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比较单关节和多关节方法以检测初次单侧全膝关节置换术后的膝关节本体感觉缺陷。

Comparing single and multi-joint methods to detect knee joint proprioception deficits post primary unilateral total knee arthroplasty.

作者信息

Ouattas Abderrahman, Wellsandt Elizabeth, Hunt Nathaniel H, Boese C Kent, Knarr Brian A

机构信息

Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA.

Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE 68198, USA.

出版信息

Clin Biomech (Bristol). 2019 Aug;68:197-204. doi: 10.1016/j.clinbiomech.2019.06.006. Epub 2019 Jun 14.

Abstract

BACKGROUND

The use of various single-joint proprioception measurements has resulted in contradictory findings after knee arthroplasty. The use of balance as a surrogate measure to assess knee proprioception post-operation has resulted in further confusion. The aim of this study was to measure single joint knee proprioception in participants after unilateral knee arthroplasty, and compares it to multi-joint balance.

METHODS

Eleven participants at 1 year after unilateral total knee arthroplasty and twelve age-matched controls were enrolled. The threshold to detect passive motion and the sensory organization test were used to measure single joint knee proprioception and multi-joint balance respectively. Two-way ANOVA and independent t-tests were used to measure differences between and within groups. Regression analysis was used to measure the association between proprioception and balance measurements.

FINDINGS

Surgical knees demonstrated significantly more deficient proprioception compared to the non-surgical knees and both knees of the control groups during flexion (P < 0.01) and extension (P < 0.05). Non-surgical knees showed similar proprioception to both knees of the control group during flexion and extension. Within the knee arthroplasty group, only deficiencies during flexion showed significant correlation with Sensory Organization Test visual ratio. No additional differences between both groups during balance measurements, nor any correlations between local joint proprioception and balance were seen.

INTERPRETATION

These findings indicate deficient surgical knee proprioception in participants one year after unilateral total knee arthroplasty. Limited associations between measurements indicate that balance may be a poor measure of single-joint proprioception.

摘要

背景

在膝关节置换术后,使用各种单关节本体感觉测量方法得出的结果相互矛盾。将平衡作为评估术后膝关节本体感觉的替代指标,这进一步造成了混淆。本研究的目的是测量单侧膝关节置换术后参与者的单关节膝关节本体感觉,并将其与多关节平衡进行比较。

方法

招募了11名单侧全膝关节置换术后1年的参与者和12名年龄匹配的对照组。分别使用被动运动检测阈值和感觉统合测试来测量单关节膝关节本体感觉和多关节平衡。采用双向方差分析和独立t检验来测量组间和组内差异。使用回归分析来测量本体感觉与平衡测量之间的关联。

结果

与对照组的非手术膝关节和双侧膝关节相比,手术膝关节在屈曲(P<0.01)和伸展(P<0.05)时的本体感觉明显更差。非手术膝关节在屈曲和伸展时的本体感觉与对照组的双侧膝关节相似。在膝关节置换组中,只有屈曲时的缺陷与感觉统合测试视觉比率有显著相关性。两组在平衡测量期间没有其他差异,也没有观察到局部关节本体感觉与平衡之间的任何相关性。

解读

这些发现表明,单侧全膝关节置换术后1年的参与者手术膝关节本体感觉存在缺陷。测量之间的有限关联表明,平衡可能不是单关节本体感觉的良好指标。

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