Schulle Nike, Winkler Tobias, Bender Alwina, Popovic Srdan, Gwinner Clemens, Perka Carsten, Duda Georg, Damm Philipp
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.
Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.
Bone Jt Open. 2025 Sep 5;6(9):1053-1064. doi: 10.1302/2633-1462.69.BJO-2025-0071.R1.
This retrospective observational study aimed to determine the in vivo joint loads in the knee after total knee arthroplasty during early postoperative rehabilitation involving different physiotherapy exercises and to analyze how these loads change over the first three weeks postoperatively.
Nine patients (six males, three females) with a primary instrumented total knee replacement participated in the study. A total of 19 selected physical therapy exercises of varying load levels were performed on the ninth (SD 3) and 21st (SD 6) postoperative day. During these sessions, the peak resultant knee contact force (F) and loading patterns were measured to assess joint loading dynamics.
F varied across different exercises, ranging from a minimum of 15% body weight (% BW) during seated leg swings to a maximum of 195% BW during stair ascent. Joint loads increased from the ninth to the 21st postoperative day for all activities, except for a few relaxed status exercises where a decrease was observed. Load-bearing activities with crutches had the highest knee joint loads.
All exercises remained below the forces of walking on ground level indicating safety for the postoperative rehabilitation. Physical therapists should consider these loads in relation to daily activities when designing treatment plans also referring to the different loads in different exercises.
这项回顾性观察研究旨在确定全膝关节置换术后早期康复过程中，在进行不同物理治疗锻炼时膝关节的体内关节负荷，并分析这些负荷在术后前三周内如何变化。
9例接受初次全膝关节置换术的患者（6例男性，3例女性）参与了本研究。在术后第9天（标准差3）和第21天（标准差6）进行了总共19项不同负荷水平的选定物理治疗锻炼。在这些疗程中，测量了膝关节接触力峰值（F）和负荷模式，以评估关节负荷动态。
F在不同锻炼中有所不同，从坐位摆腿时的最低体重的15%到上楼梯时的最高体重的195%不等。除了少数观察到负荷下降的放松状态锻炼外，所有活动的关节负荷从术后第9天到第21天均有所增加。使用拐杖的承重活动膝关节负荷最高。
所有锻炼的负荷均低于在地面行走的力量，表明术后康复是安全的。物理治疗师在设计治疗计划时应考虑这些与日常活动相关的负荷，同时也要参考不同锻炼中的不同负荷。
