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- 저자 : Hiroaki Kijima (검색결과 2 건)
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Ken Sasaki,Michio Hongo,Naohisa Miyakoshi,Toshiki Matsunaga,Shin Yamada,Hiroaki Kijima,Yoichi Shimada 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.4
Study Design: In vivo biomechanical study using a three-dimensional (3D) musculoskeletal model for elderly individuals with or without pelvic retroversion. Purpose: To evaluate the effect of pelvic retroversion on the sagittal alignment of the spine, pelvis, and lower limb in elderly females while standing and walking. Overview of Literature: Patients with hip–spine syndrome have concurrent hip-joint and spine diseases. However, the dynamic sagittal alignment between the hip joint and spine has rarely been investigated. We used a 3D musculoskeletal model to evaluate global spinopelvic parameters, including spinal inclination and pelvic tilt (PT). Methods: A total of 32 ambulant females (mean age=78 years) without assistance were enrolled in the study. On the basis of the radiographic measurement for PT, participants were divided into the pelvic retroversion group (R-group; PT≥20°) and the normal group (N-group; PT<20°). A 3D musculoskeletal motion analysis system was used to analyze the calculated value for the alignment of spine, pelvis, and lower limb, including calculated (C)-PT, sagittal vertical axis (C-SVA), pelvic incidence, lumbar lordosis, T1 pelvic angle (CTPA), as well as knee and hip flexion angles while standing and walking. Results: While standing, C-PT and C-TPA in the R-group were significantly larger than those in the N-group. Hip angle was significantly smaller in the R-group than in the N-group, unlike knee angle, which did not show difference. While walking, C-SVA and C-TPA were significantly increased, whereas C-PT decreased compared with those while standing. The maximum hip-flexion angle was significantly smaller in the R-group than in the N-group. There was a significant correlation between the radiographic and calculated parameters. Conclusions: The 3D musculoskeletal model was useful in evaluating the sagittal alignment of the spine, pelvis, and leg. Spinopelvic sagittal alignment showed deterioration while walking. C-PT was significantly decreased while walking in the R-group, indicating possible compensatory mechanisms attempting to increase coverage of the femoral head. The reduction in the hip flexion angle in the R-group was also considered as a compensatory mechanism.
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Hidetomo Saito,Kimio Saito,Yoichi Shimada,Toshiaki Yamamura,Shin Yamada,Takahiro Sato,Koji Nozaka,Hiroaki Kijima,Naohisa Miyakoshi 대한슬관절학회 2018 대한슬관절학회지 Vol.30 No.4
Purpose: High tibial valgus osteotomy (HTO) is a wellestablished surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closedwedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the shortterm results in a consecutive series of patients treated with hybrid CWHTO.Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average followup of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The KellgrenLawrence grading system and pre and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed.Results: The FTA and MA significantly changed from 180.7° to 170.4° and from 22.0° to 60.2°, respectively. No significant differences were observed between the mean pre and postoperative posterior tibial slope, InsallSalvati ratio, or CatonDeschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.
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