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早期症状性髋和/或膝骨关节炎患者关节活动范围的决定因素:CHECK 队列中的一项探索性研究。

Determinants of range of joint motion in patients with early symptomatic osteoarthritis of the hip and/or knee: an exploratory study in the CHECK cohort.

机构信息

Department of Rehabilitation Research, Reade, Centre for Rehabilitation and Rheumatology (formerly Jan van Breemen Institute), Amsterdam, The Netherlands.

出版信息

Osteoarthritis Cartilage. 2011 Apr;19(4):411-9. doi: 10.1016/j.joca.2011.01.013. Epub 2011 Jan 25.

Abstract

OBJECTIVE

Reduced range of motion (ROM) is supposed to be a characteristic feature of osteoarthritis (OA). Because little is known about determinants of ROM, the objective of the present study was to explore the association between demographic, articular, and clinical factors and ROM in patients with early symptomatic knee and/or hip OA.

DESIGN

Baseline data of 598 participants of the Cohort Hip and Cohort Knee (CHECK) study were used in this cross-sectional study.

METHODS

Separate analyses were performed for participants with knee and participants with hip symptoms. Active knee flexion, and hip internal rotation, external rotation, flexion, adduction, and abduction were assessed using a goniometer. Participants underwent a standardised physical and radiographic examination, and completed a questionnaire. Exploratory regression analyses were performed to explore the association between ROM and demographic [i.e., age, gender, body mass index (BMI)], articular [i.e., osteophytosis, joint space narrowing (JSN)], and clinical (i.e., pain, stiffness) factors.

RESULTS

In patients with early symptomatic knee OA, osteophytosis, bony enlargement, crepitus, pain, and higher BMI were associated with lower knee flexion. JSN was associated with lower ROM in all planes of motion. In addition, osteophytosis, flattening of the femoral head, femoral buttressing, pain, morning stiffness, male gender, and higher BMI were found to be associated with lower hip ROM in two planes of motion.

CONCLUSION

Features of articular degeneration are associated with lower knee ROM and lower hip ROM in patients with early OA. Pain, stiffness, higher BMI, and male gender are associated with lower ROM as well.

摘要

目的

活动度(ROM)降低被认为是骨关节炎(OA)的特征性表现。由于 ROM 的决定因素知之甚少,本研究的目的是探讨在早期有症状的膝和/或髋 OA 患者中,人口统计学、关节和临床因素与 ROM 之间的关系。

设计

本横断面研究使用了 Cohort Hip 和 Cohort Knee(CHECK)研究的 598 名参与者的基线数据。

方法

对有膝关节症状和髋关节症状的参与者分别进行分析。使用量角器评估主动膝关节屈曲以及髋关节内旋、外旋、屈曲、内收和外展。参与者接受了标准的体格检查和影像学检查,并完成了问卷调查。进行探索性回归分析,以探讨 ROM 与人口统计学因素(即年龄、性别、体重指数(BMI))、关节因素(即骨赘、关节间隙变窄(JSN))和临床因素(即疼痛、僵硬)之间的关系。

结果

在早期有症状的膝 OA 患者中,骨赘、骨增大、弹响、疼痛和较高的 BMI 与膝关节屈曲度降低有关。JSN 与所有运动平面的 ROM 降低有关。此外,在两个运动平面中,骨赘、股骨头变平、股骨支撑、疼痛、晨僵、男性和较高的 BMI 与髋关节 ROM 降低有关。

结论

关节退变的特征与早期 OA 患者的膝关节 ROM 和髋关节 ROM 降低有关。疼痛、僵硬、较高的 BMI 和男性也是与 ROM 降低相关的因素。

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