Steroid Arthropathy Treated with Semiconstrained or Constrained Total Knee Arthroplasty.

概要

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Steroid arthropathy is a difficult problem to treat because of significant instability due to bone defects and ligamentous laxity. Long-term results of total knee arthroplasty (TKA) for treating steroid arthropathy of three knee joints with supplementation of medial tibial condyle defects is reported. Two knees were replaced by a kinematic stabilizer prosthesis (semiconstrained type), one with supplementation by bone cement and the other by bone graft. Another knee needed a kinematic rotating hinge prosthesis (constrained type) because of instability even after supplementation using bone cement. The mean age at surgery was 74 years and follow-up averaged 8 years 7 months.Knee function score according to the "Three Universities Scoring System" averaged 51 points (range 39-58) before surgery which improved to 87 points (range 80-92) at follow-up.Satisfactory surgical results for steroid arthropathy of the knee joint can be obtained using a semiconstrained type TKA with a thick tibial component following the supplementation of the bone defect. In cases with an unstable knee joint even after supplementation, a constrained type TKA could provide satisfactory long term results.
西日本整形・災害外科学会の論文