Department of Orthopaedic Surgery, Itami City Hospital, Itami, Japan.
Mod Rheumatol. 2013 Jul;23(4):646-52. doi: 10.1007/s10165-012-0703-0. Epub 2012 Jul 8.
The purpose of this study is to investigate the three-dimensional (3D) kinematics of preoperative osteoarthritic (OA) knees, and to clarify the validity of the findings in comparison with previous studies of kinematics in normal and OA knees.
Fifteen preoperative OA knees were scanned by 3D computed tomography (CT) at three positions. We created 3D bone models and quantitatively evaluated motion of the knee joint using a markerless volume-based registration technique. Assessment categories comprised rotation angles and anterior-posterior (AP) translation. The Pearson correlation test was used to analyze correlations between rotational angle and femorotibial angle.
From maximum extension to 90° flexion, 11 femurs displayed internal rotation relative to the tibia. In 10 knees, the sulcus moved >1 mm more backward than the lateral epicondyle. Significant differences were apparent between movement of the sulcus and lateral epicondyle. A correlation of -0.42 was found between the rotational angle and femorotibial angle.
The kinematics of OA knees differed from that of normal knees in that femurs did not present external rotation with flexion. One reason for this movement is that the medial condyle of the femur tended to move backward in knee flexion due to disruption of the tibial joint surface.
本研究旨在探讨术前骨关节炎(OA)膝关节的三维(3D)运动学,并与正常和 OA 膝关节运动学的先前研究结果进行比较,以明确这些发现的有效性。
对 15 例术前 OA 膝关节分别在三个位置进行 3D CT 扫描。我们创建了 3D 骨骼模型,并使用无标记容积配准技术定量评估膝关节运动。评估类别包括旋转角度和前后(AP)平移。采用 Pearson 相关检验分析旋转角度与股胫角之间的相关性。
从最大伸展到 90°屈曲,11 个股骨相对于胫骨呈现内旋。在 10 个膝关节中,髁间窝向后移动超过 1 毫米,超过外侧髁。髁间窝和外侧髁的运动之间存在显著差异。旋转角度与股胫角之间存在-0.42 的相关性。
OA 膝关节的运动学与正常膝关节不同,因为股骨在屈曲时没有出现外旋。这种运动的一个原因是,由于胫骨关节面的破坏,股骨内侧髁在膝关节屈曲时往往向后移动。