アブストラクト
| Title | 人工膝関節術後のスポーツ活動とリハビリテーション治療 |
|---|---|
| Subtitle | 特集 膝スポーツ障害・外傷のリハビリテーション診療実践マニュアル |
| Authors | 佐藤慧*1, 乾洋*2 |
| Authors (kana) | |
| Organization | *1埼玉医科大学総合医療センター整形外科, 助教, *2同, 教授 |
| Journal | MB Medical Rehabilitation |
| Volume | |
| Number | 300 |
| Page | 170-176 |
| Year/Month | 2024 / 5 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」人工膝関節全置換術(TKA), 人工膝関節単顆置換術(UKA)術後のスポーツ復帰は推奨傾向にある. スポーツ復帰率, 臨床成績, 患者満足度に明らかな有意差はないが, 復帰までの期間はUKAの方が短い. またスポーツの種類では登山, サイクリングなどのlow impact sportsへの復帰は良好だが, サッカー, ジョギング, シングルテニスなどのhigh impact sportsへの復帰率は決して良好とは言えず, モチベーションなどの精神的要因も関わっていると考えられており, 今後の課題と考えられる. リハビリテーションについては人工膝関節術後のスポーツ復帰への特有のリハビリテーションの報告はない. 人工膝関節置換術後の遷延疼痛が20%程度と報告されている. 痛みを管理しながら, 大腿四頭筋を代表とする膝関節周囲筋の筋力, 良好な可動域の獲得をエビデンスに基づき目指すことが重要と考えられる. 近年では生理的な膝関節運動を再現する設計のインプラントも使用可能となり, 人工膝関節術後のスポーツに対する臨床成績の向上が期待される. |
| Practice | 医療技術 |
| Keywords | 人工膝関節全置換術(total knee arthroplasty;TKA), 人工膝関節単顆置換術(unicompartmental knee arthroplasty;UKA), 疼痛管理(pain control), 大腿四頭筋(quadriceps) |
- 全文ダウンロード： 従量制、基本料金制の方共に968円(税込) です。
参考文献
- 1) 日本人工関節学会: JAR年次報告書, 日本整形外科学会, 2023.10.13. [https://www.joa.or.jp/joa/annual_report_JAR.html]
- 2) 厚生労働省: 平成28年国民健康・栄養調査報告, 厚生労働省, 2023.10.8. [https://www.mhlw.go.jp/content/001066497.pdf]
- 3) Inui H, et al: Short-term clinical results of bicru-ciate-retaining total knee arthroplasty using personalized alignment. BMC Musculoskelet Dis-ord, 24(1): 965, 2023.
- 4) Kono K, et al: Bicruciate-stabilised total knee arthroplasty provides good functional stability during high-flexion weight-bearing activities. Knee Surg Sports Traumatol Arthrosc, 27: 2096-2103, 2019.
- 5) Song SJ, et al: What to know selecting cruciate-retaining posterior-stabilized total knee arthro-plasty. Clin Orthop Surg, 11: 142-150, 2019.
残りの18件を表示する
- 6) Pronk Y, et al: No difference in patient satisfac-tion after mobile bearing or fixed bearing medial unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 29: 947-954, 2021.
- 7) Yoshida K, et al: Oxford phase 3 unicompart-mental knee arthroplasty in JAPAN-clinical results in greater than one thousand cases over ten years. J Arthroplasty, 28: 168-171, 2018.
- 8) Winnock de Grave P, et al: Outcome of a fixed-bearing, medial, cemented unicondyler knee arthroplasty design: survival analysis and func-tional score of 460 cases. J Arthroplasty, 33: 2792-2799, 2018.
- 9) Su W, et al: The effects preoperative rehabilita-tion on pain and functional outcome after total knee arthroplasty: a meta-analysis of random-ized controller trials. J Orthop Surg Res, 17: 175, 2022.
- 10) Ikeuchi M, et al: Effects of dexamethasone on local infiltration analgesia in total knee arthro-plasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc, 22: 1638-1643, 2014.
- 11) Bade M, et al: Early high-intensity versus low-intensity rehabilitation after total knee arthro-plasty: a randomized controlled trial. Arthritis Care Res(Hoboken), 69(9): 1360-1368, 2020.
- 12) Beswick AD, et al: What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in un selected patients. BMJ Open, 2: e000435, 2020.
- 13) Bade MJ, et al: Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther, 40(9): 559-567, 2010.
- 14) Kittelson AJ, et al: Neuromuscular electrical stimulation after total joint arthroplasty: a criti-cal review of recent controlled studies. Eur J Phys Rehabil Med, 49(6): 909-920, 2013.
- 15) Stevens JE, et al: Neuromuscular electrical stimulation for quadriceps muscle strengthening after bilateral total knee arthroplasty: a case series. J Orthop Sports Phys Ther, 34(1): 21-29, 2004.
- 16) Yang X, et al: Continuous passive motion after total knee arthroplasty: a systematic review and meta-analysis of associated effects on clini-cal outcomes. Arch Phys Med Rehabil, 100: 1763-1778, 2019.
- 17) Healy WL, et al: Athletic activity after total joint arthroplasty. J Bone Joint Surg Am, 90: 2245-2252, 2008.
- 18) Thaler M, et al: Twenty-one sports activities are recommended by the European Knee Asso-ciates(EKA) six months after total knee arthro-plasty. Knee Surg Sports Traumatol Arthrosc, 29: 694-709, 2021.
- 19) Crawford DA, et al: Higher activity level follow-ing total knee arthroplasty is not deleterious to mid-term implant survivorship. J Arthroplasty, 35: 116-120, 2020.
- 20) Witjes S, et al: Return to sports and physical activity after total and unicondylar knee arthro-plasty: a systematic review and meta-analysis. Sports Med, 46: 269-292, 2016.
- 21) Radhakrishnan GT, et al: Return to sports after unicompartmental knee arthroplasty: a system-atic review and meta-analysis. Orthop J Sports Med, 10(3): 23259671221079285, 2022.
- 22) Bonnin M, et al: Can patients really do sport after TKA? Knee Surg Sports Traumatol, Arthrosc, 18: 853-862, 2010.
- 23) Zimmerer A, et al: Sports activity and patient-related outcomes after fixed-bearing lateral uni-compartmental knee arthroplasty. Knee, 28: 64-71, 2021.
