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膝关节内侧和外侧骨关节炎患者的髋关节和膝关节旋转存在差异:30例患者和15名对照者的步态分析

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: gait analysis of 30 patients and 15 controls.

作者信息

Weidow Jonas, Tranberg Roy, Saari Tuuli, Kärrholm Johan

机构信息

Department of Orthopaedics, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.

出版信息

J Orthop Res. 2006 Sep;24(9):1890-9. doi: 10.1002/jor.20194.

Abstract

The motions and moments in the hip and knee in female patients on the waiting list for knee prosthesis surgery with medial (n = 15) or lateral (n = 15) osteoarthritis (OA) were compared with a control group (n = 15). We hypothesized that not only the kinematics and kinetics of the knee but also of the hip would differ between patients the medial and lateral groups. At midstance, patients with lateral OA showed slightly (2 degrees) more maximal (peak) adduction (p = 0.015) of the hip joint and patients with medial OA had 7 degrees more abduction (p < 0.001) than did controls. In patients with lateral OA, the femur was positioned in about 7 degrees more maximum external rotation (p = 0.001), but femur position did not differ between medial OA and controls (p > or = 0.8). There was a tendency to higher internal hip rotation moment in lateral OA compared to controls (p = 0.021). The maximum values of the internal knee abduction moments were 52% higher in medial OA (p = 0.005) and 63% lower in lateral OA (p < 0.001) compared to controls. Cases with medial OA had 9 degrees more, whereas those with lateral OA had 6 degrees less external tibial rotation than controls (medial vs. lateral OA, p = 0.001). We found an association between presence of lateral OA of the knee and the biomechanics of the hip joint. It remains to be evaluated if the changed biomechanics of the hip joint is a reason for development of lateral OA or an observation that is a result of this disease.

摘要

将等待膝关节置换手术的内侧(n = 15)或外侧(n = 15)骨关节炎(OA)女性患者的髋部和膝部的运动及力矩与对照组(n = 15)进行比较。我们假设,内侧组和外侧组患者之间不仅膝关节的运动学和动力学不同,髋部的也会不同。在双下肢支撑中期,外侧OA患者的髋关节最大(峰值)内收角度略大(2度)(p = 0.015),内侧OA患者的外展角度比对照组多7度(p < 0.001)。在外侧OA患者中,股骨最大外旋角度多出约7度(p = 0.001),但内侧OA患者与对照组之间的股骨位置无差异(p ≥ 0.8)。与对照组相比,外侧OA患者的髋部内旋力矩有升高趋势(p = 0.021)。与对照组相比,内侧OA患者的膝关节内收力矩最大值高52%(p = 0.005),外侧OA患者低63%(p < 0.001)。内侧OA患者的胫骨外旋角度比对照组多9度,而外侧OA患者比对照组少6度(内侧与外侧OA相比,p = 0.001)。我们发现膝关节外侧OA的存在与髋关节生物力学之间存在关联。髋关节生物力学的改变是外侧OA发生的原因还是该疾病的一种表现,仍有待评估。

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