Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature

被引:10
作者
Risitano, Salvatore [1 ,2 ]
Cacciola, Giorgio [1 ]
Capella, Marcello [1 ,2 ]
Bosco, Francesco [1 ,3 ]
Giustra, Fortunato [1 ,3 ]
Fusini, Federico [4 ]
Indelli, Pier Francesco [5 ]
Masse, Alessandro [1 ,2 ]
Sabatini, Luigi [1 ,2 ]
机构
[1] Univ Turin, Dept Orthopaed Surg & Traumatol, I-10126 Turin, Italy
[2] CTO Hosp Turin, Dept Orthopaed Surg & Traumatol, Citta Salute E & Sci, I-10126 Turin, Italy
[3] ASL Citta Torino, Osped San Giovanni Bosco, Dept Orthopaed & Traumatol, Piazza Donatore Sangue,3, I-10154 Turin, Italy
[4] Regina Montis Regalis Hosp, Dept Orthopaed Surg, I-12084 Cuneo, Italy
[5] Stanford Univ, Sch Med, Dept Orthopaed Surg & Bioengn, Palo Alto Vet Affairs Hlth Care Syst PAVAHCS, Palo Alto, CA 94304 USA
关键词
Total knee replacement; Posterior stabilised; Medial pivot; Kinematics; Walking; Gait analysis; OUTCOMES; BIOMECHANICS; REPLACEMENT; MOVEMENT; DESIGNS; IMPACT; HIP;
D O I
10.1186/s42836-023-00165-8
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BackgroundTotal knee arthroplasty (TKA) is one of the most performed orthopedic procedures worldwide. While excellent efficacy has been reported, about 20% of patients are not satisfied with the result. A potential cause is the problematic reproduction of knee kinematics. This systematic review examines gait analysis studies in primary medial pivot (MP) and posterior stabilized (PS) TKAs to investigate the differences between the two prosthesis designs.MethodsA systematic review was conducted by following PRISMA guidelines. Five databases (PubMed, Medline, Embase, Scopus and the Cochrane Database of Systematic Reviews) were analyzed, and eligible articles were evaluated in terms of the levels of evidence. The methodological quality of the articles was assessed by using the MINORS scoring. This review was registered in PROSPERO.ResultsNine studies were included. Gait analysis was performed in 197 MP TKA and 192 PS TKA patients. PS TKA cases showed (P < 0.05) a significantly higher peak of knee flexion angle during the swing phase, greater knee flexion angle at toe-off, an increased knee adduction angle, higher knee flexion and extension moment, increased anterior femoral roll during knee flexion and anterior translation on medial and lateral condyle during knee flexion compared to MP TKA. MP TKA showed statistically significant (P < 0.05) higher knee rotational moment and greater tibiofemoral external rotation motion during knee flexion than PS TKA. No statistically significant difference (P > 0.05) was reported regarding gait spatial-temporal parameters. The Forgotten Joint Score (FJS) and Western Ontario and McMaster Universities Comparison in terms of Arthritis Index (WOMAC) score (mean stiffness) showed that MP TKA yielded significantly better results than PS TKA.ConclusionsThis systematic review revealed significant kinematic and kinetic differences between MP and PS TKA at all gait analysis phases. Furthermore, the considerable difference between TKA design and the kinematics of healthy knee were highlighted in this study.
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页数:11
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