The Mark Coventry Award In Vivo Knee Forces During Recreation and Exercise After Knee Arthroplasty
The Mark Coventry Award In Vivo Knee Forces During Recreation and Exercise After Knee Arthroplasty
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DOI：
10.1007/s11999-008-0345-x
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发表时间：
2008-11-01
影响因子：
4.2
通讯作者：
Colwell, Clifford W., Jr.
中科院分区：
文献类型：
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作者：
D'Lima, Darryl D.;Steklov, Nikolai;Colwell, Clifford W., Jr.
膝关节力直接影响关节置换术部件的存活率、关节面的磨损以及骨-植入物界面的完整性。目前尚不清楚哪些活动产生的力在生理学所需的范围内，但又不足以危及假体组件的存活率。我们在三名患者体内植入了内固定胫骨假体，并在运动和娱乐活动中测量了膝关节的力和力矩。正如预期的那样，固定骑自行车产生低胫骨力，而慢跑和网球产生高峰力。另一方面，高尔夫挥杆产生了意想不到的高力量，特别是在领先的膝盖。在椭圆机上锻炼产生的力量低于慢跑，但不低于跑步机步行。这些新数据为推荐TKA术后活动提供了更科学的方法。此外，这些数据可用于开发临床相关的结构和摩擦学测试，这可能会导致特定于活动的膝关节设计，例如通过优化增加旋转松弛度和贴合性的冲突需求，使膝关节设计更能耐受高尔夫运动。
Knee forces directly affect arthroplasty component survivorship, wear of articular bearing surfaces, and integrity of the bone-implant interface. It is not known which activities generate forces within a range that is physiologically desirable but not high enough to jeopardize the survivorship of the prosthetic components. We implanted three patients with an instrumented tibial prosthesis and measured knee forces and moments in vivo during exercise and recreational activities. As expected, stationary bicycling generated low tibial forces, whereas jogging and tennis generated high peak forces. On the other hand, the golf swing generated unexpectedly high forces, especially in the leading knee. Exercise on the elliptical trainer generated lower forces than jogging but not lower than treadmill walking. These novel data allow for a more scientific approach to recommending activities after TKA. In addition, these data can be used to develop clinically relevant structural and tribologic testing, which may result in activity-specific knee designs such as a knee design more tolerant of golfing by optimizing the conflicting needs of increased rotational laxity and conformity.