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行走过程中关节负荷增加——膝骨关节炎疼痛缓解的一个后果。

Increased joint loads during walking--a consequence of pain relief in knee osteoarthritis.

作者信息

Henriksen Marius, Simonsen Erik B, Alkjaer Tine, Lund Hans, Graven-Nielsen Thomas, Danneskiold-Samsøe Bente, Bliddal Henning

机构信息

The Parker Institute, Frederiksberg Hospital, Ndr. Fasanvej 57, DK-2000 Frederiksberg, Denmark.

出版信息

Knee. 2006 Dec;13(6):445-50. doi: 10.1016/j.knee.2006.08.005. Epub 2006 Sep 29.

Abstract

Joint pain is a primary symptom in knee osteoarthritis (OA), but the effect of pain and pain relief on the knee joint mechanics of walking is not clear. In this study, the effects of local knee joint analgesia on knee joint loads during walking were studied in a group of knee osteoarthritis patients. A group of healthy subjects was included as a reference group. The joint loads were calculated from standard gait analysis data obtained with standardised walking speed (4 km/h). The gait analyses were performed before and after pain relief by intra-articular injections of 10 mL lidocaine (1%). Pre-injection measurements revealed lower joint loads in the OA group compared to the reference group. Following injections pain during walking decreased significantly and the joint loads increased in the OA group during the late single support phase to a level comparable to the reference group. Although the patients walked with less compressive knee joint forces compared to the reference group, the effects of pain relief may accelerate the degenerative changes.

摘要

关节疼痛是膝关节骨关节炎(OA)的主要症状,但疼痛及疼痛缓解对步行时膝关节力学的影响尚不清楚。在本研究中,对一组膝关节骨关节炎患者进行了局部膝关节镇痛对步行时膝关节负荷影响的研究。纳入一组健康受试者作为参照组。根据以标准化步行速度(4公里/小时)获得的标准步态分析数据计算关节负荷。通过关节内注射10毫升1%利多卡因进行疼痛缓解,在注射前后分别进行步态分析。注射前测量显示,与参照组相比,OA组的关节负荷较低。注射后,OA组步行时的疼痛显著减轻,且在单腿支撑后期关节负荷增加至与参照组相当的水平。尽管与参照组相比,患者行走时膝关节的压缩力较小,但疼痛缓解的影响可能会加速退行性改变。

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