変形性膝関節症における人工膝関節全置換術前後の3次元歩行解析―片側置換術前後の比較

Three-dimensional Gait Analysis of Patients Before and After Unilateral Total Knee Arthroplasty for Bilateral Knee Osteoarthritis

　背景：両側の変形性膝関節症に対して片側の人工膝関節置換術(TKA)を行った症例の術前後における歩行の3次元動作解析を行い，非手術側の術前の日本整形外科学会膝疾患治療成績判定基準(JOAスコア)が術後の歩行に与える影響について検討した．

　対象と方法：症例は26例，手術時年齢は平均74歳であった．

　結果：術前の非手術側のJOAスコアが60点以上の群では，術後は術前と比べて歩行における様々な因子が改善したが，60点未満の群ではこれらの改善はほとんど認めなかった．

　まとめ：本手術による歩行因子の改善は，非手術側の術前のJOAスコアに大きく影響を受ける可能性が示唆された．

　Background：The purpose of this study was to compare the three-dimensional gait analysis data of patients with bilateral knee osteoarthritis who had undergone unilateral total knee arthroplasty (TKA);the analysis was performed before and after the surgery.

　Methods：There were 26 subjects of this study, and their mean age at the time of surgery was 74 years old.　The analysis was performed using a VICON 370 and ground force measurement system.

　Results：Various gait parameters improved as a result of TKA in the patients who had a preoperative JOA score of 60 points or more on the unoperated side.　On the other hand, there was no improvement in the gait parameters of the patients with severe OA on the unoperated side (preoperative JOA score below 60 points).

　Conclusion：We concluded that improvement in gait after TKA is largely affected by the preoperative JOA score.