Relationship between pain and medial knee joint loading in mild radiographic knee Osteoarthritis
Relationship between pain and medial knee joint loading in mild radiographic knee Osteoarthritis
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DOI：
10.1002/art.22991
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发表时间：
2007-10-15
期刊：
影响因子：
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通讯作者：
Block, Joel A.
中科院分区：
文献类型：
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作者：
Thorp, Laura E.;Sumner, Dale R.;Block, Joel A.
Objective.众所周知，膝关节疼痛和膝关节骨关节炎（OA）的放射学证据之间的关系是不完美的。特别是，区分有症状的个体与那些有相当放射学受累但无症状的个体的条件尚不清楚。我们研究了通过有无膝关节疼痛区分的轻度放射学OA患者的膝关节动态负荷。受试者被招募到3组：有症状的Kellgren/Lawrence（K/L）等级为2（n = 52），无症状的K/L等级为2（n = 19），无症状的K/L等级为0或1（n = 37），后者代表正常对照组。通过步态分析评估膝关节动态负荷，并测定膝关节峰值外收力矩和膝关节内收角冲量。有症状的K/L 2级患者的膝关节内收力矩峰值和膝关节内收角冲量峰值分别比无症状患者高19%和30%（P < 0.05）。相反，无症状性K/L 2级组与K/L 0-1级正常对照组无差异（P = 1.00）。在轻度放射学膝关节OA（K/L 2级）患者中，有症状者的内侧间室负荷显著高于无症状者，而无症状者与正常对照（无症状K/L 0级或1级）无差异。这些发现表明，生物力学成分之间的无症状和症状的放射学OA的区别，这可能是重要的病理生理。
Objective. The relationship between knee pain and radiographic evidence of knee osteoarthritis (OA) is notoriously imperfect. In particular, conditions that distinguish individuals with symptoms from those with comparable radiographic involvement who remain asymptomatic are unclear. We investigated dynamic loading across the knee in individuals with mild radiographic OA who were distinguished by the presence or absence of knee pain.Methods. Subjects were recruited into 3 groups: symptomatic with a Kellgren/Lawrence (K/L) grade of 2 (n = 52), asymptomatic with a K/L grade of 2 (n = 19), and asymptomatic with a K/L grade of 0 or 1 (n = 37), the latter representing a normal comparator group. Dynamic knee loading was assessed with gait analysis, and both the peak external knee adduction moment and the knee adduction angular impulse were determined.Results. Peak knee adduction moment and knee adduction angular impulse were 19% and 30% higher, respectively, in symptomatic K/L grade 2 individuals than in asymptomatic individuals with the same radiographic grade (P < 0.05). Conversely, the asymptomatic K/L grade 2 group did not differ from the K/L grade 0-1 normal comparator group (P = 1.00).Conclusion. Among individuals with mild radiographic knee OA (K/L grade 2), those who are symptomatic have significantly higher medial compartment loads than those who are asymptomatic, whereas those who are asymptomatic do not differ from normal controls (asymptomatic K/L grade 0 or 1). These findings suggest a biomechanical component to the distinction between asymptomatic and symptomatic radiographic OA, which may be pathophysiologically important.