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负重状态会影响单髁膝关节置换术后的体内运动学。

Weight-bearing status affects in vivo kinematics following mobile-bearing unicompartmental knee arthroplasty.

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2021 Mar;29(3):718-724. doi: 10.1007/s00167-020-05893-x. Epub 2020 Feb 13.

Abstract

PURPOSE

The effects of weight bearing (WB) on knee kinematics following mobile-bearing unicompartmental knee arthroplasty (UKA) remain unknown. The purpose of this study was to clarify the effects of WB on in vivo kinematics of mobile-bearing UKA during high knee flexion activities.

METHODS

The kinematics of UKA were evaluated under fluoroscopy during squatting (WB) and active-assisted knee flexion (non-weight bearing, NWB). Range of motion, femoral axis rotation relative to the tibia, anteroposterior (AP) translation of the medial and lateral sides, and kinematic pathway were measured.

RESULTS

There were no differences in knee flexion range and external rotation of the femur in each flexion angle between the WB conditions. The amount of femoral external rotation between minimum flexion and 60° of flexion during WB was significantly larger than that during NWB, and that between 60° and 130° of flexion during NWB was significantly larger than that during WB. There were no differences in medial AP translation of the femur in each flexion angle between the WB conditions. However, on the lateral side, posterior translation of 52.9 ± 12.7% was observed between minimum flexion and 130° of flexion during WB. During NWB, there was no significant translation between minimum flexion and 60° of flexion; beyond 60° of flexion, posterior translation was 41.6 ± 8.7%. Between 20° and 80° of flexion, the lateral side in WB was located more posteriorly than in NWB (p < 0.05).

CONCLUSION

Mobile-bearing UKA has good anterior stability throughout the range of knee flexion. WB status affects the in vivo kinematics following mobile-bearing UKA.

LEVEL OF EVIDENCE

III.

摘要

目的

在活动型单髁膝关节置换术后,负重(WB)对膝关节运动学的影响尚不清楚。本研究旨在阐明高膝关节屈曲活动时 WB 对活动型膝关节置换的体内运动学的影响。

方法

在膝关节镜下评估深蹲(WB)和主动辅助膝关节屈曲(非负重,NWB)时的 UKA 运动学。测量运动范围、股骨相对于胫骨的轴旋转、内外侧前后(AP)平移以及运动轨迹。

结果

在每个屈曲角度下,WB 条件下的膝关节屈曲范围和股骨外旋均无差异。WB 时,最小屈曲和 60°屈曲之间的股骨外旋量明显大于 NWB,NWB 时,60°和 130°屈曲之间的股骨外旋量明显大于 WB。在每个屈曲角度下,WB 条件下的股骨内侧 AP 平移均无差异。然而,在外侧,在 WB 时,从最小屈曲到 130°屈曲,后移量为 52.9±12.7%。在 NWB 时,最小屈曲和 60°屈曲之间没有明显的平移;超过 60°屈曲时,后移量为 41.6±8.7%。在 20°至 80°屈曲之间,WB 时的外侧比 NWB 更靠后(p<0.05)。

结论

活动型单髁膝关节置换在膝关节整个屈曲范围内具有良好的前向稳定性。WB 状态影响活动型膝关节置换后的体内运动学。

证据水平

III。

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