Relationships Between Varus-Valgus Laxity of the Severely Osteoarthritic Knee and Gait, Instability, Clinical Performance, and Function
Relationships Between Varus-Valgus Laxity of the Severely Osteoarthritic Knee and Gait, Instability, Clinical Performance, and Function
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DOI：
10.1002/jor.23447
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发表时间：
2017-08-01
影响因子：
2.8
通讯作者：
Chaudhari, Ajit M. W.
中科院分区：
文献类型：
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作者：
Freisinger, Gregory M.;Hutter, Erin E.;Chaudhari, Ajit M. W.
据报道，与对照组相比，膝关节骨关节炎（OA）患者的内翻-外翻松弛度增加。然而，大多数以前的研究可能没有报告真正的被动关节松弛，因为他们的测试是在有意识的参与者身上进行的，这些参与者在松弛评估期间可能会防止肌肉收缩的运动。本研究的目的是研究受试者在麻醉状态下记录的被动膝关节松弛测量值与步态期间内翻-外翻偏移、临床性能测量值、感知不稳定性和重度膝关节OA受试者自我报告的功能之间的关系。我们评估了29名（30个膝关节）重度OA患者在接受全膝关节置换术（TKA）时的被动膝关节内翻-外翻松弛。参与者还完成了步态分析、临床性能评估（6分钟步行（6 MW）、爬楼梯试验（SCT）、等长膝关节力量）和自我报告的功能测量（感知不稳定性、膝关节损伤和骨关节炎结局评分（KOOS），中位时间为TKA手术前18天。我们观察到，更大的被动内翻-外翻松弛与步态中更大的内翻-外翻偏移相关（R-2 = 0.34，p = 0.002）。还观察到更大的松弛度与更大的等长膝关节伸展强度（p = 0.014）、更远的6 MW距离（p = 0.033）和更短的SCT时间（p = 0.046）之间存在显著关联。未观察到被动内翻-外翻松弛与等长膝关节屈曲强度、感知不稳定或任何KOOS子量表之间存在相关性。松弛、步态过程中的额叶偏移和功能表现之间的相互冲突的关联表明松弛与膝关节软骨健康、临床表现和自我报告的功能之间存在复杂的关系，值得进一步研究。(C)2016骨科研究学会。由威利期刊公司出版
Increased varus-valgus laxity has been reported in individuals with knee osteoarthritis (OA) compared to controls. However, the majority of previous investigations may not report truly passive joint laxity, as their tests have been performed on conscious participants who could be guarding against motion with muscle contraction during laxity evaluation. The purpose of this study was to investigate how a measure of passive knee laxity, recorded when the participant is under anesthesia, is related to varus-valgus excursion during gait, clinical measures of performance, perceived instability, and self-reported function in participants with severe knee OA. We assessed passive varus-valgus knee laxity in 29 participants (30 knees) with severe OA, as they underwent total knee arthroplasty (TKA). Participants also completed gait analysis, clinical assessment of performance (6-min walk (6 MW), stair climbing test (SCT), isometric knee strength), and self-reported measures of function (perceived instability, Knee injury, and Osteoarthritis Outcome Score (KOOS) a median of 18 days before the TKA procedure. We observed that greater passive varus-valgus laxity was associated with greater varus-valgus excursion during gait (R-2 = 0.34, p = 0.002). Significant associations were also observed between greater laxity and greater isometric knee extension strength (p = 0.014), farther 6 MW distance (p = 0.033) and shorter SCT time (p = 0.046). No relationship was observed between passive varus-valgus laxity and isometric knee flexion strength, perceived instability, or any KOOS subscale. The conflicting associations between laxity, frontal excursion during gait, and functional performance suggest a complex relationship between laxity and knee cartilage health, clinical performance, and self-reported function that merits further study. (C) 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.