Knee joint contact mechanics during downhill gait and its relationship with varus/valgus motion and muscle strength in patients with knee osteoarthritis
Knee joint contact mechanics during downhill gait and its relationship with varus/valgus motion and muscle strength in patients with knee osteoarthritis
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DOI：
10.1016/j.knee.2015.07.011
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发表时间：
2016-01-01
期刊：
影响因子：
1.9
通讯作者：
Tashman, Scott
中科院分区：
文献类型：
--
作者：
Farrokhi, Shawn;Voycheck, Carrie A.;Tashman, Scott
目的：本探索性研究的目的是评估下坡步态时胫股关节接触点的偏移和速度，并评估膝关节骨关节炎（OA）患者胫股关节接触力学与膝关节前平面运动和下肢肌肉无力之间的关系。方法：采用动态立体x线测量11例膝关节OA患者和11例对照志愿者在下坡步态负荷反应阶段的胫股关节接触力学和额平面运动。还进行了股四头肌和髋外展肌的定量测试。结果：与对照组相比，膝关节OA患者表现出更大的内侧/外侧关节接触点偏移（p < 0.02）和更大的内侧和外侧腔室的脚跟撞击关节接触点速度（p < 0.05）。与对照组相比，膝关节OA患者的内侧/外侧关节接触点速度峰值也更高（p = 0.02）。此外，膝关节OA患者表现出明显增加的额平面内翻运动偏差（p < 0.01）和大股四头肌和髋关节外展肌无力（p = 0.03）。一般来说，膝关节OA患者关节接触点位移和速度的增加与更大的额平面内翻运动位移呈线性相关（p < 0.04），但与股四头肌或髋外展肌力量无关。结论：膝关节OA患者接触力学的改变可能与关节前平面稳定性受损有关，但与肌肉力量不足无关。(C) 2015 Elsevier B.V.版权所有
Objective: The objective of this exploratory study was to evaluate tibiofemoral joint contact point excursions and velocities during downhill gait and assess the relationship between tibiofemoral joint contact mechanics with frontal-plane knee joint motion and lower extremity muscle weakness in patients with knee osteoarthritis (OA).Methods: Dynamic stereo X-ray was used to quantify tibiofemoral joint contact mechanics and frontal-plane motion during the loading response phase of downhill gait in 11 patients with knee OA and 11 control volunteers. Quantitative testing of the quadriceps and the hip abductor muscles was also performed.Results: Patients with knee OA demonstrated larger medial/lateral joint contact point excursions (p < 0.02) and greater heel-strike joint contact point velocities (p < 0.05) for the medial and lateral compartments compared to the control group. The peak medial/lateral joint contact point velocity of the medial compartment was also greater for patients with knee OA compared to their control counterparts (p = 0.02). Additionally, patients with knee OA demonstrated significantly increased frontal-plane varus motion excursions (p < 0.01) and greater quadriceps and hip abductor muscle weakness (p = 0.03). In general, increased joint contact point excursions and velocities in patients with knee OA were linearly associated with greater frontal-plane varus motion excursions (p < 0.04) but not with quadriceps or hip abductor strength.Conclusion: Altered contact mechanics in patients with knee OA may be related to compromised frontal-plane joint stability but not with deficits in muscle strength. (C) 2015 Elsevier B.V. All rights reserved.