Center for Orthopaedic Biomechanics, Dept. of Mechanical and Materials Engineering, The University of Denver, CO, USA.
Stryker Corporation, Mahwah, NJ, USA.
Hum Mov Sci. 2021 Feb;75:102746. doi: 10.1016/j.humov.2020.102746. Epub 2020 Dec 27.
The patellofemoral (PF) joint is susceptible to many pathologies resulting from acute injury, chronic disease and complications following surgical treatment of the knee. The objectives of this study were to describe case series measurements of patellar motion in healthy older adults as they performed three gait activities, determine patellar tendon angle and moment arm, and show if these quantities were activity dependent. A stereo radiography system was utilized to obtain the 3D PF kinematics of seventeen healthy people over 55 years of age (8F/9M, 66 ± 7.9 years old, 75.7 ± 20.5 kg) as they performed level walking, a step down, and a pivot turn. For a similar portion of the gait cycle, patellar flexion (6.2° ± 5.8) and average range of motion (ROM) (11.0° ± 5.9°) for walking with a step down was greater compared to the other gait activities (gait ROM 6.9° ± 4.3°, pivot ROM 5.7° ± 3.3°), while the average range of motion for patella tilt was greater during walking with a pivot turn (8.6° ± 3.9°). However, each subject displayed distinct PF kinematic trends during all activities with a few notable exceptions. Importantly, the knee extensor mechanism characteristics of patellar tendon angle and moment arm showed considerable variation across subjects but were largely unaltered by changing activities. The variation between subjects and the different behavior of the patella during the step down and pivot emphasized the need for analysis of a range of activities to reveal individual response to pathology and treatment in patellar maltracking and osteoarthritis.
髌股(PF)关节容易受到多种疾病的影响,这些疾病可由急性损伤、慢性疾病以及膝关节手术后的并发症引起。本研究的目的是描述在健康老年人进行三种步态活动时髌股运动的病例系列测量结果,确定髌腱角度和力臂,并展示这些量是否与活动有关。利用立体射线照相系统获得了 17 名 55 岁以上健康人的 3D PF 运动学数据(8 名女性/9 名男性,66±7.9 岁,75.7±20.5kg),他们进行了平地行走、下台阶和旋转转弯。在相似的步态周期部分,与其他步态活动相比,下台阶行走时的髌股屈曲(6.2°±5.8)和平均活动范围(ROM)(11.0°±5.9°)更大,而在旋转转弯行走时,髌股倾斜的平均活动范围更大(8.6°±3.9°)。然而,每个受试者在所有活动中都表现出明显的 PF 运动学趋势,只有少数例外。重要的是,髌腱角度和力臂的膝伸肌机制特征在受试者之间存在很大差异,但活动变化对其影响不大。受试者之间的差异以及在下台阶和旋转过程中髌股的不同行为强调了需要分析一系列活动,以揭示髌股轨迹不良和骨关节炎中个体对病理和治疗的反应。