論文 - 竹上　靖彦

Total Hip Arthroplasty After Transtrochanteric Rotational Osteotomy for Osteonecrosis of the Femoral Head: A Mean 10-Year Follow-Up 査読有り 国際誌

Osawa, Y; Seki, T; Morita, D; Takegami, Y; Okura, T; Ishiguro, N

JOURNAL OF ARTHROPLASTY   32 巻 ( 10 ) 頁： 3088 - 3092   2017年10月

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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 The objective of the present study was to investigate clinical, quality of life, and radiographic outcomes of patients who underwent total hip arthroplasty (THA) after transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). Methods We performed a case-control study. The participants were 29 patients (34 hips) who underwent THA after TRO (TRO group). These patients had a mean age at surgery of 51.6 years (range, 30-72 years) and underwent postoperative follow-up for a mean period of 10.5 years (range, 3-19 years). For the control group (primary group), we included 58 patients (68 hips) who underwent primary THA for ONFH, matching for age and gender. Results The Harris Hip Scores at the last follow-up were significantly poorer in the TRO group than in the primary group. Similarly, preoperative and postoperative hip range of motion was significantly poorer in the TRO group than in the primary group. Quality of life (Short Form-36, Oxford Hip Score, and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire) and complication rates were not significantly different between the groups. The survival rates at 10 years, with revision for any reason as the endpoint, were 81% in the TRO group and 91% in the primary group, showing no significant difference between the groups. The TRO group had a larger average postoperative leg length discrepancy and a higher rate of stem malalignment than the primary group. Conclusion The clinical outcomes of THA after TRO for ONFH were poorer than those of primary THA.

DOI： 10.1016/j.arth.2017.05.020

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The poor quality and reliability of information on periacetabular osteotomy on the internet in Japan 査読有り

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

NAGOYA JOURNAL OF MEDICAL SCIENCE   79 巻 ( 3 ) 頁： 375 - 385   2017年8月

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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  

Although many patients use the internet to access health-related information, the quality and the reliability of the information is highly inconsistent. Periacetabular osteotomy (PAO) is one of the surgical procedures for hip dysplasia. However, medical information on PAO is limited on the internet. This study aims to evaluate the quality and reliability of information available on PAO on the internet in Japan. A web search was conducted on two search engines for the following terms: "hip osteotomy," "pelvic osteotomy," and "osteotomy for hip preservation" in Japanese. In total, we found 120 websites. To determine the quality and reliability of information on each website, we used the Health on the Net Foundation (HON) score, the Brief DISCERN score, and an osteotomy-specific content (OSC) score. After eliminating duplicate websites, we reviewed 49 unique websites. Only three websites (6.1%) had good reliability, as indicated by their HON scores. Twelve websites (24.4%) had good-quality information, as measured by their Brief DISCERN scores. As evaluated by their OSC scores, physician websites were found to be biased toward etiology and surgical indication and did not provide information on the complications of procedures. Nonphysician websites were generally insufficient. The information about PAO on the internet is, therefore, unreliable and of poor-quality for Japanese patients.

DOI： 10.18999/nagjms.79.3.375

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Laterality of radiographic osteoarthritis of the knee 査読有り 国際誌

Komatsu, D; Ikeuchi, K; Kojima, T; Takegami, Y; Amano, T; Tsuboi, M; Ishiguro, N; Hasegawa, Y

LATERALITY   22 巻 ( 3 ) 頁： 340 - 353   2017年

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

There are few reports of the laterality in radiological knee osteoarthritis (ROA). This study aimed to evaluate laterality in terms of the minimum joint space width (mJSW) and osteophyte areas (OFs) in a cross-sectorial general population screen and elucidate the association between laterality and risk of osteoarthritis. We enrolled 330 participants (mean age 64.6 years) and examined the presence of ROA (Kellgren–Lawrence grade ≧ 2) laterality in terms of the mJSW and OF on the medial tibia using auto-measuring software. Moreover, we examined the association between laterality and leg dominance. The right and left medial mJSWs were 4.02 ± 0.98 mm and 4.05 ± 1.01 mm, respectively, showing no laterality; the laterals were also similar. The participants who had osteophytes ≥1 mm2 in the right, left, and bilateral knees were 15, 37, and 57 respectively, with osteophytes being significantly more common in the left knee. The OF was significantly larger in the left knee. Conversely, the medial and lateral mJSWs and OF did not differ according to leg dominance. The prevalence of ROA was higher and the OF was more pronounced in the left knee. However, the mJSW showed no laterality. Additionally, the mJSW and OF showed no differences according to leg dominance.

DOI： 10.1080/1357650X.2016.1199560

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変形性股関節症患者の身体活動量および活動強度に影響する因子 査読有り

鈴木 謙太郎, 加古 誠人, 寺井 千晶, 安田 尚太郎, 松山 美乃里, 佐藤 幸治, 門野 泉, 竹上 靖彦, 天野 貴文, 関 泰輔

理学療法学Supplement   2016 巻 ( 0 ) 頁： 281 - 281   2017年

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：公益社団法人 日本理学療法士協会  

<p>【はじめに，目的】</p><p></p><p>我々はこれまでに，人工股関節全置換術（THA）前の身体活動量は術後早期の歩行能力や在院日数に関連するという結果を得ており，術前の変形性股関節症（股OA）患者にとって身体活動量低下の予防は重要であると考えられる。3軸加速度計は，患者の実際の日常生活において，歩数などで示される身体活動量に加え，活動強度の測定を行うことが可能である。股OA患者の身体活動量や活動強度は，痛みや身体機能，精神機能など様々な因子の影響を受けることが予測されるが，これらを包括的に検討した報告はない。本研究の目的は，3軸加速度計を用いて股OA患者の身体活動量および活動強度に影響する因子を検討することである。</p><p></p><p>【方法】</p><p></p><p>対象は2015年12月～2016年9月に当院にて片側THAを施行された患者のうち，術前に身体活動量および活動強度，下肢関節可動域，下肢筋力，10m歩行の測定，痛みおよび精神機能に関するアンケート評価を行い，歩行非自立であった2例を除いた40例（男性7例，女性33例，年齢66.9±10.5歳）とした。3軸加速度計（ActiGraph GT3X-BT）を用いて入院前1週間分の1日平均歩数，1日のうちの低強度の身体活動時間（light physical activity；LPA），中～高強度の身体活動時間（moderate-to-vigorous physical activity；MVPA）を測定した。ハンドヘルドダイナモメーター（μTas F-100）を用い，術側，非術側の股関節外転および膝関節伸展トルクを算出した。Visual Analogue Scale（VAS），Pain Catastrophizing Scale（PCS），Hospital Anxiety and Depression Scale（HADS）を用い，痛みおよび精神機能を評価した。Pearsonの相関係数を用い歩数および活動強度と各評価項目にて相関関係を検討した。次に，歩数および活動強度を従属変数とし，これらと有意な相関関係を認めた各評価項目を独立変数に投入したステップワイズ重回帰分析を行った。いずれの検定も有意水準を5%とした。</p><p></p><p>【結果】</p><p></p><p>歩数は，術側および非術側股関節伸展可動域，非術側股関節外転可動域，非術側股関節外転トルク，HADS抑うつと有意に相関し，重回帰分析の結果，非術側股関節伸展可動域（p＜0.01，β=0.41），HADS抑うつ（p＜0.01，β=-0.36），非術側股関節外転可動域（p=0.02，β=0.35）が有意な関連因子として抽出された。LPAと有意に相関する因子は無かった。MVPAは，非術側股関節伸展可動域，非術側股関節外転可動域，年齢と有意に相関し，重回帰分析の結果，非術側股関節伸展可動域（p＜0.05，β=0.34），年齢（p＜0.05，β=-0.30）が有意な関連因子として抽出された。</p><p></p><p>【結論】</p><p></p><p>歩数，MVPAは，ともに非術側股関節伸展可動域と関連しており，非術側股関節伸展可動域の低下は身体活動量，活動強度を低下させる因子であった。また，股OA患者の精神的健康の低下は，身体活動量を低下させる因子であった。さらに，股OA患者では年齢とともに活動強度が低下することが示された。</p>

DOI： 10.14900/cjpt.2016.0281

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