Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
Osteoarthritis Cartilage. 2011 Nov;19(11):1338-42. doi: 10.1016/j.joca.2011.07.018. Epub 2011 Aug 16.
Unilateral ankle osteoarthritis (OA) is a debilitating condition which may lead to limb deformity, severe pain, and functional disability due to tibiotalar malalignment and gait dysfunction. The purpose of this study was to determine if coronal plane alignment (varus, valgus, or neutral) of the ankle resulted in different spatial-temporal gait mechanics, clinically-assessed function, and self-reported function in patients with end-stage ankle OA.
Following informed consent, 96 patients with end-stage unilateral ankle OA were radiographically categorized as having varus, valgus, or neutral tibiotalar alignment. Each subject completed the foot and ankle disability index (FADI) questionnaire to assess self-reported function. The spatial-temporal parameters of interest (stance time, step length, stride length, stride width, single-support time, double support time, and walking speed) were assessed while the subject walked at a self-selected speed.
The varus group performed the timed up and go test significantly faster than the other groups (P=0.05). All other variables were similar between the three alignment groups.
There was little difference in gait mechanics and function between patients with end-stage OA based on coronal plane ankle alignment suggesting that factors other than coronal plane alignment contribute to diminished function.
单侧踝关节骨关节炎(OA)是一种使人虚弱的疾病,由于距下关节对线不良和步态功能障碍,可能导致肢体畸形、严重疼痛和功能障碍。本研究的目的是确定踝关节冠状面对线(内翻、外翻或中立)是否会导致终末期踝关节 OA 患者的步态力学、临床评估功能和自我报告功能出现不同。
在获得知情同意后,96 例终末期单侧踝关节 OA 患者的影像学分类为内翻、外翻或中立距下关节对线。每位患者均完成足踝残疾指数(FADI)问卷以评估自我报告功能。当患者以自我选择的速度行走时,评估感兴趣的时空参数(站立时间、步长、步长、步宽、单足支撑时间、双足支撑时间和行走速度)。
与其他两组相比,内翻组的计时起立行走测试明显更快(P=0.05)。在这三组中,所有其他变量都相似。
基于冠状面踝关节对线,终末期 OA 患者的步态力学和功能差异不大,这表明除了冠状面对线外,还有其他因素导致功能下降。