Harato Kengo, Sakurai Aiko, Kudo Yutaka, Nagura Takeo, Masumoto Ko, Otani Toshiro, Niki Yasuo
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Physical Therapy, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
Knee. 2016 Aug;23(4):622-6. doi: 10.1016/j.knee.2015.10.007. Epub 2016 Mar 12.
To date, the knee kinematics of a discoid lateral meniscus (DLM) has not been elucidated. The aim was to investigate the three-dimensional knee kinematics in knees with a DLM using gait analysis.
Ten patients (mean: 14years) diagnosed with bilateral DLM and unilaterally symptomatic snapping as well as 10 healthy controls (mean: 23years) participated in the study. Each patient with a DLM had unilaterally snapping knee in full extension and deep flexion. The three-dimensional gait analysis was performed with the point cluster technique. All subjects were asked to walk on a level floor at the speed of their choice. In the sagittal plane, knee excursion was separately evaluated during the weight acceptance phase and the mid-stance phase. In the axial plane, knee excursion during the stance phase was assessed. Finally, knee excursion during the whole gait cycle was evaluated in the frontal plane. Statistical comparison was conducted between groups, and between both sides in the DLM group.
In the sagittal plane, knee excursions during the weight acceptance phase and the mid-stance phase were significantly smaller in the DLM group than in the control group; in addition, these were smaller on the symptomatic side than on the asymptomatic side in the DLM group. In the axial plane, knee excursion was also significantly smaller on the symptomatic side than on the asymptomatic side in the DLM group, whereas the frontal knee motion did not differ significantly.
Less knee motion in the sagittal plane may prevent snapping during extension and flexion in patients with a DLM.
III.
迄今为止，盘状外侧半月板（DLM）的膝关节运动学尚未阐明。目的是通过步态分析研究患有DLM的膝关节的三维运动学。
10例（平均年龄14岁）被诊断为双侧DLM且单侧有症状性弹响的患者以及10名健康对照者（平均年龄23岁）参与了本研究。每例患有DLM的患者在完全伸展和深度屈曲时均有单侧膝关节弹响。采用点簇技术进行三维步态分析。所有受试者被要求以自己选择的速度在水平地面上行走。在矢状面，分别在负重接受阶段和站立中期评估膝关节活动度。在轴平面，评估站立阶段的膝关节活动度。最后，在额状面评估整个步态周期中的膝关节活动度。在两组之间以及DLM组的双侧之间进行统计学比较。
在矢状面，DLM组在负重接受阶段和站立中期的膝关节活动度明显小于对照组；此外，DLM组中症状侧的膝关节活动度小于无症状侧。在轴平面，DLM组中症状侧的膝关节活动度也明显小于无症状侧，而额状面的膝关节运动无明显差异。
矢状面膝关节活动度较小可能会防止DLM患者在伸展和屈曲过程中出现弹响。
III级。
