内側型変形性膝関節症における鏡視下内側解離術の検討

概要

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Arthroscopic debridement for early-stage medial osteoarthritis has been recognized as useful to a certain extent. The surgical treatments for advanced medial osteoarthritis with extensive cartilage damage are high tibial osteotomy or total knee arthroplasty, and good results have been obtained. However, arthroscopic surgery for such cases has not been considered very useful. In recent years we have carried out arthroscopic medial release and found it useful in such advanced cases for a specific percentage and period. With this surgery, the MCL (medial collateral ligament) deep layer and capsule are released from the tibial attachment medially to posteriorly using arthroscopy; that is, the medial compartment is decompressed arthroscopically. We performed arthroscopic decompressive medial compartment release on 42 knees in 28 subjects from June 1999 to July 2000. Good results were obtained for cases without extensive cartilage damage, but even advanced osteoarthritis patients were satisfied with the results and the VAS (visual analog scale) was also improved. The markedly apparent features of these cases in particular were disappearance of night pain and improvement in pain while walking short distances. Therefore, arthroscopic medial release was considered useful also for advanced osteoarthritis.
2003-04-25