Shakoor Najia, Lee Kristen J, Fogg Louis F, Block Joel A
Section of Rheumatology, Rush Medical College, 1725 West Harrison, Suite 1017, Chicago, IL 60612-3862, USA.
Arthritis Rheum. 2008 Sep 15;59(9):1237-40. doi: 10.1002/art.24004.
Lower extremity sensory deficits, including reduced proprioception, joint kinesthesia, and, recently, vibratory sense, have been described in subjects with osteoarthritis (OA) of the knee. However, comparable deficits in OA of the hip have not previously been evaluated. Vibratory perception threshold (VPT) is a reliable measure used to assess sensory deficits and is amenable to testing multiple body sites. This study examined VPT at the upper and lower extremities of subjects with hip OA compared with subjects without hip OA.
Fourteen subjects with symptomatic and radiographic hip OA were compared with 13 age-matched controls without hip OA. VPT was assessed using a biothesiometer. Five sites in the lower extremity and 1 site in the upper extremity (radial head) were evaluated and compared between OA and control subjects.
VPT was significantly reduced at all 6 testing sites of the OA subjects compared with controls (P < 0.05 for all sites). VPT scores (mean +/- SEM volts) for OA subjects and controls were as follows: first metatarsophalangeal joint (13.5 +/- 1.4 versus 7.4 +/- 0.7), medial malleolus (18.1 +/- 2.6 versus 11.2 +/- 1.7), lateral malleolus (20.9 +/- 2.4 versus 10.6 +/- 1.5), medial femoral condyle (22.8 +/- 2.9 versus 12.6 +/- 1.3), lateral femoral condyle (26.7 +/- 2.6 versus 16.2 +/- 1.9), and radial styloid [corrected] (10.2 +/- 0.8 versus 7.5 +/- 0.6).
To our knowledge, this is the first study to evaluate sensory deficits in hip OA and to demonstrate that there is vibratory sense loss at both the upper and lower extremities in these subjects compared with controls. The noted generalized deficits may have significant implications in the neuromechanical pathophysiology of OA.
有研究描述了膝关节骨关节炎（OA）患者存在下肢感觉缺陷，包括本体感觉、关节运动觉减退，以及最近发现的振动觉减退。然而，此前尚未评估髋关节OA患者是否存在类似缺陷。振动觉阈值（VPT）是一种用于评估感觉缺陷的可靠指标，适用于多个身体部位的测试。本研究比较了髋关节OA患者与无髋关节OA患者上下肢的VPT。
将14例有症状且经影像学检查确诊为髋关节OA的患者与13例年龄匹配的无髋关节OA的对照者进行比较。使用生物感觉阈值测量仪评估VPT。对下肢的5个部位和上肢的1个部位（桡骨头）进行评估，并在OA患者和对照者之间进行比较。
与对照组相比，OA患者所有6个测试部位的VPT均显著降低（所有部位P<0.05）。OA患者和对照者的VPT评分（平均值±标准误，单位为伏）如下：第一跖趾关节（13.5±1.4对7.4±0.7）、内踝（18.1±2.6对11.2±1.7）、外踝（20.9±2.4对10.6±1.5）、股骨内侧髁（22.8±2.9对12.6±1.3）、股骨外侧髁（26.7±2.6对16.2±1.9）以及桡骨茎突（10.2±0.8对7.5±0.6）。
据我们所知，这是第一项评估髋关节OA感觉缺陷并证明与对照组相比这些患者上下肢均存在振动觉丧失的研究。所发现的全身性缺陷可能对OA的神经力学病理生理学具有重要意义。
