EFORT Michael Freeman Award 2020: Knee biomechanics before and after total knee arthroplasty with either a medial pivot or posterior stabilized implants

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-07-01 DOI:10.1016/j.clinbiomech.2025.106604

Erik Kowalski , Danilo S. Catelli , Alexandre R.M. Pelegrinelli , Geoffrey Dervin , Mario Lamontagne

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Abstract

Background

Can the design of a total knee replacement affect how patients walk and their reported outcomes compared to healthy adults, considering age and body mass index (BMI)? Many studies have produced conflicting results, often not including a pre-operative assessment and relying on discrete measurements.

Methods

Twenty-eight patients randomly received either a medial-ball-and-socket (n = 14, age = 62.7(5.8) years, BMI = 27.0(3.8)kg/m², females = 6) or posterior-stabilized (n = 14, age = 64.5(8.1) years, BMI = 29.8(3.4)kg/m², females = 6) implant and completed a gait analysis before and 12 months following total knee arthroplasty and were compared to 14 healthy controls (age = 64.4(5.6) years, BMI = 24.9(2.1) kg/m², females = 7). Temporospatial, knee biomechanics and patient-reported outcome measures were measured during five gait trials. Knee biomechanical measures were evaluated across the gait cycle using statistical parametric mapping.

Findings

Preoperatively, the medial-ball-and-socket and posterior-stabilized were similar, with no differences in age, BMI, patient-reported outcome measures, or knee biomechanics (P > .05). Pre-operatively, compared to controls, both medial-ball-and-socket and posterior-stabilized had different movement patterns, primarily in stance and swing phase knee flexion angles (P < .05). Postoperatively the medial-ball-and-socket had less knee flexion angle during stance phase compared to the controls (P < .05), whereas the posterior-stabilized walked with less knee flexion angle than the controls during stance and swing phase (P < .05).

Interpretation

The medial-ball-and-socket group demonstrated a gait pattern more closely resembling that of the controls compared to the PS group, exhibiting fewer differences in sagittal knee angles. Although both groups showed post-operative improvement across all patient-reported outcome measures, no significant differences were detected between them.

Trial registration: NCT02589197, October 28, 2015.

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EFORT Michael Freeman奖2020：全膝关节置换术前后的膝关节生物力学，无论是内侧枢轴还是后部稳定植入物

与健康成人相比，考虑到年龄和体重指数（BMI），全膝关节置换术的设计是否会影响患者的行走方式及其报告的结果？许多研究得出了相互矛盾的结果，通常不包括术前评估，而是依赖于离散的测量。方法28例患者随机接受内侧球窝植入（n = 14，年龄= 62.7（5.8）岁，BMI = 27.0(3.8)kg/m2，女性= 6）或后稳定植入（n = 14，年龄= 64.5（8.1）岁，BMI = 29.8(3.4)kg/m2，女性= 6），在全膝关节置换术前和术后12个月完成步态分析，并与14例健康对照（年龄= 64.4（5.6）岁，BMI = 24.9(2.1) kg/m2，女性= 7）进行比较。在五次步态试验中测量了时空、膝关节生物力学和患者报告的结果测量。使用统计参数映射评估整个步态周期的膝关节生物力学测量。手术后，内侧球窝式和后稳定式相似，在年龄、BMI、患者报告的结果测量或膝关节生物力学方面没有差异(P >；. 05)。术前，与对照组相比，内侧球窝和后稳定体均有不同的运动模式，主要是在站立和摆位阶段膝关节屈曲角度(P <；. 05)。与对照组相比，术后内侧球窝组在站立阶段的膝关节屈曲角度较小(P <；.05)，而在站立和摇摆阶段，后稳定组的膝关节屈曲角度小于对照组(P <；. 05)。解释：与PS组相比，内侧球窝组的步态模式更接近于对照组，膝关节矢状角的差异更小。尽管两组在所有患者报告的结果测量中都显示出术后改善，但两组之间没有发现显著差异。试验注册：NCT02589197, 2015年10月28日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.