論文 - 山口 奈美
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Clinical backgrounds and outcomes of patients with Barrett's esophageal adenocarcinoma treated via endoscopic submucosal dissection in Kyushu, Japan: A retrospective multicenter cohort study. 査読あり
Sasaki F, Mizukami K, Akashi T, Yamaguchi N, Gushima R, Miyamoto H, Uehara S, Ono Y, Hisabe T, Kinjo Y, Nasu Y, Fukuda K, Inada T, Sumida Y, Akutagawa T, Miike T, Suzuki S, Fukuya H, Mukasa M, Esaki M, Kumei S, Minoda Y, Kinjo T, Yamaguchi D, Fukuda Y, Hashiguchi K, Yano H, Fujita H, Shimoda R, GI‐Kysuhu study group
DEN open 6 ( 1 ) e70102 2026年4月
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悪性腫瘍と鑑別を要した原発性結核膿瘍の1例 査読あり
鮫島 勇汰, 大田 智美, 田島 卓也, 山口 奈美, 長澤 誠, 森田 雄大, 横江 琢示, 土屋 慧祐, 帖佐 悦男, 亀井 直輔
整形外科と災害外科 74 ( 4 ) 827 - 830 2025年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
【はじめに】転移性結核膿瘍の報告は散見されるが,原発病変のない結核膿瘍は稀である.悪性腫瘍と鑑別を要した原発性結核膿瘍の1例を経験したので報告する.【症例】73歳男性.誘因なく背部腫瘤を自覚し,MRIで背部皮下に8×7 cm大で中心部T2 high,T1 low,辺縁部T2 high,lowが混在し,一部胸腔内に浸潤した腫瘤を認めた.PETCTでも腫瘤に高度集積あり,悪性軟部腫瘍を疑った.切開生検術の際,多量の排膿あり,培養で<i>M. tuberculosis</i>が同定され,結核膿瘍の診断となった.INH,RFP,EB,PZAの内服を12か月継続し,現在再発は認めていない.【考察】原発巣のない結核膿瘍は非常に稀であり,炎症で見られる疼痛・発赤・熱感に乏しいことが多く,画像上も悪性腫瘍を疑ったため,排膿を確認するまで結核膿瘍を疑えなかった症例である.結核膿瘍の診断について,文献的考察を加え報告する.
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ハムストリング近位部損傷における当科での2例の手術経験 査読あり
土屋 慧祐, 森田 雄大, 田島 卓也, 山口 奈美, 大田 智美, 長澤 誠, 横江 琢示, 帖佐 悦男, 亀井 直輔
整形外科と災害外科 74 ( 3 ) 634 - 636 2025年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
【はじめに】ハムストリングの肉ばなれはスポーツ外傷において比較的頻繁に経験するが,手術に至るケースは稀である.今回,ハムストリング腱近位部損傷において手術加療を要した2例を経験したので報告する.【症例1】22歳男性,実業団柔道選手.練習中に強制開脚位となり受傷.MRIにて大腿二頭筋腱,半腱様筋腱の坐骨結節からの断裂(JISS分類:3型3度)と診断し手術を施行した.術後6か月で競技復帰し経過良好であった.【症例2】17歳男性,走高跳選手.跳躍時に踏み込んだ際に左臀部痛自覚.MRIにて大腿二頭筋腱損傷(JISS分類:2型3度)と診断し手術施行した.術後3か月で競技復帰し経過良好であった.【考察】スポーツ選手においてハムストリング腱の3型3度損傷は絶対的手術適応であるが,2型損傷においても手術加療を選択する場合がある.今回,2型,3型損傷に対して手術加療を行い,再損傷なく元のレベルに競技復帰可能であり良好な成績を得た.
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Impact of lymph-node dissection during radical cystectomy for non-muscle-invasive bladder cancer: Japanese multicenter retrospective study. 査読あり
Sazuka T, Taoka R, Miki J, Saito R, Fukuokaya W, Matsui Y, Hatakeyama S, Kawahara T, Matsuda A, Kawai T, Kato M, Sano T, Urabe F, Kashima S, Naito H, Murakami Y, Miyake M, Daizumoto K, Matsushita Y, Hayashi T, Inokuchi J, Sugino Y, Shiga K, Yamaguchi N, Yamamoto S, Yasue K, Abe T, Nakanishi S, Hashine K, Sawada A, Nishihara K, Matsumoto H, Tatarano S, Wada K, Sekito S, Maruyama R, Nishiyama N, Nishiyama H, Kitamura H, Ichikawa T, Japan Urological Oncology Group
International journal of clinical oncology 2025年5月
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Effects of the Number of Neoadjuvant Cycles and Addition of Adjuvant Chemotherapy on the Prognosis of Muscle-Invasive Bladder Cancer Treated With Radical Cystectomy. 査読あり
Hatakeyama S, Taoka R, Miki J, Saito R, Fukuokaya W, Matsui Y, Kawahara T, Matsuda A, Kawai T, Kato M, Sazuka T, Sano T, Urabe F, Kashima S, Naito H, Murakami Y, Miyake M, Daizumoto K, Matsushita Y, Hayashi T, Inokuchi J, Sugino Y, Shiga KI, Yamaguchi N, Taguchi M, Yasue K, Abe T, Nakanishi S, Hashine K, Fujii M, Nishihara K, Matsumoto H, Tatarano S, Wada K, Sekito S, Maruyama R, Nishiyama N, Nishiyama H, Kitamura H, Ohyama C, Japanese Urological Oncology Group
Cancer medicine 14 ( 9 ) e70782 2025年5月
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Stage III substaging and outcomes in patients with bladder cancer undergoing radical cystectomy. 査読あり
Hara S, Fukuokaya W, Miki J, Taoka R, Saito R, Matsui Y, Hatakeyama S, Kawahara T, Matsuda A, Kawai T, Kato M, Sazuka T, Sano T, Urabe F, Kashima S, Naito H, Murakami Y, Miyake M, Daizumoto K, Matsushita Y, Hayashi T, Inokuchi J, Sugino Y, Shiga K, Yamaguchi N, Yamamoto S, Yasue K, Abe T, Nakanishi S, Hashine K, Fujii M, Nishihara K, Matsumoto H, Tatarano S, Wada K, Sekito S, Maruyama R, Nishiyama N, Nishiyama H, Kitamura H, Kimura T, Japan Urological Oncology Group
International journal of urology : official journal of the Japanese Urological Association 32 ( 5 ) 544 - 552 2025年5月
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Patient Preferences for Post-Radical Cystectomy Treatment in Muscle-Invasive Bladder Cancer: A Discrete Choice Experiment in Japan. 査読あり
Yajima S, Hata S, Masumori N, Matsuoka Y, Sawada A, Miki J, Tambo M, Kobayashi Y, Matsuda A, Nakane K, Kobayashi T, Tanaka H, Yamaguchi N, Kaneko G, Miller R, Seto T, Ito H, Kikuchi E
International journal of urology : official journal of the Japanese Urological Association 2025年3月
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Yokoe T., Yang F., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Foot and Ankle Surgery 31 ( 1 ) 20 - 24 2025年1月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Foot and Ankle Surgery
Background: This study aimed to investigate ankle syndesmosis in healthy subjects under non-weight bearing (NWB) and weight bearing (WB) conditions using two US methods. Methods: The anterior tibiofibular clear space (ATFCS) was measured in healthy subjects in NWB and WB conditions using two US procedures. Method 1 measured 10 mm above the ankle joint and Method 2 measured 30° from the line of 10 mm above the ankle joint. Results: A total of 60 ankles from 30 subjects (male/female, 15/15) were included. There was a significant difference in the ATFCS between the two US methods (p < 0.001), and Method 2 was better at detecting the change in diastasis from NWB to WB conditions. The ATFCS was significantly greater on WB than on NWB, irrespective of the US method. Conclusions: Method 2 was better at detecting diastasis of the syndesmosis from NWB to WB conditions. The influence of WB needs to be considered when evaluating syndesmosis using US. Level of evidence: Cross-sectional cohort study; Level of evidence, Ⅳ
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Direct repair of the chronic ochronotic Achilles tendon rupture: a case report 査読あり
Yokoe T., Nagasawa M., Tajima T., Yamaguchi N., Ota T., Morita Y., Chosa E.
BMC Musculoskeletal Disorders 25 ( 1 ) 843 2024年12月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元: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.
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Morita Y., Tajima T., Yamaguchi N., Yokoe T., Nagasawa M., Ota T., Ouchi K., Chosa E.
Scientific Reports 14 ( 1 ) 6192 2024年12月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Scientific Reports
Posterior tibial translation (PTT) after double-bundle posterior cruciate ligament (PCL) reconstruction has sometimes occurred. Purpose of this study is to identify the risk factors for postoperative PTT after double-bundle PCL reconstruction with a hamstring autograft. Comparing the results of bilateral gravity sag view (GSV) at 12 months after surgery, over 5-mm PTT was defined as ‘failure’ in this study. Of 26 isolated PCL reconstruction cases, over 5-mm PTT was seen in 7 cases (group F: 9.57 ± 1.28 mm), and 19 cases had less than 5 mm (group G: 2.84 ± 1.29 mm). Age, sex, body mass index (BMI), preoperative GSV, posterior slope angle of the tibia, anterolateral bundle (ALB) and posteromedial bundle (PMB) graft diameters, and tibial tunnel diameter were evaluated. The two groups were compared with the 2 × 2 chi-squared test, the Mann Whitney U-test, and Spearman’s rank correlation coefficient. Multivariate logistic regression analysis was also performed to determine the risk factor. Statistical significance was indicated as p < 0.01 for correlation with postoperative PTT, and as p < 0.05 for all other comparisons. Mean age (group G 31.8 ± 12.5 vs group F 34.9 ± 15.9 years), sex (male/female: 15/4 vs 3/4), BMI (25.6 ± 4.6 vs 24.9 ± 3.9 kg/m<sup>2</sup>), preoperative GSV (11.3 ± 2.2 vs 11.6 ± 2.9 mm), PMB diameter (5.37 ± 0.33 vs 5.36 ± 0.48 mm), and tibial tunnel diameter (9.32 ± 0.58 vs 9.29 ± 0.49 mm) showed no significant differences. ALB diameter was significantly greater in group G (7.0 ± 0.5 mm) than in group F (6.5 ± 0.29 mm; p = 0.022). There was also a significant difference in posterior tibial slope angle (group G 9.19 ± 1.94 vs group F 6.54 ± 1.45, p = 0.004). On Spearman rank correlation coefficient analysis, ALB diameter GSV (correlation coefficient: − 0.561, p = 0.003) and posterior tibial slope angle (correlation coefficient: − 0.533, p = 0.005) showed a significant correlation with postoperative PTT. Multivariate logistic regression analysis showed that ALB diameter (OR 19.028; 95% CI 1.082–334.6; p = 0.044) and posterior slope angle of tibia (OR 3.081; 95% CI 1.109–8.556; p = 0.031) were independently associated with postoperative PTT, respectively. In double-bundle PCL reconstruction with hamstring, smaller ALB graft diameter and lower (flatted) tibial slope angle were considered risk factors for postoperative PTT.
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Reproductive organ involvement in women undergoing radical cystectomy for urothelial bladder cancer: a nationwide multicenter study. 査読あり
Kato M, Taoka R, Miki J, Saito R, Fukuokaya W, Matsui Y, Yamamoto S, Matsue T, Hatakeyama S, Kawahara T, Matsuda A, Kawai T, Sazuka T, Sano T, Urabe F, Kashima S, Naito H, Murakami Y, Miyake M, Daizumoto K, Matsushita Y, Hayashi T, Inokuchi J, Sugino Y, Shiga K, Yamaguchi N, Yamamoto S, Yasue K, Abe T, Nakanishi S, Hashine K, Fujii M, Nishihara K, Matsumoto H, Tatarano S, Wada K, Sekito S, Maruyama R, Nishiyama N, Nishiyama H, Kitamura H, Uchida J, Japan Urological Oncology Group
International journal of clinical oncology 29 ( 12 ) 1937 - 1945 2024年12月
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Yokoe T., Yang F., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Foot and Ankle Surgery 30 ( 7 ) 608 - 611 2024年10月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元: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
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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 査読あり
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年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元: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.
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Prognostic impact of histological discordance between transurethral resection and radical cystectomy. 査読あり
Matsuda A, Taoka R, Miki J, Saito R, Fukuokaya W, Hatakeyama S, Kawahara T, Fujii Y, Kato M, Sazuka T, Sano T, Urabe F, Kashima S, Naito H, Murakami Y, Miyake M, Daizumoto K, Matsushita Y, Hayashi T, Inokuchi J, Sugino Y, Shiga K, Yamaguchi N, Iio H, Yasue K, Abe T, Nakanishi S, Matsumura M, Fujii M, Nishihara K, Matsumoto H, Tatarano S, Wada K, Sekito S, Maruyama R, Nishiyama N, Nishiyama H, Kitamura H, Matsui Y, Japanese Urological Oncology Group
BJU international 134 ( 2 ) 207 - 218 2024年8月
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Differences in Retromalleolar Fibular Groove Morphology According to Level of Axial Computed Tomography Scans 査読あり
Takuji Yokoe, Takuya Tajima, Koki Ouchi, Nami Yamaguchi, Yudai Morita, and Etsuo Chosa
The Orthopaedic Journal of Sports Medicine 12 ( 3 ) 2024年3月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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Screening of Undiagnosed Increased Lateral Ankle Laxity Using Stress Ultrasonography 査読あり
Yokoe T., Tajima T., Chosa E., Yamaguchi N., Morita Y.
Orthopaedic Journal of Sports Medicine 12 ( 4 ) 23259671241235162 2024年3月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元: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.
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An Analysis of Delayed Bleeding in Cases of Colorectal Endoscopic Submucosal Dissection Due to Types of Direct Oral Anticoagulants in Japan. 査読あり
Yoshida N, Hayashi Y, Togo D, Oka S, Takada K, Fukunaga S, Morita Y, Hayashi T, Kozuka K, Tsuji Y, Murakami T, Yamamura T, Komeda Y, Takeuchi Y, Shinmura K, Fukuda H, Yoshii S, Ono S, Katsuki S, Kawashima K, Nemoto D, Yamamoto H, Saito Y, Tamai N, Iwao A, Itoi Y, Tsuji S, Inagaki Y, Inada Y, Soga K, Hasegawa D, Murakami T, Yoriki H, Fukumoto K, Motoyoshi T, Nakatani Y, Sano Y, Iguchi M, Fujii S, Ban H, Harada K, Okamoto K, Nishiyama H, Sasaki F, Mizukami K, Shono T, Shimoda R, Miike T, Yamaguchi N
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 22 ( 2 ) 271 - 282.e3 2024年2月
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Analysis of clinicopathological factors associate with the visibility of early gastric cancer in endoscopic examination and usefulness of linked color imaging: A multicenter prospective study. 査読あり
Fukuda K, Mizukami K, Yamaguch D, Tanaka Y, Hashiguchi K, Akutagawa T, Shimoda R, Suzuki S, Miike T, Sumida Y, Maeda H, Sasaki F, Gushima R, Miyamoto H, Hashiguchi K, Yamaguchi N, Ohira T, Kinjo T, Ohnita K, Moriyama T, Ohtsu K, Aso A, Ogawa R, Ueo T, Fukuda M
PloS one 19 ( 11 ) e0312385 2024年
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Journal of Orthopaedic Science 28 ( 6 ) 1543 - 1547 2023年11月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Orthopaedic Science
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Remnant-Preserved Single-Bundle Anterior Cruciate Ligament Augmentation in Multi-ligamentous Knee Reconstruction. 査読あり
Tajima T, Yamaguchi N, Morita Y, Yokoe T, Nagasawa M, Ota T, Kawagoe S, Nakamura Y, Chosa E.
J Knee Surg 36 ( 10 ) 1095 - 1101 2023年10月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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第2趾DIP関節脱臼に対する観血的整復術後の早期スポーツ復帰の一例
川越 亮, 田島 卓也, 山口 奈美, 大田 智美, 長澤 誠, 森田 雄大, 横江 琢示, 帖佐 悦男
整形外科と災害外科 72 ( 3 ) 485 - 487 2023年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
【はじめに】観血的整復術を必要とした第2趾のDIP関節脱臼の1例を経験した.【症例】16歳男性.空手中に受傷.第2趾DIP関節脱臼で徒手整復を行ったが整復不能であったため,観血的整復術を行った.整復阻害因子は長趾屈筋腱であり,蹠側板の嵌頓は認めなかった.術後早期の競技復帰希望があったため母趾とのbuddy tapingを指示し復帰とした.術後6か月が経過し特に問題なく競技継続している.【考察】DIP関節脱臼の整復阻害因子は蹠側板や長趾屈筋腱の報告があり,本症例では長趾屈筋腱であった.また,術後のスポーツ復帰について,競技によっては症状次第で早期復帰が見込めると考えられた.
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Risk factors associated with throwing injuries in young baseball players
Nagasawa M., Tajima T., Kawagoe S., Yamaguchi N., Morita Y., Yokoe T., Ota T., Izumi T., Ishida Y., Chosa E.
Journal of Shoulder and Elbow Surgery 32 ( 8 ) 1673 - 1680 2023年8月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Shoulder and Elbow Surgery
Background: Few studies have retrospectively analyzed the relationship between joint range of motion (ROM) and muscle flexibility and shoulder and elbow throwing injuries in a large number of elementary school baseball players. The purpose of this study was to retrospectively identify the physical factors related to shoulder and elbow throwing injuries in younger baseball players. Methods: A total of 2466 younger baseball players belonging to our Prefecture Rubber Baseball Federation who participated in medical check-ups from 2016 to 2019 were analyzed. Players completed a questionnaire and had a medical check-up that included a physical examination and ultrasonography. ROM (internal rotation [IR] angle and external rotation angle) of the shoulder and hip and the finger-to-floor distance and heel-to-buttock distance were measured. The straight leg raise was also performed. The results of two groups (normal group and injury group) were compared using the χ<sup>2</sup> test, Mann-Whitney U test, and Student t test. Stepwise forward logistic regression models were developed to identify risk factors. Results: On univariate analysis, nine of the 13 evaluated items showed significant decreases in ROM and muscle flexibility in the injury group. On multiple logistic regression analysis, grade, finger-to-floor distance, IR angle of the dominant side shoulder, and IR angle of the nondominant side hip were significantly associated with the occurrence of throwing injuries. Decreased total shoulder angle was observed not only on the dominant side but also on the nondominant side in the injury group. Conclusion: Decreased ROM and muscle flexibility were risk factors for baseball-related throwing injuries in elementary school baseball players. To prevent shoulder and elbow throwing injuries, players, coaches, medical staff, and parents need to be aware of these findings.
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Ureter position and risk of ureteral injury during lateral lumbar interbody fusion 査読あり
Makoto Nagasawa,MD,Takuya Tajima,MD,PhD,Shuichi Kawagoe, MD,Nami Yamaguchi,MD,PhD, Yudai Morita,MD,Takuji Yokoe, MD,Tomomi Ota,MD,Toshihiko Izumi, MD, PhD,Yasuyuki Ishida, MD,Etsuo Chosa,MD,PhD
Journal of Clinical Medicine 32 ( 8 ) 1673 - 1680 2023年5月
記述言語:英語 掲載種別:研究論文(大学,研究機関等紀要) 出版者・発行元:Elsevier
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Knee Surgery Sports Traumatology Arthroscopy 31 ( 5 ) 1994 - 2000 2023年5月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Knee Surgery Sports Traumatology Arthroscopy
Purpose: This study aimed to evaluate the relationship between generalized joint laxity (GJL) and stress ultrasonographic (US) findings of the anterior talofibular ligament (ATFL) of healthy young men. Methods: The ATFL lengths of healthy young men were consecutively measured in the stress and nonstress positions. The ATFL ratio was calculated as an indicator of lateral ankle laxity. GJL was evaluated using the Beighton score (BS), and a BS of ≥ 5 was considered GJL. The manual anterior drawer test (ADT) was also performed. The results of stress US and ADT were compared between subjects with and without GJL, and the correlation between GJL and US findings was examined. Results: A total of 13 subjects with GJL and 95 without GJL were included in the study. The mean BSs in the GJL and no-GJL groups were 5.9 ± 0.9 and 1.1 ± 1.3, respectively (p < 0.0001). The GJL group showed a higher grade of ADT than the no-GJL group (p < 0.0001). Significant differences were found in the stress ATFL length (23.6 ± 1.8 mm vs. 21.7 ± 1.8 mm, p = 0.002) and ATFL ratio (1.15 ± 0.06 vs. 1.07 ± 0.03, p < 0.0001) between the GJL and no-GJL groups. Spearman’s correlation coefficients showed a moderate correlation between the BS and ATFL ratio (r = 0.45, p < 0.0001). Conclusion: The present study showed significant differences in the ATFL ratio and stress ATFL length between young men with and without GJL. The BS was moderately correlated with the lateral ankle laxity in this population. Level of evidence: Level IV.
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Risk factors of failure results after double-bundle reconstruction with autogenous hamstring grafts for isolated posterior cruciate ligament rupture cases 査読あり
Yudai Morita,Takuya Tajima,Nami Yamaguchi,Takuji Yokoe,Makoto Nagasawa,Tomomi Ota,Kouki Ouchi,Etsuo Chosa
Scientific reports 6192 2023年3月
記述言語:英語 掲載種別:研究論文(大学,研究機関等紀要) 出版者・発行元:nature portfolio
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Risk factors of failure results after double-bundle reconstruction with autogenous hamstring grafts for isolated posterior cruciate ligament rupture cases 査読あり
Yudai Morita,Takuya Tajima,Nami Yamaguchi,Takuji Yokoe,Makoto Nagasawa,Tomomi Ota,Kouki Ouchi,Etsuo Chosa
Scientific reports 6192 2023年3月
記述言語:英語 掲載種別:研究論文(大学,研究機関等紀要)
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Medicina Lithuania 59 ( 3 ) 2023年3月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Medicina Lithuania
Muscle herniation of the lower extremity, such as tibialis anterior muscle herniation (TAMH), is not a rare cause of leg pain in athletes. However, a few studies have reported surgical treatment for TAMH, and the optimal surgical procedure remains controversial. Fasciotomy was reported to be effective for patients with TAMH. However, this procedure would be associated with a risk of intraoperative injury to the superficial peroneal nerve (SPN), although no previous literature has reported this complication. This case report aimed to report a case of bilateral TAMHs in which a traumatic neuroma of the SPN developed after fasciotomy. A 16-year-old baseball player presented with painful swelling lesions of the bilateral lower extremities (1 lesion on the right, 3 lesions on the left) after sports activities. An ultrasonographic evaluation showed swelling lesions of the anterolateral parts of the bilateral lower extremities in the standing position after dashing, while these lesions were not detected in the supine position. A fasciotomy of the crural fascia was performed after conservative treatment failed. Several days after surgery, the patient presented with weakened touch sensation over the dorsal area of the left foot. At the three-month follow-up examination, a swelling lesion with hard elasticity was identified. The palpation of this lesion caused a radiating sensation in the area supplied by the SPN. He was able to return to playing baseball six months after surgery. The patient was asymptomatic without palpation of the traumatic neuroma of the SPN at the latest follow-up examination. In conclusion, the present case report suggests that orthopedic surgeons need to consider the risk of iatrogenic injury to the SPN during fasciotomy for the treatment of TAMHs. However, there may be a risk of injuring the SPN because of the many variants of the course of the SPN within the compartment of the lower extremities.
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A Traumatic Neuroma Formation Following Fasciotomy for the Treatment of Tibialis Anterior Muscle Herniation:A Case Report 査読あり
Takuji Yokoe,Takuya Tajima,Nami Yamaguchi,Yudai Morita and Etsuo Chosa
medicina 2023年2月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:MDPI
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[Practices and challenges of joint education at two medical schools utilizing online pharmacology role-playing]. 査読あり
Okada S, Kondo K, Yamaguchi N, Ichinose C, Yanagita T
Nihon yakurigaku zasshi. Folia pharmacologica Japonica 158 ( 2 ) 134 - 137 2023年
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Risk Factors of Loss of Knee Range of Motion after Primary Anterior Cruciate Ligament Reconstruction following Preoperative Recovery of Knee Range of Motion 査読あり
Takuji Yokoe, Takuya Tajima, Nami Yamaguchi, Yudai Morita, Etsuo Chosa
The Journal of Knee Surgery 2022年12月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Thieme
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Yokoe T., Tajima T., Kawagoe S., Yamaguchi N., Morita Y., Chosa E.
BMC Musculoskeletal Disorders 23 ( 1 ) 887 2022年12月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:BMC Musculoskeletal Disorders
Background: A number of studies have evaluated risk factors for lateral ankle sprain (LAS) or chronic lateral ankle instability (CLAI). However, the definitive risk factors for LAS or CLAI remain controversial. The purpose of this study was to evaluate whether the contralateral healthy ankles of subjects with ipsilateral mechanical lateral ankle laxity (group I) show greater lateral ankle laxity in comparison to the healthy ankles of bilateral healthy controls (group B). Methods: From March 2020, anterior talofibular ligament (ATFL) lengths of young adult volunteers were cross-sectionally measured in non-stress and stress positions using a previously reported stress ultrasonography (US) procedure. The ATFL ratio (the ratio of stress ATFL/non-stress ATFL length) was calculated as an indicator of lateral ankle laxity. The manual anterior drawer test (ADT) was also performed. The US findings of healthy ankles from groups I and B were compared. Results: A total of 154 subjects in group B (mean age, 24.5 ± 2.8 years; male/female, 84/70) and 40 subjects in group I (mean age, 24.4 ± 2.3 years; male/female, 26/14) were included in the study. There was no significant difference in the ADT between the groups. There were no significant differences in the non-stress ATFL length (19.4 ± 1.8 vs. 19.3 ± 1.9, p = 0.84), stress ATFL length (20.8 ± 1.8 vs. 20.9 ± 1.9, p = 0.66), length change (1.5 ± 0.6 vs. 1.6 ± 0.6, p = 0.12) and ATFL ratio (1.08 ± 0.03 vs. 1.08 ± 0.03, p = 0.13) between the groups. Conclusion: No significant difference was detected between the contralateral healthy ankles of subjects with ipsilateral mechanical lateral ankle laxity and those of bilateral healthy controls.
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Medicina Lithuania 58 ( 11 ) 2022年11月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Medicina Lithuania
Osteochondral lesion (OCL) of the patellofemoral (PF) joint is not an uncommon cause of knee pain, and surgery is needed when conservative treatment fails. However, there is a lack of evidence regarding the optimal surgical treatment for OCL of the PF joint. Fixation of OCLs using autogenous osteochondral grafts has been reported to be effective for OCL of the knee. However, in this surgical technique, the biomechanical strength of osteochondral grafts may not be sufficient in patients with open physes due to the specific quality of the cartilage and subchondral bone given their age. There is a lack of studies reporting fixation of the OCL located in the PF joint using autogenous osteochondral grafts. We herein report a case of OCL of the femoral intercondylar groove where autogenous osteochondral grafts augmented with bioabsorbable pins were used to fix the lesion in a 14-year-old patient with open physes. Preoperative MRI revealed a completely detached OCL of the intercondylar groove (36 mm × 20 mm). Although a total of four osteochondral grafts were harvested from the non-weightbearing area of the lateral femoral condyle, cartilage detached from one of the grafts. The quality of the osteochondral grafts was considered to be insufficient for stabilization of the OCL; thus, two bioabsorbable pins were additionally inserted following fixation of the lesion using three osteochondral grafts. After two years of follow-up, postoperative functional scores were favorable without knee pain. The present case suggests that fixation of the OCL using autogenous osteochondral grafts may not be appropriate for young patients with open physes.
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The Results of Orthopaedic Medical Examinations in Adolescent Amateur Weightlifters 査読あり
Yokoe T., Tajima T., Yamaguchi N., Nagasawa M., Morita Y., Chosa E.
International Journal of Environmental Research and Public Health 19 ( 21 ) 2022年11月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:International Journal of Environmental Research and Public Health
Few studies have reported injuries and physical characteristics in adolescent weightlifters. The purpose of this study was to report the results of orthopaedic medical examinations in adolescent amateur weightlifters that were performed cross-sectionally from 2012 to 2019. The orthopaedic medical examination included physical examinations, generalized joint laxity, muscle and joint tightness, static alignment, muscle volume of the lower extremities, and medial longitudinal arch of the foot (the height from the tip of the navicular tubercle to the ground surface). A questionnaire survey regarding pain in the spine and lower extremities was also performed. A total of 99 adolescent weightlifters were included (male/female, 71/28; mean age, 16.2 ± 0.2 years). A total of 9.1% had received orthopaedic treatments, with spine injuries being the most prevalent. Of those who had not received orthopaedic treatments, 31.1% had pain in the spine or lower extremities (for >4 weeks). There were no significant gender differences in the incidence of pain or positive findings of physical examinations. Female weightlifters had a more reduced dorsiflexion of the ankle joint than male weightlifters (p = 0.02). Male weightlifters had a lower flexibility of the quadriceps than female weightlifters. The results of orthopaedic medical examinations in this study may help clinicians and young weightlifters to prevent injuries in competitive weightlifting.
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The Results of Orthopaedic Medical Examinations in Adolescent Amateur Weightlifters 査読あり
Takuji Yokoe,Takuya Tajima,Nami Yamaguchi,Makoto Nagasawa,Yudai Morita and Etsuo Chosa
International Journal of Environmental Research and Public Health 19 13947 2022年10月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:International Journal fo Environmental Research and Public Health
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The Results of Orthopaedic Medical Examinations in Adolescent Amateur Weightlifters 査読あり
Takuji Yokoe, Takuya Tajima, Nami Yamaguchi, Makoto Nagasawa, Yudai Morita, Etsuo Chosa
International Journal of Environmental Research and Public Health 19 ( 21 ) 13947 2022年10月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:MDPI
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Fixation of an Osteochondral Lesion of the Femoral Intercondylar Groove Using Autogenous Osteochondral Grafts and Bioabsorbabale Pins in a Patient with Open Physes:A Case Report 査読あり
Takuji Yokoe,Takuya Tajima,Nami Yamaguchi,Yudai Morita and Etsuo Chosa
medicina 2022年10月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:MDPI
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足部びまん性色素性絨毛結節性滑膜炎に対し,関節鏡下腫瘍切除術を施行した一例 査読あり
外山 宗樹,横江 琢示,田島 卓也,山口 奈美,大田 智美,長澤 誠,森田 雄大,川越 秀一,帖佐 悦男
整形外科と災害外科 71 ( 4 ) 725 - 729 2022年9月
記述言語:日本語 掲載種別:研究論文(その他学術会議資料等) 出版者・発行元:西日本整形・災害外科学会
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健常者スポーツ,パラスポーツの相互理解を目指して‐合同メディカルチェックの試み- 査読あり
喜多恒允,田島卓也,横江琢示,森田雄大,長澤誠,山口奈美,帖佐悦男
日本臨床スポーツ医学会誌 30 ( 3 ) 695 - 702 2022年8月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:日本臨床スポーツ医学会
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宮崎県の高校ラグビーにおけるメディカルサポート-3年間の外傷調査- 査読あり
森田 恭史,今里 浩之,岩佐 一真,横江 琢示,森田 雄大,比嘉 聖,山口 奈美,中村 嘉宏,田島 卓也,帖佐 悦男,吉川 大輔
九州・山口スポーツ医・科学研究会誌 33 37 - 40 2022年7月
記述言語:日本語 掲載種別:研究論文(研究会,シンポジウム資料等) 出版者・発行元:九州・山口スポーツ医・科学研究会
我々は宮崎県で開催されるラグビーの公式戦で要請のあった全試合にマッチデイドクター配備および後方支援病院を整備している.今回,15人制高校ラグビー宮崎県大会の外傷調査を行ったため報告する.
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Remnant-Rreserved Single-Bundle Anterior Cruciate Ligament Augmentation in Multi-ligamentous Knee Reconstruction 査読あり
Takuya Tajima,MD, PhD NamiYamaguchi,MD,PhD Yudai Morita,MD Takuji Yokoe,MD Makotot Nagasawa,MD Tomomi Ota,MD Shuichi Kawagoe,MD Yoshihiro Nakamura, MD Etsuo Chosa,MD,PhD
The Journal of Knee Surgery 2022年6月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Thieme Medical Publishers,Inc.
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Elective one-stage all four-ligament reconstruction after open knee dislocation: A case report 査読あり
Takuji Yokoe, Takuya Tajima, Nami Yamaguchi, Etsuo Chosa
Journal of Orthopaedic Science 27 ( 3 ) 743 - 749 2022年5月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Elsevier
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A longer duration from injury to surgery is associated with preoperative deterioration of an isolated meniscal tear in patients aged 40 years or older 査読あり
Takuji Yokoe, Takuya Tajima, Nami Yamaguchi, Yudai Morita, Etsuo Chosa
Journal of Orthopaedic Surgery (Hong Kong) 30 ( 2 ) 10225536221101692 2022年5月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:SAGE Publishing
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Journal of Knee Surgery 36 ( 13 ) 1365 - 1373 2022年5月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Knee Surgery
The loss of knee range of motion (ROM) is not an uncommon complication after anterior cruciate ligament reconstruction (ACLR). However, the risk factors of loss of knee ROM remain debatable. The purpose of this study was to evaluate the incidence and risk factors of loss of knee ROM at 12 months after primary ACLR performed after regaining full knee ROM preoperatively. Consecutive patients who underwent primary ACLR after regaining full ROM between January 2014 and January 2020 were retrospectively reviewed. Patients who received a surgical arthrolysis within 12 months after ACLR or those who had a loss of knee ROM at 12 months postoperatively were defined as the loss of ROM group. Possible risk factors of loss of knee ROM, including patient demographic, preoperative, surgical, and postoperative factors, were assessed. The notch wide index and radiographic parameters of the tibial spines; medial tibial spine height/tibial length (TL), lateral tibial spine height (LTSH)/TL, and tibial spine width (TSW)/TL, were also assessed. A total of 141 patients (141 knees) were included (mean age, 25.8 ± 11.4 years; male/female, 56/85). Of the 141 patients, three received surgical arthrolysis within 12 months, and 23 had a loss of knee ROM at 12 months after ACLR. On comparing patients with and without loss of knee ROM, significant differences were found in the age (p = 0.04), LTSH/TL (p = 0.02), and TSW/TL (p = 0.02). A multivariate regression analysis showed that the age (odds ratio [OR]; 1.05, 95% confidence interval [CI]: 1.01-1.09, p = 0.02), LTSH/TL (OR: 1.44, 95% CI: 1.01-2.1, p = 0.04), and TSW/TL (OR: 0.79, 95% CI: 0.65-0.97, p = 0.02) were identified as significant independent risk predictors of loss of knee ROM. This study showed that the incidence of loss of knee ROM at 12 months after primary ACLR was 18.4% (26/141). An older age, a higher LTSH/TL, and a smaller TSW/TL may be associated with loss of knee ROM at 12 months after ACLR.
DOI: 10.1055/a-1934-0776
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Journal of Orthopaedic Surgery 30 ( 2 ) 2022年5月
担当区分:筆頭著者, 最終著者, 責任著者 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Orthopaedic Surgery
Purpose: To evaluate the preoperative deterioration of an isolated meniscal tear in patients aged 40 years or older, and whether time from injury to surgery is associated with worsening of a meniscal tear. Methods: Patients aged 40 years or older who underwent arthroscopic surgery for isolated meniscal tear between 2014 and 2019 were retrospectively reviewed. The diagnostic magnetic resonance imaging (MRI) findings and arthroscopic findings were compared to evaluate the deterioration of meniscal tears. Predictors of the development of meniscal tears; patient demographic factors, duration from injury to surgery (injury to MRI and MRI to surgery), and image findings were assessed. Results: A total of 58 patients (58 knees) were included (mean age, 55.9 ± 8.5 years; male/female, 31/27). An isolated meniscal tear deteriorated in 28 (48.3%). Compared patients with and without deteriorated meniscal tear, significant differences were found in the MRI grade of meniscal tear (p = 0.03), duration from injury to MRI (164.2 ± 167.9 vs 45.2 ± 48.7 days, p < 0.001), and from MRI to surgery (148.8 ± 91.1 vs 67.6 ± 56.7 days, p < 0.001). A multivariate regression analysis showed that the duration from injury to MRI (odds ratio [OR], 1.03; p < 0.001) and from MRI to surgery (OR, 1.02; p < 0.001) were independent predictors. Conclusion: Approximately 50% of isolated meniscal tears deteriorated preoperatively in patients aged 40 years or older. The duration from injury to surgery was an independent predictor of worsening of an isolated meniscal tear.
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Symptomatic discoid lateral meniscus shows a relationship between types and tear patterns, and between causes of clinical symptom onset and the age distribution 査読あり
Nami Yamaguchi, Etsuo Chosa, Takuya Tajima, Yudai Morita, Takuji Yokoe
Knee Surgery, Sports Traumatology, Arthroscopy 30 ( 4 ) 1436 - 1442 2022年4月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:European Society of Sports Traumatology, Knee Surgery and Arthroscopy
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Journal of Clinical Medicine 11 ( 7 ) 2022年4月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Clinical Medicine
The Beighton score (BS) is widely used to evaluate generalized joint laxity. However, the association between the BS and lateral ankle laxity is unclear. This study compared the ultrasono-graphic (US) findings of the anterior talofibular ligament (ATFL) between high-(≥6) and low-(≤3) BS groups of healthy young women. The ATFL lengths of healthy young women were measured in the stress and nonstress positions using the previously reported technique from March 2021 to January 2022. The ATFL ratio (ratio of stress to nonstress ATFL length) was used as an indicator of lateral ankle laxity. The anterior drawer test (ADT) was performed. The correlation between the BS and US findings was also examined. A total of 20 (high-BS group) and 61 (low-BS group) subjects with a mean age of 23.8 ± 1.0 years were included. The high-BS group showed a higher grade of ADT than the low-BS group. No significant differences were found in the nonstress and stress ATFL lengths and ATFL ratio (1.10 ± 0.05 vs. 1.09 ± 0.05, p = 0.19) between the groups. No correlation was found between the BS and US findings. In conclusion, this study did not detect significant differences in the US findings of the ATFL between the high-and low-BS groups.
DOI: 10.3390/jcm11071759
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Does the contralateral healthy ankle of patient with ipsilateral mechanical lateral ankle laxity show greater lateral ankle laxith? Evaluation of the anterior talofibular ligament by stress ultrasonography 査読あり
Takuji Yokoe,Takuya Tajima,Shuichi Kawagoe,Nami Yamaguchi,Yudai Morita and Etsuo Chosa
BMC Musculoskeletal Disorders 23 ( 1 ) 887 2022年
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:BMC
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Clinical and Radiographic Outcomes of Double-Bundle Anterior Cruciate Ligament Reconstruction for Asian Patients with Bone-Patellar Tendon-Bone and Gracilis Tendon Grafts: A Matched-Control Comparison
Takuya Tajima, Nami Yamaguchi, Yudai Morita, Makoto Nagasawa, Tomomi Ota, Yoshihiro Nakamura, Takuji Yokoe, Etsuo Chosa
Journal of Knee Surgery 2021年12月
掲載種別:研究論文(学術雑誌)
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
BMC Musculoskeletal Disorders 22 ( 1 ) 636 2021年12月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:BMC Musculoskeletal Disorders
Background: Lateral ankle sprain (LAS) is one of the most common musculoskeletal injuries. Numerous studies regarding LAS have been performed. However, there are few studies evaluating the current clinical practice of orthopaedic surgeons regarding LAS. The purpose of this study was to evaluate the current clinical practice of general orthopaedic surgeons in the treatment of LAS. Methods: A questionnaire survey was conducted from September 2020 to December 2020 in Miyazaki, Japan, to evaluate the clinical practice of general orthopaedic surgeons in the treatment of LAS. The survey was composed of 12 questions that were developed with consideration of the recommendations in the current clinical practice guidelines (CPGs) published by the Dutch orthopaedic society. The questions in this study were focused on the diagnosis, conservative treatment, rehabilitation, and the criteria for return to sports (RTS). Results: The survey response rate was 82.7% (129/156). Among the respondents, 95.3% did not consider the Ottawa Ankle Rules in the decision to perform plain radiography for patients. Rehabilitation following LAS was performed in 58.9% of patients. Eighty-five (65.9%) of the surgeons used only one factor as the criterion for RTS. The absence of pain was the most frequently used criterion (45.7%). No objective criteria were used for the RTS decision in athletes with LAS. Conclusions: The present study suggested that most general orthopaedic surgeons do not provide the care for patients with LAS recommended by the current CPGs. No objective criteria for the RTS decision are used for athletes with LAS.
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A case of nail-patella syndrome with osteochondral lesion of the lateral femoral condyle accompanied with anomalies of anterior horns of the menisci and lateral femoral condyle 査読あり
Takuji Yokoe, Takuya Tajima, Nami Yamaguchi, Yudai Morita, Etsuo Chosa
Journal of Orthopaedic Science 2021年10月
掲載種別:研究論文(学術雑誌)
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Dextran sulphate inhibits an association of prions with plasma membrane at the early phase of infection. 査読あり
Fuse T, Nakagaki T, Homma T, Tange H, Yamaguchi N, Atarashi R, Ishibashi D, Nishida N
Neuroscience research 171 34 - 40 2021年10月
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木戸 義隆, 田島 卓也, 山口 奈美, 長澤 誠, 大田 智美, 森田 雄大, 横江 琢示, 川越 秀一, 帖佐 悦男
整形外科と災害外科 70 ( 4 ) 703 - 706 2021年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
【目的】高校空手選手の貧血について調査したので報告する.【対象・方法】2012-2019年の宮崎県某高校空手部1年生68名(男子39名,女子29名)を対象とし,2015-2019年の国民体育大会宮崎県代表候補選手のうち高校1年生160名(男子114名,女子46名)と比較した.【結果】男子はHb<13 g/dL,女子はHb<12 g/dLを貧血とした.【結果】空手選手では30.8%(男子28.2%,女子34.5%)に貧血を認め,全例正球性貧血だった.他競技の貧血例は陸上女子選手1例だった.空手選手の貧血群と非貧血群で血清鉄,網赤血球,フェリチン,不飽和鉄結合能に有意差はなく,貧血と鉄欠乏に関連はなかった.【考察】空手部の貧血が全例正球性貧血であったことから,空手の突き動作に伴い頻回に足を踏み込む動作で足底血管にて溶血をきたしたと考えた.空手選手のメディカルサポートの際には,貧血を考慮する必要があると考えられた.
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當瀬 雅大, 大田 智美, 坂本 武郎, 田島 卓也, 山口 奈美, 長澤 誠, 森田 雄大, 横江 琢示, 川越 秀一, 帖佐 悦男, 川野 啓介
整形外科と災害外科 70 ( 4 ) 749 - 753 2021年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
〔はじめに〕腱鞘巨細胞腫は手指に多く発生することが知られているが,多発例の報告は稀である.上下肢3か所に多発した稀な腱鞘巨細胞腫の症例を経験したので報告する.〔症例〕45歳男性で,約4年前に左示指に釣り針が刺さった同時期より左示指,左肘,左膝の腫瘤を自覚した.MRIで3か所とも関節外にT1強調画像で等から軽度高信号,T2強調画像で低信号,造影で不均一に造影される境界明瞭な腫瘤を認めた.左膝腫瘤の切除生検を施行した結果,腱鞘巨細胞腫の診断に至った.生検と画像所見より,多発腱鞘巨細胞腫と判断し,3か所同時に腫瘍摘出術を施行し,最終診断もすべて腱鞘巨細胞腫であった.〔考察〕我々が渉猟しえた限りでは多発例は32報告で,上下肢に及ぶ2か所発生例,3病変の発生例はそれぞれ1例のみであった.本症例は上下肢に及ぶ3病変の多発例であり,稀な症例であると思われた.〔結語〕本症例は再発リスク因子が多く,今後の慎重な経過観察が必要と考える.
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Internal Fixation of a Lateral Inverted Osteochondral Fracture of the Talus (LIFT) Lesion Using an Innovative Surgical Approach: Inverting the Capsulo-Lateral Fibulotalocalcaneal Ligament (LFTCL)–Fibular Periosteum Complex
Yokoe T, Tajima T, Yamaguchi N, Ota T, Nagasawa M, Morita Y, Chosa E
Journal of Foot and Ankle Surgery 2021年9月
掲載種別:研究論文(学術雑誌)
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Journal of Knee Surgery 34 ( 11 ) 1237 - 1242 2021年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Knee Surgery
Atopic dermatitis (AD), sometimes referred to as eczema, is a common skin disease, and skin barrier dysfunction and immunological disorders are well recognized. However, surgical wound complications after orthopaedic surgery in patients with AD have not been described. This study aimed to report four patients with AD who developed foreign body reactions to FiberWire sutures with or without surgical wound infection (SSI) after knee cruciate ligament reconstruction (CLR). The mean age was 19.8 (range, 16-25) years, and patients 1 and 3 underwent reconstructions of the posterior and anterior cruciate ligament, respectively. At a mean of 7.5 (range, 4-10) weeks postoperatively, discharge from the surgical wound at the tibial side of the fixed graft was identified. All patients were treated with continuous saline lavage and antibiotics; however, their wounds did not heal. Second-look arthroscopy and hardware removal were performed at a mean 12.2 (range, 9-15) months postoperatively. Proliferated granulation tissue surrounding the FiberWire was identified. Intraoperative wound cultures were negative in three of the four patients. Histological examination of the tissues adjacent to the FiberWire revealed a foreign body reaction. All wounds healed immediately after the second surgery. In addition to SSI, foreign body reactions are more likely to occur in patients with AD than in those without AD. Preoperative management of AD by dermatologists and consideration of appropriate suture materials are mandatory to reduce surgical wound complications after knee CLR in patients with AD.
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高校空手選手における貧血調査 査読あり
木戸 義隆, 田島 卓也, 山口 奈美, 長澤 誠, 大田 智美, 森田 雄大, 横江 琢示, 川越 秀一, 帖佐 悦男
整形外科と災害外科 2021年9月
掲載種別:研究論文(学術雑誌)
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上下肢3ヶ所に多発した腱鞘巨細胞腫の治療経験 査読あり
當瀬 雅大, 大田 智美, 坂本 武郎, 田島 卓也, 山口 奈美, 長澤 誠, 森田 雄大, 横江 琢示, 川越 秀一, 帖佐 悦男, 川野 啓介
整形外科と災害外科 2021年9月
掲載種別:研究論文(学術雑誌)
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The current clinical practice of general orthopaedic surgeons in the treatment of lateral ankle sprain: a questionnaire survey in Miyazaki, Japan
Yokoe T, Tajima T, Yamaguchi N, Morita Y, Chosa E
BMC Musculoskeletal Disorders 2021年7月
掲載種別:研究論文(学術雑誌)
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Symptomatic discoid lateral meniscus shows a relationship between types and tear patterns, and between causes of clinical symptom onset and the age distribution
Yamaguchi N, Chosa E, Tajima T, Morita Y, Yokoe T
Knee Surgery, Sports Traumatology, Arthroscopy 2021年6月
掲載種別:研究論文(学術雑誌)
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Yokoe T., Tajima T., Yamaguchi N., Nagasawa M., Ota T., Morita Y., Chosa E.
BMJ Open 11 ( 1 ) e042188 2021年1月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:BMJ Open
Objectives Medical examinations for adult elite athletes are performed all over the world, however, no studies in the relevant English literature have reported on orthopaedic medical examinations for young amateur athletes. The purpose of this study was to report the results of orthopaedic medical examinations of the spine and lower extremities in young amateur athletes. Methods This repeated cross-sectional study from 2014 to 2018 included a total of 323 young amateur athletes (age, 12-18 years) who were active in one of the following four sports: boxing, canoeing, weightlifting and track and field. The orthopaedic medical examination consisted of six assessments (physical examinations, the generalised joint laxity, muscle and joint tightness, static alignment and muscle volume of the lower extremities and the medial longitudinal arch of the foot). Questions regarding pain in the spine and lower extremities were also performed. Results Among 323 young amateur athletes, 17 (5.3%) had received orthopaedic treatment at the time of the medical examination, with spondylolysis being the most common cause (29.4%, 5/17). Among 306 young athletes who had not received orthopaedic treatment, 61 (19.9%) had at least one positive finding in physical examinations or had pain in the spine or lower extremities. Anterior drawer test of the ankle and Kemp test for the spine accounted for 34% and 28% of positive findings, respectively. Low back pain and knee pain accounted for 58% and 16% of pain, respectively. Conclusions The present study showed that approximately one-fifth of young amateur athletes who had not received orthopaedic treatment had pain in the spine and lower extremities and positive findings in physical examinations that may require orthopaedic treatments. In addition to the early detection of injuries, orthopaedic medical examinations for young amateur athletes provide an opportunity to educate such athletes.
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Predictors of Spondylolysis on Magnetic Resonance Imaging in Adolescent Athletes With Low Back Pain 査読あり
Yokoe T., Tajima T., Sugimura H., Kubo S., Nozaki S., Yamaguchi N., Morita Y., Chosa E.
Orthopaedic Journal of Sports Medicine 2021年1月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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Symptomatic discoid lateral meniscus shows a relationship between types and tear patterns, and between causes of clinical symptom onset and the age distribution 査読あり
Yamaguchi N., Chosa E., Tajima T., Morita Y., Yokoe T.
Knee Surgery, Sports Traumatology, Arthroscopy 2021年1月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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Minimizing the expected value of the asymmetric loss function and an inequality for the variance of the loss. 査読あり
Yamaguchi N, Yamaguchi Y, Nishii R
Journal of applied statistics 48 ( 13-15 ) 2348 - 2368 2021年
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Yokoe T., Tajima T., Kawagoe S., Yamaguchi N., Morita Y., Chosa E.
Orthopaedic Journal of Sports Medicine 9 ( 11 ) 23259671211056305 2021年
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Orthopaedic Journal of Sports Medicine
Background: Stress ultrasonography (US) has been shown to be a valid procedure for evaluating chronic anterior talofibular ligament (ATFL) injury. The ratio of stress/nonstress ATFL length (ATFL ratio) as measured on US is clinically useful; however, there are no published normative data concerning this ratio. Purpose: To report a normative value of the ATFL ratio on US and evaluate the relationships between sex, generalized joint laxity (GJL), and the grade of anterior drawer test (ADT). Study Design: Cross-sectional study; Level of evidence, 3. Methods: The ATFL lengths were prospectively measured in the stress and nonstress positions (manual maximal anterior drawer position) for participants with noninjured ankles from March 2020 to March 2021. GJL was defined as a Beighton score ≥4. A manual ADT was also performed. The ATFL ratio was calculated, and the relationships between sex, GJL, and ADT grade were evaluated. Results: A total of 333 ankles in 184 participants (mean age, 24.5 ± 2.7 years; range, 20-33 years) were eligible for the analysis. GJL was found in 69 ankles (20.7%). The mean ATFL ratio was 1.08 ± 0.04 (95% CI, 1.08-1.09; range, 1.01-1.24), and there was a significant difference between male (1.07 ± 0.04; 95% CI, 1.07-1.08; range, 1.02-1.23) and female (1.09 ± 0.04; 95% CI, 1.08-1.10; range, 1.01-1.24) ankles (P =.001). In male ankles, the ATFL ratio was significantly greater in participants with GJL (1.11 ± 0.06 vs 1.07 ± 0.03; P =.02) or a higher grade of ADT (grade 2 vs grade 1: 1.11 ± 0.06 vs 1.07 ± 0.03, P =.002). These findings were not observed in female ankles. Conclusion: The normative value of the ATFL ratio on stress US was 1.07 ± 0.04 in men and 1.09 ± 0.04 in women. The ATFL ratio was affected by the presence of GJL in men but not in women. These findings will be useful for future studies seeking to establish the cutoff value of the ATFL ratio for diagnosing chronic lateral ankle stability on stress US.
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コリジョンスポーツにおける至適な頸部周囲筋力と頸椎アライメントの解明:重症頭頸部外傷を予防するために 査読あり
田島卓也、山口奈美、黒木修司、森田雄大、帖佐悦男
デサントスポーツ科学 41 135 - 144 2020年9月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Comparison of symptomatic spondylolysis in young soccer and baseball players 査読あり
横江 琢示, 田島 卓也, 山口 奈美, 森田 雄大, 帖佐 悦男
Journal of Orthopaedic Surgery and Research 15 378 2020年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:BMC
Background
Spondylolysis is the main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activities. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis.
Methods
The medical records of 267 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 and 2020 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions.
Results
A total of 33 soccer players (mean age, 15.4 ± 1.4 years) and 49 baseball players (mean age, 15.4 ± 1.6 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p < 0.001) and bilateral (p < 0.001) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.001).
Conclusions
The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis. -
Comparison of symptomatic spondylolysis in young soccer and baseball players 査読あり
Yokoe T., Tajima T., Sugimura H., Kubo S., Nozaki S., Yamaguchi N., Morita Y., Chosa E.
Journal of Orthopaedic Surgery and Research 15 ( 1 ) 378 2020年9月
担当区分:筆頭著者, 最終著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Orthopaedic Surgery and Research
Background: Spondylolysis is the main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activities. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis. Methods: The medical records of 267 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 and 2020 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions. Results: A total of 33 soccer players (mean age, 15.4 ± 1.4 years) and 49 baseball players (mean age, 15.4 ± 1.6 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p < 0.001) and bilateral (p < 0.001) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.001). Conclusions: The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis.
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Clinical and Radiographic Outcomes of Double-Bundle Anterior Cruciate Ligament Reconstruction for Asian Patients with Bone-Patellar Tendon-Bone and Gracilis Tendon Grafts: A Matched-Control Comparison 査読あり
Takuya Tajima、Nami Yamaguchi、Yudai Morita、Makoto Nagasawa、Tomomi Ota、Yoshihiro Nakamura、Takuji Yokoe、Etsuo Chosa
The Journal of Knee Surgery 1 - 8 2020年5月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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Prion protein interacts with the metabotropic glutamate receptor 1 and regulates the organization of Ca(2+) signaling. 査読あり
Matsubara T, Satoh K, Homma T, Nakagaki T, Yamaguchi N, Atarashi R, Sudo Y, Uezono Y, Ishibashi D, Nishida N
Biochemical and biophysical research communications 525 ( 2 ) 447 - 454 2020年4月
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Elective one-stage all four-ligament reconstruction after open knee dislocation: A case report 査読あり
Yokoe T., Tajima T., Yamaguchi N., Chosa E.
Journal of Orthopaedic Science 27 ( 3 ) 743 - 749 2019年9月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Orthopaedic Science
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上腕骨小頭離断性骨軟骨炎手術例と野球検診の関係 査読あり
岩佐一真、長澤誠、田島卓也、山口奈美、大田智美、森田雄大、帖佐悦男
九州・山口スポーツ医・科学研究会誌 31 35 - 37 2019年7月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Early weight-bearing after anterior cruciate ligament reconstruction with hamstring grafts induce femoral bone tunnel enlargement: A prospective clinical and radiographic study 査読あり
Tajima T., Yamaguchi N., Nagasawa M., Morita Y., Nakamura Y., Chosa E.
BMC Musculoskeletal Disorders 20 ( 1 ) 274 2019年6月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:BMC Musculoskeletal Disorders
© 2019 The Author(s). Background: Bone tunnel enlargement following primary anterior cruciate ligament (ACL) reconstruction with soft tissue graft might be a severe disadvantage for revision surgery. The postoperative rehabilitation protocol including the non-weight-bearing periods were different depending on the surgeon or institute. To determine the relationship between femoral bone tunnel enlargement and the postoperative non-weight-bearing period after double-bundle ACL reconstruction with hamstring grafts. Methods: Forty-two patients who underwent primary double-bundle ACL reconstruction with hamstring grafts were divided into two postoperative non-weight-bearing protocol groups: 1-week non-weight-bearing postoperatively (group A, n = 19); and 2-week non-weight-bearing (group B, n = 18). Five cases were excluded due to additional knee injury, pregnancy, and lost to follow-up. Bone tunnel enlargement was evaluated by computed digital radiographs (anteroposterior (A-P) and lateral views) taken on the first postoperative day and at 12 months. Each tunnel diameter was shown as a percentage to the maximum joint width of the proximal tibia in the A-P view, or a percentage of the maximum diameter of the patella in the lateral view. To determine the incidence of tunnel enlargement, percentage diameter changes of more than 10% were defined as an enlarged tunnel. The magnitude of tunnel enlargement and the standard clinical evaluation were also evaluated. Results: There were no significant differences between groups in the incidences of anteromedial and posterolateral bone tunnel enlargement, both in the A-P and lateral views (2 × 2 Chi-squared test). The magnitude of femoral posterolateral bone tunnel enlargement was significantly greater in group A in the A-P view (p = 0.01) and lateral view (p = 0.03) (Mann Whitney U-test). Twelve months after surgery, the Lysholm score and Tegner activity level scale were not significantly different between the groups. Conclusions: This prospective, clinical and radiographical study showed that early weight-bearing protocol after double-bundle ACL reconstruction with hamstring grafts might have the potential risk of significant postoperative femoral bone tunnel enlargement of the posterolateral bundle. There was no significant difference in clinical outcomes by postoperative non-weight-bearing period. To reduce and prevent the femoral bone tunnel enlargement, the comprehensive management could be considered and required to establish the suitable early stage rehabilitation protocol after surgery. Trial registration: Trial registration number; UMIN000036212. Scientific title: Prospective comparisons of femoral tunnel enlargement with two different postoperative non weight bearing periods after double-bundle anterior cruciate ligament reconstruction with hamstring grafts. Registered date: 15 Mar 2019 (retrospectively registered).
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サッカー日本女子代表(なでしこジャパン)のメディカルサポートを通して 招待あり 査読あり
山口奈美、田島卓也、長澤誠、森田雄大、帖佐悦男、園田典生
日本整形外科スポーツ医学会雑誌 39 ( 2 ) 10 - 14 2019年5月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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全国レベルの高校空手道部の新入生メディカルチェック:3年間の結果より 査読あり
北堀貴史、森田雄大、長澤誠、黒木修司、山口奈美、田島卓也、石田康行、帖佐悦男
日本臨床スポーツ医学会誌 27 ( 2 ) 266 - 272 2019年4月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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ヘモグロビンは滑膜からADAMTS-5,-9の発現を亢進させる:関節血症の軟骨変性に及ぼす影響 査読あり
田島卓也、谷口昇、山口奈美、帖佐悦男
日本関節鏡・膝・スポーツ整形外科学会雑誌 44 ( 1 ) 292 - 293 2019年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Double crushを呈していた橈尺骨骨幹部骨折後尺骨神経障害の1例 査読あり
藤田貢司、石田康行、谷口昇、田島卓也、山口奈美、長澤誠、森田雄大、関本朝久、帖佐悦男
整形外科と災害外科 67 ( 4 ) 674 - 676 2018年9月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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サッカー日本女子代表:メディカルサポートの実際と課題 招待あり 査読あり
山口奈美、石田康行、田島卓也、森田雄大、帖佐悦男、園田典生
日本整形外科スポーツ医学会雑誌 38 ( 3 ) 5 - 9 2018年7月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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宮崎県少年野球検診−検診結果と可動域の関係− 査読あり
長澤誠、石田康行、谷口昇、田島卓也、山口奈美、三橋龍馬、川野啓介、帖佐悦男
日本関節鏡・膝・スポーツ整形外科學會雑誌 43 ( 2 ) 562 - 563 2018年4月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Larson変法を用いた膝後外側支持機構再建術 査読あり
山口奈美、田島卓也、石田康行、谷口昇、大田智美、長澤誠、帖佐悦男
日本関節鏡・膝・スポーツ整形外科學會雑誌 43 ( 2 ) 506 - 507 2018年4月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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脛骨付着部を温存した自家半健様筋健グラフトによるMCL再建術の術後短期成績 査読あり
田島卓也、山口奈美、谷口昇、石田康行、大田智美、長澤誠、帖佐悦男
日本関節鏡・膝・スポーツ整形外科學會雑誌 43 ( 1 ) 180 - 181 2018年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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外側広範型上腕骨小頭離断性骨軟骨炎の手術成績を左右する因子 査読あり
石田康行、長澤誠、谷口昇、田島卓也、山口奈美、大田智美、帖佐悦男
日本関節鏡・膝・スポーツ整形外科學會雑誌 43 ( 1 ) 16 - 17 2018年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Tajima T., Sekimoto T., Yamaguchi N., Taniguchi N., Kurogi S., Maruyama M., Chosa E.
BMC Musculoskeletal Disorders 18 ( 1 ) 449 - 457 2017年11月
記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:BMC Musculoskeletal Disorders
© 2017 The Author(s). Background: ADAMTS (a disintegrin and metalloprotease with thrombospondin motifs) proteins play an important pathological role in matrix degeneration. Aggrecan degradation is a significant and critical event in early-stage osteoarthritis. To determine the effect of hemoglobin (Hb) on the ability of synovial tissues to produce ADAMTS family members, we examined the influence of Hb by synovial cells in an in vitro experimental system. Methods: Synovial tissues were obtained from five young patients with meniscal injury under arthroscopic surgery. Primary cultures of human knee synovial cells were treated with different doses of human Hb (0, 25, 50, 100 μg/ml). The culture media were collected 24 h after Hb-treatment. In the time-course studies, cells were treated with and without 100 μg/ml Hb, and culture media were taken at 6, 12, and 24 h. To identify the proteins responsible for aggrecanase activity, Western blot analysis using antibodies against human ADAMTS-5, -8, -9, and -10; enzyme-linked immunosorbent assay (ELISA); and gene expression for ADAMTS-5 and -9 were examined. Statistical comparisons between each group were performed using paired t-tests. Results: Western blot analysis revealed that Hb-treatment resulted in the expression of ADAMTS-5 and -9. Neither control group nor Hb-treated medium showed immunoreactivity against ADAMTS-8 or -10. In a dose-dependency study, the Hb-treated group showed significantly higher levels of ADAMTS-5 and -9 compared with the control (p < 0.05). There was no significant difference between 25, 50, and 100 μg/ml Hb-treated groups. In a time-course study, the ADAMTS-5 and -9 levels in the conditioned medium had significantly increased expression at 6, 12, and 24 h in the Hb-treated group (p < 0.05). Hb evoked significant expression of ADAMTS-9 mRNA at 12 and 24 h (p < 0.05). Conclusions: These findings indicate that Hb induces the expression of ADAMTS-5 and -9 by synovial cells at low doses, even at an acute phase, and suggests a possible role for Hb in cartilage damage after intra-articular hemorrhage. The results also suggest a new potential therapeutic target by inhibiting the activities of ADAMTS-5 and -9 to prevent cartilage damage after intra-articular hemorrhage.
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当院における Fibrin Clot を用いた関節鏡視下半月縫合術の治療経験(共著) 査読あり
戸田雅, 田島卓也, 山口奈美, 帖佐悦男
整形外科と災害外科 66 ( 2 ) 52 - 55 2017年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Screening for musculoskeletal problems in Japanese schoolchildren: a cross-sectional study nested in a cohort(共著) 査読あり
N.Yamaguchi,E.Chosa,K.Yamamoto,K.Kawahara,H.Hamada,N.Taniguchi,T.Tajima,T.Funamoto,S.Kurogi,T.Ota,S.Nakamura
Public Health 139 189 - 197 2016年8月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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膝関節外側滑膜ヒダ障害による弾発膝を来した1例 査読あり
三股奈津子, 石田康行, 谷口昇, 田島卓也, 山口奈美, 大田智美, 帖佐悦男
九州・山口スポーツ医・科学研究会誌 28 78 - 80 2016年7月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Remnant-preserving, selective single-bundle augmentation of the anterior cruciate ligament using a bone-patellar tendon-bone autograft: A technical note. 査読あり
Tajima T, Chosa E, Yamaguchi N, Taniguchi N, Ishida Y.
The Knee 23 ( 3 ) 554 - 558 2016年6月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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BTBと薄筋腱を併用した2重束ACL再建術の臨床成績と画像評価 査読あり
田島卓也、石田康行、谷口昇、山口奈美、帖佐悦男
JOSKAS 41 ( 1 ) 116 - 117 2016年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Remnant-preservint, selective single-bundle augmentation of the anterior cruciate ligament using a bone-patellar tendon-bone autograft: a technical note(共著) 査読あり
Takuya Tajima, Etsuo Chosa, Nami Yamaguchi, Noboru Taniguchi, Yasuyuki Ishida
The Knee 2016年2月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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石田 康行, 帖佐 悦男, 長澤 誠, 谷口 昇, 山口 奈美, 大田 智美, 中村 志保子
日本肘関節学会雑誌 23 ( 2 ) 366 - 370 2016年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:日本肘関節学会
野球選手の上腕骨小頭離断性骨軟骨炎(小頭OCD)の手術成績を検討することを目的とした.対象は31例31肘であり,年齢は11~16歳(平均13.9歳)であった.手術法は鏡視下廓清術:15肘,骨軟骨片固定術:5肘,および骨軟骨柱移植術:11肘であった.病型とICRS OCD分類別の成績を術前,術後1年時JOA-JES score,自動屈曲,伸展角度,競技復帰状況で評価した.各手術とも外側広範型OCD IV以外は術後概ね良好に回復していた.外側広範型OCD IVの鏡視下廓清術,骨軟骨柱移植術の成績は不安定であった.外側広範型OCD IVの3肘以外は完全復帰していた.外側広範型OCD IVを生じさせないために早期発見,早期治療,保存療法の徹底,手術手技の習熟,新たな手術手技の検討が必要である.
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横江 琢示, 田島 卓也, 中村 嘉宏, 山口 奈美, 黒木 修司, 帖佐 悦男
整形外科と災害外科 65 ( 1 ) 54 - 57 2016年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
宮崎大学医学部整形外科は宮崎県と連携し,積極的にスポーツイベントへのメディカルサポートを行なっている.平成25年度に当科が行ったメディカルサポート状況につき調査した.宮崎大学医学部整形外科所属の医師が出務した宮崎県外・海外へのチーム帯同や医事運営は10件でその期間は3日間から32日間であった.内訳としては,U-17女子サッカー日本代表帯同が3件,国民体育大会(国体)宮崎県選手団帯同が3件,国体サッカー少年の部帯同が3件,全国高校ラグビー大会帯同が1件であった.宮崎県内で開催されたスポーツイベントのマッチドクター,医事運営への出務は46競技会62日間であった.内訳としては,ラグビー32日,サッカー11日,柔道8日,マラソン2日でその他競技が9日であった.出務医師総数は15人で8人はスポーツドクター資格保持者であった.当科でのスポーツイベントへの医師派遣の現状および課題について報告する.
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宮崎県における2014春季キャンプに対するメディカルサポート報告-キャンプの地の総合的メディカルサポート体制の構築にむけて-(共著)
小島岳史, 田島卓也, 帖佐悦男, 石田康行, 河原勝博, 山口奈美, 日吉優, 永井琢哉, 園田典生, 松岡知己, 井上篤, 田島直也, 山本惠太郎, 樋口潤一
九州・山口スポーツ医・科学研究会志 ( 27 ) 4 - 7 2015年7月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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フルスレッドアンカーを用いたスーチャーブリッジ法後のアンカー孔の検討(共著) 査読あり
石田康行, 帖佐悦男, 谷口昇, 田島卓也, 山口奈美, 大田智美, 中村志保子
JOSKAS 40 ( 3 ) 587 - 590 2015年6月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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少年野球検診で発見された上腕骨小頭離断性骨軟骨炎の経過(共著) 査読あり
石田康行, 帖佐悦男, 河原勝博, 山口奈美, 長澤誠
日本整形外科スポーツ医学会雑誌 35 ( 2 ) 139 - 143 2015年5月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Prospective Comparisons of Femoral Tunnel Enlargement With 3 Different Postoperative Immobilization Periods After Double-Bundle Anterior Cruciate Ligament Reconstruction With Hamstring Grafts(共著) 査読あり
Takuya Tajima, Etsuo Chosa, Katsuhiro Kawahara, Nami Yamaguchi.
Arthroscopy 31 ( 4 ) 651 - 658 2015年4月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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Comprehensive safety management and assessment at rugby football competitions
Tajima T., Chosa E., Kawahara K., Nakamura Y., Yoshikawa D., Yamaguchi N., Kashiwagi T.
International Journal of Sports Medicine 35 ( 12 ) 1012 - 1016 2014年6月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:International Journal of Sports Medicine
© Georg Thieme Verlag KG Stuttgart New York ISSN 0172-4622. The present study aims to improve medical systems by designing objective safety assessment criteria for rugby competitions. We evaluated 195 competitions between 2002 and 2011 using an original safety scale comprising the following sections: 1) competence of staff such as referees, medical attendants and match day doctor; 2) environment such as weather, wet bulb globe temperature and field conditions; and 3) emergency medical care systems at the competitions. Each section was subdivided into groups A, B and C according to good, normal or fair degrees of safety determined by combinations of the results. Overall safety was assessed as A, B and C for 110, 78 and 7 competitions, respectively. The assessments of individual major factors were mostly favorable for staff, but the environment and medical care systems were assessed as C in 25 and 70, respectively, of the 195 competitions. Medical management involves not having a match day doctor, but also comprehensive management including preventive factors and responses from the staff, environment and medical-care systems. 6 cases of severe injuries and accidents occurred between 2002 and 2011, which were observed in Grade A competition. These cases revealed better prognosis without obvious impairment, thus confirming the value of the present assessment scale.
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森田 雄大, 大塚 記史, 帖佐 悦男, 河原 勝博, 田島 卓也, 山口 奈美, 矢野 浩明, 石田 康行, 村上 恵美, 大田 智美, 中村 志保子
整形外科と災害外科 63 ( 2 ) 260 - 262 2014年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
【はじめに】われわれは,膝前十字靱帯(以下,ACL)損傷と半月損傷を合併した症例で,諸事情により半月縫合術を単独で施行した症例について,ACL再建術時に半月の状態を評価検討した.【対象・方法】対象は2006年1月から2012年12月の期間に,ACL損傷に半月損傷を合併した症例のうち半月縫合のみ施行した症例6例6膝である.これらについて半月損傷形態,縫合方法,再鏡視所見,待機期間との関連について検討した.【結果】6膝中2膝に再断裂を認め,いずれも待機期間の長い症例であった.【考察】ACL不全膝で半月縫合術を施行した症例は,半月単独損傷で半月縫合術を施行した症例と比較し再断裂は高率であった.待機期間の長い症例で再断裂の可能性が高くなることが示唆された.ACL不全膝に対する半月縫合術は半月単独損傷に比べ再断裂の危険性は高いが,癒合率は66.7%であり禁忌でないと思われた.
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学校健診における運動器検診の普及に向けて : 宮崎方式:なぜ子供の頃からロコモティブシンドローム予防が必要か・課題とその対策
帖佐 悦男, 山口 奈美, 河原 勝博, 山本 惠太郎
日本臨床スポーツ医学会誌 = The journal of Japanese Society of Clinical Sports Medicine 21 ( 3 ) 574 - 580 2013年8月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:日本臨床スポーツ医学会
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田島 卓也, 山本 惠太郎, 河原 勝博, 石田 康行, 山口 奈美, 大田 智美, 帖佐 悦男
JOSKAS 38 ( 1 ) 54 - 55 2013年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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石田 康行, 帖佐 悦男, 山本 惠太郎, 田島 卓也, 山口 奈美, 大田 智美
JOSKAS 38 ( 1 ) 16 - 17 2013年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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膝外側円板状半月に合併した大腿骨内顆離断性骨軟骨炎の治療経験
山口 奈美, 山本 惠太郎, 石田 康行, 河原 勝博, 田島 卓也, 大田 智美, 帖佐 悦男
JOSKAS 38 ( 1 ) 150 - 151 2013年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Anterior cruciate ligament reconstruction in a patient with Athetoid cerebral palsy: a case report
Tajima T., Chosa E., Yamamoto K., Kawahara K., Yamaguchi N., Watanabe S.
Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology 4 ( 1 ) 36 2012年10月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology
Recent years have seen ACL reconstruction performed in a broad range of patients, regardless of age, sex or occupation, thanks to great advances in surgical techniques, instrumentation and the basic research. Favorable results have been reported; however, we have not been able to locate any reports describing ACL reconstruction in patients with athetoid cerebral palsy.We present herein a previously unreported anterior cruciate ligament (ACL) reconstruction performed in a patient with athetoid cerebral palsy. The patient was a 25-year-old woman with level II athetoid cerebral palsy according to the Gross Motor Function Classification System. She initially injured her right knee after falling off a bicycle. Two years later, she again experienced right-knee pain and a feeling of instability. A right-knee ACL tear and avulsion fracture was diagnosed upon physical examination and confirmed with magnetic resonance imaging (MRI) and X-ray examination at that time. An ACL reconstruction using an autologous hamstring double-bundle graft was performed for recurrent instability nine years after the initial injury. Cast immobilization was provided for 3 weeks following surgery and knee extension was restricted for 3 months with the functional ACL brace to prevent hyperextension due to involuntary movement. Partial weight-bearing was started 1 week postoperatively, with full weight-bearing after 4 weeks. The anterior drawer stress radiography showed a 63% anterior displacement of the involved tibia on the femur six months following the surgery, while the contralateral knee demonstrated a 60% anterior displacement of the tibia. The functional ACL functional brace was then removed. A second-look arthroscopy was performed 13 months after the ACL reconstruction, and both the anteromedial and posterolateral bundles were in excellent position as per Kondo's criteria. The Lachman and pivot shift test performed under anesthesia were also negative. An anterior drawer stress radiography of the involved knee at 36 months following surgery showed a 61% anterior translation of the tibia. The preoperative symptoms of instability resolved and the patient expressed a high degree of satisfaction with the result of her surgery. © 2012 Tajima et al.; licensee BioMed Central Ltd.
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石田 康行, 矢野 浩明, 山本 惠太郎, 河原 勝博, 田島 卓也, 山口 奈美, 大田 智美, 中村 志保子, 帖佐 悦男
整形外科と災害外科 61 ( 3 ) 346 - 349 2012年9月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
以前,鏡視下腱板修復術(ARCR)の成績を報告した.術後臨床成績は良好であったが大,広範囲断裂例,術前筋萎縮進行例で再断裂が多かった.この反省を踏まえ適応を厳選しARCRを行ってきた.今回,適応厳選前後の成績を調査したので報告する.2005年10月から2009年7月の前期に行った80肩と2009年8月から2010年8月の後期に行った58肩を対象とした.両期での断裂形態,断裂腱板筋萎縮,腱板修復状態,臨床成績を調査した.大,広範囲断裂,筋萎縮進行例の割合が有意差はなかったが後期で減少していた.腱板修復状態は後期で有意に改善していた.臨床成績は両期とも術後有意に改善していた.適応を厳選すれば再断裂例は減少していた.一時修復不能例の多くは陳旧性腱板断裂の有症状化と考えられる.個々の症例に合わせた保存療法も含めた治療法の選択が必要である.近年のARCRの成績から若年の修復可能な症候性腱板断裂例は修復不能例を予防するためにも積極的な手術が推奨される.
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Effect of genu recurvatum on the anterior cruciate ligament-deficient knee during gait
Kawahara K., Sekimoto T., Watanabe S., Yamamoto K., Tajima T., Yamaguchi N., Chosa E.
Knee Surgery, Sports Traumatology, Arthroscopy 20 ( 8 ) 1479 - 1487 2012年8月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Knee Surgery, Sports Traumatology, Arthroscopy
Purpose: This study aimed to investigate the effects of genu recurvatum, which is considered to carry a high risk for anterior cruciate ligament (ACL) injury, on healthy and post-ACL injury gait and lower extremity muscle strength. Methods: Subjects were 36 patients with ACL-deficient knee and 40 healthy controls without pain or restricted range of motion of the lower extremity during gait. The knee joints of all subjects were examined; those with over 10° hyperextension of both knees were defined as exhibiting genu recurvatum. On this basis, the subjects were further subdivided into two groups: with or without genu recurvatum. A three-dimensional motion analysis system and force plates were used for gait analysis. Isokinetic dynamometers were used to measure knee muscle strength. Results: There were no differences in joint angles, joint moments, or components of ground reaction force during gait or in knee strength for the healthy control subjects with and without genu recurvatum. ACL-deficient subjects without genu recurvatum showed a decrease in knee angles during the stance phase and a decrease in extension moments during the early stance phase compared with ACL-deficient subjects with genu recurvatum and controls. In contrast, neither knee angles nor extension moments during the stance phase differed significantly between ACL-deficient subjects with genu recurvatum and controls. Conclusions: This study provides clinically relevant information regarding the effects of genu recurvatum on gait parameters. The results suggest that in ACL injuries, the presence of genu recurvatum alters gait pattern. Consideration of the presence of genu recurvatum would be useful during rehabilitation following ACL injuries or ACL reconstruction. Level of evidence: II. Prospective comparative study. © 2011 Springer-Verlag.
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石田 康行, 山本 惠太郎, 田島 卓也, 山口 奈美, 大田 智美, 帖佐 悦男
JOSKAS 37 ( 3 ) 391 - 394 2012年6月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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田島 卓也, 山本 惠太郎, 石田 康行, 山口 奈美, 崎濱 智美, 帖佐 悦男
JOSKAS 37 ( 1 ) 126 - 127 2012年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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Tajima T., Chosa E., Yamamoto K., Yamaguchi N.
Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology 4 ( 1 ) 9 2012年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology
Background: Recent years have seen anterior cruciate ligament (ACL) reconstruction being performed in a broad range of patients, regardless of age, sex and occupation, thanks to great advances in surgical techniques, surgical instruments and basic research. In cases of ACL reconstruction, bone-patellar tendon-bone (BTB) graft or hamstring graft are frequency used. However, potential complications associated with tunnel enlargement due to soft tissue graft such as hamstring were reported. On the other hand, an altered rotational axis resulting in significantly greater translation of the lateral compartment in the single bundle compared with double bundle ACL reconstruction was reported.Method and procedure: A reconstruction procedure was modified for the ACL using a double bundle that is the combination of BTB and gracilis tendon composite autograft. Two tibial and two femoral bone tunnels are used to reconstruct two bundles of ACL; an anteromedial bundle (AMB) and a posterolateral bundle (PLB). The femoral bone tunnels are created just posterior to the resident's ridge. The tibial bone tunnels are created at the center of AM and PL tibial attachment, respectively. BTB is fixed in the AM tunnels produced on the anatomical points of tibia and femur. The gracilis graft is fixed in an anatomical PL tunnel produced. The mean width of BTB is 7 mm, since10 mm graft is sometimes not suitable for patients, especially small Asian people and females. For these patients, 10 mm graft is bigger than one third of patella tendon width.Conclusion: The devised surgical procedure based on a combination of BTB and gracilis autograft is suitable reconstruction method for patients who have small or medium width of patellar tendon such as Asian people and females. This technique is also applicable to revision surgery. © 2012 Tajima et al; licensee BioMed Central Ltd.
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石田 康行, 帖佐 悦男, 矢野 浩明, 山本 惠太郎, 河原 勝博, 田島 卓也, 山口 奈美, 崎濱 智美, 長澤 誠, 川野 啓介
整形外科と災害外科 60 ( 3 ) 373 - 377 2011年9月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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宮元 修子, 矢野 浩明, 山本 惠太郎, 石田 康行, 田島 卓也, 山口 奈美, 崎濱 智美, 長澤 誠, 帖佐 悦男
整形外科と災害外科 60 ( 4 ) 692 - 696 2011年9月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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当科における鏡視下腱板修復術の成績 : 術後1年のMRI像と臨床成績
石田 康行, 山本 惠太郎, 田島 卓也, 山口 奈美, 崎濱 智美, 帖佐 悦男
JOSKAS 36 ( 2 ) 212 - 216 2011年5月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:日本関節鏡・膝・スポーツ整形外科学会
近年, 鏡視下腱板修復術(ARCR)の良好な成績が報告されているが, 断裂サイズが大きい例, 断裂腱板の脂肪変性が高度な例では再断裂が多いといわれる. 当科で行ったARCRの術後成績,腱板修復状態を検討したので報告する. 2005年9月より重層固定法でARCRを行い,術後1年でMRI評価ができた65肩,男性52肩,女性13肩を対象とした. サイズは小断裂7肩, 中断裂15肩, 大断裂32肩, 広範囲断裂11肩であった. 手術時年齢は30~78歳,平均61.8歳であった. 臨床成績を術前と術後1年時のJOA scoreで評価し, 腱板修復状態を術後1年時MRIでの菅谷の分類で評価した. 断裂腱板の脂肪変性をGoutallierの分類で評価した. サイズ別のJOA scoreは各サイズで術前より術後有意に改善していたが, 術後JOA scoreはサイズが増大するにつれて低下傾向であった. 腱板修復状態はtype1が28肩,type2が11肩,type3が7肩,type4が9肩,type5が10肩であった. 再断裂とされるtype4, 5は全例中29%であった.### 腱板修復状態別のJOA scoreはすべてのtypeで術前より術後有意に改善していたが, 術後JOA scoreは再断裂であるtype4, 5で低下傾向であった. サイズ別でtype4, 5の占める割合は小, 中断裂は0%, 大断裂は31.3%, 広範囲断裂は81,8%であった. 断裂腱板脂肪変性別でのtype4, 5の占める割合はgrade0, grade1は0%, grade2は23.1%, grade3は39.1%, grade4は87.5%であった.### 我々の鏡視下重層固定法の成績は諸家の報告と同等であったがサイズが大きい例, 断裂腱板脂肪変性が進んだ例で再断裂率が高かった.### 再断裂率を低下させるために, 手術手技や後療法の工夫が行われている. しかし, 腱板の質が不良な例では手技や後療法を工夫しても再断裂は生じ,一次修復の限界である. 患者の活動性を考慮し保存療法を見直し,手術適応を再検討していきたい. また,腱板の質が不良な例で手術が必要な場合は一次修復にこだわらず, patch法, 部分修復, debridement, 筋移行といった手術法を患者の活動性を考慮し選択していく方針である.
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田島 卓也, 山本 惠太郎, 石田 康行, 山口 奈美, 崎濱 智美, 帖佐 悦男
JOSKAS 36 ( 2 ) 258 - 263 2011年5月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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石田 康行, 川野 啓介, 帖佐 悦男, 矢野 浩明, 山本 惠太郎, 河原 勝博, 田島 卓也, 山口 奈美, 崎濱 智美, 長澤 誠
整形外科と災害外科 60 ( 3 ) 373 - 377 2011年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
鏡視下腱板修復術(ARCR)の良好な成績が報告されているが再断裂例も存在する.ARCRの再断裂率,再断裂に関わる因子,臨床成績,再断裂MRIの検討を行ったので報告する.当科でARCRを行い,調査可能であった80肩,男性61肩,女性19肩を対象とした.年齢は30~78歳であった.臨床成績を術後1年時のJOA score,再断裂の有無を術後1年時MRIで評価した.全例中30%に再断裂を認め,断裂が大きい例,術前腱板脂肪変性が進んだ例,肩甲下筋断裂合併例で再断裂率が高かった.臨床成績は再断裂なし群が術後平均93.9点,再断裂あり群が術後平均87.2点であった.再断裂例を菅谷分類type 4,5に分けるとtype 4がtype 5に比べ有意に術後JOA scoreが改善していた.本術式は置換術ではないので残存腱板の状態が重要である.手術適応,手技についてさらなる検討が必要である.
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宮元 修子, 矢野 浩明, 山本 惠太郎, 石田 康行, 田島 卓也, 山口 奈美, 崎濱 智美, 長澤 誠, 帖佐 悦男
整形外科と災害外科 60 ( 4 ) 692 - 696 2011年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
軟骨芽細胞腫は10歳代の長管骨骨端部に好発する比較的稀な腫瘍である.今回我々は軟骨芽細胞腫の1症例を経験したので文献的考察を加え報告する.症例は15歳女性,右肩を壁に打ちつけ,右肩痛・可動域制限が出現した.その後,右肩挙上困難が出現したため近医受診し,レントゲンで上腕骨頚部に仮骨を認めたため,骨折の診断でリハビリを施行されていた.数か月後,右肩の腫脹に気づいたが放置していた.右背部の外傷あり,その際のレントゲンにて上腕骨に骨透亮像認めたため,MRI施行したところ骨腫瘍疑われ,当科紹介初診となった.生検術を施行し,軟骨芽細胞腫の診断となり,骨腫瘍掻爬と人工骨移植術を施行した.術後3年の最終経過観察時,再発なく右肩可動域制限もない.
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崎浜 智美, 石田 康行, 矢野 浩明, 山本 惠太郎, 河原 勝博, 田島 卓也, 山口 奈美, 深尾 悠, 河野 雅充, 帖佐 悦男
整形外科と災害外科 59 ( 3 ) 533 - 535 2010年9月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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宮崎県高校女子バスケットボール国体候補選手10名に対するメディカルチェック : 3年間の調査結果と問題点
山口 奈美, 山本 惠太郎, 石田 康行, 河原 勝博, 田島 卓也, 帖佐 悦男, 田島 直也
日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine 30 ( 2 ) 79 - 86 2010年5月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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肩関節過外転で生じた bony PASTA lesion の1例
石田 康行, 帖佐 悦男, 矢野 浩明, 山本 惠太郎, 河原 勝博, 田島 卓也, 山口 奈美, 崎濱 智美
JOSKAS 35 ( 3 ) 468 - 471 2010年5月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:日本関節鏡・膝・スポーツ整形外科学会
2004年Kasparらは肩関節過外転による肩峰と上腕骨の衝突で上腕骨近位に骨欠損と骨折を生じる症例があると報告し,2007年Bhatiaらは肩関節前方脱臼後に生じた棘上筋腱大結節付着部関節面側裂離骨折をbony PASTA lesionと称した. 今回,肩関節過外転で生じたbony PASTA lesionの症例を経験したので報告する. 症例は41歳,男性で建築作業中,足場より転落し左手でぶら下がり左肩関節過外転となり,左棘上筋腱大結節付着部関節面側裂離骨折を受傷した. 転位が軽度であったため近医にて保存的加療を行った. 左肩関節運動時痛,ひっかかり感が改善しないため受傷後7カ月で当科紹介受診となった. 画像所見上,上腕骨大結節に直径約10mmの骨欠損像と棘上筋腱大結節付着部関節面側に2×2×5mm大の小骨片を認め,小骨片による肩インピンジメント症候群と考え鏡視下手術を施行した. 小骨片は切除し,棘上筋腱関節面部分断裂を残存腱板を温存し,鏡視下に経腱板的に修復した(arthroscopic PASTA repair). 術後経過良好で術前の症状は消失した. 本例に対する鏡視下手術は鏡視による低侵襲での病変部の評価と残存組織を温存した修復が可能で最良の方法であった.
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棘窩切痕部ガングリオンに対する肩峰下滑液包からの鏡視下除圧術の短期成績
石田 康行, 帖佐 悦男, 矢野 浩明, 山本 惠太郎, 河原 勝博, 田島 卓也, 山口 奈美, 崎濱 智美
JOSKAS 35 ( 2 ) 338 - 341 2010年5月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:日本関節鏡・膝・スポーツ整形外科学会
【目的】肩甲上神経麻痺を呈する棘窩切痕部ガングリオンに対する鏡視下除圧術は肩甲上腕関節(GHJ)からの除圧が主流であった. しかし,GHJから除圧が困難な症例を時に経験する. 我々はGHJからの除圧が困難な症例や多房性の症例には肩峰下滑液包(SAB)からの除圧術を行っている. 同法を紹介し成績を評価する. ###【対象と方法】2006年5月より棘窩切痕部ガングリオンに対して鏡視下除圧術を行った4肩,男性3肩,女性1肩を対象とした. 年齢は36~56歳. 平均43.5歳. 経過観察期間は8~33カ月,平均17.8カ月. 発生部位は棘上窩1肩,棘上窩2肩,棘上窩から棘下窩1肩であった. 主訴は肩痛が2肩,外旋筋力低下が1肩,肩痛と外旋筋力低下が1肩であった. 除圧は全例鏡視下に行い,GHJから行ったが除圧できずSABから行ったのが1肩,多房性でGHJとSAB双方から行ったのが1肩,SAB単独で行ったのが2肩であった. 1例に関節唇修復を追加した. ###【結果】全例,術前の症状は改善し,経過観察時のMRIで再発を認めていない. ###【考察】肩甲上神経の走行からGHJから除圧する場合のsafety zoneは肩甲棘レベルで関節窩から1cmといわれている. ガングリオンが関節窩の近位に存在する場合,GHJからと比べてSABからの除圧は神経損傷の危険性が少なくなる. また,多房性の場合SABからの除圧はGHJからと併用すれば再発の危険性も少なくなる. SABからの除圧は肩甲上神経より離れた部位での除圧が可能でより安全である.
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深尾 悠, 山本 惠太郎, 矢野 浩明, 河原 勝博, 石田 康行, 田島 卓也, 山口 奈美, 崎〓 智美, 山口 志保子, 帖佐 悦男
整形外科と災害外科 59 ( 1 ) 178 - 182 2010年3月
記述言語:日本語 掲載種別:研究論文(学術雑誌)
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崎浜 智美, 帖佐 悦男, 石田 康行, 矢野 浩明, 山本 惠太郎, 河原 勝博, 田島 卓也, 山口 奈美, 深尾 悠, 河野 雅充
整形外科と災害外科 59 ( 3 ) 533 - 535 2010年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:西日本整形・災害外科学会
我々は疼痛や可動域制限を有する変形性肘関節症に対して関節鏡視下関節形成術を行なっている.今回,その短期成績を報告する.症例は変形性肘関節症に対し肘関節鏡を施行し術後4ヶ月以上経過観察可能であった5例5肘で男性5肘を対象とした.手術時平均年齢は54.0歳,平均経過観察期間は14.2ヶ月であった.評価方法として,術前後の日本整形外科学会肘機能評価法(JOAスコア)および可動域,合併症の有無で評価した.JOA肘スコアは平均69.0点から91.2点に,可動域は屈曲が平均106.4度から115.6度に,伸展が平均-12.4度から-3.6度と改善が見られたが,術前可動域制限が強い症例での改善度が低い傾向にあった.術後合併症は全例なかった.変形性肘関節症に対する鏡視下手術は組織への侵襲が少なく,有効な手術法であるが,術前可動域制限が強い症例では手術手技の更なる検討が必要である.
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矢野 浩明, 帖佐 悦男, 山本 惠太郎, 石田 康行, 河原 勝博, 田島 卓也, 山口 奈美, 崎濱 智美
臨床スポーツ医学 = The journal of clinical sports medicine 26 ( 8 ) 975 - 983 2009年8月
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:文光堂