单侧全膝关节置换术后两下肢受力不对称性的影响因素  

Factors affecting asymmetrical lower extremity loading after unilateral total knee arthroplasty

作　　者：马青川[1] 肖丽英[1] 李志昌[2] 董雪[2] 林剑浩[2] 

机构地区：[1]清华大学机械工程系,设计工程研究所,北京100084 [2]北京大学人民医院骨关节科,北京100044

出　　处：《医用生物力学》2015年第1期89-93,共5页Journal of Medical Biomechanics

基　　金：国家自然科学基金面上项目(51275267)

摘　　要：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,compensation of asymmetrical loading on the body segments and clinical interventions are also discussed. Specific clinical interventions can be introduced to reduce the risk of osteoarthritis or replacement of contralateral knee by analyzing the above factors affecting asymmetrical loading on lower limbs after unilateral TKA.

关 键 词：单侧全膝关节置换术 膝骨关节炎 受力对称性 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]