Institute of Science, Technology and Humanities, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
J Orthop Surg Res. 2024 Aug 27;19(1):509. doi: 10.1186/s13018-024-05001-6.
This study aims to quantitatively assess the relationship between the patella alignment and morphology and knee osteoarthritis (KOA), as well as the kinematics and kinetics of the knee, using gait analysis.
Eighty age-matched patients with KOA and control subjects were evaluated. Incident radiographic osteoarthritis (iROA) was identified using a Kellgren-Lawrence (KL) grade of ≥ 2. The modified Insall-Salvati ratio (Mod-ISR), patellar tilt angle (PTA), and patella index (PI) were utilized to evaluate the sagittal and transverse alignment of the patella and its morphology, respectively. Regression analyses were conducted to explore associations between patellar measurements and KOA, iROA, kinematics, and kinetics.
Significant differences were observed between the control and KOA groups in terms of KL grade, patella alta, abduction angle, and reaction force to the ground (P < 0.05, respectively). Following adjustment for covariates, a significant positive association was found between patella alta and KOA (OR = 0.307, 95%CI: 0.103 to 0.918, P = 0.035). Additionally, a significant negative association was observed between PTA and abduction angle (B = -0.376, 95%CI: -0.751 to -0.002; P = 0.049). The PI exhibited a statistically significant association with log-transformed vertical ground reaction force (B = 0.002, 95%CI: 0.001 to 0.003, P = 0.002). Furthermore, adjustment for covariates did not reveal any significant correlations with other indicators (P > 0.05, respectively).
This study provides further evidence that proper alignment and morphology of the patella might be associated with maintaining normal biomechanical function. In addition, intervention measures targeting relevant patellar parameters, such as Mod-ISR, PTA, and PI, may positively impact KOA treatment outcomes.
本研究旨在通过步态分析定量评估髌股排列和形态与膝骨关节炎（KOA）以及膝关节运动学和动力学之间的关系。
评估了 80 名年龄匹配的 KOA 患者和对照组。使用 Kellgren-Lawrence（KL）分级≥2 确定偶发性放射学骨关节炎（iROA）。使用改良 Insall-Salvati 比（Mod-ISR）、髌股倾斜角（PTA）和髌股指数（PI）分别评估髌股矢状和横向排列及其形态。进行回归分析以探讨髌股测量值与 KOA、iROA、运动学和动力学之间的关联。
在 KL 分级、高位髌骨、外展角和地面反作用力方面，对照组和 KOA 组之间存在显著差异（P<0.05）。在调整协变量后，发现高位髌骨与 KOA 之间存在显著正相关（OR=0.307，95%CI：0.103 至 0.918，P=0.035）。此外，还发现 PTA 与外展角之间存在显著负相关（B=-0.376，95%CI：-0.751 至 -0.002；P=0.049）。PI 与垂直地面反作用力的对数呈显著正相关（B=0.002，95%CI：0.001 至 0.003，P=0.002）。此外，调整协变量后，与其他指标之间未发现任何显著相关性（P>0.05）。
本研究进一步证明了髌股的适当排列和形态可能与维持正常生物力学功能有关。此外，针对 Mod-ISR、PTA 和 PI 等相关髌股参数的干预措施可能对 KOA 的治疗结果产生积极影响。
