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腫瘍切除後に遠位脛腓間固定を行った多発性外骨腫症の1例

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S160 - S160 2023年11月

小児期股関節MRIで将来の関節適合性を予測する新たな指標

小浦卓, 鉄永智紀, 山田和希, 井上智博, 奥田龍一郎, 赤澤啓史, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S68 - S68 2023年11月

10代の若年者に対するTHAの検討

奥田龍一郎, 鉄永智紀, 山田和希, 小浦卓, 井上智博, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S76 - S76 2023年11月

内側半月板後根断裂に対する経脛骨pullout修復術術後1週からの部分荷重は治療成績を悪化させない

田村優典, 古松毅之, 横山裕介, 東原直裕, 川田紘己, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 417 - 417 2023年11月

内側半月板後根断裂はUKAのよい適応となるか? MMPRT群とnon-MMPRT群の比較

川田紘己, 古松毅之, 横山裕介, 東原直裕, 田村優典, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 409 - 409 2023年11月

小児下肢疾患の診断・治療運動器検診も含めて

鉄永智紀, 赤澤啓史, 山田和希, 小浦卓, 井上智博, 奥田龍一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 333 - 333 2023年11月

当院におけるOrthoMasterのカップアライメント精度

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 430 - 430 2023年11月

肩甲骨体部骨折に対しスクリューおよび鋼線固定を行った1例

古谷友希, 齋藤太一, 中道亮, 島村安則, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 376 - 376 2023年11月

腰部脊柱管狭窄症と併存した脊髄動静脈奇形の一例

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

中国・四国整形外科学会雑誌 35 ( 3 ) 342 - 342 2023年11月

骨接合術を行い椎間可動域を温存しえた椎弓根骨折の1例

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

中国・四国整形外科学会雑誌 35 ( 3 ) 407 - 407 2023年11月

著明な疼痛を伴う椎間板発生の仙骨脊索腫の一例

藤原智洋, 魚谷弘二, 国定俊之, 中田英二, 小田孔明, 三澤治夫, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 423 - 423 2023年11月

骨粗鬆症性椎体骨折と椎弓根骨折合併例に骨接合術を行い椎間可動性温存を試みた1例

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

日本最小侵襲整形外科学会プログラム・抄録集 29回 73 - 73 2023年11月

The current management of clear cell sarcoma 査読

Kunihiro Ikuta, Yoshihiro Nishida, Shiro Imagama, Kazuhiro Tanaka, Toshifumi Ozaki

Japanese Journal of Clinical Oncology 2023年10月

Associations among Preoperative Malnutrition, Muscle Loss, and Postoperative Walking Ability in Intertrochanteric Fractures: A Retrospective Study. 査読

Kohei Sato, Hironori Tsuji, Masanori Yorimitsu, Takenori Uehara, Yuki Okazaki, Shinichiro Takao, Toshiaki Hata, Shiro Fukuoka, Tomoyuki Noda, Hideyuki Kanda, Toshifumi Ozaki

Acta medica Okayama 77 ( 5 ) 511 - 516 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Sarcopenia and malnutrition are increasing in older adults and are reported risk factors for functional impairment after hip fracture surgery. This study aimed to investigate the associations between skeletal muscle mass loss, malnutrition, and postoperative walking ability in patients with hip fracture. We retrospectively reviewed patients who underwent intertrochanteric fracture surgery at our institute. The psoas muscle index, controlling nutritional status score, and functional ambulation category (FAC) were used to evaluate skeletal muscle mass, nutritional status, and walking ability, respectively. Six months after surgery, walking ability was assessed as either "gait disturbance" or "independent gait". Multivariate binomial logistic regression analysis, with skeletal muscle mass, nutritional status, and other factors, was used to predict the risk of being assigned to the gait disturbance group. This study included 95 patients (mean age, 85.2 years; 70 women). Sixty-six patients had low skeletal muscle mass, 35 suffered from malnutrition, and 28 had both. Malnutrition and low skeletal muscle mass were significantly associated with postoperative gait disturbance (FAC < 3). Preoperative low skeletal muscle mass and malnutrition were risk factors for postoperative poor walking ability. Further preventive interventions focusing on skeletal muscle mass and nutritional status are required.

DOI： 10.18926/AMO/65973

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Time-Dependent Increase in Medial Meniscus Extrusion Predicts the Need for Meniscal Repair in Patients with Partial Medial Meniscus Posterior Root Tears: A Case-Control Study. 査読国際誌

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

Indian journal of orthopaedics 57 ( 10 ) 1633 - 1639 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: This study aimed to compare medial meniscus extrusion (MME) in patients with partial medial meniscus posterior root tears (MMPRTs) through magnetic resonance imaging (MRI) conducted at two-time points and to determine whether patient characteristics or MME measurements differ in patients who respond to nonoperative treatment compared with those who require surgical treatment. METHODS: Thirty-seven patients with partial MMPRTs underwent two MRI scans during nonoperative management or before pull-out repair. Among these, 17 patients received nonoperative management, and 20 underwent pull-out repair. Partial MMPRTs were diagnosed based on the MRI findings. MME measurements were performed on both MRI scans. Statistical and receiver operating curve (ROC) analyses were performed. RESULTS: The duration between the two MRI scans was significantly shorter in the pull-out repair group than in the nonoperative management group. The increase in MME (ΔMME) on MRI scans was significantly greater in the pull-out repair group than in the nonoperative management group. Linear regression analysis revealed a weak correlation between the MRI interval and ΔMME in the nonoperative management group and a moderate correlation in the pull-out repair group. In the ROC construction, the cut-off value for ΔMME that requires surgical intervention was 0.41 mm, with a sensitivity and specificity of 85.0% and 52.9%, respectively. CONCLUSION: Patients with partial MMPRTs requiring surgical treatment had greater MME progression in a shorter time and a time-dependent increase in MME. Therefore, a ΔMME of ≥ 0.41 mm may be useful in deciding surgical intervention based on MRI retests. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s43465-023-00987-3

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Medial joint space narrowing progresses after pullout repair of medial meniscus posterior root tear. 査読国際誌

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

International orthopaedics 47 ( 10 ) 2401 - 2407 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: The extent to which arthropathic changes progress after medial meniscus posterior root tear (MMPRT) repair remains controversial. This retrospective study assessed medial joint space (MJS) narrowing progression after pullout repair for MMPRT and identified the correlating factors. METHODS: We included 56 patients who underwent pullout repair for MMPRT. The MJS of the bilateral knees was assessed with radiography using the fixed-flexion view. A second-look arthroscopy was performed one year post-operatively for all patients. The baseline characteristics, clinical scores, Kellgren-Lawrence (KL) grade, and medial meniscus extrusion (MME) were identified. Statistical comparisons and correlation analyses were conducted. RESULTS: The MJS narrowing width was significantly larger in MMPRT knees than in contralateral knees (0.51 ± 0.85 mm vs. 0.09 ± 0.49 mm, p < 0.001). KL grade progression was observed in 23.2% (13/56) of patients. There was a significant difference between pre- and post-operative MME values, indicating MME progression (p < 0.001). Each clinical score showed significant improvement one year post-operatively (p < 0.001). Positive correlations were found between MJS narrowing and pre-operative MJS (coefficient = 0.510, p < 0.001), rate of change in MJS (coefficient = 0.929, p < 0.001), and increase in MME (ΔMME) (coefficient = 0.506, p < 0.001). CONCLUSION: Knees that underwent pullout repair for MMPRT showed progression of MJS narrowing by 0.51 mm at one year post-operatively, although clinical scores markedly improved. Correlating factors for MJS narrowing were pre-operative MJS, rate of change in MJS, and ΔMME. Preventing MME progression is essential for preventing arthropathic changes.

DOI： 10.1007/s00264-023-05701-4

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Concomitant posterior anchoring further reduces posterior meniscal extrusion during pullout repair of medial meniscus posterior root tears: a retrospective study. 査読国際誌

Haowei Xue, Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Ximing Zhang, Toshifumi Ozaki

International orthopaedics 47 ( 10 ) 2391 - 2400 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Transtibial pullout repair improves the clinical outcomes of medial meniscus (MM) posterior root tears (PRTs); however, reducing MM extrusion remains challenging. Thus, the purpose of this study was to examine the role of additional posterior anchoring (PA) during pullout repair in reducing the severity of MM extrusion compared to pullout repair alone. METHODS: Patients who underwent pullout repair with two-cinch stitches (TCS) only or TCS combined with PA (TCS-PA)-deployment of an additional suture anchor in the posteromedial corner of MM-were included retrospectively. MM medial and posterior extrusion (MMME and MMPE), MM extrusion and remaining volume (MMEV and MMRV), and corresponding ratios were evaluated pre-operatively and three months post-operatively using a three-dimensional meniscal model at 10° and 90° of knee flexion and compared within and between groups. RESULTS: A total of 15 and 16 patients treated with TCS and TCS-PA, respectively, were enrolled. At 90° knee flexion, both techniques significantly reduced MMPE (TCS: 4.2 ± 0.7 mm to 3.5 ± 0.6 mm, p < 0.05; TCS-PA: 3.7 ± 0.8 mm to 2.8 ± 0.7 mm, p < 0.05) at three months post-operatively. TCS-PA reduced MMPE more significantly than TCS alone (p < 0.05). Only TCS-PA significantly improved the MMEV and MMRV ratios (39.6 ± 8.9% to 28.1 ± 6.0%, p < 0.05 and 60.4 ± 8.9% to 71.9 ± 6.0%, p < 0.05, respectively). Significance was not found in all other comparisons. CONCLUSIONS: Both techniques improved MMPE at knee flexion at the three month follow-up, with TCS-PA providing significantly superior results. Our findings support the evidence that the application of PA may be an effective surgical option for alleviating persistent MMPE.

DOI： 10.1007/s00264-022-05660-2

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Epidemiological features of acute medial meniscus posterior root tears. 査読国際誌

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

International orthopaedics 47 ( 10 ) 2537 - 2545 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Untreated or overlooked medial meniscus posterior root tears (MMPRTs) induce sequential knee joint degradation. We evaluated epidemiological features of acute MMPRT for its early detection and accurate diagnosis. METHODS: Among 330 MMPRT patients from 2018 to 2020, those who underwent arthroscopic pullout repairs were enrolled. Patients who underwent non-operative treatment or knee arthroplasty, those with a cruciate ligament-deficient knee or advanced osteoarthritis of the knee, and those with insufficient data were excluded. Finally, we retrospectively evaluated data from 234 MMPRTs (female: 79.9%, complete tears: 92.7%, mean age: 65 years). Welch's t-test and Chi-squared test were used for pairwise comparisons. Spearman's rank correlation analysis was performed between age at surgery and body mass index (BMI). Multivariable logistic regression analysis with stepwise backward elimination was applied to the values as risk factors for painful popping events. RESULTS: In both sexes, there were significant differences in height, weight, and BMI. In all patients, there was a significant negative correlation between BMI and age (ρ = - 0.36, p < 0.001). The BMI cutoff value of 27.7 kg/m2 had a 79.2% sensitivity and a 76.9% specificity for detecting MMPRT patients aged < 50 years. A painful popping event was confirmed in 187 knees (79.9%), and the frequency was significantly reduced in partial tears as compared to complete tears (odds ratio: 0.080, p < 0.001). CONCLUSION: Higher BMI was associated with a significantly younger age of MMPRT onset. Partial MMPRTs had a low frequency of painful popping events (43.8%).

DOI： 10.1007/s00264-023-05848-0

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【整形外科外来Red Flags 2023】脊椎転移におけるRed Flags 査読

中田英二, 藤原智洋, 国定俊之, 尾崎敏文

Orthopaedics 36 ( 10 ) 69 - 80 2023年10月

記述言語：日本語出版者・発行元：(株)全日本病院出版会

椎体転移では腫瘍が増大すると腫瘍が直接神経を圧迫したり,椎体圧潰により脊髄が圧迫され,知覚障害や運動麻痺が生じることがある.ほとんどの骨転移患者は,麻痺が発生する前に脊椎転移部に痛みを自覚している.したがって,痛みは麻痺の危険信号であり,脊椎転移部に痛みが出現した場合,早急に治療を開始することが重要である.麻痺を予防するために,最も基本的で重要な対処法は,脊椎転移部に痛みが出現した場合,脊椎SREsの発生も考え,早急に画像検査を行い,痛みの原因と考えられる著しい椎体破壊や脊髄圧迫を認めた場合,早急に治療(RTなど)を行うことである(Red Flag).なお,早急に画像検査が行えない場合,直近のCT等を見直し,椎体破壊の有無を確認すべきである.Red Flagに対して早急に対処し,麻痺が出現する前に治療が開始できれば,麻痺発生数を減らすことができる.(著者抄録)

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慢性疼痛患者の破局的思考が身体的機能と活動能力に与える影響 1年間の継時的推移の特徴

太田晴之, 齋藤圭介, 横山暁大, 堅山佳美, 濱田全紀, 鉄永倫子, 西田圭一郎, 尾崎敏文

日本運動器理学療法学会学術大会抄録集 11回 348 - 348 2023年10月

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