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ID 116362
タイトル別表記
両十字靭帯温存型人工膝関節における外側弛緩性の不足が膝屈曲時のキネマティクスに影響を及ぼす
著者
髙砂, 智哉 徳島大学大学院医科学教育部(医学専攻)
Nitta, Akihiro Tokushima University
キーワード
bicruciate-retaining total knee arthroplasty
joint laxity
anterior cruciate ligament
computer navigation system
biomechanical cadaveric study
資料タイプ
学位論文
抄録
Background: Soft tissue balancing in bicruciate-retaining (BCR) total knee arthroplasty (TKA) is a challenge that must be overcome to achieve excellent clinical outcomes. However, the optimal degree of joint laxity has yet to be clarified. This cadaveric study sought to examine joint laxity after BCR TKA using a navigation system.
Methods: Knee joint laxity was quantified using an image-free navigation system in 8 intact fresh frozen cadavers under three conditions: the native knee, BCR TKA knee, and BCR TKA knee after anterior cruciate ligament resection. Rotational kinematics in the BCR TKA knee during flexion were compared according to whether joint laxity was increased or decreased.
Results: Knee joint laxity after BCR TKA under varus-valgus movement, anterior translation, and internal-external rotation loadings was similar to that of the native knee. However, lateral joint laxity was decreased during flexion in some cases. BCR TKA-treated knees with decreased lateral joint laxity at 90° of flexion demonstrated more limited tibial internal rotation in deep flexion than the native knee (p < 0.05). The loss of internal rotation in deep flexion was partly recovered by using a lateral insert with a posterior slope of +3°.
Conclusions: Restoring optimal joint laxity was not always straightforward in BCR TKA if the 4 ligaments were preserved. Lateral joint laxity was potentially decreased in BCR TKA and may result in kinematic conflict during flexion. Surgeons should be aware of the need to achieve sufficient lateral joint laxity in this type of BCR TKA.
掲載誌名
The Knee
ISSN
09680160
cat書誌ID
AA10996272
AA11534443
出版者
Elsevier
28
開始ページ
311
終了ページ
318
発行日
2021-01-18
備考
内容要旨・審査要旨・論文本文の公開
本論文は,著者Tomoya Takasago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。
権利情報
© 2021 Elsevier B.V. All rights reserved.
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3536号
学位記番号
甲医第1503号
学位授与年月日
2021-09-09
学位名
博士(医学)
学位授与機関
徳島大学
部局
医学系
病院