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无症状老年人膝关节旋转中心位置。

Knee pivot location in asymptomatic older adults.

机构信息

University of Denver, Denver, CO, USA.

University of Denver, Denver, CO, USA.

出版信息

J Biomech. 2023 Mar;149:111487. doi: 10.1016/j.jbiomech.2023.111487. Epub 2023 Feb 9.

Abstract

Representative data of asymptomatic, native-knee kinematics is important when studying changes in knee function across the lifespan. High-speed stereo radiography (HSSR) provides a reliable measure of knee kinematics to <1 mm of translation and 1° of rotation, but studies often have limited statistical power to make comparisons between groups or measure the contribution of individual variability. The purpose of this study is to examine in vivo condylar kinematics to quantify the transverse center-of-rotation, or pivot, location across the flexion range and challenge the medial-pivot paradigm in asymptomatic knee kinematics. We quantified the pivot location during supine leg press, knee extension, standing lunge, and gait for 53 middle-aged and older adults (27 men; 26 women: 50.8 ± 7.0 yrs, 1.75 ± 0.1 m, 79.1 ± 15.4 kg). A central- to medial-pivot location was identified for all activities with increased knee flexion associated with posterior translation of the center-of-rotation. The association between knee angle and anterior-posterior center-of-rotation location was not as strong as the relation between medial-lateral and anterior-posterior location, excluding gait. The Pearson's correlation for gait was stronger between knee angle and anterior-posterior center-of-rotation location (P < 0.001) than medial-lateral and anterior-posterior location (P = 0.0122). Individual variability accounted for a measurable proportion in variance explained of center-of-rotation location. Unique to gait, the lateral translation of center-of-rotation location resulted in the anterior translation of center-of-rotation at <10° knee flexion. Furthermore, no association between vertical ground-reaction force and center-of-rotation was identified.

摘要

当研究一生中膝关节功能的变化时,具有代表性的无症状、自然膝关节运动学数据是很重要的。高速立体射线照相术(HSSR)提供了一种可靠的膝关节运动学测量方法,可测量到<1mm 的平移和 1°的旋转,但研究通常在组间比较或测量个体变异性的贡献方面统计能力有限。本研究的目的是检查体内髁间运动学,以量化整个屈曲范围内的横向旋转中心或枢轴位置,并对无症状膝关节运动学中的内侧枢轴范式提出挑战。我们在仰卧腿压机、膝关节伸展、站立弓步和步态中定量测量了 53 名中老年人(27 名男性;26 名女性:50.8±7.0 岁,1.75±0.1 米,79.1±15.4 公斤)的枢轴位置。所有活动都确定了从中枢到内侧的枢轴位置,随着膝关节的进一步弯曲,旋转中心向后平移。膝关节角度与前后旋转中心位置之间的相关性不如内外侧和前后位置之间的关系强,除了步态。步态的 Pearson 相关系数在膝关节角度与前后旋转中心位置之间更强(P<0.001),而不是内外侧和前后位置之间(P=0.0122)。旋转中心位置的个体变异性在可解释的旋转中心位置方差中占了一定比例。独特的是步态,旋转中心的横向平移导致<10°膝关节弯曲时旋转中心的前向平移。此外,未发现垂直地面反作用力与旋转中心之间存在关联。

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