変形性膝関節症における3次元関節運動解析について

Three-dimensional Kinematics and Kinetics in Osteoarthritis of the Knee

はじめに

　変形性膝関節症（膝OA）に対する手術術式には，関節を温存し下肢アライメントを矯正する脛骨骨切り術と金属インプラントで関節表面を置換する人工膝関節置換術（Total knee arthroplasty：TKA）がある．両者とも，手術器具や術式の改良等により，術後成績は向上してきているが，近年，さらなる成績向上を目指し，生体内3次元関節運動解析による術前・術後評価が行われている．本稿では，これらの術式に対し，我々が現在取り組んでいる3次元関節運動解析について述べる．

Abstract : For surgical treatment of osteoarthritis of the knee, proximal tibial osteotomy with native joint preservation to correct varus alignment of the lower limb or total knee arthroplasty with a metal prosthesis are most often performed. In the last decade, the clinical results of those surgical techniques have been significantly improved due to new developments in the surgical devices used and a change for the better in surgical technique. Furthermore, pre- and postoperative assessment using the analysis of three-dimensional in vivo kinematics and kinetics has recently been added to the treatment mix in order to improve those outcomes even more. In this article, we describe the gait analysis results before and after proximal tibial osteotomy with hemical-lotasis for the varus deformity in medial osteoarthritis of the knee, and the postoperative three-dimensional in vivo kinematics during weight-bearing kneeling in a mobile-bearing high-flexion knee arthroplasty design.