高度内反膝に対する人工膝関節置換術の治療経験

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We report clinical results of total knee arthroplasty in 22 knees with severe varus deformity. The mean follow-up period was 5.4 years. We define severe varus knee femorotibial angle (FTA) as over 195 degrees. Severe varus knees were classified into the bone defect type and fixed varus type. Medial tibial bone defect is the main cause of varus deformity in the bone defect type. Altough, the fixed varus type reveals large laxity of the lateral supporting structure, it is difficult to correct varus deformity by valgus stress because of severe medial soft tissue contracture. We evaluated clinical results using the Knee Society Score. The knee score improved from 38.6 points to 76.6 points after TKA. The Function score also improved from 40.7 to 80.9. The mean standing FTA was 198.8° (range 195° to 209°) before surgery and corrected to 176.1° (range: 167° to 188°). Four knees, however, was over 180°. Although slight varus instability was observed on stress Xray, it had no significant effects on clinical results.
西日本整形・災害外科学会の論文