Gapeyeva Helena, Buht Nele, Peterson Katrin, Ereline Jaan, Haviko Tiit, Pääsuke Mati
Institute of Exercise Biology and Physiotherapy, University of Tartu, 5 Jakobi Street, Tartu 51014, Estonia.
Knee Surg Sports Traumatol Arthrosc. 2007 Feb;15(2):202-11. doi: 10.1007/s00167-006-0166-y. Epub 2006 Sep 28.
The purpose of the present prospective intervention study was to evaluate voluntary isometric force production, relaxation and activation capacity of the quadriceps femoris (QF) muscle before and 6 months after unilateral total knee arthroplasty (TKA). TKA was performed in ten women with primary knee osteoarthritis (OA) using the condylar endoprostheses. Isometric maximal voluntary contraction (MVC) force, rate of force development at 50% of MVC (RFD50) and their ratio to body mass, half-relaxation time (HRT) and voluntary activation (VA) of the QF muscle were recorded in patients for operated and non-operated leg before and 6 months after TKA. Established characteristics were compared with data on the dominant leg of ten age- and gender-matched controls. The clinical examination was performed using the Knee Society System (KSS) scores and pain intensity was assessed by visual analogue scale. MVC force in operated leg was lower (P < 0.05) before and 6 months after TKA as compared with the non-operated leg (31 and 32%, respectively) and controls (48 and 44%, respectively). Patients had lower (P < 0.05) VA of the QF muscle in operated leg 6 months after TKA as compared to controls. Significant increase (P < 0.05) of KSS clinical scores and the tendency for the increasing of explosive force production of QF muscle in the operated leg were observed 6 months after TKA (RFD50 was 60% lower before TKA and 40% lower 6 months after surgery as compared to controls). When compared with the preoperative value, HRT prolongation (P < 0.05) was noted 6 months after TKA in QF muscle of both legs in patients. Therefore, the present study confirmed that patients with knee OA had reduced force generation ability of QF muscle before TKA and the improvement of explosive force was noted 6 months after surgery.
本前瞻性干预研究的目的是评估单侧全膝关节置换术(TKA)前后6个月股四头肌(QF)的自主等长肌力产生、放松和激活能力。对10名患有原发性膝关节骨关节炎(OA)的女性患者使用髁型假体进行TKA手术。记录患者在TKA术前和术后6个月患侧和健侧QF肌肉的等长最大自主收缩(MVC)力、MVC 50%时的力发展速率(RFD50)及其与体重的比值、半放松时间(HRT)和自主激活(VA)。将既定特征与10名年龄和性别匹配的对照者优势腿的数据进行比较。使用膝关节协会系统(KSS)评分进行临床检查,并通过视觉模拟量表评估疼痛强度。与健侧(分别为31%和32%)和对照组(分别为48%和44%)相比,患侧在TKA术前和术后6个月的MVC力较低(P < 0.05)。与对照组相比,患者在TKA术后6个月患侧QF肌肉的VA较低(P < 0.05)。TKA术后6个月观察到KSS临床评分显著增加(P < 0.05),患侧QF肌肉爆发力产生有增加趋势(与对照组相比,TKA术前RFD50低60%,术后6个月低40%)。与术前值相比,患者双腿QF肌肉在TKA术后6个月HRT延长(P < 0.05)。因此,本研究证实膝关节OA患者在TKA术前QF肌肉的力量产生能力降低,术后6个月爆发力有所改善。