单侧全膝关节置换术后两下肢受力不对称性的影响因素

全膝关节置换术（total knee arthroplasty, TKA）是晚期膝骨关节炎最常见的手术治疗手段。已有研究发现，单侧TKA术后两下肢受力不对称，对侧膝关节承担更大载荷，从而使骨关节炎加重面临再次置换的风险。综述单侧TKA术后可能引起两下肢受力不对称的影响因素，主要介绍下肢力线、疼痛、肌肉、本体感受、心理原因等；同时探讨这些影响因素对人体总的影响效果、人体对不对称载荷的补偿机制以及临床干预手段。通过对单侧TKA术后两下肢受力影响因素的分析，可以制定针对性的临床干预手段，用以减小患者对侧膝关节发展为骨关节炎甚至置换的风险。
Total knee arthroplasty (TKA) is the most common surgery for treating late-stage knee osteoarthritis. Previous studies have shown that after unilateral TKA, the load-carrying on lower limbs is asymmetrical and the contralateral knee have to bear even greater loads. Therefore, the osteoarthritis side is susceptible to become even worse and under the risk of subsequent replacement. In this review, factors affecting asymmetrical loading on lower limbs, including changes in alignment, pain, muscle weakness, loss of proprioception, and psychological factors are reviewed. The overall effects of these affecting factors on human body,