新しい歩行解析による変形性膝関節症の関節動揺性および治療法の検討

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This study attempted to evaluate a sideway movement of the knee which occures suddenly in the early stance phase of walking and usually present in knees in osteoarthritic knees, and also to investigate effectiveness of various types of treatment for osteoarthritice of the knee. Following results were obtained from this study : 1. Basic investigation on the effects of anatomical positions and methods of fixation of a senser of the accelerometer show that the most suitable site is over the fibular head fixed with adhesive tape. 2. Sufficient reproducibility was comfirmed in the accelerometric values even if the measurement was repearted on different dates for a same person. 3. Osteoarthritic knees were clasified into three different accelerometric types : 1) Lateral thrust type in which a single peak of acceleration appears in the lateral direction immediately after heel strike ; 2) Medial thrust type in which the acceleration appears in the medial direction ; and 3) Mixed type in which both lateral and medial peaks appears. Most knees with medial compartmental osteoarthritis shows lateral thrust type whereas all knees with lateral compartmental osteoarthritis show medial thrust type. 4. The peak amplitude of lateral acceleration was significantly increased with increased speed of walking, climbing up and down slopes, or ambulation carrying a heavy object. The rate of increase was significantly greater in osteoarthritic knees than in normal kennes. 5. The peak lateral acceleration was significantly reduced with the use of a shoe insole having thirty mm wedge base laterally. On the other hand, Medial acceleration peask was significantly reduced with the use of medially elevated shoe insole. Osteoarthritic knees with clinically effective insoles show greater reduction in the peak lateral acceleration than those with ineffective insoles. 6. The lateral thrust pattern observes in the medial compartmental osteoarthritic knees changed to the medical thrust pattern after hi