Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan.
Knee Surg Sports Traumatol Arthrosc. 2022 Feb;30(2):574-583. doi: 10.1007/s00167-020-06323-8. Epub 2020 Oct 16.
Whether the inclined articular surface on the medial proximal tibia and the external knee adduction moment (KAM) correlate remains unclear. The hypothesis was that a steeper inclined articular surface correlated with a larger KAM in advanced knee osteoarthritis (OA).
A total of 44 females (non-OA, 9 knees; early OA, 14 knees; advanced OA, 21 knees; mean age, 58 ± 16 years) were examined. Three-dimensional (3D) assessment was used on biplanar long-leg radiographs and 3D bone models using a 3D to 2D image registration technique. The approximation plane in the proximal tibia was determined using the least-square method. The joint moments were mathematically calculated in a gait analysis, applying a motion capture system and force plates. The main evaluation parameters were the femorotibial angle (FTA), the coronal inclination of the approximation plane in the medial proximal tibia (coronal inclination), and internal knee joint moments. The KAM means the external moments balanced with the internal knee abduction moments.
The advanced OA showed a larger internal abduction moment (p = 0.017) at the loading response than the other groups. The larger FTA and steeper coronal inclination correlated with the larger internal abduction moment (FTA, p < 0.001; coronal inclination, p = 0.003) at the loading response.
As the clinical relevance, the association among the coronal inclination of the medial proximal tibia, lower extremity alignment, and KAM is one of the key factors to help better understand the etiology of knee OA.
III.
内侧胫骨近端的倾斜关节面与膝关节外展力矩（KAM）之间是否存在相关性尚不清楚。本研究假设在膝关节进展性骨关节炎（OA）中，较陡的倾斜关节面与较大的 KAM 相关。
共纳入 44 名女性（非 OA，9 膝；早期 OA，14 膝；进展性 OA，21 膝；平均年龄 58±16 岁）进行检查。在双平面长骨 X 线片和使用三维到二维图像配准技术的三维骨模型上进行三维（3D）评估。使用最小二乘法确定胫骨近端的近似平面。在步态分析中，应用运动捕捉系统和测力板对关节力矩进行数学计算。主要评估参数为股胫角（FTA）、内侧胫骨近端近似平面的冠状倾斜（冠状倾斜）和膝关节内力矩。KAM 是指与膝关节内展力矩平衡的外部力矩。
进展性 OA 在负荷反应期的内收力矩（p=0.017）大于其他两组。较大的 FTA 和较陡的冠状倾斜与较大的内收力矩（FTA，p<0.001；冠状倾斜，p=0.003）在负荷反应期相关。
从临床相关性的角度来看，内侧胫骨近端的冠状倾斜、下肢对线与 KAM 之间的相关性是帮助更好地理解膝 OA 病因的关键因素之一。
III 级。
