Faculty Profiles - TAKEGAMI Yasuhiko

Papers - TAKEGAMI Yasuhiko

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Bilateral curved intertrochanteric varus osteotomy for osteonecrosis of the femoral head: a retrospective comparative study

Oono, K; Osawa, Y; Funahashi, H; Ido, H; Takegami, Y; Imagama, S

INTERNATIONAL ORTHOPAEDICS 2026.2

Radiographic lateral hip joint view can predict contralateral asymptomatic osteonecrosis of the femoral head

Osawa, Y; Takegami, Y; Iida, H; Ozawa, Y; Funahashi, H; Imagama, S

HIP INTERNATIONAL page： 11207000251405161 2026.2

Language：English Publishing type：Research paper (scientific journal) Publisher：HIP International

Background: Even in cases of bilateral osteonecrosis of the femoral head (ONFH), only one side often collapses and the contralateral side is often asymptomatic at the time of initial diagnosis. This study aimed to evaluate the presence of asymptomatic ONFH based on the radiographic necrotic area on the symptomatic side. Methods: The study included 89 hips of patients with ONFH who were divided into two groups: unilateral ONFH and bilateral ONFH groups, with a minimum follow-up of 3 years. The extent of the necrotic area in the anteroposterior (ANA) and lateral (LNA) radiographic hip joint views on the symptomatic side in the groups was assessed using plain radiography. The most effective cut-off value was extracted from the receiver operating characteristic (ROC) curve of the radiographic necrosis area of symptomatic ONFH in the absence of contralateral ONFH. Results: The unilateral ONFH and bilateral ONFH groups included 36 and 53 patients, respectively. There was a significant difference in ANA and LNA between the unilateral ONFH and bilateral ONFH groups (ANA: 66.5 ± 16.3% vs. 77.2 ± 16.4%, p < 0.01; LNA: 62.2 ± 17.7% vs. 72.9 ± 17.6%, p <0.01). Multivariate analysis revealed that only LNA of the symptomatic side was a predictor of contralateral ONFH (odds ratio 1.052, 95% confidence interval 1.01-1.12, p = 0.028). A cut-off value of 67% of the LNA was extracted from the ROC curve analysis. The 4-year survival rates with the collapse progression as the endpoint were 30.6% in LNA ⩾67% and 80.0% in LNA <67% (p <0.01 and p <0.01, respectively). Conclusions: The LNA of ONFH on the symptomatic side is a useful indicator of the presence and prognosis of contralateral ONFH. The findings of this study provide useful information for planning treatment strategies and predicting the prognosis of patients with ONFH.

DOI： 10.1177/11207000251405161

Web of Science

Scopus

PubMed

Outcomes of Curved Intertrochanteric Varus Osteotomy for Osteonecrosis of the Femoral Head With a Beak-Shaped Healthy Area. Open Access

Osawa Y, Funahashi H, Ido H, Asamoto T, Takegami Y, Imagama S

The Journal of arthroplasty 2026.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Arthroplasty

Background Indications for curved intertrochanteric varus osteotomy (CVO) for osteonecrosis of the femoral head (ONFH) with a beak-shaped healthy area (BHA) remain unclear. This study aimed to evaluate the clinical outcomes and radiographic findings of CVO for ONFH with BHA. Methods This comparative study included 77 patients who were Japanese Investigation Committee type B and C1 ONFH. From January 2005 to December 2022, 21 patients (22 hips) who had a BHA underwent CVO (BHA group), whereas 56 patients (62 hips) who did not have a BHA underwent CVO (control group). The average follow-up period was 98.4 and 97.2 months in the BHA and control groups, respectively. Clinical and radiographic evaluations included the Harris Hip Score, complication rates, radiographic parameters, and survival rates. Endpoints were defined as conversion to total hip arthroplasty or radiographic failure. Results The preoperative and postoperative Harris Hip Score values were similar between the BHA and control groups. The complication rates were comparable between the groups. The postoperative intact ratio and varus angle showed no significant differences. In the BHA group, three cases of beak fractures occurred within the first year postoperatively. The 8-year survival rate based on conversion to total hip arthroplasty and radiographic failure did not differ significantly between the groups. Conclusions The clinical outcomes of CVO for ONFH with BHA were comparable to those of CVO for ONFH without BHA, indicating that CVO may be a viable joint-preserving option even in cases presenting with BHA.

DOI： 10.1016/j.arth.2026.01.016

Open Access

Scopus

PubMed

Japanese Orthopaedic Association (JOA) clinical practice guidelines on the management of osteoarthritis of the hip, 2024-the third edition-secondary publication

Miyatake, K; Nakashima, Y; Inaba, Y; Kobayashi, N; Jinno, T; Kabata, T; Kajino, Y; Mitani, S; Endo, H; Hamai, S; Ueshima, K; Takao, M; Yamasaki, T; Fujii, M; Takegami, Y; Choe, H; Homma, Y; Fujie, A; Ike, H; Hayama, T; Koyano, G; Taniguchi, N; Tomizawa, K; Watarai, K; Gotow, T; Ohmori, T; Inoue, D; Nishiwaki, T; Tanaka, T; Saiki, Y; Furuichi, S; Kawamoto, T; Tetsunaga, T; Kadowaki, M; Fujimoto, Y; Yamaguchi, R; Uehara, Y; Hara, D; Shimizu, T; Hosoyama, T; Hoshino, H; Hamada, H; Ishida, M; Hayashi, S; Imagama, T; Sugama, R; Sato, R; Uchihara, Y; Fukushima, K; Takada, R; Yamada, K; Shoji, T

JOURNAL OF ORTHOPAEDIC SCIENCE Vol. 31 ( 1 ) page： 1 - 62 2026.1

誌説 AI時代の整形外科医道

竹上靖彦

整形外科 Vol. 76 ( 11 ) page： 1080 - 1080 2025.10

特集整形外科領域におけるAIの応用 Ⅶ章.生成AIによる医療DX 2.言語生成型AIから得られる整形外科的専門知識は不正確である

竹上靖彦

整形外科 Vol. 76 ( 6 ) page： 649 - 652 2025.5

特集股関節温存手術-寛骨臼側股関節周囲骨切り術- 偏心性寛骨臼回転骨切り術のピットフォール

大澤郁介, 竹上靖彦, 船橋洋人, 今釜史郎

関節外科　基礎と臨床 Vol. 44 ( 2 ) page： 131 - 138 2025.2

Discrepancy between radiography and magnetic resonance imaging in Japanese Investigation Committee classification type C osteonecrosis of the femoral head

Otaka K., Osawa Y., Takegami Y., Funahashi H., Imagama S.

International Orthopaedics Vol. 49 ( 2 ) page： 391 - 397 2025.2

Language：English Publishing type：Research paper (scientific journal) Publisher：International Orthopaedics

Purpose: The Japanese Investigation Committee (JIC) classification for osteonecrosis of the femoral head (ONFH) is based on the necrotic area relative to the weight-bearing surface on anteroposterior (AP) radiographs or central coronal MRI. Discrepancies exist between these methods, potentially related to the AP necrosis area. This study evaluated these discrepancies and the extent of AP necrotic lesions. Methods: We retrospectively reviewed 139 patients (188 hips) with nontraumatic ONFH, JIC type C1 or C2 on radiography, and collapse < 3 mm. Cases with and without discrepancies between radiography and MRI were designated as discrepancy and consistent groups, respectively. We assessed the proportion of patients in the discrepancy group and survival rates in both groups, with femoral head collapse > 3 mm as the endpoint. The cutoff value for AP necrotic regions on lateral radiographs identifying discrepancies was calculated using ROC curve analysis. Results: The discrepancy group comprised 28 hips (14.9%) vs. 160 hips in the consistent group. Five-year survival rates were 73.3% vs. 31.9% (P < 0.01), and AP necrotic region extent was 61.2 vs. 73.8 mm (P < 0.001) in discrepancy vs. consistent groups. The cutoff value for necrotic region extent revealing discrepancies was 66.9% (AUC 0.833, sensitivity 83.8%, specificity 82.4%). Conclusion: Patients with AP necrotic regions < 66.9% were more likely to show discrepancies between radiography and MRI in type classification. This study can help improve accuracy in assessing ONFH severity and prognosis.

DOI： 10.1007/s00264-024-06396-x

Scopus

Discrepancy between radiography and magnetic resonance imaging in Japanese Investigation Committee classification type C osteonecrosis of the femoral head.

Otaka K, Osawa Y, Takegami Y, Funahashi H, Imagama S

International orthopaedics Vol. 49 ( 2 ) page： 391 - 397 2025.2

Discrepancy between radiography and magnetic resonance imaging in Japanese Investigation Committee classification type C osteonecrosis of the femoral head

Otaka, K; Osawa, Y; Takegami, Y; Funahashi, H; Imagama, S

INTERNATIONAL ORTHOPAEDICS Vol. 49 ( 2 ) page： 391 - 397 2025.2

Discrepancy between radiography and magnetic resonance imaging in Japanese Investigation Committee classification type C osteonecrosis of the femoral head

Otaka, K; Osawa, Y; Takegami, Y; Funahashi, H; Imagama, S

INTERNATIONAL ORTHOPAEDICS Vol. 49 ( 2 ) page： 391 - 397 2025.2

連載最新原著レビュー大腿骨頭壊死における圧潰停止は骨頭前後の壊死範囲と関連する

大澤郁介, 関泰輔, 竹上靖彦, 今釜史郎

整形外科 Vol. 76 ( 1 ) page： 89 - 93 2025.1

ステロイド関連大腿骨頭壊死症に併発する多発性骨壊死のリスク因子

大高圭司, 竹上靖彦, 大澤郁介, 今釜史郎, 福島若葉, 坂井孝司

日本関節病学会誌 Vol. 44 ( 1 ) page： 3 - 8 2025

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本関節病学会

目的：大腿骨頭壊死症（ONFH）では他部位にも骨壊死を合併することがあり，解剖学的に異なる3部位以上の骨壊死を認めるものは多発性骨壊死（MFON）と呼ばれる。本研究ではステロイド関連ONFHについて，定点モニタリングデータ（厚生労働省ONFH研究班運用のレジストリ）を用いてMFONに関連する因子を検討した。 方法：2009年10月から2023年6月に全国43施設からレジストリに報告されたONFH4,986例のうち，ステロイド全身投与歴があり，他部位の壊死の検索が行われた658例（平均年齢46.4歳，男性294例，女性364例）を対象とした。検討項目はMFONの頻度，骨壊死の部位，またMFON群とONFH以外の骨壊死を認めない群（Non-MFON群）の2群比較を行いMFONの危険因子を評価した。 結果：MFONを35例（5.3％）に認めた。主な骨壊死の部位は膝関節35例（100％），肩関節24例（68.6％）であった。Non-MFON群は458例あった。MFON群で有意に年齢が低く，女性の割合が多かった（P＜0.01）。ステロイド使用期間・最大使用量・パルス療法の有無，習慣飲酒歴，喫煙歴，病型・病期分類に有意差は認めなかった。罹患疾患はMFON群で全身性エリテマトーデス，血液腫瘍の患者が有意に多かった（順にP＜0.05，P＜0.01）。多変量解析の結果，若年，女性，血液腫瘍の罹患が独立した危険因子であった。 考察：ステロイド使用歴のある若年，女性，血液腫瘍患者ではMFONを発症する可能性が高く，全身検索を考慮すべきである。

DOI： 10.11551/jsjd.44.3

CiNii Research

酸化ストレスが変形性膝関節症の進行に及ぼす影響

井戸洋旭, 竹上靖彦, 大澤郁介, 小澤悠人, 船橋洋人, 大高圭司, 今釜史郎, 関泰輔

日本関節病学会誌 Vol. 44 ( 1 ) page： 9 - 16 2025

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本関節病学会

目的：酸化ストレスによる軟骨細胞機能低下が変形性膝関節症（KOA）発症や進行要因の1つとされるが，ヒトにおいてKOA進行と酸化ストレスの関連についての報告はない。本研究の目的は地域一般住民において，酸化ストレスとKOA進行の関連について検討することである。 方法：対象は2017/2018年の北海道八雲町運動器検診受診者の内，活性酸素種量を示す酸化ストレス度（d-ROMs）を測定し，5年後の検診も受診した95例（平均年齢64.2歳，平均BMI23.4，女性52例）とした。計測ソフト（KOACAD）で関節列隙最小距離（mJSW）を計測した。d-ROMsを中央値（320 U.CARR）で2群に分け，5年後と初回受診時のmJSWの差との関連について比較した。また，内側mJSWの1 mm以上狭小化をKOA進行と定義し，その危険因子について多変量解析を行った。 結果：初回受診時の内外側の関節裂隙距離はd-ROMs高値群は低値群より有意に狭く（P≦0.01），d-ROMs高値は5年後の内側mJSWの狭小化と関連した（低値群/高値群，0.09 mm/0.70 mm，P＝0.004）。多変量解析を行うと，d-ROMs ≥ 320 U.CARR （P＝0.014，オッズ比2.63，95％信頼区間1.21-5.70）とBMI，mJSW が独立したKOA進行の危険因子であった。 考察：血液中の活性酸素種量が初回受診時の関節裂隙狭小化と5年後の関節列隙狭小化の進行と関連を認めた。活性酸素種量の増加がKOA進行に関連し，重要な因子であると示唆された。

DOI： 10.11551/jsjd.44.9

CiNii Research

地域在住高齢者の転倒と転倒予防〜ロコモティブシンドロームおよび脊椎グローバルアライメントの観点から〜 Reviewed Open Access

世木直喜, 中島宏彰, 伊藤定之, 大内田隼, 飯田浩貴, 竹上靖彦, 田中智史, 両角正義, 村本明生, 小林和克, 石塚真哉, 関泰輔, 長谷川幸治, 今釜史郎

日本転倒予防学会誌 Vol. 10 ( 1 ) page： 19 - 25 2024.3

Early Recovery of Physical Function After Total Hip Arthroplasty in a Patient With Osteopetrosis: A Case Report Reviewed

Nojiri, S; Kayamoto, A; Terai, C; Osawa, Y; Takegami, Y

CUREUS JOURNAL OF MEDICAL SCIENCE Vol. 16 ( 1 ) page： e52293 2024.1

Factors affecting return to sports after eccentric rotational acetabular osteotomy Open Access

Osawa Y., Seki T., Takegami Y., Makida K., Ochiai S., Hasegawa Y., Imagama S.

Revue De Chirurgie Orthopedique Et Traumatologique Vol. 109 ( 4 ) 2023.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Revue De Chirurgie Orthopedique Et Traumatologique

Background: Although eccentric acetabular rotation osteotomy (ERAO) is an effective treatment for developmental dysplasia of the hip (DDH), there is little information about return to sports after ERAO. This study aimed to investigate 1) the patient factors that influence the return to sports after ERAO, 2) whether postoperative sports participation will affect future osteoarthritis progression. Hypothesis: Some factors affect the return to sports after ERAO. Patients and methods: Of 503 patients who underwent ERAO from 1990 to 2010, 124 who had been continuously participating in sports preoperatively (average 13.2 years after surgery) were included. Patient demographics of sex, age, body mass index, unilateral to bilateral case ratio, history of treatment for childhood DDH, preoperative Kellgren-Lawrence (KL) grade, center edge angle, joint congruency, Harris hip score, complications and the survival rate were compared between the S group (patients who participated in the same sports preoperatively) and N group (patients who could not participate in sports postoperatively). Results: Seventy-two (58%) and 52 patients (42%) in the S and N groups, respectively, had an overall return to sports rate of 64% (79 patients). The most common sports that patients participated in were swimming (30 patients [24%]), jogging (12 [10%]), and golf (10 [8%]) preoperatively, and swimming (14 patients [11%]), golf (8 [6%]), and jogging (8 [6%]) postoperatively. There were no significant differences between both groups in terms of sex, age, body mass index, unilateral to bilateral case ratio, history of treatment for childhood DDH, preoperative KL grade, and joint congruency. There was a significant difference in patient factors between the S (11 joints [14%]) and N (20 joints [38%]) groups only when the preoperative center edge angle was < 0°. There was no significant difference in the preoperative Harris hip score and the final survey between the S (73.2 ± 4.6 and 93.4 ± 7.2) and N (72.5 ± 4.8 and 92.1 ± 7.4) groups. Complications showed no significant differences between the five patients (7%) in the S group and six patients (13%) in the N group. The KL grade progressed in 10 cases (grade II to III in 2 cases and grade III to IV in 8) in the S group and 8 cases (grade II to III in 1 case and grade III to IV in 7 cases) in the N group. The 10-year and 20-year joint survival rates with THA conversion as the endpoint were 98.1% (95% CI: 87.4%–99.7%) and 83.7% (95% CI: 62.6%–93.4%) in the S group and 100% (95% CI: 70.7%–99.3%) and 95.2% (95% CI: 12.6%–92.6%) in the N group, respectively. In the evaluation of factors affecting sports return by logistic regression analysis, only one significant factor (odds ratio 3.42, 95% confidence interval: 1.58–7.42, p < 0.01) was the preoperative center edge angle < 0°. Discussion: The chief factor affecting the return to sports after surgery was a preoperative center edge angle < 0°; moreover, the continuation of sports did not affect the subsequent progression of osteoarthritis or THA conversion. Level of evidence: Level III, cohort study.

DOI： 10.1016/j.rcot.2022.10.006

Scopus

Re: Shibata et al. Comparison of surgical treatments for distal ulna fracture when combined with anterior locking plate fixation of the distal radius in the over 70 age group. J Hand Surg Eur. Epub ahead of print 28 January 2023. DOI: 10.1177/17531934221150495 Invited Reviewed

Shibata, R; Tokutake, K; Takegami, Y; Natsume, T; Matsubara, Y; Imagama, S

JOURNAL OF HAND SURGERY-EUROPEAN VOLUME 2023.4

人工股関節全置換術術後のPelvic obliquityは術前の腰椎側屈可動性と関連している Reviewed

小澤悠人, 大澤郁介, 竹上靖彦, 船橋洋人

日本関節病学会誌 Vol. 42 ( 1 ) page： 12 - 21 2023

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本関節病学会

目的：側方骨盤傾斜は変形性膝関節症や変形性腰椎症などの隣接椎間障害や自覚的な脚長差を生じることからQOLを障害する因子の一つとして知られている。変形性股関節症では脚長差や可動域制限により側方骨盤傾斜を呈することが少なくなく，ときとして人工股関節置換術（以下THA）後でも側方骨盤傾斜の改善が得られない症例が存在する。本研究の目的はTHA後の側方骨盤傾斜を認めない症例と残存する症例を比較し，術後側方骨盤傾斜に影響を与える因子について調査することである。症例および方法：単一施設後ろ向きコホート研究にて，2018年6月から2020年7月までに片側THAを行った91股を対象とした。これらの症例をTHA後の側方骨盤傾斜が2°以内であった48例（以下F群）と2°以上であった43例（以下O群）に分けた。調査項目は年齢，性別，身長，体重，Body Mass Index，術前後のHarris hip score（以下HHS），術前後の股関節可動域，術前後の自覚的脚長差の有無，術前後の側方骨盤傾斜，脚長差，オフセット，術前腰椎側屈可動性について両群間で比較検討を行い，多変量解析を用いて術後の側方骨盤傾斜に影響する因子を評価した。結果：年齢，性別，身長，体重，BMIは両群で有意差を認めなかった。術前のHHSは両群で有意差を認めなかったが，術後1年でのHHSはF群90.8±7.6に対してO群86.4±11.0で有意にO群が不良であった。術前自覚的脚長差には両群で有意差を認めなかったが術後の自覚的脚長差認識率はF群で20.8%，O群で51.1%と有意にO群で自覚的脚長差を有する症例が多かった。術前後の画像的な脚長差は両群で有意差を認めなかった。術前の腰椎側屈可動性はF群で8.7±4.3°，O群で6.9±4.9°で有意にO群が不良であった。多変量解析の結果では術前側方骨盤傾斜と術前の腰椎側屈可動性が術後の側方骨盤傾斜≧2°の有意なリスク因子であった。結論：術前の側方骨盤傾斜が大きい症例や腰椎可動性が不良な症例ではTHA後の側方骨盤傾斜が残存するリスクが高く，慎重な術前計画が必要である。

DOI： 10.11551/jsjd.42.12

CiNii Research

荷重部の後方壊死範囲が大腿骨頭壊死の圧潰停止に影響する Reviewed

大澤郁介, 関泰輔, 竹上靖彦, 加藤大策, 竹本元大

日本関節病学会誌 Vol. 41 ( 4 ) page： 275 - 279 2022

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本関節病学会

目的：圧潰をきたした大腿骨頭壊死が自然経過において圧潰停止し，長期的に手術治療を回避できることは少なくない。我々は骨頭後方の壊死領域の範囲が大腿骨頭壊死の圧潰停止に関与すると仮説し，後方壊死領域と圧潰停止の関係性について調査した。対象および方法：2010年から2016年までに当院に初回受診した片側症状かつ圧潰が3mm以内（Stage 3A）の大腿骨頭壊死77例を対象とした。性別は男性37例，女性40例で平均年齢は45.1歳，平均観察期間は48.7か月，Type分類（B/C1/C2）は3/35/39であった。調査項目は圧潰停止の有無，骨頭後方壊死領域とした。圧潰停止は初診から2年時点で3mm以内の圧潰にとどまった場合に圧潰停止と定義した。骨頭後方壊死領域はMRI横断面で骨頭後方1/3レベルの冠状断T1 MRIにおける荷重面おける壊死領域の割合を評価した。ROC曲線を用いて圧潰停止が得られる後方壊死領域のcut off値を割り出し，cut off値より圧潰進行（>3mm）および人工股関節全置換術をendpointとした生存率を評価した。結果：圧潰停止は31例（40%）に認めた。後方壊死域は圧潰停止例43.1±31.8%に対して圧潰進行例95.6±19.1%で有意差を認めた（P<0.01）。ROC曲線のAUCは0.946でcut off値は後方壊死領域68%（感度96%，特異度92%）であった。圧潰進行および人工股関節全置換術をendpointとした4年生存率は後方壊死領域>68%では6.9%および33%に対し，後方壊死領域<68%では96%および93%でいずれも有意差を認めた（P<0.01およびP<0.01）。結論：一旦圧潰をきたした大腿骨頭壊死においても後方壊死領域が2/3以下の症例は高い確率で自然経過による圧潰停止が期待でき，保存的治療を行うか判断する際の有効な指標となる。

DOI： 10.11551/jsjd.41.275

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Papers - TAKEGAMI Yasuhiko