Ishii Yosuke, Ishikawa Masakazu, Kurumadani Hiroshi, Hayashi Seiju, Nakamae Atsuo, Nakasa Tomoyuki, Sumida Yoshikazu, Tsuyuguchi Yusuke, Kanemitsu Munekazu, Deie Masataka, Adachi Nobuo, Sunagawa Toru
Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Orthopedic Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
J Orthop Sci. 2020 Jul;25(4):640-646. doi: 10.1016/j.jos.2019.07.003. Epub 2019 Jul 23.
Lateral thrust is known to be risk factors for knee osteoarthritis progression. Medial meniscus extrusion is also known to be risk factors for knee osteoarthritis progression; moreover, the amount of change in medial meniscus extrusion from non-weight bearing to weight bearing is an important factor for the progression of knee osteoarthritis. This study aimed to investigate the correlation between lateral thrust and the change in medial meniscus extrusion.
In total, 44 knees from 44 patients (mean age, 68.9 years) with knee osteoarthritis were divided into two groups according to the Kellgren-Lawrence grade: early-stage osteoarthritis (Kellgren-Lawrence = 2) and severe osteoarthritis (Kellgren-Lawrence = 3 or 4). The lateral thrust during gait, represented as the lateral acceleration peak immediately after heel strike, was recorded by an inertial sensor. The amount of change in medial meniscus extrusion, which was the difference between weight-bearing (unipedal standing) and non-weight-bearing (supine) conditions, was evaluated using ultrasonography.
The mean value of the lateral acceleration peak in the severe osteoarthritis group was higher than that of the early-stage osteoarthritis group (p < 0.05). The non-weight-bearing and weight-bearing medial meniscus extrusion in the severe OA group were significantly higher than those of the early-stage osteoarthritis group (p < 0.001). However, the amount of change in medial meniscus extrusion in severe osteoarthritis group was significantly lower than in the early-stage osteoarthritis group (p < 0.05). The amount of change in medial meniscus extrusion showed a significant correlation with the lateral acceleration peak in the early-stage osteoarthritis group (r = 0.56, p < 0.001). On the other hand, there was no significant correlation in the severe osteoarthritis group.
The lateral thrust shows a positive correlation with the amount of change in medial meniscus extrusion by weight bearing in patients with early-stage knee osteoarthritis.
已知侧向推力是膝关节骨关节炎进展的危险因素。内侧半月板挤压也是膝关节骨关节炎进展的危险因素；此外，内侧半月板从非负重到负重时挤压的变化量是膝关节骨关节炎进展的一个重要因素。本研究旨在探讨侧向推力与内侧半月板挤压变化之间的相关性。
将44例膝关节骨关节炎患者（平均年龄68.9岁）的44个膝关节根据凯尔格伦-劳伦斯分级分为两组：早期骨关节炎（凯尔格伦-劳伦斯分级=2级）和重度骨关节炎（凯尔格伦-劳伦斯分级=3级或4级）。通过惯性传感器记录步态期间的侧向推力，以足跟触地后立即出现的侧向加速度峰值表示。使用超声评估内侧半月板挤压的变化量，即负重（单腿站立）和非负重（仰卧）状态之间的差异。
重度骨关节炎组的侧向加速度峰值平均值高于早期骨关节炎组（p<0.05）。重度骨关节炎组的非负重和负重内侧半月板挤压明显高于早期骨关节炎组（p<0.001）。然而，重度骨关节炎组内侧半月板挤压的变化量明显低于早期骨关节炎组（p<0.05）。早期骨关节炎组内侧半月板挤压的变化量与侧向加速度峰值呈显著相关性（r=0.56，p<0.001）。另一方面，重度骨关节炎组无显著相关性。
在早期膝关节骨关节炎患者中，侧向推力与负重引起的内侧半月板挤压变化量呈正相关。
