Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan; Department of Rehabilitation, Japanese Red Cross Nagahama Hospital, 14-7 Miyamae-cho, Nagahama, Shiga 526-8585, Japan.
Clin Biomech (Bristol). 2024 Mar;113:106212. doi: 10.1016/j.clinbiomech.2024.106212. Epub 2024 Feb 20.
Joint moment arm is a major element that determines joint torque. This study aimed to investigate factors associated with knee extensor and valgus moment arms of the patellar tendon in older individuals with and without knee osteoarthritis.
Thirty-six participants with knee osteoarthritis (mean age, 78.1 ± 6.0 years) and 43 healthy controls (mean age, 73.0 ± 6.3 years) were analyzed. Magnetic resonance images (MRI) from the knee joint and thigh were acquired using a 3.0 T MRI scanner. The three-dimensional moment arm was defined as the distance between the contact point of the tibiofemoral joint and the patellar tendon line. The three-dimensional moment arm was decomposed into sagittal and coronal components, which were calculated as knee extensor and valgus moment arms, respectively. Quadriceps muscle volume, epicondylar width, bisect offset, Insall-Salvati ratio, and Kellgren-Lawrence grade were assessed. Multiple regression analyses were performed in the healthy control and knee osteoarthritis groups, with knee extensor and valgus moment arms as dependent variables.
Knee extensor moment arm was significantly associated with epicondylar width and the Insall-Salvati ratio in the healthy control group and with Kellgren-Lawrence grade, epicondylar width, and quadriceps muscle volume in the knee osteoarthritis group. Valgus knee moment arm was significantly associated with bisect offset in both the groups.
Knee size, osteoarthritis severity, and quadriceps muscle volume affect the knee extensor moment arm in knee osteoarthritis, whereas lateral patellar displacement affects the valgus knee moment arms in older individuals with and without knee osteoarthritis.
关节力矩臂是决定关节力矩的主要因素。本研究旨在探讨膝骨关节炎（OA）患者和非 OA 患者的髌腱伸膝和外翻力矩臂的相关因素。
分析了 36 例膝骨关节炎（OA）患者（平均年龄 78.1±6.0 岁）和 43 例健康对照者（平均年龄 73.0±6.3 岁）。使用 3.0T MRI 扫描仪采集膝关节和大腿的磁共振图像（MRI）。三维力矩臂定义为胫股关节接触点与髌腱线之间的距离。三维力矩臂分解为矢状面和冠状面成分，分别计算为伸膝和外翻力矩臂。评估股四头肌体积、髁间宽度、二分偏移量、Insall-Salvati 比和 Kellgren-Lawrence 分级。在健康对照组和膝骨关节炎组中，以伸膝和外翻力矩臂为因变量进行多元回归分析。
健康对照组中，伸膝力矩臂与髁间宽度和 Insall-Salvati 比显著相关，膝骨关节炎组中与 Kellgren-Lawrence 分级、髁间宽度和股四头肌体积显著相关。外翻膝力矩臂与两组的二分偏移量显著相关。
膝关节大小、OA 严重程度和股四头肌体积影响膝骨关节炎患者的伸膝力矩臂，而外侧髌股位移影响膝骨关节炎患者和非 OA 患者的外翻膝力矩臂。
