Author: "Matsushita, Takehiko" / Database: Supplemental Index - Searchworks@Jio Institute Digital Library Search Results

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1. Re-tear after arthroscopic rotator cuff tear surgery: risk analysis using machine learning.

Author: Shinohara, Issei, Mifune, Yutaka, Inui, Atsuyuki, Nishimoto, Hanako, Yoshikawa, Tomoya, Kato, Tatsuo, Furukawa, Takahiro, Tanaka, Shuya, Kusunose, Masaya, Hoshino, Yuichi, Matsushita, Takehiko, Mitani, Makoto, and Kuroda, Ryosuke
Abstract: Postoperative rotator cuff retear after arthroscopic rotator cuff repair (ARCR) is still a major problem. Various risk factors such as age, gender, and tear size have been reported. Recently, magnetic resonance imaging-based stump classification was reported as an index of rotator cuff fragility. Although stump type 3 is reported to have a high retear rate, there are few reports on the risk of postoperative retear based on this classification. Machine learning (ML), an artificial intelligence technique, allows for more flexible predictive models than conventional statistical methods and has been applied to predict clinical outcomes. In this study, we used ML to predict postoperative retear risk after ARCR. The retrospective case-control study included 353 patients who underwent surgical treatment for complete rotator cuff tear using the suture-bridge technique. Patients who initially presented with retears and traumatic tears were excluded. In study participants, after the initial tear repair, rotator cuff retears were diagnosed by magnetic resonance imaging; Sugaya classification types IV and V were defined as re-tears. Age, gender, stump classification, tear size, Goutallier classification, presence of diabetes, and hyperlipidemia were used for ML parameters to predict the risk of retear. Using Python's Scikit-learn as an ML library, five different AI models (logistic regression, random forest, AdaBoost, CatBoost, LightGBM) were trained on the existing data, and the prediction models were applied to the test dataset. The performance of these ML models was measured by the area under the receiver operating characteristic curve. Additionally, key features affecting retear were evaluated. The area under the receiver operating characteristic curve for logistic regression was 0.78, random forest 0.82, AdaBoost 0.78, CatBoost 0.83, and LightGBM 0.87, respectively for each model. LightGBM showed the highest score. The important factors for model prediction were age, stump classification, and tear size. The ML classifier model predicted retears after ARCR with high accuracy, and the AI model showed that the most important characteristics affecting retears were age and imaging findings, including stump classification. This model may be able to predict postoperative rotator cuff retears based on clinical features. [ABSTRACT FROM AUTHOR]
Published: 2024
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2. Knee Osteotomy Decreases Joint Inflammation Based on Synovial Histology and Synovial Fluid Analysis.

Author: Watanabe, Shu, Matsushita, Takehiko, Nishida, Kyohei, Nagai, Kanto, Hoshino, Yuichi, Matsumoto, Tomoyuki, and Kuroda, Ryosuke
Abstract: To examine the biological changes in the joints of patients with knee osteoarthritis (OA) before and after around-knee osteotomy (AKO), focusing on synovial fluid (SF) and synovial pathological changes. Patients who underwent AKO for medial compartment knee OA between 2019 and 2021 were examined. SF and synovium were obtained at the time of AKO and plate removal after bone union (mean, 16.8 months [range: 11–38 months] postoperatively). SF volume and interleukin (IL)-6 concentrations in SF were assayed using enzyme-linked immunosorbent assay. Synovitis was assessed histologically using a semiquantitative scoring system. Macrophage infiltration was assessed by immunohistochemistry using a semiquantitative score for F4/80 expression. The M1/M2 ratio was calculated using percentage of cells positive for CD80 and CD163. The expression of proinflammatory cytokines was assessed by the percentage of IL-1β- and IL-6-positive cells. The number of vascular endothelial growth factor-positive luminal structures was counted to assess angiogenesis. The change in each parameter was compared before and after AKO using the Wilcoxon matched-pairs signed-rank test. Twenty-four knees of 21 patients were included. SF volume and IL-6 concentration significantly decreased postoperatively (12.6 ± 2.1 mL vs 4.2 ± 0.6 mL; P <.0001 and 50.5 ± 8.6 pg/mL vs 20.7 ± 3.8 pg/mL; P =.0001, respectively). A significant reduction in synovitis score (P =.0001), macrophage infiltration (P <.0003), M1/M2 ratio (P <.0007), angiogenesis (P <.0001), and the percentage of IL-1β- and IL-6-positive cells in the intima (P <.008 and P <.002, respectively) was found after AKO. SF volume and IL-6 concentrations in the SF decreased and inflammatory synovium pathology improved after AKO. In addition to biomechanical changes, the biological environment of the joint can be improved after AKO. Level IV, retrospective therapeutic case series. [ABSTRACT FROM AUTHOR]
Published: 2024
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3. Outcomes of palliative surgery for bone metastasis of metastatic renal cell carcinoma in the era of targeted therapy.

Author: Hara, Hitomi, Kawamoto, Teruya, Fukase, Naomasa, Sawada, Ryoko, Fujiwara, Shuichi, Yahiro, Shunsuke, Miyamoto, Tomohiro, Terakawa, Tomoaki, Mifune, Yutaka, Hoshino, Yuichi, Kakutani, Kenichiro, Matsumoto, Tomoyuki, Matsushita, Takehiko, Niikura, Takahiro, Kuroda, Ryosuke, and Akisue, Toshihiro
Subjects: RENAL cell carcinoma, BONE metastasis, BONE surgery, TREATMENT effectiveness, ACETABULUM surgery, METASTASIS
Abstract: The introduction of tyrosine kinase inhibitors has revolutionized treatment strategies for metastatic renal cell carcinoma (RCC) and has improved survival rates. The number of patients with bone metastases from RCC requiring surgery will increase as survival rates improve. However, there is insufficient evidence to standardize the treatment of bone metastases after the introduction of targeted therapy for metastatic RCC. We aimed to determine the outcomes of palliative surgical treatment of bone metastases in the extremities of patients with metastatic RCC. We retrospectively reviewed 26 lesions from 17 patients who underwent surgery for extremity and acetabular bone metastases and were treated with targeted therapies for advanced RCC between 2008 and 2020. The median follow-up duration was 19 months (range, 4–76). We assessed the patients' activities of daily living, quality of life, and pain and analyzed their postoperative values relative to preoperative values. Postoperative overall survival (OS), local progression-free survival (LPFS), and the factors affecting them were evaluated using the Kaplan-Meier method and log-rank test. The 5-year OS and LPFS rates were 39.5% and 65.6%, respectively. The factors affecting OS were sex, Katagiri score, visceral metastases, and preoperative targeted therapy, while the factors affecting LPFS were pathologic fractures and surgical technique. In this study, the postoperative outcomes of palliative surgery for bone metastases from metastatic RCC were good. We suggest that systemic treatment should be prioritized over local control for advanced bone metastasis in RCC and surgery before pathological fracture should be performed for local control. [ABSTRACT FROM AUTHOR]
Published: 2023
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4. Novel therapy using a fish scale collagen scaffold for rotator cuff healing in rat models.

Author: Yamaura, Kohei, Mifune, Yutaka, Inui, Atsuyuki, Nishimoto, Hanako, Mukohara, Shintaro, Yoshikawa, Tomoya, Shinohara, Issei, Kato, Tatsuo, Furukawa, Takahiro, Hoshino, Yuichi, Matsushita, Takehiko, and Kuroda, Ryosuke
Abstract: Large and massive rotator cuff tears are challenging for surgeons because of postoperative complications such as repaired site retears. Recently, collagen extracted from fish scales has gained more attention because fish byproducts are considered a safer collagen source than other animal-derived scaffolds. This study aimed to evaluate the biological efficacy of tilapia scale–derived collagen scaffolds for rotator cuff repair in rat models. The infraspinatus tendon was resected from the greater tuberosity of Sprague-Dawley rats. In the control group, the tendon edge was sutured directly to the humeral head. In the augmentation group, the repaired site was augmented with a tilapia scale–derived collagen scaffold. Histologic examinations were performed at 2 and 4 weeks postoperatively via safranin O and immunofluorescence staining (isolectin B4 and type II collagen) in the bone-tendon junction. For mechanical analysis, the ultimate failure load of the tendon-humeral head complex was evaluated at 6 weeks postoperatively. During safranin O staining, the repaired enthesis demonstrated greater proteoglycan staining in the augmentation group than in the control group at 4 weeks postoperatively. Compared to controls, the augmentation group had significantly higher vascular staining with isolectin B4 at 2 and 4 weeks postoperatively, type II collagen expression at 4 weeks postoperatively, and ultimate failure load at 6 weeks postoperatively. Augmentation therapy using tilapia scale–derived type I collagen scaffolds promoted angiogenesis and fibrocartilage regeneration at the enthesis and provided higher mechanical strength than controls. [ABSTRACT FROM AUTHOR]
Published: 2022
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5. Association Between Meeting Return-to-Sport Criteria and Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction.

Author: Ueda, Yuya, Matsushita, Takehiko, Shibata, Yohei, Takiguchi, Kohei, Ono, Kumiko, Kida, Akihiro, Ono, Rei, Nagai, Kanto, Hoshino, Yuichi, Matsumoto, Tomoyuki, Sakai, Yoshitada, and Kuroda, Ryosuke
Published: 2022
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6. Comparison of Clinical Outcomes Between Ceramic-Based Total Ankle Arthroplasty with Ceramic Total Talar Prosthesis and Ceramic-Based Total Ankle Arthroplasty.

Author: Yamamoto, Tetsuya, Nagai, Kanto, Kanzaki, Noriyuki, Kataoka, Kiminari, Nukuto, Koji, Hoshino, Yuichi, Matsushita, Takehiko, and Kuroda, Ryosuke
Abstract: Background: Total ankle arthroplasty (TAA) has become one of the standard surgical treatments for patients with end-stage ankle osteoarthritis (OA). In recent years, TAA with total talar prosthesis (combined TAA) has been used for ankle OA patients with talar osteonecrosis, with severe talar collapse, or with subtalar joint OA. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA, compared with conventional TAA. Methods: Forty-six ankles (44 patients, 32 women/12 men) that underwent conventional TAA with mean follow-up of 42 months, and 26 ankles (25 patients, 18 women/7 men) that underwent combined TAA with mean follow-up of 46 months were included. Clinical outcomes, which included ankle range of motion (ROM), the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Self-Administered Foot Evaluation Questionnaire (SAFE-Q), and complications were compared between the groups. Results: The preoperative ROM was significantly worse in combined TAA for both dorsiflexion and plantarflexion; however, in the final ROM, there was no significant difference between the groups. There was no significant difference in JSSF scale and SAFE-Q between the groups. Revision rate was 10.9% in conventional TAA and 0% in combined TAA. Conclusion: In this small series, at an average of 3.5 years, we found no significant difference in clinical results between conventional TAA and combined TAA; however, the revision rate was higher in conventional TAA. Level of Evidence: Level III, retrospective cohort study. [ABSTRACT FROM AUTHOR]
Published: 2022
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7. Patellofemoral Osteoarthritis Progresses After Medial Open-Wedge High Tibial Osteotomy: A Systematic Review.

Author: Kataoka, Kiminari, Watanabe, Shu, Nagai, Kanto, Kay, Jeffrey, Matsushita, Takehiko, Kuroda, Ryosuke, and de SA, Darren
Abstract: Purpose: To investigate the progression of patellofemoral (PF) osteoarthritis (OA) after medial open-wedge high tibial osteotomy (OWHTO) and whether PF OA progression has an influence on clinical outcomes.Methods: According to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA), EMBASE, PubMed, and Cochrane Library were searched in June 2020 for English-language studies that presented data on PF OA or cartilage degeneration before and after OWHTO. Descriptive statistics are presented.Results: Twenty studies comprising 1,173 patients were included. The mean age was 57.1 years (range 18-84) with 826 (70.4%) female. The mean follow-up was 27.1 months (range 7-144). Ten studies reported the trochlear International Cartilage Research Society (ICRS) scores, with each of these studies reporting a greater proportion of patients with grades 2-4 OA postoperatively compared with preoperatively (relative risk = 1.19-2.76, I2 = 1.9%). Similarly, 7 studies reported patellar ICRS scores and found a greater proportion with grades 2-4 OA postoperatively (relative risk = 1.08-2.44, I2 = 0%). Four studies assessed PF Kellgren-Lawrence grade, each of which reported a greater proportion of patients with grades 2-4 OA postoperatively (relative risk = 1.25-21.0, I2 = 31%). The PF OA assessments were heterogenous, and studies using classifications except the ICRS score or Kellgren-Lawrence grade were not included in statistical analysis. Fifteen studies assessed patellar height; 10 studies reported significant decrease in patellar height after OWHTO. Only 3 studies reported clinical outcomes for patients with and without PF OA progression. Outcome reporting was variable across these studies, and a relationship between PF OA progression and clinical outcome could not be definitively determined.Conclusions: Patients appear to have progression of PF OA after medial OWHTO. However, there are currently insufficient studies with inconsistent measurements of outcomes to make meaningful conclusions regarding the impact of PF OA on clinical outcomes.Level Of Evidence: Level IV, systematic review of Level III-IV studies. [ABSTRACT FROM AUTHOR]
Published: 2021
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8. Goal Orientation and Desire for Approval Were Associated With Sports Injuries Among Young Japanese Athletes

Author: Kimotsuki, Yukiko, Ogasawara, Issei, Iwasaki, Susumu, Nagai, Kanto, Nishida, Kyohei, Kanzaki, Noriyuki, Hoshino, Yuichi, Matsushita, Takehiko, Kuroda, Ryosuke, Uchida, Ryohei, Take, Yasuhiro, and Nakata, Ken
Abstract: •Young Japanese athlete's task and ego orientations were correlated.•Athletes with severe injury history had a high task orientation.•Athletes with severe injury history reported a high desire for approval.
Published: 2024
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9. Operative Techniques in Sports Medicine focusing on the Aging Athlete Management of Meniscus Pathology-Repair and centralize or Resect?

Author: Nakanishi, Yuta, Nagai, Kanto, Hoshino, Yuichi, Matsushita, Takehiko, and Kuroda, Ryosuke
Abstract: This chapter will discuss relevant topics regarding management of meniscus pathology, with focus on the aging athlete. It is now commonly accepted that meniscal repair should be performed whenever possible to preserve the meniscus, which is crucial in load transmission, chondroprotection, and function as a secondary stabilizer. Despite knowing the benefits of meniscal repair, resection is still often performed. The chapter will discuss how age and involvement in sports are important variables to consider when treating the aging athlete. A broad overview of meniscus repair, centralization, and resection will be provided with emphasis on the aging athlete, outlining benefits and limitations of each technique. [ABSTRACT FROM AUTHOR]
Published: 2024
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10. Comparison of Clinical Outcomes Between Ceramic-Based Total Ankle Arthroplasty with Ceramic Total Talar Prosthesis and Ceramic-Based Total Ankle Arthroplasty

Author: Yamamoto, Tetsuya, Nagai, Kanto, Kanzaki, Noriyuki, Kataoka, Kiminari, Nukuto, Koji, Hoshino, Yuichi, Matsushita, Takehiko, and Kuroda, Ryosuke
Abstract: Background: Total ankle arthroplasty (TAA) has become one of the standard surgical treatments for patients with end-stage ankle osteoarthritis (OA). In recent years, TAA with total talar prosthesis (combined TAA) has been used for ankle OA patients with talar osteonecrosis, with severe talar collapse, or with subtalar joint OA. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA, compared with conventional TAA.Methods: Forty-six ankles (44 patients, 32 women/12 men) that underwent conventional TAA with mean follow-up of 42 months, and 26 ankles (25 patients, 18 women/7 men) that underwent combined TAA with mean follow-up of 46 months were included. Clinical outcomes, which included ankle range of motion (ROM), the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Self-Administered Foot Evaluation Questionnaire (SAFE-Q), and complications were compared between the groups.Results: The preoperative ROM was significantly worse in combined TAA for both dorsiflexion and plantarflexion; however, in the final ROM, there was no significant difference between the groups. There was no significant difference in JSSF scale and SAFE-Q between the groups. Revision rate was 10.9% in conventional TAA and 0% in combined TAA.Conclusion: In this small series, at an average of 3.5 years, we found no significant difference in clinical results between conventional TAA and combined TAA; however, the revision rate was higher in conventional TAA.Level of Evidence: Level III, retrospective cohort study.
Published: 2022
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11. Inhibition of Knee Osteoarthritis Progression in Mice by Administering SRT2014, an Activator of Silent Information Regulator 2 Ortholog 1

Author: Miyaji, Nobuaki, Nishida, Kyohei, Tanaka, Toshikazu, Araki, Daisuke, Kanzaki, Noriyuki, Hoshino, Yuichi, Kuroda, Ryosuke, and Matsushita, Takehiko
Abstract: Objective Previous findings suggest that silent information regulator 2 ortholog 1 (SIRT1) plays essential roles in chondrocytes and prevents osteoarthritis (OA) development. The purpose of this study was to investigate the effects of intraperitoneal (i.p.) and intra-articular (i.a.) administration of the SIRT1 activator SRT2104, which has been approved for use in humans.Design OA was induced by destabilizing the medial meniscus in the knee joint of 12-week-old CL57BL/6J mice. The mice were divided into 3 groups, that is, the control group, SRT2104 i.p.-injection group, and SRT2104 i.a.-injection group. Tissues were harvested at 4, 8, 12, and 16 weeks postsurgery. OA progression was evaluated using the Osteoarthritis Research Society International (OARSI) score. The production of OA-related proteins in cartilage and synovium was examined by immunohistochemistry.Results OARSI scores in the control group were significantly higher at 8 and 12 weeks compared with other 2 groups. Immunohistochemical analysis showed that Sirt1 and type-2 collagen significantly increased, whereas MMP-13, ADAMTS-5, IL-1β, IL-6, cleaved caspase 3, PARP p85, acetylated NF-κB p65, and iNOS decreased significantly in cartilage tissues from the i.p. and i.a, SRT2104 groups. In the synovium, more iNOS-positive M1-like macrophages were observed in the control group than in the i.p. and i.a, SRT2104 groups, whereas more CD206-positive M2-like macrophages were detected in the i.p. and i.a. SRT2104 groups.Conclusions Both i.p. and i.a. SRT2104 injection reduced OA progression in the mouse OA model, suggesting that SRT2104 can serve as a new treatment for OA.
Published: 2021
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12. Conventional computed tomography software can be used for accurate pre-operative templating in bipolar hip arthroplasty: A preliminary report.

Author: Chinzei, Nobuaki, Noda, Mitsuaki, Nashiki, Hiroshi, Matsushita, Takehiko, Inui, Atsuyuki, and Hayashi, Shinya
Abstract: The aim of this study was to investigate the use of pre-operative templating for bipolar hip arthroplasty (BHA) for displaced femoral neck fracture using multiplanar reconstruction (MPR) of computed tomography (CT) images. Nineteen patients who underwent BHA were enrolled in this study. For pre- and post-operative evaluation, a CT scan was performed from the pelvis to the knee joints. MPR of the CT image was done using software to measure the femoral head cup diameter, offset, stem size, length of the modular neck, distance from the neck osteotomy, and femoral anteversion. We compared these parameters pre- and post-operatively. Both the femoral head cup diameter and length of the modular neck were found to be significantly different between pre- and post-operative measurements, although the differences were minor. Other parameters, including the femoral offset, were not significantly different between the pre- and post-operative measurements. The size of the femoral stem, cup diameter, and length of the modular neck were consistent with the planned size and accurate (within ±1 size) in more than 84% cases. Our pre-operative templating approach for BHA using MPR of CT has potential clinical utility as a complementary tool for pre-operative planning using three-dimensional templating software. Moreover, this technique could be feasible in most hospitals without additional expenditure. [ABSTRACT FROM AUTHOR]
Published: 2021
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13. The Influences of Chronicity and Meniscal Injuries on Pivot Shift in Anterior Cruciate Ligament-Deficient Knees: Quantitative Evaluation Using an Electromagnetic Measurement System.

Author: Nishida, Kyohei, Matsushita, Takehiko, Hoshino, Yuichi, Araki, Daisuke, Matsumoto, Tomoyuki, Niikura, Takahiro, and Kuroda, Ryosuke
Abstract: Purpose: To investigate the influences of time from injury to surgery and meniscal injuries on knee rotational laxity in anterior cruciate ligament (ACL)-deficient knees using the electromagnetic system retrospectively.Methods: Ninety-four unilateral ACL-injured patients (44 male and 50 female, mean age: 27.3 ± 11.8 years) were included. The pivot-shift test was performed before ACL reconstruction, as was a quantitative evaluation using the electromagnetic system to determine tibial acceleration. Patients were divided into 4 groups according to the chronicity: group 1, within 3 months (22 patients); group 2, between 3 and 6 months (29 patients); group 3, between 6 and 12 months (23 patients); and group 4, more than 12 months (20 patients). The presence of meniscal injuries was examined arthroscopically.Results: The tibial acceleration was significantly greater in group 4. There was a positive correlation between tibial acceleration and the time from injury to surgery (r = 0.47, P = .02). In groups 1, 2 and 3, the tibial acceleration in patients with a lateral meniscal injury was significantly greater than in patients with a medial meniscal injury and without meniscal injury. When patients with lateral meniscal injury were excluded (leaving those with medial meniscus injury or without meniscal injury), group 4 had significantly greater accelerations than other groups.Conclusions: In ACL-deficient knees, rotational laxity increased with time and the increased rotational laxity was evident more than 1 year after injury whereas it increased with concomitant lateral meniscal injuries within 1 year after injury.Level Of Evidence: Ⅳ, diagnostic study of nonconsecutive patients. [ABSTRACT FROM AUTHOR]
Published: 2020
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14. Changes in knee extensor strengths before and after medial patellofemoral ligament reconstruction.

Author: Matsushita, Takehiko, Araki, Daisuke, Matsumoto, Tomoyuki, Niikura, Takahiro, and Kuroda, Ryosuke
Abstract: Objective: Quadriceps dysfunction has been suggested as a complication after medial patellofemoral ligament (MPFL) reconstruction. The purpose of this study was to investigate changes in knee extensor strength before and after MPFL reconstruction. Methods: Twenty patients who underwent MPFL reconstruction for unilateral recurrent patellar dislocation (18 females and 2 males; mean age 20.8 ± 7.6 years) were examined. The peak isometric torque at 60° and 90° of knee flexion and isokinetic knee extensor strength at speeds of 60°/s and 90°/s in operated and non-operated legs were measured using a dynamometer preoperatively and 6 months, 1 year, and 2 years postoperatively. The following parameters were evaluated: (1) body weight-adjusted muscle strength, (2) improvement index (post-/preoperative value × 100) (%), and (3) extensor strength ratio (operated/non-operated value × 100) (%). Results: The mean knee extensor strength in both operated and non-operated legs significantly increased 2 years after surgery compared with that before surgery. At 2 years postoperatively, the improvement indexes of the isometric knee extensor strength at 60° and 90° and of the isokinetic knee extensor strength at 60°/s and 90°/s were 237%, 192%, 318%, and 186%, respectively, in the operated legs and 144%, 124%, 140%, and 140%, respectively, in the non-operated legs. At 2 years postoperatively, the mean isometric knee extensor strength ratios at 60° and 90° and the isokinetic knee extensor strength ratios at 60°/s and 180°/s were 81%, 84%, 81%, and 82%, respectively. Conclusions: Knee extensor strength was improved in most patients after MPFL reconstruction, at least compared with that before surgery, although an approximately 20% deficit against the non-operated legs remained even 2 years after surgery. [ABSTRACT FROM AUTHOR]
Published: 2019
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15. A majority of the patient achieved both patient-acceptable symptom state and minimal clinically important difference of International Knee Documentation Committee Subjective Knee Form score at one year after anatomical double-bundle anterior cruciate ligament reconstruction

Author: Tokura, Takeo, Hoshino, Yuichi, Nagai, Kanto, Nishida, Kyohei, Kanzaki, Noriyuki, Matsushita, Takehiko, and Kuroda, Ryosuke
Abstract: There is a paucity of data about clinical outcomes after double-bundle anterior cruciate ligament reconstruction (DB-ACLR) using the concepts of patient-acceptable symptom state (PASS) and minimal clinically important difference (MCID). The aim of the present study was to evaluate the one-year clinical outcomes of patients who underwent DB-ACLR using PASS and MCID.
Published: 2024
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16. Patellofemoral instability part 1 (When to operate and soft tissue procedures): State of the art

Author: Hinckel, Betina, Smith, Justin, Tanaka, Miho J., Matsushita, Takehiko, and Martinez-Cano, Juan Pablo
Abstract: Patellofemoral instability is usually initially treated non-operatively. Surgery is considered in patients with recurrent patellar dislocation and after a first-time patellar dislocation in the presence of either an associated osteochondral fracture or high risk of recurrence. Stratifying the risk of recurrence includes evaluating risk factors such as age, trochlear dysplasia, contralateral dislocation, and patellar height. Surgery with soft tissue procedures includes restoring the medial patellar restraints and balancing the lateral side of the joint. Reconstruction of the medial patellofemoral ligament is the most frequent way of addressing the medial soft tissues in patients with patellofemoral instability. Meanwhile, lateral tightness can be achieved by lateral retinaculum lengthening or release. Approaching patellofemoral instability in a patient-specific approach, combined with a shared decision-making process with the patient/family, will guide surgeons to the deliver optimal care for the patellar instability patient.
Published: 2024
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17. Locking plate osteosynthesis for a femoral fracture and subsequent nonunion in a patient with osteopetrosis.

Author: Matsuo, Tomoya, Lee, Sang Yang, Iwakura, Takashi, Fukui, Tomoaki, Oe, Keisuke, Matsumoto, Tomoyuki, Matsushita, Takehiko, Nishida, Kotaro, Kuroda, Ryosuke, and Niikura, Takahiro
Abstract: Highlights • We performed osteosynthesis with a single locking plate in a patient with osteopetrosis. • Union was delayed, and plate breakage occurred along with nonunion of the fracture. • We then used double locking plates and attained stronger internal fixation with complete fracture healing. Abstract Introduction Osteopetrosis is a skeletal disorder characterized by increased osteodensity and a remodeling defect. The fragility of dense sclerotic bones may lead to an increased incidence of fractures. Although internal fixation can be performed, technical challenges may be experienced because of the increased bone density. Complications such as delayed union, nonunion, or implant failure may occur postoperatively. Presentation of case We describe a patient with autosomal-dominant osteopetrosis type 2 who suffered a shaft fracture below a plate of his right femur. We performed osteosynthesis with a single locking plate. Union was delayed, and plate breakage occurred along with nonunion of the fracture. The nonunion was addressed using double locking plates, which secured fixation and allowed complete fracture healing. Discussion There were three reasons of nonunion in our case. First, we left gaps between the fragments. Second, we used mainly cerclage wires, rather than screws, for plate fixation, which led to inadequate stability. Third, the patient was large (height 167 cm, weight 93.1 kg), so the single plate provided insufficient fixing force. We then used double locking plates and attained stronger internal fixation with complete fracture healing. Conclusion Double plating with locking plates may be an effective treatment option for femoral fractures in patients with osteopetrosis. [ABSTRACT FROM AUTHOR]
Published: 2018
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18. Medial clavicle pseudarthrosis successfully treated with an inverted distal clavicle locking plate

Author: Sasaki, Yu, Lee, Sang Yang, Iwakura, Takashi, Fukui, Tomoaki, Oe, Keisuke, Matsumoto, Tomoyuki, Matsushita, Takehiko, Kawamoto, Teruya, Mifune, Yutaka, Kuroda, Ryosuke, and Niikura, Takahiro
Abstract: Medial clavicle fractures are rare injuries. Symptomatic nonunion arises up to 8% of medial clavicle fractures when treated conservatively.
Published: 2019
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19. Changes in knee extensor strengths before and after medial patellofemoral ligament reconstruction

Author: Matsushita, Takehiko, Araki, Daisuke, Matsumoto, Tomoyuki, Niikura, Takahiro, and Kuroda, Ryosuke
Abstract: ABSTRACTObjective: Quadriceps dysfunction has been suggested as a complication after medial patellofemoral ligament (MPFL) reconstruction. The purpose of this study was to investigate changes in knee extensor strength before and after MPFL reconstruction.Methods: Twenty patients who underwent MPFL reconstruction for unilateral recurrent patellar dislocation (18 females and 2 males; mean age 20.8 ± 7.6 years) were examined. The peak isometric torque at 60° and 90° of knee flexion and isokinetic knee extensor strength at speeds of 60°/s and 90°/s in operated and non-operated legs were measured using a dynamometer preoperatively and 6 months, 1 year, and 2 years postoperatively. The following parameters were evaluated: (1) body weight-adjusted muscle strength, (2) improvement index (post-/preoperative value × 100) (%), and (3) extensor strength ratio (operated/non-operated value × 100) (%).Results: The mean knee extensor strength in both operated and non-operated legs significantly increased 2 years after surgery compared with that before surgery. At 2 years postoperatively, the improvement indexes of the isometric knee extensor strength at 60° and 90° and of the isokinetic knee extensor strength at 60°/s and 90°/s were 237%, 192%, 318%, and 186%, respectively, in the operated legs and 144%, 124%, 140%, and 140%, respectively, in the non-operated legs. At 2 years postoperatively, the mean isometric knee extensor strength ratios at 60° and 90° and the isokinetic knee extensor strength ratios at 60°/s and 180°/s were 81%, 84%, 81%, and 82%, respectively.Conclusions: Knee extensor strength was improved in most patients after MPFL reconstruction, at least compared with that before surgery, although an approximately 20% deficit against the non-operated legs remained even 2 years after surgery.
Published: 2019
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20. High tibial osteotomy combined with cancellous bone graft and osteochondral autograft transplantation in a patient with massive osteochondral defects in the medial femoral condyle.

Author: Takehiko Matsushita, Shu Watanabe, Daisuke Araki, Tomoyuki Matsumoto, Koji Takayama, Masahiro Kurosaka, Ryosuke Kuroda, Matsushita, Takehiko, Watanabe, Shu, Araki, Daisuke, Matsumoto, Tomoyuki, Takayama, Koji, Kurosaka, Masahiro, and Kuroda, Ryosuke
Published: 2017
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21. Clinical and Radiological Comparison of Single and Double Intra-articular Injection of Adipose-Derived Stromal Vascular Fraction for Knee Osteoarthritis

Author: Fujita, Masahiro, Matsumoto, Tomoyuki, Sobajima, Satoshi, Tsubosaka, Masanori, Matsushita, Takehiko, Iwaguro, Hideki, and Kuroda, Ryosuke
Abstract: The aim of the article is to compare the clinical and radiological outcomes between single and double stromal vascular fraction (SVF) cell injections in patients with knee osteoarthritis (OA). We included 54 patients treated for varus knee OA with intra-articular SVF cell injection. They were divided into two groups: those who received one injection and those who received two. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, knee range of motion, and knee muscle force were assessed at baseline and 3, 6, 12, and 24 months after the first injection. The preoperative hip-knee-ankle (HKA) angle was evaluated using plain radiographs, and T2 mapping values were assessed. The total WOMAC score improved significantly in the single injection group from 3 to 24 months, but the total WOMAC score in the double injection group improved significantly at 24 months. The T2 mapping values in both the groups improved, with a significant difference at 12 months. The preoperative mean HKA angle and the correlation coefficients between the HKA angle and the total WOMAC score and between the HKA angle and the T2 mapping value of the medial femur were significant. In conclusion, double injections may provide more satisfactory treatment outcomes in patients with severe varus knee alignment. This clinical trial is registered in the Japanese Ministry of Health, Labour and Welfare (URL: https://saiseiiryo.mhlw.go.jp/published_plan/index/2) with the registration name “Cell transplantation therapy for osteoarthritis using autologous subcutaneous adipose tissue-derived regenerative (stem) cells (ADRCs),” and the registration number was “PB5160012.”
Published: 2023
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22. Biomechanical Function of Anterior Cruciate Ligament Remnants: Quantitative Measurement With a 3-Dimensional Electromagnetic Measurement System.

Author: Nagai, Kanto, Araki, Daisuke, Matsushita, Takehiko, Nishizawa, Yuichiro, Hoshino, Yuichi, Matsumoto, Tomoyuki, Takayama, Koji, Nakano, Naoki, Nagamune, Kouki, Kurosaka, Masahiro, and Kuroda, Ryosuke
Abstract: Purpose: To evaluate quantitatively the biomechanical function of anterior cruciate ligament (ACL) remnants in patients with ACL injuries. Anterior tibial translation (ATT) with KT-1000 and during the Lachman test with an electromagnetic measurement system (EMS) and tibial acceleration during the pivot shift test with EMS were measured.Methods: A total of 121 unilateral ACL injuries were examined. ACL remnants were morphologically classified as being attached to the posterior cruciate ligament (PCL group), to the roof of the intercondylar notch (RIN group), to the lateral wall of the intercondylar notch (LWIN group), or as having no substantial remnants (NONE group). Partial ACL tears were excluded. ATT was measured using KT-1000. ATT during the Lachman test and tibial acceleration during the pivot shift test were measured using EMS.Results: ACL remnant patterns were as follows: PCL group, 27 knees; RIN group, 34 knees; LWIN group, 27 knees; and NONE group, 33 knees. The ATT side-to-side difference in LWIN group (3.4 ± 0.7 mm) by KT-1000 was significantly smaller than the RIN (5.7 ± 1.0 mm) and NONE groups (5.9 ± 1.0 mm) (P < .05). The ATT side-to-side difference during the Lachman test was significantly smaller in the LWIN group (5.3 ± 1.2 mm) than the PCL (8.6 ± 1.4 mm), RIN (8.5 ± 1.2 mm), and NONE groups (7.6 ± 1.0 mm) (P < .05). Tibial accelerations were 2.0 ± 0.4, 1.7 ± 0.2, 1.9 ± 0.2, and 1.8 ± 0.3 m/s(2) in the PCL, RIN, LWIN, and NONE groups, respectively. There were no significant differences among groups.Conclusions: ACL remnants attached to the lateral wall of the intercondylar notch partially contributed to anterior-posterior stability but did not contribute to dynamic knee stability. These findings suggest that ACL remnants attached to nonanatomic insertion sites do not contribute significantly to knee stabilization.Level Of Evidence: Level III, diagnostic study of nonconsecutive patients. [ABSTRACT FROM AUTHOR]
Published: 2016
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23. Semimembranosus Release Reduces Tibial Internal Rotation and Flexion Angle in Cruciate-Retaining Total Knee Arthroplasty.

Author: Matsumoto, Tomoyuki, Takayama, Koji, Muratsu, Hirotsugu, Matsushita, Takehiko, Kuroda, Ryosuke, and Kurosaka, Masahiro
Abstract: Medial release for varus knee is a key procedure to obtain appropriate soft tissue balance in total knee arthroplasty (TKA). The influence of semimembranosus release during cruciate-retaining (CR) TKA on knee kinematics and clinical outcomes were investigated in consecutive 50 patients (25: semimembranosus release group, 25: minimum release group) with moderate varus osteoarthritis using a navigation system. Semimembranosus release significantly reduced the amount of tibial internal rotation before bone cut and after all prostheses implanted. Despite of no significant differences in clinical scores between the groups, minimum release group exhibited significantly higher postoperative flexion angle compared to the semimembranosus release group. Minimal medial release with avoiding semimembranosus release maintains tibial internal rotation in CR TKA, resulting in achievement of postoperative high flexion angle. [ABSTRACT FROM AUTHOR]
Published: 2015
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24. L’incidence de la coalition du tunnel est plus élevée pour le tibia que pour le fémur après reconstruction du ligament croisé antérieur à double faisceau aux ischio-jambiers : une analyse systématique de la littérature

Author: Nakanishi, Yuta, Nagai, Kanto, Kay, Jeffrey, Zakharia, Alexander, Nukuto, Koji, Hoshino, Yuichi, Matsushita, Takehiko, Kuroda, Ryosuke, and de SA, Darren
Abstract: Intraoperative and postoperative coalition of tunnels may occur in double-bundle (DB) anterior cruciate ligament reconstruction (ACLR). However, the incidence and effect on clinical outcomes of tunnel coalition following primary DB ACLR using a hamstring autograft has yet be analyzed and thus remains unknown. The objective of this systematic review was to identify the incidence of tunnel coalition upon DB ACLR using hamstring autografts and to elucidate any clinical outcomes and/or complications that tunnel coalition may have postoperatively.
Published: 2022
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25. Analysis of popliteal artery location for high tibial and distal tuberosity osteotomy using contrast-enhanced computed tomography

Author: Mori, Akiyoshi, Matsushita, Takehiko, Miyaji, Nobuaki, Nagai, Kanto, Araki, Daisuke, Kanzaki, Noriyuki, Matsumoto, Tomoyuki, Niikura, Takahiro, Hoshino, Yuichi, and Kuroda, Ryosuke
Abstract: Background: Our objective was to evaluate the location of popliteal artery (PA) in osteotomy planes during high tibial osteotomy (HTO) and to determine a safer angle for screw drilling to the tibial tuberosity during distal tuberosity osteotomy (DTO). Methods: Twenty knees in 20 patients who underwent contrast-enhanced computed tomography for cardiovascular diseases were examined. Osteotomy planes for open-wedge HTO (OWHTO) and hybrid closed-wedge HTO (hybrid CWHTO) were created using three-dimensional bone models. The distance from the posterior cortex of the tibia to the PA (dPC-PA) in the osteotomy planes was measured in the virtual osteotomy planes. The dangerous point (Point D1) was defined as the point 17.5 mm away from PA, setting the working length of the bone saw as 35 mm. The distance between the most medial point of the tibial cortex (Point M) and Point D1 in OWHTO and the most lateral point (Point L) and Point D1 in hybrid CWHTO were examined (dM-D1 and dL-D1, respectively). The location of Point D1 to the osteotomy line (%D1) was expressed as percentage, setting the start and end of the osteotomy line as 0% and 100%, respectively. To determine the safe angle for screw drilling in DTO, the angle between the line tangential to the medial cortex of the tibia and that passing through the center of the tibial tuberosity and PA were measured. Results: In OWHTO and hybrid CWHTO, the mean dPC-PA was 10.6 mm (6.9–16.5 mm) and 10.2 mm (7.3–15.4 mm), respectively. The mean dM-D1 in OWHTO was 25.9 mm (24.6–27.2 mm) and dL-D1 in hybrid CWHTO was 5.1 mm (2.9–7.4 mm). The mean %D1 was 47.6 ± 3.7% in OWHTO and 9.3 ± 4.1% in hybrid CWHTO, respectively. The minimal angle between the two lines in DTO was 35.2°. Conclusion: PAs could run within 10 mm from the posterior cortex in the osteotomy planes of HTO. Therefore, proper posterior protection is necessary when cutting posterior cortex. An angle of less than 35° against the medial cortex line would be safe for screw fixation to avoid vascular injury in DTO.
Published: 2022
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26. Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

Author: Klionsky, Daniel J, Abdelmohsen, Kotb, Abe, Akihisa, Abedin, Md Joynal, Abeliovich, Hagai, Acevedo Arozena, Abraham, Adachi, Hiroaki, Adams, Christopher M, Adams, Peter D, Adeli, Khosrow, Adhihetty, Peter J, Adler, Sharon G, Agam, Galila, Agarwal, Rajesh, Aghi, Manish K, Agnello, Maria, Agostinis, Patrizia, Aguilar, Patricia V, Aguirre-Ghiso, Julio, Airoldi, Edoardo M, Ait-Si-Ali, Slimane, Akematsu, Takahiko, Akporiaye, Emmanuel T, Al-Rubeai, Mohamed, Albaiceta, Guillermo M, Albanese, Chris, Albani, Diego, Albert, Matthew L, Aldudo, Jesus, Algül, Hana, Alirezaei, Mehrdad, Alloza, Iraide, Almasan, Alexandru, Almonte-Beceril, Maylin, Alnemri, Emad S, Alonso, Covadonga, Altan-Bonnet, Nihal, Altieri, Dario C, Alvarez, Silvia, Alvarez-Erviti, Lydia, Alves, Sandro, Amadoro, Giuseppina, Amano, Atsuo, Amantini, Consuelo, Ambrosio, Santiago, Amelio, Ivano, Amer, Amal O, Amessou, Mohamed, Amon, Angelika, An, Zhenyi, Anania, Frank A, Andersen, Stig U, Andley, Usha P, Andreadi, Catherine K, Andrieu-Abadie, Nathalie, Anel, Alberto, Ann, David K, Anoopkumar-Dukie, Shailendra, Antonioli, Manuela, Aoki, Hiroshi, Apostolova, Nadezda, Aquila, Saveria, Aquilano, Katia, Araki, Koichi, Arama, Eli, Aranda, Agustin, Araya, Jun, Arcaro, Alexandre, Arias, Esperanza, Arimoto, Hirokazu, Ariosa, Aileen R, Armstrong, Jane L, Arnould, Thierry, Arsov, Ivica, Asanuma, Katsuhiko, Askanas, Valerie, Asselin, Eric, Atarashi, Ryuichiro, Atherton, Sally S, Atkin, Julie D, Attardi, Laura D, Auberger, Patrick, Auburger, Georg, Aurelian, Laure, Autelli, Riccardo, Avagliano, Laura, Avantaggiati, Maria Laura, Avrahami, Limor, Awale, Suresh, Azad, Neelam, Bachetti, Tiziana, Backer, Jonathan M, Bae, Dong-Hun, Bae, Jae-sung, Bae, Ok-Nam, Bae, Soo Han, Baehrecke, Eric H, Baek, Seung-Hoon, Baghdiguian, Stephen, Bagniewska-Zadworna, Agnieszka, Bai, Hua, Bai, Jie, Bai, Xue-Yuan, Bailly, Yannick, Balaji, Kithiganahalli Narayanaswamy, Balduini, Walter, Ballabio, Andrea, Balzan, Rena, Banerjee, Rajkumar, Bánhegyi, Gábor, Bao, Haijun, Barbeau, Benoit, Barrachina, Maria D, Barreiro, Esther, Bartel, Bonnie, Bartolomé, Alberto, Bassham, Diane C, Bassi, Maria Teresa, Bast, Robert C, Basu, Alakananda, Batista, Maria Teresa, Batoko, Henri, Battino, Maurizio, Bauckman, Kyle, Baumgarner, Bradley L, Bayer, K Ulrich, Beale, Rupert, Beaulieu, Jean-François, Beck, George R., Becker, Christoph, Beckham, J David, Bédard, Pierre-André, Bednarski, Patrick J, Begley, Thomas J, Behl, Christian, Behrends, Christian, Behrens, Georg MN, Behrns, Kevin E, Bejarano, Eloy, Belaid, Amine, Belleudi, Francesca, Bénard, Giovanni, Berchem, Guy, Bergamaschi, Daniele, Bergami, Matteo, Berkhout, Ben, Berliocchi, Laura, Bernard, Amélie, Bernard, Monique, Bernassola, Francesca, Bertolotti, Anne, Bess, Amanda S, Besteiro, Sébastien, Bettuzzi, Saverio, Bhalla, Savita, Bhattacharyya, Shalmoli, Bhutia, Sujit K, Biagosch, Caroline, Bianchi, Michele Wolfe, Biard-Piechaczyk, Martine, Billes, Viktor, Bincoletto, Claudia, Bingol, 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Scott J, Bultynck, Geert, Bumbasirevic, Vladimir, Burelle, Yan, Burke, Robert E, Burmeister, Margit, Bütikofer, Peter, Caberlotto, Laura, Cadwell, Ken, Cahova, Monika, Cai, Dongsheng, Cai, Jingjing, Cai, Qian, Calatayud, Sara, Camougrand, Nadine, Campanella, Michelangelo, Campbell, Grant R, Campbell, Matthew, Campello, Silvia, Candau, Robin, Caniggia, Isabella, Cantoni, Lavinia, Cao, Lizhi, Caplan, Allan B, Caraglia, Michele, Cardinali, Claudio, Cardoso, Sandra Morais, Carew, Jennifer S, Carleton, Laura A, Carlin, Cathleen R, Carloni, Silvia, Carlsson, Sven R, Carmona-Gutierrez, Didac, Carneiro, Leticia AM, Carnevali, Oliana, Carra, Serena, Carrier, Alice, Carroll, Bernadette, Casas, Caty, Casas, Josefina, Cassinelli, Giuliana, Castets, Perrine, Castro-Obregon, Susana, Cavallini, Gabriella, Ceccherini, Isabella, Cecconi, Francesco, Cederbaum, Arthur I, Ceña, Valentín, Cenci, Simone, Cerella, Claudia, Cervia, Davide, Cetrullo, Silvia, Chaachouay, Hassan, Chae, Han-Jung, Chagin, Andrei S, Chai, Chee-Yin, Chakrabarti, Gopal, Chamilos, Georgios, Chan, Edmond YW, Chan, Matthew TV, Chandra, Dhyan, Chandra, Pallavi, Chang, Chih-Peng, Chang, Raymond Chuen-Chung, Chang, Ta Yuan, Chatham, John C, Chatterjee, Saurabh, Chauhan, Santosh, Che, Yongsheng, Cheetham, Michael E, Cheluvappa, Rajkumar, Chen, Chun-Jung, Chen, Gang, Chen, Guang-Chao, Chen, Guoqiang, Chen, Hongzhuan, Chen, Jeff W, Chen, Jian-Kang, Chen, Min, Chen, Mingzhou, Chen, Peiwen, Chen, Qi, Chen, Quan, Chen, Shang-Der, Chen, Si, Chen, Steve S-L, Chen, Wei, Chen, Wei-Jung, Chen, Wen Qiang, Chen, Wenli, Chen, Xiangmei, Chen, Yau-Hung, Chen, Ye-Guang, Chen, Yin, Chen, Yingyu, Chen, Yongshun, Chen, Yu-Jen, Chen, Yue-Qin, Chen, Yujie, Chen, Zhen, Chen, Zhong, Cheng, Alan, Cheng, Christopher HK, Cheng, Hua, Cheong, Heesun, Cherry, Sara, Chesney, Jason, Cheung, Chun Hei Antonio, Chevet, Eric, Chi, Hsiang Cheng, Chi, Sung-Gil, Chiacchiera, Fulvio, Chiang, Hui-Ling, Chiarelli, Roberto, Chiariello, Mario, Chieppa, Marcello, 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de Figueiredo, Regina Celia Bressan Queiroz, de la Fuente, José, De Martino, Luisa, De Matteis, Antonella, De Meyer, Guido RY, De Milito, Angelo, De Santi, Mauro, de Souza, Wanderley, De Tata, Vincenzo, De Zio, Daniela, Debnath, Jayanta, Dechant, Reinhard, Decuypere, Jean-Paul, Deegan, Shane, Dehay, Benjamin, Del Bello, Barbara, Del Re, Dominic P, Delage-Mourroux, Régis, Delbridge, Lea MD, Deldicque, Louise, Delorme-Axford, Elizabeth, Deng, Yizhen, Dengjel, Joern, Denizot, Melanie, Dent, Paul, Der, Channing J, Deretic, Vojo, Derrien, Benoît, Deutsch, Eric, Devarenne, Timothy P, Devenish, Rodney J, Di Bartolomeo, Sabrina, Di Daniele, Nicola, Di Domenico, Fabio, Di Nardo, Alessia, Di Paola, Simone, Di Pietro, Antonio, Di Renzo, Livia, DiAntonio, Aaron, Díaz-Araya, Guillermo, Díaz-Laviada, Ines, Diaz-Meco, Maria T, Diaz-Nido, Javier, Dickey, Chad A, Dickson, Robert C, Diederich, Marc, Digard, Paul, Dikic, Ivan, Dinesh-Kumar, Savithrama P, Ding, Chan, Ding, Wen-Xing, Ding, Zufeng, Dini, Luciana, Distler, Jörg HW, Diwan, Abhinav, Djavaheri-Mergny, Mojgan, Dmytruk, Kostyantyn, Dobson, Renwick CJ, Doetsch, Volker, Dokladny, Karol, Dokudovskaya, Svetlana, Donadelli, Massimo, Dong, X Charlie, Dong, Xiaonan, Dong, Zheng, Donohue, Terrence M, Doran, Kelly S, D'Orazi, Gabriella, Dorn, Gerald W, Dosenko, Victor, Dridi, Sami, Drucker, Liat, Du, Jie, Du, Li-Lin, Du, Lihuan, du Toit, André, Dua, Priyamvada, Duan, Lei, Duann, Pu, Dubey, Vikash Kumar, Duchen, Michael R, Duchosal, Michel A, Duez, Helene, Dugail, Isabelle, Dumit, Verónica I, Duncan, Mara C, Dunlop, Elaine A, Dunn, William A, Dupont, Nicolas, Dupuis, Luc, Durán, Raúl V, Durcan, Thomas M, Duvezin-Caubet, Stéphane, Duvvuri, Umamaheswar, Eapen, Vinay, Ebrahimi-Fakhari, Darius, Echard, Arnaud, Eckhart, Leopold, Edelstein, Charles L, Edinger, Aimee L, Eichinger, Ludwig, Eisenberg, Tobias, Eisenberg-Lerner, Avital, Eissa, N Tony, El-Deiry, Wafik S, El-Khoury, Victoria, Elazar, Zvulun, Eldar-Finkelman, Hagit, Elliott, Chris JH, Emanuele, Enzo, Emmenegger, Urban, Engedal, Nikolai, Engelbrecht, Anna-Mart, Engelender, Simone, Enserink, Jorrit M, Erdmann, Ralf, Erenpreisa, Jekaterina, Eri, Rajaraman, Eriksen, Jason L, Erman, Andreja, Escalante, Ricardo, Eskelinen, Eeva-Liisa, Espert, Lucile, Esteban-Martínez, Lorena, Evans, Thomas J, Fabri, Mario, Fabrias, Gemma, Fabrizi, Cinzia, Facchiano, Antonio, Færgeman, Nils J, Faggioni, Alberto, Fairlie, W Douglas, Fan, Chunhai, Fan, Daping, Fan, Jie, Fang, Shengyun, Fanto, Manolis, Fanzani, Alessandro, Farkas, Thomas, Faure, Mathias, Favier, Francois B, Fearnhead, Howard, Federici, Massimo, Fei, Erkang, Felizardo, Tania C, Feng, Hua, Feng, Yibin, Feng, Yuchen, Ferguson, Thomas A, Fernández, Álvaro F, Fernandez-Barrena, Maite G, Fernandez-Checa, Jose C, Fernández-López, Arsenio, Fernandez-Zapico, Martin E, Feron, Olivier, Ferraro, Elisabetta, Ferreira-Halder, Carmen Veríssima, Fesus, Laszlo, Feuer, Ralph, Fiesel, Fabienne C, Filippi-Chiela, Eduardo C, Filomeni, 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Sedej, Simon, Segatori, Laura, Segev, Nava, Seglen, Per O, Seguí-Simarro, Jose M, Segura-Aguilar, Juan, Seki, Ekihiro, Seiliez, Iban, Sell, Christian, Semenkovich, Clay F, Semenza, Gregg L, Sen, Utpal, Serra, Andreas L, Serrano-Puebla, Ana, Sesaki, Hiromi, Setoguchi, Takao, Settembre, Carmine, Shacka, John J, Shajahan-Haq, Ayesha N, Shapiro, Irving M, Sharma, Shweta, She, Hua, Shen, C-K James, Shen, Chiung-Chyi, Shen, Han-Ming, Shen, Sanbing, Shen, Weili, Sheng, Rui, Sheng, Xianyong, Sheng, Zu-Hang, Shepherd, Trevor G, Shi, Junyan, Shi, Qiang, Shi, Qinghua, Shi, Yuguang, Shibutani, Shusaku, Shibuya, Kenichi, Shidoji, Yoshihiro, Shieh, Jeng-Jer, Shih, Chwen-Ming, Shimada, Yohta, Shimizu, Shigeomi, Shin, Dong Wook, Shinohara, Mari L, Shintani, Michiko, Shintani, Takahiro, Shioi, Tetsuo, Shirabe, Ken, Shiri-Sverdlov, Ronit, Shirihai, Orian, Shore, Gordon C, Shu, Chih-Wen, Shukla, Deepak, Sibirny, Andriy A, Sica, Valentina, Sigurdson, Christina J, Sigurdsson, Einar M, Sijwali, Puran Singh, 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D, Springer, Wolfdieter, Clair, Daret St, Stacchiotti, Alessandra, Staels, Bart, Stang, Michael T, Starczynowski, Daniel T, Starokadomskyy, Petro, Steegborn, Clemens, Steele, John W, Stefanis, Leonidas, Steffan, Joan, Stellrecht, Christine M, Stenmark, Harald, Stepkowski, Tomasz M, Stern, Stęphan T, Stevens, Craig, Stockwell, Brent R, Stoka, Veronika, Storchova, Zuzana, Stork, Björn, Stratoulias, Vassilis, Stravopodis, Dimitrios J, Strnad, Pavel, Strohecker, Anne Marie, Ström, Anna-Lena, Stromhaug, Per, Stulik, Jiri, Su, Yu-Xiong, Su, Zhaoliang, Subauste, Carlos S, Subramaniam, Srinivasa, Sue, Carolyn M, Suh, Sang Won, Sui, Xinbing, Sukseree, Supawadee, Sulzer, David, Sun, Fang-Lin, Sun, Jiaren, Sun, Jun, Sun, Shi-Yong, Sun, Yang, Sun, Yi, Sun, Yingjie, Sundaramoorthy, Vinod, Sung, Joseph, Suzuki, Hidekazu, Suzuki, Kuninori, Suzuki, Naoki, Suzuki, Tadashi, Suzuki, Yuichiro J, Swanson, Michele S, Swanton, Charles, Swärd, Karl, Swarup, Ghanshyam, Sweeney, Sean T, Sylvester, Paul W, Szatmari, Zsuzsanna, Szegezdi, Eva, Szlosarek, Peter W, Taegtmeyer, Heinrich, Tafani, Marco, Taillebourg, Emmanuel, Tait, Stephen WG, Takacs-Vellai, Krisztina, Takahashi, Yoshinori, Takáts, Szabolcs, Takemura, Genzou, Takigawa, Nagio, Talbot, Nicholas J, Tamagno, Elena, Tamburini, Jerome, Tan, Cai-Ping, Tan, Lan, Tan, Mei Lan, Tan, Ming, Tan, Yee-Joo, Tanaka, Keiji, Tanaka, Masaki, Tang, Daolin, Tang, Dingzhong, Tang, Guomei, Tanida, Isei, Tanji, Kunikazu, Tannous, Bakhos A, Tapia, Jose A, Tasset-Cuevas, Inmaculada, Tatar, Marc, Tavassoly, Iman, Tavernarakis, Nektarios, Taylor, Allen, Taylor, Graham S, Taylor, Gregory A, Taylor, J Paul, Taylor, Mark J, Tchetina, Elena V, Tee, Andrew R, Teixeira-Clerc, Fatima, Telang, Sucheta, Tencomnao, Tewin, Teng, Ba-Bie, Teng, Ru-Jeng, Terro, Faraj, Tettamanti, Gianluca, Theiss, Arianne L, Theron, Anne E, Thomas, Kelly Jean, Thomé, Marcos P, Thomes, Paul G, Thorburn, Andrew, Thorner, Jeremy, Thum, Thomas, Thumm, Michael, Thurston, Teresa LM, Tian, Ling, Till, Andreas, Ting, Jenny Pan-yun, Titorenko, Vladimir I, Toker, Lilach, Toldo, Stefano, Tooze, Sharon A, Topisirovic, Ivan, Torgersen, Maria Lyngaas, Torosantucci, Liliana, Torriglia, Alicia, Torrisi, Maria Rosaria, Tournier, Cathy, Towns, Roberto, Trajkovic, Vladimir, Travassos, Leonardo H, Triola, Gemma, Tripathi, Durga Nand, Trisciuoglio, Daniela, Troncoso, Rodrigo, Trougakos, Ioannis P, Truttmann, Anita C, Tsai, Kuen-Jer, Tschan, Mario P, Tseng, Yi-Hsin, Tsukuba, Takayuki, Tsung, Allan, Tsvetkov, Andrey S, Tu, Shuiping, Tuan, Hsing-Yu, Tucci, Marco, Tumbarello, David A, Turk, Boris, Turk, Vito, Turner, Robin FB, Tveita, Anders A, Tyagi, Suresh C, Ubukata, Makoto, Uchiyama, Yasuo, Udelnow, Andrej, Ueno, Takashi, Umekawa, Midori, Umemiya-Shirafuji, Rika, Underwood, Benjamin R, Ungermann, Christian, Ureshino, Rodrigo P., Ushioda, Ryo, Uversky, Vladimir N, Uzcátegui, Néstor L, Vaccari, Thomas, Vaccaro, Maria I, Váchová, Libuše, Vakifahmetoglu-Norberg, Helin, Valdor, Rut, Valente, Enza Maria, Vallette, Francois, Valverde, Angela M, Van den Berghe, Greet, Van Den Bosch, Ludo, van den Brink, Gijs R, van der Goot, F Gisou, van der Klei, Ida J, van der Laan, Luc JW, van Doorn, Wouter G, van Egmond, Marjolein, van Golen, Kenneth L, Van Kaer, Luc, van Lookeren Campagne, Menno, Vandenabeele, Peter, Vandenberghe, Wim, Vanhorebeek, Ilse, Varela-Nieto, Isabel, Vasconcelos, M Helena, Vasko, Radovan, Vavvas, Demetrios G, Vega-Naredo, Ignacio, Velasco, Guillermo, Velentzas, Athanassios D, Velentzas, Panagiotis D, Vellai, Tibor, Vellenga, Edo, Vendelbo, Mikkel Holm, Venkatachalam, Kartik, Ventura, Natascia, Ventura, Salvador, Veras, Patrícia ST, Verdier, Mireille, Vertessy, Beata G, Viale, Andrea, Vidal, Michel, Vieira, Helena LA, Vierstra, Richard D, Vigneswaran, Nadarajah, Vij, Neeraj, Vila, Miquel, Villar, Margarita, Villar, Victor H, Villarroya, Joan, Vindis, Cécile, Viola, Giampietro, Viscomi, Maria Teresa, Vitale, Giovanni, Vogl, Dan T, Voitsekhovskaja, Olga V, von Haefen, Clarissa, von Schwarzenberg, Karin, Voth, Daniel E, Vouret-Craviari, Valérie, Vuori, Kristina, Vyas, Jatin M, Waeber, Christian, Walker, Cheryl Lyn, Walker, Mark J, Walter, Jochen, Wan, Lei, Wan, Xiangbo, Wang, Bo, Wang, Caihong, Wang, Chao-Yung, Wang, Chengshu, Wang, Chenran, Wang, Chuangui, Wang, Dong, Wang, Fen, Wang, Fuxin, Wang, Guanghui, Wang, Hai-jie, Wang, Haichao, Wang, Hong-Gang, Wang, Hongmin, Wang, Horng-Dar, Wang, Jing, Wang, Junjun, Wang, Mei, Wang, Mei-Qing, Wang, Pei-Yu, Wang, Peng, Wang, Richard C, Wang, Shuo, Wang, Ting-Fang, Wang, Xian, Wang, Xiao-jia, Wang, Xiao-Wei, Wang, Xin, Wang, Xuejun, Wang, Yan, Wang, Yanming, Wang, Ying, Wang, Ying-Jan, Wang, Yipeng, Wang, Yu, Wang, Yu Tian, Wang, Yuqing, Wang, Zhi-Nong, Wappner, Pablo, Ward, Carl, Ward, Diane McVey, Warnes, Gary, Watada, Hirotaka, Watanabe, Yoshihisa, Watase, Kei, Weaver, Timothy E, Weekes, Colin D, Wei, Jiwu, Weide, Thomas, Weihl, Conrad C, Weindl, Günther, Weis, Simone Nardin, Wen, Longping, Wen, Xin, Wen, Yunfei, Westermann, Benedikt, Weyand, Cornelia M, White, Anthony R, White, Eileen, Whitton, J Lindsay, Whitworth, Alexander J, Wiels, Joëlle, Wild, Franziska, Wildenberg, Manon E, Wileman, Tom, Wilkinson, Deepti Srinivas, Wilkinson, Simon, Willbold, Dieter, Williams, Chris, Williams, Katherine, Williamson, Peter R, Winklhofer, Konstanze F, Witkin, Steven S, Wohlgemuth, Stephanie E, Wollert, Thomas, Wolvetang, Ernst J, Wong, Esther, Wong, G William, Wong, Richard W, Wong, Vincent Kam Wai, Woodcock, Elizabeth A, Wright, Karen L, Wu, Chunlai, Wu, Defeng, Wu, Gen Sheng, Wu, Jian, Wu, Junfang, Wu, Mian, Wu, Min, Wu, Shengzhou, Wu, William KK, Wu, Yaohua, Wu, Zhenlong, Xavier, Cristina PR, Xavier, Ramnik J, Xia, Gui-Xian, Xia, Tian, Xia, Weiliang, Xia, Yong, Xiao, Hengyi, Xiao, Jian, Xiao, Shi, Xiao, Wuhan, Xie, Chuan-Ming, Xie, Zhiping, Xie, Zhonglin, Xilouri, Maria, Xiong, Yuyan, Xu, Chuanshan, Xu, Congfeng, Xu, Feng, Xu, Haoxing, Xu, Hongwei, Xu, Jian, Xu, Jianzhen, Xu, Jinxian, Xu, Liang, Xu, Xiaolei, Xu, Yangqing, Xu, Ye, Xu, Zhi-Xiang, Xu, Ziheng, Xue, Yu, Yamada, Takahiro, Yamamoto, Ai, Yamanaka, Koji, Yamashina, Shunhei, Yamashiro, Shigeko, Yan, Bing, Yan, Bo, Yan, Xianghua, Yan, Zhen, Yanagi, Yasuo, Yang, Dun-Sheng, Yang, Jin-Ming, Yang, Liu, Yang, Minghua, Yang, Pei-Ming, Yang, Peixin, Yang, Qian, Yang, Wannian, Yang, Wei Yuan, Yang, Xuesong, Yang, Yi, Yang, Ying, Yang, Zhifen, Yang, Zhihong, Yao, Meng-Chao, Yao, Pamela J, Yao, Xiaofeng, Yao, Zhenyu, Yao, Zhiyuan, Yasui, Linda S, Ye, Mingxiang, Yedvobnick, Barry, Yeganeh, Behzad, Yeh, Elizabeth S, Yeyati, Patricia L, Yi, Fan, Yi, Long, Yin, Xiao-Ming, Yip, Calvin K, Yoo, Yeong-Min, Yoo, Young Hyun, Yoon, Seung-Yong, Yoshida, Ken-Ichi, Yoshimori, Tamotsu, Young, Ken H, Yu, Huixin, Yu, Jane J, Yu, Jin-Tai, Yu, Jun, Yu, Li, Yu, W Haung, Yu, Xiao-Fang, Yu, Zhengping, Yuan, Junying, Yuan, Zhi-Min, Yue, Beatrice YJT, Yue, Jianbo, Yue, Zhenyu, Zacks, David N, Zacksenhaus, Eldad, Zaffaroni, Nadia, Zaglia, Tania, Zakeri, Zahra, Zecchini, Vincent, Zeng, Jinsheng, Zeng, Min, Zeng, Qi, Zervos, Antonis S, Zhang, Donna D, Zhang, Fan, Zhang, Guo, Zhang, Guo-Chang, Zhang, Hao, Zhang, Hong, Zhang, Hong, Zhang, Hongbing, Zhang, Jian, Zhang, Jian, Zhang, Jiangwei, Zhang, Jianhua, Zhang, Jing-pu, Zhang, Li, Zhang, Lin, Zhang, Lin, Zhang, Long, Zhang, Ming-Yong, Zhang, Xiangnan, Zhang, Xu Dong, Zhang, Yan, Zhang, Yang, Zhang, Yanjin, Zhang, Yingmei, Zhang, Yunjiao, Zhao, Mei, Zhao, Wei-Li, Zhao, Xiaonan, Zhao, Yan G, Zhao, Ying, Zhao, Yongchao, Zhao, Yu-xia, Zhao, Zhendong, Zhao, Zhizhuang J, Zheng, Dexian, Zheng, Xi-Long, Zheng, Xiaoxiang, Zhivotovsky, Boris, Zhong, Qing, Zhou, Guang-Zhou, Zhou, Guofei, Zhou, Huiping, Zhou, Shu-Feng, Zhou, Xu-jie, Zhu, Hongxin, Zhu, Hua, Zhu, Wei-Guo, Zhu, Wenhua, Zhu, Xiao-Feng, Zhu, Yuhua, Zhuang, Shi-Mei, Zhuang, Xiaohong, Ziparo, Elio, Zois, Christos E, Zoladek, Teresa, Zong, Wei-Xing, Zorzano, Antonio, and Zughaier, Susu M
Published: 2016
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27. Recombinant human SIRT1 protects against nutrient deprivation-induced mitochondrial apoptosis through autophagy induction in human intervertebral disc nucleus pulposus cells

Author: Miyazaki, Shingo, Kakutani, Kenichiro, Yurube, Takashi, Maeno, Koichiro, Takada, Toru, Zhang, Zhongying, Kurakawa, Takuto, Terashima, Yoshiki, Ito, Masaaki, Ueha, Takeshi, Matsushita, Takehiko, Kuroda, Ryosuke, Kurosaka, Masahiro, and Nishida, Kotaro
Abstract: Nutrient deprivation is a likely contributor to intervertebral disc (IVD) degeneration. Silent mating type information regulator 2 homolog 1 (SIRT1) protects cells against limited nutrition by modulation of apoptosis and autophagy. However, little evidence exists regarding the extent to which SIRT1 affects IVD cells. Therefore, we conducted an in vitro study using human IVD nucleus pulposus (NP) cells. Thirty-two IVD specimens were obtained from patients who underwent surgical intervention and were categorized based on Pfirrmann IVD degeneration grades. Cells were isolated from the NP and cultured in the presence of recombinant human SIRT1 (rhSIRT1) under different serum conditions, including 10 % (v/v) fetal bovine serum (FBS) as normal nutrition (N) and 1 % (v/v) FBS as low nutrition (LN). 3-Methyladenine (3-MA) was used to inhibit autophagy. Autophagic activity was assessed by measuring the absorbance of monodansylcadaverine and immunostaining and Western blotting for light chain 3 and p62/SQSTM1. Apoptosis and pathway analyses were performed by flow cytometry and Western blotting. Cells cultured under LN conditions decreased in number and exhibited enhanced autophagy compared with the N condition. Medium supplementation with rhSIRT1 inhibited this decrease in cell number and induced an additional increase in autophagic activity (P< 0.05), whereas the combined use of rhSIRT1 and 3-MA resulted in drastic decreases in cell number and autophagy (P< 0.05). The incidence of apoptotic cell death increased under the LN condition, which was decreased by rhSIRT1 (P< 0.05) but increased further by a combination of rhSIRT1 and 3-MA (P< 0.05). Under LN conditions, NP cells showed a decrease in antiapoptotic Bcl-2 and an increase in proapoptotic Bax, cleaved caspase 3, and cleaved caspase 9, indicating apoptosis induction via the mitochondrial pathway. These changes were suppressed by rhSIRT1 but elevated further by rhSIRT1 with 3-MA, suggesting an effect of rhSIRT1-induced autophagy on apoptosis inhibition. Furthermore, the observed autophagy and apoptosis were more remarkable in cells from IVDs of Pfirrmann grade IV than in those from IVDs of Pfirrmann grade II. SIRT1 protects against nutrient deprivation-induced mitochondrial apoptosis through autophagy induction in human IVD NP cells, suggesting that rhSIRT1 may be a potent treatment agent for human degenerative IVD disease.
Published: 2015
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28. Reduction of Tunnel Enlargement With Use of Autologous Ruptured Tissue in Anterior Cruciate Ligament Reconstruction: A Pilot Clinical Trial.

Author: Matsumoto, Tomoyuki, Kuroda, Ryosuke, Matsushita, Takehiko, Araki, Daisuke, Hoshino, Yuichi, Nagamune, Kouki, and Kurosaka, Masahiro
Abstract: Purpose: To compare the tunnel enlargement of double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) with and without suturing of autologous ruptured tissue to hamstring graft in patients with subacute anterior cruciate ligament injury. Methods: Ten patients with subacute (≤3 months after injury) anterior cruciate ligament rupture were randomly allocated to undergo DB ACLR with suturing of the ruptured tissue to hamstring graft (n = 5) or conventional DB ACLR (n = 5). When autologous ruptured tissue was used, remnant ruptured tissue was then harvested, divided into 4 pieces, placed between the loops at the distal and proximal portions of the graft, and secured with the suture. As the primary endpoint, tunnel volume assessment by 3-dimensional multi–detector row computed tomography (MDCT) was performed 1 year after ACLR. To assess the efficacy of these procedures, the Lysholm score, anterior tibial translation (measured with a KT-1000 arthrometer [MEDmetric, San Diego, CA]), and rotational instability (measured by the pivot-shift test) were evaluated after 2 years. Results: Tunnel volume enlargement between 3 weeks and 1 year after ACLR as assessed by 3-dimensional MDCT was significantly less for ACLR using ruptured tissue than for conventional ACLR, especially at the femoral site (P < .05). However, the postoperative Lysholm score, anterior stability of the knee measured with the KT-1000 arthrometer, and rate of negative manual pivot-shift test results did not differ significantly between the 2 groups. There was no correlation to the clinical outcomes in terms of tunnel size. Conclusions: The Lysholm score, anterior laxity measured with the KT-1000 arthrometer, and rotational instability according to the pivot-shift test did not differ significantly between ACLR using ruptured tissue and the conventional technique. However, ACLR using ruptured tissue produced less femoral tunnel enlargement as assessed by MDCT, warranting further long-term follow-up to elucidate its effectiveness. Level of Evidence: Level II, prospective comparative study. [Copyright &y& Elsevier]
Published: 2014
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29. Local intra-articular injection of rapamycin delays articular cartilage degeneration in a murine model of osteoarthritis

Author: Takayama, Koji, Kawakami, Yohei, Kobayashi, Makoto, Greco, Nick, Cummins, James, Matsushita, Takehiko, Kuroda, Ryosuke, Kurosaka, Masahiro, Fu, Freddie, and Huard, Johnny
Abstract: Recent studies have revealed that rapamycin activates autophagy in human chondrocytes preventing the development of osteoarthritis (OA) like changes in vitro, while the systemic injection of rapamycin reduces the severity of experimental osteoarthritis in a murine model of OA in vivo. Since the systemic use of rapamycin is associated with numerous side effects, the goal of the current study was to examine the beneficial effect of local intra-articular injection of rapamycin in a murine model of OA and to elucidate the mechanism of action of rapamycin on articular cartilage. Destabilization of the medial meniscus (DMM) was performed on 10-week-old male mice to induce OA. Intra-articular injections of 10 μl of rapamycin (10 μM) were administered twice weekly for 8 weeks. Articular cartilage damage was analyzed by histology using a semi-quantitative scoring system at 8 and 12 weeks after surgery. Mammalian target of rapamycin (mTOR), light chain 3 (LC3), vascular endothelial growth factor (VEGF), collagen, type X alpha 1 (COL10A1), and matrix metallopeptidase 13 (MMP13) expressions were analyzed by immunohistochemistry. VEGF, COL10A1, and MMP13 expressions were further examined via quantitative RT-PCR (qPCR). Intra-articular injection of rapamycin significantly reduced the severity of articular cartilage degradation at 8 and 12 weeks after DMM surgery. A reduction in mTOR expression and the activation of LC3 (an autophagy marker) in the chondrocytes was observed in the rapamycin treated mice. Rapamycin treatment also reduced VEGF, COL10A1, and MMP13 expressions at 8 and 12 weeks after DMM surgery. These results demonstrate that the intra-articular injection of rapamycin could reduce mTOR expression, leading to a delay in articular cartilage degradation in our OA murine model. Our observations suggest that local intra-articular injection of rapamycin could represent a potential therapeutic approach to prevent OA.
Published: 2014
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30. Biomechanical Analysis of the Knee With Partial Anterior Cruciate Ligament Disruption: Quantitative Evaluation Using an Electromagnetic Measurement System.

Author: Araki, Daisuke, Kuroda, Ryosuke, Matsushita, Takehiko, Matsumoto, Tomoyuki, Kubo, Seiji, Nagamune, Kouki, and Kurosaka, Masahiro
Abstract: Purpose: To investigate the biomechanical function of anterior cruciate ligament (ACL) remnants in ACL-deficient knees with both partial and complete tears. Methods: Twenty partial ACL–deficient (group P), 20 complete ACL–deficient (group C), and 40 contralateral ACL-intact knees were examined. The end point during the Lachman test, side-to-side differences of KT-1000 measurements, and the pivot shift test were evaluated. Additionally, the side-to-side difference of anterior tibial translation during the Lachman test and the acceleration during the pivot shift test were calculated using an electromagnetic measurement system (EMS). Results: The end point was found in 9 patients in group P, whereas it was not detected in group C. In KT-1000 measurements, the mean side-to-side differences were 3.8 ± 2.4 mm in group P and 5.4 ± 2.3 mm in group C. There was a significant difference between these 2 groups (P < .05). In the pivot shift test evaluation in group P, one patient was evaluated as grade 0, 17 patients as grade 1+, and 2 patients as grade 2+. In group C, 10 patients were evaluated as grade 1+, 9 patients as grade 2+, and one patient as grade 3+. Using the EMS, mean side-to-side differences during the Lachman test were 3.1 ± 2.1 mm in group P and 7.2 ± 3.2 mm in group C. The anterior-posterior displacement in group P was significantly less than that in group C (P < .05). In the quantitative pivot shift test, the mean acceleration in the contralateral ACL-intact knees was −632.7 ± 254.5 mm/s2, whereas it was −1107.5 ± 398.9 mm/s2 in group P and −1652.2 ± 754.9 mm/s2 in group C. Significant differences were detected between the 3 knee conditions (P < .05). Conclusions: The quantitative assessments of knees with partial ACL ruptures during the Lachman test and the pivot shift test using the EMS showed less laxity than did knees with complete ACL tears, whereas their laxity was greater than the contralateral knees with intact ACLs. Level of Evidence: Level III, diagnostic study of nonconsecutive patients. [Copyright &y& Elsevier]
Published: 2013
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31. Intraoperative Soft Tissue Balance Reflects Minimum 5-Year Midterm Outcomes in Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty.

Author: Matsumoto, Tomoyuki, Muratsu, Hirotsugu, Kubo, Seiji, Matsushita, Takehiko, Kurosaka, Masahiro, and Kuroda, Ryosuke
Abstract: Abstract: With the use of an offset type tensor for total knee arthroplasties (TKAs), intraoperative soft tissue balance including the joint component gap and ligament balance was measured in 41 varus-type osteoarthritic patients (19 cruciate-retaining [CR] TKAs and 22 posterior-stabilized [PS] TKAs), and the correlations between the intraoperative values and the postoperative values assessed by stress radiographs at extension and flexion were examined at a minimum 5-year follow-up. In CR TKAs, the postoperative soft tissue balances at both angles were significantly correlated with the intraoperative values. In PS TKAs, the postoperative soft tissue balances at extension, not flexion, were significantly correlated with the intraoperative values. In conclusion, the intraoperative condition of the soft tissue balance reflected the postoperative values especially in CR TKAs even at 5-year midterm follow-ups. [Copyright &y& Elsevier]
Published: 2012
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32. The Influence of Preoperative Deformity on Intraoperative Soft Tissue Balance in Posterior-Stabilized Total Knee Arthroplasty.

Author: Matsumoto, Tomoyuki, Muratsu, Hirotsugu, Kubo, Seiji, Matsushita, Takehiko, Kurosaka, Masahiro, and Kuroda, Ryosuke
Abstract: Abstract: Using a tensor for total knee arthroplasty (TKA) enabling soft tissue balance measurements with a reduced patellofemoral joint and femoral component in place, we examined the influence of preoperative deformity on intraoperative soft tissue balance during posterior-stabilized TKA at 0°, 10°, 45°, 90°, and 135° of flexion in 60 varus-type osteoarthritic patients. Despite more than 20° of preoperative varus deformity influencing intraoperative ligament balance in varus, joint gap showed no significant difference regardless of the amount of preoperative varus deformity. Accordingly, even in pre-operative severe varus deformed knees, gap balancing can be adjusted during PS TKA. [Copyright &y& Elsevier]
Published: 2011
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33. Relationship between clinical outcomes and unintentional pulmonary vein isolation during substrate ablation of atrial fibrillation guided solely by complex fractionated atrial electrogram mapping.

Author: Iriki, Yasuhisa, Ishida, Sanemasa, Oketani, Naoya, Ichiki, Hitoshi, Okui, Hideki, Ninomiya, Yuichi, Maenosono, Ryuichi, Matsushita, Takehiko, Miyata, Masaaki, Hamasaki, Shuichi, and Tei, Chuwa
Subjects: ATRIAL fibrillation, CATHETER ablation, ARRHYTHMIA, ELECTROPHYSIOLOGY, FOLLOW-up studies (Medicine), HEALTH outcome assessment
Abstract: Background: Controversy exists as to whether atrial fibrillation (AF) ablation guided solely by complex fractionated atrial electrogram (CFAE) has a good outcome despite not requiring pulmonary vein isolation (PVI). Objectives: The purpose of this study was to evaluate the effectiveness of AF ablation guided solely by targeting CFAE areas, and to determine whether its clinical efficacy has any relationship with unintentionally isolating the PV. Methods: We studied 100 consecutive patients (ages 59±11 years; 54 with paroxysmal, 35 persistent, and 11 long-standing persistent AF), who underwent CFAE-ablation. PV potential (PVP) was recorded before and after ablation. After excluding 39 patients in whom sinus rhythm could not be maintained before ablation by internal cardioversion and/or who had a history of PVI(s), PVPs were analyzed. Results: AF was terminated during ablation in 98% of paroxysmal, 80% of persistent, and 55% of long-standing persistent AF patients. Nifekalant (0.3-0.6 mg/kg) was administered in 30%, 57%, and 83%, respectively. The common areas of CFAE around the PVs were anterior to the right PVs, posterior to the left PVs, and at the ridge of the left atrial appendage. Among 215 PVs in 61 patients (42 paroxysmal, 19 persistent), only 17 PVs (8%) were unintentionally isolated. The atrial potential to PVP was prolonged (>30 ms) in 13% of PVs. After at least 12 months of follow-up (23 ± 5 months), 65% of paroxysmal (11% with drug), 54% of persistent (37% with drug), and 45% of long-standing (60% with drug) AF patients were free from atrial arrhythmia after one session. Conclusions: CFAE-ablation terminates AF without isolating PVs in a high percentage of patients, and yields excellent clinical outcomes. [ABSTRACT FROM AUTHOR]
Published: 2011
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34. Soft Tissue Tension in Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty.

Author: Matsumoto, Tomoyuki, Muratsu, Hirotsugu, Kubo, Seiji, Matsushita, Takehiko, Kurosaka, Masahiro, and Kuroda, Ryosuke
Abstract: Abstract: Using a tensor for total knee arthroplasty (TKA) designed to facilitate soft tissue balance measurements with a reduced patellofemoral joint, we intraoperatively compared the soft tissue tension of cruciate-retaining (CR) and posterior-stabilized (PS) TKAs performed at 0°, 10°, 45°, 90°, and 135° of flexion, with the patella both everted and reduced in 40 osteoarthritic patients. Although balance of soft tissue tension with a reduced patella of PS TKA slightly increased in varus from extension to flexion, these values slightly decreased for CR TKA from extension to flexion. Accordingly, we conclude that soft tissue tension patterns differ between everted and reduced patellae, as well as between PS and CR TKA. [Copyright &y& Elsevier]
Published: 2011
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35. Comparison of the Clinical Outcome of Double-Bundle, Anteromedial Single-Bundle, and Posterolateral Single-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Graft With Minimum 2-Year Follow-up.

Author: Fujita, Norifumi, Kuroda, Ryosuke, Matsumoto, Tomoyuki, Yamaguchi, Motoi, Yagi, Masayoshi, Matsumoto, Akio, Kubo, Seiji, Matsushita, Takehiko, Hoshino, Yuichi, Nishimoto, Koji, Araki, Daisuke, and Kurosaka, Masahiro
Abstract: Purpose: The purpose of this study was to obtain more than 2 years'' follow-up after surgery to investigate the effect of the difference in rotatory stability based on our previous data on the clinical outcome among 3 groups: double-bundle (DB) reconstruction group, anteromedial (AM) single-bundle reconstruction group, and posterolateral (PL) single-bundle reconstruction group. Methods: We randomly separated 55 patients with anterior cruciate ligament rupture into 3 groups: 18 in DB group, 18 in AM group, and 19 in PL group. The mean follow-up period is 33.7 months for the DB group, 31.9 months for the AM group, and 33.2 months for the PL group. We evaluated the Lysholm score, Tegner score, anterior laxity with the KT-1000 arthrometer (MEDmetric, San Diego, CA), rotator instability with the pivot-shift test, and muscle strength with knee extensor and flexor isokinetic peak torques at 60°/s. Results: There were no significant differences in postoperative Lysholm score and Tegner score. Anterior stability of the knee, as measured by the KT-1000 arthrometer, was significantly better in the DB group than the PL group (P < .05). The negative rate of the manual pivot-shift test in the DB group was significantly superior to the PL group (P < .05). Muscle strength of the extensor in the DB group was significantly superior to that in the AM group (P < .05), and muscle strength of the flexor in the PL group was significantly inferior to that in both the DB and AM groups (P < .05). Two patients in the PL group had rerupture; however, there was no graft failure in the other groups. Conclusions: At 2 years'' follow-up, patients undergoing DB anterior cruciate ligament reconstruction had greater extension strength than patients receiving an AM single-bundle reconstruction. The DB and AM groups had greater flexion strength than the PL group. The DB and AM groups had a similar rate of negative pivot-shift test results, whereas the PL group had fewer negative pivot-shift test results than the DB group. There were no KT-1000 side-to-side differences between the DB and AM groups, whereas the DB group had better results than the PL group. Overall, the clinical outcome as measured by Lysholm and Tegner scores was not different between groups. Level of Evidence: Level II, prospective comparative study. [Copyright &y& Elsevier]
Published: 2011
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36. The Use of an Electromagnetic Measurement System for Anterior Tibial Displacement During the Lachman Test.

Author: Araki, Daisuke, Kuroda, Ryosuke, Kubo, Seiji, Nagamune, Kouki, Hoshino, Yuichi, Nishimoto, Koji, Takayama, Koji, Matsushita, Takehiko, Tei, Katsumasa, Yamaguchi, Motoi, and Kurosaka, Masahiro
Abstract: Purpose: The purpose of this study was to assess quantitative anterior/posterior values during the Lachman test by an electromagnetic measurement system and to compare data with KT-1000 arthrometric measurements (MEDmetric, San Diego, CA), as well as the measurement of radiologic laxity by dynamic radiographs. Methods: We used an electromagnetic device to quantitatively evaluate anterior knee displacements. We tested 82 knees in 41 patients (30 isolated anterior cruciate ligament [ACL]–deficient, 11 ACL-reconstructed, and 41 contralateral ACL-intact knees). Anterior displacements during the Lachman test were calculated by the electromagnetic measurement system and fluoroscopic measurement, and anterior displacements were also measured by the KT-1000 arthrometer. Anterior/posterior displacements measured by these methods were compared, and correlations were assessed. Results: In ACL-deficient knees, mean anterior/posterior displacement (±SE) was 22.4 ± 0.8 mm in electromagnetic measurements, 22.0 ± 0.7 mm in fluoroscopic measurements, and 15.0 ± 0.6 mm in KT-1000 measurements. In contralateral ACL-intact knees, it was 15.7 ± 0.6 mm, 15.6 ± 0.5 mm, and 9.9 ± 0.4 mm, respectively. In ACL-reconstructed knees, it was 15.7 ± 0.7 mm, 16.2 ± 0.8 mm, and 11.2 ± 0.6 mm, respectively. In all knee conditions, significant differences between fluoroscopic measurements and KT-1000 measurements were detected (P < .01). Significant differences were also detected between electromagnetic measurements and KT-1000 measurements (P < .01). No significant differences were detected between fluoroscopic measurements and electromagnetic measurements. A strong correlation was obtained between KT-1000 measurements and fluoroscopic measurements (r = 0.62, P < .01) and between electromagnetic measurements and KT-1000 measurements (r = 0.64, P < .01). However, the strongest correlation was observed between electromagnetic measurements and fluoroscopic measurements (r = 0.96, P < .01). Conclusions: An electromagnetic measurement system to test anterior/posterior tibial translation determined that quantification of the Lachman test could be performed as accurately as fluoroscopic measurements. Level of Evidence: Level II, development of diagnostic criteria on basis of consecutive patients with universally applied reference gold standard. [Copyright &y& Elsevier]
Published: 2011
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37. The role of infection in the development of non-valvular atrial fibrillation: Up-regulation of Toll-like receptor 2 expression levels on monocytes.

Author: Ichiki, Hitoshi, Orihara, Koji, Hamasaki, Shuichi, Ishida, Sanemasa, Oketani, Naoya, Iriki, Yasuhisa, Ninomiya, Yuichi, Okui, Hideki, Kuwahata, So, Fujita, Shoji, Matsushita, Takehiko, Yoshifuku, Shiro, Oba, Ryutaro, Hirai, Hiroyuki, Nagata, Kinya, and Tei, Chuwa
Subjects: ATRIAL fibrillation, ACUTE phase proteins, RETICULO-endothelial system, ATRIAL arrhythmias
Abstract: Summary: Many studies have suggested that inflammation may participate in the pathogenesis of non-valvular atrial fibrillation (AF). However, it has been unknown by exposure to what the inflammation is caused. Recently, we reported that Toll-like receptor 2 (TLR2) level on monocytes was significantly up-regulated in viral and bacterial infections, but not in non-infectious inflammatory states. Our purpose was to test the hypothesis that expression of TLR2 levels may be up-regulated in patients with non-valvular AF. A total of 48 consecutive patients with non-valvular AF who were hospitalized for catheter ablation were enrolled in this study. TLR2 levels were assayed by using flow-cytometric analysis and compared with volunteers in sinus rhythm (control group, n =24). Additionally, C-reactive protein (CRP) and interleukin-6 (IL-6) levels were assayed, and the left atrial volume indexes (LAVI) in the non-valvular AF group were measured. The results demonstrated that TLR2 levels in the non-valvular AF group were significantly higher than in the control group (median, 4682 vs. 3866 sites/cell; P <0.01). Moreover, non-valvular AF patients had significantly higher IL-6 levels than controls. However, there was no significant difference in CRP levels between the two groups. It was observed in 44 AF patients, in whom pulmonary vein isolation was confirmed to be successful, that the LAVI significantly diminished 1 month after ablation (median, 33.6 vs. 29.5ml/m2; P <0.001), but not the TLR2 and IL-6 levels. Our results implied that an infectious inflammation may participate in the pathogenesis of non-valvular AF. [Copyright &y& Elsevier]
Published: 2009
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38. A Bone Segmentation for the Knee Joint in MDCT Image Based on Anatomical Information

Author: Uozumi, Yosuke, Nagamune, Kouki, Araki, Daisuke, Hoshino, Yuichi, Matsushita, Takehiko, Kuroda, Ryosuke, and Kurosaka, Masahiro
Abstract: The purpose of this study is to propose an automated segmentation about the knee bones (femur, tibia, patellar, and fibula) in MDCT images. The proposed method was applied for six patients (Age 33 ± 13, four males / two females). The proposed method segments the knee joint into each bone by using anatomical structure for the knee joint. The experiments calculate accuracy of the proposed method by comparing with the manual delineation result. As a result, The accuracy of the femur, tibia, patellar, and fibula were 95.84 ± 0.57%, 94.12 ± 1.01%, 94.49 ± 0.83%, 86.37 ± 4.28%, respectively. This study concluded that the proposed method is enough to segment the knee bones.
Published: 2013
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39. Local Administration of Low-Dose Simvastatin-Conjugated Gelatin Hydrogel for Tendon–Bone Healing in Anterior Cruciate Ligament Reconstruction

Author: Oka, Shinya, Matsumoto, Tomoyuki, Kubo, Seiji, Matsushita, Takehiko, Sasaki, Hiroshi, Nishizawa, Yuichiro, Matsuzaki, Tokio, Saito, Takashi, Nishida, Kotaro, Tabata, Yasuhiko, Kurosaka, Masahiro, and Kuroda, Ryosuke
Abstract: Anterior cruciate ligament (ACL) reconstruction with the hamstring tendon graft takes a long time, as the tendon graft needs to heal at the site of the bone–tendon integration in the created bone tunnels. Several reports have shown the therapeutic effects of simvastatin on bone formation with neovascularization. The aim of this study was to test the hypothesis that enhanced angiogenesis and osteogenesis by locally applied simvastatin promotes tendon–bone healing after ACL reconstruction. Rabbits received ACL reconstruction with hamstring tendon graft and were implanted with either simvastatin-conjugated gelatin hydrogel or gelatin hydrogel alone in their bone tunnels, and then bone regeneration and neovascularization at tendon–bone interface and biomechanical properties were assessed. Histological analysis at week 2 demonstrated that tendon–bone healing was significantly greater with angiogenesis and osteogenesis in the simvastatin-treated group than in the control group. Computed tomography at weeks 2 and 4 showed a significantly smaller tibial bone tunnel in the simvastatin-treated group. Biomechanical testing at week 2 demonstrated a significant increase in ultimate failure load in the simvastatin-treated group. This study suggested that local administration of low-dose simvastatin-conjugated gelatin hydrogel promotes the tendon–bone healing via its effect on both angiogenesis and osteogenesis at an early phase in a rabbit model, but does not affect biomechanical property in long-term after ACL reconstruction.
Published: 2013
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40. Bone Regeneration Properties of Granulocyte Colony-Stimulating Factor via Neovascularization and Osteogenesis

Author: Ishida, Kazunari, Matsumoto, Tomoyuki, Sasaki, Ken, Mifune, Yutaka, Tei, Katsumasa, Kubo, Seiji, Matsushita, Takehiko, Takayama, Koji, Akisue, Toshihiro, Tabata, Yasuhiko, Kurosaka, Masahiro, and Kuroda, Ryosuke
Abstract: Objectives:It has been well recognized that appropriate vascularization is emerging as a prerequisite for bone development and regeneration. The aim of this study was to test the hypothesis that locally applied granulocyte colony-stimulating factor (G-CSF) enhances bone regeneration via revascularization and osteogenesis.Methods:A segmental bone defect (20 mm) was created at the diaphysis of the rabbit ulna. The defects were treated with cationized gelatin hydrogel, which was the drug delivery system, with G-CSF, and then bone regeneration, neovascularization, and osteogenesis properties with G-CSF were assessed.Results:Radiographic, computed tomography, and histological findings revealed that bone formation was significantly promoted in G-CSF-treated group as early as 2 weeks. Immunohistochemistry, real-time reverse transcription-polymerase chain reaction, and flow cytometry studies indicated that angiogenesis/vasculogenesis, which are regulated by mobilization and incorporation of CD34+/G-CSF receptor (CSFR+) cells, and osteogenesis, which is regulated by osteocalcin+/G-CSFR+cells, were also significantly enhanced in the G-CSF group.Conclusions:This study suggests that locally applied G-CSF contributes to an ideal local environment for fracture healing by supplying adequate blood flow and stimulating osteogenesis. G-CSF may have the therapeutic potential for bone regeneration.
Published: 2010
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41. Influence of isoproterenol on the accelerated junctional rhythm observed during radiofrequency catheter ablation of atrioventricular nodal slow pathway conduction

Author: Matsushita, Takehiko, Chun, Sung, and Sung, Ruey J.
Abstract: BackgroundAccelerated junctional rhythm (AJR) has been considered as a sensitive but rather nonspecific marker of successful radiofrequency (RF) ablation of slow pathway in patients with atrioventricular nodal reentrant tachycardia (AVNRT). However, AJR also occurs commonly during isoproterenol infusion. We therefore investigated the effect of isoproterenol on the significance of AJR while attempting slow pathway ablation. MethodsForty patients with AVNRT underwent slow pathway ablation. Sixty-nine RF applications accompanied by AJR were observed and were separated into 2 groups: applications performed without (group I, n = 26) and with (group II, n = 43) isoproterenol infusion. The specificity of AJR for successful ablation for each group was calculated. ResultsThe specificity of AJR in groups I and II was 73% (19/26) and 49% (21/43), respectively (P<.05). There was no significant difference between the groups in the atrial electrogram width, atrial/ventricular electrogram amplitude ratio, the time from application onset to AJR emergence, or AJR cycle length. The catheter-tip temperature at AJR emergence was significantly lower (47°C ± 3°C vs 52°C ± 3°C, P<.001) and the ratio of junctional beats to total heart beats during RF application was significantly greater (46% ± 24% vs 33% ± 18%, P<.05) in group II compared with group I. ConclusionsIsoproterenol lowers the threshold of AJR emergence during RF application and thereby lowers the specificity of AJR for successful ablation. Complete washout of isoproterenol may therefore improve the specificity of AJR during RF ablation in patients with AVNRT. (Am Heart J 2001;142:664-8.)
Published: 2001
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42. Heart rate decline after exercise in patients with hypertrophic cardiomyopathy

Author: Matsushita, Takehiko, Tanaka, Yasuhiro, Horinouchi, Osamu, Sonoda, Masahiro, and Arima, Terukatsu
Abstract: To evaluate the heart rate recovery, submaximal exercise, echocardiographic examination, and Holter monitoring were performed on 30 patients with hypertrophic cardiomyopathy and 11 controls. The time constant of heart rate decline after exercise was calculated. Spectral analysis was performed on Holter recordings. The time constant did not correlate with heart rate, left ventricular end-diastolic pressure, ejection fraction, or wall thickness. There was no correlation between the time constant and any mean spectral indices over 24 hours in patients. However, the time constant correlated with high frequency component in the night. Nocturnal high frequency component in patients with short time constant was significantly less than in those with long time constant, but did not significantly differ from that in controls. In conclusion, the heart rate decline after exercise does not primarily reflect the severity of hypertrophy or hemodynamic impairment but is associated with nocturnal parasympathetic modulation in patients with hypertrophic cardiomyopathy.
Published: 2001
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43. Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

Author: Tsubosaka, Masanori, Matsumoto, Tomoyuki, Sobajima, Satoshi, Matsushita, Takehiko, Iwaguro, Hideki, and Kuroda, Ryosuke
Abstract: Favorable clinical outcomes of intra-articular injection of adipose-derived stromal vascular fraction (SVF) cells for knee osteoarthritis (OA) have been reported, but the effects of different doses of SVF cells have not been examined. This study aimed to compare the short-term clinical and imaging outcomes of different doses of SVF cells for knee OA treatment. This study included 60 patients with knee OA who underwent intra-articular injection of SVF cells. The follow-up period was at least 12 months. Thirty patients received an intra-articular injection of 2.5×107SVF cells (low-dose group), and the remaining 30 patients received an intra-articular injection of 5.0×107SVF cells (high-dose group). Clinical evaluations were performed for the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, including the magnetic resonance imaging Osteoarthritis Knee Score (MOAKS) features (bone marrow lesions, cartilage defects, osteophytes, Hoffa’s synovitis, and effusion synovitis), were also performed. All clinical and imaging evaluations were performed preoperatively and 12 months postoperatively and compared between the groups. In demographic data, no significant differences were found between the two groups. The total score of KOOS at 12 months postoperatively was significantly more favorable than the preoperative score in the high-dose groups. Pain and symptoms subscale scores of KOOS at 12 months postoperatively were significantly better in the high-dose group than in the low-dose group. The bone marrow lesions, Hoffa’s synovitis, and effusion synovitis improved approximately 30–40% at 12 months postoperatively compared to baseline in both groups. However, there were no significant differences in imaging evaluations between the two groups. In conclusion, the pain and symptoms subscale scores of KOOS from baseline to 12 months postoperatively improved better in the high-dose group than in the low-dose group. Our findings suggest that intra-articular injection of SVF cells for knee OA is an innovative approach.
Published: 2021
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44. Postextrasystolic transient contractile alternans in canine hearts

Author: Araki, Junichi, Takaki, Miyako, Matsushita, Takehiko, Matsubara, Hiromi, and Suga, Hiroyuki
Abstract: Summary We found that postextrasystolic potentiated contractility after a spontaneous extrasystole most frequently decayed as a transient alternans over several beats in excised, cross-circulated, atrially paced canine hearts. This type of heart preparation, which we have been using consistently in mechanoenergetic studies, had normal coronary blood perfusion pressure as well as flow and mechanoenergetic performance. Spontaneous atrial and ventricular extrasystoles occurred occasionally in every heart. Arrhythmic changes in left ventricular (LV) pressure at a fixed volume reflected corresponding changes in contractility. We analyzed nearly 3,600 cases of postextrasystolic potentiation in 68 hearts; 84% decayed as transient alternans, 6% decayed exponentially, and 10% belonged to neither type. We found that a postextrasystolic compensatory pause always preceded the transient alternans after either an atrial or ventricular extrasystole at any constant atrial pacing rate (85–188 beats/min). The decay was either exponential or nonalternating when the pause did not exist after an atrial extrasystole during occasional pacing failure. Therefore, the compensatory pause after either an atrial or ventricular extrasystole seems essential for the postextrasystolic transient alternans of LV contractility in the type of canine heart preparation we have been using.
Published: 1994
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45. Endochondral Bone Tissue Engineering Using Human Induced Pluripotent Stem Cells

Author: Arakura, Michio, Lee, Sang Yang, Fukui, Tomoaki, Oe, Keisuke, Takahara, Shunsuke, Matsumoto, Tomoyuki, Hayashi, Shinya, Matsushita, Takehiko, Kuroda, Ryosuke, and Niikura, Takahiro
Abstract: There has been great interest in the use of induced pluripotent stem cells (iPSCs) in bone regenerative strategies for bone defects. In the present study, we investigated whether the implantation of chondrogenically differentiated iPSC-derived mesenchymal stem cells (iMSCs) could lead to the successful regeneration of bone defects in nude mice. Two clones of human iPSCs (201B7 and 454E2) were used. After the generation of iMSCs, chondrogenic differentiation was achieved using a three-dimensional pellet culture. Then, a 2-mm defect was created in the radius of nude mice and chondrogenically differentiated iMSC pellets were placed in the defect. Micro-computed tomography (μ-CT) imaging analysis was performed 8 weeks after transplantation to assess bone regeneration. Eleven out of 11 (100%) radii in the 201B7 cell-derived-pellet transplantation group and 7 out of 10 (70%) radii in the 454E2 cell-derived-pellet transplantation group showed bone union. On the other hand, only 2 out of 11 radii (18%) in the control group showed bone union. Therefore, the bone union rates in the experimental groups were significantly higher than that in the control group (p < 0.05). Histological analysis 2 weeks post-implantation in the experimental groups revealed hypertrophic chondrocytes within grafted iMSC pellets, and the formation of woven bone around them; this hypertrophic chondrocyte transitioning to the newly formed bone suggests that the cartilaginous template can trigger the process of endochondral bone ossification (ECO). Four weeks post-implantation, the cartilage template was reduced in size; newly formed woven bone predominated at the defect site. New vessels were surrounded by a matrix of woven bone and the hypertrophic chondrocytes transitioning to the newly formed bone indicated the progression of ECO. Eight weeks post-implantation, the pellets were completely resorbed and replaced by bone; complete bone union was overall observed. Dense mature bone developed with evidence of lamellar-like bone formation. Collectively, our results suggest that iMSC-based cartilage grafts recapitulating the morphogenetic process of ECO in the context of embryonic skeletogenesis are a novel and promising strategy for the repair of large bone defects.
Published: 2021
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46. Insufficiency and deficiency of vitamin D in elderly patients with fragility fractures of the hip in the Japanese population.

Author: Niikura, Takahiro, Oe, Keisuke, Sakai, Yoshitada, Iwakura, Takashi, Fukui, Tomoaki, Nishimoto, Hanako, Hayashi, Shinya, Matsumoto, Tomoyuki, Matsushita, Takehiko, Maruo, Akihiro, Yagata, Yukihisa, Kishimoto, Kenta, Sakurai, Atsushi, and Kuroda, Ryosuke
Published: 2019
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47. Analysis of anterior tibial subluxation to the femur at maximum extension in anterior cruciate ligament-deficient knees.

Author: Nishida, Kyohei, Matsushita, Takehiko, Araki, Daisuke, Sasaki, Hiroshi, Tanaka, Toshikazu, Hoshino, Yuichi, Kanzaki, Noriyuki, Matsumoto, Tomoyuki, Nagamune, Kouki, Niikura, Takahiro, Kurosaka, Masahiro, and Kuroda, Ryosuke
Published: 2019
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48. Insufficiency and deficiency of vitamin D in elderly patients with fragility fractures of the hip in the Japanese population

Author: Niikura, Takahiro, Oe, Keisuke, Sakai, Yoshitada, Iwakura, Takashi, Fukui, Tomoaki, Nishimoto, Hanako, Hayashi, Shinya, Matsumoto, Tomoyuki, Matsushita, Takehiko, Maruo, Akihiro, Yagata, Yukihisa, Kishimoto, Kenta, Sakurai, Atsushi, and Kuroda, Ryosuke
Abstract: Background: Data of vitamin D sufficiency in Asian patients with osteoporotic fragility hip fractures are limited. This study aimed to obtain data from the Japanese population.Methods: Patients aged 60 years or older with hip fractures were prospectively enrolled. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured. Levels were compared between patients receiving and not receiving treatment for osteoporosis, those with and without previous contralateral hip fractures, and those with femoral neck versus trochanteric fractures. Sex-based differences were also assessed. The serum levels in patients younger than 60 years with extremity fractures were assessed, and differences between elderly and younger patients were evaluated. The individual correlation between 25(OH)D levels and the ultraviolet (UV) index and age was analyzed in elderly patients with hip fractures.Results: The data of 360 patients (aged 84.7 ± 8.2 years), comprising 80 men and 280 women, were analyzed. The mean 25(OH)D level was 16.5 ± 7.2 ng/mL. The prevalence of vitamin D insufficiency (25(OH)D <30 ng/mL) and deficiency (25(OH)D <20 ng/mL) was 93.9% and 71.7%, respectively. A significant difference was noted in the prevalence of vitamin D deficiency between patients with and without previous contralateral hip fractures. Age and 25(OH)D levels were found to be correlated, with no correlation between the UV index and the 25(OH)D levels. The 25(OH)D level in the younger population (n= 123) was 20.7 ± 8.6 ng/mL, which was significantly higher than that of the elderly.Conclusion: Perennial vitamin D insufficiency is prevalent in elderly Japanese patients with hip fractures.
Published: 2019
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49. Analysis of anterior tibial subluxation to the femur at maximum extension in anterior cruciate ligament-deficient knees

Author: Nishida, Kyohei, Matsushita, Takehiko, Araki, Daisuke, Sasaki, Hiroshi, Tanaka, Toshikazu, Hoshino, Yuichi, Kanzaki, Noriyuki, Matsumoto, Tomoyuki, Nagamune, Kouki, Niikura, Takahiro, Kurosaka, Masahiro, and Kuroda, Ryosuke
Abstract: Purpose: The factors affecting anterior tibial subluxation (ATS) have not yet been well examined. To assess the factors affecting ATS in anterior cruciate ligament (ACL)-deficient knees.Methods: One hundred twenty-four patients with unilateral ACL injuries were included. True lateral views of the ACL-deficient knee and contralateral normal knee were obtained during maximum extension using fluoroscopy under general anesthesia, and ATS was calculated as the side-to-side difference in the tibial position relative to the femur. Patients were divided into four groups according to the time from injury to surgery. To identify the factors affecting ATS, the following possible factors were assessed: (1) the time from injury to surgery, (2) presence of a medial meniscal injury, and (3) posterior tibial slope angle.Results: There was a positive correlation between the ATS ratio and the time from injury to surgery (r= 0.52). The ratio of the presence of a medial meniscus injury was significantly higher in patients who underwent anterior tibial subluxation reconstruction (ACL-R) more than 12 months after an injury than in other patients who underwent ACL-R within 12 months after an injury. The ATS ratio was significantly higher in patients with a medial meniscus injury than in those without a medial meniscus injury (5.6% vs. 4.1%).Conclusions: Our results suggested that ACL-R should be performed within 6 months after injury if surgeons prefer to avoid an increase in ATS in maximum knee extension and at the latest within 12 months to avoid medial meniscal injury at the time of ACL-R.
Published: 2019
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50. A Periprosthetic Femoral Fracture with Characteristics of Atypical Femoral Fracture

Author: Tanaka, Shuya, Fukui, Tomoaki, Oe, Keisuke, Matsumoto, Tomoyuki, Matsushita, Takehiko, Hayashi, Shinya, Kawamoto, Teruya, Kuroda, Ryosuke, and Niikura, Takahiro
Abstract: Although the definition of atypical femoral fracture (AFF) excludes periprosthetic femoral fracture (PFF), the number of reports about PFF with characteristics of AFF is increasing. We present the case of such a fracture in this report. An 87-year-old woman who underwent bipolar hip arthroplasty for a femoral neck fracture 38 months prior reported left thigh pain with no history of trauma. Radiographs showed a simple transverse fracture at the level of the stem distal end with features of AFF: periosteal thickening of the lateral cortex, a medial spike, and a noncomminuted fracture. She presented other features resembling AFF: history of bisphosphonate use, prodromal symptoms, no associated trauma, and lateral bowing of the contralateral femur. The fracture showed nonunion after the initial osteosynthesis, and a revision surgery of the arthroplasty and osteosynthesis was performed. Nine months after the surgery, bony union was achieved and she regained the ability to walk. It is supposed that the fracture was influenced by a stress force related to implants and lateral bowing concentrating on the fracture site as a mechanical factor in addition to bisphosphonates as a biological factor. It would be important to recognize that AFF could occur at the peri-implant location, and early detection and treatment are essential.
Published: 2019
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