马青川,肖丽英,林剑浩,李志昌,董 雪.单侧全膝关节置换术前两下肢步态差异性分析[J].中国康复医学杂志,2015,(5):447~453 |
单侧全膝关节置换术前两下肢步态差异性分析 点此下载全文 |
马青川 肖丽英 林剑浩 李志昌 董 雪 |
清华大学机械工程系设计工程研究所,北京,100084 |
基金项目:国家自然科学基金面上项目(51275267) |
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摘要
目的:比较在单侧全膝关节置换术(TKR)前以美国膝关节协会评分(KSS)为依据确定的手术侧和非手术侧在步态上的差异性。
方法:筛选16例即将做单侧TKR手术的患者,使用KSS评分、WOMAC、SF-36评判患者健康状况,并将KSS得分较低的一侧确定为手术侧。使用三维步态分析系统采集患者以自选步速赤脚穿袜行走时的步态数据,比较患者手术侧和非手术侧在时空、运动学和动力学参数上的差异。
结果:KSS评分手术侧和非手术侧存在显著差异(P<0.001),支撑期非手术侧显著长于手术侧(P=0.002),患者手术侧和非手术侧在矢状面及冠状面上膝、踝、髋关节转角曲线及关节力矩曲线总体相似,关节转角幅值和关节力矩峰值均为未表现出显著差异(P>0.05)。
结论:单侧TKR术前患者行走时偏向于使用非手术侧,手术侧和非手术侧在关节活动能力和关节受载方面并无明显差异。 |
关键词:步态分析 单侧全膝关节置换 膝关节骨性关节炎 生物力学 |
Gait difference between lower limbs before unilateral total knee replacement Download Fulltext |
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Tsinghua University, Beijing, 100084 |
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Abstract
Objective: To compare gait difference between operated and nonoperated limb determined by knee society score(KSS) before unilateral total knee replacement(TKR).
Method: Sixteen knee osteoarthritis patients prepared for unilateral TKR were recruited from Peking University People's Hospital, China. Common clinical measurement scale KSS was used to evaluate health status of patients, and the limb with lower KSS score was determined as operated limb. Gait parameters were collected by a three dimensional gait analysis system when patients walking at a self-selected speed in stockings, and the difference of temporal-spatial, kinematic and kinetics parameters were compared between operated and nonoperated limb.
Result: Significant difference of KSS score were found between operated and nonoperated limb (P<0.001). Nonoperated limb showed significant longer stance duration than that of operated limb (P=0.002). Operated and nonoperated limb had similar curve trend of joint angle and joint moment on both sagittal and coronal planes. Joint motion angle range and peak joint torque showed no significant difference between two limbs(P>0.05).
Conclusion:Before unilateral TKR, patients tend to use nonoperated limb during walking, joint motion and joint loading showed no significant difference between operated and nonoperated limbs. |
Keywords:gait analyze unilateral total knee replacement knee osteoarthritis biomechanics |
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