膝骨关节炎患者膝关节面夹角与步态的相关性研究

A correlation analysis of the relationship between knee joint angle and gait in patients with knee osteoarthritis

目的:探讨膝骨关节炎(knee osteoarthritis,KOA)患者膝关节面夹角与其步态的关系。方法:2015年1-12月收集72例KOA患者。男30例,女42例;年龄45~80岁,中位数56.5岁;左膝32例,右膝40例;病程2~28个月,中位数14个月。拍摄其患侧膝关节正位X线片,在X线片上测定膝关节面夹角(股骨内、外侧髁最低点连线与胫骨平台内外侧关节面最低点连线的夹角);以步态测试系统测定患者的步速、步长、步角、支撑期时间、支撑期百分数等步态指标。对膝关节面夹角与各步态指标进行相关性分析。结果:膝关节面夹角为3.61°±1.57°,步速为(60.86±14.16)cm·s-1,步长为(50.28±7.66)cm,步角为15.99°±4.17°,支撑期时间为(0.84±0.10)s,支撑期百分数为(63.57±1.80)%。相关性分析结果显示,膝关节面夹角与步速、步长呈负相关(r=-0.704,P=0.000;r=-0.720,P=0.000),与步角、支撑期时间、支撑期百分数呈正相关(r=0.745,P=0.000;r=0.734,P=0.000;r=0.542,P=0.000)。结论:KOA患者膝关节面夹角与其步态密切相关,对其病情判断具有一定的指导意义。

Objective：To explore the relationship between knee joint angle and gait in patients with knee osteoarthritis（KOA）.Methods：Seventy-two patients with KOA were collected from January 2015 to December 2015.The patients consisted of 30 males and 42 females and ranged in age from 45 to 80 years（Median=56.5 yrs） and ranged in disease course from 2 to 28 months（Median=14months）.The KOA located in left knee for 32 patients and right knee for 40 patients.The anteroposterior X-ray films of affected knee were taken,and the knee joint angle（the included angle between the line from the lowest point of medial femoral condyle to the lowest point of lateral femoral condyle and the line from the lowest point of medial articular surface to the lowest point of lateral articular surface of tibial plateau） were measured on the X-ray films.The patient＇s gait indexes such as gait speed,step length,step angle,support phase time and percentage of support phase were measured by using Gait Test System.The correlation analysis were applied to study the relationship between knee joint angle and gait indexes.Results：The knee joint angle,gait speed,step length,step angle,support phase time and percentage of support phase were 3.61＋/-1.57 degrees,60.86＋/-14.16 cm/s,50.28＋/-7.66 cm,15.99＋/-4.17 degrees,0.84＋/-0.10 seconds and 63.57＋/-1.80% respectively.The results of correlation analysis showed that knee joint angle was negatively correlated with gait speed and step length（r=-0.704,P=0.000;r=-0.720,P=0.000） and were positively correlated with step angle,support phase time and percentage of support phase（r=0.745,P=0.000;r=0.734,P=0.000;r=0.542,P=0.000）.Conclusion：Knee joint angle is closely related to gait in patients with KOA,so it has some guiding significance for judging the condition of patients with KOA.