全膝关节置换术后患者步态振荡的时间变化

T. Mine, Yuuki Fukuda, Mami Handa, Hironori Takase, K. Ihara, H. Kawamura, Michio Shinohara, Ryutaro Kuriyama, Yasunari Tominaga
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摘要

全膝关节置换术(TKA)后疼痛和膝关节功能立即得到改善。然而,TKA后步态振荡没有立即改善。该分析旨在按时间顺序评估tka后患者行走时步态振荡的变化。20例诊断为膝骨关节炎的患者行单侧全膝关节置换术。所有患者均使用双表面后稳定(PS)假体。行走时检测加速度(前、垂直、TKA侧和对侧方向)。术前分析,术后3、6、9和12个月分析。骶区前方向的加速度趋于增加,直到tka后6个月,但此后基本保持不变。在背侧椎体区域,向前方向的加速度随着时间的推移而减小。此外,随着时间的推移,骶椎和椎背区的tka侧方向的加速度也趋于降低。tka后骶背椎体比值在tka侧方向随时间的推移呈增加趋势,在对侧方向呈增加趋势,持续时间长达6个月;然而,此后没有明显的变化。在TKA后,前方向和外侧方向(TKA侧)的加速度可以按时间顺序改善,并且在TKA术后过程中,步态可能主要在骨盆带上进行。
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Chronological Changes in Gait Oscillation in Patients after Total Knee Arthroplasty
Pain and knee function improve immediately following total knee arthroplasty (TKA). However, immediate improvements in gait oscillation are not observed following TKA. This analysis aimed to chronologically assess changes in gait oscillation during walking in post-TKA patients. Twenty patients who were diagnosed with knee osteoarthritis underwent unilateral TKA. A Bi-Surface posterior-stabilized (PS) prosthesis with cementation was used for all patients. Acceleration (anterior, vertical, TKA side -, and -contralateral side directions) was examined during walking. A preoperative analysis was performed followed by postoperative analyses at 3, 6, 9, and 12 months. Acceleration in the anterior direction in the sacral region tended to increase until 6months post-TKA, but remained largely unchanged thereafter. In the dorsal vertebral region, acceleration to the anterior direction trended to decrease over time. Additionally, acceleration in the TKA-side direction in the sacral and dorsal vertebral region also tended to decrease over time. The post-TKA sacral-dorsal vertebral ratio in the TKA-side direction tended to increase over time, and the values on the contralateral side direction tended to increase for up to 6 months; however, there was no significant change thereafter. Acceleration in the anterior and lateral directions (TKA side) may improve chronologically after TKA, and gait may be performed mainly on the pelvic girdle during the postoperative course of TKA.
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