Seymour Hannah, Chen Fangjian, Zheng Naiquan Nigel
Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28223, USA.
Bioengineering (Basel). 2024 Sep 19;11(9):938. doi: 10.3390/bioengineering11090938.
Total knee arthroplasty (TKA) is a commonly performed surgery aimed at alleviating pain and improving functionality. However, patients often face uncertainties in selecting the timing, location, and type of TKA implant that best meets their needs. This study aims to comprehensively compare various variables, explore trends, and identify factors potentially influencing TKA outcomes. A cohort of 40 TKA subjects received either unilateral posterior stabilized (Persona) TKA or bi-cruciate stabilized (Journey II) TKA. Additionally, 20 healthy controls matched for age, gender, and BMI were included. Participants underwent patient-reported outcome assessments, range of motion evaluations, balance assessments, proprioception tests, and biomechanical analyses. These analyses covered motion, loading, and electromyography during five daily activities and two clinical tests. Multifactor ANOVA was utilized to compare 283 variables and assess their impact on TKA outcomes. A knee biomechanics index was formulated to evaluate deviations from healthy norms. Significant differences were observed in EMG varus/valgus rotation during both ramp-up and ramp-down phases between the two implant groups. Although significant improvements were noted post-TKA for both implants, the results remained below those of the control group. Gender, age, and BMI exhibited noticeable effects on TKA outcomes across several biomechanical variables and demonstrated significant disparities compared to the controls.
全膝关节置换术(TKA)是一种常见的手术,旨在减轻疼痛并改善功能。然而,患者在选择最符合其需求的TKA植入物的时间、位置和类型时往往面临不确定性。本研究旨在全面比较各种变量,探索趋势,并确定可能影响TKA结果的因素。一组40名TKA受试者接受了单侧后稳定型(Persona)TKA或双交叉韧带稳定型(Journey II)TKA。此外,还纳入了20名年龄、性别和BMI相匹配的健康对照者。参与者接受了患者报告的结局评估、活动范围评估、平衡评估、本体感觉测试和生物力学分析。这些分析涵盖了五项日常活动和两项临床试验中的运动、负荷和肌电图。采用多因素方差分析来比较283个变量,并评估它们对TKA结果的影响。制定了膝关节生物力学指数以评估与健康标准的偏差。在两个植入物组之间的上升和下降阶段,肌电图内翻/外翻旋转均观察到显著差异。尽管两种植入物在TKA后均有显著改善,但结果仍低于对照组。性别、年龄和BMI在几个生物力学变量上对TKA结果表现出明显影响,并且与对照组相比存在显著差异。