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Papers - WATANABE Kouta

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運動器リハビリ領域におけるSUPERSONIC MACH 30の応用可能性

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

映像情報Medical ( 産業開発機構(株) ) 55 ( 6 ) 97 - 102 2023.05

運動器リハビリ領域におけるSUPERSONIC MACH 30の応用可能性

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

映像情報Medical ( 産業開発機構(株) ) 55 ( 6 ) 97 - 102 2023.05

Three-dimensional morphological variations in the calcaneus and talus in relation to the hallux valgus angle.

Shuhei Nozaki, Kota Watanabe, Masaki Katayose, Kenta Yamatsu, Atsushi Teramoto, Naomichi Ogihara

Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft 247 152053 - 152053 2023.04 [International journal]

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 PubMed

Comparison of the three-dimensional bone morphology of the first proximal phalanx and first metatarsal between normal and hallux valgus foot using the homologous model technique.

Kenta Yamatsu, Mizuho Hayashi, Hiroyuki Takashima, Kota Watanabe

Foot (Edinburgh, Scotland) 54 101968 - 101968 2023.03 [International journal]

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 PubMed

High reproducibility of a novel supported anterior drawer test for diagnosing ankle instability.

Yasutaka Murahashi, Atsushi Teramoto, Katsunori Takahashi, Yohei Okada, Shinichiro Okimura, Rui Imamura, Makoto Kawai, Kota Watanabe, Toshihiko Yamashita

BMC musculoskeletal disorders 24 ( 1 ) 148 - 148 2023.02 [International journal]

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 PubMed

Effects of superficial tissue and intermuscular connections on rectus femoris muscle shear modulus heterogeneity.

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

Journal of ultrasound 2023.02 [International journal]

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 PubMed

アキレス腱術後感染により皮膚・腱欠損を生じた症例に運動器エコーを用いた動態評価と理学療法を行い、スポーツ復帰した一例

河合誠, 小出所大樹, 山田由奈, 片寄正樹, 渡邉耕太, 千葉充将, 村橋靖崇, 寺本篤史, 山下敏彦, 谷口圭吾

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 65 ( 142nd suppl ) 85 - 85 2023

アキレス腱術後感染により皮膚・腱欠損を生じた症例に運動器エコーを用いた動態評価と理学療法を行い、スポーツ復帰した一例

河合誠, 小出所大樹, 山田由奈, 片寄正樹, 渡邉耕太, 千葉充将, 村橋靖崇, 寺本篤史, 山下敏彦, 谷口圭吾

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 65 ( 142nd suppl ) 85 - 85 2023

腱板表層断裂症例に対する運動療法安全域の検討未固定凍結遺体を用いた表層断裂有無での腱深層伸び率比較

宮本浩樹, 渡邉耕太, 廣田健斗, 根岸奎輔, 飯田尚弥, 谷口達也, 藤宮峯子

運動器理学療法学 ( (一社)日本運動器理学療法学会 ) 2 ( Suppl. ) O - 64 2022.10

バウンディング距離の低さがスポーツ障害発生と関連する高校生スピードスケート選手におけるメディカルチェック報告

矢島健吾, 松村崇史, 吉川祐樹, 成田有子, 渡邉耕太, 大坪英則, 片寄正樹, 山下敏彦

日本臨床スポーツ医学会誌 ( (一社)日本臨床スポーツ医学会 ) 30 ( 4 ) S280 - S280 2022.10

外反母趾角に関連する踵骨・距骨の3次元形態変異の抽出

野崎修平, 渡邉耕太, 片寄正樹, 山津健太, 寺本篤史, 荻原直道

日本足の外科学会雑誌 ( (一社)日本足の外科学会 ) 43 ( Suppl. ) S166 - S166 2022.10

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 ) 43 ( Suppl. ) S165 - S165 2022.10

Effect of Anterior Horn Tears of the Lateral Meniscus on Knee Stability.

Kousuke Shiwaku, Tomoaki Kamiya, Hidenori Otsubo, Tomoyuki Suzuki, Shogo Nabeki, Satoshi Yamakawa, Yohei Okada, Atsushi Teramoto, Kota Watanabe, Kousuke Iba, Hiromichi Fujie, Toshihiko Yamashita

Orthopaedic journal of sports medicine 10 ( 9 ) 23259671221119173 - 23259671221119173 2022.09 [International journal]

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 PubMed

Thiel法固定献体を用いたハムストリングス各筋の組織弾性と受動張力の関係

中尾学人, 谷口圭吾, 加藤拓也, 小出所大樹, 横山祐, 斎藤佑平, 渡邉耕太, 藤宮峯子, 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 ) 96 ( 8 ) S1683 - S1683 2022.09

腱板表層断裂の有無による棘上筋腱深層伸び率の比較未固定凍結遺体を用いた検討

宮本浩樹, 渡邉耕太, 青木光広, 廣田健斗, 根岸奎輔, 谷口達也, 飯田尚哉, 日高恵喜, 高島健一, 寺本篤史, 山下敏彦

日本整形外科学会雑誌 ( (公社)日本整形外科学会 ) 96 ( 8 ) S1601 - S1601 2022.09

Effects of the Ankle Flexion Angle During Anterior Talofibular Ligament Reconstruction on Ankle Kinematics, Laxity, and In Situ Forces of the Reconstructed Graft.

Yuzuru Sakakibara, Atsushi Teramoto, Tetsuya Takagi, Satoshi Yamakawa, Hiroaki Shoji, Yohei Okada, Takuma Kobayashi, Tomoaki Kamiya, Mineko Fujimiya, Hiromichi Fujie, Kota Watanabe, Toshihiko Yamashita

Foot & ankle international 43 ( 5 ) 725 - 732 2022.05 [International journal]

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 PubMed

Surgically treated reactive arthritis of the ankle after COVID-19 infection: A case report.

Kohei Shimoyama, Atsushi Teramoto, Yasutaka Murahashi, Katsunori Takahashi, Kota Watanabe, Kousuke Iba, Toshihiko Yamashita

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 4 ) 587 - 590 2022.04 [International journal]

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 PubMed

カッティング動作中の床反力における内側ハムストリングの機能選択的筋疲労条件を用いた検討

山津健太, 青木信裕, 片寄正樹, 渡邉耕太

日本臨床スポーツ医学会誌 ( (一社)日本臨床スポーツ医学会 ) 30 ( 2 ) 484 - 491 2022.04

カッティング動作は下肢スポーツ損傷の受傷機転の一つであり、内側ハムストリングがそのリスク低下に働くと考えられるが、筋機能の詳細は不明である。本研究は内側ハムストリングの選択的筋疲労介入前後のカッティング動作中の床反力を計測し、内側ハムストリングの力学的機能を明らかにすることを目的とした。8人の健康成人男性を対象として、半腱様筋への神経筋電気刺激により筋疲労を誘発し、その前後で随意収縮課題とカッティング動作を実施した。随意収縮課題として膝関節最大等尺性収縮と、最大膝屈曲トルクの50%を発揮する最大下等尺性収縮を行った。随意収縮課題中の最大膝屈曲トルクとハムストリングの筋電図中央周波数を算出し、筋疲労の確認に用いた。カッティング動作として方向転換角度(45°、90°)と助走速度(Slow、Fast)を組み合わせた4種類を実施した。動作時の床反力の値から、左右方向の推進成分と前後方向の減速・推進成分を筋疲労前後で比較した。電気刺激による筋疲労の結果、全対象者8人で内側ハムストリングの筋疲労を誘起した。床反力は、筋疲労前は前後方向の減速成分で4種類のカッティング動作方法全てで有意差を認めた。一方、筋疲労後には同一の助走速度で方向転換角度の異なる動作間での有意差が消失していた。このことより、内側ハムストリングは方向転換角度に応じてカッティング動作時の減速をコントロールする機能を有すると考えられた。(著者抄録)

Syndesmotic instability can be assessed by measuring the distance between the tibia and the fibula using an ultrasound without stress: a cadaver study.

Hiroaki Shoji, Atsushi Teramoto, Yasutaka Murahashi, Kota Watanabe, Toshihiko Yamashita

BMC musculoskeletal disorders 23 ( 1 ) 261 - 261 2022.03 [International journal]

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 PubMed

The prevalence of posterior inferior tibiofibular ligament and inferior tibiofibular transverse ligament injuries in syndesmosis-injured ankles evaluated by oblique axial magnetic resonance imaging: a retrospective study.

Kousuke Shiwaku, Atsushi Teramoto, Kousuke Iba, Hidenori Otsubo, Tomoaki Kamiya, Hiroaki Shoji, Kota Watanabe, Toshihiko Yamashita

BMC musculoskeletal disorders 23 ( 1 ) 264 - 264 2022.03 [International journal]

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 PubMed

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