HSS J. 2010 Sep;6(2):138-44. doi: 10.1007/s11420-009-9150-7. Epub 2010 Jan 29.
Implants designed for enhanced flexion offer the prospect of improved function after total knee replacement (TKR). Whereas most studies evaluating these implants have focused on the range of knee flexion achieved, this study investigated the quality of function in deep knee flexion. The influences of residual pain and maximum flexion angle on function in deep knee flexion were also examined. Eighty-three patients (100 knees) were prospectively followed for 1 year after TKR with a rotating-platform posterior-stabilized high-flexion prosthesis. Range of motion was measured and Knee Society scores were calculated. A questionnaire evaluated residual knee pain and function in high-flexion activities. Mean Knee Society score was 95, and mean knee flexion was 125°, yet 20% of patients could neither kneel, nor squat, nor sit on their heels. Fifty-seven percent were able to kneel without significant difficulty; 69% were able to squat without significant difficulty; and 46% were able to sit on their heels without significant difficulty. Function in deep flexion correlated with pain scores but did not correlate with knee flexion angles or Knee Society scores. Results 1 year after TKR with a rotating-platform posterior-stabilized high-flexion prosthesis are encouraging, but one in five patients remain significantly limited in high-flexion activities.
为增强膝关节弯曲度而设计的植入物有望改善全膝关节置换术后的功能。虽然大多数评估这些植入物的研究都集中在膝关节弯曲度的范围上，但本研究调查了深度膝关节弯曲度下的功能质量。还研究了残余疼痛和最大弯曲角度对深度膝关节弯曲功能的影响。83 名患者（100 膝）在接受旋转平台后稳定高弯曲度假体的全膝关节置换术后 1 年进行了前瞻性随访。测量了运动范围并计算了膝关节协会评分。问卷调查评估了高屈曲活动中残余膝关节疼痛和功能。平均膝关节协会评分为 95 分，平均膝关节弯曲度为 125°，但 20%的患者无法跪地、深蹲或坐脚跟。57%的患者可以无明显困难跪地；69%的患者可以无明显困难深蹲；46%的患者可以无明显困难坐脚跟。深度弯曲功能与疼痛评分相关，但与膝关节弯曲角度或膝关节协会评分无关。在接受旋转平台后稳定高弯曲度假体的全膝关节置换术后 1 年的结果令人鼓舞，但仍有五分之一的患者在高弯曲活动中受到明显限制。
