Updated on 2026/05/25

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写真a

 
Kazuma Miyatake
 
Organization
Graduate School of Medicine Department of Medicine Orthopedic Surgery Lecturer
School of Medicine Medical Course
Title
Lecturer
Profile

肩肘関節のスポーツ障害を中心に、エコーやMRI、その他のモダリティーを用いた診断、関節鏡を中心とした手術治療について研究しています。

また、難治性疼痛に対する末梢神経を標的にしたハイドロリリース、高周波パルスに対する臨床成績、基礎実験を行っています。

加えて、超音波ガイド下手術、X線動態解析、VR・MR・XRに対する整形外科的な応用も着手しています。

External link

Degree

  • 博士（医学） ( 2021.3 )

Research Interests

  • 関節鏡

  • 運動器超音波

  • 肘関節

  • 肩関節

  • 末梢神経

  • スポーツ

Research Areas

  • Life Science / Sports sciences

  • Life Science / Anatomy

  • Life Science / Rehabilitation science

  • Life Science / Orthopedics

Papers

  • Lower Subscapular Nerve Hydrodissection and Subscapularis Re-education for Residual Anterior Shoulder Pain After Superior Labrum Anterior to Posterior Debridement: A Case Report. International journal

    Daichi Naoi, Masashi Kawabata, Daiki Watanabe, Kazuma Miyatake

    Cureus   17 ( 10 )   e93985   2025.10

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    Language：English   Publishing type：Research paper (scientific journal)  

    Superior labrum anterior to posterior (SLAP) lesions are frequently identified on magnetic resonance imaging (MRI), particularly in middle-aged patients, yet many remain incidental and asymptomatic. Arthroscopic debridement of type I lesions may provide symptomatic relief; however, unsatisfactory outcomes may occur in some patients. Residual anterior shoulder pain may not be fully attributed to structural pathology alone, indicating a potential contribution of functional deficits, such as dynamic anterior instability and subscapularis dysfunction. We report the case of a right-handed male amateur arm wrestler in his 40s, who presented with residual anterior shoulder pain (Numerical Rating Scale (NRS) score, 7) and internal rotation weakness (Manual Muscle Testing (MMT) grade, 3) following arthroscopic debridement of a type I SLAP lesion. Steroid injections and hydrodissection of the suprascapular and axillary nerves yielded limited benefits. Targeted ultrasound-guided hydrodissection of the lower subscapular nerve (LSN) was subsequently performed in combination with weekly physiotherapy, including ultrasound-guided subscapularis activation and manual neural mobilization. Pain improved immediately (NRS 3) and resolved within one month (NRS 0), with restoration of internal rotational strength (MMT 5). He resumed competitive arm wrestling four months postoperatively and subsequently won a local tournament. Residual anterior shoulder pain after SLAP debridement may primarily reflect functional impairment, particularly subscapularis dysfunction, rather than residual labral pathology. Ultrasound-guided lower subscapular nerve (LSN) hydrodissection combined with subscapularis-specific rehabilitation is a promising therapeutic option for refractory postoperative anterior shoulder pain.

    DOI： 10.7759/cureus.93985

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  • Immediate Effects of Ultrasound-Guided Superior Gluteal Nerve-Targeted Manual Therapy and Exercise on Hip Abductor Strength, Gait Speed, and Pain in Early Postoperative Total Hip Arthroplasty: A Case Series. International journal

    Mitsuaki Ashihara, Masashi Kawabata, Masato Aratake, Kazuma Miyatake

    Cureus   17 ( 10 )   e94708   2025.10

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    Hip abductor weakness is a common functional impairment in the early postoperative phase following total hip arthroplasty (THA), often contributing to gait disturbance, pain, and delayed recovery. Emerging evidence suggests that dysfunction of the superior gluteal nerve (SGN) may play a critical role in these impairments. However, clinical evidence for SGN-targeted rehabilitation remains limited. This case series aimed to explore the feasibility and preliminary effects of physiotherapy targeting the SGN on hip abductor strength, gait speed, and walking pain in the early postoperative period after THA. Eight patients (three males and five females; aged 60-85 years) who underwent primary unilateral THA via the anterolateral approach were included. On postoperative day 14, all participants received ultrasound-guided manual therapy targeting the SGN combined with visual feedback-based therapeutic exercises for the gluteus medius and minimus. Outcome measures assessed immediately before and after the intervention included hip abductor strength measured with a handheld dynamometer, maximum gait speed measured with the 10-m walk test, and walking pain assessed with the Numerical Rating Scale (NRS). Hip abductor strength improved from 3.4 ± 0.8 kgf to 5.3 ± 1.3 kgf. Gait speed increased from 0.55 ± 0.08 m/s to 0.73 ± 0.11 m/s. NRS pain scores for walking decreased from 3.6 ± 0.6 to 1.5 ± 0.7. Ultrasound assessment revealed consistent tenderness between the gluteus medius and minimus in all participants, supporting the rationale for SGN-focused intervention. This case series demonstrated that a single session of ultrasound-guided manual therapy combined with targeted therapeutic exercise focusing on SGN function led to immediate improvements in hip abductor strength, gait speed, and walking pain in patients during the early postoperative phase after THA. These preliminary findings suggest the potential clinical value of incorporating nerve-focused interventions into standard rehabilitation programs following THA.

    DOI： 10.7759/cureus.94708

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  • Ultrasound-Guided Manual Therapy for the Infrapatellar Branch of the Saphenous Nerve Entrapment Presenting as Anterior Knee Pain: A Case Report

    Toru Miyata, Masashi Kawabata, Daiki Watanabe, Kazuma Miyatake

    Cureus   2025.9

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    Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

    DOI： 10.7759/cureus.93051

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  • Ultrasound-Guided Rotator Cuff Re-education for Residual Dysfunction After Shoulder Manipulation Under Ultrasound-Guided Cervical Nerve Root Block: A Case Report. International journal

    Masashi Kawabata, Toru Miyata, Daichi Naoi, Kazuma Miyatake

    Cureus   17 ( 9 )   e92237   2025.9

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    Language：English   Publishing type：Research paper (scientific journal)  

    Shoulder manipulation under ultrasound-guided cervical nerve root block (MUC) can effectively restore the range of motion (ROM) in frozen shoulders; however, some patients experience persistent functional limitations. This case report describes a post-MUC rehabilitation program using ultrasound-guided real-time visual feedback to re-educate patients on rotator cuff contractions, complemented by targeted neural and muscle interventions. A recreational golfer in her 50s presented with frozen shoulder; ROM was limited to flexion 100°, abduction 80°, external rotation (ER) 20°, and internal rotation (IR) to L5, and she underwent MUC. At one month after the first MUC, the Disabilities of the Arm, Shoulder and Hand (DASH) decreased from 65 to 48 and ROM improved (flexion 165°, abduction 150°, ER 50°, IR to T12); at three months the DASH was 32, yet movement-evoked pain and motion apprehension persisted. A second MUC was performed; one month later the DASH was 15, but pain remained at 8/10 on the Numerical Rating Scale (NRS), dressing was infeasible, and golf practice/swing were not possible. She was referred to our clinic for physiotherapy. During the first session, ultrasound-guided contraction training immediately increased ER/IR strength from 2/10 to 7-8/10 on a patient-reported 0-10 scale, and movement-evoked pain decreased to 3-4/10 on the NRS. Ultrasound-guided manual therapy targeting the axillary nerve reduced apprehension in provocative positions and improved hand-behind-back motion. Subsequent training enhanced subscapularis strength in elevated position (bear-hug test: 3/10 → 7/10 on a patient-reported 0-10 scale). At 12 weeks, she returned fully to recreational golf, with a DASH score of 2 (sports module: 0). Ultrasound-guided real-time feedback with targeted neural and muscle interventions may facilitate neuromuscular re-education of the rotator cuff and bridge the gap between restored passive motion and functional performance after MUC.

    DOI： 10.7759/cureus.92237

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  • 手根管症候群に対する手術の術後経過における感覚障害の変化

    中村 玲菜, 仲 拓磨, 芝崎 泰弘, 草場 洋平, 宮武 和馬, 東 莞爾, 三津谷 勇磨, 稲葉 裕

    日本手外科学会雑誌   42 ( 2 )   229 - 229   2025.9

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    Language：Japanese   Publisher：(一社)日本手外科学会  

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  • 観血的整復を要したDRUJ脱臼の2例

    芝崎 泰弘, 仲 拓磨, 中村 玲菜, 草場 洋平, 宮武 和馬, 東 莞爾, 三津谷 勇磨, 稲葉 裕

    東日本整形災害外科学会雑誌   37 ( 3 )   367 - 367   2025.8

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    Language：Japanese   Publisher：東日本整形災害外科学会  

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  • 母指CM関節症にともなうZigzag変形に影響する因子のX線学的検討

    仲 拓磨, 中村 玲菜, 藤森 翔太, 瀬崎 真帆, 草場 洋平, 宮武 和馬, 荒川 裕和, 高島 寛之, 坂野 裕昭, 稲葉 裕

    東日本整形災害外科学会雑誌   37 ( 3 )   330 - 330   2025.8

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  • Reproducibility of Ulnar Nerve Displacement Prevalence in Youth Baseball Players: A Follow-Up Study. International journal

    Masashi Kawabata, Sohei Shimizu, Koji Saito, Yudai Nagano, Toru Miyata, Daichi Naoi, Takehiro Yamamoto, Kazuma Miyatake, Yohei Kusaba, Hiroyuki Watanabe, Naonobu Takahira

    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine   44 ( 7 )   1315 - 1317   2025.7

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    DOI： 10.1002/jum.16681

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  • 股関節術後の股関節外転筋筋力低下に対する上臀神経への理学療法の有効性

    芦原 光明, 河端 将司, 宮田 徹, 直井 大地, 内田 悠登, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   36回   227 - 227   2025.7

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  • スポーツ現場におけるエコー活用術を学ぼう! ラグビーにおけるエコーの活用法

    草場 洋平, 宮武 和馬, 仲 拓磨, 中村 玲菜, 稲葉 裕

    日本整形外科超音波学会学術集会プログラム・抄録集   36回   106 - 106   2025.7

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  • 我々はどこまで痛みと向き合えるのか 痛みの超音波診療2025

    宮武 和馬, 草場 洋平, 稲葉 裕

    日本整形外科超音波学会学術集会プログラム・抄録集   36回   87 - 87   2025.7

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  • 肩関節授動術後のエコーフィードバック外旋エクササイズの効果 シングルケースデザインによる検討

    直井 大地, 河端 将司, 宮田 徹, 芦原 光明, 内田 悠登, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   36回   211 - 211   2025.7

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  • 脛骨神経滑走セルフエクササイズ開発のための脛骨神経滑走動態の質的評価

    宮田 徹, 河端 将司, 直井 大地, 芦原 光明, 中尾 健, 内田 悠登, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   36回   160 - 160   2025.7

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  • Ischiofemoral impingementに対する超音波アシスト鏡視下小転子切除術

    三津谷 勇磨, 宮武 和馬, 草場 洋平, 仲 拓磨, 中村 玲菜, 東 莞爾, 柴崎 泰弘, 稲葉 裕

    日本整形外科超音波学会学術集会プログラム・抄録集   36回   158 - 158   2025.7

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    Language：Japanese   Publisher：(一社)日本整形外科超音波学会  

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  • 一念通巌 エコーは低侵襲治療における必須ツール! 神経障害性疼痛に対するハイドロリリース

    宮武 和馬, 草場 洋平, 稲葉 裕

    日本整形外科超音波学会学術集会プログラム・抄録集   36回   108 - 108   2025.7

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  • 膝屈曲位MRIによるHypermobile Lateral Meniscusの診断法の検討

    草場 洋平, 宮武 和馬, 仲 拓磨, 中村 玲菜, 稲葉 裕, 間瀬 泰克

    日本関節病学会誌   44 ( 2 )   242 - 242   2025.6

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  • Computed Tomography Analysis for Postoperative Muscle Changes in Patients With Ankylosed Hips Who Underwent Total Hip Arthroplasty: Three Case Reports. International journal

    Shinya Tsujiku, Hyonmin Choe, Kazuma Miyatake, Hiroyuki Ike, Ken Kumagai, Naomi Kobayashi, Yutaka Inaba

    Cureus   17 ( 4 )   e82654   2025.4

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    In patients with ankylosed hips, activities of daily living (ADL) are often restricted because of the limited range of hip motion and adjacent joint disorders that cause severe low back and knee pain. Total hip arthroplasty (THA) can improve hip mobility and reduce adjacent joint pain; however, muscle atrophy around the hip joint potentially interferes with ADL improvement. Herein, we describe the seven-year clinical outcomes of computed tomography (CT)-based navigation THA in three patients with ankylosed hips. Additionally, we report the longitudinal changes in muscle atrophy; the muscle volume around the hip joint was measured using CT analysis. The three patients include one woman and two men, aged 75, 65, and 73, respectively, who underwent THA using a CT-based navigation system. None of the patients experienced THA post-operative complications, and all were able to walk with a cane and sit freely in a chair. The hip function of the Harris Hip Score improved from a mean of 71.0 points to 86.6 points at seven years postoperatively. The volume of the gluteus maximus muscle increased in all patients (mean +10.1%); however, the gluteus medius and minimus decreased in all patients (mean, -42.2% and -51.0%). THA with CT-based navigation for ankylosed hips improves ADL, hip joint function, and muscle volume of the gluteus maximus in mid-term clinical results; however, muscle volume recovery in the gluteus medius and minimus can be insufficient.

    DOI： 10.7759/cureus.82654

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  • 手根管症症候群における錯感覚と異常感覚の術後変化の調査

    中村 玲菜, 仲 拓磨, 芝崎 泰弘, 草場 洋平, 宮武 和馬, 東 莞爾, 三津谷 勇磨, 稲葉 裕

    日本手外科学会雑誌   42 ( 1 )   492 - 492   2025.4

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  • A Novel Figure-Eight Taping Technique for Managing Anterior Shoulder Instability in a Recreational Pitcher: A Case Report. International journal

    Masashi Kawabata, Toru Miyata, Kazuma Miyatake

    International journal of sports physical therapy   20 ( 5 )   741 - 748   2025

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    BACKGROUND AND PURPOSE: Shoulder instability, particularly in overhead athletes, such as baseball pitchers, poses significant challenges in management, often leading to chronic pain and functional impairment. This case report describes the immediate and sustained effects of a novel figure-eight taping technique for a recreational baseball player with shoulder instability. CASE DESCRIPTION: A 41-year-old male had been unable to pitch for six years due to progressive shoulder pain, significantly impacting his daily life. The clinical examination revealed severe pain localized to the rotator cuff interval and posterior shoulder, with marked limitations in range of motion and muscle strength. Ultrasound imaging confirmed significant anterior shoulder instability, characterized by anterior subluxation of the humeral head and inflammation around Bennett's lesion. INTERVENTION AND DISCUSSION: A novel figure-eight taping technique was used to control shoulder anterior instability while maintaining functional alignment. The intervention resulted in immediate improvement in neuromuscular control and significantly reduced pain, with Numeric Rating Scale (NRS) scores improving to 1-3 out of 10. Moreover, the subject could perform painless and smooth pitching motions immediately after the intervention. Remarkably, the subject pitched from 18.44 meters at 85% intensity on the same day. Four months later, the subject successfully returned to competitive pitching, achieving a maximum pitch speed of 115 km/h with minimal pain (NRS, 3/10). The subject continued to practice independently, adhering to the rotator cuff exercises and pitching form corrections that occurred with the taping intervention. Notably, the positive effects of taping and exercises persisted even eight months after the intervention, underscoring the potential of this technique as a valuable non-invasive treatment option within conservative management strategies for shoulder anterior instability. CONCLUSION: The figure-eight taping technique demonstrated potential as an effective non-invasive option for managing anterior shoulder instability, supporting sustained pain relief and functional recovery. EVIDENCE LEVEL: 5.

    DOI： 10.26603/001c.136406

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  • 難治性上腕骨外側上顆炎に対するPercutaneous Ultrasound Tenotomyの治療成績と単純MRI画像所見の検討

    東 莞爾, 宮武 和馬, 草場 洋平, 中村 玲菜, 内藤 雅文, 三品 茉琳, 稲葉 裕

    日本肘関節学会雑誌   32 ( 1 )   S125 - S125   2025

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    Language：Japanese   Publisher：日本肘関節学会  

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  • 整形外科外来診療の工夫--診断,保存療法,外来手術 Ⅰ.総論 2.薬物療法 変形性膝関節症に対する超音波ガイド下内側側副靱帯滑液包内多血小板血漿(PRP)療法

    草場 洋平, 宮武 和馬, 東 莞爾, 内藤 雅文, 稲葉 裕

    別冊整形外科   1 ( 86 )   31 - 36   2024.10

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  • Satisfaction of patients with frozen shoulder following silent manipulation: a prospective observation study. International journal

    Kazuma Miyatake, Ryusei Wakita, Takahiro Fujisawa, Yusuke Kawabata, Yohei Kusaba, Takuma Naka, Reina Nakamura, Shinya Tsujiku, Yutaka Inaba

    Scientific reports   14 ( 1 )   22409 - 22409   2024.9

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    Silent manipulation is a procedure for frozen shoulders that involves manipulating the shoulder while the patient is awake by performing C5, C6, and C7 cervical nerve root block under ultrasound guidance. This retrospective study, conducted at Yokohama City University Hospital, aimed to evaluate the clinical outcomes of silent manipulation and assess whether the experience level of the practitioner influenced treatment efficacy. Between October 2020 and January 2022, 53 patients who met the inclusion criteria underwent silent manipulation for frozen shoulder. The procedure was performed by either an experienced or a less experienced practitioner, and the patients were followed-up for up to 1 year post-treatment. Silent manipulation resulted in significant improvements in shoulder range of motion, as measured by forward flexion, abduction, external rotation, and hand-behind-back, as well as in patient-reported outcomes, including disabilities of the arm, shoulder, and hand and Shoulder 36 scores. These improvements were observed 1 week, 3 months, and 1 year after silent manipulation, indicating the short-term efficacy of the procedure. Furthermore, this study revealed that the practitioners' level of experience played a significant role in the outcomes. The experienced doctor achieved better 1st external rotation and belt tying outcomes, as well as Shoulder 36 pain, muscle strength, and activities of daily living domain scores. This suggests that technical expertise in silent manipulation is crucial to achieve optimal outcomes. Silent manipulation offers an effective therapeutic approach for frozen shoulder, leading to significant improvements in range of motion and patient satisfaction. Practitioner expertise is a vital factor in treatment success, emphasizing the importance of skilled professionals in the performance of this procedure.

    DOI： 10.1038/s41598-024-67699-y

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  • 増大号特集 絶対! 整形外科外傷学 2章 整形外来 超音波を用いた新時代の外傷診療の現状と展望

    宮武 和馬, 草場 洋平, 都竹 伸哉, 稲葉 裕

    臨床整形外科   59 ( 5 )   542 - 548   2024.5

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    Publisher：株式会社医学書院  

    DOI： 10.11477/mf.1408202970

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  • 特集 レジデントが知るべき整形外科の画像診断 総論

    宮武 和馬, 都竹 伸哉, 川端 祐介, 藤澤 隆弘, 草場 洋平, 稲葉 裕

    関節外科 基礎と臨床   43 ( 13 )   10 - 15   2024.4

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    Publisher：メジカルビュー社  

    DOI： 10.18885/jjs.0000001751

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  • 足関節外側靱帯II度損傷患者におけるエコーガイド下前方ストレステスト時の関節不安定性は3週で軽減する.

    内田 悠登, 河端 将司, 熊澤 祐輔, 對比地 優介, 高木 一也, 宮武 和馬, 小林 匠, 渡邊 裕之, 見目 智紀, 高平 尚伸

    日本整形外科超音波学会会誌   34 ( 1 )   114 - 120   2024.3

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  • 特集 はじめたい人と極めたい人のための 超音波ガイド下インターベンション 肘への超音波ガイド下インターベンションの基礎と応用

    宮武 和馬, 藤澤 隆弘, 草場 洋平, 稲葉 裕

    臨床整形外科   59 ( 1 )   25 - 31   2024.1

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    Publisher：株式会社医学書院  

    DOI： 10.11477/mf.1408202869

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  • Safe Ultrasonography-Assisted Knee Posterior Transseptal Portal Creation Technique. International journal

    Takahiro Fujisawa, Hyonmin Choe, Kazuma Miyatake, Youhei Kusaba, Yusuke Kawabata, Kagayaki Sahara, Yutaka Inaba

    Arthroscopy techniques   12 ( 11 )   e1879-e1884   2023.11

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    Knee arthroscopy is a minimally invasive surgical technique that allows surgeons to diagnose and treat various knee conditions using much smaller incisions than open surgery. However, it is difficult to fully visualize the posterior compartment of the knee joint using the usual anterior portal approach because of blind spots. The transseptal portal technique enables surgeons to visualize the surgical field and access instruments in the posterior compartment of the knee during arthroscopic surgery. However, creation of the posterior transseptal portal increases the risk of neurovascular injury. Particular attention should be paid to avoid damaging the saphenous nerve, common peroneal nerve, popliteal artery, and tibial nerve. Here, we describe an ultrasonography-guided surgical method for creating the posterior transseptal portal by confirming the surrounding anatomy.

    DOI： 10.1016/j.eats.2023.07.001

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  • 肩疾患リハビリテーションにおける超音波の活用 凍結肩のリハビリにエコーを活用する

    河端 将司, 宮田 徹, 直井 大地, 宮武 和馬

    日本肩関節学会学術集会・日本肩の運動機能研究会学術集会抄録集   50回・20回   91 - 91   2023.9

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    Language：Japanese   Publisher：(一社)日本肩関節学会  

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  • 後果骨折を伴う足関節骨折は足関節背屈可動域と母趾背屈可動域が制限される

    芦原 光明, 河端 将司, 宮田 徹, 直井 大地, 小林 明裕, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   34回   158 - 158   2023.7

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    Language：Japanese   Publisher：日本整形外科超音波学会  

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  • 今だから言いたい!私たち裏で治してます!-最新超音波診療に対する理学療法士の本音- サイレント・マニピュレーションに対する本音 大きな声では言えない理学療法

    河端 将司, 宮田 徹, 直井 大地, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   34回   92 - 92   2023.7

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  • Application of Intraoperative CT-Ultrasound Fusion Imaging in Hip Endoscopy for Treatment of Iatrogenic Impingement Due to PLLA Screw: A Novel Surgical Technique

    Kazuma Miyatake, Hyonmin Choe, Fujisawa Takahiro, Yuusuke Kawabata, Yohei Kusaba, Yutaka Inaba

    Arthroscopy Techniques   12 ( 6 )   e801 - e805   2023.5

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    Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

    DOI： 10.1016/j.eats.2023.02.009

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  • Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients. International journal

    Hyonmin Choe, Naomi Kobayashi, Koki Abe, Yuta Hieda, Hiroyuki Ike, Ken Kumagai, Kazuma Miyatake, Takahiro Fujisawa, Yutaka Inaba

    Journal of clinical medicine   12 ( 8 )   2023.4

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    BACKGROUND: Hip resurfacing arthroplasty (HRA) patients require subsequent annual screening for postoperative complications. Ultrasonography may be useful for this purpose but lacks a screening protocol for hips. The purpose of this study was to evaluate the accuracy of ultrasonography for detecting postoperative complications in HRA patients using a screening protocol that specifically targets periprosthetic muscles. METHODS: We enrolled 45 hips from 40 HRA patients with a mean follow-up period of 8.2 years. MRI and ultrasonography scans were simultaneously conducted at follow-up. The ultrasonography assessments were conducted on the anterior part of the hip that targets iliopsoas, sartorius, rectus femoris, lateral with anterior superior and inferior iliac spine (ASIS and AIIS) as bony landmarks, and the lateral and posterior parts that target fascia tensor, short rotators, and gluteus minimus, medius, and maximus with greater trochanter and ischial tuberosity as bony landmarks. The accuracy of diagnosing postoperative abnormalities and the visibility of periprosthetic muscles were compared between these two modalities. RESULTS: Both MRI and ultrasonography detected an abnormal region in eight cases comprising two infections, two pseudotumors, and four patients with greater trochanteric bursitis. Among these cases, four hips required implant removal. The increase in anterior space, measured as the distance between the iliopsoas and resurfacing head, was a good indicator for the abnormal mass in these four HRA cases. In the assessment of periprosthetic muscles, MRI showed a much lower visibility than ultrasonography in the iliopsoas (6.7% vs. 100%), gluteus minimus (6.7% vs. 88.9%), and short rotators (8.8% vs. 71.4%) due to implant halation. CONCLUSIONS: By targeting periprosthetic muscles, ultrasonography can detect postoperative complications as effectively as MRI assessments in HRA patients. Ultrasonography has superior visibility in the periprosthetic muscles of HRA patients, indicating its utility for the screening of small legions in these cases which may not be visible by MRI.

    DOI： 10.3390/jcm12082871

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  • Dynamic sonographic diagnosis of snapping elbow associated with congenital radioulnar synostosis

    Kensuke Kameda, Kazuma Miyatake, Takahiro Fujisawa, Akio Otoshi, Yusuke Kawabata, Yohei Kusaba, Yutaka Inaba

    JSES Reviews, Reports, and Techniques   3 ( 1 )   116 - 119   2023.2

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    Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

    DOI： 10.1016/j.xrrt.2022.09.006

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  • 実践講座 リハビリテーション治療に生かすエコー 運動器リハビリテーションにおけるエコーの活用

    宮田 徹, 直井 大地, 芦原 光明, 太附 広明, 河端 将司, 宮武 和馬

    総合リハビリテーション   51 ( 1 )   67 - 72   2023.1

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    Language：Japanese   Publisher：(株)医学書院  

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  • 上肢疾患の診断と治療の進歩(新鮮外傷を除く) Ⅱ.疾患各論 1.肩関節･上腕部 2)凍結肩 凍結肩に対する診断と治療の工夫

    大歳 晃生, 藤澤 隆弘, 草場 洋平, 川端 佑介, 宮武 和馬, 稲葉 裕

    別冊整形外科   1 ( 82 )   70 - 73   2022.10

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  • 末梢神経で考える肩関節機能障害に対する評価・治療戦略

    宮武 和馬, 河端 将司, 藤澤 隆弘, 稲葉 裕

    日本肩関節学会学術集会・日本肩の運動機能研究会学術集会抄録集   49回・19回   414 - 414   2022.9

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    Language：Japanese   Publisher：(一社)日本肩関節学会  

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  • Double Level Osteotomy後の膝蓋大腿関節痛に対し内側広筋関節枝への理学療法が奏功した一例

    芦原 光明, 宮田 徹, 河端 将司, 直井 大地, 草場 洋平, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   33回   134 - 134   2022.7

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  • サイレント・マニピュレーション後の肩関節外旋後方動態と術後成績の関係

    宮田 徹, 直井 大地, 河端 将司, 芦原 光明, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   33回   113 - 113   2022.7

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  • 理学療法へのエコー活用法～1単位での使い方～ 伏在神経(膝蓋下枝)に対する理学療法

    宮田 徹, 芦原 光明, 河端 将司, 直井 大地, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   33回   73 - 73   2022.7

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  • サイレント・マニピュレーション前後の肩関節下垂位自動外旋に伴う肩前上方結合組織の経時変化

    直井 大地, 河端 将司, 宮田 徹, 芦原 光明, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   33回   112 - 112   2022.7

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  • 知っておきたい・深めたい Close-up 身体内滑走 神経の滑走

    河端 将司, 宮武 和馬, 宮田 徹

    理学療法ジャーナル   56 ( 6 )   702 - 706   2022.6

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    Language：Japanese   Publisher：(株)医学書院  

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  • Medial meniscus extrusion and stage are related to the size of spontaneous osteonecrosis of the knee in patients who underwent high tibial osteotomy

    Takahiro Fujisawa, Hyonmin Choe, Youhei Kusaba, Yusuke Kawabata, Akio Otoshi, Kazuma Miyatake, Yutaka Inaba

    The Knee   36   72 - 79   2022.6

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    Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

    DOI： 10.1016/j.knee.2022.04.011

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  • 特集 整形外科画像診断･評価の進歩 Ⅳ.エコー 1.超音波診断装置の立ち位置

    宮武 和馬, 藤澤 隆弘, 大歳 晃生, 草場 洋平, 川端 佑介, 稲葉 裕

    整形外科   73 ( 6 )   622 - 626   2022.5

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  • 軟部腫瘍と鑑別を要した筋損傷の7例における画像的特徴の検討

    斎藤 桂樹, 川端 佑介, 林田 健太, 藤田 真太朗, 荒川 裕和, 宮川 秀俊, 宮武 和馬, 竹山 昌伸, 稲葉 裕

    関東整形災害外科学会雑誌   53 ( 2 )   33 - 33   2022.4

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  • Return to sports activity after opening wedge high tibial osteotomy in patients aged 70 years and older

    Akio Otoshi, Ken Kumagai, Shunsuke Yamada, Shuntaro Nejima, Takahiro Fujisawa, Kazuma Miyatake, Yutaka Inaba

    Journal of Orthopaedic Surgery and Research   16 ( 1 )   2021.12

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    Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

    Abstract

    Background

    The purpose of this study was to evaluate return to sports (RTS) after opening wedge high tibial osteotomy (OWHTO) in elderly patients and associated factors affecting RTS.

    Methods

    Seventy-four patients (mean age 68 years) who underwent OWHTO were enrolled. Clinical outcomes were evaluated using the Knee Society Score (KSS). Patients were asked regarding types of sports activities and their levels of participation within preoperative 1 year and postoperative 1 year. Levels of participation in sports and recreational activities were examined using the Tegner activity scale. The outcomes were compared between two age groups (≥ 70 years vs. < 70 years).

    Results

    Of the 74 patients overall, 59 participated in at least one sport preoperatively, and 55 returned to sports postoperatively (RTS 93%). The KSS knee score and function score were significantly improved after surgery in both age groups (P < 0.05), but no significant differences were found between the age groups. The Tegner activity scales for ≥ 70 years and < 70 years were 2.9 ± 1.1 and 4.0 ± 1.9 preoperatively (P < 0.01) and 2.7 ± 1.2 and 3.3 ± 1.4 postoperatively (P = 0.16), respectively. RTS was reported by 24 of 25 (96.0%) in the age < 70 years group and 31 of 34 (91.2%) in the age ≥ 70 years group. Majority of age ≥ 70 years participated in low-impact sports preoperatively and returned to the same impact level postoperatively.

    Conclusions

    The rate of RTS after OWHTO was high in patients aged 70 years and older with low-impact level. OWHTO is a preferred surgical option for elderly patients who desire RTS.

    DOI： 10.1186/s13018-021-02718-6

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    Other Link： https://link.springer.com/article/10.1186/s13018-021-02718-6/fulltext.html

  • Silent Manipulation for Adhesive Capsulitis Reviewed

    Kazuma Miyatake, Takahiro Fujisawa, Akio Otoshi, Yusuke Kawabata, Yohei Kusaba, Shinya Tsujiku, Yutaka Inaba

    Current Physical Medicine and Rehabilitation Reports   2021.11

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    Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

    DOI： 10.1007/s40141-021-00332-5

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    Other Link： https://link.springer.com/article/10.1007/s40141-021-00332-5/fulltext.html

  • 【スポーツ現場における超音波診療】大腿-膝関節周囲のスポーツ外傷・障害に対する超音波を用いたアプローチ

    宮田 徹, 河端 将司, 宮武 和馬

    臨床スポーツ医学   38 ( 11 )   1238 - 1242   2021.11

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    Language：Japanese   Publisher：(株)文光堂  

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  • 【スポーツ現場における超音波診療】上腕-肘関節周囲のスポーツ外傷・障害に対する超音波を用いたアプローチ

    河端 将司, 宮田 徹, 宮武 和馬

    臨床スポーツ医学   38 ( 11 )   1192 - 1197   2021.11

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  • 【スポーツ現場における超音波診療】上腕-肘関節周囲のスポーツ外傷・障害に対する超音波を用いたアプローチ

    河端 将司, 宮田 徹, 宮武 和馬

    臨床スポーツ医学   38 ( 11 )   1192 - 1197   2021.11

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  • 【スポーツ現場における超音波診療】大腿-膝関節周囲のスポーツ外傷・障害に対する超音波を用いたアプローチ

    宮田 徹, 河端 将司, 宮武 和馬

    臨床スポーツ医学   38 ( 11 )   1238 - 1242   2021.11

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  • 特集 運動器エコーのエキスパートを目指そう 筋･腱のエコー

    宮武 和馬, 藤澤 隆弘, 大歳 晃生, 草場 洋平, 川端 佑介, 稲葉 裕

    関節外科 基礎と臨床   40 ( 14 )   8 - 15   2021.10

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    Publisher：メジカルビュー社  

    DOI： 10.18885/jjs.0000000771

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  • Ultrasonographic prevalence of ulnar nerve displacement at the elbow in young baseball players International journal

    Masashi Kawabata, Toru Miyata, Hiroaki Tatsuki, Daichi Naoi, Mitsuaki Ashihara, Kazuma Miyatake, Yohei Kusaba, Daiki Watanabe, Masashi Matsuzaki, Yuta Suzuki, Kentaro Kamiya

    PM&R   2021.7

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    BACKGROUND: Overhead-throwing athletes are at risk of elbow injury because of valgus stress, leading to unstable ulnar nerves and neuropathy. Studies regarding ulnar nerve damage/displacement have been performed primarily in adults. OBJECTIVE: To determine the prevalence and related factors associated with ulnar nerve displacement at the elbow in young baseball players. DESIGN: Cross-sectional study. PARTICIPANTS: Youth baseball players ages 10-12 years were eligible to participate. Exclusion criteria were history of neuropathic pain, trauma, or prior surgery of the upper limb. Fifty-seven participants were eligible for inclusion in the study. MAIN OUTCOME MEASUREMENTS: Demographic data and ultrasonography findings of ulnar nerve dynamics at the cubital tunnel were analyzed in a total of 114 elbows. Elbows were grouped into nondislocation and displacement (subluxation or dislocation) groups according to ultrasound findings. Logistic generalized estimating equations were used to identify factors associated with ulnar nerve displacement. RESULTS: Thirty-six (31.6%) elbows demonstrated sonographic findings of ulnar nerve displacement, with 13 (11.4%) subluxations and 23 (20.2%) dislocations. Fourteen (24.6%) participants experienced nerve displacement in the dominant elbow only, whereas nerve displacement in both elbows occurred in 11 (19.3%) participants. Nerve displacement in the nondominant elbow only was not observed. Hand dominance and tenderness of the arcade of Struthers' were factors associated with ulnar nerve displacement (odds ratio, 2.81, and 9.73; 95% confidence interval, 1.34-5.91 and 2.45-38.68; p = .006 and .001, respectively). CONCLUSION: One-third of the young baseball players evaluated had ultrasonographic findings compatible with ulnar nerve displacement at the elbow. Hand dominance and tenderness of Struthers arcade were the only factors associated with ulnar nerve displacement. Ultrasound may help identify patients with ulnar nerve displacement and contribute to the understanding of its pathophysiology in young baseball players.

    DOI： 10.1002/pmrj.12658

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    Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/pmrj.12658

  • 肩関節下垂位外旋における肩前上方結合組織の形態変化に関する視覚的評価

    直井 大地, 河端 将司, 宮田 徹, 芦原 光明, 宮武 和馬, 草場 洋平

    日本整形外科超音波学会学術集会プログラム・抄録集   32回   150 - 150   2021.7

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  • サッカー選手における足関節捻挫の既往と距腿関節動態の関連性

    宮田 徹, 芦原 光明, 河端 将司, 直井 大地, 草場 洋平, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   32回   122 - 122   2021.7

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  • 少年野球選手の尺骨神経脱臼の出現頻度とリスク因子に関する横断的調査

    河端 将司, 宮田 徹, 直井 大地, 芦原 光明, 草場 洋平, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   32回   123 - 123   2021.7

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  • 足関節荷重下背屈運動における距腿関節後方動態の検者内・検者間信頼性の検討

    芦原 光明, 宮田 徹, 河端 将司, 直井 大地, 草場 洋平, 宮武 和馬

    日本整形外科超音波学会学術集会プログラム・抄録集   32回   140 - 140   2021.7

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  • よくある痛みの超音波診療の実際 膝前面痛に対する超音波診療 PTの場合

    河端 将司, 宮田 徹, 宮武 和馬

    超音波医学   48 ( Suppl. )   S462 - S462   2021.4

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  • 運動器エコー普及の背景と将来の展望 SMAP(Sonography for MSK Activating Project)設立の経緯と今後の展望

    笹原 潤, 宮武 和馬

    超音波医学   48 ( Suppl. )   S456 - S456   2021.4

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  • アスリートの難治性疼痛外来からみえたもの 上肢機能障害を末梢神経の「線」で捉えるミカタ

    河端 将司, 宮田 徹, 宮武 和馬

    Journal of Athletic Rehabilitation   17 ( 1 )   30 - 30   2021.2

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    Language：Japanese   Publisher：スポーツ選手のためのリハビリテーション研究会  

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  • US-guided Intervention for Neck Pain and Low Back Pain

    Miyatake Kazuma, Fujisawa Takahiro, Otoshi Akio, Kawabata Yusuke, Kusaba Yohei, Inaba Yutaka

    Japanese Journal of Orthopaedic Sports Medicine   41 ( 3 )   180 - 185   2021

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    Language：Japanese   Publisher：Japanese Orthopaedic Socety for Sports Medicine  

    DOI： 10.34473/jossm.41.3_180

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  • Sclerostin inhibits interleukin-1β-induced late stage chondrogenic differentiation through downregulation of Wnt/β-catenin signaling pathway. Reviewed International journal

    Kazuma Miyatake, Ken Kumagai, Sosuke Imai, Yasuteru Yamaguchi, Yutaka Inaba

    PloS one   15 ( 9 )   e0239651   2020

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    Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

    It is known that Wnt/β-catenin signaling induces endochondral ossification and plays a significant role in the pathophysiology of osteoarthritis (OA). Sclerostin is a potent inhibitor of the Wnt/β-catenin signaling pathway. This study investigated the role of sclerostin in the endochondral differentiation under an OA-like condition induced by proinflammatory cytokines. ATDC5 cells were used to investigate chondrogenic differentiation and terminal calcification, and 10 ng/ml IL-1β and/or 200 ng/ml sclerostin were added to the culture medium. IL-1β impaired early chondrogenesis from undifferentiated state into proliferative chondrocytes, and it was not altered by sclerostin. IL-1β induced progression of chondrogenic differentiation in the late stage and promoted terminal calcification. These processes were inhibited by sclerostin and chondrogenic phenotype was restored. In addition, sclerostin restored IL-1β-induced upregulation of Wnt/β-catenin signaling in the late stage. This study provides insights into the possible role of sclerostin in the chondrogenic differentiation under the IL-1β-induced OA-like environment. Suppression of Wnt signaling by an antagonist may play a key role in the maintenance of articular homeostasis and has a potential to prevent the progression of OA. Thus, sclerostin is a candidate treatment option for OA.

    DOI： 10.1371/journal.pone.0239651

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  • Platelet-Rich Plasma Promotes Migration, Proliferation, and the Gene Expression of Scleraxis and Vascular Endothelial Growth Factor in Paratenon-Derived Cells In Vitro

    Sosuke Imai, Ken Kumagai, Yasuteru Yamaguchi, Kazuma Miyatake, Tomoyuki Saito

    Sports Health   11 ( 2 )   142 - 148   2019.3

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications Inc.  

    DOI： 10.1177/1941738118807479

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  • Sclerostin is upregulated in the early stage of chondrogenic differentiation, but not required in endochondral ossification in vitro. International journal

    Yasuteru Yamaguchi, Ken Kumagai, Sosuke Imai, Kazuma Miyatake, Tomoyuki Saito

    PloS one   13 ( 8 )   e0201839   2018

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    Sclerostin is a potent inhibitor of the canonical Wnt signaling pathway. Wnt signaling pathways have multiple roles in the regulation of cartilage development, growth, and maintenance. This study focused on the role of sclerostin in the process of chondrogenic differentiation. We hypothesized that sclerostin is essential to induce chondrogenic differentiation and regulate endochondral ossification. ATDC5 cells were used to investigate chondrogenic differentiation and terminal calcification. During chondrogenic differentiation, intrinsic sclerostin was upregulated in the early stage, but downregulated in the late stage. Addition of sclerostin elevated expressions of Sox9 and Col2a1 (P<0.05) and reduced expressions of Runx2, Col10a1, MMP-3, MMP-13, and ADAMTS5 (P<0.05) through inhibition of the Wnt-β-catenin signaling pathway (P<0.05). Terminal calcification was significantly inhibited by sclerostin (P<0.05). In contrast, deletion of sclerostin decreased expressions of Sox9 and Col2a1 (P<0.05), increased expressions of Runx2, Col10a1, MMP-3, and MMP-13 (P<0.05), and promoted terminal calcification (P<0.05). This study provides insights into the possible role of sclerostin in the regulation of chondrogenic differentiation. Sclerostin is upregulated in the early stage of chondrogenic differentiation, but is not required in endochondral ossification. Sclerostin is a candidate modulator for chondrogenic differentiation.

    DOI： 10.1371/journal.pone.0201839

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  • Effect of Low-Intensity Pulsed Ultrasound (LIPUS) on Endochondral Ossification via the Wnt Signaling Pathway. International journal

    Ken Kumagai, Yasuteru Yamaguchi, Kazuma Miyatake, Hironori Tanabe, Sosuke Imai, Tomoyuki Saito

    Journal of orthopaedic trauma   31 ( 7 )   S4-S5   2017.7

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    OBJECTIVE: We have previously demonstrated that LIPUS stimulates endochondral ossification with decreased expression of sclerostin. The Wnt signaling pathway was examined in vitro to further address the effect of LIPUS on endochondral ossification. MATERIALS AND METHODS: ATDC5 cells were plated at an initial density of 6 × 10 cells/well in a 6-multiwell plate and cultured in the presence of 5% FBS plus ITS. The bottom of the culture plate was treated every day with LIPUS for 20 minutes. The level of calcification and the expression of Wnt signaling were investigated. RESULTS: The area of calcified nodules in the LIPUS-treated group was significantly greater than in the control group. The expression of Wnt was significantly elevated by LIPUS exposure. Markers associated with endochondral ossification were increased in the LIPUS-treated group. When sclerostin was added to the culture media, calcified nodule formation and the expression of Wnt were inhibited in both the LIPUS-treated group and the control group. DISCUSSION: This study suggests that endochondral ossification was stimulated by LIPUS via the Wnt signaling pathway.

    DOI： 10.1097/01.bot.0000520898.92470.94

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Presentations

  • 私のエコー活用法 肘・肩関節痛診療でのエコー活用法

    宮武 和馬, 藤澤 隆弘, 大歳 晃生, 川端 佑介, 草場 洋平, 稲葉 裕

    日本整形外科学会学術集会  2021 

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    Event date： 2021.3

    Presentation type：Symposium, workshop panel (nominated)  

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Research Projects

  • ラットの坐骨神経癒着モデルを用いた 超音波ガイド下神経剥離術の薬剤選定

    Grant number：22K16745  2022.4 - 2026.3

    日本学術振興会  科学研究費助成事業  若手研究

    宮武 和馬

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    Grant amount：\4550000 （ Direct Cost: \3500000 、 Indirect Cost：\1050000 ）

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