全膝关节置换术对患者躯体平衡性的影响

Effect of total knee arthroplasty on body balance of patients with knee osteoarthritis

背景:目前已有研究多以关节活动功能和膝关节假体长期存活率作为判断全膝关节置换术(TKA)是否成功的主要标准,而尚无有关TKA对患者维持躯体平衡性能力影响的研究报道。目的:研究TKA对膝骨关节炎(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功能恢复情况是否存在相关性。方法:对2011年1月至2013年12月行单侧TKA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量躯体重心位置(GCP)。对GCP在单位时间内的横轴方向偏移(ML-X range)、纵轴方向偏移(AP-Y range)以及GCP漂移轨迹(LG)进行量化分析,探讨GCP的ML-X range、AP-Y range以及LG变化程度与患者膝关节恢复情况之间的相关性。结果:患者行单侧TKA后的GCP在横轴方向上的位置由初始位置逐渐向术侧方向转移,且其转移程度和LG变化程度均与膝关节功能恢复情况随术后时间呈线性相关,而GCP在纵轴方向上的转移与膝关节功能恢复情况无明显相关性。结论:患者行单侧TKA后,维持躯体平衡能力逐渐提高,且与膝关节功能恢复情况随术后时间呈线性相关。

Background： The present reports are mostly focused on the function and survival of knee joint after TKA. There are few ones on the effect of TKA on body balance of patients who suffered from knee osteoarthritis. Objective： The aim of this study is to assess the changes induced by TKA in knee osteoarthritis （OA） patient＇s postural con- trol and the relationship between body balance and function recovery of knee joint. Methods： Twenty-one patients with unilateral knee osteoarthritis （12 right knees and 9 left knees）, who underwent TKA from January 2011 to December 2013, were enrolled in the study. The subjects completed three consecutive double-limb standing balance trials. The medio-lateral displacement, antero-posterior displacement and locus length of gravity center po- sition （GCP） in unit time were derived from the instrument. The correlation between parameter changes and HSS score were analyzed. Results： The GCP in medio-lateral direction shifted to the operative side after surgery. There was a direct linear relationship between GCP in the medio-lateral direction and HSS score at the same period. But GCP in antero-posterior direction was not related to HSS score. Conclusions： The body balance of patients will be significantly improved after TKA. There is a direct linear relationship be- tween body balance in the medio-lateral direction and HSS score after TKA.