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外侧楔形物改变肥胖个体膝关节的内外侧负荷分布。

Lateral wedges alter mediolateral load distributions at the knee joint in obese individuals.

机构信息

Biomechanics Laboratory, Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, USA.

出版信息

J Orthop Res. 2013 May;31(5):665-71. doi: 10.1002/jor.22248. Epub 2012 Dec 13.

DOI:10.1002/jor.22248
PMID:23239489
Abstract

Obesity is the primary risk factor for knee osteoarthritis (OA). Greater external knee adduction moments, surrogate measures for medial compartment loading, are present in Obese individuals and may predispose them to knee OA. Laterally wedged insoles decrease the magnitude of the external adduction moment in Obese individuals but it is unknown how they alter the center of pressure on the tibial plateau. A gait analysis was performed on 14 Obese (avg. 29.3 years; BMI range: 30.3-51.6 kg/m(2) ) and 14 lean women (avg. 26.1 years; BMI range: 20.9-24.6 kg/m(2) ) with and without a full-length, wedged insole. Computed joint angles, joint moments, and knee extensor strength values were input into a musculoskeletal model to estimate center of pressure of the contact force on the tibial plateau. Statistical significance was assessed using a two-way ANOVA to compare the main effects of group and insole condition (α = 0.05). The insole resulted in a significant (p < 0.01) lateral shift in the center of pressure location in both the Obese and Control groups (mean: 2.9 ± 0.7 and 1.5 ± 0.7 mm, respectively). The insole also significantly reduced the peak external knee adduction moment 1.88 ± 1.82 N m in the Control group (p < 0.01) and 3.62 ± 3.90 N m in the Obese group (p < 0.01). The results of this study indicate the effects of a prophylactic wedged insole for reducing the magnitude of the load on the knee's medial compartment in Obese women who are at risk for knee OA development.

摘要

肥胖是膝关节骨关节炎(OA)的主要危险因素。肥胖个体存在较大的膝关节外展力矩,这是内侧间室负荷的替代测量指标,可能使他们易患膝 OA。外侧楔形鞋垫可减小肥胖个体的外展力矩,但尚不清楚它们如何改变胫骨平台上的压力中心。对 14 名肥胖(平均 29.3 岁;BMI 范围:30.3-51.6kg/m2)和 14 名瘦(平均 26.1 岁;BMI 范围:20.9-24.6kg/m2)女性进行了步态分析,分析时她们穿着全长楔形鞋垫和不穿楔形鞋垫两种情况。将计算得到的关节角度、关节力矩和膝关节伸肌力量值输入到肌肉骨骼模型中,以估计胫骨平台上接触力的压力中心。使用双因素方差分析比较组和鞋垫条件的主要影响(α=0.05)来评估统计学意义。鞋垫在肥胖组和对照组中均导致压力中心位置发生显著(p<0.01)的外侧移位(平均值分别为 2.9±0.7 和 1.5±0.7mm)。鞋垫还显著降低了对照组(p<0.01)和肥胖组(p<0.01)的峰值膝关节外展力矩,分别为 1.88±1.82N·m 和 3.62±3.90N·m。本研究结果表明,预防性楔形鞋垫可降低有膝关节 OA 发展风险的肥胖女性膝关节内侧间室负荷的大小。

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