Goetz Julia, Maderbacher Günther, Gerg Anna, Leiss Franziska, Dullien Silvia, Zeman Florian, Meyer Matthias, Reinhard Jan, Grifka Joachim, Greimel Felix
Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany.
Center for Clinical Studies, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
J Exp Orthop. 2023 Apr 15;10(1):44. doi: 10.1186/s40634-023-00604-0.
Total knee arthroplasty (TKA) combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate isokinetic knee muscle strength after cemented TKA in combination with an enhanced recovery after surgery (ERAS) compared to a conventional setup.
In the single blinded prospective randomized study, 52 patients underwent navigated primary cemented TKA within an ERAS (n = 30) or a conventional setup (n = 22). Preoperatively, five days and four weeks after surgery isokinetic knee muscle strength with BIODEX-type measuring device (peak torque in Nm, work in Joules and power in Watt) and subjective patient-related outcome measures (PROMs) were investigated.
The ERAS group showed significantly better outcomes in knee flexion at 180°/s (peak torque (Nm) p = 0.047, work (J) p = 0.040 and power (W) p = 0.016) 5 days postoperatively. The isokinetic measuring at knee extension 60°/s and 180°/s demonstrated no significant difference. The PROMs showed that patients were satisfied with the postoperative results in both groups. After 4 weeks, there was no longer a significant difference in isokinetic measuring at knee extension and flexion between the ERAS and conventional group.
TKA with the concept of ERAS improves excellent isokinetic outcome and patient satisfaction. The isokinetic muscle strength measurement can help patients and surgeons to modify expectations and improve patient satisfaction.
全膝关节置换术（TKA）结合加速康复理念在全球范围内持续受到关注，因为据报道它能改善早期功能结果和治疗质量，且不增加并发症。本研究的目的是调查与传统手术方案相比，骨水泥型TKA联合术后加速康复（ERAS）后的等速膝关节肌肉力量。
在这项单盲前瞻性随机研究中，52例患者接受了导航下的初次骨水泥型TKA，其中30例采用ERAS方案，22例采用传统方案。术前、术后5天和4周，使用BIODEX型测量设备对等速膝关节肌肉力量（以牛顿米为单位的峰值扭矩、以焦耳为单位的功和以瓦特为单位的功率）以及患者主观相关结局指标（PROMs）进行了调查。
ERAS组在术后5天180°/s膝关节屈曲时的结果明显更好（峰值扭矩（牛顿米）p = 0.047，功（焦耳）p = 0.040，功率（瓦特）p = 0.016）。在60°/s和180°/s膝关节伸展时的等速测量结果无显著差异。PROMs显示两组患者对术后结果均满意。4周后，ERAS组和传统组在膝关节伸展和屈曲的等速测量上不再有显著差异。
采用ERAS理念的TKA可改善等速运动结果并提高患者满意度。等速肌肉力量测量有助于患者和外科医生调整预期并提高患者满意度。
