Fantini Pagani Cynthia H, Willwacher Steffen, Benker Rita, Brüggemann Gert-Peter
Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany.
Prosthet Orthot Int. 2014 Dec;38(6):481-91. doi: 10.1177/0309364613513297. Epub 2013 Dec 10.
Several conservative treatments for medial knee osteoarthritis such as knee orthosis and laterally wedged insoles have been shown to reduce the load in the medial knee compartment. However, those treatments also present limitations such as patient compliance and inconsistent results regarding the treatment success.
To analyze the effect of an ankle-foot orthosis on the knee adduction moment and knee joint alignment in the frontal plane in subjects with knee varus alignment.
Controlled laboratory study, repeated measurements.
In total, 14 healthy subjects with knee varus alignment were analyzed in five different conditions: without orthotic, with laterally wedged insoles, and with an ankle-foot orthosis in three different adjustments. Three-dimensional kinetic and kinematic data were collected during gait analysis.
Significant decreases in knee adduction moment, knee lever arm, and joint alignment in the frontal plane were observed with the ankle-foot orthosis in all three different adjustments. No significant differences could be found in any parameter while using the laterally wedged insoles.
The ankle-foot orthosis was effective in reducing the knee adduction moment. The decreases in this parameter seem to be achieved by changing the knee joint alignment and thereby reducing the knee lever arm in the frontal plane.
This study presents a novel approach for reducing the load in the medial knee compartment, which could be developed as a new treatment option for patients with medial knee osteoarthritis.
多项针对膝关节内侧骨关节炎的保守治疗方法，如膝关节矫形器和外侧楔形鞋垫，已被证明可减轻膝关节内侧间室的负荷。然而，这些治疗方法也存在局限性，如患者依从性以及治疗效果不一致等问题。
分析踝足矫形器对膝内翻患者膝关节内收力矩和额状面膝关节对线的影响。
对照实验室研究，重复测量。
总共对14名膝内翻的健康受试者在五种不同条件下进行分析：不使用矫形器、使用外侧楔形鞋垫以及使用三种不同调整方式的踝足矫形器。在步态分析过程中收集三维动力学和运动学数据。
在踝足矫形器的三种不同调整方式下，均观察到膝关节内收力矩、膝关节力臂和额状面关节对线显著降低。使用外侧楔形鞋垫时，在任何参数上均未发现显著差异。
踝足矫形器在降低膝关节内收力矩方面有效。该参数的降低似乎是通过改变膝关节对线从而减少额状面的膝关节力臂来实现的。
本研究提出了一种减轻膝关节内侧间室负荷的新方法，可作为膝关节内侧骨关节炎患者的一种新治疗选择来开发。
