Zürcher Arthur W, van Hutten Kim, Harlaar Jaap, Terwee Caroline B, Rob Albers G H, Pöll Ruud G
Department of Orthopedic Surgery, Diakonessen Hospital, Bosboomstraat 1, 3582 KE Utrecht, The Netherlands.
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Knee. 2014 Oct;21(5):960-3. doi: 10.1016/j.knee.2014.05.007. Epub 2014 May 27.
Some reports showed few but significant more axial femorotibial rotation in favor of mobile-bearing (MB) versus fixed-bearing (FB) total knee arthroplasty (TKA), mostly during knee bend fluoroscopic studies. The goal of the current study was to submit MB and FB groups of TKA patients to a turning activity, in which additional rotation was to be expected.
Two consecutive cohorts of patients after TKA (10 FB and 11 MB knees in a total of 18 patients) were assessed using motion analysis five year postoperatively, while performing gait and sit-to-walk (STW) movements with and without turning steps.
Mean range of rotation in the FB group increased from 9.7° during gait, to 11.7° during STW straight, and to 14.3° during STW turning. Mean range of rotation in the MB group increased from 13.4° during gait to 21.0° during STW straight, and stayed at 21.1° during STW turning.
Too many uncontrolled variables in the current study hinder a meaningful discrimination of MB from FB TKA rotation. However, the study does illustrate how more demanding task loads could be helpful in exploring the geometric constraints of TKA variants.
Level III, therapeutic study.
一些报告显示，在全膝关节置换术（TKA）中，相对于固定平台（FB），活动平台（MB）的股胫轴向旋转虽少但更为显著，这一情况主要出现在膝关节弯曲的透视研究中。本研究的目的是让TKA患者的MB组和FB组进行一项旋转活动，预计在此活动中会出现额外的旋转。
连续两组TKA术后患者（共18例患者，10例FB膝关节和11例MB膝关节）在术后五年进行运动分析评估，同时在有和没有转弯步骤的情况下进行步态和从坐到走（STW）动作。
FB组的平均旋转范围从步态期间的9.7°增加到STW直线行走期间的11.7°，并在STW转弯期间增加到14.3°。MB组的平均旋转范围从步态期间的13.4°增加到STW直线行走期间的21.0°，并在STW转弯期间保持在21.1°。
本研究中存在过多无法控制的变量，阻碍了对MB和FB TKA旋转进行有意义的区分。然而，该研究确实说明了要求更高的任务负荷如何有助于探索TKA不同类型的几何限制。
III级，治疗性研究。
