GOTO Kouji

Researcher Information

J-Global ID

• 201401045043864388

Research Interests

• total hip arthroplasty   bioactivity   bone cement   biomaterial   hip surgery   

Research Areas

• Life sciences / Biomaterials
• Life sciences / Orthopedics

Academic & Professional Experience

• 2023/04  Kindai University整形外科学教室主任教授
• 2020/04 - 2023/03  京都大学医学部附属病院整形外科准教授
• 2015/04 - 2020/03  京都大学大学院医学研究科運動器機能再建外科学講座特定講師
• 2014/04 - 2015/03  京都大学医学部附属病院整形外科助教
• 2011/04 - 2014/03  市立長浜病院整形外科部長
• 2008/04 - 2011/03  京都大学医学部附属病院整形外科助教
• 2006/04 - 2008/03  京都大学医学部附属病院整形外科医員
• 1998/04 - 2002/03  松江赤十字病院整形外科医員
• 1996/04 - 1998/03  社会保険小倉記念病院整形外科医員
• 1995/05 - 1996/03  京都大学医学部附属病院整形外科研修医

Education

• 2002/04 - 2006/03  Kyoto University  Graduate School of Medicine
• 1989/04 - 1995/03  Kyoto University  Faculty of Medicine

Association Memberships

• European Hip Society   日本リハビリテーション医学会   International Society for Technology in Arthroplasty   The Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine   Orthopedics Biomaterial Bureau   Japanese Society for Hip Arthroscopy   The Central Japan Association of Orthopaedic Surgery & Traumatology   Japanese Society for Biomaterials   The Japanese Society for Replacement Arthroplasty   Japanese Hip Society   The Japanese Orthopaedic Association   

Published Papers

• Fabrication of Artificial Nerve Conduits Used in a Long Nerve Gap: Current Reviews and Future Studies.

  Ryosuke Kakinoki; Yukiko Hara; Koichi Yoshimoto; Yukitoshi Kaizawa; Kazuhiko Hashimoto; Hiroki Tanaka; Takaya Kobayashi; Kazuhiro Ohtani; Takashi Noguchi; Ryosuke Ikeguchi; Masao Akagi; Koji Goto

  Bioengineering (Basel, Switzerland) 11 (4) 2024/04 

  There are many commercially available artificial nerve conduits, used mostly to repair short gaps in sensory nerves. The stages of nerve regeneration in a nerve conduit are fibrin matrix formation between the nerve stumps joined to the conduit, capillary extension and Schwann cell migration from both nerve stumps, and, finally, axon extension from the proximal nerve stump. Artificial nerves connecting transected nerve stumps with a long interstump gap should be biodegradable, soft and pliable; have the ability to maintain an intrachamber fibrin matrix structure that allows capillary invasion of the tubular lumen, inhibition of scar tissue invasion and leakage of intratubular neurochemical factors from the chamber; and be able to accommodate cells that produce neurochemical factors that promote nerve regeneration. Here, we describe current progress in the development of artificial nerve conduits and the future studies needed to create nerve conduits, the nerve regeneration of which is compatible with that of an autologous nerve graft transplanted over a long nerve gap.
• Bone ingrowth into a porous structure is achieved by preceding fibrogenesis and vascularization

  Yusuke Takaoka; Shunsuke Fujibayashi; Hirotaka Onoe; Koji Goto; Bungo Otsuki; Toshiyuki Kawai; Yaichiro Okuzu; Takayoshi Shimizu; Norimasa Ikeda; Kazuki Orita; Shintaro Honda; Tatsuhito Ikezaki; Takeshi Yabutsuka; Shuichi Matsuda

  Acta Biomaterialia Elsevier BV 1742-7061 2024/02
• Association of physical activity with fatty infiltration of muscles after total hip arthroplasty.

  Takumi Kawano; Manabu Nankaku; Masanobu Murao; Takuma Yuri; Gakuto Kitamura; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Yaichiro Okuzu; Ryosuke Ikeguchi; Shuichi Matsuda

  Skeletal radiology 2023/11 [Refereed]
   

  OBJECTIVE: This study aimed to investigate the association between muscle density as an indicator of fatty infiltration of lower extremity muscles and physical activity (PA) after total hip arthroplasty (THA) and identify the patient characteristics with high postoperative PA. METHODS: This study included 62 female patients who underwent THA for unilateral hip osteoarthritis. Muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles was measured using computed tomography (CT). PA was assessed using University of California, Los Angeles (UCLA) activity scores. CT and UCLA activity score were obtained before and 1 year after THA. The patients were divided into two groups, sufficient (score ≥ 6) and insufficient (score < 6) activity groups, based on their level of PA as determined by their UCLA activity score 1 year after THA. The association of PA with the amount of changes in muscle density was examined with Spearman's rank correlation coefficient. Logistic regression analysis was performed to identify postoperative factors determining PA at 1 year after THA. RESULTS: Spearman's rank correlation coefficient showed a significantly positive association between recovery in PA and an increase in muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles. Additionally, logistic regression analysis confirmed that postoperative muscle densities of the gluteus maximus and quadriceps muscles were variables determining the PA 1 year after THA. CONCLUSION: The findings of this study indicated that the improvement of fatty infiltration in lower limb muscles, especially in the gluteus maximus and quadriceps, is likely to promote the increase in postoperative PA.
• Treatment of Complete Brachial Plexus Injuries Using Double Free Muscle Transfer.

  Ryosuke Kakinoki; Kazuhiro Ohtani; Souichi Ohta; Ryosuke Ikeguchi; Masao Akagi; Koji Goto

  The Journal of hand surgery 2023/11 [Refereed]
   

  PURPOSE: The purpose of this study was to examine the surgical outcomes of double free muscle transfer (DFMT) performed in patients with complete brachial plexus injury (BPI). METHODS: We retrospectively analyzed the outcomes of DFMT for 12 patients with complete BPI who were followed up for more than 2 years after the final muscle transplantation. Their mean age was 29 years (range, 18-41). Three patients underwent contralateral C7 nerve root transfer before the DFMT. The range of motion (ROM) of the shoulder, elbow, and fingers was measured. Patient-reported outcome measures, including Disability of the Shoulder, Arm, and Hand (DASH) scores and visual analog scale (VAS) scores for pain, were also examined. RESULTS: The mean shoulder ROM against gravity was 22° ± 8° in abduction and 33° ± 5° in flexion. Seven patients underwent phrenic nerve (PhN) transfer to the suprascapular nerves, and five exhibited asymptomatic lung impairment on spirography more than 2 years after PhN transfer. The mean elbow ROM against gravity was 111° ± 9° in flexion and -32° ± 7° in extension. All patients obtained elbow flexion >90° against a 0.5-kg weight. All patients obtained touch sensation and two recognized warm and cold sensations in the affected palm. The mean total active motion of the affected fingers was 44° ± 11°. All patients exhibited hook function of the hands. The mean preoperative and postoperative DASH scores were 70.3 ± 13.4 and 51.8 ± 15.9, respectively. The mean pain VAS score was 28 ± 31 at the final follow-up. CONCLUSIONS: Double free muscle transfer provided patients with complete brachial plexus palsy with good elbow flexion and hand hook functions. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
• Investigating sagittal spinopelvic alignment and equivalent stress on the femoral head in patients with rapidly destructive coxarthrosis.

  Kazuki Orita; Yaichiro Okuzu; Takayoshi Shimizu; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2023/09 [Refereed]
   

  PURPOSE: Rapidly destructive coxarthrosis (RDC) is a rare syndrome of unknown etiology. This study evaluated sagittal spinopelvic alignment (SSPA) in patients with RDC and compared it with that in patients with hip osteoarthritis (HOA). In addition, finite element analysis (FEA) was performed to investigate the distribution of stress on the femoral head in RDC versus HOA. METHODS: This retrospective study included patients who had undergone primary total hip arthroplasty for RDC (n = 33) and HOA (n = 99; age- and sex-matched to patients with RDC) at three hospitals from June 2014 to September 2020. Preoperative SSPA parameters and inflammatory blood markers were compared between the two groups. FEA on the computed tomography data was performed for four patients from each group with similar pelvic tilt (PT) and lateral center-edge angle (LCEA). The distribution of Drucker-Prager equivalent stress was assessed at the loaded area of the femoral head. RESULTS: Patients with RDC had significantly higher PT, lower sacral slope, decreased lumbar lordosis (LL), higher sagittal vertical axis, and higher pelvic incidence minus LL than patients with HOA, indicating sagittal spinal imbalance. Blood test revealed patients with RDC had higher levels of inflammation markers than patients with HOA. FEA revealed no statistically significant difference in the degree of stress concentration or the maximum equivalent stress between the two groups when PT and LCEA were comparable. CONCLUSION: Patients with RDC tend to have sagittally imbalanced spine. Decreased acetabular coverage of the femoral head may heighten mechanical load of the hip joint in patients with RDC.
• Closed Suction Drainage May Not be Beneficial in Revision Total Hip Arthroplasty: A Propensity Score-Matched Cohort Study.

  Yaichiro Okuzu; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  Indian journal of orthopaedics 57 (7) 1041 - 1048 2023/07 [Refereed]
   

  BACKGROUND: Many studies on closed suction drainage (CSD) in primary total hip arthroplasty (THA) have demonstrated that it has no definite benefit. However, evidence of the clinical benefits of CSD in revision THA has not yet been established. Therefore, this retrospective study aimed to investigate the benefits of CSD in revision THA. MATERIALS AND METHODS: We reviewed 107 hips of patients who underwent revision THA between June 2014 and May 2022, excluding cases of fracture and infection. We compared perioperative blood test results, calculated total blood loss (TBL), and postoperative complications, including allogenic blood transfusion (ABT), wound complications, and deep venous thrombosis (DVT), between the groups with and without CSD. Propensity score matching was conducted to balance patients' demographics and surgical factors. RESULTS: ABT, wound complications, and DVT were observed in 10.3% (n = 11), 5.6% (six), and 5.6% (six) of patients, respectively. There were no significant differences in ABT, calculated TBL, wound complications, and DVT between all patients and propensity score-matched patients with or without CSD. The calculated TBL was approximately 1200 mL and showed no significant difference between the two groups in the matched cohort (p = 0.40) but tended to have a greater volume in the drain group than in the non-drain group. CONCLUSION: The routine use of CSD in revision THA for aseptic loosening may not be useful in clinical practice.
• How Do Spinal Parameters Change in Patients Who Have Improvement of Low Back Pain After Total Hip Arthroplasty? A Propensity Score-Matched Cohort Study.

  Yaichiro Okuzu; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  The Journal of arthroplasty 2023/06 [Refereed]
   

  BACKGROUND: Many studies have demonstrated that low back pain (LBP) improves after total hip arthroplasty (THA). However, the mechanism underlying this improvement remains unclear. We aimed to investigate changes in the spinal parameters of patients who had LBP improvement after THA to elucidate the mechanism of LBP improvement. METHODS: We included 261 patients who underwent primary THA between December 2015 and June 2021 and had a preoperative visual analog scale score of ≥ 2 for LBP. The patients were classified into the LBP-improved or LBP-continued groups based on the visual analog scale for LBP at 1 year after THA. Preoperative and postoperative changes in the coronal and sagittal spinal parameters were compared between the 2 groups after propensity score matching for age, sex, body mass index, and preoperative spinal parameters. RESULTS: A total of 161 patients (61.7%) were classified into the LBP-improved group. After 85 patients in both groups were matched, the LBP-improved group showed significant differences in spinal parameter changes, which were a higher lumbar lordosis (LL) (P = .04) and lower sagittal vertical axis (SVA) (P = .02) and pelvic incidence (PI) minus LL (PI-LL) (P = .01) postoperatively, whereas the LBP-continued group showed worsened changes in LL and SVA and PI-LL mismatch. CONCLUSION: Patients who had LBP improvement after THA had significant differences in spinal parameter changes in LL, SVA, and PI-LL. These spinal parameters may be the key factors in the mechanism of LBP improvement after THA.
• 骨・軟部悪性腫瘍切除後のメガプロテーゼによるバンコマイシン含有セメント併用留置再建法

  橋本 和彦; 伊藤 智彦; 西村 俊司; 柿木 良介; 赤木 將男; 後藤 公志

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (6) S1461 - S1461 0021-5325 2023/06
• メトトレキサート内服治療開始後20年以上を経てリンパ球増殖性疾患を発症した高齢関節リウマチ患者の1例

  橋本 和彦; 赤木 將男; 後藤 公志

  日本関節病学会誌 (一社)日本関節病学会 42 (3) 212 - 212 1883-2873 2023/06
• 早期変形性膝関節症において軟骨下骨が及ぼす影響

  橋本 晃明; 赤木 將男; 森下 貴文; 橋本 和彦; 墳本 一郎; 伊藤 智彦; 後藤 公志

  日本関節病学会誌 (一社)日本関節病学会 42 (3) 258 - 258 1883-2873 2023/06
• Total hip arthroplasty in patients with vertebral compression fracture is associated with poor clinical outcomes - retrospective analysis on 453 cases.

  Chin-Hsi Chen; Yaichiro Okuzu; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  Journal of experimental orthopaedics 10 (1) 53 - 53 2023/05 [Refereed]
   

  PURPOSE: Total hip arthroplasty (THA) is increasingly performed in older adults, and the prevalence of vertebral compression fracture (VCF) increases with age. We aimed to investigate the clinical outcomes of THA in patients with VCF. METHODS: We reviewed the records of 453 patients who underwent THA at our institution between 2015 and 2021. We classified patients into those with and without VCF. VCF was identified using preoperative upright whole-spine radiographs. Spinal parameters, preoperative and 1-year postoperative clinical outcomes of the Harris hip score (HHS), Oxford hip score (OHS), and visual analog scale (VAS) for low back pain (LBP) were assessed. Furthermore, propensity score-matched cohorts for age, sex, body mass index, and spinal parameters were created, and the clinical outcomes were compared between the two groups. RESULTS: Among the 453 patients, 51 (11.3%) with VCF and 402 without VCF were identified. Before matching, patients with VCF were older (p < 0.01), had sagittal spinal imbalance (p < 0.01), and had worse clinical outcomes pre- and postoperatively. After matching 47 patients in both groups, patients with VCF had worse HHS (p < 0.05), especially regarding support and distance walked, and worse VAS scores for LBP (p < 0.05) pre- and postoperatively. However, the improvements in scores were not significantly different between the groups. CONCLUSIONS: HHS, especially regarding support and distance walked, and VAS scores for LBP were poorer in patients with VCF preoperatively and 1-year postoperatively. Our findings suggest that hip surgeons should evaluate not only spinal alignment but also the presence of VCF before performing THA. LEVEL OF EVIDENCE: Level III, Retrospective cohort study.
• Identifying Muscle Function-based Phenotypes Associated With Radiographic Progression of Secondary Hip Osteoarthritis

  Hiroshige Tateuchi; Masahide Yagi; Haruhiko Akiyama; Koji Goto; Kazutaka So; Yutaka Kuroda; Noriaki Ichihashi

  Archives of Physical Medicine and Rehabilitation 2023/05 [Refereed]
  
• 術後coronal imbalanceが股関節すり減りに与える影響 C7が右に寄っていると右の股関節がすり減りやすい

  河井 利之; 清水 孝彬; 後藤 公志; 黒田 隆; 奥津 弥一郎; 大槻 文悟; 藤林 俊介; 松田 秀一

  Journal of Spine Research (一社)日本脊椎脊髄病学会 14 (3) 268 - 268 1884-7137 2023/04
• Assessment of the Damage to Hip Abductor Muscles in Primary Total Hip Arthroplasty With a Minimally Invasive Anterolateral Approach With or Without Trochanteric Flip Osteotomy.

  Yusuke Takaoka; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Yaichiro Okuzu; Shuichi Matsuda

  The Journal of arthroplasty 2023/03 [Refereed]
   

  BACKGROUND: Although introduction of minimally invasive techniques via anterolateral approaches considerably decreased prolonged limp after total hip arthroplasty (THA), potential damage to the abductor muscles is still a concern. This study aimed to evaluate the residual damage after primary THA with two types of anterolateral approach by assessing fatty infiltration and atrophy of the gluteus medius (GMed) and gluteus minimus (GMin) muscles. METHODS: We retrospectively analyzed 100 primary THAs using computed tomography; surgeries were performed by detaching the anterior part of the abductor muscles with a bone fragment (anterolateral approach with trochanteric flip osteotomy) or without it (anterolateral approach without trochanteric flip osteotomy). The change in radiodensities (RDs), cross-sectional areas (CSAs), and clinical scores preoperatively and at 1 year after operation were evaluated. RESULTS: The RD and CSA of GMed increased 1 year postoperatively in 86 and 81% of patients, respectively, while RD and CSA of GMin decreased in 71 and 94%, respectively. The improvement of RD of GMed was more frequently seen in the posterior rather than the anterior part, while the GMin decreased in both parts. The RD decrease of GMin was significantly lower in the anterolateral approach with trochanteric flip osteotomy group than the anterolateral approach without trochanteric flip osteotomy group (P = .0250). However, there was no difference in the clinical scores between the two groups. The change in the RD of GMed was the only factor that correlated with clinical scores. CONCLUSION: The two anterolateral approaches both improved the RD of GMed, recovery of which was significantly associated with postoperative clinical scores. Although the two approaches showed different recovery patterns in GMin until 1 year after THA, both showed similar improvements in clinical scores.
• 人工股関節全置換術において術後腰痛改善と関連する術前脊椎アライメント

  奥津 弥一郎; 後藤 公志; 黒田 隆; 河井 利之; 松田 秀一

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 66 (春季学会) 143 - 143 0008-9443 2023/03
• 椎体骨折既往患者における人工股関節全置換術の臨床成績

  陳 勁溪; 奥津 弥一郎; 河井 利之; 黒田 隆; 後藤 公志; 松田 秀一

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 66 (春季学会) 237 - 237 0008-9443 2023/03
• ビスフォスフォネート内服は股関節の変性を抑制する可能性がある

  河井 利之; 西谷 江平; 後藤 公志; 黒田 隆; 奥津 弥一郎; 栗山 新一; 中村 伸一郎; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (2) S211 - S211 0021-5325 2023/03
• CPOにおいて一過性大腿神経麻痺を回避する取り組み

  後藤 公志; 黒田 隆; 河井 利之; 奥津 弥一郎; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (2) S214 - S214 0021-5325 2023/03
• 診断遅延の発育性股関節形成不全症の開排位持続牽引法における股関節形態と求心性の関係について

  奥津 弥一郎; 塚中 真佐子; 後藤 公志; 黒田 隆; 河井 利之; 下園 芙紗子; 宗圓 充; 三輪 晶子; 二見 徹; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (2) S225 - S225 0021-5325 2023/03
• 脚延長量が大きいと人工股関節術後可動域は減少する

  河井 利之; 後藤 公志; 黒田 隆; 奥津 弥一郎; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (3) S733 - S733 0021-5325 2023/03
• 脊椎固定と股関節変性の関連

  河井 利之; 清水 孝彬; 後藤 公志; 黒田 隆; 奥津 弥一郎; 藤林 俊介; 大槻 文悟; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (3) S774 - S774 0021-5325 2023/03
• 人工股関節全置換術後における腰痛改善症例の脊椎パラメーターの変化

  奥津 弥一郎; 後藤 公志; 黒田 隆; 河井 利之; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (3) S875 - S875 0021-5325 2023/03
• 大腿骨頭壊死症に対する骨髄間葉系幹細胞移植10年後の機能およびQOL変化

  青山 朋樹; 後藤 公志; 池口 良輔; 柿木 良介; 松田 秀一; 中村 孝志; 戸口田 淳也

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (2) S159 - S159 0021-5325 2023/03
• 脊椎固定と股関節変性の関連

  河井 利之; 清水 孝彬; 後藤 公志; 黒田 隆; 奥津 弥一郎; 藤林 俊介; 大槻 文悟; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (3) S774 - S774 0021-5325 2023/03
• 大腿骨頭壊死症に対する骨髄間葉系幹細胞移植10年後の機能およびQOL変化

  青山 朋樹; 後藤 公志; 池口 良輔; 柿木 良介; 松田 秀一; 中村 孝志; 戸口田 淳也

  日本整形外科学会雑誌 (公社)日本整形外科学会 97 (2) S159 - S159 0021-5325 2023/03
• Evaluating the contribution of fat infiltration in anterior gluteus minimus muscle to walking ability in female with unilateral hip osteoarthritis and candidates for total hip arthroplasty.

  Takuma Yuri; Manabu Nankaku; Takumi Kawano; Masanobu Murao; Ryota Hamada; Kouji Goto; Yutaka Kuroda; Toshiyuki Kawai; Ryosuke Ikeguchi; Shuichi Matsuda

  Clinical biomechanics (Bristol, Avon) 103 105909 - 105909 2023/03 [Refereed]
   

  BACKGROUND: The purpose of this study is to investigate the relationship between gait and fat infiltration in anterior and posterior gluteus minimus in the patients with hip osteoarthritis. METHODS: Ninety-one female patients who were diagnosed as the unilateral hip osteoarthritis, classified into Kellgren-Lawrence global scoring system grades 3 or 4, and candidate for total hip arthroplasty were retrospectively reviewed. The horizontally cross-sectional regions of interest for the gluteus medius and anterior and posterior gluteus minimus were manually circumscribed in a single transaxial computed tomography image and muscle density of those regions were obtained. The gait was assessed as the step and speed with the 10-Meter Walk Test. The multiple regression analysis was used to compare the step and speed with age, height, range of motion in flexion, the muscle density of anterior gluteus minimus in the affected side, and that of gluteus medius muscle in both affected and unaffected sides. FINDINGS: Multiple regression analysis for step revealed that the muscle density of anterior gluteus minimus in the affected side and height were the independent predictors for step (R2 = 0.389, p < 0.001). That for speed identified the muscle density of anterior gluteus minimus in the affected side as the only factor determining speed (R2 = 0.287, p < 0.001). INTERPRETATION: The fatty infiltration of anterior gluteus minimus muscle in affected side can be a predictor for the gait in in female with unilateral hip osteoarthritis and candidates for total hip arthroplasty.
• Synergistic effect of sulfonation followed by precipitation of amorphous calcium phosphate on the bone-bonding strength of carbon fiber reinforced polyetheretherketone

  Yusuke Takaoka; Shunsuke Fujibayashi; Takeshi Yabutsuka; Yuya Yamane; Chihiro Ishizaki; Koji Goto; Bungo Otsuki; Toshiyuki Kawai; Takayoshi Shimizu; Yaichiro Okuzu; Kazutaka Masamoto; Yu Shimizu; Makoto Hayashi; Norimasa Ikeda; Shuichi Matsuda

  Scientific Reports Springer Science and Business Media LLC 13 (1) 2023/01 [Refereed]
   

  Abstract Sulfonation and applications of amorphous calcium phosphate are known to make polyetheretherketone (PEEK) bioactive. Sulfonation followed by precipitation of amorphous calcium phosphate (AN-treatment) may provide PEEK with further bone-bonding strength. Herein, we prepared a carbon-fiber-reinforced PEEK (CPEEK) with similar tensile strength to cortical bone and a CPEEK subjected to AN-treatment (CPEEK-AN). The effect of AN-treatment on the bone-bonding strength generated at the interface between the rabbit’s tibia and a base material was investigated using a detaching test at two time-points (4 and 8 weeks). At 4 weeks, the strength of CPEEK-AN was significantly higher than that of CPEEK due to the direct bonding between the interfaces. Between 4 and 8 weeks, the different bone forming processes showed that, with CPEEK-AN, bone consolidation was achieved, thus improving bone-bonding strength. In contrast, with CPEEK, a new bone was absorbed mainly on the interface, leading to poor strength. These observations were supported by an in vitro study, which showed that pre-osteoblast on CPEEK-AN caused earlier maturation and mineralization of the extracellular matrix than on CPEEK. Consequently, AN-treatment, comprising a combination of two efficient treatments, generated a synergetic effect on the bonding strength of CPEEK.
• アパタイト核処理を行った炭素繊維強化PEEKの骨結合力の評価について

  高岡 佑輔; 藤林 俊介; 薮塚 武史; 山根 侑也; 後藤 公志; 大槻 文悟; 河井 利之; 清水 孝彬; 奥津 弥一郎; 池田 周正; 織田 和樹; 池崎 龍仁; 本田 新太郎; 松田 秀一

  日本バイオマテリアル学会大会予稿集 日本バイオマテリアル学会 44回 127 - 127 2022/11
• Bisphosphonate use is associated with a decreased joint narrowing rate in the non-arthritic hip.

  Toshiyuki Kawai; Kohei Nishitani; Yaichiro Okuzu; Koji Goto; Yutaka Kuroda; Shinichi Kuriyama; Shinichiro Nakamura; Shuichi Matsuda

  Bone & joint research 11 (11) 826 - 834 2022/11 [Refereed]
   

  AIMS: The preventive effects of bisphosphonates on articular cartilage in non-arthritic joints are unclear. This study aimed to investigate the effects of oral bisphosphonates on the rate of joint space narrowing in the non-arthritic hip. METHODS: We retrospectively reviewed standing whole-leg radiographs from patients who underwent knee arthroplasties from 2012 to 2020 at our institute. Patients with previous hip surgery, Kellgren-Lawrence grade ≥ II hip osteoarthritis, hip dysplasia, or rheumatoid arthritis were excluded. The rate of hip joint space narrowing was measured in 398 patients (796 hips), and the effects of the use of bisphosphonates were examined using the multivariate regression model and the propensity score matching (1:2) model. RESULTS: A total of 45 of 398 (11.3%) eligible patients were taking an oral bisphosphonate at the time of knee surgery, with a mean age of 75.8 years (SD 6.2) in bisphosphonate users and 75.7 years (SD 6.8) in non-users. The mean joint space narrowing rate was 0.04 mm/year (SD 0.11) in bisphosphonate users and 0.12 mm/year (SD 0.25) in non-users (p < 0.001). In the multivariate model, age (standardized coefficient = 0.0867, p = 0.016) and the use of a bisphosphonate (standardized coefficient = -0.182, p < 0.001) were associated with the joint space narrowing rate. After successfully matching 43 bisphosphonate users and 86 non-users, the joint narrowing rate was smaller in bisphosphonate users (p < 0.001). CONCLUSION: The use of bisphosphonates is associated with decreased joint degeneration in non-arthritic hips after knee arthroplasty. Bisphosphonates slow joint degeneration, thus maintaining the thickness of joint cartilage in the normal joint or during the early phase of osteoarthritis.Cite this article: Bone Joint Res 2022;11(11):826-834.
• アルカリ加熱処理後ヨウ素担持チタンの生体活性および抗菌性の生体内評価

  池田 周正; 藤林 俊介; 山口 誠二; 織田 和樹; 高岡 佑輔; 奥津 弥一郎; 清水 孝彬; 河井 利之; 大槻 文悟; 後藤 公志; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (8) S1824 - S1824 0021-5325 2022/09
• 荷重骨のcritical-sized bone defectに対するストロンチウムイオンを付与した積層造影チタン材料の有用性の検討

  本田 新太郎; 藤林 俊介; 清水 孝彬; 奥津 弥一郎; 河井 利之; 大槻 文悟; 後藤 公志; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (8) S1890 - S1890 0021-5325 2022/09
• アパタイト核処理により生体活性を持たせた炭素繊維強化PEEKの骨結合能について

  高岡 佑輔; 藤林 俊介; 後藤 公志; 大槻 文悟; 河井 利之; 奥津 弥一郎; 清水 孝彬; 池田 周正; 織田 和樹; 本田 新太郎; 池崎 龍仁

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (8) S1892 - S1892 0021-5325 2022/09
• 脊椎固定術の固定椎間数が増えると術後の股関節のすり減りが増大する 脊椎術後X線上の標準化関節裂隙狭小化率での解析

  河井 利之; 後藤 公志; 黒田 隆; 奥津 弥一郎; 松田 秀一

  Hip Joint 日本股関節学会 48 44 - 51 0389-3634 2022/08 

  当院で腰椎を含む脊椎固定術を行った187例を対象に、これらを固定椎間数によりsingle群80例、short群55例、middle群26例、long群26例の4群に分け、脊椎術後3ヵ月の標準化関節裂隙狭小化率(nJSNR)を比較検討した。その結果、平均nJSNRはsingle群で1.12±1.95/year、short群で1.97±3.07/year、middle群で3.92±4.20/year、long群で6.25±5.00/yearと、long群で最も高値を示し、それぞれの2群間で有意差がみられた。重回帰分析の結果、脊椎固定の椎間数が増えるほど固定術後の股関節のすり減りが増大することが示唆された。
• Bioactivity and antibacterial activity of iodine-containing calcium titanate against implant-associated infection.

  Norimasa Ikeda; Shunsuke Fujibayashi; Seiji Yamaguchi; Koji Goto; Bungo Otsuki; Toshiyuki Kawai; Takayoshi Shimizu; Yaichiro Okuzu; Kazutaka Masamoto; Yu Shimizu; Yusuke Takaoka; Shuichi Matsuda

  Biomaterials advances 138 212952 - 212952 2022/07 [Refereed]
   

  Developing antimicrobial biomaterials is a major challenge in the fields of orthopaedic and dental implants. In this study, we evaluated the bone-bonding ability and antibacterial activity of a novel biomaterial for preventing implant-associated infections. We have previously reported that NaOH heat treatment improved the bone-bonding ability of titanium, which was later modified to release target ions from the calcium titanate surface. Iodine, an essential nutrient, exhibits broad-spectrum antimicrobial activity; hence, we designed a calcium titanate that releases iodine ions (Ca-I-Ti). The material was prepared from a simple solution using heat treatments as well as inexpensive devices and chemical agents. MC3T3-E1 cells seeded on Ca-I-Ti displayed high degrees of bioactivity and viability, and Ca-I-Ti exhibited antibacterial activity against methicillin-susceptible Staphylococcus aureus. In vivo biomechanical and histological experiments showed that Ca-I-Ti had excellent bone-bonding ability at 8 weeks after implantation. In a subcutaneous infection model in rats, methicillin-susceptible Staphylococcus aureus on the implant was reduced by approximately 95% compared to that on commercially pure titanium, indicating that Ca-I-Ti has antibacterial effects in vivo. In addition, no local or systemic complications were observed, and active infection in the surrounding tissues was histologically inhibited. Thus, iodine-containing calcium titanate is a safe biomaterial with excellent bioactivity and antibacterial properties, indicating its potential in preventing implant-associated infections.
• High Subsidence Rate After Primary Total Hip Arthroplasty Using a Zweymüller-type Noncemented Implant With a Matte Surface.

  Toshiyuki Kawai; Koji Goto; Yutaka Kuroda; Yaichiro Okuzu; Shuichi Matsuda

  Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews 6 (6) 2022/06 [Refereed]
   

  INTRODUCTION: The surface topography is one key factor that affects the initial fixation of prosthesis in total hip arthroplasty (THA). We aimed to evaluate the mid-term results of a Zweymüller-type noncemented femoral implant (Elance stem) that had a matte surface with a target average roughness of 1.0 to 2.5 μm. The prosthesis was subjected to alkali and heat treatments to enhance its bone-bonding property. METHODS: In this retrospective study, 30 THAs (27 patients) done using an Elance stem from September 2012 to October 2014 were evaluated clinically and radiographically for a mean follow-up of 6.3 ± 1.7 years after the index THA. RESULTS: Stem revision was indicated for six hips (20%). The survival rate with stem revision for any reason was 86.4% (95% confidence interval, 68.9%-94.8%) at 5 years. Stem subsidence >5 mm was noted in 17 hips (56.7%). The survival rate with stem subsidence >5 mm as the end point was 46.6% (95% confidence interval, 29.9%-64.2%) at 5 years. CONCLUSION: The Zweymüller-type noncemented stem with a low-roughness matte surface demonstrated a high subsidence rate, although the bone-bonding property was potentially enhanced by the alkali and heat treatments. Surgeons should be aware that an insufficient surface roughness could lead to poor mechanical fixation of the noncemented stem, even with an appropriate stem geometry and surface chemistry.
• Reproducibility, criterion-related validity, and minimal clinically important difference of the stair negotiation test after total Hip arthroplasty.

  Masanobu Murao; Manabu Nankaku; Takumi Kawano; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Ryosuke Ikeguchi; Shuichi Matsuda

  Physiotherapy theory and practice 1 - 8 2022/05 [Refereed]
   

  OBJECTIVE: To determine the reproducibility, criterion-related validity, and minimal clinically important difference (MCID) of the stair negotiation test (SNT) after total hip arthroplasty (THA). METHODS: Sixty patients who underwent THA were included in this study. They performed the SNT and rated their difficulty in stair negotiation (question 7 of the Oxford Hip Score [OHSQ7]) before and 6 months after surgery. The SNT determined the time taken by a patient to ascend, turn around, and descend the stairs (15 cm × 4 steps) and was measured twice each time. As a measure of reproducibility, the intraclass correlation coefficient (ICC1,1) was calculated using the preoperative SNT. As an index of criterion-related validity, Spearman's rank correlation coefficient was used to evaluate the relationship between the better score of two trials in the preoperative SNT and the OHSQ7. The MCID of the SNT was calculated using the distribution-based method and the anchor-based method. The change in the OHSQ7 between before and after surgery was used as an anchor in the latter method. RESULTS: The ICC1,1 of the SNT was 0.97. The SNT was significantly correlated with the OHSQ7 (r = 0.40, p < .05). Moreover, the anchor-based MCID of the SNT was 1.98 seconds. CONCLUSION: The SNT is an objective assessable test of stair negotiation ability in post-THA patients that has good reproducibility and moderate criterion-related validity. Changes in the SNT beyond the MCID (1.98 seconds) represent clinically important changes in stair negotiation ability.
• 大腿骨頭壊死症に対する骨髄間葉系幹細胞移植10年後の機能評価とリハビリテーション治療の効果

  青山 朋樹; 後藤 公志; 池口 良輔; 窓場 勝之; 谷間 桃子; 伊藤 明良; 柿木 良介; 松田 秀一

  The Japanese Journal of Rehabilitation Medicine (公社)日本リハビリテーション医学会 (特別号) S278 - S278 1881-3526 2022/05
• Development of a clinical prediction rule to identify physical activity after total hip arthroplasty.

  Takumi Kawano; Manabu Nankaku; Masanobu Murao; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Ryosuke Ikeguchi; Shuichi Matsuda

  Archives of physical medicine and rehabilitation 103 (10) 1975 - 1982 2022/04 [Refereed]
   

  OBJECTIVE: To develop clinical prediction rule (CPR) of physical activity at 1-year after total hip arthroplasty (THA). DESIGN: Retrospective cohort study. SETTING: University hospital with orthopedic surgery. PARTICIPANTS: The study group included 321 patients (56 men) who underwent primary THA. INTERVENTION: Not applicable. MAIN OUTCOMES MEASURES: The data collected included age, body mass index, clinical score from the questionnaires, hip pain, range of motion, muscle strength, and Physical functions (10-Meter Walk Test, Timed Up and Go test and Sit-to-stand). Patients were classified into sufficient and insufficient activity groups based on their University of California, Los Angeles (UCLA) activity score 1 year after THA. Variables measured preoperatively and at 3 weeks postoperatively were analyzed using univariate and multivariate methods to derive CPR for physical activity. RESULTS: A CPR was developed using the following five factors and cut-offs: age, ≤70.5 years; preoperative UCLA activity score, ≥3.5; preoperative hip abduction strength, ≥0.54 Nm/kg; preoperative knee extension strength, ≥1.04 Nm/kg; and 10-Meter Walk Test, ≤8.49 s at 3 weeks after surgery. The presence of four of the five factors predicted a sufficient physical activity level at 1-year, with a positive likelihood ratio of 5.94 and probability of 85.4%. The presence of five predictor variables increased the probability of sufficient physical activity after THA to 94.7%. CONCLUSION: This study developed a CPR for physical activity at 1-year after THA. Having four or more of the five measurements were useful indicators for predicting of physical activity at 1 year postoperatively.
• Closed suction drainage is not beneficial in hybrid total hip arthroplasty with intra-articular administration of tranexamic acid: a propensity score-matched cohort study.

  Yaichiro Okuzu; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  International orthopaedics 46 (6) 1281 - 1287 2022/04 [Refereed]
   

  PURPOSE: This retrospective study aimed to evaluate the benefits of closed suction drainage (CSD) in hybrid total hip arthroplasty (THA) with intra-articular administration of tranexamic acid (TXA). METHODS: We included 369 hips that underwent primary hybrid THA between November 2015 and September 2020. We compared peri-operative blood test results, blood loss, and post-operative complications including transfusion, wound complications, and venous thromboembolism (VTE) with or without CSD. Propensity score matching was performed to balance baseline patient demographics. RESULTS: Transfusion, wound complications, and VTE were observed in 1.9% (seven), 2.4% (nine), and 2.2% (eight) of hips, respectively. There were no significant differences in transfusion, blood loss, wound complications, and deep venous thrombosis in both overall patients and propensity score-matched patients with or without CSD. The calculated total blood loss was approximately 600 ml and showed no significant difference between the two groups in the matched cohort (p = 0.59). CONCLUSION: CSD does not provide any benefits and is not needed in primary hybrid THA with intra-articular administration of TXA.
• ディープラーニングテクノロジー併用2D薄層MRIによる股関節微小軟部組織評価の可能性

  河井 利之; 後藤 公志; 黒田 隆; 奥津 弥一郎; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (2) S36 - S36 0021-5325 2022/03
• 特発性大腿骨頭壊死症 異なる日米での治療推奨度

  黒田 隆; 奥津 弥一郎; 河井 利之; 後藤 公志; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (2) S237 - S237 0021-5325 2022/03
• 第1世代クロスリンクポリエチレンの摩耗率の経時的変化

  織田 和樹; 後藤 公志; 黒田 隆; 河井 利之; 奥津 弥一郎; 高岡 佑輔; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (3) S563 - S563 0021-5325 2022/03
• 脊椎固定と股関節裂隙狭小化の関連

  河井 利之; 清水 孝彬; 後藤 公志; 黒田 隆; 奥津 弥一郎; 藤林 俊介; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (3) S735 - S735 0021-5325 2022/03
• 人工股関節全置換術における術後腰痛改善と関連する術前脊椎因子の解析

  奥津 弥一郎; 後藤 公志; 黒田 隆; 河井 利之; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (3) S735 - S735 0021-5325 2022/03
• 寛骨臼回転骨切り術(CPO)において、外側大腿皮神経障害を回避する工夫

  後藤 公志; 黒田 隆; 河井 利之; 奥津 弥一郎; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 96 (3) S802 - S802 0021-5325 2022/03
• Effect of a Rehabilitation Program After Mesenchymal Stromal Cell Transplantation for Advanced Osteonecrosis of the Femoral Head: A 10-Year Follow-Up Study.

  Tomoki Aoyama; Koji Goto; Ryosuke Ikeguchi; Manabu Nankaku; Katsuyuki Madoba; Momoko Nagai-Tanima; Akira Ito; Ryosuke Kakinoki; Takashi Nakamura; Shuichi Matsuda; Junya Toguchida

  Archives of rehabilitation research and clinical translation 4 (1) 100179 - 100179 2022/03 [Refereed]
   

  Objective: To assess the status of 10 patients with advanced osteonecrosis of the femoral head who underwent mesenchymal stromal cell transplants and a 12-week rehabilitation program 10 years earlier. Design: Retrospective study. Setting: University clinical research laboratory. Participants: Patients (N=10) who had undergone mesenchymal stromal cell transplantation and rehabilitation for a single hip osteonecrosis of the femoral head 10 years prior to the current study were recruited by telephone. The average age was 31.7 years and all participants were men; radiographic stages were 3A in 6 patients and 3B in 4 patients before treatment. Intervention: A 12-week rehabilitation program with follow-up once every 1 to 2 years was performed after mesenchymal stromal cell transplantation. Main Outcome Measures: Radiographic analysis, clinical score, timed Up and Go test, hip function (range of motion, muscle strength), and Short Form-36 scores were assessed before treatment and 1 and 10 years after treatment. Results: Upon imaging, 5 hips were found to be stable (stable group) and 5 had progressed (progressed group); 2 of the latter group required a total hip arthroplasty. The pretreatment radiographic stage of the progressed group was more advanced than that of the stable group. Body mass index was higher in the progressed group than in the stable group. Hip function and clinical score at 1 and 10 years after treatment improved in the hips of 8 patients without total hip arthroplasty. There were no severe adverse events during the rehabilitation. Conclusions: The 12-week rehabilitation program and annual follow-up after mesenchymal stromal cell transplantation for osteonecrosis of the femoral head was associated with pain reduction, maintaining hip muscle strength, widening range of motion, and improving quality of life. The level and timing of weight-bearing and social activity should be planned according to the individual's lifestyle and body composition.
• Association Between the Amount of Limb Lengthening and Hip Range of Motion After Total Hip Arthroplasty.

  Toshiyuki Kawai; Koji Goto; Yutaka Kuroda; Yaichiro Okuzu; Shuichi Matsuda

  The Journal of the American Academy of Orthopaedic Surgeons 30 (6) e599-e606  2022/02 [Refereed]
   

  AIMS: The relationship between prosthetic position and range of motion (ROM) after total hip arthroplasty (THA) has been rigorously examined. However, the effects of limb lengthening on postoperative hip ROM remain unclarified. We aimed to examine the effect of limb lengthening on hip ROM after THA. METHODS: We retrospectively reviewed the data from 120 patients who underwent unilateral THA. Univariate and multivariate regression models were used to evaluate the effects of the following patient- and surgery-related covariates on hip flexion ROM at 3, 6, and 12 months after THA: age, sex, body mass index, diagnosis, preoperative University of California Los Angeles activity score, preoperative Oxford Hip Score, preoperative flexion ROM, amount of leg lengthening, cup inclination, and cup anteversion. RESULTS: A large preoperative hip flexion ROM was the strongest predictor of a large hip flexion ROM at 12 months after THA (standardized coefficient: 0.519, P < 0.0001). A larger amount of leg lengthening was associated with a smaller postoperative hip flexion ROM (standardized coefficient: -0.159, P = 0.039), and male sex was another predictor of a smaller postoperative hip flexion ROM (standardized coefficient: -0.204, P = 0.014). Cup inclination (P = 0.99) and anteversion (P = 0.18) were not significantly associated with hip flexion ROM at 12 months after THA. DISCUSSION: A large amount of limb lengthening was associated with decreased hip flexion ROM after THA. In THA, minimizing the leg length discrepancy is important; however, the postoperative improvement in hip flexion ROM may be limited when a large amount of leg lengthening is needed.
• The superior accuracy of a novel method in total hip wear calculations following radiographic measurement.

  Kazutaka So; Koji Goto; Atsushi Kawaguchi; Yutaka Kuroda; Shuichi Matsuda

  BMC musculoskeletal disorders 23 (1) 130 - 130 2022/02 [Refereed]
   

  BACKGROUND: Polyethylene wear is one of the major concerns of orthopedic surgeons. However, there is no standardized calculation method for the wear rate following radiographic measurement. The purpose of this study was to propose a novel method of wear calculation and to compare its accuracy with a representative conventional method. METHODS: Relative position of the center of the femoral head to that of the cup progresses in one direction following arthroplasty surgery because of bedding-in and wear. We predetermined the amount of bedding-in, wear rate, and random error in measuring the head center position in a 2-dimensional plane. We calculated the wear rate using the head center coordinates over a certain number of measurement periods using a representative conventional method and our novel method. The conventional method consisted of transforming vector data into scalars and conducting a least-squares method. The least-squares method was directly applied to each component of the vector in the novel method. We evaluated the accuracy of these methods by comparing the expected value for the wear rate with their predetermined true values. RESULTS: If the error were limited to being random, the novel method could provide the predetermined wear rate as the calculation result. However, the conventional method could not. CONCLUSION: We recommend using the novel method for the wear calculation rather than the conventional method because of its mathematical accuracy.
• The Impact of Spinopelvic Parameters on Hip Degeneration After Spinal Fusion.

  Toshiyuki Kawai; Takayoshi Shimizu; Koji Goto; Yutaka Kuroda; Yaichiro Okuzu; Bungo Otsuki; Shunsuke Fujibayashi; Shuichi Matsuda

  Spine 47 (15) 1093 - 1102 2022/02 [Refereed]
   

  MINI: The pelvic incidence (PI), sacral slope (SS), and pelvic incidence-lumbar lordosis (PI-LL) were associated with the progression of hip joint narrowing after spinal fusion, especially after fusion of four or more levels. Surgeons need to be aware of the risk of increased hip joint narrowing in patients with a large PI, SS, and PI-LL after fusion surgery. STUDY DESIGN: Retrospective cohort study. OBJECTIVE: This study aimed to investigate the effects of spinopelvic alignment parameters after spinal fusion on the rate of joint space narrowing in nonarthritic hips. SUMMARY OF BACKGROUND DATA: Spinal fusion affects the forces on the adjacent hip joint. Therefore, hip joint narrowing may be increased after spinal fusion surgery. However, the relationship between spinal alignment and hip degeneration remains unclarified. METHODS: We retrospectively reviewed data from patients who underwent lumbar spinal fusion from 2011 to 2018 at our institute. Patients with hip osteoarthritis (Kellgren-Lawrence grade ≥II) or hip dysplasia were excluded. The rate of hip joint space narrowing after spinal fusion was measured in 191 patients (382 hips). We assessed the effects of the following spinopelvic alignment parameters on the joint narrowing rate: pelvic tilt, sacral slope (SS), pelvic incidence (PI), lumbar lordosis (LL), PI-LL, sagittal vertical axis, and distance between the C7 plumb line, and the central sacral vertical line (C7-CSVL). RESULTS: The hip joint narrowing rate was greater when four or more levels were fused compared with single-level fusion. After adjusting for the effects of patient-related factors, the alignment parameters significantly associated with the hip joint narrowing rate were the PI (P = 0.0002), SS (P = 0.047), and PI-LL (P = 0.0022). A subgroup analysis of patients who underwent long fusion (four or more levels combined with iliac screws) also indicated that the PI (P = 0.013), SS (P = 0.0054), and PI-LL (P = 0.046) were associated with the hip joint narrowing rate. CONCLUSION: The PI, SS, and PI-LL were associated with the progression of hip joint narrowing after spinal fusion, especially after fusion of four or more levels. Surgeons need to be aware of the risk of increased hip joint narrowing in patients with a large PI, SS, and PI-LL after fusion surgery.Level of Evidence: Level III.
• Wear resistance of first-generation highly cross-linked annealed polyethylene in cementless total hip arthroplasty is maintained 20 years after surgery.

  Kazuki Orita; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Yaichiro Okuzu; Shuichi Matsuda

  The bone & joint journal 104-B (2) 200 - 205 2022/02 [Refereed]
   

  AIMS: The aim of this study was to evaluate the performance of first-generation annealed highly cross-linked polyethylene (HXLPE) in cementless total hip arthroplasty (THA). METHODS: We retrospectively evaluated 29 patients (35 hips) who underwent THA between December 2000 and February 2002. The survival rate was estimated using the Kaplan-Meier method. Hip joint function was evaluated using the Japanese Orthopaedic Association (JOA) score. Two-dimensional polyethylene wear was estimated using Martell's Hip Analysis Suite. We calculated the wear rates between years 1 and 5, 5 and 10, 10 and 15, and 15 and final follow-up. RESULTS: The mean follow-up period was 19.1 years (SD 0.6; 17.3 to 20.1). The 19-year overall survival rate with the end point of all-cause revision was 97.0% (95% confidence interval (CI) 91 to 100). The mean JOA score improved from 43.2 (SD 10.6; 30 to 76) before surgery to 90.2 (SD 6.4; 76 to 98) at the final follow-up (p < 0.001). There was no osteolysis or loosening of the acetabular or femoral components. The overall steady-state wear rate was 0.013 mm/year (SD 0.012). There was no hip with a steady-state wear rate of > 0.1 mm/year. There was no significant difference in wear rates for each period. We found no significant correlation between the wear rate and age, body weight, BMI, or cup inclination. CONCLUSION: First-generation annealed HXLPE shows excellent wear resistance and no acceleration of wear for approximately 20 years, with low all-cause revision rates. Cite this article: Bone Joint J 2022;104-B(2):200-205.
• Discrepancy in the Responsiveness to Hip Range of Motion Between Harris and Oxford Hip Scores.

  Toshiyuki Kawai; Koji Goto; Yutaka Kuroda; Yaichiro Okuzu; Shuichi Matsuda

  Arthroplasty today 13 157 - 164 2022/02 [Refereed]
   

  Background: The primary objectives of total hip arthroplasty (THA) include mobility improvement and pain relief; however, the correlation between hip range of motion (ROM) and function remains unclear. We aimed to explore how ROM affects hip functions after THA and compare the responsiveness of each component of the modified Harris Hip Score (mHHS) and Oxford Hip Score (OHS) to preoperative and postoperative ROM. Methods: This prospective observational study involved 120 patients who underwent unilateral THA. Univariate regression analyses were performed using the University of California Los Angeles activity score and mHHS and OHS to determine the effects of preoperative and postoperative flex ROM on clinical scores at 12 months. Multivariate regressions were performed to adjust for the confounding effects of patient factors: age, sex, body mass index, and diagnosis. Results: A larger preoperative flexion ROM was associated with a higher score in the mHHS socks component (standardized coefficient [SC] = 0.26, P = .0041) at 12 months; the effect on the OHS socks component was not significant (P = .34). A larger flexion ROM at 12 months was associated with higher scores in the mHHS support (SC = 0.21, P = .026), stairs (SC = 0.35, P = .0002), and socks (SC = 0.32, P = .0007) components but had no significant effect on any OHS component. The effects of ROM on University of California Los Angeles activity score were limited. Conclusions: A discrepancy was noted in the responsiveness to ROM between the two major measurement tools; this difference might be because mHHS and OHS are surgeon- and patient-administered questionnaires, respectively. This discrepancy also suggests that the patients have higher satisfaction than that assumed by the surgeons.
• Long-term outcome of primary total hip arthroplasty with cementless bioactive glass ceramic bottom-coated implants and highly cross-linked polyethylene: A minimum 10-year analysis.

  Kazuki Orita; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Yaichiro Okuzu; Yusuke Takaoka; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 28 (2) 385 - 390 2022/01 [Refereed]
   

  BACKGROUND: Cementless glass ceramics containing apatite and wollastonite (AW-GC) bottom-coated titanium hip implants were developed; early excellent clinical and radiographic results have been reported previously. This study aimed to investigate the long-term clinical and radiographic outcomes in detail, and the wear rate of HXLPE. METHODS: We retrospectively evaluated 99 patients (117 hips) between November 2001 and December 2007. The survival rate was estimated using the Kaplan-Meier method. Hip joint function was evaluated using the Japanese Orthopaedic Association (JOA) score. The extent of radiographic signs was determined from the radiographs performed at the last follow-up. Polyethylene wear was measured using Martell's Hip Analysis Suite. We assessed the possible factors affecting the steady-state linear wear rate. RESULTS: The mean follow-up period was 14.8 ± 2.1 (10-18.6) years. The mean JOA score improved to 88.7 ± 9.4 (59-100) at the final follow-up from 47.8 ± 12.5 (17-76) before surgery. The overall survival rate with the end point of all-cause revision and wear-related revision was 99% and 100% respectively. There was no osteolysis or loosening of either the acetabular or femoral component. All hips were classified as having bone ingrowth fixation. The mean steady-state wear rate was 0.008 ± 0.025 mm/year. We found no significant correlation between the wear rate and age, body weight, body mass index, cup inclination and femoral head size. CONCLUSION: The combination of AW-GC bottom-coated implants and HXLPE showed excellent implant survival and wear resistance for 15 years.
• CPOの手術手技改良による手術侵襲抑制効果について

  深江 舜也; 後藤 公志; 黒田 隆; 河井 利之; 奥津 弥一郎; 松田 秀一

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 65 (1) 141 - 142 0008-9443 2022/01 

  当院で前方侵入寛骨臼回転骨切り術を行った55例を対象に、上前腸骨棘(ASIS)を骨切りして大きく展開したA群16例と、ASISを骨切りせずにX線透視下に小さな展開で手術したB群39例に分け、比較検討した。その結果、A群と比較してB群では、手術時間、術中出血量、術翌日CPK上昇幅の有意な減少を認めた。多変量解析で有意にCPK上昇に影響した項目は、性別、手術時間であり、手術時間が長いほど、女性より男性で有意にCPKの上昇を認めた。
• Radiodensity measurement is feasible for evaluating fatty infiltration in hip abductors.

  Yusuke Takaoka; Koji Goto; Yutaka Kuroda; Kawai Toshiyuki; Yaichiro Okuzu; Hayashi Makoto; Orita Kazuki; Shuichi Matsuda

  Journal of orthopaedics 30 93 - 97 2022 

  OBJECTIVE: This retrospective study aimed to compare radiodensity measurements and Goutallier grading systems for the evaluation of fatty infiltration in hip abductors. METHODS: The radiodensity of the gluteus minimus and medius muscles was measured in 80 hips of 40 patients. These muscles were graded for fatty infiltration using three five-grade classification systems: the original Goutallier classification on both computed tomography (CT) and magnetic resonance imaging (MRI), and a new objective classification based on the percentage of the functional muscle area (defined as 30-100 Hounsfield units). After measuring and grading the abductors, correlation coefficients between them were analyzed. RESULTS: Spearman's rank correlation coefficients (ρ) between radiodensity measurements of abductors and the Goutallier classification on CT and MRI were -0.701 and -0.552 for the gluteus minimus and -0.832 and -0.740 for the gluteus medius, respectively. Our new classification had correlation coefficients of -0.844 and -0.926 for the gluteus minimus and gluteus medius, respectively. CONCLUSIONS: Radiodensity measurements showed a strong correlation with the grading systems, particularly with the new classification based on the percentage of the functional muscle area. Considering the subjective nature of the original Goutallier grading systems, we conclude that radiodensity assessment is feasible and more objective for evaluating fatty infiltration in hip abductors.
• Preoperative Factors Associated With Low Back Pain Improvement After Total Hip Arthroplasty in a Japanese Population.

  Yaichiro Okuzu; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  The Journal of arthroplasty 37 (1) 69 - 74 2022/01 [Refereed]
   

  BACKGROUND: Spinal disorders and low back pain (LBP) have been associated with worse clinical outcomes of total hip arthroplasty (THA). It is essential to identify spinal factors associated with post-THA LBP improvement. Therefore, we aimed to determine the proportion of patients with improved LBP after THA and to identify the preoperative spinal factors associated with LBP improvement. METHODS: We included 151 patients who underwent primary THA between December 2015 and December 2019 and had a preoperative visual analog scale score for LBP of ≥2. The patients were classified into the LBP improved or LBP continued group based on a visual analog scale score for LBP at 1 year after THA. Preoperative spinal parameters were compared between the 2 groups. RESULTS: Ninety-five patients (62.9%) were classified into the LBP improved group. Among the coronal spinal parameters, the Cobb angle was significantly lower in the LBP improved group. Among the sagittal spinal parameters, the LBP continued group showed a significantly more posteriorly titled pelvis, lower lumbar lordosis, greater sagittal vertical axis, and greater pelvic incidence minus lumbar lordosis mismatch, indicating a sagittal spinal imbalance. Logistic regression analysis found that preoperative factors associated with LBP improvement after THA had a low Cobb angle and high anterior pelvic plane angle (anteriorly tilted pelvis). CONCLUSION: Among patients with LBP before THA, 62.9% had improved LBP. Sagittal spinal imbalance and high Cobb angle were the key spinal factors associated with persistent LBP. Our findings suggest that hip surgeons should evaluate spinal alignment before THA in patients with LBP.
• Early Breakage of All Proximal Locking Compression Screws under Non-weight-bearing Conditions after Derotational Femoral Osteotomy in a Child with Cerebral Palsy: A Case Report.

  Yaichiro Okuzu; Masako Tsukanaka; Yutaka Kuroda; Koji Goto; Tohru Futami; Shuichi Matsuda

  Journal of orthopaedic case reports 11 (12) 1 - 4 2021/12 [Refereed]
   

  Introduction: The locking compression plate (LCP) system for pediatric hips has improved fixation and angular stability. Herein, we report a rare case in which all proximal locking compression screws were broken before weight bearing in the early post-operative period after derotational femoral osteotomy in a child with spastic cerebral palsy (CP). Case Report: Derotational femoral osteotomy was performed using a LCP system for a 9-year-old boy with spastic CP to correct excessive femoral anteversion, causing unstable toe-in gait. Proximal screw breakage was found 2 weeks postoperatively during hip-spica casting under non-weight-bearing conditions. Implant breakage was considered a result of the excessive spasticity of the lower limb. At the time of reoperation, shortening and varus correction of the femur and muscle tendon release were performed in addition to the refixation of the osteotomy. Intensive pain control was ensured, and anti-spastic medication and botulinum toxin injection were administered. Complete bone healing was successfully achieved 6 months after the second surgery. Conclusion: Surgeons need to consider the spasticity of the lower limb as a cause of implant failure. Management to reduce spasticity and mechanical load to the implant is important for preventing implant failures in patients with spastic CP.
• Investigating sagittal spinal alignment, low back pain, and clinical outcomes after total hip arthroplasty for lumbar hyperlordosis: a retrospective study.

  Yaichiro Okuzu; Takuma Miyahara; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  Archives of orthopaedic and trauma surgery 142 (12) 4007 - 4013 2021/11 [Refereed]
   

  INTRODUCTION: Hip-spine syndrome, wherein flexion deformity of the hip might exaggerate normal lumbar lordosis (LL), was first described in 1983. It could result in subluxation of the posterior facets and cause low back pain (LBP). However, the clinical outcomes of total hip arthroplasty (THA) and spinal alignment changes in patients with lumbar hyperlordosis (hyper LL) remain unknown. We aimed to clarify the proportion of patients with hyper LL before THA and compare pre- and post-operative sagittal spinal alignment, LBP, and clinical outcomes between patients with hyper LL and those with normal LL. MATERIALS AND METHODS: We investigated 278 patients who underwent primary THA between December 2015 and December 2019. Spine radiographs in the standing position were examined preoperatively and 1 year postoperatively. Patients with hyper LL were defined as having a pelvic incidence (PI) minus LL of < - 9° preoperatively. The control group included age- and sex-matched patients with normal LL, defined by a PI minus LL of - 9° to 9°. Clinical outcomes were evaluated using the visual analogue scale (VAS) for LBP, Harris hip score (HHS), Oxford hip score (OHS), and University of California, Los Angeles (UCLA) activity score. RESULTS: Thirty-eight patients (13.7%) had hyper LL, and they exhibited a lower pelvic tilt, lower sagittal vertical axis, and greater sigmoid curvature than did the controls. Evaluation of changes in the spinal alignment after surgery showed that the pelvis tilted more posteriorly, and LL decreased more in the hyper LL group than in the control group. Pre- and post-operative VAS for LBP, HHS, OHS, and UCLA activity scores were not significantly different between the two groups. CONCLUSION: Hyper LL in patients with hip osteoarthritis had no adverse effects on LBP and the clinical outcomes of THA. Hyper LL may partially result from a flexible and adaptable lumbo-pelvic structure.
• 悪性リンパ腫によるAAOS type III臼蓋骨欠損に対しK-Tプレートと自家骨移植を用いて臼蓋再建した1例

  森 圭市郎; 河井 利之; 後藤 公志; 黒田 隆; 奥津 弥一郎; 松田 秀一

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 64 (6) 793 - 794 0008-9443 2021/11 

  症例は69歳男性で、右精巣原発悪性リンパ腫術後1年10ヵ月に右股関節痛が出現し、当科紹介となった。初診時画像所見から、悪性リンパ腫により生じたAAOS type IIIの臼蓋骨欠損と診断した。本症例は悪性リンパ腫の寛解が得られていることから、K-Tプレートと自家骨移植を用いて臼蓋再建を行った。術後3ヵ月で臨床スコアは改善し、現在独歩にて外来フォロー中である。
• 医と歯の注目すべきバイオマテリアル～その共通点と相違点 整形外科で注目されるバイオマテリアル 表面修飾金属材料

  河井 利之; 藤林 俊介; 後藤 公志; 大槻 文悟; 清水 孝彬; 奥津 弥一郎; 松田 秀一

  日本バイオマテリアル学会大会予稿集 日本バイオマテリアル学会 43回 JI - 04 2021/11
• Recovery of Muscle Atrophy and Fatty Infiltration in Patients With Acetabular Dysplasia After Total Hip Arthroplasty.

  Takumi Kawano; Manabu Nankaku; Masanobu Murao; Ryota Hamada; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Ryosuke Ikeguchi; Shuichi Matsuda

  The Journal of the American Academy of Orthopaedic Surgeons 30 (3) e317-e326  2021/10 [Refereed]
   

  INTRODUCTION: Hip osteoarthritis (OA) with acetabular dysplasia negatively affects pelvic alignment and muscle function. We aimed to investigate the changes in muscle atrophy and fatty infiltration of the hip and trunk muscles 1 year after total hip arthroplasty (THA) in patients with hip OA with acetabular dysplasia. METHODS: This study included 51 female patients who underwent THA for unilateral hip OA with acetabular dysplasia. The cross-sectional area (CSA) and muscle density of the gluteus maximus, gluteus medius, gluteus minimus, piriformis, iliopsoas, rectus abdominis, and abdominal oblique muscles using computer tomography and pelvic inclination angle using radiographs were assessed before and 1 year after THA. RESULTS: At the 1-year follow-up, the CSA and muscle density of the gluteus medius (2,078 to 2,522 mm2 and 30.3 to 39.4 hounsfield units [HU]), iliopsoas (715 to 901 mm2 and 40.3 to 50.8 HU), and rectus abdominis (336 to 363 mm2 and 28.6 to 30.6 HU) of the affected limb had increased significantly (P < 0.05). The CSA and muscle density of the gluteus maximus (2,429 versus 2,884 mm2 and 23.7 versus 32.6 HU), gluteus minimus (636 versus 785 mm2 and 14.3 versus 37.1 HU), piriformis (505 versus 607 mm2 and 23.4 versus 31.6 HU), and iliopsoas (901 versus 997 mm2 and 50.8 versus 54.5 HU) in the affected limb were lower than those in the unaffected limb (P < 0.01). Postoperatively, the CSA and muscle density of the rectus abdominis were not significantly different between the limbs, and the pelvic inclination angle (35.2° to 32.1°, P < 0.01) was significantly decreased. DISCUSSION: Compared with the nonoperated limb, substantial atrophy and fatty infiltration of most hip muscles persisted in the operated limb 1 year after THA in patients with acetabular dysplasia; asymmetry in the rectus abdominis muscle fully resolved. In patients with acetabular dysplasia, the surgical technique and postoperative rehabilitation should be further considered to optimize hip muscle recovery.
• Functional characteristics associated with hip abductor torque in severe hip osteoarthritis.

  Takumi Kawano; Manabu Nankaku; Masanobu Murao; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Ryosuke Ikeguchi; Shuichi Matsuda

  Musculoskeletal science & practice 55 102431 - 102431 2021/10 [Refereed]
   

  BACKGROUND: Hip abductor weakness due to the progression of hip osteoarthritis (OA) commonly causes poor functional mobility. The hip abductor strength has also been identified as a clinically relevant factor for successful functional outcomes after total hip arthroplasty. OBJECTIVES: This study aimed to examine the functional characteristics related to hip abductor torque in patients with hip OA. DESIGN: A cross-sectional survey study. METHODS: One hundred and eight female patients with severe unilateral hip OA participated in this study. Hip abductor torque and pain were measured. The muscle cross-sectional area (CSA) and skeletal muscle density (SMD) of the gluteal muscles were also measured using computed tomography. To identify the hip parameters associated with hip abductor torque, multiple regression analysis was performed. The healthy model included the CSA and SMD of gluteus maximus, gluteus medius, and gluteus minimus; range of motion in hip abduction; age; and body mass index. The affected model included hip pain in addition to the healthy model. RESULTS: In the affected limb, multiple regression analysis identified pain and angle of hip abduction as factors that determine hip abductor torque (Adjusted R2 = 0.39). In contrast, our analysis identified CSA and SMD of the gluteus medius and SMD of the gluteus minimus as the significant variables related to hip abductor torque in the healthy limb (Adjusted R2 = 0.40). CONCLUSION: The findings of this study indicated that it is necessary to consider that hip pain may inhibit muscle exertion and contraction while training to improve the hip abductor torque in the affected limb.
• Radiolucent lines do not affect the longevity of highly cross-linked polyethylene cemented components in total hip arthroplasty.

  Yusuke Takaoka; Koji Goto; Jiro Tamura; Yaichiro Okuzu; Toshiyuki Kawai; Yutaka Kuroda; Kazuki Orita; Shuichi Matsuda

  The bone & joint journal 103-B (10) 1604 - 1610 2021/10 [Refereed]
   

  AIMS: We aimed to evaluate the long-term outcome of highly cross-linked polyethylene (HXLPE) cemented acetabular components and assess whether any radiolucent lines (RLLs) which arose were progressive. METHODS: We retrospectively reviewed 170 patients who underwent 187 total hip arthroplasties at two hospitals with a minimum follow-up of ten years. All interventions were performed using the same combination of HXLPE cemented acetabular components with femoral stems made of titanium alloy. Kaplan-Meier survival analysis was performed for the primary endpoint of acetabular component revision surgery for any reason and secondary endpoint of the appearance of RLLs. RLLs that had appeared once were observed over time. We statistically assessed potential relationships between RLLs and a number of factors, including the technique of femoral head autografting and the Japanese Orthopaedic Association score. RESULTS: The mean follow-up period was 13.0 years (10.0 to 16.3). Femoral head autografting was performed on 135 hips (72.2%). One acetabular component was retrieved because of deep infection. No revision was performed for the aseptic acetabular loosening. The Kaplan-Meier survival curve for the primary and secondary endpoints were 98.2% (95% confidence interval (CI) 88.6% to 99.8%) and 79.3% (95% CI 72.8% to 84.6%), respectively. RLLs were detected in 38 hips (21.2%), at a mean of 1.7 years (1 month to 6 years) postoperatively. None of the RLLs were progressive, and the presence of RLLs did not show a significant association with the survival and clinical score. RLLs were more frequently observed in hips without femoral head autografts than in those with autografts. CONCLUSION: The use of HXLPE cemented acetabular components in total hip arthroplasty demonstrated excellent clinical outcomes after ten years, and no RLLs were progressive, and their presence did not affect the outcome. Femoral head autografting did not negatively impact the acetabular component survival or the appearance of RLLs. Cite this article: Bone Joint J 2021;103-B(10):1604-1610.
• Optimizing the layer thickness of sol-gel-derived TiO2 coating on polyetheretherketone.

  Makoto Hayashi; Takayoshi Shimizu; Masashi Imamura; Shunsuke Fujibayashi; Seiji Yamaguchi; Koji Goto; Bungo Otsuki; Toshiyuki Kawai; Yaichiro Okuzu; Shuichi Matsuda

  Scientific reports 11 (1) 15875 - 15875 2021/08 [Refereed]
   

  Sol-gel-derived TiO2 coatings have been confirmed to effectively promote bone-bonding behavior on polyetheretherketone (PEEK) surfaces; however, the optimal layer thickness to maximize the osseointegration and adhesive performance has not been yet determined. In this study, we applied sol-gel-derived TiO2 coatings with different layer thicknesses (40 and 120 nm) on PEEK implants to determine the effects of layer thickness on the surface characteristics, adhesive strength, and bone bonding capabilities (including histological osseointegration). The surface analysis results of both coated implants indicated no significant differences concerning the water contact angle, layer adhesion strength, and apatite formation ability in a simulated body fluid. Additionally, the in vivo biomechanical tests revealed a higher bone-bonding strength for both coated PEEK implants (compared with that of the uncoated sample). It was thus concluded that the factor of layer thickness marginally influences the bioactive advantages attained by sol-gel-derived TiO2 coatings on PEEK surfaces, highlighting the significant versatility and clinical availability of this coating technology.
• Ten-year results of mesenchymal stromal cell transplantation augmented with vascularised bone grafts for advanced osteonecrosis of the femoral head

  Koji Goto; Tomoki Aoyama; Junya Toguchida; Yutaka Kuroda; Toshiyuki Kawai; Yaichiro Okuzu; Shuichi Matsuda

  Journal of Orthopaedics 26 67 - 71 2021/07 [Refereed]
   

  Background: A prospective, open-label clinical trial, in which transplantation of cultured autologous bone marrow-derived multipotent mesenchymal stromal cells in combination with vascularised bone grafts for the treatment of post-collapse extensive osteonecrosis of the femoral head in ten patients, was conducted previously. The aim of this study was to assess the 10-year clinical and radiographic results of that study. Methods: Patients were evaluated for radiographic progression of osteonecrosis of the femoral head using anteroposterior radiographs at 10 years postoperatively. Clinical score and hip function, including the timed up and go test, were also estimated. Results: Osteoarthritic changes in the affected hip were found in five of the ten patients, two of whom had undergone total hip arthroplasty at 7 and 9 years postoperatively. Five of the six cases (83.3%) in which pre-operative femoral head collapse was less than 3 mm, had no further collapse. On the other hand, all four cases in which pre-operative femoral head collapse was ≥3 mm, showed osteoarthritic changes within 10 years. The average clinical score significantly improved postoperatively and was maintained at 10 years. Conclusions: Considering that eight of 10 post-collapse cases could avoid total hip arthroplasty conversion with good clinical results for 10 years and five of 6 post-collapse cases (collapse <3 mm) could avoid further collapse and osteoarthritic changes for 10 years, mesenchymal stromal cell transplantation in combination with vascularised bone grafts could be an effective treatment for post-collapse osteonecrosis of the femoral head.
• Similarity in Sequential Bilateral Transient Osteoporosis of the Hip: A Report of 3 Cases.

  Yutaka Kuroda; Satoru Koumoto; Yaichiro Okuzu; Toshiyuki Kawai; Koji Goto; Shuichi Matsuda

  JBJS case connector 11 (2) 2021/06 [Refereed]
   

  CASE: Three middle-aged men with habitual drinking developed unilateral hip pain and were referred for osteonecrosis of the femoral head (ONFH). Radiographs showed osteopenia, and magnetic resonance imaging (MRI) showed diffuse bone marrow edema (BME). After several months, the patients' symptoms resolved and radiographic images normalized. More than 6 months later, the contralateral side showed the same clinical course. CONCLUSION: Transient osteoporosis of the hip (TOH) resembles ONFH but heals spontaneously. We report 3 rare cases of sequential TOH, similar in that they occurred in middle-aged male habitual drinkers at risk for ONFH, characterized by diffuse BME on MRI and radiographic resolution.
• Number of Levels of Spinal Fusion Associated with the Rate of Joint-Space Narrowing in the Hip.

  Toshiyuki Kawai; Takayoshi Shimizu; Koji Goto; Yutaka Kuroda; Yaichiro Okuzu; Shunsuke Fujibayashi; Shuichi Matsuda

  The Journal of bone and joint surgery. American volume 103 (11) 953 - 960 2021/06 [Refereed]
   

  BACKGROUND: Fusion of a joint reportedly increases force in the adjacent joints and leads to progression of arthritis. Whether lumbar spinal fusion increases force in the hip joint and promotes wear of the joint space is unclear. The purpose of this study was to evaluate the rate of joint-space narrowing in the hip following spinal fusion and to examine the effects of the number of levels fused on the joint-narrowing rate. METHODS: We retrospectively reviewed data for patients who underwent lumbar spinal fusion from 2011 to 2018 at our institute. Patients with a previous hip surgery, Kellgren-Lawrence grade ≥II hip osteoarthritis, hip dysplasia, and rheumatoid arthritis were excluded. The rate of joint-space narrowing in the hip was measured in 205 eligible patients (410 hips) following spinal fusion, and the effects of sex, age, body mass index, indication for spinal fusion, laterality, sacral fixation, and number of levels fused on the narrowing rate were examined. RESULTS: The rate of joint-space narrowing for all patients was 0.114 ± 0.168 mm/year. The narrowing rate for single-level fusion was 0.062 ± 0.087 mm/year, whereas that for fusion of ≥7 levels was 0.307 ± 0.254 mm/year. In the multivariate regression analysis, only the length of fusion (standardized coefficient [SC] = 0.374, p < 0.0001) was associated with an increased narrowing rate. When the narrowing rate was normalized by height, female sex was another risk factor for increased narrowing (SC = 0.109, p = 0.023). Secondary regression modeling performed with patients who underwent spinal fusion for degenerative disc disease showed that the length of fusion (SC = 0.454, p < 0.0001) and female sex (SC = 0.138, p = 0.033) were associated with increased joint-space narrowing. CONCLUSIONS: Longer spinal fusion was associated with the progression of hip joint narrowing following spinal fusion. Surgeons should be aware of the possible increased risk of hip degeneration following spinal fusion and should inform patients of this risk. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.
• Recombinant human FGF-2 for the treatment of early-stage osteonecrosis of the femoral head: TRION, a single-arm, multicenter, Phase II trial.

  Yutaka Kuroda; Takeyuki Tanaka; Takaki Miyagawa; Hidetoshi Hamada; Hiroyasu Abe; Toshiko Ito-Ihara; Ryuta Asada; Yusuke Fujimoto; Daisuke Takahashi; Tomonori Tetsunaga; Ayumi Kaneuji; Michiaki Takagi; Yutaka Inaba; Satoshi Morita; Nobuhiko Sugano; Sakae Tanaka; Shuichi Matsuda; Haruhiko Akiyama

  Regenerative medicine 16 (6) 535 - 548 2021/06 [Refereed]
   

  Aim: This study aimed to evaluate the 2-year outcomes from a clinical trial of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Patients & methods: Sixty-four patients with nontraumatic, precollapse and large ONFHs were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Setting the end point of radiological collapse, we analyzed the joint preservation period of the historical control. Changes in two validated clinical scores, bone regeneration and safety were evaluated. Results: Radiological joint preservation time was significantly higher in the rhFGF-2 group than in the control group. The ONFHs tended to improve to smaller ONFHs. The postoperative clinical scores significantly improved. Thirteen serious adverse events showed recovery. Conclusion: rhFGF-2 treatment increases joint preservation time with clinical efficacy, radiological bone regeneration and safety.
• Difference in Therapeutic Strategies for Joint-Preserving Surgery for Non-Traumatic Osteonecrosis of the Femoral Head between the United States and Japan: A Review of the Literature.

  Yutaka Kuroda; Yaichiro Okuzu; Toshiyuki Kawai; Koji Goto; Shuichi Matsuda

  Orthopaedic surgery 13 (3) 742 - 748 2021/05 [Refereed]
   

  For patients with non-traumatic osteonecrosis of the femoral head (ONFH), core decompression (CD) and bone grafts (BG) are mainly performed in the West, while osteotomy is found to be predominant in Japan. It is not well recognized how the surgical procedures for joint preservation in patients with ONFH are completely different between the United States and Japan. This paper identifies the contexts and the differences in treatment strategies for ONFH between the two countries. We compared the surgical trends of the two countries over three periods, 1997-2001, 2002-2006, and 2007-2011 (the US data for the third period was 2007-2008), based on a 2014 US paper and a 2013 national publication in Japan. We compared the details of surgery for non-traumatic ONFH under the same conditions in the two reports. For the period 1997-2001, the rates of surgeries for ONFH in the US were as follows: total hip arthroplasty (THA), 86%; CD, 10%; and osteotomy, 0.4%. In Japan, THA was 61%, osteotomy 38%, and CD 0%. For the recent period, 2007-2011 (US 2007-2008), the rate of THA was 91%, CD 6%, and osteotomy 0.1%, in the US, compared to a THA rate of 73%, CD 0%, and osteotomy 26% in Japan. The results for the interim period (2002-2006) were between the old and new data. The use of joint-preserving surgery for ONFH differs greatly between the US and Japan. The first-line joint-preserving surgery was CD in the US and osteotomy in Japan. Each procedure was rarely done in the other country. From about 2000 to 2010, the percentage of THA increased in both countries. The proportion of joint-preserving surgery (CD in the US and osteotomy in Japan) declined. The decrease in joint-preserving procedures may be largely attributed to improved long-term outcomes of THA due to technological advances. There is also a reluctance for young ONFH patients to undergo joint-preserving procedures, such as osteotomy, that require long-term hospitalization.
• Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading.

  Hiroshige Tateuchi; Haruhiko Akiyama; Koji Goto; Kazutaka So; Yutaka Kuroda; Noriaki Ichihashi

  Arthritis research & therapy 23 (1) 129 - 129 2021/04 [Refereed]
   

  BACKGROUND: Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed. METHODS: Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moment changes during gait were compared between types. RESULTS: The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC. CONCLUSIONS: Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.
• Bone Coverage around Hydroxyapatite/Poly(L-Lactide) Composite Is Determined According to Depth from Cortical Bone Surface in Rabbits.

  Kazuaki Morizane; Koji Goto; Toshiyuki Kawai; Shunsuke Fujibayashi; Bungo Otsuki; Takayoshi Shimizu; Shuichi Matsuda

  Materials (Basel, Switzerland) 14 (6) 2021/03 [Refereed]
   

  Composites of unsintered hydroxyapatite (HA) and poly(L-lactide) (PLLA) reinforced by compression forging are biodegradable, bioactive, and have ultrahigh strength. However, foreign body reactions to PLLA and physical irritation can occur when not covered by bone. We aimed to confirm the relationships between the depth of the implanted HA-PLLA threaded pins and the new bone formation. We inserted HA-PLLA composite threaded pins (diameter: 2.0 or 4.5 mm) into the femoral and tibial bones of 32 mature male Japanese white rabbits (weight 3.0-3.5 kg) with the pin head 1 or 0 mm below or protruding 1 or 2 mm above surrounding cortical bone. Eight euthanized rabbits were radiologically and histologically assessed at various intervals after implantation. Bone bridging was complete over pins of both diameters at ~12 weeks, when inserted 1 mm below the surface, but the coverage of the pins inserted at 0 mm varied. Bone was not formed when the pins protruded >1 mm from the bone surface. No inflammation developed around the pins by 25 weeks. However, foreign body reactions might develop if composites are fixed above the bone surface, and intraosseous fixation would be desirable using double-threaded screws or a countersink to avoid screw head protrusion.
• Chronic Expanding Hematomas That Occurred 20 Years or More After Primary Total Hip Arthroplasty: A Report of 2 Cases.

  Tomomi Ishikawa; Toshiyuki Kawai; Naoki Goda; Koji Goto; Yutaka Kuroda; Shuichi Matsuda

  JBJS case connector 11 (1) 2021/03 [Refereed]
   

  CASE: We report 2 patients who developed chronic expanding hematomas (CEHs) more than 20 years after ceramic-on-polyethylene total hip arthroplasty (THA). One CEH occurred after a minor fall, and the other appeared with no obvious injury. Neither of the 2 was on anticoagulation. Each caused extensive osteolysis. CONCLUSION: The only 2 previously reported post-THA cases of CEH involved metal-on-metal THAs and occurred several years after the index THA. Our patients show that CEH also can occur after ceramic-on-polyethylene THA, even after an uneventful clinical course of more than 20 years. Complete removal of both hematoma stopped osteolytic progression, with no recurrence to date.
• 人工膝関節全置換術前後における股関節周囲筋の筋萎縮と筋内脂肪変性の経時的変化

  河野 拓巳; 南学 学; 村尾 昌信; 濱田 涼太; 後藤 公志; 黒田 隆; 松田 秀一

  理学療法学 (公社)日本理学療法士協会 47 (Suppl.1) O - 189 0289-3770 2021/03
• Titania-Containing Bone Cement Shows Excellent Osteoconductivity in a Synovial Fluid Environment and Bone-Bonding Strength in Osteoporosis.

  Tomotoshi Kawata; Koji Goto; Masashi Imamura; Yaichiro Okuzu; Toshiyuki Kawai; Yutaka Kuroda; Shuichi Matsuda

  Materials (Basel, Switzerland) 14 (5) 2021/02 [Refereed]
   

  Titania bone cement (TBC) reportedly has excellent in vivo bioactivity, yet its osteoconductivity in synovial fluid environments and bone-bonding ability in osteoporosis have not previously been investigated. We aimed to compare the osteoconductivity of two types of cement in a synovial fluid environment and determine their bone-bonding ability in osteoporosis. We implanted TBC and commercial polymethylmethacrylate bone cement (PBC) into rabbit femoral condyles and exposed them to synovial fluid pressure. Rabbits were then euthanized at 6, 12, and 26 weeks, and affinity indices were measured to evaluate osteoconductivity. We generated a rabbit model of osteoporosis through bilateral ovariectomy (OVX) and an 8-week treatment with methylprednisolone sodium succinate (PSL). Pre-hardened TBC and PBC were implanted into the femoral diaphysis of the rabbits in the sham control and OVX + PSL groups. Affinity indices were significantly higher for TBC than for PBC at 12 weeks (40.9 ± 16.8% versus 24.5 ± 9.02%) and 26 weeks (40.2 ± 12.7% versus 21.2 ± 14.2%). The interfacial shear strength was significantly higher for TBC than for PBC at 6 weeks (3.69 ± 1.89 N/mm2 versus 1.71 ± 1.23 N/mm2) in the OVX + PSL group. These results indicate that TBC is a promising bioactive bone cement for prosthesis fixation in total knee arthroplasty, especially for osteoporosis patients.
• Corticosteroid-associated osteonecrosis of the femoral head after orthotopic liver transplantation and the outcomes of subsequent total hip arthroplasty.

  Sadaki Mitsuzawa; Yutaka Kuroda; Yaichiro Okuzu; Toshiyuki Kawai; Koji Goto; Toshimi Kaido; Shinji Uemoto; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2021/02 [Refereed]
   

  BACKGROUND: Corticosteroids are essential for immunosuppression after orthotopic liver transplantation (OLT), but also have many side effects. Osteonecrosis of the femoral head (ONFH) is one of the most serious complications requiring prostheses. However, few studies have investigated ONFH after OLT. The purpose of this study is to survey the incidence of corticosteroid-induced ONFH after OLT and the outcomes of total hip arthroplasty (THA). METHODS: Between January 2001 and December 2010, a series of 926 patients underwent OLT at our Hospital. A retrospective analysis was performed on a total of 738 patients who survived at least 2 years after OLT. The incidence of symptomatic ONFH, the interval from OLT to the initial diagnosis of ONFH, and the cumulative dose of corticosteroids were analyzed. The side effects related to OLT, such as other osteonecrosis lesions, osteoporotic fractures, and infection, were monitored. For patients who underwent THA, radiological findings and Japanese Orthopaedic Association (JOA) scores were evaluated. RESULTS: ONFH occurred in 10 patients (13 hips) (6 men [7 hips], 4 women [6 hips]), with an incidence of 1.36%. The average age at OLT was 51.4 years (range, 31-61 years). The average interval from OLT to ONFH was 86.7 months (range, 22-155 months). The average cumulative dose of corticosteroids was 7274 mg (range, 1342-29,514 mg). Twenty patients suffered from side effects related to OLT. Seven patients (8 hips) underwent THA. No adverse events including infection arose during the perioperative process. One hip dislocated, and one femoral stem displayed a radiolucent line. The average JOA score improved from 45.4 (range, 25-76) preoperatively to 86.9 (range, 73-99) at final follow-up. No patients required revision surgery. CONCLUSIONS: The incidence of symptomatic ONFH after OLT was 1.36%. Once the graft function becomes stable, THA can be a safe and effective treatment option for patients with ONFH after OLT.
• Percutaneous autologous impaction bone graft for advanced femoral head osteonecrosis: a retrospective observational study of unsatisfactory short-term outcomes.

  Yutaka Kuroda; Manabu Nankaku; Yaichiro Okuzu; Toshiyuki Kawai; Koji Goto; Shuichi Matsuda

  Journal of orthopaedic surgery and research 16 (1) 141 - 141 2021/02 [Refereed]
   

  BACKGROUND: Half of osteonecrosis of the femoral head (ONFH) patients suffer femoral head collapse at initial diagnosis, and more than half are bilaterally affected. This study developed a percutaneous autologous impaction bone graft (IBG) technique as a modification of core decompression (CD). We also summarized the short-term results and treatment efficacy of percutaneous autologous IBG in advanced ONFH. METHODS: Twenty patients (12 males, 8 females) with nontraumatic, postcollapse ONFH except one case underwent CD (10-mm core diameter) and reverse IBG. Radiological changes of the ONFH stage and type were analyzed. Survival analysis using Kaplan-Meier estimates was performed with conversion to total hip arthroplasty (THA) as the endpoint. In addition, the Harris hip score (HHS) and University of California, Los Angeles (UCLA) activity rating scale were evaluated. RESULTS: Percutaneous autologous IBG was performed successfully, with an average operation time of < 1 h and small blood loss, and 7 patients (35%) needed conversion to THA at an average of 17 months postoperatively. We observed radiological progressive change in 60% of the patients during a mean observation period of 3 years. The mean clinical scores, except data recorded, after THA significantly improved (before vs. after 3 years: UCLA activity score, 3.7 vs. 5.2 [P = 0.014]; HHS, 57.6 vs. 76.5 points [P = 0.005]). In addition, 6 patients showed radiological progression but no clinical deterioration. CONCLUSIONS: Percutaneous autologous IBG was technically simple and minimally invasive, but short-term results were unsatisfactory for advanced ONFH. Indications for this procedure should be carefully examined to improve it in order to enable bone formation.
• Bioactivity and antibacterial activity of strontium and silver ion releasing titanium.

  Kazutaka Masamoto; Shunsuke Fujibayashi; Seiji Yamaguchi; Bungo Otsuki; Yaichiro Okuzu; Tomotoshi Kawata; Koji Goto; Takayoshi Shimizu; Yu Shimizu; Toshiyuki Kawai; Makoto Hayashi; Kazuaki Morizane; Masashi Imamura; Norimasa Ikeda; Yusuke Takaoka; Shuichi Matsuda

  Journal of biomedical materials research. Part B, Applied biomaterials 109 (2) 238 - 245 2021/02 [Refereed]
   

  To overcome problems associated with loosening of orthopedic implants and surgical site infections, we developed a novel, titanium (Ti)-based material that releases both strontium and silver ions (CaSrAg-Ti) based on alkali-and-heat treatment. The results of commercially pure Ti (cp-Ti), Ti that releases Sr ions only (CaSr-Ti), and the novel CaSrAg-Ti material were compared. Mechanical tests were performed to evaluate the in vivo bonding properties of CaSrAg-Ti and the bone-implant contact (BIC) ratio in histological specimens was determined at 4 and 8 weeks after implantation in a rat femur. Also, the in vitro antibacterial activities of this material against methicillin-susceptible Staphylococcus aureus (MSSA) were evaluated after a 24 h incubation period by assaying colony-forming units. In addition, antibacterial activities were evaluated in vivo at 7 days after implantation in a rat subcutaneous pocket model. There was direct contact between the bone and CaSrAg-Ti in histological specimens and no apparent signs of argyrosis in any rat. The bone-bonding strength and the BIC ratio were increased by 2.7- and 2.3-fold for CaSrAg-Ti vs. cp-Ti at 4 weeks and 2.2- and 2.0-fold at 8 weeks, respectively. As compared with cp-Ti, the number of viable MSSA remaining on CaSrAg-Ti was reduced by 100 ± 0% in vitro and 94.2 ± 6.9% in vivo. Ti that releases Sr and Ag ions is a promising material that exhibits both bone-bonding properties and anti-MSSA activities.
• In vitro study of antibacterial and osteogenic activity of titanium metal releasing strontium and silver ions.

  Yaichiro Okuzu; Shunsuke Fujibayashi; Seiji Yamaguchi; Kazutaka Masamoto; Bungo Otsuki; Koji Goto; Toshiyuki Kawai; Takayoshi Shimizu; Kazuaki Morizane; Tomotoshi Kawata; Yu Shimizu; Makoto Hayashi; Shuichi Matsuda

  Journal of biomaterials applications 35 (6) 670 - 680 2021/01 [Refereed]
   

  Peri-prosthetic infection and loosening of implants are major problems in orthopaedic and dental surgery. To address these issues, surface treatment methods for titanium implants have been improved by modifying the alkali and heat treatment. We have previously fabricated calcium-treated Ti metal that releases Sr ions (CaSr-Ti), which resulted in a higher in vitro osteogenic response and early in vivo bone bonding.Further, we developed a Ti metal that released both Sr and Ag ions (CaSrAg-Ti). In this study, we evaluated the antibacterial ability and osteogenic cellular response of CaSrAg-Ti and CaSr-Ti in vitro using rat bone marrow stromal cells (BMSCs) cultured on implant samples and extract mediums (EMs) made by immersing the implant samples in the medium. CaSrAg-Ti did not show cytotoxicity and was associated with a slightly higher osteogenic response when compared to CaSr-Ti, without inhibiting the effect of Sr. The osteogenic response was also observed in the cells cultured with the CaSrAg-Ti EM; however, the response was not as high as that of the cells on the CaSrAg-Ti implant sample. Significantly higher antibacterial activity was observed along with an antibacterial efficacy of more than 95% against methicillin-susceptible Staphylococcus aureus and Escherichia coli. The main advantages of our surface treatment are its simplicity and low cost. Therefore, our treatment is promising for clinical applications in orthopaedic or dental Ti-based implants with antibacterial and early bone-bonding abilities.
• Hip Abductor Strength and Lower Limb Load on Nonoperating Predict Functional Mobility in Women Patients With Total Hip Arthroplasty.

  Masanobu Murao; Manabu Nankaku; Ryota Hamada; Takumi Kawano; Koji Goto; Yutaka Kuroda; Ryosuke Ikeguchi; Shuichi Matsuda

  American journal of physical medicine & rehabilitation 100 (1) 72 - 76 2021/01 [Refereed]
   

  OBJECTIVE: The aim of this study was to identify which aspect of the preoperative lower limb functions is most likely to affect the functional mobility at 6 mos after total hip arthroplasty. DESIGN: The study subjects included 125 women who underwent total hip arthroplasty. Hip flexion and abduction angles, hip abductor and knee extensor strengths, and lower limb load were measured preoperatively. The Timed Up and Go test was performed 6 mos postoperatively. Then, patients were divided into fast or slow groups as per the comparison with the Timed Up and Go score of healthy women. RESULTS: Hip abductor strength and lower limb load on the nonoperative side were revealed as significant measurements that affected functional mobility after total hip arthroplasty according to stepwise multiple logistic regression analysis. Moreover, receiver operating characteristic curve analyses showed that the postoperative functional mobility was predicted by the lower limb load of the nonoperative side (cutoff point, 8.97 N/kg; sensitivity, 62.3%; specificity, 82.8%; and area under the curve, 77.5%). CONCLUSIONS: This study revealed that patients with preoperative hip abductor strength of greater than 0.66 Nm/kg and lower limb load of greater than 8.97 N/kg on the nonoperative side could achieve better functional mobility at 6 mos postoperatively than healthy women of the same age group.
• Recombinant human FGF-2 therapy for osteonecrosis of the femoral head: 5-year follow-up.

  Yutaka Kuroda; Toshiko Ito-Ihara; Hiroyasu Abe; Manabu Nankaku; Yaichiro Okuzu; Toshiyuki Kawai; Koji Goto; Shuichi Matsuda

  Regenerative medicine 15 (11) 2261 - 2271 2020/12 [Refereed]
   

  Aim: To evaluate the 5-year outcomes from the prospective study of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Methods: Ten patients (average age 39.8 years) with nontraumatic, precollapse ONFH were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Radiological changes and the prevalidated Harris hip score (HHS), visual analogue scale for pain and University of California, Los Angeles activity-rating scale scoring systems were evaluated. Results: The 5-year comparison in type C2 showed higher joint preservation in the rhFGF-2 group (71.4%) than in the natural course group (15.4%). Two of three clinical scores (Harris hip score and visual analogue scale for pain) improved significantly. Postoperative MRI demonstrated significant reduction in ONFH size. There were no adverse events. Conclusion: rhFGF-2 treatment for ONFH appears to be safe and effective and may have the potential to prevent disease progression.
• 人工股関節全置換術後における体幹筋の筋萎縮および脂肪変性の経時的変化

  河野 拓巳; 南角 学; 村尾 昌信; 濱田 涼太; 黒田 隆; 後藤 公志; 松田 秀一

  Hip Joint 日本股関節学会 46 (2) S290 - S293 0389-3634 2020/08
• Total Hip Arthroplasty Combined With Subtrochanteric Transverse Shortening Osteotomy: Factors Associated With Delayed Union at the Osteotomy Site.

  Toshiyuki Kawai; Koji Goto; Yutaka Kuroda; Shuichi Matsuda

  Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews 4 (8) e2000056  2020/08 [Refereed]
   

  BACKGROUND: Total hip arthroplasty (THA) with subtrochanteric shortening osteotomy for Crowe type IV hips poses the risk of nonunion at the osteotomy site. The aim of this study was to analyze the factors that affect the bone union rate at the osteotomy site. METHODS: We retrospectively reviewed a consecutive series of 27 THAs with subtrochanteric transverse shortening osteotomy performed for Crowe type IV hips. The effects of patient-related and surgery-related factors on the risk of delayed union were analyzed using univariate and multivariate regression analyses. RESULTS: The mean follow-up period was 10.0 (1.4 to 19.1) years. The implant survival rate was 87.8% (95% confidence interval: 60.2% to 97.2%) at 10 years. The length of femoral bone resection was the only factor associated with the risk of delayed union. Longer bone resection lengths were significantly correlated with the reduced risk of delayed union (odds ratio: 0.63 [0.030 to 0.90], P = 0.0013). Other variables, including the use of a cement stem (P = 0.34) and the presence of a gap >1 mm at the osteotomy site (P = 0.98), were not associated with the risk of delayed union. DISCUSSION: THA with subtrochanteric transverse osteotomy provides satisfactory long-term results for Crowe type IV hips. For shorter required femoral resection lengths, the risk of delayed union was higher. A longer resection could permit fabrication of longer autologous longitudinal bone struts and likely contributes to enhanced stability at the osteotomy site.
• Clinical phenotypes based on clinical prognostic factors in patients with secondary hip osteoarthritis: preliminary findings from a prospective cohort study.

  Hiroshige Tateuchi; Haruhiko Akiyama; Koji Goto; Kazutaka So; Yutaka Kuroda; Noriaki Ichihashi

  Clinical rheumatology 39 (7) 2207 - 2217 2020/07 [Refereed]
   

  OBJECTIVES: Recently, several clinical prognostic factors for hip osteoarthritis (OA) progression such as spinal malalignment, reduced spinal mobility, and excessive daily cumulative hip loading have been identified. This study aimed to identify clinical phenotypes based on clinical prognostic factors in patients with secondary hip OA using data from prospective cohort studies and to define the clinical features of each phenotype. METHODS: Fifty patients participated. Two-step cluster analysis was performed to identify the phenotypes using the following potential prognostic factors for hip OA progression: spinal inclination in standing, thoracolumbar spine mobility, daily cumulative hip moment, and minimum joint space width (JSW) at baseline. Comprehensive basic and clinical features (age, body mass index, hip pain, Harris hip score, JSW, radiographic hip morphology, hip impairments, spinal alignment and mobility, and gait-related variables) and ratio of progressors in 12 months were compared among the phenotypes using bootstrap method (unadjusted and adjusted for age). RESULTS: Three phenotypes were identified and each phenotype was characterized as follows (P < 0.05): phenotype 1 (30%)-relatively young age and higher daily cumulative hip loading; phenotype 2 (42.0%)-relatively older age, reduced JSW, and less spinal mobility; and phenotype 3 (28.0%)-changed thoracic spine alignment and less spinal (especially in the thoracic spine) mobility. The ratio of progressors among the phenotypes was not statistically significantly different. These characteristics remained after adjustment for age. CONCLUSION: Three phenotypes with similar progression risk were identified. This finding will help in designing treatment tailored to each phenotype for hip OA progression prevention.Key Points• Three phenotypes with similar progression risk were identified based on clinical prognostic factors.• Phenotype 1 was characterized by young age and higher daily cumulative hip loading.• Phenotype 2 was relatively old age and had reduced JSW and less spinal mobility.• Phenotype 3 had changed thoracic spine alignment and less thoracic spine mobility.
• Lower Activity and Function Scores Are Associated with a Higher Risk of Preoperative Deep Venous Thrombosis in Patients Undergoing Total Hip Arthroplasty.

  Toshiyuki Kawai; Koji Goto; Yutaka Kuroda; Shuichi Matsuda

  Journal of clinical medicine 9 (5) 2020/04 [Refereed]
   

  This study was performed to investigate the relationship between patients' activity and function levels and the incidence of preoperative deep venous thrombosis (DVT) prior to total hip arthroplasty (THA). We retrospectively reviewed 500 patients admitted for primary or revision THA from July 2014 to October 2018. The diagnosis of DVT was confirmed using Doppler ultrasonography 1 month before THA. The patients' activity and hip function were evaluated using several clinical scores: the Harris Hip Score (HHS), Oxford Hip Score (OHS), University of California Los Angeles (UCLA) activity score, and visual analog scale (VAS) score. Those scores and the medical history were examined for correlations with preoperative DVT using univariate and multivariate models. Univariate regression analysis showed that older age, current steroid use, anticoagulant use, a history of DVT, collagen disease, a lower UCLA activity score, and a lower OHS were associated with an elevated risk of preoperative DVT. The multivariate analyses showed that a higher UCLA activity score (odds ratio (OR): 0.0049-0.012) and higher OHS (OR: 0.0012-0.0088) were associated with a lower risk of preoperative DVT in each model. Age (OR: 1.07 in both models), current steroid use (OR: 9.32-10.45), and a history of DVT (OR: 27.15-74.98) were associated with a higher risk of preoperative DVT in both models. Older age, current steroid use, a history of DVT, a lower UCLA activity score, and a lower OHS were risk factors for preoperative DVT before THA, even when controlling for potential confounders. Patients exhibiting low activity and low function levels were more likely to have DVT, even before surgery.
• The Long-Term Results of Total Hip Arthroplasty With a Cemented β-Titanium Stem.

  Yusuke Takaoka; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  The Journal of arthroplasty 2020/04 [Refereed]
   

  BACKGROUND: We report on the outcomes of a double-tapered cemented stem made of β-titanium alloys (Ti-15Mo-5Zr-3Al) at least 10 years after total hip arthroplasty. METHODS: We retrospectively analyzed 148 consecutive, primary total hip arthroplasties using this stem performed in 130 patients between January 2004 and August 2008. The patients' mean age was 59.6 years (range, 24-79). Implant survival was evaluated using Kaplan-Meier curves with the primary end point being stem revision for any reason and the secondary end point being stem revision for aseptic stem loosening. We also clinically and radiologically followed 140 hips (in 123 patients) for an average of 12.2 years (range, 10-15). RESULTS: The only revisions were for 2 stems with deep infection. Ten-year survival was 99.3% (95% confidence interval, 95.4%-99.9%) and 100% for the primary and secondary end point, respectively. The mean Japanese Orthopaedic Association hip score improved from 51.4 preoperatively to 88.7 at the last follow-up. Radiolucent lines at the stem-cement interface were seen in 14 hips (10.0%). None of the hips met the criteria of radiological stem loosening. Nineteen stems (13.6%) subsided by around 1 mm between 2 and 8 years after surgery. Distal femoral cortical hypertrophy occurred in 24 hips (17.0%), mostly with valgus alignment. CONCLUSION: The clinical outcomes of the femoral stems were excellent with survival at 10 years. Stem subsidence and distal femoral cortical hypertrophy did not affect the results. Long-term use of β-titanium alloy stems is safe and effective.
• Sacroiliac joint degeneration is common in patients with end-stage hip osteoarthritis secondary to unilateral developmental dysplasia of the hip: Factors associated with its severity and laterality.

  Yaichiro Okuzu; Koji Goto; Yu Shimizu; Toshiyuki Kawai; Yutaka Kuroda; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2020/03 [Refereed]
   

  BACKGROUND: The etiology of sacroiliac joint (SIJ) degeneration has not been fully elucidated, and there has been almost no report on the relevance between SIJ degeneration and hip osteoarthritis secondary to developmental dysplasia of the hip (DDH). We investigated factors associated with SIJ degeneration, specifically its laterality in patients with end-stage hip osteoarthritis secondary to unilateral DDH. METHODS: We included 152 patients with end-stage unilateral hip osteoarthritis secondary to DDH who underwent primary THA between January 2008 and November 2015. SIJ degeneration was classified (type 0, no degenerative change, to type 3, ankyloses) using preoperative axial computed tomography. SIJ degeneration of the DDH (shorter leg) and contralateral (longer leg) sides was compared; differences in patient demographics and radiological parameters between SIJ degeneration of type 0 or 1 versus type 2 or 3 for the shorter and longer leg sides were analyzed. RESULTS: SIJ on the longer leg side showed more degenerative changes (p < 0.001). Substantial SIJ degeneration or ankylosis (type 2 or 3) was observed on 62.5% of longer leg sides and 33.6% of shorter leg sides. Factors significantly associated with SIJ degeneration severity were percent hip subluxation and leg length discrepancy for the longer leg side and body weight and body mass index (BMI) for the shorter leg side. Patients with worse degeneration on the shorter leg side (9.9%) had significantly larger BMI and longer sagittal vertical axis, whereas patients with worse degeneration on the longer leg side (46.7%) had significantly longer leg length discrepancy. CONCLUSION: Severe SIJ degeneration was common in patients with end-stage hip osteoarthritis secondary to unilateral DDH. Patients with worse SIJ degeneration on the longer leg side had more hip subluxation, whereas patients with worse SIJ degeneration on the shorter leg (DDH) side tended to have sagittal spinal imbalance and greater body weight with larger BMI.
• Gait kinematics of the hip, pelvis, and trunk associated with external hip adduction moment in patients with secondary hip osteoarthritis: toward determination of the key point in gait modification.

  Hiroshige Tateuchi; Haruhiko Akiyama; Koji Goto; Kazutaka So; Yutaka Kuroda; Noriaki Ichihashi

  BMC musculoskeletal disorders 21 (1) 8 - 8 2020/01 [Refereed]
   

  BACKGROUND: A larger daily cumulative hip loading, which is the product of the external hip adduction moment (HAM) impulse during gait and the number of steps per day has been identified as a factor associated with the progression of secondary hip osteoarthritis (OA). The cause of the increased HAM impulse in patients with hip OA has not been identified. The purpose of this study was to identify the gait parameters associated with HAM impulse during gait in patients with secondary hip OA. METHODS: Fifty-five patients (age 22-65 years) with mild-to-moderate secondary hip OA participated in this cross-sectional study. The HAM impulse during gait was measured using a three-dimensional gait analysis system. To identify the gait parameters associated with HAM impulse, hierarchical multiple regression analysis was performed. The first model (basic model) included body weight and stance phase duration. The second models included gait parameters (gait speed; ground reaction force [GRF] in frontal plane; and hip, pelvic, and trunk angle in frontal plane) and hip pain in addition to the basic model. RESULTS: Body weight and stance phase duration explained 61% of the variance in HAM impulse. In the second model, which took into account body weight and stance phase duration, hip adduction angle (9.4%), pelvic tilt (6.5%), and trunk lean (3.2%) in addition to GRF explained the variance in the HAM impulse. Whereas larger hip adduction angle and pelvic tilt toward the swing limb were associated with a larger HAM impulse, larger trunk lean toward the stance limb was associated with smaller HAM impulse. CONCLUSION: In patients with excessive hip adduction and pelvic tilt toward the swing limb during gait, gait modification may contribute to the reduction of hip joint loading.
• Gait- and Posture-Related Factors Associated With Changes in Hip Pain and Physical Function in Patients With Secondary Hip Osteoarthritis: A Prospective Cohort Study.

  Hiroshige Tateuchi; Haruhiko Akiyama; Koji Goto; Kazutaka So; Yutaka Kuroda; Noriaki Ichihashi

  Archives of physical medicine and rehabilitation 100 (11) 2053 - 2062 2019/11 [Refereed]
   

  OBJECTIVE: To identify gait- and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA). DESIGN: Prospective cohort study. SETTING: Clinical biomechanics laboratory of a university. PARTICIPANTS: Consecutive sampling of female patients with mild-to-moderate secondary hip OA (N=30). MAIN OUTCOME MEASURES: Hip pain (visual analog scale) and physical function (physical component summary of the Medical Outcomes Study 36-Item Short-Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait- and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angles of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were walking speed, steps per day, joint angles, external hip joint moment impulses, and daily cumulative hip moments. RESULTS: Multiple linear regression analyses showed that limited hip extension (adjusted standardized B coefficient [95% confidence interval]: -0.52 [-0.88 to -0.17]) and limited external rotation angles (-0.51 [-0.85 to -0.18]) during walking were associated with the worsening of hip pain. An increased thoracic kyphosis (-0.54 [-0.99 to -0.09]), less sacral anterior tilt (0.40 [0.01-0.79]), reduced thoracic spine mobility (0.59 [0.23-0.94]), less steps per day (0.53 [0.13-0.92]), and a slower walking speed (0.45 [0.04-0.86]) were associated with deterioration in physical function. CONCLUSIONS: Gait- and posture-related factors should be considered when assessing risk and designing preventive interventions for the clinical progression of secondary hip OA.
• Long-term outcome of cemented total hip arthroplasty with the Charnley-type femoral stem made of titanium alloy.

  Yuki Okutani; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Yaichiro Okuzu; Tomotoshi Kawata; Yu Shimizu; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 24 (6) 1047 - 1052 2019/11 [Refereed]
   

  BACKGROUND: Total hip arthroplasty is a successful treatment for hip diseases including osteoarthritis, osteonecrosis of the femoral head, and rheumatoid arthritis. Various designs of cemented femoral stems made of stainless steel and titanium alloy have been used. Among them, Charnley-type femoral stems made of stainless steel have often been reported to have good long-term outcome. However, the long-term outcome of the Charnley-type femoral stem made of Ti alloy is yet to be reported. We conducted a retrospective study to assess the long-term outcome of cemented primary total hip arthroplasty with the Charnley-type femoral stem made of Ti alloy. METHODS: Between October 1988 and February 1997, 341 cemented primary total hip arthroplasties with the Charnley-type femoral stem made of Ti alloy were consecutively performed in our hospital. Among these, 164 patients (211 hips) who underwent this procedure were followed up for more than 12 years, and the surgical hips were analysed clinically and radiologically. The mean follow-up period was 20.6 years. Kaplan-Meier survival analyses were performed to assess femoral component survival. Factors affecting stem revision for aseptic loosening were also investigated using log-rank tests. RESULTS: In the functional assessment, the preoperative Japanese Orthopaedic Association score significantly improved from 47.2 points preoperatively to 79.0 points at the final follow-up. Eventually, 33 femoral stems were revised, of which 12 were revised for aseptic loosening. In the Kaplan-Meier survival analysis, the 20-year survival rates with stem revision for aseptic loosening and radiological stem loosening at the end points were 95.9% and 97.1%, respectively. Original diagnosis (non-osteoarthritis) was the only significant factor for aseptic loosening of the femoral stem. CONCLUSIONS: Cemented primary total hip arthroplasty with the Charnley-type femoral stem made of Ti alloy showed excellent outcomes for more than 20 years.
• Classification of osteonecrosis of the femoral head: Who should have surgery?

  Kuroda Y; Tanaka T; Miyagawa T; Kawai T; Goto K; Tanaka S; Matsuda S; Akiyama H

  Bone & joint research 8 (10) 451 - 458 2019/10 [Refereed]
  
• Clinical application of injectable growth factor for bone regeneration: a systematic review.

  Kuroda Y; Kawai T; Goto K; Matsuda S

  Inflammation and regeneration 39 20  1880-9693 2019/10 [Refereed]
  
• カルシウムイオン徐放性新規低弾性チタン金属の評価

  林 信実; 藤林 俊介; 山口 誠二; 清水 優; 正本 和誉; 清水 孝彬; 河井 利之; 大槻 文悟; 後藤 公志; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 93 (8) S1940 - S1940 0021-5325 2019/09
• 大腿骨頭壊死症例におけるステロイド投与が股関節周囲筋の筋萎縮および脂肪変性に与える影響

  濱田 涼太; 南角 学; 黒田 隆; 後藤 公志; 松田 秀一

  Hip Joint 日本股関節学会 45 (2) S273 - S276 0389-3634 2019/08 [Refereed]
   

  特発性大腿骨頭壊死(INFH)におけるステロイド投与の有無が股関節周囲筋の質的な変化にどのような影響を及ぼすのか検討した。2008〜2016年までに当院に入院した片側罹患のINFH症例29名(男性12名、女性17名、平均50.3±12.8歳)を対象とした。ステロイド投与の有無を診療記録より後方視的に調査し、ステロイド非投与群、ステロイド投与群の2群に分類した。股関節周囲筋の筋断面積およびCT値の結果として、健側の大殿筋、中殿筋、小殿筋の筋断面積はステロイド非投与群が投与群よりも有意に高値を示した。また、健側の大殿筋、中殿筋、小殿筋および患側の小殿筋のCT値はステロイド非投与群が投与群よりも有意に高値を示した。患側の大殿筋、中殿筋、小殿筋の筋断面積および患側の大殿筋、中殿筋のCT値は両群間で有意差を認めなかった。健側の股関節外転筋力はステロイド非投与群が投与群よりも有意に高値を示した。患側の股関節外転筋力は両群間で有意差を認めなかった。
• 人工股関節全置換術後における股関節外転筋力の回復に関連する因子の検討

  南角 学; 後藤 公志; 黒田 隆; 松田 秀一

  Hip Joint 日本股関節学会 45 (2) S297 - S299 0389-3634 2019/08 [Refereed]
   

  人工股関節全置換術(THA)術後6ヵ月における股関節外転筋力の回復にかかわる因子について検討した。片側の変形性股関節症によりTHAを施行された73名(男性10名、女性63名、平均61.1±11.4歳)を対象とし、術側の股関節外転筋力が健側の80%未満の群(A群)17名、健側の80%以上100%未満の群(B群)35名、健側の100%以上の群(C群)21名の3群に分けた。年齢、性別、BMIについては、3群間で有意差を認めなかった。分散分析の結果、術前のcentral edge angle(CE角)ならびに手術による脚延長量については群間で有意差を認め、多重比較検定よりC群はA群とB群よりも有意に低い値を示した。術前の骨盤前傾角は3群間で有意差を認めなかった。術前の梨状筋、中殿筋、大殿筋の筋萎縮については、分散分析の結果、群間で有意差を認めた。また、多重比較検定より、C群の梨状筋はA群とB群よりも有意に低い値を示し、中殿筋は各群間でそれぞれ有意差を認めた。
• 変形性股関節症患者における寛骨臼形成不全が股関節周囲筋の筋萎縮と脂肪変性に及ぼす影響

  河野 拓巳; 南角 学; 村尾 昌信; 濱田 涼太; 黒田 隆; 後藤 公志; 松田 秀一

  Hip Joint 日本股関節学会 45 (2) S300 - S302 0389-3634 2019/08 [Refereed]
   

  変形性股関節症(股OA)患者における寛骨臼形成不全の有無が股関節周囲筋の量的および質的変化に及ぼす影響について検討した。当院にて片側の進行期または末期の股OAと診断された女性51名を対象とし、股関節正面のX線からCE角を用いて、20°以上(寛骨臼形成不全なし:Non-AD群)と20°未満(寛骨臼形成不全あり:AD群)に分類した。対象とした筋は大殿筋・中殿筋・梨状筋・腸腰筋であり、得られた筋断面積から筋萎縮率として患健比(患側筋断面積/健側筋断面積×100%)を算出した。また、CT値は筋断面積から信号強度であるHounsfield unit(HU)の平均値を算出した。Non-AD群は21名、AD群は30名であった。基本属性は2群間において年齢、身長、体重、BMIのすべての項目で有意差は認められなかった。AD群の大殿筋、中殿筋、梨状筋、腸腰筋の筋萎縮率およびCT値はすべての項目においてNon-AD群と比較して有意に低値であった。
• The use of a bioactive bone cement containing apatite-wollastonite glass-ceramic filler and bisphenol-a-glycidyl methacrylate resin for acetabular fixation in total hip arthroplasty: long-term follow-up results of a clinical trial.

  K Goto; Y Kuroda; T Kawai; K Kawanabe; S Matsuda

  The bone & joint journal 101-B (7) 787 - 792 2019/07 [Refereed]
   

  AIMS: In the 1990s, a bioactive bone cement (BABC) containing apatite-wollastonite glass-ceramic (AW-GC) powder and bisphenol-a-glycidyl methacrylate resin was developed at our hospital. In 1996, we used BABC to fix the acetabular component in primary total hip arthroplasty (THA) in 20 patients as part of a clinical trial. The purpose of this study was to investigate the long-term results of primary THA using BABC. PATIENTS AND METHODS: A total of 20 patients (three men and 17 women) with a mean age of 57.4 years (40 to 71), a mean body weight of 52.3 kg (39 to 64), and a mean body mass index (BMI) of 23.0 kg/m2 (19.8 to 28.6) were evaluated clinically and radiologically. Survival analyses were undertaken, and wear analyses were carried out using a computer-aided method. RESULTS: The mean follow-up was 17.6 years (1.5 to 21.1). Radiological loosening occurred in four sockets with aseptic loosening at a mean of 7.8 years (1.5 to 20.7). Kaplan-Meier survival analyses using revision of the acetabular component, radiological loosening of the acetabular component, and the worst-case scenario with revision of the acetabular component to include the two patients lost to follow-up as endpoints yielded survival rates of 94.7%, 84.4%, and 85.0% at ten years, and 70.0%, 84.4%, and 62.8% at 20 years, respectively. Wear analysis revealed a mean linear wear rate of 0.068 mm per year. CONCLUSION: The long-term results of primary THAs using BABC were unsatisfactory. Its brittle nature and poor handling properties need to be improved before it becomes an alternative method of fixing the acetabular component in cemented THA. Cite this article: Bone Joint J 2019;101-B:787-792.
• In vivo and in vitro bioactivity of a “precursor of apatite” treatment on polyetheretherketone

  Kazutaka Masamoto; Shunsuke Fujibayashi; Takeshi Yabutsuka; Tomoko Hiruta; Bungo Otsuki; Yaichiro Okuzu; Koji Goto; Takayoshi Shimizu; Yu Shimizu; Chihiro Ishizaki; Keito Fukushima; Toshiyuki Kawai; Makoto Hayashi; Kazuaki Morizane; Tomotoshi Kawata; Masashi Imamura; Shuichi Matsuda

  Acta Biomaterialia Elsevier BV 91 48 - 59 1742-7061 2019/06
• Does Prophylactic Administration of Edoxaban Increase D-Dimer Levels after Total Hip Arthroplasty?

  Toshiyuki Kawai; Yutaka Kuroda; Koji Goto; Shuichi Matsuda

  Journal of clinical medicine 8 (5) 2019/05 [Refereed]
   

  This study aimed to examine the effect of thromboprophylactic edoxaban on D-dimer levels and anemia after total hip arthroplasty (THA). We retrospectively analyzed data from 349 patients undergoing primary THA. Univariate regression and multivariate regression analyses were performed with D-dimer levels on the 7th, 14th, and 21st days postoperatively as the dependent variable Edoxaban use, age, sex, body mass index (BMI), renal function, drop in hemoglobin (Hb) drop, intraoperative blood loss and duration of surgery as were independent variables. Multivariate regression analysis was also performed with Hb drop as the dependent variable. Edoxaban administration of 15 mg/day and 30 mg/day after THA was correlated with higher D-dimer levels at 21, but not at 7 or 14, days postoperatively. Other significant independent predictors for high D-dimer levels were the duration of surgery (at 7 and 14 days), BMI (at 7 days), sex (at 14 days), and age (at 14 and 21 days). Edoxaban use was significantly, weakly correlated with a larger Hb drop at 7 and 14 days, but this was less than a clinically important difference. D-dimer levels after THA can be elevated by thromboprophylactic edoxaban after three weeks postoperatively.
• Titania-containing bioactive bone cement for total hip arthroplasty in dogs.

  Masashi Imamura; Koji Goto; Tomotoshi Kawata; Masanao Kataoka; Chisako Fukuda; Shunsuke Fujibayashi; Shuichi Matsuda

  Journal of biomedical materials research. Part B, Applied biomaterials 107 (4) 1238 - 1245 2019/05 [Refereed]
   

  We developed a composite cement containing low-content bioactive titania fillers dispersed among specific polymethylmethacrylate (PMMA) polymers and investigated the mechanical properties and bioactivity of this titania bone cement (TBC) under load-bearing conditions in cemented total hip arthroplasty (THA) in adult female beagles. TBC and PMMA bone cement (PBC) were compared using custom-made prostheses. The dogs were killed 1, 3, 6, and 12 months postoperatively. The acetabulum was harvested to evaluate the osteoconductivity of the cement, whereas the femur was harvested for the push-out test and histological analyses. The compressive strength of TBC was significantly higher than that of PBC (p < 0.001), whereas the flexural and tensile strengths, as well as fracture toughness, were equivalent. The bonding strength values for TBC and PBC were 72.9 and 58.0 N/mm at 1 month, 69.4 and 57.2 N/mm at 3 months, 106.1 and 85.0 N/mm at 6 months, and 114.3 and 100.7 N/mm at 12 months, respectively. Histologically, TBC was in direct contact with bone without intervening with fibrous tissue over larger areas and newly formed bone was observed along the cement. The excellent mechanical properties and apparent bioactivity of this novel bone cement indicate its potential utility in clinical practice. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1238-1245, 2019.
• Implantable composite devices of unsintered hydroxyapatite and poly-l-lactide with dispersive marbling morphology to enhance in vivo bioactivity and bioresorbability.

  Kazuaki Morizane; Yasuo Shikinami; Shunsuke Fujibayashi; Koji Goto; Bungo Otsuki; Toshiyuki Kawai; Takayoshi Shimizu; Shuichi Matsuda

  Materials science & engineering. C, Materials for biological applications 97 698 - 706 2019/04 [Refereed]
   

  A bone fixation device made of unsintered hydroxyapatite (u-HA) particles uniformly dispersed in a poly-l-lactide matrix and reinforced by compressive forging (uniformly dispersed composite; UDC) has been clinically applied in several fields. However, it has reported some foreign body reactions over a long implantation period due to its slow bioresorbability. To further enhance its bioresorbability, we developed devices comprising a fibrous assembly of poly-l-lactide only three-dimensionally intertwined with particulate hydroxyapatite/poly-l-lactide composite. The biological behavior of the proposed material, provisionally referred to as complementarily reinforced composite (CRC), was compared with that of UDC in vivo. Cylindrical rods of UDC and CRC with 3.2-mm diameters were inserted bilaterally into the intramedullary distal femurs of 32 male Japanese white rabbits. Eight rabbits were euthanized at four, eight, 12, and 25 weeks after insertion. There were no significant differences between the mechanical properties of UDC and CRC over time. However, the results from histological analyses, surface characterization, radiological analyses, and push-out mechanical testing substantiated CRC's superior affinity to bone and enhanced bioactivity and bioresorbability in comparison with UDC. These characteristics were attributed to the dispersive marbling morphology produced by the CRC material's successive connectivity of u-HA particles throughout the PLLA matrix, which would accelerate PLLA hydrolysis degradation by H2O intrusion and enhance the bioactivity of u-HA particles exposed on the interface soon after implantation.
• Hip-Spine Syndrome: Acetabular Anteversion Angle Is Associated with Anterior Pelvic Tilt and Lumbar Hyperlordosis in Patients with Acetabular Dysplasia: A Retrospective Study.

  Yaichiro Okuzu; Koji Goto; Yuki Okutani; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  JB & JS open access 4 (1) e0025  2019/03 [Refereed]
   

  Background: Hip-spine syndrome was originally described by Offierski and MacNab, who argued that the flexion deformity of the hip rotated the pelvis forward, causing the spine symptoms. We additionally hypothesized that in patients who have osteoarthritis (OA) of the hip, the pelvis is tilted anteriorly to compensate for the anterior acetabular coverage defect. We investigated the hip factors associated with anterior pelvic tilt (PT) in patients who had OA of the hip due to acetabular dysplasia. Methods: We retrospectively reviewed the medical records of patients who had undergone total hip arthroplasty between January 2009 and December 2017 to identify those who had unilateral secondary OA due to acetabular dysplasia. Patients who had spinal imbalance, a history of spinal or lower limb fracture or surgery, bilateral OA of the hip, or a severely subluxated hip were excluded, leaving 100 eligible patients. We defined the indicators of an anterior acetabular coverage defect, flexion deformity of the hip, and anterior PT as the acetabular anteversion angle (AAA), extension range of motion (ROM), and anterior tilt of the pelvis, respectively. We measured hip factors and spinal parameters on radiographs and the standardized axial and coronal planes on 3-dimensional computed tomography with reference to the anterior pelvic plane. Hip factors associated with PT were investigated. Results: Univariate analysis showed a significant correlation between PT and both AAA (r = -0.389, p < 0.001) and combined anteversion angle (r = -0.272, p = 0.03). Multivariate regression analysis identified AAA (β = -0.385, p < 0.001) and extension ROM (β = 0.212, p = 0.0496) as independent factors associated with PT. Lumbar lordosis and pelvic incidence minus lumbar lordosis were significantly correlated with AAA, but sagittal vertical axis was not. Conclusions: When treating patients who have acetabular dysplasia, surgeons should recognize the relationship between the anterior acetabular coverage and anterior PT. Correcting hyperlordosis of the lumbar spine can induce progression of hip OA because it may decrease the acetabular anterior coverage.
• 特発性大腿骨頭壊死症に対する成長因子を用いた再生医療

  黒田 隆; 南角 学; 河井 利之; 後藤 公志; 秋山 治彦; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 93 (3) S890 - S890 0021-5325 2019/03
• 骨盤アラインメントから再考する骨盤骨嚢胞形成部位

  清水 優; 河井 利之; 黒田 隆; 後藤 公志; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 93 (3) S917 - S917 0021-5325 2019/03
• 人工股関節再置換術臼蓋側の長期成績

  河井 利之; 後藤 公志; 黒田 隆; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 93 (3) S1090 - S1090 0021-5325 2019/03
• Crowe group IV高位脱臼股に対する転子下短縮骨切り術の術後骨切り部癒合に影響する因子の検討

  河井 利之; 後藤 公志; 黒田 隆; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 93 (3) S1202 - S1202 0021-5325 2019/03
• Dose optimization of topical tranexamic acid for primary total hip arthroplasty: A prospective cohort study.

  Akira Yamaguchi; Koji Goto; Toshiyuki Kawai; Yutaka Kuroda; Kaori Sano; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 24 (2) 275 - 279 2019/03 [Refereed]
   

  BACKGROUND: Recently, the topical application of tranexamic acid has become widespread, and it is effective in reducing postoperative blood loss and transfusion rate in total hip arthroplasty. There is no consensus on the optimal dose of topical tranexamic acid. This study aimed to assess the efficacy and safety of topical tranexamic acid on postoperative blood loss and determine the optimal topical dose for primary total hip arthroplasty. METHODS: This prospective cohort study with a robust protocol enrolled 79 patients who received either 1 or 2 g of topical tranexamic acid in 30 mL normal saline solution or an equivalent volume of normal saline at the end of surgery. The primary outcomes were postoperative drain blood loss and hemoglobin decrease on postoperative day 7. The secondary outcomes were transfusion rate, d-dimer level on postoperative day 7, symptomatic deep vein thrombosis rate, and duration of hospital stay. RESULTS: Both 1 and 2 g tranexamic acid significantly reduced postoperative drain blood loss (p < 0.001). These doses also reduced the hemoglobin concentration decrease on postoperative day 7, but not significantly. Furthermore, 1 and 2 g doses of tranexamic acid had similar effects on postoperative blood loss and hemoglobin concentration decrease. There was no difference in the transfusion rate, d-dimer level, symptomatic deep vein thrombosis rate, and length of hospital stay. CONCLUSIONS: The use of topical tranexamic acid at the end of surgery is effective and safe for reducing postoperative blood loss in primary total hip arthroplasty. Topical tranexamic acid at a dose of 1 g may be sufficient and cost-effective, with fewer side effects than the higher dose.
• 人工股関節置換術後に脊柱変形に伴う骨盤後傾をきたし前方脱臼を生じた1例

  間野 公介; 河井 利之; 黒田 隆; 後藤 公志; 松田 秀一

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 62 (1) 147 - 148 0008-9443 2019/01 [Refereed]
   

  58歳女。45歳時に左変形性股関節症に対し人工股関節全置換術(THA)を施行しており、術直後のX線およびCTでは骨盤解剖軸に対してcupの外方開角49°、前方開角23°、stem前捻角17°とインプラントの設置角度は至適範囲内であった。術後経過中に骨盤後傾が進行し、50歳時に胸椎黄色靱帯骨化症および腰椎変性の進行に対しTh8からS1・腸骨までの後方固定術を施行した。しかし、以後も徐々に骨盤が後傾し、cupの外方開角および前方開角は増大した。左THA術後12年に左THA前方脱臼を来たし、徒手整復後に股関節外転装具を装着した。術後経過は良好で、脱臼1年後に右変形性股関節症に対しTHAを施行し、以後は脱臼なく経過している。
• 塊状同種骨移植とKTプレートを用いた人工股関節再置換術の術後短期成績

  山口 晶; 後藤 公志; 杉本 正幸

  日本人工関節学会誌 (一社)日本人工関節学会 48 551 - 552 1345-7608 2018/12 

  当科におけるKTプレートと塊状骨移植を用いた人工股関節再置換術の術後短期成績について検討した。2011年4月〜2016年6月に当科で施行した人工股関節再置換術のうち、KTプレートと塊状同種骨移植を用いた21例23股を対象とした。症例の内訳は男性2例2股、女性19例21股で、手術時平均年齢は76.7歳であった。評価項目は術前最終調査時の日本整形外科学会股関節機能判定基準(JOAスコア)、X線およびCT評価とした。JOAスコアは術前50(0-80)から術後73.4(52-98)に改善した。術後合併として頻回脱臼が1股あった。この1例は術後1年で手術とは無関連に死亡した。再手術を要した症例はなかった。設置角度の変化は平均1.3度(0-8)であり、3度以上変化したものは1股であった。KTプレートの移動は平均0.8mm(0-7)であり、3mm以上移動した症例は1股であった。KTプレートが破損した症例はなかった。これらX線上の緩みの生じた症例は同一症例であった。Kawanabe分類では、4股がstage 2、14股がstage 3、5股がstage 4であった。術後フォローアップ期間中にCTを撮影した症例は15股あり、その全てで骨癒合を認めた。
• Unexpected dislocation following accurate total hip arthroplasty caused by excessive hip joint laxity during myasthenic crisis: a case report.

  Yoshiki Murotani; Yutaka Kuroda; Koji Goto; Toshiyuki Kawai; Shuichi Matsuda

  Journal of medical case reports 12 (1) 331 - 331 2018/11 [Refereed]
   

  BACKGROUND: Dislocation following total hip arthroplasty is mainly caused by malposition. However, the coexistence of neuromuscular disorders is also considered a risk for dislocation due to excessive hip joint laxity. To minimize risk of dislocation, preoperative planning using combined anteversion has been widely used. The recommended combined anteversion angle (the total of cup and stem anteversion angles) is 50 ± 10°. CASE PRESENTATION: A 33-year-old Japanese woman underwent elective total hip arthroplasty due to osteonecrosis of the femoral head associated with corticosteroid pulse therapy for myasthenia gravis. Intraoperatively, no tendency of dislocation was found when simulating an evoking position under general anesthesia. In postoperative X-ray and computed tomography scans, cup inclination, cup anteversion, and stem anteversion angles were 37°, 13°, and 35° respectively. The resulting combined anteversion was 48°, which was set as the target along with accurate placement. Her postoperative course was normal and she was discharged without adverse events. Three months postoperatively, due to worsening of myasthenic weakness in her lower extremities while resting, she tended to raise her left limb up using both hands for sitting up. An anterior dislocation occurred when her legs were in a figure-of-four position. She was brought to an emergency department, and reduction of dislocation was performed. It was inferred that myasthenic crisis in the affected limb enabled excessive passive motion due to joint hyperlaxity. At the end of 2016, elective total hip arthroplasty on the contralateral side was performed. Cup anteversion, stem anteversion, and the combined anteversion angles were 27°, 24°, and 51° respectively. We instructed her to exercise care during passive leg movement, which may worsen her myasthenic condition. She returned to a normal life and was able to walk long distances without a cane. No recurrence of dislocation was seen at final follow-up. CONCLUSIONS: Even if accurate component orientation is attained in total hip arthroplasty, patients with neuromuscular disorders such as myasthenia gravis have a potential risk of muscle weakness in the affected limb. Therefore, physicians' instructions and patients' careful attention are required to prevent dislocation due to excessive hip joint laxity under conditions of motor weakness.
• ハイドロキシアパタイト核処理PEEKの生体活性評価

  正本 和誉; 藤林 俊介; 薮塚 武史; 昼田 智子; 大槻 文悟; 清水 孝彬; 奥津 弥一郎; 河井 利之; 後藤 公志; 石崎 千尋; 松田 秀一

  日本バイオマテリアル学会大会予稿集 日本バイオマテリアル学会 40回 117 - 117 2018/11
• ハイドロキシアパタイトとLポリ乳酸より作製した新規骨接合材のin vivo骨形成能評価

  森實 一晃; 敷波 保夫; 藤林 俊介; 後藤 公志; 大槻 文悟; 河井 利之; 清水 孝彬; 松田 秀一

  日本バイオマテリアル学会大会予稿集 日本バイオマテリアル学会 40回 379 - 379 2018/11
• Patient- and Surgery-Related Factors that Affect Patient-Reported Outcomes after Total Hip Arthroplasty.

  Toshiyuki Kawai; Masanao Kataoka; Koji Goto; Yutaka Kuroda; Kazutaka So; Shuichi Matsuda

  Journal of clinical medicine 7 (10) 2018/10 [Refereed]
   

  Patient-reported outcome measures (PROMs) are used to assess satisfaction after total hip arthroplasty (THA); however, the factors that determine these PROMs remain unclear. This study aimed to identify the patient- and surgery-related factors that affect patient satisfaction after THA as indicated by the Oxford Hip Score (OHS). One-hundred-and-twenty patients who underwent primary THA were included. Various patient-related factors, including clinical scores, and surgery-related factors were examined for potential correlations with the OHS at 3, 6, and 12 months post-THA. Univariate regression analysis showed that higher preoperative University of California Los Angeles (UCLA) activity score (p = 0.027) and better preoperative OHS (p = 0.0037) were correlated with better OHS at 3 months post-THA. At 6 months post-THA, the factors associated with better OHS were higher preoperative UCLA activity score (p = 0.039), better preoperative OHS (p = 0.0006), and use of a cemented stem (p = 0.0071). At 12 months post-THA, the factors associated with better OHS were higher preoperative UCLA activity score (p = 0.0075) and better preoperative OHS (p < 0.0001). Multivariate regression analysis showed that the factors significantly correlated with better OHS were female sex (p = 0.011 at 3 months post-THA), osteoarthritis (p = 0.043 at 6 months), higher preoperative OHS (p < 0.001 at 3 and 12 months, p = 0.018 at 6 months), higher preoperative Harris Hip Score (p = 0.001 at 3 months), higher preoperative UCLA activity score (p = 0.0075 at 3 months), and the use of a cemented femoral component (p = 0.012 at 6 months). Patient- and surgery-related factors affecting post-THA PROMs were identified, although the effect of these factors decreased over time.
• ハイドロキシアパタイト前駆体処理を行ったPEEKの生体活性評価

  正本 和誉; 藤林 俊介; 大槻 文悟; 薮塚 武史; 昼田 智子; 奥津 弥一郎; 後藤 公志; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 92 (8) S1789 - S1789 0021-5325 2018/08
• ハイドロキシアパタイト(HA)およびL-ポリ乳酸(PLLA)から作製した新規生体活性吸収性骨接合材の中期における骨形成能評価

  森實 一晃; 敷波 保夫; 藤林 俊介; 後藤 公志; 大槻 文悟; 河井 利之; 松田 秀一

  日本整形外科学会雑誌 (公社)日本整形外科学会 92 (8) S1790 - S1790 0021-5325 2018/08
• 股関節鏡視下術後3ヵ月における2事例のリハビリテーション実施状況

  佐野 かおり; 上杉 裕子; 後藤 公志

  Hip Joint 日本股関節学会 44 (2) S42 - S46 0389-3634 2018/08 

  股関節鏡視下手術後3ヵ月の患者2名を対象に、股関節評価と生活状況・リハビリテーション実施状況について検討した。日本整形外科学会股関節疾患評価質問票(JHEQ)痛みでは、痛みVASで2事例ともに65mm程度の疼痛があった。JHEQ動作では2事例ともに「足の爪切り」が困難であった。JHEQメンタルについては、2事例ともに物事への「取り組みへの意欲」に影響があった。2事例とも、術前に定期的な運動は実施しておらず調査時復職していなかった。リハビリテーションについて、退院前に自宅で行う股関節周囲筋筋力トレーニングの指導を受けていた。また、指導内容に違いはなく実施方法を理解していた。在宅における運動実施の自己効力感では、2事例ともに、「疼痛がある」「時間がない」状況での在宅での定期的な運動の実施に「たぶん行う自信がない」と回答していた。
• Sagittal alignment and mobility of the thoracolumbar spine are associated with radiographic progression of secondary hip osteoarthritis.

  H Tateuchi; H Akiyama; K Goto; K So; Y Kuroda; N Ichihashi

  Osteoarthritis and cartilage 26 (3) 397 - 404 2018/03 [Refereed]
   

  OBJECTIVE: To identify predictors of radiographic progression of hip osteoarthritis (OA) over 12 months among functional hip impairments and spinal alignment and mobility. DESIGN: Fifty female patients with secondary hip OA, excluding those with end-stage hip OA, participated in this prospective cohort study. Joint space width (JSW) of the hip was measured at baseline and 12 months later. With radiographic progression of hip OA over 12 months (>0.5 mm in JSW) as dependent variable, logistic regression analyses were performed to identify predictors for hip OA progression among functional impairments of the hip and spine with and without adjustment for age, body mass index (BMI), and minimum JSW at baseline. The independent variables were hip pain, Harris hip score (HHS), hip morphological parameters, hip passive range of motion (ROM) and muscle strength, and alignment and mobility of the thoracolumbar spine at baseline. RESULTS: Twenty-one (42.0%) patients demonstrated radiographic progression of hip OA. Multivariable logistic regression analysis showed that larger anterior inclination of the spine in standing position (adjusted OR [95% CI], 1.37 [1.04-1.80]; P = 0.028) and less thoracolumbar spine mobility (adjusted OR [95% CI], 0.96 [0.92-0.99]; P = 0.037) at baseline were statistically significantly associated with radiographic progression of hip OA, even after adjustment for age, BMI, and minimum JSW. CONCLUSIONS: The findings suggest that spinal alignment and mobility should be considered when assessing risk and designing preventive intervention for radiographic progression of secondary hip OA.
• Long-term results of total hip arthroplasty using Charnley Elite-Plus stem and the effect of stem geometry on radiographic distal femoral cortical hypertrophy.

  Koji Goto; Yuki Furuya; Kazuhiro Oda; Ryosuke Minami; Kaori Sano; Masayuki Sugimoto; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 23 (2) 365 - 370 2018/03 [Refereed]
   

  BACKGROUND: The Elite-Plus stem has two shape variations: roundback and flanged. The correlation between the radiographic results and stem geometry has not been previously investigated. The objective of this study was to evaluate the long-term primary total hip arthroplasty results using Elite-Plus stems, and the effect of stem geometry on radiographic distal femoral cortical hypertrophy. METHODS: We retrospectively evaluated, radiographically, 156 patients (173 hips) who underwent total hip arthroplasty between April 1998 and November 2005, and were followed up for >5 years, postoperatively. Radiographic factors affecting distal femoral cortical hypertrophy were analysed using multivariable logistic regression analysis. RESULTS: The mean follow-up period was 11.6 (5-17.8) years. During follow-up, femoral components were revised in 7 hips; one was revised due to aseptic loosening. Another femoral component was loosened and waiting for revision. The 10- and 15-year survival rates for aseptic stem loosening were 100% and 98.1% (95% CI: 92.5-99.5), respectively. Distal femoral cortical hypertrophy occurred in 23 hips (14.8%), and more often with roundback type (34.1%) than with flanged type (7.2%). Distal femoral cortical hypertrophy was observed in 34.8% of hips with valgus alignment, 11.3% with neutral alignment, and 12.5% with varus alignment. Multivariable logistic regression analysis showed that roundback stem shape and valgus stem alignment significantly affected the occurrence of distal femoral cortical hypertrophy. CONCLUSIONS: The Elite-Plus stem has excellent long-term clinical and radiographic results in Japanese patients. The occurrence of distal femoral cortical hypertrophy significantly depends on the shape and alignment of Elite-Plus stems.
• A long-term comparative study between two different designs of cemented stems: Distal-cylindrical versus distal-taper.

  Yuki Okutani; Koji Goto; Tomotoshi Kawata; Yaichiro Okuzu; Kazutaka So; Yutaka Kuroda; Shuichi Matsuda

  Journal of orthopaedics 15 (1) 190 - 195 2018/03 [Refereed]
   

  Introduction: The aim of this study was to calculate the wear rate of highly cross-linked polyethylene (HXLPE) and investigate long-term clinical and radiographic outcomes related to two femoral stem designs, the distal-cylindrical (DC) and distal-taper (DT) stems. Materials and methods: Outcomes for the DC and DT stems were evaluated in 110 patients, who underwent total hip arthroplasty using an HXLPE socket, over a 5-year follow-up period. There were 56 hips (53 patients) in the DC group and 60 hips (57 patients) in the DT group. Clinical outcomes were measured using the Japanese Orthopaedic Association (JOA) score and radiographic changes. Polyethylene wear rate was calculated using a computer software. Results: The mean follow-up period was 135.7 and 124.0 months for the DC and DT groups, respectively. Both stem designs improved hip function. On radiographic assessment, osteolysis around the tip of the stem was more frequent in the DC than in the DT group. Three cases of aseptic loosening of the stem were identified in the DC group, and no cases were identified in the DT group. The 10-year stem survival, using aseptic loosening as the primary endpoint, was 94.1% and 100% for the DC and DT groups, respectively (p = 0.06). The polyethylene wear rate was comparable for both stem groups. Conclusion: Better clinical outcomes were obtained with the DT stem than with the DC stem regardless of the equivalent polyethylene wear rate for the two designs. The DC shape of the stem may increase the risk of aseptic loosening.
• Bilateral osteonecrosis of the femoral head associated with corticosteroid therapy for alopecia areata: a case report and review of the literature.

  Yutaka Kuroda; Toshiyuki Kawai; Koji Goto; Shuichi Matsuda

  Therapeutics and clinical risk management 14 1399 - 1405 2018 [Refereed]
   

  Corticosteroids have been widely used for the treatment of various inflammatory diseases because they provide an acute response of immunosuppression. Numerous side effects of corticosteroids have also been known, with varying degrees of severity. Osteonecrosis of the femoral head (ONFH) is a rare and serious complication that directly inhibits walking because of femoral head collapse. However, sometimes, clinicians who consider that corticosteroids are required for primary disease do not recognize steroid-induced ONFH. The final stage of ONFH is severe osteoarthritis, requiring total hip arthroplasty. We describe a 23-year-old woman with bilateral ONFH after corticosteroid treatment for alopecia areata (AA). She was administered several intralesional corticosteroid injections to the scalp and repeated systemic corticosteroid therapy for extensive AA. While undergoing therapy, she lost her balance and complained of right groin pain when standing. The patient was subsequently diagnosed with bilateral ONFH. She recovered from AA, but she complained of persistent right hip pain, which subsequently required total hip arthroplasty. We would like to emphasize that patients on corticosteroid therapy for any common disease should be considered as having a potential risk for ONFH. An early stage detection of ONFH is crucial for its treatment. MRI evaluation warrants a higher level of accuracy in early diagnosis of ONFH for the opportunity to undergo joint-preservation surgery in patients with ONFH.
• Polyethylene and highly cross-linked polyethylene for cemented total hip arthroplasty: A comparison of over ten-year clinical and radiographic results.

  Tomotoshi Kawata; Koji Goto; Kazutaka So; Yutaka Kuroda; Shuichi Matsuda

  Journal of orthopaedics 14 (4) 520 - 524 2017/12 [Refereed]
   

  INTRODUCTION: We investigated the long-term tribological outcomes of conventional polyethylene (CPE) and highly cross-linked polyethylene (HXLPE). METHODS: Ninety-four consecutive primary cemented THAs were performed using either HXLPE or CPE at our hospital. CPE sockets were used in 26 hips, and HXLPE sockets were implanted in 68 hips. RESULTS: A 10-year follow-up was completed for 69 cases. Linear wear rates of 0.138 ± 0.074 mm/year for CPE and 0.011 ± 0.020 mm/year for HXLPE were calculated. Osteolysis was identified in 10 cases (CPE group, 7; HXLPE group, 3). CONCLUSION: HXLPE had significantly less wear than CPE, and polyethylene wear was associated with osteolysis.
• Strontium and magnesium ions released from bioactive titanium metal promote early bone bonding in a rabbit implant model

  Yaichiro Okuzu; Shunsuke Fujibayashi; Seiji Yamaguchi; Koji Yamamoto; Takayoshi Shimizu; Takashi Sono; Koji Goto; Bungo Otsuki; Tomiharu Matsushita; Tadashi Kokubo; Shuichi Matsuda

  ACTA BIOMATERIALIA ELSEVIER SCI LTD 63 383 - 392 1742-7061 2017/11 [Refereed]
   

  We have previously developed the "alkali and heat treatment" method to confer bioactivity (bone bonding ability) to titanium metal (Ti). As strontium (Sr) and magnesium (Mg) ions reportedly promote osteoblastic cell proliferation and differentiation and accelerate bone formation, we improved this method to induce the release of Sr (Sr-Ti) or Mg (Mg-Ti) ions from Ti in a previous study. Here, we evaluated the bioactivity of these novel surface treatments, Sr-Ti and Mg-Ti. In vitro evaluation of cell viability, expression of integrin #1, # catenin, and cyclin Dl, osteogenic gene expression, alkaline phosphatase activity, and extracellular mineralization using MC3T3-E1 cells revealed that Sr-Ti and Mg-Ti enhanced proliferation and osteogenic differentiation. In rabbit in vivo studies, Sr-Ti and Mg-Ti also provided greater biomechanical strength and bone-implant contact than the positive control Ti (Ca-Ti), especially at the early stage (4-8 weeks), and maintained these properties for a longer period (16-24 weeks). Advantages of the improved method include process simplicity, applicability for any implant shape, and lack of adverse effects on implant composition and structure. Therefore, our treatment is promising for clinical applications to achieve early bone bonding. Statement of Significance Implantation into osteoporotic bone constitutes a challenging problem because of early migration or loosening of the implant, which is primarily due to insufficient initial fixation in porotic bone. Therefore, it is desirable to provide implants with a capacity for early bone bonding. We have achieved conferring early bone bonding ability to titanium metal by releasing strontium ions or magnesium ions. Our treatment is promising for clinical applications to achieve early bone bonding of orthopedic or dental Ti-based implants. (C) 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
• Non-navigation THAにおいて術前計画を実現するためのメモリ付きラスプハンドルの有用性

  南 良輔; 後藤 公志

  Hip Joint 日本股関節学会 43 (2) 785 - 788 0389-3634 2017/08 

  当院でhybrid THAを施行した患側Crowe 1、反対側正常股の54人54関節を対象に、non-navigation THAにおけるメモリ付きラスプハンドルを用いた術前計画の有用性について検討した。その結果、反対側を基準として計測した脚長差の平均値は0.47mm、中央値0.01mmであり、脚長差が±5mm以内の症例は46例(85%)であった。今回の結果から、正確に脚長補正ができるメモリ付きラスプハンドルは、術前計画を正確に実現する上で有用と考えられた。
• Daily cumulative hip moment is associated with radiographic progression of secondary hip osteoarthritis.

  H Tateuchi; Y Koyama; H Akiyama; K Goto; K So; Y Kuroda; N Ichihashi

  Osteoarthritis and cartilage 25 (8) 1291 - 1298 2017/08 [Refereed]
   

  OBJECTIVE: To investigate whether higher daily cumulative hip moment at baseline is associated with subsequent radiographic progression of hip osteoarthritis (OA) over 12 months. DESIGN: Fifty patients with secondary hip OA, excluding patients with end-stage hip OA, participated in this prospective cohort study. Joint space width (JSW) of the hip was measured at baseline and 12 months later. With radiographic progression of hip OA (>0.5 mm/year in JSW) as dependent variable (yes/no), univariable and multivariable logistic regression analyses were performed to assess the association between load-related parameters during gait (i.e., peak hip moment, hip moment impulse, and daily cumulative hip moment [product of hip moment impulse and mean steps/day]) and hip OA progression with and without adjustment for age, body weight, and minimum JSW. RESULTS: Of the 50 patients (47.4 ± 10.7 years old), 21 (42.0%) were classified into the progression group. The higher daily cumulative hip moment in the frontal plane at baseline was statistically significantly associated with radiographic progression of hip OA (adjusted odds ratio (OR) [95% confidence interval (CI)], 1.34 [1.06-1.70]; P = 0.013). The higher daily cumulative hip moment in the sagittal plane was also approaching significance in its association with hip OA progression (adjusted OR, 1.80 [0.99-3.26]; P = 0.052). CONCLUSIONS: In the female patients with secondary hip OA, higher daily cumulative hip moment, particularly in the frontal plane, was a predictor of radiographic progression of hip OA over 12 months. Reduction in daily cumulative hip moment by modification in gait and physical activity may potentially slow hip OA progression.
• The Relationship Between Subluxation Percentage of the Femoroacetabular Joint and Acetabular Width in Asian Women with Developmental Dysplasia of the Hip.

  Yaichiro Okuzu; Koji Goto; Tomotoshi Kawata; Kazutaka So; Yutaka Kuroda; Shuichi Matsuda

  The Journal of bone and joint surgery. American volume 99 (7) e31  2017/04 [Refereed]
   

  BACKGROUND: Implantation of the acetabular cup insert in the "true" location of the acetabulum is a fundamental principle of total hip arthroplasty for the treatment of secondary osteoarthritis due to developmental dysplasia of the hip (DDH). As knowledge of the morphology of the acetabulum is required for accurate placement, we investigated the relationship between acetabular width and the Crowe classification of subluxation percentage of the hip. We also analyzed factors associated with the acetabular width ratio (AWR), defined as the acetabular width of the dysplastic hip divided by that of the unaffected, contralateral hip. METHODS: We completed a retrospective review of the preoperative standard anteroposterior radiographs and computed tomography (CT) scans of 207 female patients who underwent primary total hip arthroplasty for unilateral DDH. The "true" acetabular plane was defined on each CT reconstruction as a plane perpendicular to the anterior pelvic plane, parallel to the teardrop line, and passing through the center of the femoral head on the unaffected, contralateral side. The acetabular width was measured for both the affected hip and the contralateral, reference hip on the true acetabular plane, with the acetabular width defined as the distance between the edges of the anterior and posterior walls of the acetabulum. All hips were classified according to the Crowe groupings on the basis of the subluxation percentage of the dysplastic hip; the subluxation percentage increased from groups I to IV, with group IVb showing joint dislocation. RESULTS: The acetabular width decreased from Crowe groups I to IVb, with a negative correlation found between the AWR and the subluxation percentage (Spearman correlation coefficient, ρ = -0.404; p < 0.001). Multivariate regression analysis identified subluxation percentage and femoral neck-shaft angle as independent factors associated with the AWR. CONCLUSIONS: Characterization of factors associated with the AWR, namely subluxation percentage and femoral neck-shaft angle, will guide surgeons in correctly implanting the acetabular cup insert during total hip arthroplasty in patients with DDH.
• X線診断Q&A

  後藤 公志

  整形外科 (株)南江堂 68 (3) 259 - 260 0030-5901 2017/03
• 変形性股関節症患者における人工股関節全置換術施行前後の歩行動揺変化の検討

  西村 圭二; 南部 利明; 後藤 公志; 杉本 正幸; 山﨑 敦

  理学療法学Supplement 公益社団法人 日本理学療法士協会 2016 159 - 159 2017 

  【はじめに】

  変形性股関節症（以下股OA）患者の歩行では，主に患側立脚期において股関節伸展に伴い体幹前傾や患側への側屈，骨盤回旋など脊柱や骨盤で代償する傾向がある。原因として，股関節伸展可動域制限，殿筋筋力低下，下部体幹筋安定性低下などが挙げられる。この代償は人工股関節全置換術（以下THA）施行後においても残存する場合があり，入院期間中での跛行改善に難渋することを経験する。加速度センサは動作を三次元的に簡便に把握できるため有効とされる。今回股OA患者の跛行を詳細に評価する目的でTHA施行前後の歩行動揺変化について加速度角速度センサを用いて検討したので報告する。

  【方法】

  対象は股OAにて視覚的に跛行を確認できる患者で，THA術後の股関節伸展可動域が5°以上有する20名（年齢49～83歳，身長154.8±7.5cm）とした。術式は側方アプローチとした。THA施行前日とTHA術後3週間後（退院時）に歩行計測を実施した。計測には体幹2点歩行動揺計MVP-WS2-S（マイクロストーン社製）を使用した。計測肢位は小型無線モーションセンサを体幹（第9胸椎部）と骨盤（仙骨後面で上後腸骨棘を結ぶ線の中央）に各々取り付けた立位とし，10mを快適な速度で歩行するように指示した。計測前に2回練習した。得られたデータから10m歩行中の歩行周期3区間における体幹，骨盤の前後，上下，左右動揺幅を各々平均化して算出し，THA施行前とTHA施行3週間後の歩行動揺を比較した。統計処理は対応のあるt検定を用い，危険率5％未満とした。歩行変化を視覚的に確認するため動画も撮影した。

  【結果】

  動揺幅は骨盤では左右が施行前40.1±15.7mm，施行後41.0±16.1mm。前後は施行前29.1±8.0mm，施行後27.5±6.9mm。上下は施行前32.3±8.2mm，施行後30.8±7.7mmと前後，上下で減少したが有意差はなかった。体幹では左右が施行前46.8±20.1mm，施行後43.0±12.3mm。前後は施行前26.7±11.0mm，施行後22.9±8.3mmと減少したが有意差はなかった。上下では施行前32.5±7.8mm，施行後28.9±6.9mmと有意な減少を認めた（p＜0.05）。

  【考察】

  THA施行後の体幹動揺に減少傾向を示した。施行前は主に患側立脚中期に患側への体幹側屈や，立脚後期の股関節伸展で骨盤前傾や回旋，体幹前傾が確認された。THAと理学療法により疼痛や可動域，筋力が改善したことで過剰な動揺が減少したと考える。歩行中の重心移動幅は左右約40mm，上下では約25～50mmといわれている。本研究は1歩行周期全体における動揺幅であるため，質的変化の把握が不十分であった。骨盤動揺幅に変化は見られなかったが，動揺の軌跡では施行後の左右非対称性が減少した。しかし動画にて骨盤前傾や回旋による代償を認め，術後3週間後でも非対称性は残存した。したがって加速度角速度センサと動画を併用し評価していく必要性が示唆された。さらに評価に基づいた適切な自主トレーニングの指導が跛行改善において重要といえる。

• 【誌上ディベート:人工股関節をめぐる議論-対立する治療法】(Part4)ポリエチレンカップに対する骨頭径 28mm以下の小径骨頭を用い続ける理由

  後藤 公志

  Bone Joint Nerve (株)アークメディア 7 (1) 65 - 69 2186-1110 2017/01
• Complete Resection of a Massive Synovial Osteochondromatosis of the Hip Using an Anterior Approach: A Report of Two Cases.

  Masanao Kataoka; Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Ouki Murata; Masayuki Sugimoto; Shuichi Matsuda

  Case reports in orthopedics 2017 9806863 - 9806863 2017 [Refereed]
   

  Arthroscopic excision of synovial osteochondromatosis of the hip is commonly performed. However, when the lesion extends to the extra-articular space of the hip joint, excision using arthroscopy becomes difficult. Although surgical dislocation of the hip with a trochanteric flip osteotomy is commonly used, manual access to the inferomedial portion of the acetabulum remains difficult. In this case report, we describe arthroscopic resection followed by open surgery using an anterior approach with or without surgical dislocation to excise a synovial osteochondromatosis of the hip that had extended to the extra-articular space and formed a herniation sac. Excision was completed without complications. An anterior approach with or without surgical dislocation should be considered as a surgical option for the treatment of a massive synovial osteochondromatosis of the hip joint.
• Hip external rotator exercise contributes to improving physical functions in the early stage after total hip arthroplasty using an anterolateral approach: a randomized controlled trial.

  Manabu Nankaku; Ryosuke Ikeguchi; Koji Goto; Kazutaka So; Yutaka Kuroda; Shuichi Matsuda

  Disability and rehabilitation 38 (22) 2178 - 83 2016/11 [Refereed]
   

  PURPOSE: The purpose of this study was to investigate the effects of an exercise program focusing on hip external rotator muscle on physical recovery in the early post-operative period of total hip arthroplasty (THA). METHODS: Patients who underwent THA were randomized to an exercise group (n = 14) or a control group (n = 14). In exercise group, the hip external rotator exercise program was performed 5 times per week for four weeks. Outcome measures were hip pain, hip range of motion, muscle strength of lower extremity and Timed Up and Go (TUG) test. RESULTS: Both the hip abductor strength (effect size = 0.60) and TUG test (effect size= -0.53) in the exercise group improved significantly after the intervention. CONCLUSIONS: The results of the present study demonstrated that exercise program focusing on hip external rotator muscle was an effective intervention, especially in improving both hip abductor strength and walking ability in the acute post-THA stage. Implication for Rehabilitation After THA, in order to safely progress patients back to their desired activity level, there is a need to develop rehabilitation strategies to expedite and promote the recovery during the acute postoperative period. Exercise program focusing on hip external rotator muscle may lead to significant improvement of hip abductor muscle strength and gait ability in the acute post-THA stage.
• Associations of radiographic degeneration and pain with daily cumulative hip loading in patients with secondary hip osteoarthritis.

  Hiroshige Tateuchi; Yumiko Koyama; Rui Tsukagoshi; Haruhiko Akiyama; Koji Goto; Kazutaka So; Yutaka Kuroda; Noriaki Ichihashi

  Journal of orthopaedic research : official publication of the Orthopaedic Research Society 34 (11) 1977 - 1983 2016/11 [Refereed]
   

  The purpose of this study was to investigate the associations of radiographic and clinical variables of hip osteoarthritis (OA) with alterations in gait and joint loading in patients with secondary hip OA. Fifty females with secondary hip OA were participated. The minimum joint space width (mJSW) of the hip as a degenerative sign and Sharp and center edge (CE) angles as morphological variables were measured radiographically. Hip joint pain was assessed using a visual analog scale. As gait variables, walking speed, range of hip motion, hip moment peak, and hip moment impulse were calculated. Daily cumulative hip loading was calculated as the hip moment impulse multiplied by the mean number of steps per day. After bivariate correlation analyses between dependent (mJSW and pain) and independent variables (age, body mass index, sharp/CE angles, steps per day, and gait variables), separate forward-backward stepwise multiple regression analyses were performed for each dependent variable. Daily cumulative hip loading in the sagittal plane (β = 0.30, p = 0.021) and age (β = -0.36, p = 0.007) were significantly associated with the mJSW. Walking speed (β = -0.36, p = 0.008) and age (β = 0.29, p = 0.031) were significantly associated with hip joint pain. Decrease in daily cumulative hip loading in the sagittal plane was associated with mJSW independently of age. Although the causal relationship was not clear, patients with hip OA reduced total exposure to hip joint loading adaptively rather than lowering the hip moment peak concerning worsening of hip degeneration. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1977-1983, 2016.
• Mid- and long-term results of femoral component revision using the cement-in-cement technique: Average 10.8-year follow-up study.

  Yaichiro Okuzu; Koji Goto; Kazutaka So; Yutaka Kuroda; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 21 (6) 810 - 814 2016/11 [Refereed]
   

  BACKGROUND: Few reports are available on the long-term outcomes of femoral component revision by using the cement-in-cement technique. We report the mid- and long-term results of femoral component revision in total hip arthroplasty using the cement-in-cement technique. METHODS: Between April 1996 and June 2009, 62 consecutive total hip arthroplasties with femoral component revision were performed in 57 patients by using the cement-in-cement technique. We retrospectively reviewed the cases with a follow-up period of at least five years. Three patients died, and two were lost to follow-up. Thus, 52 patients (57 hips), comprising 51 women and one man, were followed for average 10.8 years. RESULTS: The mean Japanese Orthopaedic Association hip score improved from 57.6 points (range, 28-95 points) preoperatively to 79.8 points (range, 52-98 points) at one year postoperatively and to 77.4 points (range, 59-96 points) at the final follow up. Three revisions of the femoral component were necessary. One of the causes for the revision was a periprosthetic infection that occurred 20 months postoperatively. Another was aseptic loosening that occurred 99 months postoperatively and required revision of the acetabular component. The well-fixed femoral component was revised using the cement-in-cement technique at time of the acetabular revision. The third case was aseptic loosening of the femoral component that occurred 84 months postoperatively. The five-, 10-, and 15-year survival rates for the femoral re-revision due to any reason were 98.4%, 94.0%, and 94.0%, respectively. CONCLUSION: Use of the cement-in-cement technique for revision total hip arthroplasty resulted in good mid- and long-term radiological and clinical outcomes.
• 前期から進行期の変形性股関節症患者における片脚立位・歩行機能に影響を与える要因は何か?

  建内 宏重; 小山 優美子; 黒田 隆; 宗 和隆; 後藤 公志; 秋山 治彦; 市橋 則明

  理学療法学 (公社)日本理学療法士協会 43 (Suppl.2) O - 2 0289-3770 2016/10
• Radiographic and clinical factors associated with one-leg standing and gait in patients with mild-to-moderate secondary hip osteoarthritis.

  Hiroshige Tateuchi; Yumiko Koyama; Haruhiko Akiyama; Koji Goto; Kazutaka So; Yutaka Kuroda; Noriaki Ichihashi

  Gait & posture 49 207 - 212 2016/09 [Refereed]
   

  A decline in physical function associated with secondary hip osteoarthritis (OA) may be caused by both radiographic and clinical factors; however, the underlying mechanism remains unclear. The purpose of this study was to determine how joint degeneration, hip morphology, pain, hip range of motion (ROM), and hip muscle strength relate to one-leg standing (OLS) and gait in patients with mild-to-moderate secondary hip osteoarthritis. Fifty-five female patients (ages 22-65 years) with mild-to-moderate hip OA secondary to hip dysplasia were consecutively enrolled. Balance during OLS and three-dimensional hip angle changes while maintaining the OLS and at foot-off of the raised leg were measured. Gait speed and peak three-dimensional hip joint angles during gait were also measured. The associations between dependent variables (balance, gait speed, and hip kinematic changes) and independent variables (age, body mass index, pain, joint degeneration, hip morphologic abnormality, passive hip ROM, and hip muscle strength) were determined. While lower hip muscle strength was associated with hip kinematic changes such as flexion and internal rotation while maintaining OLS, decreased acetabular head index (AHI) and increased pain were associated with hip extension and abduction at foot-off in OLS. Decreased passive hip ROM was associated with decreased peak hip angles (extension, adduction, and external and internal rotation) during gait, although increased pain and decreased hip extension muscle strength were associated with slower gait speed. In this study of patients with secondary hip OA, AHI, pain, and hip impairments were associated with OLS and gait independently from age and radiographic degeneration.
• 股関節鏡視下術後患者の術前後における生活実態調査

  佐野 かおり; 後藤 公志

  Hip Joint 日本股関節学会 42 (2) S29 - S32 0389-3634 2016/08 

  股関節鏡視下手術を受けた患者28名を対象に、術前後の生活実態について自記式質問紙調査を行い、16名(57.1%:男性5名、女性11名、平均年齢52.2歳)から回答を得た。調査時術後経過月数は平均19ヵ月であった。平均疼痛は術前7.94→退院時4.4→調査時2.25と改善したが、4名は退院時より増強しており、鏡視下で関節軟骨の高度変性を認めた。動作時痛は「しゃがみ込み」7名、「あぐら」「長時間歩行」各6名、「長時間立位・家事」「階段昇降」各5名などであった。困難動作は「車に乗る」術前10名→調査時3名、「車から降りる」8名→2名と改善したが、「足の爪切り」8名→7名、「重い物の片づけ」8名→8名と改善はみられなかった。筋力トレーニングを継続していたのは3名(50代女性1名、60代男性2名)であった。
• 人工股関節全置換術後患者の退院移行期における各種歩行指標に関する予備的研究(A preliminary Study on the Several Walking Indicators in Discharge Transition Period following Total Hip Arthroplasty)

  佐野 かおり; 宮島 朝子; 真継 和子; 後藤 公志; 杉本 正幸

  大阪医科大学看護研究雑誌 大阪医科大学看護学部 6 30 - 35 2186-1188 2016/03 

  片側人工股関節全置換術を施行した患者7名(全例女性、平均年齢65.3±9.2歳)の歩数、歩行時間、活動エネルギー消費量(AEE)を退院の3日前から退院の2週間後まで調べた。1名は入院前に働いていたが、退院後は全例が主婦になった。退院移行期における下肢機能は不良で、安定な歩行が不可能であった。7名の歩数は年齢のほぼ同じ健康な女性に比べて少なかった。AEEの変化は歩数および歩行時間と必ずしも相関していなかった。歩数、歩行時間およびAEEにより歩行能力と質を評価することができるため、これらを測定することにより、活動を反映する歩行状態を捉えることが可能であると考えられた。
• 下部体幹筋の収縮の有無が歩行時の体幹および骨盤動揺に与える影響

  西村 圭二; 南部 利明; 後藤 公志; 杉本 正幸; 山﨑 敦

  理学療法学Supplement 公益社団法人 日本理学療法士協会 2015 203 - 203 2016 

  【はじめに】変形性股関節症（以下股OA）患者の歩行では，立脚中期から後期において体幹前傾や患側への体幹側屈など股関節伸展を腰椎や骨盤で代償する場合がある。原因として，股関節伸展可動域制限，殿筋筋力低下，下部体幹筋安定性低下などが挙げられる。先行研究において，下部体幹筋収縮の意識により，歩行立脚期を想定した前方へのステップ動作にて骨盤および体幹前傾減少，股関節伸展角度増加など代償の抑制に関与することを報告した。今回，実際の歩行において下部体幹筋収縮の有無が体幹および骨盤動揺に与える影響について検討したので報告する。【方法】対象は健常成人10名（平均年齢33.3±7.1歳，身長173.6±2.4cm）で，股関節伸展，外転可動域および大殿筋，中殿筋筋力が正常である者とした。計測には体幹2点歩行動揺計MVP-WS2-S（マイクロストーン社製）を用いて，小型無線モーションセンサを体幹（第9胸椎部）と骨盤（仙骨後面で両上後腸骨棘を結ぶ線の中央）に各々取り付けた立位とし，快適な速度での10m歩行を指示した。これを下部体幹筋収縮を意識しない状態と意識した状態で各々実施した。計測前に2回歩行練習をした。下部体幹筋収縮を意識付けるために，まず股膝関節60°屈曲位でのハーフカットストレッチポール上端座位にて頭尾側方向への体幹伸展を10回促した。さらに両脚立位でも同様に頭尾側方向に体幹伸展する動作を10回実施した。この際の腹横筋の収縮を触診にて確認した。同様の計測を股OAによるTHA術後3週（退院時）で術側立脚期に体幹側方動揺を視覚的に確認できる患者5名にも実施した。得られたデータから10m歩行中の歩行周期3区間における体幹および骨盤の前後，上下，左右動揺幅を各々平均化して算出し，下部体幹筋収縮意識の有無による動揺変化を比較した。統計処理は対応のあるt検定を用い，危険率5％未満とした。【結果】健常成人の体幹では上下動揺にて意識無48.8±7.1mm，意識有51.8±6.5mmと有意な増加を認めた（p＜0.05）。前後，左右では有意差はなかった。骨盤では前後，上下，左右とも意識の有無による動揺幅の有意差は見られなかった。THA術後患者は意識無にて術側立脚期に術側方向への体幹側方動揺が生じ左右幅増大を認めたが，意識有にて上下動揺幅が増大し動揺の軌跡が左右対称に近づく傾向を示した。【考察】頭尾側方向へ積極的に体幹を伸展することで腹横筋の活動が高まり，腹腔内圧が上昇し腰椎安定化作用が得られるとされる。健常成人に明らかな跛行は見られなかったため，意識の有無による著明な変化はなかったが，収縮意識が頭尾側方向であることからTHA術後患者では側方動揺の抑制につながり，左右対称的な動揺に近づいたと考える。また，上下動揺幅増大は立脚中期から後期の前方推進力増大にも影響することが推測される。したがって，下部体幹筋収縮を意識することは歩容改善の一助となる可能性が示唆された。
• Clinical and radiographic evaluation of cemented socket fixation concomitant to acetabular bone grafting fixed with absorbable hydroxyapatite-poly-l-lactide composite screws.

  Koji Goto; Yaichiro Okuzu; Kazutaka So; Yutaka Kuroda; Shuichi Matsuda

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 21 (1) 57 - 62 2016/01 [Refereed]
   

  BACKGROUND: The durability of uncalcined and unsintered hydroxyapatite-poly-l-lactide composite screws is unclear when used for the fixation of acetabular bone graft in total hip arthroplasty under full-weight conditions. We have used this type of screw for the fixation of acetabular bone graft in cemented or reverse-hybrid total hip arthroplasty since 2003. Hence, we conducted a follow-up study to assess the safety and efficacy of these screws when used for cemented socket fixation. METHODS: In this study, 98 patients (106 cases) who underwent fixation of acetabular bone graft in cemented or reverse-hybrid total hip arthroplasty using hydroxyapatite-poly-l-lactide composite screws were followed up for over 5 years and evaluated clinically and radiographically. The patient population comprised 10 men and 88 women with a mean age of 60.3 years (range, 41-81 years) at the time of surgery. The original diagnosis for primary total hip arthroplasty was secondary osteoarthritis in 97 cases and high hip dislocation in nine cases. RESULTS: The mean follow-up period was 7.6 years (range, 5-11 years). No patient in this series required revision surgery, and no radiographical loosening occurred during the follow-up period. The mean Japanese Orthopaedic Association score improved from 48 (range, 7-73) preoperatively to 87 (range, 50-100) at the final follow-up. Radiographically bone graft consolidation was confirmed in all cases, and no apparent osteolysis around the cemented socket or composite screws was detected. Kaplan-Meier survival analyses with socket revision surgery for any reason, socket loosening, and appearance of a radiolucent line >1 mm in any zone as the endpoints yielded survival rates of 100%, 100%, and 86.8% at 5 years, and 100%, 100%, and 81.0% at 10 years, respectively. CONCLUSION: This absorbable screw seems to have no negative effects on the mid-term clinical results of cemented socket fixation.
• Extremely early stage osteonecrosis of the femoral head in a patient with hip pain secondary systemic steroid pulse therapy for Vogt-Koyanagi-Harada syndrome: A case report.

  Yutaka Kuroda; Kazutaka So; Koji Goto; Shuichi Matsuda

  International journal of surgery case reports 25 97 - 101 2016 [Refereed]
   

  INTRODUCTION: Osteonecrosis of the femoral head (ONFH) is a corticosteroid-associated disease that mostly cause femoral head collapse and gait disturbance. At the final stage of ONFH, the most reliable treatment is total hip arthroplasty even in young patients. Although magnetic resonance imaging (MRI) is useful for early diagnosis, initial stages are asymptomatic, with pain intensifying after femoral head collapse. PRESENTATION OF CASE: A 34-year-old female patient with rapid bilateral loss of vision was diagnosed Vogt-Koyanagi-Harada syndrome. She immediately received corticosteroid pulse therapy. While undergoing therapy, she complained of groin pain. The initial MRI of the hip did not show abnormal findings. As the right proximal thigh pain progressed, an MRI of the lumbar spine was performed. No compression of the spinal cord was observed, and right ONFH was suspected on the basis of a characteristic band image. The patient was diagnosed with Stage 1 ONFH 7 weeks after the initial symptoms. She was successfully treated by joint-preserving regenerative therapy using growth factor. After surgery, the patient completely recovered from pain. DISCUSSION: The occurrence of hip pain while receiving corticosteroid therapy was very rare. The present case was considered a result of reduction of the blood supply to the femoral head induced by hip pain that progressed to ONFH for unknown reasons. CONCLUSION: It is difficult to identify cases of corticosteroid-associated ONFH even in patients with potential risk. In this case, we could identify the patient extremely early based on the ONFH image and could provide joint-preserving regenerative therapy.
• Minimum 10-Year Wear Analysis of Highly Cross-Linked Polyethylene in Cementless Total Hip Arthroplasty.

  Kazutaka So; Koji Goto; Yutaka Kuroda; Shuichi Matsuda

  The Journal of arthroplasty 30 (12) 2224 - 6 2015/12 [Refereed]
   

  Fifty-four patients (64 hips) underwent cementless total hip arthroplasty between 2000 and 2003 with a 22-mm zirconia ceramic bearing on highly cross-linked polyethylene, and were evaluated with a mean 11.9-year postoperative follow-up (range, 10-14 years). Linear wear was measured on the anteroposterior radiograph of the hip. No evidence of osteolysis and loosening was found on the final radiograph in any of the cases, and the steady-state linear wear rate was 0.017±0.018 mm/year. No significant correlation was found between the linear wear rate and age, body weight, cup inclination angle, or polyethylene thickness. Highly cross-linked polyethylene showed excellent wear resistance for >10 years when used in combination with 22-mm zirconia heads.
• 人工股関節全置換術後早期における患者立脚型評価は運動機能の回復が関連する

  西川 徹; 南角 学; 西村 純; 黒田 隆; 後藤 公志

  Hip Joint 日本股関節学会 41 (Suppl.) 18 - 20 0389-3634 2015/08 

  人工股関節全置換術(THA)早期の患者立脚型評価における動作面のQOLに影響する運動機能について検討した。変形性股関節症および大腿骨頭壊死症でTHAを施行した44例(男性6名、女性38名、62.2±10.3歳)を対象とした。JHEQ動作の良好群は28例、不良群は16例であった。良好群の年齢とBMIは不良群と比較して有意に高値を示した。下肢筋力と歩行能力は両群間で有意差を認めなかった。良好群のJHEQ動作は不良群と比較して有意に低値を示した。術後2ヵ月の各群の股関節外転筋力は術前と比較して有意に高値を示した。術後2ヵ月の各群の膝関節伸展筋力は術前と比較して有意差を認めなかった。術後2ヵ月の良好群の脚伸展筋力は術前と比較して有意差を認めなかったが、不良群は術前と比較して有意に低値を示した。術後2ヵ月の良好群のTUGは術前と比較して有意に低値を示したが、不良群は術前と比較して有意差を認めなかった。
• THA術後の関節内へのトラネキサム酸投与と、エピネフリン入りトラネキサム酸投与の比較検討

  櫻木 淳史; 杉本 正幸; 廣瀬 伸次; 江藤 謹司; 笠原 崇; 村田 巨樹; 田中 淳; 古屋 佑樹; 琴浦 良彦; 後藤 公志

  滋賀医学 (一社)滋賀県医師会 37 142 - 142 0288-9765 2015/03
• THA術後の関節内へのトラネキサム酸投与と、エピネフリン入りトラネキサム酸投与、生食投与の比較検討

  櫻木 淳史; 後藤 公志; 杉本 正幸; 江藤 謹司; 廣瀬 伸次; 笠原 崇; 村田 巨樹; 田中 淳; 古屋 佑樹

  日本整形外科学会雑誌 (公社)日本整形外科学会 89 (3) S1017 - S1017 0021-5325 2015/03
• Rehabilitation program after mesenchymal stromal cell transplantation augmented by vascularized bone grafts for idiopathic osteonecrosis of the femoral head: a preliminary study.

  Aoyama T; Fujita Y; Madoba K; Nankaku M; Yamada M; Tomita M; Goto K; Ikeguchi R; Kakinoki R; Matsuda S; Nakamura T; Toguchida J

  Archives of physical medicine and rehabilitation 96 (3) 532 - 539 0003-9993 2015/03 [Refereed]
   

  OBJECTIVE: To determine the feasibility and safety of implementing a 12-week rehabilitation program after mesenchymal stromal cell (MSC) transplantation augmented by vascularized bone grafting for idiopathic osteonecrosis (ION) of the femoral head. DESIGN: A prospective case series. SETTING: University clinical research laboratory. PARTICIPANTS: Participants (N=10) with ION who received MSC transplantation augmented by vascularized bone grafting. INTERVENTION: A 12-week exercise program, which included range-of-motion (ROM) exercises, muscle-strengthening exercises, and aerobic training. MAIN OUTCOME MEASURES: Measures of ROM, muscle strength, Timed Up and Go test, and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were collected before surgery and again at 6 and 12 months after surgery. RESULTS: All participants completed the 12-week program. External rotation ROM as well as extensor and abductor muscle strength significantly improved 6 months after treatment compared with that before treatment (P<.05). Significant improvements were also seen in physical function, role physical, and bodily pain subgroup scores of the SF-36 (P<.05). No serious adverse events occurred. CONCLUSIONS: This study demonstrates the feasibility and safety of a multiplex rehabilitation program after MSC transplantation and provides support for further study on the benefits of rehabilitation programs in regenerative medicine.
• A Report on Three Consecutive Cases using Computer Tomography 3D Preoperative Planning for Conversion of Arthrodesed Hips to Total Hip Replacements.

  Yutaka Kuroda; Haruhiko Akiyama; Manabu Nankaku; Kazutaka So; Koji Goto; Shuichi Matsuda

  HSS journal : the musculoskeletal journal of Hospital for Special Surgery 11 (1) 76 - 83 2015/02 [Refereed]
   

  BACKGROUND: Conversion of an arthrodesed hip to a total hip arthroplasty (THA) is a technically demanding procedure with high complication rates. One important issue is that determining the amount of correction for a leg length discrepancy (LLD) can be difficult at the planning stage. QUESTIONS/PURPOSES: The aim of this study is to assess the reliable use of computer tomography (CT)-based three-dimensional (3D) preoperative planning for the conversion of arthrodesed hips to THAs. PATIENTS AND METHODS: CT-based preoperative 3D planning was used to convert three arthrodesed hips to THAs. The efficacy of the planning was evaluated with postoperative radiographic measurements involving the amount of correction for LLD, position of components, difference between targeted and actual values, and ratio of the moment arms. The clinical assessment was performed with the Japanese Orthopaedic Association (JOA) hip score before and after THA. RESULTS: The mean amount of LLD correction and median LLD after THA were 16 mm (range, 15-17 mm) and 4 mm (range, 1-10 mm), respectively. The components were implanted close to the positions recommended by the preoperative simulation. The ratio of the moment arms indicated that the converted hips were reconstructed in a biomechanically correct manner. The implants for the conversion to THA were successfully positioned with respect to anatomy and functional outcome. The median JOA hip score improved from 50 points (range, 30-66 points) preoperatively to 79 points (range, 72-86 points) at the latest follow-up. CONCLUSIONS: CT-based preoperative 3D planning could be a powerful guidance tool for conversion of arthrodesed hips to THAs.
• 下部体幹筋の収縮の有無が歩行立脚後期の股関節伸展運動に与える影響

  西村 圭二; 南部 利明; 北村 淳; 山﨑 敦; 後藤 公志; 杉本 正幸

  理学療法学Supplement 公益社団法人 日本理学療法士協会 2014 1848 - 1848 2015 

  【はじめに】変形性股関節症患者の歩行では，立脚中期から後期における股関節伸展を腰椎や骨盤で代償する場合がある。原因として，股関節伸展可動域制限，殿筋筋力低下，下部体幹筋安定性低下などが挙げられる。先行研究において，下部体幹筋収縮の意識により，腹臥位での股関節伸展や歩行立脚期を想定した前方へのステップ動作時の股関節伸展運動軸が解剖学的な運動軸に近づくことを報告した。そこで今回は，歩行を想定した前方へのステップ動作において下部体幹筋収縮の意識の有無による股関節伸展角度，骨盤および体幹傾斜角度変化について検討したので報告する。【方法】対象は健常成人10名（平均年齢30.0±4.5歳，身長172.0±2.3cm）で，股関節伸展，外転可動域および大殿筋，中殿筋筋力が正常である者とした。計測肢位は，マーカーを大転子頭側，上前腸骨棘，上後腸骨棘，腸骨稜，膝外側関節裂隙，上半身重心位置に付けた矢状面とし，歩行の立脚中期から後期を想定した前方へのステップ動作を立脚側からビデオカメラにて撮影した。この動作を下部体幹筋収縮を意識しない状態と意識した状態で各々実施した。計測前に5回練習した。下部体幹筋収縮は，まず背臥位にて骨盤底筋の収縮を伴う腹横筋と多裂筋の同時収縮を検者が触診にて指導し，さらに立位にて収縮を確認した後，ステップ動作で再現した。同様の計測を変形性股関節症によるTHA3週後（退院時）患者5名にも実施した。撮影動画より矢状面における立脚後期の股関節伸展角度，骨盤傾斜角度，体幹傾斜角度をImage Jにてパソコン上で求め，各々を比較した。計測方法は，股関節伸展は大転子頭側と膝外側関節裂隙を結ぶ線と垂直線とのなす角度，骨盤傾斜は上前腸骨棘と上後腸骨棘とを結ぶ線と水平線とのなす角度，体幹傾斜は上半身重心位置と腸骨稜を結ぶ線と垂直線とのなす角度とした。静止立位における各々の角度も計測し，下部体幹筋収縮意識の有無によるステップ動作時と静止立位時の角度を比較し変化量として算出した。統計処理は対応のあるt検定を用い，危険率5％未満とした。【結果】骨盤傾斜角度は意識無2.0±1.0°，意識有3.0±1.1°と後傾増加（前傾減少）を認めた（p＜0.01）。体幹傾斜角度は意識無0.7±3.8°，意識有0.8±3.1°と伸展が増加し，股関節伸展角度は意識無4.1±2.5°，意識有5.6±3.2°と増加したが有意差はなかった。THA3週後患者でも意識することにより同様の傾向を示したが，角度変化量にはばらつきを認めた。【考察】歩行立脚期を想定した前方へのステップ動作において，下部体幹筋収縮を意識したことで立脚後期での骨盤前傾が減少し，さらに体幹前傾減少，股関節伸展角度増加傾向を示した。一般的に立脚後期では股関節伸展に伴い骨盤前傾が生じ，見かけ上の股関節過伸展を助長するといわれている。しかし，THA後患者の歩行では，股関節伸展可動域がある程度得られていても，術前の姿勢や歩容の影響を受け，立脚後期の股関節伸展が不十分となり，骨盤の過剰な前傾や後退，腰椎伸展増大などで代償する場合がある。下部体幹筋が収縮すると腹腔内圧が上昇し腰椎の安定化作用が得られることや，頭尾側方向に積極的に体幹を伸展することで腹横筋の活動が高まることが報告されている。したがって，下部体幹筋収縮の意識により健常成人においても骨盤や体幹の動きが軽減し，股関節伸展角度が増加したことから，THA後患者の歩容改善の一助となる可能性が示唆された。THA3週後患者でも同様の傾向を示したが，角度変化量にばらつきを認めたため，下部体幹筋収縮の意識を反復的且つ継続的に実施した上での効果の検討がさらに必要であると考える。【理学療法学研究としての意義】股関節疾患は不良姿勢を伴うことが多く，手術を施行しても術前の歩行パターンを改善するのに時間を要する。特に変形性股関節症ではTHA後に理学療法を実施し，疼痛や可動域，筋力は改善しても，立脚後期における股関節伸展を腰椎および骨盤にて代償する症例を臨床上経験する。先行研究により，前方へのステップ動作にて，下部体幹筋収縮を意識することで股関節伸展の運動軸が解剖学的運動軸に近づく傾向を示した。これを踏まえ，本研究の結果より下部体幹筋収縮を意識したことで骨盤前傾および体幹前傾減少，股関節伸展増大傾向を認めたことから，代償を抑制した状態で，より股関節を中心とした立脚後期に繋がる可能性が示唆された。股関節機能の改善だけでなく，下部体幹筋の収縮方法も十分に指導し，腰椎および骨盤の安定化を得ることも，歩容改善の一助となるといえる。
• 間葉系幹細胞を用いた骨壊死治療法

  戸口田淳也; 青山朋樹; 柿木良介; 後藤公志; 笠井泰成

  関節外科 34 (5) 14 - 19 2015 [Invited]
  
• Two-staged reconstruction for ankylosed hip with severe limb shortening: a case report.

  Koji Goto; Kazutaka So; Yutaka Kuroda; Keiichi Kawanabe; Shuichi Matsuda

  Hip international : the journal of clinical and experimental research on hip pathology and therapy 24 (6) 660 - 3 2014/12 [Refereed]
   

  A 58-year-old man developed a 14 cm limb length discrepancy with a shortened and ankylosed right hip as a sequelae of multiple surgeries for recurrent dislocation and periprosthetic joint infection. He was successfully treated by limb elongation with external fixation and subsequent revision total hip arthroplasty. We discuss the efficacy of the two-staged reconstruction with initial limb elongation.
• THA再置換(大腿骨側) 術前偽関節の大転子を人工股関節再置換術時に再固定した6症例の術後成績の検討

  後藤 公志; 田中 淳; 櫻木 淳史; 朴 憲之; 古屋 佑樹; 村田 巨樹; 堤 聖吾; 廣瀬 伸次; 杉本 正幸

  日本人工関節学会誌 (一社)日本人工関節学会 44 473 - 474 1345-7608 2014/12 

  術前に大転子偽関節を認めrevision THA時に大転子再固定を行った6例の術後成績を検討した。再置換術時年齢は平均73.7歳で、いずれも初回THA時にCharnley typeのインプラントを使用し、大転子切離後の偽関節を生じていた。偽関節部の再固定にはcable grip systemを使用し、再固定時の骨欠損部には3例で他家骨移植を行った。術後骨癒合が得られた症例はなく、全例で偽関節となり、4例でcable grip systemの抜去を行い、1例でロングプレートへの入れ替えを行った。抜去理由は感染・脱臼が1例、wire破損による痛みが1例、破損したwire周囲の骨溶解が2例であった。最終評価時には3例で再々置換術が行われていた。
• THA術後の関節内へのトラネキサム酸投与と、エピネフリン入りトラネキサム酸投与の比較検討

  櫻木 淳史; 後藤 公志; 杉本 正幸; 古屋 佑樹; 田中 淳; 村田 巨樹

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 57 (秋季学会) 225 - 225 0008-9443 2014/09
• フランジタイプのElite Plus stemの抜去には注意が必要である

  後藤 公志; 古屋 佑樹

  Hip Joint 日本股関節学会 40 1029 - 1031 0389-3634 2014/08 

  74歳女。慢性関節リウマチで両側のセメント人工股関節全置換術(THA)を施行した。その後、右股関節痛が出現し、KTプレートのmigrationを伴うソケットの緩みを認め、再置換術を施行した。臼蓋側の再置換を行いやすくするため、緩んでいないステム再置換を行った。ステム抜去の際に、前方フランジの上縁に打ち込み棒を当てて金属ハンマーで近位方向へ打ち出そうとしたが、大転子基部で骨折を生じ、骨折部はオートロンワイヤーで固定した。臼蓋側はKTプレートとallo graftを用いて再建し、CLHOソケットをセメント固定し、大腿側は6型ステムをセメントインセメントで固定した。術後1年の現在、反対側のsocket looseningと関節リウマチのためにADL制限はあるものの、特に痛みはなく歩行可能である。骨溶解やインプラントのゆるみを認めず、経過良好である。
• An exploratory clinical trial for idiopathic osteonecrosis of femoral head by cultured autologous multipotent mesenchymal stromal cells augmented with vascularized bone grafts.

  Tomoki Aoyama; Koji Goto; Ryosuke Kakinoki; Ryosuke Ikeguchi; Michiko Ueda; Yasunari Kasai; Taira Maekawa; Harue Tada; Satoshi Teramukai; Takashi Nakamura; Junya Toguchida

  Tissue engineering. Part B, Reviews 20 (4) 233 - 42 2014/08 [Refereed]
   

  Idiopathic osteonecrosis of femoral head (ION) is a painful disorder that progresses to collapse of the femoral head and destruction of the hip joint. Although its precise pathology remains unknown, the loss of blood supply causing the loss of living bone-forming cells is a hallmark of the pathophysiology of osteonecrosis. Transplantation of multipotent mesenchymal stromal cells (MSCs) is a promising tool for regenerating the musculoskeletal system. The aim of the present study was to assess the safety and efficacy of transplantation of cultured autologous bone marrow-derived MSCs mixed with β-tricalcium phosphate (β-TCP) in combination with vascularized bone grafts for the treatment of advanced stage ION in a clinical trial. Ten patients with stage 3 ION were enrolled in this study. Autologous bone marrow-derived MSCs were cultured with autologous serum, and cells (0.5-1.0×10(8)) were transplanted after mixing with β-TCP granules in combination with vascularized iliac bone grafts. Patients were assessed 24 months after treatment. The primary and secondary endpoints were progression of the radiological stage and changes in bone volume at the femoral head, and clinical score, respectively. Nine of ten patients completed the protocol, seven of whom remained at stage 3, and the remaining two cases progressed to stage 4. The average bone volume increased from 56.5±8.5 cm(3) to 57.7±10.6 cm(3). The average clinical score according to the Japan Orthopaedic Association improved from 65.6±25.5 points to 87.9±19.0 points. One severe adverse event was observed, which was not related to the clinical trial. Although the efficacy of cell transplantation was still to be determined, all procedures were successfully performed and some young patients with extensive necrotic lesions with pain demonstrated good bone regeneration with amelioration of symptoms. Further improvements in our method using MSCs and the proper selection of patients will open a new approach for the treatment of this refractory disease.
• Cortical bone trajectoryを用いた脊椎固定術の経験

  櫻木 淳史; 朴 憲之; 古屋 佑樹; 村田 巨樹; 田中 淳; 堤 聖吾; 江藤 謹司; 後藤 公志; 杉本 正幸

  滋賀医学 (一社)滋賀県医師会 36 133 - 133 0288-9765 2014/03
• 関節リウマチの治療におけるMTXの増量阻害因子

  廣瀬 伸次; 杉本 正幸; 後藤 公志; 江藤 謹司; 村田 巨樹; 堤 聖吾; 櫻木 淳史; 田中 淳; 古屋 佑樹; 朴 憲之; 琴浦 良彦

  滋賀医学 (一社)滋賀県医師会 36 135 - 135 0288-9765 2014/03
• THA後の術後回収式ドレーンと、術後トラネキサム酸関節内投与、非回収式ドレーン併用との比較検討

  朴 憲之; 後藤 公志; 田中 淳; 櫻木 淳史; 堤 聖吾; 杉本 正幸

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 56 (4) 957 - 958 0008-9443 2013/07 

  人工膝関節置換術(THA)症例94例の出血量の軽減を目的に、術後回収式ドレーンを使用した29例(A群)と、トラネキサム酸関節内投与と非回収式ドレーンの併用を行った29症例(B群)ついて比較検討した。術後Hb推移において、術後14日目までB群がA群よりHb値が高かった。CPKは術前はA群が93.4、B群が89.5から術翌日にはA群は1121.3、B群は656.4となり、B群で有意に低かった。また、CRPは術翌日と術後7日目において有意にB群で低かった。患者背景および術中、術後出血量、術後平均日数は有意差を認めなかった。以上の結果から、B群はA群よりも術後の出血を抑制でき、術後早期のCRP、CPKの上昇を抑制することが示唆された。
• 吸収性材料を移植骨固定に用いた臼蓋形成術(Spitzy変法)の術後短期成績

  後藤 公志; 杉本 正幸; 櫻木 淳史; 堤 聖吾; 増田 尚也; 江藤 謹司

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 56 (1) 27 - 28 0008-9443 2013/01
• 大腿骨頸部の骨隆起に対し、小皮切前方アプローチによる切除を行った2例

  増田 尚也; 後藤 公志; 江藤 勤司; 杉本 正幸; 琴浦 良彦

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 55 (5) 1025 - 1026 0008-9443 2012/09 

  Femoroacetabular impingementを引き起こしていると考えられる大腿骨頸部に骨隆起を認めた2症例(症例1:38歳女性、症例2:77歳男性)に対して関節鏡による関節唇の処置と小皮切前方アプローチによる骨隆起切除の経験を報告した。症例1は他院にて4年前と2年前に右大腿骨頸部内方と後方の外骨腫切除歴があり、5ヵ月前より屈曲時の右股関節前方の痛みが増悪し、手術目的で入院となった。術中所見では関節鏡視では関節唇と関節軟骨に明らかな損傷や変性を認めず、皮切約7cmの小皮切アプローチにて骨隆起を切除、指で触れながら股関節を屈曲させimpingeしないことを確認した。その結果、術前と最終調査時の屈曲可動域は90°から110°に、JOAスコアは62点から76点に改善した。症例2は除雪作業中に右股関節に痛みを生じ、1ヵ月後に受診となり、3ヵ月間の保存療法では痛みが改善しないことから手術目的で入院となった。術中所見では関節鏡視にて関節唇の損傷を認めたが、縫合は行わず、滑膜切除のみを行い、次に小皮切アプローチにて直視下に骨隆起を切除した。その結果、術前と最終調査時の屈曲可動域は90°から120°に、JOAスコアは47点から93点に改善した。
• 【幹細胞治療-基礎研究の進歩と臨床応用-】臨床応用の進歩 大腿骨頭無腐性壊死症に対する細胞治療

  戸口田 淳也; 青山 朋樹; 後藤 公志; 柿木 良介; 笠井 泰成

  日本臨床 (株)日本臨床社 69 (12) 2225 - 2230 0047-1852 2011/12 [Refereed]
  
• 新しい医療技術 新しい生体活性骨セメント

  後藤 公志; 中村 孝志

  整形・災害外科 金原出版(株) 54 (12) 1503 - 1507 0387-4095 2011/11
• Bone bonding ability and handling properties of a titania-polymethylmethacrylate (PMMA) composite bioactive bone cement modified with a unique PMMA powder.

  C Fukuda; K Goto; M Imamura; M Neo; T Nakamura

  Acta biomaterialia 7 (10) 3595 - 600 2011/10 [Refereed]
   

  One of the challenges of using bioactive bone cements is adjusting their handling properties for clinical application. To resolve the poorer handling properties of bioactive bone cements we developed a novel bioactive bone cement containing a unique polymethylmethacrylate (PMMA) powder, termed SPD-PMMA (40 μm in diameter), composed of cohered minute particles of PMMA (0.5 μm). The present study aimed to examine the mechanical and handling properties and the in vivo bone bonding strength of this cement. The titania content of the cement varied from 10 to 30 wt.% (Ts10, Ts20, and Ts30). The mechanical and thermal properties of Ts10 and Ts20 exceeded those of commercially available PMMA cements (PMMAc). The setting properties of Ts20, including a shorter dough time and a working time that was comparable with that of PMMAc, were adequate for clinical application. Hardened cylindrical cement specimens were inserted into rabbit femurs and the interfacial shear strengths were measured by a push-out test at 6, 12, and 26 weeks after the operation. The interfacial shear strength values (in Newtons per square millimeter) of Ts10, Ts20, and Ts30 at 12 weeks and those of Ts20 and Ts30 at 26 weeks were significantly higher than that of PMMAc (P<0.05). These results show that a bioactive titania-PMMA composite bone cement modified by SPD-PMMA particles possesses adequate mechanical and handling properties, as well as osteoconductivity and in vivo bone bonding ability, and can be used for prosthesis fixation.
• Load dispersion effects of acetabular reinforcement devices used in revision total hip arthroplasty: a simulation study using finite element analysis.

  Keiichi Kawanabe; Haruhiko Akiyama; Koji Goto; Sumihiko Maeno; Takashi Nakamura

  The Journal of arthroplasty 26 (7) 1061 - 6 2011/10 [Refereed]
   

  Several types of acetabular reinforcement devices are used to prevent the collapse of grafted bone in revision total hip arthroplasty. However, it remains unclear how the stress is reduced by different devices. We used finite element analysis to evaluate 4 types of acetabular reinforcement devices: Kerboull-type device, Burch-Schneider anti-protrusio cage, Mueller ring, and Ganz ring. The control was a socket fixed with bone cement without any reinforcement devices. The stress distribution on the inner surface of each socket was calculated by binarization image processing. For all 4 reinforcement devices, the stress was reduced to less than one-half of that in the control. All the devices were useful for preventing the collapse of bulk bone grafts applied to load-bearing defects.
• Revision total hip arthroplasty using a Kerboull-type acetabular reinforcement device with bone allograft: minimum 4.5-year follow-up results and mechanical analysis.

  H Akiyama; K Yamamoto; M Tsukanaka; K Kawanabe; H Otsuka; K So; K Goto; T Nakamura

  The Journal of bone and joint surgery. British volume 93 (9) 1194 - 200 2011/09 [Refereed]
   

  We retrospectively reviewed 40 hips in 36 patients who had undergone acetabular reconstruction using a titanium Kerboull-type acetabular reinforcement device with bone allografts between May 2001 and April 2006. Impacted bone allografts were used for the management of American Academy of Orthopaedic Surgeons Type II defects in 17 hips, and bulk bone allografts together with impacted allografts were used for the management of Type III defects in 23 hips. A total of five hips showed radiological failure at a mean follow-up of 6.7 years (4.5 to 9.3), two of which were infected. The mean pre-operative Merle d'Aubigné score was 10 (5 to 15) vs 13.6 (9 to 18) at the latest follow-up. The Kaplan-Meier survival rate at ten years, calculated using radiological failure or revision of the acetabular component for any reason as the endpoint, was 87% (95% confidence interval 76.3 to 97.7). A separate experimental analysis of the mechanical properties of the device and the load-displacement properties of bone grafts showed that a structurally hard allograft resected from femoral heads of patients with osteoarthritis should be preferentially used in any type of defect. If impacted bone allografts were used, a bone graft thickness of < 25 mm was acceptable in Type II defects. This clinical study indicates that revision total hip replacement using the Kerboull-type acetabular reinforcement device with bone allografts yielded satisfactory mid-term results.
• Cemented total hip arthroplasty with subtrochanteric femoral shortening transverse osteotomy for severely dislocated hips: outcome with a 3- to 10-year follow-up period.

  Haruhiko Akiyama; Keiichi Kawanabe; Koji Yamamoto; Yutaka Kuroda; Kazutaka So; Koji Goto; Takashi Nakamura

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 16 (3) 270 - 7 2011/05 [Refereed]
   

  BACKGROUND: Total hip arthroplasty (THA) for the treatment of severe dislocation of the hip is a technically demanding procedure. In most previous reports, techniques and clinical outcomes using cementless prostheses are widely reported, but there have been few reports on the technique and outcomes using cemented prostheses. The purpose of this study was to evaluate the outcomes of a cemented THA with a simultaneous subtrochanteric femoral shortening transverse osteotomy in patients with Crowe type III or IV developmental dysplasia of the hip. METHODS: We retrospectively reviewed 15 hips in 11 patients who underwent cemented THA with subtrochanteric femoral shortening transverse osteotomy and with placement of the acetabular component at the level of the anatomic hip center. Patients were evaluated preoperatively and postoperatively with the Merle d'Aubigné and Postel hip score. Radiographic examination was performed to evaluate the level of the femoral osteotomy site, of the radiographic leg lengthening, and of bone union. RESULTS: The clinical evaluation by the Merle d'Aubigné and Postel hip score was improved from 8.1 ± 2.5 preoperatively to 15.1 ± 1.3 at the time of final follow-up. Radiographic evidence of bone union at the osteotomy site appeared at more than 6 months after operation. Moreover, there were 3 (20%) nonunions that needed reoperation. No acetabular and femoral components exhibited radiological loosening at the time of final follow-up. In addition, one delayed union causing thigh pain was treated with low-intensity pulsed ultrasound that accelerated bone formation. CONCLUSION: Our results in this study indicate that we should prevent instability at the transverse osteotomy site and an adequate intercalary cortical bone graft is needed to prevent nonunion in cemented THA combined with a subtrochanteric femoral shortening transverse osteotomy. We should apply this procedure with caution in patients, especially those who show less potential bone formation activity.
• 変形性股関節症患者におけるリーチ動作の運動学的・運動力学的特徴

  福元 喜啓; 建内 宏重; 塚越 累; 上村 一樹; 秋山 治彦; 後藤 公志; 宋 和隆; 中村 孝志; 市橋 則明

  理学療法学 (公社)日本理学療法士協会 38 (Suppl.2) PI1 - 232 0289-3770 2011/04
• [Cell therapy for aseptic necrosis of femoral head].

  J. Toguchida; T. Aoyama; K. Goto; R. Kakinoki; Y. Kasai

  Nihon rinsho. Japanese journal of clinical medicine 69 (12) 2225 - 2230 2011 [Refereed]
  
• Bioactive bone cement with a low content of titania particles without postsilanization: effect of filler content on osteoconductivity, mechanical properties, and handling characteristics.

  C Fukuda; K Goto; M Imamura; T Nakamura

  Journal of biomedical materials research. Part B, Applied biomaterials 95 (2) 407 - 13 2010/11 [Refereed]
   

  In this study, we developed three types of polymethylmethacrylate (PMMA)-based composite cement with low contents of nonsilanized titania particles (5, 10, and 20 wt % TiO(2), respectively: designated T5, T10, and T20). The osteoconductivity, mechanical properties, and handling characteristics of these cements were compared with those of commercially available PMMA cement (PMMAc). The cement was inserted into rat tibiae and solidified in situ. After 6 and 12 weeks, tibiae were removed for evaluation of osteoconductivity using Stevenel's Blue and Van Gieson's picrofuchsin staining. The affinity indices reflecting the osteoconductivity of T10 and T20 were 33.4 ± 12.8 and 56.5 ± 14.1 at 6 weeks, and 67.0 ± 18.0 and 65.0 ± 51.7 at 12 weeks, respectively, and were significantly higher than for PMMAc (p < 0.01). The compressive and flexural strengths of T5, T10, and T20 exceeded those of PMMAc, whereas the elasticity did not differ significantly. Scanning electron microscopy and energy-dispersive X-ray microanalysis showed that the micron-sized and spherical titania particles were well dispersed in T20 and were exposed on the surface of the cement that made direct contact with bone. These results show that T20 is a promising bioactive bone cement for use in prosthesis fixation.
• 変形性股関節症患者の股関節機能と前額面上における骨盤および脊椎のアライメントの関連性

  西村 純; 南角 学; 秋山 治彦; 後藤 公志; 中村 孝志

  Hip Joint 日本股関節学会 36 (Suppl.) 60 - 62 0389-3634 2010/10 

  片側変形性股関節症患者43例を対象に、股関節機能(脚長差、患側股関節外転筋力)の測定と、全脊柱X線画像の前額面上における骨盤・脊椎アライメントの測定を行い、相互の関連性について検討した。その結果、骨盤が患側方向に傾斜している症例では[脚長差]と[骨盤傾斜角][胸椎側彎角]との間に有意な相関が認められた。骨盤が健側方向に傾斜している症例ではこのような相関は認められなかった。
• 年齢が人工股関節全置換術後における術後経過に及ぼす影響 杖歩行自立までの期間と運動機能の回復過程に着目して

  藤田 容子; 南角 学; 西村 純; 安藝 浩嗣; 秋山 治彦; 後藤 公志; 中村 孝志

  Hip Joint 日本股関節学会 36 (Suppl.) 131 - 133 0389-3634 2010/10 

  人工股関節全置換術術後リハビリテーションプロトコールにしたがって理学療法を行った91名(男性9名、女性82名・35〜79歳)を対象に、運動機能と杖歩行自立までの期間を、年齢別(50歳未満:A群、50〜59歳:B群、60〜69歳:C群、70歳以上:D群)に分け比較した。股外転筋力は術前、術後とも各群間で有意差を認め、特にD群で有意に低値であった。膝伸展筋力は術前、術後とも各群間で有意差を認め、特に術前はD群でA・B群より有意に低値を示し、術後はA群でB・D群より有意に高値を示した。Time up and go testは術前では各群間に有意差はなかったが、術後は各群間に有意差を認め、特に術前はD群でA群より有意に高値を示し、術後はD群が他3群より有意に高値であった。運動機能の回復率は各群間に有意差はなかったが、杖歩行自立までの期間はD群で他3群より有意に長期であった。
• アプローチ方法の違いが人工股関節全置換術後の機能回復に及ぼす影響 Modified mini-one antero-lateral incision(MMIS)法とDall法の比較

  安芸 浩嗣; 南角 学; 西村 純; 藤田 容子; 秋山 治彦; 後藤 公志; 中村 孝志

  Hip Joint 日本股関節学会 36 (Suppl.) 134 - 136 0389-3634 2010/10 

  人工股関節全置換術を行った片側変形性股関節症29名(全例女性)を対象に、アプローチ方法別にmodified mini-one antero-lateral incision(MMIS)法14名(平均63.3歳)と従来のDall法15名(平均61.6歳)に分け、下肢機能の回復率、杖歩行自立までの期間を比較した。術前/術後の筋力値(Nm/kg)は股関節外転筋力がMMIS群0.53/0.50、Dall群0.49/0.50と両群とも有意差はなく、膝関節伸展筋力がMMIS群1.38/1.18、Dall群1.40/0.79とDall群で術後有意に低値であった。術側下肢筋力回復率は股関節外転筋力がMMIS群97.4%、Dall群109.1%と有意差はなく、膝関節伸展筋力はMMIS群90.0%、Dall群57.0%と有意差を認めた。杖歩行自立に要した日数はMMIS群8.7日、Dall群12.3日、術後在院日数はMMIS群22.8日、Dall群28.1日といずれもMMIS群で有意に低値であった。
• Long-term results of cemented total hip arthroplasty in developmental dysplasia with acetabular bulk bone grafts after improving operative techniques.

  Haruhiko Akiyama; Keiichi Kawanabe; Hirokazu Iida; Pan Haile; Koji Goto; Takashi Nakamura

  The Journal of arthroplasty 25 (5) 716 - 20 2010/08 [Refereed]
   

  We present the long-term results (mean follow-up, 11.8 years; range, 6.3-15.4 years) of cemented total hip arthroplasty with acetabular bulk bone grafting in 147 dysplastic hips using improved surgical techniques. Operations were performed through a direct lateral approach with partial trochanteric osteotomy to avoid nonunion of the greater trochanter. Bioresorbable poly(l-lactide) screws were used for fixation of the acetabular bone grafts to prevent any possible delayed remodeling. Preoperative planning using computer simulation was performed to estimate the optimal size and position of the acetabular component. Analysis predicted rates of survival of the acetabular component of 96% and 91% at 15 years, with revision for aseptic loosening and radiologic loosening as the end points, respectively. Our results indicate excellent long-term clinical and radiographic survivorship of a cemented acetabular component with bulk autograft for acetabular dysplasia.
• Long-term survivorship analysis of hip arthroplasty with vitallium mold cup.

  Hai-Le Pan; Haruhiko Akiyama; Keiichi Kawanabe; Koji Goto; Kazutaka So; Takashi Nakamura

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 15 (4) 459 - 62 2010/07 [Refereed]
   

  BACKGROUND: Cup arthroplasty was used in the initial attempts to preserve the bone stock of the femoral head and neck for hip reconstruction. However, little conclusive data are available regarding its long-term survivorship. METHODS: We present a long-term survivorship analysis (mean follow-up, 19.3 years; range, 5-36.6 years) after vitallium mold arthroplasty in 77 secondary osteoarthritic hips. RESULTS: Kaplan-Meier survivorship analysis predicted a survival rate for vitallium mold arthroplasty of 81.6% (95% confidence interval [CI], 76.7-86.5) at 20 years and 59.1% (95% CI, 51.8-66.5) at 30 years, with conversion to total hip arthroplasty as the endpoint. The mean Merle d'Aubigné and Postel hip score showed a significant decrease in mobility from 4.12 (range, 3.18-5.86) 6 months after the operation to 3.19 (range, 1.7-4.6) at the last follow-up. No significant differences were observed for the pain score from 6 months after the operation (5.05; range, 4.2-5.9) to the last follow-up (4.46; range, 2.88-6.04)) or score for the ability to walk, from 6 months after the operation (2.5; range, 1.4-3.6) to the last follow-up (3.13; range, 1.59-4.67). Radiographically, the proximal and medial migration of the cup measured at the last follow-up was 10.4 +/- 5.4 mm (P < 0.01) and 0.2 +/- 2.1 mm (P > 0.05), respectively. CONCLUSIONS: Our results indicate inferior long-term survivorship after vitallium mold compared with that after Charnley low-friction arthroplasty.
• 股関節疾患患者における歩行速度と腰椎アライメント・脚長差・下肢筋力の関連性 変形性股関節症と大腿骨頭壊死症の比較

  西村 純; 南角 学; 森 公彦; 安藝 浩嗣; 新宮 信之; 藤田 容子; 秋山 治彦; 後藤 公志; 中村 孝志

  理学療法学 (公社)日本理学療法士協会 37 (Suppl.2) 667 - 667 0289-3770 2010/03
• 自主臨床試験に参加した被験者を対象としたCRCの貢献に関する質問票調査

  三浦 和美; 八田 太一; 村山 敏典; 秋山 治彦; 後藤 公志; 赤水 尚史; 中村 孝志; 横出 正之

  臨床薬理 (一社)日本臨床薬理学会 41 (1) 53 - 57 0388-1601 2010/01 

  自主臨床試験の被験者が治験コーディネーター(CRC)の治験支援活動をどのように評価しているか、特に治験参加の意思決定にCRCがどう関与しているか検討した。人工股関節置換術の第II相プラセボ対照比較試験に参加した被験者32名(男性7名、女性25名、平均61歳)を対象に、治験終了後に無記名の選択・記述式質問票を郵送し、CRCによる治験支援について調査(回収率91%)した。その結果、CRCの存在を事前に知っていた被験者(4%)は少なかったが、CRCによる説明、病室訪問、検査同行などの治験支援に対してはほぼ全員が好意的に評価し、試験参加の満足度も高かった。また、治験におけるCRCの必要性を被験者全員が認識していた。
• Bonding ability evaluation of bone cement on the cortical surface of rabbit's tibia.

  K Goto; K Kawanabe; R Kowalski; D Baker; T Nakamura

  Journal of materials science. Materials in medicine 21 (1) 139 - 46 2010/01 [Refereed]
   

  A composite bone cement designated G2B1 that contains beta tricalcium phosphate particles was developed as a bone substitute for percutaneous transpedicular vertebroplasty. In this study, both G2B1 and commercial PMMA bone cement (CMW1) were implanted into proximal tibiae of rabbits, and their bone-bonding strengths were evaluated at 4, 8, 12 and 16 weeks after implantation. Some of the specimens were evaluated histologically using Giemsa surface staining, contact microradiography (CMR) and scanning electron microscopy (SEM). Histological findings showed that G2B1 contacted bone directly without intervening soft tissue in the specimens at each time point, while there was always a soft tissue layer between CMW1 and bone. The bone-bonding strength of G2B1 was significantly higher than that of CMW1 at each time point, and significantly increased from 4 weeks to 8 and 12 weeks, while it decreased significantly from 12 weeks to 16 weeks. Bone remodeling of the cortex under the cement was observed especially for G2B1 and presumably influenced the bone bonding strength of the cement. The results indicate that G2B1 has bioactivity, and bone bonding strength of bioactive bone cements can be estimated fairly with this experimental model in the short term.
• 横止め螺子付き大腿骨ステムの使用経験

  川那辺 圭一; 秋山 治彦; 後藤 公志; 中村 孝志

  東海関節 (NPO)生体材料研究所 1 1 - 5 1883-6798 2009/12
• Computed tomography-based navigation to determine the femoral neck osteotomy and location of the acetabular socket of an arthrodesed hip.

  Haruhiko Akiyama; Keiichi Kawanabe; Taisuke Ito; Koji Goto; Manabu Nangaku; Takashi Nakamura

  The Journal of arthroplasty 24 (8) 1292.e1-4  2009/12 [Refereed]
   

  In the conversion of an arthrodesed hip to a total hip arthroplasty, the osteotomy of the femoral neck and the placement of the acetabular socket are difficult procedures as anatomical abnormalities hamper identification of the femoral neck and of the original center of the acetabulum. A 59-year-old woman who had a hip arthrodesis for dysplastic osteoarthritis at 21 years of age underwent total hip arthroplasty for relief of back pain, achievement of good gait function, and improvement of activities of daily living. In this report, we introduce a technical solution, using a computed tomography-based navigation system to determine the site and direction of the femoral neck osteotomy and the positioning of the acetabular socket.
• Long-term results of cemented total hip arthroplasty for dysplasia, with structural autograft fixed with poly-L-lactic acid screws.

  Koji Goto; Haruhiko Akiyama; Keiichi Kawanabe; Kazutaka So; Takeshi Morimoto; Takashi Nakamura

  The Journal of arthroplasty 24 (8) 1146 - 51 2009/12 [Refereed]
   

  This study reviewed a series of cemented total hip arthroplasty (THA) for dysplasia, with structural autograft fixed with poly-L-lactic acid screws. Grafted bone union was confirmed radiologically in every case, and there were no cases of early collapse or extravasation of grafted bone. Kaplan-Meier survivorship analysis of socket revision, radiologic loosening of the socket, and the appearance of a radiolucent line greater than 1 mm in the graft-socket interface as the end points indicated survival rates of 99%, 97.1%, and 63.5% at 10 years and 96.6%, 90.2%, and 56.1% at 15 years, respectively. The results of this study indicated that poly-L-lactic acid screws are safe and useful for the fixation of acetabular bone graft concomitant to cemented THA with a careful rehabilitation program.
• Clinical results of the wear performance of cross-linked polyethylene in total hip arthroplasty: prospective randomized trial.

  Kentaro Ise; Keiichi Kawanabe; Jiro Tamura; Haruhiko Akiyama; Koji Goto; Takashi Nakamura

  The Journal of arthroplasty 24 (8) 1216 - 20 2009/12 [Refereed]
   

  To investigate the clinical results of cross-linked polyethylene (CLPE) and to compare the CLPE wear against zirconia and stainless steel heads, we studied the radiographic wear after a minimum 3-year follow-up in total hip arthroplasty (THA). Ninety-four hips were randomly implanted with a 22.225-mm head cemented THA-the group of non-CLPE against zirconia and CLPE against 2 different zirconias and stainless steel. The linear wear rate was significantly lower in the group of CLPE against zirconia (0.067, 0.059 mm/y) and against stainless steel (0.068 mm/y) compared with non-CLPE against zirconia (0.170 mm/y). In the short-term results, the wear performance of CLPE against zirconia was superior to that of non-CLPE; however, it did not show a better wear rate than CLPE against stainless steel. Furthermore, long-term investigations will be necessary for understanding CLPE wear in vivo.
• 人工股関節置換術後における足の爪切り方法と股関節可動域との関連性

  南角 学; 高木 彩; 藤田 容子; 秋山 治彦; 後藤 公志; 中村 孝志

  Hip Joint 日本股関節学会 35 (Suppl.) 20 - 22 0389-3634 2009/10 

  人工股関節置換術を施行した66例80関節(男11例・女55例)を対象に、術後の足の爪切り動作と股関節可動域との関係を調べた。術後2ヵ月〜5年で、足の爪切りが自立していたのは62関節、非自立が18関節であった。股関節可動域を比較すると、屈曲および外旋角度は自立群が非自立群に比較して有意に大きかったが、外転角度には有意差はなかった。判別分析の結果、自立群と非自立群における股関節可動域の判別点は、屈曲角度が79.8°(判別的中率81.1%)、外旋角度が26.5°(的中率63.3%)であった。また、足の爪切り方法は、股関節屈曲・膝関節屈曲位が27関節(A群)、股関節屈曲・外転・外旋位が11関節(B群)、股関節屈曲・膝関節伸展位が14関節(C群)、股関節屈曲・軽度内旋・膝関節屈曲位が10関節(D群)であった。各群の股関節可動域は、A群およびB群が屈曲ではD群に、外転および外旋角度ではC群に比較して有意に大きかった。
• 人工股関節置換術後におけるT字杖歩行獲得時期が術後の下肢筋力の回復に及ぼす影響

  高木 彩; 南角 学; 秋山 治彦; 後藤 公志; 中村 孝志

  Hip Joint 日本股関節学会 35 (Suppl.) 66 - 68 0389-3634 2009/10 

  人工股関節置換術(THA)を施行した片側変形性股関節症50例(男8例・女42例・平均58.5歳)を対象に、T字杖歩行獲得時期と下肢筋力回復との関係を検討した。獲得時期は平均12.2日で、10日以内が20例(平均55.0歳:A群)、11〜15日が18例(平均58.7歳:B群)、16日以上が12例(平均63.9歳:C群)であった。各群間で年齢、BMIには有意差を認めたが、術前の術側股関節外転筋力、膝関節伸展筋力には有意差は認めなかった。術前と術後の比較では、股関節外転筋力にはA群およびB群は有意差を認めなかったが、C群は術後有意に低下していた。膝関節伸展筋力は全群で術後有意に低下していた。術後4週の下肢筋力回復率をみると、C群の股関節外転筋力はA群およびB群に比較して有意に低値であった。肘関節伸展筋力の回復率は、各群間に有意差は認めないもののC群で最も低値であった。以上、THA術後早期にT字杖歩行を獲得することで術後の廃用性の筋力低下を予防できることが示唆された。
• 人工股関節置換術患者の術前の運動機能が術後初回離床時の介助の有無に与える影響

  藤田 容子; 南角 学; 高木 彩; 秋山 治彦; 後藤 公志; 中村 孝志

  Hip Joint 日本股関節学会 35 (Suppl.) 86 - 88 0389-3634 2009/10 

  人工股関節置換術を施行した変形性股関節症患者67例(女・平均58.3歳)を対象に、術前運動機能と術後初回離床時介助の有無との関係について検討した。運動機能の股関節外転筋力の測定にはHand-Held Dynamometerを、膝関節伸展筋力の測定にはIsoforce GT-330を使用した。初回離床時に介助が不要であったのは28例(平均56.6歳:A群)、介助必要は39例(平均59.5歳:B群)であった。両群間で年齢に有意差はなく、BMIはA群が有意に低値であった。術前の股関節外転筋力はA群平均0.48Nm/kg、B群0.38Nm/kg、膝関節伸展筋力はそれぞれ1.66Nm/kg、1.31Nm/kgとA群が有意に高値であった。Timed up and go testではA群平均8.7秒、B群11.2秒とA群が有意に歩行能力が高かった。術後の杖歩行自立時期は、A群平均11.0日、B群13.5日とA群が有意に短かった。術後初回離床時の動作自立可否の判断には、術前の運動機能が有用な指標になると考えられた。
• A new cementless total hip arthroplasty with bioactive titanium porous-coating by alkaline and heat treatment: average 4.8-year results.

  Keiichi Kawanabe; Kentaro Ise; Koji Goto; Haruhiko Akiyama; Takashi Nakamura; Ayumi Kaneuji; Tanzo Sugimori; Tadami Matsumoto

  Journal of biomedical materials research. Part B, Applied biomaterials 90 (1) 476 - 81 2009/07 [Refereed]
   

  A method has been developed for creating a bioactive coating on titanium by alkaline and heat treatment, and shown that it forms a thin layer of hydroxyapatite (HA) on the surface of implants when soaked in simulated body fluid. A series of 70 cementless primary total hip arthroplasties using this coating technique on a porous titanium surface was performed, and followed up the patients for a mean period of 4.8 years. There were no instances of loosening or revision, or formation of a reactive line on the porous coating. Although radiography just after operation showed a gap between the host bone and the socket in over 70% of cases, all the gaps disappeared within a year, indicating the good osteoconduction provided by the coating. Alkaline-heat treatment of titanium to provide a thin HA coating has several advantages over plasma-spraying, including no degeneration or absorption of the HA coating, simplicity of the manufacturing process, and cost effectiveness. In addition, this method allows homogeneous deposition of bone-like apatite within a porous implant. Although this was a relatively short-term study, treatment that creates a bioactive surface on titanium and titanium alloy implants has considerable promise for clinical application.
• Clinical application of bone marrow stromal cells to avascular necrosis of the femoral head combined with vascularized iliac bone graft

  Ryosuke Ikeguchi; Ryosuke Kakinoki; Tomoki Aoyama; Koji Goto; Taira Maekawa; Takashi Nakamura; Junya Toguchida

  Annual Scientific Meeting of American Society for Reconstructive Microsurgery （2009.1.10．Maui） 2009 [Refereed]
  
• Effects of ghrelin treatment on patients undergoing total hip replacement for osteoarthritis: different outcomes from studies in patients with cardiac and pulmonary cachexia.

  Takashi Akamizu; Hiroshi Iwakura; Hiroyuki Ariyasu; Toshinori Murayama; Eriko Sumi; Satoshi Teramukai; Koji Goto; Eijiro Ohnishi; Haruhiko Akiyama; Keiichi Kawanabe; Manabu Nankaku; Noriaki Ichihashi; Tadao Tsuboyama; Ken Tamai; Masako Kataoka; Takashi Nakamura; Kenji Kangawa

  Journal of the American Geriatrics Society 56 (12) 2363 - 5 2008/12 [Refereed]
  
• 人工股関節置換術の術後早期における下肢筋力と歩行能力との関連について

  安芸 浩嗣; 南角 学; 三戸 由美子; 川那辺 圭一; 秋山 治彦; 後藤 公志; 中村 孝志

  Hip Joint 日本股関節学会 34 (Suppl.) 121 - 123 0389-3634 2008/11 

  人工股関節置換術(THA)施行患者30名(男3名・女27名・平均57.2歳)を対象に、術後3〜5週の歩行能力と下肢筋力との関係を検討した。歩行能力はTime Up and Go test(TUG)、下肢筋力はHand-Held DynamometerおよびIsoforce GT-330を用いて股関節外転・屈曲・伸展、膝伸展・屈曲、脚伸展筋力を測定した。その結果、TUGと有意な相関を認めたのは股関節外転・伸展筋力、膝伸展筋力で、その他は相関がなかった。各下肢筋力の平均患健比は、股関節外転68.9%、股屈曲66.0%、股伸展78.4%、膝伸展49.7%、膝屈曲84.4%、脚伸展46.6%であった。分散分析では各筋力間で有意差を認め、多重比較で膝伸展と股伸展・膝屈曲、脚伸展と股伸展・膝屈曲との間に有意差を認めた。THA術後早期での脚伸展力の評価およびトレーニングが重要であることが示唆された。
• Clinical and radiological evaluation of revision hip arthroplasty using the cement-in-cement technique.

  K Goto; K Kawanabe; H Akiyama; T Morimoto; T Nakamura

  The Journal of bone and joint surgery. British volume 90 (8) 1013 - 8 2008/08 [Refereed]
   

  We reviewed 44 consecutive revision hip replacements in 38 patients performed using the cement-in-cement technique. All were performed for acetabular loosening in the presence of a well-fixed femoral component. The mean follow-up was 5.1 years (2 to 10.1). Radiological analysis at final follow-up indicated no loosening of the femoral component, except for one case with a continuous radiolucent line in all zones and peri-prosthetic fracture which required further revision. Peri-operative complications included nine proximal femoral fractures (20.4%) and perforation of the proximal femur in one hip. In five hips wiring or fixation with a braided suture was undertaken but no additional augmentation was required. There was an improvement in the mean Japanese Orthopaedic Association score from 55.5 (28 to 81) pre-operatively to 77.8 (40 to 95) at final follow-up (p < 0.001). Revision using a cement-in-cement technique allows increased exposure for acetabular revision and is effective in the medium term. Further follow-up is required to assess the long-term results in the light of in vitro studies which have questioned the quality of the cement-in-cement bond.
• Operative treatment of hip impingement caused by hypertrophy of the anterior inferior iliac spine.

  Hl Pan; K Kawanabe; H Akiyama; K Goto; E Onishi; T Nakamura

  The Journal of bone and joint surgery. British volume 90 (5) 677 - 9 2008/05 [Refereed]
   

  A 30-year-old man presented with pain and limitation of movement of the right hip. The symptoms had failed to respond to conservative treatment. Radiographs and CT scans revealed evidence of impingement between the femoral head-neck junction and an abnormally large anterior inferior iliac spine. Resection of the hypertrophic anterior inferior iliac spine was performed which produced full painless restoration of function of the hip. Hypertrophy of the anterior inferior iliac spine as a cause of femoro-acetabular impingement has not previously been described.
• Mechanical, setting, and biological properties of bone cements containing micron-sized titania particles.

  Koji Goto; Masami Hashimoto; Hiroaki Takadama; Jiro Tamura; Shunsuke Fujibayashi; Keiichi Kawanabe; Tadashi Kokubo; Takashi Nakamura

  Journal of materials science. Materials in medicine 19 (3) 1009 - 16 0957-4530 2008/03 [Refereed]
   

  In this study, polymethylmethacrylate-based composite cements containing 40-55.6 wt% micron-sized titania (titanium oxide) particles were developed, and their mechanical, setting, and biological properties evaluated. Three types of composite cement containing 40, 50, and 55.6 wt% silanized titania were designated ST2-40c, ST2-50c, and ST2-56c, respectively. In animal experiments, ST2-50c and ST2-56c were implanted into rat tibiae and solidified in situ. An affinity index was used to evaluate osteoconductivity. Compressive and bending strength of ST2-56c was 147.7+/-3.2 and 69.3+/-7.4; those of the other cements exceeded 100 MPa and 50 MPa, respectively. The affinity indices of ST2-56c were 42.1+/-12.9 at six weeks and 53.4+/-16.6 at 12 weeks, and were significantly higher than for ST2-50c and a commercial PMMA bone cement within 12 weeks. Our data indicate that bone cement containing micron-sized titania particles can be applied to prosthesis fixation as well as vertebroplasty, and ST2-56c is a good candidate cement.
• 【整形外科疾患感染症の予防と治療】抗菌薬含有骨セメント

  川那辺 圭一; 秋山 治彦; 後藤 公志; 中村 孝志

  Orthopaedics (株)全日本病院出版会 21 (2) 21 - 26 0914-8124 2008/02 

  人工関節置換術の感染治療あるいはその予防においても抗菌薬含有骨セメントの有効性は文献上明らかである。96時間内にセメントから徐放される抗菌薬は全体の1〜3%で、その1/3は最初の4時間以内に徐放され、セメント40gに抗菌薬1gを加えても強度の変化はない。スペーサーとして使用する場合には抗菌薬は8gまで使用可能で、バンコマイシンはトブラマイシンなど他の抗菌薬と組み合わせることにより、互いに徐放率を向上させるため単独で使用しないほうがよい。2001〜03年の3年間の抗菌薬含有骨セメントの使用状況を全国の研修指定病院へのアンケート送付により調査した。981施設(43.5%)からの回答を得たが、予防的使用が150/981施設(15%)、感染症に対する使用が384/981施設(39%)であった。主治医による抗菌薬含有骨セメントの使用効果の判定で82%が効果ありであった。(著者抄録)
• 【人工股関節置換術;Charnleyを超えたか?】Charnley型とKyocera型人工股関節長期成績の比較

  川那辺 圭一; 秋山 治彦; 後藤 公志; 中村 孝志; 大西 英次郎

  整形・災害外科 金原出版(株) 50 (11) 1179 - 1188 0387-4095 2007/10
• Computer-assisted fluoroscopic navigation system for removal of distal femoral bone cement in revision total hip arthroplasty.

  Haruhiko Akiyama; Keiichi Kawanabe; Koji Goto; Eijiro Ohnishi; Takashi Nakamura

  The Journal of arthroplasty 22 (3) 445 - 8 0883-5403 2007/04 [Refereed]
   

  Removal of the femoral bone cement in revision total hip arthroplasty with a high-powered drill or burr potentially has a risk of damage to the bone, resulting in perforation and fracture of the femur. Recently, we have used a computer-assisted fluoroscopic navigation system for the revision of cemented total hip arthroplasty with a high-powered burr and completely removed the distal femoral bone cement with no complications in 6 cases. Thus, a computer-assisted fluoroscopic navigation system is a useful tool for the improvement of the surgical technique in revision total hip arthroplasty.
• 診断の指針 治療の指針 進歩した人工骨・人工関節の有用性

  後藤 公志

  綜合臨床 (株)永井書店 56 (3) 585 - 586 0371-1900 2007/03
• 多発性外骨腫に伴う変形性股関節症に対し人工股関節全置換術を施行した1例

  京 英紀; 後藤 公志; 秋山 治彦; 坪山 直生; 川那辺 圭一; 中村 孝志

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 50 (2) 365 - 366 0008-9443 2007/03
• Bone-bonding strength of a new composite bone cement

  K. Goto; K. Kawanabe; S. Fujibayashi; R. Kowalski; T. Nakamura

  BIOCERAMICS, VOL 19, PTS 1 AND 2 TRANS TECH PUBLICATIONS LTD 330-332 827 - + 1013-9826 2007 [Refereed]
   

  A composite bone cement designated G2B1 that contains beta tricalcium phosphate particles was developed as a bone substitute for percutaneous transpedicular vertebroplasty. in this study, both G2B1 and commercial PMMA bone cement (CMW1) were implanted into proximal tibiae of rabbits with a metal frame fixed on it, and their bone-bonding strengths were evaluated at 4, 8, 12 and 16 weeks after implantation using a detaching test. Some of the specimens were evaluated histologically Using Giemsa surface staining and scanning electron microscopy (SEM). It was found that the bone-bonding strength of G2B1 was significantly higher than that of CMW1 at each time point, and significantly increased from 4 weeks to 8 and 12 weeks, while it decreased significantly from 12 weeks to 16 weeks. Giemsa Surface staining and SEW showed that G2B1 contacted bone directly without intervening soft tissue in the specimens at each time point, while there was always a soft tissue layer between CMW1 and bone. The results indicate that G21B1 has excellent bioactivity.
• The biocompatibility and osteoconductivity of a cement containing beta-TCP for use in vertebroplasty

  K. Goto; S. Shinzato; S. Fujibayashi; J. Tamura; K. Kawanabe; S. Hasegawa; R. Kowalski; T. Nakamura

  JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART A WILEY-LISS 78A (3) 629 - 637 1549-3296 2006/09 [Refereed]
   

  A new composite bone cement designated "G2B1" was developed for percutaneous transpedicular vertebroplasty. G2B1 contains beta tricalcium phosphate particles and methylmethacrylate-methylacrylate copolymer as the powder components, and methylmethacrylate, urethane dimethacrylate, and tetrahydrofurfuryl methacrylate as the liquid components. Biocompatibility and osteoconductivity were evaluated using scanning electron microscopy, contact microradiography, and Giemsa surface staining 4, 8, 12, 26, and 52 weeks after implantation into rat tibiae. To evaluate osteoconductivity, affinity indices (%) were calculated. Scanning electron microscopy and contact microradiography revealed that bone contact with G2B1 was attained within 4 weeks (affinity index: 50.2 +/- 11.8 at 4 weeks) and at most of the margin within 26 weeks (affinity index: 87.4 +/- 7.2 at 26 weeks). Specifically, G2B1 contacted bone via a wide calcium-phosphate-rich layer, and its degradation started within 8 weeks, mainly in the marginal area. Giemsa surface staining showed that there was almost no inflammatory reaction around the G2B1. These results indicate that G2B1 is a biocompatible and osteoconductive bone cement. (c) 2006 Wiley Periodicals, Inc.
• Bioactive bone cements containing micron-sized titania particles

  K Goto; M Hashimoto; H Takadama; J Tamura; S Fujibayashi; S Hasegawa; K Kawanabe; T Kokubo; T Nakamura

  BIOCERAMICS 18, PTS 1 AND 2 TRANS TECH PUBLICATIONS LTD 309-311 793 - 796 1013-9826 2006 [Refereed]
   

  Three types of polymethylmethacrylate (PMMA)-based composite cements containing 40-56 wt% micron-sized titania (titanium oxide) particles, designated ST2-40c, ST2-50c, and ST2-56c, were developed as bone substitutes for vertebroplasty, and evaluated for their mechanical, setting, and biological properties. In animal experiments, ST2-50c and ST2-56c were implanted into rat tibiae and solidified in situ. Their biological properties were evaluated at 6 and 12 weeks after implantation. Compressive strength, bending strength, and bending modulus increased with increasing titania content. Peak temperature during the setting reaction decreased as the filler content increased. ST2-56c had direct contact with bone over larger areas than ST2-50c at 6 and 12 weeks. Data from the present study indicated that ST2-56c is a good candidate as a bone substitute for vertebroplasty.
• Bioactive PMMA-based cement incorporated with nano-sized rutile particles

  M Hashimoto; H Takadama; M Mizuno; T Kokubo; K Goto; T Nakamura

  BIOCERAMICS 18, PTS 1 AND 2 TRANS TECH PUBLICATIONS LTD 309-311 797 - 800 1013-9826 2006 [Refereed]
   

  Bioactive bone cement with mechanical properties higher than that of commercial polymethylmethacrylate (PMMA) bone cement are strongly desired to be developed. In the present study, PMMA-based cement incorporated with nano-sized rutile particles was prepared. The PMMA-based cement (rutile content was 50 wt%) shows the compressive strength (136 MPa) higher than that of commercial PMMA bone cement (88 MPa). The hardened cement formed apatite on the surface in a simulated body fluid within 3 days. Therefore, this PMMA-based cement incorporated with rutile particles might be useful as cement for fixation of prostheses as well as self-setting bone substitutes, because of its high apatite forming ability and mechanical strength.
• In vivo evaluation of porous hydroxyapatite/poly D/L-lactide composite for bone substitutes and scaffolds

  S Hasegawa; J Tamura; M Neo; S Fujibayashi; K Goto; Y Shikinami; K Okazaki; T Nakamura

  BIOCERAMICS 18, PTS 1 AND 2 TRANS TECH PUBLICATIONS LTD 309-311 1311 - 1314 1013-9826 2006 [Refereed]
   

  We had investigated the biocompatibility, osteoconductivity, and biodegradability of a porous composite of hydroxyapatite (HA) and poly-DL-lactide (PDLLA) implanted into rabbit femoral condyles. It showed excellent osteoconductivity and biodegradability as a bone substitute. Newly formed bones were remodeled, and materials were resorbed almost completely at 78 weeks after implantation. In consideration of its biocompatibility and degradability, we investigated its potential for use as a cellular scaffold and evaluated its osteoinductive property. On implantation to the rat dorsal subcutaneous tissue loaded with syngeneic bone marrow cells, osteogenesis with enchondral ossification was seen both on and in the material at 3 weeks after implantation. This osteogenesis in the HA/PDLLA tended to get mature and newly formed bone tissues were found in the material by 6 weeks. To investigate the osteoinductive property material itself has, we attempted to implant this porous composite material to extra-osseous canine dorsal muscle. At 2 months, osteogenesis was seen in the pores of the material. It indicated the material induced osteogenesis with intramembranous ossification process. Therefore, HA/PDLLA might be a desirable material for bone substitutes and cellar scaffolds with osteoconductive and osteoinductive property.
• Alumina powder containing delta , gamma crystal phases: Evaluation of osteoconductivity

  S Shinzato; T Nakamura; K Goto; T Kokubo

  BIOCERAMICS 18, PTS 1 AND 2 TRANS TECH PUBLICATIONS LTD 309-311 789 - 792 1013-9826 2006 [Refereed]
   

  Alumina powder containing delta, gamma crystal phases (designated delta AP) showed osteoconducfivity. delta AP was manufactured by fusing pulverized alumina powder and quenching it. The purpose of the present study was to evaluate osteoconductivity of delta AP using rat tibiae. Alumina powder containing a crystal phase (designated alpha AP) was used as a reference material. These two types of alumina powder were packed into the intramedullary canals of rat tibiae to evaluate osteoconductivity, as determined by an affinity index. Rats were sacrificed at 4 and 8 weeks after surgery. The affinity index, equal to the length of bone in direct contact with the powder surface expressed as a percentage of the total length of the powder surface, was calculated for each alumina powder at each interval. At 4 and 8 weeks, the affinity indices for delta AP were significantly higher than those for alpha AP. For both delta AP and alpha AP, there were no significant differences between the values for 4 and 8 weeks. This study revealed that the osteoconductivity of delta AP was due to the alumina's delta crystal phases. delta AP shows promise as a basis for developing a osteoconductive biomaterial.
• Development of a new composite bone cement as a bone substitute for vertebroplasty

  K Goto; S Fujibayashi; J Tamura; K Kawanabe; S Hasegawa; R Kowalski; T Nakamura

  BIOCERAMICS 18, PTS 1 AND 2 TRANS TECH PUBLICATIONS LTD 309-311 805 - 808 1013-9826 2006 [Refereed]
   

  A new composite bone cement designated 'G2B1' was developed for percutaneous transpedicular vertebroplasty. G2B1 contains beta tricalcium phosphate particles and methylmethacrylate-methylacrylate copolymer as the powder components, and methylmethacrylate, urethane dimethacrylate, and tetrahydrofurfuryl methacrylate as the liquid components. Osteoconductivity and histological changes with time were evaluated using scanning electron microscopy, contact microradiography, and Giemsa surface staining 4, 8, 12, 26, and 52 weeks after implantation into rat tibiae. To evaluate osteoconductivity, affinity indices (%) were calculated. Scanning electron microscopy and contact microradiography revealed that bone contact with G2B1 was attained within 4 weeks (affinity index: 50.2 +/- 11.8 at 4 weeks) and at most of the margin within 26 weeks (affinity index: 87.4 +/- 7.2 at 26 weeks). Giemsa surface staining showed that there was almost no inflammatory reaction around the G2B1. These results indicate that G2B1 is a biocompatible and highly osteoconductive bone cement.
• In vivo evaluation of a porous hydroxyapatite/poly-DL-lactide composite for use as a bone substitute

  Shin Hasegawa; Jiro Tamura; Masashi Neo; Koji Goto; Yasuo Shikinami; Makoto Saito; Masakazu Kita; Takashi Nakamura

  Journal of Biomedical Materials Research - Part A 75 (3) 567 - 579 1549-3296 2005/12 [Refereed]
   

  We investigated the biocompatibility, osteoconductivity, and biodegradability of a porous composite of hydroxyapatite (HA) and poly-DL-lactide (PDLLA) implanted into rabbit femoral condyles and compared it with porous HA. Six weeks after implantation, the HA/PDLLA was covered with bone and contacted the bone directly. The amount of newly formed bone in the pores was similar in both materials during the examined period. The newly formed bone in the HA/PDLLA tended to increase over 26 weeks, but that in the HA did not show a significant increase after 12 weeks. By 26 weeks, remodeling of the newly formed bone in the pores was seen and bone marrow tissue was found in the pores of the HA/PDLLA. The porous HA/PDLLA was resorbed much faster than the porous HA. Porous HA/PDLLA was resorbed continuously through bone formation and remodeling. Conversely, porous HA was scarcely resorbed throughout the period. HA/PDLLA is thought to be degraded almost completely after about 1 year, and in this study, porous HA/PDLLA showed excellent osteoconductivity and faster resorption than HA. Therefore, HA/PDLLA might be a desirable material for bone substitutes. © 2005 Wiley Periodicals, Inc.
• Bioactive bone cements containing nano-sized titania particles for use as bone substitutes.

  K Goto; J Tamura; S Shinzato; S Fujibayashi; M Hashimoto; M Kawashita; T Kokubo; T Nakamura

  Biomaterials 26 (33) 6496 - 505 0142-9612 2005/11 [Refereed]
   

  Three types of bioactive polymethylmethacrylate (PMMA)-based bone cement containing nano-sized titania (TiO2) particles were prepared, and their mechanical properties and osteoconductivity are evaluated. The three types of bioactive bone cement were T50c, ST50c, and ST60c, which contained 50 wt% TiO2, and 50 and 60 wt% silanized TiO2, respectively. Commercially available PMMA cement (PMMAc) was used as a control. The cements were inserted into rat tibiae and allowed to solidify in situ. After 6 and 12 weeks, tibiae were removed for evaluation of osteoconductivity using scanning electron microscopy (SEM), contact microradiography (CMR), and Giemsa surface staining. SEM revealed that ST60c and ST50c were directly apposed to bone while T50c and PMMAc were not. The osteoconduction of ST60c was significantly better than that of the other cements at each time interval, and the osteoconduction of T50c was no better than that of PMMAc. The compressive strength of ST60c was equivalent to that of PMMAc. These results show that ST60c is a promising material for use as a bone substitute.
• In vivo evaluation of porous hydroxyapatite/poly D/L-lactide composite for bone substitute and scaffold

  S Hasegawa; J Tamura; M Neo; K Goto; Y Shikinami; M Saito; T Nakamura

  BIOCERAMICS, VOL 17 TRANS TECH PUBLICATIONS LTD 284-286 769 - 772 1013-9826 2005 [Refereed]
   

  We investigated the biocompatibility, osteoconductivity, and biodegradability of porous composite of Hydroxyapatite (HA) and Poly D/L-lactide (PDLLA). At 6weeks afterimplantation to rabbit femoral condyle, HA/PDLLA was covered with bone and contacted with bone directly. The amounts of newly formed bone in the pores had increased during the examined period. By 26weeks, bone remodeling of formed bone in the pores was seen and bone marrow tissue formation was seen in the pores of HA/PDLLA. Porous HA/PDLLA was resorbed much faster than porous HA as a control. Porous HA/PDLLA was resorbed constantly through the bone formation and bone remodeling but porous HA was hardly resorbed during the period. It might be one of the desirable materials for bone substitute. To evaluate for a scaffold, disc shaped blocks loaded with rat bone marrow cell were implanted in the subcutaneous pouch of the back of syngeneic rat. At 3weeks afterimplantation, newly bone fort-nation in the pores was observed at ectopic site. It also suggested the availability of this material as cell scaffolds.
• New bioactive bone cement containing nano-sized titania particles

  K Goto; M Hashimoto; S Fujibayashi; T Kokubo; T Nakamura

  BIOCERAMICS, VOL 17 TRANS TECH PUBLICATIONS LTD 284-286 97 - 100 1013-9826 2005 [Refereed]
   

  Two types of new bioactive polymethylmethacrylate (PMMA)-based bone cements containing nano-sized titania (TiO2) particles were prepared and evaluated to assess the effect of TiO2 content on their mechanical properties and osteoconductivity. We prepared two types of bioactive bone cement, ST50c and ST60c. which contained 50 wt% silanized TiO2 and 60 wt% silanized TiO2, respectively. Commercially available PMMA cement (PMMAc) was used as a control. The cements were inserted into rat tibiae and solidified in situ. After 6 and 12 weeks, they were taken out for evaluation of osteoconductivity by scanning electron microscopy (SEM), contact microradiography (CMR) and Giemsa surface staining. SEM revealed that ST60c and ST50c apposed to bone directly while PMMAc did not. The affinity index of ST60c, was significantly higher than for the other cements at each time interval. The results showed that ST60c was a promising material, but its mechanical strength should be improved before application in prosthesis fixation.
• Bioactive bone cement composed of crystallized glass beads and PMMA: Evaluation of degradation by an in vivo aging test

  S Shinzato; T Nakamura; K Goto; T Kokubo

  BIOCERAMICS, VOL 17 TRANS TECH PUBLICATIONS LTD 284-286 133 - 136 1013-9826 2005 [Refereed]
   

  A new bioactive bone cement (cGBC) consisting of crystallized MgO-CaO-SiO2-P2O5 glass beads and high-molecular-weight polymethyl methacrylate (hPMMA) has been developed to overcome the degradation seen with a previously reported cement (GBC) consisting of MgO-CaO-SiO2-P2O5-CaF2 glass beads and hPMMA. The purpose of the present study was to evaluate the degradation of cGBC using an invivo aging test, and to compare the degradation of cGBC with that of GBC. Hardened rectangular specimens (20x4x3mm) were prepared from both cements. Their initial bending strengths were measured using the three-point bending method. GBC and cGBC specimens were then implanted into the dorsal subcutaneous tissue of rats, removed after 6 or 12 months, and tested for bending strength. ne initial bending strengths (MPa) of GBC and cGBC were 141.9 +/- 1.8 and-144.4 +/- 2.4, respectively, while at 6 months they were 109.1 +/- 2.6 and 114.1 +/- 4.9, and at 12 months they were 109.1 +/- 3.2 and 113.1 +/- 3.3, respectively. Although the difference in initial bending strengths was not significant, the bending strength of cGBC was significantly higher than that of GBC at 6 and 12 months, indicating that cGBC is more resistant to cement degradation. The bending strengths of both GBC and cGBC decreased significantly from 0 to 6 months but did not change significantly thereafter. Thus, degradation of cGBC and GBC does not appear to continue after 6 months. We believe that cGBC and GBC are strong enough for use under weight-bearing conditions and that their mechanical strength (especially that of cGBC) is retained in vivo.
• 最新用語解説 臨床 人工骨(β-TCP)

  後藤 公志; 中村 孝志

  骨粗鬆症治療 (株)先端医学社 3 (3) 267 - 269 1347-572X 2004/07
• In vivo aging test for bioactive bone cements composed of glass bead and PMMA

  S Shinzato; T Nakamura; K Goto; T Kokubo

  BIOCERAMICS, VOL 16 TRANS TECH PUBLICATIONS LTD 254-2 173 - 176 1013-9826 2004 [Refereed]
   

  The degradation of a bioactive bone cement (GBC), consisting of bioactive MgO-CaO-SiO2-P2O5-CaF2 glass beads and high-molecular-weight polymethyl methacrylate (hPMMA) was evaluated in an in vivo aging test. Hardened rectangular specimens were prepared from two GBC formulations (containing 50%w/w [GBC50] or 60%w/w [GBC60] bioactive beads) and a conventional PMMA bone cement control (CMW-1). Initial bending strengths were measured using the three-point bending method. Specimens of all three cements were then implanted into the dorsal subcutaneous tissue of rats, removed after 3, 6 or 12 months, and tested for bending strength. The bending strengths (MPa) of GBC50 at baseline (0 months), 3, 6 and 12 months were 136 1, 119 3, 106 5 and 104 5, respectively. Corresponding values were 138 3, 120 3, 110 2 and 109 5 for GBC60, and 106+/-5, 97+/-5, 92+/-4 and 88+/-4 for CMW-1. Although the bending strengths of all three cements decreased significantly (p<0.05) from 0 to 6 months, those of GBC50 and GBC60 did not change significantly thereafter, whereas that of CMW-1 declined significantly between 6 and 12 months. Thus, degradation of GBC50 and GBC60 does not appear to continue after 6 months, whereas CMW-1 degrades progressively over 12 months. Moreover, the bending strengths of GBC50 and GBC60 (especially GBC60) were significantly higher than that of CMW-1 throughout. We believe that GBC60 is strong enough for use under weight-bearing conditions and that its mechanical strength is retained in vivo.
• 経験と考察 後療法を早めた新鮮アキレス腱皮下断裂に対するMarti法の手術成績

  後藤 公志; 中山 威知郎; 川合 準; 太田 雅人

  整形外科 (株)南江堂 54 (5) 521 - 524 0030-5901 2003/05 

  新鮮アキレス腱皮下断裂128例に対し,Marti法による縫合を施行し,カルテ調査,アンケート調査を行って術後成績を検討した.その結果,本法は他の手術に比べて手技がやや煩雑なため熟練を要し,やや時間がかかること,他の縦切開を用いる手術方法と同様に手術瘢痕が目立つという欠点を有するが,早期にリハビリテーションが行えるため,社会復帰を早めることができ,長期にわたって再断裂の危険が極めて少なく,優れた治療法と考えられた
• 大腿骨転子間骨折におけるAS hip screw(角度可変式ヒップスクリュー)の治療成績 カットアウト症例の検討と不安定型への対策

  中山 威知郎; 小田 祐造; 後藤 公志; 大槻 文悟; 秦 公平

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 45 (6) 991 - 992 0008-9443 2002/11 

  平成9〜13年に行われた大腿骨転子間骨折のうちAS hip screwを用いた96例(平均80.7歳)について検討した.骨癒合は97%でありカットアウトは3例に認められた.1例目はEvans分類grade 2でラグスクリューの深度が明らかに浅かった為にカットアウトしたと考えられた.2例目はEvans分類grade 4で8ヵ月後に痛みを出しカットアウトを認めた.X-P上,頸部骨折の合併があり,いわゆる内外側骨折であった.更に3例目は術前X-Pでは一見安定型骨折であったが,ラグスクリューが徐々に抜け骨頭の回転を生じカットアウトした.この症例も術前のX-Pを再検討すると内側骨折があった可能性がある.3例とも全て人工骨頭置換術を行った.平均術前待機期間3.6日,平均手術時間58分平均固定角度135°,平均入院期間80日であった.術中骨折,感染なく,インプラントの破損も認められなかった.ラグスクリューの位置はX-P前後面では99%が中央から下方,側面では96%が中央の適切な位置に固定されていた
• 人工足関節置換術の治療経験

  小田 裕造; 中山 威知郎; 川合 準; 長谷部 啓司; 後藤 公志; 大槻 文悟; 秦 公平

  整形外科と災害外科 西日本整形・災害外科学会 51 (3) 614 - 617 0037-1033 2002/09 

  人工足関節置換術11例15関節(男1例1関節・女10例14関節,平均63.2歳).関節リウマチ7例11関節,変形性足関節症4例4関節であった.合併症は術中内顆骨折2例2関節があったが,術中の骨接合術で骨癒合した.術後は創癒合不全1例1関節,感染症1例1関節,loosening1例2関節を認めた.術後2ヵ月〜6年3ヵ月で,日常生活に支障のない程度の疼痛で満足すべき結果となったのは10例であった.軽度疼痛のある2例は後足部の疼痛で,脛腓骨顆部の不完全な骨切除が原因と考えられた
• 大腿骨転子部骨折に対するEndovis nail手術手技

  小田 裕造; 中山 威知郎; 後藤 公志; 大槻 文悟; 中川 武志

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 45 (5) 813 - 814 0008-9443 2002/09 

  大腿骨転子部骨折に対するEndovis nailの臨床成績と手術手技を報告した.対象は,4ヵ月以上の経過観察が出来た30例(男性3例,女性27例・平均78.9歳)で,Evans 分類でtype1 grade1〜4まではそれぞれ1,5,16,4例で,type2が4例であった.手術適応として基本的にはEvans type1 grade1〜3にはAS hip screwを,Evans type1 grade4とtype2にはEndovis nailを使用した.術後合併症はlate segmental collapse 1例,back out 2例で,3例とも再手術を行った.cut outや骨幹部骨折はなく,全例術後4ヵ月には骨癒合が得られた.Endovis nailではlag screwを適切な位置に刺入できればcut outの重大な合併症は防ぎ得ると考えられた
• 大腿骨転子骨折に対するASヒップスクリューの使用経験

  中山 威知郎; 川合 準; 長谷部 啓司; 小田 裕造; 後藤 公志; 大槻 文悟; 秦 公平

  骨折 (一社)日本骨折治療学会 24 (1) 103 - 105 0287-2285 2002/05 

  角度可変式ヒップスクリュー(ASHS)を用いた65例を検討した.対象の平均年齢は80.7歳で,ASHSはEvans分類のtype1の安定型及び不安定型のgrade3までに用いた.骨癒合率は97%で,術中の骨折,感染はなく,インプラントの破損も認められなかった.カットアウトは2例に認められたが,このうち1例はラグスクリューの深度が浅く,明らかに手技上の問題であったが,極端に深度が浅い例はこの1例のみであった.他の1例は術後骨頭下骨折を合併した例で,術後8ヵ月でカットアウトしたが,手技上の問題はなく避けられない例と考えられた.ASHAではほぼ全例でラグスクリューを適切な位置に固定でき,術者を選ばず安定した成績が得られた
• 大腿骨転子部骨折に対するEndovis nailの使用経験

  小田 裕造; 中山 威知郎; 長谷部 啓司; 後藤 公志; 大槻 文悟; 秦 公平; 中川 武志

  骨折 (一社)日本骨折治療学会 24 (1) 151 - 154 0287-2285 2002/05 

  Evans分類type(T)1grade(G)1〜G3に対してはadjustable sliding(AS)ヒップスクリューを,T1G4とT2に対してはガンマネイルタイプの骨接合器のエンドビスネイル(EN)を使用し,手術を行ってきた.4ヵ月以上経過観察できた25例を対象に検討した.25例の骨折型はT1G2が3例,G3が15例,G4は3例,T2は4例であった.術後合併症は4例に認められたが,カットアウトや骨幹部骨折はなく,再手術はlate segmental collapseの1例のみであった.EVの手術器具は洗練されておらず,手術手技の改善が必要であるが,ラグスクリューを適切な位置に刺入できれば重大な合併症もなく,良い成績が得られると考える
• ASヒップスクリューの使用経験 その特徴とマーチンスクリューとの比較

  中山 威知郎; 小田 裕造; 後藤 公志; 大槻 文悟; 秦 公平

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 45 (3) 539 - 540 0008-9443 2002/05 

  大腿骨転子間骨折で角度可変型ヒップスクリュー(ASヒップスクリュー)を用いた76例を検討した.骨癒合は97%で,カットアウトは2例に認めた.術中骨折,感染はなく,インプラントの破損も認められなかった.ラグスクリューの位置は,レントゲン前後面で100%が中央から下方の適切な位置に固定されていた.平均手術時間は67.5分,平均固定角度は135.4°であった.本スクリューの角度可変機構はカムスライド方式であり,ウォームギヤ方式のマーチンスクリューより構造的に強度は優れている.また,プレートは11mmと薄く,大転子部への刺激も少なく,薄さと強度を兼ね備えていると考えられた
• Geomedic人工膝関節全置換術後26年目に再置換術を施行した1例

  小田 裕造; 中山 威知郎; 川合 準; 長谷部 啓司; 後藤 公志; 大槻 文悟; 秦 公平

  整形外科 (株)南江堂 53 (3) 324 - 326 0030-5901 2002/03 

  83歳女.26年前に標記置換術を受けて以来,全体的に調子がよいため一度も定期受診していなかったが,最近歩行時の右膝痛が強くなり,安静時痛もあるため受診した.X線所見から歩行時痛の原因は人工膝関節の脛骨側のコンポーネントの沈下による弛みであると判断し再置換術を行った.患者は高齢で骨萎縮が高度なっていたため,再置換術では表面置換型の人工関節では固定不能であり,骨移植を併用するステム付き人工関節を要した.本例では初回手術後5〜10年でコンポーネントに弛みを生じたが,弛みによる可動域制限のために疼痛が抑えられ,結果的に術後26年間診察を受けずに経過したものと推測された
• 大腿骨転子部骨折に対するEndovis nailの臨床成績

  小田 裕造; 中山 威知郎; 長谷部 啓司; 後藤 公志; 大槻 文悟; 秦 公平; 中川 武志

  整形外科と災害外科 西日本整形・災害外科学会 51 (1) 68 - 71 0037-1033 2002/03 

  大腿骨転子部不安定型骨折25症例(男3例・女22例,平均79.3歳)に対するEndovis nailの臨床成績(経過観察平均1年5ヵ月)について検討した.骨折型はEvans分類のtype 1/grade 2 3例,/grade 3 15例,/grade 4 3例,type 2 4例であり,手術時間は50〜211分・平均104分,術中出血量は30〜345g・平均124gであった.受傷から手術迄の期間は平均5.9日,術後平均離床時期は4.3日,術後平均荷重開始時期は15日であった.術後合併症はlate segmental collapse 1例(再手術を要した),lag screwの短縮 2例,内反変形1例であり,cut outや骨幹部骨折は認めなかった
• 鎖骨用Jプレートによる鎖骨骨折の治療経験

  大槻 文悟; 中山 威知郎; 長谷部 啓司; 小田 裕造; 後藤 公志; 秦 公平; 中川 武志

  整形外科と災害外科 西日本整形・災害外科学会 51 (1) 96 - 99 0037-1033 2002/03 

  過去2年7ヵ月間に鎖骨用Jプレートを使用した鎖骨新鮮骨折14症例(男10例・女4例,年齢15〜80歳,経過観察期間4ヵ月〜1年2ヵ月)について検討した.骨折型はロビンソン分類のtype 2A1が1例,type 2B1が3例,type 2B2が10例であった.術後4週より肩関節外転90度を,6週以降よりfull ROMを許可した結果,骨癒合は14例中13例で6ヵ月以内に得られた.1例が遷延治癒であったが,偽関節例は認めず,術後合併症として1例にプレートの屈曲変形を認めたが破損には至らなかった.以上よりJプレートはtype 2B2骨折で特に良い適応と考えられた
• ASヒップスクリューの使用経験

  中山 威知郎; 小田 祐造; 後藤 公志; 大槻 文悟; 秦 公平

  中部日本整形外科災害外科学会雑誌 (一社)中部日本整形外科災害外科学会 44 (6) 1281 - 1282 0008-9443 2001/11 

  平成9〜12年に行った大腿骨頸部外側骨折の106例のうち,角度可変式ヒップスクリュー(ASヒップスクリュー)63例について検討した.ASヒップスクリューは角度可変機構のおかげで,常にラグスクリューの位置が適切であり,術者に拘わらず安定した成績がえられた.ラグスクリューの位置はスクリューの深度も重要であり,骨頭から5mmから10mm以内が適切であった.ASヒップスクリューの手術適応はEvans分類type l grade 1から不安定型のgrade 3迄であった
• 両側先天性橈骨頭脱臼の1例

  後藤 公志; 中山 威知郎; 長谷部 啓司; 中川 武志; 小田 裕造; 大槻 文悟; 秦 公平

  整形外科と災害外科 西日本整形・災害外科学会 50 (3) 765 - 768 0037-1033 2001/09 

  61歳男.肘への外傷を契機に標記脱臼を発見された.これまで肘の変形と可動域制限はあったが,痛みを自覚したことはなく,日常生活上の障害も認めていなかった.外傷後に痛みを訴えた一側に対して橈骨頭切除術を行い良好な結果を得た
• 両側先天性橈骨頭脱臼の1例

  後藤 公志; 宗 和隆; 中川 武志; 古川 賢吾; 山田 茂; 秦 公平

  整形外科と災害外科 西日本整形・災害外科学会 49 (Suppl.2) 34 - 34 0037-1033 2000/10
• 腫瘍性病変における脊椎全摘術の治療経験

  中川 武志; 秦 公平; 山田 茂; 古川 賢吾; 後藤 公志; 宗 和隆

  中国・四国整形外科学会雑誌 中国・四国整形外科学会 12 (2) 433 - 433 0915-2695 2000/09
• 直視下皮下手根管開放術の新しい手術器具の開発

  小田 裕造; 藤尾 圭司; 山中 三知夫; 土屋 隆之; 後藤 公志

  整形外科と災害外科 西日本整形・災害外科学会 48 (2) 594 - 597 0037-1033 1999/03 

  本手術機械により直視下2皮切下皮下手根管開放術をより安全に行えるようになった
• 臼蓋側高度骨破壊例に対するケルブール十字プレートの使用経験

  小田 裕造; 藤尾 圭司; 山中 三知夫; 土屋 隆之; 後藤 公志

  整形外科と災害外科 西日本整形・災害外科学会 48 (1) 238 - 241 0037-1033 1999/03 

  経過観察期間は短期間であるが全例において臨床成績は改善し,良好な経過を得ている.臼蓋の高度骨欠損を伴う症例に対し,ケルブール十字プレートは有用である
• 陳旧性舟状骨骨折に対する移植骨形成の工夫

  藤尾 圭司; 山中 三知夫; 後藤 公志

  骨折 (一社)日本骨折治療学会 20 (2) 528 - 530 0287-2285 1998/05 

  十字の形をした移植骨を考案した.症例は男性20例,女性3例,年齢は,平均26.9歳であった.骨折部位は近位1/3が2例,中央1/3が20例,遠位1/3が1例であった.受傷から手術迄の期間は平均23.5ヵ月であった.術後経過観察期間は平均3.9年.全例に骨癒合を得た.舟状骨長軸の長さは健側が平均23.0mm,患側は術前平均21.4mmから術後平均23.1mmに改善した.RL角は健側が平均8.26度,患側は術前平均5.4度から術後平均2.6度に改善した.C.H.R.は術前平均0.52から術後平均0.52と変化は無かった.臨床成績は平均86.7点であった.術前にDISI変形を認めた13例中,初期の4例では矯正が不十分であったが,翼の形を大きくし,十分に矯正された8例は有意に成績良好であった
• 梨状筋症候群に対するエコーガイド下での局所注射療法

  後藤 公志; 樫本 龍喜; 近藤 啓

  整形外科と災害外科 西日本整形・災害外科学会 46 (3) 834 - 837 0037-1033 1997/09 

  1)梨状筋症候群に対する診断,治療法としてその有効性が認められている梨状筋への局所注射を,エコーガイド下に行う方法を考案した. 2)臨床的に梨状筋症候群を疑う患者(59歳女,55歳男)に対して上述の方法を用い,症状の軽快を認めた. 3)著者等の考案した方法は,患者の苦痛も少なく,安全で確実な方法と考えられる
• 陳旧性舟状骨骨折に対する新しい骨移植法

  藤尾 圭司; 山中 三知夫; 後藤 公志

  日本手の外科学会雑誌 (一社)日本手外科学会 14 (1) 1 - 5 0910-5700 1997/08 

  舟状骨偽関節,遷延治癒に対する骨移植法は,強固な固定と移植骨の工夫が必要である.即ち,移植骨と偽関節部の接触面積を増やし,吸収された部分の骨皮質を十分に補強でき,かつその位置を維持できる移植骨の形状が必要である.これにより舟状骨の長軸の長さが矯正され,又,掌屈変形が矯正されることとなるからである.著者等の症例でも初期の症例では矯正が不十分であったが,wingの形を大きくし,十分に矯正された症例は成績良好であった.移植骨の作成は少々煩雑であるが,DISI変形の矯正がしやすく,矯正位が維持しやすい点で勧められるべき方法である

Books etc

• 新専門医制度の功罪

  後藤公志 整形外科74巻12号p1248. 2023/11
• OS NEXUS No.8 股関節の再建手術

  後藤公志 (Contributorセメントカップ（p109-116))2023/11
• 大学病院整形外科医の本分

  後藤公志 (Single work)整形・災害外科. 66巻10号p1123. 金原出版 2023/09
• 人工股関節置換術（南江堂）

  後藤公志 (Contributor日本におけるTHA開発．K-MAX ABC (AW-GCボトムコーティング) HIP 1992⇒AHFIX Q HIP System 2007 （京セラ社）. p31-35. バイオマテリアル. セメントカップ・ステムの形状・表面粗さ．p123-129)南江堂 2023/02
• 整形外科手術Knack&Pitfalls Primary THAの要点と盲点

  後藤公志 (ContributorセメントTHAの術前プランニングと手術手技（page27-37))文光堂 2022
• Revival of Shelf Acetabuloplasty

  Koji Goto (Contributorchapter 4. The Modified Spitzy Shelf Operation Using Absorbable Fixation Device)Springer 2018
• Spitzy変法棚形成術

  後藤公志 (Contributorpage194-203)OS NEXUS No. 12 『股関節の再建法 成功への準備とコツ』 2017/11
• 【誌上ディベート:人工股関節をめぐる議論-対立する治療法】(Part4)ポリエチレンカップに対する骨頭径 28mm以下の小径骨頭を用い続ける理由(解説/特集)

  後藤公志 (Page65-69)Bone Joint Nerve 7巻1号 2017/01
• 変形性股関節症「専門医からのメッセージ」～良きライフステージに向けて～

  後藤公志 (Contributor老後をきれいに歩き続けるために～股関節手術治療のタイミング～)のぞみ会 2016/04
• 新しい医療技術 新しい生体活性骨セメント(解説)

  後藤公志、中村孝志 (Page1503-1507)整形・災害外科 54巻12号 2011/11
• 診断の指針 治療の指針 進歩した人工骨・人工関節の有用性

  後藤公志 (ContributorPage585-586)綜合臨床 (0371-1900)56巻3号 2007/04
• 人工膝関節置換術[TKA]のすべて ー安全・確実な手術のためにー

  後藤公志; 中村孝志 (Contributor人工膝関節の素材：金属素材)株式会社メジカルビュー社 2007/02
• 最新用語解説 臨床 人工骨(β-TCP)(解説).

  後藤公志 (ContributorPage267-269)骨粗鬆症治療 (1347-572X)3巻3号 2004/07

Conference Activities & Talks

• プライマリーTHAにおける寛骨臼骨欠損に対する私の対処法の変遷と、KT-plate併用セメントTHAの臨床成績  [Invited]

  後藤公志

  第7回セメントカップ研究会  2022/11
• セメントステムの手技の実際と注意点  [Invited]

  後藤公志

  東京セメントセミナー  2022/11
• 大腿骨セメンティングテクニックの習得－ここだけは気を付けよう－  [Invited]

  後藤公志

  ZB Hip Seminar in KYOTO  2022/10
• なぜセメント固定ステムが必要なのか  [Invited]

  後藤公志

  ZB Hip Seminar in KYOTO  2022/10
• 変形性股関節症と人工股関節置換術（THA）の最新の知見  [Invited]

  後藤公志

  2022/08
• 股関節鏡視から見えてくる股関節唇の役割  [Invited]

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  JOSKAS-JOSSM  2022/06
• 股関節外科最新治療アップデート  [Invited]

  後藤公志

  のぞみ会講演会  2022/06
• 当科において使用してきた各セメントステムの形状、素材と長期成績の比較  [Invited]

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第52回日本人工関節学会  2022/02
• 我々が行ってきた生体活性骨セメント開発の経緯と、時代が求める整形外科バイオマテリアルの変化について  [Invited]

  後藤公志

  第24回生体関連セラミックス討論会  2021/12
• Stage３特発性大腿骨頭壊死に対する血管柄付き腸骨移植を併用した間葉系幹細胞移植治療の長期成績  [Not invited]

  後藤公志; 青山朋樹; 戸口田淳也; 柿木良介; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第48回日本股関節学会  2021/10
• CPOの推しと問題点  [Invited]

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第48回日本股関節学会  2021/10
• CPOにおいて、外側大腿皮神経障害を回避する工夫

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第48回日本股関節学会  2021/10
• 寛骨臼回転骨切り術（CPO）の手術手技改良による出血および手術侵襲抑制効果について

  後藤公志; 深江舜也; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第48回日本股関節学会  2021/10
• DDH股に対する股関節鏡視はDDHに伴う二次性OAへの理解を深める  [Invited]

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第16回日本股関節鏡研究会  2021/09
• 股関節疾患治療に関する最新の知見  [Invited]

  後藤公志

  京都整形外科医会学術講演会  2021/06
• 術前鏡視併用の寛骨臼回転骨切り術（CPO)の短期成績と鏡視所見との関連性について

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第94回日本整形外科学会学術総会  2021/05
• 再置換を含めたTHAに必要な術前準備と、失敗例から学ぶ手技のPitfall  [Invited]

  後藤公志

  第10回轍会  2020/11
• 寛骨臼回転骨切り術（CPO）での後柱に対する最適な骨切り角度と骨切り部の骨幅の検討  [Not invited]

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第47回日本股関節学会学術集会  2020/10
• 寛骨臼回転骨切り術（CPO）での後柱に対する最適な骨切り角度と骨切り部の骨幅の検討  [Not invited]

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第93回日本整形外科学会学術総会  2020/06
• CPOにおいて、恥骨偽関節を回避する為の工夫とその短期成績  [Not invited]

  後藤公志; 黒田隆; 河井利之; 清水優; 松田秀一

  第93回日本整形外科学会学術総会  2020/06
• Short-term results of CPO combined with arthroscopy

  Koji Goto; Yutaka Kuroda; Toshiyuki Kawai; Shuichi Matsuda

  第2回アジア股関節鏡学会  2020/04
• 股関節の変形が進む前に出来ること  [Invited]

  後藤公志

  市民公開講座  2020/01
• 当科におけるDVTに対する術前術後マネジメントについて  [Invited]

  後藤公志

  Kyoto-VTE Symposium  2019/12
• CPOにおいて、恥骨偽関節を回避する為の工夫とその短期成績

  後藤公志; 黒田隆; 河井利之; 清水優; 松田秀一

  第46回日本股関節学会  2019/10
• 術前鏡視併用の寛骨臼回転骨切り術（CPO）の短期成績

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第15回日本股関節鏡研究会  2019/09
• Long-term Follow-up Results of a Clinical Trial in Total Hip Arthroplasty utilizing a Bioactive Bone Cement containing apatite-wollastonite Glass-Ceramic Fillers and Bisphenol-a-glycidyl Methacrylate Resin

  Goto K, Kuroda Y, Kawai T, Matsuda S.

  ICORS Meeting  2019/06
• Long-term Follow-up Results of a Clinical Trial in Total Hip Arthroplasty utilizing a Bioactive Bone Cement containing apatite-wollastonite Glass-Ceramic Fillers and Bisphenol-a-glycidyl Methacrylate Resin 20th EFORT congress 2019. 6.5~7 Lisbon.  [Not invited]

  Goto K, Kuroda Y, Kawai T, Matsuda S.

  20th EFORT congress  2019/06
• Cement-in-cement法によるステム再置換の長期成績

  後藤公志; 奥津弥一郎; 黒田隆; 河井利之; 松田秀一

  第92回日本整形外科学会学術総会  2019/05
• ハイブリッドTHAに対するMIS-AL approachの適用について

  後藤公志

  第6回Hybrid THA研究会  2019/04
• 当科におけるMIS-AL approachについて

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第9回THAアプローチ研究会  2019/03
• 股関節疾患の疼痛管理と病診連携～京大病院に求められる役割～  [Invited]

  後藤公志

  第5回病診連携を考える会  2019/03
• Cement-in-cement法によるステム再置換の長期成績

  後藤公志; 奥津弥一郎; 黒田隆; 河井利之; 松田秀一

  第49回日本人工関節学会  2019/02
• AWガラスセラミックフィラー含有の生体活性骨セメントを用いて固定された人工股関節の長期成績

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第38回整形外科バイオマテリアル研究会  2018/12
• セメントTHA再置換に必要な基礎知識と手技のピットフォール．  [Invited]

  後藤公志

  第7回轍会  2018/11
• AWガラスセラミックフィラー含有の生体活性骨セメントを用いて固定された人工股関節の長期成績

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第45回日本股関節学会学術集会  2018/10
• セメントステム再建法の限界  [Invited]

  後藤公志

  第6回SKJRCセミナー  2018/10
• セメントTHAの変遷  [Invited]

  後藤公志

  第6回SKJRCセミナー  2018/10
• AWガラスセラミックフィラー含有の生体活性骨セメントを用いて固定された人工股関節の長期成績

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第131回中部日本整形外科災害外科学会学術集会  2018/10
• Correlation between preoperative Tönnis grade and Outerbridge classification, and factors affecting postoperative OA progression.

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第14回日本股関節鏡研究会  2018/09
• 高位脱臼股に対するreverse hybrid THAの中期成績

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第5回Hybrid THA研究会  2018/07
• Long-term results of total hip arthroplasty using Charnley Elite-plus stem and the effect of stem geometry on radiographic distal femoral cortical hypertrophy

  Goto K, Furuya Y, Sano K, Sugimoto M, Matsuda S.

  19th EFORT congress 2018.
• 術前OA所見と軟骨損傷との関連、および股関節鏡手術後のOA進行に影響する因子について

  後藤公志; 松田秀一

  第10回JOSKAS  2018/06
• AWガラスセラミックフィラー含有の生体活性骨セメントを用いて固定された人工股関節の長期成績

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一

  第91回日本整形外科学会学術総会  2018/05
• 当科における高位脱臼股に対するTHAの術式選択  [Invited]

  後藤公志、河井利之、黒田隆、松田秀一.

  第130回中部日本整形外科災害外科学会学術集会 2018.4.20-21 松山市  2018/04
• Collared double taper stemの最適挿入方向と最終設置位置で保持する力の方向についての検討

  後藤公志; 黒田隆; 河井利之; 前野純彦; 松田秀一

  第48回日本人工関節学会  2018/02
• 股関節の痛み：原因と治療．  [Invited]

  後藤公志

  市民講座 2018.1.21  2018/01
• 股関節外科医による鏡視下手術―経験とフォローアップから見えてきたもの―  [Invited]

  後藤公志

  Smith & Nephew Japan Hip & Knee Forum 2017  2017/10
• セメントカップ（再置換）  [Invited]

  後藤公志

  第5回SKJRCセミナー  2017/10
• セメントTHAのABC  [Invited]

  後藤公志

  第5回SKJRCセミナー  2017/10
• Collared double taper stemの最適挿入方向と最終設置位置で保持する力の方向についての検討

  後藤公志; 黒田隆; 河井利之; 松田秀一

  第32回日本整形外科学会基礎学術集会  2017/10
• 前方侵入寛骨臼回転骨切り術（CPO）のリスク回避方法について

  後藤公志; 河井利之; 黒田隆; 宗和隆; 松田秀一

  第44回日本股関節学会  2017/10
• Two shape variations of the Charnley Elite Plus femoral component influence the long-term radiographic results

  K. Goto, Y. Furuya, K. Oda, R. Minami, K. Sano, M. Sugimoto, S. Matsuda

  25th Annual & Anniversary Meeting of European Orthopaedic Research Society.  2017/09
• 寛骨臼回転骨切り術（CPO）前に鏡視下に骨頭外側の骨隆起を切除した1例

  後藤公志; 黒田隆; 河井利之; 古屋祐樹; 杉本正幸; 松田秀一

  第13回日本股関節鏡研究会  2017/09
• 股関節疾患に対する疼痛対策～低侵襲な股関節骨温存手術の実際～  [Invited]

  後藤公志

  第255回北九州整形外科医会  2017/09
• 成人股関節外科医が考える骨温存手術  [Invited]

  後藤公志

  第56回日本小児股関節研究会  2017/06
• 股関節の手術治療最前線  [Invited]

  後藤公志.

  健康公開講座  2017/05
• 酸化チタン含有骨セメント（オセジョイン）の骨結合能

  後藤公志; 今村匡志; 川田交俊; 松田秀一

  第47回日本人工関節学会  2017/02
• 両側同時臼蓋形成術、4例の臨床経過

  後藤公志

  第7回臼蓋形成術研究会  2017/01
• 低侵襲な股関節骨温存手術の実際  [Invited]

  後藤公志

  岡山県西部地区整形外科連携の会  2016/11
• 成人股関節外科医が考える小児から成人までのDDH治療体系  [Invited]

  後藤公志、宗和隆、黒田隆、奥津弥一郎、川田交俊、奥谷祐希、岡畠章憲、松田秀一.

  第43回日本股関節学会学術集会  2016/11
• 股関節手術におけるHA-PLLAコンポジットスクリュー使用の利点と注意点

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 松田秀一

  日本バイオマテリアル学会シンポジウム2016  2016/11
• 人工股関節再置換術や人工股関節周囲骨折に対するCortical strut allograftを用いた大腿骨再建の治療成績

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 奥谷祐希; 岡畠章憲; 松田秀一

  第43回日本股関節学会学術集会  2016/11
• 吸収性材料を用いたSpitzy変法による臼蓋形成術の低侵襲化への試み

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 奥谷祐希; 岡畠章憲; 松田秀一

  第43回日本股関節学会学術集会  2016/11
• セメントTHAにおけるポリエチレン摩耗について～CPEとHXLPEの10年以上の前向き比較調査～

  後藤公志; 川田交俊; 宗和隆; 黒田隆; 奥津弥一郎; 奥谷祐希; 岡畠章憲; 松田秀一

  第31回日本整形外科学会基礎学術集会  2016/10
• 私の考えるハイブリッドTHAの優位性

  後藤公志

  第8回セメントヒップ関西  2016/08
• Acetabular Bone Grafting Fixed with Absorbable Hydroxyapatite-Poly-L-Lactide Composite Screws

  Goto K; So K; Kuroda Y; Fumiya Y; Okuzu Y; Matsuda S

  第89回日本整形外科学会学術集会  2016/05
• 臼蓋移植骨固定にHA-PLLAコンポジットスクリューを用いた人工股関節置換術の中期成績

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 松田秀一

  第126回中部日本整形外科災害外科学会学術集会  2016/04
• チタン合金製のセメントステムは悪くない

  後藤公志

  セメントステム研究会  2016/02
• 臼蓋移植骨固定にHA-PLLAコンポジットスクリューを用いた人工股関節置換術の中期成績

  後藤公志

  第46回日本人工関節学会  2016/02
• 臼蓋形成不全に対する棚形成術の当科における成績と、鏡視下手術、CPOに対する優位性について  [Invited]

  後藤公志. 臼蓋形成不全に対する棚形成術の当科における成績と、鏡視下手術、CPOに対する優位性について 第6回臼蓋形成術研究会 特別講演 2016.1.30 大阪

  第6回臼蓋形成術研究会  2016/01
• 臼蓋移植骨固定にHA-PLLA composite screwを用いた人工股関節置換術の中期成績

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 松田秀一

  第35回整形外科バイオマテリアル研究会  2015/12
• 股関節疾患の病診連携～治療の最前線と手術のタイミング～  [Invited]

  後藤公志

  京都病診連携を考える会  2015/12
• Clinical and Radiographic Evaluation of Cemented Socket Fixation Concomitant to Acetabular Bone Grafting Fixed With Absorbable Hydroxyapatite poly-L-Lactide Composite Screws.

  Goto K, So K, Kuroda Y, Okuzu Y, Matsuda S.

  28th Annual Congress of the International Society for Technology in Arthroplasty.  2015/10
• Spitzy変法による棚形成術のデザインとその根拠  [Invited]

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 松田秀一

  第４２回日本股関節学会学術集会  2015/10
• Correlation Between Trochanteric Nonunion and Postoperative Pain Score in the Wafer approach

  Goto K; So K; Kuroda Y; Fumiya Y; Sugimoto M; Okuzu Y; Matsuda S

  第88回日本整形外科学会学術集会  2015/05
• THAでの臼蓋移植骨固定におけるポリ乳酸/水酸化アパタイトコンポジットスクリューの有用性と安全性

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 松田秀一

  第124回中部日本整形外科災害外科学会学術集会  2015/04
• 大転子の骨きりを伴う2種類のアプローチを用いた初回THAの短期成績の比較と大転子骨片の転位との関連性

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 松田秀一; 古屋祐樹; 櫻木淳史; 田中淳; 杉本正幸

  第45回日本人工関節学会  2015/02
• 吸収性材料を移植骨固定に用いた臼蓋形成術（Spitzy変法）の低侵襲化への試み

  後藤公志

  第5回臼蓋形成術研究会  2015/01
• Over 10 years clinical experience of HXLPE  [Invited]

  Goto K, So K, Kuroda Y, Okuzu Y, Matsuda S.

  ICJR Hip2015  2015/01
• 大転子の骨切りを伴う２種類のアプローチを用いた初回THAの短期成績の比較と大転子骨片の転位との関連性

  後藤公志; 櫻木淳史; 田中淳; 朴憲之; 古屋祐樹; 杉本正幸; 松田秀一

  第41回日本股関節学会  2014/10
• 大転子の骨切りを伴う２種類のアプローチを用いた初回THAの短期成績の比較と大転子骨片の転位との関連性

  後藤公志; 櫻木淳史; 田中淳; 朴憲之; 古屋祐樹; 杉本正幸; 松田秀一

  第123回中部日本整形外科災害外科学会・学術総会  2014/10
• Correlation Between Trochanteric Nonunion and Postoperative Pain Score in the Wafer approach

  Koji Goto; Kazutaka So; Yutaka Kuroda; Yuuki Furuya; Masayuki Sugimoto; Yaichiro Okuzu; Shuichi Matsuda

  27th Annual Congress of the International Society for Technology in Arthroplasty  2014/09
• Clinical experiences with cortical strut allograft augmentation for femoral periprosthetic fractures and in revision total hip arthroplasties

  Koji Goto; Kazutaka So; Takashi Kuroda; Keiichi Kawanabe; Yaichiro Okuzu; Shuichi Matsuda

  APASTB/JSTT combined scientific meeting  2014/08
• 初回THAにおいて、Modified Dall’s approach又はMIS-AL approachを用い、大転子骨片をNespron tape又はEtibond糸で再固定した場合の術後短期成績の比較

  後藤公志

  Dall研究会  2014/03
• 人工股関節再置換術において、術後トラネキサム酸関節内投与と非回収式ドレーンの使用を行った症例の術後経過の検討

  後藤公志; 田中淳; 櫻木淳史; 朴憲之; 古屋佑樹; 村田巨樹; 堤聖吾; 廣瀬伸次; 杉本正幸

  第４４回日本人工関節学会  2014/02
• 術前偽関節の大転子を人工股関節再置換術時に再固定した６症例の術後成績の検討

  後藤公志; 田中淳; 櫻木淳史; 朴憲之; 古屋佑樹; 村田巨樹; 堤聖吾; 廣瀬伸次; 杉本正幸

  第４４回日本人工関節学会  2014/02
• 人工股関節置換術時の大転子再固定にケーブルグリップシステムを用いた6症例の検討

  後藤公志

  第40回日本股関節学会学術集会  2013/11
• フランジタイプのElite plus stemの抜去には注意が必要である

  後藤公志

  第40回日本股関節学会学術集会  2013/11
• 酸化チタンを含有した新しい生体活性骨セメントの開発

  後藤公志

  第28回日本整形外科学会基礎学術集会  2013/10
• Application of HA-PLLA Composite Screws to Hip Surgeries

  KOJI GOTO

  The 4th Asian Biomaterials Congress  2013/06
• THA後に術後回収式ドレーンを使用した症例と、術後トラネキサム酸関節内投与と非回収式ドレーンの使用を行った症例との比較検討

  後藤公志

  第43回日本人工関節学会
• 同一術者によるCPOと臼蓋形成術の短期成績の比較

  後藤公志

  第3回臼蓋形成術研究会  2013/01
• 吸収性材料を移植骨固定に用いた臼蓋形成術（Spitzy変法）の術後短期成績と骨リモデリング

  後藤公志

  第39回日本股関節学会学術集会
• 老後をきれいに歩き続けるために～股関節の大切さと手術治療のタイミング～  [Invited]

  後藤公志

  のぞみ会  2012/11
• 吸収性材料を移植骨固定に用いた臼蓋形成術（Spitzy変法）の術後短期成績

  後藤公志

  第119回中部日本整形外科災害外科学術集会
• 骨粗鬆症と健康寿命の関わり  [Invited]

  後藤公志

  市民講座（長浜市）  2012/09
• よく分かる！股関節の痛みと治療の最前線  [Invited]

  後藤公志

  市民講座（長浜市）  2012/05
• 酸化チタンを含有した新しい生体活性骨セメントの開発

  後藤公志

  第42回日本人工関節学会
• 骨代謝異常に起因すると考えられる両側大腿骨転子下不全骨折に対し、LIPUSを用いた保存療法が奏功した一例

  後藤公志

  第31回滋賀県整形外科医会学術集会  2011/11
• Use of HA-PLLA Composite Screws to Fix Acetabular Bone Graft in Cemented THA: Absorption Pattern of Screws in Six Patients

  KOJI GOTO

  Bioceramics 23
• 関節リウマチの外科的治療について  [Invited]

  後藤公志

  第一回湖北リウマチ研究会  2011/10
• 股関節疾患の治療と骨粗鬆症  [Invited]

  後藤公志

  Wの会  2011/07
• 人工関節固定用の生体活性骨セメントの開発

  後藤公志

  第84回日本整形外科学会  2011/05
• 生体吸収性材料を用いた骨移植の現状と展望  [Invited]

  後藤公志

  第41回日本人工関節学会  2011/02
• 人工股関節固定用の生体活性骨セメントの開発  [Not invited]

  後藤公志

  第41回日本人工関節学会  2011/02

MISC

• Effect of limb lengthening on cross-sectional area and density in the hip muscles after total hip arthroplasty

  堀江賢; 南角学; 河野拓巳; 後藤公志; 黒田隆; 河井利之; 松田秀一; 松田秀一  Hip Joint  49-  (2)  2023
• 人工股関節全置換術後1年における身体活動レベルに関連する因子の検討

  河野拓巳; 南角学; 村尾昌信; 由利拓真; 後藤公志; 黒田隆; 河井利之; 松田秀一; 松田秀一  日本股関節学会学術集会プログラム・抄録集  49th-  2022
• 人工股関節全置換術における脚延長が股関節周囲筋の筋断面積と筋密度に及ぼす影響

  堀江賢; 南角学; 河野拓巳; 後藤公志; 黒田隆; 河井利之; 松田秀一  日本股関節学会学術集会プログラム・抄録集  49th-  2022
• 大腿骨頭壊死症に対する骨髄間葉系幹細胞移植後10年における運動機能

  南角学; 青山朋樹; 河野拓巳; 後藤公志; 松田秀一  日本股関節学会学術集会プログラム・抄録集  49th-  2022
• 変形性股関節症患者における歩容と小殿筋前方部および後方部の脂肪浸潤との関係

  由利拓真; 由利拓真; 河野拓巳; 南角学; 村尾昌信; 後藤公志; 黒田隆; 河井利之; 松田秀一; 松田秀一  日本股関節学会学術集会プログラム・抄録集  49th-  2022
• 悪性リンパ腫によるAAOS type III臼蓋骨欠損に対しK-Tプレートと自家骨移植を用いて臼蓋再建した1例

  森 圭市郎; 河井 利之; 後藤 公志; 黒田 隆; 奥津 弥一郎; 松田 秀一  中部日本整形外科災害外科学会雑誌  64-  (6)  793  -794  2021/11
• 寛骨臼回転骨切り術(CPO)の手術手技改良による出血および手術侵襲抑制効果について

  深江 舜也; 後藤 公志; 黒田 隆; 河井 利之; 奥津 弥一郎; 松田 秀一  中部日本整形外科災害外科学会雑誌  64-  (秋季学会)  139  -139  2021/09
• アルカリ加熱処理後ヨウ素担持チタンの生体活性および抗菌性の評価

  池田 周正; 藤林 俊介; 山口 誠二; 織田 和樹; 高岡 祐輔; 奥津 弥一郎; 清水 孝彬; 河井 利之; 大槻 文悟; 後藤 公志; 松田 秀一  日本整形外科学会雑誌  95-  (8)  S1558  -S1558  2021/08
• 多椎間の腰椎固定後に股関節の関節裂隙狭小化が進行する

  河井 利之; 清水 孝彬; 後藤 公志; 黒田 隆; 奥津 弥一郎; 藤林 俊介; 松田 秀一  日本整形外科学会雑誌  95-  (2)  S424  -S424  2021/03
• 特発性大腿骨頭壊死症タイプCに対する成長因子を用いた医師主導多施設治験64例の結果

  黒田 隆; 田中 健之; 宮川 貴樹; 濱田 英敏; 奥津 弥一郎; 河井 利之; 後藤 公志; 南角 学; 菅野 伸彦; 田中 栄; 松田 秀一; 秋山 治彦  日本整形外科学会雑誌  95-  (2)  S432  -S432  2021/03
• 術前鏡視併用の寛骨臼回転骨切り術(CPO)の短期成績と鏡視所見との関連性について

  後藤 公志  日本整形外科学会雑誌  95-  (3)  S975  -S975  2021/03
• 急速破壊型股関節症における全脊椎アライメントと採血データの特徴について

  奥津 弥一郎; 後藤 公志; 黒田 隆; 河井 利之; 松田 秀一  日本整形外科学会雑誌  95-  (3)  S981  -S981  2021/03
• 骨盤に生じた悪性リンパ腫によるAAOS type3臼蓋骨欠損に対し自家骨移植とK-Tプレートを用いて再建した1例

  森 圭市郎; 河井 利之; 後藤 公志; 黒田 隆; 奥津 弥一郎; 松田 秀一  中部日本整形外科災害外科学会雑誌  64-  (春季学会)  200  -200  2021/03
• 人工膝関節全置換術前後における股関節周囲筋の筋萎縮と筋内脂肪変性の経時的変化

  河野 拓巳; 南学 学; 村尾 昌信; 濱田 涼太; 後藤 公志; 黒田 隆; 松田 秀一  理学療法学  47-  (Suppl.1)  O  -189  2021/03
• 前方進入法による人工股関節全置換術施行後患者の歩行側方動揺の有無と運動機能の関係について

  西村 圭二; 南部 利明; 杉本 正幸; 後藤 公志; 山崎 敦  理学療法学  47-  (Suppl.1)  P  -157  2021/03
• 多椎間の腰椎固定後に股関節の関節裂隙狭小化が進行する

  河井 利之; 清水 孝彬; 後藤 公志; 黒田 隆; 奥津 弥一郎; 藤林 俊介; 松田 秀一  日本整形外科学会雑誌  95-  (2)  S424  -S424  2021/03
• 特発性大腿骨頭壊死症タイプCに対する成長因子を用いた医師主導多施設治験64例の結果

  黒田 隆; 田中 健之; 宮川 貴樹; 濱田 英敏; 奥津 弥一郎; 河井 利之; 後藤 公志; 南角 学; 菅野 伸彦; 田中 栄; 松田 秀一; 秋山 治彦  日本整形外科学会雑誌  95-  (2)  S432  -S432  2021/03
• 術前鏡視併用の寛骨臼回転骨切り術(CPO)の短期成績と鏡視所見との関連性について

  後藤 公志  日本整形外科学会雑誌  95-  (3)  S975  -S975  2021/03
• 急速破壊型股関節症における全脊椎アライメントと採血データの特徴について

  奥津 弥一郎; 後藤 公志; 黒田 隆; 河井 利之; 松田 秀一  日本整形外科学会雑誌  95-  (3)  S981  -S981  2021/03
• SrおよびAgイオンを担持したチタンインプラントの骨結合性,抗菌性の検討

  正本 和誉; 藤林 俊介; 山口 誠二; 大槻 文悟; 清水 孝彬; 清水 優; 後藤 公志; 河井 利之; 松田 秀一  日本整形外科学会雑誌  94-  (8)  S1710  -S1710  2020/09
• ガリウムイオン担持チタン金属の評価

  林 信実; 藤林 俊介; 山口 誠二; 高岡 祐輔; 池田 周正; 清水 孝彬; 河井 利之; 大槻 文悟; 後藤 公志; 松田 秀一  日本整形外科学会雑誌  94-  (8)  S2040  -S2040  2020/09
• 人工股関節全置換術後における体幹筋の筋萎縮および脂肪変性の経時的変化

  河野 拓巳; 南角 学; 村尾 昌信; 濱田 涼太; 黒田 隆; 後藤 公志; 松田 秀一  Hip Joint  46-  (2)  S290  -S293  2020/08
• 人工股関節全置換術後における骨格筋の量的および質的変化 病期の違いによる検討

  河野 拓巳; 南角 学; 村尾 昌信; 濱田 涼太; 後藤 公志; 黒田 隆; 池口 良輔; 松田 秀一  The Japanese Journal of Rehabilitation Medicine  57-  (特別号)  2  -2  2020/07
• 当科におけるハイブリッドTHAの中長期成績

  森田 悟希; 後藤 公志; 黒田 隆; 河井 利之; 松田 秀一  中部日本整形外科災害外科学会雑誌  63-  (4)  589  -590  2020/07
• 人工股関節置換術後の予防的エドキサバン投与は術後D-dimer値を上昇させるか

  河井 利之; 後藤 公志; 黒田 隆; 松田 秀一  日本整形外科学会雑誌  94-  (3)  S943  -S943  2020/03
• 前方進入寛骨臼回転骨切り術(CPO)において、恥骨偽関節を回避する為の工夫とその短期成績

  後藤 公志; 黒田 隆; 河井 利之; 清水 優; 松田 秀一  日本整形外科学会雑誌  94-  (3)  S1136  -S1136  2020/03
• 寛骨臼回転骨切り術(CPO)での後柱に対する最適な骨切り角度と骨切り部の最大骨幅の検討

  後藤 公志; 黒田 隆; 河井 利之; 清水 優; 松田 秀一  日本整形外科学会雑誌  94-  (3)  S1187  -S1187  2020/03
• 特発性大腿骨頭壊死症 異なる日米での治療戦略

  黒田 隆; 河井 利之; 後藤 公志; 松田 秀一  日本整形外科学会雑誌  94-  (3)  S1233  -S1233  2020/03
• 変形性股関節症患者における歩行速度増加のための戦略:その機能的意義と股関節負荷への影響

  建内宏重; 秋山治彦; 後藤公志; 宗和隆; 黒田隆; 市橋則明  日本股関節学会学術集会プログラム・抄録集  47th-  2020
• 疾患進行リスク因子に基づいた変形性股関節症患者のサブタイプ分類

  建内宏重; 秋山治彦; 後藤公志; 宗和隆; 黒田隆; 市橋則明  日本理学療法学術大会(Web)  54th-  2020
• 生体吸収性のメッシュを用いて臼蓋再建を行った人工股関節再々置換術の1例

  領木 勇人; 後藤 公志  中部日本整形外科災害外科学会雑誌  62-  (6)  1015  -1016  2019/11
• カルシウムイオン徐放性新規低弾性チタン金属の評価

  林 信実; 藤林 俊介; 山口 誠二; 清水 優; 正本 和誉; 清水 孝彬; 河合 利之; 大槻 文悟; 後藤 公志; 松田 秀一  日本バイオマテリアル学会大会予稿集  41回-  175  -175  2019/11
• 特発性大腿骨頭壊死症に対する成長因子を用いた再生医療

  黒田 隆; 南角 学; 河井 利之; 後藤 公志; 秋山 治彦; 松田 秀一  日本整形外科学会雑誌  93-  (3)  S890  -S890  2019/03
• Cement-in-cement法によるステム再置換の長期成績

  後藤 公志; 奥津 弥一郎; 黒田 隆; 河井 利之; 松田 秀一  日本整形外科学会雑誌  93-  (2)  S260  -S260  2019/03
• 骨盤アラインメントから再考する骨盤骨嚢胞形成部位

  清水 優; 河井 利之; 黒田 隆; 後藤 公志; 松田 秀一  日本整形外科学会雑誌  93-  (3)  S917  -S917  2019/03
• 人工股関節再置換術臼蓋側の長期成績

  河井 利之; 後藤 公志; 黒田 隆; 松田 秀一  日本整形外科学会雑誌  93-  (3)  S1090  -S1090  2019/03
• Crowe group IV高位脱臼股に対する転子下短縮骨切り術の術後骨切り部癒合に影響する因子の検討

  河井 利之; 後藤 公志; 黒田 隆; 松田 秀一  日本整形外科学会雑誌  93-  (3)  S1202  -S1202  2019/03
• チタン合金製チャンレータイプのステムを用いたセメント人工股関節置換術の長期成績

  奥谷祐希; 後藤公志; 黒田隆; 河井利之; 川田交俊; 宗和隆; 松田秀一  日本整形外科学会雑誌  93-  (3)  2019
• 変形性股関節症患者の疼痛と身体機能の変化に影響を及ぼす姿勢と歩行に関する要因:前向きコホート研究

  建内宏重; 秋山治彦; 後藤公志; 宗和隆; 黒田隆; 市橋則明  日本股関節学会学術集会プログラム・抄録集  46th-  399  2019
• 人工股関節置換術後に脊柱変形に伴う骨盤後傾をきたし前方脱臼を生じた1例

  間野 公介; 河井 利之; 黒田 隆; 後藤 公志; 松田 秀一  中部日本整形外科災害外科学会雑誌  62-  (1)  147  -148  2019/01
• 骨盤アラインメントから再考する骨盤cyst形成部位

  清水優; 河井利之; 黒田隆; 後藤公志  中部日本整形外科災害外科学会雑誌  61-  291  2018/09
• 人工股関節再置換術臼蓋再建の長期成績

  河井利之; 後藤公志; 黒田隆; 松田秀一  中部日本整形外科災害外科学会雑誌  61-  106  2018/09
• 人工股関節置換術後に脊柱変形に伴う骨盤後傾をきたし前方脱臼を生じた1症例

  間野公介; 河井利之; 黒田隆; 後藤公志; 松田秀一  中部日本整形外科災害外科学会雑誌  61-  108  2018/09
• AWガラスセラミックフィラー含有の生体活性骨セメントを用いて固定された人工股関節の長期成績

  後藤公志; 黒田隆; 河井利之; 松田秀一  中部日本整形外科災害外科学会雑誌  61-  106  2018/09
• 寛骨臼回転骨切り術(CPO)前に鏡視下に骨頭外側の骨隆起を切除した1例

  後藤公志; 後藤公志; 黒田隆; 河井利之; 杉本正幸; 佐野かおり; 松田秀一  Hip Joint  44-  (2)  2  -3  2018/08
• 前方侵入寛骨臼回転骨切り術(CPO)のリスク回避方法について

  後藤公志; 黒田隆; 河井利之; 宗和隆; 松田秀一  Hip Joint  44-  (1)  369  -373  2018/08
• 人工股関節全置換術後の歩行速度が健常者と同等まで改善するために必要な下肢機能の検討

  村尾昌信; 南角学; 細江拓也; 濱田涼太; 黒田隆; 後藤公志; 松田秀一; 松田秀一  Hip Joint  44-  (2)  S292  -S294  2018/08
• 大腿骨頭壊死症例におけるステロイド投与の有無が術前の運動機能および人工股関節全置換術後の運動機能の回復に与える影響

  濱田涼太; 南角学; 黒田隆; 後藤公志; 松田秀一  Hip Joint  44-  (2)  S60  -S63  2018/08
• 術前OA所見と軟骨損傷との関連、および股関節鏡手術後のOA進行に影響する因子について

  後藤 公志; 松田 秀一  JOSKAS  43-  (4)  194  -194  2018/05
• 3年の間隔を持って両側性に一過性大腿骨頭萎縮症を生じたと考えられる1例

  河本聡; 黒田隆; 後藤公志; 松田秀一  中部日本整形外科災害外科学会雑誌  61-  (3)  511  -512  2018/05
• Relationship among biomechanical risk factors associated with radiographic progression of hip osteoarthritis.

  Tateuchi H; Akiyama H; Goto K; So K; Kuroda Y; Ichihashi N  Osteoarthritis Research Society International World Congress  2018/04  [Refereed]
  
• 寛骨臼形成不全による脚長差と仙腸関節変性の関連について

  奥津弥一郎; 後藤公志; 黒田隆; 河井利之; 岡畠憲章; 奥谷祐希; 川田交俊; 清水優; 片岡正尚; 松田秀一  日本整形外科学会雑誌  92-  (3)  S937  2018/03
• 特発性大腿骨頭壊死症に対する成長因子を用いた再生医療

  黒田隆; 浅田隆太; 猪原登志子; 南角学; 河井利之; 後藤公志; 秋山治彦; 松田秀一  日本整形外科学会雑誌  92-  (3)  S712  -S712  2018/03
• AWガラスセラミックフィラー含有の生体活性骨セメントを用いて固定された人工股関節の長期成績

  後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 松田秀一  日本整形外科学会雑誌  92-  (2)  S26  2018/03
• 高位脱臼股など難治性股関節症に対するTHA 当科における高位脱臼股に対するTHAの術式選択

  後藤 公志; 黒田 隆; 河井 利之; 松田 秀一  中部日本整形外科災害外科学会雑誌  61-  (春季学会)  34  -34  2018/03
• ハイドロキシアパタイト(HA)/L-ポリ乳酸(PLLA)化合物(superfixsorb)の刺入部周囲における新規骨形成評価

  森實 一晃; 後藤 公志; 藤林 俊介; 大槻 文悟; 河井 利之; 松田 秀一  日本整形外科学会雑誌  92-  (2)  S268  -S268  2018/03
• 酸化チタン含有セメントの関節内における骨結合能評価

  川田交俊; 後藤公志; 黒田隆; 河井利之; 奥津弥一郎; 森實一晃; 松田秀一  日本人工関節学会プログラム・抄録集  48th-  577  2018
• 変形性股関節症患者の歩行時股関節モーメント積分値に影響を与える股関節・骨盤・体幹のキネマティクス

  建内宏重; 秋山治彦; 後藤公志; 宗和隆; 黒田隆; 市橋則明  日本股関節学会学術集会プログラム・抄録集  45th-  619  2018
• 人工股関節再置換術の長期成績 臼蓋再建様式と生存率について

  河井利之; 後藤公志; 黒田隆; 松田秀一  日仏整形外科学会プログラム・抄録集  18th-  83  2018
• チタン合金製チャンレータイプのステムを用いたセメント人工股関節置換術の長期成績

  奥谷祐希; 後藤公志; 片岡正尚; 清水優; 川田交俊; 岡畠章憲; 奥津弥一郎; 河井利之; 黒田隆; 松田秀一  日本人工関節学会プログラム・抄録集  48th-  369  2018
• 人工股関節置換術(THA)後の患者満足度に寄与する因子の検討

  片岡正尚; 後藤公志; 河井利之; 黒田隆; 松田秀一  日本人工関節学会プログラム・抄録集  48th-  439  2018
• 両側ION症例に対するTHAでの摘出骨頭を用いた両側同時手術

  黒田隆; 河井利之; 後藤公志; 松田秀一  日本人工関節学会プログラム・抄録集  48th-  496  2018
• 人工股関節再置換術の長期成績 臼蓋再建様式と生存率について

  河井利之; 後藤公志; 黒田隆; 松田秀一  日本人工関節学会プログラム・抄録集  48th-  372  2018
• Crowe group IV高位脱臼股に対する転子下短縮骨切り併用THA―骨切り部癒合に影響する因子の考察―

  河井利之; 後藤公志; 黒田隆; 松田秀一  日本人工関節学会プログラム・抄録集  48th-  517  2018
• 酸化チタン含有セメントの関節内における骨結合能評価

  川田交俊; 後藤公志; 黒田隆; 奥津弥一郎; 森實一晃; 松田秀一  整形外科バイオマテリアル研究会プログラム・抄録集  37th-  28  2017/11
• 3年の間隔を持って両側性に特発性一過性大腿骨頭萎縮症(TOH)を生じた一例

  河本 聡; 黒田 隆; 河井 利之; 後藤 公志; 松田 秀一  中部日本整形外科災害外科学会雑誌  60-  (秋季学会)  262  -262  2017/09
• 脊柱のアライメントと柔軟性は変形性股関節症の進行に影響を与える.

  建内宏重; 小山優美子; 秋山治彦; 後藤公志; 宗和隆; 黒田隆; 市橋則明  第5回日本運動器理学療法学会学術大会  2017/09
• 大腿骨頭壊死症に対する成長因子を用いた再生医療―家兎モデルから臨床応用へ―

  黒田隆; 宗和隆; 後藤公志; 秋山治彦; 松田秀一  日本整形外科学会雑誌  91-  (8)  S1743  -S1743  2017/08
• 抗菌性イオンと骨形成促進イオンを同時に徐放する生体活性チタンの評価

  奥津 弥一郎; 藤林 俊介; 山口 誠二; 西谷 江平; 後藤 公志; 大槻 文悟; 松下 富春; 小久保 正; 松田 秀一  日本整形外科学会雑誌  91-  (8)  S1661  -S1661  2017/08
• Collared double taper stemの最適挿入方向と最終設置位置で保持する力の方向についての検討

  後藤 公志; 黒田 隆; 河井 利之; 松田 秀一; 前野 純彦  日本整形外科学会雑誌  91-  (8)  S1721  -S1721  2017/08
• ハイドロキシアパタイト(HA)/L-ポリ乳酸(PLLA)より作成した新規生体吸収性骨接合材のin vivoにおける骨形成能評価

  森實 一晃; 敷波 保夫; 藤林 俊介; 後藤 公志; 大槻 文悟; 松田 秀一  日本整形外科学会雑誌  91-  (8)  S1537  -S1537  2017/08
• 大腿骨頭壊死症例におけるステロイド投与が運動機能に与える影響

  濱田 涼太; 南角 学; 黒田 隆; 後藤 公志; 松田 秀一  Hip Joint  43-  (2)  S266  -S268  2017/08
• 変形性股関節症患者の骨盤前傾角は立ち上がり能力に影響する

  島村奈那; 南角学; 後藤公志; 黒田隆; 松田秀一; 松田秀一  Hip Joint  43-  (2)  S208  -S210  2017/08
• 変形性股関節症患者の股関節外転トルクは中殿筋と梨状筋の筋萎縮と関連する

  南角学; 濱田涼太; 細江拓也; 島村奈那; 後藤公志; 黒田隆; 松田秀一  Hip Joint  43-  (2)  S351  -S353  2017/08
• リウマチ患者におけるcemented double taper stemを使用した人工股関節全置換術の短期成績

  岡畠章憲; 後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 伊藤宣; 松田秀一  Hip Joint  43-  (2)  1042  -1045  2017/08
• 人工股関節全置換術における脚延長が術後の運動機能に及ぼす影響

  細江拓也; 南角学; 西川徹; 島村奈那; 濱田涼太; 黒田隆; 後藤公志; 松田秀一  Hip Joint  43-  (2)  S332  -S334  2017/08
• 人工股関節置換術後における脚伸展筋力の回復は遅延する

  細江 拓也; 南角 学; 黒田 隆; 宗 和隆; 後藤 公志; 池口 良輔; 松田 秀一  The Japanese Journal of Rehabilitation Medicine  54-  (特別号)  2  -P2K  2017/05
• 自家骨軟骨柱移植を施行し良好な経過をたどった大腿骨頭のBrodie骨膿瘍の1例

  室谷好紀; 黒田隆; 宗和隆; 後藤公志; 松田秀一  中部日本整形外科災害外科学会雑誌  60-  (3)  661  -661  2017/05
• 成長因子を用いた再生医療―特発性大腿骨頭壊死症に対する早期低侵襲治療―

  黒田隆; 浅田隆太; 猪原登志子; 山本倫生; 南角学; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  日本整形外科学会雑誌  91-  (3)  S718  -S718  2017/03
• 大腿骨頭壊死症例におけるステロイド投与は股関節機能に影響を与える

  濱田 涼太; 南角 学; 黒田 隆; 後藤 公志; 池口 良輔; 松田 秀一  理学療法京都  (46)  108  -109  2017/03
• 人工股関節置換術後早期における下肢筋力の回復状況は筋力間で異なる

  細江 拓也; 南角 学; 濱田 涼太; 黒田 隆; 宗 和隆; 後藤 公志; 池口 良輔; 松田 秀一  理学療法京都  (46)  118  -119  2017/03
• 成長因子を用いた再生医療 特発性大腿骨頭壊死症に対する早期低侵襲治療

  黒田 隆; 浅田 隆太; 猪原 登志子; 山本 倫生; 南角 学; 宗 和隆; 後藤 公志; 田畑 泰彦; 秋山 治彦; 松田 秀一  日本整形外科学会雑誌  91-  (3)  S718  -S718  2017/03
• 人工股関節置換術後早期における下肢筋力の回復状況は筋力間で異なる

  細江拓也; 南角学; 濱田涼太; 黒田隆; 宗和隆; 後藤公志; 池口良輔; 池口良輔; 松田秀一; 松田秀一  理学療法京都  (46)  118  -119  2017/03
• 大腿骨頭壊死症例におけるステロイド投与は股関節機能に影響を与える

  濱田涼太; 南角学; 黒田隆; 後藤公志; 池口良輔; 池口良輔; 松田秀一; 松田秀一  理学療法京都  (46)  108  -109  2017/03
• 学会を聞く 第43回日本股関節学会

  奥津 弥一郎; 後藤 公志  整形外科 = Orthopedic surgery  68-  (2)  194  -196  2017/02
• 特発性大腿骨頭壊死症に対するrhFGF‐2を用いた低侵襲再生医療

  黒田隆; 浅田隆太; 猪原登志子; 向井久美; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  再生医療  16-  263  2017/02
• 寛骨臼形成不全による変形性股関節症における仙腸関節変性の左右差と人工股関節全置換術の臨床成績との関連

  奥津弥一郎; 後藤公志; 清水優; 宗和隆; 黒田隆; 河井利之; 岡畠憲章; 川田交俊; 奥谷祐希; 片岡正尚; 松田秀一  日本股関節学会学術集会プログラム・抄録集  44th-  2017
• 特発性大腿骨頭壊死症の自然経過,骨頭圧潰率について

  黒田隆; 宗和隆; 後藤公志; 松田秀一; 田中健之; 田中栄; 瀧上伊織; 秋山治彦  日本股関節学会学術集会プログラム・抄録集  44th-  2017
• 特発性大腿骨頭壊死症の疫学調査・診断基準・重症度分類の改訂と診療ガイドライン策定を目指した大規模多施設研究 特発性大腿骨頭壊死症の骨頭圧潰率

  黒田隆; 宗和隆; 後藤公志; 松田秀一; 瀧上伊織; 秋山治彦; 田中健之; 田中栄  特発性大腿骨頭壊死症の疫学調査・診断基準・重症度分類の改訂と診療ガイドライン策定を目指した大規模多施設研究 平成28年度 総括・分担研究報告書(Web)  2017
• 前方侵入寛骨臼回転骨切り術(CPO)のリスク回避方法について

  後藤公志; 河井利之; 黒田隆; 宗和隆; 松田秀一  日本股関節学会学術集会プログラム・抄録集  44th-  2017
• 線摩耗率,体積摩耗率の計算方法についての検証

  宗和隆; 後藤公志; 黒田隆; 松田秀一  日本人工関節学会プログラム・抄録集  47th-  324  2017
• 股関節累積負荷の増大は変形性股関節症の進行に影響を与える―前向きコホート研究による分析―

  建内宏重; 小山優美子; 秋山治彦; 後藤公志; 宗和隆; 黒田隆; 市橋則明  日本理学療法学術大会(Web)  52nd-  (Suppl.2)  ROMBUNNO.O‐MT‐15‐5(J‐STAGE)  -5  2017
• 口腔内常在菌であるStreptococcus gordoniiが検出された左人工股関節感染の一例

  今村愛生; 宗和隆; 後藤公志; 黒田隆; 請田雄大; 長尾美紀; 福本元気; 松田秀一  日本人工関節学会プログラム・抄録集  47th-  546  2017
• 変形性股関節症患者における中殿筋の筋萎縮に関連する因子の検討

  細江拓也; 南角学; 黒田隆; 宗和隆; 後藤公志; 池口良輔; 池口良輔; 松田秀一; 松田秀一  日本理学療法学術大会(Web)  52nd-  (Suppl.2)  ROMBUNNO.O‐KS‐19‐4(J‐STAGE)  -4  2017
• 初回片側人工股関節全置換術後6か月の歩行速度を規定する因子の検討

  村尾昌信; 南角学; 細江拓也; 島村奈那; 濱田涼太; 後藤公志; 黒田隆; 松田秀一; 松田秀一  日本理学療法学術大会(Web)  52nd-  ROMBUNNO.P‐MT‐10‐3(J‐STAGE)  -160  2017
• 同一機種使用下でのOAとIONでのセメントレスTHAの術後脱臼率

  黒田隆; 宗和隆; 後藤公志; 松田秀一  日本人工関節学会プログラム・抄録集  47th-  362  2017
• 股関節疾患患者の骨盤アライメントは立ち上がり能力に影響する

  島村奈那; 南角学; 西川徹; 細江拓也; 村尾昌信; 濱田涼太; 黒田隆; 宗和隆; 後藤公志; 池口良輔; 池口良輔; 松田秀一; 松田秀一  日本理学療法学術大会(Web)  52nd-  ROMBUNNO.P‐MT‐49‐1(J‐STAGE)  -353  2017
• 重症筋無力症を背景に持つ両側大腿骨頭壊死に対し片側人工股関節全置換術を施行後,重症筋無力症の悪化に伴い脱臼した一例

  室谷好紀; 黒田隆; 宗和隆; 後藤公志; 松田秀一  日本人工関節学会プログラム・抄録集  47th-  540  2017
• 人工股関節置換術後の動作のQOLと満足度が一致しない患者の特徴

  西川徹; 南角学; 西村純; 島村那奈; 黒田隆; 後藤公志; 松田秀一; 松田秀一  日本理学療法学術大会(Web)  52nd-  (Suppl.2)  ROMBUNNO.O‐MT‐15‐3(J‐STAGE)  -3  2017
• 人工股関節置換術後早期における股関節外転筋力の回復に影響を及ぼす因子の検討

  細江拓也; 南角学; 濱田涼太; 黒田隆; 宗和隆; 後藤公志; 池口良輔; 池口良輔; 松田秀一; 松田秀一  日本理学療法学術大会(Web)  52nd-  ROMBUNNO.O‐MT‐15‐4(J‐STAGE)  -86  2017
• 人工股関節置換術後における術側上肢への重錘負荷を用いた歩行トレーニングの効果

  南角学; 細江拓也; 後藤公志; 黒田隆; 松田秀一  日本人工関節学会プログラム・抄録集  47th-  552  2017
• 人工股関節置換術後の股関節外転筋力の回復は脚延長量および術前の股関節周囲筋の筋萎縮と関連する

  南角学; 細江拓也; 池口良輔; 池口良輔; 後藤公志; 黒田隆; 松田秀一; 松田秀一  日本理学療法学術大会(Web)  52nd-  ROMBUNNO.P‐MT‐21‐1(J‐STAGE)  -213  2017
• 人工股関節置換術後の膝関節伸展筋力の回復に影響を及ぼす因子の検討

  細江拓也; 南角学; 濱田涼太; 黒田隆; 宗和隆; 後藤公志; 池口良輔; 池口良輔; 松田秀一; 松田秀一  日本人工関節学会プログラム・抄録集  47th-  353  2017
• 股関節手術におけるHA‐PLLAコンポジットスクリュー使用の利点と注意点

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 松田秀一  日本バイオマテリアル学会シンポジウム予稿集  2016-  124  -124  2016/11
• 特発性大腿骨頭壊死症に対する成長因子を用いた再生医療―臨床試験から治験へ―

  黒田隆; 浅田隆太; 猪原登志子; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  日本バイオマテリアル学会シンポジウム予稿集  2016-  199  2016/11
• 特発性大腿骨頭壊死症 成長因子rhFGF-2ゼラチンハイドロゲルを用いた低侵襲再生医療

  黒田 隆; 浅田 隆太; 南角 学; 猪原 登志子; 宗 和隆; 後藤 公志; 田畑 泰彦; 秋山 治彦; 松田 秀一  日本最小侵襲整形外科学会誌  16-  (1)  77  -77  2016/11
• 人工股関節置換術後における階段昇降能力の回復は歩行および立ち上がり能力と比較して遅延する

  島村 奈那; 南角 学; 濱田 涼太; 村尾 昌信; 黒田 隆; 後藤 公志; 松田 秀一  理学療法学  43-  (Suppl.2)  O  -MT  2016/10
• 人工股関節全置換術後6ヵ月の歩行速度は術前の非術側脚伸展筋力から予測できる

  村尾 昌信; 南角 学; 島村 奈那; 濱田 涼太; 後藤 公志; 黒田 隆; 松田 秀一  理学療法学  43-  (Suppl.2)  O  -MT  2016/10
• 変形性股関節症患者における股関節脱臼は股関節周囲筋と股関節外転トルクと関連する

  南角 学; 島村 那奈; 村尾 昌信; 濱田 涼太; 黒田 隆; 池口 良輔; 後藤 公志; 松田 秀一  理学療法学  43-  (Suppl.2)  O  -KS  2016/10
• 当科におけるセメントTHAに併用した臼蓋骨移植の工夫と固定材料の変遷,およびその長期成績について

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 松田秀一  中部日本整形外科災害外科学会雑誌  59-  (秋季学会)  111  -111  2016/09
• 人工股関節全置換術後早期における階段昇降能力は脚伸展筋力と関連する

  島村奈那; 南角学; 西川徹; 黒田隆; 後藤公志  Hip Joint  42-  (2)  S263  -S265  2016/08
• セメントTHAにおけるポリエチレン摩耗について CPEとHXLPEの10年以上の前向き比較調査

  後藤 公志; 川田 交俊; 宗 和隆; 黒田 隆; 奥津 弥一郎; 奥谷 祐希; 岡畠 章憲; 松田 秀一  日本整形外科学会雑誌  90-  (8)  S1443  -S1443  2016/08
• 変形性股関節症患者における股関節脱臼は股関節周囲筋と股関節外転トルクと関連する

  南角 学; 島村 那奈; 村尾 昌信; 濱田 涼太; 黒田 隆; 池口 良輔; 後藤 公志; 松田 秀一  日本基礎理学療法学雑誌  20-  (1)  66  -66  2016/08
• 特発性大腿骨頭壊死症の骨頭圧潰率

  黒田隆; 瀧上伊織; 田中健介; 宗和隆; 猪原登志子; 山本倫生; 後藤公志; 田中栄; 秋山治彦; 松田秀一  日本整形外科学会雑誌  90-  (3)  S917  -S917  2016/03
• Dysplastic hip女性の原臼蓋の骨形態

  奥津弥一郎; 後藤公志; 宗和隆; 黒田隆; 川田交俊; 岡畠章憲; 奥谷祐希; 松田秀一  日本整形外科学会雑誌  90-  (3)  S913  -S913  2016/03
• 特発性大腿骨頭壊死症に対する再生医療―成長因子を用いたトランスレーショナルリサーチ―

  黒田隆; 浅田隆太; 猪原登志子; 南角学; 山本倫生; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  日本整形外科学会雑誌  90-  (2)  S126  -S126  2016/03
• 臼蓋移植骨固定にHA‐PLLAコンポジットスクリューを用いた人工股関節置換術の中期成績

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 松田秀一  中部日本整形外科災害外科学会雑誌  59-  144  2016/03
• 人工股関節再置換術においてステムにcement‐in‐cement法を使用した症例の術後中・長期成績

  奥津弥一郎; 後藤公志; 宗和隆; 黒田隆; 松田秀一  中部日本整形外科災害外科学会雑誌  59-  (春季学会)  143  -143  2016/03
• 特発性大腿骨頭壊死症―rhFGF‐2ゼラチンハイドロゲルを用いた再生医療―

  黒田隆; 浅田隆太; 猪原登志子; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  日本軟骨代謝学会プログラム・抄録集  29th-  119  2016/02
• 特発性大腿骨頭壊死症に対する再生医療―成長因子を用いたトランスレーショナルリサーチ―

  黒田隆; 浅田隆太; 南角学; 猪原登志子; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  再生医療  15-  207  2016/02
• デザインの異なるセメントステムについての中期成績の比較検討

  奥谷祐希; 後藤公志; 川田交俊; 奥津弥一郎; 黒田隆; 宗和隆; 松田秀一  日本人工関節学会プログラム・抄録集  46th-  2016
• 生体肝移植後のステロイド性大腿骨頭壊死症の発生頻度とTHA症例の中期成績

  黒田隆; 光澤定己; 岡畠章憲; 川田交俊; 奥谷祐希; 奥津弥一郎; 宗和隆; 後藤公志; 松田秀一  日本人工関節学会プログラム・抄録集  46th-  2016
• 臼蓋移植骨固定にHA-PLLAコンポジットスクリューを用いた人工股関節置換術の中期成績

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 奥谷祐希; 松田秀一  日本人工関節学会プログラム・抄録集  46th-  2016
• 当院における初回人工股関節置換術後脱臼の現状からみるハイブリッドTHAの有用性

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 奥谷祐希; 松田秀一  日本人工関節学会プログラム・抄録集  46th-  2016
• 人工股関節手術でのUHMWPEテープの使用方法,使用経験

  黒田隆; 岡畠章憲; 川田交俊; 奥谷祐希; 奥津弥一郎; 宗和隆; 後藤公志; 松田秀一  日本人工関節学会プログラム・抄録集  46th-  2016
• クロスリンクポリエチレンを使用したセメント人工股関節全置換術の長期摩耗成績

  川田交俊; 後藤公志; 宗和隆; 伊勢健太郎; 黒田隆; 奥津弥一郎; 松田秀一  日本人工関節学会プログラム・抄録集  46th-  2016
• 関節リウマチに対するcemented double taper stemを使用した全人工股関節置換術の短期成績

  岡畠章憲; 後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 奥谷祐希; 伊藤宣; 松田秀一  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• 成人股関節外科医が考える小児から成人までのDDH治療体系

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 奥谷祐希; 岡畠章憲; 松田秀一  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• 人工股関節再置換術や人工股関節周囲骨折に対するCortical strut allograftと用いた大腿骨再建の治療成績

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 岡畠章憲; 奥谷祐希; 松田秀一  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• セメント人工股関節置換術におけるHXLPEの摩耗に関する長期臨床成績

  川田交俊; 後藤公志; 宗和隆; 黒田隆; 奥津弥一郎  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• 摩耗率の計算方法についての検証

  宗和隆; 黒田隆; 後藤公志; 松田秀一  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• 特発性大腿骨頭壊死症に対する成長因子を用いた再生医療

  黒田隆; 南角学; 宗和隆; 後藤公志; 松田秀一; 秋山治彦  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• 寛骨臼形成不全症による変形性股関節症と仙腸関節変性の関連について

  奥津弥一郎; 後藤公志; 宗和隆; 黒田隆; 岡畠章憲; 奥谷祐希; 川田交俊; 松田秀一  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• 特発性大腿骨頭壊死症の疫学調査・診断基準・重症度分類の改訂と診療ガイドライン策定を目指した大規模多施設研究 特発性大腿骨頭壊死症の骨頭圧潰率

  黒田隆; 宗和隆; 後藤公志; 松田秀一; 瀧上伊織; 秋山治彦; 田中健之; 田中栄  特発性大腿骨頭壊死症の疫学調査・診断基準・重症度分類の改訂と診療ガイドライン策定を目指した大規模多施設研究 平成27年度 総括・分担研究報告書  2016
• 特発性大腿骨頭壊死症に対するFGF-2を用いた再生医療-臨床試験から治験へ

  黒田隆; 浅田隆太; 南角学; 猪原登志子; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  DDS再生医療研究会プログラム・抄録集(Web)  6th-  2016
• 吸収性材料を用いたSpitzy変法による臼蓋形成術の低侵襲下への試み

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 川田交俊; 奥谷祐希; 岡畠章憲; 松田秀一  日本股関節学会学術集会プログラム・抄録集  43rd-  2016
• 特発性大腿骨頭壊死症―rhFGF‐2ゼラチンハイドロゲルを用いた再生医療―

  KURODA TAKASHI; ASADA RYUTA; INOHARA TOSHIKO; NANGAKU MANABU; SO KAZUTAKA; GOTO KOJI; TABATA YASUHIKO; AKIYAMA HARUHIKO; MATSUDA SHUICHI  日本バイオマテリアル学会大会予稿集  37th-  236  -236  2015/11
• SrイオンやMgイオンを徐放するチタン金属の生体活性能の評価

  奥津 弥一郎; 藤林 俊介; 大槻 文悟; 後藤 公志; 山本 浩司; 山口 誠二; 松下 富春; 小久保 正; 松田 秀一  日本バイオマテリアル学会大会予稿集  37回-  246  -246  2015/11
• SrイオンやMgイオンを徐放するチタン金属の生体活性能の評価

  奥津 弥一郎; 藤林 俊介; 大槻 文悟; 後藤 公志; 山本 浩司; 山口 誠二; 松下 富春; 小久保 正; 松田 秀一  日本バイオマテリアル学会大会予稿集  37回-  246  -246  2015/11
• 特発性大腿骨頭壊死症に対する薬生医療 FGF-2ハイドロゲルを用いた骨頭圧潰前の早期低侵襲治療

  黒田 隆; 宗 和隆; 後藤 公志; 南角 学; 浅田 隆太; 田畑 泰彦; 秋山 治彦; 松田 秀一  日本最小侵襲整形外科学会誌  15-  (1)  73  -73  2015/10
• 特発性大腿骨頭壊死症に対する再生医療―rhFGF‐2ゼラチンハイドロゲルを用いたトランスレーショナルリサーチ―

  KURODA YUTAKA; ASADA RYUTA; IHARA TOSHIKO; NANKAKU MANABU; SO KAZUTAKA; GOTO KOJI; TABATA YASUHIKO; AKIYAMA HARUHIKO; MATSUDA SHUICHI  日本整形外科学会雑誌  89-  (8)  S1760  -S1760  2015/09
• SrイオンやMgイオンを徐放するチタン金属の生体活性能の評価

  奥津 弥一郎; 藤林 俊介; 大槻 文悟; 後藤 公志; 山本 浩司; 山口 誠二; 松下 富春; 小久保 正; 松田 秀一  日本整形外科学会雑誌  89-  (8)  S1736  -S1736  2015/09
• 転子下骨切り併用THAにおけるセメントステムとセメントレスステムの比較

  NISHIYAMA HOMARE; SO KAZUTAKA; KURODA TAKASHI; GOTO KOJI; MATSUDA SHUICHI  中部日本整形外科災害外科学会雑誌  58-  (秋季学会)  173  -173  2015/09
• 転子下骨切り併用THAにおけるセメントステムとセメントレスステムの比較

  西山 誉; 宗 和隆; 黒田 隆; 後藤 公志; 松田 秀一  中部日本整形外科災害外科学会雑誌  58-  (秋季学会)  173  -173  2015/09
• 特発性大腿骨頭壊死症に対する再生医療 rhFGF-2ゼラチンハイドロゲルを用いたトランスレーショナルリサーチ

  黒田 隆; 浅田 隆太; 猪原 登志子; 南角 学; 宗 和隆; 後藤 公志; 田畑 泰彦; 秋山 治彦; 松田 秀一  日本整形外科学会雑誌  89-  (8)  S1760  -S1760  2015/09
• 人工股関節全置換術後早期における患者立脚型評価は運動機能の回復が関連する

  西川 徹; 南角 学; 西村 純; 黒田 隆; 後藤 公志  Hip Joint  41-  (Suppl.)  18  -20  2015/08
• 前方アプローチにて全摘出した股関節滑膜骨軟骨腫症の1例

  片岡 正尚; 後藤 公志; 宗 和隆; 村田 巨樹; 杉本 正幸; 松田 秀一  中部日本整形外科災害外科学会雑誌  58-  (4)  723  -724  2015/07
• 【整形外科領域における再生医療の最前線】 間葉系幹細胞を用いた骨壊死治療法

  戸口田 淳也; 青山 朋樹; 柿木 良介; 後藤 公志; 笠井 泰成  関節外科  34-  (5)  430  -435  2015/05
• 人工股関節再置換術において大腿骨ステムをcement in cement法で固定した症例の術後長期成績

  OKUZU YAICHIRO; GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI; MATSUDA SHUICHI  日本整形外科学会雑誌  89-  (3)  S829  -S829  2015/03
• 特発性大腿骨頭壊死症に対する再生治療の取り組みと臨床応用―FGF‐2ゼラチンハイドロゲルを用いた骨頭圧潰前の早期低侵襲治療の短期成績―

  KURODA YUTAKA; SO KAZUTAKA; NANKAKU MANABU; ASADA RYUTA; GOTO KOJI; TABATA YASUHIKO; AKIYAMA HARUHIKO; MATSUDA SHUICHI  日本整形外科学会雑誌  89-  (2)  S163  -S163  2015/03
• 特発性大腿骨頭壊死症313例の背景因子,診断時病型,病期別の自然経過

  KURODA YUTAKA; SO KAZUTAKA; OKUTSU YAICHIRO; GOTO KOJI; AKIYAMA HARUHIKO; MATSUDA SHUICHI  日本整形外科学会雑誌  89-  (2)  S159  -S159  2015/03
• クロスリンクポリエチレンを使用した人工股関節術後10年以上経過例の線摩耗率について:セメント,セメントレスの比較

  SO KAZUTAKA; KURODA TAKASHI; GOTO KOJI; MATSUDA SHUICHI  日本整形外科学会雑誌  89-  (2)  S186  -S186  2015/03
• THAでの臼蓋移植骨固定におけるポリ乳酸/水酸化アパタイトコンポジットスクリューの有用性と安全性

  後藤 公志; 宗 和隆; 黒田 隆; 奥津 弥一郎; 松田 秀一  中部日本整形外科災害外科学会雑誌  58-  (春季学会)  59  -59  2015/03
• 前方アプローチにて全摘出した股関節滑膜骨軟骨腫症の1例

  KATAOKA MASANAO; GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI; MATSUDA SHUICHI; SUGIMOTO MASAYUKI  中部日本整形外科災害外科学会雑誌  58-  (春季学会)  219  -219  2015/03
• 特発性大腿骨頭壊死症に対する再生治療の取り組みと臨床応用―FGF‐2ハイドロゲルを用いた早期低侵襲治療―

  KURODA TAKASHI; SO KAZUTAKA; NANKAKU MANABU; ASADA RYUTA; GOTO KOJI; TABATA YASUHIKO; AKIYAMA HARUHIKO; MATSUDA SHUICHI  再生医療  14-  223  2015/02
• 特発性大腿骨頭壊死症に対するrhFGF-2ハイドロゲルを用いた低侵襲再生医療

  黒田隆; 浅田隆太; 南角学; 猪原登志子; 宗和隆; 後藤公志; 田畑泰彦; 秋山治彦; 松田秀一  DDS再生医療研究会プログラム・抄録集(Web)  5th-  2015
• Spitzy変法による棚形成術のデザインとその根拠

  後藤公志; 宗和隆; 黒田隆; 奥津弥一郎; 松田秀一  日本股関節学会学術集会プログラム・抄録集  42nd-  2015
• 変形性股関節症患者の階段昇降能力には下肢筋力が影響する

  NISHIMURA JUN; NANKAKU MANABU; NISHIKAWA TOORU; IKEGUCHI RYOSUKE; GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI; MATSUDA SHUICHI  日本理学療法学術大会(Web)  50th-  (Suppl.2)  P1-A-0224(J-STAGE)  -0224  2015
• 特発性大腿骨頭壊死症の骨頭圧潰率

  KURODA YUTAKA; TAKIGAMI IORI; TANAKA TAKEYUKI; SO KAZUTAKA; GOTO KOJI; TANAKA SAKAE; AKIYAMA HARUHIKO; MATSUDA SHUICHI  日本股関節学会学術集会プログラム・抄録集  42nd-  298  2015
• Dysplastic hip女性の原臼蓋の骨形態の計測

  OKUZU YAICHIRO; GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI; MATSUDA SHUICHI  日本股関節学会学術集会プログラム・抄録集  42nd-  630  2015
• 人工股関節置換術後早期における階段昇降能力は脚伸展筋力と関連する

  SHIMAMURA NANA; NANKAKU MANABU; NISHIKAWA TOORU; KURODA TAKASHI; GOTO KOJI  日本股関節学会学術集会プログラム・抄録集  42nd-  609  2015
• 遠位固定型ステムELANCEの短期成績およびFEM解析―SL‐PLUSとの比較

  SO KAZUTAKA; KURODA TAKASHI; GOTO KOJI; MATSUDA SHUICHI  日本股関節学会学術集会プログラム・抄録集  42nd-  652  2015
• 前期から進行期変形性股関節症患者における関節裂隙狭小化と歩行特性との関連性 股関節累積負荷に着目した解析

  TATEUCHI HIROSHIGE; KOYAMA YUMIKO; TSUKAGOSHI RUI; SO KAZUTAKA; KURODA TAKASHI; GOTO KOJI; AKIYAMA HARUHIKO; ICHIHASHI NORIAKI  日本理学療法学術大会(Web)  50th-  (Suppl.2)  O-0029(J-STAGE)  -0029  2015
• 前期から進行期の変形性股関節症患者における関節形態および変性変化と股関節可動域・筋力の関連性

  TATEUCHI HIROSHIGE; KOYAMA YUMIKO; TSUKAGOSHI RUI; AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI; ICHIHASHI NORIAKI  日本股関節学会学術集会プログラム・抄録集  42nd-  593  2015
• ネスプロンテープを用いた外側広筋温存Waferアプローチでの大転子再建は術後の骨癒合率を高める

  KURODA TAKASHI; SO KAZUTAKA; NANKAKU MANABU; GOTO KOJI; MATSUDA SHUICHI  日本人工関節学会プログラム・抄録集  45th-  551  2015
• 遠位固定型ステムELNACEの短期成績―SL‐PLUSとの比較

  SO KAZUTAKA; KURODA TAKASHI; GOTO KOJI; MATSUDA SHUICHI  日本人工関節学会プログラム・抄録集  45th-  606  2015
• 大転子の骨切りを伴う2種類のアプローチを用いた初回THAの短期成績の比較と大転子骨片の転位との関連性

  GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI; MATSUDA SHUICHI; FURUYA YUKI; SAKURAGI ATSUSHI; TANAKA JUN; SUGIMOTO MASAYUKI  日本人工関節学会プログラム・抄録集  45th-  333  2015
• 大転子の骨切りを伴う2種類のアプローチを用いた初回THAの短期成績の比較と大転子骨片の転位との関連性

  後藤 公志; 松田 秀一; 櫻木 淳史; 古屋 祐樹; 田中 淳; 杉本 正幸  中部日本整形外科災害外科学会雑誌  57-  (秋季学会)  223  -223  2014/09
• 大腿骨頭壊死症に対する自己骨随由来間葉系幹細胞を用いた臨床試験におけるリハビリテーション

  青山 朋樹; 藤田 容子; 窓場 勝之; 南角 学; 冨田 素子; 後藤 公志; 柿木 良介; 中村 孝志; 戸口田 淳也  理学療法学  41-  (大会特別号2)  0593  -0593  2014/05
• 大腿骨頭壊死症に対する自己骨髄間葉系幹細胞を用いた臨床試験

  AOYAMA TOMOKI; GOTO KOJI; KAKINOKI RYOSUKE; IKEGUCHI RYOSUKE; UEDA MICHIKO; KASAI YASUNARI; MAEKAWA TAIRA; TADA HARUE; TERAMUKAI SATOSHI; TOGUCHIDA JUN'YA  再生医療  13-  213  2014/01
• Linear Wear Rate of Cases Followed for More Than Ten Years After Cementless THA Using Highly Cross-Linked Polyethylene

  Kazutaka So; Yutaka Kuroda; Koji Goto; Shuichi Matsuda  27th Annual Congress of International Society for Technology in Arthroplasty  2014
• 人工股関節再置換術において大腿骨ステムをcement in cement法で固定した症例の術後長期成績

  OKUZU YAICHIRO; GOTO KOJI; SO KAZUTAKA; KURODA YUTAKA; MATSUDA SHUICHI  日本股関節学会学術集会プログラム・抄録集  41st-  469  2014
• クロスリンクポリエチレンを使用したセメントレス人工股関節置換術後10年以上経過例の線摩耗率について

  SO KAZUTAKA; KURODA YUTAKA; GOTO KOJI; MATSUDA SHUICHI  日本股関節学会学術集会プログラム・抄録集  41st-  464  2014
• アプローチ方法による人工股関節置換術後の運動機能回復過程の違い

  NISHIMURA JUN; NANKAKU MANABU; NISHIKAWA TOORU; GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI  日本股関節学会学術集会プログラム・抄録集  41st-  605  2014
• 変形性股関節症患者の骨盤アライメントと腸骨筋の筋萎縮は関連する

  NANKAKU MANABU; GOTO KOJI; KURODA YUTAKA  日本股関節学会学術集会プログラム・抄録集  41st-  399  2014
• 大転子前方の骨切りを伴う2種類のアプローチを用いた初回THAの短期成績の比較,および大転子骨片の転位との関連性について

  GOTO KOJI; SO KAZUTAKA; KURODA TAKASHI; FURUYA YUKI; MATSUDA SHUICHI  日本股関節学会学術集会プログラム・抄録集  41st-  525  2014
• 特発性大腿骨頭壊死症に対する再生医療の取り組み‐FGF‐2ゼラチンハイドロゲルを用いた骨頭圧潰前の早期低侵襲治療‐

  KURODA YUTAKA; SO KAZUTAKA; GOTO KOJI; NANKAKU MANABU; ASADA RYUTA; AKIYAMA MASAHIKO; MATSUDA SHUICHI  日本股関節学会学術集会プログラム・抄録集  41st-  190  2014
• Use of HA-PLLA composite screws to fix acetabular bone graft in cemented THA: Absorption pattern of screws in six patients

  Koji Goto; Haruhiko Akiyama; Keiichi Kawanabe; Kazutaka So; Takashi Nakamura  Key Engineering Materials  493-494-  422  -425  2012
• 人工股関節置換術後患者の下肢筋力と歩行能力の関連性 術前と術後6ヵ月の比較

  藤田 容子; 南角 学; 西村 純; 中村 孝志; 柿木 良介; 秋山 治彦; 後藤 公志  The Japanese Journal of Rehabilitation Medicine  48-  (7)  488  -488  2011/07
• セメント固定ロングステムを用いた人工股関節再置換術の長期成績

  SO KAZUTAKA; AKIYAMA HARUHIKO; GOTO KOJI; NAKAMURA TAKASHI  日本整形外科学会雑誌  85-  (3)  S711  2011/03
• Long-term results of cemented total hip arthroplasty for dysplasia, with structural autograft fixed with poly-L-lactic acid screws

  後藤 公志  Orthopedic surgery  62-  (3)  285  -287  2011/03
• チタン合金製セメントステムの臨床成績および実験的検証

  AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; KANEUJI AYUMI; MATSUMOTO TADAMI; NAKAMURA TAKASHI  日本人工関節学会プログラム・抄録集  41st-  286  2011
• 人工股関節置換術後患者における歩行時股関節伸展制限の原因は何か?

  TSUKAGOSHI RUI; TATEUCHI HIROSHIGE; FUKUMOTO KIKEI; UEMURA KAZUTAKA; AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; OKUMURA HIDEO; NAKAMURA TAKASHI; ICHIHASHI NORIAKI  理学療法学  38-  (Suppl.2)  ROMBUNNO.PI1-236  -236  2011
• セメント固定ロングステムを用いた人工股関節再置換術の長期成績

  SO KAZUTAKA; AKIYAMA HARUHIKO; GOTO KOJI; NAKAMURA TAKASHI  日本人工関節学会プログラム・抄録集  41st-  (3)  338  -S711  2011
• 人工関節固定用の生体活性骨セメントの開発

  GOTO KOJI; FUKUDA CHISAKO; IMAMURA MASASHI; AKIYAMA HARUHIKO; SO KAZUTAKA; NAKAMURA TAKASHI  日本人工関節学会プログラム・抄録集  41st-  335  2011
• カップ関節形成術後に人工股関節置換術をおこなった症例の検討

  OKAHATA AKINORI; AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; NAKAMURA TAKASHI  日本人工関節学会誌  40-  114  -115  2010/12
• Computed tomography-based navigation for curved periacetabular osteotomy

  Haruhiko Akiyama; Koji Goto; Kazutaka So; Takashi Nakamura  Journal of Orthopaedic Science  15-  (6)  829  -833  2010/11
• セメントレスTHA後疼痛に対して腸腰筋腱切離施行した後に反復性脱臼を生じた1例

  YURUE HIROFUMI; SO KAZUTAKA; GOTO KOJI; AKIYAMA HARUHIKO; NAKAMURA TAKASHI  中部日本整形外科災害外科学会雑誌  53-  (6)  1431  -1431  2010/11
• 安全にCPO(寛骨臼回転骨切り術)を行うための術前3Dシミュレーション

  GOTO KOJI; AKIYAMA HARUHIKO; SO KAZUTAKA; NAKAMURA TAKASHI; KAWANABE KEIICHI  Hip Jt  36-  367  -370  2010/10
• 酸化チタン含有生体活性骨セメントの開発

  GOTO KOJI; FUKUDA CHISAKO; IMAMURA MASASHI; AKIYAMA HARUHIKO; SO KAZUTAKA; NAKAMURA TAKASHI  日本整形外科学会雑誌  84-  (4)  S536  -S536  2010/04
• AHFIX Q System抜去インプラントの組織学的評価

  SO KAZUTAKA; GOTO KOJI; AKIYAMA HARUHIKO; NAKAMURA TAKASHI  日本整形外科学会雑誌  84-  (4)  S573  -S573  2010/04
• 臼蓋側Impaction bone grafting法の術前設計と術式の工夫

  AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; NAKAMURA TAKASHI; MORISHIMA TATSUMI; OTSUKA HIROMI; SATO KEIJI; KAWANABE KEIICHI  日本人工関節学会プログラム・抄録集  40th-  262  2010
• セメントレス人工股関節AHFIX抜去例の組織学的検討

  SO KAZUTAKA; GOTO KOJI; AKIYAMA HARUHIKO; NAKAMURA TAKASHI  日本人工関節学会プログラム・抄録集  40th-  364  2010
• 臼蓋移植骨固定にHA‐PLLA serewを使用したセメントTHA6症例の長期成績の検討

  GOTO KOJI; AKIYAMA HARUHIKO; KAWANABE KEIICHI; SO KAZUTAKA; NAKAMURA TAKASHI  整形外科バイオマテリアル研究会プログラム・抄録集  30th-  36  2010
• 臼蓋移植骨固定にHA‐PLLA screwを使用したセメントTHA6症例の長期成績の検討

  GOTO KOJI; AKIYAMA HARUHIKO; SO KAZUTAKA; NAKAMURA TAKASHI  日本人工関節学会プログラム・抄録集  40th-  321  2010
• CUP関節形成術後に全人工股関節置換術を行った症例の検討

  OKAHATA AKINORI; AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; NAKAMURA TAKASHI  日本人工関節学会プログラム・抄録集  40th-  374  2010
• 人工股関節置換術後感染にて広範囲骨欠損をきたした難治症例

  OKAHATA AKINORI; AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; NAKAMURA TAKASHI  中部日本整形外科災害外科学会雑誌  52-  (4)  1038  -1038  2009/07
• 大腿骨頭壊死症に対する血管柄付腸骨移植と併用した骨髄間葉系幹細胞移植法について

  IKEKUCHI YOSHISUKE; KAKINOKI RYOSUKE; GOTO KOJI; NAKAMURA TAKASHI; AOYAMA TOMOKI; UEDA MICHIKO; KIN YOKI; ITO KIN'YA; TOGUCHIDA JUN'YA; MAEKAWA TAIRA  日本マイクロサージャリー学会会誌  22-  (2)  127  -128  2009/06
• Relationship between patterns of putting-on and taking-off socks and hip flexion range of motion in early stages after total hip arthroplasty surgery

  Manabu Nankaku; Aya Takagi; Haruhiko Akiyama; Koji Goto; Takashi Nakamura; Ryosuke Kakinoki  Rigakuryoho Kagaku  24-  (2)  241  -244  2009/04
• Cement‐in‐cement techniqueを用いた人工股関節再置換術の合併症および術後X線像の変化について

  GOTO KOJI; AKIYAMA HARUHIKO; SO KAZUTAKA; NAKAMURA TAKASHI; KAWANABE KEIICHI  日本整形外科学会雑誌  83-  (3)  S710  -S710  2009/03
• 臼蓋移植骨固定にPLLAスクリューを用いたセメントTHAの長期成績の検討

  GOTO KOJI; AKIYAMA HARUHIKO; SO KAZUTAKA; NAKAMURA TAKASHI; KAWANABE KEIICHI  日本整形外科学会雑誌  83-  (3)  S481  -S481  2009/03
• KTプレートおよびallograft bone blockを用いた臼蓋再建の解析

  AKIYAMA HARUHIKO; GOTO KOJI; SO KAZUTAKA; NAKAMURA TAKASHI  日本整形外科学会雑誌  83-  (3)  S709  -S709  2009/03
• セメントレスTHA(H6システムとAHFIXシステム)の治療成績比較

  SO KAZUTAKA; GOTO KOJI; AKIYAMA HARUHIKO; KAWANABE KEIICHI; NAKAMURA TAKASHI  日本整形外科学会雑誌  83-  (2)  S137  -S137  2009/02
• Clinical and radiological evaluation of revision hip arthroplasty using the cement-in-cement technique

  GOTO KOJI; AKIYAMA HARUHIKO; SO KAZUTAKA; KAWANABE KEIICHI; NAKAMURA TAKASHI  中部日本整形外科災害外科学会雑誌  52-  (1)  21  -22  2009/01
• The use of the corrective shoe lifts for leg discrepancy for THA patients : Analysis of patterns of displacement of center of gravity and walking efficiency

  NANKAKU Manabu  Hip Joint  34-  (Suppl.)  146  -149  2008/11
• In‐cement techniqueを用いた人工股関節再置換術の治療成績

  GOTO KOJI; AKIYAMA HARUHIKO; SO KAZUTAKA; NAKAMURA TAKASHI; KAWANABE KEIICHI  中部日本整形外科災害外科学会雑誌  51-  61  2008/09
• 家兎大腿骨頭壊死モデルに対するbFGFゼラチンハイドロゲルの治療効果

  KURODA TAKASHI; KAWANABE KEIICHI; TABATA YASUHIKO; GOTO KOJI; AKIYAMA HARUHIKO; NEO MASASHI; NAKAMURA TAKASHI  日本整形外科学会雑誌  82-  (8)  S1168  -S1168  2008/08
• 大腿骨頭壊死症の家兎動物モデル

  KURODA TAKASHI; KAWANABE KEIICHI; GOTO KIMISHI; AKIYAMA HARUHIKO; NAKAMURA TAKASHI  日本整形外科学会雑誌  81-  (8)  S881  -S881  2007/08
• 大腿骨頭壊死症の家兎動物モデル

  KURODA YUTAKA; GOTO KOJI; AKIYAMA HARUHIKO; KAWANABE KEIICHI; NAKAMURA TAKASHI  中部日本整形外科災害外科学会雑誌  50-  (春季学会)  89  -89  2007/03
• チタニア微粒子含有生体活性骨セメントの開発

  後藤 公志; 藤林 俊介; 川那辺 圭一; 中村 孝志; 橋本 雅美; 小久保 正  Orthopaedic Ceramic Implants  23〜24-  95  -99  2005/12
• 酸化チタン微粒子含有骨セメントの力学的および生物学的特性の評価

  後藤 公志; 橋本 雅美; 藤林 俊介; 田村 治郎; 川那辺 圭一; 小久保 正; 中村 孝志  日本バイオマテリアル学会大会予稿集  27回-  115  -115  2005/11
• 経皮的椎体形成術に応用可能なβ-TCP含有コンポジットセメントの骨伝導能

  後藤 公志; 藤林 俊介; 田村 治郎; 川那辺 圭一; 長谷川 新; Kowalski Rick; 中村 孝志  日本バイオマテリアル学会大会予稿集  27回-  116  -116  2005/11
• 人工骨による骨再生 ハイドロキシアパタイト・ポリ乳酸複合多孔質体の骨補填材,scaffoldとしての有用性の検討

  長谷川 新; 田村 治郎; 根尾 昌志; 藤林 俊介; 後藤 公志; 竹本 充; 中村 孝志; 敷波 保夫; 斎藤 真  日本骨代謝学会学術集会プログラム抄録集  23回-  98  -98  2005/06
• ハイドロキシアパタイト・ポリ乳酸複合多孔質体の骨補填材,scaffoldとしての有用性の検討

  長谷川 新; 田村 治郎; 根尾 昌志; 後藤 公志; 竹本 充; 中村 孝志; 敷波 保夫; 斎藤 真  移植  40-  (1)  73  -73  2005/02
• チタニア微粒子含有生体活性骨セメントの開発

  後藤 公志; 藤林 俊介; 川那辺 圭一; 中村 孝志; 橋本 雅美; 小久保 正  整形外科セラミック・インプラント研究会プログラム・抄録集  24回-  36  -36  2004/12
• 胸壁より発生したデスモイドの1例

  大槻 文悟; 中山 威知郎; 長谷部 啓司; 中川 武志; 小田 裕造; 後藤 公志; 山本 一道; 秦 公平  中国・四国整形外科学会雑誌  13-  (1)  116  -116  2001/04
• ハンソンピンによる大腿骨頚部骨折の手術治療の短期成績

  SO KAZUTAKA; SHIN KOHEI; YAMADA SHIGERU; FURUKAWA KENGO; NAKAGAWA TAKESHI; GOTO KOJI  中国・四国整形外科学会雑誌  12-  (2)  432  -432  2000/09
• 両側先天性とう骨頭脱臼の一例

  後藤公志; 宗和隆; 中川武志; 古川賢吾; 山田茂; 秦公平  整形外科と災害外科  49-  (Suppl.2)  2000

Research Grants & Projects

• Development of bioactive bone cement applicable for the cases with osteoporosis and periprosthetic infection

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2018/04 -2021/03 

  Author : Goto Koji

   

  We aimed to compare the osteoconductivity of titania bone cement(TBC) and commercial PMMA bone cement (PBC) in the knee joint and determine their bone-bonding ability in osteoporosis. We implanted TBC and PBC into rabbit femoral condyles and euthanized at 6, 12, and 26 weeks, and affinity indices were measured to evaluate osteoconductivity. We generated a rabbit model of osteoporosis through bilateral ovariectomy (OVX) and an 8-week treatment with methylprednisolone sodium succinate (PSL). Pre-hardened TBC and PBC were implanted into the femoral diaphysis of the OVX+PSL rabbits, and they were killed at 6 weeks to evalulate the interfacial shear strength. Affinity indices were significantly higher for TBC than for PBC at 12 weeks and 26 weeks. The interfacial shear strength was significantly higher for TBC than for PBC at 6 weeks. These results indicate that TBC is a promising bioactive bone cement for prosthesis fixation in total knee arthroplasty, especially for osteoporosis patients.
• Development of a bone cement which improves the long-term clinical results of joint arthroplasty and vertebroplasty

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2015/04 -2018/03 

  Author : Goto Koji

   

  We conducted 29 cemented total hip arthroplasties in 18 adult female beagles using titania bone cement (TBC) or commercial polymethylmethacrylate bone cement (PBC). The dogs were killed 1, 3, 6, and 12 months postoperatively to evaluate osteoconductivity using bone-cement contact ratio (affinity index) in the acetabulum. Push-out tests were also performed with femoral specimen to evaluate bone-bonding strength at 1, 3, 6, and 12 months. The affinity indices and the bone-bonding strength of TBC were higher than those of PBC at each time interval. Histologically, TBC was in direct contact with bone without intervening with fibrous tissue over larger areas, and newly formed bone was observed along the cement. The apparent bioactivity of TBC indicates its potential utility in clinical practice.
• セメント人工関節置換術の長期成績を向上させる新規骨セメントの開発

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2011/04 -2012/03 

  Author : 後藤 公志

Other link

researchmap

https://researchmap.jp/7000009575