体质量指数对全髋关节置换后早期髋关节功能恢复影响的三维步态分析  

Effect of body mass index on the early-term hip functional recovery after total hip arthroplasty by three-dimensional gait analysis

作　　者：陈浩鹏 谢辉[2] 傅维民[2] 王本杰[2] 赵德伟[2] Chen Haopeng;Xie Hui;Fu Weimin;Wang Benjie;Zhao Dewei(Dalian Medical University,Dalian 116044,Liaoning Province,China;Department of Orthopedics,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,Liaoning Province,China)

机构地区：[1]大连医科大学,辽宁省大连市116044 [2]大连大学附属中山医院骨科,辽宁省大连市116001

出　　处：《中国组织工程研究》2020年第18期2842-2847,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家十三五“国家重点研发计划”项目(2016YFC1102000)，课题名称：生物活性脊柱及节段骨缺损修复器械的产品研发，项目负责人：赵德伟~~

摘　　要：背景:肥胖对全髋关节置换的影响已有学者进行讨论,但目前尚缺乏对不同体质量指数患者使用三维步态分析技术进行随访的研究。目的:通过三维步态分析系统定量分析体质量指数对全髋关节置换后早期髋关节功能恢复的影响。方法:选择大连大学附属中山医院关节外科2017年1月至2018年6月收治的全髋关节置换患者60例,根据入院时体质量指数分为超重组(体质量指数≥25 kg/m2)与正常组(体质量指数<25 kg/m2),每组30例。所有患者对检测方案均知情同意,且得到医院伦理委员会批准。收集患者的手术部位、年龄、性别、身高、体质量、手术时间等临床基本资料;术后6个月时使用三维步态分析技术采集时间-距离参数(步幅、步频、平均步速)、动力学参数及运动学参数对髋关节功能进行评价。结果与结论:①2组在手术部位、性别比例及年龄方面差异无显著性意义(P>0.05);但超重组手术时间明显长于正常组,差异有显著性意义(P=0.000);②时间-距离参数方面,2组在步幅、步频及平均步速上差异虽无显著性意义,但超重组步幅(1.08±0.18)m小于正常组(1.35±1.45)m;③运动学参数中,超重组在髋关节各个面的活动范围均小于正常组,差异有显著性意义(P<0.05);④动力学参数方面,屈髋力矩峰值超重组小于正常组,差异有显著性意义(P=0.011);伸髋力矩峰值2组差异无显著性意义(P=1.000);⑤提示肥胖对全髋关节置换后早期功能恢复存在一定影响。BACKGROUND:The impact of obesity on total hip arthroplasty has been discussed.However,there is a lack of follow-up study on the patients with different body mass indexes using three-dimensional gait analysis.OBJECTIVE:To investigate the effect of body mass index on the early-term functional recovery after total hip arthroplasty by three-dimensional gait analysis.METHODS:Sixty patients who underwent total hip arthroplasty at Department of Joint Surgery of Affiliated Zhongshan Hospital of Dalian University from January 2017 to June 2018 were enrolled.According to the body mass index at admission,they were divided into overweight group(body mass index≥25 kg/m2)and normal group(body mass index<25 kg/m2),n=30/group.All patients signed the informed consents and the study was approved by the ethics committee of the hospital.The clinical data such as surgical site,age,sex,height,body mass,and operating time were collected.At 6 months postoperatively,three-dimensional gait analysis was used to collect the time-distance parameters(stride length,stride frequency,mean velocity),kinetic parameters,and kinematic parameters to evaluate the hip joint function.RESULTS AND CONCLUSION:(1)There was no significant difference in the surgical site,sex proportion and age between two groups(P>0.05).The operation time in the overweight group was significantly longer than that in the normal group(P=0.000).(2)In terms of time-distance parameters,there was no significant difference in the stride length,stride frequency and mean velocity between two groups.The stride length in the overweight group was smaller than that in the normal group(1.08±0.18 vs.1.35±1.45 m).(3)The range of motion of each planes of hip joint in the overweight group was significantly less than that in the normal group(P<0.05).(4)In terms of kinetic parameters,the peak torque of hip flexion in the overweight group was significantly less than in the normal group(P=0.011).There was no significant difference in the peak torque of hip extension between two groups(P=1.000)

关 键 词：体质量指数 全髋关节置换 步态分析 髋关节功能 动力学参数 运动学参数 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]