臨床整形外科49巻7号

2014年07月発行

論述

セメントレス人工膝関節置換術後のweekly PTH療法は，bone ingrowthを促進させる

著者： 金子卓男¹ 大谷崇裕¹ 河野紀彦¹ 望月雄大¹ 南郷脩史² 池上博泰¹ 武者芳朗¹

所属機関： ¹東邦大学医学部整形外科学講座（大橋） ²ラトックシステムエンジニアリング

ページ範囲：P.583 - P.590

　背景：今研究ではセメントレス人工膝関節置換術(TKA)術後に，副甲状腺ホルモン製剤(weekly PTH.1-34，56.5μg)療法により人工関節と海綿骨間においてbone ingrowthを促進させるかを検討した．

　対象と方法：セメントレスTKAを施行した20膝に対し，術直後，3，6，9カ月にmulti detector-row CT(以下：MDCT)を撮像し，3D骨形態計測ソフトウェアで海綿骨骨梁構造を3次元的に可視化し骨石灰化度を測定した．Weekly PTH使用群(A群)10膝，非使用群(B群)10膝に分け，経時的に6つのregion of interest(以下，ROI)部位でBMC/TV値(体積あたりの骨石灰化度)，BV/TV値(体積あたりの骨梁の量)を測定し2群間で比較検討した．

　結果：術後，3，6，9カ月の脛骨コンポーネント，ペグ直下の内側部位で，B群よりA群で有意にBMC/TV値の増加を認めた．

　まとめ：セメントレスTKA術後のweekly PTH療法により骨成長を促進できた．

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