Favre J, Erhart-Hledik J C, Andriacchi T P
Department of Mechanical Engineering, Stanford University, Stanford, CA, USA.
Department of Mechanical Engineering, Stanford University, Stanford, CA, USA; Palo Alto VA, Palo Alto, CA, USA.
Osteoarthritis Cartilage. 2014 Mar;22(3):464-71. doi: 10.1016/j.joca.2013.12.014. Epub 2014 Jan 18.
To compare age-related patterns of gait with patterns associated with knee osteoarthritis (OA), the following hypotheses were tested: (H1) The sagittal-plane knee function during walking is different between younger and older asymptomatic subjects; (H2) The age-related differences in H1 are increased in patients with knee OA.
Walking trials were collected for 110 participants (1.70 ± 0.09 m, 80 ± 14 kg). There were 29 younger asymptomatic subjects (29 ± 4 years) and 81 older participants (59 ± 9 years), that included 27 asymptomatic subjects and 28 and 26 patients with moderate and severe medial knee OA. Discrete variables characterizing sagittal-plane knee function were compared among the four groups using ANOVAs.
During the heel-strike portion of the gait cycle at preferred walking speed, the knee was less extended and the shank less inclined in the three older groups compared to the younger asymptomatic group. There were similar differences between the severe OA group and the older asymptomatic and moderate OA groups. Both OA groups also had the femur less posterior relative to the tibia and smaller extension moment than the younger group. During terminal stance, the severe OA group had the knee less extended and smaller knee extension moment than the younger asymptomatic and older moderate OA groups.
The differences in knee function, particularly those during heel-strike which were associated with both age and disease severity, could form a basis for looking at mechanical risk factors for initiation and progression of knee OA on a prospective basis.
为比较与年龄相关的步态模式和与膝关节骨关节炎（OA）相关的模式，对以下假设进行了检验：（H1）年轻和年长的无症状受试者在行走过程中矢状面膝关节功能不同；（H2）膝关节OA患者中，H1中与年龄相关的差异会增大。
收集了110名参与者（身高1.70±0.09米，体重80±14千克）的行走试验数据。有29名年轻无症状受试者（29±4岁）和81名年长参与者（59±9岁），其中包括27名无症状受试者以及28名和26名中度和重度膝关节内侧OA患者。使用方差分析对四组中表征矢状面膝关节功能的离散变量进行比较。
在以偏好步行速度进行的步态周期的足跟触地阶段，与年轻无症状组相比，三个年长组的膝关节伸展程度较小，小腿倾斜度较小。重度OA组与年长无症状组和中度OA组之间也存在类似差异。两个OA组的股骨相对于胫骨的后移程度也小于年轻组，伸展力矩也较小。在终末支撑期，重度OA组的膝关节伸展程度小于年轻无症状组和年长中度OA组，膝关节伸展力矩也较小。
膝关节功能的差异，尤其是足跟触地时与年龄和疾病严重程度相关的差异，可为前瞻性地研究膝关节OA发病和进展的机械危险因素奠定基础。
