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저자명
이상훈,정진엽,김한수,김병성,이한구,Lee. Sang-Hoon,Chung. Chin-Youb,Kim. Han-Soo,Kim. Byung-Sung,Lee. Han-Koo
간행물명
대한골관절종양학회지
권/호정보
1997년|3권 1호|pp.18-25 (8 pages)
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대한골관절종양학회
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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기타언어초록

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2<G1<control) and extension in mid stance in group 2 compared with group 1. In group 2, the greater knee coronal and transverse plane motion and decreased maximum ankle dorsiflexion in terminal stance and terminal swing, and decreased maximum hip extension in terminal stance were also significant(p<.05). In kinetics, the maximum knee flexion moment and sum of flexion moment at stance were increased in group 2 significantly(p<.05). Maintenance of extensor mechanism through secure attachment of patellar tendon is believed to be more important than the amount of resected quadriceps muscle foe active knee extension and powerful stance. Gait analysis is very useful and objective in the assessment of postoperative gait function and also helpful in establishing a physical therapy program and a novel prosthesis design with physiologic mechanism.