Department of Radiology, Second Affiliated Hospital of Hainan Medical University, Haikou, China.
Department of Radiology, Second Affiliated Hospital of Hainan Medical University, Haikou, China.
World Neurosurg. 2021 May;149:372-379. doi: 10.1016/j.wneu.2020.10.032. Epub 2020 Oct 12.
To use computed tomography image analysis of iterative reconstruction algorithm to understand effect of neuromuscular electrical stimulation of quadriceps on motor function rehabilitation after total knee arthroplasty.
After total knee arthroplasty, 104 patients were randomly divided into 2 groups. The treatment group comprised 52 patients. The quadriceps femoris was stimulated by neuromuscular electrical stimulation, and patients were required to actively extend the knee along with the current stimulation. In the second group, which received cutaneous nerve electrical stimulation, 2 sets of electrodes were placed on knee pain points. All patients participated in conventional rehabilitation and were discharged from the hospital a mean 14.89 ± 3.65 days after treatment. Visual analog scale, range of motion of knee joint, and Knee Injury and Osteoarthritis Score were evaluated before discharge. The mean interval between follow-up evaluations after discharge was 9.5 months. Knee Society Score and Knee Injury and Osteoarthritis Score were assessed during follow-up.
Visual analog scale scores of treatment and control groups at discharge were 18.11 ± 9.66 and 16.13 ± 4.25, and active range of motion of the knee joint was 103.21° ± 15.44° and (99.21° ± 15.19°, respectively. Limitation of active knee extension in the treatment group was 1.93° ± 3.47°, which was significantly smaller than in the control group (6.26° ± 4.28°).
Neuromuscular electrical stimulation of the quadriceps muscle early after total knee arthroplasty helps to improve the function of the knee extension device and accelerate functional rehabilitation. Computed tomography has found that changes in tibial subchondral bone plate and subchondral cancellous bone in patients with knee osteoarthritis are mainly due to destruction of ultrastructural homeostasis. This change may be the cause of knee osteoarthritis.
利用迭代重建算法的计算机断层成像分析了解股四头肌神经肌肉电刺激对全膝关节置换术后运动功能康复的影响。
全膝关节置换术后，104 例患者随机分为 2 组。治疗组 52 例，采用神经肌肉电刺激刺激股四头肌，患者在电流刺激下主动伸展膝关节。在接受皮神经电刺激的第二组中，在膝关节痛点放置 2 组电极。所有患者均接受常规康复治疗，平均在治疗后 14.89±3.65 天出院。出院前评估视觉模拟评分、膝关节活动度和膝关节损伤和骨关节炎评分。出院后随访平均间隔时间为 9.5 个月。随访期间评估膝关节学会评分和膝关节损伤和骨关节炎评分。
出院时治疗组和对照组的视觉模拟评分分别为 18.11±9.66 和 16.13±4.25，膝关节主动活动度分别为 103.21°±15.44°和（99.21°±15.19°），治疗组膝关节主动伸直受限 1.93°±3.47°，明显小于对照组（6.26°±4.28°）。
全膝关节置换术后早期股四头肌神经肌肉电刺激有助于改善膝关节伸展装置的功能，加速功能康复。计算机断层扫描发现，膝骨关节炎患者胫骨软骨下骨板和软骨下骨的变化主要是由于超微结构平衡的破坏。这种变化可能是膝骨关节炎的原因。
