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医学部 附属病院 救命救急センター |
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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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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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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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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
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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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）
講演・口頭発表等 【 表示 ／ 非表示 】
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柔道競技における膝前十字靭帯損傷の特徴
森田雄大、田島卓也、山口奈美、横江琢示、帖佐悦男
第49回九州膝関節研究会 2024年3月16日
開催年月日： 2024年3月16日
会議種別：口頭発表（一般）
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CT画像による腓骨筋腱溝の形態学的評価
横江琢示、田島卓也、山口奈美、森田雄大、帖佐悦男
第10回九州足の外科研究会 2024年3月2日
開催年月日： 2024年3月2日
会議種別：口頭発表（一般）
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Predicting The Clinical Decision Limits of Locomotive Syndrome from The Screening Questionnaire Using Machine Learning 国際会議
Yoichiro Yamaguchi、Hiroyuki Imazato、Takuji Yokoe、Yudai Morita、Takuya Tajima、Etsuo Chosa
ORS2024 ANNUAL MEETING
開催年月日： 2024年2月2日 - 2024年2月6日
会議種別：ポスター発表
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A possible Cause of Articular Cartilage Degeneration in the Acute Phase after Anterior Cruciate Ligament Reconstruction 国際会議
Yudai Morita、Takuya Tajima、Nami Yamaguchi、Takuji Yokoe、Etsuo Chosa
ORS2024 ANNUAL MEETING
開催年月日： 2024年2月2日 - 2024年2月6日
会議種別：ポスター発表
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徒手前方引き出しテストとストレス超音波検査による足関節回旋不安定性の関係
横江琢示、田島卓也、山口奈美、大田智美、長澤誠、森田雄大、帖佐悦男
第35回九州・山口スポーツ医・科学研究会 2023年12月9日
開催年月日： 2023年12月9日
会議種別：口頭発表（一般）