Komnik Igor, Peters Markus, Funken Johannes, David Sina, Weiss Stefan, Potthast Wolfgang
Institute for Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Nordrhein-Westfalen, Germany.
ARCUS Clinics Pforzheim, Pforzheim, Baden-Württemberg, Germany.
PLoS One. 2016 Dec 21;11(12):e0168566. doi: 10.1371/journal.pone.0168566. eCollection 2016.
After knee arthroplasty (KA) surgery, patients experience abnormal kinematics and kinetics during numerous activities of daily living. Biomechanical investigations have focused primarily on level walking, whereas walking on sloped surfaces, which is stated to affect knee kinematics and kinetics considerably, has been neglected to this day. This study aimed to analyze over-ground walking on level and sloped surfaces with a special focus on transverse and frontal plane knee kinematics and kinetics in patients with KA. A three-dimensional (3D) motion analysis was performed by means of optoelectronic stereophogrammetry 1.8 ± 0.4 years following total knee arthroplasty (TKA) and unicompartmental arthroplasty surgery (UKA). AnyBody™ Modeling System was used to conduct inverse dynamics. The TKA group negotiated the decline walking task with reduced peak knee internal rotation angles compared with a healthy control group (CG). First-peak knee adduction moments were diminished by 27% (TKA group) and 22% (UKA group) compared with the CG during decline walking. No significant differences were detected between the TKA and UKA groups, regardless of the locomotion task. Decline walking exposed apparently more abnormal knee frontal and transverse plane adjustments in KA patients than level walking compared with the CG. Hence, walking on sloped surfaces should be included in further motion analysis studies investigating KA patients in order to detect potential deficits that might be not obvious during level walking.
膝关节置换术(KA)后,患者在众多日常活动中会出现异常的运动学和动力学表现。生物力学研究主要集中在平地行走方面,而在倾斜表面行走对膝关节运动学和动力学有显著影响,至今却一直被忽视。本研究旨在分析全膝关节置换术(TKA)和单髁置换术(UKA)患者在平地和倾斜表面上的地面行走情况,特别关注膝关节在横断面和额状面的运动学和动力学。在全膝关节置换术(TKA)和单髁置换术(UKA)术后1.8±0.4年,通过光电立体摄影测量法进行三维(3D)运动分析。使用AnyBody™建模系统进行逆动力学分析。与健康对照组(CG)相比,TKA组在走下坡路任务中膝关节内旋峰值角度减小。在走下坡路时,与CG相比,TKA组的首个膝关节内收力矩降低了27%,UKA组降低了22%。无论运动任务如何,TKA组和UKA组之间均未检测到显著差异。与CG相比,KA患者走下坡路时膝关节在额状面和横断面的调整明显比平地行走时更异常。因此,在进一步研究KA患者的运动分析中应纳入在倾斜表面行走的情况,以便检测出在平地行走时可能不明显的潜在缺陷。