Faculty Profiles - SAIGA Kenta

Papers - SAIGA Kenta

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A Characteristic Magnetic Resonance Imaging Finding to Identify Morton Neuroma: The Slug Sign Reviewed

Masahiro Horita, Kenta Saiga, Tomohiro Fujiwara, Eiji Nakata, Toshifumi Ozaki

Foot & Ankle Orthopaedics 9 ( 3 ) 2024.7

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Background:

Morton neuroma is a common cause of forefoot pain and sensory disturbances, but it is difficult to identify on magnetic resonance imaging (MRI). The aim of this study was to verify the usefulness of a characteristic MRI finding (slug sign) for identifying Morton neuroma and to clarify the relationship between excised neuroma characteristics and preoperative MRI findings.

Methods:

Twenty-two web spaces were retrospectively assessed from the second and third intermetatarsal spaces of 11 feet of 10 patients (7 women and 3 men, aged average 59.5 years) who underwent surgical excision of Morton neuroma between 2017 and 2022. Asymptomatic web spaces were used as control. Neuromas with 2 branches of the plantar digital nerves on axial T1-weighted MRI (MRI-T1WI) were considered the slug sign. We investigated the preoperative presence of the slug sign in Morton neuroma and asymptomatic control web spaces. We also investigated the relationship between the maximum transverse diameter of the excised specimen and that estimated on coronal MRI-T1WI.

Results:

A total of 15 Morton neuromas were excised and assessed. The slug signs were present in 10 intermetatarsal spaces in 15 web spaces with Morton neuroma whereas the sign was found in 1 intermetatarsal space in 7 asymptomatic web spaces. The sensitivity and specificity for the slug sign to diagnose Morton neuroma was 66.7% and 85.7%, respectively. The positive and negative predictive values were 90.9% and 54.5%, respectively. The mean maximum transverse diameter of excised neuromas was 4.7 mm. The mean maximum transverse diameter of neuromas on coronal MRI-T1WI was 3.4 mm. A significant positive correlation was found between the maximum transverse diameters of excised specimens and diameters estimated on coronal MRI-T1WI ( r = 0.799, P < .001).

Conclusion:

The slug sign may be a useful indicator of Morton neuroma on MRI to confirm nerve involvement after bifurcation.

Level of Evidence:

Level IV, retrospective series.

DOI： 10.1177/24730114241268285

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Other Link： https://journals.sagepub.com/doi/full-xml/10.1177/24730114241268285

Prosthetic joint infection after total talar replacement: An implant-retained case treated with combined continuous local antibiotic perfusion (CLAP)

Kohei Iwamoto, Norio Yamamoto, Kenta Saiga, Akihiro Maruo, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Journal of Orthopaedic Science 29 ( 1 ) 349 - 353 2024.1

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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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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Larger sagittal inter-screw distance/tibial width ratio reduces delayed union or non-union after arthroscopic ankle arthrodesis. Reviewed International journal

Suguru Yokoo, Kenta Saiga, Koji Demiya, Hideki Ohashi, Masahiro Horita, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2022.6

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

BACKGROUND: Arthroscopic ankle arthrodesis (AAA) has risks of complications, such as delayed union and non-union. The number and direction of the inserted screws have been reported as important factors affecting the time to union of AAA. However, the ratio of inter-screw distance (ISD) to tibial width (TW) in different planes has not been investigated. Therefore, we aimed to explore the effect of this ratio on bone union following AAA. METHODS: We retrospectively enrolled 63 patients (64 ankles) undergoing AAA from 2013 to 2019. Then, their age, body mass index (BMI), sex, diabetes mellitus (DM) status, Takakura-Tanaka classification, number of screws and radiographic parameters were analysed. RESULTS: The patients had a mean age of 70.3 (range, 45-91) years. Bone fusion was achieved in 57 ankles (89%) in a mean period of 3.3 (range, 2-6) postoperative months. There were four cases of delayed union and three of non-union. No significant differences in age, BMI, sex, DM, Takakura-Tanaka classification, and number of screws could be detected between the groups. However, the sagittal ISD/TW ratio was significantly larger in the union group than in the delayed/non-union group with a cut-off value of 57.0%. CONCLUSION: Larger sagittal ISD/TW ratios result in reduced post-AAA delayed union or non-union. The surgeon should be aware that the anterior and posterior screw widths should be approximately 60% or more of the anteroposterior width of the tibia.

DOI： 10.1007/s00590-022-03307-x

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寛骨臼骨折における術後臨床成績評価方法の比較 Matta scoreとJHEQの比較検討

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 齋藤太一, 雑賀建多, 島村安則, 依光正則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S874 - S874 2022.3

Outcome after resection arthroplasty or shortening oblique osteotomy of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal joint for severe rheumatoid forefoot deformities

Masahiro Horita, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Masanori Hamada, Toshifumi Ozaki

Journal of Orthopaedic Surgery 30 ( 2 ) 102255362211179 - 102255362211179 2022.1

Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Purpose

We investigated objective and patient-reported outcomes after resection arthroplasty or shortening oblique osteotomy (SOO) of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal (MTP) joint for severe rheumatoid forefoot deformities.

Methods

17 feet from 14 women (mean age, 67.8 years) underwent resection arthroplasty of the lesser metatarsal heads (MTH resection group), while 13 feet from nine women and two men (mean age, 68.7 years) underwent SOO of the lesser metatarsals (MTH preservation group). Arthrodesis of the first MTP joint was performed in all cases. Mean follow-up in the MTH resection and preservation groups was 25.0 and 21.3 months, respectively. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) scale and self-administered foot evaluation questionnaire (SAFE-Q) scores.

Results

Mean total JSSF scale significantly improved from 53.4 to 76.4 in the MTH resection group ( p < .001) and from 50.1 to 74.2 in the MTH preservation group ( p = .002). Pain and pain-related and shoe-related SAFE-Q subscale scores significantly improved after surgery in both groups. In the MTH resection group, recurrence of painful callosities and claw toe deformity was observed in four and three feet, respectively. In the MTH preservation group, one patient experienced recurrence of painful callosities and one underwent revision surgery for IP joint dislocation.

Conclusion

Resection arthroplasty or SOO of the lesser metatarsals combined with arthrodesis of the first MTP joint achieved significant improvement with respect to pain relief, deformity correction, and footwear comfort.

DOI： 10.1177/10225536221117903

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Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/10225536221117903

A Novel Radiographic Measurement Method for the Evaluation of Metatarsophalangeal Joint Dislocation of the Lesser Toe in Patients with Rheumatoid Arthritis Reviewed International journal

Hideki Ohashi, Keiichiro Nishida, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Masahiro Horita, Shunji Okita, Toshifumi Ozaki

International Journal of Environmental Research and Public Health 18 ( 14 ) 7520 - 7520 2021.7

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

Dorsal dislocation of metatarsophalangeal (MTP) joints of the lesser toe frequently occurs in patients with rheumatoid arthritis (RA), and may cause painful and uncomfortable plantar callosities and ulceration. The current study examined the reliability and clinical relevance of a novel radiographic parameter (the MTP overlap distance [MOD]) in evaluating the severity of MTP joint dislocation. The subjects of the current study were 147 RA patients (276 feet; 1104 toes). MOD, defined as the overlap distance of the metatarsal head and the proximal end of the phalanx, was measured on plain radiographs. The relationship between the MOD and clinical complaints (forefoot pain and/or callosity formation) was analyzed to create a severity grading system. As a result, toes with callosities had a significantly larger MOD. ROC analysis revealed that the MOD had a high AUC for predicting an asymptomatic foot (−0.70) and callosities (0.89). MOD grades were defined as follows: grade 1, 0 ≤ MOD < 5 mm; grade 2, 5 ≤ MOD < 10 mm; and grade 3, MOD ≥ 10 mm. The intra- and inter-observer reliability of the MOD grade had high reproducibility. Furthermore, the MOD and MOD grade improved significantly after joint-preserving surgeries for lesser toe deformities. Our results suggest that MOD and MOD grade might be useful tools for the evaluation of deformities of the lesser toe and the effect of surgical intervention for MTP joints in patients with RA.

DOI： 10.3390/ijerph18147520

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多発外傷患者における筋断面積の推移の比較

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S371 - S371 2021.7

関節面の整復に術中3D撮影およびナビゲーションが有用であった寛骨臼骨折の2例

畑利彰, 野田知之, 島村安則, 上原健敬, 福岡史朗, 佐藤浩平, 近藤宏也, 齋藤太一, 雑賀建多, 尾崎敏文

骨折 43 ( Suppl. ) S367 - S367 2021.7

踵骨骨折における3DCTを用いた後距踵関節面の評価

上原健敬, 野田知之, 福岡史朗, 佐藤浩平, 畑利彰, 近藤宏也, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

骨折 43 ( Suppl. ) S248 - S248 2021.7

寛骨臼骨折に対する術後臨床成績評価方法の比較 Matta scoreとJHEQの比較検討

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S283 - S283 2021.7

Subjective and Objective Outcomes of Surgery for Rheumatoid Forefoot Deformities Under the Current Treatment Paradigm. International journal

Masahiro Horita, Keiichiro Nishida, Daisuke Kaneda, Kenzo Hashizume, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Hideki Ohashi, Masahito Watanabe, Toshifumi Ozaki

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 61 ( 1 ) 53 - 59 2021.6

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

We investigated the clinical outcomes of surgical procedures for the treatment of forefoot deformities in patients with rheumatoid arthritis. Twenty feet in 16 women (mean age 62.1 years) underwent corrective osteotomy of the first metatarsal bone with shortening oblique osteotomy of the lesser metatarsophalangeal joints (joint-preservation group), while 13 feet in 12 women (mean age 67.4 years) underwent arthrodesis of the first metatarsophalangeal joint with resection arthroplasty of the lesser metatarsophalangeal joints (joint-sacrifice group); mean follow-up for each group was 25.8 and 23.8 months, respectively. The mean total Japanese Society for Surgery of the Foot (JSSF) scale improved significantly from 64.2 to 89.2 in the joint-preservation group (p < .001), and from 54.2 to 74.2 in the joint-sacrifice group (p = .003). In the joint-preservation group, the postoperative range of motion (ROM) of the joint, walking ability, and activities of daily living scores of the JSSF scale were significantly higher than those in the joint-sacrifice group (p = .001, p = .001, and p = .019, respectively). There were no differences in the subscale scores of the self-administered foot evaluation questionnaire between 2 groups either pre- or postoperatively. No differences in the postoperative complications were found between 2 groups. Although the joint-sacrificing procedure resulted in lower objective outcomes than the joint-preserving procedure regarding the ROM of the joint, the walking ability, and the level of activities of daily living, both procedures resulted in similar treatment outcomes when evaluated by the subjective measures.

DOI： 10.1053/j.jfas.2021.06.008

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Ilizarov創外固定とMasquelet法が有効であった下腿遠位部開放骨折の1例

近藤宏也, 上原健敬, 根津智史, 松橋美波, 出宮光二, 横尾賢, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

日本創外固定・骨延長学会雑誌 32 226 - 226 2021.4

大腿骨頸部前捻角に左右差はあるか 3D計測による検討

佐藤浩平, 野田知之, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1125 - S1125 2021.3

大腿骨頸部前捻角に左右差はあるか 3D計測による検討

佐藤浩平, 野田知之, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1125 - S1125 2021.3

Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears Reviewed International journal

Yuki Okazaki, Takayuki Furumatsu, Yuya Kodama, Yusuke Kamatsuki, Yoshiki Okazaki, Takaaki Hiranaka, Shota Takihira, Tomonori Tetsunaga, Kenta Saiga, Toshifumi Ozaki

Knee Surgery, Sports Traumatology, Arthroscopy 29 ( 1 ) 44 - 50 2021.1

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

PURPOSE: Bone morphological factors are important for menisci. Their association with medial meniscus posterior root tears, however, has not yet been studied. This study aimed to compare sagittal medial tibial slope and medial tibial plateau depth between knees with and without medial meniscus posterior root tears. METHODS: Nine healthy volunteers, 24 patients who underwent anterior cruciate ligament reconstruction, and 36 patients who underwent medial meniscus posterior root pullout repair were included. Magnetic resonance imaging examinations were performed in the 10°-knee-flexed position. The medial tibial slope and medial tibial plateau depth were compared among the groups. RESULTS: In healthy volunteers, the anterior cruciate ligament reconstruction group, and the medial meniscus posterior root tear group, the medial tibial slopes were 3.5° ± 1.4°, 4.0° ± 1.9°, and 7.2° ± 1.9°, respectively, and the medial tibial plateau depths were 2.1 ± 0.7 mm, 2.2 ± 0.6 mm, and 1.2 ± 0.5 mm, respectively. Patients with medial meniscus posterior root tears had a significantly steep medial tibial slope and shallow medial tibial plateau concavity compared to those of healthy volunteers (P < 0.01) and the anterior cruciate ligament group (P < 0.01). In the multivariate logistic regression analysis, body mass index, medial tibial slope, and medial tibial plateau depth were significantly associated with medial meniscus posterior root tears. CONCLUSIONS: A steep posterior slope and a shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tear. LEVEL OF EVIDENCE: Level III: Case-control study.

DOI： 10.1007/s00167-019-05590-4

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Other Link： http://link.springer.com/content/pdf/10.1007/s00167-019-05590-4.pdf

整形外科医の家事・育児の役割分担，現状と課題夫婦へのアンケート調査および主婦業体験を踏まえて Reviewed

雑賀建多

中・四整会誌 32 ( 2 ) 223 - 230 2020.9

Effect of Lateral Gutter Osteophyte Resection on Correction of Varus Deformity in Arthroscopic Ankle Arthrodesis. Reviewed International journal

Kenta Saiga, Suguru Yokoo, Hideki Ohashi, Masahiro Horita, Takayuki Furumatsu, Toshifumi Ozaki

Foot & ankle international 41 ( 6 ) 683 - 688 2020.6

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

BACKGROUND: Recently, arthroscopic ankle arthrodesis has been performed for moderate-to-severe varus-deformed ankle osteoarthritis. However, the effect of osteophyte resection in the lateral gutter in arthroscopic ankle arthrodesis has not been clarified. We hypothesized that a varus-deviated ankle with lateral gutter osteophytes can be corrected by osteophyte resection. METHODS: Thirty-nine ankles of 38 patients were included. The mean age of patients was 70.0 (45-83) years. The patients were divided into the following groups: group with an osteophyte in the lateral gutter (osteophyte) and group with no osteophytes (nonosteophyte). Preoperative and postoperative tibiotalar angle, tibial plafond angle, and tibiotalar angle under valgus stress, as well as the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale, were recorded. Twelve ankles underwent lateral gutter osteophyte resection, whereas the other 27 ankles did not require osteophyte resection. RESULTS: Preoperative tibiotalar angle was higher in the osteophyte group than in the nonosteophyte group (21.8 vs 11.2 degrees, P = .01). The tibiotalar angle in the preoperative valgus stress imaging was higher in the osteophyte group (12.9 vs 5.7, P < .01). However, the postoperative tibiotalar angle was similar between the 2 groups (7.1 vs 5.4, P = .183). JSSF ankle/hindfoot scale improved in both groups. CONCLUSION: Lateral gutter osteophyte resection enabled correction of the varus malalignment in arthroscopic ankle arthrodesis. LEVEL OF EVIDENCE: Level III, retrospective comparative series.

DOI： 10.1177/1071100720910388

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人工関節周囲骨折に対するプレート骨接合術 Locking plate を中心に. Reviewed

野田知之, 山川泰明, 横尾賢, 出宮光二, 清野正普, 望月雄介, 雑賀建多, 齋藤太一, 遠藤裕介, 島村安則, 尾崎敏文

日本創外固定・骨延長学会雑誌 31 196 - 196 2020.3

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