Hall Michelle, Nielsen Jonas Høberg, Holsgaard-Larsen Anders, Nielsen Dennis Brandborg, Creaby Mark W, Thorlund Jonas Bloch
The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Melbourne, Australia.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Knee. 2015 Dec;22(6):506-9. doi: 10.1016/j.knee.2015.03.005. Epub 2015 Apr 20.
Patients following meniscectomy are at increased risk of developing knee osteoarthritis in the tibiofemoral compartment and at the patellofemoral joint. As osteoarthritis is widely considered a mechanical disease, it is important to understand the potential effect of arthroscopic partial meniscectomy (APM) on knee joint mechanics. The purpose of this study was to evaluate changes in knee joint biomechanics during a forward lunge in patients with a suspected degenerative meniscal tear from before to three months after APM.
Twenty-two patients (35-55 years old) with a suspected degenerative medial meniscal tear participated in this study. Three dimensional knee biomechanics were assessed on the injured and contralateral leg before and three months after APM. The visual analogue scale was used to assess knee pain and the Knee Injury Osteoarthritis Outcome Score was used to assess sport/recreation function and knee-related confidence before and after APM.
The external peak knee flexion moment reduced in the APM leg compared to the contralateral leg (mean difference (95% CI)) -1.08 (-1.80 to -0.35) (Nm/(BW × HT)%), p = 0.004. Peak knee flexion angle also reduced in the APM leg compared to the contralateral leg -3.94 (-6.27 to -1.60) degrees, p = 0.001. There was no change in knee pain between the APM leg and contralateral leg (p=0.118). Self-reported sport/recreation function improved (p = 0.004).
Although patients self-reported less difficulty during strenuous tasks following APM, patients used less knee flexion, a strategy that may limit excessive patellar loads during forward lunge in the recently operated leg.
半月板切除术后的患者在胫股关节和髌股关节发生膝关节骨关节炎的风险增加。由于骨关节炎被广泛认为是一种机械性疾病，因此了解关节镜下部分半月板切除术（APM）对膝关节力学的潜在影响非常重要。本研究的目的是评估疑似退变半月板撕裂患者在APM术前至术后三个月的前弓步过程中膝关节生物力学的变化。
22例（35 - 55岁）疑似内侧半月板退变撕裂的患者参与了本研究。在APM术前和术后三个月对患侧和对侧下肢进行三维膝关节生物力学评估。采用视觉模拟量表评估膝关节疼痛，并使用膝关节损伤骨关节炎结局评分评估APM术前和术后的运动/娱乐功能以及与膝关节相关的信心。
与对侧下肢相比，APM侧下肢的膝关节外侧峰值屈曲力矩降低（平均差异（95%CI））-1.08（-1.80至-0.35）（Nm/(BW×HT)%），p = 0.004。与对侧下肢相比，APM侧下肢的膝关节峰值屈曲角度也降低了-3.94（-6.27至-1.60）度，p = 0.001。APM侧下肢与对侧下肢之间的膝关节疼痛无变化（p = 0.118）。自我报告的运动/娱乐功能有所改善（p = 0.004）。
尽管患者自我报告在APM术后进行剧烈任务时困难减少，但患者使用的膝关节屈曲较少，这是一种可能在最近手术侧的前弓步过程中限制髌股关节过度负荷的策略。
