研究・業績 研究・業績

研究・業績

上肢グループ
▲上肢グループ

上肢グループはスタッフと大学院生が協力して臨床・基礎研究をすすめております。対象となる疾患としては、肩から手指までの上肢全体の疾患や外傷が挙げられます。
肩・肘・手関節のスポーツ障害については、エコーを活用した診断の元に、関節鏡による低侵襲治療と早期復帰に努めており、特に肩腱板断裂については一次修復不能な肩腱板広範囲断裂に対する、大腿筋膜グラフト併用の鏡視下腱板修復に積極的に取り組んでおります。さらに、関節の破壊が高度な症例にはリバース型人工関節置換術などの各種の人工関節置換を行っております。
また末梢神経障害については、マイクロサージャリ―による神経縫合や神経移植術、残存した障害については腱移行による機能再建を行っております。

【臨床研究】
近年のエコー技術の発展に伴い、当グループでもエコーを活用した診断や神経、腱鞘ブロック等を行い、上肢疾患のみならず整形外科全体の様々な疾患の治療成績の向上に寄与したいと考えております。
末梢神経障害における'痛み'や'痺れ'の研究にも取り組んでおり、患者立脚型評価用紙、電気刺激による痛み定量装置（Pain Vision）などによる痛み評価と電気生理学的検査結果の関連性等についても解析を進めております。
【基礎研究】
肩腱板の再生医療をメインテーマとして研究を行っております。腱板断裂部組織より幹細胞の分離・同定に成功し、腱板由来幹細胞培養により作成された細胞シートの研究や、筋膜グラフトによる腱板修復術の治癒過程の研究を行い、断裂した腱板の早期再生を目標として日々研究を行っております。
さらに、腱組織の加齢変性やアンチエイジングに関する研究として、老化関連物質の一つであるAGEs(Advanced Glycation End Products) に注目し、糖化ストレスと腱の脆弱化との関連性の検討や、腱板の老化や脂肪変性に関する分子生物学的研究も進めており、将来的には加齢による腱板の変性断裂を予防できる新たな方法の開発につながることを期待しております。
英文原著論文（2019年以降）
(1) Kato T, Shinohara I, Mifune Y, Inui A, Nishimoto H, Yoshikawa T, Furukawa T, Tanaka S, Kusunose M, Hoshino Y, Matsushita T, Kuroda R. Intra-articular site-specific distribution of advanced glycation end products in the shoulder of patients with diabetes mellitus having rotator cuff tears. Mol Biol Rep. 2023 ;50(12):10339-10349.

(2) Shinohara I, Mifune Y, Inui A, Nishimoto H, Yoshikawa T, Kato T, Furukawa T, Tanaka S, Kusunose M, Hoshino Y, Matsushita T, Mitani M, Kuroda R. Re-tear after arthroscopic rotator cuff tear surgery: risk analysis using machine learning. J Shoulder Elbow Surg. 2023 :S1058-2746(23)00600-6.

(3) Kokubu T, Mifune Y, Inui A. Clinical outcomes of medialized single-row repair with fascia lata graft augmentation for large and massive rotator cuff tears. J Shoulder Elbow Surg. 2023 :S1058-2746(23)00603-1.

(4) Inui A, Mifune Y, Nishimoto H, Mukohara S, Fukuda S, Kato T, Furukawa T, Tanaka S, Kusunose M, Takigami S, Ehara Y, Kuroda R. Detection of Elbow OCD in the Ultrasound Image by Artificial Intelligence Using YOLOv8. Applied Sciences. 2023; 13(13):7623.

(5) Kusunose M, Inui A, Nishimoto H, Mifune Y, Yoshikawa T, Shinohara I, Furukawa T, Kato T, Tanaka S, Kuroda R. Measurement of Shoulder Abduction Angle with Posture Estimation Artificial Intelligence Model. Sensors. 2023; 23(14):6445.

(6) Kinugasa M, Inui A, Satsuma S, Kobayashi D, Sakata R, Morishita M, Komoto I, Kuroda R. Diagnosis of Developmental Dysplasia of the Hip by Ultrasound Imaging Using Deep Learning. J Pediatr Orthop. 2023 Aug 1;43(7):e538-e544.

(7) Yamaura K, Fujibayashi I, Kurosawa T, Mifune Y, Inui A, Ozaki T, Mitani M. Timing of retears after arthroscopic rotator cuff repair and associated factors: a retrospective analysis. J Shoulder Elbow Surg. 2023;32(9):1929-1936.

(8) Furukawa T, Kurosawa T, Mifune Y, Inui A, Nishimoto H, Ueda Y, Kataoka T, Yamaura K, Mukohara S, Yoshikawa T, Shinohara I, Kato T, Tanaka S, Kusunose M, Hoshino Y, Matsushita T, Kuroda R. Elicitation of Inhibitory Effects for AGE-Induced Oxidative Stress in Rotator Cuff-Derived Cells by Apocynin. Curr Issues Mol　Biol.2023 ;45(4):3434-3445.

(9) Kato T, Inui A, Mifune Y, Nishimoto H, Yoshikawa T, Shinohara I, Furukawa T, Tanaka S, Kusunose M, Kuroda R. Dynamic Analysis of the Coracohumeral Ligament Using Ultra-Sonography in Shoulder Contracture. Sensors (Basel). 2023;23(8):4015.

(10) Yamaura K, Mifune Y, Inui A, Nishimoto H, Mukohara S, Yoshikawa T, Shinohara I, Kato T, Furukawa T, Hoshino Y, Matsushita T, Kuroda R. Novel therapy using a fish scale collagen scaffold for rotator cuff healing in rat models. J Shoulder Elbow Surg. 2022;31(12):2629-2637.

(11) Tanaka S, Inui A, Mifune Y, Nishimoto H, Yoshikawa T, Shinohara I, Furukawa T, Kato T, Kusunose M, Kuroda R. Motion Analysis of the Extensor Carpi Ulnaris in Triangular Fibrocartilage Complex Injury Using Ultrasonography Images. Sensors (Basel). 2022 ;22(21):8216.

(12) Shinohara I, Inui A, Mifune Y, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Hoshino Y, Matsushita T, Kuroda R. Using deep learning for ultrasound images to diagnose carpal tunnel syndrome with high accuracy. Ultrasound Med Biol. 2022;48(10):2052-2059.

(13) Yamaura K, Inui A, Mifune Y, Mukohara S, Furukawa T, Kuroda R. Efficacy of Abductor Pollicis Longus Suspension Arthroplasty Combined With Mini TightRope for Osteoarthritis of Thumb Carpometacarpal Joint. Hand (N Y). 2022 Sep 16:15589447221120849. doi: 10.1177/15589447221120849.

(14) Harada R, Taniguchi-Ikeda M, Nagasaka M, Nishii T, Inui A, Yamamoto T, Morioka I, Kuroda R, Iijima K, Nozu K, Sakai Y, Toda T. Assessment of the upper limb muscles in patients with Fukuyama muscular dystrophy: Noninvasive assessment using visual ultrasound muscle analysis and shear wave elastography. Neuromuscul Disord. 2022 ;32(9):754-762.

(15) Shinohara I, Inui A, Mifune Y, Nishimoto H, Mukohara S, Yoshikawa T, Kuroda R. Ultrasound With Artificial Intelligence Models Predicted Palmer 1B Triangular Fibrocartilage Complex Injuries. Arthroscopy. 2022;38(8):2417-2424.

(16) Yoshikawa T, Mifune Y, Inui A, Nishimoto H, Yamaura K, Mukohara S, Shinohara I, Kuroda R. Quercetin treatment protects the Achilles tendons of rats from oxidative stress induced by hyperglycemia. BMC Musculoskelet Disord. 2022;23(1):563.

(17) Shinohara I, Mifune Y, Inui A, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Hoshino Y, Matsushita T, Kuroda R. Biochemical Markers of Aging (Advanced Glycation End Products) and Degeneration Are Increased in Type 3 Rotator Cuff Tendon Stumps With Increased Signal Intensity Changes on MRI. Am J Sports Med. 2022 (7):1960-1970.

(18) Yoshikawa T, Mifune Y, Inui A, Nishimoto H, Yamaura K, Mukohara S, Shinohara I, Kuroda R. Influence of Diabetes-Induced Glycation and Oxidative Stress on the Human Rotator Cuff. Antioxidants (Basel). 2022;11(4):743.

(19) Shinohara I, Mifune Y, Inui A, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Hoshino Y, Matsushita T, Kuroda R. Advanced glycation end products are associated with limited range of motion of the shoulder joint in patients with rotator cuff tears associated with diabetes mellitus. BMC Musculoskelet Disord. 2022;23(1):271.

(20) Yamaura K, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Mukohara S, Hoshino Y, Niikura T, Kuroda R. Antioxidant effect of nicotinamide mononucleotide in tendinopathy. BMC Musculoskelet Disord. 2022;23(1):249.

(21) Shinohara I, Inui A, Mifune Y, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Hoshino Y, Matsushita T, Kuroda R. Diagnosis of Cubital Tunnel Syndrome Using Deep Learning on Ultrasonographic Images. Diagnostics (Basel). 2022;12(3):632.

(22) Nagura I, Kanatani T, Harada Y, Takase F, Inui A, Mifune Y, Kuroda R. Preoperative Evaluation of Thenar Muscles in Carpal Tunnel Syndrome by Ultrasonography. Hand Clin. 2022 ;38(1):55-58.

(23) Yamaura K, Mifune Y, Inui A, Nishimoto H, Kataoka T, Kurosawa T, Mukohara S, Hoshino Y, Niikura T, Nagamune K, Kuroda R. Accuracy and reliability of tridimensional electromagnetic sensor system for elbow ROM measurement. J Orthop Surg Res. 2022;17(1):60.

(24) Shinohara I, Kataoka T, Mifune Y, Inui A, Sakata R, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Matsushita T, Kuroda R. Influence of adiponectin and inflammatory cytokines in fatty degenerative atrophic muscle. Sci Rep. 2022;12(1):1557.

(25) Shinohara I, Inui A, Mifune Y, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Hoshino Y, Matsushita T, Kuroda R. Motion Analysis of Triangular Fibrocartilage Complex by Using Ultrasonography Images: Preliminary Analysis. Sensors (Basel). 2022;22(1):345.

(26) Kataoka T, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Yamaura K, Mukohara S, Matsushita T, Niikura T, Tabata Y, Kuroda R. Combined therapy of platelet-rich plasma and basic fibroblast growth factor using gelatin-hydrogel sheet for rotator cuff healing in rat models. J Orthop Surg Res. 2021 Oct 16;16(1):605.

(27) Yamaura K, Mifune Y, Inui A, Nishimoto H, Kataoka T, Kurosawa T, Mukohara S, Niikura T, Kokubu T, Kuroda R. Sequential Changes in Posterior Shoulder Muscle Elasticity After Throwing as Assessed via Ultrasound Shear Wave Elastography. Orthop J Sports Med. 2021 Aug 11;9(8):23259671211021362.

(28) Mukohara S, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Yamaura K, Yoshikawa T, Shinohara I, Hoshino Y, Nagamune K, Kuroda R. A new quantitative evaluation system for distal radioulnar joint instability using a three-dimensional electromagnetic sensor. J Orthop Surg Res. 2021 Jul 14;16(1):452.

(29) Mukohara S, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Yamaura K, Yoshikawa T, Waki T, Kuroda T, Niikura T, Kuroda R. Effects of trochlear fragmentation on functional outcome in coronal shear fractures: a retrospective comparative study. JSES Int. 2021 Feb 20;5(3):571-577.

(30) Mukohara S, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Yamaura K, Yoshikawa T, Kuroda R. In vitro and in vivo tenocyte-protective effectiveness of dehydroepiandrosterone against high glucose-induced oxidative stress. BMC Musculoskelet Disord. 2021 Jun 5;22(1):519.

(31) Yamaura K, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Mukohara S, Yoshikawa T, Hoshino Y, Niikura T, Kokubu T, Kuroda R. Relationship between glenohumeral internal rotation deficit and shoulder conditions in professional baseball pitchers. J Shoulder Elbow Surg. 2021 Sep;30(9):2073-2081.

(32) Inui A, Mifune Y, Nishimoto H, Niikura T, Kuroda R. Reconstruction of Carpal Bone Loss of Septic Wrist Arthritis Using Induced Membrane Technique. J Hand Microsurg. 2020 12:S54-S57.

(33) Kokubu T, Mifune Y, Kanzaki N, Hoshino Y, Kakutani K, Inui A, Hashimoto S, Kuroda R. Muscle Strains in the Lower Extremity of Japanese Professional Baseball Players. Orthop J Sports Med. 2020;8(10):2325967120956569.

(34) Harada Y, Inui A, Mifune Y, Nishimoto H, Kokubu T, Hiroyuki F, Kuroda R. Treatment of Locking of the Metacarpophalangeal Joint of the Thumb. J Hand Microsurg. 2020;12(1):62-66.

(35) Ueda Y, Inui A, Mifune Y, Takase F, Kataoka T, Kurosawa T, Yamaura K, Kokubu T, Kuroda R. Molecular changes to tendons after collagenase-induced acute tendon injury in a senescence-accelerated mouse model.　BMC Musculoskelet Disord. 2019;20(1):120

(36) Mifune Y, Inui A, Muto T, Nishimoto H, Kataoka T, Kurosawa T, Yamaura K, Mukohara S, Niikura T, Kokubu T, Kuroda R. Influence of advanced glycation end products on rotator cuff. J Shoulder Elbow Surg. 2019;28(8):1490-1496

(37) Mifune Y, Inui A, Nishimoto H, Kataoka T, Kurosawa T, Yamaura K, Mukohara S, Niikura T, Kokubu T, Akisue T, Kuroda R. Assessment of posterior shoulder muscle stiffness related to posterior shoulder tightness in college baseball players using shear wave elastography. J Shoulder Elbow Surg. 2019; doi: 10.1016/j.jse.2019.05.028
英文症例報告（2019年以降）
(1) Higashi T, Mifune Y, Nishimoto H, Inui A, Hoshino Y, Matsushita T, Niikura T, Kuroda R. Co-occurring Acromioclavicular Joint Cyst and Hemarthrosis of the Shoulder Associated With Rotator Cuff Tear Arthropathy. Cureus. 2022;14(3):e23353.

(2) Kataoka T, Kokubu T, Mifune Y, Inui A, Yamazaki T, Kuroda R. Isolated Musculocutaneous Nerve Injury in a Professional Baseball Player: A Case Report. J Orthop Case Rep. 2021 Mar;11(3):113-116.

(3) Harada Y, Inui A, Kokubu T, Mifune Y, Nishimoto H, Kuroda R. Osteochondritis Dissecans of the Humeral Trochlea Treated with Mosaic-type Osteochondral Autologous Transplantation. J Orthop Case Rep. 2020 Dec;10(9):106-108.

(4) Shinohara I, Takahara S, Uefuji A, Inui A, Mifune Y, Ichimura K, Nishihara H, Kishimoto K, Aoki K, Takayama H, Nakagawa N, Harada T. Floating forearm associated with terrible triad injury and Essex-Lopresti injury: a case report and literature review. JSES Int. 2020 Nov 30;5(2):320-327.

(5) Yamaura K, Inui A, Mifune Y, Nishimoto H, Kataoka T, Kurosawa T, Mukohara S, Yoshikawa T, Niikura T, Kokubu T, Kuroda R. Anterior transolecranon fracture dislocation with an associated avulsion fracture of coronoid process of ulna in a child: a case report. JSES Int. 2020 Nov 28;5(1):9-12.

(6) Harada Y, Inui A, Mifune Y, Nishimoto H, Kokubu T, Hiroyuki F, Kuroda R. Treatment of Locking of the Metacarpophalangeal Joint of the Thumb. J Hand Microsurg. 2020 Apr;12(1):62-66.

(7) Mukohara S, Inui A, Mifune Y, Nishimoto H, Kataoka T, Kurosawa T, Yamaura K, Kuroda R. Isolated Nerve Grafting for a Young Patient with a Complete Common Peroneal Nerve Palsy Following a Traumatic Knee Dislocation: A case report. Kobe J Med Sci;65(3):E110-E113.

(8) Kataoka T, Kokubu T, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Yamaura K, Mukohara S, Kuroda R. Bilateral Collateral Ligament Reconstruction for Chronic Elbow Dislocation. Kobe J Med Sci. 2020;66(2):E71-E74.

(9) Inui A, Mifune Y, Nishimoto H, Niikura T, Kuroda R. A case of a painful coalition between pisiform and hamate. Case Reports Plast Surg Hand Surg. 2019;6(1):35-37.

(10) Tanaka T, Inui A, Mifune Y. Treatment of Nonunion of the Ulnar Styloid by Low-Intensity Pulsed Ultrasound in a Baseball Player. J Hand Microsurg. 2019;11(Suppl 1):S59-S60