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活动平台单髁膝关节置换术后膝外侧骨关节炎患者的步态变化

Change of gait in patients with lateral osteoarthritis of the knee after mobile-bearing unicompartmental knee arthroplasty.

作者信息

Seeger J B, Schikschneit J P, Schuld C, Rupp R, Jäger S, Schmitt H, Maier G S, Clarius M

机构信息

Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Klinikstraße 33, 35392, Giessen, Germany,

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Jul;23(7):2049-54. doi: 10.1007/s00167-014-2944-2. Epub 2014 Mar 27.

Abstract

PURPOSE

Patients with lateral osteoarthritis of the knee suffer not only from pain but also impaired gait and limited mobility. Common treatment options are total knee replacement and lateral unicompartmental knee arthroplasty (UKA). The domed lateral mobile-bearing Oxford Uni is a new treatment option for patients with isolated osteoarthritis of the lateral compartment of the knee joint. We used instrumented gait analysis and clinical scores to study patients before and after lateral UKA.

METHODS

Nineteen patients suffering from lateral osteoarthritis underwent implantation of a mobile-bearing lateral UKA. They were examined in a gait analysis before the operation and after an average follow-up time of 7 months. Gait analysis was performed on a treadmill with six infrared cameras to identify gait characteristics (e.g. velocity, stride time, stride length, knee abduction or hip adduction).

RESULTS

Mean velocity changed from 0.58 to 0.73 m/s. Significant advancements were also found in knee abduction and hip adduction. Time and length of strides improved significantly as well as the clinical scores American Knee Society Score, Oxford-12, FFb-H-OA and Devane Score.

CONCLUSION

Patients with lateral osteoarthritis of the knee showed an impaired gait with an increased knee abduction and hip adduction angle. Implantation of a lateral mobile UKA can restore normal axis of the leg and improve gait and function of the knee. Instrumented gait analysis is a suitable measuring instrument to quantify and qualify the post-operative change of gait.

LEVEL OF EVIDENCE

II.

摘要

目的

膝关节外侧骨关节炎患者不仅遭受疼痛,而且步态受损、活动受限。常见的治疗选择是全膝关节置换术和外侧单髁膝关节置换术(UKA)。圆顶形外侧活动平台牛津单髁膝关节置换术是膝关节外侧间室孤立性骨关节炎患者的一种新的治疗选择。我们使用仪器化步态分析和临床评分来研究外侧UKA手术前后的患者。

方法

19例患有外侧骨关节炎的患者接受了活动平台外侧UKA植入术。在手术前和平均随访7个月后对他们进行步态分析。在带有六个红外摄像机的跑步机上进行步态分析,以确定步态特征(如速度、步幅时间、步幅长度、膝关节外展或髋关节内收)。

结果

平均速度从0.58米/秒变为0.73米/秒。在膝关节外展和髋关节内收方面也发现了显著改善。步幅时间和长度以及美国膝关节协会评分、牛津12项评分、FFb-H-OA和德瓦恩评分等临床评分均有显著改善。

结论

膝关节外侧骨关节炎患者表现出步态受损,膝关节外展和髋关节内收角度增加。植入外侧活动UKA可以恢复腿部的正常轴线,改善膝关节的步态和功能。仪器化步态分析是一种适用于量化和定性术后步态变化的测量工具。

证据水平

II级。

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