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-  2015 

关节镜下髁间窝成形术对老年膝骨关节炎患者神经肌肉控制能力影响的临床研究

DOI: doi:10.7507/1002-1892.20150204

Keywords: 骨关节炎, 髁间窝成形术, 神经肌肉控制能力, 本体感觉, 肌肉动员能力, 老年患者

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Abstract:

目的研究关节镜下髁间窝成形术对老年膝关节骨关节炎(knee osteoarthritis,KOA)患者膝关节神经肌肉控制能力的影响。 方法以2012年6月-2013年3月收治并符合选择标准的20例(20膝)老年KOA患者作为手术组,均行关节镜下髁间窝成形术;以20例健康老年人作为对照组。两组研究对象年龄、身高、体质量、体质量指数等一般资料比较,差异均无统计学意义(P>0.05)。两组术前均行本体感觉(采用被动角度再生试验,测量角度分别为15、30、60°)及股四头肌动员能力[包括股四头肌最大随意等长收缩肌力(maximum voluntary contraction,MVC)、中枢动员比率(central activation ratio,CAR)、肌力储备(activation deficit,AD)]评定,评价膝关节神经肌肉控制能力;使用Lysholm膝关节功能评分表评价膝关节功能。手术组患者于术后3、6、9个月再次行以上评价,以评价膝关节神经肌肉控制能力和关节功能恢复情况。 结果与对照组相比,手术组术前CAR、MVC、Lysholm评分显著降低,AD及各角度误差显著增加(P<0.05)。术后随时间延长,CAR、MVC、Lysholm评分逐渐增高,AD及角度误差逐渐减小,至术后9个月时与对照组比较差异均无统计学意义(P>0.05)。 结论关节镜下髁间窝成形术后,ACL受压、磨损、撞击情况解除,老年KOA患者神经肌肉控制能力恢复,本体感觉及股四头肌动员能力提高,关节功能改善

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