日本リウマチ・関節外科学会雑誌
Online ISSN : 1884-9059
Print ISSN : 0287-3214
ISSN-L : 0287-3214
変形性膝関節症に対する高位脛骨骨切り術後の膝蓋大腿関節部の誘発痛の改善と膝蓋骨の偏位および高さ
斎藤 裕斉藤 知行腰野 富久
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2001 年 20 巻 2 号 p. 157-168

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The purpose of this study was to investigate the relationship between the clinical findings and radiological changes in patellofemoral joints after high tibial valgus osteotomy for medial and patellofemoral osteoarthritic knees with varus deformity.
Two hundred and nine knees in 153 patients (117 women and 36 men, with an average of 64.3 years) were followed for an average of 4.5 years (range, 2-11 years) .
Clinical findings for patellofemoral joints involved retropatellar crepitation, grating pain, tenderness around the patella, pain in deviating the patella (medially, laterally, proximally, distally), and pain in holding the patella against knee extension.
The width of joint space was measured in both the medial and lateral compartments of the Patellofemoral joints. Patellar height was evaluated using the ratio of patellar ligament length to patellar length (the Insall-Salvati ratio) and patellotibial distance.
In clinical findings, all kinds of patellof emoral provoked pain were relieved significantly after osteotomy.
The mean width of joint space in medial compartments was 5.5mm before osteotomy and 4.2mm at the final follow-up. That in lateral compartment was 4.7mm and 4.8mm respectively. Consequently, patellar tilt and shift were improved after osteotomy.
Patellar position was slightly lower after osteotomy.
The results suggested that patellofemoral pain was relieved and patellar position was improved after high tibial osteotomy.
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