体质量指数对全髋关节置换后早期髋关节功能恢复影响的三维步态分析

文题释义：三维步态分析系统：通过对利用摄像机得到的人体运动图像进行图像处理，来进行步态分析的技术及装置。以获取人体在各体态和运动下的生理、病理的力学和数学参数，进行人体各部位和机能检测，所检测的数据经进一步分析计算后可获得人体各部位(特别是关节)的受力状态，以及机械功、代谢能量消耗的情况。 体质量指数：是一个计算值，当需要比较及分析一个人的体质量对于不同高度的人所带来的健康影响时，体质量指数值是一个中立而可靠的指标。 背景：肥胖对全髋关节置换的影响已有学者进行讨论，但目前尚缺乏对不同体质量指数患者使用三维步态分析技术进行随访的研究。 目的：通过三维步态分析系统定量分析体质量指数对全髋关节置换后早期髋关节功能恢复的影响。 方法：选择大连大学附属中山医院关节外科2017年1月至2018年6月收治的全髋关节置换患者60例，根据入院时体质量指数分为超重组(体质量指数≥25 kg/m²)与正常组(体质量指数< 25 kg/m²)，每组30例。所有患者对检测方案均知情同意，且得到医院伦理委员会批准。收集患者的手术部位、年龄、性别、身高、体质量、手术时间等临床基本资料；术后6个月时使用三维步态分析技术采集时间-距离参数(步幅、步频、平均步速)、动力学参数及运动学参数对髋关节功能进行评价。 结果与结论：①2组在手术部位、性别比例及年龄方面差异无显著性意义(P > 0.05)；但超重组手术时间明显长于正常组，差异有显著性意义(P=0.000)；②时间-距离参数方面，2组在步幅、步频及平均步速上差异虽无显著性意义，但超重组步幅(1.08±0.18) m小于正常组(1.35±1.45) m；③运动学参数中，超重组在髋关节各个面的活动范围均小于正常组，差异有显著性意义(P < 0.05)；④动力学参数方面，屈髋力矩峰值超重组小于正常组，差异有显著性意义(P=0.011)；伸髋力矩峰值2组差异无显著性意义(P=1.000)；⑤提示肥胖对全髋关节置换后早期功能恢复存在一定影响。 ORCID: 0000-0003-1824-687X(陈浩鹏) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Effect of body mass index on the early-term hip functional recovery after total hip arthroplasty by three-dimensional gait analysis

BACKGROUND:The impact of obesity on total hip arthroplasty has been discussed.However,there is a lack of follow-up study on the patients with different body mass indexes using three-dimensional gait analysis.OBJECTIVE:To investigate the effect of body mass index on the early-term functional recovery after total hip arthroplasty by three-dimensional gait analysis.METHODS:Sixty patients who underwent total hip arthroplasty at Department of Joint Surgery of Affiliated Zhongshan Hospital of Dalian University from January 2017 to June 2018 were enrolled.According to the body mass index at admission,they were divided into overweight group(body mass index≥25 kg/m2)and normal group(body mass index<25 kg/m2),n=30/group.All patients signed the informed consents and the study was approved by the ethics committee of the hospital.The clinical data such as surgical site,age,sex,height,body mass,and operating time were collected.At 6 months postoperatively,three-dimensional gait analysis was used to collect the time-distance parameters(stride length,stride frequency,mean velocity),kinetic parameters,and kinematic parameters to evaluate the hip joint function.RESULTS AND CONCLUSION:(1)There was no significant difference in the surgical site,sex proportion and age between two groups(P>0.05).The operation time in the overweight group was significantly longer than that in the normal group(P=0.000).(2)In terms of time-distance parameters,there was no significant difference in the stride length,stride frequency and mean velocity between two groups.The stride length in the overweight group was smaller than that in the normal group(1.08±0.18 vs.1.35±1.45 m).(3)The range of motion of each planes of hip joint in the overweight group was significantly less than that in the normal group(P<0.05).(4)In terms of kinetic parameters,the peak torque of hip flexion in the overweight group was significantly less than in the normal group(P=0.011).There was no significant difference in the peak torque of hip extension between two groups(P=1.000).(5)To conclude,obesity has certain effect on the early functional recovery after total hip arthroplasty.