DOI QR코드

DOI QR Code

A Biomechanical Comparative Analysis of the Multi-Radius Total Knee Arthroplastry System for Go up Stair and Go down Stair

계단 오르기와 내리기 동안 다축범위(multi-radius) 무릎인공관절 수술자의 운동역학적 비교분석

  • Published : 2006.03.31

Abstract

The primary purpose of a TKA is to restore normal knee function Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from climbing stairs; (b) provide adequate knee joint stability. A 16-channel MyoResearch XP EMG system was used to collect the differential input surface electromyography signals VM, VL, RF, BF, ST during climbing/descending stair tests. A Peak Motion Measurement System was used to collect the kinematic and kinetic data. AKIN-COM Ill isokinetic dynamometer was used for EMG of VM, VL, RF, BF and ST during maximal voluntary contraction. I Quadriceps EMG results for the VM of the passed 1year group limb demonstrated significant less RMS EMG than that of the passed 3year group limb $60^{\circ}-15^{\circ}$ of knee flexion(p<0.05). The VL of the passed 1year group limb also demonstrated significants less RMS EMG than that of the passed 3year group limb from $60^{\circ}-45^{\circ}$ of knee flexion(p<0.05). Similar to the VM and VL, the RF of the passed 1year group limb showed less RMS EMG than that of the passed 3year group limb from $60^{\circ}-30^{\circ}$ do knee flexion(p<0.05). Hamstring EMG results for the BF of the passed 1year group limb demonstrated less RMS EMG than that of the passed 3year group limb from $75^{\circ}-15^{\circ}$ of knee flexion(p<0.05). The passed 1year group limb tended to have less ADD displacement(p<0.071) than that of the passed 3year group limb. There was no significant difference of the ABD displacement between the passed 1year group and the passed 3year group limbs(p<0.73). The passed 3year group used compensatory adaptation movement strategies to compensate for the strength deficit of passed 3year group limbs. The passed 3year group limb also increased the quadriceps muscle activation level to produce more knee extension moment to compensate for the short quadriceps moment arm. The passe 3year group limb might have an unstable knee joint in the medio-Iateral direction during the climbing/descending by showing a tendency of more ADD displacement and greater hamming co-activation EMG than the passed 1year group limbs. The TKA design was not able to help the knee joint to produce adequate knee extension moment with less quadriceps muscle effort. I think that old man needs continuous exercise for muscle strength.

Keywords

References

  1. 신제민(2005). 두가지 축구 골킥 동작의 운동역학적 분석. 한국운동역학회지. 제15권 1호, pp. 29-44.,
  2. Alexander, N.B., Schultz, A.B., & Warwick, D.N.(1991). Rising from a chair: effects of age and functional ability on performance bio- mechanics. Journal of Gerontol, 46(3).
  3. Allard, P.S., Ian, A.F. & Blanchi, J.(1995). Three dimensional analysis of human movement. Human Kinetics, Champaign, 145-175.
  4. Churchill,D.L., & Beynnon,B.D.(1998). The transepi- condylar axis approximates the optimal flexion axis of the knee. Clinical Orthopedic (356),111-118.
  5. Dempster, W. T.(1955). Space requirements of the seated operator. WADC Technical Reports. Aerospace Medical Research Laboratory, Wright Patterson Air Development Center, Wright Patterson Air Force Base, Ohio.
  6. Felter & Dapena(1989).Three-Dimensional interactions in a two-segment kinetic chain. Part II: Application to the throwing arm in baseball pitching. International Journal of Sport Biomechanics.
  7. Freund,D.A.,& Dittus, R.S.(1997).Assessing and im- proving outcomes: total knee replacement. AHCPR Pub. No.97-N 015.
  8. Isao Asayama (2003). Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. 1st International High Perfor- mance Hip Meeting, Athens, Georgia.
  9. Jin & Kwak(2004).Strength Evalution of Single-Radius Total Knee Replacement (TKR). Journal of life science.
  10. Kasman, G.S., Cram, J.R., & Wolf, S.L.(1998). Knee Dysfunction. Clinical in Surfaces Electrom- yography. Gaithersburg, Maryland. Aspen Publishers. 363-389.
  11. Mahoney, O. K.(1999).Posterior cruciate function following total knee arthroplastry. Journal of Arthroplasty.
  12. Mahoney. O. K.(2002). Laboratory Demonstration of Mechanical and Functional Advantages of Single-Radius TKA Design. Proceeding of 69th American Academy of Orthopaedic Surgeons Meeting, 3, 442.
  13. Putnam, C. A.(1983). Segment interaction in Selected two-segment motion. Doctoral dissertation, University of Iowa.
  14. Putnam, C. A.(1993).Sequential motion of body segments in striking and throwing skills: Descriptions and explanations. Journal of Biomechanics Vol. 26, suppl. 1, pp. 125-135. https://doi.org/10.1016/0021-9290(93)90084-R
  15. Riley,L.H.(1983).History and Evaluation of total Knee Replacement. Baltimore, MD, Williams & Wilkins.1-4.
  16. Simpson,K.J.(2003).An electromyographic study of the hip abductor muscles during gait in in- dividuals with total arthroplasty. International Scientific Congress of Hip and Knee Joint.
  17. Solomonow, M., Baratta, R.(1987) The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability. American Journal of Medicine, 15(3),207-213.
  18. Zatsiorsky, V.M.(2002). Kinematics of Human Motion. Champaign, IL : Human Kinetics. 225-281.
  19. Zhang, L.Q. (2001). Dynamic and static control of the human knee joint in abduction-adduction. Journal of Biomechanics, 34(9), 1107-1115. https://doi.org/10.1016/S0021-9290(01)00080-X