目的:分析双膝骨性关节炎(Osteoarthritis,OA)患者全膝关节置换(Total Knee Arthroplasty,TKA)手术前后足底压力分布变化。方法:选取2014年1月-2015年12月于西京医院就诊的25名双侧膝关节OA患者为研究对象,分别于术前、术后6个月两个时间点采用Footscan测量系统采集患者足底10个区域的压力数据,选择达峰值压力(Maximal Force,Max-F)、达峰值时间(Maximal Time,Max-T)作为主要参数进行统计分析。结果:双膝OA患者TKA术后与术前相比发现Max-F:重侧患肢足底分区第1足趾、第2-5足趾、第4、5跖骨头区减小;后足区增大;轻侧患肢足底分区前足、中足、后足均减小。Max-T:重侧足底分区第2-5足趾区、第一跖骨头区、中足、后足区增大;轻侧足底分区第2-5足趾区、第5跖骨头区减小。以上结果均存在显著性差异(P〈0.05)。结论:通过足底压力步态系统分析双膝OA患者手术前后的足底压力数据,可以更加科学、客观、量化的评价TKA手术疗效。
Objective: Through the assessment of the changes in plantar pressure distribution before and after total knee arthroplasty (TKA), the gait changes and the limb alignment were analyzed to evaluate the flexion contracture deformity correction and the reconstruction of knee function postoperatively. Methods: 25 patients who underwent bilateral TKA were analyzed as the research object. Plantar pressure data was collected in acquisitioned 10 areas before and 6 months after TKA respectively. Maximal Force (Max-F), maximal time (Max-T) were chosen as the main parameters for statistical analysis. Results: 1, Max-F. The postoperative Max-F in Toel-5 and M4-5 regions of the severe symptomatic limb were significantly lower than the preoperative, there were significant differences (P 〈0.05). Compared with the preoperative Max-F, the postoperative Max-F in HM region was significant increased (P 〈0. 05). On the mild symptomatic limb, the Max-F in Toel-5, M1, M3, M5, MF, HL, HM regions were significantly lower than the preoperative ones, there were significant differences (P 〈0.05). 2. Max-T. The postoperative forefoot regions (Toe2-5, M1), midfoot region (MF), heel area (HM, ML) of the severe symptomatic limb had higher max-T than the preoperative ones, the differences were significant (P 〈 0.05). On the mild symptomatic limb, the postoperative max-T of Toe2-5, M5 regions were shorter than the preoperative ones, there were significant differences (P 〈0.05). Conclusions: Analysing the plantar pressure data of the double knee OA patients before and after operation, plantar pressure gait system can be a more scientific, objective and quantitative evaluation of TKA.