Fukaya Takashi, Mutsuzaki Hirotaka, Wadano Yasuyoshi
Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Ibaraki, Japan.
Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan.
Knee. 2015 Jun;22(3):213-6. doi: 10.1016/j.knee.2015.02.012. Epub 2015 Mar 18.
The purposes of this study were to understand the kinematics changes in the frontal and horizontal planes with severe medial knee OA at the stance phase and to examine the relationship between varus and rotational movements.
The OA group comprised 18 knees in 12 subjects (five men, seven women) with a Kellgren-Lawrence grade of three or four in at least one knee. From the results of gait analysis, we calculated Spearman rank-correlation coefficients for the following items: varus angle at initial contact (IC); varus angle at loading response (LR); amount of varus thrust from IC to LR; rotational angle at IC; rotational angle at LR and amount of rotational angle change from IC to LR.
The results indicated that, as the external rotation angle at IC and internal rotational movement from IC to LR increased, the maximum varus angle to LR showed a tendency to become large. In addition, varus thrust showed a tendency to become larger as the external rotation angles increased at IC and LR. The subjects with severe knee OA showed a strong correlation between the knee varus angle at IC and at LR. Furthermore, an increase in movement to internal rotation of the knee during the initial stance phase increased the knee varus angle at LR.
The control of the rotational movement according to the extent of varus thrust during the initial stance phase may have possible effects to decrease the load on the medial compartment of the knee.
本研究的目的是了解重度膝关节内侧骨关节炎患者在站立期额状面和水平面的运动学变化，并研究内翻与旋转运动之间的关系。
骨关节炎组包括12名受试者的18个膝关节（5名男性，7名女性），至少一个膝关节的Kellgren-Lawrence分级为三级或四级。根据步态分析结果，我们计算了以下各项的Spearman等级相关系数：初始接触（IC）时的内翻角度；负荷反应（LR）时的内翻角度；从IC到LR的内翻推力大小；IC时的旋转角度；LR时的旋转角度以及从IC到LR的旋转角度变化量。
结果表明，随着IC时的外旋角度以及从IC到LR的内旋运动增加，到LR时的最大内翻角度呈增大趋势。此外，随着IC和LR时的外旋角度增加，内翻推力呈增大趋势。重度膝关节骨关节炎患者在IC和LR时的膝关节内翻角度之间显示出强相关性。此外，初始站立期膝关节内旋运动的增加会使LR时的膝关节内翻角度增大。
在初始站立期根据内翻推力的程度控制旋转运动可能对减轻膝关节内侧间室的负荷有潜在作用。
