Increased knee joint loads during walking are present in subjects with knee osteoarthritis
Increased knee joint loads during walking are present in subjects with knee osteoarthritis
复制标题
DOI：
10.1053/joca.2002.0797
复制
发表时间：
2002-07-01
影响因子：
7
通讯作者：
Andriacchi, TP
中科院分区：
文献类型：
--
作者：
Baliunas, AJ;Hurwitz, DE;Andriacchi, TP
目的：本研究检验了一组接受药物治疗的膝关节骨关节炎（OA）患者的步态峰值膝关节外收力矩增加的假设。胫股膝关节OA更常影响内侧间室。膝关节外收力矩可用于评估膝关节内外侧间室之间的载荷分布。此外，本研究测试，如果在膝关节角度的变化，如减少midstance膝关节屈曲角度，或减少矢状面的时刻以前确定的其他负载减少mechanisms是presentin this OA group.Design：31个受试者与膝关节OA和内侧间室软骨损伤的放射学证据进行步态测试后，2周的药物洗脱期。还测试了31名具有可比年龄、体重和身高分布的正常受试者（无症状对照受试者）。正常和膝关节OA组之间的矢状面膝关节运动和峰值外部力矩的显着差异被确定使用t tests.Results：受试者与膝关节OA走大于正常峰值外部膝关节内收力矩（P=0.003）。站立中期膝关节屈曲角度两组间无显著差异（P=0.625）峰值屈曲和伸展力矩也不（P>0.037）。负荷减少机制，例如减少站立中期膝关节屈曲角度，其他人在终末期膝关节OA受试者中发现的或外部屈曲或伸展力矩减少的情况在这组接受治疗的膝关节OA受试者中不存在通过保守治疗进行管理。膝关节OA组中膝关节外收力矩显著大于正常值的发现支持了步态期间膝关节内收力矩增加与膝关节OA相关的假设。(C)2002年国际骨关节炎研究学会。由Elsevier Science Ltd.出版，版权所有。
Objective: This study tests the hypothesis that the peak external knee adduction moment during gait is increased in a group of ambulatory subjects with knee osteoarthritis (OA) of varying radiographic severity who are being managed with medical therapy. Tibiofemoral knee OA more commonly affects the medial compartment. The external knee adduction moment can be used to assess the load distribution between the medial and lateral compartments of the knee joint. Additionally, this study tests if changes in the knee angles, such as a reduced midstance knee flexion angle, or reduced sagittal plane moments previously identified by others as load reducing mechanisms are present in this OA group.Design: Thirty-one subjects with radiographic evidence of knee OA and medial compartment cartilage damage were gait tested after a 2-week drug washout period. Thirty-one normal subjects (asymptomatic control subjects) with a comparable age, weight and height distribution were also tested. Significant differences in the sagittal plane knee motion and peak external moments between the normal and knee OA groups were identified using t tests.Results: Subjects with knee OA walked with a greater than normal peak external knee adduction moment (P=0.003). The midstance knee flexion angle was not significantly different between the two groups (P=0.625) nor were the peak flexion and extension moments (P>0.037).Conclusions: Load reducing mechanisms, such as a decreased midstance knee flexion angle, identified by others in subjects with endstage knee OA or reduced external flexion or extension moments were not present in this group of subjects with knee OA who were being managed by conservative treatment. The finding of a significantly greater than normal external knee adduction moment in the knee OA group lends support to the hypothesis that an increased knee adduction moment during gait is associated with knee OA. (C) 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.