Pfeiffer Steven J, Valentine Joshua A, Goodwin Johnathan S, Nissman Daniel B, Blackburn Troy, Pietrosimone Brian
Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
Knee. 2019 Oct;26(5):1067-1072. doi: 10.1016/j.knee.2019.06.014. Epub 2019 Jul 21.
Knee varus alignment may increase loading in the medial tibiofemoral compartment, which can increase strain on the articular cartilage. Knee valgus unloader braces seek to reduce loading through the medial femoral compartment, but their effects on cartilage characteristics during dynamic tasks have not been evaluated.
To determine the effects of a knee valgus unloader brace on medial femoral articular cartilage deformation following a single 5000-step walking protocol in individuals with varus-knee alignment.
Twenty-four healthy individuals (63% female, BMI = 22 ± 3 kg/m, age = 21 ± 3 years) completed two testing sessions (braced and unbraced) separated by one week. During both sessions, femoral cartilage ultrasound images were acquired prior to and following a 5000-step treadmill walking protocol at self-selected speed. Percent change scores in medial cartilage cross-sectional area (MCCA) were calculated and used as the primary outcome, and compared between the braced and unbraced conditions.
There was no difference in percent change of MCCA between conditions (braced = -2.77%, unbraced = -3.15%, p = 0.699). Individuals whose cartilage deformed more than a previously established minimal detectable change (MDC ≥ 1.58 mm) deformed less during the braced condition (braced = -2.94%, unbraced = -6.34%, p = 0.028), compared to individuals who did not deform greater than the MDC (n = 15, braced = -2.67%, unbraced = -1.23%, p = 0.210).
There was no significant difference in MCCA percent change between the braced and unbraced conditions across the entire cohort; yet a valgus unloader braces may serve as a potential intervention strategy for reducing articular cartilage deformation in certain varus-aligned individuals who normally undergo measurable deformation during walking.
膝内翻对线可能会增加胫股内侧间室的负荷，从而增加关节软骨的应变。膝外翻卸载支具旨在减轻通过股内侧间室的负荷，但它们在动态任务中对软骨特性的影响尚未得到评估。
确定膝外翻卸载支具对膝内翻对线个体单次5000步步行方案后股内侧关节软骨变形的影响。
24名健康个体（63%为女性，体重指数=22±3kg/m，年龄=21±3岁）完成了两次测试，间隔一周（佩戴支具和不佩戴支具）。在两次测试中，在以自选速度进行5000步跑步机步行方案之前和之后采集股骨软骨超声图像。计算内侧软骨横截面积（MCCA）的百分比变化分数并将其用作主要结果，并在佩戴支具和不佩戴支具的情况下进行比较。
两种情况下MCCA的百分比变化没有差异（佩戴支具=-2.77%，不佩戴支具=-3.15%，p=0.699）。与软骨变形未超过先前确定的最小可检测变化（MDC≥1.58mm）的个体相比，软骨变形超过MDC的个体在佩戴支具时变形较小（佩戴支具=-2.94%，不佩戴支具=-6.34%，p=0.028）（n=15，佩戴支具=-2.67%，不佩戴支具=-1.23%，p=0.210）。
在整个队列中，佩戴支具和不佩戴支具的情况下MCCA百分比变化没有显著差异；然而，外翻卸载支具可能是一种潜在的干预策略，用于减少某些膝内翻个体在行走过程中通常会发生可测量变形的关节软骨变形。
