COBRE: UD: PROJ 4: CORRECTION OF VARUS DEFORMITY BY AN OPENING WEDGE OSTEOTOMY

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 骨关节炎是关节软骨的进行性破坏，最终导致关节间隙变窄、进行性骨质侵蚀和韧带松弛。膝骨性关节炎通常与致残性疼痛有关，在美国老年人的功能性残疾中占很大比例。膝关节内侧间隙受累最多，与内侧关节间隙狭窄、膝内翻和内侧关节结构松弛有关。膝内翻本身会导致膝部过度内收，这可能会加剧骨关节炎的进展。膝关节骨性关节炎的进展还涉及肌肉无力、感觉丧失和膝关节不稳定之间的复杂相互作用，所有这些都受到骨骼排列不良的负面影响。为矫正活跃个体的内翻畸形而进行的内翻矫正手术提供了一个模型，用于评估骨骼对齐对那些据称导致膝关节骨性关节炎、肌肉无力、本体感觉、膝关节松弛和功能进展的变量的影响。 这项研究的总体目标是确定中度膝内翻畸形患者的胫股关节解剖重组是否允许肌肉力量、膝关节松弛、膝关节不稳定和本体感觉的改变，从而与阻止膝骨性关节炎的进展相一致。 目的1：探讨胫股关节解剖重建术对内侧骨性关节炎疼痛患者股四头肌活动、股四头肌力量和内外侧关节稳定性的恢复作用。 目的：验证胫股关节解剖重排对内侧骨性关节炎疼痛患者行走时肌肉活动和运动模式(时间、激活程度和协同收缩程度)正常化的影响。 目的3：证实胫股关节解剖重排对膝关节内侧扰乱的正常化的影响。 目的4：通过股四头肌功能、膝关节运动、力矩和神经肌肉反应的线性组合来预测胫股关节解剖整复前后疼痛、内侧骨性关节炎和膝内翻患者的功能结果。 作为一种替代手术，开口楔形截骨术涉及在胫骨内侧创造一个开口，随着时间的推移，这个开口可以慢慢分散。本研究的目的是研究截骨楔形截骨联合骨痂牵张矫正膝内翻手术前后运动和肌肉活动的差异。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Osteoarthritis (OA), a progressive destruction of articular cartilage, ultimately leads to joint space narrowing, progressive erosion of bone and ligament laxity. Knee OA is often associated with disabling pain and accounts for a large portion of functional disability in older Americans. The medial compartment of the knee is most frequently involved and is associated with medial joint space narrowing, genu varum and laxity of the medial joint structures. Genu varum itself leads to an excessive adduction moment at the knee that may exacerbate the progression of the OA. Progression of knee OA also involved an intricate interaction between muscle weakness, sensory loss and knee instability, all of which are negatively effected by the bony malalignment. Realignment procedures performed to correct the varus deformity in active individuals provide a model for assessment of the effect of skeletal alignment on thosevariables purported to contribute to the progression of knww OA, muscle weakness, proprioception, knee joint laxity, and function. The overall goal of this study is to determine whether anatomic realignment of the tibiofemoral joint in patients with moderate genu varus deformity allows for changes in muscle strength, knee joint laxity, knee joint instability and proprioception that is compatible with halting the progression of knee OA. Aim 1: demonstrate the effect of anatomic realignment of the tibiofemoral joint in restoring quadriceps activation, quadriceps strength and mediolateral joint stability in persons with painful, medial compartment OA. Aim 2: demonstrate the effect of anatomic realignment of the tibiofemoral joint on normalization of muscle activation and movement patterns (timing, level of activation and degree of co-contraction) during walking in persons with painful, medial compartment OA. Aim 3: demonstrate the effect of anatomic realignment of the tibiofemoral joint on normalization of the neuromuscular response to a medial perturbation at the knee in persons with painful, medial compartment OA. Aim 4: Predict functional outcome from linear combinations of quadriceps function, knee motion, moments, and neuromuscular responses in people with painful, medial compartment OA and genu varum before and after anatomic realignment of the tibiofemoral joint. An alternative surgery, the opening wedge osteotomy involves the creation of an opening on the medial side of the tibia which can be distracted slowly over time. The purpose of this study is to characterize the differences in movement and muscle activity before and after an opening wedge osteotomy with callus distraction to correct genu varum.