Silva Mauricio, Shepherd Eric F, Jackson Walter O, Pratt Jeffrey A, McClung Christian D, Schmalzried Thomas P
Joint Replacement Institute at Orthopaedic Institute, Los Angeles, CA 90007, USA.
J Arthroplasty. 2003 Aug;18(5):605-11. doi: 10.1016/s0883-5403(03)00191-8.
Fifty-two knees in normal healthy subjects and 32 knees more than 2 years after total knee arthroplasty (TKA) were evaluated. Average isometric extension peak torque values in TKA patients were reduced by up to 30.7% (P=.01). Isometric flexion peak torque values in patients with TKA were, on average, 32.2% lower than those from control subjects throughout the motion arc (P=.004). Knee Society Functional Scores were positively correlated to the average isometric extension peak torque (r=0.57; P=.004) and negatively correlated to the average isometric hamstring to quadriceps (H/Q) ratio (r=-0.78, P<.0001). Relatively greater quadriceps strength was associated with a better functional score. Older TKA patients (>/=70 years) generated lower isometric extension peak torque values in terminal extension than younger TKA patients (>24.2%; P=.05). Higher body mass index (BMI) was associated with relative quadriceps weakness (r=0.44; P=.007). These results suggest that more thorough rehabilitation after TKA would improve functional outcomes.
对52例正常健康受试者的膝关节以及32例全膝关节置换术(TKA)后2年以上的膝关节进行了评估。TKA患者的平均等长伸展峰值扭矩值降低了30.7%(P = 0.01)。在整个运动弧度中,TKA患者的等长屈曲峰值扭矩值平均比对照组低32.2%(P = 0.004)。膝关节协会功能评分与平均等长伸展峰值扭矩呈正相关(r = 0.57;P = 0.004),与平均等长绳肌与股四头肌(H/Q)比值呈负相关(r = -0.78,P < 0.0001)。相对较强的股四头肌力量与较好的功能评分相关。老年TKA患者(≥70岁)在终末伸展时产生的等长伸展峰值扭矩值低于年轻TKA患者(>24.2%;P = 0.05)。较高的体重指数(BMI)与股四头肌相对无力相关(r = 0.44;P = 0.007)。这些结果表明,TKA术后更全面的康复将改善功能结局。