骨髓单个核细胞移植结合髓芯减压治疗早期股骨头坏死的三维步态分析

Bone marrow mononuclear cell transplantation combined with core decompression treatment for early osteonecrosis: A three-dimensional gait analysis

背景:步态分析是骨外科检查中较为客观、精确的定量评定标准。目的:观察骨髓单个核细胞移植结合髓芯减压治疗早期股骨头缺血性坏死患者步态运动学的特点及变化规律。方法:对髓芯减压骨髓单个核细胞回植21例早期股骨头坏死患者行三维运动捕捉步态分析,于治疗前及治疗后3,6,9,12个月测量受试者在0°和15°时运动平板上行走的步长、步宽时空参数,髋关节运动角度、髋关节角加速度运动学数据。同期采集33名健康人步态数据与之比较。结果与结论:21例患者治疗后3个月均出现减痛步态,治疗后3个月0°运动平板的时空参数与正常人比较差别无显著性意义,治疗后6个月15°倾斜运动平板的时空参数与正常人比较差别无显著性意义,治疗后9个月15°倾斜运动平板的运动学指标与正常人比较差别无显著性意义。显示骨髓单个核细胞治疗股骨头坏死能够恢复髋关节正常的步态模式,并表现出一种时间相关趋势。

BACKGROUND： Gait analysis provides an objective and accurate quantitative assessment for the orthopedic examination. OBJECTIVE： To observe the gait kinematic characteristics and change rule of patients with early avascular necrosis of the femoral head following treatment of bone marrow mononuclear cell （BMMCs） transplantation combined with core decompression treatment. METHODS： Three-dimensional motion capture gait analysis was performed in 21 cases of early osteonecrosis undergoing BMMCs transplantation with core decompression. Before and 3, 6, 9, 12 months after treatment, step length, step width, angle of hip motion, kinematic data of hip angle acceleration in the 22 patients walking on the treadmill of 0° and 15°. Gait data of 33 healthy subjects were collected for comparison. RESULTS AND CONCLUSION： Three months after treatment, 21 patients presented with reduced pain gait. The spatial-temporal parameters had no difference from normal people at 3 months for treadmill movement of 0° and 6 months for treadmill movement of 15°. At 9 months, kinematic indexes for 15° inclined treadmill movement were consistent with the normal. The findings indicated that BMMSCs for necrosis of the femoral head can recover normal gait mode of the hip in a time-dependent manner.