Department of Physical Therapy, Georgia State University, Atlanta, GA, USA.
Department of Physical Therapy, Georgia State University, Atlanta, GA, USA.
Phys Ther Sport. 2024 Jan;65:14-22. doi: 10.1016/j.ptsp.2023.10.005. Epub 2023 Nov 7.
To determine the changes in knee flexion moment (KFM) and knee adduction moment (KAM) during weight-bearing activities following meniscectomy.
Meta-Analysis.
Laboratory.
332 meniscectomy patients and 137 healthy controls (from 13 qualified studies) MAIN OUTCOME MEASURES: Cohen's d effect sizes (ESs) were calculated to compare KAM and KFM values of the surgical legs to the non-surgical and to healthy control legs.
When compared to healthy controls, meniscectomy patients' surgical legs demonstrated a significantly greater KAM (ES = 0.310; P = 0.002) but no significant difference in KFM (ES = -0.182; P = 0.051). When compared to the patients' non-surgical legs, however, the surgical legs showed no difference in KAM (ES = -0.024; P = 0.716) but a significantly lower KFM (ES = -0.422; P < 0.001). High heterogeneity among study ESs was observed in patients' between-limb comparison for KAM (Q-value = 20.08, P = 0.005; I = 65.1%) and KFM (Q-value = 43.96, P < 0.001; I = 79.5%). However, no significant differences in study ESs (all P > 0.102) of KFM and KAM were identified when comparing studies with various times post-surgery, weight-bearing tasks, walking speeds, or patient demographics.
Elevated KAM and reduced/asymmetrical KFM observed in meniscectomy patients may contribute to the increased risk of knee OA. Rehabilitation should focus on movement education to restore between-limb KFM symmetry and reduce KAM bilaterally post-meniscectomy.
确定膝关节屈伸力矩（KFM）和膝关节内收力矩（KAM）在半月板切除术后负重活动中的变化。
荟萃分析。
实验室。
332 名半月板切除术患者和 137 名健康对照者（来自 13 项合格研究）
计算科恩氏 d 效应量（ES），以比较手术腿的 KAM 和 KFM 值与非手术腿和健康对照组腿。
与健康对照组相比，半月板切除术患者的手术腿显示出明显更大的 KAM（ES=0.310；P=0.002），但 KFM 无显著差异（ES=-0.182；P=0.051）。然而，与患者的非手术腿相比，手术腿的 KAM 没有差异（ES=-0.024；P=0.716），但 KFM 明显较低（ES=-0.422；P<0.001）。在患者的肢体间比较中，观察到研究 ES 存在高度异质性（Q 值=20.08，P=0.005；I=65.1%），KAM（Q 值=43.96，P<0.001；I=79.5%）和 KFM。然而，当比较不同术后时间、负重任务、行走速度或患者人口统计学的研究时，KFM 和 KAM 的研究 ES 无显著差异（均 P>0.102）。
半月板切除术患者观察到的 KAM 升高和 KFM 降低/不对称可能导致膝关节 OA 的风险增加。康复应侧重于运动教育，以恢复肢体间的 KFM 对称性，并在半月板切除术后双侧降低 KAM。
