Ahmed Issaq, Gray Andrew C, van der Linden Marietta, Nutton Richard
Department of Trauma and Orthopedics, The Royal Infirmary of Edinburgh, Little France, Edinburgh, Scotland, United Kingdom.
Orthopedics. 2009 Nov;32(11):811. doi: 10.3928/01477447-20090922-13.
Range of motion following total knee arthroplasty (TKA) is a crucial measure of clinical outcome. The purpose of this randomized, controlled study was to determine which factors are predictive of postoperative range of flexion. Fifty-six patients received either a standard or a high-flexion design NexGen Legacy Posterior-Stabilized TKA (Zimmer, Warsaw, Indiana). The relationship between preoperative flexion, intraoperative flexion, and range of flexion 1 year postoperatively was determined. The influence of soft tissue release and the type of femoral component was also investigated. A significant correlation existed between preoperative flexion, intraoperative flexion, and maximum flexion 1 year postoperatively. Patients who had a preoperative range of flexion less than the mean range of flexion for the overall group gained flexion, whereas patients with a preoperative range of flexion greater than the mean range of flexion lost flexion. The degree of soft tissue release performed and the type of implant used had no influence on maximum flexion at 1 year. The principal predictive factor of postoperative range of flexion, regardless of the degree of soft tissue release or implant design, is the preoperative and intraoperative range of flexion.
全膝关节置换术（TKA）后的活动范围是临床疗效的关键指标。这项随机对照研究的目的是确定哪些因素可预测术后屈曲范围。56例患者接受了标准或高屈曲设计的NexGen Legacy后稳定型TKA（捷迈公司，印第安纳州华沙）。确定了术前屈曲、术中屈曲与术后1年屈曲范围之间的关系。还研究了软组织松解和股骨假体类型的影响。术前屈曲、术中屈曲与术后1年最大屈曲之间存在显著相关性。术前屈曲范围小于总体组平均屈曲范围的患者获得了屈曲，而术前屈曲范围大于平均屈曲范围的患者则失去了屈曲。软组织松解程度和所用植入物类型对1年时的最大屈曲没有影响。无论软组织松解程度或植入物设计如何，术后屈曲范围的主要预测因素是术前和术中的屈曲范围。
