2017 年 36 巻 1 号 p. 21-26
Objective: Anterior cruciate ligament deficiency of the knee can lead to secondary osteoarthritis of the patellofemoral joint (PFJ). About 20% of patients who have undergone total knee arthroplasty (TKA) have not been satisfied. Fujikawa observed the cartilage lesion of the patella (inferior facet>odd facet>medial facet) for osteoarthritis of the PFJ. The JOURNEYTM II Bi-Cruciate Stabilized (BCS) Total Knee System, that substitutes for the anterior and posterior cruciate ligaments, may cause pressure on the PFJ compared to conventional (Con) TKA. The purpose of this study was to examine the effect on the PFJ for BCS.
Methods: We prospectively analyzed patients with BCS TKA (20 knees) and Con TKA (20 knees) for a year postoperatively. Several evaluation methods were used for clinical outcomes including the Knee Society Score (KSS), anterior knee pain, plain radiographs, and quantitative analysis of two-dimensional bone formation levels (proposed by the American Society for Bone and Mineral Research ; bone mineral content/total volume: BMC/TV value) measured every three months postoperatively. Two-dimensional bone morphometry software (TRI/3D-BON64, Ratoc System Engineering Co., Ltd. Tokyo, Japan) was then used to calculate the structural parameters in the region of interest (ROI 1: upper part of the patella, ROI 2: center of the patella, and ROI 3: inferior part of the patella).
Results: No significant difference was recognized in age, body mass index, KSS, or between the two groups postoperatively. There were significantly higher BMC/TV values in ROI 1 for BCS TKA patients compared to Con TKA patients at 12 months postoperatively (P<0.05).
Conclusion: This study reveals that the BCS TKA, which substitutes for both the anterior and posterior cruciate ligaments, is similar to the kinematic pathway of the normal knee for results of bony structural parameters in the PFJ.
