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使用压力分散垫可使全膝关节置换术后的患者舒适地跪姿。

Pressure dispersion pad use allows patients to kneel comfortably after total knee arthroplasty.

作者信息

Watamori Kunihiko, Hino Kazunori, Kutsuna Tatsuhiko, Kinoshita Tomofumi, Tsuda Takashi, Miura Hiromasa, Takao Masaki

机构信息

Department of Orthopaedic Surgery Ehime University Graduate School of Medicine Matsuyama Japan.

Department of Orthopaedic Surgery Kyusyu Rosai Hospital Kitakyushu Japan.

出版信息

J Exp Orthop. 2025 Apr 24;12(2):e70157. doi: 10.1002/jeo2.70157. eCollection 2025 Apr.

DOI:10.1002/jeo2.70157
PMID:40276497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12019298/
Abstract

PURPOSE

This study aimed to clarify the contact pressure at which patients with difficulty in kneeling after total knee arthroplasty (TKA) feel pain and the contact pressure at which kneeling can be performed after using a pressure dispersion pad.

METHODS

Sixty patients (69 knees) who underwent TKA for end-stage knee osteoarthritis were included. The patients performed single stance kneeling on the sheet-type pressure mapping system, and the contact pressure and area were measured before and after using the pressure dispersion pad. The Oxford Knee Score was used to evaluate kneeling ability.

RESULTS

The group of patients who were unable to kneel had significantly lower contact pressure than those who were able to kneel easily (0.61 N/cm/kg vs. 0.99 N/cm/kg;  = 0.04). No patient reported kneeling as being 'impossible' or 'extremely difficult' when using the pressure dispersion pad. Moreover, all patients except those without pain had less pain and improved kneeling scores when using the pressure dispersion pad. Use of the pressure dispersion pad significantly reduced contact pressure for all kneeling score groups after TKA (0.12 N/cm/kg for the impossible group).

CONCLUSIONS

The patients who could not kneel after TKA felt pain at 61% of the contact pressure compared to those who could kneel easily. Even patients who were unable to kneel after TKA were able to kneel when the contact pressure was reduced to 12% of that of the patients who could easily kneel using a pressure dispersion pad.

LEVEL OF EVIDENCE

Level III.

摘要

目的

本研究旨在明确全膝关节置换术（TKA）后跪姿困难的患者感到疼痛时的接触压力，以及使用压力分散垫后能够进行跪姿的接触压力。

方法

纳入60例（69膝）因终末期膝骨关节炎接受TKA的患者。患者在片状压力映射系统上进行单腿跪姿，在使用压力分散垫前后测量接触压力和面积。采用牛津膝关节评分评估跪姿能力。

结果

无法跪姿的患者组接触压力显著低于能够轻松跪姿的患者组（0.61 N/cm/kg对0.99 N/cm/kg；P = 0.04）。使用压力分散垫时，没有患者报告跪姿“不可能完成”或“极其困难”。此外，除无疼痛的患者外，所有患者在使用压力分散垫时疼痛减轻且跪姿评分改善。TKA后，使用压力分散垫使所有跪姿评分组的接触压力显著降低（无法完成跪姿组为0.12 N/cm/kg）。

结论

与能够轻松跪姿的患者相比，TKA后无法跪姿的患者在61%的接触压力时感到疼痛。即使是TKA后无法跪姿的患者，当接触压力降低至能够轻松跪姿患者的12%时，也能够跪姿。

证据水平

III级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/e709089cfa06/JEO2-12-e70157-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/e0a1b80f04dd/JEO2-12-e70157-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/e5fd99ee74fd/JEO2-12-e70157-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/5628c15ec5b3/JEO2-12-e70157-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/9da6a45b9687/JEO2-12-e70157-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/e709089cfa06/JEO2-12-e70157-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/e0a1b80f04dd/JEO2-12-e70157-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/e5fd99ee74fd/JEO2-12-e70157-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/5628c15ec5b3/JEO2-12-e70157-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/9da6a45b9687/JEO2-12-e70157-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23d/12019298/e709089cfa06/JEO2-12-e70157-g005.jpg

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本文引用的文献

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Item response theory assumptions were adequately met by the Oxford hip and knee scores.牛津髋关节和膝关节评分充分满足项目反应理论假设。
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Higher rate of kneeling after primary knee arthroplasty without patellar resurfacing at midterm review.在中期复查时，初次膝关节置换未进行髌骨表面置换术后出现跪姿的发生率更高。
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