著者
腰野 富久
出版者
Japanese Society for Joint Diseases
雑誌
日本リウマチ・関節外科学会雑誌 (ISSN:02873214)
巻号頁・発行日
vol.6, no.2, pp.173-180, 1987-11-15 (Released:2010-10-07)
参考文献数
28
被引用文献数
1

Patello-femoral disorders with anterior knee pain have become one of the most important subjects in orthopaedic surgery. The greater part of them are those with chondromalacia patella, patello-femoral compartment osteoarthritis, mal-tracking patella and painful shelf. The synovial impingement syndrome in the lateral patello-femoral facets, however, was rarely found and reported here as a new disease entity. Lateral shift and degree of lateral tilt of the patella shown on roentgenograms were found to be the most useful indications for deciding to perform medialization of the tibial tuberosity. Measurements were done in knees with surgical indication of patients with ages of less than 40 years. The former was 9.9 mm±4.8 mm in 13 knees. The latter was 24.6°±9.7°in 18 knees. Subluxation of the patella is, thus, defined by either more than 5 mm of the former or more than 15°of the latter.Clinical results of medialization or advancement of the tibial tuberosity revealed that improvements of symptoms were noted in 75-85% of the 26 knees operated on, except for those with retropatellar crepitation, improvement of which was found only in 20% of the cases. The position of the patella, however, was lowered after the above surgeries in 58.8% of 34 knees operated on, especially in the elderly. Fracture of the fragment was observed in 2 of 50 operated knees as a complication, but ended in there being satisfactory results. In 9 knees articular cartilages were observed at surgery and at the time of removal of internal fixation, usually one to two years after the initial surgery. All of the knees showed regeneration of degenerated cartilage postoperatively. The dege-neration grading and regeneration staging attempted were found to be satisfactory for evaluation of disorders.
著者
腰野 富久 近藤 邦明
出版者
医学書院
雑誌
総合リハビリテーション (ISSN:03869822)
巻号頁・発行日
vol.13, no.3, pp.197-201, 1985-03-10

はじめに 膝内障の定義に関しては,さまざまな意見があるが,一般的な概念としては急激な疼痛,嵌頓症状および膝くずれなどを訴え,単純X線像に病的所見を認めないものをさしている.このように膝内障という呼称は判然としない面があるが,膝関節内の不定の障害に対する総称であり,診断をつけるには便利なものであるため,ごく最近まで広く用いられてきた. 一般的には半月板損傷,陳旧性十字靱帯損傷,膝蓋軟骨軟化症,棚障害,膝蓋下脂肪体障害(Hoffa's disease)などの膝障害をさすことが多い8). しかし最近では,各種診断技術の進歩に加えて,X線学的検査でも膝蓋骨軸射像,関節造影,関節鏡などが広く行われるようになり,これまで膝内障として一括して扱われていた疾患に対しても,病態が明確に把握され個個の疾患に即応した治療が行われるようになった.これら膝内障に属する個々の疾患に対して若干の解説を加えた.
著者
長岡 亜紀子 中澤 明尋 酒井 直隆 竹内 良平 高木 敏貴 斎藤 知行 岡本 連三 腰野 富久
出版者
Japanese Society for Joint Diseases
雑誌
日本リウマチ・関節外科学会雑誌 (ISSN:02873214)
巻号頁・発行日
vol.19, no.3-4, pp.197-202, 2001-02-25 (Released:2010-10-07)
参考文献数
10

The purpose of this study was to describe the clinical course of steroid induced osteonecrosis of the humeral head, and to investigate the relationship between radiological stage, pain, and range of motion (ROM) .Nine patients (16 shoulders) were examined directly at our out-patient clinic, with an average follow-up period of 4.2 years. There were 2 men and 7 women, with an average age of 42 years at the first visit. Correlation between radiological stage and both pain and ROM of the shoulder was evaluated with Spearman's rank correlation coefficient.At the first examination, 9 of 16 shoulders were evaluated as radiological Stage III or IV, and only 7 as II. During follow-up, the stage advanced from Stage III to IV in 2 of 5 shoulders, but no advance-ment from Stage II to III was observed. Thus, the radiological stage did not progress in a time-dependent manner. A positive correlation was found between radiological stage and pain grade (p<0.0001), and between that and limitation of active movement (p=0.0064) .