Harvey Adrian, Kohli Suraj, Al-Nasser Samira, Noroozi Siamak
University Hospital Dorset, Castle Ln E, Bournemouth, BH7 7DW, United Kingdom.
Department of Design and Engineering, Faculty of Science and Technology, Bournemouth University, United Kingdom.
J Orthop. 2024 Feb 28;56:1-5. doi: 10.1016/j.jor.2024.02.025. eCollection 2024 Oct.
The analysis of gait is an important tool for evaluating postoperative outcomes of a Total Knee Replacement (TKR). There are few studies which have evaluated the gait parameters of a Kinematic retaining (Kr) prosthesis. This study therefore aims to investigate the kinetic and kinematic differences of running and walking, in the ankle, knee and hip joints in patients who underwent a Kr TKR.
This study assessed the gait of 12 patients with physica lima Kr TKRs at 1 year follow up and 8 healthy controls using 3D video analysis. Data was collected on the kinetics and kinematics of walking and running at the ankle, knee and hip. Comparison was made between the operated and non-operated limbs of the patients, and between the operated and control limbs.
Gait analysis showed no statistically significant difference in the hip, ankle and knee angles or moments between the non-operated and operated legs during walking and running. However, there was a statistically significant difference between the knee angles of initial contact, maximum flexion during stance and swing in the TKR knees vs controls in walking and running. Similarly, there was also a statistically significantly higher max knee flexion moment between operated knees and controls in both walking and running.
This study has shown that a quadriceps avoidance gait persists in patients after TKR, and that there was symmetry and reciprocated gait parameters in non-operated limbs. These findings suggest that Kr TKRs could be capable of replicating normal knee kinematics when running and walking.
步态分析是评估全膝关节置换术(TKR)术后效果的重要工具。很少有研究评估运动保留(Kr)假体的步态参数。因此,本研究旨在调查接受Kr TKR的患者在跑步和行走时踝关节、膝关节和髋关节的动力学和运动学差异。
本研究使用3D视频分析评估了12例接受物理利马Kr TKR的患者在1年随访时的步态以及8名健康对照者的步态。收集了踝关节、膝关节和髋关节在行走和跑步时的动力学和运动学数据。对患者的手术侧和非手术侧肢体之间以及手术侧和对照侧肢体之间进行了比较。
步态分析显示,在行走和跑步过程中,非手术侧和手术侧腿部的髋关节、踝关节和膝关节角度或力矩没有统计学上的显著差异。然而,在行走和跑步时,TKR膝关节与对照组相比,初始接触时的膝关节角度、站立期和摆动期的最大屈曲角度存在统计学上的显著差异。同样,在行走和跑步时,手术侧膝关节与对照组相比,最大膝关节屈曲力矩也有统计学上的显著升高。
本研究表明,TKR术后患者存在股四头肌回避步态,且非手术侧肢体的步态参数对称且相互对应。这些发现表明,Kr TKR在跑步和行走时能够复制正常的膝关节运动学。