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習慣性膝蓋骨脱臼を合併した変形性膝関節症に対して人工膝関節置換術を施行した症例を報告した.68歳の女性で,主訴は右膝関節痛で,膝90°以上で膝蓋骨は外側へ脱臼した.単純X線像において変形性関節症変化と膝蓋骨の外側への亜脱臼を認めた.手術は人工膝関節置換術を施行した.手術時の工夫点として大腿前面の骨切り術は可及的に後方で行い,さらに大腿骨コンポーネントの外旋,外側設置,脛骨コンポーネントの外旋設置,膝蓋コンポーネントの内側設置によって膝蓋骨のトラッキングの改善を図った.術後1年経過時,膝蓋骨脱臼はみられない.
We report the case of 68-year-old woman with osteoarthritis of the knee and habitual dislocation of the patella. Dislocation of the patella occurred ever the right knee was extended more than 90°. Plain preoprerative radiographs demonstrated osteoarthritis and lateral subluxation of the patella. We treated the osteoarthritis and subluxation by total knee arthroplasty (TKA) and attempted to improve of tracking of the patella by cutting the anterior aspect of the femur as far posteriorly as possible, positioning the femoral component laterally, the tibial component in external rotation, and the patellar component medially. Dislocation of the patella was not observed at the 12-month follow-up examination.
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