Papers - CHOSA Etsuo
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特集 偽関節治療のエキスパートを目指そう 偽関節の保存療法
日吉 優, 帖佐 悦男
関節外科 基礎と臨床 42 ( 11 ) 1219 - 1226 2023.11
Publishing type:Research paper (scientific journal) Publisher:メジカルビュー社
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Okura T., Tajima T., Fukuda H., Matsuoka T., Chosa E.
Journal of Clinical Ultrasound 51 ( 9 ) 1522 - 1528 2023.11
Language:English Publishing type:Research paper (scientific journal) Publisher:Journal of Clinical Ultrasound
Purpose: To investigate the efficacy of sagittal ultrasonography of the median nerve in diagnosing carpal tunnel syndrome (CTS). Methods: Seventy-six hands with idiopathic CTS and 80 hands of asymptomatic subjects were included. All patients with CTS underwent ultrasonographic examination, electrodiagnostic testing, and CTS-6 assessment. In the sagittal ultrasonographic examination, the maximum and minimum median nerve diameters (MNDs) were measured at the proximal and distal ends of the carpal tunnel, respectively. The median nerve stenosis rate (MNSR) was computed as (1 – minimum MND/maximum MND) × 100 (%). The cross-sectional area (CSA) of the median nerve at the level of the pisiform was measured. Results: In the sagittal ultrasonographic examination, the mean maximum MNDs were 0.252 cm and 0.202 cm, mean minimum MNDs were 0.145 cm and 0.165 cm, and mean MNSRs were 41.83% and 17.35% in the CTS and control groups, respectively; the mean maximum MND and MNSR were considerably larger in the CTS group. The maximum MND and MNSR were correlated with the electrodiagnostic testing results and CTS-6 score. The MNSR with a cut-off value of 34.0% had a higher sensitivity and specificity than the CSA in diagnosing CTS. Conclusions: Sagittal ultrasonographic examination is useful in diagnosing CTS.
DOI: 10.1002/jcu.23584
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特集 変形性関節症の最新の治療戦略 Ⅱ 各論 人工関節置換術 人工股関節置換術(THA)に対する最新のトレンド−下肢牽引台を用いた最小侵襲アプローチ「intra-capsular THA」に関して−
中村 嘉宏, 帖佐 悦男
関節外科 基礎と臨床 42 ( 14 ) 147 - 156 2023.10
Publishing type:Research paper (scientific journal) Publisher:メジカルビュー社
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Effect of age on upper limb, neck, and trunk kinematics during activities of daily living
Nakatake J., Arakawa H., Shogo M., Totoribe K., Chosa E.
Heliyon 9 ( 10 ) e20535 2023.10
Language:English Publishing type:Research paper (scientific journal) Publisher:Heliyon
Motion analysis during activities of daily living has been conducted in numerous studies. However, information is lacking regarding age-related differences that affect clinical assessment and treatment goals. This study aimed to examine the effect of age on kinematics during activities of daily living. Three-dimensional motions of the shoulder, elbow, neck, and trunk of 12 younger adults (age, 29.8 ± 5.4 years; 7 men and 5 women) and 10 older adults (age, 69.5 ± 4.9 years; 6 men and 4 women) were measured during the acts of reaching for a table, bringing a glass to the mouth for drinking, wiping the buttocks, tying shoelaces, washing hair, washing the axilla, reaching for a high shelf, and reaching for the floor. The ranges of motion and sequential joint angles were compared between age groups by using discrete analysis and statistical parametric mapping, respectively. The ranges of motion of all joint angles in older and younger adults were comparable in the drinking, washing hair, washing the axilla, and reaching for the floor tasks. Statistical parametric mapping indicated that older adults had significantly poorer neck extension than did younger adults during the drinking (67–92% cycle time) and tying shoelaces (64–95% cycle time) tasks. Kinematics were mostly maintained in healthy older adults during activities of daily living. However, reduced motions were confirmed later during some tasks. The results indicated that existing knowledge combined with the current findings, which take age into account, could be used in clinical settings to assess the kinematics of activities of daily living and set treatment goals.
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頚部傍脊椎領域原発悪性リンパ腫に対し椎弓形成術を施行した小児の1例
飯田 暁人, 濱中 秀昭, 黒木 修司, 比嘉 聖, 永井 琢哉, 黒木 智文, 日髙 三貴, 帖佐 悦男
整形外科と災害外科 72 ( 4 ) 735 - 738 2023.9
Language:Japanese Publishing type:Research paper (scientific journal) Publisher:西日本整形・災害外科学会
【はじめに】非常に稀な小児頚部傍脊椎領域原発悪性リンパ腫に対し,椎弓形成術を施行した症例を報告する.【症例】12歳,男児.1か月前より頚部痛あり,徐々に上肢麻痺(MMT3),巧緻運動障害が出現し紹介となった.MRIでC3-6の椎体から椎弓にかけての腫瘍性病変と脊髄腫大を認めた.受診翌日にC3-6の椎弓形成を行い,前駆B細胞性リンパ芽球性リンパ腫と診断された.小児科にて化学療法施行後,C3-6に対し陽子線を18 Gy照射した.現在術後4年で麻痺なく,寛解を維持している.最終観察時C2-7角は11度であった.陽子線照射にもかかわらず,脂肪髄化した椎体がリモデリングし,椎体高も1椎体平均4.15 mm成長した.【考察】小児に対する頚椎椎弓形成術や陽子線治療後の椎体成長に関する報告は少ない.小児腫瘍は予後が改善してきており,骨成長や変形に対しても長期に経過観察する必要がある.
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鮫島 央, 濱中 秀昭, 黒木 修司, 比嘉 聖, 永井 琢哉, 黒木 智文, 日髙 三貴, 帖佐 悦男
整形外科と災害外科 72 ( 4 ) 749 - 753 2023.9
Language:Japanese Publishing type:Research paper (scientific journal) Publisher:西日本整形・災害外科学会
症例は85歳,男性.近医にて腰部脊柱管狭窄症,腰椎辷り症に対しL4/5の腰椎前外側椎体間固定術(以下,OLIF)を施行された.術直後に発熱と腰痛が出現し,画像検査にてインストゥルメント周囲感染と診断され,後方からの洗浄デブリードマンや固定延長を行うも感染コントロール不良なために術後6か月で当科紹介となった.当科にてケージ抜去・前方掻爬自家骨移植術・後方固定術を施行した.その後,起炎菌は同定できなかったが長期の抗生剤内服を併用したことで感染は沈静化し疼痛も消失しADLも改善した.脊椎インストゥルメンテーション手術後の感染の治療は感染制御と脊椎安定性の維持の2つの柱のバランスを踏まえて行う必要がある.しかし,エビデンスに基づいた治療が確立されていないのが現状である.脊椎インストゥルメント周囲感染について最近の知見を踏まえ当院での治療方針に関して検討したので報告する.
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股関節高位脱臼に対して大腿骨遠位短縮骨切りを併用した人工股関節再置換術の1例
座間味 陽, 中村 嘉宏, 坂本 武郎, 舩元 太郎, 日吉 優, 山口 洋一朗, 今里 浩之, 平川 雄介, 帖佐 悦男
整形外科と災害外科 72 ( 3 ) 424 - 426 2023.9
Language:Japanese Publishing type:Research paper (scientific journal) Publisher:西日本整形・災害外科学会
股関節高位脱臼に対して大腿骨遠位短縮骨切り術を併用した1例を経験したので報告する.【症例】72歳女性,1980年に左人工股関節置換術(以下THA),以降,右THA並びに2003年に左THA(Depuy AML)を施行.徐々に左股関節痛の増悪を認め,X線にて高度寛骨臼骨欠損に伴うカップの高位脱臼を認めた.手術は同種骨移植後原臼位にセメントレスカップを設置.Well fixed状態のためステムは温存し,大転子移動量70mmであったため大腿骨遠位35mm短縮骨切り術を併用.術後麻痺なく経過した.【考察】広く転子下骨切り術は併用される一方,既存ステム挿入例や近位高度骨変形などでは遠位骨切りも選択肢の一つとなり得る.
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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 2023.9
Language:Japanese Publishing type:Research paper (scientific journal) Publisher: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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Is the Small Ossicle of Type 1 Accessory Navicular a Cause of Foot Pain?—A Case Report
Yokoe T., Uemichi K., Tajima T., Chosa E.
Medicina (Lithuania) 59 ( 9 ) 2023.9
Language:English Publishing type:Research paper (scientific journal) Publisher:Medicina (Lithuania)
Background and objectives: An accessory navicular (AN) bone is often classified into types 1–3 according to the Veitch classification, and symptomatic type 1 patients usually receive non-surgical treatment. However, there are cases in which AN cannot be classified into one of these three types using this classification system, and the small ossicle of type 1 AN may not be the cause of foot pain. This report aimed to present a case of symptomatic type 1 AN that required surgical treatment without the excision of the small ossicle after long-term conservative treatment had failed. Case presentation: A 15-year-old girl who was diagnosed with symptomatic type 1 AN was referred to our department. Medial-side foot pain had prevented her from playing soccer well. She had been treated conservatively for type 1 AN for more than 12 months at several orthopedic clinics. Tenderness of the prominent navicular tubercle was identified, and computed tomography and magnetic resonance imaging findings suggested that the cause of her foot pain was derived from the prominent navicular tubercle not the small ossicle itself. Osteotomy of the prominent navicular tubercle with the advancement of the tibialis posterior tendon, without excision of the ossicle, was performed. At the 12-month follow-up examination, she was completely free from foot pain, and the patient-reported outcome measures were excellent. She now plays soccer at the pre-injury level. Conclusions: We report the case of a patient with symptomatic type 1 AN who underwent osteotomy of the prominent navicular tubercle with advancement of the tibialis posterior tendon, without excision of the ossicle, and who showed favorable short-term clinical outcomes. The evaluation of symptomatic patients with AN based on the Veitch classification alone may lead to inappropriate management. The small ossicle of type 1 AN was not the cause of foot pain in the present case.
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Shear stress in the medial meniscus posterior root during daily activities
Yokoe T., Ouchi K., Yamaguchi Y., Enzaki M., Tajima T., Chosa E.
Knee 43 176 - 183 2023.8
Language:English Publishing type:Research paper (scientific journal) Publisher:Knee
Background: Medial meniscus posterior root (MMPR) tears have been reported to occur in middle-aged patients with minor trauma. However, the injury mechanism of MMPR tears remains unclear. The purpose of this study was to evaluate the shear stress in the MMPR during daily activities using a finite-element analysis. Methods: Subject-specific finite-element models of the knee joint of a healthy middle-aged subject were developed from computed tomographic and magnetic resonance images. A three-dimensional motion capture system “VICON” was used to capture four daily activities: walking, jogging, descending stairs, and landing. The knee joint reaction force was estimated using the AnyBody modeling system. Based on these procedures, the shear stress in the MMPR was calculated during each motion. The shear stress in the lateral meniscus posterior root (LMPR) was also measured to compare the stress between the MMPR and LMPR. Results: The shear stress in the MMPR increased as the knee flexion angle increased during each motion. Descending stairs caused more than two-fold greater stress in the MMPR than walking and a similar or greater amount of stress than jogging. The LMPR tended to receive more shear stress than the MMPR throughout each motion. Conclusions: The present study showed that descending stairs confers almost the same amount of shear stress to the MMPR as jogging. The results of the present study may suggest that descending motion of the knee is an important cause of MMPR tear, and the initiation of descending stairs should be delayed after MMPR repair.
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書評 『ナショナルチームドクター・トレーナーが書いた種目別スポーツ障害の評価とリハビリテーション』
帖佐 悦男
整形外科 74 ( 8 ) 892 - 892 2023.7
Publishing type:Research paper (scientific journal) Publisher:南江堂
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宮崎式サーフィン競技安全度評価を1シーズン使用してみて Reviewed
小島岳史、柏木輝行、柏木悠吾、福嶋研人、吉田尚紀、石田翔太郎、帖佐悦男、田島卓也
九州・山口 スポーツ医・科学研究会誌 34 28 - 32 2023.7
Publishing type:Research paper (scientific journal)
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特集 変形性関節症の診断と治療--保存的治療から再生医療まで Ⅵ章.変形性股関節症 3.変形性股関節症の画像診断(X線像,CT,MRIなど)
帖佐 悦男
整形外科 74 ( 6 ) 609 - 615 2023.5
Publishing type:Research paper (scientific journal) Publisher:南江堂
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脆弱性骨折に対する当院の取り組み―活動を見直し,OLSからFLSに的を絞って得られた効果についての検討― Reviewed
小牧亘、帖佐悦男
骨折 45 ( 3 ) 936 - 940 2023.5
Language:Japanese Publishing type:Research paper (scientific journal)
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Ureter position and risk of ureteral injury during lateral lumbar interbody fusion Reviewed
Hideaki Hamanaka,Takuya Tajima,Syuji Kurogi,Kiyoshi Higa, Takuya Nagai,Tomofumi Kuroki,Hiroki Takamori, Syoichiro Mukai,Toshiyuki Kamoto,Etsuo Chosa
Journal of Orthopaedic Science 2023.5
Authorship:Last author Language:English Publishing type:Research paper (scientific journal)
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Retrograde Autologous Talar Osteocancellous Bone Grafting for the Treatment of Osteochondral Lesions of the Talus: A Technical Note Reviewed
Takuji Yokoe,Takuya Tajima,Nami Yamaguchi,Yudai Morita,Etsuo Chosa
Journal of Clinical Medicine 2023.5
Authorship:Last author Language:English Publishing type:Research paper (scientific journal)
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Risk factors associated with throwing injuries in young baseball players Reviewed
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 2023.5
Authorship:Last author Language:English Publishing type:Research paper (scientific journal)
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人工関節における進歩 Ⅶ.インプラント抜去 人工股関節再置換術における合併症対策
中村 嘉宏, 帖佐 悦男
別冊整形外科 1 ( 83 ) 164 - 170 2023.4
Publishing type:Research paper (scientific journal) Publisher:南江堂
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Yamako G., Punchihewa N.G., Arakawa H., Tajima T., Chosa E.
Sensors 23 ( 7 ) 2023.4
Language:Japanese Publishing type:Research paper (scientific journal) Publisher:Sensors
Standing up from a chair is a mechanically demanding daily motion, and its biomechanics represent motor performance. In older adults with locomotive syndrome (LS), sit-to-stand (STS) movement with adequate postural control is essential to prevent falls. This study evaluated the characteristics of dynamic balance during STS movement on older adults with LS. A total of 116 participants aged ≥65 years were divided into Non-LS, LS stage 1, and LS stage 2 groups using the LS risk test. The participants were instructed to stand on the Nintendo Wii Balance Board as quickly as possible, and the STS movement was quantified using the vertical ground reaction force (VGRF) and center of pressure (CoP). The STS score, which represented dynamic balance, was significantly different among the groups (p < 0.001). The rate of VGRF development was significantly lower in the LS stages 1 and 2 than in the Non-LS group (p < 0.001). On the other hand, the total distance of the CoP path did not differ among the groups (p = 0.211). These findings indicated a reduction of postural control in older adults with LS. The STS score emphasized the importance of balance training to prevent falls in older adults with LS.
DOI: 10.3390/s23073368
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Yokoe T, Ouchi K, Matsumoto T, Tajima T, Chosa E
The Knee 42 57 - 63 2023.3
Language:English Publishing type:Research paper (scientific journal) Publisher:Knee
Background: Partial meniscectomy is commonly performed for symptomatic patients with discoid lateral meniscus (DLM) if conservative treatment fails. However, the development of knee osteoarthritis and osteochondral lesion are detrimental postoperative complications. This study aimed to evaluate the effect of the volume of resected DLM on the contact stress of the tibiofemoral joint using a finite element analysis. Methods: Subject-specific finite-element models of the knee joint of a patient with DLM were developed from computed tomographic and magnetic resonance images. To evaluate the effect of partial meniscectomy on the contact stress in the lateral tibiofemoral joint, six knee models were created in the study (the native DLM, and five partially meniscectomized DLMs (according to the preserved width of the meniscus: 12 mm, 10 mm, 8 mm, 6 mm, and 4 mm)). Results: As the volume of resected DLM increased, higher contact stress was applied to the lateral tibiofemoral joint. Greater contact stress was applied to the preserved lateral meniscus than to the native DLM. Conclusions: From a biomechanical viewpoint, the native DLM was the most protective against lateral tibiofemoral contact stress in comparison to partially meniscectomized DLMs.