Department of Orthopedics and Traumatology, Achilopouleio General Hospital of Volos, Volos, Greece.
Department of Orthopedics and Traumatology, Tzaneio General Hospital of Piraeus, Piraeus, Greece.
Clin Orthop Surg. 2021 Jun;13(2):185-195. doi: 10.4055/cios20123. Epub 2021 Mar 16.
Osteoarthritis (OA) of the hip and knee is a degenerative disease with complications, including reduced range of motion and pain. Although OA of the hip and knee is common, there are few studies that investigated if patients with this condition had affected morphological truncal parameters. The objectives of this study were to compare the morphology of the spine and the pelvis of patients with hip or knee OA to that of a control group (CG) and to comment on the proposed mechanisms of these changes and the clinical effects on patients.
This study included three groups of individuals. The first group consisted of 34 patients (15 men and 19 women with a mean age of 67.62 ± 8.28 years) suffering from hip OA. The second group consisted of 45 patients (11 men and 34 women with a mean age of 72.47 ± 7.0 years) suffering from knee OA. These patients were compared with a CG, which consisted of 25 individuals (13 men and 12 women with a mean age of 69.28 ± 10.11 years). The DIERS formetric 4D analysis system was used to calculate several truncal parameters in all planes. All analyses were accomplished using the SPSS ver. 17.0, and < 0.05 was used to determine statistical significance.
Patients with hip OA presented with significantly increased values than those in the CG for sagittal imbalance, scoliosis angle, vertebral rotation, trunk torsion, and pelvic obliquity, and decreased values than those in the CG for fleche lombaire. Patients with knee OA presented with significantly increased values than those in the CG for sagittal imbalance, apical deviation, scoliosis angle, vertebral rotation, trunk torsion, and pelvic obliquity. Patients with hip or knee OA, compared to the CG, had greater forward inclination of the spine, greater scoliosis, greater vertebral rotation and trunk torsion, and greater obliquity of the pelvis at the frontal plane.
Patients with severe hip or knee OA could have truncal morphology alterations, in addition to reduced hip or knee range of motion and pain. These alterations could cause significant negative effects, which may then seriously affect the patients' quality of life.
髋膝关节骨关节炎(OA)是一种退行性疾病,伴有运动范围减小和疼痛等并发症。尽管髋膝关节 OA 较为常见,但针对此类患者是否存在胸廓形态参数改变的研究较少。本研究旨在比较髋膝关节 OA 患者与对照组(CG)的脊柱和骨盆形态,并对这些改变的潜在机制及对患者的临床影响进行探讨。
本研究纳入三组人群。第一组为 34 例髋 OA 患者(15 例男性,19 例女性,平均年龄 67.62±8.28 岁);第二组为 45 例膝 OA 患者(11 例男性,34 例女性,平均年龄 72.47±7.0 岁);第三组为 CG,包含 25 例个体(13 例男性,12 例女性,平均年龄 69.28±10.11 岁)。使用 DIERS 形态 4D 分析系统在所有平面计算多项胸廓参数。所有分析均使用 SPSS 17.0 版完成,P<0.05 表示具有统计学意义。
与 CG 相比,髋 OA 患者矢状面失衡、脊柱侧凸角、椎体旋转、躯干扭转和骨盆倾斜显著增加,腰骶角显著减小;膝 OA 患者矢状面失衡、顶椎偏移、脊柱侧凸角、椎体旋转、躯干扭转和骨盆倾斜显著增加。与 CG 相比,髋或膝 OA 患者脊柱前凸增加,脊柱侧凸、椎体旋转和躯干扭转加重,骨盆在额状面倾斜度增加。
严重髋或膝 OA 患者除髋或膝关节活动范围减小和疼痛外,还可能存在胸廓形态改变。这些改变可能会产生严重的负面影响,进而严重影响患者的生活质量。