Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3086, Australia.
J Orthop Res. 2012 Mar;30(3):371-6. doi: 10.1002/jor.21545. Epub 2011 Sep 1.
An abnormal flexor moment pattern is often evident following total knee replacement (TKR) surgery. We investigated whether such a pattern at 12 months post-surgery could be predicted using biomechanical gait measures assessed before surgery and at 4 months post-surgery. Thirty two TKR patients were evaluated and classified as normal (biphasic pattern) or abnormal (flexor moment pattern) at each time point. Biomechanical parameters collected before surgery and at 4 months post-surgery were then explored for their ability to predict gait patterns at 12 months post-surgery. The gait pattern at 4 months was significantly associated with the 12 month post-surgery gait pattern, with over half of those with a flexor moment pattern at 4 months retaining this pattern at 12 months. Discriminant function analysis indicated that peak knee flexion during early stance, peak knee extension, and peak knee extension moment at 4 months post-surgery were independent predictors of the gait pattern at 12 months. Thus, an abnormal knee flexor moment pattern at 12 months post-surgery can be predicted by biomechanical analysis 4 months after surgery. Therefore, interventions aimed at improving active extension may need to be implemented early after surgery to restore a normal gait pattern.
全膝关节置换（TKR）手术后通常会出现异常的屈肌力矩模式。我们研究了在术后 12 个月，是否可以使用术前和术后 4 个月评估的生物力学步态测量来预测这种模式。对 32 例 TKR 患者进行评估，并在每个时间点将其分类为正常（双相模式）或异常（屈肌力矩模式）。然后探讨了术前和术后 4 个月收集的生物力学参数，以预测术后 12 个月的步态模式。术后 4 个月的步态模式与术后 12 个月的步态模式显著相关，其中超过一半的术后 4 个月存在屈肌力矩模式的患者在术后 12 个月仍保持这种模式。判别函数分析表明，术后 4 个月早期站立时的膝关节最大屈曲、膝关节最大伸展和膝关节最大伸展力矩是术后 12 个月步态模式的独立预测因素。因此，术后 4 个月的生物力学分析可以预测术后 12 个月的膝关节屈肌力矩异常模式。因此，为了恢复正常步态，可能需要在手术后早期实施旨在改善主动伸展的干预措施。
