Mine Takatomo, Ihara Koichiro, Kawamura Hiroyuki, Kuriyama Ryutaro, Date Ryo
Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, Simonoseki, Japan.
J Orthop Surg (Hong Kong). 2015 Apr;23(1):76-9. doi: 10.1177/230949901502300118.
To compare gait parameters in women after unilateral total knee arthroplasty (TKA) versus sequential bilateral TKA to determine the need for sequential TKA.
35 women aged 60 to 74 (mean, 70) years with bilateral varus knee osteoarthritis (OA) underwent unilateral (n=23) or sequential bilateral (n=12) TKA by a single surgeon. All patients underwent unilateral TKA; 12 patients then underwent sequential TKA after 3 to 6 months of the first TKA. Gait parameters (step length, step width, gait velocity, single support phase value, and the maximum centre of gravity ratio) were compared before and after TKA, and between patients with unilateral versus bilateral TKA.
Patients with sequential bilateral TKA had more severe OA in their contralateral knee than patients with unilateral TKA. In patients with unilateral and sequential bilateral TKA respectively, the mean step width differed at postoperative one month (12.9 vs. 19.1, p<0.01) and 3 months (11.9 vs. 16, p=0.03), and the mean maximum centre of gravity ratio differed at postoperative 3 months (2.43 vs. 1.75, p=0.02), whereas the mean step length, mean gait velocity, and mean single support phase values did not differ significantly between groups.
After unilateral TKA, contralateral TKA may not be necessary in some patients whose gait has improved.
比较单侧全膝关节置换术（TKA）与序贯双侧TKA术后女性的步态参数，以确定序贯TKA的必要性。
35名年龄在60至74岁（平均70岁）的双侧膝内翻骨关节炎（OA）女性患者由同一位外科医生进行单侧（n = 23）或序贯双侧（n = 12）TKA。所有患者均接受了单侧TKA；其中12名患者在首次TKA术后3至6个月接受了序贯TKA。比较TKA前后以及单侧与双侧TKA患者之间的步态参数（步长、步宽、步态速度、单支撑相值和最大重心比值）。
序贯双侧TKA患者对侧膝关节的OA比单侧TKA患者更严重。在单侧和序贯双侧TKA患者中，术后1个月（12.9对19.1，p<0.01）和3个月（11.9对16，p = 0.03）的平均步宽不同，术后3个月的平均最大重心比值也不同（2.43对1.75，p = 0.02），而两组之间的平均步长、平均步态速度和平均单支撑相值没有显著差异。
单侧TKA术后，对于一些步态已改善的患者，可能无需进行对侧TKA。
