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Papers - WATANABE Kouta

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Biomechanical Comparison of Inside-Out and All-Inside Meniscal Repair in Controlling the Peripheral Gap and Extrusion of the Lateral Meniscus With a Complete Radial Tear: A Cadaveric Study Using a Robotic Simulator.

Kousuke Shiwaku, Hidenori Otsubo, Katsunori Takahashi, Daisuke Suzuki, Satoshi Yamakawa, Tomoaki Kamiya, Tomoyuki Suzuki, Yohei Okada, Shinichiro Okimura, Kota Watanabe, Hiromichi Fujie, Atsushi Teramoto

Orthopaedic journal of sports medicine 13 ( 3 ) 23259671241308854 - 23259671241308854 2025.03 [International journal]

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

DOI PubMed

Passive muscle tension changes in the biceps femoris long head after biceps femoris short head detachment: A human cadaver study.

Gakuto Nakao, Kazuma Yamagata, Risa Adachi, Koki Ishiyama, Kazuyoshi Kozawa, Kota Watanabe, Yuki Ohsaki, Kousuke Shiwaku, Norio Hayashi, Masaki Katayose, Keigo Taniguchi

Journal of biomechanics 179 112480 - 112480 2024.12 [International journal]

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

DOI PubMed

大腿二頭筋短頭の剥離に伴う大腿二頭筋長頭の受動張力変化

中尾学人, 谷口圭吾, 山形一真, 足立梨紗, 石山輝希, 小澤和祥, 渡邉耕太, 大崎雄樹, 林典雄, 塩泡孝介, 片寄正樹, 金谷耕平

日本整形外科超音波学会学術集会プログラム・抄録集 ( (一社)日本整形外科超音波学会 ) 35回 119 - 119 2024.10

Validity of Elastic Imaging Evaluation of Hamstring Muscles With Knee Contracture Using Ultrasound Shear Wave Elastography.

Gakuto Nakao, Taiki Kodesho, Kazuma Yamagata, Kota Watanabe, Yuki Ohsaki, Masaki Katayose, Keigo Taniguchi

Cureus 16 ( 8 ) e68343 2024.08 [International journal]

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

DOI PubMed

大腿二頭筋長頭の力学的特性弾性部位差と伸長速度間の応力差

中尾学人, 山形一真, 足立梨紗, 石山輝希, 小澤和祥, 小出所大樹, 渡邉耕太, 大崎雄樹, 片寄正樹, 谷口圭吾

体力科学 ( (一社)日本体力医学会 ) 73 ( 4 ) 179 - 179 2024.08

大腿二頭筋長頭の力学的特性弾性部位差と伸長速度間の応力差

中尾学人, 山形一真, 足立梨紗, 石山輝希, 小澤和祥, 小出所大樹, 渡邉耕太, 大崎雄樹, 片寄正樹, 谷口圭吾

体力科学 ( (一社)日本体力医学会 ) 73 ( 4 ) 179 - 179 2024.08

High Tibial Osteotomy Alone Does Not Decrease Medial Meniscus Extrusion in the Setting of Medial Meniscus Posterior Root Tear: A Cadaveric Study.

Kazushi Horita, Yohei Okada, Kousuke Shiwaku, Satoshi Yamakawa, Yuta Mori, Tomoaki Kamiya, Makoto Emori, Kota Watanabe, Hiromichi Fujie, Atsushi Teramoto

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2024.07 [International journal]

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 PubMed

Stress–strain relationship of individual hamstring muscles: A human cadaver study

Gakuto Nakao, Taiki Kodesho, Kazuma Yamagata, Kota Watanabe, Yuki Ohsaki, Masaki Katayose, Keigo Taniguchi

Journal of the Mechanical Behavior of Biomedical Materials ( Elsevier BV ) 153 106473 - 106473 2024.05

DOI

Correction: Relationship between shear elastic modulus and passive muscle force in human hamstring muscles using a Thiel soft-embalmed cadaver.

Gakuto Nakao, Taiki Kodesho, Takuya Kato, Yu Yokoyama, Yuhei Saito, Yuki Ohsaki, Kota Watanabe, Masaki Katayose, Keigo Taniguchi

Journal of medical ultrasonics (2001) 2024.03 [Domestic journal]

DOI PubMed

ハムストリングスの局所的な力学特性 Thiel法固定献体を用いた検討

中尾学人, 谷口圭吾, 小出所大樹, 山形一真, 渡邉耕太, 大崎雄樹, 片寄正樹, 寺本篤史

日本整形外科学会雑誌 ( (公社)日本整形外科学会 ) 98 ( 3 ) S1379 - S1379 2024.03

せん断波イメージングを用いた筋の粘弾性評価静的ストレッチングの効果検証と関節可動性との関係

小出所大樹, 谷口圭吾, 中尾学人, 山形一真, 渡邉耕太, 片寄正樹, 寺本篤史

日本整形外科学会雑誌 ( (公社)日本整形外科学会 ) 98 ( 3 ) S1359 - S1359 2024.03

Comparison by ultrasound shear wave elastography of toe flexor muscle contraction during MTP flexion exercise and short-foot exercise

Kento Hirota, Kota Watanabe, Hiroki Miyamoto, Keisuke Negishi, Mako Watase, Atsushi Teramoto

Journal of Back and Musculoskeletal Rehabilitation ( IOS Press ) 1 - 7 2024.02

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

Relationships between flexion strength and dexterity of the toes and physical performance.

Kota Watanabe, Yuzo Ashida, Kento Hirota, Tatsuya Taniguchi, Hiroki Miyamoto, Atsushi Teramoto

Journal of back and musculoskeletal rehabilitation 2023.12 [International journal]

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 PubMed

Quantitative assessment of anterior talofibular ligament quality in chronic lateral ankle instability using magnetic resonance imaging T2* value.

Yoshihiro Akatsuka, Atsushi Teramoto, Yasutaka Murahashi, Katsunori Takahashi, Rui Imamura, Hiroyuki Takashima, Kota Watanabe, Toshihiko Yamashita

Skeletal radiology 2023.10 [International journal]

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 PubMed

Ultra-Short Echo Time-MRI T2* Mapping of Articular Cartilage Layers Is Associated with Histological Early Degeneration.

Rui Imamura, Atsushi Teramoto, Yasutaka Murahashi, Yohei Okada, Shinichiro Okimura, Yoshihiro Akatsuka, Kota Watanabe, Toshihiko Yamashita

Cartilage 19476035231205685 - 19476035231205685 2023.10 [International journal]

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 PubMed

第1基節骨と第1中足骨の3次元骨形態における正常足の性別による比較相同モデルを用いた検討

山津健太, 渡邉耕太, 寺本篤史

日本足の外科学会雑誌 ( (一社)日本足の外科学会 ) 44 ( 1 ) 13 - 20 2023.08

ハムストリングス各筋の応力-歪み関係 Thiel法固定献体を用いた検討

中尾学人, 谷口圭吾, 小出所大樹, 山形一真, 渡邉耕太, 大崎雄樹, 片寄正樹, 山下敏彦

日本整形外科学会雑誌 ( (公社)日本整形外科学会 ) 97 ( 8 ) S1901 - S1901 2023.08

Three-dimensional motion of the toes with simulated contraction of individual toe flexors and extensors: A cadaver study.

Keisuke Negishi, Kota Watanabe, Atsushi Teramoto, Kenta Yamatsu, Mizuho Hayashi

Foot (Edinburgh, Scotland) 56 102044 - 102044 2023.07 [International journal]

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 PubMed

屈曲拘縮膝におけるハムストリングスの弾性画像評価の妥当性

中尾学人, 谷口圭吾, 小出所大樹, 山形一真, 渡邉耕太, 大崎雄樹, 片寄正樹, 金谷耕平

日本整形外科超音波学会学術集会プログラム・抄録集 ( 日本整形外科超音波学会 ) 34回 135 - 135 2023.07

Relationship between shear elastic modulus and passive muscle force in human hamstring muscles using a Thiel soft-embalmed cadaver.

Gakuto Nakao, Taiki Kodesho, Takuya Kato, Yu Yokoyama, Yuhei Saito, Yuki Ohsaki, Kota Watanabe, Masaki Katayose, Keigo Taniguchi

Journal of medical ultrasonics (2001) 50 ( 3 ) 275 - 283 2023.05 [Domestic journal]

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 PubMed

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Papers - WATANABE Kouta