研究者詳細 - 渡邉　耕太

論文 - 渡邉　耕太

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足部・足関節疾患における保存治療の限界変形性足関節症の保存治療と限界

寺本篤史, 村橋靖崇, 高橋克典, 渡邉耕太, 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 ( 2 ) S488 - S488 2022年03月

多施設共同観察研究における鏡視下足関節固定術の骨癒合不全率とその特徴

高橋克典, 寺本篤史, 山口智志, 天羽健太郎, 雑賀建多, 野口幸志, 渡邉耕太

日本整形外科学会雑誌 ( (公社)日本整形外科学会 ) 96 ( 2 ) S123 - S123 2022年03月

Kinematic alignment法とmechanical alignment法によるTKAの術後早期可動域・歩行能力の比較

岡田葉平, 寺本篤史, 鍋城尚伍, 興村慎一郎, 口岩毅人, 渡邉耕太, 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 ( 2 ) S171 - S171 2022年03月

骨性足関節後方インピンジメント症候群の発症に影響する因子の検討

森勇太, 寺本篤史, 松村崇史, 成田有子, 宮下賢, 村橋靖崇, 渡邉耕太, 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 ( 2 ) S124 - S124 2022年03月

股関節外転に伴う長内転筋の力学ストレスは股関節伸展位で増大する

加藤拓也, 谷口圭吾, 小出所大樹, 中尾学人, 横山祐, 齋藤佑平, 片寄正樹, 渡邉耕太, 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 ( 3 ) S1170 - S1170 2022年03月

Three-dimensional motion analysis of the hindfoot resulting from simulated contraction of individual lower leg muscles utilizing Thiel-embalmed cadavers.

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

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons 28 ( 7 ) 1040 - 1044 2022年02月 [国際誌]

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 PubMed

Posterior shoulder capsule of the dominant arm is stiffer in baseball players than that in non-throwing population.

Naoya Iida, Keigo Taniguchi, Shogo Soma, Kazuya Saizaki, Hajime Toda, Kota Watanabe, Masaki Katayose

Journal of shoulder and elbow surgery 31 ( 7 ) 1335 - 1343 2022年02月 [国際誌]

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 PubMed

アスリートに対して1.9mm径小関節鏡を用いた三角骨切除術の経験

森勇太, 寺本篤史, 村橋靖崇, 神谷智昭, 渡邉耕太, 山下敏彦

整形・災害外科 ( 金原出版(株) ) 65 ( 2 ) 207 - 210 2022年02月

【知っておきたい足関節周囲骨折の新展開】生体力学に裏付けられた遠位脛腓靱帯結合損傷の治療戦略

寺本篤史, 小路弘晃, 高橋克典, 村橋靖崇, 渡邉耕太, 山下敏彦

臨床整形外科 ( (株)医学書院 ) 57 ( 1 ) 31 - 35 2022年01月

＜文献概要＞遠位脛腓靱帯結合は複合的な遠位脛腓関節の動きを許容している.この脛腓関節運動が遠位脛腓靱帯結合損傷の治療を難しくさせる.筆者らは未固定凍結遺体と電磁気センサーを用いた生体力学的研究を行い,遠位脛腓靱帯損傷モデルと各治療法における脛腓間安定性の評価を行ってきた.金属スクリュー固定は腓骨の生理的運動を阻害し,スーチャーボタン固定は脛腓間不安定性を制動できないことがわかった.スーチャーテープを用いたanterior inferior tibiofibular ligament(AITFL)補強術は正常足関節と同等の生理的な安定性が得られた.生体力学的研究に基づいた遠位脛腓靱帯結合損傷の理想的治療は現時点においてAITFL補強術と考えられる.

中足趾節関節の他動的伸展がアーチ剛性に与える影響

小田航平, 根岸奎輔, 本村遼介, 寺本篤史, 渡邉耕太, 片寄正樹

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 ( 1 ) 83 - 88 2022年01月

中足趾節(Metatarsophalangeal:MTP)関節の他動的伸展は、足部アーチの剛性(アーチ剛性)を高める働きがあるとされているが、科学的に検討されていない。本研究の目的は、MTP関節の他動的伸展がアーチ剛性に与える影響を検証することとした。健常男性14名を対象に3つのMTP関節伸展角度条件(0°、30°、60°)におけるアーチ剛性の違いを2つの荷重条件(両脚立位、片脚立位)で検討した。結果として、片脚立位ではMTP関節伸展0°・30°と比べて60°でアーチ剛性が有意に高値を示した。両脚立位においては、MTP関節伸展角度間で有意差はみられなかった。本研究から、荷重下におけるアーチ剛性は、MTP関節伸展角度と荷重量の影響を受けることがわかり、アーチ剛性を実際に高めるためにはMTP関節伸展60°、また片脚立位程度の荷重量が必要な条件となることが示唆された。(著者抄録)

Evaluation of the Activities of the Intrinsic and Extrinsic Muscles of the Foot During Toe Flexion With or Without Interphalangeal Joint Flexion Using Ultrasound Shear Wave Elastography

Kento Hirota, Kota Watanabe, Keisuke Negishi, Hiroki Miyamoto, Tatsuya Taniguchi, Atsushi Teramoto

The Foot ( Elsevier BV ) 101945 - 101945 2022年 [査読有り]

DOI

足関節外側靱帯における3D MRIシーケンスの比較

赤塚吉紘, 寺本篤史, 高島弘幸, 中西光広, 渡邉耕太, 山下敏彦

整形・災害外科 ( 金原出版(株) ) 64 ( 13 ) 1705 - 1709 2021年12月

＜文献概要＞足関節外側靱帯損傷における三次元(3D)MRI評価は有用であるが,最適な撮像条件に関しては一定の見解が得られていない。本研究では,健常ボランティア22名22足(男性15名,女性7名)を対象に,spin echo法である3D VISTAと,gradient echo法である3D balanced FFEの撮像を行い,前距腓靱帯(ATFL)と踵腓靱帯(CFL)の画像コントラストを比較した。取得した画像のATFL,CFL,およびそれらの周囲組織である腓骨,皮下脂肪に関心領域を設定し,コントラストノイズ比を測定した。ATFLと周囲組織とのコントラストノイズ比は,3D balanced FFEより3D VISTAの方が高い値を示した。また,CFLに関しても同様の傾向を示した。足関節外側靱帯を対象に3D MRIを撮像する場合には3D VISTAを選択することが望ましい。

Symptomatic ossicle lesion at the anterior tip of the medial malleolus in soccer players.

Atsushi Teramoto, Kousuke Iba, Kota Watanabe, Tomoaki Kamiya, Yohei Okada, Toshihiko Yamashita

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 6 ) 1069 - 1073 2021年11月 [国内誌]

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 PubMed

Relationship Between Plantar Callosity and Foot Deformity in Hallux Valgus Using Weightbearing Computed Tomography

Yasutaka Murahashi, Kousuke Iba, Atsushi Teramoto, Katsunori Takahashi, Yohei Okada, Tomoaki Kamiya, Hiroyuki Takashima, Kota Watanabe, Hirofumi Ohnishi, Toshihiko Yamashita

JOURNAL OF FOOT & ANKLE SURGERY ( ELSEVIER SCIENCE INC ) 60 ( 6 ) 1207 - 1211 2021年11月

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. (c) 2021 by the American College of Foot and Ankle Surgeons. All rights reserved.

DOI

足部外在筋と内在筋の違いを考慮した新規足趾トレーニングの効果検証

渡邉耕太, 廣田健斗, 寺本篤史, 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 ) 29 ( 4 ) S193 - S193 2021年10月

多施設共同観察研究による鏡視下足関節固定術の骨癒合不全率とその特徴

高橋克典, 寺本篤史, 山口智志, 天羽健太郎, 雑賀建多, 野口幸志, 渡邉耕太

日本足の外科学会雑誌 ( (一社)日本足の外科学会 ) 42 ( Suppl. ) S219 - S219 2021年10月

外側進入型人工足関節置換術(Trabecular Metal Total Ankle)における術前後joint lineの検討

霜村耕太, 寺本篤史, 小林拓馬, 渡邉耕太, 山下敏彦

日本足の外科学会雑誌 ( (一社)日本足の外科学会 ) 42 ( Suppl. ) S284 - S284 2021年10月

足関節不安定性の定量評価を考える〜目指せ!ゆるさの数値化〜静電容量型センサによる足関節不安定性の定量評価

寺本篤史, 村橋靖崇, 小路弘晃, 高橋克典, 廣田健斗, 河合誠, 池田祐真, 今村塁, 渡邉耕太, 山下敏彦