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Posterior-Stabilized型人工膝関節置換術における内側側副靱帯の解離が脛骨内旋動態に与える影響 : 未固定遺体を用いた検討
Posterior-Stabilized型人工膝関節置換術において内側側副靭帯の解離が腔骨内旋運動に及ぼす影響の検討 : 未固定遺体を用いた研究
著者
和田, 佳三 徳島大学大学院医科学教育部(医学専攻) 徳島大学 教育研究者総覧
東野, 恒作 The University of Tokushima KAKEN研究者をさがす
キーワード
navigation system
total knee arthroplasty
rotational kinematics
medial collateral ligament
multiple needle puncturing
資料タイプ
学位論文
抄録
Background: Previous studies suggested that changes in kinematics in total knee arthroplasty (TKA) affected satisfaction level. The aim of this cadaveric study was to evaluate the effect of medial collateral ligament (MCL) release by multiple needle puncture on knee rotational kinematics in posterior-stabilized TKA.
Methods: Six fresh, frozen cadaveric knees were included in this study. All TKA procedures were performed with an image-free navigation system using a 10-mm polyethylene insert. Tibial internal rotation was assessed to evaluate intraoperative knee kinematics. Multiple needle puncturing was performed 5,10, and 15 times for the hard portion of the MCL at 90° knee flexion. Kinematic analysis was performed after every 5 punctures. After performing 15 punctures, a 14-mm polyethylene insert was inserted, and kinematic analysis was performed.
Results: The tibial internal rotation angle at maximum knee flexion without multiple needle puncturing was significantly larger (9.42°) than that after 15 punctures (3°). Negative correlation (Pearson r.=0.715, P < .001) between tibial internal rotation angle at maximum knee flexion and frequency of puncture was observed. The tibial internal rotation angle with a 14-mm insert was significantly larger (7.25°) compared with the angle after 15 punctures.
Conclusion: Tibial internal rotation during knee flexion was reduced by extensive MCL release using multiple needle puncturing and was recovered by increasing of medial tightness. From the point of view of knee kinematics, medial tightness should be allowed to maintain the internal rotation angle of the tibia during knee flexion which might lead to patient satisfaction.
掲載誌名
The Journal of Arthroplasty
ISSN
08835403
cat書誌ID
AA10691730
AA11542270
出版者
Elsevier
32
1
開始ページ
270
終了ページ
273
発行日
2016-06-22
備考
内容要旨・審査要旨・論文本文の公開
本論文は, 著者Keizo Wadaの学位論文として提出され, 学位審査・授与の対象となっている。
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3218号
学位記番号
甲医第1386号
学位授与年月日
2018-09-27
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系