University of British Columbia, Vancouver, Canada.
Arthritis Care Res (Hoboken). 2010 Oct;62(10):1426-32. doi: 10.1002/acr.20248.
To examine hip, pelvis, and trunk walking biomechanics in individuals with medial compartment knee osteoarthritis (OA) of varying radiographic disease severities and others without knee pain.
Hip, pelvis, and trunk kinematics and hip kinetics were assessed in 75 individuals with radiographically confirmed OA and 20 asymptomatic individuals. Differences in peak hip adduction and abduction angles, the amount of contralateral pelvic drop, and peak lateral trunk lean measured by 3-dimensional gait analysis were examined using analyses of variance. Peak external hip abduction and adduction moments were compared using analyses of covariance, with gait speed as a covariate.
Those with severe OA disease exhibited significantly less peak hip adduction (5.0°), but more ipsilateral trunk lean toward the study extremity (5.0°) than all other groups (P < 0.001). Those in the severe (1.1°) and asymptomatic (0.9°) groups also exhibited significantly less lateral trunk lean toward the non-study extremity (P = 0.004). No significant differences in hip joint moments or contralateral pelvic drop were observed between the groups (P > 0.02).
Gait changes at the hip and trunk were evident across the groups based on radiographic disease severity and compared with those without knee pain. Although not conclusive from this cross-sectional study design, the results provide initial evidence to support increased lateral trunk lean as being a compensatory response to the disease.
研究不同影像学严重程度内侧间室膝关节骨关节炎(OA)患者和无膝关节疼痛患者的髋关节、骨盆和躯干行走生物力学。
对 75 例影像学确诊 OA 患者和 20 例无症状患者进行髋关节、骨盆和躯干运动学以及髋关节动力学评估。通过三维步态分析,检查髋关节内收和外展角度、对侧骨盆下降量和横向躯干倾斜度的峰值差异。采用协方差分析比较髋关节外展和内收的峰值外部力矩,以步态速度为协变量。
严重 OA 患者的髋关节内收角度明显减小(5.0°),但向研究肢体的同侧躯干倾斜度增加(5.0°),明显大于其他所有组(P < 0.001)。严重组(1.1°)和无症状组(0.9°)的患者向非研究肢体的横向躯干倾斜度也明显减小(P = 0.004)。各组间髋关节力矩或对侧骨盆下降无明显差异(P > 0.02)。
根据影像学疾病严重程度和与无膝关节疼痛患者比较,髋关节和躯干的步态变化在各组中均明显可见。尽管这是一项横断面研究设计,结果不能得出明确结论,但为支持增加横向躯干倾斜是对疾病的代偿反应提供了初步证据。