膝骨关节炎患者膝关节置换术后足底压力研究  

Plantar Pressure in Patients with Knee Osteoarthritis after Knee Joint Replacement Surgery

作　　者：黄萍[1] 钱念东[1] 齐进[1] 陈博[1] 刘志宏[2] 郭蕾[1] Huang Ping1, Qian Niandong1, Qi Jin1,Chen Bo1, Liu Zhihong2, Guo Lei1(1 Shanghai Institute of Traumatology and Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases with Integrated Chinese-Western Medicine, Shanghai Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China 2 Department of Orthopaedics, Shanghai Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, Chin)

机构地区：[1]上海市伤骨科研究所上海市中西医结合防治骨与关节病损重点实验室上海交通大学医学院附属瑞金医院,上海200025 [2]上海交通大学医学院附属瑞金医院骨科,上海200025

出　　处：《中国运动医学杂志》2018年第3期197-201,共5页Chinese Journal of Sports Medicine

基　　金：上海市卫生和计划生育委员会面上项目(201640190)

摘　　要：目的:了解膝骨关节炎患者膝关节置换术后足底压力分布情况。方法:运用比利时footscan足底压力测试系统对33例双膝骨关节炎单膝关节置换患者平常自然行走时的足底压力进行测试,观察受试者足底区域压力峰值、冲量、最大压力峰值出现的时间、单足支撑期参数。结果:膝关节置换侧足底第2、3、4跖骨区以及中足、足跟内外侧、全足底的平均压力峰值和平均冲量均高于未置换侧,两侧比较差异有统计学意义(P<0.001,P<0.05);膝关节置换侧足底第1、2、3、4、5跖骨区和中足的最大压力峰值出现时间均长于未置换侧,两侧比较差异有统计学意义(P<0.001,P<0.05);膝关节置换侧开始着地阶段时间、整足接触阶段时间、单足支撑期总时间均长于未置换侧,两侧比较差异有统计学意义(P<0.05)。结论:膝骨关节炎患者膝关节置换侧足底压力参数较未置换侧有明显改变,置换侧膝关节的运动能力显著增强。运用足底压力分析对膝关节置换患者进行功能量化评价,可以更准确地了解膝关节的生物力学变化,进而探索最佳治疗手段和置换后的康复方法。Objective To explore the distribution of the plantar pressure in patients with knee osteo-arthritis after knee joint replacement surgery. Methods The plantar pressure of 33 patients with double knee osteoarthritis and single knee replacement was measured using the Belgian footscan plantar pressure test system. The peak pressure,the impulse,the peak time of the peak pressure and the parameters of the foot support period were observed. Results The average peak pressure and average impulse of the 2 nd,3 rd and 4 th foot metatarsal,together with the medial and lateral heel,midfoot and full plantar of the knee replacement side were higher than the other side but without significant differences（P0.001,P〈0.05）. The duration of the maximum pressure peak of the 1 st,2 nd,3 rd,4 th and 5 th metatarsal area and midfoot of the knee replacement side was significantly longer than the other side（P0.001,P〈0.05）. The time of initial contact phase,the duration of foot flat phase and the duration of all single foot support of knee replacement side were significantly longer than the other side（P〈0.05）.Conclusions It shows that the plantar pressure parameters and the knee joint′s movement ability haveimproved significantly after the replacement. The foot pressure analysis can be used to evaluate the function of knee joint,to better understand the biomechanical changes of knee joint,so as to explore the best treatment and rehabilitation after the knee arthroplasty.

关 键 词：膝骨关节炎 膝关节置换 足底压力 步态 

分 类 号：R687.4[医药卫生—骨科学]