Details of a Researcher - TERAMOTO Atsushi

Papers - TERAMOTO Atsushi

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銭谷俊毅, 江森誠人, 射場浩介, 清水淳也, 村橋靖崇, 寺本篤史, 山下敏彦, 土江博幸, 永澤博幸, 宮腰尚久, 島田洋一, 水島衣美

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 63 ( 139th suppl ) 73 - 73 2021

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

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 60 ( 6 ) 1207 - 1211 2021 [International journal]

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.

DOI PubMed

Prevalence of multiple-level spondylolysis and the bone union rates among growth-stage children with lower back pain

Noriyuki Iesato, Kousuke Iba, Mitsunori Yoshimoto, Hidenori Otsubo, Tomoaki Kamiya, Tsuyoshi Miyakawa, Yuko Narita, Makoto Emori, Atsushi Teramoto, Toshihiko Yamashita

Spine Surgery and Related Research ( Japanese Society for Spine Surgery and Related Research ) 5 ( 4 ) 292 - 297 2021

Introduction: Lumbar spondylolysis is usually single level, and only a few multiple-level cases have been reported. We investigated the frequency of multiple-level spondylolysis and the bone union rates among growth-stage children with lower back pain (LBP). Methods: The subjects were growth-stage children examined for LBP between April 2013 and December 2018. All patients with LBP persisting for at least 2 weeks and severe enough to make playing sports difficult underwent lumbar plain radiogram, computed tomography, and magnetic resonance imaging. The cases diagnosed as multiple-level spondylolysis and classified as early or progressive stage received conservative treatment to achieve bone union. Results: A total of 782 growth-stage children were examined for LBP. Of them, 243 children (31.1%) were diagnosed with lumbar spondylolysis. Of these 243 children, 23 (9.5%) children had multiple-level spondylolysis. Of the children diagnosed with multiple-level spondylolysis, most children (87.0%) had pars defects in the early or progressive stage in which bone union could be expected. Most children (78.3%) had pars defects in the terminal stage and combined with these defects, had pars defects in the early or progressive stage at a different spinal level. Twenty children diagnosed with multiple-level spondylolysis who also had pars defects in the early or progressive stage received conservative treatment for bone union, which was achieved in 31 of 39 sites (79.5%). The bone union rate by stage was 92.9% (26 of 28 sites) in the early stage and 45.5% (5 of 11 sites) in the progressive stage. Conclusions: In cases of multiple-level spondylolysis, bone union is likely to be achieved with conservative treatment when the pars defects are in the early or progressive stage. Therefore, the first choice of treatment should be conservative treatment to achieve bone union, the same for single-level spondylolysis.

DOI

Long-term outcomes after phalangeal distraction lengthening in patients with constriction band syndrome

Kousuke Iba, Kenichi Takashima, Megumi Hanaka, Atsushi Teramoto, Makoto Emori, Akira Saito, Hikaru Hayakawa, Toshihiko Yamashita

Journal of Plastic Surgery and Hand Surgery ( Taylor and Francis Ltd. ) 55 ( 5 ) 268 - 272 2021

We investigated the long-term post-operative outcomes, more than 10 years after surgery, of distraction lengthening of phalanges in patients with congenital constriction band syndrome. Five shortened digits of two patients with congenital constriction band syndrome underwent distraction lengthening of the proximal phalanges using external fixator for the reconstruction of grasp and pinch at age of 53 and 41 months. The post-operative followed-up was 126 and 124 months. Subjective evaluation of hand function was performed using the tape measure method and Functional Dexterity Test pre-operatively and at 1 year after surgery. The parameters for proximal phalangeal distraction and the changes in the length ratio of the phalanges were evaluated. Grasp and pinch function was markedly improved after phalangeal lengthening. Regarding the radiographic findings, the length of distraction was 9.7 mm, % increase of lengthening: 52%, duration of distraction: 28 days, duration of fixation: 83 days, and healing index: 90 days. At the latest follow-up, the relative length of the proximal phalanx did not change significantly (−6%) during the 10 years after distraction lengthening. Patients with constriction band syndrome obtained favorable hand function and preserved those functions for more than 10 years after distraction lengthening of short phalanges using an external fixator.

DOI

Strain measurement of the deep layer of the supraspinatus tendon using fresh frozen cadaver: The influence of shoulder elevation.

Hiroki Miyamoto, Kota Watanabe, Atsushi Teramoto, Naoya Iida, Tatsuya Taniguchi, Kento Hirota, Keisuke Negishi, Mineko Fujimiya

Clinical biomechanics (Bristol, Avon) 80 105160 - 105160 2020.12 [International journal]

BACKGROUND: The shoulder is a uniquely complex large joint. Effective and safe physical therapy efforts towards rehabilitating injured and repaired shoulders requires a thorough understanding of shoulder mechanics from both generalized and very specific perspectives. Numerous biomechanical studies have been published on the shoulder. None of the studies, to our knowledge, considered the strain of the deep layers of the supraspinatus tendon for scapular plane elevation. METHODS: Ten unilateral fresh-frozen human cadaveric specimens were used for the study. Scapular plane angles ranging from -10 to 30 degrees were evaluated for tensile loads, ranging from 0 to 120 Newtons, exerted on the supraspinatus tendon. Strain measurements that specifically targeted the deep layer of the supraspinatus tendon during tensile loading were recorded. FINDINGS: Strains recorded in the supraspinatus deep layer while increasing tendon force of the supraspinatus were significant for isometric gleno-humeral elevation of 30° and 20°. The response of strain to tendon force was less pronounced for 10° or less of gleno-humeral elevation. INTERPRETATION: When performing isometric shoulder exercise regimens, rotator cuff forces and both surface and deep tendon strain, relative to scapular positioning, are relevant and should be considered.

DOI PubMed

Flexor hallucis longus tendinous slips and the relationship to toe flexor strength.

Kento Hirota, Kota Watanabe, Atsushi Teramoto, Yuki Saito, Masaki Katayose

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons ( Elsevier {BV} ) 27 ( 8 ) 851 - 854 2020.11 [International journal]

BACKGROUND: In the general population, the flexor hallucis longus (FHL) often has tendinous slips to lesser toes and the number of FHL slips varies between individuals. The purpose of this study was to investigate the relationship between the number of FHL tendinous slips in an individual foot and its toe flexor strength. METHODS: Forty healthy men were included in the study. The FHL branch test was used to assess each subject for the number of FHL tendinous slips. Toe flexor strength in each toe was measured using a force gauge. A two-way ANOVA was used to compare toe flexor strength between groups classified according to the number of FHL slips. RESULTS: The group of subjects with FHL branching to the second toe was the most common (20/40). The toe flexor strength ratio of the third toe was significantly lower in feet lacking FHL branching to the third toe than in those feet which did have branching to the third toe (P = 0.005). CONCLUSIONS: Toe flexor strength was affected by FHL tendinous slips. Considering the number of the FHL tendinous slips an individual foot has may be useful in clinical practice for rehabilitation or training of toe flexor muscles.

DOI PubMed

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

Anatomical Science International ( Springer Science and Business Media LLC ) 96 ( 2 ) 258 - 264 2020.11 [Domestic journal]

The high prevalence of foot pathologies in women and the elderly could be associated with gender and age difference in the morphology of the foot, particularly the morphology of the keystone of the foot, the talus. The present study investigated the orientation and curvature of the three articular surfaces of the talus in relation to sex and age based on computer tomography (CT), to identify possible morphological factors of the higher prevalence of foot disorders in women and elderly. Fifty-six participants were included in this study. The orientations of the talocrural, subtalar, and talonavicular joints were quantified three-dimensionally by calculating normal and principal axes of the articular surfaces defined by planar approximation. The curvature radii of the articular surfaces were quantified by cylindrical and spherical approximations. The talonavicular surface was significantly more twisted in the frontal plane and less adducted in the transverse plane in females than in males. With aging, the subtalar articular surface was significantly facing more posteriorly. Moreover, it was found that the curvature radii of the trochlea and navicular articular surfaces significantly increased with aging, indicating a flattening of these surfaces. The identified changes in the talar morphology with aging could potentially lead to a higher prevalence of foot disorders in the elderly.

DOI PubMed

Tibial Plafond Attachment of the Posterior-Inferior Tibiofibular Ligament: A Cadaveric Study

Shutaro Fujimoto, Atsushi Teramoto, Ken Anzai, Yasutaka Murahashi, Yohei Okada, Tomoaki Kamiya, Kota Watanabe, Mineko Fujimiya, Toshihiko Yamashita

Foot & Ankle Orthopaedics 5 ( 4 ) 2473011420945689 - 2473011420945689 2020.10 [International journal]

BACKGROUND: Some recent studies have reported the role of the posterior malleolus as an attachment of the posterior-inferior tibiofibular ligament (PITFL) and suggested that even a small fragment should be fixed. However, there are few anatomic studies of the tibial plafond attachment of the PITFL. METHODS: Seven Thiel-embalmed ankles were obtained. The margin of the distal tibial joint surface and the attachments of the superficial fiber of the PITFL (sPITFL) and the deep fiber (dPITFL) were identified. In the frontal view, the percentages of the attachments of the sPITFL and dPITFL of the mediolateral dimension of the posterior tibial plafond were measured. In the lateral view, the line that started from the proximal margin of the attachment of the sPITFL and parallel to the tibial axis was drawn, and the distance between that line and the posterior edge of the joint surface was measured (AP distance of the sPITFL). Then, the percentage of the AP distance of the sPITFL of the joint surface in the anteroposterior dimension of the tibial plafond was measured. RESULTS: In the frontal view, the mediolateral distance of the attachment of the sPITFL was 5.0 mm, and that of the dPITFL was 19.5 mm. The percentage of the attachment of the sPITFL on the tibial plafond was 20.6%, and that of the dPITFL was 78.2%. In the lateral view, the average AP distance of the sPITFL was 0.5 mm, and the percentage in the anteroposterior dimension of the tibial plafond was 1.7%. CONCLUSION: The PITFL was attached to less than 10% of the anteroposterior dimension of the tibial plafond in most ankles. Conversely, the PITFL attached widely in the mediolateral dimension. CLINICAL RELEVANCE: This study suggests that the size of the posterior malleolar fragment in the mediolateral dimension could help estimate how much of the PITFL attaches to the fragment which may have implications for ankle stability.

DOI PubMed

Effective stretching positions for the posterior shoulder capsule as determined by shear wave elastography.

Naoya Iida, Keigo Taniguchi, Kota Watanabe, Hiroki Miyamoto, Tatsuya Taniguchi, Atsushi Teramoto, Masaki Katayose

Journal of shoulder and elbow surgery ( Elsevier {BV} ) 30 ( 5 ) 1186 - 1195 2020.09 [International journal]

BACKGROUND: Stretching is often used to prevent and treat posterior shoulder capsule tightness; however, the most effective stretching positions are not clearly defined. The purpose of this study was to identify the stretching positions that specifically applied the greatest passive tension on the posterior shoulder capsule by evaluating the elastic characteristics of posterior capsules and muscles in various stretching positions using ultrasound shear wave elastography (SWE). METHODS: We evaluated 9 fresh-frozen shoulders (mean age 86.6 ± 7.7 years) without osteoarthritis or rotator cuff tears. All posterior shoulder tissues were preserved intact. Shear moduli of the middle and inferior posterior shoulder capsules and the posterior shoulder muscles were evaluated using SWE. We obtained shear modulus measurements in 9 stretching positions using a combination of glenohumeral elevation planes and angles (frontal, sagittal, scapular; -30°, 0°, 30°, 60°, respectively). A 4-Nm torque for shoulder internal rotation or horizontal adduction was applied in each position. We also measured shear moduli in the resting position (0° elevation with neutral shoulder internal/external rotation). We compared the shear moduli of all stretching and resting positions using 1-way repeated measures analysis of variance (P < .05). In addition, we compared the shear modulus in 2 positions (ie, resting and each stretching) among tissues (ie, capsules and muscles) with repeated measures using 2-way analysis of variance (P < .05). RESULTS: Shear modulus values for the middle posterior capsules in "internal rotation at 30° in scapular plane elevation" (28.7 ± 14.3 kPa, P = .01) and in "horizontal adduction at 60° of elevation" (31.1 ± 13.1 kPa, P < .001) were significantly higher than that of the resting position (11.0 ± 7.3 kPa). The shear modulus value for the inferior posterior capsule in "internal rotation at 30° of flexion" was significantly higher than that of the resting position (39.0 ± 17.3 vs. 15.4 ± 13.9 kPa, respectively; P = .004). Additionally, the shear modulus values for the posterior capsules in "internal rotation at 30° in scapular plane elevation and flexion" were significantly higher than that of the posterior shoulder muscles. CONCLUSION: Effective middle posterior shoulder capsule stretching positions were shoulder "internal rotation at 30° of scapular plane elevation" and "horizontal adduction at 60° of elevation." Shoulder "internal rotation at 30° of flexion" was the most effective position for the inferior posterior shoulder capsule. Stretching in these positions could relieve posterior shoulder capsule tightness and contribute to the prevention and treatment of throwing injuries of the shoulder.

DOI PubMed

Is the Lipid Content of the Psoas Major Correlated with Chronic Low Back Pain and Spinopelvic Alignment? A Magnetic Resonance Spectroscopic Study.

Izaya Ogon, Hiroyuki Takashima, Tomonori Morita, Tsutomu Oshigiri, Yoshinori Terashima, Mitsunori Yoshimoto, Makoto Emori, Atsushi Teramoto, Tsuneo Takebayashi, Toshihiko Yamashita

Asian spine journal 14 ( 4 ) 430 - 437 2020.08 [Refereed] [International journal]

STUDY DESIGN: Cross-sectional observational study. PURPOSE: This study aimed to analyze any potential associations of extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) contents with (1) the intensity of low back pain (LBP); (2) age, cross-sectional area (CSA), and fatty infiltration (FI) of the psoas major; and (3) spinopelvic parameters. OVERVIEW OF LITERATURE: The psoas major has clinically relevant function; however, the association of this muscle with chronic LBP is controversial. Magnetic resonance spectroscopy enables a detailed analysis of the composition of muscular fat tissues such as its EMCL and IMCL contents. METHODS: The study population comprised 40 patients (19 males, 21 females; mean age, 61.7±2.4 years). Possible correlations of LBP Visual Analog Scale (VAS) scores, age, CSA, FI, and spinopelvic parameters with EMCL and IMCL contents of the psoas major were assessed. RESULTS: No association was identified between the EMCL and IMCL contents and LBP VAS scores (r=0.05, p=0.79 and r=0.06, p=0.75, respectively). The EMCL content correlated with age (r=0.47, p<0.01), body mass index (BMI) (r=0.44, p<0.01), CSA (r=-0.59, p< 0.01), and FI (r=0.49, p<0.01). EMCL content showed a significant negative correlation with sacral slope (SS) (r=-0.43, p<0.05) and positive correlation with pelvic tilt (PT) (r=0.56, p<0.01). CONCLUSIONS: EMCL content correlated with age, BMI, CSA, and FI of the psoas major, while IMCL content had no correlation. This study found correlations between SS and PT and EMCL content of the psoas major, but no correlations were found between spinopelvic parameters and IMCL content of the psoas major.

DOI PubMed

【キャダバー・サージカル・トレーニングの現状と展望】骨盤・下肢領域における橋渡し研究を生むサージカルトレーニングの役割

名越智, 鈴木大輔, 寺本篤史, 岡田葉平, 佐々木幹人, 渡邉耕太, 小助川維摩, 舘田健児, 金泉新, 山下敏彦

関節外科 ( (株)メジカルビュー社 ) 39 ( 8 ) 861 - 866 2020.08

超音波診断装置による足部腱滑走距離計測異なる足関節肢位の影響

谷口達也, 渡邉耕太, 宮本浩樹, 廣田健斗, 寺本篤史

日本足の外科学会雑誌 ( (一社)日本足の外科学会 ) 41 ( 1 ) 118 - 121 2020.08

超音波診断装置で足・足趾運動に伴う腱滑走距離を計測し、その信頼性と腱滑走距離への関節肢位の影響を検討した。対象は成人男性10名10足で、対象腱は後脛骨筋腱、腓骨筋腱、長母趾屈筋腱、長趾屈筋腱とした。運動条件は他動運動とし、後脛骨筋腱の計測は内がえし20°から外がえし20°、腓骨筋腱では外がえし20°から内がえし20°を行い、それぞれ足関節底屈40°、中間位、足関節背屈10°の3肢位で計測した。長母趾屈筋腱と長趾屈筋腱は運動条件(1)(足関節中間位で足趾中間位から足趾最大伸展)と運動条件(2)(足関節底屈40°、足趾中間位から足関節背屈10°、足趾最大伸展)で計測した。検者間、検者内信頼性(ICC)はおおむね0.7以上と高かった。後脛骨筋腱、腓骨筋腱では足関節底屈位で腱滑走距離が有意に大きく、長母趾屈筋腱、長趾屈筋腱では運動条件(1)の腱滑走距離は運動条件(2)の6割程度だった。本法によって、関節運動に伴う足部の腱滑走距離とそれに対する関節運動や肢位の影響を定量化し得た。(著者抄録)

大腿骨髄内ロッドを使用せずに行ったPS型人工膝関節全置換術後の中期臨床成績

鍋城尚伍, 寺本篤史, 岡田葉平, 神谷智昭, 山下敏彦, 渡邉耕太

東日本整形災害外科学会雑誌 ( 東日本整形災害外科学会 ) 32 ( 3 ) 382 - 382 2020.08

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)

Lumbar disc degeneration assessment using T2* relaxation time with ultra-short TE.

Hiroyuki Takashima, Mitsunori Yoshimoto, Izaya Ogon, Yoshinori Terashima, Rui Imamura, Yoshihiro Akatsuka, Noriyuki Iesato, Tsutomu Oshigiri, Tomonori Morita, Tsuneo Takebayashi, Makoto Emori, Atsushi Teramoto, Toshihiko Yamashita

Magnetic resonance imaging 73 11 - 14 2020.07 [Refereed] [International journal]

DOI PubMed

High bone turnover state under osteoporotic changes induces pain-like behaviors in mild osteoarthritis model mice.

Kenta Kiyomoto, Kousuke Iba, Megumi Hanaka, Koji Ibe, Hikaru Hayakawa, Atsushi Teramoto, Makoto Emori, Toshihiko Yamashita

Journal of bone and mineral metabolism 38 ( 6 ) 806 - 818 2020.07 [Refereed] [Domestic journal]

INTRODUCTION: Our previous studies demonstrated that a high bone turnover state under osteoporotic changes decreased the threshold of skeletal pain. Recent studies reported that the incidence of joint pain due to osteoarthritis (OA) in postmenopausal women was higher than that in males even with the same radiographic OA grade. The aim of this study was to evaluate whether a high bone turnover state affects the induction of pain-like behaviors in mild OA model mice. MATERIALS AND METHODS: We established mild OA model mice with accompanying osteoporotic changes by monosodium iodoacetate injection after ovariectomy. We assessed pain-like behaviors by von Frey test and paw-flick test; histological changes in OA joints; the expression of Runx2, Osterix, Osteocalcin, and Rankl; bone micro-architecture by μCT and measured serum tartrate-resistant acid-phosphatase 5b levels in the model mice. RESULTS: Pain-like behaviors in mice with OA and osteoporotic changes were significantly increased in comparison with those in OA mice without osteoporotic changes. The severity of histological OA changes did not differ significantly between the OA mice with and without osteoporotic changes. Bisphosphonate significantly improved pain-like behaviors accompanied with improvement in the high bone turnover state in the OA mice with osteoporosis, while it had no significant effect on pain-like behaviors in the OA mice without osteoporosis. In addition, the improvement was maintained for more than 4 weeks even after the discontinuation of bisphosphonate treatment. CONCLUSION: These results indicated that a high bone turnover state under osteoporotic changes could affect the induction of pain-like behaviors in mild OA model mice.

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 [Refereed] [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

Hypersensitivity to cold stimulation associated with regional osteoporotic changes in tail-suspended mice.

Koji Ibe, Kousuke Iba, Megumi Hanaka, Kenta Kiyomoto, Hikaru Hayakawa, Atsushi Teramoto, Makoto Emori, Toshihiko Yamashita

Journal of bone and mineral metabolism 38 ( 4 ) 469 - 480 2020.07 [Refereed] [Domestic journal]

INTRODUCTION: Cold intolerance is defined as abnormal pain resulting from exposure to cold stimulation after trauma. However, the pathophysiology remains unclear. We recently demonstrated that regional osteoporotic changes accompanied by high bone turnover were involved in causing pain-like behaviors in the unloaded hind limbs of tail-suspended mice. Bisphosphonate prevented pain-like behaviors and high bone turnover conditions in tail-suspended mice. The aims of this study were to examine the relationship between regional osteoporotic changes and the induction of hypersensitivity to cold stimulation. MATERIALS AND METHODS: The hind limbs of tail-suspended mice were unloaded for 2 weeks. The von Frey test and paw-flick test assessed pain-like behaviors and cold plate test evaluated cold escape behaviors. Furthermore, we examined whether cold hypersensitivity associated with regional osteoporotic changes could be improved by bisphosphonate, TRPV1 and TRPA1 antagonists. RESULTS: Hypersensitivity to cold stimulation was induced more noticeably in the tail-suspended mice, and this effect was related to the increased expression of bone metabolism markers. In addition, the cold hypersensitivity was improved by the resumption of weight bearing and prevented by bisphosphonate or a TRPV1 antagonist, and was accompanied with a decrease in the expression of bone metabolism markers. TRPA1 antagonist significantly improved the cold escape behavior, but had no significant effects on the expression of those markers. CONCLUSION: We demonstrated that the regional osteoporotic changes accompanying a high bone turnover state could be involved in the induction of hypersensitivity to cold stimulation in the tail-suspended mice.

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 [Refereed]

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

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 [Refereed] [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.

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