関節リウマチの強直膝に対する人工膝関節置換術後長期経過観察した2例

Long-Term Follow-up of Total Knee Arthroplasty for Knees Ankylosed by Rheumatoid Arthritis. Report of Two Cases

　関節リウマチの強直膝に施行したTKAの比較的長期経過を観察した2例について報告する．症例1：年齢が47歳で周囲の関節に可動域制限が少ないclassⅢの女性は，TKA術後14年時伸展-5°，屈曲105°で，JOAスコアは88点であった．症例2：年齢が65歳で周囲の関節に可動域制限を生じたclassⅣの女性は，術後9年8カ月において，伸展-15°，屈曲50°，JOAスコアは53点であった．強直膝に対するTKAの術後長期成績には，年齢，classおよび周囲の関節の病態が影響すると考えられた．

　We report two cases of total knee arthroplasty and long-term follow-up for ankylosis of the knee in rheumatoid arthritis patients. Case 1：A 47-year-old woman with class Ⅲ had minor restriction of the range of motion of the adjacent joints. Fourteen years after total knee arthroplasty, the range of motion of the operated knee was-5 degrees of extension and 105 degrees of flexion, and the JOA score was 88 points. Case 2：A 65-year-old woman with class Ⅳ had severe restriction of the range of motion of the adjacent joints. Nine years eight months after total knee arthroplasty, the range of motion of the operated knee was-15 degrees of extension and 50 degrees of flexion, and the JOA score was 53 points. Conclusion：It was concluded that the results of long-term follow-up after total knee arthroplasty for the ankylosed knee were affected by age, class, and degree of restriction of range of motion in the adjacent joints.