Comparison of plantar pressure distribution during walking and lower limb alignment between modified kinematically and mechanically aligned total knee arthroplasty
Comparison of plantar pressure distribution during walking and lower limb alignment between modified kinematically and mechanically aligned total knee arthroplasty
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DOI：
10.1016/j.jbiomech.2021.110379
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发表时间：
2021-04-09
影响因子：
2.4
通讯作者：
Matsumoto, Tomoyuki
中科院分区：
文献类型：
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作者：
Kamenaga, Tomoyuki;Nakano, Naoki;Matsumoto, Tomoyuki
全膝关节置换术（TKA）后下肢对线非常重要。本研究旨在比较运动学（KA）和机械对准（MA）TKA之间行走时的足底压力分布和整体肢体对准（包括后足）。在四组患者中，使用压力板在行走和单腿站立时研究足底压力分布：KA-TKA后1年的患者（KA组; n = 25）、MA-TKA后1年的患者（MA组，n = 25）、接受非手术治疗的骨关节炎（OA）患者（OA组，n = 25）和健康对照（健康组; n = 25）。在KA、MA和OA组的单足站立长腿X线片上评价传统和真实机械轴（从股骨头到跟骨最低点的线）。采用方差分析比较结果。OA组在中足和后足表现出外侧负载模式，而MA组在行走过程中表现出内侧后足负载模式。相反，KA组和健康组显示出内侧和外侧后足之间几乎相等的压力分布。此外，尽管KA组的两个机械轴都更内侧地穿过膝关节，但与MA组相比，真正的机械轴实现了更中性的对线。KA-TKA通过真正的机械轴实现更中性的负重，并允许患者行走，同时比MA-TKA更均匀地保持内侧和外侧后足压力。(c)2021爱思唯尔有限公司保留所有权利。
Lower extremity alignment is very important after total knee arthroplasty (TKA). This study aimed to compare the plantar pressure distribution while walking and the overall limb alignment, including the hindfoot, between kinematically (KA) and mechanically aligned (MA) TKA. The plantar pressure distribution was investigated using a pressure plate during walking and one-leg standing among four groups: patients one year after KA-TKA (KA group; n = 25), patients one year after MA-TKA (MA group, n = 25), patients with osteoarthritis (OA) undergoing non-surgical care (OA group, n = 25), and healthy controls (Healthy group; n = 25). Conventional and true mechanical axes (the line from the femoral head to the lowest point of the calcaneus) were evaluated on unipedal standing long-leg radiographs in the KA, MA, and OA groups. Results were compared using analysis of variance. The OA group showed a lateral loading pattern in the mid-and rearfoot, while the MA group showed a medial rearfoot loading pattern during walking. On the contrary, the KA and Healthy groups showed an almost equal pressure distribution between the medial and lateral rearfoot. Moreover, although both mechanical axes in the KA group passed through the knee more medially, a more neutral alignment was achieved in the true mechanical axis compared to that in the MA group. KA-TKA results in more neutral weight-bearing through the true mechanical axis and allows patients to walk while maintaining medial and lateral rearfoot pressure more evenly than MA-TKA.(c) 2021 Elsevier Ltd. All rights reserved.