人工膝関節全置換術後の臨床評価と運動機能 非手術例との比較
【目的】TKA術後は十分に膝関節機能（臨床評価と運動機能）を再建しているかを調査する．【方法】膝関節X線検査と運動機能検査を受けていた65～85歳の612例の外来通院患者を対象に，重症側膝関節のK-L分類を参考に，N群：膝OA（n＝82），M群：軽度膝OA（n＝82），S群：高度膝OA（n＝190），UT群：片側TKA（n＝115），BT群：両側TKA（n＝143）の5群に分類．JOA Score，JKOM，膝屈曲角度，膝伸展筋力，下肢筋量，TUG（Timed Up & Go Test），OLST（One Leg Standing Time）を比較検討した．【結果】UT群，BT群は全て...
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| Published in | 整形外科と災害外科 Vol. 67; no. 2; pp. 332 - 335 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
西日本整形・災害外科学会
25.03.2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0037-1033 1349-4333 |
| DOI | 10.5035/nishiseisai.67.332 |
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| Abstract | 【目的】TKA術後は十分に膝関節機能（臨床評価と運動機能）を再建しているかを調査する．【方法】膝関節X線検査と運動機能検査を受けていた65～85歳の612例の外来通院患者を対象に，重症側膝関節のK-L分類を参考に，N群：膝OA（n＝82），M群：軽度膝OA（n＝82），S群：高度膝OA（n＝190），UT群：片側TKA（n＝115），BT群：両側TKA（n＝143）の5群に分類．JOA Score，JKOM，膝屈曲角度，膝伸展筋力，下肢筋量，TUG（Timed Up & Go Test），OLST（One Leg Standing Time）を比較検討した．【結果】UT群，BT群は全ての項目でM群より劣っており，UT群の膝伸展筋力とTUG以外は有意差を認めた．BT群のOLSTはS群より有意に劣っていた．【結論】TKA例は全ての項目で軽度OA例に及ばず，「高齢者の正常膝」を再建できるとは言い難い． |
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| AbstractList | 【目的】TKA術後は十分に膝関節機能（臨床評価と運動機能）を再建しているかを調査する．【方法】膝関節X線検査と運動機能検査を受けていた65～85歳の612例の外来通院患者を対象に，重症側膝関節のK-L分類を参考に，N群：膝OA（n＝82），M群：軽度膝OA（n＝82），S群：高度膝OA（n＝190），UT群：片側TKA（n＝115），BT群：両側TKA（n＝143）の5群に分類．JOA Score，JKOM，膝屈曲角度，膝伸展筋力，下肢筋量，TUG（Timed Up & Go Test），OLST（One Leg Standing Time）を比較検討した．【結果】UT群，BT群は全ての項目でM群より劣っており，UT群の膝伸展筋力とTUG以外は有意差を認めた．BT群のOLSTはS群より有意に劣っていた．【結論】TKA例は全ての項目で軽度OA例に及ばず，「高齢者の正常膝」を再建できるとは言い難い． 【目的】TKA術後は十分に膝関節機能 (臨床評価と運動機能) を再建しているかを調査する. 【方法】膝関節X線検査と運動機能検査を受けていた65～85歳の612例の外来通院患者を対象に, 重症側膝関節のK-L分類を参考に, N群 : 膝OAなし (n=82) , M群 : 軽度膝OA (n=82) , S群 : 高度膝OA (n=190) , UT群 : 片側TKA (n=115) , BT群 : 両側TKA (n=143) の5群に分類. JOA Score, JKOM, 膝屈曲角度, 膝伸展筋力, 下肢筋量, TUG (Timed Up & Go Test) , OLST (One Leg Standing Time) を比較検討した. 【結果】UT群, BT群は全ての項目でM群より劣っており, UT群の膝伸展筋力とTUG以外は有意差を認めた. BT群のOLSTはS群より有意に劣っていた. 【結論】TKA例は全ての項目で軽度OA例に及ばず, 「高齢者の正常膝」を再建できるとは言い難い. |
| Author | 日野, 敏明 細井, 由美 中野, 唯 吉野, 興一郎 原口, 和史 鈴木, 裕也 |
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| References | 1) Akai, M., et al.: An outcome measure for Japanese people with knee osteoarthritis. J. Rheumatol., 32: 1524-1532, 2005. 16) Noble, P. C., et al.: Patient expectations affect satisfaction with total knee arthroplasty. Clin. Orthop. Relat. Res., 452: 35-43, 2006. 5) Bourne, R. B., et al.: Comparing patient outcomes after THA and TKA: is there adifference?. Clin. Orthop. Relat. Res., 468: 542-546, 2010. 14) Nilsdotter, A. K., Toksvig-Larsen, S., Roos, E. M.: Knee arthroplasty: are patients' expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop., 80: 55-61, 2009. 3) Becker, R., et al.: Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg. Sports Traumatol. Arthrosc., 19: 1433-1441, 2011. 2) Bade, M. J., Kohrt, W. M., Stevens-Lapsley, J. E.: Outcomes before and after total knee arthroplasty compared to healthy adults. J. Orthop. Sports Phys. Ther., 40: 559-567, 2010. 13) Muraki, S., et al.: Association of knee osteoarthritis with onset and resolution of pain and physical functional disability: The ROAD study. Mod. Rheumatol., 24: 966-973, 2014. 8) Mahomed, N. N., et al.: The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J. Rheumatol., 29: 1273-1279, 2002. 7) 黒田良祐ほか：Meet the Expert座談会 人工膝関節置換術後の患者満足度向上のために．VIVA'ORTHO,2016年5月号，東京，アステラス製薬，2016. https: ams.astellas.jp/jp/specialty/orthopaedist/viva/2016_02/index.html. 11) Muraki, S., Oka, H., Mabuchi, A.: Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: The ROAD study. Osteoarthritis and Cartilage, 17: 1137-1143, 2009. 9) Matsumoto, H., et al.: Incidence and risk factors for falling in patients after total knee arthroplasty comparted to healthy elderly individuals. Yonago Acta Medica., 57: 137-145, 2014. 10) 三浦裕正ほか：人工膝関節置換術後のスポーツ活動．日スポ会誌，25: 6-10, 2005. 15) Noble, P. C., et al.: Dose total knee replacement restore normal knee function. Clin. Orthop. Relat. Res., 431: 157-165, 2005. 20) Weiss, J. M., et al.: What functional activities are important to patients with knee replacements?. Clin. Orthop. Relat. Res., 404: 172-188, 2005. 12) Muraki, S., et al.: Association of radiographic and symptomatic knee osteoarthritis with health-related quality of life in a population-based cohort study in Japan: the ROAD study. Osteoarthritis and Cartilage, 18: 1227-1234, 2010. 6) Hawker, G., et al.: Health-related quality of life after knee replacement. J. Bone Joint Surg. Am., 80: 163-173, 1998. 17) Schnurr, C., Jarrous, M., Güdden, I.: Pre-operative arthritis severity as a predictor for total knee arthroplasty patients' satisfaction. Int. Orthop., 37: 1257-1261, 2013. 18) Swinkeles, A., Newman, J. H., Allain, T. J.: A prospective observational study of falling before and after knee replacement surgery. Age Ageing, 38: 175-181, 2009. 19) Walsh, M., et al.: Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Phys. Ther., 78: 48-58, 1998. 4) Bourne, R. B., et al.: Patient satisfaction after total knee arthroplasty: Who is satisfied and who is not?. Clin. Orthop. Relat. Res., 468: 57-63, 2010. |
| References_xml | – reference: 11) Muraki, S., Oka, H., Mabuchi, A.: Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: The ROAD study. Osteoarthritis and Cartilage, 17: 1137-1143, 2009. – reference: 4) Bourne, R. B., et al.: Patient satisfaction after total knee arthroplasty: Who is satisfied and who is not?. Clin. Orthop. Relat. Res., 468: 57-63, 2010. – reference: 13) Muraki, S., et al.: Association of knee osteoarthritis with onset and resolution of pain and physical functional disability: The ROAD study. Mod. Rheumatol., 24: 966-973, 2014. – reference: 5) Bourne, R. B., et al.: Comparing patient outcomes after THA and TKA: is there adifference?. Clin. Orthop. Relat. Res., 468: 542-546, 2010. – reference: 12) Muraki, S., et al.: Association of radiographic and symptomatic knee osteoarthritis with health-related quality of life in a population-based cohort study in Japan: the ROAD study. Osteoarthritis and Cartilage, 18: 1227-1234, 2010. – reference: 3) Becker, R., et al.: Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg. Sports Traumatol. Arthrosc., 19: 1433-1441, 2011. – reference: 10) 三浦裕正ほか：人工膝関節置換術後のスポーツ活動．日スポ会誌，25: 6-10, 2005. – reference: 17) Schnurr, C., Jarrous, M., Güdden, I.: Pre-operative arthritis severity as a predictor for total knee arthroplasty patients' satisfaction. Int. Orthop., 37: 1257-1261, 2013. – reference: 18) Swinkeles, A., Newman, J. H., Allain, T. J.: A prospective observational study of falling before and after knee replacement surgery. Age Ageing, 38: 175-181, 2009. – reference: 1) Akai, M., et al.: An outcome measure for Japanese people with knee osteoarthritis. J. Rheumatol., 32: 1524-1532, 2005. – reference: 19) Walsh, M., et al.: Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Phys. Ther., 78: 48-58, 1998. – reference: 15) Noble, P. C., et al.: Dose total knee replacement restore normal knee function. Clin. Orthop. Relat. Res., 431: 157-165, 2005. – reference: 20) Weiss, J. M., et al.: What functional activities are important to patients with knee replacements?. Clin. Orthop. Relat. Res., 404: 172-188, 2005. – reference: 6) Hawker, G., et al.: Health-related quality of life after knee replacement. J. Bone Joint Surg. Am., 80: 163-173, 1998. – reference: 9) Matsumoto, H., et al.: Incidence and risk factors for falling in patients after total knee arthroplasty comparted to healthy elderly individuals. Yonago Acta Medica., 57: 137-145, 2014. – reference: 16) Noble, P. C., et al.: Patient expectations affect satisfaction with total knee arthroplasty. Clin. Orthop. Relat. Res., 452: 35-43, 2006. – reference: 8) Mahomed, N. N., et al.: The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J. Rheumatol., 29: 1273-1279, 2002. – reference: 14) Nilsdotter, A. K., Toksvig-Larsen, S., Roos, E. M.: Knee arthroplasty: are patients' expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop., 80: 55-61, 2009. – reference: 7) 黒田良祐ほか：Meet the Expert座談会 人工膝関節置換術後の患者満足度向上のために．VIVA'ORTHO,2016年5月号，東京，アステラス製薬，2016. https: ams.astellas.jp/jp/specialty/orthopaedist/viva/2016_02/index.html. – reference: 2) Bade, M. J., Kohrt, W. M., Stevens-Lapsley, J. E.: Outcomes before and after total knee arthroplasty compared to healthy adults. J. Orthop. Sports Phys. Ther., 40: 559-567, 2010. |
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| Snippet | 【目的】TKA術後は十分に膝関節機能（臨床評価と運動機能）を再建しているかを調査する．【方法】膝関節X線検査と運動機能検査を受けていた65～85歳の612例の外来通院患者を対... 【目的】TKA術後は十分に膝関節機能 (臨床評価と運動機能) を再建しているかを調査する. 【方法】膝関節X線検査と運動機能検査を受けていた65～85歳の612例の外来通院患者を対... |
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| SubjectTerms | 人工膝関節置換術 膝関節のX線重症度 臨床評価 運動機能 非手術例との比較 |
| Subtitle | 非手術例との比較 |
| Title | 人工膝関節全置換術後の臨床評価と運動機能 |
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