猪前交叉韧带重建联合髌骨脱位多间室骨关节炎模型的步态分析

Gait analysis of multi-compartment osteoarthritis porcine model induced by anterior cruciate ligament reconstruction combined with patellar dislocation

背景:骨关节炎(OA)患者逐渐增多,其给患者带来极大的生活障碍。步态分析能揭示步态异常的关键环节,帮助OA早期临床诊断,指导患者康复。目的:探讨猪前交叉韧带重建联合髌骨脱位术制备多间室OA模型并分析其步态特征。方法:18月龄健康雌性巴马小型猪6只,右后肢(RH)实施前交叉韧带重建联合髌骨脱位术制备多间室OA模型,左后肢(LH)不做处理作为对照。术前及术后7、15、30、45、60、75、90 d采集实验动物LH与RH步态数据,包括负重、触地面积、触地冲量、局部最大压力、支撑相时间、摆动相时间等,并进行比较。结果:自然状态下实验动物LH与RH所有步态指标基本相等,差异均无统计学意义。术后各时间点RH负重、触地面积、触地冲量均小于LH,且差异均有统计学意义;术后60 d,RH的负重、触地面积、触地冲量指标恢复到最高水平,但与LH比较差异仍均有统计学意义(P均<0.05)。RH足底局部最大压力在术后60 d恢复到最佳水平,与LH比较差异无统计学意义;但术后7、15、30、45、75、90 d均小于LH,且差异均有统计学意义(P均<0.05)。RH摆动相时间恢复较快,术后45、60 d与LH比较差异无统计学意义;而术后7、15、30、75、90 d均长于LH,且差异均有统计学意义(P均<0.05)。RH支撑相时间在术后7、15、30、45、90 d均短于LH,且差异均有统计学意义(P均<0.05);而术后60、75 d与LH比较差异无统计学意义。结论:前交叉韧带重建联合髌骨脱位术可以制备多间室OA模型并明确其步态特征。

Background: Osteoarthritis patients are increasing, and their daily life will encounter great obstacles. Gait analysis can reveal the key factors of abnormal gait, help early clinical diagnosis and guide rehabilitation. Objective: To explore the multi-compartment osteoarthritis model induced by anterior cruciate ligament reconstruction combined with patella dislocation, and to analyze its gait characteristics. Methods: Six healthy female Bama mini pigs at 18 months old were used to model.Their right hind limbs(RH) underwent anterior cruciate ligament reconstruction combined with patella dislocation to induce multi-compartment osteoarthritis(experiment group). Their left hind limbs(LH) were not treated(control group). Gait indicators(load body weight, contact area, impulse, local peak force, swing phase and stance phase) were collected preoperatively(day 0) and postoperatively on days 7, 15, 30, 45, 60, 75 and 90. Results: There was no statistical difference in the gait parameters between RH and LH at baseline(P>0.05). The load body weight, contact area and impulse of RH were significantly lower than those of LH at each time point after surgery. The load body weight, contact area and impulse of RH returned to the maximum at 60 d postoperatively, which were significantly different from those of LH(P<0.05). The local peak force of RH returned to the maximum at 60 d postoperatively, which was not significantly different from that of LH. But there were statistical differences between RH and LH in the local peak force at 7, 15, 30, 45, 75 and 90 d postoperatively(P<0.05). The swing phase of RH quickly returned, which was not significantly different from LH at 45 and 60 d postoperatively. The swing phase of RH was significantly longer than that of LH at 7, 15, 30, 75 and 90 d postoperatively(P<0.05). The stance phase of RH was significantly shorter than that of LH at 7, 15, 30, 45 and 90 d postoperatively(P<0.05), but no significant difference was found in the stance phase between RH and LH at 60 d and 75 d postoperatively. Conclusions: Multi-compartment osteoarthritis model can be induced by anterior cruciate ligament reconstruction combined with patellar dislocation and clarify its gait characteristics.