臨床整形外科53巻3号

2018年03月発行

誌上シンポジウム THAの低侵襲性と大腿骨ステム選択

テーパーウェッジ型ステムの特徴と低侵襲THA

著者： 中田活也¹ 北田誠¹ 田村理¹

所属機関： ¹地域医療機能推進機構大阪病院人工関節センター

ページ範囲：P.205 - P.216

　テーパーウェッジ(TW)型ステムは良好な長期成績と易挿入性と安全性を背景に，近年，人工股関節全置換術(THA)使用症例が急増している．Single wedgeによるproximal metaphysisにおけるステム前額面でのwedge-fitあるいはテーパーロックにより初期固定を獲得するコンセプトを有する．特にショートTW型ステムでは，初期固定性を担保するために適切な髄腔適合性が求められ，それによりステムコンセプトが実現されると考えられる(fitting first theory)．骨温存も可能で低侵襲THAに適するステムであるが，髄腔形状，骨質，ステムの適合性，脚長差，オフセット，前捻角，骨盤と大腿骨の相対的位置関係など総合的に判断して，症例個別的に機種を選択する必要がある．

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