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：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：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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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：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：(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 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）  

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

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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：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

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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

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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：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

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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: 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

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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

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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

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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：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：日本靴医学会  

医中誌

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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：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：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：(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：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：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：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：(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  

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：(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：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：(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：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：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：(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：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

PubMed

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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

Web of Science

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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

PubMed

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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

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

PubMed

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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

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00276-018-2098-x

PubMed

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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

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：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: Suture-button (SB) fixation has been widely performed for syndesmosis injuries, but it has been reported unstable in some biomechanical studies. The purpose of this study was to evaluate the stability of the syndesmosis using SB fixation with anterior inferior tibiofibular ligament augmentation using suture-tape (ST). METHODS: Eight normal fresh-frozen cadaveric legs were used. After initial tests of intact and injured models, SB fixation, SB fixation with ST augmentation, ST augmentation alone, and screw fixation were performed sequentially for each specimen. Loading tests stimulating dorsiflexion, inversion, and external rotation of the ankle joint were performed for each model. The tibiofibular diastasis (TFD) and the fibular rotational angle related to the tibia (FRA) were measured using a magnetic tracking system. FINDINGS: In the injured model, both TFD and FRA increased significantly compared with the intact model in all directions (P < .05). In the SB fixation model, TFD and FRA generally showed significant increases (P < .05, except for TFD in external rotation). In the SB fixation with ST augmentation model and ST augmentation alone, TFD and FRA were not significantly different compared with the intact model (P > .05). In the screw fixation model, FRA with inversion force at the ankle was significantly decreased compared with the intact model (P = .027). INTERPRETATION: SB fixation alone did not provide stability of the syndesmosis, and screw fixation became too rigid compared with the intact model. Using ST augmentation achieved dynamic stability similar to the intact model for syndesmotic injuries.

DOI： 10.1016/j.clinbiomech.2018.10.014

PubMed

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記述言語：日本語   出版者・発行元：日本基礎理学療法学雑誌編集委員会  

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J05805&link_issn=&doc_id=20190121420011&doc_link_id=%2Fch1thrpy%2F2018%2F002101%2F011%2F0088-0094%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fch1thrpy%2F2018%2F002101%2F011%2F0088-0094%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：(一社)日本内視鏡外科学会  

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：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: Although a variety of surgical procedures for lateral ankle ligament reconstruction have frequently been reported, little is known about the effects of initial graft tension. Purpose/Hypothesis: The purpose was to investigate the effects of initial graft tension in calcaneofibular ligament (CFL) reconstruction. It was hypothesized that a high degree of initial graft tension would cause abnormal kinematics, laxity, and excessive graft tension. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve cadaveric ankles were tested with a 6 degrees of freedom robotic system to apply passive plantarflexion-dorsiflexion motion and multidirectional loads. A repeated-measures experiment was designed with the CFL intact, CFL transected, and CFL reconstructed with 4 initial tension conditions (10, 30, 50, and 70 N). The 3-dimensional path and reconstructed graft tension were simultaneously recorded. RESULTS: The calcaneus in CFL reconstruction with an initial tension of 70 N had the most eversion relative to the intact condition (mean eversion translations of 1.2, 3.0, 5.0, and 6.2 mm were observed at initial tensions of 10, 30, 50, and 70 N, respectively). The calcaneus also moved more posteriorly with external rotation as the initial tension increased. The reconstructed graft tension tended to increase as the initial tension increased. CONCLUSION: Ankle kinematic patterns and laxity after CFL reconstruction tended to become more abnormal as the initial graft tension increased at the time of surgery. Moreover, excessive initial graft tension caused excessive tension on the reconstructed graft. CLINICAL RELEVANCE: This study indicated the importance of initial graft tension during CFL reconstruction. Overtensioning during CFL reconstruction should be avoided to imitate a normal ankle.

DOI： 10.1177/0363546518790254

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Bicruciate-retaining total knee arthroplasty (BCR-TKA) is attracting attention because of the functional and satisfaction outcomes associated with keeping the anterior cruciate ligament (ACL) intact. However, knowledge of the functional importance of the ACL after BCR-TKA is limited. We performed a biomechanical investigation of ACL function following BCR-TKA compared with that in the intact knee. METHODS: We investigated 8 fresh-frozen human cadaveric knees using a 6-degrees-of-freedom robotic system that allowed natural joint motion. Three knee states-intact knee, BCR-TKA, and BCR-TKA with ACL transection (BCR-TKA + ACLT)-were evaluated. For each knee state, the kinematics during passive flexion-extension motion (from 0° to 120°) and anteroposterior laxity at 0°, 15°, 30°, 60°, and 90° of flexion in response to a 100-N load were investigated. The recorded knee motions of the intact and BCR-TKA knees during each test were repeated after ACLT to calculate the ACL in situ force. RESULTS: The femur in the BCR-TKA group translated posteriorly and rotated externally during passive knee flexion and was in an anterior position compared with the femur in the intact-knee state. After ACLT, the femur translated posteriorly, compared with the BCR-TKA group, at 0° and 10° (p < 0.05). The anteroposterior laxities of the BCR-TKA and intact knees were comparable at all flexion angles and increased 2-fold or more after ACLT (p < 0.01). The ACL in situ force in the BCR-TKA knees was 2-fold to 6-fold higher than that in the intact knees at 0°, 15°, 90°, and 120° during a passive path (p < 0.05) and equivalent to that in the intact knees under anterior loading. CONCLUSIONS: The preserved ACL in the BCR-TKA knees was functional, like the ACL in the intact knees, under anterior tibial loading and contributed to good anteroposterior stability. However, the kinematics and ACL in situ force differed between the intact and BCR-TKA knees during passive flexion-extension movements. CLINICAL RELEVANCE: Surgeons may not be able to prevent overtensioning of the ACL during a standardized BCR-TKA procedure, which could potentially limit range of motion.

DOI： 10.2106/JBJS.18.00099

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

It has been reported that an accelerometer-based portable navigation device can achieve accurate bone cuts, but there have been few studies of clinical outcomes after total knee arthroplasty (TKA) using such a device. The aim of this study was to evaluate lower limb alignment and clinical outcomes after TKA using an accelerometer-based portable navigation device. Thirty-five patients (40 knees) underwent primary TKAs using an accelerometer-based portable navigation device. Postoperative radiographic assessments included the hip-knee-ankle angle, femoral component angle (FCA), and tibial component angle (TCA) in the coronal plane and the sagittal FCA and sagittal TCA in the sagittal plane. Clinical outcomes were evaluated by the Japanese Orthopedic Association score for osteoarthritic knees, Japanese Knee Osteoarthritis Measure, and the New Knee Society Score. The frequency of outliers (>3 degrees) was 10% for the hip-knee-ankle angle, 8% for FCA, 0% for TCA, 19% for sagittal FCA, and 9% for sagittal TCA. The Japanese Orthopedic Association score and Japanese Knee Osteoarthritis Measure were significantly improved postoperatively. The postoperative New Knee Society Score was 67.2% for symptoms, 50.3% for satisfaction, 58.6% for expectation, and 44.1% for function. TKA using an accelerometer-based portable navigation device achieved good results for both lower limb alignment and clinical outcomes.

DOI： 10.1016/j.artd.2017.11.012

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：(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：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：金原出版(株)  

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00767&link_issn=&doc_id=20180613120018&doc_link_id=10.18888%2Fse.0000000518&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fse.0000000518&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：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: The purpose of this study was to evaluate the relationship between the lateral malleolus view under ankle arthroscopy and the anterior talofibular ligament (ATFL) attachment site. METHODS: Seven normal ankles from Thiel-embalmed cadavers were investigated. Ankle arthroscopy was performed using a 2.7 mm-diameter, 30-degree, oblique-viewing endoscope. An antero-medial portal (AM), a medial midline portal (MML), and an antero-central portal (AC) were created in order, and the ankle arthroscope was inserted. The lateral malleolus was visualized as distally as possible, and the site that appeared to be the distal margin was marked with a 1.5 mm-diameter K-wire. Visualization with arthroscopy was carried out from all portals to mark the distal margin, and the ankle was subsequently exposed to directly measure the distance from the center of the ATFL attachment site at the fibula to each marking. RESULTS: The distances from the ATFL attachment site to the markings made under arthroscopy from the AM, MML, and AC portals were 10.4 ± 2.6 mm, 7.4 ± 1.9 mm, and 7.3 ± 1.9 mm, respectively. Compared to markings made from the MML or AC portal, the marking made from the AM portal was significantly further away from the ATFL attachment site. CONCLUSIONS: A typical ankle arthroscopy portal may not allow complete visualization of the tip of the lateral malleolus, indicating that it may not be feasible to thoroughly observe the ATFL attachment site. It is necessary to perform arthroscopic surgeries with the understanding that the distal margin of the lateral malleolus that appears under ankle arthroscopy is 7-10 mm proximal to the ATFL attachment site.

DOI： 10.1016/j.jos.2018.01.002

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：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：(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：(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=2018&ichushi_jid=J03582&link_issn=&doc_id=20180207440017&doc_link_id=%2Fdp2sport%2F2018%2F002601%2F017%2F0109-0114%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdp2sport%2F2018%2F002601%2F017%2F0109-0114%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）  

DOI： 10.1053/j.jfas.2017.07.007

Web of Science

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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: Patient-specific instrumentation (PSI) is attracting attention as a mechanical method of ensuring the accuracy of osteotomy during total knee arthroplasty (TKA). Few studies have focused on preoperative plans; thus, it is unclear how often initial plans have to be corrected preoperatively and intraoperatively. We investigated the frequency of corrections, the accuracy of intraoperative osteotomy, and postoperative alignment. METHODS: We analyzed 45 knees of 40 patients who underwent TKA using magnetic resonance imaging (MRI)-based PSI. We evaluated the frequency of corrections to preoperative plans and intraoperative corrections for each part. We also evaluated osteotomy error, defined as the difference between the planned and actual thickness of resected bone. Hip-knee-ankle angle (HKA), femoral component angle (FCA), and tibial component angle (TCA) on plain X-rays were evaluated for postoperative alignment. RESULTS: Corrections were made to the initial plans in 91.1% of cases with a mean of 3.3 corrections per knee. Intraoperative corrections were made in 57.8% of cases, with a mean of 0.6 corrections per knee. Mean absolute osteotomy error was around one millimeter, and values were within two millimeters over 80% of cases on most parts except the proximal lateral tibia. In terms of postoperative alignment, HKA was 178.5±1.7°, FCA was 89.0±1.6°, and TCA was 89.4±1.9°. Proportions of outliers were 11.1%, 15.6%, and 20.0%, respectively. CONCLUSIONS: Most of the cases required preoperative corrections for planning of PSI. PSI may be useful for ensuring the accuracy of osteotomy and postoperative alignment.

DOI： 10.1016/j.knee.2017.09.008

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)日本運動器疼痛学会  

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： 10.1007/s00276-017-1851-x

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：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: Pathogenesis of ankle disorders with a large bone defect is varied and treatment for those problems is challenging for orthopaedic surgeons. The aims of this study were to present an operative technique of arthrodesis for the reconstruction of the ankle and hindfoot with a large bone defect using a soft tissue-preserved fibular strut graft and to report outcomes of consecutively treated patients. METHODS: Twelve feet from 11 patients, including feet with aseptic necrosis of the talus and total ankle implant loosening, were treated. Bone defects were filled using iliac bone and/or resected fibula and tibiotalocalcaneal arthrodesis was performed using a retrograde intramedullary nail. A modified transfibular approach was used to expose the affected joint while preserving the lateral to posterior skin and soft tissues on the fibula. The periods of bony fusion and outcomes were radiographically and clinically evaluated. The mean follow-up period was 33.4 months. RESULTS: Bony fusion was achieved within 3 months in all cases. Coronal and sagittal alignments were acceptable, and the mean American Orthopaedic Foot & Ankle Score improved from 53.8 to 75.5 at the final follow-up. All patients graded their results of treatment as "satisfied." CONCLUSION: This procedure did not require special techniques and it should be applicable to complicated cases with large bone defects. High fusion rates that we believe are due to preserving blood supply to the fibular graft can be expected with preservation of the hindfoot height. LEVEL OF EVIDENCE: Level IV, case series.

DOI： 10.1177/1071100717696252

PubMed

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

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：(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：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：(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：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：(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: Patients with hallux valgus present a variety of symptoms that may be related to the type of deformity. Weightbearing affects the deformities, and the evaluation of the load response of tarsal bones has been mainly performed using two-dimensional plane radiography. The purpose of this study was to investigate and compare structural changes in the medial foot arch between patients with hallux valgus and normal controls using a computer image analysis technique and weightbearing computed tomography data. METHODS: Eleven patients with hallux valgus and eleven normal controls were included. Computed tomograms were obtained with and without simulated weightbearing using a compression device. Computed tomography data were transferred into a personal computer, and a three-dimensional bone model was created using image analysis software. The load responses of each tarsal bone in the medial foot arch were measured three-dimensionally and statistically compared between the two groups. FINDINGS: Displacement of each tarsal bone under two weightbearing conditions was visually observed by creating three-dimensional bone models. At the first metatarsophalangeal joint, the proximal phalanges of the hallux valgus group showed significantly different displacements in multiple directions. Moreover, opposite responses to axial loading were also observed in both translation and rotation between the two groups. INTERPRETATION: Weightbearing caused deterioration of the hallux valgus deformity three-dimensionally at the first metatarsophalangeal joint. Information from the computer image analysis was useful for understanding details of the pathology of foot disorders related to the deformities or instability and may contribute to the development of effective conservative and surgical treatments.

DOI： 10.1016/j.clinbiomech.2017.01.012

PubMed

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本臨床バイオメカニクス学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Numerous biomechanical studies of the lateral ankle ligaments have been reported; however, the isolated function of the calcaneofibular ligament has not been clarified. We hypothesize that the calcaneofibular ligament would stabilize the ankle joint complex under multidirectional loading, and that the in situ force in the calcaneofibular ligament would change in each flexed position. METHODS: Using seven fresh frozen cadaveric lower extremities, the motions and forces of the intact ankle under multidirectional loading were recorded using a 6-degree-of-freedom robotic system. On repeating these intact ankle joint complex motions after the calcaneofibular ligament transection, the in situ force in the calcaneofibular ligament and the contribution of the calcaneofibular ligament to ankle joint complex stability were calculated. Finally, the motions of the calcaneofibular ligament-transected ankle joint complex were recorded. FINDINGS: Under an inversion load, significant increases of inversion angle were observed in all the flexed positions following calcaneofibular ligament transection, and the calcaneofibular ligament accounted for 50%-70% of ankle joint complex stability during inversion. The in situ forces in the calcaneofibular ligament under an anterior force, inversion moment, and external rotation moment were larger in the dorsiflexed position than in the plantarflexed position. INTERPRETATION: The calcaneofibular ligament plays a role in stabilizing the ankle joint complex to multidirectional loads and the role differs with load directions. The in situ force of the calcaneofibular ligament is larger at the dorsiflexed position. This ligament provides the primary restraint to the inversion ankle stability.

DOI： 10.1016/j.clinbiomech.2016.10.009

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本人工関節学会  

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： 10.1002/ca.22785

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY DESIGN: Cross-sectional study of healthy volunteers. PURPOSE: We aimed to investigate the variation in the lumbar facet joint orientation in an adult Asian population. The relationship between the facet joint orientation and muscle cross-sectional area (CSA) of multifidus and erector spinae was also clarified. OVERVIEW OF LITERATURE: Several studies have reported that lumbar pathologies, such as lumbar spondylolysis and degenerative spondylolisthesis, were related to the horizontally shaped lumbar facet joint orientation at the lower lumbar level. However, data regarding variations in the facet joint orientation in asymptomatic subjects have not been well documented. METHODS: In 31 healthy male adult Asian volunteers, the facet joint orientation and CSA of multifidus and erector spinae were measured using magnetic resonance imaging at the L4-5 and L5-S1 levels. Variation in the facet joint orientation was examined using coefficients of variation (CV). Pearson's product-moment coefficient was used to investigate the relationship between the facet joint orientation and CSA of multifidus and erector spinae. RESULTS: Lumbar facet joint orientation had a wider range of variation at L5-S1 (CV=0.30) than at L4-5 (CV=0.18). The L4-5 facet joint orientation had a weak but significant correlation with the CSA of erector spinae (r=0.40; p=0.031). The CSA of the multifidus had no relationship with the facet joint orientation at the L4-5 (r=0.19; p=0.314) and the L5-S1 level (r=0.19; p=0.312). CONCLUSIONS: The lumbar facet joint orientation was found to have a wide variation, particularly at the L5-S1 in the Asian adult population, and the facet joint orientation had a relationship with the CSA of the erector spinae at the L4-5.

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  

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：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：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：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：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：(一社)日本小児整形外科学会  

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：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：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：(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：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)日本関節鏡・膝・スポーツ整形外科学会  

医中誌

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

医中誌

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

医中誌

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

医中誌

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

医中誌

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

医中誌

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   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： http://search.jamas.or.jp/link/ui/2016350923

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)南江堂  

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2016&ichushi_jid=J04037&link_issn=&doc_id=20160426450045&doc_link_id=issn%3D0287-1645%26volume%3D35%26issue%3D69%26spage%3D207&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0287-1645%26volume%3D35%26issue%3D69%26spage%3D207&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_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：(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：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)日本関節鏡・膝・スポーツ整形外科学会  

医中誌

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記述言語：日本語   出版者・発行元：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：(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：(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：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）   出版者・発行元：Lippincott Williams and Wilkins  

DOI： 10.2106/JBJS.CC.O.00002

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：(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：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