研究者詳細 - 竹上　靖彦

論文 - 竹上　靖彦

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Author Correction: Mianserin suppresses R-spondin 2-induced activation of Wnt/β-catenin signaling in chondrocytes and prevents cartilage degradation in a rat model of osteoarthritis. 査読有り国際誌 Open Access

Okura T, Ohkawara B, Takegami Y, Ito M, Masuda A, Seki T, Ishiguro N, Ohno K

Scientific reports 10 巻 ( 1 ) 頁： 2995 - 2995 2020年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Scientific Reports

This Article contains errors in the Reference list. Reference 21 is incorrectly listed as: Masahiro N. et al. A genome-wide association study identifies susceptibility loci for ossification of the posterior longitudinal ligament of the spine. Nature Genetics 46(9), 1012–1016 (2014). The correct reference is listed below as ref. 1. Additionally, Reference 23 is incorrectly listed as: Rita D. Hypertrophic differentiation of chondrocytes in osteoarthritis: the developmental aspect of degenerative joint disorders. Arthritis Research & Therapy 12(5), 216 (2010). The correct reference is listed below as ref. 2. Furthermore, Reference 25 is incorrectly listed as: Marlies, B. et al. The Reason for Discontinuation of the First Tumor Necrosis Factor (TNF) Blocking Agent Does Not Influence the Effect of a Second TNF Blocking Agent in Patients with Rheumatoid Arthritis. The Journal of Rheumatology 36(10), 2171–2177 (2009). The correct reference is listed below as ref. 3. In addition, there is an error in the legend of Figure 4, where: “The number of β-catenin-positive cells is divided by the number of DAPI signals to calculate the ratio of nuclear β-catenin-positive cells. The number of β-catenin-positive cells is divided by the number of DAPI signals to calculate the ratio of nuclear β-catenin-positive cells. *P < 0.05 by one-way ANOVA followed by Tukey’s post-hoc test. Scale = bar 200 μm (A), 100 μm (C), and 25 μm (D). (G) Model of Rspo2-mediated OA development, and the effect of mianserin.” should read:“The number of β-catenin-positive cells is divided by the number of DAPI signals to calculate the ratio of nuclear β-catenin-positive cells. *P < 0.05 by one-way ANOVA followed by Tukey’s post-hoc test. Scale bar = 200 μm (A), 100 μm (C), and 25 μm (D). (G) Model of Rspo2-mediated OA development, and the effect of mianserin.”.

DOI： 10.1038/s41598-020-60112-4

MicroRNA-130aは骨粗鬆症の新たなバイオマーカーとなるか? 4から6年の縦断研究(Yakumo Study) 査読有り

樋口善俊, 関泰輔, 竹上靖彦, 濱田恭, 今釜史郎, 鈴木康司, 長谷川幸治, 石黒直樹

日本骨粗鬆症学会雑誌 5 巻 ( Suppl.1 ) 頁： 384 - 384 2019年9月

Comparison of Wear Rate between Ceramic-on-Ceramic, Metal on Highly Cross-linked Polyethylene, and Metal-on-Metal Bearings. 査読有り国際誌 Open Access

Higuchi Y, Seki T, Morita D, Komatsu D, Takegami Y, Ishiguro N

Revista brasileira de ortopedia 54 巻 ( 3 ) 頁： 295 - 302 2019年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Revista Brasileira de Ortopedia

Objective Currently, there is a lack of evidence on the medium-term follow-up of cementless total hip arthroplasty (THA) using metal on highly cross-linked polyethylene (MoP), ceramic-on-ceramic (CoC), and metal-on-metal (MoM) bearings. Our aim was to calculate the 5- to 10-year wear rate and the incidence rate of osteolysis for these 3 types of bearings. Methods A total of 77 patients underwent THA with MoP, 105 underwent THA with CoC, and 55 underwent THA with MoM. The average patient age at the time of surgery was 64.7, 55.9, and 59.9 years old in the MoP, CoC, and MoM bearings, respectively. Clinical and radiologic measurements at a mean follow-up of 7.6 years were analyzed. Results The mean postoperative Harris hip scores showed no difference among the groups. The mean annual liner wear rates were 0.0160, 0.0040 and 0.0054 mm/year in MoP, CoC, and MoM bearings, respectively, with that of CoC bearings being significantly lower than those of the others. Osteolysis (14.5%) among MoM bearings was significantly more frequently observed compared with the others. Kaplan-Meier survival at 10 years with implant loosening, or revision THA as the endpoint, was 96.1% (95% confidence interval [CI]: 88.4–98.7) for MoP bearings, 98.6% (95%CI: 90.3–98.6) for CoC bearings, and 98.2% (95%CI: 88.0–99.7) for MoM bearings (p ¼ 0.360). Conclusion Excellent clinical and radiological outcomes were obtained for MoP and CoC bearings.

DOI： 10.1055/s-0039-1691762

What factors predict ceramic liner malseating after ceramic-on-ceramic total hip arthroplasty? 査読有り国際誌 Open Access

Higuchi, Y; Seki, T; Takegami, Y; Osawa, Y; Kusano, T; Ishiguro, N

ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH 105 巻 ( 3 ) 頁： 453 - 459 2019年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Orthopaedics and Traumatology: Surgery and Research

Background: There is a lack of evidence about the risk factors associated with the malseating of the acetabular liner after ceramic-on-ceramic (CoC) total hip arthroplasty (THA). Therefore, we performed a complementary retrospective case-control study to determine the factors predicting the malseating of the acetabular liner after CoC THA and to evaluate the relationship between malseating and (1) osteoarthritis, (2) particularly in terms of the new radiographic parameter “bone sclerotic length” of the acetabular bone. Hypothesis: Osteoarthritis, particularly bone sclerotic length, was an independent risk factor for malseating of ceramic liners. Patients and methods: In total, 219 CoC THAs (174 women and 45 men) were evaluated to determine the risk factors influencing the malseating of the acetabular ceramic liner. An average patient age at the time of surgery was 55.9 ± 9.5 years (range, 23 to 75 years). Data on patient background and preoperative radiographs, such as Tönnis grades; Crowe classification; and indices of acetabular osteoarthritis change; including bone cyst, osteophyte and bone sclerosis, were assessed. The bone sclerotic length in patients with osteoarthritis was measured as the slant distance between the bilateral edges of the sclerosis lesion of the acetabulum on the anteroposterior view. Results: Preoperative less hip flexion (hazard ratio [HR]: 0.98; 95% CI: 0.97–0.99), osteoarthritis (HR: 3.15; 95% CI: 1.02–9.70) and the bone sclerotic length (HR: 1.83; 95% CI: 1.35–2.48) were independent risk factors determining the malseating of ceramic liners. Receiver operating characteristic curve analysis showed that a bone sclerotic length of 24.6 mm was defined as the cut-off point for the malseating of the ceramic liner. Discussion: Age, preoperative less flextion, osteoarthritis, and the bone sclerotic were independent risk factors determining malseating of ceramic liners. The acetabular shell can also deform upon insertion of the cup with sclerotic bone of the acetabulum and prevent correct seating of liners. Therefore, these factors must be taken into consideration when seating the ceramic liner. Level of evidence: Case control study III, case control retrospective design.

DOI： 10.1016/j.otsr.2019.01.009

Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty 査読有り国際誌

Osawa, Y; Seki, T; Takegami, Y; Kusano, T; Ishiguro, N; Hasegawa, Y

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 139 巻 ( 5 ) 頁： 729 - 734 2019年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Archives of Orthopaedic and Trauma Surgery

Background Acetabular wall defects after periacetabular osteotomy (PAO) lead to technical difficulties when performing subsequent total hip arthroplasty (THA). There is no unified consensus regarding the solution for THA socket installation after PAO. In the current study, we performed computed tomography (CT)-based simulation of socket installation and evaluated the acetabular defect following THA after PAO and after primary osteoarthritis (OA). Patients and methods The study group comprised 55 patients (56 hips) who underwent THA after PAO. For the control group, after matching for age, sex, and Crowe classification, we included 55 patients (56 hips) who underwent primary THA for hip dysplasia. We evaluated the anterior, posterior, and superior acetabular sector angle (ASA) and medial wall thickness (MWT) at the anatomical hip center (at the 20-mm vertical hip level from teardrop) in the study group (anatomical PAO group) and control group (primary OA group). In addition, we investigated the changes in the socket covering when the socket was positioned 10 mm above the anatomical hip center (30 mm above the teardrop; elevated osteotomy group). Results All ASA and MWT values were significantly smaller in the anatomical PAO group than in the primary OA group. In particular, the individuals with a Crowe classification of II/III in the anatomical PAO group presented severe acetabular defects. However, the elevated PAO group had a significantly larger ASA compared to the anatomical PAO group, with improved socket coverings. Conclusion Acetabular defects in the anatomical hip center following THA after PAO were significantly common compared to those after primary THA. Elevation of hip joint centers as much as 10 mm is one therapeutic option in the case of severe acetabular defects following THA after PAO.

DOI： 10.1007/s00402-019-03174-y

THE ASSOCIATIONS BETWEEN CIRCULATING MICRORNAS AND OSTEOARTHRITIS OF THE KNEE IN COMMUNITY-DWELLING PEOPLE: YAKUMO STUDY 査読有り

Takegami, Y; Seki, T; Imagama, S; Ishiguro, N

OSTEOARTHRITIS AND CARTILAGE 27 巻頁： S282 - S283 2019年4月

Mianserin suppresses R-spondin 2-induced activation of Wnt/β-catenin signaling in chondrocytes and prevents cartilage degradation in a rat model of osteoarthritis 査読有り国際誌 Open Access

Okura, T; Ohkawara, B; Takegami, Y; Ito, M; Masuda, A; Seki, T; Ishiguro, N; Ohno, K

SCIENTIFIC REPORTS 9 巻 ( 1 ) 頁： 2808 - 2808 2019年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Scientific Reports

Aberrant activation of the Wnt/β-catenin signaling pathway promotes the progression of osteoarthritis (OA). We previously reported that R-spondin 2 (Rspo2), an activator of the Wnt/β-catenin signaling, facilitates differentiation of proliferating chondrocytes into hypertrophic chondrocytes by enhancing Wnt/β-catenin signaling in endochondral ossification. However, the role of Rspo2 in OA remains elusive. Here, we showed that the amounts of Rspo2 protein in synovial fluid were increased in OA patients. We searched for a preapproved drug that suppresses Rspo2-induced Wnt/β-catenin signaling in chondrogenic cells and reduces joint pathology in a rat model of OA. In Rspo2-treated ATDC5 cells, mianserin, a tetracyclic antidepressant, inhibited Wnt/β-catenin signaling, increased proteoglycan production, and upregulated chondrogenic marker genes. Mianserin suppressed Rspo2-induced accumulation of β-catenin and phosphorylation of Lrp6. We identified that mianserin blocked binding of Rspo2 to its receptor Lgr5. We also observed that intraarticular administration of mianserin suppressed β-catenin accumulation and prevented OA progression in a rat model of OA. We conclude that mianserin suppresses abnormally activated Wnt/β-catenin signaling in OA by inhibiting binding of Rspo2 to Lgr5.

DOI： 10.1038/s41598-019-39393-x

Acetabular fracture non-union with pelvic discontinuity treated with two-stage total hip arthroplasty after intra- and extra-articular plate fixation 査読有り

Morita, D; Seki, T; Takegami, Y; Kasai, T; Higuchi, Y; Ishiguro, N

NAGOYA JOURNAL OF MEDICAL SCIENCE 81 巻 ( 1 ) 頁： 113 - 119 2019年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Nagoya Journal of Medical Science

Surgical intervention for the treatment of acetabular fracture non-union is often challenging. Here, we present a case of acetabular fracture non-union with pelvic discontinuity in a patient who underwent cemented total hip arthroplasty (THA) after intra- and extra-articular plate fixation. The case was a 70-year-old male with left T-shaped acetabular fracture non-union neglected for 5 months after the injury. The anterior and posterior columns were not healed, and the articular surface was displaced toward the medial side with a protrusion of the collapsed femoral head. As the first surgical intervention, we performed intra- and extra-articular plate fixation after femoral head decapitation. We fixed non-union regions from the inferior acetabular margin to the anterior column using a pelvic reconstruction plate bent three-dimensionally at the acetabular curvature on the intra-articular side. Furthermore, we fixed that of the posterior column on the outside of the acetabulum using a bent pelvic reconstruction plate. Union of the anterior and posterior columns was observed at 4 and 6 months after the first surgical intervention. At 7 months, we performed a cemented THA without additional bone grafting. At 1-year follow-up, the patient did not have left coxalgia and could walk without any gait supports. Based on our experience, we propose this surgical protocol as a useful treatment option for cases of acetabular fracture non-union.

DOI： 10.18999/nagjms.81.1.113

32-mm ceramic-on-ceramic total hip arthroplasty versus 28-mm ceramic bearings: 5-to 15-year follow-up study 査読有り国際誌 Open Access

Higuchi, Y; Seki, T; Hasegawa, Y; Takegami, Y; Morita, D; Ishiguro, N

HIP INTERNATIONAL 29 巻 ( 1 ) 頁： 65 - 71 2019年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：HIP International

Introduction: This study aimed to compare the clinical and radiographic results of 28-mm ceramic-on-ceramic (CoC) total hip arthroplasty (THA) to those of 32-mm CoC during a 5- to 15-year follow-up period. Methods: 107 joints (95 women and 6 men) underwent 28-mm CoC, and 60 (49 women and 7 men) underwent 32-mm CoC. The average patient age at the time of surgery was 56.1 and 55.7 years in the 28-mm and 32-mm CoC groups, respectively. Clinical and radiologic measurements of all patients were analysed. Results: The mean preoperative Harris hip score (HHS) was similar in the 2 groups (28-mm, 58.9; and 32-mm, 58.5). However, at final follow-up, the mean HHS of the 32-mm CoC (91.8) was significantly better than that of the 28-mm CoC (88.2) (p = 0.003), as were the ranges of motion (ROM) for flexion (98.3 ± 13.5° vs. 87.3 ± 19.3°, p < 0.001) and abduction (27.8 ± 14.9° vs. 22.1 ± 19.3°, p = 0.007). The mean wear rate was 0.0044 mm/year for the 28-mm CoC and 0.0044 mm/year for the 32-mm CoC. No ceramic fractures were found in the 2 groups. One joint in the 28-mm CoC (0.9%) required revision owing to progressive osteolysis. Kaplan-Meier survival at 10 years, with implant loosening or revision THA as the endpoint, was 98.3% for 28-mm CoC and 100% for 32-mm CoC (p = 0.465). Conclusion: There was no significant difference in ceramic-related complications between the 2 groups. Our study demonstrated that the 32-mm and 28-mm CoC are safe and are associated with good clinical outcomes.

DOI： 10.1177/1120700018760971

Same survival but higher rate of osteolysis for metal-on-metal Ultamet versus ceramic-on-ceramic in patients undergoing primary total hip arthroplasty after 8 years of follow-up 査読有り国際誌 Open Access

Higuchi, Y; Seki, T; Takegami, Y; Komatsu, D; Morita, D; Ishiguro, N

ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH 104 巻 ( 8 ) 頁： 1155 - 1161 2018年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Orthopaedics and Traumatology: Surgery and Research

Background: To avoid wear-induced osteolysis, ceramic-on-ceramic (CoC) and metal-on-metal (MoM) bearings have been developed. At present, there are no direct material related clinical comparisons between cementless total hip arthroplasty with CoC and MoM at more than 5-year follow-up. The bearing that is more likely to prevent osteolysis is still controversial. Therefore, we performed a retrospective case control study evaluating CoC and MoM cementless THAs in order to: – compare the longevity and complications for CoC and MoM THAs at 5–10 years postoperatively; – compare the incidence of osteolysis between both type THAs; – evaluate pseudotumors in MoM THAs. Hypothesis: CoC THAs will have a lower rate of osteolysis, better longevity, and better clinical outcomes than MoM THAs. Patients and methods: Ninety-six hips underwent CoC THAs, and 56 hips underwent MoM THA (Ultamet, Pinnacle, Depuy). Average patient age at the time of surgery was 57.1 years (range, 28 to 77 years). Results: There were no differences with regard to the Harris hip score (89.5 and 90.3 for the CoC and MoM groups, respectively). Osteolysis (9 hips, 14.3%) among MoM THAs were significantly more frequently observed compared to CoC THAs (2 hips, 2.1%). Kaplan-Meier survival at 8 years with implant loosening or revision THA as the endpoint was 98.2% (95% CI: 87.8–99.8) for CoC, and 98.6% (95% CI: 90.2–99.8) for MoM (p = 0.684). There was one audible squeaking (1.0%) and no ceramic fracture among CoC THAs. Five (8.9%) hips showed pseudotumors among MoM THAs. Discussion: CoC THAs had a low incidence of osteolysis. No significant difference was seen in the 8-year survival rate between implants, when using implant loosening and revision THA as endpoints. These data indicate that CoC THAs have excellent clinical and radiological outcomes, compared with MoM THAs. Ultamet MoM had a higher rate of osteolysis compared to other MoM bearings; the cup modularity (without polyethylene) and the use of 36 mm heads as well as the process of production (after 2006) may play a significant role in the higher rate of osteolysis. Level of evidence: III, Case control study, case control retrospective design.

DOI： 10.1016/j.otsr.2018.08.005

A Possible New Radiographic Predictor of Progression of Osteoarthritis in Developmental Dysplasia of the Hip: The Center Gap 査読有り国際誌 Open Access

Morita, D; Hasegawa, Y; Seki, T; Amano, T; Takegami, Y; Kasai, T; Higuchi, Y; Ishiguro, N

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH 476 巻 ( 11 ) 頁： 2157 - 2166 2018年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Clinical Orthopaedics and Related Research

Background Patients with comparable severities of developmental dysplasia of the hip (DDH) may variably progress to osteoarthritis (OA) over time. Although joint congruency may be associated with OA progression in patients with DDH, it has only been assessed subjectively. We assessed the gap between the rotational centers of the acetabulum and femoral head (center gap) as a possible predictive measure ofOAprogression in patientswithDDH. Questions/purposes In patients with bilateral DDH, we asked: (1) What is the probability of OA progression (Tönnis grade) or symptom development (pain) in the asymptomatic contralateral hip of patients with DDH undergoing unilateral joint-preserving surgery? (2) Is the center gap measurement associated with OA progression or symptom development in these hips? (3) Is the center gap measurement correlated with previous radiographic parameters? Methods A total of 297 patients (319 hips) underwent unilateral eccentric rotational acetabular osteotomy at our institution between July 1989 and December 1999. We performed no other joint-preserving surgery to treat patients with DDH during this timeframe. The inclusion criteria for the study were patients younger than 55 years of age, the contralateral hip classified as Tönnis Grade 0, no previous surgical interventions, and asymptomatic at the time of eccentric rotational acetabular osteotomy (155 patients, 155 hips). The exclusion criteria were a contralateral hip without dysplasia (four patients, four hips), loss to followup before 10 years (42 patients, 42 hips [27%]), or missing medical records or radiographs (21 patients, 21 hips [14%]). The remaining 88 patients (88 hips; 11 males and 77 females) with a mean age of 39 years (range, 17-53 years) and mean followup of 20 years (range, 10-27 years) were analyzed. From the institutional database, radiographic parameters including the center gap in the AP view were assessed using radiographs at the time of eccentric rotational acetabular osteotomy, and the Tönnis grade was recorded 1 year postoperatively and annually thereafter retrospectively. We defined migration of the rotational center of the femoral head based on the rotational center of the acetabulum in the horizontal plane as center gap X (mm) and in the vertical plane as center gap Y (mm) and defined the absolute value between the centers as center gap distance (mm). Using κ statistics, intra- and interobserver reliabilities were determined to be 0.896 and 0.857 for center gap X, 0.912 and 0.874 for center gap Y, and 0.912 and 0.901 for the center gap distance, respectively. When patients reported any contralateral ipsilateral hip pain during clinic visits, the hip was considered symptomatic. Kaplan-Meier survivorship analyses were performed with OA progression or symptom development in the nonoperative hip as the endpoint. Multivariate analyses were performed to assess risk factors for each outcome using the Cox proportional hazards model. Correlation analyses between the center gap and other parameters including lateral center-edge angle, femoral head extrusion index, acetabular depth-to-width index, femoral head lateralization, minimum width of the joint space, head sphericity, and joint congruency were performed using Pearson's correlation coefficient. Results At 20 years postoperatively, the probability of OA progression in the nonoperative hip was 13% (95% confidence interval [CI], 7.1-22.1) and the probability of symptom development was 34% (95% CI, 24.7-46.1). The center gap X measurements in the groups with OA progression (lateral 2.0 ± 2.1 [SD] mm) or symptom development (lateral 0.9 ± 2.4 mm) took a more lateral direction than those in the group without OA progression (medial 0.4 ± 2.1 mm) or symptom development (medial 0.5 ± 2.0 mm) (OA progression, p < 0.001; symptom development, p = 0.005). The center gap Y measurements in the groups with OA progression (distal 2.767.1 mm) or symptom development (distal 2.1 ± 6.0 mm) took a more distal direction than those in the group without OA progression (proximal 1.6 ± 6.2 mm) or symptom development (proximal 2.5 ± 6.1 mm) (OA progression, p = 0.027; symptom development, p = 0.001). Independent risk factors for OA progression were the femoral head extrusion index (hazard ratio [HR], 1.11; 95% CI, 1.01-1.22; p = 0.028) and the center gap X (HR, 1.52; 95% CI, 1.07-2.16; p = 0.019), whereas no independent risk factors for symptom development were found. The center gap in the horizontal plane had no correlations with any other radiographic parameter studied. Conclusions The center gap in the horizontal plane had a modest association with OA progression in this group of patients with DDH. Future studies are needed to determine the normal value of the center gap for patients without DDH and to assess the center gap in lateral radiographic views. Level of Evidence Level IV, prognostic study.

DOI： 10.1097/CORR.0000000000000458

Comparison of cementless total hip arthroplasty survivorship between metal-on-highly cross-linked polyethylene and ceramic-on-ceramic bearings: A case control study with a 5–9-year follow-up 査読有り

104 巻 ( 5 ) 2018年9月

Drug repositioning strategyを用いた異所性骨化を抑制する薬剤探索査読有り

草野大樹, 中谷直史, 笠井健広, 竹上靖彦, 関泰輔, 大野欽司, 上住聡芳, 山田治基, 土田邦博, 石黒直樹

日本整形外科学会雑誌 92 巻 ( 8 ) 頁： S1807 - S1807 2018年8月

Do femoral head collapse and the contralateral condition affect patient-reported quality of life and referral pain in patients with osteonecrosis of the femoral head? 査読有り国際誌 Open Access

Osawa, Y; Seki, T; Takegami, Y; Kasai, T; Higuchi, Y; Ishiguro, N

INTERNATIONAL ORTHOPAEDICS 42 巻 ( 7 ) 頁： 1463 - 1468 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Orthopaedics

Purposes: The objectives of this study were to investigate patient-reported outcomes and referral pain at the first visit in patients with osteonecrosis of the femoral head (ONFH) and to clarify the influence of collapse of the femoral head and the contralateral condition. Methods: The study included 105 patients (130 hips) with ONFH at the first visit, who were divided into two groups based on the presence of bilateral walking hip pain (bilateral group 25 patients, 50 hips) and unilateral hip pain (unilateral group 80 patients, 80 hips). We compared the Short Form-36 (SF-36), Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), and visual analog scale (VAS) responses for hip, knee, and low back pain between the groups to investigate the influence of the contralateral condition. Regarding the influence of femoral head collapse, we investigated these subjects based on the stage classification in the unilateral group. Results: The physical component summary (PCS) of the SF-36 and all domains of the JHEQ were poorer in the bilateral group than in the unilateral group. In addition, the VAS score for low back pain was significantly poorer in the bilateral group than in the unilateral group. Regarding the collapse of the femoral head, the SF-36 for the PCS and JHEQ for pain had a significant relationship in the ONFH stage. The VAS scores for hip and knee pain had a significant relationship in the ONFH stage. Conclusion: Collapse of the femoral head and the contralateral condition of ONFH strongly affect patients’ activities of daily life.

DOI： 10.1007/s00264-018-3867-1

Cementless total hip arthroplasty for osteonecrosis and osteoarthritis produce similar results at ten years follow-up when matched for age and gender 査読有り国際誌

Osawa, Y; Seki, T; Takegami, Y; Kusano, T; Makida, K; Ishiguro, N

INTERNATIONAL ORTHOPAEDICS 42 巻 ( 7 ) 頁： 1683 - 1688 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Orthopaedics

Purpose: The aim of this study was to compare the clinical outcomes of cementless total hip arthroplasty (THA) used for the treatment of osteonecrosis of the femoral head (ONFH) and for osteoarthritis (OA) at a mean ten years follow-up. Methods: Case-control study of 78 patients (86 hips) who underwent THA for ONFH treatment (ONFH group). Patients were matched for age and sex to 78 patients (86 hips) who underwent THA for OA (OA group). We compared the clinical and patient-reported outcomes, implant survival rates, and rates of complications between the groups. Results: There were no between-group differences in the Harris Hip Score and in the following patient-reported outcomes at the last follow-up: Japanese Orthopedic Association Hip-Disease Evaluation Questionnaire (JHEQ) pain and movement scores and the Physical Component Summary and Role/Social Component Summary scores of Short Form-36 (SF-36). However, the mental score of the JHEQ, the Mental Component Summary score of SF-36, and The Visual Analog Scale score for satisfaction were lower for the ONFH group than for OA group. The rate of complication was equivalent between the groups: 5% for the ONFH group and 3% for the OA group. The ten year implant survival rate was equivalent between the groups, at 97.5% for the ONFH group and 98.2% for the OA group. Conclusion: The functional outcomes, implant survival, and rate of complications for cementless THAs are comparable at a mean follow-up of ten years for ONFH and OA.

DOI： 10.1007/s00264-018-3987-7

The influence of early radiolucent lines appearing on femoral head penetration into HXLPE cemented sockets 査読有り国際誌

Morita, D; Seki, T; Higuchi, Y; Takegami, Y; Amano, T; Ishiguro, N

HIP INTERNATIONAL 28 巻 ( 4 ) 頁： 369 - 374 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：HIP International

Introduction: This study investigates differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets both with and without radiolucent lines (RLLs) in the early postoperative phase and at 5 years follow-up. Methods: There were 35 patients (37 hips), mean age of 66.8 years, who underwent total hip arthroplasty (THA) using highly HXLPE cemented sockets. They were divided into 2 groups based on postoperative the early appearance of RLLs. Femoral head penetrations on both anteroposterior- and Lauenstein-view radiographs were evaluated, and the mean polyethylene (PE) wear rate was calculated based on femoral head penetrations between 2 and 5 years. Results: Femoral head penetrations in the proximal direction were 0.075 mm and 0.150 mm in the RLL and non-RLL groups at 1 year postoperatively (p = 0.019). At 5 years measured penetration was 0.107 mm and 0.125 mm in the RLL and non-RLL groups, respectively (p = 0.320). The mean PE wear rates in anteroposterior-view were 0.008 mm/year and 0.003 mm/year in the RLL and non-RLL groups (p = 0.390) and those in Lauenstein-view were 0.010 mm/year and 0.005 mm/year, respectively (p = 0.239). Conclusions: In the RLL group, the PE bedding-in was less compared with those in the non-RLL group. Additionally, the mean PE wear rate in the RLL group tended to be higher than that in the non-RLL group. The distribution of stress loading through the cement may differ according to whether early RLLs appear.

DOI： 10.1177/1120700018754308

Preoperative Canal Bone Ratio is Related to High-Degree Stress Shielding: A Minimum 5-Year Follow-Up Study of a Proximally Hydroxyapatite-Coated Straight Tapered Titanium Femoral Component 査読有り国際誌

Kusano, T; Seki, T; Higuchi, Y; Takegami, Y; Osawa, Y; Ishiguro, N

JOURNAL OF ARTHROPLASTY 33 巻 ( 6 ) 頁： 1764 - 1769 2018年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Arthroplasty

Background: Few studies have reported risk factors for stress shielding. We sought to evaluate clinical and radiographic outcomes of a proximally hydroxyapatite-coated straight tapered titanium femoral component stem during a minimum 5-year follow-up and identify factors associated with high-degree stress shielding. Methods: A total of 156 total hip arthroplasties (n = 124; 98 women and 26 men; mean age, 56.5 years) with a minimum follow-up period of 5 years were included in the study. Clinical and radiologic measurements at follow-up (range, 5-16.3 years; mean, 10.2 years) were analyzed. Results: The mean preoperative Harris Hip Score (HHS) was 56.6, and the mean HHS at the latest follow-up was considerably improved at 86.8. Stress shielding at the latest follow-up was low degree in 136 (87%) hips and high degree in 20 (13%) hips. On average, high-degree stress shielding occurred 9.9 years (5-14 years) after surgery. The results of Cox proportional hazard analysis showed that a canal bone ratio ≥ 0.49 was an independent risk factor for high-degree stress shielding (P =.0075; hazard ratio, 3.981). HHS at the latest follow-up was significantly lower in high-degree stress shielding than in low-degree stress shielding (80.7 and 87.7, respectively; P =.0030). Conclusion: Preoperative canal bone ratio ≥ 0.49 is independently associated with high-degree stress shielding. In addition, the number of cases with high-degree stress shielding significantly increased over time during a mean 10-year follow-up.

DOI： 10.1016/j.arth.2017.12.019

Patient-reported outcomes in patients who undergo total hip arthroplasty after periacetabular osteotomy 査読有り

Osawa, Y; Hasegawa, Y; Seki, T; Takegami, Y; Amano, T; Ishiguro, N

JOURNAL OF ORTHOPAEDIC SCIENCE 23 巻 ( 2 ) 頁： 346 - 349 2018年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Orthopaedic Science

Background: There has been constant discussion about whether the clinical outcome of THA after periacetabular osteotomy (PAO) is equivalent to that after primary total hip arthroplasty (THA). However, there have been few reports about patient-reported outcomes (PRO) for those who undergo THA after PAO. We compared the pre- and postoperative PRO of patients who underwent THA after PAO and those who underwent primary THA alone. Methods: We performed a case–control study. Twenty-seven patients (29 hips) underwent THA after PAO (osteotomy group); their mean age at surgery was 57.2 years, and they underwent postoperative follow-up for a mean period of 3.0 years. For the control group, after matching age, sex, and Crowe classification, we included 54 patients (58 joints) who underwent primary THA for hip dysplasia. Assessment performed preoperatively and at the last follow-up included the Harris hip score, the Short Form 36 (SF-36) for the Physical Component Summary (PCS), Mental Component Summary (MCS), and Role/Social Component Summary (RCS) domains, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) for pain, movement, and mental health, and the visual analog scale (VAS) score of hip pain and satisfaction. Results: The two groups demonstrated no significant difference in the preoperative Harris hip score, each domain of the SF-36, JHEQ, and the VAS score of hip pain and satisfaction. The osteotomy group demonstrated significantly poor Harris hip scores for gait and activity, and JHEQ for movement at the last follow-up. There was no significant difference in each domain of the SF-36 and the VAS score of hip pain and satisfaction at the last follow-up. Conclusion: Previous PAO affects the quality of physical function in patients who undergo subsequent THA.

DOI： 10.1016/j.jos.2017.11.001

Differences in Femoral Head Penetration Between Highly Cross-Linked Polyethylene Cemented Sockets and Uncemented Liners 査読有り国際誌

Morita, D; Seki, T; Higuchi, Y; Takegami, Y; Ishiguro, N

JOURNAL OF ARTHROPLASTY 32 巻 ( 12 ) 頁： 3796 - 3801 2017年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Arthroplasty

Background This study aimed at investigating differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets and uncemented liners during 5 years postoperatively. Methods Ninety-six patients (106 hips) with a mean age of 64.4 (range, 35-83) years underwent total hip arthroplasty using a HXLPE cemented socket or liner and were respectively divided into cemented (35 patients [37 hips]) and uncemented (61 patients [69 hips]) groups. Femoral head penetrations were evaluated on both anteroposterior (AP)-view and Lauenstein-view radiographs, and mean polyethylene (PE) wear rates were calculated based on femoral head penetration from 2 to 5 years. Multivariate analyses were performed to assess risk factors for PE wear. Results At 5 years postoperatively, the cemented and uncemented groups exhibited proximal direction femoral head penetrations of 0.103 mm and 0.124 mm (P =.226) and anterior direction penetrations of 0.090 mm and 0.151 mm (P =.002), respectively. The corresponding mean PE wear rates were 0.004 mm/y and 0.009 mm/y in the AP-view (P =.286) and 0.005 mm/y and 0.012 mm/y in the Lauenstein-view (P =.168), respectively. Left-side operation and high activity were independent risk factors for PE wear on AP-view. Conclusion When HXLPE was used, all mean PE wear rates were very low and those of cemented sockets and uncemented liners were very similar. PE particle theory suggests that the occurrence of osteolysis and related aseptic loosening might consequently decrease.

DOI： 10.1016/j.arth.2017.07.017

Independent association of joint space narrowing, cyst formation and health-related quality of life of patients with hip osteoarthritis in Japan 査読有り

Takegami, Y; Seki, T; Higuchi, Y; Komatsu, D; Nishida, Y; Ishiguro, N

JOURNAL OF ORTHOPAEDIC SCIENCE 22 巻 ( 6 ) 頁： 1096 - 1101 2017年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Orthopaedic Science

Introduction This study clarified individual associations of joint space narrowing (JSN) and radiographic features (RF) of hip osteoarthritis (HOA), i.e., cyst and osteophyte formation and subchondral sclerosis, with quality of life (QOL) in Japanese HOA patients. Methods This cross-sectional study comprised 117 Japanese HOA patients (98 women, 17 men; mean age, 61.2 years). We recorded locations and the size of each RF and measured JSN on the acetabular side (Ace) or femoral head (FH). We evaluated pain with the Visual Analog Scale (VAS) and assessed QOL with the physical component summary (PCS) and mental component summary (MCS) of the Medical Outcomes Study Short Form-36. We compared QOL with/without the RF on the Ace, FH or both and analyzed relationships between each RF and VAS, PCS and MCS with linear regression analysis. We assessed independent associations of each RF with PCS and MCS with multiple regression analysis using various independent variables. Results VAS values with the cyst on the Ace only were significantly lower than those with the cyst at both locations. PCS values with the cyst on the Ace only were significantly higher than those for both locations. Independent associations existed for maximum cyst length on the Ace and FH with VAS and for JSN with PCS, but none existed for MCS. Conclusions Our study suggested that the location and the size of the cyst formation were associated with both VAS and QOL in Japanese HOA patients. The JSN was independently associated with the PCS.

DOI： 10.1016/j.jos.2017.08.014

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