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髌股关节骨关节炎患者与健康同龄对照者在行走时的骨盆和髋关节运动学比较。

Pelvic and Hip Kinematics During Walking in People With Patellofemoral Joint Osteoarthritis Compared to Healthy Age-Matched Controls.

机构信息

La Trobe University, Bundoora, Victoria, Australia.

University of Melbourne, Parkville, Victoria, Australia.

出版信息

Arthritis Care Res (Hoboken). 2018 Feb;70(2):309-314. doi: 10.1002/acr.23261. Epub 2017 Dec 29.

Abstract

OBJECTIVE

Patellofemoral (PF) joint osteoarthritis (OA) is common, yet little is known about how this condition influences lower-extremity biomechanical function. This study compared pelvis and lower-extremity kinematics in people with and without PF joint OA.

METHODS

Sixty-nine participants (64% women, mean ± SD age 56 ± 10 years) with anterior knee pain aggravated by PF joint-loaded activities (e.g., stair ambulation, rising from sitting, or squatting) and radiographic lateral PF joint OA on skyline radiographs were compared with 18 controls (78% women, mean ± SD age 53 ± 7 years) with no lower-extremity pain or radiographic OA. Knee Injury and Osteoarthritis Outcome Score (KOOS) data were collected from participants with PF joint OA. Quantitative gait analyses were conducted during overground walking at a self-selected speed. Pelvis and lower-extremity kinematics were calculated across the stance phase. Data were statistically analyzed using analyses of covariance, with age and sex as covariates (P < 0.05).

RESULTS

Participants with PF joint OA reported a mean ± SD KOOS pain subscale score of 65 ± 15, KOOS symptoms subscale score of 63 ± 16, KOOS activities of daily living subscale score of 73 ± 13, KOOS sports/recreation subscale score of 45 ± 23, and KOOS quality of life subscale score of 43 ± 16. Participants with PF joint OA walked with greater anterior pelvic tilt throughout the stance phase, as well as greater lateral pelvic tilt (i.e., pelvis lower on the contralateral side), greater hip adduction, and lower hip extension during the late stance phase. No differences in knee and ankle joint angles were observed between groups.

CONCLUSION

People with PF joint OA walk with altered pelvic and hip movement patterns compared with aged-matched controls. Restoring normal movement patterns during walking in people with PF joint OA may be warranted to help alleviate symptoms.

摘要

目的

髌股(PF)关节骨关节炎(OA)较为常见,但人们对于这种疾病如何影响下肢生物力学功能知之甚少。本研究比较了 PF 关节 OA 患者与无 PF 关节 OA 患者的骨盆和下肢运动学。

方法

将 69 名(64%为女性,平均年龄 56 ± 10 岁)有膝关节前侧疼痛且 PF 关节负重活动(如上下楼梯、从坐姿站起或下蹲)加重、膝关节侧位 skyline 射线照相显示外侧 PF 关节 OA 的患者与 18 名(78%为女性,平均年龄 53 ± 7 岁)无下肢疼痛或放射学 OA 的对照者进行比较。PF 关节 OA 患者收集膝关节损伤和骨关节炎结果评分(KOOS)数据。在自然步态速度下进行地面步行的定量步态分析。计算整个站立阶段的骨盆和下肢运动学。使用协方差分析,将年龄和性别作为协变量进行统计学分析(P < 0.05)。

结果

PF 关节 OA 患者的 KOOS 疼痛亚量表平均得分 ± 标准差为 65 ± 15,KOOS 症状亚量表平均得分 ± 标准差为 63 ± 16,KOOS 日常生活活动亚量表平均得分 ± 标准差为 73 ± 13,KOOS 运动/娱乐亚量表平均得分 ± 标准差为 45 ± 23,KOOS 生活质量亚量表平均得分 ± 标准差为 43 ± 16。PF 关节 OA 患者在整个站立阶段骨盆前倾角度更大,以及骨盆在对侧倾斜更大(即骨盆在对侧更低),髋关节内收更大,晚期站立阶段髋关节伸展更小。两组之间的膝关节和踝关节角度没有差异。

结论

与年龄匹配的对照组相比,PF 关节 OA 患者在行走时骨盆和髋关节运动模式发生改变。在 PF 关节 OA 患者行走时恢复正常的运动模式可能有助于缓解症状。

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