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不对称髋关节旋转角度对膝骨关节炎患者步态生物力学的影响。

Impacts of asymmetric hip rotation angle on gait biomechanics in patients with knee osteoarthritis.

作者信息

Yoon Ji-Yeon, Moon Sang Won

机构信息

Department of Physical Therapy, Inje University Haeundae Paik Hospital, Busan, Korea.

Department of Orthopedic Surgery, Inje University Haeundae-Paik Hospital, 875 Haeun-Daero, Haeundae-Gu, Busan, 48108, Korea.

出版信息

Knee Surg Relat Res. 2024 Jul 14;36(1):23. doi: 10.1186/s43019-024-00226-5.

Abstract

BACKGROUND

Knee Osteoarthritis (OA) is a highly prevalent age-related disease. The altered kinematic pattern of the knee joint as well as the adjacent joints affects to progression of knee OA. However, there is a lack of research on how asymmetry of the hip rotation angle affects the gait pattern in knee OA patients.

RESEARCH QUESTION

What are the impacts of asymmetric hip rotation range on gait biomechanical characteristics and do the gait patterns differ between patients with knee OA and healthy elderly people?

METHODS

Twenty-nine female patients with knee OA and 15 healthy female elders as control group were enrolled in this study. The spatiotemporal parameters, kinematic and kinetic data during walking were measured using a three-dimensional motion capture system. The differences between knee OA and control group were analyzed using an independent t-test.

RESULTS

The knee OA group exhibited a significant reduction in hip internal rotation range and internal/external rotation ratio on more affected side (p < 0.05). Significant differences were found in spatiotemporal parameters except to the step width. Significant reductions were also found in kinematic parameters (pelvic lateral tilt range, sagittal angle ranges in hip, knee and ankle, knee adduction mean angle). There were also significant differences in vertical ground reaction force and knee adduction moment (p < 0.05).

CONCLUSIONS

Knee OA patients have asymmetric hip rotation ranges. Especially limited hip internal rotation could lead to the reduction of pelvic lateral tilt, which may cause greater knee joint loading. Therefore, it is necessary to pay attention to recovery of hip rotation after knee surgery.

摘要

背景

膝关节骨关节炎(OA)是一种高度流行的与年龄相关的疾病。膝关节以及相邻关节的运动模式改变会影响膝关节OA的进展。然而,关于髋关节旋转角度不对称如何影响膝关节OA患者的步态模式,目前缺乏相关研究。

研究问题

髋关节旋转范围不对称对步态生物力学特征有何影响,膝关节OA患者与健康老年人的步态模式是否存在差异?

方法

本研究纳入了29名膝关节OA女性患者和15名健康女性老年人作为对照组。使用三维运动捕捉系统测量行走过程中的时空参数、运动学和动力学数据。采用独立样本t检验分析膝关节OA组与对照组之间的差异。

结果

膝关节OA组患侧髋关节内旋范围和内/外旋比值显著降低(p < 0.05)。除步幅宽度外,时空参数存在显著差异。运动学参数(骨盆侧倾范围、髋、膝和踝关节矢状角范围、膝关节内收平均角度)也显著降低。垂直地面反作用力和膝关节内收力矩也存在显著差异(p < 0.05)。

结论

膝关节OA患者存在髋关节旋转范围不对称。尤其是髋关节内旋受限可能导致骨盆侧倾减少,这可能会导致膝关节承受更大的负荷。因此,膝关节手术后有必要关注髋关节旋转功能的恢复。

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Effects of Knee Osteoarthritis on Hip and Ankle Gait Mechanics.膝骨关节炎对髋和踝关节步态力学的影响。
Adv Orthop. 2019 Mar 24;2019:9757369. doi: 10.1155/2019/9757369. eCollection 2019.

本文引用的文献

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The stabilizing properties of foot yaw in human walking.人类行走中足部偏航的稳定特性。
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