Zhu Zhengfei, Wang Ling, Li Dichen, Wang Hanghui, Jin Zhongmin, Wang Zhiyuan, Hui Shuguo, Chen Chenglin, Zhang Shu, Li Wenjiao
State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, P.R.China.
State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, P.R.China;Xi'an Jiaotong University Affiliated Honghui Hospital, Xi'an 710054,
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2018 Feb 25;35(1):38-44. doi: 10.7507/1001-5515.201702049.
Aiming at comparing the pre-operative and post-operative gait characteristics and therefore establishing post-operative rehabilitation guidance for patients with end-stage knee osteoarthritis (KOA) merged with varus deformity, this study captured the level walking and sit-to-stand trials of 9 patients with 3-dimensional motion analysis system and after which musculoskeletal multi-body dynamic analysis was conducted. The study indicated that the average range of motion (ROM) of the proposed-surgical knee was 24.4°-57.6° and that of the non-surgical knee was 22.5°-71.5°. The knee ROM of control group during level walking was 7.2°-62.4°. When the unilateral KOA patients stood up from chair to complete the sit-to-stand movement, the ground reaction forces (GRFs) symmetry was 0.72-0.85, which means that the non-surgical limb bear the majority of body weight. The GRFs of the bilateral KOA patients were smallest during the sit-to-stand movement. The strategy that the non-surgical limb dominates in loading bearing taken by the unilateral KOA patients to cover most post-operative daily activities could increase the risk of KOA among non-surgical side joints as a result of long-term excessive loading-bearing. The study, on kinematics and biomechanical characteristics of patients with KOA merged with varus deformity, could help to understand the pathogenesis of KOA merged with varus deformity from the perspective of biomechanics and to provide strong clinic guidance for the pre-operative evaluation, prevention and post-operative recovery for patients.
为比较终末期膝骨关节炎(KOA)合并膝内翻畸形患者术前和术后的步态特征,从而为其制定术后康复指导方案,本研究采用三维运动分析系统采集了9例患者的平地行走和从坐到站试验数据,并在此基础上进行了肌肉骨骼多体动力学分析。研究表明,拟手术膝关节的平均活动范围(ROM)为24.4°-57.6°,非手术膝关节的平均活动范围为22.5°-71.5°。对照组在平地行走时膝关节ROM为7.2°-62.4°。单侧KOA患者从椅子上站起来完成从坐到站动作时,地面反作用力(GRFs)对称性为0.72-0.85,这意味着非手术侧肢体承担了大部分体重。双侧KOA患者在从坐到站动作过程中的GRFs最小。单侧KOA患者在术后日常活动中以非手术侧肢体为主承重的策略,可能会因长期过度承重而增加非手术侧关节发生KOA的风险。本研究对KOA合并膝内翻畸形患者的运动学和生物力学特征进行了研究,有助于从生物力学角度理解KOA合并膝内翻畸形的发病机制,并为患者的术前评估、预防和术后康复提供有力的临床指导。