Kashin-Beck病による両変形性膝関節症に対して両側同時人工膝関節全置換術を施行した1例

抄録

Introduction: Kashin-Beck disease (KBD) is a chronic disease which is mainly distributed in a limited endemic area from South-Eastern Siberia to North China. The most frequently involved joints are ankles, knees, wrists, and elbows. Symptoms are pain and limited motion of the affected joints. The main treatments for KBD are rehabilitation, osteotomy or total knee arthroplasty (TKA). We report our experience of a case in which simultaneous bilateral TKA for KBD of the knee was undertaken.

Case: A 75-year-old woman presented with a history of chronic bilateral knee pain. On a physical examination, the range of motion (ROM) of the knee was −5°/−5° in extension and 130°/130° in flexion. The Japan Orthopaedic Association (JOA) score was 40/40 points, Knee Score (KS) was 45/60 points, Function Score (FS) was five points and Functional Score for Adult Tibetans with Kashin-Beck Disease (FAST-KBD) was 24 points, respectively. On radiographic examination, Femorotibial angle (FTA) was 194°/189° with narrowing of the medial joint space, osteosclerosis and osteophyte formation were found. We diagnosed osteoarthritis with KBD, and the patient underwent simultaneous bilateral TKA (Smith & Nephew JOURNEY^TM Ⅱ BCS Bi-Cruciate Stabilized Knee System). At eight months postoperatively, ROM of the knee was 0°/0° in extension and 140°/140° in flexion. JOA score was 85/85 points, KS was 95/92 points, FS was 80 points and FAST-KBD was 39 points, respectively. The patient had relief of pain and she could walk without assistance.

Conclusion: Simultaneous bilateral TKA can be regarded as useful for the treatment of severe KBD of the knee, and it is associated with good clinical and radiographic outcomes, at least in short-term follow-up.