The relationship between pain and dynamic knee joint loading in knee osteoarthritis varies with radiographic disease severity. A cross sectional study
The relationship between pain and dynamic knee joint loading in knee osteoarthritis varies with radiographic disease severity. A cross sectional study
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DOI：
10.1016/j.knee.2011.07.003
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发表时间：
2012-08-01
期刊：
影响因子：
1.9
通讯作者：
Bliddal, Henning
中科院分区：
文献类型：
--
作者：
Henriksen, Marius;Aaboe, Jens;Bliddal, Henning
目的：在一项横断面研究中，我们调查了膝关节疼痛和机械负荷之间的关系，在步行过程中的症状性膝关节OA患者的膝关节外收力矩（RAM）所示的不同的放射学疾病severity.Methods：从137有症状的内侧膝关节OA患者的数据。根据Kellgren/Lawrence（K/L）分级，将患者分为X线片不太严重（K/L 2，n = 69）的内侧膝关节OA。整体膝关节疼痛评分为10 cm视觉模拟量表，并从步态分析中获得峰值KAM和RAM脉冲。混合线性回归分析与KAM变量的结果，疼痛和疾病的严重程度作为自变量，调整年龄，性别，和步行speed.Results：在调整后的分析，不太严重的患者表现出疼痛强度和动态负荷之间的负相关。重度患者组的疼痛强度与KAM峰值无关，而疼痛强度与RAM脉冲呈正相关。结论：在X线检查不太严重的膝关节OA中，疼痛强度与动态膝关节负荷之间呈负相关，表明对疼痛的自然反应，这将限制关节的应力。相比之下，严重OA患者疼痛和动态负荷之间的关系缺失或呈正相关可能导致过度使用和加速疾病进展。这些发现可能对膝关节OA的治疗策略有很大的潜在意义。(C)2011爱思唯尔有限公司版权所有。
Objective: In a cross sectional study, we investigated the relationships between knee pain and mechanical loading across the knee, as indicated by the external knee adduction moment (RAM) during walking in patients with symptomatic knee OA who were distinguished by different radiographic disease severities.Methods: Data from 137 symptomatic medial knee OA patients were used. Based on Kellgren/Lawrence (K/L) grading, the patients were divided into radiographically less severe (K/L 2, n = 69) medial knee OA. Overall knee pain was rated on a 10 cm visual analog scale, and peak KAM and RAM impulses were obtained from gait analyses. Mixed linear regression analyses were performed with KAM variables as the outcome, and pain and disease severity as independent variables, adjusting for age, gender, and walking speed.Results: In adjusted analyses, less severe patients demonstrated negative relationships between pain intensities and dynamic loading. The severe patient group showed no relationship between pain intensity and peak KAM, and a positive relationship between pain intensity and RAM impulse.Conclusion: In radiographically less severe knee OA, the negative relationships between pain intensity and dynamic knee joint loading indicate a natural reaction to pain, which will limit the stress on the joint. In contrast, either absent or positive relationships between pain and dynamic loading in severe OA may lead to overuse and accelerated disease progression. These findings may have a large potential interest for strategies of treatment in knee OA. (C) 2011 Elsevier B.V. All rights reserved.