Okita Yuriko, Sadamatsu Toshihiro, Kawahara Toshio, Gamada Kazuyoshi
Department of Rehabilitation, Sadamatsu Hospital, Japan.
Department of Orthopedic Surgery, Sadamatsu Hospital, Japan.
J Phys Ther Sci. 2022 Aug;34(8):561-570. doi: 10.1589/jpts.34.561. Epub 2022 Aug 3.
[Purpose] This study aimed to determine whether the volume and mobility of the infrapatellar fat pad (IPFP) change as a result of manual release or stretching during quasi-static knee extension in patients with knee osteoarthritis (KOA). [Participants and Methods] Fourteen patients with KOA were allocated to one of two groups: the manual release (R) and stretching (S, control) groups. They all underwent 12 treatment sessions in in a space of four weeks. We created 3D models of the IPFP, tibia, patella, and patellar tendon using sagittal MRI scans with the knee at 30° or 0°. We compared the differences in (1) the distance of anterior movement of the anterior surface of the IPFP (IPFP movement) and (2) the volume of the IPFP, between the R and S groups, using the 3D models. [Results] Neither group showed any anterior movement of the IPFP during quasi-static knee extension at pre-intervention; however, both groups showed significant anterior movement of the IPFP at post-intervention. IPFP movement decreased in the S group, meanwhile it increased in the R group at post-intervention. [Conclusion] Anterior movement of the IPFP was more increased by manual release than by stretching since the latter may have shortened the distance between the patella and tibial tuberosity at 0° and 30° flexion.
[目的] 本研究旨在确定膝关节骨关节炎（KOA）患者在准静态膝关节伸展过程中，手动松解或拉伸是否会导致髌下脂肪垫（IPFP）的体积和活动度发生变化。[参与者与方法] 14例KOA患者被分为两组：手动松解（R）组和拉伸（S，对照组）组。他们均在四周内接受了12次治疗。我们使用膝关节处于30°或0°时的矢状面MRI扫描创建了IPFP、胫骨、髌骨和髌腱的3D模型。我们使用3D模型比较了R组和S组之间（1）IPFP前表面向前移动的距离（IPFP移动）和（2）IPFP的体积的差异。[结果] 干预前，两组在准静态膝关节伸展过程中IPFP均未出现向前移动；然而，两组在干预后IPFP均出现了明显的向前移动。干预后，S组的IPFP移动减少，而R组增加。[结论] 手动松解比拉伸更能增加IPFP的向前移动，因为拉伸可能缩短了膝关节在0°和30°屈曲时髌骨与胫骨结节之间的距离。
