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Oku K, Yabuki M, Kishimoto T, Shinonaga A, Kimura D, Ito T, Sugioka T, Kobayashi Y, Satake H, Nagamoto H, Kawaguchi Y, Kumai T. Clinical reasoning of ultrasound imaging-guided manual passive manipulation for adhesion prevention in a patient with total knee arthroplasty: a case report. Physiother Theory Pract 2024; 40:1064-1071. [PMID: 36346357 DOI: 10.1080/09593985.2022.2143737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Patients with total knee arthroplasty occasionally develop postoperative abnormalities such as posttraumatic knee stiffness and arthrofibrosis, which may affect activities of daily living. However, there are no clear assessment methods or interventions for knee stiffness. Musculoskeletal ultrasound imaging enables real-time evaluation of mobility and flexibility of tissues. The purpose of this case report was to describe the use of musculoskeletal ultrasound imaging for evaluating the optimal location and methods of passive manipulation. CASE DESCRIPTION The patient was an 82-year-old woman who had undergone total knee arthroplasty. She was unable to climb stairs due to limited knee flexion. Based on the results of musculoskeletal ultrasound imaging assessment, we hypothesized that the knee flexion limitation was caused by decreased sliding movement of the suprapatellar pouch. Hence, we performed passive manipulation on the tissue with decreased sliding under musculoskeletal ultrasound guidance. OUTCOMES The patient's knee flexion angle increased from 90° to 110° within 1 week of intervention, and her gait speed improved from 16.48 to 13.2 s per 10 m. Furthermore, after the intervention, she was able to climb 10 steps using a handrail. DISCUSSION Ultrasound imaging is important because it allows the examination of tissues with mobility changes such as in arthrofibrosis. Our work highlights the use of musculoskeletal ultrasound imaging for identifying the target region for therapy and for providing guidance during passive manipulation.
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Affiliation(s)
- Kosuke Oku
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
- Department of Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Mayumi Yabuki
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Tomoya Kishimoto
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Atsushi Shinonaga
- Department of Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Daisuke Kimura
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Tomotaka Ito
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Tatsuya Sugioka
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Japan
| | - Yusuke Kobayashi
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Japan
| | - Hayato Satake
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Japan
| | - Hideaki Nagamoto
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | | | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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Liu Z, Zhong Y, Maemichi T, Zhou Q, Okunuki T, Li Y, Kazuki W, Kumai T. Acute Effects of Local High-Frequency Percussive Massage on Deep Fascial and Muscular Stiffness and Joint Range of Motion in Young Adult Men. J Sport Rehabil 2024:1-7. [PMID: 38508160 DOI: 10.1123/jsr.2022-0455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Local high-frequency percussive (HFP) massage has recently found widespread application in physical therapy. Although HFP massage reportedly improves range of motion (ROM), the mechanism underlying its action has not yet been proven. This study aimed to clarify whether a 5-minute percussive massage regimen affects muscular or connective tissues, such as the deep fascia and deep intermuscular fascia and the change in joint ROM. METHOD The study sample was calculated using G*Power analysis program, and this study enrolled 15 healthy men who underwent 5-minute HFP massage to the medial gastrocnemius muscle. Shear-wave elastography was used to measure tissue stiffness in the deep fascia, muscle, and deep intermuscular fascia through shear-wave velocity as well as the ROM of the volunteers' ankle joint dorsiflexion before and after the HFP massage. A value of P < .05 was used to declare statistical significance, and post hoc was used to calculate the effect size using G*Power. RESULTS Shear-wave velocity revealed a significant change in the deep fascia (P = .003; shear-wave velocity: -0.7 m/s) and significant increase in ROM of ankle dorsiflexion (P = .002; increase in ROM: 3.0°) after 5 minutes of HFP massage. However, the muscle and deep intermuscular fascia did not exhibit any significant changes. CONCLUSIONS HFP massage for 5 minutes modified the stiffness of the deep fascia and concurrently improved the ankle joint-dorsiflexion ROM. This method can be used as an intervention to decrease stiffness of the deep fascia and increase the ROM efficiently.
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Affiliation(s)
- Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Yicheng Zhong
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Toshihiro Maemichi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
| | - Qianhui Zhou
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
- Research Organization of Science and Technology, Ritsumeikan University/Research Fellow of Japan Society for the Promotion of Science, Japan
| | - Yanshu Li
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | - Wakamiya Kazuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Liu Z, Gong Y, Nagamoto H, Okunuki T, Yamaguchi R, Kobayashi Y, Li Y, Maemichi T, Kumai T. Low Body Fat Percentage and Menstrual Cycle Disorders in Female Elite Adolescent Dancers. J Dance Med Sci 2024:1089313X241227282. [PMID: 38284148 DOI: 10.1177/1089313x241227282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Introduction: The menstrual cycle is an important indicator of health in female athletes. Female elite adolescent dancers are expected to control their weight while also training intensely, which can lead to menstrual disorders. This study aimed to investigate the relationship between body composition and menstrual status in female elite adolescent dancers. Methods: In total, 131 female elite adolescent dancers (age: 15.9 ± 1.5 years) were enrolled in this study. We measured the height, weight, and body fat percentage (BFP) for each participant and calculated their body mass index (BMI). We gathered information on individual menstruation patterns and the participants' menstrual cycles over the previous year using recall methods. We then compared the differences between dancers with menstrual cycle disorders and those without. Primary amenorrhea was defined as menarche occurring after the age of 15, while secondary amenorrhe was defined as experiencing fewer than 5 or no menstrual periods for at least 3 of the previous 12 months. We conducted a reliability test using the same questionnaire 2 weeks later. Statistical significance was defined as P < .05, and we calculated the effect sizes (d) and 95% confidence intervals (95% CI). Results: The average BMI and BFP were 22.6 ± 3.0% and 19.4 ± 2.2 kg/m2, respectively. Low BFP and low BMI were observed in 51 (38.6%) and 47 (35.6%) participants, respectively. Primary amenorrhea in 3 participants (2.3%) and 29 (22.1%) reported experiencing secondary amenorrhea; they had lower BFP than the dancers who did not experience amenorrhea (P = .041, 95% CI, -2.51 to -0.05). Conclusion: Female elite adolescent dancers in China may have lower BFP and menstrual problems. Given that lower BFP may contribute to the occurrence of menstruation disorders, it is essential to pay an attention to both BFP and the menstruation status in female elite adolescent dancers.
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Affiliation(s)
- Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Yining Gong
- Graduate School of Economics, Osaka University of Economics and Law, Yao, Osaka, Japan
| | - Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Ryusei Yamaguchi
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Yusuke Kobayashi
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
- Sport & Arthroscopy Center, Hanna Central Hospital, Nara, Japan
| | - Yanshu Li
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | | | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Nagamoto H, Okunuki T, Takahashi S, Wakamiya K, Liu Z, Maemichi T, Katsutani H, Yamada Y, Takahashi H, Tanaka H, Aizawa T, Kumai T. Are floating toes associated with lifestyle in children? A cross-sectional study. J Foot Ankle Res 2023; 16:90. [PMID: 38087348 PMCID: PMC10717254 DOI: 10.1186/s13047-023-00685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Floating toes are a condition and deformity in which some of the toes are afloat. Many functional impairments in floating toes have been previously studied lately and several factors related to floating toes have also been reported. However, no reports have considered the relationship between lifestyle and floating toes among children. The purpose of this study was to reveal the prevalence of floating toes among school children and reveal its relationship with lifestyle. METHODS In total, 138 young male baseball players were recruited. Lifestyle was evaluated by using a questionnaire and chosen whether the main lifestyle was Japanese or Western, if the bedding was futons or beds, and if the toilet was Japanese style (a squat toilet) or Western style. Floating toes were defined as toes that were not in contact with the mat. Ankle dorsiflexion in the knee-flexed and knee-extended positions was measured in a weight-bearing position. The relationship between the floating toes and lifestyles, and the comparison of ankle dorsiflexion range of motion between the lifestyles were statistically analyzed. RESULTS Players living in a Western style showed a significantly higher prevalence of floating toes on both feet compared with the players living in a Japanese style (throwing side; 39% vs. 19%, p = 0.04, and non-throwing side; 43% vs. 19%, p = 0.01). Players living in a Western style with beds showed a significantly smaller range of motion on both sides of ankle dorsiflexion in the knee-flexed position compared with those who were not (throwing side; 37.2 ± 5.7° vs. 39.0 ± 6.6°, p = 0.04, and non-throwing side; 36.8 ± 5.8° vs. 38.6 ± 6.1°, p = 0.04). CONCLUSION Children mainly living in a Western lifestyle showed a significantly higher prevalence of floating toes on both feet compared to those mainly living in a Japanese lifestyle. The prevalence of floating toes may be related to lifestyles among children. TRIAL REGISTRATION The study was approved by the institutional review board of the Waseda University Graduate School of Sport Sciences (IRB number 2021-185).
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Affiliation(s)
- Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Miyagi, Japan.
- Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan.
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan.
| | - Takumi Okunuki
- Japan Society for the Promotion of Sciences, Tokyo, Japan
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
| | - Shimpei Takahashi
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School, Sendai, Miyagi, Japan
| | - Kazuki Wakamiya
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Zijian Liu
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Toshihiro Maemichi
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Hirofumi Katsutani
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Yoshiyasu Yamada
- Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan
| | - Hiroyuki Takahashi
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan
- Department of Orthopaedic Surgery, Kesen-Numa City Hospital, Kesen-Numa, Miyagi, Japan
| | - Hirofumi Tanaka
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Toshimi Aizawa
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Miyagi, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Maemichi T, Meguriya S, Furusho A, Liu Z, Tsutsui T, Kumai T. Combined effects of stretching and low-frequency electroacupuncture on posterior shoulder joint tightness: a case report. Acupunct Med 2023; 41:380-382. [PMID: 37740698 DOI: 10.1177/09645284231197231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Affiliation(s)
- Toshihiro Maemichi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
| | - Shigeru Meguriya
- Acupuncture and Physical Therapy Teacher Training School, Tsukuba University, Tsukuba, Japan
| | | | - Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | | | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Liu Z, Maemichi T, Matsumoto M, Okunuki T, Tanaka H, Katsutani H, Li Y, Kumai T. Change in the sub-sesamoid soft tissue thickness under different loading conditions. J Phys Ther Sci 2023; 35:602-607. [PMID: 37529059 PMCID: PMC10390041 DOI: 10.1589/jpts.35.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/18/2023] [Indexed: 08/03/2023] Open
Abstract
[Purpose] To measure the sub-sesamoid soft tissue thickness change from non-loading to self-weight loading conditions. [Participants and Methods] The study included 17 female participants for the study. A questionnaire was used to collect the demographic data and participant anamnesis, such as the presence of foot injuries and diabetes. The measured height and weight were used to calculate the body mass index. Participants were required to stand on an evaluation device from non-loading to 100% loading conditions to measure the sub-sesamoid soft tissue thickness. [Results] Significant differences were observed between the tibial and fibular sub-sesamoid soft tissue thicknesses under non-loading and all loading conditions. Significant soft tissue thinning was observed with a change from non-loading to 25% loading condition. However, no significant differences in the rate of change were observed between the tibial and fibular sub-sesamoid soft tissue thicknesses at 100% loading. [Conclusion] The sub-fibular sesamoid soft tissue was thicker than the sub-tibial sesamoid soft tissue in all loading conditions. The sub-sesamoid soft tissue thickness change was larger during initial loading stage than during the late loading stage, which may be normal in healthy females in their 20s.
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Affiliation(s)
- Zijian Liu
- Graduate School of Sport Sciences, Waseda University,
Japan
| | - Toshihiro Maemichi
- Faculty of Sport Sciences, Waseda University: 2-579-15
Mikajima, Tokorozawa-shi, Saitama 359-1192, Japan
| | | | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University,
Japan
| | | | | | - Yanshu Li
- Graduate School of Human Sciences, Waseda University,
Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University: 2-579-15
Mikajima, Tokorozawa-shi, Saitama 359-1192, Japan
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Nagamoto H, Kimura R, Hata E, Kumai T. Disabled throwing shoulder/elbow players have high rates of impaired foot function. Res Sports Med 2023; 31:679-686. [PMID: 35139696 DOI: 10.1080/15438627.2022.2038160] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
Abstract
The prevalence of impaired foot function and floating toes of 91 baseball players with disabled throwing shoulder or elbow were retrospectively investigated. Foot function was evaluated by foot "rock paper scissors" and floating toes were confirmed if none of the toes made contact with the mat in standing posture. The prevalence of impaired foot function and floating toes and the relationship between between them were determined. Abnormal foot function was observed in 83 players (91%); of those, 73 players (88%) also had floating toes, and the prevalence was statistically significant compared to those without it (12%) (P < 0.001). Floating toes were observed in 74 players (81%); of those, 73 players (99%) had impaired foot function, and the prevalence was also statistically significant compared to those without them (59%) (P < 0.001). Baseball players with disabled throwing shoulder or elbow have high rates of impaired foot function and floating toes.
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Affiliation(s)
- Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Japan
- Department of Orthopaedic Surgery, Kurihara Central Hospital, Kurihara, Japan
| | - Rei Kimura
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Japan
- Department of Orthopaedic Surgery, Kurihara Central Hospital, Kurihara, Japan
| | - Eri Hata
- Department of Rehabilitation, Kurihara Central Hospital, Kurihara, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Yabiku H, Matsui T, Sugimoto T, Mase Y, Higa K, Uehara F, Toma T, Azuma C, Tome Y, Nishida K, Kumai T. Relationship between the morphology of osteophytes and cartilage lesions in anterior ankle impingement in athletes: a cross-sectional study. J Foot Ankle Res 2023; 16:31. [PMID: 37259105 DOI: 10.1186/s13047-023-00633-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/24/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The present study aimed to describe the frequency and severity of tram-track lesions in anterior ankle impingement in athletes and to evaluate the association between osteophyte morphology and severity of tram-track lesions, the distinctive cartilage lesions associated with tibial osteophytes in anterior ankle impingement syndrome. METHODS We evaluated 34 athletes who underwent arthroscopic osteophyte resection for anterior ankle impingement between January 2017 and March 2021. RESULTS We found tram-track lesions in 26 athletes (76.5%). Arthroscopic findings revealed the distribution of the International Cartilage Repair Society grades of tram-track lesions (grade 0, eight; grade 1, seven; grade 2, ten; grade 3, nine; grade 4, zero). These findings indicate that athletes with anterior ankle impingement syndrome may have more severe cartilage lesions than non-athletes. There was a positive correlation between the International Cartilage Repair Society grade and osteophyte size (r = 0.393, p = 0.021). We divided athletes into two groups according to the presence or absence of osteophyte protrusion into the joint space. Osteophyte protrusion was present in 14 athletes (41.2%). All athletes in the protrusion-type group had tram-track lesions; seven (50%) had International Cartilage Repair Society grade 3. The protrusion-type group's International Cartilage Repair Society grade was significantly higher than that of the non-protrusion-type group (p = 0.008). The osteophyte sizes in the two groups were not significantly different (p = 0.341). CONCLUSIONS Based on these findings, osteophyte protrusion should be assessed when an indication of arthroscopic treatment for anterior ankle impingement syndrome is considered, particularly in athletes.
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Affiliation(s)
- Hiroki Yabiku
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Okinawa, 903-0215, Nishihara, Japan
| | - Tomohiro Matsui
- Department of Orthopaedic Surgery, Saiseikai Nara Hospital, Nara, 4-643, Japan
| | - Takeshi Sugimoto
- Department of Orthopedic Surgery, Osaka Global Orthopedic Hospital, 6-15-30 Sekime, Osaka Joto-ku, Osaka, Japan
| | - Yasuyoshi Mase
- Department of Orthopedic Surgery and Rehabilitation, Hachioji Sports Orthopedic Clinic, 5-1 Nakacho, Tokyo, Hachioji, Japan
| | - Kotaro Higa
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Okinawa, 903-0215, Nishihara, Japan
| | - Fuminari Uehara
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Okinawa, 903-0215, Nishihara, Japan
| | - Takashi Toma
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Okinawa, 903-0215, Nishihara, Japan
| | - Chinatsu Azuma
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Okinawa, 903-0215, Nishihara, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Okinawa, 903-0215, Nishihara, Japan.
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Okinawa, 903-0215, Nishihara, Japan
| | - Tsukasa Kumai
- Faculty of Sports Sciences, Waseda University, 2-579-15 Mikajima, Saitama, Tokorozawa, Japan.
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Akuzawa H, Morito T, Oshikawa T, Kumai T, Kaneoka K. Functional relationship between the foot intrinsic and extrinsic muscles in walking. J Electromyogr Kinesiol 2023; 71:102781. [PMID: 37247509 DOI: 10.1016/j.jelekin.2023.102781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
The intrinsic and extrinsic muscles are considered to stabilize the foot and contribute to propulsion during walking. This study aimed to clarify the functional relationship between intrinsic and extrinsic muscles during walking. Thirteen healthy men participated in this study. The muscle activities of the intrinsic muscles (quadratus plantae and abductor hallucis), and the extrinsic muscles (flexor hallucis longus, flexor digitorum longus, and tibialis posterior) were measured using fine-wire and surface electromyography during walking. The muscle onset timing after foot contact was calculated and compared among muscles using the one-way ANOVA. The stance phase was divided into early and late braking, and early and late propulsion phases. Muscle activity among phases was compared using repeated-measures ANOVA. The onset time of the abductor hallucis was significantly earlier than those of the flexor digitorum longus and tibialis posterior. The quadratus plantae demonstrated significantly earlier onset than that of the tibialis posterior. In the late propulsion phase, the activity of extrinsic muscles decreased, whereas intrinsic muscles were continuously active. Early activation of the intrinsic muscles may stabilize the foot for efficient torque production by the extrinsic muscles. Furthermore, the intrinsic muscles may contribute to the final push-off after the deactivation of extrinsic muscles.
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Affiliation(s)
- Hiroshi Akuzawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan; Institute for Sport Sciences, Waseda University, Nishi-Tokyo, Japan.
| | - Tsuyoshi Morito
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Tomoki Oshikawa
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Koji Kaneoka
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
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Matsumoto M, Maemichi T, Wada M, Niwa Y, Inagaki S, Taguchi A, Okunuki T, Tanaka H, Kumai T. Ultrasonic Evaluation of the Heel Fat Pad Under Loading Conditions Using a Polymethylpentene Resin Plate: Part 2. Reliability and Agreement Study. Ultrasound Med Biol 2023; 49:460-472. [PMID: 36335054 DOI: 10.1016/j.ultrasmedbio.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/10/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Previously, we developed an instrument to evaluate the heel fat pad (HFP) two-layer structure, under varying loading conditions, with ultrasonography from the plantar surface through a polymethylpentene resin plate; the measured values were equivalent to those obtained without this plate. The study described here aimed to determine the intra- and inter-examiner reliabilities of the HFP thickness measurements and the agreement between long- and short-axis measured values using this instrument. Two examiners successively recorded the HFPs of 40 healthy adults twice under the no loading and loading conditions on the long- and short-axis scans. The HFPs were classified into two layers, and their thicknesses were measured. Short-term intra- and inter-examiner reliabilities were determined using the intraclass correlation coefficients. Measurements were repeated 1 mo later to determine the long-term intra-examiner reliability. The agreement between the measured long- and short-axis values was investigated by calculating the minimal detectable changes. The determined short- and long-term intra-examiner reliabilities ranged from 0.750 to 0.999 and from 0.765 to 0.952, respectively. Inter-examiner reliability ranged from 0.765 to 0.997. Differences may occur between the values measured at different axes. The measurements using this evaluation instrument were reliable, and it is best to unify the measurement axis for quantitative research.
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Affiliation(s)
- Masatomo Matsumoto
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie, Japan.
| | - Toshihiro Maemichi
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Mitsunari Wada
- Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie, Japan
| | - Yuki Niwa
- Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie, Japan
| | - Shinobu Inagaki
- Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie, Japan
| | - Atsuya Taguchi
- Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; Research Fellow of Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Hirofumi Tanaka
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; Hyakutake Orthopedic & Sports Clinic, Saga City, Saga, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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11
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Okunuki T, Magoshi H, Maemichi T, Liu Z, Tanaka H, Matsumoto M, Hoshiba T, Kumai T. The prevalence and effect of the sites of pain in female soccer players with medial shin pain. J Sports Med Phys Fitness 2023; 63:111-120. [PMID: 35333031 DOI: 10.23736/s0022-4707.22.13655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Female soccer players are often diagnosed with medial shin pain, which includes tibial stress fracture, medial tibial stress syndrome, and chronic exertional compartment syndrome. As the possibility of varied sites of pain affecting sports activities has not been fully researched, an urgent discussion and evidence is required. This study investigates the prevalence and effect of sites of pain on the sports activities of female soccer players with medial shin pain. METHODS A questionnaire survey was conducted for 196 female soccer players with medial shin pain to assess symptom duration, the effect of practice and performance, and sites of pain. The players were classified into three conditions (tibial stress fracture, medial tibial stress syndrome, or medial shin pain with neurological symptoms) and compared based on sites of pain. RESULTS We observed that medial tibial stress syndrome had a lower impact on performance compared to that of tibial stress fracture and medial shin pain with neurological symptoms. While participants with tibial stress fracture had to suspend practice sessions more frequently, the difference in symptom duration between the classified groups was not statistically significant. The effect of sites of pain on sports activities was not significantly different in participants with medial tibial stress syndrome. CONCLUSIONS Medial shin pain should be evaluated carefully to differentiate between medial tibial stress syndrome and medial shin pain with neurological symptoms. Restriction of sports activities may help improve the patient's condition early, regardless of the presentation.
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Affiliation(s)
- Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hirohisa Magoshi
- Department of Rehabilitation, Hachioji Sports Orthopedic Clinic, Tokyo, Japan
| | | | - Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Hirofumi Tanaka
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Hyakutake Orthopedic and Sports Clinic, Saga, Japan
| | - Masatomo Matsumoto
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Kuwana City Medical Center, Mie, Japan
| | - Takuma Hoshiba
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan -
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12
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Maemichi T, Meguriya S, Furusho A, Tsutsui T, Kumai T. Electroacupuncture of muscle and tendon attachments in an athlete with lateral epicondylitis of the humerus: a case report. Acupunct Med 2022:9645284221131335. [DOI: 10.1177/09645284221131335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Toshihiro Maemichi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Institute of Life Innovation Studies, Toyo University, Saitama, Japan
| | - Shigeru Meguriya
- Acupuncture and Physical Therapy Teacher Training School, Tsukuba University, Tokyo, Japan
| | | | | | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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13
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Nagamoto H, Takahashi H, Kurokawa D, Muraki T, Yaguchi H, Shinagawa K, Kumai T. Prevalence of disabled throwing shoulder and its shoulder function among youth football goalkeepers. J Orthop 2022; 34:74-79. [PMID: 36035200 PMCID: PMC9411177 DOI: 10.1016/j.jor.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/20/2022] Open
Abstract
Aim Although the football goalkeepers are overhead athletes, no studies have reported the prevalence of disabled throwing shoulder (DTS) and the shoulder function. Thus, this study aimed to investigate the prevalence of DTS among youth football goalkeepers and to determine the relationship among their shoulder functions. Methods Youth football goalkeepers, who participated in a pre-participation medical examination were included in the study. The questionnaire was handed out before the examination to determine the players' age, dominant hand, and shoulder pain history. If the player had a history of shoulder pain during ball throwing motion in the past, they were defined as goalkeepers with DTS. Physical examination of scapular positioning, scapular retraction and rotator cuff muscle strength, and ultrasonographic evaluation were performed. Results Six goalkeepers (16%) had a history of DTS among the 38 male youth football goalkeepers. The presence of scapular malpositioning, limitation of scapular retraction, and decrease in rotator cuff strength was significantly higher in goalkeepers with DTS than in those without DTS (p = 0.03, p < 0.001, p < 0.001, respectively). Three goalkeepers with DTS revealed ultrasonographic findings. Conclusion The prevalence of DTS among youth football goalkeepers was 16%. All these players had scapular malpositioning and limitation of scapular retraction. Scapular malpositioning and limitation of scapular retraction may be related to the DTS in youth football goalkeepers. Level of evidence Level IV.
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Affiliation(s)
- Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Japan
- Department of Orthopaedic Surgery, Kurihara Central Hospital, Kurihara, Japan
- Specified Nonprofit Organization, Network for Sports Medicine and Science, Sendai, Japan
| | - Hiroyuki Takahashi
- Department of Orthopaedic Surgery, Kesen-numa City Hospital, Kesen-numa, Japan
- Specified Nonprofit Organization, Network for Sports Medicine and Science, Sendai, Japan
| | - Daisuke Kurokawa
- Department of Orthopaedic Surgery, JCHO Sendai Hospital, Sendai, Japan
- Specified Nonprofit Organization, Network for Sports Medicine and Science, Sendai, Japan
| | - Takayuki Muraki
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School, Sendai, Japan
- Specified Nonprofit Organization, Network for Sports Medicine and Science, Sendai, Japan
| | - Haruki Yaguchi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School, Sendai, Japan
- Specified Nonprofit Organization, Network for Sports Medicine and Science, Sendai, Japan
| | - Kiyotsugu Shinagawa
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Japan
- Specified Nonprofit Organization, Network for Sports Medicine and Science, Sendai, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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14
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Liu Z, Yabiku H, Okunuki T, Chen S, Hoshiba T, Maemichi T, Nagamoto H, Li Y, Kumai T. The Effect of Foot Deformity and First Metatarsophalangeal Joint Plantar Pain on Performance in DanceSport Athletes. Children 2022; 9:children9081169. [PMID: 36010059 PMCID: PMC9406650 DOI: 10.3390/children9081169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
Background: Adolescent DanceSport athletes who regularly dance in high heels have a higher possibility of developing hallux valgus deformity and foot pain. We believe that the occurrence of foot disorders may change the loading on their feet, which thus affects the athletic performance of those adolescents. Methods: A total of 63 adolescent DanceSport athletes (16 boys, 47 girls) were included. The plantar pain in the first metatarsophalangeal (1st MTP) joint was evaluated using a questionnaire, and the hallux valgus angle was evaluated using digital photographs (HVAp). The loading values of the plantar pressure while performing relève on demi-pointe were measured using sensor sheets. The participating boys and girls were analyzed separately. Results: The results showed that female adolescent DanceSport athletes with the 1st MTP joint plantar pain showed a decrease in the loading distribution and plantar pressure percentage on the hallux and an increased loading distribution and pressure distribution of the metatarsal head as the HVAp increased. Conclusion: Among adolescent DanceSport athletes with plantar pain in the 1st MTP joint and a large HVAp, the loading manner of the foot may have changed, which may be associated with a decrease in the toe function and performance.
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Affiliation(s)
- Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Hiroki Yabiku
- Graduate School of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Shuo Chen
- Graduate School of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Takuma Hoshiba
- Waseda Institute for Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | | | - Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Yanshu Li
- Graduate School of Human Sciences, Waseda University, Saitama 359-1192, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan
- Correspondence: ; Tel.: +81-(0)4-2947-6853
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15
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Yanagawa Y, Muto T, Shakagori M, Terakado A, Kumai T. Activities of medical centers for athletes and spectators at cycling track events in the Tokyo 2020 Olympic and Paralympic Games. Acute Med Surg 2022; 9:e728. [PMID: 35169484 PMCID: PMC8836220 DOI: 10.1002/ams2.728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/03/2021] [Accepted: 01/12/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Youichi Yanagawa
- Acute Critical Care Medicine Juntendo University Shizuoka Hospital Izunokuni Japan
| | - Takuya Muto
- Department of Medical Service, Tokyo Organizing Committee of the Olympic and Paralympic Games Tokyo Metropolitan Government Shinjuku‐ku Japan
| | - Masami Shakagori
- Department of Medical Service, Tokyo Organizing Committee of the Olympic and Paralympic Games Tokyo Metropolitan Government Shinjuku‐ku Japan
| | - Atsuhiko Terakado
- Department of Medical Service, Tokyo Organizing Committee of the Olympic and Paralympic Games Tokyo Metropolitan Government Shinjuku‐ku Japan
| | - Tsukasa Kumai
- Department of Medical Service, Tokyo Organizing Committee of the Olympic and Paralympic Games Tokyo Metropolitan Government Shinjuku‐ku Japan
- Faculty of Sport Sciences Waseda University Tokorozawa Japan
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16
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Matsumoto M, Maemichi T, Wada M, Niwa Y, Inagaki S, Okunuki T, Ichikawa S, Kumai T. Ultrasonic Evaluation of the Heel Fat Pad under Weight-Bearing Conditions Using a Polymethylpentene Resin Plate: Part 1. Ultrasound Med Biol 2022; 48:358-372. [PMID: 34823945 DOI: 10.1016/j.ultrasmedbio.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 09/01/2021] [Accepted: 10/13/2021] [Indexed: 06/13/2023]
Abstract
To evaluate the two-layer structure of the heel fat pad (HFP) from non-weight-bearing to full-weight-bearing conditions, we developed an instrument that assesses these changes from the sole through a polymethylpentene resin plate (PMP) with ultrasonography. For actual use, we investigated the influence on measured values and ultrasonogram appearance by interposing the PMP. Additionally, as the PMP may be bent under weight-bearing conditions, its influence on the measured values was investigated. First, two examiners measured the distances inside the phantom with and without a PMP. Second, ultrasonograms were obtained from 40 healthy adults with and without a PMP, and the thicknesses of the whole layer and the two layers of the HFP were measured using the same ultrasonogram. For each experiment, reproducibility was investigated. Third, the distances inside the phantom were measured and compared through the bent PMP, which models the weight-bearing condition, and the flat PMP. The reproducibility of the measurements was equivalent with and without the PMP interposed. Potential bias in measured values arising from deformation of PMP under weight-bearing conditions was not detected. Overall, the PMP's interposition and the bending of the PMP might not influence the measured values and reproducibility of the measurements.
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Affiliation(s)
- Masatomo Matsumoto
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie Prefecture, Japan.
| | - Toshihiro Maemichi
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Mitsunari Wada
- Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie Prefecture, Japan
| | - Yuki Niwa
- Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie Prefecture, Japan
| | - Shinobu Inagaki
- Department of Medical Rehabilitation, Kuwana City Medical Center, Kuwana City, Mie Prefecture, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Shota Ichikawa
- Department of Orthopedic Surgery, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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17
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Ichikawa S, Kumai T, Okunuki T, Maemichi T, Matsumoto M, Yabiku H, Liu Z, Yamaguchi R, Iwayama A, Ayukawa G, Akiyama Y, Mitsui H, Niki H. Comparison of foot posture and foot muscle morphology between lifesaver athletes and healthy adults. Res Sports Med 2021:1-11. [PMID: 34802357 DOI: 10.1080/15438627.2021.2002330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to compare the foot muscle morphology and foot posture between healthy adults and lifesavers in sandy beach sports. The participants included 15 lifesaver athletes and 15 healthy adults. Using a non-contact three-dimensional foot measurement device, the foot length, width, and arch height of the right foot were measured while standing and sitting without back support, and the transverse arch length ratio and arch height index were subsequently calculated. Muscle cross-sectional area was measured using an ultrasound imaging device. Muscle cross-sectional areas, arch height, foot width, arch height index, and transverse arch length ratio were larger in the lifesaver than in the healthy adult group. Lifesavers had higher arches and more developed intrinsic and extrinsic muscles than healthy adults. Performing physical activity while barefoot on sandy beaches may effectively develop the foot intrinsic and extrinsic muscles and raise the arch.
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Affiliation(s)
- Shota Ichikawa
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan.,Department of Orthopaedic Surgery, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | | | - Masatomo Matsumoto
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan.,Department of Rehabilitation, Kuwana City Medicine Center, Mie, Japan
| | - Hiroki Yabiku
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Ryusei Yamaguchi
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Arina Iwayama
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Goro Ayukawa
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Yui Akiyama
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroyuki Mitsui
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hisateru Niki
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
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18
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Kawakami Y, Shiotani H, Otsuka S, Hui L, Ichinose H, Chi Y, Kurumisawa K, Yamada Y, Shan X, Saeki J, Sado N, Tanaka F, Kumai T, Nishitani S, Takada M, Toyoda S, Uchida H, Adachi Y. Effects Of Amino Acid Mixture On Functional And Morphological Properties Of Achilles Tendon. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000760576.41415.c6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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19
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Matsui T, Kumai T, Kamijo S, Shinohara Y, Kurokawa H, Taniguchi A, Mahakkanukrauh P, Tanaka Y. Effect of Ankle Motion and Tensile Stress at the Achilles Tendon on the Contact Pressure Between the Achilles Tendon and the Calcaneus. J Foot Ankle Surg 2021; 60:753-756. [PMID: 33766480 DOI: 10.1053/j.jfas.2021.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/08/2020] [Accepted: 02/22/2021] [Indexed: 02/03/2023]
Abstract
Impingement between the Achilles tendon and the posterosuperior prominence of the calcaneus is considered to be a cause of insertional Achilles tendinopathy. The corresponding treatment intends to reduce tensile stress from calf muscles and avoid hyper-dorsiflexion of the ankle joint for decreasing the contact pressure; however, no study has reported on whether these treatments can decrease impingement. Thus, this study investigated the hypothesis that the tensile stress of the Achilles tendon and ankle motion affect the contact pressure between the Achilles tendon and the posterosuperior prominence of the calcaneus. Six fresh-frozen cadaveric lower leg specimens were procured. Each specimen was set to a custom foot-loading frame and loaded with a ground reaction force of 40 N and a tensile load of 70 N along the Achilles tendon. The contact pressure between the Achilles tendon and the posterosuperior prominence of the calcaneus was measured using a miniature pressure sensor under different tensile loadings of the Achilles tendon at the neutral ankle position. Similarly, the contact pressures during the ankle motion from a neutral position to maximum dorsiflexion were measured. The tensile load of the Achilles tendon and ankle motion affected the contact pressure between the Achilles tendon and the posterosuperior prominence of the calcaneus. The contact pressure increased with tensile load or ankle dorsiflexion. Conditions with increasing the tensile load of the Achilles tendon or under ankle dorsiflexion increase the contact pressure between the Achilles tendon and the posterosuperior prominence of the calcaneus.
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Affiliation(s)
- Tomohiro Matsui
- Surgeon, Department of Orthopedic Surgery, Saiseikai Nara Hospital, Nara City, Japan.
| | - Tsukasa Kumai
- Professor, Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Satoshi Kamijo
- Surgeon, Department of Orthopaedic Surgery, Fujimori Hospital, Matsumoto, Japan
| | - Yasushi Shinohara
- Professor, Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Hiroaki Kurokawa
- Surgeon, Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
| | - Akira Taniguchi
- Surgeon, Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
| | | | - Yasuhito Tanaka
- Professor, Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
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20
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Mineta S, Inami T, Hoshiba T, Higashihara A, Kumai T, Torii S, Hirose N. Greater knee varus angle and pelvic internal rotation after landing are predictive factors of a non-contact lateral ankle sprain. Phys Ther Sport 2021; 50:59-64. [PMID: 33894569 DOI: 10.1016/j.ptsp.2021.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aimed to clarify the kinematic, kinetic characteristics associated with lateral ankle sprain. DESIGN A 16-month prospective cohort study. SETTING Laboratory. PARTICIPANTS A total of 179 college athletes. MAIN OUTCOME MEASURES Joint kinematics, moment during single-leg landing tasks, and ankle laxity were measured. The attendance of each participating team, injury mechanism, existence of body contact, presence of orthosis, with or without medical diagnosis, and periods of absence were recorded. RESULTS Twenty-nine participants incurred lateral ankle sprain during non-contact motion. The Cox regression analysis revealed that greater knee varus peak angle (hazard ratio: 1.16 [95% confidence interval: 1.10-1.22], p < 0.001) and greater pelvic internal rotation peak angle toward the support leg were associated with lateral ankle sprain (hazard ratio: 1.08 [95% confidence interval: 1.02-1.15], p = 0.009). The cut-off values for each predictive factor were -0.17° (area under the curve = 0.89, p < 0.001) and 6.63° (area under the curve = 0.74, p < 0.001), respectively. CONCLUSIONS A greater knee varus peak angle and pelvic internal rotation peak angle after single-leg landing are predictive factors for lateral ankle sprain.
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Affiliation(s)
- Shinshiro Mineta
- Graduate School of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan; Research Fellowships for Young Scientists, Japan Society for the Promotion of Science, Chiyoda-ku, Kojimachi, Japan.
| | - Takayuki Inami
- Institute of Physical Education, Keio University, Hiyoshi, Yokohama, Japan.
| | - Takuma Hoshiba
- Waseda Institute for Sport Sciences, Waseda University, Mikajima, Tokorozawashi, Saitama, Japan.
| | - Ayako Higashihara
- Institute of Physical Education, Keio University, Hiyoshi, Yokohama, Japan; Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
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21
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Matsui T, Kumai T, Shinohara Y, Kanzaki N, Noguchi K, Tanaka H, Sugimoto T, Yabiku H, Higashiyama I. A false-pouch closure technique with an intact superior peroneal retinaculum for recurrent dislocation of the peroneal tendon. J Exp Orthop 2021; 8:22. [PMID: 33738604 PMCID: PMC7973320 DOI: 10.1186/s40634-021-00343-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose To evaluate the usefulness of the false-pouch closure technique with an intact superior peroneal retinaculum (SPR). Methods From 2016 to 2020, 30 patients with recurrent dislocation of the peroneal tendon were treated with the current procedure. Clinical outcomes, including the time to resume running, the rate and time to return to sports, and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind Foot score, were evaluated preoperatively and at the last follow-up. Results The rate of return to the pre-injury level of sports activity was 93.3%, and the mean duration to return to running and sports was 8.0 ± 2.8 weeks (range: 3–12 weeks) and 14.4 ± 3.2 weeks (range: 10–24 weeks), respectively. The mean preoperative AOFAS score was 79.7 ± 9.6 points (range: 41–90), which improved significantly to 98.9 ± 3.2 (87–100) postoperatively (p < 0.01). Conclusion The false-pouch closure technique with suture tape and anchors had a reliable clinical outcome and can enable the early return of patients to their sports activities. Level of evidence IV, Case series
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Affiliation(s)
- Tomohiro Matsui
- Department of Orthopaedic Surgery, Saiseikai Nara Hospital, Nara, Japan
| | - Tsukasa Kumai
- Faculty of Sports Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa city, Saitama, Japan.
| | - Yasushi Shinohara
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Noriyuki Kanzaki
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koji Noguchi
- Department of Orthopaedic Surgery, Kurume University Medical Center, Kurume, Japan
| | - Hirofumi Tanaka
- Department of Orthopaedic Surgery, Hyakutake Orthopaedic & Sports Clinic, Saga, Japan
| | - Takeshi Sugimoto
- Department of Orthopaedic Surgery, Maki Orthopaedic Hospital, Osaka, Japan
| | - Hiroki Yabiku
- Faculty of Sports Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa city, Saitama, Japan
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22
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Murata K, Kumai T, Hirose N. Lateral Ankle Sprains and Their Association with Physical Function in Young Soccer Players. Open Access J Sports Med 2021; 12:1-10. [PMID: 33469390 PMCID: PMC7811480 DOI: 10.2147/oajsm.s283421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/03/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose Lateral ankle sprain (LAS) in childhood can result in lateral malleolus avulsion fractures; additionally, bone nonunion may occur. Physical maturity relates to the development of bone morphology and physical functionality. It is unknown how changes in physical functionality attributable to physical maturity affect young soccer players with abnormal lateral malleolus (ALM) morphology. Hence, the present study aimed to investigate the bone morphology of the lateral malleolus in young soccer players and to examine its relationship with physical functionality at different maturity levels. Subjects and Methods Two hundred and ninety young soccer players aged 6–15 years were included. The presence of ALM was assessed using ultrasonography. The subjects were allocated to three groups based on physical maturity (Pre-, Mid-, and Post-peak height velocity age [PHVA]). The prevalence of ALM and the relationship between ALM and physical maturity were examined for body composition, foot pressure distribution, foot alignment, ankle mobility, and single-leg balance. Results The prevalence of ALM was 17.6%. For physical maturity, the post-PHVA group showed a decrease in ankle dorsiflexion and eversion and an increase in one-leg hop distance compared to the Pre-PHVA group (P < 0.05). In the ALM group, the center of pressure during heel raising was distributed laterally in the Post-PHVA (P < 0.01), and the weight-bearing dorsiflexion angle was decreased in the Mid- and Post-PHVA (P < 0.05). Conclusion In the Post-PHVA young soccer players, decreased ankle dorsiflexion and eversion and increased one-leg hop distance were observed. The ALM group exhibited lateral loading during heel raising in the Post-PHVA group and decreased weight-bearing ankle dorsiflexion angle in the Mid- and Post-PHVA groups. The findings indicate the importance of secondary prevention of LAS and ultrasonography. Prospective studies of LAS in young athletes are required in the future.
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Affiliation(s)
- Kenichiro Murata
- Graduate School of Sport Sciences, Waseda University, Nishi-tokyo, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Hattori S, Onishi K, Yano Y, Kato Y, Ohuchi H, Hogan MV, Kumai T. Sonographically Guided Anchor Placement in Anterior Talofibular Ligament Repair Is Anatomic and Accurate. Orthop J Sports Med 2020; 8:2325967120967322. [PMID: 33354581 PMCID: PMC7734515 DOI: 10.1177/2325967120967322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/17/2020] [Indexed: 12/27/2022] Open
Abstract
Background Arthroscopic repair is a widely accepted surgical treatment for chronic ankle instability; however, recent studies have shown that arthroscopic repair is nonanatomic in its anchor placement and resultant biomechanics. Ultrasound may improve the accuracy of the anchor placement. Hypothesis Our hypothesis was that the accuracy of anchor placement in sonographically guided anterior talofibular ligament (ATFL) repair will be comparable with that in open ATFL repair. Study Design Cohort study; Level of evidence, 3. Methods The study included 26 patients who received surgical treatment between April 2012 and October 2019 for chronic ankle instability. Fifteen patients underwent open modified Broström repair and 11 underwent sonographically guided ATFL repair. The distance between the anchor hole and the fibular obscure tubercle was measured using 3-dimensional computed tomography and was compared between the operative procedures. For comparison, a noninferiority trial was employed, with open modified Broström repair as the reference surgery. The noninferiority margin was defined as 5 mm. Results The mean ± SD distance between the anchor and fibular obscure tubercle was 6.0 ± 2.7 mm in open repair and 5.6 ± 3.3 mm in sonographically guided repair. The mean difference in distance between the techniques (open repair - sonographically guided repair) was 0.37 mm (95% CI, -2.1 to 2.9 mm). The lower margin of the confidence interval was within the noninferiority margin (-5 to 5 mm). Conclusion Anchor placement under sonographically guided ATFL repair was equivalent to that of open ATFL repair and can be considered anatomic and accurate.
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Affiliation(s)
- Soichi Hattori
- Department of Sports Medicine, Kameda Medical Center, Kamogawa, Japan.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Foot and Ankle Injury Research Group, Division of Foot and Ankle Surgery, Department of Orthopedic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kentaro Onishi
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Orthopedic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yuji Yano
- Department of Sports Medicine, Kameda Medical Center, Kamogawa, Japan.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Foot and Ankle Injury Research Group, Division of Foot and Ankle Surgery, Department of Orthopedic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yuki Kato
- Department of Sports Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Hiroshi Ohuchi
- Department of Sports Medicine, Kameda Medical Center, Kamogawa, Japan
| | - MaCalus V Hogan
- Foot and Ankle Injury Research Group, Division of Foot and Ankle Surgery, Department of Orthopedic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Orthopedic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
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Kanzaki N, Chinzei N, Yamashita T, Kumai T, Kuroda R. A Novel Technique of Arthroscopic Ankle Lateral Ligament Repair Using a Knotless Suture Anchor. Orthop J Sports Med 2020; 8:2325967120962079. [PMID: 33225007 PMCID: PMC7658529 DOI: 10.1177/2325967120962079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 05/26/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Although arthroscopic lateral ligament repair (ALLR) with suture anchors for chronic lateral ankle instability has become widely accepted, some complications have been reported as well. Establishment of a new technique is essential for better clinical outcomes after ALLR. Purpose To report a novel technique and good clinical results of ALLR using a knotless suture anchor. Study Design: Case series; Level of evidence, 4. Methods: We examined 30 patients (16 men and 14 women) who underwent ALLR. The mean age of the patients was 30.0 years, and the average period of postoperative monitoring was 21 months. The Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale was used for clinical evaluation postoperatively, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) for patient-reported results. Surgical complications were also examined. Results: The JSSF ankle-hindfoot scale showed a significant improvement from preoperatively to follow-up (from 72.1 to 96.1; P < 0.001), and the SAFE-Q was significantly improved in all subscales (pain and pain-related, physical function and daily living, social function, shoe-related, and general health and well-being; P < 0.004 for all). Complications included residual joint pain due to remaining osteophytes in 1 case, scar pain of the accessory anterolateral portal in 2 cases, and positive Tinel sign indicative of superficial peroneal nerve irritation at the anterolateral portal in 1 case. Conclusion: The clinical results of the novel ALLR technique were overall satisfactory. Knot-related complications, one of the main reasons for postoperative complications, were reduced by using a knotless suture anchor.
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Affiliation(s)
- Noriyuki Kanzaki
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuaki Chinzei
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Kobe, Japan
| | - Takahiro Yamashita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tsukasa Kumai
- Faculty of Sports Sciences, WASEDA University, Saitama, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Oku K, Kawahara I, Sugioka T, Tanaka Y, Hoshiba T, Hirose N, Kumai T. Immediate effects of plantar vibration stimuli during static upright posture following total hip arthroplasty in females. Somatosens Mot Res 2020; 37:238-244. [PMID: 32597287 DOI: 10.1080/08990220.2020.1784129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Proprioceptive function of the lower limbs deteriorates in patients following total hip arthroplasty. Patients show poor balance and rely more on visual information than proprioceptive information. Plantar vibration stimuli can mechanically enhance somatosensory input from the plantar cutaneous mechanoreceptors, thereby improving static balance. Plantar vibration stimuli may improve static balance in patients after total hip arthroplasty. This is the first study to investigate whether plantar vibration stimuli affects static balance during the early phase following total hip arthroplasty. MATERIALS AND METHODS In this cross-over design study, 16 female patients (aged 65.1 ± 11.0 years) received plantar vibration stimuli for 2 minutes or the sham interventions after total hip arthroplasty in a randomized order on different days. The foot centre of pressure was measured for the total path length, mediolateral path length, and anteroposterior path length directions before and immediately after the interventions in the static standing position both with eyes open and closed. Patients were instructed to minimize body sway when standing. RESULTS A significant increase was observed in the centre of pressure parameters in the eyes closed condition than in the eyes open condition. The centre of pressure parameters for the eyes closed condition was significantly decreased after vibration interventions than that before intervention. CONCLUSIONS This study supports the view that plantar vibration stimuli can change static balance in patients in the early phase after total hip arthroplasty temporarily by up-weighting sensory information. These stimuli may serve as a treatment option for influencing balance following total hip arthroplasty.
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Affiliation(s)
- Kosuke Oku
- Nara Medical University Graduate School, Kashihara, Nara, Japan.,Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Isao Kawahara
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Nara, Japan.,Department of Molecular Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Tatsuya Sugioka
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Nara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Takuma Hoshiba
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan.,Department of Sports Medicine, Nara Medical University, Kashihara, Nara, Japan
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Fukano M, Fukubayashi T, Kumai T. In vivo talocrural and subtalar kinematics during the stance phase of walking in individuals with repetitive ankle sprains. J Biomech 2020; 101:109651. [DOI: 10.1016/j.jbiomech.2020.109651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 01/25/2023]
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Mae T, Nakata K, Kumai T, Ishibashi Y, Suzuki T, Sakamoto T, Ohori T, Hirose T, Yoshikawa H. Characteristics of ultrasound device: a new technology for bone curettage and excavation. J Exp Orthop 2019; 6:35. [PMID: 31346807 PMCID: PMC6658631 DOI: 10.1186/s40634-019-0203-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/03/2019] [Indexed: 01/19/2023] Open
Abstract
Background Ultrasonic (US) devices are used in laparoscopic, dental, and spinal surgeries, while it is difficult to use for the joint under irrigation and perfusion solutions due to lack of power. A new US device is developed with greater voltage improvement and has been implemented in the arthroscopic field. The aim is to compare the characteristics of the US devices with the conventional ones in water. Methods Twenty bone blocks from the porcine femur were settled in a holder in water. A 4.0 mm diameter abrader burr moved 15 mm along the long axis of the bone block in ten blocks for three times. A 4.3 mm wide curette blade powered by ultrasonic vibration was moved in the same manner in the other ten blocks. The gutter shape, including the gutter depth and the bottom angle of the gutter, and the curetted area ratio of the gutter were assessed. Forty bones blocks from the porcine femurs were clamped with a holder in water, while the cortical bone surface must be located on the side. A 5 mm diameter drill excavated the bone along the previously-inserted guide wire to the 15 mm depth for twenty blocks. Next, the US excavation probe of 5x4mm rectangular shape was moved to the same depth in the other twenty blocks. Each ten block was cut in half along the bone tunnel and was assessed the surface roughness at three area, while the cross-sectional area (CSA) of the tunnel were measured and the ratio of the measured CSA was calculated based on an expected CSA in the remaining ten blocks for each device. Results The depth of curettage and bottom angle were significantly smaller with the US device than with the abrader burr at all planes, while the curetted area ratio created by each device was mostly equal to the other. Surface roughness was similar in two evacuating devices except one area. CSA ratio with the US excavation device was significantly smaller than that with the drill. Conclusion US curettage has an advantage to flatly curette bone surfaces, while a bone tunnel can be accurately created with the US device.
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Affiliation(s)
- Tatsuo Mae
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Ken Nakata
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Tsukasa Kumai
- Faculty of Sports Sciences, Waseda University, Japan. 2-579-15, Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirsosaki University Graduate School of Medicine, Japan. 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Tomoyuki Suzuki
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Japan. S1-W6, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Takamitsu Sakamoto
- Orthopedic Products Department, OLYMPUS CORPORATION, Japan. 2951, Ishikawa-cho, Hachioji, Tokyo, 192-8507, Japan
| | - Tomoki Ohori
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Takehito Hirose
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
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Ohara K, Tanaka Y, Taniguchi A, Kurokawa H, Kumai T, Yamada H. Is metatarsus primus elevatus truly observed in hallux rigidus? Radiographic study using mapping methods. J Orthop Sci 2019; 24:312-319. [PMID: 30279135 DOI: 10.1016/j.jos.2018.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/27/2018] [Accepted: 09/02/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hallux rigidus and metatarsus primus elevatus (MPE) are associated, but their causal relationship remains unknown. Several surgical approaches for treating hallux rigidus are available. We evaluated morphological characteristics of hallux rigidus with different grades to determine the optimal surgical approach. The amount of degenerative change in the metatarsophalangeal joint on the preoperative roentgenograms was graded on a scale of 1-3. We analyzed the morphology of hallux rigidus using X-ray image mapping developed by our team. METHODS This study involved weight-bearing, dorsoplantar, and lateral foot X-rays of 36 feet from 26 patients underwent surgery for hallux rigidus (Group R) at our institution, and 26 normal feet (Group N). A two-dimensional coordinate system was used to analyze the sharps of these feet by converting each dot on the radiographs into X and Y coordinates. Diagrams of the feet from each group were drawn for comparison. Feet with grades 2 (Group R2) and 3 (Group R3) hallux rigidus and normal feet were compared by Kruskal-Wallis test. RESULTS Mapping revealed that the tip of distal phalanges of the second, and third toes in Group R medially shifted (P < 0.05) in dorsoplantar image of the feet, and that the medial point, a part of the talus, navicular, cuneiform, and first metatarsal bone in Group R, shifted lower (P < 0.05) in lateral feet images of the feet. Multiple comparisons revealed a significant navicular bone depression in grade 3 hallux rigidus compared with normal feet. A significant difference was observed between Group N and R3 but not between Group R2 and N or R3. CONCLUSIONS X-ray morphological analysis of the foot revealed MPE in Group R. Elevation gradually increased as hallux rigidus grade worsened. Therefore, osteotomy combined with cheilectomy, whereby the first metatarsal bone can be tilted toward the plantar side, are useful for treating a higher-grade hallux rigidus. LEVEL OF EVIDENCE Level III, comparative study.
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Affiliation(s)
- Kuniji Ohara
- Takagi Hospital, Department of Orthopaedic Surgery, Nagoya, Aichi, 4670806, Japan; Nara Medical University, Department of Orthopaedic Surgery, Kashihara, Nara, 6348522, Japan.
| | - Yasuhito Tanaka
- Nara Medical University, Department of Orthopaedic Surgery, Kashihara, Nara, 6348522, Japan
| | - Akira Taniguchi
- Nara Medical University, Department of Orthopaedic Surgery, Kashihara, Nara, 6348522, Japan
| | - Hiroaki Kurokawa
- Nara Medical University, Department of Orthopaedic Surgery, Kashihara, Nara, 6348522, Japan
| | - Tsukasa Kumai
- Nara Medical University, Department of Orthopaedic Surgery, Kashihara, Nara, 6348522, Japan
| | - Harumoto Yamada
- Fujita Health University, Department of Orthopaedic Surgery, Toyoake, Aichi, 4701192, Japan
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Matsui T, Kumai T, Tanaka Y. Recurrent Dislocation of the Tibialis Posterior Tendon Treated With Suture Tape: A Case Report of an Innovative Operative Procedure. J Foot Ankle Surg 2019; 57:1267-1271. [PMID: 30007514 DOI: 10.1053/j.jfas.2018.03.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Indexed: 02/03/2023]
Abstract
Dislocation of the tibialis posterior tendon (PTT) is a rare traumatic injury, and treatment is often delayed. Conservative treatment is ineffective for recurrent dislocation of the PTT; however, a reference standard procedure has not yet been established. In the present case report, we describe an innovative pseudo-pouch closing procedure with suture tape and a suture anchor for recurrent PTT dislocation. The patient returned to preoperative levels of activity at 21 weeks postoperatively and was asymptomatic at the 1-year follow-up examination.
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Affiliation(s)
- Tomohiro Matsui
- Surgeon, Department of Orthopedic Surgery, Saiseikai Nara Hospital, Nara City, Japan
| | - Tsukasa Kumai
- Professor, Faculty of Sport Sciences, Waseda University, Tokyo, Japan.
| | - Yasuhito Tanaka
- Professor, Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
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Abstract
BACKGROUND While ankle arthrodesis is a common treatment for severe ankle osteoarthritis, performing bilateral ankle arthrodesis is controversial because of associated problems, such as severe gait abnormality and bilateral loss of talocrural joint motion. Furthermore, few reports exist regarding the detailed outcomes of bilateral ankle arthrodesis. Therefore, we aimed to compare the outcomes of bilateral ankle arthrodesis with those of unilateral ankle arthrodesis, using both subjective and objective assessments. METHODS The data from 20 patients (10 each in the bilateral and unilateral groups), who underwent arthrodesis between 2005 and 2015, were retrospectively reviewed. The minimum follow-up duration was 2 years. Radiographic outcomes were assessed using radiographs and computed tomography. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) scale and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). RESULTS With the numbers available, no significant group differences were observed for any of the patient characteristics or postoperative range of motion. Mean JSSF scale scores significantly improved in both groups ( P < .001); however, scores on the SAFE-Q subscale for "social functioning" were significantly lower in the bilateral group compared to the unilateral group ( P = .049). CONCLUSIONS Within the limitations of the current study design, bilateral ankle arthrodesis did not appear to be inferior to unilateral ankle arthrodesis, with the possible exception of social functioning ability. Thus, bilateral ankle arthrodesis can be considered a viable treatment option. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- Yuji Maenohara
- 1 Department of Orthopedic Surgery, Nara Medical University, Kashihara-shi, Nara, Japan.,2 Department of Orthopedic Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Bunkyo-ku, Japan
| | - Akira Taniguchi
- 1 Department of Orthopedic Surgery, Nara Medical University, Kashihara-shi, Nara, Japan
| | - Kiyonori Tomiwa
- 1 Department of Orthopedic Surgery, Nara Medical University, Kashihara-shi, Nara, Japan
| | - Daisuke Tsuboyama
- 1 Department of Orthopedic Surgery, Nara Medical University, Kashihara-shi, Nara, Japan.,3 Department of Orthopedic Surgery, Dokkyo Medical University, Mibu, Japan
| | - Hiroaki Kurokawa
- 1 Department of Orthopedic Surgery, Nara Medical University, Kashihara-shi, Nara, Japan
| | - Tsukasa Kumai
- 4 Department of Sports Medicine, Nara Medical University, Kashiharah, Nara, Japan
| | - Sakae Tanaka
- 2 Department of Orthopedic Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Bunkyo-ku, Japan
| | - Yasuhito Tanaka
- 1 Department of Orthopedic Surgery, Nara Medical University, Kashihara-shi, Nara, Japan
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Kumai T, Samoto N, Hasegawa A, Noguchi H, Shiranita A, Shiraishi M, Ikeda S, Sugimoto K, Tanaka Y, Takakura Y. Short-term efficacy and safety of hyaluronic acid injection for plantar fasciopathy. Knee Surg Sports Traumatol Arthrosc 2018; 26:903-911. [PMID: 28255655 DOI: 10.1007/s00167-017-4467-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 02/06/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Plantar fasciopathy is the most common cause of plantar heel pain and is considered to be a type of enthesopathy. The short-term efficacy, safety, and dose-response relationship of high-molecular-weight hyaluronic acid (HA) was investigated in patients with plantar fasciopathy. METHODS In this multicenter, prospective, randomized, double-blind, placebo-controlled trial, 168 patients with persistent pain from plantar fasciopathy for more than 12 weeks were randomly assigned to receive 2.5 mL of 1% HA (H-HA), 0.8 mL of 1% HA (L-HA), or 2.5 mL of 0.01% HA (control group) once a week for 5 weeks. The primary endpoint was improvement in visual analogue scale (VAS) score for pain from baseline to week 5. RESULTS The VAS scores (least squares mean ± standard error) in each group decreased gradually after the start of treatment, a change of -3.3 ± 0.3 cm for the H-HA group, -2.6 ± 0.3 cm for the L-HA group, and -2.4 ± 0.3 cm for the control group, with the H-HA group improving significantly more than the control group (P = 0.029). No serious adverse events were reported. There was no difference between the groups in the incidence rates of adverse drug reactions. CONCLUSION The administration of five injections of high-molecular-weight HA is an effective treatment with no serious adverse drug reactions and is a conservative treatment option for plantar fasciopathy. This treatment contributed to alleviation of pain in patients with plantar fasciopathy and improvement in their activities of daily living. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Tsukasa Kumai
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
| | - Norihiro Samoto
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Atsushi Hasegawa
- Agatsuma Higashi Orthopaedic Clinic, 756-1, Isemachi, Nakanojo-machi Agatsuma-gun, Gumma, 377-0423, Japan
| | - Hideo Noguchi
- Ishii Orthopaedic and Rehabilitation Clinic, 1089-1, Shimo-Oshi, Gyoda-shi, Saitama, 361-0037, Japan
| | - Atsushi Shiranita
- Shiranita Orthopaedic Clinic, 1-6-13, Shiragane, Kokurakita-ku Kitakyushu-shi, Fukuoka, 802-0074, Japan
| | - Masaharu Shiraishi
- Shiraishi Orthopaedic Pain Clinic, 5-41-16, Nakakasai, Edogawa-ku, Tokyo, 134-0083, Japan
| | - Satoshi Ikeda
- Department of Orthopaedic Surgery, Ken-Ai Memorial Hospital, 1191, Kimori, Onga-cho, Onga-gun, Fukuoka, 811-4313, Japan
| | - Kazuya Sugimoto
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Yoshinori Takakura
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
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Abstract
Background: Studies comparing the types and severity of trauma and injuries caused by different types of field surfaces have been conducted. However, there have been no studies on sports injuries caused by temporal deterioration of long-pile artificial turf fields and related decreases in the rubber chip and silica sand infill. Purpose: To investigate the influence of an artificial turf field on sports injuries in a university soccer team. Study Design: Descriptive epidemiological study. Methods: A total of 397 male soccer players who were members of a single university soccer team were surveyed over a 12-year period, from April 2003 to March 2015. During this period, the team played for 4 years on a soil field (2003-2006) and 8 years on artificial turf (2007-2014). We analyzed the effect of changes in the artificial turf on the incidence rate of sports injuries (injury rate per 1000 athlete-exposures). We calculated the incidence rate of injuries sustained by the team and compared the results for each year of the study. Results: After conversion of the field to artificial turf, there was a significant increase in the incidence of upper extremity trauma (P < .05). There was a significant increase in lower extremity sprains from 2007 to 2008, 1 year after the conversion from soil to artificial turf (P < .05). Analysis of the incidence of lower extremity muscle strain indicated that although the injury rate increased progressively, it decreased significantly after the insertion of additional rubber chips in 2014 (P < .05). Conclusion: After conversion to artificial turf, there was a significant increase in the incidence of upper extremity trauma. After the refurbishing with additional rubber chips, the incidence of lower extremity muscle strain significantly declined. When analyzing measures that could prevent sports injuries related to soccer, it is necessary to take into consideration the changes that occur to the artificial turf over time.
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Affiliation(s)
- Kohei Fujitaka
- Nara Medical University Graduate School, Kashihara Nara, Japan
| | - Akira Taniguchi
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara Nara, Japan
| | - Tsukasa Kumai
- Department of Sports Medicine, Nara Medical University, Kashihara Nara, Japan
| | | | - Mamoru Okubo
- Department of Orthopaedic Surgery, Kishima Hon-in Hospital, Osaka, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara Nara, Japan
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Kamijo S, Kumai T, Tanaka S, Mano T, Tanaka Y. Comparison of compressive forces caused by various cannulated cancellous screws used in arthroscopic ankle arthrodesis. J Orthop Surg Res 2017; 12:7. [PMID: 28095870 PMCID: PMC5240347 DOI: 10.1186/s13018-016-0503-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 10/16/2016] [Indexed: 11/10/2022] Open
Abstract
Background When performing arthroscopic ankle arthrodesis for end-stage ankle arthritis, internal fixation is performed using bone screws after appropriate preparation. However, optimal characteristics of bone screws have not been examined in terms of pressure force. Objective comparisons of bone-screw performance may provide information on procedures for arthroscopic ankle arthrodesis. The study objectives were to determine whether it was possible to measure compressive force changes using the newly developed device and to infer all screw characteristics from measurement results when used in actual surgeries. In addition, we performed experiments on cadavers to verify whether the experimental results could be applied to the joints of living subjects. Methods Three types of screws (S1, S2, and S3) were inserted into the unique measurement device, and the changes in pressure were measured for each 45° turn. Changes in pressure and maximum pressure force were recorded after the application of the screws. After reaching the maximum pressure in the simulated bone, further screw rotations were accompanied by a gradual pressure decrease to 0 MPa. We also measured pressure changes in a similar manner by inserting a miniature pressure sensor into the talocrural joints of cadavers. Results The mean maximum pressure ± standard deviation for S1, S2, and S3 were 0.832 ± 0.164 MPa, 0.434 ± 0.116 MPa, and 0.414 ± 0.127 MPa, respectively. Pressure slopes to the maximum did not significantly differ between the screws in the simulated bone, and a subsequent pressure decrease to 0 MPa was significantly more rapid for S1 than for S2 and S3. Although pressure failure after the overtightening of screws was only observed in the simulated bone, patterns of pressure vs. rotation angle were similar in simulated and cadaveric bones. The pressure profile characteristics of three different screw types were determined. Conclusions We were able to measure the compressive force changes using the newly developed device when the screws were inserted. On the basis of the measurement results, we were able to infer the characteristics of all screws when used in actual surgery.
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Affiliation(s)
- Satoshi Kamijo
- Department of Orthopaedic Surgery, Fujimori Hospital, Matsumoto, Nagano Pref., 390-0811, Japan.,Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
| | - Tsukasa Kumai
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan. .,Department of Sports Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara, 634-8522, Japan.
| | - Shogo Tanaka
- Industrial Research Institute of Shizuoka Prefecture, Aoi-ku, Shizuoka City, 421-1298, Japan
| | - Tsuyoshi Mano
- Industrial Research Institute of Shizuoka Prefecture, Aoi-ku, Shizuoka City, 421-1298, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
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Sugimoto K, Kumai T, Kurokawa H, Isomoto S, Tanaka Y, Fujitaka K, Taniguchi A. Pathogenesis of Fifth Metatarsal Stress Fractures in College Soccer Players. Foot & Ankle Orthopaedics 2016. [DOI: 10.1177/2473011416s00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Category: Sports Introduction/Purpose: The pathogenesis of fifth metatarsal stress fractures remains uncertain. We hypothesized that physical characteristics and environmental factors, which have received limited attention in the literature thus far, might be involved in the development of such fractures. To test our hypothesis, we performed a medical checkup and a survey of the living environment of athletes in college soccer teams, and subsequently, we investigated the existence of fifth metatarsal stress fractures, and examined the differences between the injury group and the non-injury group. Methods: The survey and measurements were conducted in 273 male athletes from the same college soccer team between 2005 and 2013. A medical checkup, comprising assessment of stature, body weight, body mass index, arch height ratio, toe-grip strength, quadriceps angle, leg-heel angle, functional reach test, one-leg standing time with eyes closed, straight leg raise test, finger-floor distance, heel-to-buttock distance, ankle joint range of motion, and general joint laxity test, and a questionnaire survey were performed once a year. A survey was conducted at the time of injury that resulted in fifth metatarsal stress fractures. The study participants were separated into an injury group and a non-injury group, depending on whether they had a fifth metatarsal stress fracture. The measurement items and survey items were compared, and the association between the presence or absence of injury and the measurement items was analyzed. Results: Toe-grip strength was significantly weaker in the injury group, compared with the non-injury group, suggesting that a weak toe-grip is associated with fifth metatarsal stress fracture (p < 0.05). In addition, injury on the non-dominant leg was more frequent in the fifth metatarsal stress fracture injury group (p < 0.05). Between-group comparisons of the other items showed no statistically significant differences. Conclusion: The association between weak toe-grip strength and fifth metatarsal fracture suggests that a weak toe-grip may lead to an increase in the load applied onto the lateral side of the foot; this may cause mechanical stress on the bone. In addition, the effect of the non-dominant leg on the fifth metatarsal bone may need to be studied further.
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Fujitaka K, Taniguchi A, Isomoto S, Samoto N, Sugimoto K, Kumai T, Tanaka Y. Morphological Characteristics Of The Foot With Jones Fracture. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485117.85547.af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Shinohara Y, Tanaka M, Yokoi K, Kumai T, Tanaka Y. Arthroscopic Resection of Symptomatic Ossicle of the Medial Malleolus: A Case Report. J Foot Ankle Surg 2016; 55:1302-1306. [PMID: 26860047 DOI: 10.1053/j.jfas.2015.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Indexed: 02/03/2023]
Abstract
An ossicle around the medial malleolus is difficult to differentiate from an unfused ossification center, an avulsion fracture, and os subtibiale. Misdiagnosis can lead to inappropriate or unnecessary treatments. We describe a patient with a symptomatic ossicle of the medial malleolus in the left ankle that prevented participation in sports activities because of medial ankle pain. Plain radiography and computed tomography revealed a small ossicle associated with the anterior colliculus of the medial malleolus. Conservative treatment failed, and the patient underwent ankle arthroscopy. Instability of the ossicle was identified after the hypertrophic inflammatory synovium had been debrided. The ossicle was resected in a step-by-step manner with an arthroscopic shaver and grasper through the anteromedial accessary portal. The deltoid ligament sustained minimal damage after resection. The patient fully recovered and was able to return to sports activities 3 months after surgery. Arthroscopic resection of the ossicle at the medial malleolus requires no additional treatments of the deltoid ligament, effectively relieves symptoms, and enables the patient to return to full preinjury activities.
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Affiliation(s)
- Yasushi Shinohara
- College of Sports and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan.
| | - Masato Tanaka
- Department of Orthopaedic Surgery, Okanami General Hospital, Iga, Mie, Japan
| | - Kazuyuki Yokoi
- Department of Orthopaedic Surgery, Okanami General Hospital, Iga, Mie, Japan
| | - Tsukasa Kumai
- Department of Sports Medicine, Nara Medical University, Kashihara, Nara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan
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Abstract
Background: The pathogenesis of fifth metatarsal stress fractures remains uncertain. Hypothesis: Physical characteristics and environmental factors, which have received limited attention in the literature thus far, might be involved in the development of fifth metatarsal stress fractures. Study Design: Case-control study; Level of evidence, 3. Methods: To test the study hypothesis, a medical examination and survey of the living environment of collegiate soccer players was conducted and correlated with the existence of fifth metatarsal stress fractures. The survey and measurements were conducted in 273 male athletes from the same college soccer team between 2005 and 2013. A medical examination comprising assessment of stature, body weight, body mass index, foot–arch height ratio, toe-grip strength, quadriceps angle, leg-heel angle, functional reach test, single-leg standing time with eyes closed, straight-leg raise angle, finger-floor distance, heel-buttock distance, ankle joint range of motion, and a general joint laxity test were performed once a year, along with a questionnaire survey. The survey was also repeated when a fifth metatarsal stress fracture was diagnosed. The study participants were separated into a fifth metatarsal stress fracture injury group and a noninjury group. The measurement items and survey items were compared, and the association between the factors and the presence or absence of injuries was analyzed. Results: Toe-grip strength was significantly weaker in the injury group compared with the noninjury group, suggesting that weak toe-grip is associated with fifth metatarsal stress fracture (P < .05). In addition, fifth metatarsal stress fractures were more common in the nondominant leg (P < .05). Between-group comparisons of the other items showed no statistically significant differences. Conclusion: The association between weak toe-grip strength and fifth metatarsal fracture suggests that weak toe-grip may lead to an increase in the load applied onto the lateral side of the foot, resulting in stress fracture. The finding of stress fracture being more common in the nondominant leg needs further study.
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Affiliation(s)
- Kohei Fujitaka
- Nara Medical University, Graduate School, Kashihara Nara, Japan
| | - Akira Taniguchi
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara Nara, Japan
| | | | - Tsukasa Kumai
- Department of Sports Medicine, Nara Medical University, Kashihara Nara, Japan
| | | | - Mamoru Okubo
- Department of Orthopaedic Surgery, Kishima Hon-in Hospital, Osaka, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara Nara, Japan
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Taniguchi A, Takakura Y, Tanaka Y, Kurokawa H, Tomiwa K, Matsuda T, Kumai T, Sugimoto K. An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus. J Bone Joint Surg Am 2015; 97:1348-53. [PMID: 26290086 DOI: 10.2106/jbjs.n.01272] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Treatment of osteonecrosis of the talus is challenging. Total talar replacement has the potential to restore the function of the ankle joint without an associated leg-length discrepancy. The purpose of the present study was to investigate postoperative function and pain after total talar replacement in patients with osteonecrosis of the talus. METHODS Fifty-five ankles in fifty-one consecutive patients with osteonecrosis of the talus who were treated with a total talar replacement from 2005 to 2012 were included in the investigation. Scores according to the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and the Ankle Osteoarthritis Scale (AOS) were assessed before surgery and at the final follow-up evaluation. RESULTS According to the JSSF ankle-hindfoot scale, the score for pain improved from a mean (and standard deviation) of 15 ± 9.4 points (range, 0 to 20 points) to 34 ± 5.6 points (range, 20 to 40 points); the score for function, from 21.2 ± 9.7 points (range, 4 to 38 points) to 45.1 ± 4.0 points (range, 37 to 50 points); the score for alignment, from 6.0 ± 2.8 points (range, 5 to 10 points) to 9.8 ± 0.9 points (range, 5 to 10 points); and the total score, from 43.1 ± 17.0 points (range, 11 to 68 points) to 89.4 ± 8.4 points (range, 76 to 100 points). According to the AOS scale, the score for "pain at its worst" improved from a mean of 6.1 ± 3.3 points (range, 0 to 9.9 points) to 2.0 ± 1.7 points (range, 0 to 6.3 points). CONCLUSIONS Prosthetic talar replacement is a useful procedure for patients with osteonecrosis of the talus as it maintains ankle function.
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Affiliation(s)
- Akira Taniguchi
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi:
| | - Yoshinori Takakura
- Department of Orthopaedic Surgery, Nishi Nara Central Hospital, 1-15 Tsurumai Nishi-cho, Nara-shi, Nara 631-0022, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi:
| | - Hiroaki Kurokawa
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi:
| | - Kiyonori Tomiwa
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi:
| | - Takenori Matsuda
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi:
| | - Tsukasa Kumai
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi:
| | - Kazuya Sugimoto
- Department of Orthopaedic Surgery, Nara Prefecture General Medical Center, 1-30-1 Hiramatsu, Nara-shi, Nara 631-0846, Nara, Japan
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Abstract
BACKGROUND Hallux valgus foot with laterally deviated lesser toes is a complex condition to treat. Ignoring the laterally deviated lesser toes in hallux valgus might result in unsatisfactory foot shape. Without lateral support of the lesser toes, it might increase the risk of recurrence of hallux valgus. We sought to identify associated radiographic findings in patients where lesser toes follow the great toe in hallux valgus and deviate laterally. METHODS The weight-bearing, anteroposterior foot radiographs of 24 female hallux valgus feet with laterally deviated lesser toes (group L), 34 female hallux valgus feet with normal lesser toes (group H), and 43 normal female feet (group N) were selected for the study. A 2-dimensional coordinated system was used to analyze the shapes and angles of these feet by converting each dot made on the radiographs onto X and Y coordinates. Diagrams of the feet in each group were drawn for comparison. The hallux valgus angle, lateral deviation angle of the second toe, intermetatarsal angles, toe length, metatarsal length, and metatarsus adductus were calculated according to the coordinates of the corresponding points. RESULTS The mapping showed the bases of the second, third, and fourth toe in group L shifted laterally away from their corresponding metatarsal head (P < .001). The mean 2-3 intermetatarsal angles were: group L, H, N = 7.7 ± 2.6, 4.3 ± 1.9, 4.3 ± 1.3 degrees, respectively (P < .001); mean 3-4 intermetatarsal angles were, for groups L, H, N = 7.3 ± 2.3, 6.1 ± 2.1, 6.3 ± 1.4 degrees, respectively (P < .05). Larger hallux valgus angles (P < .001), more adducted first metatarsal (P < .05), and divergent lateral splaying of the lesser metatarsals (P < .001) were found in group L. CONCLUSION Larger 2-3 and 3-4 intermetatarsal angles, larger hallux valgus angle, more adducted first metatarsal, and divergent lateral splaying of the lesser metatarsals were associated with lateral deviation of the lesser toes in hallux valgus. LEVEL OF EVIDENCE Level III, comparative study.
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Affiliation(s)
- Li-Yi Roan
- Department of Orthopaedic Surgery, Yuan's General Hospital, Kaohsiung, Taiwan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Akira Taniguchi
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Kiyonori Tomiwa
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Tsukasa Kumai
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Yuh-Min Cheng
- Department of Orthopaedic Surgery, Pingtung Hospital, Pingtung, Taiwan
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Shinohara Y, Kumai T, Higashiyama I, Tanaka Y, Takakura Y, Nishi M, Azuma C, Minami T, Tohno Y. Differences in elements between intact and disrupted human ligamenta capitum femorum. Biol Trace Elem Res 2014; 160:161-8. [PMID: 24930779 DOI: 10.1007/s12011-014-0036-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 06/02/2014] [Indexed: 10/25/2022]
Abstract
To compare the element compositions between intact (i.e., intact throughout its length) and disrupted (i.e., ligament no longer attached to the attachment) ligaments, the contents of elements in the human ligamenta capitum femorum (LCF) were analyzed by inductively coupled plasma-atomic emission spectrometry. Histological and immunohistological assessments were also performed in both groups. The subjects were 8 men and 32 women. Trace element analyses showed that the sulfur and iron contents were significantly greater in the intact group than in the disrupted group, while the phosphorus and magnesium contents were significantly smaller in the intact group than in the disrupted group. The calcium and zinc contents were smaller in the intact group than in the disrupted group, with no significant differences. Histologically, there were fibrocartilage cells and extracellular matrix metachromasia in ligaments of the intact group. In contrast, fibrocartilage cells disappeared, and fat cells appeared instead of collagen fibrils in ligaments of the disrupted group. The LCFs of the intact group were immunohistologically positive for all components examined including collagens, glycosaminoglycans, and proteoglycans. The increase in sulfur suggested the presence of high glycosaminoglycan levels associated with fibrocartilaginous metaplasia in the ligament by compressive force. The reduction in iron may show a decreased number of blood vessels in the synovium after ligament disruption. The increases in phosphorus, magnesium, and calcium are indicative of degenerative changes including calcification and ossification. We conclude that differences in the contents of elements between intact and disrupted LCFs indicate degenerative alterations to the ligament structure after disruption.
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Affiliation(s)
- Yasushi Shinohara
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan,
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Kumai T, Muneta T, Tsuchiya A, Shiraishi M, Ishizaki Y, Sugimoto K, Samoto N, Isomoto S, Tanaka Y, Takakura Y. The short-term effect after a single injection of high-molecular-weight hyaluronic acid in patients with enthesopathies (lateral epicondylitis, patellar tendinopathy, insertional Achilles tendinopathy, and plantar fasciitis): a preliminary study. J Orthop Sci 2014; 19:603-11. [PMID: 24817495 DOI: 10.1007/s00776-014-0579-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 03/30/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Hyaluronic acid (HA) with a high molecular weight of 2700 kDa is approved in Japan to treat osteoarthritis of the knee, periarthritis scapulohumeralis, and knee pain associated with rheumatoid arthritis. The purpose of this preliminary study was to investigate the short-term efficacy, safety, and injectable volume of HA in the treatment of enthesopathies. METHODS A total of 61 patients (16 with lateral epicondylitis, 14 with patellar tendinopathy, 15 with insertional Achilles tendinopathy, and 16 with plantar fasciitis) were each administered a single injection of HA (up to 2.5 ml). Efficacy and safety were assessed by comparing the visual analog scale (VAS) for pain and local symptoms before injection (baseline) and at 1 week after injection. We also investigated the injectable volume by means of the difference in syringe weight before and after injection and by the judgment of the administering investigator. RESULTS The injection of HA resulted in a change in VAS (mean ± SD) of -2.20 ± 2.26 cm for the four sites overall and -2.55 ± 2.43 cm for lateral epicondylitis, -2.01 ± 2.16 cm for patellar tendinopathy, -1.80 ± 1.91 cm for insertional Achilles tendinopathy, and -2.38 ± 2.61 cm for plantar fasciitis. The injection of HA also improved local symptoms in each site. It was also determined that 2.5 ml of HA can be injected in each of the four sites. CONCLUSION A single injection of HA resulted in similar improvements of pain in each of the four enthesopathies (lateral epicondylitis, patellar tendinopathy, insertional Achilles tendinopathy, and plantar fasciitis). These results suggest that HA could be clinically effective in the treatment of enthesopathies.
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Affiliation(s)
- Tsukasa Kumai
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan,
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Hashiuchi T, Sakurai G, Takakura Y, Inoue K, Kumai T, Tanaka Y. Superficial blood flow of the superior labrum associated with rotator cuff tear using laser Doppler flowmeter. J Orthop Sci 2014; 19:424-8. [PMID: 24493204 DOI: 10.1007/s00776-014-0539-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 01/17/2014] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Superior labrum anterior and posterior (SLAP) lesions due to overuse by repeated pitching motion and trauma are often noted and usually. However, shoulder disorders with a chronic course are often accompanied by SLAP lesions. SLAP lesions are frequently observed during arthroscopic surgery of the shoulder joint for rotator cuff tear in middle-aged and elderly individuals, suggesting the involvement of factors other than pitching motion and traumatic events in the pathogenesis. We considered that blood flow in the labrum is altered. The purpose of this study was to clarify the superficial blood flow in the superior labrum during arthroscopic surgery of the rotator cuff tear and investigate whether it is altered with labrum injury. MATERIALS AND METHODS We evaluated 33 subjects with a mean age of 55.1 years who underwent arthroscopic surgery for partial or complete rotator cuff tears. The blood flow measurement site for the superior labrum was set at the supraglenoid tubercle attachment site, and blood flow was measured twice using laser Doppler flowmeter. The mean was calculated and compared among the normal labrum and type 1 SLAP lesions. RESULTS The morphology of the labrum was normal in 16 subjects, and 17 subjects had type 1 SLAP lesions. The mean blood flow was 1.75 ml/min/100 g in subjects with a normal labrum; however, in subjects with type 1 SLAP lesions, blood flow was 1.32 ml/min/100 g, showing significant differences (P < 0.01). CONCLUSION Superficial blood flow in the superior labrum of the shoulder with rotator cuff tear was measured using laser Doppler flowmetry. The blood flow in type 1 SLAP lesions was lower than that in the normal labrum.
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Affiliation(s)
- Tomohisa Hashiuchi
- Department of Orthopedics, Nishinara Central Hospital, 1-15 Tsurumainishimachi, Nara, 631-0022, Japan,
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Hayashi K, Kumai T, Tanaka Y. Endoscopic resection of a talocalcaneal coalition using a posteromedial approach. Arthrosc Tech 2013; 3:e39-43. [PMID: 24749021 PMCID: PMC3986476 DOI: 10.1016/j.eats.2013.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 08/14/2013] [Indexed: 02/03/2023] Open
Abstract
Resection is a standard surgical procedure for a talocalcaneal coalition (TCC). A posterior approach is the representative technique for hindfoot endoscopy, and there is only 1 report of endoscopic resection of TCC using this approach. Disadvantages of the posterior approach for TCC are as follows: (1) the indication is limited to posterior-facet coalition, (2) the flexor hallucis longus can be an obstacle in approaching the coalition, (3) the acute insertion angle between the endoscope and instrument reduces operability, and (4) a position change and additional skin incision are essential for conversion to an open procedure. In contrast, a posteromedial approach for TCC with established portals at the entrance and exit of the flexor retinaculum is a useful technique because (1) the indication is allow to middle- and posterior-facet coalitions, (2) increased perfusion pressure allows the creation of sufficient working space, (3) operating the instrument only at the coalition site decreases the risk of tendon injury and neurovascular damage, (4) the obtuse insertion angle between the endoscope and instrument improves operability, and (5) a position change and additional skin incision are unnecessary for conversion to an open procedure.
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Affiliation(s)
- Koji Hayashi
- Department of Orthopaedic Surgery and Rehabilitation, Otemae Hospital, Osaka, Japan,Address correspondence to Koji Hayashi, M.D., 1-5-34, Otemae, Chuo-ku, Osaka-shi, Osaka, 540-0008, Japan.
| | - Tsukasa Kumai
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
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Shinohara Y, Kumai T, Higashiyama I, Hayashi K, Matsuda T, Tanaka Y, Takakura Y. Histological and molecular characterization of the femoral attachment of the human ligamentum capitis femoris. Scand J Med Sci Sports 2013; 24:e245-53. [DOI: 10.1111/sms.12155] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Y. Shinohara
- Department of Orthopaedic Surgery; Nara Medical University; Nara Japan
| | - T. Kumai
- Department of Orthopaedic Surgery; Nara Medical University; Nara Japan
| | - I. Higashiyama
- Department of Orthopaedic Surgery; Nara Medical University; Nara Japan
| | - K. Hayashi
- Department of Orthopaedic Surgery; Nara Medical University; Nara Japan
| | - T. Matsuda
- Department of Orthopaedic Surgery; Nara Medical University; Nara Japan
| | - Y. Tanaka
- Department of Orthopaedic Surgery; Nara Medical University; Nara Japan
| | - Y. Takakura
- Department of Orthopaedic Surgery; Nara Medical University; Nara Japan
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Kumai T, Matsuda Y, Oikawa K, Aoki N, Kimura S, Harabuchi Y, Celis E, Kobayashi H. EGFR inhibitors augment antitumour helper T-cell responses of HER family-specific immunotherapy. Br J Cancer 2013; 109:2155-66. [PMID: 24045666 PMCID: PMC3798972 DOI: 10.1038/bjc.2013.577] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 08/23/2013] [Accepted: 08/28/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) is a major cause of cancer-related morbidity and mortality worldwide. Epidermal growth factor receptor (EGFR)-targeted therapy is an attractive strategy alternative to conventional cancer treatments for HNSCC, but its efficacy remains controversial. T-cell-based immunotherapy has been proposed as a novel therapeutic approach to improve the clinical outcome for HNSCC. In this study, we report human epidermal receptor (HER) family epitopes that induced CD4 T-cell responses to HNSCC. The results provide support for a novel strategy to treat HNSCC by combining EGFR-targeted therapy with T-cell-based immunotherapy. METHODS We evaluated the capacity of predicted CD4 T-cell peptide epitopes from EGFR to induce antitumour immune responses in vitro. In addition, EGFR inhibitors were evaluated for their ability to augment tumour MHC class II expression in HNSCC cell lines and subsequently increase T-cell recognition. RESULTS Among several predicted peptide epitopes, EGFR875-889 elicited CD4 T-cell responses that were restricted by HLA-DR4, DR15, or DR53 molecules, indicating that the peptide functions as a promiscuous T-cell epitope. The peptide-reactive T cells responded to autologous dendritic cells loaded with EGFR-expressing tumour cell lysates, indicating that these epitopes are naturally processed. In addition, the CD4 T cells were capable of directly recognising and killing HNSCC cells expressing EGFR and the appropriate HLA class II molecule. T cells reactive with the EGFR875-889 epitope could be detected in the blood of HNSCC patients. EGFR875-889-reactive CD4 T cells were also able to recognise several peptide analogues derived from homologous regions of EGFR family members, HER-2, HER-3 and c-MET. Finally, we examined the effects of EGFR tyrosine kinase inhibition or EGFR-blocking antibodies on CD4 T-cell tumour reactivity. Treatment of tumour cells with the EGFR inhibitors enhanced tumour recognition by EGFR875-889-reactive T cells presumably due to the upregulation of HLA-DR expression in the HNSCC cells. CONCLUSION We identified novel CD4 T-cell EGFR epitopes and amongst these, EGFR875-889 functions as a promiscuous helper T-cell epitope that can elicit effective antitumour T-cell responses against tumours expressing HER family members and c-MET. These observations should facilitate the translation of T-cell-based immunotherapy into the clinic for the treatment of HNSCC and provide a rational basis for EGFR inhibition, immune-targeted combination therapy.
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Affiliation(s)
- T Kumai
- 1] Department of Pathology, Asahikawa Medical University, Asahikawa, Japan [2] Department of Otolaryngology, Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
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Matsumoto N, Kumai T, Isomoto S, Shinohara Y, Tanaka Y, Azuma C, Minami T, Tohno Y. Regional differences in elements of human peroneus longus tendons. Biol Trace Elem Res 2013; 154:185-9. [PMID: 23812651 DOI: 10.1007/s12011-013-9735-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
Abstract
Many studies have been performed on the structure, molecular composition, and biochemical properties of tendons. However, comparatively little research has been conducted on the content of various trace elements within tendons. Six elements were analyzed in four regions of the peroneus longus tendon: the tensional part of the tendon immediately proximal to the lateral malleolus (region A), the compressive region of the tendon in contact with the lateral malleolus (region B), the compressive region of the tendon in contact with the deep surface of the cuboid (region C), and the tensional part of the tendon between the cuboid and first metatarsal, to which the tendon is attached (region D). Regions B and C are wraparound regions. The calcium content was higher in region C (2.10 ± 0.93 mg/g) than in both regions A (1.25 ± 0.51 mg/g) and D (1.43 ± 0.41 mg/g) (p < 0.05), indicating that it is likely related to regional differences in cartilage degeneration. The phosphorus content was also higher in region C, possibly because of low alkaline phosphatase activity in this region. The sulfur content was higher in the wraparound regions (region B: 0.98 ± 0.09 mg/g, region C: 1.24 ± 0.19 mg/g) than in both regions A (0.83 ± 0.11 mg/g) and D (0.83 ± 0.1 mg/g) (p < 0.01); sulfur content is thought to be influenced by tendon-bone compression. Finally, the magnesium content in the wraparound regions was also higher, which is probably related to a higher level of fibrocartilage. No significant relationships were found with regard to zinc or iron. Overall, the findings of the present study indicate that element contents are related to function and anatomical differences in tendons, and that they may even vary within the same tendon.
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Affiliation(s)
- Norikazu Matsumoto
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan.
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Hashiuchi T, Sakurai G, Sawai K, Komei T, Shimaya M, Takakura Y, Kumai T, Tanaka Y. Ultrasound-guided arthroscope insertion and decompression of a supraspinous fossa cyst. J Med Ultrason (2001) 2013; 40:475-81. [PMID: 27277465 DOI: 10.1007/s10396-013-0452-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 03/29/2013] [Indexed: 12/01/2022]
Abstract
A cyst arising in the scapular supraspinous fossa may cause shoulder pain; subsequently, enlargement of the cyst may result in severe compression of the adjacent suprascapular nerve, leading to muscle weakness and sensory disorder. Decompression of the nerve through cyst removal is effective in resolving these symptoms. However, treatment can also be performed less invasively through arthroscopy. Insertion of an arthroscope without visual guidance could cause tissue damage and, consequently, would become an invasive procedure itself. The use of ultrasonography to guide the scope to the cyst decreases the invasiveness of the procedure. Here, we present the case of a patient with a cyst arising in the scapular supraspinous fossa, in whom we could relatively readily and safely observe the cyst by advancing an arthroscope under ultrasonographic guidance. The suprascapular nerve was decompressed via cyst removal.
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Affiliation(s)
- Tomohisa Hashiuchi
- Department of Orthopaedic Surgery, Nishinara Central Hospital, 5-2-6 Hyakurakuen, Nara City, 631-0024, Japan.
| | - Goro Sakurai
- Department of Orthopaedic Surgery, Nishinara Central Hospital, 5-2-6 Hyakurakuen, Nara City, 631-0024, Japan
| | - Koichi Sawai
- Department of Orthopaedic Surgery, Nishinara Central Hospital, 5-2-6 Hyakurakuen, Nara City, 631-0024, Japan
| | - Tatsuya Komei
- Department of Orthopaedic Surgery, Nishinara Central Hospital, 5-2-6 Hyakurakuen, Nara City, 631-0024, Japan
| | - Masataka Shimaya
- Department of Orthopaedic Surgery, Nishinara Central Hospital, 5-2-6 Hyakurakuen, Nara City, 631-0024, Japan
| | - Yoshinori Takakura
- Department of Orthopaedic Surgery, Nishinara Central Hospital, 5-2-6 Hyakurakuen, Nara City, 631-0024, Japan
| | - Tsukasa Kumai
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
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Taniguchi A, Takakura Y, Sugimoto K, Hayashi K, Ouchi K, Kumai T, Tanaka Y. The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus. ACTA ACUST UNITED AC 2013; 94:1529-33. [PMID: 23109634 DOI: 10.1302/0301-620x.94b11.29543] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The purpose of this study was to evaluate the clinical results of a newly designed prosthesis to replace the body of the talus in patients with aseptic necrosis. Between 1999 and 2006, 22 tali in 22 patients were replaced with a ceramic prosthesis. A total of eight patients were treated with the first-generation prosthesis, incorporating a peg to fix into the retained neck and head of the talus, and the remaining 14 were treated with the second-generation prosthesis, which does not have the peg. The clinical results were assessed by the American Orthopaedic Foot and Ankle Society ankle/hindfoot scale. The mean follow-up was 98 months (18 to 174). The clinical results of the first-generation prostheses were excellent in three patients, good in one, fair in three and poor in one. There were, however, radiological signs of loosening, prompting a change in design. The clinical results of the second-generation prostheses were excellent in three patients, good in five, fair in four and poor in two, with more favourable radiological appearances. Revision was required using a total talar implant in four patients, two in each group. Although the second-generation prosthesis produced better results, we cannot recommend the use of a talar body prosthesis. We now recommend the use of a total talar implant in these patients.
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Affiliation(s)
- A Taniguchi
- Nara Medical University, Department of Orthopaedic Surgery, 840 Shijyo-cho, Kashihara Chity, Nara 634-8522, Japan.
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Tsukamoto S, Tanaka Y, Matsuda T, Shinohara Y, Taniguchi A, Kumai T, Tomiwa K, Tanaka I, Shima M, Yoshioka A. Arthroscopic ankle arthrodesis for hemophilic arthropathy: two cases report. Foot (Edinb) 2011; 21:103-5. [PMID: 21295463 DOI: 10.1016/j.foot.2011.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 12/25/2010] [Accepted: 01/05/2011] [Indexed: 02/04/2023]
Abstract
In the second decade of life, the ankle joint can be considered as the most common site for haemophilic arthropathy. To the best of our knowledge, no detailed reports have been published regarding arthroscopic ankle arthrodesis with haemophilic arthropathy. The aim of this paper is to report the outcomes of arthroscopic ankle arthrodesis in haemophilic arthropathy of the hindfoot. We performed three arthroscopic ankle arthrodeses in two patients. Case 1 was a 26-year-old man and case 2 was a 25-year-old man. The follow-up periods ranged from 2 year and 4 months to 6 years and one month. Union was obtained in all three ankles. All the arthroscopic ankle arthrodeses stopped or significantly reduced recurrent joint bleeding. With our procedure, we achieved pain relief and walking ability improvement. The mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale scores were 39 (range: 32-52) points preoperatively and 80 (range: 74-92) points postoperatively. Our cases achieved high satisfaction levels with pain relief and minimal complications for arthroscopic ankle arthrodesis, and case 2 who originally underwent arthroscopic arthrodesis of the left ankle demanded the same operation for his right ankle. We consider that arthroscopic ankle arthrodesis is an effective technique for haemophilic arthropathy.
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Affiliation(s)
- Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara 634-8521, Japan.
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