大腿骨遠位を最初に切骨するＤｅｐｅｎｄｅｎｔ　ｃｕｔ法のコンセプトと現状における問題点　　Ｊｏｉｎｔ　ｇａｐ　ｃｏｎｔｒｏｌ法という概念の提唱:—Joint gap control法という概念の提唱—

概要

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Component design and operative technique for total knee arthroplasty have been established based on anatomic configuration of normal knees in the United States and Europe, but these are not suitable for osteoarthritic knees in Japanese patients. We therefore have developed a modified dependent cut method called "Joint gap control method". In this method, the distal femur and proximal tibia are cut. Ligament balance is established in full extension using a ligament balancer. The knee is flexed at 90°, and the degree of external rotation of the femoral component is determined according to the angle between the posterior condylar line and cut surface of the tibia keeping the ligament balance. The distance of the joint gap can be set equally between full extension and 90° knee flexion. The size of the femoral component is also decided according to the distance of the joint gap at 90° knee flexion. With this method, ligament balance can be obtained from full extension to 90° knee flexion in any knee.
西日本整形・災害外科学会の論文