Vicon运动捕捉系统对单侧膝关节置换术后双侧膝关节生物力学的评价

Biomechanical evaluation of the knee joints with Vicon motion capture system after unilateral knee replacement

目的探讨双侧膝关节骨关节炎患者单侧膝关节置换术后膝关节生物力学情况。方法应用Vicon运动捕捉系统采集30例双侧膝关节骨关节炎单侧膝关节置换术后行走数据,比较手术侧与非手术侧膝关节生物力学差异。结果手术侧与非手术侧膝关节生物力学存在明显差异。手术侧矢状面膝关节最大屈曲度、最大伸展度及最大活动范围较未手术侧增大(P<0.05);手术侧冠状面膝关节最大内翻度较未手术侧减小(P<0.05),手术侧冠状面膝关节最大外翻度较未手术侧增大(P<0.05);手术侧膝关节角速度和角加速度较未手术侧增快(P<0.05);手术侧膝关节屈曲力矩峰值较未手术侧增大(P<0.05),手术侧膝关节伸展力矩峰值较未手术侧减小(P<0.05);手术侧膝关节前后方向和垂直方向受力较未手术侧增大(P<0.05),手术侧膝关节左右方向受力较未手术侧减小(P<0.05)。结论采用Vicon运动捕捉系统对单侧膝关节置换术患者进行双侧膝关节生物力学评价可以准确地判断手术疗效和预测非手术侧手术时机。

Objective To explore the biomechanics of knee joints after unilateral knee replacement in patients with bilateral knee osteoarthritis.Methods The Vicon motion capture system was used to test the walking data of 30 patients with bilateral knee osteoarthritis after unilateral knee arthroplasty.The biomechanical differences between the surgical and non-surgical knees were compared.Results There were significant differences in biomechanics between the surgical and non-surgical knees.The maximum flexion,maximum extension,and maximum range of motion of the operated knee joints on the sagittal plane were significantly more than those of the non-operated joints(P<0.05).The maximum varus degree of the operated knee joints was significantly less than that of the non-operated(P<0.05),whereas the maximum valgus degree was significantly more than that on the non-operative side(P<0.05).The angular velocity and angular acceleration of the knee joints on the surgical side were faster than those on the non-operative side(P<0.05).The peak knee flexion moment on the surgical side was more than that on the non-operative side(P<0.05),while the peak knee extension moment on the surgical side was reduced in comparison withthe non-operative side(P<0.05).The knee force on the surgical side in the anterior-posterior and vertical directions was increased compared to the non-operative side(P<0.05),but the knee force on the surgical side in the medial-lateral directions was reduced(P<0.05).Conclusion The Vicon motion capture analysis system can be used to perform biomechanical evaluation of bilateral knee joints in patients undergoing unilateral knee arthroplasty,in order to accurately determine the efficacy of surgery and predict the surgical timing of knee joints.