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

PURPOSE: To reveal the outcomes of partial medial meniscus posterior root tears following transtibial pullout repair compared with the outcomes of complete radial meniscus posterior root tears. MATERIALS AND METHODS: We retrospectively evaluated 15 consecutive patients (male/female, 5/10; average age, 64.4 years) who underwent transtibial pullout repair for partial medial meniscus posterior root tears and compared their results with those of 86 consecutive patients who underwent the same surgery for complete medial meniscus posterior root tears. All patients underwent second-look arthroscopy on average 1 year postoperatively, and a semi-quantitative meniscal healing score (anteroposterior width, stability, and synovial coverage, total 10 points) was evaluated. Medial meniscus extrusion was evaluated preoperatively and at second-look arthroscopy. RESULTS: Postoperative clinical scores were not significantly different in the short term. However, second-look arthroscopy revealed a significant difference in repaired meniscal stability (partial tear; 3.3 points, complete tear; 2.3 points, p < 0.001) and total meniscal healing scores (partial tear; 8.3 points, complete tear; 7.1 points, p < 0.001). Medial meniscus extrusion progression was significantly different (partial tear; 0.4 mm, complete tear; 1.0 mm, p < 0.001). CONCLUSION: Partial medial meniscus posterior root tears showed better meniscal healing and less medial meniscus extrusion progression following pullout repair than complete medial meniscus posterior root tears.

DOI： 10.1186/s43019-023-00206-1

PubMed

researchmap

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

BACKGROUND: Despite good clinical results, repair of medial meniscus (MM) posterior root tears (MMPRTs) may not completely prevent knee osteoarthritis progression. This study evaluated changes in the medial joint space (MJS) during the first and second years after repair, compared to narrowing in the contralateral knee, using fixed-flexion view (FFV) radiographs. METHODS: Fifty-four patients who underwent pull-out repair for a unilateral MMPRT were included. FFV radiographs were obtained pre-operatively and at the 1- and 2-year post-repair timepoints to evaluate changes in the MJS and Kellgren-Lawrence grade bilaterally. Clinical outcomes were also evaluated. RESULTS: The change in the MJS was greater in MMPRT knees than in contralateral knees during the first year (0.48 ± 0.80 mm vs. 0.09 ± 0.49 mm, p < 0.001), but this difference lessened in the second year (0.09 ± 0.36 mm vs. 0.07 ± 0.38 mm, p = 0.285). Kellgren-Lawrence grade progression in MMPRT knees was less in the second year. Clinical outcomes significantly improved at both 1 and 2 years post-repair than the pre-operative values (p < 0.001), with continued improvement in clinical outcomes in the second year. There was no significant correlation between patient characteristics and the change in the MJS from preoperatively to 2 years postoperatively. CONCLUSION: Pull-out repair for MMPRTs did not completely prevent MJS narrowing, but the rate of narrowing decreased in the second year (mean, 0.09 mm) compared to that in the first year (mean, 0.48 mm). MJS narrowing in the second year after MM posterior root repair was comparable to that of the contralateral knee. Clinical outcomes further improved over the second year after repair. LEVEL OF EVIDENCE: IV.

DOI： 10.1016/j.knee.2024.01.005

PubMed

researchmap

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

The use of various strategies for arthroscopic meniscal repairs to save the meniscus and prevent the progression of knee osteoarthritis has gradually increased. We investigated the frequency of various arthroscopic treatments and the short-term clinical outcomes of symptomatic isolated medial meniscus (MM) injuries. This retrospective observational study included 193 patients (197 knees) who underwent arthroscopic meniscal treatment for isolated MM injuries between January 2016 and April 2019. Arthroscopic meniscal repairs were divided into two groups: transtibial pullout repairs of MM posterior root tears (MMPRTs) and arthroscopic meniscal repairs for other types of MM injuries. MMPRT pullout repair, other meniscal repairs, and partial meniscectomy were performed in 71.0%, 16.8%, and 12.2% of the knees, respectively. The ratio of women to men and the patient age were higher in the pullout-repair group than the meniscal-repair group. The Preoperative Knee Injury and Osteoarthritis Outcome Score subscale (as an index of daily living activities) was significantly lower in the pullout-repair group than the meniscus-repair group. However, no significant differences were observed in these scores among the two groups postoperatively. Our results suggest that familiarity with the diagnosis and treatment of MMPRTs is necessary for orthopedic surgeons to manage isolated MM injuries.

DOI： 10.18926/AMO/66667

PubMed

researchmap

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

OBJECTIVES: This study aimed to investigate whether the initial suture tension when pullout sutures are fixed affects postoperative clinical outcomes following medial meniscus posterior root repair. METHODS: The data of 48 patients who underwent transtibial pullout repair using two simple stitches (outer and inner sutures) with an additional all-inside posteromedial pullout were retrospectively investigated. The patients were sequentially divided into two groups to compare the clinical efficacy of the initial pullout tension when pullout sutures were fixed: the 30N Group (April 2019 to September 2019, 24 patients) and the 15N group (October 2019 to February 2020, 24 patients). The rate of suture breakage (suture cutout or rupture) at the second-look arthroscopy at 1 year postoperatively and clinical outcomes at 2 years postoperatively were compared between the two groups. RESULTS: In both groups, each clinical score significantly improved at 2 years postoperatively. At the second-look arthroscopy, the rate of posteromedial suture breakage was significantly higher in the 30 N Group (19 patients, 79%) than in the 15 N Group (10 patients, 42%); the rate of outer suture breakage was also higher in the 30 N group (five patients, 21%) than in the 15 N group (no patients). On comparing 2 years of preoperative clinical scores between the groups categorized according to posteromedial suture breakage, the pain score was significantly higher in the suture breakage group. CONCLUSION: The initial tension of pullout repair of the medial meniscus posterior root tear is related to suture breakages. To prevent suture breakage, 15 N is a more initially suitable condition than 30 N. LEVEL OF EVIDENCE: Level III.

DOI： 10.1016/j.jisako.2024.01.004

PubMed

researchmap

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

PURPOSE: This retrospective study aimed to investigate the relationship between intercondylar notch width (ICNW), osteophyte width (OW), and the healing of medial meniscus posterior root tears (MMPRTs) following arthroscopic pullout repair. METHODS: The study included 155 patients diagnosed with MMPRTs who underwent transtibial pullout repair. Meniscal healing status was evaluated on second-look arthroscopy using a previously reported meniscus healing score. Patients were divided into two groups based on this score: the high healing score (group HH, healing score ≥ 8 points) and suboptimal healing score (group SO, healing score ≤ 6 points) groups. Computed tomography scans were performed on patients 1 week postsurgery. ICNW and OW widths were measured and relatively evaluated based on their ratio to the intercondylar distance (ICD), represented as the ICNW/ICD ratio (%) and OW/ICD ratio (%), respectively. Patient-reported outcomes were assessed preoperatively and on second-look arthroscopy using the Knee injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS). RESULTS: There were no significant demographic differences between the SO and HH group (n = 35 and 120 patients, respectively). Regarding radiographic measurements, significant differences were observed in the ICNW/ICD ratio (group SO, 24.2%; group HH, 25.2%; p = 0.024), OW (group SO, 2.6 mm; group HH, 2.0 mm; p < 0.001), and OW/ICD ratio (group SO, 3.5%; group HH, 2.7%; p < 0.001). Both groups had similar preoperative clinical scores, but postoperative clinical scores, including KOOS-activities of daily living (group SO, 83.4; group HH, 88.7; p = 0.035) and VAS (group SO, 19.1; group HH, 11.3; p = 0.005), were significantly better in group HH. CONCLUSION: The study suggests that ICNW and OW may play a crucial role in MMPRT healing following arthroscopic pullout repair, as evidenced by the worse clinical outcomes associated with a narrower ICNW and wider OW. These findings highlight the potential significance of ICNW and OW assessments when evaluating meniscal repair indications. LEVEL OF EVIDENCE: Level III.

DOI： 10.1002/ksa.12032

PubMed

researchmap

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

PURPOSE: This study investigated the impact of weight change on the success of transtibial pullout repair for medial meniscus (MM) posterior root tears (MMPRTs). METHODS: The study included 129 patients diagnosed with MMPRTs who had undergone transtibial pullout repair. The patients were screened between July 2018 and November 2021. Patient-reported outcomes were assessed preoperatively and at 12 months postoperatively using the Knee injury and Osteoarthritis Outcome Score (KOOS). MM extrusion (MME) and ΔMME (postoperative MME - preoperative MME) were calculated preoperatively and at 12 months postoperatively using magnetic resonance imaging. RESULTS: Patients were divided into weight loss (body mass index [BMI] decrease of at least 0.5 kg/m2 after primary repair; n = 63) and weight gain (BMI increase of at least 0.5 kg/m2 ; n = 66) groups. Both groups had similar demographic variables and preoperative clinical scores; patient-reported outcomes significantly improved postoperatively. The weight loss group had significantly greater improvement in KOOS-quality of life (weight loss, 29.4 ± 23.7; weight gain, 23.9 ± 27.6; p = 0.034), lower postoperative MME (weight loss, 3.9 ± 1.7 mm; weight gain, 4.2 ± 1.2 mm; p = 0.043) and lower ΔMME (weight loss, 0.8 ± 0.8 mm; weight gain, 1.2 ± 0.9 mm; p = 0.002) than the weight gain group. Total arthroscopic healing scores (weight loss, 7.6 ± 1.0; weight gain, 7.2 ± 1.5; p = 0.048) and associated subscales, including anteroposterior bridging tissue width (weight loss, 4.0 ± 0.0; weight gain, 3.8 ± 0.7; p = 0.004) and MM posterior root stability (weight loss, 2.6 ± 0.7; weight gain, 2.4 ± 0.7; p = 0.041), significantly differed between the groups. CONCLUSIONS: Weight loss was associated with better meniscal healing and less MME progression after MMPRT repair, highlighting the significance of weight management in individuals undergoing meniscal surgery. These findings provide valuable insights into the clinical significance of weight loss in the success of transtibial pullout repair for MMPRTs. LEVEL OF EVIDENCE: Level III.

DOI： 10.1002/ksa.12037

PubMed

researchmap

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

Bone and soft-tissue sarcomas are rare malignancies with histological diversity and tumor heterogeneity, leading to the lack of a common molecular target. Telomerase is a key enzyme for keeping the telomere length and human telomerase reverse transcriptase (hTERT) expression is often activated in most human cancers, including bone and soft-tissue sarcomas. For targeting of telomerase-positive tumor cells, we developed OBP-301, a telomerase-specific replication-competent oncolytic adenovirus, in which the hTERT promoter regulates adenoviral E1 gene for tumor-specific viral replication. In this study, we present the diagnostic potential of green fluorescent protein (GFP)-expressing oncolytic adenovirus OBP-401 for assessing virotherapy sensitivity using bone and soft-tissue sarcomas. OBP-401-mediated GFP expression was significantly associated with the therapeutic efficacy of OBP-401 in human bone and soft-tissue sarcomas. In the tumor specimens from 68 patients, malignant and intermediate tumors demonstrated significantly higher expression levels of coxsackie and adenovirus receptor (CAR) and hTERT than benign tumors. OBP-401-mediated GFP expression was significantly increased in malignant and intermediate tumors with high expression levels of CAR and hTERT between 24 and 48 h after infection. Our results suggest that the OBP-401-based GFP expression system is a useful tool for predicting the therapeutic efficacy of oncolytic virotherapy on bone and soft-tissue sarcomas.

DOI： 10.1371/journal.pone.0298292

PubMed

researchmap

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

BACKGROUND: In acetabular fracture surgery, an infra-acetabular screw (IAS) is inserted from the anterior to the posterior column through the infra-acetabular corridor to stabilize both columns. Although the IAS is useful for increasing fixation strength, proper placement requires proficiency and often results in extraosseous screw penetration. The complex anatomy of the infra-acetabular corridor and difficult intraoperative detection of the ideal insertion point and angle make proper placement of the IAS challenging. This study aimed to detect the ideal insertion point and angle of the IAS based on anatomical landmarks that can be directly identified intraoperatively. METHODS: We retrospectively reviewed the pelvic CT of 50 adults who underwent serial slice CT imaging. The pelvic inlet plane (PIP), which contains the anterior border of both the sacroiliac joint and posterior superior edge of the pubic symphysis, was used as the reference plane for the pelvic coordinate system to simulate the ideal insertion of IAS. The distance from the posterior superior edge of the pubic symphysis to the ideal insertion point of the IAS (IAS distance) and the angle and length of the IAS that could be inserted from the ideal insertion point were measured. RESULTS: The mean IAS distance was 61.0 ± 5.7 mm (57.6 ± 4.3 mm in men and 64.4 ± 4.9 mm in women). The mean angle between ideal IAS and yz-plane on the outlet view (α-angle) was 8.4 ± 6.6 ° (6.4 ± 5.6° in men and 10.5 ± 7.0° in women). The mean angle between ideal IAS and y-axis on the yz-plane (β-angle) was 86.5 ± 10.6 ° (86.0 ± 10.3° in men and 87.0 ± 10.9° in women). The length of IAS was 97.1 ± 4.7 mm in men and 89.2 ± 3.6 mm in women. CONCLUSION: The IAS ideal insertion point detected as a distance from the pubic symphysis may aid in the proper insertion of the IAS during surgery. The insertion angle was parallel or tilted 10 ° laterally to the longitudinal axis in the pelvic outlet plane and almost perpendicular to the PIP in the sagittal plane when inserted from the ideal insertion point.

DOI： 10.1016/j.injury.2023.111264

PubMed

researchmap

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

Background: It is not clear whether rehabilitation after surgery for trigger finger is effective. The aim of this study was to reveal its effectiveness for trigger finger. Methods: This study was a randomized, controlled trial that included patients who underwent operations for trigger fingers. The patients in the rehabilitation group had postoperative occupational therapy (OT) for 3 months, while the patients in the control group were not referred for rehabilitation but received advice for a range of motion exercises. We evaluated the severity of trigger finger, Disability of Arm-Shoulder-Hand (DASH) score, pain-visual analogue scale (VAS), grip strength, whether they gained a full range of motion (ROM), and complications before and after surgery. Results: Finally, 29 and 28 patients were included in the control and rehabilitation groups, respectively. At final follow-up, the DASH score, grip strength, and ROM were significantly improved in the rehabilitation group compared to that preoperatively. At final follow-up, pain was significantly improved in both groups from that preoperatively. There were no significant differences in the results, including the DASH score, grip strength, ROM and pain-VAS between the control and rehabilitation groups at the final follow-up. Subgroup analysis showed that there is a significant difference in the DASH score of patients doing housework or light work and those with a duration of symptoms &gt;12 months between the control and rehabilitation groups at the final follow-up.

DOI： 10.3390/jcm12227187

researchmap

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

AIMS: Clear cell sarcoma (CCS) of soft-tissue is a rare melanocytic subtype of mesenchymal malignancy. The aim of this study was to investigate the clinical and therapeutic factors associated with increased survival, stratified by clinical stage, in order to determine the optimal treatment. METHODS: The study was a retrospective analysis involving 117 patients with histologically confirmed CCS, between July 2016 and November 2017, who were enrolled in the Bone and Soft Tissue Tumour Registry in Japan. RESULTS: The five- and ten-year survival rates were 41% (95% confidence interval (CI) 29 to 52) and 37% (95% CI 25 to 49), respectively. On multivariable analysis, the size of the tumour of > 10 cm (p = 0.006), lymph node metastasis at the time of diagnosis (p < 0.001), distant metastases at the time of diagnosis (p < 0.001), and no surgery for the primary tumour (p = 0.019) were independently associated with a poor survival. For N0M0 CCS (n = 68), the development of distant metastases was an independent prognostic factor for survival (early (< 12 months), hazard ratio (HR) 116.78 (95% CI 11.69 to 1,166.50); p < 0.001; late (> 12 months), HR 14.79 (95% CI 1.66 to 131.63); p = 0.016); neoadjuvant/adjuvant chemotherapy (p = 0.895) and/or radiotherapy (p = 0.216) were not significantly associated with survival. The five-year cumulative incidence of local recurrence was 19% (95% CI 8 to 35) and the size of the tumour was significantly associated with an increased rate of local recurrence (p = 0.012). For N1M0 CCS (n = 18), the risk of mortality was significantly lower in patients who underwent surgery for both the primary tumour and lymph node metastases (HR 0.03 (95% CI 0.00 to 0.56); p = 0.020). For M1 CCS (n = 31), excision of the primary tumour was independently associated with better survival (HR 0.26 (95% CI 0.09 to 0.76); p = 0.013). There was no significant difference in survival between the different types of systemic treatment (p = 0.523). CONCLUSION: Complete excision of the primary tumour and lymph nodes is associated with a better survival in patients with CCS. Systemic treatment appears to provide limited benefits, demonstrating a pressing need for novel systemic agents.

DOI： 10.1302/0301-620X.105B11.BJJ-2022-0743.R3

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：西日本脊椎研究会  

researchmap

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

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

PubMed

researchmap

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

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

PubMed

researchmap

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

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

PubMed

researchmap

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

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

PubMed

researchmap

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

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

PubMed

researchmap

Language：Japanese   Publisher：(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)

researchmap

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

BACKGROUND: This study aimed to assess quadriceps muscle strength after medial meniscus (MM) posterior root repair and determine its relationship with clinical scores and MM extrusion (MME). METHODS: Thirty patients who underwent pullout repair for MM posterior root tear and were evaluated for quadriceps muscle strength preoperatively and at 1 year postoperatively were included in this study. Quadriceps muscle strength was measured using the Locomo Scan-II instrument (ALCARE, Tokyo, Japan). MME and clinical scores (i.e., Knee Injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee score, Lysholm score, Tegner score, and visual analog scale pain score) were evaluated preoperatively and at 1 year postoperatively, and second-look arthroscopy was performed at 1 year postoperatively. Wilcoxon's signed-rank test was used to compare each measure pre- and postoperatively. Pearson's correlation coefficient was used to assess the correlation with quadriceps muscle strength values. Multiple regression analysis was performed to identify factors associated with the change in MME (ΔMME). RESULTS: Second-look arthroscopy confirmed continuity of the posterior root in all patients. The quadriceps muscle strength measured at 1 year postoperatively (355.1 ± 116.2 N) indicated significant improvement relative to the quadriceps muscle strength measured preoperatively (271.9 ± 97.4 N, p < 0.001). The MME at 1 year postoperatively (4.59 ± 1.24 mm) had progressed significantly relative to the MME preoperatively (3.63 ± 1.01 mm, p < 0.001). The clinical scores at 1 year postoperatively were improved significantly relative to the scores preoperatively (p < 0.001). The postoperative quadriceps muscle strength was correlated with ΔMME (correlation coefficient = -0.398, p = 0.030), and the change in quadriceps muscle strength was correlated with the KOOS-Quality of Life (correlation coefficient = 0.430, p = 0.018). Multiple regression analysis showed that the postoperative quadriceps muscle strength had a significant effect on ΔMME even when the body mass index and time from injury to surgery were included. CONCLUSIONS: After MM posterior root repair, patients with greater quadriceps muscle strength showed less MME progression. In addition, patients with greater improvement in quadriceps muscle strength had better clinical scores; therefore, continued rehabilitation aimed at improving quadriceps muscle strength after MM posterior root repair is recommended. LEVEL OF EVIDENCE: IV.

DOI： 10.1186/s12891-023-06858-0

PubMed

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02438&link_issn=&doc_id=20231004050018&doc_link_id=10.11360%2Fjcsoa.35.285&url=https%3A%2F%2Fdoi.org%2F10.11360%2Fjcsoa.35.285&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

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

Alveolar soft part sarcoma is a rare neoplasm of uncertain histogenesis that belongs to a newly defined category of ultra-rare sarcomas. The neoplasm is characterized by a specific chromosomal translocation, der (17) t(X; 17)(p11.2;q25), that results in ASPSCR1-TFE3 gene fusion. The natural history of alveolar soft part sarcoma describes indolent behaviour with slow progression in deep soft tissues of the extremities, trunk and head/neck in adolescents and young adults. A high rate of detection of distant metastasis at presentation has been reported, and the most common metastatic sites in decreasing order of frequency are the lung, bone and brain. Complete surgical resection remains the standard treatment strategy, whereas radiotherapy is indicated for patients with inadequate surgical margins or unresectable tumours. Although alveolar soft part sarcoma is refractory to conventional doxorubicin-based chemotherapy, monotherapy or combination therapy using tyrosine kinase inhibitors and immune checkpoint inhibitors have provided antitumor activity and emerged as new treatment strategies. This article provides an overview of the current understanding of this ultra-rare sarcoma and recent advancements in treatments according to the clinical stage of alveolar soft part sarcoma.

DOI： 10.1093/jjco/hyad102

PubMed

researchmap

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

Total wrist arthroplasty is a challenging procedure for wrist joints severely destroyed by rheumatoid arthritis. The most common postoperative complication of total wrist arthroplasty is the loosening of the carpal component. Revision surgeries for failed total wrist arthroplasties can be complicated owing to severe bone loss and concomitant soft-tissue problems. Here we report a case (68-year-old woman with a history of rheumatoid arthritis for 24 years) of severe aseptic loosening of semi-constrained total wrist arthroplasty and its salvage surgery. During the primary arthroplasty procedure, severe instability at the second through fifth carpometacarpal joints was observed, and arthrodesis of these joints was required. The radiographs obtained nine months after surgery showed loosening of the carpal component. Subsequently, she suffered a stroke, resulting in a loss of follow-up, and higher stress was loaded on her upper extremities during standing and walking. In the radiograph taken at her revisit 25 months after the primary surgery, the subsidence of the carpal component progressed, and loosening of the radial component was observed. Total wrist arthrodesis was performed using a bulk bone allograft of the femoral head, combined with a penetrating Wrist Fusion Rod®. Rapid bone union was achieved without soft tissue irritation. We conclude that wrist arthrodesis with a bulk bone allograft combined with an intramedullary nail is a reasonable option for failed total wrist arthroplasty.

DOI： 10.1093/mrcr/rxad048

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

Mesenchymal stem cells (MSCs) are used as a major source for cell therapy, and its application is expanding in various diseases. On the other hand, reliable method to evaluate quality and therapeutic properties of MSC is limited. In this study, we focused on TWIST1 that is a transcription factor regulating stemness of MSCs and found that the transmembrane protein LRRC15 tightly correlated with the expression of TWIST1 and useful to expect TWIST1-regulated stemness of MSCs. The LRRC15-positive MSC populations in human and mouse bone marrow tissues highly expressed stemness-associated transcription factors and therapeutic cytokines, and showed better therapeutic effect in bleomycin-induced pulmonary fibrosis model mice. This study provides evidence for the important role of TWIST1 in the MSC stemness, and for the utility of the LRRC15 protein as a marker to estimate stem cell quality in MSCs before cell transplantation.

DOI： 10.1016/j.isci.2023.106946

PubMed

researchmap

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

OBJECTIVE: We retrospectively reviewed the records of rheumatoid arthritis (RA) patients who underwent orthopaedic surgery to examine the influence of the perioperative use of Janus kinase (JAK) inhibitors on early postoperative complications. PATIENTS AND METHODS: Thirty-two patients with RA under disease control with JAK inhibitors who underwent 49 orthopaedic procedures were included in the study. Patient records after surgery were investigated for surgical site infection (SSI), delayed wound healing (DWH), flare-up of the disease, pre-and postoperative absolute lymphocyte counts (ALCs), venous thromboembolism and other postoperative complications. RESULTS: JAK inhibitors were continued during the perioperative period in 31 procedures. In the remaining 18 procedures, JAK inhibitors were discontinued perioperatively with a mean discontinuation period of 2.4 days. No instances of SSI were identified in any patient during at least 90 days' follow-up, while DWH was seen in one patient. Disease flare-up was noted in two patients after 3 and 9 days of discontinuation of JAK inhibitors, respectively. The ALCs significantly decreased on postoperative Day 1 (P < 0.0001) and there was a significant correlation between pre- and post-one day ALCs (r = 0.75, P < 0.0001). CONCLUSION: JAK inhibitors seem to be safe during the perioperative period of orthopaedic surgery.

DOI： 10.1093/mr/road047

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨・関節感染症学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

PURPOSE: The aim of this study was to compare the clinical outcomes of different subtypes of type 2 medial meniscus posterior root tears following transtibial pullout repair. METHODS: In total, 147 patients (mean age: 66.2 ± 8.3 years) who were diagnosed with type 2 medial meniscus posterior root tears and underwent transtibial pullout repair were included. Patients were divided into 2A (n = 31), 2B (n = 90), and 2C (n = 26) groups according to tear type. Clinical outcomes were assessed pre-operatively and at second-look arthroscopy using the Knee injury and Osteoarthritis Outcome Score. The meniscal healing status was evaluated at second-look arthroscopy. Medial meniscus extrusion was calculated using magnetic resonance imaging pre-operatively and at second-look arthroscopy. RESULTS: No significant differences in pre-operative or post-operative clinical scores were observed between each subtype, although clinical scores improved post-operatively for each subtype. Significant differences were noted in the anteroposterior width of the bridging tissues at second-look arthroscopy (2A, 7.1 ± 1.2; 2B, 6.2 ± 1.7; and 2C, 6.2 ± 1.7 mm; p = 0.045); type 2A tears were the widest. There was a significant difference in post-operative medial meniscus extrusion (2A, 3.2 ± 0.9; 2B, 4.0 ± 1.2; and 2C, 4.0 ± 1.4 mm; p = 0.004) and its progression (2A, 0.7 ± 0.6; 2B, 1.2 ± 0.8; and 2C, 1.2 ± 0.8 mm; p = 0.008), and type 2A tears were the shortest. CONCLUSION: Although there was no significant difference in the post-operative clinical scores among different type 2 tears in the short term, type 2A tears showed better healing and medial meniscus extrusion progression prevention, thus indicating the usefulness of classifying tear type in estimating post-operative outcomes. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-022-07293-9

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本関節病学会  

researchmap

Language：Japanese   Publisher：(一社)日本関節病学会  

researchmap

Language：Japanese   Publisher：(一社)日本関節病学会  

researchmap

Language：Japanese   Publisher：(一社)日本関節病学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：日本運動器科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨・関節感染症学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨・関節感染症学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨・関節感染症学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：English  

Although there are some reports highlighting the applicability of double plates in distal femoral fractures, there is no standard approach or fixation method for supracondylar fractures combined with posterior coronal shear fractures. We report a case of distal femoral fracture treated with a lateral locking plate and posterior buttress plate using anterolateral and posterolateral approaches from one incision. A 70-year-old man was hit by a motorcycle and had an intra-articular distal femoral fracture involving a long medial proximal spike and a single lateral condyle fragment, with the lateral condyle fragment posteriorly displaced. A 12-cm lateral skin incision was made, and the joint was developed using a para-patellar approach from the anterior to iliotibial band. Posterior buttress plate fixation was successfully performed from behind the iliotibial band using a posterolateral approach, followed by cannulated cancellous screw and lateral locking plate fixation from the anterolateral window. Combined anterolateral and posterolateral approaches from one incision enable intra-articular exposure and fixation based on fixation principles for lateral condyle fragments combined with supracondylar fracture.

DOI： 10.1016/j.tcr.2023.100803

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本移植学会  

researchmap

Language：Japanese   Publisher：(一社)日本移植学会  

researchmap

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

BACKGROUND/OBJECTIVE: Accurate tibial tunnel creation is crucial for successful transtibial pullout repair of medial meniscus (MM) posterior root tears (MMPRTs). This study aimed to evaluate the accuracy of the newly developed Zimmer Biomet Root Aiming (ZeBRA) guide for transtibial pullout repair of MMPRTs. METHODS: This study included 50 patients who underwent transtibial pullout repair using the Unicorn Meniscal Root (UMR) (n = 25) and ZeBRA (n = 25) guides. The expected anatomic centre (AC) and tibial tunnel centre (TC) were assessed using three-dimensional postoperative computed tomography (CT) images. The expected AC was defined as the centre of the circle tangent to the triangular footprint of the MM posterior root. The expected AC and TC on the tibial surface were assessed using the percentage-based posterolateral location on the tibial surface. The absolute distance between the AC and TC (mm) was evaluated. RESULTS: The mean AC location was 76.1% ± 3.1% posterior and 40.8% ± 2.1% lateral, whereas the mean TC location was 76.7% ± 5.3% posterior and 37.2% ± 3.6% lateral using the UMR guide and 75.8% ± 3.1% posterior and 36.5% ± 2.4% lateral using the ZeBRA guide. No significant difference was observed in the absolute distance between the UMR and ZeBRA guides (3.9 ± 1.4 and 3.8 ± 1.3 mm, respectively; p = 0.617). CONCLUSIONS: The newly developed ZeBRA guide allows accurate tibial tunnel creation, and its accuracy is comparable to that of the conventional UMR guide. Tibial tunnels were created at optimal positions using both guides, and the choice of the guide would depend on the surgeon's preference.

DOI： 10.1016/j.asmart.2023.03.001

PubMed

researchmap

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

Rupture of the extensor pollicis longus (EPL) tendon is a known complication after undisplaced distal radius fracture (DRF). However, no report has revealed the relationship between EPL tendon rupture and the fracture pattern. Thus, this study aimed to investigate the characteristics of fractures at risk of EPL tendon rupture using fracture line mapping of undisplaced DRFs. This study used computed tomography imaging data of undisplaced DRFs with (n=18) and without EPL tendon rupture (n=52). Fracture lines obtained from 3D reconstruction data were drawn manually after matching with a 2D template wrist model. Fracture maps represented the fracture line distribution by superimposing the fracture lines of all 70 patients. Heat maps showed the relative frequency of the fracture lines as a gradual color change. Fracture lines of cases with EPL tendon rupture were concentrated in the proximal border of Lister's tubercle. By contrast, fracture lines of cases without EPL tendon rupture were relatively dispersed.

DOI： 10.18926/AMO/65147

PubMed

researchmap

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

researchmap

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

researchmap

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

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

症例は21歳男性で、左下腿脛骨外側部のグロムス腫瘍切除術後2ヵ月経過した時点で左下腿の疼痛が再燃した。MRIでは左脛骨前面、脛骨後面、脛腓間、腓骨周囲に多発性の腫瘤を認め、これら全病変を辺縁切除した。病理検査では全てグロムス腫瘍と診断され、術後1年の時点で疼痛の再燃や腫瘍の再発は認めず、趣味のダンスも再開している。

researchmap

Language：Japanese   Publisher：(一社)日本脊椎脊髄病学会  

researchmap

Language：Japanese   Publisher：(一社)日本脊椎脊髄病学会  

researchmap

Language：Japanese   Publisher：(一社)日本脊椎脊髄病学会  

researchmap

Language：Japanese   Publisher：(一社)日本脊椎脊髄病学会  

researchmap

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

BACKGROUND: Patients with partial medial meniscus posterior root tears (MMPRTs) sometimes require arthroscopic pullout repair because of their intolerable/repeated knee pains and continuous disturbance in gait during activities of daily living. However, the predisposing factors for future knee surgery in patients with partial MMPRTs remain unclear. We compared the findings of magnetic resonance imaging (MRI) between patients who underwent pullout repair and nonoperative management following partial MMPRTs. METHODS: Twenty-five patients who required arthroscopic repair for partial MMPRTs and 23 patients who were managed nonoperatively were evaluated during a mean follow-up period of 27.1 months. Sex, age, height, body weight, body mass index, duration from onset to initial MRI, MRI findings, and medial meniscus (MM) extrusion were compared between the two groups. Linear regression analysis was used to assess the correlation between MM extrusion and duration from onset to MRI examination. RESULTS: No significant differences were observed between the pullout repair and nonoperative management groups in terms of patient demographics and the positive ratio of MRI-based root tear signs. However, absolute MM extrusion in the pullout repair group (3.49 ± 0.82 mm) was larger than that in the nonoperative management group (2.48 ± 0.60 mm, P < 0.001). Extrusion of the MM (> 3 mm) was detected more frequently in the pullout repair group than in the nonoperative management group (P < 0.001). The odds ratio in the pullout repair and MM extrusion > 3 mm cases was 9.662. Linear regression analysis revealed a fair correlation between the duration from onset to MRI and MM extrusion only in the pullout repair group (0.462 mm/month increase in MM extrusion). CONCLUSIONS: This study demonstrated that more severe MM extrusions were observed in the pullout repair group than in the nonoperative management group. Major extrusion (> 3 mm) was also observed more in the pullout repair group than in the nonoperative group. Assessing MM extrusion and its severity can help determine a valid treatment for patients with partial MMPRTs. LEVEL OF EVIDENCE: IV, Retrospective comparative study.

DOI： 10.1186/s43019-023-00182-6

PubMed

researchmap

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

BACKGROUND: Soft tissue sarcomas (STS) are a rare type of malignancy comprising a variety of histological diagnoses. Chemotherapy constitutes the standard treatment for advanced STS. Doxorubicin-based regimens, which include the administration of doxorubicin alone or in combination with ifosfamide or dacarbazine, are widely accepted as first-line chemotherapy for advanced STS. Trabectedin, eribulin, pazopanib, and gemcitabine plus docetaxel (GD), which is the empirical standard therapy in Japan, are major candidates for second-line chemotherapy for advanced STS, although clear evidence of the superiority of any one regimen is lacking. The Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group (JCOG) conducts this trial to select the most promising regimen among trabectedin, eribulin, and pazopanib for comparison with GD as the test arm regimen in a future phase III trial of second-line treatment for patients with advanced STS. METHODS: The JCOG1802 study is a multicenter, selection design, randomized phase II trial comparing trabectedin (1.2 mg/m2 intravenously, every 3 weeks), eribulin (1.4 mg/m2 intravenously, days 1 and 8, every 3 weeks), and pazopanib (800 mg orally, every day) in patients with unresectable or metastatic STS refractory to doxorubicin-based first-line chemotherapy. The principal eligibility criteria are patients aged 16 years or above; unresectable and/or metastatic STS; exacerbation within 6 months prior to registration; histopathological diagnosis of STS other than Ewing sarcoma, embryonal/alveolar rhabdomyosarcoma, well-differentiated liposarcoma and myxoid liposarcoma; prior doxorubicin-based chemotherapy for STS, and Eastern Cooperative Oncology Group performance status 0 to 2. The primary endpoint is progression-free survival, and the secondary endpoints include overall survival, disease-control rate, response rate, and adverse events. The total planned sample size to correctly select the most promising regimen with a probability of > 80% is 120. Thirty-seven institutions in Japan will participate at the start of this trial. DISCUSSION: This is the first randomized trial to evaluate trabectedin, eribulin, and pazopanib as second-line therapies for advanced STS. We endeavor to perform a subsequent phase III trial comparing the best regimen selected by this study (JCOG1802) with GD. TRIAL REGISTRATION: This study was registered with the Japan Registry of Clinical Trials ( jRCTs031190152 ) on December 5, 2019.

DOI： 10.1186/s12885-023-10693-w

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(株)癌と化学療法社  

researchmap

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00296&link_issn=&doc_id=20230324430008&doc_link_id=%2Fab8gtkrc%2F2023%2F005003%2F009%2F0314-0320%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2023%2F005003%2F009%2F0314-0320%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

researchmap

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

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

researchmap

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

researchmap

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

Spinal metastases are common in patients with advanced stages of cancer and frequently cause vertebral body collapse (VBC). Although conventional radiotherapy (RT) is used for spinal metastases, the rates of occurrence of new VBC and progression of VBC at RT initiation have not been fully investigated. The present retrospective study assessed VBC and its associated risk factors after RT over time and evaluated new VBC and progression of VBC in patients who presented with VBC at RT initiation. The study evaluated 177 patients who received RT for vertebral metastases without paralysis between July 2012 and November 2016. Radiological responses of the irradiated vertebrae were assessed using computed tomography. Follow-up assessments were performed at RT initiation and 1, 2, 3, 4 and 6 months after RT. New VBC occurred in 12% of patients with no prior VBC within 1 month of RT. Multivariate analysis revealed that numeric rating scale (NRS) score (≥4) [relative risk (RR), 27.1; 95% confidence interval (CI), 1.86 to 394.9; P=0.016] was associated with the occurrence of new VBC at the 1 month follow-up time point. VBC progression occurred in 51% of the patients with collapse at RT initiation. Multivariate analysis revealed that bone quality (lytic metastases) (RR, 3.1; 95% CI, 1.28 to 7.70; P=0.013), NRS score (≥4) (RR, 3.0; 95% CI, 1.18 to 7.45; P=0.021) and tumor involvement of posterolateral elements of the spine (RR, 2.7; 95% CI, 1.03 to 7.29; P=0.04) were associated with the progression of VBC at the 1 month follow-up time point. The current study findings suggested that clinicians should pay attention to the factors that predict the occurrence of new VBC and VBC progression to ensure proper evaluation of conservative treatment effectiveness and facilitate the determination of patients who need close monitoring.

DOI： 10.3892/ol.2023.13695

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

【背景】脛骨骨幹部骨折に対しては髄内釘固定が標準的治療である.しかしながら,脛骨近位および遠位骨幹部骨折においては,髄腔径が広いことや膝屈曲位での整復位の獲得およびその確認が困難なことから,変形癒合の報告が散見される.【目的】脛骨遠位骨幹部骨折における髄内釘固定において,infra-patellar approachとsemi-extended approachの2つのアプローチ間で術後整復位の比較を行い,適したアプローチを選択する.【研究デザイン】過去起点コホート研究.【設定】大学附属病院と関連病院の2施設.【対象】2012～21年において,脛骨遠位骨幹部骨折に対し髄内釘固定を行い,小児や骨癒合までフォローできなかった症例などを除外した56例(男性36例,女性20例)を対象とした.使用インプラントや免荷期間は各施設の判断に委ねた.【方法】2つのアプローチ間での術後整復位(正面天蓋角を測定し,内外反角の絶対値を計測)を比較検討した.また,年齢,性別,BMI,骨折型(AO/OTA分類),nail径,最峡部径,骨癒合期間についても比較を行った.各々の検討項目をFisher's exact test,Mann-Whitney U testを用い有意水準5%で群間比較検討した.【結果】Infra-patellar approach 37例,semi-extended approach 19例であり,内外反変形において有意差を認めた(infra-patellar:3.65°,semi-extended:2.11°,p<0.05).足関節アライメント以外の検討項目においてはアプローチ間での有意差は認めなかった.【結論】脛骨遠位骨幹部骨折における髄内釘固定後の足関節アライメントは,semi-extended approachの方がinfra-patellar approachよりも良好であった.(著者抄録)

researchmap

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

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

【背景】脛骨プラトーおよび骨幹部の合併骨折は高エネルギー外傷に伴って認められることが多い.単一のインプラント固定では治療困難である場合も認められ,骨折型や軟部状態に応じて内固定方法の選択が重要である.【目的】比較的稀な脛骨プラトーおよび骨幹部骨折を合併した9例を経験し,骨折型による内固定方法の選択を検討したので報告する.【方法】2009～20年において,高エネルギー外傷で受傷した脛骨プラトーおよび骨幹部合併骨折に対して内固定を行い,骨癒合まで経過観察可能であった9例(男性5名,女性4名)を対象とし,骨折型と内固定方法を後ろ向きに検討した.【結果】平均年齢66(45～86)歳,受傷機転は交通外傷6例,転落外傷3例であった.そのうち開放骨折2例,コンパートメント症候群2例を認めた.内固定方法の内訳として,外側プレート固定1例,内側と外側のプレート固定(以下,ダブルプレート固定)3例,外側(内側)プレートおよび髄内釘固定4例,関節面スクリューおよび髄内釘固定1例であった.また外側プレートおよび髄内釘固定を予定していた1例において,術中に髄内釘挿入部近傍の骨折が顕在化し,整復位の保持が困難となったためダブルプレート固定に変更した.【結論】脛骨プラトー・骨幹部合併骨折の内固定方法として,外側プレート固定,ダブルプレート固定,外(内)側プレート(またはスクリュー)および髄内釘固定が報告されており,骨折型や骨幹部骨折の位置,軟部組織の状態が内固定方法の選択要因となっている.今回我々が経験した症例のなかで,術中の整復不良により内固定方法を変更した1例は,後方で脛骨プラトーと骨幹部にかけて骨折線が連続しており,髄内釘挿入のアプローチはinfrapatellar approachであった.他の同様な骨折型に対して髄内釘固定を行った症例では,suprapatellar approachが選択されていた.脛骨プラトーと骨幹部の骨折線が連続している不安定な骨折の場合には,suprapatellar approachが選択されるべきである.(著者抄録)

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

researchmap

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

BACKGROUND: Cell sheet fabrication for articular cartilage regenerative medicine necessitates a large number of chondrocytes of consistent quality as a cell source. Previously, we have developed human-induced pluripotent stem cell (iPSC)-derived expandable PRRX1+ limb-bud mesenchymal cells (ExpLBM) with stable expansion and high chondrogenic capacity, while in this study; our ExpLBM technology was combined with cell sheet engineering to assess its potential as a stable cell source for articular cartilage regeneration. METHODS: ExpLBM cells derived from human-induced pluripotent stem cells (hiPSCs), including 414C2 and Ff-KVs09 (HLA homozygous), were seeded onto a culture plate and two-dimensional chondrogenic induction (2-DCI) was initiated. After 2-DCI, ExpLBM-derived chondrocytes were stripped and transferred to temperature-responsive culture inserts and the chondrocyte sheets were histologically examined or transplanted into osteochondral knee defects of immunodeficient rats. RESULTS: Immunohistochemistry revealed that ExpLBM-derived cell sheets were positive for Safranin O, COL2, and ACAN but that they were negative for COL1 and RUNX2. Furthermore, the engrafted tissues in osteochondral knee defects in immunodeficient rats were stained with SafO, human VIMENTIN, ACAN, and COL2. CONCLUSIONS: The present study is the first to report the chondrocyte sheet fabrication with hiPSC-derived cell source. hiPSC-derived ExpLBM would be a promising cell source for cell sheet technology in articular cartilage regenerative medicine.

DOI： 10.1186/s13287-023-03252-4

PubMed

researchmap

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

Cancer stem-like cells (CSCs) have a unique translation mode, but little is understood about the process of elongation, especially the contribution of tRNA modifications to the maintenance of CSCs properties. Here, it is reported that, contrary to the initial aim, a tRNA-modifying methylthiotransferase CDKAL1 promotes CSC-factor SALL2 synthesis by assembling the eIF4F translation initiation complex. CDKAL1 expression is upregulated in patients with worse prognoses and is essential for maintaining CSCs in rhabdomyosarcoma (RMS) and common cancers. Translatome analysis reveals that a group of mRNAs whose translation is CDKAL1-dependent contains cytosine-rich sequences in the 5' untranslated region (5'UTR). Mechanistically, CDKAL1 promotes the translation of such mRNAs by organizing the eIF4F translation initiation complex. This complex formation does not require the enzyme activity of CDKAL1 but requires only the NH2 -terminus domain of CDKAL1. Furthermore, sites in CDKAL1 essential for forming the eIF4F complex are identified and discovered candidate inhibitors of CDKAL1-dependent translation.

DOI： 10.1002/advs.202206542

PubMed

researchmap

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

BACKGROUND: In chronic musculoskeletal pain patients, detection of sarcopenia is of significant clinical interest. Phase angle, which can be measured through bioelectrical impedance analysis (BIA), can detect sarcopenia; however, the evidence in chronic musculoskeletal pain patients is limited. This study aimed to assess the relationship between phase angle and sarcopenia in patients with chronic musculoskeletal pain. Our hypothesis was that phase angle would be a useful indicator to identify sarcopenia in patients with chronic musculoskeletal pain. METHODS: A total of 190 patients (51 men and 139 women) with chronic musculoskeletal pain were included in this retrospective cross-sectional study. Patient data of backgrounds, numeric rating scale score for pain, skeletal muscle index, and phase angle assessed using BIA were retrospectively reviewed. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. RESULTS: A total of 51 patients (26.7%), including 10 men (19.6%) and 41 women (29.5%), were diagnosed with sarcopenia. Phase angle, sarcopenia-related factors, age, and body mass index (BMI) differed significantly in patients with and without sarcopenia. On multiple logistic regression analysis, the prevalence of sarcopenia was significantly correlated with phase angle and BMI. The areas under the curve exhibited high accuracy in discriminating sarcopenia in men and moderate accuracy in both sexes and in women. CONCLUSIONS: Phase angle may be a valid discriminator of sarcopenia in patients with chronic musculoskeletal pain.

DOI： 10.1186/s13018-023-03567-1

PubMed

researchmap

Language：Japanese   Publisher：日本レックリングハウゼン病学会  

researchmap

Language：Japanese   Publisher：日本レックリングハウゼン病学会  

researchmap

Language：Japanese   Publisher：日本レックリングハウゼン病学会  

researchmap

Language：Japanese   Publisher：日本肘関節学会  

researchmap

Language：Japanese   Publisher：日本肘関節学会  

researchmap

Language：Japanese   Publisher：日本肘関節学会  

researchmap

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

PubMed

researchmap

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

PubMed

researchmap

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)

researchmap

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

PubMed

researchmap

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。

researchmap

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

Publishing type：Part of collection (book)   Publisher：Springer US  

DOI： 10.1007/978-1-0716-2744-0_15

researchmap

Language：Japanese   Publisher：日本リウマチの外科学会  

researchmap

Language：Japanese   Publisher：日本リウマチの外科学会  

researchmap

Language：Japanese   Publisher：日本肘関節学会  

researchmap

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

PubMed

researchmap

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 &lt; 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

PubMed

researchmap

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

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

researchmap

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

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)

researchmap

Language：Japanese   Publisher：西日本脊椎研究会  

researchmap

Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jos.2022.09.017

researchmap

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

Abstract

Background

There are no recommendations for specific suture materials in transtibial pullout repair of medial meniscus posterior root tears. This study aimed to evaluate the clinical outcomes of transtibial pullout repair of medial meniscus posterior root tears using ultrahigh-molecular-weight polyethylene sutures and suture tape.

Methods

We retrospectively reviewed the data of 36 patients (27 women and 9 men, mean age 64.1 years) who had undergone transtibial pullout repair of medial meniscus posterior root tears between November 2018 and December 2019. Two groups of 18 patients each received either two different cord-like sutures or suture tape. Clinical parameters were assessed preoperatively and on second-look arthroscopy (mean postoperative period 12 months). The meniscal healing status was assessed using a previously published scoring system (ranging from 0 to 10), and the incidence rate of suture cut-out was assessed on second-look arthroscopy.

Results

All clinical scores significantly improved in both groups, with no significant between-group differences on second-look arthroscopy. The arthroscopic meniscal healing scores significantly differed between sutures (mean 6.7 points) and suture tape (mean 7.4 points; p = 0.044). No significant between-group difference in the suture cut-out rate was observed.

Conclusions

This study found no significant differences in the clinical outcomes between ultrahigh-molecular-weight polyethylene sutures and suture tape. Favorable clinical outcomes were obtained using both types of suture; however, the usefulness of suture tape appears to be limited.

DOI： 10.1186/s43019-022-00167-x

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1186/s43019-022-00167-x/fulltext.html

Authorship：Last author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.knee.2022.08.010

researchmap

Language：Japanese   Publisher：(一社)日本運動器疼痛学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

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

researchmap

Language：English   Publisher：(一社)日本癌治療学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌治療学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌治療学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(一社)日本小児血液・がん学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

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

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

Chronic pain coexists with disability, anxiety, depression, and sleep disturbances, which are factors of pain chronicity in the fear-avoidance model. Self-efficacy for managing pain plays a protective role against pain chronicity. For chronic pain sufferers, social support from caregivers is important. However, such caregivers face enormous physical and mental burdens. This study aimed to assess how self-efficacy and factors related to the fear-avoidance model affect caregiver burden. Participants were 135 chronic pain patients and their caregivers who visited our outpatient pain special clinic. In clinical assessments, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), Athens insomnia scale (AIS), pain disability assessment scale (PDAS), pain self-efficacy questionnaire (PSEQ) for the patients and Zarit Burden Interview (ZBI) for their caregivers were evaluated. Participants were divided into 2 groups (L group ZBI < 24 points and H group ZBI ≥ 24 points) and compared. Regression analyses were conducted to identify factors correlated with the ZBI scores. Compared to L group, H group showed significantly higher NRS and HADs depression scores, and lower PSEQ scores. In univariate regression analysis, ZBI scores were significantly correlated with NRS, PCS, HADS anxiety, HADS depression, PDAS and PSEQ. Multiple linear regression analysis revealed that ZBI scores were significantly correlated with PSEQ. The caregivers who perceived high caregiver burden had significantly higher patients' pain intensity, depression, and lower self-efficacy than those who perceived low caregiver burden. Caregiver burden correlated with the pain intensity, pain catastrophizing, anxiety, depression, disability, and self-efficacy of chronic pain patients. Among these factors, self-efficacy was the most negatively correlated with caregiver burden. Treatments focused on increasing self-efficacy for managing pain have the potential to reduce caregiver burden.

DOI： 10.1097/md.0000000000030802

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

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

Giant cell tumor of bone (GCTB) is an intermediate bone tumor that rarely undergoes malignant transformation. Secondary malignant GCTB (SMGCTB) is defined as a lesion in which high-grade sarcoma occurs at the site of previously treated GCTB. The present study retrospectively reviewed the medical records of patients with GCTB treated at Okayama University Hospital between April 1986 and April 2020. The clinicopathological and histological features of patients with SMGCTB without prior radiotherapy were investigated. A total of three patients (4%) with SMGCTB were detected, and the tumor sites were the distal ulna, distal femur and sacrum. Two of the patients had been treated with curettage and bone graft, and one had been treated with denosumab. In all cases, the lesions were made up of two components, the conventional GCTB component and the malignant component. The Ki67 labeling index was higher in the malignant components of SMGCTB and metastatic lesions compared with that in primary and recurrent conventional GCTB, or the conventional GCTB component of SMGCTB. Moreover, p53 expression was higher in these same components in patients who underwent curettage and bone grafting; however, there was no difference in the patient that received denosumab treatment. In this patient, clinical cancer genomic profiling revealed loss of CDKN2A, CDKN2B and MTAP expression. All three patients developed distant metastasis. The patients with SMGCTB in the ulna and femur died 13 and 54 months after detection of malignant transformation, respectively. The patient with SMGCTB in the sacrum received carbon-ion radiotherapy to the sacrum and pazopanib; the treatment was effective and the patient was alive at the last follow-up 3 years later. In conclusion, p53 may be associated with malignant transformation in GCTB. Future studies should investigate the association of between denosumab treatment and malignant transformation, as well as molecular targeted therapy to improve the clinical outcomes of SMGCTB.

DOI： 10.3892/ol.2022.13439

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jos.2022.08.005

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本関節病学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本関節病学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：English   Publisher：(一社)日本癌学会  

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

症例1は86歳女で、プラトー骨折のAO/OTA分類は41B2.1.、骨幹部骨折は42A3であった。治療方法は外側プレートと髄内釘を用いて固定した。症例2は74歳男で、プラトー骨折のAO/OTA分類は41C1.1.、骨幹部骨折は42A1で、治療方法はダブルプレート固定を行った。症例3は67歳女で、プラトー骨折は41B1.1.、骨幹部骨折は42B1で、スクリューと髄内釘による固定を計画したが、術中に髄内釘挿入部近傍の骨折が顕在化し、整復位の保持が困難となったためダブルプレート固定に変更した。3例とも骨癒合が得られた。

researchmap

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J02438&link_issn=&doc_id=20221011120020&doc_link_id=%2Fcm4ortho%2F2022%2F003402%2F020%2F0287-0290%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2022%2F003402%2F020%2F0287-0290%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

Tarsometatarsal joint(TMT関節)損傷例の中で、内側楔状骨の脱臼を伴った症例は極めて稀である。今回、内側楔状骨の背側脱臼骨折を伴ったTMT関節損傷の1例を経験した。症例は14歳女性で、自動車のタイヤが左足部を轢過して受傷した。手術では、脱臼した楔状骨を含めて内側カラムを再建するために、舟状骨から中足骨まで架橋する強固なプレート固定を行い、術後に損傷部の再転位は認めなかったが、術後徐々に外反母趾が進行した。その原因として、内側カラムの整復不良による第1中足骨の内反(M1-M2角の開大)が残存したことと、内側の軟部組織損傷による不安定性が残存したことが考えられた。

researchmap

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00831&link_issn=&doc_id=20221201050037&doc_link_id=10.11359%2Fchubu.2022.705&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2022.705&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Publishing type：Research paper (scientific journal)   Publisher：Hindawi Limited  

Lateral meniscus (LM) posterior root tear (LMPRT) is mainly caused by trauma, especially trauma associated with anterior cruciate ligament (ACL) injuries. Although a transtibial pullout repair or a side-to-side repair is commonly performed for LMPRT, to the best of our knowledge, there is no clinical report of LMPRT with tissue loss using the pullout technique. Thus, the purpose of this report was to describe a clinical, radiographic, and arthroscopic outcome after pullout repair for a case of LMPRT with a large defect with a chronic ACL tear and complex medial meniscus (MM) tears. A 31-year-old man complained of knee pain and restricted range of motion after twisting his knee when he stepped on an iron pipe. The patient had a football-related injury to his right knee 14 years before presentation, and since then, the patient’s knee has given out more than 10 times but was left unassessed. Magnetic resonance imaging showed LMPRT with tissue loss, ACL tears, and complex MM tears. Transtibial pullout repair of the LMPRT with ACL reconstruction and MM repairs were performed. Following the pullout repair of the LMPRT, an approximately 6 mm gap remained between the LM posterior root and root insertion. However, magnetic resonance imaging and second-look arthroscopy at 1 year postoperatively revealed meniscal healing, gap filling with some regeneration tissue, of the LM posterior root. Furthermore, the lateral meniscus extrusion in the coronal plane improved from 3.1 mm (preoperative) to 1.6 mm (1 year postoperatively). Transtibial pullout repair with the remaining gap could be a viable treatment option for LMPRT with tissue loss, combined with ACL reconstruction.

DOI： 10.1155/2022/9776388

researchmap

Other Link： http://downloads.hindawi.com/journals/crior/2022/9776388.xml

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

Failed internal fixations for trochanteric fractures have a strong negative impact owing to increased postoperative mortality and high medical costs. However, evidence on the prognostic value of postoperative radiographic findings for failed internal fixations is limited. We aimed to clarify the association between comprehensive immediate postoperative radiographic findings and failed internal fixation using relative and absolute risk measures. We followed the meta-analysis of observational studies in epidemiology guidelines and the Cochrane handbook. We searched specific databases in November 2021. The outcomes of interest were failed internal fixation and cut-out. We pooled the odds ratios and 95% confidence intervals using a random-effects model and calculated the number needed to harm for each outcome. Thirty-six studies involving 8938 patients were included. The certainty of evidence in the association between postoperative radiographic findings and failed internal fixation or cut-out was mainly low or very low except for the association between intramedullary malreduction on the anteromedial cortex and failed internal fixation. Moderate certainty of evidence supported that intramedullary malreduction on the anteromedial cortex was associated with failed internal fixation. Most postoperative radiographic findings on immediate postoperative radiographs for trochanteric fractures were uncertain as prognostic factors for failed internal fixations.

DOI： 10.3390/jcm11164879

PubMed

researchmap

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

PURPOSE: Medial meniscus posterior root tears (MMPRTs) occur most frequently in middle-aged and older adults. However, this serious condition can also occur in younger patients. The purpose of this study was to compare anterior cruciate ligament (ACL) degeneration and sagittal medial tibial slope in young adults with and without MMPRT. METHODS: Eighteen healthy volunteers, 18 young patients (20-49 years of age), and 30 middle-aged and older patients (50-70 years of age) with MMPRT repair were included in the study. Sex, body mass index (BMI), femorotibial angle, ACL degeneration, and medial tibial slope angle were compared among the groups. ACL degeneration and medial tibial slope angle were assessed using magnetic resonance imaging. RESULTS: In the healthy volunteer group, the young patient group, and the older patient group, the medial tibial slopes were 3.5° ± 1.4°, 6.1° ± 2.7°, and 7.2° ± 1.9°, respectively, and the ACL degeneration rates were 5.6%, 38.9%, and 43.3%, respectively. Young patients with MMPRT had significantly steeper medial tibial slopes and ACL degeneration compared to those of the healthy volunteers (P < 0.05). The parameters of young patients were similar to those of older patients with MMPRT. In the multivariate logistic regression analysis, BMI, medial tibial slope, and ACL degeneration were significantly associated with MMPRT in young patients. CONCLUSION: BMI, steep medial tibial slope, and ACL degeneration contribute to MMPRT development in younger patients. LEVEL OF EVIDENCE: Level III.

DOI： 10.1007/s00167-022-07095-z

PubMed

researchmap

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

DOI： 10.1007/s00068-022-02079-7

researchmap

Other Link： https://link.springer.com/article/10.1007/s00068-022-02079-7/fulltext.html

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

Malignant wounds (MWs) are rare skin lesions, which accompany ulceration, necrosis and infection caused by infiltration or damage by malignant tumor. The present study aimed to investigate the bacterial etiology implicated in MW in soft tissue sarcoma (STS), and the effectiveness of culture-guided perioperative antibacterial administration. A retrospective evaluation was conducted on medical records of patients who presented with MW between 2006 and 2020. A total of seven patients were included in the present study, in whom all tumors were relatively large (>5 cm) and high-grade. Subsequently, five patients underwent limb-sparing surgery, and three patients had distant metastases with a 5-year overall survival of 71%. Preoperative microbiological sampling from the wound identified 11 different bacterial strains in five patients. The infections were polymicrobial with an average of 2.6 strains isolated per patient (1 aerobic, 1.6 anaerobic bacteria). They were predominantly methicillin-sensitive Staphylococcus aureus. Patients with MWs from STS reported symptoms, including bleeding (71%), exudation (71%) and malodorous wound (43%) at the initial presentation; these completely resolved after surgery. All but one patient reported pain at the MW site with an average numeric rating scale of 4.4 at presentation that decreased to 1.4 (P=0.14) and 0.6 (P=0.04) one and two weeks after surgery, respectively. The patients had elevated C-reactive protein (71%), anemia (57%), low albumin (86%) and renal/liver dysfunction (14-29%). One patient was diagnosed with sepsis. Surgical resection afforded symptomatic relief and resolution of abnormal laboratory values. Although selected antibiotics were administered in four patients based on the preoperative antibiotic sensitivity test, surgical site infection (SSI) occurred in three patients. Therefore, the effectiveness of the selected antibiotics based on the results of the preoperative culture in preventing SSI needs to be investigated in the future. In conclusion, physicians should keep in mind that although surgical resection can improve the symptoms and abnormal values in laboratory examination form MW, it is accompanied with a high rate of SSI and poor prognosis.

DOI： 10.3892/ol.2022.13465

PubMed

researchmap

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

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare histological subtype of soft-tissue sarcoma, which remains refractory to conventional cytotoxic chemotherapy. We aimed to characterize ASPS and investigate whether the oncological outcome has improved over the past decade. METHODS: One hundred and twenty patients with newly diagnosed ASPS from 2006 to 2017, identified from the Bone and Soft-Tissue Tumor Registry in Japan, were analyzed retrospectively. RESULTS: The study cohort comprised 34 (28%) patients with localized ASPS and 86 (72%) with metastatic disease at presentation. The 5-year disease-specific survival (DSS) was 68% for all patients and 86% and 62% for localized and metastatic disease, respectively (p = 0.019). Metastasis at presentation was the only adverse prognostic factor for DSS (hazard ratio [HR]: 7.65; p = 0.048). Patients who were > 25 years (80%; p = 0.023), had deep-seated tumors (75%; p = 0.002), and tumors > 5 cm (5-10 cm, 81%; > 10 cm, 81%; p < 0.001) were more likely to have metastases at presentation. In patients with localized ASPS, adjuvant chemotherapy or radiotherapy did not affect survival, and 13 patients (45%) developed distant metastases in the lung (n = 12, 92%) and brain (n = 2, 15%). In patients with metastatic ASPS (lung, n = 85 [99%]; bone, n = 12 [14%]; and brain n = 9 [11%]), surgery for the primary or metastatic site did not affect survival. Prolonged survival was seen in patients who received pazopanib treatment (p = 0.045), but not in those who received doxorubicin-based cytotoxic chemotherapy. Overall, improved DSS for metastatic ASPS has been observed since 2012 (5-year DSS, from 58 to 65%) when pazopanib was approved for advanced diseases, although without a statistically significant difference (p = 0.117). CONCLUSION: The national study confirmed a unique feature of ASPS with frequent metastasis to the lung and brain but an indolent clinical course. An overall trend toward prolonged survival after the introduction of targeted therapy encourages continuous efforts to develop novel therapeutic options for this therapeutically resistant soft-tissue sarcoma.

DOI： 10.1186/s12885-022-09968-5

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1186/s12885-022-09968-5/fulltext.html

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

Background: Identification of the risk factors for surgical site infection (SSI) can be a straightforward and cost-effective measure to reduce or prevent the occurrence of SSI. However, there are no studies that revealed risk factors for SSI for traumatic upper extremity amputation. The aim of this study is to investigate the risk factors that promote SSI after surgery for traumatic upper extremity amputation using a large nationwide database. Methods: We used data from the Japan Trauma Data Bank. Diagnoses were defined using the Abbreviated Injury Scale code. We applied multivariate logistic regression to evaluate the infection risk factor. We chose age, sex, vital signs, cause and type of trauma, concomitant injury, diabetes, amputation level, Glasgow coma scale, Injury Severity Score (ISS) and blood transfusion within 24 hours following hospital arrival as confounders. Receiver operating characteristic (ROC) curve analysis was adopted to identify thresholds for change in infection risk. We also applied propensity score (PS) matching to adjust for confounding factors that may affect the outcome. Results: A total of 1,150 patients (967 males, 183 females) had traumatic upper extremity amputation. The mean patient age was 46.5 years. A total of 21 patients (1.8%) suffered from SSI. ISS, blood transfusion, systolic blood pressure (BP) and the upper extremity amputation except for finger were identified as the independent significant risk factors for SSI occurrence by the multivariate analysis (p < 0.05, p < 0.005, p < 0.05 and p < 0.005, respectively). ROC modelling revealed that patients with ISS of over 9 or systolic BP of over 160 had a risk for SSI. After PS matching, the patients with blood transfusion or systolic BP of over 160 had a significantly higher risk of infection (OR 9.0; p = 0.01 and OR 7.0; p = 0.03, respectively). Conclusions: In treating patients with these risk factors, we must be especially careful in performing thorough debridement and wound care. Level of Evidence: Level II (Therapeutic).

DOI： 10.1142/S2424835522500709

PubMed

researchmap

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

There are currently no reports of implant-related neuropathy associated with humeral proximal fracture surgery. Herein, we report a case of implant-related late-onset neuropathy that developed 3 years after proximal humeral fracture surgery. A 51-year-old man underwent minimally invasive plate osteosynthesis for a left proximal humeral fracture 3 years prior. Left upper limb pain and reduced angle of elevation of the shoulder were recognized 1 month before the outpatient consultation. Numbness was noted on the ulnar side of the hand, and radiating pain to the ulnar nerve region was noted during shoulder abduction and compression of the medial side of the upper arm. Computed tomography revealed close proximity of the neurovascular bundle to the locking screw along with muscle atrophy around the shoulder. Hence, the patient was diagnosed with neuropathy. After implant removal, the pain in the ulnar nerve region improved, and the upper arm could be elevated. In our case, the cause of muscle atrophy was axillary nerve manipulation and cervical myelopathy caused by the operation. When late-onset neuropathy occurs, implant-related neuropathy with muscle atrophy should be considered.

DOI： 10.1016/j.tcr.2022.100670

PubMed

researchmap

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

BACKGROUND: This randomised phase II/III trial aimed to determine whether perioperative chemotherapy with gemcitabine plus docetaxel (GD) is non-inferior to the standard Adriamycin plus ifosfamide (AI) in terms of overall survival (OS) in patients with soft tissue sarcoma (STS). METHODS: Patients with localised high-risk STS in the extremities or trunk were randomised to receive AI or GD. The treatments were repeated for three preoperative and two postoperative courses. The primary endpoint was OS. RESULTS: Among 143 enrolled patients who received AI (70 patients) compared to GD (73 patients), the estimated 3-year OS was 91.4% for AI and 79.2% for GD (hazard ratio 2.55, 95% confidence interval: 0.80-8.14, P = 0.78), exceeding the prespecified non-inferiority margin in the second interim analysis. The estimated 3-year progression-free survival was 79.1% for AI and 59.1% for GD. The most common Grade 3-4 adverse events in the preoperative period were neutropenia (88.4%), anaemia (49.3%), and febrile neutropenia (36.2%) for AI and neutropenia (79.5%) and febrile neutropenia (17.8%) for GD. CONCLUSIONS: Although GD had relatively mild toxicity, the regimen-as administered in this study-should not be considered a standard treatment of perioperative chemotherapy for high-risk STS in the extremities and trunk. CLINICAL TRIAL REGISTRATION: jRCTs031180003.

DOI： 10.1038/s41416-022-01912-5

PubMed

researchmap

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

OBJECTIVES: Early sarcopenia detection using screening tools, such as SARC-F and SARC-CalF, has been proven reliable. However, the relationship between chronic musculoskeletal pain with sarcopenia is unknown. This study assessed sarcopenia morbidity as well as the reliability of sarcopenia screening with SARC-F and SARC-CalF in patients with chronic musculoskeletal pain. METHODS: Overall, 172 patients with chronic musculoskeletal pain were included in this cross-sectional study. All participants completed the SARC-F, SARC-CalF, numeric rating scale (NRS), and pain disability assessment scale (PDAS) assessments. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. Correlations between SARC-F and SARC-CalF scores and each measured variable were evaluated using univariate and multiple linear regression analyses. A receiver operating characteristic curve analysis was conducted, and reliabilities of SARC-F and SARC-CalF scores for diagnosing sarcopenia were compared. RESULTS: Thirty-nine patients were diagnosed with sarcopenia. Among these, 10 patients were <65 years old, and 29 were >65 years old. Both SARC-F and SARC-CalF scores significantly correlated with grip power, gait speed, skeletal mass index, numeric rating scale score, and PDAS score. In multiple linear regression analysis, SALC-F and SALC-CalF scores significantly correlated with PDAS score, skeletal mass index, and gait speed. The area under the curve were 0.70 for SARC-F and 0.88 for SARC-CalF; SARC-CalF had a significantly higher area under the curve than SARC-F. DISCUSSION: Sarcopenia was diagnosed in patients aged <65 years with chronic musculoskeletal pain. SALC-F and SARC-CalF scores showed a significant correlation with disability due to pain and were reliable sarcopenia screening tools for chronic musculoskeletal pain. SARC-CalF was more reliable than SARC-F.

DOI： 10.1097/MD.0000000000029568

PubMed

researchmap

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

Recently, transtibial pullout repair of the medial meniscus (MM) posterior root tear (PRT) has become widely accepted and provides satisfactory clinical outcomes. Widening after cyclic loading or ultimate failure load using different suture materials and configurations has been studied. However, no study has compared the clinical outcomes using different suture materials. This study aimed to evaluate the clinical outcomes after performing MMPRT pullout repair using different suture materials. We hypothesized that better clinical outcomes would be achieved using ultra-high molecular weight polyethylene (UHMWPE) tape compared with a normal polyester suture. Thirty-seven patients who underwent MM posterior root repair between November 2019 and May 2020 were retrospectively investigated. Pullout repair was performed using a hollow no. 0 polyester suture (n = 14) and UHMWPE tape (n = 23). Clinical outcomes were assessed preoperatively and at 1 year postoperatively, using the Lysholm knee score, Knee Injury and Osteoarthritis Outcome Score, and visual analogue scale (VAS) pain score. The meniscal healing status was assessed using an arthroscopic scoring system (range: 0-10). All clinical scores were improved significantly in both groups. However, significantly higher meniscal healing scores and decreased VAS pain scores were observed in the UHMWPE group (7.3 ± 0.9 and 7.7 ± 11.3, respectively) than in the polyester group (5.6 ± 2.1 and 18.4 ± 18.6, respectively; p < 0.01). Suture cut-out and loss of the root continuity were observed in some cases (three cases [21.4%] in the polyester suture group and one case [4.3%] in the UHMWPE tape group). Both suture materials led to satisfactory clinical outcomes at 1 year postoperatively, whereas the UHMWPE tape was useful for obtaining good meniscal healing and decreasing the VAS pain score.

DOI： 10.1055/s-0042-1750047

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本骨・関節感染症学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨・関節感染症学会  

researchmap

Authorship：Last 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

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Publishing type：Research paper (scientific journal)   Publisher：American Association for the Advancement of Science (AAAS)  

How mechanical stress affects physical performance via tendons is not fully understood. Piezo1 is a mechanosensitive ion channel, and E756del PIEZO1 was recently found as a gain-of-function variant that is common in individuals of African descent. We generated tendon-specific knock-in mice using R2482H Piezo1 , a mouse gain-of-function variant, and found that they had higher jumping abilities and faster running speeds than wild-type or muscle-specific knock-in mice. These phenotypes were associated with enhanced tendon anabolism via an increase in tendon-specific transcription factors, Mohawk and Scleraxis, but there was no evidence of changes in muscle. Biomechanical analysis showed that the tendons of R2482H Piezo1 mice were more compliant and stored more elastic energy, consistent with the enhancement of jumping ability. These phenotypes were replicated in mice with tendon-specific R2482H Piezo1 replacement after tendon maturation, indicating that PIEZO1 could be a target for promoting physical performance by enhancing function in mature tendon. The frequency of E756del PIEZO1 was higher in sprinters than in population-matched nonathletic controls in a small Jamaican cohort, suggesting a similar function in humans. Together, this human and mouse genetic and physiological evidence revealed a critical function of tendons in physical performance, which is tightly and robustly regulated by PIEZO1 in tenocytes.

DOI： 10.1126/scitranslmed.abj5557

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (bulletin of university, research institution)  

Secondary hip fractures (SHFs) rarely occur after intramedullary nailing (IMN) fixation without femoral neck fixation for atypical femoral fractures (AFFs). We report three cases of older Japanese women who sustained SHFs presumably caused by osteoporosis and peri-implant stress concentration around the femoral neck after undergoing IMN without femoral neck fixation for AFF. All cases were fixed with malalignment. In AFF patients, postoperative changes due to postoperative femoral bone malalignment may affect the peri-implant mechanical environment around the femoral neck, which can result in insufficiency fractures. At the first AFF surgery, we recommend femoral neck fixation after adequate reduction is achieved.

DOI： 10.18926/AMO/63741

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：日本運動器科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本骨折治療学会  

researchmap

Language：English   Publisher：(一社)日本骨折治療学会  

researchmap

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

PURPOSE: Medial meniscus (MM) posterior root tears (PRTs) lead to abnormal kinematic changes in the knee and may induce pathological external rotation of the tibia during knee flexion. This study aimed to investigate changes in the length and inclination of the anterior cruciate ligament (ACL) after MM posterior root repair using magnetic resonance imaging (MRI). METHODS: This retrospective study included 44 patients who underwent MM posterior root repair between 2016 and 2019. Clinical outcomes were evaluated before and after surgery. MRI examinations were performed at 10°/90° of knee flexion preoperatively and 3 months postoperatively. The ACL length, proximal angle, and distal angle were determined using the sagittal view. MM extrusion and ACL inclination angle were determined using the coronal view. RESULTS: Clinical outcomes significantly improved 1 year after surgery. The postoperative ACL length (29.7 ± 2.4 mm) and proximal angle (47.0 ± 7.4°) at 90° of knee flexion decreased relative to the preoperative values (31.5 ± 2.3 mm and 51.8 ± 8.7°, P < 0.01). The postoperative ACL inclination (64.9 ± 5.6°) at 10° of knee flexion decreased relative to the preoperative value (69.7 ± 5.6°, P < 0.01). CONCLUSION: Pathologically-stretched linear ACL at 90° of knee flexion and a steep ACL inclination at 10° of knee flexion could be reduced after MM posterior root repair. This suggests that pullout repair could restore MM function as a secondary stabilizer, thereby preventing meniscal and cartilage degeneration.

DOI： 10.1007/s00590-022-03285-0

PubMed

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Abstract

Giant-cell tumor of bone is a rare, locally aggressive and rarely metastasizing primary bone tumor. The mainstay of treatment remains controversial and is decided by the balance between adequate surgical margin and sufficient adjacent joint function. Although curettage with a high-speed burr and local adjuvants can maintain normal joint function, many reports have revealed a high local recurrence rate. Conversely, en bloc resection and reconstruction with prostheses for highly aggressive lesions have reportedly lower local recurrence rates and poorer functional outcomes. Denosumab—a full human monoclonal antibody that inhibits receptor activator of nuclear factor-kappa β ligand—was approved by the Food and Drug Authority in 2013 for use in surgically unresectable or when resection is likely to result in severe morbidity for skeletally mature adolescents and adults with giant-cell tumor of bone. However, subsequent studies have suggested that the local recurrence rate would be increased by preoperative use of denosumab. In systematic reviews of the local recurrence rate after preoperative use of denosumab, conclusions vary due to the small sample sizes of the studies reviewed. Therefore, controversy regarding the treatment of giant-cell tumor of bone is ongoing. Here, this review elucidates the management of giant-cell tumor of bone, especially with the local adjuvant and neoadjuvant use of denosumab, and presents the current, evidence-based treatment for giant-cell tumor of bone.

DOI： 10.1093/jjco/hyac018

PubMed

researchmap

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

PURPOSE: This study aimed to evaluate changes in the cleft width, defined as the distance between the lateral edge of the medial tibial plateau and that of the medial meniscus (MM) posterior root, using open magnetic resonance imaging (MRI) in patients with MM posterior root tear (MMPRT). METHODS: This study included 25 patients (20 women and 5 men; mean age: 65.2 years) who were diagnosed with MMPRT and underwent pullout repair. Upon coronal imaging, the cleft width was evaluated at the 10° and 90° flexed knee positions. The difference in the cleft width (defined as the cleft width at 90° minus the cleft width at 10°) was also calculated. Upon sagittal imaging, the MM posterior extrusion (MMPE) at 90° was also evaluated. Separate univariate linear regression models were used to determine the association between the time from injury to MRI and radiographic measurements. RESULTS: The mean cleft width at 10° and 90° was 4.9 ± 2.6 mm and 7.4 ± 3.7 mm, respectively; the mean difference in cleft width was 2.5 ± 1.5 mm, and the mean MMPE at 90° was 3.7 ± 1.3 mm. There was a significant difference in cleft width at 10° and 90° (p < 0.001). The time from injury to MRI was significantly associated with the cleft width at 10° (R = 0.42; p = 0.023), cleft width at 90° (R = 0.59; p = 0.002), the difference in the cleft width (R = 0.62; p = 0.008), and MMPE at 90° (R = 0.53; p = 0.008). CONCLUSION: This study demonstrates that the cleft width is significantly larger during knee flexion than during knee extension. Increased cleft width during knee flexion ("graben" sign) may help diagnose MMPRT, especially in cases where the cleft sign is unclear during knee extension. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-022-06983-8

PubMed

researchmap

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

Osteochondral fractures of the medial femoral condyle accompanied by medial wall fracture are rare. Surgeons often have difficulty in selecting the most appropriate treatment, especially the plating technique for internal fixation since the available femoral locking plates are made to fit the femoral lateral condyle and there is no anatomical plate for the medial condyle. We, herein, report a case of a 44-year- old female patient who suffered from an osteochondral fracture of the medial femoral condyle accompanied by medial wall fracture treated by a low-profile mesh plate contoured to fit around the fracture site. Bone union was achieved at postoperative week 12 and the patient was able to return to her normal activities. At the 16-month follow-up exam, the patient's functional and clinical outcomes were satisfactory. Her Oxford knee score was 47 points, and the Western Ontario and McMaster Universities Arthritis Index scores were 2 points for pain and 5 points for physical function. We believe that the mesh plate has several advantages. This is the first report of using a mesh plate for the femur, and we were able to achieve good results. We conclude that treatment with a mesh plate can be applied in well- selected patients with medial femoral condyle osteochondral fracture and has the potential to be applied to the treatment of fractures in various regions in the future.

DOI： 10.5152/j.aott.2022.21325

PubMed

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

researchmap

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

Background and Objectives: Spine surgery using a percutaneous pedicle screw placement (PPSP) is widely implemented for spinal trauma. However, percutaneous systems have been reported to have weak screw-rod connections. In this study, conventional open and percutaneous systems were biomechanically evaluated and compared. Material and Methods: The experiments were performed in two stages: the first stage was a break test, whereas the second stage was a fatigue test. Four systems were used for the experiments. System 1 was intended for conventional open surgery (titanium rod with a 6.0 mm diameter, using a clamp connecting mechanism). System 2 was a percutaneous pedicle screw (PPS) system for trauma (titanium alloy rod with a 6.0 mm diameter, using ball ring connections). System 3 was a PPS system for trauma (cobalt-chromium alloy rod with a 6.0 mm diameter, using sagittal adjusting screw connections). System 4 was a general-purpose PPS system (titanium alloy rod with a 5.5 mm diameter, using a mechanism where the adapter in the head holds down the screw). Results: Stiffness values of 54.8 N/mm, 43.1 N/mm, 90.9 N/mm, and 39.3 N/mm were reported for systems 1, 2, 3, and 4, respectively. The average number of load cycles in the fatigue test was 134,393, 40,980, 1,550,389, and 147,724 for systems 1 to 4, respectively. At the end of the test, the displacements were 0.2 mm, 16.9 mm, 1.2 mm, and 8.6 mm, respectively. System 1, with a locking mechanism, showed the least displacement at the end of the test. Conclusion: A few PPS systems showed better results in terms on stiffness and life than the open system. The experiments showed that mechanical strength varies depending on the spinal implant. The experiments conducted are essential and significant to provide the mechanical strength required for surgical reconstruction.

DOI： 10.3390/medicina58050565

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS  

Though JCOG1610 gave only descriptive results, the superiority of preoperative denosumab was not observed in patients with giant cell tumor of bone without possible post-operative large bone defect in terms of relapse-free survival.Objectives The aim of JCOG1610 (randomized controlled phase III trial) was to confirm the superiority of preoperative denosumab to curettage with adjuvant local therapy for patients with giant cell tumor of bone without possible post-operative large bone defect. Methods The primary endpoint was relapse-free survival and the total sample size was set at 106 patients. Patient accrual began in October 2017. However, the accrual was terminated in December 2020 due to a recommendation from the Data and Safety Monitoring Committee because of poor patient accrual. Now, we report the descriptive results obtained in this study. Results A total of 18 patients had been registered from 13 Japanese institutions at the time of termination on December 2020. Eleven patients were assigned to Arm A (curettage and adjuvant local therapy) and 7 to Arm B (preoperative denosumab, curettage and adjuvant local therapy). Median follow-up period was 1.6 (range: 0.5-2.8) years. Protocol treatment was completed in all but one patient in Arm A who had a pathological fracture before surgery. All patients in Arm B were treated with five courses of preoperative denosumab. Relapse-free survival proportions in Arm A and B were 90.0% (95% confidence interval: 47.3-98.5) and 100% (100-100) at 1 year, and 60.0% (19.0-85.5) and 62.5% (14.2-89.3) at 2 years, respectively [hazard ratio (95% confidence interval): 1.51 (0.24-9.41)]. Conclusion In terms of relapse-free survival, the superiority of preoperative denosumab was not observed in patients with giant cell tumor of bone without possible post-operative large bone defect.

DOI： 10.1093/jjco/hyac071

Web of Science

researchmap

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

Bone marrow edema (BME) after meniscus injury and risk factors for subchondral insufficiency fracture of the knee (SIFK) have been reported. However, their association with medial meniscus posterior root tear (MMPRT) remains unknown. We investigated the association of BME volume (BME-V), posterior shinycorner lesion (PSCL), and SIFK with MMPRT to examine the correlations between BME-V and medial meniscus extrusion (MME), PSCL and duration from injury to the time of magnetic resonance imaging (duration), and SIFK and duration. Twenty-nine patients who underwent surgery for MMPRT were included (mean age, 59.2; range, 39-84). The presence of PSCL, femoral BME-V (cm3), and SIFK grade (1-4) were evaluated. Preoperative factors, such as MME (mm) and duration (weeks), were investigated using multivariate linear/ logistic regression analyses. Multivariate linear regression analysis revealed duration as a significant factor for high-grade SIFK (p<0.01). Multivariate logistic regression analysis revealed duration as a significant factor for the presence of PSCL (odds ratio=0.94, p<0.05). A long duration of MMPRT leads to severe MME and highgrade SIFK (3 and 4), often resulting in knee arthroplasty. Early diagnosis of MMPRT and pullout repair can prevent severe MME and high-grade SIFK.

DOI： 10.18926/AMO/63405

PubMed

researchmap

Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ejca.2022.01.013

researchmap

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

researchmap

Language：Japanese   Publisher：中国・四国整形外科学会  

Zimmer Biomet社Augmented Reality Hip Navigation System(AR Hip Navi)を用いてTHAを施行した11例11股を対象に検討した。骨盤傾斜角の計測方法は、術前・術後はCTデータをもとに三次元術前計画ソフトZedHipを用いて計測し、術中はAR Hip Naviを用いて計測した。結果、術前CTでの計測値は平均3.8度、術中AR Hip Naviでの計測値は平均-2.6度、術後CTでの計測値は平均4.1度であった。術前計測値と術中計測値との差の絶対値(術前-術中)は10.1度、術中計測値と術後計測値との差の絶対値(術中-術後)は9.9度、術前計測値と術後計測値との差の絶対値(術前-術後)は2.3度であり、術前-術後の計測値差に比べて術前-術中の計測値差と術中-術後の計測値差は有意に大きかった。

researchmap

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J02438&link_issn=&doc_id=20220608080001&doc_link_id=%2Fcm4ortho%2F2022%2F003401%2F001%2F0001-0005%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2022%2F003401%2F001%2F0001-0005%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

researchmap

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

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Abstract

Approximately, 40% of bone sarcomas and 60% of soft tissue sarcoma arise in patients aged ≥65 years. However, because sarcoma is very rare, there is little evidence regarding the management of elderly patients with sarcoma. Age has been reported as a prognostic factor in patients with sarcomas. The standard therapy for all localized bone and soft tissue sarcomas is surgical resection, even in elderly patients. Radiation or ion-beam therapy can be considered for unresectable sarcomas. Although adjuvant chemotherapy is standard for osteosarcoma, the usefulness of adjuvant chemotherapy for elderly patients has not been verified; therefore, it may not be recommended for elderly patients with osteosarcoma. For elderly patients with advanced osteosarcoma, if general conditions permit, doxorubicin- and/or ifosfamide-based regimens as well as molecular-targeted therapies, including sorafenib, regorafenib and everolimus, may be considered, although these drugs have not been approved for sarcoma in Japan. Adjuvant chemotherapy with doxorubicin plus ifosfamide is recommended for patients with high-risk localized soft tissue sarcoma if they are aged ≤70 years. For first-line treatment of advanced soft tissue sarcoma in elderly patients, doxorubicin monotherapy is considered to be the standard regimen, and pazopanib can be an alternative. For second-line treatment, gemcitabine-based regimens, pazopanib, trabectedin and eribulin may be options for elderly patients with advanced soft tissue sarcoma.

DOI： 10.1093/jjco/hyac027

PubMed

researchmap

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

DOI： 10.1007/s00402-022-04401-9

researchmap

Other Link： https://link.springer.com/article/10.1007/s00402-022-04401-9/fulltext.html

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

BACKGROUND: These clinical practice guidelines are intended to provide recommendations based on the best evidence obtained to date on key issues in clinical practice to improve the prognosis, diagnostic and therapeutic processes for patients with soft tissue tumors. METHODS: The Guidelines Development Committee and Systematic Review Committee were composed of a multidisciplinary team of specialists who play an important role in soft tissue tumor care. Clinical questions (CQs) were determined by choosing key decision-making points based on Algorithms for the diagnosis and treatment of soft tissue tumors. The guidelines were developed according to the "Medical Information Network Distribution Service (Minds) Handbook for Clinical Practice Guideline Development 2014" and "Minds Manual for Clinical Practice Guideline Development 2017." Recommendation strength was rated on two levels and the strength of evidence was rated on four levels. The recommendations were decided based on agreement by 70% or more voters. RESULTS: Twenty-two CQs were chosen by the Guidelines Development Committee. The Systematic Review Committee reviewed the evidence concerning each CQ, a clinical value judgment was added by experts, and the text of each recommendation was determined. CONCLUSION: We established 22 CQs and recommendations for key decision-making points in the diagnosis and treatment of soft tissue tumors according to the Minds Clinical Practice Guideline development methods. We hope that these guidelines will assist the decision-making of all medical staff engaged in the treatment and diagnosis of soft tissue tumors, and eventually lead to improved soft tissue tumor care in the country.

DOI： 10.1016/j.jos.2021.11.023

PubMed

researchmap

Authorship：Last author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.injury.2022.02.046

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Authorship：Last author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.injury.2021.10.024

researchmap

Authorship：Last author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.knee.2022.02.004

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap

Language：Japanese   Publisher：(公社)日本整形外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本リウマチ学会  

researchmap