Saral İlknur, Sürücü Serkan, Tekeci Esra, Ağırman Mehmet, Mahiroğulları Mahir, Çakar Engin
Department of Physiotherapy and Rehabilitation, Bahçeşehir University Faculty of Health Sciences, Istanbul, Türkiye.
Department of Orthopaedic Surgery, University of Missouri Kansas City, Kansas City, USA.
Turk J Phys Med Rehabil. 2023 Feb 28;69(1):105-110. doi: 10.5606/tftrd.2023.12374. eCollection 2023 Mar.
This study analyzed whether the isokinetic muscle strength of bilateral knee osteoarthritis patients undergoing unilateral total knee arthroplasty (TKA) is a predictor for prior surgery side.
In the prospective study conducted between April 2021 and December 2021, 58 knees of 29 unilateral TKA candidates (6 males, 23 females; mean age: 66.7±7.4 years; range, 53 to 81 years) were enrolled. The patients were divided into surgical (n=29)and nonsurgical (n=29) groups. The knees of patients with bilateral knee osteoarthritis (Stage III or IV) according to the Kellgren-Lawrence (KL) scale were scheduled for unilateral TKA. An isokinetic testing system was used to assess knee flexor and extensor muscle strength (peak torque) at angular velocities of 60°/sec and 180°/sec (five cycles per velocity). The radiological (X-ray-based KL scale and magnetic resonance imaging-based quadriceps angle) and clinical findings (isokinetic test and Visual Analog Scale pain scores) in both groups were compared.
The mean symptom duration was 10±5.4 years. The KL score and quadriceps angle showed no significant differences (p=0.056 and p=0.663, respectively). Isokinetic test results were in accordance with the clinical results of the surgery group. In the isokinetic evaluation, both the 60°/sec concentric extension (35.00 46.00, p=0.002) and flexion peak torque (18.00 26.00, p=0.001) values were significantly lower in the surgical group than in the nonsurgical group.
Isokinetic testing can be a supportive tool for assessing the prior side of TKA in patients with bilateral knee osteoarthritis. Further studies are required to support these findings.
本研究分析了接受单侧全膝关节置换术（TKA）的双侧膝关节骨关节炎患者的等速肌力是否可作为手术侧别的预测指标。
在2021年4月至2021年12月进行的前瞻性研究中，纳入了29例单侧TKA候选患者的58个膝关节（6例男性，23例女性；平均年龄：66.7±7.4岁；范围53至81岁）。患者被分为手术组（n=29）和非手术组（n=29）。根据Kellgren-Lawrence（KL）分级为双侧膝关节骨关节炎（III期或IV期）的患者计划接受单侧TKA。使用等速测试系统评估膝关节屈伸肌肌力（峰值扭矩），角速度为60°/秒和180°/秒（每个速度5个周期）。比较两组的影像学（基于X线的KL分级和基于磁共振成像的股四头肌角）和临床结果（等速测试和视觉模拟评分疼痛评分）。
平均症状持续时间为10±5.4年。KL评分和股四头肌角无显著差异（分别为p=0.056和p=0.663）。等速测试结果与手术组的临床结果一致。在等速评估中,手术组60°/秒的向心伸展（35.00对46.00，p=0.002）和屈曲峰值扭矩（18.00对26.00，p=0.001）值均显著低于非手术组。
等速测试可作为评估双侧膝关节骨关节炎患者TKA手术侧别的辅助工具。需要进一步研究来支持这些发现。
