Kurihara Yasushi, Ohsugi Hironori, Choda Kohei, Endo Yuki, Tosaka Tomonari, Matsuda Tadamitsu, Tsuneizumi Yoshikazu, Tsukeoka Tadashi
Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, 1 Gumyo, Togane-City, Chiba-Prefecture 283-8555, Japan.
Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, 1 Gumyo, Togane-City, Chiba-Prefecture 283-8555, Japan.
Knee. 2021 Jan;28:354-361. doi: 10.1016/j.knee.2020.12.021. Epub 2021 Jan 23.
This study was focused on the gait parameters of the knee extensor and hip abductor muscle groups, which are believed to contribute to knee joint function improvement in early postoperative TKA. The associations between patient-reported outcome measures (PROMs) 6 months after total knee arthroplasty (TKA) and the early postoperative internal knee extension moment, knee extension negative joint power, and internal hip abduction moment while walking were investigated.
Twenty-one patients who underwent primary TKA for knee osteoarthritis were included. Three weeks after TKA, gait at a comfortable speed was measured by three-dimensional motion analysis. The lower limb joint angle, internal joint moment, and joint power parameters on the operated side while standing were calculated. The PROMs 6 months after TKA were assessed using the Japanese Knee Osteoarthritis Measure (JKOM). The relationship between each gait biomechanical parameter and the JKOM was determined.
The maximum internal knee extension moment and maximum knee extension negative joint power during the early stance showed moderate negative correlations with the JKOM scores. The maximum internal hip abduction moment was not correlated with the JKOM scores. The maximum internal hip extension moment during the early stance and internal hip flexion moment during the late stance showed moderate negative correlations with the total JKOM scores.
The early postoperative internal knee extension moment, maximum knee extension negative joint power, and internal hip extension and flexion moment are associated with patient PROMs 6 months after TKA.
本研究聚焦于膝关节伸肌和髋关节外展肌组的步态参数，这些参数被认为有助于全膝关节置换术（TKA）术后早期膝关节功能的改善。研究调查了全膝关节置换术（TKA）6个月后患者报告的结局指标（PROMs）与术后早期行走时膝关节内翻伸展力矩、膝关节伸展负关节功率以及髋关节内收力矩之间的关联。
纳入21例因膝关节骨关节炎接受初次TKA的患者。TKA术后3周，通过三维运动分析测量舒适速度下的步态。计算站立时患侧下肢关节角度、关节内力矩和关节功率参数。使用日本膝关节骨关节炎测量量表（JKOM）评估TKA术后6个月的PROMs。确定每个步态生物力学参数与JKOM之间的关系。
早期站立时最大膝关节内翻伸展力矩和最大膝关节伸展负关节功率与JKOM评分呈中度负相关。最大髋关节内收力矩与JKOM评分无关。早期站立时最大髋关节伸展力矩和晚期站立时髋关节屈曲力矩与JKOM总分呈中度负相关。
TKA术后早期膝关节内翻伸展力矩、最大膝关节伸展负关节功率以及髋关节伸展和屈曲力矩与TKA术后6个月患者的PROMs相关。
