Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking
Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking
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DOI：
10.1177/03635465030310012401
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发表时间：
2003-01-01
影响因子：
4.8
通讯作者：
Stergiou, N
中科院分区：
文献类型：
--
作者：
Georgoulis, AD;Papadonikolakis, A;Stergiou, N
背景资料：步态异常可能在前交叉韧带缺损患者的膝关节损伤和骨关节炎的发病机制中发挥作用。假设：即使在低应力活动（如行走）期间，前交叉韧带缺损膝关节的三维运动学也会发生变化，但可以通过重建恢复。研究设计：病例对照研究。方法：使用三维光电步态分析系统，我们检查了13例前交叉韧带缺陷的膝关节患者，21例前交叉韧带重建的膝关节患者，以及10例未受伤膝关节的对照受试者。所有受试者在步态周期中保持膝关节屈曲-伸展、外展-内收和内外旋转的正常模式。前交叉韧带缺损膝关节与重建膝关节和对照膝关节相比，在初始摆动阶段胫骨旋转角度有显著差异。前交叉韧带缺损膝关节患者在初始摆动阶段胫骨内旋，而其他患者胫骨外旋。结论：前交叉韧带缺损膝关节患者在行走过程中反复发生旋转不稳定，而重建患者胫骨旋转更接近正常。临床相关性：膝关节旋转不稳定的反复发作可能在病理性膝关节疾病的发展中起作用。(C)2003年美国骨科学会运动医学。
Background: It is possible that gait abnormalities may play a role in the pathogenesis of meniscal or chondral injury as well as osteoarthritis of the knee in patients with anterior cruciate ligament deficiency.Hypothesis: The three-dimensional kinematics of anterior cruciate ligament-deficient knees are changed even during low-stress activities, such as walking, but can be restored by reconstruction.Study Design: Case control study.Methods: Using a three-dimensional optoelectronic gait analysis system, we examined 13 patients with anterior cruciate ligament-deficient knees, 21 patients with anterior cruciate ligament-reconstructed knees, and 10 control subjects with uninjured knees during walking.Results: Normal patterns of knee flexion-extension, abduction-adduction, and internal-external rotation during the gait cycle were maintained by all subjects. A significant difference in tibial rotation angle during the initial swing phase was found in anterior cruciate ligament-deficient knees compared with reconstructed and control knees. The patients with anterior cruciate ligament-deficient knees rotated the tibia internally during the initial swing phase, whereas the others rotated externally.Conclusions: Patients with anterior cruciate ligament-deficient knees experienced repeated episodes of rotational instability during walking, whereas patients with reconstruction experienced tibial rotation that is closer to normal.Clinical Relevance: Repeated episodes of knee rotational instability may play a role in the development of pathologic knee conditions. (C) 2003 American Orthopaedic Society for Sports Medicine.