Gait Lab, Orthopedic Hospital for Children, Aschau i. Chiemgau, Germany.
Gait Posture. 2011 Mar;33(3):490-5. doi: 10.1016/j.gaitpost.2011.01.001. Epub 2011 Jan 26.
Three-dimensional gait analysis is a diagnostic tool that can be used to gain a better understanding of the relationship between joint loading and the onset or progression of articular cartilage degeneration in subjects with varus malalignment. The purpose of the present study was to investigate knee and hip joint angles and moments in children and adolescents with pathological varus alignment of the knee without signs of knee osteoarthritis (OA). Moreover, we wanted to know if compensatory mechanisms are present in this young patient group. Fourteen, otherwise healthy patients with varus malalignment of the knee and 15 healthy control subjects were analysed. Patients showed a reduced knee extension and a significantly lower maximum knee extension moment in terminal stance compared to controls. The maximum knee adduction moment in mid and terminal stance and the maximum hip abduction moment in loading response were significantly higher in the patient group. In the transverse plane, abnormally increased knee internal rotation and hip external rotation moments were present in patients with varus malalignment. These findings imply that varus malalignment is not an isolated problem in the frontal plane. In contrast to adult patients with established medial knee OA, the young patients assessed in the present study did not show typical compensatory mechanisms such as increased foot progression angle or reduced walking speed. This suggests that children and adolescents with varus malalignment of the knee probably do not need to alter their spatio-temporal gait parameters in order to decrease knee joint loading.
三维步态分析是一种诊断工具，可用于更好地了解关节负荷与关节软骨退变发生或进展之间的关系，尤其是在存在内翻畸形而没有骨关节炎（OA）迹象的受试者中。本研究旨在探讨膝关节病理内翻对线而无膝关节 OA 迹象的儿童和青少年的膝关节和髋关节角度和力矩。此外，我们还想知道在这个年轻的患者群体中是否存在代偿机制。分析了 14 名膝关节内翻畸形且无其他健康问题的患者和 15 名健康对照者。与对照组相比，患者在终末站立时膝关节伸展减少，最大膝关节伸展力矩明显降低。在中末期站立时膝关节内收最大力矩和负重反应时髋关节外展最大力矩，在患者组中明显更高。在横断面上，内翻畸形的患者膝关节内旋和髋关节外旋力矩异常增加。这些发现表明，内翻畸形不仅仅是额状面上的孤立问题。与已确立的内侧膝关节 OA 的成年患者不同，本研究评估的年轻患者没有表现出典型的代偿机制，例如增加的足进角或降低的步行速度。这表明，膝关节内翻畸形的儿童和青少年可能不需要改变他们的时空步态参数来减少膝关节负荷。
