Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California, San Francisco, 185 Berry Street, Suite 350, San Francisco, California, CA94107.
Department of Physical Therapy, California State University, Long Beach, California.
J Orthop Res. 2019 Dec;37(12):2593-2600. doi: 10.1002/jor.24433. Epub 2019 Aug 13.
To identify the biomechanical risk factors associated with symptomatic progression at 1-year follow-up in persons with patellofemoral joint (PFJ) osteoarthritis (OA). Patients' self-reported Knee Injury and Osteoarthritis Outcome Score questionnaires, magnetic resonance (MR) imaging, and three-dimensional gait analysis were obtained in 53 subjects with PFJ OA at baseline and after 1 year. Joint OA was diagnosed on knee MR images if cartilage lesions existed. Progression was defined by worsening of patients' self-reported symptoms from baseline to 1 year exceeding the minimal detectable change score. Analysis of covariance was used to compare peak knee flexion moment, knee flexion moment impulse, and vertical ground reaction force loading rate between progressors and non-progressors. Seven (13.2%) subjects exhibited progression in self-reported symptoms at 1-year follow-up. When comparing to non-progressors, significantly higher peak knee flexion moment during first half of stance (p = 0.017) and higher moment impulse during the both halves of stance were observed among progressors (p = 0.020-0.040). Persons with symptomatic PFJ OA progression with or without concurrent tibiofemoral OA exhibited abnormal joint loading mechanics when compared with individuals who did not progress. Further work is needed to determine if modification to these loading variables results in a change in the symptomatic progression in these individuals. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2593-2600, 2019.
为了确定与髌股关节（PFJ）骨关节炎（OA）患者 1 年随访时症状进展相关的生物力学危险因素。在基线和 1 年后，对 53 例 PFJ OA 患者进行了膝关节损伤和骨关节炎结果评分问卷、磁共振成像（MR）和三维步态分析。如果存在软骨病变，则在膝关节 MR 图像上诊断为关节 OA。如果患者自报告的症状从基线到 1 年的恶化超过最小可检测变化评分，则定义为进展。使用协方差分析比较进展者和非进展者的峰值膝关节屈曲力矩、膝关节屈曲力矩脉冲和垂直地面反作用力加载率。7 名（13.2%）受试者在 1 年随访时出现自报告症状进展。与非进展者相比，进展者在站立的前半段时的峰值膝关节屈曲力矩明显更高（p=0.017），在站立的整个阶段的力矩脉冲更高（p=0.020-0.040）。与没有进展的个体相比，有或没有合并胫股关节 OA 的有症状的 PFJ OA 进展者表现出异常的关节负荷力学。需要进一步的工作来确定是否这些负荷变量的改变会导致这些个体的症状进展发生变化。2019 年 Orthopaedic Research Society。由 Wiley Periodicals，Inc. 出版。J Orthop Res 37:2593-2600，2019。
