記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jor.2020.03.051

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2019.05.012

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2019.05.012

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.arth.2019.12.039

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.arth.2019.12.039

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2019.03.019

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.clinbiomech.2019.05.035

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s13256-019-2192-7

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00590-019-02443-1

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jor.2018.12.002

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s13256-018-1942-2

その他リンク： https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-018-1942-2

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.clinbiomech.2018.07.017

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3928/01477447-20180806-04

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s13018-018-0873-3

その他リンク： https://josr-online.biomedcentral.com/articles/10.1186/s13018-018-0873-3

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jor.2018.05.003

記述言語：その他   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.rcot.2017.12.025

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00264-018-3921-z

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.otsr.2017.11.015

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-018-4899-1

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.arth.2017.08.035

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.ijscr.2017.12.007

その他リンク： https://www.sciencedirect.com/science/article/pii/S2210261217306545?via%3Dihub

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.ijscr.2017.12.008

その他リンク： https://www.sciencedirect.com/science/article/pii/S2210261217306557?via%3Dihub

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2017.05.011

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00256-017-2677-7

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

その他リンク： https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-8-447

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1155/2013/717546

その他リンク： http://www.hindawi.com/journals/bmri/2013/717546/

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   出版者・発行元：Journal of Orthopaedics  

Background: Despite experiencing pain relief and improved activities of daily living after total hip arthroplasty (THA) for osteoarthritis of the hip, a Trendelenburg gait may be observed in some patients. The concentric and eccentric contraction patterns of hip muscles in a Trendelenburg gait are not well understood. Methods: This study included 89 patients (28 males and 61 females, mean age 66.5 ± 8.4 years, mean postoperative period 1.3 ± 0.4 years) after unilateral THA without functional impairment on the contralateral side. Gait analysis utilized a three-dimensional motion capture system to assess pelvis and hip angles, hip moment, and hip power. A Trendelenburg gait was defined as positive when nonoperative pelvic descent occurred at 30 % of the gait cycle, equivalent to mid-stance. Patients were classified into Trendelenburg gait-positive and -negative groups for statistical analysis. Unpaired t-test and chi-square test were used to compare the two groups. Multiple regression analysis was conducted to identify factors associated with the presence of a Trendelenburg gait. Results: A Trendelenburg gait was observed in 24 patients (27 %). Multiple regression analysis indicated that abduction (p < 0.01) and extension (p = 0.03) of hip joint power were significant determining of a Trendelenburg gait. Patients with a Trendelenburg gait exhibited reduced eccentric contraction of the hip abductor muscles and decreased concentric contraction of hip extensor muscles during early to mid-stance of their gait. Conclusion: Centrifugal contraction of hip abductor muscles and diminished eccentric contractility of hip extensor muscles appear crucial for hip stabilization mechanisms during gait after THA.

DOI： 10.1016/j.jor.2024.07.020

Scopus

PubMed

記述言語：英語  

DOI： 10.1302/0301-620X.106B10.BJJ-2023-1425.R1

PubMed

記述言語：英語   出版者・発行元：Arthroplasty Today  

Background: Accurate cup placement in total hip arthroplasty (THA) for patients with dysplasia is challenging due to the distinctive bone deformities. This study aimed to compare the accuracy of cup placement position and orientation across robotic arm–assisted systems (R-THA), computed tomography–based navigation (N-THA), and manual procedure (M-THA) in THA for osteoarthritis secondary to dysplasia. Methods: A total of 167 patients (197 hips), including 88 R-THAs, 45 N-THAs, and 46 M-THAs, were analyzed. Propensity score matching was performed to align the patient backgrounds. Horizontal and vertical centers of rotation were measured for cup position, whereas radiographic inclination and anteversion were measured for cup orientation. The proportion of cases with cup placement within 3 mm and 5° from the target was compared. Results: R-THA had a significantly higher percentage of cup placement within 3 mm of the target compared to N-THA (78% vs 49%; P = .0041) and M-THA (78% vs 53%; P = .013). Similarly, R-THA was significantly more successful in placing the cup within 5° of the target compared to N-THA (84% vs 58%; P = .0049) and M-THA (91% vs 20%; P < .0001). Moreover, N-THA was significantly better at placing the cup within 5° of the target compared to M-THA (62% vs 14%; P < .0001), whereas there was no significant difference in the percentage of cup placement within 3 mm of the target (51% vs 51%; P = 1.0). Conclusions: Robotic arm–assisted system and computed tomography–based navigation improved accuracy in cup orientation compared to the manual procedure. Additionally, the robotic arm–assisted system further improved cup position accuracy.

DOI： 10.1016/j.artd.2024.101461

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：Skeletal Radiology  

Objective: Although some patients may experience collapse progression while others may not in post-collapse osteonecrosis of the femoral head (ONFH) with a necrotic lesion located within the weight-bearing part of the acetabulum (Type B/C1), few studies have focused on the natural course after collapse. This study aimed to clarify the correlation between necrotic volume (NV) and necrotic depth (ND) in predicting collapse progression in patients with post-collapse ONFH Type B/C1. Materials and methods: We retrospectively reviewed 54 hips with post-collapse ONFH Type B/C1 from 52 consecutive patients who were conservatively followed up for more than 1 year. We measured the amount of femoral head collapse using biplane radiographs at each follow-up period, and produced Kaplan–Meier survival curves with collapse progression (≥ 1 mm) as the endpoint. We compared NV and ND, which were calculated as the ratio of the distance from the articular surface of the femoral head to the deepest point of a necrotic lesion to the femoral head diameter in the mid-coronal slice of T1-weighted magnetic resonance imaging (MRI). Results: We observed collapse progression in 31 hips (57.4%). The NV and ND were significantly greater in hips with collapse progression than in those without collapse progression (p = 0.0127 and 0.0047, respectively). Necrotic volume was significantly correlated with ND　(rs = 0.56, p < 0.0001). Conclusion: This study suggests that necrotic depth on the mid-coronal slice of T1-weighted MRI can be a substitute for necrotic volume to predict collapse progression in ONFH Type B/C1.

DOI： 10.1007/s00256-024-04741-0

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：Journal of Experimental Orthopaedics  

Purpose: This study assessed rotational mismatch between components after total knee arthroplasty (TKA) in the supine and standing positions and aimed to investigate the effect of rotational mismatch in the standing position on postoperative patient-reported outcome measures (PROMs). Methods: Seventy-one patients (71 knees) who underwent TKA for medial knee osteoarthritis were used to investigate rotational mismatches between components. Rotational mismatches between components were examined on postoperative standing whole-leg and supine knee radiographs using a three-dimensional-to-two-dimensional model image registration technique, and the angles between the reference axes of the components were measured. Component alignment was evaluated using postoperative computed tomography images, and a questionnaire (2011 version of the Knee Society Score: [KSS 2011]) was mailed to investigate postoperative PROMs. Results: In the entire cohort, rotational mismatches in the supine and standing positions were similar (p = 0.9315). In 15% of patients, the mismatch was large (>5°) in the supine position but small (<5°) in the standing position (overestimated group). However, in 23% of patients, the mismatch was small (<5°) in the supine position and large (>5°) in the standing position (underestimated group). The underestimated group had severe preoperative varus deformity, resulting in external rotation of both femoral and tibial components. Rotational mismatch in the standing position (p = 0.0032) was a significant risk factor for unfavourable PROMs. Patients with a mismatch in the standing position had significantly lower scores than those without a mismatch (p = 0.0215), exceeding the minimal clinically important difference values. Conclusions: The underestimated group is clinically important because the surgical procedure and intraoperative assessment of component placement are performed in the supine position. In cases of severe preoperative varus deformity, care should be taken not to place the component in malrotation to avoid rotational mismatch in the standing position. Level of Evidence: Ⅳ, Case series.

DOI： 10.1002/jeo2.12069

Web of Science

Scopus

PubMed

出版者・発行元：株式会社医学書院  

DOI： 10.11477/mf.1408203032

CiNii Research

記述言語：英語   出版者・発行元：PLoS ONE  

Background Rebamipide has been widely co-prescribed with non-steroidal anti-inflammatory drugs (NSAIDs) in Japan for decades. This study aimed to evaluate the effectiveness of rebamipide in preventing upper gastrointestinal bleeding in new users of NSAIDs without risk factors of NSAID-induced ulcers other than age. Methods A nested case-control study was conducted using medical claims data of 1.66 million inhabitants of 17 municipalities participating in Japan’s Longevity Improvement & Fair Evidence study. The cohort entry (t0) corresponded to a new user of NSAIDs for osteoarthritis or low back pain. Patients with risk factors of NSAID-induced ulcers other than age were excluded. Cases were defined as patients who underwent gastroscopy for upper gastrointestinal bleeding (occurrence date was defined as index date). A maximum of 10 controls were selected from non-cases at the index date of each case by matching sex, age, follow-up time, and type and dosage of NSAIDs. Exposure to rebamipide was defined as prescription status from t0 to index date: Non-user (rebamipide was not co-prescribed during the followup period), Continuous-user (rebamipide was co-prescribed from t0 with the same number of tablets as NSAIDs), and Irregular-user (neither Non-user nor Continuous-user). Conditional logistic regression analysis was conducted to estimate each category’s odds ratio compared to non-users. Findings Of 67,561 individuals who met the inclusion criteria, 215 cases and 1,516 controls were selected. Compared with that of Non-users, the odds ratios and 95% confidence interval were 0.65 (0.44–0.96) for Continuous-users and 2.57 (1.73–3.81) for Irregular-users. Conclusions Continuous co-prescription of rebamipide significantly reduced the risk of upper gastrointestinal bleeding in an Asian cohort of new users of NSAIDs with osteoarthritis or low back pain without risk factors other than age.

DOI： 10.1371/journal.pone.0305320

Web of Science

Scopus

PubMed

出版者・発行元：Journal of Bone and Joint Surgery  

Background:The incidence of developmental dysplasia of the hip (DDH) in Japanese newborns has reduced drastically following a primary prevention campaign initiated around 1972 to 1973; this perinatal education campaign promoted maintaining the hips of newborns in the naturally flexed-leg position. The purpose of the present study was to describe the life course epidemiology of hip osteoarthritis (OA) in adolescent and adult patients and to assess its association with exposure to the primary prevention campaign for DDH.Methods:We included new patients with hip OA diagnosed from January 1, 2022, to December 31, 2022, at 12 core hospitals (8 special-function hospitals and 4 regional medical care support hospitals). The trend in the percentage of hips with a history of DDH treatment in childhood was estimated with use of a centered moving average using the birth year of the patient. We compared the prevalence of severe subluxation (Crowe type II, III, or IV) between patients with secondary hip OA due to hip dysplasia who were born in or before 1972 and those who were born in or after 1973.Results:Overall, 1,095 patients (1,381 hips) were included. The mean age at the time of the survey was 63.5 years (range, 15 to 95 years). A total of 795 patients (1,019 hips; 73.8% of hips) were diagnosed with secondary OA due to hip dysplasia. Approximately 13% to 15% of hips among patients born from 1963 to 1972 had a history of DDH treatment in childhood; however, the percentage decreased among patients born in or after 1973. The prevalence of severe subluxation (Crowe type II, III, or IV) among patients born in or after 1973 was 2.4%, which was significantly less than that among patients born in or before 1972 (11.1%; odds ratio, 0.20; p < 0.001).Conclusions:As of 2022, secondary hip OA due to hip dysplasia is still responsible for most new cases of adolescent and adult hip OA seen in core hospitals in Japan. However, the perinatal education campaign initiated 50 years ago, which utilized a population approach and advocated for maintaining the hips of newborns in the naturally flexed-leg position, may have improved the environmental factors of DDH, as indicated by the apparently reduced need for treatment of DDH in childhood and the associated severe subluxation. This may result in a reduced need for challenging hip surgery later in life.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

DOI： 10.2106/JBJS.23.01044

Scopus

記述言語：英語   出版者・発行元：Archives of Orthopaedic and Trauma Surgery  

Introduction: The optimal lower-limb alignment after unicompartmental knee arthroplasty (UKA) remains controversial. This study aimed to investigate the optimal lower-limb alignment for functional improvement in the early post-UKA period. We hypothesized that a small change (Δ) in the arithmetic hip-knee-ankle (aHKA) angle during surgery would result in better postoperative knee function. Materials and methods: This single-centered, retrospective study analyzed 91 patients (91 knees) who underwent UKA from April 2021 and December 2022. Preoperative and postoperative standing whole-leg radiographs were used to evaluate the mechanical HKA angle and aHKA angle. The aHKA angle was calculated from the medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA). We defined restored aHKA angle as a postoperative aHKA angle within ± 3° of the preoperative aHKA angle. Functional improvement was evaluated using the preoperative and one-year postoperative Knee Society Scoring 2011 (KSS 2011). A multivariate regression analysis was performed to investigate the optimal lower-limb alignment for functional improvement. Result: Postoperative restored aHKA angle (p = 0.020) was the only significant factor for improved KSS 2011 scores. Postoperative restored aHKA angle was obtained in 64 patients (70%). ΔMPTA (p < 0.001) and ΔLDFA (p = 0.037) were significant factors associated with a postoperative restored aHKA angle. Conclusions: UKA restores the native knee, including resurfacing constitutional alignment and medial collateral ligament tension. Minimal change in the aHKA angle during UKA improves the functional outcomes of the knee during the early postoperative period, consistent with the minimally invasive surgical concept of UKA.

DOI： 10.1007/s00402-024-05309-2

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Scopus

PubMed

記述言語：英語   出版者・発行元：Arthroscopy Techniques  

We present a knee osteotomy procedure that we have termed the interlocking open-wedge distal tibial tuberosity osteotomy. In this context, the term interlocking pertains to the manner in which the repositioned segments of the retro-tubercle seamlessly fit together as the transverse osteotomy opens to the intended corrective angle. This interlocking mechanism, serving as a distinctive feature, engenders a stable retro-tubercle configuration resembling a mortise-and-tenon joint. The distal end of the tibial tuberosity fits snugly behind the tibial diaphysis, augmenting stability and promoting the healing process. Consequently, poor union of the retro-tubercle caused by the widening of the retro-tubercle gap and an increase in posterior tibial slope are effectively prevented. In addition, the need for complementary hardware such as anteroposterior screw fixation, which is used to secure the retro-tubercle during the healing process, is notably eliminated. This elimination not only simplifies the surgical procedure but also eliminates potential complications that could arise from its use.

DOI： 10.1016/j.eats.2024.102939

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Scopus

PubMed

記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【目的】脚長・オフセットがforgotten joint score（FJS）-12を含めた患者立脚型アウトカムに影響するか否かを明らかにすること．【対象】当科の初回THAで，対側健常な203例203股を対象とした．術前後の単純X線画像評価と術後の患者立脚型評価（FJS-12，Oxford hip score: HS，満足度）を行い，脚長・オフセットが及ぼす影響について多変量解析した．【結果】FJS-12が有意に低スコアを示す因子は，術後の脚長が健側より長いこと，術前の重度大転子高位例であった．脚長はOHS，満足度には有意な影響を認めず，オフセットは全てに有意な影響を認めなかった．【考察】THAの際に，安定性に懸念がある場合は過延長になるよりも，オフセットを延長する方が，FJS-12への負の影響は少ないと考えられた．</p>

DOI： 10.5035/nishiseisai.73.1

CiNii Research

記述言語：英語   出版者・発行元：Elsevier B.V.  

膝関節全置換術(TKA)において、3Dシミュレーション解析を用いて円形と解剖学的楕円形の2種類のコンポーネントの明確な設定ランドマークについて検討した。内反型変形性膝関節症に対してTKAを施行された54例68膝関節(男性17関節、女性51関節、平均75.7±8.2歳)の術前CTデータを用いて膝蓋切除面の3Dシミュレーションを行った。オリジナルの膝蓋隆線の内外側位置を測定し、内側縁、膝蓋隆線および最大サイズの各設定時の円形・楕円形コンポーネントをアライメントとした。シミュレーション上での膝蓋切除厚は9.2±0.9mmで、実際の手術での値とほぼ一致しており、膝蓋隆線は切除面の内側縁から約40%の位置に局在していた。円形膝蓋コンポーネントのアライメントでは、内側縁、膝蓋隆線、最大サイズの順に内側に位置しており、コンポーネントサイズは内側縁、膝蓋隆線、最大サイズの順に小さかった。解剖学的楕円形膝蓋コンパートメントでは、内側縁の方が最大サイズより有意に内側に位置しており、コンポーネントサイズも有意に小さかった。コンポーネントでカバーされない内側骨幅の約4mmを解剖学的ランドマークとして設定するのが望ましいと考えられた。

記述言語：英語   出版者・発行元：(公社)日本整形外科学会  

記述言語：英語   出版者・発行元：Journal of Orthopaedic Science  

Background: The location of the lateral boundary of the necrotic lesion to the weight-bearing portion of the acetabulum (Type classification) is an important factor for collapse in osteonecrosis of the femoral head (ONFH). Recent studies also reported the significance of the location of the anterior boundary of the necrotic lesion on the occurrence of collapse. We aimed to assess the effects of the location of both anterior and lateral boundaries of the necrotic lesion on collapse progression in ONFH. Methods: We recruited 55 hips with post-collapse ONFH from 48 consecutive patients, who were conservatively followed for more than one year. Using a plain lateral radiograph (Sugioka's lateral view), the location of the anterior boundary of the necrotic lesion to the weight-bearing portion of the acetabulum was classified as follows: Anterior-area I (two hips) occupying the medial one-third or less; Anterior-area II (17 hips) occupying the medial two-thirds or less; and Anterior-area III (36 hips) occupying greater than the medial two-thirds. The amount of femoral head collapse was measured by biplane radiographs at the onset of hip pain and each follow-up period, and Kaplan–Meier survival curves with collapse progression (≥1 mm) as the endpoint were produced. The probability of collapse progression was also assessed by the combination of Anterior-area and Type classifications. Results: Collapse progression was observed in 38 of the 55 hips (69.0%). The survival rate of hips with Anterior-area III/Type C2 was significantly lower. Among hips with Type B/C1, collapse progression occurred more frequently in hips with Anterior-area III (21 of 24 hips) than in hips with Anterior-area I/II (3 of 17 hips, P < 0.0001). Conclusions: Adding the location of the anterior boundary of the necrotic lesion to Type classification was useful to predict collapse progression especially in hips with Type B/C1.

DOI： 10.1016/j.jos.2023.01.011

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PubMed

記述言語：英語   出版者・発行元：Journal of Orthopaedics  

Purpose: The dislocation rate after total hip arthroplasty for osteonecrosis of the femoral head is higher than that after total hip arthroplasty for osteoarthritis. However, few reports have investigated the factors contributing to dislocation after total hip arthroplasty for osteonecrosis of the femoral head. The aim of this study was to assess radiological factors associated with posterior dislocation after total hip arthroplasty for osteonecrosis of the femoral head. Methods: We retrospectively reviewed 179 cementless total hip arthroplasties for osteonecrosis of the femoral head using a posterolateral approach between 2002 and 2020 with a minimum follow-up period of 24 months. The following radiological factors were examined for a possible association with posterior dislocation after total hip arthroplasty: cup anteversion angle, cup inclination angle, femoral offset, and stem anteversion angle. Results: Posterior dislocation occurred in seven hips (3.9 %). Compared to hips without posterior dislocation, those with posterior dislocation exhibited a significantly smaller cup anteversion angle (p = 0.045) and a nonsignificantly greater decrease in femoral offset (p = 0.089). Based on receiver operating characteristic curve analyses, the cutoff values for predicting posterior dislocation were 9.9° for the cup anteversion angle and 8.1 mm for the decrease in femoral offset. Logistic regression analysis showed a significantly higher risk of posterior dislocation among hips with a cup anteversion angle less than 9.9° (odds ratio = 7.1, p = 0.022) or with a decrease in femoral offset over 8.1 mm (odds ratio = 5.0, p = 0.040). Conclusions: A small cup anteversion angle and a decreased femoral offset are suggested to be associated with posterior dislocation after total hip arthroplasty in patients with osteonecrosis of the femoral head.

DOI： 10.1016/j.jor.2023.11.015

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PubMed

記述言語：日本語   出版者・発行元：日本関節病学会  

<p><b>目的：</b>Adverse pelvic mobility（APM），Flatback deformity（FB），Stiff spinopelvic mobility（SPM）における三次元動態の特徴を解析することで，人工股関節置換術におけるCup設置の目標値を示すこと。</p><p><b>方法：</b>脊椎固定患者40人（腰椎単椎間，腰椎多椎間，腰仙椎単椎間，腰仙椎多椎間の各10人）を対象とした。座位起立動作の連続X線撮影を行い，イメージマッチング法を用いた三次元動態解析により骨盤前後傾と股関節屈伸角を算出し，CTより臥位の角度も測定した。APM（臥位−立位Δ骨盤傾斜＞13°），FB（PI-LL mismatch≧10°），Stiff SPM（立位−座位Δ骨盤傾斜＜10°）の有無で，座位起立動作中の骨盤・股関節動態を比較した。</p><p><b>結果：</b>APM有群（15人，38%）は無群と比べ，臥位−立位の骨盤後傾量は9°，股関節伸展量は5°大きく，立位の骨盤後傾は6°増加していたが，臥位と座位起立動作中の股関節動態に有意差はなかった。FB有群（24人，60%）は無群と比べ，臥位−立位の骨盤後傾量と股関節伸展量に有意差はなく，臥位と座位起立動作中の骨盤後傾は7～9°，股関節伸展角は6～9°増加していた。Stiff SPM有群（24人，65%）は無群と比べ，臥位−立位の骨盤後傾量と股関節伸展量，および臥位と立位の骨盤前後傾と股関節屈伸展角に有意差はないが，座位（座位起立動作の初期姿勢）と深座位（股関節最大屈曲角となる姿勢）の骨盤後傾は7～10°，股関節伸展は7～10°低下していた。</p><p><b>考察：</b>APMは骨盤後傾増加に応じたCup減捻を行うと後方脱臼リスク増加の可能性がある。FBは臥位FPPに対したCup前捻設置が必要であり，Stiff SPMは前傾増加に応じたCup約6°の増捻が目安となる。</p>

DOI： 10.11551/jsjd.43.16

CiNii Research

記述言語：日本語   出版者・発行元：日本関節病学会  

<p><b>目的：</b>個人で異なる生来のアライメントを予測するために提唱されたCoronal Plane Alignment of the Knee（CPAK）分類に基づくTKA術前後のphenotypeが，術後中期以降の患者立脚型アウトカムに影響するか否かを検討すること。</p><p><b>方法：</b>2013年から2019年に当院で変形性膝関節症に対して初回TKAをmechanical alignment（MA）法で施行した187名231膝（年齢74±8歳，術後経過期間4.2±1.8年）を対象とし，患者立脚型アウトカムとしてKSS 2011，KOOS-12，FJS-12を調査した。術前後全下肢正面X線画像よりMPTA，LDFAを計測，aHKA，JLOを算出，CPAK分類phenotypeを同定した。患者背景，術前後aHKA，JLOを因子として，ステップワイズ法を用いた多変量解析を行い，KSS 2011，KOOS-12に及ぼす影響を調査した。</p><p><b>結果：</b>術前CPAK分類はphenotype（Ⅰ）が最も多く53%，術後CPAK分類はMA法の目標であるphenotype（Ⅴ）が最も多く26%であった。多変量解析の結果，術前後でaHKAが変化しないことがすべての患者立脚型アウトカムへの有意な正の影響因子であり，術後JLOが内方傾斜またはニュートラルであることがKSS 2011への有意な正の影響因子であった。</p><p><b>考察：</b>TKA術前後のCPAK分類phenotypeは術後中期以降の患者立脚型アウトカムに影響していた。術後aHKAは術前と分類が変わる，術後JLOは外方傾斜になると患者立脚型アウトカムが低下するため，CPAK分類に基づく術前計画および再現のある達成は患者立脚型アウトカムのさらなる改善に有用であると示された。</p>

DOI： 10.11551/jsjd.43.24

CiNii Research

記述言語：英語   出版者・発行元：Journal of Orthopaedic Science  

Background: This study assessed the hip survival rate and patient-reported outcome measures (PROMs) of transtrochanteric curved varus osteotomy (CVO) for osteonecrosis of the femoral head (ONFH) compared with those of conservative management. Methods: The CVO group comprised 32 consecutive patients (39 hips) who underwent CVO for ONFH between 2000 and 2011. The conservative group consisted of 36 consecutive patients (37 hips) who were managed conservatively for at least 1 year after collapse and who had ONFH classified by the Japanese Investigation Committee of Health and Welfare as type B or C1, for which CVO is indicated. Kaplan–Meier analysis of hip survival used any ONFH-related therapeutic surgery as the endpoint. PROMs were evaluated for all patients with surviving hips and radiographs available at the latest follow-up. Result: The 10-year hip survival rate in the CVO group was 86.7%, which was significantly higher than the 51.0% 5-year survival rate in the conservative group (p < 0.0001). The Oxford Hip Score and UCLA Activity Score were significantly better in the CVO group without joint space narrowing than in the conservative group, with no significant differences between the CVO group with joint space narrowing and the conservative group. Conclusion: CVO could preserve hip joints more effectively than conservative follow-up after collapse, although the presence of joint space narrowing could reduce satisfaction levels even in patients with long-term hip survival.

DOI： 10.1016/j.jos.2024.03.010

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PubMed

出版者・発行元：金原出版  

DOI： 10.18888/se.0000002807

CiNii Research

出版者・発行元：南江堂  

DOI： 10.15106/j_seikei74_1424

CiNii Research

記述言語：英語   出版者・発行元：Elsevier B.V.  

股関節全置換術(THA)を施行された変形性股関節症(股OA)の日本人患者における患者申告アウトカム尺度(PROMs)の適用状況について検討した。PROMsを取り上げた文献をレビューし、ガイドラインの有無、質問票日本語版の妥当性、治療効果の評価方法などを評価項目とした。患者申告アウトカム(PROs)/PROMsに関するガイドラインとして、Consensus-based standards for the selection of health measurement instruments(COSMIN)チェックリスト、Standard protocol items:recommendations for interventional trials-PRO extension(SPIRIT-PRO extension)、the consolidated standards of reporting trials-PRO extension(CONSORT-PRO extension)が存在することが示され、方法論的な質や試験プロトコルが評価されていた。簡易36/12項目健康サーベイが多次元的評価に用いられており、EuroQol 5 dimension(EQ-5D)は患者選好性をベースとする有用性の評価に最も多く使用されていた。疾患特異的QOLの評価にはWestern Ontario and McMaster Universities変形性関節症指数、Oxford股関節スコア、股関節障害度・変形性関節症アウトカムスコア、Forgotten関節スコア-12、日本整形外科学会股関節疾患評価質問票が用いられていた。このほか、中枢神経感作症候群の評価には中枢神経感作尺度、「生きがい」の評価にはIkigai-9が活用されていた。THAを受けた股OA患者に対して、さまざまな手法によってQOLが評価されていることが明らかになった。

記述言語：英語   出版者・発行元：International Orthopaedics  

Purpose: Little is known about the changes and the factors in physical activity as following total hip arthroplasty (THA). There are potential discrepancies between subjective and objective measurements of physical activity. Thus, our porpose is to compare objective and subjective measurements of activity levels in patients undergoing THA preoperatively, three months and one year following surgery, and investigated the factors that predicts the objective activity level after THA. Methods: This prospective observational study included 42 patients with unilateral symptomatic hip osteoarthritis who underwent THA. The objective activity level (step counts, sit-to-stands, and upright time) by using a tri-axial accelerometer, PRO (Oxford hip score; OHS and University of California, Los Angeles activity score; UCLA score), and muscle volume around the hip joint by using preoperative computed tomography were measured. Results: The number of steps, OHS, and UCLA score before, at three months, and one year after THA averaged 5092, 6532, and 6545 steps, 30.3, 43.0, and 44.2 points, and 3.4, 4.8, and 4.6 points, respectively, with significant postoperative increases (P < 0.05). No significant difference was found between three months and one year postoperatively. In multivariate analysis, younger age and higher preoperative contralateral gluteal medius volume were the predictors of higher postoperative step counts (P < 0.05). Conclusions: Physical activity, including step counts, OHS, and UCLA score increased significantly until three months after unilateral THA. Early surgical intervention before contralateral muscle declines and preoperative rehabilitation including contralateral side may additionally improve postoperative activity levels.

DOI： 10.1007/s00264-023-06022-2

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PubMed

記述言語：英語   出版者・発行元：(公社)日本整形外科学会  

症例1は72歳女性で、数年前より内側コンパートメント変形性膝関節症による左膝関節痛を自覚しており、前医で遠位結節骨切りによる内側楔状開大式高位脛骨骨切り術(OWHTO)を施行された。開大楔状角は11°とし、多孔性β-リン酸三カルシウム(TCP)足場を楔状ギャップに挿入された。術後1週より歩行訓練を開始し、4週後には全荷重下に歩行可能となった。術後1ヵ月で創部治癒が得られたが、X線所見でTakeuchi I型の外側ヒンジ部骨折(LHF)を認め、3ヵ月後、足場周囲にlow bandが観察された。12ヵ月後もlow bandの存在が確認され、足場の再吸収を伴う骨リモデリングがlow band領域で遅延していることが示唆された。ロッキングプレートの抜去時にlow band領域を含めて生検を行った結果、足場の再吸収のほか、low band領域における新規骨と軟部組織による置換が認められた。症例2は52歳女性で、数年前から左膝関節痛をきたしており、内側OWHTOを受けβ-TCP足場を楔状ギャップに挿入された。6週後に歩行可能となったが、左膝に軽度疼痛が残存し杖歩行の状況であった。術後1ヵ月目のX線検査でTakeuchi III型のLHFと足場周囲のlow bandが認められ、骨切り部の治癒遷延および足場の非感染性ゆるみと診断された。6ヵ月後に再手術を施行し、楔状ギャップ領域の生検を行った。その結果、足場とホスト骨との間に骨統合の遅延が生じ、low band領域で統合が進展しなかったことが示唆された。

記述言語：英語   出版者・発行元：Journal of Orthopaedic Science  

DOI： 10.1016/j.jos.2021.12.012

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PubMed

記述言語：英語   出版者・発行元：Scientific Reports  

No report has clarified the frequency and interacting factors affecting sleep disturbance among Asian patients at midterm after total knee arthroplasty (TKA). This study aimed to evaluate the frequency of sleep disturbance at midterm after TKA in a Japanese cohort and to identify intervening factors for sleep. We hypothesized that residual knee pain and decreased functional capability negatively interact with sleep quality after TKA. A total of 209 Japanese participants (average age: 77.1 ± 8.3 years; postoperative follow-up period: 4.5 ± 1.9 years) who underwent primary TKA for knee osteoarthritis were included in this study. Sleep quality, satisfaction, pain, functional capability, joint awareness, and mental condition were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Knee Society Score (KSS) 2011, Forgotten Joint Score (FJS)-12, and 12-Item Short-Form Health Survey (SF-12) Mental Component Summary (MCS). Multivariable analysis was performed to determine the influencing factors on PSQI. The scores for the PSQI, satisfaction with pain level while lying in bed, pain during level walking, functional activity category in the KSS 2011, awareness of the artificial joint in bed at night in the FJS-12, and SF-12 MCS were 6.7 ± 3.0, 5.8 ± 1.8, 1.6 ± 2.3, 62 ± 22, 1.5 ± 1.4, and 56 ± 9.3 on average, respectively. Sleep disturbance (PSQI ≥ 5.5) occurred in 54% of the Japanese participants. Multivariable analysis revealed that high functional capability was a significant factor associated with sleep quality improvement (p < 0.05). Decreased functional capability, not residual knee pain, negatively interacted with sleep quality. The sleep disturbance rate was high during the middle postoperative period after TKA in the Japanese cohort.

DOI： 10.1038/s41598-023-45603-4

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PubMed

出版者・発行元：メジカルビュー社  

DOI： 10.18885/jjs.0000001562

CiNii Research

出版者・発行元：金原出版  

DOI： 10.18888/se.0000002739

CiNii Research

記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【目的】特発性大腿骨頭壊死症（ONFH）の予後因子として海外では壊死体積や壊死のサイズが頻用される一方，日本ではType分類が重視され，Type B/C1では圧潰進行が静止する場合もあるとの報告があるが，一定の見解は得られていない．今回Type B/C1での圧潰進行に関連する因子を検証した．【方法】2010年1月－2017年8月に当科を受診したONFH症例の中で，発症後1年以上保存的に経過観察し得たType B/C1の39例41股を対象とした．単純X線で発症時から各受診時の圧潰幅を計測し，1mm以上の圧潰進行の頻度を調査した．また単純MRIを用い壊死体積（％），サイズを表すCombined Necrotic Angle，深さを表すNecrotic Depth Ratioを評価し，圧潰進行の有無と比較した．【結果】41股中25股（60.9％）で1mm以上の圧潰進行を認めた．圧潰進行群では圧潰非進行群と比べ，壊死体積，Combined Necrotic Angle，Necrotic Depth Ratioはいずれも有意に高値であった．【考察】Type B/C1で壊死体積やサイズ，壊死の深さを加味することで圧潰進行の予測に有用であった．</p>

DOI： 10.5035/nishiseisai.72.445

CiNii Research

記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【目的】寛骨臼移動術（TOA）などの関節温存術は，前初期変形性股関節症（OA）に推奨される治療法だが，中年期以降の患者において保存治療症例と比較された報告はなく，その有効性には結論が出ていない．本研究の目的は，中年期の初期OA患者においてTOAが保存治療と比較して股関節予後を改善するか検討することである．【方法】寛骨臼形成不全に伴う初期OAの中年期（45-64歳）患者で5年以上経過観察された患者のうち，TOAを施行されたTOA群77例（女性68例，平均年齢：51歳，平均観察期間：13年）と，対側手術から1年以上保存治療が行われた保存治療群64例（女性59例，平均年齢：53歳，平均観察期間：13年）において関節生存率を比較検討した．【結果】THA移行での関節生存率は，TOA群92％，保存治療群64%と，TOA群は保存治療群よりも関節生存率が有意に高かった．【考察】寛骨臼移動術は中年期の初期OA患者の股関節予後を改善する．</p>

DOI： 10.5035/nishiseisai.72.399

CiNii Research

記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【背景】人工膝関節全置換術（TKA）において，大腿骨前方切除面の‘Grand piano sign’が回旋設置を確認する指標として提唱されているが，これは内側型変形性膝関節症（OA）で提唱された指標であり，外側型膝OAでも同様であるか，検討したものはない．【方法】外側型膝OAでTKAを施行した30例の術前CTを用いて，三次元術前計画ソフト（Zed Knee）内でsurgical epicondylar axis（SEA）に平行（NR），3°内旋（IR），3°外旋（ER）での前方切除面をsimulationし，内側顆/外側顆の高さの比率（M/L比）を検討した．【結果】M/L比は，NRで0.59±0.11，IRで0.68±0.12と増大，ERで0.49±0.09と減少し，数値・傾向とも過去の内側型OAの報告と同様であった．【考察】外側型膝OAにおいても‘Grand piano sign’は有用な指標となり得た．</p>

DOI： 10.5035/nishiseisai.72.433

CiNii Research

記述言語：英語   出版者・発行元：Scientific Reports  

This study aimed to clarify the clinical utility of the sourcil roundness index (SRI), a novel index for quantifying the asphericity of the acetabular concavity, by determining (1) the difference in the SRI between dysplastic and normal hips and (2) the correlation between the SRI and radiographic parameters of hip dysplasia. We reviewed standing anteroposterior pelvic radiographs of 109 dysplastic and 40 normal hips. The SRI was determined as the ratio of the distance from the medial edge of the sourcil to the most concave point of the acetabular sourcil (A) to the distance from the medial to the lateral edge of the sourcil (B). The formula for SRI is (A/B) × 100–50 (%), with an SRI of 0% indicating a perfectly spherical acetabulum, and higher SRI values indicating a more aspherical shape. The median SRI was greater in patients with hip dysplasia than in normal hips (5.9% vs. − 1.4%; p < 0.001). Furthermore, the median SRI was greater in the severe dysplasia subgroup (18.9%) than in the moderate (3.5%) and borderline-to-mild (− 1.3%) dysplasia subgroups (p < 0.05). Quantification of acetabular concavity asphericity by the SRI showed that dysplastic hips had a more lateral acetabular concave point than normal hips, and that the severity of hip dysplasia had an effect on the acetabular concavity asphericity.

DOI： 10.1038/s41598-023-42630-z

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PubMed

記述言語：英語   出版者・発行元：Journal of Clinical Medicine  

There are no studies that have investigated the characteristics of car use across THA patients, including those who do not drive. This study aimed to evaluate, in THA patients, (1) postoperative car usage, (2) comfort while entering and exiting a car, and (3) whether lower limb muscle strength affects action comfort. One hundred seventy-two post-THA patients completed the questionnaire in 2020, along with assessments of hip abductor and knee extensor muscle strength before surgery and at discharge. Patients whose overall comfort level was judged as comfortable were defined as the comfort group; others were placed in the discomfort group. Of the 172 patients, 161 reported car usage at a mean of 5.6 years after THA. Of these, 114 and 47 patients were placed in the comfort and discomfort groups, respectively. Patients in the discomfort group were three times more likely to experience discomfort using the contralateral side door than the surgical side door, and about twice as many patients experienced discomfort when entering as when exiting. Lower preoperative contralateral hip abductor muscle strength was the only independent predictor for discomfort. The take-home messages were that prevention of contralateral-side weakness may improve comfort during the action after THA.

DOI： 10.3390/jcm12175515

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記述言語：英語   出版者・発行元：Knee Surgery, Sports Traumatology, Arthroscopy  

Purpose: The “Grand-piano sign” is a popular indicator of the appropriate rotational alignment of the femoral component during total knee arthroplasty (TKA). The aim of the study was to investigate the shape of the anterior femoral resection surface of varus and valgus knees. Methods: A cohort of 80 varus knees and 40 valgus knees (hip–knee–ankle angle > 2° for varus and < − 2° for valgus knees) matched for age, sex, height, body weight, and KL grade was made using propensity score matching. Virtual TKA was performed using 3 patterns of components (anterior flange flexion angles of 3°, 5°, and 7°). The anterior femoral resection surface was evaluated for 3 patterns of rotational alignments: parallel to the surgical epicondylar axis (NR, neutral rotation), 3° internal rotation (IR), and 3°external rotation (ER) relative to the surgical epicondylar axis. In each anterior femoral resection surface, the vertical height of medial and lateral condyles was measured, and the ratio of the medial to the lateral height (M/L ratio) was evaluated. Results: The M/L ratio in NR for both varus and valgus knees was 0.57 to 0.64, with no significant difference between the cohorts (p value > 0.05). The M/L ratio showed a similar pattern of increasing at IR and decreasing at ER in both varus and valgus knees. The variation in the M/L ratio with malrotation in valgus knees was smaller than in varus knees. Conclusion: During TKA, the anterior femoral resection surface was similar in varus and valgus knees; however, the variation with malrotation was smaller in valgus knees than in varus knees. TKA for valgus knees requires precise surgical technique and careful intraoperative assessment. Level of evidence: IV, Case series.

DOI： 10.1007/s00167-023-07365-4

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記述言語：英語   出版者・発行元：HIP International  

Background: No studies have compared patient satisfaction between periacetabular osteotomy (PAO) and total hip arthroplasty (THA) for osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) in Asian cohorts. Methods: Multivariate analyses were applied to determine whether patient demographics and postoperative patient-reported outcomes were correlated with postoperative patient satisfaction in 737 DDH patients (251 PAO and 486 THA patients). Additionally, postoperative patient satisfaction, Oxford Hip Score (OHS), University of California-Los Angeles (UCLA) activity score, and sports participation were compared between propensity-matched PAO and THA patients for OA secondary to DDH (Kellgren-Lawrence grade II: 32 PAO and 16 THA patients, grade III: 20 PAO and 40 THA patients). Results: Of the 737 patients, 663 patients (90%) were postoperatively satisfied. Multivariate analysis demonstrated that THA was positively correlated with patient satisfaction. Furthermore, high postoperative OHS-pain, OHS-ADL, and UCLA scores were positively correlated with satisfaction. In propensity-matched PAO and THA patients, PAO elicited greater patient satisfaction than THA for KL grade II OA secondary to DDH, with comparable postoperative OHS (including the pain and ADL subscale), UCLA score, and sports participation rate. In contrast, THA resulted in better satisfaction and OHS-pain for KL grade III OA secondary to DDH, with comparable postoperative OHS-ADL, UCLA score, and sports participation rate in the 2 surgeries. Conclusions: Both PAO and THA procedures offer distinct patient satisfaction advantages based on preoperative OA severity. These findings can assist in the clinical decision-making process for the surgical treatment of middle-aged patients with symptomatic DDH.

DOI： 10.1177/11207000221114272

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記述言語：英語   出版者・発行元：Scientific Reports  

There are no reports on hip kinetics including contact forces and muscle activities during the golf swing after total hip arthroplasty (THA). The aim of this study was to identify the characteristics of three-dimensional dynamics during the golf swing. Ten unilateral primary THA patients participated in motion capture test of their driver golf swing. The driver swing produced approximately 20–30° of rotation in both lead and trail replaced hips. The mean hip contact forces (HCFs) of lead and trail replaced hips were 5.1 and 6.6 × body weight, respectively. Left and right THAs showed similar HCFs of lead and trail hips. More than 60% of the Percent maximum voluntary isometric contraction was found in bilateral iliopsoas muscles in all unilateral THA. Three factors [female sex, lower modified Harris Hip Score, and higher HCF of surgical side] were associated with the golf-related replacement hip pain. Golf is an admissible sport after THA because driver swings do not contribute excessive rotation or contact forces to hip prostheses. HCF could be reduced through swing adjustments, which may allow patients with golf-related replacement hip pain to develop a comfortable golf game free from pain.

DOI： 10.1038/s41598-023-35484-y

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記述言語：英語   出版者・発行元：Scientific Reports  

This study aimed to (1) set a reference value for anterior center edge angle (ACEA) for preoperative planning of periacetabular osteotomy (PAO), (2) investigate the effects of pelvic rotation and inclination from false profile (FP) radiographs on the measured ACEA, and (3) determine the “appropriate range of positioning” for FP radiograph. This single-centered, retrospective study analyzed 61 patients (61 hips) who underwent PAO from April 2018 and May 2021. ACEA was measured in each digitally reconstructed radiography (DRR) image of the FP radiograph reconstructed in different degrees of pelvic rotation. Detailed simulations were performed to determine the “appropriate range of positioning” (0.67 < ratio of the distance between the femoral heads to the diameter of the femoral head < 1.0). The vertical-center-anterior (VCA) angle was measured on the CT sagittal plane considering the patient-specific standing positions, and its correlation with the ACEA was investigated. The reference value of ACEA was determined by receiver operating characteristic (ROC) curve analysis. The ACEA measurement increased by 0.35° for every 1° pelvic rotation approaching the true lateral view. The pelvic rotation with the “appropriate range of positioning” was found at 5.0° (63.3–68.3°). The ACEA on the FP radiographs showed a good correlation with the VCA angle. The ROC curve revealed that an ACEA < 13.6° was associated with inadequate anterior coverage (VCA < 32°). Our findings suggest that during preoperative PAO planning, an ACEA < 13.6° on FP radiographs indicates insufficient anterior acetabular coverage. Images with the “appropriate positioning” can also have a measurement error of 1.7° due to the pelvic rotation.

DOI： 10.1038/s41598-023-35514-9

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記述言語：英語   出版者・発行元：Oxford University Press  

脛骨の楔状開大型骨切り術または人工膝関節置換術を受けた60歳以上の患者を対象に、患者立脚型評価法(KOOS)を用いて短期治療成績を評価した。炎症性および外傷性関節炎の症例は除外した。患者を術式に応じて高位脛骨骨切り術(HTO)群162例と人工膝関節置換術(TKA)群134例の2群に分類した。患者背景に有意な群間差を認めたため、傾向スコアマッチング法により55組の患者群を選出した。マッチング後は年齢、性別、BMI、術前のKOOSスコアに有意な群間差はなかった。いずれの群においても術前に比べて術後1年におけるKOOSの5項目(症状、疼痛、ADL、スポーツ・娯楽活動、QOL)の平均値は有意に上昇した。術後1年の上記5項目はいずれもHTO群とTKA群の間に有意差はなく、症状に関するKOOSスコアはHTO群で78.8、TKA群で79.2で、ADLおよびQOLの項目に関しても同等であった。疼痛はTKA群(83.4)の方がHTO群(79.4)より高く、スポーツ・娯楽活動はHTO群(53.3)の方がTKA群(47.9)より高かったが、いずれも統計的に有意でなかった(それぞれP=0.20とP=0.29)。

記述言語：英語   出版者・発行元：(公社)日本整形外科学会  

絶対骨盤軸として用いられる上前腸骨棘(ASIS軸)の確度について検討した。膝関節全置換術を受けた60例(A群:男性17例、女性43例、平均75.7±8.2歳)と大腿頸部骨折患者50例(B群:男性14例、女性36例、平均81.2±8.1歳)のCTスキャンデータを収集した。三次元的に両大腿骨頭を通過するラインを骨盤の絶対参照軸と定義し、冠状面では大腿骨頭軸と六つの骨盤ランドマークを介した軸との誤差を求め、軸平面では四つの骨盤ランドマークを通過するラインの誤差を測定した。A群とB群にみられる冠状面での軸誤差は同等の結果となり、A群の誤差は寛骨臼上面、ティアドロップ基部、ASIS前面、閉鎖孔上面、閉鎖孔下面、坐骨結節遠位面の順に小さく、B群の誤差は寛骨臼上面、ティアドロップ基部、閉鎖孔上面、ASIS前面、閉鎖孔下面、坐骨結節遠位面の順に小さかった。軸平面での軸誤差はA群、B群ともに寛骨臼後面、寛骨臼前面、ASIS前面、坐骨結節後面の順に小さかった。軸誤差は測定ラインが大腿骨頭軸に近づくにつれて小さくなり、ASIS軸の誤差は中等量を示していた。ASISは必ずしも信頼に足る指標になるとは限らないと考えられた。

記述言語：英語   出版者・発行元：Journal of Orthopaedic Science  

Background: This study aims to evaluate the accuracy of the axis connecting both anterior superior iliac spines (ASIS axis) as the absolute pelvic axis. No study has ever verified the accuracy of ASIS axis particularly on the AP pelvic radiograph, which cannot be specified on it. Methods: Sixty patients who underwent total knee arthroplasty and fifty patients with femoral neck fracture were recruited as subjects without hip deformities and their CT scan data were collected. We defined the line through both center of femoral heads as absolute reference axis of pelvis three-dimensionally. On the coronal plane, the errors between the femoral head axis and the axes through six pelvic landmarks in total, including ASIS were analyzed. On the axial plane, the errors of the lines through four landmarks were analyzed in the same way. Finally, on the coronal images, the mediolateral diameter of the obturator foramen and the mediolateral distance between the midline of the sacrum and the pelvic cavity were measured to evaluate bilateral symmetry of the pelvis. Results: The errors tended to be smaller as the axes were closer to the femoral head axis (axes connecting bilateral superior aspects of the acetabulum and the teardrops) and the ASIS axis errors were moderate. The obturator foramen based on the ASIS axis was more asymmetrical than the femoral head axis. Conclusion: Adjusting the pelvic tilt and rotation, surgeons should not always rely on the ASIS and refer to appropriate, close to the hip joint references in each case.

DOI： 10.1016/j.jos.2022.01.011

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記述言語：英語   出版者・発行元：Modern Rheumatology  

Objectives: The purpose of the present study was to evaluate improvement in the Knee Injury and Osteoarthritis Outcome Score (KOOS) after open-wedge high tibial osteotomy (HTO) in comparison with total knee arthroplasty (TKA) in cohorts over age 60 matched by pre-operative age, gender, body mass index (BMI), hip-knee-ankle angle (HKAA), KOOS sub-scores, and osteoarthritis (OA) grade. Methods: Propensity score matching was performed between 162 HTO patients and 134 TKA patients. When calculating the propensity score by multivariate logistic regression analysis, the following pre-operative confounders were included: age, gender, BMI, HKAA, KOOS sub-scores, and OA grade. Consequently, a total of 55 patients were included in each group. The Student's t-test was used to analyse differences in the post-operative KOOS sub-scores between groups. Results: After propensity score matching, all matched pre-operative valuables were identical, with no significant differences between the HTO and TKA groups. None of the post-operative KOOS sub-scores at 1 year after surgery showed a significant difference between the HTO and TKA groups. Both groups demonstrated significant and comparable post-operative improvement in every KOOS sub-score. Conclusions: In patients over age 60, there was no significant difference in short-term pain relief and improvements in activity and quality of life between HTO and TKA after propensity score matching including pre-operative age, KOOS sub-scores, and OA grade. HTO is a joint preservation procedure that is valid for knee OA even in individuals over age 60.

DOI： 10.1093/mr/roac052

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記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【目的】当院における関節リウマチ（RA）に対する人工膝関節全置換術（TKA）の患者背景の変遷を調査し，長期患者立脚評価を行った．【対象と方法】2001年～2015年に当院で施行されたTKA数の推移を調査した．同期間に施行されたRAに対するTKA（RA-TKA）158例で術前の患者背景を解析した．同158例から現在の年齢が80歳以下である52例72膝を抽出し，Knee Society Score（KSS）を送付した．返答のあった28例38膝でKSSの各項目（膝の症状，満足度，手術に関する期待度）における点数，各項目に影響を与えうる因子に関して統計解析を行った．【結果】RA-TKAの症例数は減少し，TKA患者の術前の血液検査で炎症所見は有意に低下傾向であった．術後平均14年のRA-TKAのKSSのスコアは，当院にて施行された変形性膝関節症に対するTKAの術後平均4年成績と同等であった．【考察】薬物療法の変遷の影響と思われるRA-TKA数の減少傾向を認めた．術後長期のKSSは比較的良好であったが，その影響因子の解明が今後の課題である．</p>

DOI： 10.5035/nishiseisai.72.212

CiNii Research

記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【はじめに】本研究の目的は，当院で施行した寛骨臼移動術（TOA）の術後20年以上の長期成績を調査し，関節温存に関連する影響因子を明らかにすることである．【方法】1996-2005年に当院でTOAを施行した患者で追跡可能であった159例172股（平均観察期間21年）を対象とした．THA conversionをエンドポイントとしたときの累積温存率を，Kaplan-Meier生存分析を用いて調査した．関節温存に関連する影響因子は，単変量および多変量Cox回帰分析を用いて調査した．【結果】31例33股がTHA conversionとなり，術後20年の累積温存率は79.7％であった．多変量解析では，術前病期が唯一の有意な影響因子であり，リスク比は2.69（p＝0.003）だった．一方，年齢は影響因子ではなかった（p＝0.153）．手術時年齢を考慮して術前病期別に比較したところ，前・初期では45歳未満が89.8％，45歳以上が86.2％と年齢に関わらず（p＝0.62），良好な結果を示した．一方で，進行期では45歳未満が66.7％，45歳以上51.1％と年齢に関わらず（p＝0.75），前・初期よりも関節温存率は低かった．【考察】寛骨臼形成不全に対するTOAにおいて，長期での良好な関節温存を得るためには，術前病期が前期・初期であることが重要であり，手術時の年齢は影響しなかった．</p>

DOI： 10.5035/nishiseisai.72.24

CiNii Research

記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【目的】Dorr type Cに対するTHAにおけるステム沈下（Subsidence）に関してFit-and-fill stemとTaper wedge stemで比較検討すること．【方法】Dorr type Cに対してPrimary THAを行ったFit-and-fill stem群48例，Taper wedge stem群43例を対象とした．患者背景として疾患，性別，年齢，BMIを調査した．Subsidence量は術直後と術後1週，術後1週と術後6週，術直後と術後6週の3ポイントでX線を用いて評価した．【結果】両群間で患者背景に有意差は認めなかった．術直後から術後6週，術後1週から術後6週でのSubsidence量は，Fit-and-fill stem群に比べTaper wedge stem群の方が有意に小さかった．また，3 mmを超えるSubsidenceは，Fit-and-fill stem群で8例，Taper wedge stem群で1例に認め有意にFit-and-fill stem群で多かった．多変量解析の結果，ステムの種類が3 mmを超えるSubsidenceに影響を与える独立した因子であった．【結語】本研究結果からDorr type CにはFit-and-fill stemよりTaper wedge stemの方が適していると考えられた．</p>

DOI： 10.5035/nishiseisai.72.292

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記述言語：英語  

DOI： 10.1093/jhps/hnac047

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出版者・発行元：南江堂  

DOI： 10.15106/j_seikei74_291

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Journal of Arthroplasty  

Background: There is increasing interest in improving activity after total hip arthroplasty (THA) and periacetabular osteotomy (PAO). The present study evaluated whether there were differences in the subjective and objective activity levels of THA and PAO patients at mean 12-year follow-up (range 4-20) and what factors influence the objective activity levels. Methods: THA and PAO patients (30 patients each; mean age: 66 and 63 years, respectively), who had undergone surgery for osteoarthritis due to acetabular dysplasia, were included. Patients were retrospectively matched based on age, gender, body mass index, follow-up duration, and preoperative University of California, Los Angeles activity score (UCLA score). Patients were surveyed for the subjective activity levels using the Oxford Hip Score and UCLA score. Objective activity levels (the number of steps, upright time, and the number of sit-to-stand transitions) were made using an accelerometer. Results: There was no significant difference in subjective activity level between THA and PAO patients. The number of steps was significantly higher in PAO than in THA patients. Multivariable analyses revealed that THA and low Oxford Hip Score activities of daily living were negatively associated with the number of steps, that men and high UCLA score were negatively associated with upright time, and that high body mass index was negatively associated with sit-to-stand transitions in THA and PAO patients. Conclusion: This study suggested that although there was no difference in postoperative subjective activity level between THA and PAO patients, there was a difference in objective activity level. Providing guidance to these patients based on objective activity may lead to higher activity levels.

DOI： 10.1016/j.arth.2022.08.034

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記述言語：英語   出版者・発行元：Modern Rheumatology Case Reports  

To our knowledge, only one previous report described the treatment of osteochondral autograft for steroid-induced osteonecrosis of the humeral head (ONHH) in a middle-aged patient. The present report describes a 20-year-old man who was found to have avascular osteonecrosis of the right humeral head after corticosteroid pulse treatment, followed by oral corticosteroid therapy. The patient complained of serious right shoulder pain and limited range of motion (ROM). Anteroposterior (AP) radiographs of the right shoulder revealed a crescent sign at the humeral head, indicating subchondral bone collapse with a linear sclerotic change and normal articular surface of the glenoid. The case was categorized as Stage 3 according to the Cruess classification. In general, Cruess classification Stage 3 is treated with humeral head replacement and shoulder arthroplasty. The patient underwent surgical treatment involving osteochondral autograft transplantation. Autografts were harvested from the right knee. At the 1.5-year follow-up, the patient was pain-free and showed an improved active ROM. Furthermore, AP radiographs demonstrated that the glenohumeral joint space was maintained, and no progression of humeral head collapse was observed. This case may be helpful in decision-making if young patients with ONHH require surgical treatment. Furthermore, osteochondral autograft transplantation may be an effective treatment for ONHH.

DOI： 10.1093/mrcr/rxac037

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Oxford University Press  

症例は20歳男性で、重度の右肩関節痛と可動域(ROM)制限を訴えた。1年前に皮膚筋炎と診断されてステロイドパルス療法を開始されたが、その後、両側肩関節痛、股関節痛、軽度膝関節痛をきたした。両側上腕骨頭、大腿骨頭、大腿顆に生じた骨壊死と診断され、肩関節のUCLAスコアは17点、JOAスコアは48点を示し、肩関節前後方向X線検査では上腕骨頭にcrescent sign、CTにて軟骨下骨挫滅を認め、右上腕骨頭のステロイド誘発性骨壊死と診断した。本例は若年で忍容性が高いと判断し、人工関節置換術ではなく自家骨を用いた骨軟骨カラム移植を行う方針とした。術中所見では長軸に沿って22mm、短軸に沿って20mmの範囲で軟骨下骨の挫滅が認められ、内側滑車と外側滑車の非荷重領域より計三つの自家骨を採取し、骨壊死部に埋入した。術後、右上肢に三角巾をかけて固定し、2週後に振り子運動、3週後にROM運動を許可した。1年後のCTでは自家骨の完全癒合がみられ、1年半後、無痛状態を維持しておりROM改善が得られていた。

記述言語：日本語   出版者・発行元：日本関節病学会  

<p><b>目的</b>：寛骨臼形成不全（DDH）に対するperiacetabular osteotomy（PAO）の至適な骨片の移動方向・移動量については定まった指標がない。本研究の目的は，PAOにおいて，股関節の力学的環境を最適化する骨片の移動方向・移動量を明らかにすることである。</p><p><b>方法</b>：DDH患者（LCE角<25°）の32例32股（全例女性，平均年齢40歳，平均LCEA 9°）を対象とした。股関節CT DICOM dataを用い，立位骨盤傾斜を再現した上で有限要素解析を行った。LCEA 30°・35°・40°に前方回転0°・5°・10°・15°を追加した12通りのPAOシミュレーションを行い，片脚立位想定時の寛骨臼軟骨の接触面積・最大接触圧力（Max CP）を算出した。正常ボランティア16例16股の結果からMax CPの正常範囲は4.1MPa未満とした。</p><p><b>結果</b>：前方回転（−）よりも前方回転（＋）で接触面積は増加し，Max CPは減少した。12通りのPAOシミュレーションの中で，Max CPが正常化する割合はLCE角30°＋前方回転15°のときで87.5%（27/32股）と最も多く，続いてLCE角35°＋前方回転15°のときで84.4%（27/32股）であった。</p><p><b>考察</b>：PAOの際，寛骨臼の側方回転に前方回転を追加することで接触面積は増大し，接触圧力は減少した。症例により骨片の至適位置は異なるが，LCE角30°～35°に前方回転を15°追加した際，Max CPは最も正常化しやすいことが示唆された。</p>

DOI： 10.11551/jsjd.42.36

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本運動器理学療法学会  

DOI： 10.57281/jofmpt.3.o-141

CiNii Research

記述言語：英語   出版者・発行元：Journal of Bone and Joint Surgery  

Background:Missing responses are common when Asian patients complete the Forgotten Joint Score-12 (FJS-12), which is widely used to evaluate total hip arthroplasty (THA). We aimed to provide orthopaedic researchers with a solution for handling missing values in such patient-reported outcome measures (PROMs).Methods:Patients who had undergone primary THA between 1998 and 2016 (n = 1,021) were investigated in 2020. The FJS-12 and 9 other PROMs, including questions related to Asian lifestyle activities, were administered. Risk factors for missing FJS-12 items were investigated. Partial respondents were matched with complete respondents; then, in each pair, the items not completed by the partial respondent were deleted from the responses of the complete respondent. Predictive mean matching (PMM) was performed in an attempt to recover the deleted items, using 65 sets of imputation models. After the missing values had been imputed, we explored patient characteristics that affected the FJS-12, using data from all complete and partial respondents.Results:A total of 652 patients responded to the survey (393 complete and 193 partial respondents). Partial respondents were older, more often female, and less active. Older respondents were more likely to skip items involving the bed, while those who reported a better ability to sit in the seiza style (traditional Japanese floor sitting) were more likely to skip items about chair sitting. The imputed FJS-12 value exhibited excellent reliability (intraclass correlation coefficient for agreement with the true scores, 0.985). FJS-12 values of complete respondents were significantly higher than those of respondents with 4 to 11 missing items (51.6 versus 32.8, p < 0.001). Older age was associated with higher FJS-12 values, which was revealed only via analysis of the multiply imputed data sets (p < 0.001).Conclusions:Analysis of only complete FJS-12 responses after THA resulted in a nonresponse bias, preferentially excluding older, female, and less active individuals and those with a traditional floor living style. Multiple imputation could provide a solution to scoring and analyzing PROMs with missing responses by permitting the inclusion of partial respondents.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

DOI： 10.2106/JBJS.21.01547

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記述言語：英語   出版者・発行元：Knee Surgery, Sports Traumatology, Arthroscopy  

Purpose: To identify the factors impacting changes in valgus laxity between before and after open-wedge high tibial osteotomy (OW-HTO) using quantitative valgus stress radiographs. Methods: A total of 40 knees from 38 patients who underwent OW-HTO were assessed. The study population comprised 14 men and 24 women, with a mean age of 61.5 years. Valgus stress radiographs before and 1 year after OW-HTO were performed using a Telos device. The difference between pre- and postoperative joint line convergence angle (JLCA) was expressed as ΔJLCA (post–pre). As indicators of the proximal detachment of superficial medial collateral ligament (sMCL) on radiographs, two distances were defined: the distance from the level of the osteotomy starting point to the tangent line of the proximal tibial plateau (Distance A), or to the medial edge of the proximal tibial plateau (Distance B). Correlations between ΔJLCA and radiographic parameters or KOOS sub-scores were assessed using Spearman’s rank correlation coefficient analysis. Receiver operator curves were generated to evaluate the predictive strength of the significant factor for an increase in ΔJLCA > 1°. Results: Pre-operative OA severity consisted of Kellgren–Lawrence grade 2 (n = 18), 3 (n = 16), and 4 (n = 6). The average ΔJLCA (post–pre) was 0.5°, and ranged from − 1.4° to + 3.0°. The maximum systemic measurement error and limits of agreement were 0.07° and 0.20°, respectively. There were significant correlations between ΔJLCA and Distance A (36.9 ± 3.9 mm, R = − 0.46, p = 0.002), between ΔJLCA and Distance B (39.9 ± 4.0 mm, R = − 0.49, p = 0.001). The cut-off value for Distance A was determined to be 35 mm below the tibial plateau; the AUC was 0.804, with a sensitivity of 0.75 and a specificity of 0.82. Distance B correlated strongly with Distance A (R = 0.96, p < 0.001). There was no significant correlation between ΔJLCA and KOOS sub-scores 1 year after OW-HTO. Conclusions: Transverse osteotomy closer to tibial plateau was associated with larger valgus joint laxity postoperatively. This finding implies that sMCL proximal detachment, which was related to the level of the osteotomy starting point on the proximal tibia, potentially affected postoperative valgus laxity. Level of evidence: IV.

DOI： 10.1007/s00167-021-06810-6

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記述言語：英語   出版者・発行元：Frontiers in Bioengineering and Biotechnology  

Objectives: The study aimed to elucidate target cup orientation and stem anteversions to avoid impingement between the liner and stem neck even at hip rotation with adduction during the deeply flexed posture. Methods: A computer simulation analysis was performed on 32 total hip arthroplasty patients applying patient-specific orientation of the components and in vivo hip kinematics obtained from three-dimensional analysis of the squatting motion. The anterior/posterior liner-to-neck distance and impingement were evaluated based on a virtual change in internal/external rotation (0°–60°) and adduction/abduction (0°–20°) at actual maximum flexion/extension during squatting. Cutoff values of cup orientations, stem anteversion, and combined anteversion to avoid liner-to-neck impingements were determined. Results: The anterior liner-to-neck distance decreased as internal rotation or adduction increased, and the posterior liner-to-neck distance decreased as external rotation or adduction increased. Negative correlations were found between anterior/posterior liner-to-neck distances at maximum flexion/extension and internal/external rotation. Anterior/posterior liner-to-neck impingements were observed in 6/18 hips (18/56%) at 45° internal/external rotation with 20° adduction. The range of target cup anteversion, stem anteversion, and combined anteversion to avoid both anterior and posterior liner-to-neck impingements during squatting were 15°–18°, 19°–34°, and 41°–56°, respectively. Conclusion: Simulated hip rotations caused prosthetic impingement during squatting. Surgeons could gain valuable insights into target cup orientations and stem anteversion based on postoperative simulations during the deeply flexed posture.

DOI： 10.3389/fbioe.2022.1023721

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記述言語：英語   出版者・発行元：Scientific Reports  

This study aimed to investigate the influence of bone marrow edema (BME) for the assessment of the boundaries of necrotic lesions using unenhanced and contrast-enhanced (CE) magnetic resonance (MR) images in patients with osteonecrosis of the femoral head (ONFH). We retrospectively reviewed 72 consecutive hips in 55 patients of ONFH that were Association Research Circulation Osseous (ARCO) stage III or higher and underwent both unenhanced and contrast-enhanced MR imaging between January 2005 and February 2016. The degree of extension of BMEs, and the boundaries of the necrotic lesions were compared using unenhanced and CE MR images on both mid coronal and mid oblique-axial slices. Forty-two percent of the coronal T1 images, 40% of the coronal fat-saturated T2 images, and 48% of the oblique-axial T1 images showed differences in the boundaries of necrotic lesion, by comparison with those of CET1-weighted MR images. The boundaries of necrotic lesions were clearly detected in all hips on CE coronal slices and 97% of all hips on CE oblique-axial slices. The BME grade in the difference group was significantly higher than in the non-difference group on the coronal plane (P = 0.0058). There were significant differences between the BME grade and duration from the onset of hip pain to MR imaging examination. Multivariate analyses revealed that the duration from the onset to MR imaging examination in both coronal (P = 0.0008) and oblique-axial slices (P = 0.0143) were independently associated with differences in the boundary of necrotic lesion between T1 and CET1-weighted MR images. Our findings suggest that unenhanced MR image may be insufficient for a precise assessment of the boundaries of the necrotic lesions for ONFH cases in the early phase of subchondral collapse due to the diffuse BME.

DOI： 10.1038/s41598-022-23427-y

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記述言語：英語   出版者・発行元：Archives of Orthopaedic and Trauma Surgery  

Introduction: The purpose of this study was to evaluate balance function before and after total knee arthroplasty (TKA) using Berg balance scale (BBS). The study also aimed to identify factors associated with balance impairment. Materials and methods: Ninety-three knees in 90 patients were prospectively evaluated using their BBS scores, passive knee extension/flexion angles, Visual analogue scale for pain scores, hip–knee–ankle angles, and knee extensor/flexor muscle strengths before and after TKA. A total BBS score of less than 45 indicates an enhanced risk of multiple falls. Multivariate logistic regression models were performed to elucidate factors associated with post-operative BBS score. Results: A significant difference in mean pre- and post-operative BBS scores were noted (49.3 ± 6.4 vs. 52.2 ± 4.7) (p < 0.05). The percentage of pre- and post-operative BBS scores less than 45 were 20% and 10% (p < 0.05). Rheumatoid Arthritis (RA), lower pre-operative BBS score, and larger post-operative knee flexion contracture were significantly associated with lower post-operative BBS score (p < 0.01). The post-operative knee flexion contracture greater than 10° was significantly associated with substantially high odds of post-operative BBS scores less than 45 (Odds ratio 7.6; 95% confidential interval 1.69–34.17). Conclusions: While TKA significantly improved BBS scores, 10% of the patients remained at a risk for multiple falls. RA, lower pre-operative BBS score, and post-operative knee flexion contracture greater than 10° retained balance impairment even after TKA.

DOI： 10.1007/s00402-021-04233-z

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記述言語：英語   出版者・発行元：Clinical Anatomy  

It is important to investigate anatomical differences of the femur and tibia three-dimensionally between varus and valgus knees to enhance surgical approaches and better understand structural factors related to specific patterns of osteoarthritis progression. Three-dimensional femoral and tibial bone models were reconstructed from transverse computed-tomography scans in varus osteoarthritis (43 knees), valgus osteoarthritis (40 knees), and healthy (32 knees) groups. Different coordinate systems were defined in each femoral bone model (“Knee” and “Hip” Coordinate System). Femoral neck inclination, lateral bowing, anterior bowing, and neck anteversion were measured and compared between knee and hip coordinate systems. Those parameters were also compared between varus, valgus, and healthy groups. The tibial anterior and lateral bowing, external torsion and the fibular axis relative to the tibial mechanical axis were measured and compared between varus and valgus groups. Femoral neck anteversion was significantly 1–2° greater in the hip coordinate system compared to the knee coordinate system. Femoral neck anteversion was significantly smaller in varus knees than in healthy or valgus knees, with average difference of approximately 5°. The knee and hip joint are often rotated externally relative to the trunk axis in patients with varus osteoarthritis, perhaps maintaining the geometric relations between pelvis and proximal femur (including peripheral hip muscles) regardless of knee deformities. The fibular axis was inclined slightly valgus and posteriorly in two groups. The results may inform hypotheses on, and future studies of, skeletal morphologic development and factors contributing to the progression of knee osteoarthritis.

DOI： 10.1002/ca.23862

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記述言語：英語   出版者・発行元：Gait and Posture  

Background: In modern society, car usage is one of the most important activities of daily living. However, the three-dimensional (3D) mechanics of getting into and out of a car in total hip arthroplasty (THA) patients have not been studied. Research question: This study aimed to elucidate the hip kinematics and kinetics of unilateral THA patients while getting into and out of a car. Methods: 3D motion and ground reaction force data were collected for 40 unilateral primary THA and 30 control participants using motion capture of getting into and out of a car. Normalized joint power was used to determine the individual joint contribution and was calculated by dividing the power of each joint by the total lower-extremity power. These kinematic and kinetic data were compared between unilateral THA and control participants. Results: When getting into the car using the surgical side as the pivot limb, the peak flexion, abduction angle, and normalized power of the pivot hip were significantly lower, and the normalized power of the contralateral ankle was significantly higher. The peak flexion and abduction angle of the pivot hip were significantly lower, and normalized contralateral hip power was significantly higher when getting out of the car. In getting into and out of the car using the contralateral side as the pivot limb, there was no significant difference in the range of motion (RoM) and normalized joint power. Significance: The restoration of RoM and muscle strength in the surgical hip joint and adopting the normal side as the pivot limb may allow for a more appropriate balance in motion of getting into and out of a car, which will lead to safe mobility, assist in social participation, and improved quality of life. Level of evidence: Level III, therapeutic study.

DOI： 10.1016/j.gaitpost.2022.10.003

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記述言語：英語   出版者・発行元：Journal of Arthroplasty  

Background: Identifying factors associated with poor hip contact mechanics after periacetabular osteotomy (PAO) may help surgeons optimize acetabular corrections in individual patients. We performed individual-specific finite-element analyses to identify preoperative morphological and surgical correction factors for abnormal contact pressure (CP) after PAO. Methods: We performed finite-element analyses before and after PAO with reference to the standing pelvic position on individual-specific 3-dimensional hip models created from computed tomography images of 51 dysplastic hips. Nonlinear contact analyses were performed to calculate the joint CP of the acetabular cartilage during a single-leg stance. Results: The maximum CP decreased in 50 hips (98.0%) after PAO compared to preoperative values, and the resulting maximum CP was within the normal range (<4.1 MPa) in 33 hips (64.7%). Multivariate analysis identified the roundness index of the femoral head (P = .002), postoperative anterior center-edge angle (CEA; P = .004), and surgical correction of lateral CEA (Δlateral CEA; P = .003) as independent predictors for abnormal CP after PAO. A preoperative roundness index >54.3°, a postoperative anterior CEA <36.3°, and a Δlateral CEA >27.0° in the standing pelvic position predicted abnormal CP after PAO. Conclusion: PAO normalized joint CP in 64.7% of the patients but was less likely to normalize joint CP in patients with aspheric femoral heads. Successful surgical treatment depends on obtaining adequate anterior coverage and avoiding excessive lateral correction, while considering the physiological pelvic tilt in a weight-bearing position.

DOI： 10.1016/j.arth.2022.04.045

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記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>内側楔状開大式高位脛骨骨切り術（Open wedge high tibial osteotomy以下OW-HTO）後の満足度・期待度を評価した報告は少ない．今回当科でのOW-HTO術後の満足度・期待度を調査し，影響因子を探索した．当院で2014年8月～2019年12月の期間中にOW-HTO手術を受けた80膝に対し，2011 Knee Society scoreアンケートを送付した．手術時年齢，手術時BMI，術前可動域，術前K-L分類，術中開大角，術前後X線計測値（％MA，HKA angle，MPTA，JLCA），62.5-術後％MAの絶対値（outlier）を計測し，KSSの満足度スコア，期待度スコアに相関する因子を評価した．計54膝の返信（67.5％）を得られ，術後フォロー期間は平均3.6年であった．62.5-術後％MAの絶対値が大きいほど，術後の期待度除痛スコアが有意に低かった（p＝0.01）．術後％MAが62.5％から10％以上外れているoutlier群とそうでない群の群間比較にて期待度除痛スコアに有意差がみられた（p＝0.0292）．術後％MAのoutlierは，OW-HTO術後の期待する除痛に影響する重要な指標である．</p>

DOI： 10.5035/nishiseisai.71.584

CiNii Research

記述言語：日本語   出版者・発行元：西日本整形・災害外科学会  

<p>【はじめに】大腿骨骨切り後の人工股関節置換術（以下THA）は，通常の初回THAと比較して骨折の合併に注意が要することが報告されている．骨切り時に挿入した固定材料の抜去（抜釘）が骨折合併に影響するかを検討した報告は渉猟する限りない．骨切り後THA症例における骨折合併に影響する因子を，抜釘の有無を含めて検討することを本研究の目的とした．【対象と方法】2008年-2020年の間にPerfix HA 910を用いて施行された骨切り後THA101股を対象とした．術中骨折または術後1ヶ月以内の外傷のない骨折を骨折合併ありとした．THA時の年齢，骨切りからTHAまでの期間，同時抜釘の有無，先行骨切り術について調査し，骨折合併に影響する因子を解析した．【結果】骨折合併は7関節（6.9％）に認めた．多変量解析の結果，同時抜釘ありと骨切りからTHAまでの期間が骨折合併に有意な影響を及ぼす因子として同定された．【結語】本研究結果より，抜釘を伴う骨切り後THAは骨折を合併しやすいことが示唆された．大腿骨骨切り後症例に対しては，将来のTHAを考慮すると，事前に抜釘しておくことが薦められる．</p>

DOI： 10.5035/nishiseisai.71.494

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Geriatric Orthopaedic Surgery and Rehabilitation  

Introduction: Lower-limb osteoarthritis (OA) in the elderly can be a risk factor for frailty, which is the preliminary of disability, but it may be reversible with appropriate interventions. We aimed to use the Kihon Check List (KCL) to assess multiple domains of frailty and to identify the characteristics of frailty in patients with hip or knee OA following total joint arthroplasty. Materials and Methods: This study included 136 ≥ 65-year-old patients (mean age: 73.0 years) who underwent total arthroplasty with end-stage hip and knee OA. We assessed frailty status, instrumental activities of daily living (IADL), and health-related quality of life (HRQoL) according to the KCL, functional ambulatory index (FAI) and EuroQol-5 Dimension (EQ5D), respectively, as well as the extent of pain preoperatively and at postoperative 6 months. Results: Using KCL, seventy-eight (57.4%) patients were frail preoperatively, but the prevalence significantly decreased to 52 patients (38.2%) at postoperative 6 months. Total arthroplasty intervention provided significant improvements in the total KCL scores, including the physical domain (P <.01), pain (P <.01), FAI scores (P <.01), and EQ5D (P <.01), but not the social domain. Multivariate logistic regression analysis identified age at surgery (OR:.93, 95% CI:.86-.99) and preoperative FAI score (OR: 1.10, 95% CI: 1.03-1.19) as independent predictors of postoperative frailty. Conclusions: Total arthroplasty procedures on patients with hip and knee OA reduced their KCL score, but social aspects were less improved than physical aspects in the shortterm. Older age and preoperative lower IADL score can be useful for accurately estimating less improvement of frailty in the early postoperative phase. Our results suggest that long term follow-up of OA is needed to provide comprehensive interventions, including in social aspects, especially for patients with lower activity.

DOI： 10.1177/21514593221126019

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記述言語：英語   出版者・発行元：International Journal of Rehabilitation Research  

The intensive rehabilitation of older patients after total knee arthroplasty (TKA) is vital for short-term improvement in mobility and daily living activities. We aimed to investigate the effectiveness of multidisciplinary rehabilitation and assess the early postoperative predictors that are associated with functional gain in TKA patients aged from 75 years in a postacute care setting. This study included 190 patients following primary TKA who were admitted at the postacute rehabilitation hospital. The main outcome measures were the motor component of functional independence measure (M-FIM), M-FIM effectiveness, numerical rating scale, knee extension strength and range of motion, 10-m walk test, Berg balance scale (BBS), and mini-mental state examination (MMSE). The functional gain between patient age groups of ≥75 (n = 105) and <75 (n = 85) years were compared. Although patients aged ≥75 years showed lower improvement in BBS score compared with <75 years, the M-FIM gains and other physical functions were similar in both age groups. In multivariate analysis, the results for M-FIM at admission (β: -0.703; P = 0.001), BBS (β: 0.342; P = 0.032) and MMSE (β: 0.446; P = 0.021) were independently associated with functional gain in the patients following TKA aged ≥75 years. Multidisciplinary inpatient rehabilitation was beneficial for basic functional gain except for improvement in balance ability in patients after TKA aged ≥75 years. Functional level, balance ability and cognitive status in the early postoperative period can be useful predictors for short-term functional gain in the postacute care phase.

DOI： 10.1097/MRR.0000000000000538

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出版者・発行元：Orthopedics  

Periacetabular osteotomy (PAO) is an effective joint-preserving procedure for developmental dysplasia of the hip. However, some patients report dissatisfaction after PAO. Because patient satisfaction is increasingly used as a health care quality metric, it is important to gain a better understanding of factors associated with patient satisfaction after PAO. The goal of this study was to investigate patient satisfaction among a cohort of Asian patients undergoing PAO. This study included 227 Asian patients who had undergone PAO at our institution between 1998 and 2016. The study participants completed a questionnaire assessing patient satisfaction, reasons for dissatisfaction, and postoperative Oxford Hip Score (OHS) and University of California, Los Angeles (UCLA), activity scale score. Based on their satisfaction levels, the participants were divided into 4 subgroups, and their demographic characteristics and postoperative patient-reported outcomes were compared. Of the 227 patients, 190 expressed satisfaction that correlated with OHS-pain, OHD-activities of daily living, and UCLA activity scale scores. Primary reasons for dissatisfaction after PAO were persistent pain (24 of 49, 49%), functional limitations (14 of 49, 29%), stiffness around the hip (4 of 49, 8%), unmet expectations (4 of 49, 8%), conversion to total hip arthroplasty (2 of 49, 4%), and complications (1 of 49, 2%). Multivariate analysis showed that preoperative Kellgren-Lawrence grades 1 and 3 were the significant predictive factors for satisfaction and dissatisfaction, respectively. The potential for lower patient satisfaction associated with Kellgren-Lawrence grade 3 because of persistent pain and functional limitations postoperatively suggests that consideration of preoperative severity of osteoarthritis could enhance patient satisfaction after PAO.

DOI： 10.3928/01477447-20220425-02

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Bone and Joint Journal  

Aims although periacetabular osteotomies are widely used for the treatment of symptomatic dysplastic hips, long-term surgical outcomes and patient-reported outcome measures (proMs) are still unclear. accordingly, we assessed hip survival and proMs at 20 years after transpositional osteotomy of the acetabulum (Toa). Methods a total of 172 hips in 159 patients who underwent Toa were followed up at a mean of 21.02 years (16.6 to 24.6) postoperatively. Kaplan-Meier analysis was used to assess survivorship with an endpoint of total hip arthroplasty (Tha). proMs included the visual analogue scale (VaS) Satisfaction, VaS pain, oxford hip Score (ohS), and Forgotten Joint Score-12 (FJS-12). Thresholds for favourable outcomes for OHS (≥ 42) and FJS-12 (≥ 51) were obtained using the receiver operating characteristic curve with VAS Satisfaction ≥ 50 and VaS pain < 20 as anchors. Results Tha was performed on 37 hips (21.5%) by the latest follow-up. Kaplan-Meier analysis indicated that the hip survival rate at 20 years was 79.7% (95% confidence interval (CI) 73.7 to 86.3). Multivariate analysis showed that preoperative Tönnis grade significantly influenced hip survival. Tönnis grades 0, 1, and 2 were associated with 20-year survival rates of 93.3% (95% cI 84.8 to 100), 86.7% (95% cI 79.8 to 94.3), and 54.8% (95% cI 41.5 to 72.3), respectively. More than 60% of the patients exhibited favourable proMs. an advanced Tönnis grade at the latest follow-up and a higher BMI were both significantly associated with unfavourable ohS, but not with other proMs. conclusion This study demonstrated the durability of Toa for hips with Tönnis grades 0 to 1 at 20 years. While the presence of advanced osteoarthritis and higher BMI was associated with lower hip functions (ohS), it was not necessarily associated with worse patient satisfaction and joint awareness.

DOI： 10.1302/0301-620X.104B7.BJJ-2021-1767.R1

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記述言語：英語   出版者・発行元：BMC Musculoskeletal Disorders  

Background: The coronal whole-leg radiograph is generally used for preoperative planning in total knee arthroplasty. The distal femoral valgus angle (DFVA) is measured for distal femoral bone resection using an intramedullary guide rod. The effect of coronal and sagittal femoral shaft bowing on DFVA measurement in the presence of malrotation or knee flexion contracture has not been well reported. The objectives of this study were: (1) to investigate the effects of whole-leg malrotation and knee flexion contracture on the DFVA in detail, (2) to determine the additional effect of coronal or sagittal femoral shaft bowing. Methods: We studied 100 consecutive varus and 100 valgus knees that underwent total or unicompartmental knee arthroplasty. Preoperative CT scans were used to create digitally reconstructed radiography (DRR) images in neutral rotation (NR, parallel to the surgical epicondylar axis), and at 5° and 10° external rotation (ER) and internal rotation (IR). The images were also reconstructed at 10° femoral flexion. The DFVA was evaluated in each DRR image, and the angular variation due to lower limb malposition was investigated. Results: The DFVA increased as the DRR image shifted from IR to ER, and all angles increased further from extension to 10° flexion. The DFVA variation in each position was 1.3° on average. A larger variation than 2° was seen in 12% of all. Multivariate regression analysis showed that sagittal femoral shaft bowing was independently associated with a large variation of DFVA. Receiver operating characteristic analysis showed that more than 12° of sagittal bowing caused the variation. Conclusion: If femoral sagittal bowing is more than 12°, close attention should be paid to the lower limb position when taking whole-leg radiographs. Preoperative planning with whole-leg CT data should be considered.

DOI： 10.1186/s12891-022-05542-z

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記述言語：英語   出版者・発行元：International Journal of Computer Assisted Radiology and Surgery  

Purpose: This prospective randomized controlled study examined whether accelerometer-based navigation resulted in more accurate or precise cup orientation than a conventional mechanical guide. We used a simulation to evaluate how cup orientation affected potential hip range of motion (RoM) and freedom from prosthetic impingement. Methods: Sixty hips were randomly allocated 1:1 to accelerometer-based portable navigation or conventional guidance. Procedures were performed through a standard posterolateral approach and combined anteversion technique. Cup inclination, cup anteversion, and stem anteversion were measured using computed tomography (CT). Using CT-based simulation, we evaluated impingement-free potential RoM and the proportion of hips with potential RoM required for daily activities. Results: Absolute cup inclination and anteversion error averaged 4.3° ± 3.2° and 4.4° ± 2.9° for the navigation cohort and 5.6° ± 3.7° and 5.7° ± 4.2° for the conventional cohort, with no significant differences. Navigation resulted in significantly less variation in anteversion error than the conventional guide (p =.0049). Flexion, internal rotation (IR) at 90° of flexion, extension, and external rotation (ER) averaged 123° ± 12°, 46° ± 13°, 50° ± 10°, and 73° ± 23°, respectively, in the navigation cohort and 127° ± 10°, 52° ± 14°, 45° ± 10°, and 63° ± 12°, respectively, in the conventional cohort (p =.15,.15,.03, and.03, respectively). Flexion > 110°, IR > 30° at 90° of flexion, extension > 30°, and ER > 30° were achieved by 93%, 90%, 100%, and 100% of hips, respectively, in the navigation cohort and 97%, 93%, 97%, and 100% of hips, respectively, in the conventional cohort, with no significant differences. Conclusions: Cup anteversion with the navigation system was more precise, but not more accurate, than with the conventional guide. The navigation cohort exhibited greater potential extension and ER than the conventional cohort, but no significant difference in impingement within the potential RoM required for daily activities. Trial registration number: 29036. Date of registration: November 14, 2017.

DOI： 10.1007/s11548-022-02592-5

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記述言語：英語   出版者・発行元：Journal of Artificial Organs  

The impact of sports on long-term wear of highly cross-linked polyethylene (XLPE) after total hip arthroplasty (THA) is not fully understood. We investigated (1) the wear performance of the first-generation XLPE, and (2) whether sports participation influences the steady wear rate of XLPE. The femoral head penetration into the cup was measured digitally on radiographs of hips undergoing THA with XLPE. We retrospectively reviewed data that included age, gender, body mass index, follow-up period, preoperative diagnosis, types of XLPE, ball diameter, head material, inclination of the cup, physical function score, and sports participation. Statistical analyses were applied to determine whether sports affect the wear of XLPE and which factors were associated with the steady wear rate. Creep and steady wear rate were found to be 0.18 mm and 0.005 mm/year, respectively. Sports participation, regardless of impact, provided no significant difference in the steady wear rate. Multiple regression analysis demonstrated that sports did not increase the steady wear rate. Our findings showed excellent wear performance of the first-generation XLPE at a minimum of ten years after THA, without significant effect of sports participation on the liner wear.

DOI： 10.1007/s10047-021-01297-x

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記述言語：英語   出版者・発行元：シュプリンガー・ジャパン(株)  

高架橋ポリエチレン(XLPE)寛骨臼ライナーを組込んだ人工股関節全置換術(THA)を受け、10年間の追跡検査後にスポーツ活動に関する質問票に回答した215名(236肢)を対象として、第一世代XLPEの摩耗性能とスポーツ活動がXLPE摩耗率に及ぼす影響を調査した。THAカップへの大腿骨頭のpenetrationはXLPEによるTHAを受けた腰のX線写真でデジタル測定した。年齢、性別、BMI、経過観察期間、術前診断、XLPEの種類、ボール直径、ヘッド材質、カップ傾き、身体機能スコア、スポーツ参加などのデータを後ろ向きに検討した。その結果、クリープと定常摩耗率(SWR)はそれぞれ0.18mm/年と0.00mm/年で、スポーツ参加はSWRに有意な影響を及ぼさなかった。重回帰分析では、スポーツ参加はSWRを増加させなかった。以上より、スポーツ参加はTHAライナーの摩耗に大きな影響を与えず、第1世代XLPEはTHA後に最低10年間の優れた摩耗性能を持つと考えられた。

出版者・発行元：南江堂  

DOI： 10.15106/j_seikei73_541

CiNii Research

記述言語：英語   出版者・発行元：BMC Musculoskeletal Disorders  

Background: In performing primary constrained total knee arthroplasties (TKA) to imbalanced knees, the offset stem is sometimes compelled to use, although this is associated with surgical difficulties. We developed a modified procedure which might be able to fit the anteroposterior (AP) and mediolateral (ML) position of the femoral component simultaneously with the straight stem. Purposes of this study were to evaluate usefulness of the modified procedure both in computer simulations and actual surgeries. Methods: We included 32 knees that had undergone primary TKA using constrained implants because of the coronal imbalance. In the component-first procedure, the distal femur was prepared to fit the AP and ML position of the femoral component simultaneously at first, as in primary TKA. Finally, the stem hole is created based on the femoral component position (the component-first procedure). The femoral component and extension stem were simulated using the three-dimensional planning software (ZedKnee) following the component-first procedure. We investigated the suitability of the straight stem through computer simulation and evaluation of actual surgeries. Clinical and radiographical outcomes were also evaluated at the latest follow-up. Results: The component-first procedure enabled the AP and ML position of the femoral component to be fitted simultaneously with the straight stem in simulations and actual surgeries in all cases. The stem diameter was not significantly different between simulations and actual surgeries (13.9 and 13.7 mm on average, respectively, p = 0.479) and almost similar from intraclass correlation coefficient analysis (kappa value 0.790). Clinical and radiographical outcomes were almost similar to primary TKA cases and there was no case of component loosening, cortical bone hypertrophy around the stem and stem-tip pain. Conclusions: Our improved surgical procedure may facilitate use of the constrained implant for more cases of primary TKA in imbalanced knees without the usual surgical difficulties. Trial registration: Retrospectively registered.

DOI： 10.1186/s12891-022-05367-w

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：(公社)日本整形外科学会  

遠距離X線像と実大X線像を用いた脚部アライメントにおける測定角度の精度を比較検討した。アライメントを内反10°および15°に設定したモデルを作成し、股関節-膝関節-足関節角(HKAA)、機能軸(MA)長、MA率(%MA)をそれぞれ遠隔X線撮影と実大X線撮影によって測定した。HKAAに関して標準遠距離X線撮影では精度の高い測定値が得られており、内反10°、15°のいずれでも真値との差は最小にとどまっていた。実大X線撮影では修正法においてHKAAの測定精度は遠距離X線撮影とほぼ同等であったが、標準法では真値との間に有意な誤差が生じていた。MA長の評価では、実大X線像は標準法でも修正法でも測定精度は高かったが、遠距離X線像は内反10°で61.5mm、15°で58.9mmの誤差が認められ、被写体との距離が長くなるのに伴い誤差も大きくなっていた。%MAは修正実大X線像において内反10°で2.0%、15°で2.4%の誤差がみられ、遠距離X線像と標準実大X線像の測定精度は高かった。

記述言語：英語   出版者・発行元：(公社)日本整形外科学会  

逐次大腿骨半径コンポーネントとs-curve post-camを用いた新規人工膝関節全置換術(TKA)後の膝関節挙動と臨床アウトカムについて検討した。大腿骨コンポーネントとpost-camメカニズムの矢状プロフィールを改変した後方固定TKAを施行された20膝関節(男性4例、女性16例、平均74.6±5.7歳)を対象に、大腿脛骨の前後移動、軸回転、しゃがみ込み時と階段昇降時の前後cam-post接触を解析した。さらに、2011膝関節学会スコア(KSS 2011)の患者申告アウトカムを評価した。KSS 2011の症状サブスコア、満足度サブスコア、機能的活動サブスコアはいずれも術前と比較して術後に有意に改善しており、術後の平均等尺性膝伸展力は1.1±0.4Nm/kg、膝弛緩は内反ストレス下で伸展時5.3±1.3°、屈曲時4.2±2.6°、外反ストレス下で伸展時3.0±1.1°、屈曲時1.4±1.4°となっていた。膝関節の挙動に関して、中等度伸展(30～80°)にて大腿骨コンポーネントの脛骨コンポーネントの安定した後方移動が得られ、平均値はしゃがみ込み時が4.2±1.3mm、階段昇降時が4.8±0.8mmであった。平均脛骨大腿骨回転角はしゃがみ込み時と階段昇降時において有意差はみられなかった。しゃがみ込み時、17例に後方cam-post接触が認められ、85.9±12.4°以上の動作で接触が生じていた。S-curve post-camを用いた逐次大腿骨半径コンポーネントの使用により、安定した膝関節の挙動と良好な術後アウトカムが得られることが示された。

記述言語：英語   出版者・発行元：Journal of Orthopaedic Science  

Background: Mid-flexion instability is the one of the reasons for patient dissatisfaction after total knee arthroplasty (TKA). The purposes of this study were to evaluate in vivo knee kinematics and clinical outcomes using a novel TKA design with a gradual femoral radius component and s-curve post-cam, which are intended to prevent the instability initiated by sudden reductions in the femoral radius observed with conventional components. Methods: We used radiographic-based, image-matching techniques to analyze femorotibial anteroposterior translation, axial rotation, and anterior/posterior cam-post contact during two dynamic movements, squatting and stair climbing, in 20 knees that had undergone posterior-stabilized fixed-bearing TKA with an improved sagittal profiles of the femoral component and post-cam mechanism. We also evaluated patient-reported outcomes assessed by the 2011 Knee Society Score (KSS 2011). Results: Squatting and stair climbing produced a similar trend in anteroposterior translation and a relatively small standard deviation at mid-flexion. Although the rotation angles varied widely during squatting and stair climbing, the femoral component was consistently externally rotated. Anterior/posterior cam-post contact during squatting and stair climbing were observed in 0/17 knees and 0/0 knees, respectively. The “Symptoms”, “Satisfaction”, and “Functional activities” subscales of the KSS 2011 were significantly (P < 0.05) improved postoperatively compared to preoperatively (“Symptoms”, 10 to 21; “Satisfaction”, 15 to 26; “Functional activities”, 25 to 71). Conclusion: A gradual femoral radius component with an s-curve post-cam provided stable kinematics and favorable clinical results during squatting and stair climbing at 1 year after surgery.

DOI： 10.1016/j.jos.2021.02.015

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記述言語：英語   出版者・発行元：Journal of Orthopaedic Science  

Background: The purpose of the present study was to evaluate the accuracy of the measurements associated with leg alignment on a teleoroentgenogram and an orthoroentgenogram. Methods: The models being irradiated were manufactured and represented 10° varus and 15° varus leg alignment, in which the true values of hip-knee-ankle angle (HKAA), mechanical axis (MA) length, and percentage of MA (%MA) were already known. HKAA, MA length, and %MA were measured in various radiographic conditions of the teleoroentgenogram and orthoroentgenogram. Then, the differences between the radiographic measurement values and the corresponding true values were analyzed. Results: Regarding HKAA, the teleoroentgenogram provided accurate angular measurements with minimal differences between the measurement and true value in both the 10° and 15° varus models, irrespective of the radiographic condition. In the orthoroentgenogram, the modified method measured accurate HKAA; however, the standard method showed significant angular measurement errors with a 0.6° and 1.0° difference from the true value in the 10° and 15° varus models, respectively. This angular measurement error of HKAA in the standard orthoroentgenogram became significantly larger with object-to-image distance. Regarding MA length, the orthoroentgenogram exhibited accurate length measurements. In contrast, the teleoroentgenogram showed a significant length measurement error for the MA length. Regarding %MA, significant differences from the true values of 2.0% and 2.4% were observed in the modified orthoroentgenograms of the 10° and 15° varus models, respectively. The teleoroentgenogram and standard orthoroentgenogram reproduced the accurate measurement value of %MA in the 10° and 15° varus models. Conclusion: A teleoroentgenogram is a reliable modality for accurate angular measurements such as HKAA and %MA. An orthoroentgenogram has the potential to measure both HKAA and length accurately if the radiographic condition was modified; however, measurement error in %MA may occur.

DOI： 10.1016/j.jos.2021.02.011

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記述言語：英語   出版者・発行元：Journal of Orthopaedic Surgery and Research  

Background: To compare the degree of stem subsidence between two different femoral component designs and to determine the risk factors associated with stem subsidence after cementless total hip arthroplasty (THA) in Dorr type C femurs. Methods: We retrospectively reviewed 104 consecutive hips in 100 patients with Dorr type C proximal femoral morphology who underwent primary cementless THA using a fit-and-fill stem or a tapered wedge femoral stem at our institution between January 2012 and June 2021. A fit-and-fill stem was used in 55 hips and a tapered wedge stem was used in 49 hips. Radiologically, the distance between the apex of the major trochanter and the stem shoulder were measured at three different time points (immediately [0W], one week [1W], and six weeks [6W] after surgery) and the degrees of stem subsidence were assessed by comparing the distance between 0 and 1W, 1W and 6W, and 0W and 6W, respectively. Results: The mean degree of stem subsidence (0W vs. 1W) was 0.24 mm (standard deviation [SD] 0.36) in the fit-and-fill stem group, and 0.23 mm (SD 0.41) in the tapered wedge stem group. There was no significant difference between the two groups (P = 0.4862). However, the mean degrees of subsidence were significantly higher in the fit-and-fill stem group (1W vs. 6W, 0.38 mm [SD 0.68]; 0W vs. 6W, 0.65 mm [SD 0.87]) than in the tapered wedge stem group (1W vs. 6W, 0.16 mm [SD 0.32]; 0W vs. 6W, 0.24 mm [SD 0.38]) (P < 0.05 for both). In addition, the rates of > 3 mm subsidence (in which instability can be observed) were 18.2% (10 of 55 hips) and 2.0% (1 of 49 hips), respectively. There was also a significant difference between the two stems (P = 0.0091). Multivariate analysis demonstrated that fit-and-fill stem was a risk factor for > 3 mm subsidence after THA in Dorr type C femurs (P = 0.0050). Conclusion: Our findings suggest that the tapered wedge stem is more suitable for Dorr type C femurs than the fit-and-fill stem to avoid early postoperative subsidence in cementless THA.

DOI： 10.1186/s13018-022-03111-7

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記述言語：英語   出版者・発行元：Journal of Bone and Joint Surgery  

Background: Little is known concerning differences in assessment of anteroposterior osteonecrotic lesion of the femoral head (ONFH) between the axial plane parallel to the body axis (axial) and the axial plane parallel to the femoral neck axis (oblique axial) using magnetic resonance imaging (MRI). This study aimed to compare the posterior boundary of necrotic lesions between the axial and oblique axial planes on MRI. Methods: This study retrospectively reviewed 120 consecutive hips in 71 patients (47 males and 24 females; mean age, 42 years) with ONFH, for which both axial and oblique axial MRI slices were available. The posterior boundaries of the necrotic lesions were calculated as the ratio of posterior intact circumference to anteroposterior circumference of the femoral head using mid-axial and mid-oblique axial MRI slices. The necrotic angles, calculated using the modified Kerboul method, were compared between cases with progression and nonprogression of collapse. Results: The mean posterior intact ratio in the axial slice was 49.2% (range, 8.6 to 85.1%), while that in the oblique axial slice was 33.5% (7.5 to 79.2%). The posterior intact ratio in the oblique axial slice significantly decreased compared to that in the axial slice (p < 0.0001). In cases with progression of collapse, the mean necrotic angle was significantly larger in the oblique axial slice than in the axial slice (p < 0.0001). The sensitivity and specificity of the necrotic angle with regard to the prognosis of the femoral head were both higher when using the oblique axial slice (sensitivity: 88.4%, specificity: 82.3%) than when using the axial slice (sensitivity: 85.1%, specificity: 62.0%). The posterior intact ratio at a mean of 6.8 mm superior to the mid-axial slice corresponded to that of the mid-oblique axial slice. Conclusion: Our findings suggest that the posterior boundaries of necrotic lesions differ between axial and oblique axial slices, and examination of the oblique axial MRI slice might be more suitable for predicting the prognosis of the femoral head.

DOI： 10.2106/JBJS.20.00493

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Journal of Arthroplasty  

Background: Squatting is an important function for many daily activities, but has not been well documented after total hip arthroplasty (THA). This study investigated the participation rate of squatting and in vivo kinematics during squatting. Methods: A survey questionnaire about squatting was mailed to patients who underwent primary THA and 328 patients returned acceptable responses. Additionally, 32 hips were evaluated for dynamic 3-dimensional kinematics of squatting using density-based image-matching techniques. Multivariate analyses were applied to determine which factors were associated with anterior liner-to-neck distance at maximum hip flexion. Results: Patients who could easily squat significantly increased this ability postoperatively (23.5% vs 46%, P <.01). In 29.5% of the patients there was still no ability to squat after THA; the main reason was anxiety of dislocation (34.2%). Kinematic analysis revealed that maximum hip flexion averaged 80.7° ± 12.3° with 12.8° ± 10.7° of posterior pelvic tilt and 9.7 ± 3.0 mm of anterior liner-to-neck distance. Neither liner-to-neck, bone-to-bone, nor bone-to-implant contact was observed in any of the hips. Larger hip flexion and smaller cup anteversion were negatively associated with the anterior liner-to-neck distance at maximum hip flexion (P <.05). Conclusion: Postoperatively, approximately 70% of patients squatted easily or with support. Anxiety of dislocation made patients avoid squatting after THA. In vivo squatting kinematics suggest no danger of impingement or subsequent dislocation, but excessively large hip flexion and small cup anteversion remain as risks.

DOI： 10.1016/j.arth.2021.12.028

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jor.2022.02.021

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：(一社)理学療法科学学会  

日本人コホートにおける人工股関節全置換術(THA)後の患者満足度を判定すると共に、患者満足度に有意な影響を及ぼす因子を同定した。2012年1月～2016年1月に当施設で変形性関節症に対して初回THAを施行した患者に質問紙調査を実施し、回答が得られた285例(男性33例、女性252例、平均69.1±9.9歳)を評価した。89例で筋力、26例で日歩数を判定した。術後満足度、Oxford hip score-activities of daily living(OHS-ADL)、University of California Los Angeles activity score(UCLA AS)に関連する因子を同定した。OHS-ADLと日歩数との関連を検討した。患者の94.7%がTHAに満足したと回答した。OHS-ADLとUCLA ASは患者満足度と有意に関連していた。若年と股関節外転筋力は高OHS-ADLおよびUCLA ASと有意に関連していた。平均日歩数はOHS-ADLと有意に関連していた。

記述言語：英語   出版者・発行元：International Orthopaedics  

Purpose: Stem subsidence is a known cause of early failure in cementless total hip arthroplasty (THA). The aim of this study was to determine the usefulness of pneumatic femoral broaching in preventing post-operative subsidence of a proximally porous-coated, taper-wedge stem. Methods: We reviewed 169 cases of primary THA with a single taper-wedge stem. Eighty THAs performed using pneumatic broaching were compared with 89 THAs performed using manual broaching in terms of postoperative canal fill ratio (CFR) at three levels, stem subsidence at one year post-operation, and stem fixation at latest follow-up (median, 24 months). Results: The median CFRs were higher in the pneumatic group than in the manual group at all levels (p < 0.05). The median stem subsidence at one year after THA was lower in the pneumatic group than in the manual group (0.2 mm vs. 0.6 mm, p = 0.007). A multivariate analysis determined a decreased CFR at 60 mm below the lesser trochanter and the manual broaching as independent factors affecting post-operative stem subsidence. At the latest follow-up, all stems showed stable fixation by bone ingrowth in both groups. Conclusion: Our results showed that the pneumatic broaching device was useful in maximizing the mediolateral canal filling and initial stability and minimizing the subsidence of taper-wedge stems.

DOI： 10.1007/s00264-021-05196-x

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記述言語：英語   出版者・発行元：Clinical Biomechanics  

Background: Dislocation after total hip arthroplasty is a frequent cause of revision surgery. This study was performed to determine the optimal implant alignment in total hip arthroplasty by simulating the postoperative range of motion. Methods: All operations were performed via posterolateral approach using combined anteversion of the stem and cup technique. Maximum range of motion without implant impingement was simulated in 79 replaced hips using postoperative computed tomography and the achievement of the required range of motion defined by previous studies was assessed. Optimal cup and stem alignment for impingement-free range of motion were statistically determined using the receiver operator coefficient curve. Findings: Cup inclination and anteversion, stem anteversion, and combined anteversion were 37.6°, 20.1°, 26.2°, and 46.3°, respectively. Maximum range of motion in flexion, extension, internal rotation at 90° of flexion, and external rotation were 131.8°, 42.3°, 56.4°, and 64.5°, respectively. Flexion >110°, extension >30°, internal rotation >30° at 90° of flexion, and external rotation >30° were fulfilled by 96%, 86%, 92%, and 96% of all replaced hips, respectively. Optimal implant alignment for impingement-free range of motion was 34°–43° of cup inclination, 18°–26° of cup anteversion, 17°–29° of stem anteversion, and 35°–56° of combined anteversion. Both cup and stem anteversion showed significant relationship with postoperative range of motion. Interpretation: Surgeons could gain valuable insights into optimal cup and stem alignment to perform postoperative range of motion simulations.

DOI： 10.1016/j.clinbiomech.2021.105555

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PubMed

記述言語：英語   出版者・発行元：BMC Musculoskeletal Disorders  

Background: The ideal acetabular position for optimizing hip joint biomechanics in periacetabular osteotomy (PAO) remains unclear. We aimed to determine the relationship between acetabular correction in the coronal plane and joint contact pressure (CP) and identify morphological factors associated with residual abnormal CP after correction. Methods: Using CT images from 44 patients with hip dysplasia, we performed three patterns of virtual PAOs on patient-specific 3D hip models; the acetabulum was rotated laterally to the lateral center-edge angles (LCEA) of 30°, 35°, and 40°. Finite-element analysis was used to calculate the CP of the acetabular cartilage during a single-leg stance. Results: Coronal correction to the LCEA of 30° decreased the median maximum CP 0.5-fold compared to preoperatively (p < 0.001). Additional correction to the LCEA of 40° further decreased CP in 15 hips (34%) but conversely increased CP in 29 hips (66%). The increase in CP was associated with greater preoperative extrusion index (p = 0.030) and roundness index (p = 0.038). Overall, virtual PAO failed to normalize CP in 11 hips (25%), and a small anterior wall index (p = 0.049) and a large roundness index (p = 0.003) were associated with residual abnormal CP. Conclusions: The degree of acetabular correction in the coronal plane where CP is minimized varied among patients. Coronal plane correction alone failed to normalize CP in 25% of patients in this study. In patients with an anterior acetabular deficiency (anterior wall index < 0.21) and an aspherical femoral head (roundness index > 53.2%), coronal plane correction alone may not normalize CP. Further studies are needed to clarify the effectiveness of multiplanar correction, including in the sagittal and axial planes, in optimizing the hip joint’s contact mechanics.

DOI： 10.1186/s12891-022-05005-5

Web of Science

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Clinical Orthopaedics and Related Research  

Background Inappropriate sagittal plane correction can result in an increased risk of osteoarthritis progression after periacetabular osteotomy (PAO). Individual and postural variations in sagittal pelvic tilt, along with acetabular deformity, affect joint contact mechanics in dysplastic hips and may impact the direction and degree of acetabular correction. Finite-element analyses that account for physiologic pelvic tilt may provide valuable insight into the effect of PAO on the contact mechanics of dysplastic hips, which may lead to improved acetabular correction during PAO.

DOI： 10.1097/CORR.0000000000001893

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：Clinical Biomechanics  

Background After total hip arthroplasty, dislocation can occur when a patient unexpectedly assumes internal/external limb positions, even during chair-rising, which is a frequently activity of daily life. Therefore, determining the target cup position to avoid impingement in unexpected limb positions using in vivo data of daily life activities is critical. Methods A computer simulation was performed on 21 total hip arthroplasty patients using patient-specific component placements and hip kinematics obtained during chair-rising analysis using image-matching techniques. The liner-to-neck distance and impingement were evaluated by simulating the change in internal/external rotation angle at maximum hip flexion/extension from 0 to 90°. The cutoff values of cup anteversion and combined anteversion at 60° of internal/external rotation were determined. Findings The anterior/posterior liner-to-neck distances were negatively correlated with internal/external rotation angles (r = −0.82 and −0.78, respectively) and decreased by 1.7 and 1.8 mm for every 15° increase, respectively. Three cases (14%) of anterior/posterior impingement were observed at 60° of internal/external rotation angle, respectively. The cutoff values for cup anteversion and combined anteversion to avoid impingement at 60° of internal/external rotation angle were 12°–25°/38°–62°, respectively. The stem anteversion, adjustable by cup anteversion to meet both the target cup anteversion and combined anteversion, was 13°–50°. Interpretation Simulated unintentional internal or external hip rotation, even during chair-rising, caused impingement and posed a dislocation risk. If the stem anteversion is excessively small or large in meeting the target combined anteversion, adjustments to stem anteversion could be recommended in addition to adjustments in cup anteversion.

DOI： 10.1016/j.clinbiomech.2021.105537

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：理学療法科学学会  

DOI： 10.1589/jpts.34.76

PubMed

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-019-05821-8

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-019-05821-8

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jor.2020.01.042

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2019.05.015

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.clinbiomech.2020.02.011

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.clinbiomech.2020.02.011

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1080/14397595.2018.1558917

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1080/14397595.2018.1558917

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2019.02.014

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2017.05.011

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00264-018-4154-x

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2018.12.022

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-018-5286-7

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1080/14397595.2018.1486954

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-019-05821-8

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-019-05468-5

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2019.02.014

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2018.12.022

記述言語：その他   掲載種別：研究論文（学術雑誌）  

Background: In total hip arthroplasty (THA), placing the cup in an anatomic position is not always possible in case of deformities related to developmental dysplasia of the hip (DDH). Thus far, the influence of a hip center on the abductor moment after THA has not been clearly elucidated. Therefore, we performed a retrospective study to assess 1) how abductor muscle moment recovers postoperatively in THA and 2) whether acetabular cup position affects the recovery of abductor moment. Hypothesis: A high hip center affects the recovery of abductor moment of a dysplastic hip after THA. Patients and methods: We evaluated 100 patients, who underwent unilateral primary THA, at 12 months postoperatively. The study included 86 women and 14 men, with a mean age of 65.5 ± 9.9 years (range, 40 to 86 years). Patients with secondary osteoarthritis due to DDH were included (Crowe 1: 76; Crowe 2: 15, Crowe 3: 9, and Crowe 4: none). A cementless straight stem was implanted in all hips. Hip abductor moment was measured using a belt-stabilized handheld dynamometer. The ratio of moment of the affected side to that of the contralateral side was calculated as moment ratio. The horizontal and vertical centers of rotation (H-COR and V-COR) (with respect to the inter teardrop line) and vertical shift (V-shift) (difference in V-COR between the affected hip and the contralateral normal hip) were determined. Results: At 6 and 12 months postoperatively, the abductor moment ratios were 95.1 and 94.7%, respectively. Significant negative correlation was observed between the postoperative abductor moment ratio and V-COR at 6 months postoperatively (r = −0.2436, p = 0.0238). Significant delay in the recovery of abductor moment ratio was observed in the groups with higher hip center (V-shift > 15 mm) (odds ratio = 12.7; 95% CI, 2.11–232.1, p = 0.0034) at 6 months postoperatively, which was fully recovered at 12 months postoperatively. Discussion: Superior placement of a hip center, more than 15 mm above the true hip center, delayed the recovery of abductor muscle moment after THA. Level of evidence: III, retrospective comparative study.

DOI： 10.1016/j.rcot.2018.09.138

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.otsr.2018.06.022

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/jor.24066

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-018-5052-x

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-017-4718-0

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1080/14397595.2018.1486954

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.asmart.2017.11.003

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s13018-017-0709-6

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00402-017-2828-2

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s13018-018-0714-4

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00167-018-5286-7

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00264-018-4154-x

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2017.08.010

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

掲載種別：研究論文（学術雑誌）  

掲載種別：研究論文（学術雑誌）  

掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

開催年月日： 2023年10月

記述言語：英語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：福岡   国名：日本国  

開催年月日： 2023年6月 - 2023年7月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：広島   国名：日本国  

開催年月日： 2023年6月

記述言語：日本語  

国名：日本国  

開催年月日： 2023年5月

記述言語：日本語  

国名：日本国  

開催年月日： 2023年2月

記述言語：日本語   会議種別：口頭発表（一般）  

国名：日本国  

開催年月日： 2023年2月

記述言語：日本語  

国名：日本国  

開催年月日： 2022年10月

記述言語：日本語   会議種別：公開講演，セミナー，チュートリアル，講習，講義等  

国名：日本国  

開催年月日： 2022年7月

記述言語：日本語  

開催地：福岡   国名：日本国  

開催年月日： 2022年6月

記述言語：日本語   会議種別：口頭発表（一般）  

国名：日本国  

開催年月日： 2022年2月

記述言語：日本語   会議種別：口頭発表（一般）  

国名：日本国  

開催年月日： 2022年2月

記述言語：日本語  

国名：日本国  

開催年月日： 2021年7月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2020年6月 - 2020年8月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2020年3月

記述言語：日本語  

国名：日本国  

開催年月日： 2020年2月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2019年11月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2019年11月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2019年11月

記述言語：日本語  

国名：日本国  

開催年月日： 2019年10月

記述言語：日本語  

国名：日本国  

開催年月日： 2019年4月

記述言語：日本語  

国名：日本国  

開催年月日： 2019年3月

記述言語：日本語   会議種別：口頭発表（一般）  

国名：日本国  

開催年月日： 2019年2月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2019年2月

記述言語：英語  

国名：日本国  

開催年月日： 2019年2月

記述言語：英語  

国名：日本国  

開催年月日： 2018年11月

記述言語：日本語  

国名：日本国  

開催年月日： 2018年11月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2018年10月

記述言語：日本語  

国名：日本国  

開催年月日： 2018年9月

記述言語：日本語  

国名：日本国  

開催年月日： 2018年9月

記述言語：英語  

国名：日本国  

開催年月日： 2018年5月 - 2019年5月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2018年5月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：神戸   国名：日本国  

開催年月日： 2018年2月

記述言語：日本語  

開催地：東京   国名：日本国  

開催年月日： 2018年1月

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：福岡   国名：日本国  

開催年月日： 2017年10月

記述言語：日本語  

国名：日本国  

開催年月日： 2017年5月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：神戸   国名：日本国  

開催年月日： 2017年5月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：仙台   国名：日本国  

開催年月日： 2017年4月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2017年4月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：Tokyo   国名：日本国  

開催年月日： 2017年4月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2017年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2017年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2016年9月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：札幌   国名：日本国  

開催年月日： 2016年5月

記述言語：日本語  

開催地：横浜   国名：日本国  

開催年月日： 2016年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2015年9月 - 2015年10月

記述言語：英語  

国名：オーストリア共和国  

開催年月日： 2015年7月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2015年7月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2015年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2014年12月

記述言語：英語  

国名：日本国  

開催年月日： 2014年6月

記述言語：英語  

国名：日本国  

開催年月日： 2014年6月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：福岡   国名：日本国  

開催年月日： 2014年5月

記述言語：英語  

国名：中華人民共和国  

開催年月日： 2014年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2014年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2014年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2014年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2014年3月

記述言語：英語  

国名：日本国  

開催年月日： 2013年2月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：京都   国名：日本国  

開催年月日： 2013年1月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2010年10月

国名：日本国  

開催年月日： 2010年3月

国名：アメリカ合衆国  

開催年月日： 2009年2月

国名：アメリカ合衆国  

開催年月日： 2009年2月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2009年2月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2007年10月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2007年10月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2007年2月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2007年2月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2006年9月

記述言語：英語  

国名：大韓民国  

開催年月日： 2006年7月 - 2006年8月

記述言語：英語  

国名：ドイツ連邦共和国  

開催年月日： 2006年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2006年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2006年3月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2005年10月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2005年9月 - 2005年10月

記述言語：英語  

国名：日本国  

開催年月日： 2005年5月

記述言語：英語  

国名：アメリカ合衆国  

開催年月日： 2004年10月

記述言語：英語  

国名：カナダ  

開催年月日： 2003年5月

記述言語：英語  

国名：イタリア共和国