Abstract：
Kinetic asymmetries during sit-to-stand have been consistently observed early after total knee arthroplasty; however, the longer-term outcomes are less clear. The purpose of this systematic review and meta-analysis was to analyze the results of studies examining inter-limb kinetic symmetry during sit-to-stand performance among individuals who were at least one-year post unilateral total knee arthroplasty.
PubMed, SPORTDiscus, CINAHL, and Health Source databases were searched. Studies were included if they were published in a peer-reviewed journal, included subjects who had undergone unilateral total knee arthroplasty at least one-year prior, and examined vertical ground reaction forces and/or knee extension moments for the involved and uninvolved limbs during sit-to-stand performance. Data were transformed into a limb symmetry index, which expressed the ratio of the peak forces/moments for the involved limb, relative to the uninvolved limb (1.0 reflects perfect symmetry). These ratios were meta-analyzed using the ratio of means method.
Seven studies were deemed eligible for inclusion. Ground reaction force data was pooled from seven studies and knee extension moment data was pooled from two studies. For the peak vertical ground reaction forces, the pooled limb symmetry index was 0.96 (CI95% = [0.93, 0.99]). For the peak knee extension moments, the pooled limb symmetry index was 0.91 (CI95% = [0.84, 0.98]). In both cases this reflects greater limb/knee loading for the uninvolved limb, relative to the involved limb.
Asymmetries in limb/knee loading persist beyond the one-year post-operative period following total knee arthroplasty, potentially contributing to degenerative changes for the uninvolved limb.
PubMed, SPORTDiscus, CINAHL, and Health Source databases were searched. Studies were included if they were published in a peer-reviewed journal, included subjects who had undergone unilateral total knee arthroplasty at least one-year prior, and examined vertical ground reaction forces and/or knee extension moments for the involved and uninvolved limbs during sit-to-stand performance. Data were transformed into a limb symmetry index, which expressed the ratio of the peak forces/moments for the involved limb, relative to the uninvolved limb (1.0 reflects perfect symmetry). These ratios were meta-analyzed using the ratio of means method.
Seven studies were deemed eligible for inclusion. Ground reaction force data was pooled from seven studies and knee extension moment data was pooled from two studies. For the peak vertical ground reaction forces, the pooled limb symmetry index was 0.96 (CI95% = [0.93, 0.99]). For the peak knee extension moments, the pooled limb symmetry index was 0.91 (CI95% = [0.84, 0.98]). In both cases this reflects greater limb/knee loading for the uninvolved limb, relative to the involved limb.
Asymmetries in limb/knee loading persist beyond the one-year post-operative period following total knee arthroplasty, potentially contributing to degenerative changes for the uninvolved limb.
摘要：
背景：在全膝关节置换术后早期一直观察到静坐到站立过程中的运动不对称性；然而，长期结果不太清楚。本系统评价和荟萃分析的目的是分析研究在单侧全膝关节置换术后至少一年的个体中，在坐位至站立过程中检查肢体间动力学对称性的研究结果。
方法：PubMed，SPORTDiscus,CINAHL,并搜索了健康源数据库。如果研究发表在同行评审的期刊上，包括至少一年前接受过单侧全膝关节置换术的受试者，和检查垂直地面反作用力和/或膝盖伸展力矩涉及和不涉及的四肢在坐到站的表现。数据被转换成肢体对称指数，表示所涉及肢体的峰值力/力矩之比，相对于未受累的肢体（1.0反映了完美的对称性）。使用均值比率方法对这些比率进行荟萃分析。
结果：7项研究被认为符合纳入条件。地面反作用力数据来自七项研究，膝盖伸展力矩数据来自两项研究。对于峰值垂直地面反作用力，合并的肢体对称指数为0.96(CI95%=[0.93,0.99]).对于膝盖伸展的峰值时刻，合并的肢体对称指数为0.91(CI95%=[0.84,0.98]).在这两种情况下，这都反映了未受累肢体的肢体/膝盖负荷更大，相对于涉及的肢体。
结论：全膝关节置换术后，肢体/膝关节负荷的不对称持续超过一年，可能导致未受累肢体的退行性变化。
方法：PubMed，SPORTDiscus,CINAHL,并搜索了健康源数据库。如果研究发表在同行评审的期刊上，包括至少一年前接受过单侧全膝关节置换术的受试者，和检查垂直地面反作用力和/或膝盖伸展力矩涉及和不涉及的四肢在坐到站的表现。数据被转换成肢体对称指数，表示所涉及肢体的峰值力/力矩之比，相对于未受累的肢体（1.0反映了完美的对称性）。使用均值比率方法对这些比率进行荟萃分析。
结果：7项研究被认为符合纳入条件。地面反作用力数据来自七项研究，膝盖伸展力矩数据来自两项研究。对于峰值垂直地面反作用力，合并的肢体对称指数为0.96(CI95%=[0.93,0.99]).对于膝盖伸展的峰值时刻，合并的肢体对称指数为0.91(CI95%=[0.84,0.98]).在这两种情况下，这都反映了未受累肢体的肢体/膝盖负荷更大，相对于涉及的肢体。
结论：全膝关节置换术后，肢体/膝关节负荷的不对称持续超过一年，可能导致未受累肢体的退行性变化。
