Details of a Researcher - WATANABE Kouta

Papers - WATANABE Kouta

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後足部内視鏡手術が有効であった色素性絨毛結節性滑膜炎の1例

銭谷俊毅, 寺本篤史, 神谷智昭, 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 ) 41 ( 1 ) 279 - 281 2020.08

色素性絨毛結節性滑膜炎(PVNS)の発生部位は膝関節が多く、足部・足関節の発生は比較的まれである。治療法は切除が基本であり、鏡視下手術は低侵襲で有効であるが、open synovectomyと比べると取り残しによる再発の可能性があるとされている。今回、著者らは長母趾屈筋腱鞘から後足部に発生したPVNSに対して後足部内視鏡手術を施行し腫瘍の摘出を行った。症例は45歳女性。1年前より右後足部の腫脹と熱感が出現し近医を受診した。MRIで軟部腫瘍を指摘され、手術目的に当科を紹介受診した。初診時、足関節後方に腫脹を認め、荷重時に疼痛も認めた。可動域制限は認めず、筋力低下や採血での炎症反応の上昇も認めなかった。FHL testは陰性であった。MRIでは距腿関節後方からFHL腱鞘内にかけてT1、T2強調像で低信号の腫瘤像を認めた。van Dijkの方法に準じた後足部内視鏡下に腫瘤切除を施行した。病理診断の結果はPVNSであった。現在、術後半年を経過しているが疼痛は改善しており、再発の徴候も認められていない。(著者抄録)

足趾屈筋群の付着部とその相互関係

上村杏菜, 渡邉耕太, 廣田健斗, 齋藤悠城

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 ) 28 ( 3 ) 441 - 446 2020.08

長母趾屈筋(以下FHL)、長趾屈筋(以下FDL)、足底方形筋(以下QP)には筋の付着部に個人差がある。各筋についての解剖研究はあるが、3筋の相互関係は不明である。本研究では足底におけるFHL腱とFDL腱の解剖学的バリエーションごとのQPの付着部を調査した。日本人解剖標本38体50足でFHL腱とFDL腱の関係、FHLが分枝する足趾、QPの付着部について肉眼解剖をし、QPの付着部データをFHL分枝別に解析した。FHL腱とFDL腱の関係では、FHL腱からFDL腱へ分枝するものが96%であった。FHLの分枝については、第2、3趾へ分枝するものが50%と最多であった。QPは96%でFDL腱とFHL腱に付着し、FHLの分枝にも高率に付着していた。またFHL分枝数の違いにかかわらず、QPが第5趾のFDL腱に付着する割合は低率であった。本研究結果から、QPはFDL腱だけでなくFHL分枝にも付着し、それらの機能を補助する例が多いことが示された。また、FHLの分枝数が足趾屈曲機能に大きな影響を与える可能性がある。(著者抄録)

Flexor hallucis longus tendon branch test: Development and validation of a new method to assess anatomical variation of the tendinous slip.

Kento Hirota, Kota Watanabe, Yuki Saito, Masaki Katayose

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons 26 ( 6 ) 607 - 613 2020.08 [International journal]

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 PubMed

Tibiofibular Space Widening Assessment With a Ball-Tipped Probe in a Syndesmosis Injury Model.

Atsushi Teramoto, Hiroaki Shoji, Ken Anzai, Tomoaki Kamiya, Kota Watanabe, Toshihiko Yamashita

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 2020.07 [International journal]

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 PubMed

Biomechanical Analysis of Midfoot Instability After Bifurcate Ligament Injury and Ankle Brace Application: A Cadaveric Study

Takuma Kobayashi, Kota Watanabe, Atsushi Teramoto, Daisuke Suzuki, Mineko Fujimiya, Toshihiko Yamashita

JOURNAL OF FOOT & ANKLE SURGERY ( ELSEVIER SCIENCE INC ) 59 ( 4 ) 711 - 715 2020.07

This cadaveric study investigated the biomechanical characteristics and stabilizing contribution of the bifurcate ligament using a multidirectional loading method and assessed the stabilizing effect of a brace after injury of the ligament. Eight freshly frozen cadaveric feet were tested for forefoot torque in inversion, eversion, adduction, and plantar flexion. Each band of the bifurcate ligament was transected sequentially, and the contribution of each por-tion of the ligament, as well as the stabilizing effects of the ankle brace, were examined. Stability decreased sub-stantially after calcaneocuboid ligament transection for inversion and adduction loading. Bracing restored some stability, except for the adduction loading direction, for which it had only limited effect. The data indicate that inversion and adduction loading are strongly related to bifurcate ligament injury. The stabilizing effect of the ankle brace may have limited effectiveness for loads under adduction. (c) 2019 by the American College of Foot and Ankle Surgeons. All rights reserved.

DOI

ストリートダンスにおける運動器外傷・障害の発生状況

向井力哉, 寺本篤史, 神谷智昭, 渡邉耕太, 山下敏彦

整形・災害外科 ( 金原出版(株) ) 63 ( 6 ) 845 - 849 2020.05

＜文献概要＞ストリートダンスは競技人口が増加している。しかしストリートダンスに伴う運動器外傷・障害発生状況に対する調査は極めて少ない。本研究では大学生122名を対象にストリートダンスにおける運動器外傷・障害発生状況を調査した。記入回答式アンケート配布ならびにGoogleフォームを用いて回答を得た。調査項目は受傷歴,受傷後の医療機関受診の有無,受傷部位,ダンス歴,競技レベル(趣味もしくは大会参加レベル),練習頻度,ダンス種目とした。外傷・障害歴の有無と各調査項目との関係をunpaired t-test,Chi-squared testを用いて解析した。外傷・障害の経験があるものは54名44.2%で,そのうち病院を受診したことがあるものは37.0%であった。受傷部位は足部・足関節が30.0%と最も多く,次いで膝22.9%,腰15.7%であった。ダンス種目別ではブレイクダンスが最も多く88.2%であった。外傷・障害の経験があるものは練習回数および練習時間が有意に多かった。

Nontraumatic Chronic Subcutaneous Extensor Digitorum Longus Tendon Rupture in a Recreational Runner: A Case Report

Kodai Hamaoka, Kota Watanabe, Tomoaki Kamiya, Atsushi Teramoto, Toshihiko Yamashita

JBJS case connector ( NLM (Medline) ) 10 ( 2 ) e0058 2020.04

CASE: Nontraumatic chronic subcutaneous rupture of the extensor digitorum longus (EDL) tendon is rare. A 66-year-old man, recreational runner, suddenly injured his EDL tendon while walking. We surgically reconstructed the ruptured EDL tendon with a free palmaris longus tendon graft. During the surgery, an osteophyte was found to have penetrated the ankle joint capsule and was considered the cause of the tendon rupture. Active toe extension was restored, and the patient completed a 10-km race at 2 months postoperatively. CONCLUSION: EDL tendon reconstruction using a free palmaris longus tendon graft is an effective surgical option for athletes.

DOI PubMed

Varus kinematics at knee flexion affect clinical outcomes of unicompartmental knee arthroplasty: Intraoperative navigation-based kinematics evaluation.

Kousuke Shiwaku, Atsushi Teramoto, Satoshi Nuka, Takashi Matsumura, Kota Watanabe, Toshihiko Yamashita

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology 20 6 - 11 2020.04 [International journal]

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 PubMed

【半月板-Save the Meniscus】保存療法とリハビリテーション半月板手術後のスポーツ復帰

渡邉耕太

整形・災害外科 ( 金原出版(株) ) 63 ( 5 ) 733 - 737 2020.04

＜文献概要＞半月板損傷手術後は,現在では高率にスポーツ復帰が可能である。復帰に影響する因子は多岐にわたる。損傷部位,損傷形態,手術方法のほか,スポーツ種目やそのレベルも影響する。また,同じスポーツ種目でもそのポジションが復帰率に影響する。スポーツ復帰が最も早いのは半月板切除術であるが,復帰後の骨軟骨損傷や変形性膝関節症の発生が危惧される。半月板縫合術では,術後8〜9割がスポーツ復帰可能であり,復帰までの期間は通常4〜6ヵ月である。スポーツに復帰させる過程では上記の因子を念頭に置き,スポーツ種目に特化した動きの獲得や再損傷予防に留意する。スポーツ復帰時期にはまだ半月板の治癒過程が続いており,筋力が完全に回復していないこともある。症状とパフォーマンスの回復過程を評価しながら,多職種と連携をとってスポーツ復帰を進めることが重要である。

Morphological variations of the human talus investigated using three-dimensional geometric morphometrics.

Shuhei Nozaki, Kota Watanabe, Tomoaki Kamiya, Masaki Katayose, Naomichi Ogihara

Clinical anatomy (New York, N.Y.) 34 ( 4 ) 536 - 543 2020.03 [Refereed] [International journal]

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 PubMed

Screw Internal Fixation and Ilizarov External Fixation: A Comparison of Outcomes in Ankle Arthrodesis

Atsushi Teramoto, Koji Nozaka, Tomoaki Kamiya, Takeshi Kashiwagura, Hiroaki Shoji, Kota Watanabe, Yoichi Shimada, Toshihiko Yamashita

JOURNAL OF FOOT & ANKLE SURGERY ( ELSEVIER SCIENCE INC ) 59 ( 2 ) 343 - 346 2020.03

The purpose of this study was to compare the mid-term clinical outcomes between screw internal fixation and Ilizarov external fixation in patients who underwent ankle arthrodesis and to elucidate the differences between the 2 fixation methods. This study investigated 43 ankles in 41 patients who underwent ankle arthrodesis at 1 of the 2 study institutions. There were 15 men and 26 women, and their mean age was 66.2 (range 49 to 87) years. The primary disease included osteoarthritis (OA) (79%), rheumatoid arthritis (RA) (16.3%), and Charcot joint (4.7%). Patients were divided into 2 groups depending on the surgical approach: the screw group (S) and the Ilizarov group (I). The following items were evaluated and compared between the 2 groups: patient characteristics, Tanaka-Takakura classification based on preoperative plain X-ray images, duration of surgery, blood loss, surgical complications, time to start weightbearing, and the Japanese Society of Surgery of the Foot (JSSF) standard rating system for the ankle-hind-foot. Duration of surgery was significantly shorter in the S group (162.3 versus 194.9 min), and the amount of blood loss was also significantly lower in the S group (29.2 versus 97.5 ml). Preoperative JSSF scale was significantly lower in the I group (44.8 versus 33), but postoperative JSSF scale was not significantly different between the 2 groups (82.1 versus 77.9). The S group had satisfactory clinical outcomes with a shorter duration of surgery and smaller amount of blood loss than the I group. However, severe patients in the I group achieved similar treatment outcomes. (C) 2019 by the American College of Foot and Ankle Surgeons. All rights reserved.

DOI

Effect of Initial Graft Tension 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

The American journal of sports medicine 48 ( 4 ) 916 - 922 2020.03 [International journal]

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 PubMed

Denosumab prevents periprosthetic bone mineral density loss in the tibial metaphysis in total knee arthroplasty.

Yasutaka Murahashi, Atsushi Teramoto, Shunsuke Jimbo, Yohei Okada, Tomoaki Kamiya, Rui Imamura, Hiroyuki Takashima, Kota Watanabe, Satoshi Nagoya, Toshihiko Yamashita

The Knee 27 ( 2 ) 580 - 586 2020.03 [International journal]

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 PubMed

股関節屈曲・伸展運動時における長内転筋の筋スティフネスに及ぼす股関節角度の影響

加藤拓也, 谷口圭吾, 神谷智昭, 寺本篤史, 渡邉耕太, 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 ) 94 ( 3 ) S995 - S995 2020.03

NSAIDs貼付剤単剤で効果不十分な変形性膝関節症例への追加療法セレコキシブvs運動療法

渡邉耕太, 寺本篤史, 鈴木智之, 山下敏彦

整形・災害外科 ( 金原出版(株) ) 63 ( 2 ) 231 - 238 2020.02

＜文献概要＞ケトプロフェン貼付剤が効果不十分だった変形性膝関節症59例を無作為に2群に分け,1群にはセレコキシブの経口投与を,他の1群には運動療法を4週間追加実施した。追加療法開始時からの最終評価時の疼痛Visual Analogue Scale(VAS)の平均変化量は,それぞれ22.3および14.4で統計学的に有意に改善したが,両群間に有意差はなかった。一方,最終評価時の医師による全般改善度は,改善率が38.5%と22.2%で両群間に有意差を認めた。JKOMと患者日誌による疼痛VASおよび健康状態の変化は経時的に改善していたが,この改善はセレコキシブ群でより早かった。有害事象発現率に関しては,セレコキシブ併用群で13.3%,運動療法併用群で3.6%であり,セレコキシブ併用群が高い発現率を示した。セレコキシブ経口投与併用治療は運動療法併用治療と比較して,全般改善度の改善率がより高く,痛みが早期に軽減していた。

Relationship between shear modulus and passive tension of the posterior shoulder capsule using ultrasound shear wave elastography: A cadaveric study.

Naoya Iida, Keigo Taniguchi, Kota Watanabe, Hiroki Miyamoto, Tatsuya Taniguchi, Mineko Fujimiya, Masaki Katayose

Journal of biomechanics 99 109498 - 109498 2020.01 [International journal]

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 PubMed

Radiographic Evaluation of Medial Opening-Wedge High Tibial Osteotomy Using a New Internal Fixator with a Wedge-Shaped Spacer Block.

Shinichiro Okimura, Atsushi Teramoto, Kota Watanabe, Satoshi Nuka, Tomoaki Kamiya, Toshihiko Yamashita

The journal of knee surgery 2020.01 [International journal]

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 PubMed

Sex- and age-related morphological variations in the talar articular surfaces of the calcaneus

Nozaki S, Watanabe K, Kamiya T, Katayose M, Ogihara N

Annals of Anatomy 2020.01 [Refereed]

3D MRI evaluation of morphological characteristics of lateral ankle ligaments in injured patients and uninjured controls.

Atsushi Teramoto, Yoshihiro Akatsuka, Hiroyuki Takashima, Hiroaki Shoji, Yuzuru Sakakibara, Kota Watanabe, Toshihiko Yamashita

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 25 ( 1 ) 183 - 187 2020.01 [Domestic journal]

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 PubMed

外側進入型人工足関節置換術の使用経験

霜村耕太, 小林拓馬, 堀田和志, 向井力哉, 寺本篤史, 山下敏彦, 渡邉耕太

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 62 ( 138th suppl ) 44 - 44 2020

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