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单髁膝关节置换术后步态的逐渐恢复:一项前瞻性研究。

Gradual restoration of gait following unicompartmental knee arthroplasty: a prospective study.

作者信息

Zhang Ming, Wang Haoyue, Zhang Yu, Zhang Haochong, Zhang Quanlei, Zu Xiaoran, Chai Wei, Li Xiang

机构信息

Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, 100048, People's Republic of China.

Medical School of Chinese People'S Liberation Army, Beijing, 100853, People's Republic of China.

出版信息

J Orthop Surg Res. 2025 Mar 26;20(1):315. doi: 10.1186/s13018-025-05662-x.

Abstract

BACKGROUND

This study investigates the gait characteristics and clinical outcomes following Unicompartmental Knee Arthroplasty (UKA) to provide scientific evidence for optimizing postoperative rehabilitation and patient management.

METHODS

Between December 2022 and November 2023, 34 patients with unilateral medial compartment knee osteoarthritis (KOA) underwent UKA. Preoperative and postoperative videos of patients in standing, walking (side view), squatting, and supine knee-bending positions were captured using smartphones. Gait parameters including gait cycle, swing time, swing phase, stance time, stance phase, double support time, walking speed, step time, cadence, step length, stride length, stride width, active knee flexion angle, and maximum hip and knee flexion angles during squatting were analyzed using the MediaPipe framework for human pose estimation.

RESULTS

Postoperative WOMAC scores were significantly lower than preoperative scores (P < 0.001), while postoperative KSS scores were significantly higher than preoperative scores (P < 0.001).Compared to preoperatively, postoperative affected-side gait speed, step length, step width, and active knee flexion angle all increased (P < 0.05). Additionally, postoperative gait cycle time and double-limb support time were reduced compared to preoperative values (P < 0.05). Among the 17 patients who could perform squats preoperatively and postoperatively, the maximum knee flexion angle and hip flexion angle in the squat position increased from preoperative values of (96.41 ± 20.65)° and (113.77 ± 22.56)° to postoperative values of (110.15 ± 20.79)° and (124.84 ± 21.13)°.

CONCLUSIONS

UKA significantly enhances knee joint kinematics, facilitating the transition from basic to advanced functional activities.

摘要

背景

本研究旨在调查单髁膝关节置换术(UKA)后的步态特征和临床结果,为优化术后康复和患者管理提供科学依据。

方法

2022年12月至2023年11月期间,34例单侧内侧间室膝关节骨关节炎(KOA)患者接受了UKA手术。使用智能手机拍摄患者站立、行走(侧视图)、下蹲和仰卧屈膝位的术前和术后视频。使用MediaPipe人体姿态估计框架分析步态参数,包括步态周期、摆动时间、摆动相、支撑时间、支撑相、双支撑时间、步行速度、步幅时间、步频、步长、步幅长度、步幅宽度、主动膝关节屈曲角度以及下蹲时最大髋关节和膝关节屈曲角度。

结果

术后WOMAC评分显著低于术前评分(P < 0.001),而术后KSS评分显著高于术前评分(P < 0.001)。与术前相比,术后患侧步态速度、步长、步幅宽度和主动膝关节屈曲角度均增加(P < 0.05)。此外,术后步态周期时间和双下肢支撑时间较术前缩短(P < 0.05)。在术前和术后均能进行下蹲的17例患者中,下蹲位最大膝关节屈曲角度和髋关节屈曲角度从术前的(96.41±20.65)°和(113.77±22.56)°增加到术后的(110.15±20.79)°和(124.84±21.13)°。

结论

UKA显著改善膝关节运动学,促进从基本功能活动向高级功能活动的转变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9d3/11938596/1766e24598de/13018_2025_5662_Fig1_HTML.jpg

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