Milner Clare E
Department of Exercise, Sport, and Leisure Studies, University of Tennessee, Knoxville, TN 37996-2700, USA.
J Orthop Sci. 2009 Jan;14(1):114-20. doi: 10.1007/s00776-008-1285-8. Epub 2009 Feb 13.
Development or retention of abnormal gait patterns after total knee arthroplasty may be related to the predictable pattern of further deterioration of other lower extremity joints. The purpose of this study was to determine whether gait mechanics are abnormal after total knee arthroplasty by conducting a systematic review of the literature.
Articles were identified by searching the following electronic databases: PubMed, Cinahl, Web of Science: 221 references were retrieved. The titles and abstracts were reviewed to identify studies that potentially met the inclusion criteria. These articles were retrieved for further assessment. Ten articles met the inclusion criteria and were included in the review.
There was a lack of common variables across the studies. Studies indicated smaller peak knee flexion during weight acceptance and less knee flexion excursion in total knee arthroplasty subjects compared to controls. Knee angle at foot strike was generally similar in arthroplasty groups compared to controls. Maximum external knee flexion moment was generally lower in arthroplasty groups compared to controls. Conflicting results were found for other knee moments. Several other stance phase variables were reported by individual studies only.
Peak knee flexion and knee flexion excursion during weight acceptance are smaller in the operated knee following total knee arthroplasty compared to healthy controls. There may also be a smaller peak knee flexion moment after arthroplasty compared to controls. Knee mechanics in the operated knee are not normal after total knee arthroplasty. Abnormal gait mechanics may predispose the individual to further joint degeneration, particularly in the nonoperated knee. Further research should focus on the effects of unilateral total knee arthroplasty on the nonoperated knee.
全膝关节置换术后异常步态模式的出现或持续可能与其他下肢关节进一步退变的可预测模式有关。本研究的目的是通过对文献进行系统综述，确定全膝关节置换术后步态力学是否异常。
通过检索以下电子数据库来识别文章：PubMed、护理学与健康领域数据库（Cinahl）、科学网（Web of Science）：共检索到221篇参考文献。对标题和摘要进行审查，以确定可能符合纳入标准的研究。检索这些文章以进行进一步评估。10篇文章符合纳入标准并被纳入综述。
各项研究之间缺乏共同变量。研究表明，与对照组相比，全膝关节置换术患者在负重时的膝关节最大屈曲角度较小，膝关节屈曲活动度也较小。与对照组相比，置换组在足跟着地时的膝关节角度通常相似。与对照组相比，置换组的最大膝关节外侧屈曲力矩通常较低。对于其他膝关节力矩，研究结果相互矛盾。个别研究仅报告了其他几个站立期变量。
与健康对照组相比，全膝关节置换术后患侧膝关节在负重时的最大屈曲角度和膝关节屈曲活动度较小。与对照组相比，置换术后的膝关节最大屈曲力矩可能也较小。全膝关节置换术后患侧膝关节的力学状态不正常。异常的步态力学可能使个体更容易发生进一步的关节退变，尤其是在未手术的膝关节。进一步的研究应关注单侧全膝关节置换术对未手术膝关节的影响。
