Suppr超能文献

全髋关节置换术后髋骨关节炎患者的膝关节负荷分布

Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement.

作者信息

van Drongelen Stefan, Wesseling Mariska, Holder Jana, Meurer Andrea, Stief Felix

机构信息

Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopaedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany.

Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.

出版信息

Front Bioeng Biotechnol. 2020 Sep 21;8:578030. doi: 10.3389/fbioe.2020.578030. eCollection 2020.

Abstract

Reduced external knee adduction moments in the second half of stance after total hip replacement have been reported in hip osteoarthritis patients. This reduction is thought to shift the load from the medial to the lateral knee compartment and as such increase the risk for knee osteoarthritis. The knee adduction moment is a surrogate for the load distribution between the medial and lateral compartments of the knee and not a valid measure for the tibiofemoral contact forces which are the result of externally applied forces and muscle forces. The purpose of this study was to investigate whether the distribution of the tibiofemoral contact forces over the knee compartments in unilateral hip osteoarthritis patients 1 year after receiving a primary total hip replacement differs from healthy controls. Musculoskeletal modeling on gait was performed in OpenSim using the detailed knee model of Lerner et al. (2015) for 19 patients as well as for 15 healthy controls of similar age. Knee adduction moments were calculated by the inverse dynamics analysis, medial and lateral tibiofemoral contact forces with the joint reaction force analysis. Moments and contact forces of patients and controls were compared using Statistical Parametric Mapping two-sample -tests. Knee adduction moments and medial tibiofemoral contact forces of both the ipsi- and contralateral leg were not significantly different compared to healthy controls. The contralateral leg showed 14% higher medial tibiofemoral contact forces compared to the ipsilateral (operated) leg during the second half of stance. During the first half of stance, the lateral tibiofemoral contact force of the contralateral leg was 39% lower and the ratio 32% lower compared to healthy controls. In contrast, during the second half of stance the forces were significantly higher (39 and 26%, respectively) compared to healthy controls. The higher ratio indicates a changed distribution whereas the increased lateral tibiofemoral contact forces indicate a higher lateral knee joint loading in the contralateral leg in OA patients after total hip replacement (THR). Musculoskeletal modeling using a detailed knee model can be useful to detect differences in the load distribution between the medial and lateral knee compartment which cannot be verified with the knee adduction moment.

摘要

据报道,髋关节骨关节炎患者全髋关节置换术后站立后半程的膝关节内收力矩降低。这种降低被认为会将负荷从膝关节内侧转移到外侧,从而增加患膝关节骨关节炎的风险。膝关节内收力矩是膝关节内侧和外侧间负荷分布的一个替代指标,而不是胫股接触力的有效测量指标,胫股接触力是外部施加力和肌肉力的结果。本研究的目的是调查单侧髋关节骨关节炎患者在接受初次全髋关节置换术后1年,其膝关节各腔室间胫股接触力的分布与健康对照组是否不同。在OpenSim中使用Lerner等人(2015年)的详细膝关节模型对19名患者以及15名年龄相仿的健康对照者进行步态的肌肉骨骼建模。通过逆动力学分析计算膝关节内收力矩,通过关节反力分析计算胫股内侧和外侧接触力。使用统计参数映射双样本检验比较患者和对照组的力矩和接触力。与健康对照组相比,同侧和对侧腿的膝关节内收力矩和胫股内侧接触力均无显著差异。在站立后半程,对侧腿的胫股内侧接触力比同侧(手术)腿高14%。在站立前半程,对侧腿的胫股外侧接触力比健康对照组低39%,力比低32%。相比之下,在站立后半程,与健康对照组相比,这些力显著更高(分别为39%和26%)。更高的力比表明分布发生了变化,而增加的胫股外侧接触力表明全髋关节置换(THR)术后骨关节炎患者对侧腿的膝关节外侧负荷更高。使用详细膝关节模型进行肌肉骨骼建模有助于检测膝关节内侧和外侧腔室间负荷分布的差异,而这是膝关节内收力矩无法验证的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e375/7534409/da8f8715be68/fbioe-08-578030-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验