臨床整形外科59巻6号

2024年06月発行

特集 TKAにおける最新Topics

TKA Sagittal Alignmentの重要性

著者： 西谷江平¹

所属機関： ¹京都大学医学部附属病院整形外科

ページ範囲：P.769 - P.773

大腿骨コンポーネントは軽度屈曲位設置が推奨され，過伸展や過屈曲設置は疼痛や臨床スコアの低下，異常なバイオメカニクスと関連する．また，前方皮質のノッチ形成は術後骨折と関連するため可能な限り避ける．脛骨コンポーネントの設置角は十字靱帯温存の有無により異なる．CR TKAでは可能な限り術前の後傾を温存するが，後傾を減じた場合はPCLの緊張に注意を要する．一方でPS TKAでは3〜5°程度の後傾が推奨され，通常後傾は減じられるがPCL切除により屈曲ギャップがきつくなりすぎることは少ない．

参考文献

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