Faculty Profiles - OZAKI Toshifumi

Papers - OZAKI Toshifumi

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Self-controlled case seriesを用いた内側型野球肘からTommy John手術へのリスク比

根津智史, 島村安則, 中道亮, 齋藤太一, 三橋利晴, 尾崎敏文

日本肘関節学会雑誌 30 ( 1 ) S80 - S80 2023.2

関節面再建・温存手術上腕骨滑車部骨軟骨障害に対する鏡視下骨軟骨柱移植の治療成績

島村安則, 根津智史, 中道亮, 齋藤太一, 名越充, 尾崎敏文

日本肘関節学会雑誌 30 ( 1 ) S89 - S89 2023.2

Effectivity of the Outside-In Pie-Crusting Technique and an All-Inside Meniscal Repair Device in the Repair of Ramp Lesions. International journal

Koki Kawada, Takayuki Furumatsu, Masanori Tamura, Haowei Xue, Naohiro Higashihara, Keisuke Kintaka, Yusuke Yokoyama, Toshifumi Ozaki

Arthroscopy techniques 12 ( 2 ) e273-e278 2023.2

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

Ramp lesions are characteristic medial meniscus injuries seen in anterior cruciate ligament-injured knees. Anterior cruciate ligament injuries combined with ramp lesions increase the amount of anterior tibial translation and tibial external rotation. Therefore, the diagnosis and treatment of ramp lesions have received increasing attention. However, ramp lesions can be difficult to diagnose on preoperative magnetic resonance imaging. Additionally, ramp lesions are difficult to observe and treat intraoperatively in the posteromedial compartment. Although good results have been reported with the use of a suture hook through the posteromedial portal in the treatment of ramp lesions, the complexity and difficulty of the technique are further problems. The outside-in pie-crusting technique is a simple procedure that can enlarge the medial compartment and facilitate the observation and repair of ramp lesions. After this technique, ramp lesions can be properly sutured, using an all-inside meniscal repair device, without damaging the surrounding cartilage. A combination of the outside-in pie-crusting technique and an all-inside meniscal repair device (with only anterior portals) is effective in the repair of ramp lesions. This Technical Note aims to report in detail the flow of a series of techniques, including our diagnostic and therapeutic methods.

DOI： 10.1016/j.eats.2022.11.002

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移植腱固定法の違いとmicrofracture手技が腱-骨接合部の癒合に与える影響

根津智史, 齋藤太一, 島村安則, 尾崎敏文

日本肘関節学会雑誌 30 ( 1 ) S16 - S17 2023.2

Comparison of screw versus locking plate fixation via sinus tarsi approach for displaced intra-articular calcaneal fractures. International journal

Kohei Sato, Masanori Yorimitsu, Takenori Uehara, Shiro Fukuoka, Toshiaki Hata, Kenta Saiga, Tomoyuki Noda, Toshifumi Ozaki

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons 29 ( 1 ) 97 - 102 2023.1

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

BACKGROUND: The optimal treatment of displaced intra-articular calcaneal fractures (DIACF) is controversial. This study compared the fixation stability of screws and locking plates in DIACF treated via the sinus tarsi approach (STA). METHODS: We retrospectively evaluated 118 DIACF cases treated via STA and extracted data that could affect treatment outcomes. Loss of Böhler's angle after surgery was measured to compare fixation stability. RESULTS: The loss of Böhler's angles was significantly smaller in the locking plate group than in the screw group (2.6 ± 2.7º vs. 5.6 ± 5.3º, P < 0.01). There was no difference in the clinical outcomes between the groups. On multivariate logistic regression analysis, screw fixation was significantly associated with loss of Böhler's angle by> 10º (odds ratio, 8.63; 95% confidence interval, 1.16-64.4; P < 0.05). CONCLUSIONS: Locking plate fixation is more reliable than screw fixation for preventing correction loss in DIACF treated via STA. LEVEL OF EVIDENCE: III.

DOI： 10.1016/j.fas.2022.11.002

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関節リウマチにおける手指関節・手関節の超音波パワードプラスコアと関節破壊の関連

沖田駿治, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 4 ) 524 - 527 2023.1

Language：Japanese Publisher：(一社)日本手外科学会

関節リウマチ患者において,関節超音波検査(以下US)で滑膜炎を認めた関節と関節破壊が進行する関節は必ずしも一致しないことが報告されている.USで評価を行った手指・手関節の関節破壊に対する予後を検討した.調査開始時にUSによるパワードプラ(以下PD)スコアの計測が行われ,調査開始時および調査開始後1年以上経過時に両手単純X線写真による関節破壊の進行が評価可能であった関節リウマチ患者70例を対象とした.多変量解析ではPDスコアの合計値のみが関節破壊の有意な危険因子として同定された(オッズ比1.19,P=0.010).両手のPDスコアの合計値は手関節の関節破壊(P=0.001)およびMCP関節の関節破壊(P<0.001)と相関を認めた.各関節のPDスコアは同関節の関節破壊と相関を認めた(P<0.001).諸家の報告と異なりUSで滑膜炎を認めた関節は関節破壊が進行しやすい結果であった.(著者抄録)

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Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old. International journal

Keiichiro Nishida, Yoshihisa Nasu, Kenzo Hashizume, Shunji Okita, Ryuichi Nakahara, Taichi Saito, Toshifumi Ozaki, Hajime Inoue

Bone & joint open 4 ( 1 ) 19 - 26 2023.1

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

AIMS: There are concerns regarding complications and longevity of total elbow arthroplasty (TEA) in young patients, and the few previous publications are mainly limited to reports on linked elbow devices. We investigated the clinical outcome of unlinked TEA for patients aged less than 50 years with rheumatoid arthritis (RA). METHODS: We retrospectively reviewed the records of 26 elbows of 21 patients with RA who were aged less than 50 years who underwent primary TEA with an unlinked elbow prosthesis. The mean patient age was 46 years (35 to 49), and the mean follow-up period was 13.6 years (6 to 27). Outcome measures included pain, range of motion, Mayo Elbow Performance Score (MEPS), radiological evaluation for radiolucent line and loosening, complications, and revision surgery with or without implant removal. RESULTS: The mean MEPS significantly improved from 47 (15 to 70) points preoperatively to 95 (70 to 100) points at final follow-up (p < 0.001). Complications were noted in six elbows (23%) in six patients, and of these, four with an ulnar neuropathy and one elbow with postoperative traumatic fracture required additional surgeries. There was no revision with implant removal, and there was no radiological evidence of loosening around the components. With any revision surgery as the endpoint, the survival rates up to 25 years were 78.1% (95% confidence interval 52.8 to 90.6) as determined by Kaplan-Meier analysis. CONCLUSION: The clinical outcome of primary unlinked TEA for young patients with RA was satisfactory and comparable with that for elderly patients. A favourable survival rate without implant removal might support the use of unlinked devices for young patients with this disease entity, with a caution of a relatively high complication rate regarding ulnar neuropathy.Level of Evidence: Therapeutic Level IVCite this article: Bone Jt Open 2023;4(1):19-26.

DOI： 10.1302/2633-1462.41.BJO-2022-0151.R1

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踵骨関節内骨折に対する低侵襲ロッキングプレート固定は早期荷重を可能とさせる

國富康資, 依光正則, 上原健敬, 福岡史朗, 佐藤浩平, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 1 ) 139 - 140 2023.1

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

当院で踵骨関節内骨折に対し治療を行った24例を対象に、これらをスクリュー固定を行った11例(S群)とロッキングプレート固定を行った14例(LP群)に分け、臨床成績を比較検討した。その結果、S群と比べ、LP群では最終調査時のBoehler角が有意に良好で、Boehler角の矯正損失は有意に少なかった。最終調査時のAOFAS score(AOFAS)は両群間で有意差がなかったものの、LP群の方がscoreが高い傾向がみられた。また、最終のBoehle角とAOFASの間には相関は認められなかったが、術後の横径とAOFASの間には有意な相関が認められた。以上より、踵骨関節内骨折に対するロッキングプレート固定は術後成績を低下させず、荷重時期を短縮する上で有用と考えられた。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00831&link_issn=&doc_id=20230519070065&doc_link_id=10.11359%2Fchubu.2023.139&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2023.139&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

The Evaluation of Meniscus Regenerative Effects 2 of LIPUS-Induced CCN Proteins: Induction by LIPUS of CCN2 3 and Meniscus-Related Genes in Cultured Meniscus Cells 4 and Meniscus Tissues

Yusuke Kamatsuki, Eriko Aoyama, Takayuki Furumatsu, Toshifumi Ozaki, Masaharu Takigawa

Methods in Molecular Biology 2582 223 - 235 2023

関節リウマチによる高度手関節変形に対して手関節全固定術あるいは人工手関節置換術を行った8例の術後経過

市川千夏, 西田圭一郎, 志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 尾崎敏文

関節の外科 50 ( 2 ) 122 - 122 2023

関節リウマチ患者に対するSauve-Kapandji法の臨床成績の検討

志水紀之, 西田圭一郎, 市川千夏, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文

関節の外科 50 ( 2 ) 121 - 121 2023

Panner病の治療成績と単純X線画像での離断性骨軟骨炎との鑑別

石原健嗣, 島村安則, 中道亮, 斎藤太一, 尾崎敏文

日本肘関節学会雑誌 30 ( 2 ) 222 - 228 2023

関節リウマチ患者に対するSauve-Kapandji法の臨床成績の検討

志水紀之, 西田圭一郎, 市川千夏, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文

関節の外科 50 ( 2 ) 121 - 121 2023

関節リウマチによる高度手関節変形に対して手関節全固定術あるいは人工手関節置換術を行った8例の術後経過

市川千夏, 西田圭一郎, 志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 尾崎敏文

関節の外科 50 ( 2 ) 122 - 122 2023

Elevated Expression of CCN3 in Articular Cartilage Induces Osteoarthritis in Hip Joints Irrespective of Age and Weight Bearing. International journal

Kazuki Hirose, Miho Kuwahara, Eiji Nakata, Tomonori Tetsunaga, Kazuki Yamada, Kenta Saiga, Masaharu Takigawa, Toshifumi Ozaki, Satoshi Kubota, Takako Hattori

International journal of molecular sciences 23 ( 23 ) 2022.12

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

Osteoarthritis (OA) occurs not only in the knee but also in peripheral joints throughout the whole body. Previously, we have shown that the expression of cellular communication network factor 3 (CCN3), a matricellular protein, increases with age in knee articular cartilage, and the misexpression of CCN3 in cartilage induces senescence-associated secretory phenotype (SASP) factors, indicating that CCN3 promotes cartilage senescence. Here, we investigated the correlation between CCN3 expression and OA degenerative changes, principally in human femoral head cartilage. Human femoral heads obtained from patients who received total hip arthroplasty were categorized into OA and femoral neck fracture (normal) groups without significant age differences. Gene expression analysis of RNA obtained from femoral head cartilage revealed that CCN3 and MMP-13 expression in the non-weight-bearing part was significantly higher in the OA group than in the normal group, whereas the weight-bearing OA parts and normal cartilage showed no significant differences in the expression of these genes. The expression of COL10A1, however, was significantly higher in weight-bearing OA parts compared with normal weight-bearing parts, and was also higher in weight-bearing parts compared with non-weight-bearing parts in the OA group. In contrast, OA primary chondrocytes from weight-bearing parts showed higher expression of CCN3, p16, ADAMTS4, and IL-1β than chondrocytes from the corresponding normal group, and higher ADAMTS4 and IL-1β in the non-weight-bearing part compared with the corresponding normal group. Acan expression was significantly lower in the non-weight-bearing group in OA primary chondrocytes than in the corresponding normal chondrocytes. The expression level of CCN3 did not show significant differences between the weight-bearing part and non-weight-bearing part in both OA and normal primary chondrocytes. Immunohistochemical analysis showed accumulated CCN3 and aggrecan neoepitope staining in both the weight-bearing part and non-weight-bearing part in the OA group compared with the normal group. The CCN3 expression level in cartilage had a positive correlation with the Mankin score. X-ray analysis of cartilage-specific CCN3 overexpression mice (Tg) revealed deformation of the femoral and humeral head in the early stage, and immunohistochemical analysis showed accumulated aggrecan neoepitope staining as well as CCN3 staining and the roughening of the joint surface in Tg femoral and humeral heads. Primary chondrocytes from the Tg femoral head showed enhanced expression of Ccn3, Adamts5, p16, Il-6, and Tnfα, and decreased expression of Col2a1 and -an. These findings indicate a correlation between OA degenerative changes and the expression of CCN3, irrespective of age and mechanical loading. Furthermore, the Mankin score indicates that the expression level of Ccn3 correlates with the progression of OA.

DOI： 10.3390/ijms232315311

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Standardization of evaluation method and prognostic significance of histological response to preoperative chemotherapy in high-grade non-round cell soft tissue sarcomas International journal

Yoshinao Oda, Kazuhiro Tanaka, Takanori Hirose, Tadashi Hasegawa, Nobuyuki Hiruta, Masanori Hisaoka, Masato Yoshimoto, Hiroshi Otsuka, Hirofumi Bekki, Takeaki Ishii, Makoto Endo, Toshiyuki Kunisada, Toru Hiruma, Hiroyuki Tsuchiya, Hirohisa Katagiri, Yoshihiro Matsumoto, Akira Kawai, Robert Nakayama, Hiroyuki Kawashima, Satoshi Takenaka, Makoto Emori, Munenori Watanuki, Yukihiro Yoshida, Takeshi Okamoto, Junki Mizusawa, Haruhiko Fukuda, Toshifumi Ozaki, Yukihide Iwamoto, Takayuki Nojima

BMC Cancer 22 ( 1 ) 94 - 94 2022.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Background

Preoperative chemotherapy is widely applied to high-grade localized soft tissue sarcomas (STSs); however, the prognostic significance of histological response to chemotherapy remains controversial. This study aimed to standardize evaluation method of histological response to chemotherapy with high agreement score among pathologists, and to establish a cut-off value closely related to prognosis.

Methods

Using data and specimens from the patients who had registered in the Japan Clinical Oncology Group study, JCOG0304, a phase II trial evaluating the efficacy of perioperative chemotherapy with doxorubicin (DOX) and ifosfamide (IFO), we evaluated histological response to preoperative chemotherapy at the central review board.

Results

A total of 64 patients were eligible for this study. The percentage of viable tumor area ranged from 0.1% to 97.0%, with median value of 35.7%. Regarding concordance proportion between pathologists, the weighted kappa coefficient (κ) score in all patients was 0.71, indicating that the established evaluation method achieved substantial agreement score. When the cut-off value of the percentage of the residual tumor area was set as 25%, the p-value for the difference in overall survival showed the minimum value. Hazard ratio of the non-responder with percentage of the residual tumor < 25%, to the responder was 4.029 (95% confidence interval 0.893–18.188, p = 0.070).

Conclusion

The standardized evaluation method of pathological response to preoperative chemotherapy showed a substantial agreement in the weighted κ score. The evaluation method established here was useful for estimating of the prognosis in STS patients who were administered perioperative chemotherapy with DOX and IFO.

Trial registration

UMIN Clinical Trials Registry C000000096. Registered 30 August, 2005 (retrospectively registered).

DOI： 10.1186/s12885-022-09195-y

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Other Link： https://link.springer.com/article/10.1186/s12885-022-09195-y/fulltext.html

Large flexion contracture angle predicts tight extension gap during navigational posterior stabilized-type total knee arthroplasty with the pre-cut technique: a retrospective study

Takaaki Hiranaka, Shinichi Miyazawa, Takayuki Furumatsu, Yuya Kodama, Yusuke Kamatsuki, Shin Masuda, Yuki Okazaki, Keisuke Kintaka, Toshifumi Ozaki

BMC Musculoskeletal Disorders 23 ( 1 ) 2022.12

Authorship：Last author Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Background

This study aimed to determine the predictors of tight extension gap (EG) compared with the flexion gap (FG) during navigational posterior stabilized-type total knee arthroplasty using the pre-cut technique.

Methods

Nineteen patients with tight EG (defined as FG-EG ≥2 mm after pre-cut; group T) and 84 patients with an approximately equal gap (defined as FG-EG = 0–1 mm after pre-cut; group E) were enrolled. Medial tibial slope angle, hip knee ankle angle, flexion contracture angle, and active maximum flexion angle were compared between the two groups.

Results

The multivariate logistic regression model indicated that the probability of tight EG increased with flexion contracture angle (odds ratio, 1.13; 95% confidence interval 1.05–1.20; P ≤ 0.001). According to the receiver operating characteristic analysis, the flexion contracture angle cut-off value associated with tight EG was 15.0° (sensitivity, 85%; specificity, 78%).

Conclusion

This study demonstrated that a large flexion contracture angle (cut-off 15.0°) was associated with tight EG after pre-cut osteotomy during posterior stabilized-type total knee arthroplasty. Awareness of this risk factor may help improve preoperative predictability of tight EGs and preparedness for additional procedures, such as soft tissue release or capsulotomy, to correct them.

Level of evidence

Level III.

DOI： 10.1186/s12891-022-05035-z

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Other Link： https://link.springer.com/article/10.1186/s12891-022-05035-z/fulltext.html

尺骨突き上げ症候群に対する尺骨骨幹部短縮骨切り術と遠位部短縮骨切り術の治療成績の比較

齋藤太一, 中道亮, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 3 ) 315 - 318 2022.12

Language：Japanese Publisher：(一社)日本手外科学会

当院では以前より尺骨突き上げ症候群に対しては尺骨骨幹部での短縮骨切りを施行してきたが,近年皮膚切開量が短く,骨癒合が有利な尺骨遠位部での骨切りをおこなっている.今回骨切り部位別に治療成績を比較検討したので報告する.尺骨突き上げ症候群に対して骨切り術を行い,術後評価可能であった37例を対象とした.骨幹部骨切り症例は15例,遠位部骨切り症例は,22例含まれていた.これらの群に対して平均の骨癒合期間,握力,手関節可動域,DASH,Pain-VAS,および術後合併症をそれぞれ比較した.平均骨癒合期間は骨幹部骨切り群では3.3ヵ月,遠位部骨切り群では2.6ヵ月,術後1年経過時の握力については骨幹部,遠位部骨切り群それぞれ平均31.7kg,30.2kgであった.術後1年経過時の掌背屈可動域は骨幹部,遠位部骨切り群それぞれ150.0度,152.7度,回内外可動域は骨幹部,遠位部骨切り群それぞれ155.0度,170.1度であり,平均術後成績に有意差は認められなかった.DASHに関しては骨幹部骨切りでは23.9から20.1,遠位部骨切りでは33.3から9.9へと遠位部骨切りに関してのみ術後有意差をもって改善していた.またVASを用いた痛み評価では骨幹部骨切りでは7.2から1.0,遠位部骨切りでは5.8から1.2へとどちらの群も有意差をもって改善していた.(著者抄録)

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後期高齢者頸椎損傷の急性期手術介入のタイミングにコロナ禍は影響したか

魚谷弘二, 植田昌敬, 志渡澤央和, 小田孔明, 鉄永倫子, 三澤治夫, 尾崎敏文

西日本脊椎研究会抄録集 96回 21 - 21 2022.12

野球選手における肘頭疲労骨折のtransitional typeに対する骨釘固定法の治療成績

根津智史, 島村安則, 齋藤太一, 尾崎敏文

日本肘関節学会雑誌 29 ( 2 ) 190 - 193 2022.12

Language：Japanese Publisher：日本肘関節学会

【目的】transitional typeは移行型とされる骨折型であるが内固定方法には議論の余地がある.本研究の目的はOSFのtransitional typeに対する骨釘固定法の成績と癒合に関連する因子を調査すること.【対象と方法】骨釘固定を行った22例の野球選手を対象とした.調査項目は癒合期間,2方向での骨釘固定角度,プレー復帰期間,合併症である.【結果】全例男性,手術時平均年齢は15.8歳,癒合期間は平均2.3ヵ月で全例骨癒合が得られた.骨釘固定角度は正面像で83.1度,側面像で78.6度で復帰には平均4.6ヵ月,合併症は術後再発が1例,骨釘の追加処置が1例であった.【結語】OSFのtransitional typeに対する骨釘固定術は早期より全例骨癒合が得られた.骨移植に加え適切な骨釘固定角度が良好な成績の要因と考える.(著者抄録)

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