( ISSN:1536-0652

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BSD.0000000000000197

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  • Role of FDG-PET for Monitoring Malignant Bone and Soft Tissue Tumors

    50 ( 3 )   237 - 242   2015.03( ISSN:05570433 ( eISSN:18821286

  • Fate, origin and roles of cells within free bone grafts Reviewed

    Yano Koichi, Yasuda Hiroyuki, Takaoka Kunio, Takahashi Masafumi, Nakamura Hiroaki, Imai Yuuki, Wakitani Shigeyuki

    JOURNAL OF ORTHOPAEDIC SCIENCE   20 ( 2 )   390 - 396   2015.03( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00776-014-0673-5

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  • In vivo wear particles of remelted highly crosslinked polyethylene after total hip arthroplasty: report of four cases Reviewed

    Hata Kanako, Minoda Yukihide, Ikebuchi Mitsuhiko, Mizokawa Shigekazu, Ohta Yoichi, Miyazaki Nobuyuki, Miyake Yusuke, Nakamura Hiroaki

    JOURNAL OF MATERIALS SCIENCE-MATERIALS IN MEDICINE   26 ( 3 )   133   2015.03( ISSN:0957-4530

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s10856-015-5472-9

    PubMed

  • Fertility following treatment of high-grade malignant bone and soft tissue tumors in young adults. Reviewed

    Manabu Hoshi, Masatsugu Takami, Makoto Ieguchi, Masanari Aono, Jun Takada, Naoto Oebisu, Tadashi Iwai, Hiroaki Nakamura

    Molecular and clinical oncology   3 ( 2 )   367 - 374   2015.03( ISSN:2049-9450

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    This study was conducted to investigate marriage and fertility in long-term survivors with high-grade bone and soft tissue tumors following chemotherapy. We reviewed issues related to fertility in 47 patients (24 men and 23 women) who had survived for >5 years. The median age at diagnosis was 18.0±8.9 years and the mean duration of follow-up 11.0 years. We investigated the proportions of married subjects (number of married/total number of subjects) and fertile subjects (number who had fathered or conceived offspring/total number of subjects), the interval between first delivery and last chemotherapy, type of delivery, congenital deformities in the offspring and the association between cumulative dose of chemotherapeutic agents and subsequent reproduction. The final proportions of married and fertile subjects following sarcoma treatment were 36.2% (17/47) and 29.8% (14/47), respectively. Two subjects had fathered and 8 had conceived a total of 15 offspring. The proportion of fertile men was significantly lower compared to that of women. The mean interval between the last chemotherapy and the first delivery was 9.5 years. Of the 10 first births, 6 were normal transvaginal deliveries and 4 were caesarean sections (1 was a medical termination due to lung metastases, 1 was due to infected amniotic fluid caused by uterine myomas and 2 were performed due to abnormal rotation of the fetus). No offspring presented with congenital deformities. Fertile men had received smaller cumulative chemotherapeutic agent doses, particularly of ifosfamide, compared to those who had not fathered any offspring. In conclusion, infertility occurs more frequently in men compared to women following intensive chemotherapy. All the patients should be offered counseling regarding the potential risk of infertility prior to cancer treatment.

    DOI: 10.3892/mco.2014.474

    PubMed

  • Case report demonstrating effectiveness of sorafenib in multiple lung and bone metastases of renal cell carcinoma Reviewed

    Hoshi Manabu, Oebisu Naoto, Takada Jun, Iwai Tdashi, Nakamura Hiroaki

    ONCOLOGY LETTERS   9 ( 3 )   1409 - 1411   2015.03( ISSN:1792-1074

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3892/ol.2015.2844

    PubMed

  • ACL再建術脛骨骨孔作製時における脛骨刺入位置の検討 レムナントを温存するために

    寺井 彰三郎, 橋本 祐介, 山崎 真哉, 瀧上 順誠, 新熊 孝文, 中村 博亮

    JOSKAS   40 ( 1 )   122 - 123   2015.03( ISSN:1884-8842

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    伸展位固定された屍体膝19例を対象に、AM束前縁に沿って関節面からK-wireを先端が脛骨皮質を貫通するまで刺入した。K-wireの先端から脛骨粗面内縁までの距離(T)、薄筋上縁までの距離(G)を計測した。屍体膝をX線撮影し、骨軸とK-wireの成す角を正面像でtibial angle、側神経像でinclination angleとし計測した。その結果、Tの平均距離は11.5mm、Gの平均距離は17.7mmであった。男女別にみると、TもGも男性が女性より少し長い結果であった。平均tibial angleは23.5°、平均inclination angleは41.2°であった。男女別に分けるとtibial angle、inclination angleとも殆ど差がなく、骨格の違いを考慮すると男女差はないと考えられた。以上、本研究はレムナント温存前十字靱帯再建術の脛骨骨孔作製に有用であると考えられた。

  • T2マッピングを用いた正常半月板の評価

    寺岡 貴徳, 山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   40 ( 1 )   210 - 211   2015.03( ISSN:1884-8842

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    2012年2月〜2013年12月の間に膝関節鏡手術を行い、術中関節鏡所見で半月板損傷を認めなかった40例(男性17例、女性23例、平均年齢21.2歳)48半月板を対象にMRI T2-mapping(T2値)を用いて正常半月板の定量的評価を試みた。内側半月板(MM)は23半月板、外側半月板は25半月板であり、MRIでの測定部位はMRI矢状断で同一半月板の前角・体部・後角の3ヵ所とし関心領域を半月板全域とした。また、評価項目はT2計測値を部位別に分類してT2値の相対的散布度を評価するためCoefficient of Variation(CV値)を算出した。その結果、部位別平均T2値はMM、LMともに平均T2値に部位別の有意差は認めず、CV値においてもMM、LMともに部位別CV値に有意差は認められなかった。以上より、T2-mappingを用いて正常半月板のT2値の測定結果と文献的考察から正常半月板に対する定量的な評価が期待できると考えられたが、臨床応用には更なる検討が必要と考えられた。

  • Snappingを伴う外側円板状半月患者の理学的所見、MRIの特徴

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 富原 朋弘, 中村 博亮

    JOSKAS   40 ( 1 )   214 - 215   2015.03( ISSN:1884-8842

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    2007年〜2013年の間に15歳以下の外側円板状半月手術患者55例中、snappingを有する16例(男児2例、女児14例、手術時平均年齢11.2歳)を対象にsnappingを有する患者の理学的所見とMRI所見の特徴について調査した。手術では全例、術中に辺縁部断裂を認め、関節鏡を用いて断裂部を確認、前方辺縁断裂は膝を屈伸させることで術中snappingを再現し、円盤状半月を関節内側からくり抜くように部分切除を行ない、辺縁を約8mm程度残存させ半月板を縫合した。一方、後節不安定性の場合はinside out法で15針程度縫合し、前節不安定正の場合は中節まで至る場合はinside out法、outside in法、スーチャーフックを用いたall inside法を用いて縫合した。その結果、1)伸展時痛を認めた3例と伸展制限を認めた2例はみなAC型であり、PC型、N型では伸展時痛、伸展制限を来した症例はなかった。2)MRI形態評価ではAC型3例、N型7例、PC型6例、C型0例であったが、N型の症例を過伸展または深屈曲位でMRI撮影すると1例がAC型、6例がPC型となった。以上より、術中所見でAC型4例は全例が後方辺縁断裂であり、またPC型12例では全例で前方辺縁断裂が存在していた。

  • MRIを用いた有症状外側円板状半月患者の半月板形態と年齢分布の検討

    瀧上 順誠, 橋本 祐介, 山崎 真哉, 寺井 彰三郎, 新熊 孝文, 富原 朋弘, 中村 博亮

    JOSKAS   40 ( 1 )   224 - 225   2015.03( ISSN:1884-8842

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    2000年〜2014年の間に有症状のため単純MRIにて外側円板状半月(DLM)と診断された279例(男性155膝、女性140膝、年齢5〜70歳、平均年齢20.7歳)を対象に半月板形態とその特徴について評価した。半月板形態は渡辺分類に従い完全型(C型)、不完全型(IC型)に分け、不完全型はAhnの報告に基づき内側半月板より大きくC型に至っていないものとした。その結果、1)年齢分布では10歳代のDLM患者が全体の約5割を占めていた。2)形態別の割合は295膝中、C型が203膝、IC型が92膝とC型が全体の約7割を占めていた。また形態別ではC型の割合は20歳以下が75%を占めるのに対し、20歳以上では60%程度と10代から20代にかけて割合の減少がみられ、IC型の割合が増す傾向であった。3)OCDの合併は30膝(5〜17歳、C型24膝、IC型6膝)にみられ、18歳以上では認められなかった。尚、5〜17歳のDLM 179膝のOCD合併率はC型が17.1%、IC型が15.4%と、形態別でのOCD合併率には有意差は認められなかった。

  • ウサギの半腱様筋腱へのrhBMP-2注入による1期的ACL再建の試み

    瀧上 順誠, 橋本 祐介, 山崎 真哉, 寺井 彰三郎, 新熊 孝文, 中村 博亮

    JOSKAS   40 ( 1 )   96 - 97   2015.03( ISSN:1884-8842

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    New Zealand white rabbit(ウサギ)のメス54羽の左膝を対象に、全身麻酔下でウサギの半腱様筋腱(ST)にBMP+群としてヒト組み替え骨形成蛋白(rhBMP-2)を、BMP-群としてリン酸緩衝生理食塩水をそれぞれインドシアニングリーンで着色し、骨孔予定部2ヶ所に投与した。注入20分後にSTを切離し、作成したシングル骨孔に誘導して骨外ポストスクリューで固定し、術後4週〜12週の組織学的評価およびpull-out試験による最大破断強度とstiffness測定を行った。組織学的所見として、BMP-群ではグラフト内骨化を認めなかったが、BMP+群では4週で腱内軟骨化を、8週から腱内の骨化を認め、拡大写真ではBMP+群での正常のenthesisに類似した所見を認め、tidemarkの出現も確認された。力学試験ではBMP+群のstiffnessはBMP-と比較して有意に高い値であったが、最大破断強度は有意差を認めなかった。

  • 膝前十字靱帯再建と併用した半月縫合における、術前後半月T2 mapping値変化と再鏡視所見との比較

    山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 寺岡 貴徳, 中村 博亮

    JOSKAS   40 ( 1 )   212 - 213   2015.03( ISSN:1884-8842

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    本研究では同一症例における半月縫合前後におけるMRI-T2mapping値(T2値)変化量と半月治癒状態との関連ついて検討した。対象は前十字靱帯(ACL)再建術に半月縫合術を併用し再鏡視とT2mapping撮影が可能であった7例(男性2例、女性5例、年齢17〜43歳、平均年齢27.4歳)とした。方法は半月縫合前後にMRIにてプロトン強調像およびT2脂肪抑制像を撮影し、Mink分類にて損傷を評価し、次にT2mappingを撮影した。関心領域は矢状断にて半月損傷が最も明瞭に描出された1スライドの半月とし、計測ソフトBaum 2Dを用いてT2値を計測した。また、再鏡視での半月板治癒状況はCannonらの方法に基づき治癒状態別に分類しT2値を比較し、次いで級内相関係数(ICC)を用いて検者内信頼性、検者間信頼性を計測して信頼性を評価した。その結果、1)再鏡視所見では完全治癒は4例、部分治癒は2例、治癒不全は1例であった。一方、MRIでの術前評価では全例がMink Grade (G)3であり、再鏡視時には完全治癒の1例はG1まで改善し、その他は全てG2までの改善であった。2)T2値変化量は完全治癒例平均で-10.9ms、部分治癒例平均で-6.2ms、治癒不全例+6.1msであった。3)T2計測値の検者内信頼性はICC(1.1)=0.988、検者間信頼性はICC(2.1)=0.973であった。

  • 遊離骨移植片における細胞の運命、起源、役割(Fate, origin and roles of cells within free bone grafts)

    Yano Koichi, Yasuda Hiroyuki, Takaoka Kunio, Takahashi Masafumi, Nakamura Hiroaki, Imai Yuuki, Wakitani Shigeyuki

    Journal of Orthopaedic Science   20 ( 2 )   390 - 396   2015.03( ISSN:0949-2658

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    動物モデルを用いて、移植骨内での細胞の役割と運命、移植片における新規骨形成に対する細胞の寄与について検討した。緑色蛍光タンパク質(GFP)導入ラットおよび野生型ラットから得た骨幹中央部円柱状骨の検体を、それぞれ野生型ラットおよびGFPラットの背筋に移植した。免疫組織化学的検査、in situハイブリダイゼーション、量的逆転写PCRにより移植骨を評価した。新たに形成された骨における細胞はすべて移植骨由来であり、骨芽細胞が徐々に宿主細胞により置換された。対照的に、破骨細胞は骨移植の2週間後に宿主細胞により直ちに置換された。移植骨における骨形成タンパク質(Bmp)-4、Bmp受容体、ノギンの発現は、新たな骨形成が生じる前に有意にアップレギュレートされ、移植細胞は間葉系細胞の移植床への動員に寄与していることが示唆された。

  • 若年性外側完全型円板状半月に対する離断性骨軟骨炎合併のリスク因子の検討

    瀧上 順誠, 橋本 祐介, 山崎 真哉, 寺井 彰三郎, 新熊 孝文, 富原 朋弘, 中村 博亮

    JOSKAS   40 ( 1 )   222 - 223   2015.03( ISSN:1884-8842

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    外側円板状半月(DLM)に対する離断性骨軟骨炎(OCD)合併率、半月板の不安定性とOCDの関係についての報告は少ない。今回、著者らは2000年〜2014年の間に受診した15歳以下で、有症状の完全型DLM(CDLM)にて術前に単純X線とMRI像が撮影可能であった105例119膝(男子54膝、女子65膝、年齢5〜15歳、平均年齢11.6歳)を対象に治療前のOCD合併率、半月板shiftに着目した半月板形態とOCDの関係について検討した。方法はOCDの評価をBruckl分類で単純X線像で行い、あわせて半月板の形態評価は単純MRIでAhn分類に基づき半月板shift様式で4typeに分類して行った。その結果、1)OCD合併率は19.3%で、Bruckl分類はstage1が6膝、stage 2が12膝、stage 3が3膝、stage 4とstage 5が各1膝であった。2)MRIを用いた半月板形態(Ahn分類)はtype Nが最多で58.8%、次いでtype ACが17.6%、type PCが14.8%、type Cが11膝であった。3)半月板の各shift形態別におけるOCD合併率はtype Cが最も多く45.5%で、ほかtype ACは28.6%、type Nは17.1%で、type PCは認められなかった。4)リスク因子は男子であることほか、年齢が1歳下がるごとに単変量・多変量解析とも有意にオッズ比が高くなった。尚、半月板の形態別ではtype Nを基準にするとtype Cが有意にオッズ比高値であった。

  • 80歳以上の腰部脊柱管狭窄症の手術成績 除圧術vs固定術

    斧出 絵麻, 松村 昭, 林 和憲, 加藤 相勲, 並川 崇, 中村 博亮

    整形・災害外科   58 ( 2 )   229 - 232   2015.02( ISSN:0387-4095

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    2009年1月〜2011年12月の間に腰椎脊柱管狭窄症(LCS)に対して手術治療を行い、術後1年以上経過観察可能であった80歳以上の61症例(男性30例、女性31例、手術時年齢80〜91歳。平均年齢82.3歳)を対象に、患者背景や臨床成績について除圧術(40例)と固定術(21例)で比較検討した。その結果、1)手術時年齢は除圧術80〜86歳(平均年齢82.2歳)、固定術80〜91歳(平均年齢82.5歳)と有意差は認められなかった。2)術前併存疾患を有していた症例では除圧群が62%、固定群74%と固定群が多く、高血圧など生活習慣病が多くを占めていた。3)平均手術時間は除圧群が120分、固定群が284分で、平均出血量は除圧群が61g、固定群457gであった。また、平均在院日数は除圧群が25.9日、固定群40.3日であった。4)周術期合併症は除圧群が4例(10%)、固定群が4例(20%)であった。5)術前平均JOA scoreは除圧群が11.9点、固定群が10.3点であったが、最終観察時JOA scoreは除圧群が20.3%、固定群19.4点と、JOA score改善率は両群とも48%であった。以上より、80歳以上のLCS患者に対する手術治療成績は80歳未満の患者に比べ回復に時間を要するものの術前の全身状態を適確に評価し治療方法を選択することでADLの維持・改善に寄与し得るものと考えられた。

  • 整形外科/知ってるつもり 骨軟部腫瘍治療前の妊孕性温存

    星 学, 大戎 直人, 家口 尚, 中村 博亮

    臨床整形外科   50 ( 1 )   28 - 30   2015.01( ISSN:05570433 ( eISSN:18821286

  • Severe low back pain in patients with rheumatoid arthritis is associated with Disease Activity Score but not with radiological findings on plain X-rays Reviewed

    Yamada Kentaro, Suzuki Akinobu, Takahashi Shinji, Yasuda Hiroyuki, Koike Tatsuya, Nakamura Hiroaki

    MODERN RHEUMATOLOGY   25 ( 1 )   56 - 61   2015.01( ISSN:1439-7595

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3109/14397595.2014.924187

    PubMed

  • 骨粗鬆症性椎体骨折の長期予後(5年以上) 生存・ADL・遺残疼痛に影響する因子解析

    星野 雅俊, 寺井 秀富, 辻尾 唯雄, 鈴木 亨暢, 並川 崇, 加藤 相勲, 松村 昭, 高岡 邦夫, 中村 博亮

    Journal of Spine Research   6 ( 1 )   12 - 16   2015.01( ISSN:1884-7137

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    骨粗鬆症性椎体骨折患者で5年以上追跡できた107例を対象とし、死亡や寝たきりなどの重篤な長期予後に関連する因子を解析した。追跡調査時の生存状況は死亡が26例、ADLは寝たきりが11例、準寝たきりが19例、自立が51例であった。多変量解析の結果、受傷時の椎体後壁損傷と6ヵ月時の高度椎体圧潰が長期予後には最も関連しており、治療上最も留意すべきポイントと考えられた。(著者抄録)

  • 関節リウマチ患者における重篤な腰痛は疾患活動性スコアと関連したが、単純X線画像所見とは関連しなかった(Severe low back pain in patients with rheumatoid arthritis is associated with Disease Activity Score but not with radiological findings on plain X-rays)

    Yamada Kentaro, Suzuki Akinobu, Takahashi Shinji, Yasuda Hiroyuki, Koike Tatsuya, Nakamura Hiroaki

    Modern Rheumatology   25 ( 1 )   56 - 61   2015.01( ISSN:1439-7595

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    脊髄手術を受けていない関節リウマチ(RA)患者201名を対象に、重篤な腰痛(LBP)と関連する因子を検索するための横断研究を行った。重篤なLBPは4週間以内の視覚的評価尺度(VAS)スコア(最大スコア100mm)が50mm以上と定義した。48名のRA患者(23.9%)がLBPを示した。多変量解析を行ったところ、重篤なLBPと関連する因子は女性、喫煙、28関節の疾患活動性スコア-赤沈速度(DAS28-ESR)における中等度から重度の疾患活動性であり、X線所見とは関連しなかった。DAS28-ESRサブスコアでは、重篤なLBPの患者は圧痛関節数と全体的健康についてのVASスコアが有意な高値を示した。RA患者では重篤なLBPの有病率が高く、重篤なLBPと関連する因子は疾患活動性スコアであり、X線所見とは関連しなかった。重篤なLBPは圧痛関節数やRAの主観的愁訴と関連した。

  • ArthroTunneler <SUP>TM</SUP> を用いた鏡視下腱板修復術における骨孔亀裂の検討 Reviewed

    松田 淑伸, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 清水 勇人, 松本 一伸, 中村 博亮

    日本肩関節学会 肩関節   39 ( 3 )   749 - 752   2015( ISSN:0910-4461 ( eISSN:18816363

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    ArthroTunneler <SUP>TM</SUP> は鏡視下腱板修復術に用いられるデバイスで,上腕骨大結節に骨孔を作製しアンカー用いずに腱板縫合が可能であるが,縫合時に大結節外側の骨孔が糸でカットアウトしてしまう症例をしばしば経験することから,その骨孔亀裂に関しての検討を行った.対象は2012年5月から2013年4月までの間に当院及び関連病院にて同術式を施行した76例77肩で,女性31名,男性45名,平均年齢は67.2才(36-83才),腱板断裂サイズは小断裂5肩,中断裂14肩,大断裂26肩,広範囲断裂32肩であった.術中の関節鏡所見にて大結節外側に作成した骨孔に亀裂が生じた割合,骨孔亀裂と性別,年齢,腱板断裂サイズとの関連性を調査した.骨孔亀裂は35肩(45.5%)に生じた.65才以上の高齢者では有意に高頻度に骨孔亀裂を認めた.一方,骨孔亀裂と性別や腱板断裂サイズとの間には統計学的関連はみられなかった.

    DOI: 10.11296/katakansetsu.39.749

    CiNii Article

  • Arthro-tunneler&trade; を用いた鏡視下腱板修復術後のMRI評価 Reviewed

    間中 智哉, 伊藤 陽一, 市川 耕一, 平川 義弘, 清水 勇人, 松本 一伸, 中村 博亮, 松田 淑伸

    日本肩関節学会 肩関節   39 ( 2 )   506 - 509   2015( ISSN:0910-4461 ( eISSN:18816363

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    Arthro-tunneler&trade; を用いた鏡視下腱板修復術後の腱板修復状態と骨孔形態をMRIにて評価した.対象は,76例76肩で,腱板断裂サイズは,小断裂7肩,中断裂13肩,大断裂27肩,広範囲断裂29肩であった.腱板修復状態を菅谷分類に従って評価し,骨孔形態をL字型,カーブ型,直線型に分類した.腱板修復状態は,typeI 8肩,typeII 27肩,typeIII 28肩,typeIV 4肩,typeV 9肩であり,再断裂率は17.1%であった.広範囲断裂症例に限定した再断裂率は31%で,棘上筋あるいは棘下筋がGoutallier分類Grade3以上の脂肪変性が高度な症例では有意に再断裂が多かった.また,骨孔形態は,L字型23%,カーブ型41%,直線型36%であった.Arthro-tunneler&trade; を用いたARCR後の腱板修復状態は概ね良好で,骨孔形態はL字型が少なく,カーブ型と直線型が多かった.

    DOI: 10.11296/katakansetsu.39.506

    CiNii Article

  • A new corrective technique for adolescent idiopathic scoliosis: convex manipulation using 6.35 mm diameter pure titanium rod followed by concave fixation using 6.35 mm diameter titanium alloy Reviewed

    Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Dozono Sho, Yasuda Hiroyuki, Tamai Koji, Nakamura Hiroaki

    SCOLIOSIS AND SPINAL DISORDERS   10 ( Suppl 2 )   S14   2015( ISSN:1748-7161

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    DOI: 10.1186/1748-7161-10-S2-S14

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  • Radiological assessment of shoulder balance following posterior spinal fusion for thoracic adolescent idiopathic scoliosis Reviewed

    Namikawa Takashi, Matsumura Akira, Kato Minori, Hayashi Kazunori, Nakamura Hiroaki

    SCOLIOSIS AND SPINAL DISORDERS   10 ( Suppl 2 )   S18   2015( ISSN:1748-7161

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    DOI: 10.1186/1748-7161-10-S2-S18

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  • The effect of sagittal spinopelvic alignment on low back pain and HRQOL in patients with lumbar spinal canal stenosis Reviewed

    KATO Minori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   58 ( 6 )   1203 - 1204   2015( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2015.1203

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  • A case of dedifferentiated chordoma Reviewed

    IEGUCHI Makoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   58 ( 4 )   733 - 734   2015( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2015.733

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  • Surgical technique of pedicled posterior tibial artery perforator flap for soft tissue reconstruction of the foot::Anatomical study of the perforator vessels of the posterior tibial artery by ultrasonic color Doppler imaging Reviewed

    IIDA Ken

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   58 ( 3 )   615 - 616   2015( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2015.615

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  • 拘縮肩に対する鏡視下関節授動術術後可動域改善の経時的評価 Reviewed

    平川 義弘, 中野 禎, 伊藤 陽一, 間中 智哉, 市川 耕一, 清水 勇人, 松本 一伸, 中村 博亮, 松田 淑伸, 村西 壽祥

    日本肩関節学会 肩関節   39 ( 2 )   547 - 549   2015( ISSN:0910-4461 ( eISSN:18816363

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    特発性拘縮肩は保存的治療で自然治癒することが多い疾患であるが,保存的治療でも症状が残存する場合には,手術的治療を考慮すべきである.本研究の目的は,特発性拘縮肩に対する鏡視下関節授動術後経時的な可動域改善の推移を検討することで,術後良好な可動域を得るための指標を決定することである.対象は当院及び関連病院にて,拘縮肩に対し鏡視下関節授動術を施行し術後24週以上の経過観察が可能であった39例であった.術前平均屈曲105度,平均外転91度が術後24週で平均屈曲141度,平均外転130度に改善しており,良好な術後成績であった.術後24週の屈曲角度を基準とし,術後各時点での屈曲,外転,1<SUP>st</SUP>外旋角度との相関を検討した結果,術後4週時点の1<SUP>st</SUP>外旋と最も強い相関を認めた.良好な肩関節可動域の獲得には,術後4週時点の1<SUP>st</SUP>外旋可動域の獲得が重要な指標になると考えられた.

    DOI: 10.11296/katakansetsu.39.547

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  • A retrospective study on medical costs and length of hospital stay for spinal infection Reviewed

    UEYAMA Hideki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   58 ( 3 )   413 - 416   2015( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2015.413

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  • A case of ossification of posterior longitudinal ligament presenting huge intensity change and spinal cord swelling from medulla to thoracic spine needed to distinguish from myelitis Reviewed

    SHIBATA Yuki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   58 ( 5 )   939 - 940   2015( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2015.939

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  • 広範囲腱板断裂修復術術後のprotective rehabilitationの可能性 Reviewed

    平川 義弘, 中野 禎, 伊藤 陽一, 間中 智哉, 市川 耕一, 清水 勇人, 松本 一伸, 中村 博亮, 松田 淑伸, 村西 壽祥

    日本肩関節学会 肩関節   39 ( 3 )   810 - 813   2015( ISSN:0910-4461 ( eISSN:18816363

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    本研究の目的は,広範囲腱板断裂修復術後に可動域や筋力訓練に制限を加えて修復部を保護するprotective rehabilitationが腱板修復状態および術後可動域等に関して及ぼす影響について検討することである.対象は鏡視下腱板修復術を施行した43例であった.術後2週間の他動運動の禁止と術後8週間の装具固定を行ったL8群(29症例)と術後6週間の他動運動の禁止と術後12週間の装具固定を行ったL12群(14症例)の二群に分類した.腱板修復状態はSugayaらの分類に従って評価検討しtype4,5を再断裂とするとL8群において再断裂率は34%(9肩/29肩)であり,L12群において再断裂率は21.0%(3肩/14肩)であった.術前,術後で両群ともに可動域は有意に改善した.広範囲腱板断裂修復術後におけるprotective rehabilitationは腱板修復状態を改善する傾向を認めた.

    DOI: 10.11296/katakansetsu.39.810

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  • A case of liposarcoma in anterior mediastinum Reviewed

    SAITO Kosuke

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   58 ( 4 )   739 - 740   2015( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2015.739

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  • 三角筋内のデスモイド切除後に肩関節外転位拘縮を生じた一症例 Reviewed

    清水 勇人, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 中村 博亮, 松田 淑伸

    日本肩関節学会 肩関節   39 ( 3 )   856 - 859   2015( ISSN:0910-4461 ( eISSN:18816363

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    三角筋内デスモイド切除後に肩関節外転位拘縮を生じた症例を経験した.デスモイド切除術施行後に肩関節外転位拘縮を認めたため,鏡視下関節授動術の追加手術を行ったが,外転位拘縮の改善は不十分であった.追加手術後経過観察中のMRIにてデスモイドの再発と瘢痕索状物を認めたため,再切除術及び瘢痕索状物切離除去術を施行し,外転位拘縮の改善を認めた.デスモイドは局所再発率が高いため,今後も注意深い経過観察を要する.

    DOI: 10.11296/katakansetsu.39.856

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  • Which is the best schedule of autologous blood storage for preoperative adolescent idiopathic scoliosis patients? Reviewed

    Tamai Koji, Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Yasuda Hiroyuki, Dozono Shou, Nakamura Hiroaki

    SCOLIOSIS AND SPINAL DISORDERS   10 ( Suppl 2 )   S11   2015( ISSN:1748-7161

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    DOI: 10.1186/1748-7161-10-S2-S11

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  • Elbow septic arthritis associated with pediatric acute leukemia: a case report and literature review Reviewed

    Uemura Takuya, Yagi Hirohisa, Okada Mitsuhiro, Yokoi Takuya, Shintani Kosuke, Nakamura Hiroaki

    EKLEM HASTALIKLARI VE CERRAHISI-JOINT DISEASES AND RELATED SURGERY   26 ( 3 )   171 - 174   2015( ISSN:1305-8282

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    DOI: 10.5606/ehc.2015.35

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  • The effect of laminar closure after laminoplasty in patients with cervical spondylotic myelopathy Reviewed

    USUI Toshimasa

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   58 ( 5 )   913 - 914   2015( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2015.913

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  • 内視鏡を用いた椎間板ヘルニア摘出術

    寺井 秀富, 中村 博亮

    整形外科surgical technique : 手術が見える・わかる専門誌   5 ( 3 )   271 - 278   2015( ISSN:21857733

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  • Detection of small periprosthetic bone defects after total knee arthroplasty. Reviewed

    Yukihide Minoda, Taku Yoshida, Kazutaka Sugimoto, Shinogo Baba, Mitssuhiko Ikebuchi, Hiroaki Nakamura

    The Journal of arthroplasty   29 ( 12 )   2280 - 2284   2014.12( ISSN:0883-5403

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    Large bone defect around total knee prostheses is among the most critical challenges in revision surgery. However, it is difficult to detect bone defects around a prosthesis in early stage. We compared the efficacy of the detection of small bone defects between fluoroscopically guided plain radiography, CT, MRI, and a novel tomographic technique (tomosynthesis) using the six pig knee models. No bone defects were detected with plain radiography and MRI. The sensitivity and specificity of CT were 61.5% and 64.1%, respectively. The sensitivity and specificity of tomosynthesis were 85.4% and 87.2%, respectively. The radiation dose of tomosynthesis was 6% of that of CT. The cost of tomosynthesis was 28% of that of CT. Tomosynthesis was superior in terms of diagnosis, radiation dose, and cost.

    DOI: 10.1016/j.arth.2014.05.013

    PubMed

  • THA感染 人工股関節後感染に対するセメントスペーサーを使用した二期的再置換の検討

    溝川 滋一, 山村 一正, 糸数 万紀, 大田 陽一, 箕田 秀行, 中村 博亮

    日本人工関節学会誌   44   581 - 582   2014.12( ISSN:1345-7608

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    2007年1月〜2013年3月の遅発性人工股関節感染5例5関節(全例女、平均年齢70歳)を対象に二期的再置換術を行い、治療成績を報告した。前回手術から感染発症までの期間は平均8年であり、起炎菌はメチシリン耐性黄色ブドウ球菌1例を含め全例ブドウ球菌であった。治療は人工関節抜去、病巣掻爬・イソジンガーゼパッキング、洗浄後、バンコマイシン含有セメントスペーサーを留置し、4週間経静脈的抗菌薬および経口抗菌薬を投与した。CRP陰性化の後に抗菌薬フリーとし、CRP上昇・感染再燃を認めなければ二期的再置換を行った。人工関節抜去から再置換までの待機期間は平均152日であり、待機期間中にセメントスペーサーの折損2例、脱臼を1例に認め、これらの症例には両松葉杖使用を義務付け完全免荷とした。全例感染の鎮静化が得られ再置換を施行し、経過観察期間平均24ヵ月で感染の再燃は認めなかった。

  • Current prevalence and characteristics of cervical spine instability in patients with rheumatoid arthritis in the era of biologics Reviewed

    Takahashi Shinji, Suzuki Akinobu, Koike Tatsuya, Yamada Kentaro, Yasuda Hiroyuki, Tada Masahiro, Sugioka Yuko, Okano Tadashi, Nakamura Hiroaki

    MODERN RHEUMATOLOGY   24 ( 6 )   904 - 909   2014.11( ISSN:1439-7595

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    DOI: 10.3109/14397595.2014.895123

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  • Pre-chemotherapy preservation of fertility in male patients with high-grade malignant bone and soft tissue tumors. Reviewed

    Manabu Hoshi, Naoto Oebisu, Jun Takada, Tadashi Iwai, Rie Tsuruta, Hiroaki Nakamura

    Molecular and clinical oncology   2 ( 6 )   1111 - 1114   2014.11( ISSN:2049-9450

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Only a limited number of orthopedic oncologists make arrangements for pre-chemotherapy fertility preservation, such as sperm cryopreservation, for their patients. The purpose of this study was to offer fertility preservation to male patients with high-grade malignant bone and soft tissue tumors and assess the outcomes. The study included 14 male patients, aged <45 years, with high-grade bone and soft tissue tumors. The median age at diagnosis was 23.0±12.0 years (range, 8-42 years). Following pathological confirmation of high-grade malignant tumor, we informed all the patients and/or their guardians on the issue of chemotherapy-related male infertility. If the patients were interested in preserving fertility, they were referred to a team of reproductive specialists. We documented the patients' clinical characteristics and techniques used for fertility preservation. The majority of unmarried and childless patients were interested in fertility preservation. Four patients (28.5%) selected sperm cryopreservation and 1 patient (7.1%) selected hemi-testicular preservation, as he had developed erectile dysfunction following previous surgery for colon cancer. Married patients and those with children did not wish to preserve fertility. In conclusion, infertility following chemotherapy raises serious concerns for young male patients with high-grade bone and soft tissue tumors. Prior to initiating chemotherapy, the potential risks of chemotherapy should be explained, counseling should be provided and informed consent should be obtained from the patients, ideally without delaying commencement of cancer treatment. Prior to administering cancer chemotherapy, orthopedic oncologists are encouraged to offer sperm banking to young male patients at risk of infertility.

    DOI: 10.3892/mco.2014.367

    PubMed

  • Entrapment of Digital Nerves due to an Embedded Ring: A Case Report Reviewed

    Uemura Takuya, Takamatsu Kiyohito, Okada Mitsuhiro, Ikeda Mikinori, Nakamura Hiroaki

    JOURNAL OF RECONSTRUCTIVE MICROSURGERY   30 ( 9 )   659 - 661   2014.11( ISSN:0743-684X

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    DOI: 10.1055/s-0034-1370362

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  • JuggerKnotソフトアンカー使用視鏡下バンカート修復術の短期成績

    市川 耕一, 伊藤 陽一, 間中 智哉, 松本 一伸, 松田 淑伸, 平川 義弘, 中村 博亮

    肩関節   38 ( 3 )   802 - 805   2014.11( ISSN:0910-4461

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    反復性肩関節前方脱臼に対し、JuggerKnotソフトアンカーを用いて鏡視下バンカート修復術を施行し、術後6ヵ月以上の経過観察が可能であった25例25肩を対象に、短期成績について検討した。手術時年齢は平均28.4歳で、経過観察期間は平均15.1ヵ月であった。術中の使用アンカー数は平均5.9個であった。臨床成績を術後再(亜)脱臼率、最終調査時のRoweスコア、外肩関節外転90度での外旋可動域の患健側比で検討した。その結果、術後に亜脱臼を1例(4%)に認め、再亜脱臼は認めなかった。最終調査時の平均Roweスコアはstabilityが49.2点、motionが19.8点、functionが28.8点、合計97.8点であった。外旋可動域の患健側比は平均92.5%であった。JuggerKnotソフトアンカーを用いた鏡視下バンカート修復術の短期成績は概ね良好であり、有効な低侵襲手術法であると考えられた。

  • Lenke 1C、2C特発性側彎症に対する固定範囲の検討 選択的胸椎固定と非選択的固定

    並川 崇, 松村 昭, 加藤 相勲, 林 和憲, 小西 定彦, 中村 博亮

    Journal of Spine Research   5 ( 11 )   1543 - 1548   2014.11( ISSN:1884-7137

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    Lenke 1C、2C手術例を対象に、選択的胸椎固定(STF)と非選択的固定(NSF)におけるX線学的パラメーターの差異を後ろ向きに検討した。比較的小さく柔軟性の高いTL/LカーブをSTFの適応とした結果、11例中5例(45%)にSTFが施行された。STF施行例においてもTL/L矯正、L4 tiltの改善は良好であり、術後顕著な代償不全を認めなかったことから、その適応は適切であったと考えられた。(著者抄録)

  • 患者立脚式肩関節評価法Shoulder36と客観的実測値との相関

    平川 義弘, 伊藤 陽一, 間中 智哉, 松本 一伸, 市川 耕一, 松田 淑伸, 中村 博亮

    肩関節   38 ( 3 )   766 - 770   2014.11( ISSN:0910-4461

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    肩腱板断裂、肩峰下インピンジメント症候群または拘縮肩に対し、肩関節鏡視下手術を行った117例117肩(平均年齢63.2歳)を対象に、ハンドヘルドダイナモメーターを用いて肩関節の外旋・外転筋力を測定した。またVASを用いて疼痛を評価し、日本整形外科学会が制定する関節可動域測定法に準じてゴニオメーターで自動屈曲と自動外転を測定した。これら客観的実測値と患者立脚式肩関節評価法Shoulder36 V1.3(Sh36)で得られた術前の筋力、疼痛、可動域の値との関連を疾患別に検討した。その結果、肩腱板断裂と肩峰下インピンジメント症候群に対するSh36による術前機能評価では、筋力、疼痛、可動域の客観的実測値との間に有意な相関を認めた。一方、拘縮肩に対するSh36による術前機能評価では、可動域のみ客観的実測値との間に有意な相関を認めた。肩関節疾患によっては、Sh36の評価値と客観的実測値が一致しない可能性が考えられた。

  • 生物学的製剤時代における関節リウマチ患者の頸椎不安定性の現在の有病率と特徴(Current prevalence and characteristics of cervical spine instability in patients with rheumatoid arthritis in the era of biologics)

    Takahashi Shinji, Suzuki Akinobu, Koike Tatsuya, Yamada Kentaro, Yasuda Hiroyuki, Tada Masahiro, Sugioka Yuko, Okano Tadashi, Nakamura Hiroaki

    Modern Rheumatology   24 ( 6 )   904 - 909   2014.11( ISSN:1439-7595

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    2010年8月〜2011年6月に当施設を受診した関節リウマチ外来患者220例(女性182例、男性38例、25〜84歳)を対象とする横断研究を実施し、頸椎不安定性(CSI)の有病率を調査した。さらに、臨床因子および放射線学的因子とCSIの関連を評価した。単純X線撮影とMRIで前方環椎歯突起間距離、Ranawat値、隣接椎体間間隙、頸椎前彎を測定した。CSIには環軸椎亜脱臼(AAS)、環軸関節垂直亜脱臼(VS)、軸椎下亜脱臼(SAS)を含めた。CSIは93例で認められた。10年以上の罹病期間、スタインブロッカー分類ステージIII、C2/3〜C6/7の3ヶ所以上の椎間板狭小化がCSIと有意に関連していた。頸部痛はVSと関連していたが、AASとSASとは関連せず、メトトレキサート(MTX)と生物学的製剤はCSIに対して効果がなかった。以上から、生物学的製剤承認後はCSI有病率が低下していることが裏付けられたが、生物学的製剤とMTXの有効性を検出することはできなかった。

  • 手術治療を要した両側変形性肩鎖関節症の臨床的特徴

    松田 淑伸, 伊藤 陽一, 間中 智哉, 市川 耕一, 松本 一伸, 平川 義弘, 中村 博亮

    肩関節   38 ( 3 )   1000 - 1003   2014.11( ISSN:0910-4461

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    手術治療を要した両側変形性肩鎖関節症の臨床的特徴について検討した。両側鏡視下鎖骨遠位端切除術を施行した両側変形性肩鎖関節症17例34肩(男性13名、女性4名、30〜70歳)を対象とした。片側変形性肩鎖関節症の102例(男性65名、女性37名、32〜80歳)を対照とした。両側群では60歳以上の割合が71%と多い傾向にあったが、片側群との間で有意差は認めなかった。合併症では、腱板全層性断裂、関節面側腱板部分断裂、滑液包側腱板部分断裂、肩関節拘縮肩、上腕二頭筋長頭腱断裂、肩甲下筋腱断裂、変形性肩関節症、打撲などの外傷は、両群間で有意差は認めなかった。画像スコアリングでは、両側群は平均5.1点、片側群は平均3.8点で、両側群は片側群と比較して画像上の重症度は有意に高値であった。

  • 悪性骨軟部腫瘍の治療後の婚姻と就労問題

    星 学, 高田 潤, 大戎 直人, 岩井 正, 家口 尚, 中村 博亮

    中部日本整形外科災害外科学会雑誌   57 ( 6 )   1243 - 1244   2014.11( ISSN:0008-9443

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    1986年4月〜2013年9月の間に受診時年齢が40歳以下であった悪性骨軟部腫瘍患者で、最終観察時に生存し、カルテまたは診察時の対面による聞き取り調査が可能であった57症例(男性27例、女性30例、診断時平均年齢23.7±10.1歳)を対象に、悪性骨軟部腫瘍治療後の患者の婚姻状況と就労について検討した。1)症例の内訳は骨腫瘍が40例、軟部腫瘍が17例で、手術は患肢温存術が52例、切断術が5例であった。また、放射線治療有群は8例、無群は49例であった。2)組織型は骨腫瘍では骨肉腫が27例、軟骨肉腫が7例、Ewing肉腫が6例で、軟部腫瘍では粘液型脂肪肉腫、平滑筋肉腫が各3例、類上皮肉腫、悪性線維性組織球腫が各2例、悪性混合性腫瘍、悪性末梢神経鞘腫瘍、孤立性線維性腫瘍、粘液型線維肉腫ほか、包巣状軟部肉腫、血管上皮腫、滑膜肉腫が各1例であった。3)婚姻率では初診時(平均23.7歳)は26%、最終観察時(平均30.6歳)は44%であり、婚姻率と各要因の関連性には有意差は認めなかった。一方、就労内容の変化は初診時に学生であった患者は肉体労働ではなく事務職に就く傾向がみられ、無職は最終観察時点で7例であった。尚、医療保険では生活保護を受けていた患者は全体の4%で大阪の平均と同等であった。

  • Discriminating imaging findings of acute osteoporotic vertebral fracture: a prospective multicenter cohort study. Reviewed

    Qasem KM, Suzuki A, Yamada K, Hoshino M, Tsujio T, Takahashi S, Nakamura H

    Journal of orthopaedic surgery and research   9   96   2014.10( ISSN:1749-799X

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    Background: Appropriate treatment of osteoporotic vertebral fractures (OVF) requires knowledge of the age of the fracture. Although diagnostic imaging has made remarkable progress in recent years, it remains difficult to differentiate acute fractures from old. Our purpose was to investigate chronological changes in radiological findings after OVF and to identify discriminators of acute versus older injuries.
    Methods: We evaluated 139 vertebrae in 136 patients. All patients underwent X-ray and magnetic resonance imaging (MRI) examination within 2 weeks of injury and again after 6 months. The anterior vertebral height ratio (AVHR) was calculated on lateral X-ray, and the intensity change of the posterior wall of the fractured vertebra was evaluated on T1-weighted MRI. The cutoff AVHR value to diagnose acute fracture was determined by receiver operating characteristic (ROC) curve analysis.
    Results: Average AVHR fell from 84.6% at initial visit to 63.7% at 6 months. When acute fracture was defined as AVHR &gt; 75%, sensitivity was 85.6%, specificity was 67.6%, and positive predictive value was 72.6%. On MRI, 83.5% of fractured vertebrae showed intensity change in the posterior wall in the acute stage, which fell to 41.7% of vertebrae after 6 months. When intensity change in the posterior wall and AVHR &gt; 75% were both present, the specificity and positive predictive value for diagnosing acute fracture improved to 87.1% and 84.7%, respectively.
    Conclusions: This study suggests that vertebral fracture rarely shows significant collapse on X-ray in the first 2 weeks after injury. The combination of intensity change in the posterior wall on MRI and AVHR &gt; 75% on X-ray indicates a high probability of acute fracture.

    DOI: 10.1186/s13018-014-0096-1

    PubMed

  • 整形外科の手術手技-私はこうしている 脊椎・骨盤・体幹 腰椎 腰部脊柱管狭窄症に対する棘突起縦割式片側進入両側除圧術

    鈴木 亨暢, 玉井 孝司, 寺井 秀富, 豊田 宏光, 中村 博亮

    別冊整形外科   1 ( 66 )   222 - 226   2014.10( ISSN:02871645

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  • Contrast-enhanced color Doppler ultrasonography increases diagnostic accuracy for soft tissue tumors Reviewed

    Oebisu Naoto, Hoshi Manabu, Ieguchi Makoto, Takada Jun, Iwai Tadashi, Ohsawa Masahiko, Nakamura Hiroaki

    ONCOLOGY REPORTS   32 ( 4 )   1654 - 1660   2014.10( ISSN:1021-335X

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3892/or.2014.3378

    PubMed

  • JuggerKnotソフトアンカーによる鏡視下腱板修復術後のMRI評価

    間中 智哉, 伊藤 陽一, 松本 一伸, 市川 耕一, 平川 義弘, 松田 淑伸, 中村 博亮

    肩関節   38 ( 2 )   528 - 531   2014.10( ISSN:0910-4461

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    JuggerKnotソフトアンカーのみを用いて鏡視下腱板修復術を行い術後6ヵ月以上観察しえた31例を対象とし、腱板断裂の形状とサイズ別に、滑液包側腱板部分断裂群(20例)と、全層性断裂の小断裂群(6例)および中断裂群(5例)に分け、術中に使用したアンカーの個数を群ごとに調査するとともに、術後6ヵ月時のMRIによる腱板修復状態を菅谷分類に従って評価した。結果、アンカーの個数は滑液包側腱板部分断裂群が平均3.2個、小断裂群も3.2個、中断裂群が4.8個であり、中断裂群は他の2群に比べて有意に多かった。術後の腱板修復状態は、Type Iが11例(35%)、IIが18例(58%)、IIIが2例(6%)であり、IVとVはなかった。代表例として、滑液包側腱板部分断裂で腱板修復状態がType IIの1例を提示した。

  • 【整形外科の手術手技-私はこうしている】脊椎・骨盤・体幹 腰椎 腰部脊柱管狭窄症に対する棘突起縦割式片側進入両側除圧術

    鈴木 亨暢, 玉井 孝司, 寺井 秀富, 豊田 宏光, 中村 博亮

    別冊整形外科   ( 66 )   222 - 226   2014.10( ISSN:0287-1645

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    腰部脊柱管狭窄症に対する棘突起縦割式片側進入両側除圧術について検討した。腰部脊柱管狭窄症に対して棘突起縦割式片側進人両側除圧を行い、2年以上経過観察可能であった34例(縦割群)を対象とした。通常の傍脊柱筋を棘突起から切離する方法で片側進入両側除圧術を行った34例(筋切離群)を対照群とした。術前腰痛VASは縦割群で有意に高かった。1椎間あたりの平均手術時間は、有意に縦割群のほうが短かったが、1椎間あたり平均出血量は両群間に有意差は認めなかった。両群ともに術前JOAスコアおよび各種VASは術後有意に改善し、術後2年時まで改善は保たれた。術後2年時の下肢しびれVASは有意に縦割群で低かったが、その他の項目は両群間に有意差は認めなかった。再手術例の割合に両群間で有意差は認めなかった。縦割群における術後2年時点での縦割棘突起の癒合率は86.7%であった。

  • 烏口突起基部に発生した類骨骨腫を鏡視下切除した一例

    木下 拓也, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 中村 博亮, 松本 一伸

    肩関節   38 ( 2 )   730 - 733   2014.10( ISSN:0910-4461

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    症例は16歳男性で、左肩の疼痛が夜間に増強し、近医にて診断が付かずステロイド系消炎鎮痛剤(NSAIDs)を内服していたが、夜間痛の増強で紹介受診した。触診で烏口突起と腱板疎部に圧痛を認め、X線で烏口突起基部に骨透亮性変化と周囲骨の硬化を認めた。MRIで烏口突起基部に11×11×11mmの腫瘤を認め、関節内に液の貯留と肩関節周囲筋組織に浮腫性変化を認めた。腫瘤はT1 low、T2ややhigh、造影で造影効果を認めた。夜間痛の持続でNSAIDs内服でも症状が遷延し、9ヵ月後の2回目MRIで腫瘍の増大を認め、肩関節鏡視下手術を行った。腱板疎部に炎症性滑膜の増生を認めてデブリードマンを行い、腱板疎部の開放と中関節上腕靱帯を関節窩縁で切離し、烏口突起基部を展開して腫瘍切除と烏口突起接触部の骨掻爬を行った。病理組織所見で多数の骨芽細胞の増殖、線維性骨の増生を認めて類骨骨腫と診断した。夜間痛は劇的に改善し、術後3ヵ月で関節可動域は正常まで改善した。

  • 腰椎変性後側彎症に対するPosterior Transvertebral Closing-wedge Osteotomyを用いた後方矯正固定術

    松村 昭, 並川 崇, 加藤 相勲, 林 和憲, 小西 定彦, 中村 博亮

    Journal of Spine Research   5 ( 10 )   1456 - 1460   2014.10( ISSN:1884-7137

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    腰椎変性後側彎症(DLKS)に対するPosterior transvertebral closing-wedge osteotomy(PTO)を用いた矯正固定術の術後成績を検討した。術後の脊柱アライメント・バランスは良好に改善し、全例で骨癒合が得られていた。PTOでは骨切り椎体頭側の椎間板を切除しbone to boneの固定を可能にするため、骨癒合・側彎矯正の点でpedicle subtraction osteotomy(PSO)より有利と考える。(著者抄録)

  • 肩鎖関節近傍発生のガングリオンを鏡視下に切除した3例

    平川 義弘, 伊藤 陽一, 間中 智哉, 松本 一伸, 市川 耕一, 松田 淑伸, 中村 博亮

    肩関節   38 ( 2 )   726 - 729   2014.10( ISSN:0910-4461

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    症例1は73歳男性で、左肩鎖関節直上に腫瘤形成を認め、近医の穿刺吸引で改善せず紹介受診した。X線・MRIで肩甲上腕関節の関節症性変化、肩峰の臼蓋化と骨棘形成、肩鎖関節の関節症性変化、肩鎖関節上に腫瘤像と広範囲腱板断裂を認め、鏡視下に腫瘤切除術、肩鎖遠位端切除術を行った。腫瘤はガングリオンであった。症例2は61歳女性で、右肩広範囲腱板断裂に鏡視下修復術を行い、術後半年で右肩関節上に腫瘤が出現し、内容物穿刺でゼリー状の粘液を採取し、ガングリオンの診断でガングリオン切除術、肩鎖遠位端切除術を行った。症例3は91歳女性で、両肩の広範囲腱板断裂で保存加療中であった。左肩の疼痛と左肩鎖関節から鎖骨上に腫瘤が出現し、内容物穿刺でゼリー状の粘液を採取し、ガングリオンの診断で数回の内容物吸引を行ったが改善せず、鏡視下にガングリオン切除術、肩鎖関節遠位端切除術を行った。3例とも術後にガングリオンの再発は認めていない。

  • 習慣性肩関節後方脱臼に対する関節鏡視下手術の術後臨床成績

    間中 智哉, 伊藤 陽一, 松本 一伸, 市川 耕一, 平川 義弘, 松田 淑伸, 中村 博亮

    肩関節   38 ( 2 )   464 - 467   2014.10( ISSN:0910-4461

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    保存的療法が無効の習慣性肩関節後方不安定症に対し鏡視下関節包縫縮術を行った23例24肩について、術中所見(後方関節唇損傷の有無)と臨床成績(JSSスコア・主観的不安定性・客観的不安定性)を中心に報告した。術中所見で後方関節唇損傷を認めたのは3肩(13%)であった。JSSスコアは術前平均59.8点が術後6ヵ月で86.9点、術後12ヵ月で93.7点に改善した。主観的不安定性と客観的不安定性は術前に全例で認め、術後6ヵ月時には主観的不安定性は1例も認めず、客観的不安定性は4肩(17%)に認め、術後12ヵ月時にはこの4肩中3肩で主観的不安定性の出現を認めた。

  • Diagnosis of osteosarcoma in a patient previously treated for Ewing sarcoma Reviewed

    Hoshi Manabu, Ieguchi Makoto, Yamato Kazumi, Tokimasa Sadao, Nakamura Hiroaki

    SKELETAL RADIOLOGY   43 ( 9 )   1319 - 1324   2014.09( ISSN:0364-2348

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00256-014-1880-z

    PubMed

  • Osteosarcoma arising from the parapharyngeal space: A case report Reviewed

    Hoshi Manabu, Takada Jun, Oebisu Naoto, Nakamura Hiroaki

    ONCOLOGY LETTERS   8 ( 3 )   1240 - 1242   2014.09( ISSN:1792-1074

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3892/ol.2014.2265

    PubMed

  • Knee Reconstruction with Endoprosthesis After Extra-articular and Intra-articular Resection of Osteosarcoma Reviewed

    Ieguchi Makoto, Hoshi Manabu, Aono Masanari, Takada Jun, Ohebisu Naoto, Kudawara Ikuo, Nakamura Hiroaki

    JAPANESE JOURNAL OF CLINICAL ONCOLOGY   44 ( 9 )   812 - 817   2014.09( ISSN:0368-2811

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1093/jjco/hyu093

    PubMed

  • Combined medialis pedis and medial plantar fasciocutaneous flaps for coverage of soft tissue defects of multiple adjacent fingers. Reviewed

    Mitsuhiro Okada, Hidehiko Saito, Kenichi Kazuki, Hiroaki Nakamura

    Microsurgery   34 ( 6 )   454 - 458   2014.09( ISSN:0738-1085

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    Soft tissue defects of adjacent multiple fingers covered by a single large flap require secondary separation of the flap into each finger. Such covering obstructs independent motion of injured fingers until the single large flap is separated. This report describes the technique of combined medialis pedis and medial plantar fasciocutaneous flaps for reconstructing soft tissue defects of multiple adjacent fingers. Three male patients (age range, 18-33 years) underwent soft tissue reconstructions of multiple adjacent fingers with combined flaps. Injuries involved three adjacent palmar fingers, two adjacent palmar fingers, and two adjacent dorsal fingers. Average sizes of the combined flaps were 4.2 × 4.0 cm for the medialis pedis flap and 3.0 × 1.8 cm for the medial plantar fasciocutaneous flap. All flaps survived without vascular complications, and donor sites healed uneventfully. All patients experienced excellent recovery of range of motion for the reconstructed fingers. In conclusion, combined flaps may offer an alternative for coverage of soft tissue defects that involve multiple adjacent fingers.

    DOI: 10.1002/micr.22222

    PubMed

  • The limited effects of anti-tumor necrosis factor blockade on bone health in patients with rheumatoid arthritis under the use of glucocorticoid. Reviewed

    Tadashi Okano, Tatsuya Koike, Masahiro Tada, Yuko Sugioka, Kenji Mamoto, Shigeyuki Wakitani, Hiroaki Nakamura

    Journal of bone and mineral metabolism   32 ( 5 )   593 - 600   2014.09( ISSN:0914-8779 ( eISSN:1435-5604

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:Domestic journal  

    We investigated the effects of biologics for rheumatoid arthritis (RA) patients on bone mineral density (BMD) and bone metabolic markers (BMM), retrospectively, and also clarified the effects of bisphosphonates (alendronate or risedronate 35 mg/week) and glucocorticoids. Participants in this study comprised 219 patients with RA, including 117 patients treated with biologics (infliximab, n = 90; etanercept, n = 27) and 102 patients with conventional disease-modifying anti-rheumatic drugs (DMARDs) for 1 year. Changes in BMD at the lumbar spine and total hip and BMMs [urinary type I collagen cross-linked N-telopeptide (NTX) and bone-specific alkaline phosphatase] were measured. BMD of the lumbar spine in both groups and total hip BMD in the biologics group were unchanged during treatment with biologics. However, BMD of the total hip was significantly decreased in the DMARDs group (from 0.731 ± 0.135 to 0.706 ± 0.135 g/cm2). Patients receiving glucocorticoids without bisphosphonates showed significant decrease in BMD of the total hip compared with patients not receiving glucocorticoids or receiving glucocorticoids with bisphosphonates in both biologics and DMARDs groups. Furthermore, BMD of the lumbar spine increased (p < 0.05) for patients in the biologics group who received bisphosphonates. NTX was significantly decreased only in the biologics group. Multiple regression analysis showed that BMD and bone metabolic marker levels correlated positively with bisphosphonate and biologics use and negatively with glucocorticoid use. BMD of the total hip was maintained in the patients using biologics without glucocorticoids or with bisphosphonates, but it was not maintained in the DMARDs patients, even without glucocorticoids or with bisphosphonates. Even if biologics have protective effect against bone loss of RA patients, we should consider reducing the dose of glucocorticoids and adding bisphosphonates for the treatment of osteoporosis.

    DOI: 10.1007/s00774-013-0535-9

    PubMed

  • グルココルチコイドを服用している関節リウマチ患者の骨の健康に対する抗腫瘍壊死因子遮断薬の限定的効果(The limited effects of anti-tumor necrosis factor blockade on bone health in patients with rheumatoid arthritis under the use of glucocorticoid)

    Okano Tadashi, Koike Tatsuya, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Wakitani Shigeyuki, Nakamura Hiroaki

    Journal of Bone and Mineral Metabolism   32 ( 5 )   593 - 600   2014.09( ISSN:0914-8779

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    生物学的製剤または疾患修飾抗リウマチ薬(DMARD)で1年間治療された関節リウマチ患者219名を対象として、骨密度(BMD)と骨代謝マーカーの変化を調べた。腰椎BMDは生物学的製剤治療群、DMARD治療群とも変化しなかった。股関節BMDは生物学的製剤治療群で不変、DMARD治療群で有意に低下した。ビスホスホネート非服用でグルココルチコイド(GC)を服用している患者は両群とも、GC非服用患者やGC+ビスホスホネート服用患者に比べて股関節のBMDが有意に低下した。腰椎BMDはビスホスホネート+生物学的製剤治療群で増加した。尿中I型コラーゲン架橋N-テロペプチドは生物学的製剤治療群のみ有意に低下した。重回帰分析では、BMDと骨代謝マーカーがビスホスホネート+生物学的製剤の使用と正の相関、GC使用と負の相関を示した。DMADR群の股関節BMDは、GC非服用やビスホスホネート服用でも維持されなかった。

  • 骨肉腫の関節外および関節内切除後の内部人工器官を用いた膝再建術(Knee Reconstruction with Endoprosthesis After Extra-articular and Intra-articular Resection of Osteosarcoma)

    Ieguchi Makoto, Hoshi Manabu, Aono Masanari, Takada Jun, Ohebisu Naoto, Kudawara Ikuo, Nakamura Hiroaki

    Japanese Journal of Clinical Oncology   44 ( 9 )   812 - 817   2014.09( ISSN:0368-2811

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    膝周囲の骨肉腫は関節内手術が行われることが多いが、関節への浸潤や医原性汚染が見られる症例では、関節外切除が行われる。1999〜2012年に手術を実施した骨肉腫患者14名における関節内法と関節外法の転帰を比較した。関節外切開は6名(23〜65歳)、関節内切開は8名(8〜58歳)であった。関節外群と関節内群の無病生存は各々2名と7名、有病生存は2名と0名、病死は各1名であった。平均筋骨格腫瘍学会機能スコアは関節外群で69.4%、関節内群で88.3%で、有意差が見られた。5年生存率は両群で80%を超えた。関節外群の1名で切断が必要であった。5年生存率は関節外群で33.3%、関節内群で75.0%であった。関節外群では骨および筋肉の広範囲な切除のために合併症が多かった。救肢率は両群で同程度であった。

  • 悪性大腿骨骨腫瘍に対する不適切治療の1例

    大戎 直人, 星 学, 高田 潤, 岩井 正, 中村 博亮

    中部日本整形外科災害外科学会雑誌   57 ( 5 )   981 - 982   2014.09( ISSN:0008-9443

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    65歳男性。2年前に単純X線像にて左変形性股関節症と診断、MRIとCTにて大転子部に異常所見を認めるも精査はされず、人工股関節全置換術(THA)の施行後、左大腿に腫脹が認められたが血腫の診断にて経過観察されていた。しかし今回、徐々に腫脹の増大ほか、腫瘤性病変も認められたため、著者らの施設へ紹介となった。所見では単純X線像で大転子部の溶骨性変化を認め、MRIでは腸骨から大腿外側に広がるT1強調像で低信号、T2強調像で高信号の、造影効果を伴う約20cm大の充実性腫瘍が認められた。また、FDG-PETでも異常集積を認め、針生検にてchondrosarcoma grade IIと診断、肺CTでは転移を疑う結節が認められた。治療は腫瘍が腸骨に接しており、臼蓋部のスクリューを取り囲んでいたため、臼蓋周囲を腫瘍内切除する方針で、遠位部を3cm wide marginで切除し、近位は正常組織と隔離して臼蓋部腫瘍を腫瘍内切除、スクリューはヘッドのみ切断した。尚、追加補助療法としてアルコール処理を加え、腫瘍用人工関節再置換術を施行して手術は終了とし、更に術後2週目よりは根治的放射線療法を45+16Gy行い、肺転移に対し切除術を2回施行した。その結果、1年6ヵ月経過現在、新たな肺転移巣の出現は認めるものの大腿部の再発はなく、局所コントロールは良好である。

  • 嚢胞状変化を呈した肺癌肩甲骨転移の1例

    高田 潤, 星 学, 大戎 直人, 岩井 正, 家口 尚, 中村 博亮

    中部日本整形外科災害外科学会雑誌   57 ( 5 )   987 - 988   2014.09( ISSN:0008-9443

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    61歳男性。肩痛を主訴とした。胸部単純X線像にて右上肺野に腫瘤陰影を指摘され、肺腺癌と診断、加えて全身検索で脳転移も指摘され、stage IV(T2N0M1b)と考えられた。また、骨シンチでは右上腕骨近位から肩甲骨にかけて集積が認められた。著者らの施設へ紹介後の所見では右肩単純X線像で右上腕骨近位部の骨梁の粗そう化がみられたが、骨皮質の明らかな破壊や膨隆は認められなかった。更に肩甲骨には体部から頸部に掛けて関節窩を残す形で広がる溶骨性の病変がみられるも、右肩単純CTでは関節窩の軟骨下骨は薄く保たれており、肩甲骨病変内部は均一で石灰化などは認められなかった。しかし、骨転移として典型的な画像所見ではないことから、切開生検を行なったところ、内溶液は茶褐色で採取した壁にあたる組織の一部に低分化腺癌の転移と考えられる異型細胞が認められ、骨転移と診断された。以後、治療として全身化学療法に加えゾレドロン酸を投与したものの、頭部MRIで乳突蜂巣炎が疑われる所見が確認され、ゾレドロン酸の投与は1回のみとなった。一方、化学療法は33コース目まで行われたが、局所の放射線治療は行われることはなかった。その結果、右肩甲骨転移巣の増大は認めず、周囲の硬化も単純X線で確認できたが、本症例は肩甲骨生検後2年で腫瘍死した。

  • バルーン椎体形成術を応用した大腿骨骨病変に対する人工骨充填術の1例

    藪 晋人, 星 学, 大戎 直人, 岩井 正, 高田 潤, 中村 博亮

    中部日本整形外科災害外科学会雑誌   57 ( 5 )   989 - 990   2014.09( ISSN:0008-9443

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    53歳女性。左腎癌の両肺転移にてIFN治療中であったが、左腎癌摘出後、精査にて左大腿骨骨頭の異常が判明し紹介となった。受診時、左股関節X線およびCT像にて大腿骨頭部に辺縁骨硬化を伴う骨透亮像がみられるも骨頭の圧潰は認められなかった。だが、MRIではT1強調像で低信号、T2強調像で高信号な辺縁に一部造影効果のある32×28×31mm大の嚢胞性病変が認められた。また、骨シンチでは左股関節に軽度の異常集積が確認され、FDG-PET所見から良性病変と推測して経過観察していたが、9ヵ月後に左大腿の疼痛が出現、この時点で本症例は腎癌の転移または良性病変による切迫骨折の鑑別が考えられた。そこで、大腿骨外側から大腿骨骨頭に向けて開窓し生検術を施行したところ、迅速診断にて骨壊死と診断された。以後、鋭匙で病巣を可及的切除後に開窓路からウロマティックバルーンを大腿骨頭に向けて留置した。そして透視下にオムにパーク入りの生理食塩水を注入し、風船をふくらませスペースを確認、そのスペースにペースト状骨充填材を注入した。すると術後のCT像では人工骨は分葉状の末梢までは充填しきれていないことが確認されたが、最終的には左大腿の除痛が得られた。

  • Intraoperative assessment of midflexion laxity in total knee prosthesis. Reviewed

    Yukihide Minoda, Shigeru Nakagawa, Ryo Sugama, Tessyu Ikawa, Takahiro Noguchi, Masashi Hirakawa, Hiroaki Nakamura

    The Knee   21 ( 4 )   810 - 814   2014.08( ISSN:0968-0160

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    BACKGROUND: Soft-tissue balancing of the knee is fundamental to the success of a total knee arthroplasty (TKA). In posterior-stabilized TKA, there is no stabilizer of the anterior-posterior translation in the midflexion range in which the cam-post mechanism does not engage yet. Therefore, instability in the midflexion range is suspected to occur in posterior-stabilized TKA. The purpose of this study was to measure the joint gap throughout a full range of motion and to analyze the joint gap laxity in the midflexion range after implantation of a mobile-bearing posterior-stabilized total knee prosthesis. METHODS: Joint gap kinematics in 259 knees with varus osteoarthritis were measured during TKAs using a tensor device with the same shape of a total knee prosthesis of the same design was used. After the implantation of a mobile-bearing posterior-stabilized prosthesis and the reduction of the patellofemoral joint, the joint gap was measured at 0°, 30°, 60°, 90°, 120°, and 145° of flexion. RESULTS: The center size of the joint gap was tight in extension and deep flexion and loose at midflexion ranges, especially at 30° of flexion (p<0.001). The symmetry of the joint gap was varus at 0° and 145° of flexion (p<0.001). CONCLUSIONS: Our results showed the joint gap laxity in the midflexion range after the implantation of a mobile-bearing posterior-stabilized prosthesis. Our new tensor device, which can attach the polyethylene insert trial, will provide the important information about the joint gap kinematics after implantation of total knee prostheses. LEVEL OF EVIDENCE: IV.

    DOI: 10.1016/j.knee.2014.04.010

    PubMed

  • 高齢者脆弱性骨折の予防と治療 高齢者脆弱性骨折の治療 部位別各論 新鮮脊椎椎体骨折 保存的治療

    豊田 宏光, 中村 博亮

    整形外科   65 ( 8 )   802 - 808   2014.07( ISSN:00305901 ( eISSN:24329444

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  • 関節リウマチと脂質代謝および骨粗鬆症の関係を調査するための前向きコホート研究

    多田 昌弘, 小池 達也, 杉岡 優子, 岡野 匡志, 真本 建司, 乾 健太郎, 中村 博亮

    Osteoporosis Japan   22 ( 3 )   559 - 563   2014.07( ISSN:0919-6307

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    経過観察を2年間継続できた関節リウマチ(RA)患者202人(女性171人、男性31人)および健常者202人(女性170人、男性32人)を対象に骨代謝マーカーの経年的変化の違いとRA患者における骨代謝マーカーに影響する因子について検討した。エントリー時、RA患者は罹病期間14.1±11.8年、生物学的製剤使用率53.4%、骨粗鬆症治療薬使用率31.6%であった。ステロイド(PSL)使用量は1年間でDAS28-ESRに殆ど変化はなく、PSL使用率と使用量は減少していた。骨代謝マーカーNTXの経年的変化は健常者に比してRA患者で有意な改善を認め、骨形成マーカーOCが有意に上昇していた。重回帰分析よりRA患者でOC変化量に影響する因子としてPSL変化量が抽出されたが、疾患活動性との相関は認めなかった。以上より、RA患者ではステロイドの減量にて骨代謝マーカーが改善することが明らかとなった。

  • 腰椎破裂骨折における上位終板整復への新しい試み

    林 和憲, 小西 定彦, 松村 昭, 加藤 相勲, 並川 崇, 中村 博亮

    Journal of Spine Research   5 ( 7 )   1113 - 1117   2014.07( ISSN:1884-7137

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    腰椎破裂骨折の後方矯正固定術における、上位終板整復を目的とした手技を試みた。X線透視下に、終板を含んだ椎弓根間の骨片に上関節突起外側よりプローベを進め、これを頭側に傾斜させて骨片に刺入し、プローベを終板と平行まで戻して骨片終板前方傾斜の整復を行う。4例に対して本手技を施行し、終板の前方傾斜角は術後良好に整復されていた。硬膜損傷や神経損傷など手技にともなう神経合併症はみとめられなかった。(著者抄録)

  • EFFECTS OF ABATACEPT AND TNF INHIBITORS COMPARED WITH ULTRASONOGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Mamoto K., Koike T., Okano T., Sugioka Y., Tada M., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   73   949 - 949   2014.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2014-eular.3222

  • MRI evaluation of lumbar endplate and facet erosion in rheumatoid arthritis. Reviewed

    Yamada K, Suzuki A, Takahashi S, Yasuda H, Tada M, Sugioka Y, Okano T, Koike T, Nakamura H

    Journal of spinal disorders & techniques   27 ( 4 )   E128 - 35   2014.06( ISSN:1536-0652

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BSD.0b013e3182a22a34

    PubMed

  • MRI Evaluation of Lumbar Endplate and Facet Erosion in Rheumatoid Arthritis Reviewed

    Yamada Kentaro, Suzuki Akinobu, Takahashi Shinji, Yasuda Hiroyuki, Tada Masahiro, Sugioka Yuko, Okano Tadashi, Koike Tatsuya, Nakamura Hiroaki

    JOURNAL OF SPINAL DISORDERS & TECHNIQUES   27 ( 4 )   E128 - E135   2014.06( ISSN:1536-0652

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    Publishing type:Research paper (scientific journal)  

  • INFLUENCE OF BIOLOGIC AGENTS ON POSTOPERATIVE INFECTION IN RHEUMATOID ARTHRITIS PATIENTS Reviewed

    Tada M., Koike T., Inui K., Sugioka Y., Mamoto K., Okano T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   73   389 - 389   2014.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2014-eular.1735

  • GLUCOCORTICOID IS A RISK FACTOR FOR FALL AND FRACTURE IN PATIENTS WITH RHEUMATOID ARTHRITIS: THIRD YEAR RESULTS OF THE TOMORROW STUDY Reviewed

    Mamoto K., Koike T., Okano T., Sugioka Y., Tada M., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   73   404 - 405   2014.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2014-eular.3468

  • FACTORS PREDICTING CHANGE IN BONE MINERAL DENSITY IN PATIENTS WITH RHEUMATOID ARTHRITIS: THE TOMORROW STUDY Reviewed

    Tada M., Koike T., Inui K., Sugioka Y., Mamoto K., Okano T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   73   409 - 409   2014.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2014-eular.1729

  • RESTART FOR SUSTAINING REMISSION OF RHEUMATOID ARTHRITIS IN USE OF ETANERCEPT: RESUME STUDY Reviewed

    Inui K., Koike T., Tada M., Sugioka Y., Mamoto K., Okano T., Sakawa A., Fukushima K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   73   936 - 937   2014.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2014-eular.1098

  • VERY-HIGH-CONCENTRATION LEPTIN SUPPRESSES AGGRAVATION OF COLLAGEN ANTIBODY-INDUCED ARTHRITIS IN MICE Reviewed

    Okano T., Koike T., Inui K., Tada M., Sugioka Y., Mamoto K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   73   519 - 519   2014.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2014-eular.1945

  • Spinopelvic alignment of diffuse idiopathic skeletal hyperostosis in lumbar spinal stenosis Reviewed

    Yamada Kentaro, Toyoda Hiromitsu, Terai Hidetomi, Takahashi Shinji, Nakamura Hiroaki

    EUROPEAN SPINE JOURNAL   23 ( 6 )   1302 - 1308   2014.06( ISSN:0940-6719

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00586-013-3154-1

    PubMed

  • THE FEATURES OF DEGENERATIVE LUMBAR SCOLIOSIS IN RHEUMATOID ARTHRITIS PATIENTS - MATCHED COHORT STUDY Reviewed

    Anno S., Yasuda H., Suzuki A., Koike T., Inui K., Terai H., Toyoda H., Tada M., Sugioka Y., Okano T., Yamada K., Takahashi S., Mamoto K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   73   305 - 305   2014.06( ISSN:0003-4967

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1136/annrheumdis-2014-eular.2459

  • 多数の米粒体と腱板断裂を伴った関節リウマチ性肩峰下滑液包炎に対して関節鏡視下手術を施行した1例

    新熊 孝文, 間中 智哉, 伊藤 陽一, 中村 博亮

    JOSKAS   39 ( 3 )   658 - 662   2014.06( ISSN:1884-8842

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    【目的】肩峰下滑液包(以下,SAB)内に米粒体を伴い,腱板断裂を認めた関節リウマチ(以下,RA)の症例に対して関節鏡視下手術を施行した1例を経験したので報告する.【症例】68歳,男性.約2年前より左肩関節痛が出現し,当科受診.同時期にRAと診断され,DMARDsの内服加療が開始された.薬物治療とリハビリにより一時疼痛の軽減を認めたが,疼痛が再燃し関節鏡視下手術を施行した.理学的所見は,肩峰下に圧痛があり,自動関節可動域は屈曲130°,外転130°,外旋40°,内旋第1腰椎であった.MRI T2強調画像でSAB内の滑液貯留,その内部に多数の蜂巣状低信号域を認めた.同時に棘上筋腱の断裂も認めた.【結果】RAによる肩峰下滑液包炎および腱板断裂と診断し,関節鏡視下肩峰下除圧術,スーチャーブリッジ法による関節鏡視下腱板修復術および関節鏡視下デブリドマンを施行し,米粒体を摘出した.病理学的所見は,米粒体はフィブリンよりなる均質な構造体であり,RAに伴う変化と考えられた.【考察】RAでの米粒体の発生頻度は,関節内に比べて滑液包内では稀である.しかし肩関節においては,SAB内での発生が多く,MRI T2強調画像でSAB内の滑液貯留,その内部に多数の蜂巣状低信号域が特徴的である.治療法としては,直視下での滑液包切除および米粒体摘出が有用という報告があるが,本症例では関節鏡視下手術が有用であった.【結論】今後も慎重な経過観察が必要であるが,関節リウマチ性肩峰下滑液包炎に対する関節鏡視下手術は有用であった.(著者抄録)

  • Tandem keyhole foraminotomy in the treatment of cervical radiculopathy: retrospective review of 35 cases Reviewed

    Terai Hidetomi, Suzuki Akinobu, Toyoda Hiromitsu, Yasuda Hiroyuki, Kaneda Kunikazu, Katsutani Hirofumi, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH   9   38   2014.05( ISSN:1749-799X

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    DOI: 10.1186/1749-799X-9-38

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  • Acceleration of peripheral nerve regeneration using nerve conduits in combination with induced pluripotent stem cell technology and a basic fibroblast growth factor drug delivery system Reviewed

    Ikeda Mikinori, Uemura Takuya, Takamatsu Kiyohito, Okada Mitsuhiro, Kazuki Kenichi, Tabata Yasuhiko, Ikada Yoshito, Nakamura Hiroaki

    JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART A   102 ( 5 )   1370 - 1378   2014.05( ISSN:1549-3296

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    DOI: 10.1002/jbm.a.34816

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  • Nucleated cells circulating in the peripheral blood contribute to the repair of osteochondral defects only in the early phase of healing. Reviewed

    Tadashi Okano, Shigeyuki Wakitani, Takahiro Okabe, Masafumi Takahashi, Tatsuya Koike, Hiroaki Nakamura

    Journal of tissue engineering and regenerative medicine   8 ( 5 )   414 - 420   2014.05( ISSN:1932-6254

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    The role of cells circulating in the peripheral blood to participate in the natural repair process of osteochondral defects was evaluated in a green fluorescent protein (GFP) transgenic and wild rat parabiosis model. Two weeks after the parabiosis operation, vascular communication between the conjoined rats was confirmed by flow-cytometry analysis. A 1.5 mm diameter and 1.0 mm depth osteochondral defect was made in the patellar groove of each rat femoral bone. Histological examination was performed at 1, 2, 4 and 24 weeks following surgery. In the early postoperative phase (1-4 weeks) there were GFP-negative and -positive cells in the defects of both parabiotic rats. GFP-positive chondrocytes were confirmed partly in the repair tissue of the wild parabiotic rat. In the late postoperative phase (24 weeks), the repaired defects were occupied by cells originating from the adjacent tissue and not from the peripheral blood. The ratio of cells originating from the peripheral blood was approximately 30-40% in the repair tissue at 1 week after surgery, reduced to 0-7% at 24 weeks. From these results it is confirmed that cells circulating in the peripheral blood contributed to the repair of the osteochondral defects, particularly in the early phase of healing. Thus, peripheral blood not only supplies the factors needed for repair but also provides a cell population involved in the wound-healing process.

    DOI: 10.1002/term.1536

    PubMed

  • 化学療法施行前に妊孕性を温存すべきであった軟部肉腫の1例

    八木 寛久, 星 学, 高田 潤, 大戎 直人, 岡田 充弘, 中村 博亮

    中部日本整形外科災害外科学会雑誌   57 ( 3 )   679 - 680   2014.05( ISSN:0008-9443

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    27歳男。左前腕に腫瘤を自覚し、徐々に増大した。単純X線画像で左前腕尺側の軟部陰影の増強を認め、MRIではT1強調像で等信号、T2強調像で強信号を示す腫瘍性病変を認めた。生検で類上皮肉腫の診断で、画像検査で左腋窩リンパ節および左第4肋骨に転移を認めた。術前後に化学療法を併用し、腫瘍広範囲切除を施行した。再建にはsingle-bone forearm、大腿外側皮弁による皮膚再建を行った。肋骨転移に対しては放射線治療を行い、一旦退院した。12ヵ月後に血痰が出現し、胸部CTで右気管支内に腫瘍性病変を認めた。生検で肉腫の転移と診断し、化学療法後に同部位に重粒子線治療を施行した。両側肺野に微小の多発転移を認めているものの明らかな進行はなく、現在約5年に渡り病変を抑制している。

  • A Comparative Study of Clinicopathological Features Between Simple Bone Cysts of the Calcaneus and the Long Bone Reviewed

    Takada Jun, Hoshi Manabu, Oebisu Naoto, Ieguchi Makoto, Kakehashi Anna, Wanibuchi Hideki, Nakamura Hiroaki

    FOOT & ANKLE INTERNATIONAL   35 ( 4 )   374 - 382   2014.04( ISSN:1071-1007

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    DOI: 10.1177/1071100713519600

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  • Role of FDG-PET/CT for monitoring soft tissue tumors. Reviewed

    Manabu Hoshi, Naoto Oebisu, Jun Takada, Makoto Ieguchi, Kenichi Wakasa, Hiroaki Nakamura

    Oncology letters   7 ( 4 )   1243 - 1248   2014.04( ISSN:1792-1074

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    The aim of the current study was to evaluate the limitations of 2-deoxy-2-F18-fluoro-D-glucose positron emission tomography combined with computed tomography (FDG-PET/CT) when monitoring soft tissue tumors. The diagnostic criteria of malignancy was defined as the tumor having a maximum standardized uptake value (SUVmax) ≥2.0 and a maximum diameter ≥5 cm as measured using FDG-PET/CT. One-hundred-and-thirteen patients, that were either included in the criteria or not, were compared. In addition, the values of SUVmax of the primary tumor and relapse in 12 patients were evaluated. The Kaplan-Meier analysis demonstrated that patients with tumors measuring ≥5 cm size and ≥2.0 SUVmax were associated with a worse survival rate. Among the 12 patients with relapse, statistical significances were detected in the tumor diameters, however, not in the SUVmax values. Thus, the criteria identified patients that were associated with a poor prognosis, and the SUVmax of distant metastases and local recurrences were identified to be significantly affected by tumor size.

    DOI: 10.3892/ol.2014.1876

    PubMed

  • SYSTEMIC ADMINISTRATION OF GRANULOCYTE COLONY-STIMULATING FACTOR (G-CSF) FOR CARTILAGE REPAIR IN RAT OSTEOCHONDRAL DEFECT Reviewed

    Mera H., Okano T., Itokazu M., Okabe T., Koike T., Nakamura H., Wakitani S.

    OSTEOARTHRITIS AND CARTILAGE   22   S464 - S465   2014.04( ISSN:1063-4584

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  • THE ENHANCEMENT OF HUMAN BONE MARROW DERIVED MESENCHYMAL STEM CELLS (HBMSCS) FOR SCAFFOLD-FREE CARTILAGE-LIKE CELL-SHEETS Reviewed

    Itokazu M., Mera H., Sato Y., Nakamura H., Takagi M., Wakitani S.

    OSTEOARTHRITIS AND CARTILAGE   22   S487 - S488   2014.04( ISSN:1063-4584

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  • Systemic Administration of Granulocyte Colony-Stimulating Factor for Osteochondral Defect Repair in a Rat Experimental Model. Reviewed

    Tadashi Okano, Hisashi Mera, Maki Itokazu, Takahiro Okabe, Tatsuya Koike, Hiroaki Nakamura, Shigeyuki Wakitani

    Cartilage   5 ( 2 )   107 - 113   2014.04( ISSN:1947-6035

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    OBJECTIVE: The objective of this study was to assess the effect of granulocyte colony-stimulating factor (G-CSF) on osteochondral defect repair in the rat knee. DESIGN: Twenty-six 12-week-old male Lewis rats were randomly divided into 2 groups. From day 0 to day 4, the G-CSF group received glycosylated G-CSF, and the control group received phosphate-buffered saline. A 1.5-mm diameter and 1.0-mm deep osteochondral defect was introduced in the patellar groove of the bilateral femur in all rats on day 4. The peripheral blood nucleated cells were counted for 14 days from the first day of injection, the appearance of the cartilage repair was observed histologically and macroscopically for 2, 4, 8, 12, and 24 weeks after surgery. RESULTS: The number of peripheral blood leukocytes increased 3 days and returned to normal levels 7 days after the first injection. Compared with the control group, the G-CSF group had more fibrous and/or bony tissue at earlier points in time. The tissue repair rate, which is defined as the percentage of repaired osteochondral defects, was significantly higher in the G-CSF group 4 weeks after surgery. However, there were no significant differences in the cartilage repair rate and the modified Wakitani score between the 2 groups at each time point. CONCLUSIONS: The defect filling was significantly better in the G-CSF group in the early phases. Our findings suggest that G-CSF may promote the repair of osteochondral defects by mediating an increase in the number of peripheral blood nucleated cells.

    DOI: 10.1177/1947603514520628

    PubMed

  • A comparative study of clinicopathological features between simple bone cysts of the calcaneus and the long bone.

    Takada J, Hoshi M, Oebisu N, Ieguchi M, Kakehashi A, Wanibuchi H, Nakamura H

    Foot & ankle international   35 ( 4 )   374 - 82   2014.04( ISSN:1071-1007

  • No difference in in vivo polyethylene wear particles between oxidized zirconium and cobalt-chromium femoral component in total knee arthroplasty. Reviewed

    Yukihide Minoda, Kanako Hata, Hiroyoshi Iwaki, Mitsuhiko Ikebuchi, Yusuke Hashimoto, Fumiaki Inori, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   22 ( 3 )   680 - 686   2014.03( ISSN:0942-2056

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    PURPOSE: Polyethylene wear particle generation is one of the most important factors affecting mid- to long-term results of total knee arthroplasties. Oxidized zirconium was introduced as a material for femoral components to reduce polyethylene wear generation. However, an in vivo advantage of oxidized zirconium on polyethylene wear particle generation is still controversial. The purpose of this study was to compare in vivo polyethylene wear particles between oxidized zirconium total knee prosthesis and conventional cobalt-chromium (Co-Cr) total knee prosthesis. METHODS: Synovial fluid was obtained from the knees of 6 patients with oxidized zirconium total knee prosthesis and from 6 patients with conventional cobalt-chromium (Co-Cr) total knee prosthesis 12 months after the operation. Polyethylene particles were isolated and examined using a scanning electron microscope and image analyser. RESULTS: Total number of particles in each knee was 3.3 ± 1.3 × 10(7) in the case of oxidized zirconium (mean ± SD) and 3.4 ± 1.2 × 10(7) in that of Co-Cr (n.s.). The particle size (equivalent circle diameter) was 0.8 ± 0.3 μm in the case of oxidized zirconium and 0.6 ± 0.1 μm in that of Co-Cr (n.s.). The particle shape (aspect ratio) was 1.4 ± 0.0 in the case of oxidized zirconium and 1.4 ± 0.0 in that of metal Co-Cr (n.s). CONCLUSIONS: Although newly introduced oxidized zirconium femoral component did not reduce the in vivo polyethylene wear particles in early clinical stage, there was no adverse effect of newly introduced material. At this moment, there is no need to abandon oxidized zirconium femoral component. However, further follow-up of polyethylene wear particle generation should be performed to confirm the advantage of the oxidized zirconium femoral component. LEVEL OF EVIDENCE: Therapeutic study, Level III.

    DOI: 10.1007/s00167-013-2724-4

    PubMed

  • 二重束前十字靱帯再建術後MRI評価と前方不安定性の関係

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   39 ( 1 )   88 - 89   2014.03( ISSN:1884-8842

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    2004〜2011年に二重束ACL再建術を受け術後1年以上経過している62例を対象とし、MRIによるAM束・PL束の所見と前方不安定性との関係について検討した。前方不安定性の評価にはKT-1000を用い、KT値健患差2mm未満を「安定」、2mm以上3mm未満を「軽度不安定」、3mm以上を「不安定」とした。検討の結果、MRIによるAM束の異常所見は「不安定」に関係しており、PL束の異常所見は「軽度不安定」に関与している可能性が示唆された。

  • 腰部脊柱管狭窄症に対するMETRx tubeを用いた顕微鏡視下除圧術 IPD値を用いた術式選択

    関 昌彦, 辻尾 唯雄, 星野 雅俊, 田中 秀和, 中村 博亮

    中部日本整形外科災害外科学会雑誌   57 ( 2 )   255 - 256   2014.03( ISSN:0008-9443

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    標記の手術を施行した49例(男25例、女24例、年齢51〜87歳)67椎間を対象に椎弓根間距離(IPD)、術前後のJOAスコア、手術合併症を調査し、術式の選択の基準となるIPD値を検討した。片側侵入両側除圧術(MBDU)37例53椎間のJOAスコアは術前16点から術後24点に改善し、IPD値は20〜27mmであり、初期の症例で硬膜損傷を2例認めた。両側侵入両側除圧術(MBDB)14例14椎間のJOAスコアは術前16点から術後25点に改善し、IPD値は23〜30mmであり、硬膜損傷認めなかった。IPD値が28mmまではMBDU、29mm以上はMBDBを選択し、28mm以下でも椎間腔楔状化があり、狭小化側に椎間板ヘルニアの突出があればMBDBを選択している。

  • 超音波検査で神経鞘腫の診断は可能か

    大戎 直人, 星 学, 高田 潤, 岩井 正, 中村 博亮

    中部日本整形外科災害外科学会雑誌   57 ( 2 )   311 - 312   2014.03( ISSN:0008-9443

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    神経鞘腫に特徴的な超音波所見について検討するため、当科で2010年10月以降に超音波検査を施行され神経鞘腫の診断が得られた13例の超音波画像を調査した。結果、神経原性腫瘍の超音波所見として一般的とされるwell-defined(以下WD)やdistal acoustic enhancement(以下DAE)のうち、WDが全例に認められ、DAEが10例(77%)に認められた。また、良性神経原性腫瘍の所見として有用とされるsonographic target signが7例(54%)に認められ、神経原性腫瘍に特異的とされるring signが1例(8%)に認められた。

  • 外側完全型円板状半月の術前離断性骨軟骨炎合併率と半月板形成切除後の離断性骨軟骨炎発生率の検討

    瀧上 順誠, 橋本 祐介, 山崎 真哉, 寺井 彰三郎, 中村 博亮

    JOSKAS   39 ( 1 )   200 - 201   2014.03( ISSN:1884-8842

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    外側完全型円板状半月の術前離断性骨軟骨炎合併率と半月板形成切除後の離断性骨軟骨炎(OCD)発生率について検討した。術前OCD合併率は38膝中8膝であった。手術方法別におけるOCD合併率では、亜全摘群では2膝中0膝、形成切除のみの群では15膝中3膝、形成に縫合を追加した群は21膝中5膝にOCD合併を認めた。縫合術を要した辺縁部断裂があるComplete-typeにOCDが多い傾向にあったが、有意差は認めなかった。半月板形成切除術後のOCD発生率は、22膝中1膝であった。この症例は9歳男児で、後節の不安定性を伴うIncomplete-typeに対して、形成術と縫合術を施行した。術後3年でinfero-centralにOCD発生を認め、現在保存加療中である。

  • 壮年期円板状半月損傷に対しfibrin clot併用半月形成縫合術を施行した一例

    寺井 彰三郎, 橋本 祐介, 山崎 真哉, 瀧上 順誠, 堀 悠介, 中村 博亮

    JOSKAS   39 ( 1 )   208 - 209   2014.03( ISSN:1884-8842

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    38歳男。半月板水平断裂に対しfibrin clotを埋入させ縫合糸で固定するとともに、半月板の不安定性に対しinside-out縫合を行った。術後6ヵ月時のMRIで水平断裂が残存していたが、臨床的には疼痛や歩行障害なく日常生活を過ごせている。本例は若年者でないことと半月板の損傷が大きかったことから通常であれば半月板全切除術の適応と考えられるが、変形性関節症の進行を予防すべく半月形成縫合術を選択し、良好な結果が得られた。

  • 円板状半月手術後の半月中節残存量と骨棘発生の関係

    山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   39 ( 1 )   218 - 219   2014.03( ISSN:1884-8842

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    2007〜2012年に小児期の膝外側円板状半月に対して鏡視下手術を行い術後1年以上観察しえた16例を対象に標題の関係を検討した。方法は、最終経過時のX線像によって脛骨高原外側骨棘の有無を判定するとともに、最終観察時のMRIコロナル像によって骨棘と同部位での半月中節残存量(外側半月中節の幅)を計測し、骨棘あり群(7例)となし群(9例)で比較した。結果、骨棘あり群が平均2.93±0.64mm、骨棘なし群が5.23±1.34mmであり、骨棘なし群のほうが有意に高値であった。半月中節残存量と骨棘の有無との関係をみると、4mm以上残存している症例は全て骨棘なしであった。

  • 円板状半月形成術後のMRIを用いた半月形態と内部変化の検討

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   39 ( 1 )   206 - 207   2014.03( ISSN:1884-8842

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    2007〜2011年に有症状完全円板状半月患者に対して半月板形成術を行い術後6ヵ月以上観察しえた18例を対象に、術後のLysholmスコアと術前後のMRI所見について調査し、手術方法別に半月板形成のみ施行した群(7例)と縫合を追加した群(11例)に分けて比較検討した。MRI検査ではsagittal像とcoronal像により内部変化をMink分類で評価するとともに、半月板の長さ・高さと半月偏位を計測した。検討の結果、Lysholmスコアは半月板形成のみ施行群が平均97.9点、縫合追加群が96.9点で有意差はなかった。術前後のMink分類は、縫合追加群で術前に比べて術後に輝度変化の減少が認められた。半月板形成のみ施行群における術後の半月板前・中・後節の長さはそれぞれ平均9.7mm・6.8mm・7.9mm、高さは4.3mm・4.2mm・5.4mmであった。縫合追加群では長さが6.9mm・4.2mm・7.8mm、高さが4.1mm・4.3mm・5.8mmであり、半月板形成のみ施行群に比べて中節の長さが短い傾向にあった。半月板偏位は半月板形成のみ施行群0.6mm、縫合追加群1.0mmで有意差はなかった。

  • W9 peptide repaired full-thickness articular cartilage defects in rabbits. - Mechanism of chondrogenic differentiation by W9 peptide - Reviewed

    Furuya Yuriko, Mera Hisashi, Itokazu Maki, Nakamura Hiroaki, Uchida Kohji, Wakitani Shigeyuki, Yasuda Hisataka

    JOURNAL OF BONE AND MINERAL RESEARCH   29   S237 - S238   2014.02( ISSN:0884-0431

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  • JuggerKnot <SUP>TM</SUP> ソフトアンカーによる鏡視下腱板修復術後のMRI評価 Reviewed

    間中 智哉, 伊藤 陽一, 松本 一伸, 市川 耕一, 平川 義弘, 松田 淑伸, 中村 博亮

    日本肩関節学会 肩関節   38 ( 2 )   528 - 531   2014( ISSN:0910-4461 ( eISSN:18816363

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    JuggerKnot <SUP>TM</SUP> ソフトアンカーのみを用いた鏡視下腱板修復術後の腱板修復状態をMRIにて評価した.対象は,31例31肩(男性17例,女性14例)である.腱板断裂の形状とサイズ別に,滑液包側腱板部分断裂群(BPRCT群):20肩,小断裂群(S群):6肩,中断裂群(M群):5肩であった.術中に使用したアンカーの個数を各群で検討した.また,術後6ヶ月にて全例MRI撮影し,菅谷らの分類に従って評価した.術中に使用したアンカーの個数は,BPRCT群で平均3.2個,S群で平均3.2個,M群で平均4.8個であった.M群では,BPRCT群とS群に比べて有意に使用アンカー個数は多かった.術後MRI評価にてtype I:11肩,type II:18肩,type III:2肩,type IV:0肩,type V:0肩であった.滑液包側腱板部分断裂,小断裂及び中断裂に対してJuggerKnot <SUP>TM</SUP> ソフトアンカーのみを用いた鏡視下腱板修復術術後の腱板修復状態は良好であった.

    DOI: 10.11296/katakansetsu.38.528

    CiNii Article

  • Long-Term Efficacy and Safety Outcomes of Transplantation of Induced Pluripotent Stem Cell-Derived Neurospheres with Bioabsorbable Nerve Conduits for Peripheral Nerve Regeneration in Mice Reviewed

    Uemura Takuya, Ikeda Mikinori, Takamatsu Kiyohito, Yokoi Takuya, Okada Mitsuhiro, Nakamura Hiroaki

    CELLS TISSUES ORGANS   200 ( 1 )   78 - 91   2014( ISSN:1422-6405

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    DOI: 10.1159/000370322

    PubMed

  • JuggerKnot&trade; ソフトアンカー使用鏡視下バンカート修復術の短期成績 Reviewed

    市川 耕一, 伊藤 陽一, 間中 智哉, 松本 一伸, 松田 淑伸, 平川 義弘, 中村 博亮

    日本肩関節学会 肩関節   38 ( 3 )   802 - 805   2014( ISSN:0910-4461 ( eISSN:18816363

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    反復性肩関節前方脱臼に対する鏡視下バンカート修復術は有用な低侵襲手術である.本研究の目的は全て縫合糸素材からなる小径のJuggerKnot&trade; ソフトアンカーを用いた本術式の短期成績を評価検討することである.25例25肩を対象とし,術後再脱臼率,Roweスコア,外旋可動域の患健側比,使用アンカー数を評価した.全症例中,再脱臼を1例(4%)に認めたが,再亜脱臼は認めなかった.平均Roweスコアはstability49.2点,motion19.8点,function28.8点,合計97.8点で良好であった.外旋可動域は患健側比平均92.5%,平均使用アンカー数は5.9個であった.JuggerKnot&trade; ソフトアンカーを用いた本術式は,従来よりも多数のアンカーを使用することで力学的ストレスの分散化が可能で,良好な短期成績が期待できる低侵襲手術方法であると判断できた.

    DOI: 10.11296/katakansetsu.38.802

    CiNii Article

  • A case of artificial bone filling for the bone lesion in the femur using balloon kyphoplasty Reviewed

    YABU Akito

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   57 ( 5 )   989 - 990   2014( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2014.989

    CiNii Article

  • Is the diagnosis of schwannoma possible with ultrasound sonography? Reviewed

    OEBISU Naoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   57 ( 2 )   311 - 312   2014( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2014.311

    CiNii Article

  • Microsurgical decompression using METRx tubular retractor for lumbar spinal canal stenosis―surgical options using interpedicular distance― Reviewed

    SEKI Masahiko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   57 ( 2 )   255 - 256   2014( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2014.255

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  • 肩鎖関節近傍発生のガングリオンを鏡視下に切除した3例 Reviewed

    平川 義弘, 伊藤 陽一, 間中 智哉, 松本 一伸, 市川 耕一, 松田 淑伸, 中村 博亮

    日本肩関節学会 肩関節   38 ( 2 )   726 - 729   2014( ISSN:0910-4461 ( eISSN:18816363

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    肩鎖関節より発生したと思われるガングリオン3例に対し,関節鏡視下ガングリオン切除術及び鎖骨遠位端切除術を施行した.全例,修復困難な広範囲腱板断裂を認めた.広範囲腱板断裂により関節内および肩峰下滑液包内から産生された滑液が,肩鎖関節よりチェックバルブを介して漏出してガングリオンを形成したと判断できた.術後早期より症状の消失を認め,ガングリオンの再発を認めなかった.肩鎖関節近傍に発生した本症例群の場合,本術式が有効な低侵襲手術方法であると考えられた.

    DOI: 10.11296/katakansetsu.38.726

    CiNii Article

  • 習慣性肩関節後方脱臼に対する関節鏡視下手術の術後臨床成績 Reviewed

    間中 智哉, 伊藤 陽一, 松本 一伸, 市川 耕一, 平川 義弘, 松田 淑伸, 中村 博亮

    日本肩関節学会 肩関節   38 ( 2 )   464 - 467   2014( ISSN:0910-4461 ( eISSN:18816363

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    習慣性肩関節後方脱臼は位置性肩関節後方脱臼とも言われ,肩関節90&deg;挙上時に,後方へ(亜)脱臼し,水平外転位により自己整復されて挙上可能になるのが特徴的である.今回我々は本疾患に対する鏡視下後方関節包縫縮術の術後臨床成績を評価した.対象は23例24肩(男18肩,女6肩)である.臨床成績は,自覚症状,posterior jerk testを中心とした理学所見及びJSS shoulder instability score(以下JSS score)による評価を術後6ヶ月及び12ヶ月に施行し,術前と比較した.自覚症状は,術後6ヶ月で全例消失した.しかし術後12ヶ月で,理学所見上の不安定性の再発を4/24肩(17%)に認め,その内3肩では,自覚症状の再発も認めた.JSS scoreは術前平均59.8点から,術後6ヶ月で86.9点,術後12ヶ月で93.7点に有意に改善した(P<0.02).本術式の術後12ヶ月の臨床成績は概ね良好であり,有用な低侵襲手術方法であるが,再発例に対する検討が必要である.

    DOI: 10.11296/katakansetsu.38.464

    CiNii Article

  • 第443回整形外科集談会京阪神地方会 Best Paper Award Reviewed

    八木 寛久, 星 学, 高田 潤, 大戎 直人, 岡田 充弘, 中村 博亮

    中部日本整形外科災害外科学会 中部日本整形外科災害外科学会雑誌   57 ( 3 )   679 - 680   2014( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2014.679

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  • 烏口突起基部に発生した類骨骨腫を鏡視下切除した一例 Reviewed

    木下 拓也, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 中村 博亮, 松本 一伸

    日本肩関節学会 肩関節   38 ( 2 )   730 - 733   2014( ISSN:0910-4461 ( eISSN:18816363

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    烏口突起基部に発生した類骨骨腫を,鏡視下切除した一例を経験した.症例は16歳男性.約1 年前より明らかな誘因なく左肩の夜間痛を認めていた.MRI画像にて烏口突起基部に接して,直径11mm大の球形腫瘍を認めた.保存的治療に抵抗性があり,診断および治療目的に肩関節鏡視下手術を施行し,後方鏡視下に前方ポータルより腫瘍を切除した.術後,夜間痛は劇的に改善し,本術式は有効な低侵襲手術方法であると判断できた.

    DOI: 10.11296/katakansetsu.38.730

    CiNii Article

  • Marriage and occupation after treatment for malignant bone and soft tissue tumor Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   57 ( 6 )   1243 - 1244   2014( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2014.1243

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  • Unplanned resection of a malignant tumor of the femur; a case report Reviewed

    OEBISU Naoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   57 ( 5 )   981 - 982   2014( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2014.981

    CiNii Article

  • 患者立脚式肩関節評価法Shoulder36と客観的実測値との相関 Reviewed

    平川 義弘, 伊藤 陽一, 間中 智哉, 松本 一伸, 市川 耕一, 松田 淑伸, 中村 博亮

    日本肩関節学会 肩関節   38 ( 3 )   766 - 770   2014( ISSN:0910-4461 ( eISSN:18816363

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    肩関節疾患において,患者立脚式肩関節評価法Shoulder36 V1.3(以下,Sh36)の評価値と客観的実測値の関連性を検討することで,Sh36の評価意義を検討した.対象は肩関節鏡視下手術を施行した117名117肩であった.肩関節の外旋筋力,外転筋力,疼痛評価,自動屈曲,自動外転の客観的実測値とSh36による評価値との関連性を統計学的に検証した.腱板断裂および肩峰下インピンジメント症候群に対するSh36による術前機能評価は,客観的実測値との間に有意な相関を認めた.しかし,拘縮肩に対するSh36による術前機能評価では,筋力,疼痛で有意な相関を認めなかった.拘縮肩では可動域制限により,筋力評価が困難であり,痛みを起こさないよう代償している可能性が考えられた.肩関節疾患によっては,Sh36の評価値と客観的実測値が一致しない可能性があることが示された.

    DOI: 10.11296/katakansetsu.38.766

    CiNii Article

  • Bone metastasis with prominent cystic change in a patient with lung adenocarcinoma: A case report Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   57 ( 5 )   987 - 988   2014( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2014.987

    CiNii Article

  • iPS細胞ハイブリッド型人工神経による末梢神経再生 Reviewed

    上村 卓也, 高松 聖仁, 岡田 充弘, 中村 博亮

    末梢神経   25(2)   220 - 225   2014

  • 小児肘関節脱臼の治療

    上村 卓也, 中村 博亮

    関節外科   33(8)   849 - 858   2014

  • 末梢神経絞扼性障害重症例におけるICG蛍光法を用いた神経血流測定 Reviewed

    岡田 充弘, 上村 卓也, 中村 博亮

    末梢神経   25(2)   420   2014

  • Porous tantalum tibial component prevents periprosthetic loss of bone mineral density after total knee arthroplasty for five years-a matched cohort study. Reviewed

    Yukihide Minoda, Akio Kobayashi, Mitsuhiko Ikebuchi, Hiroyoshi Iwaki, Fumiaki Inori, Hiroaki Nakamura

    The Journal of arthroplasty   28 ( 10 )   1760 - 1764   2013.12( ISSN:0883-5403

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    In 21 knees receiving porous tantalum tibial component and 21 knees receiving a cemented cobalt-chromium tibial component, dual x-ray absorptiometry scans were performed for five years post-operatively. The postoperative decrease in the bone mineral density in the lateral aspect of the tibia was significantly less in knees with porous tantalum tibial components (11.6%) than in knees with cemented cobalt-chromium tibial components (29.6%) at five years (p < 0.05). No prosthetic migration or periprosthetic fracture was detected in either group. The present study is one of the studies with the longest follow-up period on bone mineral density after total knee arthroplasty. Porous tantalum tibial component has a favorable effect on the bone mineral density of the proximal tibia after total knee arthroplasty up to five years.

    DOI: 10.1016/j.arth.2013.03.031

    PubMed

  • 脊柱管内硬膜外血管脂肪腫の3例

    森本 英之, 下野 太郎, 塚本 太朗, 中村 博亮, 大畑 建治, 大澤 政彦, 三木 幸雄

    臨床放射線   58 ( 13 )   1901 - 1905   2013.12( ISSN:0009-9252

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    脊柱管内硬膜外血管脂肪腫を3例経験した。症例1は68歳男で、2年前より左下肢痛、間歇性跛行が出現し、腰部脊柱管狭窄症を指摘された。歩行障害、下肢脱力が徐々に増悪した。硬膜外腫瘍に対して腫瘍摘出術、腰部脊柱管狭窄症に対して腰椎後方除圧術を施行した。術後より歩行障害、下肢脱力は改善した。症例2は43歳男で、2ヵ月前より右腰痛、1ヵ月前より臀部から右大腿部に疼痛が出現し、さらに左大腿部にも疼痛が出現し、歩行困難となった。硬膜外腫瘍に対して腫瘍摘出術を施行した。術後、臀部痛、両側大腿部痛は消炎し、歩行も問題なく可能となり、退院した。症例3は74歳女で、1ヵ月前より両側下肢脱力感を自覚し、その後、4〜5日間で立位並びに歩行が不能となった。排尿困難も出現した。硬膜外腫瘍に対して腫瘍摘出術を施行した。術後、神経所見の明らかな改善は認めず、6ヵ月後の現在、リハビリを継続中である。

  • 頭頸部科より肉腫として紹介された軟部肉腫の1例

    星 学, 大戎 直人, 高田 潤, 家口 尚, 高見 勝次, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 6 )   1433 - 1434   2013.11( ISSN:0008-9443

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    症例は62歳女性で、鼻腔内からの腫瘤の突出を主訴とした。頭頸部科を受診後に、鼻腔外の腫瘍の体積が増大したため、生検術が施行された。生検時には出血のため、微小な組織しか採取できなかったが「肉腫」と診断され、肉腫治療の目的で整形外科を紹介受診となった。初診時の理学的所見では鼻腔から突出する腫瘍を認め、週単位で急速に増大した。MRIでは右上顎洞を占拠する腫瘍を認め、病期診断はAJCCT2bN0M0、stageIIIであった。治療として、ADR+IFMによる抗癌剤治療を開始したところ、腫瘍の増大は停止した。抗癌剤投与直後は健側の鼻腔の開通性が改善し、CRPの低下を認めたが、化学療法の休薬期間中には再度増悪したため、機能障害の観点から手術不可と判断され重粒子線治療が選択された。照射後に腫瘍は著明に縮小し、副鼻腔でのMRSA感染を認めてはいたが、照射後8ヵ月間は重篤な有害事象を認めなかった。その後、MRIで脳膿瘍と診断され、後頭部周囲に疼痛が出現し、レントゲン撮影にて環軸椎亜脱臼を認めた。最終観察時には正常な副鼻腔構造は破壊された状態で、頬部での皮膚は壊死し、外気と副鼻腔は開通していた。

  • 腰椎変性側彎症に対するmultilevel TLIFによる矯正固定術 TLIFの局所矯正効果に注目して

    松村 昭, 加藤 相勲, 小西 定彦, 中村 博亮

    Journal of Spine Research   4 ( 11 )   1692 - 1696   2013.11( ISSN:1884-7137

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    Cobb角45°以上の腰椎変性側彎症(Degenerative Lumbar Scoliosis;DLS)に対するmultilevel TLIFによる矯正固定術の術後成績を検討した。multilevel TLIFによる矯正固定術により術後の脊柱アライメント・バランスは良好に改善しており、DLSに対するmultilevel TLIFによる矯正固定術は有効と考える。ただ、TLIFは側彎の矯正には非常に有効であるが、腰椎前彎の獲得には限界がある。われわれはPI(Pelvic Incidence)-LL(Fulcrum bendingでの腰椎前彎)<25°が本術式の良い適応と考える。(著者抄録)

  • 2歳・男児の大腿骨転子下に病的骨折をきたした好酸球性肉芽腫の1例 Reviewed

    松田 淑伸, 星 学, 高田 潤, 大戎 直人, 上村 卓也, 中村 博亮

    整形外科   64 ( 11 )   1185 - 1187   2013.10( ISSN:00305901 ( eISSN:24329444

  • Efficacy and Safety Of Biologics Agents For Patients With Rheumatoid Arthritis and Hepatitis B Carrier. Reviewed

    Tada Masahiro, Koike Tatsuya, Tamori Akihiro, Okano Tadashi, Sugioka Yuko, Mamoto Kenji, Inui Kentaro, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   65   S566 - S566   2013.10( ISSN:0004-3591

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  • Comparison Of Effects Of Standard- and Low-Dose Etanercept On Inflammatory Synovitis In Rheumatoid Arthritis Patients As Assessed By Ultrasonography Reviewed

    Mamoto Kenji, Koike Tatsuya, Okano Tadashi, Sugioka Yuko, Tada Masahiro, Inui Kentaro, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   65   S615 - S615   2013.10( ISSN:0004-3591

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  • Radiographic Evaluation of Segmental Motion of Scoliotic Wedging Segment in Degenerative Lumbar Scoliosis Reviewed

    Yasuda Hiyoyuki, Matsumura Akira, Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Dozono Sho, Nakamura Hiroaki

    JOURNAL OF SPINAL DISORDERS & TECHNIQUES   26 ( 7 )   379 - 384   2013.10( ISSN:1536-0652

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    DOI: 10.1097/BSD.0b013e31824a4129

    PubMed

  • Theoretical Risk of Anterior Femoral Cortex Notching in Total Knee Arthroplasty Using a Navigation System Reviewed

    Minoda Yukihide, Watanabe Kenichi, Iwaki Hiroyoshi, Takahashi Shinji, Fukui Mitsuru, Nakamura Hirokai

    JOURNAL OF ARTHROPLASTY   28 ( 9 )   1533 - 1537   2013.10( ISSN:0883-5403

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    DOI: 10.1016/j.arth.2013.02.015

    PubMed

  • Research On Factors Influenced For Bone Metabolic Markers In Rheumatoid Arthritis Patients From Prospective Cohort Study Reviewed

    Tada Masahiro, Koike Tatsuya, Okano Tadashi, Sugioka Yuko, Mamoto Kenji, Inui Kentaro, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   65   S964 - S964   2013.10( ISSN:0004-3591

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  • The Dosage Of Prednisolone Is a Risk Factor For Falls In Rheumatoid Arthritis Patients-The Third Year Results Of The Tomorrow Study Reviewed

    Sugioka Yuko, Koike Tatsuya, Mamoto Kenji, Okano Tadashi, Tada Masahiro, Inui Kentaro, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   65   S171 - S172   2013.10( ISSN:0004-3591

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  • 2歳・男児の大腿骨転子下に病的骨折をきたした好酸球性肉芽腫の1例

    松田 淑伸, 星 学, 高田 潤, 大戎 直人, 上村 卓也, 中村 博亮

    整形外科   64 ( 11 )   1185 - 1187   2013.10( ISSN:0030-5901

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    2歳8ヵ月男。1ヵ月前に自己転倒し、右下肢の疼痛が出現した。画像診断により大腿骨の骨腫瘍が判明したため、紹介受診した。2日目に転倒して右股関節痛のため歩行不可能となった。単純X線像で右大腿骨転子下に病的骨折を認めた。画像診断からは、線維性骨異形成や好酸球性肉芽腫などの良性または腫瘍類似病変に続発する二次性の動脈瘤様骨嚢腫、および悪性では骨肉腫、Ewing肉腫を鑑別診断に考えた。確定診断目的に切開生検術を施行した。迅速病理診断で好酸球性肉芽腫と診断し、可及的に病巣掻爬を行った。大腿骨転子部の病的骨折部の不安定性を認めたため、骨折部の鋼線固定を行った。術後2ヵ月で支持なしで独歩可能となった。術後5ヵ月の最終調査時では、右股関節痛は消失し、走行可能であった。単純X線像では大腿骨転子下に一部骨透亮像の残存を認めるが、病的骨折部の骨癒合は良好である。永久病理標本所見で、好酸球性肉芽腫と診断した。

  • Paraglenoid ganglion cystに対する鏡視下減圧術術後のリハビリテーション期間の検討

    平川 義弘, 伊藤 陽一, 松本 一伸, 間中 智哉, 市川 耕一, 中村 博亮

    肩関節   37 ( 3 )   1185 - 1188   2013.10( ISSN:0910-4461

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    対象は10例10肩(男6例、女4例、平均年齢42歳)。術後2日目から棘上筋(SSP)と棘下筋(ISP)の筋力トレーニングおよび肩甲上神経に対する低周波刺激、自動および介助下自動可動域訓練を中心とするリハビリテーションを週3回施行し、術後3ヵ月および6ヵ月の屈曲・外転可動域の変化、SSPとISPに対する徒手筋力テストで判定した。術前・術後3ヵ月・術後6ヵ月の自動屈曲可動域は、151°、172°、178°、自動外転可動域は144°、170°、177°であった。徒手筋力テストにて術前SSPは3.8、ISPは4.4がいずれも術後3ヵ月および6ヵ月で5レベルまで改善した。全例肩関節後面の圧痛は術後早期に消失し、術後6ヵ月以降のMRIにてganglion cystは消失し再発例は認めなかった。Paraglenoid ganglion cystに対する鏡視下ガングリオン減圧術に対するリハビリテーションは、術後3ヵ月間で有意な改善が期待できると考えられた。

  • Oxford phase 3 unicompartmental knee arthroplasty in Japan--clinical results in greater than one thousand cases over ten years.

    Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H

    The Journal of arthroplasty   28 ( 9 Suppl )   168 - 71   2013.10( ISSN:0883-5403

  • JuggerKnotソフトアンカーを用いた鏡視下腱板修復術の短期臨床成績

    間中 智哉, 伊藤 陽一, 松本 一伸, 市川 耕一, 平川 義弘, 中村 博亮

    肩関節   37 ( 3 )   1113 - 1116   2013.10( ISSN:0910-4461

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    JuggerKnotソフトアンカーを用いて鏡視下腱板縫合術(ARCR)を施行した28肩(手術時平均年齢60.5歳、平均経過観察期間8.8ヵ月)の臨床成績を検討した。腱板断裂の形状とサイズは滑液包側腱板部分断裂6肩、全層性断裂は小断裂4肩、中断裂10肩、大断裂・広範囲断裂8肩であり、滑液包側腱板部分断裂と小断裂はJuggerKnotソフトアンカー単独で、中断裂以上ではrotator cuffアンカーと併用した。術中アンカー使用時の問題と腱板修復状態、使用アンカーの種類と個数、ならびに自動屈曲可動域と自動外転可動域、日本整形外科学会肩関節疾患治療成績判定基準の経時的変化を評価した結果、全例、術中の腱板修復状態と短期臨床成績は良好で、アンカーの脱転は中断裂の1肩のみであったことから、JuggerKnotソフトアンカーを用いたARCRは有用と判断できた。

  • 上腕二頭筋長頭腱完全断裂肩の臨床的特徴

    市川 耕一, 伊藤 陽一, 平川 義弘, 松本 一伸, 間中 智哉, 中村 博亮

    肩関節   37 ( 3 )   1157 - 1161   2013.10( ISSN:0910-4461

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    肩峰下インピンジメント症候群もしくは腱板断裂の診断で関節鏡視下肩峰下除圧術(ASD)単独およびASDと関節鏡視下腱板修復術を行った症例のうち、上腕二頭筋長頭腱(LHB)完全断裂が確認された116肩を対象として、LHB完全断裂と肩峰下インピンジメント症候群および腱板断裂との関連性に後ろ向きに調査した。内訳は肩峰下インピンジメント症候群単独20例、腱板断裂96例であり、特に腱板断裂サイズ、断裂腱板の種類及び棘上筋腱断裂の局在に注目して検討した結果、LHB完全断裂の発生頻度は腱板断裂例に有意に多く、肩峰下インピンジメント症候群では男性が有意に多かった。また、腱板断裂例では腱板断裂サイズの増大に伴ってLHB完全断裂例が増加しており、その断裂部位は棘上筋腱および肩峰下筋腱を含む腱板前方成分での断裂が多く、特に棘上筋腱断裂は大結節付着部の前方部と中央部に有意に多い結果であった。

  • 肩峰下インピンジメント症候群に対する鏡視下肩峰下除圧術と鏡視下関節包切開術の併用術式の短期成績

    松田 淑伸, 伊藤 陽一, 市川 耕一, 松本 一伸, 間中 智哉, 平川 義弘, 中村 博亮

    肩関節   37 ( 3 )   1203 - 1207   2013.10( ISSN:0910-4461

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    肩峰下インピンジメント症候群のみのI群(男17例、女8例、平均年齢50.4歳)には鏡視下肩峰下除圧術(ASD)のみを、肩関節拘縮合併肩峰下インピンジメント症候群のII群(男17例、女8例、平均年齢50.9歳)にはASDと鏡視下関節包切開術併用術式を施行し、併用術式の意義を検討した。Hawkinsのインピンジメント徴候は、I群では全例術後3ヵ月に消失したのに対し、II群では術後3ヵ月で5例に残存し、術後6ヵ月では全例で消失した。自動屈曲可動域と自動外転可動域は両群ともに経時的に改善を認めたが、II群はI群より高い改善率を認めた。日本整形外科学科肩関節疾患治療成績判定基準は、I群は術前77.0点、術後3ヵ月93.1点、術後6ヵ月96.5点であったのに対しII群はそれぞれ59.0点、80.6点、88.0点であった。肩峰下インピンジメント症候群に肩関節拘縮を合併した症例に対してASDと鏡視下関節包切開術の併用術式は臨床成績の改善が期待できると考えられた。

  • 患者立脚肩関節評価法Shoulder36の評価意義の検討

    平川 義弘, 伊藤 陽一, 市川 耕一, 松本 一伸, 間中 智哉, 中村 博亮

    肩関節   37 ( 3 )   941 - 944   2013.10( ISSN:0910-4461

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    患者立脚肩関節評価法Shoulder36(Sh36)と日本整形外科学会肩関節疾患治療成績判定基準(JOAスコア)の相関性を中心に、Sh36の評価意義について検討した。肩関節鏡視下手術を施行した40例を対象とした。Sh36とJOAスコアの合計点の間に有意な強い相関を認めた。項目別の比較では、疼痛、ADL、筋力に比較的高い相関係数を認め、可動域のみ低かった。疼痛とADLは疾患により相関係数が有意に異なったが、その他の項目では疾患別に相関係数に有意差を認めなかった。合計点では拘縮肩、腱板断裂、インピンジメント症候群の順に相関が強く、疼痛、ADLでは、腱板断裂、拘縮肩、インピンジメント症候群の順に相関が強かった。筋力、可動域は相関係数のばらつきが大きかった。合計点を含めて全項目で女性の相関係数が男性よりも高値を示し、特に、疼痛、ADL、筋力の各項目は、女性の相関係数が有意に高値を示した。

  • 5°以上の椎間楔状化を合併した腰部脊柱管狭窄症は顕微鏡下片側侵入両側除圧で治療可能か

    林 和憲, 加藤 相勲, 小西 定彦, 松村 昭, 香月 憲一, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 5 )   803 - 804   2013.09( ISSN:0008-9443

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    腰部脊柱管狭窄症(LSS)に対して、L3/4、L4/5、L5/6のいずれかの1椎間除圧を行い、2年以上フォロー可能であった104例を対象として、臨床成績および画像成績について検討した。LSSの罹患椎間において、5°以上の椎間楔状化を認めた20例をA群(楔状化群)、認めない84例をB群(非楔状化群)とした結果、JOAスコアでは、両群共に術後有意な改善を認めたが、改善率はB群が61.2%、A群は47%とA群で改善率が低かった。腰痛visual analog scale(VAS)の改善度はA群が7.4点、B群が23.2点とA群で有意に不良であった。再手術率はA群が15%、B群が4.8%とA群で高率であった。椎間楔状角・側彎角・前後屈可動域および各画像パラメータの変化量については2群間で有意差は見られなかった。

  • 化膿性肩関節炎に対する関節鏡視下手術の治療経験

    松本 一伸, 伊藤 陽一, 間中 智哉, 市川 耕一, 平川 義弘, 中村 博亮

    肩関節   37 ( 2 )   829 - 832   2013.09( ISSN:0910-4461

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    2006年8月〜2011年3月に鏡視下手術を行った化膿性肩関節炎12例について報告した。基礎疾患は7例(58%)に認め、内訳は糖尿病2例、肝機能障害2例、透析1例、糖尿病+透析1例、SLE 1例であった。手術方法は鏡視下に肩関節と肩峰下滑液包を観察し、炎症性滑膜を切除するとともに、感染性組織と判断できる軟部および骨軟骨組織を可及的に切除した。術後は肩関節内と肩峰下滑液包内にドレーンを各々2本ずつ(流入1本、流出1本)留置し、持続洗浄を適宜行った。治療成績(感染消退の有無)は、消退せず敗血症で死亡したものが2例(17%)あり、この2例は基礎疾患としてそれぞれ肝硬変とSLEを有していた。他の10例は感染が消退し、消退までに要した術後期間は6日〜12週(平均25.6日)で、1ヵ月以内が7例、1ヵ月以上2ヵ月未満が1例、2ヵ月以上3ヵ月未満が1例、3ヵ月以上が1例であった。死亡した2例を除く10例の最終的な肩関節可動域は、120°以上の挙上可能が6例、不可能が4例で、この4例はいずれも広範囲腱板断裂を伴っていた。代表例として、良好な術後経過が得られた1例を提示した。

  • Prevalence and motion characteristics of degenerative cervical spondylolisthesis in the symptomatic adult. Reviewed

    Akinobu Suzuki, Michael D Daubs, Hirokazu Inoue, Tetsuo Hayashi, Bayan Aghdasi, Scott R Montgomery, Monchai Ruangchainikom, Xueyu Hu, Christopher J Lee, Christopher J Wang, Benjamin J Wang, Hiroaki Nakamura

    Spine   38 ( 17 )   E1115 - E1120   2013.08( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    STUDY DESIGN: Retrospective analysis of kinetic magnetic resonance images. OBJECTIVE: To define the prevalence of degenerative cervical spondylolisthesis in symptomatic patients and to analyze the motion characteristics and influence on the spinal canal at the affected level. SUMMARY OF BACKGROUND DATA: When compared with lumbar spondylolisthesis, there are few studies evaluating cervical spondylolisthesis, and the prevalence and motion characteristics of cervical spondylolisthesis are not well defined. METHODS: Four hundred sixty-eight symptomatic patients underwent upright cervical kinetic magnetic resonance images in neutral, flexion, and extension positions. Segmental displacement and intervertebral angles were measured in 3 positions using computer analysis software. Spondylolisthesis was defined as the vertebral displacement more than 2 mm, and graded based on the magnitude into 2 groups at each level: grade 1 (2-3 mm), grade 2 (>3 mm). Instability was defined as segmental translational motion exceeding 3 mm. RESULTS: Grade 1 and 2 spondylolisthesis at a minimum of 1 level were observed with a prevalence of 16.4% and 3.4% of all patients, respectively. The most affected levels were C4-C5 (6.2%) and C5-C6 (6.0%) followed by C3-C4 (3.6%) and C6-C7 (3.0%). Translational motion was greater in levels with grade 1 as compared with segments without spondylolisthesis, but there was no difference in angular motion between the 3 groups. Translational instability was observed with a prevalence of 16.7% in grade 2, 4.3% in grade 1, and 3.4% in segments without spondylolisthesis. Space available for the cord at the affected level was decreased and spinal cord compression grade was higher in grade 1 and grade 2 as compared with levels without spondylolisthesis. CONCLUSION: Cervical spondylolisthesis of at least 2 mm was observed in 20% of patients and was most common at C4-C5 and C5-C6. The presence of spondylolisthesis was associated with increased translational motion and decreased segmental spinal canal diameter. LEVEL OF EVIDENCE: N/A.

    DOI: 10.1097/BRS.0b013e31829b1487

    PubMed

  • Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease. Reviewed

    Kato M, Konishi S, Matsumura A, Hayashi K, Tamai K, Shintani K, Kazuki K, Nakamura H

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   22 ( 8 )   1750 - 7   2013.08( ISSN:0940-6719

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    DOI: 10.1007/s00586-013-2763-z

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  • Clinical outcome of microsurgical bilateral decompression via a unilateral approach of treatment of degenerative lumbar disease with more over 5 degress scoliotic disc wedging Reviewed

    HAYASHI Kazunori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 4 )   803 - 804   2013.07( ISSN:00089443

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    DOI: 10.11359/chubu.2013.803

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  • Bony fusion rate of the spinous process in the partial spinous process splitting approach Reviewed

    SEKI Masahiko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 4 )   999 - 1000   2013.07( ISSN:00089443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2013.999

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  • A case report of intradural lumbar disc herniation Reviewed

    MATSUMOTO Tomiya

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 4 )   863 - 864   2013.07( ISSN:00089443 ( eISSN:13490885

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.11359/chubu.2013.863

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  • Simple bone cyst of the talus : A case report Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 4 )   833 - 834   2013.07( ISSN:00089443 ( eISSN:13490885

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.11359/chubu.2013.833

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  • Radial artery perforator adiposal flap for coverage of the scarred median nerve Reviewed

    Uemura Takuya, Takamatsu Kiyohito, Okada Mitsuhiro, Ikeda Mikinori, Nakamura Hiroaki

    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY   66 ( 7 )   1019 - 1021   2013.07( ISSN:1748-6815

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.bjps.2013.01.024

    PubMed

  • The role of internal fixation for long bone metastasis prior to impending fracture: an experimental model Reviewed

    Ibrahim Mohammad, Terai Hidetomi, Yamada Kentaro, Suzuki Akinobu, Toyoda Hiromitsu, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   18 ( 4 )   659 - 666   2013.07( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00776-013-0380-7

    PubMed

  • 5°以上の椎間楔状化を合併した腰部脊柱管狭窄症は顕微鏡下片側侵入両側除圧で治療可能か

    林 和憲, 加藤 相勲, 小西 定彦, 松村 昭, 香月 憲一, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 4 )   803 - 804   2013.07( ISSN:0008-9443

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    著者等は腰部脊柱管狭窄症(LSS)に対する治療方針として、高度の腰椎変性すべりや、不安定性に起因するspinal fatigueを認めず、かつ側彎角が20°以下の症例に対しては、椎間楔状化の有無にかかわらず顕微鏡下片側進入両側除圧術(MBDU)を行ってきた。今回、2007〜2010年にMBDUを行い術後2年以上観察しえた104例のうち、LSS罹患椎間に5°以上の椎間楔状化を認めた20例を"楔状化群"、他の84例を"非楔状化群"として手術成績を群間比較した。結果、楔状化群の成績は明らかに不良であり、椎間楔状化5°はMBDUの適応限界である可能性が示唆された。

  • 切迫骨折に先立つ長骨転移に対する内部固定の役割 実験モデル(The role of internal fixation for long bone metastasis prior to impending fracture: an experimental model)

    Ibrahim Mohammad, Terai Hidetomi, Yamada Kentaro, Suzuki Akinobu, Toyoda Hiromitsu, Nakamura Hiroaki

    Journal of Orthopaedic Science   18 ( 4 )   659 - 666   2013.07( ISSN:0949-2658

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    内部固定による長骨転移モデルを確立し、切迫骨折に先立つ長骨転移に対する予防的内部固定の骨破壊、腫瘍進行、死亡に及ぼす影響について検討した。ウサギ45匹を均等に内部固定、対照、シャムの3群に分け、脛骨にVX2腫瘍細胞を移植した。ウサギをX線とCTでモニターし、2週間ごとに血清検査を行った。固定群に比べてシャム群と対照群でウサギ脛骨の有意に高い骨破壊率が認められた。3週間目に固定群、シャム群、対照群でそれぞれ0.2、0.4、2.3%の容積骨量減少を認め、5週目にはそれぞれ1.2、2.5、6.1%に増加した。固定群はシャム群と対照群に比べ、有意な生存延長を示した。予防的内部固定は骨破壊と腫瘍進行を抑制し、長骨転移患者の生存期間を延長することが示唆された。

  • 距骨に発生した単純性骨嚢腫の1例

    高田 潤, 星 学, 大戎 直人, 高見 勝次, 家口 尚, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 4 )   833 - 834   2013.07( ISSN:0008-9443

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    16歳男。右足関節を捻挫し、単純X線で距骨の異常陰影を偶発的に指摘された。単純X線で、距骨頭から距骨頸にかけて径2cmの辺縁骨硬化を伴う骨透亮像を認めた。単純CTでも辺縁の骨硬化が明らかで、内部に石灰化は認めなかった。MRIでT1低信号、T2高信号で、単房性の病変ながら液面形成を認めた。切除生検を行った。正確な掻爬を低侵襲に行うために、CTナビゲーション補助下に小切開で骨皮質の開窓を行った。壁組織の迅速病理診断で悪性所見がなかったため、引き続いて嚢腫壁の掻爬、drilling、エタノール処理、人工骨(β-TCP)移植を行った。掻爬した壁組織では、cholesterol cleft、ヘモジデリン沈着、線維化を伴った肉芽組織を認めた。内容液は漿液性、嚢腫壁に滑膜表属細胞も認めず、他の腫瘍性病変も否定的であったことなどから、単純性骨嚢腫と診断した。術後半年で疼痛なく、画像上の再発も認めていない。

  • 硬膜内に脱出した腰椎椎板ヘルニアの1例

    松本 富哉, 豊田 宏光, 寺井 秀富, 堂園 将, 堀 悠介, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 4 )   863 - 864   2013.07( ISSN:0008-9443

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    63歳男。3年ほど前から腰痛、右臀部から下腿外側痛が出現した。腰椎椎間板ヘルニアを指摘され、保存治療にて軽快していた。突然激しい右臀部から下腿外側痛が出現した。MRIの矢状断像でL4/5椎間板の後方への突出、また硬膜内にT1、T2ともに等信号の腫瘤陰影をみとめ、水平断像では椎間板レベルでは硬膜嚢の連続性の途絶、また椎弓根レベルでは硬膜内に腫瘤陰影をみとめた。CTでL4/5椎間板内、脊柱管内にガス像をみとめた。L4/5椎間板造影、椎間板造影後CTでは硬膜管内への造影剤の流入をみとめた。硬膜内腰椎椎間板ヘルニアと診断し、手術を施行した。足部のしびれが軽度残存しているが、筋力低下、疼痛は消失した。

  • 棘突起部分的縦割式椎弓間開窓術における棘突起骨癒合率の検討

    関 昌彦, 辻尾 唯雄, 星野 雅俊, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 4 )   999 - 1000   2013.07( ISSN:0008-9443

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    腰部脊柱管狭窄に対して棘突起を部分的に縦割して椎弓間開窓術(本術式)を施行し、術後4ヵ月以上経過後に骨癒合を得た64例を対象に、骨癒合率について検討した。復元した縦割棘突起と残存棘突起との間の骨癒合は54突起(49%)認めた。術前に下位棘突起との間がkissing spine(KS)であった棘突起は55であり、その内骨癒合が得られたのは15(27%)であった。一方、KSでなかった棘突起51中、骨癒合が得られたのは39(76%)であった。基部骨折は15棘突起(14%)認め、その内14(93%)がKSで、KSであった棘突起の内、骨折は14(25%)で、KSでかなった棘突起の骨折は1(2%)と両群で有意差が認められた。

  • BIOLOGICS THERAPY FOR PATIENTS WITH RHEUMATOID ARTHRITIS AND HEPATITIS B INFECTION Reviewed

    Tada M., Koike T., Tamori A., Okano T., Sugioka Y., Mamoto K., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   72   430 - 430   2013.06( ISSN:0003-4967

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  • PREDICTIVE FACTORS FOR RADIOGRAPHIC PROGRESSION IN LOW- AND STANDARD-DOSE ETANERCEPT THERAPY FOR RHEUMATOID ARTHRITIS FROM THE PREVENTION OF CARTILAGE DESTRUCTION BY ETANERCEPT (PRECEPT) STUDY Reviewed

    Tada M., Koike T., Okano T., Sugioka Y., Mamoto K., Wakitani S., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   71   519 - 519   2013.06( ISSN:0003-4967

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  • PREDICTION OF RESPONSE TO TOCILIZUMAB USING BIOMARKERS (INTERLEUKIN-1 BETA, D-DIMER AND FIBRINOGEN) IN PATIENTS WITH RHEUMATOID ARTHRITIS Reviewed

    Okano T., Koike T., Tada M., Sugioka Y., Mamoto K., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   72   628 - 628   2013.06( ISSN:0003-4967

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  • PATIENTS WITH RHEUMATOID ARTHRITIS HAVE FALL MORE OFTEN THAN HEALTHY INDIVIDUALS: THE TOMORROW STUDY Reviewed

    Mamoto K., Koike T., Okano T., Sugioka Y., Tada M., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   72   390 - 390   2013.06( ISSN:0003-4967

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  • LOW BACK PAIN IN RHEUMATOID ARTHRITIS PATIENTS CORRELATED WITH DAS28-ESR Reviewed

    Yamada K., Koike T., Suzuki A., Takahashi S., Yasuda H., Inui K., Tada M., Sugioka Y., Okano T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   72   421 - 422   2013.06( ISSN:0003-4967

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  • IMPACT OF DISEASE ACTIVITY ON LIPID PROFILES AND ADIPOCYTOKINES IN PATIENTS WITH RHEUMATOID ARTHRITIS -THE TOMORROW STUDY- Reviewed

    Sugioka Y., Koike T., Mamoto K., Okano T., Tada M., Wakitani S., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   71   510 - 510   2013.06( ISSN:0003-4967

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  • HIGH ULTRASONOGRAPHIC SCORES PERSIST AMONG PATIENTS WITH RHEUMATOID ARTHRITIS IN CLINICAL REMISSION WITH NORMAL SERUM MMP-3 VALUES Reviewed

    Okano T., Koike T., Tada M., Sugioka Y., Mamoto K., Wakitani S., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   71   305 - 306   2013.06( ISSN:0003-4967

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  • EVALUATION OF LUMBAR ENDPLATE EROSION IN PATIENTS WITH RHEUMATOID ARTHRITIS USING MRI Reviewed

    Yamada K., Suzuki A., Yasuda H., Takahashi S., Tada M., Sugioka Y., Okano T., Kamiyama A., Koike T., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   71   350 - 350   2013.06( ISSN:0003-4967

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  • COMPARISON OF EFFECTS OF STANDARD- AND LOW-DOSE ETANERCEPT ON INFLAMMATORY SYNOVITIS IN RHEUMATOID ARTHRITIS PATIENTS AS ASSESSED BY ULTRASONOGRAPHY Reviewed

    Mamoto K., Koike T., Okano T., Sugioka Y., Tada M., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   72   1010 - 1011   2013.06( ISSN:0003-4967

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  • REDUCED STEROID DOSAGE IMPROVES BONE METABOLIC MARKERS IN PATIENTS WITH RHEUMATOID ARTHRITIS: THE TOMORROW STUDY Reviewed

    Tada M., Koike T., Okano T., Sugioka Y., Mamoto K., Inui K., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   72   298 - 298   2013.06( ISSN:0003-4967

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  • RISK FACTORS FOR VERTEBRAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS - THE TOMORROW STUDY Reviewed

    Okano T., Koike T., Tada M., Sugioka Y., Mamoto K., Wakitani S., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   71   600 - 600   2013.06( ISSN:0003-4967

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  • RHEUMATOID ARTHRITIS IS A RISK FACTOR FOR ATHEROSCLEROSIS -THE TOMORROW STUDY Reviewed

    Sugioka Y., Koike T., Mamoto K., Okano T., Tada M., Wakitani S., Nakamura H.

    ANNALS OF THE RHEUMATIC DISEASES   71   358 - 358   2013.06( ISSN:0003-4967

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  • Solitary neurolymphomatosis of the brachial plexus mimicking benign nerve sheath tumour: case report Reviewed

    Okada Mitsuhiro, Takamatsu Kiyohito, Oebisu Naoto, Nakamura Hiroaki

    BRITISH JOURNAL OF NEUROSURGERY   27 ( 3 )   386 - 387   2013.06( ISSN:0268-8697

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    DOI: 10.3109/02688697.2012.737959

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  • 末梢神経の再生医療 生体吸収性人工神経を用いたiPS cell- & bFGF drug-delivery systemの有効性

    上村 卓也, 高松 聖仁, 池田 幹則, 岡田 充弘, 香月 憲一, 田畑 泰彦, 筏 義人, 中村 博亮

    末梢神経   24 ( 1 )   90 - 98   2013.06( ISSN:0917-6772

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    マウスの坐骨神経欠損部を、1)人工神経単独(C群)、2)人工多能性幹細胞ハイブリッド型人工神経(I群)、3)線維芽細胞増殖因子を付加した人工多能性幹細胞ハイブリッド型人工神経(I+F群)、4)神経移植(A群)の4群で架橋再建を行った。12週までのマウスの下肢運動・知覚機能は、A群、I+F群並びにI群、C群の順に良好な回復を示した。12週目の人工神経および移植神経の組織像ではA群、I+F群、I群、C群の順で統計学的に有意に多くの再生軸索を認めた。人工神経による末梢神経の再生医療では、人工神経をscaffoldとして細胞と成長因子の両者を組み合わせることによって、末梢神経の再生が促進される。(著者抄録)

  • Clinical and Radiological Outcomes of Microscopic Partial Pediculectomy for Degenerative Lumbar Foraminal Stenosis Reviewed

    Yamada Kentaro, Matsuda Hideki, Cho Hisanori, Habunaga Hiroshi, Kono Hiroshi, Nakamura Hiroaki

    SPINE   38 ( 12 )   E723 - E731   2013.05( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e31828f4e12

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  • Impact of initial conservative treatment interventions on the outcomes of patients with osteoporotic vertebral fractures. Reviewed

    Hoshino M, Tsujio T, Terai H, Namikawa T, Kato M, Matsumura A, Suzuki A, Takayama K, Takaoka K, Nakamura H

    Spine   38 ( 11 )   E641 - E648   2013.05( ISSN:0362-2436

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    Study Design. Prospective multicenter study.
    Objective. To examine whether initial conservative treatment interventions for osteoporotic vertebral fractures (OVF) influence patient outcomes.
    Summary of Background Data. OVFs have been described as stable spinal injuries and, in most cases, are managed well with conservative treatment. However, systematic treatments for OVF have not been clearly established.
    Methods. A total of 362 patients with OVF (59 males and 303 females; mean age, 76.3 yr) from 25 institutes were enrolled in this clinical study. All the patients were treated conservatively without any surgical interventions. The patient outcomes were evaluated 6 months after the fractures on the basis of Short Form-36 (SF-36) physical component summary (PCS) and mental component summary (MCS), activities of daily living (the Japanese long-term care insurance system), back pain (visual analogue scale), cognitive status (mini-mental state examination), and vertebral collapse, which were used as response variables. Furthermore, brace type, hospitalization, bisphosphonates after injury, and painkillers after injury were explanatory variables for the treatment interventions. To evaluate the independent effects of treatment interventions on patient outcomes, we performed multivariate logistic regression analyses and obtained odds ratios that were adjusted for the potential confounding effects of age, sex, level of fracture, presence of middle-column injury, pain visual analogue scale at enrollment, mini-mental state examination score at enrollment, and previous use of steroids.
    Results. There was no significant difference for treatment intervention factors including brace type, hospitalization, bisphosphonates after injury, and painkillers after injury. For adjusting factors, the presence of middle-column injury was significantly associated with SF-36 PCS &lt;= 40, reduced activities of daily living, prolonged back pain, and vertebral collapse. Female sex and advanced age were associated with SF-36 PCS &lt;= 40. Low mini-mental state examination scores at enrollment were associated with SF-36 PCS &lt;= 40 and reduced activities of daily living. The previous use of steroids was associated with SF-36 MCS &lt;= 40, prolonged back pain, and vertebral collapse. No other examined variables were significant risk factors for patient outcomes.
    Conclusion. These results showed that treatment intervention factors did not affect patient outcomes 6 months after OVF. Middle-column injury was a significant risk factor for both clinical and radiological outcomes. In the future, establishing systematic treatments for cases with middle-column injuries is needed.

    DOI: 10.1097/BRS.0b013e31828ced9d

    PubMed

  • Clinical results of surgical treatment for patients with metastatic spine tumor Reviewed

    DATE Yuko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 3 )   659 - 660   2013.05( ISSN:00089443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2013.659

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  • Non-surgicla treatment with a collar wearing 12 hours per day method for cervical radiculopathy Reviewed

    HAYASHI Kazunori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 3 )   647 - 648   2013.05( ISSN:00089443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2013.647

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  • A propeller flap based on the thoracoacromial artery for reconstruction of a skin defect in the cervical region: A case report Reviewed

    Okada Mitsuhiro, Ikeda Mikinori, Uemura Takuya, Takada Jun, Nakamura Hiroaki

    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY   66 ( 5 )   720 - 722   2013.05( ISSN:1748-6815

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    DOI: 10.1016/j.bjps.2012.08.045

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  • Radiographic evaluation of postoperative bone regrowth after microscopic bilateral decompression via a unilateral approach for degenerative lumbar spondylolisthesis Reviewed

    Dohzono Sho, Matsumura Akira, Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   18 ( 5 )   472 - 478   2013.05( ISSN:1547-5654

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3171/2013.2.SPINE12633

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  • 頸部神経根症に対する保存療法(頸椎装具1日12時間法)の有用性

    林 和憲, 加藤 相勲, 小西 定彦, 松村 昭, 香月 憲一, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 3 )   647 - 648   2013.05( ISSN:0008-9443

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    頸部神経根症(CSR)あるいは頸部脊髄神経根症の28例(男性18例、女性10例、平均年齢52.8歳)を対象に頸椎装具を中心とした保存療法の有効率と上肢症状の改善率、ならびに頸椎装具装着率について調査した。方法は全例に装具装着に伴う不快感の軽減と装着率の上昇を目的として考案した頸椎装具療法(頸椎装具1日12時間法)を行い、26例には薬物療法を併用した。その結果、1)装具・薬物で症状をコントロールできたのは28例中22例(有効率79%)であった。ブロックを追加したのは6例で、うち4例に手術が施行されていた。2)最終診察時の上肢症状は初診時に比して56%軽減しており、装具・薬物でコントロール可能であった例では70%の改善がみられた。だが、ブロックへの移行が必要であった例は5%の改善に留まっていた。3)筋力低下があったのは14例で、うち5例で完全回復となり、6例で改善がみられた。尚、頸椎装具の装着率は開始時点で100%であったが、3週の時点では86%であった。

  • 転移性脊椎腫瘍患者の手術成績の検討

    伊達 優子, 加藤 相勲, 松村 昭, 小西 定彦, 田中 亨, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 3 )   659 - 660   2013.05( ISSN:0008-9443

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    1998年3月〜2011年3月の間に手術を施行した転移性脊椎腫瘍患者44例(男性27例、女性17例、手術時年齢20〜76歳、平均年齢60.6歳)の手術成績について検討した。原発巣は肺癌が9例、肝細胞癌が7例、乳癌、大腸癌が各6例、前立腺癌が3例、甲状腺癌、腎癌が各2例、その他9例であった。また、罹患椎は胸椎が33例、腰椎が6例、頸椎が5例であった。手術術式は後方法が30例、前方法が3例、前方・後方法の併用が3例、脊椎全摘術が7例であった。術後経過観察期間1〜103ヵ月(平均13.0ヵ月)の結果、1)術後6ヵ月以上追跡し得た7例の成績では術前の徳橋スコアは0〜8点が5例、9〜11点が18例、12〜15点が4例であり、術後3ヵ月以内に死亡した5例では0〜8点が4例、9点が1例であった。2)術後の麻痺では改善が7例、不変が28例で悪化例は認められなかった。術後合併症は4例で、局所再発が2例、せん妄によるスペーサー脱転や再手術が1例、急性硬膜下血腫が1例であった。以上より、術前徳橋スコアと術後生存期間の一致率は高く、徳橋スコアは治療法選択の指標になると考えられた。

  • A case of tibial condyle valgus osteotomy for instability of the knee due to correction loss of tibial plateau fracture Reviewed

    YAMASAKI Shinya

    38 ( 2 )   338 - 339   2013.04( ISSN:18848842

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  • A case of asymptomatic bilateral pulmonary embolism and unilateral deep venous thrombosis after arthroscopic repair of multiple knee ligament deficiency Reviewed

    TAKIGAMI Junsei

    38 ( 2 )   316 - 317   2013.04( ISSN:18848842

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    CiNii Article

  • A case of dedifferentiated liposarcoma showing a biphasic pattern on 2-deoxy-2-f(18)-fluoro-d-glucose positron emission tomography/computed tomography. Reviewed

    Hoshi M, Oebisu N, Takada J, Wakasa K, Nakamura H

    Rare tumors   5 ( 2 )   95 - 7   2013.04( ISSN:2036-3605

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    DOI: 10.4081/rt.2013.e26

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  • A case of dedifferentiated liposarcoma showing a biphasic pattern on 2-deoxy-2-f(18)-fluoro-d-glucose positron emission tomography/computed tomography.

    Hoshi M, Oebisu N, Takada J, Wakasa K, Nakamura H

    Rare tumors   5 ( 2 )   95 - 7   2013.04( ISSN:2036-3605

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  • 脛骨高原骨折後変形治癒による内側不安定性に対し、3D術前計画併用脛骨顆外反骨切り術にて対応した1例

    山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   38 ( 2 )   338 - 339   2013.04( ISSN:1884-8842

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    36歳男性。バイク事故で脛骨内側高原骨折を受傷、前医で観血的整復固定術を施行されたが、術後4ヵ月頃より歩行時に右膝不安定感を自覚し、著者らの施設へ紹介となった。画像所見から不安定性の原因は靱帯不全ではなく、脛骨近位内側の落ち込みによるteeter effectと判断して手術が行われた。手術では前回骨折部を指標に脛骨内顆外反骨切りを行い、透視下に矯正損失の改善を確認し、骨欠損部には腸骨・人工骨移植を用いTomofix standardで固定した。後療法は術後4週間免荷とし、可動域訓練は1週後から開始、8週で全荷重とした。その結果、不安定感・疼痛ともに改善し、X線像上で骨癒合が確認、術後1年8ヵ月でプレートを抜去した。尚、最終診察時、Lysholm scoreは術前の49点から85点に改善し、日常生活に問題なく経過良好である。

  • 術中電気生理学的検査による手根管症候群重症例における正中神経の神経上膜剥離の必要性の検討(第1報)

    岡田 充弘, 池田 幹則, 高松 聖仁, 中村 博亮

    日本手外科学会雑誌   29 ( 6 )   837 - 839   2013.04( ISSN:2185-4092

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    【目的】手根管症候群の重症例に対し手根管開放術と神経上膜剥離術を行い,その効果を検討した.【方法】症例は7例(男性4例,女性3例)で,手術時平均年齢70.6歳(59-79歳)であった.7例全てが,術前の電気生理学的検査で,手関節レベルにて正中神経を刺激し短母指外転筋で複合筋活動電位(CMAP)の記録ができなった.術中に手根管開放術を行った後に,神経上膜の剥離を行い,第2虫様筋でCMAPの記録を行った.【結果】1例を除き全例において,神経上膜剥離前後でCMAPの振幅の増大,または遠位潜時の短縮を認めた.【考察】今回我々は術中電気生理学的検査を用いることで,手根管症候群重症例における神経上膜剥離の効果を判定した.電気生理学的検査の改善を認めたことより,線維化した神経上膜を剥離することによる神経除圧効果があるのではないかと推測される.(著者抄録)

  • 膝複合靱帯再々建術後に発生した無症候性の両側PEと片側DVTの一例

    瀧上 順誠, 橋本 祐介, 山崎 真哉, 寺井 彰三郎, 中村 博亮

    JOSKAS   38 ( 2 )   316 - 317   2013.04( ISSN:1884-8842

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    43歳女性。27歳時に左膝ACL再建術(骨付き膝蓋腱:BTB)とMCL修復術が施行された。42歳時に転倒にて左膝受傷し、左ACL再々建術(半腱様筋腱:ST)、MCL術が施行されたが、術後2ヵ月時に階段から転落、左膝を捻って受傷した。BMLは30.8で左膝に可動域制限は認められなかったが、MRI上ではACL、MCL、後内側線維束(PCL)の損傷がみられ、再建ACLとMCLの再損傷、PCLの損傷と診断された。治療として鏡視下複合靱帯再建術を施行し、移植腱はACLに健側BTB、MCLに患側腸脛靱帯、PCL(後内側線維束)に健側薄筋を使用した。その結果、術後8日目にD-ダイマー値の軽度上昇が確認され、術後10日目の造影CTにて両側肺動脈中枢に巨大血栓と健側膝窩静脈に血栓が認められた。無症候性両側肺塞栓症(PE)および片側深部静脈血栓症(DVT)の診断で循環器内科へコンサルトとしたが、肺血流シンチでは右上肺野の血流低下が認められるも厳重な内科的全身管理と抗凝固療法で、経過中、造影CT上でDVTは消失、PEの縮小も認められた。以後、患者は部分荷重、CPM等のリハビリを開始し、術後6ヵ月で造影CT上でPEは消失、現在は無症状で外来経過観察中である。

  • BMPを用いた骨再生治療研究の現状と展望

    寺井 秀富, 中村 博亮, 高岡 邦夫

    整形・災害外科 = Orthopaedic surgery and traumatology   56 ( 5 )   643 - 649   2013.04( ISSN:03874095

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  • Revision cases of operative treatment of discoid lateral meniscus : A report of 3 cases Reviewed

    HASHIMOTO Yusuke

    38 ( 1 )   172 - 173   2013.03( ISSN:18848842

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  • Morphological change of juvenile discoid meniscus after surgical treatment of saucerization with repair Reviewed

    HASHIMOTO Yusuke

    38 ( 1 )   170 - 171   2013.03( ISSN:18848842

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  • MRI and clinical assessment of the contralateral knee with symptomatic discoid lateral meniscus Reviewed

    TAKIGAMI Junsei

    38 ( 1 )   156 - 157   2013.03( ISSN:18848842

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  • The clinical results of saucerization only versus saucerization and repair for discoid lateral meniscus in young patients Reviewed

    YAMASAKI Shinya

    38 ( 1 )   168 - 169   2013.03( ISSN:18848842

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  • Evaluation of a New Spino-pelvic Fixation (Sacral-alar-iliac Fixation) Technique for Severe Degenerative Thoracolumbar Kyphoscoliosis

    48 ( 3 )   253 - 259   2013.03( ISSN:05570433 ( eISSN:18821286

  • Characteristics of Diabetes Associated With Poor Improvements in Clinical Outcomes After Lumbar Spine Surgery Reviewed

    TAKAHASHI Shinji, SUZUKI Akinobu, TOYODA Hiromitsu, TERAI Hidetomi, DOHZONO Sho, YAMADA Kentarou, MATSUMOTO Tomiya, YASUDA Hiroyuki, TSUKIYAMA Kuniaki, SHINOHARA Yoshikazu, IBRAHIM Mohammad, NAKAMURA Hiroaki

    Spine   38 ( 6 )   516 - 522   2013.03( ISSN:03622436

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  • Characteristics of Diabetes Associated With Poor Improvements in Clinical Outcomes After Lumbar Spine Surgery Reviewed

    Takahashi Shinji, Suzuki Akinobu, Toyoda Hiromitsu, Terai Hidetomi, Dohzono Sho, Yamada Kentarou, Matsumoto Tomiya, Yasuda Hiroyuki, Tsukiyama Kuniaki, Shinohara Yoshikazu, Ibrahim Mohammad, Nakamura Hiroaki

    SPINE   38 ( 6 )   516 - 522   2013.03( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e318273583a

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  • Seven cases of intraosseous lipoma of the calcaneus Reviewed

    TAKADA Jun

    56 ( 2 )   351 - 352   2013.03( ISSN:00089443

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  • 円板状半月手術後再手術に至った症例検討

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   38 ( 1 )   172 - 173   2013.03( ISSN:1884-8842

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    症例1(13歳男性)。左膝ロッキングを主訴とした。術前MRIでは半月板は顆間に陥頓し、後方成分は消失しているAhn分類のantero-central typeであった。半月板亜全摘を施行し、中後節の半月板を残存させた。術後3年半経過で再度ロッキングが出現し、MRIにて半月板のflap損傷がみられたため再手術を施行、残存半月を整復し、fast fixを用いて6針縫合が行われた。症例2(16歳男性)。左膝腫脹と不安定感を主訴とした。術前MRIでは完全円板状半月のAhn分類はno shift typeであった。半月板形成術が施行されたが、術後1年目のMRIにて半月板の内部変性がみられた。術後2年目に引っかかり感と腫脹が出現し、MRIで半月板のflap損傷が認められため、再手術にて半月板亜全摘が行われた。症例3(9歳男児)。左膝の引っかかり感を主訴とした。術前MRIでは半月板は顆間に移動しており、後方成分は消失しているAhn分類のantero-central typeであった。半月板形成を施行し、不安定部分後節をin-side out法にて7針縫合した。更に術後3週目に深屈曲矯正が行われたが、術後1年半でclickと疼痛が認められ、関節造影MRIで外側半月後節癒合不全が示唆されたため、再手術が施行された。その結果、術中に縫合糸のゆるみと半月板不安定性があり、再度inside out法にて10針縫合が行われた。

  • 踵骨に発生した骨内脂肪腫の7例

    高田 潤, 星 学, 大戎 直人, 家口 尚, 青野 勝成, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 2 )   351 - 352   2013.03( ISSN:0008-9443

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    加療を行った踵骨発生の骨内脂肪腫7例(男4例、女3例、平均42.1歳)について報告した。病変は5例が疼痛をきっかけに、2例は偶発的に指摘され、患側は右5例、左2例で、全例踵骨三角部に認めた。MRIのT1・T2強調画像では病巣内部が高信号で脂肪抑制され、骨内脂肪腫と診断した。治療は5例に対して掻爬・人工骨移植を施行し、2例は保存的に経過観察した。手術例では病理所見で骨内脂肪腫が確認され、術後再発はなかった。画像所見の特徴としては、6例でX線またはCTで内部の石灰化・骨化がみられ、MRIでも症例によって内部壊死、石灰化・骨化、嚢胞変性の所見が認められた。Milagram分類では1例がstage I、4例がstage II、2例がstage IIIに相当すると考えられた。疼痛のあった2例では、MRIで脂肪腫の後方の踵骨骨髄内を中心に、骨髄浮腫を疑わせるT2強調画像高信号の領域の広がりが認められた。

  • 若年者円板状半月損傷に対する半月形成と縫合併用手術後MRIの経時的変化

    橋本 祐介, 山崎 真哉, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   38 ( 1 )   170 - 171   2013.03( ISSN:1884-8842

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    2007年〜2011年に円板状半月に対して半月形成+後節縫合術を施行し、経時的にMRIを撮像した4症例(平均10歳、男児3例、女児1例)を対象に検討した。手術方法は半月板辺縁を6〜8mm残存させ、水平断裂ごとにinside out法にて平均8針縫合した。MRIは術前、術後3、6、12ヵ月に撮影し、内部変化をMinkの分類、半月損傷部位をAhn分類を用いて評価した。その結果、全例がcomplete discoidで、術中には残存半月の水平断裂が認められた。また、術後3ヵ月のMRIで残存半月板は前後節ともに鈍化した三角となり、術後経過にしたがい鋭な三角となった。尚、Mink分類では術後3ヵ月で3例がgrade 2となり、術後1年でgrade 1が3例、grade 0が1例と、術後1年でほぼ正常に近い半月板へと形成されていた。

  • 有症状外側円板状半月患者の対側膝における症状とMRI画像評価

    瀧上 順誠, 橋本 祐介, 山崎 真哉, 寺井 彰三郎, 中村 博亮

    JOSKAS   38 ( 1 )   156 - 157   2013.03( ISSN:1884-8842

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    有症状の外側円板状半月患者13名(男性7例、女性6例、平均11.8歳)を対象に、対側膝における症状およびMRI画像評価について検討した。その結果、1)全例に対側膝の円板状半月が認められ、12例が完全型円板状半月坂で、1例が不完全型円板状半月板であった。2)対側膝における半月板Shiftは認められなかったが、5例にMink grade 2がみられ、また5例中3例は疼痛が認められた。そのため半月板形成切除が行われた。3)対側膝の有症状患者は7例で、疼痛を有する患者は4例であった。以上、これらの結果により、半月板内部変性を認め疼痛があれば、断裂やshiftを認めない場合も、後日手術に至るケースがあると考えられた。

  • 手術手技/私のくふう Cobb角40°以上の胸腰椎・腰椎変性後側彎症に対する矯正固定術における新しいアンカー(sacral-alar-iliac fixation)

    加藤 相勲, 小西 定彦, 松村 昭, 林 和憲, 玉井 孝司, 新谷 康介, 香月 憲一, 中村 博亮

    臨床整形外科   48 ( 3 )   253 - 259   2013.03( ISSN:0557-0433

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    背景:仙椎から仙腸関節を貫通させ遠位部を腸骨とする新しいスクリュー固定方法(sacral-alar-iliac fixation:以下,SAIF)が成人脊柱変形例に対する後方矯正固定手術において有用であるかを検討した.対象と方法:Cobb角40°以上の胸腰椎・腰椎変性後側彎症6例を対象とした.術前後の臨床成績,骨癒合,矯正率を検討した.結果:JOAスコアは術前11.3点,最終診察時21点(改善率54.9%)であった.全例,腰仙椎間の骨癒合が得られ,皮膚トラブルはなかった.Cobb角の矯正率は68.1%で良好であった.まとめ:SAIFは重度脊柱変形に対する矯正固定術における有用な遠位部アンカーである.(著者抄録)

  • 当院における若年齢外側円板状半月に対する形成術と追加縫合術の手術成績比較検討

    山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   38 ( 1 )   168 - 169   2013.03( ISSN:1884-8842

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    外側円板状半月の診断にて手術を施行した16名19膝を対象として、形成術および追加縫合術の短期成績について報告した。形成術のみ施行したのは8名9膝群(男6名、女2名、平均12.7歳:形成群)、形成術に縫合術を併用したのは10名10膝(男4名、女性6名、平均11.3歳:縫合群)であった。両群とも全例で疼痛が認められ、縫合群のうち5例で特有のclunkが認められた。術中所見では形成群は全例完全型であり、うち中心性の損傷が3例で確認された。縫合群も全例、完全型であり、損傷部位は前節4例、中〜後節8例であった。Lysholm scoreは形成群は術前平均73.4から術後平均97.2点へと改善し、縫合群は術前平均58.7から術後平均94.4点へと改善していた。再手術症例は各群1例ずつあったが、形成群の1例は形成不足による余剰半月のflap断裂を部分切除し、最終Lysholm scoreは94点へと改善した。一方、縫合群の1例は縫合部の治癒不全で、再縫合にて最終Lysholmが95点へと改善した。

  • Prognostic factors for patients with solitary bone metastasis Reviewed

    HOSHI Manabu, TAKADA Jun, IEGUCHI Makoto, TAKAHASHI Shinji, NAKAMURA Hiroaki

    International journal of clinical oncology   18 ( 1 )   164 - 169   2013.02( ISSN:13419625

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  • Prognostic factors for patients with solitary bone metastasis Reviewed

    Hoshi Manabu, Takada Jun, Ieguchi Makoto, Takahashi Shinji, Nakamura Hiroaki

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   18 ( 1 )   164 - 169   2013.02( ISSN:1341-9625

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    DOI: 10.1007/s10147-011-0359-3

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  • 孤発性骨転移患者の予後因子(Prognostic factors for patients with solitary bone metastasis)

    Hoshi Manabu, Takada Jun, Ieguchi Makoto, Takahashi Shinji, Nakamura Hiroaki

    International Journal of Clinical Oncology   18 ( 1 )   164 - 169   2013.02( ISSN:1341-9625

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    1994年3月〜2011年3月の間に治療を行った孤発性骨転移(内臓転移がない骨転移例)の42症例(男性25例、女性17例、年齢41〜82歳)を対象として、生存率と予後因子を評価した。平均経過観察期間は21.2ヵ月(0.4〜127.3ヵ月)であり、原発巣に対する治療法は手術17例、化学療法16例、放射線療法4例であった。20例に原発癌が存在しており、6例に病的骨折が認められた。生存の影響因子は単変量・多変量解析により決定した結果、1年生存率は76.5%、生存期間中央値は30.0ヵ月であった。Cox回帰分析の結果においては、原発癌の存在とパフォーマンスステータス不良が独立予後因子であることが確認されたが、腫瘍切除と手術断端においては生存との関連性は認められなかった。

  • 新しい断層技術、トモシンセシスを使用したTKAの金属周囲の微小骨欠損の検出

    箕田 行秀, Iwaki Hiroyoshi, Yoshida Taku, Ikebuchi Mitsuhiko, Mizokawa Shigekazu, Inori Fumiaki, Itokazu Maki, Maki Takatoshi, Sugimoto Kazutaka, Baba Shingo, Kasai Akira, Nakamura Hiroaki

    MEDICAL NOW   ( 73 )   16 - 17   2013.02( ISSN:0916-8745

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    6個のセメント大腿骨コンポーネントを豚の大腿骨に設置した。2個は通常のセメント法で設置(標準モデル)、2個は骨嚢胞による骨欠損(0.7立方cm)を摸擬して設置(骨融解モデル)、2個はセメントと骨の間に2mmの欠損を作成して設置(骨透亮像モデル)し、骨病変を摸擬した部分には空気によるアーチファクトを避けるためアガロースゲルを封入した。各検体を4方向から単純X線画像を撮影し、断層撮影(トモシンセシス)では74フレームを撮影して自動的に画像を再構成し、内顆と外顆のファイルを作成した。単純X線画像では骨欠損は一切検出できず、感度、特異度とも0%であった。トモシンセシスでの感度/特異度は、標準モデルで90.5%/74.4%、骨融解モデルで81.3%/100%、骨透亮像モデルで85.4%/87.2%であった。トモシンセシスはTKAの大腿骨コンポーネント周囲における傍金属の早期の小さな骨欠損検出に有用と考えられた。

  • Successful management for infection of tumor prosthesis in proximal femur Reviewed

    HOSHI Manabu

    56 ( 1 )   163 - 164   2013.01( ISSN:00089443

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  • Changes in serum creatine phosphokinase after interlaminar fenestration by partial spinous process splitting approach for lumbar spinal canal stenosis Reviewed

    SEKI Masahiko

    56 ( 1 )   65 - 66   2013.01( ISSN:00089443

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  • Transsacral interbody fusion for high-grade spondylolisthesis with cylindrical cage Reviewed

    TERAKAWA Masaki

    56 ( 1 )   103 - 104   2013.01( ISSN:00089443

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  • Evaluation of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease Reviewed

    KATO Minori

    56 ( 1 )   57 - 58   2013.01( ISSN:00089443

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  • Treatment of retro-odontoid pseudotumor associated with non-rheumatoid atlantaxial instability : 3 cases Reviewed

    OZAKI Tomonori

    56 ( 1 )   119 - 120   2013.01( ISSN:00089443

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  • 腫瘍用人工関節置換術後感染の1例

    星 学, 大戎 直人, 家口 尚, 高田 潤, 高見 勝次, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 1 )   163 - 164   2013.01( ISSN:0008-9443

  • 腰部脊柱管狭窄症に対する棘突起部分的縦割式椎弓間開窓術における血中CPK値について

    関 昌彦, 辻尾 唯雄, 星野 雅俊, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 1 )   65 - 66   2013.01( ISSN:0008-9443

  • 軸椎歯突起後方偽腫瘍に対し手術加療を行った超高齢者の2例

    尾崎 友則, 堂園 将, 寺井 秀富, 豊田 宏光, 松本 富哉, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 1 )   119 - 120   2013.01( ISSN:0008-9443

  • 顕微鏡視下片側進入両側除圧術後に生じた腰椎椎間関節嚢腫の検討

    加藤 相勲, 小西 定彦, 松村 昭, 林 和憲, 香月 憲一, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 1 )   57 - 58   2013.01( ISSN:0008-9443

  • 高度(第5)腰椎分離すべり症に対して経仙骨的椎間固定を行った1例

    寺川 雅基, 堂園 将, 豊田 宏光, 寺井 秀富, 中村 博亮

    中部日本整形外科災害外科学会雑誌   56 ( 1 )   103 - 104   2013.01( ISSN:0008-9443

  • Arthroscopic treatment for septic arthritis of the shoulder Reviewed

    Matsumoto Isshin, Ito Yoichi, Manaka Tomaya, Ichikawa Koichi, Hirakawa Yoshihiro, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   37 ( 2 )   829 - 832   2013( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> Septic arthritis of the shoulder is thought to be difficult to treat, though current shoulder arthroscopic surgery has brought possible good operative options for the treatment of this disease. The aim of this study was to evaluate postoperative clinical results of the arthroscopic treatment for septic arthritis of the shoulder.<BR><B>Methods:</B> We retrospectively evaluated 12 shoulders in 12 consecutive patients with septic arthritis of the shoulder who had arthroscopic shoulder surgeries. Average age at the surgery was 63.0 years. We performed arthroscopic irrigation, debridement, synovectomy and followed by continuous irrigation with drainage in the septic shoulders. Clinical evaluation was composed of 1: basic disease, 2: supposed infection process, 3: identified bacteria, 4: time between symptom and surgery, 5: number of times of surgery, 6: number of times of continuous irrigation with drainage, 7: time between surgery and complete cure, 8: final shoulder functions.<BR><B>Results:</B> 1: two cases of diabetes, one case of dialysis, 1 one case of SLE, two cases of liver dysfunction 2: eight cases of blood induced, 2 four cases of injection induced 3: five cases of MRSA, three cases of MSSA, one case of Pseudomonas aeruginosa, one case of Neisseria species, one case of Staphylococcus haemolyticus 4: two cases of acute phase within 2 weeks, ten cases of sub acute phase 5: eight cases of single surgery, four cases of twice, 6: seven cases of single continuous irrigation with drainage, four cases of twice 7: complete cure was obtained in cases at postoperative 35.6 days in average; two cases were dead because of 10 sepsis, 8: good shoulder functions were obtained in six cases, poor functions in four cases.<BR><B>Conclusion:</B> Postoperative clinical results of the arthroscopic treatment for septic arthritis of the shoulder were relatively acceptable, though further improvement might be necessary in the cases of poor postoperative shoulder functions.

    DOI: 10.11296/katakansetsu.37.829

    CiNii Article

  • Successful management for infection of tumor prosthesis in proximal femur Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 1 )   163 - 164   2013( ISSN:0008-9443

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    DOI: 10.11359/chubu.2013.163

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  • Significance of Shoulder evaluation sheet Shoulder 36 Reviewed

    Hirakawa Yoshihiro, Ito Yoichi, Ichikawa Koichi, Matsumoto Isshin, Manaka Tomoya, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   37 ( 3 )   941 - 944   2013( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> The Japanese Orthopaedic Association (JOA) shoulder scoring system (JOA score) has been used of clinical evaluation for shoulder disease. Currently Shoulder evaluation sheet Shoulder 36 (Sh36) has been introduced as a new evaluation system, though the differences and similarities between these two clinical evaluations is not well known. The purpose of this study was to evaluate correlations between Sh36 and JOA score; assess clinical significance in Sh36.<BR><B>Methods:</B> We evaluated 40 shoulders in 40 consecutive patients (18 male, 22 female) who had arthroscopic shoulder surgeries. Average age at the surgery was 59.0 years. Forty shoulders were divided into 3 disease groups: 22 cases of impingement syndrome, 11 cases of rotator cuff tears and 7 cases of stiff shoulders. Preoperative clinical evaluation was performed with both Sh36 and JOA score; correlations between domains, disease groups and gender in the two clinical evaluations were statistically evaluated.<BR><B>Results:</B> Each domain (Pain, ROM, Muscle strength, General health and ADL) has significant correlation between Sh36 and JOA score. A relatively weak correlation was observed at ROM domain in all three disease groups. Pain, Total and ADL scores have significant correlations in male patients. Pain, Muscle strength and ADL scores have significant correlations in female patients.<BR><B>Conclusion:</B> Significant correlations between Sh36 and JOA score were observed except for ROM domain; Sh36 was recognized as a clinically useful evaluation system.

    DOI: 10.11296/katakansetsu.37.941

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  • Transsacral interbody fusion for high-grade spondylolisthesis with cylindrical cage Reviewed

    TERAKAWA Masaki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 1 )   103 - 104   2013( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2013.103

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  • A case of patient with sarcoma, introduced from otolaryngology Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 6 )   1433 - 1434   2013( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2013.1433

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  • Treatment of retro-odontoid pseudotumor associated with non-rheumatoid atlantaxial instability: 3 cases Reviewed

    OZAKI Tomonori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 1 )   119 - 120   2013( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2013.119

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  • Seven cases of intraosseous lipoma of the calcaneus Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 2 )   351 - 352   2013( ISSN:0008-9443

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    DOI: 10.11359/chubu.2013.351

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  • Clinical outcome of microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease with more over 5 degrees scoliotic disc wedging

    HAYASHI Kazunori

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   56 ( 4 )   803 - 804   2013( ISSN:00089443 ( eISSN:13490885

  • 末梢神経の再生医療 生体吸収性人工神経を用いたiPS cell- & bFGF drug-delivery systemの有効性 Reviewed

    上村 卓也, 高松 聖仁, 岡田 充弘, 中村 博亮

    末梢神経   24(1)   90 - 98   2013

  • 骨粗鬆症性椎体骨折後偽関節に対する内視鏡併用椎体形成術 Reviewed

    中村 博亮

    Monthly Orthopaedics   26(3)   7 - 13   2013

  • BMPを用いた骨再生治療研究の現状と展望 Reviewed

    中村 博亮

    整形・災害外科   56(5)   643 - 649   2013

  • Diagnostic imaging and pathogenesis of the traumatic intratumoural haemorrhage of schwannoma causing acute high radial nerve palsy: case report Reviewed

    Okada Mitsuhiro, Takada Jun, Ohsawa Masahiko, Nakamura Hiroaki

    BRITISH JOURNAL OF NEUROSURGERY   26 ( 6 )   907 - 908   2012.12( ISSN:0268-8697

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    DOI: 10.3109/02688697.2012.685784

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  • Conventional or navigated total knee arthroplasty affects sagittal component alignment Reviewed

    Sugama Ryo, Minoda Yukihide, Kobayashi Akio, Iwaki Hiroyoshi, Ikebuchi Mitsuhiko, Takaoka Kunio, Nakamura Hiroaki

    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY   20 ( 12 )   2454 - 2459   2012.12( ISSN:0942-2056

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    DOI: 10.1007/s00167-012-1889-6

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  • Comparison of joint destruction between standard- and low-dose etanercept in rheumatoid arthritis from the Prevention of Cartilage Destruction by Etanercept (PRECEPT) study. Reviewed

    Masahiro Tada, Tatsuya Koike, Tadashi Okano, Yuko Sugioka, Shigeyuki Wakitani, Kenzo Fukushima, Akira Sakawa, Kazunori Uehara, Kentaro Inui, Hiroaki Nakamura

    Rheumatology (Oxford, England)   51 ( 12 )   2164 - 2169   2012.12( ISSN:1462-0324

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    OBJECTIVE: To evaluate the prevention of joint destruction and clinical efficacy of low-dose etanercept (ETN) (25 mg/week) compared with standard-dose ETN (50 mg/week) in RA. METHODS: In this prospective, randomized, open-label study, 70 patients were assigned to receive ETN at either 50 or 25 mg/week for 52 weeks. The primary endpoint was the variation in modified total Sharp score (mTSS), and secondary endpoints were variations in disease activity score in 28 joints (DAS-28), modified HAQ and adverse event rate. Values of mTSS were calculated at baseline and after 52 weeks. Non-progression was estimated as ΔmTSS ≤0.5, and the non-progression rate was compared between groups. RESULTS: Mean values at baseline were as follows: disease duration 9.2 years; DAS-28 5.45; and annual progression of mTSS 26.1. No significant differences in background were seen between groups. At 52 weeks, the non-progression rate was significantly less in the 25 mg/week group (36.7%) than in the 50 mg/week group (67.7%) (P = 0.041). Mean ΔmTSS was higher at 25 mg/week (1.03) than at 50 mg/week (-0.13). DAS-28 was significantly improved at 4 weeks, and the effect of treatment lasted for 52 weeks in both groups. No differences in adverse event rates were seen between groups. CONCLUSION: Low-dose ETN is not inferior to standard-dose ETN in terms of effects on clinical manifestations. However, in terms of the radiographic non-progression rate, the effects of low-dose ETN may be inferior to the effects of standard-dose ETN. TRIAL REGISTRATION: UMIN Clinical Trials Registry, http://www.umin.ac.jp/ctr/, UMIN000001798.

    DOI: 10.1093/rheumatology/kes188

    PubMed

  • The flexion gap preparation does not disturb the modified gap technique in posterior stabilized total knee arthroplasty. Reviewed

    Yukihide Minoda, Hiroyoshi Iwaki, Mitsuhiko Ikebuchi, Taku Yoshida, Hiroaki Nakamura

    The Knee   19 ( 6 )   832 - 835   2012.12( ISSN:0968-0160

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    PURPOSE: Preparation of the flexion gap (resection of the posterior femoral condyle and removal of the osteophytes on the posterior aspect of the femur to re-establish the posterior capsular recess) during modified gap technique might change the soft-tissue balancing and disturb the preparation of equal and rectangular extension and flexion joint gaps. The purpose of this study was to measure the change in the extension and flexion gaps using tension device during posterior stabilized TKA with modified gap technique. METHODS: We examined changes in the extension gap and flexion gap during posterior stabilized TKA using modified gap technique in 100 consecutive varus osteoarthritis knees. The extension gap was first prepared and then the distance and angle of both extension and flexion gaps were measured before and after preparation of the flexion gap using a tension device. RESULTS: Although both the extension and flexion gaps significantly increased during the operation, the amount of the increase was very small, and the difference between the increase in the extension gap (0.9 ± 0.1mm [mean ± SE]) and that in the flexion gap (0.7 ± 0.1mm) was not statistically significant. Mean angular changes in extension and flexion gaps during the operation were less than 1°. CONCLUSIONS: The preparation of the flexion gap in posterior stabilized TKA did not disturb the modified gap technique in terms of equal and rectangular extension and flexion gaps.

    DOI: 10.1016/j.knee.2012.03.007

    PubMed

  • THA MIS MIS-THAにおけるOCMとDAAの比較

    槇 孝俊, 岩城 啓好, 池渕 充彦, 箕田 行秀, 吉田 拓, 山崎 真哉, 瀧上 順誠, 中村 博亮

    日本人工関節学会誌   42   333 - 334   2012.12( ISSN:1345-7608

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    MIS-THAをOCM(Modified Watson Jones approach)で行った54例とDAA(Direct anterior approach)で行った39例の成績を群間比較した。比較項目は「手術時間」「皮切長」「術中出血量」「総出血量」「術後CK・CRP値」「術後歩行開始時期」「術後入院期間」「術後の外転・伸展筋力回復率」「ステム設置角」「カップ設置角」「術後脚長差」「術後合併症」などとした。手術時間はOCM群が有意に短かった。術後の伸展筋力回復率は、術後3日目・7日目にはOCM群が有意に高かったが、14日目には有意差を認めなかった。カップ設置角はOCM群でoutlierの割合が有意に高かった。術後合併症はOCM群で静脈血栓塞栓症の発生率が有意に高かった。他の項目に有意な群間差は認めなかった。

  • TKA周術期 人工膝関節置換術におけるトラネキサム酸の有効性の検討

    西田 洋平, 池渕 充彦, 岩城 啓好, 箕田 行秀, 橋本 祐介, 吉田 拓, 山崎 真哉, 瀧上 順誠, 中村 博亮

    日本人工関節学会誌   42   693 - 694   2012.12( ISSN:1345-7608

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    人工膝関節置換術(TKA)におけるトラネキサム酸の有効性について検討した。変形性膝関節症に対しタニケット下にPrimary TKAを施行した121例134関節を対象とした。トラネキサム酸を使用しなかった群(NTA群)とトラネキサム酸を使用した群(TA群)に分けた。返血を施行した症例数はTA群が78例中12例、NTA群が56例中51例で、両群間に有意差を認めた。返血量、ドレーン吸引量、術後推定出血量はTA群で有意に少なかった。深部静脈血栓症は、TA群で造影MDCTを施行した68例中11例、NTA群では30例中9例に認めたが、両群間で有意差はなく、全例無症候性であった。返血を施行しなかったと仮定した場合の術翌日の推定Hb値はTA群で有意に高く、また推定Ht値はTA群で有意に高値を認めた。推定Hb値が7g/dl以下となった症例数はTA群では存在せず、NTA群では4例であった。

  • 周術期 人工股関節全置換術におけるトラネキサム酸の有効性

    南 義人, 池渕 充彦, 岩城 啓好, 箕田 行秀, 吉田 拓, 羅 建華, 中村 博亮

    日本人工関節学会誌   42   773 - 774   2012.12( ISSN:1345-7608

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    2009年3月〜2011年4月の間に2次性変形性股関節症に対して初回人工股関節全置換術(THA)を施行した110例110関節を対象に、トラネキサム酸(TA)を投与したTA群51例(男性12例、女性39例、平均年齢62.0歳)とTA非投与のNTA群59例(男性12例、女性47例、平均年齢63.7歳)の、これら2群間におけるTAの有効性と自己血輸血の必要性について検討した。執刀15分前に1回1gのTAを静脈内投与した結果、1)ヘモグロビン値の推移は術前・術翌日・術後6日において両群間に有意差は認められなかった。だが、洗浄式自己血輸血量はTA群58ml、NTA群127ml、総輸血量はTA群79ml、NTA群311mlとTA群で有意に軽減していた。2)術後6日の造影MDCTで診断されたVTE発生数はTA群2例、NTA群0例で、両群間に有意差はなかった。尚、VTEを認めた2例は無症候性であったが、洗浄回収式自己血輸血が完全に不要であるとの結果は得られなかった。以上より、初回THAにおいてTAの投与は有用と考えられた。

  • Overexpression of hexokinase-2 in giant cell tumor of bone is associated with false positive in bone tumor on FDG-PET/CT Reviewed

    Hoshi Manabu, Takada Jun, Oebisu Naoto, Hata Kanako, Ieguchi Makoto, Nakamura Hiroaki

    ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY   132 ( 11 )   1561 - 1568   2012.11( ISSN:0936-8051

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    DOI: 10.1007/s00402-012-1588-2

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  • Pronounced risk of nontraumatic osteonecrosis of the femoral head among cigarette smokers who have never used oral corticosteroids: a multicenter case-control study in Japan Reviewed

    Takahashi Shinji, Fukushima Wakaba, Kubo Toshikazu, Iwamoto Yukihide, Hirota Yoshio, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   17 ( 6 )   730 - 736   2012.11( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00776-012-0293-x

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  • 経口コルチコステロイド剤を使用した経験のない喫煙者における大腿骨頭非外傷性骨壊死の顕著なリスク 日本における多施設共同症例対照研究(Pronounced risk of nontraumatic osteonecrosis of the femoral head among cigarette smokers who have never used oral corticosteroids: a multicenter case-control study in Japan)

    Takahashi Shinji, Fukushima Wakaba, Kubo Toshikazu, Iwamoto Yukihide, Hirota Yoshio, Nakamura Hiroaki

    Journal of Orthopaedic Science   17 ( 6 )   730 - 736   2012.11( ISSN:0949-2658

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    喫煙の影響、コルチコステロイド剤使用との相互作用について、多施設共同症例対象研究により検討した。それぞれの症例に一致させた対照を大腿骨頭壊死(ONFH)を有しない患者から選択した。一致させた条件は、性別、年齢、民族であった。ロジスティック回帰モデルを使用して、オッズ比(OR)および95%信頼区間(95% CI)を計算した。症例72例を一致させた対照244例と比較した。ORは、現喫煙者に対しては3.89、1日に20本超の喫煙者に対しては3.89、26箱年以上の喫煙者に対しては4.26、29年以上の喫煙歴を有する喫煙者に対しては3.11であり、有意なまたはわずかに有意な用量反応関係が示された。現喫煙者のORは、コルチコステロイド剤を使用した経験のない患者では10.3であり、以前または現コルチコステロイド剤使用者では1.56であった。より大量の喫煙はONFHの高リスクと関連した。喫煙によるリスク上昇は、経口コルチコステロイド剤を使用した経験のない喫煙者において、顕著に大きかった。

  • 卒後研修講座 骨粗鬆症性椎体骨折の治療戦略

    豊田 宏光, 中村 博亮

    整形外科   63 ( 11 )   1189 - 1196   2012.10( ISSN:00305901 ( eISSN:24329444

  • Power Doppler Signal Is Frequently Positive Among Patients with Rheumatoid Arthritis in Clinical Remission and Normal Serum Matrix Metalloproteinase-3 (MMP-3) Levels Reviewed

    Okano Tadashi, Koike Tatsuya, Tada Masahiro, Mamoto Kenji, Sugioka Yuko, Kamiyama Atsuko, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   64 ( 10 )   S50 - S50   2012.10( ISSN:0004-3591

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  • Radiographic Deformity of the Foot Is Starting From the Early Stage of Rheumatoid Arthritis. Reviewed

    Mamoto Kenji, Koike Tatsuya, Okano Tadashi, Kamiyama Atsuko, Sugioka Yuko, Tada Masahiro, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   64 ( 10 )   S437 - S438   2012.10( ISSN:0004-3591

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  • Risk of Falling Is Equivalent Between Patients with Rheumatoid Arthritis and Healthy Individuals-the Tomorrow Study Reviewed

    Mamoto Kenji, Koike Tatsuya, Okano Tadashi, Kamiyama Atsuko, Sugioka Yuko, Tada Masahiro, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   64 ( 10 )   S843 - S844   2012.10( ISSN:0004-3591

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  • Risk Factors for Vertebral Fractures in Patients with Rheumatoid Arthritis - the Tomorrow Study - Reviewed

    Okano Tadashi, Koike Tatsuya, Tada Masahiro, Mamoto Kenji, Sugioka Yuko, Kamiyama Atsuko, Nakamura Hiroaki

    ARTHRITIS AND RHEUMATISM   64 ( 10 )   S843 - S843   2012.10( ISSN:0004-3591

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  • Wearable加速度計を用いた三次元的な歩行時重心動揺評価

    池渕 充彦, 岩城 啓好, 中村 博亮, 中土 保, 加藤 良一, 赤松 波子, 今久保 伸二, 中島 重義

    臨床バイオメカニクス   33   433 - 438   2012.10( ISSN:1884-5274

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    離散フーリエ変換を用いた歩行時重心動揺の三次元的評価手法を開発し、その正確性を検討した。ボランティアの健常男性10例25Trialを対象とした。wearable加速度計による各軸方向の最大振幅は、Lateral方向18.7±6.0mm、Forward-Back方向11.7±2.8mm、Vertical方向13.1±3.8mmで、VICONによる各軸方向の最大振幅は、Lateral方向25.9±5.8mm、Forward-Back方向12.8±5.7mm、Vertical方向14.9±3.6mmであった。Pearsonの相関係数は、Lateral方向、Forward-Back方向、Vertical方向で強い相関関係を認めた。第1ピーク周波数から算出したStride timeは、wearable加速度計において1.05±0.04秒、VICONにおいて1.06±0.06秒で強い相関関係を認めた。

  • Prognosis of single bone metastasis Reviewed

    HOSHI Manabu

    55 ( 5 )   979 - 980   2012.09( ISSN:00089443

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  • Single-bone forearm reconstruction for musculoskeletal tumors Reviewed

    OEBISU Naoto

    55 ( 5 )   1041 - 1042   2012.09( ISSN:00089443

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  • Malignant peripheral nerve sheath tumors (MPNST) of the brachial plexus : Report of three cases Reviewed

    TAKADA Jun

    55 ( 5 )   1153 - 1154   2012.09( ISSN:00089443

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  • Proteomic analysis of cyst fluid of simple bone cysts : A comparative study between long bone cysts and calcaneal cysts Reviewed

    TAKADA Jun

    55 ( 5 )   1169 - 1170   2012.09( ISSN:00089443

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  • Usefulness of FDG-PET for bone tumors Reviewed

    HOSHI Manabu

    55 ( 5 )   1059 - 1060   2012.09( ISSN:00089443

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  • Proteomic analysis of cyst fluid of simple bone cysts : A comparative study between long bone cysts and calcaneal cysts

    TAKADA Jun

    55 ( 5 )   1169 - 1170   2012.09( ISSN:00089443

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  • Acquired leptin resistance by high-fat feeding reduces inflammation from collagen antibody-induced arthritis in mice. Reviewed

    Sugioka Y, Tada M, Okano T, Nakamura H, Koike T

    Clinical and experimental rheumatology   30 ( 5 )   707 - 13   2012.09( ISSN:0392-856X

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  • Intraosseous schwannoma of the proximal femur. Reviewed

    Manabu Hoshi, Jun Takada, Naoto Oebisu, Hiroaki Nakamura

    Asia-Pacific journal of clinical oncology   8 ( 3 )   E29 - E33   2012.09( ISSN:1743-7555

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    A schwannoma is a benign nerve sheath tumor commonly located in soft tissue. An intraosseous schwannoma is very rare, and only four cases involving the femur were found in a review of the English-language medical literature. We present a rare case of a schwannoma with well-defined, lytic, dumbbell-shaped and benign-appearing lesions of the proximal femur.

    DOI: 10.1111/j.1743-7563.2012.01539.x

    PubMed

  • Radiation Therapy without Surgery for Spinal Metastases: Clinical Outcome and Prognostic Factors Analysis for Pain Control. Reviewed

    Akira Matsumura, Manabu Hoshi, Masatsugu Takami, Takahiko Tashiro, Hiroaki Nakamura

    Global spine journal   2 ( 3 )   137 - 42   2012.09( ISSN:2192-5682

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    The purpose of radiation therapy (RT) for patients with spinal metastases is pain relief and control of paralysis. The aim of the present study was to assess pain relief using RT and to evaluate prognostic factors for pain control. We evaluated 97 consecutive patients, of mean age 62.7 years (range 28 to 86), with spinal metastases that had been treated by RT. We evaluated the effects of RT using pain level assessed using a drug grading scale based on the World Health Organization standards. The following potential prognostic factors for pain control of RT were evaluated using multivariate logistic regression analysis: age, gender, tumor type, performance status (PS), number of spinal metastases, and a history of chemotherapy. Among the 97 patients who underwent RT for pain relief, 68 patients (70.1%) presented with pain reduction. PS (odds ratio: 1.931; 95% confidence interval: 1.244 to 2.980) was revealed by multivariate logistic regression analysis to be the most important prognostic factor for pain control using RT. In conclusion, we found that RT was more effective for patients with spinal metastases while they maintained their PS.

    DOI: 10.1055/s-0032-1326948

    PubMed

  • Acquired leptin resistance by high-fat feeding reduces inflammation from collagen antibody-induced arthritis in mice.

    Sugioka Y, Tada M, Okano T, Nakamura H, Koike T

    Clinical and experimental rheumatology   30 ( 5 )   707 - 13   2012.09( ISSN:0392-856X

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  • Single-bone forearm reconstructionを用いた前腕軟部腫瘍の2例

    大戎 直人, 星 学, 高田 潤, 中村 博亮

    中部日本整形外科災害外科学会雑誌   55 ( 5 )   1041 - 1042   2012.09( ISSN:0008-9443

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    症例1(26歳男性)。左前腕軟部腫瘍を主訴に針生検にて類上皮肉腫と診断された。術前抗癌剤治療5コースの後に腫瘍広範切除術を施行し、再建にはsingle-bone forearm、伸筋腱再建、大腿外側遊離皮弁を用いた。その結果、術後2年9ヵ月現在、肘関節可動域制限および局所再発は認められていないが、肺転移を来しAWDの状態である。症例2(47歳女性)。左肘関節痛を主訴に画像検査にて左橈骨骨腫瘍を認め、切開生検にてgiant cell tumor of boneと診断された。治療として腫瘍を切除後、骨切り部橈尺骨間に腸骨移植とCCS2本、更に遠位橈尺関節には腸骨移植とACUTRACKで固定し、外側側副靱帯と上腕二頭筋腱を再建した。目下、術後1年経過で肘関節可動域制限や局所再発は認めず、CDFの状態である。

  • 上腕二頭筋長頭筋腱欠損が広範囲腱板断裂例の肩関節機能低下および回復に及ぼす影響

    市川 耕一, 伊藤 陽一, 松本 一伸, 間中 智哉, 中村 信之, 中村 博亮

    肩関節   36 ( 3 )   999 - 1002   2012.09( ISSN:0910-4461

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    広範囲腱板断裂の診断で、鏡視下腱板修復術(ARCR)を施行した122例中、術後6ヵ月以上の経過観察が可能であった85肩(男性46肩、女性39肩、41〜83歳、平均67.5歳)を対象に、広範囲腱板断裂例における上腕二頭筋長頭筋腱(LHB)損傷の程度が肩関節機能低下に及ぼす影響およびARCR後の術後回復に及ぼす影響について検討した。LHBの損傷程度を手術時LHBが完全に断裂していたLHB完全断裂群(LHB-群)26肩とLHB非断裂群(LHB+群)59肩に分類した。術前肩機能において平均自動屈曲可動域(LHB-群101.3°、LHB+群98.9°)、自動外転可動域(LHB-群86.7°、LHB+群86.1°)、JOAスコア(LHB-群50.7、LHB+群50.6)で両群に有意差を認めなかった。術中に評価した腱板断裂の縦径および横径は、縦径(LHB-群52.2mm、LHB+群50.2mm)、横径(LHB-群50.0mm、LHB+群43.8mm)で両群に有意差を認めなかった。術後の自動屈曲可動域はLHB-群LHB113.0°、LHB+群134.2°、自動外転可動域はLHB-群97.8°、LHB+群122.2°、JOAスコアはLHB-群69.5、LHB+群76.2で、LHB+群はLHB-群に比べ有意に良好な術後成績が認められた。よりよい術後機能回復を求めるに当たりLHBの連続性が確認できる期間に手術することが望ましいと思われた。

  • 腱板断裂が肩関節拘縮に及ぼす影響 断裂形態別比較

    松本 一伸, 伊藤 陽一, 間中 智哉, 市川 耕一, 中村 信之, 中村 博亮

    肩関節   36 ( 3 )   933 - 936   2012.09( ISSN:0910-4461

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    肩関節鏡視下手術時に腱板断裂の有無および断裂形態が十分に評価可能であった症例中、腱内水平断裂症例、脱臼歴のある症例および40歳未満の症例を除いた903例(男性506例、女性397例、40〜86歳、平均63歳)を対象に、関節面側部分断裂(A群)237例、滑液包側部分断裂(B群)141例、全層性断裂(C群)525例に分け、腱板断裂形態と肩関節拘縮の関連性を解明し、各断裂形態が肩関節拘縮に及ぼす影響について検討した。903例中、拘縮が認められたのは127例(14.7%)であった。拘縮症例の占める割合はA群拘縮あり70例、拘縮なし167例で29.5%、B群拘縮あり24例、拘縮なし117例で17%、C群拘縮あり33例、拘縮なし492例で6.3%であった。部分断裂群と全層断裂群の比較ではA群、B群を合わせた部分断裂群378例中94例、24.9%に拘縮を認め、C群の全層断裂群の6.3%より高頻度に拘縮の合併が認められた。部分断裂群の中ではA群においてB群より高頻度に拘縮の合併が認められた。A群においては外傷と拘縮の関連性が示唆された。腱板断裂形態と肩関節拘縮の関連性において、腱板部分断裂との相関を認め、特に関節面側腱板部分断裂との相関を強く認められた。

  • 骨腫瘍に対するFDG-PETの意義

    星 学, 高田 潤, 大戎 直人, 家口 尚, 中村 博亮

    中部日本整形外科災害外科学会雑誌   55 ( 5 )   1059 - 1060   2012.09( ISSN:0008-9443

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    骨腫瘍79例(男性51例、女性28名、良性17例、悪姓62例、平均年齢55.5±19.3歳)を対象にFDG-PETのSUV値と各要因について比較検討した。ROC曲線による解析ではAUCが0.70であり、良悪性の鑑別はSUV値単独では困難であると考えられた。また、組織別では骨巨細胞腫のSUV値が骨肉腫よりも有意に高値を示し、代表的な偽陽性を示す良性骨腫瘍であった。

  • 腕神経叢に発生した悪性末梢神経鞘腫瘍の3例

    高田 潤, 星 学, 大戎 直人, 家口 尚, 青野 勝成, 中村 博亮

    中部日本整形外科災害外科学会雑誌   55 ( 5 )   1153 - 1154   2012.09( ISSN:0008-9443

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    症例1:63歳女。悪性末梢神経鞘腫瘍(MPNST)にて摘出術を受け経過観察していたところ、左上肢麻痺が進行し、MRIで腕神経叢に沿って左腋窩からC6-T1の脊柱管内に進展する腫瘍を認めた。MPNSTの診断で椎弓形成術(C4-T1)を行い、術後は重粒子線治療を追加した。数ヵ月の経過で左上肢の疼痛が出現し、重粒子線治療後10ヵ月に胸腰椎レベルに多発する腫瘍を認め、治療後1年5ヵ月に腫瘍死した。症例2:57歳男。前医で右鎖骨上の腫瘤に対し腫瘍切除を受け、MPNSTと診断された。腕神経叢に沿って進展する腫瘍に対し重粒子線治療を行ったが、数ヵ月の経過で右上肢の疼痛が出現した。重粒子線治療後2年半から局所再発を繰り返し、治療後6年に腫瘍死した。症例3:25歳男。左頸部の腫瘤が急速増大し、針生検でMPNSTと診断した。大動脈弓部まで及ぶ腫瘍で広範切除は難しく、conventionalな放射線治療を行った。疼痛は出現しなかったが、照射後1年4ヵ月に腫瘍の増大と多発転移を認め、照射後1年9ヵ月に腫瘍死した。

  • 脊椎内視鏡下手術の現状 2011年1月〜12月手術施行状況調査・インシデント報告集計結果

    長谷川 徹, 佐藤 公昭, 中村 博亮, 長谷川 和宏, 蜂谷 裕道, 松本 守雄, 吉本 三徳, 高橋 和久, 吉田 宗人, 日本整形外科学会脊椎脊髄病委員会脊椎内視鏡下手術インシデントワーキンググループ

    日本整形外科学会雑誌   86 ( 9 )   724 - 729   2012.09( ISSN:0021-5325

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    2011年のアンケート調査結果を過去の結果と比較し、脊椎内視鏡下手術の施行状況およびインシデント発生状況の現状について検討した。全国の2022施設にアンケート用紙を郵送し、1143施設から回答を得た。そのうち1年間に脊椎内視鏡下手術が行われたのは287施設であった。脊椎内視鏡下手術の施行施設は前年比0.97倍とわずかに減少したが、手術件数は1.1倍に増加して11154件となった。手術内容としては過去の調査と同様、腰椎後方手術が全体の96.7%と大部分を占めた。インシデント発生状況では、2010年の統計と比べ発生頻度は前年比0.85の2.39%とわずかではあるが減少した。インシデント内容としては、過去の調査結果と同様に硬膜損傷が65.2%と最も多く、ついで術後血腫が10.9%で、術式別では腰椎椎弓切除術・開窓術に21.1%と多く発生した。

  • 肩鎖関節変形性関節症に対する鏡視下鎖骨遠位端切除術の中期臨床成績

    間中 智哉, 伊藤 陽一, 松本 一伸, 市川 耕一, 中村 信之, 中村 博亮

    肩関節   36 ( 3 )   1011 - 1014   2012.09( ISSN:0910-4461

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    2001年4月〜2010年6月に関節鏡視下手術を行った1730例中、有痛性肩鎖関節変形性関節症に対し、鏡視下鎖骨遠位端切除術を行った症例は102肩であった。その中で術後1年以上、10年未満の経過観察が可能であった91例101肩(男性58例、女性33例、30〜80歳、平均59.1歳)を対象に、中期臨床成績と、関節鏡を用いた肩鎖関節以外の病変の状態を評価した。肩鎖関節以外の病変は肩峰下インピンジメントを全例に認め、SLAP病変38肩(38%)、腱板断裂52肩(51%)、上腕二頭筋長頭腱断裂17肩(17%)、関節拘縮30肩(29%)であった。術式は鏡視下肩峰除圧術(ASD)+鏡視下鎖骨遠位端切除術49肩、ASD+鏡視下腱板修復術(ARCR)+鏡視下鎖骨遠位端切除術22肩、鏡視下関節包切離術+ASD+鏡視下鎖骨遠位端切除術24肩、鏡視下関節包切離術+ASD+ARCR+鏡視下鎖骨遠位端切除術6肩であった。術後3ヵ月時、肩鎖関節部の圧痛は90肩(89%)で完全消失し、11肩(11%)で軽度残存した。最終経過観察時には軽度残存11肩中4肩(36%)で圧痛の完全消失を認め、肩鎖関節部の圧痛は94肩(93%)で完全消失し、7肩(7%)で軽度残存した。経過観察中の肩鎖関節部の再発は認めなかった。水平内転ストレステストでの疼痛誘発は、術後3ヵ月および最終観察時共に101肩全例で消失した。術式の経過観察中、全例で患者の満足度は高く、術後3ヵ月時に得られる改善が中期的にも継続した。

  • 神経障害を合併した骨粗鬆症性椎体骨折後偽関節に対する内視鏡下椎体形成術の治療成績

    鈴木 亨暢, 寺井 秀富, 豊田 宏光, 中村 博亮, 辻尾 唯雄, 星野 雅俊

    骨折   34 ( 3 )   528 - 531   2012.09( ISSN:0287-2285

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    今回我々は神経障害を合併した骨粗鬆症性椎体骨折後偽関節に対して行った内視鏡下椎体形成術単独の治療成績を検討した。対象は13例(男性2例、女性11例)であり、治療成績は腰背部痛VAS、歩行状態、modified Frankel scaleにより評価した。画像的評価として椎体楔状角、椎体高比率および骨片の脊柱管占拠率を測定・評価した。腰背部痛VASは術後有意に改善し、全例で術後歩行可能となった。神経障害は11例で改善が認められた。椎体楔状角および椎体高比率はいずれも術後改善を認めたが、骨片の脊柱管占拠率は術前後で有意な変化は認められなかった。本研究より神経障害を有する骨粗鬆症性椎体骨折後偽関節に対しても椎体形成術のみで一定の治療成績が得られることが判明した。骨片の脊柱管占拠率が変化しないにも関わらず神経障害の改善が認められたことから、椎体の安定化が神経障害の改善に非常に重要であることが示唆された。(著者抄録)

  • 単純性骨嚢腫内溶液のプロテオーム解析 長管骨症例と踵骨症例の比較

    高田 潤, 星 学, 大戎 直人, 家口 尚, 青野 勝成, 中村 博亮

    中部日本整形外科災害外科学会雑誌   55 ( 5 )   1169 - 1170   2012.09( ISSN:0008-9443

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    単純性骨嚢腫の長管骨症例と踵骨症例の内容液に対して、iTRAQ-labeling法およびQSTAR Elite LC-MS/MSを用いて蛋白・ペプチドの発現パターンを網羅的に解析した。その結果、長管骨症例の内容液にlumicanやperiostinの発現上昇を認め、踵骨発生例の内容液にafaminやapolipoprotein Eの発現上昇を認めた。Ingenuity Pathway Analysisを用いて高発現しているpathwayの解析を行ったところ、踵骨症例の内容液において脂質代謝関連経路の活性化を認めた。その他の症例の内容液を用いてapolipoprotein Eを生化学的に測定したところ、踵骨症例の内容液で有意にapolipoprotein Eが高値であることを確認した。アポリポ蛋白質はコレステロール代謝に関わる物質であり、内容液中のコレステロールも生化学的に測定し、長管骨症例と踵骨症例での比較を行ったところ、やはり踵骨症例で有意に高値であった。以上、踵骨骨嚢腫は長管骨内の同様病変とは病態が異なる可能性が示唆された。

  • 単発性骨転移の予後

    星 学, 高田 潤, 大戎 直人, 家口 尚, 高橋 真治, 中村 博亮

    中部日本整形外科災害外科学会雑誌   55 ( 5 )   979 - 980   2012.09( ISSN:0008-9443

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    1994年3月〜2011年6月の間に整形外科初診の単発性骨転移42例(男性25例、女性17例、年齢41〜82歳、平均63.2±9.4歳)を対象に、予後因子について検討した。平均経過観察期間21.2ヵ月の結果、単発性骨転移患者の1年生存率は76.5%、2年生存率は60.0%で、中央生存期間は30.0ヵ月であった。予後因子は単変量解析では原発巣が肺癌であること、原発巣が残存していること、PS不良群であることが有意な因子であり、多変量解析では原発巣が残存していること、PS不良群であることが有意な因子であった。以上より、単発性骨転移症例では長期間の生存期間が期待できると考えられた。

  • Mid-term clinical results of alumina medial pivot total knee arthroplasty. Reviewed

    Takahiro Iida, Yukihide Minoda, Yoshinori Kadoya, Yoshio Matsui, Akio Kobayashi, Hiroyoshi Iwaki, Mitsuhiko Ikebuchi, Taku Yoshida, Hiroaki Nakamura

    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA   20 ( 8 )   1514 - 1519   2012.08( ISSN:0942-2056

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    PURPOSE: The medial pivot total knee prosthesis has been designed to reproduce physiological knee kinematics. It has been reported that alumina ceramic femoral components reduce polyethylene wear. Thus, medial pivot total knee prostheses with alumina ceramic femoral components were introduced. The purpose of this study was to evaluate the clinical results of patients who underwent newly introduced alumina medial pivot total knee arthroplasties (TKA). METHODS: We evaluated the clinical results of 107 alumina medial pivot TKAs in 80 consecutive patients with a mean follow-up period of 5 years. RESULTS: Alumina medial pivot TKAs provided significant improvements in the patients' Knee Society knee scores, function scores and post-operative ranges of motion compared with their pre-operative statuses (each, P < 0.05). There was no statistical correlation between the change in maximum knee flexion and the increase in posterior condylar offset. Revision surgery was required in one knee due to a post-operative fracture of the tibial plateau after a fall that occurred 2 years postoperatively. No knees had aseptic loosening, osteolysis, or ceramic fractures. The survival rate was 98.6% at 5 years. CONCLUSIONS: This study demonstrates satisfactory mid-term clinical results for patients receiving the alumina medial pivot prosthesis. LEVEL OF EVIDENCE: Therapeutic study, Level IV.

    DOI: 10.1007/s00167-011-1734-3

    PubMed

  • Palliative Surgery for Acetabular Metastasis with Pathological Central Dislocation of the Hip Joint after Radiation Therapy: A Case Report Reviewed

    Hoshi Manabu, Taguchi Susumu, Takada Jun, Oebisu Naoto, Nakamura Hiroaki, Takami Masatsugu

    JAPANESE JOURNAL OF CLINICAL ONCOLOGY   42 ( 8 )   757 - 760   2012.08( ISSN:0368-2811

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1093/jjco/hys071

    PubMed

  • Profemur Zの固定性に関する短期成績について

    羅 建華, 池渕 充彦, 南 義人, 吉田 拓, 箕田 行秀, 岩城 啓好, 中村 博亮

    Hip Joint   38   202 - 205   2012.08( ISSN:0389-3634

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    Profemur Z(PFZ)を用いたprimary THAの固定性を臨床評価・レントゲン学的調査および大腿骨側ステム周囲の骨塩量の経特的変化をDEXA法を用いて検討した。PFZを用いてprimary THAを行い、1年以上経過観察でき、DEXA法で骨密度を測定可能であった58関節54例を対象とした。JOAスコアは平均46.2点から92.5点に改善した。術後大腿部痛および再手術は認めなかった。明らかな不安定性はなかった。spot weldsは7例認めた。骨塩量は、術後半年頃までは全てのzoneで軽度低下あるいは横ばいであるが、その後徐々に増加傾向を認めた。zone 7において骨塩の減少が最も目立ったが、2年以降は徐々に改善し、以後は維持した。

  • Wearable加速度計を用いた歩行時重心動揺評価の解析手法についての検討

    服部 暁穂, 橋本 宏行, 加藤 良一, 今久保 伸二, 大橋 弘嗣, 中土 保, 中島 重義, 岩城 啓好, 池渕 充彦, 中村 博亮

    Hip Joint   38 ( Suppl. )   85 - 88   2012.08( ISSN:0389-3634

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    初回THAを施行した変形性股関節症17例を対象に、術前後にWearable三軸加速度計を腰部に装着し、10m歩行を実施し、三軸方向の加速変化を測定した。得られた各方面の加速度の波形解析は離散フーリエ変換の手法を用いた。解析後、フィルタリングを行い、逆変換を実施し、2階積分を行い距離データに変換し、グラフ化した。作成したグラフを波形の形状から、重心軌跡が途中で交差し左右対称であるもの(A群)、重心軌跡が途中で交差するが左右非対称となるもの(B群)、重心軌跡が交差しないもの(C群)の3群に分類した。その結果、術前の波形はA群5例、B群7例、C群5例であったが、術後の波形はA群8例、B群7例、C群2例であった。VASを用いて疼痛評価を行ったところ、全例が術前後で改善した。グラフ化することで術前後の歩容の特徴を可視化することが可能になると考えられた。

  • 三次元術前計画とPST(patient-specific template)による術中支援を用いた大腿骨頭回転骨切り術

    岩城 啓好, 池渕 充彦, 吉田 拓, 箕田 行秀, 中村 博亮

    Hip Joint   38   175 - 177   2012.08( ISSN:0389-3634

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    三次元画像による術前計画により適応を決め、適応がある場合には最適な骨切り角度を設定し、それを術中再現するためにpatient-specific templateを作成し、大腿骨頭回転骨切術(RO)に対し使用したので報告した。特発性大腿骨頭壊死2例、外傷性大腿骨頭壊死1例を対象とした。正確な術前計画と術中の再現が可能となった。前捻角が症例3にて20°前捻と大きく術前計画との差がみられたが、その原因として、骨片の回転角度が術前の135°に対して110°と回転不足であることが術後計測でわかっており、そのことが理由でないかと思われた。術中支援システムはROを行うための非常に有用なツールになりえるが、現状では骨切り画に関しての術中支援のみで回転や位置については従来法で行っており、これらについてはさらなる検討が必要と思われた。

  • 放射線療法後の病理学的股関節中心性脱臼を伴う寛骨臼蓋部転移に対する緩和手術 症例報告(Palliative Surgery for Acetabular Metastasis with Pathological Central Dislocation of the Hip Joint after Radiation Therapy: A Case Report)

    Hoshi Manabu, Taguchi Susumu, Takada Jun, Oebisu Naoto, Nakamura Hiroaki, Takami Masatsugu

    Japanese Journal of Clinical Oncology   42 ( 8 )   757 - 760   2012.08( ISSN:0368-2811

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    右股関節痛を呈する80歳女性症例について検討した。5年前に肺癌に対する手術を受け、その後右寛骨臼蓋部に転移が生じた。転移巣のコントロールを目的に、放射線療法が実施された。2年後、重度の疼痛の突然の発症とともに病理学的股関節中心性脱臼が生じ、座位を維持できなくなり、寝たきりとなった。緩和のために大腿骨頸部に意図的な偽関節を作成した。手術後、良好な疼痛緩和と可動性の著しい改善が達成された。この手技は低侵襲性の治療法であり、放射線療法後の骨壊死による病理学的股関節脱臼に対する緩和手術として代替治療選択肢になると思われた。

  • 広範囲腱板断裂に対する鏡視下手術治療成績 術式別比較を中心に

    伊藤 陽一, 間中 智哉, 松本 一伸, 市川 耕一, 中村 信之, 中村 博亮

    肩関節   36 ( 2 )   653 - 656   2012.08( ISSN:0910-4461

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    断裂縦径50mmを超える広範囲腱板断裂に対して鏡視下手術を行い、術後6ヵ月以上経過観察し得た120肩について、術式別の治療効果を評価し、的確な鏡視下手術の術式選択と手術適応を検討した。術式はdouble row法で完全修復し得た27肩、single row法で完全修復し得た42肩、完全修復不能で腱板部分修復に留まった23肩、デブリードマンを単独施行した4肩、鏡視下肩峰下除圧術(ASD)を行った19肩であり、術前と術後約6ヵ月の日本整形外科学会肩関節治療成績判定基準、自動屈曲・外転可動域を評価した。その結果、手術治療効果は腱板完全修復術群で有意に高く、部分修復、ASDおよびデブリードマンは有意に劣っていた。部分修復で成績不良にとどまった広範囲腱板断裂症例に対しては、腱板の代用機能も期待する何らかのパッチを用いた補強や上方関節包再建等も検討すべきと考えられた。

  • 寛骨臼回転骨切り術の三次元術前計画とナビゲーションへの応用

    池渕 充彦, 岩城 啓好, 羅 建華, 南 義人, 吉田 拓, 箕田 行秀, 中村 博亮, 中島 重義

    Hip Joint   38   166 - 170   2012.08( ISSN:0389-3634

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    寛骨臼回転骨切り術(RAO)の三次元術前計画とナビゲーションへの応用について検討した。RAOコンピュータ支援手法は、三次元術前計画を含めたコンピュータシミュレーションと、計画を実際の術野に反映させる術中ナビゲーションから構成される。臼蓋形成不全の患者3患者3関節に対し、コンピュー夕支援下にRAOを施行した。術前・術後4週目に骨盤正面X線・骨盤CTを撮影し、X線学的評価を行った。3例ともRAO施行によりCEA・AHIともに改善を認めた。臼蓋骨頭荷重面積比は、3例ともRAO施行により著明な改善を認めた。また、全症例において、閉鎖孔に切り込むことなく骨切りが行われており、関節内へのノミの迷入も認めなかった。

  • スポーツ選手に対するMED法の実際

    中村 博亮

    臨床スポーツ医学   29 ( 8 )   805 - 809   2012.08( ISSN:02893339

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  • Asymmetric Degeneration of Paravertebral Muscles in Patients With Degenerative Lumbar Scoliosis Reviewed

    Shafaq Najibullah, Suzuki Akinobu, Matsumura Akira, Terai Hidetomi, Toyoda Hiromitsu, Yasuda Hiroyuki, Ibrahim Mohammad, Nakamura Hiroaki

    SPINE   37 ( 16 )   1398 - 1406   2012.07( ISSN:0362-2436

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/BRS.0b013e31824c767e

    PubMed

  • 肝癌骨転移の整形外科的問題点

    星 学, 高田 潤, 大戎 直人, 家口 尚, 高見 勝次, 中村 博亮

    整形外科   63 ( 7 )   616 - 620   2012.07( ISSN:00305901 ( eISSN:24329444

  • Efficacy of interspinous process lumbar fusion with recombinant human bone morphogenetic protein-2 delivered with a synthetic polymer and beta-tricalcium phosphate in a rabbit model Reviewed

    Matsumoto Tomiya, Toyoda Hiromitsu, Dohzono Sho, Yasuda Hiroyuki, Wakitani Shigeyuki, Nakamura Hiroaki, Takaoka Kunio

    EUROPEAN SPINE JOURNAL   21 ( 7 )   1338 - 1345   2012.07( ISSN:0940-6719

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00586-011-2130-x

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  • Regenerative repair of bone defects with osteoinductive hydroxyapatite fabricated to match the defect and implanted with combined use of computer-aided design, computer-aided manufacturing, and computer-assisted surgery systems: a feasibility study in a canine model Reviewed

    Yano Koichi, Namikawa Takashi, Uemura Takuya, Hoshino Masatoshi, Wakitani Shigeyuki, Takaoka Kunio, Nakamura Hiroaki

    JOURNAL OF ORTHOPAEDIC SCIENCE   17 ( 4 )   484 - 489   2012.07( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00776-012-0235-7

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  • 肝癌骨転移の整形外科的問題点

    星 学, 高田 潤, 大戎 直人, 家口 尚, 高見 勝次, 中村 博亮

    整形外科   63 ( 7 )   616 - 620   2012.07( ISSN:0030-5901

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    著者らが治療を行った肝癌骨転移15例(男性14例、女性1例、平均年齢70.8歳)を対象に臨床症状、治療法、予後について検討した。平均追跡期間333日の結果、1)Performance statusはgrade 0が5例、grade 1が3例、grade 2が4例、grade 3が2例、grade 4が1例であった。2)原発巣に対する治療は肝切除が4例、TAEが7例、PEITが3例、RFAが3例、全身化学療法が1例であった。3)予後は9例が腫瘍死しており、うち2例は整形外科手術直後であった。また、生存率は1年が43.3%、2年が32.3%で、中央生存期間は310日であった。4)放射線治療は13例30部位に行われ、2ヵ月後の効果判定では改善もしくは変化なしを合わせた奏効率は80.6%であった。一方、整形外科的治療は10例15部位に行われ、うち病的骨折に対する手術は大腿骨4例、上腕骨1例の計5例に行われた。主に骨幹の病巣に対しては病巣掻爬後に骨セメントの充填を併用した髄内釘固定が施行され、2例は生存中である。

  • 骨欠損部に合わせて作製し、コンピュータ支援設計、コンピュータ支援製造、コンピュータ支援手術システムを併用して移植した骨誘導ヒドロキシアパタイトによる骨欠損の再生修復 イヌモデルにおける実施可能性研究(Regenerative repair of bone defects with osteoinductive hydroxyapatite fabricated to match the defect and implanted with combined use of computer-aided design, computer-aided manufacturing, and computer-assisted surgery systems: a feasibility study in a canine model)

    Yano Koichi, Namikawa Takashi, Uemura Takuya, Hoshino Masatoshi, Wakitani Shigeyuki, Takaoka Kunio, Nakamura Hiroaki

    Journal of Orthopaedic Science   17 ( 4 )   484 - 489   2012.07( ISSN:0949-2658

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    イヌモデルにおいて、コンピュータ支援技術と骨形成タンパク質(BMP)の局所送達を併用して、大規模な骨欠損を3D解剖学的状態に修復した。各イヌの骨盤CT画像を取得し、3D CT画像上でイヌの左腸骨に直径15mmの架空の球状の悪性骨腫瘍を配置した。術前にコンピュータ支援設計(CAD)ソフトウェアを使用して、健康な骨のマージンを10mmとった腫瘍全体の切除を計画した。骨欠損充填のために使用する移植片の画像を、コンピュータ画像で構築した。架空の骨欠損と同一の多孔性ヒドロキシアパタイト(HA)移植片を、CADシステムから得た骨欠損のCT画像データを用いて動作するコンピュータ支援製造システムを使用して、正方晶系の多孔性アパタイト塊(40×20×10mm)を切削して作製した。術前に3D CT画像上で計画した通りに腸骨を切除するため、CTデータを用いてコンピュータ支援手術を実施した。前述のように作製したHA移植片で欠損部を充填し、BMP-2を含有する(BMP群、n=6)、またはBMP-2を含有しない(対照群、n=6)パテによる担体でコーティングした。BMP群では、術後3週間目のCT画像で、各移植片の周囲に新骨形成が認められ、経時的CT画像では、腸骨の本来の解剖学的形態に回復するまでリモデリングされていた。12週間目には、移植片は新生骨で囲まれており、組織学的解析により移植片上および移植片内での骨形成が明らかになった。対照群では、骨形成はほとんど認められなかった。骨移植を施行することなく大規模な骨欠損の効率的で正確な再生修復が可能になると思われた。

  • Treatment Strategy for Simple/Unicameral/Solitary Bone Cysts

    47 ( 6 )   539 - 544   2012.06( ISSN:05570433 ( eISSN:18821286

  • Prognostic Factors for Reduction of Activities of Daily Living Following Osteoporotic Vertebral Fractures Reviewed

    MATSUMOTO Tomiya, HOSHINO Masatoshi, TSUJIO Tadao, TERAI Hidetomi, NAMIKAWA Takashi, MATSUMURA Akira, KATO Minori, TOYODA Hiromitsu, SUZUKI Akinobu, TAKAYAMA Kazushi, TAKAOKA Kunio, NAKAMURA Hiroaki

    Spine   37 ( 13 )   1115 - 1121   2012.06( ISSN:03622436

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  • Prognostic factors for reduction of activities of daily living following osteoporotic vertebral fractures. Reviewed

    Matsumoto T, Hoshino M, Tsujio T, Terai H, Namikawa T, Matsumura A, Kato M, Toyoda H, Suzuki A, Takayama K, Takaoka K, Nakamura H

    Spine   37 ( 13 )   1115 - 1121   2012.06( ISSN:0362-2436

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    Study Design. Prospective cohort study.
    Objective. To elucidate the prognostic factors indicating reduced activities of daily living (ADL) at the time of the 6-month follow-up after osteoporotic vertebral fracture (OVF).
    Summary of Background Data. OVF has severe effects on ADL and quality of life (QOL) in elderly patients and leads to long-term deteriorations in physical condition. Many patients recover ADL with acceleration of bony union and spinal stability, but some experience impaired ADL even months after fracture. Identifying factors predicting reduced ADL after OVF may prove valuable.
    Methods. Subjects in this prospective study comprised 310 OVF patients from 25 institutes. All patients were treated conservatively without surgery. Pain, ADL, QOL, and other factors were evaluated on enrollment and at 6 months. ADL were evaluated using the criteria of the Japanese long-term care insurance system to evaluate the degree of independence. We defined reduced ADL as a reduction of at least single grade at 6 months after fracture and investigated factors predicting reduced ADL after OVF, using uni- and multivariate regression analysis.
    Results. ADL were reduced at 6 months after OVF in 66 of 310 patients (21.3%). In univariate analysis, age more than 75 years (P = 0.044), female sex (P = 0.041), 2 or more previous spine fractures (P = 0.009), presence of middle column injury (P = 0.021), and lack of regular exercise before fracture (P = 0.001) were significantly associated with reduced ADL. In multivariate analysis, presence of middle column injury (odds ratio [OR], 2.26; P = 0.022) and lack of regular exercise before fracture (OR, 2.49; P = 0.030) were significantly associated with reduced ADL.
    Conclusion. These results identified presence of middle column injury of the vertebral body and lack of regular exercise before fracture as prognostic factors for reduced ADL. With clarification and validation, these risk factors may provide crucial tools for determining subsequent OVF treatments. Patients showing these prognostic factors should be observed carefully and treated with more intensive treatment options.

    DOI: 10.1097/BRS.0b013e3182432823

    PubMed

  • 末梢神経再生へのiPS細胞の応用 iPS細胞ハイブリッド型人工神経はマウスの末梢神経再生を促進する

    上村 卓也, 高松 聖仁, 池田 幹則, 岡田 充弘, 香月 憲一, 筏 義人, 中村 博亮

    末梢神経   23 ( 1 )   55 - 62   2012.06( ISSN:0917-6772

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    末梢神経再生にiPS細胞を応用するため、人工神経(生体吸収性ポリマーチューブ)にiPS細胞から分化誘導したニューロスフェアを3次元培養したiPS細胞ハイブリッド型人工神経を作成し、マウスの坐骨神経欠損部に移植した(iPS群:n=10)。Control群は人工神経のみを移植した(n=10)。移植後12週でのマウスの下肢機能は、iPS群でcontrol群よりも有意に良好な回復を示した。12週目に採取した人工神経中央部の組織像では、両群ともに人工神経内腔に再生した軸索が認められたが、特にiPS群でより旺盛な再生軸索が認められた。iPS細胞ハイブリッド型人工神経を用いてマウスの坐骨神経欠損部を架橋すると、末梢神経再生および下肢機能回復が促進した。(著者抄録)

  • Navigation-assisted surgery for bone and soft tissue tumors with bony extension Reviewed

    Ieguchi Makoto, Hoshi Manabu, Takada Jun, Hidaka Noriaki, Shigeoka Yasushi, Nakamura Hiroaki

    JOURNAL OF CLINICAL ONCOLOGY   30 ( 15 )   2012.05( ISSN:0732-183X

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  • Repair of critical long bone defects using frozen bone allografts coated with an rhBMP-2-retaining paste Reviewed

    Yasuda Hiroyuki, Yano Koichi, Wakitani Shigeyuki, Matsumoto Tomiya, Nakamura Hiroaki, Takaoka Kunio

    JOURNAL OF ORTHOPAEDIC SCIENCE   17 ( 3 )   299 - 307   2012.05( ISSN:0949-2658

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00776-012-0196-x

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  • rhBMP-2含有ペーストで被覆した凍結骨同種移植片を用いた長骨の大型欠損の修復(Repair of critical long bone defects using frozen bone allografts coated with an rhBMP-2-retaining paste)

    Yasuda Hiroyuki, Yano Koichi, Wakitani Shigeyuki, Matsumoto Tomiya, Nakamura Hiroaki, Takaoka Kunio

    Journal of Orthopaedic Science   17 ( 3 )   299 - 307   2012.05( ISSN:0949-2658

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    ラットモデルの大腿骨骨幹部の欠損修復において、組換型ヒト骨形態形成蛋白(rhBMP)-2含有ペーストが、凍結保管した同種骨移植片の骨形成能を増強させる能力について検討した。2種類のラット系統(WistarおよびLewis)間の移植不寛容をLewisラットからWistarラットへの皮膚移植により確認後、8mmの長骨セグメントをWistarラットから除去した。凍結保管し、rhBMP-2含有ペーストで被覆したLewisラット由来の同種移植片を、欠損部に移植し、18ゲージ注射針で髄内固定した。移植した大腿骨は、定めた時点で放射線検査、組織検査、および生体力学的検査により評価した。大型の皮質骨欠損が、rhBMP-2含有合成生分解性担体ペーストを被覆した免疫不寛容のホスト由来の凍結保管同種移植片の移植により修復された。rhBMP-2およびその局所送達システムと組み合わせた同種骨移植が、骨欠損の再建アプローチである可能性が示唆された。

  • Patella tendon rupture accompanied with dilated cardiomyopathy-A case report Reviewed

    YAMASAKI Shinya

    37 ( 2 )   282 - 283   2012.04( ISSN:18848842

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    CiNii Article

  • Exostosis developed in the intercondylar fossa -A case report- Reviewed

    TERAI Shozaburo

    37 ( 2 )   292 - 293   2012.04( ISSN:18848842

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    CiNii Article

  • A case report of winged deformity caused by osteochondroma arising from the ventral side of the scapula Reviewed

    Hoshi Manabu, Hayakawa Keiko, Takada Jun, Nakamura Hiroaki

    EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY   22 ( 3 )   261 - 264   2012.04( ISSN:1633-8065

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00590-011-0786-x

  • Cellularity and Cartilage Matrix Increased in Hypertrophied Ligamentum Flavum Histopathological Analysis Focusing on the Mechanical Stress and Bone Morphogenetic Protein Signaling Reviewed

    Shafaq Najibullah, Suzuki Akinobu, Terai Hidetomi, Wakitani Shigeyuki, Nakamura Hiroaki

    JOURNAL OF SPINAL DISORDERS & TECHNIQUES   25 ( 2 )   107 - 115   2012.04( ISSN:1536-0652

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  • Cellularity and cartilage matrix increased in hypertrophied ligamentum flavum: histopathological analysis focusing on the mechanical stress and bone morphogenetic protein signaling. Reviewed

    Shafaq N, Suzuki A, Terai H, Wakitani S, Nakamura H

    Journal of spinal disorders & techniques   25 ( 2 )   107 - 15   2012.04( ISSN:1536-0652

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    DOI: 10.1097/BSD.0b013e31820bb76e

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  • 拡張型心筋症患者に発生した膝蓋腱断裂の1例

    山崎 真哉, 橋本 祐介, 瀧上 順誠, 寺井 彰三郎, 中村 博亮

    JOSKAS   37 ( 2 )   282 - 283   2012.04( ISSN:1884-8842

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    12歳男児。出生時より拡張型心筋症と診断され、経過観察が行われていた。今回、ジャンプ着地時に転倒受傷し、近医の整形外科を受診、打撲と診断後、経過観察されていたが、膝自動伸展は依然不能であったことから膝蓋腱損傷と診断され、加療目的で著者らの施設へ紹介となった。所見では単純X線側面像で膝蓋腱実質部に数個の小骨片がみられ、更に健側ではOsgood-Schlatter病様の脛骨粗面裂離骨折に加えて、膝蓋骨側での裂離骨片も認められた。また、Insall-Salvati ratioは健側1.13に対し、患側1.6と膝蓋骨高位が確認された。一方、CT像では脛骨粗面裂離骨折はWatson-Jones分類でtype Iとわかり、MRI像ではT2強調像で膝蓋腱の高信号域と辺縁の不整像が確認された。以上より、本症例は左膝腱両端性裂離骨折と診断され、手術が施行された。その結果、術後は経過良好で、術後4週間で全荷重が得られ、目下、術後8ヵ月経過で伸展制限や疼痛なく運動可能である。尚、採取した組織像では血管増生とリンパ球細胞浸潤が認められた。

  • 膝関節内に発生した外骨腫様病変の一例

    寺井 彰三郎, 橋本 祐介, 原 庸, 山崎 真哉, 瀧上 順誠, 錦野 匠一, 高田 潤, 星 学, 中村 博亮

    JOSKAS   37 ( 2 )   292 - 293   2012.04( ISSN:1884-8842

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    14歳女性。運動時に右膝痛が出現し、単純X線にて異常所見を認め、著者らの施設へ紹介となった。初診時、Xpでは顆間内側に骨透瞭像ほか、ローゼンバーグビューで同部位に腫瘤性病変の関節内への突出が認められた。また、MRIでは顆間内側にT1強調画像にて低信号、T2強調画像で高信号の内部に隔壁を有する腫瘤性病変が認められ、PCLは腫瘤によって圧排されていた。以上、これらの所見を踏まえ、手術を行なったところ、内顆内側には骨性隆起病変が認められ、内部は骨髄などの物質で満たされてなく嚢胞状であった。悪性細胞がないことを生検と迅速病理診断にて確認後、鋭匙鉗子で可及的に病変切除が行われた。本症例は結果的に外骨腫と診断された。尚、術後は経過良好で、術後1ヵ月でスポーツ復帰し、再発はみられていない。

  • Efficacy of the bone tunnel evaluation by CT for ACL revision surgery : A report of 3 cases Reviewed

    HASHIMOTO Yusuke

    37 ( 1 )   100 - 101   2012.03( ISSN:18848842

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  • Transplantation of induced pluripotent stem cell-derived neurospheres for peripheral nerve repair Reviewed

    Uemura Takuya, Takamatsu Kiyohito, Ikeda Mikinori, Okada Mitsuhiro, Kazuki Kenichi, Ikada Yoshito, Nakamura Hiroaki

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   419 ( 1 )   130 - 135   2012.03( ISSN:0006-291X

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    DOI: 10.1016/j.bbrc.2012.01.154

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  • 骨粗鬆症性椎体骨折後QOL低下に関与する因子についての調査研究

    豊田 宏光, 松本 富哉, 星野 雅俊, 辻尾 唯雄, 寺井 秀富, 並川 崇, 松村 昭, 加藤 相勲, 鈴木 亨暢, 高山 和士, 高岡 邦夫, 中村 博亮

    Osteoporosis Japan   20 ( 1 )   70 - 73   2012.02( ISSN:0919-6307

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    骨粗鬆症性椎体骨折患者310例(男性44例、女性266例、年齢64〜93歳、平均年齢75.8歳)を対象に受傷時と受傷後6ヵ月目のQOL/ADL評価を行い、QOL低下に関与する因子について検討した。その結果、QOL回復を阻害する因子として「椎体後壁に損傷を認める」と「定期的な運動をしていない」が有意な危険因子として抽出された。特に椎体後壁に損傷を認める症例では認めない症例と比較し、受傷後6ヵ月目のVAS、椎体高比率、骨折部の骨癒合が得られていない偽関節になる割合が有意に高いことが判明した。

  • Early Biological Fixation of Porous Implant Coated With Paste-Retaining Recombinant Bone Morphogenetic Protein 2 Reviewed

    Fukunaga Kenji, Minoda Yukihide, Iwakiri Kentaro, Iwaki Hiroyoshi, Nakamura Hiroaki, Takaoka Kunio

    JOURNAL OF ARTHROPLASTY   27 ( 1 )   143 - 149   2012.01( ISSN:0883-5403

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    DOI: 10.1016/j.arth.2011.06.017

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  • Navigation-assisted Surgery for Bone and Soft Tissue Tumors With Bony Extension Reviewed

    Ieguchi Makoto, Hoshi Manabu, Takada Jun, Hidaka Noriaki, Nakamura Hiroaki

    CLINICAL ORTHOPAEDICS AND RELATED RESEARCH   470 ( 1 )   275 - 283   2012.01( ISSN:0009-921X

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    DOI: 10.1007/s11999-011-2094-5

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  • Acquired leptin resistance by high-fat feeding reduces inflammation from collagen antibody-induced arthritis in mice Reviewed

    Sugioka Y., Tada M., Okano T., Nakamura H., Koike T.

    CLINICAL AND EXPERIMENTAL RHEUMATOLOGY   30 ( 5 )   707 - 713   2012( ISSN:0392-856X

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  • Influence of LHB tendon deficiencies on shoulder dysfunction or recovery in the shoulders with massive rotator cuff tears Reviewed

    Ichikawa Koichi, Ito Yoichi, Matsumoto Isshin, Manaka Tomoya, Nakamura Nobuyuki, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   36 ( 3 )   999 - 1002   2012( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> Long head of the biceps brachii (LHB) tendon has an important role in maintaining shoulder function. LHB tendon ruptures sometimes occur in the cases of rotator cuff tears. Severe shoulder dysfunction was recognized in massive rotator cuff tears, though the influence of LHB tendon deficiencies in such cases is not well known. The aim of this study was to determine the influence of LHB tendon deficiencies on shoulder dysfunction or recovery in shoulders with massive rotator cuff tears.<BR><B>Methods:</B> We evaluated 85 shoulders that had undergone arthroscopic rotator cuff repair surgeries for massive rotator cuff tears. We evaluated LHB tendon during arthroscopy; 26 shoulders were classified into the group of LHB deficiencies (group minus) and 59 shoulders were classified into the group of intact LHB(group plus). We assessed each surgical procedure as a complete repair or an partial repair. Clinical outcomes were evaluated by the JOA shoulder scoring system, active ROM preoperatively and postoperatively. Each parameter was statistically analyzed between the two groups.<BR><B>Results:</B> The average preoperative JOA scores and active ROM were not different between two groups. Complete repair was performed in 15/26(58%) cases in group minus and in 50/56(89%) cases in group plus. Postoperative clinical results were significantly lower in group minus than those in group plus when partial repair was included.<BR><B>Conclusion:</B> LHB tendon deficiencies do not have an influence on preoperative shoulder dysfunction in shoulders with massive rotator cuff tears. However, LHB tendon deficiencies make complete rotator cuff repair more difficult than intact LHB tendon does. Postoperative clinical results were not different between two groups when excluded partial repair.

    DOI: 10.11296/katakansetsu.36.999

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  • Single-bone forearm reconstruction for musculoskeletal tumors Reviewed

    OEBISU Naoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   55 ( 5 )   1041 - 1042   2012( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2012.1041

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  • Relationship between rotator cuff tear morphology and shoulder joint stiffness Reviewed

    Matsumoto Isshin, Ito Yoichi, Manaka Tomoya, Ichikawa Koichi, Nakamura Nobuyuki, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   36 ( 3 )   933 - 936   2012( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> Shoulder joint stiffness commonly occurs in patients with rotator cuff tears. Rotator cuff tear morphology can be classified into articular side partial-thickess tears, bursal side partial-thickess tears and full-thickness tears. However, the relationship between rotator cuff tear morphology and shoulder joint stiffness is not well known. The aim of this study was to evaluate the correlation between rotator cuff tear patterns and shoulder joint stiffness.<BR><B>Methods:</B> We retrospectively evaluated 903 arthroscopically treated shoulders (506 male, 397 female), in which rotator cuff tears morphology were correctly recorded. Patients below 40 years of age and accompanied shoulder dislocation histories were excluded in this study. Concerning rotator cuff tear morphology, articular side partial-thickness tears were classified as group A, bursal side partial-thickness tears were classified as group B and full-thickness complete tears were classified as group C. Shoulder joint stiffness was diagnosed in the patients with less than 120 degrees in maximum rotational angles: total external and internal rotation angles at 90 degrees of abduction under general anesthesia. The ratio of shoulder joint stiffness in the three groups was statistically evaluated.<BR><B>Results:</B> The ratio of shoulder joint stiffness was 29.5% (70/237) in group A, 17.0% (24/141) in group B and 6.3% (33/525) in group C. Shoulder joint stiffness was observed more frequently in partial-thickness tears than in full-thickness tears. Articular side partial-thickness tears have the highest correlation between shoulder joint stiffness.<BR><B>Conclusion:</B> Our results showed that there is significant correlation between rotator cuff tear morphology and shoulder joint stiffness.

    DOI: 10.11296/katakansetsu.36.933

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  • Malignant peripheral nerve sheath tumors (MPNST) of the brachial plexus: Report of three cases Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   55 ( 5 )   1153 - 1154   2012( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2012.1153

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  • Medium Term Clinical Results of Arthroscopic Distal Clavicle Resection for the Treatment of Acromioclavicular Joint Osteoarthritis Reviewed

    Manaka Tomoya, Ito Yoichi, Matsumoto Isshin, Ichikawa Koichi, Nakamura Nobuyuki, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   36 ( 3 )   1011 - 1014   2012( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> The purpose of this study was to evaluate medium term clinical results of arthroscopic distal clavicle resection for the treatment of painful acromioclavicular (AC) joint osteoarthritis.<BR><B>Methods:</B> We evaluated 101 shoulders of 91 patients, who had undergone arthroscopic distal clavicle resection with a minimum 12 months follow up. Average age at the time of surgery was 59.1 years old and average duration of the follow up was 40.6 months. Histories of traumatic episode were observed in 3 cases of type I and II AC joint injury and in 8 cases of other major traumatic events. Clinical evaluation was composed of 4 different items: other pathological lesions except AC lesion, arthroscopic surgical procedure, tenderness of the AC joint and horizontal adduction test.<BR><B>Results:</B> Impingement syndrome was accompanied in all the cases. Thirty-eight cases of SLAP lesion, 52 cases of rotator cuff tears, 17 cases of LHB tear and 30 cases of shoulder joint stiffness were observed. ASD and arthroscopic distal clavicle resection was performed on 101 shoulders, ARCR on 28 shoulders and capsulotomy on 30 shoulders. Complete disappearance of AC joint tenderness was recognized in 94 shoulders; mild AC joint tenderness remained in 7 shoulders at final follow up. There was no pain in horizontal adduction test in all cases at final follow up as well as at 3 months follow up.<BR><B>Conclusion:</B> Our results showed arthroscopic distal clavicle resection is an effective surgical procedure at medium term follow up for the treatment of painful AC joint osteoarthritis.

    DOI: 10.11296/katakansetsu.36.1011

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  • Comparison among clinical results of several arthroscopic surgical procedures for the treatment of massive rotator cuff tears Reviewed

    Ito Yoichi, Manaka Tomoya, Matsumoto Isshin, Ichikawa Koichi, Nakamura Nobuyuki, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   36 ( 2 )   653 - 656   2012( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> There are various pathological conditions in massive rotator cuff tears and arthroscopic surgical procedure is not uniform. The aim of this study was to determine the accurate arthroscopic surgical indications, procedures and estimated results for the treatment of massive rotator cuff tears by comparison among surgical effects of several procedures.<BR><B>Methods:</B> We retrospectively evaluated 120 shoulders that had undergone arthroscopic surgeries for massive rotator cuff tears with a minimum of 6 months follow up. We performed five arthroscopic surgical procedures: debridement (group D) in 9 shoulders, partial rotator cuff repair (group PR) in 23 shoulders, single row rotator cuff repair (group SR) in 42 shoulders, double row rotator cuff repair (group DR) in 27 shoulders and solitary ASD (group ASD) in 19 shoulders. Clinical outcomes were evaluated by the JOA shoulder scoring system; improvement between preoperative and postoperative scores at 6 months follow up was statistically analyzed among the five different surgical procedures.<BR><B>Results:</B> Average JOA scores were improved from preoperative to postoperative as follows: 45.9 points improved to 64.0 points (+ 18.1 points) in group D, 47.0 points improved to 70.3 points (+ 23.3 points) in group PR, 50.5 points improved to 84.7 points (+ 34.2 points) in group SR, 55.0 points improved to 87.5 points (+ 32.4 points) in group DR and 63.4 points improved to 83.6 points (+ 20.2 points) in group ASD.<BR><B>Conclusion:</B> Arthroscopic rotator cuff repair procedures (group SR and DR) have a more significant surgical effect than other surgical procedures (group D, PR and ASD) for the treatment of massive rotator cuff tears.

    DOI: 10.11296/katakansetsu.36.653

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  • Proteomic analysis of cyst fluid of simple bone cysts: A comparative study between long bone cysts and calcaneal cysts Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   55 ( 5 )   1169 - 1170   2012( ISSN:0008-9443

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    DOI: 10.11359/chubu.2012.1169

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  • Prognosis of single bone metastasis Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   55 ( 5 )   979 - 980   2012( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2012.979

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  • Usefulness of FDG-PET for bone tumors Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   55 ( 5 )   1059 - 1060   2012( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2012.1059

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  • Proteomic analysis of cyst fluid of simple bone cysts: A comparative study between long bone cysts and calcaneal cysts

    TAKADA Jun

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   55 ( 5 )   1169 - 1170   2012( ISSN:00089443 ( eISSN:13490885

  • Wearable加速度計を用いた三次元的な歩行時重心動揺評価

    池渕 充彦, 岩城 啓好, 中村 博亮

    臨床バイオメカニクス = Japanese journal of clinical biomechanics / 日本臨床バイオメカニクス学会 編   33   433 - 438   2012( ISSN:18845274

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  • 「骨粗鬆症性椎体骨折の保存療法」序文 Reviewed

    市村 正一, 中村 博亮

    日本整形外科學會雜誌   85 ( 12 )   921 - 922   2011.12( ISSN:00215325

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  • The application of induced pluripotent stem cells for regenerative medicine of peripheral nerves Reviewed

    UEMURA Takuya, TAKAMATSU Kiyohito, IKEDA Kiminori, OKADA Mitsuhiro, KAZUKI Kenichi, IKADA Yoshito, NAKAMURA Hiroaki

    22 ( 2 )   210   2011.12( ISSN:09176772

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  • A ganglion within the ulnar nerve and communication with the distal radioulnar joint via an articular branch: case report.

    Okada M, Sakaguchi K, Oebisu N, Takamatsu K, Nakamura H

    The Journal of hand surgery   36 ( 12 )   2024 - 6   2011.12( ISSN:0363-5023

  • Local delivery of siRNA using a biodegradable polymer application to enhance BMP-induced bone formation Reviewed

    Manaka Tomoya, Suzuki Akinobu, Takayama Kazushi, Imai Yuuki, Nakamura Hiroaki, Takaoka Kunio

    BIOMATERIALS   32 ( 36 )   9642 - 9648   2011.12( ISSN:0142-9612

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    DOI: 10.1016/j.biomaterials.2011.08.026

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  • ACL Reconstruction Using Bone-Tendon-Bone Graft Engineered from the Semitendinosus Tendon by Injection of Recombinant BMP-2 in a Rabbit Model Reviewed

    Hashimoto Yusuke, Naka Yoshifumi, Fukunaga Kenji, Nakamura Hiroaki, Takaoka Kunio

    JOURNAL OF ORTHOPAEDIC RESEARCH   29 ( 12 )   1923 - 1930   2011.12( ISSN:0736-0266

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    DOI: 10.1002/jor.21455

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  • A Ganglion Within the Ulnar Nerve and Communication With the Distal Radioulnar Joint via an Articular Branch: Case Report Reviewed

    Okada Mitsuhiro, Sakaguchi Kimikazu, Oebisu Naoto, Takamatsu Kiyohito, Nakamura Hiroaki

    JOURNAL OF HAND SURGERY-AMERICAN VOLUME   36A ( 12 )   2024 - 2026   2011.12( ISSN:0363-5023

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    DOI: 10.1016/j.jhsa.2011.08.008

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  • Gastrocnemius contracture caused by traumatic injury without fracture: a case report. Reviewed

    Junsei Takigami, Yusuke Hashimoto, Shinya Yamasaki, Yo Hara, Shoichi Nishikino, Hiroaki Nakamura

    Foot & ankle international   32 ( 12 )   1152 - 1154   2011.12( ISSN:1071-1007

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    Publishing type:Research paper (scientific journal)   International / domestic magazine:International journal  

    DOI: 10.3113/FAI.2011.1152

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  • ACL reconstruction using bone-tendon-bone graft engineered from the semitendinosus tendon by injection of recombinant BMP-2 in a rabbit model.

    Hashimoto Y, Naka Y, Fukunaga K, Nakamura H, Takaoka K

    Journal of orthopaedic research : official publication of the Orthopaedic Research Society   29 ( 12 )   1923 - 30   2011.12( ISSN:0736-0266

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  • インフリキシマブ投与にて治療効果が得られている関節リウマチ患者におけるメソトレキセートの減量での効果維持と、インフリキシマブ効果不良例に対するタクロリムスの少量追加による効果 メトトレキセート、インフリキシマブ、タクロリムスによる併用療法(COMMITプロジェクト)(Tapering methotrexate to minimum dosage in rheumatoid arthritis patients with adequate response to infliximab or adding low-dose tacrolimus with inadequate response to therapy: COMbination therapy with Methotrexate、Infliximab、and Tacrolimus(COMMIT project))

    Sugioka Yuko, Wakitani Shigeyuki, Tada Masahiro, Okano Tadashi, Nakamura Hiroaki, Koike Tatsuya

    臨床リウマチ   23 ( 4 )   269 - 278   2011.12( ISSN:0914-8760

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    インフリキシマブ(IFX)とメソトレキセート(MTX)の併用療法を22週以上受けている関節リウマチ(RA)患者51名を対象に検討した。Disease activity score(DAS) 28-CRPを使用して、DAS28≦3.2を効果良好とした。エントリー時点でIFX療法に対し、効果良好例はMTXを8週ごとに2mgずつ最小2mg/週まで減量し、減量にてDAS28>3.2に増悪した際には、TACを1mg/日追加した。また、エントリー時、DAS28>3.2の効果不良例にはTACを8週ごとに1mg/日ずつ最大2mgまで追加投与し、32週間経過観察をした。30名がエントリーし、21名(70%)が効果良好のため、MTXの減量を行った。その結果、21名中16名はMTXを平均7.18mgから2.50mg/週まで減量しても、良好な治療効果が維持された。罹病期間が5年以下、もしくはclass Iの患者は全員減量にても効果が維持できた。再燃した5名に対して少量のTACを追加したが、十分な効果は得られなかった。また、エントリー時に効果不良であった9名について、TACを平均1.22mg/日追加したところ、3名のみがDAS28≦3.2へと改善が認められた。

  • Clinical results of surgically treated simple bone cysts Reviewed

    TAKADA Jun

    54 ( 6 )   1207 - 1208   2011.11( ISSN:00089443

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  • A case report of synovial osteochondromatosis of the subtalar joint Reviewed

    TAKADA Jun

    54 ( 6 )   1265 - 1266   2011.11( ISSN:00089443

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  • 脊椎内視鏡下手術の現状 : 2010年1月〜12月 手術施行状況調査・インシデント報告集計結果 Reviewed

    長谷川 徹, 伊東 学, 佐藤 公昭, 中村 博亮, 蜂谷 裕道, 松本 守雄, 八木 省次, 矢吹 省司, 永田 見生, 吉田 宗人

    日本整形外科学会 日本整形外科學會雜誌   85 ( 10 )   761 - 766   2011.10( ISSN:00215325

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  • Prevention of Cartilage Destruction by Etanercept (PRECEPT) Study: the Comparison of Joint Destruction Between Low-Dose and Standard-Dose Etanercept in Rheumatoid Arthritis. Reviewed

    Tada Masahiro, Okano Tadashi, Sugioka Yuko, Mamoto Kenji, Wakitani Shigeyuki, Nakamura Hiroaki, Koike Tatsuya

    ARTHRITIS AND RHEUMATISM   63 ( 10 )   S151 - S152   2011.10( ISSN:0004-3591

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  • Risk Factors for Osteoporosis in Patients with Rheumatoid Arthritis (TOMORROW STUDY) Reviewed

    Okano Tadashi, Tada Masahiro, Sugioka Yuko, Mamoto Kenji, Wakitani Shigeyuki, Nakamura Hiroaki, Koike Tatsuya

    ARTHRITIS AND RHEUMATISM   63 ( 10 )   S429 - S430   2011.10( ISSN:0004-3591

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  • Reversed lateral upper arm flap with a vascularised fragment of the humerus for reconstruction of ulna shaft fracture after resection of malignant tumour: A case report Reviewed

    Okada M., Takamatsu K., Oebisu N., Nakamura H.

    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY   64 ( 10 )   1373 - 1376   2011.10( ISSN:1748-6815

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    DOI: 10.1016/j.bjps.2011.01.021

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  • Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion: a prospective multicenter study. Reviewed

    Tsujio T, Nakamura H, Terai H, Hoshino M, Namikawa T, Matsumura A, Kato M, Suzuki A, Takayama K, Fukushima W, Kondo K, Hirota Y, Takaoka K

    Spine   36 ( 15 )   1229 - 1235   2011.07( ISSN:0362-2436

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    Study Design. Prospective multicenter study.
    Objective. To identify radiographic or magnetic resonance (MR) images of fresh vertebral fractures that can predict a high risk for delayed union or nonunion of osteoporotic vertebral fractures (OVFs).
    Summary of Background Data. Vertebral body fractures are the most common fractures in osteoporosis patients. Conservative treatments are typically chosen for OVFs, and associated back pain generally subsides within several weeks with residual persistent deformity of the vertebral body. In some patients, OVF healing is impaired and correlated with prolonged back pain. However, assessments such as plain radiograph or MR images taken during the early phase to predict high risks for nonunions of OVFs and/or poor prognoses have not been identified.
    Methods. A total of 350 OVF patients from 25 institutes were enrolled in this clinical study. Plain radiograph and MR images of the OVFs were routinely taken at enrollment at the respective institutes. The findings on the plain radiograph and MR images were classified after enrollment in the study. All the patients were treated conservatively without any surgical intervention. After a 6-month follow-up, the patients were classified into two groups, a union group and a nonunion group, depending on the presence of an intravertebral cleft on plain radiograph or MR images. The associations of the images from the first visit with those of the corresponding nonunions at the 6-month follow-up were analyzed by multivariate logistic regression to elucidate specific image characteristics that may predict a high risk for nonunion of OVFs.
    Results. Forty-eight patients (49 vertebrae) among the 350 patients (363 vertebrae) were classified as nonunions, indicating a nonunion incidence of 13.5% for conventional conservative treatments for OVFs. The statistical analyses revealed that a vertebral fracture in the thoracolumbar spine, presence of a middle-column injury, and a confined high intensity or a diffuse low intensity area in the fractured vertebrae on T2-weighted MR images were significant risk factors for nonunion of OVFs.
    Conclusion. The results of this study revealed significant relationships between plain radiograph and MR images of acute phase OVFs and the incidence of nonunion. As these risk factors are defined more clearly and further validated, they may become essential assessment tools for determining subsequent OVF treatments. Patients with one or more of the earlier-described risk factors for nonunion should be observed carefully and provided with more intensive treatments.

    DOI: 10.1097/BRS.0b013e3181f29e8d

    PubMed

  • Characteristic Radiographic or Magnetic Resonance Images of Fresh Osteoporotic Vertebral Fractures Predicting Potential Risk for Nonunion : A Prospective Multicenter Study Reviewed

    TSUJIO Tadao, NAKAMURA Hiroaki, TERAI Hidetomi, HOSHINO Masatoshi, NAMIKAWA Takashi, MATSUMURA Akira, KATO Minori, SUZUKI Akinobu, TAKAYAMA Kazushi, FUKUSHIMA Wakaba, KONDO Kyoko, HIROTA Yoshio, TAKAOKA Kunio

    Spine   36 ( 15 )   1229 - 1235   2011.07( ISSN:03622436

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  • Unplanned resection of a primary malignant bone tumor Reviewed

    OEBISU Naoto

    54 ( 4 )   771 - 772   2011.07( ISSN:00089443

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  • Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery? Reviewed

    Manaka Tomoya, Ito Yoichi, Matsumoto Isshin, Takaoka Kunio, Nakamura Hiroaki

    CLINICAL ORTHOPAEDICS AND RELATED RESEARCH   469 ( 6 )   1660 - 1666   2011.06( ISSN:0009-921X

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    DOI: 10.1007/s11999-010-1689-6

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  • Clinical outcomes of microscopic decompression for degenerative lumbar foraminal stenosis: a comparison between patients with and without degenerative lumbar scoliosis Reviewed

    Yamada Kentaro, Matsuda Hideki, Nabeta Masaharu, Habunaga Hiroshi, Suzuki Akinobu, Nakamura Hiroaki

    EUROPEAN SPINE JOURNAL   20 ( 6 )   947 - 953   2011.06( ISSN:0940-6719

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    DOI: 10.1007/s00586-010-1597-1

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  • Regenerative repair of bone defect with osteoinductive hydroxyapatite fabricated to match the defect and implanted with combined use of computer-aided design, manufacturing, and surgery systems: A feasibility study in a canine model Reviewed

    Yano K., Namikawa T., Uemura T., Wakitani S., Takaoka K., Nakamura H.

    BONE   48   S166 - S166   2011.05( ISSN:8756-3282

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    DOI: 10.1016/j.bone.2011.03.375

  • Utility of tranexamic acid for blood loss after total knee arthroplasty Reviewed

    IWAI Tadashi

    54 ( 3 )   489 - 490   2011.05( ISSN:00089443

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  • Labile electronic and spin states of the CaMn4O5 cluster in the PSII system refined to the 1.9 angstrom X-ray resolution. UB3LYP computational results Reviewed

    Kanda Keita, Yamanaka Shusuke, Saito Tohru, Umena Yasufumi, Kawakami Keisuke, Shen Jian-Ren, Kamiya Nobuo, Okumura Mitsutaka, Nakamura Haruki, Yamaguchi Kizashi

    CHEMICAL PHYSICS LETTERS   506 ( 1-3 )   98 - 103   2011.04( ISSN:0009-2614

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    DOI: 10.1016/j.cplett.2011.02.030

  • Hypergravity suppresses bone resorption in ovariectomized rats Reviewed

    Ikawa Tesshu, Kawaguchi Amu, Okabe Takahiro, Ninomiya Tadashi, Nakamichi Yuko, Nakamura Midori, Uehara Shunsuke, Nakamura Hiroaki, Udagawa Nobuyuki, Takahashi Naoyuki, Nakamura Hiroaki, Wakitani Shigeyuki

    ADVANCES IN SPACE RESEARCH   47 ( 7 )   1214 - 1224   2011.04( ISSN:0273-1177

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    DOI: 10.1016/j.asr.2010.12.004

  • Familial osteochondritis dissecance of the knee with epiphyseal dysplasia. A case report Reviewed

    NISHIKINO Shoichi

    36 ( 1 )   162 - 163   2011.03( ISSN:18848842

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  • Gait disturbance causally related to discoid meniscus in children Reviewed

    HASHIMOTO Yusuke

    36 ( 1 )   32 - 33   2011.03( ISSN:18848842

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  • Synovial osteochondromatosis of the knee joint in a pregnant woman. A case report Reviewed

    HARA Yo

    36 ( 1 )   146 - 147   2011.03( ISSN:18848842

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  • Patellar subluxiation with familial osteochondritis dissecans of patella accompany by Exostosis of the lateral condyle of femur. A case report Reviewed

    NISHIKINO Shoichi

    36 ( 1 )   160 - 161   2011.03( ISSN:18848842

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  • Anterior opening wedge HTO for genu recurvatum caused by proximal tibial epiphyseal arrest. A case report Reviewed

    HARA Yo

    36 ( 1 )   134 - 135   2011.03( ISSN:18848842

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  • Clinical Outcome of Microsurgical Bilateral Decompression via Unilateral Approach for Lumbar Canal Stenosis : Minimum Five-Year Follow-up Reviewed

    TOYODA Hiromitsu, NAKAMURA Hiroaki, KONISHI Sadahiko, DOHZONO Sho, KATO Minori, MATSUDA Hideki

    Spine   36 ( 5 )   410 - 415   2011.03( ISSN:03622436

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  • Comparison of motor nerve conduction study of pre- and post surgery of cubital tunnel syndrome Reviewed

    NAKATA Nobuaki

    54 ( 2 )   399 - 400   2011.03( ISSN:00089443

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  • Clinical Outcome of Microsurgical Bilateral Decompression via Unilateral Approach for Lumbar Canal Stenosis Minimum Five-Year Follow-up Reviewed

    Toyoda Hiromitsu, Nakamura Hiroaki, Konishi Sadahiko, Dohzono Sho, Kato Minori, Matsuda Hideki

    SPINE   36 ( 5 )   410 - 415   2011.03( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e3181d25829

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  • An Injectable Composite Material Containing Bone Morphogenetic Protein-2 Shortens the Period of Distraction Osteogenesis In Vivo Reviewed

    Eguchi Yoshitaka, Wakitani Shigeyuki, Naka Yoshifumi, Nakamura Hiroaki, Takaoka Kunio

    JOURNAL OF ORTHOPAEDIC RESEARCH   29 ( 3 )   452 - 456   2011.03( ISSN:0736-0266

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    DOI: 10.1002/jor.21225

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  • Risk Factor Analysis for Motor Deficit and Delayed Recovery Associated With L4/5 Lumbar Disc Herniation Reviewed

    Suzuki Akinobu, Matsumura Akira, Konishi Sadahiko, Terai Hidetomi, Tsujio Tadao, Dozono Sho, Nakamura Hiroaki

    JOURNAL OF SPINAL DISORDERS & TECHNIQUES   24 ( 1 )   1 - 5   2011.02( ISSN:1536-0652

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    DOI: 10.1097/BSD.0b013e3181c5be1d

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  • FGF2-Drug Delivery System が生体吸収性ポリマーチューブで架橋された末梢側神経断端の Schwann 細胞に及ぼす影響 Reviewed

    高松 聖仁, 上村 卓也, 岡田 充弘, 坂口 公一, 香月 憲一, 中村 博亮

    日本手外科学会雑誌 = The journal of Japanese Society for Surgery of the Hand   27 ( 4 )   359 - 363   2011.01( ISSN:21854092

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  • A case report of destructive spondyloarthropathy forced to undergo early revision surgery after less invasive lumbar decompression Reviewed

    YAMADA Kentaro

    54 ( 1 )   91 - 92   2011.01( ISSN:00089443

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  • An evaluation of surgical treatment for lumbar isthmic spondylolisthesis Reviewed

    SHINOHARA Yoshikazu

    54 ( 1 )   135 - 136   2011.01( ISSN:00089443

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  • A case report of multiple bone metastases from intracranial meningioma Reviewed

    TAKADA Jun

    54 ( 1 )   65 - 66   2011.01( ISSN:00089443

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  • Is the preservation of paraspinal muscle of C7 spinous process effective for decreasing the postoperative axial pain after cervical laminoplasty, considering the shape of the C6 spinous processes? Reviewed

    KATO Minori

    54 ( 1 )   111 - 112   2011.01( ISSN:00089443

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  • A evaluation of postoperative continuous intravenous anesthesia for cervical laminoplasty Reviewed

    DATE Yuko

    54 ( 1 )   115 - 116   2011.01( ISSN:00089443

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  • Bone morphogenetic protein-2 retained in synthetic polymer/β-tricalcium phosphate composite promotes hypertrophy of a vascularized long bone graft in rabbits. Reviewed

    Mitsuhiro Okada, Koich Yano, Takashi Namikawa, Takuya Uemura, Masatoshi Hoshino, Kenichi Kazuki, Kunio Takaoka, Hiroaki Nakamura

    Plastic and reconstructive surgery   127 ( 1 )   98 - 106   2011.01( ISSN:0032-1052

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    BACKGROUND: Vascularized bone grafting is a useful method for repairing critical bone defects. The repaired bone often presents compromised mechanical strength because of insufficient thickness of the graft. To promote the hypertrophic response, bone morphogenetic protein (BMP) with osteoinductive capacity may be effective. This study was designed to evaluate the efficacy of BMP in rabbits. METHODS: The first metatarsal bones with or without feeding vessels were transferred to critical-sized bone defects in the femurs of rabbits. Recombinant human (rh) BMP-2 (0, 30, or 60 μg) with a carrier material composed of 30 mg of β-tricalcium phosphate powder, 30 mg of a polymer gel (p-dioxanone/polyethylene glycol block copolymer) was placed in contact with the cortical surface and the elevated periosteum of the vascularized bone graft. After surgery, hypertrophic changes were evaluated radiographically. Twelve weeks after surgery, the reconstructed femurs were harvested for investigation by biomechanical and histologic methods. RESULTS: Rapid hypertrophy was observed on radiographs in the vascularized bone grafts with rhBMP-2-retaining implants. The increase of bone volume and the biomechanical strength were dependent on the dose of rhBMP-2 (p < 0.01). Histologic sections in the vascularized bone grafts with rhBMP-2-retaining implants revealed a large amount of newly formed bone. CONCLUSION: The potential use of BMP may improve clinical outcome by promoting hypertrophy of the vascularized bone graft and shortening the treatment time.

    DOI: 10.1097/PRS.0b013e3181f95a73

    PubMed

  • Evaluation of clinical problems associated with bone metastases from carcinoma from unknown primary sites Reviewed

    Hoshi Manabu, Taguchi Susumu, Hayakawa Keiko, Ieguchi Makoto, Nakamura Hiroaki

    ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY   131 ( 1 )   59 - 64   2011.01( ISSN:0936-8051

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    DOI: 10.1007/s00402-010-1102-7

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  • Sagittal alignment of the lower extremity while standing in female Reviewed

    Sugama Ryo, Minoda Yukihide, Kobayashi Akio, Iwaki Hiroyoshi, Ikebuchi Mitsuhiko, Hashimoto Yusuke, Takaoka Kunio, Nakamura Hiroaki

    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY   19 ( 1 )   74 - 79   2011.01( ISSN:0942-2056

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    DOI: 10.1007/s00167-010-1137-x

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  • Arthroscopic Bankart Repair in the Middle Aged Patients over 50 years old<BR>- Clinical Features and Results of Minimum One-year Follow-up - Reviewed

    MATSUMOTO Isshin, ITO Yoichi, MANAKA Tomoya, OEBISU Naoto, MAMOTO Kenji, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   35 ( 3 )   759 - 763   2011( ISSN:0910-4461

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    The purpose of this study was to evaluate a minimum of one-year clinical results and clinical features of arthroscopic Bankart repair in middle aged patients over 50 years old. We retrospectively evaluated 22 shoulders (22 middle aged patients, 9 male and 13 female) of arthroscopically treated Bankart lesions with a minimum of one-year follow up. The average age at the time of surgery was 63.1 years old(range, 50-82). Clinical features such as previous histories of shoulder dislocations, morphological evaluation of Bankart lesion, accompanied rotator cuff tears and additional surgeries were evaluated. Clinical results were evaluated using a Rowe score. Range of motions of external rotation at 90&deg; of abduction at supine position was measured and compared to those of healthy shoulders.Previous shoulder dislocations below the age of 30 years old were in 23%; Bankart lesions were in 91% and capsular rupture were in 9%; accompanied rotator cuff tears were in 55%; additional rotator cuff repair surgeries were performed in 6 patients. Recurrence of shoulder dislocation in these cases was not observed. The averaged Rowe score was 45.5 points in stability, 15.9 points in motion, 22.0 points in function and 83.4 points in total. Averaged acquired range of motion of external rotation was 89.3&deg; for surgically treated shoulders and 99.5&deg; for healthy shoulders; the ratio between these was 90%. Arthroscopic Bankart repair surgeries in middle aged patients over 50 years old have shown good clinical outcomes at a minimum of one-year follow up.

    DOI: 10.11296/katakansetsu.35.759

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  • Partial laceration of the flexor tendon as an unusual cause of trigger finger. Reviewed

    Tadashi Okano, Noriaki Hidaka, Hiroaki Nakamura

    Journal of plastic surgery and hand surgery   45 ( 4-5 )   248 - 251   2011( ISSN:2000-656X

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    We present two cases of trigger finger caused by partial laceration of a flexor tendon. Both patients had preceding skin injury and required operative treatment with resection of the lacerated portion of the tendon and incision of the A1 pulley. We describe keys to the diagnosis of this type of lesion.

    DOI: 10.3109/2000656X.2010.517676

    PubMed

  • A tissue-engineered bioabsorbable nerve conduit created by three-dimensional culture of induced pluripotent stem cell-derived neurospheres Reviewed

    Uemura Takuya, Takamatsu Kiyohito, Ikeda Mikinori, Okada Mitsuhiro, Kazuki Kenichi, Ikada Yoshito, Nakamura Hiroaki

    BIO-MEDICAL MATERIALS AND ENGINEERING   21 ( 5-6 )   333 - 339   2011( ISSN:0959-2989

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    DOI: 10.3233/BME-2012-0680

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  • Prolonged airway obstruction after posterior occipitocervical fusion: a case report and literature review. Reviewed

    Morita M, Nobuta M, Naruse H, Nakamura H

    Advances in orthopedics   2011   791923   2011( ISSN:2090-3464

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    DOI: 10.4061/2011/791923

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  • An evaluation of surgical treatment for lumbar isthmic spondylolisthesis Reviewed

    SHINOHARA Yoshikazu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 1 )   135 - 136   2011( ISSN:0008-9443

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    DOI: 10.11359/chubu.2011.135

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  • Comparison of motor nerve conduction study of pre- and post surgery of cubital tunnel syndrome Reviewed

    NAKATA Nobuaki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 2 )   399 - 400   2011( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2011.399

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  • A case report of destructive spondyloarthropathy forced to undergo early revision surgery after less invasive lumbar decompression Reviewed

    YAMADA Kentaro

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 1 )   91 - 92   2011( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2011.91

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  • Evaluation of the Affect Level of Lesions in Subacromial Bursa in Frozen Shoulder<BR>- Analyses with Subacromial Bursographies- Reviewed

    ITO Yoichi, MATSUMOTO Isshin, MANAKA Tomoya, MAMOTO Kenji, OEBISU Naoto, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   35 ( 2 )   563 - 566   2011( ISSN:0910-4461 ( eISSN:18816363

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    We previously reported the clinical significance of lesions in subacromial bursa (SAB) in frozen shoulder. Two main symptoms of frozen shoulder are pain and limitation of range of motion. The aim of this study was to understand the affect level of lesions in subacromial bursa to these two main symptoms in frozen shoulder. The cases of less than 120&deg; in maximum rotational angles: total angles of external and internal rotation, at 90&deg; of abduction under general anesthesia were recognized as frozen shoulder; arthroscopic capsulotomy was added when a minimum of six months of conservative treatment was not effective. We retrospectively evaluated subacromial bursographies of 38 frozen shoulders (21 male, 17 female). Anesthetic was used during subacromial bursography; pain block effect and improvement of the shoulder motion (passive flexion and passive abduction) were evaluated in the frozen shoulder group. Non-frozen shoulder group: 95 shoulders of impingement syndrome (57 male, 38 female), was used as a control for statistical analysis. The averaged pain block effect was 59.9% in the frozen shoulder group and 79.5% in the non-frozen shoulder group. Average improvement of passive flexion angles was 14.5&deg; in the frozen shoulder group and 7.4&deg; in the non-frozen shoulder group. Average improvement of passive abduction angles was 22.1&deg; in the frozen shoulder group and 6.1&deg; in the non-frozen shoulder group. Lesions in subacromial bursa had the affect level of about 60% of shoulder pain, about 15&deg; of flexion angles and about 22&deg; of abduction angles in frozen shoulder.

    DOI: 10.11296/katakansetsu.35.563

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  • Clinical results of surgically treated simple bone cysts Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 6 )   1207 - 1208   2011( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2011.1207

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  • Utility of tranexamic acid for blood loss after total knee arthroplasty Reviewed

    IWAI Tadashi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 3 )   489 - 490   2011( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2011.489

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  • Unplanned resection of a primary malignant bone tumor Reviewed

    OEBISU Naoto

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 4 )   771 - 772   2011( ISSN:0008-9443

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    DOI: 10.11359/chubu.2011.771

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  • Application of Anterolateral Thigh Flap in Reconstructing Trochanteric Pressure Sore Defect Reviewed

    TAKAMATSU Kiyohito, OKADA Mitsuhiro, UEMURA Takuya, ENOMOTO Makoto, KAZUKI Kenichi, NAKAMURA Hiroaki

    Journal of Japanese Society of Reconstructive Microsurgery   24 ( 4 )   458 - 462   2011( ISSN:0916-4936 ( eISSN:21859949

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     Recurrence of pressure sores remains a major challenge in surgical treatment. Recently the perforator flap has proven to be effective in the reconstruction of pressure sores in a variety of regions.<br> We describe our experience using the proximal pedicled anterolateral thigh (ALT) flap in the treatment of trochanteric pressure sores.<br> In this study, five ALT flap procedures were performed in 4 patients who had trochanteric pressure sores (NPUAP classification grade IV). They were 2 females and 2 males, and averaged 74.3 years old. In these patients, after the sores were debrided, pedicled ALT flaps were transferred to defects in trochanteric regions. After the operations, all of the flaps survived, with primary closure of the donor site. One flap had a superficial peripheral erosion that was treated conservatively. At the final follow up, there was no recurrence of pressure ulcers. <br> Trochanteric coverage with the proximal pedicled ALT flap gave excellent results. The ALT flap has the following advantages: 1) reliability because of the pedicled flap, 2) good matching of thickness and skin texture, 3) less damage comparative to muscle flap, 4) primary closure of the donor site, and 5) simultaneous operations of debridement and flap elevation. We conclude that the ALT flap is a reliable alternative flap for trochanteric coverage.

    DOI: 10.11270/jjsrm.24.458

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  • Tapering methotrexate to minimum dosage in rheumatoid arthritis patients with adequate response to infliximab or adding low-dose tacrolimus with inadequate response to therapy ― COMbination therapy with Methotrexate, Infliximab, and Tacrolimus (COMMIT project) ― Reviewed

    Sugioka Yuko, Wakitani Shigeyuki, Tada Masahiro, Okano Tadashi, Nakamura Hiroaki, Koike Tatsuya

    The Japanese Society for Clinical Rheumatology and Related Research, Clinical Rheumatology and Related Research   23 ( 4 )   269 - 278   2011( ISSN:0914-8760 ( eISSN:21890595

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    Aim: Based on the benefit/risk profile of combination therapy with methotrexate (MTX) and Infliximab (IFX), a lower dosage of MTX might be preferable if IFX efficacy can be maintained.<br>Objectives: We evaluated whether MTX could be tapered to the minimum dosage (2 mg/week) in patients with rheumatoid arthritis (RA) who achieved adequate response to combination therapy. In addition, we evaluated whether adding low-dose tacrolimus (TAC) is efficacious for patients showing inadequate response to the therapy.<br>Method: Subjects comprised 51 RA patients who had received the combination therapy for ≥22 weeks. To analyze clinical response, disease activity score 28 using C-reactive protein (DAS28-CRP) was used to judge response to IFX. In patients with adequate response (DAS28≤3.2), MTX tapering was initiated by 2 mg every 8 weeks. In patients with inadequate response (DAS28>3.2) to therapy at entry, TAC was added (maximum,2 mg/day).<br>Results: Thirty patients were enrolled and 21 patients (70%) with adequate response to therapy underwent reductions in MTX dosage. Sixteen of 21 patients maintained good response despites the mean dosage of MTX being reduced from 7.18 to 2.50 mg/week over 32 weeks. All patients with short disease duration (<5 years) or with Steinbrocker class I could maintain good clinical response despite of MTX tapering. Nine inadequate-responders to IFX received added low-dose TAC, and clinical response improved in only 3 patients. Addition of low-dose TAC appears few efficacious.<br>Conclusion: Seventy six percent of the patients with adequate response to combination therapy with MTX and IFX achieved DAS28≤3.2 while reducing the mean MTX dose to 2.50 mg/week.

    DOI: 10.14961/cra.23.269

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  • Is the preservation of paraspinal muscle of C7 spinous process effective for decreasing the postoperative axial pain after cervical laminoplasty, considering the shape of the C6 spinous processes? Reviewed

    KATO Minori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 1 )   111 - 112   2011( ISSN:0008-9443

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    DOI: 10.11359/chubu.2011.111

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  • A evaluation of postoperative continuous intravenous anesthesia for cervical laminoplasty Reviewed

    DATE Yuko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 1 )   115 - 116   2011( ISSN:0008-9443

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    DOI: 10.11359/chubu.2011.115

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  • Advantages of Arthroscopic Rotator Cuff Repair Combined with Distal Clavicle Resection Reviewed

    MANAKA Tomoya, ITO Yoichi, MATSUMOTO Isshin, OEBISU Naoto, MAMOTO Kenji, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   35 ( 2 )   587 - 591   2011( ISSN:0910-4461 ( eISSN:18816363

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    The purpose of this study was to evaluate clinical outcomes of arthroscopic rotator cuff repair (ARCR) combined with distal clavicle resection for the treatment of rotator cuff tear and painful acromioclavicular (AC) joint osteoarthritis. We evaluated 25 shoulders of 24 patients (group I), who had undergone this combined arthroscopic surgery with a minimum of six months follow up. Average age at the time of surgery was 61.2 years old. Twenty five shoulders with only ARCR (group II) were evaluated as a control group. Clinical evaluation was composed of volume of the bone resection, tenderness of the AC joint, horizontal adduction test and postoperative complications. Surgical outcomes were evaluated by using the Japanese Orthopaedic Association (JOA) shoulder scoring system and statistically evaluated between the two groups. Average volume of distal clavicle resection was 10.3 (8 to 13) mm. Complete disappearance of AC joint tenderness was recognized in 23/25 shoulders; mild AC joint tenderness remained in 2/25 shoulders. No pain was observed in horizontal adduction test. All the patients were satisfied with surgical results without major complications. Preoperative average JOA score was 55.6 points and improved to 79.2 points at 3 months F/U and 86.6 points at 6 months F/U respectively in group I. Preoperative average JOA score was 55.9 points and improved to 79.3 points at 3 months F/U and 87.1 points at 6 months F/U respectively in group II. There was no significant difference between the two groups. Our results showed ARCR combined with distal clavicle resection was an effective surgical procedure for the treatment of combined lesions with rotator cuff tears and painful AC joint osteoarthritis.

    DOI: 10.11296/katakansetsu.35.587

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  • Clinical Outcome of Arthroscopic Treatment for<BR>Hemodialytic Shoulders Reviewed

    MANAKA Tomoya, ITO Yoichi, MATSUMOTO Isshin, OEBISU Naoto, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   35 ( 3 )   923 - 926   2011( ISSN:0910-4461 ( eISSN:18816363

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    Hemodialytic shoulder is a common shoulder disorder with severe shoulder pain in long-term hemodialysis patients. Shoulder arthroscopic surgeries have recently developed, though few reports about the effectiveness of arthroscopic surgeries for hemodialytic shoulders are reported in the literature. The aim of this study was to evaluate clinical results of arthroscopic treatment for hemodialytic shoulders with a minimum follow-up of 6 months. We retrospectively evaluated 11 shoulders in 8 patients, who were diagnosed as having hemodialytic shoulders and who received arthroscopic treatment. Average age at the time of surgery was 60.3 years old (range; 49-64 years). Average post-surgical follow-up was 29.8 months (range; 6-58 months). Arthroscopic surgeries included debridement in 11 shoulders, subacromial decompression in 10 shoulders and rotator cuff repair in 4 shoulders. Clinical features such as hemodialysis duration and hemodialysis pain were evaluated. Clinical results were evaluated using the Japanese Orthopaedic Association shoulder scoring system (JOA score). Average duration of hemodialysis was 21.8 years (range; 4-31 years) and over 20 years of long-term duration were observed in 8 cases. Hemodialysis pain was observed in all cases preoperatively. The average JOA score improved from 53.6 points preoperatively to 79.5 and 86.0 points at 3 and 6 months follow-up respectively. Patients treated with arthroscopic surgeries for hemodialytic shoulders showed excellent clinical outcome at a minimum of 6 months follow-up.

    DOI: 10.11296/katakansetsu.35.923

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  • A case report of synovial osteochondromatosis of the subtalar joint Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 6 )   1265 - 1266   2011( ISSN:0008-9443

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    DOI: 10.11359/chubu.2011.1265

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  • Intracranial subdural hematoma as a cause of postoperative delirium and headache in cervical laminoplasty: A case report and review of the literature. Reviewed

    Habunaga H, Nakamura H

    SAS journal   5 ( 1 )   1 - 3   2011( ISSN:1935-9810

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    DOI: 10.1016/j.esas.2010.11.001

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  • Over Ten Years of Long Term Clinical Results of Mini-open Rotator Cuff Repair Reviewed

    MAMOTO Kenji, ITO Yoichi, MANAKA Tomoya, MATSUMOTO Isshin, OEBISU Naoto, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   35 ( 2 )   443 - 447   2011( ISSN:0910-4461 ( eISSN:18816363

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    The goal of this study is to evaluate the over 10 years of long term clinical results of mini-open rotator cuff repair. We retrospectively evaluated 30 shoulders in 29 consecutive patients who had mini-open rotator cuff repair surgeries and at least 10 years clinical follow up. Average age at the time of surgery was 61.6 years. Clinical results were assessed with active ROM of flexion and abduction; were evaluated with the JOA score at 6 months, 1 year, 5 years and 10 years of follow up and compared to the preoperative evaluations. 30 shoulders were divided into 3 groups: 6 small, 18 middle and 6 large or massive size tears. All the cases were evaluated with necessities of additional surgical interventions during over 10 years of follow up. Additional arthroscopic rotator cuff repair surgeries were necessary in two medium size tear shoulders (6.7%) because of rotator cuff re-tears. Additional surgical treatments were not necessary in the other 28 shoulders (93.3%). The average pre-surgical JOA score of 57.1 points was significantly increased at 6 months and 1 year of follow up (93.4 and 93.9 points respectively); gradually decreased to 92.1 points at 5 years of follow up and maintained significantly good scores: 90.1 points at 10 years of follow up. Mini-open rotator cuff repair is an effective, minimally invasive surgical treatment for rotator cuff tears at a minimum of 10 years of follow up.

    DOI: 10.11296/katakansetsu.35.443

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  • A case report of multiple bone metastases from intracranial meningioma Reviewed

    TAKADA Jun

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   54 ( 1 )   65 - 66   2011( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2011.65

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  • Arthroscopic Bankart Repair in the Middle Aged Patients over 50 years old<BR>- Clinical Features and Results of Minimum One-year Follow-up -

    MATSUMOTO Isshin, ITO Yoichi, MANAKA Tomoya, OEBISU Naoto, MAMOTO Kenji, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Katakansetsu   35 ( 3 )   759 - 763   2011( ISSN:09104461 ( eISSN:18816363

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    The purpose of this study was to evaluate a minimum of one-year clinical results and clinical features of arthroscopic Bankart repair in middle aged patients over 50 years old. We retrospectively evaluated 22 shoulders (22 middle aged patients, 9 male and 13 female) of arthroscopically treated Bankart lesions with a minimum of one-year follow up. The average age at the time of surgery was 63.1 years old(range, 50-82). Clinical features such as previous histories of shoulder dislocations, morphological evaluation of Bankart lesion, accompanied rotator cuff tears and additional surgeries were evaluated. Clinical results were evaluated using a Rowe score. Range of motions of external rotation at 90° of abduction at supine position was measured and compared to those of healthy shoulders.Previous shoulder dislocations below the age of 30 years old were in 23%; Bankart lesions were in 91% and capsular rupture were in 9%; accompanied rotator cuff tears were in 55%; additional rotator cuff repair surgeries were performed in 6 patients. Recurrence of shoulder dislocation in these cases was not observed. The averaged Rowe score was 45.5 points in stability, 15.9 points in motion, 22.0 points in function and 83.4 points in total. Averaged acquired range of motion of external rotation was 89.3° for surgically treated shoulders and 99.5° for healthy shoulders; the ratio between these was 90%. Arthroscopic Bankart repair surgeries in middle aged patients over 50 years old have shown good clinical outcomes at a minimum of one-year follow up.

    DOI: 10.11296/katakansetsu.35.759

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  • Use of infliximab in a patient with pyoderma gangrenosum and rheumatoid arthritis Reviewed

    TADA Masahiro, NAKANISHI Takeshi, HIRATA Chika, OKANO Tadashi, SUGIOKA Yuko, WAKITANI Shigeyuki, NAKAMURA Hiroaki, KOIKE Tatsuya

    Modern rheumatology   20 ( 6 )   598 - 601   2010.12( ISSN:14397595

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  • [Control of bone remodeling by nervous system. Neural involvement in fracture healing and bone regeneration]. Reviewed

    Suzuki A, Uemura T, Nakamura H

    Clinical calcium   20 ( 12 )   1820 - 7   2010.12( ISSN:0917-5857

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    DOI: CliCa101218201827

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  • Clinical outcomes of primary skin closure with Y-V and Z-plasties for Dupuytren's contracture: Use of one-stage skin closure Reviewed

    Uemura Takuya, Kazuki Kenichi, Egi Takeshi, Yoneda Masahiro, Takamatsu Kiyohito, Nakamura Hiroaki

    JOURNAL OF PLASTIC SURGERY AND HAND SURGERY   44 ( 6 )   306 - 310   2010.12( ISSN:2000-656X

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    DOI: 10.3109/2000656X.2010.534340

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  • Use of infliximab in a patient with pyoderma gangrenosum and rheumatoid arthritis Reviewed

    Tada Masahiro, Nakanishi Takeshi, Hirata Chika, Okano Tadashi, Sugioka Yuko, Wakitani Shigeyuki, Nakamura Hiroaki, Koike Tatsuya

    MODERN RHEUMATOLOGY   20 ( 6 )   598 - 601   2010.12( ISSN:1439-7595

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    DOI: 10.1007/s10165-010-0336-0

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  • The influence of approach side on facet preservation in microscopic bilateral decompression via a unilateral approach for degenerative lumbar scoliosis Reviewed

    Matsumura Akira, Namikawa Takashi, Terai Hidetomi, Tsujio Tadao, Suzuki Akinobu, Dozono Sho, Yasuda Hiroyuki, Nakamura Hiroaki

    JOURNAL OF NEUROSURGERY-SPINE   13 ( 6 )   758 - 765   2010.12( ISSN:1547-5654

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    DOI: 10.3171/2010.5.SPINE091001

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  • 脊椎内視鏡下手術の現状 : 2009年1月-12月 手術施行状況調査・インシデント報告集計結果 Reviewed

    長谷川 徹, 伊東 学, 佐藤 公昭, 中村 博亮, 蜂谷 裕道, 松本 守雄, 八木 省次, 矢吹 省司, 永田 見生, 吉田 宗人

    日本整形外科学会 日本整形外科學會雜誌   84 ( 11 )   1071 - 1075   2010.11( ISSN:00215325

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  • Interlaminar fenestration by partial spinous process splitting approach for lumbar spinal canal stenosis Reviewed

    SEKI Masahiko

    53 ( 6 )   1319 - 1320   2010.11( ISSN:00089443

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  • A characteristic findings of gouty arthritis from a diet standpoint in the Airin area of Nishinari-ku, Osaka Reviewed

    NAKATA Nobuaki

    53 ( 6 )   1255 - 1256   2010.11( ISSN:00089443

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  • Articular Cartilage Repair With Autologous Bone Marrow Mesenchymal Cells Reviewed

    Matsumoto Tomiya, Okabe Takahiro, Ikawa Tesshu, Iida Takahiro, Yasuda Hiroyuki, Nakamura Hiroaki, Wakitani Shigeyuki

    JOURNAL OF CELLULAR PHYSIOLOGY   225 ( 2 )   291 - 295   2010.11( ISSN:0021-9541

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    DOI: 10.1002/jcp.22223

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  • 肩関節・肩甲帯部疾患 病態・診断・治療の現状 診断 各種疾患の現在の画像診断法 肩鎖関節変形性関節症における画像スコアリングの意義

    伊藤 陽一, 間中 智哉, 松本 一伸, 月山 国明, 中村 博亮

    別冊整形外科   1 ( 58 )   41 - 45   2010.10( ISSN:02871645

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  • Elevated Straight Arm Traction in Children for Treating a Supracondylar Fracture in the Distal Humerus Reviewed

    EGUCHI Yoshitaka

    19 ( 2 )   317 - 320   2010.10( ISSN:09176950

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  • Assessment of dislocation about toe-reaching after Total Hip Arthroplasty Reviewed

    MIYOSHI Takashi

    36   93 - 96   2010.10( ISSN:03893634

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  • Epinephrine accelerates osteoblastic differentiation by enhancing bone morphogenetic protein signaling through a cAMP/protein kinase A signaling pathway Reviewed

    Uemura Takuya, Ohta Yoichi, Nakao Yoshihiro, Manaka Tomoya, Nakamura Hiroaki, Takaoka Kunio

    BONE   47 ( 4 )   756 - 765   2010.10( ISSN:8756-3282

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    DOI: 10.1016/j.bone.2010.07.008

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  • CLINICAL OUTCOME OF CARPAL TUNNEL RELEASE WITH AND WITHOUT OPPOSITION TRANSFER Reviewed

    Uemura T., Hidaka N., Nakamura H.

    JOURNAL OF HAND SURGERY-EUROPEAN VOLUME   35E ( 8 )   632 - 636   2010.10( ISSN:1753-1934

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    DOI: 10.1177/1753193410369988

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  • Assessment of Gait in Patients with Neck Disease Using a Wearable Accelerometer Reviewed

    AKAMATSU Namiko, IMAKUBO Shinji, KATO Ryoichi, MIYOSHI Takashi, NAKATSUCHI Tamotsu, NAKAJIMA Shigeyoshi, IWAKI Hiroyoshi, IKEBUCHI Mitsuhiko, TERAI Hidetomi, NAKAMURA Hiroaki

    Japanese journal of clinical biomechanics   31   85 - 90   2010.09( ISSN:18845274

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  • The Factor of Reaching the Toes in Patients after Total Hip Arthroplasty Reviewed

    MIYOSHI Takashi, IMAKUBO Shinji, KATO Ryoichi, AKAMATSU Namiko, NAKATSUCHI Tamotsu, IWAKI Hiroyoshi, IKEBUCHI Mitsuhiko, NAKAMURA Hiroaki

    Japanese journal of clinical biomechanics   31   427 - 430   2010.09( ISSN:18845274

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  • Treatment of chondroblastoma Reviewed

    HAYAKAWA Keiko

    53 ( 5 )   1057 - 1058   2010.09( ISSN:00089443

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  • The deference between surgical approaches on microscopic lumbar foraminotomy : analysis using Multidetector-row computed tomography Reviewed

    YAMADA Kentaro

    53 ( 5 )   1021 - 1022   2010.09( ISSN:00089443

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  • 大腸癌骨転移の整形外科的治療

    星 学, 大戎 直人, 早川 景子, 家口 尚, 豊田 宏光, 中村 博亮

    整形外科   61 ( 10 )   1073 - 1076   2010.09( ISSN:00305901 ( eISSN:24329444

  • スポーツにおける腰椎障害に対する治療 Reviewed

    大久保 衞, 中村 博亮

    日本臨床スポーツ医学会誌 = The journal of Japanese Society of Clinical Sports Medicine   18 ( 3 )   386 - 387   2010.08( ISSN:13464159

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  • Endoscopic posterior decompression surgery for the lumbar spine Reviewed

    Japanese journal of clinical sports medicine   18 ( 3 )   393 - 395   2010.08( ISSN:13464159

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  • Short Term Clinical Results of Arthroscopic Capsular Placation for MDI Reviewed

    MATSUMOTO Isshin, ITO Yoichi, MANAKA Tomoya, OEBISU Naoto, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   34 ( 3 )   713 - 716   2010.08( ISSN:09104461 ( eISSN:18816363

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    Arthroscopic capsular plication has been reported to be a novel surgical treatment for MDI: Multidirectional instability of the shoulder, which was previously treated by capsular shift open surgical procedure. The purpose of this study was to evaluate short term clinical results of arthroscopic capsular placation for MDI. We retrospectively evaluated 17 shoulders (16 patients, 15 male and 1 female) arthroscopically treated by capsular plication. Arthroscopic capsular plication was performed for the loose capsular portion which was correctly determined by symptom and physical examination under anesthesia.The average age at the time of surgery was 28.17 years old(range, 15-47 years). The average follow-up was 26.0 months (range, 6-60 months). Clinical results were evaluated by symptomatic instability, physical examination and assessment with JSS shoulder instability score. Disappearance of instability by physical examination with no apparent complication was confirmed in all cases and surgical good effect of this procedure was recognized. However we observed symptomatic instability remained in 7 of 17 shoulders (41.2%) and patients' symptom has not yet completely disappeared. The average JSS shoulder instability score improved from 52.4 points preoperatively to 91.4 points postoperatively. Patients treated with Arthroscopic capsular placation for MDI have shown excellent short term clinical outcomes. Longer follow up is necessary for the evaluation of the remaining symptomatic instability.

    DOI: 10.11296/katakansetsu.34.713

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  • Antibiotic administration for bone and soft tissue tumor Reviewed

    HOSHI Manabu

    53 ( 4 )   927 - 928   2010.07( ISSN:00089443

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  • A cemented mobile-bearing total knee replacement prevents periprosthetic loss of bone mineral density around the femoral component A MATCHED COHORT STUDY Reviewed

    Minoda Y., Ikebuchi M., Kobayashi A., Iwaki H., Inori F., Nakamura H.

    JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME   92B ( 6 )   794 - 798   2010.06( ISSN:0301-620X

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    DOI: 10.1302/0301-620X.92B6.23159

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  • FACTOR SUBSTITUTION, MECHANIZATION, AND ECONOMIC GROWTH Reviewed

    Nakamura Hideki

    JAPANESE ECONOMIC REVIEW   61 ( 2 )   266 - 281   2010.06( ISSN:1352-4739

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    DOI: 10.1111/j.1468-5876.2009.00486.x

  • The risk of notching the anterior femoral cortex with the use of navigation systems in total knee arthroplasty Reviewed

    Minoda Yukihide, Kobayashi Akio, Iwaki Hiroyoshi, Mitsuhiko Ikebuchi, Kadoya Yoshinori, Ohashi Hirotsugu, Takaoka Kunio, Nakamura Hiroaki

    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY   18 ( 6 )   718 - 722   2010.06( ISSN:0942-2056

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    DOI: 10.1007/s00167-009-0927-5

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  • Treatment of bone metastatic tumor with renal cancer Reviewed

    HAYAKAWA Keiko

    53 ( 3 )   679 - 680   2010.05( ISSN:00089443

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  • Five cases report of bone metastases with esophageal cancer Reviewed

    HOSHI Manabu

    53 ( 3 )   677 - 678   2010.05( ISSN:00089443

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  • 原発不明癌骨転移の臨床的問題点

    星 学, 早川 景子, 家口 尚, 青野 勝成, 田口 晋, 中村 博亮

    整形外科   61 ( 5 )   455 - 460   2010.05( ISSN:00305901 ( eISSN:24329444

  • Antitumor necrotic factor agent promotes BMP-2-induced ectopic bone formation Reviewed

    EGUCHI Yoshitaka, WAKITANI Shigeyuki, IMAI Yuuki, NAKA Yoshifumi, HASHIMOTO Yuusuke, NAKAMURA Hiroaki, TAKAOKA Kunio

    Journal of bone and mineral metabolism   28 ( 2 )   157 - 164   2010.03( ISSN:09148779

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  • Bone morphology of the tibial attachment of anterior cruciate ligament Reviewed

    HARA Yo

    35 ( 1 )   100 - 101   2010.03( ISSN:18848842

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  • Analysis of tibial attachment of the anterior cruciate ligament in cadaveric knee Reviewed

    TAKIGAMI Junsei

    35 ( 1 )   102 - 103   2010.03( ISSN:18848842

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  • Anatomical and computed tomographic analysis of the femoral attachment of the PCL Reviewed

    NISHIKINO Shoichi

    35 ( 1 )   174 - 175   2010.03( ISSN:18848842

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  • Antitumor necrotic factor agent promotes BMP-2-induced ectopic bone formation Reviewed

    Eguchi Yoshitaka, Wakitani Shigeyuki, Imai Yuuki, Naka Yoshifumi, Hashimoto Yuusuke, Nakamura Hiroaki, Takaoka Kunio

    JOURNAL OF BONE AND MINERAL METABOLISM   28 ( 2 )   157 - 164   2010.03( ISSN:0914-8779

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    DOI: 10.1007/s00774-009-0127-x

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  • Incidence of complications associated with spinal endoscopic surgery : nationwide survey in 2007 by the Committee on Spinal Endoscopic Surgical Skill Qualification of Japanese Orthopaedic Association Reviewed

    MATSUMOTO MORIO, HASEGAWA TORU, ITO MANABU, AIZAWA TOSHIMI, KONNO SHINICHI, YAMAGATA MASATSUNE, EBARA SOHEI, HACHIYA YUDO, NAKAMURA HIROAKI, YAGI SHOJI, SATO KIMIAKI, DEZAWA AKIRA, YOSHIDA MUNETO, SHINOMIYA KENICHI, TOYAMA YOSHIAKI, SHIMIZU KATSUJI, NAGATA KENSEI

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   15 ( 1 )   92 - 96   2010.01( ISSN:09492658

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  • Incidence of complications associated with spinal endoscopic surgery: nationwide survey in 2007 by the Committee on Spinal Endoscopic Surgical Skill Qualification of Japanese Orthopaedic Association Reviewed

    Matsumoto Morio, Hasegawa Toru, Ito Manabu, Aizawa Toshimi, Konno Shinichi, Yamagata Masatsune, Ebara Sohei, Hachiya Yudo, Nakamura Hiroaki, Yagi Shoji, Sato Kimiaki, Dezawa Akira, Yoshida Muneto, Shinomiya Kenichi, Toyama Yoshiaki, Shimizu Katsuji, Nagata Kensei

    JOURNAL OF ORTHOPAEDIC SCIENCE   15 ( 1 )   92 - 96   2010.01( ISSN:0949-2658

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    DOI: 10.1007/s00776-009-1428-6

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  • Image Evaluation for Acromioclavicular Joint Osteoarthritis Reviewed

    MANAKA Tomoya, ITO Yoichi, MATSUMOTO Isshin, OEBISU Naoto, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   34 ( 2 )   503 - 506   2010( ISSN:0910-4461 ( eISSN:18816363

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    In decision making of surgical treatment for painful acromioclavicular (AC) joint osteoarthritis, image evaluation of AC joint is essential. The purpose of this study was to evaluate AC joint by X-ray and MRI images and to introduce new classification of these images. We retrospectively evaluated 40 shoulders of 38 patients (23 male, 15 female), who had arthroscopic distal clavicle resection under the diagnosis of degenerative AC joint osteoarthritis. Average age at the time of surgery was 60.1 years. X-ray images were assessed by the following 3 items: joint space narrowing, osteophyte formation and osteosclerotic change. MRI images were assessed by the following 3 items: joint fluid formation, distal clavicular bony marrow edema and acromional bony marrow edema. Each item was scored 1 point and total assessment was scored 6 points in total based on this new image classification. X-ray images evaluation revealed joint space narrowing in 27 shoulders (67.5%), osteophyte formation in 28 shoulders (70%) and osteosclerotic change in 20 shoulders (50%). MRI images evaluation revealed joint fluid formation in 33 shoulders (82.5%), distal clavicular bony marrow edema in 22 shoulders (55%) and acromional bony marrow edema in 22 shoulders (55%). Average total score was 3.8 points; joint space narrowing, joint fluid formation, distal clavicular bony marrow edema, and acromional bony marrow edema were significantly related to the severity of image evaluation. Our results showed that this new image classification of AC joint is helpful for the severity evaluation of the painful AC joint osteoarthritis.

    DOI: 10.11296/katakansetsu.34.503

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  • Interlaminar fenestration by partial spinous process splitting approach for lumbar spinal canal stenosis Reviewed

    SEKI Masahiko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   53 ( 6 )   1319 - 1320   2010( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2010.1319

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  • Clinical Significance of Subacromial Bursographies Reviewed

    MATSUMOTO Isshin, ITO Yoichi, MANAKA Tomoya, OEBISU Naoto, NAKAMURA Nobuyuki, NAKAMURA Hiroaki

    Japan Shoulder Society, Katakansetsu   34 ( 2 )   333 - 337   2010( ISSN:0910-4461 ( eISSN:18816363

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    Subacromial impingement syndrome or rotator cuff tears are very common shoulder diseases which occur in the subacromial bursa. Subacromial injection of anesthetic during subacromial bursography is very helpful for understanding the pathological condition in the subacromial bursa. The aim of this study was to evaluate the correlation between visual change in the subacromial bursa and its pathology and to identify the significance of subacromial bursographies. We retrospectively evaluated subacromial bursographies of 133 shoulders in 133 patients (78 males, 55 females), who were diagnosed as having subacromial impingement in 71 cases, stiff shoulder in 39 cases, calcifying tendonitis in 5 cases, and partial thickness rotator cuff tear in 18 cases. We classified four types of bursographies based on the visualized portion such as subacromial portion: SA, subcoracoid portion: SC and subdeltoid portion: SD according to the Mikasa's classification. <Type 1: SA, Type 2: SA and SC, Type 3: SA and SD, Type 4: SA, SC and SD> Anesthetic was used during subacromial bursography; pain block effect and improvement of the shoulder motion were statistically analyzed. We observed 76 cases of type 1, 21 cases of type 2, 35 cases of type 3 and 1 case of type 4. There was a correlation between stiff shoulder and SA narrowed subtype in type 1. Pain block effect in type 2 was more significant than other types.Our results showed that four types of new image classification of subacromial bursography are helpful for understanding the pathology in subacromial bursa.

    DOI: 10.11296/katakansetsu.34.333

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  • Five cases report of bone metastases with esophageal cancer Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   53 ( 3 )   677 - 678   2010( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2010.677

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  • Treatment of chondroblastoma Reviewed

    HAYAKAWA Keiko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   53 ( 5 )   1057 - 1058   2010( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2010.1057

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  • Treatment of bone metastatic tumor with renal cancer Reviewed

    HAYAKAWA Keiko

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   53 ( 3 )   679 - 680   2010( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2010.679

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  • Antibiotic administration for bone and soft tissue tumor Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   53 ( 4 )   927 - 928   2010( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2010.927

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  • A characteristic findings of gouty arthritis from a diet standpoint in the Airin area of Nishinari-ku, Osaka Reviewed

    NAKATA Nobuaki

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   53 ( 6 )   1255 - 1256   2010( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2010.1255

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  • The deference between surgical approaches on microscopic lumbar foraminotomy:—analysis using Multidetector-row computed tomography— Reviewed

    YAMADA Kentaro

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   53 ( 5 )   1021 - 1022   2010( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2010.1021

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  • Annual report 2008 of the spinal endoscopic surgery Reviewed

    The Journal of the Japanese Orthopaedic Association   83 ( 12 )   1022 - 1027   2009.12( ISSN:00215325

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  • Recovery Process Following Cervical Laminoplasty in Patients With Cervical Compression Myelopathy : Prospective Cohort Study Reviewed

    SUZUKI A (鈴木亨暢), MISAWA Hiromichi, SIMOGATA Mitsuhiko, TSUTSUMIMOTO Takahiro, TAKAOKA Kunio, NAKAMURA Hiroaki

    Spine   34 ( 26 )   2874 - 2879   2009.12( ISSN:03622436

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  • Recovery Process Following Cervical Laminoplasty in Patients With Cervical Compression Myelopathy Prospective Cohort Study Reviewed

    Suzuki Akinobu, Misawa Hiromichi, Simogata Mitsuhiko, Tsutsumimoto Takahiro, Takaoka Kunio, Nakamura Hiroaki

    SPINE   34 ( 26 )   2874 - 2879   2009.12( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e3181bb0e33

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  • Successful Spinal Fusion by E. coli-derived BMP-2-adsorbed Porous beta-TCP Granules: A Pilot Study Reviewed

    Dohzono Sho, Imai Yuuki, Nakamura Hiroaki, Wakitani Shigeyuki, Takaoka Kunio

    CLINICAL ORTHOPAEDICS AND RELATED RESEARCH   467 ( 12 )   3206 - 3212   2009.12( ISSN:0009-921X

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    DOI: 10.1007/s11999-009-0960-1

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  • Primary NK/T-cell lymphoma of the cauda equina: a case report and literature review. Reviewed

    Morita M, Osawa M, Naruse H, Nakamura H

    Spine   34 ( 24 )   E882 - 5   2009.11( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e3181b29de6

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  • The change of hip abductor muscle strength after Total Hip Arthroplasty Reviewed

    KATO Ryoichi

    35   115 - 118   2009.10( ISSN:03893634

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  • Range of motion for reaching toe in patients after Total Hip Arthroplasty Reviewed

    MIYOSHI Takashi

    35   46 - 49   2009.10( ISSN:03893634

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  • Investigation of ADL training after Total Hip Arthroplasty Reviewed

    MIYOSHI Takashi

    Hip Joint Supplement   35   42 - 45   2009.10( ISSN:03893634

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  • Prospect of Gait after Total Hip Arthroplasty in the Early Stage Using a Wearable Accelerometer Reviewed

    KATO Ryoichi

    35   72 - 75   2009.10( ISSN:03893634

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  • Low Back Pain in Patients Treated Surgically for Scoliosis : Longer Than Sixteen-Year Follow-up Reviewed

    TAKAYAMA Kazushi, NAKAMURA Hiroaki, MATSUDA Hideki

    Spine   34 ( 20 )   2198 - 2204   2009.09( ISSN:03622436

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  • Low Back Pain in Patients Treated Surgically for Scoliosis Longer Than Sixteen-Year Follow-up Reviewed

    Takayama Kazushi, Nakamura Hiroaki, Matsuda Hideki

    SPINE   34 ( 20 )   2198 - 2204   2009.09( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e3181b3f31f

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  • Quality of Life in Patients Treated Surgically for Scoliosis : Longer Than Sixteen-Year Follow-up Reviewed

    TAKAYAMA Kazushi, NAKAMURA Hiroaki, MATSUDA Hideki

    Spine   34 ( 20 )   2179 - 2184   2009.09( ISSN:03622436

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  • Quality of Life in Patients Treated Surgically for Scoliosis Longer Than Sixteen-Year Follow-up Reviewed

    Takayama Kazushi, Nakamura Hiroaki, Matsuda Hideki

    SPINE   34 ( 20 )   2179 - 2184   2009.09( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e3181abf684

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  • 腰部脊柱管狭窄症に対する手術侵襲度の比較(内視鏡下手術vs顕微鏡視下手術)

    寺井 秀富, 中村 博亮

    整形外科   60 ( 10 )   1072 - 1072   2009.09( ISSN:00305901 ( eISSN:24329444

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  • Factors affecting neurological deficits and intractable back pain in patients with insufficient bone union following osteoporotic vertebral fracture. Reviewed

    Hoshino M, Nakamura H, Terai H, Tsujio T, Nabeta M, Namikawa T, Matsumura A, Suzuki A, Takayama K, Takaoka K

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society   18 ( 9 )   1279 - 1286   2009.09( ISSN:0940-6719

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    The purpose of this study was to examine factors affecting the severity of neurological deficits and intractable back pain in patients with insufficient bone union following osteoporotic vertebral fracture (OVF). Reports of insufficient union following OVF have recently increased. Patients with this lesion have various degrees of neurological deficits and back pain. However, the factors contributing to the severity of these are still unknown. A total of 45 patients with insufficient union following OVF were included in this study. Insufficient union was diagnosed based on the findings of vertebral cleft on plain radiography or CT, as well as fluid collection indicating high-intensity change on T2-weighted MRI. Multivariate logistic regression analysis was performed to determine the factors contributing to the severity of neurological deficits and back pain in the patients. Age, sex, level of fracture, duration after onset of symptoms, degree of local kyphosis, degree of angular instability, ratio of occupation by bony fragments, presence or absence of protrusion of flavum, and presence or absence of ossification of the anterior longitudinal ligament (OALL) in the adjacent level were used as explanatory variables, while severity of neurological deficits and back pain were response variables. On multivariate analysis, factors significantly affecting the severity of neurological deficits were angular instability of more than 15 degrees [adjusted odds ratio (OR), 9.24 (95% confidence interval, CI 1.49-57.2); P &lt; 0.05] and ratio of occupation by bony fragments in the spinal canal of more than 42% [adjusted OR 9.23 (95% CI 1.15-74.1); P &lt; 0.05]. The factor significantly affecting the severity of back pain was angular instability of more than 15 degrees [adjusted OR 14.9 (95% CI 2.11-105); P &lt; 0.01]. On the other hand, presence of OALL in the adjacent level reduced degree of back pain [adjusted OR 0.14 (95% CI 0.03-0.76); P &lt; 0.05]. In this study, pronounced angular instability and marked posterior protrusion of bony fragments in the canal were factors affecting neurological deficits. In addition, marked angular instability was a factor affecting back pain. These findings are useful in determining treatment options for patients with insufficient union following OVF.

    DOI: 10.1007/s00586-009-1041-6

    PubMed

  • Gemcitabine-based adjuvant chemotherapy improves survival after aggressive surgery for hilar cholangiocarcinoma. Reviewed

    Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasuo Hayashidani, Yasushi Hashimoto, Hiroaki Nakamura, Akira Nakashima, Taijiro Sueda

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract   13 ( 8 )   1470 - 9   2009.08( ISSN:1091-255X

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    BACKGROUND: The prognosis of hilar cholangiocarcinoma is dismal although aggressive surgery including major hepatectomy has been performed. The aim of this study was to clarify useful prognostic factors and the usefulness of gemcitabine-based adjuvant chemotherapy for patients with hilar cholangiocarcinoma who had undergone aggressive surgical resection. METHODS: Medical records of 42 patients with hilar cholangiocarcinoma who underwent surgical resection were reviewed retrospectively. Univariate and multivariate models were used to analyze the effect of various clinicopathological factors on long-term survival. RESULTS: Overall 1-, 3-, and 5-year survival rates of the 42 patients with hilar cholangiocarcinoma were 81%, 42%, and 30%, respectively (median survival time, 21.5 months). Univariate analysis revealed that adjuvant gemcitabine-based chemotherapy, tumor differentiation, lymph node metastasis, and surgical margin status were associated significantly with long-term survival (P < 0.05). Furthermore, use of a Cox proportional hazards regression model indicated that only adjuvant gemcitabine-based chemotherapy was a significant independent predictor of a favorable prognosis (P = 0.035). The toxicity of adjuvant gemcitabine-based chemotherapy was mild. Five-year actuarial survival rates of patients who did or did not receive adjuvant gemcitabine-based chemotherapy were 57% and 23%, respectively (P = 0.026). CONCLUSIONS: Postoperative adjuvant gemcitabine-based chemotherapy may be a promising strategy to improve survival after surgical resection for hilar cholangiocarcinoma. A prospective randomized study should be done to confirm the results of this study.

    DOI: 10.1007/s11605-009-0900-0

    PubMed

  • Change of bone markers in patients with bone metastases treated with zoledronic acid Reviewed

    TAKAHASHI Shinji

    52 ( 4 )   969 - 970   2009.07( ISSN:00089443

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  • Adverse effect in laboratory data of caffeine assisted chemotherapy for high grade bone and soft tissue sarcoma Reviewed

    HOSHI Manabu

    52 ( 4 )   835 - 836   2009.07( ISSN:00089443

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  • Comparison of clinical outcome after treatment of hip arthritis caused by MRSA with that caused by non-MRSA in infants. Reviewed

    Mortia M, Nakamura H, Kitano T

    Journal of pediatric orthopedics. Part B   18 ( 1 )   1 - 5   2009.01( ISSN:1060-152X

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    DOI: 10.1097/BPB.0b013e3283150659

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  • Short term clinical results of arthroscopic rotator cuff repair with JuggerKnot <SUP>TM</SUP> soft anchors Reviewed

    Manaka Tomoya, Ito Yoichi, Matsumoto Isshin, Ichikawa Koichi, Hirakawa Yoshihiro, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   37 ( 3 )   1113 - 1116   2009( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> The purpose of this study was to evaluate short term clinical results of arthroscopic rotator cuff repair with JuggerKnot<SUP>TM</SUP> soft anchors for rotator cuff tears.<BR><B>Methods:</B> We evaluated 28 shoulders in 28 consecutive patients who had arthroscopic rotator cuff repair with JuggerKnot<SUP>TM</SUP> soft anchors with a minimum of six months follow up. Average age at the surgery was 60.5 years. 28 shoulders were divided into 4 groups: 6 partial tears, 4 small size tears, 10 medium size tears and 8 large or massive size tears. Clinical evaluation was composed of intra-operative trouble of JuggerKnot<SUP>TM</SUP> soft anchor and repaired rotator cuff condition, number of used anchors, active ROM in flexion and abduction; clinical assessment with the JOA shoulder scoring system at 3 and 6 months follow up.<BR><B>Results:</B> Intra-operative JuggerKnot<SUP>TM</SUP> soft anchor failure was observed only in one case with a medium size tear and repaired rotator cuff condition was good in arthroscopic findings in all cases. In partial and small size tear, 3.2 JuggerKnot<SUP>TM</SUP> soft anchors were used on average. In medium and large or massive size tear, 3.6 JuggerKnot<SUP>TM</SUP> soft anchors were used on average combined with 1.6 conventional metal anchors. Preoperative active ROM in flexion and abduction significantly improved postoperatively. Average preoperative JOA score was significantly increased at 3 and 6 months follow up.<BR><B>Conclusion:</B> JuggerKnot<SUP>TM</SUP> soft suture anchors were useful instruments in partial and small size tears; they were also useful if combined with conventional anchors in medium and large or massive size tears.

    DOI: 10.11296/katakansetsu.37.1113

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  • Clinical experience of arthroscopic decompression for paraglenoid ganglion cyst<BR>-Evaluation of postoperative rehabilitation period Reviewed

    Hirakawa Yoshihiro, Ito Yoichi, Matsumoto Isshin, Manaka Tomoya, Ichikawa Koichi, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   37 ( 3 )   1185 - 1188   2009( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> The purpose of this study was to evaluate clinical results of arthroscopic treatment for paraglenoid ganglion cysts and to investigate the postoperative rehabilitation period for sufficient recovery of SSN palsy.<BR><B>Methods:</B> We evaluated 10 shoulders diagnosed as having paraglenoid ganglion cysts by MRI and EMG preoperatively and arthroscopically treated with a minimum of 6 months follow up. Average age at the time of surgery was 42 years. Postoperative rehabilitation including exercise in SSP and ISP; peripheral nerve stimulation in SSN was performed three times a week. Clinical evaluation was composed of posterior scapular pain, active range of motion in flexion and abduction, MMT in SSP and ISP.<BR><B>Results:</B> Complete disappearance of posterior scapular pain was recognized in all shoulders. Average active flexion was 151 degrees preoperatively and improved to 172 degrees at 3 months F/U and 178 degrees at 6 months F/U respectively. Average active abduction was 144 degrees preoperatively and improved to 170 degrees at 3 months F/U and 177 degrees at 6 months F/U respectively. Average preoperative MMT in SSP was 3.8 and improved to 5 at 3 and 6 months F/U; average preoperative MMT in ISP was 4. 4 and improved to 5 at 3 and 6 months F/U.<BR><B>Conclusion:</B> Our results showed arthroscopic resection was an effective surgical procedure for the treatment of paraglenoid ganglion cyst and the postoperative rehabilitation period for sufficient recovery of SSN palsy was three months.

    DOI: 10.11296/katakansetsu.37.1185

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  • Change of bone markers in patients with bone metastases treated with zoledronic acid Reviewed

    TAKAHASHI Shinji

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   52 ( 4 )   969 - 970   2009( ISSN:0008-9443

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    DOI: 10.11359/chubu.2009.969

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  • Short-term outcome of arthroscopic subacromial decompression and arthroscopic capsular release for subacromial impingement syndrome Reviewed

    Matsuda Yoshinobu, Ito Yoichi, Ichikawa Koichi, Matsumoto Isshin, Manaka Tomoya, Hirakawa Yoshihiro, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   37 ( 3 )   1203 - 1207   2009( ISSN:0910-4461 ( eISSN:18816363

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    <B>Hypothesis:</B> Impingement syndrome restricts the shoulder motion and can cause shoulder joint stiffness. This study was carried out to evaluate the functional outcome of arthroscopic surgical management for impingement syndrome with shoulder joint stiffness.<BR><B>Methods:</B> We evaluated a total of 50 shoulders with impingement syndrome, consisting of 25 shoulders with impingement syndrome alone (Group I) and 25 shoulders with impingement syndrome associated with shoulder joint stiffness (Group II). Group I shoulders were treated by arthroscopic subacromial decompression (ASD) alone and Group II shoulders were treated by ASD with capsular release. Clinical evaluation was composed of Hawkins impingement sign (+ or -), active ROM in flexion and abduction; clinical assessment with the Japanese Orthopaedic Association (JOA) shoulder scoring system at 3 and 6 months follow up. Statistical evaluation was performed between the two groups.<BR><B>Results:</B> Hawkins impingement sign was observed preoperatively in all 50 shoulders and had disappeared in all 25 shoulders of Group I at 3 months follow up. In Group II it had not disappeared in 5 shoulders (20%) at 3 months follow up, though it had disappeared in all 25 shoulders at 6 months follow up. Average active ROM in flexion and abduction was significantly improved in both Groups at 3 and 6 months follow up. JOA score was significantly higher in Group I than Group II.<BR><B>Conclusion:</B> Our results showed ASD combined with capsular release was an alternative surgical procedure for the treatment of combined lesions with subacromial impingement and shoulder joint stiffness.

    DOI: 10.11296/katakansetsu.37.1203

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  • Clinical features of the shoulders with complete LHB ruptures Reviewed

    Ichikawa Koichi, Ito Yoichi, Hirakawa Yoshihiro, Matsumoto Isshin, Manaka Tomoya, Nakamura Hiroaki

    Japan Shoulder Society, Katakansetsu   37 ( 3 )   1157 - 1161   2009( ISSN:0910-4461 ( eISSN:18816363

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    <B>Background:</B> Long head of the biceps brachii (LHB) tendon has an important role to maintain shoulder function. LHB tendon ruptures occur in the cases of subacromial impingement syndrome and rotator cuff tears (RCT), though we don't known about the pathological mechanism in these disease. The aim of this study was to determine the correlation between LHB tendon ruptures and rotator cuff disease.<BR><B>Methods:</B> We retrospectively evaluated 116 shoulders that had undergone arthroscopic surgeries for rotator cuff disease combined with complete LHB tendon ruptures. We evaluated four clinical items as follows during the arthroscopic surgeries. 1: Subacromial impingement sign, rotator cuff tears, 2: RCT size, 3: Involved torn tendon, 4: RCT localization. Each parameter was statistically analyzed.<BR><B>Results:</B> Subacromial impingement sign was observed in all shoulders. The cases without full-thickness RCT were observed in 17%. The cases with full-thickness RCT were observed in 81%; other two cases were one with septic arthritis and one with hemodialytic shoulder. Small size tear occured in 3.2%, middle size tear occured in 23.4%, large size tear was in 21.3% and massive size tear was in 52.1%. Supraspinatus tear was observed in all 94 shoulders, subscapularis tear was observed in 50% and infraspinatus tear in 51%. Supraspinatus tear was localized at the anterior one-third of the greater tuberosity in 98%.<BR><B>Conclusion:</B> LHB tendon ruptures were frequently recognized in massive RCT. LHB tendon deficient RCT were significantly localized at the anterior one-third of the greater tuberosity.

    DOI: 10.11296/katakansetsu.37.1157

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  • Adverse effect in laboratory data of caffeine assisted chemotherapy for high grade bone and soft tissue sarcoma Reviewed

    HOSHI Manabu

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   52 ( 4 )   835 - 836   2009( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2009.835

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  • Role of angiotensin II type 1 receptor on retinal vascular leakage in a rat oxygen-induced retinopathy model. Reviewed

    Hiroaki Nakamura, Mami Yamazaki, Takao Ohyama, Tatsuya Inoue, Naohisa Arakawa, Yuki Domon, Tomihisa Yokoyama

    Ophthalmic research   41 ( 4 )   210 - 5   2009( ISSN:0030-3747

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    AIM: To investigate the role of angiotensin type 1 (AT1) and type 2 (AT2) receptors in hypoxia-induced retinal vascular hyperpermeability. METHODS: Brown-Norway rat pups were exposed to hyperoxic conditions from postnatal day 7 (P7) to P12, and to subsequent normal air for 5 days [oxygen-induced retinopathy (OIR) model]. Olmesartan medoxomil (AT1 receptor antagonist; administered orally), PD123319 (AT2 receptor antagonist; administered subcutaneously) or a vehicle was administered once daily during the last 5 days. At P16, the retinal permeability was determined by measuring the leaked fluorescein-conjugated dextran concentration in the retina. The vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 (HIF-1) alpha proteins in the retina were assessed by an ELISA and western blotting, respectively. RESULTS: Olmesartan medoxomil partially, but significantly, inhibited the retinal vascular hyperpermeability induced by hypoxia. In contrast, PD123319 did not show a significant effect. The VEGF and HIF-1alpha protein levels were significantly elevated in the OIR retina; however, there was no significant effect of olmesartan medoxomil on the expression of either protein. CONCLUSIONS: These results suggest that the AT1 receptor is, at least partly, responsible for hyperpermeability in the OIR rat retina via a mechanism independent of HIF-1 and VEGF expression.

    DOI: 10.1159/000217725

    PubMed

  • The Incidence of Detedion of DVT and PE by Multi Detecter Row CT in Total Hip Arthroplasty Reviewed

    FUKUNAGA Kenji

    Japanese Society for Joint Diseases, Japanese Journal of Joint Diseases   28 ( 2 )   213 - 217   2009( ISSN:1883-2873 ( eISSN:18849067

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    Deep venous thrombosis (DVT) and pulmonary embolism (PE) are serious complications of total hip arthroplasty (THA). We assessed DVT and PE after THA with 64-slice multi-detector row CT (MDCT), which can detect DVT and PE simultaneously within one minute. We examined 114 cases of THA (101 patients) and 11 of revision THA (10 patients) between May 2006 and September 2007. There were 87 women and 14 men. The mean age at operation was 62.6 years (range, 3684 years). All patients used a venous foot pump (VFP) on both legs until walking. Compression stockings were routinely used for 2 weeks after walking, and no drug prophylaxis was performed. At day 7, patients underwent combined MDCT pulmonary angiography and indirect CT venography of the lower limbs, with analysis of results by a radiologist. DVT was revealed by MDCT in 7 patients (6.1%). PE was detected in 5 patients (4.4%). None of these lesions was symptomatic. The incidence of DVT or PE was 8.7% in patients who underwent primary THA and 27% in those who underwent revision THA. A cutoff value of 10.0 &micro;g/ml for the D-dimer on day 7 had high sensitivity (100%) but low specificity (55%) in the diagnosis of DVT. Our incidences of DVT and PE in primary THA were quite low, possibly due to accelerated rehabilitation and usage of the VFP. The D-dimer level under 10 &micro;g/ml on postoperative day 7 appears to be an indicator of lack of occurrence of DVT after THA.

    DOI: 10.11551/jsjd.28.213

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  • Why does delay exist in the diagnosis of intradural spinal cord tumor despite the availability of MRI? Reviewed

    Kato Minori, Nakamura Hiroaki, Terai Hidetomi, Konishi Sadahiko, Nagayama Ryuichi, Takaoka Kunio

    JOURNAL OF CLINICAL NEUROSCIENCE   15 ( 8 )   880 - 885   2008.08( ISSN:0967-5868

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    DOI: 10.1016/j.jocn.2007.03.019

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  • Foot drop of sudden onset caused by acute hematoma in the lumbar ligamentum flavum: a case report and review of the literature. Reviewed

    Kono H, Nakamura H, Seki M, Motoda T

    Spine   33 ( 16 )   E573 - 5   2008.07( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e31817c6cb5

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  • Ependymal cyst in the lumbar spine associated with cauda equina compression Reviewed

    Kato Minori, Nakamura Hiroaki, Suzuki Eisuke, Terai Hidetomi, Wakasa Kenichi, Wakasa Tomoko, Takaoka Kunio

    JOURNAL OF CLINICAL NEUROSCIENCE   15 ( 7 )   827 - 830   2008.07( ISSN:0967-5868

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    DOI: 10.1016/j.jocn.2006.12.020

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  • Effect of preserving paraspinal muscles on postoperative axial pain in the selective cervical laminoplasty. Reviewed

    Kato M, Nakamura H, Konishi S, Dohzono S, Toyoda H, Fukushima W, Kondo K, Matsuda H

    Spine   33 ( 14 )   E455 - 9   2008.06( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e318178e607

    PubMed

  • Effect of preserving paraspinal muscles on postoperative axial pain in the selective cervical laminoplasty Reviewed

    Kato Minori, Nakamura Hiroaki, Konishi Sadahiko, Dohzono Sho, Toyoda Hiromitsu, Fukushima Wakaba, Kondo Kyoko, Matsuda Hideki

    SPINE   33 ( 14 )   E455 - E459   2008.06( ISSN:0362-2436

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  • Thoracic epidural and intradural meningioma with calcification ; A case report Reviewed

    MAENO Takafumi

    51 ( 3 )   397 - 399   2008.05( ISSN:00089443

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  • Prognostic Factors on Pseudoarthrosis Following Osteoporotic Vertebral Fractures: Prospective Multicenter Study Reviewed

    中村 博亮, 辻尾 唯雄, 寺井 秀富, 星野 雅俊, 松村 昭, 加藤 相勲, 鈴木 亨暢, 高山 和士, 高岡 邦夫

    臨床整形外科   43 ( 4 )   309 - 314   2008.04( ISSN:05570433 ( eISSN:18821286

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    関連27施設において65歳以上の骨粗鬆症性椎体骨折例を登録し,6ヵ月後の予後を検討した.登録時に疼痛部位の単純X線とルーチンMRIを施行した.6ヵ月後に症例を偽関節症例群と骨癒合症例群に分類し,登録時の画像的所見を比較検討した.対象症例は150例で,6ヵ月後のX線像で骨癒合群が129例に,偽関節が21例にみられ,偽関節への移行率は14.0%であった.登録時のMRI T2強調画像で高輝度限局型が最も偽関節への移行率が高く,次いで低輝度広範型が高かった.また椎体後壁損傷がある症例では,ない症例に比較して偽関節へ移行しやすかった.(著者抄録)

    DOI: 10.11477/mf.1408101256

    CiNii Article

    Other URL: http://search.jamas.or.jp/link/ui/2008183079

  • Result of C3-6 Laminoplasty with PLLA lateral mass screw Reviewed

    MAENO T.

    19 ( 2 )   275   2008.03( ISSN:13464876

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  • Low back pain in surgically treated patients with scoliosis : Longer than 15-year follow-up Reviewed

    TAKAYAMA K.

    19 ( 2 )   285   2008.03( ISSN:13464876

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  • A clinical prospective study on the operative invasion for lumbar spinal canal stenosis : comparison between microendoscopic and microscopic posterior decompression Reviewed

    TERAI H.

    19 ( 2 )   220   2008.03( ISSN:13464876

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  • Risk factor analysis for motor deficits and the late recovery associated with L4/5 lumbar disc herniation Reviewed

    S. Akinobu

    19 ( 2 )   311   2008.03( ISSN:13464876

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  • Radiographic evaluation of microscopic bilateral decompression via unilateral approach for degenerative lumbar scoliosis Reviewed

    MATSUMURA A.

    19 ( 1 )   67   2008.03( ISSN:13464876

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  • Clinical results of Unilateral Transforaminal Lumbar Interbody Fusionfor degenerative lumbar scoliosis Reviewed

    HAYAKAWA K.

    19 ( 1 )   56   2008.03( ISSN:13464876

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  • Radiographic evaluation of the postoperative bone re-growth in bilateral decompression via unilateral approach in degenerative lumbar spondylolisthesis Reviewed

    DOUZONO S.

    19 ( 1 )   82   2008.03( ISSN:13464876

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  • Prognostic evaluatuion of an osteoporotic vertebral fracture by MRI scanned in early stage : prospective multicenter study Reviewed

    TSUJIO T.

    19 ( 2 )   374   2008.03( ISSN:13464876

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  • Foot drop of sudden onset caused by acute hematoma in the lumbar ligamentum flavum - A Case Report and Review of the Literature

    Spine   33 ( 16 )   :E573-E575   2008

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  • Ependymal cyst in the lumbar spine associated with cauda equine compression

    J Clin Neurosci   15 ( 7 )   827 - 30   2008

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  • An ultrastructural study of Porphyromonas gingivalis-induced platelet aggregation. Reviewed

    Li X, Iwai T, Nakamura H, Inoue Y, Chen Y, Umeda M, Suzuki H

    Thrombosis research   122 ( 6 )   810 - 9   2008( ISSN:0049-3848

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    DOI: 10.1016/j.thromres.2008.03.011

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  • Thoracic epidural and intradural meningioma with calcification; A case report Reviewed

    MAENO Takafumi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   51 ( 3 )   397 - 399   2008( ISSN:0008-9443

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    DOI: 10.11359/chubu.2008.397

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  • Enhancing effects of a prostaglandin EP4 receptor agonist on recombinant human bone morphogenetic protein-2 mediated spine fusion in a rabbit model Reviewed

    Namikawa Takashi, Terai Hidetomi, Hoshino Masatoshi, Kato Minori, Toyoda Hiromitsu, Yano Koichi, Nakamura Hiroaki, Takaoka Kunio

    SPINE   32 ( 21 )   2294 - 2299   2007.10( ISSN:0362-2436

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  • Enhancing effects of a prostaglandin EP4 receptor agonist on recombinant human bone morphogenetic protein-2 mediated spine fusion in a rabbit model. Reviewed

    Namikawa T, Terai H, Hoshino M, Kato M, Toyoda H, Yano K, Nakamura H, Takaoka K

    Spine   32 ( 21 )   2294 - 9   2007.10( ISSN:0362-2436

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    DOI: 10.1097/BRS.0b013e318154c5b6

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  • Prognostic factor on MRI findings inducing prolonged intractable pain due to pseudoarthrosis following osteoporotic vertebral fracture Reviewed

    Tsujio T., Nakamura H., Terai H., Matsumura A., Hoshino M., Suzuki A., Takayama K., Takaoka K.

    JOURNAL OF BONE AND MINERAL RESEARCH   22   S433 - S433   2007.09( ISSN:0884-0431

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  • A case of soft tissue tumor in infantile from birth

    OKANO Tadashi

    The Central Japan Journal of Orthopaedic Surgery & Traumatology   50 ( 6 )   1115 - 1116   2007( ISSN:00089443 ( eISSN:13490885

  • Cohort study on clinical results in muscle-preserving selective laminoplasty Reviewed

    KATO Minori, MATSUDA Hideki, NAKAMURA Hiroaki, KONISHI Sadahiko, DOHZONO Sho, TAKAOKA Kunio

    17 ( 3 )   855 - 857   2006.12( ISSN:13464876

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  • Endoscopic vertebroplasty for the treatment of chronic vertebral compression fracture - Technical note Reviewed

    Hoshino Masatoshi, Nakamura Hiroaki, Konishi Sadahiko, Nagayama Ryuichi, Terai Hidetomi, Tsujio Tadao, Namikawa Takashi, Kato Minori, Takaoka Kunio

    JOURNAL OF NEUROSURGERY-SPINE   5 ( 5 )   461 - 467   2006.11( ISSN:1547-5654

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  • Endoscopic vertebroplasty for the treatment of chronic vertebral compression fracture. Technical note. Reviewed

    Hoshino M, Nakamura H, Konishi S, Nagayama R, Terai H, Tsujio T, Namikawa T, Kato M, Takaoka K

    Journal of neurosurgery. Spine   5 ( 5 )   461 - 7   2006.11( ISSN:1547-5654

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    DOI: 10.3171/spi.2006.5.5.461

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  • Endoscopic vertebroplasty for the treatment of chronic vertebral compression fracture - Technical note Reviewed

    Masatoshi Hoshino, Hiroaki Nakamura, Sadahiko Konishi, Ryuichi Nagayama, Hidetomi Terai, Tadao Tsujio, Takashi Namikawa, Minori Kato, Kunio Takaoka

    JOURNAL OF NEUROSURGERY-SPINE   5 ( 5 )   461 - 7   2006.11( ISSN:1547-5654

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    root The authors describe a new vertebroplasty technique for the treatment of chronic painful vertebral compression fractures (VCFs).
    A urinary balloon catheter is introduced into the vertebral body (VB) via a bilateral transpedicular approach and inflated with contrast medium to obtain sufficient space for endoscopic observation. The granulation tissue occupying the VB is then removed using a punch or curette inserted through one pedicle, with the guidance of an endoscope introduced through the contralateral pedicle. After endoscopic resection of granulation tissue in the fractured VB, vertebroplasty is performed by injecting calcium phosphate cement (CPC) into the VB.
    Fourteen patients in whom chronic painful VCFs were diagnosed underwent surgery involving the aforementioned technique. In all cases, intractable pain and ambulatory function improved after surgery, and there were no significant systemic complications. On radiological evaluation in eight cases in which the follow-up period exceeded 1 year, the mean height of the fractured VB improved from 38% of that of adjacent intact VBs to 85%. Although a slight loss of correction was routinely observed at 1 month postoperatively, an additional loss of VB height was not noted up to 1 year later. Bone formation was commonly seen along the anterior wall of the involved vertebrae in all cases.
    Vertebroplasty involving the endoscopic removal of granulation tissue proved to be an efficacious procedure for the treatment of chronic painful VCFs. The osteoconductive capacity of CPC facilitated callus formation and ultimately restoration of vertebral bone structure.

    DOI: 10.3171/spi.2006.5.5.461

    PubMed

  • Vertebroplasty for pseudoarthrosis following osteoporotic vertebral fracture : Use of urinary balloon catheter and endoscope Reviewed

    HOSHINO Masatoshi

    49 ( 5 )   959 - 960   2006.09( ISSN:00089443

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  • 【鏡視下手術の進歩】 脊椎 腰椎変性すべり症に対する鏡視下手術

    中村 博亮

    整形外科   57 ( 8 )   1169 - 1175   2006.07( ISSN:00305901 ( eISSN:24329444

  • Lumbar juxta-facet cyst after trauma Reviewed

    Kono Hiroshi, Nakamura Hiroaki, Seki Masahiko, Hosomi Ryo, Hara Yoshinobu

    JOURNAL OF CLINICAL NEUROSCIENCE   13 ( 6 )   694 - 696   2006.07( ISSN:0967-5868

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    DOI: 10.1016/j.jocn.2005.09.013

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  • Objective assessment of reduced invasiveness in MED Reviewed

    Sasaoka Ryuichi, Nakamura Hiroaki, Konishi Sadahiko, Nagayama Ryuichi, Suzuki Eisuke, Terai Hidetomi, Takaoka Kunio

    EUROPEAN SPINE JOURNAL   15 ( 5 )   577 - 582   2006.05( ISSN:0940-6719

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00586-005-0912-8

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  • Evaluation of Prognostic Factors for Osteoporotic Vertebral Fractures

    41 ( 4 )   499 - 506   2006.04( ISSN:05570433 ( eISSN:18821286

  • The Efficacy of Local Administration of Prostaglandin E EP-4 Receptor Agonist with rhBMP-2 for Enhancing Bone Formation in a Rabbit Spinal Fusion Model Reviewed

    NAMIKAWA T.

    17 ( 1 )   150   2006.03( ISSN:13464876

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  • Prospective cohort study of clinical results in muscle-preserving selective laminoplasty : Emphasis on effect of preserving deep muscles of C2 or C7 Reviewed

    KATO Minori, MATSUDA Hideki, NAKAMURA Hiroaki, KONISHI Sadahiko, TAKAOKA Kunio

    17 ( 1 )   39 - 40   2006.03( ISSN:13464876

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  • [Vertebroplasty for osteoporotic vertebral fracture]. Reviewed

    Nakamura H, Takaoka K

    Clinical calcium   16 ( 1 )   153 - 8   2006.01( ISSN:0917-5857

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    DOI: CliCa0601153158

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  • 屈筋腱部分損傷が原因となったばね指の2例 Reviewed

    岡野 匡志, 日高 典昭, 上村 卓也, 明石 健一, 中村 博亮

    中部日本整形外科災害外科学会 中部日本整形外科災害外科学会学術集会 抄録集   107 ( 0 )   376 - 376   2006

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    DOI: 10.11359/cjaost.107.0.376.0

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  • 後腹膜鏡下腰椎前方固定術の実際 Reviewed

    中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富, 辻尾 唯雄, 高岡 邦夫

    中部日本整形外科災害外科学会 中部日本整形外科災害外科学会学術集会 抄録集   106 ( 0 )   61 - 61   2006

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    DOI: 10.11359/cjaost.106.0.61.0

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  • 骨粗鬆症性椎体骨折後偽関節例に対するCPCを用いた椎体形成術 ―バルーンと内視鏡の応用― Reviewed

    星野 雅俊, 中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富, 辻尾 唯雄, 高岡 邦夫

    中部日本整形外科災害外科学会 中部日本整形外科災害外科学会学術集会 抄録集   106 ( 0 )   278 - 278   2006

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    DOI: 10.11359/cjaost.106.0.278.0

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  • Vertebroplasty for pseudoarthrosis following osteoporotic vertebral fracture:&mdash;Use of urinary balloon catheter and endoscope&mdash; Reviewed

    HOSHINO Masatoshi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   49 ( 5 )   959 - 960   2006( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2006.959

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  • Experimental spinal fusion with recombinant human bone morphogenetic protein-2 delivered by a synthetic polymer and beta-tricalcium phosphate in a rabbit model Reviewed

    Namikawa T, Terai H, Suzuki E, Hoshino M, Toyoda H, Nakamura H, Miyamoto S, Takahashi N, Ninomiya T, Takaoka K

    SPINE   30 ( 15 )   1717 - 1722   2005.08( ISSN:0362-2436

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  • Experimental Spinal Fusion With Recombinant Human Bone Morphogenetic Protein-2 Delivered by a Synthetic Polymer and β-Tricalcium Phosphate in a Rabbit Model Reviewed

    NAMIKAWA Takashi, TERAI Hidetomi, SUZUKI Eisuke, HOSHINO Masatoshi, TOYODA Hiromitsu, NAKAMURA Hiroaki, MIYAMOTO Shimpei, TAKAHASHI Naoyuki, NINOMIYA Tadashi, TAKAOKA Kunio

    Spine   30 ( 15 )   1717 - 1722   2005.08( ISSN:03622436

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  • Experimental spinal fusion with recombinant human bone morphogenetic protein-2 delivered by a synthetic polymer and beta-tricalcium phosphate in a rabbit model. Reviewed

    Namikawa T, Terai H, Suzuki E, Hoshino M, Toyoda H, Nakamura H, Miyamoto S, Takahashi N, Ninomiya T, Takaoka K

    Spine   30 ( 15 )   1717 - 22   2005.08( ISSN:0362-2436

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    DOI: 10.1097/01.brs.0000172155.17239.fa

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  • A case report of central disc herniation at C3/4 presenting specific symptoms Reviewed

    CHO Hisanori

    48 ( 2 )   251 - 252   2005.03( ISSN:00089443

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  • Potential risk factors for prolonged recovery following whiplash injury Reviewed

    Osti OL, Gun RT, Abraham G, Pratt NL, Eckerwall G, Nakamura H

    EUROPEAN SPINE JOURNAL   14 ( 1 )   90 - 94   2005.02( ISSN:0940-6719

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    DOI: 10.1007/s00586-004-0711-7

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  • Balloon kyphoplasty for pseudoarthrosis following osteoporotic compression fracture Reviewed

    HOSHINO Masatoshi

    48 ( 1 )   155 - 156   2005.01( ISSN:00089443

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  • A case report of central disc herniation at C3/4 presenting specific symptoms Reviewed

    CHO Hisanori

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   48 ( 2 )   251 - 252   2005( ISSN:0008-9443 ( eISSN:13490885

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    DOI: 10.11359/chubu.2005.251

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  • Balloon kyphoplasty for pseudoarthrosis following osteoporotic compression fracture Reviewed

    HOSHINO Masatoshi

    THE CENTRAL JAPAN ASSOCIATION OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY, The Central Japan Journal of Orthopaedic Surgery & Traumatology   48 ( 1 )   155 - 156   2005( ISSN:0008-9443 ( eISSN:13490885

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    骨粗鬆症性椎体骨折偽関節症例8例9椎体(男性3例・女性5例,平均年齢72歳)を対象にリン酸カルシウム骨ペースト(CPC)挿入腔の形成と可及的後彎の矯正目的にウロマチックバルーンを応用した低侵襲のKyphoplastyを試みた.対象の罹患椎はTh12;6椎体・L1・L2・L4各1椎体で,受傷から手術までの経過観察期間は平均5.7ヵ月であった.手術時間は平均177分(135〜212分)・出血量平均87ml(10〜250ml)で,全身合併症は全例で認めず,術前寝たきり6例・車椅子移動1例・歩行器歩行1例であったが,術後は全例歩行可能となった.%椎体高の平均は前壁で術前49%・術直後88%・最終観察時71%であり,後壁で術前82%・術直後90%・最終観察時82%であった.局所後彎角は術前17°,術直後4°,最終観察時10°であった.以上より,短期成績ではあるが本法は骨粗鬆症性椎体骨折偽関節症例に対して有用な方法と考えられた.本法の実際について解説した

    DOI: 10.11359/chubu.2005.155

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  • Palsy of the C5 nerve root after midsagittal-splitting laminoplasty of the cervical spine

    Spine   28 ( 11 )   1123 - 1127   2003

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  • Piriformis syndrome diagnosed by Cauda Equina Action Potentials: report of two cases

    Spine   28 ( 2 )   E37-E40   2003

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  • Idiopathic spinal cord herniation as a cause of intractable leg pain

    J Spinal Disord Tech   16 ( 3 )   288 - 294   2003

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  • Hydroxyapatite granule graft combined with recombinant human bone morphogenic protein-2 for solid lumbar fusion

    J Spinal Disord Tech   15 ( 3 )   237 - 244   2002

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  • Analysis of spastic gait caused by cervical compression myelopathy

    J Spinal Disord Tech   15 ( 6 )   519 - 522   2002

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  • Meningioma with cystic degeneration in the thoracic spine: A case report

    Spine   27   E193-196   2002

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  • Translaviular approach for a huge dumbbell tumor in the cervicothracic junction.

    J Spinal Disord   14   79 - 83   2001

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  • Idiopathic spinal cord herniation associated with intervertebral disc extrusion -A case report and review of the literature-

    Spine   26   1090 - 1094   2001

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  • Single-stage excision of hemivertebra via posterior approach alone for congenital spinal deformity. longer than 10-year follow up

    Spine   in press   2001

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  • Case report: Intradural arachnoid cyst associated with thoracic spinal compression fracture-seven-year-follow up after surgery-

    Spinal Cord   in press   2001

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  • Use of folded vascularized rib graft in anterior fusion after treatment of thoracic and upper lumbar lesions.

    J. Neurosug.   94   323 - 327   2001

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  • Micro Endoscopic Discectomyにおけるスコープの位置に対する考察

    中村博亮、小西定彦、辻尾唯雄、山野慶樹

    日本脊椎、脊髄神経手術手技学会誌   30   108 - 111   2001

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  • An Experimental Study of the Effects of Nerve Root Retraction on the Posterior Ramu

    Spine   25   418 - 424   2000

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  • 腰部脊柱管狭窄症に対する片側進入脊柱管拡大術の検討

    小西定彦、中村博亮、関昌彦、山野慶樹

    中部整災誌   43   673 - 674   2000

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  • 脊椎のてこ作用に対する形態学的検討

    中村博亮,大橋弘嗣,小西定彦,山野慶樹,島津晃

    日本臨床バイオメカニクス学会誌   21   69 - 72   2000

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  • Symptomatic perineurial cyst in thesacrum- case report-.

    Journal of Musculoskeletal Research   4   63 - 66   2000

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  • Osteoid osteoma of the cervical spine depicted as dumb-bell tumor by MRI.

    Eur. Spine J.   9   426 - 429   2000

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  • Psoas strapping technique: a new technique for laparoscopic anterior lumbar interbody fusion

    J. Am. Coll. Surg.   191   686 - 688   2000

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  • 第2胸椎に発生した孤立性骨嚢腫の1例

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    整形外科   50   271 - 273   1999

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  • Experimental stationary potential recorded with using spine and skull model

    Electromyogr. and Clin. Neurophysiol.   39   55 - 60   1999

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  • Discal cyst in the lumbar spine; Imaging characteristics and possible pathogenesis

    American Journal of Neuroradiology   20   1373 - 1377   1999

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  • 非外傷性に胸椎脱臼骨折を生じた強直性脊椎炎の1例

    宮口正継, 中村博亮, 山野慶樹, 森英隆

    整形外科   50   1455 - 1457   1999

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Books and Other Publications

MISC

  • 【私の膝外来-エキスパートの診察室-】外側円板状半月板の診断法

    橋本 祐介, 西野 壱哉, 中村 博亮

    Orthopaedics   37 ( 2 )   31 - 39   2024.02( ISSN:0914-8124

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    外側円板状半月板は,本邦では比較的頻度が高い疾患である.外側円板状半月板は半月板だけでなく骨形態も通常とは異なった形を呈するため,単純X線でも診断可能である.症状は明確なロッキングから,違和感まであり,手術が必要かの判断が困難な場合がある.損傷形態はMRIで診断を行い,MRIによる分類によって治療方針が明確となってきているが,分類困難な症例も存在する.症状とその根拠をMRIで確認し,その原因を除去するような手術方法を選択する必要がある.(著者抄録)

  • 【リハビリテーション診療update】(IV章)リハビリテーションが必要となる疾患 運動器疾患 脊椎疾患

    寺井 秀富, 中村 博亮, 池淵 充彦

    日本医師会雑誌   152 ( 特別2 )   S160 - S161   2023.10( ISSN:0021-4493

  • 【整形外科におけるコンピュータ支援技術】加速度計ナビゲーションシステムを用いた人工膝関節全置換術

    箕田 行秀, 上山 秀樹, 岩切 健太郎, 渭川 徹秀, 中村 博亮

    整形・災害外科   66 ( 9 )   1045 - 1052   2023.08( ISSN:0387-4095

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    <文献概要>加速度計ナビゲーションシステムの一つであるKneeAlign2(OrthAlign社)は,MEMS加速度計によって,大腿骨遠位端と脛骨近位端の冠状面,矢状面の骨切り角度を補助するコンピュータ支援技術器械である。KneeAlign2の特徴は,(1)初期投資が不要で安価なため手術数が少ない病院でも導入しやすい,(2)簡便で,従来の手術手技を変更する必要がなく,(3)手術時間の延長はなく,出血量も低減する,(4)従来法よりもアライメント精度が高い,(5)術者間での精度の差がない,(6)ピン周囲骨折のリスクがない,(7)光学式ナビゲーションに匹敵する精度が得られる,などが挙げられる。加速度計ナビゲーションシステムは,人工膝関節全置換術(TKA)の専門家だけでなく,むしろTKAの症例数が少ない整形外科医がアライメントエラーを減らしたい場合に臨床上有用なツールである。

  • 【成人脊柱変形とロコモ】骨粗鬆症性椎体骨折と体幹筋力・脊椎アライメントの関連

    高橋 真治, 大山 翔一朗, 堀 悠介, 星野 雅俊, 寺井 秀富, 中村 博亮

    Loco Cure   9 ( 3 )   236 - 242   2023.08( ISSN:2189-4221

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    脊椎アライメントの異常は腰背部痛や歩行障害,QOL低下などの要因となりうる.脊椎アライメント不良の関連因子として年齢や骨粗鬆症性椎体骨折(osteoporotic vertebral fracture:OVF),体幹筋低下などが報告されている.OVFは脊椎および骨盤のパラメーターを変化させるが,筋力により代償機構がはたらくと脊椎のバランスを保持できる.しかし体幹筋量が減少すると脊椎アライメントや腰痛,QOLに影響を及ぼすことが示されている.さらに,縦断研究では,ロコモ度2が脊椎アライメント悪化の予測因子であり,運動介入が予防に有効である可能性も示唆された.これらの知見は,高齢者の健康寿命維持に重要な情報となりうる.(著者抄録)

  • ロコモティブシンドロームと骨折に関する今後の課題 高齢者における体幹筋量と脊柱矢状面アライメントと腰痛の関係

    宮城 正行, 村田 幸佑, 藤巻 寿子, 高橋 真治, 堀 悠介, 星野 雅俊, 中村 博亮, 稲毛 一秀, 大鳥 精司, 井上 玄, 高相 晶士

    日本整形外科学会雑誌   97 ( 4 )   232 - 237   2023.04( ISSN:0021-5325

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    ロコモティブシンドロームを有する高齢者はしばしば骨粗鬆症やサルコペニアを合併し,脊柱矢状面アライメント異常や腰痛の有病率が高い.われわれの調査により,腰痛の影響因子として骨高代謝回転,脊柱矢状面アライメント異常,体幹筋量低下などが関与している可能性が明らかとなった.また,脊柱矢状面アライメント異常については,体幹筋量低下や筋力低下などが関与している可能性がある.骨高代謝回転に関しては,骨粗鬆症に対して通常行われている薬物治療で対処可能であると考えられるが,脊柱矢状面アライメント異常や筋量・筋力低下に対しては,運動療法などの別なアプローチが必要と考える.特に,高齢者の腰痛や脊柱矢状面アライメント異常に対して,体幹筋量が双方の影響因子である可能性があり,脊柱伸展運動などの介入がこれらの改善に奏功する可能性がある.(著者抄録)

  • 【整形外科領域における人工知能の応用】人工知能を活用した骨粗鬆症性椎体骨折の画像診断補助システム MR画像における新鮮椎体骨折の識別

    藪 晋人, 星野 雅俊, 田淵 仁志, 高橋 真治, 寺井 秀富, 升本 浩紀, 前野 考史, 岩前 真由, 豊田 宏光, 鈴木 亨暢, 玉井 孝司, 猪瀬 弘之, 吉井 俊貴, 大川 淳, 中村 博亮

    臨床整形外科   57 ( 10 )   1205 - 1211   2022.10( ISSN:0557-0433

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    <文献概要>畳み込みニューラルネットワーク(CNN)を用いてMR画像(T1強調画像,矢状断)による新鮮骨粗鬆症性椎体骨折(OVF)の診断を行い,その精度を2人の脊椎外科医と比較した.新鮮OVFの診断においてCNNのROC曲線下面積は0.949であった.感度,特異性および精度は(CNN/脊椎外科医1/脊椎外科医2)感度:0.881/0.881/1.000,特異度:0.879/0.862/0.655,精度:0.880/0.870/0.800であった.MR画像を用いた新鮮OVF診断において,CNN分類器の診断能は良好であり,また脊椎外科医と同等であった.

  • 【脊椎・脊髄感染症の診断と治療-最近の知見】脊椎感染症の手術療法

    寺井 秀富, 中村 博亮

    脊椎脊髄ジャーナル   35 ( 3 )   153 - 160   2022.08( ISSN:0914-4412

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    <文献概要>はじめに 近年,人口の高齢化に伴って脊椎感染症の発生も増加している.脊椎感染症の治療戦略は,基本的に適切な抗菌薬投与と局所安静による保存療法である.しかし,抗菌薬投与のみで感染を鎮静化できない場合,疼痛を制御できない場合,神経障害を生じている場合,椎体破壊が進行し脊柱不安定性を生じる場合などでは手術加療を検討しなければならない.手術療法として,ドレナージ,後方除圧術,後方固定術,前方固定術などさまざまな方法が報告されている.個々の症例の状態に応じた手術療法を選択すべきであるが,骨粗鬆症,糖尿病といった併存症の多い高齢者,ステロイド・免疫抑制剤の使用や血液透析患者などの易感染性宿主など本来手術を避けたい症例にこそ手術加療が必要になることも多く,可能な限り低侵襲な治療法が望まれる.近年,経皮的スクリューや低侵襲前方アプローチといった低侵襲脊椎手術の発展とともに,脊椎感染症の治療も変化してきている.本稿では,脊椎感染症に対する手術療法としてドレナージ,後方除圧,後方固定,前方固定(椎体間固定)の各手技について概説する.

  • 【超高齢社会における腰痛診療】Shiraniwa Studyからみた高齢者腰痛の特徴とその対策

    大山 翔一朗, 高橋 真治, 星野 雅俊, 堀 悠介, 藪 晋人, 辻尾 唯雄, 竹内 雄一, 寺井 秀富, 中村 博亮

    Journal of Spine Research   13 ( 6 )   809 - 817   2022.06( ISSN:1884-7137

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    我々は2016年8月より都市圏在住65歳以上の高齢者409名を対象に,腰痛を含めた身体症状や,身体機能評価,画像検査からなる観察研究(Shiraniwa Study)を行っている.その横断解析の結果より,高齢者腰痛の独立した関連因子は脊柱インバランス(SVA>95),肥満(BMI≧25.0),既存椎体骨折,不安の強さであり,腰痛対策としてこれらに介入することが有効と考えた.縦断的に脊柱インバランス進行を生じた高齢者の特徴を解析したところ,ロコモ度2は独立した脊柱インバランス進行の予測因子であった.また,経時的にロコモ度が改善した高齢者は体重減少を認めていたことから,減量はロコモ度改善を介して脊柱インバランス進行の抑制に寄与する可能性があると考えられた.減量は高齢者腰痛の関連因子である,肥満,脊柱インバランスの両者に影響することから,有効な高齢者腰痛対策となり得ると注目している.(著者抄録)

  • 【新技術の腰痛診療への応用】人工知能技術を活用した骨粗鬆症性椎体骨折の画像診断補助システム

    藪 晋人, 高橋 真治, 寺井 秀富, 星野 雅俊, 中村 博亮

    Journal of Spine Research   13 ( 6 )   844 - 850   2022.06( ISSN:1884-7137

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    高齢化社会の進行に伴い,骨粗鬆症患者数も増加の一途をたどっている.骨粗鬆症性椎体骨折は高齢者のADLやQOLを低下させるため,早期に適切な治療介入を行う必要があり,精度の高い診断が重要となる.近年,人工知能による物体認識は畳み込みニューラルネットワーク(Convolutional neural network:CNN)の開発により著しく改善を認め,画像診断サポートツールに応用されている.過去に我々はCNNを用いてMR画像で新鮮椎体骨折を検出するシステムを構築した.本稿ではその研究成果を述べるとともに骨粗鬆症性椎体骨折に関する診断や画像診断サポートツールとしての人工知能の有用性についてレビューした.(著者抄録)

  • 【スポーツ外傷・障害の予防と治療-TOKYO 2020が終了して】アスリートのマネジメント

    橋本 祐介, 洲鎌 亮, 中村 博亮, 中田 研

    医学のあゆみ   281 ( 8 )   815 - 820   2022.05( ISSN:0039-2359

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    アスリートとは「スポーツや他の形式の身体運動に習熟している人」(オックスフォード辞典より)である。よって日頃からスポーツに特化した生活を送っている人をアスリートとして捉えると、整形外科医としてアスリートを保険診療するとすれば主に外傷、障害の治療を行うことになる。一方、スポーツドクターが保険診療以外でアスリートと接する機会として、チームサポートドクター、大会トーナメントドクターが代表的である。ここでは、病院でのアスリートへの治療、チームサポートドクター、大会トーナメントドクターの実際を述べる。(著者抄録)

  • 【末梢神経-Current Concept in 2022】末梢神経再生の基礎 末梢神経再生におけるextrinsic growthとハイブリッド型人工神経の開発

    上村 卓也, 横井 卓哉, 高松 聖仁, 中村 博亮

    整形・災害外科   65 ( 5 )   479 - 484   2022.04( ISSN:0387-4095

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    <文献概要>末梢神経は神経細胞体と軸索,髄鞘(Schwann細胞)から構成され,末梢神経が損傷を受けるとそれぞれの場所から神経修復が開始される。軸索における神経再生(extrinsic growth)ではSchwann細胞とマクロファージが重要な役割を担っており,互いに密接に関わり連携協力している。Schwann細胞は神経再生のフェーズに応じて,分化した成熟型から未分化な修復型へとその形態をダイナミックに変化させている。炎症を惹起するマクロファージは軸索再生の過程において,debrisのクリアランス,微小血管形成,修復型Schwann細胞の分化,再髄鞘化に作用している。人工神経による神経再生は自家神経移植ほど万全ではないが,ヒトiPS細胞ハイブリッド型人工神経は免疫不全ラットにおいて末梢神経再生を促進させた。細胞付加によるextrinsic growthを利用したハイブリッド型人工神経によって,末梢神経再生は促進される。

  • 【アスリートの椎間板-椎間板を制するものは腰痛を制す-】アスリートの椎間板 ラグビー選手の椎間板

    寺井 秀富, 橋本 祐介, 西野 壱哉, 中村 博亮

    臨床スポーツ医学   39 ( 3 )   256 - 261   2022.03( ISSN:0289-3339

  • Ultrasound and biopsy findings in arthritis with familial Mediterranean fever(和訳中)

    Yamada Yutaro, Inui Kentaro, Okano Tadashi, Mandai Koji, Nishikomori Ryuta, Nakamura Hiroaki, Tsuruta Daisuke

    Journal of Medical Ultrasonics   49 ( 1 )   115 - 116   2022.01( ISSN:1346-4523

  • 【スポーツ選手の半月板損傷に対する治療戦略】半月板治療戦略 半月板損傷形態・受傷機転・治療など 半月形状による影響 円板状半月板損傷

    橋本 祐介, 中村 博亮, 山崎 真哉, 瀧上 順誠

    臨床スポーツ医学   38 ( 12 )   1322 - 1329   2021.12( ISSN:0289-3339

  • 【末梢神経の再建2021】人工神経の展望 iPS細胞を付加した人工神経の研究開発

    上村 卓也, 高松 聖仁, 中村 博亮

    臨床整形外科   56 ( 11 )   1343 - 1348   2021.11( ISSN:0557-0433

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    <文献概要>末梢神経欠損に対して自家神経移植に代わる神経再生誘導管(人工神経)が開発され,すでに臨床応用されている.しかし,人工神経による神経再生が自家神経移植ほど十分でないため,すべての神経欠損に人工神経の適応があるわけではない.われわれは人工神経による神経再生を促進させるために,人工神経を足場としてiPS細胞由来神経前駆細胞を付加したハイブリッド型人工神経の研究開発を行ってきた.本稿では,幹細胞を付加したハイブリッド型人工神経のなかで,特にiPS細胞ハイブリッド型人工神経に関する基礎研究結果について紹介する.

  • 【骨・軟部腫瘍のマネジメント(その2)】良性骨腫瘍・腫瘍類似疾患の治療 類骨骨腫 類骨骨腫のマネジメント

    大戎 直人, 星 学, 岩井 正, 嶋谷 彰芳, 伴 祥高, 中村 博亮

    別冊整形外科   ( 80 )   63 - 66   2021.10( ISSN:0287-1645

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    <文献概要>はじめに 類骨骨腫は原発性良性骨腫瘍の10〜12%を占める2cm未満の骨腫瘍であり,特徴的な臨床症状を有することが多い.これまで,さまざまな治療方法や成績が報告されてきている.本稿では類骨骨腫の臨床的特徴と治療方法・合併症について当院での経験をふまえて述べる.

  • 【骨・軟部腫瘍のマネジメント(その2)】良性骨腫瘍・腫瘍類似疾患の治療 単純性骨嚢腫 単純性骨嚢腫の病因

    星 学, 大戎 直人, 岩井 正, 家口 尚, 高見 勝次, 中村 博亮

    別冊整形外科   ( 80 )   45 - 49   2021.10( ISSN:0287-1645

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    <文献概要>はじめに 単純性骨嚢腫とは小児期に好発する腫瘍類似病変であり,真性の腫瘍ではないとされている.発生頻度は上腕骨,大腿骨,踵骨,腓骨,橈骨の順である.特に好発部位である大腿骨と上腕骨の長管骨では近位骨幹端に発生することが多い.大腿骨と上腕骨の長管骨に発生する単純性骨嚢腫(長管骨嚢腫)では病的骨折を契機に発見されるのに対して,踵骨発生の単純性骨嚢腫(踵骨骨嚢腫)は足関節周囲の外傷を契機に偶然発見されることが多い.踵骨骨嚢腫では病的骨折は非常にまれである.単純性骨嚢腫の臨床上の問題点は,骨脆弱性のために病的骨折をきたし,変形,成長障害,短縮をきたすことである.単純性骨嚢腫の病因については現在も未解明の状態である.本稿では,単純性骨嚢腫の病因について過去の報告をふまえて解説する.

  • 【痛み-慢性痛研究の最近の話題と将来展望】診断と評価 腰痛における骨粗鬆症や筋減少症の関わり

    堀 悠介, 高橋 真治, 中村 博亮

    医学のあゆみ   278 ( 1 )   69 - 73   2021.07( ISSN:0039-2359

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    腰痛は日常生活を障害する最大の原因であり、高齢になるほどその頻度は増加するが、同時に骨粗鬆症や筋減少症も進行する。骨粗鬆症による腰痛の発生機序としては、急性期の骨粗鬆症性椎体骨折(OVF)による腰痛、OVF後に生じた腰曲がりによる疲労性の腰痛、骨粗鬆症自体に伴う腰痛が考えられる。一方で、筋減少症が進行すると、体幹の支持機構の低下や腰曲がりに伴って、腰痛が発生する。これらの疾患は未治療のまま放置されることも多く、進行するとOVFや腰曲がりを伴い、難治性の腰痛の原因となる。両疾患は合併する頻度も高く、とくに高齢者においては、骨粗鬆症と筋減少症に対する適切な治療が腰痛予防につながる可能性がある。骨粗鬆症に対しては、薬物療法を中心に治療法が確立されつつあるが、筋減少症に対する効果的で持続可能な治療法の開発が今後の課題である。(著者抄録)

  • 【人工神経の現状と展望】今後の展望 iPS細胞を併用した人工神経の開発研究

    上村 卓也, 高松 聖仁, 中村 博亮

    人工臓器   50 ( 1 )   89 - 93   2021.06( ISSN:0300-0818

  • 【骨粗鬆症性椎体骨折-難治例の診断・治療を中心に-】骨粗鬆症性椎体骨折に対するBKP治療 難治例への応用とピットフォール

    高橋 真治, 寺井 秀富, 星野 雅俊, 大山 翔一朗, 堀 悠介, 中村 博亮

    関節外科   40 ( 5 )   529 - 534   2021.05( ISSN:0286-5394

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    <文献概要>Balloon kyphoplasty(BKP)は,骨粗鬆症性椎体骨折(osteoporotic vertebral fracture;OVF)に対してよく行われる手技ではあるが,BKPが適応となる骨折型にはまだまだ議論の余地がある。患者の全身状態やOVFが多発している場合など後方固定を選択しにくい状況もあるが,その場合にBKPでどこまで対応可能かは未知な部分も多い。本稿ではBKPがどういった症例に有用なのか,筆者らの過去のデータを示しながら具体例を論じている。本稿を参考にしていただき今後の診療に役立てていただきたい。

  • 【ロコモティブシンドロームの現況】疾患とロコモ 脊柱アライメントと筋量,筋力

    堀 悠介, 高橋 真治, 大山 翔一朗, 星野 雅俊, 寺井 秀富, 中村 博亮

    整形外科   72 ( 6 )   667 - 670   2021.05( ISSN:0030-5901

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    <文献概要>はじめに 超高齢社会において脊椎疾患の病的意義はますます大きい.特に脊柱矢状面アライメントの悪化は腰痛や生活の質(QOL)に大きな影響を及ぼし,高齢者の日常生活を著しく障害する.手術機器,技術の進歩により脊柱変形に対する矯正固定術が行われるようになってはいるが,高齢者では高い合併症率や高コストが報告されており,予防的治療を中心とした治療戦略への見直しが必要である.近年ではサルコペニアをはじめ,筋量減少と疾病との関係に注目が集まっている.体幹筋は脊柱の支持に不可欠な要素であり,体幹筋への介入により脊柱変形を予防できる可能性はあるが,脊柱アライメントと体幹筋量や筋力との関係は十分に解明されていない.本稿では脊柱アライメントと,特に体幹部の筋量,筋力との関係について筆者らの研究成果を最新の知見をふまえて考察する.

  • 【ロコモティブシンドロームの現況】住民コホートによる評価 Shiraniwaスタディ

    大山 翔一朗, 高橋 真治, 寺井 秀富, 星野 雅俊, 中村 博亮

    整形外科   72 ( 6 )   642 - 645   2021.05( ISSN:0030-5901

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    <文献概要>はじめに 本邦の超高齢社会への対策上の課題として,高齢者の実数や,今後の高齢者増加率が都市部で圧倒的に高いという現状を考慮すると,都市部在住高齢者の健康実態,特に整形外科にとっては運動器の実態調査をする必要がある.そこでわれわれは2016年8月より,第三次産業に従事してきた高齢者を中心とする大都市圏ベッドタウンである奈良県生駒市において都市圏高齢者運動器コホート研究(Shiraniwaスタディ)を開始した.対象は歩行可能な65歳以上の高齢者で,縦断5年間,計6回の運動器調査に参加する意志がある方とし,自治体回覧板および院内掲示により参加を募った.初年度409名(男性164名,女性245名,平均年齢73.5歳)が参加し,現在進行形で調査中である.本稿ではShiraniwaスタディより得たロコモティブシンドローム(ロコモ)に関する知見について述べる.

  • TKA後のスポーツ活動

    洲鎌 亮, 箕田 行秀, 大田 陽一, 上山 秀樹, 竹村 進, 山本 展生, 中村 博亮

    JOSKAS   46 ( 2 )   424 - 425   2021.05( ISSN:1884-8842

  • 【運動器疼痛】運動器疼痛の臨床研究 脊柱インバランス進行予測因子

    大山 翔一朗, 高橋 真治, 星野 雅俊, 寺井 秀富, 辻尾 唯雄, 中村 博亮

    ペインクリニック   42 ( 別冊春 )   S139 - S147   2021.05( ISSN:0388-4171

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    脊柱インバランスは運動器疼痛のみならず、高齢者のQOLを著しく損なうことが知られているが、その原因については十分に解明されていない。われわれが実施している都市圏高齢者運動器コホート研究(Shiraniwa Study)の結果より、加齢、椎間板変性、背筋力低下、ロコモ度2はそれぞれ独立した脊柱インバランスの関連因子であることが判明した。また、ロコモ度2は2年の経過で新たに脊柱インバランスが進行することを予測する因子でもあり、脊柱インバランス進行を予防する上でのターゲットとなり得る。(著者抄録)

  • 【骨粗鬆症性椎体骨折-難治例の診断・治療を中心に-】急性期骨粗鬆症性椎体骨折の診断 難治例の予測も含めて

    寺井 秀富, 高橋 真治, 星野 雅俊, 藪 晋人, 中村 博亮

    関節外科   40 ( 5 )   482 - 488   2021.05( ISSN:0286-5394

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    <文献概要>診断の目的は大きく2つであり,1つは骨粗鬆症治療に重要な形態骨折を判別すること,もう1つは骨折治療が必要な臨床骨折を判別することである。「疼痛持続・ADL(activities of daily living)低下」や単純X線で「強い椎体圧壊やクレフト」がみられた患者にはMRIを撮像し精度の高い予後予測を行うべきであり,予後不良が予見される患者には慎重な経過観察を施さなくてはならない。

  • 思春期特発性側彎症に対する新たな凸型ロット回旋矯正法の手術成績(Surgical Outcomes of a New Technique Using a Convex Rod Rotation Maneuver for Adolescent Idiopathic Scoliosis)

    Takahashi Shinji, Terai Hidetomi, Toyoda Hiromitsu, Hoshino Masatoshi, Suzuki Akinobu, Tamai Koji, Ohyama Shoichiro, Hori Yusuke, Yabu Akito, Nakamura Hiroaki

    Spine Surgery and Related Research   5 ( 3 )   205 - 210   2021.05

  • 【膝関節リハビリテーション診療マニュアル】人工膝関節全置換術(TKA)後リハビリテーション治療 Reviewed

    箕田 行秀, 上山 秀樹, 池渕 充彦, 金本 成煕, 中村 博亮

    (株)全日本病院出版会 MEDICAL REHABILITATION   ( 258 )   73 - 77   2021.02( ISSN:1346-0773

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    TKA(人工膝関節全置換術)術後リハビリテーション目的は、VTE(静脈血栓塞栓症)予防、筋力訓練・歩行訓練による早期回復、可動域訓練による拘縮予防・可動域拡大である。周術期の必須アミノ酸投与は、TKA術後ADLの回復を早めるため推奨できる。膝関節可動域は術後約2年間で徐々に改善するため、入院中よりも退院後のリハビリテーションがむしろ重要である。入院中に可動域訓練の方法を十分に教育しておく。退院時に可動域訓練の方法を記した冊子を渡すこと、紹介元の整形外科クリニックと連携して外来リハビリテーションを行うことも有用である。(著者抄録)

  • 【脊椎骨粗鬆症性椎体骨折に対する治療戦略-薬物療法を中心にUP TO DATE】骨粗鬆症性椎体骨折の保存療法の限界について 前向き多施設研究結果を踏まえて Reviewed

    寺井 秀富, 高橋 真治, 星野 雅俊, 藪 晋人, 中村 博亮

    (株)三輪書店 脊椎脊髄ジャーナル   33 ( 12 )   1052 - 1057   2020.12( ISSN:0914-4412

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    <文献概要>はじめに 人生100年時代といわれる超長寿社会において,疫学的に医療の重要課題は"老化"といわれている.骨粗鬆症は老化に典型的な伴う疾患であり,人類に与える影響は各種がん以上とされる.基礎的臨床的集学的な研究が進み,骨粗鬆症が治療可能な時代となった理由のうち最も中心的な役割を担うのが薬物療法である.一方で,われわれ脊椎外科医が最前線に立って治療にあたるべき骨粗鬆症性椎体骨折(osteoporotic vertebral fracture:OVF)の治療成績は改善されているのであろうか.本稿では,われわれが15年以上にわたって注力してきた臨床OVFのデータとともに現在進行形の研究を紹介し,OVF研究の問題点と今後の展望を私見ながら提案したい.

  • 骨粗鬆症性椎体骨折における診断とリハビリテーションを含めた治療の変遷 Reviewed

    高橋 真治, 星野 雅俊, 中村 博亮

    (公社)日本リハビリテーション医学会 The Japanese Journal of Rehabilitation Medicine   57 ( 9 )   836 - 844   2020.09( ISSN:1881-3526

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  • 【頸・肩・腰痛の最新の診断と治療】腰痛の診療 骨粗鬆症性椎体骨折 Reviewed

    高橋 真治, 星野 雅俊, 中村 博亮

    大道学館出版部 臨牀と研究   97 ( 7 )   861 - 867   2020.07( ISSN:0021-4965

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  • 体幹筋の臨床的意義 Reviewed

    堀 悠介, 星野 雅俊, 中村 博亮

    (一社)日本脊椎脊髄病学会 Journal of Spine Research   11 ( 6 )   883 - 889   2020.06( ISSN:1884-7137

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    腰痛や脊柱変形は健康寿命の延伸を目指す我が国にとって克服すべき課題である.体幹筋は体幹支持に重要な要素だが,体幹筋の萎縮や脂肪変性がこうした病態に与える影響は明らかになっていない.我々は多施設横断研究によって体幹筋量の低下と腰痛や機能障害,脊柱後彎が関連していることを証明した.本稿ではその研究結果を中心に,体幹筋の加齢に伴う変化と,腰痛や脊柱アライメントとの関連,介入方法に関して文献をレビューした.(著者抄録)

  • Balloon Kyphoplasty後隣接椎体骨折の臨床的意義とその予測 Reviewed

    高橋 真治, 星野 雅俊, 中村 博亮

    (一社)日本脊椎脊髄病学会 Journal of Spine Research   11 ( 5 )   811 - 819   2020.05( ISSN:1884-7137

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    Balloon kyphoplasty(BKP)後に隣接椎体骨折が生じることはよく知られているが,その危険因子や予測については報告が限られている.また,その臨床的意義も報告により異なる.我々は隣接椎体骨折が及ぼす影響およびその発生を予測する因子を受傷後2ヵ月以内にBKPを実施した症例で検討した.本著ではその研究を中心に,隣接椎体骨折が臨床的に及ぼす影響,またその予測に関して文献をレビューした.(著者抄録)

  • 【強直性脊椎炎・乾癬性関節炎とその周辺疾患】脊椎関節炎を見逃さないための留意点 若年者の持続する腰背部痛 Reviewed

    乾 健太郎, 岡野 匡志, 中村 博亮

    (株)メジカルビュー社 関節外科   39 ( 4 )   414 - 424   2020.04( ISSN:0286-5394

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    脊椎関節炎で重要な症候である炎症性腰背部痛を有する患者は整形外科を訪ねる可能性が高いため,その診断に整形外科医の果たす役割は大きい。各種分類基準を参考にして慎重に診療に当たり,専門医へ紹介を躊躇しないことが必要である。ただし,画像所見に頼りすぎると過剰診断につながることにも留意する。(著者抄録)

  • 【鏡視下手術の進歩-小関節から脊椎まで】L字型骨孔作製デバイスを用いた骨孔式鏡視下腱板修復術の実際 Reviewed

    平川 義弘, 間中 智哉, 伊藤 陽一, 市川 耕一, 松田 淑伸, 中村 博亮

    (株)南江堂 別冊整形外科   ( 77 )   51 - 56   2020.04( ISSN:0287-1645

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    <文献概要>はじめに 鏡視下腱板修復術(arthroscopic rotator cuff repair:ARCR)は,現在,縫合糸アンカーを用いたsingle-row法やdual-row法,suture bridge法が主流であるが,縫合糸アンカー特有の合併症である縫合糸アンカーの脱転や縫合部への応力集中,医療コストなどの問題点がある.一方,縫合糸アンカーを使用しない腱板修復法として骨孔式腱板修復法がある.骨孔式ARCRは手技が煩雑とされているが,上記の縫合糸アンカー特有の問題点を回避でき,臨床成績,コスト,手術時間など総合的に判断し,現時点では,われわれはArthro-Tunneler(Wright Medical社,Memphis)を用いた骨孔式ARCRを採用している.Arthro-Tunnelerは骨孔式ARCRを簡便に行うことができるデバイスであり,一般的な前外側ポータルから簡便に骨孔をL字状で作製できる(図1).直線状の骨孔式ARCRの際にみられた外側よりさらに遠位に追加ポータルを作製する必要がないため,追加した遠位ポータルでの腋窩神経損傷のリスクがなく,通常の縫合糸アンカーを用いたARCRと同じポータルでの手術が可能である.われわれはこれらの理由で2012年5月から,Arthro-Tunnelerを用いた骨孔式ARCRを採用しており,これまでに少しずつ手術手技を改良してきた.本稿では,Arthro-Tunnelerを用いた骨孔式ARCRの手術手技の実際,臨床成績,合併症とその対策および文献的な考察を述べる.

  • 【脊椎脊髄疾患に対する分類・評価法】(第2章)胸椎・胸腰椎 びまん性特発性骨増殖症(DISH)の診断基準 Reviewed

    高橋 真治, 中村 博亮

    (株)三輪書店 脊椎脊髄ジャーナル   33 ( 4 )   320 - 325   2020.04( ISSN:0914-4412

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    <文献概要>はじめに びまん性特発性骨増殖症(diffuse idiopathic skeletal hyperostosis:DISH)は,脊椎を中心として主に腱や靱帯,関節包の付着部であるenthesisの石灰化,骨化を特徴とする非炎症性の疾患である.1950年にForestierらが強直性脊椎炎(ankylosing hyperostosis:AS)とは異なる病態として,高齢者に生じる脊椎の骨増殖症(senile ankylosing hyperostosis)を報告したのが始まりである.その後,1975年にResnickらが脊椎以外の末梢関節にも同様の変化が生じることからDISHと命名し,その翌年に診断基準を定めて世界に広まっている.有病率に関しては人種差がみられる.日本では,1,690例(平均65歳)を対象として全脊柱単純X線を利用した研究で10.8%(男性22.0%,女性4.8%),3,013例(平均65歳)を対象として胸部CTを利用した研究で8.7%(男性13.1%,女性2.5%)と報告されているが,Caucasianでは男性で20〜30%,女性で10〜20%と報告されている.DISHの画像的特徴としては,中下位胸椎および頸椎が好発部位であり,前縦靱帯(anterior longitudinal ligament:ALL)の骨化や側面の骨化が生じる.側面の骨化は通常両側性だが,胸椎部では右側がより突出していることが多い.内臓逆位では左側がより突出していることが多く,大動脈の影響が考えられる.危険因子としては,高齢,男性,肥満,糖尿病,高尿酸血症などが挙げられる.病因はまだ解明されてないが,遺伝的要因として後縦靱帯骨化症(ossification of the posterior longitudinal ligament:OPLL)に関連するCOL6A1,線維芽細胞や軟骨細胞の増殖に関連する代謝性因子(成長因子,IGF-1など),また肥満や脂質異常なども報告されている.診断基準としては,いまだに1975年に報告されたResnickらの診断基準が広く使用されているが,本稿ではほかの報告も含めたDISHの診断基準および脊椎症やASとの鑑別について要点をまとめ,最後にその診断基準,分類についての課題を述べたい.

  • 【強直性脊椎炎・乾癬性関節炎とその周辺疾患】脊椎関節炎を見逃さないための留意点 若年者の持続する腰背部痛

    乾 健太郎, 岡野 匡志, 中村 博亮

    関節外科   39 ( 4 )   414 - 424   2020.04( ISSN:0286-5394

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    脊椎関節炎で重要な症候である炎症性腰背部痛を有する患者は整形外科を訪ねる可能性が高いため,その診断に整形外科医の果たす役割は大きい。各種分類基準を参考にして慎重に診療に当たり,専門医へ紹介を躊躇しないことが必要である。ただし,画像所見に頼りすぎると過剰診断につながることにも留意する。(著者抄録)

  • 【骨粗鬆症性椎体骨折治療の最新知見】骨粗鬆症性椎体骨折による脊椎障害に対する手術治療 Reviewed

    寺井 秀富, 中村 博亮

    金原出版(株) 整形・災害外科   63 ( 2 )   187 - 194   2020.02( ISSN:0387-4095

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    <文献概要>骨粗鬆症性椎体骨折は背部痛だけでなく,神経圧排や脊柱変形など様々な脊椎障害の原因となる。骨粗鬆症性椎体骨折に対する治療は薬物治療を含む保存治療から外科的治療まで多岐にわたり現在もエビデンスの構築が進んでいる。椎体形成術に対するエビデンスは本邦を中心として蓄積が進んでいるが,椎体形成術以外の外科的治療に関しては病態のバリエーションが多く,一定の見解が得られていないのが現状である。椎体形成術以外の外科的手術方法の選択には病態の把握が重要であり,病態に即してin situ固定,椎体形成術+後方固定,前方固定,骨切り術を含めた変形矯正などが選択され,時にはそれらを同時に行うこともある。前方固定術では局所後彎の矯正は可能であるが,短い後方固定では脊柱アライメント矯正は得られないが満足な除痛効果とADLの改善は得られることから,病態に即した術式選択が重要であるといえる。

  • 【骨粗鬆症性椎体骨折治療の最新知見】骨粗鬆症性椎体骨折治療体系における医療経済 Reviewed

    高橋 真治, 星野 雅俊, 中村 博亮

    金原出版(株) 整形・災害外科   63 ( 2 )   211 - 215   2020.02( ISSN:0387-4095

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    <文献概要>骨粗鬆症患者は社会の高齢化とともに増加しており,それに伴い医療費の増加も見込まれる。毎年多額の国債を発行している本邦において医療費の問題は喫緊の課題であり,医療者は治療の費用対効果について理解を深める必要がある。薬剤に関して,ビスホスホネートは費用対効果に優れるが,デノスマブは高額なため高リスク群に使用すべきである。テリパラチドはさらに高額な薬剤のためその使用は限定すべきである。また,椎体骨折の外科的治療に関しては,balloon kyphoplasty(BKP)の費用対効果は報告によりばらつきはあるが,われわれが本邦で実施した研究では,遷延治癒の高リスク群に対するBKPの費用対効果は許容範囲内であった。治療の費用対効果をより適切にするためには,適切な患者選択・治療選択が重要である。

  • 整形外科治療の費用対効果 骨粗鬆症性椎体骨折に対するBalloon Kyphoplastyの費用対効果 Reviewed

    高橋 真治, 星野 雅俊, 中村 博亮

    (株)医学書院 臨床整形外科   54 ( 8 )   791 - 797   2019.08( ISSN:0557-0433

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    <文献概要>骨粗鬆症性椎体骨折に対する外科的治療の1つとしてballoon kyphoplasty(BKP)が広く行われているが,その費用対効果に関して各国で見解が異なっている.英国では費用対効果に優れるという結果であったが,スウェーデンでは許容範囲外であった.われわれが行った予後不良因子を有する椎体骨折患者へのBKPと保存治療に関する研究の結果,増分費用効果比が約242万円/QALYと許容範囲内であったが,80歳以上では費用対効果比が増加する傾向を認めた.しかし,80歳以上では他の侵襲的外科的治療が困難な保存治療抵抗例もあるため,低侵襲なBKPは治療選択肢の1つであると考える.

  • 【DISHの臨床】DISHの疫学 Reviewed

    豊田 宏光, 寺井 秀富, 山田 賢太郎, 中村 博亮

    (株)三輪書店 脊椎脊髄ジャーナル   32 ( 7 )   653 - 660   2019.07( ISSN:0914-4412

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    <文献概要>はじめに 近年,びまん性特発性骨増殖症(diffuse idiopathic skeletal hyperostosis:DISH)に対する関心が高まりつつある.DISHは前縦靱帯骨化を主病変とする病態から脊柱不撓性をもたらすものの,後縦靱帯骨化症(ossification of the posterior longitudinal ligament:OPLL)や黄色靱帯骨化症(ossification of the yellow ligament:OYL)とは異なり単独で神経障害や著しい疼痛をもたらすことはまれな疾患である.しかしながら,高齢者の脊椎疾患の治療を行っていると,DISHが背景に存在する脊椎外傷や変性疾患に遭遇することは少なくない.本稿では,DISHに関する本邦の臨床研究の歴史を振り返り,疫学知見に関するレビューを行った.

  • 【DISHの臨床】腰椎変性疾患とDISH Reviewed

    山田 賢太郎, 豊田 宏光, 寺井 秀富, 中村 博亮

    (株)三輪書店 脊椎脊髄ジャーナル   32 ( 7 )   685 - 692   2019.07( ISSN:0914-4412

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    <文献概要>はじめに Diffuse idiopathic skeletal hyperostosis(DISH)は,Resnickらにより定義された椎体に骨性架橋を認める病態である.DISHの弊害の中で脊椎脊髄外科医にとって最も特徴的なものは,DISHに伴う椎体骨折である.DISHによる椎体骨折は低エネルギー外傷で起こり得,遅発性神経麻痺,また骨折部の高度な不安定性に留意するべきと報告されている.これらはDISHによる骨性架橋による長いレバーアームのため,骨折部へ応力が集中され引き起こされると考えられている.同様の機序で,慢性疾患である腰部脊柱管狭窄症に対してもDISHは負の影響があると推察されるが,古くにDISHと脊柱管狭窄に関する症例報告がなされて以降,まとまった症例での報告は数少ない.本稿では,著者らの臨床研究結果も交えて,DISHの腰椎変性疾患への影響に焦点を当てて解説する.

  • 【整形外科診療における最先端技術】診断、評価 動的評価 2D-3Dマッチングを用いた肩甲骨三次元動態解析 術後リハビリテーションへの臨床応用を目指して Reviewed

    池淵 充彦, 箕田 行秀, 中村 博亮, 中土 保, 中島 重義

    (株)南江堂 別冊整形外科   ( 75 )   108 - 111   2019.04( ISSN:0287-1645

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  • 【整形外科診療における最先端技術】診断、評価 新しい画像・機能診断 多機能OCTを用いた早期変形性関節症軟骨の粘弾性力学特性マイクロ断層診断 Reviewed

    池淵 充彦, 中村 卓, 箕田 行秀, 中村 博亮, 古川 大介, 佐伯 壮一

    (株)南江堂 別冊整形外科   ( 75 )   27 - 31   2019.04( ISSN:0287-1645

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  • 人工臓器 最近の進歩 人工臓器 ハイブリッド型人工神経による末梢神経再生と癒着予防材料への応用 Reviewed

    横井 卓哉, 上村 卓也, 高松 聖仁, 中村 博亮

    (一社)日本人工臓器学会 人工臓器   47 ( 3 )   185 - 188   2018.12( ISSN:0300-0818

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  • 【歯突起後方偽腫瘍】関節リウマチに伴う歯突起後方偽腫瘍の臨床 Reviewed

    鈴木 亨暢, 堂園 将, 中村 博亮

    (株)三輪書店 脊椎脊髄ジャーナル   31 ( 10 )   891 - 897   2018.10( ISSN:0914-4412

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    <文献概要>はじめに 関節リウマチ(rheumatoid arthritis:RA)では,四肢の関節のみならず,脊椎,特に頸椎病変を有することも多い.RAに対する治療はメトトレキサートや生物学的製剤の登場により大きく進歩したが,2011年のわれわれの調査結果ではRA患者の42%に頸椎病変が認められており,今なお多くのRA患者が頸椎病変を有していることが判明している.RA患者における頸椎病変の特徴は上位頸椎に多い点である.C1-C2間には椎間板がなく,前方の環椎歯突起関節も後側方の外側環軸関節も滑膜関節であるため,RAの滑膜炎に侵されやすい.環軸椎水平亜脱臼や垂直脱臼がよく知られているが,歯突起後方偽腫瘍も重要な病変の1つである.本稿では,RAにおける歯突起後方偽腫瘍に焦点を当て解説する.

  • 【画像診断の別の貌-定量化と正常値のまとめ,適正使用と被曝】脊椎の画像評価 骨粗鬆症を中心に Reviewed

    星野 雅俊, 中村 博亮

    (株)三輪書店 脊椎脊髄ジャーナル   31 ( 9 )   795 - 801   2018.09( ISSN:0914-4412

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  • 整形トピックス iPS細胞由来神経前駆細胞を付加したハイブリッド型人工神経 免疫応答下での移植細胞による神経再生促進効果 Reviewed

    上村 卓也, 高松 聖仁, 中村 博亮

    (株)南江堂 整形外科   69 ( 10 )   1044 - 1044   2018.09( ISSN:0030-5901

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  • 低侵襲脊椎手術のこれまでの経過と現状、今後の課題 Reviewed

    中村 博亮, 高橋 真治, 星野 雅俊

    (公社)日本整形外科学会 日本整形外科学会雑誌   92 ( 9 )   561 - 567   2018.09( ISSN:0021-5325

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  • 椎弓形成術 アップデート 高齢者に対する頸椎椎弓形成術

    豊田 宏光, 鈴木 亨暢, 玉井 孝司, 中村 博亮

    臨床整形外科   53 ( 8 )   705 - 711   2018.08( ISSN:0557-0433

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    <文献概要>高齢者頸髄症の特徴は,罹病期間が長く,術前神経障害が重篤で,動的因子の関与が多くなると脊髄症状の急速な悪化を認める点である.具体的には,C3-4レベルの不安定性による急性増悪例や頸椎すべり症を伴う例に留意が必要となる.後療法の簡便さ,合併症の頻度などから椎弓形成術が一般的に選択され,多くの研究者がその良好な安定した臨床成績を報告しているが,高齢者の脊椎手術に対する期待も変化してきており,患者や家族のニーズを尊重しながら治療方針を進めていくことが求められる.

  • 予後不良因子を持つ骨粗鬆症性新鮮椎体骨折に対するBKPの有用性 多施設前向き介入研究(第1報) Reviewed

    星野 雅俊, 高橋 真治, 安田 宏之, 寺井 秀富, 渡辺 享永, 林 和憲, 辻尾 唯雄, 河野 浩, 鈴木 亨暢, 玉井 孝司, 大山 翔一朗, 豊田 宏光, 笹岡 隆一, 堂園 将, 兼松 文昭, 白 隆光, 高山 和士, 加藤 相勲, 堀 悠介, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   9 ( 5 )   959 - 964   2018.05( ISSN:1884-7137

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    予後不良因子(MRI・T2強調画像における高信号あるいは低信号広範)を持つ骨粗鬆症性新鮮椎体骨折に対するBKP早期介入の多施設単群前向き介入試験における中間解析では、BKP早期介入の45例は、同一の予後不良因子を持ち保存治療を受けた患者で性・年齢・骨折高位をマッチさせた45例との比較で、有意にADLの低下を防ぎ、QOLを回復させ、椎体変形を改善した。しかし隣接椎体骨折の発生は高率に認められた。(著者抄録)

  • 応力緩和OCT(SR-OCSA)を用いた早期変形性関節症軟骨の粘弾性力学特性マイクロ断層診断

    池渕 充彦, 中村 卓, 箕田 行秀, 中村 博亮, 佐伯 壮一, 古川 大介, 新実 信夫, 塚原 義人

    別冊Bio Clinica: 慢性炎症と疾患   7 ( 2 )   128 - 133   2018.05

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    軟骨の変性については組織学的には解明が進んでいるが、力学的な解明は進んでいないのが現状である。光コヒーレンス断層画像は非破壊・非侵襲的で高空間分解能を有しており、軟骨研究においても用いられている。我々はこれをさらに発展させたStress Relaxation Optical Coherence Straingraphy(SR-OCSA)を開発し、家兎OA軟骨に荷重負荷を与え、断層画像の経時変化から軟骨の粘弾性力学特性を可視化することを試み、一定の成果を得た。今後、軟骨の力学的評価の必要性は大きくなると予想され、SR-OCSAはこれに大きく寄与するものと考えている。(著者抄録)

  • Balloon kyphoplasty後隣接椎体骨折の検討 Reviewed

    高橋 真治, 星野 雅俊, 安田 宏之, 寺井 秀富, 辻尾 唯雄, 河野 浩, 鈴木 亨暢, 豊田 宏光, 堂園 将, 兼松 文昭, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   92 ( 3 )   S851 - S851   2018.03( ISSN:0021-5325

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  • 受傷早期の骨粗鬆症性椎体骨折に対する椎体形成術 Reviewed

    辻尾 唯雄, 関 昌彦, 星野 雅俊, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   9 ( 3 )   616 - 616   2018.03( ISSN:1884-7137

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  • 予後不良因子を有する骨粗鬆症性新鮮椎体骨折に対する早期BKP介入は、サルコペニアの有無によらず有効である Reviewed

    大山 翔一朗, 星野 雅俊, 高橋 真治, 安田 宏之, 寺井 秀富, 林 和憲, 辻尾 唯雄, 河野 浩, 鈴木 亨暢, 玉井 孝司, 堀 悠介, 豊田 宏光, 堂園 将, 笹岡 隆一, 兼松 文昭, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   9 ( 3 )   416 - 416   2018.03( ISSN:1884-7137

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  • BKPのセメント注入形状による手術成績への影響 一塊を目指すべきか Reviewed

    堀 悠介, 星野 雅俊, 高橋 真治, 安田 宏之, 寺井 秀富, 林 和憲, 辻尾 唯雄, 河野 浩, 鈴木 亨暢, 玉井 孝司, 大山 翔一朗, 豊田 宏光, 堂園 将, 笹岡 隆一, 兼松 文昭, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   9 ( 3 )   767 - 767   2018.03( ISSN:1884-7137

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  • Balloon Kyphoplasty後隣接椎体骨折の臨床的意義と危険因子 Reviewed

    高橋 真治, 星野 雅俊, 安田 宏之, 寺井 秀富, 辻尾 唯雄, 河野 浩, 鈴木 亨暢, 豊田 宏光, 堂園 将, 兼松 文昭, 林 和憲, 玉井 孝司, 大山 翔一朗, 堀 悠介, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   9 ( 3 )   768 - 768   2018.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折に対しX-coreを用いた椎体置換術施行後に生じる隣接椎骨折に関する検討 Reviewed

    寺井 秀富, 星野 雅俊, 豊田 宏光, 鈴木 亨暢, 高橋 真治, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   61 ( 春季学会 )   60 - 60   2018.03( ISSN:0008-9443 ( eISSN:1349-0885

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  • 骨粗鬆症性椎体骨折遅発性圧壊に対する矯正固定手術後上位固定端椎体再骨折の危険因子 Reviewed

    玉井 孝司, 寺井 秀富, 鈴木 亨暢, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   92 ( 3 )   S853 - S853   2018.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折後圧潰に対する矯正固定手術後UIV再骨折の危険因子 Reviewed

    玉井 孝司, 寺井 秀富, 鈴木 亨暢, 中村 博亮, Japan Association of Spine Surgeons with Ambition

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   9 ( 3 )   708 - 708   2018.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折受傷後早期予後予測と治療的介入 Reviewed

    中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   92 ( 2 )   S325 - S325   2018.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折に対する固定術の侵襲と治療成績(前方アプローチVS後方アプローチ) Reviewed

    寺井 秀富, 星野 雅俊, 豊田 宏光, 鈴木 亨暢, 高橋 真治, 山田 賢太郎, 玉井 孝司, 林 和憲, 大山 翔一朗, 堀 悠介, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   9 ( 3 )   595 - 595   2018.03( ISSN:1884-7137

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  • 高齢者脊柱後彎症において骨粗鬆症性椎体骨折が存在する割合とその特徴について Reviewed

    藪 晋人, 星野 雅俊, 豊田 宏光, 寺井 秀富, 鈴木 亨暢, 高橋 真治, 玉井 孝司, 辻尾 唯雄, 関 昌彦, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   92 ( 3 )   S825 - S825   2018.03( ISSN:0021-5325

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  • 【アスリートの脊椎・脊髄障害-病態と早期復帰への工夫】スポーツ選手の腰椎椎間板ヘルニアに対する内視鏡下後方手術

    寺井 秀富, 金田 国一, 大嶺 俊充, 中村 博亮

    脊椎脊髄ジャーナル   31 ( 3 )   239 - 245   2018.03( ISSN:0914-4412

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    <文献概要>はじめに 腰椎椎間板ヘルニアに対する手術療法(椎間板摘出術)として,顕微鏡下椎間板ヘルニア摘出術(microscopic discectomy:MD)や内視鏡下椎間板ヘルニア摘出術(microendoscopic discectomy:MED),経皮的内視鏡下椎間板ヘルニア摘出術(percutaneous endoscopic lumbar discectomy:PELD)など,さまざまな低侵襲手術手技が確立している.一般患者におけるそれら低侵襲手術手技の成績は非常に良好であり,術式間で大きな差はないとされている5).しかし,アプローチやワーキングスペースの大きさなど各術式の特徴とそれらの手技に適するヘルニアのタイプについて知っておく必要がある.本稿では,アスリートの腰椎椎間板ヘルニアの手術に関して,どのような場合にMEDが適しているか,実際にMEDを行う際の注意点,MED術後のスポーツ復帰の状況などについて述べる.

  • 急性期における経時的MRIを用いた骨粗鬆症性椎体骨折後遷延治癒の予測 Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 辻尾 唯雄, 安田 宏之, 佐々木 健陽, 兼松 文昭, 河野 浩, 豊田 宏光, 中村 博亮

    大阪市医学会, 大阪市医学会雑誌   66   40 - 40   2017.12( ISSN:0386-4103

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  • 慢性腰痛のサイエンス 高齢者の腰痛 腰痛と骨粗鬆症性椎体骨折 Reviewed

    豊田 宏光, 星野 雅俊, 高橋 真治, 辻尾 唯雄, 中村 博亮

    (株)医学書院, 臨床整形外科   52 ( 12 )   1153 - 1158   2017.12( ISSN:0557-0433

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    当教室で行った骨粗鬆症性椎体骨折に対する多施設研究の結果について概説する.1回目の研究から,約80%は予後良好であるが,骨癒合不全に至ると臨床上の問題が増え,予後不良例の予測においては,装具や入院などの治療的介入よりも,後壁損傷を認めること,T2強調画像の特徴的な所見,運動習慣のないことなどの要因が重要であることが判明した.2回目の研究からは,MRIでの骨折部の信号変化は長期にわたり残存すること,椎体骨折後の腰痛の推移には4つのパターンがあり,骨折部の安定化が疼痛緩和に寄与することが判明した.(著者抄録)

    DOI: 10.11477/mf.1408200975

  • 慢性腰痛のサイエンス 高齢者の腰痛 腰痛と骨粗鬆症性椎体骨折

    豊田 宏光, 星野 雅俊, 高橋 真治, 辻尾 唯雄, 中村 博亮

    臨床整形外科   52 ( 12 )   1153 - 1158   2017.12( ISSN:0557-0433

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    当教室で行った骨粗鬆症性椎体骨折に対する多施設研究の結果について概説する.1回目の研究から,約80%は予後良好であるが,骨癒合不全に至ると臨床上の問題が増え,予後不良例の予測においては,装具や入院などの治療的介入よりも,後壁損傷を認めること,T2強調画像の特徴的な所見,運動習慣のないことなどの要因が重要であることが判明した.2回目の研究からは,MRIでの骨折部の信号変化は長期にわたり残存すること,椎体骨折後の腰痛の推移には4つのパターンがあり,骨折部の安定化が疼痛緩和に寄与することが判明した.(著者抄録)

  • 【高齢者脊椎疾患の診断・治療の最近の進歩】 骨粗鬆症性 骨粗鬆症性椎体骨折(OVF)における遷延治癒・偽関節のリスク因子 Reviewed

    高橋 真治, 星野 雅俊, 中村 博亮

    (株)メジカルビュー社, 関節外科   36 ( 10月増刊 )   98 - 104   2017.10( ISSN:0286-5394

  • 骨粗鬆症性椎体骨折受傷後早期予後予測と治療的介入 Reviewed

    中村 博亮

    西日本整形・災害外科学会, 整形外科と災害外科   66 ( Suppl.2 )   71 - 71   2017.10( ISSN:0037-1033

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  • 【高齢者脊椎疾患の診断・治療の最近の進歩】骨粗鬆症性 骨粗鬆症性椎体骨折(OVF)における遷延治癒・偽関節のリスク因子

    高橋 真治, 星野 雅俊, 中村 博亮

    関節外科   36 ( 10月増刊 )   98 - 104   2017.10( ISSN:0286-5394

  • 【高齢者(75歳以上)の運動器変性疾患に対する治療】脊椎の変性疾患に対する高齢者治療 頸椎変性疾患 高齢者のmidcervical central cord syndromeに対する頸椎前方固定術

    寺井 秀富, 玉井 孝司, 中村 博亮

    別冊整形外科   ( 72 )   78 - 84   2017.10( ISSN:0287-1645

  • 骨粗鬆症性椎体骨折受傷後早期予後予測と治療的介入 Reviewed

    中村 博亮

    (一社)日本骨粗鬆症学会, 日本骨粗鬆症学会雑誌   3 ( Suppl.1 )   107 - 107   2017.09( ISSN:2189-8383

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  • 骨粗鬆症性椎体骨折後の認知機能へ影響を与える因子 Reviewed

    高橋 真治, 星野 雅俊, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 林 和憲, 玉井 孝司, 大山 翔一朗, 堀 悠介, 中村 博亮

    (一社)日本骨粗鬆症学会, 日本骨粗鬆症学会雑誌   3 ( Suppl.1 )   264 - 264   2017.09( ISSN:2189-8383

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  • 骨粗鬆症性椎体骨折におけるMRI所見の自然経過の解明 Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   60 ( 春季学会 )   59 - 59   2017.04( ISSN:0008-9443 ( eISSN:1349-0885

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    DOI: 10.11359/chubu.2017.59

  • 骨粗鬆症性椎体骨折に対する椎体形成術の隣接椎体骨折についての検討 Reviewed

    辻尾 唯雄, 関 昌彦, 星野 雅俊, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   8 ( 3 )   640 - 640   2017.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後の認知機能へ影響を与える因子 Reviewed

    高橋 真治, 星野 雅俊, 辻尾 唯雄, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 山田 賢太郎, 林 和憲, 大山 翔一朗, 堀 悠介, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   91 ( 2 )   S127 - S127   2017.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折後の認知機能へ影響を与える因子 Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 辻尾 唯雄, 寺井 秀富, 鈴木 亨暢, 山田 賢太郎, 林 和憲, 大山 翔一朗, 堀 悠介, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   8 ( 3 )   529 - 529   2017.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後、骨癒合不全の高リスク患者に対する装具療法の効果 Reviewed

    豊田 宏光, 星野 雅俊, 辻尾 唯雄, 高橋 真治, 寺井 秀富, 鈴木 亨暢, 高山 和士, 井関 一道, 笹岡 隆一, 安田 宏之, 兼松 文昭, 河野 浩, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   8 ( 3 )   346 - 346   2017.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折の術前骨折形態がBKPの術後有害事象へ及ぼす影響 Reviewed

    星野 雅俊, 高橋 真治, 豊田 宏光, 辻尾 唯雄, 玉井 孝司, 寺井 秀富, 鈴木 亨暢, 笹岡 隆一, 堂園 将, 安田 宏之, 渡辺 享永, 山田 賢太郎, 林 和憲, 大山 翔一朗, 堀 悠介, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   8 ( 3 )   531 - 531   2017.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折の術前骨折形態がBKPの術後成績へ及ぼす影響 Reviewed

    星野 雅俊, 高橋 真治, 豊田 宏光, 辻尾 唯雄, 玉井 孝司, 寺井 秀富, 鈴木 亨暢, 笹岡 隆一, 安田 宏之, 渡辺 享永, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   91 ( 3 )   S833 - S833   2017.03( ISSN:0021-5325

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  • 【骨粗鬆症治療の現状と展望】 骨粗鬆症性椎体骨折の診断・治療の意義 Reviewed

    星野 雅俊, 中村 博亮

    (株)ライフ・サイエンス, Progress in Medicine   37 ( 1 )   21 - 25   2017.01( ISSN:0287-3648

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  • iPS細胞の足場となる高柔軟性人工神経の開発

    上村 卓也, 高松 聖仁, 中村 博亮

    細胞   49 ( 1 )   36 - 37   2017.01( ISSN:1346-7557

  • 【骨粗鬆症治療の現状と展望】骨粗鬆症性椎体骨折の診断・治療の意義

    星野 雅俊, 中村 博亮

    Progress in Medicine   37 ( 1 )   21 - 25   2017.01( ISSN:0287-3648

  • 各種疾患 末梢神経障害 iPS細胞ハイブリッド型人工神経による末梢神経再生

    上村 卓也, 高松 聖仁, 中村 博亮

    Annual Review神経   2017   222 - 227   2017.01

  • 【脆弱性骨折のすべて】 骨折の臨床、手術療法<椎体> 骨粗鬆症性椎体骨折に対する保存治療(EBMと治療のコツ) Reviewed

    豊田 宏光, 中村 博亮

    (株)全日本病院出版会, Orthopaedics   29 ( 12 )   31 - 36   2016.11( ISSN:0914-8124

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    骨粗鬆症性椎体骨折の保存療法におけるEBMについて概説する。保存療法にまつわるエビデンスは海外の論文を参考にしても乏しく、安静臥床が果たして必要なのか、どの装具が一番効果があるのか、入院させたほうが予後が良くなるのかなどの疑問に答えられる研究報告はまだ出ていないのが現状である。患者背景の違いが大きく画一的な治療を求めることに無理があるのかもしれないが、予後を予測して予後不良因子を持った患者に対して選択的かつ強力な医療介入を行うことが、高騰する社会医療費を鑑みたうえでも重要になってくる。予後予測には受傷時のMRI T2強調画像や後壁損傷の有無が重要な因子となる。さらなるデータの蓄積により予後不良因子をもった患者に対する保存治療の最適化や手術療法への切り替えのタイミングについて検討を行っていく必要がある。(著者抄録)

  • 骨粗鬆症性椎体骨折の自然経過からみた治療戦略 Reviewed

    豊田 宏光, 中村 博亮

    日本生体電気・物理刺激研究会, 日本生体電気・物理刺激研究会誌   30   9 - 13   2016.11( ISSN:1882-1014

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  • 【脆弱性骨折のすべて】骨折の臨床、手術療法<椎体> 骨粗鬆症性椎体骨折に対する保存治療(EBMと治療のコツ)

    豊田 宏光, 中村 博亮

    Orthopaedics   29 ( 12 )   31 - 36   2016.11( ISSN:0914-8124

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    骨粗鬆症性椎体骨折の保存療法におけるEBMについて概説する。保存療法にまつわるエビデンスは海外の論文を参考にしても乏しく、安静臥床が果たして必要なのか、どの装具が一番効果があるのか、入院させたほうが予後が良くなるのかなどの疑問に答えられる研究報告はまだ出ていないのが現状である。患者背景の違いが大きく画一的な治療を求めることに無理があるのかもしれないが、予後を予測して予後不良因子を持った患者に対して選択的かつ強力な医療介入を行うことが、高騰する社会医療費を鑑みたうえでも重要になってくる。予後予測には受傷時のMRI T2強調画像や後壁損傷の有無が重要な因子となる。さらなるデータの蓄積により予後不良因子をもった患者に対する保存治療の最適化や手術療法への切り替えのタイミングについて検討を行っていく必要がある。(著者抄録)

  • 骨粗鬆症性椎体骨折の自然経過からみた治療戦略

    豊田 宏光, 中村 博亮

    日本生体電気・物理刺激研究会誌   30   9 - 13   2016.11( ISSN:1882-1014

  • 【細胞移植と神経再生】末梢神経 iPS細胞移植を併用したハイブリッド型人工神経によるマウス坐骨神経再生

    上村 卓也, 高松 聖仁, 中村 博亮

    Clinical Neuroscience   34 ( 10 )   1166 - 1169   2016.10( ISSN:0289-0585

  • 【よくわかる、臨床で使える「骨粗鬆症」アップデート】骨粗鬆症の治療 椎体骨折の外科的治療

    豊田 宏光, 中村 博亮

    診断と治療   104 ( 10 )   1287 - 1292   2016.10( ISSN:0370-999X

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    <Headline>1 (1)神経障害、(2)骨癒合が得られず疼痛が遷延、(3)AS/DISH(強直性脊椎骨増殖症)を伴う場合は手術を考慮する。2 骨癒合が得られず、体動時の腰背部痛が残存する患者は椎体形成術のよい適応となる。3 骨癒合後遺残変形に対して矯正固定術が施行される場合がある。(著者抄録)

  • 階層的クラスター解析からみた骨粗鬆症性椎体骨折後腰痛の分類と臨床的特徴 多施設前向きコホート研究 Reviewed

    豊田 宏光, 高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 辻尾 唯雄, 安田 宏之, 河野 浩, 中村 博亮

    (一社)日本骨粗鬆症学会, 日本骨粗鬆症学会雑誌   2 ( Suppl.1 )   201 - 201   2016.09( ISSN:2189-8383

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  • 骨粗鬆症性椎体骨折は高齢者脊柱後彎症の主因ではない Reviewed

    星野 雅俊, 藪 晋人, 高橋 真治, 豊田 宏光, 寺井 秀富, 鈴木 亨暢, 辻尾 唯雄, 関 昌彦, 中村 博亮

    (一社)日本骨粗鬆症学会, 日本骨粗鬆症学会雑誌   2 ( Suppl.1 )   200 - 200   2016.09( ISSN:2189-8383

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  • 骨粗鬆症性椎体骨折におけるMRI所見の経時的変化の解明 Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 高山 和士, 井関 一道, 笹岡 隆一, 辻尾 唯雄, 安田 宏之, 河野 浩, 中村 博亮

    (一社)日本骨粗鬆症学会, 日本骨粗鬆症学会雑誌   2 ( Suppl.1 )   200 - 200   2016.09( ISSN:2189-8383

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  • 【整形外科の新専門医制度】脊椎脊髄外科における新専門医制度に対応した取り組み

    波呂 浩孝, 中村 博亮, 中村 雅也, 持田 譲治, 田口 敏彦

    整形・災害外科   59 ( 10 )   1329 - 1332   2016.09( ISSN:0387-4095

  • 椎体骨折癒合不全に伴う神経根症 Reviewed

    玉井 孝司, 豊田 宏光, 鈴木 亨暢, 寺井 秀富, 星野 雅俊, 高橋 真治, 林 和憲, 大山 翔一朗, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 8 )   1246 - 1250   2016.08( ISSN:1884-7137 ( eISSN:2435-1563

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    骨粗鬆症性椎体骨折後癒合不全に起因する神経根症の頻度や推移を明らかにするため、椎体形成術を行った症例を後ろ向きに解析した。結果、椎体骨折後癒合不全の20%に根症状を伴っており、70%の症例で腰痛≦下肢痛であったが、90%の症例で罹患椎体単独の椎体形成術にて早期に根症状が消失していた。発症要因としては、静的因子である椎間孔狭窄などより、動的因子である椎体不安定性の関与が強い可能性が示唆された。(著者抄録)

    Other URL: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J05510&link_issn=&doc_id=20160906150007&doc_link_id=%2Ffg7spine%2F2016%2F000708%2F008%2F1246-1250%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg7spine%2F2016%2F000708%2F008%2F1246-1250%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 境界領域 知っておきたい 脊椎脊髄外科専門医制度 整形外科と脳神経外科の融合

    中村 博亮

    臨床整形外科   51 ( 8 )   736 - 739   2016.08( ISSN:0557-0433

  • 【脊椎・脊髄外傷診療の最前線】 脊椎外傷の治療 骨粗鬆症性椎体骨折におけるMRIの有用性 Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 中村 博亮

    (株)南江堂, 整形外科   67 ( 8 )   788 - 793   2016.07( ISSN:0030-5901 ( eISSN:2432-9444

  • 【脊椎・脊髄外傷診療の最前線】脊椎外傷の治療 骨粗鬆症性椎体骨折におけるMRIの有用性

    高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 中村 博亮

    整形外科   67 ( 8 )   788 - 793   2016.07( ISSN:0030-5901

  • 【脊椎・脊髄外傷診療の最前線】脊椎外傷の治療 仙骨骨折

    加藤 相勲, 宮市 功典, 森本 健, 並川 崇, 松村 昭, 日高 典昭, 中村 博亮

    整形外科   67 ( 8 )   814 - 820   2016.07( ISSN:0030-5901

  • 整形外科における組織移植の現状(2010-2014年) 日本整形外科学会認定研修施設を対象としたアンケート集計結果

    水田 博志, 中村 雅也, 安達 伸生, 占部 憲, 佐藤 正人, 中村 憲正, 蜂谷 裕道, 中村 博亮, 日本整形外科学会移植・再生医療委員会

    日本整形外科学会雑誌   90 ( 7 )   526 - 531   2016.07( ISSN:0021-5325

  • 整形外科領域における再生医療実施の現状(2008-2014年) 日本整形外科学会認定研修施設を対象としたアンケート集計結果

    水田 博志, 中村 雅也, 安達 伸生, 占部 憲, 佐藤 正人, 中村 憲正, 蜂谷 裕道, 中村 博亮, 日本整形外科学会移植・再生医療委員会

    日本整形外科学会雑誌   90 ( 7 )   532 - 533   2016.07( ISSN:0021-5325

  • 【骨粗鬆症性椎体骨折-治療の現状と問題点】 骨粗鬆症性椎体骨折における後壁損傷の追跡調査 Reviewed

    星野 雅俊, 高橋 真治, 辻尾 唯雄, 寺井 秀富, 中村 博亮

    金原出版(株), 整形・災害外科   59 ( 7 )   903 - 907   2016.06( ISSN:0387-4095

  • 【骨粗鬆症性椎体骨折-治療の現状と問題点】骨粗鬆症性椎体骨折における後壁損傷の追跡調査

    星野 雅俊, 高橋 真治, 辻尾 唯雄, 寺井 秀富, 中村 博亮

    整形・災害外科   59 ( 7 )   903 - 907   2016.06( ISSN:0387-4095

  • 【骨癒合促進の最前線】骨形成促進蛋白質(BMP)による骨形成促進

    江口 佳孝, 高岡 邦夫, 中村 博亮

    整形・災害外科   59 ( 5 )   509 - 516   2016.05( ISSN:0387-4095

  • 【脊椎領域におけるスポーツ医学の最近の話題】スポーツ選手の腰椎椎間板ヘルニアに対する内視鏡下後方手術

    寺井 秀富, 中村 博亮

    関節外科   35 ( 5 )   476 - 481   2016.05( ISSN:0286-5394

  • 【新専門医制度に備えた必履修分野の教え方・学び方】必履修分野の研修方法 頸椎

    中村 博亮, 星野 雅俊

    関節外科   35 ( 4月増刊 )   42 - 52   2016.04( ISSN:0286-5394

  • 傍脊柱筋の骨粗鬆症性椎体骨折における影響 多施設共同前向きコホート研究 Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 高山 和士, 辻尾 唯雄, 笹岡 隆一, 安田 宏之, 河野 浩, 兼松 文昭, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   288 - 288   2016.03( ISSN:1884-7137

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  • 急性期における骨粗鬆症性椎体骨折後壁損傷の診断 骨粗鬆症性椎体骨折MRI多施設研究 Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 辻尾 唯雄, 笹岡 隆一, 安田 宏之, 河野 浩, 兼松 文昭, 豊田 宏光, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   460 - 460   2016.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折におけるMRIのSTIRは発症時期の特定に有用か? Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   59 ( 春季学会 )   128 - 128   2016.03( ISSN:0008-9443 ( eISSN:1349-0885

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  • 骨粗鬆症性椎体骨折遅発性麻痺の術後神経回復から見た術式検討 Reviewed

    河野 浩, 曹 寿憲, 高橋 佳史, 田中 秀和, 松田 英樹, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   291 - 291   2016.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後骨癒合不全に至るMRIの経時的変化の解明 多施設共同前向きコホート研究 Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 高山 和士, 辻尾 唯雄, 笹岡 隆一, 安田 宏之, 河野 浩, 兼松 文昭, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   762 - 762   2016.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後骨癒合不全に至るMRIの経時的変化の解明 多施設共同前向きコホート研究 Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 辻尾 唯雄, 安田 宏之, 河野 浩, 兼松 文昭, 豊田 宏光, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   90 ( 2 )   S100 - S100   2016.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折受傷時の椎体後壁損傷は長期予後不良に関連する Reviewed

    星野 雅俊, 辻尾 唯雄, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   90 ( 3 )   S711 - S711   2016.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折の長期予後に影響する受傷時の特徴的MRI所見 Reviewed

    星野 雅俊, 寺井 秀富, 辻尾 唯雄, 鈴木 亨暢, 並川 崇, 加藤 相勲, 松村 昭, 高山 和士, 豊田 宏光, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   289 - 289   2016.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折に対する椎体形成術の術後の局所後彎についての検討 Reviewed

    辻尾 唯雄, 関 昌彦, 星野 雅俊, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   622 - 622   2016.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折に対する後方固定術における術前後冠状面パラメータの検討 Reviewed

    並川 崇, 松村 昭, 加藤 相勲, 尾崎 友則, 日高 典昭, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   59 ( 春季学会 )   99 - 99   2016.03( ISSN:0008-9443

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    DOI: 10.11359/chubu.2016.99

  • 骨粗鬆症性椎体骨折における腰痛の推移からみた臨床的特徴の探索研究 多施設前向きコホート研究2012-2014(中間報告) Reviewed

    豊田 宏光, 高橋 真治, 星野 雅俊, 高山 和士, 井関 一道, 笹岡 隆一, 辻尾 唯雄, 安田 宏之, 兼松 文昭, 河野 浩, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   229 - 229   2016.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折におけるMRIのSTIRは発症時期の特定に有用か? Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 辻尾 唯雄, 笹岡 隆一, 安田 宏之, 河野 浩, 兼松 文昭, 豊田 宏光, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   475 - 475   2016.03( ISSN:1884-7137

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  • 高齢者脊柱後彎症において骨粗鬆症性椎体骨折が存在する割合と特徴 Reviewed

    藪 晋人, 星野 雅俊, 豊田 宏光, 寺井 秀富, 鈴木 亨暢, 林 和憲, 玉井 孝司, 大山 翔一朗, 寺川 雅基, 辻尾 唯雄, 関 昌彦, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   7 ( 3 )   473 - 473   2016.03( ISSN:1884-7137

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  • 歯髄における幹細胞と前駆細胞の硬組織形成能(Ability of stem and progenitor cells in the dental pulp to form hard tissue)

    Hosoya Akihiro, Nakamura Hiroaki

    The Japanese Dental Science Review   51 ( 3-4 )   75 - 83   2015.11( ISSN:1882-7616

  • 骨粗鬆症性椎体骨折後偽関節に対する椎体形成術併用後方固定術 矯正損失をおこさない最小固定範囲は? Reviewed

    並川 崇, 松村 昭, 寺岡 貴徳, 加藤 相勲, 大山 翔一朗, 日高 典昭, 中村 博亮

    日本最小侵襲整形外科学会, 日本最小侵襲整形外科学会誌   15 ( 1 )   59 - 59   2015.10( ISSN:1348-6098

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  • 【整形外科領域における移植医療】総論 新規人工材料の開発と課題 神経損傷に対する柔軟性の高い人工神経の開発 人工多能性幹細胞移植を併用したハイブリッド型人工神経による再生医療をめざして

    上村 卓也, 高松 聖仁, 中村 博亮

    別冊整形外科   ( 68 )   47 - 51   2015.10( ISSN:0287-1645

  • 【できる医療スタッフはココまで知ってる!ココまでみてる!糖尿病患者の他科受診スマートサポート】他科受診スマートサポート 整形外科受診スマートサポート

    星野 雅俊, 中村 博亮

    糖尿病ケア   12 ( 10 )   931 - 935   2015.10( ISSN:1348-9968

  • 骨粗鬆症性椎体骨折に対する診断と治療の現状と未来 Reviewed

    中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   89 ( 9 )   624 - 632   2015.09( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折後に骨癒合不全へ至る経時的MRI所見の特徴 Reviewed

    高橋 真治, 星野 雅俊, 高山 和士, 辻尾 唯雄, 笹岡 隆一, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   58 ( 秋季学会 )   108 - 108   2015.09( ISSN:0008-9443 ( eISSN:1349-0885

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  • 骨粗鬆症性椎体骨折受傷時の椎体後壁損傷は長期予後不良に関連する Reviewed

    星野 雅俊, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 高橋 真治, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   58 ( 秋季学会 )   108 - 108   2015.09( ISSN:0008-9443 ( eISSN:1349-0885

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  • 骨粗鬆症性椎体骨折に対する診断と治療の現状と未来

    中村 博亮

    日本整形外科学会雑誌   89 ( 9 )   624 - 632   2015.09( ISSN:0021-5325

  • 骨粗鬆症性椎体骨折の診断と治療 Reviewed

    中村 博亮

    東日本整形災害外科学会, 東日本整形災害外科学会雑誌   27 ( 3 )   209 - 209   2015.08( ISSN:1342-7784

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  • 骨粗鬆症性椎体骨折受傷時の椎体後壁損傷は長期予後不良に関連する Reviewed

    星野 雅俊, 寺井 秀富, 辻尾 唯雄, 鈴木 亨暢, 並川 崇, 加藤 相勲, 松村 昭, 高山 和士, 豊田 宏光, 中村 博亮

    ライフサイエンス出版(株), Osteoporosis Japan   23 ( Suppl.1 )   225 - 225   2015.08( ISSN:0919-6307

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  • iPS細胞を付加できる高柔軟性人工神経の開発

    上村 卓也, 高松 聖仁, 中村 博亮

    細胞   47 ( 8 )   421 - 422   2015.07( ISSN:1346-7557

  • 【腰椎椎間板ヘルニアに対する手術療法 低侵襲手術の実際と合併症対策】手術の実際 内視鏡を用いた椎間板ヘルニア摘出術

    寺井 秀富, 中村 博亮

    整形外科Surgical Technique   5 ( 3 )   271 - 278   2015.06( ISSN:2185-7733

  • 【高齢者の脊柱変形-椎体骨折の診断と治療】 (Part1.)骨粗鬆症性椎体骨折の診断と分類 画像診断と自然経過 Reviewed

    星野 雅俊, 高橋 真治, 中村 博亮

    (株)アークメディア, Bone Joint Nerve   5 ( 2 )   257 - 264   2015.03( ISSN:2186-1110

  • 経時的MRIによる骨粗鬆症性椎体骨折の自然経過の解明 多施設前向きコホート研究2012-2014(中間報告) Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 辻尾 唯雄, 井関 一道, 高山 和士, 笹岡 隆一, 安田 宏之, 兼松 文昭, 河野 浩, 長山 隆一, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   6 ( 3 )   540 - 540   2015.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折における椎体後壁損傷の発生リスク Reviewed

    星野 雅俊, 辻尾 唯雄, 寺井 秀富, 並川 崇, 加藤 相勲, 松村 昭, 鈴木 亨暢, 豊田 宏光, 高山 和士, 高岡 邦夫, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   6 ( 3 )   241 - 241   2015.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後遷延治癒・偽関節へ至る経時的MRI所見の特徴 多施設前向きコホート研究2012-2014(中間報告) Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 辻尾 唯雄, 井関 一道, 高山 和士, 笹岡 隆一, 安田 宏之, 兼松 文昭, 河野 浩, 長山 隆一, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   6 ( 3 )   540 - 540   2015.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後の椎体圧潰に対する経時的MRI画像所見による予後予測 多施設前向きコホート研究2012-2014(中間報告) Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 辻尾 唯雄, 井関 一道, 高山 和士, 笹岡 隆一, 安田 宏之, 兼松 文昭, 河野 浩, 長山 隆一, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   6 ( 3 )   418 - 418   2015.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後における骨折部椎体可動性と経時的MRI画像の関連 多施設前向きコホート研究2012-2014(中間報告) Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 辻尾 唯雄, 井関 一道, 高山 和士, 笹岡 隆一, 安田 宏之, 兼松 文昭, 河野 浩, 長山 隆一, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   6 ( 3 )   555 - 555   2015.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折における腰痛と経時的画像所見との関連 多施設前向きコホート研究2012-2014(中間報告) Reviewed

    高橋 真治, 星野 雅俊, 豊田 宏光, 辻尾 唯雄, 井関 一道, 高山 和士, 笹岡 隆一, 安田 宏之, 兼松 文昭, 河野 浩, 長山 隆一, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   6 ( 3 )   539 - 539   2015.03( ISSN:1884-7137

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  • 【高齢者の脊柱変形-椎体骨折の診断と治療】(Part1.)骨粗鬆症性椎体骨折の診断と分類 画像診断と自然経過

    星野 雅俊, 高橋 真治, 中村 博亮

    Bone Joint Nerve   5 ( 2 )   257 - 264   2015.03( ISSN:2186-1110

  • 骨軟部腫瘍における画像評価最前線 悪性骨軟部腫瘍に対するFDG-PETの役割

    星 学, 大戎 直人, 家口 尚, 中村 博亮

    臨床整形外科   50 ( 3 )   237 - 242   2015.03( ISSN:0557-0433

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    悪性骨軟部腫瘍に対し施行したFDG-PETによるSUVmaxの意義を検討した.骨腫瘍では骨巨細胞腫のSUVmaxは,骨肉腫,軟骨肉腫よりも高値を示した.軟部腫瘍では,横紋筋肉腫,悪性末梢神経鞘腫瘍,類上皮肉腫,悪性線維性組織球腫が高値を示していた.脂肪肉腫では,多形型,脱分化型が粘液型,高分化型よりも高値を示しており,悪性度を反映している可能性があった.現段階ではFDG-PETは骨軟部腫瘍では良性,悪性の鑑別には応用できないとされている.今後,各組織型に焦点を絞って悪性度評価,転移の有無の診断,治療効果,再発評価を解析していく必要がある.(著者抄録)

  • 骨粗鬆症性椎体骨折の長期予後(5年以上) 生存・ADL・遺残疼痛に影響する因子解析 Reviewed

    星野 雅俊, 寺井 秀富, 辻尾 唯雄, 鈴木 亨暢, 並川 崇, 加藤 相勲, 松村 昭, 高岡 邦夫, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   6 ( 1 )   12 - 16   2015.01( ISSN:1884-7137

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    骨粗鬆症性椎体骨折患者で5年以上追跡できた107例を対象とし、死亡や寝たきりなどの重篤な長期予後に関連する因子を解析した。追跡調査時の生存状況は死亡が26例、ADLは寝たきりが11例、準寝たきりが19例、自立が51例であった。多変量解析の結果、受傷時の椎体後壁損傷と6ヵ月時の高度椎体圧潰が長期予後には最も関連しており、治療上最も留意すべきポイントと考えられた。(著者抄録)

  • 整形外科 知ってるつもり 骨軟部腫瘍治療前の妊孕性温存

    星 学, 大戎 直人, 家口 尚, 中村 博亮

    臨床整形外科   50 ( 1 )   28 - 30   2015.01( ISSN:0557-0433

  • 【骨粗鬆症性椎体骨折治療のコツとpitfall】 骨粗鬆症性椎体骨折に対するリン酸カルシウムセメントを用いた椎体形成術のコツとpitfall 骨セメント塊逸脱や再圧潰発生の危険因子からみた椎体形成術の適応と限界 Reviewed

    豊田 宏光, 寺井 秀富, 中村 博亮

    (株)全日本病院出版会, 整形外科最小侵襲手術ジャーナル   ( 73 )   53 - 62   2014.12( ISSN:1342-3991

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    当院では、骨粗鬆症性椎体骨折骨癒合不全に対して経椎弓根的に挿入した内視鏡下に椎体クレフト腔内を掻爬し、ウロマチックバルーンを用いてリン酸カルシウムペーストの充填空間を形成する椎体形成術を行っている。1年以上経過観察が可能であった49椎体の臨床成績は良好であり、除痛効果、ADL改善ともに優れた術式であった。しかし、続発性新規椎体骨折や術後再圧潰(再骨折)、骨セメント塊の逸脱などが課題として挙げられた。多変量解析を用いて、術後再圧潰、骨セメント塊の逸脱の危険因子を検討した結果、American Society of Anesthesiologists-Physical Statusが3以上、椎体壁損傷数が3以上であることが、年齢や骨密度よりも重要な因子であることが判明した。椎体形成術単独療法の良い適応は、椎体壁損傷数が2以下の生体材料を格納する椎体の壁がしっかりと保たれた椎体骨折であり、3以上の高度椎体壁破壊例に対しては、後方インストゥルメンテーションの併用が推奨される。(著者抄録)

  • 【骨粗鬆症性椎体骨折治療のコツとpitfall】骨粗鬆症性椎体骨折に対するリン酸カルシウムセメントを用いた椎体形成術のコツとpitfall 骨セメント塊逸脱や再圧潰発生の危険因子からみた椎体形成術の適応と限界

    豊田 宏光, 寺井 秀富, 中村 博亮

    整形外科最小侵襲手術ジャーナル   ( 73 )   53 - 62   2014.12( ISSN:1342-3991

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    当院では、骨粗鬆症性椎体骨折骨癒合不全に対して経椎弓根的に挿入した内視鏡下に椎体クレフト腔内を掻爬し、ウロマチックバルーンを用いてリン酸カルシウムペーストの充填空間を形成する椎体形成術を行っている。1年以上経過観察が可能であった49椎体の臨床成績は良好であり、除痛効果、ADL改善ともに優れた術式であった。しかし、続発性新規椎体骨折や術後再圧潰(再骨折)、骨セメント塊の逸脱などが課題として挙げられた。多変量解析を用いて、術後再圧潰、骨セメント塊の逸脱の危険因子を検討した結果、American Society of Anesthesiologists-Physical Statusが3以上、椎体壁損傷数が3以上であることが、年齢や骨密度よりも重要な因子であることが判明した。椎体形成術単独療法の良い適応は、椎体壁損傷数が2以下の生体材料を格納する椎体の壁がしっかりと保たれた椎体骨折であり、3以上の高度椎体壁破壊例に対しては、後方インストゥルメンテーションの併用が推奨される。(著者抄録)

  • 再生医療を用いた神経再生 iPS細胞ハイブリッド型人工神経による末梢神経再生

    上村 卓也, 高松 聖仁, 池田 幹則, 横井 卓哉, 岡田 充弘, 中村 博亮

    末梢神経   25 ( 2 )   220 - 225   2014.12( ISSN:0917-6772

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    これまで我々は神経再生誘導管(以下人工神経)を用いた末梢神経の再生医療について研究を重ね、神経再生を促進させるために、人工多能性幹細胞(induced pluripotent stem cell以下iPS細胞)由来の神経前駆細胞を人工神経に付加させたiPS細胞ハイブリッド型人工神経を開発した。マウスモデルにおいて末梢神経の再生医療を行うべく、坐骨神経欠損に対するiPS細胞ハイブリッド型人工神経の移植長期成績について検証した。次に、自家神経移植の神経再生に近づけるために、線維芽細胞増殖因子(Fibroblast growth factor以下FGF)を成長因子として追加付加した。iPS細胞ハイブリッド型人工神経を用いた坐骨神経再建では、長期経過(移植後48週)においても末梢神経再生が確認でき、またFGFを付加したiPS細胞ハイブリッド型人工神経では、移植後12週で神経再生がさらに促進した。マウス坐骨神経欠損モデルにおいてiPS細胞ハイブリッド型人工神経の長期有用性が示され、FGF付加iPS細胞ハイブリッド型人工神経は、自家神経移植に代わる新たな末梢神経の再生医療となる可能性がある。(著者抄録)

  • 【小児肘外傷の初期治療と後遺症に対する治療】小児肘関節脱臼の治療

    上村 卓也, 日高 典昭, 中村 博亮

    関節外科   33 ( 8 )   849 - 858   2014.08( ISSN:0286-5394

  • 【高齢者脆弱性骨折の予防と治療】高齢者脆弱性骨折の治療 部位別各論 新鮮脊椎椎体骨折 保存的治療

    豊田 宏光, 中村 博亮

    整形外科   65 ( 8 )   802 - 808   2014.07( ISSN:0030-5901

  • 【高齢者の首下がり・腰曲がり-脊柱変形と姿勢-】腰椎変性後彎に対する腰仙椎固定の適応

    松村 昭, 並川 崇, 加藤 相勲, 林 和憲, 中村 博亮

    関節外科   33 ( 5 )   540 - 545   2014.05( ISSN:0286-5394

  • 胸腰椎移行部の骨粗鬆症性椎体骨折後圧潰に対する手術治療 Reviewed

    寺岡 貴徳, 松村 昭, 並川 崇, 加藤 相勲, 林 和憲, 大山 翔一朗, 小西 定彦, 香月 憲一, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   88 ( 3 )   S698 - S698   2014.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折における遷延治癒例と骨癒合例における違い 多施設前向き研究 Reviewed

    安田 宏之, 星野 雅俊, 辻尾 唯雄, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 堂園 将, 松本 富哉, 篠原 良和, 玉井 孝司, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   88 ( 3 )   S599 - S599   2014.03( ISSN:0021-5325

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  • 骨粗鬆症性脊椎椎体骨折に対する治療戦略 骨粗鬆症性椎体骨折の長期予後(5年以上) 生存・ADL・遺残疼痛に影響する因子解析 Reviewed

    星野 雅俊, 寺井 秀富, 辻尾 唯雄, 鈴木 亨暢, 並川 崇, 加藤 相勲, 松村 昭, 高岡 邦夫, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   5 ( 3 )   650 - 650   2014.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折治療の現状と未来 Reviewed

    中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   88 ( 3 )   S577 - S577   2014.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折における遷延治癒例と骨癒合例における違い 多施設前向き研究 Reviewed

    安田 宏之, 星野 雅俊, 辻尾 唯雄, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 堂園 将, 松本 富哉, 篠原 良和, 玉井 孝司, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   5 ( 3 )   681 - 681   2014.03( ISSN:1884-7137

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  • 【術後疼痛管理の最前線】肩関節(鏡視下)手術後鎮痛 整形外科からの視点

    伊藤 陽一, 市川 耕一, 間中 智哉, 松本 一伸, 松田 淑伸, 中村 博亮

    整形・災害外科   56 ( 13 )   1555 - 1559   2013.12( ISSN:0387-4095

  • 神経症状を呈した中下位腰椎骨粗鬆症性椎体骨折の手術成績 Reviewed

    寺岡 貴徳, 松村 昭, 並川 崇, 加藤 相勲, 香月 憲一, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   56 ( 秋季学会 )   127 - 127   2013.09( ISSN:0008-9443

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  • 骨粗鬆症性椎体骨折に対する椎体形成術の現状 Reviewed

    中村 博亮

    ライフサイエンス出版(株), Osteoporosis Japan   21 ( Suppl.1 )   110 - 110   2013.09( ISSN:0919-6307

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  • 脳神経外科医と整形外科医とのコラボレーション(No.8) 「脊椎脊髄外科専門医」制度策定に関わる作業部会からの報告

    谷 諭, 花北 順哉, 持田 讓治, 冨永 悌二, 米延 策雄, 金 彪, 中村 博亮, 高安 正和, 高橋 和久, 紺野 愼一, 加藤 真介, 飛騨 一利, 波呂 浩孝, 谷口 真, 中村 雅也, 「脊椎脊髄外科専門医」制度策定に関わる作業部会

    脊椎脊髄ジャーナル   26 ( 9 )   921 - 923   2013.09( ISSN:0914-4412

  • 脊椎骨折治療の最前線 骨粗鬆症性椎体骨折に対する予後不良因子について Reviewed

    中村 博亮, 星野 雅俊, 辻尾 唯雄

    ライフサイエンス出版(株), Osteoporosis Japan   21 ( 3 )   475 - 475   2013.07( ISSN:0919-6307

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  • 【脊柱変形A to Z】成人の脊柱変形 変性後側彎 多椎間後方経路腰椎椎体間固定術を用いた矯正固定術

    松村 昭, 加藤 相勲, 小西 定彦, 中村 博亮

    整形外科   64 ( 8 )   893 - 900   2013.07( ISSN:0030-5901

  • 【整形外科領域と再生医療】神経再生 iPS細胞と人工神経を用いた末梢神経再生治療開発

    上村 卓也, 高松 聖仁, 中村 博亮

    Pharma Medica   31 ( 4 )   37 - 42   2013.04( ISSN:0289-5803

  • 【再生医療の現況と最前線】再生医療の現状と展望 細胞を用いない再生医療 BMPを用いた骨再生治療研究の現状と展望

    寺井 秀富, 中村 博亮, 高岡 邦夫

    整形・災害外科   56 ( 5 )   643 - 649   2013.04( ISSN:0387-4095

  • 【脊椎椎体骨折の治療】 骨粗鬆症性椎体骨折後偽関節に対する内視鏡併用椎体形成術 Reviewed

    寺井 秀富, 豊田 宏光, 中村 博亮

    (株)全日本病院出版会, Orthopaedics   26 ( 3 )   7 - 13   2013.03( ISSN:0914-8124

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    高齢者の増加に伴って骨粗鬆症性椎体骨折後偽関節となる症例が増加している。偽関節レベルでの不安定性が疼痛の原因となっていれば、偽関節腔にセメントを注入する椎体形成術によって疼痛や歩行機能障害の劇的な改善が期待できる。椎体形成術にはHAやPMMA、CPC(リン酸カルシウムセメント)が用いられるが、我々は偽関節に対してはCPCを用いている。椎体内で長期にCPCを安定させるには、ある程度大きなセメント塊を形成させる必要がある。そのためにはセメント注入スペース確保のための偽関節腔掻爬が重要なステップとなる。本稿ではバルーンを使って偽関節腔を広げた後に内視鏡を用いて偽関節腔内を掻爬し、十分なセメント注入スペースを確保する術式を詳説し、当院で施行した本法の手術加療成績を併せて報告する。(著者抄録)

  • 続発性骨粗鬆症性椎体骨折に対する椎体形成術の臨床成績 Reviewed

    篠原 良和, 豊田 宏光, 寺井 秀富, 鈴木 亨暢, 堂園 将, 松本 富哉, 山田 賢太郎, 高橋 真治, 月山 国明, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   4 ( 3 )   584 - 584   2013.03( ISSN:1884-7137

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  • 続発性骨粗鬆症性椎体骨折に対する椎体形成術の臨床成績 Reviewed

    篠原 良和, 豊田 宏光, 寺井 秀富, 鈴木 亨暢, 堂園 将, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   56 ( 春季学会 )   168 - 168   2013.03( ISSN:0008-9443

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  • 骨粗鬆症性椎体骨折に対する手術療法 Reviewed

    中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   87 ( 3 )   S955 - S955   2013.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折患者における遺残椎体変形が患者に与える影響 X線学的に何を指標に治療すべきか Reviewed

    星野 雅俊, 辻尾 唯雄, 寺井 秀富, 並川 崇, 加藤 相勲, 松村 昭, 鈴木 亨暢, 高山 和士, 高岡 邦夫, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   4 ( 3 )   713 - 713   2013.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後遅発性麻痺の治療 Reviewed

    中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   56 ( 春季学会 )   17 - 17   2013.03( ISSN:0008-9443

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  • 骨粗鬆症性椎体骨折後遅発性神経障害に対する椎体形成術(単独)の有用性と限界 Reviewed

    星野 雅俊, 辻尾 唯雄, 加藤 相勲, 鈴木 亨暢, 松本 富哉, 豊田 宏光, 松村 昭, 寺井 秀富, 小西 定彦, 関 昌彦, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   4 ( 3 )   708 - 708   2013.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折の診断と治療に纏わる言葉の定義 骨粗鬆症性椎体骨折研究会提言 Reviewed

    戸川 大輔, 武政 龍一, 星野 雅洋, 笹生 豊, 中野 正人, 小西 宏昭, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   87 ( 3 )   S782 - S782   2013.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折の治癒過程、形態に纏わる言葉の定義 骨粗鬆症性椎体骨折研究会提言 Reviewed

    戸川 大輔, 武政 龍一, 星野 雅洋, 宮腰 尚久, 笹生 豊, 中野 正人, 小西 宏昭, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   4 ( 3 )   662 - 662   2013.03( ISSN:1884-7137

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  • 【脊椎椎体骨折の治療】骨粗鬆症性椎体骨折後偽関節に対する内視鏡併用椎体形成術

    寺井 秀富, 豊田 宏光, 中村 博亮

    Orthopaedics   26 ( 3 )   7 - 13   2013.03( ISSN:0914-8124

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    高齢者の増加に伴って骨粗鬆症性椎体骨折後偽関節となる症例が増加している。偽関節レベルでの不安定性が疼痛の原因となっていれば、偽関節腔にセメントを注入する椎体形成術によって疼痛や歩行機能障害の劇的な改善が期待できる。椎体形成術にはHAやPMMA、CPC(リン酸カルシウムセメント)が用いられるが、我々は偽関節に対してはCPCを用いている。椎体内で長期にCPCを安定させるには、ある程度大きなセメント塊を形成させる必要がある。そのためにはセメント注入スペース確保のための偽関節腔掻爬が重要なステップとなる。本稿ではバルーンを使って偽関節腔を広げた後に内視鏡を用いて偽関節腔内を掻爬し、十分なセメント注入スペースを確保する術式を詳説し、当院で施行した本法の手術加療成績を併せて報告する。(著者抄録)

  • 卒後研修講座 骨粗鬆症性椎体骨折の治療戦略 Reviewed

    豊田 宏光, 中村 博亮

    (株)南江堂, 整形外科   63 ( 11 )   1189 - 1196   2012.10( ISSN:0030-5901

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  • 【専門医のための疾患・外傷必須診療ガイド】脊椎・脊髄 日常疾患 腰椎分離症・すべり症(変性すべり除く)

    堂園 将, 中村 博亮

    関節外科   31 ( 10月増刊 )   151 - 157   2012.10( ISSN:0286-5394

  • 卒後研修講座 骨粗鬆症性椎体骨折の治療戦略

    豊田 宏光, 中村 博亮

    整形外科   63 ( 11 )   1189 - 1196   2012.10( ISSN:0030-5901

  • 神経障害を合併した骨粗鬆症性椎体骨折後偽関節に対する内視鏡下椎体形成術の治療成績 Reviewed

    鈴木 亨暢, 寺井 秀富, 豊田 宏光, 中村 博亮, 辻尾 唯雄, 星野 雅俊

    (一社)日本骨折治療学会, 骨折   34 ( 3 )   528 - 531   2012.09( ISSN:0287-2285

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    今回我々は神経障害を合併した骨粗鬆症性椎体骨折後偽関節に対して行った内視鏡下椎体形成術単独の治療成績を検討した。対象は13例(男性2例、女性11例)であり、治療成績は腰背部痛VAS、歩行状態、modified Frankel scaleにより評価した。画像的評価として椎体楔状角、椎体高比率および骨片の脊柱管占拠率を測定・評価した。腰背部痛VASは術後有意に改善し、全例で術後歩行可能となった。神経障害は11例で改善が認められた。椎体楔状角および椎体高比率はいずれも術後改善を認めたが、骨片の脊柱管占拠率は術前後で有意な変化は認められなかった。本研究より神経障害を有する骨粗鬆症性椎体骨折後偽関節に対しても椎体形成術のみで一定の治療成績が得られることが判明した。骨片の脊柱管占拠率が変化しないにも関わらず神経障害の改善が認められたことから、椎体の安定化が神経障害の改善に非常に重要であることが示唆された。(著者抄録)

  • 脊椎骨折治療の最前線 骨粗鬆症性椎体骨折に対する予後不良因子について Reviewed

    中村 博亮, 星野 雅俊, 辻尾 唯雄

    ライフサイエンス出版(株), Osteoporosis Japan   20 ( Suppl.1 )   127 - 127   2012.08( ISSN:0919-6307

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  • スポーツ復帰のための腰椎手術療法 スポーツ選手の腰椎椎間板ヘルニアに対する内視鏡下後方手術の実際

    中村 博亮, 金田 国一, 吉田 玄, 寺井 秀富, 島田 永和

    日本整形外科スポーツ医学会雑誌   32 ( 3 )   215 - 218   2012.07( ISSN:1340-8577

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    われわれはスポーツ選手の腰椎椎間板ヘルニア手術適応症例にMicro Endoscopic Discectomy(以下MED)を施行してきた。対象症例は21例で、年齢は18.2歳、罹患椎間はL3/4間1例、L4/5間12例、L5/S間8例であった。スポーツレベルはすべて学生スポーツのレベルで、サッカー、バレーボールが最も多かった。JOAスコアーは術前平均13.4点が術後27.4点に改善し、その改善率は平均89.8%であった。また21例中、18例が元のスポーツレベルへ復帰し、その復帰率は86%、復帰までの期間は平均3.0ヵ月であった。スポーツ選手に対するMED後の予後は良好で、スポーツ復帰に支障をきたすものではないことが判明した。(著者抄録)

  • 【知っておきたい最新骨粗鬆症診療マニュアル】 骨粗鬆症性椎体骨折の治療 保存療法 Reviewed

    豊田 宏光, 中村 博亮

    (株)全日本病院出版会, Orthopaedics   25 ( 5 )   131 - 140   2012.05( ISSN:0914-8124

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    骨粗鬆症性椎体骨折の保存療法についての現状、治療の流れ、ブロック治療、装具療法の効果について私見を交え概説する。保存療法にまつわるエビデンスは海外の論文を参考にしても乏しく、どの装具が一番効果があるのか、どれくらいの期間装着させればよいのか、入院させたほうが予後が良くなるのかなどの疑問に答えられる研究報告はまだ出ていないのが現状であった。患者背景の違いが大きく画一的な治療を求めることに無理があるのかもしれないが、予後を予測して予後不良因子を持った患者に対して選択的かつ強力な医療介入を行うことで治療の効率化が図れるのではないかと考えている。また予後不良因子を持った患者に対する最適な保存治療、手術療法への切り替えのタイミングについても今後検討を行っていく必要がある。我が国でも、大規模な疫学研究や介入研究が行われるようになってきており、今後さらなるデータの蓄積により治療のガイドライン策定が望まれる。(著者抄録)

  • 骨粗鬆症性椎体骨折に対する初期治療が患者へ与える影響 Reviewed

    星野 雅俊, 辻尾 唯雄, 寺井 秀富, 並川 崇, 加藤 相勲, 松村 昭, 鈴木 亨暢, 高山 和士, 高岡 邦夫, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   3 ( 3 )   378 - 378   2012.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折の受傷早期のX線とMRIによる診断と予後予測についての検討 Reviewed

    辻尾 唯雄, 中村 博亮, 星野 雅俊, 関 昌彦, 安藤 佳幸, 岩切 健太郎, 小林 章郎, 寺井 秀富, 鈴木 亨暢

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   3 ( 3 )   384 - 384   2012.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折に対する手術療法 Reviewed

    中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   86 ( 3 )   S314 - S314   2012.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折の診断と治療 Reviewed

    中村 博亮

    (社医)景岳会南大阪病院, 南大阪病院医学雑誌   59 ( 1 )   1 - 5   2012.02( ISSN:0540-1259

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    骨粗鬆症性椎体骨折は、通常骨癒合の進行とともに受傷当初の強い疼痛は軽快する。しかし、近年骨癒合の進行しない偽関節例が報告され、これらの症例では強い疼痛が遷延化することがわかってきた。このような症例を対象に我々は椎体形成術を施行してきた。我々の方法は、椎体内に空隙を形成すること、後彎を矯正すること、Calcium Phophate Cement(以下CPC)の挿入前に可及的な圧迫止血を計ることを目的にウロマチックバルーンを使用し、加えてCPCの骨伝導能を有効化し、母床骨と直接接触させるために内視鏡下椎体内ソウハを併用した椎体形成術を施行している。下肢の運動麻痺がない場合はこの方法を単独で、麻痺がある場合に除圧とインストルメンテーションを併用するという治療方針のもと、これまで36例の症例に施行した。対象症例の平均年齢は75歳であった。この手技により、インストルメンテーション使用の有無に関わらず、VASは有意に減少し、疼痛改善に有効であった。(著者抄録)

  • 骨粗鬆症性椎体骨折後QOL低下に関与する因子についての調査研究 Reviewed

    豊田 宏光, 松本 富哉, 星野 雅俊, 辻尾 唯雄, 寺井 秀富, 並川 崇, 松村 昭, 加藤 相勲, 鈴木 亨暢, 高山 和士, 高岡 邦夫, 中村 博亮

    ライフサイエンス出版(株), Osteoporosis Japan   20 ( 1 )   70 - 73   2012.02( ISSN:0919-6307

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    骨粗鬆症性椎体骨折患者310例(男性44例、女性266例、年齢64〜93歳、平均年齢75.8歳)を対象に受傷時と受傷後6ヵ月目のQOL/ADL評価を行い、QOL低下に関与する因子について検討した。その結果、QOL回復を阻害する因子として「椎体後壁に損傷を認める」と「定期的な運動をしていない」が有意な危険因子として抽出された。特に椎体後壁に損傷を認める症例では認めない症例と比較し、受傷後6ヵ月目のVAS、椎体高比率、骨折部の骨癒合が得られていない偽関節になる割合が有意に高いことが判明した。

  • 骨粗鬆症性椎体骨折の診断と治療

    中村 博亮

    南大阪病院医学雑誌   59 ( 1 )   1 - 5   2012.02( ISSN:0540-1259

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    骨粗鬆症性椎体骨折は、通常骨癒合の進行とともに受傷当初の強い疼痛は軽快する。しかし、近年骨癒合の進行しない偽関節例が報告され、これらの症例では強い疼痛が遷延化することがわかってきた。このような症例を対象に我々は椎体形成術を施行してきた。我々の方法は、椎体内に空隙を形成すること、後彎を矯正すること、Calcium Phophate Cement(以下CPC)の挿入前に可及的な圧迫止血を計ることを目的にウロマチックバルーンを使用し、加えてCPCの骨伝導能を有効化し、母床骨と直接接触させるために内視鏡下椎体内ソウハを併用した椎体形成術を施行している。下肢の運動麻痺がない場合はこの方法を単独で、麻痺がある場合に除圧とインストルメンテーションを併用するという治療方針のもと、これまで36例の症例に施行した。対象症例の平均年齢は75歳であった。この手技により、インストルメンテーション使用の有無に関わらず、VASは有意に減少し、疼痛改善に有効であった。(著者抄録)

  • 骨粗鬆症性椎体骨折の治療 Reviewed

    鈴木 亨暢, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   3 ( 1 )   7 - 15   2012.01( ISSN:1884-7137

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    骨粗鬆症性椎体骨折は骨粗鬆症に続発する骨折として最も頻度が高く、高齢者のQOLに関わる重要な疾患である。受傷早期には薬物療法、装具療法といった保存療法が第一選択であり、多くは骨癒合が得られ治癒に至る。しかし疼痛の持続や神経麻痺、高度の後彎変形などによって著しいADLの低下を認める場合には、椎体形成術や脊柱再建術といった外科的治療が必要となる。患者個々の状態や病態に応じて適切な治療を選択することが重要である。(著者抄録)

  • 【骨粗鬆症-早期に見つけ寝たきりを防ぐ】 外科的療法 骨粗鬆症性椎体骨折の手術治療 慢性期を中心に Reviewed

    星野 雅俊, 高岡 邦夫, 中村 博亮

    (株)診断と治療社, 診断と治療   99 ( 10 )   1739 - 1743   2011.10( ISSN:0370-999X

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  • 多発する骨粗鬆症性骨折の新たな動向 骨粗鬆症性椎体骨折に対する治療戦略 Reviewed

    中村 博亮, 辻尾 唯雄, 星野 雅俊, 高岡 邦夫

    日本医学会, 日本医学会総会会誌   28回 ( I )   289 - 289   2011.10

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  • 骨粗鬆症性椎体骨折の受傷早期X線とMRIによる診断と予後予測 Reviewed

    辻尾 唯雄, 中村 博亮, 星野 雅俊, 寺井 秀富, 鈴木 亨暢

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   55 ( 秋季学会 )   74 - 74   2011.10( ISSN:0008-9443

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  • 骨粗鬆症性椎体骨折における遅発性神経障害に影響する因子の解明 Reviewed

    星野 雅俊, 辻尾 唯雄, 高岡 邦夫, 中村 博亮, 寺井 秀富, 鈴木 亨暢, 鍋田 正晴, 並川 崇, 松村 昭, 高山 和士

    北海道整形災害外科学会, 北海道整形災害外科学会雑誌   53 ( 1 )   137 - 137   2011.08( ISSN:1343-3873

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  • 神経障害を合併した骨粗鬆症性椎体骨折後偽関節に対する内視鏡下椎体形成術の治療成績 Reviewed

    鈴木 亨暢, 辻尾 唯雄, 星野 雅俊, 寺井 秀富, 豊田 宏光, 中村 博亮

    (一社)日本骨折治療学会, 骨折   33 ( Suppl. )   S201 - S201   2011.07( ISSN:0287-2285

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  • 骨粗鬆症性椎体骨折の治療 骨粗鬆症性椎体骨折に対する初期治療は予後に影響を与えるか 治療介入因子の各種患者アウトカムへの影響 Reviewed

    星野 雅俊, 辻尾 唯雄, 寺井 秀富, 並川 崇, 松村 昭, 加藤 相勲, 鈴木 亨暢, 高山 和士, 高岡 邦夫, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   2 ( 3 )   568 - 568   2011.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後遅発性神経障害に対する椎体形成術(単独)とInstrumentation併用除圧固定術の手術成績の比較 神経所見の改善に注目して Reviewed

    星野 雅俊, 加藤 相勲, 鈴木 亨暢, 松本 富哉, 辻尾 唯雄, 豊田 宏光, 寺井 秀富, 小西 定彦, 関 昌彦, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   2 ( 3 )   447 - 447   2011.03( ISSN:1884-7137

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  • 神経障害を合併した骨粗鬆症性椎体骨折後偽関節に対する内視鏡下椎体形成術の治療成績 Reviewed

    鈴木 亨暢, 辻尾 唯雄, 星野 雅俊, 寺井 秀富, 豊田 宏光, 中村 博亮

    (公社)日本整形外科学会, 日本整形外科学会雑誌   84 ( 4 )   S424 - S424   2010.04( ISSN:0021-5325

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  • 遅発性神経麻痺を呈した骨粗鬆症性椎体骨折後偽関節に対する内視鏡下椎体形成術単独の治療成績 Reviewed

    鈴木 亨暢, 辻尾 唯雄, 星野 雅俊, 寺井 秀富, 豊田 宏光, 松本 富哉, 中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   1 ( 4 )   990 - 990   2010.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折は認知症に影響を与えるか? 多施設前向き研究 Reviewed

    星野 雅俊, 中村 博亮, 辻尾 唯雄, 寺井 秀富, 並川 崇, 加藤 相勲, 松村 昭, 鈴木 亨暢, 高山 和士, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   1 ( 3 )   524 - 524   2010.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折に対する治療戦略 Reviewed

    中村 博亮

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   1 ( 3 )   392 - 392   2010.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折 遅発性神経麻痺の病態と治療 骨粗鬆症性椎体骨折における遅発性神経麻痺に影響する因子の解明 病態に基づいた治療につなげるために Reviewed

    星野 雅俊, 中村 博亮, 寺井 秀富, 辻尾 唯雄, 鍋田 正晴, 並川 崇, 松村 昭, 鈴木 亨暢, 高山 和士, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, Journal of Spine Research   1 ( 3 )   427 - 427   2010.03( ISSN:1884-7137

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  • 骨粗鬆症性椎体骨折後偽関節例に対する内視鏡を応用した椎体形成術の臨床成績 Reviewed

    中村 博亮, 寺井 秀富, 豊田 宏光, 鈴木 亨輔

    (一社)日本内視鏡外科学会, 日本内視鏡外科学会雑誌   14 ( 7 )   338 - 338   2009.12( ISSN:1344-6703

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  • 骨粗鬆症性椎体骨折後のMRI所見の変化についての検討 Reviewed

    辻尾 唯雄, 中村 博亮, 星野 雅俊, 寺井 秀富, 鈴木 亨暢, 加藤 相勲

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   52 ( 秋季学会 )   136 - 136   2009.09( ISSN:0008-9443

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  • 骨粗鬆症性脊椎骨折の治療 骨粗鬆症性椎体骨折偽関節発生の予測因子 Reviewed

    中村 博亮, 辻尾 唯雄, 寺井 秀富, 星野 雅俊, 豊田 宏光, 鈴木 亨暢, 伊達 優子, 高岡 邦夫

    ライフサイエンス出版(株), Osteoporosis Japan   17 ( 2 )   177 - 181   2009.04( ISSN:0919-6307

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    大阪市立大学整形外科関連25施設に登録され、6ヵ月間の経過観察を終了した新鮮骨粗鬆症性椎体骨折280例を対象に、偽関節の発生率と偽関節発生を予測する受傷時の画像的因子について検討した。内訳は男性43例、女性237例で、平均年齢は75.9歳であった。その結果、6ヵ月後の偽関節発生率は12.7%(37例)であった。6ヵ月後の偽関節を目的変数とした多変量解析の結果、胸腰椎移行部の骨折、MRI T2強調画像における高輝度限局性変化、広範な低輝度性変化が、偽関節発生を予測させる受傷時の画像的変化であることが判明した。

  • 【骨粗鬆症性脊椎骨折 診断、治療の最前線】 骨粗鬆症性椎体骨折偽関節発生の予測因子 Reviewed

    中村 博亮, 辻尾 唯雄, 寺井 秀富, 星野 雅俊, 高岡 邦夫

    (株)三輪書店, 脊椎脊髄ジャーナル   22 ( 3 )   240 - 246   2009.03( ISSN:0914-4412

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    椎体骨折後における偽関節の発生率と偽関節発生を予測するため、大阪府下の関連25施設において、6ヵ月間の観察期間を有する前向きコ-ホ-ト研究を行った。研究対象は、65歳以上の新鮮骨粗鬆症性椎体骨折例280例291椎体で、男性43例、女性237例、登録時平均75.9歳であった。研究の結果、6ヵ月の経過観察において、骨粗鬆症性椎体骨折の後、偽関節が発生する頻度は12.7%であった。偽関節例は、骨癒合例に比較して、寝たきりになる症例数比率、ADLの低下する症例比率、高度疼痛が遷延する症例比率が高く、その経過はより不良であった。また、偽関節発生を予測させる受傷時の画像的変化として、胸腰椎移行部の骨折、T2強調像における高輝度限局性変化、広範な低輝度性変化が有効であった。

  • 中下位腰椎骨粗鬆症性椎体骨折後脊柱変形に対するPLIFによる脊柱再建術の治療成績 Reviewed

    松村 昭, 寺井 秀富, 前野 考史, 加藤 相勲, 小西 定彦, 中村 博亮

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   52 ( 春季学会 )   50 - 50   2009.03( ISSN:0008-9443

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  • 骨粗鬆症性椎体骨折においてADLを低下させる因子はなにか Prospective cohort study,subgroup analysis Reviewed

    松本 富哉, 中村 博亮, 星野 雅俊, 辻尾 唯雄, 寺井 秀富, 高岡 邦夫

    (公社)日本整形外科学会, 日本整形外科学会雑誌   83 ( 3 )   S333 - S333   2009.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折患者治療成績は治療方法で左右されるか 治療介入因子の健康関連QOLへの影響 Reviewed

    星野 雅俊, 中村 博亮, 辻尾 唯雄, 寺井 秀富, 高岡 邦夫

    (公社)日本整形外科学会, 日本整形外科学会雑誌   83 ( 3 )   S334 - S334   2009.03( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折における後壁損傷はその後のQOL悪化因子である Reviewed

    星野 雅俊, 中村 博亮, 辻尾 唯雄, 寺井 秀富, 並川 崇, 松村 昭, 加藤 相勲, 鈴木 亨暢, 高山 和士, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   20 ( 1 )   236 - 236   2009.03( ISSN:1346-4876

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  • 骨粗鬆症性椎体骨折における偽関節発生の頻度と予測因子 Reviewed

    中村 博亮, 辻尾 唯雄, 星野 雅俊, 寺井 秀富, 豊田 宏光, 鈴木 亨暢, 伊達 優子, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   20 ( 1 )   53 - 53   2009.03( ISSN:1346-4876

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  • 骨粗鬆症性椎体骨折においてADLを低下させる因子はなにか 多施設前向き観察研究 Reviewed

    松本 富哉, 中村 博亮, 星野 雅俊, 辻尾 唯雄, 寺井 秀富, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   20 ( 1 )   234 - 234   2009.03( ISSN:1346-4876

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  • 骨粗鬆症性椎体骨折における後壁損傷は半年後の健康関連QOLを下げる Reviewed

    星野 雅俊, 辻尾 唯雄, 寺井 秀富, 中村 博亮, 高岡 邦夫

    (公社)日本整形外科学会, 日本整形外科学会雑誌   83 ( 2 )   S279 - S279   2009.02( ISSN:0021-5325

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  • 骨粗鬆症性脊椎骨折の治療 骨粗鬆症性椎体骨折の予後予測 Reviewed

    中村 博亮

    ライフサイエンス出版(株), Osteoporosis Japan   16 ( Suppl.1 )   73 - 73   2008.10( ISSN:0919-6307

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  • 骨粗鬆症性脊椎骨折の病態 骨粗鬆症性椎体骨折後偽関節発生に関与する予後不良因子について 多施設前向きコーホート研究 Reviewed

    中村 博亮, 辻尾 唯雄, 寺井 秀富, 星野 雅俊, 松村 昭, 加藤 相勲, 鈴木 亨暢, 高山 和士, 高岡 邦夫

    (株)医学書院, 臨床整形外科   43 ( 4 )   309 - 314   2008.04( ISSN:0557-0433

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    関連27施設において65歳以上の骨粗鬆症性椎体骨折例を登録し,6ヵ月後の予後を検討した.登録時に疼痛部位の単純X線とルーチンMRIを施行した.6ヵ月後に症例を偽関節症例群と骨癒合症例群に分類し,登録時の画像的所見を比較検討した.対象症例は150例で,6ヵ月後のX線像で骨癒合群が129例に,偽関節が21例にみられ,偽関節への移行率は14.0%であった.登録時のMRI T2強調画像で高輝度限局型が最も偽関節への移行率が高く,次いで低輝度広範型が高かった.また椎体後壁損傷がある症例では,ない症例に比較して偽関節へ移行しやすかった.(著者抄録)

    DOI: 10.11477/mf.1408101256

  • 骨粗鬆症性椎体骨折後の偽関節発生に関与する予後不良因子について Reviewed

    中村 博亮, 寺井 秀富, 辻尾 唯雄, 星野 雅俊, 松村 昭, 鈴木 亨暢, 高山 和士, 加藤 相勲, 豊田 宏光, 小西 定彦, 高岡 邦夫

    (公社)日本整形外科学会, 日本整形外科学会雑誌   82 ( 2 )   S261 - S261   2008.02( ISSN:0021-5325

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  • 【関節リウマチおよびその脊髄病変】 骨粗鬆症性脊椎椎体骨折による遅発性脊髄麻痺に対する手術療法 Reviewed

    辻尾 唯雄, 中村 博亮, 寺井 秀富, 松村 昭, 星野 雅俊, 高岡 邦夫

    (株)金芳堂, 脳21   10 ( 2 )   178 - 183   2007.04( ISSN:1344-0128

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    骨粗鬆症性椎体骨折の治療として一般的に、保存療法が行われ、多くの症例では骨癒合とともに疼痛は軽快することが多い。しかし、一方では高度な椎体圧潰や椎体偽関節を生じ、さらには遅発性に神経症状を発症するものがある。それらに対する手術術式として、脊柱再建と前方除圧が短椎間固定で行える前方除圧固定が最も理にかなっている。しかし、本症の対象患者は高齢者で多発骨折例も多いためにその適応を狭めている。我々は、腰背部痛を主症状とし下肢神経症状が軽微なものには椎体形成術のみ行い、下肢神経症状が高度なものには椎体形成術と後方除圧固定術の併用を行っている。一方椎体骨折が高度に圧潰したまま癒合し局所後彎による神経要素の圧排が強い場合には、脊椎後方短縮術を行っている。治療対象となる症例は内科的合併症を有することが多く、骨脆弱性をも有するため手術適応の決定とその方法の選択には慎重でなければならない。(著者抄録)

  • 骨粗鬆症性椎体骨折遷延治癒・偽関節の麻痺及び疼痛発生因子の解明 Reviewed

    星野 雅俊, 中村 博亮, 寺井 秀富, 辻尾 唯雄, 松村 昭, 鍋田 正晴, 並川 崇, 鈴木 亨暢, 高山 和士, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   18 ( 1 )   112 - 112   2007.03( ISSN:1346-4876

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  • 骨粗鬆症性脊椎の病態 骨粗鬆症性椎体骨折後偽関節発生に関与する予後不良因子について 多施設前向きコーホート研究 Reviewed

    中村 博亮, 寺井 秀富, 辻尾 唯雄, 星野 雅俊, 松村 昭, 並川 崇, 加藤 相勲, 鈴木 亨暢, 高山 和士, 小西 定彦, 豊田 宏光, 堂園 将, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   18 ( 2 )   245 - 245   2007.03( ISSN:1346-4876

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  • 骨粗鬆症性脊椎の治療 脊柱管内陥入骨片を伴う骨粗鬆症性椎体骨折後偽関節に対する椎体形成術 Reviewed

    辻尾 唯雄, 寺井 秀富, 松村 昭, 星野 雅俊, 鈴木 亨暢, 並川 崇, 高山 和士, 中村 博亮, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   18 ( 2 )   316 - 316   2007.03( ISSN:1346-4876

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  • 【骨粗鬆性脊椎骨折の発症リスクファクターと予後因子】 早期MRIからみた骨粗鬆症性脊椎椎体骨折の予後不良因子 Reviewed

    辻尾 唯雄, 中村 博亮, 星野 雅俊, 寺井 秀富, 松村 昭, 並川 崇, 鈴木 亨暢, 高山 和士, 高岡 邦夫

    (株)アークメディア, 骨・関節・靱帯   20 ( 1 )   45 - 53   2007.01( ISSN:0915-1125

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    椎体骨折後の予後不良因子、特に偽関節へ移行する危険因子を特定するため、受傷後早期のMRI画像について検討した。新鮮骨粗鬆症性椎体骨折で、受傷後より1週以内にMRIを実施でき、6ヵ月以上その後の経過を観察することができた58例62椎体を対象とした。T1強調像で低輝度性変化が広範囲にみられ、T2強調像でも広範囲に低輝度を呈する場合やまたはT2強調像では限局した高輝度を呈する場合は偽関節へ移行する因子として高いオッズ比を示し、偽関節発生を予見するうえで有用であった。

    CiNii Article

  • 内視鏡とバルーンを応用した骨粗鬆症性椎体骨折後偽関節例に対する椎体形成術 Reviewed

    星野 雅俊, 中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富, 辻尾 唯雄, 並川 崇, 加藤 相勲, 鈴木 亨暢, 伊達 優子, 前野 考史, 高山 和士, 高岡 邦夫

    (公社)日本整形外科学会, 日本整形外科学会雑誌   80 ( 4 )   S376 - S376   2006.04( ISSN:0021-5325

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  • 高齢者骨粗鬆症性椎体骨折の早期MRIを中心とした予後不良因子の検討 Reviewed

    辻尾 唯雄, 中村 博亮, 寺井 秀富, 星野 雅俊, 並川 崇, 加藤 相勲, 鈴木 亨暢, 高岡 邦夫

    (公社)日本整形外科学会, 日本整形外科学会雑誌   80 ( 4 )   S440 - S440   2006.04( ISSN:0021-5325

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  • 骨粗鬆症性椎体骨折の治療 骨粗鬆症性椎体骨折後偽関節例に対するCPCを用いた椎体形成術-バルーンと内視鏡の応用 Reviewed

    星野 雅俊, 中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富, 辻尾 唯雄, 高岡 邦夫

    中部日本整形外科災害外科学会, 中部日本整形外科災害外科学会雑誌   49 ( 春季学会 )   47 - 47   2006.03( ISSN:0008-9443

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    当科では骨粗鬆症性椎体骨折後偽関節に対して、椎体内壊死組織の掻爬と充分なCPC(calcium phosphate cement)挿入腔の形成を目的に、ウロマチックバルーンと内視鏡を用いた椎体形成術を行っている。本術式の適応と手術方法を紹介し、治療成績を報告した。適応は「明らかな麻痺がなく、遷延する強い腰背部痛のためADLが高度に制限されている症例」としている。2003年3月〜2006年1月に手術を行い術後1年以上経過観察しえた14例の成績は、疼痛のvisual analogue scaleが術前平均85から術後19に改善した。ADLは術前10例が歩行不能、4例が介助歩行であったが、術後は6例が独歩可能、8例が介助歩行可能となった。X線学的評価では、%椎体高は術前平均38%、術中85%、術後1ヵ月61%、術後1年61%で、矯正損失を術後1ヵ月まで認めたが、その後変形は進行せず安定化した。

    DOI: 10.11359/chubu.2006.959

    CiNii Article

  • 骨粗鬆症性椎体骨折後偽関節例に対するCPCを使用した椎体形成術 内視鏡とバルーンの応用 Reviewed

    星野 雅俊, 中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富, 辻尾 唯雄, 並川 崇, 加藤 相勲, 鈴木 亨暢, 伊達 優子, 前野 考史, 高山 和士, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   17 ( 1(2/2) )   404 - 404   2006.03( ISSN:1346-4876

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  • 【カルシウム研究 最近の進歩】 骨粗鬆症の治療 骨粗鬆症性椎体骨折に対する椎体形成術の現状 Reviewed

    中村 博亮, 高岡 邦夫

    (株)医薬ジャーナル社, Clinical Calcium   16 ( 1 )   153 - 158   2005.12( ISSN:0917-5857

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    骨粗鬆症性椎体骨折に対する椎体形成術は,損傷椎体の強度を保持あるいは増強させ,早期に疼痛を軽減させる手技として注目されている.通常はpolymethylmethacrylate(PMMA)骨セメントやcalcium phospate cement(CPC)等の骨セメントが使用される.この際,椎体外へのセメントのリークあるいはそれに続発する神経合併症や肺塞栓症が問題となる.これらの問題点を解消するために,あらかじめ椎体内に十分な空間を作成しておくことが必要で,我々はバルーンによる椎体内空隙形成および内視鏡下掻爬を応用した,椎体形成術を偽関節例に対して施行している.本方法により疼痛は著明に軽快し,それに伴い日常生活動作(ADL)の改善が認められた.また肺塞栓症を代表とする全身合併症は認められなかった.今後の展望として,受傷後の予後不良因子を検討し,不良因子を有する症例に対してはより早期に本法を施行する必要がある(著者抄録)

  • 【整形外科最新技術 手技のポイントとコツ】 低侵襲手術 脊椎 骨粗鬆症性椎体骨折に対する内視鏡とバルーンを用いた椎体形成術 Reviewed

    星野 雅俊, 中村 博亮, 高岡 邦夫

    (株)メジカルビュー社, 新OS NOW   ( 27 )   84 - 90   2005.08

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  • 骨粗鬆症性椎体骨折偽関節例に対する内視鏡とバルーンを用いた椎体形成術 Reviewed

    星野 雅俊, 中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富

    日本外科系連合学会, 日本外科系連合学会誌   30 ( 3 )   397 - 397   2005.06( ISSN:0385-7883

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  • 内視鏡とバルーンを応用した骨粗鬆症性椎体骨折偽関節症例に対する椎体形成術 Reviewed

    星野 雅俊, 中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富, 並川 崇, 加藤 相勲, 豊田 宏光, 鈴木 亨暢, 前野 考史, 高岡 邦夫

    (一社)日本脊椎脊髄病学会, 日本脊椎脊髄病学会雑誌   16 ( 1 )   314 - 314   2005.05( ISSN:1346-4876

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  • 内視鏡とバルーンを応用した骨粗鬆症性椎体骨折偽関節例に対する椎体形成術 Reviewed

    星野 雅俊, 中村 博亮, 小西 定彦, 長山 隆一, 寺井 秀富, 高岡 邦夫

    (公社)日本整形外科学会, 日本整形外科学会雑誌   79 ( 4 )   S377 - S377   2005.04( ISSN:0021-5325

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  • Diagnostic application of ascending evoked spinal cord potential and descening nerve root action potential for nerve root avulsion

    The journal of Electrodiagnosis of the Spinal Cord   10   51 - 54   1997

  • Osteosynthesis for humeral neck fracture utilizing hook plate

    Kossetu   18   444 - 448   1996

  • Vascularized rob graft for the treatment of spinal tuberculosis

    10   93 - 97   1996

  • Evaluation on the relationship between the motion of spinal cord and neurological findings in the cases of cervical disc herniation

    39   495 - 496   1996

  • long-term results of resection of hemivertebra for condenital spinal dformity

    J Jpn Scoliosis Soc   10   68 - 72   1995

  • Evaluation on ascending auda equina potential(A-CEAP)in lumber lesion

    Cent Jpn J Orthop Traumat   38   713 - 714   1995

  • experience on themanagement of dumbbell shape tumor of the spine

    Cent Jpn J Orthop Traumat   38   1023 - 1024   1995

  • Spinal balance after selective fusion with Cotrel-Doubousset instrumentation for thoracic curve in idiopathi scoliosis

    J Jpn Scoliosis Soc   10   717 - 175   1995

  • Study on the coagulative manuever for spinal nerve root

    Cent Jpn J Orthop Traumat   38   769 - 770   1995

  • Histological examiation on the mechanism of lumber disc degeneration

    Cent Jnp J Orthop Traumat   38   777 - 778   1995

  • Trunk balance after Cotrel-Doubosset instrumentation in idiopathic scoliosis

    Cent Jpn J Orthop Traumat   38   1519 - 1520   1995

  • Effectiveness of preserving yellow ligament at the time of surgery for lumbar disc herniation

    Cent Jpn J Orthop Traumat   38   239 - 240   1995

  • Evaluation on prognosis of lumber disc herniation based on MRI findings

    Cent Jpn J Orrthop Traumat   37   251 - 252   1994

  • 整形外科major surgeryの発展 脊柱 黄色靭帯温存ヘルニア切除術

    -

    OXNOW   13   56 - 59   1994

  • Evaluation on psychologiacl aspect of brace treatment for patients with idiopathic scoliosis

    J Jpn Paed Orghop Ass   4   178 - 181   1994

  • Evaluation on psychological aspect of the brace treatment for patients with idiopathic scoliosis

    J Jpn Scoliosis Soc   8   67 - 70   1993

  • Ossification of te posterior longitudinal ligament in te thoracic spine causing intermittent paraplegia in an Englishman : a case report

    Paraplegia   30   277 - 281   1992

  • Spinal cord monitoring during scoliosis surgery using spinal-MEP combined with A-ESCP

    Cent Jpn J Orthop Traumat   35   657 - 658   1992

  • Analysis of spinal sagittal balance with CDinstrumentation in idiopathic scoliosis

    The jouranl of Japanese Scoliosis Society(J Jpn   7   73 - 78   1992

  • Evaluation of the prognosis based on X-ray findings for lumber disc herniation

    The Centeral Japan Jpurnal of Orthopaedic Surgery &   34   807 - 808   1991

  • Clinical and experimental studies on ascending cauda equina potentil (A-CEAP)in lumber lesion with reference to positivisation

    The Jounal of the Japanese Orthopaedic Association   64   27 - 42   1990

  • An autopsy case of rheumatioid artritis associated with secondary amyloidosis

    seikeigeka   37   214 - 218   1986

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Presentations

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Grant-in-Aid for Scientific Research

  • meniscal regeneration by endogenous mobilization and transplantation of Muse cells

    Grant-in-Aid for Scientific Research(C)  2026

  • meniscal regeneration by endogenous mobilization and transplantation of Muse cells

    Grant-in-Aid for Scientific Research(C)  2025

  • meniscal regeneration by endogenous mobilization and transplantation of Muse cells

    Grant-in-Aid for Scientific Research(C)  2024

  • 力学的ストレスに対する分子応答の遮断による腰部脊柱管狭窄症の新規治療法の開発

    Grant-in-Aid for Scientific Research(C)  2024

  • 力学的ストレスに対する分子応答の遮断による腰部脊柱管狭窄症の新規治療法の開発

    Grant-in-Aid for Scientific Research(C)  2022.04

  • iPS細胞とPRPを併用した人工神経の開発 末梢神経再生におけるアンチエイジング

    Grant-in-Aid for Scientific Research(C)  2019.04

  • 体幹筋を基盤にしたサルコペニアの定義の提唱と腰痛等の臨床症状との相関に関する研究

    Grant-in-Aid for Scientific Research(C)  2019.04

  • 制御可能なiPS細胞注射による低侵襲脊椎固定術の開発

    Grant-in-Aid for Scientific Research(C)  2017.04

  • Dual release of stromal cell-derived factor-1 and basic fibroblast growth factor with a nerve conduit accelerates peripheral nerve regeneration

    Grant-in-Aid for Scientific Research(C)  2016.04

  • Peripheral nerve regeneration using nerve conduit in combination with human iPS cells

    Grant-in-Aid for Scientific Research(C)  2016.04

  • Efficacy and safety of electroporation and MTX combination therapy for the patients with RA

    Grant-in-Aid for Scientific Research(C)  2014.04

  • Investigation of minimum invasive fusion surgery using injection of novel induced pluripotent stem cells cell

    Grant-in-Aid for Scientific Research(C)  2014.04

  • Effects of internal fixation for metastatic bone tumor.

    Grant-in-Aid for Scientific Research(C)  2013.04

  • The effect of iPS cell- and bFGF drug- delivery system on bioabsorbable nerve conduits in peripheral nerve regeneration

    Grant-in-Aid for Scientific Research(C)  2013.04

  • Development of a new lumbar spinal canal stenosis therapy to prevent the progression of yellow ligament thickening.

    Grant-in-Aid for Scientific Research(C)  2013.04

  • Acceleration of peripheral nerve regeneration with safety by tissue-engineered nerve conduits combined with induced pluripotent stem cell transplantation

    Grant-in-Aid for Scientific Research(C)  2013.04

  • Circulating nucleated peripheral blood cells contribute to early-phase meniscal healing

    Grant-in-Aid for Scientific Research(C)  2012.04

  • Local mechanism of new bone formatior in bone grafting-interaotion between cells in the graft and cells in host-

    Grant-in-Aid for Scientific Research(C)  2009

  • Computer aided skeletal reconstruction with use of Bone Morphogenetic Protein -Experimental study of new method for skeletal reconstructive surgery-

    Grant-in-Aid for Scientific Research(C)  2006

  • The effect of electrochemotherapy for the lungmetastasis mouse osteosarcoma cell

    Grant-in-Aid for Scientific Research(C)  2003

  • Development of computer assisted microsurgery system

    Grant-in-Aid for Scientific Research(C)  2002

  • 脊髄神経根の易損為性に関する研究

    一般研究(C)  1994

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Other subsidies, etc.

  • 骨粗鬆症性椎体骨折の治療成績不良をもたらす因子の解明と効果的かる効率的な治療法の確立―多施設共同前向き研究―

    厚生労働省  2005.04

Outline of education staff

  • これまで大阪市立大学医学研究科に教員として、臓器別講義やBed Side Learningを通じて医学生の教育を実践してきた。また医学教育セミナーやOSCE評価者講習会に出席し、教育手段およびその教育方法について、造詣を深めてきた。本学の医学生をミニレクチャーや術前、術後カンファレンスを通じて、教育することはもちろんのこと、国際交流の一環として海外かららい学される医学生に対しても積極的にその受け入れと、医学教育の実践を行っている。また、後期専門研修の本学における研修プログラムに応募する研修医も多く、大学病院に特有な難易度の高い手術的加療やその術前・術後管理について教育を実践している。また大学院生には臨床から生じた疑問を解決し、臨床現場へ還元するために、基礎的実験を指導しており、海外からの大学院生も受け入れている。

Charge of on-campus class subject

  • 運動器

    2017     Undergraduate

  • 運動器

    2018     Undergraduate

  • 運動器

    2019     Undergraduate

  •  現代の医療 ー腰痛性疾患の診断と治療

    1900     Undergraduate

Number of instructed thesis, researches

  • 2019

    Number of instructed the graduation thesis:Number of graduation thesis reviews:9

    [Number of instructed the Master's Program] (letter term):19

    [Number of master's thesis reviews] (chief):[Number of master's thesis reviews] (vice-chief):1

    [Number of doctoral thesis reviews] (chief):[Number of doctoral thesis reviews] (vice-chief):2

  • 2018

    Number of instructed the graduation thesis:11  Number of graduation thesis reviews:11

    [Number of instructed the Master's Program] (letter term):20

    [Number of master's thesis reviews] (chief):[Number of master's thesis reviews] (vice-chief):3

    [Number of doctoral thesis reviews] (chief):[Number of doctoral thesis reviews] (vice-chief):4

  • 2017

    Number of instructed the graduation thesis:Number of graduation thesis reviews:11

    [Number of instructed the Master's Program] (letter term):20

    [Number of master's thesis reviews] (chief):[Number of master's thesis reviews] (vice-chief):0

    [Number of doctoral thesis reviews] (chief):[Number of doctoral thesis reviews] (vice-chief):2

Original item・Special report (Education Activity)

  • 2017

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    Original item:医学部ラグビー部部長

  • 2018

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    Original item:医学部ラグビー部部長

  • 2019

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    Original item:医学部ラグビー部部長

Foreigner acceptance

  • 2017

    foreigners accepted :4

    International Students :4

  • 2018

    foreigners accepted :4

    International Students :5

  • 2023

    International Students :0

  • 2019

    foreigners accepted :3

    International Students :5

Job title

  • Manager within the university

    2015.04

Other

  • Job Career

    1983.06 - 1985.03

  • Job Career

    1990.04 - 1997.06

  • Job Career

    1997.07 - 2001.06

  • Job Career

    2001.07 - 2002.03

  • Job Career

    2003.04 - 2006.03

  • Job Career

    2008.04 - 2009.03

  • Job Career

    2009.04 - Now

  • Job Career

    2012.04 - 2015.03

  • Job Career

    2015.04 - Now

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