Barrios Joaquin A, Strotman Danielle E
Department of Physical Therapy, University of Dayton, Dayton, OH.
J Appl Biomech. 2014 Oct;30(5):632-6. doi: 10.1123/jab.2014-0039. Epub 2014 Jul 9.
The prevalence of medial knee osteoarthritis is greater in females and is associated with varus knee alignment. During gait, medial knee osteoarthritis has been linked to numerous alterations. Interestingly, there has been no research exploring sex differences during walking in healthy individuals with and without varus alignment. Therefore, the gait mechanics of 30 asymptomatic individuals with varus knees (15 females) and 30 normally-aligned controls (15 females) were recorded. Gait parameters associated with medial knee osteoarthritis were analyzed with two-factor analyses of variance. In result, varus males exhibited the greatest peak knee adduction moments, while normal females showed the greatest peak hip adduction angles and pelvic drop excursions. By sex, females exhibited greater peak hip adduction angles and moments and greater pelvic drop excursion, but lesser peak knee adduction angles. By alignment type, varus subjects exhibited greater peak knee adduction angles and moments, midstance knee flexion angles and excursion, and eversion angles and lateral ground reaction forces, but lesser peak hip adduction angles. In conclusion, females generally presented with proximal mechanics related to greater hip adduction, whereas males presented with more knee adduction. Varus subjects demonstrated a number of alterations associated with medial knee osteoarthritis. The differential sex effects were far less conclusive.
内侧膝关节骨关节炎在女性中的患病率更高,且与膝内翻有关。在步态过程中,内侧膝关节骨关节炎与多种改变有关。有趣的是,尚未有研究探讨有无膝内翻的健康个体在行走过程中的性别差异。因此,记录了30名膝内翻无症状个体(15名女性)和30名正常对线对照者(15名女性)的步态力学数据。采用双因素方差分析对与内侧膝关节骨关节炎相关的步态参数进行分析。结果显示,膝内翻男性表现出最大的膝关节内收峰值力矩,而正常女性表现出最大的髋关节内收峰值角度和骨盆下降幅度。按性别划分,女性表现出更大的髋关节内收峰值角度和力矩以及更大的骨盆下降幅度,但膝关节内收峰值角度较小。按对线类型划分,膝内翻受试者表现出更大的膝关节内收峰值角度和力矩、站立中期膝关节屈曲角度和幅度、外翻角度以及外侧地面反作用力,但髋关节内收峰值角度较小。总之,女性通常表现出与更大髋关节内收相关的近端力学特征,而男性则表现出更多的膝关节内收。膝内翻受试者表现出一些与内侧膝关节骨关节炎相关的改变。性别差异的影响远没有那么确凿。