| Objective: To evaluate the clinical effect of balanced manipulation of knee joint on functional rehabilitation after knee joint replacement for genu varus deformityMethods: 30 eligible patients and 15 healthy volunteers were included in the study.Thirty patients were randomly divided into the control group(conventional rehabilitation training group)and the experimental group(knee joint balance manipulation + conventional rehabilitation training group)with 15 cases in each group,and the 15 healthy volunteers were set as baseline reference for normal gait analysis group.Patients in both groups underwent strict functional exercise in accordance with the formulated rehabilitation plan after surgery.(1)Knee joint function scores(including HSS total score,pain score,muscle strength score,knee flexion)were performed before and 1,3 and 6 months after operation,and the differences of knee joint function scores between the experimental group and the control group were compared.(2)Six months after operation,three-dimensional gait analysis was carried out in the experimental group,the control group and the normal group.Spatio-temporal parameters(including stride length,stride speed,stride frequency,single leg support time on the affected side),kinematics parameters(including peak flexion and extension angle,peak valgus angle,peak internal and external rotation angle),dynamics parameters(including peak flexion and extension moment,peak inversion moment,peak internal and external rotation moment)were compared among the three groups.The difference of the value and the peak value of the ground reaction force in three directions.Results:(1)Knee joint function score:(1)Postoperative pain score 1 month after surgery,there was a difference between the experimental group and the control group(P<0.05),and no difference in pain score 3 months after surgery,6 months after surgery(P>0.05).(2)1 month after surgery,there was no difference in the total HSS score between the experimental group and the control group(P>0.05),while the total HSS score 3 months after surgery was improved in the experimental group compared with the control group(P<0.05),and the total HSS score 6 months after surgery was significantly improved in the experimental group(P<0.01).(3)Postoperative muscle strength score and knee flexion at each stage showed no difference between the experimental group and the control group(P > 0.05).(2)The gait parameters:(1)Spatial and temporal parameters: 6 months after operation,the stride frequency and the time of one leg support in the experimental group and the control group were significantly different from those in the normal group(P<0.05),and the stride length and the stride speed were significantly improved(P<0.05)compared with the control group(P<0.01),while the stride frequency and the time of one leg support in the affected side were significantly improved(P<0.01).There was no difference(P>0.05).(2)Kinematics parameters: 6 months after operation,the peak value of flexion angle and varus angle in the experimental group and the control group were different from those in the normal group(P<0.05).There was no difference in the peak value of extension angle,valgus angle and internal and external rotation angle(P>0.05).However,compared with the control group,the peak value of flexion angle in the experimental group was improved(P<0.05),and there was no difference in the remaining indexes(P>0.05).(3)Dynamic parameters: At 6 months after operation,the peak value of stretching moment,the peak value of ground reaction force of Y and Z axes in test group and control group were different from those in normal group(P<0.05),while the peak value of buckling moment,inversion moment,internal and external rotation moment and the peak value of ground reaction force of X axis were not different(P>0.05),but compared with control group,the peak value of stretching moment,Y and Z axes in test group were similar.The peak value of ground reaction force was improved P<0.05),and the remaining indicators had no difference(P>0.05).Conclusion: The balanced manipulation of knee joint can effectively improve the function of knee joint after knee joint replacement for genu varus deformity and improve the gait of patients,which is worthy of clinical application. |
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