Knee joint loading differs in individuals with mild compared with moderate medial knee osteoarthritis
Knee joint loading differs in individuals with mild compared with moderate medial knee osteoarthritis
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DOI：
10.1002/art.22247
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发表时间：
2006-12-01
影响因子：
--
通讯作者：
Wimmer, Markus A.
中科院分区：
文献类型：
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作者：
Thorp, Laura E.;Sumner, D. Richman;Wimmer, Markus A.
目标。比较不同级别膝关节骨性关节炎（OA）患者的膝关节负荷模式，以表征不同结构状态的机械影响，并比较膝关节内收角冲量（一种常用的膝关节内收峰值力矩的步态测量方法）。方法。招募了Kellgren/Lawrence （K/L）影像学严重程度分级为0或1 （n = 28）的无症状受试者（无膝关节OA）和K/L分级为2 （n = 66）或3 （n = 23）的有症状的膝关节OA受试者。采用步态分析方法计算整个姿态和4个细分姿态的膝外内收力矩峰值和膝外内收角冲量。结果。膝关节内收力矩峰值和膝关节内收角冲量均随K/L影像学分级增大（P < 0.05）。然而，只有膝关节内收角冲量在中度（3级）和轻度（2级）膝关节炎患者之间存在差异（P < 0.05）。结论。根据膝关节内侧负荷的大小，轻度和中度症状性膝关节炎的影像学差异不仅是结构上的，而且是功能上的。此外，膝关节内收角脉冲提供了膝关节内收峰值力矩之外的额外信息，因此可能是OA研究中一个重要的步态参数。这些发现对我们理解骨关节炎的病理生理机制具有重要意义。
Objective. To compare the knee joint loading patterns in individuals with differing radiographic grades of knee osteoarthritis (OA) for characterization of the mechanical implications of different structural states, and to compare the knee adduction angular impulse, a measure of gait complementary to the commonly used peak knee adduction moment. Methods. Asymptomatic subjects (those without knee OA) having a Kellgren/Lawrence (K/L) radiographic severity grade of 0 or 1 (n = 28) and subjects with symptomatic knee OA having K/L grades of 2 (n = 66) or 3 (n = 23) were recruited. Gait analysis was used to calculate the peak external knee adduction moment and the external knee adduction angular impulse for the whole stance and for the 4 subdivisions of stance. Results. Both the peak knee adduction moment and the knee adduction angular impulse increased with K/L radiographic grade (P < 0.05). However, only the knee adduction angular impulse differed between subjects with moderate (grade 3) and those with mild (grade 2) radiographic knee OA (P < 0.05). Conclusion. The differences between mild and moderate symptomatic radiographic knee OA are not only structural but also functional, based on the magnitude of load in the medial knee joint. Moreover, knee adduction angular impulse provides additional information beyond that available from the peak knee adduction moment, and may therefore be an important gait parameter to include in OA research. These findings are important for our understanding of the pathophysiologic mechanisms of OA.