膝前交叉韧带重建术后患者的步态周期特征研究

Gait cycle characteristics of patients after anterior cruciate ligament reconstruction

目的:研究膝前交叉韧带(ACL)重建术后患者的步态周期特征。方法:选取36例单侧膝前交叉韧带断裂的患者,均行自体腘绳肌肌腱重建术治疗,并选取12名健康者为对照组;采用Tekscan裸足步态分析系统分析步态数据,比较患者患侧与健侧差异及组间差异。结果:术前观察组患侧步行周期、蹬离期时间长于健侧和对照组,步长、步速、晃动面积、晃动距离、位移速度及身体重心前后、左右移动距离低于健侧和对照组,步宽、步角高于健侧和对照组,跟骨着地、脚掌着地及支撑中期时间短于健侧和对照组(P<0.05);术后3、6个月,观察组患侧步行周期、蹬离期时间短于术前,但长于健侧和对照组(P<0.05),步长、步速、晃动面积、晃动距离、位移速度及身体重心前后、左右移动距离高于术前,但低于健侧和对照组(P<0.05),步宽、步角低于术前,但高于健侧和对照组(P<0.05),跟骨着地、脚掌着地及支撑中期时间长于术前,但短于健侧和对照组(P<0.05)。结论:ACL重建术可改善膝前交叉韧带断裂后步态,并运用步态分析数据进行功能量化评价,可了解ACL断裂及重建术后步态参数变化,为评定术后疗效和制定治疗方案提供依据。

Objective:To study the gait cycle characteristics of patients after anterior cruciate ligament(ACL) reconstruction.Methods:36 patients with unilateral ACL rupture who underwent autologous harmstring tendon reconstruction were selected as the observation group.12 healthy individuals were selected as the control group.Tekscan gait analysis system was used to analyze the gait data and the differences between the affected side and unaffected side of patients and between groups were compared.Results:Before operation, the gait cycle and departure stage on affected side of the observation group were longer than those on the unaffected side and the control group.The step length, walking speed, swaying area, swaying distance, displacement velocity, back-and-forth and left-to-right distances of the center of body weight were smaller than those on the unaffected side and the control group.The step width and step angle were larger than those on the unaffected side and the control group.The time of initial contact phase, forefoot contact phase and foot flat phase were shorter than those on the unaffected side and the control group(P<0.05).The gait cycle and departure stage on affected side of the observation group were shortened at 3 and 6 months after operation, but longer than those on the unaffected side and the control group(P<0.05).The step length, walking speed, swaying area, swaying distance, displacement velocity, back-and-forth and left-to-right distances of the center of body weight were increased, but smaller than those on the unaffected side and the control group(P<0.05).The step width and step angle were decreased, but larger than those on the unaffected side and the control group(P<0.05).The time of initial contact phase, forefoot contact phase and foot flat phase were prolonged, but shorter than those in the unaffected side and the control group(P<0.05).Conclusion:ACL reconstruction can improve gait after ACL rupture.Using gait data analysis for functional quantitative evaluation can help to understand the changes in gait parameters after ACL rupture and reconstruction, thereby providing a basis for postoperative curative effect evaluation and development of treatment plan.