Correlation Between Preoperative and Postoperative Alignment and Kinematic Gait in Total Knee Arthroplasty.

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
Peng Liu, Huifeng Xie, Yushu Chen, Rixu Liu, Junjie Zeng, Bo Bai
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引用次数: 0

Abstract

Objective: Maintaining the lower limb in a neutral posture following total knee arthroplasty (TKA) has long been a concept maintained by operators. This study aimed to investigate the relationship between changes in lower limb alignment and the dynamics of knee gait before and after TKA to understand the impact of alignment on gait better and offer a theoretical foundation for correcting lower limb alignment in TKA.

Methods: Our study included a group of 20 participants. The cohort consisted of 1 male and 19 females, 11 left and 9 right knees, ages 58 to 81. Using the Opti_Knee® Knee Motion Test System with infrared reflective markers and a high-speed camera, the step length and 6 degrees of freedom of the knee were recorded. Following that, we investigated the association between HKA angle and knee kinematic gait before and after surgery.

Results: For preoperative HKA angles ranging from -28° to -3°, we observed increased step length, flexion-extension rotation, and varus-valgus rotation with an increase in HKA angle. Conversely, an increase in HKA angle from -3 ° to 15° corresponded with decreased step length, flexion-extension rotation, and varus-valgus rotation. An increase in HKA angle from 1° to 3° postoperatively increased step length, flexion-extension rotation, and varus-valgus rotation. In contrast, increasing the HKA angle from 3° to 5° resulted in less flexion-extension rotation. The flexion-extension rotation was at its maximum when the HKA angle was 3°. A 3° postoperative varus resulted in improved kinematic gait. Step length, varus-valgus rotation, and flexion-extension rotation increased with increasing HKA angle in the neutral alignment group. In contrast, the non-neutral alignment group exhibited decreased flexion-extension rotation as the HKA angle increased, while step length and varus-valgus rotation increased as the HKA angle increased. The varus-valgus rotation was statistically significant (P < .05) in the preoperative versus early postoperative period in the 6 degrees of freedom.

Conclusions: A 3° varus alignment was found to have a superior postoperative knee kinematic gait, implying that a 3° varus alignment may be more suitable as a new gold standard for TKA than the traditional "0°" alignment. The neutral alignment group demonstrated a better knee kinematic gait than the non-neutral alignment group. During early postoperative walking, significant improvements in varus-valgus rotation were found in the 6 degrees of knee freedom.

全膝关节置换术术前术后对位与运动步态之间的相关性
目的:全膝关节置换术(TKA)后保持下肢中立位一直是术者坚持的理念。本研究旨在调查 TKA 手术前后下肢对位变化与膝关节步态动态之间的关系,以更好地了解对位对步态的影响,并为矫正 TKA 手术中的下肢对位提供理论依据:我们的研究包括 20 名参与者。研究对象包括 1 名男性和 19 名女性,11 个左膝和 9 个右膝,年龄在 58 岁至 81 岁之间。我们使用带有红外线反射标记和高速摄像机的 Opti_Knee® 膝关节运动测试系统记录了膝关节的步长和 6 个自由度。随后,我们研究了 HKA 角度与手术前后膝关节运动步态之间的关联:结果:在术前 HKA 角度为 -28° 至 -3° 的范围内,我们观察到随着 HKA 角度的增加,步长、屈伸旋转和屈曲-外翻旋转均有所增加。相反,HKA 角度从 -3° 增加到 15° 时,步长、屈伸旋转和曲髋旋转均相应减少。术后 HKA 角度从 1° 增加到 3° 会增加步长、屈伸旋转和曲髋旋转。相反,HKA角度从3°增加到5°时,屈伸旋转幅度较小。当 HKA 角度为 3° 时,屈伸旋转达到最大值。术后3°的变位可改善运动步态。在中性对齐组中,步长、变位-瓣膜旋转和屈伸旋转随着 HKA 角度的增加而增加。相反,非中性对齐组的屈伸旋转随着 HKA 角度的增加而减少,而步长和曲髋旋转随着 HKA 角度的增加而增加。在6个自由度中,术前与术后早期的曲-瓣旋转具有统计学意义(P < .05):结论:3°变位对位的术后膝关节运动步态更优越,这意味着3°变位对位可能比传统的 "0°"对位更适合作为TKA的新金标准。中性对位组的膝关节运动步态优于非中性对位组。在术后早期行走过程中,6 个膝关节自由度的变位-外翻旋转均有明显改善。
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来源期刊
Alternative therapies in health and medicine
Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
0.90
自引率
0.00%
发文量
219
期刊介绍: Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.
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