臨床整形外科51巻2号

2016年02月発行

誌上シンポジウム MISの功罪

人工膝関節置換術におけるMISの功罪

著者： 松本知之¹ 高山孝治¹ 黒田良祐¹ 黒坂昌弘¹

所属機関： ¹神戸大学大学院医学系研究科整形外科学

ページ範囲：P.117 - P.122

　Minimally invasive surgery(MIS)の概念が人工膝関節全置換術(TKA)に導入されて10年以上経過し，その適応の是非が論じられてきた．TKAにおいて，正確な骨切り・インプラント設置による下肢アライメントの再現，適切な軟部組織バランスの獲得が良好な術後成績に重要である．MIS-TKAにおいてもこれら2つのessential partが担保可能か否かが議論の中心となっており，真のMIS-TKAであるquadriceps sparing approachは淘汰されることとなった．現時点では無理のない広義のMIS-TKAが主体となっており，その普及・定着のためには従来型TKAを凌駕する優位性を見極める必要がある．

参考文献

1　）Alcelik I, Sukeik M, Pollock M, et al:Comparison of the minimally invasive and standard medial parapatellar approaches for primary total knee arthroplasty. Kee Surg Sports Traumatol Arthrosc 20:2502-2512, 2012

2　）Barrack RL, Barnes CL, Burnett RS, et al:Minimal incision surgery as a risk factor for early failure of total knee arthroplasty. J Arthroplasty 24:490-498, 2009

3　）Cheng T, Liu T, Zhang G, et al:Does minimally invasive surgery improve short-term recovery in total knee arthroplasty? Clin Orthop Relat Res 468:1635-1648, 2010

4　）Chin PL, Foo LS, Yang KY, et al:Randomized controlled trial comparing the radiologic outcomes of conventional and minimally invasive techniques for total knee arthroplasty. J Arthroplasty 22:800, 2007

5　）Dalury DF, Dennis DA:Mini-incision total knee arthroplasty can increase risk of component malalignment. Clin Orthop Relat Res 440:77-81, 2005

6　）Fehring TK, Odum S, Griffin WL, et al:Early failures in total knee arthroplasty. Clin Orthop Relat Res 392:315-318, 2001

7　）Insall JN, Tria AJ, Scott WN:The total condylar knee prosthesis:the first 5 years. Clin Orthop Relat Res 145:68-77, 1979

8　）Jeffery RS, Morris RW, Denham RA:Coronal alignment after total knee replacement. J Bone Joint Surg Br 73:709-714, 1991

9　）Khanna A, Gougoulias N, Longo UG, et al:Minimally invasive total knee arthroplasty;a systemic review. Orthop Clin North Am 10:479-489, 2009

10　）Leopold SS:Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med 23:1749-1758, 2009

11　）Li C, Zeng Y, Shen B, et al:A meta-analysis of minimally invasive and conventional medial parapatella approaches for primary total knee arthroplasty. Kee Surg Sports Traumatol Arthrosc 23:1971-1985, 2015

12　）Lin SY, Chen CH, Fu YC, et al:Comparison of the clinical and radiological outcomes of three minimally invasive techniques for total knee replacement at two years. Bone Joint J 95:906-910, 2013

13　）村津裕嗣，松井允三，吉矢晋一・他：人工膝関節置換術の軟部組織バランサー．整・災外47：145-151，2004

14　）Matsumoto T, Kuroda R, Kudo S, et al:The intra-operative joint gap in cruciate-retaining comparing with posterior-stabilized total knee replacement. J Bone Joint Surg Br 91:475-480, 2009

15　）Matsumoto T, Muratsu H, Tsumura N, et al:Joint gap kinematics in posterior-stabilized total knee arthroplasty measured by a new tensor with the navigation system. J Biomech Eng 128:867-871, 2006

16　）Matsumoto T, Muratsu H, Kubo S, et al:Soft tissue balance measurement in minimal incision surgery compared to conventional total knee arthroplasty. Kee Surg Sports Traumatol Arthrosc 19:880-886, 2011

17　）Niki Y, Takeda Y, Kanagawa H, et al:Effects of four different surgical approaches on intra-operative joint gap in posterior-stabilized total knee arthroplasty. Kee Surg Sports Traumatol Arthrosc 20:2026-2031, 2011

18　）Oka S, Muratsu H, Matsumoto T, et al:The influence of patellar position on soft tissue balance in minimal incision total knee arthroplasty. Kee Surg Sports Traumatol Arthrosc 20:1064-1068, 2012

19　）Pagnano MW, Meneghini RM, Trousdale RT:Anatomy of the extensor mechanism in reference to quadriceps-sparing TKA. Clin Orthop Relat Res 452:102-105, 2006

20　）Paxton EW, Furnes O, Namba RS, et al:Comparison of the Norwegian knee arthroplasty register and a United States arthroplasty registry. J Bone Joint Surg Am 93〔Supple 3(E)〕:20-30, 2011

21　）Smith TO, King JJ, Hing CB, et al:A meta-analysis of randomized controlled trials comparing the clinical and radiological outcomes following minimally invasive to conventional exposure for total knee arthroplasty. Knee 19(1):1-7, 2012

22　）Tria AJ Jr, Coon TM:Quadriceps sparing total knee arthroplasty. Semin Arthroplasty 16:208-214, 2005

23　）Watanabe N, Narita W, Namura T, et al:Anatomical assessment of the vastus medialis oblique muscle in patients with osteoarthritis of the knee. J Arthroplasty 23:287-297, 2008