Tan Yong Yao, Ang Ke Xin Magneline, Wong Ching Yi Aliza, Mehta Kinjal Vidyut, Loh Sir Young James
Department of Orthopaedic Surgery Changi General Hospital, Singapore, Singapore.
Front Rehabil Sci. 2025 Jan 7;5:1446389. doi: 10.3389/fresc.2024.1446389. eCollection 2024.
The prevalence of knee osteoarthritis in Southeast Asia has increased steadily over the years. When conservative management options fail, total knee arthroplasty (TKA) is a reliable surgical option. Despite over 90% post-operative satisfaction, the high volume of TKAs performed means that even a small percentage of dissatisfied patients holds significance. Dissatisfaction often arises from unmet expectations, which are influenced by cultural and urban factors specific to the region. Surgeons must counsel patients on likely post-operative activities, but limited data on knee range of motion (ROM) for daily tasks in Southeast Asia renders personalised guidance challenging.
The primary aim of this study was to evaluate the minimum knee ROM required for daily activities (walking, stair climbing, squatting, kneeling, and sitting cross-legged) in a healthy Southeast Asian urban population. The secondary aim was to determine the association between anthropometric measurements and knee ROM required for the activities. This information is useful in managing patient expectations after TKA.
An email describing the study was sent to hospital staff to recruit them as volunteers for the study. Enrolled participants were required to be between the ages of 21 and 65 years and capable of providing informed consent. Interested volunteers with a past medical history involving the lower limbs and spine were excluded. Those with a history of lower limb joint pain or back pain within the last 1 year were also excluded. The KINEXCS KIMIA device (KIMIA Recover System, 2022 edition v1.0) was used to measure the knee ROM. The overall characteristics of participants were summarised using descriptive statistics. Anthropometric measurements and their association with knee ROM during the various activities were analysed. Variables with -values <0.3 in univariate analysis were included in the multivariable analysis.
Fifty participants (32 men, 18 women) were enrolled in the study. The average age of participants was 28.5 years (SD 5.57). The average height was 168 cm (SD 0.0870), and the average body mass index was 23.02 kg/m (SD 2.82). The average knee ROM requirements for various activities are as follows: walking on flat ground and stair climbing required less than 90°, squatting and kneeling required at least 127°, and sitting cross-legged required 106°. Lower limb length, leg length, and calf circumference were significantly correlated with the knee ROM required to perform the activities.
The findings of this study, combined with an understanding of cultural expectations, might prove valuable for counselling and managing patients undergoing TKA in an urban Southeast Asian country.
多年来，东南亚地区膝关节骨关节炎的患病率一直在稳步上升。当保守治疗方案无效时，全膝关节置换术（TKA）是一种可靠的手术选择。尽管术后满意度超过90%，但大量的TKA手术意味着即使是一小部分不满意的患者也具有重要意义。不满意往往源于未满足的期望，而这些期望受到该地区特定的文化和城市因素的影响。外科医生必须就可能的术后活动向患者提供咨询，但关于东南亚日常任务中膝关节活动范围（ROM）的有限数据使得个性化指导具有挑战性。
本研究主要目的是评估健康的东南亚城市人群日常活动（行走、爬楼梯、下蹲、跪和盘腿坐）所需的最小膝关节ROM。次要目的是确定人体测量指标与这些活动所需膝关节ROM之间的关联。这些信息有助于管理TKA术后患者的期望。
向医院工作人员发送一封描述该研究的电子邮件，招募他们作为研究志愿者。入选参与者年龄需在21至65岁之间，且能够提供知情同意书。有涉及下肢和脊柱既往病史的感兴趣志愿者被排除。过去1年内有下肢关节疼痛或背痛病史的也被排除。使用KINEXCS KIMIA设备（KIMIA Recover System，2022版v1.0）测量膝关节ROM。使用描述性统计总结参与者的总体特征。分析人体测量指标及其与各种活动中膝关节ROM的关联。单变量分析中P值<0.3的变量纳入多变量分析。
50名参与者（32名男性，18名女性）纳入研究。参与者的平均年龄为28.5岁（标准差5.57）。平均身高为168厘米（标准差0.0870），平均体重指数为23.02千克/平方米（标准差2.8）。各种活动的平均膝关节ROM要求如下：在平地上行走和爬楼梯需要小于90°，下蹲和跪需要至少127°，盘腿坐需要106°。下肢长度、腿长和小腿围与进行这些活动所需的膝关节ROM显著相关。
本研究结果，结合对文化期望的理解，可能对东南亚城市国家接受TKA手术的患者咨询和管理具有重要价值。
