Biomedical subjects

Masataka Deie

Publications and source records attributed to Masataka Deie.

At least 19 recordsLinked to original sources

PubMed2006

A prospective study of 3-day versus 2-week immobilization period after anterior cruciate ligament reconstruction.

BACKGROUND: Aggressive early rehabilitation is recommended after reconstruction of the anterior cruciate ligament (ACL) using a patellar tendon-bone graft. However, rehabilitation after reconstruction of ACL using the multistranded hamstring is controversial. In this study, we compared the clinical results of 3-day immobilization after reconstruction of ACL using the multistranded hamstring, with those of 2-week immobilization prospectively. METHODS: A total of 30 consecutive patients with ruptured ACL underwent single-socket ACL reconstruction. 10 male and 5 female patients (mean age of 29.2+/-10.0 years) were prospectively randomized for a 3-day immobilization period, and 6 male and 9 female patients (mean age of 27.3+/-10.9 years) were randomized for a 2-week immobilization period. We measured the anterior laxity with a KT-2000 arthrometer, joint position sense, and thigh muscle strength at 3, 6 and 12 months after surgery. RESULTS AND CONCLUSIONS: There were no statistically significant differences between the two groups. We concluded that the post-operative 3-day immobilization period is preferable to the longer 2-week period in our rehabilitation program from the viewpoint of psychological load to the patients and the duration of hospitalization after ACL reconstruction using multistranded hamstring tendons.

Adolescent↗

PubMed2006

The long-term results of meniscus transplantation for articular cartilage defects in the knee joint.

The purpose of this study was to examine the long-term clinical results of meniscus transplantation for articular cartilage defects in the knee joint. The type of study was case series. From October 1990 to June 1995, eight cases underwent allogenic or autogenic meniscus transplantations for articular cartilage defects, and seven cases were available for follow-up evaluations. The age at surgery ranged from 14 to 42 years of age (average 22.5). In one case, transplantation of tissue-engineered cartilage was performed due to pain 5 years after surgery. The other six cases were followed up for 8-13 years (average 10.1). The size of the cartilage defect ranged from 1.0 to 6.3 cm2 (average 2.8 cm2). Patients were evaluated with the Lysholm score and MR images. We also performed arthroscopic examinations in three cases at the final evaluation. This study leads to the conclusion that meniscus transplantation for articular cartilage damage is not comparable to autologous chondrocyte transplantation. Two cases showed a good clinical outcome but the tissue remained as fibrocartilage tissue in the long-term.

Adolescent↗

PubMed2006

Anterior cruciate ligament augmentation procedure with a 1-incision technique: anteromedial bundle or posterolateral bundle reconstruction.

Arthroscopic examination before anterior cruciate ligament (ACL) reconstruction sometimes reveals that there is a relatively thick ACL remnant bridging the femur and the tibia that may function to stabilize the knee, although its attachment is not the same as the anatomic site. We have established an ACL augmentation procedure that preserves the ACL remnant with the 1-incision technique using an autogenous semitendinosus tendon and EndoButton-CL (Acufex, Smith & Nephew, Mansfield, MA) instead of ACL reconstruction. When the ACL remnant was attached to the anteroinferior portion of the anatomic femoral origin and the posterolateral (PL) bundle was well preserved, the anteromedial (AM) bundle was reconstructed. When, in contrast, the ACL remnant was attached to the high-noon position with a well-preserved AM bundle, the PL bundle should be reconstructed. We have performed 13 AM bundle reconstructions and 4 PL bundle reconstructions. The merits of our ACL augmentation procedure are (1) it is performed under arthroscopy with 1 incision, (2) it avoids resection of the ACL remnant, which contributes to prevention of anterior laxity, (3) it preserves the ACL remnant's neural elements and mechanoreceptors, and (4) it provides a favorable influence on vascularity and reinnervation to the graft.

Anterior Cruciate Ligament↗

PubMed2006

Lateral compartment osteoarthritis of the knee after meniscectomy treated by the transplantation of tissue-engineered cartilage and osteochondral plug.

Management of osteoarthritis of the knee after meniscectomy has been challenging, especially for young patients, because articular cartilage has very poor healing capacity because of its lack of vessels, nerve supply, and isolation from systemic regulation. Osteoarthritic lesions often involve both femoral and tibial cartilage, requiring treatments for both lesions. We report the case of a 14-year-old girl with lateral compartment osteoarthritis of the knee after a total meniscectomy of the discoid meniscus, who was successfully treated by the transplantation of both tissue-engineered cartilage made ex vivo for a femoral lesion and an autologous osteochondral plug for a tibial lesion. We treated both femoral and tibial cartilage defects simultaneously with this procedure. We confirmed cartilaginous regeneration in both femoral and tibial lesions at second-look arthroscopy. This procedure is one option to prevent further development of osteoarthritis in young patients.

Adolescent↗

PubMed2006

Predictive value of preoperative 3-dimensional computer tomography measurement of semitendinosus tendon harvested for anterior cruciate ligament reconstruction.

PURPOSE: The aim of this study was to evaluate preoperative measurement of the semitendinosus tendon (ST) by 3-dimensional computed tomography (3-D CT), before using ST as the substitute in the anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: Cross-sectional study to compare anatomic findings with clinical findings. METHODS: The study involved 28 patients who underwent ACL reconstruction using autogenous ST graft. Preoperative 3-D CT images of ST were obtained with a multidetector-row CT scanner, and rendered qualitatively by the volume-rendering technique. The length and cross-sectional area of ST measured with 3-D CT were compared with the length of the harvested ST and the cross-sectional area of the grafted quadrupled tendon. RESULTS: The total length of ST measured with 3-D CT ranged from 220.3 to 285.4 mm, with a mean (+/- SD) of 248.0 +/- 17.1 mm, and that measured at surgery ranged from 230.0 to 290.0 mm, with a mean of 257.1 +/- 16.5 mm. These 2 values showed a close positive correlation (gamma = 0.634, P = .002). The cross-sectional area of ST measured with 3-D CT ranged from 4.29 to 18.5 mm2 with a mean of 11.9 +/- 4.6 mm2, and that of the substitute measured at surgery ranged from 28.3 to 56.7 mm2 with a mean of 45.5 +/- 6.9 mm2). There was no significant correlation between the areas of ST measured by CT and the areas of ST measured during surgery. CONCLUSIONS: Preoperative 3-D CT imaging predicts the length of ST. These findings support the measurement of ST length by 3-D CT as a useful tool for planning ACL reconstructive surgery and for providing important preoperative information to patients. LEVEL OF EVIDENCE: Level III, diagnostic study.

Adolescent↗

PubMed2006

New hamstring fixation technique for medial collateral ligament or posterolateral corner reconstruction using the mosaicplasty system.

In this study, we describe a new hamstring fixation technique with a bone graft using the Mosaicplasty system for the reconstruction of the medial collateral ligament (MCL) or posterolateral corner (PLC) of the knee. In this technique, a cylindrical bone plug (6.5 mm in diameter, 15 mm in length) is harvested from the anatomical femoral attachment of the MCL or popliteal tendon using the Mosaicplasty system. After placing the autologous semitendinosus or gracilis tendon as a graft in the created bone socket, the bone plug is replaced over the graft. The graft is secured with a spike staple after appropriate tension is applied to the graft. This fixation technique can provide rigid and less invasive fixation, because the distance between the fixation sites can be shorter than that in the Endobutton technique. Compared to fixation with only a staple with no bone graft, the bone graft may enhance tendon to bone healing.

Arthroplasty↗

PubMed2005

Meniscal regeneration using tissue engineering with a scaffold derived from a rat meniscus and mesenchymal stromal cells derived from rat bone marrow.

The purpose of this study was to regenerate a meniscus using a scaffold from a normal meniscus and mesenchymal stromal cells derived from bone marrow (BM-MSCs). Thirty Sprague-Dawley rat menisci were excised and freeze-thawed three times with liquid nitrogen to kill the original meniscal cells. Bone marrow was aspirated from enhanced green fluorescent protein transgenic Sprague-Dawley rats. BM-MSCs were isolated, cultured for 2 weeks, and 2 x 10(5) cells were then seeded onto the meniscal scaffolds. Using a fluorescent microscope and immunohistochemical staining, repopulation of enhanced green fluorescent protein positive cells was observed in the superficial zone of the scaffold after 1 week of culture, and then in the deep zone after 2 weeks. At 4 weeks, expression of extracellular matrices was detected histologically and expression of mRNA for aggrecan and type X collagen was detected. Stiffness of the cultured tissue, assessed by the indentation stiffness test, had increased significantly after 2 weeks in culture, and approximated the stiffness of a normal meniscus. From this study, we conclude that a scaffold derived from a normal meniscus seeded with BM-MSCs can form a meniscus approximating a normal meniscus.

Animals↗

PubMed2005

A long-term follow-up study after medial patellofemoral ligament reconstruction using the transferred semitendinosus tendon for patellar dislocation.

The management of patellar dislocation syndrome has traditionally been difficult. There are no golden standard methods for patellar dislocations probably due to the many etiologies. However, it is known that medial patellofemoral ligament (MPFL) is damaged when the patella is dislocated. The purpose of this study is to examine whether our method of MPFL reconstruction is useful for the treatment of dislocated patellae and unstable patellae. Forty-six knees (43 patients) of 68 knees (65 patients) that were operated on using our surgical procedure for MPFL reconstruction with the advancement of the vastus medialis or the MPFL reconstruction with Insall's procedure were followed up for at least 5 years. The patient age ranged from 6 to 43 years. These knees consisted of six habitual dislocation patellae, twenty-six recurrent dislocation patellae, ten traumatic dislocation patellae, and four unstable patellae. The patients were evaluated pre-operatively and more than three times post-operatively at 6, 12, 36, 60, or 120 months. No patient experienced patellar dislocation after surgery. Their post-operative Kujala's scores were significantly improved. On conventional X-ray and on stress X-ray evaluations, the mean values for congruence angle, tilting angle, lateral shift ratio, medial stress shift ratio, and lateral stress shift ratio at the final follow-up (60 or 120 months) were demonstrated to be within the normal range. We conclude that our MPFL reconstruction method with the advancement of the vastus medialis or with Insall's procedure might be recommended for the treatment of habitual, recurrent, and indeed any other type of patellar dislocation, as well as for unstable patellae.

Adolescent↗

PubMed2005

Efficiency of magnetic liposomal transforming growth factor-beta 1 in the repair of articular cartilage defects in a rabbit model.

We evaluated the efficacy of a magnetic liposomal delivery system of transforming growth factor (TGF)-beta(1) in the treatment of articular cartilage defects in a rabbit model. Articular cartilage defects were created in the patellar groove of rabbits, and a permanent magnet or a nonmagnetic alloy was implanted in the defect site. Magnetic liposomal drugs, prepared by the conventional film method and sonication, were injected into the defect site 1 week after surgery. First, the efficacy of the magnetic liposomal delivery system was evaluated by using a model compound fluorescence-labeled dextran 40,000 (FD-40). Then, the therapeutic efficiency of magnetic liposomal TGF-beta(1) was evaluated by cartilage histological scoring at 4, 8, and 12 weeks after surgery. The injected magnetic liposomal FD-40 accumulated at the target site where a permanent magnet had been implanted. The histological score showed that the injection of magnetic liposomal TGF-beta(1) under magnetic force was significantly effective in the repair of the defect site over 12 weeks after surgery. Injection of TGF-beta(1) into the cartilage defect was effective as a magnetic liposomal preparation under magnetic force, resulting in acceleration of the cartilage repair, probably because of the desirable accumulation of TGF-beta(1) at the target site.

Animals↗

PubMed2005

Meniscal repair using bone marrow-derived mesenchymal stem cells: experimental study using green fluorescent protein transgenic rats.

Meniscal tears in the avascular zone have very limited potential to heal because of a poor blood supply. Although there have been many attempts to promote the healing potential of the torn meniscus, no established treatments have achieved sufficient meniscal healing. In this study, we evaluated the efficacy of mesenchymal stem cell transplantation as a cell source to promote meniscal healing, using cells from the green fluorescent protein (GFP) transgenic rat and organ culture model. Mesenchymal stem cells from bone marrow were isolated and expanded in monolayer culture. They were embedded in fibrin glue and were transplanted into the meniscal defects of Sprague-Dawley rats. In the control groups, the defects remained untreated, or only fibrin glue without cells was transplanted. The GFP-positive cells enabled us to detect the transplanted cells from recipient cells easily. As a result, transplanted mesenchymal stem cells could survive and proliferate in the meniscal defects in the organ culture model. They also could produce an abundant extracellular matrix stained by toluidine blue around the cells which contributed to meniscal healing in the avascular status. We could detect transplanted GFP cells under a fluorescent microscope until 8 weeks after transplantation. In a clinical situation, mesenchymal stem cell transplantation is a promising new clinical strategy for the treatment of meniscal tears in the avascular zone.

Animals↗

PubMed2005

Hyperbaric oxygen as an adjuvant for athletes.

There has recently been a resurgence in interest in hyperbaric oxygen (HBO) treatment in sports therapy, especially in Japan. Oxygen naturally plays a crucial role in recovery from injury and physiological fatigue. By performing HBO treatment, more oxygen is dissolved in the plasma of the pulmonary vein via the alveolar, increasing the oxygen reaching the peripheral tissues. HBO treatment is therefore expected to improve recovery from injury and fatigue. HBO treatment has been reported to reduce post-injury swelling in animals, and in humans; swelling was also mitigated, but to a lesser extent. Positive results have also been reported regarding tissue remodelling after injury, with injuries involving bones, muscles and ligaments showing improved recovery. Furthermore, HBO treatment has effectively increased recovery from fatigue. This was clearly seen at the Nagano Winter Olympics, where sports players experiencing fatigue were successfully treated, enabling the players to continue performing in the games. Despite its potential, HBO treatment does have its risks. Increasing oxygen levels in tissues poses a risk to DNA through oxidative damage, which can lead to pathological changes in the CNS and the lungs. Regarding the operating of HBO systems, safer administration should be advised. Further research into HBO treatment is required if this therapy is to become more widespread. It should become possible to tailor treatment to an individual's condition in order to use HBO treatment efficiently.

Animals↗

PubMed2005

Transplant of mesenchymal stem cells and hydroxyapatite ceramics to treat severe osteochondral damage after septic arthritis of the knee.

We describe a 21-year-old man with a large osteochondral defect of the knee after septic arthritis, successfully treated by transplant of mesenchymal stem cells (MSC) from bone marrow and a new type of interconnected porous hydroxyapatite ceramic (IP-CHA). We confirmed successful cartilage-like tissue regeneration by a second arthroscopy. Biopsy of the repaired tissue revealed cartilage-like regeneration and bone formation. We were able to regenerate new bone and cartilage-like tissue in a one-stage operation, without sacrificing autologous bone or other tissue. This cultured MSC and IP-CHA hybrid material transplant represents a novel treatment for a severe osteochondral defect after septic arthritis.

Adult↗

PubMed2005

Magnetically labeled human natural killer cells, accumulated in vitro by an external magnetic force, are effective against HOS osteosarcoma cells.

We evaluated the efficacy of a novel natural killer (NK) cell delivery system in vitro, and also investigated the antitumor effect of the accumulated cells on HOS osteosarcoma cells. Human peripheral blood mononuclear cells were isolated and co-cultured with inactivated K562 erythroleukaemic cells in the presence of IL-2 for 5 days. CD3- CD56+ NK cells were labeled with immunomagnetic beads and separated using a magnetic cell sorting system. Purity and cytotoxicity against K562 cells and HOS cells of the magnetically labeled NK cells were measured. To evaluate whether magnetically labeled NK cells could be accumulated in a specific area by magnetic force, the NK cells were placed in chamber slides in the presence, or not, of an external magnetic force of a neodymium magnet (diameter: 1.5 mm, height: 3 mm, total magnetic flux density: 0.282 T). Moreover, to investigate the antitumor effect on HOS cells, the magnetically labeled NK cells were added to HOS cells in chamber slides in the presence, or not, of an external magnetic force for various times. HOS cells were subsequently stained with Papanicolaou for histological examination. It was found that the magnetically labeled NK cells were highly purified and had cytotoxicity against target cells. The NK cells were accumulated effectively by the magnetic field and, when the NK cells were added to HOS cells in a chamber slide with a magnet placed beneath, a significantly larger number of HOS cells detached from the magnet zone than from other zones. Apoptosis was detected in most detached HOS cells. In conclusion, these findings indicate that magnetically accumulated NK cells efficiently induced apoptosis in HOS cells, suggesting that magnetic targeting therapy using magnetically labeled NK cells holds promise as an immunotherapy for osteosarcoma.

Antineoplastic Agents↗

PubMed2004

Osteochondral lesion located at the lateral femoral condyle reconstructed by the transplantation of tissue-engineered cartilage in combination with a periosteum with bone block: a case report.

We report herein the successful treatment of a patient with an osteochondral defect extending to the edge of the lateral femoral condyle by transplantation of tissue-engineered cartilage made ex vivo using atelocollagen gel covered by periosteum with a bone block to reconstruct the normal contour of the femoral condyle.

Adult↗

PubMed2004

Synovial cyst formation resulting from nonabsorbable meniscal repair devices for meniscal repair.

Several arthroscopic meniscal repair techniques and devices have been developed during the past decade. The Mitek Meniscal Repair System (Mitek, Ethicon, Norderstedt, Germany) is one of these devices. We report a case of synovial cyst formation after medial meniscus repair with a nonabsorbable Mitek Meniscal Repair System. The cyst in the right knee developed 5 months after the meniscus repair. After excision of the synovial cysts and removal of these devices, the mass and pain of the knee were relieved. To our knowledge, this is the first report of synovial cyst formation resulting from this device.

Adolescent↗

PubMed2004

Regional differences in the healing potential of the meniscus-an organ culture model to eliminate the influence of microvasculature and the synovium.

Meniscal healing is well known to be region-specific, and this is thought to be mainly due to its specific vascularity. The purpose of this study was to assess regional differences in the intrinsic healing potential of the meniscus, using an organ culture model to eliminate the influence of microvasculature and the synovium. A full-thickness circular defect, 1.5 mm in diameter, was created in the inner avascular zone in meniscal explants from rabbits. As a control, a column of 1.5 mm in diameter was removed then replanted in the area where it had been obtained (Group C). In the experimental group, a 1.5 mm-diameter meniscal graft obtained from the peripheral zone of the same specimen was implanted in the damaged area (Group T). These meniscal explants were cultured for 2, 4 or 6 weeks, and the relationship between the recipient tissue and the graft was examined using both gross and histological semiquantitative scoring. The 6-week gross-examination showed that the openings were more apparent in Group C, and the score of Group T was significantly higher than that of Group C (P=0.0152). Histologically, the healing responses after both 4 and 6 weeks of incubation were significantly better in Group T than in Group C (P=0.0237, 0.0281). These results using organ culture demonstrate that intrinsic healing potential differs even without the influence of vascular supply and the synovium, indicating that the superior healing potential in the peripheral zone may contribute to the good meniscal healing in this location.

Animals↗

PubMed2004

Anterior cruciate ligament graft impingement against the posterior cruciate ligament: diagnosis using MRI plus three-dimensional reconstruction software.

OBJECTIVE: The purpose of this study was to evaluate anterior cruciate ligament (ACL) impingement against the posterior cruciate ligament (PCL) with the knee in an extended position, which arthroscopy cannot detect. MATERIALS AND METHODS: Ten normal knees and 30 ACL-reconstructed knees were assessed using MR imaging. The three-dimensional reconstruction of the ACL, PCL, femur and tibia were carried out using commercially available three-dimensional reconstruction software. Anterior cruciate ligament impingement against the PCL was graded into three categories: Grade 1, some space between the ligaments; Grade 2, no space between the ligaments, and the reconstructed ACL ran straight; and Grade 3, the reconstructed ACL did not run straight. The angle of the reconstructed ACL against the tibial plateau was also measured. RESULTS: All normal knees were classified as Grade 1. The 30 reconstructed knees were classified as follows: Grade 1, 12 cases; Grade 2, 7 cases; and Grade 3, 11 cases. The mean angle of the Grade 3 reconstructed ACL knees was significantly more vertical against the tibia as compared with the Grade 1 knees (P<.05). The postoperative KT-2000 side-to-side difference of the Grade 3 knees (2.8+/-4.5 mm) was larger than that of the Grade 1 knees (0.2+/-1.7 mm) and Grade 2 knees (-0.6+/-2.2 mm), but no statistically significant difference could be detected between the three groups in the postoperative KT-2000 data. CONCLUSION: This method is useful to evaluate ACL impingement against PCL, which cannot be detected by conventional arthroscopy during the operation. The surgeon should pay careful attention to the coronal angle of the reconstructed ACL.

Adolescent↗

PubMed2004

An early return to vigorous activity may destabilize anterior cruciate ligaments reconstructed with hamstring grafts.

OBJECTIVE: To evaluate the actual date of the return to activity and its impact on the postsurgical stability of anterior cruciate ligament reconstruction (ACLR) using hamstring grafts. DESIGN: A retrospective analysis. The time of return to activity was determined by a questionnaire at 24 to 36 months after ACLRs. SETTING: An orthopedic center. PARTICIPANTS: Fifty consecutive patients who had ACLRs using hamstring grafts 24 to 36 months earlier. INTERVENTIONS: Not applicable. Main outcome measure The time of return to activity from a questionnaire and serial KT-2000 data at 3, 6, 12, 18, and 24 months postsurgery. RESULTS: Patients were divided into 2 groups according to their KT-2000 side-to-side difference at 12, 18, and 24 months postsurgery. Group I consisted of patients whose differences were 3mm or less. Group II consisted of patients whose differences were more than 3mm. At 12 and 18 months postsurgery, significant differences were detected for the time of return to running and full-speed running. A multiple regression analysis for postsurgical stability at 24 months and the time of return to these 5 activities indicated that the time of return to full-speed running and sports activities had an effect on ACL stability. CONCLUSIONS: An early return to vigorous activities is not recommended in patients undergoing ACLRs with hamstring grafts.

Adolescent↗