Details of a Researcher

Biomechanical effect of metal augment and bone graft on cup stability for acetabular reconstruction of total hip arthroplasty in hip dysplasia: a finite element analysis Reviewed

Wang Y., Wang M., Li C., Nakamura Y., Deng L., Yamako G., Chosa E., Pan C.

BMC Musculoskeletal Disorders 23 ( 1 ) 277 2022.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：BMC Musculoskeletal Disorders

Background: Different methods of acetabular reconstruction with total hip arthroplasty (THA) for Crowe II and III of adult developmental dysplasia of the hip (DDH) acetabular bone defect have been implemented clinically. However, the biomechanical effect of different augmented materials for acetabular reconstruction in THA on shell stability has never been discussed. Methods: In the present study, autologous bone graft (BG)and metal (Ti6Al4V) augment (MA) were simulated with several acetabular bone defect models of DDH in THA. The contact pressure and micromotion between the shell and host bone were measured for evaluating the shell stability using a finite element method. Results: The peak contact stress between shell and host bone was higher in the MA situation (12.45 vs 8.71 MPa). And the load transfer path was different, for BG models, the high local contact stresses were found at the junction of bone graft and host bone while for MA models the concentrated contact stresses were at the surface of MA. The peak relative micromotion between shell and host bone was higher in the MA situation (12.61 vs 11.13 µm). However, the peak micromotion decreased in the contact interface of MA and cup compared to the BG models. Conclusions: The higher micromotion was found in MA models, however, enough for bone ingrowth, and direct stronger fixation was achieved in the MA-cup interface. Thus, we recommended the MA can be used as an option, even for Crowe III, however, the decision should be made from clinical follow-up results.

DOI： 10.1186/s12891-022-05168-1

Does the contralateral healthy ankle of patient with ipsilateral mechanical lateral ankle laxity show greater lateral ankle laxity? Evaluation of the anterior talofibular ligament by stress ultrasonography Reviewed

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

BMC Musculoskeletal Disorders 23 ( 1 ) 887 2022.12

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

DOI： 10.1186/s12891-022-05838-0

Pivotal role of High-Mobility Group Box 2 in ovarian folliculogenesis and fertility

Shirouzu S., Sugita N., Choijookhuu N., Yamaguma Y., Takeguchi K., Ishizuka T., Tanaka M., Fidya F., Kai K., Chosa E., Yamashita Y., Koshimoto C., Hishikawa Y.

Journal of Ovarian Research 15 ( 1 ) 133 2022.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Ovarian Research

Background: High-Mobility Group Box 1 (HMGB1) and HMGB2 are chromatin-associated proteins that belong to the HMG protein family, and are involved in the regulation of DNA transcription during cell differentiation, proliferation and regeneration in various tissues. However, the role of HMGB2 in ovarian folliculogenesis is largely unknown. Methods: We investigated the functional role of HMGB1 and HMGB2 in ovarian folliculogenesis and fertilization using C57BL/6 wild type (WT) and HMGB2-knockout (KO) mice. Ovarian tissues were obtained from WT and HMGB2-KO mice at postnatal days 0, 3, 7, and 2, 6 months of age, then performed immunohistochemistry, qPCR and Western blotting analyses. Oocyte fertilization capability was examined by natural breeding and in vitro fertilization experiments. Results: In HMGB2-KO mice, ovary weight was decreased due to reduced numbers of oocytes and follicles. Natural breeding and in vitro fertilization results indicated that HMGB2-KO mice are subfertile, but not sterile. Immunohistochemistry showed that oocytes expressed HMGB2, but not HMGB1, in neonatal and adult WT ovaries. Interestingly, in HMGB2-KO ovaries, a compensatory increase in HMGB1 was found in oocyte nuclei of neonatal and 2-month-old mice; however, this was lost at 6 months of age. Conclusions: The depletion of HMGB2 led to alterations in ovarian morphology and function, suggesting that HMGB2 plays an essential role in ovarian development, folliculogenesis and fertilization.

DOI： 10.1186/s13048-022-01071-4

Investigation of cryotherapy for pain relief after arthroscopic shoulder surgery

Uchida R., Hombu A., Ishida Y., Nagasawa M., Chosa E.

Journal of Orthopaedic Surgery and Research 17 ( 1 ) 553 2022.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Orthopaedic Surgery and Research

Background: Recently, cryotherapy has become a common practice for postoperative pain management. The current accepted practice in Japan is the use of cryotherapy at 5 °C after arthroscopic shoulder surgery. However, this therapy has been reported to be highly intense because the sustained low temperature causes discomfort for patients. The optimum temperature and duration of cooling required for comfortable and effective cryotherapy after arthroscopic shoulder surgery were investigated. Methods: Because pain levels might differ depending on the condition, we selected 52 patients with rotator cuff injuries, which were the most common disorders indicated for arthroscopic shoulder surgery. Patients were treated with cryotherapy at 5 °C or 10 °C for 16 h or 24 h. The pain level was determined using the visual analogue scale, and deep shoulder joint temperatures were recorded at different time points for analysis. Results: Pain after arthroscopic shoulder surgery was found to be related to the presence of a brachial plexus block using the interscalene approach during surgical anesthesia. To obtain effective analgesia with cryotherapy, the cooling temperature and duration of cryotherapy had to be changed based on the presence or absence of the brachial plexus block. Patients who received brachial plexus blocks had the lowest recorded pain scores after receiving cryotherapy at 5 °C for 24 h after surgery. Patients who did not receive the block had the lowest recorded pain scores when receiving cryotherapy at either 5 °C for 16 h or 10 °C for 24 h. Conclusions: Using universal cryotherapy intensity and duration settings regardless of the use of other interventions is likely to unintentionally increase postoperative pain levels. This study revealed that cryotherapy at 5 °C for 24 h was optimal for patients who received an anesthesia block and at 5 °C for 16 h or at 10 °C for 24 h for those who did not receive the anesthesia block. These results can be used as a reference for setting the temperature and duration of cryotherapy after arthroscopic shoulder surgery.

DOI： 10.1186/s13018-022-03404-x

特集腱板断裂治療のエキスパートを目指そう鏡視下腱板修復術:腱板断裂は何で縫うか Reviewed

長澤誠, 帖佐悦男

関節外科　基礎と臨床 41 ( 11 ) 1220 - 1228 2022.11

Publishing type：Research paper (scientific journal) Publisher：メジカルビュー社

DOI： 10.18885/jjs.0000001198

特集腱板断裂治療のエキスパートを目指そう introduction Reviewed

帖佐悦男

関節外科　基礎と臨床 41 ( 11 ) 1157 - 1157 2022.11

Publishing type：Research paper (scientific journal) Publisher：メジカルビュー社

DOI： 10.18885/jjs.0000001190

The Results of Orthopaedic Medical Examinations in Adolescent Amateur Weightlifters. Reviewed

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

International journal of environmental research and public health 19 ( 21 ) 2022.10

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

DOI： 10.3390/ijerph192113947

Fixation of an Osteochondral Lesion of the Femoral Intercondylar Groove Using Autogenous Osteochondral Grafts and Bioabsorbable Pins in a Patient with Open Physes: A Case Report. Reviewed

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

Medicina (Kaunas, Lithuania) 58 ( 11 ) 2022.10

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

DOI： 10.3390/medicina58111528

HMM-Based Action Recognition System for Elderly Healthcare by Colorizing Depth Map Reviewed

Htet Y., Zin T.T., Tin P., Tamura H., Kondo K., Chosa E.

International Journal of Environmental Research and Public Health 19 ( 19 ) 2022.10

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：International Journal of Environmental Research and Public Health

Addressing the problems facing the elderly, whether living independently or in managed care facilities, is considered one of the most important applications for action recognition research. However, existing systems are not ready for automation, or for effective use in continuous operation. Therefore, we have developed theoretical and practical foundations for a new real-time action recognition system. This system is based on Hidden Markov Model (HMM) along with colorizing depth maps. The use of depth cameras provides privacy protection. Colorizing depth images in the hue color space enables compressing and visualizing depth data, and detecting persons. The specific detector used for person detection is You Look Only Once (YOLOv5). Appearance and motion features are extracted from depth map sequences and are represented with a Histogram of Oriented Gradients (HOG). These HOG feature vectors are transformed as the observation sequences and then fed into the HMM. Finally, the Viterbi Algorithm is applied to recognize the sequential actions. This system has been tested on real-world data featuring three participants in a care center. We tried out three combinations of HMM with classification algorithms and found that a fusion with Support Vector Machine (SVM) had the best average results, achieving an accuracy rate (84.04%).

DOI： 10.3390/ijerph191912055

頚椎前方固定術後の食道損傷2例 Reviewed

河野翔, 黒木智文, 李徳哲, 永井琢哉, 比嘉聖, 黒木修司, 濱中秀昭, 帖佐悦男

整形外科と災害外科 71 ( 3 ) 333 - 338 2022.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会

【はじめに】頸椎前方固定術の合併症である食道損傷の発生率は0.1～0.45%と報告されている．今回，我々は頸椎前方固定術後に発症した食道損傷の2例を経験したので文献的考察を加えて報告する．【症例1】41歳女性，頸椎椎間板ヘルニアの診断で頸椎前方除圧固定術を施行中にエアードリルが食道に接触した．術後に創部膿瘍から口腔内常在菌を検出し，嚥下造影検査にて食道損傷と診断した．保存的加療により術後56日で食事摂取が可能となった．【症例2】54歳女性，頸椎骨肉腫の診断で頸椎前方固定術及び術後放射線治療を施行された．術15年後に感染を伴う食道瘻のためプレート抜去されたが椎体の骨溶解像を認め，生検で口腔内常在菌が検出された．保存的加療によりプレート抜去後1年3ヶ月で食事摂取可能となった．【考察】頸椎前方固定術後の食道損傷は発症時期や穿孔部の大きさで治療が異なる．本症例では診断に嚥下造影検査が有用であった．長期絶食期間を要した．

DOI： 10.5035/nishiseisai.71.333

びまん性特発性骨増殖症に伴う腰椎骨折に対しDouble endplates penetrating screw（DEPS）法にて後方固定術を施行した一例 Reviewed

黒木啓吾, 黒木智文, 永井琢哉, 比嘉聖, 黒木修司, 濱中秀昭, 帖佐悦男

整形外科と災害外科 71 ( 3 ) 352 - 354 2022.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会

要旨：びまん性特発性骨増殖症（以下DISH）に伴う椎体骨折は不安定性が強く，手術が必要な場合が多い．今回Double endplates penetrating screw（以下DEPS法）と5.5mmのチタンロッドを用いた後方固定で良好な成績を得たので報告する．症例は83歳男性，1週前に転倒し，疼痛のため体動困難となり，紹介入院となった．DISHに伴う第2腰椎骨折と診断し，手術を施行した．腹臥位で可及的に後弯を保持し，O-armナビ下に経皮的に3above-3belowのDEPSを刺入，5.5mmのチタンロッドで締結した．術直後は第2腰椎の終板角が20度と開大していたが，術後7ヶ月で7度と減弱し，スクリューの緩みはなく，骨癒合が得られた．DISHに伴う骨折には強固な固定力のあるDEPS法と術後のしなりによる整復を利用した5.5mmチタンロッドによる経皮的後方固定が有用と考える．

DOI： 10.5035/nishiseisai.71.352

股関節鏡での摘出術後にSurgical dislocationを用いて摘出を行った股関節滑膜性骨軟骨腫症の一例 Reviewed

山元楓子, 日吉優, 今里浩之, 平川雄介, 山口洋一朗, 中村嘉宏, 舩元太郎, 坂本武郎, 帖佐悦男

整形外科と災害外科 71 ( 4 ) 744 - 746 2022.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会

【はじめに】股関節滑膜性骨軟骨腫症の治療では鏡視下手術か外科的脱臼操作を伴う直視下手術が選択される．股関節鏡での摘出術後にSurgical dislocationを用いて再摘出を行った1例を報告する．【症例】38歳男性．10年前に誘因なく右股関節痛と可動域制限が出現．滑膜性骨軟骨腫症の診断で鏡視下に滑膜・遊離体を摘出した．疼痛改善したが一部残存を認め，再発に伴い疼痛増強しSurgical dislocationを用いて摘出した．術後再発なく経過している．【考察】鏡視下手術は低侵襲だが，体格や病変の位置により鏡視困難な場合，病変の残存・再発の可能性がある．Surgical dislocationを用いた直視下手術では寛骨臼への視野確保が可能だが，大腿骨頭壊死の危険性が指摘される．当院では側方アプローチでSurgical dislocationを行っており，大転子の骨切り量は少なく低侵襲で大腿骨頭壊死の危険性も低いという利点がある．本症例のように鏡視困難な位置に病変がある場合，Surgical dislocationを用いた手術は有用と考える．

DOI： 10.5035/nishiseisai.71.744

診断に時間を要したIliosacral screw挿入に伴う上殿動脈仮性動脈瘤の1例 Reviewed

森田恭史, 今里浩之, 日吉優, 山元楓子, 平川雄介, 山口洋一朗, 舩元太郎, 中村嘉宏, 坂本武郎, 帖佐悦男

整形外科と災害外科 71 ( 4 ) 842 - 844 2022.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会

【はじめに】Iliosacral screw（IS screw）挿入に伴う上殿動脈損傷は注意すべき合併症であり，術後に貧血の進行などを契機に早期発見される事が多い．今回診断に時間を要した上殿動脈仮性動脈瘤を経験したため報告する．【症例】68歳男性，40 m滑落し受傷．AO分類61B2. 1，Lateral compression 1の骨盤輪骨折と診断しIS screwによる骨接合術を施行した．術後9ヶ月で発熱と左臀部の著明な腫脹を認め当院救急搬送．造影CT検査で上殿動脈の仮性動脈瘤を認めた．動脈塞栓術，血腫除去術を施行し術後1年で再発を認めていない．【考察】IS screw挿入に伴う上殿動脈損傷は考慮しなければならない合併症である．本症例は貧血進行が緩徐であった事，単純CTのみで評価をした事が発見の遅れに繋がった．綿密な術前計画を立てること，上殿動脈損傷の可能性を考慮し合併症を見逃さない事が重要である．

DOI： 10.5035/nishiseisai.71.842

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 Reviewed

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 2022.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会

【背景】色素性絨毛結節性滑膜炎（Pigmented villonodular Synovitis, PVS）は関節滑膜や腱鞘に発生する比較的稀な良性腫瘍である．多くは膝関節周囲に発生し，足関節発生症例は稀である．今回，足部びまん性PVSに対して関節鏡下腫瘍切除術を行い，良好な短期成績を得た一例を経験したので報告する．【症例】23歳女性．数年前から左足部外側に腫瘤を自覚していたが，放置していた．しかしながら，腫瘤の消退を認めず前医を受診し，PVSの疑いで当科紹介となった．当科では関節鏡下腫瘍切除術を施行した．足関節前方および後足部鏡視下併用で足関節，足関節周囲，距骨下に病変を認め，関節鏡視下に腫瘍を切除した．術後病理診断ではびまん性PVSの診断であった．術後26ヶ月経過し，再発なく経過している．【結語】足部びまん性PVSに対し，足関節前方および後足部鏡視下併用での関節鏡下腫瘍切除術を施行し，良好な短期成績を得た一例を経験した．

DOI： 10.5035/nishiseisai.71.725

転位の大きい上前腸骨棘裂離骨折に対してSuture anchorを用いて固定した3例 Reviewed

高橋巧, 帖佐悦男, 栗原典近, 小薗敬洋, 川野啓介, 石原和明, 木戸義隆

整形外科と災害外科 71 ( 4 ) 625 - 627 2022.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会

【目的】転位の大きい（15 mm以上）上前腸骨棘裂離骨折の治療方針に一定の見解は得られていない．今回Suture anchorを使用して骨接合術を施行した3例を経験したため報告する．【症例】（1）14歳男児．骨片は17 mm下方に転位．（2）13歳男児．骨片は19 mm下方に転位．（3）13歳男児．骨片は15mm下方に転位．受傷起点は全例ダッシュ時であった．いずれも転位が15 mm以上と大きく，手術加療を選択した．手術は骨片を整復しSuture anchorを1～2本使用し，骨片・骨腱移行部に縫合固定した．【結果】全例8週程度で骨癒合を認め，術後8～9週で部活動復帰が可能であった．1例外側大腿皮神経領域の知覚低下を認めた．【考察】上前腸骨棘裂離骨折の手術加療は，スクリュー固定が多く報告されている．しかし抜釘が必要なことや骨片が小さい時に固定困難である．Suture anchorでの固定は，スクリュー固定と比較して骨癒合，スポーツ復帰期間に遜色なく，有用である可能性がある．

DOI： 10.5035/nishiseisai.71.625

Head Injury Assessment in the Elite Level Rugby Union in Japan: Review of 3 Seasons Reviewed

Tajima T., Ota O., Nagayama M., Takahashi M., Yamada M., Ishiyama N., Yoshida I., Takemura M., Hara K., Akama T., Mitsumori N., Higashihara J., Toyama Y., Furuya M., Chosa E., Nakamura A.

International Journal of Sports Medicine 43 ( 10 ) 889 - 894 2022.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：International Journal of Sports Medicine

Head Injury Assessment (HIA) is the screening tool for head injury during a rugby game. The purpose of this study was to investigate the epidemiology of HIA in the Japan Rugby Top League (JRTL). The incidences of HIA, defined concussion (per 1,000 player-hours) and repeated concussions were evaluated in three seasons (2016-17, 2017-18, 2018-19; total 360 games). The HIA incidence rates were 12.7 (95% confidence interval 9.5-15.9), 20.8 (16.8-24.9), and 25.0 (20.5-29.5) in each season. HIA-1 criteria 2, which is applied for suspected concussion cases, was performed for 46 cases in the 2016-17 season, 81 cases in the 2017-18 season, and 88 cases in the 2018-19 season. The concussion incidence rates were significantly greater in the 2017-18 season (9.6/1000 player-hours, 95% confidence interval 6.8-12.4) and the 2018-19 season (14.4, 11-17.8) compared to the 2016-17 season (4.8, 2.8-6.8). The number of repeated concussion cases in the same season was 1 in the 2016-17 season and 4 in both the 2017-18 and 2018-19 seasons. This study confirmed significantly higher HIA and concussion incidence rates over time. Although the HIA system might have been established in the three seasons in JRTL, comprehensive management needs to be improved to prevent repeated concussions.

DOI： 10.1055/a-1810-6509