不同坡度对前交叉韧带损伤后膝关节运动学的影响

发布时间：2018-01-30 15:11

本文关键词： 前交叉韧带不同坡度前移内旋内翻三维步态分析　出处：《上海体育学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的:本研究是通过Opti-Knee膝关节三维动作步态系统分析前交叉韧带(ACL)损伤后在不同坡度步行时膝关节功能及稳定性的影响、生物力学参数的变化及相关临床意义。方法:本研究选取体育医院16名住院患者,运用Opti-Knee膝关节三维动作步态分析系统监测ACL损伤后患者于0°平地和15°上、下坡行走时患侧及健侧膝关节的运动学参数,记录双侧膝关节相对胫骨前向位移距离、内旋角度及内翻角度,分析比较健患侧在不同状态下有无差异,并进行分析15°上下坡度各指标X相对0°平路行走时步态变化的百分比。结果:(1)ACL损伤患者在不同状态下行走时患侧的前向位移距离、内旋角度及内翻角度均明显大于健侧(P0.05)。(2)ACL损伤患者在15°上下坡度行走时健患侧的前向位移距离、内旋角度及内翻角度均明显大于0°平地行走时健患侧(P0.05)。(3)ACL损伤患者在15°下坡行走时健侧的前向位移距离、内旋角度及内翻角度与15°上坡健侧无明显差异(P0.05)。(4)ACL损伤患者在15°下坡行走时患侧的前向位移距离、内旋角度及内翻角度均明显大于15°上坡患侧(P0.05)。(5)ACL损伤患者健侧在15°上坡与15°下坡度敏感度无明显差异(P0.05)。ACL损伤患者患侧在15°下坡行走时要比15°上坡时膝关节更敏感(P0.05)。结论:ACL对膝关节的作用至关重要,ACL损伤后严重影响膝关节的功能及稳定性,不同倾斜度对发生ACL损伤的关节功能影响也是不同的。(1)ACL损伤后健侧膝关节上下坡运动时明显要比平地行走时稳定性差,但健侧膝关节在上下坡运动时无明显差异。(2)ACL损伤后患侧膝关节上、下坡运动时明显要比平地行走时稳定性差。(3)ACL损伤后在15°下坡行走时患侧膝关节前向位移距离、内旋角度、内翻角度均比15°上坡时更敏感。由此亦可得出ACL损伤后上下坡运动时膝关节的稳定性明显减弱,特别是下坡时膝关节稳定性减弱更明显,同时也更容易加重ACL的进一步损伤,最终导致膝关节的退化或不可逆修复。ACL损伤后通过膝关节三维动作步态分析系统对膝关节进行功能量化评估,有助于更精准的把握ACL损伤后膝关节运动学的变化,从而为临床的诊疗提供可行性依据。
[Abstract]:Objective: the purpose of this study was to analyze the effects of Opti-Knee knee joint motion gait system on knee function and stability during walking with different slopes after anterior cruciate ligament (ACL) injury. Changes of biomechanical parameters and their clinical significance. Methods: 16 inpatients in sports hospital were selected in this study. Three dimensional gait analysis system of Opti-Knee knee joint was used to monitor the kinematic parameters of the knee joint of the affected side and the healthy side during walking downhill on 0 掳flat ground and 15 掳after ACL injury. The distance of bilateral knee joint relative to tibia forward displacement, internal rotation angle and varus angle were recorded to analyze and compare the differences between the affected sides in different states. The percentage of gait changes of 15 掳upper and lower slope X relative to 0 掳horizontal walk was analyzed. Results the forward displacement distance of the affected side of the patients with ACL injury in different states was analyzed. The internal rotation angle and the varus angle were significantly larger than the forward displacement distance of the healthy side when the patients with ACL injury were walking at the slope of 15 掳. The forward displacement distance of the healthy side with ACL injury was significantly higher than that of the normal side when walking on 0 掳flat ground at 15 掳downhill walking with internal rotation angle and varus angle. There was no significant difference between the rotation angle and the varus angle between the healthy side of the upper slope and the healthy side of the 15 掳slope. The forward displacement distance of the affected side in 15 掳downhill walking was not significantly different from that of the patients with ACL injury. There was no significant difference in the sensitivity of the healthy side between 15 掳and 15 掳in patients with ACL injury with internal rotation angle and varus angle higher than that of 15 掳upper slope (P 0.05). The patients with ACL injury were more sensitive to the knee joint walking at 15 掳downhill than the knee joint with 15 掳uphill. Conclusion the role of ACL in knee joint is very important. The function and stability of knee joint were seriously affected after ACL injury. The effect of different inclination on the joint function of ACL injury was also different. The stability of the knee joint was obviously worse when the knee joint moved up and down after the injury of the normal side than when walking on the ground. However, there was no significant difference between the healthy knee joint and the upper knee joint after ACL injury. The stability of the knee joint in downhill motion was obviously worse than that in walking on the flat ground. The anterior displacement distance and internal rotation angle of the knee joint were lower than that of the ACL walking on the lower slope at 15 掳. The varus angle is more sensitive than 15 掳uphill, and it can be concluded that the stability of knee joint is obviously weakened after ACL injury, especially when the knee joint is downhill. At the same time, it is easier to aggravate the further injury of ACL, which eventually leads to the degeneration or irreversible repair of the knee joint. After the injury, the function of the knee joint is evaluated quantitatively by the three-dimensional gait analysis system. It is helpful to grasp the changes of knee joint kinematics after ACL injury more accurately, and to provide a feasible basis for clinical diagnosis and treatment.
【学位授予单位】：上海体育学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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