43 results on '"Keiji Tensho"'
Search Results
2. Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Suture Augmentation
- Author
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Tomoya Iwaasa, Keiji Tensho, Tsuneari Takahashi, Suguru Koyama, Hiroki Shimodaira, Hiroshi Horiuchi, and Jun Takahashi
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Orthopedics and Sports Medicine - Published
- 2023
3. Anatomical implications of the subvastus approach on major vascular injury during a distal femoral osteotomy: a computed tomographic venography study
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Keiji Tensho, Daiki Kumaki, Tomoya Iwaasa, Suguru Koyama, Hiroki Shimodaira, Shota Ikegami, Hiroshi Horiuchi, Yoshinori Tsukahara, and Jun Takahashi
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Orthopedics and Sports Medicine ,Surgery - Abstract
This study evaluated major vascular injury risk in distal femoral osteotomy (DFO) via the subvastus approach and examined the relationship between the posterior border of the vastus medialis (VM) and the superficial femoral artery (SFA) and vein (SFV).Eighty limbs from 80 patients were evaluated using lower extremity computed tomographic venography. The positional relationship between the VM, SFA, and SFV was evaluated by measuring the angle between each structure and the horizontal reference point (VMA: VM angle, FAA (femoral arterial angle), FVA (femoral venous angle) and the distance between VM and the SFA and SFV (VMAD: VM-arterial distance, VMVD: VM-venous distance) in each axial slice (0/10/20/30/40 mm) proximal to the level of the superior patellar margin. The proximity of the posterior border of the VM and the SFA/SFV as a vertical distance, measured between the slice of the superior border of the patella and the slice where the posterior border of the VM contacted the SFA was evaluated. Single and multiple regression analyses were performed using the vertical distance as the objective variable.As the slice shifted proximally, the VMA significantly increased (24.9 ± 8.5, 36.3 ± 8.8, 47.4 ± 11.8, 59.9 ± 14, 70.3 ± 13.7 degrees, respectively, p 0.001 between all slices) and moved posteromedially from a medial direction. FAA (94.2 ± 7, 86.9 ± 9.2, 78.4 ± 9.7, 71.4 ± 9.8, 66.6 ± 10.5 degree, respectively, p 0.001 between all slices) and FVA (100.6 ± 4.9, 98.3 ± 5.9, 93.7 ± 7.5, 88 ± 9.2, 81.1 ± 10.5 degrees, respectively, p 0.001 between all slices) decreased and moved from a posterolateral to a posteromedial direction, while VMAD (35.4 ± 7.8, 24.1 ± 7.3, 14.3 ± 6, 8.4 ± 7, 6.2 ± 6.3 mm, respectively, p 0.001 between all slices) and VMVD significantly decreased (42.7 ± 7.3, 32 ± 7.4, 22.4 ± 6.8, 14.5 ± 10.6, 8.7 ± 7.1 mm, respectively, p 0.001 between all slices). The average vertical distance was 36 ± 9.3 mm (range 18.6-61.5 mm). The body height and the patellar length significantly affected the vertical distance.The posterior border of the VM shifted posteromedially from distal to proximal and contacted the SFA at an average of 36 mm from the suprapatellar border. Surgeons should be aware of the risk of major vascular injury during exposure and osteotomy.Case series, Level IV.
- Published
- 2022
4. Clinical outcome of a new remnant augmentation technique with anatomical double-bundle anterior cruciate ligament reconstruction: Comparison among remnant preservation, resection, and absent groups
- Author
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Hiroshi Horiuchi, Keiji Tensho, Hiroki Shimodaira, Suguru Koyama, Tomoya Iwaasa, Jun Takahashi, and Naoto Saito
- Subjects
medicine.medical_specialty ,Anterior cruciate ligament reconstruction ,Anterior cruciate ligament ,medicine.medical_treatment ,Physical Therapy, Sports Therapy and Rehabilitation ,Augmentation ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Double bundle ,Remnant ,medicine ,Orthopedics and Sports Medicine ,Anterior stability ,030222 orthopedics ,Lysholm Knee Score ,business.industry ,ACL ,Rehabilitation ,030229 sport sciences ,Preservation ,Surgery ,ACL reconstruction ,medicine.anatomical_structure ,Remnant preservation ,Sports medicine ,Multiple linear regression analysis ,Original Article ,Tegner Activity Scale ,business ,RC1200-1245 - Abstract
Purpose The aim of this study was to verify the effects of a new remnant augmentation technique with anatomical double-bundle anterior cruciate ligament (ACL) reconstruction for postoperative clinical scores, anterior stability and frequency of complications compared to remnant removal and cases with remnant defects. Methods The 105 patients who underwent anatomical double-bundle ACL reconstruction were divided into three groups. If the remnant was a Crain I-III type, remnant-preserving bone tunnel creation was attempted. After the creation of the bone tunnel, good continuity was maintained in 34 patients (preserved group). Due to lost continuity, the remnant was resected in 26 patients (resected group). No identifiable remnant continuity remained (Crain IV) in 45 patients (absent group). The Lysholm knee score, Tegner activity scale, International Knee Documentation Committee (IKDC) subjective score, anterior stability measured using the KT-1000 arthrometer at 2 years postoperatively, and frequency of complications were compared among the three groups. Univariate and multiple linear regression analysis were performed to clarify the factors affecting postoperative anterior stability. Results The Lysholm knee score, Tegner activity scale, IKDC subjective score, and frequency of complications were not significantly different among the groups. The mean side-to-side difference of anterior stability was significantly better in the preserved group (0.3 ± 1.6 mm) compared to the resected group (1.6 ± 2.3 mm, p = 0.003) and absent group (1.6 mm ± 1.7, p = 0.009). The multiple linear regression analysis showed remnant preservation significantly related to postoperative anterior stability. Conclusion Although there were no differences in clinical scores, the ACL reconstruction with new preservation technique showed good anterior stability and no difference in the frequency of complications.
- Published
- 2021
5. Macroscopic and microscopic findings of multi-folded hamstring grafts of anatomical double-bundle ACL reconstruction 13 years after surgery
- Author
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Daiki Kumaki, Keiji Tensho, Mai Iwaya, Tomoya Iwaasa, Kazushige Yoshida, Suguru Koyama, Hiroki Shimodaira, Hiroshi Horiuchi, and Jun Takahashi
- Subjects
Orthopedics and Sports Medicine ,Surgery - Abstract
A 49-year-old woman underwent anatomic double-bundle anterior cruciate ligament reconstruction using a hamstring tendon. Due to knee osteoarthritis progression, total knee arthroplasty was performed 13 years after the surgery. The anteromedial (AM) bundle was composed partly of tendon-like tissue and partly of scar-like tissue. In the tendon-like part of the AM bundle, the collagen fibers were slightly loose and showed a low-frequency crimp structure with an ovoid cell shape. In contrast, the collagen arrangement in the scar-like part was irregular, edematous, and sparsely cell-dense, with an ovoid cell shape. The posterolateral bundles were generally composed of spindle-shaped cells, and the collagen was arranged in tight cohesion and had well-demarcated bundles with normal crimping. Within the tibial tunnel, the graft was mainly connected to the surrounding lamellar bone on the posterior sides, with sparser connections on the anterior and medial/lateral side. The findings of this long-term case provide valuable information to enable understanding of multiple-folded hamstring tendons.Level of evidence V.
- Published
- 2022
6. Effect of a new remnant-preserving technique with anatomical double-bundle anterior cruciate ligament reconstruction on MRI-based graft maturity: a comparison cohort study
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Hiroki Shimodaira, Keiji Tensho, Suguru Koyama, Tomoya Iwaasa, Daiki Kumaki, Kazushige Yoshida, Hiroshi Horiuchi, and Jun Takahashi
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Orthopedics and Sports Medicine ,Surgery - Abstract
To investigate the effects of a new remnant-preserving double-bundle anterior cruciate ligament reconstruction (ACLR) technique, focused on avoiding remnant damage and preserving continuity of remnants, on graft maturity using magnetic resonance imaging (MRI).A total of 169 patients were divided into three groups: 41 in the preservation group, 70 in the resection group, and 58 in the absent group. In the preservation group, rather than passing the graft through the remnant tissue, the graft was reconstructed such that the anteromedial and posterolateral bundles sandwiched the remnant to avoid damage to the remnant and maintain its continuity. Based on 1-year postoperative MRI, the grafts were divided into three regions: distal, middle, and proximal. The signal/noise quotient (SNQ) of each region of interest was calculated to evaluate the signal intensity of the graft and was compared among the three groups. Additionally, to identify factors influencing graft maturity, a multiple regression analysis was performed with SNQ as the dependent variable and patient demographics, bone morphology, and surgical factors as independent variables.In a three-group comparison of mean SNQs, the distal region was 3.3 ± 3.4, 8.9 ± 8.3, and 9.0 ± 8.6 (p 0.001), the middle region was 5.3 ± 3.7, 10.9 ± 11.1, and 11.3 ± 10.2 (p 0.001), and the proximal region was 6.8 ± 4.5, 11.1 ± 8.8, and 11.7 ± 10.8 (p = 0.017), in order of the preservation, resection, and absent groups, respectively. That indicated that the remnant-preserving ACLR was more hypointense than ACLR with remnant resection or absent in all three regions. Multiple regression analysis showed that remnant preservation remained the relevant factor affecting SNQ of the graft at the distal and middle levels.The new remnant-preserving anatomic double-bundle ACLR had significantly better graft maturity, measured by SNQ on MRI, than the remnant resection and absent groups. The remnant procedure was the relevant factor affecting graft maturity.Level III.
- Published
- 2022
7. Simultaneous Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament Reconstructions Using an Artificial Ligament for Lateral Patella Instability
- Author
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Hiroki Shimodaira, Keiji Tensho, Suguru Koyama, Tomoya Iwaasa, Daiki Kumaki, Hiroshi Horiuchi, and Jun Takahashi
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Orthopedics and Sports Medicine - Abstract
Recent studies on the detailed anatomy of the medial patellar stabilizer have revealed that the medial patellofemoral ligament (MPFL) not only attaches to the patella but also has fibers that attach to the quadriceps muscle, known as the medial quadriceps tendon femoral ligament (MQTFL). Reconstruction of the medial stabilizer for patellar dislocation that includes both the MPFL and MQTFL may achieve better anatomical and physiological correction. In this Technical Note, we will describe a simultaneous reconstruction technique of the MPFL and MQTFL for patellar dislocation using an artificial ligament.
- Published
- 2021
8. A new remnant preservation technique reduces bone tunnel enlargement after anatomic double-bundle anterior cruciate ligament reconstruction
- Author
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Suguru Koyama, Keiji Tensho, Hiroki Shimodaira, Tomoya Iwaasa, Daiki Kumaki, Hiroshi Horiuchi, Naoto Saito, and Jun Takahashi
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Anterior Cruciate Ligament Reconstruction ,Knee Joint ,Tibia ,Anterior Cruciate Ligament Injuries ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Femur ,Tomography, X-Ray Computed - Abstract
To investigate the effect of a new remnant preservation technique with a focus on remnant continuity on postoperative femoral and tibial tunnel enlargement after anatomical double-bundle anterior cruciate ligament reconstruction (ACLR).A total of 150 knees were divided into three groups: Preservation Group (Group P: 49 knees), wherein the remnant continuity remained after tunnel creation; Resection Group (Group R: 47 knees), wherein the remaining remnant was resected, and Absent Group (Group A: 54 knees), wherein the remnant had no femoral attachment before tunnel creation. In Group P, the remnant maintained continuity, and the anteromedial (AM) and posterolateral (PL) bundles were positioned anterior and posterior to the remnant, respectively. Computed tomographic scans were performed at 1 week and 1 year after surgery, and the cross-sectional area of each tunnel aperture was measured. Tunnel enlargement was compared among the three groups by one-way analysis of variance (ANOVA) and the Bonferroni test. Univariate and multivariate logistic analyses were performed to identify the risk factors for tunnel enlargement in demographic and radiographic data.For femoral AM tunnels, the tunnel enlargement of Group P was significantly smaller than Groups R and A (p 0.001), femoral PL (p 0.001 vs. R and A), tibial AM (p 0.001 vs. R, 0.002 vs. A), and tibial PL (p 0.001 vs. R, 0.002 vs. A). There was no significant difference between Groups R and A. Multivariate logistic analysis showed that remnant preservation was a significant factor in reducing tunnel enlargement in the femoral AM, femoral PL, tibial AM, and tibial PL.The new remnant-preserving anatomical double-bundle ACLR, which preserves the continuity of the remnant, prevented all bone tunnel enlargement at 1 year postoperatively.Level III.
- Published
- 2021
9. A Case of Prefemoral Fat Pad Impingement Syndrome Caused by Hyperplastic Fat Pad
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Hiroyuki Kato, Suguru Koyama, Hiroki Shimodaira, Keiji Tensho, Hiroshi Horiuchi, Naoto Saito, and Tomoya Iwaasa
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030222 orthopedics ,medicine.medical_specialty ,Mri imaging ,business.industry ,Anterior knee pain ,Impingement syndrome ,Adipose tissue ,Case Report ,Patellofemoral joint ,General Medicine ,Hyperplasia ,medicine.disease ,Fat pad ,030218 nuclear medicine & medical imaging ,Conservative treatment ,lcsh:RD701-811 ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Orthopedic surgery ,medicine ,Radiology ,business - Abstract
Case. We report a rare case of prefemoral fat pad impingement syndrome that was caused by a hyperplasia of the normal suprapatellar fat pad. Pain and catching were observed in the proximal-lateral patellofemoral joint, and MRI imaging confirmed a hyperplasic mass in the same area. Although conservative treatment showed no signs of improvement, symptoms improved after an arthroscopic excision of the mass. Conclusion. Prefemoral fat pad impingement syndrome is related to patellar motion and should be considered as one of the underlying causes of anterior knee pain (AKP). Surgeons should recognize that a small hyperplasia composed of normal adipose tissue can cause AKP.
- Published
- 2018
10. Bone Bruises of the Ankle and Mid-foot Often Associate with Ankle Sprain
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Hidefumi Koiwai, Mikio Kamimura, Akira Taguchi, Keiji Tensho, Yukio Nakamura, and Jun Takahashi
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human activities - Abstract
Background: Ankle sprains are one of the most common musculoskeletal injuries. However, they may be more serious than commonly believed since many patients reportedly experience chronic problems afterwards. It is necessary to improve the treatment, such as the method and duration of fixation, of sprained ankles.Methods: Magnetic resonance imaging of 70 patients with acute moderate or advanced ankle sprains presenting consecutively between November 2014 and December 2019 were reviewed for analysis of bone bruising associated with ankle sprains. The patients were treated conservatively with a solid splint or cast until walking pain could be resolved without external fixation. In cases with pain at the time of weight bearing after solid fixation, crutches were prescribed for pain relief. The fixation period ranged from 8 days to 72 days (mean: 29.5 days). Afterwards, 54.0% of patients had walking pain and required the use of crutches. The ankle joint pain disappeared after conservative treatment in all patients.Results: The incidence of bone bruises detected by magnetic resonance imaging in the ankle and midfoot associated with ankle sprain was 81.4%. Bone bruises of the midfoot, including the tarsal bone and Chopart joint, were found in 34.3% of ankle sprains. Bone bruises of the talus were the most common, being present in 60% of ankle sprains. Bone bruises were also evident in the tibia (44.3%), the calcaneus (21.4%), and the tarsal bone (25.7%). There was a significant association between bone bruises of the talocrural joint surface and use of the crutches after fixation (P=0.041). Multiple regression analysis adjusted for age and gender revealed that bone bruises of the talocrural joint surface of the talus was a significant independent predictor of crutch use (P=0.045), with an odds ratio (95% confidence interval) of 3.03 (1.03-8.94).Conclusion: Bone bruises of the ankle and midfoot are often present in ankle sprains. In moderate or advanced cases of ankle sprain, external solid fixation of both the ankle and midfoot should be performed. In cases with pain at weight bearing following solid fixation, crutches are advised for pain relief and proper ligament and bone healing.
- Published
- 2020
11. Potential risk of medial cortex perforation due to peg position of morphometric tibial component in unicompartmental knee arthroplasty: a computer simulation study
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Hiroki Shimodaira, Suguru Koyama, Naoto Saito, Tomoya Iwaasa, Jun Takahashi, Keiji Tensho, and Hiroshi Horiuchi
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musculoskeletal diseases ,Male ,medicine.medical_specialty ,Knee Joint ,Medial cortex ,medicine.medical_treatment ,Perforation (oil well) ,Osteotomy ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Computer Simulation ,Unicompartmental knee arthroplasty ,Arthroplasty, Replacement, Knee ,Retrospective Studies ,Orthodontics ,030222 orthopedics ,biology ,Tibia ,business.industry ,Tibial tray ,030229 sport sciences ,Osteoarthritis, Knee ,musculoskeletal system ,biology.organism_classification ,Valgus ,Orthopedic surgery ,Surgery ,Female ,Implant ,business ,Knee Prosthesis - Abstract
The purpose of this study is to evaluate the risk of medial tibial cortical perforation in unicompartmental knee arthroplasty (UKA) due to peg positions on the tibial tray of the Persona Partial Knee (PPK). Preoperative CT images of 60 patients and 60 osteoarthritic knees (30 male and 30 female patients) were used. A tibial multiplanar reconstruction (MPR) image was reconstructed in preoperative planning software, and the implant was placed in a virtual osteotomy plane. In addition to PPK, Zimmer Unicompartmental Knee (ZUK) and TRIBRID (TBD) were used for evaluation. The horizontal distances from the medial tibial cortex to the anterior and posterior pegs (APCD/PPCD, respectively) were measured under neutral, 3-degree varus, 3-degree valgus and 2 mm distal positions. The differences between implants under the same positions and between positions using the same implants were compared. The percentage of total cases with APCD/PPCD of less than 3 mm and the perforation risk rate were calculated. The APCD of PPK was significantly shorter at all positions except for the varus position of TBD. The PPCD of PPK was significantly shorter at all positions compared to ZUK and TBD. There were no cases with an APCD of less than 3 mm. Except for varus positions, the perforation risk rate of PPCD was significantly higher for PPK than the other two implants. The posterior pegs of the PPK are located more medially than the other two implants, which may result in perforation of the medial tibial cortex during implantation. Surgeons should consider the risk involved in the type of implant used.
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- 2020
12. Plica syndrome after medial patellofemoral ligament reconstruction: a case report
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Hiroshi Horiuchi, Naoto Saito, Hiroki Shimodaira, Suguru Koyama, Keiji Tensho, Tomoya Iwaasa, and Jun Takahashi
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medicine.medical_specialty ,arthroscopic resection of plica ,medicine.diagnostic_test ,business.industry ,Recurrent patellar dislocation ,Postoperative pain ,Arthroscopy ,Case Report ,complication ,Medial patellofemoral ligament ,medicine.disease ,Asymptomatic ,medial patellofemoral ligament reconstruction ,Surgery ,medicine.anatomical_structure ,Medicine ,Patella ,plica syndrome ,medicine.symptom ,Complication ,business ,Plica syndrome ,postoperative pain - Abstract
A 16-year-old female with a history of left recurrent patellar dislocation underwent medial patellofemoral ligament (MPFL) reconstruction surgery. Two months postoperatively, the patient presented with medial patellar pain. Left medial plica syndrome was suspected, and we performed a partial arthroscopic resection of the medial synovial plica. The symptom gradually improved after surgery. To the best of our knowledge, there are no reports that discuss the relationship between postoperative pain of MPFL reconstruction and synovial plica as found in this case report. Surgeons should be aware of the possibility that asymptomatic synovial plica could become symptomatic.
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- 2020
13. Postoperative change in patellofemoral alignment following closing-wedge distal femoral osteotomy performed for valgus osteoarthritic knees
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Hiroshi Nakayama, Ryo Kanto, Keiji Tensho, Shinichi Yoshiya, Yusuke Akaoka, and Tomoya Iseki
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musculoskeletal diseases ,Osteoarthritis of the knee ,medicine.medical_specialty ,Radiography ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Orthopedic surgery ,medicine ,Valgus deformity ,Orthopedics and Sports Medicine ,Distal femoral osteotomy ,Closing wedge ,Patellar height ,Orthodontics ,030222 orthopedics ,biology ,business.industry ,030229 sport sciences ,musculoskeletal system ,medicine.disease ,biology.organism_classification ,Sagittal plane ,Patellofemoral joint congruity ,lcsh:RD701-811 ,Valgus ,Medial closed distal femoral osteotomy (DFO) ,medicine.anatomical_structure ,Orthopedic surgery ,Surgery ,Plain radiographs ,business ,human activities ,Research Article - Abstract
Purpose To evaluate the postoperative change in patellar position after medial closed distal femoral osteotomy (DFO) performed for valgus osteoarthritic knees. Methods The study included 21 consecutive knees in 20 patients undergoing DFO. A minimum of 2-year follow-up data was obtained for all subjects with a mean follow-up period of 42 months (range 31–59 months). The patellar position was evaluated on plain radiographs preoperatively, 1-year postoperatively, and 2-year postoperatively. For patellar height, the modified Insall–Salvati Index (mISI), modified Caton–Deschamps Index (mCDI) and modified Blackburne–Peel Index (mBPI) were measured on the standing lateral radiographs. Patellofemoral alignment on the axial plane was assessed on skyline views with 30° flexion based on the measurements for lateral patellar tilt (LPT) and lateral patellar shift (LPS). Measured values at pre- and postoperative phases were statistically compared using a two-way analysis of variance. Results All indices including mISI, mCDI, mBPI, LPT and LPS showed no statistically significant postoperative changes. Conclusion Medial closed-wedge DFO performed for valgus osteoarthritic knees did not significantly influence patellofemoral alignment either on the sagittal or axial plane. Therefore, to highlight the clinical relevance of our findings, medial closed-wedge DFO for the valgus knee does not adversely affect the patellofemoral joint. Level of evidence Level IV, case series.
- Published
- 2020
14. Tibial Tunnel Positioning Technique Using Bony/Anatomical Landmarks in Anatomical Anterior Cruciate Ligament Reconstruction
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Hiroyuki Kato, Yusuke Akaoka, Hiroki Shimodaira, Naoto Saito, Seiji Takanashi, and Keiji Tensho
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Orthopedic surgery ,030222 orthopedics ,medicine.medical_specialty ,Anterior cruciate ligament reconstruction ,business.industry ,Tibial tunnel ,Anterior cruciate ligament ,medicine.medical_treatment ,Technical note ,030229 sport sciences ,Anatomy ,musculoskeletal system ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Technical Note ,medicine ,Orthopedics and Sports Medicine ,business ,RD701-811 - Abstract
Because various biomechanical studies and clinical results have shown the effectiveness of an anatomical approach for anterior cruciate ligament (ACL) reconstruction, this approach has become gradually commonplace to improve postoperative performance. Standard tunnel positioning methods with accuracy, reproducibility, and adaptability to varied concepts are essential for the success of anatomical ACL reconstruction. However, there were no standard tibial tunnel positioning methods to satisfy these conditions. This technical note reports our tibial tunnel positioning technique using bony and/or anatomical landmarks for anatomical ACL reconstruction.
- Published
- 2017
15. The interrelationship between anterior cruciate ligament tibial footprint and anterolateral meniscal root insertions: Quantitative, morphological and positional analyses using three-dimensional computed tomography images
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Hiroshi Horiuchi, Tomoya Iwaasa, Kazushige Yoshida, Nanae Fukushima, Hiroki Shimodaira, Hiroyuki Kato, Keiji Tensho, Naoto Saito, and Suguru Koyama
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Male ,Knee Joint ,Anterior cruciate ligament ,Computed tomography ,Menisci, Tibial ,Footprint ,03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,medicine ,Cadaver ,Humans ,Orthopedics and Sports Medicine ,Anterior Cruciate Ligament ,Aged ,Aged, 80 and over ,030222 orthopedics ,medicine.diagnostic_test ,Anterior Cruciate Ligament Reconstruction ,Tibia ,business.industry ,Significant difference ,030229 sport sciences ,Anatomy ,Middle Aged ,musculoskeletal system ,medicine.anatomical_structure ,Female ,business ,Cadaveric spasm ,Tomography, X-Ray Computed - Abstract
The purpose of this study was to evaluate quantitative, morphological and positional differences between the anterior cruciate ligament (ACL) tibial footprint and anterolateral meniscal root (ALMR) insertion and investigate an intraoperative landmark to estimate their boundaries.Thirty-three fixed human cadaveric knees were evaluated. After resecting the components, the anterior fiber (AF) and posterior fiber (PF) of ALMR, the tibial center of ACL bundles (anteromedial (AM) and posterolateral (PL) bundles) and ACL were marked. Insertion morphology was classified into three categories, and the distance and relative positional relationship between AF/PF insertions and the center of each attachment were measured on three-dimensional computed tomography images.There was no significant difference between the AF of AM and ACL (P = 0.16), but both were significantly shorter than the AF of PL (both P 0.001). There was no significant difference between the PF of ACL and PL (P = 0.99), which were significantly shorter than PF of AM (both P 0.001). Morphology of the ACL tibial insertion was classified as follows: triangular, 15 knees (45.5%); oval, 18 knees (54.5%); none, C-shape. Quantitative and positional analyses showed that the AF insertion was significantly closer to AM and ACL centers in the oval type than in the triangular type. Excluding two cases, the AF/PF insertion was located laterally to the ML center of the medial and lateral intercondylar tubercles.Proximity of ACL tibial footprint and ALMR varies by their footprint morphology. The medial and lateral intercondylar tubercles were useful landmarks for ALMR injury prevention.
- Published
- 2019
16. Remnant-Preserving Tibial Tunnel Positioning Using Anatomic Landmarks in Double-Bundle Anterior Cruciate Ligament Reconstruction
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Keiji Tensho, Seiji Takanashi, Hiroyuki Kato, Naoto Saito, Hiroki Shimodaira, and Yusuke Akaoka
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Adult ,Male ,Adolescent ,Knee Joint ,Anterior cruciate ligament reconstruction ,Anterior cruciate ligament ,medicine.medical_treatment ,Arthroscopy ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Double bundle ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Tibia ,Retrospective Studies ,Lateral meniscus ,030222 orthopedics ,Anterior Cruciate Ligament Reconstruction ,medicine.diagnostic_test ,business.industry ,Tibial tunnel ,Videotape Recording ,030229 sport sciences ,Anatomy ,Middle Aged ,Dissection ,medicine.anatomical_structure ,Female ,Anatomic Landmarks ,business - Abstract
Purpose To assess (1) if 6 anatomic landmarks (ALs) could be arthroscopically confirmed with remnant preservation and (2) if creating tibial tunnels using these landmarks reduces individual variation and improves reproducibility in double-bundle anterior cruciate ligament (ACL) reconstruction. Methods We retrospectively reviewed data of patients who chronologically underwent double-bundle ACL reconstruction by either referencing the footprint after remnant dissection (non-AL group) or subsequently with the ALs (AL group). Using operative videos, 3 independent observers judged whether they could confirm 6 ALs (medial intercondylar ridge, medial and lateral intercondylar tubercles, anterior horn of lateral meniscus, Parsons' knob, and L-shaped ridge) in 20 patients randomly selected from the AL group. We then compared tunnel positions between the 2 groups, measured from the anterior and medial borders of the proximal tibia and expressed as percentage of the total depth and width of the proximal tibia using 3-dimensional computed tomography. Results One hundred four patients (non-AL group, n = 54; AL group, n = 50) were included. All 6 ALs were arthroscopically confirmed in most cases (89.7% to 100%). The mean percentages of the anteroposterior (AP) depth for anteromedial (AM) tunnel, mediolateral (ML) width for AM tunnel, AP depth for posterolateral (PL) tunnel, and ML width for PL tunnel, respectively, were 27.8% ± 6.6%, 46.7% ± 2.8%, 41.4% ± 7.3%, and 46.1% ± 2.6% for the non-AL group and 30.7% ± 4.5%, 45.7% ± 2.2%, 45.2% ± 4.5%, and 46.9% ± 2.1% for the AL group, revealing significantly less variation in the AL group compared with the non-AL group, excluding the ML width of the PL tunnel ( P = .007, .046, .002, .209, respectively). Conclusions Six landmarks could be reliably confirmed in cases with remnant preservation, and creating tibial tunnels using these landmarks were reproducible and resulted in less individual variation. Level of Evidence Level III, retrospective comparative study.
- Published
- 2016
17. Aperture elongation of the femoral tunnel on the lateral cortex in anatomical double-bundle anterior cruciate ligament reconstruction using the outside-in technique
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Tomoya Iwaasa, Keiji Tensho, Hiroki Shimodaira, Suguru Koyama, Yusuke Akaoka, Naoto Saito, and Hiroshi Horiuchi
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Adult ,Male ,Adolescent ,Anterior cruciate ligament reconstruction ,Aperture ,Anterior cruciate ligament ,medicine.medical_treatment ,Observational Study ,outside-in technique ,03 medical and health sciences ,elliptical elongation of aperture ,0302 clinical medicine ,femoral lateral cortex ,suspension device ,Cortex (anatomy) ,medicine ,Humans ,Femur ,030212 general & internal medicine ,Retrospective Studies ,Fixation (histology) ,Anterior Cruciate Ligament Reconstruction ,business.industry ,anterior cruciate ligament ,General Medicine ,Anatomy ,Middle Aged ,Elongation factor ,Cross-Sectional Studies ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Elongation ,business ,Research Article - Abstract
In anatomical anterior cruciate ligament reconstruction surgery using the outside-in technique, the aperture of the femoral lateral cortex may become elliptical. Retrospective cross-sectional study To evaluate the extent of elliptical eccentricity in lateral apertures relative to aperture positioning and clinical failure rate in anatomical anterior cruciate ligament double-bundle reconstruction using outside-in technique. In 75 patients, the aperture elongation factor was defined as the ratio of the major axis of the elliptical aperture to the drill size. Using the lateral epicondyle as a reference point, the lateral femur was divided into sections by distance and angle, and the minimum area was evaluated to assess the relationship between the elongation factor and aperture position of the lateral cortex for each bundle. The incidence and associated clinical performance regarding cortical button migration were also investigated. Aperture elongation factors were 120.2 ± 13.3% and 120.0 ± 16.3% on the anteromedial (AM) and posterolateral (PL) sides, respectively. Femoral tunnel elongation was smallest when the entry point axis were both between 30 to 60° and distance was between 10 to 20 mm and 0 to 10 mm on the AM and PL sides, respectively. During the postoperative follow-up period, intra-tunnel migration was confirmed in 4 of 75 cases (5.3%). Fixation failure neither affected clinical scores nor knee laxity. Areas of minimum elongation for each bundle on both AM and PL sides were found anteroproximally to the lateral epicondyle and positioned near each other. Elongation did not directly affect the clinical outcome. Level of evidence grade: prognostic level III
- Published
- 2020
18. Lateralization of the Tibial Tubercle in Recurrent Patellar Dislocation: Verification Using Multiple Methods to Evaluate the Tibial Tubercle
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Hiroyuki Kato, Shota Ikegami, Keiji Tensho, Daisuke Hatanaka, Suguru Koyama, Naoto Saito, Hiroki Shimodaira, and Yusuke Akaoka
- Subjects
Male ,Torsion Abnormality ,Tubercle ,Recurrent patellar dislocation ,Patellar Dislocation ,Multiple methods ,Lateralization of brain function ,Cruciate ligament ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Recurrence ,medicine ,Cutoff ,Humans ,Orthopedics and Sports Medicine ,Retrospective Studies ,030222 orthopedics ,Receiver operating characteristic ,Tibia ,business.industry ,Area under the curve ,030229 sport sciences ,General Medicine ,musculoskeletal system ,medicine.anatomical_structure ,Case-Control Studies ,Surgery ,Female ,Nuclear medicine ,business ,Tomography, X-Ray Computed - Abstract
Background The tibial tubercle deviation associated with recurrent patellar dislocation (RPD) has not been studied sufficiently. New methods of evaluation were used to verify the extent of tubercle deviation in a group with patellar dislocation compared with that in a control group, the frequency of patients who demonstrated a cutoff value indicating that tubercle transfer was warranted on the basis of the control group distribution, and the validity of these methods of evaluation for diagnosing RPD. Methods Sixty-six patients with a history of patellar dislocation (single in 19 [SPD group] and recurrent in 47 [RPD group]) and 66 age and sex-matched controls were analyzed with the use of computed tomography (CT). The tibial tubercle-posterior cruciate ligament (TT-PCL) distance, TT-PCL ratio, and tibial tubercle lateralization (TTL) in the SPD and RPD groups were compared with those in the control group. Cutoff values to warrant 10 mm of transfer were based on either the minimum or -2SD (2 standard deviations below the mean) value in the control group, and the prevalences of patients in the RPD group with measurements above these cutoff values were calculated. The area under the curve (AUC) in receiver operating characteristic (ROC) curve analysis was used to assess the effectiveness of the measurements as predictors of RPD. Results The mean TT-PCL distance, TT-PCL ratio, and TTL were all significantly greater in the RPD group than in the control group. The numbers of patients in the RPD group who satisfied the cutoff criteria when they were based on the minimum TT-PCL distance, TT-PCL ratio, and TTL in the control group were 11 (23%), 7 (15%), and 6 (13%), respectively. When the cutoff values were based on the -2SD values in the control group, the numbers of patients were 8 (17%), 6 (13%), and 0, respectively. The AUC of the ROC curve for TT-PCL distance, TT-PCL ratio, and TTL was 0.66, 0.72, and 0.72, respectively. Conclusions The extent of TTL in the RPD group was not substantial, and the percentages of patients for whom 10 mm of medial transfer was indicated were small. Level of evidence Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Published
- 2018
19. Intrameniscal Gouty Tophi in the Knee: A Case Report
- Author
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Keiji Tensho, Hiroyuki Kato, Seiji Takanashi, Tetsuhiro Aoki, Hisashi Shimojo, Naoto Saito, Hiroki Shimodaira, and Yusuke Akaoka
- Subjects
Lateral meniscus ,medicine.medical_specialty ,Knee arthroscopy ,medicine.diagnostic_test ,business.industry ,Arthritis ,Magnetic resonance imaging ,Recurrent acute ,Knee Joint ,medicine.disease ,Lesion ,medicine.anatomical_structure ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Arthroscopic synovectomy ,Radiology ,medicine.symptom ,business - Abstract
Case: We report a case of recurrent acute arthritis and restricted range of motion in the knee joint, with magnetic resonance imaging subsequently detecting a nodular lesion within the lateral meniscus. Knee arthroscopy and histology revealed that the lesion was intrameniscal gouty tophi. After arthroscopic synovectomy and excision of the tophi, the symptoms resolved and the patient remained symptom-free at two years of follow-up. Conclusion: Surgeons should be aware of the presence of such pathology and consider arthroscopic surgery if the mechanical symptoms persist.
- Published
- 2017
20. Standing Versus Supine Radiographs to Evaluate Femoral Head Penetration in the Polyethylene Liner After Total Hip Arthroplasty
- Author
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Keiji Tensho, Masaaki Maruyama, Shinji Wakabayashi, and Kenji Hisa
- Subjects
Adult ,Male ,Ceramics ,medicine.medical_specialty ,Supine position ,Conventional polyethylene ,Arthroplasty, Replacement, Hip ,Radiography ,Posture ,Biocompatible Materials ,Young Adult ,Femoral head ,medicine ,Humans ,Orthopedics and Sports Medicine ,Aged ,Aged, 80 and over ,business.industry ,Polyethylene liner ,Femur Head ,Penetration (firestop) ,Middle Aged ,Biocompatible material ,Prosthesis Failure ,Surgery ,medicine.anatomical_structure ,Polyethylene ,Female ,Hip Prosthesis ,Nuclear medicine ,business ,Total hip arthroplasty - Abstract
The linear penetration rates for ceramic femoral heads on conventional and highly cross-linked polyethylene were measured and compared with radiographs taken in the standing and supine position taken three weeks postoperatively and at final follow-up. Seventy-five patients (83 hips) with conventional polyethylene (group-1) and two hundred and seventy five patients (300 hips) with highly cross-linked polyethylene (group-2) were studied. Follow-up periods were 14.5years in group-1 and 8.6years in group-2. The average penetration rates in group-1 were 0.17mm/year in supine position and 0.18mm/year in standing position (P
- Published
- 2014
21. A Descriptive Study Investigating the Feasibility and Selectivity of Current Perception Threshold in the Objective Assessment of Post-operative Sub-acute Knee Pain
- Author
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Mikimasa Aoki, Keiji Tensho, Ah-Cheng Goh, and Yukihiko Hata
- Subjects
medicine.medical_specialty ,Future studies ,business.industry ,Visual analogue scale ,Physical Therapy, Sports Therapy and Rehabilitation ,Sub acute ,Transcutaneous electrical nerve stimulation ,Objective assessment ,law.invention ,Knee pain ,Physical medicine and rehabilitation ,law ,Pain assessment ,Medicine ,Post operative ,medicine.symptom ,business - Abstract
[Purpose] The aim of this study was to investigate the feasibility of using the current perception threshold (CPT), in a comparison with the visual analog scale (VAS), to assess its selectivity in assessing the excitability of Aβ, Aδ and C fibers in subjects with sub-acute post-operative pain who were being treated with conventional transcutaneous electrical nerve stimulation (TENS). [Subjects and Methods] A total of 17 subjects (mean age of 29.2 ±10.8 years) participated in this study. For all subjects, the study commenced on the fifth post-operative day and continued for the next five consecutive days following a descriptive time-series design. Both CPT and VAS were measured for all subjects on all five days following 15 minutes rest with the TENS output intensity set at zero on the baseline days (Days 1, 3, 5), and after 15 minutes TENS stimulation on the intervention days (Days 2 and 4). [Results] The results demonstrate that CPT was able to selectively assess the excitability of the Aβ and Aδ fibers. However, the selectivity of CPT in assessing the C fibers could not be verified in this study. [Conclusion] The various limitations of the time series design used in this study suggest the need to verify some of these results in a different experimental design in future studies.
- Published
- 2013
22. Tibial Insertion of the ACL: 3D-CT Images, Macroscopic, and Microscopic Findings
- Author
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Keiji Tensho
- Subjects
Orthodontics ,endocrine system ,Reconstructive surgery ,medicine.medical_specialty ,endocrine system diseases ,business.industry ,Tibial tunnel ,Attachment site ,musculoskeletal system ,Tunnel construction ,humanities ,Anatomical landmark ,medicine ,Femoral bone ,business ,psychological phenomena and processes - Abstract
Accurate and detailed knowledge of ACL footprint anatomy is essential for successful anatomical ACL reconstruction. On the femoral side, the discovery of bony landmarks led to the standardization of femoral bone tunnel construction; however, the detailed morphology and location of ACL tibial footprint continue to be a topic of debate, and there are still no standardized methods for tibial tunnel construction. We previously reported the ACL tibial attachment site anatomy and bony landmarks and compared 3D images with visual and histological evaluations. The results from the study found a unique bony landmark surrounding the ACL attachment site, showing the relationship of these bony landmarks and surrounding anatomical landmarks as a useful indicator for determining tunnel positions during arthroscopic surgery. This section will clarify the detailed anatomy and bony landmark of the ACL tibial footprint necessary for reconstructive surgery by reviewing our previous research in conjunction with the available literature.
- Published
- 2016
23. Hydroxyapatite Block for Reconstruction of Severe Dysplasia or Acetabular Bone Defects in Total Hip Arthroplasty
- Author
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Keiji Tensho, Shinji Wakabayashi, Kazuo Terayama, and Masaaki Maruyama
- Subjects
medicine.medical_specialty ,Osteolysis ,business.industry ,Developmental dysplasia ,Radiography ,Dentistry ,equipment and supplies ,medicine.disease ,Severe dysplasia ,Osseointegration ,Surgery ,body regions ,Dysplasia ,Acetabular bone ,medicine ,Orthopedics and Sports Medicine ,business ,Total hip arthroplasty - Abstract
Fourteen hips in 14 patients (all female; average age, 64 years) with severe bone defects due to developmental dysplasia of the hip or migration of the socket were treated with hydroxyapatite block with impacted morselized bone graft in conjunction with a cemented socket. All patients were followed clinically in a prospective fashion, and radiographs were analyzed retrospectively. One initial patient had 17-year follow-up, whereas the remaining 13 patients had follow-up between 4 and 6.5 years. No acetabular components were revised, including the socket of a 17-year postoperative case that remains rigidly fixed and supported by the graft and hydroxyapatite block with only mild polyethylene wear and minor osteolysis. Osteointegration and good clinical outcome were achieved in all cases by reconstruction with this technique in total hip arthroplasty.
- Published
- 2012
24. Xeno-free proliferation of human bone marrow mesenchymal stem cells
- Author
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Mutsumi Takagi, Hiroto Miwa, Keiji Tensho, Shigeyuki Wakitani, and Yoshiki Hashimoto
- Subjects
JAACT Special Issue ,Cartilage ,Clinical Biochemistry ,Mesenchymal stem cell ,Biomedical Engineering ,Bioengineering ,Cell Biology ,Biology ,Trypsin ,Chondrogenesis ,Molecular biology ,Regenerative medicine ,Chondrocyte ,medicine.anatomical_structure ,Immunology ,medicine ,CD90 ,Aggrecan ,Biotechnology ,medicine.drug - Abstract
The proliferation of human bone marrow mesenchymal stem cells (MSCs) employing xeno-free materials not containing fetal calf serum (FCS) and porcine trypsin was investigated for the regenerative medicine of cartilage using MSCs. Four sequential subcultivations of MSCs using a medium containing 10% FCS and recombinant trypsin (TrypLESelect™) resulted in cell growth comparable to that with porcine trypsin. There was no apparent difference in the cell growth and morphology between two kinds of MSC stored in liquid nitrogen using 10% FCS plus DMSO or serum-free TC protector™. MSCs were isolated from human bone marrow cells, stored in liquid nitrogen, and sequentially subcultivated four times employing conventional materials that included FCS, porcine trypsin, and DMSO, or xeno-free materials that included serum-free medium (MesenCult-XF™), TC protector™ and TrypLESelect™. Cells in the culture using the xeno-free materials maintained typical fibroblast-like morphology and grew more rapidly than the cells in the culture using the conventional materials, while the cell surface markers of MSCs (CD90 and CD166) were well maintained in both cultures. Chondrogenic pellet cultures were carried out using these subcultivated cells and a medium containing TGFβ3 and IGF1. The pellet culture using cells grown with the xeno-free materials showed an apparently higher gene expression of aggrecan, a chondrocyte marker, than the pellet culture using cells grown with the conventional materials. Consequently, MSCs that are isolated, stored, and grown using the xeno-free materials including the serum-free medium (MesenCult-XF™), TC protector™, and recombinant trypsin (TrypLESelect™) might be applicable for regenerative medicine of cartilage.
- Published
- 2011
25. Anatomic double-bundle anterior cruciate ligament reconstruction, using CT-based navigation and fiducial markers
- Author
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Yasuo Yoshimura, Hiroyuki Kodaira, Nobuyo Narita, Gaku Yasuda, Susumu Morioka, Hiroyuki Kato, Keiji Tensho, and Naoto Saito
- Subjects
Male ,Anterior cruciate ligament reconstruction ,Anterior cruciate ligament ,medicine.medical_treatment ,Knee Joint ,Radiography, Interventional ,Surgical planning ,Cohort Studies ,Arthroscopy ,Imaging, Three-Dimensional ,Fiducial Markers ,Suture Anchors ,Preoperative Care ,Image Processing, Computer-Assisted ,medicine ,Humans ,Orthopedics and Sports Medicine ,Femur ,Tibia ,Fiducial marker ,Anterior Cruciate Ligament ,business.industry ,Anatomy ,Plastic Surgery Procedures ,musculoskeletal system ,Navigation ,Sagittal plane ,ACL reconstruction ,medicine.anatomical_structure ,Female ,Surgery ,Tomography, X-Ray Computed ,business ,Nuclear medicine ,CT - Abstract
Accurate placement of separate anteromedial and posterolateral bundle bone tunnels is crucial for anatomic, double-bundle anterior cruciate ligament (ACL) reconstruction. However, identifying the anatomic footprint at which to make the tibial and femoral bone tunnels is not a straightforward procedure. To overcome this problem, we used a CT-based navigation technique with a registration procedure based on fiducial markers (FMs). Preoperatively, 10 FM points were placed on skin around knee joint and scanned with CT. Imaging data of the knee were recorded on the computer system for preoperative registration and surgical planning. Intraoperatively, with a reference frame fixed to the distal medial aspect of femur and tibia, paired-point matching registration was performed with the use of points marked on skin through FM center holes. During tibial tunnel guide wire placement, tibial aiming guide with tracking device fed back the position of tip and direction of the guide wire on the three-dimensional (3D) tibia bone surface image and multiple image planes in real time. For the femoral side, the navigation pointer was placed at the footprint center with visual guidance of 3D image of lateral wall sagittal view on navigation monitor and marked with navigation awl. The average registration accuracy of 22 consecutive patients was 0.7 +/- A 0.2 mm and 0.6 +/- A 0.2 mm for femoral and tibial bone, respectively. Most of the bone tunnel positions evaluated with 3D-CT image were confirmed to be accurately placed in reference to the preoperative plan. There was no damage to femoral condyle cartilage and no other complication. This new CT-based computer navigation system opens the possibility for surgeons to plan bone tunnel positioning preoperatively and control it during technically demanding anatomic double-bundle ACL reconstruction., Article, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 19(3):378-383 (2011)
- Published
- 2010
26. The Acetabular Fossa May Not Be Located at the True Center of the Acetabulum
- Author
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Naoto Saito, Hiroki Shimodaira, Suguru Koyama, Masaaki Maruyama, Keiji Tensho, Hiroyuki Kato, and Yusuke Akaoka
- Subjects
Adult ,Male ,musculoskeletal diseases ,Adolescent ,Fossa ,Arthroplasty, Replacement, Hip ,medicine.medical_treatment ,Osteotomy ,Osteoarthritis, Hip ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,Femoral head ,0302 clinical medicine ,medicine ,Deformity ,Humans ,Orthopedics and Sports Medicine ,Hip Dislocation, Congenital ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hip surgery ,030222 orthopedics ,biology ,business.industry ,Acetabulum ,General Medicine ,Middle Aged ,biology.organism_classification ,Arthroplasty ,medicine.anatomical_structure ,Female ,Hip Joint ,Surgery ,medicine.symptom ,Tomography, X-Ray Computed ,Acetabular fossa ,Nuclear medicine ,business - Abstract
Background The acetabular fossa is thought to be located in the center of the acetabulum, and acetabular reaming in total hip arthroplasty is conventionally performed in the center of the fossa. However, the actual location of the fossa and the influence that hypoplasia or deformity may have on the position of the fossa are unknown. We hypothesized that the fossa is located in the center of the acetabulum, regardless of hypoplasia or deformity. Methods Fifty patients with normal hips (normal hip group), 50 patients with dysplasia who underwent rotational acetabular osteotomy (dysplastic hip group), and 46 patients with osteoarthritis who underwent total hip arthroplasty (osteoarthritic hip group) were evaluated by computed tomography (CT) imaging. On the horizontal plane that passes through the center of the femoral head, the center line of the acetabulum was defined as the perpendicular bisector of the anterior and posterior rims of the acetabulum. The angle and distance of the center of the acetabular fossa in relation to the center line of the acetabulum were evaluated; furthermore, the center position of the fossa from the anterior margin of the acetabulum was calculated as a ratio relative to acetabular size. A 1-way analysis of variance was performed to compare measurements among the 3 groups. Results The center of the acetabular fossa was positioned anteriorly to the center line of the acetabulum in all 3 groups. The mean center angle of the acetabular fossa was 14.0° ± 3.8°, 15.2° ± 5.6°, and 14.9° ± 5.5° in the normal, dysplastic, and osteoarthritic hip groups, respectively (p = 0.33). The mean center distance of the acetabular fossa was 5.6 ± 1.8, 5.8 ± 2.3, and 6.1 ± 2.2 mm, respectively (p = 0.55). The mean center position of the acetabular fossa was 38.8% ± 3.3%, 38.5% ± 4.2%, and 38.3% ± 3.9%, respectively (p = 0.71). Conclusions The center of the acetabular fossa is positioned anteriorly to the center of the acetabulum, and the positioning is affected by neither dysplasia nor osteoarthritis. The preconception that the center of the acetabulum corresponds to the center of the acetabular fossa may risk eccentric reaming, possibly damaging the anterior wall. Level of evidence Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Published
- 2018
27. Direct evaluation of fatigue property of ultra-high molecular weight polyethylene components of retrieved knee implants using small specimens
- Author
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Toshie Tsuchiya, Itaru Ishikawa, Keiji Tensho, Hideyuki Sakoda, Duk-Young Jung, Shigeyuki Wakitani, and Michio Sato
- Subjects
Ultra-high-molecular-weight polyethylene ,Materials science ,Mechanical Engineering ,Delamination ,Implant failure ,Test method ,Polyethylene ,Condensed Matter Physics ,chemistry.chemical_compound ,chemistry ,Mechanics of Materials ,Bearing surface ,Implant ,Composite material ,Direct evaluation - Abstract
Ultra-high molecular weight polyethylene (UHMWPE) has been widely used as a bearing surface of joint implants. Since wear of UHMWPE component has been the primal cause of implant failure, crosslinking of UHMWPE is now widely used to improve its wear property. On the other hand, crosslinking degrades its fatigue property and increase of fatigue related failure, such as delamination, is possible. However, the relationship between degraded fatigue property and implant failure is not clear, primarily because the fatigue properties of failed and retrieved UHMWPE components are not known. In this study, we propose a new test method to evaluate the fatigue property of retrieved UHMWPE components or final products using small specimens. First, the effects of test conditions were investigated using virgin UHMWPE. Then, tests were repeated using specimens from UHMWPE components of retrieved knee implants. The fatigue properties of virgin and retrieved UHMWPE were suc- cessfully evaluated by the new test method and a relationship was found among the extent of oxidation, the fatigue property, and occurrence of delamination. This result suggested that evaluation of fatigue property of UHMWPE component can predict the occurrence of fatigue related implant failure during operation in vivo.
- Published
- 2010
28. Blocking of tumor necrosis factor activity promotes natural repair of osteochondral defects in rabbit knee
- Author
-
Hiroyuki Nakaya, Yuuki Imai, Takahiro Okabe, Amu Kawaguchi, Kunio Takaoka, Yoshitaka Eguchi, Masashi Nawata, Keiji Tensho, and Shigeyuki Wakitani
- Subjects
Injections, Subcutaneous ,Blotting, Western ,Receptors, Tumor Necrosis Factor ,Etanercept ,medicine ,Animals ,Limited capacity ,Orthopedics and Sports Medicine ,Receptor ,Osteochondritis ,Lagomorpha ,Dose-Response Relationship, Drug ,biology ,Tumor Necrosis Factor-alpha ,business.industry ,Cartilage ,Anti-Inflammatory Agents, Non-Steroidal ,Patella ,General Medicine ,biology.organism_classification ,Blockade ,Blot ,medicine.anatomical_structure ,Immunoglobulin G ,Immunology ,Cancer research ,Surgery ,Tumor necrosis factor alpha ,Rabbits ,business ,Research Article ,medicine.drug - Abstract
Background and purpose Osteochondral defects have a limited capacity for repair. We therefore investigated the effects of tumor necrosis factor (TNF) signal blockade by etanercept (human recombinant soluble TNF receptor) on the repair of osteochondral defects in rabbit knees. Material and methods Osteochondral defects (5 mm in diameter) were created in the femoral patellar groove in rabbits. Soon after the procedure, a first subcutaneous injection of etanercept was performed. This single injection or, alternatively, 4 injections in total (twice a week for 2 weeks) were given. Each of these 2 groups was divided further into 3 subgroups: a low-dose group (0.05 μg/kg), an intermediate-dose group (0.4 μ g/kg), and a high-dose group (1.6 μ g /kg) with 19 rabbits in each. As a control, 19 rabbits were injected with water alone. The rabbits in each subgroup were killed 4 weeks (6 rabbits), 8 weeks (6 rabbits), or 24 weeks (7 rabbits) after surgery and repair was assessed histologically. Results Histological examination revealed that the natural process of repair of the osteochondral defects was promoted by 4 subcutaneous injections of intermediate-dose etanercept and by 1 or 4 injections of high-dose etanercept at the various time points examined postoperatively (4, 8, and 24 weeks). Western blot showed that rabbit TNFα had a high affinity for etanercept. Interpretation Blocking of TNF by etanercept enabled repair of osteochondral defects in rabbit knee. Anti-TNF therapy could be a strategy for the use of tissue engineering for bone and cartilage repair.
- Published
- 2009
29. Repair of articular cartilage defects in the patello-femoral joint with autologous bone marrow mesenchymal cell transplantation: three case reports involving nine defects in five knees
- Author
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Keiji Tensho, Hiroko Machida, Shigeyuki Wakitani, Masashi Nawata, Takahiro Okabe, and Hajime Ohgushi
- Subjects
Adult ,Cartilage, Articular ,Male ,Pathology ,medicine.medical_specialty ,Biomedical Engineering ,Medicine (miscellaneous) ,Collagen sheet ,Mesenchymal Stem Cell Transplantation ,Transplantation, Autologous ,Iliac crest ,Biomaterials ,medicine ,Humans ,Knee ,Femur ,Bone Marrow Transplantation ,Stem cell transplantation for articular cartilage repair ,Periosteum ,Hyaline cartilage ,business.industry ,Cartilage ,Patella ,Middle Aged ,Surgery ,Transplantation ,medicine.anatomical_structure ,Female ,Joints ,Bone marrow ,business - Abstract
To investigate the effectiveness of autologous culture-expanded bone marrow mesenchymal cell transplantation for repairing articular cartilage defects, we transplanted autologous culture-expanded bone marrow mesenchymal cells into nine full-thickness articular cartilage defects of the patello-femoral joints (including two kissing lesions) in the knees of three patients, a 31 year-old female, a 44 year-old male and a 45 year-old male. Three weeks before transplantation, bone marrow blood was aspirated from the iliac crest. Adherent cells were cultured with media containing autologous serum. Single-passaged cells were collected, embedded in a collagen solution (5 x 10(6) cells/ml), placed on a collagen sheet, gelated, transplanted into the defect and covered with autologous periosteum or synovium. Six months after transplantation, the patients' clinical symptoms had improved and the improvements have been maintained over the follow-up periods (17-27 months). Histology of the first patient 12 months after the transplantation revealed that the defect had been repaired with the fibrocartilaginous tissue. Magnetic resonance imaging of the second patient 1 year after transplantation revealed complete coverage of the defect, but we were unable to determine whether or not the material that covered the defects was hyaline cartilage. Autologous bone marrow mesenchymal cells transplantation may be an effective approach to promote the repair of articular cartilage defects.
- Published
- 2007
30. What Components Comprise the Measurement of the Tibial Tuberosity-Trochlear Groove Distance in a Patellar Dislocation Population?
- Author
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Yusuke Akaoka, Shota Ikegami, Hiroyuki Kato, Seiji Takanashi, Naoto Saito, Keiji Tensho, and Hiroki Shimodaira
- Subjects
musculoskeletal diseases ,Adult ,Male ,Torsion Abnormality ,Scientific Articles ,Adolescent ,Tubercle ,Patellar Dislocation ,Population ,Tibial tuberosity ,Trochlear groove ,Positive correlation ,Young Adult ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Tibia ,education ,Retrospective Studies ,education.field_of_study ,business.industry ,General Medicine ,Anatomy ,Middle Aged ,musculoskeletal system ,eye diseases ,Case-Control Studies ,Surgery ,Female ,Dislocation ,business ,Tomography, X-Ray Computed ,Groove (joinery) - Abstract
Background: The tibial tuberosity-trochlear groove distance is used as an indicator for medial tibial tubercle transfer; however, to our knowledge, no studies have verified whether this distance is strongly affected by tubercle lateralization at the proximal part of the tibia. We hypothesized that the tibial tuberosity-trochlear groove distance is mainly affected by tibial tubercle lateralization at the proximal part of the tibia. Methods: Forty-four patients with a history of patellar dislocation and forty-four age and sex-matched controls were analyzed with use of computed tomography. The tibial tuberosity-trochlear groove distance, tibial tubercle lateralization, trochlear groove medialization, and knee rotation were measured and were compared between the patellar dislocation group and the control group. The association between the tibial tuberosity-trochlear groove distance and three other parameters was calculated with use of the Pearson correlation coefficient and partial correlation analysis. Results: There were significant differences in the tibial tuberosity-trochlear groove distance (p < 0.001) and knee rotation (p < 0.001), but there was no difference in the tibial tubercle lateralization (p = 0.13) and trochlear groove medialization (p = 0.08) between the patellar dislocation group and the control group. The tibial tuberosity-trochlear groove distance had no linear correlation with tubercle lateralization (r = 0.21) or groove medialization (r = −0.15); however, knee rotation had a good positive correlation in the patellar dislocation group (r = 0.62). After adjusting for the remaining parameters, knee rotation strongly correlated with the tibial tuberosity-trochlear groove distance (r = 0.69, p < 0.001), whereas tubercle lateralization showed moderate significant correlations in the patellar dislocation group (r = 0.42; p = 0.005). Conclusions: Because the tibial tuberosity-trochlear groove distance is affected more by knee rotation than by tubercle malposition, its use as an indicator for tibial tubercle transfer may not be appropriate. Clinical Relevance: Surgical decisions of tibial tubercle transfer should be made after the careful analysis of several underlying factors of patellar dislocation.
- Published
- 2015
31. The effects of heat on the biological activity of recombinant human bone morphogenetic protein-2
- Author
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Shigeyuki Wakitani, Yukio Nakamura, Naoto Saito, Hiroshi Horiuchi, Kunio Takaoka, Shinji Wakabayashi, Yuuki Imai, Keiji Tensho, Kazutoshi Nozaki, and Hiroshi Ohta
- Subjects
Hot Temperature ,Endocrinology, Diabetes and Metabolism ,Bone Morphogenetic Protein 2 ,Bone morphogenetic protein ,Bone tissue ,Bone morphogenetic protein 2 ,Cell Line ,Mice ,Calcification, Physiologic ,Endocrinology ,Transforming Growth Factor beta ,In vivo ,medicine ,Animals ,Humans ,Orthopedics and Sports Medicine ,Chemistry ,Biological activity ,General Medicine ,Alkaline Phosphatase ,Molecular biology ,Recombinant Proteins ,In vitro ,medicine.anatomical_structure ,Biochemistry ,Cell culture ,Enzyme Induction ,Bone Morphogenetic Proteins ,Alkaline phosphatase ,Electrophoresis, Polyacrylamide Gel - Abstract
This study was designed to investigate effects of heat on the bone-inducing activity of recombinant human bone morphogenetic protein (rhBMP)-2. rhBMP-2 samples were heated at 50, 70, 90, or 100 degrees C for 15 min, or 1, 2, 4, or 8 h, or autoclaved at 120 degrees C for 15 min. The bone-inducing activity of the rhBMP-2 before and after heating was assayed in in vivo and in vitro systems. For the in vivo assay, 5 microg rhBMP-2 samples were impregnated into porous collagen disks (6 mm in diameter, 1 mm thickness), freeze dried, and implanted into the back muscles of ddY mice. Three weeks later, the implant was harvested from the host and examined for ectopic new bone tissue by radiography. The new bone mass was quantified by single-energy X-ray absorptiometry. The in vitro activity of the rhBMP-2 was assayed by adding the BMP sample at a concentration of 100 ng/ml to cultures of MC3T3-E1 cells. After 48 h, the alkaline phosphatase activity was measured. After heating at 50 degrees or 70 degrees C, no significant reduction in bone-inducing activity was noted in either in vivo or in vitro assay systems unless the protein was exposed to sustained heat at 70 degrees C for 8 h, based on in vitro assay data. However, heating above 90 degrees C and for longer periods led to a decrease in the biological activity of the rhBMP-2 in a time- and temperature-dependent manner. rhBMP-2 was rendered inactive when exposed to temperatures at or in excess of 120 degrees C.
- Published
- 2005
32. Low dose fibroblast growth factor-2 (FGF-2) enhances bone morphogenetic protein-2 (BMP-2)-induced ectopic bone formation in mice
- Author
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Masashi Nawata, Hiroyuki Nakaya, Takahiro Okabe, Keiji Tensho, Shigeyuki Wakitani, and Yukio Nakamura
- Subjects
Male ,medicine.medical_specialty ,animal structures ,Histology ,Physiology ,Endocrinology, Diabetes and Metabolism ,Basic fibroblast growth factor ,Bone Morphogenetic Protein 2 ,Bone morphogenetic protein ,Bone morphogenetic protein 2 ,Drug Administration Schedule ,Mice ,chemistry.chemical_compound ,Bone Density ,Osteogenesis ,Transforming Growth Factor beta ,Internal medicine ,medicine ,Animals ,Noggin ,Muscle, Skeletal ,BMP signaling pathway ,Bone mineral ,biology ,Ossification, Heterotopic ,Drug Synergism ,Bone morphogenetic protein 7 ,Endocrinology ,chemistry ,Bone Morphogenetic Proteins ,embryonic structures ,Osteocalcin ,biology.protein ,Fibroblast Growth Factor 2 ,Signal Transduction - Abstract
To examine how fibroblast growth factor-2 (FGF-2) affects the BMP signaling pathway during bone morphogenetic protein-2 (BMP-2)-induced ectopic bone formation, we implanted type I collagen disks containing constant amounts of BMP-2 (5 micrograms) and varying amounts of FGF-2 onto the back muscles of adult male mice. We then performed histological analyses and histomorphometry, and measured bone mineral density and radiopaque area on the discs 1, 2, and 3 weeks after implantation. We also determined the expression profiles of several genes involved in bone formation and the BMP signaling pathway in the muscle that had been adjacent to the implanted disc and in muscle-derived primary culture cells that had similarly been treated with a constant concentration of BMP-2 and a varying concentration of FGF-2. In the presence of a constant amount of BMP-2, we confirmed that low doses of FGF-2 increased ectopic bone formation in vivo and high doses inhibited bone formation. Northern and/or Western blots of recovered muscle from the in vivo experiment and treated muscle-derived primary culture cells from the in vitro experiment revealed that low doses of FGF-2, but not high doses, increased the expression BMP receptor (BMPR)-1B, phosphorylated Smad1, Noggin, and Osteocalcin. Our results indicate that low-dose FGF-2 may facilitate BMP-2-induced ectopic bone formation by altering the expression of BMPRs on the surface of bone forming progenitor cells. They also indicate that the inhibitory effect of high-dose FGF-2 is not mediated via increased expression of the BMP inhibitor Noggin.
- Published
- 2005
33. Microbubble-enhanced ultrasound exposure promotes uptake of methotrexate into synovial cells and enhanced antiinflammatory effects in the knees of rabbits with antigen-induced arthritis
- Author
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Masashi Nawata, Ken'ichi Isobe, Keiji Tensho, Hiroyuki Nakaya, Shigeyuki Wakitani, Yukio Nakamura, Kunio Takaoka, Takahiro Okabe, Hideki Yoshikawa, and Tominaga Shimizu
- Subjects
musculoskeletal diseases ,Pathology ,medicine.medical_specialty ,Knee Joint ,Ovalbumin ,medicine.drug_class ,Immunology ,Anti-Inflammatory Agents ,Arthritis ,Inflammation ,Antimetabolite ,Injections, Intra-Articular ,chemistry.chemical_compound ,Rheumatology ,immune system diseases ,medicine ,Animals ,Immunology and Allergy ,Ultrasonics ,heterocyclic compounds ,Pharmacology (medical) ,skin and connective tissue diseases ,Microbubbles ,Lagomorpha ,biology ,business.industry ,Osmolar Concentration ,Synovial Membrane ,biology.organism_classification ,medicine.disease ,Arthritis, Experimental ,Methotrexate ,chemistry ,Synovial Cell ,Antifolate ,biology.protein ,Rabbits ,medicine.symptom ,business ,medicine.drug - Abstract
Objective To evaluate whether microbubble-enhanced ultrasound (US) treatment promotes the delivery of methotrexate (MTX) into synovial cells and the enhanced antiinflammatory effects of intraarticular MTX therapy in a rabbit arthritis model. Methods Arthritis was induced in both knees of 53 rabbits by immunization with ovalbumin. MTX including a microbubble agent was then injected into the left and right knee joints, and the right knees were exposed to US (MTX+/US+ group), while the left knees were not (MTX+/US− group). The knee joints were evaluated histologically in 7 rabbits at 5 time points up to day 56. Quantitative gene expression of interleukin-1β (IL-1β) in synovial tissue was measured on days 7 and 28. Eight rabbits were used for the measurement of MTX concentration in synovial tissue 12 hours after treatment. To evaluate the effect of microbubble-enhanced US treatment in the absence of MTX, only the microbubble agent was injected into the left and right knee joints of 10 rabbits with or without US exposure, and these animals were evaluated histologically on days 7 and 28. Results The MTX concentration in synovial tissue was significantly higher in the MTX+/US+ group than in the MTX+/US− group. Synovial inflammation was less prominent in the MTX+/US+ group compared with the MTX+/US− group, judging from the results of the histologic evaluation and the gene expression levels of IL-1β in synovial tissue. It also appeared that microbubble-enhanced US exposure itself did not affect inflammation. Conclusion Microbubble-enhanced US exposure promoted the uptake of MTX into synovial cells, which resulted in enhancement of the antiinflammatory effects of the intraarticular MTX injection. These results suggest that application of this technique may have clinical benefit.
- Published
- 2005
34. Snapping pes syndrome after total knee arthroplasty
- Author
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Hiroyuki Kato, Keiji Tensho, S. Morioka, Tetsuhiro Aoki, Nobuyo Narita, and Naoto Saito
- Subjects
Male ,musculoskeletal diseases ,medicine.medical_specialty ,Knee Joint ,integumentary system ,business.industry ,Total knee arthroplasty ,Level iv ,Syndrome ,Osteoarthritis, Knee ,Surgery ,Orthopedic surgery ,medicine ,Physical therapy ,Humans ,Female ,Orthopedics and Sports Medicine ,Joint Diseases ,Range of Motion, Articular ,Arthroplasty, Replacement, Knee ,business ,human activities ,Aged - Abstract
Snapping syndrome rarely occurs at the knee joint. This is the first report of snapping pes syndrome after total knee arthroplasty. Surgeons should be aware of the presence of such a case and pay attention to the fact that snapping symptoms could be caused by a residual bony prominence and a change in alignment after total knee arthroplasty. Level of evidence Therapeutic study, Case report with no comparison group, Level IV.
- Published
- 2012
35. Construction of an osteochondral-like tissue graft combining β-tricalcium phosphate block and scaffold-free mesenchymal stem cell sheet
- Author
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Shigeyuki Wakitani, Mutsumi Takagi, Keiji Tensho, and Shigeharu Miyagi
- Subjects
Adult ,Calcium Phosphates ,Male ,Scaffold ,Biocompatible Materials ,Bone and Bones ,chemistry.chemical_compound ,Young Adult ,stomatognathic system ,Block (telecommunications) ,medicine ,Humans ,Orthopedics and Sports Medicine ,Cells, Cultured ,Aged ,β tricalcium phosphate ,Tissue Engineering ,Tissue Scaffolds ,Cartilage ,Mesenchymal stem cell ,Mesenchymal Stem Cells ,Anatomy ,Biocompatible material ,Phosphate ,Tissue Graft ,medicine.anatomical_structure ,chemistry ,Surgery ,Biomedical engineering - Abstract
Aiming to construct an osteochondral-like structure, the combination of a β-tricalcium phosphate (βTCP) block with a scaffold-free sheet formed using mesenchymal stem cells (MSCs) was investigated.Human bone marrow MSCs in a cell culture insert that was set in a 24-well plate were cultivated using a chondrogenic medium containing dexamethasone, IGF-1, and TGFβ3 for 3 weeks during which a cylindrical βTCP block was put on the sheet at day 1, and the cell sheet construct was harvested. In other experiments, at day 14, the construct was put on a cell sheet that was prepared the day before and cultivated for 3 weeks.The addition of a βTCP block resulted in a combined osteochondral-like construct and comparable staining intensity by Alcian blue, while the expression levels of the aggrecan and type II collagen genes decreased a little. During the culture with the βTCP block, the expression levels of the aggrecan gene increased monotonically. The increase in the inoculum cell number from 1.86 to 3.72 × 10(6) cells resulted in marked increases in the thickness of cell sheet parts in the βTCP block and expression levels of the aggrecan and type II collagen genes, while the thickness of cell sheet parts on the βTCP block scarcely changed. On the other hand, the addition of a cell sheet that was prepared a day before to the construct at day 14 resulted in the marked increase in thickness of the cell sheet part on the βTCP block, while the thickness of that in the βTCP block did not increase.A combined osteochondral-like structure was produced by putting a βTCP block on the sheet of MSC. The thickness of the cell sheet parts in and on the βTCP block could be increased by the increase in inoculum cell number and by providing an additional cell sheet, respectively.
- Published
- 2012
36. Less invasive rotational acetabular osteotomy for hip dysplasia
- Author
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Masaaki Maruyama, Keiji Tensho, and Shinji Wakabayashi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Rotation ,medicine.medical_treatment ,Osteotomy ,Osteoarthritis, Hip ,Clinical Research ,medicine ,Humans ,Orthopedics and Sports Medicine ,Hip Dislocation, Congenital ,Gluteus medius muscle ,Aged ,Hip surgery ,Hip dysplasia ,business.industry ,Soft tissue ,Acetabulum ,General Medicine ,Middle Aged ,musculoskeletal system ,medicine.disease ,Surgery ,body regions ,Dissection ,Treatment Outcome ,Fluoroscopy ,Orthopedic surgery ,Female ,business - Abstract
Background Broad dissection with a long skin incision and detachment of the gluteus medius muscle performed for rotational acetabular osteotomy (RAO) can result in weakness in abduction strength of the hip. We use a surgical procedure for RAO that minimizes operative invasion of soft tissue and reduces incision length compared with conventional procedures. Questions/Purposes We evaluated the clinical results of this less-invasive RAO comparing it with the more-invasive prior procedure with respect to improvement in clinical hip scores and radiographic coverage and overall hip survival after the procedure. Methods In this less-invasive exposure, the medial gluteus muscle is retracted to expose the ilium without detachment from the iliac crest. Similarly, the rectus femoris muscle tendon is retracted, not excised. The lateral part of the osteotomized ilium is cut to form the bone graft instead of harvesting it from the outer cortical bone of the ilium. Between 2000 and 2009, 62 patients (71 hips) underwent this procedure. Twenty-eight hips had early-stage osteoarthritis and 43 had advanced-stage osteoarthritis. Mean patient age was 40 years at the time of surgery. We evaluated improvement in hip scores (Merle d’Aubigné-Postel, Japanese Orthopaedic Association) and radiographic appearance (lateral center-edge angle, Sharp’s angle, acetabular head index [AHI]). Kaplan-Meier survivorship analysis was performed. Mean followup was 5 years (range, 2.0–10.4 years). Results Clinical hip scores improved postoperatively. On average, lateral center-edge angle, Sharp’s angle, and AHI improved by 38°, 11°, and 42%, respectively. Predicted 10-year survival rates were 100% and 72% for hips with early- and advanced-stage osteoarthritis, respectively. Conclusions In hips with early-stage osteoarthritis treated by this less-invasive approach, no progression of osteoarthritis was documented and Trendelenburg gait was avoided. However, further investigation is necessary for hips with advanced-stage osteoarthritis. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
- Published
- 2012
37. Hydroxyapatite block for reconstruction of severe dysplasia or acetabular bone defects in total hip arthroplasty: operative technique and clinical outcome
- Author
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Masaaki, Maruyama, Keiji, Tensho, Shinji, Wakabayashi, and Kazuo, Terayama
- Subjects
Reoperation ,Bone Transplantation ,Arthroplasty, Replacement, Hip ,Incidence ,Bone Cements ,Acetabulum ,Osteolysis ,Middle Aged ,Radiography ,Durapatite ,Treatment Outcome ,Polyethylene ,Humans ,Female ,Hip Joint ,Hip Prosthesis ,Prospective Studies ,Hip Dislocation, Congenital ,Aged ,Follow-Up Studies ,Retrospective Studies - Abstract
Fourteen hips in 14 patients (all female; average age, 64 years) with severe bone defects due to developmental dysplasia of the hip or migration of the socket were treated with hydroxyapatite block with impacted morselized bone graft in conjunction with a cemented socket. All patients were followed clinically in a prospective fashion, and radiographs were analyzed retrospectively. One initial patient had 17-year follow-up, whereas the remaining 13 patients had follow-up between 4 and 6.5 years. No acetabular components were revised, including the socket of a 17-year postoperative case that remains rigidly fixed and supported by the graft and hydroxyapatite block with only mild polyethylene wear and minor osteolysis. Osteointegration and good clinical outcome were achieved in all cases by reconstruction with this technique in total hip arthroplasty.
- Published
- 2010
38. Safety of autologous bone marrow-derived mesenchymal stem cell transplantation for cartilage repair in 41 patients with 45 joints followed for up to 11 years and 5 months
- Author
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Ryosuke Kuroda, Keiji Tensho, Hajime Ohgushi, Takahiro Okabe, Shinichi Yoshiya, Masashi Nawata, Hiroyuki Kato, Shuji Horibe, Tomoki Mitsuoka, Koji Hattori, Tsuyoshi Koyama, Masanobu Saito, Masahiro Kurosaka, Kota Uematsu, and Shigeyuki Wakitani
- Subjects
Adult ,Cartilage, Articular ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Angiogenesis ,Biomedical Engineering ,Medicine (miscellaneous) ,Mesenchymal Stem Cell Transplantation ,Transplantation, Autologous ,Biomaterials ,Bone Marrow ,medicine ,Humans ,Bone regeneration ,Aged ,business.industry ,Cartilage ,Mesenchymal stem cell ,Mesenchymal Stem Cells ,Middle Aged ,Surgery ,Transplantation ,medicine.anatomical_structure ,Female ,Bone marrow ,Stem cell ,Safety ,business ,Cartilage Diseases ,Adult stem cell ,Follow-Up Studies - Abstract
Among autologous somatic stem cells, bone marrow-derived mesenchymal stem cells (BMSCs) are the most widely used worldwide to repair not only mesenchymal tissues (bone, cartilage) but also many other kinds of tissues, including heart, skin, and liver. Autologous BMSCs are thought to be safe because of the absence of immunological reaction and disease transmission. However, it is possible that they will form tumours during long-term follow-up. In 1988, we transplanted autologous BMSCs to repair articular cartilage, which was the first such trial ever reported. Subsequently we performed this procedure in about 40 patients. Demonstration that neither partial infections nor tumours appeared in these patients provided strong evidence for the safety of autologous BMSC transplantation. Thus, in this study we checked these patients for tumour development and infections. Between January 1998 and November 2008, 41 patients received 45 transplantations. We checked their records until their last visit. We telephoned or mailed the patients who had not visited the clinics recently to establish whether there were any abnormalities in the operated joints. Neither tumours nor infections were observed between 5 and 137 (mean 75) months of follow-up. Autologous BMSC transplantation is a safe procedure and will be widely used around the world.
- Published
- 2010
39. Early Postoperative Intratunnel Migration of an EndoButton After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction
- Author
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Tetsuhiro Aoki, Keiji Tensho, Hiroyuki Kato, Seiji Takanashi, Naoto Saito, Yusuke Akaoka, and Hiroki Shimodaira
- Subjects
Fixation (surgical) ,medicine.medical_specialty ,Double bundle ,Anterior cruciate ligament reconstruction ,business.industry ,medicine.medical_treatment ,Rare case ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Femoral fixation ,business - Abstract
Case: We report a rare case of early postoperative migration of an EndoButton following anatomic double-bundle anterior cruciate ligament reconstruction with use of the EndoButton for femoral fixation. Although secure fixation of the EndoButton was confirmed during the operation, one-week postoperative radiographs revealed an intratunnel displacement of the posterolateral EndoButton. We performed a reoperation and refixed the EndoButton to the surface of the femoral cortex; we also hooked and tied both ends of the sutures to make a knot in order to prevent remigration. Conclusion: Orthopaedic surgeons should be aware that EndoButton displacement and migration could arise at an early postoperative stage.
- Published
- 2014
40. [Articular cartilage repair with cell transplantation]
- Author
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Takahiro, Okabe, Keiji, Tensho, Shigeyuki, Wakitani, and Hiroyuki, Nakaya
- Subjects
Cartilage, Articular ,Chondrocytes ,Tissue Engineering ,Multipotent Stem Cells ,Cell Culture Techniques ,Animals ,Humans ,Cartilage Diseases ,Transplantation, Autologous ,Bone Marrow Transplantation - Abstract
Articular cartilage has a limited capacity for repair. Repair of articular cartilage has been an important theme for orthopaedic surgeons. With the progress of tissue engineering in the treatment of articular cartilage injury, we can obtain good results, to some extent, by cell transplantations. This review summarized the present status of the treatment of articular cartilage injuries by cell transplantations.
- Published
- 2004
41. 852 Miniature fatigue test for retrieved UHMWPE components of joint prostheses
- Author
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Duk Young Jung, Michio Sato, Shigeyuki Wakitani, Hideyuki Sakoda, Toshie Tsuchiya, and Keiji Tensho
- Subjects
Orthodontics ,Computer science ,Joint (geology) ,Test (assessment) - Published
- 2008
42. Corrigendum to 'Low dose fibroblast growth factor-2 (FGF-2) enhances bone morphogenetic protein-2 (BMP-2)-induced ectopic bone formation in mice' [Bone 36 (2005) 399–407]
- Author
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Hiroyuki Nakaya, Keiji Tensho, Takahiro Okabe, Masashi Nawata, Shigeyuki Wakitani, and Yukio Nakamura
- Subjects
Bone morphogenetic protein 7 ,Histology ,Bone morphogenetic protein 5 ,Physiology ,Chemistry ,Endocrinology, Diabetes and Metabolism ,Low dose ,Fibroblast growth factor ,Bone morphogenetic protein 2 ,Ectopic bone formation ,Cell biology - Published
- 2007
43. Erratum to: Less Invasive Rotational Acetabular Osteotomy for Hip Dysplasia
- Author
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Masaaki Maruyama, Keiji Tensho, and Shinji Wakabayashi
- Subjects
Hip dysplasia ,medicine.medical_specialty ,Sports medicine ,business.industry ,medicine.medical_treatment ,Less invasive ,General Medicine ,medicine.disease ,Osteotomy ,Surgery ,Orthopedic surgery ,medicine ,Orthopedics and Sports Medicine ,Erratum ,business - Abstract
The online version of the original article can be found under doi:10.1007/s11999-012-2599-6.
- Published
- 2013
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