Rodriguez Jose A, Bas Marcel A, Orishimo Karl F, Robinson Jonathan, Nicholas Stephen J
Department of Orthopaedic Surgery, Lenox Hill Hospital, North Shore-LIJ Health System, New York, New York.
Nicholas Institute of Sports Medicine and Athletic Trauma, Department of Orthopaedic Surgery, Lenox Hill Hospital, North Shore-LIJ Health System, New York, New York.
J Arthroplasty. 2016 Sep;31(9 Suppl):248-53. doi: 10.1016/j.arth.2016.06.061. Epub 2016 Jul 6.
Total knee arthroplasty and its relation to gait abduction or adduction moment has not been fully described.
Gait analysis was performed on 25 patients (27 knees) preoperatively, 6 months and 1 year after total knee arthroplasty. Reflective markers were placed on the lower extremity, and motion data were collected at 60 Hz using 6 infrared cameras. Ground reaction forces were recorded at 960 Hz with a force plate. Stance phase was divided into braking and propulsive phases. Coronal knee angles and moments were calculated. Repeated-measures analysis of variance was used to compare frontal plane knee impulse over time and between the braking and propulsive phases of stance.
In varus knees, static alignment was corrected from 2.2° varus to 3.3° valgus and in valgus knees from 15.2° valgus to 2.7° valgus (P < .010). Braking phase adduction impulse decreased from 0.145 to 0.111 at 6 months but increased to 0.126 Nm/kg s (P > .05) at 1 year. Propulsive phase impulse changed from 0.129 to 0.085 and persisted at 1 year. Impulse changed from 0.01 (abduction) to 0.11 Nm/kg s (adduction) at 6 months and persisted (P = .01).
Restoration of anatomic alignment and soft tissue balancing changes the lateral loading conditions of valgus knees. Both cases, between 6 months and 1 year, increased peak moment.
全膝关节置换术及其与步态外展或内收力矩的关系尚未得到充分描述。
对25例患者（27个膝关节）在全膝关节置换术前、术后6个月和1年进行步态分析。在下肢放置反光标记，使用6台红外摄像机以60Hz的频率收集运动数据。用测力板以960Hz记录地面反作用力。站立期分为制动期和推进期。计算冠状面膝关节角度和力矩。采用重复测量方差分析比较不同时间以及站立期制动和推进阶段之间的额面膝关节冲量。
在膝内翻患者中，静态对线从2.2°内翻矫正至3.3°外翻，在膝外翻患者中从15.2°外翻矫正至2.7°外翻（P <.010）。制动期内收冲量在6个月时从0.145降至0.111，但在1年时增至0.126 Nm/kg·s（P>.05）。推进期冲量从0.129变为0.085，并在1年时持续存在。冲量在6个月时从0.01（外展）变为0.11 Nm/kg·s（内收）并持续存在（P =.01）。
解剖对线的恢复和软组织平衡改变了膝外翻膝关节的外侧负荷条件。在6个月至1年之间，两种情况的峰值力矩均增加。
