オカザキ　ケン   Okazaki Ken   岡崎　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Kinematic analysis of stair climbing in rotating platform cruciate-retaining and posterior-stabilized mobile-bearing total knee arthroplasties.
掲載誌名	正式名：Archives of orthopaedic and trauma surgery 略　 称：Arch Orthop Trauma Surg ISSNコード：14343916/09368051
掲載区分	国外
巻・号・頁	137(5),pp.701-711
著者・共著者	Murakami Koji, Hamai Satoshi, Okazaki Ken, Ikebe Satoru, Nakahara Hiroyuki, Higaki Hidehiko, Shimoto Takeshi, Mizu-Uchi Hideki, Kuwashima Umito, Iwamoto Yukihide
発行年月	2017/05
概要	INTRODUCTION:The aim of our study was to compare and contrast the effects of two types of mobile-bearing total knee arthroplasties (TKA), namely, the cruciate-retaining (CR) and posterior-stabilized (PS) TKAs, on clinical outcomes and in vivo kinematics during stair climbing.MATERIALS AND METHODS:The Press-Fit Condylar Sigma rotating platform was used for both CR and PS TKAs. Patient-reported outcomes were assessed using the 2011 Knee Society Score. Quadriceps muscle strength was evaluated by isokinetic dynamometry. In vivo kinematics were evaluated using periodic sagittal plane radiographic images obtained during stair climbing to quantify anteroposterior (AP) tibiofemoral translation, implant flexion and axial rotation angles using image-matching techniques. Outcomes were evaluated in 20 TKAs, which had been undergone with clinical success, including ten knees with CR types and ten knees with PS types.RESULTS:There were no significant differences between the CR and PS TKA groups (p > 0.05) in isometric extensor torque (1.0 ± 0.2 and 1.1 ± 0.6 N m/kg, respectively) or patient-reported score for stair climbing function (4.0 ± 0.5 and 3.8 ± 0.9, respectively). Both types of TKAs showed stable AP translation in the mid range of knee flexion and paradoxical translation in the low range of flexion, with limited rotation, during stair climbing. There were no significant differences between the CR and PS TKA groups (P > 0.05) in anterior translation from 80° to 40° of knee flexion (4.2 ± 1.2 and 3.5 ± 1.6 mm, respectively), posterior translation from 40° to 10° of knee flexion (2.3 ± 1.9 and 2.0 ± 1.5 mm, respectively), and total external rotation (2.8° ± 4.9° and 0.5° ± 5.0°, respectively).CONCLUSIONS:Both CR and PS types of rotating platform mobile-bearing TKAs provided reproducible knee joint kinematics during stair climbing and equivalent clinical outcomes.LEVEL OF EVIDENCE:IV.
DOI	10.1007/s00402-017-2662-6
PMID	28289890