Kuroyanagi Yuji, Nagura Takeo, Kiriyama Yoshimori, Matsumoto Hideo, Otani Toshiro, Toyama Yoshiaki, Suda Yasunori
Department of Orthopedic Surgery, Keio University, Tokyo, Japan.
Knee. 2012 Mar;19(2):130-4. doi: 10.1016/j.knee.2010.12.007. Epub 2011 Feb 5.
Varus thrust is an abnormal lateral knee motion frequently seen in patients with medial knee osteoarthritis (OA) during gait. It is a worsening of the alignment in the stance phase of the gait cycle and closely relates to disease progression. In this study, we measured the thrust quantitatively using skin markers and examined the relationship to other static and dynamic parameters. Forty-four knees in 32 patients (mean age, 72years; range, 64-81years) who exhibited the radiographic OA at least grade 2 according to the Kellgren-Lawrence (K-L) scale were enrolled. Gait analysis was performed for each patient to measure the amount of thrust and knee adduction moment. The amounts of thrust in subjects with K-L grades 2 (25 knees), 3 (13 knees), and 4 (6 knees) were 2.4°(±1.3°), 2.8°(±1.4°), and 7.2°(±5.3°), respectively and the knee adduction moments were 3.6(±1.5) %BW⁎Ht, 3.9(±1.2) %BW⁎Ht and 6.9(±2.2%) BW⁎Ht, respectively. The amount of thrust also exhibited significant correlation to static radiographic alignment (R=0.47: 95% confidence interval 0.67-0.21, p=0.0038) and showed greater correlation to the knee adduction moment (R=0.73: 95% confidence interval 0.84-0.55, p<0.001), which has been identified as an important dynamic index of the disease. The amount of thrust, which is able to be measured by simple inexpensive equipment, correlated to static and dynamic parameters and may offer an important clinical index for knee OA.
内翻推力是膝内翻骨关节炎（OA）患者在步态中常见的一种异常的膝关节向外运动。它是步态周期站立期对线的恶化，与疾病进展密切相关。在本研究中，我们使用皮肤标记物对推力进行了定量测量，并研究了其与其他静态和动态参数的关系。纳入了32例患者（平均年龄72岁；范围64 - 81岁）的44个膝关节，这些膝关节根据Kellgren - Lawrence（K - L）分级标准至少有2级的影像学OA表现。对每位患者进行步态分析，以测量推力和膝关节内收力矩的大小。K - L 2级（25个膝关节）、3级（13个膝关节）和4级（6个膝关节）受试者的推力大小分别为2.4°（±1.3°）、2.8°（±1.4°）和7.2°（±5.3°），膝关节内收力矩分别为3.6（±1.5）%BW⁎Ht、3.9（±1.2）%BW⁎Ht和6.9（±2.2%）BW⁎Ht。推力大小与静态影像学对线也存在显著相关性（R = 0.47：95%置信区间0.67 - 0.21，p = 0.0038），并且与膝关节内收力矩的相关性更强（R = 0.73：95%置信区间0.84 - 0.55，p < 0.001），膝关节内收力矩已被确定为该疾病的一个重要动态指标。能够通过简单廉价的设备测量的推力大小与静态和动态参数相关，可能为膝骨关节炎提供一个重要的临床指标。
