单纯前交叉韧带断裂与合并半月板损伤患者的步态分析

发布时间：2018-05-15 23:43

本文选题：前交叉韧带断裂 + 半月板损伤　；参考：《中国运动医学杂志》2017年10期

【摘要】：目的:比较单侧单纯前交叉韧带(anterior cruciate ligament,ACL)断裂和ACL断裂合并半月板损伤患者的三维步态特征,分析ACL断裂继发膝骨关节炎的可能机制,为制定ACL断裂康复方案以及膝关节炎防治提供依据。方法:3组受试者分别为单侧单纯前交叉韧带断裂组(ACL组)、合并半月板损伤的前交叉韧带断裂组(ACL+M组)、健康对照组(C组),每组各13名,同步采集步行过程中的运动学和动力学参数,计算膝关节的三维角度和关节净力矩。结果:(1)ACL+M组和C组的屈膝角度峰值均大于ACL组(均P=0.001),但ACL+M组和C组间无显著差异(P=0.847)。(2)健侧膝关节屈伸活动范围、垂直地面反作用力第1峰值、水平向后地面反作用力峰值、内源性伸膝力矩峰值显著大于患侧(P=0.006,P=0.001,P0.001,P=0.001)。(3)ACL+M组产生的膝外展力矩峰值大于ACL组和C组(P=0.045,P=0.014),ACL组和C组之间的膝外展力矩峰值无显著差异(P=0.616)。结论:ACL断裂患者健侧受到的地面反作用力大于患侧,这种受力不均衡改变了下肢受力模式,长期持续会增加ACL断裂者发生膝骨关节炎的风险。与单纯ACL断裂患者相比,合并半月板损伤的ACL断裂者产生较大的内源性膝外展力矩,可能是发生膝骨关节炎的危险因素。
[Abstract]:Objective: to compare the three dimensional gait characteristics between unilateral anterior cruciate ligamentum rupture and ACL rupture with meniscus injury, and to analyze the possible mechanism of knee osteoarthritis secondary to ACL rupture. To establish ACL fracture rehabilitation program and knee arthritis prevention and treatment to provide the basis. Methods three groups of subjects were divided into three groups: unilateral simple anterior cruciate ligament rupture (ACL) group, anterior cruciate ligament rupture with meniscus injury group (ACLM) and healthy control group (n = 13). The kinematics and dynamics parameters of the knee joint were simultaneously collected and the three dimensional angle and the joint net torque were calculated. Results the peak value of flexion angle in ACLM group and C group was higher than that in ACL group (P < 0.001, but there was no significant difference between ACL M group and C group) in flexion and extension range of knee joint, the first peak value of vertical ground reaction force and the peak value of horizontal backward ground reaction force. The peak value of endogenous knee extension torque was significantly higher than that of P0. 006, P0. 001, P0. 001, P0. 001, P0. 001, P0. 001, P0. 045, P0. 014, ACLM of ACL and group C, and there was no significant difference between P0. 616 and P0. 616 in ACLM group (P = 0. 616, P = 0. 616, P = 0. 616, P = 0. 616, P = 0. 616, P = 0. 616). Conclusion the surface reaction force on the healthy side of the patients with ACL fracture is greater than that on the affected side, which changes the stress pattern of the lower extremity and increases the risk of knee osteoarthritis in the patients with ACL rupture for a long time. Compared with the patients with simple ACL rupture, the ACL rupture with meniscus injury may be a risk factor for the occurrence of knee osteoarthritis.
【作者单位】：北京大学第三医院运动医学研究所;北京体育大学运动人体科学学院;运动医学关节伤病北京市重点实验室;
【基金】：北京市科技新星计划交叉学科合作课题(编号:xxjc201705) 2016年度北京大学医学-信息科学联合研究种子基金项目(BMU20160590)
【分类号】：R687.4

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