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Rinsho Seikei Geka Volume 39, Issue 11 （November 2004）

臨床整形外科 39巻11号（2004年11月発行）

Japanese English

論述

高齢女性の変形性膝関節症患者に対する足関節固定付き足底板の臨床的効果 Clinical Efficacy of Insole with Ankle Strapping for Osteoarthritis of the Knee in Older Women 戸田佳孝 ¹ , 月村規子 ¹ Yoshitaka Toda ¹ , Noriko Tsukimura ¹ ¹貴晶会戸田整形外科リウマチ科クリニック ¹Toda Orthopedic Rheumatology Clinic キーワード： osteoarthritis , 変形性関節症 , knee , 膝 , insole , 足底挿板 Keyword: osteoarthritis , 変形性関節症 , knee , 膝 , insole , 足底挿板 pp.1397-1402

発行日 2004年11月1日 Published Date 2004/11/1

DOI https://doi.org/10.11477/mf.1408100570

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　抄録：過去のわれわれの研究では，平均年齢65歳の女性変形性膝関節症（膝OA）患者に対する足関節固定付き足底板（新型足底板）は従来の靴の中敷き型足底挿板に比べて，大腿けい骨角（FTA）の外反矯正度も臨床症状の改善度も有意に優れていた．しかし，新型足底板が高齢者にも適応があるか否かは不明であった．今回は70歳以上の高齢女性膝OA患者を対象に調査を行った．74例の膝OA患者を対象に誕生日が奇数の者（n＝39）には新型足底板を，偶数日の者（n＝35）には靴中敷き足底挿板を8週間装着させた．足底板装着前後での患側片脚立位FTAの変化は，新型足底板群では中敷き型足底挿板群に比べて有意に高い外反矯正角度を示した（p＜0.0001）．治療前後でのLequesneの重症度指数の変化も新型足底板群では中敷き足底挿板群に比べて有意に改善した（p＝0.031）．新型足底板群で転倒による骨折や捻挫を受傷した者は皆無であった．以上の結果より，高齢女性膝OA患者に対しても新型足底板は効果のある保存的療法である．

　We previously reported that insoles with ankle strapping lead to valgus realignment of the femorotibial angle and clinical improvement osteoarthritis of the knee (knee OA) with varus deformity in patients with a mean age of 65 of years. In a follow-up study we assessed the efficacy of insoles with ankle strapping for knee OA in women over 70 years of age.

　The efficacy of novel insoles with elastic ankle strapping and traditional shoe-insert wedged insoles was compared. Seventy-four new female knee OA subjects over 70 years of age were treated with wedged insoles for eight weeks. Randomization was performed according to birth date. Standing radiographs during unilateral insole use were used to analyze the femorotibial angles of each subject with and without their respective insole in place. The remission scores according to the Lequesne index for severity of knee OA were compared between the two groups at the conclusion of the study.

　The strapping-insole group (n＝39) showed a greater valgus correction of the femorotibial angle than the inserted-insole group (n＝35), and the difference was statistically significant (p＜0.0001). The remission score had also significantly improved in the strapping insole group compared to the inserted insole group (p＝0.031).

　These results suggest that the insoles with a ankle strap led to valgus correction of the femorotibial angle in patients over 70 years of age with varus knee OA, indicating clinical improvement.