Department of Physical Therapy, College of Health Sciences, Sun Moon University, Asan-si, Korea.
Department of Orthopedic Surgery, CM General Hospital, Seoul, Korea.
J Back Musculoskelet Rehabil. 2022;35(6):1211-1218. doi: 10.3233/BMR-210086.
Tibial rotation accompanying sagittal movement contains the phenomenon of screw-home movement (SHM) of the knee, which plays an important role in knee stability during extension.
This study aimed to investigate the change of SHM in patients with knee osteoarthritis (OA).
Thirty-one sex-matched patients with knee OA and 31 normal subjects were recruited. The total tibial rotation was obtained during knee sagittal movement (extension and flexion) using an inertial measurement unit. The acquired angle of tibial rotation was divided into eight periods. The total tibial rotation and the variation of each period were compared between the OA and control groups. The difference in tibial rotation according to Kellgren-Lawrence (KL) grade was compared.
The total tibial rotation of the OA group decreased compared with the control group during knee extension and flexion (P< 0.001). Variations of tibial rotation were significantly different between groups in all periods (P< 0.001) except for knee extension at 70∘ to 45∘ (P= 0.081). There was no significant difference in tibial rotations among the KA grades of OA patients.
We found a reduction in the total tibial rotation and loss of the SHM in the unloaded OA knee. It could be predicted that reduced SHM appeared early in knee OA.
胫骨旋转伴随矢状面运动包含膝关节的内旋运动（SHM）现象，它在膝关节伸展时对稳定性起着重要作用。
本研究旨在探讨膝骨关节炎（OA）患者 SHM 的变化。
招募了 31 名性别匹配的膝 OA 患者和 31 名正常受试者。使用惯性测量单元获得膝关节矢状面运动（伸展和弯曲）期间的总胫骨旋转角度。将获得的胫骨旋转角度分为 8 个时期。比较 OA 组和对照组之间的总胫骨旋转和每个时期的变化。比较根据 Kellgren-Lawrence（KL）分级的胫骨旋转差异。
与对照组相比，OA 组在膝关节伸展和弯曲时的总胫骨旋转减小（P<0.001）。在所有时期，组间胫骨旋转的变化均有显著差异（P<0.001），除了膝关节伸展 70∘ 到 45∘（P=0.081）。OA 患者的 KA 分级之间的胫骨旋转无显著差异。
我们发现未负重 OA 膝关节的总胫骨旋转减少和 SHM 丧失。可以预测，在膝骨关节炎中，减少的 SHM 出现较早。
