Are Knee Biomechanics Different in Those With and Without Patellofemoral Osteoarthritis After Anterior Cruciate Ligament Reconstruction?
Are Knee Biomechanics Different in Those With and Without Patellofemoral Osteoarthritis After Anterior Cruciate Ligament Reconstruction?
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DOI：
10.1002/acr.22313
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发表时间：
2014-10-01
影响因子：
4.7
通讯作者：
Crossley, Kay M.
中科院分区：
文献类型：
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作者：
Culvenor, Adam G.;Schache, Anthony G.;Crossley, Kay M.
Objective.髌股（PF）骨关节炎（OA）在前交叉韧带重建（ACLR）后很常见。本研究旨在研究ACLR术后PFOA患者和非PFOA患者在步态中膝关节内翻和外翻对线时的横向平面旋转差异。ACLR术后9 +/- 2年平均值为+/- SD的36名患者（18名影像学PFOA和18名无膝关节OA）参加了这项横断面研究。在步行和跑步过程中，使用三维运动分析系统测量膝关节内外旋角。使用倾斜仪测量的负重额面膝关节对线用于将参与者分类为内翻或外翻对线。双因素协方差分析用于评估煮沸：PFOA和额状面膝关节对线对动态膝关节内外旋转的影响。在步行（P = 0.019）和跑步（P = 0.002）过程中，PFOA状态和额状面对齐对膝关节内外旋角度的影响存在显著的相互作用。简单效应检验显示，在行走过程中，外翻对线和PFOA患者的膝关节内旋平均比外翻对线和无OA患者低3.9度（95%置信区间[95% CI] 0.7，7.1）。在运行期间，该差异增加至6.1（95% CI 1.8，10.4）。对于内翻对线的个体，没有显著的影响。在PFOA和外翻对线的个体中，步态中膝关节内旋较少。这种幅度的旋转移位可能足以引发或加速髌股软骨退变。需要进行前瞻性研究，以确定这些改变的运动模式是否是重建后PFOA发展的结果或贡献。
Objective. Patellofemoral (PF) osteoarthritis (OA) is prevalent following anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate differences in transverse plane rotation between knees with varus and valgus alignment during gait in people with and without PFOA after ACLR.Methods. Thirty-six individuals who were mean +/- SD 9 +/- 2 years post-ACLR (18 radiographic PFOA and 18 no knee OA) participated in this cross-sectional study. Knee internal-external rotation angles were measured using a 3-dimensional motion analysis system during walking and running. Weight-bearing frontal plane knee alignment, measured with an inclinometer, was used to classify participants as having varus or valgus alignment. Two-way analysis of covariance was used to assess the effect of boil: PFOA and frontal plane knee alignment on dynamic knee internal-external rotation.Results. Significant interactions were found between PFOA status and frontal plane alignment on knee internal-external rotation angles during walking (P = 0.019) and running (P = 0.002). Tests of simple effects revealed that during walking, individuals with valgus alignment and PFOA demonstrated a mean 3.9 degrees (95% confidence interval [95% CI] 0.7, 7.1) less knee internal rotation than those with valgus alignment and no OA. During running this difference increased to 6.1 (95% CI 1.8, 10.4). For individuals with varus alignment, no significant effects were observed.Conclusion. Less knee internal rotation during gait was found in individuals with PFOA and valgus alignment. A rotational shift of this magnitude may be sufficient to initiate or accelerate patellofemoral cartilage degeneration. Prospective studies are required to determine if these altered kinematic patterns result from, or contribute to, PFOA development after reconstruction.