小切開・低侵襲による人工膝関節形成術の適応と問題点

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Objective: The purpose of this study was to compare the short-term results of minimalally invasive total knee arthroplasty (MIS-TKA) by standard large incision TKA and to discribe improvements inspecial surgical instruments and operative technique for MIS-TKA.Methods: Forty knees of 37 patients (71 males and 30 females) who underwent primary MIS-TKA (MIS-TKA group) and thirty knees of twenty six patients (41 males and 22 females) who underwent primary standard TKA (standard group) were assessed, and range of motion, JOA score, operationtime, intraoperative bleeding, and component positioning in the two groups were compared.Results: Mean operation time was significantly longer and mean range of motion at the time of discharge from the hospital was significantly greater in the MIS-TKA group than in the standard group. No significant differences were observed many other clinical parameters evaluated in this study.Conclusion: Special surgical instruments are needed to perform MISTKA properly, and the operative technique needs to be improved to perform MIS-TKA because of the limited visibiiity. Although the MIS-TKA operation time in our series was more than 20 minutes longer than required to perform the standard procedure, the one-year postoperative clinical outcome was the same as after standard TKA. We do not expect MIS-TKA to increase the long-term failure rate, but careful follow-up is necessary in the future.
日本関節病学会の論文