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全膝关节置换术与单髁膝关节置换术步态动力学的比较。

Comparison of gait kinetics in total and unicondylar knee replacement surgery.

作者信息

Miller S, Agarwal A, Haddon W B, Johnston L, Arnold G, Wang W, Abboud R J

机构信息

Department of Orthopaedics, TORT Centre, Ninewells Hospital, University of Dundee , Dundee , UK.

出版信息

Ann R Coll Surg Engl. 2018 Apr;100(4):267-274. doi: 10.1308/rcsann.2017.0226. Epub 2018 Feb 27.

Abstract

Introduction The aim of this study was to compare kinetical data from gait analysis of patients who have undergone total and uni-condylar knee replacement. Materials and methods Thirteen patients with unilateral total knee arthroplasty (TKA) and 13 unicondylar knee arthroplasty (UKA), were included, all performed by the same surgeon more than one year prior. The Vicon gait analysis system was used. Statistical power was calculated using SPSS. Results No significant difference was found in the spatiotemporal parameters of gait and survival years of the knee prosthesis between the two groups. The UKA group was found to have significantly larger moments than the TKA group in knee adduction on the operated side and knee flexion moment on the unoperated side during the loading phase. The maximum and minimum sagittal plane moments of the operated sides in the TKA group were significantly lower than the unoperated side. The difference was most significant at pre-swing. The maximum and minimum moments on the operated sides in the UKA group were significantly lower for the knee flexion and adduction moments when compared with the unoperated side and were most prevalent during the loading phase. Conclusions These results are relevant in terms of prosthesis wear. The TKA knees had smaller magnitude moments than the UKA knees in the sagittal and coronal planes. This could explain the higher revision rates for UKA. In both groups, the non-operated knees had significantly larger moments than the operated knees, which implies that after unilateral knee replacement of either type, the non-operated knee is being put under greater stress.

摘要

引言 本研究的目的是比较全膝关节置换术和单髁膝关节置换术患者步态分析的动力学数据。

材料与方法 纳入13例单侧全膝关节置换术(TKA)患者和13例单髁膝关节置换术(UKA)患者,均由同一位外科医生在一年多以前完成手术。使用Vicon步态分析系统。使用SPSS计算统计功效。

结果 两组之间在步态的时空参数和膝关节假体的生存年限方面未发现显著差异。发现在负重期,UKA组患侧膝关节内收力矩和非患侧膝关节屈曲力矩均显著大于TKA组。TKA组患侧矢状面最大和最小力矩显著低于非患侧。在摆动前期差异最为显著。UKA组患侧膝关节屈曲和内收力矩的最大和最小力矩与非患侧相比显著更低,且在负重期最为明显。

结论 这些结果在假体磨损方面具有相关性。TKA膝关节在矢状面和冠状面的力矩幅度小于UKA膝关节。这可以解释UKA较高的翻修率。在两组中,非手术侧膝关节的力矩显著大于手术侧膝关节,这意味着在进行任何一种单侧膝关节置换术后,非手术侧膝关节承受着更大的压力。

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