University Hospital
附属病院
日本語
Update date：2022/04/25
Assistant Professor
Kutsuna Tatsuhiko

Degree

  1. Fibronectin orchestrates both cell survival and the pattern of proteoglycan production during Transforming Growth Factor-beta1-inducing chondrogenesis愛媛大学2011/07/28

Books and Other Publications

  1. TKAの手術手技⑤：ギャップ、トラッキングの確認と補正方法2017/05
  2. Topics 超短期抗菌薬予防投与2010/10
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Papers

  1. Efficacy of posterior capsular release for flexion contracture in posterior-stabilized total knee arthroplasty.2021/11/04Kinoshita Tomofumi,Hino Kazunori,Kutsuna Tatsuhiko,Watamori Kunihiko,Tsuda Takashi,Miura HiromasaJournal of experimental orthopaedics8/ 1, 10210.1186/s40634-021-00422-2Posterior capsular contracture causes stiffness during knee extension in knee osteoarthritis. Furthermore, in posterior-stabilized total knee arthroplasty (PS-TKA), a unique design such as the cam mechanism could conflict with the posterior capsule (PC) causing flexion contracture (FC). However, few studies have focused on the anatomical aspects of the PC. This study aimed to investigate the anatomical site and forms of posterior capsular attachment to the femoral cortex, and to evaluate the efficacy of posterior capsular release for FC by assessing changes in knee extension angles using a navigation system.Attachment sites of the PC were investigated in 10 cadaveric knees using computed tomography. PS-TKA was performed in six cadaveric knees using a navigation system to evaluate the efficacy of posterior capsular release for FC. Posterior capsular release was performed stepwise at each part of the femoral condyle.The gastrocnemius tendon and PC were integrally attached to the femoral cortex at the medial and lateral condyles, whereas the PC at the intercondylar fossa was independently attached directly to the femoral cortex. Moreover, the PC at the intercondylar fossa was attached most distally among each femoral condyle. Posterior capsular release at the intercondylar fossa allowed 11.4° ± 2.8° improvement in knee extension. This angle was further improved by 5.5° ± 1.3°, after subsequent capsular release at the medial and lateral condyles.The forms and sites of posterior capsular attachment differed based on the part of the femoral condyle. Stepwise posterior capsular release was effective for FC in PS-TKA.III.
  2. Gender-specific difference in the recurrence of flexion contracture after total knee arthroplasty.2021/10/06Kinoshita Tomofumi,Hino Kazunori,Kutsuna Tatsuhiko,Watamori Kunihiko,Tsuda Takashi,Miura HiromasaJournal of experimental orthopaedics8/ 1, 8710.1186/s40634-021-00409-zRange of motion after total knee arthroplasty (TKA) can impact patients' daily lives. Nevertheless, flexion contracture (FC) often recurs after TKA, even upon achieving full extension intraoperatively. This study aimed to evaluate the relationship among preoperative, intraoperative, and postoperative knee extension angles, and clarify the risk factor for postoperative FC.One hundred forty-seven knees undergoing TKA using a navigation system were evaluated. We measured the pre- and postoperative (6 months after TKA) extension angles using a goniometer, and intraoperative (before and after TKA) extension angle using a navigation system; the correlation between these angles at each time point was evaluated.The mean preoperative, intraoperative (before and after TKA) and postoperative extension angles were -9.9°, -6.8°, -0.1°, and -2.0°. Regarding intraoperative extension angle after TKA, 58 knees showed ≤ 5° hyperextension and six knees showed > 5° hyperextension. At 6 months, no cases showed hyperextension and 105 knees showed full extension. The mean intraoperative extension angle after TKA in the postoperative full extension group was 0.4°. A significant correlation was found among extension angles at each point (p<0.01, respectively). However, the intraoperative extension angle after TKA correlated with the postoperative extension angle only in females. Contrarily, the recurrence rate of FC was significantly higher in males than in females (p<0.01).Intraoperative extension angles significantly correlated with pre- and postoperative extension angles in TKA. Moreover, intraoperative mild (≤ 5°) hyperextension is acceptable for postoperative full extension. There was a gender-specific difference in correlation between intra- and postoperative knee extension angles.III.
  3. Rotational Soft-Tissue Balance Is Highly Correlated with Rotational Kinematics in Total Knee Arthroplasty.2021/05/15Kinoshita Tomofumi,Hino Kazunori,Kutsuna Tatsuhiko,Watamori Kunihiko,Miura HiromasaThe journal of knee surgery10.1055/s-0041-1729619Recovery of normal knee kinematics is critical for improving functional outcomes and patient satisfaction after total knee arthroplasty (TKA). The kinematics pattern after TKA varies from case to case, and it remains unclear how to reproduce normal knee kinematics. The present study aimed to evaluate rotational knee kinematics and soft-tissue balance using a navigation system and to assess the influence of intraoperative soft-tissue balance on the rotational knee kinematics. We evaluated 81 osteoarthritic knees treated with TKA using a posterior stabilized (50 knees) or cruciate retaining (31 knees) prosthesis. Rotational kinematics were assessed at 0, 30, 45, 60, and 90 degrees flexion angles by using a computer-assisted navigation system. Correlation between femorotibial rotational position and measured soft tissue balance was assessed by using Spearman's rank correlation coefficient. Rotational soft-tissue balance (the median angle of rotational stress) was significantly correlated with rotational kinematics (rotational axis of the femur relative to the tibia throughout the range of motion) at all measured angles after TKA. The correlation coefficients between the median angle of rotational stress and rotational kinematics were 0.97, 0.80, 0.74, 0.71, and 0.70 at 0, 30, 45, 60, and 90 degrees of flexion, respectively (-values <0.0001 in all measured angles). The correlation coefficient increased as the knee approached full extension. Our findings suggest that soft-tissue balance is a key factor for rotational kinematics, following both cruciate-retaining and posterior-stabilized TKA.
  4. 局所高濃度抗菌薬投与による人工膝関節周囲感染の治療成績2020/12忽那 辰彦, 日野 和典, 渡森 一光, 木下 智文, 清松 悠, 渡邊 誠治, 三浦 裕正愛媛医学39/ 4, 202-203愛媛医学会
  5. ボックス型関節鏡シミュレータによる関節鏡手術トレーニング　トレーニング後実施したアンケート調査の検討2020/10忽那 辰彦, 日野 和典, 渡森 一光, 木下 智文, 清松 悠, 三浦 裕正中部日本整形外科災害外科学会雑誌63/ 秋季学会, 118(一社)中部日本整形外科災害外科学会
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Presentations

  1. 後十字靭帯温存型人工膝関節置換術においてbone island温存が術後中期臨床成績向上につながる第51回日本人工関節学会2021/07/08
  2. Periprosthetic joint infection after total knee arthroplasty treated with direct intraarticular antibiotic infusion第1２回日本関節鏡・膝・スポーツ整形外科学会2020/12
  3. 初回人工膝関節置換術における 選択的軟部組織解離による靭帯バランス調整法の術後成績第50回日本人工関節学会2020/02
  4. 局所高濃度抗菌薬投与による 人工膝関節周囲感染の治療成績第50回日本人工関節学会2020/02
  5. 後十字靭帯温存型人工膝関節置換術に おいてbone islandは温存すべきか？第49回日本人工関節学会2019/02
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Allotted Class

  1. 2024Introduction to Emergency Medical Treatment
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