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单半径和多半径全膝关节置换术后下楼梯时膝关节运动学和动力学比较。

Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty.

机构信息

Department of Research, MORE Foundation, Phoenix, Arizona.

Department of Adult Reconstruction, The CORE Institute, Phoenix, Arizona.

出版信息

J Knee Surg. 2020 Oct;33(10):1020-1028. doi: 10.1055/s-0039-1692652. Epub 2019 Aug 7.

Abstract

Despite continuing advances, nearly 20% of patients remain dissatisfied with their total knee arthroplasty (TKA) outcomes. Single-radius (SR) and multiradius (MR) TKA designs are two commonly used knee replacement designs based on competing theories of the flexion/extension axis of the knee. Our aim was to characterize stair descent kinematics and kinetics in SR and MR TKA subjects. We hypothesized that 1 year after TKA, patients who received SR TKA will more closely replicate the knee kinematics and kinetics of healthy age-matched controls during stair descent, than will MR TKA patients. SR subjects ( = 12), MR subjects ( = 12), and age-matched controls ( = 12) descended four stairs affixed to force platforms, while 10 infrared cameras tracked markers attached to the body to collect kinematic and kinetic data. Both patient groups had improvements in stair descent kinetics and kinematics at the 1-year postoperative time point. However, SR TKA subjects were indistinguishable statistically from age-matched controls, while MR TKA subjects retained many differences from controls. Similar to previous reports for level walking, the SR knee design performs closer to healthy controls than MR knees during stair descent. This study demonstrates that patients who receive SR TKA have more improved kinematic normalization during stair descent postoperatively than those who received an MR TKA.

摘要

尽管不断取得进展,但仍有近 20%的患者对全膝关节置换术 (TKA) 的结果不满意。单半径 (SR) 和多半径 (MR) TKA 设计是两种基于膝关节屈伸轴竞争理论的常用膝关节置换设计。我们的目的是描述 SR 和 MR TKA 受试者在楼梯下降时的运动学和动力学特征。我们假设,在 TKA 后 1 年,接受 SR TKA 的患者在楼梯下降时更接近健康同龄对照组的膝关节运动学和动力学,而 MR TKA 患者则不然。SR 组(n=12)、MR 组(n=12)和年龄匹配的对照组(n=12)在固定在力台上的四个楼梯上下降,同时使用 10 个红外摄像机跟踪附着在身体上的标记以收集运动学和动力学数据。两组患者在术后 1 年时的楼梯下降动力学和运动学都有所改善。然而,SR TKA 组在统计学上与年龄匹配的对照组没有区别,而 MR TKA 组与对照组仍存在许多差异。与之前关于平地行走的报告类似,SR 膝关节设计在楼梯下降时比 MR 膝关节更接近健康对照组。这项研究表明,接受 SR TKA 的患者在术后楼梯下降时的运动学正常化改善程度比接受 MR TKA 的患者更大。

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