Thorp L E, Wimmer M A, Foucher K C, Sumner D R, Shakoor N, Block J A
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
J Musculoskelet Neuronal Interact. 2010 Jun;10(2):166-73.
High dynamic loads of the medial knee are associated with tibiofemoral osteoarthritis (OA) severity and progression. The lower extremity acts as an integrated kinetic unit, thus treatments targeting adjacent segments may promote reductions in the loading of a symptomatic knee. This study examined the biomechanical effects of a lower extremity exercise regimen, emphasizing training of hip abductor musculature, on dynamic knee loads in individuals with knee OA.
Six subjects with medial compartment knee OA participated in a proof of concept study of a four-week exercise program specifically targeting the hip abductor musculature in combination with traditional quadriceps and hamstring training. Assessments included gait analyses to measure the external knee adduction moment, a surrogate marker of medial knee joint loading as well as WOMAC questionnaires and strength evaluations.
All subjects demonstrated a decrease in their external knee adduction moment, with an average decrease of 9% (p<0.05) following the exercise intervention. There was a 78% (p<0.05) decrease in WOMAC knee pain scores.
These results suggest that targeting hip, rather than only knee musculature, may represent an effective biomechanically-based treatment option for medial knee OA.
膝关节内侧的高动态负荷与胫股关节骨关节炎（OA）的严重程度和进展相关。下肢作为一个整合的动力学单元，因此针对相邻节段的治疗可能会促进减轻有症状膝关节的负荷。本研究探讨了一种强调髋外展肌训练的下肢运动方案对膝OA患者动态膝关节负荷的生物力学影响。
6名膝关节内侧间室OA患者参与了一项概念验证研究，该研究为一项为期四周的运动计划，专门针对髋外展肌，并结合传统的股四头肌和腘绳肌训练。评估包括步态分析以测量膝关节外展力矩，这是膝关节内侧关节负荷的替代指标，以及WOMAC问卷和力量评估。
所有受试者的膝关节外展力矩均降低，运动干预后平均降低9%（p<0.05）。WOMAC膝关节疼痛评分降低了78%（p<0.05）。
这些结果表明，针对髋部而非仅针对膝关节肌肉组织，可能是一种基于生物力学的有效治疗膝内侧OA的方法。
