Faculty Profiles - OZAKI Toshifumi

Papers - OZAKI Toshifumi

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Evaluation of the labrum on postoperative magnetic resonance images: a predictor of acetabular development in developmental dysplasia of the hip. International journal

Tomonori Tetsunaga, Tomoko Tetsunaga, Hirofumi Akazawa, Kazuki Yamada, Takayuki Furumatsu, Toshifumi Ozaki

Hip international : the journal of clinical and experimental research on hip pathology and therapy 11207000211004917 - 11207000211004917 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Residual acetabular dysplasia of the hip after open reduction can complicate the treatment of developmental dysplasia of the hip (DDH) due to the potential need for corrective surgery. This retrospective study aimed to determine the predictive factors for acetabular development using postoperative radiographs and magnetic resonance imaging (MRI). METHODS: We retrospectively investigated 74 hips of patients with DDH who underwent open reduction after reaching walking age and were followed up radiologically until skeletal maturity. We evaluated the cartilaginous acetabulum and labrum using a new method that measures the cartilaginous and labral landmarks on coronal and axial MR T2*-weighted images in patients aged 5 years. The mean age at the time of surgery was 22 months and that at the final survey was 20 years. Severin classification was determined at the final follow-up. Groups with good (53 hips) and poor (21 hips) outcomes were compared using the postoperative radiographic and MRI parameters recorded at 5 years of age. Factors predicting acetabular development were identified using univariate and multiple logistic analyses. RESULTS: There were no significant differences in the bony-acetabular index (AI) and centre-edge (CE) angle between the good and poor outcome groups. However, the poor outcome group had significantly larger cartilaginous- and labral-AIs but significantly smaller cartilaginous- and labral-CE angles than the good outcome group (both p < 0.05). Multiple logistic regression analysis showed that labral-AI and labral-CE angle were predictors of acetabular development after open reduction for DDH, and their optimal cut-offs were 4° (77% sensitivity, 76% specificity) and 37° (68% sensitivity, 85% specificity), respectively. DISCUSSION: Normal cartilaginous acetabulum development occurs in childhood, and evaluation using only radiographs is difficult. However, labral-AI ⩾4° and labral-CE angle <37° on MRI at 5 years of age offer useful indications for corrective surgery in patients with DDH.

DOI： 10.1177/11207000211004917

Histologic Evaluation of Tibial Attachment in 11-Year Double-Bundle ACL Reconstruction with Hamstring Tendons: A Case Report. International journal

Yuki Okazaki, Nobuhiro Abe, Kimihiko Makiyama, Takayuki Furumatsu, Shinichi Miyazawa, Toshifumi Ozaki

JBJS case connector 11 ( 2 ) 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

CASE: A 49-year-old woman injured her anterior cruciate ligament (ACL) as a high-school student. Double-bundle ACL reconstruction (DBACLR) using hamstring tendon grafts was performed because of recurrent instability. Eleven years after DBACLR, total knee arthroplasty was performed because of osteoarthritis progression. Histologic analysis was completed to observe the osteointegration of the tendon in the obtained proximal tibia. The tibial tunnel showed Sharpey-like fibers anteriorly, connecting the tendon graft and lamellar bone, whereas the intraarticular exit revealed well-aligned chondrocytes posteriorly, indicating chondral metaplasia of the tendon graft. CONCLUSION: Tendon-bone healing can regenerate both fibrous insertion and chondral metaplasia in DBACLR.

DOI： 10.2106/JBJS.CC.20.00509

Immunotherapy for sarcomas. International journal

Eiji Nakata, Tomohiro Fujiwara, Toshiyuki Kunisada, Tastuo Ito, Shota Takihira, Toshifumi Ozaki

Japanese journal of clinical oncology 51 ( 4 ) 523 - 537 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Sarcomas are a heterogeneous group of malignancies of mesenchymal origin; their molecular and genomic mechanisms differ with regard to histology. These characteristics lead to the presentation of varied immunological profiles based on the tumor microenvironment. Various immunotherapies are considered for the treatment of sarcoma. These treatments are performed either in isolation or in combination with other methods such as cytotoxic chemotherapy or the use of molecular target agents. Among these, two recently emerging immunotherapies include T-cell receptor gene therapy and immune checkpoint inhibitor therapy, which are expected to be effective for many types of sarcoma. A sarcoma with a disease-specific translocation and a limited number of mutations, such as synovial sarcoma, expresses high levels of self-antigens, like the New York esophageal squamous cell carcinoma 1, which has been targeted in T-cell receptor gene therapy. On the other hand, sarcomas with a greater number of mutations, such as undifferentiated pleomorphic sarcomas, myxofibrosarcoma and dedifferentiated liposarcomas, can be good candidates for immune checkpoint inhibitors. Among immune checkpoint inhibitor therapies, programmed cell death-1 blockade (nivolumab and pembrolizumab) and cytotoxic T-lymphocyte-associated antigen 4 blockade (ipilimumab) have been investigated most often in sarcoma. Although the sole use of immune checkpoint inhibitors provides limited efficacy, combined immunotherapy with immune checkpoint inhibitors or molecular target agents, especially antiangiogenic agents, has shown moderate results against some types of sarcoma, such as the alveolar soft part sarcoma. Several clinical trials utilizing immunotherapy, including T-cell receptor gene therapy and immune checkpoint inhibitors, in sarcomas are under progress. By clarifying the tumor microenvironment and biomarker-predictive capacity of immunotherapy in sarcomas, better clinical trials can be designed; this could lead to improved outcomes for immunotherapy in sarcoma.

DOI： 10.1093/jjco/hyab005

Placement of an anatomic tibial tunnel significantly improves the medial meniscus posterior extrusion at 90° of knee flexion following medial meniscus posterior root pullout repair. International journal

Yusuke Kamatsuki, Takayuki Furumatsu, Takaaki Hiranaka, Yoshiki Okazaki, Yuki Okazaki, Yuya Kodama, Tomohito Hino, Shin Masuda, Shinichi Miyazawa, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 4 ) 1025 - 1034 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: The purpose of this study was to evaluate the influence of tibial tunnel position in pullout repair for a medial meniscus (MM) posterior root tear (MMPRT) on postoperative MM extrusion. METHODS: Thirty patients (median age 63 years, range 35-72 years) who underwent transtibial pullout repairs for MMPRTs were included. Three-dimensional computed tomography images of the tibial surface were evaluated using a rectangular measurement grid for assessment of tibial tunnel position and MM posterior root attachment. Preoperative and postoperative MM medial extrusion (MMME) and posterior extrusion (MMPE) at 10° and 90° knee flexion were measured using open magnetic resonance imaging. RESULTS: Tibial tunnel centers were located more anteriorly and more medially than the anatomic center (median distance 5.8 mm, range 0-9.3 mm). The postoperative MMPE at 90° knee flexion was significantly reduced after pullout repair, although there was no significant reduction in MMME or MMPE at 10° knee flexion after surgery. In the correlation analysis of the displacement between the anatomic center to the tibial tunnel center and improvements in MMME, and MMPE at 10° and 90° knee flexion, there was a significant positive correlation between percentage distance and improvement of MMPE at 90° knee flexion. CONCLUSION: This study demonstrated that the nearer the tibial tunnel position to the anatomic attachment of the MM posterior root, the more effective the reduction in MMPE at 90° knee flexion. Our results emphasize that an anatomic tibial tunnel should be created in the MM posterior root to improve the postoperative MMPE and protect the articular cartilage in a knee flexion position. Placement of an anatomic tibial tunnel significantly improves the MMPE at 90° of knee flexion after MM posterior root pullout repair. LEVEL OF EVIDENCE: IV.

DOI： 10.1007/s00167-020-06070-w

Steep posterior slope of the medial tibial plateau is associated with ramp lesions of the medial meniscus and a concomitant anterior cruciate ligament injury. International journal

Yuki Okazaki, Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology 24 23 - 28 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Background: Medial meniscus (MM) tears are associated with both acute and chronic anterior cruciate ligament (ACL) insufficiency and can lead to degenerative changes in the knee. ACL reconstruction (ACLR) combined with the meniscal repair was reported to result in decreased anterior knee joint laxity with evidence of improved patient-reported outcomes in the long term. However, a subtle tear of the MM posterior segment, also known as a ramp lesion, is difficult to detect on conventional magnetic resonance imaging (MRI) and is frequently missed in ACL-deficient knees. However, there are few studies about the associations between bone geometry and ramp lesion of the MM. This study aimed to compare sagittal medial tibial slope (MTS), medial tibial plateau depth (MTPD), and coronal tibial slope (CTS) between ACL-injured knees with and without ramp lesion of the MM. We hypothesised that patients with ramp lesion of the MM and a concomitant ACL injury have a steeper MTS and shallower MTPD than those without ramp lesion of the MM. Methods: Twenty-seven patients who underwent ACLR (group A), and 15 patients with combined MM repair (group AM) were included in the study. Anterior tibial translation (ATT) was measured under general anaesthesia just before surgery using a knee arthrometer. MRI was performed in the 10°-knee-flexed position. The MTS and MTPD were measured on sagittal view, and the CTS was measured on coronal view. These parameters were compared between the groups. Differences in MRI measurements or patient demographics between the groups were evaluated using the Mann-Whitney U test. Results: No significant difference was observed in demographic data and post-operative side-to-side difference in ATT between both groups. Pre-operative ATT was significantly higher in group AM than in group A (P < 0.05), whereas post-operative ATT was similar in both groups. Further, Pre-operative ATT was significantly higher in patients with MTS ≥5.0° than in those with MTS <5.0° (P < 0.05). In groups A and AM, the MTS were 3.6° ± 1.8° and 6.2° ± 2.9°, the MTPD were 2.0 ± 0.5 mm and 2.1 ± 0.6 mm, and the CTS were 2.5° ± 1.8° and 2.4° ± 1.6°, respectively. Patients in group AM had a significantly steeper MTS compared to those in group A (P < 0.01), whereas MTPD and CTS were nearly the same in both groups. When the MTS cut-off value was set at 5.0°, the sensitivity and specificity for ACL injury with concomitant ramp lesion of the MM were 0.73 and 0.76, respectively. Conclusion: A steep posterior slope of the medial tibial plateau is a risk factor for ramp lesion of the MM associated with an ACL injury. Especially in patients with MTS ≥5.0°, an occult MM ramp lesion should be strongly suspected, and surgeons should prepare for MM repair in combination with ACLR.

DOI： 10.1016/j.asmart.2021.01.005

Knee Flexion-induced Translation of Pullout Sutures Used in the Repair of Medial Meniscus Posterior Root Tears.

Haowei Xue, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Keisuke Kintaka, Masataka Fujii, Ximing Zhang, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 147 - 152 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Medial meniscus posterior root tears (MMPRTs) have recently attracted considerable interest in orthopedics. To date, no in vivo human study has investigated suture translation changes in repaired MMPRTs with different degrees of knee flexion. This study examined suture translation at various degrees of knee flexion in 30 patients undergoing medial meniscus posterior root repair using the modified Mason-Allen suture technique between August 2016 and September 2017. Intraoperatively, sutures were provisionally fixed to an isometric positioner at the tibial site of the desired meniscal attachment, and the suture translation was measured at 0°, 30°, 60°, and 90° of knee flexion. The results showed significant increases in mean suture translation at the knee flexion positions from 0° to 30°, 30° to 60°, and 60° to 90° (p<0.01 for all). Our findings indicate that surgeons should carefully assess the degree of knee flexion at the moment when the meniscus is refixed by surgical sutures.

DOI： 10.18926/AMO/61881

Maximal Resection of Intramedullary Lipoma Using Intraoperative Ultrasonography: A Technical Note.

Haruo Misawa, Yoshiaki Oda, Kentaro Yamane, Tomoko Tetsunaga, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 239 - 242 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

One of the problems during surgery for intramedullary lipoma is the ambiguous boundary between the lipoma and the spinal cord, resulting in either incomplete resection or damage to the spinal cord. We report a case of intramedullary lipoma resection on a 61-year-old man in which the boundary between the tumor and spinal cord was repeatedly visualized with intraoperative ultrasonography. We focused on the distinctive features of fat as hyperechoic, in contrast to low-echo neural tissue. Subtotal resection of the tumor was achieved without any aggravation of neurological symptoms. Intraoperative ultrasonography may be useful for confirming tumor boundaries during intramedullary lipoma resection.

DOI： 10.18926/AMO/61907

Histological Analysis of Repaired Tissue after Pullout Repair of a Medial Meniscus Posterior Root Tear.

Haowei Xue, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Keisuke Kintaka, Ximing Zhang, Aki Yoshida, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 225 - 230 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

A 65-year-old man presented with a left medial meniscus (MM) posterior root tear (PRT). Unicompartmental knee arthroplasty was performed 12 months after transtibial pullout repair of the MMPRT. Repaired MM posterior root tissue was subjected to histological analysis. Immunostaining and picrosirius red staining showed sufficient deposition of type I collagen, and hematoxylin-eosin staining using a polarized microscope showed well-aligned fiber orientation in the repaired tissue. The repaired posterior root (post-transtibial pullout repair) showed mature and well-aligned ligament-like tissue. Preserving the MM posterior root remnant to mimic the original posterior root tissue might be useful when performing pullout repair.

DOI： 10.18926/AMO/61905

Osteosynthesis for Geriatric Acetabular Fractures: An Epidemiological and Clinico-Radiological Study Related to Marginal or Roof Impaction.

Madoka Inoue, Tomoyuki Noda, Takenori Uehara, Tomonori Tetsunaga, Kazuki Yamada, Taichi Saito, Yasunori Shimamura, Yasuaki Yamakawa, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 177 - 185 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

This retrospective study sought to elucidate the incidence rates of roof impaction (RI) and marginal impaction (MI) and radiological and clinical outcomes of open reduction and internal fixation (ORIF) for RI and MI in geriatric acetabular fractures. The cases of 68 patients aged ≥ 65 years (mean 71 years) treated with ORIF were analyzed. MI was present in 12 fractures (67%) and an RI of the weight-bearing surface was present in 24 (46%) of the potential fracture types. Regarding the reduction quality, 54% of the reductions were graded as anatomical, 37% as imperfect, and 9% as poor. In the clinical evaluations of the 45 patients who had > 1-year follow-up (follow-up rate: 66.2%), 18% were graded as excellent, 53% as good, 16% as fair, and 13% as poor. An anatomic reduction was strongly associated with good or excellent clinical and radiological outcomes. CT was superior to radiographs for detecting the residual displacement postoperatively. Postoperative deep infection occurred in four patients. Three patients (6.7%) underwent a total hip arthroplasty conversion due to secondary osteoarthritis of the hip. We recommend ORIF as the preferred surgical treatment option for displaced acetabular fractures in elderly patients.

DOI： 10.18926/AMO/61895

Steep medial tibial slope and prolonged delay to surgery are associated with bilateral medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Tadashi Yamawaki, Yoshiki Okazaki, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 4 ) 1052 - 1057 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Contralateral medial meniscus posterior root tear (MMPRT) can sometimes occur after primary surgeries for MMPRT and lead to unsatisfactory outcomes. The incidence rate and risk factors for contralateral MMPRT have not been well investigated, despite their clinical importance. Therefore, the incidence and predictors of bilateral MMPRT were aimed to be evaluated. METHODS: Fourteen patients with bilateral MMPRT (group B) and 169 patients with unilateral MMPRT (group U) were enrolled in this study. Sex, age, body mass index, time between injury and surgery, and medial tibial slope angle (MTSA) were compared between the groups. MTSA was measured using lateral radiographs. RESULTS: The incidence rate of bilateral MMPRT was 6.2% among all patients with MMPRTs. Multivariate logistic regression analysis showed that a prolonged time between injury and surgery (odds ratio [OR], 1.0; 95% confidence interval [CI] 1.00-1.01; P < 0.05) and steeper MTSA (OR, 1.85; 95% CI 1.21-2.64; P < 0.01) were significantly associated with the development of bilateral MMPRT. Receiver operating characteristic curve analysis showed that MTSA > 10.0° was associated with bilateral MMPRT, with a sensitivity of 93% and specificity of 69%. CONCLUSION: A longer time between injury and surgery and steeper MTSA were risk factors for the development of bilateral MMPRT. Surgeons need to pay close attention to the contralateral knee in addition to the primary injured knees when treating knees with steep MTSA. Besides, early meniscal repair of primary MMPRT would be important to prevent the events of contralateral MMPRT. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-020-06079-1

Intraarticular lengths of double-bundle grafts can change during knee flexion: Intraoperative measurements in anatomic anterior cruciate ligament reconstructions. International journal

Takayuki Furumatsu, Takaaki Hiranaka, Yuya Kodama, Yusuke Kamatsuki, Yuki Okazaki, Tadashi Yamawaki, Hirosuke Endo, Toshifumi Ozaki

Orthopaedics & traumatology, surgery & research : OTSR 107 ( 2 ) 102816 - 102816 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The lengths of the anteromedial bundle (AMB) and posterolateral bundle (PLB) change during knee motion in double-bundle anterior cruciate ligament (ACL) reconstruction. However, the actual intraarticular graft length would be affected by the bone tunnel position and tunnel creation angle during ACL reconstruction. The aim of this study was to investigate the intraarticular length change of the AMB and PLB in patients who underwent anatomic double-bundle ACL reconstruction. HYPOTHESIS: We hypothesized that the PLB would show a more dynamic length change pattern than the AMB during knee flexion at ACL reconstruction. METHODS: Thirty-two patients (16 men and 16 women) who had isolated ACL injuries with intact menisci were investigated. Anatomic double-bundle ACL reconstructions were performed using semitendinosus tendon autografts at a mean age of 30.6 years. The graft and tunnel lengths were measured intraoperatively. Intraarticular graft lengths and length changes were calculated at 0° and 90° of knee flexion during ACL reconstruction. Intraoperative data were collected prospectively, and analyses were performed retrospectively. RESULTS: The intraarticular length of the AMB at 0° of knee flexion was 28.1±5.5mm. At 90° of knee flexion, the AMB intraarticular length decreased to 25.6±4.8mm. The intraarticular length of the PLB decreased to 17.7±4.6mm at 90° of knee flexion compared to 22.0±4.2mm at 0° of knee flexion. Changes in the intraarticular graft length during knee flexion were detected more in the PLB (4.1mm) than in the AMB (2.0mm, p=0.01). DISCUSSION: This study demonstrated that the intraarticular length change of the PLB during knee motion was larger than that of the AMB in anatomic double-bundle ACL reconstructions with semitendinosus tendon autografts and suspensory femoral fixation devices. LEVEL OF EVIDENCE: IV; retrospective cohort study.

DOI： 10.1016/j.otsr.2021.102816

Correction to: Steep medial tibial slope and prolonged delay to surgery are associated with bilateral medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Tadashi Yamawaki, Yoshiki Okazaki, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 4 ) 1058 - 1058 2021.4

当科における切断指治療の現状

松橋美波, 齋藤太一, 堀田佳史, 島村安則, 渡邊敏之, 長谷川健二郎, 尾崎敏文

日本手外科学会雑誌 38 ( 1 ) O43 - 11 2021.4

当科における切断指治療の現状

松橋美波, 齋藤太一, 堀田佳史, 島村安則, 渡邊敏之, 長谷川健二郎, 尾崎敏文

日本手外科学会雑誌 38 ( 1 ) O43 - 11 2021.4

手根管症候群患者に対する神経伝導検査の術後成績予後予測能の検討

斎藤太一, 伊勢真人, 堀田佳史, 根津智史, 松橋美波, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 38 ( 1 ) O23 - 34 2021.4

Medial meniscus posterior root repair reduces the extruded meniscus volume during knee flexion with favorable clinical outcome. International journal

Ximing Zhang, Takayuki Furumatsu, Yoshiki Okazaki, Yuki Okazaki, Takaaki Hiranaka, Haowei Xue, Keisuke Kintaka, Takatsugu Yamauchi, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: The volume of medial meniscus (MM) extrusion at 10° and 90° knee flexions using three-dimensional (3D) magnetic resonance imaging (MRI) and assessed relevant clinical outcomes at 1-year follow-up were evaluated. METHODS: Twenty-four patients who underwent MM posterior root repair were retrospectively reviewed. At 10° and 90° knee flexions, the meniscal extrusion distance and volume were measured using 3D meniscus models constructed by SYNAPSE VINCENT®. The correlation between Knee Injury and Osteoarthritis Outcome Score, Lysholm, International Knee Documentation Committee scores, Tegner activity, and pain visual analog scales and changes in MM extrusion were assessed. RESULTS: No significant differences in the MM medial extrusion were observed between 10° and 90° knee flexions postoperatively. MM posterior extrusion (MMPE) decreased significantly at 10° and 90° knee flexions postoperatively. At 90° knee flexion, the meniscus volume at the intra-tibial surface increased at 3 and 12 months postoperatively. The MM extrusion volume increased slightly at 10° knee flexion; however, the volume decreased significantly at 90° knee flexion postoperatively. The change in MMPE significantly correlated with clinical scores. All 12-month clinical scores were significantly improved compared to preoperative scores. CONCLUSIONS: The progression of meniscus posterior extrusion and reduction of its volume at 90° knee flexion can be suppressed by MM posterior root repair. Postoperative clinical scores correlated with reductions of the posterior extrusion. Regarding clinical relevance, the dynamic stability of the meniscus can be maintained by MM posterior root repair, which is an effective therapeutic method for improving its clinical status. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1007/s00167-021-06505-y

Role of Tumor-Associated Macrophages in Sarcomas. International journal

Tomohiro Fujiwara, John Healey, Koichi Ogura, Aki Yoshida, Hiroya Kondo, Toshiaki Hata, Miho Kure, Hiroshi Tazawa, Eiji Nakata, Toshiyuki Kunisada, Toshiyoshi Fujiwara, Toshifumi Ozaki

Cancers 13 ( 5 ) 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Sarcomas are complex tissues in which sarcoma cells maintain intricate interactions with their tumor microenvironment. Tumor-associated macrophages (TAMs) are a major component of tumor-infiltrating immune cells in the tumor microenvironment and have a dominant role as orchestrators of tumor-related inflammation. TAMs promote tumor growth and metastasis, stimulate angiogenesis, mediate immune suppression, and limit the antitumor activity of conventional chemotherapy and radiotherapy. Evidence suggests that the increased infiltration of TAMs and elevated expression of macrophage-related genes are associated with poor prognoses in most solid tumors, whereas evidence of this in sarcomas is limited. Based on these findings, TAM-targeted therapeutic strategies, such as inhibition of CSF-1/CSF-1R, CCL2/CCR2, and CD47/SIRPα, have been developed and are currently being evaluated in clinical trials. While most of the therapeutic challenges that target sarcoma cells have been unsuccessful and the prognosis of sarcomas has plateaued since the 1990s, several clinical trials of these strategies have yielded promising results and warrant further investigation to determine their translational benefit in sarcoma patients. This review summarizes the roles of TAMs in sarcomas and provides a rationale and update of TAM-targeted therapy as a novel treatment approach for sarcomas.

DOI： 10.3390/cancers13051086

Differences between the root and horn cells of the human medial meniscus from the osteoarthritic knee in cellular characteristics and responses to mechanical stress.

Yuki Okazaki, Takayuki Furumatsu, Yusuke Kamatsuki, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Taichi Saito, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 230 - 236 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Many histological, mechanical, and clinical studies have been performed on the medial meniscus posterior root attachment, as it often tears in patients with osteoarthritic knee. Medial meniscal root repair is recommended in clinical situations; however, to date, no studies have examined the differences between meniscal root and horn cells. The aim of this study was, therefore, to investigate the morphology, reaction to cyclic tensile strain, and gene expression levels of medial meniscal root and horn cells. METHODS: Meniscal samples were obtained from the medial knee compartments of 10 patients with osteoarthritis who underwent total knee arthroplasty. Root and horn cells were cultured in Dulbecco's modified Eagle's medium without enzymes. The morphology, distribution, and proliferation of medial meniscal root and horn cells, as well as the gene and protein expression levels of Sry-type HMG box 9 and type II collagen, were determined after cyclic tensile strain treatment. RESULTS: Horn cells had a triangular morphology, whereas root cells were fibroblast-like. The number of horn cells positive for Sry-type HMG box 9 and type II collagen was considerably higher than that of root cells. Although root and horn cells showed similar levels of proliferation after 48, 72, or 96 h of culture, more horn cells than root cells were lost following a 2-h treatment with 5% and 10% cyclic tensile. Sry-type HMG box 9 and α1(II) collagen mRNA expression levels were significantly enhanced in both cells after 2- and 4-h cyclic tensile strain (5%) treatment. CONCLUSIONS: Medial meniscal root and horn cells have distinct morphologies, reactions to mechanical stress, and cellular phenotypes. Our results suggest that physiological tensile strain is important to activate extracellular matrix production in horn cells.

DOI： 10.1016/j.jos.2020.02.015

Radiological findings and outcomes of anterior wall fractures in pertrochanteric fractures.

Norio Yamamoto, Ryu Tamura, Tomoo Inoue, Tomoyuki Noda, Hiroshi Nagano, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 247 - 253 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Anterior wall fractures with comminution at the anterior cortex in pertrochanteric fractures are relatively rare. We aimed to investigate the prevalence and clinical findings of anterior wall fractures in this comparative cohort study. METHODS: We reviewed 516 consecutive patients who underwent internal fixation. Anterior wall fractures were classified into three types: proximal, distal, and proximal/distal. Outcome measures included demographic data, residual anterior cortex length, fracture reduction, tip-apex distance (TAD), sliding distance, bone union, and revision surgery. We compared radiological outcomes between patients with anterior wall fractures and posterior comminuted fractures without an anterior wall fracture. The groups were matched for age and sex. RESULTS: Anterior wall fractures were noted in 44 patients (8.5%). Residual anterior cortex length was shorter for the proximal/distal type. The distal type was the most common, was the most difficult to achieve an acceptable reduction status for, and was associated with the longest sliding distance. The proportion of unacceptable reduction status was higher for anterior wall fractures. However, there were no statistically significant differences between anterior wall fractures and posterior comminuted fractures without an anterior wall fracture in terms of TAD, sliding distance, bone union, and revision rate. CONCLUSIONS: This study suggests that anterior wall fracture is not a significant predictor of over-sliding distance.

DOI： 10.1016/j.jos.2020.02.020

関節リウマチ超音波検査におけるデジタルカメラ画像とAIを用いたボディーマーク付与

中原龍一, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 555 - 555 2021.3

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