リウマチ膝に対する後十字靱帯温存型人工膝関節の術後可動域について―深屈曲獲得群，非獲得群における比較

Range of Motion of Rheumatoid Knees Treated with a Posterior Cruciate-retaining Total Knee Arthroplasty (CR-TKA).

　リウマチ膝に対する深屈曲対応後十字靱帯温存型膝人工関節置換術(20膝)の術後可動域に影響を与える因子について検討した．術前後の屈曲角度は相関していたが，深屈曲が獲得できたのは6膝(30％)のみであった．これらと非獲得群(14膝)との間における，罹病期間，大腿下腿周径，body mass index，CRP値，コンポーネント設置角度などに差を認めなかった．また術後キネマティクスは正常膝パターンと異なるものであったが，深屈曲獲得群，非獲得群における差は認めなかった．深屈曲獲得のためには，術前の屈曲角度が重要と考えられた．

　We investigated factors affecting the range of motion of rheumatoid knees treated with flexion-enhanced posterior cruciate-retaining total knee arthroplasty (CR-TKA).　Although the maximal flexion angles before and after CR-TKA were correlated, deep flexion was achieved in 6 knees (30% of the cases), and no other clinical factors or component alignments affected the range of motion.　In the kinematic study, postoperative knees showed different patterns from those previously reported in normal knees.　However, no statistical differences were confirmed in the kinematic patterns between patients who achieved deep flexion and those who did not.　It appears that preoperative flexion angles play a critical role in enhancing postoperative flexion performance.