骨水泥型与非骨水泥型全膝关节置换后的步态差异

背景：全膝关节置换已经被证明是一种有效治疗膝骨性关节炎的方法,但是不同类型的全膝关节置换假体固定方式术后所产生的膝关节下肢生物力学差异至今仍不明确。目的：通过三维步态分析骨水泥固定和非骨水泥固定两种不同的全膝关节置换术后患者的膝关节生物力学差异。方法：分别选取骨水泥型全膝关节置换以及非骨水泥型全膝关节置换患者各16例,通过测力台以及三维步态分析系统比较2组患者术前以及术后3个月的膝关节生物力学变化并进行对比。结果与结论：与手术前相比两组患者术后步速及步长均明显增加,支撑相在整个步态周期中的百分比明显减小,膝关节屈在支撑相及摆动相中最大屈曲角度均明显增加,膝关节外翻角度增加。两种患者术后膝关节内翻角度以及膝关节内收力矩均明显减小。提示,骨水泥型与非骨水泥型全膝关节置换术均能有效改善膝骨性关节炎患者的步行能力以及下肢关节功能,两者间未见明显生物力学差异。

Gait analysis after total knee arthroplasty with cemented versus cementless type

BACKGROUND：Total knee arthroplasty （TKA） has been proved to be a very effective method for patients with knee osteoarthritis.But the biomedical changes at knee joint between two different types of TKA （cemented and cementless） after operation remain not clear.OBJECTIVE：To explore the different biomechanical changes between the cemented and cementless TKA through three-dimensional gait analysis.METHODS：A total of 16 knee osteoarthritis patients treated with cemented TKA and 16 with cementless TKA were included.Force plates and three-dimensional gait analysis system were used to compare differences in biomechanics before and 3 months after operations.RESULTS AND CONCLUSION：Both groups showed significant increased walking speed and stride length,but decreased percentage of stance phase in gait cycle after operation,significant increased knee flexion angle in stance phase and swing phase and knee valgus degrees.In addition,both groups showed significant decreased knee varus degrees and knee adduction moments.Results indicated that both types of TKA can help to improve the joint function,walking ability and reduce the pressure of the knee in the patients with knee osteoarthritis,but there were no significant biomechanical changes between cemented TKA and cementless TKA on the operated side.