急性膝关节后外侧旋转脱位修复治疗后的步态分析及其指导意义  

Postoperative gait analysis of acute posterolateral rotatory dislocation of knee joint and its guiding significance

作　　者：黄华强[1] 云翥 蒋海[1] 付维力[1] 李箭[1] 唐新[1] 

机构地区：[1]四川大学华西医院骨科,四川省成都市610041

出　　处：《中国组织工程研究》2017年第31期5007-5013,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:近年来对膝关节后外侧旋转脱位的评估常依赖传统影像技术获取静态解剖信息,同时以Lysholm评分和国际膝关节文献委员会评分进行功能评估,但这些均无法对患者的运动学特征进行定量评价,亦无法为术后提供具体的康复指导。目的:通过对急性膝关节后外侧旋转脱位术后患者进行步态分析,动态评估术后的运动学指标和位移指标,帮助指导康复。方法:纳入2011年1月至2014年12月四川大学华西医院收治的急性膝关节后外侧旋转脱位患者12例,行关节镜下一期韧带重建或修复,术后常规康复训练,同时采用Opti-Knee~?分析系统采集患侧膝关节(损伤组)及健侧膝关节(正常组)的6个自由度数据(包括运动角度和位移),计算其变化范围,并将2组结果进行比较。结果与结论:(1)运动角度方面:2组膝关节最大内/外翻转角,内/外旋转角差异无显著性意义(P>0.05),而损伤组膝关节最小屈曲角,最大屈曲角及屈曲/伸展、内/外翻角、内/外旋转角度变化范围均大于正常组(P<0.05);(2)位移方面:2组股骨相对于胫骨前移、内移、外移最大值及内/外位移变化范围差异无显著性意义(P>0.05),损伤组股骨相对于胫骨后移、下移最大值及胫骨前/后移变化范围大于正常组,而上移最大值和上/下位移变化范围则小于正常组(P<0.05);(3)结果提示,关节镜辅助一期治疗急性膝关节后外侧旋转脱位可在一定程度上恢复膝关节步态,Opti-Knee~?分析系统可客观提供运动参数信息,其自由度数据的改变有助于指导康复。BACKGROUND： The evaluation for posterolateral rotatory dislocation of knee joint often relys on traditional imagingtechniques to obtain static anatomical information; meanwhile, the knee function was assessed by Lysholm and theInternational Knee Documentation Committee scores. However, none can quantitatively evaluate the kinematiccharacteristics, let alone providing guidance for postoperative rehabilitation.OBJECTIVE： To analyze the gait characters of the patients with acute posterolateral rotatory dislocation of knee jointand to dynamically evaluate the postoperative kinematic parameters and displacement indicators, thereby providingguidance for rehabilitation.METHODS： Twelve patients with acute knee posterolateral rotatory dislocation were admitted in the West China Hospital,Sichuan University between January 2011 and December 2014, and all patients underwent one-stage reconstruction orrepair of ligaments under arthroscopy, followed by routine rehabilitation training. Opti-Knee？ analysis system was usedto collect 6 degrees of freedom （movement angle and displacement） of the ipsilateral （injury group） and contralateralknee joints （normal group）, the change levels were calculated, and were then compared between two groups.RESULTS AND CONCLUSION： （1） There was no significant difference in the maximum varus/valgus angles andmaximum intersion/extorsion angles （P 〉 0.05）. While, the minimum flexion angle, maximum flexion angle, as well as thechange level of flexion/extension angles, varus/valgus angles and maximum intersion/extorsion angles in the injurygroup were significantly higher than those in the normal group （P 〈 0.05）. （2） There was no significant difference in themaximum forward, inward and outward displacement as well as the change levels of inward/outward displacementbetween two groups （P 〉 0.05）. The maximum backward, and downward displacement as well as the change levels offorward/backward displacement in the injury group were significantly higher than tho

关 键 词：骨科植入物 关节植入物 急性膝关节后外侧旋转脱位 步态分析 关节镜 康复 

分 类 号：R318[医药卫生—生物医学工程]