前交叉韧带重建术后下肢行走过程中的异常步态表现

Systematic review and meta analysis on aberrant gait during treadmill walking after anterior cruciate ligament reconstruction

和全文后筛选出最终纳入的文献。对纳入文献分别进行数据提取、方法学质量评估,采用RevMan 5.3进行统计分析并得出结论。结果最终纳入35篇文献,共包含925例ACLR患者和241例健康对照者。和对侧和对照组相比,ACLR术侧下肢在支撑相膝关节最大屈曲角度(pKFA)[平均差(MD)=-1.19,95%置信区间(CI)(-1.96,-0.42),P=0.002]、膝关节屈曲力矩[MD=-0.06,95%CI(-0.12,0),P=0.04]、膝关节伸展力矩[MD=-0.01,95%CI(-0.01,0),P=0.04]、垂直地面反作用力峰值[MD=-0.03,95%CI(-0.04,-0.01),P=0.0003]等指标差异存在统计学意义。结论ACLR后术侧肢体在行走过程中长期存在异常步态表现,包括支撑相膝关节最大屈曲角度、膝关节屈曲力矩、膝关节伸展力矩和垂直地面反作用力减小,值得引起关注。

s and full texts by two researchers.After data extraction and methodological quality evaluation,a statistic analysis was performed with RevMan 5.3.Results A total of 35 articles including 925 ACLR patients and 241 healthy control participants met the inclusion criteria finally.Compared with contralateral limbs or healthy control limbs,operated limbs showed smaller peak knee flexion angle[mean deviation(MD)=-1.19,95%confidence interval(CI)(-1.96,-0.42),P=0.002],knee flexion moment[MD=-0.06,95%CI(-0.12,0),P=0.04],knee extension moment[MD=-0.01,95%CI(-0.01,0),P=0.04]and peak vertical ground react force[MD=-0.03,95%CI(-0.04,-0.01),P=0.0003].Conclusion Aberrant gait of operated limb during treadmill walking could exist in long term after anterior cruciate ligament reconstruction,including smaller peak knee flexion angle,knee flexion moment,knee extension moment as well as peak vertical ground react force.