全膝关节置换治疗成人膝外翻畸形：胫股角及膝关节活动度变化

背景：膝外翻畸形施行人工全膝关节置换难度很大,涉及面多,争议亦颇多。 目的：观察全膝关节置换治疗成人膝外翻畸形的手术方法和临床效果。 方法：对12例15膝采用髌骨内侧入路,正确截骨,选择性的软组织松解,恢复膝关节正常的力线和软组织平衡,采用后稳定型假体进行全膝关节置换,获得膝关节的稳定,置换后采取针对性的康复训练,置换前后测量胫股角,并置换后定期随访检查膝关节活动度并进行HSS评分。 结果与结论：所有患者获得随访均>6个月。置换前胫股角平均21.47°降低至置换后的5.47°(P < 0.01),膝关节活动度由置换前的81.33°提高到121.07°(P < 0.01);HSS评分由置换前的25.47分提高到89.87分(P < 0.01)。置换后1例出现关节积液较多,2例出现膝关节内测不稳。无髌骨脱位或半脱位,下肢力线均恢复正常。提示成人膝外翻畸形经全膝关节置换后外翻畸形均得到纠正,功能较前明显改善。     

保留髌骨膝关节置换的症状及影像学评价

背景：膝关节置换中是否置换髌骨是一个持续争论的话题。 目的：侧重评价保留髌骨膝关节置换后髌骨的影像学稳定性和症状改善。 方法：对39例(48膝)骨关节炎及类风湿性关节炎患者行保留髌骨的全膝关节置换。 结果与结论：术中记录髌骨软骨退变分级Ⅲ级和IV级达36膝,占75%,置换后HSS评分及FELLER髌骨评分较置换前明显改善,明显膝前痛病例为5例,占10%,其髌骨病理分级均达到Ⅳ级。保留髌骨膝关节置换前后影像学评价髌股关节的对线差异无显著性意义,下肢力线校正满意。提示对于置换前髌股轨迹不良、术中软骨病理分级较低者应该进行选择性的髌骨置换,恰当选择病例采用保留髌骨的膝关节置换可减少髌股关节并发症,置换前仔细评估,综合考虑多种因素操作可进一步改善髌股轨迹。     

CR假体与PS假体全膝关节置换治疗膝骨性关节炎合并膝外翻畸形的疗效分析

目的 比较后交叉韧带保留型（CR）假体与后方稳定型（PS）假体行人工全膝关节置换术（TKA）治疗膝骨性关节炎合并膝外翻畸形的临床疗效。方法 回顾性分析南昌大学附属赣州医院关节外科2019年5月至2021年5月收治的60例（60膝）膝骨性关节炎合并膝外翻畸形患者资料,均为单侧置换。30例采用CR假体行TKA治疗（CR组）,30例采用PS假体行TKA治疗（PS组）。比较两组患者的手术时间、术中失血量、术后引流量、术后3 d血红蛋白（Hb）下降量及深静脉血栓发生情况;比较两组患者手术前后膝外翻角;比较两组患者术后1周、1个月、3个月、6个月、1年疼痛视觉模拟评分（VAS）、膝关节活动度（ROM）、美国特种外科医院膝关节评分（HSS）。结果 60例患者均顺利完成TKA手术,所有患者随访13 ～ 28个月,平均（18.51±0.90）个月。CR组术中出血量、术后引流量、术后3 d的Hb下降量较PS组减少（P＜0.05）;两组手术时间相当、术后均无深静脉血栓发生,差异无统计学意义（P＞0.05）;两组手术前后膝外翻角的比较差异无统计学意义（P＞0.05）;CR组术后1周、1个月VAS评分较PS组更低（P＜0.05）,两组术后3个月、6月、1年VAS评分比较差异无统计学意义（P＞0.05）;CR组术后1周、1个月、3个月膝关节ROM和HSS评分优于PS组（P＜0.05）,两组术后6个月、1年膝关节ROM和HSS评分比较差异无统计学意义（P＞0.05）。结论 采用CR或PS假体行TKA手术治疗膝骨性关节炎合并膝外翻畸形均可有效纠正膝关节畸形、减轻膝关节疼痛、改善膝关节活动度及功能,取得满意临床疗效;但相对PS假体,CR假体保留了后交叉韧带,减少了股骨髁部截骨量,从而减少手术出血,更好减轻早期术后疼痛,有助于TKA术后早期功能康复。     

髌骨成形术对类风湿关节炎全膝关节置换术后髌骨轨迹和膝前痛的影响

分析全膝关节置换术（total knee arthroplastv,TKA）保留髌骨并行髌骨成形术后对膝前区疼痛及髌骨运动轨迹影响的疗效,为临床治疗提供参考。2007年1月~2011年1月,共随访类风湿关节炎保留髌骨全膝关节置换术患者226例383膝,其中男51例,女175例,年龄34~85岁。所有患者膝关节评分采用美国HSS评分系统,髌骨评分采用Feller等评分标准,随访时调查膝前痛,拍摄膝关节正、侧及髌骨90度轴位X射片。髌骨成形术：去除髌骨周围所有骨赘,磨平边缘,修整髌骨至Wiberg分型II型,用电刀切除髌骨周围软组织,试模复位后无拇指试验no thumb test阳性者松解髌骨支持带。结果显示患者术前、术后的HSS评分、髌骨评分、膝前痛评分、髌骨功能评分差异均有显著意义（P〈0.01）。类风湿关节炎保留髌骨的全膝关节置换术,术中对髌骨进行髌骨成形术处理,使髌骨形态恢复至Wiberg分型II型,术后髌骨运动轨迹良好,膝前痛的发生率低,术后疗效可靠。     

Patellar reshaping versus resurfacing in total knee arthroplasty - Results of a randomized prospective trial at a minimum of 7 years' follow-up

ObjectiveTo compare the results of primary total knee arthroplasty with patellar reshaping or resurfacing.MethodsOne hundred thirty-three patients were randomized into patellar reshaping group and patellar resurfacing group. Patellar reshaping includes resecting the partial lateral facet of the patella and the osteophytes surrounding the patella, trimming the patella to match the trochlea of the femoral component. The minimum follow-up time was 7 years. The outcome was measured by anterior knee pain rate, Knee Society clinical score, and radiographs.ResultsEight patients in the reshaping group (12.5%) and 10 patients in the resurfacing group (14.7%) complained of anterior knee pain (P = 0.712). Meanwhile, there were no significant differences between the two groups in terms of total Knee Society score, Knee Society pain score, Knee Society function score, as well as anterior knee pain rate.ConclusionsWith the numbers available, there was no significant difference between the groups treated with patellar reshaping or patellar resurfacing with regard to the KSS, anterior knee pain rate and radiographs. We prefer reshaping the patella to resurfacing the patella because the former preserves sufficient patellar bone stock and can easily be converted to patellar replacement if patients complain of recurrent anterior knee pain.     

人工膝关节表面置换术近期疗效观察

目的评估膝关节表面置换术的近期疗效,分析主要并发症发生的原因和预防方法。方法回顾分析自2010年1月~2013年12月在我院初次接受膝关节表面置换术的63例70膝患者资料,比较并分析术前和随访时患膝KSS和HSS评分、关节活动度检查等数据。结果通过各个时间段随访及X线检查结果的观察,正位片示膝关节人工假体位置安放好,关节间隙平衡;侧位片示人工关节假体大小合适,胫骨假体后倾角度良好,股骨假体包裹效果好。术后腓总神经麻痹2例,于术后4~6个月逐渐恢复。5例患者术后关节活动度较差,为(0~60±10)°,术后2~3周在强镇痛药物辅助下行手法松解处理;髌前痛1例,术后4个月经关节镜下行髌骨外侧支持带松解术后症状解除。随访时膝关节表面置换术后HSS及KSS评分均较术前显著提高。膝关节活动度从术前的(78.3±18.6)°提高至术后的(109.2±19.9)°(P0.O1)。结论初次人工膝关节表面置换术对于消除膝关节疼痛,改善关节的活动功能效果明显,术后近期的并发症发生率低。     

No difference in the anteroposterior stability between the GRADIUS and multi-radius designs in total knee arthroplasty

BackgroundThis retrospective study aimed to compare stability and clinical and radiological outcomes of total knee arthroplasty (TKA) for the GRADIUS and multi-radius femoral designs after minimum of two-year follow-up.MethodsA total of 142 patients who underwent TKA using ATTUNE posterior stabilized (PS) implants (68 patients, GRADIUS group) or Persona PS implants (74 patients, multi-radius group) for degenerative osteoarthritis were included. After an average of 2-year follow-up, the anteroposterior (AP) stability at 30°, 60°, and 90° was measured using KT 2000 device and compared between the two groups. The clinical outcome measurements included range of motion (ROM) of the knee, patient-reported outcomes and anterior knee pain (AKP). For the clinical evaluation of mid-flexion instability, pain was evaluated using the visual analog scale (VAS) score recorded during climbing up or going down stairs. The radiolucent lines on knee radiographs obtained at final follow-up were evaluated and compared between two groups.ResultsThe average AP stability at 30° knee flexion was 5.7 mm in the GRADIUS group and 5.9 mm in the multi-radius group; however, the difference was not significant. The AP stability at 60° and 90° knee flexion was also similar in both groups. There were no significant differences in the ROM, patient-reported outcomes at follow-up, incidence of AKP and VAS scores between the two groups. There were no differences in the incidence of radiolucency around the components between the two groups.ConclusionThe GRADIUS design did not show any advantage with respect to the stability or clinical outcomes compared with the multi-radius design in TKA.     

同时双侧全膝表面置换与单侧全膝关节置换围手术期康复的比较

背景：目前对于双膝严重骨性关节炎行两组同时双侧全膝表面置换的围手术期康复的相关研究尚不多见。 目的：比较双膝骨性关节炎两组同时双侧全膝表面置换术与单侧全膝关节置换围手术期康复训练的效果。 方法：两组医生对59例(118膝)患者双膝骨性关节炎同台同时全膝表面置换,与同期80例单膝骨性关节炎行单侧全膝关节置换患者(对照组)进行疗效比较。两组患者置换前均进行康复教育及预备康复,置换后康复方法标准一致。 结果与结论：同时双侧全膝表面置换组置换前通过压腿平均减小屈曲畸形角度11.2°(5°~22°)。置换后3~6周,股四头肌、腘绳肌肌力5级,较置换前平均增加0.8级;平均ROM≥95°(110±15) °;无痛行走500 m以上;独自无痛上下10级楼梯,无肿胀;出院时HSS评分较置换前增加。置换后3个月没有发现松动表现及不良反应,其康复疗效与对照组对比差异无显著性意义。表明,在围手术期对双膝骨性关节炎两组医生行同时双侧全膝表面置换,通过系统而量化的康复,有利于减少置换中截骨量和置换后并发症,促进患者膝关节功能恢复,与单侧全膝关节置换相比康复结果无明显差异。     

同期双侧全膝关节置换与选择性单侧全膝关节置换后的早期功能恢复

背景：同期双侧全膝关节置换与选择性单侧全膝关节置换后的早期功能恢复一直存在着争议。 目的：评价双膝骨关节炎患者同期双侧全膝关节置换与选择性单侧全膝关节置换后功能恢复情况的差异。 方法：根据置换方案将初次行全膝关节置换的双膝骨关节炎患者86例(116膝)分为两组,双膝组(n=29,58膝)行同期双侧全膝关节置换,单膝组(n =57,57膝)行单侧全膝关节置换。分别对两组患者置换前后的关节活动度、屈曲挛缩度、肌力、疼痛评分、双下肢不等长及HSS评分进行比较分析,并记录并发症的发生率。 结果与结论：置换后1年随访,两组患者置换后关节活动度和肌力差异无显著性意义(P=0.171,0.418);置换后屈曲挛缩度、疼痛评分及双下肢不等长双膝组均显著低于单膝组(P=0.006,0.0013,0.026);同时双膝组置换后HSS评分优于单膝组(P=0.003)。提示同期双侧全膝关节置换患者在屈曲挛缩度、疼痛症状评分、双下肢不等长及HSS评分方面优于单侧全膝关节置换,而两种方案在置换后关节活动度和下肢肌力方面无明显差异。     

骨关节炎患者全膝关节置换：多中心的随机对照

背景：年龄在60岁以上存在关节疼痛、功能障碍和关节畸形的骨关节炎患者均可以考虑行全膝关节置换。 目的：比较传统全膝关节置换、微创全膝置换和避开股四头肌的微创全膝置换后早期膝关节功能恢复情况的差异。 方法：选择北京301医院、山东省立医院、山东省交通医院获得随访的120例骨关节炎患者,其中42例接受常规全膝关节置换,42例接受微创全膝关节置换,36例接受避开股四头肌的微创全膝关节置换。所有患者置换后第2,6,12周进行膝关节HSS评分及关节活动度检测。 结果与结论：微创全膝关节置换组及避开股四头肌的微创全膝关节置换组较常规全膝关节置换组手术时间长(P < 0.01),出血量少(P < 0.01);两微创手术组间差异无显著性意义(P > 0.05)。置换后2周微创全膝关节置换组及避开股四头肌的微创全膝关节置换组关节活动度、HSS评分均优于常规全膝关节置换组(P < 0.01),两微创组间关节活动度差异无显著性意义(P > 0.05),但避开股四头肌的微创全膝关节置换组HSS评分优于微创全膝关节置换组(P < 0.01);置换后6,12周3组HSS评分及关节活动度差异无显著意义(P > 0.05)。提示避开股四头肌的微创全膝关节置换与微创全膝关节置换以及常规全膝关节置换相比,手术损伤较小,术后疼痛程度更轻,术后能早期进行康复锻炼。     

Evaluation of anteroposterior accelerometric change after bi-cruciate stabilized total knee arthroplasty and posterior stabilized total knee arthroplasty

BackgroundIn conventional total knee arthroplasty (TKA), the anterior cruciate ligament (ACL) is resected. ACL dysfunction causes knee instability and is regarded as one factor in poor TKA outcomes. In bi-cruciate stabilized (BCS) TKA, the implant reproduces ACL function and provides anterior stability. The objective of this study was to evaluate preoperative and postoperative X-rays and accelerometer gait measurements in patients who underwent BCS TKA and posterior-stabilized (PS) TKA to assess the postoperative acceleration changes of knees after these procedures and to compare them in terms of joint range of motion (ROM) and the New Knee Society Score (New KSS).MethodsThe subjects were 60 patients, 30 of whom underwent BCS TKA and 30 PS TKA. Joint ROM, New KSS, lateral X-rays of the standing extended knee, and accelerometer data were evaluated 12 months postoperatively.ResultsThere was no significant difference in joint ROM between the groups. Both had good New KSS results, but the functional activity score was significantly higher after BCS TKA than after PS TKA. X-rays showed a lower posterior offset ratio after BCS TKA than after PS TKA, with anteroposterior positioning closer to that of the normal knee.Accelerometer data showed that postoperative anteroposterior acceleration on the femoral side in the stance phase and swing phase was lower after BCS TKA than after PS TKA.ConclusionCompared with PS TKA, BCS TKA resulted in a higher functional activity score, closer positioning to that of the normal knee on lateral X-ray, and lower anteroposterior acceleration on the femoral side.     

髌周去神经化预防全膝关节置换术后膝前疼痛

目的　依据髌周解剖学特点，探讨全膝关节置换术（total knee arthroplasty，TKA）中应用髌周电灼去神经化的临床效果。 方法　纳入82名诊断为骨性关节炎的患者（91膝），予行双侧或单侧不置换髌骨的TKA，按随机对照原则将病人分为两组，共有41名实验组患者（45膝）在TKA中接受了髌周去神经化处理，41名对照组患者（46膝）未做该处理。手术主刀为同一骨科医师，均使用相同的膝关节假体系统。主要评价项目包括膝关节KSS评分、Western Ontario and McMaster Universities（WOMAC）、Feller髌骨评分及VAS评分。 结果　82名患者术后均获随访，平均随访时间为12个月，两组病人的膝关节KSS评分、WOMAC、Feller髌骨评分及VAS评分均无显著统计学差异（P>0.05）。 结论　在TKA中行髌周电灼去神经化，不能显著改善病人的预后。     

数字化和3D打印技术辅助治疗陈旧性髌骨骨折

目的探讨数字化和3D打印技术辅助陈旧性髌骨骨折精确截骨、复位和内固定方法,了解其在辅助治疗陈旧性髌骨骨折中的价值。方法自2006年以来,纳入5例陈旧性髌骨骨折畸形愈合患者采用CT薄层扫描、三维重建获得骨折部位骨关节三维模型,采用计算机辅助分析骨折移位和新生骨痂形成情况,CAD设计辅助手术模板引导骨折面准确截骨、精确复位,仿真模拟骨折复位、内固定过程,最后采用膝关节HSS评分标准评定术前、术后2周、末次随访时的膝关节功能。结果5例患者经14~23个月的随访,随访期间未发现螺钉、钢缆滑脱松动以及伤口感染等并发症,术后X线片证实骨折均解剖复位;根据膝关节HSS评分标准评价,术前HSS评分为47、53、35、40、42分,术后2周HSS评分为82、83、80、85、86分,末次随访HSS评分为95、86、89、90、91分。最后根据膝关节HSS评分标准评价:优5例。结论采用计算机辅助精确界定髌骨骨折面、模拟骨折复位内固定、个性化手术模板引导精确截骨、复位和内固定过程,解决了陈旧性髌骨骨折截骨部位确定困难、复位欠佳等问题。     

Advanced functional biomechanical analysis of medial rotation knee arthroplasty

BackgroundThe Medacta GMK-Sphere total knee arthroplasty (TKA) is designed to mimic the movements and stabilimidty of a natural knee for optimal post-operative function and mobility. This study aimed to quantify the early functional outcome of patients with this implant.MethodsPatients due to undergo TKA to treat end-stage osteoarthritis were recruited into this study. Functional tests of knee range of motion (ROM), strength, and gait kinematics were carried out pre-operatively and one year post-operatively at routine clinics. Motion capture technology and a force transducer were used to collect all data. Normality tests were completed on all data sets to confirm normal distribution of the data, then paired t-tests were used to statistically compare the results. The level of significance was set as α = 0.05.ResultsSixty-three patients underwent pre-operative assessments; of which 30 returned one year post-operatively and consented to have follow-up testing. The operative knee was found to have poorer function than the contralateral knee pre-operatively (p < 0.05). Post-operatively, knee ROM significantly improved on the operative side to a mean of 116.1 ± 19.0. Gait kinematics also improved, especially in the frontal plane, but some abnormal traits remained in the sagittal plane. Knee strength decreased post-operatively.ConclusionsThe Medacta GMK-Sphere TKA improves knee range of motion sufficiently within the first postoperative year to allow patients to carry out most activities of daily living (> 110° knee flexion), but continued poor knee strength may limit their abilities to complete tasks which are more biomechanically demanding than walking.     

温针灸与针刺治疗老年性膝骨关节病的临床疗效对比

目的 探究温针灸与针刺治疗老年性膝骨关节病的临床疗效。方法 选取我院2015年1月~2017年1月收治的老年性膝骨关节病患者110例,按随机数字表法分为实验组和对照组,每组55例。实验组采取温针灸疗法,对照组采取针刺治疗。对比两组患者治疗有效率、治疗前后膝关节评分和疼痛量表评分。结果 实验组治疗有效率为94.55%,高于对照组的74.55%,差异具有统计学意义（P＜0.05）。治疗后1周、2周,实验组膝关节HSS评分均高于对照组,差异具有统计学意义（P＜0.05）。治疗后1周,实验组膝关节ROM评分为（82.24±9.46）分,高于对照组的（75.24±9.32）分,差异具有统计学意义（P＜0.05）;治疗2周,两组膝关节ROM评分对比,差异无统计学意义（P＞0.05）。治疗前后,两组间疼痛量表VAS评分及评分差值对比,差异均无统计学意义（P＞0.05）。结论 与针刺治疗相比,温针灸能在较短时间内缓解患者膝骨关节疼痛,且治疗方式较适宜老年患者。     

血友病患者全膝置换围手术期的凝血因子替代治疗

背景：世界血友病协会的治疗指南明确表示,关节置换应当在保证患者凝血因子活性的情况下进行。 目的：观察血友病关节炎患者行人工膝关节置换围手术期凝血因子替代治疗的安全性和有效性。 方法：1997/2006在血液内科的配合下,围手术期行凝血因子Ⅷ和Ⅸ活性水平监测,根据指南制定常规流程,进行因子Ⅷ(冻干人凝血因子Ⅷ)或因子Ⅸ(凝血酶原复合物)的替代治疗,对4例血友病关节炎患者共6个膝关节行人工膝关节置换治疗。 结果与结论：围手术期应用凝血因子进行常规替代治疗,血友病患者围手术期出血量与类风湿关节炎和骨关节炎患者差异无显著性意义(P=0.885)。置换后早期3个膝关节出现关节内血肿或肌肉出血,其中1例患者因凝血因子抑制性抗体形成,导致1侧膝关节置换后伤口裂开,行扩创清理后,伤口愈合良好。4例患者6个膝关节置换后没有晚期感染、假体松动、移位和断裂等并发症发生。所有4例患者置换前膝关节KSS评分平均28.2分,功能评分平均35分。置换后KSS评分85.2分,功能评分87分,与普通类风湿关节炎和骨关节炎膝关节置换后评分相似,但平均住院天数延长约3倍,住院费用为普通膝关节置换的2.5~3倍。结果显示凝血因子的替代治疗和凝血因子水平监测是保证血友病关节炎行人工膝关节置换最后成功的关键。     

智能可穿戴康复系统在膝关节置换术后康复训练中的应用效果

目的 探讨智能可穿戴康复系统在人工全膝关节置换(TKA)术后患者康复训练中的临床应用价值。方法 前瞻性研究。纳入2017年10月—2018年4月在北京博爱医院接受TKA手术治疗的120例患者,其中男51例、女69例,年龄55~78岁,体质量指数(BMI)19.7~32.6 kg/m²,术前膝关节活动度(ROM)84°~117°,K-L分级Ⅲ级42例、Ⅳ级78例。采用随机数法将患者分为对照组60例和康复组60例。住院期间和出院后,对照组患者采用传统遵医嘱、按时复查方式训练,康复组使用NEO-SMART智能可穿戴康复系统辅助进行康复训练。观察两组患者在各随访时间点的膝关节疼痛视觉模拟评分(VAS)、ROM、美国特种外科医院(HSS)膝关节评分。结果 两组患者性别、年龄、BMI、K-L分级比较,差异均无统计学意义(P值均＞0.05)。120例患者中4例失访,其余均获随访6个月。对照组和康复组患者的VAS比较,术后48 h差异无统计学意义(P＞0.05),术后2周和1个月时康复组VAS分别为(2.2±0.61)和(1.2±0.37)分,对照组分别为(2.5±0.82)和(1.7±0.53)分,康复组均低于对照组,差异均有统计学意义(P值均＜0.01);两组患者膝关节ROM比较,术后48 h差异无统计学意义(P＞0.05)。术后 2周、1个月、3个月时分别为88.7°±3.60°和93.1°±3.07°、96.8°±3.76°和103.5°±3.47°、99.8°±4.05°和107.3°±4.33°,差异均有统计学意义(P值均＜0.01);两组患者HSS评分比较,术后1、3、6个月康复组均显著优于对照组(P值均＜0.01)。结论 使用智能可穿戴康复系统可显著提高TKA患者的术后康复训练效果,值得临床推广应用。     

第三代牛津单髁系统在膝关节内侧间室骨性关节炎的应用

目的探讨牛津第三代单髁假体微创单髁置换术治疗膝关节内侧间室骨性关节炎的疗效与技术。方法回顾性分析2005年5月~2011年6月采用微创单髁置换术治疗100例膝关节内侧间室骨性关节炎患者的资料,对患者术前、术后膝关节疼痛及关节活动度进行评估(HSS评分法),并测量术后假体力线,分析假体设计、手术适应证的选择及手术技术。结果 100例术后平均随访36个月(12~75个月),末次随访时膝关节HSS评分和膝关节活动度明显增加,股骨假体力线平均为0.69°内旋±3.18°,0.83°伸直±3.63°,胫骨假体力线平均为0.12°内翻±0.80°,0.39°伸直±1.24°,无假体位置不良、脱位及假体松动等并发症。结论微创单髁置换术治疗膝关节内侧间室骨性关节炎具有很好的疗效,其关键在于手术适应证的选择和手术技术。     

Separation of bipartite patella in nail–patella syndrome: a case report

We report an unusual case of separation of bipartite patella in a patient with nail–patella syndrome. Arthroscopic lateral release and medial plication was carried out for anterior knee pain and patellar subluxation. During post-operative rehabilitation the bipartite patella separated. This was bone grafted and internally fixed by tension band wiring with good end results.     

Correlation between objective gait parameters and subjective score measurements before and after total knee arthroplasty

The absence of uniformity, the use of different terminologies, and the diversity of methods used to translate numerical data into clinical outcomes have been described as potential problems when dealing with clinical knee scores for total knee arthroplasty (TKA). Gait analysis is believed to provide more objective parameters. The aim of the present study was to obtain information about the correlation between the outcome in terms of locomotion and the clinical knee score after TKA. Thirty consecutive patients awaiting TKA were involved in the study. One day prior to surgery and 3 months postoperatively, data pertaining to the Hospital for Special Surgery Score (HSS) and the Knee Society Score (KSS) (subgroups 'pain', 'knee', 'function' and 'total sum') were analyzed for correlations with kinematic and temporospatial parameters of gait analysis. At a significance-level of p相似文献