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比较膝骨关节炎单侧全膝关节置换术前和术后的步态分析。

Comparison of gait analysis before and after unilateral total knee arthroplasty for knee osteoarthritis.

机构信息

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8550, Japan.

Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi, 474-8511, Japan.

出版信息

J Orthop Surg Res. 2024 Aug 27;19(1):506. doi: 10.1186/s13018-024-04891-w.

Abstract

BACKGROUND

Gait ability can be objectively assessed using gait analysis. Three-dimensional gait analysis, the most commonly used analytical method, has limitations, such as a prolonged examination, high system costs, and inconsistently reported gait symmetry in patients with knee osteoarthritis (OA). Therefore, we aimed to evaluate the gait symmetry and changes before and after unilateral total knee arthroplasty (TKA) using the Walkway analyzer, a sheet-type gait analyzer.

METHODS

The healthy group included 38 participants from the Locomotor Frailty and Sarcopenia Registry study with lower limb pain or Kellgren-Lawrence classification grade 3 or 4 OA. The OA group included 34 participants from the registry study who underwent unilateral TKA. The walking speed, step length, step width, cadence, stride time, stance time, swing phase time, double-limb support phase time, stride, step length, and step width were analyzed per side using the Walkway gait analyzer.

RESULTS

No significant differences between the right and left sides were observed in the healthy group. In the OA group, the time indices and stance phase (p = 0.011) and the double-limb support phase time (p = 0.039) were longer on the contralateral side and the swing phase was longer on the affected side (p = 0.004) pre-operatively. However, these differences disappeared post-operatively. There were no significant differences in the spatial indices. Thus, this study revealed that patients undergoing unilateral TKA had an asymmetric gait pre-operatively, with a time index compensating for the painful side, and an improved symmetric gait post-operatively.

CONCLUSIONS

The Walkway analyzer employs a simple test that requires only walking; hence, it is expected to be used for objective evaluation in actual clinical practice.

摘要

背景

步态能力可以通过步态分析进行客观评估。三维步态分析是最常用的分析方法,但存在检查时间长、系统成本高以及膝关节骨关节炎(OA)患者步态对称性不一致等局限性。因此,我们旨在使用 Walkway 步态分析器(一种片状步态分析器)评估单侧全膝关节置换术(TKA)前后的步态对称性和变化。

方法

健康组包括来自 Locomotor Frailty and Sarcopenia Registry 研究的 38 名下肢疼痛或 Kellgren-Lawrence 分级 3 或 4 OA 的参与者。OA 组包括来自该登记研究的 34 名接受单侧 TKA 的参与者。使用 Walkway 步态分析器对每侧的步行速度、步长、步宽、步频、步时、支撑时、摆动时、双支撑时、步长、步长和步宽进行分析。

结果

健康组左右侧无显著差异。OA 组术前对侧时间指标和支撑相(p=0.011)和双支撑时(p=0.039)较长,患侧摆动时较长(p=0.004)。然而,这些差异在术后消失。空间指标无显著差异。因此,本研究表明单侧 TKA 患者术前步态不对称,时间指标补偿疼痛侧,术后步态对称性改善。

结论

Walkway 分析仪采用简单的测试,只需行走即可,因此有望在实际临床实践中用于客观评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8024/11348746/c57a96c8ecc8/13018_2024_4891_Fig1_HTML.jpg

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