研究者詳細 - 竹上　靖彦

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

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

Revue de Chirurgie Orthopedique et Traumatologique 104 巻 ( 8 ) 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：Revue de Chirurgie Orthopedique et Traumatologique

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, and; 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.rcot.2018.09.121

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

Higuchi Yoshitoshi, Seki Taisuke, Hasegawa Yukiharu, Morita Daigo, Komatsu Daigo, Takegami Yasuhiko, Ishiguro Naoki

ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH 104 巻 ( 5 ) 頁： 663 - 669 2018年9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: 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 bearing (MoXPE), ceramic on ceramic bearing (CoC) at more than 5 years follow-up. Therefore, we performed a case control study to: compare the incidence rate of osteolysis; compare the longevity for both types of THAs, and to evaluate the wear rate of MoXPE THAs. Hypothesis: CoC THAs will have a lower rate of osteolysis and better longevity than MoXPE THAs. Patients and methods: We performed a retrospective analysis of 77 MoXPE (68 women, 9 men) and 105 CoC (85 women, 20 men) THAs, with an average patient age at the time of surgery of 64.7 years (range, 27 to 76 years). The cohorts were matched according to sex, body mass index, or diagnosis of hip joint disease. Clinical and radiologic measurements were analyzed at a mean follow-up of 6.7 years (range, 5–9 years). Results: There were no between-group differences with regard to the Harris hip score (87.0 [64.0–98.0] and 89.9 [70.0–100.0] for the MoXPE and CoC group, respectively) and the incidence rate of osteolysis (2.6% and 1.9%, respectively). Revision was required for 1 case for each THA type. The Kaplan-Meier survival at 8 years, using implant loosening or revision as the end-point of analysis, was 96.1% (95% confidence interval [CI], 90.0–99.3) for the MoXPE group and 98.9% (95% CI, 92.2–99.8) for the CoC group (p = 0.189). The mean annual liner wear rate was 0.0160 mm/year (range, 0.0050 to 0.0390 mm/year) for the MoXPE THAs. Discussion: There was no difference between CoC and MoXPE THAs in the incidence of osteolysis or in survival rate at 8 years post-surgery. Excellent clinical and radiological outcomes were obtained for both types of bearings. Level of evidence: III, Case control study, case control retrospective design.

DOI： 10.1016/j.otsr.2018.04.016

Wnt/Beta-catenin Signaling as one of the Therapeutic Targets in Osteoarthritis 招待有り査読有り

竹上靖彦

Nov Tech Arthritis Bone Res 2 巻頁： 1 - 3 2018年

Comparative Outcomes of Anterior and Posterior Plating for Distal-Third Humerus Shaft Fractures. 査読有り国際誌

Shimamoto Y, Tokutake K, Takegami Y, Asami Y, Sato K, Ueno H, Nakano T, Fujii S, Okui N, Imagama S

The Journal of hand surgery 50 巻 ( 3 ) 頁： 375.e1 - 375.e8 2025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 Hand Surgery

Purpose: When treating distal-third humerus shaft fractures (HSFs) surgically, the optimal approach for plating is controversial. We conducted a retrospective multicenter study to investigate and compare the clinical outcomes of anterior and posterior plating in distal-third HSFs and the incidence of complications including iatrogenic radial nerve palsy. Methods: We identified 116 patients from our multicenter trauma database who were diagnosed as having distal-third HSFs and who underwent surgical treatment, including intramedullary nailing between 2011 and 2020. We analyzed 50 cases treated in one of two ways: open reduction internal fixation with anterior plating (group A: 20 cases) and open reduction internal fixation with posterior plating (group P: 30 cases). Results: The findings were similar in terms of operation time, estimated bleeding, and clinical and radiographic outcomes between the groups. Postoperative radial nerve palsy occurred only in group P (4 cases) and never in group A. Conclusions: The results of this study suggest that the anterior approach is a safe and effective method for treating distal-third HSFs with satisfactory outcomes. Type of study/level of evidence: Therapeutic IV.

DOI： 10.1016/j.jhsa.2023.07.014

PDZRN3 regulates adipogenesis of mesenchymal progenitors in muscle

Iida, H; Kawai-Takaishi, M; Miyagawa, Y; Takegami, Y; Uezumi, A; Honda, T; Imagama, S; Hosoyama, T

REGENERATIVE THERAPY 28 巻頁： 473 - 480 2025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：Regenerative Therapy

Introduction: Intramuscular adipose tissue (IMAT) is frequently formed in certain pathological conditions, such as biological aging, and ectopic fat accumulation leads to muscle weakness and a subsequent decline in physical function. Although mesenchymal progenitors (MPs) are present in postnatal skeletal muscle and are the cells from which IMAT originates, the molecular mechanism by which MPs contribute to IMAT formation has not been completely elucidated. Recently, we found that PDZ domain-containing ring finger 3 (PDZRN3), an E3-ubiquitin ligase, was highly expressed in MPs. In this study, we aimed to clarify the functions of PDZRN3 in MPs and the roles of PDZRN3 in IMAT formation using in vitro and in vivo experiments. Methods: Primary mouse MPs isolated from hindlimb muscles were applied to adipogenic differentiation conditions, and expression fluctuation of PDZRN3 was verified with adipogenic differentiation and Wnt signaling markers. The role of PDZRN3 on MP's adipogenesis was evaluated in vitro by gene knock-down experiments. To evaluate the contribution of PDZRN3 to IMAT formation in vivo, tamoxifen-inducible MP-specific Pdzrn3 knockout (Pdzrn3MPcKO) mice were developed. Results: PDZRN3 was more expressed in MPs than in muscle stem cells, and its expression profile of PDZRN3 fluctuated with the adipogenic differentiation of MPs. Our results revealed that PDZRN3 suppressed the adipogenesis of MPs in vitro through the activation of Wnt signaling and that a decrease in PDZRN3 accelerated adipogenesis. Indeed, IMAT significantly increased in the denervated muscles of Pdzrn3MPcKO mice. Conclusions: Our findings suggest that PDZRN3 is a key molecule in regulating IMAT formation. Since ectopic fat accumulation is frequently found in the skeletal muscles of older adults and also muscular dystrophy patients, PDZRN3 and its related pathways may represent a novel therapeutic target for these muscle pathologies.

DOI： 10.1016/j.reth.2025.01.018

Risk factors for intraoperative femoral fractures in cementless bipolar hip arthroplasty for femoral neck fracture in multicenter: The TRON group study 査読有り

Impact of diffuse idiopathic skeletal hyperostosis on quality of life and locomotive syndrome in community-dwelling older adults: the Yakumo study 国際誌 Open Access

Ohshima, K; Nakashima, H; Segi, N; Ito, S; Ouchida, J; Takegami, Y; Ishizuka, S; Yamauchi, I; Hasegawa, Y; Murotani, K; Imagama, S

SCIENTIFIC REPORTS 15 巻 ( 1 ) 頁： 3582 - 3582 2025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：Scientific Reports

Diffuse idiopathic skeletal hyperostosis (DISH) is a common disease in older adults that causes extensive spinal ankylosis. However, its impact on quality of life (QOL) and locomotive syndrome (LS) remains unknown. Thus, we aimed to evaluate the DISH effect on QOL and LS in community-dwelling middle-aged and older adults. Data of community volunteers who attended a health checkup in 2018–2019 were assessed. A total of 455 subjects were included. Whole spine lateral radiographs were obtained to detect DISH according to the Resnik criteria. QOL was evaluated using SF-36 and EQ5D HUSV. LS was evaluated using the stand-up and two-step tests and GLFS-25. Multivariate regression analysis was performed, adjusting for sex, age, body mass index, and knee osteoarthritis. Additionally, a sex-stratified analysis was performed. DISH was detected in 83 (18.2%) participants. Multivariate analysis demonstrated that DISH was significantly associated with low EQ5D HSUV. Multivariate analysis in men demonstrated that DISH was associated with low PCS, low EQ5D HSUV, high LS stage. Multivariate analysis in women demonstrated that DISH was not associated with any QOL or LS. DISH may be associated with a poor QOL. Additionally, DISH is more common and produces a greater clinical impact in men than in women.

DOI： 10.1038/s41598-025-87878-9

Ido, H; Takegami, Y; Osawa, Y; Okamoto, M; Iida, H; Imagama, S

JOURNAL OF ORTHOPAEDIC SCIENCE 30 巻 ( 1 ) 頁： 101 - 106 2025年1月

担当区分：責任著者記述言語：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: Intraoperative femoral fractures are more common in cementless bipolar hip arthroplasty (BHA) for displaced femoral neck fractures than they are in cemented BHA and remain one of the major concerns. This study aimed to investigate the risk factors for intraoperative femoral fractures in cementless BHA. Methods: The study included 1,392 patients who underwent cementless BHA for displaced femoral neck fractures from January 2015 to December 2019 in 14 hospitals of the Trauma Research Group. They were divided into two groups according to the presence or absence of intraoperative femoral fractures, and factors associated with intraoperative fractures were statistically examined. Results: Forty (2.9 %) intraoperative and 28 (2.0 %) postoperative, totally 68 (4.9 %) femoral fractures occurred. The mean age of the patients, presence of opposite-side proximal femoral fracture, approach, and cementless stem design were significantly different between the two groups (P < 0.05). The logistic regression analysis model showed that a fully HA-coated stem (odds ratio, 4.12; 95 % confidence interval, 1.43–11.9) was an independent factor associated with intraoperative femoral fractures. Conclusion: This study investigated the risk factors associated with intraoperative fractures and showed that fully HA-coated stems were an independent factor associated with intraoperative femoral fractures. Surgeons should be cautious in the early stages of introducing fully HA-coated stems.

DOI： 10.1016/j.jos.2024.01.005

Acetabular osteophyte formation in dysplastic hip osteoarthritis 査読有り国際誌 Open Access

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

BMC MUSCULOSKELETAL DISORDERS 25 巻 ( 1 ) 頁： 1072 - 1072 2024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：BMC Musculoskeletal Disorders

The growth of periacetabular osteophytes with developmental dysplasia of the hip (DDH) remains unclear. This study aimed to perform a three-dimensional assessment of periacetabular osteophytes and the effects of superiorization (SP) and lateralization (LT) of the femoral head on osteophyte formation. Female (n = 105) with unilateral hip osteoarthritis due to DDH who underwent total hip arthroplasty between 2016 and 2022 were included. The SP and LT of the femoral head were assessed using anteroposterior radiographs. We measured the periacetabular osteophyte using computed tomography. The correlation coefficient between SP or LT and the length of each osteophyte were investigated. Furthermore, multiple regression analyses with SP and LT as explanatory variables and each osteophyte as an objective variable were performed to evaluate the effect of SP and LT on osteophyte formation. The longest osteophyte was the anterior osteophyte (20.48 mm ± 11.8 mm). Acetabular osteophytes correlated with LT as follows: anterior (r = 0.55), posterosuperior (r = 0.51), and inferior (r = 0.48). Multiple regression analysis showed that all acetabular osteophytes were influenced by LT (p < 0.05 for all factors). Hip surgeons may need to be aware that cases with marked lateralization of the femoral head require treatment of the periacetabular osteophytes.

DOI： 10.1186/s12891-024-08211-5

Discrepancy between radiography and magnetic resonance imaging in Japanese Investigation Committee classification type C osteonecrosis of the femoral head. 査読有り国際誌

Keiji Otaka, Yusuke Osawa, Yasuhiko Takegami, Hiroto Funahashi, Shiro Imagama

International orthopaedics 2024年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Changes of hip fracture in older patients before and after the COVID-19 pandemic: a retrospective multicentre study in Japan 査読有り国際誌 Open Access

Tanaka, S; Osawa, Y; Takegami, Y; Okui, N; Yamauchi, KI; Aoki, Y; Imagama, S

BMC MUSCULOSKELETAL DISORDERS 25 巻 ( 1 ) 頁： 1006 - 1006 2024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：BMC Musculoskeletal Disorders

Background: The COVID-19 pandemic had a significant impact on healthcare systems and the general population. However, it remains unclear to what extent these major societal changes have had an impact on the management of hip fractures in older people in Japan. Therefore, we investigated the effect of the COVID-19 pandemic on the number of patients with hip fractures, their characteristics, and their perioperative management as a retrospective multicentre study. Methods: We included 1894 patients aged ≥ 65 years who underwent surgery for hip fracture at three hospitals between January 2019–December 2021. Patients were classified according to the time of injury; patients treated between January–December 2019, January–December 2020, and January–December 2021 were divided into the pre-COVID-19 group, early COVID-19 group, and late COVID-19 group, respectively. We compared age, sex, body mass index, preadmission residence, surgical procedure, length of hospital stay, waiting time for surgery, in-hospital complications, and in-hospital death. Results: Our findings suggested that the early COVID-19 and late COVID-19 groups showed a 6.8% and 7.5% reduction in the number of HF patients, respectively, compared to the pre-COVID-19 group. Waiting days for surgery, length of hospital stay, and in-hospital mortality or complication rates did not significantly change before and after the pandemic. However, infection was increased in the early COVID-19 group regarding the subgroup of complications. Conclusions: The COVID-19 pandemic altered the characteristics of hip fractures in older individuals.

DOI： 10.1186/s12891-024-08050-4

The Wait Time for Surgery Following Injury Affects Functional Outcomes and Complications After an Ankle Fracture: A Propensity Score-Matched Multicenter Study, the TRON Study 査読有り国際誌

Sugino, T; Takegami, Y; Bando, K; Sato, T; Fujita, T; Oka, Y; Imagama, S

FOOT & ANKLE SPECIALIST 17 巻 ( 6 ) 頁： 592 - 597 2024年12月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Foot and Ankle Specialist

Background: The present study aimed to evaluate the hypothesis that a 1-week extension of the waiting period to perform surgery for ankle fracture might affect postoperative results and complications. Methods: We used our multicenter database named TRON (Trauma Research Group of Nagoya). In all, 779 patients who underwent surgery for ankle fracture, who had no comorbidities were eligible. After exclusion, we analyzed 596 patients. We divided the patients into 2 groups according to whether they were operated on within 7 days after the injury with propensity score matching. Results: The operative time of the delayed operation group (DO group) was significantly longer than that of the early operation group (EO group) (115.87 ± 56.59 vs 85.93 ± 34.58 minutes; P <.001). The rate of infection in the DO group was significantly higher than that of the EO group (16 patients [6.5%] vs 4 patients [1.6%]; P =.016). Conclusion: Waiting for more than a week to perform ankle surgery may lead to longer operative times and increased infection rates. Levels of Evidence: III

DOI： 10.1177/19386400231164211

Free bone fragments are associated with the development of heterotopic ossification after hemiarthroplasty for femoral neck fracture: a retrospective observational study 査読有り国際誌 Open Access

Yokoi, H; Takegami, Y; Ochiai, S; Miyachi, T; Urasaki, T; Imagama, S

EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 34 巻 ( 8 ) 頁： 3947 - 3953 2024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：European Journal of Orthopaedic Surgery and Traumatology

Purpose: Heterotopic ossification (HO) can occur after hemiarthroplasty (HA) for femoral neck fractures (FNF). This study aimed to investigate the frequency and factors contributing to the development of HO after HA. Methods: The study included data from 92 of 183 patients (26 male and 66 female) who sustained FNF and underwent HA between April 2019 and January 2022. HO was identified on postoperative radiographic images. Patient background, operative duration, blood loss, and presence of free bone fragments immediately after surgery were compared between the HO and non-HO groups. Statistical analyses included the independent-sample t-test for continuous variables and the chi-squared test for categorical variables. A multivariate logistic regression analysis was performed using HO as an objective variable. Results: HO occurred in 50 of the 92 (54%) patients. There were no statistically significant differences in patient backgrounds. Univariate analysis revealed significantly longer mean operative duration and greater blood loss in the HO group. Free bone fragments in the immediate postoperative period were observed in 29 of 50 (58%) patients in the HO group and in 3 of 42 (7.1%) patients in the non-HO group, a statistically significant difference. Logistic regression analysis revealed that the presence of free bone fragments was an independent explanatory factor for HO development. Conclusion: The presence of free bone fragments immediately after surgery may be significantly associated with the development of HO. Therefore, it is necessary to sufficiently remove such fragments during surgery because they may trigger HO.

DOI： 10.1007/s00590-024-04083-6

Radiographic factors affecting contralateral knee alignment in patients with dysplastic hip osteoarthritis 査読有り国際誌

Tanaka, S; Osawa, Y; Takegami, Y; Ozawa, Y; Imagama, S

KNEE 51 巻頁： 249 - 257 2024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：Knee

Introduction: Patients with dysplastic hip arthritis (DHA) often present with abnormal knee alignment. We investigate the factors influencing varus and valgus knee alignment on the contralateral side in patients with unilateral DHA. Methods: 123 patients with unilateral DHA were enrolled between 2018 and 2022. Based on the hip-knee-ankle angle (HKAA), patients were divided into three groups: neutral group (HKAA <3° varus and valgus), varus group (>3° varus), and valgus group (>3° valgus). Demographics, radiographic parameters, and functional scores were compared between the groups. Results: There were 58, 44, and 21 patients in the neutral, varus, and valgus group, respectively. The varus group had a varus HKAA and hip adduction angle in the affected hip and a large femoral offset in the healthy hip. The valgus group had a valgus HKAA and large hip adduction angle in the affected hip and a small femoral offset in the healthy hip. In addition, the valgus group presented with pelvic obliquity, expressed as an upper pelvic tilt on the affected side. Multivariate analysis identified a varus HKAA in the affected hip (odds ratio [OR], 0.64; 95% confidence interval [CI]: 0.51–0.79; p < 0.01) as a factor associated with the varus group, while pelvic obliquity (OR, 0.69; 95% CI: 0.53–0.89; p = 0.01) was associated with the valgus group. The varus and valgus groups had significantly worse functional scores than the neutral group. Conclusions: This study demonstrated that varus and valgus alignments of the contralateral knee with unilateral DHA were associated with radiographic parameters and hip function.

DOI： 10.1016/j.knee.2024.09.014