抄録
We investigated periprosthetic fractures adjacent to total knee implants. In our hospital, periprosthetic fractures occurred in 9 (1.3%) of 700 patients who had undergone a total knee arthroplasty (TKA). Four patients who underwent TKA in another hospital but were treated for periprosthetic fractures in our hospital were added to the study. All 13 suffered from collagen disease, including RA, and had taken steroids for an extended period of time. The fractures were caused by minor accidents, such as falls. Non-surgical treatment was performed in one case, while the other 12 patients were treated surgically. In 9 cases, the bone mineral density (BMD) was measured near the time of injury. The results of the examination were as follows: BMD (lumbar spine): 0.527-0.758 g/cm 2, T score: 52-75%, and Z score: 66-94%; BMD (femoral neck): 0.341-0.502 g/cm 2, T score: 45-66%, and Z score: 52-80%. Nearly all patients suffered from severe osteoporosis. RA patients may be more likely to be osteoporotic because of the constant presence of inflammation, long-term steroid use, and a lower amount of physical exercise in daily life. It is thus advantageous to detect osteoporosis in its early stages and begin medical care for it as quickly as possible.
