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新型 Helix 3D 髋关节是否改善髋关节离断截肢者的步行能力?

Does the new Helix 3D hip joint improve walking of hip disarticulated amputees?

机构信息

Department of Physical Medicine and Rehabilitation, Grenoble University Hospital, Institute of Rehabilitation, avenue de Kimberley, CS 90338, BP, 38434 Echirolles cedex, France.

出版信息

Ann Phys Rehabil Med. 2013 Jul;56(5):411-8. doi: 10.1016/j.rehab.2013.05.001. Epub 2013 Jun 19.

Abstract

PURPOSE

Testing the new hip joint Helix3D efficiency through clinical data and walking parameters.

METHOD

Three young hip-disarticulated patients (P1, P2 and P3) were assessed both with their previous prosthesis at first day, then four days and six months after being trained with a new prosthesis equipped with the Helix3D hip joint. Assessments comprised a satisfaction questionnaire, a two-minute walk test and a recording of main spatiotemporal gait parameters

RESULTS

After four days with the Helix3D, the satisfaction for the prosthesis was improved for P1, unchanged for P2 and reduced for P3. Distance walked during two minutes increased for P1, unchanged for P2 and slightly improved for P3. Gait pattern was improved in P1, only. P1 abandoned the Helix3D at six months due to an ischiatic wound. P2 and P3 chose not to use the Helix at the end of the four days training period because they could not adapt to the Helix3D characteristics (hydraulic control of hip extension and assistance to hip flexion) and because they did not gain enough benefits. Despite much effort to adjust the prosthesis, the three patients definitively abandoned the Helix3D because of comfort problems, and decided to walk with their previous prosthesis equipped with a monocentric hip joint or even with crutches only.

CONCLUSION

The Helix3D hip joint may need further developments to get clinically relevant for hip-disarticulated amputees who may also need a long training period to adapt to its technical characteristics.

摘要

目的

通过临床数据和步行参数测试新型髋关节 Helix3D 的效率。

方法

对 3 名年轻的髋关节离断患者(P1、P2 和 P3)进行评估,首先使用他们之前的假体进行评估,然后在使用配备 Helix3D 髋关节的新假体训练 4 天后和 6 个月后再次进行评估。评估包括满意度问卷、2 分钟步行测试和主要时空步态参数的记录。

结果

在使用 Helix3D 4 天后,P1 对假体的满意度提高,P2 不变,P3 降低。P1 的两分钟步行距离增加,P2 不变,P3 略有改善。P1 的步态模式得到改善,P2 和 P3 在 4 天的训练期结束时选择不使用 Helix3D,因为他们无法适应 Helix3D 的特性(髋关节伸展的液压控制和髋关节屈曲的辅助),也没有获得足够的收益。尽管努力调整假体,但这 3 名患者最终因舒适度问题放弃了 Helix3D,并决定使用之前配备单轴髋关节的假体,甚至只用拐杖行走。

结论

Helix3D 髋关节可能需要进一步开发,才能为髋关节离断患者提供临床相关的效果,而这些患者可能还需要很长的适应期来适应其技术特性。

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