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| 1.
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論文
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Nakase, Junsuke ; Aiba, Tomohiro ; Goshima, Kenichi ; Takahashi, Ryohei ; Toratani, Tatsuhiro ; Kosaka, Masahiro ; Ohashi, Yoshinori ; Tsuchiya, Hiroyuki
概要:
Purpose: The aim of this study was to compare ultrasonography stages of the tibial tuberosity development and physical f
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eatures. Methods: This study examined 200 knees in 100 male football players aged 10-15 years. Tibial tuberosity development on ultrasonography was divided into 3 stages: Sonolucent stage (stage S), Individual stage (stage I), and Connective stage (stage C). Age, height, quadriceps and hamstring muscle tightness, and muscle strength in knee extension and flexion were determined. These findings were compared with the respective stages of development. Results: The tibial tuberosity was stage S in 27 knees, stage I in 69 knees, and stage C in 104 knees, with right and left sides at the same stage in 95 %. Average age and height significantly increased with advancing tibial tuberosity development. Quadriceps tightness increased with tibial tuberosity development. Hamstring tightness decreased with development. The strength of both knee extension and flexion increased with advancing development, with a greater change seen in knee extension, hamstring/quadriceps ratio: stage C, 0.74; stage A, 0.64; stage E, 0.53. Conclusions: Osgood-Schlatter pathogenesis reportedly involves increased quadriceps tightness with rapidly increasing femoral length during tibial tuberosity development. In this study, it was confirmed that quadriceps tightness increased, yet hamstring tightness decreased, suggesting that quadriceps tightness is not due to femoral length alone. Other factors, including muscle strength, may be involved. The study shows that thigh muscle tightness and thigh muscle performance change with the skeletal maturation of the distal attachment of the patellar tendon. These results add new information to the pathogenesis of Osgood-Schlatter disease. Level of evidence: Cross-sectional study, Level III. © 2012 Springer-Verlag Berlin Heidelberg.
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| 2.
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Kosaka, Masahiro ; Nakase, Junsuke ; Toratani, Tatsuhiro ; Ohashi, Yoshinori ; Kitaoka, Katsuhiko ; Yamada, Hiroshi ; Komura, Koji ; Nakamura, Shinji ; Tsuchiya, Hiroyuki
概要:
Background: The purpose of this study was to investigate the efficacy of additional oblique magnetic resonance imaging (
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MRI) for the diagnosis of anterior cruciate ligament (ACL) tear and evaluation of ACL remnant tissue. Methods: We retrospectively reviewed the records of 54 knees. Three independent readers evaluated the MR images by the use of three methods: orthogonal sagittal images only (method A); orthogonal sagittal and additional oblique sagittal images (method B); and orthogonal sagittal and oblique coronal images (method C). The sensitivity, specificity, and accuracy for the diagnosis of an ACL tear and the detection of the condition of the ACL remnant tissue by the use of each method were calculated in comparison with arthroscopic findings as the reference standard. Results: The arthroscopic records revealed 27 knees with intact ACLs and 27 with torn ACLs. Among the 27 knees with torn ACLs, 9 did not have continuous remnant tissue and 18 had certain remnant tissue attached to the femur or the posterior cruciate ligament. The specificities and accuracies of methods B and C for diagnosing an ACL tear were higher than those for method A. The sensitivity, specificity, and accuracy of method C for the detection of ACL remnant tissue were higher than those for method A and B. Conclusions: Additional use of oblique MRI improved the accuracy of diagnosis of ACL tear and showed a reasonable level of efficacy in detecting ACL remnant tissue. Level of evidence: Level IV (case series). © 2013 Elsevier B.V.
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| 3.
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Nakase, Junsuke ; Toratani, Tatsuhiro ; Kosaka, Masahiro ; Ohashi, Yoshinori ; Numata, Hitoaki ; Oshima, Takeshi ; Takata, Yasushi ; Tsuchiya, Hiroyuki
概要:
Background: This study aimed to present a new technique for anatomical single bundle anterior cruciate ligament (ACL) re
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construction. We developed an original rounded rectangular dilator set to create rounded rectangular femoral tunnels. This technique can increase the femoral tunnel size without roof impingement, and has the potential to reduce the graft failure rate. We investigated the tunnel position and the incidence of intraoperative complications. Method: The presented technique is anatomical single bundle ACL reconstruction using a semitendinosus graft (with or without the gracilis tendon). The tunnel was drilled via an additional medial portal. Rounded rectangular tunnels were created using a special dilator. Tibial tunnels were created using conventional rounded tunnels. Fixation was achieved using a suspensory device on the femoral side and a plate and screw on the tibial side. Patients: Fifty patients underwent this surgery, and intraoperative complications were investigated. The femoral tunnel positions were documented postoperatively from computed tomography scans using the quadrant method. The tibial tunnel positions (anterior-to-posterior, medial-to-lateral) were documented using intraoperative X-ray scans. Results: Only one patient had a partial posterior tunnel wall blowout. The femoral tunnel length varied between 30 and 40 mm (mean, 34.9 ± 3.3 mm). All femoral and tibial tunnels were located within the area of the anatomical ACL insertions. Conclusion: We did not experience any serious intraoperative complications during anatomical single bundle ACL reconstruction using a rounded rectangle dilator, and the resulting locations of the femoral and tibial tunnels were within the anatomical ACL footprint. Level of evidence: Level IV. © 2015 Elsevier B.V..<br />Embargo Period 12 months
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| 4.
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論文
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Kosaka, Masahiro ; Nakase, Junsuke ; Takahashi, Ryohei ; Toratani, Tatsuhiro ; Ohashi, Yoshinori ; Kitaoka, Katsuhiko ; Tsuchiya, Hiroyuki
概要:
BACKGROUND: Osteochondritis dissecans (OCD) of the capitellum is an intra-articular lesion and one of the leading causes
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of permanent elbow disability. The treatment of advanced capitellar OCD remains challenging because of the limited potential of the articular cartilage for self-repair. The purpose of this study was to investigate the outcome of surgical treatment for OCD of the capitellum. METHODS: From 2000 to 2010, 32 male patients who had advanced lesions of capitellar OCD were treated operatively. The mean age of the patients was 14.4 years at the time of surgery. Twenty-nine patients played baseball and 3 played other sports. The lesions were of the centralized type in 9 patients, the lateral type in 4 patients, and the widespread type in 19 patients. For the surgical procedure, osteochondral peg fixation was selected for 13 patients and osteochondral autograft transplantation for 19 patients. Clinical outcome was measured with the elbow rating system including range of motion, and the number of patients who returned to active sports participation within 1 year after surgery was determined. RESULTS: The mean total arc of elbow motion increased from 123±17 degrees preoperatively to 132±14 degrees postoperatively. The mean clinical score improved significantly from 133±24 to 177±27. Within the first year after surgery, 81.3% of the patients returned to active sports playing. However, 4 of 8 patients (50%) in which osteochondral peg fixation was performed for lesions of the lateral widespread type required reoperation. CONCLUSIONS: Our results indicate that osteochondral peg fixation and osteochondral autograft transplantation may improve elbow rating score, and may facilitate a return to active sports participation. However, osteochondral peg fixation may be insufficient for lesions of the widespread type because of their poor stability. The large lateral condyle lesions had a worse outcome, and future studies will need to develop improved treatment for these defects. Copyright © 2013 by Lippincott Williams & Wilkins.
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| 5.
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Nakase, Junsuke ; Inaki, Anri ; Mochizuki, Takafumi ; Toratani, Tatsuhiro ; Kosaka, Masahiro ; Ohashi, Yoshinori ; Taki, Junichi ; Yahata, Tetsutaro ; Kinuya, Seigo ; Tsuchiya, Hiroyuki
概要:
Purpose:This study investigated the effect of the FIFA 11+ warm-up program on whole body muscle activity using positron
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emission tomography.Methods:Ten healthy male volunteers were divided into a control group and a group that performed injury prevention exercises (The 11+). The subjects of the control group were placed in a sitting position for 20 min and 37 MBq of 18F-fluorodeoxyglucose (FDG) was injected intravenously. The subjects then remained seated for 45 min. The subjects of the exercise group performed part 2 of the 11+for 20 min, after which FDG was injected. They then performed part 2 of the 11+for 20 min, and rested for 25 min in a sitting position. Positron emission tomography-computed tomography images were obtained 50 min after FDG injection in each group. Regions of interest were defined within 30 muscles. The standardized uptake value was calculated to examine the FDG uptake of muscle tissue per unit volume.Results:FDG accumulation within the abdominal rectus, gluteus medius and minimus were significantly higher in the exercise group than in the control group (P<0.05).Conclusion:The hip abductor muscles and abdominal rectus were active during part 2 of the FIFA 11+ program. © 2013 Nakase et al.
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