53rd Annual Meeting of the Orthopaedic Research Society ...impottmt factors tt dtt longcvity of...
Transcript of 53rd Annual Meeting of the Orthopaedic Research Society ...impottmt factors tt dtt longcvity of...
SAGttTAL MECIIANICAL AXIS OF TIIE LOWER EX□ 田郵凋『Y IN ELDERLY FEMALES
ギ,雑sllgaIIla RガKobay甑 A,親 も施阻め Y,中Iwaki H,ネInOtt F,ⅢTada M,41w水 血 K,球Ohta Y,雑NakaBawa S,練 Kadoya Y,をTakaOka K寄Osaka C■y Univcrsity Medlcal School,Osaka,Japan,
suHamttmsic,med.osaka―cLI.ac,lD
INェRODUCT10N:■has been repolted dlat attlment ofprosdlesis is one ofthe lnost
impottmt factors tt dtt longcvity of total knee anoplasty(TKA5,Tcachieve all accurate and uroduCablc al亀要班nttt h TKA, navlgattonsystem地益recently been dtteloped.To develop such navigatlon wstem,adequate hfoIIIlatiOn ofttignment troun the femoral head to ttЮ側岨els essential.
Altlouか coronal ttg―ent of the lower extremity h noIIna鋭瑚eCtS has been shown h maayコ 斡Orts,上de立 由回阻よmお avallable
on sagttal alittment of tte lower extremty h wettht―bearhg becauseof the dittcutt to takc the radおgraph of鈍徒 lower extrcmity hwcight―bearlng
We previously玉 コorted血 筑 the simple method to take tteradiOgFaph Oflower eremty in welght_beamg mll extenslon(1),and
腕 tthe lnettanical axis o臥)Of10Wer tttrenlty h healthy young mttedtt not pass arouぶdle center ofl血3knee h磁 夢ねl plane(2).HoweVe毛dderly females who are de leadtt can価 的に Of TKA may havedirerent anatomical morphology from young male.
m c p u l p O S e o f t t i s 」岨 y l s t o e x a l m e d l e M A o f l o w e r e x t r e m 町血 weight_bearmg tt exten並温h elderly fcmales宙血 ut osteoa耐航ts.
剛 THODS:
Coronal and sagitt radiographs werc made of 血 80 1owere x t r e t t t e s o f 4 0 h e a l h y f e m a r e J a p a n e s e v o l u n t e e r s ( I I l e a n a g e o f 7 1 , 9
years,range is 66-84 yearsy ttth stand血3 Au volunteers have noc o m p l a m t a n d n o d e f o m i t y i n a p p e a r a n c e t t t h e t t b i l a t e r a l k n e e s , h " s
a n d れ出e s . F o r 研よ明d o n o f t h e o t t e o 斌脱 t s o f d l e k n e e , K d l B r e n ―Lawcnce classiflcation(3)was uSed.h dlis sttes,su町 ∝tS Of Oade 0were txぅluded. In d賞3 80 1owg extremtes, therefore, S2 1owcrex位●m品 es were hcluded in the cu向に独t study.Coronalっ比配
Standardized antcropostenor radiograph ofdle bwer extremiけwih山e sdttect standing was made by tte posltlo― g accordmg to tlememod ofMoreland(4).
The femorotibial angle cTA)(5)and wdBht‐ bear逸 岡tO(WBR)
(6)were mCaswedSttidtt Dlane
L a t e r a l r a dおg r a p h o f t t e l o w c r e x t r e mⅢ血 o l l e―L g g e d s t a n d i n g
po豆血n was made in the mehod ofour preuous reports(1):1.ご ミ Swas rotated so hat fcmoral head could be visualittd by lower energy
setting ofx―ray beam.2.□ 拒 hee was ttily exterlded.3.■拒 posttredge of medial and iateral felnoFal COndyle wereぷi課胡 so tlat rotationof dle lower emty was cOntrolled and standattized,4,A graduated
lead―lo組胡 awlic ilteF WaS plac胡 血 血 nt of the c制 臨賦劇 x_raybealn tt latral radiomph SO ttat hc femoral hcad was apphed hD
energy x―ray9 and the knee and dle anklc were applicd relat持dy lowerenergy x―ray.
Sagit絶狂 mechanよ光述 旗 s was dermed as tte lhe dram ■ om ttecenter oftt femoral head to dtt centcr oftte talocRraljO血t(Figure l)ャStti祖劇 femOral WBR and弱 胡 tibiぶWBR were defmed as flgllre 2
(2).A1l the pamlneters on radiographs were measured usmg ttage
anttyzer(Q■iCk Grain;Vtton 3.2,Inoteckl and Calcultted to onedeciIIlal placc.
RESULTS:
C O F O I l a l D l a n e
距 A wa s 1 7 6 . 8 + / _ 3 . l K I n e a n t /―stan d淳配 devi a t l o n r m n g e , 1 7 0 . 6t o 1 8 3 . 8 ] ) d e g r e c s . W B R w a s 3 2 . 2 +た12,7 K r a n g e , 7 . 4 t o 5 8 . 0 ) ,S狙 胡 Dlan C
sagiml fmOral WBR was 52.4■ /‐29.5.Sagital tbial WBR waswas 45。8+/-43.3.Sagit協 l femoral WBR and sagital tbial WBR had
隅 裸 瑞 浦 無 堵 b押 軸 洲 描 錨 憾 紺 鮮 品徒 kneej o m t w a s O d e g r e e e x t e n s i o L s a g i t t a l f e m o r a l W B R a n d s a g i t t a l
tibial WBR were calculated■om the regresdon ttmcs in FIpre 3 to bewas 47.6 and 38.9,respectively.
DISCUN10N:
血 曲ユs elderly female ttctt MA oflower eremty dtt notpassthe
ceはkl ofthe knee(32.20/c Hxtthally and 38 90/s posterloFly On the tbial
p l a t e a l l l a S i n y o u n g m a l e s t t e s o 3 9 % m e d i a l l y a n d 3 3 . 0 % P o s t e r i o r l yon dle tibial plateau)(2)ci81re 4)、The MA of elderly female was,howevett passed a tttde more post9dorly than dat of young male,It is
unclear whether thc cause oft姑s differencc is age or sex.Fumer sttdyh a s t o b e d o n e t o e l u c i d a t c t t s p o m t
T h e c ―n t s m d y d O w e d i 叩碗 a n t 的脇 おI I S f O r t t i g n m e n t i nTKA,espedally witl配】vigation systelns,and osteotomyt
Figure l:Lateral dttram Oftle lower extrelmty tt oneriegged hndhg
posmon and saginl mechttal axis were shou.
軸 gure 2:Dttraln sho―g the Saginl femOraI WBR and SagitaltibialWBR Sagitt Semoral WBR=A/KAtB)x100.Sagital tihal WBR=
C/KCttD)x100S箸 的劇 Fにせh舶工cal aus=s、 こ代.
R2=o948,pく o o001R2=a936,pく o o001
Fをure 3:Scater diagrams of the angle of the kncc joht and sagiml
parametcrs.SagimlfemOFtt WBR o代)and ttgital tbial WBR c)had血e stattdcally signiflcaIIt correlttion wttl dle angtt of佐血ee.
Figure 4助 agmm sho― g tlelocattn ofthe MA on ight thA
plateau,?ゅelderly female and c)young malc(2)。
REFERENCES:
( 1 ) M h t t a Y e t a l . T r a n s O R S。2 0 0 5 , 3 1 0。
( 2 )ぶ血恵ia C t a l T r a n s」O A . 2 0 0 4
(3)Kel131m JH,Lawence JC.Ann Rheum Dis.1958;17:388-397.
律)MOrelalld JR et al.J Bonc Jomt Surg Am.1987o9:745-9.
(5)K対誼10 T et al.htOmop。1979;3:37-45.
c)Andr― Metal.JOmop酪 1996;14i289-95.AFF工 五MEIコD INS□『丁肛ONSFOR CO‐ AtFIIORSi革 Osaka Ro航Hotttal,OSaktt Japan‐ Kanstt Rostt Hospital,Hyougo,」apan
3 A
53rd Annual Meeting of the Orthopaedic Research Society
Poster No: 0758