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中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (01) : 77 -85. doi: 10.3877/cma.j.issn.1674-134X.2023.01.011

综述

步态分析作为全膝关节置换术预后评估手段的研究进展
王泽华1, 赵瑞鹏1, 毛兴佳1, 高振中1, 郭子瑊1, 田最1, 尹志文1, 向川1,†()   
  1. 1. 030001　太原，山西医科大学第二医院骨科
  • 收稿日期:2021-11-05 出版日期:2023-02-01
  • 通信作者: 向川
  • 基金资助:
    国家自然科学基金(81972075)

Progress in gait analysis as prognostic evaluation method for total knee replacement

Zehua Wang1, Ruipeng Zhao1, Xingjia Mao1, Zhenzhong Gao1, Zijian Guo1, Zui Tian1, Zhiwen Yin1, Chuan Xiang1,†()   

  1. 1. Department of Orthopedics, The Second Affiliated Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Received:2021-11-05 Published:2023-02-01
  • Corresponding author: Chuan Xiang
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王泽华, 赵瑞鹏, 毛兴佳, 高振中, 郭子瑊, 田最, 尹志文, 向川. 步态分析作为全膝关节置换术预后评估手段的研究进展[J]. 中华关节外科杂志(电子版), 2023, 17(01): 77-85.

Zehua Wang, Ruipeng Zhao, Xingjia Mao, Zhenzhong Gao, Zijian Guo, Zui Tian, Zhiwen Yin, Chuan Xiang. Progress in gait analysis as prognostic evaluation method for total knee replacement[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(01): 77-85.

全膝关节置换术(TKA)被认为是治疗终末期膝关节病变的最有效方法之一，能够在缓解患者疼痛的同时恢复膝关节的功能，改善患者的生活质量，得到了广泛的推广和应用。目前主要通过影像学及各类评分体系来对TKA术后的临床疗效进行评估，但均存在缺陷和不足，如辐射、评分体系中的部分指标受到主观因素的影响而不能客观量化、无法反映术后膝关节的整体功能情况等。步态分析是利用物理手段研究步行规律的检查方法，能够揭示步态异常的关键环节及影响因素，其与影像学检查和各种评分体系等评估手段相比，具有无辐射、无创伤、可动态测量以及获取数据便捷等特点，因此在TKA术后膝关节功能评估方面具有显著优势。本文通过文献整理发现：全膝关节置换术步态分析研究主要集中在患者特征、手术策略和假体类型等方面，因此本文系统汇总了近几年来国内外对上述步态分析的相关文献，总结了关于该研究范畴的最新研究进展，为其在临床的应用推广提供新思路。

关键词: 步态分析, 关节成形术，置换，膝, 骨关节炎，膝

Total knee arthroplasty (TKA) is considered as one of the most effective methods in treatment of end-stage knee lesions. TKA can not only relieves pain but also restores the function of knee and improves the quality of life of patients, hence it has been widely applied. Currently, imaging and various scoring systems are used to evaluate the clinical efficacy after TKA. However, all of the assessment methods have flaws and deficiencies in many aspects, such as irradiation and some of the indexes in scoring systems are unable to be objectively quantified due to influences of subjective factors, nor able to reflect an overall function of the knee after TKA. Gait analysis is a physical examination that evaluates walking patterns. It can reveal the key links and influencing factors of gait abnormalities. Compared with imaging examinations and various scoring systems, the gait analysis has been found having characteristics of non-radiation, non-invasive, dynamic measurement and convenient data acquisition. Gait analysis has a significant advantage in evaluation of knee function after TKA. Through literature review, it is clear that gait analysis after TKA focuses on patient characteristics, surgical strategies and type of prostheses. This review systematically summarised relevant literatures and the latest research progress in gait analysis after TKA at home and abroad in recent years, therefore to provide new ideas for clinical application and promotion of it.

Key words: Gait analysis, Arthroplasty, replacement, knee, Osteoarthritis, knee
图1 步行周期模式图注：根据单侧肢体的触地情况可分为支撑相(60%)和摆动(40%)，摆动相包括足跟接地、足掌接地、支撑中期、足跟离地、足趾离地，摆动相包括加速期、摆动中期、减速期；双支撑为两侧肢体均触地的时间阶段，单支撑为仅一侧肢体触地的时间阶段
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