Garner Amy, Dandridge Oliver, Amis Andrew A, Cobb Justin P, van Arkel Richard J
MSk Lab, Sir Michael Uren Biomedical Engineering Research Hub, Imperial College London, London, UK.
Biomechanics Group, Mechanical Engineering Department, Imperial College London, London, UK.
Bone Joint Res. 2021 Jan;10(1):1-9. doi: 10.1302/2046-3758.101.BJR-2020-0248.R1.
Unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BCA) have been associated with improved functional outcomes compared to total knee arthroplasty (TKA) in suitable patients, although the reason is poorly understood. The aim of this study was to measure how the different arthroplasties affect knee extensor function.
Extensor function was measured for 16 cadaveric knees and then retested following the different arthroplasties. Eight knees underwent medial UKA then BCA, then posterior-cruciate retaining TKA, and eight underwent the lateral equivalents then TKA. Extensor efficiency was calculated for ranges of knee flexion associated with common activities of daily living. Data were analyzed with repeated measures analysis of variance (α = 0.05).
Compared to native, there were no reductions in either extension moment or efficiency following UKA. Conversion to BCA resulted in a small decrease in extension moment between 70° and 90° flexion (p < 0.05), but when examined in the context of daily activity ranges of flexion, extensor efficiency was largely unaffected. Following TKA, large decreases in extension moment were measured at low knee flexion angles (p < 0.05), resulting in 12% to 43% reductions in extensor efficiency for the daily activity ranges.
This cadaveric study found that TKA resulted in inferior extensor function compared to UKA and BCA. This may, in part, help explain the reported differences in function and satisfaction differences between partial and total knee arthroplasty. Cite this article: 2021;10(1):1-9.
对于合适的患者，单髁膝关节置换术（UKA）和双髁膝关节置换术（BCA）与全膝关节置换术（TKA）相比，功能结局有所改善，尽管原因尚不清楚。本研究的目的是测量不同的关节置换术如何影响膝关节伸肌功能。
对16具尸体膝关节测量伸肌功能，然后在进行不同的关节置换术后重新测试。8个膝关节先进行内侧UKA，然后是BCA，再进行后交叉韧带保留型TKA，另外8个膝关节先进行外侧相应手术，然后是TKA。计算与日常生活常见活动相关的膝关节屈曲范围内的伸肌效率。采用重复测量方差分析（α = 0.05）对数据进行分析。
与天然膝关节相比，UKA术后伸肌力矩和效率均未降低。转换为BCA后，在70°至90°屈曲之间伸肌力矩略有下降（p < 0.05），但在日常活动屈曲范围内检查时，伸肌效率基本未受影响。TKA术后，在低膝关节屈曲角度时伸肌力矩大幅下降（p < 0.05），导致日常活动范围内伸肌效率降低12%至43%。
这项尸体研究发现，与UKA和BCA相比，TKA导致伸肌功能较差。这可能在一定程度上有助于解释部分膝关节置换术和全膝关节置换术在功能和满意度方面报道的差异。引用本文：2021;10(1):1-9。
