人工しつ関節置換の手術技法の工夫 Ｉ／Ｂ ｔｏｔａｌ ｃｏｎｄｙｌａｒ ｋｎｅｅ型に関して

Abstract

For the knee with severe pain and deformity, the total knee replacement may be one of the most effective therapy. To obtain fine results and to prevent the future migration and loosening of implants, this operation demands exact correction of the alignment of the lower limb.Some scales are designed to catch mechanical axis of thigh and lower leg. One is a staple shaped acrylic scale with buried wires at every 1cm. The position of the femoral head can be detected in a preoperative roentgenogram with this scale. Another is an isosceles triangle scale with a slit in the base. In the thigh, a bisector to the base is adjusted to the femoral mechanical axis in the coronall plane from the head to the center of condyles, and in the lower leg, to the tibial axis from the center of the tibial plateau to the center of condyles of the ankle respectively, and the bone cut is done through the slit of the base. By these scales and several techniques with this operative procedure, we are able to perform precise correction of the alignment under the direct visual orientation.In 26 joints of 22 patients, using I/B total condylar knee system, 25 joints showed strict alignment and their clinical results were good.