Ngai Valentina, Wimmer Markus A
Department of Orthopedic Surgery, Rush University Medical Center, 1611 W. Harrison Street, Suite 204, Chicago, IL 60612, USA.
Biomed Res Int. 2015;2015:284513. doi: 10.1155/2015/284513. Epub 2015 Mar 19.
Several factors, including compressive load and knee kinematics, have been shown to influence wear. External knee moments (a surrogate for load) have recently been correlated with the medial and lateral wear scar areas of an unconstrained, PCL retaining knee design. Therefore, the purpose of this study was to determine whether differences in kinetics during level walking are accompanied by specific differences in relative knee kinematics. Thirty TKR patients were gait tested using the point cluster technique to obtain 3D motions of the knee. External knee moments were calculated from ground reaction forces recorded with a multicomponent force plate. The subjects were separated into two distinct anteroposterior (AP) motion categories: a low motion group and a high motion group. Similarly, the low and high motion groups for internal-external (IE) rotation were also identified. For the IE motion, there was no significant difference between the transverse internal rotation moments between the two IE motion groups. However for the AP motion groups, a higher external peak flexion moment was found for the group displaying less AP motion. These observations suggest that subjects with higher joint moments execute smaller ranges of AP motion and thus are likely to incur less wear.
包括压缩负荷和膝关节运动学在内的几个因素已被证明会影响磨损。外部膝关节力矩（负荷的替代指标）最近已与无约束、保留后交叉韧带膝关节设计的内侧和外侧磨损瘢痕面积相关联。因此，本研究的目的是确定在平地行走过程中动力学差异是否伴随着相对膝关节运动学的特定差异。使用点簇技术对30名全膝关节置换术患者进行步态测试，以获取膝关节的三维运动。外部膝关节力矩由用多分量测力板记录的地面反作用力计算得出。受试者被分为两个不同的前后（AP）运动类别：低运动组和高运动组。同样，也确定了内外（IE）旋转的低运动组和高运动组。对于IE运动，两个IE运动组之间的横向内旋力矩没有显著差异。然而，对于AP运动组，在显示较少AP运动的组中发现了更高的外部峰值屈曲力矩。这些观察结果表明，具有较高关节力矩的受试者执行的AP运动范围较小，因此可能产生较少的磨损。
