著者

松本 淳

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.7, no.4, pp.509-510, 1989-03-05 (Released:2010-10-07)

参考文献数

2

著者

岩田 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.13, no.1, pp.1-3, 1994-06-30 (Released:2010-10-07)

参考文献数

13

著者

村田 英明 村上 恒二 宗重 博 浜田 宣和 天野 幹三 山本 健之 生田 義和

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.12, no.3, pp.273-282, 1993-12-20 (Released:2010-10-07)

参考文献数

13

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To study the effectiveness of bone peg graft from the ulna for osteochondritis dissecans of the elbow joint, we analyzed 16 patients with bone peg graft who had various types of preoperative and postoperative findings. All the cases were baseball players except for one volleyball player. The onset ages ranged from 10 to 16 years (mean 11.2), and the periods from then to the operation from 5 to 72 months (mean 2.6 years) . The follow-up periods were from 12 to 29 months (mean 20 months) . Based on Minami's X-P classification, 8 cases were categorized into the stage of fragmentation and 8 into the stage of isolation. Patients were also classified with respect to the osteochondral lesion found during operation; 9 were without abrasion of the lesion or, if with it, without invasion of fibrocartilage into the lesion and were classified into Type 1. The 7 in which the osteochondral lesion was unstable due to the invasion of fibrocartilage were classified as Type 2. The results with regard to postoperative X-P were classified as excellent when the osteochondral lesion was repaired anatomically, as ‘good’ when the lesion was under repair and the osteosclerotic halo of the capitulum had disappeared, and as ‘poor’ when the halo remained. As a result, 7 Type 1 cases (78%) were excellent and 2 cases (22%) good, while one Type 2 case (14%) was excellent, 4 (57%) were good and 2 (29%) were poor. All patients were clinically not symptomatic and were satisfied with the surgery. We emphasized that bone peg graft could be indicated in all cases of osteochondral dissecans of the elbow joint and that there were difficulties in repairing osteochondral lesion in Type 2 (unstable) cases.

著者

岩本 幸英

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.17, no.2, pp.89-98, 1998-10-31 (Released:2010-10-07)

参考文献数

32

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The process of bone metastasis consists of several distinct but essential events: escape from the original site, dissemination through blood vessels, and growth at a bone. Tumor cells cross basement membranes as they initially invade vascular beds during the dissemination. The inva sion of tumor cells through basement membranes involves three distinct events: attachment of the tumor cells to the basement membrane, secretion of MMPs by tumor cells which causes degradation of the adjacent basement membrane, and migration of the cells into the target tissue. Bone metastases are frequently associated with osteolysis, which leads to pathologic frac tures and hypercalcemia, while metastasis from prostatic carcinoma usually shows osteosclerotic changes. Cancer cells promote osteolysis by activating osteoclasts through a variety of chemical mediators secreted by cancer cells themselves or by monocytes. The risk of pathological frac ture is high if lytic metastasis involves cortical destruction.When skeletal metastasis is suspected following a roentgenogram, we suggest that a bone scintigram be performed primarily in order to identify whether the lesion is single or multiple. Patients with multiple skeletal metastases usually do not undergo surgery. Instead, radiation or chemotherapy is indicated. Surgery for skeletal metastasis does not necessarily affect the life expectancies of patients. However, if dramatic improvement in the quality of patients' lives can be expected, surgery for long bone metastasis or spinal metastasis is indicated.For patients with long bone metastasis, we prefer to carry out resection with a wide margin before a pathological fracture occurs, since the fracture carries the risk of disseminating tumor cells. Reconstruction after the resection of long bone involving metastasis may be best achieved by prosthetic replacement. The spine is the most common site of skeletal metastasis, irrespective of the primary tumor. When patients with spinal metastasis are expected to survive longer than six months, and neurological deficits become evident in addition to back pain, decompression followed by posterior stabilization is indicated.

著者

土屋 弘行 加畑 多文 北野 慎治 上原 健治 森永 敏生 富田 勝郎

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.17, no.4, pp.237-248, 1999-06-10 (Released:2010-10-07)

参考文献数

11

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Introduction of the Ilizarov external fixator has bought about a treatment revolution to resolve such orthopaedic problems as fracture fixation, limb lengthening, deformity correction, joint mobilization, and reconstruction of bone and soft tissue defects. One of the advantages of the Ilizarov method is its versatility, that is, different orthopaedic problems can be simultaneously treated with the Ilizarov method. In this study, we introduce a method of deformity correction of the lower extremities and reconstruction of skeletal defects using the Ilizarov external fixator. Deformity correction with the Ilizarov hinge system is very useful to realign the mechanical axis of the lower extremities. We also introduce a new concept of high tibial osteotomy called“mechanical axis lateralization”for genu varum resulting from unicompartmental medial osteoarthrosis, Blount's disease and so on. In addition, the Ilizarov method made it possible to successfully reconstruct extensive bone defects combined with or without intramedullary nailing. The Ilizarov method will become more widely used and advantageous if the treatment period is shortened.

著者

宮本 浩次

出版者

日本関節病学会

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.11, no.1, pp.77-88, 1992

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Although many investigators had studied the innervation of the posterior longitudinal ligament (PLL) with regard to the pathogenesis of low back pain, the precise distribution of the nerve fibers had not been clarified before Kojima's acetylcholinesterase histochemical study. In my study here, innervation of the PLL of the rat lumber vertebral column was investigated by immunohistochemical staining of the calcitonin gene-related peptide (CGRP) and substance P (SP) .<BR>The PLL was found to contain dense nerve networks of numerous CGRP and SP-like Immunoreactive fibers which demonstrated nerve endings with marked varicosity. They were divided into two systems. One was a network which was distributed in the vertebral portion and in the superficial layer of the intervertebral portion of the PLL, and the other was the network existing in the profound layer in the intervertebral portion known as enthesis of the PLL. They were supplied by nerve fibers through the meningeal branches of the spinal nerves and the gray communicating branches.<BR>This study suggests that the CGRP and the SP-like immunoreactive fibers in the PLL are associated with not only the conduction of nociceptive stimuli but also the regulation of spinal motion and metabolism of the enthesis.

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

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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

杉本 勝正 松井 宣夫 種田 陽一 大藪 直子 藤森 修

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.11, no.1, pp.71-76, 1992-06-05 (Released:2010-10-07)

参考文献数

6

被引用文献数

3

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Twenty-six coracohumeral ligaments (C-H hg) were studied by histochemical methods in order to investigate collagen structures and distribution of the nerves. The collagen structure of the C-H hg was different from that of the shoulder capsule in that tere was mainly Type III collagen in it. On the other hand, both Type I and III collagen were in the capsule of the shoulder joints. Regarding the distribution of the nerves, there were a lot of different types. Some C-H hg had many nerves and some had few nerves. Histologically the C-H hg was loose connective tissue which was connected with the periosteum of the coracoid process. We think such a characteristic of the C-H hg may be associated with the cause of frozen shoulder.

著者

町田 正文

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.18, no.1-2, pp.13-18, 1999-08-31 (Released:2010-10-07)

参考文献数

19

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Idiopathic scoliosis is a common cause of spinal deformity in children and adolescents. Despite extensive studies, the etiology and pathogenesis remain unknown. Idiopathic scoliosis probably results from a multifactorial abnormality involving genetic, biochemical, and neuromuscular factors. Numerous experiments on various animal models and clinical studies have suggested possible anatomic or functional influences for the etiology, but many of them may be epiphenomena rather than etiologic causes. Recently, great emphasis has been placed on the role of the central nervous system. There is mounting evidence that a primary defect of central nervous system function - namely, a defect of posture, proprioception, or equilibrium control -is responsible for the development of scoliosis. More recently, results of studies indicate that calmodulin and/or melatonin are associated with the progression of idiopathic scoliosis. We have found that pinealectomy in chickens consistently produces scoliosis, which had similar anatomic characteristic of human idiopathic scoliosis. In addition, the intramuscular implantation of the pineal gland and interperitoneal injection of melatonin prevented the development of scoliosis. Furthermore, we demonstrated experimentally that induced scoliosis in pinealectomized rats occurs only in bipedal but not in quadrupedal rats.From our series of experimental studies we have proposed that a defect of melatonin synthesis may contribute to the etiology of experimental scoliosis model in chickens and rats, and bipedal condition may also be an important factor for the development of scoliosis.In a human study we found significantly decreased integrated concentration of melatonin over a 24-hour period and at night in adolescent idiopathic scolosis patients with progressive curves, while those with stable curves were similar to the control. We postulated that balanced muscle tone controlled by postural reflex is important to maintain normal posture with a straight spine in a bipedal condition. The disturbance of equilibrium and posture mechanism, secondary to a defect of melatonin synthesis, may promote development of rotational lordoscoliosis, especially in bipedal posture.

著者

重野 陽一 福島 美歳 原田 憲正 石田 通暁 大西 純二 中川 滋人

出版者

日本関節病学会

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.9, no.4, pp.593-602, 1990

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The porous total knee replacement designed by Miller and Galante has been performed on 31 knees in 23 cases from November 1986 to June 1988 in the Kure National Hospital. We evaluated the postoperative results over an average follow-up period of 2.7 years (ranging from 2 to 3.6 years) on 6 knees in 4 men and 25 knees in 19 women, with ages ranging from 49 to 81 (average 69.0) . The original diseases were 5 cases of rheumatoid arthritis (7 knees) and 18 cases of osteoarthritis (24 knees) .<BR>Each knee was evaluated preoperatively and postoperatively by the functional evaluation score system proposed by the three universities. Preoperative and postoperative femoro-tibial angle, alignment of each component, degree of lateral displacement of the patella on the patellofemoral groove, occupancy ratio of the component to the tibial surface, amount of resection of the tibia, radiolucent line and sclerotic line adjacent to the component were investigated with roentgenograms.<BR>Postoperatively the clinical score improved from 36.9 to 80.3 points in rheumatoid knees and from 48.5 to 87.3 in osteoarthritic knees.<BR>In each case, the insertion angle of the components was close to ideal. The degree of lateral displacement of the patella was significantly decreased in cases with lateral retinacular release. The mean occupancy ratio of tibial component to tibial surface was 95.8% on A-P and lateral view X-rays, showing that the components used are small for the tibial surface. The mean resection of the tibia was 7mm from the surface of the lateral plateau in varus knees. Only 2 rheumatoid patients had radiolucent lines surrounding the tibial component. In 2 rheumatoid knees and 11 osteoarthritic knees there were sclerotic lines surrounding the pegs of the tibial components.<BR>In general, the short-term results of total knee replacement using this prosthesis were satisfactory. The long-term radiographic observation has shown that the choice of a tibial component of adequate size is mandatory to prevent the component from sinking.

著者

黒田 司 佐浦 隆一 廣畑 和志 石川 斉

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.9, no.3, pp.503-506, 1990-12-15 (Released:2010-10-07)

参考文献数

8

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Although a number of cases of spontaneous medial dislocation of the long head of the biceps brachii muscle have been reported, lateral dislocation of this tendon has not. We describe a man with habitual lateral dislocation of the long head of the biceps tendon, and discuss the pathomechanics of this unusual condition. Enhanced computed tomography was useful for diagnosis in this case.

著者

陳 隆明 井口 哲弘 三枝 康宏 松原 司 廣畑 和志

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.10, no.1, pp.61-70, 1991-06-20 (Released:2010-10-07)

参考文献数

17

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RA joints whose bone scan was positive are thought to have a subclinical abnormality even if there aren't any symptoms. Two hundred joints in 45 patients with positive 99m Tc -HMDP bone scan without clinical signs except in small joints in hands and feet were followed for 12 to 45 months (mean: 22 months) . The age of the patients ranged from 24 to 76 (average : 57) and they had suffered from RA from 4 to 30 years (mean: 14) .Clinical signs such as pain and/or swelling appeared in 88 out of the 200 joints during the follow-up time. The new symptoms appeared frequently in the knee joint. There was no significant difference in the occurrence of the symptoms, however, between loaded and non-loaded joints. Those new symptoms were observed within 18 months in 79 % out of 88 joints.It is therefore considered that bone scans are an useful means for prospective detection of inflammatory joints. Careful observation is necessary for at least 18 months for RA joints with positive scintigraphic findings.

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

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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) .

著者

大塚 隆信

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.26, no.2, pp.77-78, 2007-08-25