Department of Orthopedics and Traumatology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey,
Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):3067-73. doi: 10.1007/s00167-014-2896-6. Epub 2014 Feb 12.
The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups.
In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90°. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60° and 180°/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees.
No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180°/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (-4.2%) than in Group 1 (-23.1%).
For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure.
II.
本研究旨在评估膝关节在全膝关节置换术中（伸直位与屈曲位）关闭伤口时对膝关节力量和功能的影响，通过膝关节学会评分和等速测试伸肌和屈肌肌群来确定。
在一项前瞻性、随机、双盲试验中，将 29 名患者分为两组：第一组患者的膝关节伸直进行手术关闭，第二组患者的膝关节屈曲 90°进行手术关闭。所有患者均采用相同的麻醉方法、手术团队、手术技术、假体类型和康复过程进行治疗。记录美国膝关节学会评分值和膝关节屈曲度。使用 60°和 180°/s 角速度对双膝进行等速肌肉力量测试，分别在屈肌和伸肌进行测试。计算手术修复和健康膝关节的峰值扭矩和总功值、等速肌肉力量差异和总功差值。
两组间平均美国膝关节学会评分值和膝关节屈曲度无显著差异。然而，使用等速评估，当患者以 180°/s 进行测试时，两组间屈肌的等速肌肉力量差异和总功差值存在显著差异。第二组（-4.2%）屈肌的等速肌肉力量差异较第一组（-23.1%）的力量损失更小。
对于接受全膝关节置换术的患者，如果在伤口关闭时膝关节处于屈曲状态，术后屈肌力量会得到改善。
II 级。
