臨床整形外科52巻11号

2017年11月発行

症例報告

人工膝関節全置換術においてCustom Cutting Guideを併用する利点はあるか？

著者： 石井克尚¹ 河野紀彦¹ 望月雄大¹ 羽田勝¹ 池上博泰¹ 武者芳朗¹ 金子卓男¹

所属機関： ¹東邦大学医学部整形外科学講座

ページ範囲：P.1085 - P.1089

　Custom cutting guide(以下，CCG)を併用した人工膝関節全置換術(以下，TKA)は，conventional TKAと比べ臨床成績は改善しないとの報告がある．しかし，重度関節外変形，骨内異物残存や重度内反変形に対し，CCGを併用することで最小侵襲かつ，骨内異物を干渉することなくTKA施行が可能であった症例を経験したので，文献的考察を含め報告する．

参考文献

1）Lombardi AV Jr, Berend KR, Adams JB. Patient-specific approach in total knee arthroplasty. Orthopedics 2008;31:927-30.

2）Nam D, Park A, Stambough J, et al. Custom cutting guides do not improve total knee arthroplasty clinical outcomes at 2 years follow up. Clin Orthop Relat Res 2016;474:40-6.

3）Yan CH, Chiu KY, Ng FY, et al. Comparison between patient-specific instruments and conventional instuments and computer navigation in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015;23:3637-45.

4）Hamilton WG, Parks NL, Saxena A. Patient-specific instrumentation does not shorten surgical time. J Arthroplasty 2013;28(8 suppl):96-100.

5）Victor J, Dujardin J, Vandenneuckker H, et al. Patient-specific guides do not improve accuracy in total knee arthroplasty:a prospective randomized controlled trial. Clin Orthop Relat Res 2014;472:263-71.

6）Ollivier M, Parratte S, Lunebourg A, et al. No functional benefit after unicompartmental knee arthroplasty performed with patientspecific instrumentation. A randomized trial. Clin Orthop Relat Res 2016;474:60-8.

7）Yamamura K, Minoda Y, Mizokawa S, et al. Novel alignment measurements technique for total knee arthroplasty using patient specific instrumentation. Arch Orthop Trauma Surg 2017;137(3):401-7.

8）Sorensen E, Huijbregts R, Khan R, et al. Patient matched instrumentation for total knee replacement:a randomized controlled trial. AAOS 2017 San Diego;abstract;110.

9）Goyal T, Tripathy S. Does Patient-specific instrumentations improve short-term functional outcomes after total knee arthroplasty? a systematic review and meta-analysis. J Arthroplasty 2016;31:2173-80.

10）Bonutti P, Dethmers D, Stiehl JB. Case report:femoral shaft fracture resulting from femoral tracker placement in navigated TKA. Clin Orthop Relat Res 2008;466;1499-502.

11）Wysocki RW, Sheinkop MB, Virkus WW, et al. Femoral fracture through a previous pin site after computer-assisted total knee arthroplasty. J Arthroplasty 2007;23;462-5.

12）Brin YS, Nikolaou VS, Joseph L, et al. Imageless computer assisted versus conventional total knee replacement. A Bayesian meta-analysis of 23 comparative studies. Int Orthop. 2011;35:331-9.