記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Lumbar disc herniation (LDH) is a frequently encountered pathologic condition in orthopedic daily practice. Discectomy is considered when patients with LDH experience persistent limb or lumbar pain or neurologic deficits. Various minimally invasive techniques are available for discectomy. Among these techniques, full-endoscopic lumbar discectomy (FED) is one of the least invasive options. During FED, removal of LDH is accomplished using 2 major approaches: transforaminal (TF) or interlaminar (IL). The prototype FED was percutaneous nucelotomy. An endoscope was integrated to percutaneous nucelotomy and TF endoscopic lumbar discectomy (TELD) was first derived. IL endoscopic lumbar discectomy (IELD) was introduced years after TELD. TELD and IELD can compensate for the shortcomings of each other and endoscopic spine surgeons need to acquire both techniques to deal with all type of LDHs. Because of its long history, the TF approach seems to represent the major approach for FED, but the IL approach has numerous benefits in particular types of LDH. The present article focuses on IELD and reviews the history, surgical techniques, indications and contraindications, clinical outcomes, and complications. This review will contribute to improved understanding of IELD as an important technique in full-endoscopic spine surgery.

DOI： 10.1016/j.wneu.2022.08.080

PubMed

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Knees with severe varus osteoarthritis can develop medial structure contracture. However, there is no report on the relationship between severity of varus deformity and contracture of the medial structure. We aimed to determine the threshold angle that could be corrected in proportion to the width of medial osteophyte removal and to examine correction differences between angles larger and smaller than the threshold angle in total knee arthroplasty. METHODS: This study included 27 varus osteoarthritic knees scheduled for total knee arthroplasty (TKA). A navigation system was used to measure hip-knee-ankle angle (HKA) in all knees at maximum extension and 30˚ and 60˚ flexion, before and after osteophyte removal and with and without external 10 N-m valgus torque loads. Subsequently, resected osteophyte widths were measured. Mean correction angle per 1 mm of osteophyte removal was calculated, and the threshold angle was calculated with the receiver operating characteristic curve. HKA differences were compared against deformities larger and smaller than the threshold angle. RESULTS: Mean osteophyte width was 7.1±2.20 mm. Osteophyte removal produced a mean 3.1° correction, which equaled a 0.4° correction per 1 mm of osteophyte width removal. The varus deformity threshold angle was 9.5°. However, when comparing groups with angles larger and smaller than the threshold angle, there was no significant difference in HKA difference between each step and flexion angle. CONCLUSIONS: The threshold angle for expected correction with medial osteophyte removal was 9.5˚. However, because there were no differences in correction between those with angles larger or smaller than this, medial structure contracture seemed to be unrelated to the severity of deformity.

DOI： 10.1272/jnms.JNMS.2022_89-113

PubMed

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：英語  

DOI： 10.2106/JBJS.21.01476

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MDPI AG  

Full-endoscopic lumbar discectomy (FED) is one of the least invasive procedures for lumbar disc herniation. Patients who receive FED for lumbar disc herniation may develop recurrent herniation at a frequency similar to conventional procedures. Reoperation and risk factors of recurrent lumbar disc herniation were investigated among 909 patients who received FED using an interlaminar approach (FED-IL). Sixty-five of the 909 patients received reoperation for recurrent herniation. Disc height, smoking, diabetes mellitus (DM), subligamentous extrusion (SE) type, and Modic change were identified as the risk factors for recurrence. Other indicators such as LL, Cobb angle, disc migration, age, sex, and body mass index (BMI) did not reach significance. Among 65 patients, reoperation was performed within 14 days following FED-IL (very early) in 7 patients, from 15 days to 3 months (early) in 14 patients, from 3 months to 1 year (midterm) in 17 patients, and after more than 1 year (late) in 27 patients. The very early group included a greater number of males, and the mean age was significantly lower in comparison to other groups. All patients in the very early group received FED-IL for reoperation. Reoperation within 2 weeks allows FED-IL to be performed without adhesion. Fusion surgery was performed on three cases in the early and midterm groups and on 10 cases in the late group, which increased over time as degenerative change and adhesion progressed. The procedure selected to treat recurrent herniation mostly depends on the surgeon’s preference. Revision FED-IL is the first choice for recurrent herniation in terms of minimizing surgical burden, whereas fusion surgery offers the advantage that discectomy can be performed through unscarred tissues. FED-IL is recommended for recurrent herniation within 2 weeks before adhesion progresses.

DOI： 10.3390/jcm11030748

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記述言語：英語  

We report our case of ligament reconstruction for treatment of proximal tibiofibular joint disorder using a semitendinosus tendon graft. A 21-year-old male college soccer player with no remarkable history of injury had been suffering from pain at the lateral aspect of the left knee when playing soccer. At another hospital, the patient was diagnosed with a lateral meniscus injury and cartilage injury of the external condyle of the tibia and underwent partial resection of the meniscus and bone drilling. However, his symptoms continued, and he was referred to our institution. Instability of the left proximal tibiofibular joint and pain were noted during weight-bearing dorsiflexion of the ankle. We diagnosed the case as a proximal tibiofibular joint disorder and surgically treated it by dissecting the proximal portion of the semitendinosus tendon, creating one transfibular and two transtibial tunnels, and then reconstructing the proximal tibiofibular ligament using the harvested semitendinosus tendon graft. The patient was allowed to run at postoperative 2 months, with no pain occurring while squatting at postoperative 3 months, subsequently resuming soccer at postoperative 8 months. The proximal tibiofibular joint disorder is a relatively rare pathology, and diagnosis and conservative treatment are often difficult. Although various surgical treatments are known, the clinical outcome of our case has been successful after reconstructing the anterior and posterior proximal tibiofibular ligaments using a semitendinosus tendon graft.

DOI： 10.1051/sicotj/2022008

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

BACKGROUND: The pedicle sign is a radiographic indicator of spinal metastases. However, it is not only the pedicle sign that is important in radiographic diagnosis of bone metastases. In the present study, the radiological features of symptomatic spinal metastases in patients without the pedicle sign were retrospectively examined. MATERIALS AND METHODS: Among 186 patients with symptomatic spinal metastases who visited our department between January 1, 2011, and December 31, 2017, 64 without the pedicle sign and with available computed tomography (CT) and magnetic resonance imaging (MRI) data in the first visit were enrolled and their data were analyzed. One author evaluated radiographs for findings suggestive of spinal metastases, CT to assess bone destruction, and MRI to evaluate the extent of lesions. Clinical variables were also examined and compared between patients with and without bone changes on radiography. RESULTS: Bone changes strongly suggesting bone metastasis, other than the pedicle sign, were observed in 31 out of 64 patients: bone cortical disappearance in 20, increased radiolucency of the central area in the vertebral body in 8, an irregular osteoblastic change in 5, and asymmetrical vertebral collapse in 10. An analysis of CT data revealed that intertrabecular, mildly osteolytic, and mildly osteoblastic types were more frequent in patients without any changes suggestive of bone metastases on radiographs. CONCLUSION: Radiographic findings other than the pedicle sign are useful for diagnosing bone metastases. The key to a radiographic diagnosis of spinal metastases is to pay attention to changes in the bone cortex of all vertebral components on radiographs in addition to the pedicle.

DOI： 10.1272/jnms.jnms.2022_89-404

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

66歳女性。55歳時の人工股関節置換術(THA)後、外来にて経過観察していた。65歳時の外来受診時に単純X線・CTでカップの弛みを認めた。CRP軽度陽性であったため、CRP陰性を3回連続して確認後に手術を行った。術中、ステムの安定性は良好で、カップ側のみ抜去・洗浄・掻爬して二期的再置換とした。セメントスペーサーはアウター形状でバンコマイシン混入の物を作成し、その中央に抜去したヘッド部分を埋込んだ。術後1年半現在、疼痛や可動域制限は認めない。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J05177&link_issn=&doc_id=20220112310019&doc_link_id=10.11551%2Fjsjd.40.439&url=https%3A%2F%2Fdoi.org%2F10.11551%2Fjsjd.40.439&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(一社)日本人工関節学会  

過去5年間の、Short stem(MINIMA)を使用したTHA症例(16例21股、手術時平均年齢39歳)を対象に、大腿骨頭壊死症(ON)16股(27〜46歳)と変形性股関節症(OA)5股(34〜48歳)に分類し、術前単純X線および術後早期のCT水平断画像で大腿骨形状、ステムの髄腔占拠率の比較検討を行った。CTでは大腿骨の骨切り部、小転子部、遠位部の各レベルでの髄腔に対するステムの内外側径、前後径、面積の占拠率の計測を行った。その結果、CR、占拠率・占拠部位に2群間の有意差は認めなかった。MINIMAは特徴的な外側への張り出し形状により髄腔外側の占拠を得るが、本報告のCTの計測方法はこの特徴の詳細な数値化が可能であった。

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記述言語：日本語   出版者・発行元：(一社)日本人工関節学会  

Lewinnekが提唱したセーフゾーンの問題点として、機能的活動を介した骨盤の回旋と、患者特有の動きの結果としての機能的前方開角・外方開角の変化を考慮していないことが挙げられる。この問題を解決するために開発されたOPSシステム(コリン社)は、術前の座位と立位での単純X線・CT画像から、骨盤が機能的に傾斜するときにカップが外方開角・前方開角ともセーフゾーン内に常にとどまり最適に設置されるよう術前計画を行うものである。今回、OPSシステムの有用性を検証するため、OPSシステムガイドを用いてカップ設置した群(5例)と、一般的なガイドを用いてカップ設置した群(5例)とでカップ設置角度の精度を比較検討した。結果、OPSシステムガイド使用群において術前計画とカップ設置後での外方開角の差は平均-1.06°、前方開角の差は平均0.66°、一般的なガイド使用群では外方開角の差が平均-6.37°、前方開角の差が平均2.74°であり、OPSシステムガイド使用群は外方開角の差が有意に小さかった。

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本人工関節学会  

関節窩骨形態不良例30例(男性13例、女性17例、手術時平均年齢79歳)に対し、下方傾斜設置および回転中心の外側化獲得目的に上腕骨移植併用リバース型人工肩関節置換術(RSA)を行った。術後経過観察期間は12〜61ヵ月(平均29.2ヵ月)であった。術式はdelt pectoralアプローチで小円筋温存、肩甲下筋腱修復、後捻10度で上腕骨ステムのセメント固定、ベースプレートが約10度下方傾斜するように移植骨設置を行った。術後、JOAスコアは有意に改善した。各自動可動域も改善し、前方挙上角度・外転角度は有意な改善を認めた。全例で骨癒合を得られ、βアングルは有意な下方傾斜角度を得られた。術中・術後合併症はなく、全例が良好な成績を得られた。

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記述言語：日本語   出版者・発行元：(一社)日本人工関節学会  

リバース型人工肩関節置換術(RSA)を行った上腕骨近位端骨折新鮮例6肩(男性1例、女性5例、74〜92歳、平均84.2歳)と腱板断裂性肩関節症(CTA)10肩(男性6例、女性4例、70〜82歳、平均75.1歳)を対象に、術後成績(術後6ヵ月、1年のJOAスコア、術後1年の自動可動域、最終診察時の単純X線)の比較検討を行った。その結果、術後1年時点で、平均JOAスコアは骨折症例に比べてCTAで有意に高く、自動可動域はCTAで自動前方挙上角度が有意に大きかった。単純X線は骨折例1例で大結節の骨吸収を認めたが、その他の症例は良好な骨癒合が得られた。インプラントの緩みはなかった。以上より、上腕骨近位端骨折例はCTAと比べて術後成績や前方挙上角度が劣ることが示された。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Osteoporotic vertebral compression fractures (OVCFs) are common fractures in the elderly suffering osteoporosis. Most patients have bone fusion with deformity of vertebral collapse; however, some patients suffer nonunion and persistent pain at the fracture site. Due to the limitations of conservative treatment, balloon kyphoplasty (BKP) has been recently performed for OVCFs. This study aimed to investigate the relationship between cement embolization and balloon expansion pressure (BEP) in patients who underwent BKP. METHODS: We investigated 62 patients who underwent BKP for cement embolization into the perivertebral veins among the 155 patients admitted to our hospital due to thoracolumbar vertebral compression fractures between April 1, 2019, and March 31, 2020. Surgery was indicated for patients who had severe back or low back pain and whose daily life was severely impaired, and in whom the shape of the vertebral body was clearly changed on functional X-ray. RESULTS: Intraoperative X-ray and postoperative CT revealed cement embolization into the perivertebral veins in three cases (4.83%). The BEP was significantly higher in the group with cement embolism than in the group without cement embolism (P < 0.001). Pulmonary cement embolism (PCE) and infection were not observed. One case of cement leakage into the spinal canal was observed (1.61%). CONCLUSIONS: While the surgical intervention of BKP can contribute to the treatment of OVCFs, careful attention should be paid to the prevention of complications, including cement embolization into the perivertebral veins, and such complications should be appropriately managed.

DOI： 10.31662/jmaj.2021-0065

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記述言語：日本語   出版者・発行元：(一社)日本肩関節学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We present a case of solitary chondrosarcoma arising from the proximal phalanx of the ring finger in an elderly man. The chondrosarcoma developed over a period of 14 years, during which the phalanx became progressively more deformed. Several radiographic investigations were carried out, but the patient declined further suggested diagnostic examinations (computed tomography, magnetic resonance imaging, biopsy). Eventually, the lesion became significantly enlarged, and radiographs showed osteolytic lesions in the phalangeal bone. Ray amputation of the finger was required to establish a wide resection of the chondrosarcoma. Most osteochondral tumors arising from the phalanges are benign tumors such as enchondromas, but primary chondrogenic malignant bone tumors (chondrosarcomas) occasionally occur. Chondrosarcoma of the phalanx is difficult to distinguish from enchondroma of the phalanx, because histological investigations of the two neoplasms often produce similar findings. Even with a combination of clinical, biopsy, and imaging findings, differentiating these neoplasms is still challenging, because the characteristic clinical and radiological features of chondrosarcoma do not appear until it becomes aggressive and starts to cause destructive changes. Once that happens, radical expanded resection of the tumor is essential. Therefore, longstanding enchondroma-like lesions should be actively treated in elderly patients, even if a definite diagnosis of chondrosarcoma cannot be made.

DOI： 10.1272/jnms.JNMS.2022_89-602

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The purpose of this study is to evaluate the clinical outcomes of the elderly with coronal shear fractures (CSFs) of the distal humerus who had undergone open reduction and internal fixation (ORIF). METHODS: Between April 2002 and March 2019, eight elderly patients (76.3 ± 5.1 years)with CSFs of the distal humerus were investigated retrospectively. Postoperative complications, the range of motion (ROM) of the elbow joint, and functional elbow scoring (Mayo elbow performance score; MEPS) were assessed. RESULTS: The mean follow-up duration was 23.6 ± 13.9 months. CSFs were treated by a buried implantable headless screw or Kirshner wires or bioresorbable screw with/without lateral locking plates. There were no superficial or deep infections, or elbow joint instability. Seven patients obtained fracture healing, but one patient showed non-union. Osteochondritis dissecans was present in one patient. Three patients showed step-off deformity (> 2 mm) of the articular surface. Two patients displayed a collapse of the fractured articular surface. A patient with severe comminution of both the capitellum and the trochlear showed the collapse of the whole articular surface with osteonecrosis of the capitellum and trochlea. Mean the range of motion of the elbow were flexion, 116.3±12.7° and extension, -28.8±14.1°. The mean MEPS was 78.8±10.2 points, representing patients who scored an excellent (n=1), good (n=3), and fair (n=4). CONCLUSION: ORIF yielded satisfactory outcomes for theelderly with noncomminuted CSF of the distal humerus. However, the cases with comminuted articular fragment or complex posterior fractures were still challenging.

DOI： 10.1272/jnms.JNMS.2022_89-202

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: This study sought to assess the efficacy of a deep-tissue thermal therapy system with a resonant cavity applicator (DTT-RCA), which safely heats deep joint tissue for treating osteoarthritis (OA) of the knee. METHODS: Two groups of participants were recruited. The DTT-RCA group comprised 20 knees. Kellgren-Lawrence (K-L) grade was I and II in 8 knees (DTT-RCA I/II group) [mean age 73.3 years (standard deviation 11.4) ], III and VI in 12 knees (DTT-RCA III/IV group) [75.4 (8.6) years]. The control group comprised 13 knees [68.2 (10.8) years]. K-L grade was I in 7 knees and II in 6 knees. This group received exercise therapy. The DTT-RCA I/II group and the control group were imaged by MRI T2 mapping at baseline and 6 months to determine the area of cartilage degeneration. RESULTS: Visual Analogue Scale improved only in the DTT-RCA I/II post-intervention (p < 0.01). Japanese Orthopedic Association knee rating scores (DTT-RCA I/II: p < 0.01, control group: p < 0.01), the Japanese Knee Osteoarthritis Measure (DTT-RCA I/II: p < 0.05, control: p < 0.01), and the Knee injury and Osteoarthritis Outcome Score (DTT-RCA I/II: p < 0.01, DTT-RCA III/IV: p < 0.05, control: p < 0.01) post-intervention. The magnitude of change did not differ significantly between the three groups. The area of cartilage degeneration did not change significantly post-intervention in the DTT-RCA I/II group, not even relative to the control group. CONCLUSIONS: This was the first study to test a DTT-RCA system in patients with knee OA. The system reduced the clinical symptoms of knee OA and could potentially be effective for conservative therapy.

DOI： 10.1272/jnms.JNMS.2021_88-505

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Obtaining well-balanced soft tissues is important to achieve natural knee kinematics after total knee arthroplasty (TKA). In conventional procedures, soft tissue balance is evaluated with spacer blocks or lamina spreaders. However, the evaluation depends on the surgeons' experience and is not quantitative. This study aims to measure the mechanical properties of knee soft tissue with a new ligament balancer and to determine the optimal distraction force for evaluating tibiofemoral joint gaps in TKA. METHODS: This study included 30 consecutive patients with medial knee osteoarthritis who were scheduled to undergo posterior stabilized TKA. The mean age of patients was 73 ± 9.6 years at the time of surgery, and the mean hip-knee-ankle angle was 13.1 ± 6.5° in varus. After distal femoral and proximal tibial resections, the tibiofemoral joint gaps under several distraction forces were measured in extension and at 90° flexion. The load-displacement curves in extension and flexion were drawn with these data, and the stability range, which was defined as the shift range from the toe region to the linear region in the curves, was calculated. RESULTS: The stability ranges were 160 Newtons (N) in extension and 140 N in flexion. CONCLUSIONS: These displacement forces were considered optimal for evaluating tibiofemoral joint gaps during surgery and ensuring knee stability after TKA.

DOI： 10.1272/jnms.JNMS.2021_88-519

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Rotator cuff tear with delamination is considered a risk factor for postoperative retear. The purpose of this study was to compare clinical outcomes between three repair procedures for large or massive rotator cuff tears with delamination: conventional en masse suture bridge (EMSB), double-layer suture bridge (DLSB), and the combination of DLSB with modified Debyere-Patte (DLSB + DP). METHODS: 53 shoulders of 52 patients who had massive rotator cuff tears with delamination were categorized into three groups: EMSB (18 shoulders), DLSB (24 shoulders), and DLSB + DP (11 shoulders). The mean postoperative follow-up period was 34.6 months. Pre- and postoperative evaluations included a range of motion (ROM), Constant scores, global fatty degeneration (GFDI), and tendon integrity according to Sugaya's classification by magnetic resonance images (MRI). RESULTS: In all groups, ROM significantly improved after the procedures. Mean constant scores significantly improved: from 45.5 to 77.4 after EMSB, from 45.5 to 87.6 after DLSB, and from 46.3 to 88.0 after DLSB + DP. Significant differences were noted in postoperative Constant scores (p = 0.018: DLSB vs. EMSB, and p = 0.045: DLSB + DP vs. EMSB). The Constant pain scores were better for DLSB + DP than for EMSB (p = 0.012). Global fatty degeneration index (GFDI) with DLSB + DP was significantly higher than that for either EMSB or DLSB, indicating significant preoperative fatty degeneration for DLSB + DP. Retear occurred in 27.8% of the EMSB group, 12.5% of the DLSB group, and 9.1% of the DLSB + DP group. DISCUSSION: Comparisons of the three groups demonstrated that DLSB and DLSB + DP achieved better clinical outcomes than EMSB for the repair of large or massive rotator cuff tears. DLSB + DP is useful for massive rotator cuff tears with severe fatty degeneration or for cases where the presence of excessive tension is anticipated when repairing the torn cuff.

DOI： 10.1051/sicotj/2021039

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記述言語：日本語   出版者・発行元：日本股関節学会  

大腿骨転子部骨折術後にlag screwがカットアウトし、再手術を行った10例を対象に、受傷時3D-CT中野分類やTAD、手術時間、合併症、術前後のADLを調査した。その結果、初回の観血的整復固定術(OR/IF)は、sliding hip screwが2例、short femoral nailが8例であった。TADが25mm以上のlag screw刺入位置不良例は7例であった。再手術までの期間は平均133日で、9例に人工股関節全置換術、1例に人工骨頭置換術を行った。使用ステムは2例にMODULUS、7例にAlloclassic、1例にVerSysを使用した。Alloclassic使用7例中4例はCable-Readyを併用した。合併症は1例が手術翌日に肺塞栓症を発症して死亡し、1例が出血性ショックを発症した。ADLは8例が手術翌日から車椅子移乗を開始し、平均4週で全荷重を開始したが、4例が屋外車椅子となった。以上より、再手術は遠位固定型ステムの使用により関節機能は回復するが、手術侵襲は高いと考えられた。

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本肩関節学会  

われわれは,鎖骨と肩甲骨の協調運動と鎖骨のsuspension mechanismを再獲得するため肩鎖関節脱臼Rockwood分類type IIIに対して手術加療を推奨している.当院で関節鏡下にDog Bone Buttonによる烏口鎖骨靱帯再建とソフトアンカーを用いた肩鎖靱帯再建を行い,臨床成績を検討したので報告する.対象は肩鎖関節脱臼Rockwood分類type III新鮮例に対して鏡視下靱帯再建術を施行した7例である.評価項目は最終診察時の単純X線所見,JOA score,JSS-ACJ score,術中・術後合併症とした.また,単純X線で骨孔拡大および亜脱臼率を評価した.術後平均JOA scoreは93.7点,平均JSS-ACJ scoreは91.6点,単純X線で骨孔拡大を5例,術後亜脱臼を1例に認めた.今回,概ね良好な成績を得たが,合併症として鎖骨の骨孔拡大を高頻度に認め,1例で亜脱臼を認めたことを考慮すると,より解剖学的な烏口鎖骨靱帯再建やより強固な肩鎖靱帯再建といったさらなる工夫が必要である可能性が示唆された.(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00256&link_issn=&doc_id=20210913370003&doc_link_id=10.11296%2Fkatakansetsu.45.10&url=https%3A%2F%2Fdoi.org%2F10.11296%2Fkatakansetsu.45.10&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

はじめに:保存療法抵抗性のメチシリン耐性黄色ブドウ球菌(MRSA)胸椎化膿性脊椎炎に対して全内視鏡下椎間板掻爬洗浄術(FEDD)と低侵襲脊椎安定化術(MISt)が奏功した症例を報告する.症例:70歳男性,第8/9胸椎化膿性脊椎炎と診断,血液培養からMRSAが検出された.保存療法抵抗性であり,FEDDとMIStを同時に行い,抗生剤を術後6週間継続し感染を鎮静化し得た.結語:胸椎化膿性脊椎炎に対して一期的に行うFEDDとMIStは有効であった.(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J05510&link_issn=&doc_id=20210728350016&doc_link_id=%2Ffg7spine%2F2021%2F001207%2F017%2F1002-1006%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg7spine%2F2021%2F001207%2F017%2F1002-1006%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Posttraumatic malunion of the phalanx with rotational deformity may cause crossing of the finger and impair hand function. Cosmetic disfigurement and severe dysfunction of the fingers require surgical correction, most often via open corrective osteotomies and rigid fixation with plates. However, such an approach requires a longer incision, inevitably results in a scar, and has a higher potential for extensor tendon adhesions, which result in extension lags. In addition, abruption of the periosteum and plating of the phalanges require longer bone healing. This report describes the straightforward, minimally invasive correction of phalangeal malunions with a mini-external fixator. In this procedure, a digital block of the affected finger can be performed. The fully flexed position of all fingers provides accurate correction of phalangeal malunions. Although treatment of phalangeal malunions remains challenging, the present procedure is an alternative solution for phalangeal malunions.

DOI： 10.1272/jnms.JNMS.2021_88-314

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s43019-021-00099-y

PubMed

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DOI： 10.1186/s43019-021-00101-7

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

人工股関節再々置換術後,サポートリング(KT-プレートS)が骨盤内に迷入し治療に難渋した症例を経験した.インプラント抜去時の術前検査で,尿管・血管損傷のリスクを危惧し,泌尿器科および心臓血管外科と協議し合同手術を施行することで合併症を回避することが可能であった.術前にリスクを評価することが非常に重要であり,各科と密に連携して治療方針を決定する必要がある.(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J03098&link_issn=&doc_id=20210715250007&doc_link_id=%2Fdx3eastj%2F2021%2F003302%2F007%2F0137-0141%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdx3eastj%2F2021%2F003302%2F007%2F0137-0141%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Open wedge high tibial osteotomy (OWHTO) is an effective treatment option for young and middle-aged active patients with medial unicompartmental knee osteoarthritis (OA). In addition, particulated cartilage implantation has been developed as a simple procedure for cartilage regeneration. Thus, to improve the OWHTO outcomes, a single-stage, simultaneous bilateral knee arthroscopic particulated cartilage implantation with OWHTO was performed. CASE PRESENTATION: A 60-year-old male patient presented with severe bilateral knee pain, with grade 2 varus knee OA of the Kellgren-Lawrence classification. Primary arthroscopic evaluations based on the International Cartilage Repair Society grading system showed grade 3c articular cartilage defects of 1.5 cm in diameter at the center of the bilateral medial femoral condyles. Following bilateral OWHTO, the healthy cartilage tissue was harvested from the lateral wall of the unilateral femoral intercondylar notch and minced with the cartilage processor. Then, subchondral drillings and cartilage fragment implantations into the bilateral defects were performed arthroscopically. One year postsurgery, second-look arthroscopy findings revealed that the defects were filled with cartilage-like tissues. The maturation process of the regenerated tissues was confirmed with T2 mapping magnetic resonance imaging during the 3-year follow-up period. The patient could walk without a cane, and all Knee Injury and Osteoarthritis Outcome Score parameters were improved without any correction loss in 3 years. CONCLUSIONS: This is the first report to evaluate the maturation process of the implanted particulated cartilage tissue with T2 mapping magnetic resonance imaging for 3 years. The effect of chondral resurfacing procedure with OWHTO remains unclear; however, the implantation of arthroscopic particulated cartilage fragments is a single-stage and less-invasive procedure. This treatment could regenerate cartilage-like tissue in the present case. Therefore, this additional procedure could potentially improve the long-term outcomes of OWHTO.

DOI： 10.1186/s12891-021-04368-5

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

CASE: A 49-year-old man, who had started jogging 3 months before his first participation in a marathon race, presented with acute pain and difficulty walking that began during the marathon race. Tumors and bone metabolism factors were ruled out by blood examination and various imaging findings. Isolated iliac wing fatigue fracture was diagnosed and treated with conservative therapy. CONCLUSION: This is the first English-literature report we know of an isolated iliac wing stress fracture in a male marathon runner without underlying disease. Our study highlights the importance of considering this rare fracture when diagnosing patients presenting with iliac pain.

DOI： 10.2106/JBJS.CC.20.00541

PubMed

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1272/jnms.JNMS.2021_88-418.

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記述言語：日本語   出版者・発行元：(株)南江堂  

＜文献概要＞はじめに わが国の癌の年間罹患数が100万人を超えるようになり,また分子標的治療薬の登場によりこれまで予後不良であった癌の生存期間が伸長していることで骨転移患者数は増加している.患者の多くは癌や骨転移と共存し,薬物治療を続け,経過によっては治験治療を受けながら,闘病生活を継続している人が多い.そのような患者に骨転移による病的骨折や麻痺が生じてしまった場合には,日常生活動作は極端に悪化し,またパフォーマンスステイタスの低下により薬物治療の継続に支障が生じる.近年,骨転移の治療は集学化がすすんでおり,骨転移の患者には,化学療法,手術的治療,放射線療法のみならず,早期緩和ケア,早期リハビリテーション,精神的ケア,歯科医,看護師,栄養サポート,退院・転院・就労支援など多面的に多くの職種が携わっている.整形外科医は骨の専門家であることからその主要なメンバーであり,託されている役割は骨転移の診断,生検,手術,治療方針(装具,手術,放射線治療,骨修飾薬など)の提案,安静度,荷重制限,病的骨折・麻痺リスク評価,リハビリテーション前評価,装具作成指示,経過観察など多岐にわたる.しかし,整形外科医は骨転移診療の集学化にやや乗り遅れているようにもみえる.われわれは骨転移診療に対して2014年から積極的な取り組みをはじめ他科からの紹介患者が約2倍になった経験をもとに,骨転移診療を積極的対応に転換する際の留意点を3ステップに分けて述べる.

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J04037&link_issn=&doc_id=20210514600024&doc_link_id=10.15106%2Fj_besei79_126&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_besei79_126&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

記述言語：日本語   出版者・発行元：(株)南江堂  

＜文献概要＞はじめに 穿刺吸引細胞診(fine needle aspiration cytology:FNAC)は,乳癌や甲状腺癌など表在にある腫瘍では以前より広く行われており,その診断学的価値は生検に匹敵するとされている.軟部腫瘍も表在腫瘍の一つであり,軟部腫瘍に対するFNACは欧米において広く行われているが,わが国では十分普及していると言い難い.その理由は軟部腫瘍の発生母地が多岐にわたりその種類も膨大であり,かつ良悪性の境界病変もあるため,病理組織診断そのものが難解であるからである.われわれは約30年にわたって使用し,軟部腫瘍のマネジメントにおける有用性を実感している.本稿では軟部腫瘍に対するFNACの必要性,目的,特徴,MRIとの相補性,実際の方法について述べる.

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J04037&link_issn=&doc_id=20210514600010&doc_link_id=10.15106%2Fj_besei79_47&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_besei79_47&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

記述言語：日本語   出版者・発行元：(株)南江堂  

＜文献概要＞はじめに 整形外科外来には,さまざまな痛みを理由に患者が受診する.痛みの原因の一つに腫瘤性病変がある.多くは足底の粉瘤や末梢神経近傍に生じたガングリオンなど周囲組織との関係が痛みの発生に関与している場合が多いが,中には腫瘤性病変そのものが痛みの原因となっている場合がある.いわゆる有痛性軟部腫瘍は発生部位に関係なく痛みを生じることがある.しかし,下肢の皮下に好発する小腫瘤である血管平滑筋腫や上腕皮下に触れる小さな脂肪腫のような腫瘤(血管脂肪腫)が疼痛の原因になりうることはあまり知られていない.また,尺骨神経など太い神経幹に発生する神経鞘腫や爪下腫瘍としてのグロムス腫瘍はよく知られているが,太い神経幹とは無関係な神経鞘腫や爪下以外に発生するグロムス腫瘍の存在はあまり知られていない.そのため,痛みの原因をほかに求めて過剰な検査を行ったり,患者が痛みを主張することに対して懐疑的になり腫瘍が治療されずに放置されたりすることもある.これらの腫瘍の治療は単純な摘出で十分なので,整形外科医が有痛性軟部腫瘍について知ることが重要である.本稿では,有痛性軟部腫瘍のうち,特にその小ささに不釣り合いな痛みを伴うことが多い血管平滑筋腫,血管脂肪腫,グロムス腫瘍の診断について述べる.

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J04037&link_issn=&doc_id=20210514600007&doc_link_id=10.15106%2Fj_besei79_34&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_besei79_34&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

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：(一社)日本肩関節学会  

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記述言語：日本語   出版者・発行元：(一社)日本肩関節学会  

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記述言語：日本語   出版者・発行元：(一社)日本肩関節学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Ganglion cysts are common benign lesions in the hand and wrist. However, intratendinous ganglion cysts are fairly rare lesions. We present the case of a 73-year-old woman with an intratendinous ganglion cyst occurring in the extensor pollicis longus (EPL) tendon of her right hand. The subcutaneous mass moved according to the movement of the EPL tendon of her right thumb. Magnetic resonance imaging showed a space-occupying lesion in the EPL tendon. Biochemical and hematoimmunological examinations ruled out diabetes mellitus, rheumatoid arthritis and other connective tissue diseases. She complained of a motion pain during thumb extension, and she had desired surgery. Intraoperatively, an intratendinous cyst was identified within the tendon substance of the EPL, in which a part of the cyst was herniated into a slit in the tendon substance, just distal to the extensor retinaculum without remarkable proliferative synovial tissue. The EPL tendon was opened longitudinally, and a cystic lesion was enucleated. The pathological findings showed that the cyst wall consisted of fibrous tissue with degeneration, lacking epithelial lining. Postoperative recovery was uneventful. Six months after surgery, the patient had no residual pain and cyst recurrence. The rarity of intratendinous ganglion cysts makes diagnosis and treatment challenging. Since intratendinous ganglion cysts and associated synovitis frequently weaken the structure of the affected tendons, prompt diagnosis and surgical excision are necessary.

DOI： 10.1272/jnms.JNMS.2021_88-416

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Thumb opposition is an essential movement for daily use of the hand, including precise pinch or grasping as well as fine and complicated hand movement. Although previous studies have reported several donor tendons for opponensplasty, opponensplasty using palmaris longus, Camitz opponensplasty, have been utilized in patients who have loss of opposition function due to long-standing carpal tunnel syndrome, because the procedure involves a simple and useful tendon transfer without causing functional deficits. To obtain enough length to transfer the tendon to the metacarpophalangeal joint of the thumb, the PL tendon should be obtained along with the palmar aponeurosis. However, the palmar aponeurosis is not always available for the opponensplasty, as it occasionally appears thin and is not sufficient for the elongation of the palmaris longus. The extended skin incision over the palm causes painful scar formation or postoperative residual pain. This procedure restores the palmar abduction function of the thumb, but not the opposition function. In the present article, we present the modified Camitz opponensplasty using half split of palmaris longus, which has enough length to anchor to the insertion of the adductor pollicis at the metacarpophalangeal joint of the thumb.

DOI： 10.1272/jnms.JNMS.2020_88-206

PubMed

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：日本股関節学会  

64歳男性。陳旧性右大腿骨頸部骨折に対する人工大腿骨頭置換術から1年後に再度右股関節痛が出現し、体動困難となったため当院を再受診した。単純X線で右股関節の前方脱臼を認め、CTでは右大腿骨小転子、大転子の周囲に骨化像がみられた。以上より、異所性骨化を伴う前方脱臼と診断し、全身麻酔下で脱臼整復を試みたが整復不能であったため、異所性骨化の摘出とステム再置換および人工股関節全置換術を施行した。術後はリハビリを開始し、術後2年で易脱臼性はみられず、ADLはピックアップ歩行可能となり、経過良好であった。

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担当区分：最終著者   記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：日本股関節学会  

2011〜2018年に手術加療した非定型大腿骨骨折(AFF)8例10肢(男2例、女6例、平均年齢74.7歳)の治療経験を報告した。対象疾患は乳癌1例、前立腺癌2例、骨粗鬆症5例で、病期はII期1肢、III期9肢であり、II期の1例は予防的手術であった。全例にビスホスホネート製剤(BP)の使用歴があり、骨粗鬆症のうち4例は4年以上BPを内服していた。また、乳癌1例と前立腺癌2例3肢はゾレドロン酸点滴静注を4年以上受けており、受傷前から骨シンチで転子下外側の高集積を指摘されていた。全例に髄内釘を用いた骨接合術を行い、最終的に術前のADLまで回復したが、骨癒合には長期間を要した。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Posterior cruciate ligament (PCL) resection during posterior-stabilized total knee arthroplasty (PS-TKA) has been reported to preferentially increase the tibiofemoral joint gap in flexion compared with extension. However, previous assessments of the joint gaps have been performed after bone resection and medial soft tissue release. Thus, these procedural steps may have the potential to influence soft tissue balance. In native knees, soft tissue laxity is generally greater in the lateral compartment than in the medial compartment both with the knee in extension and in flexion. Some surgeons may retain this natural soft tissue balance with less aggressive medial release during TKA. We performed this study to evaluate the impact of the PCL resection on the extension and flexion gaps in the absence of bone resection or medial soft tissue release. Tibiofemoral joint gaps for 41 patients (10 males and 31 females) in full extension and at 90 degrees of flexion both before and after the resections of both the anterior cruciate ligament (ACL) and PCL were assessed using a ligament tensioner device. The statistical analyze was performed using the Mann-Whitney U test. The results showed that medial gap in extension and flexion were 6.7 ± 1.0 and 7.3 ± 0.9 mm, and lateral gap in extension and flexion were 7.6 ± 1.1 and 8.4 ± 1.6 mm, respectively. Thus, physiological tibiofemoral gaps just after knee arthrotomy were trapezoidal and asymmetric shape with the significantly wider gaps in lateral and flexion, compared with the medial and extension, respectively (p < 0.05). However, the increases of the gaps with the ACL and PCL resections were less than 1 mm under the existence of medial soft tissues. As the medial collateral ligament is the primary restraint for the valgus instability, it was also considered to prevent the increase of the flexion gap although the PCL-which is the secondary restraint for the valgus instability-was resected. This finding is critically important for orthopedic surgeons applying PS-TKA implants, particularly for preserving soft tissues to achieve natural knee kinematics postoperatively.

DOI： 10.1055/s-0040-1713810

PubMed

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.jnms.2020_87-202

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記述言語：日本語   出版者・発行元：(株)南江堂  

<文献概要>はじめに 人工膝関節全置換術(TKA)は除痛や膝関節機能の再獲得に優れた手術であり,本邦では年間約8万例の初回TKAが施行されている.一方,TKA後の拘縮膝は生活の質(QOL)を低下させるため,追加手術の適応となることがある.そこで,TKA後の拘縮膝に対する治療戦略を紹介する.

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J04037&link_issn=&doc_id=20200527600039&doc_link_id=10.15106%2Fj_besei77_210&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_besei77_210&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

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

当院で2017〜2018年に内側開大型高位脛骨骨切り術を行った28例31膝を対象とし、術前後の膝アライメント変化と矯正角との関連性について検討した。その結果、有意な相関は認められなかった。

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

BACKGROUND: In order to restore the neutral limb alignment in total knee arthroplasty (TKA), surgical procedure usually starts with removing osteophytes in varus osteoarthritic knees, however, that the exact influence on alignment correction is unknown. The purpose of this study was to define the influence of osteophyte removal alone on limb alignment correction in the coronal plane in TKA for varus knee. METHODS: Fifteen medial osteoarthritic knees with varus malalignment scheduled for TKA were included in this study. After registration of a navigation system, each knee was tested at maximum extension, and at 30, 40 and 60 degrees of flexion before and after osteophyte removal. External loads of 10 N-m valgus torque at each angle and in both states were applied. Subsequently, the widths of the resected osteophytes were measured. RESULTS: The average pre-operative hip-knee-ankle angle was -14.2 degrees. The average width of osteophytes was 7.6 mm in femur and 5.3 mm in tibia, respectively. Angle corrections after osteophyte removal were 3.4 degrees at maximum extension, 3.4 degrees at 30 degrees flexion and 3.6 degrees at 60 degrees flexion; and at all angles, the difference was significant. There was positive correlation between the widths of osteophytes and the degree of angle correction at 30 degrees. CONCLUSION: Correlation was found at 30 degrees of knee flexion between the widths of osteophytes and the degree of angle correction in the coronal plane in TKA. We found the degree of angle correction per 1mm width of osteophyte removal to be 0.4 degrees.

DOI： 10.1272/jnms.JNMS.2020_87-503

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

BACKGROUND: Total knee arthroplasty (TKA) aims to correct the rotation as well as the alignment and the articulation of the osteoarthritic knee. In this study, we hypothesized that TKA affects hip rotational movement, in addition to improving knee kinematics. The objective was to evaluate the variation in lower extremity alignment and hip rotational range of motion (ROM) with TKA. METHODS: A total of 53 knees among 47 patients with primary varus knee osteoarthritis who were scheduled for primary TKA in our institute were enrolled. Hip rotational ROM was measured in the supine position with 90° flexion of the hip and knee before and 3 weeks after TKA. Variations in tibial axis alignment compared to femoral axis alignment by bone resections were also examined as changes in the joint lines of the distal femur and the proximal tibia using plain radiography and computed tomography. RESULTS: The average internal and sum of the internal and external hip rotational ROM increased significantly; however, the external hip rotational ROM was not significantly changed after TKA. The imaging findings also showed that the axis of the lower leg externally rotated 2.5° with a 4° external rotation of the distal femur and a 6.5° correction of the varus deformity. CONCLUSION: TKA was proven to vary the neutral position of hip rotational movement and to increase hip rotational range of motion.

DOI： 10.1272/jnms.JNMS.2020_87-401

PubMed

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-018-5319-2

PubMed

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その他リンク： http://link.springer.com/article/10.1007/s00167-018-5319-2/fulltext.html

記述言語：日本語   出版者・発行元：日本股関節学会  

76歳女性。右股関節痛を主訴とした。51歳時に前医で初回人工股関節全置換術を受け、その後8回の再置換術を受けていた。X線で右大腿骨内のステム折損とセメント骨折によるステムの弛みを認めた。骨欠損範囲が広く、骨皮質の菲薄化が著明であった。同種骨を用いた人工股関節再置換術を検討したが、当科では同種骨のシステムが整っておらず、impaction bone graftを併用した人工股関節再置換術は困難と考えられた。腫瘍用人工関節OSSを使用した再置換術を施行し、術後X線で十分なステムの固定性を認めた。周術期合併症の深部静脈血栓や神経麻痺、感染を認めず、術後経過は良好であった。術後4週に部分荷重で立位歩行を開始し、術後7週に50%部分荷重での歩行訓練が可能となった。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1155/2019/8484938

PubMed

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その他リンク： http://downloads.hindawi.com/journals/aorth/2019/8484938.xml

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: A vitamin A derivative, 13-cis-retinoic acid (isotretinoin), has been administered to treat several types of pediatric cancer and has improved survival rates in patients despite being known to induce premature epiphyseal closure. As the number of patients treated by 13-cis-retinoic acid increases, demands for salvage treatment after systemic retinoid therapy are emerging. However, few studies have described the surgical treatment of this disease. CASE PRESENTATION: We report a case with bilateral varus knee deformity due to premature epiphyseal closure that occurred during treatment with isotretinoin for neuroblastoma. The patient was successfully treated with correction osteotomy using a Taylor spatial frame in the right knee joint and femoral closed wedge osteotomy using a locking plate in left knee joint. Histopathological examination of the growth plate showed polar irregularity of chondrocytes and decreased cartilage matrix without apoptosis. In contrast, arthroscopic findings showed an intact joint surface. No recurrence of varus deformity was evident on follow-up at 1 year. CONCLUSIONS: To the best of our knowledge, this represents the first report of correction osteotomy for varus knee deformity due to premature epiphyseal closure that occurred during treatment with isotretinoin.

DOI： 10.1186/s12891-019-2665-2

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語   出版者・発行元：(株)南江堂  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J04037&link_issn=&doc_id=20190617600047&doc_link_id=10.15106%2Fj_besei75_202&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_besei75_202&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

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

89歳女性。両側変形性膝関節症に対し、8年前に右側、3ヵ月前に左側の人工膝関節置換術を受けた。今回、誘因なく左股関節痛が出現し、歩行困難となったため当院へ受診となった。単純X線所見より両側大腿骨彎曲変形に合併した左大腿骨頸部骨折と診断され、大腿骨彎曲変形に対してセメントステムを内反設置として人工骨頭置換術を施行した。術後6ヵ月経過現在、杖なし歩行、階段昇降も可能な状態まで回復している。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J05177&link_issn=&doc_id=20190405250007&doc_link_id=%2Ffd8kanse%2F2019%2F003801%2F007%2F0043-0047%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffd8kanse%2F2019%2F003801%2F007%2F0043-0047%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Ovid Technologies (Wolters Kluwer Health)  

DOI： 10.1097/md.0000000000013978

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.jnms.2018_85-50

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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担当区分：最終著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.jos.2017.11.015

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記述言語：日本語   出版者・発行元：関東整形災害外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Morphological features of the distal femur and proximal tibia associated with cartilage degeneration are unknown. This study aimed to elucidate local anatomical parameters of the knee which correlate with articular cartilage degeneration using MRI T1ρ mapping. METHODS: This study involved 200 subjects with knee pain (mean age, 48.7 years; range, 14-80 years) with no severe osteoarthritic changes on plain X-ray. T1ρ values were measured in the regions of interest on the surface layer of the cartilage on mid-coronal images of the femorotibial joint. Assessment of medial and lateral posterior tibial slope (MTS, LTS) and medial and lateral femoral condylar offset ratio (MFCOR, LFCOR) was performed using sagittal proton density-weighted imaging. Morphological assessment of posterior root and horn of menisci was also performed according to a modified Whole Organ Magnetic Resonance Imaging Score (WORMS) of the knee. RESULTS: Multiple regression analysis revealed that a decrease in MTS was associated with increased T1ρ values in the medial tibia, independent of age, osteoarthritic changes on plain X-ray, femur-tibia angle (FTA), and posterior medial meniscal lesions. CONCLUSIONS: Shallow MTS correlates with cartilage degeneration in symptomatic patients. This parameter could help in understanding the etiology of osteoarthritis in the early stage. Future kinematic studies will be needed to confirm our findings.

DOI： 10.1080/14397595.2017.1332539

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

BACKGROUND: Femoral rotational alignment is considered an essential factor for total knee arthroplasty because malrotation of femoral components results in poor outcomes. To obtain proper alignment, we developed a superimposable computed tomography (CT) scan-based template to intraoperatively determine the accurate surgical epicondylar axis (SEA), and evaluated the effectiveness of this CT template. METHODS: In the experimental group (n=55), three serial slices of CT images, including medial and lateral epicondyles, were merged into a single image, and SEA was overlaid. SEA was traced onto an image of an assumed distal femoral resection level; this combined image was then printed out onto a transparent film as a CT template. Following a distal femoral resection in TKA, SEA was duplicated onto the femoral surface. Thereafter, the posterior condyle was resected parallel to this SEA. In the control group (n=53), posterior condyles were resected at three degrees of the external rotation from the posterior condylar line (PCL). A posterior condylar angle (PCA) between PCL of the femoral component and SEA was postoperatively evaluated. Positive values indicated external rotation of the femoral component from the SEA. RESULTS: In the experimental group, PCA was 0.01°±1.61°, and three cases were considered as outliers (greater than three degrees or less than -3 degrees). Conversely, in the control group, PCA was 0.10°±2.4°, and 12 cases were considered as outliers. Consequently, dispersion of PCA data was significantly smaller in the experimental group (P=0.004). CONCLUSIONS: The CT template accurately determined intraoperative SEA.

DOI： 10.1016/j.knee.2017.11.009

PubMed

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担当区分：最終著者,　責任著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.knee.2017.08.056

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Aiming to increase the content of type 2 collagen in scaffold-free cartilage-like cell sheets prepared using human bone marrow mesenchymal stem cells, the effect of several kinds of additives in a chondrogenic medium was investigated. Addition of ascorbic acid 2 phosphate (VCP) at a high concentration (250 µg/ml) and type 1 atelocollagen (5 µg/ml) increased the accumulation of type 2 collagen by fourfold and twofold, respectively. On the other hand, an antioxidant, glutathione showed no such effect. The synergistic effect of VCP and type 1 atelocollagen resulted in an eightfold increase in the accumulation level of type 2 collagen. Furthermore, the gene expression level of type 2 collagen increased and that of matrix metalloproteinase-13 (MMP-13) decreased to approximately one-third of the control. The increase in type 2 collagen accumulation in the scaffold-free cartilage-like cell sheet might be due to not only the enhancement of the synthesis but also the suppression of the degradation of type 2 collagen by MMP-13.

DOI： 10.1007/s10616-015-9924-3

PubMed

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その他リンク： http://link.springer.com/article/10.1007/s10616-015-9924-3/fulltext.html

記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

We describe a rare case of a fracture of the medial tubercle of the posterior process of the talus in a 16-year-old male athlete who fell during basketball practice. The patient presented to our orthopedic clinic when pain and swelling had persisted despite 2 weeks of anti-inflammatory medication and rest. Computed tomography and magnetic resonance imaging scans revealed a fracture of the posteromedial tubercle of the talus and a small amount of retained fluid in the joint. Immobilization with a below-the-knee cast and non-weightbearing for 4 weeks, with a gradual return to full activity, was successful. At the 1-year follow-up evaluation, the patient expressed no complaints. Fracture of the posteromedial tubercle of the talus will usually result in a misdiagnosis or delayed diagnosis owing to the insidious onset of symptoms. We believe the present fracture configuration resulted from the vertical compression force that occurred on landing by posterior medial ankle impingement in plantarfiexion-supination, modifying the conventional concept of the posteromedial tubercle fracture. We also present a suggested classification with a flowchart diagram. (C) 2016 by the American College of Foot and Ankle Surgeons. All rights reserved.

DOI： 10.1053/j.jfas.2016.02.001

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記述言語：日本語   出版者・発行元：(株)全日本病院出版会  

表面置換型TKAは開発のコンセプトから、生体膝組織の解剖学的構造・バイオメカニクスを人工関節でできるだけ忠実に再現しようと考える"anatomical approach"と、実用的な機能の再現を第一に考え、構造・バイオメカニクスで機能を代償して人工関節を作ろうとする"functional approach"の2つに分けられる。インプラントの開発は手術手技とともに行われた。CRでは解剖学的指標に基づいてimplantを設置し、joint lineを保つというコンセプトで、今日の手術手技のひとつであるanatomical measured resection techniqueが開発された。一方PSでは、flexion-extension gap technique(classic alignment method)と言われる手術手技が開発された。これはまず脛骨近位のbone cutを行い、膝屈曲位で大腿骨後顆を切除し、extension gapがflexion gapと等しくなるよう大腿骨遠位を切除する方法である。現在はclassical gap techniqueではなく大腿骨遠位を先に切除してから行うanatomical measured resection techniqueを取り入れたmodified gap techniqueが主流である。CRとPSそれぞれに特徴があり、OA膝に対する表面置換型TKAの機種選択においては膝可動域や顆間窩の骨棘の状態を指標に十字靱帯の状態を把握しCRとPSの使い分けをする治療戦略が有効である。(著者抄録)

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.joca.2016.01.150

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.arth.2015.09.027

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

[Purpose] This study aimed to compare the efficacy of radiofrequency diathermy with that of microwave diathermy in combination with intra-articular injection of hyaluronic acid into the knee of patients with osteoarthritis (OA). [Subjects] A total of 17 patients with knee OA were enrolled. The participants were randomly divided into two groups: a radiofrequency diathermy group (RF group, 9 subjects), and a microwave diathermy group (MW group, 8 subjects). [Methods] Subjects received radiofrequency or microwave thermal therapy 3 times at 1-week intervals. Intra-articular injection of hyaluronic acid was administered 10 min before every thermal therapy session. The outcome was evaluated using the Japan Orthopaedic Association (JOA) and the Lequesne Index (LI) at baseline, at weeks 1 (1 week after the first thermal therapy) and 3 (1 week after the last thermal therapy). [Results] The JOA scale increased significantly after three sessions of thermal therapy in the RF group, while no significant increase was observed in the MW group. LI decreased significantly after 3 weeks in the RF group. In the MW group, there was no significant difference in LI between the two time points. [Conclusion] This study revealed that symptom relief in patients with knee OA was greater with radiofrequency diathermy than with microwave diathermy with concurrent use of hyaluronic acid injection, presumably due to the different heating characteristics of the two methods.

DOI： 10.1589/jpts.28.525

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担当区分：最終著者,　責任著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s00167-014-3103-5

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その他リンク： http://link.springer.com/article/10.1007/s00167-014-3103-5/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.ejrad.2015.02.008

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記述言語：日本語   出版者・発行元：北海道外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/art.38924

Scopus

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/art.38924

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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担当区分：最終著者,　責任著者  

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Churchill Livingstone Inc.  

The aim of this study was to evaluate the relationship between clinical results including patient-reported outcomes and intraoperative knee kinematic patterns after total knee arthroplasty (TKA). A cross-sectional survey of forty consecutive medial osteoarthritis patients who had a primary TKA using a CT-based navigation system was conducted. Subjects were divided into two groups based on intraoperative kinematic patterns: a medial pivot group (n. =. 20) and a non-medial pivot group (n. =. 20). Subjective outcomes with the new Knee Society Score and clinical outcomes were evaluated. The functional activities, patient satisfaction and the knee flexion angle of the medial pivot group were significantly better than those of the non-medial pivot group. An intraoperative medial pivot pattern positively influences deep knee flexion and patient-reported outcomes. © 2014 Elsevier Inc.

DOI： 10.1016/j.arth.2013.06.035

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Aim: The current needs of patients with idiopathic osteonecrosis of the femoral head were analyzed for the purpose of seeking effective support programs that would maintain and improve the quality of life of the patients. Methods: A focus group interview method was used to collect data. Interviewees included eight patients. They were asked about their opinions and needs with respect to medicine, health care, and welfare. Results: Overall, four needs were revealed as particularly significant: information needs, decision-making in the absence of pre-established treatment, psychological support, and sufficient medical healthcare institutions. Conclusion: These four needs are useful for the foundation of future support systems, whose main concerns will be: counseling support for patients with idiopathic osteonecrosis of the femoral head, currently adopted institutions, and resources that may be required in the future. © 2012 Japan Academy of Nursing Science.

DOI： 10.1111/j.1742-7924.2012.00219.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Non-steroidal anti-inflammatory drugs play a major role in the management of osteoarthritis (OA). However, it remains unknown whether these drugs affect cartilage and synovial metabolism in osteoarthritic joints. The aim of this study was to evaluate the effects of a selective cyclooxygenase (COX)-2 inhibitor, celecoxib, on synovial fluids and tissues in severely osteoarthritic knees.
Patients were randomized into three groups and medicated two weeks prior to total knee arthroplasty with celecoxib, diclofenac sodium, or no medication (control). We checked for the presence of matrix metalloproteinase-3 (MMP-3), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and hyaluronic acid (HA) in the synovial fluids of all three groups.
MMP-3 significantly decreased in the celecoxib-treated patients (p = 0.0031). On the other hand, there were no significant differences among the three groups in their TNF-alpha and IL-1 beta levels. HA in the joint fluid was significantly increased in the diclofenac-treated group, while HA was not changed in the celecoxib-treated patients.
Our study suggests that celecoxib did not affect the level of HA in the joint fluid in the knee in severe OA, in contrast to the effect of the dual COX inhibitor.

DOI： 10.1007/s10165-012-0772-0

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記述言語：日本語   出版者・発行元：日本股関節学会  

2000〜2012年の間に治療を行った外傷性股関節後方脱臼骨折19例20関節(男性16例17関節、女性3例3関節、受傷時年齢20〜76歳、平均年齢45.5歳、経過観察期間4ヵ月〜8年7ヵ月)を対象に治療成績を検討した。1)骨折型はThompson Epstein分類でType 2が3例、Type 3が7例、Type 4が2例ほか、骨頭骨折を合併しているType 5が8例であった。また、Pipkin分類ではType 1が1例、Type 2が2例、Type 4が5例であった。2)手術法は観血的骨接合術が18例、人工股関節全置換術(THA)が2例であり、初回THA施行の2例中1例は両側骨頭骨骨折で粉砕が強く骨接合術困難と判断され、他の1例は粉砕の強い骨頭骨折で対側の下腿粉砕骨折を合併していた。3)全例、Kocher-Langenbeck approachで展開し2例に大転子骨きり術を併用、後療法は骨接合術を行った症例では術後6週より部分荷重を開始、術後8週で全荷重を許可した。4)術後の画像評価は変性変化が3例、大腿骨頭壊死症が2例、異所性骨化が2例に認められた。尚、術後JOAスコアは平均86.4(56〜100)点であったが、骨頭骨折を合併した症例、股関節以外の合併損傷を認めた症例の臨床成績は有意に悪かった。

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

The aim of this study was to clarify the risk of knee flexion contracture associated with a posterior femoral condylar offset after total knee replacement (TKR). Radiographs from 100 healthy Japanese volunteers were included in the study. We evaluated femoral component posterior offset in various implants and compared them with the normal Japanese knee. Posterior offset of the femoral condyle is up to a maximum of 4.7 times greater than that of the healthy Japanese knee in all knee implants. Excess posterior offset of the femoral condyle in TKR prostheses may cause knee joint flexion contracture due to the relative shortening of the posterior soft tissue. (c) 2013 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.arth.2012.07.029

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1053/j.jfas.2012.12.016

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objectives: Venous thromboembolism (VTE) is the most frequent complication following major orthopaedic surgery (MOS). Although studies in Western populations have demonstrated significantly higher costs for patients with VTE versus those without VTE after MOS, there is a paucity of such data in Japan. This study was conducted to understand the costs and VTE rates in Japanese patients. Methods: Data were extracted from a hospital claims database. MOS was defined as total hip replacement, total knee replacement, or hip fracture repair. Subjects who underwent more than one MOS during the same admission were excluded. Identified VTE cases were matched on a 1:2 matching scheme on the basis of surgery type, hospital, and date of surgery (±6 months). The primary outcome was the difference in 90-day costs. Secondary outcomes included differences in total 6-month costs postsurgery and average length and cost of initial hospital stay. Results: The 90-day cumulative VTE incidence was 0.774%, with 94% of the cases occurring within 30 days postsurgery. Total 90-day costs were significantly higher in patients with VTE (difference of 864,153 Japanese yen [US $10,538]). Average length of stay was longer for patients with VTE (66 days vs. 42 days). Costs incurred by patients with VTE were on average much higher than those incurred by patients without VTE throughout 5 months postsurgery. Conclusions: The development of a VTE in patients undergoing MOS results in a 1.5-fold increase in the length of stay and a 1.7-fold increase in 90-day costs. Findings indicate that the avoidance of VTEs through more effective prophylaxis will help to reduce the economic burden associated with MOS. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

DOI： 10.1016/j.vhri.2013.01.001

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

Background: There is limited information regarding the cause of revision TKA in Asia, especially Japan. Owing to differences in patient backgrounds and lifestyles, the modes of TKA failures in Asia may differ from those in Western countries. Questions/purposes: We therefore determined (1) causes of revision TKA in a cohort of Japanese patients with revision TKA and (2) whether patient demographic features and underlying diagnosis of primary TKA are associated with the causes of revision TKA. Methods: We assessed all revision TKA procedures performed at five major centers in Hokkaido from 2006 to 2011 for the causes of failures. Demographic data and underlying diagnosis for index primary TKA of the revision cases were compared to those of randomly selected primary TKAs during the same period. Results: One hundred forty revision TKAs and 4047 primary TKAs were performed at the five centers, indicating a revision burden of 3.3%. The most common cause of revision TKA was mechanical loosening (40%) followed by infection (24%), wear/osteolysis (9%), instability (9%), implant failure (6%), periprosthetic fracture (4%), and other reasons (8%). The mean age of patients with periprosthetic fracture was older (77 versus 72 years) and the male proportion in patients with infection was higher (33% versus 19%) than those of patients in the primary TKA group. There was no difference in BMI between primary TKAs and any type of revision TKA except other causes. Conclusions: The revision burden at the five referral centers in Hokkaido was 3.3%, and the most common cause of revision TKA was mechanical loosening followed by infection. Demographic data such as age and sex might be associated with particular causes of revision TKA. © 2013 The Association of Bone and Joint Surgeons®.

DOI： 10.1007/s11999-013-2820-2

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担当区分：責任著者  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：HONG KONG ACAD MEDICINE PRESS  

Purpose. To measure the transverse acetabular ligament (TAL) anteversion in hips with severe deformity, using fluoroscopy-computed tomographic navigation.
Methods. 31 hips in 10 men and 19 women aged 40 to 78 (mean, 58.7) years who underwent total hip arthroplasty for primary osteoarthritis (n=6) or osteoarthritis secondary to developmental hip dysplasia (n=19) or congenital hip dislocation (n=6) were included. The severity of hip dislocation was classified according to the Crowe classification; 15 hips were grade 1, 7 were grade 2, 3 were grade 3, and 6 were grade 4. The TAL anteversion was measured using fluoroscopy-computed tomographic navigation. The difference in TAL anteversion between non-dislocated hips (Crowe grade 1, n=15) and dislocated hips (Crowe grades 2-4, n=16) was compared.
Results. In all 31 hips, the TAL could be visualised intra-operatively. No patient reported severe pain, early wear, loosening, or dislocation after 2 years. The mean TAL anteversion and inclination angles measured by the navigation system were 26.5 degrees (SD, 8.9 degrees; range, 8 degrees-42 degrees) and 41.5 degrees (SD, 4.6 degrees; range, 32 degrees-49 degrees), respectively. 22 of the 31 hips were in the safe zone. TAL anteversion in non-dislocated and dislocated hips was not significantly different. Interand intra-observer mean absolute differences in TAL anteversion were 0.3 degrees and 0.4 degrees, respectively.
Conclusion. The TAL is a useful anatomic landmark for total hip arthroplasty in dislocated hips.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Factor XIII (FXIII) is the final enzyme in the coagulation cascade. Acquired FXIII deficiency is caused by inhibitors of FXIII or decreased synthesis and/or increased consumption of FXIII, which leads to severe bleeding. Recently, we experienced a case of hemorrhagic-acquired factor XIII deficiency that occurred during treatment with the IL-6 inhibitor tocilizumab for rheumatoid arthritis. A 48-year-old man was referred because of right hip pain due to a hematoma. Laboratory findings showed that routine coagulation tests were normal, while FXIII activity was slightly low (52.4 %). The patient was successfully treated with plasma-derived factor XIII concentrates. The time course of recovery suggests that tocilizumab might have inhibited FXIII production. To our knowledge, this is the first report of acquired factor XIII deficiency associated with administering of tocilizumab. When recurrent bleeding is seen during administering of tocilizumab, acquired factor XIII deficiency may have been induced, thus attending physicians should consider this disease in a differential diagnosis.

DOI： 10.1007/s12185-012-1191-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ORTHOPAEDIC FOOT & ANKLE SOC, INC  

Background: Both transfibular ankle arthrodesis with fibular onlay grafting and ankle arthrodesis using the Ilizarov apparatus have resulted in acceptable fusion rates. This study analyzed outcomes in the authors' practice for all patients who underwent transfibular ankle arthrodesis with fibular onlay grafting using the Ilizarov apparatus. Materials and Methods: A retrospective review was conducted of all patients who experienced severe ankle pain associated with osteoarthritis, rheumatoid arthritis, talar osteonecrosis, or septic arthritis and underwent transfibular ankle arthrodesis with an Ilizarov apparatus between 1995 and 2010. Postoperative clinical outcomes were evaluated for 42 consecutive patients (43 feet) who received primary or revision ankle arthrodesis using the Ilizarov technique at two centers. Mean duration of follow-up was 4.1 (range, 1.5 to 13) years. Outcomes were assessed using the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society. Results: All ankles fused successfully. Mean clinical outcome improved significantly from 36.2 (range, 8 to 64) preoperatively to 77.4 (range, 0 to 86; p &lt; .05) postoperatively. Conclusion: Transfibular ankle arthrodesis using the Ilizarov external fixation system and fibular onlay strut grafting can achieve a very high rate of bony union and lead to general improvements in clinical outcome. Forefoot stabilization with a forefoot ring achieved rigid stabilization resulting in a shorter duration of external fixation.

DOI： 10.3113/FAI.2012.0964

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

The stress distribution of an ankle under various physiological conditions is important for long-term survival of total ankle arthroplasty. The aim of this study was to measure subchondral bone density across the distal tibial joint surface in patients with malalignment/instability of the lower limb.
We evaluated subchondral bone density across the distal tibial joint in patients with malalignment/instability of the knee by computed tomography (CT) osteoabsorptiometry from ten ankles as controls and from 27 ankles with varus deformity/instability of the knee. The quantitative analysis focused on the location of the high-density area at the articular surface, to determine the resultant long-term stress on the ankle joint.
The area of maximum density of subchondral bone was located in the medial part in all subjects. The pattern of maximum density in the anterolateral area showed stepwise increases with the development of varus deformity/instability of the knee.
Our results should prove helpful for designing new prostheses and determining clinical indications for total ankle arthroplasty.

DOI： 10.1007/s00264-012-1607-5

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記述言語：日本語   出版者・発行元：日本股関節学会  

症例1(58歳女性)。症例2(73歳女性)。両症例とも右大腿骨骨幹部骨折に対する保存治療を受けたが、それぞれ29年後、50年後に脚長差による歩行障害と股関節痛が出現し、著者らの施設へ受診となった。精査を行なったところ、いずれの症例も大腿骨骨折後高度変形治癒による変形性股関節症と診断され、大腿骨矯正骨切り術が施行された。その結果、症例1は術後48ヵ月の現在、脚長差は術前の5cmから術後2.5cmへ改善し、JOAスコアは術前47点が術後85点となった。症例2は術前に認めた5cmの脚長差が術後消失し、術直後は股関節痛も改善したが、術後4ヵ月の時点で股関節痛が軽度出現した。尚、JOAスコアは術前49点が術後61点であった。

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Boiogito (Japanese herbal medicine, Tsumura Co. Tokyo, Japan) contains sinomenin which inhibits inflammatory reactions. Since sinomenine is a principle component of the Boiogito, there is a possibility of it being effective on osteoarthritis (OA) of the knee with joint effusion. However, there is no report concerning the effectiveness of Boiogito on knee OA. The objective of the present study is to investigate the therapeutic effect of Boiogito on OA of the knee associated with joint effusion in a comparative study among randomly assigned groups.Methods: Study was performed using 50 patients who were diagnosed with primary osteoarthritis of the knee with joint effusion. The patients were randomly assigned to two groups: one group (25 patients) using both loxoprofen (2-{4-[(2-oxocyclopentyl) methyl]} propanoic acid) and Boiogito and the other group (25 patients) using loxoprofen, and were evaluated during a 12 week observation period. The assessment parameters including knee scores in the Knee Society Rating System including Knee score and Functional scores, amount of joint effusion by joint puncture in clinically detected cases, the 36-items short form of the Medical Outcome Study Questionnaire (SF-36) as a measurement of health related quality of life were used.Results: The knee scores based on the Knee Society Rating System were improved in both groups. The staircase climbing up and down ability in the Knee society rating system functional score was significantly improved in the group using Boiogito and loxoprofen compared to the loxoprofen group. In the evaluation using SF-36, significant improvements were found in the scores in both groups in physical functioning after 12 weeks. The amount of joint fluid was significantly decreased at 4, 8 and 12 weeks compared to pre-administration baseline in the group using Boiogito and loxoprofen. A side effect of Boiogito, dry mouth, was found in one case. The symptom was mild and improved immediately after discontinuation of administration.Conclusion: The results indicated that Boiogito have a possibility for a treatment modality for joint effusion with osteoarthritis of the knee. © 2012 Majima et al
licensee BioMed Central Ltd.

DOI： 10.1186/1758-2555-4-3

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担当区分：責任著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.arth.2011.02.004

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：2  

In this study, we used a rabbit medial collateral ligament reconstruction model to evaluate a novel chitosan-based hyaluronan hybrid polymer fiber scaffold for ligament tissue engineering and to examine whether mechanical forces exerted in an in vivo model increased extracellular matrix production by seeded fibroblasts. Scaffolds were used 2 weeks after incubation with fibroblasts obtained from the same rabbit in a cell-seeded scaffold (CSS) group and without cells in a noncell-seeded scaffold (NCSS) group. At 3, 6, and 12 weeks after surgery, the failure loads of the engineered ligaments in the CSS groups were significantly greater than those in the NCSS groups. At 6 weeks after surgery, the reconstructed tissue of the CSS group was positive for type I collagen, whereas that in the NCSS group was negative for type I collagen. At 12 weeks after surgery, the reconstructed tissue stained positive for type I collagen in the CSS group, but negative in the NCSS group. Our results indicate that the scaffold material enhanced the production of type I collagen and led to improved mechanical strength in the engineered ligament in vivo. © 2011 Wiley Periodicals, Inc. J Biomed Mater Res Part A:, 2011. Copyright © 2011 Wiley Periodicals, Inc.

DOI： 10.1002/jbm.a.32938

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：日本股関節学会  

症例は74歳女性で、右変形性股関節症に対し、metal on metal THAが施行され、術後8ヵ月に右下肢腫脹が出現したが、疼痛、掻痒感なく自然消退したため放置した。術後1年時に腫脹が再度出現したため受診し、精査したところ骨盤腔内に腫瘤を認め入院した。右逃避性跛行を認め、右股関節可動域は屈曲90°、外転20°であった。JOAスコア68点、15cmの手術創および局所に発赤を認めなかった。右臀部から大腿に圧痛があり大腿周囲径右46cm、左41cmと左右差を認めた。右鼠径靱帯から2横指頭側に6×3.5cmの皮膚との癒着のない弾性硬の腫瘤を触知した。可動性はなく圧痛を伴い、波動、拍動、Tinel徴候は認めなかった。金属アレルギー検査でニッケル、コバルトで陽性であった。末梢血採血検査で感染を疑う所見はなく、単純X線におけるinclination angleは41°で明らかなルースニング、骨融解像は認めなかった。検査結果より神経鞘腫や類腱腫などの軟部腫瘍、感染、metallosisなどを考慮し確定診断のため切開生検を行った。病理組織検査、臨床経過を併せ、ALVAL(aseptic lymphocytic vasculitis associated lesions)と診断した。術後3ヵ月、CT上で腫瘤は縮小傾向で下腿腫脹感、自覚症状は消失した。

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.arth.2009.07.024

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：3  

The selective estrogen receptor modulator raloxifene is therapeutically beneficial for postmenopausal connective tissue degradation, such as osteoporosis, vascular sclerosis, and dermal degradation
however, the effects of raloxifene on postmenopausal tendon metabolism have not been clarified. In this study, we investigated the effects of raloxifene analogue (LY117018) on cell proliferation and collagen metabolism using cultured rat Achilles tendon fibroblasts. 17β-Estradiol (E2
10-1110-9 M) and LY117018 (10-910-7 M) had no significant effects on tendon fibroblast proliferation, based on a BrdU (5-bromo-2′- deoxyuridine) incorporation assay (24 hr) and a WST-8 colorimetric assay (2 or 6 days). Neither E2 nor LY117018 significantly altered the expression of type I collagen, which is a main component of the tendon extracellular matrix (ECM), whereas both E2 and LY117018 significantly increased the expression of matrix metalloproteinase (MMP)-13, which is responsible for tendon collagen degradation in rat. Also, both E2 and LY117018 increased the expression of type III collagen and elastin, which are minor components of tendon ECM, but are considered to govern the elastic properties of tendons. These changes in collagen and MMP induced by either E2 or LY117018 were attenuated by the estrogen receptor alpha blocker ICI 182,780. The results of this study suggest that postmenopausal estrogen deficiency might downregulate tendon collagen turnover and decrease tendon elasticity. Further, raloxifene treatment might restore these changes to premenopausal levels. © 2010 Informa UK Ltd.

DOI： 10.3109/03008200903204669

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記述言語：日本語   出版者・発行元：(一社)日本リウマチ学会  

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記述言語：英語   掲載種別：論文集(書籍)内論文   出版者・発行元：World Scientific Publishing Co.  

DOI： 10.1142/9789814282048_0019

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Tokyo  

Background. Tissue engineering techniques using biodegradable three-dimensional (3D) scaffolds with cultured cells offer more potential alternatives for the treatment of severe ligament and tendon injuries. In tissue engineering, one of the crucial roles of 3D scaffolds is to provide a temporary template with the biomechanical characteristics of the native extracellular matrix (ECM) until the regenerated tissue matures. The purpose of the present study was to assess the effect of various cyclic mechanical stresses on cell proliferation and ECM production in a 3D scaffold made from chitosan and hyaluronan for ligament and tendon tissue engineering. Methods. Three-dimensional scaffolds seeded with rabbit patella tendon fibroblasts were attached to a bioreactor under various conditions: static group, no strain
stretch group, tensile strain
rotational group, rotational strain
combined group, rotational and tensile strain. In the Static group, 3 weeks of stationary culture was performed. In the remaining three groups, a loading regimen of 0.5 Hz for 18 h and then 6 h rest was carried out for 2 weeks after 1 week of static culture. The DNA content was determined to quantify cell proliferation. Real-time reverse transcription polymerase chain reaction analysis was performed to assess the mRNA levels of the ECM products. Results. DNA content of the combined group was significantly higher than that of the static and stretch groups, and that of the rotational group was significant higher than that of the static and stretch groups at 21 days after cultivation. The mRNA level of types I and III collagen and fibromodulin in the combined group was significantly higher than that in the other three groups. The amount of collagen synthesis in the combined group was higher than that in the static group, but the difference was not significant. Conclusions. Multidimensional cyclic mechanical strain to mimic the physiological condition in vivo has the potential to improve or accelerate tissue regeneration in ligament and tendon tissue engineering using 3D scaffolds in vitro. © The Japanese Orthopaedic Association.

DOI： 10.1007/s00776-010-1488-7

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1186/1758-2555-1-6

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その他リンク： http://link.springer.com/article/10.1186/1758-2555-1-6/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

Background. New tissue-engineering technology was developed to create a cartilage-like tissue in a three-dimensional culture using atelocollagen gel. The minimum 2-year follow-up outcome of transplanting autologous chondrocytes cultured in atelocollagen gel for the treatment of full-thickness defects of cartilage in knees was reported from the single institution. The present multicenter study was conducted to determine clinical and arthroscopic outcomes in patients who underwent atelocollagen-associated autologous chondrocyte implantation for the repair of chondral defects of the knees.
Methods. At six medical institutes in Japan, we prospectively evaluated the clinical and arthroscopic outcomes of transplanting autologous chondrocytes cultured in atelocollagen gel for the treatment of full-thickness defects of cartilage in 27 patients (27 knees) with cartilage lesions on a femoral condyle or on a patellar facet over 24 months.
Results. The Lysholm score significantly increased from 60.0 +/- 13.7 points to 89.8 +/- 9.5 points (P = 0.001). Concerning the ICRS grade for arthroscopic appearance, 6 knees (24%) were assessed as grade I (normal) and 17 knees (68%) as grade II (nearly normal). There were few adverse features, except for detachment of the graft in two cases.
Conclusions. We concluded that transplanting chondrocytes in a newly formed matrix of atelocollagen gel can promote restoration of the articular cartilage of the knee.

DOI： 10.1007/s00776-009-1384-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ASSOC CANCER RESEARCH  

The adaptor protein Crk mediates intracellular signaling related to cell motility and proliferation and is implicated in human tumorigenesis. The role of Crk in the growth of human sarcoma has remained unclear, however. The present study shows that Crk-induced activation of Src and subsequent signaling by p38 mitogen-activated protein kinase (MAPK) contribute to the enhanced proliferation of human synovial sarcoma cells. Depletion of Crk by RNA interference markedly inhibited proliferation of the synovial sarcoma cell lines HS-SYII, SYO-1, and Fuji as well as prevented anchorage-independent growth. Conversely, reconstitution with CrkII by authentic small interfering RNA-resistant Crk gene restored proliferation in Crk-silenced SYO-1 cells. Crk-depleted synovial sarcoma cells manifested enhanced transcriptional activity and expression of the p16(INK4A) gene, resulting in their accumulation in G, phase of the cell cycle. In response to hepatocyte growth factor stimulation, Crk prominently induced the tyrosine phosphorylation of Grb2-associated binder 1 through activation of Src and focal adhesion kinase, and the Src family kinase inhibitor PP2 almost completely inhibited the proliferation of SYO-1 cells. Crk also induced the phosphorylation of p38 MAPK, and SB203580, a p38 MAPK-specific inhibitor, increased expression of p16(INK4A) gene in SYO-1 cells. Furthermore, SB203580 or depletion of p38 MAPK by small interfering RNA suppressed both the phosphorylation of Akt triggered by hepatocyte growth factor and the proliferation of SYO-1 cells. These results suggest that Crk promotes proliferation of human synovial sarcoma cells through activation of Src and its downstream signaling by a novel p38 MAPK-Akt pathway, with these signaling molecules providing potent new targets for molecular therapeutics. (Mol Cancer Res 2009;7(9):1582-92)

DOI： 10.1158/1541-7786.MCR-09-0064

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MARY ANN LIEBERT INC  

In the present study the local expression of stromal cell-derived factor-1 (SDF-1) after ligament injury and correlated change in the homing rate of systemically induced bone marrow stromal cells (BMSCs) to the injured site were clarified using a rat medial collateral ligament (MCL) injury model. SDF-1 was temporarily upregulated peaking at 2 weeks after injury. Correlated with the alteration in SDF-1 expression, the homing rate of systemically induced BMSCs was temporarily upregulated peaking at 2-4 weeks after injury. The SDF-1 expression in the MCL seems to play a crucial role in cell homing. In addition, SDF-1 did not influence the BMSCs behavior in vitro in terms of the proliferation, adhesivity, and expression of ligament fibroblast markers. The cell-based therapy for ligament and tendon injury with reference to local expression of SDF-1 may be one of the available applications.

DOI： 10.1089/ten.tea.2008.0224

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-LISS  

Objective. The hypothesis of this study was that synovial factors playing a pivotal role in the pathogenesis of osteoarthritis (OA) and thus gene expression in the synovium would be altered at the initial stage of OA. The aims of this study were to identify the candidate genes in synovium related to OA initiation, to evaluate cartilage degeneration after knockdown of the gene using small interfering RNA (siRNA) gene silencing in the knee joints at the initial stage of OA, and to determine the potential role of the knocked-down gene in OA initiation.
Methods. Genes overexpressed in synovium at the initial stage of disease in a rabbit model of anterior cruciate ligament transection (ACLT)-induced OA were identified using the suppression subtractive hybridization technique and differential screening. Candidate gene expression in the synovium of the knees of rabbits with OA was manipulated with electroporation-assisted siRNA transduction 4 times before and after operation. Four weeks after surgery, histologic analysis was performed.
Results. Cathepsin K gene and protein expression was significantly up-regulated in synovium at the initial stage of OA in rabbits. Down-regulation of cathepsin K in synovium at the initial stage of OA significantly accelerated cartilage degeneration.
Conclusion. These results indicate that cathepsin K plays a protective role in cartilage degeneration at the initial stage of OA. We believe that the current results obtained from models of the early phase of OA will provide useful information for developing a novel strategy to prevent disease progression.

DOI： 10.1002/art.24718

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Upon growth factor stimulation, the scaffold protein, Gab1, is tyrosine phosphorylated and subsequently the adaptor protein, Crk, transmits signals from Gab1. We have previously shown that Crk overexpression, which is detectable in various human cancers, induces tyrosine phosphorylation of Gab1 without extracellular stimuli. In the present study, the underlying mechanisms were further investigated. Mutational analyses of CrkII demonstrated that the SH2 domain, but not the SH3(N) or the regulatory Y221 residue of CrkII, is critical for the induction of Gab1-Y307 phosphorylation. SH2 mutation of CrkII also decreased the interaction with Gab1. In GST pull-down assay, Crk-SH2 bound to wild-type Gab1, whereas Crk-SH3(N) interacted with the Gab1 mutant, which lacks the clustered tyrosine region (residues 242-410). Tyrosine phosphorylation of Gab1 was induced by all Crk family proteins, but not other SH2-containing signalling adaptors. Src-family kinase inhibitor, PP2, abrogates Crk-induced tyrosine phosphorylations of Gab1. Y307 phosphorylation was undetectable in fibroblasts lacking Src, Yes, and Fyn, even upon overexpression of Crk, whereas cells lacking only Yes and Fyn still contained Gab1 with phosphorylated Y307. Furthermore, Crk induced the phosphorylation of Src-Y416
accordingly the interaction between Crk and Csk was increased. The Gab1-Y307F mutant failed to localize near the plasma membrane even upon HGF stimulation and decreased cell migration. Moreover, Gab1-Y307F disturbed the localization of Crk, FAK, and paxillin, which are the typical components of focal adhesions. Taken together, these results indicate that Crk facilitates tyrosine phosphorylation of Gab1-Y307 through Src, contributing to the organization of focal adhesions and enhanced cell migration, thereby possibly promoting human cancer development. © 2009 IBCB, SIBS, CAS All rights reserved.

DOI： 10.1038/cr.2009.40

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-LISS  

It has been widely recognized that cells are seeded onto only the superficial layer of three-dimensional (3D) scaffolds in tissue engineering technology. This leads to tissue necrosis that occurs in the central part of 3D scaffolds. To solve this issue, an effective cell seeding technique into the central part of 3D scaffolds is required. Chitosan has characteristics of biocompatibility, biodegradability, and low-toxicity. In this study, rye developed novel magnetic nanoparticles (MNs) coated with chitosan for enhancing cellular invasion using magnetic force. Cell-invasion efficiency was enhanced by introducing our novel MNs into cells and by the presence of magnetic force. This invasion efficacy depends on the degree of magnetic force. Matrix metalloproteinases and adhesion molecules that were upregtrlated in response to the attached nanoparticles and exposure to a magnetic force may also play a crucial role in improving cell-invasive ability in this system. This current system can efficiently enhance cell seeding into the depth of the scaffold, increase subsequent cell-cell interactions and shorten the period of cell proliferation. This system is thought to be useful in the development of cell-based strategies for the repair or replacement of tissue and other novel therapies. (C) 2007 Wiley Periodicals, Inc.

DOI： 10.1002/jbm.a.31724

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jse.2007.12.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

In this study, we successfully developed two types of volume-reduced three-dimensional scaffolds, including cushion- and cylinder-shape scaffolds, fabricated from chitosan-based hyaluronic acid hybrid polymer fibers. Using these scaffolds combined with a bioreactor system, we regenerated histologically and mechanically mature cartilage constructs. The final goal of this study was to clarify the ability of this engineered cartilage construct to induce cartilage repair in osteochondral defects. The mature cartilage constructs regenerated with two types of scaffolds were implanted into 5-mm diameter osteochondral defects in the patellar groove of rabbits. At 12 weeks after implantation, the reparative tissues consisted of hyaline-like cartilage with evidence of stable fusion to adjacent native cartilage and normal reconstitution of subchondral bone. The histological score of these tissues significantly outranked the value of untreated tissue. Biomechanically, compression modulus of reparative tissue at 12 weeks postoperatively was comparative to that of normal articular cartilage. Our results indicate that the implantation of constructs with mature cartilage have potential as a better approach for joint resurfacing. (C) 2007 Wiley Periodicals, Inc.

DOI： 10.1002/jbm.a.31259

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：W B SAUNDERS CO LTD  

Objective: Osteoarthritis (OA) is the most common of all joint diseases, but the molecular basis of its onset and progression is controversial. Several studies have shown that modifications of N-glycans contribute to pathogenesis. However, little attention has been paid to N-glycan modifications seen in articular cartilage. The goal of this study was to identify disease specific N-glycan expression profiles in degenerated cartilage in a rabbit OA model induced by anterior cruciate ligament transection (ACLT).
Methods: Cartilage samples were harvested at 7, 10, 14, and 28 days after ACLT and assessed for cartilage degeneration and alteration in N-glycans. N-Glycans from cartilage were analyzed by high performance liquid chromatography and mass spectrometry.
Results: Histological analysis showed that osteoarthritic changes in cartilage occurred 10 days after ACLT. Apparent alterations in the N-glycan peak pattern in cartilage samples were observed 7 days after ACLT, and overall N-glycan changes in CA reflected alterations in both sialylation and fucosylation. These changes apparently preceded histological changes in cartilage.
Conclusion: These results indicate that changes in the expression of N-glycans are correlated with OA in an animal model. Understanding mechanisms underlying changes in N-glycans seen in CA may be of therapeutic value in treating cartilage deterioration. (C) 2007 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.joca.2007.11.004

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

Background. Medial compartment osteoarthritis (OA) of the knee frequently accompanies patellofemoral osteoarthritis (PF-OA). No consensus has been reached whether it is better to include treatment for the PF joint at the time of high tibial osteotomy (HTO), or if treatment of the PF joint is unnecessary. The purpose of this comparative retrospective study on medial compartment OA of the knee accompanying PF-OA was to examine the effects of PF-OA on the long-term outcome of HTO and to evaluate the significance of ventralization of the tibial tubercle when combined with HTO.
Methods. We studied the impact of PF-OA on the long-term outcome of HTO and the effects of ventralization of the tibial tubercle, which was performed in conjunction with HTO for medial and PF compartment OA more than 10 years previously. The 42 subjects included 14 men (15 knees) and 26 women (27 knees). Their mean age at the time of surgery was 60.7 years, and the follow-up period was 10-15 years (average 12 years). Ventralization of the tibial tubercle was performed on 18 knees.
Results. A significant relation was observed between improvement of the clinical knee score and preoperative radiological PF-OA stage in the HTO patients (P &lt; 0.05). Radiologically, no correlation was observed between the shift in radiological PF-OA stage and the presence or absence of ventralization of the tibial tubercle. Among the preoperative radiological moderate and severe PF-OA cases, no significant relation was found between the presence or absence of ventralization of the tibial tubercle performed with HTO and improvement of the knee joint function score.
Conclusion. In cases of severe PF-OA in which HTO was performed, ventralization of the tibial tubercle as combined surgery did not prove effective at the long-term follow-up.

DOI： 10.1007/s00776-008-1225-7

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

In a prospective study, 194 knees undergoing total knee arthroplasty (110 knees with alumina ceramic prostheses; 84 knees with Co-Cr alloy prostheses) were clinically and radiologically evaluated. Average follow-up period was 66 months (36-124 months). Average age at the time of surgery was 66 years. In the ceramic prostheses, two revision surgeries were performed because of breakage of the tibial tray and late infection, whereas two revisions of the Co-Cr alloy prostheses were carried out due to loosening and late infection. In the other patients, there were no significant differences in clinical parameters (HSS knee score and range of motion) between the two prostheses. In radiological evaluation, we could not find any radiolucent lines around the femoral ceramic component while radiolucency was present in three knees (3.6%) around the Co-Cr femoral component. Beneath the tibial tray, three knees (2.7%) showed a radiolucent line around the former prosthesis while eight knees (9.5%) demonstrated a radiolucent line around the latter prosthesis. Chi-square tests showed a significant difference in the occurrence of radiolucent line around both of the femoral and tibial prosthesis. This study demonstrated that clinical results of the alumina ceramic PCL retaining total knee prosthesis are comparable to the standard Co-Cr alloy PCL retaining total knee prosthesis. Although we could not draw any conclusions regarding the superiority of the ceramic prosthesis with respect to UHMWPE wear and long-term survivorship, this report encouraged a long-term follow-up study on ceramic prostheses.

DOI： 10.1007/s00167-007-0435-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ORTHOPAEDIC FOOT & ANKLE SOC, INC  

DOI： 10.3113/FAI.2007.1190

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PROFESSIONAL ENGINEERING PUBLISHING LTD  

To establish medical use of tissue engineering technology for ligament and tendon injuries, a scaffold was developed which has sufficient ability for cell growth, cell differentiation, and mechanical properties. The scaffold made from chitosan and 0.1 per cent hyaluronic acid has adequate biodegradability and biocompatibility. An animal experiment showed that the scaffold has less toxicity and less inflammation induction. Furthermore, in-vivo animal experiments showed that the mechanical properties of the engineered ligament or tendon had the possibility to stabilize the joint. It was shown that newly developed hybrid-polymer fibre scaffold has feasibility for joint tissue engineering.

DOI： 10.1243/09544119JEIM203

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Sialic acid. which is located at the end of the carbohydrate moiety of cell surface glycoconjugates, is involved in many biologic responses, such as intercellular reactions and virus-cell fusion, especially in hematopoietic cells. Here we provide experimental evidence that the sialic acid of cell surface glycoconjugates has a role in osteoclast differentiation. Lectin histochemical study demonstrated the existence of both alpha (2,3)-linked-sialic acid and alpha (2,6)-linked-sialic acid in mouse bone marrow-derived macrophages and in the RAW264.7 macrophage cell line, which are osteoclast precursors. Flow cytometric analysis of surface lectin staining revealed the kinetics of these sialic acids during osteoclastogenesis: alpha (2,3)-linked-sialic acid was abundantly expressed throughout osteoclastogenesis, whereas alpha (2,6)-linked-sialic acid levels declined at the terminal stage of osteoclast differentiation. To investigate the role of sialic acid in osteoclast differentiation, we performed an osteoclastogenesis assay with or without exogenous sialidase treatment. Desialylated cells formed TRAP-positive mononuclear cells, but did not become multinuclear cells despite the normal expression of osteoclast markers such as cathepsin K, integrin 3, and nuclear factor-ATc1. Flow cytometric analysis also demonstrated that exogenous sialidase effectively removed alpha (2,6)-linked-sialic acid, but only slightly changed the alpha (2,3)-linked-sialic acid content, suggesting that alpha (2,6)-linked-sialic acid might be involved in osteoclast differentiation. Findings from knockdown analysis using small interfering RNA oligonucleotides against alpha 2,6-sialyttransferase support this idea: alpha (2,6)-linked-sialic acid-deficient cells markedly inhibit the formation of multinuclear osteoclasts. Our findings suggest that alpha (2,6)- linked-sialic acid of cell surface glycoconjugates has a role in osteoclast differentiation, possibly via its role in the cell-cell fusion process. (c) 2007 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bone.2007.03.016

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-LISS  

In this study, we successfully developed three-dimensional scaffolds fabricated from the chitosan-based hyaluronic acid hybrid polymer fibers, which can control the porous structure. To determine the adequate pore size for enhancing the chondrogenesis of cultured cells, we compared the behaviors of rabbit chondrocytes in scaffolds comprising different pore sizes (100, 200, and 400 mu m pore size). Regarding the cell proliferation, there was no significant difference among the three groups. On the other hand, glycosaminoglycan contents in the 400 pm group significantly increased during the culture period, compared with those in the other groups. The ratio of type II to type I collagen mRNA level was also significantly higher in the 400 mu m group than in the other groups. These results indicate that our scaffold with 400 mu m pore size significantly enhances the extracellular matrix synthesis by chondrocytes. Additionally, the current scaffolds showed high mechanical properties, compared with liquid and gel materials. The data derived from this study suggest great promise for the future of a novel fabricated material with relatively large pore size as a scaffold for cartilage regeneration. The biological and mechanical advantages presented here will make it possible to apply our scaffold to relatively wide cartilaginous lesions. (C) 2006 Wiley Periodicals, Inc. J Biomed Mater Res 81A: 586-593, 2007.

DOI： 10.1002/jbm.a.31095

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MARY ANN LIEBERT INC  

Feeder effects of bone marrow stromal cells (BMSCs) on tendon fibroblasts were investigated using a coculture method for the application of ligament or tendon tissue engineering and cell therapy. BMSCs had significant effects on enhancing cell proliferation, the ability of cells to migrate, and cell adhesivity but little effect on the extracellular matrix (ECM) synthesis of tendon fibroblasts without cell-cell contact. Furthermore, the conditioned medium from BMSCs, despite the existence of fibroblasts, significantly increased the number of fibroblasts. Based on these results, the mechanism of the feeder effects is considered to be a certain signal of soluble factors from BMSCs to the fibroblasts. Comparative proteome analysis of the conditioned medium from co-culture of fibroblasts and BMSCs revealed less expression of plasminogen, which showed inhibitory effects on fibroblast proliferation. With regard to the relationships between plasminogen and BMSCs in the co-culture system, we speculate that BMSCs allow resolution of plasminogen or its cleavage activity in the medium via some mechanism.

DOI： 10.1089/ten.2006.0079

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE BV  

It has been shown that musculoskeletal tissues undergo dynamic tissue remodeling by a process that is quite sensitive to the mechanical environment. However, the detailed molecular mechanism underlying this process remains unclear. We demonstrate here that after denervation-induced mechanical stress deprivation, tendons undergo dynamic tissue remodeling as evidenced by a significant reduction of the collagen fibril diameter. Importantly, the transient up-regulation of osteopontin (OPN) expression was characteristic during the early phase of tendon tissue remodeling. Following this dynamic change of OPN expression, matrix metalloproteinase (MMP)-13 expression was induced, which presumably accounts for the morphological changes of tendon by degrading tendon collagen fibrils. The modulation of MMP-13 expression by OPN was specific, since the expression of MMP-2, which is also known to be involved in tissue remodeling, did not alter in the tendons under the absence or presence of OPN. We also demonstrate that the modulation of MMP-13 expression by OPN is due to the signaling through cell surface receptors for OPN. Thus, we conclude that OPN plays a crucial role in conveying the effect of denervation-induced mechanical stress deprivation to the tendon fibroblasts to degrade the extracellular matrices by regulating MMP-13 expression in tendon fibroblasts. (c) 2006 Elsevier B.V./International Society of Matrix Biology. All rights reserved.

DOI： 10.1016/j.matbio.2006.09.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3113/FAI.2007.0022

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER CHEMICAL SOC  

We synthesized an aminooxyl polymer that is reactive with the reduced end of carbohydrates using our sugar-displaying approach. The carbohydrates were easily immobilized on the polymer film (glycoblotting film) by simple immersion in a in sugar solution through stable oxime bond. The in vitro behaviors of human fibroblasts on the carbohydrate-coated surface were investigated. The adhesion of human fibroblasts on the cellobiose- and cellotriose-coated surfaces was much greater than on the other coated surfaces and the noncoated surface. This result indicated that simple structural differences in carbohydrates induced biological changes in human cells, especially cell adhesion. Our approach provides a high-throughput assay system for carbohydrate-related cell adhesion and proliferation.

DOI： 10.1021/bm060027w

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BRITISH EDITORIAL SOC BONE JOINT SURGERY  

We compared the results ten years after an inverted V-shaped high tibial osteotomy with those of a historical series of conventional closing-wedge osteotomies. The closing-wedge series consisted of 56 knees in 51 patients with a mean follow-up of 11 years (10 to 15). The inverted V-shaped osteotomy was evaluated in 48 knees in 43 patients at a mean follow-up of 14 years (10 to 19). All the patients were scored using the Japanese Orthopaedic Association rating scale for osteoarthritis of the knee and radiological assessment.
The pre-operative grade of osteoarthritis was similar in both groups. Post-operatively, the knee function score was graded as satisfactory in 63% (35) of the closing-wedge group but in 89% (43) of the inverted V-shaped osteotomy group. Post-operative radiological examination showed that delayed union and loss of correction occurred more often after a closing-wedge osteotomy than after an inverted V-shaped procedure.
Our study suggests that the inverted V-shaped osteotomy may offer more dependable long-term results than traditional closing-wedge osteotomy.

DOI： 10.1302/0301-620X.88B10.17532

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

We present the results of total hip arthroplasty using S-ROM (Depuy, Warsaw, Ind) prosthesis combined with corrective femoral transverse osteotomy for hips with proximal femoral deformity. Fourteen hips were followed up for a mean of 61 months (range, 36-95 months), with a mean age at surgery of 55 years (range, 44-69 years). The average intraoperative blood loss was 638 mL, and the average operative time was 136 minutes. The average Harris Hip Score increased from 38.0 (range, 15.0-55.7) preoperatively to 82.0 (range, 34.6-92.7) at the latest follow-up. All the hips except for 1 acquired union of osteotomy and bone ingrowth. S-ROM modular stem, which gives sufficient rotational stability at both proximal and distal parts of the osteotomy, is useful for total hip arthroplasty combined with corrective femoral transverse osteotomy.

DOI： 10.1016/j.arth.2005.08.016

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

Background. Previous clinical studies have reported that conservatively managed medial collateral ligament (MCL) injuries remained unstable 9 years post injury with subjective complaints of muscle weakness, reinjuries, and post-traumatic osteoarthritis. Animal studies have also reported that healing MCLs were weaker and more lax than controls. Therefore, our purpose was to study the early effects of ligament repair on scar laxity, creep, and creep recovery in a rabbit model of bilateral medial collateral ligament (MCL) injury.
Methods. Each rabbit had one MCL cut in midsubstance which was not repaired, while the other MCL had a sagittal Z-plasty repair. Six weeks after surgery, isolated bone-MCL-bone complexes were biomechanically tested for MCL laxity, cyclic creep, creep recovery, and then loaded to ultimate failure.
Results. Nonrepaired scars were significantly more lax than both repaired Z-plasty scars and normal controls. In contrast, there was no significant difference in MCL laxity between repaired scars and normal controls. There were no significant differences between nonrepaired or repaired scars for either cyclic creep and creep recovery. Both crept significantly more and recovered significantly less than normal controls after the same load history. There were no significant differences in the failure load, stiffness, and tensile strength between gap scars and Z-plasty scars. All healing ligaments had significantly lower failure load, stiffness, and tensile strength than normal controls.
Conclusions. The present study demonstrates that ligament repair is effective in decreasing short-term laxity of ligament scars. These 6-week scars would be prone to abnormal creep if loaded excessively.

DOI： 10.1007/s00776-006-1015-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TAYLOR & FRANCIS LTD  

Cell-surface proteoglycans are involved in many functions, including interactions with components of the extracellular microenvironment. They also act as coreceptors that bind and modify the actions of various growth factors, cytokines, and the extracellular matrix (ECM). This study investigated the regulation by the ECM of the expression of cell-surface proteoglycans (CD44, syndecan-1-4, betaglycan, glypican-1). We examined the changes in the expression levels of cell-surface proteoglycan genes in intact tendon, monolayer culture, and under various culture conditions. There was a significant increase in the expression of CD44 and syndecan-4 mRNAs during cell isolation from the tendon. With the switch to a 3D culture environment, there was a significant increase in the expression of CD44 at each passage point relative to its expression in 2D at those passage points. Syndecan-4 mRNA also increased steadily at each passage point in 3D culture environment. This influence on cell surface proteoglycans gene expression may indicate that collagen gel culture mimics in vivo tendon environment. This study provides further insight into the regulation of cell-surface proteoglycans in ligament and tendon fibroblasts by the ECM and 3D culture conditions.

DOI： 10.1080/03008200600685459

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY, INC  

Twenty-one rabbits were used to investigate the feasibility of using nonwoven chitin fabric as an acellular matrix for rotator cuff regeneration. Infraspinatus tendons were cut bilaterally to create 10 x 10-mm defects. The defect in the right shoulder was covered with chitin fabric. The contralateral defect was left free as a control. The specimens were evaluated histologically and immunohistochemically at 2, 4, 8, and 12 weeks and biomechanically at 12 weeks after surgery. The acellular matrix increased cell numbers and improved collagen fiber alignment. The regenerated tissues were composed of type III collagen. The structural properties of the grafted shoulder were significantly greater than those of the control. This study revealed that using chitin fabric as an acellular matrix has advantages in enhancing both biologic and mechanical regeneration of rotator cuff tendons.

DOI： 10.1016/j.jse.2005.05.012

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Background. No investigators have studied the effects of an application of growth factors on the in vivo tissue regeneration in the tendon after resecting the central portion. The purpose of this study is to clarify whether an application of transforming growth factor (TGF)-betal increases the mechanical properties of the regenerated tissue in the patellar tendon after resecting the central portion.
Methods. Thirty female rabbits were divided into three groups, after a 3 mm wide and 10 mm long tendon substance was resected from the central portion in the patellar tendon. In Group I, 5-ng TGF-betal dissolved in 0.1-ml saline was injected into the resected portion in the patellar tendon. In Group II, only 0.1-ml saline was injected into the resected portion. In Group III, nothing was injected. All animals were sacrificed at 6 weeks after surgery. Mechanical and histological evaluations were made concerning the regenerated tissue and the unresected tendon tissue in the patellar tendon.
Findings. Concerning the regenerated tissue, the tangent modulus and the tensile strength of Group I were significantly greater than those of Groups II and III, while there were no significant differences in these parameters between Groups II and III.
Interpretation. The application of TGF-betal significantly increases the tangent modulus and the tensile strength of the fibrous tissue regenerated in the patellar tendon after resecting the central portion. This study has provided basic important information on the utility of TGF-betal in the in vivo tendon regeneration. (c) 2005 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.clinbiomech.2005.05.012

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To clarify the feasibility of using novel chitosan-based hyaluronan hybrid polymer fibers as a scaffold in ligament tissue engineering, their mechanical properties and ability to promote cellular adhesion, proliferation, and extracellular matrix production were studied in vitro. Chitosan fibers and chitosan-based 0.05% and 0.1% hyaluronan hybrid fibers were developed by the wet spinning method. Hyaluronan coating significantly increased mechanical properties, compared to the chitosan fibers. Rabbit fibroblasts adhesion onto hybrid fibers was significantly greater than for the control and chitosan fibers. For analysis of cell proliferation and extracellular matrix production, a three-dimensional scaffold was created by simply piling up each fiber. At 1 day after cultivation, the DNA content in the hybrid scaffolds was higher than that in the chitosan scaffold. Scanning electron microscopy showed that the fibroblasts had produced collagen fibers after 14 days of culture. Immunostaining for type I collagen was clearly predominant in the hybrid scaffolds, and the mRNA level of type I collagen in the hybrid scaffolds were significantly greater than that in the chitosan scaffold. The present study revealed that hyaluronan hybridization with chitosan fibers enhanced fiber mechanical properties and in vitro biological effects on the cultured fibroblasts. © 2005 Wiley Periodicals, Inc.

DOI： 10.1002/jbm.a.30237

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

In the present study, we have developed a novel and versatile method for the preparation of chitosan-peptide complex based on the selective reaction of chitosan with 2-iminothiolane. The new type of SH-chitosan derivative showed an excellent solubility to aqueous solution even in the alkaline conditions. This characteristic greatly facilitated further modification study of chifosan with a variety of bioactive substances. A synthetic peptide, RGDSGGC containing RGDS moiety that is known as one of the most important cell adhesive peptides, was readily coupled by disulfide bonds formation with sulfhydryl groups of SH-chitosan in the presence of dimethyl sulfoxide. Next, the effect of the introduction of RGDSGGC moiety to chitosan on cell adhesion and proliferation activity of chondrocytes and fibroblasts were evaluated. As a result, it was suggested that this polysaccharide-peptide conjugate exhibited excellent capacities for both cell adhesion and cell proliferation of chondrocytes and fibroblasts. Considering the growing importance of the biocompatible scaffolds in the recent tailored tissue engineering technique, these results indicate that the present strategy of 2-iminothiolane-based conjugation of polysaccharides with biologically active peptides will become a key and potential technology to develop desirable scaffold materials for the tissue regenerations. (c) 2005 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.biomaterials.2005.01.062

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DOI： 10.1002/jbm.a.30237

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SAGE PUBLICATIONS INC  

Background: The current surgical procedures for irreparable rotator cuff tears have considerable limitations. Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing these conditions.
Hypothesis: A chitosan-based hyaluronan hybrid scaffold could enhance type I collagen products with seeded fibroblasts and thereby increase the mechanical strength of regenerated tendon in vivo.
Study Design: Controlled laboratory study.
Methods: The scaffolds were created from chitosan-based hyaluronan hybrid polymer fibers. Forty-eight rabbit infraspinatus tendons and their humeral insertions were removed to create defects. Each defect was covered with a fibroblast-seeded scaffold (n = 16) or a non-fibroblast-seeded scaffold (n = 16). In the other 16 shoulders, the rotator cuff defect was left free as the control. At 4 and 12 weeks after surgery, the engineered tendons were assessed by histological, immunohistochemical (n = 2), and biomechanical (n = 6) analyses.
Results: Type I collagen was only seen in the fibroblast-seeded scaffold and increased in the regenerated tissue. The tensile strength and tangent modulus in the fibroblast-seeded scaffold were significantly improved from 4 to 12 weeks postoperatively. The fibroblast-seeded scaffold had a significantly greater tangent modulus than did the non-fibroblast-seeded scaffold and the control at 12 weeks.
Conclusion: This scaffold material enhanced the production of type I collagen and led to improved mechanical strength in the regenerated tissues of the rotator cuff in vivo.
Clinical Relevance: Rotator cuff regeneration is feasible using this tissue engineering technique.

DOI： 10.1177/036354650427689

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

Background The purpose of this study was to examine the influence of removing menisci from their in vivo loading environment on gene expression patterns and to determine whether in vitro loading can maintain the tissues in their in vivo phenotype.
Methods. Lateral and medial rabbit meniscal explants from one leg were cultured in vitro and subjected to intermittent cyclic hydrostatic pressure (CHP) of 1 MPa at 0.5 Hz for 1 min and a rest period of 14 min (4 h of culture). The contralateral menisci were incubated at atmospheric pressure for 4 h. Menisci from both legs of another set of rabbits were frozen immediately to yield time zero values reflective of in vivo mRNA levels. Total RNA was isolated from all groups and processed for reverse transcription-polymerase chain reaction analysis for a subset of relevant genes (matrix molecules, cytokines, proteinases and inhibitors, enzymes).
Results. It was found that mRNA levels for MMP-1, MMP-3. TIMPs, iNOS, COX-2, interleukin-1 beta in both menisci, and interleukin-6 in medial menisci were significantly elevated in tissues cultured under nonloading conditions compared to the time zero controls. Subjecting menisci to CHP significantly prevented these increases in mRNA levels for nearly all of the indicated molecules. In contrast, there were no significant differences in mRNA levels for collagens, biglycan, MMP-13, or TIMP-4 between the time zero values and those cultured under either nonloading or loading conditions.
Conclusions. These studies demonstrate that removing rabbit menisci from their normal in vivo mechanical environment leads to an apparent up-regulation of a subset of potent effector molecules that could mediate catabolic activities, and that in vitro CHP can largely prevent this apparent up-regulation.

DOI： 10.1007/s00776-005-0912-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

There have been few reports about hypoplasia of the femur and tibia in congenital clubfeet. The subjects of this study were 38 patients with unilateral congenital clubfoot. All the measurements were significantly less in the affected side than in the normal side. Although the decrease in length itself was higher in the distal segment, the tibial length contributed mostly to limb length shortening. There was no significant difference between male and female patients. Only the tibial length and the calf girth were significantly less in patients who had undergone surgery than in those without. The discrepancies might not improve with growth, as there was no significant difference between bony mature patients and those who were immature. We conclude that hypoplasia of the femur and the tibia, not only the tarsal bones, does exist to some extent, or it can be said that there must be a generalized decrease in limb size in congenital clubfeet. J Pediatr Orthop B 14:280-284 (c) 2005 Lippincott Williams & Wilkins.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

Selecting the material for a scaffold is critically important for the success of tissue engineering. To simplify complicated biosynthetic matrices and achieve a novel class of potential materials, a model of polyion complex fibers was prepared from alginate and chitosan. In the current in vitro study, we thought that alginate-based chitosan hybrid biomaterials could provide excellent supports for fibroblast adhesion. In the current study, alginate polymer fiber (alginate group) and alginate-based chitosan hybrid polymer fibers (alginate with 0.05% chitosan, alginate-chitosan 0.05% group; alginate with 0.1% chitosan, alginate-chitosan 0.1% group) were originally prepared. We investigated the adhesion behavior of rabbit tendon fibroblast onto alginate polymer fibers versus the adhesion of the fibroblast onto alginate-based chitosan hybrid polymer fibers. Furthermore, mechanical properties and synthesis of the extracellular matrix were investigated. Mechanically, the novel fiber has considerable tensile strength of more than 200MPa. We demonstrated that the alginate-based chitosan hybrid polymer fibers showed much improved adhesion capacity with fibroblast compared with alginate polymer fiber. Additionally, morphologic studies revealed the dense fiber of the type I collagen produced by the fibroblast in the hybrid polymer fibers. We concluded that an alginate-based chitosan hybrid polymer fiber has considerable potential as a desirable biomaterial scaffold for tendon and ligament tissue engineering.

DOI： 10.1007/s00776-005-0891-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ACADEMIC PRESS INC ELSEVIER SCIENCE  

Among many colorimetric methods for carbohydrate analysis, the phenol-sulfuric acid method is the easiest and most reliable method. It has been used for measuring neutral sugars in oligosaccharides, proteoglycans, glycoproteins, and glycolipids. This method is used widely because of its sensitivity and simplicity. In its original form, it required 50-450 nmol of monosaccharides or equivalent for analysis and thus is inadequate for precious samples. A scaled-down version requiring only 10-80 nmol of sugars was reported previously. We have now modified and optimized this method to use 96-well microplates for high throughput, to gain greater sensitivity, and to economize the reagents. This modified and optimized method allows longer linear range (1-150 nmol for Man) and excellent sensitivity. Moreover, our method is more convenient, requiring neither shaking nor covering, and takes less than 15 min to complete. The speed and simplicity of this method would make it most suitable for analyses of large numbers of samples such as chromatographic fractions. (c) 2004 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ab.2004.12.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER CHEMICAL SOC  

Chitosan has a variety of biological functions through conjugating of other compounds to their amino and hydroxyl groups. To further expand applicability of chitosan, we have modified the amino group of chitosan with 2-iminothiolane to bestow thiol groups and obtained about 20% yield, which is equivalent to 913 mu equiv SH/g chitosan or 457 nequiv SH/nmol chitosan. Bovine serum albumin (BSA) was reacted with N-(c-maleimidocaproyloxy)sulfosuccinimide ester (sulfo-EMCS), and maleimide-modified BSA (MaINBSA) was obtained. The yield of sulfo-EMCS addition was 12.8-36.8 mol MaIN/mol BSA. When the chitosan-SH was reacted with MalN-BSA via thioether, 97.8% of the maleimide group was reacted, and 37.2% of the SH group was consumed. The remaining SH group was quenched by bromoacetamide. This is the first report of covalent conjugation of a protein to chitosan. Our method should find many applications in developing new chitosan-based biomedical materials containing other components such as growth factors and cell adhesion molecules, known to be crucial to cells. Our thiolated chitosan will facilitate conjugation of such biomedical components to provide new types of materials for tissue engineering.

DOI： 10.1021/bm049352e

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

In this study, we hypothesized that hyaluronic acid could provide superior biological effects on the chondrocytes in a three-dimensional culture system. To test this hypothesis, we investigated the in vitro behavior of rabbit chondrocytes oil a novel chitosan-based hyaluronic acid hybrid polymer fiber. The goal of the current study was to show the Superiority of this novel fiber as a scaffold biomaterial for cartilage tissue engineering. Chitosan polymer fibers (chitosan group) and chitosan-based hyaluronic acid hybrid polymer fibers (HA 0.04% and HA 0.07% groups, chitosan coated with hyaluronic acid 0.04% and 0.07%, respectively) were originally developed by the wetspinning method. Articular chondrocytes were isolated from Japanese white rabbits and cultured in the sheets consisting of each polymer fiber. The effects of each polymer fiber oil cell adhesivity, proliferation, morphological changes. and synthesis of the extracellular matrix were analyzed by quantitative a cell attachment test, DNA quantification, light and scanning electron microscopy, semi-quantitative RT-PCR, and immunohistochemical analysis. Cell adhesivity, proliferation and the synthesis of agrecan were significantly higher in the hybrid fiber (HA 0.04% and 0.07%) groups than in the chitosan group. On the cultured hybrid polymer materials, scanning electron microscopic observation showed that chondrocytes proliferated while maintaining their morphological phenotype and with a rich extracellular matrix synthesis around the cells. Immunohistochemical staining with an anti-type II collagen antibody demonstrated rich production of the type II collagen in the pericellular matrix from the chondrocytes. The chitosan-based hyaluronic acid hybrid polymer fibers show great potential as a desirable biomaterial for cartilaginous tissue scaffolds. (C) 2004 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.biomaterials.2004.03.013

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：Springer Japan  

Background. Secondary collapse of the femoral head after transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head is a major complication leading to failure. We investigated the relation between the extent and shape of a newly established healthy weight-bearing area and the incidence of secondary collapse. Methods. Altogether, 38 hips in 32 patients with a mean age of 33 years at the time of surgery were followed for a mean of 4 years. Results. The outcome was satisfactory in 22 hips (58%) and unsatisfactory in 16 hips (42%), with 9 requiring total hip arthroplasty. The extent of the newly established healthy weight-bearing area as depicted on the immediate postoperative radiograph was significantly greater in the satisfactory group than in the unsatisfactory group. The rate of secondary collapse was significantly higher when the newly established weight-bearing area was thin, like a beak ("beak-shaped" healthy area). The incidence of a beak-shaped healthy area was significantly higher in the steroid group than in nonsteroid group. Conclusions. We concluded that we should be cautious when the newly established healthy weight-bearing area exhibits this beak shape, even if its extent in the weight-bearing area is large, because of the higher risk of postoperative secondary collapse. In such cases, alteration of the after-treatment program (e.g., prolonging the non-weight-bearing period) should be considered. © The Japanese Orthopaedic Association.

DOI： 10.1007/s00776-005-0906-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER CHEMICAL SOC  

The ideal cell-carrier material for cartilage regeneration should be one that closely mimics the natural environment in a living articular cartilage matrix. In the current study, we considered that alginate-based chitosan hybrid biomaterials could provide excellent supports for chondrocyte adhesion. To test this hypothesis, we investigated the adhesion behavior of rabbit chondrocytes onto an alginate polymer versus the adhesion of the chondrocytes onto some alginate-based chitosan hybrid polymer fibers in vitro. We demonstrated that the alginate-based chitosan hybrid polymer fibers showed much improved adhesion capacity with chondrocytes in comparison with alginate polymer fiber. Additionally, morphologic studies revealed maintenance of the characteristic round morphology of the chondrocyte and the dense fiber of the type II collagen produced by the chondrocytes in the hybrid polymer. On the basis of these results, we conclude that an alginate-based chitosan hybrid polymer fiber has considerable potential as a desirable biomaterial for cartilage tissue scaffolds.

DOI： 10.1021/bm0400067

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective. Interleukin-8 (IL-8) plays an important role in the migration of inflammatory cells into the synovium and joint fluids in rheumatoid arthritis (RA). This study was undertaken to investigate the IL-8 inductive activity of the macrophage migration inhibitory factor (MIF) in RA synovial fibroblasts. The regulatory mechanism of IL-8 was compared with that of IL-1β. Methods. MIF-induced IL-8 and IL-1β transcriptional activation was studied in RA synovial fibroblasts by Northern blot analysis, enzyme-linked immunosorbent assay, and electromobility shift assay. The effect of anti-MIF antibody administration on murine passive collagen-induced arthritis (CIA) was also evaluated by histologic examination and reverse transcriptase-polymerase chain reaction. Results. MIF up-regulated the IL-8 messenger RNA (mRNA) and protein levels in a dose-dependent manner. The IL-8 mRNA up-regulation started 1 hour poststimulation by MIF, and reached a maximum level at 6 hours. IL-1β mRNA was also up-regulated by MIF. The mRNA up-regulation of IL-8 and IL-1β by MIF was inhibited by 2 tyrosine kinase inhibitors, a protein kinase C (PKC) inhibitor, an activator protein 1 (AP-1) inhibitor, and by an NF-κB inhibitor. A cAMP-dependent kinase inhibitor did not inhibit it. MIF enhanced AP-1 and NF-κB binding activities in a dose-dependent manner. Passive CIA enhanced mRNA levels of macrophage inflammatory protein 2 and cytokine-induced neutrophil chemoattractants and, moreover, migration and proliferation of inflammatory cells within the synovium, which were suppressed by administration of an anti-MIF antibody. Conclusion. MIF may play an important role in the migration of inflammatory cells into the synovium of rheumatoid joints via induction of IL-8. MIF up-regulates IL-8 and IL-1β mRNA via tyrosine kinase-, PKC-, AP-1-, and NF-κB-dependent pathways.

DOI： 10.1002/art.20190

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1007/s00776-003-0707-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

One of the future goals in ligament reconstruction is to prevent graft deterioration after transplantation. The aim of this study is to clarify whether an administration of TGF-beta1 and EGF significantly affect biomechanical properties of the in situ frozen-thawed anterior cruciate ligament (ACL), an ACL autograft model, and to elucidate whether the timing of this administration may influence its effect. Rabbits were randomly divided into 4 groups after the freeze-thaw treatment with liquid nitrogen was applied to the right knee. In 2 groups, 4-ng TGF-betal and 100-ng EGF mixed with 0.2-ml fibrin sealant were applied around the ACL at 3 and 6 weeks after the treatment, respectively. In the remaining two groups, only 0.2-ml fibrin sealant was applied around the ACL at 3 and 6 weeks, respectively. In each group, all animals were sacrificed at 12 weeks after the freeze-thaw treatment. These growth factors applied at 3 weeks significantly inhibited not only the increase of water content and the cross-sectional area of the ACL but also reduction of the tensile strength and the tangent modulus of the ACL (p&lt;0.0001), which were induced by the freeze-thaw treatment. However, the application at 6 weeks did not significantly affect the changes of these parameters after the treatment. This study demonstrated that the timing of administration of TGF-beta and EGF after the freeze-thaw treatment significantly influences its effect on the biomechanical properties of the frozen-thawed ACL. (C) 2003 Elsevier Science Ltd. All rights reserved.

DOI： 10.1016/S0021-9290(02)00426-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Objective. To clarify the effect of complete stress deprivation on the mechanical properties of the in situ frozen-thawed semitendinosus tendon, an idealized autograft model.
Design. Ninety-six rabbits were divided into three groups. In the frozen group (n = 36), we applied the freeze-thaw treatment to the semitendinosus tendon to necrotize fibroblasts in the tendon. In the frozen and stress-shielded group (n = 30), after we applied the same freeze-thaw treatment to the tendon, we completely released the tendon from stress. In the sham group (n = 30), a sham operation was applied. In each group, 6 rabbits were sacrificed at 0 (only in the frozen group), 1, 2, 3, 6 and 12 weeks after surgery.
Background. Previous studies have not clarified remodeling of the semitendinosus autograft in ligament reconstruction or its idealized model.
Method. The tendon was frozen with liquid nitrogen. The tendon was released from stress with the originally developed technique using a polyester tape. In each period, 5 out of the 6 rabbits were evaluated with tensile testing, and the remaining rabbit was histologically observed.
Result. Complete stress shielding significantly increased the cross-sectional area of the frozen-thawed tendon at I and 2 weeks, while it significantly inhibited the increase of the area due to the freeze-thaw treatment at 3 and 6 weeks. Complete stress shielding significantly reduced material properties of the frozen-thawed tendon after 2 weeks.
Conclusion. The frozen-thawed semitendinosus tendon has unique remodeling characteristics under a stress-shielded condition, which were not the same as those of the frozen-thawed patellar tendon.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

The mechanical properties of tendon autografts used in reconstruction of the anterior cruciate ligament (ACL) are reduced after surgery. Previous studies showed that growth factors such as transforming growth factor-beta1 (TGF-beta1) and epidermal growth factor (EGF) can stimulate fibroblast proliferation and increase collagen and noncollagenous protein synthesis by these cells. These factors might be useful, therefore, in preventing graft deterioration after transplantation or accelerating mechanical restoration of the deteriorated graft. The purpose of our study, therefore, was to clarify the effects of TGF-beta1 and EGF on biontechanical properties using an in situ freeze-thaw ACL model in the rabbit. A total of 142 rabbits underwent the freeze-thaw treatment in the right ACL and. were then divided into four groups. Group I served as a freeze-thaw, but otherwise untreated control, In Group II, a delivery vehicle (fibrin sealant) alone was applied. In Group III, 4-ng TGF-beta1 and 100-ng EGF mixed with the vehicle were applied. In pared at Group IV, higher doses (2-mug TGF-beta1 and 50-mug EGF) of growth factors were mixed with the vehicle. The groups were compared 12 weeks on the basis of mechanical properties, water content, and histological and ultrastructural observations, The cross-sectional sectional area of Group Ill (average, 7.1 mm(2)) was significantly less than that of Groups I, II, and IV (9.0, 8,2., and 9.4 mm(2) respectively) at 12 weeks. The tensile strength of Group III (62.2 MPa) was significantly greater than that of Groups I, II, and IV (35.6, 43.7, and 36.9 MPa, respectively) at 12 weeks, while the water content of Group III. (70.7%) was significantly lower than that of Group I (75.2%). No other significant differences occurred among Groups I, II, and IV. A unimodal distribution of collagen fibril diameters was noted in Groups I and , while a bimodal pattern was found in Group Ill. This study demonstrated that low dose application of TGF-beta1 and EGF significantly inhibited not only the increased water content and cross-sectional area, but also the decreased tensile strength. caused by the freeze-thaw treatment, while a high dose of TGF-beta1 and EGF does not have the same beneficial effects. (C) 2002. Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：Lippincott Williams and Wilkins  

A prospective comparative study was conducted involving 62 patients to determine the effects and limits of accelerated rehabilitation on clinical outcome. The study focused on whether aggressive rehabilitation after anterior cruciate ligament reconstruction with the doubled semitendinosus and gracilis tendon autograft results in stretching the graft. Thirty patients had postoperative rehabilitation according to the current conservative protocol, and 32 patients had rehabilitation using an accelerated regime. Each patient was evaluated subjectively and objectively 36 months or more after surgery. Concerning the side-to-side difference in the anterior laxity, 87% of the patients in the conservative rehabilitation group had 3 mm or less and 80% of the patients in the accelerated rehabilitation group had the same acceptable laxity. There was no significant difference between the two groups. Muscle torque was restored significantly earlier in the patients in the accelerated rehabilitation group than in the patients in the conservative rehabilitation group. Nine months after surgery, however, there were no significant differences in the torque between the two groups. Accelerated rehabilitation significantly increased the incidence of knee effusion during rehabilitation. This study showed that acceleration of postoperative rehabilitation could rapidly restore muscle strength without significantly compromising graft stability in anterior cruciate ligament reconstruction with the doubled hamstring tendon autograft. However, this study also showed that acceleration significantly increases the incidence of synovitis. Acceleration of postoperative rehabilitation has advantages and disadvantages for clinical outcome after anterior cruciate ligament reconstruction.

DOI： 10.1097/00003086-200204000-00043

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Forty-eight knees in 44 patients who had a high tibial osteotomy performed for medial compartment osteoarthritis were reevaluated twice, once at 1 year after surgery and again at 10 to 15 years after the high tibial osteotomy, to determine the effects of high tibial osteotomy on progression of medial and lateral joint arthrosis, Radiologically, although arthrosis significantly increased in the medial and the lateral joint compartment, there was no significant difference in the degree of progression between the two compartments, There was a significant correlation between the progression of medial joint arthrosis evaluated at 10 years or more after surgery and the femorotibial angle measured at 1 year. There was no significant correlation between the progression of lateral joint arthrosis in 10 to 15 years and the femorotibial angle measured at 1 year, The average knee function score improved significantly from 59.1 +/- 5.5 points before surgery to 85.1 +/- 6.1 points at the 1-year followup, At the final followup, the clinical score (80.7 +/- 5.4) had deteriorated relative to the 1-year results but still was significantly better than the preoperative score, The current results indicate that the greater the surgical valgus correction, the slower the progression of medial joint arthrosis, Lateral joint arthrosis did not progress more quickly after high tibial osteotomy, even if an overcorrection was performed.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JOURNAL BONE JOINT SURGERY INC  

To test the hypothesis that loading conditions can be used to engineer early ligament star behaviors, we used an in vitro system to examine the effect that cyclic hydrostatic compression and cyclic tension applied to 6-week rabbit medial collateral ligament scars had on mRNA levels for matrix molecules, collagenase, and the proto-oncogenes c-fos and c-jun. Our specific hypothesis was that tensile stress would promote more normal mRNA expression in ligament whereas compression mould lead to higher levels of mRNA for cartilage-like molecules. Femur (injured medial collateral ligament)-tibia complexes were subjected to a hydrostatic pressure of 1 MPa or a tensile stress of 1 MPa of 0.5 Hz for 1 minute followed by 14 minutes of rest. On the basis of a preliminary optimization experiment, this 15-minute testing cycle was repeated for 4 hours Semiquantitative reverse transcription-polymerase chain reaction analysis was performed for mechanically treated medial collateral ligament scars with use of rabbit specific primer sets for types I, II, and III collagen, decorin, biglycan, fibromodulin, versican, aggrecan, collagenase, c-fos, c-jun, and a housekeeping gene, glyceraldehyde-3-phosphate dehydrogenase. Cyclic hydrostatic compression resulted in a statistically significant increase in mRNA levels of type-II collagen (171% of nonloaded values) and aggrecan (313% of nonloaded values) but statistically significant decreases in collagenase mRNA levels (35% of nonloaded values). Cyclic tension also resulted in a statistically significant decrease in collagenase mRNA levels (66% of nonloaded values) and an increase in aggrecan mRNA levels (458% of nonloaded values) but no significant change in the mRNA levels for the other molecules. The results show that it is possible to alter mRNA levels for a subset of genes in scar tissue by supplying unique mechanical stimuli in vitro and thus that further investigation of scar engineering for potential reimplantation appears feasible.

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DOI： 10.1097/00001433-200010000-00015

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担当区分：筆頭著者,　責任著者   記述言語：英語  

DOI： 10.1007/s007760070030

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JOURNAL BONE JOINT SURGERY INC  

A rabbit model was used to discover whether the effects of stress shielding on the mechanical properties of the patellar tendon depend on the degree of stress reduction. Ninety mature female Japanese White rabbits were divided into three groups: completely stress-shielded, partially stress-shielded, and sham-operation and contralateral controls. In the experimental groups, tension applied to the patellar tendon was 0%, approximately 30%. and 100% of the normal tension, respectively, with a polyester artificial ligament. Tensile tests were carried out on patella-patellar tendon-tibia complexes harvested 1, 2, 3, 6, or 12 weeks after surgery. The tensile strength decreased in comparison with the sham-operation group to 50.2, 13.5, 9.7, and 20.7% in the completely stress-shielded group and to 75.2, 57.6, 59.6, 57.3, and 72.9% in the partially stress-shielded group. The tensile strength in the completely stress-shielded group was significantly less than that in the partially stress-shielded group at 1, 2, 3, and 6 weeks. The cross-sectional area of the patellar tendon significantly increased to 132, 206, 237, and 136% in the completely stress-shielded group and to 136, 170, 175, 155, and 127% in the partially stress-shielded group, compared with the sham-operation group. The cross-sectional area of the completely stress-shielded tendon was significantly larger than that of the partially stress-shielded tendon at 1, 2, and 3 weeks. This study demonstrated that effects of stress shielding on the mechanical properties of the patellar tendon were dependent on the degree of stress shielding.

DOI： 10.1002/jor.1100140306

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ORTHOPAEDIC SOC SPORT MED  

Effects of partial and complete stress shielding on mechanical properties and histology of in situ frozen patellar tendons were studied in 120 mature female Japanese White rabbits that were divided into three groups: completely stress-shielded, partially stress-shielded, and sham-operated groups. In the former two groups, tendon tension was reduced to 0% and about 30% of normal force, respectively, with a polyester artificial ligament. Tensile tests were conducted on patella-patellar tendon-tibia complexes harvested 1, 2, 3, 6, or 12 weeks after surgery. Tensile strength significantly decreased compared with the sham group to 17% and 28% at 3 and 6 weeks, respectively, in the completely stress-shielded group, and to 54% and 63% at 3 and 12 weeks, respectively, in the partially stress-shielded group. Patellar tendon cross-sectional area significantly increased to 156% and 157% at 2 and 3 weeks, respectively, in the completely stress-shielded group and to 133% at 2 weeks in the partially stress-shielded group, compared with the sham group. Stress shielding significantly changed tensile strength, tangent modulus, and cross-sectional area of in situ frozen patellar tendon; these changes depended on degree of stress shielding. Histologic observations indicated that remodeling occurred in the patellar tendon while there were no cells in the fascicle.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE LTD  

This reports presents the changing morphological characteristics of collagen and fibroblasts in the soleus and gastrocnemius muscle tendon of female Japanese white rabbits with ageing. The fibroblasts decreased in number per 37 mu m(2) with ageing in each group, and their morphology became longer and more slender through ageing. The mean fibril area and diameter of the collagen fibrils of soleus muscle tendon (SMT) and lateral gastrocnemius muscle tendon (GMT) in 8- to 10-month old rabbits were significantly higher than those of 3-wk-old rabbits during growth (P &lt; 0.01). The mean area and diameter of collagen fibrils of SMT and GMT decreased during senescence: the values for 4- to 5-yr-old rabbits were lower than those for 8- to 10-month-old rabbits, but the difference was not significant. Statistically significant differences in fibril area and diameter between the SMT and GMT were not found during ageing. The number of thick fibrils increased during growth, but decreased in senescence. There were more thin fibrils (30-60 nm) in the 3-wk-old rabbits than in the 8- to 10-month old and 4 to 5-yr-old groups, and the large-diameter collagen (300-360 nm) was more abundant in the 8- to 10-month-old group than in the 3-wk-old and 4- to 5-yr-old groups. Differences in fibril size between slow and fast muscle tendons were not observed during ageing.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT-RAVEN PUBL  

High tibial osteotomy (HTO) was performed on 86 medially osteoarthritic knees in 78 patients. Twelve patients died during the follow-up period. Fifty-six knees of 51 patients were evaluated twice postoperatively: once at six years after surgery and again after ten to 15 years. Results were satisfactory in 88% of the knees at the six-year follow-up evaluation and in 63% at the post-ten-year follow-up evaluation. Ten-year follow-up results significantly deteriorated. The femorotibial angle (FTA) at the time of bone union after HTO was a significant factor that contributed to the ten-year results. In patients maintaining excellent improvement of knee function at the post-ten-year follow-up evaluation, the mean FTA at one year after surgery was 165-degrees; this value was constant through ten years after HTO. An FTA of 164-degrees-168-degrees should be attained to ensure favorable long-term results in HTO.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Fifty-five medial osteoarthritic knees in 50 patients who had undergone high tibial osteotomies (HTO) were followed up twice: once, six years after surgery, and again, 10-15 years postoperatively. The results were satisfactory in 85% of the knees at the six-year follow-up and in 62% of the knees at the 10-year follow-up. The results post 10 or more years had deteriorated significantly compared to those seen six years postoperatively. In patients maintaining excellent improvement of knee function post 10 or more years, the mean femorotibial angle (FTA) one year after surgery had been 165°
this value remained constant for 10 years postoperatively. The authors believe that an FTA of 164°-168° should be set as a goal when performing a high tibial osteotomy to ensure favorable long-term results in HTO.

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PubMed

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記述言語：日本語   出版者・発行元：公益社団法人日本理学療法士協会  

DOI： 10.14900/cjpt.1990.17.1.131

CiNii Books

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記述言語：英語   出版者・発行元：BRITISH EDITORIAL SOC BONE JOINT SURGERY  

Web of Science

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J-GLOBAL

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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J-GLOBAL

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J-GLOBAL

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記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本肩関節学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2017354875

記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：(株)南江堂  

大腿骨顆部特発性骨壊死に対して骨軟骨柱移植術を行った21例22膝の中・長期成績を検討した。対象は男6例6膝、女15例16膝で、手術時平均59歳、経過観察期間は平均10年であった。治療は骨軟骨柱移植術単独(M群)が16膝、高位脛骨骨切り術(HTO)+骨軟骨柱移植術併用(HM群)が6膝であった。全例で関節温存可能であった。手術年齢はM群で有意に高く、JOAスコアはHM群で有意に高く、術前後でROMに有意な変化はなかった。大腿脛骨角はM群で有意に内反変形が進行していた。MRI撮影しRoberts等の評価基準で行った軟骨評価では、両群間に有意差は認めなかった。

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

膝離断性骨軟骨炎(OCD)の手術治療成績について報告した。治療を施行した膝OCD患者22例25膝28部位を対象とした。Tegner Activity scoreは平均6.3±1.4→6.1±1.4と活動性は維持された。Juvenile typeに限ると平均7.0±0.6→6.9±0.5と活動性は高いレベルで維持されていた。Adult typeに限ると平均5.5±1.6→5.2±1.5であった。Lysholm scoreは平均72.4±15.6→97.1±と9.1と有意に改善し、juvenile type、adult typeも術前に比べて術後は有意に改善した。

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：日本足の外科学会  

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記述言語：日本語   出版者・発行元：日本足の外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本臨床スポーツ医学会  

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担当区分：最終著者   記述言語：日本語  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：医学書院  

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語   出版者・発行元：北海道医学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：(一社)日本関節鏡・膝・スポーツ整形外科学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：金原出版  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2010244385

記述言語：日本語  

CiNii Books

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記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：日本臨床バイオメカニクス学会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2010099154

記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本機械学会  

CiNii Books

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記述言語：日本語   出版者・発行元：Japanese Society for Joint Diseases  

Introduction: We compared the clinical results for the treatment background with the use of a biological agent after total knee arthroplasty (TKA) in patients with rheumatoid arthritis.Methods: The study followed 31 knees in 25 patients who had undergone TKA from February 2005. Patients were divided into two groups according to the baseline use of the biological agent. The biological agent group (BA group) consisted of 12 knees in 8 patients, and the non-biological agent group (nBA group) consisted of 19 knees in 17 patients. There were no significant differences in the patients&#039; background except for age. The period of use of the biological agent before surgery ranged from 6 to 30 months (avg. 15.2 months). Results: Significant differences were seen on postoperative knee function score and improvement of the score between the two groups (p&lt;0.01). No complications including deep infection were observed in either of the groups.Conclusion: The use of a biological agent may adversely affect the clinical results after TKA in rheumatoid patients. On the other hand, no deterioration was observed with the use of the biological agent.

DOI： 10.11551/jsjd.28.539

CiNii Books

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記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語  

CiNii Books

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記述言語：日本語  

CiNii Books

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記述言語：日本語  

CiNii Books

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記述言語：日本語  

CiNii Books

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記述言語：日本語  

CiNii Books

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：金原出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2007200008

The purpose of this study is to evaluate results of the combined anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL) injuries with one-stage reconstruction using hybridized autogenous multi-strand hamstring tendon graft. 19 patients with chronic combined ligamentous injuries underwent one - stage arthroscopically assisted ACL and PCL reconstruction. ACL, PCL and medial structure were reconstructed in 7 knees, and ACL, PCL and posterolateral structure were reconstructed in 2 knees. The IKDC evaluation form and Lysholm&#039;s scale were used to make clinical evaluations. Anteroposterior translation was measured with the KT-2000 arthrometer and stress view radiography. The mean of Lysholm&#039;s score was 95.1 points. At the IKDC evaluation, 3 patients were grade A, 11 were grade B, 4 were grade C, and 1 patient was grade D. The results show the effectiveness and safety of one-stage reconstruction of combined ligamentous injuries of the knee that can adequately restore satisfactory stability.

Scopus

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記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

本研究の目的は、陳旧性膝重度複合靱帯損傷に対する一期的再建術の治療成績を評価することである。症例は前十字靱帯(ACL)および後十字靱帯(PCL)損傷を含む陳旧性重度複合靱帯損傷に対して一期的複合靱帯再建術を行った19例19膝である。7例で内側支持機構再建が、2例で後外側支持機構再建が同時に行われた。関節可動域に関しては、5°以上の伸展制限を認めた症例はなく、屈曲16°以上の制限を3例に認めた。KT-2000による膝前後方向不安定性の患腱側差は20°屈曲位では平均1.9mm、70°では2.1mmであった。Lysholm scaleは平均95点であった。IKDC評価はAが3例、Bが11例、Cが4例、Dが1例だった。治療成績はおおむね良好かつ安定していた。しかし、IKDC評価でCおよびDの症例が5例に存在し、今後も更なる研究および改良の必要性があると考えられた。(著者抄録)

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記述言語：日本語  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：OXFORD UNIV PRESS INC  

Web of Science

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：英語  

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記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：北海道整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本人工関節学会  

Posterior stabilizer(PS型)セラミックLFA-III人工膝関節置換術(TKA)を施行後1年以上経過観察が可能であった22例28膝(OA10例12膝,RA12例16膝)を対象に,短期成績について調査検討した.その結果,最終調査時のJOAスコアと全可動域はOA及びRA共に有意な改善を認めた.又,X線学的評価,Mechanical axisも良好な結果が得られたが有意差は見られず,%MAはRAの方が良好な改善が見られた.術後,早期感染例以外にコンポーネントの弛み及び沈下は見られず,インプラント周囲には1mm以上のclear zoneは認めなかった.合併症は,早期深部感染と麻酔下の関節受動術施行の各1例であった

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