Knee implant kinematics are task-dependent
Knee implant kinematics are task-dependent
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DOI：
10.1098/rsif.2018.0678
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发表时间：
2019-02-01
影响因子：
3.9
通讯作者：
List, Renate
中科院分区：
文献类型：
--
作者：
Schutz, Pascal;Postolka, Barbara;List, Renate
虽然全膝关节置换术（TKA）已成为缓解疼痛的标准手术程序，但在日常生活的常见功能活动中，体内膝关节运动学的知识仍然缺失。本研究的目的是分析TKA受试者在整个日常活动周期中的膝关节运动，以确定不同活动之间的关节运动学是否存在显著差异。使用动态视频透视，我们评估了6名受试者在步行、下楼梯、从坐到站和从站到坐的完整周期中的胫股运动学。髁突前后平移的平均范围在所有受试者中表现出明显的任务依赖性。与水平行走和站立至坐下相比，在下楼梯期间观察到显著更大的前后平移。局部最小值观察到约30度屈曲不同的任务，这是更突出的负载任务阶段。该特征可能与植入物的特定设计相对应。根据本研究中提供的数据，很明显，屈曲角度本身不能完全解释胫股植入物的运动学。因此，在体内评价TKA设计的行为时，似乎必须评估最频繁功能活动的完整周期。
Although total knee arthroplasty (TKA) has become a standard surgical procedure for relieving pain, knowledge of the in vivo knee joint kinematics throughout common functional activities of daily living is still missing. The goal of this study was to analyse knee joint motion throughout complete cycles of daily activities in TKA subjects to establish whether a significant difference in joint kinematics occurs between different activities. Using dynamic videofluoroscopy, we assessed tibio-femoral kinematics in six subjects throughout complete cycles of walking, stair descent, sit-to-stand and stand-to-sit. The mean range of condylar anterior-posterior translation exhibited clear task dependency across all subjects. A significantly larger anterior-posterior translation was observed during stair descent compared to level walking and stand-to-sit. Local minima were observed at approximately 30 degrees flexion for different tasks, which were more prominent during loaded task phases. This characteristic is likely to correspond to the specific design of the implant. From the data presented in this study, it is clear that the flexion angle alone cannot fully explain tibio-femoral implant kinematics. As a result, it seems that the assessment of complete cycles of the most frequent functional activities is imperative when evaluating the behaviour of a TKA design in vivo.