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固定和活动平台全膝关节置换术后步态分析和肌电图:一项前瞻性、对照研究。

Gait analysis and electromyography in fixed- and mobile-bearing total knee replacement: a prospective, comparative study.

机构信息

Sporthopaedicum Straubing, Bahnhofplatz 8, 94315, Straubing, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12):2052-9. doi: 10.1007/s00167-011-1540-y. Epub 2011 May 12.

Abstract

PURPOSE

The theoretical superiority of mobile-bearing total knee arthroplasties (TKAs) has not yet been proven in clinical studies. The aim of the current study was to compare and to analyse in a patient population that had received either a fixed or a mobile TKA differences in gait analysis electromyography and clinical scores.

METHODS

In a prospective, randomized, patient- and observer-blinded clinical study, 33 patients with primary osteoarthritis of the knee were included. All patients received a Genesis II total knee replacement. Sixteen patients received a mobile and 17 a fixed-bearing cruciate retaining Genesis II TKA. Clinical and quality-of-life scores, electromyography and gait analysis were applied preoperatively and postoperatively with a follow-up of 24 months.

RESULTS

In both groups, improvements from pre- to postoperative were detected. whereas the results of gait analysis and electromyography did not show any differences. The results from the clinical and the quality-of-life scores improved from pre- to postoperative, while the Knee Society Score showed a superiority of the mobile-bearing group (mean 159 ± 28) over the fixed-bearing group (mean 134 ± 41).

CONCLUSION

No functional advantage of mobile over fixed-bearing TKA was detected, although the mobile-bearing group had better clinical results for which a reason could not be found. These results only apply to cruciate retaining mobile-bearing TKA with a bearing which allows both rotation and anteroposterior translation.

摘要

目的

尽管在临床研究中,并未证明活动衬垫全膝关节置换术(TKA)具有理论上的优越性,但目前研究的目的是在接受固定或活动 TKA 的患者人群中比较和分析步态分析肌电图和临床评分的差异。

方法

在一项前瞻性、随机、患者和观察者双盲的临床研究中,纳入了 33 名患有原发性膝关节骨关节炎的患者。所有患者均接受了 Genesis II 全膝关节置换术。其中 16 名患者接受了活动衬垫、17 名患者接受了固定衬垫保留交叉韧带的 Genesis II TKA。在术后 24 个月的随访中,分别在术前和术后应用临床和生活质量评分、肌电图和步态分析。

结果

两组患者均显示出从术前到术后的改善,而步态分析和肌电图的结果没有差异。临床和生活质量评分的结果从术前到术后都有所改善,而膝关节协会评分显示活动衬垫组(平均 159 ± 28)优于固定衬垫组(平均 134 ± 41)。

结论

尽管活动衬垫组的临床结果更好,但并未发现活动衬垫 TKA 比固定衬垫 TKA 具有功能优势,原因尚不清楚。这些结果仅适用于允许旋转和前后平移的交叉韧带保留活动衬垫 TKA。

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