中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (5): 607-611.doi: 10.13418/j.issn.1001-165x.2024.5.21

• 临床研究 • 上一篇    下一篇

全膝关节置换术对老年膝关节等速肌力曲线特征的影响

曾凡令1, 贾蕊1,2, 黄艺林1, 高卫邦1, 张雷1*   

  1. 1.南方医科大学附属广东省人民医院(广东省医学科学院)康复医学科,  广州   510080;    2.南方医科大学基础医学院人体解剖学教研室,广东省数字医学与生物力学重点实验室,广东省医学3D打印应用转化工程技术研究中心,  广州   510515
  • 收稿日期:2024-04-19 出版日期:2024-09-25 发布日期:2024-10-21
  • 作者简介:曾凡令(1985-),男,广东惠州人,学士,主要从事肌骨生物力学研究,E-mail: 439408636@qq.com
  • 基金资助:
    广东省医学科学技术研究基金项目(A2022507);广东省人民医院国家自然科学基金启动项目(82170900328/KY012021754)

Effect of total knee arthroplasty on isokinetic muscle strength curve in knee joint of the aged

Zeng Fanling1, Jia Rui1,2, Huang Yilin1, Gao Weibang1, Zhang Lei1*   

  1. 1. Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; 2. Department of Human Anatomy, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
  • Received:2024-04-19 Online:2024-09-25 Published:2024-10-21

摘要: 目的 探究全膝关节置换术(total knee arthroplasty, TKA)对老年膝关节等速肌力曲线特征的影响。  方法 采集TKA术后一年和性别、年龄与之相匹配的健康人在180 °/s、60 °/s角速度下进行等速肌力测试和等长屈伸测试。采集屈伸肌群的峰力矩和腘绳肌/股四头肌比率(H/Q),并采用 1°递增的平均力矩结果进行标准化(力矩/体质量)。  结果 TKA术后患者在180°/s的角速度下患侧屈膝力矩在16°至64°范围内低于健侧,在10°至83°范围内低于健康受试者同侧(P<0.05);60°/s的角速度下患侧屈膝力矩在72°至76°范围内低于健侧,在59°至87°范围内低于健康受试者同侧(P<0.05);患侧与健康受试者同侧等长屈膝力矩无统计学差异(P>0.05)。TKA术后患者在180°/s的角速度下患侧伸膝力矩、峰力矩、H/Q与健康受试者同侧均无统计学差异(P>0.05);60°/s的角速度下患侧伸膝力矩在68°至85°范围内低于健侧,在18°至37°和72°至81°范围内低于健康受试者同侧,患侧H/Q高于健康受试者同侧(P<0.05),两组伸展峰力矩和等长伸膝力矩无统计学差异(P>0.05)。  结论 TKA术后高速运动及关节活动末低速运动中患侧腘绳肌肌力下降,患侧股四头肌在关节活动起始和终末范围内低速运动中肌力下降。

关键词: 全膝关节置换术,  等速肌力测试,  膝关节,  膝骨关节炎

Abstract: Objective To explore the influence of total knee arthroplasty (TKA) on the isokinetic muscle strength curve of knee joints in the aged. Methods Patients underwent TKA one year after surgery and healthy people who matched in age and sex were selected. Isometric and isokinetic strength of knee flexion and extension at velocity of 180°/s and 60°/s was tested by isokinetic dynamometer. The peak moment and hamstring/quadriceps ratio (H/Q) of flexion and extension muscles were collected, normalized torque-angle curves (torque/body mass) were generated in steps of 1°. Results At 180°/s for patients after TKA, the flexion moment of the affected side was lower than that of the healthy side in the range of 16° to 64° and lower than that of the same side of the healthy subjects in the range of 10° to 83° (P<0.05); at 60°/s, the flexion moment of the affected side was lower than that of the healthy side in the range of 72° to 76° and lower than that of the healthy subjects in the range of 59° to 87° (P<0.05). There were also no significant differences in knee extension moment, the peak moment and H/Q between the affected side of patients and healthy subjects at 180°/s (P>0.05); at 60°/s, the knee extension moment on the affected side was lower than that on the healthy side in the range of 68° to 85°, and lower than that of the healthy subjects in the range of 18° to 37° and 72° to 81°, the H/Q on the affected side was higher than that of the healthy subjects (P<0.05). There was no significant difference in the peak moment and extension moment of isometric test between the affected side and the healthy subjects (P>0.05). Conclusions After total knee arthroplasty, the hamstring strength of the affected side decreased during high-speed and low-speed within the end range of joint movement, and the quadriceps strength of the affected side decreased during low-speed within the starting range of joint movement. 

Key words: Total knee arthroplasty,  Isokinetic muscle test,  Knee,   Knee osteoarthritis

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