著者

重野 陽一 福島 美歳 原田 憲正 石田 通暁 大西 純二 中川 滋人

出版者

日本関節病学会

雑誌

日本リウマチ・関節外科学会雑誌 (ISSN:02873214)

巻号頁・発行日

vol.9, no.4, pp.593-602, 1990

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The porous total knee replacement designed by Miller and Galante has been performed on 31 knees in 23 cases from November 1986 to June 1988 in the Kure National Hospital. We evaluated the postoperative results over an average follow-up period of 2.7 years (ranging from 2 to 3.6 years) on 6 knees in 4 men and 25 knees in 19 women, with ages ranging from 49 to 81 (average 69.0) . The original diseases were 5 cases of rheumatoid arthritis (7 knees) and 18 cases of osteoarthritis (24 knees) .<BR>Each knee was evaluated preoperatively and postoperatively by the functional evaluation score system proposed by the three universities. Preoperative and postoperative femoro-tibial angle, alignment of each component, degree of lateral displacement of the patella on the patellofemoral groove, occupancy ratio of the component to the tibial surface, amount of resection of the tibia, radiolucent line and sclerotic line adjacent to the component were investigated with roentgenograms.<BR>Postoperatively the clinical score improved from 36.9 to 80.3 points in rheumatoid knees and from 48.5 to 87.3 in osteoarthritic knees.<BR>In each case, the insertion angle of the components was close to ideal. The degree of lateral displacement of the patella was significantly decreased in cases with lateral retinacular release. The mean occupancy ratio of tibial component to tibial surface was 95.8% on A-P and lateral view X-rays, showing that the components used are small for the tibial surface. The mean resection of the tibia was 7mm from the surface of the lateral plateau in varus knees. Only 2 rheumatoid patients had radiolucent lines surrounding the tibial component. In 2 rheumatoid knees and 11 osteoarthritic knees there were sclerotic lines surrounding the pegs of the tibial components.<BR>In general, the short-term results of total knee replacement using this prosthesis were satisfactory. The long-term radiographic observation has shown that the choice of a tibial component of adequate size is mandatory to prevent the component from sinking.