Wang Xiao-Fei, Ma Zhen-Hua, Teng Xue-Ren
Dalian Medical University, Dalian, China.
Department of Orthopaedic Surgery, Qingdao Municipal Hospital, Qingdao, China.
Orthop Surg. 2020 Jun;12(3):878-889. doi: 10.1111/os.12699. Epub 2020 May 21.
To use isokinetic strength testing system to test and analyze the relationship between changes in muscle strength before and after knee replacement in patients undergoing total knee arthroplasty (TKA).
A total of 200 patients with advanced knee osteoarthritis treated from June 2018 to June 2019 were selected for TKA. The patient's isokinetic muscle strength test was performed in the first, third, and the sixth month before and after the operation. The knee hamstring peak torque (PT value), quadriceps peak torque (PT value), and total work were mainly measured. The knee joint was evaluated at the hospital for special surgery score, range of motion and other knee function standards, and then healthy limbs and normal people were tested with the same method. Statistical data was used to analyze and deal with the data, evaluate the muscle strength and motor function changes with time progressing, then compare the differences to the healthy limb. From P < 0.05, we can see that the differences have some statistical significance. The influences that TKA has on motor function changes of lower limbs were also observed.
Among the 200 subjects, 162 completed all follow-up tests, and the remaining 38 were lost to follow-up for various reasons. The rate of loss of follow-up was approximately 19%. The isokinetic muscle strength test system and the knee joint function scoring standard were used to record the knee joint muscle strength and function changes before and after knee joint replacement. Statistical analysis was performed to show the knee joint hamstring muscle force and quadriceps muscle strength and joint mobility in the first month after the surgery. The knee joint muscle strength and joint mobility were significantly improved after the third month after the surgery, but there were still some differences compared with normal people. The knee function index was significantly improved in the sixth month after operation (P < 0.05), and there were no significant differences compared with normal people.
Knee joint strength and knee function after TKA are significantly improved compared with preoperative function, which is of great significance for the treatment of knee osteoarthritis. The constant velocity muscle strength test system has the advantages of safety, accuracy, repeatability and easy operation. It is a good method to evaluate the knee joint's muscle strength and function after the knee joint replacement.
采用等速肌力测试系统，对全膝关节置换术（TKA）患者膝关节置换前后肌肉力量的变化关系进行测试与分析。
选取2018年6月至2019年6月接受TKA治疗的200例晚期膝关节骨关节炎患者。在手术前后的第1、3、6个月对患者进行等速肌力测试。主要测量膝关节腘绳肌峰值扭矩（PT值）、股四头肌峰值扭矩（PT值）及总功。在医院按照特殊手术评分、活动范围等膝关节功能标准对膝关节进行评估，然后用相同方法对健侧肢体及正常人进行测试。运用统计学数据对数据进行分析处理，评估随着时间推移肌肉力量和运动功能的变化，再与健侧肢体比较差异。P＜0.05表明差异具有一定统计学意义。同时观察TKA对下肢运动功能变化的影响。
200例受试者中，162例完成了所有随访测试，其余38例因各种原因失访，失访率约为19%。采用等速肌力测试系统及膝关节功能评分标准记录膝关节置换前后膝关节肌肉力量及功能变化。进行统计学分析显示术后第1个月膝关节腘绳肌肌力、股四头肌肌力及关节活动度情况。术后第3个月膝关节肌肉力量及关节活动度明显改善，但与正常人相比仍存在一定差异。术后第6个月膝关节功能指标明显改善（P＜0.05），与正常人相比无明显差异。
与术前功能相比，TKA术后膝关节力量和膝关节功能明显改善，这对膝关节骨关节炎的治疗具有重要意义。等速肌力测试系统具有安全、准确、可重复及操作简便等优点，是评估膝关节置换术后膝关节肌肉力量和功能的良好方法。
