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尽管 Western Ontario 和 McMaster 大学骨关节炎指数评分的疗效指数被认为在双侧全膝关节置换术后 1 年已治愈,但步态功能仍存在缺陷。

Deficient gait function despite effect index of the Western Ontario and McMaster university osteoarthritis index score considered cured one year after bilateral total knee arthroplasty.

机构信息

Department of Orthopaedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China.

Shanxi Institute of Sports Science, Taiyuan, 030001, Shanxi, China.

出版信息

BMC Musculoskelet Disord. 2024 Mar 23;25(1):230. doi: 10.1186/s12891-024-07348-7.

Abstract

BACKGROUND

To clarify the value of gait analysis and its consistency with traditional scoring scales for the evaluation of knee joint function after total knee arthroplasty (TKA).

METHODS

This study included 25 patients with knee osteoarthritis (KOA) who underwent bilateral TKA, and 25 conditionally matched healthy individuals, categorised into the experimental and control groups, respectively. Patients in the experimental group underwent gait analysis and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) evaluation before and 1 year after TKA. Weight-bearing balance and walking stability were assessed using discrete trends of relevant gait indicators. Pearson's correlation analysis was performed on the gait and WOMAC score data of the experimental group before and after TKA.

RESULTS

One year after TKA, patients' gait indices (except gait cycle) were significantly better than before surgery, but significantly worse than that of the control group (P < 0.01). The shape of patients' plantar pressure curves did not return to normal. Additionally, the discrete trend of related gait indicators reflecting weight-bearing balance and walking stability were smaller than before TKA, but still greater than that of the control group. The WOMAC scores of patients 1 year after TKA were significantly lower than those before TKA (P < 0.001), and the efficacy index was > 80%. The WOMAC scores and gait analysis results were significantly correlated before TKA (P < 0.05).

CONCLUSIONS

Gait analysis should be used in conjunction with scoring scales to assess joint functions.

摘要

背景

阐明步态分析及其与传统评分量表在全膝关节置换术后膝关节功能评估中的一致性的价值。

方法

本研究纳入了 25 例膝关节骨关节炎(KOA)患者,这些患者均接受了双侧全膝关节置换术,将其分为实验组和对照组,每组各 25 例。实验组患者在 TKA 前后进行步态分析和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评估。采用相关步态指标的离散趋势来评估负重平衡和行走稳定性。对实验组 TKA 前后的步态和 WOMAC 评分数据进行 Pearson 相关性分析。

结果

TKA 后 1 年,患者的步态指标(除步态周期外)明显优于手术前,但明显差于对照组(P<0.01)。患者足底压力曲线的形态并未恢复正常。此外,反映负重平衡和行走稳定性的相关步态指标的离散趋势虽小于 TKA 前,但仍大于对照组。TKA 后 1 年患者的 WOMAC 评分明显低于 TKA 前(P<0.001),且疗效指数>80%。TKA 前 WOMAC 评分和步态分析结果显著相关(P<0.05)。

结论

应结合评分量表使用步态分析来评估关节功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a9d/10960387/8657a5118d4f/12891_2024_7348_Fig1_HTML.jpg

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