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髌股关节骨关节炎患者上楼梯时的髌股关节负荷

Patellofemoral joint loading during stair ambulation in people with patellofemoral osteoarthritis.

作者信息

Fok Laurence A, Schache Anthony G, Crossley Kay M, Lin Yi-Chung, Pandy Marcus G

机构信息

University of Melbourne, Parkville, Victoria, Australia.

出版信息

Arthritis Rheum. 2013 Aug;65(8):2059-69. doi: 10.1002/art.38025.

DOI:10.1002/art.38025
PMID:23740512
Abstract

OBJECTIVE

To determine whether people with patellofemoral (PF) joint osteoarthritis (OA) ascend and descend stairs with different PF joint loading, knee joint moments, lower limb kinematics, and muscle forces compared to healthy people.

METHODS

We recruited 17 participants with isolated PF joint OA, 13 participants with concurrent PF joint OA and tibiofemoral (TF) joint OA, and 21 age-matched controls. Joint kinematics and ground reaction forces were measured while participants ascended and descended stairs at a self-selected speed. Musculoskeletal computer modeling was used to determine lower limb muscle forces and the PF joint reaction force, and these parameters were compared between groups by analysis of variance.

RESULTS

Compared to their healthy counterparts, participants with isolated PF joint OA and participants with concurrent PF and TF joint OA ascended and descended stairs with lower knee extension moments, lower quadriceps muscle forces, lower PF joint reaction forces, and increased anterior pelvic tilt. Participants with OA also ascended stairs with increased hip flexion angles and descended stairs with smaller knee flexion angles and smaller hip abductor muscle forces. No differences were evident between the two groups with OA.

CONCLUSION

Compared to their healthy counterparts, people with PF joint OA (with or without concurrent TF joint OA) exhibit lower PF joint reaction forces during stair ascent and descent, in conjunction with lower knee extension moments and lower quadriceps muscle forces.

摘要

目的

确定与健康人相比,髌股(PF)关节骨关节炎(OA)患者在上下楼梯时是否具有不同的PF关节负荷、膝关节力矩、下肢运动学和肌肉力量。

方法

我们招募了17名单纯PF关节OA患者、13名同时患有PF关节OA和胫股(TF)关节OA的患者以及21名年龄匹配的对照者。在参与者以自选速度上下楼梯时测量关节运动学和地面反作用力。使用肌肉骨骼计算机模型来确定下肢肌肉力量和PF关节反作用力,并通过方差分析比较组间这些参数。

结果

与健康对照者相比,单纯PF关节OA患者以及同时患有PF和TF关节OA的患者在上下楼梯时膝关节伸展力矩更小、股四头肌力量更小、PF关节反作用力更小,且骨盆前倾增加。OA患者上楼梯时髋关节屈曲角度增加,下楼梯时膝关节屈曲角度更小且髋外展肌力量更小。两组OA患者之间无明显差异。

结论

与健康对照者相比,PF关节OA患者(无论是否同时患有TF关节OA)在上下楼梯时PF关节反作用力更低,同时膝关节伸展力矩和股四头肌力量也更低。

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