Briem Kristin, Axe Michael J, Snyder-Mackler Lynn
Research Centre of Movement Science School of Health Sciences, University of Iceland, Reykjavik, Iceland.
J Orthop Res. 2009 Nov;27(11):1420-5. doi: 10.1002/jor.20899.
Knee osteoarthritis (OA) is a cause of decline in function and the medial compartment is often affected. Intraarticular injection of hyaluronic acid (HA) is indicated as a symptom modifying treatment with at least 6 months passing between consecutive injection series. The effects of HA injection on gait variables have not been extensively examined. Therefore, our objective was to investigate the effects of HA injection on gait in people with medial knee OA. Twenty-seven subjects were included; each was tested prior to treatment (baseline), no later than 3 weeks following the last injection (post-HA), and again 5 months after treatment ended (follow-up). Responder criteria were defined to identify responders and non-responders. Subjects underwent 3D gait analysis, muscle activity was sampled, and co-contraction indices were calculated. Responders experienced increased peak knee adduction moments post-HA, whereas non-responders did not. Improved self-report scores were associated with increased knee adduction moments and increased medial co-contraction. Pain relief may result in higher loading onto the already vulnerable medial compartment due to changes in lower limb mechanics and muscle activation patterns. Eventually this may result in a more rapid progression of joint deterioration.
膝关节骨关节炎（OA）是功能下降的一个原因，内侧间室常受影响。关节内注射透明质酸（HA）被用作一种改善症状的治疗方法，连续注射系列之间至少间隔6个月。HA注射对步态变量的影响尚未得到广泛研究。因此，我们的目的是研究HA注射对内侧膝关节OA患者步态的影响。纳入了27名受试者；每个人在治疗前（基线）、最后一次注射后不迟于3周（HA后）以及治疗结束后5个月再次进行测试（随访）。定义了反应标准以识别反应者和无反应者。受试者接受三维步态分析，采集肌肉活动数据，并计算共同收缩指数。反应者在HA后膝关节内收力矩峰值增加，而无反应者则没有。自我报告评分的改善与膝关节内收力矩增加和内侧共同收缩增加有关。疼痛缓解可能会由于下肢力学和肌肉激活模式的改变而导致对本已脆弱的内侧间室施加更高的负荷。最终，这可能会导致关节退变更快进展。
