• 下肢スポーツ・関節機能温存／研究

• 業績

▲下肢スポーツ・関節機能温存グループ

【臨床研究】

膝前十字靭帯を損傷すると、その自然治癒能が乏しいことにより前十字靭帯再建術を行うことがGold standardとなっています。我々は従来より、前十字靭帯再建術において、膝蓋腱（Bone-tendon-bone graft）およびハムストリング腱（Hamstrings tendon graft）を用いた前十字靱帯再建術の臨床成績を比較検討し、国内外で報告してきました。術式は変遷し、現在では解剖学的二重束再建術が主流となり、本術式の良好な臨床成績も報告してきています。またその有用性についても我々は様々な観点から評価を行っており、三次元電磁気センサーを用いて、屈曲/伸展など膝関節6自由度を非侵襲性に定量評価できるシステムを構築し、徒手検査であるLachman test、Pivot shift testの定量化を行い、国内外で高い評価を受けています。さらにこれらの結果と臨床成績との関連を検討し、さらなる術式の向上を目指しています。これらの実績から神戸大学整形外科には多くのアスリートが訪れ手術治療を受けています。
手術治療が必要な限局性軟骨損傷および離断性骨軟骨炎に対しては、従来より症例に応じて関節鏡下骨髄刺激法（ドリリング、マイクロフラクチャー）、骨軟骨移植術（モザイクプラスティー）を行っており、その良好な臨床成績を報告してきています。さらに大きな軟骨欠損に対してはこれらの標準治療では治癒をみることが困難であり、2012年9月より先端医療センター病院（現:神戸市立医療センター中央市民病院 南館）（http://chuo.kcho.jp/outline_index）との共同で第三世代自家培養軟骨移植術を行い、良好な成果を確認しております。現在まだ治験段階ですが、ヨーロッパでは2000例以上の実績があり、国内では初の治療となり、今後標準治療への定着を目指しています。現在では自家培養軟骨ジャック®(J-TEC)が2013年4月1日付で保険適用となっており、当院でも大きな軟骨欠損に対して治療を行っております。
半月板損傷に対しては、切除した場合高率に変形性膝関節症へと進行するため、関節鏡下縫合術を積極的に施行しています。また現在適応に応じてFibrin clotを使用した半月板縫合術を行っており、さらなる成績向上を目指しています。今後は動物実験の結果からよりよい半月板再生を目指して、臨床試験として多血小板血漿（PRP）を併用した手術治療あるいは関節内注射を検討し、さらなる成績向上を目指しています。
膝蓋骨脱臼に対しては、内側膝蓋大腿靭帯再建術（MPFL再建術）という手術治療を行っています。その術式は神戸大学病院独自で開発した手術手技であり、良好な臨床成績が得られています。また、三次元解析ソフトを神戸大学工学部と連携・開発し、正常膝での動作解析を行い、各症例の独自の解剖を加味して術前計画を行い、さらなる術後成績の向上を目指しています。
また、変形性膝関節症患者様の中でも特に活動性の高い方、比較的若年の方に対して、積極的に骨切り術を選択して治療に取り組んでいます。骨切り術には大腿骨遠位骨切り術、高位脛骨骨切り術(Open wedge, Hybrid)、またこれらを組み合わせたDouble level osteotomyなどを症例に応じて選択しています。当科では術中にコンピューターナビゲーションシステムを導入し、より正確なアライメントが獲得を目指して治療を進めています。

足の外科

【臨床研究】

足の外科の分野におきましては、整形外科の中でも特殊性が高く専門的な治療を受けられる病院は限られていると考えております。我々は大学病院の専門性を生かし、保存療法だけでなく、最新の器材や方法による手術や関節鏡による低侵襲手術なども積極的に行っており、さまざまな種類の競技のスポーツ選手の加療も行っております。日常もっともよくするスポーツ障害の一つである足関節外側靭帯損傷に対しては、近年術式が開発され徐々に広がりつつある、関節鏡視下の靭帯修復術（鏡視下Brostrom法）をいち早く導入し、積極的に行っております。それにより、従来の大きく切開を加えて手術を行っていたころに比べて、より早いスポーツ復帰が可能となってきておりますが、今後さらなる詳細な検討をしていき従来法との差異を明確にしていく予定です。変形性足関節症に対しましては、鏡視下滑膜切除術や低位脛骨骨切り術、足関節固定術（関節鏡視下）、人工足関節置換術などの手術を行っておりますが、それらの手術も患者様の変形の程度や年齢、活動性などを考慮し、ひとりひとりに最も適した方法で行っております。特に、人工足関節置換術は日本でも行われている施設は限定されており、今後のさらなる発展のため様々な臨床研究を行っております。

【基礎研究】

(1) Biomechanics

当科では2004年より三次元電磁気センサーを用いて非侵襲的にLachman test、Pivot shift testを定量的に計測できるシステムを開発し、臨床応用してきました。これまでにFresh cadaverを用いた実験や臨床データの解析に使用して、解剖学的二重束再建術の有用性につき検討してきました。また、福井大学大学院工学研究科知能システム工学科(https://eng.eng.u-fukui.ac.jp/his/)と共同研究を行っており、膝前十字再建靭帯にかかる圧力を計測できるシステムや指先に装着して徒手検査時の圧力を計測するシステム、測定にセンサーを埋め込み測定圧を計測するシステムを開発してきました。また、膝前十字靭帯再建術において術後の骨孔を半自動的に抽出できるシステムを構築し、骨孔の経時的な変化についても研究しています。これらの研究成果を日本整形外科学会、日本関節鏡・膝・スポーツ整形外科学会（JOSKAS）、日本臨床バイオメカニクス学会、日本臨床スポーツ医学会、アメリカ整形外科学会(AAOS)、アメリカ整形外科基礎学会（ORS）、アメリカスポーツ整形外科学会（AOSSM）、ヨーロッパ関節鏡・膝・スポーツ整形外科学会（ESSKA）、国際関節鏡・膝・スポーツ整形外科学会(ISAKOS)、等で報告し、よりよい膝前十字靭帯再建術の開発を目指しています。

(2) Biology

当科では、京都大学再生医科学研究所（http://www2.infront.kyoto-u.ac.jp/te02/index-j.php3）と共同研究を行っており、種々の増殖因子（b-FGF, BMP, G-CSF、Statin, 多血小板血漿など）を用いた半月板、靭帯、骨の再生の研究も行っており、さらに血管内皮前駆細胞（末梢血にある幹細胞といわれている）を用いた骨、前十字靭帯の再建靭帯のリモデリング促進に関する研究を、先端医療センター（現:神戸市立医療センター中央市民病院 南館）（http://chuo.kcho.jp/）とともに進めています。また、軟骨再生・代謝研究においては、ヒストン脱アセチル化酵素であるSIRT1（silent information regulator two ortholog 1）に着目し、寿命延長に必須因子であることから変形性膝関節症との関連を解析しています。2015年より、大阪医科大学からヒト脂肪由来幹細胞（Adipose-derived stem cells; ADSC）の提供を受け、骨折治癒・変形性関節症治療への応用を研究しています。

これらの研究成果をアメリカ整形外科基礎学会（ORS）、国際関節症学会（OARSI）、国際軟骨治療学会（ICRS）、国際組織再生工学・再生医療会議（TERMIS）等にて報告しています。

• 下肢スポーツ・関節機能温存／業績

• 研究

英文原著論文（2017年以降）

(1) Kamada K, Nagai K, Nagamune K, Hoshino Y, Nakanishi Y, Araki D, Kanzaki N, Matsushita T, Kuroda R. Direct suturing quadriceps tendon to a continuous loop with a suspensory button provides biomechanically superior fixation in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2021 Nov 22. doi: 10.1007/s00167-021-06805-3. Epub ahead of print.

(2) Yamamoto T, Nagai K, Kanzaki N, Kataoka K, Nukuto K, Hoshino Y, Matsushita T, Kuroda R. Comparison of Clinical Outcomes Between Ceramic-Based Total Ankle Arthroplasty with Ceramic Total Talar Prosthesis and Ceramic-Based Total Ankle Arthroplasty. Foot Ankle Int. 2021 Nov 18:10711007211051353. doi: 10.1177/10711007211051353. Epub ahead of print.

(3) Matsushita T, Akiyama T, Osano K, Yokoyama Y, Okazaki K. Biomechanical analysis of the role of hinge support fixators on hinge stability in medial closing wedge distal femoral osteotomy. Clin Biomech. 2021 Nov 15;91:105528. doi: 10.1016/j.clinbiomech.2021.105528. Epub ahead of print.

(4) Nagai K, Kamada K, Kay J, Hoshino Y, Matsushita T, Kuroda R, de Sa D. Clinical Outcomes After Anterior Cruciate Ligament Reconstruction in Patients With a Concomitant Segond Fracture: A Systematic Review. Am J Sports Med. 2021 Oct 20;3635465211045689. doi: 10.1177/03635465211045689. Epub ahead of print.

(5) Nishida K, Xu C, Gale T, Anderst W, Fu F. Symmetry and sex differences in knee kinematics and ACL elongation in healthy collegiate athletes during high-impact activities revealed through dynamic biplane radiography. J Orthop Res. 2021 Aug 13. doi: 10.1002/jor.25162. Epub ahead of print.

(6) Kataoka K, Hoshino Y, Nagamune K, Nukuto K, Yamamoto T, Yamashita T, Kanzaki N, Kakutani K, Matsushita T, Kuroda R. The quantitative evaluation of anterior drawer test using an electromagnetic measurement system. Sports Biomech. 2021 May 20:1-12. doi: 10.1080/14763141.2021.1918754. Epub ahead of print.

(7) Nishida K, Gale T, Chiba D, Suntaxi F, Lesniak B, Fu F, Anderst W, Musahl V. The effect of lateral extra-articular tenodesis on in vivo cartilage contact in combined anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2021 Feb 12. doi: 10.1007/s00167-021-06480-4. Epub ahead of print.

(8) Yamamoto T, Miyaji N, Kataoka K, Nishida K, Nagai K, Kanzaki N, Hoshino Y, Kuroda R, Matsushita T. Knee Osteoarthritis Progression Is Delayed in Silent Information Regulator 2 Ortholog 1 Knock-in Mice. Int J Mol Sci. 2021;22(19):10685.

(9) Kamada K, Matsushita T, Yamashita T, Matsumoto T, Iwaguro H, Sobajima S, Kuroda R. Attenuation of Knee Osteoarthritis Progression in Mice through Polarization of M2 Macrophages by Intra-Articular Transplantation of Non-Cultured Human Adipose-Derived Regenerative Cells. J Clin Med. 2021;10(19):4309.

(10) Kataoka K, Watanabe S, Nagai K, Kay J, Matsushita T, Kuroda R, de Sa D. Patellofemoral Osteoarthritis Progresses After Medial Open-Wedge High Tibial Osteotomy: A Systematic Review. Arthroscopy. 2021;37(10):3177-3186.

(11) Ueda Y, Matsushita T, Shibata Y, Takiguchi K, Ono K, Kida A, Ono R, Nagai K, Araki D, Hoshino Y, Matsumoto T, Niikura T, Sakai Y, Kuroda R. Satisfaction with playing pre-injury sports 1 year after anterior cruciate ligament reconstruction using a hamstring autograft. Knee. 2021;33:282-289.

(12) Yamamoto T, Nagai K, Araki D, Miyaji N, Nakanishi Y, Hoshino Y, Kanzaki N, Matsumoto T, Niikura T, Kuroda R, Matsushita T. Influence of selected plane on the evaluation of tibial tunnel locations using a three-dimensional bone model in double-bundle anterior cruciate ligament reconstruction. Knee. 2021;29:298-304.

(13) Yamamoto T, Nagai K, Kanzaki N, Nukuto K, Yamashita T, Ibaraki K, Araki D, Hoshino Y, Matsushita T, Kuroda R. Anterior placement of the talar component in total ankle arthroplasty: A risk factor for talar component subsidence. Foot Ankle Surg. 2021;27(3):311-315.

(14) Matsushita T, Watanabe S, Araki D, Nagai K, Hoshino Y, Kanzaki N, Matsumoto T, Niikura T, Kuroda R. Differences in preoperative planning for high-tibial osteotomy between the standing and supine positions. Knee Surg Relat Res. 2021;33(1):8.

(15) Buerba RA, Zaffagnini S, Kuroda R, Musahl V. ACL reconstruction in the professional or elite athlete: state of the art. J ISAKOS. 2021;6(4):226-236.

(16) Chiba D, Gale T, Nishida K, Suntaxi F, Lesniak BP, Fu FH, Anderst W, Musahl V. Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. Am J Sports Med. 2021;49(7):1803-1812.

(17) Sasaki Y, Fujii M, Araki D, Marshall BD, Linde MA, Smolinski P, Fu FH. Effect of Percentage of Femoral Anterior Cruciate Ligament Insertion Site Reconstructed With Hamstring Tendon on Knee Kinematics and Graft Force. Am J Sports Med. 2021;49(5):1279-1285.

(18) Matsui T, Kumai T, Shinohara Y, Kanzaki N, Noguchi K, Tanaka H, Sugimoto T, Yabiku H, Higashiyama I. A false-pouch closure technique with an intact superior peroneal retinaculum for recurrent dislocation of the peroneal tendon. J Exp Orthop. 2021;8(1):22.

(19) Nukuto K, Hoshino Y, Yamamoto T, Miyaji N, Nagai K, Araki D, Kanzaki N, Matsushita T, Kuroda R. Anatomic double-bundle anterior cruciate ligament reconstruction could not achieve sufficient control of pivot-shift when accompanying tibial tunnel coalition. Knee Surg Sports Traumatol Arthrosc. 2021;29(11):3743-3750.

(20) Yamamoto T, Nagai K, Kanzaki N, Nukuto K, Yamashita T, Ibaraki K, Araki D, Hoshino Y, Matsushita T, Kuroda R. Anterior placement of the talar component in total ankle arthroplasty: A risk factor for talar component subsidence. Foot Ankle Surg. 2021;27(3):311-315.

(21) Miyaji N, Araki D, Hoshino Y, Kanzaki N, Nagai K, Matsumoto T, Niikura T, Kuroda R, Matsushita T. The sagittal cutting plane affects evaluation of the femoral bone tunnel position on three-dimensional computed tomography after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2021;29(2):398-404.

(22) Miyaji N, Nishida K, Tanaka T, Araki D, Kanzaki N, Hoshino Y, Kuroda R, Matsushita T. Inhibition of Knee Osteoarthritis Progression in Mice by Administering SRT2014, an Activator of Silent Information Regulator 2 Ortholog 1. Cartilage. 2020:1947603519900795. doi: 10.1177/1947603519900795. Epub ahead of print.

(23) Byrne KJ, Rothrauff BB, Nagai K, Onishi K, Fu FH. Two-fragment Segond fracture validates historical descriptions of independent soft tissue attachments. Knee Surg Sports Traumatol Arthrosc 2021 Epub ahead of print. doi: 10.1007/s00167-021-06515-w.

(24) Longo UG, Nagai K, Salvatore G, Cella E, Candela V, Cappelli F, Ciccozzi M, Denaro V. Epidemiology of anterior cruciate ligament reconstruction surgery in Italy: a 15-year nationwide registry study. J Clin Med 2021;10(2):223.

(25) Nakanishi Y, Hoshino Y, Nagamune K, Yamamoto T, Nagai K, Araki D, Kanzaki N, Matsushita T, Kuroda R. Radial Meniscal Tears Are Best Repaired by a Modified "Cross" Tie-Grip Suture Based on a Biomechanical Comparison of 4 Repair Techniques in a Porcine Model. Orthop J Sports Med. 2020;8(7):2325967120935810.

(26) Yamamoto T, Hoshino Y, Kanzaki N, Nukuto K, Yamashita T, Ibaraki K, Nagamune K, Nagai K, Araki D, Matsushita T, Kuroda R. Plantar pressure sensors indicate women to have a significantly higher peak pressure on the hallux, toes, forefoot, and medial of the foot compared to men. J Foot Ankle Res. 2020;13(1):40.

(27) Hoshino Y, Hiroshima Y, Miyaji N, Nagai K, Araki D, Kanzaki N, Kakutani K, Matsushita T, Kuroda R. Unrepaired lateral meniscus tears lead to remaining pivot-shift in ACL-reconstructed knees. Knee Surg Sports Traumatol Arthrosc. 2020;28(11):3504-3510.

(28) Hiroshima Y, Hoshino Y, Miyaji N, Tanaka T, Araki D, Kanzaki N, Matsushita T, Kuroda R. No difference in postoperative rotational laxity after ACL reconstruction in patients with and without anterolateral capsule injury: quantitative evaluation of the pivot-shift test at 1-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2020;28(2):489-494.

(29) Nakanishi Y, Matsushita T, Nagai K, Araki D, Kanzaki N, Hoshino Y, Matsumoto T, Niikura T, Kuroda R. Greater knee joint laxity remains in teenagers after anatomical double-bundle anterior cruciate ligament reconstruction compared to young adults. Knee Surg Sports Traumatol Arthrosc. 2020;28(8):2663-2667.

(30) Kanzaki N, Chinzei N, Yamashita T, Kumai T, Kuroda R. A Novel Technique of Arthroscopic Ankle Lateral Ligament Repair Using a Knotless Suture Anchor. Orthop J Sports Med. 2020;8(11):2325967120962079.

(31) Nishida K, Matsushita T, Hoshino Y, Araki D, Matsumoto T, Niikura T, Kuroda R. The Influences of Chronicity and Meniscal Injuries on Pivot Shift in Anterior Cruciate Ligament-Deficient Knees: Quantitative Evaluation Using an Electromagnetic Measurement System. Arthroscopy. 2020;36(5):1398-1406.

(32) Lian J, Diermeier T, Meghpara M, Popchak A, Smith CN, Kuroda R, Zaffagnini S, Samuelsson K, Karlsson J, Irrgang JJ, Musahl V; PIVOT Study Group. Rotatory Knee Laxity Exists on a Continuum in Anterior Cruciate Ligament Injury. J Bone Joint Surg Am. 2020;102(3):213-220.

(33) Diermeier T, Meredith SJ, Irrgang JJ, Zaffagnini S, Kuroda R, Hochino Y, Samuelsson K, Smith CN, Popchak A, Musahl V; PIVOT Study Group, Sheean A, Burnham JM, Lian J, Smith C, Popchak A, Herbst E, Pfeiffer T, Araujo P, Oostdyk A, Guenther D, Ohashi B, Irrgang JJ, Fu FH, Nagamune K, Kurosaka M, Kuroda R, Hoshino Y, Grassi A, Muccioli GMM, Lopomo N, Signorelli C, Raggi F, Zaffagnini S, Horvath A, Svantesson E, Senorski EH, Sundemo D, Bjoernsson H, Ahlden M, Desai N, Samuelsson K, Karlsson J. Patient-Reported and Quantitative Outcomes of Anatomic Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autografts. Orthop J Sports Med. 2020;8(7):2325967120926159.

(34) Horvath A, Meredith SJ, Nishida K, Hoshino Y, Musahl V. Objectifying the Pivot Shift Test. Sports Med Arthrosc Rev. 2020;28(2):36-40.

(35) Nagai K, Rothrauff BB, Li RT, Fu FH. Over-the-top ACL reconstruction restores anterior and rotatory knee laxity in skeletally immature individuals and revision settings. Knee Surg Sports Traumatol Arthrosc 2020;28(2):538-43.

(36) Naendrup JH, Pfeiffer TR, Chan C, Nagai K, Novaretti JV, Sheean AJ, Shafizadeh ST, Debski RE, Musahl V. Effect of Meniscal Ramp Lesion Repair on Knee Kinematics, Bony Contact Forces, and In Situ Forces in the Anterior Cruciate Ligament: Response. Am J Sports Med 2020;48(2):NP25-NP7.

(37) Matsushita T, Araki D, Matsumoto T, Niikura T, Kuroda R. Changes in knee extensor strengths before and after medial patellofemoral ligament reconstruction. Phys Sportsmed. 2019;47(2):220-226.

(38) Hoshino Y, Miyaji N, Nishida K, Nishizawa Y, Araki D, Kanzaki N, Kakutani K, Matsushita T, Kuroda R. The concomitant lateral meniscus injury increased the pivot shift in the anterior cruciate ligament-injured knee. Knee Surg Sports Traumatol Arthrosc. 2019;27(2):646-651.

(39) Kanzaki N, Chinzei N, Yamamoto T, Yamashita T, Ibaraki K, Kuroda R. Clinical Outcomes of Total Ankle Arthroplasty With Total Talar Prosthesis. Foot Ankle Int. 2019;40(8):948-954.

(40) Araki D, Matsushita T, Hoshino Y, Nagai K, Nishida K, Koga H, Nakamura T, Katakura M, Muneta T, Kuroda R. The Anterolateral Structure of the Knee Does Not Affect Anterior and Dynamic Rotatory Stability in Anterior Cruciate Ligament Injury: Quantitative Evaluation With the Electromagnetic Measurement System. Am J Sports Med. 2019;47(14):3381-3388.

(41) Nishida K, Matsushita T, Araki D, Sasaki H, Tanaka T, Hoshino Y, Kanzaki N, Matsumoto T, Nagamune K, Niikura T, Kurosaka M, Kuroda R. Analysis of anterior tibial subluxation to the femur at maximum extension in anterior cruciate ligament-deficient knees. J Orthop Surg (Hong Kong). 2019;27(1):2309499019833606.

(42) Tanaka T, Matsushita T, Miyaji N, Ibaraki K, Nishida K, Oka S, Araki D, Kanzaki N, Hoshino Y, Matsumoto T, Kuroda R. Deterioration of patellofemoral cartilage status after medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1347-1354.

(43) Tanaka T, Matsushita T, Nishida K, Takayama K, Nagai K, Araki D, Matsumoto T, Tabata Y, Kuroda R. Attenuation of osteoarthritis progression in mice following intra-articular administration of simvastatin-conjugated gelatin hydrogel. J Tissue Eng Regen Med. 2019;13(3):423-432.

(44) Miyaji N, Hoshino Y, Tanaka T, Nishida K, Araki D, Kanzaki N, Matsushita T, Kuroda R. MRI-determined anterolateral capsule injury did not affect the pivot-shift in anterior cruciate ligament-injured knees. Knee Surg Sports Traumatol Arthrosc. 2019;27(11):3426-3431.

(45) Ueda Y, Matsushita T, Shibata Y, Takiguchi K, Kida A, Araki D, Kanzaki N, Hoshino Y, Ono R, Sakai Y, Kuroda R. Longitudinal Quadriceps Strength Recovery After Anterior Cruciate Ligament Reconstruction With Hamstring Autograft: Patients Stratified by Preoperative Quadriceps Strength Deficit. J Sport Rehabil. 2019;16:1-20.

(46) Shibata Y, Matsushita T, Araki D, Kida A, Takiguchi K, Ueda Y, Ono K, Matsumoto T, Niikura T, Sakai Y, Kuroda R. Prediction of quadriceps strength recovery after anterior cruciate ligament reconstruction with a hamstring autograft: Decision tree analysis. J Orthop Sci. 2019;24(2):301-305.

(47) Katakura M, Koga H, Nakamura T, Araki D, Nagai K, Nishida K, Kuroda R, Muneta T.　Biomechanical Effects of Additional Anterolateral Structure Reconstruction with Different Femoral Attachment Sites on Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2019;47(14):3373-3380.

(48) Naendrup JH, Pfeiffer TR, Chan C, Nagai K, Novaretti JV, Sheean AJ, Shafizadeh ST, Debski RE, Musahl V. Effect of Meniscal Ramp Lesion Repair on Knee Kinematics, Bony Contact Forces, and In Situ Forces in the Anterior Cruciate Ligament. Am J Sports Med 2019;47(13):3195-3202.

(49) Takenaga T, Yoshida M, Albers M, Nagai K, Nakamura T, Fu FH, Onishi K. Preoperative sonographic measurement can accurately predict quadrupled hamstring tendon graft diameter for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2019;27(3):797-804.

(50) Nagai K, Yang S, Fu FH, Anderst W. Unloader knee brace increases medial compartment joint space during gait in knee osteoarthritis patients. Knee Surg Sports Traumatol Arthrosc 2019;27(7):2354-60.

(51) Nagai K, Gale T, Chiba D, Su F, Fu FH, Anderst W. The Complex Relationship Between In Vivo ACL Elongation and Knee Kinematics During Walking and Running. J Orthop Res 2019;37(9):1920-1928.

(52) Tanaka T, Hoshino Y, Miyaji N, Ibaragi K, Nishida K, Nishizawa Y, Araki D, Kanzaki N, Matsushita T, Kuroda R. The diagnostic reliability of the quantitative pivot-shift evaluation using an electromagnetic measurement system for anterior cruciate ligament deficiency was superior to those of the accelerometer and iPad image analysis. Knee Surg Sports Traumatol Arthrosc. 2018;26(9)2835-2840.

(53) Matsushita T, Araki D, Hoshino Y, Oka S, Nishida K, Tanaka T, Miyaji N, Kanzaki N, Ibaraki K, Matsumoto T, Kurosaka M, Kuroda R. Analysis of Graft Length Change Patterns in Medial Patellofemoral Ligament Reconstruction via a Fluoroscopic Guidance Method. Am J Sports Med. 2018;46(5):1150-1157.

(54) Nishida K, Matsushita T, Takayama K, Tanaka T, Miyaji N, Ibaraki K, Araki D, Kanzaki N, Matsumoto T, Kuroda R. Intraperitoneal injection of the SIRT1 activator SRT1720 attenuates the progression of experimental osteoarthritis in mice. Bone Joint Res. 2018;7(3):252-262.

(55) Kirizuki S, Matsumoto T, Ueha T, Uefuji A, Inokuchi T, Takayama K, Hashimoto S, Hayashi S, Matsushita T, Kuroda R. The Influence of Ruptured Scar Pattern on the Healing Potential of Anterior Cruciate Ligament Remnant Cells. Am J Sports Med. 2018;46(6):1382-1388.

(56) Zaffagnini S, Signorelli C, Grassi A, Hoshino Y, Kuroda R, de Sa D, Sundemo D, Samuelsson K, Musahl V, Karlsson J, Sheean A, Burnham JM, Lian J, Smith C, Popchak A, Herbst E, Pfeiffer T, Araujo P, Oostdyk A, Guenther D, Ohashi B, Irrgang JJ, Fu FH, Nagamune K, Kurosaka M, Marcheggiani Muccioli GM, Lopomo N, Raggi F, Svantesson E, Hamrin Senorski E, Bjoernsson H, Ahlden M, Desai N. Anatomic Anterior Cruciate Ligament Reconstruction Using Hamstring Tendons Restores Quantitative Pivot Shift. Orthop J Sports Med. 2018;6(12):2325967118812364.

(57) Musahl V, Burnham J, Lian J, Popchak A, Svantesson E, Kuroda R, Zaffagnini S, Samuelsson K; PIVOT Study Group. High-grade rotatory knee laxity may be predictable in ACL injuries. Knee Surg Sports Traumatol Arthrosc. 2018;26(12):3762-3769.

(58) Sundemo D, Blom A, Hoshino Y, Kuroda R, Lopomo NF, Zaffagnini S, Musahl V, Irrgang JJ, Karlsson J, Samuelsson K; PIVOT Study Group. Correlation between quantitative pivot shift and generalized joint laxity: a prospective multicenter study of ACL ruptures. Knee Surg Sports Traumatol Arthrosc. 2018;26(8):2362-2370.

(59) Nagai K, Gale T, Herbst E, Tashiro Y, Irrgang JJ, Tashman S, Fu FH*, Anderst W. Knee hyperextension does not adversely affect dynamic in vivo kinematics after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2018;26(2):448-454.

(60) Tashiro Y, Lucidi GA, Gale T, Nagai K, Herbst E, Irrgang JJ, Nakashima Y, Anderst W, Fu FH*. Anterior cruciate ligament tibial insertion site is elliptical or triangular shaped in healthy young adults: high-resolution 3-T MRI analysis. Knee Surg Sports Traumatol Arthrosc 2018;26(2):485-490.

(61) Hoshino Y*, Kuroda R, Nishizawa Y, Nakano N, Nagai K, Araki D, Oka S, Kawaguchi S, Nagamune K, Kurosaka M. Stress distribution is deviated around the aperture of the femoral tunnel in the anatomic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2018;26(4):1145-1151.

(62) Albers M, Shaikh H, Herbst E, Onishi K, Nagai K, Musahl V, Fu FH*. The iliotibial band and anterolateral capsule have a combined attachment to the Segond fracture. Knee Surg Sports Traumatol Arthrosc 2018;26(5):1305-1310.

(63) Pfeiffer TR, Kanakamedala AC, Herbst E, Nagai K, Murphy C, Burnham JM, Popchak A, Debski RE, Musahl V*. Female sex is associated with greater rotatory knee laxity in collegiate athletes. Knee Surg Sports Traumatol Arthrosc 2018;26(5):1319-1325.

(64) Ferrer GA, Guenther D, Pauyo T, Herbst E, Nagai K, Debski RE, Musahl V*. Structural properties of the anterolateral complex and their clinical implications. Clin Sports Med 2018;37:41-47.

(65) Nagai K, Herbst E, Gale T, Tashiro Y, Irrgang JJ, Anderst W, Fu FH. Patient-reported outcome measures following anterior cruciate ligament reconstruction are not related to dynamic knee extension angle. Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 2018;3(1):33-37.

(66) Nagai K, Gale T, Irrgang JJ, Tashman S, Fu FH, Anderst W. Anterior cruciate ligament reconstruction affects tibiofemoral joint congruency during dynamic functional movement. Am J Sports Med 2018;46(7):1566-1574.

(67) Nagai K, Muratsu H Kanda Y, Tsubosaka M, Kamenaga T, Miya H, Matsushita T, Niikura T, Kuroda R, Matsumoto T. Intraoperative soft tissue balance using novel medial preserving gap technique in posterior-stabilized total knee arthroplasty: comparison to measured resection technique. Knee Surg Sports Traumatol Arthrosc 2018 ;26(11):3474-3481.

(68) Nagai K, Tashiro Y, Herbst E, Gale T, Wang JH, Irrgang JJ, Anderst W, Fu FH. Steeper posterior tibial slope correlates with greater tibial tunnel widening following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2018;26(12):3717-3723.

(69) Patel NK, Murphy CI, Nagai K, Canton S, Herbst E, Naendrup J-H, Debski RE, Musahl V. Passive teaching is not as effective as active teaching for learning the standard technique of pivot shift test. Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 2018;3(4):193-197.

(70) Offerhaus C, Albers M, Nagai K, Arner JW, Hoher J, Musahl V, Fu FH. Individualized Anterior Cruciate Ligament Graft Matching: In Vivo Comparison of Cross-sectional Areas of Hamstring, Patellar, and Quadriceps Tendon Grafts and ACL Insertion Area. Am J Sports Med 2018;46(11):2646-2652.

(71) Nagai K, Nakamura T, Fu FH. The diagnosis of early osteoarthritis of the knee using magnetic resonance imaging. Annals of Joint 2018;3(2):110.

(72) Matsushita T, Nagai K, Araki D, Tanaka T, Matsumoto T, Nishida K, Kurosaka M, Kuroda R. Factors associated with the status of meniscal tears following meniscal repair concomitant with anterior cruciate ligament reconstruction. Connect Tissue Res. 2017;58(3-4):386-392.

(73) Inokuchi T, Matsumoto T, Takayama K, Nakano N, Zhang S, Araki D, Matsushita T, Kuroda R. Influence of the Injury-to-Surgery Interval on the Healing Potential of Human Anterior Cruciate Ligament-Derived Cells. Am J Sports Med. 2017;45(6):1359-1369.

(74) Matsushita T, Oka S, Araki D, Nishida K, Tanaka T, Kanzaki N, Nishida K, Kuroda R. Patient-based outcomes after medial patellofemoral ligament reconstruction. Int Orthop. 2017;41(6):1147-1153.

(75) Matsushita T, Kuroda R, Nishizawa Y, Araki D, Hoshino Y, Nagai K, Matsumoto T, Kurosaka M. Clinical outcomes and biomechanical analysis of posterolateral bundle augmentation in patients with partial anterior cruciate ligament tears. Knee Surg Sports Traumatol Arthrosc. 2017;25(4):1279-1289.

(76) Ueda Y, Matsushita T, Araki D, Kida A, Takiguchi K, Shibata Y, Ono K, Ono R, Matsumoto T, Takayama K, Sakai Y, Kurosaka M, Kuroda R. Factors affecting quadriceps strength recovery after anterior cruciate ligament reconstruction with hamstring autografts in athletes. Knee Surg Sports Traumatol Arthrosc. 2017;25(10):3213-3219.

(77) Kuroda R, Nagai K, Matsushita T, Araki D, Matsumoto T, Takayama K, Kurosaka M. A new quantitative radiographic measurement of patella for patellar instability using the lateral plain radiograph: 'patellar width ratio'. Knee Surg Sports Traumatol Arthrosc. 2017;25(1):123-128.

(78) Tsubosaka M, Matsushita T, Kuroda R, Matsumoto T, Kurosaka M. Pseudoaneurysm of the articular branch of the descending genicular artery following double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2017;25(9):2721-2724.

(79) Nishizawa Y, Hoshino Y, Nagamune K, Araki D, Nagai K, Kurosaka M, Kuroda R. Comparison between intra- and extra-articular tension of the graft during fixation in anterior cruciate ligament reconstruction. Arthroscopy 2017;33(6):1204-1210.

(80) Tashiro Y, Gale T, Sundaram V, Nagai K, Irrgang JJ, Anderst W, Nakashima Y, Tashman S, Fu FH. The graft bending angle can affect early graft healing after anterior cruciate ligament reconstruction: in vivo analysis with 2 years' follow-up. Am J Sports Med 2017;45(8):1829-1836.

英文症例報告（2017年以降）

(1) Chinzei N, Kanzaki N, Matsushita T, Matsumoto T, Hayashi S, Hoshino Y, Hashimoto S, Takayama K, Araki D, Kuroda R. Total ankle arthroplasty with total talar prosthesis for talar osteonecrosis with ankle osteoarthritis: A case report. J Orthop Sci. 2021;26(4):725-730.

(2) Chinzei N, Kanzaki N, Nagai K, Haneda M, Yamamoto T, Kuroda R. Posterior Ankle Arthroscopy for Flexor Hallucis Longus Entrapment: A Case Report. J Orthop Case Rep. 2021;11(4):70-74.

(3) Matsushita T, Watanabe S, Araki D, Matsumoto T, Takayama K, Kurosaka M, Kuroda R. High tibial osteotomy combined with cancellous bone graft and osteochondral autograft transplantation in a patient with massive osteochondral defects in the medial femoral condyle: A case report and literature review. J Orthop Surg. 2017;25(1):1-6.

(4) Kamada K, Matsumoto T, Takayama K, Araki D, Hashimoto S, Hayashi S, Matsushita T, Kuroda R. Mobile Bearing Total Knee Arthroplasty for Valgus Knee Osteoarthritis with Permanent Patellar Dislocation: A Case Report and Review of the Literature. Case Rep Orthop. 2017;2017:1230412.

英文著書（2017年以降）

(1) Nagai K, Nakanishi Y, Kamada K, Hoshino Y, Kuroda R Anatomy and Biomechanics of the Collateral Ligaments of the Knee. In: Koh J, Zaffagnini S, Kuroda R, Longo UG, Amirouche F. eds. Orthopaedic Biomechanics in Sports Medicine. Springer, Cham; 2021:311-320.

(2) Hoshino Y, Barnechea A. How to Assess Patient’s Outcome?. In: Musahl V, Karlsson J, Hirschmann MT, et al., eds. Basic Methods Handbook for Clinical Orthopaedic Research: Springer, Berlin, Heidelberg; 2019:83-88.

(3) Patel NK, Yeung M, Nagai K, Musahl V. How to Review a Clinical Research Paper? In: Musahl V, Karlsson J, Hirschmann MT, et al., eds. Basic Methods Handbook for Clinical Orthopaedic Research: Springer, Berlin, Heidelberg; 2019:255-262.