論文 - 原藤　健吾

When does postoperative standing function after total knee arthroplasty improve beyond preoperative level of function?

Harato Kengo, Otani Toshiro, Nakayama Nobuyasu, Watarai Hiroko, Wada Mayu, Yoshimine Fumihiro

Knee 16 （ 2 ） 112 - 115 2009年03月

ISSN  0968-0160

　概要を見る

<p>The purpose of the current study was to investigate inpatient recovery process during relaxed standing, and to clarify the question of when postoperative standing function would improve beyond preoperative level of function following total knee arthroplasty (TKA). Thirty patients with bilateral knee osteoarthritis, averaged 75 years old, participated. Subjects underwent unilateral TKA. Evaluations were divided into two categories; subjective and objective components. Subjective component was based on pain level (Visual Analog Scale: 100 mm), and objective component consisted of vertical knee force (%BW) and knee flexion angle (degrees) during relaxed standing. Data evaluations were done pre- and post-operatively. Preoperative pain score was 69.1. After TKA, pain level became maximum (89.9) and significantly larger on postoperative day 3. Thereafter, pain gradually decreased, and it (60.4) was significantly smaller on postoperative day 8 than preoperative score. Preoperative vertical knee force was 43.5%BW. After TKA, it became minimum (32.8) on postoperative day 3. Thereafter, knee force gradually increased, and it (44.1) was significantly larger on postoperative day 17. Preoperative knee flexion angle was 15.6°. After TKA, knee flexion angle during standing became maximum (20.0) on postoperative day 4. Thereafter, subjects could gradually extend the knee, and on postoperative day 16, it (14.3°) was smaller. From our results, subjective pain was significantly reduced from postoperative day 8, and objective knee condition, including vertical knee force on TKA side and knee flexion angle on TKA side during standing, significantly became better from postoperative day 17 and 16, respectively. © 2008 Elsevier B.V. All rights reserved.</p>

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人工膝関節置換術後に適切な入院期間はどれくらいか?

原藤健吾

整形外科 60   101 - 103 2009年

中下位頚椎の脊柱管狭窄を伴う軸椎歯突起後方腫瘤による頚髄症の1例

原藤健吾，丸岩博文，松本守雄，西澤隆，中村雅也，千葉一裕，藤村祥一，戸山芳昭

整形外科 60   1361 - 1364 2009年

脛骨近位端の不顕性骨折および脆弱性骨折13例の検討

松本秀男，大谷俊郎，須田康文，松崎健一郎，原藤健吾，金子大毅

整形外科 60   17 - 21 2009年

変形性膝関節症は大腿骨近位部骨折術後膝関節痛に関与しているか

原藤健吾

日本関節病学会誌 28   559 - 562 2009年

脛骨顆部骨折手術後に関節内血腫を繰り返した血友病A患者の1例

原藤健吾，吉峰史博，中山玄康，渡来比呂子，和田真裕，大谷俊郎

整形外科 60   339 - 342 2009年

Knee flexion contracture will lead to mechanical overload in both limbs

Harato Kengo, Nagura Takeo, Matsumoto Hideo, Otani Toshiro, Toyama Yoshiaki, Suda Yasunori

Knee 15 （ 6 ） 467 - 472 2008年12月

ISSN  0968-0160

　概要を見る

<p>The purpose of the current study was to investigate the effect of knee flexion contracture on the knee mechanics both in affected and contralateral limbs during gait. Ten healthy old women, with mean age of 62 years, participated. Unilateral knee flexion contractures of 0, 15, and 30° were simulated with a knee brace. All subjects performed walking trials with or without the simulation. Net knee extension moments, net knee adduction moments (%BW Ht), external knee forces (%BW), and maximum axial loading rate (%BW/s) at the knee were calculated both in contracture side and non-contracture side under different contracture conditions. Bilateral net knee extension moment gradually increased as the angle of contracture increased. The net knee extension moments in non-contracture limb were significantly larger with 15 and 30° contracture than those without the contracture. Net knee adduction moment in non-contracture limb significantly increased with 15 and 30° contracture. The knee shearing forces in contracture side and the knee compressive force in non-contracture side also significantly increased with 15 and 30° simulation. As the flexion contracture became greater than 15°, maximum axial loading rate also significantly increased in non-contracture side. From our results, the knee flexion contracture greater than 15° led to mechanical overloads in both limbs. Correction of the contracture is clinically important to avoid any adverse effect. © 2008 Elsevier B.V. All rights reserved.</p>

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A gait analysis of simulated knee flexion contracture to elucidate knee-spine syndrome

Harato Kengo, Nagura Takeo, Matsumoto Hideo, Otani Toshiro, Toyama Yoshiaki, Suda Yasunori

Gait and Posture 28 （ 4 ） 687 - 692 2008年11月

ISSN  0966-6362

　概要を見る

<p>Knee flexion contracture influences the physiological movements in lower extremities and may cause the kinematic changes of the trunk. Our purpose was to investigate static and dynamic changes in trunk kinematics with simulated knee flexion contracture. Ten healthy females averaged 62 years participated in our study. Unilateral knee flexion contractures of 15° and 30° were simulated with a knee brace. Relaxed standing and level walking were measured at our laboratory using a motion analysis system which consisted of five cameras, a force plate, and thirteen retro-reflective markers. Three-dimensional trunk kinematics and vertical knee forces (% Body Weight) with the contractures were compared with those without the contracture. The 15° contracture did not significantly change trunk kinematics. However, the 30° contracture significantly changed the kinematics in each of the following planes. In the coronal plane, the trunk tilted to the contracture side in standing and walking. In the sagittal plane, posterior inclination of the pelvis in standing significantly increased. In addition, anterior inclination of the trunk and pelvis during walking significantly increased. In the axial plane, trunk rotation to the unaffected side significantly decreased during walking. The vertical knee force in the contracture limb decreased, being accompanied by the increase of the force in the unaffected limb during standing and walking. Results of our study suggest that knee flexion contracture significantly influences three-dimensional trunk kinematics during relaxed standing and level walking, and will lead to spinal imbalance. These facts may explain the onset of the "Knee-Spine Syndrome". © 2008 Elsevier B.V. All rights reserved.</p>

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Midterm comparison of posterior cruciate-retaining versus -substituting total knee arthroplasty using the Genesis II prosthesis. A multicenter prospective randomized clinical trial

Harato Kengo, Bourne Robert B., Victor Jan, Snyder Mark, Hart John, Ries Michael D.

Knee 15 （ 3 ） 217 - 221 2008年06月

ISSN  0968-0160

　概要を見る

<p>The purpose of the current study was to compare midterm outcomes of posterior cruciate-retaining (CR) versus posterior cruciate-substituting (PS) procedures using the Genesis II total knee arthroplasty (TKA) system (Smith and Nephew, Memphis, TN). Ninety-nine (99) CR and 93 PS TKA's were analyzed in this prospective, randomized clinical trial. Surgeries were performed at seven medical centers by participating surgeons. Clinical outcomes (Knee Society Score, Range of Motion, WOMAC, SF-12, and Radiographic Findings), in addition to postoperative complications, were evaluated with a minimum follow-up of 5 years. Following data analysis, there were no significant differences in patient demographics or preoperative clinical measures between the two groups. At the latest follow-up interval, no significant differences were found between the CR and PS groups with regards to functional assessment, patient satisfaction, or postoperative complication. However, the PS group did display statistically significant improvements in range of motion when compared with the CR group. The results of this investigation would suggest that, while comparable in regards to supporting good clinical outcomes, the PS Genesis II design does appear to support significantly improved postoperative range of motion when compared with the CR design. © 2007 Elsevier B.V. All rights reserved.</p>

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スノーボードによる成人上腕骨外顆骨折の1例

原藤健吾，佐々木孝，山中一良，野本聡，河野克己，西脇正夫，前野晋一，金子大毅，大山順子

栃木県整形外科医会会誌 22   19 - 21 2008年

異なるヘッド径、ネック径、回転中心位置の人工股関節におけるインピンジメントまでの可動域と脱臼までの可動域

吉峰史博，井口理，佐々木政幸，原藤健吾，塩野将平

整形外科 59   1383 - 1388 2008年

初診時膝関節痛のみを訴え診断が遅延した高齢者の大腿骨頸部骨折の2例

吉峰史博，井口理，佐々木政幸，原藤健吾，高尾英龍

整形外科 59   608 - 611 2008年

人工股関節全置換術での側臥位固定ポジショナーによると思われる感覚異常性大腿痛に手術的治療を行った1例

吉峰史博，井口理，佐々木政幸，原藤健吾，高尾英龍

整形外科 59   1219 - 1222 2008年

人工股関節にて非円形の断面をもつネックがoscillation angleの大きさに及ぼす有効性

原藤健吾，吉峰史博，井口理，佐々木政幸，高尾英龍，大谷俊郎

整形外科 59   1605 - 1609 2008年

大腿骨転子下骨折手術後に膝関節拘縮を生じた1例

吉峰史博，井口理，佐々木政幸，原藤健吾，高尾英龍

東日本整形災害外科学会雑誌 20   249 - 252 2008年

下腿骨の不顕性骨折、脆弱性骨折16例の検討

吉峰史博，井口理，佐々木政幸，原藤健吾，高尾英龍

東日本整形災害外科学会雑誌 20   188 - 192 2008年

経験と考察 下腿骨遠位端の不顕性骨折および脆弱性骨折の検討

武田勇樹，吉田宏樹，原藤健吾，岡村保成，許斐恒彦

整形外科 59   469 - 473 2008年

人工股関節の通常平坦ライナーに対し2種類の後方脱臼予防用変則型ライナー使用時の可動域変化の特徴

吉峰史博，井口理，佐々木政幸，原藤健吾，塩野将平

整形外科 58   1390 - 1394 2007年

厳しい可動域条件を満たす人工股関節のカップ前捻角とネック前捻角のセーフゾーンと最適なカップ、ネック設置位置の組み合せを求める数式

吉峰史博，井口理，佐々木政幸，原藤健吾，塩野将平

整形外科 58   466 - 473 2007年

人工股関節のカップネックインピンジメント点のカップ内位置 oscillation angle、ネックステム角の影響

原藤健吾

整形外科 57   1653 - 1659 2006年