摘要
目的探讨使用基于股骨外侧髁软骨顶点(apex of deep cartilage,ADC)设计的个性化股骨定位器辅助前交叉韧带(anterior cruciate ligament,ACL)重建术后患侧膝关节运动学变化情况。方法2021年1月—2022年1月共纳入40例符合选择标准的初次ACL断裂患者,随机分为研究组(使用基于ADC设计的个性化股骨定位器辅助ACL重建)和对照组(不使用上述个性化股骨定位器辅助ACL重建),每组20例;另外收集20名膝关节正常志愿者作为健康组。3组患者/志愿者性别、年龄、身体质量指数比较差异无统计学意义(P>0.05)。术后3、6、12个月,使用Opti_Knee膝关节三维运动测量分析系统对所有患者行步态分析,记录膝关节6个自由度(屈伸角、内外翻角、内外旋角、前后位移、上下位移及内外位移)和运动周期(最大步长、最小步长及步频),将患者数据与健康组数据进行比较。结果健康组志愿者屈伸角为(57.80±3.45)°、内外翻角为(10.54±1.05)°、内外旋角为(13.02±1.66)°、前后位移为(1.44±0.39)cm、上下位移为(0.86±0.20)cm、内外位移为(1.38±0.39)cm,最大步长为(51.24±1.29)cm、最小步长为(45.69±2.28)cm、步频为(12.45±0.47)步/min。与健康组比较,研究组和对照组患者术后3个月屈伸角和内外旋角减小,术后6个月对照组屈伸角减小,差异均有统计学意义(P<0.05);其余各时间点各指标与健康组比较差异均无统计学意义(P>0.05)。研究组组内比较,除术后6、12个月屈伸角和内外旋角大于术后3个月,差异有统计学意义(P<0.05)外,其余各时间点间各指标比较差异均无统计学意义(P>0.05)。研究组与对照组间除术后6个月屈伸角比较差异有统计学意义(P<0.05)外,其余各时间点两组间各指标比较差异均无统计学意义(P>0.05)。结论与常规手术相比,使用基于ADC设计的个性化股骨定位器辅助ACL重建术可帮助患者获得更满意的术后早期运动学疗效,三维运动学
Objective To investigate the changes of knee joint kinematics after anterior cruciate ligament(ACL)reconstruction assisted by personalized femoral positioner based on the apex of deep cartilage(ADC).Methods Between January 2021 and January 2022,a total of 40 patients with initial ACL rupture who met the selection criteria were randomly divided into the study group(using the personalized femoral positioner based on ADC design to assist ACL reconstruction)and the control group(not using the personalized femoral positioner to assist ACL reconstruction),with 20 patients in each group.Another 20 volunteers with normal knee were collected as a healthy group.There was no significant difference in gender,age,body mass index,and affected side between groups(P<0.05).Gait analysis was performed at 3,6,and 12 months after operation using Opti_Knee three-dimensional knee joint motion measurement and analysis system,and the 6 degrees of freedom(flexion and extension angle,varus and valgus angle,internal and external rotation angle,anteroposterior displacement,superior and inferior displacement,internal and external displacement)and motion cycle(maximum step length,minimum step length,and step frequency)of the knee joint were recorded.The patients'data was compared to the data of healthy group.Results In the healthy group,the flexion and extension angle was(57.80±3.45)°,the varus and valgus angle was(10.54±1.05)°,the internal and external rotation angle was(13.02±1.66)°,and the anteroposterior displacement was(1.44±0.39)cm,the superior and inferior displacement was(0.86±0.20)cm,and the internal and external displacement was(1.38±0.39)cm.The maximum step length was(51.24±1.29)cm,the minimum step length was(45.69±2.28)cm,and the step frequency was(12.45±0.47)step/minute.Compared with the healthy group,the flexion and extension angles and internal and external rotation angles of the patients in the study group and the control group decreased at 3 months after operation,and the flexion and extension angles of the patien
作者
何任杰
宁梓文
施政良
谷梓铭
李彦林
王国梁
何川
HE Renjie;NING Ziwen;SHI Zhengliang;GU Ziming;LI Yanlin;WANG Guoliang;HE Chuan(Department of Sports Medicine,the First Affiliated Hospital of Kunming Medical University,Kunming Yunnan,650032,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2023年第6期663-669,共7页
Chinese Journal of Reparative and Reconstructive Surgery
基金
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(202001AY070001-042)
云南省骨关节疾病临床医学中心项目(ZX2019-03-04)
昆明医科大学第一附属医院“535”高层次人才引培工程。
关键词
膝关节
前交叉韧带
股骨定位器
股骨隧道
步态分析
Knee joint
anterior cruciate ligament
femoral positioner
femoral tunnel
gait analysis
