記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Evaluation of medial meniscal extrusion (MME) under physiological loads is crucial because of the influence of MME on meniscal function. Reducing the MME is essential for meniscal function. Few studies have compared the extent of MME in cases of complete radial tears of the posterior segment of the medial meniscus (MM) treated using basic meniscal repair techniques: the inside-out and all-inside techniques. PURPOSE: To compare the extent of MME after the treatment of complete radial tears of the posterior segment using inside-out and all-inside meniscal repair techniques in a cadaveric model. STUDY DESIGN: Controlled laboratory study. METHODS: Six fresh-frozen human cadaveric knees were subjected to a compression load of 250 N using a 6 degrees of freedom robotic system under ultrasound evaluation. The MME was evaluated at 30° and 90° knee flexion in 4 meniscal conditions: (1) intact; (2) complete radial tear in the posterior segment of the MM; (3) inside-out repair technique; and (4) all-inside repair technique using 1 horizontal suture. Conditions 3 and 4 were performed on the same knee in a randomized order. Measurements were obtained at the center of the superficial medial collateral ligament (MCL) (central image) and 1 cm posterior to the superficial MCL (posterior image). Statistical analysis was conducted using a 2-factor repeated-measures analysis of variance with Bonferroni post-hoc correction, with significance level set at P < .05. RESULTS: The amount of MME under compression load after inside-out repair was significantly lower than that after all-inside repair (mean ± SD values for the central image: 30°, 1.93 ± 0.26 mm vs 2.45 ± 0.34 mm; 90°, 2.02 ± 0.29 mm vs 2.53 ± 0.42 mm; for the posterior image: 30°, 1.98 ± 0.30 mm vs 2.43 ± 0.35 mm; 90°, 2.45 ± 0.26 mm vs 3 ± 0.42 mm; P < .001 for all comparisons). CONCLUSION: Although the inside-out repair technique reduced the amount of MME to a greater extent than the all-inside repair technique using a single horizontal stitch for MM posterior segment tears, neither technique was able to reduce MME to the same level as that of the intact state; furthermore, the change in MME was relatively small. CLINICAL RELEVANCE: The findings indicate that the inside-out repair technique should be used to repair complete radial tears in the posterior segment of the MM.

DOI： 10.1177/23259671251356695

PubMed

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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.clinbiomech.2025.106586

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Each band of the deltoid ligament cooperatively contributes to stability of the medial side of the ankle joint. Investigating the function of each band of the deltoid ligament is essential to assess abnormalities and develop treatment options. PURPOSE: To evaluate the changes in ankle kinematics when each band of the deltoid ligament is injured and to measure the in situ force of each ligamentous band in intact ankle kinematics. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 8 healthy fresh-frozen cadaveric legs were examined by applying forces through eversion and external rotation of the ankle joint using a 6 degrees of freedom robotic system. The deltoid ligament was separated into 6 discrete bands: tibionavicular ligament, tibiospring ligament, tibiocalcaneal ligament (TCL), anterior tibiotalar ligament, superficial posterior tibiotalar ligament (sPTTL), and deep posterior tibiotalar ligament; the bands were then sequentially transected. A loading test was performed in each model, and the changes in ankle motion and in situ force of each ligamentous band were measured using the robotic system. RESULTS: When an eversion force was applied to the intact ankle, the in situ force of the sPTTL was 21.6 N in dorsiflexion and that of the TCL was 19.4 N in plantarflexion, both of which were significantly greater than those of the other ligamentous bands. Additionally, the amount of eversion under eversion loading increased significantly by 3.3° with sPTTL resection in dorsiflexion and by 4.2° with TCL resection in plantarflexion. CONCLUSION: The TCL and sPTTL play important roles among the ligamentous bands of the deltoid ligament. The sPTTL played a more significant role in ankle dorsiflexion, whereas the TCL played a more significant role in ankle plantarflexion. CLINICAL RELEVANCE: The TCL and sPTTL should receive attention in the treatment of deltoid ligamentous injuries.

DOI： 10.1177/23259671251327406

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although both the classical inside-out and all-inside techniques are performed for the repair of complete radial tears, which should be the standard technique is, to the authors' knowledge, controversial considering the clinical outcomes and biomechanical studies. There are no biomechanical studies of repairs of the lateral meniscus (LM) evaluating the peripheral side gap (peripheral gap) of the radial tear site and extrusion of the LM, which seems to be important in the treatment of radial tears. PURPOSE: To compare the inside-out and all-inside meniscal repair techniques by evaluating the peripheral gap and extrusion of the LM with complete radial tear using a 6 degrees of freedom robotic system and fresh-frozen cadavers. STUDY DESIGN: Controlled laboratory study. METHODS: This study was performed using 6 fresh-frozen cadaveric knee specimens, a robotic testing system, and ultrasound evaluation. Ultrasound evaluations were performed to measure peripheral gaps and extrusions. The first ultrasound evaluation under 5 N·m of valgus load was performed on the knee at 30° and 90° of flexion. After a complete radial tear at the midsegment of the LM was created, a second ultrasound evaluation under valgus load was performed. Finally, all-inside and inside-out meniscal repairs done with 1 horizontal suture were performed on the same knee in a randomized order. Subsequently, the third and fourth ultrasound evaluations under valgus load were performed. RESULTS: The peripheral gap of the inside-out meniscal repair technique was significantly smaller than that of all-inside meniscal repairs at knee flexion angles of 30° and 90° (6.0 vs 11.5 mm and 5.6 vs 10.9 mm [both P < .0167], respectively). The extrusion of inside-out meniscal repair was significantly smaller than that of all-inside meniscal repair at a knee flexion angle of 90° (2.6 vs 3.2 mm; P < .0083). CONCLUSION: The inside-out meniscal repair technique showed less peripheral gap and extrusion of the LM in a complete radial tear than the all-inside meniscal repair. Inside-out repair may be advantageous for radial tears over all-inside repair because only inside-out repair can tighten the peripheral side of the radial tear. CLINICAL RELEVANCE: The LM with a complete radial tear should be repaired using the inside-out technique.

DOI： 10.1177/23259671241308854

PubMed

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本舞台医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本舞台医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本膝関節学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The functional role of the biceps femoris short head (BFsh) remains unclear. Clarifying the functional role of each biceps femoris head may provide useful insights into the reduction of biceps femoris long head (BFlh) injuries. This study aimed to clarify whether the passive tension in the BFlh would change with BFsh detachment using cadavers. The shear modulus of the BFlh and BFsh was measured using ultrasonic shear wave elastography as an index of passive tension in three tissue processing conditions (intact, removal of all tissues from skin to deep fascia, and BFsh detachment) in four limb positions, with hip [H0°, H90°] and knee [K0°, K90°] joint angles under each tissue processing condition. The measurement site was the distal 30 % of the line connecting the sciatic tuberosity (100 %) and fibular head (0 %). Three-way analysis of variance was conducted with muscles, tissue processing, and positions as factors, which revealed a significant interaction (P < 0.01). The post-test results indicated that the BFlh was significantly higher than the BFsh at H90° and K0° before tissue processing; however, no difference was observed between the muscles after skin and deep fascia removal. After BFsh detachment, the shear modulus of the BFsh decreased, whereas that of the BFlh significantly increased (P < 0.01), suggesting that the BFsh might be involved in the passive tension reduction of the BFlh in a lengthened position, as the shear modulus of the BFlh increased after detachment.

DOI： 10.1016/j.jbiomech.2024.112480

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  

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J03098&link_issn=&doc_id=20250729460006&doc_link_id=%2Fdx3eastj%2F2024%2F003604%2F006%2F0343-0347%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdx3eastj%2F2024%2F003604%2F006%2F0343-0347%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Recently, arthroscopic anterior talofibular ligament (ATFL) repair has become popular, and favorable outcomes have been reported. In general, ATFL injuries are often caused by fibular attachment, and there are no reports of arthroscopic ligament repair of talar attachment injuries. We present a surgical technique for arthroscopic ligament repair via the anterolateral portal, accessory anterolateral portal, and far accessory anterolateral portal for ATFL injuries on the talar side. Ligament plication is performed using a suture anchor at the talar footprint of the ATFL after the small bone fragments are removed under arthroscopy. Arthroscopic surgery may lead to less postoperative swelling and pain than open surgery, allowing for early exercise and return to activity.

DOI： 10.1016/j.eats.2024.103098

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本整形外科超音波学会  

医中誌

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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：Edizioni Minerva Medica  

添付ファイル： EffectOfNewlyDeveloped,J.SportsMedPhysFitness2024.pdf

DOI： 10.23736/s0022-4707.24.15877-x

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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 used ultrasound shear wave elastography (SWE) to evaluate the mechanical properties of hamstring muscles from cadaveric specimens with knee flexion contractures. METHODS: Hamstring muscles for tensile testing were harvested from Thiel soft-embalmed cadavers with and without knee flexion contracture. Muscle specimens were mounted on a testing machine. The initial load detected when a tensile load was applied to the distal end was used as the slack length. The cross-sectional areas of the muscle at slack length were measured at the proximal and distal sites using B-mode ultrasonography. Subsequently, the muscle specimen was elongated from the slack length to 8% strain, with the shear modulus measured using SWE. Young's modulus (stress/strain) was calculated based on the displacement and tensile force obtained from the tensile test. RESULTS: Regression analysis showed a significant positive linear relationship between the Young's and shear moduli for all specimens at all the sites (P < 0.01 and coefficient of determination: 0.95-0.99). The Young's and average shear moduli at the proximal and distal sites were higher in all hamstring muscles with contractures than in those without contractures. CONCLUSIONS: SWE can be used to estimate Young's moduli of hamstring muscles with contractures. Muscle specimens with contractures exhibited higher resistance to elongation, thereby indicating that their mechanical properties differed from those of muscles without contractures.

DOI： 10.7759/cureus.68343

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本体力医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本体力医学会  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: To investigate whether inducing valgus alignment and shifting the load laterally through high tibial osteotomy (HTO) alone decreases the extent of medial meniscus extrusion (MME) in the setting of medial meniscus posterior root tear (MMPRT) using ultrasound evaluation. METHODS: Eight fresh-frozen human cadaveric knee specimens were tested using a 6-degree-of-freedom robotic testing system and ultrasound. Each specimen was tested in 5 conditions: (1) intact, (2) MMPRT, (3) medial meniscus repair (MMR), (4) combined medial open-wedge HTO + MMR, and (5) HTO + MMPRT. Measurements were obtained over the medial collateral ligament (central image) and posterior to the medial collateral ligament (posterior image) with a 250-N axial load at 0°, 30°, and 90° of knee flexion. Statistical analysis was performed using a 2-factor repeated-measures analysis of variance. RESULTS: MME was significantly greater in HTO + MMPRT (0°: 2.44 ± 0.41 mm, 30°: 2.47 ± 0.37 mm, 90°: 2.41 ± 0.28 mm) than HTO + MMR in central images (mean difference +0.83 mm, P < .001). No significant difference was found between HTO + MMPRT and MMPRT in MME. MMR had significantly less MME than MMPRT (mean difference -0.58 mm, P < .001, posterior image at 0° and central image at 90°, P = .002). HTO + MMR showed significantly less MME than MMR alone at 30° and 90° of knee flexion in the central image (30°: -0.38 ± 0.05 mm, 90°: -0.45 ± 0.06 mm, P < .001) and 90° of knee flexion in the posterior image (-0.38 ± 0.08 mm, P = .004). CONCLUSIONS: HTO alone did not decrease MME in the setting of MMPRT, while MMR alone decreased MME after MMPRT. Additionally, HTO + MMR decreased MME after MMPRT compared to MMR alone, although the clinical significance was uncertain. CLINICAL RELEVANCE: The findings of this study provide clinicians with valuable insights for improving MME. HTO alone does not decrease MME in cases of MMPRT.

DOI： 10.1016/j.arthro.2024.06.038

PubMed

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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.jmbbm.2024.106473

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記述言語：日本語   出版者・発行元：(一社)日本舞台医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本舞台医学会  

医中誌

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記述言語：英語  

DOI： 10.1007/s10396-024-01436-w

PubMed

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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掲載種別：研究論文（学術雑誌）   出版者・発行元：IOS Press  

BACKGROUND: The intrinsic foot muscles play an important role in medial longitudinal arch support, as well as several extrinsic foot muscles. While various strength training methods specific to intrinsic foot muscles have been conducted, these exercises are associated with certain concerns regarding their effectiveness and difficulty. We developed a new exercise for the intrinsic muscles (MTP flexion exercise). OBJECTIVE: The aim was to compare the shear modulus of the toe flexors as the muscle contraction activity during MTP flexion and short-foot exercises using ultrasound shear wave elastography. METHODS: Eleven healthy participants were included in this study. The shear modulus of the toe flexor muscles was measured during MTP flexion and short-foot exercises using ultrasound shear wave elastography. The muscle shear modulus was statistically compared between the resting phase, and during the two exercises. RESULTS: The shear modulus during MTP flexion exercise was significantly greater than in the resting phase in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, and flexor digitorum longus. The flexor digitorum longus showed greater shear modulus during MTP flexion exercise than during short-foot exercise. CONCLUSION: MTP flexion exercise showed equivalent or greater contraction activity in certain intrinsic and extrinsic foot muscles when compared with short-foot exercise. This exercise is considered one of the training options for strengthening the intrinsic muscles of the foot.

DOI： 10.3233/bmr-230282

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Toe function is characterised by the strength and dexterity of toe motion. However, previous studies have mostly focused on the importance of toe strength. OBJECTIVE: This study aimed to investigate the relationships between flexion strength and dexterity of the toes and physical performance. METHODS: Twenty healthy participants were included in this study. The flexion force of each toe was measured using a digital force gauge, and the toe dexterity was evaluated using the marble pick-up and rock-paper-scissors tests. These parameters were statistically analysed in relation to physical performance, including repeated side step and balance ability, which was evaluated using centre of pressure (COP) data during single-leg standing, tiptoe standing, and single-leg drop-jumping. RESULTS: A significant correlation was found between the first toe flexion force and the total trajectory length of the COP during one-leg standing and between the time required for marble pick-up and the rock-paper-scissors score and the COP during single-leg drop-jumping. CONCLUSION: The results underscore the importance of flexion strength and dexterity of the toes in human physical performance and the necessity for the evaluation and improvement of both functions.

DOI： 10.3233/BMR-230263

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To determine T2* normal reference values for anterior talofibular ligament (ATFL) and to investigate the feasibility of the quantitative ATFL quality evaluation in chronic lateral ankle instability (CLAI) using T2* values. MATERIALS AND METHODS: This study enrolled 15 patients with CLAI and 30 healthy volunteers. The entire ATFL T2* values from the MRI T2* mapping were measured. The prediction equation (variables: age, height, and weight) in a multiple linear regression model was used to calculate the T2* normal reference value in the healthy group. T2* ratio was defined as the ratio of the actual T2* value of the patient's ATFL to the normal reference value for each patient. A Telos device was used to measure the talar tilt angle (TTA) from the stress radiograph. RESULTS: T2* values of ATFL in the healthy and CLAI groups were 10.82 ± 1.84 ms and 14.36 ± 4.30 ms, respectively, which are significantly higher in the CLAI group (P < 0.05). The prediction equation of the normal reference T2* value was [14.9 + 0.14 × age (years) - 4.7 × height (m) - 0.03 × weight (kg)] (R2 = 0.65, P < 0.0001). A significant positive correlation was found between the T2* ratio and TTA (r = 0.66, P = 0.007). CONCLUSION: MRI T2* values in patients with CLAI were higher than those in healthy participants, and the T2* ratio correlated with TTA, suggesting that T2* values are promising for quantitative assessment of ATFL quality preoperatively.

DOI： 10.1007/s00256-023-04480-8

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Ultra-short TE (UTE) sequences on MRI are a technique that improves the visualization of tissues with short T2 relaxation time, such as deep cartilage layers. In addition, T2* relaxation time calculated from the UTE has the potential to evaluate water molecules bound to the cartilage matrix. This study was performed to determine if there is an association between UTE-T2* relaxation time by cartilage layer and histological degeneration in knee osteoarthritis (OA). DESIGN: Seven knees that had undergone total knee arthroplasty (TKA) were included in the study, and the lateral tibial cartilage, which had the least degeneration of the resected bones, was used as the sample. The T2* relaxation time of 4 patients with no abnormal findings on MRI was the reference relaxation time. Histological degeneration of TKA samples was assessed by the Mankin score and graded as the early OA group (≤3 points) and the advanced OA group (≥4 points). The association between T2* relaxation time and Mankin grade in each cartilage layer was compared. The effect of angiogenesis to the tidemark on T2* relaxation time was also compared. RESULTS: T2* relaxation time of the cartilage layer was significantly longer in early OA than that in the control group. In the deep cartilage layer, the mean T2* relaxation time for angiogenesis (-) was 15.7 ms, whereas it was significantly shorter for angiogenesis (+) at 8.2 ms. CONCLUSIONS: The UTE-T2* relaxation time was associated with histological cartilage degeneration, suggesting a potential application in monitoring early cartilage degeneration.

DOI： 10.1177/19476035231205685

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The primary motion of the toes is flexion and extension. The motion results from activity of multiple muscles, and toe disorders may result from muscle dysfunction. The relationships of specific muscles related to toe function is underreported. The purpose of this study was to quantitatively evaluate three-dimensional toe motion resulting from specific muscle contraction using cadavers. METHODS: Three-dimensional joint movements of the 1st, 2nd, and 5th toe were produced by applying traction of individual muscles using six Thiel-embalmed cadaver legs. The traction increments were 3 mm, 6 mm, and 9 mm, during which the angle of the distal bone with respect to the proximal bone of each toe joint was measured using a magnetic tracking system. RESULTS: As tendon traction distance increased, the angular measure of the distal bone with respect to the proximal bone at each toe joint increased linearly and three-dimensionally. The flexor hallucis brevis significantly pronated and abducted the 1st toe compared to the extensor hallucis longus and brevis. The flexor digitorum brevis significantly supinated and adducted the 2nd toe compared to the flexor digitorum longus and quadratus plantae, while the extensor digitorum brevis demonstrated significant pronation and abduction compared to the extensor digitorum longus. CONCLUSIONS: Three intrinsic muscles produced significant toe motion in frontal and horizontal planes. Our results revealed that there was a proportional relationship between tendon excursion and joint angle, and an antagonistic relationship of muscles acting on the toes. These results can be considered regarding pathogenesis of toe disorders or deformity and regarding treatment such as exercise therapy or tendon transfer. LEVEL OF EVIDENCE: V, cadaveric study.

DOI： 10.1016/j.foot.2023.102044

PubMed

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記述言語：日本語   出版者・発行元：日本整形外科超音波学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: It has been suggested that lower limb strength related to persistent postsurgical pain. The aim of the present study was to investigate the relationships of pre-operative or postoperative cross-sectional area (CSA) of the thigh muscles with knee pain or patient satisfaction after total knee arthroplasty (TKA). METHODS: Twenty patients who had undergone TKA (3 men and 17 women; mean age 75.2 ± 8.7 years) were included. CSAs of the thigh muscle (THIGH) and quadriceps muscle (QUAD) were retrospectively measured at the CT slice 10-cm superior to the quadriceps tendon insertion at the proximal pole of the patella. THIGH CSA and QUAD CSA to body weight ratios (mm2/kg), THIGH/W and QUAD/W ratios, respectively, were calculated. Knee pain and patient satisfaction postoperatively were also quantified by patient-reported measurements based on the 2011 Knee Society Score (KSS). The correlations between the THIGH/W and QUAD/W ratios and the KSS were evaluated using Spearman's rank correlation coefficient. RESULTS: The preoperative THIGH/W ratio was positively correlated with KSS-pain, (r = 0.58, p < 0.05). The preoperative QUAD/W ratio was positively correlated with KSS-pain (r = 0.52, p < 0.05) and KSS-satisfaction (r = 0.44, p < 0.05). The postoperative THIGH/W ratio was positively correlated with KSS-pain (r = 0.45, p < 0.05). The postoperative QUAD/W ratio was positively correlated with KSS-pain (r = 0.49, p < 0.05) and KSS-satisfaction (r = 0.48, p < 0.05). CONCLUSION: There were significant correlations between quadriceps or thigh muscle CSA and pain or patient satisfaction after TKA. This research may help relieve pain and increase patient satisfaction after TKA in the future.

DOI： 10.1016/j.asmart.2023.08.006

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Bi-cruciate retaining total knee arthroplasty with an asymmetrical design may improve knee function and clinical outcomes. This study aimed to compare the kinematics, anteroposterior laxity, and in situ forces of the anterior and posterior cruciate ligaments of knees subjected to this treatment with those of healthy knees. METHODS: Seven fresh-frozen cadaveric knees were tested using a robotic/universal force-moment sensor system. The kinematics during passive flexion-extension motion and anteroposterior laxity for native knee, treated knee, and treated knee with cruciate ligament transection states were investigated. The motions of the intact and treated knees during each test were repeated after anterior/posterior cruciate ligament transection to calculate the in situ force in the ligaments. FINDINGS: The screw-home movement of normal knees disappeared after treatment. The in situ force of the anterior cruciate ligament in treated knees was higher than that in intact knees at ˃15° during flexion and at 60° and 90° against an anterior force. The in situ force of the posterior cruciate ligament in treated knees was higher at 0°, 15°, and 30° during flexion and at all flexion angles against a posterior force. INTERPRETATION: The screw-home movement of normal knees decreased, and the in situ force of the anterior and posterior cruciate ligaments increased after treatment.

DOI： 10.1016/j.clinbiomech.2023.106038

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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本整形外傷学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Assessing muscle flexibility and architecture is important for hamstring strain injury (HSI) prevention. We investigated the relationship between shear modulus and passive force in hamstring muscles at different sites and the effect of muscle architecture on the slope of the shear modulus-passive force using shear wave elastography (SWE). METHODS: The biceps femoris long head (BFlh), semitendinosus (ST), and semimembranosus (SM) muscles were dissected from nine Thiel-embalmed cadavers and fixed to a custom-made mechanical testing machine. Calibrated weights (0-1800 g) were applied gradually in 150-g increments. The shear modulus and anatomical cross-sectional area (ACSA) were measured at proximal, central, and distal points using SWE. The muscle mass and length were measured before the loading test. The shear modulus-passive load relationship of each tested muscle region was analyzed by fitting a least-squares regression line. The increase in shear modulus slope per unit load was calculated and compared between the muscles before and after normalization by the muscle mass, length, and ACSA. RESULTS: The shear modulus and passive force for all hamstring muscles in each region showed a statistically significant linear correlation. Furthermore, the increase in shear modulus slope was greater for BFlh and ST than for SM (P < 0.05), but after normalization by the muscle length and ACSA, there were no significant differences among the muscles. CONCLUSION: The local mechanical properties of individual hamstring muscles can be indirectly estimated using SWE, and the slope of increase in shear modulus reflects characteristics of the muscle architecture.

DOI： 10.1007/s10396-023-01317-8

PubMed

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記述言語：日本語   出版者・発行元：産業開発機構(株)  

医中誌

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記述言語：日本語   出版者・発行元：産業開発機構(株)  

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00116&link_issn=&doc_id=20230519190016&doc_link_id=%2Fan7eizoc%2F2023%2F005506%2F018%2F0097-0102%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fan7eizoc%2F2023%2F005506%2F018%2F0097-0102%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The present study aimed to clarify the morphological patterns of the calcaneus and talus that are associated with hallux valgus angle (HVA) by quantifying the differences in the hindfoot bone morphology between left and right sides in HV patients with clear bilateral difference of HVA. METHODS: Three-dimensional (3D) computed tomography scans of 32 feet of 16 patients with HV who had right-to-left HVA differences of more than 5 degrees (68.8 ± 8.6 years) were enrolled, and 3D surface models of the calcaneus and talus were generated. A total of 556 and 430 landmarks were placed on the calcaneal and talar surfaces, respectively, to calculate the principal components (PCs) of shape variations. The PC scores were compared between the small and large HVA sides within an individual. RESULTS: The calcaneus in patients with a larger HVA (mean, 43.2 degrees) possessed slender calcaneal tuberosity, more medially oriented posterior articular surface in the coronal plane, and narrower and more concave anterior-middle articular surfaces compared to those with a small HVA (mean, 33.7 degrees). The talus with a larger HVA exhibited more medially oriented talar head in the transverse plane and more anteriorly protruded lateral region of the talar head compared to the small HVA. CONCLUSIONS: The morphological patterns of the calcaneus in patients with a larger HVA allows the hindfoot bones to easily rotate in the everting direction, while those of the talus could induce a larger internal rotation of the first metatarsal. These morphological patterns of the calcaneus and talus could be structural factors affecting the HV.

DOI： 10.1016/j.aanat.2023.152053

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Bone morphology is one of the factors involved in hallux valgus development. However, previous studies have not evaluated the overall bone shape in three dimensions. This study aimed to compare the overall shape of the first proximal phalanx and first metatarsal in hallux valgus with those of normal feet.Homologous models were created from computed tomography data of the first proximal phalanx and first metatarsal of 75 healthy men and 53 women in the control group and 10 men and 71 women in the hallux valgus group. Principal component analysis was performed to examine the differences in bone morphology between the control and hallux valgus groups. In men and women with hallux valgus, the proximal articular surface of the first proximal phalanx was characterized by a more lateral inclination and torsion of the pronated first metatarsal. Additionally, the first metatarsal head was characterized by a more lateral inclination in male hallux valgus. This study is the first to reveal the morphological characteristics of the first metatarsal and first proximal phalanx in hallux valgus as a whole bone using a homologous model technique. These characteristics are considered possible causes of hallux valgus development. The shapes of the first proximal phalanx and first metatarsal in hallux valgus were different from those in normal feet. This finding should be useful when considering the pathogenesis and treatment development for hallux valgus.

DOI： 10.1016/j.foot.2023.101968

PubMed

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The manual traditional anterior drawer test (ADT) is essential for deciding the treatment for chronic ankle instability, but it has been shown to have a comparatively low reproducibility and accuracy, especially in less experienced hands. To clarify the inter-examiner reproducibility, we compared the actual distance of anterior translation between junior and senior examiners in ADT. We also evaluated the diagnostic abilities of traditional ADT, and a novel modified ADT (supported ADT). METHODS: Thirty ankles were included in this study, and ankle instability was defined using stress radiography. All subjects underwent two methods of manual ADT by junior and senior examiners, and ankle instability was judged in a blinded fashion. The anterior drawer distance was calculated from the lengthening measured using a capacitance-type sensor device. RESULTS: The degree of anterior translation determined by the junior examiner was significantly lower than that determined by the senior examiner when traditional ADT was performed (3.3 vs. 4.5 mm, P = 0.016), but there was no significant difference in anterior translation between the two examiners when supported ADT was performed (4.6 vs. 4.1 mm, P = 0.168). The inter-examiner reliability of supported ADT was higher than that of traditional ADT. For the junior examiner, the diagnostic accuracy of supported ADT was higher than that of traditional ADT (sensitivity, 0.40 vs. 0.80; specificity, 0.75 vs. 0.80). CONCLUSION: Supported ADT may have the advantage of being a simple manual test of ankle instability with less error between examiners.

DOI： 10.1186/s12891-023-06246-8

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Intramuscular heterogeneity exists in the shear modulus of the rectus femoris (RF) muscle. However, the underlying heterogeneity mechanisms are not entirely understood. Previous research has reported that detachment of superficial tissues reduces the shear modulus by 50%. The aim of this study was to examine the effects of the skin, deep fascia, and intermuscular connections on the shear modulus of the RF at multiple sites. MATERIALS AND METHODS: Eleven donors were fixed using the Thiel method. Measurements were performed at 0°, 60°, and 120° knee flexion in a neutral hip position. Tissue processing was performed under four conditions: superficial tissue (CONT), skin off (SKIN), deep fascia detachment (FASC), and intermuscular connections detachment (ALL). The shear modulus at the proximal, central, and distal regions were measured using ultrasound shear wave elastography. The study was approved by the Sapporo Medical University Ethical Committee. RESULTS: Three-way ANOVA revealed no significant interaction between treatment, site, and angle (P = 0.156), treatment and angle (P = 0.067), or site and angle (P = 0.441). There was a significant effect of treatment (P < 0.001), site (P = 0.010), and angle (P < 0.001) and interaction between treatment and site (P < 0.001). The proximal shear modulus was greater than the central for CONT. There were no significant differences between the measurement sites for SKIN. The distal shear modulus was greater than the proximal for FASC. The distal shear modulus was also greater than the proximal and central for ALL. CONCLUSIONS: Intramuscular regional differences that influence superficial tissue and intermuscular connections of RF elasticity heterogeneity were observed.

DOI： 10.1007/s40477-022-00769-x

PubMed

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Subtalar arthrodesis in addition to ankle arthrodesis (AA) should have effect on foot motion and functional capabilities pertaining to activities of daily living (ADL); however, it is not well characterized. We compared the foot range of motion and ADL-related functional capabilities between patients who had undergone AA and tibiotalocalcaneal arthrodesis (TTC). Twenty-one AA patients and 10 TTC patients were enrolled. Foot sagittal motion arc was measured by radiographs. Patient satisfaction, ADL, footwear restriction, and rating scale scores were compared between the 2 groups. The mean sagittal motion arc in the AA group (23.5 ± 6.2°) was significantly greater than that in the TTC group (15.3 ± 3.5°). Patient satisfaction and overall ADL status was comparable in the 2 groups. Difficulties in climbing stairs, wearing rubber boots, and sitting in cross-legged position were more frequently reported in the TTC group. Our findings may be valuable for both surgeons and patients in predicting post-treatment ADL status and avoiding over expectations.

DOI： 10.1053/j.jfas.2022.12.007

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Lower extremity sports injuries frequently occur during an individual's growth period. The object of the current study was to analyse the risk factors for lower extremity sports injuries for youth athletes. The secondary objective was to clarify the factors related to new injuries after a lower extremity injury. METHODS: We extracted information on youth athletes (aged 10-15 years) with sports-related disorders. Background data and injury situations were collected via a specific application. During the follow-up period, new injuries were also recorded. The athletes were divided into two groups according to injury location (lower extremity or other). We performed a multiple logistic regression analysis to clarify the association between injury location and background data. RESULTS: 1575 complaints of lower extremity disorders and 328 complaints in other body parts were registered. According to the multiple regression analysis, practice time per week was significantly shorter for the lower extremity group than the other locations group (OR 0.98; 95% CI 0.963 to 0.999). Athletes whose future goal was at the recreational level had a significantly low incidence of new injuries after experiencing lower extremity disorders. CONCLUSION: The practice environments and psychological factors should receive more attention to prevent lower extremity injuries.

DOI： 10.1136/bmjsem-2022-001493

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本運動器理学療法学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Investigations on the biomechanical characteristics of the anterior horn of the lateral meniscus (AHLM) related to anterior cruciate ligament (ACL) tibial tunnel reaming have revealed increased contact pressure between the femur and tibia, decreased attachment area, and decreased ultimate failure strength. Purpose/Hypothesis: The purpose of this study was to investigate the influence of a complete radial tear of the AHLM on force distribution in response to applied anterior and posterior drawer forces and internal and external rotation torques. We hypothesized that the AHLM plays an important role in knee stability, primarily at lower knee flexion angles. Study Design: Controlled laboratory study. Methods: A total of 9 fresh-frozen cadaveric knee specimens and a robotic testing system were used. Anterior and posterior drawer forces up to 89 N and internal and external rotation torques up to 4 N·m were applied at 0°, 30°, 60°, and 90° of knee flexion. A complete AHLM tear was then made 10 mm from the lateral border of the tibial attachment of the ACL, and the same tests performed in the intact state were repeated. Next, the recorded intact knee motion was reproduced in the AHLM-torn knee, and the change in the resultant force after an AHLM tear was determined by calculating the difference between the 2 states. Results: In the torn AHLM, the reduction in the resultant force at 0° for external rotation torque (34.8 N) was larger than that at 60° (5.2 N; P < .01) and 90° (6.7 N; P < .01). Conclusion: The AHLM played a role in facilitating knee stability against an applied posterior drawer force of 89 N and external rotation torque of 4 N·m, especially at lower knee flexion angles. Clinical Relevance: This study provides information about the effects of AHLM injuries that may occur during single-bundle ACL reconstruction using a round tunnel.

DOI： 10.1177/23259671221119173

PubMed

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Studies on ankle syndesmosis have focused on anterior inferior tibiofibular ligament (AITFL) and interosseous membrane injuries; however, the characteristics of posterior inferior tibiofibular ligament (PITFL) ruptures remain unclear. PURPOSE/HYPOTHESIS: This study evaluated the biomechanical characteristics of syndesmotic instability caused by PITFL injury and compared various treatment methods. We hypothesized that PITFL injury would lead to syndesmotic internal rotational instability and that the stability would be restored with suture tape (ST) PITFL augmentation. STUDY DESIGN: Controlled laboratory study. METHODS: Ten uninjured fresh-frozen cadaveric leg specimens were tested via forces applied to the external and internal rotation of the ankle joint. The fibular rotational angle (FRA) related to the tibia, anterior tibiofibular diastasis (aTFD), and posterior tibiofibular diastasis (pTFD) were measured using a magnetic tracking system. Six models were created: (1) intact, (2) AITFL injury; (3) AITFL + PITFL injury; (4) suture button (SB) fixation; (5) SB + anterior ST (aST) fixation; and (6) SB + aST + posterior ST fixation. The FRA, aTFD, and pTFD were statistically compared between the intact ankle and each injury or fixation model. RESULTS: In the intact state, the changes in FRA and aTFD were 1.09° and 0.33 mm when external rotation force was applied and were 0.57° and 0.41 mm when internal rotation force was applied. In the AITFL injury model, the changes in FRA and aTFD were 2.38° and 1.51 mm when external rotation force was applied, which were significantly greater versus intact (P = .032 and .008, respectively). In the AITFL + PITFL injury model, the changes in FRA and pTFD were 2.12° and 1.02 mm when internal rotation force was applied, which were significantly greater versus intact (P = .007 and .003, respectively). In the SB fixation model, the change in FRA was 2.98° when external rotation force was applied, which was significantly higher compared with intact (P < .001). There were no significant differences between the SB + aST fixation model and the intact state on any measurement. CONCLUSION: PITFL injury significantly increased syndesmotic instability when internal rotation force was applied. SB + aST fixation was effective in restoring syndesmotic stability. CLINICAL RELEVANCE: These results suggest that SB + aST fixation is sufficient for treating severe syndesmotic injury with PITFL rupture.

DOI： 10.1177/23259671221122811

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although the minimal invasiveness of arthroscopic ankle lateral ligament repair (ALLR) means that an early return to sporting activities can be anticipated, studies have described postoperative cast immobilization and the avoidance of weightbearing for a certain period. Accelerated rehabilitation may be helpful for an early return to sport. PURPOSE: To investigate clinical outcomes of ALLR and accelerated rehabilitation with a minimum duration of postoperative ankle immobilization and proactive early weightbearing. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This study investigated 23 ankles of 22 patients (11 men, 11 women; mean age, 38.7 years) who underwent ALLR for chronic lateral ankle instability. Postoperative management included the avoidance of weightbearing until postoperative day 3, after which full weightbearing walking with a brace was permitted. The objective was to return to competitive sport 8 weeks after surgery. The following were evaluated: pre- and postoperative instability and pain symptoms, ankle range of motion, anterior drawer distance on stress radiograph, anterior translation measured with a capacitance-type strain sensor, the Ankle-Hindfoot Scale from the Japanese Society for Surgery of the Foot, and the SAFE-Q (Self-Administered Foot Evaluation Questionnaire). RESULTS: Two male patients dropped out and were excluded from analysis. Postoperatively, instability and pain resolved or improved in all patients. There was no significant postoperative change in range of motion. There were significant pre- to postoperative improvements in talar tilt angle (from 12.2°-5.6°, P < .01), anterior drawer distance (8.2-4.4 mm, P < .01), and anterior translation (10.5-4.6 mm, P < .01) as well as the Ankle-Hindfoot Scale score (68.8-96.8, P < .01) and all subscales of the SAFE-Q (P ≤ .01 for all). Complete return to sport was achieved by 75% of the patients at 8 weeks postoperatively. CONCLUSION: When accelerated rehabilitation with proactive weightbearing exercises was implemented from postoperative day 3 without ankle immobilization after ALLR, there were significant improvements in objective assessments of ankle stability and clinical scores, and as many as 75% of the patients were able to make a complete return to sport within 8 weeks.

DOI： 10.1177/23259671221121676

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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/22104917221092166

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY DESIGN: Retrospective Cohort Study. OBJECTIVE: The purpose of this study was to investigate the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors. METHODS: We included 1353 cases of elderly cervical SCI patients collected from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were defined as the respiratory disability group. Patients' background characteristics, injury mechanism, injury form, neurological disability, complications, and treatment methods were compared between the disability and non-disability groups. Multiple logistic regression analysis was used to examine the independent factors. Patients who required respiratory management for 6 months or longer after injury and those who died of respiratory complications were classified into the severe disability group and were compared with minor cases who were weaned off the respirator. RESULTS: A total of 104 patients (7.8%) had impaired respiratory function. Comparisons between the disabled and non-disabled groups and between the severe and mild injury groups yielded distinct trends. In multiple logistic regression analysis, age, blood glucose level, presence of ossification of posterior longitudinal ligament (OPLL), anterior vertebral hematoma, and critical paralysis were selected as independent risk factors. CONCLUSION: Age, OPLL, severe paralysis, anterior vertebral hematoma, hypoalbuminemia, and blood glucose level at the time of injury were independent factors for respiratory failure. Hyperglycemia may have a negative effect on respiratory function in this condition.

DOI： 10.1177/21925682221095470

PubMed

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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 aimed to evaluate the effects of the ankle flexion angle during anterior talofibular ligament (ATFL) reconstruction on ankle kinematics, laxity, and in situ force of a graft. METHODS: Twelve cadaveric ankles were evaluated using a 6-degrees of freedom robotic system to apply passive plantar flexion and dorsiflexion motions and multidirectional loads. A repeated measures experiment was designed using the intact ATFL, transected ATFL, and reconstructed ATFL. During ATFL reconstruction (ATFLR), the graft was fixed at a neutral position (ATFLR 0 degrees), 15 degrees of plantar flexion (ATFLR PF15 degrees), and 30 degrees of plantar flexion (ATFLR PF30 degrees) with a constant initial tension of 10 N. The 3-dimensional path and reconstructed graft tension were simultaneously recorded, and the in situ force of the ATFL and reconstructed grafts were calculated using the principle of superposition. RESULTS: The in situ forces of the reconstructed grafts in ATFLR 0 degrees and ATFLR PF 15 degrees were significantly higher than those of intact ankles. The ankle kinematics and laxity produced by ATFLR PF 30 degrees were not significantly different from those of intact ankles. The in situ force on the ATFL was 19.0 N at 30 degrees of plantar flexion. In situ forces of 41.0, 33.7, and 21.9 N were observed at 30 degrees of plantar flexion in ATFLR 0, 15, and 30 degrees, respectively. CONCLUSION: ATFL reconstruction with the peroneus longus (PL) tendon was performed with the graft at 30 degrees of plantar flexion resulted in ankle kinematics, laxity, and in situ forces similar to those of intact ankles. ATFL reconstructions performed with the graft fixed at 0 and 15 degrees of the plantar flexion resulted in higher in situ forces on the reconstructed graft. CLINICAL RELEVANCE: Fixing the ATFL tendon graft at 30 degrees of plantar flexion results in an in situ force closest to that of an intact ankle and avoids the excessive tension on the reconstructed graft.

DOI： 10.1177/10711007211069327

PubMed

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記述言語：日本語   出版者・発行元：日本靴医学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A 37-year-old man developed right ankle pain and swelling six days after being diagnosed with coronavirus disease (COVID-19). Despite conservative treatment, his ankle symptoms persisted. Magnetic resonance imaging and computed tomography showed synovial hypertrophy and bone erosion in the ankle. Following arthroscopic synovectomy, performed 69 days after the COVID-19 diagnosis, the pain improved significantly. The clinical course was consistent with that of reactive arthritis following severe acute respiratory syndrome coronavirus 2 infection. The pathological findings resembled rheumatoid nodules. The bone erosion may have originated from the inflammatory pathway, which resembles the mechanism of rheumatoid arthritis.

DOI： 10.1016/j.jiac.2021.12.028

PubMed

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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  

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J03582&link_issn=&doc_id=20220603480022&doc_link_id=%2Fdp2sport%2F2022%2F003002%2F025%2F0484-0491%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdp2sport%2F2022%2F003002%2F025%2F0484-0491%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Transverse ligament and posterior inferior tibiofibular ligament injuries have not been investigated till date because these are difficult to evaluate using standard magnetic resonance imaging. This study aimed to investigate the prevalence of transverse ligament and posterior inferior tibiofibular ligament injuries in syndesmosis-injured ankles using oblique axial magnetic resonance imaging. METHODS: The patients who were diagnosed with syndesmosis injury using magnetic resonance imaging (MRI) within 7 days of the trauma were included. Patients with concomitant fractures were excluded. A total of 34 patients (1 woman and 33 men) with an average age of 22 years (range, 14-64 years) were included. The anterior inferior tibiofibular, interosseous, transverse, and posterior inferior tibiofibular ligaments were classified as intact, partial tear, or complete tear using usual axial and oblique axial MRIs. RESULTS: There were 8 (23.5%) ankles with an intact, 21 (61.8%) ankles with a partially torn, and 5 (14.7%) ankles with a complete tear of transverse ligament. There were 20 (58.8%) ankles with an intact, 12 (35.3%) ankles with a partially torn, and 2 (5.9%) ankles with a complete tear of posterior inferior tibiofibular ligament. Overall, 50% of the transverse ligament injuries occurred without posterior inferior tibiofibular ligament involvement. CONCLUSIONS: The oblique axial magnetic resonance imaging scan revealed that the prevalence of transverse ligament and posterior inferior tibiofibular ligament injuries in syndesmosis-injured ankles were 76.5 and 41.2%, respectively.

DOI： 10.1186/s12891-022-05220-0

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Ultrasound examinations for syndesmosis injury might be useful for the quantitative evaluation of syndesmotic instability. The purpose of this study was to evaluate the efficacy of ultrasound assessment by measuring the tibiofibular distance of syndesmosis injuries in various ligament-injured models and stress load conditions. METHODS: Five normal ankles from Thiel-embalmed cadavers were used. Ultrasound assessment was performed by placing a probe in parallel with the ligament running just above the anterior inferior tibiofibular ligament (AITFL). The distance between the anterior border of the tibia and the fibula was measured in the intact condition. Next, Bassett's ligament was cut arthroscopically to reduce damage to soft tissues as much as possible and measurement was performed in the same way. After that, the AITFL, interosseous membrane (IOM), deltoid ligament, and posterior inferior tibiofibular ligament (PITFL) were macroscopically cut and measured in that order. Ankle positions were without stress (natural plantar flexion without applying stress to the ankle joint), dorsiflexion stress, inversion stress, and external rotation stress. All stress to the ankle joint was carried out manually to the maximum extent. RESULTS: As with the without-stress condition, significant increases in tibiofibular distances after AITFL dissection were seen compared with the intact state under all stress conditions (intact: 4.9 ± 1.0 mm without stress, 5.6 ± 1.2 mm with dorsiflexion, 5.9 ± 1.0 mm with inversion, and 6.7 ± 1.3 mm with external rotation; AITFL dissection: 6.7 ± 1.5 mm without stress, 7.3 ± 1.2 mm with dorsiflexion, 7.5 ± 1.4 mm with inversion, and 8.7 ± 1.6 mm with external rotation). AITFL dissection with external rotation stress significantly increased the tibiofibular distance compared to without stress. CONCLUSION: Changes in tibiofibular distance with the severity of syndesmosis injury were measured by ultrasound using cadavers. No significant change was seen with Bassett's ligament injury, but tibiofibular distance increased significantly with injuries of equal to or greater severity than AITFL injury. Results were similar not only for external rotation stress, but also for dorsiflexion stress and inversion stress, and even in unloaded states, significant tibiofibular widening was confirmed with injuries of equal to or greater severity than AITFL injury.

DOI： 10.1186/s12891-022-05221-z

PubMed

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Joint movement within the foot is complex involving multiple muscles. We evaluated three-dimensional movement of the hindfoot through simulated traction of extrinsic tendons of the foot. METHODS: Six Thiel-embalmed cadavers were utilized and thread was sutured to each tendon of the lower leg muscles. Traction of the thread was prescribed and the change of calcaneal position used to quantify foot motion was measured for each increment using a magnetic tracking system. RESULTS: As the tendon traction length advanced, the angle of the calcaneus with respect to the tibia increased linearly. Eversion and abduction angles due to extensor digitorum longus (EDL) traction were significantly greater than that due to the peroneus longus. Plantarflexion due to Achilles tendon traction was significantly greater than that of other plantarflexors. CONCLUSIONS: Our results demonstrated three-dimensional characteristics of hindfoot motion by simulated muscle contraction and importance of EDL as an evertor. These information should be applicable for tendon transfer procedures around the ankle and physical therapy for ankle dysfunction such as chronic ankle instability.

DOI： 10.1016/j.fas.2022.02.012

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Posterior shoulder capsule tightness is one of the factors for shoulder injuries in overhead athletes. Recent studies have shown the posterior capsule of the dominant arm to be stiffer than that of the non-dominant arm in baseball players. However, whether posterior capsule tightness in the dominant arm is exclusive to overhead athletes remains unknown. This study aimed to investigate whether the posterior shoulder capsule of the dominant arm in baseball players is stiffer than that in non-throwing population. METHODS: Fifteen male collegiate asymptomatic baseball players (baseball-player group) and fifteen male college students who did not partake in overhead sports (non-throwing group) participated in this study. We measured the shear moduli of the middle and inferior posterior capsules, superior infraspinatus, inferior infraspinatus, teres minor, and posterior deltoid in the dominant arm using ultrasound shear wave elastography. We compared shear moduli between the two groups using an independent samples t-test and Mann-Whitney test. In addition, we investigated the correlation between the range of glenohumeral internal rotation and each shear modulus in each group using the Pearson correlation coefficient. RESULTS: The shear moduli in the baseball-player group were significantly higher than those in the non-throwing group in both the middle posterior capsule (baseball-players group: 36.1 ± 5.6 kPa vs. non-throwing group: 29.0 ± 8.6 kPa; p = 0.018) and inferior posterior capsule (37.1 ± 9.6 kPa vs. 27.9 ± 6.8 kPa; p = 0.002). However, no difference in the shear moduli of individual muscle groups was identified. The glenohumeral internal rotation range exhibited a statistically significant negative correlation with the shear modulus of the inferior posterior capsule in the baseball-player group (Pearson correlation coefficient = -0.586, p = 0.022). CONCLUSION: Our findings suggest that the posterior shoulder capsule of the dominant arm in baseball players is stiffer than that in non-throwing population.

DOI： 10.1016/j.jse.2022.01.119

PubMed

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記述言語：日本語   出版者・発行元：金原出版(株)  

医中誌

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記述言語：日本語   出版者・発行元：(株)医学書院  

医中誌

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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  

医中誌

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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.foot.2022.101945

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記述言語：日本語   出版者・発行元：金原出版(株)  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Unfused accessory ossification centers in the medial ankle are sometimes misdiagnosed and should be distinguished from other bone lesions such as fracture, stress fracture, os subtibiale, or pseudoarthrosis of the medial malleolus. The purpose of this study was to report our experience in treating soccer players with bony elements in the subtibial region. METHODS: We surgically treated seven soccer players who experienced medial ankle pain with bony fragments at the tip of the medial malleolus. Their ages were between 13 and 27 years. The mean duration from symptom onset to hospital visit was 4.7 years (range: 2 months to 14 years). The bony lesion located at the anterior tip of the medial malleolus in all patients and we diagnosed the lesion as an unfused accessory ossification center. RESULTS: Three types of surgical treatments were performed in patients according to age, ossicle size, status of the epiphyseal plate, and degenerative changes around the lesion. Bony fusion was achieved in patients who underwent open reduction and fusion with bone graft. Patients who underwent focal drilling or removal of the bony fragment experienced improvement in symptoms, and all patients were allowed to resume their sports or full preinjury activities. CONCLUSION: We believe that surgery is the first-line treatment for the patients with unfused accessory ossification centers with their prolonged symptom and favorable outcomes can be expected. Bony fusion should be attempted in the patients with the large ossicle especially in their growth period.

DOI： 10.1016/j.jos.2020.09.008

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1053/j.jfas.2021.05.007

Web of Science

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The malignant potential of the musculoskeletal tumors of the foot and ankle has often been underestimated because of their rarity. The current study reviewed the clinical features of the tumors of the foot and ankle, and evaluated the tumor size via imaging-based analysis to distinguish between benign and malignant lesions. METHODS: A retrospective review was performed using the clinical records of all patients with histologically confirmed musculoskeletal tumors of the foot and ankle, treated between 1998 and 2020 at our institution. We examined the distribution of tumors, rate of unplanned excision for primary surgery, and subsequent outcomes. In addition, the tumor size was examined via magnetic resonance imaging, and the cut-off value was determined via receiver operating characteristic (ROC) curve. RESULTS: A total of 103 bone and soft tissue tumors of the foot and ankle were included, of which 78 were soft tissue tumors and 25 were bone tumors. Of the 14 cases of malignant bone and soft tissue tumors, 6 (42.9%) received unplanned excision in the primary surgery, followed by amputation in 3 cases. Tumor size of malignant soft tissue tumors was significantly larger than that of benign soft tissue tumors (47.6 mm vs. 31.0 mm, respectively, P < .001). However, the difference between benign and malignant bone tumors was not statistically significant with the numbers available. ROC curve determined that the optimum diagnostic cutoff value for soft tissue tumor size was 40 mm, with a high area under the ROC curve 0.816 (95% CI: 0.711-0.921, sensitivity 91.7%, specificity 70.5%) CONCLUSIONS: We highlighted that bone and soft tissue tumors of the foot and ankle were often misdiagnosed and initially inadequately treated. We suggest that a cutoff value of 40 mm may be a useful index for prediction of malignancy in soft tissue tumors of the foot and ankle. LEVEL OF EVIDENCE: Ⅲ.

DOI： 10.1016/j.jos.2020.08.016

PubMed

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記述言語：日本語   出版者・発行元：(株)文光堂  

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01715&link_issn=&doc_id=20210826150009&doc_link_id=%2Fag9rsige%2F2021%2F003809%2F010%2F0986b0989%26dl%3D3&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fag9rsige%2F2021%2F003809%2F010%2F0986b0989%26dl%3D3&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_4.gif

医中誌

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記述言語：日本語   出版者・発行元：日本靴医学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Manual evaluation is an important method for assessing ankle instability, but it is not quantitative. Capacitance-type sensors can be used to measure the distance on the basis of the capacitance value. We applied the sensor to the noninvasive device for measuring ankle instability and showed its utility. METHODS: First, 5 ankles embalmed by Thiel's method were used in an experiment using a cadaver. The capacitance-type sensor was fixed alongside the anterior talofibular ligament (ATFL) of a specially made brace, and the anterior drawer test was performed. The test had been performed for the intact ankle, with the ATFL transected and with both the ATFL and calcaneofibular ligament (CFL) transected. The anterior drawer distance was calculated by the sensor. Intra- and interinvestigator reliability were also analyzed.Next, as a clinical study, a brace with a sensor was fitted to 22 ankles of 20 patients with a history of ankle sprain. An anterior drawer test at a load of 150 N was conducted using a Telos stress device. The anterior drawer distances measured by the sensor and based on radiographic images were then compared. RESULTS: The mean anterior drawer distances were 3.7 ± 1.0 mm for the intact cadavers, 6.1 ± 1.6 mm with the ATFL transected (P < .001), and 7.9 ± 1.8 mm with the ATFL and CFL transected (P < .001). The intrainvestigator intraclass correlation coefficients (ICCs) were 0.862 to 0.939, and the interinvestigator ICC was 0.815. In the experiments on patients, the mean anterior drawer distance measured by the sensor was 2.9 ± 0.9 mm, and it was 2.7 ± 0.9 mm for the radiographic images. The correlation coefficient between the sensor and the radiographic images was 0.843. CONCLUSION: We quantitatively evaluated anterior drawer laxity using a capacitance-type sensor and found it had high reproducibility and strongly correlated with stress radiography measurements in patients with ankle instability. Capacitance-type sensors can be used for the safe, simple, and accurate evaluation of ankle instability.

DOI： 10.1177/1071100721996714

PubMed

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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  

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J03582&link_issn=&doc_id=20210908380009&doc_link_id=%2Fdp2sport%2F2021%2F002903%2F009%2F0321-0324%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdp2sport%2F2021%2F002903%2F009%2F0321-0324%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：日本整形外科超音波学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The nano-arthroscopic ultrasound-guided ossicle excision technique is used in the management of an unresolved Osgood-Schlatter disease. The NanoScope is inserted slightly lateral to the proximal patella tendon and moved on between the ossicle and anterior surface of the proximal tibia under ultrasonographic guidance. The 5-mm skin incision is made as a working portal on the medial side of the proximal patella tendon. The proximal border of the ossicle is clearly identified after bursectomy. Then, the ossicles are removed piece by piece using a 2-mm arthroscopic punch. During the resection, the remaining ossicle is continuously confirmed by ultrasound. Finally, the complete excision of the ossicle is shown by the nano-arthroscopic view and ultrasound. The patient is allowed to have a full weight-bearing and an unrestricted range of motion on the day of surgery. Patients are permitted to resume their sports activities without any restriction after 6 weeks. This technique is recommended to athletes who suffer from painful unresolved Osgood-Schlatter disease because of the benefits of it being a minimally invasive surgery with an early postoperative recovery.

DOI： 10.1016/j.eats.2021.02.026

PubMed

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記述言語：日本語   出版者・発行元：(公社)日本リハビリテーション医学会  

医中誌

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記述言語：日本語   出版者・発行元：(公社)日本リハビリテーション医学会  

医中誌

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記述言語：日本語   出版者・発行元：(公社)日本リハビリテーション医学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Estimation of muscle passive force from elasticity using shear wave elastography (SWE) has been reported. However, the relationship between the elasticity and passive force of human muscles has not been elucidated. This study investigated the elastic modulus-passive force relationship in human skeletal muscles at multiple sites. METHODS: Four rectus femoris (RF) muscles were dissected from a human Thiel-embalmed cadaver. Calibration weights (0-600 g in 60-g increments) were applied to the distal tendon via a pulley system, and the shear elastic modulus as an index of elasticity was measured using SWE. The shear elastic modulus of the RF was measured at the proximal, central, and distal portions. RESULTS: The results demonstrated that the relationships between the elasticity in the longitudinal direction of the muscle and the passive force were nearly linear for all tested sites, with coefficients of determination ranging from 0.813 to 0.993. CONCLUSION: Shear wave elastography may be used as an indirect method to measure the changing passive force at any site within human muscles.

DOI： 10.1007/s10396-020-01076-w

PubMed

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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  

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J03582&link_issn=&doc_id=20210514370011&doc_link_id=%2Fdp2sport%2F2021%2F002902%2F011%2F0158-0163%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdp2sport%2F2021%2F002902%2F011%2F0158-0163%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

医中誌

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記述言語：日本語   出版者・発行元：金原出版(株)  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本基礎理学療法学会  

Thiel法固定人体標本のヒト大腿直筋を対象に、筋伸長時の受動張力-筋弾性関係を筋内の複数部位で検討した。研究対象として、大腿部に損傷や変形の無いThiel法固定人体標本の1体1肢(男性、死亡時84歳)を用いた。ヒト屍体の大腿直筋の長軸方向において測定した全ての部位で受動張力とせん断弾性率の間に強い正の相関を認め、回帰式の決定係数R2はいずれの部位でも0.9以上であった。さらに、2回の弾性計測における再現性はいずれの測定部位でも変動係数CVが1%未満、級内相関係数ICCが0.99以上と先行研究と同等の高い再現性が得られた。すなわち、ヒト大腿直筋は筋腹中央部のみならず近位部および遠位部においても筋弾性を用いた受動張力の推定が高い精度で可能であることを示す結果となった。

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J05805&link_issn=&doc_id=20210319280015&doc_link_id=%2Fch1thrpy%2F2020%2F002301%2F015%2F0117-0122%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fch1thrpy%2F2020%2F002301%2F015%2F0117-0122%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Plantar callosities under lesser metatarsals are often accompanied by the hallux valgus, and the cause of callosity is thought to be associated with the foot deformity, such as the metatarsal length discrepancy, the abnormal metatarsal head height, cavus, flat foot, and rheumatoid conditions. However, it is unclear which variable is most involved in the cause of callosity in hallux valgus deformity. To clarify the factors associated with the callosity with hallux valgus deformity, we conducted multiple image assessments based on weightbearing radiography and computed tomography. A retrospective review was performed based on the collection of clinical records from all patients with hallux valgus treated from 2010 to 2019 in our institution. We measured the hallux valgus angle, intermetatarsal angles, calcaneal pitch angles, talo-first metatarsal angles, metatarsal length, metatarsal head height, first metatarsal pronation angles, and sesamoid position with weightbearing radiography and computed tomography. We analyzed the relation between callosity formation and imaging assessments using univariate and multivariate logistic regression models. Fifty feet were retrospectively evaluated, and multiple logistic analyses by the stepwise method revealed that the first metatarsal-lateral-sesamoid distance was the only radiographical variable associated with callosity formation among all the tested variables (p < .001). As the grade of the callosity became more severe, the lateral shift of the lateral sesamoid increased. The position of the sesamoid bone appears to have a critical role in the assessment and choice of treatment protocols and further research needs to be conducted on the relationship with the position of sesamoid bone to elucidate the mechanism of callus formation.

DOI： 10.1053/j.jfas.2021.05.007

PubMed

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：日本語   出版者・発行元：(株)メジカルビュー社  

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00282&link_issn=&doc_id=20201120230013&doc_link_id=10.18885%2FJJS.0000000481&url=https%3A%2F%2Fdoi.org%2F10.18885%2FJJS.0000000481&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

医中誌

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記述言語：日本語   出版者・発行元：(公社)日本義肢装具士協会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The shoulder is a uniquely complex large joint. Effective and safe physical therapy efforts towards rehabilitating injured and repaired shoulders requires a thorough understanding of shoulder mechanics from both generalized and very specific perspectives. Numerous biomechanical studies have been published on the shoulder. None of the studies, to our knowledge, considered the strain of the deep layers of the supraspinatus tendon for scapular plane elevation. METHODS: Ten unilateral fresh-frozen human cadaveric specimens were used for the study. Scapular plane angles ranging from -10 to 30 degrees were evaluated for tensile loads, ranging from 0 to 120 Newtons, exerted on the supraspinatus tendon. Strain measurements that specifically targeted the deep layer of the supraspinatus tendon during tensile loading were recorded. FINDINGS: Strains recorded in the supraspinatus deep layer while increasing tendon force of the supraspinatus were significant for isometric gleno-humeral elevation of 30° and 20°. The response of strain to tendon force was less pronounced for 10° or less of gleno-humeral elevation. INTERPRETATION: When performing isometric shoulder exercise regimens, rotator cuff forces and both surface and deep tendon strain, relative to scapular positioning, are relevant and should be considered.

DOI： 10.1016/j.clinbiomech.2020.105160

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In the general population, the flexor hallucis longus (FHL) often has tendinous slips to lesser toes and the number of FHL slips varies between individuals. The purpose of this study was to investigate the relationship between the number of FHL tendinous slips in an individual foot and its toe flexor strength. METHODS: Forty healthy men were included in the study. The FHL branch test was used to assess each subject for the number of FHL tendinous slips. Toe flexor strength in each toe was measured using a force gauge. A two-way ANOVA was used to compare toe flexor strength between groups classified according to the number of FHL slips. RESULTS: The group of subjects with FHL branching to the second toe was the most common (20/40). The toe flexor strength ratio of the third toe was significantly lower in feet lacking FHL branching to the third toe than in those feet which did have branching to the third toe (P = 0.005). CONCLUSIONS: Toe flexor strength was affected by FHL tendinous slips. Considering the number of the FHL tendinous slips an individual foot has may be useful in clinical practice for rehabilitation or training of toe flexor muscles.

DOI： 10.1016/j.fas.2020.11.002

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：Springer Science and Business Media LLC  

The high prevalence of foot pathologies in women and the elderly could be associated with gender and age difference in the morphology of the foot, particularly the morphology of the keystone of the foot, the talus. The present study investigated the orientation and curvature of the three articular surfaces of the talus in relation to sex and age based on computer tomography (CT), to identify possible morphological factors of the higher prevalence of foot disorders in women and elderly. Fifty-six participants were included in this study. The orientations of the talocrural, subtalar, and talonavicular joints were quantified three-dimensionally by calculating normal and principal axes of the articular surfaces defined by planar approximation. The curvature radii of the articular surfaces were quantified by cylindrical and spherical approximations. The talonavicular surface was significantly more twisted in the frontal plane and less adducted in the transverse plane in females than in males. With aging, the subtalar articular surface was significantly facing more posteriorly. Moreover, it was found that the curvature radii of the trochlea and navicular articular surfaces significantly increased with aging, indicating a flattening of these surfaces. The identified changes in the talar morphology with aging could potentially lead to a higher prevalence of foot disorders in the elderly.

その他リンク： http://link.springer.com/article/10.1007/s12565-020-00585-5/fulltext.html

DOI： 10.1007/s12565-020-00585-5

PubMed

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記述言語：日本語   出版者・発行元：(株)医学書院  

医中誌

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記述言語：日本語   出版者・発行元：(公社)日本超音波医学会  

医中誌

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Some recent studies have reported the role of the posterior malleolus as an attachment of the posterior-inferior tibiofibular ligament (PITFL) and suggested that even a small fragment should be fixed. However, there are few anatomic studies of the tibial plafond attachment of the PITFL. METHODS: Seven Thiel-embalmed ankles were obtained. The margin of the distal tibial joint surface and the attachments of the superficial fiber of the PITFL (sPITFL) and the deep fiber (dPITFL) were identified. In the frontal view, the percentages of the attachments of the sPITFL and dPITFL of the mediolateral dimension of the posterior tibial plafond were measured. In the lateral view, the line that started from the proximal margin of the attachment of the sPITFL and parallel to the tibial axis was drawn, and the distance between that line and the posterior edge of the joint surface was measured (AP distance of the sPITFL). Then, the percentage of the AP distance of the sPITFL of the joint surface in the anteroposterior dimension of the tibial plafond was measured. RESULTS: In the frontal view, the mediolateral distance of the attachment of the sPITFL was 5.0 mm, and that of the dPITFL was 19.5 mm. The percentage of the attachment of the sPITFL on the tibial plafond was 20.6%, and that of the dPITFL was 78.2%. In the lateral view, the average AP distance of the sPITFL was 0.5 mm, and the percentage in the anteroposterior dimension of the tibial plafond was 1.7%. CONCLUSION: The PITFL was attached to less than 10% of the anteroposterior dimension of the tibial plafond in most ankles. Conversely, the PITFL attached widely in the mediolateral dimension. CLINICAL RELEVANCE: This study suggests that the size of the posterior malleolar fragment in the mediolateral dimension could help estimate how much of the PITFL attaches to the fragment which may have implications for ankle stability.

DOI： 10.1177/2473011420945689

PubMed

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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  

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J05471&link_issn=&doc_id=20201007150032&doc_link_id=%2Fcx9biomc%2F2020%2F004100%2F033%2F0197-0202%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcx9biomc%2F2020%2F004100%2F033%2F0197-0202%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Stretching is often used to prevent and treat posterior shoulder capsule tightness; however, the most effective stretching positions are not clearly defined. The purpose of this study was to identify the stretching positions that specifically applied the greatest passive tension on the posterior shoulder capsule by evaluating the elastic characteristics of posterior capsules and muscles in various stretching positions using ultrasound shear wave elastography (SWE). METHODS: We evaluated 9 fresh-frozen shoulders (mean age 86.6 ± 7.7 years) without osteoarthritis or rotator cuff tears. All posterior shoulder tissues were preserved intact. Shear moduli of the middle and inferior posterior shoulder capsules and the posterior shoulder muscles were evaluated using SWE. We obtained shear modulus measurements in 9 stretching positions using a combination of glenohumeral elevation planes and angles (frontal, sagittal, scapular; -30°, 0°, 30°, 60°, respectively). A 4-Nm torque for shoulder internal rotation or horizontal adduction was applied in each position. We also measured shear moduli in the resting position (0° elevation with neutral shoulder internal/external rotation). We compared the shear moduli of all stretching and resting positions using 1-way repeated measures analysis of variance (P < .05). In addition, we compared the shear modulus in 2 positions (ie, resting and each stretching) among tissues (ie, capsules and muscles) with repeated measures using 2-way analysis of variance (P < .05). RESULTS: Shear modulus values for the middle posterior capsules in "internal rotation at 30° in scapular plane elevation" (28.7 ± 14.3 kPa, P = .01) and in "horizontal adduction at 60° of elevation" (31.1 ± 13.1 kPa, P < .001) were significantly higher than that of the resting position (11.0 ± 7.3 kPa). The shear modulus value for the inferior posterior capsule in "internal rotation at 30° of flexion" was significantly higher than that of the resting position (39.0 ± 17.3 vs. 15.4 ± 13.9 kPa, respectively; P = .004). Additionally, the shear modulus values for the posterior capsules in "internal rotation at 30° in scapular plane elevation and flexion" were significantly higher than that of the posterior shoulder muscles. CONCLUSION: Effective middle posterior shoulder capsule stretching positions were shoulder "internal rotation at 30° of scapular plane elevation" and "horizontal adduction at 60° of elevation." Shoulder "internal rotation at 30° of flexion" was the most effective position for the inferior posterior shoulder capsule. Stretching in these positions could relieve posterior shoulder capsule tightness and contribute to the prevention and treatment of throwing injuries of the shoulder.

DOI： 10.1016/j.jse.2020.08.021

PubMed

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The flexor hallucis longus (FHL) muscle often has a tendinous slip with a variable number of branches. We aimed at developing the FHL branch test to determine the number of FHL branches. METHODS: In anatomical validation study, 6 intact cadavers were used. The toe flexion angles were measured while the FHL and flexor digitorum longus (FDL) were manually pulled individually. For electrophysiological studies, 4 healthy men participated. The FHL was electrically stimulated, and electromyography (EMG) of the FHL and FDL were recorded during the FHL branch test. RESULTS: The toe flexion angles' changes in the FHL pulling condition were equivalent with pulling FDL in toes with FHL branching. The electrical stimulation of the FHL produced similar flexion as the FHL branch test. EMG of the FHL was higher than FDL during the FHL branch test (p=0.036). CONCLUSIONS: The FHL branch test could be used to evaluate the number of FHL branches.

DOI： 10.1016/j.fas.2019.08.003

PubMed

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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  

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J03582&link_issn=&doc_id=20200917570006&doc_link_id=2020%2Ffiles%2F28-3%2F441-446&url=https%3A%2F%2Fwww.rinspo.jp%2Fjournal%2F2020%2Ffiles%2F28-3%2F441-446.pdf&type=%93%FA%96%7B%97%D5%8F%B0%83X%83%7C%81%5B%83c%88%E3%8Aw%89%EF%8E%8F&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00032_3.gif

医中誌

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記述言語：日本語   出版者・発行元：(株)メジカルビュー社  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Assessment of syndesmotic instability is not precise with existing evaluation methods. This study was conducted to investigate the use of a ball-tipped probe under arthroscopy for quantitative assessment of tibiofibular space widening in a syndesmosis injury model. The test specimens were 5 uninjured ankles from Thiel-fixed cadavers of 2 male subjects and 3 female subjects of mean age of 82.4 years at death. The ball-tipped probe consisted of a metal probe having a ball at each end with diameters ranging from of 1.5 mm to 5.0 mm, in increments of 0.5 mm. The tibiofibular joint was observed arthroscopically as the largest-diameter ball probe as possible was inserted into its anterior third, middle, or posterior third portion with the ankle in natural plantarflexion or under external rotational stress. These measurements were performed for the uninjured ankle and then performed following Bassett's ligament sectioning, anterior inferior tibiofibular ligament sectioning, interosseous membrane distal 15 cm sectioning, or deltoid ligament, and posterior inferior tibiofibular ligament sectioning, with the sections added in this sequence and each followed by a similar assessment. The results of quantitative assessment of tibiofibular space widening with the ball-tipped probe in the syndesmosis injury model under arthroscopy were that the maximum possible diameter of ball probe that could be inserted was 1.5 to 2.0 mm in the uninjured state, 3.0 to 3.5 mm in the sectioned anterior inferior tibiofibular ligament model, and 5.0 mm in the severe-state model. The ball probe can serve as an effective tool for quantitative assessment of the intraoperative instability in cases of syndesmosis injury.

DOI： 10.1053/j.jfas.2020.03.024

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1053/j.jfas.2019.12.002

Web of Science

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記述言語：日本語   出版者・発行元：金原出版(株)  

医中誌

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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：NLM (Medline)  

DOI： 10.2106/JBJS.CC.19.00058

PubMed

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記述言語：日本語   出版者・発行元：金原出版(株)  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: The aim of the study was to investigate the effects of navigation-based varus or axial rotational alignment through knee flexion on patient reported outcomes or the maximum flexion angle of unicompartmental knee arthroplasty (UKA). Methods: Data were retrospectively collected from 46 knees that underwent UKA for medial unicompartmental knee osteoarthritis. An image-free knee navigation system was used in all cases, and intraoperative varus and axial rotational alignment at every knee flexion angle were recorded before and after implantation. All patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS) at final follow-up. By varus or valgus at 0° knee flexion, the knees were subdivided into two groups (varus at 0° group, varus above the median value; neutral at 0° group, varus equal to or below the median value). By varus or valgus at 90° knee flexion, patients were similarly subdivided into two groups (varus at 90° group; neutral at 90° group). The maximum knee flexion angle was measured 3 months after surgery. Results: There were no differences in the KOOS between the neutral at 0° group and the varus at 0° group. However, the KOOS activity score (79 ± 17 vs 69 ± 16, p = 0.02) and the KOOS total score (72 ± 17 vs 65 ± 15, p = 0.03) of the neutral at 90° group were better than those of the varus at 90° group. The alignment and the maximum knee flexion angle 3 months after surgery were not correlated. Conclusion: Varus at 0° knee flexion and axial rotational alignment did not affect the clinical outcomes of UKA. Patient reported outcomes was better for the neutral knees with less varus at 90° knee flexion than for varus knees.

DOI： 10.1016/j.asmart.2020.01.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: The shape of the talus determines the positional and kinematic features of the subtalar, talonavicular, and talocrural joints during walking. Thus, detailed knowledge of the pattern of sexual dimorphism of the human talus may be useful for revealing the pathogenetic mechanism of foot and knee disorders, which are more prevalent in females. The aim of this study was to characterize and visualize the three-dimensional shape variations of the talus in relation to sex and age using geometric morphometrics. MATERIALS AND METHODS: Computed tomography images of 56 ft without talar injuries or disorders were used in this study. Thirty-seven anatomical landmarks were identified on a bone model of the talus to calculate principal components (PCs) of shape variations among specimens. PC scores were compared between sexes, and their correlations with age were also investigated. RESULTS: The female talus had a longer neck and narrower head width than the male talus. The superior trochlea was tilted more laterally in the frontal plane in females. Furthermore, the female talar head was more twisted and was more elongated in the dorsoplantar direction. CONCLUSIONS: Morphological features of the talus in females could alter the subtalar and talonavicular joint kinematics during walking and could be a structural factor in the pathogenetic mechanism underlying foot and knee disorders. This study contributes to the comprehensive understanding of shape variations in the human talus. This article is protected by copyright. All rights reserved.

DOI： 10.1002/ca.23588

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1053/j.jfas.2019.09.012

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although a variety of surgical procedures for anterior talofibular ligament (ATFL) reconstruction have been reported, the effect of initial graft tension during ATFL reconstruction remains unclear. PURPOSE/HYPOTHESIS: This study investigated the effects of initial graft tension on ATFL reconstruction. We hypothesized that a high degree of initial graft tension would cause abnormal kinematics and laxity. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve cadaveric ankles were tested with a robotic system with 6 degrees of freedom to apply passive plantarflexion and dorsiflexion motions and a multidirectional load. A repeated measures experiment was designed with the intact ATFL, transected ATFL, and reconstructed ATFL at initial tension conditions of 10, 30, 50, and 70 N. The 3-dimensional path and reconstructed graft tension were simultaneously recorded, and the in situ forces of the ATFL and reconstructed graft were calculated with the principle of superposition. RESULTS: Initial tension of 10 N was sufficient to imitate normal ankle kinematics and laxity, which were not significantly different when compared with those of the intact ankles. The in situ force on the reconstructed graft tended to increase as the initial tension increased. In situ force on the reconstructed graft >30 N was significantly greater than that of intact ankles. The in situ force on the ATFL was 19 N at 30° of plantarflexion. In situ forces of 21.9, 30.4, 38.2, and 46.8 N were observed at initial tensions of 10, 30, 50, and 70 N, respectively, at 30° of plantarflexion. CONCLUSION: Approximate ankle kinematic patterns and sufficient laxity, even with an initial tension of 10 N, could be obtained immediately after ATFL reconstruction. Moreover, excessive initial graft tension during ATFL reconstruction caused excessive in situ force on the reconstructed graft. CLINICAL RELEVANCE: This study revealed the effects of initial graft tension during ATFL reconstruction. These data suggest that excessive tension during ATFL reconstruction should be avoided to ensure restoration of normal ankle motion.

DOI： 10.1177/0363546520902725

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Periprosthetic bone quality is one of the most important factors preventing early prosthesis migration and long-term failure. Although denosumab, which binds to the receptor activator of nuclear factor kappa-B ligand (RANKL), has been linked with periprosthetic bone mineral density (BMD), the effectiveness of denosumab against bone loss remains unclear. We hypothesized that denosumab treatment after total knee arthroplasty (TKA) could prevent periprosthetic bone resorption. METHODS: In this prospective cohort study, 28 patients with primary knee osteoarthritis were divided into two groups: denosumab (denosumab and vitamin D) and control (vitamin D only) groups. All patients underwent TKA with the same implant model and received medication after surgery. We used dual-energy X-ray absorptiometry to measure periprosthetic BMD after TKA. RESULTS: In the control group, the BMD of the proximal medial tibia decreased drastically at 12 months after TKA (-19.7%). Denosumab treatment significantly preserved this BMD loss (0.7%). The linear regression analysis revealed that denosumab intervention had the highest significantly positive relationship with BMD. CONCLUSIONS: Our results indicate that denosumab treatment significantly reduces periprosthetic BMD loss, even at the early stages after TKA. This therapeutic strategy may facilitate early stable fixation of the prosthesis which, in turn, may help to prevent early implant migration and reduce the need for revision surgery.

DOI： 10.1016/j.knee.2019.12.010

PubMed

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記述言語：日本語   出版者・発行元：金原出版(株)  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Although shear wave elastography (SWE) has been used to indirectly measure passive tension in muscle tissues, it is unknown whether SWE can adequately evaluate passive tension in capsule tissues. This study investigated the relationship between the shear modulus and passive tension in the posterior shoulder capsule using SWE. Ten posterior middle and ten posterior inferior shoulder capsules were dissected from ten fresh-frozen cadavers; humeral head-capsule-glenoid specimens were created from each capsule. The humeral head and glenoid were immobilized with clamps in a custom-built device. Loads (0-400 g, in 25-g increments) were applied to each capsule via a pulley system; elasticity was simultaneously measured using SWE. The elasticity-load relationship of each tested capsule was analyzed by fitting a least-squares regression line to the data. Elasticity change due to creep or hysteresis effects was evaluated by comparing the elastic modulus for a 100-g load during and after the stepwise application of the loads. The observed relationship between the shear modulus and passive capsule tension was highly linear for all twenty tested capsules (p < 0.01). The mean coefficient of determination was 0.882 ± 0.075 and 0.901 ± 0.050 for the posterior middle and posterior inferior capsules, respectively. There was no difference in the shear modulus between the two 100-g load assessments for both the posterior middle (p = 0.205) and posterior inferior capsules (p = 0.161). Thus, SWE is a valid and useful method for indirectly evaluating the change in the passive tension under loading in specific posterior shoulder capsule.

DOI： 10.1016/j.jbiomech.2019.109498

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We developed a new internal fixator: a rigid T: -shaped plate with locking screws and wedge-shaped spacer block for high tibial osteotomy. The purpose of the present study was to evaluate the radiographic outcome of opening-wedge high tibial osteotomy (OWHTO) using this new internal fixator. Sixty OWHTOs were performed in patients with medial compartment osteoarthritis and varus deformity (28 males and 23 females). Patients' mean age was 60.4 years. Preoperative and postoperative radiographs were obtained. The paired t-test was used to evaluate the differences over time with respect to radiographic variables. Union of the osteotomy gap was obtained in all patients, and no implant breakage was found. On anterior-posterior radiographs, a significant difference was observed (p < 0.01) between the preoperative and postoperative mean values of femorotibial angles (179.6 ± 3.2 vs. 170.6 ± 2.5 degrees), weight-bearing line ratios (23.8 ± 13.5 vs. 60.5 ± 11.5%), anatomical medial proximal tibial angles (84.8 ± 2.5 vs. 91.0 ± 2.6 degrees), and joint line coverage angles (3.6 ± 2.0 vs. 2.4 ± 1.7 degrees). On lateral radiographs, posterior tibial slopes were 11.5 ± 3.9 degrees preoperatively and 12.2 ± 4.0 degrees postoperatively (p < 0.01), and Insall-Salvati ratios were 1.04 ± 0.12 preoperatively and 1.06 ± 0.13 postoperatively (p = 0.24). Performing OWHTO using a new internal fixator with a wedge-shaped spacer achieves adequate correction of lower limb alignment without implant-related complications. This is a Level IV, case series study.

DOI： 10.1055/s-0039-1700977

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: With ultrasonography or 2D magnetic resonance imaging (MRI) of the lateral ankle ligament, it is particularly difficult to show the entire calcaneofibular ligament (CFL). The purpose of this study was to evaluate the morphological characteristics of the lateral ankle ligaments in injured patients and uninjured controls using 3D MRI. METHODS: A total of 64 ankles of 59 healthy volunteers and lateral ligament injury patients (mean age of 32.4 years) were examined. The 64 ankles included a healthy group of 11 ankles, an acute injury group of 12 ankles that underwent MRI a month after injury, and a chronic injury group of 41 ankles that underwent MRI more than 3 months after injury. Using a 3.0-T MRI system, imaging was done with fast imaging employing steady-state acquisition cycled phases. Oblique sagittal images that most clearly depicted the entire anterior talofibular ligament (ATFL) and CFL were prepared manually and evaluated using a workstation. RESULTS: In the healthy group, both the ATFL and CFL were clearly and entirely visualized. The mean width in the central portion was 4.0 ± 1.0 mm in the ATFL and 4.8 ± 0.6 mm in the CFL. 3D MRI in the acute injury group showed findings of diffuse swelling with hyperintensity in the ATFL of all patients. The CFL in 7 of 12 ankles showed findings of diffuse swelling with hyperintensity. In the chronic injury group, morphological abnormalities of the ATFL were seen in 19 of 41 ankles. The ligament signal disappeared in 2 ankles, thinned in 4 ankles, and showed swelling in 13 ankles. Morphological abnormalities of the CFL were seen in 17 of 41 ankles. The ligament signal disappeared in 1 ankle, thinned in 2 ankles, and showed swelling in 14 ankles. CONCLUSION: 3D MRI may be a useful modality to visualize both the ATFL and the CFL.

DOI： 10.1016/j.jos.2019.02.018

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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掲載種別：研究論文（学術雑誌）  

その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ca.23501

DOI： 10.1002/ca.23501

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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  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本整形外科スポーツ医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本整形外科スポーツ医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本整形外科スポーツ医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本整形外科スポーツ医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本整形外科スポーツ医学会  

医中誌

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記述言語：日本語   出版者・発行元：(一社)日本足の外科学会  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/0363546518820527

PubMed

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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  

医中誌

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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  

医中誌

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Low tibial osteotomy is an effective joint-preserving surgery for ankle arthritis. However, poor postoperative wound healing, infection, and delayed or non-union of bones remain significant concerns. We describe a modified distal tibial oblique osteotomy procedure and report preliminary results for varus ankle arthritis. METHODS: The osteotomy path consisted of an oblique doglegged line from the lateral end of the distal tibia to a proximal point about one-third from the lateral edge and continuing along an arc defined by virtual coronal-plane rotation of the doglegged line to the medial edge. After osteotomy, the distal tibial fragment was rotated distally in the coronal plane for realignment while maintaining contact with the proximal tibia and the distal tibial fragment. The resulting wedge-shaped gap was filled with artificial bone blocks and tibial bone projecting medially from rotation. A locking plate was then applied for stabilization. We evaluated 7 ankles from 6 osteoarthritis patients both clinically and radiographically following this procedure. RESULTS: Bone union was achieved within 3 months for all patients. The Japanese Society for Surgery of the Foot ankle-hindfoot scale improved from a mean of 38.4 points preoperatively to 85.7 points at the latest follow-up. No wound healing problems, infections, or nerve disturbances were observed. Multiple radiographic parameters were also improved following the operation. CONCLUSIONS: This procedure maintains close bone contact for better postoperative union, obviates the need for iliac bone harvesting, and reduces tension on medial soft tissue. We believe these modifications are potential advantages for achieving stable results in patients with ankle osteoarthritis.

DOI： 10.1016/j.jos.2018.08.020

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Evaluating images of the lateral ligament of the ankle is not easy, and evaluation of the calcaneofibular ligament (CFL) in particular is difficult. We prospectively conducted morphological measurements of the CFL in different ankle positions and obtain basic data for use in functional assessment of the CFL, diagnosis of CFL injury, and determination of treatment effects. METHODS: The subjects were ten healthy volunteers (ten ankles) with a mean age of 27.8 years and no history of ankle disease. Imaging was done using a 3-T magnetic resonance imaging (MRI) machine and fast imaging employing steady-state acquisition cycled phases (FIESTA-C), a three-dimensional (3D) sequence, with the ankle in a neutral position, maximum dorsiflexion, and maximum plantar flexion. 3D images of the CFL, peroneal muscle tendons, fibula, and calcaneus were prepared at a workstation, and morphological measurements of the CFL were made. RESULTS: In all positions, the CFL showed a gently curving course with the peroneal muscle tendons as a fulcrum. The tortuosity angle was significantly smaller in plantar flexion (30.0° ± 7.4°) than in the neutral position (41.7° ± 8.3°). CONCLUSIONS: 3D MRI sequences showed that, in all positions, the CFL curved due to the influence of the peroneal muscle tendons. With maximum plantar flexion, the CFL tortuosity angle was small, which was thought to have been due to the tension in the CFL.

DOI： 10.1007/s00276-018-2152-8

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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/s00276-018-2098-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We describe the medical services provided and report the injuries and illnesses that occurred at the eighth Asian Winter Games 2017. METHODS: A total of 2010 athletes and team officials from 32 National Olympic Committees and 2 guest countries attended this event; medical services were provided for 16 days. Medical data (medical care and physiotherapy) were collected for the same period by the organising committee for athletes and non-athletes (team officials, workforce, media and spectators) and recorded on the electronic medical record system at the medical rooms in the venues and the team residences. RESULTS: We recorded 745 medical encounters (medical care, 443; physiotherapy, 302), of which 549 (74%) were among athletes. There were 214 injuries as well as 144 illnesses and other medical conditions. Of the 1164 athletes, 549 (47%) utilised the services. Ice hockey, snowboarding and alpine skiing had high rate of medical encounters. More than half of the delegations were not accompanied by team doctor, and rate of medical encounters was high in these teams. The vast majority of patients transferred to hospital for further care were mostly athletes (n=36 out of 41), mostly alpine skiers and ice hockey players. CONCLUSION: Injuries and illnesses varied depending on NOC medical staffing and sport events. These data will serve organisers of medical and physiotherapy services in the Asian Winter Games and similar large events.

DOI： 10.1136/bjsports-2018-099061

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose: Ankle osteoarthritis (OA) causes significant pain and debilitation; yet, its underlying mechanisms remain unclear. Clinically, hyaluronic acid (HA) is widely used to treat OA. The present study aimed to investigate the roles of HA in pain-related behavior, joint function, swelling, and pathological changes in cartilage in a rat model of monoiodoacetate (MIA)-induced ankle OA. Materials and methods: Male Sprague Dawley rats were assigned to three experimental groups as follows: 1) MIA rats injected with 1 mg MIA in the right tibiotarsal joint for two consecutive days; 2) sham rats injected with saline instead of MIA; and 3) MIA-HA rats injected with HA in the tibiotarsal joint at 7, 14, and 21 days after MIA injection. Joint swelling, range of motion (ROM), and pain-related behavior were evaluated 1 day before and on the 7th, 14th, 21st, and 28th day after MIA or saline injection. Pathological changes in the ankle joint were assessed 28 days after MIA or saline injection. Results: No significant difference in the degree of ankle swelling or ROM reduction was observed between MIA rats and MIA-HA rats. However, compared with those in MIA rats, mechanical and thermal hypersensitivity was significantly reduced and stride length significantly improved in MIA-HA rats. Histologic analysis revealed that cartilage degeneration was significantly suppressed in MIA-HA rats compared with that in MIA rats, reflecting the chondroprotective effects of HA. Conclusion: HA improved pain-related behavior and stride length and suppressed MIA-induced cartilage degeneration. HA may thus inhibit OA progression and suppress peripheral and/or central sensitization.

DOI： 10.2147/JPR.S186413

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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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  

医中誌

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