第9 回日本 フォーラム開催にあたって

1 2021 11 9 Knee osteotomy 8 Knee osteotomy 9 1 Knee osteotomy & Joint Preservation 5 7 3 10 2011 Knee osteotomy & Joint Preservation 12 : 2021 12 17 ( ) 8:55 17:25 ( 8.)

2 00 ) 6 9-1 078-302-5200 Hybrid Web 5,000 ( 2,000 ) 1,000 Knee osteotomy 151-0073 1- 50-1 Daiwa TEL:03-5738-3409 FAX:03-5738-3966 e-mail: URL QR Web URL 2021 12 10 1 151-0073 1-50-1 Daiwa TEL:03-5738-3409 FAX:03-5738-3966 E-MAIL: URL QR 8:55 9:00 9:00 9:50 1 1 5 3 1-1.

3 Xp HTO JLCA 1-2. MPTA 1-3. Open wedge safe zone safe 1-4. ( ) 1-5. ( ) 1-6. PCL OA OWHTO ( ) 10:00 10:50 2 2 5 3 2-1. Bone marrow lesion ( ) 2-2. 2-3. 3 HTO ( ) ( ) 2-6.

4 11:00 11:50 3 DFO/DLO 5 3 3-1 CT ( ) 3-2. ( ) 3-3. ( ) 3-4. Lateral opening wedge distal femoral osteotomy (LOW-DFO) DFO ( ) 3-5. neutral alignment double level osteotomy ( ) 3-6. DLO Open wedge HTO Joint line obliquity ( ) 12:00 13:00 [2] [12] 13:30 14:20 4 5 3 4-1.

5 Open-wedge ( ) 4-3. Distal tibial tuberosity osteotomy (DTO) 4-4. X ( ) Hip abduction angle ( ) 4-6. 10 ( ) 14:30 15:20 5 DTO 5 3 OWHTO ( ) 5-2. OWDTO OWHTO ( ) 5-3 1 ( ) 5-4. (OWDTO) ( ) 5-5.

6 Distal tuberosity osteotomy DTO ( ) 5-6. DTO ( ) 15:30 16:20 6 Hybrid 5 3 closed wedge HTO Medial open wedge HTO ( ) closed wedge Opening wedge Joint line convergence angle ( ) CWHTO ( ) closed Wedge HTO 11 ( ) closed wedge HTO ( ) hybrid closed wedge high tibial osteotomy ( ) 16:30 17.

7 20 7 7 3 7-1. ( ) 7-2. wedge 7-4. TCVO ( ) 7-5. Interlocking wedge osteotomy -15 - ( ) 17:20 17:25 9:00 9:50 1 1 5 3 1-1 Xp HTO JLCA ( ), , , , HTO JLCA 40 OW-HTO Xp HTO Xp JLCA HTO JLCA JLCA HTO JLCA JLCA HTO JLCA %MA JLCA R= Miniaci HTO JLCA R= Xp JLCA 1-2 MPTA ( )

8 1, 1,2, 1, 1, 1 1 2 HTO ,MPTA , 2013-2020 HTO 1 152 63 , MPTA MPTA 89 , 1 KOOS MPTA MPTA ( vs : p< ) KOOS MPTA MPTA ( vs : p< ) MPTA , MPTA 1-3 Open wedge safe zone safe 1, 2, 2 1 2 OWHTO safe zone safe 2017 OWHTO42 X safe zone P zone S D S 4 CT (PTFJ-T) (S- P )/ (S- J )/ (S- D ) X P 5 S 33 (S- P 10 /S-J 23 /S-D 0 ) D 4 ( ) P S (S- P ) D P 0% S 36%(S- P 20%/S-J 43%)

9 D 50% S- J D safe zone safe PTFJ-T 1-4 1, 1, 1, 1, 2, 1,2 1 2 (OWHTO) (LHF) LHF OWHTO 53 ( ) Kellgren-Lawrence Grade2/3/4 3 (6 )/35 (66 )/15 (28 ) LHF ( ) ROC LHF LHF 14 Type1 8 (15 ) Type2 2 (4 ) Type3 4 (8 ) Type3 ROC ( , p= , 100%) Type3 (odds infinity p ) Type3 LHF 1-5 1,2, 3, 1,4, 1, 1, 1,2, 1 1 2 3 4 PFEI.

10 PFEI . 25 PFEI( 20ml) . , . , . , 2 , Visual Analogue Scale VAS , . , 2 2 . VAS , . PFEI , . 1-6 PCL OA OWHTO , , (PCL) (PTS) OWHTO 5 5 K-L grade 3 II +1mm -1mm 1 DFO KOOS X FTA PTS PTS HTO PCL 10:00 10.