臨床整形外科48巻3号

2013年03月発行

臨床経験

人工膝関節置換術における大腿骨頭中心マーキングの重要性―大腿骨コンポーネントの冠状面アライメントの正確性に関する検討

著者： 杉森端三¹ 北村憲司¹ 兼氏歩¹ 松本忠美¹

所属機関： ¹金沢医科大学整形外科

ページ範囲：P.301 - P.307

　背景：人工膝関節置換術(TKA)では，コンポーネントを正確なアライメントで設置することが重要であるが，大腿骨コンポーネントを冠状面において機能軸に対し垂直に設置することは容易ではない．

　対象と方法：TKAにおいて大腿骨頭中心をマーキングせずにガイドのみを使用して大腿骨遠位骨切りを行った30例，骨頭中心をマーキングして骨切りを行った30例，ナビゲーションを用いた30例それぞれについて，大腿骨コンポーネントの冠状面設置角度を調査した．

　結果：非マーカー群で87.9±3.7°，マーカー群で89.6±1.0°，ナビ群で90.1±1.3°であり，マーカー群とナビ群では機能軸にほぼ垂直な角度で設置されていた．

　まとめ：TKAにおいては骨頭中心のマーキングは正確なアライメントを獲得するために推奨される方法である．

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