関節リウマチ患者における人工膝関節置換術後の筋侵襲回復の検討―筋逸脱酵素の視点から―

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Objective: Some surgeons have reported that MIS-TKA has many advantages. In the past we reported finding no difference between MIS and conventional TKA in operative injury by muscle enzymes. The present study comparared muscle enzyme recovery after MIS and conventional TKA in rheumatoid arthritis (RA).Methods: TKA procedures were performed on 89 RA knees of 80 patients, MIS-TKA in 44 of the knees and conventional TKA in the other 45 knees. Blood samples were collected to measure serum CPK, aldorase (ALD), and myoglobin (MG) before the operation and on postoperative days 1, 2, 4, 7, and 14 to determine how many days after each procedure (MIS-TKA, conventional-TKA) were needed for the value to return to the preoperative levels.Results: All muscle enzymes recovered to their preoperative values after MIS-TKA and conventional TKA: CPK in 6.8 days, 6.5 days respectively; ALD: in 11.7 day and 8.4 days respectivly; and MG: in 13.6 days and 3.8 days, respectively.Conclusion: The postoperative decrease in muscle enzyme values was slower after MIS-TKA. The faster rehabilitation after MIS-TKA, which caused greater muscle damage, is thought to have been responsible for these result.
日本関節病学会の論文