Ulrich Baptiste, Erhart-Hledik Jennifer C, Asay Jessica L, Omoumi Patrick, Andriacchi Thomas P, Jolles Brigitte M, Favre Julien
Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.
Department of Orthopaedic Surgery, Stanford University, Stanford, CA, United States.
Front Bioeng Biotechnol. 2023 Jun 13;11:1176471. doi: 10.3389/fbioe.2023.1176471. eCollection 2023.
To characterize ambulatory knee moments with respect to medial knee osteoarthritis (OA) severity comprehensively and to assess the possibility of developing a severity index combining knee moment parameters. Nine parameters (peak amplitudes) commonly used to quantify three-dimensional knee moments during walking were analyzed for 98 individuals (58.7 ± 9.2 years old, 1.69 ± 0.09 m, 76.9 ± 14.5 kg, 56% female), corresponding to three medial knee osteoarthritis severity groups: non-osteoarthritis ( = 22), mild osteoarthritis ( = 38) and severe osteoarthritis ( = 38). Multinomial logistic regression was used to create a severity index. Comparison and regression analyses were performed with respect to disease severity. Six of the nine moment parameters differed statistically significantly among severity groups ( ≤ 0.039) and five reported statistically significant correlation with disease severity (0.23 ≤ || ≤ 0.59). The proposed severity index was highly reliable (ICC = 0.96) and statistically significantly different between the three groups ( < 0.001) as well as correlated with disease severity ( = 0.70). While medial knee osteoarthritis research has mostly focused on a few knee moment parameters, this study showed that other parameters differ with disease severity. In particular, it shed light on three parameters frequently disregarded in prior works. Another important finding is the possibility of combining the parameters into a severity index, which opens promising perspectives based on a single figure assessing the knee moments in their entirety. Although the proposed index was shown to be reliable and associated with disease severity, further research will be necessary particularly to assess its validity.
为全面描述与膝关节内侧骨关节炎（OA）严重程度相关的动态膝关节力矩，并评估开发一种结合膝关节力矩参数的严重程度指数的可能性。对98名个体（年龄58.7±9.2岁，身高1.69±0.09米，体重76.9±14.5千克，56%为女性）分析了9个常用于量化步行过程中三维膝关节力矩的参数（峰值幅度），这些个体对应三个膝关节内侧骨关节炎严重程度组：非骨关节炎组（n = 22）、轻度骨关节炎组（n = 38）和重度骨关节炎组（n = 38）。采用多项逻辑回归创建严重程度指数。针对疾病严重程度进行了比较和回归分析。九个力矩参数中的六个在严重程度组之间存在统计学显著差异（P≤0.039），五个与疾病严重程度存在统计学显著相关性（0.23≤|r|≤0.59）。所提出的严重程度指数具有高度可靠性（组内相关系数ICC = 0.96），三组之间存在统计学显著差异（P<0.001），并且与疾病严重程度相关（r = 0.70）。虽然膝关节内侧骨关节炎的研究大多集中在少数几个膝关节力矩参数上，但本研究表明其他参数也随疾病严重程度而不同。特别是，它揭示了先前研究中经常被忽视的三个参数。另一个重要发现是将这些参数组合成一个严重程度指数的可能性，这基于一个整体评估膝关节力矩的单一数值开辟了有前景的前景。尽管所提出的指数被证明是可靠的且与疾病严重程度相关，但仍需要进一步研究，特别是评估其有效性。
