Researcher Profile and Settings

Master

Affiliation (Master)

• Faculty of Medicine

Affiliation (Master)

• Faculty of Medicine

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Profile and Settings

Affiliation

• Hokkaido University, Graduate School of Medicine

Profile and Settings

• Name (Japanese)

  Iwasaki

• Name (Kana)

  Koji

• Name

  201801015433397652

Affiliation

• Hokkaido University, Graduate School of Medicine

Achievement

Research Areas

• Life sciences / Orthopedics

Published Papers

• Higher association of articular surface destruction with rheumatoid forefoot deformity arising from dislocation of the metatarsophalangeal joints in the lateral column.

  Yuki Suzuki, Tomohiro Onodera, Koji Iwasaki, Masatake Matsuoka, Masanari Hamasaki, Eiji Kondo, Norimasa Iwasaki

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2024/08/14 

  BACKGROUND: To evaluate the relationship between the pattern and severity of metatarsophalangeal (MTP) joint dislocation in the lesser toes and severity of joint destruction in rheumatoid forefoot deformities. METHODS: Participants comprised of 13 patients (16 feet) who underwent resection arthroplasty of the metatarsal head of the lesser toes for rheumatoid arthritis of the MTP joints. Correlations between preoperative radiographic findings and histological grades second to fifth metatarsal heads taken intraoperatively were analyzed. RESULTS: In 62 metatarsal heads, complete dislocation of the MTP joint in the lesser toes significantly resulted in severe joint destruction compared to mild or moderate dislocation (P < 0.05). The proportion of severe cartilage damage in MTP joints with complete dislocation was 100 % in the 5th MTP joint, 83.3 % in the 4th MTP joint, and 58.3 % in the 2nd and 3rd MTP joints. Moreover, complete dislocation of the MTP joints in the lateral column showed the most severe joint destruction compared to that in the medial column (P = 0.03). CONCLUSION: Complete dislocation of the MTP joint in the lateral column is related to joint destruction in rheumatoid forefoot deformities.
• Amputation surgery associated with shortened survival in patients with localized extremity bone sarcoma.

  Nayuhito Yanagisawa, Masatake Matsuoka, Tomohiro Onodera, Koji Iwasaki, Masanari Hamasaki, Taku Ebata, Yoshiaki Hosokawa, Eiji Kondo, Norimasa Iwasaki

  Journal of orthopaedics 54 124 - 130 2024/08 

  BACKGROUND: This study assesses survival rates among patients with localized extremity bone sarcoma who have undergone amputation, pinpointing subpopulations that are disproportionately affected by amputation-related survival disparities. METHODS: Examination of data was conducted using the Surveillance, Epidemiology, and End Results (SEER) program, analyzing records of 3765 patients diagnosed with localized extremity bone sarcoma between 2000 and 2019. Of these, 857 received amputations (Amputation cohort), and 2908 underwent limb-sparing surgeries. Propensity score matching, considering demographic and clinical features, was utilized to ensure a fair comparison. RESULTS: Following propensity score matching, the study focused on 1714 cases. The Amputation cohort was observed to have significantly poorer survival rates (Cancer-Specific Survival [CSS]: Hazard Ratio [HR] = 1.28, 95% Confidence Interval [CI]: 1.05-1.55; Overall Survival [OS]: HR = 1.37, 95% CI: 1.15-1.63). Subsequent subgroup analysis indicated that individuals with tumors exceeding 8 cm in size or those located in the lower limbs were notably at a higher risk of shortened survival (for tumors >8 cm - CSS: HR = 1.32, 95% CI: 1.02-1.71; OS: HR = 1.39, 95% CI: 1.09-1.76; for lower limb tumors - CSS: HR = 1.25, 95% CI: 1.01-1.54; OS: HR = 1.33, 95% CI: 1.11-1.61). CONCLUSIONS: Our findings demonstrate that patients diagnosed with localized extremity bone sarcoma undergoing amputation exhibit lower survival rates, especially in cases involving tumors of greater size or those situated in the lower limbs. In patient groups where amputation is inevitable, careful follow-up is required after surgical intervention.
• Radiation therapy improves survival in elderly patients with localized extremity soft tissue sarcoma.

  Masatake Matsuoka, Tomohiro Onodera, Koji Iwasaki, Masanari Hamasaki, Taku Ebata, Yoshiaki Hosokawa, Ryuichi Fukuda, Eiji Kondo, Norimasa Iwasaki

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2024/07/15 

  BACKGROUND: This study aims to evaluate the efficacy of radiation therapy in enhancing survival outcomes among elderly patients diagnosed with localized extremity soft tissue sarcomas (STSs). Furthermore, it seeks to explore whether the survival benefits conferred by radiation therapy differ according to tumor characteristics and treatment modalities. METHODS: We conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database to identify patients aged 80 years and older diagnosed with localized extremity STSs. The study assessed 1498 eligible patients, analyzing cancer-specific survival (CSS) and overall survival (OS) through Kaplan-Meier survival analysis and Cox proportional hazards modeling. Propensity score matching was employed to adjust for potential confounders. RESULTS: Among the analyzed patients, 773 patients underwent radiation therapy (Radiation group), while 725 patients either did not receive radiation therapy or it was unknown if they had (No-Radiation group). The 5-year OS rate was 40% in the radiation group compared to 38% in the no-radiation group. After propensity score matching, radiation therapy was associated with a significant improvement in OS (P = 0.005, HR = 0.8, 95% CI 0.7-0.9). Subgroup analyses indicated that patients undergoing primary tumor resection benefited most from radiation therapy in terms of OS. CONCLUSION: Radiation therapy is associated with improved overall survival in elderly patients with localized extremity STSs. These findings suggest that radiation therapy should be considered as a key component of the treatment strategy for this patient population, taking into account individual patient characteristics and comorbidities.
• Paradoxical Change in Subchondral Bone Density in the Medial Compartment of the Proximal Tibial Articular Surface After High Tibial Osteotomy: A Detailed Subchondral Bone Density Analysis.

  Yuki Fujie, Koji Iwasaki, Masanari Hamasaki, Yuki Suzuki, Masatake Matsuoka, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki

  The American journal of sports medicine 3635465241256100 - 3635465241256100 2024/06/20 

  BACKGROUND: High tibial osteotomy (HTO) aims to realign the varus knee to alleviate stress in the medial compartment. However, detailed information on the impact of HTO on stress distribution across the tibiofemoral joint surface still needs to be completely elucidated. PURPOSE/HYPOTHESIS: The present study aimed to analyze the subchondral bone density distribution to validate the alignment threshold causing paradoxical changes. We hypothesized that there would be a paradoxical stress change in the medial compartment beyond a specific threshold for lower limb realignment after HTO. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A retrospective clinical study of 32 knees from 30 patients who underwent medial opening-wedge HTO between 2015 and 2019 was conducted at Hokkaido University Hospital. The subchondral bone density across the tibiofemoral joint was analyzed using computed tomography-osteoabsorptiometry before and after HTO. The high-density area (HDA) within the medial and lateral compartments and their subregions, which were quartered in the coronal plane, was specifically examined. RESULTS: The hip-knee-ankle angle, medial proximal tibial angle (MPTA), joint line obliquity (JLO), and joint line convergence angle significantly changed after HTO (P < .01). The HDA of the medial compartment to the total HDA ratio decreased from 83% to 77%. Paradoxically, the HDA in the most central subregion of the medial compartment increased from 24% to 30%. There were significant differences between MPTA and JLO in patients with and without paradoxical changes in the HDA. MPTA and JLO cutoff values causing paradoxical changes in the HDA were 94° and 4°, respectively. CONCLUSION: There was a paradoxical stress increase in the M4 region at the medial compartment associated with the MPTA and JLO beyond specific thresholds. Therefore, surgical planning should be cautiously performed to prevent overcorrection, which can lead to adverse stress distribution changes.
• Elucidation of the association between additional distal femoral resection and extension angle improvement following the actual surgical steps with the Robot-TKA system.

  Ryosuke Hishimura, Koji Iwasaki, Yuki Suzuki, Masatake Matsuoka, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki

  The Knee 49 36 - 44 2024/06/04 

  BACKGROUND: This study investigates the association between additional distal femoral resection and improved flexion contracture in total knee arthroplasty (TKA) with a robot-assisted system. Flexion contracture is a common issue in patients with knee osteoarthritis, which causes postoperative complications and functional limitations. This study aims to evaluate the effectiveness of additional bone resection in flexion contracture correction and knee extension angle improvement after the actual surgical steps. METHODS: The study included 11 patients who underwent posterior-stabilized (PS)-type TKA with a robot-assisted system. The surgical technique consisted of precise bone resection and range of motion evaluation using a navigation system. A precut technique was used to facilitate posterior access and remove osteophytes that cause the contracture. The amount of additional distal femoral resection was determined based on the thickness of the insert trial required for achieving full extension. RESULTS: The flexion contracture correction angle and the amount of additional distal femoral resection demonstrated a linear relationship. An average of 2.0° with the standard error (SE) of 0.6° improvement in flexion contracture was observed per 1.0 mm of additional bone resection. The postoperative evaluation demonstrated a significant improvement in knee extension angle, thereby reducing the contracture degree. CONCLUSION: This study was the first to perform the additional distal femoral resection on the living knee, which closely replicates the actual surgical steps. The current study revealed that an additional 1.0 mm of distal femoral resection in PS-type TKA improves knee extension angle by 2.0° (SE 0.6°) within an additional resection range of 1.0 mm to 3.3 mm.
• Analysis of foot-originating malignant bone tumors: Epidemiology, characteristics, and survival outcomes.

  Masatake Matsuoka, Tomohiro Onodera, Koji Iwasaki, Masanari Hamasaki, Taku Ebata, Yoshiaki Hosokawa, Ryuichi Fukuda, Eiji Kondo, Norimasa Iwasaki

  Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons 2024/05/29 

  BACKGROUND: The study examines the characteristics and outcomes of foot-originating malignant bone tumors via Surveillance Epidemiology and End Results (SEER) database analysis. METHODS: A retrospective review of 14,695 malignant bone tumor cases from 2000 to 2019 was conducted. RESULTS: Of the eligible cases, 147 (2.3 %) were foot-origin tumors, typically smaller and more commonly treated with surgery than those in other locations. These tumors were more frequently treated with surgical resection, with a higher proportion undergoing amputation. In contrast, foot-origin tumors were less often managed with chemotherapy and radiation. Foot-origin tumors exhibited higher survival rates compared to non-foot-origin tumors as shown in univariate analysis, although multivariate analysis did not reflect significant differences. CONCLUSION: Foot-originating malignant bone tumors tend to be smaller and are frequently surgically treated, correlating with favorable survival outcomes. These findings point to early detection as a potential factor in the improved survival rates, not necessarily the tumor's origin.
• The alterations in nerve growth factor concentration in plasma and synovial fluid before and after total knee arthroplasty.

  Tomohiro Onodera, Koji Iwasaki, Masatake Matsuoka, Yasuhide Morioka, Shinji Matsubara, Eiji Kondo, Norimasa Iwasaki

  Scientific reports 14 (1) 8943 - 8943 2024/04/18 

  Total knee arthroplasty (TKA) is an effective procedure for pain relief; however, the emergence of postsurgical pain remains a concern. In this study, we investigated the production of nerve growth factor (NGF) and mediators that affect NGF production and their function in the synovial fluid and plasma after TKA. This study included 19 patients (20 knees) who had rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and knee osteoarthritis (OA) who underwent TKA, categorized into OA and non-OA groups. The levels of NGF, inflammatory cytokines, and lipid mediators were analyzed before and after surgery. The intraoperative synovial fluid NGF concentration was more than seven times higher in the non-OA group than in the OA group. The intra-articular NGF levels increased significantly by more than threefold postoperatively in the OA group but not in the non-OA group. Moreover, the levels of inflammatory cytokines and lipid mediators were increased in the synovial fluid of both groups. The intra-articular cytokines or NGF concentrations positively correlated with postoperative pain. Targeted NGF control has the potential to alleviate postsurgical pain in TKA, especially in patients with OA, emphasizing the importance of understanding NGF dynamics under different knee conditions.
• Surgical Resection of Primary Tumor for Bone Metastatic Breast Cancer Patients at Initial Presentation.

  Nayu Kitsuya, Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Yuki Suzuki, Masanari Hamasaki, Eiji Kondo, Norimasa Iwasaki

  Anticancer research 44 (4) 1591 - 1601 2024/04 

  BACKGROUND/AIM: The purpose of this study was to investigate whether primary tumor resection in patients with bone metastatic breast cancer has an impact on survival using the Surveillance, Epidemiology, and End Results database, considering subtype classification. PATIENTS AND METHODS: We included all female patients with bone metastatic breast cancer at initial presentation between 2010 and 2016 with known hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) statuses. Cases showing unknown cause of death or unknown HR/HER2 status were excluded. Survival analysis was performed using Cox proportional hazards modeling to calculate hazard ratios (HZR). RESULTS: Of the 13,450 patients included in this study, 2,073 patients were HR+/HER2+, 8,597 patients were HR+/HER2-, 797 patients were HR-/HER2+, and 1,182 patients were HR-/HER2- (triple-negative). Five-year overall survival (OS) rate was 34.5% in HR+/HER2+, 26.0% in HR+/HER2-, 29.2% in HR-/HER2+ and 8.0% in triple-negative. Triple-negative patients showed the worsen OS [HR+/HER2+: HZR=2.1, 95% confidence interval (CI)=1.9-2.3; HR+/HER2-: HZR= 2.4, 95%CI=2.2-2.6; HR-/HER2+: HZR=1.5, 95%CI=1.3-1.6]. After excluding patients who died within six months, primary tumor resection prolonged survival in each subtype classification except HR-/HER2+. CONCLUSION: Patients with triple-negative bone metastatic breast cancer showed unfavorable survival. Primary tumor resection prolonged survival in each subtype except for HR-/HER2+.
• Bone Density Distribution Pattern in the Lateral Wall of the Femoral Intercondylar Notch: Implications for the Direct Insertion of the Femoral ACL Attachment.

  Yutaro Sugawara, Koji Iwasaki, Yuki Suzuki, Ryosuke Hishimura, Shinji Matsubara, Masatake Matsuoka, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki

  Orthopaedic journal of sports medicine 12 (4) 23259671241236807 - 23259671241236807 2024/04 

  BACKGROUND: The ideal position of the femoral bone tunnel in the anterior cruciate ligament (ACL) is controversial. The functional importance of the ACL fiber varies depending on where it is attached to the femur. Functionally important fibers can cause high mechanical stress on the bone, and the Wolff law predicts that bone mineral density will increase at high mechanical stress sites. PURPOSE/HYPOTHESIS: The purpose of this study was to use computed tomography imaging to determine the distribution pattern of bone density in the lateral intercondylar wall. It was hypothesized that the high-density area (HDA) of the lateral intercondylar wall would reflect the functional insertion of the ACL as reported in previous anatomic studies. STUDY DESIGN: Descriptive epidemiology study. METHODS: Data from 39 knees without ACL injuries were retrospectively collected. The HDA of the lateral intercondylar wall was defined as the region containing the top 10% of the radiodensity values. The shape of the HDA was approximated as an ellipse, and the quadrant method was used to determine the center of the ellipse. The association between the ratio of the minor axis to the major axis of the ellipse and background characteristics was investigated. RESULTS: According to the quadrant method, the center of the HDA ellipse was 33.6% in the deep-shallow direction and 23.4% in the high-low direction. The center of the ellipse was comparable to the anatomic center of the ACL footprint, as previously reported. The ratio of the minor axis to the major axis of the ellipse was 0.58 (95% CI, 0.54-0.62). There was a significant negative correlation between the ratio of the minor axis to the major axis of the HDA ellipse and the posterior tibial slope (r = -0.38, P = .02). CONCLUSION: The center of the HDA ellipse was found to be similar to the anatomic center of the ACL footprint. Considering the mechanical stress responses in bone, the HDA of the lateral intercondylar wall has the potential to represent the ACL insertion, especially functional insertion.
• 遠隔転移を有する原発性悪性骨腫瘍において原発巣切除は生存を改善するか? 米国SEERデータベースを用いた研究

  福田 龍一, 松岡 正剛, 小野寺 智洋, 岩崎 浩司, 江畑 拓, 濱崎 雅成, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 98 (2) S94 - S94 0021-5325 2024/03
• 内側型変形性膝関節症および膝蓋大腿関節症に対する組み合わせ式二顆置換術(BiKA)の術後10年成績

  馬場 力哉, 大越 康充, 前田 龍智, 岩館 茜, 岩崎 浩司, 小野寺 智洋, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 98 (2) S168 - S168 0021-5325 2024/03
• 足部に発生した原発性悪性骨腫瘍の生存解析 SEER databaseを用いた研究

  松岡 正剛, 小野寺 智洋, 岩崎 浩司, 濱崎 雅成, 江畑 拓, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 98 (2) S277 - S277 0021-5325 2024/03
• 脛骨関節面の骨密度分布に半月板逸脱と下肢アライメントが与える影響

  佐藤 知哉, 岩崎 浩司, 濱崎 雅成, 鈴木 裕貴, 松岡 正剛, 小野寺 智洋, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 98 (2) S399 - S399 0021-5325 2024/03
• 80歳以上高齢者に発生した四肢発生軟部肉腫における放射線照射

  松岡 正剛, 小野寺 智洋, 岩崎 浩司, 濱崎 雅成, 江畑 拓, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 98 (2) S415 - S415 0021-5325 2024/03
• 女性乳がんサブタイプ分類が骨転移症例における生存へ与える影響 米国SEERデータベースを用いた研究

  松岡 正剛, 木津谷 菜悠, 小野寺 智洋, 横田 勲, 岩崎 浩司, 濱崎 雅成, 江畑 拓, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 98 (2) S417 - S417 0021-5325 2024/03
• コラーゲン膜を用いた自家培養軟骨移植の臨床成績 骨膜被覆との比較

  甲斐原 拓真, 近藤 英司, 濱崎 雅成, 江畑 拓, 原 健人, 岩崎 浩司, 松岡 正剛, 小野寺 智洋, 門間 太輔, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 98 (2) S448 - S448 0021-5325 2024/03
• 外反膝に対して行った内側閉鎖式大腿骨遠位内反骨切り術の成績と膝蓋大腿関節のバイオメカニクスに与える影響

  濱崎 雅成, 松岡 正剛, 岩崎 浩司, 鈴木 裕貴, 小野寺 智洋, 岩崎 倫政, 近藤 英司, 井上 雅之, 八木 知徳, 安田 和則

  日本関節病学会誌 (一社)日本関節病学会 43 (1) 63 - 71 1883-2873 2024/03
• The Influence of Patello-Femoral Overstuffing After Modular Unlinked Bicompartmental Knee Arthroplasty (BiKA) for Medial Tibio-Femoral and Patello-Femoral Osteoarthritis of the Knee.

  Rikiya Baba, Yasumitsu Ohkoshi, Tatsunori Maeda, Ko Suzuki, Akane Iwadate, Koji Iwasaki, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki

  The Journal of arthroplasty 39 (3) 638 - 644 2024/03 

  BACKGROUND: The factors affecting results after bicompartmental knee arthroplasty (BiKA) have not been fully elucidated. This major ligament-preserving procedure may be more susceptible to overstuffing of the patello-femoral (PF) joint than the major ligament-sacrificing total knee arthroplasty. Currently, we investigated the effect of PF overstuffing after BiKA on its clinical outcome. METHODS: There were 71 patients (74 knees) who underwent modular unlinked BiKA at our clinic who had a follow-up of 5 to 9 years. Final follow-up results were assessed by evaluating knee range of motion, the 2011 Knee Society Score (2011KSS), Japanese Knee Osteoarthritis Measure, and radiological findings. The degree of postoperative PF overstuffing was evaluated by computed tomography and magnetic resonance images for 55 knees, and the correlation between the degree of overstuffing and postoperative clinical results were examined. RESULTS: Overall clinical results improved significantly after surgery without any revision cases. The X-ray measurements showed the improved coronal alignments and the appropriate implant installation angles. Higher degree of postoperative PF overstuffing caused by insufficient amount of osteotomy on the anterior surface of the femur correlated with worse postoperative total 2011KSS at 2 years after surgery (Spearman's rank correlation coefficient (rs) = -0.387, P = .004), as opposed to no correlation at the time of the final follow-up (Spearman's rank correlation coefficient = 0.068, P = .623). CONCLUSION: Modular unlinked BiKA provided patients with a high level of satisfaction and functional improvement over 5 to 9 years postoperatively. However, because PF overstuffing affects initial patient satisfaction, the amount of osteotomy should be determined carefully during the surgery.
• Simultaneous medial closing wedge distal femoral varus osteotomy and double-bundle anterior cruciate ligament reconstruction in the symptomatic femoral valgus deformity: A case report.

  Masatake Matsuoka, Eiji Kondo, Koji Iwasaki, Tomohiro Onodera, Ryuichi Nakamura, Hiroshi Nakayama, Takenori Akiyama, Daisuke Momma, Norimasa Iwasaki

  Joint diseases and related surgery 35 (2) 422 - 432 2024/02/13 

  Distal femoral varus osteotomy (DFVO) is a widely recognized surgical procedure used to address valgus malalignment in patients with knee joint disorders. However, it still remains unclear whether anterior cruciate ligament (ACL) reconstruction can be performed in a single procedure along with DFVO. Herein, we present a 73-year-old female patient who developed lateral osteoarthritis of the knee with valgus alignment due to chronic ACL deficiency following a twisting injury during skiing. She was physiologically very active, and strongly demanded to return to sports. We performed a combined procedure involving a medial closing wedge DFVO using an anatomical locking plate, along with double-bundle ACL reconstruction. The postoperative radiograph confirmed successful correction of knee alignment, specifically achieving varus alignment with precise conformance of the anatomical plate to the medial contour of the distal femur following the osteotomy. The patient resumed her previous sports activities without experiencing knee pain. The operated knee demonstrated restored anterior stability, as indicated by negative Lachman test results, and regained full range of motion. Both the Knee Injury and Osteoarthritis Outcome Score and the 2011 Knee Society score demonstrated continuous postoperative improvements over the three-year follow-up period, indicating positive functional outcomes and joint preservation. To the best of our knowledge, this is the first case of medial closing wedge DFVO with anatomic double-bundle ACL reconstruction in the symptomatic femoral valgus deformity with chronic ACL deficiency in the literature.
• 変形性膝関節症の重症度別外的膝関節モーメント成分の寄与率変化の検討

  鈴木 裕貴, 小野寺 智洋, 岩崎 倫政, 大越 康充, 前田 龍智, 川上 健作, 清水 健太, 千田 周也, 浮城 健吾, 岩崎 浩司, 鈴木 昭二, 近藤 英司

  日本関節病学会誌 (一社)日本関節病学会 42 (4) 340 - 346 1883-2873 2023/12 

  目的:内側型変形性膝関節症(KOA:knee osteoarthritis)の運動力学的特徴に関しては,いまだ解明されていない部分が多い。本研究の目的は,重症度別モーメント寄与率の特徴を明らかにすることである。方法:当院で歩行解析を実施し得たKOA症例77例93膝(北大KOA重症度分類;Stage II:19例22膝,Stage III:26例30膝,Stage IV:17例24膝,Stage V:15例19膝)を対象としてStageごとに群分けした。全症例に対し,膝関節可動域,歩行速度,単純X線所見を評価した。また,ポイントクラスター法に準じた光学式モーションキャプチャー技術と逆動力学計算により,床反力ピーク時における外的膝関節モーメントの総量(TJM:total joint moment)とそれに対する各モーメントの寄与率を求めた。結果:歩行速度と膝屈曲可動域はKOAの重症例ほど有意に小さかった(P<0.05)。KOA重症例では,femorotibial angleは大きく,TJMは大きく,TJM第一ピーク時における各モーメント寄与率は,内反モーメント(KAM:knee adduction moment)の割合が有意に大きく,屈曲モーメント(KFM:knee flexion moment)の割合が有意に小さかった。考察:KOAの重症例においては,高度の膝内反変形による長いレバーアームがKAMの寄与率が大きい要因と考えられた。また,膝屈曲可動域とKFMの寄与率が低いことから,大腿四頭筋力と膝関節機能の不良が示唆された。(著者抄録)
• Assessing knee joint biomechanics and trunk posture according to medial osteoarthritis severity.

  Yuki Suzuki, Yasumitsu Ohkoshi, Kensaku Kawakami, Kenta Shimizu, Shuya Chida, Kengo Ukishiro, Tomohiro Onodera, Koji Iwasaki, Tatsunori Maeda, Sho'ji Suzuki, Eiji Kondo, Norimasa Iwasaki

  Scientific reports 13 (1) 19186 - 19186 2023/11/06 

  During progression of knee osteoarthritis (OA), gait biomechanics changes three-dimensionally; however, its characteristics and trunk posture according to OA severity remain unknown. The present study investigated three-dimensional knee joint biomechanics and trunk posture according to knee OA severity. Overall, 75 patients (93 knees) with medial knee OA [Kellgren-Lawrence grade ≥ 2, grade 2: 20 patients with 24 knees (mean 60.0 years old); grade 3: 25 with 28 knees (mean 62.0 years old); grade 4: 30 with 41 knees (mean 67.9 years old)] and 14 healthy controls (23 knees, mean 63.6 years old) underwent gait analysis using an optical motion capture system and point cluster technique. In grade 2 knee OA, the relative contribution of the knee adduction moment (KAM) increased significantly (P < 0.05), and that of the knee flexion moment decreased (P < 0.05) prior to significant progression of varus knee deformity. Grade 3 knee OA showed significant exacerbation of varus knee deformity (P < 0.01) and KAM increase (P < 0.001). The maximum knee extension angle decreased (P < 0.05) and trunk flexion increased during gait in grade 4 knee OA (P < 0.001). Our study clarified the kinematics and kinetics of medial knee OA with trunk flexion according to severity. Kinetic conversion occurred in grade 2 knees prior to progression of varus deformities, knee flexion contractures, and sagittal imbalance during gait in patients with severe knee OA.
• Effect of Patient Age on Clinical and Radiological Outcomes After Medial Open-Wedge High Tibial Osteotomy: A Comparative Study With 344 Knees.

  Koji Yabuuchi, Eiji Kondo, Takuma Kaibara, Jun Onodera, Koji Iwasaki, Masatake Matsuoka, Tomohiro Onodera, Norimasa Iwasaki, Tomonori Yagi, Kazunori Yasuda

  Orthopaedic journal of sports medicine 11 (10) 23259671231200227 - 23259671231200227 2023/10 

  BACKGROUND: There exists some controversy regarding whether patient age is a predictive factor for outcomes after high tibial osteotomy (HTO). PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate whether patient age affects clinical and radiological outcomes after medial open-wedge HTO (OWHTO) in a large population with a wider age range than previous studies. It was hypothesized that there would be no differences in outcomes when compared across age-groups. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A retrospective comparative study was conducted using 344 patients (303 knees) who underwent OWHTO from 2009 to 2018. These patients were divided into 3 groups based on age at the time of surgery: ≥55 years (group Y: 76 knees in 57 patients), 56 to 64 years (group M: 129 knees in 120 patients), and ≤65 years (group O: 139 knees in 126 patients). Clinical and radiological evaluations were performed immediately before surgery and at the final follow-up period, at a mean of 5.1 years (range, 3-11 years). Comparisons among the 3 groups were conducted with 1-way analysis of variance for continuous variables. When a significant result was obtained, a post hoc test with Bonferroni correction was conducted for multiple comparisons. RESULTS: In clinical evaluations, there were no significant differences among the 3 groups either preoperatively or postoperatively concerning the Japanese Orthopaedic Association score, the Lysholm score, or the Knee injury and Osteoarthritis Outcome Score (KOOS), with the exception of the preoperative KOOS Symptoms subscale, which was significantly higher in group Y versus group O (48.9 ± 18.7 vs 58.7 ± 15.4, respectively; P = .011). The Tegner activity score was significantly different among the groups, both preoperatively and postoperatively (P < .001 for both). There was no significant difference in the occurrence of complications or the survival rate at final follow-up among the 3 groups. CONCLUSION: The study findings suggest that patient age does not affect clinical and radiological outcomes after OWHTO.
• 四肢原発悪性骨腫瘍症例における患肢温存術と切断術の比較 米国SEERデータベースを用いた研究

  柳澤 那由他, 松岡 正剛, 小野寺 智洋, 岩崎 浩司, 鈴木 裕貴, 濱崎 雅成, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (8) S1887 - S1887 0021-5325 2023/08
• 診断時遠隔転移を有する四肢発生原発性悪性骨腫瘍の原発巣切除が生存に与える影響 米国SEERデータベースを用いた研究

  福田 龍一, 松岡 正剛, 小野寺 智洋, 岩崎 浩司, 鈴木 裕貴, 濱崎 雅成, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (8) S1888 - S1888 0021-5325 2023/08
• アテロコラーゲンを用いた自家培養軟骨移植後に軟骨下骨嚢胞を生じた1例

  甲斐原 拓真, 近藤 英司, 濱崎 雅成, 鈴木 裕貴, 岩崎 浩司, 松岡 正剛, 小野寺 智洋, 種井 善一, 田中 伸哉, 岩崎 倫政

  東日本整形災害外科学会雑誌 東日本整形災害外科学会 35 (3) 361 - 361 1342-7784 2023/08
• アテロコラーゲンを用いた自家培養軟骨移植後に軟骨下骨嚢胞を生じた1例

  甲斐原 拓真, 近藤 英司, 濱崎 雅成, 鈴木 裕貴, 岩崎 浩司, 松岡 正剛, 小野寺 智洋, 種井 善一, 田中 伸哉, 岩崎 倫政

  東日本整形災害外科学会雑誌 東日本整形災害外科学会 35 (3) 361 - 361 1342-7784 2023/08
• Bone metastatic cancer of unknown primary at initial presentation.

  Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Yuki Suzuki, Hamasaki Masanari, Eiji Kondo, Norimasa Iwasaki

  Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 2023/07/03 

  INTRODUCTION: Cancer of unknown primary (CUP) is a challenging malignancy. The purpose of this study was to investigate the clinical characteristics and prognosis of bone metastatic CUP using the population-based Surveillance, Epidemiology, and End Results (SEER) database. METHODS: From the SEER database, we identified 1908 patients with bone metastatic CUP at initial presentation between 2010 and 2018. Histology was subdivided following International Classification of Diseases for Oncology codes as Adenocarcinoma, Squamous cell, Neuroendocrine, or Carcinoma not otherwise specified (NOS). Cox proportional hazard modeling was applied using factors of age, sex, ethnicity, histological subtype, and therapeutic intervention. RESULTS: Among the 1908 patients, histology was Neuroendocrine in 240 patients, Squamous cell in 201 patients, Adenocarcinoma in 810 patients and NOS in 657 patients. In each subtype, patients tended to be predominantly male and white. Chemotherapy was introduced for 28% of patients and radiation for 34% in the entire cohort. Survival in patients with bone metastatic CUP was unfavorable, with a median survival of 2 months. Among the histological subtypes, Adenocarcinoma showed shorter survival than the other groups. In addition, treatment interventions such as chemotherapy and radiation therapy prolonged survival, particularly for Squamous cell, Adenocarcinoma and NOS, but not for Neuroendocrine. DISCUSSION: Bone metastatic CUP showed extremely poor prognosis, but treatment interventions such as chemotherapy and radiation generally offered survival benefits. Further randomized clinical research is needed to confirm the present results.
• Symptomatic bilateral complete discoid medial menisci of the knee in a child: A case report.

  Yuki Suzuki, Eiji Kondo, Takuma Kaibara, Masatake Matsuoka, Ryosuke Hishimura, Koji Iwasaki, Tomohiro Onodera, Daisuke Momma, Shinya Tanaka, Norimasa Iwasaki

  Joint diseases and related surgery 34 (2) 455 - 462 2023/04/26 

  Bilateral complete discoid medial menisci are extremely rare congenital anatomic variants of the knee. Currently, arthroscopic partial meniscectomy with or without peripheral suture repair is performed for symptomatic discoid meniscus. However, most of the outcomes are short-term. In this article, we present a pediatric case of symptomatic bilateral complete discoid medial menisci and highlight the effectiveness of arthroscopic partial meniscectomy with or without peripheral suture on symptomatic complete discoid medial menisci based on 60-month excellent clinical and functional results.
• Amputation surgery associated with shortened survival in patients with localized soft tissue sarcoma.

  Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Ryosuke Hishimura, Yuki Suzuki, Masanari Hamasaki, Akira Iwata, Eiji Kondo, Norimasa Iwasaki

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2023/03/15 

  BACKGROUND: The objectives of this study were to clarify whether localized extremity soft tissue sarcoma (STS) patients who underwent amputation surgery experienced worsened survival and to identify those patients for whom amputation surgery worsened survival. METHODS: Using the Surveillance, Epidemiology, and End Results database, we identified 8897 patients with localized extremity STS between 1983 and 2016. Of these 6431 patients, 733 patients underwent amputation surgery (Amputation group), and 5698 underwent limb-sparing surgery (Limb-sparing group). RESULTS: After adjusting for patient background by propensity score matching, a total of 1346 patients were included. Patients in the Amputation group showed worsened survival (cancer-specific survival (CSS): hazard ratio (HR) = 1.42, 95% confidence interval (CI) 1.15-1.75, overall survival (OS): HR = 1.41, 95%CI 1.20-1.65). In subclass analysis, patients with high-grade STS, spindle cell sarcoma and liposarcoma in the Amputation group showed shortened survival (high-grade-CSS: HR = 1.44, 95%CI 1.16-1.77, OS: HR = 1.38, 95%CI 1.18-1.62; spindle cell sarcoma-CSS: HR = 4.75, 95%CI 1.56-14.4, OS: HR = 2.32, 95%CI 1.45-3.70; liposarcoma-CSS: HR = 2.91, 95%CI 1.54-5.50, OS: HR = 2.32, 95%CI 1.45-3.70). CONCLUSIONS: Survival was shortened in localized extremity STS patients who received amputation surgery.
• 大腿骨顆間外側壁における骨密度分布 前十字靱帯の大腿骨付着部に関する考察

  菅原 悠太郎, 岩崎 浩司, 遠藤 香織, 菱村 亮介, 松原 新史, 松岡 正剛, 門間 太輔, 小野寺 智洋, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (2) S193 - S193 0021-5325 2023/03
• 遠隔転移を有する軟部肉腫症例において原発巣切除は生存を延長する SEERデータベースを用いた研究

  松岡 正剛, 小野寺 智洋, 横田 勲, 岩崎 浩司, 松原 新史, 菱村 亮介, 近藤 英司, 岩崎 倫政

  北海道整形災害外科学会雑誌 北海道整形災害外科学会 64 (2) 49 - 58 1343-3873 2023/03 

  【目的】本研究の目的は,遠隔転移を有する四肢発生軟部肉腫(Soft tissue sarcoma:STS)症例について,原発巣切除が生存を延長するか否かを明らかにし,さらに原発巣切除を考慮すべき患者群を明らかにすることである.【方法】SEERデータベースを用いて,1983年から2016年の間に初診時に遠隔転移を有する四肢発生STS1453例を抽出した.そのうち原発巣切除を施行された患者は898名,されなかった症例は555名であった.傾向スコアマッチングにより患者背景を調整後,804名を解析対象とし切除群では生存が延長した(Cancer specific survival(CSS):Hazard ratio[HR]=0.59,95% confidence interval[CI]0.50-0.71;Overall survival[OS]:HR=0.60,95% CI 0.60-0.71).サブクラス解析では,病理学的高悪性度腫瘍や未分化多形肉腫,平滑筋肉腫,滑膜肉腫症例において,原発巣切除は生存を改善した(高悪性度;CSS:HR=0.57,95% CI 0.45-0.72,OS:HR=0.58,95% CI 0.48-0.71,未分化多形肉腫;CSS:HR=0.60,95% CI 0.42-0.84,OS:HR=0.61,95% CI 0.46-0.82,平滑筋肉腫;CSS:HR=0.50,95% CI 0.33-0.75,OS HR=0.50,95% CI 0.35-0.72,滑膜肉腫;CSS:HR=0.46,95% CI 0.31-0.68,OS:HR=0.43,95% CI 0.30-0.62).【結語】本研究は,遠隔転移を有する四肢発生STS症例において原発巣切除術が生存を延長することを示した.今後,本研究結果を追試するための前向き臨床試験が必要である.(著者抄録)
• 変形性膝関節症患者における下腿加速度と膝関節の荷重分布との関係 ウェアラブルセンサーを用いて

  佐橋 健人, 岩崎 浩司, 安倍 雄一郎, 渡邊 謙太郎, 千徳 風真, 千葉 健, 小野寺 智洋, 近藤 英司, 岩崎 倫政, 遠山 晴一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (3) S864 - S864 0021-5325 2023/03
• Higher Association of Pelvis-Knee-Ankle Angle Compared With Hip-Knee-Ankle Angle With Knee Adduction Moment and Patient-Reported Outcomes After High Tibial Osteotomy.

  Koji Iwasaki, Yasumitsu Ohkoshi, Yoshiaki Hosokawa, Shuya Chida, Kengo Ukishiro, Kensaku Kawakami, Sho'ji Suzuki, Tatsunori Maeda, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki

  The American journal of sports medicine 51 (4) 977 - 984 2023/03 

  BACKGROUND: High tibial osteotomy (HTO) reduces the load distribution of the medial compartment by modifying leg alignment. Knee adduction moment (KAM), a surrogate measure of dynamic loading in the knee joint, decreases after HTO. However, leg alignment does not fully account for KAM. PURPOSE: To assess the association between the pelvis-knee-ankle angle (PKA), a novel radiographic parameter reflecting leg alignment and pelvic width, and KAM and patient-reported outcomes after HTO. STUDY DESIGN: Cross sectional study; Level of evidence, 3. METHODS: PKA is the angle between the line from the midpoint of the anterior superior iliac spine to the center of the knee joint and the mechanical axis of the tibia. In this study, 54 patients with medial compartment knee osteoarthritis and varus alignment who underwent 3-dimensional gait analysis preoperatively and 2 years after medial open-wedge HTO were evaluated. The primary outcomes were hip-knee-ankle angle (HKA), PKA, KAM peaks, and Knee Society Score (KSS). Single and multivariate regression analysis including PKA and KAM peaks as well as other demographic and radiologic factors was performed. RESULTS: HKA was weakly correlated with the first peak KAM (r = -0.33; P < .01) and second peak KAM (r = -0.27; P = .01) before HTO, but not significantly correlated after HTO. PKA was moderately correlated with the first peak KAM (r = 0.45; P < .01) and second peak KAM (r = 0.45; P < .01) before HTO and with the first peak KAM (r = 0.51; P < .01) and second peak KAM (r = 0.56; P < .01) after HTO. Multivariate linear regression revealed that postoperative PKA was still associated with the KAM peaks after HTO. Only postoperative PKA was correlated with the KSS satisfaction subscale (r = -0.30; P = .03). CONCLUSION: Although HKA was not correlated with KAM peaks after HTO, PKA was significantly correlated with KAM peaks in patients with varus knee osteoarthritis after HTO.
• Atelocollagen-associated autologous chondrocyte implantation for the repair of large cartilage defects of the knee: Results at three to seven years.

  Takuma Kaibara, Eiji Kondo, Masatake Matsuoka, Koji Iwasaki, Tomohiro Onodera, Keita Sakamoto, Yoshitaka Oda, Zen-Ichi Tanei, Daisuke Momma, Shinya Tanaka, Norimasa Iwasaki

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2023/01/09 

  BACKGROUND: Recently, various types of engineered autologous chondrocyte implantation (ACI) have been developed. Atelocollagen-associated ACI (A-ACI) is the only ACI procedure covered by Japanese Health Insurance since 2013. The indications of the A-ACI are traumatic cartilage defects and osteochondral dissecans (OCD) for knee joints. PURPOSE: To evaluate midterm clinical results after A-ACI for the treatment for full-thickness cartilage defects of the knee. METHODS: Thirteen consecutive patients who underwent A-ACI between 2014 and 2018 had been prospectively enrolled in this study. There were 11 men and 2 women with a mean age of 34 years at the time of surgery. The causes of the cartilage defect were trauma in 10 knees and OCD in 3 knees. The total number of lesions was 15, which were comprised of the medial femoral condyle in 5 knees, the lateral femoral condyle in 5 knees, and the femoral trochlea in 5 knees. The mean size of the lesion was 5.3 cm2. Each knee was clinically and radiologically evaluated preoperatively and postoperatively. RESULTS: The mean Lysholm score improved significantly from 74.0 points to 94.0 points (p = 0.008) and each subscale in Knee injury and Osteoarthritis Outcome Score improved significantly (p < 0.001) at the mean final follow-up period of 51 months (range, 36-84 months). The magnetic resonance observation of cartilage repair tissue 2.0 score at the mean follow-up of 38 months was significantly higher than that at 2 months postoperatively (p = 0.014). According to the International Cartilage Repair Society (ICRS) grading scale, 3 knees were graded as normal, 3 knees as nearly normal, and 1 knee as severely abnormal in second-look arthroscopic evaluation at a mean of 22 months (range, 8-41 months) after A-ACI. CONCLUSION: The present study showed a significant subjective and objective clinical improvement in the A-ACI for large cartilage defects of the knee at a mean follow-up of 51 months (range, 36-84 months).
• Three-stage total knee arthroplasty combined with deformity correction and leg lengthening using Taylor spatial frames and conversion to internal fixation for severe intra- and extra-articular deformities and hypoplasia in a patient with hemophilic knee arthropathy: A case report.

  Akira Fukushima, Koji Iwasaki, Ryousuke Hishimura, Shinji Matsubara, Zenta Joutoku, Masatake Matsuoka, Tomoyuki Endo, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki

  The Knee 40 90 - 96 2023/01 

  BACKGROUND: Hemophilic arthropathy is a cause of severe knee deformity, because chronic synovitis due to repeated hemarthrosis affects the area of the epiphyseal plates in juvenile cases. Total knee arthroplasty (TKA) is the standard treatment for end-stage knee arthropathy. However, it is difficult to perform one-stage TKA in patients with severe intra- and extra-articular deformities. CASE PRESENTATION: We reported a case of hemophilic arthropathy in a 55-year-old male with leg length discrepancy of 4 cm, limited range of knee motion (-40° extension and 85° flexion), intra-articular deformity (medial proximal tibial angle: 69°; mechanical lateral distal femoral angle: 79°), extra-articular deformity at the distal femoral metaphyseal (30° valgus and 45° flexion deformity), and varus malalignment (% mechanical axis: 33%). We planned a three-stage TKA. Firstly, we performed gradual correction and lengthening of the distal femur using Taylor spatial flame. Six months after surgery, we performed conversion surgery from external fixation to internal fixation. Finally, we performed TKA with rotating hinged type implant. Two years after surgery, physical examination showed a normal gait, leg length discrepancy of 2 cm (the right leg was shorter), improvement in the range of knee motion (0° extension and 100° flexion). CONCLUSION: To the best of our knowledge, this presents the first combination of three-stage TKA with correction of femoral deformity and leg lengthening using a Taylor spatial frame and conversion to internal fixation in a patient with hemophilic knee arthropathy and severe intra- and extra-articular deformities.
• Early Changes in Postural Balance Following Inverted V-Shaped High Tibial Osteotomy in Patients With Knee Osteoarthritis.

  Kento Sabashi, Takeshi Chiba, Koji Iwasaki, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki, Harukazu Tohyama

  Journal of applied biomechanics 39 (2) 1 - 6 2023/01/01 

  Patients with knee osteoarthritis and varus knee deformity have impaired postural balance, resulting in decreased walking performance and an increased risk of falls. This study aimed to investigate the early changes in the postural balance following inverted V-shaped high tibial osteotomy (HTO). Fifteen patients with medial knee osteoarthritis were recruited. Postural balance was assessed using the center-of-pressure (COP) data during single-leg standing before and 6 weeks after inverted V-shaped HTO. The maximum range, mean velocity, and area of COP movements in the anteroposterior and mediolateral directions were analyzed. Preoperative and postoperative visual analog scale for knee pain was assessed. The maximum range of COP in the mediolateral direction decreased (P = .017), whereas the mean velocity of COP in the anteroposterior direction increased 6 weeks postoperatively (P = .011). The visual analog scale score for knee pain significantly improved at 6 weeks postoperatively (P = .006). Valgus correction with inverted V-shaped HTO resulted in improved postural balance in the mediolateral direction and good short-term clinical outcomes early following surgery. Early rehabilitation after inverted V-shaped HTO should focus on postural balance in the anteroposterior direction.
• Occurrence Rate of Cyclops Lesion After Anatomic Double-Bundle ACL Reconstruction: Comparison Between Remnant Tissue Preservation and Resection Methods.

  Ryosuke Hishimura, Eiji Kondo, Yuki Suzuki, Masatake Matsuoka, Koji Iwasaki, Tomohiro Onodera, Daisuke Momma, Tomonori Yagi, Kazunori Yasuda, Norimasa Iwasaki

  Orthopaedic journal of sports medicine 10 (10) 23259671221130688 - 23259671221130688 2022/10 

  BACKGROUND: The occurrence rate of cyclops lesion after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction with remnant tissue preservation remains unclear. HYPOTHESIS: The study hypotheses were as follows: (1) the occurrence rate of cyclops lesion will be comparable between the remnant-preserving and remnant-resecting ACL reconstruction methods, and (2) there will be no significant differences in clinical outcomes between the remnant-preserving and remnant-resecting procedures. METHODS: This retrospective comparative study involved 177 patients who underwent unilateral anatomic double-bundle ACL reconstruction using hamstring tendon autografts from 2014 to 2018 at our hospital. According to the Crain classification of ACL remnant tissue, 98 patients with remnant types I, II, or III underwent the remnant-preserving procedure (group A), and the remaining 79 patients with remnant type IV underwent the remnant-resecting procedure (group B). All patients underwent second-look arthroscopy. Patients were evaluated according to arthroscopic and clinical results at postoperative 15.2 ± 8.4 months (mean ± SD). Statistical comparisons between groups were made using the paired Student t test, chi-square test, and Fisher exact test. STUDY DESIGN: Cohort study; Level of evidence, 3. RESULTS: At second-look arthroscopy, the incidence of cyclops lesions was significantly higher in group B than in group A (29.1% vs 13.3%; P = .0139). Cyclops lesions were divided into 4 locations: femoral side (type 1), midsubstance (type 2), tibial side (type 3), and anterior (type 4) of the ACL graft. The ratio of the tibial-side cyclops lesion (type 3) was significantly higher in group B than in group A (P = .0354). There were no significant differences in the clinical evaluation scores between the procedures. Side-to-side anterior laxity was significantly less in group A than in group B (0.7 vs 1.6 mm; P = .0035). Concerning postoperative laceration and synovium coverage of the grafts, group A was significantly better than group B (P < .0001). CONCLUSION: In this cohort of patients undergoing double-bundle ACL reconstruction, resection of the ACL remnant was associated with a significantly higher rate of cyclops lesion formation when compared with preservation of the remnant.
• Comparison of clinical features between patients with bone and soft tissue fibrosarcomas.

  Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Ryosuke Hishimura, Yuki Suzuki, Eiji Kondo, Norimasa Iwasaki

  Journal of surgical oncology 126 (7) 1299 - 1305 2022/08/08 

  BACKGROUND AND OBJECTIVES: Fibrosarcomas predominantly arise in soft tissues, but can also develop in bone. Because of their rarity, whether bone development has an impact on clinical features has not been addressed. METHODS: We included fibrosarcoma patients diagnosed between 1983 and 2016 in the Surveillance, Epidemiology, and End Results database. Differences in clinical features between fibrosarcoma of bone (FS-B) and fibrosarcoma of soft tissue (FS-ST) were investigated. RESULTS: After excluding patients without information regarding cause of death, site of origin, distant tumor or survival, 1443 patients were included. Of those, 98 patients had FS-B. Patients with FS-B were younger, more frequently male, with fibrosarcomas that more often developed in an extremity and were histologically high-grade. In contrast, no difference in potential to metastasize was observed. Survival was almost equal between FS-B and FS-ST (FS-B/FS-ST: cancer-specific survival, hazard ratio [HR]: 1.2, 95% confidence interval [CI]: 0.8-1.7; overall survival, HR: 1.3, 95% CI: 0.9-1.7). CONCLUSIONS: Our results clearly indicated that patient backgrounds differed, such as younger age and greater tendencies to affect males, develop in an extremity and show high-grade tumor in patients with FS-B. In contrast, no differences were observed in distant metastatic potential or survival.
• Liver metastasis in soft tissue sarcoma at initial presentation.

  Yuta Kawae, Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Ryosuke Hishimura, Yuki Suzuki, Eiji Kondo, Norimasa Iwasaki

  Journal of surgical oncology 126 (6) 1074 - 1079 2022/07/06 

  BACKGROUND AND OBJECTIVES: Noncontrast computed tomography of the chest is the standard imaging modality for cancer staging in patients with soft tissue sarcoma (STS), but appropriate candidates for liver screening have not been clarified. METHODS: We reviewed all patients with STS diagnosed between 2010 and 2018 in the Surveillance, Epidemiology, and End Results database. Incidence of liver metastasis at initial presentation and high incidence of liver metastasis by histological subtype were investigated. In addition, risk factors for liver metastasis were investigated by multiple logistic regression analysis. RESULTS: After excluding patients without information about liver metastasis, cause of death or primary liver tumor, 47 260 patients were included in this study. Of those, 1471 patients (3.2%) showed liver metastasis at initial presentation. The histological subtype showing the highest incidence of liver metastasis was desmoplastic small round cell tumor (30.3%), followed by malignant hemangioendothelioma (11.5%) and angiomyoliposarcoma (10.5%). Deep-rooted tumor, location in the body wall, retroperitoneum, or thorax/peritoneum, high histological grade, and higher T stage were associated with higher incidences of liver metastasis at initial presentation. CONCLUSION: Risk factors for liver metastasis were deep location, trunk development, larger tumor size, high histological grade, and specific histological subtypes.
• Effect of the Inverted V-Shaped Osteotomy on Patellofemoral Joint and Tibial Morphometry as Compared With the Medial Opening Wedge High Tibial Osteotomy.

  Eiji Kondo, Koji Yabuuchi, Zenta Joutoku, Shinji Matsubara, Koji Iwasaki, Masatake Matsuoka, Tomohiro Onodera, Daisuke Momma, Masayuki Inoue, Tomonori Yagi, Norimasa Iwasaki, Kazunori Yasuda

  The American journal of sports medicine 50 (9) 2439 - 2452 2022/07 

  BACKGROUND: Recent studies have reported that medial opening wedge (OW) high tibial osteotomy (HTO) induces patella baja, resulting in degenerative changes in the patellofemoral joint. We have developed an inverted V-shaped (iV) HTO, which is classified as a neutral wedge osteotomy. HYPOTHESES: The study hypotheses were as follows: (1) patellar height, posterior tibial slope, and tibial length will not change between pre- and postoperative evaluations after iV-HTO; (2) the lateral shift ratio of the patella and the distance between the tibial tubercle and the trochlear groove may be significantly decreased after iV-HTO. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 191 patients (220 knees) who underwent HTO for medial osteoarthritis were enrolled retrospectively in this study: 107 knees underwent OW-HTO and 113 knees underwent iV-HTO. Clinical and radiological evaluations were performed before and at least 3 years after surgery. RESULTS: Postoperatively, the mean Caton-Deschamps ratio was significantly decreased (P < .0001) from 0.95 to 0.79 in the OW group, while there were no significant changes in the iV group. The mean posterior tibial slope was significantly increased (P < .0001) from 8.5° to 10.5° in the OW group, while there were no significant differences in the iV group. Although the entire leg length was significantly increased (P < .0003) in both groups after HTO, there were no significant differences in tibial length between the pre- and postoperative periods in the iV group. Regarding the congruity of the patellofemoral joint, the mean lateral shift ratio did not significantly change in the OW group, whereas it was significantly decreased (P = .0012) from 11.5% to 8.8% in the iV group. The mean tibial tubercle-trochlear groove distance was significantly decreased (P < .0001) from 12.8 to 9.7 mm in the iV group, while it was significantly increased in the OW group (P < .0001). Concerning the clinical outcome, the Japanese Orthopaedic Association (JOA) and Lysholm knee scores at final follow-up (OW vs iV: JOA, 91.2 vs 90.1; Lysholm, 92.5 vs 89.0) were significantly increased (P < .0001) as compared with the preoperative values (OW vs iV: JOA, 68.3 vs 66.8; Lysholm, 67.9 vs 61.0). CONCLUSION: Patellar height, posterior tibial slope, and tibial length did not change after the iV-HTO, while they were significantly changed after the OW-HTO. Although the preoperative degrees of varus knee and patellofemoral osteoarthritis were more severe in the iV group than the OW group, the iV-HTO led to altered patellofemoral joint congruity.
• Does Primary Tumor Resection in Patients with Metastatic Primary Mobile Vertebral Column Sarcoma Improve Survival?

  Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Ryosuke Hishimura, Yuki Suzuki, Akira Iwata, Eiji Kondo, Norimasa Iwasaki

  World neurosurgery 163 e647-e654  2022/04/18 

  BACKGROUND: Primary mobile vertebral column sarcoma is an exceedingly rare malignancy. Although primary tumor resection has been reported to prolong survival in patients with metastatic bone sarcoma, whether primary tumor resection in patients with advanced primary mobile vertebral column sarcoma is associated with survival remains unclear owing to the rarity of this pathological entity. METHODS: Using the Surveillance, Epidemiology, and End Results database, 182 patients with metastatic primary mobile vertebral column sarcoma were identified between 1983 and 2015. Of the 182 patients enrolled, 101 patients (55%) underwent primary tumor resection (Surgery group) and 81 patients (45%) did not undergo resection (No Surgery group). To account for imbalances in the basic characteristics of patients between groups, propensity score matching was performed. Survival analysis was performed by weighted Cox proportional hazards modeling to calculate hazard ratios. RESULTS: After adjusting for patient background characteristics, 138 patients were included for the analysis (Surgery group: 69 patients; No Surgery group: 69 patients). The Surgery group did not show improved cancer-specific survival (hazard ratio = 0.73, 95% CI 0.49-1.10). Similarly, the Surgery group did not show improved overall survival compared with the No Surgery group (hazard ratio = 0.80, 95% CI 0.55-1.16). CONCLUSIONS: To our knowledge, this is the first study to indicate that surgical resection for advanced primary mobile vertebral column sarcoma does not have a positive impact on survival.
• Double-bundle anterior cruciate ligament reconstruction using autologous hamstring tendon hybrid grafts in a patient with hypermobile Ehlers-Danlos Syndrome: A case report.

  Ryosuke Hishimura, Eiji Kondo, Masatake Matsuoka, Koji Iwasaki, Yasuyuki Kawaguchi, Yuki Suzuki, Tomohiro Onodera, Daisuke Momma, Norimasa Iwasaki

  The Knee 35 81 - 86 2022/03 

  BACKGROUND: Ehlers-Danlos syndrome (EDS) is a connective tissue disorder characterized by skin hyperextensibility, joint hypermobility, and tissue friability. Hypermobile type Ehlers-Danlos syndrome (hEDS) is considered one of the EDS subtypes characterized by generalized joint hypermobility. Although there have been a few case reports which described surgical considerations for anterior cruciate ligament (ACL) reconstructions in patients with other types of EDS, no reports have described those in patients with hEDS. CASE PRESENTATION: We report a case of ACL injury in an 18-year-old male patient with hEDS. The patient was successfully treated with an anatomic double-bundle ACL reconstruction using autologous hamstring tendon hybrid grafts which consist of hamstring tendons connected in a series with commercially available polyester tape. The autogenous tendon portion of the anteromedial and posterolateral bundles were composed of 4 and 2 strands of hamstring tendons, respectively. After 2 weeks of knee joint immobilization, continuous passive motion exercise of the knee joint and partial weight-bearing was allowed. A hinged knee brace was used for a period of 5 months postoperatively. Second-look arthroscopy at 30 months showed that the ACL graft had no laceration and an excellent coverage of the synovium. At 36 months after surgery, the side-to-side differences in the anterior laxity was remarkably improved. The operated knee showed negative Lachman test and had a full range of motion. CONCLUSIONS: To the best of our knowledge, this represents the first report of anatomic double-bundle ACL reconstruction in patients with hEDS and demonstrates excellent clinical and functional outcomes.
• Primary Malignant Osseous Neoplasms in the Hand.

  Shota Ike, Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Ryosuke Hishimura, Yuki Suzuki, Eiji Kondo, Norimasa Iwasaki

  Anticancer research 42 (3) 1635 - 1640 2022/03 

  BACKGROUND: Primary malignant osseous neoplasms of the hand are rare malignancies. Comprehensive demographic and survival data regarding primary malignant osseous neoplasms of the hand are lacking in the literature. PATIENTS AND METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified all patients with primary malignant osseous neoplasms of the hand diagnosed between 1983 and 2015. Demographic data were searched for primary osseous neoplasms in the hand and higher incidence of histological subtype. RESULTS: A total of 197 patients were analyzed: 103 patients were diagnosed with histologically low-grade tumor, and 31 were diagnosed with high-grade tumor. Five-year cancer-specific and overall survival rates for the entire cohort were 91.4% and 81.9%, respectively. Histological high tumor grade and regional stage from SEER historic stage data were associated with unfavorable cancer-specific survival. CONCLUSION: Special caution is required if patients have histologically high-grade tumor or tumor extending beyond the periosteum into surrounding joints, as these features worsen cancer-specific mortality.
• The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial.

  Ryosuke Hishimura, Tomohiro Onodera, Yasumitsu Ohkoshi, Kazufumi Okada, Masatake Matsuoka, Shinji Matsubara, Koji Iwasaki, Eiji Kondo, Norimasa Iwasaki

  BMC musculoskeletal disorders 23 (1) 111 - 111 2022/02/02 

  BACKGROUND: Tranexamic acid (TXA) is used as a synthetic anti-fibrinolytic agent for total knee arthroplasty (TKA) to reduce postoperative bleeding. Though the effects on bleeding reduction of several methods of administering TXA have been demonstrated, the optimal method remains controversial. Recently, the hemostatic effect of periarticular local injection of TXA during TKA was reported. Although this method can be expected to suppress postoperative bleeding without placing a drain, its hemostatic effect has not yet been assessed in comparison with local injection and other methods of administering TXA. The aim of this randomized, prospective study was to assess the efficacy of local injection of TXA during TKA. METHODS: To confirm the effect of the local injection of TXA, drain clamping was set as the control. The subjects included a prospective series of 109 patients randomly divided into 2 groups: the local injection (group L) and the drain clamping (group D). The main outcome measure was postoperative bleeding. Secondary outcomes included pain, physical measurements, and laboratory findings. RESULTS: The calculated total blood loss (CTBL) in groups L and D was nearly equal and did not show the non-inferiority of group L to group D (883 ± 248 vs. 841 ± 257 ml, P = .564). Drained blood loss was significantly higher in group L than in group D (395 ± 130 vs 276 ± 78.8 ml, P < .0001). There was no significant difference in hidden blood loss between the groups (488 ± 269 vs 565 ± 261 ml, P = .131). The other laboratory findings and physical measurements were identical between the groups. CONCLUSIONS: Although CTBL in group L did not show non-inferiority to group D, the local injection of TXA was considered to be superior for suppressing bleeding considering the risk of the adverse effects of using a drain. TRIAL REGISTRATION: This was a randomized, prospective study registered with UMIN Clinical Trials Registry (Registration number: UMIN000036146, date of disclosure: 10/3/2019).
• Discrepancy in the Distribution Patterns of Subchondral Bone Density Across the Ankle Joint After Medial Opening-Wedge and Lateral Closing-Wedge High Tibial Osteotomy.

  Shinji Matsubara, Tomohiro Onodera, Koji Iwasaki, Ryosuke Hishimura, Masatake Matsuoka, Eiji Kondo, Norimasa Iwasaki

  The American journal of sports medicine 50 (2) 478 - 485 2022/02 

  BACKGROUND: High tibial osteotomy (HTO) changes the alignment and dynamics of the ankle joint; however, differences in the stress distribution of the ankle joint after opening-wedge HTO (OWHTO) and closing-wedge HTO (CWHTO) are not understood. It is believed that subchondral bone density of the articular surface reflects the pattern of cumulative stress distribution across the joint surface. PURPOSE: To clarify the effects of OWHTO and CWHTO on the distribution patterns of subchondral bone density across the ankle joint using computed tomography (CT)-osteoabsorptiometry. STUDY DESIGN: Cohort study; Level of evidence, 4. METHODS: Radiographic and CT data of 18 cases who underwent OWHTO (OW group), 12 cases who underwent CWHTO (CW group), and 11 cases with unilateral anterior cruciate ligament injury serving as controls were retrospectively reviewed. The subchondral bone density of the distal tibia was assessed in the 3 groups using CT-osteoabsorptiometry. The distal tibial surface of the ankle joint was divided into 4 parts in the coronal direction, and the percentage of the high-density area (%HDA) to each subregion was compared before and after HTO. RESULTS: Preoperatively, comparing %HDA among the 3 groups, there were no significant differences in any regions. In the OW group, postoperative %HDA in the most medial region was significantly increased compared with preoperative %HDA (49.3% to 53.0%; P = .011), and postoperative %HDA in the most lateral region was significantly decreased (21.4% to 17.2%; P = .003). On the other hand, in the CW group, postoperative %HDA in the most medial region was significantly decreased (55.7% to 35.7%; P = .001), and %HDA in the second lateral region was significantly increased (23.6% to 29.2%; P = .002). CONCLUSION: The ankle distribution pattern of subchondral bone density shifted significantly medially after OWHTO without fibular osteotomy, whereas the distribution pattern shifted laterally after CWHTO with fibular osteotomy. When the OWHTO is performed for patients with medial ankle osteoarthritis, surgeons should pay attention to potential postoperative progression of ankle osteoarthritis due to medial shift of the stress distribution in the ankle joint.
• Surgical resection of primary tumor in the extremities improves survival for metastatic soft-tissue sarcoma patients: a population-based study of the SEER database.

  M Matsuoka, T Onodera, I Yokota, K Iwasaki, S Matsubara, R Hishimura, E Kondo, N Iwasaki

  Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 23 (12) 2474 - 2481 2021/12 

  PURPOSE: The objectives of this study were to clarify whether resection of primary tumor in the extremities for patients with metastatic soft-tissue sarcoma (STS) improves survival, and to clarify patient groups for whom primary tumor resection should be considered. METHODS/PATIENTS: Using the surveillance, epidemiology, and end results database, we identified 1453 patients with metastatic STS of the extremities at initial presentation between 1983 and 2016. Of these 1453 patients, 898 patients underwent primary tumor resection (Surgery group), and 555 patients did not (No-surgery group). RESULTS: After adjusting for patient background by propensity score matching, a total of 804 patients were included for analysis. Patients in the Surgery group showed improved survival (cancer-specific survival (CSS) hazard ratio (HR) = 0.59, 95% confidence interval (CI) 0.50-0.71 overall survival rate (OS) HR = 0.60, 95% CI 0.51-0.70). In subclass analysis, patients with high-grade STS, undifferentiated pleomorphic sarcoma, leiomyosarcoma, or synovial sarcoma showed improved survival in the Surgery group (high grade-CSS HR = 0.57, 95% CI 0.45-0.72, OS HR = 0.58, 95% CI 0.48-0.71; undifferentiated pleomorphic sarcoma-CSS HR = 0.60, 95% CI 0.42-0.84, OS HR = 0.61, 95% CI 0.46-0.82; leiomyosarcoma-CSS HR = 0.50, 95% CI 0.33-0.75, OS HR = 0.50, 95% CI 0.35-0.72; synovial sarcoma-CSS HR = 0.46, 95% CI 0.31-0.68, OS HR = 0.43, 95% CI 0.30-0.62). CONCLUSIONS: Our results indicated that primary tumor resection in metastatic STS exerts positive impacts on survival. Further clinical research is needed to confirm these results.
• Favorable effects of burosumab on tumor-induced osteomalacia caused by an undetectable tumor: A case report.

  Yuki Oe, Hiraku Kameda, Hiroshi Nomoto, Keita Sakamoto, Takeshi Soyama, Kyu Yong Cho, Akinobu Nakamura, Koji Iwasaki, Daisuke Abo, Kohsuke Kudo, Hideaki Miyoshi, Tatsuya Atsumi

  Medicine 100 (46) e27895  2021/11/19 

  RATIONALE: Tumor-induced osteomalacia (TIO) is curable by tumor resection, but detection of the tumor can be challenging. Overproduction of fibroblast growth factor 23 (FGF23) by the tumor causes hypophosphatemia and consequently induces inappropriate bone turnover. Conventionally oral phosphate supplementation was the only treatment for TIO, but had risks of hypercalciuria and nephrocalcinosis. Burosumab, a human monoclonal anti-FGF23 antibody, was recently post-marketed in Japan against for FGF23-related hypophosphatemia. Herein, we present a case of TIO with undetectable tumor that was successfully treated with burosumab. PATIENT CONCERNS: A 47-year-old woman was forced to use a wheelchair because of pain in both feet. DIAGNOSIS: Laboratory findings showed hypophosphatemia, elevated bone markers, and high serum FGF23 without renal tubular defects. Imaging studies revealed bone atrophy in the feet, decreased bone density, and multiple pseudofractures in the talar, sacral, and L5 vertebral regions. After excluding drug-induced and hereditary osteomalacia, we diagnosed her as TIO. INTERVENTIONS: Comprehensive imaging studies and stepwise venous sampling failed to localize the tumor, and we started to administer subcutaneous burosumab. OUTCOMES: After administration of burosumab, her serum phosphate was normalized without phosphate supplementation within 2 months. Improvement of pseudofractures, relief of pain evaluated by a visual analog scale, and normalization of bone biomarkers were observed. The patient was able to stand by herself after 6 months administration of burosumab. LESSONS: This is the first report in clinical practice to demonstrate favorable effects of burosumab, including not only normalization of serum phosphate but also improvements of pseudofractures and subjective pain, in a patient with TIO and undetectable tumor.
• Brain Metastasis in Soft Tissue Sarcoma at Initial Presentation.

  Ryo Itoga, Masatake Matsuoka, Tomohiro Onodera, Isao Yokota, Koji Iwasaki, Shinji Matsubara, Ryosuke Hishimura, Yuki Suzuki, Akira Iwata, Eiji Kondo, Norimasa Iwasaki

  Anticancer research 41 (11) 5611 - 5616 2021/11 

  BACKGROUND/AIM: Brain metastasis is a rare condition among patients with soft tissue sarcoma (STS), and its precise incidence remains unclear. The aim of this study was to investigate which patients should be screened for brain metastasis. PATIENTS AND METHODS: We identified all patients with STS diagnosed between 2010 and 2015 in the SEER database. Incidence of brain metastasis at initial presentation and higher incidence of brain metastasis by histological subtype were investigated. In addition, risk factors for brain metastasis were examined. RESULTS: A total of 26,676 patients were included for analysis, of whom 162 patients (0.6%) had brain metastasis. Alveolar soft part sarcoma (6.3%), malignant hemangioendothelioma (3.1%) and malignant schwannoma (2.6%) showed higher incidence of brain metastasis. Deep-rooted tumor, trunk tumor, and histological high-grade tumor tended to show higher incidence of brain metastasis. CONCLUSION: Risk factors for brain metastasis were deep location, trunk development and histologically high-grade tumor, or specific histological subtypes.
• Stress on the posteromedial region of the proximal tibia increased over time after anterior cruciate ligament injury

  Soya Miura, Koji Iwasaki, Eiji Kondo, Kaori Endo, Shinji Matsubara, Masatake Matsuoka, Tomohiro Onodera, Norimasa Iwasaki

  Knee Surgery, Sports Traumatology, Arthroscopy 30 (5) 1744 - 1751 2021/09/10 [Refereed]
   

  PURPOSE: Anterior cruciate ligament (ACL) injury induces anterior and rotatory instability of the knee. However, the effect of this instability on the stress distribution in the knee joint in living participants is not clear. The aim of this study was to compare the distribution pattern of subchondral bone density across the proximal tibia in the knees with and without ACL injury, and to investigate the correlation between the distribution patterns of the subchondral bone density and the duration of ACL-deficiency. METHODS: Radiographic and computed tomography (CT) data pertaining to 20 patients with unilateral ACL injury without combined injury (ACL-deficient group) and 19 nontraumatic subjects (control group) were collected retrospectively. Subchondral bone density of the proximal tibia was assessed using CT-osteoabsorptiometry. Both the medial and lateral compartments of the proximal tibia were divided into three subregions of equal width in the sagittal direction. The percentage of high subchondral bone density areas (HDA%) in each subregion was quantitatively analyzed. RESULTS: HDA% of the posteromedial region was significantly higher in the ACL-deficient group (mean: 21.6%) than in the control group (14.7%) (p = 0.002). In contrast, HDA% of the anteromedial region was significantly lower in the ACL-deficient group (9.4%) than in the control group (15.3%) (p = 0.048). The logarithm of the time elapsed from ACL injury to CT examination showed a significant correlation with HDA% in the posteromedial region (p = 0.032). CONCLUSIONS: Subchondral bone density in the posteromedial region significantly increased after ACL injury and correlated with the duration of ACL-deficiency in semi-log manner in meniscus intact knees. The increase in stress on the posteromedial region after ACL injury, which induces a change in the subchondral bone density, justifies early ACL reconstruction after ACL injury.
• Medial closed-wedge distal femoral osteotomy with local bone grafts for large collapsed steroid-induced osteonecrosis of the lateral femoral condyle: A case report.

  Takuma Kaibara, Eiji Kondo, Masatake Matsuoka, Koji Iwasaki, Tomohiro Onodera, Daisuke Momma, Norimasa Iwasaki

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2021/08/04
• 大腿骨顆間外側壁における骨密度分布 前十字靱帯の大腿骨付着部についての考察

  菅原 悠太郎, 岩崎 浩司, 遠藤 香織, 菱村 亮介, 松原 新史, 松岡 正剛, 門間 太輔, 小野寺 智洋, 近藤 英司, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 95 (8) S1715 - S1715 0021-5325 2021/08
• Delayed Onset of Infectious Foreign Body Granuloma for Nonabsorbable Sutures After Open Achilles Tendon Repair: A Case Report

  Ryo Itoga, Masatake Matsuoka, Tomohiro Onodera, Ai Shimizu, Koji Iwasaki, Shinji Matsubara, Ryosuke Hishimura, Eiji Kondo, Norimasa Iwasaki

  The Journal of Foot and Ankle Surgery 60 (6) 1297 - 1300 1067-2516 2021/07 [Refereed]
   

  Foreign body granulomas from sutures are more common among non-absorbable sutures compared to absorbable sutures and have been reported as a postoperative complication in a variety of medical fields. However, only a few cases of delayed foreign body reaction have been reported and addressed with orthopedics. We present a patient with systemic lupus erythematosus who developed an infectious suture granuloma that extended to the entire Achilles tendon and was induced by nonabsorbable sutures that were used for open Achilles tendon repair 20 years before. This granuloma was resistant to antibiotic treatment and drainage and required surgical intervention. The tumor was marginally resected, and the continuity of the Achilles tendon was preserved. Histopathological examination detected many suture materials surrounded by xanthochromic necrotic lesions and the lesion was diagnosed as a foreign body granuloma. At 1 year after the operation, the patient did not exhibit exacerbation of infection or recurrence of the tumor, and she became able to walk by herself. To the best of our knowledge, this represents the first report of an infectious delayed foreign body granuloma in autoimmune disorder patient after open Achilles tendon repair. Surgical intervention should be considered, as treatment with conservative therapy such as antibiotics may be difficult.
• Effect of High Tibial Osteotomy on the Distribution of Subchondral Bone Density Across the Proximal Tibial Articular Surface of the Knee With Medial Compartment Osteoarthritis.

  Koji Iwasaki, Eiji Kondo, Shinji Matsubara, Masatake Matsuoka, Kaori Endo, Isao Yokota, Tomohiro Onodera, Norimasa Iwasaki

  The American journal of sports medicine 49 (6) 1561 - 1569 1552-3365 2021/05 [Refereed]
   

  BACKGROUND: The effect of high tibial osteotomy (HTO) on the stress distribution across the knee joint is not completely understood. Subchondral bone density is considered to reflect the pattern of stress distribution across a joint surface. PURPOSE: To assess the distribution of subchondral bone density across the proximal tibia in nonarthritic knees and in the knees of patients with osteoarthritis (OA) before and after HTO. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively collected radiological and computed tomography data from 16 patients without OA (control group) and 17 patients with OA. Data from the OA group were collected before and 1.5 years after HTO. Subchondral bone density of the proximal tibia was assessed with computed tomography-osteoabsorptiometry. The locations and percentages represented by high-density areas (HDAs) on the articular surface were quantitatively analyzed. RESULTS: The ratio of the HDA of the medial compartment to the total HDA (medial ratio) was significantly higher in the preoperative OA group (mean, 80.1%) than in the control group (61.3%) (P < .001). After HTO, the medial ratio decreased significantly to 75.1% (P = .035 in comparison with preoperative values) and was significantly correlated with the hip-knee-ankle angle in both groups: control (r = -0.551; P = .033) and OA (r = -0.528; P = .043). The change in medial ratio after HTO was significantly correlated with the change in hip-knee-ankle angle (r = 0.587; P = .035). In the medial compartment, the HDA in the most lateral region of 4 subregions increased after HTO, but that in 3 medial subregions decreased. CONCLUSION: In this exploratory study, HTO shifted the HDA of the medial compartment of the proximal tibial articular surface toward the lateral compartment. In contrast, the HDA of the most lateral region of the medial compartment increased after HTO. This change in subchondral bone density may result from the change in stress distribution.
• Changes in the Contact Stress Distribution Pattern of the Patellofemoral Joint After Medial Open-Wedge High Tibial Osteotomy: An Evaluation Using Computed Tomography Osteoabsorptiometry.

  Toshiaki Kameda, Eiji Kondo, Tomohiro Onodera, Koji Iwasaki, Jun Onodera, Kazunori Yasuda, Norimasa Iwasaki

  Orthopaedic journal of sports medicine 9 (4) 2325967121998050 - 2325967121998050 2021/04 

  Background: Medial open-wedge high tibial osteotomy (OWHTO) theoretically causes distalization and lateralization of the tibial tuberosity and the patella. Purpose/Hypothesis: The purpose of the study was to identify any changes in the stress distribution of subchondral bone density across the patellofemoral (PF) joint before and after OWHTO through the use of computed tomography (CT) osteoabsorptiometry. We hypothesized that OWHTO would alter the distribution of contact stress in the PF joint. Study Design: Case series; Level of evidence, 4. Methods: A total of 17 patients (17 knees) who underwent OWHTO were enrolled in this study between September 2013 and September 2015. All patients underwent radiologic examination preoperatively and at 1 year postoperatively, and the distribution patterns of subchondral bone density through the articular surface of the femoral trochlea and patella were assessed preoperatively and >1 year postoperatively using CT osteoabsorptiometry. The quantitative analysis of the obtained mapping data focused on location of the high-density area (HDA) through the articular surface of the PF joint. The percentage of HDA at each divided region of the articular surface of the femoral trochlea and the patella was calculated. Results: In the radiologic evaluation, the Blackburne-Peel ratio was significantly reduced (P < .001) after surgery, and the tilting angle of the patella was significantly decreased (P < .001). On CT evaluation, the percentage of HDA in the lateral notch and lateral trochlea of the femur and in the medial portion of the lateral facet of the patella increased significantly after OWHTO surgery (P ≤ .038). Conclusion: OWHTO significantly increased the stress distribution pattern of the lateral trochlea of the femur and the medial portion of the lateral facet of the patella. The procedure significantly lowered the patellar height and significantly decreased the patellar tilting angle after surgery.
• Local Administration of Low-Dose Nerve Growth Factor Antibody Reduced Pain in a Rat Osteoarthritis Model

  Yuan Tian, Tomohiro Onodera, Mohamad Alaa Terkawi, Koji Iwasaki, Ryosuke Hishimura, Dawei Liang, Takuji Miyazaki, Norimasa Iwasaki

  International Journal of Molecular Sciences 22 (5) 2552 - 2552 1422-0067 2021/03/04 [Refereed]
   

  Systemic injection of a nerve growth factor (NGF) antibody has been proven to have a significant relevance in relieving osteoarthritis (OA) pain, while its adverse effects remain a safety concern for patients. A local low-dose injection is thought to minimize adverse effects. In this study, OA was induced in an 8-week-old male Sprague–Dawley (SD) rat joint by monoiodoacetate (MIA) injection for 2 weeks, and the effect of weekly injections of low-dose (1, 10, and 100 µg) NGF antibody or saline (control) was evaluated. Behavioral tests were performed, and at the end of week 6, all rats were sacrificed and their knee joints were collected for macroscopic and histological evaluations. Results showed that 100 µg NGF antibody injection relieved pain in OA rats, as evidenced from improved weight-bearing performance but not allodynia. In contrast, no significant differences were observed in macroscopic and histological scores between rats from different groups, demonstrating that intra-articular treatment does not worsen OA progression. These results suggest that local administration yielded a low effective NGF antibody dose that may serve as an alternative approach to systemic injection for the treatment of patients with OA.
• 大腿骨顆間窩外側壁における骨密度分布 前十字靱帯の大腿骨付着部に関する考察

  菅原 悠太郎, 遠藤 香織, 菱村 亮介, 松原 新史, 松岡 正剛, 小野寺 智洋, 岩崎 倫政, 岩崎 浩司, 門間 大輔, 近藤 英司

  北海道整形災害外科学会雑誌 北海道整形災害外科学会 63 (139th suppl) 36 - 36 1343-3873 2021
• Hallux Valgus With Second Brachymetatarsia Discovered Accidentally: A Case Report.

  Shinji Matsubara, Tomohiro Onodera, Koji Iwasaki, Ryosuke Hishimura, Masatake Matsuoka, Eiji Kondo, Norimasa Iwasaki

  The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 60 (5) 1060 - 1062 2021 

  Hallux valgus deformity is one of the most common foot and ankle diseases, while brachymetatarsia is a rare foot anomaly with pathological shortening of a metatarsal bone. We present a case of hallux valgus deformity possibly due to second brachymetatarsia. As the hallux valgus was associated with dorsal dislocation of the second toe that made it difficult to evaluate the length of the second toe, the patient was unaware of the second metatarsal shortening until the lengths of the toes compared by manual reposition of the second MTP joint. In this case, proximal osteotomy of the first metatarsal on the hallux valgus and single-stage bone lengthening of the second metatarsal with iliac bone grafting on the second brachymetatarsia were performed. One year after the operation, the callosity of the third toe resolved and the clinical scores were improved. In the case of a hallux valgus deformity with second dorsal dislocation of the toes, surgeons should consider that there are rare cases with second metatarsal shortening. When hallux valgus associated with second brachymetatarsia is diagnosed, second metatarsal lengthening should be considered in addition to hallux valgus surgery.
• Analysis of ground reaction force passing point on the proximal tibial surface.

  井上貴博, 岩崎浩司, 大越康充, 川上健作, 鈴木昭二, 浮城健吾, 櫻井茂幸, 大森啓司, 井野拓実, 井野拓実, 前田龍智, 鈴木裕貴, 鈴木裕貴, 近藤英司, 岩崎倫政

  臨床バイオメカニクス 42 1884-5274 2021
• Angiosarcoma after revision total knee arthroplasty

  Ryuichi Fukuda, Masatake Matsuoka, Tomohiro Onodera, Koji Iwasaki, Daisuke Tanaka, Hiroaki Hiraga, Hiromi Kanno-Okada, Yoshihiro Matsuno, Eiji Kondo, Norimasa Iwasaki

  The Knee 28 151 - 158 2021/01 [Refereed]
   

  BACKGROUND: Hemarthrosis after total knee arthroplasty (TKA) is a relatively rare complication. Although most cases are effectively treated with conservative therapy, some cases require angiographic embolization or surgical intervention. Angiosarcoma is a rare malignant tumor derived from the vascular endothelium with neovascular hyperplasia and mainly arises in the skin and superficial soft tissue, and less frequently in deep soft tissue and bone. Although malignant neoplasms such as angiosarcoma in the vicinity of orthopedic implants were reported, the causal relationship between development of the malignant tumor and the orthopedic implant is widely debated in the literature. CASE PRESENTATION: We report the case of a 68-year-old female with angiosarcoma that developed in the knee joint 2 years after revision TKA. The patient exhibited severe persistent bleeding, which reached 1000-1400 ml per day for 4 months. Histological analysis of the synovial tissue in the knee joint showed large cells with nuclear atypia. Immunohistochemical staining showed cells that were positive for CD31, CD34, and D2-40, and she was diagnosed with angiosarcoma. The patient underwent an amputation at the level of the thigh, and her general condition immediately improved after the operation. The patient did not exhibit bleeding from the site of amputation, and no local recurrence or distant metastases were detected 1 year after the amputation. CONCLUSIONS: To the best of our knowledge, this represents the first report of angiosarcoma 2 years after revision TKA. Further careful follow up is needed, given the high-grade malignancy.
• Large osteochondral defect in the lateral femoral condyle reconstructed by Atelocollagen-associated autologous chondrocyte implantation combined with anterior cruciate ligament reconstruction

  Takuma Kaibara, Eiji Kondo, Masatake Matsuoka, Koji Iwasaki, Tomohiro Onodera, Daisuke Momma, Naoki Seito, Susumu Mikami, Norimasa Iwasaki

  BMC Musculoskeletal Disorders 21 (1) 1471-2474 2020/12 [Refereed]
   

  Abstract Background Articular surface damage commonly associated with rupture of the anterior cruciate ligament (ACL). Large osteochondral defect, which consists of a severe depression fracture and a large cartilage defect, need to be treated due to deformation of the articular surface as it can impact the clinical outcome of ACL reconstruction. Although autologous chondrocyte implantation is one of the useful options in such cases, it can be questioned whether the reconstruction of the ACL and osteochondral defect should be performed in one procedure alone. Case presentation We report a case of a 38-year-old male with a deep depression fracture extending to the edge of the lateral femoral condyle associated with ACL injury after twisting his right knee while skiing. The patient was successfully treated with tissue-engineered cartilage transplantation covered by the periosteum with an iliac bone graft combined with anatomic double-bundle ACL reconstruction. Histopathological examination of the transplanted cartilage taken at second-look arthroscopy showed a cartilage-like tissue in the middle to deep zone in which the extracellular matrix was largely stained with Safranin O. The patient was able to return to his previous level of skiing activity without any experience of knee pain. Magnetic resonance imaging at 4 years after surgery showed that the graft integrated to the border zone and subchondral bone. The operated knee showed negative Lachman test and had a full range of motion. Conclusions To our knowledge, this is the first report of anatomic double-bundle ACL reconstruction with tissue-engineered cartilage transplantation and an iliac bone graft to restore the lateral edge of the femoral condyle.
• Stress distribution patterns through the subchondral bone density of the proximal tibia in anterior cruciate ligament injured knee assessed using computed tomography osteoabsorptiometry.

  三浦宗也, 岩崎浩司, 近藤英司, 岩崎倫政

  臨床バイオメカニクス 41 1884-5274 2020
• Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report

  Yuki Suzuki, Toshihiko Kasashima, Kazutoshi Hontani, Yasuhiro Yamamoto, Kanako Ito, Liang Xu, Masatake Matsuoka, Koji Iwasaki, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki

  Geriatric Orthopaedic Surgery & Rehabilitation 11 215145932096938 - 215145932096938 2151-4593 2020/01/01 [Refereed]
   

  Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.
• Caspase-3 knockout inhibits intervertebral disc degeneration related to injury but accelerates degeneration related to aging.

  Takashi Ohnishi, Katsuhisa Yamada, Koji Iwasaki, Takeru Tsujimoto, Hideaki Higashi, Taichi Kimura, Norimasa Iwasaki, Hideki Sudo

  Scientific reports 9 (1) 19324 - 19324 2045-2322 2019/12/18 [Refereed][Not invited]
   

  Approximately 40% of people under 30 and over 90% of people 55 or older suffer from moderate-to-severe levels of degenerative intervertebral disc (IVD) disease in their lumbar spines. Surgical treatments are sometimes effective; however, the treatment of back pain related to IVD degeneration is still a challenge; therefore, new treatments are necessary. Apoptosis may be important in IVD degeneration because suppressing cell apoptosis inside the IVD inhibits degeneration. Caspase-3, the primary effector of apoptosis, may be a key treatment target. We analyzed caspase-3's role in two different types of IVD degeneration using caspase-3 knockout (Casp-3 KO) mice. Casp-3 KO delayed IVD degeneration in the injury-induced model but accelerated it in the age-induced model. Our results suggest that this is due to different pathological mechanisms of these two types of IVD degeneration. Apoptosis was suppressed in the IVD cells of Casp-3 KO mice, but cellular senescence was enhanced. This would explain why the Casp-3 KO was effective against injury-induced, but not age-related, IVD degeneration. Our results suggest that short-term caspase-3 inhibition could be used to treat injury-induced IVD degeneration.
• Correction osteotomy for bilateral varus knee deformity caused by premature epiphyseal closure induced by hypervitaminosis A: a case report

  Masatake Matsuoka, Tomohiro Onodera, Tokifumi Majima, Koji Iwasaki, Daisuke Takahashi, Eiji Kondo, Norimasa Iwasaki

  BMC Musculoskeletal Disorders 20 (1) 1471-2474 2019/12 [Refereed]
  
• Impact of Surgical Timing on Clinical Outcomes in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts

  Rikiya Baba, Eiji Kondo, Koji Iwasaki, Zenta Joutoku, Jun Onodera, Tomohiro Onodera, Tomonori Yagi, Norimasa Iwasaki, Kazunori Yasuda

  Orthopaedic Journal of Sports Medicine 7 (11) 232596711988055 - 232596711988055 2325-9671 2019/11/01 [Refereed]
   

  Background: To date, no studies have analyzed the influence on clinical outcomes of the interval between an anterior cruciate ligament (ACL) injury and double-bundle (DB) reconstruction with hamstring tendon autografts. Hypotheses: (1) Performing ACL reconstruction sooner after an injury will reduce postoperative anterior and rotatory knee instability, (2) postoperative range of knee motion or functional results will not be affected by different intervals between injury and surgery, and (3) preoperative isokinetic peak torque of the quadriceps and hamstring muscles will be lower in patients undergoing surgery earlier, while postoperative muscle strength will not be affected by surgery timing. Study Design: Cohort study; Level of evidence, 3. Methods: This study was conducted on a total of 171 patients who had undergone anatomic DB ACL reconstruction with hamstring tendon autografts. The patients were divided into 3 groups based on the time to surgery: (1) ≤1 month after the injury (group E; n = 25), (2) between 1 and 3 months after the injury (group M; n = 72), and (3) >3 months after the injury (group D; n = 74). Patients were assessed for a minimum of 2 years after surgery. Results: Concerning postoperative anterior laxity, 1-way analysis of variance demonstrated a significant difference ( P = .0274) among the 3 groups. Anterior laxity was significantly less in group E than in group D ( P = .0206). Spearman rank correlation analysis showed a significant correlation (ρ = 0.200; P = .0327) between anterior knee laxity and time to surgery. Also, a significant correlation ( P = .0461) was found between the degree of the pivot-shift phenomenon and time to surgery. There were no significant differences in loss of knee extension or flexion among the 3 groups, nor were there any differences in the Lysholm knee score or International Knee Documentation Committee grade. Postoperatively, there were no significant differences in peak torque of the quadriceps or hamstring muscles among the 3 groups. Conclusion: Early DB reconstruction led to significantly less anterior laxity compared with delayed reconstruction. There were no significant differences in postoperative range of knee motion or functional results among the 3 time intervals between injury and surgery in this study.
• Effects of Intradiscal Injection of Local Anesthetics on Intervertebral Disc Degeneration in Rabbit Degenerated Intervertebral Disc.

  Ura K, Sudo H, Iwasaki K, Tsujimoto T, Ukeba D, Iwasaki N

  Journal of orthopaedic research : official publication of the Orthopaedic Research Society 37 (9) 1963 - 1971 0736-0266 2019/09 [Refereed][Not invited]
  
• Inclination of Blumensaat's line influences on the accuracy of the quadrant method in evaluation for anterior cruciate ligament reconstruction.

  Iwasaki K, Inoue M, Kasahara Y, Tsukuda K, Kawahara H, Yokota I, Kondo E, Iwasaki N, Yasuda K

  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 28 (6) 1885 - 1893 0942-2056 2019/07 [Refereed][Not invited]
   

  PURPOSE: The quadrant method is used to evaluate the bone tunnel position with the grid based on the Blumensaat's line in anterior cruciate ligament (ACL) reconstruction. This study aimed to clarify the influence of variation in the Blumensaat's line on the accuracy of the quadrant method measurements. METHODS: A retrospective review of the radiological records of patients aged 18-30 years who underwent computed tomography (CT) scanning of the knee joint was conducted. The Blumensaat's line inclination angle (BIA), along with the most posterior point of the posterior condyle (point P) position using the quadrant method and morphology of the Blumensaat's line were measured on true lateral transparent three-dimensional CT images of the distal femoral condyle in 147 patients. Statistical analysis was conducted to determine associations among these measurements. RESULTS: BIA was 37.5° (standard deviation 4.2°; range 27°-48°). The point P position was significantly correlated with BIA in the high/low (R2 = 0.590, P < 0.0001) and deep/shallow (R2 = 0.461, P < 0.0001) directions. The morphology of the Blumensaat's line was straight in 35 knees (23.8%); whereas, the remaining 112 knees (76.2%) were not straight but had some hill on the Blumensaat's line. No significant difference among the morphological variation of the Blumensaat's line was observed in BIA and the point P position. CONCLUSION: There was a strong correlation between BIA and the point P measured using the quadrant method, suggesting the influence of the Blumensaat's line on the accuracy of the quadrant method measurements in ACL reconstruction. As for the clinical relevance, surgeons should be careful in application of the quadrant method for ACL reconstruction, because the variation of the Blumensaat's line inclination influences the accuracy of this method.
• 脊椎・椎間板外傷に対する細胞死をターゲットとした分子標的治療の可能性

  大西 貴士, 須藤 英毅, 岩崎 浩司, 辻本 武尊, 山田 勝久, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 93 (3) S1177 - S1177 0021-5325 2019/03
• An acellular bioresorbable ultra-purified alginate gel promotes intervertebral disc repair: A preclinical proof-of-concept study.

  Takeru Tsujimoto, Hideki Sudo, Masahiro Todoh, Katsuhisa Yamada, Koji Iwasaki, Takashi Ohnishi, Naoki Hirohama, Takayuki Nonoyama, Daisuke Ukeba, Katsuro Ura, Yoichi M Ito, Norimasa Iwasaki

  EBioMedicine 37 521 - 534 2352-3964 2018/11 [Refereed][Not invited]
   

  BACKGROUND: The current surgical procedure of choice for lumbar intervertebral disc (IVD) herniation is discectomy. However, defects within IVD produced upon discectomy may impair tissue healing and predispose patients to subsequent IVD degeneration. This study aimed to investigate whether the use of an acellular bioresorbable ultra-purified alginate (UPAL) gel implantation system is safe and effective as a reparative therapeutic strategy after lumbar discectomy. METHODS: Human IVD cells were cultured in a three-dimensional system in UPAL gel. In addition, lumbar spines of sheep were used for mechanical analysis. Finally, the gel was implanted into IVD after discectomy in rabbits and sheep in vivo. FINDINGS: The UPAL gel was biocompatible with human IVD cells and promoted extracellular matrix production after discectomy, demonstrating sufficient biomechanical characteristics without material protrusion. INTERPRETATION: The present results indicate the safety and efficacy of UPAL gels in a large animal model and suggest that these gels represent a novel therapeutic strategy after discectomy in cases of lumbar IVD herniation. FUND: Grant-in-Aid for the Ministry of Education, Culture, Sports, Science, and Technology of Japan, Japan Agency for Medical Research and Development, and the Mochida Pharmaceutical Co., Ltd.
• 椎間板再生治療における組織修復材の開発

  辻本 武尊, 山田 勝久, 岩崎 浩司, 大西 貴士, 岩崎 倫政, 須藤 英毅, 東藤 正浩

  北海道整形災害外科学会雑誌 北海道整形災害外科学会 60 (1) 144 - 145 1343-3873 2018/08
• 遺伝子改変マウスを用いた椎間板変性におけるcaspase 3遺伝子の果たす機能解析

  大西 貴士, 岩崎 浩司, 辻本 武尊, 岩崎 倫政, 須藤 英毅

  北海道整形災害外科学会雑誌 北海道整形災害外科学会 60 (1) 162 - 162 1343-3873 2018/08
• 高純度硬化性ゲルによる無細胞移植椎間板組織自然再生誘導法の検討

  辻本 武尊, 須藤 英毅, 岩崎 浩司, 大西 貴士, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 91 (8) S1534 - S1534 0021-5325 2017/08
• 椎間板変性と再生医療 椎間板変性におけるcaspase 3の関与

  大西 貴士, 須藤 英毅, 岩崎 浩司, 辻本 武尊, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 91 (8) S1689 - S1689 0021-5325 2017/08
• 高純度硬化性ゲルによる無細胞移植椎間板組織自然再生誘導法

  辻本 武尊, 須藤 英毅, 岩崎 浩司, 大西 貴士, 岩崎 倫政

  Journal of Spine Research (一社)日本脊椎脊髄病学会 8 (3) 298 - 298 1884-7137 2017/03
• Effects of Multiple Intra-articular Injections of 0.5% Bupivacaine on Normal and Osteoarthritic Joints in Rats

  Koji Iwasaki, Hideki Sudo, Yasuhiko Kasahara, Katsuhisa Yamada, Takashi Ohnishi, Takeru Tsujimoto, Norimasa Iwasaki

  ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 32 (10) 2026 - 2036 0749-8063 2016/10 [Refereed][Not invited]
   

  Purpose: To determine the in vivo effects of multiple local anesthetic injections of 0.5% bupivacaine on normal and osteoarthritic articular cartilage. Methods: Rats with normal knee joints received an intra-articular injection of 0.9% saline solution or 0.5% bupivacaine in their right knees joint once a week for 5 consecutive weeks, starting 4 weeks after the beginning of the experiment. Rats were humanely killed at 8, 16, and 24 weeks. In a parallel experiment, rats underwent anterior cruciate ligament transection to induce osteoarthritic changes. These rats were subjected to the same protocol as those with normal knee joints, starting 4 weeks after the procedure. Static weight-bearing tests were performed on both hind limbs to evaluate changes in weight-bearing ability throughout the experiments. Rats were humanely killed at 8 and 16 weeks. Cell viability was assessed with confocal microscopy, using samples from the distal femur. Histologic assessment of osteoarthritis was performed using samples from the tibial plateau based on the Osteoarthritis Research Society International (OARSI) cartilage histopathology assessment system (i.e., OARSI score). Results: Static weight-bearing tests showed no significant changes after intra-articular injection of saline solution or bupivacaine, and bupivacaine injection did not increase weight bearing compared with saline solution injection, regardless of whether there were osteoarthritic changes. There were also no significant differences in cell viability, cell density, or OARSI scores between the saline solution and bupivacaine groups at each time point, regardless of whether osteoarthritic changes were induced. Conclusions: This study suggested that single or intermittent intra-articular bupivacaine injections might not have deleterious effects on either osteoarthritic or normal joints.
• In Vivo Mouse Intervertebral Disc Degeneration Model Based on a New Histological Classification.

  Ohnishi T, Sudo H, Iwasaki K, Tsujimoto T, Ito YM, Iwasaki N

  PloS one The Public Library of Science 11 (8) e0160486  1932-6203 2016 [Refereed][Not invited]
   

  Although human intervertebral disc degeneration can lead to several spinal diseases, its pathogenesis remains unclear. This study aimed to create a new histological classification applicable to an in vivo mouse intervertebral disc degeneration model induced by needle puncture. One hundred six mice were operated and the L4/5 intervertebral disc was punctured with a 35- or 33-gauge needle. Micro-computed tomography scanning was performed, and the punctured region was confirmed. Evaluation was performed by using magnetic resonance imaging and histology by employing our classification scoring system. Our histological classification scores correlated well with the findings of magnetic resonance imaging and could detect degenerative progression, irrespective of the punctured region. However, the magnetic resonance imaging analysis revealed that there was no significant degenerative intervertebral disc change between the ventrally punctured and non-punctured control groups. To induce significant degeneration in the lumbar intervertebral discs, the central or dorsal region should be punctured instead of the ventral region.
• Effects of Single Injection of Local Anesthetic Agents on Intervertebral Disc Degeneration: Ex Vivo and Long-Term In Vivo Experimental Study

  Koji Iwasaki, Hideki Sudo, Katsuhisa Yamada, Hideaki Higashi, Takashi Ohnishi, Takeru Tsujimoto, Norimasa Iwasaki

  PLOS ONE 9 (10) e109851  1932-6203 2014/10 [Refereed][Not invited]
   

  Background: Analgesic discography (discoblock) can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD) cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model. Methods: For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine). Nucleus pulposus (NP) cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI) and histological analysis. Results: In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline-and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups. Conclusions/Significance: In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents on degenerated IVDs.
• Cytotoxic Effects of the Radiocontrast Agent Iotrolan and Anesthetic Agents Bupivacaine and Lidocaine in Three-Dimensional Cultures of Human Intervertebral Disc Nucleus Pulposus Cells: Identification of the Apoptotic Pathways

  Koji Iwasaki, Hideki Sudo, Katsuhisa Yamada, Manabu Ito, Norimasa Iwasaki

  PLOS ONE 9 (3) e92442  1932-6203 2014/03 [Refereed][Not invited]
   

  Background: Discography and discoblock are imaging procedures used to diagnose discogenic low back pain. Although needle puncture of the intervertebral disc (IVD) itself induces disc degeneration, the agents used in these procedures may also have harmful effects on IVD cells. The purpose of this study was to analyze whether radiocontrast agents and local anesthetic agents have detrimental effects on human nucleus pulposus (NP) cells. Methods: Healthy human NP cells were cultured for 7 days in three-dimensional (3D) cell-alginate bead composites, and were then exposed to clinically relevant doses of a radiocontrast agent (iotrolan) or local anesthetic (lidocaine or bupivacaine). Cell viability and apoptosis were measured by confocal microscopy and flow cytometry. On the basis of caspase expression profiles, the apoptotic pathways activated by the agents were identified by Western blot analysis. Results: The radiocontrast agent iotrolan did not affect NP cell viability or induce apoptosis. In contrast, both the anesthetic agents significantly decreased cell viability and increased the apoptotic cell number in a time-and dose-dependent manner. After 120 min, 2% lidocaine and 0.5% bupivacaine decreased percent live cells to 13% and 10%, respectively (p<0.05). The number of apoptotic cells was doubled by increasing lidocaine dosage from 1% to 2% (23% and 42%) and bupivacaine from 0.25% to 0.50% (25% and 48%) (p<0.05). Western blot analysis revealed that both anesthetic agents upregulated cleaved caspase-3 and caspase-8, whereas only bupivacaine upregulated cleaved caspase-9. Conclusions/Significance: The present study demonstrates that iotrolan does not affect the viability of healthy human NP cells. In contrast, the two anesthetic agents commonly used in discography or discoblock may cause extensive damage to IVDs by inducing apoptotic cell death.
• Caspase 3 silencing inhibits biomechanical overload-induced intervertebral disk degeneration.

  Yamada K, Sudo H, Iwasaki K, Sasaki N, Higashi H, Kameda Y, Ito M, Takahata M, Abumi K, Minami A, Iwasaki N

  The American journal of pathology 184 (3) 753 - 764 0002-9440 2014/03 [Refereed][Not invited]
   

  Intervertebral disk (IVD) degeneration causes debilitating low back pain in much of the worldwide population. No efficient treatment exists because of an unclear pathogenesis. One characteristic event early in such degeneration is the apoptosis of nucleus pulposus (NP) cells embedded in IVDs. Excessive biomechanical loading may also be a major etiology of IVD degeneration. The present study used in vitro and in vivo models of compressive loading to elucidate the underlying mechanism of IVD degeneration. In addition, we investigated whether the inhibition of apoptosis is a potential clinical therapeutic strategy for the treatment of IVD degeneration induced by biomechanical stress. A TUNEL assay showed that NP cell-agarose three-dimensional composite cultures subjected to uniaxial, unconfined, static, compressive loading exhibited a time-dependent increase in apoptosis. Western blot analysis revealed the up-regulation of several extracellular matrix-degrading enzymes and down-regulation of tissue inhibitor of metalloproteinase 1. These responses to compressive loading were all significantly inhibited by caspase 3 siRNA. In the in vivo model of compressive loading-induced IVD degeneration, a single local injection of caspase 3 siRNA significantly inhibited IVD degeneration by magnetic resonance imaging, histological findings, IHC, and TUNEL assay. The present study suggests that caspase 3 siRNA attenuates overload-induced IVD degeneration by inhibiting NP cell apoptosis and the expression of matrix-degrading enzymes.
• Global identification of genes related to nutrient deficiency in intervertebral disc cells in an experimental nutrient deprivation model.

  Sudo H, Yamada K, Iwasaki K, Higashi H, Ito M, Minami A, Iwasaki N

  PloS one Public Library of Science 8 (3) e58806  1932-6203 2013 [Refereed][Not invited]
   

  Background: Intervertebral disc degeneration is a significant cause of degenerative spinal diseases. Nucleus pulposus (NP) cells reportedly fail to survive in large degenerated discs with limited nutrient availability. Therefore, understanding the regulatory mechanism of the molecular response of NP cells to nutrient deprivation may reveal a new strategy to treat disc degeneration. This study aimed to identify genes related to nutrient deprivation in NP cells on a global scale in an experimental nutrient deprivation model. Methodology/Principal Findings: Rat NP cells were subjected to serum starvation. Global gene expression was profiled by microarray analysis. Confirmation of the selected genes was obtained by real-time polymerase chain reaction array analysis. Western blotting was used to confirm the expression of selected genes. Functional interactions between p21(Cip1) and caspase 3 were examined. Finally, flow cytometric analyses of NP cells were performed. Microarray analysis revealed 2922 differentially expressed probe sets with >= 1.5-fold changes in expression. Serum starvation of NP cells significantly affected the expression of several genes involved in DNA damage checkpoints of the cell cycle, including Atm, Brca1, Cdc25, Gadd45, Hus1, Ppm1D, Rad 9, Tp53, and Cyclin D1. Both p27(Kip1) and p53 protein expression was upregulated in serum-starved cells. p21(Cip1) expression remained in NP cells transfected with short interfering RNA targeting caspase 3 (caspase 3 siRNA). Both G1 arrest and apoptosis induced by serum starvation were inhibited in cells transfected with caspase 3 siRNA. Conclusions/Significance: Nutrient deprivation in NP cells results in the activation of a signaling response including DNA damage checkpoint genes regulating the cell cycle. These results provide novel possibilities to improve the success of intervertebral disc regenerative techniques.

MISC

• 大腿骨顆間外側壁における骨密度分布-前十字靱帯の大腿骨付着部に関する考察-

  菅原悠太郎, 岩崎浩司, 遠藤香織, 菱村亮介, 松原新史, 松岡正剛, 門間太輔, 小野寺智洋, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  97-  (2)  2023
• 3次元Computed Tomographyを用いた内側楔状開大式高位脛骨骨切り術前後の膝蓋骨高位の評価

  土橋晋也, 岩崎浩司, 塩田惇喜, 門間太輔, 菱村亮介, 小野寺智洋, 近藤英司, 岩崎倫政  東日本整形災害外科学会雑誌(Web)  35-  (3)  2023
• 高純度アルギン酸ゲルを用いた運動器再生医療開発

  小野寺智洋, 門間太輔, 馬場力哉, 松岡正剛, 岩崎浩司, 山口純, 斎藤充, 長濱宏治, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 三次元動作解析による内側型変形性膝関節症患者におけるVarus Thrustの運動学的特徴の検討

  岩崎浩司, 大越康充, 館山唯, 三浦浩太, 浮城健吾, 川上健作, 鈴木昭二, 小野寺智洋, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 高位脛骨骨切り術後の非術側膝の生体工学的変化

  岩崎浩司, 大越康充, 笹谷一輝, 櫻井茂幸, 浮城健吾, 川上健作, 鈴木昭二, 前田龍智, 小野寺智洋, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 脛骨関節面の軟骨下骨の骨密度分布に関わる半月板逸脱の評価方法の検討

  岩崎浩司, 佐藤知哉, 濱崎雅成, 鈴木裕貴, 小野寺智洋, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 内側閉鎖式大腿骨遠位内反骨切り術が大腿脛骨関節の応力分布に与える効果-CT osteoabsorptiometry法を用いた検討-

  濱崎雅成, 近藤英司, 鈴木裕貴, 松岡正剛, 岩崎浩司, 小野寺智洋, 井上雅之, 安田和則, 八木知徳, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 高純度アルギン酸ゲル移植術後3年の臨床成績の検討

  小野寺智洋, 門間太輔, 松岡正剛, 岩崎浩司, 近藤英司, 鈴木孝治, 井上雅之, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 脛骨関節面の骨密度分布に半月板逸脱と下肢アライメントが与える影響

  岩崎浩司, 佐藤知哉, 濱崎雅成, 鈴木裕貴, 松岡正剛, 小野寺智洋, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 診断時遠隔転移を有する四肢発生原発性悪性骨腫瘍の原発巣切除が生存に与える影響-米国SEERデータベースを用いた研究-

  福田龍一, 松岡正剛, 小野寺智洋, 岩崎浩司, 鈴木裕貴, 濱崎雅成, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 四肢原発悪性骨腫瘍症例における患肢温存術と切断術の比較-米国SEERデータベースを用いた研究-

  柳澤那由他, 松岡正剛, 小野寺智洋, 岩崎浩司, 鈴木裕貴, 濱崎雅成, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  97-  (8)  2023
• 変形性膝関節症の重症度別外的膝関節モーメント成分の寄与率変化の検討

  鈴木裕貴, 鈴木裕貴, 小野寺智洋, 岩崎倫政, 大越康充, 前田龍智, 川上健作, 清水健太, 千田周也, 浮城健吾, 岩崎浩司, 鈴木昭二, 近藤英司  日本関節病学会誌(Web)  42-  (4)  2023
• 踵骨を含めた下肢アライメントX線画像評価と膝関節内反モーメントの関係

  塩田惇喜, 塩田惇喜, 大越康充, 井上貴博, 浮城健吾, 川上健作, 前田龍智, 岩崎浩司, 岩崎浩司, 小野寺智洋, 近藤英司, 岩崎倫政  日本足の外科学会雑誌  44-  (Supplement)  2023
• 重度外反母趾変形に対してParallel cut deviceを用いたLapidus変法の臨床成績の検討

  小野寺智洋, 松岡正剛, 岩崎浩司, 甲斐原拓真, 濱崎雅成, 江畑拓, 原健人, 近藤英司, 岩崎倫政  日本足の外科学会雑誌  44-  (Supplement)  2023
• 変形性膝関節症患者における歩行中の膝関節内側荷重量とKinematicsの関連

  佐橋健人, 渡邊謙太郎, 千徳風真, 千葉健, 岩崎浩司, 小野寺智洋, 岩崎倫政, 近藤英司, 遠山晴一  北海道整形災害外科学会  142nd-  2023
• 広範な膝軟骨欠損に対するアテロコラーゲンを用いた自家培養軟骨移植の中期臨床成績

  甲斐原拓真, 濱崎雅成, 鈴木裕貴, 松岡正剛, 小野寺智洋, 岩崎倫政, 近藤英司, 岩崎浩司, 小田義崇, 種井善一, 田中伸哉  北海道整形災害外科学会  142nd-  2023
• 膝軟骨欠損に対するアテロコラーゲンを用いた自家培養軟骨移植の臨床成績-3年以上経過例について

  甲斐原拓真, 近藤英司, 濱崎雅成, 鈴木裕貴, 岩崎浩司, 松岡正剛, 小野寺智洋, 小田義崇, 種井善一, 田中伸哉, 岩崎倫政  整形外科バイオマテリアル研究会プログラム・抄録集  41st-  2022
• 大腿骨顆間窩外側壁における骨密度分布:前十字靱帯の大腿骨付着部に関する考察

  菅原悠太郎, 遠藤香織, 菱村亮介, 松原新史, 松岡正剛, 小野寺智洋, 岩崎倫政, 岩崎浩司, 門間大輔, 近藤英司  北海道整形災害外科学会  139th-  2021
• 大腿骨顆間外側壁における骨密度分布:前十字靱帯の大腿骨付着部についての考察

  菅原悠太郎, 岩崎浩司, 遠藤香織, 菱村亮介, 松原新史, 松岡正剛, 門間太輔, 小野寺智洋, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  95-  (8)  2021
• 変形性膝関節症症例におけるウェアラブルセンサーを用いた歩行評価時の最適なセンサー貼付位置の検討

  佐橋 健人, 千葉 健, 岩崎 浩司, 小野寺 智洋, 岩崎 倫政, 近藤 英司, 遠山 晴一  北海道整形災害外科学会雑誌  63-  (139th suppl)  35  -35  2021
• 変形性膝関節症症例におけるウェアラブルセンサーを用いた歩行評価時の最適なセンサー貼付位置の検討

  佐橋 健人, 千葉 健, 岩崎 浩司, 小野寺 智洋, 岩崎 倫政, 近藤 英司, 遠山 晴一  北海道整形災害外科学会雑誌  63-  (139th suppl)  35  -35  2021
• アテロコラーゲンを用いた自家培養軟骨移植の組織学的検討

  甲斐原 拓真, 近藤 英司, 岩崎 浩司, 小野寺 智洋, 遠山 晴一, 岩崎 倫政, 安田 和則  日本整形外科スポーツ医学会雑誌  39-  (4)  469  -469  2019/08  [Not refereed][Not invited]
  
• 両先天性内反母趾に対し両第I中足骨外反矯正骨切り術を施行した1例

  徳廣 泰貴, 小野寺 智洋, 上徳 善太, 岩崎 浩司, 新井 隆太, 岩崎 倫政, 近藤 英司  北海道整形災害外科学会雑誌  61-  (136th suppl)  36  -36  2019
• 膝十字靱帯不全を合併した内側型変形性膝関節症に対する膝十字靱帯再建術と高位脛骨骨切り術の二期的手術の短期成績

  清水 寛和, 岩崎 浩司, 近藤 英司, 小野寺 智洋, 新井 隆太, 上徳 善太, 岩崎 倫政  北海道整形災害外科学会雑誌  61-  (137th suppl)  23  -23  2019
• Ilizarov創外固定器を用いた足関節固定術の中期臨床成績の検討

  小野寺 智洋, 山崎 修司, 岩崎 浩司, 上徳 善太, 馬場 力哉, 近藤 英司, 岩崎 倫政  日本足の外科学会雑誌  39-  (Suppl.)  S426  -S426  2018/10  [Not refereed][Not invited]
  
• 全身性エリテマトーデスにおける骨壊死部位発症頻度の検討

  佐藤 恒明, 小野寺 智洋, 馬場 力哉, 上徳 善太, 岩崎 浩司, 高橋 大介, 近藤 英司, 藤枝 雄一郎, 岩崎 倫政  日本関節病学会誌  37-  (3)  239  -239  2018/10  [Not refereed][Not invited]
  
• 関節リウマチ患者に対する人工膝関節置換術後深部静脈血栓症の発生頻度

  上徳 善太, 小野寺 智洋, 近藤 英司, 岩崎 浩司, 馬場 力哉, 中條 正英, 岩崎 倫政  日本関節病学会誌  37-  (3)  318  -318  2018/10  [Not refereed][Not invited]
  
• 遺残組織を温存した解剖学的2束前十字靱帯再建術の臨床成績:多数例における非温存群と比較

  塩田惇喜, 近藤英司, 小野寺智洋, 岩崎浩司, 珍部正嗣, 新井隆太, 岩崎倫政  日本整形外科スポーツ医学会雑誌  38-  (4)  434  2018/08/31  [Not refereed][Not invited]
  
• 小児Run-over injuryによる広範囲足背部組織欠損に対してcrossleg flap施行後骨成長終了までフォローし得た1例

  珍部 正嗣, 小野寺 智洋, 新井 隆太, 岩崎 浩司, 岩崎 倫政, 近藤 英司, 綛村 俊之  北海道整形災害外科学会雑誌  60-  (1)  116  -116  2018/08  [Not refereed][Not invited]
  
• 膝複合靱帯損傷を合併した脛骨高原骨折術後下肢外反変形に対してDouble Level Osteotomyを行った1例

  下田 康平, 近藤 英司, 珍部 正嗣, 小野寺 智洋, 新井 隆太, 岩崎 浩司, 岩崎 倫政  北海道整形災害外科学会雑誌  60-  (1)  109  -115  2018/08  [Not refereed][Not invited]
   

  右脛骨高原骨折術後変形治癒に対して自家腸骨移植術、複合靱帯再建術、およびDouble level osteotomy(DLO)を行った症例を経験した。症例は33歳男性。3年前に交通事故で受傷。右脛骨高原骨折に対し他院にて骨接合術が行われたが、術後の変形治癒、膝内側および後方不安定性のため当科紹介となった。初診時、右脛骨外側関節面の著しい陥没と右膝外反および後方不安定性を認めた。脛骨関節面再建のため抜釘および自家腸骨移植術を行い、2期的に1束後十字靱帯再建と、内側側副靱帯浅層および後斜走靱帯再建を行った。しかしながら徐々に外反変形が進行、下肢機能軸は125%、Medial proximal tibial angle(MPTA)が97°であったため、関節面傾斜を考慮に、大腿骨および脛骨の内側楔状閉鎖式DLOを行った。術後6ヵ月で、関節可動域は0〜130°、膝前後・外反不安定性の左右差は認めず、単純X線にて下肢機能軸が35%、MPTA85°、Lateral distal femoral angle 89°となった。JOA scoreは80点である。今後長期の経過観察の必要がある。(著者抄録)
• 両側膝複合靱帯損傷に対して一期的靱帯再建術を行った一例

  鈴木 瞭太, 岩崎 浩司, 下田 康平, 小林 英之, 忠鉢 敏弥, 珍部 正嗣, 新井 隆太, 小野寺 智洋, 岩崎 倫政, 近藤 英司  北海道整形災害外科学会雑誌  60-  (1)  158  -158  2018/08  [Not refereed][Not invited]
  
• 膝複合靱帯損傷を合併した脛骨高原骨折術後下肢外反変形に対してDouble Level Osteotomyを行った1例

  下田 康平, 珍部 正嗣, 小野寺 智洋, 新井 隆太, 岩崎 浩司, 小林 英之, 鈴木 瞭太, 忠鉢 敏弥, 岩崎 倫政, 近藤 英司  北海道整形災害外科学会雑誌  60-  (1)  160  -160  2018/08  [Not refereed][Not invited]
  
• 当科における人工距骨置換術の短期臨床成績

  小林 英之, 小野寺 智洋, 近藤 英司, 岩崎 浩司, 珍部 正嗣, 岩崎 倫政, 深谷 英昭  北海道整形災害外科学会雑誌  60-  (1)  188  -188  2018/08  [Not refereed][Not invited]
  
• 膝屈筋腱ハイブリッド代用材料を用いた遺残組織温存解剖学的2束前十字靱帯再建術の臨床成績 非温存群との年齢別の検討

  江畑 拓, 近藤 英司, 岩崎 浩司, 珍部 正嗣, 新井 隆太, 小野寺 智洋, 小野寺 純, 安田 和則, 八木 知徳, 岩崎 倫政  日本整形外科スポーツ医学会雑誌  38-  (4)  434  -434  2018/08  [Not refereed][Not invited]
  
• 膝屈筋腱ハイブリッド代用材料を用いた2束前十字靱帯再再建術の臨床成績 1束再建との比較

  岩崎 浩司, 近藤 英司, 珍部 正嗣, 小野寺 智洋, 小野寺 純, 八木 知徳, 安田 和則, 岩崎 倫政  日本整形外科スポーツ医学会雑誌  38-  (4)  432  -432  2018/08  [Not refereed][Not invited]
  
• 重度複合靱帯損傷に対し後外側支持機構修復後、二期的に解剖学的2束ACL・PCL同時再建術を行った一例

  細川 吉暁, 近藤 英司, 珍部 正嗣, 岩崎 浩司, 小野寺 智洋, 安田 和則, 岩崎 倫政  日本整形外科スポーツ医学会雑誌  38-  (4)  701  -701  2018/08  [Not refereed][Not invited]
  
• 新鮮膝重度複合靱帯損傷に対する二期的再建術の短期成績

  上徳 善太, 岩崎 浩司, 近藤 英司, 小野寺 智洋, 珍部 正嗣, 馬場 力哉, 安田 和則, 岩崎 倫政  日本整形外科スポーツ医学会雑誌  38-  (4)  702  -702  2018/08  [Not refereed][Not invited]
  
• 膝屈筋腱ハイブリッド代用材料を用いた遺残組織温存解剖学的2束前十字靱帯再建術の再鏡視所見:非温存群との年齢別の検討

  江畑拓, 近藤英司, 岩崎浩司, 珍部正嗣, 新井隆太, 小野寺智洋, 小野寺純, 安田和則, 八木知徳, 岩崎倫政  JOSKAS  43-  (4)  685  2018/05/09  [Not refereed][Not invited]
  
• 人工膝関節全置換術後インプラント周囲感染に対する治療成績の検討

  新井隆太, 小野寺智洋, 岩崎浩司, 珍部正嗣, 近藤英司, 岩崎倫政  JOSKAS  43-  (4)  747  2018/05/09  [Not refereed][Not invited]
  
• 両膝に発生した内側円板状半月板の2例

  青木佑介, 珍部正嗣, 近藤英司, 岩崎浩司, 新井隆太, 小野寺智洋, 安田和則, 岩崎倫政  JOSKAS  43-  (4)  624  2018/05/09  [Not refereed][Not invited]
  
• 内側楔状開大式骨切り術後の脛骨の捻転変化 Multiple Planner Reconstruction-CTを用いて

  珍部 正嗣, 近藤 英司, 岩崎 浩司, 小野寺 智洋, 小野寺 純, 井上 雅之, 八木 知徳, 安田 和則, 岩崎 倫政  JOSKAS  43-  (4)  293  -293  2018/05  [Not refereed][Not invited]
  
• ロッキングプレートを用いた逆V字型高位脛骨骨切り術の短期成績

  岩崎 浩司, 近藤 英司, 珍部 正嗣, 小野寺 智洋, 小野寺 純, 井上 雅之, 青木 喜満, 八木 知徳, 安田 和則, 岩崎 倫政  JOSKAS  43-  (4)  396  -396  2018/05  [Not refereed][Not invited]
  
• 新鮮膝重度複合靱帯損傷に対する二期的再建術の短期成績

  上徳 善太, 岩崎 浩司, 近藤 英司, 小野寺 智洋, 珍部 正嗣, 安田 和則, 岩崎 倫政  JOSKAS  43-  (4)  676  -676  2018/05  [Not refereed][Not invited]
  
• 骨移植を併用した2期的前十字靱帯再再建術の臨床成績

  岩崎 浩司, 近藤 英司, 珍部 正嗣, 小野寺 智洋, 小野寺 純, 八木 知徳, 安田 和則, 岩崎 倫政  JOSKAS  43-  (4)  679  -679  2018/05  [Not refereed][Not invited]
  
• 高位脛骨骨切り術が膝蓋骨高位に与える影響 内側楔状開大式と逆V字型の比較

  細川 吉暁, 近藤 英司, 珍部 正嗣, 岩崎 浩司, 小野寺 智洋, 安田 和則, 岩崎 倫政  JOSKAS  43-  (4)  757  -757  2018/05  [Not refereed][Not invited]
  
• 膝屈筋腱ハイブリッド代用材料を用いた遺残組織温存解剖学的2束前十字靱帯再建術の臨床成績―非温存群との年齢別検討―

  江畑拓, 近藤英司, 岩崎浩司, 珍部正嗣, 新井隆太, 小野寺智洋, 小野寺純, 安田和則, 八木知徳, 岩崎倫政  日本整形外科学会雑誌  92-  (3)  S617  2018/03/14  [Not refereed][Not invited]
  
• 人工膝関節全置換術後インプラント周囲感染に対する治療成績の検討

  新井隆太, 小野寺智洋, 岩崎浩司, 珍部正嗣, 近藤英司, 岩崎倫政  日本整形外科学会雑誌  92-  (3)  S1287  2018/03/14  [Not refereed][Not invited]
  
• 前十字靱帯再建術-Update- 前十字靱帯再建術における遺残組織温存の効果

  近藤 英司, 岩崎 浩司, 珍部 正嗣, 小野寺 純, 横田 正司, 小野寺 智洋, 安田 和則, 岩崎 倫政  日本整形外科学会雑誌  92-  (2)  S444  -S444  2018/03  [Not refereed][Not invited]
  
• リウマチ性外反母趾変形に対するLapidus変法と近位骨切り術の臨床成績の比較

  小野寺 智洋, 林 晴久, 近藤 英司, 岩崎 浩司, 珍部 正嗣, 岩崎 倫政  日本整形外科学会雑誌  92-  (3)  S1029  -S1029  2018/03  [Not refereed][Not invited]
  
• 緩徐矯正術後の高度尖足に対する創外固定装着下鏡視下足関節固定術の有用性

  小野寺 智洋, 岩崎 浩司, 珍部 正嗣, 林 晴久, 深谷 英昭, 山崎 修司, 近藤 英司, 岩崎 倫政  日本整形外科学会雑誌  92-  (3)  S1051  -S1051  2018/03  [Not refereed][Not invited]
  
• 遺残組織を温存した解剖学的2束前十字靱帯再建術の臨床成績 多数例における非温存群と比較

  塩田 惇喜, 近藤 英司, 小野寺 智洋, 岩崎 浩司, 珍部 正嗣, 小野寺 純, 安田 和則, 八木 知徳, 岩崎 倫政  日本整形外科学会雑誌  92-  (3)  S1205  -S1205  2018/03  [Not refereed][Not invited]
  
• 膝屈筋腱ハイブリッド代用材料を用いた一期的および二期的2束前十字靱帯再再建術の臨床成績

  岩崎 浩司, 近藤 英司, 珍部 正嗣, 小野寺 智洋, 小野寺 純, 八木 知徳, 安田 和則, 岩崎 倫政  日本整形外科学会雑誌  92-  (3)  S1206  -S1206  2018/03  [Not refereed][Not invited]
  
• 膝屈筋腱ハイブリッド代用材料を用いた遺残組織温存解剖学的2束前十字靱帯再建術の臨床成績 非温存群との年齢別検討

  江畑 拓, 近藤 英司, 岩崎 浩司, 新井 隆太, 小野寺 智洋, 小野寺 純, 安田 和則, 八木 知徳, 岩崎 倫政  北海道整形災害外科学会雑誌  60-  (135th suppl)  24  -24  2018
• ビタミンA誘導体の長期投与による早期骨端線閉鎖により両膝内反変形を認めた一例

  長谷川 裕一, 小野寺 智洋, 岩崎 浩司, 珍部 正嗣, 新井 隆太, 近藤 英司, 岩崎 倫政  北海道整形災害外科学会雑誌  60-  (135th suppl)  63  -63  2018
• 両膝に発生した内側円板状半月板の1例

  青木 佑介, 珍部 正嗣, 近藤 英司, 岩崎 浩司, 新井 隆太, 小野寺 智洋, 安田 和則, 岩崎 倫政  北海道整形災害外科学会雑誌  60-  (135th suppl)  63  -63  2018
• 両側膝複合靱帯損傷に対して一期的靱帯再建術を行った一例

  鈴木瞭太, 近藤英司, 忠鉢敏弥, 下田康平, 小林英之, 岩崎浩司, 珍部正嗣, 新井隆太, 小野寺智洋, 岩崎倫政  日本関節病学会誌  36-  (3)  379  2017/10/16  [Not refereed][Not invited]
  
• 膝複合靱帯損傷を合併した脛骨高原骨折術後下肢外反変形に対してDouble Level Osteotomyを行った1例

  下田康平, 珍部正嗣, 近藤英司, 小野寺智洋, 新井隆太, 岩崎浩司, 小林英之, 鈴木瞭太, 忠鉢敏弥, 岩崎倫政  東日本整形災害外科学会雑誌  29-  (3)  286  2017/08/15  [Not refereed][Not invited]
  
• 膝屈筋腱ハイブリッド代用材料を用いた解剖学的2束前・後十字靱帯同時再建術の2例

  珍部 正嗣, 近藤 英司, 小野寺 純, 石田 博英, 小野寺 智洋, 岩崎 浩司, 下出 和美, 安田 和則, 岩崎 倫政  日本整形外科スポーツ医学会雑誌  37-  (4)  607  -607  2017/08  [Not refereed][Not invited]
  
• 遺残靱帯を温存した解剖学的二束ACL再建術におけるEndobuttonとTightrope使用による膝安定性および大腿骨孔骨孔拡大の違い

  井上 雅之, 岩崎 浩司, 岩崎 倫政, 近藤 英司, 安田 和則  JOSKAS  42-  (4)  712  -712  2017/05  [Not refereed][Not invited]
  
• 遺伝子改変マウスを用いた椎間板変性におけるcaspase 3遺伝子の果たす機能解析

  大西 貴士, 岩崎 浩司, 辻本 武尊, 岩崎 倫政, 須藤 英毅  北海道整形災害外科学会雑誌  58-  (2)  270  -270  2017/03  [Not refereed][Not invited]
  
• 高純度硬化性ゲルによる無細胞移植椎間板組織自然再生誘導法

  辻本 武尊, 須藤 英毅, 岩崎 浩司, 大西 貴士, 岩崎 倫政  Journal of Spine Research  8-  (3)  298  -298  2017/03  [Not refereed][Not invited]
  
• 局所麻酔薬0.5%ブピバカイン関節内頻回投与が膝関節軟骨に与える影響ラット正常膝関節及び外科的変形性関節症誘発モデルでの検討

  岩崎 浩司, 笠原 靖彦, 山田 勝久, 大西 貴士, 辻本 武尊, 岩崎 倫政, 須藤 英毅  北海道整形災害外科学会雑誌  58-  (1)  82  -82  2016/10  [Not refereed][Not invited]
  
• 遺伝子改変マウスを用いた椎間板変性におけるcaspase 3遺伝子の果たす機能解析

  大西 貴士, 須藤 英毅, 岩崎 浩司, 辻本 武尊, 岩崎 倫政  日本整形外科学会雑誌  90-  (8)  S1685  -S1685  2016/08  [Not refereed][Not invited]
  
• 0.5%ブピバカインは関節軟骨に変性変化を惹起するか ラット正常膝および変形性膝関節症誘発モデルを用いた検討

  岩崎 浩司, 須藤 英毅, 笠原 靖彦, 山田 勝久, 大西 貴士, 辻本 武尊, 岩崎 倫政  日本整形外科学会雑誌  90-  (8)  S1770  -S1770  2016/08  [Not refereed][Not invited]
  
• 椎間板造影・ブロックが正常椎間板細胞・組織に与える長期的影響

  岩崎 浩司, 山田 勝久, 大西 貴士, 辻本 武尊, 岩崎 倫政, 須藤 英毅  北海道整形災害外科学会雑誌  57-  (2)  290  -290  2016/04  [Not refereed][Not invited]
  
• 新病理分類に基づいた再現性の高いin vivoマウス腰椎椎間板変性モデルの確立

  大西 貴士, 須藤 英毅, 岩崎 浩司, 辻本 武尊, 岩崎 倫政  Journal of Spine Research  7-  (3)  387  -387  2016/03  [Not refereed][Not invited]
  
• 遺伝子改変マウスを用いた椎間板変性におけるcaspase 3遺伝子の果たす機能解析

  大西 貴士, 須藤 英毅, 岩崎 浩司, 辻本 武尊, 岩崎 倫政  Journal of Spine Research  7-  (3)  558  -558  2016/03  [Not refereed][Not invited]
  
• 再現性の高いマウス椎間板穿刺変性モデルの作成

  大西 貴士, 須藤 英毅, 岩崎 浩司, 辻本 武尊  日本整形外科学会雑誌  89-  (8)  S1615  -S1615  2015/09  [Not refereed][Not invited]
  
• 椎間板造影・ブロックが正常椎間板細胞・組織に与える長期的影響

  岩崎 浩司, 須藤 英毅, 山田 勝久, 大西 貴士, 辻本 武尊, 岩崎 倫政  Journal of Spine Research  6-  (3)  590  -590  2015/03  [Not refereed][Not invited]
  

Research Projects

• 膝周囲骨切り術の最適化を目指した大規模バイオメカニクスデータベースの構築

  日本学術振興会：科学研究費助成事業 若手研究

  Date (from‐to) : 2021/04 -2024/03 

  Author : 岩崎 浩司

   

  膝周囲骨切り術の術式、矯正目標を個人に至適化することを最終的な目標として、まず変形性膝関節症（OA）患者と膝周囲骨切り術症例の患者背景、歩行解析、患者満足度のデータを多施設で収集するための多施設研究を開始した。共同研究施設は北海道内で人工膝関節置換術、膝周囲骨切り術併せて年間200例以上行っている3施設である。歩行解析は、全4施設で加速度センサーによる歩行解析を、三次元動作解析装置を備えている2施設では三次元動作解析を行うこととした。この多施設研究により加速度センサーによる解析は年間400例以上、三次元動作解析は100例以上蓄積できることとなった。 加速度のデータは全施設で収集可能であり、今後膨大に蓄積されていくことが明らかである。これに対応するため得られた加速度データを自動で1歩行周期分毎に切り出すプログラムを開発し、処理時間の短縮を図った。蓄積した加速度データと組み合わせて解析する項目としては①HTO前後での変化、②HTO後の満足度、③三次元動作解析装置から得られた膝内反モーメント、④三次元動作解析と筋骨格シミュレーションソフト（Anybody）、症例ごとの膝骨格モデルを組み合わせた有限要素解析による膝関節面の荷重分布とした。 加速度は膝内外方向だけではなく、鉛直方向、前後方向の3軸ある。また、本研究で使用する加速度センサーシステムでは同時に最大5つの部位の加速度を計測可能である。従って1症例でも、そこから得られる加速度情報は時間的、空間的に膨大となるため、その特徴を解析するにはヒトの解析だけでは不十分な可能性がある。そこで、加速度波形と目的とする解析項目との関連を調べるに当たり、機械学習を導入することとした。Preliminaryな解析として、健常成人20例とOA患者20例の加速度波形を、GoogLeNetを用いた機械学習で解析したところ正診率は80%であった。
• 抗神経成長因子抗体と関節注射併用による変形性膝関節症に対する新たな疼痛治療の開発

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2018/04 -2023/03 

  Author : 岩崎 浩司

   

  モノヨード酢酸（MIA)関節内投与(0.5mg)による変形性膝関節症（OA)モデルのラットを作成した。抗神経成長因子（NGF）抗体投与は2週後から週1回6週までの計4回行い、7週目に関節組織を採取し評価を行った。 このMIA誘発性OAモデルを用いて①MIA+生食、②MIA+1ug抗NGF抗体、MIA+10μg、④MIA+100μg、⑤Sham ope+100μg、⑥Sham+生食の6群（各群n=6)で抗NGF抗体の効果の評価を行った。MIA投与3週後から1週間おきに連続4週抗NGF抗体を投与を行った。②③では両下肢の荷重分布は有意な改善は認めなかったが、④の荷重分布は⑤、⑥と同等であった。Von freyテストではMIAを投与した①-④間に有意差なく、①-④いずれも⑤、⑥と比較し有意に低値であった。組織の関節軟骨の肉眼的評価では①-④間に有意差は認めず、①-④いずれも⑤、⑥と比較し有意に高値であった。HE染色、Safranin-O染色、Mankin scoreを用いた組織学的検討でも同様に、①-④間に有意差は認めず、①-④いずれも⑤、⑥と比較し有意に高値であった。滑膜組織のNGF抗体の免疫染色では、①の群で関節近傍にNGFの集積を認めたが、④では関節近傍のNGFの発現は抑制されていた。以上の動物実験より抗NGF抗体の関節内投与は、全身投与と比べて少量で除痛効果が得られる一方で、有意な変性進行を引き起こさないことが明らかになった。 次に、人工膝関節置換術（TKA)の侵襲が血漿中および関節内NGF 濃度に及ぼす影響を検討するため、術前後の関節液又はドレーン廃液と血中のNGF 濃度を測定した。OA 膝ではTKA 後において血中NGF 濃度に変化はないが、関節内NGF 濃度の上昇を認めた。関節内NGF 濃度の上昇が術後疼痛に関与している可能性が示された。