Chen Zhihuang, Wei Song, Xu Wei, Li Xiaohao, Zhang Xianxian, Liu Yinwan, Li Hui, Chen Jianchun
Department of Traditional Chinese Medicine, General Hospital of Southern Theater Command, PLA, Guangzhou, China.
Chengdu Rheumatism Hospital, Chengdu, China.
Ann Palliat Med. 2020 Sep;9(5):3340-3349. doi: 10.21037/apm-20-1705.
The purpose of this study was to use kinematic gait analysis, to evaluate the clinically curative effects of minimally invasive needle-knife scope therapy in the treatment of rheumatoid arthritis (RA) of the knee joint.
A total of 32 patients with RA of the knee joint were treated with minimally invasive needle-knife scope therapy. All patients were assessed with a kinematic gait analysis system, and then analyzed and compared the measurements with the kinematic gait performances of 28 healthy middle-aged and elderly participants.
Before receiving the therapy, the ranges of motion (ROMs) of the patients' tibial inward and outward rotation, flexion and extension, anterior and posterior displacement of the tibia, and tibial upward and downward movement were all smaller than those of the healthy middle-aged and elderly group (P<0.05). After receiving the therapy, the patients' knees had a remarkably larger ROM. After one month of this therapy, they had a noticeably greater ROM in flexion and extension, tibial inward and outward rotation, and upward and downward movement of the tibia (P<0.05). After 1 month of therapy, the patients' maximum flexion angle and tibial posterior displacement angle were noticeably greater than beforehand (P<0.01). After 1 year of therapy, the patients' flexion and extension range became remarkably greater than it was after 1 month of the therapy (P<0.01). Their ranges of DOF reflected no apparent difference to the healthy middle-aged and elderly group, which remained smaller than the latter (P<0.05). After 1 year of therapy, the maximum values of the patients' flexion angle, tibial internal rotation angle, tibial posterior displacement angle, and tibial downward movement angle were remarkably higher than before commencing treatment (P<0.05).
Minimally invasive needle-knife scope therapy enables a good recovery of function for patients with RA and remarkably improves the DOF of knees. Gait analyses are more objective, accurate, and quantitative than other indexes, and thus may become a new means to assess the changes in knee joint functions.
本研究旨在运用运动步态分析，评估微创针刀镜治疗膝关节类风湿关节炎（RA）的临床疗效。
对32例膝关节RA患者采用微创针刀镜治疗。所有患者均通过运动步态分析系统进行评估，然后将测量结果与28名健康中老年参与者的运动步态表现进行分析比较。
治疗前，患者胫骨内旋和外旋、屈伸、胫骨前后位移以及胫骨上下移动的活动范围均小于健康中老年组（P<0.05）。治疗后，患者膝关节的活动范围明显增大。治疗1个月后，患者屈伸、胫骨内旋和外旋以及胫骨上下移动的活动范围明显增大（P<0.05）。治疗1个月后，患者的最大屈曲角度和胫骨后移角度明显大于治疗前（P<0.01）。治疗1年后，患者的屈伸范围比治疗1个月后明显增大（P<0.01）。其自由度范围与健康中老年组相比无明显差异，但仍小于后者（P<0.05）。治疗1年后，患者的屈曲角度、胫骨内旋角度、胫骨后移角度和胫骨下移角度的最大值明显高于治疗前（P<0.05）。
微创针刀镜治疗可使RA患者功能良好恢复，显著改善膝关节的自由度。步态分析比其他指标更客观、准确和定量，因此可能成为评估膝关节功能变化的新手段。
