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The pathomechanism of joint destruction in subchondral insufficiency fracture

Research Project

Project/Area Number 19K09635
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 56020:Orthopedics-related
Research InstitutionFukuoka University

Principal Investigator

Yamamoto Takuaki  福岡大学, 医学部, 教授 (20336035)

Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords脆弱性骨折 / 股関節 / 肩関節 / 関節破壊 / 膝関節 / 骨壊死 / 膝骨壊死
Outline of Research at the Start

関節内に発生する代表的疾患である大腿骨頭軟骨下脆弱性骨折の予後規定因子を多角的に解析し、関節破壊のメカニズムを解明し、もって健康寿命の延伸に寄与する。
具体的には、
(1)骨粗鬆症に伴って発生する大腿骨頭軟骨下脆弱性骨折を検討する
(2)骨粗鬆症に伴って関節破壊を来すという新たな概念を多角的に解析する
(3)各関節での関節破壊を来す疾患群の病態解明も併せて行う

Outline of Final Research Achievements

Subchondral insufficiency fracture (SIF)often results in the rapid destruction of the joints. In this study, SIF in the hip, shoulder, and knee joints are clinicopathologically investigated. On plain radiographs, the normal joint space had undergone rapid narrowing and/or disappeared within 9 months. Histopathologically, all cases showed evidence of subchondral insufficiency fracture and, in the marrow space, there were several round to oval granulomatous foci, which consisted of amorphous debris, fragmented bone and articular cartilage surrounded by reactive histiocytes and giant cells. SIF resulting from osteopenia may lead to a rapid breakdown of the joints.

Academic Significance and Societal Importance of the Research Achievements

骨粗鬆症性軟骨下脆弱性骨折と関節破壊に関する検討を行った報告は国内外を問わずこれまでになく、新しい病態を世界に先駆けて解析するものである。今回の研究結果より、早期にSIFを診断し、適切な治療を行うことで、関節破壊を防止できる可能性が示唆された。また、関節内における軟骨下脆弱性骨折の代表的疾患である大腿骨頭軟骨下脆弱性骨折は、われわれが世界で初めてその発生を病理組織学的に報告しており、引き続いて典型的画像所見、合併症などを報告した。本分野に関しては検討症例が多く、このような豊富な症例数と経験に基づいた環境のもとに行われる本研究は、世界最先端のものである。

Report

(4 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (13 results)

All 2021 2020 2019

All Journal Article (8 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 8 results,  Open Access: 2 results) Presentation (5 results) (of which Int'l Joint Research: 1 results,  Invited: 4 results)

  • [Journal Article] Leg Length Change After Curved Periacetabular Osteotomy and Its Impact on the Clinical Outcomes2021

    • Author(s)
      Suzuki M, Kinoshita K, Sakamoto T, Seo H, Kinoshita S, Yamamoto T.
    • Journal Title

      J Arthroplasty.

      Volume: 36(9) Issue: 9 Pages: 3089-3096

    • DOI

      10.1016/j.arth.2021.04.019

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Femoral nerve status during the anterolateral approach for total hip arthroplasty: Motor-evoked potential analysis and an influencing factor.2021

    • Author(s)
      Kinoshita S, Ishimatsu T, Suzuki M, Seo H, Sakamoto T, Kinoshita K, Yamamoto T.
    • Journal Title

      J Orthop Sci.

      Volume: - Issue: 1 Pages: 152-155

    • DOI

      10.1016/j.jos.2021.09.007

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Histopathologic evaluation of bone marrow lesions in early stage subchondral insufficiency fracture of the medial femoral condyle.2021

    • Author(s)
      Kosaka H, Maeyama A, Nishio J, Nabeshima K, Yamamoto T.
    • Journal Title

      Int J Clin Exp Pathol.

      Volume: 14(7) Pages: 819-826

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Japanese Orthopaedic Association 2019 Guidelines for osteonecrosis of the femoral head2021

    • Author(s)
      Ando W, Sakai T, Fukushima W, Kaneuji A, Ueshima K, Yamasaki T, Yamamoto T, Nishii T; Working group for ONFH guidelines, Sugano N.
    • Journal Title

      Journal of Orthopaedic Science

      Volume: 26 Issue: 1 Pages: 46-68

    • DOI

      10.1016/j.jos.2020.06.013

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Transtrochanteric Anterior Rotational Osteotomy Combined with Re-Sphericalization of the Collapsed Femoral Head Using Calcium Phosphate Cement Filling2020

    • Author(s)
      Motomura G, Yamamoto T, Kubo Y, Utsunomiya T, Hamai S, Ikemura S, Fujii M, Nakashima Y.
    • Journal Title

      Surg Technol Int .

      Volume: 36 Pages: 347-350

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Effect of a Specific Questionnaire Sheet on Subclassification of Osteonecrosis of the Femoral Head2020

    • Author(s)
      Hatanaka H, Motomura G, Ikemura S, Sonoda K, Kubo Y, Utsunomiya T, Nakashima Y, Yamamoto T.
    • Journal Title

      Med Sci Monit.

      Volume: 26

    • DOI

      10.12659/msm.921327

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Meta-analysis of 208370 East Asians identifies 113 susceptibility loci for systemic lupus erythematosus.2020

    • Author(s)
      Xianyong Yin, et al.
    • Journal Title

      Ann Rheum Dis.

      Volume: 80(5) Issue: 5 Pages: 632-640

    • DOI

      10.1136/annrheumdis-2020-219209

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Incidence of osteonecrosis and insufficiency fracture of the hip and knee joints based on MRI in 300 renal transplant patients2019

    • Author(s)
      Ohtsuru T, Yamamoto T, Murata Y, Morita Y, Munakata Y, Kato Y, Okazaki K.
    • Journal Title

      Hip Int

      Volume: 29 Issue: 3 Pages: 316

    • DOI

      10.1177/1120700018808693

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Presentation] 特発性大腿骨頭壊死症の病態と治療戦略2021

    • Author(s)
      山本卓明
    • Organizer
      第94回日本整形外科学会学術総会
    • Related Report
      2021 Annual Research Report
    • Invited
  • [Presentation] 日本で培われた骨切り術とその魅力「大腿骨頭回転骨切り術」2021

    • Author(s)
      山本卓明
    • Organizer
      第48回日本股関節学会学術集会
    • Related Report
      2021 Annual Research Report
    • Invited
  • [Presentation] 教育研修講演:特発性大腿骨頭壊死症の診断と治療2020

    • Author(s)
      山本卓明
    • Organizer
      第93回日本整形外科学会学術総会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 高齢者脆弱性骨折に対する診断と治療:大腿骨軟骨下脆弱性骨折の診断と治療2019

    • Author(s)
      山本卓明
    • Organizer
      第46回日本股関節学会
    • Related Report
      2019 Research-status Report
  • [Presentation] Differentiation diagnosis between Osteonecrosis of the femoral head and Subchondral insufficiency fracture of the femoral head2019

    • Author(s)
      Takuaki Yamamoto
    • Organizer
      European Orthopaedic Research Society
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research / Invited

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Published: 2019-04-18   Modified: 2023-01-30  

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