Siriraj Hospital, Department of Orthopaedic Surgery, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
Bone Joint J. 2014 Jul;96-B(7):902-6. doi: 10.1302/0301-620X.96B7.33290.
We have compared the time to recovery of isokinetic quadriceps strength after total knee replacement (TKR) using three different lengths of incision in the quadriceps. We prospectively randomised 60 patients into one of the three groups according to the length of incision in the quadriceps above the upper border of the patella (2 cm, 4 cm or 6 cm). The strength of the knees was measured pre-operatively and every month post-operatively until the peak quadriceps torque returned to its pre-operative level. There was no significant difference in the mean operating time, blood loss, hospital stay, alignment or pre-operative isokinetic quadriceps strength between the three groups. Using the Kaplan-Meier method, group A had a similar mean recovery time to group B (2.0 ± 0.2 vs 2.5 ± 0.2 months, p = 0.176). Group C required a significantly longer recovery time (3.4 ± 0.3 months) than the other groups (p < 0.03). However, there were no significant differences in the mean Oxford knee scores one year post-operatively between the groups. We conclude that an incision of up to 4 cm in the quadriceps does not delay the recovery of its isokinetic strength after TKR.
我们比较了全膝关节置换术后（TKR）三种不同股四头肌切口长度对股四头肌等速力量恢复的时间。我们前瞻性地根据髌骨上缘上方股四头肌切口的长度（2cm、4cm 或 6cm）将 60 例患者随机分为三组。术前和术后每月测量膝关节力量，直到股四头肌峰值扭矩恢复到术前水平。三组间平均手术时间、失血量、住院时间、对线和术前等速股四头肌力量无显著差异。使用 Kaplan-Meier 法，A 组与 B 组的平均恢复时间相似（2.0±0.2 与 2.5±0.2 个月，p=0.176）。C 组的恢复时间明显长于其他两组（3.4±0.3 个月，p<0.03）。然而，术后 1 年各组间平均牛津膝关节评分无显著差异。我们得出结论，股四头肌的切口不超过 4cm 不会延迟 TKR 后其等速力量的恢复。
