【摘要】：背景:近年來對(duì)膝關(guān)節(jié)后外側(cè)旋轉(zhuǎn)脫位的評(píng)估常依賴傳統(tǒng)影像技術(shù)獲取靜態(tài)解剖信息,同時(shí)以Lysholm評(píng)分和國際膝關(guān)節(jié)文獻(xiàn)委員會(huì)評(píng)分進(jìn)行功能評(píng)估,但這些均無法對(duì)患者的運(yùn)動(dòng)學(xué)特征進(jìn)行定量評(píng)價(jià),亦無法為術(shù)后提供具體的康復(fù)指導(dǎo)。目的:通過對(duì)急性膝關(guān)節(jié)后外側(cè)旋轉(zhuǎn)脫位術(shù)后患者進(jìn)行步態(tài)分析,動(dòng)態(tài)評(píng)估術(shù)后的運(yùn)動(dòng)學(xué)指標(biāo)和位移指標(biāo),幫助指導(dǎo)康復(fù)。方法:納入2011年1月至2014年12月四川大學(xué)華西醫(yī)院收治的急性膝關(guān)節(jié)后外側(cè)旋轉(zhuǎn)脫位患者12例,行關(guān)節(jié)鏡下一期韌帶重建或修復(fù),術(shù)后常規(guī)康復(fù)訓(xùn)練,同時(shí)采用Opti-Knee~?分析系統(tǒng)采集患側(cè)膝關(guān)節(jié)(損傷組)及健側(cè)膝關(guān)節(jié)(正常組)的6個(gè)自由度數(shù)據(jù)(包括運(yùn)動(dòng)角度和位移),計(jì)算其變化范圍,并將2組結(jié)果進(jìn)行比較。結(jié)果與結(jié)論:(1)運(yùn)動(dòng)角度方面:2組膝關(guān)節(jié)最大內(nèi)/外翻轉(zhuǎn)角,內(nèi)/外旋轉(zhuǎn)角差異無顯著性意義(P0.05),而損傷組膝關(guān)節(jié)最小屈曲角,最大屈曲角及屈曲/伸展、內(nèi)/外翻角、內(nèi)/外旋轉(zhuǎn)角度變化范圍均大于正常組(P0.05);(2)位移方面:2組股骨相對(duì)于脛骨前移、內(nèi)移、外移最大值及內(nèi)/外位移變化范圍差異無顯著性意義(P0.05),損傷組股骨相對(duì)于脛骨后移、下移最大值及脛骨前/后移變化范圍大于正常組,而上移最大值和上/下位移變化范圍則小于正常組(P0.05);(3)結(jié)果提示,關(guān)節(jié)鏡輔助一期治療急性膝關(guān)節(jié)后外側(cè)旋轉(zhuǎn)脫位可在一定程度上恢復(fù)膝關(guān)節(jié)步態(tài),Opti-Knee~?分析系統(tǒng)可客觀提供運(yùn)動(dòng)參數(shù)信息,其自由度數(shù)據(jù)的改變有助于指導(dǎo)康復(fù)。
[Abstract]:Background: in recent years, the evaluation of posterolateral rotated dislocation of the knee often relies on traditional imaging techniques to obtain static anatomical information. At the same time, the Lysholm score and the International knee Joint documentation Committee score are used to evaluate the function of the knee joint. However, all of these can not quantitatively evaluate the kinematic characteristics of the patients, nor can they provide specific rehabilitation guidance for postoperative patients. Aim: to evaluate the postoperative kinematic and displacement indexes of patients with acute posterolateral rotational dislocation of knee joint by gait analysis, and to help guide the rehabilitation of patients with post-operative posterolateral rotational dislocation of knee joint. Methods: from January 2011 to December 2014, 12 patients with acute posterolateral rotatory dislocation of knee joint were treated with arthroscopic reconstruction or repair of ligaments. Routine rehabilitation training was performed and Opti-Knee~? was used at the same time. The data of 6 degrees of freedom (including motion angle and displacement) of the affected knee joint (injury group) and the healthy side knee joint (normal group) were collected, the range of variation was calculated, and the results of the two groups were compared. Results & conclusion: (1) the angle of motion: there was no significant difference between the two groups in the maximum angle of varus / varus and the angle of internal / external rotation (P0.05), but the minimum angle of flexion, the maximum angle of flexion and the flexion / extension of the knee joint in the injured group were not significantly different (P0.05). The change range of internal / external angle and internal / external rotation angle was larger than that of normal group (P0.05). (2) displacement: there was no significant difference in the maximum value of femur relative to tibia, internal and external displacement between the two groups (P0.05), and there was no significant difference between the injured group and the injured group in the change range of femur relative to tibia (P0.05), and there was no significant difference between the two groups (P0.05). The maximum value of downward movement and the range of anterior / backward tibial displacement were larger than those of normal group, while the maximum value of upward shift and the range of upper / lower displacement were smaller than those of normal group (P0.05). (3) the results suggest that arthroscope-assisted one-stage treatment of acute posterolateral rotatory dislocation of the knee can restore the gait of the knee to a certain extent, Opti-Knee~? The analysis system can provide the motion parameter information objectively, and the change of the degree of freedom data is helpful to guide the rehabilitation.
【作者單位】： 四川大學(xué)華西醫(yī)院骨科;
【分類號(hào)】：R687.4
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本文編號(hào)：2452575