Department of Orthopaedic Surgery, Fundación Jiménez Díaz Hospital, Universidad Autónoma de Madrid, Avda Reyes Católicos 2, Madrid 28040, Spain.
Clin Orthop Relat Res. 2010 May;468(5):1214-20. doi: 10.1007/s11999-009-1190-2.
Better muscular recovery of the extensor mechanism after TKA is claimed by femoral designs based on a sagittal single radius.
QUESTIONS/PURPOSES: We aimed to compare postoperative knee performance through the Knee Society scores, flexor and extensor muscle function, stability, and gait of a series of patients receiving a posterior stabilized, cemented TKA, with a single-radius femoral design.
We compared a series of patients treated with a single-radius femoral design TKA to a simultaneous series of patients receiving a multiradius femoral design. Both groups were similar in demographics and preoperative Knee Society scores. The clinical pathways were identical. Outcome assessment included Knee Society scores, isokinetic assessment, stabilometry, and gait cycle analysis.
We observed higher functional Knee Society scores (86.6 +/- 1.89 versus 80.3 +/- 1.90), fewer physiotherapy sessions (19.9 +/- 4.65 versus 22.2 +/- 3.34), and less time with two crutches (3.5 +/- 1.2 versus 5.2 +/- 1.04 weeks) for patients receiving the single-radius design. Isokinetic evaluation showed decreased flexion peak torque (40.3 +/- 7.9 versus 48.7 +/- 9.6), increased extension peak torque (77.2 +/- 16.1 versus 69.1 +/- 14.4), and lower flexor/extensor ratio (0.5 +/- 0.08 versus 0.7 +/- 0.1) in patients with the single-radius design. Stabilometry showing less relative oscillation, and gait cycle indirectly confirmed better support in the limb with the single-radius design.
The studied single-radius femoral design showed better functional short-term outcome and better extensor performance.
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
基于矢状单半径的股骨设计据称可使 TKA 后的伸肌机制更好地恢复。
问题/目的：我们旨在通过膝关节协会评分、屈肌和伸肌功能、稳定性以及一系列接受后稳定型、骨水泥固定 TKA 的患者的步态比较一系列接受单半径股骨设计的患者的术后膝关节表现。
我们将一组接受单半径股骨设计 TKA 的患者与一组同时接受多半径股骨设计的患者进行比较。两组在人口统计学和术前膝关节协会评分方面相似。临床路径相同。结果评估包括膝关节协会评分、等速评估、稳定计和步态周期分析。
我们观察到接受单半径设计的患者具有更高的功能膝关节协会评分（86.6 +/- 1.89 与 80.3 +/- 1.90）、更少的物理治疗次数（19.9 +/- 4.65 与 22.2 +/- 3.34）和更少的双拐时间（3.5 +/- 1.2 与 5.2 +/- 1.04 周）。等速评估显示，接受单半径设计的患者的膝关节屈曲峰值扭矩降低（40.3 +/- 7.9 与 48.7 +/- 9.6），膝关节伸展峰值扭矩增加（77.2 +/- 16.1 与 69.1 +/- 14.4），并且膝关节屈肌/伸肌比降低（0.5 +/- 0.08 与 0.7 +/- 0.1）。稳定计显示相对摆动较少，步态周期间接证实了单半径设计的肢体更好的支撑。
研究中的单半径股骨设计显示出更好的短期功能结果和更好的伸肌表现。
三级，治疗研究。有关证据水平的完整描述，请参阅作者指南。
