【摘要】 目的 对膝关节后外复合体（posterolateral corner，PLC）损伤患者重建术后的旋转稳定性进行测试，探讨外旋拨号试验和步态分析测量外旋角度的关系。方法 2007年3月至2008年3月，对13例后十字韧带（posterior cruciate ligament，PCL）合并PLC损伤患者进行重建手术，男10例，女3例；年龄21～46岁，平均33.2岁；术前行外旋拨号试验，术后1年再行外旋拨号试验及步态分析测试。比较术前、术后外旋拨号试验测得外旋角度的改变以及重建术后1年步态分析中膝关节外旋角度与外旋拨号试验之间的关系。结果 13例患者术前外旋拨号试验患侧外旋角度较对侧平均增大16.3°±6.1°，重建术后1年外旋拨号试验患侧较对侧外旋角度平均增大-4.2°±8.0°，患侧外旋拨号试验最大外旋角度绝对值平均为29.6°±15.1°。术后1年步态分析测试结果示患侧较对侧平均增大-3.7°±7.2°，患侧最大外旋角度平均13.8°±15.8°。外旋拨号试验和步态分析中患侧和对侧外旋角度差值行配对t检验，结果显示，两组比较差异无统计学意义，且两组外旋角度之间存在较强的直线相关关系，相关系数r=0.9670。由外旋拨号试验估计步态中外旋角度的回归方程为：Y=-7.5721+0.7234X。结论 使用韧带重建后外复合体可以有效控制患者外旋角度。外旋拨号试验和步态分析均可测量患者后外旋转稳定性，且两者测量外旋角度之间存在较强的直线相关关系。

    【关键词】 步态；膝关节；创伤和损伤

    【证据等级】 预后性研究Ⅳ级

 

    Evaluation of posterolateral knee instability using gait analysis versus dial test ZHANG Jin, FENG Hua, HONG Lei, et al. Sports Medicine Service, Jishuitan Hospital, Beijing 100035, China

    【Abstract】 Objective To test the external rotation stability after post reconstruction of posterior cruciate ligament (PCL)/posterolateral corner (PLC) injury, and investigate the relationship of external rotation angle between the gait analysis and dial test. Methods Between March 2007 and March 2008, 13 patients with PCL/PLC injuries were performed allograft reconstruction. There were 10 males and 3 females, with the average age of 33.2 years. All patients underwent the dial test preoperatively, and did gait analysis and dial test again 1 year postreconstructively. The differences of external rotation angle during dial test were measured and compared between pre-and 1 year post-reconstruction. Results During dial test, the mean external rotation angle at lesion side was 16.3°±6.1° higher than that at healthy side preoperatively, and was -4.2°±8.0° higher at 1 year postoperatively. The mean absolute value of maximal external rotation angle at lesion side during dial test were 29.6°±15.1° postoperatively． At gait analysis, the mean external rotation angle at lesion side was -3.7°±7.2° higher than that at healthy side 1 year post operation. The mean maximal external rotation angle at lesion side during gait analysis was 13.8°±15.8°. With paired t test, there was no difference between the side-to-side differences of dial test and the gait analysis, and there was strongly linear correlation between the dial test and the external rotation angle of gait analysis, correlation coefficient r=0.9670. The regression equation：Y=-7.5721+0.7234X. Conclusion Reconstruction of the PLC using an allograft reconstruction can restore posterolateral knee stability. There is strongly linear correlation between the dial test and the external rotation angle of gait analysis.

    【Key words】 Gait; Knee joint; Wounds and injuries