McWalter E J, Macintyre N J, Cibere J, Wilson D R
Department of Mechanical Engineering, University of British Columbia, 500-828 West 10th Avenue, Vancouver, BC, Canada V5Z 1L8.
Knee. 2010 Mar;17(2):135-40. doi: 10.1016/j.knee.2009.08.001. Epub 2009 Aug 31.
Patellofemoral disorders, such as osteoarthritis and patellofemoral pain, are thought to be associated with abnormal patellar kinematics. However, assessments of three-dimensional patellar kinematics are time consuming and expensive. The aim of this study was to determine whether a single static measure of three-dimensional patellar kinematics provides a surrogate marker for three-dimensional patellar kinematics over a range of flexion angles. We assessed three-dimensional patellar kinematics (flexion, tilt and spin; lateral, anterior and proximal translation) at sequential static angles through approximately 45 degrees of loaded knee flexion in 40 normal subjects using a validated, MRI-based method. The surrogate marker was defined as the static measure at 30 degrees of knee flexion and the pattern of kinematics was defined as the slope of the linear best fit line of each subject's kinematic data. A regression model was used to examine the relationship between the surrogate marker and pattern of kinematics. The surrogate marker predicted 26% of the variance in pattern of patellar flexion (p<0.001), 27% of the variance in pattern of patellar spin (p=0.003), 11% of the variance in pattern of proximal translation (p=0.037) and 39% of the variance in pattern of anterior translation (p<0.001). No relationships were seen between the surrogate marker and tilt or lateral translation. The results suggest that a single measure of patellar parameters at 30 degrees knee flexion is an inadequate surrogate marker of three-dimensional patellar kinematics; therefore, a complete assessment of patellar kinematics, over a range of knee flexion angles, is preferable to adequately assess patterns of patellar kinematics.
髌股关节疾病，如骨关节炎和髌股关节疼痛，被认为与髌骨异常运动学有关。然而，三维髌骨运动学的评估既耗时又昂贵。本研究的目的是确定在一系列屈曲角度下，单一的三维髌骨运动学静态测量是否能作为三维髌骨运动学的替代指标。我们使用一种经过验证的基于MRI的方法，在40名正常受试者中，通过大约45度的负重膝关节屈曲，在连续的静态角度下评估三维髌骨运动学（屈曲、倾斜和旋转；外侧、前方和近端平移）。替代指标被定义为膝关节屈曲30度时的静态测量值，运动学模式被定义为每个受试者运动学数据的线性最佳拟合线的斜率。使用回归模型来检验替代指标与运动学模式之间的关系。替代指标预测了髌骨屈曲模式中26%的方差（p<0.001）、髌骨旋转模式中27%的方差（p=0.003）、近端平移模式中11%的方差（p=0.037）和前方平移模式中39%的方差（p<0.001）。未发现替代指标与倾斜或外侧平移之间存在关系。结果表明，膝关节屈曲30度时单一的髌骨参数测量作为三维髌骨运动学的替代指标是不充分的；因此，在一系列膝关节屈曲角度下对髌骨运动学进行完整评估，对于充分评估髌骨运动学模式更为可取。
