Ishii Yosuke, Ishikawa Masakazu, Nakashima Yuko, Takahashi Makoto, Iwamoto Yoshitaka, Hashizume Takato, Okamoto Saeko, Sunagawa Toru, Okada Kaoru, Takagi Kazuya, Adachi Nobuo
Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Knee. 2022 Oct;38:82-90. doi: 10.1016/j.knee.2022.07.011. Epub 2022 Aug 2.
An increase in medial meniscus extrusion (MME) due to abnormal biomechanical stress leads to knee osteoarthritis (OA) progression. MME evaluation during walking is a key method of detecting dynamic changes in the meniscus, and in combination with motion analysis, can provide a deeper understanding of the mechanisms involved in the increase of MME.
To validate the feasibility of MME dynamic evaluation in combination with a motion analysis system based on the correlation between the increase in MME and biomechanical factors.
Twenty-three knees from 23 patients with mild to moderate knee OA were analysed in this study. The medial meniscus during walking was evaluated by ultrasound. The increase in MME was calculated as the difference between the minimum and maximum MME during walking. A three-dimensional motion analysis system was synchronised with the ultrasound and then, biomechanical factors such as knee moment and ground reaction force were evaluated.
The wave patterns of the mediolateral and vertical components of ground reaction forces and knee adduction moment were similar to those in the MME based on a high cross-correlation coefficient (>0.8). The increase in MME was significantly correlated with the peak value of the knee adduction moment (r = 0.54, P = 0.0073) but not with the mediolateral and vertical components of the ground reaction force.
The findings show that knee adduction moment is correlated with an increase in MME during walking and indicates the validity and feasibility of the dynamic evaluation of MME in combination with a motion analysis system.
由于异常生物力学应力导致的内侧半月板挤压（MME）增加会导致膝关节骨关节炎（OA）进展。步行过程中的MME评估是检测半月板动态变化的关键方法，并且与运动分析相结合，可以更深入地了解MME增加所涉及的机制。
基于MME增加与生物力学因素之间的相关性，验证MME动态评估与运动分析系统相结合的可行性。
本研究分析了23例轻至中度膝关节OA患者的23个膝关节。通过超声评估步行过程中的内侧半月板。MME增加量计算为步行过程中MME最小值与最大值之间的差值。将三维运动分析系统与超声同步，然后评估膝关节力矩和地面反作用力等生物力学因素。
基于高交叉相关系数（>0.8），地面反作用力的内外侧和垂直分量以及膝关节内收力矩的波形与MME中的波形相似。MME增加量与膝关节内收力矩峰值显著相关（r = 0.54，P = 0.0073），但与地面反作用力的内外侧和垂直分量无关。
研究结果表明，膝关节内收力矩与步行过程中MME的增加相关，并表明MME动态评估与运动分析系统相结合的有效性和可行性。
