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骨关节炎膝关节与正常膝关节相比,三维步态运动学与关节线倾斜度之间的关联:一项流行病学研究。

Association between three-dimensional gait kinematics and joint-line inclination in osteoarthritic knees compared with normal knees: An epidemiological study.

作者信息

Chi Fangzhou, Mochizuki Tomoharu, Koga Hiroshi, Omori Go, Nishino Katsutoshi, Takagi Shigeru, Koga Yoshio, Kawashima Hiroyuki

机构信息

Division of Orthopedic Surgery, Graduate School of Medical and Dental Sciences Niigata University Niigata Japan.

Department of Orthopedic Surgery, The First Affiliated Hospital Harbin Medical University Harbin China.

出版信息

J Exp Orthop. 2024 Jun 11;11(3):e12040. doi: 10.1002/jeo2.12040. eCollection 2024 Jul.

Abstract

PURPOSE

No report has proven how tibial and femoral joint-line inclinations affect thigh and shank motion, respectively, according to Kellgren-Lawrence grade in motion analysis with a sufficient sample size. Therefore, this study aimed to evaluate the motion of the thigh and shank individually from the ground and the relative motion between bones in a large-sample motion analysis to determine the differences between normal and osteoarthritic knees and examine the effects of tibial and femoral joint-line inclination on motion according to osteoarthritis (OA) grade.

METHODS

Of 459 participants with healthy knees and varus knee OA undergoing three-dimensional gait analysis, 383 (218 females and 165 males) with an average age of 68 ± 13 years were selected. Gait analysis was performed using a motion-capture system. The six degrees of freedom motion parameters of the knee in the Grood and world coordinate systems and the joint-line inclination in the standing radiographs were measured.

RESULTS

Osteoarthritic knees demonstrated a relative motion different from that of normal knees, with responsibility for the thigh in the sagittal and rotational planes and the thigh and shank in the coronal plane. The involvement of joint-line inclination in motion was mainly on the tibial side, and the effect was minimal in normal knees.

CONCLUSIONS

The details of the relative motion of both the thigh and shank can be clarified by analysing individual motions to determine the responsible part. The tibial joint-line affected knee motion: however, the effect was minimal in normal knees. This finding implies that if physical ability can be improved, the negative effects of deformity in osteoarthritic knees may be compensated for.

LEVEL OF EVIDENCE

Level Ⅱ.

摘要

目的

在有足够样本量的运动分析中,尚无报告证明根据凯尔格伦-劳伦斯分级,胫股关节线倾斜度分别如何影响大腿和小腿的运动。因此,本研究旨在通过大样本运动分析,分别评估大腿和小腿相对于地面的运动以及骨骼之间的相对运动,以确定正常膝关节和骨关节炎膝关节之间的差异,并根据骨关节炎(OA)分级检查胫股关节线倾斜度对运动的影响。

方法

在459名接受三维步态分析的健康膝关节和膝内翻OA患者中,选取了383名(218名女性和165名男性),平均年龄为68±13岁。使用运动捕捉系统进行步态分析。测量了膝关节在Grood坐标系和世界坐标系中的六个自由度运动参数以及站立位X线片上的关节线倾斜度。

结果

骨关节炎膝关节表现出与正常膝关节不同的相对运动,在矢状面和旋转平面上影响大腿,在冠状面上影响大腿和小腿。关节线倾斜度对运动的影响主要在胫骨侧,在正常膝关节中影响最小。

结论

通过分析个体运动以确定责任部位,可以阐明大腿和小腿相对运动的细节。胫骨关节线影响膝关节运动;然而,在正常膝关节中影响最小。这一发现意味着,如果身体能力能够得到改善,骨关节炎膝关节畸形的负面影响可能会得到补偿。

证据水平

Ⅱ级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2657/11165678/df032cf16206/JEO2-11-e12040-g005.jpg

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