运动学对线技术对全膝关节置换患者疼痛程度及膝关节功能恢复的影响

Effect of kinematics alignment technique on pain degree and knee joint recovery of patients underwent total knee replacement

目的探究运动学对线技术对全膝关节置换患者疼痛程度、膝关节功能恢复的影响。方法选取2021年7月至2022年6月于莱阳市中医医院行全膝关节置换术的110例患者作为研究对象,按照随机数字表法分为A组与B组,各55例。A组实施常规对线技术,B组实施运动学对线技术,比较两组疼痛程度[视觉模拟评分法(VAS)评分]、康复时间(首次下地时间、首次直腿抬高>30°时间)、膝关节活动指标(膝关节最大屈曲度、膝关节主动活动度、髋-膝-踝角)、步行情况(步速、步频、步幅)、膝关节功能[膝关节协会系统(KSS)评分]、并发症发生情况。结果术后1个月,两组VAS评分均低于术后3 d及术前,且术后3 d高于术前,差异有统计学意义(P<0.05);术后3 d、1个月,两组VAS评分比较差异无统计学意义。两组首次下地时间、首次直腿抬高>30°时间比较差异无统计学意义。术后3、6个月,两组膝关节最大屈曲度均大于术前,膝关节主动活动度均大于前一时间点,髋-膝-踝角均小于前一时间点,且B组膝关节最大屈曲度、膝关节主动活动度均大于A组,髋-膝-踝角小于A组,差异有统计学意义(P<0.05);两组术后3个月与术后6个月膝关节最大屈曲度比较差异无统计学意义。术后3、6个月,两组步速、步频均快于术前,步幅均大于术前,且B组步速、步频均快于A组,步幅大于A组,差异有统计学意义(P<0.05);两组术后3个月与术后6个月步速、步频、步幅比较差异无统计学意义。术后3、6个月,两组KSS评分均高于术前,且B组高于A组,差异有统计学意义(P<0.05);两组术后3个月与术后6个月KSS评分比较差异无统计学意义。两组并发症发生率比较差异无统计学意义。结论对全膝关节置换术患者实施运动学对线技术,可改善其膝关节活动功能及步行情况,且不会增加患者疼痛程度,并发症较少。

Objective To explore the effect of kinematic alignment technique on the pain degree and knee joint recovery of patients undergoing total knee replacement.Methods 110 patients who underwent total knee replacement at Laiyang Traditional Chinese Medicine Hospital from July 2021 to June 2022 were selected as the research subjects,and they were divided into the group A and the group B according to random number table method,with 55 cases in each group.The group A implements conventional alignment technology,the group B implements kinematic alignment technology,the pain degree(visual analogue scale[VAS]score),rehabilitation time(first ambulation time,first straight leg elevation>30°time),knee joint activity index(maximum knee flexion,active knee range of motion,hip-knee-ankle Angle),walking condition(stride speed,stride frequency,stride length),knee joint function(Knee Society Scoring[KSS]score),and incidence of complications were compared between the two groups.Results 1 month after operation,the VAS scores of two groups were lower than 3 d after operation and before operation,and 3 d after operation was higher than before operation,the differences were statistically significant(P<0.05);3 d and 1 month after operation,there was no significant difference in VAS scores between the two groups.There was no significant difference in the first ambulation time and the first straight leg elevation>30°time between the two groups.At 3 and 6 months after operation,the maximum knee flexion was greater than that before operation,the active knee range of motion was greater than that at the previous time point,and the hip-knee-ankle Angle was smaller than that at the previous time point,and the maximum knee flexion and active knee range of motion in the group B were larger than those in the group A,and the hip-knee-ankle Angle was smaller than that in the group A,and the differences were statistically significant(P<0.05);there was no significant difference in the maximum knee flexion between the two groups at 3 months and 6 months after operation.At 3 and 6 months after operation,the stride speed and stride frequency of the two groups were faster than those before operation,and the stride length was greater than that before operation,and the stride speed and stride frequency in the group B were faster than those in the group A,and the stride length was greater than that in the group A,the differences were statistically significant(P<0.05);there was no significant difference in stride speed,stride frequency and stride length between the two groups at 3 months and 6 months after operation.At 3 and 6 months after operation,the KSS scores of the two groups were higher than those before operation,and the group B were higher than the group A,and the differences were statistically significant(P<0.05);there was no significant difference in KSS score between the two groups at 3 months and 6 months after operation.There was no significant difference in the incidence of complications between the two groups.Conclusion The application of kinematic alignment technique in patients with total knee replacement can improve the knee joint function and walking condition,without increasing the degree of pain of patients,and has few complications.