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オカザキ ケン
KEN OKAZAKI
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 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Bi-cruciate stabilized total knee arthroplasty can reduce the risk of knee instability associated with posterior tibial slope. |
| 掲載誌名 | 正式名：Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 略 称：Knee Surg Sports Traumatol Arthrosc ISSNコード：14337347/09422056 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 26(6),pp.1709-1716 |
| 著者・共著者 | Hada Masaru†, Mizu-Uchi Hideki, Okazaki Ken, Kaneko Takao, Murakami Koji, Ma Yuan, Hamai Satoshi, Nakashima Yasuharu |
| 発行年月 | 2018/06 |
| 概要 | PURPOSE:The purpose of this study was to evaluate the relationship between posterior tibial slope and knee kinematics in bi-cruciate stabilized (BCS) total knee arthroplasty (TKA), which has not been previously reported.METHODS:This computer simulation study evaluated Journey 2 BCS components (Smith & Nephew, Inc., Memphis, TN, USA) implanted in a female patient to simulate weight-bearing stair climbing. Knee kinematics, patellofemoral contact forces, and quadriceps forces during stair climbing (from 86° to 6° of flexion) were computed in the simulation. Six different posterior tibial slope angles (0°-10°) were simulated to evaluate the effect of posterior tibial slope on knee kinematics and forces.RESULTS:At 65° of knee flexion, no anterior sliding of the tibial component occurred if the posterior tibial slope was less than 10°. Anterior contact between the anterior aspect of the tibial post- and the femoral component was observed if the posterior tibial slope was 6° or more. An increase of 10° in posterior tibial slope (relative to 0°) led to a 4.8% decrease in maximum patellofemoral contact force and a 1.2% decrease in maximum quadriceps force.CONCLUSION:BCS TKA has a wide acceptable range of posterior tibial slope for avoiding knee instability if the posterior tibial slope is less than 10°. Surgeons should prioritize avoiding adverse effects over trying to achieve positive effects such as decreasing patellofemoral contact force and quadriceps force by increasing posterior tibial slope. Our study helps surgeons determine the optimal posterior tibial slope during surgery with BCS TKA; posterior tibial slope should not exceed 10° in routine clinical practice. |
| DOI | 10.1007/s00167-017-4718-0 |
| PMID | 28940016 |