Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089-9006, USA.
J Orthop Sports Phys Ther. 2010 Feb;40(2):42-51. doi: 10.2519/jospt.2010.3337.
During the last decade, there has been a growing body of literature suggesting that proximal factors may play a contributory role with respect to knee injuries. A review of the biomechanical and clinical studies in this area indicated that impaired muscular control of the hip, pelvis, and trunk can affect tibiofemoral and patellofemoral joint kinematics and kinetics in multiple planes. In particular, there is evidence that motion impairments at the hip may underlie injuries such as anterior cruciate ligament tears, iliotibial band syndrome, and patellofemoral joint pain. In addition, the literature suggests that females may be more disposed to proximal influences than males. Based on the evidence presented as part of this clinical commentary, it can be argued that interventions which address proximal impairments may be beneficial for patients who present with various knee conditions. More specifically, a biomechanical argument can be made for the incorporation of pelvis and trunk stability, as well as dynamic hip joint control, into the design of knee rehabilitation programs.
Aetiology/therapy, level 5.
在过去十年中，越来越多的文献表明，近端因素可能对膝关节损伤起促成作用。对该领域的生物力学和临床研究进行回顾表明，髋关节、骨盆和躯干的肌肉控制受损会影响胫骨股骨和髌股关节在多个平面上的运动学和动力学。特别是，有证据表明髋关节运动障碍可能是前交叉韧带撕裂、髂胫束综合征和髌股关节疼痛等损伤的基础。此外，文献表明女性比男性更容易受到近端影响。基于本临床评论中提出的证据，可以认为针对近端损伤的干预措施可能对患有各种膝关节疾病的患者有益。更具体地说，可以从生物力学的角度提出将骨盆和躯干稳定性以及髋关节动态控制纳入膝关节康复计划设计中的观点。
病因学/治疗，5 级。
