Department of Bioengineering, Imperial College London, Sir Michael Uren Hub, Imperial College London White City Campus, 86 Wood Ln, London, W12 0BZ, UK.
Department of Surgery and Cancer, Imperial College London, Sir Michael Uren Hub, Imperial College London White City Campus, 86 Wood Ln, London, W12 0BZ, UK.
Ann Biomed Eng. 2023 Nov;51(11):2490-2503. doi: 10.1007/s10439-023-03289-9. Epub 2023 Jul 23.
Most cases of unilateral knee osteoarthritis (OA) progress to bilateral OA within 10 years. Biomechanical asymmetries have been implicated in contralateral OA development; however, gait analysis alone does not consistently detect asymmetries in OA patient gait. Stair ambulation is a more demanding activity that may be more suited to reveal between-leg asymmetries in OA patients. The objective of this study was to investigate the between-leg biomechanical differences in patients with unilateral mild-to-moderate knee OA. Sixteen unilateral mild-to-moderate medial knee OA patients and 16 healthy individuals underwent kinematic and kinetic analysis of stair ascent and descent. Stair ascent produced higher loading and muscle forces in the unaffected limb compared to the OA limb, and stair descent produced lower loading on the OA limb compared to healthy subjects. These biomechanical differences were apparent in the ankle, knee, and hip joints. The implications of these findings are that OA patients rely more heavily on their unaffected sides than the affected side in stair ascent, a strategy that may be detrimental to the unaffected joint health. The reduction in affected limb loading in stair descent is thought to be related to minimizing pain.
大多数单侧膝关节骨关节炎（OA）病例在 10 年内会进展为双侧 OA。生物力学不对称性与对侧 OA 的发展有关；然而，仅步态分析并不总能检测到 OA 患者步态的不对称性。爬楼梯是一项更具挑战性的活动，可能更适合揭示 OA 患者双腿之间的不对称性。本研究的目的是研究单侧轻中度膝关节 OA 患者的双腿之间的生物力学差异。16 名单侧轻中度内侧膝关节 OA 患者和 16 名健康个体接受了上楼梯和下楼梯的运动学和动力学分析。上楼梯时，非患病侧的下肢比患病侧承受更高的负荷和肌肉力量，而下楼梯时，患病侧的下肢比健康受试者承受的负荷更小。这些生物力学差异在踝关节、膝关节和髋关节都很明显。这些发现的意义在于，OA 患者在上楼梯时比在患病侧更依赖未患病侧，这种策略可能对未患病关节的健康有害。下楼梯时患病侧下肢负荷的减轻被认为与减轻疼痛有关。
