Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ,USA.
Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ,USA.
J Appl Biomech. 2022 May 19;38(3):179-189. doi: 10.1123/jab.2020-0324. Print 2022 Jun 1.
Patients following unilateral total knee arthroplasty (TKA) display interlimb differences in knee joint kinetics during gait and more recently, stationary cycling. The purpose of this study was to use musculoskeletal modeling to estimate total, medial, and lateral tibiofemoral compressive forces for patients following TKA during stationary cycling. Fifteen patients of unilateral TKA, from the same surgeon, participated in cycling at 2 workrates (80 and 100 W). A knee model (OpenSim 3.2) was used to estimate total, medial, and lateral tibiofemoral compressive forces for replaced and nonreplaced limbs. A 2 × 2 (limb × workrate) and a 2 × 2 × 2 (compartment × limb × workrate) analysis of variance were run on the selected variables. Peak medial tibiofemoral compressive force was 23.5% lower for replaced compared to nonreplaced limbs (P = .004, G = 0.80). Peak medial tibiofemoral compressive force was 48.0% greater than peak lateral tibiofemoral compressive force in nonreplaced limbs (MD = 344.5 N, P < .001, G = 1.6) with no difference in replaced limbs (P = .274). Following TKA, patients have greater medial compartment loading on their nonreplaced compared to their replaced limbs and ipsilateral lateral compartment loading. This disproportionate loading may be cause for concern regarding exacerbating contralateral knee osteoarthritis.
单侧全膝关节置换（TKA）后的患者在行走和最近的静止踏车时表现出膝关节动力学的肢体间差异。本研究的目的是使用肌肉骨骼建模来估计 TKA 后患者在静止踏车时的总、内侧和外侧胫骨股骨压缩力。15 名来自同一位外科医生的单侧 TKA 患者参与了 2 种功量（80 和 100 W）的踏车运动。使用膝关节模型（OpenSim 3.2）来估计替代和未替代肢体的总、内侧和外侧胫骨股骨压缩力。对选定变量进行了 2 × 2（肢体×功量）和 2 × 2 × 2（腔室×肢体×功量）方差分析。与未替代肢体相比，替代肢体的峰值内侧胫骨股骨压缩力低 23.5%（P =.004，G = 0.80）。在未替代肢体中，峰值内侧胫骨股骨压缩力比峰值外侧胫骨股骨压缩力高 48.0%（MD = 344.5 N，P <.001，G = 1.6），而在替代肢体中没有差异（P =.274）。TKA 后，患者的未替代肢体比替代肢体以及同侧外侧腔室的内侧腔室负荷更大。这种不成比例的负荷可能会引起对加重对侧膝关节骨关节炎的担忧。
