臨床整形外科50巻8号

2015年08月発行

症例報告

初回人工膝関節全置換術後感染に対して二期的再置換を目指すも反復性脱臼に難渋した1例

著者： 津田晃佑¹ 原口圭司¹ 小柳淳一朗¹ 金政孝¹ 小川剛¹ 藤原達司¹ 藤原桂樹¹

所属機関： ¹大阪府立急性期・総合医療センター整形外科

ページ範囲：P.827 - P.831

　初回人工膝関節全置換術後感染で，人工関節抜去，抗生剤含有セメントスペーサー(以下スペーサー)留置により二期的再置換を目指したが，スペーサーの反復性脱臼に陥ったため，リング式創外固定器を併用しながら再置換術を施行した．スペーサー留置により，局所での抗生剤の徐放効果を期待できるとともに側副靱帯の緊張を保つことが可能となる一方で，骨面とスペーサー面が適合せずに亜脱臼や脱臼，進行性の骨破壊などが手技上の注意点として挙げられており，スペーサーの反復性脱臼は難渋する合併症の1つであると考えられた．

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