Details of a Researcher - TERAMOTO Atsushi

Papers - TERAMOTO Atsushi

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Reliability and accuracy of the critical shoulder angle measured by anteroposterior radiographs: using digitally reconstructed radiograph from 3-dimensional computed tomography images

Yuji Shibayama, Rui Imamura, Toshiaki Hirose, Akira Sugi, Emi Mizushima, Yuto Watanabe, Rira Tomii, Makoto Emori, Atsushi Teramoto, Kousuke Iba, Toshihiko Yamashita

Journal of Shoulder and Elbow Surgery 2023.02

DOI

Measurement of the median nerve strain within the carpal tunnel using a capacitance-type strain sensor: A cadaver study.

Kenichi Takashima, Atsushi Teramoto, Mitsuhiro Aoki, Hiroki Miyamoto, Egi Hidaka, Rikiya Shirato, Yasuhiro Ozasa, Akira Saito, Makoto Emori, Toshihiko Yamashita, Kousuke Iba

Clinical biomechanics (Bristol, Avon) 102 105894 - 105894 2023.01 [International journal]

BACKGROUND: Direct and quantitative measurement of median nerve strain within the carpal tunnel has been difficult because of the technical limitations associated with conventional devices. We used capacitive sensors (C-stretch), which are thin and flexible, to measure the median nerve strain within the carpal tunnel. METHODS: We used 12 fresh frozen upper extremity specimens. The transverse carpal ligament was left in situ, and we attached the sensor to the palmar surface of the median nerve to measure the nerve strain at 60 degrees of wrist extension. The sensor measured the median nerve strain at both the carpal tunnel site and the proximal to the carpal tunnel site before and after the carpal tunnel release. The amount of nerve excursion during wrist extension was also measured with the length change of the attached suture by a digital caliper. FINDINGS: The mean median nerve strain within the carpal tunnel [8.07% (95 %CI:7.17-8.97)] was significantly higher than that proximal to the carpal tunnel [5.21% (95 %CI:4.46-5.97)] at the wrist extension. There was no significant difference of the mean nerve excursion within and proximal to the carpal tunnel. The mean nerve strain and excursion were unaffected by carpal tunnel release. INTERPRETATION: These results indicated that wrist extension position might lead to increased strain on the median nerve within the carpal tunnel compared with at the proximal to the carpal tunnel. We believe that the current study might provide new information and help us understand the pathogenesis of carpal tunnel syndrome.

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

Reliability and validity of the Forgotten Joint Score-12 for total ankle replacement and ankle arthrodesis.

Koji Noguchi, Satoshi Yamaguchi, Atsushi Teramoto, Kentaro Amaha, Noriyuki Kanzaki, Hirofumi Tanaka, Tetsuro Yasui, Yosuke Inaba

PloS one 18 ( 6 ) e0286762 2023 [International journal]

OBJECTIVES: This study evaluated the reliability and validity of the Forgotten Joint Score-12 (FJS-12)-a measure of patients' ability to forget their joints in daily life-in patients who underwent total ankle replacement (TAR) or ankle arthrodesis (AA). METHODS: Patients who underwent TAR or AA were recruited from seven hospitals. The patients completed the Japanese version of FJS-12 twice, at an interval of two weeks, at a minimum of one year postoperatively. Additionally, they answered the Self-Administered Foot Evaluation Questionnaire and EuroQoL 5-Dimension 5-Level as comparators. The construct validity, internal consistency, test-retest reliability, measurement error, and floor and ceiling effects were evaluated. RESULTS: A total of 115 patients (median age, 72 years), comprising 50 and 65 patients in the TAR and AA groups respectively, were evaluated. The mean FJS-12 scores were 65 and 58 for the TAR and AA groups, respectively, with no significant difference between groups (P = 0.20). Correlations between the FJS-12 and Self-Administered Foot Evaluation Questionnaire subscale scores were good to moderate. The correlation coefficient ranged from 0.39 to 0.71 and 0.55 to 0.79 in the TAR and AA groups, respectively. The correlation between the FJS-12 and EuroQoL 5-Dimension 5-Level scores was poor in both groups. The internal consistency was adequate, with Cronbach's α greater than 0.9 in both groups. The intraclass correlation coefficients of test-retest reliability was 0.77 and 0.98 in the TAR and AA groups, respectively. The 95% minimal detectable change values were 18.0 and 7.2 points in the TAR and AA groups, respectively. No floor or ceiling effect was observed in either group. CONCLUSIONS: The Japanese version of FJS-12 is a valid and reliable questionnaire for measuring joint awareness in patients with TAR or AA. The FJS-12 can be a useful tool for the postoperative assessment of patients with end-stage ankle arthritis.

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

A Biomechanical Comparison of 2 Over-the-Top Anterior Cruciate Ligament Reconstruction Techniques: A Cadaveric Study Using a Robotic Simulator.

Kousuke Shiwaku, Tomoyuki Suzuki, Konsei Shino, Satoshi Yamakawa, Hidenori Otsubo, Shinichiro Okimura, Daisuke Suzuki, Shogo Nabeki, Atsushi Teramoto, Hirofumi Ohnishi, Hiromichi Fujie, Toshihiko Yamashita

Orthopaedic journal of sports medicine 10 ( 12 ) 23259671221139876 - 23259671221139876 2022.12 [International journal]

BACKGROUND: For skeletally immature patients, over-the-top (OTT) anterior cruciate ligament (ACL) reconstruction (ACLR) is preferred. However, increased anterior laxity at deep knee flexion angles remains concerning. We modified the procedure to proximally shift the graft fixation site on the femur to prevent graft loosening at higher knee flexion angles and named it the supra-OTT procedure. PURPOSE: To compare anterior laxity and in situ forces of the ACL graft between conventional OTT and supra-OTT ACLR in a cadaveric model. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 11 fresh-frozen cadaveric knee specimens underwent 4 robotic testing conditions: ACL intact, ACL resected, conventional OTT, and supra-OTT. For each condition, a 100-N load was applied at 0°, 15°, 30°, 60°, and 90° of knee flexion to simulate the Lachman test or anterior drawer test. In addition, a combined load of 5-N·m internal tibial torque and 10-N·m valgus torque was applied at 15° and 30° of knee flexion as a simulated pivot-shift test. Anterior tibial translation and in situ graft forces were recorded. The only difference between conventional OTT and supra-OTT ACLR was the graft fixation site on the femur. For conventional OTT ACLR, graft fixation was performed just on the proximal and lateral ends of the posterior condyle. For supra-OTT ACLR, the fixation point was around the proximal insertion of the lateral head of the gastrocnemius and the lateral edge of the posterior cortex, approximately 2 cm proximal to the conventional OTT position. RESULTS: On the simulated anterior drawer test at 60° and 90° of knee flexion, anterior tibial translation after supra-OTT ACLR was significantly smaller than after conventional OTT ACLR (P < .01). However, no significant differences were noted at other flexion angles or on the simulated pivot-shift test between the conventional OTT and supra-OTT procedures. Some overconstraint and higher graft forces were noted with both techniques, but the supra-OTT technique caused even more overconstraint at higher flexion angles. CONCLUSION: Supra-OTT ACLR showed better biomechanical performance to control anterior laxity than conventional OTT ACLR at higher knee flexion angles. CLINICAL RELEVANCE: The supra-OTT procedure may improve anterior stability at deep knee flexion angles.

DOI PubMed

The Role of the Medial Meniscus in Anterior Knee Stability.

Kousuke Shiwaku, Tomoaki Kamiya, Daisuke Suzuki, Satoshi Yamakawa, Hidenori Otsubo, Tomoyuki Suzuki, Katsunori Takahashi, Yohei Okada, Atsushi Teramoto, Hirofumi Ohnishi, Hiromichi Fujie, Toshihiko Yamashita

Orthopaedic journal of sports medicine 10 ( 11 ) 23259671221132845 - 23259671221132845 2022.11 [International journal]

Background: Few studies have compared the force distribution between the anterolateral, posterolateral, and medial structures of the knee. Purpose: To investigate the important structures in an intact knee contributing to force distribution in response to anterior tibial load. Study Design: Controlled laboratory study. Methods: Nine fresh-frozen cadaveric knee specimens underwent robotic testing. First, 100 N of anterior tibial load was applied to the intact knee at 0°, 15°, 30°, 60°, and 90° of knee flexion. The anterior cruciate ligament (ACL), anterolateral capsule, lateral collateral ligament, popliteal tendon, posterior root of the lateral meniscus, superficial medial collateral ligament, posterior root of the medial meniscus (MM), and posterior cruciate ligament were then completely transected in sequential order. After each transection, the authors reproduced the intact knee motion when a 100-N anterior tibial load was applied. By applying the principle of superposition, the resultant force of each structure was determined based on the 6 degrees of freedom force/torque data of each state. Results: At every measured knee flexion angle, the resultant force of the ACL was the largest of the tested structures. At knee flexion angles of 60° and 90°, the resultant force of the MM was larger than that of all other structures with the exception of the ACL. Conclusion: The MM was identified as playing an important role in response to anterior tibial load at 60° and 90° of flexion. Clinical Relevance: In clinical settings, the ACL of patients with a poorly functioning MM, such as tear of the MM posterior root, should be monitored considering the large resultant force in response to an anterior tibial load.

DOI PubMed

Degenerative Lumbar Spondylolisthesis Patients With Movement-related Low Back Pain Have Less Postoperative Satisfaction After Decompression Alone

Ryosuke Hirota, Atsushi Teramoto, Ryota Kimura, Takashi Kobayashi, Mitsunori Yoshimoto, Noriyuki Iesato, Koichiro Okuyama, Izaya Ogon, Michio Hongo, Yuji Kasukawa, Arihiko Tsukamoto, Daisuke Kudo, Makoto Emori, Kousuke Iba, Yoichi Shimada, Naohisa Miyakoshi, Toshihiko Yamashita

Spine 47 ( 19 ) 1391 - 1398 2022.10

Study Design. Retrospective analysis of prospectively collected multicenter observational data. Objective. The aim was to examine the preoperative factors affecting postoperative satisfaction following posterior lumbar interbody fusion (PLIF) and microendoscopic muscle-preserving interlaminar decompression (ME-MILD) in patients with degenerative lumbar spondylolisthesis (DLS). Summary of Background Data. The technique involved in DLS surgery may either be decompression alone or decompression-fixation. Poor performance may occur after either of these surgical treatments. The author hypothesized that evaluating the correlation between preoperative quality of life and postoperative performance would aid in determining the optimal procedure. Materials and Methods. This study included 138 patients who underwent surgery for 1-level mild DLS. The authors performed PLIF for 79 patients and ME-MILD for 59 patients. When the satisfaction subscale of the Zurich Claudication Questionnaire exceeded 2 points, postoperative satisfaction was considered poor. The clinical characteristics were investigated. Responses to preoperative health-related quality of life questionnaires, such as the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), short form-36 health survey (SF-36), and visual analog scale, were compared between the satisfied and unsatisfied groups. Results. In the PLIF group, no endogenous factors influenced postoperative satisfaction. The ME-MILD cohort's satisfied and unsatisfied patients differed significantly in terms of preoperative lumbar spine dysfunction (P<0.001) items of the JOABPEQ, role physical (P=0.03), and role emotional (P=0.03) items of the SF-36. A strong correlation (r=-0.609 P=0.015) was found between preoperative lumbar spine dysfunction and postoperative satisfaction. Conclusions. In the ME-MILD group, preoperative lumbar spine function was correlated with postoperative satisfaction. Decompression alone may be ineffective in cases with decreased lumbar spine function prior to surgery. The degree of low back pain on movement should be considered before selecting the surgical method.

DOI PubMed

【上肢疾患の診断と治療の進歩(新鮮外傷を除く)】総論病態・診断動作解析手関節運動時における正中神経伸長率測定の新しい試み

高島健一, 射場浩介, 青木光広, 寺本篤史, 斎藤憲, 小笹泰宏, 白戸力也, 日高惠喜, 宮本博樹, 山下敏彦

別冊整形外科 ( (株)南江堂 ) ( 82 ) 26 - 30 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

Patient-specific three-dimensional evaluation of interface micromotion in two different short stem designs in cementless total hip arthroplasty: a finite element analysis

Arata Kanaizumi, Daisuke Suzuki, Satoshi Nagoya, Atsushi Teramoto, Toshihiko Yamashita

Journal of Orthopaedic Surgery and Research ( Springer Science and Business Media LLC ) 17 ( 1 ) 2022.09

Abstract Background Evaluation of micromotion in various activities in daily life is essential to the assessment of the initial fixation of cementless short stems in total hip arthroplasty. This study sought to evaluate three-dimensionally the micromotion of two types of cementless short stems. Methods Two types of stems were used: the Fitmore stem with a rectangular cross-section (rectangular stem) and the octagonal-oval GTS stem with fins (finned stem). Finite element analysis was used to calculate the micromotion of two activities that place a heavy load on the stem (single-leg stance and stair climbing). Three values were measured: the magnitude of micromotion (mean and 95th percentile), the location of micromotion above the 95th percentile value, and the directions of the micromotion vector. Results 1. There was no significant difference in the magnitude of the micromotion between the rectangular stem and finned stem groups for single-leg stance or stair climbing. 2. In both groups, the micromotion was greatest at the proximal and distal ends. 3. The direction of the micromotion was similar in both groups; internal rotation occurred from the distal to the middle of the stem during stair climbing. Conclusions The rectangular stem had comparable initial fixation to that of the finned stem. In both models, the micromotion was greater at the proximal and distal ends. The direction of the micromotion was not dependent on the stem shape but on the direction of the load on the artificial femoral head. These results will be important for stem selection and future stem development.

DOI

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

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

大腿四頭筋セッティング時の膝窩圧迫力と大腿四頭筋弾性の関係

小出所大樹, 河合誠, 時田諒, 青木昌弘, 寺本篤史, 金谷耕平, 片寄正樹, 谷口圭吾

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 ) 33回 108 - 108 2022.07

Factors associated with low back pain in patients with lumbar spinal stenosis: a cross-sectional study.

Izaya Ogon, Atsushi Teramoto, Hiroyuki Takashima, Yoshinori Terashima, Mitsunori Yoshimoto, Makoto Emori, Kousuke Iba, Tsuneo Takebayashi, Toshihiko Yamashita

BMC musculoskeletal disorders 23 ( 1 ) 552 - 552 2022.06 [International journal]

BACKGROUND: Low back pain (LBP) is a major symptom of symptomatic lumbar spinal stenosis (SLSS). It is important to assess LBP in patients with SLSS to develop better treatment. This study aimed to analyse the factors associated with LBP in patients with SLSS. METHODS: This cross-sectional study included consecutive patients with SLSS aged between 51 and 79 years who had symptoms in one or both the legs, with and without LBP. The participants were classified into two groups: the high group (LBP visual analogue scale [VAS] score ≥ 30 mm) and the low group (LBP VAS score < 30 mm). We performed multiple logistic regression analysis with the high and low groups as dependent variables, and a receiver operating characteristic (ROC) analysis. RESULTS: A total of 80 patients with LSS were included (35 men and 45 women; mean age 64.5 years), with 47 and 30 patients in the high and low groups, respectively. Multivariate logistic regression analysis revealed that the sagittal vertical axis (SVA; + 10 mm; odds ratio, 1.331; 95% confidence interval, 1.051 - 1.660) and pelvic incidence-lumbar lordosis (PI-LL; + 1°; odds ratio, 1.065; 95% confidence interval, 1.019-1.168) were significantly associated with LBP. A receiver operating characteristic analysis revealed cut-off values of 47.0 mm of SVA and 30.5° of PI-LL, respectively. CONCLUSION: Our results indicated that SVA and PI-LL were significant predictors for LBP in SLSS. It is suggested that these parameters should be taken into consideration when assessing LBP in patients with SLSS.

DOI PubMed

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 ( {SAGE} Publications ) 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

Non-ossifying fibromas and fibrous cortical defects around the knee - an epidemiologic survey in a Japanese pediatric population.

Makoto Emori, Hiroyuki Tsuchie, Atsushi Teramoto, Junya Shimizu, Emi Mizushima, Yasutaka Murahashi, Hiroyuki Nagasawa, Naohisa Miyakoshi, Toshihiko Yamashita

BMC musculoskeletal disorders 23 ( 1 ) 378 - 378 2022.04 [International journal]

BACKGROUND: The aim of the present study was to evaluate the prevalence of non-ossifying fibroma (NOF) and fibrous cortical defect (FCD) in a Japanese pediatric population and the association between the lesion size and pain. METHODS: This retrospective study, conducted across 10 Japanese institutions, included patients aged 5-15 years who had undergone standard antero-posterior and lateral view radiography of the knee. Using these radiographs, we diagnosed the lesion as a NOF or FCD. Patient demographics, including age, sex, the size and location of the NOF, and chief complaint were recorded. The lesion size was determined using radiographs. Student's t-test was used to compare the associations between the lesion size and spontaneous pain. RESULTS: A total of 6222 subjects (3567 boys and 2455 girls) were included in this study. The number of NOF and FCD cases was 143 and 437, respectively, and the prevalence of NOF and FCD was 2.3% and 7.0%, respectively. The average size of NOF and FCD was 22.1 mm (range: 4-102 mm) and 13.2 mm (range: 5-21 mm), respectively. Three patients (2.1%) had pathological fractures due to NOF. Of the 140 NOFs and 437 FCDs, we obtained complaints from the medical records of 126 and 393 patients, respectively. The number of patients with spontaneous pain or other problems with NOF was 68 (54%) and 58 (46%), respectively, that of patients with FCD was 195 (50%) and 198 (50%) patients, respectively. The lesion size was not associated with spontaneous pain in either lesion (p = 0.67 and p = 0.27, respectively). CONCLUSION: The prevalence of NOF and FCD around the knee was lower than that reported in previous studies. The prevalence of NOF increased and that of FCD decreased with advancing age. In both lesions, the lesion size may not be associated with pain.

DOI PubMed

Risk Factors for Postoperative Loss of Correction in Thoracolumbar Injuries Caused by High-Energy Trauma Treated via Percutaneous Posterior Stabilization without Bone Fusion

Ryosuke Hirota, Atsushi Teramoto, Hideto Irifune, Mitsunori Yoshimoto, Nobuyuki Takahashi, Mitsumasa Chiba, Noriyuki Iesato, Kousuke Iba, Makoto Emori, Toshihiko Yamashita

Medicina ( {MDPI} {AG} ) 58 ( 5 ) 583 - 583 2022.04 [International journal]

Background and Objectives: Percutaneous pedicle screws were first introduced in 2001, soon becoming the cornerstone of minimally invasive spinal stabilization. Use of the procedure allowed adequate reduction and stabilization of spinal injuries, even in severely injured patients. This decreased bleeding and shortened surgical time, thereby optimizing outcomes; however, postoperative correction loss and kyphosis still occurred in some cases. Thus, we investigated cases of percutaneous posterior fixation for thoracolumbar injury and examined the factors affecting the loss of correction. Materials and Methods: Sixty-seven patients who had undergone percutaneous posterior fixation for thoracolumbar injury (AO classifications A3, A4, B, and C) between 2009 and 2016 were included. Patients with a local kyphosis angle difference ≥10° on computed tomography at the postoperative follow-up (over 12 months after surgery) or those requiring additional surgery for interbody fusion were included in the correction loss group (n = 23); the no-loss group (n = 44) served as the control. The degree of injury (injury level, AO classification, load-sharing score, local kyphosis angle, cuneiform deformity angle, and cranial and caudal disc injury) and surgical content (number of fixed intervertebral vertebrae, type of screw used, presence/absence of screw insertion into the injured vertebrae, and presence/absence of vertebral formation) were evaluated as factors of correctional loss and compared between the two groups. Results: Comparison between each group revealed that differences in the wedge-shaped deformation angle, load-sharing score, degree of cranial disc damage, AO classification at the time of injury, and use of polyaxial screws were statistically significant. Logistic regression analysis showed that the differences in wedge-shaped deformation angle, AO classification, and cranial disc injury were statistically significant; no other factors with statistically significant differences were found. Conclusion: Correction loss was seen in cases with damage to the cranial intervertebral disc as well as the vertebral body.

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 ( Elsevier {BV} ) 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

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

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Papers - TERAMOTO Atsushi