人工全膝关节置换术对患者躯体平衡性影响的研究

摘要

目的：研究人工全膝关节置换术（total knee arthroplasty，TKA）对膝关节骨关节炎（osteoarthritis，OA）患者躯体平衡性的影响，并探讨患者维持躯体平衡性的变化与术后膝关节恢复情况是否存在相关性。方法对2011年1月至2013年12月在我院关节外科接受单侧 TKA 术的膝 OA 患者21例（右侧12例，左侧9例）进行站立平衡试验，用重心测量仪连续测出躯体重心位置（gravity center position，GCP）。对 GCP 在单位时间内横轴方向偏移（medio-lateral dis-placement，ML-X range），纵轴方向的偏移（antero-posterior displacement，AP-Y range）以及重心位置 GCP 漂移轨迹（locus of GCP，LG）进行量化并分析 GCP 在 ML-X range，AP-Y range 以及 LG 变化程度跟术后患者膝关节恢复情况之间进行相关性分析。结果患者 TKA 后 GCP 在横轴水平上的单位时间内平均位置由初始位置逐渐向术侧方向转移，且其转移程度和 LG 变化程度均跟同一随访期的膝关节恢复情况呈线性相关，而 GCP 在纵轴方向的偏移跟术后恢复情况无明显相关性。结论 TKA 术后患者维持躯体平衡能力逐渐提高，且躯体平衡性的提高跟同期的患者膝关节功能恢复呈线性相关。%Objective To assess the body balance changes induced by the total knee arthroplasty procedure in knee osteo-arthritis patient's postural control( OA),and explore the relationship between changing of body balance and recover of the knee's function. Methods Twenty-one patients with single osteoarthritis knee who underwent TKA at our department from January 2011 to December 2013 were analyzed(12 consecutive patients underwent right TKA,and 9 consecutive patients un-derwent left TKA). The measurements were performed using the corresponding instrument and three consecutive double-limb standing balance trials were complated. The Medio-lateral,antero-posterior displacements and Locus length of GCP(LG)in u-nit-time were analyed. Correlation analysis between changing degree of them and degree of changing HSS score were analyzed. Results The mean GCP in the medio-lateral direction shifted to the operative side in both groups after surgery. There was a direct linear relationship between shifting degree of GCP in the medio-lateral direction and degree of changing HSS score at the same period after the surgery. There was a poor relationship between shifting degree of GCP in the antero-posterior direction and degree of changing HSS score. Conclusion The body balance of patients can be significantly improved after TKA. There is a direct linear relationship between improving degree of body balance in the medio-lateral direction and degree of changing HSS score at the same period after the surgery.