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Investigation of the pathogenesis of steroid-induced osteonecrosis and its prevention

Research Project

Project/Area Number 15591587
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Orthopaedic surgery
Research InstitutionKYUSHU UNIVERSITY

Principal Investigator

YAMAMOTO Takuaki  Kyushu University, Faculty of Medicine, Orthopaedic Surgery, Research Associate, 大学院・医学研究院, 助手 (20336035)

Project Period (FY) 2003 – 2005
Project Status Completed (Fiscal Year 2005)
Budget Amount *help
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2005: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2004: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 2003: ¥1,500,000 (Direct Cost: ¥1,500,000)
Keywordsosteonecrosis / steroid / prevention / femoral head / lipid metabolism / coagulation / insufficiency fracture / pathology / 大腿骨折
Research Abstract

1 Prevention of steroid-induced osteonecrosis using animal models
We investigated the effects of the combination treatment with an anticoagulant (warfarin) plus a lipid-lowering agent (probucol) on prevention of steroid-induced osteonecrosis (ON) in rabbits. The incidence of ON in the WP group (5%) was significantly lower than that observed in the NP group (70%) (p<0.0001). While the incidences of ON in the PA and WA groups (37% and 33%, respectively) were also significantly lower than that seen in the NP group (p<0.05), they were significantly higher than that observed in the WP group (p<0.01 and p<0.05, respectively). The sizes of the bone marrow fat cells in both the WP (53.5±4.1 μm) and PA groups (52.0±5.0 μm) were significantly smaller than those in the NP group (60.0±4.0 μm) (p< 0.01). We also observed elongation of prothrombin time and reduced plasma lipid levels in the WP group during the study duration. This study experimentally confirmed that the combined use of an anticoagulant and a lipid-lowering agent helps prevent steroid-induced ON in rabbits.
2 The concept of subchondral insufficiency fracture
Subchondral insufficiency fracture of the femoral head (SIF) is a recently proposed concept, which needs to be differentiated from osteonecrosis. We investigated its clinicopathological appearance and frequency. SIF should be included in the differential diagnosis of acute onset of coxarthrosis, especially in the elderly female.

Report

(4 results)
  • 2005 Annual Research Report   Final Research Report Summary
  • 2004 Annual Research Report
  • 2003 Annual Research Report
  • Research Products

    (53 results)

All 2006 2005 2004 2003 Other

All Journal Article (43 results) Book (4 results) Publications (6 results)

  • [Journal Article] 特発性大腿骨頭壊死症とその鑑別疾患2006

    • Author(s)
      山本卓明, 岩本幸英, 他
    • Journal Title

      臨床画像 22

      Pages: 518-29

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Bilateral Subchondral Insufficiency Fracture of the Femoral Head after Renal Transplantation2005

    • Author(s)
      Ikemura S, Yamamoto T, et al.
    • Journal Title

      Arthritis and Rheumatism 52

      Pages: 1293-6

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Bone marrow fat-cell enlargement in early steroid-induced osteonecrosis2005

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      Pathol Res Pract 200

      Pages: 807-11

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Early MRI findings of the acetabulum and femoral head in a dysplastic hip resulting in a rapid destruction of the hip joint.2005

    • Author(s)
      Nishida K, Yamamoto T, et al.
    • Journal Title

      Archives Orthop Traum Surg 125

      Pages: 567-70

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Annual Research Report 2005 Final Research Report Summary
  • [Journal Article] 急速破壊型股関節症の病態に迫る2005

    • Author(s)
      山本卓明, 中島康晴, 他
    • Journal Title

      日本整形外科学会雑誌 79

      Pages: 786-92

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Annual Research Report 2005 Final Research Report Summary
  • [Journal Article] 大腿骨頭壊死症に対する大腿骨頭回転骨切り術2005

    • Author(s)
      山本卓明, 杉岡洋一, 他
    • Journal Title

      骨・関節・靱帯 18

      Pages: 157-60

    • NAID

      10016493129

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 大腿骨頭壊死症 -骨切り術後を中心に2005

    • Author(s)
      山本卓明, 高杉紳一郎, 他
    • Journal Title

      整形外科 56

      Pages: 999-1005

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Effects of different corticosteroids on the development of osteonecrosis in rabbits.2005

    • Author(s)
      Miyanishi K, Yamamoto T, et al.
    • Journal Title

      Rheumatology 44

      Pages: 332-6

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 大腿骨頭壊死症に対する大腿骨頭回転骨切り術の適応とその根拠2005

    • Author(s)
      山本卓明, 杉岡洋一, 他
    • Journal Title

      Hip Joint 31

      Pages: 21-4

    • NAID

      10016833197

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 大腿骨頭壊死症と大腿骨頭軟骨下脆弱性骨折の鑑別2005

    • Author(s)
      山本卓明, 木村悟郎, 他
    • Journal Title

      Hip Joint 31

      Pages: 133-6

    • NAID

      10016833435

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 大腿骨頭前方回転骨切り術におけるK-MAX AA Hip Screwの使用経験2005

    • Author(s)
      池村聡, 山本卓明, 他
    • Journal Title

      Hip Joint 31

      Pages: 356-8

    • NAID

      10016833858

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 9歳以上発症のペルテス病に対する大腿骨頭前方骨切り術2005

    • Author(s)
      中島康晴, 山本卓明, 他
    • Journal Title

      Hip Joint 31

      Pages: 252-7

    • NAID

      10016833656

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Bone marrow fat-cell enlargement in early steroid-induced osteonecrosis. A histomorphometric study of autopsy cases2005

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      Pathol Res Pract 200

      Pages: 807-811

    • NAID

      10020560434

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Bilateral Subchondral Insufficiency Fracture of the Femoral Head after Renal Transplantation.2005

    • Author(s)
      Ikemura S, Yamamoto T, et al.
    • Journal Title

      Arthritis Rheum 52

      Pages: 1293-1296

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Bilateral Subchondral Insufficiency Fracture of the Femoral Head after Renal Transplantation.2005

    • Author(s)
      Ikemura G, Yamamoto T, et al.
    • Journal Title

      Arthritis and Rheumatism 52

      Pages: 1293-1296

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Bone marrow fat-cell enlargement in early steroid-induced osteonecrosis.2005

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      Pathol Res Pract 200

      Pages: 807-811

    • Related Report
      2005 Annual Research Report
  • [Journal Article] 大腿骨頭壊死症に対する大腿骨頭回転骨切り術2005

    • Author(s)
      山本卓明, 杉岡洋一, 他
    • Journal Title

      骨・関節・靭帯 18

      Pages: 157-160

    • NAID

      10016493129

    • Related Report
      2005 Annual Research Report
  • [Journal Article] 大腿骨頭壊死症-骨切り術後を中心に2005

    • Author(s)
      山本卓明, 高杉紳一郎, 他
    • Journal Title

      整形外科 56

      Pages: 999-1005

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Subchondral insufficiency fracture of the humeral head and glenoid resulting in rapidly destructive arthrosis2004

    • Author(s)
      Tokuya S, Yamamoto T, et al.
    • Journal Title

      J Shoulder Elbow Surg 13

      Pages: 86-9

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Combined effects of anticoagulant and lipid-lowering agent on the prevention of steroid-induced osteonecrosis in rabbits.2004

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      Arthritis and Rheumatism 47

      Pages: 3387-91

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 特発性膝骨壊死の病因・病態 -本当に骨壊死なのか?-2004

    • Author(s)
      山本卓明, 三浦裕正, 他
    • Journal Title

      日本整形外科学会雑誌 78

      Pages: 838-42

    • NAID

      10014246878

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 大腿骨頭回転骨切り術の適応と限界2004

    • Author(s)
      山本卓明, 杉岡洋一, 他
    • Journal Title

      Hip Joint 30

      Pages: 36-40

    • NAID

      10013749070

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 特発性大腿骨頭壊死症に対する転子間弯曲内反大骨切り術の術後成績2004

    • Author(s)
      山本卓明, 神宮司誠也, 他
    • Journal Title

      Hip Joint 30

      Pages: 418-20

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 特発性大腿骨頭壊死症の動物モデル2004

    • Author(s)
      山本卓明, 本村悟朗, 他
    • Journal Title

      関節外科 23

      Pages: 41-8

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 骨粗鬆症に伴う大腿骨頭軟骨下脆弱性骨折 -その概念の確立と啓発2004

    • Author(s)
      山本卓明, 岩本幸英
    • Journal Title

      Osteoporosis Japan 12

      Pages: 7-11

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Subchondral insufficiency fracture of the humeral head and glenoid resulting in rapidly destructive arthrosis.2004

    • Author(s)
      Tokuya S, Yamamoto T, et al.
    • Journal Title

      J Shoulder Elbow Surg 13

      Pages: 86-89

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Combined effects of anticoagulant and lipid-lowering agent on the prevention of steroid-induced osteonecrosis in rabbits.2004

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      Arthritis Rheum 50

      Pages: 3387-3391

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Combined effects of anticoagulant and lipid-lowering agent on the prevention of steroid-induced ostenecrosis in rabbits.2004

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      Arthritis and Rheumatism 47

      Pages: 3387-3391

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 特発性膝骨壊死の病因・病態-本当に骨壊死なのか?-2004

    • Author(s)
      山本卓明, 三浦裕正, 松田秀一他
    • Journal Title

      日本整形外科学会雑誌 78

      Pages: 838-842

    • NAID

      10014246878

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 大腿骨頭回転骨切り術の適応と限界2004

    • Author(s)
      山本卓明, 杉岡洋一他
    • Journal Title

      Hip Joint 30

      Pages: 36-40

    • NAID

      10013749070

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 特発性大腿骨頭壊死症に対する転子間弯曲内反大骨切り術の術後成績2004

    • Author(s)
      山本卓明, 神宮司誠也他
    • Journal Title

      Hip Joint 30

      Pages: 418-420

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 特発性大腿骨頭壊死症の動物モデル2004

    • Author(s)
      山本卓明, 本村悟朗, 岩本幸英他
    • Journal Title

      関節外科 23

      Pages: 41-48

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 骨粗鬆症に伴う大腿骨頭軟骨下脆弱性骨折-その概念の確立と啓発-2004

    • Author(s)
      山本卓明, 岩本幸英
    • Journal Title

      Osteoporosis Japan 12

      Pages: 7-11

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 一過性大腿骨頭萎縮症の病態2003

    • Author(s)
      山本卓明, 宮西圭太, 他
    • Journal Title

      Hip Joint 292

      Pages: 270-3

    • NAID

      10011932172

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 術中超音波検査を用いた大腿骨頭回転骨切り術における栄養血管の血流確認法2003

    • Author(s)
      末永英慈, 山本卓明, 他
    • Journal Title

      整形外科と災害外科 52

      Pages: 1-4

    • NAID

      10010515370

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Rapid destruction of the femoral head after a single intraarticular injection of corticosteroids into the hip joint.

    • Author(s)
      Yamamoto T, Iwamoto Y, et al.
    • Journal Title

      J Rheumatology (in press)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Subchondral insufficiency fracture of the femoral head in a SLE patient.

    • Author(s)
      Yamamoto T, Iwamoto Y, et al.
    • Journal Title

      Ann Rheum Dis (in press)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Effects of cyclosporin A on the development of osteonecrosis in rabbits.

    • Author(s)
      Miyanishi K, Yamamoto T, et al.
    • Journal Title

      Acta Orthop Scan (in press)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Outcome of the contralateral hip in rapidly destructive arthrosis after total hip arthroplasty -a preliminary report-

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      J Arthroplasty (in press)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Subchondral insufficiency fracture of the femoral head in a SLE patient.

    • Author(s)
      Yamamoto T, Iwamoto Y, et al.
    • Journal Title

      Ann Rheum Dis (in press)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Rapid destruction of the femoral head after a single intraarticular injection of corticosteroids into the hip joint.

    • Author(s)
      Yamamoto T, Iwamoto Y, et al.
    • Journal Title

      J Rheumat (in press)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Outcome of the contralateral hip in rapidly destructive arthrosis after total hip arthroplasty -a preliminary report-

    • Author(s)
      Motomura G, Yamamoto T, et al.
    • Journal Title

      J Arthroplasty (in press)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Effects of cyclosporin A on the development of osteonecrosis in rabbits.

    • Author(s)
      Miyanishi K, Yamamoto T, et al.
    • Journal Title

      Acta Orthop Scan (in press)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Book] 股関節外科の要点と盲点2005

    • Author(s)
      山本卓明
    • Total Pages
      383
    • Publisher
      文光堂
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Book] 股関節外科の要点と盲点2005

    • Author(s)
      山本卓明, 他
    • Total Pages
      383
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 神中整形外科学 上巻2004

    • Author(s)
      山本卓明
    • Publisher
      南山堂
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Book] 神中整形外科学 下巻2004

    • Author(s)
      山本卓明
    • Publisher
      南山堂
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary 2004 Annual Research Report
  • [Publications] 山本卓明, 宮西圭太, 中島康晴, 他: "一過性大腿骨頭萎縮症の病態"Hip Joint. 29. 270-273 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] 末永英慈, 野口康男, 神宮司誠也, 首藤敏秀, 中島康晴, 山本卓明, 他: "術中超音波検査を用いた大腿骨頭回転骨切り術における栄養血管の血流確認法"整形外科と災害外科. 52. 1-4 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Tokuya S, Kusumi T, Yamamoto T, Sakurada S, Toh S.: "Subchondral insufficiency fracture of the humeral head and glenoid resulting in rapidly destructive arthrosis"J Shoulder Elbow Surg. 13. 86-89 (2004)

    • Related Report
      2003 Annual Research Report
  • [Publications] 山本卓明, 岩本幸英: "Subchondral insufficiency fracture - 軟骨下脆弱性骨折 -"臨床画像. 19. 788-795 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] 山本卓明, 本村悟朗, 神宮司誠也, 岩本幸英: "大腿骨頭壊死症と軟骨下脆弱性骨折の鑑別点"厚生労働省特定疾患特発性大腿骨頭壊死症研究分科会研究報告書. 61-62 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] 本村悟朗, 山本卓明, 宮西圭太, 神宮司誠也, 岩本幸英: "プロブコール及びワ-ファリンを併用したステロイド性骨壊死予防実験"厚生労働省特定疾患特発性大腿骨頭壊死症研究分科会研究報告書. 53-55 (2003)

    • Related Report
      2003 Annual Research Report

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Published: 2003-04-01   Modified: 2016-04-21  

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