Meireles S, De Groote F, Reeves N D, Verschueren S, Maganaris C, Luyten F, Jonkers I
Department of Kinesiology, KU Leuven, Belgium.
Department of Mechanical Engineering, KU Leuven, Belgium.
Gait Posture. 2016 Mar;45:115-20. doi: 10.1016/j.gaitpost.2016.01.016. Epub 2016 Jan 25.
This study calculated knee contact forces (KCF) and its relations with knee external knee adduction moments (KAM) and/or flexion moments (KFM) during the stance phase of gait in patients with early osteoarthritis (OA), classified based on early joint degeneration on Magnetic Resonance Imaging (MRI). We aimed at assessing if altered KCF are already present in early structural degeneration.
Three-dimensional motion and ground reaction force data in 59 subjects with medial compartment knee OA (N=23 established OA, N=16 early OA, N=20 controls) were used as input for a musculoskeletal model. KAM and KFM, and KCF were estimated using OpenSim software.
No significant differences were found between controls and subjects with early OA. In early OA patients, KAM significantly explained 69% of the variance associated with the first peaks KCF but only KFM contributed to the second peaks KCF. The multiple correlation, combining KAM and KFM, showed to be higher. However, only 20% of the variance of second peak KCF was explained by both moments in established OA.
KCF are not increased in patients with early OA, suggesting that knee joint overload is more a consequence of further joint degeneration in more advanced stages of OA. Additionally, our results clearly show that KAM is not sufficient to predict joint loading at the end of the stance, where KFM contributes substantially to the loading, especially in early OA.
本研究计算了早期骨关节炎(OA)患者在步态站立期的膝关节接触力(KCF)及其与膝关节外展力矩(KAM)和/或屈曲力矩(KFM)的关系,这些患者根据磁共振成像(MRI)上的早期关节退变进行分类。我们旨在评估在早期结构退变中是否已经存在KCF改变。
将59例内侧间室膝关节OA患者(n = 23例确诊OA,n = 16例早期OA,n = 20例对照)的三维运动和地面反作用力数据用作肌肉骨骼模型的输入。使用OpenSim软件估计KAM、KFM和KCF。
对照组与早期OA患者之间未发现显著差异。在早期OA患者中,KAM显著解释了与KCF第一个峰值相关的69%的方差,但只有KFM对KCF第二个峰值有贡献。结合KAM和KFM的多重相关性更高。然而,在确诊OA中,两个力矩仅解释了KCF第二个峰值20%的方差。
早期OA患者的KCF没有增加,这表明膝关节超负荷更多是OA更晚期进一步关节退变的结果。此外,我们的结果清楚地表明,KAM不足以预测站立末期的关节负荷,此时KFM对负荷有很大贡献,尤其是在早期OA中。