Pepe Murad, Calisal Emre, Kocadal Onur, Bicer Eren, Taskin Suhan, Aktekin Cem Nuri
Department of Orthopedics and Traumatology, Amasya University, Amasya, Turkey.
Department of Orthopedics and Traumatology, Yeditepe University, Istanbul, Turkey.
J Knee Surg. 2019 Jul;32(7):624-629. doi: 10.1055/s-0038-1666865. Epub 2018 Jul 10.
We aimed to investigate the effect of the knee position during the surgical closure on isokinetic muscle strength, clinical score, and range of motion in total knee arthroplasty. Seventy-five eligible patients were enrolled in the study and randomly divided into two groups; wound closure was performed with the knee flexed at 90° in group 1 and knee extended in group 2. All the surgeries were performed by the same surgeon and by the same prosthesis type. All the patients received the same rehabilitation program postoperatively. The primary outcomes were the knee flexion degrees and the American Knee Society Score values at preoperative and postoperative 6 weeks, 3, and 6 months. The secondary outcome was the isokinetic muscle strength measurements of both knees before the surgery and after 6 months. There were no significant differences in the American Knee Society Scores and knee flexion degrees between the flexion and extension groups. However, a significant decrease was found in the extensor muscle strength in the extension group after 6 months of the surgery. The findings of our study are that the closing of the knee in flexion or extension does not affect the postoperative knee flexion degrees and scores in total knee arthroplasty. However, quadriceps strength recovers early if the knee closure is performed in flexion position.
我们旨在研究全膝关节置换术中手术切口闭合时膝关节位置对等速肌力、临床评分和活动范围的影响。75名符合条件的患者纳入本研究并随机分为两组；第1组在膝关节屈曲90°时进行伤口闭合，第2组在膝关节伸直时进行伤口闭合。所有手术均由同一位外科医生使用同一类型的假体进行。所有患者术后均接受相同的康复计划。主要结局指标为术前及术后6周、3个月和6个月时的膝关节屈曲度数和美国膝关节协会评分。次要结局指标为术前及术后6个月时双膝关节的等速肌力测量结果。屈曲组和伸直组之间的美国膝关节协会评分和膝关节屈曲度数无显著差异。然而，术后6个月时伸直组的伸肌力量显著下降。我们的研究结果表明，在全膝关节置换术中，膝关节在屈曲或伸直位闭合不影响术后膝关节屈曲度数和评分。然而，如果在屈曲位进行膝关节闭合，股四头肌力量恢复较早。
