中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (31): 4969-4973.doi: 10.3969/j.issn.2095-4344.1971

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

步态分析应用在前交叉韧带损伤诊断中的意义

罗  鸿1,刘  方1,李顺华1,邱  冰1,刘福尧1,张  余2,马立敏3   

  1. (1贵州省骨科医院,贵州省贵阳市  550001;2广州省人民医院,广东省广州市  510010;3广州军区广州总医院,广东省广州市  510010)
  • 收稿日期:2019-06-20 出版日期:2019-11-08 发布日期:2019-11-08
  • 通讯作者: 李顺华,副主任医师,贵州省骨科医院,贵州省贵阳市 550001
  • 作者简介:罗鸿,男,1980年生,贵州省人,土家族,2008年贵阳医学院毕业,主治医师,主要从事关节运动医学的研究。
  • 基金资助:

    贵州省科技支撑计划项目(黔科合支撑[2018]2763),项目负责人:罗鸿

Significance of gait analysis in the diagnosis of anterior cruciate ligament injury

Luo Hong1, Liu Fang1, Li Shunhua1, Qiu Bing1, Liu Fuyao1, Zhang Yu2, Ma Limin3   

  1.  (1Guizhou Orthopedics Hospital, Guiyang 550001, Guizhou Province, China; 2Guangzhou Provincial People’s Hospital, Guangzhou 510010, Guangdong Province, China; 3Guangzhou General Hospital of Guangzhou Military Region of Chinese PLA, Guangzhou 510010, Guangdong Province, China)
  • Received:2019-06-20 Online:2019-11-08 Published:2019-11-08
  • Contact: Li Shunhua, Associate chief physician, Guizhou Orthopedics Hospital, Guiyang 550001, Guizhou Province, China
  • About author:Luo Hong, Attending physician, Guizhou Orthopedics Hospital, Guiyang 550001, Guizhou Province, China
  • Supported by:

     the Science and Technology Supporting Program of Guizhou Province, No. [2018]2763 (to LH)

摘要:

文章快速阅读:

文题释义:

步态分析:步态是指人或动物通过肢体运动并前进的一种周期性的形式和样子。与走路不同,走路一个过程,而步态是一种形式。通常来说,步态就是描述人走路特点的一种周期性现象,并且每个周期可以被分为多个部分进行分析。
前交叉韧带损伤:前交叉韧带损伤是骨关节外科和运动医学领域最常见的损伤之一,也是膝关节比较常见的运动伤之一。正面看膝关节,中间有一个像拱桥一样的结构,这个叫做髁间窝。有2根前后呈十字状交叉的韧带,前面的一根叫做前交叉韧带也叫前十字韧带,后面的一根就叫做后交叉韧带,前面的韧带断裂称为前交叉韧带断裂。
摘要
背景:
步态分析是生物力学领域里的一个特殊分支学科,已广泛应用于步态障碍和矫正骨科手术的效果评估。目前缺乏步态分析在前交叉韧带损伤诊断的相关研究。
目的:探讨步态分析在在前交叉韧带损伤诊断的应用价值。
方法:该临床研究的实施符合贵州省骨科医院对研究的相关伦理要求。参与试验的患病个体及其家属均签署了“知情同意书”。选取经关节镜确诊为前交叉韧带损伤的患者60例,比较采用红外光学导航膝关节运动分析系统、体格检查及磁共振检查3种方法诊断前交叉韧带损伤的价值。
结果与结论:①步态分析诊断出前交叉韧带损伤(n=49)优于体格检查(n=29)和磁共振检查(n=35)方法(P < 0.05),尤其体现在前交叉韧带轻度损伤的患者(P < 0.05);而3种方法在前交叉韧带中、重度损伤诊断中差异无显著显著性意义(P > 0.05);②步态分析与磁共振检查比较,ROC的曲线下面积为0.636 4(95%可信区间,0.535 9-0.736 8,P=0.010);与体格检查比较ROC的曲线下面积为0.620 3(95%可信区间,0.519 4-0.721 1,P=0.023 0);③结果说明,光学导航下步态分析为诊断前交叉韧带损伤的另一种有效方法。

关键词: 步态分析, 前交叉韧带损伤, 膝关节体格检查, 磁共振, 诊断准确性

Abstract:

BACKGROUND: Gait analysis is a special subdiscipline in the field of biomechanics and has been widely used to evaluate the effects of gait disorders and orthopedic surgery. There is a lack of gait analysis in the diagnosis of anterior cruciate ligament injury.
OBJECTIVE: To investigate the application value of gait analysis in the diagnosis of anterior cruciate ligament injury.
METHODS: The study was in accordance with the ethical requirements of Guizhou Orthopedics Hospital, and the patients and their families signed the informed consents. Sixty patients with anterior cruciate ligament injury diagnosed by arthroscopic surgery were selected. The infrared optical navigation knee motion analysis system, gait analysis, and physical examination were performed to explore their diagnostic values of anterior cruciate ligament injury.
RESULTS AND CONCLUSION: (1) The results showed that gait analysis (n=49) was superior to physical examination (n=29) and magnetic resonance imaging (n=35) in the diagnosis of anterior cruciate ligament injury (P < 0.05), especially in patients with mild anterior cruciate ligament injury (P < 0.05). There was no significant difference in moderate and severe anterior cruciate ligament injuries (P > 0.05). (2) Comparison between gait analysis and magnetic resonance examination showed that the area under the curve of ROC was 0.636 4 (95% confidence interval, 0.535 9-0.736 8, P=0.010). Comparison between gait analysis and physical examination, the area under the curve of ROC was 0.620 3 (95% confidence interval, 0.519 4-0.721 1, P=0.023 0). (3) In summary, gait analysis under optical navigation is another effective method for diagnosing anterior cruciate ligament injury.

Key words: gait analysis, anterior cruciate ligament injury, knee joint physical examination, magnetic resonance examination, accuracy diagnosis

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