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    全膝关节置换术后步态改善的生物力学分析

    Biomechanical analysis of gait improvement after total knee arthroplasty

    • 摘要: 目的 探讨全膝关节置换(total knee arthroplasty,TKA)后步态的生物力学变化。方法 采集18例单侧TKA患者和18例健康对照组的步态数据,比较TKA组术侧与健侧及对照组的步态参数变化。结果 与对照组相比,TKA组术后步长、步频、步速、摆动期、膝关节最大屈曲角度及矢状面活动范围明显减小;此外,双侧下肢关节屈曲力矩峰值及地面反作用力纵向峰值和前后峰值也小于对照组。TKA组内对比发现,术侧仅膝关节最大屈曲角度及屈伸范围、踝关节矢状面活动范围和地面反作用力内侧峰值明显小于健侧。结论 TKA患者术后步态对称性较好,但未恢复到正常水平,仍需术后康复训练来进一步改善步态。

       

      Abstract: Objective To explore the biomechanical changes of gait after total knee arthroplasty (TKA). Methods The gait data were collected from 18 unilateral TKA patients and 18 healthy subjects. The changes of gait parameters were compared between the surgical and health sides in the TKA group and also between the TKA and control groups. Results Compared with the control group, the TKA group presented remarkable decreases in step length, step frequency, walking speed, swing phase, the maximum flexion and the sagittal range of motion for the knee joint. Moreover, the TKA group showed decreases in the peak flexion torques of the lower limb joint, the peak ground reaction force in vertical and anteroposterior directions, compared with the control group. For the TKA group, the surgical side presented significant decreases in the maximum flexion and flexion-extension range within the knee joint, the ankle sagittal range of motion, and the medial peak of ground reaction force compared with the health side. Conclusions TKA patients show good gait symmetry after surgery, which however does not get back to normal; and post-operative rehabilitation training is still needed.

       

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