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非创伤性和创伤性膝骨关节炎疾病进展的步态风险因素不同。

Gait risk factors for disease progression differ between non-traumatic and post-traumatic knee osteoarthritis.

机构信息

Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-MacKay Rehabilitation Centre, PERFORM Centre, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.

Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Canada.

出版信息

Osteoarthritis Cartilage. 2021 Nov;29(11):1487-1497. doi: 10.1016/j.joca.2021.07.014. Epub 2021 Aug 1.

Abstract

OBJECTIVE

To examine if relationships between knee osteoarthritis (OA) progression with knee moments and muscle activation during gait vary between patients with non-traumatic and post-traumatic knee OA.

DESIGN

This longitudinal study included participants with non-traumatic (n = 17) and post-traumatic (n = 18) knee OA; the latter group had a previous anterior cruciate ligament rupture. Motion capture cameras, force plates, and surface electromyography measured knee moments and lower extremity muscle activation during gait. Cartilage volume change were determined over 2 years using magnetic resonance imaging in four regions: medial and lateral plateau and condyle. Linear regression analysis examined relationships between cartilage change with gait metrics (moments, muscle activation), group, and their interaction.

RESULTS

Measures from knee adduction and rotation moments were related to lateral condyle cartilage loss in both groups, and knee adduction moment to lateral plateau cartilage loss in the non-traumatic group only [β = -1.336, 95% confidence intervals (CI) = -2.653 to -0.019]. Generally, lower levels of stance phase muscle activation were related to greater cartilage loss. The relationship between cartilage loss in some regions with muscle activation characteristics varied between non-traumatic and post-traumatic groups including for: lateral hamstring (lateral condyle β = 0.128, 95%CI = 0.003 to 0.253; medial plateau β = 0.199, 95%CI = 0.059 to 0.339), rectus femoris (medial condyle β = -0.267, 95%CI = -0.460 to -0.073), and medial hamstrings (medial plateau; β = -0.146, 95%CI = -0.244 to -0.048).

CONCLUSION

Findings indicate that gait risk factors for OA progression may vary between patients with non-traumatic and post-traumatic knee OA. These OA subtypes should be considered in studies that investigate gait metrics as risk factors for OA progression.

摘要

目的

研究膝关节骨关节炎(OA)进展与步态时膝关节力矩和肌肉激活之间的关系是否因非创伤性和创伤后膝关节 OA 患者而有所不同。

设计

本纵向研究纳入了 17 名非创伤性和 18 名创伤后(均有前交叉韧带断裂史)膝关节 OA 患者;使用运动捕捉摄像机、测力板和表面肌电图在步态时测量膝关节力矩和下肢肌肉激活情况。在 2 年内使用磁共振成像在四个区域(内侧和外侧平台和髁)测量软骨体积变化。线性回归分析检查了软骨变化与步态测量值(力矩、肌肉激活)、组和它们之间的相互关系。

结果

在两组中,膝关节内收和旋转力矩的测量值与外侧髁软骨丢失有关,而非创伤性组中膝关节内收力矩与外侧平台软骨丢失有关[β=-1.336,95%置信区间(CI)=-2.653 至-0.019]。一般来说,站立相肌肉激活水平较低与更大的软骨丢失有关。一些区域的软骨丢失与肌肉激活特征之间的关系在非创伤性和创伤后组之间有所不同,包括:外侧腘绳肌(外侧髁β=0.128,95%CI=0.003 至 0.253;内侧平台β=0.199,95%CI=0.059 至 0.339)、股直肌(内侧髁β=-0.267,95%CI=-0.460 至-0.073)和内侧腘绳肌(内侧平台;β=-0.146,95%CI=-0.244 至-0.048)。

结论

研究结果表明,非创伤性和创伤后膝关节 OA 患者的 OA 进展的步态危险因素可能不同。在研究步态指标作为 OA 进展危险因素的研究中,应考虑这些 OA 亚型。

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