Ro Du Hyun, Lee Joonhee, Lee Jangyun, Park Jae-Young, Han Hyuk-Soo, Lee Myung Chul
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Adv Orthop. 2019 Mar 24;2019:9757369. doi: 10.1155/2019/9757369. eCollection 2019.
Knee osteoarthritis (OA) can affect the hip and ankle joints, as these three joints operate as a kinetic/kinematic chain while walking.
This study was performed to compare (1) hip and ankle joint gait mechanics between knee OA and control groups and (2) to investigate the effects of knee gait mechanics on the ipsilateral hip and ankle joint.
The study group included 89 patients with end-stage knee OA and 42 age- and sex-matched controls without knee pain or OA. Kinetic and kinematic parameters were evaluated using a commercial optoelectric gait analysis system. Range of motion (ROM) during gait, coronal motion arc, and peak joint moment of hip, knee, and ankle joints were investigated.
Ankle varus moment was 50% higher in the OA group (p=0.005) and was associated with higher knee adduction moment (p<0.001). The ROM of the hip and ankle joints were significantly smaller in the OA group and were associated with limited ROM of the knee joint (both p<0.001). The coronal motion arc of the hip was smaller in the OA group and was also associated with limited motion arc of the knee (p<0.001).
Knee OA has a negative effect on the ROM, coronal motion arc, and joint moment of the ankle joint and hip joint. As knee OA is associated with increased moment of the ankle joint, attention should be paid to the ankle joint when treating patients with knee OA.
膝关节骨关节炎(OA)会影响髋关节和踝关节,因为这三个关节在行走时作为一个动力/运动链发挥作用。
本研究旨在比较(1)膝关节OA组和对照组之间的髋关节和踝关节步态力学,以及(2)研究膝关节步态力学对同侧髋关节和踝关节的影响。
研究组包括89例终末期膝关节OA患者和42例年龄及性别匹配、无膝关节疼痛或OA的对照组。使用商用光电步态分析系统评估动力学和运动学参数。研究了步态期间的运动范围(ROM)、冠状面运动弧以及髋关节、膝关节和踝关节的峰值关节力矩。
OA组的踝关节内翻力矩高50%(p=0.005),且与较高的膝关节内收力矩相关(p<0.001)。OA组髋关节和踝关节的ROM明显较小,且与膝关节ROM受限相关(均p<0.001)。OA组髋关节的冠状面运动弧较小,也与膝关节运动弧受限相关(p<0.001)。
膝关节OA对踝关节和髋关节的ROM、冠状面运动弧和关节力矩有负面影响。由于膝关节OA与踝关节力矩增加有关,在治疗膝关节OA患者时应关注踝关节。