Details of a Researcher - TAJIMA Takuya

Direct repair of the chronic ochronotic Achilles tendon rupture: a case report Reviewed

Yokoe T., Nagasawa M., Tajima T., Yamaguchi N., Ota T., Morita Y., Chosa E.

BMC Musculoskeletal Disorders 25 ( 1 ) 843 2024.12

Authorship：Lead author,　Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：BMC Musculoskeletal Disorders

Background: Alkaptonuria (AKU) is a rare hereditary disease. Ochronotic arthropathy, tendinopathy, and osteopenia/osteoporosis are generally musculoskeletal manifestations in patients with AKU. Because of the ochronotic tendinopathy and osteopenia, the surgical strategy for chronic ochronotic Achilles tendon rupture may be challenging. No studies have reported the surgical treatment of chronic Achilles tendon rupture in patients with AKU. Case presentation: We report a case of AKU that required surgical treatment for chronic Achilles tendon rupture. A 60-year-old woman was referred to our department for the assessment of left hindfoot pain that persisted for more than nine months after an ankle sprain. Three years prior to the first presentation to our hospital, she was diagnosed with AKU due to pigmented hip cartilage at the time of total hip arthroplasty. The patient was diagnosed as chronic Achilles tendon rupture based on the results of physical examination and magnetic resonance imaging (MRI). The MRI showed enlarged scar tissue of the Achilles tendon with an intrasubstance high signal intensity. We performed resection of the central part of the scar tissue (total length, 24 mm) followed by direct repair using the proximal and distal stumps of the scar tissue. The MRI at 12months after surgery showed continuity of the repaired Achilles tendon. At 18 months after surgery, the Achilles Tendon Total Rupture Score improved from 22 points preoperatively to 84 points postoperatively. The foot and ankle outcome score also improved. Conclusions: We reported a case of AKU with chronic Achilles tendon rupture in which direct repair using scar tissue between the tendon stumps was effective. Careful selection of the surgical procedure for the treatment of chronic ochronotic Achilles tendon rupture is recommended because of concomitant ochronotic tendinopathy and osteopenia/osteoporosis.

DOI： 10.1186/s12891-024-07973-2

The evaluation of rotational lateral ankle laxity in gravity stress position by ultrasonography: normative value in uninjured ankles Reviewed

Yokoe T., Yang F., Tajima T., Chosa E.

BMC Musculoskeletal Disorders 25 ( 1 ) 764 2024.12

Authorship：Lead author,　Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：BMC Musculoskeletal Disorders

Background: The evaluation of lateral ankle laxity remains challenging when diagnosing chronic lateral ankle instability (CLAI). Several studies have reported that internal rotation of the talus as an indicator of rotational lateral ankle laxity (RLAL) increases in patients with CLAI. However, there is no established method for detecting and evaluating the RLAL. This study aimed to report a novel method for evaluating the RLAL in the gravity stress position by measuring the talofibular distance (TFD) using ultrasonography (US) and show the normative value of the TFD. Methods: The TFDs in the subjects with healthy ankles were prospectively measured 10 mm distal to the ankle joint in the neutral ankle position and gravity stress position using US. The differences in the TFD between the two ankle positions were evaluated. The differences in the TFD by gender and ankle laterality were also evaluated. Results: A total of 52 healthy ankles of 28 subjects (mean age, 24.0 ± 1.6; male/female, 12/16) were finally included. There was a significant difference in the TFD between the neutral ankle position (6.9 ± 0.9 mm) and gravity stress position (9.0 ± 0.9 mm) (p < 0.001). The mean difference in the TFD between the two ankle positions was 2.1 ± 0.6 mm. There were no significant differences in the TFD by gender and ankle laterality. Conclusions: The present study reported a novel US method for evaluating RLAL by applying gravity stress and the normative value of the TFD.

DOI： 10.1186/s12891-024-07881-5

特集外来でできる運動器疾患に対する最先端保存療法神経筋電気刺激療法(NMES)の筋萎縮予防･筋力増強効果 Reviewed

田島卓也, 帖佐悦男

関節外科　基礎と臨床 43 ( 14 ) 116 - 123 2024.10

Authorship：Lead author,　Corresponding author Publishing type：Research paper (scientific journal) Publisher：メジカルビュー社

DOI： 10.18885/jjs.0000001945

Retromalleolar groove morphology of the tibialis posterior tendon (TPT) in patients without TPT pathology evaluated by axial computed tomography scans Reviewed

Yokoe T., Yang F., Tajima T., Yamaguchi N., Morita Y., Chosa E.

Foot and Ankle Surgery 30 ( 7 ) 608 - 611 2024.10

Authorship：Lead author,　Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Foot and Ankle Surgery

Background: This study aimed to evaluate the shape of the retromalleolar groove of the tibialis posterior tendon (TPT) using computed tomography (CT). Methods: CT images of patients with foot or ankle pathologies were retrospectively reviewed. The morphology of the retromalleolar groove of the TPT was assessed at two different levels: the ankle joint and 10 mm above the ankle joint. The groove shape was classified into three types; concave, flat, or irregular. In cases with concave grooves, the width and depth of the grooves were measured. Results: Of the 116 ankles from 116 subjects included in this study, 80.2 % showed a shallow concave shape (mean depth, 1.6 mm) at the two scan levels. The shape and width of the groove differed significantly by gender, although there was no significant difference in the groove depth. Conclusion: Approximately 80% showed a shallow concave groove of the TPT. The groove characteristics differed by gender, although there was no significant difference in the groove depth. Level of evidence: Cross-sectional cohort study; Level of evidence, Ⅳ

DOI： 10.1016/j.fas.2024.05.006

リファンピシン使用によりステロイド作用が減弱し治療に難渋した手関節非結核性抗酸菌症の1例 Reviewed

松永美穂, 大田智美, 田島卓也, 山口奈美, 長澤誠, 森田雄大, 横江琢示, 帖佐悦男

整形外科と災害外科 73 ( 3 ) 602 - 605 2024.9

Authorship：Lead author,　Last author,　Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会

【はじめに】ステロイド薬は他薬との薬物相互作用が比較的少なく汎用されるが，抗結核薬のリファンピシン（以下RFP）との相互作用はあまり知られていない．ネフローゼ症候群加療中に非結核性抗酸菌症（以下NTM）を合併し，ステロイドとRFPの併用で原疾患およびNTMの治療に難渋した1例を経験した．【症例】41歳男性，21歳時にネフローゼ症候群と診断され，ステロイドを内服中に手関節掌背側の腫脹を認め，滑膜切除術後に非結核性抗酸菌性滑膜炎の診断となった．RFPを含む抗結核薬3剤を開始したところ，ネフローゼ症候群が悪化しステロイドを増量，尿蛋白は改善するも手関節腫脹が再発し，2回目の滑膜切除術施行後，高気圧酸素療法で感染は鎮静化した．【考察】NTMにはRFPが汎用されるが，ステロイドとの相互作用により治療に難渋することがある．薬物の相互作用を十分に熟知し，NTMの治療にあたる必要がある．

DOI： 10.5035/nishiseisai.73.602

特集大規模レジストリーによる整形外科リアルワールドエビデンス構築関節鏡およびスポーツ整形外科関連手術に対するレジストリー-JOSKAS eNOTEからJSOAレジストリーへ Reviewed

リファンピシン使用によりステロイド作用が減弱し治療に難渋した手関節非結核性抗酸菌症の１例 Reviewed

松永美穂、大田智美、田島卓也、山口奈美、長澤誠、森田雄大、横江琢示、帖佐悦男

整形外科と災害外科 73 ( 3 ) 204 - 207 2024.9

Language：Japanese Publishing type：Research paper (scientific journal)

Favorable Short-Term Outcomes of a Patient With Symptomatic Bipartite Navicular Bone Treated by Screw Fixation Reviewed

Takuji Yokoe, Takuya Tajima, Etsuo Chosa

Cureus 2024.8

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.7759/cureus.67959

田島卓也, 鈴木朱美

臨床整形外科 59 ( 7 ) 891 - 895 2024.7

Authorship：Lead author,　Corresponding author Publishing type：Research paper (scientific journal) Publisher：株式会社医学書院

DOI： 10.11477/mf.1408203050

Differences in Retromalleolar Fibular Groove Morphology According to Level of Axial Computed Tomography Scans Reviewed

Retromalleolar groove morphology of the tibialis posterior tendon (TPT) in patients without TPT pathology evaluated by axial computed Reviewed International coauthorship

Takuji Yokoe, Fan Yang,Takuya Tajima, Nami Yamaguchi,Yudai Morita,Etsuo Chosa

Foot and Ankle Surgery 2024.5

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1016/j.fas.2024.05.006

Ureter position and risk of ureteral injury during lateral lumbar interbody fusion Reviewed

Hamanaka H., Tajima T., Kurogi S., Higa K., Nagai T., Kuroki T., Takamori H., Mukai S., Kamoto T., Chosa E.

Journal of Orthopaedic Science 2024.5

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1177/23259671241235162

Screening of Undiagnosed Increased Lateral Ankle Laxity Using Stress Ultrasonography Reviewed

Takuji Yokoe, Takuya Tajima, Etsuo Chosa,Nami Yamaguchi and Yudai Morita

Orthopaedic Journal of Sports Medicine 2024.4

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1177/23259671241235162

Takuji Yokoe, Takuya Tajima, Koki Ouchi, Nami Yamaguchi, Yudai Morita, and Etsuo Chosa

The Orthopaedic Journal of Sports Medicine 12 ( 3 ) 23259671241237255 2024.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Orthopaedic Journal of Sports Medicine

Background: Studies have evaluated types of retromalleolar groove using axial magnetic resonance imaging at the level of 10 mm above the tip of the lateral malleolus. However, no evidence is available to support that this level is appropriate for evaluating retromalleolar groove morphology. Purpose: To assess the influence of the level of axial computed tomography (CT) scans on the assessment of retromalleolar groove morphology. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The study population included 122 patients (mean age, 27.9 ± 11.8 years; 69 males, 53 female) who underwent CT scans to evaluate foot or ankle pathologies between 2020 and 2023. The shape of the retromalleolar groove (concave, flat, convex, or irregular) at 3 levels of axial CT scans (8, 10, and 12 mm above the tip of the lateral malleolus) was assessed independently by 2 orthopaedic surgeons. The length from the tip of the lateral malleolus to the proximal tip of the fossa of the lateral malleolus was also measured on coronal CT scans. Results: The type of retromalleolar groove was significantly different according to the level of CT scans (8 vs 10 mm, P =.0001; 10 vs 12 mm, P =.0001; 8 vs 12 mm, P =.001). The type of retromalleolar groove was the same at all 3 levels in 31.1% of patients (38/122). The length from the tip of the lateral malleolus to the proximal tip of the fossa of the lateral malleolus was <10 mm in 17.2% of patients (21/122). Conclusion: The shape of the retromalleolar fibular groove was affected by the level at which the CT scan was obtained. Approximately 70% of the patients showed different types of retromalleolar grooves among the 3 CT scan levels.

DOI： 10.1177/23259671241237255

Screening of Undiagnosed Increased Lateral Ankle Laxity Using Stress Ultrasonography Reviewed

Yokoe T., Tajima T., Chosa E., Yamaguchi N., Morita Y.

Orthopaedic Journal of Sports Medicine 12 ( 4 ) 23259671241235162 2024.3

Authorship：Lead author,　Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Orthopaedic Journal of Sports Medicine

Background: Some patients with lateral ankle sprain (LAS) will experience chronic lateral ankle instability (CLAI). However, not all of those with residual increased lateral ankle laxity (ILAL) become symptomatic. There is a lack of evidence regarding the prevalence of undiagnosed ILAL in the general population. Purpose: To evaluate the prevalence of undiagnosed ILAL with the use of stress ultrasonography (US) and to investigate the percentage of ankle sprain copers (ASCs) with ILAL. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The anterior talofibular ligament (ATFL) lengths in college students without diagnosis of CLAI were measured consecutively in stress and nonstress positions. The ATFL ratio was calculated as an indicator of lateral ankle laxity according to a previously reported method. The manual anterior drawer test was also performed. The Cumberland Ankle Instability Tool (CAIT) and Ankle Instability Instrument (AII) were used to assess subjective impairments related to CLAI. The correlation between the ATFL ratio and CAIT score was evaluated. Results: A total of 207 ankles from 106 participants (mean age, 23.9 ± 2.2 years; male/female, 64/42) were included. Overall, 38 participants (35.8%; 50 ankles [24.2%]) were classified as having undiagnosed ILAL. Of the ankles with no history of LAS, 8% showed ILAL. Overall, 53 participants (50%) had a history of LAS and were all classified as ASCs. Of the 82 ankles from these ASCs, 40 (48.8%) were regarded as having undiagnosed ILAL. There was no correlation between the ATFL ratio and CAIT scores (r = -0.09, P =.414). Conclusion: The prevalence of undiagnosed ILAL by stress US screening was approximately one-third in young adults. In this study, 48.8% of the ankles from ASCs showed ILAL.

DOI： 10.1177/23259671241235162

Risk of Skull Perforation with Halo Vest Skull Pins Reviewed

Hamanaka Hideaki, Tajima Takuya, Kurogi Syuji, Higa Kiyoshi, Nagai Takuya, Takahashi Takumi, Matsumoto Takayuki, Chosa Etsuo

Spine Surgery and Related Research 8 ( 5 ) 480 - 484 2024

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Society for Spine Surgery and Related Research

Introduction: A halo vest is an immobilization device widely used to stabilize the cervical spine. Pain and infection at the skull pin insertion site are common complications, but skull perforation is rare, and most published studies are case reports. This study aimed to identify risk factors for skull perforation by comparing patients who did and did not develop perforation.Methods: Overall thickness and the thicknesses of the internal and external laminae of the skull at the skull pin insertion sites were measured on cranial computed tomography scans of 66 patients fitted with a halo vest. The results were compared between patients who did and did not develop perforation.Results: Four patients developed perforations. All patients with perforation were older women, and their external and internal laminae were significantly thinner than those of patients who did not develop perforation.Conclusions: The reported causes of skull pin perforation include infection around the pin, osteoporosis, and an enlarged frontal sinus. However, most patients with perforation in the present study were older women, and the cause was the thinning of the external and external laminae.

DOI： 10.22603/ssrr.2023-0261

3．ジャパンラグビーリーグワンにおける外傷・障害調査 Reviewed

田島卓也, 帖佐悦男, 中村明彦

日本臨床スポーツ医学会誌 32 ( 3 ) 342 - 344 2024

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：一般社団法人日本臨床スポーツ医学会

DOI： 10.57474/jjcsm.32.3_342

Spatiotemporal gait characteristics post-total hip arthroplasty and its impact on locomotive syndrome: a before-after comparative study in hip osteoarthritis patients Reviewed

Miyazaki S., Fujii Y., Tsuruta K., Yoshinaga S., Hombu A., Funamoto T., Sakamoto T., Tajima T., Arakawa H., Kawaguchi T., Nakatake J., Chosa E.

Peerj 12 ( 10 ) e18351 2024

Authorship：Lead author,　Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Peerj

Background. Understanding the gait pattern of patients eligible for total hip arthroplasty (THA) due to hip osteoarthritis (OA) offers valuable information for improving locomotive syndrome (LS). This study aims to measure the gait patterns of THA-eligible patients using an optical motion capture system and to analyze these patterns using principal component analysis (PCA). Additionally, this study examines the relationship between THA-induced gait patterns and LS. Methods. This before-after study included 237 patients who underwent unilateral primary THA due to hip OA. The primary outcome measures were spatiotemporal gait parameters. Secondary outcome measures included three LS risk tests: a stand-up test, a two-step test, a 25-question Geriatric Locomotive Function Scale (GLFS-25), and total clinical decision limits stages. PCA was performed using 16 spatiotemporal gait parameters collected before and three months after THA. Principal components (PC) were selected to achieve a cumulative contribution rate of 90% (0.9) or higher. Each summarized PC was compared using a paired t-test before and three months after THA. Furthermore, multiple regression analysis was conducted to determine how changes in each PC between before and three months after THA related to changes in the four LS evaluation items. Results. PCA identified three principal components (PC1, PC2, PC3) that accounted for a cumulative contribution rate of 0.910 using 16 spatiotemporal gait parameters. When comparing before and three months after THA for all three PCs, significant differences were observed in each PC (p < 0.001), with overall walking ability and stance phase being higher three months after THA than before THA, while the asymmetry of support time was lower three months after THA. The results of multiple regression analysis revealed that PC1, PC2, and PC3 were the most influential factors in total clinical decision limits stage. For each LS risk test, the factors related to the stand-up test were identified as PC1, PC2, and PC3, while the factors related to the two-step test were identified as PC1 and PC2. The factors related to the GLFS-25 were also identified as PC1 and PC2. Conclusions. The most important findings of this study indicate that the three PCs represent over 90% of the 16 spatiotemporal gait parameters, which are associated with total clinical decision limits stage and LS risk tests. The present results suggest that PC1 represents overall walking ability, PC2 represents the stance phase, and PC3 represents asymmetry of support time. Gait pattern characteristics, such as overall walking ability, stance phase, and asymmetry of support time, were clearly defined by these PCs. Regarding the relationship between PC and LS, all three PCs are related to total clinical decision limits stage. In addition, PC1 and PC2 related to all three LS risk tests, and PC3 related only to the stand-up test.

DOI： 10.7717/peerj.18351