Paracelsus Medical University, Institute of Anatomy Salzburg & Nuremberg, Salzburg, Austria; La Trobe University, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Bundoora, Australia; Australian Hip and Knee Institute, Melbourne, Australia.
The University of Melbourne, Department of Physiotherapy, School of Medicine, Dentistry and Health Sciences, Parkville, Australia.
Osteoarthritis Cartilage. 2016 Sep;24(9):1548-53. doi: 10.1016/j.joca.2016.05.010. Epub 2016 May 14.
Patellofemoral osteoarthritis (PFOA) commonly occurs following anterior cruciate ligament reconstruction (ACLR). Our study aimed to compare knee kinematics and kinetics during a hop-landing task between individuals with and without early PFOA post-ACLR.
Forty-five individuals (mean ± SD 26 ± 5 years) 1-2 years post-ACLR underwent 3T isotropic MRI scans and 3D biomechanical assessment of a standardised forward hop task. Knee kinematics (initial contact, peak, excursion) in all three planes and sagittal plane kinetics (peak) were compared between 15 participants with early PFOA (MRI-defined patellofemoral cartilage lesion) and 30 participants with no PFOA (absence of patellofemoral cartilage lesion on MRI) using analysis of covariance (ANCOVA), adjusted for age, BMI, sex and the presence of early tibiofemoral OA.
Compared to participants without PFOA, those with early PFOA exhibited smaller peak knee flexion angles (mean difference, 95% confidence interval [CI]: -5.2°, -9.9 to -0.4; P = 0.035) and moments (-4.2 Nm/kg.m, -7.8 to -0.6; P = 0.024), and greater knee internal rotation excursion (5.3°, 2.0 to 8.6; P = 0.002).
Individuals with early PFOA within the first 2-years following ACLR exhibit distinct kinematic and kinetic features during a high-load landing task. These findings provide new information regarding common post-ACLR biomechanical patterns and PFOA. Since management strategies, such as altering knee load, are more effective during the early stages of disease, this knowledge will help to inform clinical management of early PFOA post-ACLR.
髌股关节炎（PFOA）在膝关节前交叉韧带重建（ACLR）后很常见。我们的研究旨在比较 ACLR 后 1-2 年早期 PFOA 患者和无 PFOA 患者在跳跃着陆任务中的膝关节运动学和动力学。
45 名个体（平均年龄 ± 标准差 26 ± 5 岁）在 ACLR 后 1-2 年接受了 3T 各向同性 MRI 扫描和标准前向跳跃任务的 3D 生物力学评估。使用协方差分析（ANCOVA）比较了 15 名早期 PFOA 患者（MRI 定义的髌股软骨病变）和 30 名无 PFOA 患者（MRI 上无髌股软骨病变）在所有三个平面上的膝关节运动学（初始接触、峰值、偏移）和矢状面动力学（峰值），调整了年龄、BMI、性别和早期胫股关节炎的存在。
与无 PFOA 的参与者相比，早期 PFOA 患者的膝关节最大屈曲角度较小（平均差异，95%置信区间[CI]：-5.2°，-9.9 至-0.4；P=0.035）和力矩较小（-4.2 Nm/kg.m，-7.8 至-0.6；P=0.024），膝关节内旋偏移较大（5.3°，2.0 至 8.6；P=0.002）。
ACLR 后 2 年内出现早期 PFOA 的患者在高负荷着陆任务中表现出明显的运动学和动力学特征。这些发现为常见的 ACLR 后生物力学模式和 PFOA 提供了新的信息。由于管理策略，如改变膝关节负荷，在疾病的早期阶段更有效，因此这些知识将有助于为 ACLR 后早期 PFOA 的临床管理提供信息。
