Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Phys Ther. 2010 Feb;90(2):149-56. doi: 10.2522/ptj.20090119. Epub 2009 Dec 10.
Functional recovery of patients after a total knee arthroplasty (TKA) usually is measured with questionnaires. However, these self-report measures assess the patient's perspective on his or her ability to perform a task. Performance-based tests are needed to assess the patient's actual ability to perform a task.
The main purpose of this study was to quantify improvement in performance of the sit-to-stand movement of patients with a TKA.
In this prospective study of 16 patients with end-stage knee osteoarthritis followed by a TKA, the maximal knee angular extension velocity and amount of unloading (shifting weight) of the affected leg during the sit-to-stand movement and the visual analog scale score for pain were assessed preoperatively and 6 months and 1 year postoperatively. These data were compared with data for a control group of individuals who were healthy (n=27).
Before surgery, the participants in the TKA group unloaded their affected leg, but within 6 months after implantation, the affected leg was almost fully loaded again and comparable to the loading symmetry ratio of the control group. Furthermore, knee extension velocity also had increased, but remained lower than that of the control group. The changes in knee extension velocity took place during the first 6 months, after which a plateau was visible. Limitations A potential limitation of the study design was that the patients were not perfectly matched with the control subjects.
Implantation of a total knee prosthesis partly improved performance of the sit-to-stand movement. Participants in the TKA group could fully load their operated leg, but they could not generate enough knee angular velocity during rising compared with the control group.
全膝关节置换术（TKA）后患者的功能恢复通常通过问卷进行评估。然而，这些自我报告的测量方法评估的是患者对完成任务的能力的看法。需要进行基于表现的测试来评估患者执行任务的实际能力。
本研究的主要目的是量化 TKA 患者从坐到站运动的表现改善情况。
在这项对 16 名终末期膝关节骨关节炎患者的前瞻性研究中，在 TKA 后，对受影响腿在从坐到站运动过程中的最大膝关节角度伸展速度和卸载量（转移重量）以及疼痛视觉模拟评分进行了术前、术后 6 个月和 1 年的评估。这些数据与健康对照组（n=27）的数据进行了比较。
在手术前，TKA 组的参与者会卸载受影响的腿，但在植入后的 6 个月内，受影响的腿再次几乎完全承重，与对照组的承重对称性比例相当。此外，膝关节伸展速度也有所提高，但仍低于对照组。膝关节伸展速度的变化发生在最初的 6 个月内，之后出现了一个平台期。局限性：研究设计的一个潜在局限性是患者与对照组并非完全匹配。
全膝关节假体植入部分改善了从坐到站的运动表现。TKA 组的参与者可以完全承重他们的手术腿，但与对照组相比，他们在起身过程中无法产生足够的膝关节角度速度。
