The University of Melbourne, Melbourne, Victoria, Australia.
Arthritis Care Res (Hoboken). 2010 Sep;62(9):1237-43. doi: 10.1002/acr.20220.
To compare differences in knee varus and valgus angular laxity and passive mechanical stiffness between asymptomatic knees and those with mild, moderate, and severe knee osteoarthritis (OA).
A total of 127 participants with symptomatic medial tibiofemoral OA and 32 asymptomatic controls participated. OA knees were stratified according to radiographic severity. Varus-valgus laxity was evaluated using a customized dynamometer, providing continuous measurement of varus-valgus joint angle and torque. The following indices were calculated: 1) varus, valgus, and total angular laxity, 2) end-range varus and valgus stiffness, and 3) midrange stiffness.
There was no difference in varus, valgus, and total angular laxity, or varus and valgus end-range stiffness between the groups (P > 0.05 for all). The OA groups were less stiff in the midrange compared with the controls (P = 0.004-0.043).
The absence of differences in total angular laxity is contrary to previous findings, and may be associated with the failure of previous work to account for body size effects. Less midrange stiffness in OA participants compared with controls may indicate less rotational support provided by passive joint structures in knee OA within the functionally important range. The role of passive varus-valgus stiffness in disease onset and progression is worthy of further investigation.
比较无症状膝关节与轻度、中度和重度膝骨关节炎(OA)膝关节在膝内翻和外翻角度松弛度以及被动机械刚度方面的差异。
共纳入 127 名有症状的内侧胫骨股骨 OA 患者和 32 名无症状对照者。根据影像学严重程度对 OA 膝关节进行分层。使用定制的测力计评估内外翻松弛度,提供内外翻关节角度和扭矩的连续测量。计算以下指标:1)内外翻角度松弛度,2)终末位内外翻刚度,和 3)中段刚度。
各组之间的内外翻角度松弛度、总角度松弛度、内外翻终末位刚度没有差异(P>0.05 均)。OA 组中段刚度小于对照组(P=0.004-0.043)。
总角度松弛度无差异与既往发现相反,这可能与既往工作未能考虑到体型影响有关。OA 患者中段刚度小于对照组,表明在功能重要范围内,OA 膝关节中被动关节结构提供的旋转支撑减少。被动内外翻刚度在疾病发病和进展中的作用值得进一步研究。